Allergic Purpura

General

Clinical Manifestations	Allergic purpura (AP), a form of vasculitis (inflammation of the blood vessels), is a disease characterized by inflammation of the small arterial vessels (capillaries) in the skin, kidneys, and intestinal tract. Symptoms include: A purple spotted skin rash Abdominal pain Gastrointestinal upsets Joint inflammation, swelling and pain Although the exact cause of the disease is unknown, it often develops following a recent viral or bacterial infection of the respiratory tract and is an abnormal reaction of the immune system to the infection. AP may occur suddenly, or it may develop slowly over a period of weeks. The characteristic rash is always present in the disease. The rash begins as areas of redness and as small hives, which may develop anywhere on the body, but especially on the legs and buttocks, and may itch. The rash is caused by inflamed capillaries rupturing, allowing small amounts of blood to accumulate in the surrounding tissues. Through time the rash changes color from red to a bruised, purple color. Each rash spot will last about five days, and the rash can reoccur several times. The skin rash is the most obvious symptom of AP but is not the most serious, for the joints, gastrointestinal tract, and kidneys may also be affected.
Treatment Principle
Herb Formulas
Points

Tai Yang Zhong Feng

Clinical Manifestations	Aversion to Wind Mild, or severe chills Fever which may be persistent Uneasiness from fever Spontaneous perspiration Headache Nausea Nasal irritation Nasal obstruction Tendency to snore Itchy throat Purpura T: Normal C: Thin and white P: Superficial and slow or Moderate and maybe weak
Treatment Principle	Create sweat to relieve the Exterior and expel Wind Harmonize Ying and Wei to protect digestion and nourish Wei Qi
Herb Formulas	Gui Zhi Tang
Points	Bitong, DU-16, GB-20, KI-7, LI-4, LI-20, LU-7, SJ-5, UB-12, UB-13, Yintang With stiff neck and shoulders: + GB-21 With Dampness: + SP-6, SP-9 With dyspnea, asthma and sputum: Dingchuan, REN-22 With nocturnal emission, excess dreams, Cold lower extremities, dizziness and hair loss: + DU-4, KI-3, UB-23 With continuous perspiration, muscle spasms of the limbs with difficult flexion and extension and difficult urination: + REN-4 With sustained fever of long duration accompanied by severe chills: + DU-14

Qi Stage: Lung Heat

Clinical Manifestations	Purpura High fever No chills Aversion to Heat Cough Asthma Restlessness Thirst Dark yellow urine Dyspnea Chest pain Shortness of breath Thick yellow Phlegm T: Red C: Thick and yellow, maybe dry and sticky P:  Rapid, maybe slippery, maybe forceful
Treatment Principle	Clear Heat in Lungs Strengthen when weak or elderly
Herb Formulas	Huang Lian Jie Du Tang
Points	Dingchuan, DU-13, DU-14, LI-11, LU-5, LU-10, ST-44. UB-13

Qi Stage: Lung And Stomach Heat Injuring Qi And Fluids

Clinical Manifestations	Purpura Lingering fever from a febrile disease Vomiting Irritability Thirst with a desire to drink Parched mouth, lips and throat Choking cough Restlessness Insomnia Nausea Anorexia Profuse perspiration A dry mouth Indigestion Listlessness Chest oppression Ulcerations of the mouth Coarse skin Cough Night sweats Stifling sensation in the chest or epigastrium T: Red C: Little or None P: Rapid and Deficient or Thready and rapid
Treatment Principle	Clear Heat Generate fluids Tonify Qi Harmonize the Stomach
Herb Formulas	Zhu Ye Shi Gao Tang
Points

Wind-Cold-Dampness

Clinical Manifestations	Fever Chills Anhidrosis Pain and stiffness of the head and neck Stuffy nose Blood shot eyes Sores that are red, swollen and painful Generalized body aches and pain Headache Swollen eyes Thirst or no thirst T: Normal C: Thin white P: Floating or Floating and rapid
Treatment Principle	Induce sweat Release the Exterior Dispel Wind-Cold-Damp Alleviate pain Treat skin and External diseases
Herb Formulas	Jing Fang Bai Du San
Points

Wind-Damp-Heat

Clinical Manifestations	Weepy, itchy, red skin lesions Lesions may range over a large portion of the body Thirst Rashes Lesions may be worse in hot weather Severe itching T: Pink C: Yellow or White P: Superficial, forceful and rapid or Soft and rapid
Treatment Principle	Disperse Wind Eliminate Dampness Clear Heat Cool Blood Nourish the Blood Stop itch
Herb Formulas	Xiao Feng San
Points

Damp-Heat Injures The Spleen

Clinical Manifestations	Anorexia Abdominal distention and discomfort Suffocating sensation in the chest Epigastric mass Maybe abdominal pain on palpation Yang jaundice (sclera and skin are bright yellow) Dislike of oily foods Nausea Vomiting Lassitude Scanty, dark urine Maybe thirst or thirst with no desire to drink Diarrhea with foul smell or Constipation Fever Sweet sticky taste or bitter taste in mouth T: Pink C: Thick, yellow and greasy (maybe sticky) P: Soft and rapid
Treatment Principle	Clear Heat Benefit Dampness
Herb Formulas	Xiao Feng San
Points	LI-11, REN-12, SP-9, ST-36, ST-44, UB-20

