Traditional Chinese Medicine Case Study of Congenital Urticaria

Author: Nan Kaiyang  Editor: Gu Yuxi Translator: Gu Yuxi

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Only provide recent physical conditions; do not include past health history.

Gender: Male Age: 29 Height: 1.80 m Weight: 140 lbs Usual Complexion: Tanned Hair Texture (Coarse or Fine): Coarse Skin Flaking (and where): Scrotum flaked once (not a regular occurrence)

Current Main Health Concern

What is the most important health issue you currently want to resolve? Please explain in detail. Answer: Greasy yellow tongue coating in the morning and evening, and itching around the scrotum and anus.

(I) Cold and Heat Sensation

1.Do you experience aversion to cold, aversion to wind, or aversion to heat?

●Answer: In summer, I don’t like using high-power electric fans.

2.If yes, which specific body part feels cold, averse to wind, or averse to heat?

●Answer: Torso and head (small fan is fine).

(II) Sweating

3.Do you sweat easily? If so, is it excessive or scant?

●Answer: I sweat quite a lot.

4.Where do you mainly sweat?

●Answer: Primarily on the forehead and sides of the head.

(III) Upper Respiratory Tract

5.Do you have dry mouth all day?

●Answer: No.

6.Do you constantly feel like drinking water?

●Answer: No.

7.Do you prefer warm or cold water?

●Answer: I prefer warm water, but I don’t dislike cold water.

8.Do you have bad breath?

●Answer: My tongue coating is yellow, thick, and greasy, but I don’t have bad breath.

9.Do your lips appear purplish or dry and peeling around the edges?

●Answer: No.

(IV) Shoulders and Neck

10.Do you experience stiffness or discomfort in your shoulders and neck?

●Answer: No.

(V) Bowel Movements and Urination

11.Is urination frequent?

●Answer: Normal.

12.Is your urine color white or yellow?

●Answer: Recently yellowish.

13.Do you have a bowel movement every day? If not, how often?

●Answer: Every day.

14.Are bowel movements smooth?

●Answer: Smooth.

15.Is stool hard, soft, or watery?

●Answer: Normal.

(VI) Chest and Abdomen

16.Do you experience chest tightness? Is there pain under the armpits (hypochondria)?

●Answer: No.

17.Do you feel nauseous or want to vomit?

●Answer: No discomfort/pain.

18.Pressing the solar plexus with medium force a few times, do you feel pain?

●Answer:

19.Pressing above, below, left, and right of the navel with medium force a few times, do you feel any pain?

●Answer: I feel a stimulated sensation at the acupoints, but no pain.

(VII) Hands and Feet

20.Are your hands and feet warm or cold to the touch?

●Answer: Warm.

21.Do your limbs feel painful or weak?

●Answer: No.

(VIII) Diet

22.How has your appetite been recently?

●Answer: Not bad.

23.Do you eat eggs, dairy, or fruit daily?

●Answer: I haven’t eaten meat, eggs, or dairy for over half a year; I often eat fruit.

24.Do you prefer warm or cold food?

●Answer: I can accept both, but I prefer warm.

(IX) Sleep

25.Do you fall asleep easily?

●Answer: Easily.

26.Do you wake up easily after falling asleep?

●Answer: Not easily.

27.Do you dream a lot?

●Answer: Yes.

28.Do you need to get up at night to urinate after falling asleep? If so, how many times a night?

●Answer: Very rarely, at most once.

(X) Other

29.Are there any other discomforts in your body? Please explain in detail.

●Answer: Recently, I’ve developed a lot of heat rash on my upper body and head/neck.

30.What medications did you take for this condition previously, and what was their effect?

●Answer: None.

Additional: Do you have a bitter taste or unusual odor in your mouth?

Answer: My tongue coating is yellow, thick, and greasy; otherwise, I haven’t noticed any.

Pattern Differentiation and Prescription / Follow-up

This is a Taiyang Exterior Excess pattern. Since the patient has congenital urticaria, along with red rash and heat rash, the dampness is no longer confined to the exterior. Therefore, Fang Ji Huang Qi Tang will be used to clear both exterior and interior dampness.

Modified Fang Ji Huang Qi Tang:

• Radix Stephaniae Tetrandrae (Fang Ji): 5g
• Radix Astragali (Huang Qi): 15g
• Rhizoma Atractylodis Macrocephalae (Sheng Bai Zhu): 10g
• Rhizoma Alismatis (Ze Xie): 10g
• Radix Glycyrrhizae Preparata (Zhi Gan Cao): 6g
• Fresh Ginger (Sheng Jiang): 3 slices
• Jujube (Hong Zao): 6 pieces (pitted)
• Radix Asari (Xi Xin): 6g
• Rhizoma Coptidis (Huang Lian): 5g

Instructions: 5 doses, three times a day, taken before meals (itching basically subsided after the third dose). No recurrence observed after one year of follow-up.

Disclaimer:​

The experiences and insights shared above represent the author’s personal usage and understanding, and are provided for reference only as part of academic exchange. Please do not blindly replicate or apply them; any consequences arising from such actions are solely your responsibility. As individual constitutions vary, medication should be tailored accordingly. It is advisable to use such treatments under the guidance of a qualified physician. If you have additional experiences to share, comments and submissions are welcome.​
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