Spleen Not Governing The Blood

Clinical Manifestations	Sallow or pale complexion Anorexia Four limbs feel tired and heavy Physical and mental exhaustion Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose or unformed stools Shortness of breath Dizziness Palpitations Functional Uterine Bleeding Purpura Epistaxis Hemafecia Hematuria Menorrhagia Metrorrhagia T: Pale and flabby - may have teethmarks C: White P: Thready and weak
Treatment Principle	Benefit Qi Conserve Blood
Herb Formulas	Gui Pi Tang Dang Gui Bu Xue Tang Bao Yuan Tang
Points	SP-1, SP-3, ST-36, UB-20

Liver Qi Stagnation Invades The Spleen

Clinical Manifestations	Purpura Abdominal distention and pain Gas Borborygmus Diarrhea Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Women: Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: White and greasy P: Slippery and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Shao Yao Gan Cao Tang
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

Kidney Yin Deficiency Due To Stomach Fire

Clinical Manifestations	Purpura Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of the low back Spermatorrhea or Premature ejaculation Aching in the bones Aching in the leg and heel Dry mouth Thirst Night sweats Five Sole Heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Urine short and red Heightened libido Toothache Loose teeth Bleeding gums Frontal headache Irritability Fever Thirst with a desire to drink cold beverages Epistaxis Dysphoria Excess hunger Hemoptysis Dry throat Hematemesis Restlessness Warm sensations T: Red and dry C: White or Yellow and dry P: Superficial, full, slippery, deficient and large or Gigantic and rapid or Rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Yu Nu Jian
Points	KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23

Damp-Heat In The Bladder

Clinical Manifestations	Purpura Hypochondriac pain Headache Dizziness Red sore eyes Hearing loss Swelling in the ears Bitter taste in the mouth Irritability Short temper Difficult and painful urination with a heat sensation in the urethra Swollen and itchy genitalia Yellow, foul smelling leukorrhea Short menstrual cycle with reddish-purple blood Ear discharge Yellow urine Chest pain Constipation Turbid urine Dry throat Hematuria Pain in the armpits Sweating in the groin T: Red or Red edges C: Yellow or Yellow and greasy P: Wiry, Excess and rapid
Treatment Principle	Clear and Drain Damp-Heat
Herb Formulas	Xiao Ji Yin Zi
Points

Blood Stagnation

Clinical Manifestations	Purpura Pain that is fixed, stabbing and /or severe Pan is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the Blood Break up Stagnation
Herb Formulas	Xue Fu Zhu Yu Tang Shen Tong Zhu Yu Tang Huo Xue Hua Yu
Points	SP-6, SP-10, ST-36, UB-17, UB-40

Damp-Heat

Clinical Manifestations	Purpura Hypochondriac pain Headache Dizziness Red sore eyes Hearing loss Swelling in the ears Bitter taste in the mouth Irritability Short temper Difficult and painful urination with a heat sensation in the urethra Swollen and itchy genitalia Yellow, foul smelling leukorrhea Short menstrual cycle with reddish-purple blood Ear discharge Yellow urine Chest pain Constipation Turbid urine Dry throat Hematuria Pain in the armpits Sweating in the groin T: Red or Red edges C: Yellow or Yellow and greasy P: Wiry, Excess and rapid
Treatment Principle	Clear and Drain Damp-Heat
Herb Formulas	Long Dan Xie Gan Tang Yin Chen Wu Ling San Xi Jiao Di Huang Tang With bleeding: Si Sheng Wan
Points

Toxic Heat

Clinical Manifestations	High fever Irritability Fidgeting Dry mouth Dry throat Incoherent speech Insomnia Dark urine Deep-rooted boils Maculae Carbuncles Hematemesis Hemoptysis Palpitations Furuncles Tinnitus Purpura Red face Rashes Deep-rooted boils Red eyes Itchy skin Fidgeting Dry lips Delirium Dysentery with fever Jaundice Epistaxis Hematuria Cloudy mind Diarrhea T: Red C: Yellow P: Rapid and forceful
Treatment Principle	Clear Heat Resolve Toxicity
Herb Formulas	Huang Lian Jie Du Tang With Kidney and Liver Yin Deficiency Fire and Blood Deficiency: Dang Gui Liu Huang Tang
Points

Lower Jiao Blood Stagnation With Heat

Clinical Manifestations	Purpura Acute lower abdominal pain Incontinence of urine Night fevers Delirious speech Irritability Restlessness Thirst May be mania (severe) Dysmenorrhea Amenorrhea Hard stool Dark red complexion Headache Vertigo Tinnitus Insomnia Palpitations Constipation Frequent urination Emotional instability Chills in the waist and feet Afternoon fever Tremors Excruciating abdominal pain with cold Black stool May be chills and fever Hemoptysis Hematuria Red eyes Pain and distention of the head Toothache Irregular menstruation Lochioschesis Severe wheezing Distention of the chest T: Red and dry C: Yellow P: Deep and forceful or Choppy
Treatment Principle	Drain Heat Break up Blood Stasis
Herb Formulas	Tao He Cheng Qi Tang
Points