The Snakehead Case

Gu Bohua’s Works

Cao ×, male, 21 years old. : September 17, 1984.

Main Complaint: The snakehead furuncle on the right middle finger has been present for half a month, and three local incisions were performed in an external hospital, gentamicin was injected intramuscularly, and the nails were removed. X-rays showed that the inflammation of the soft tissue of the right middle finger spread to the bone. When the sore was explored with medical thread, there was a rough feeling of bone destruction, and thin black pus overflowed from the sore. Western medicine diagnosed it as purulent dactylitis combined with digital osteomyelitis.

Diagnosis and examination: Fingers are swollen and painful, the fur is yellow and greasy, red in texture, and the pulse is stringy and slippery.

Syndrome differentiation: The disease is characterized by excessive fire poisoning, which accumulates for a long time, causing damage to the muscles and bones, and is commonly known as snakehead boils.

Treatment method: Treatment is to clear away heat, reduce swelling and detoxify, and wait until the dead bone falls off before closing.

Oral administration: Purpurea purpurea 30g wild chrysanthemum 6g Scutellaria barbata 15g Silver Flower 9g Forsythia suspensa 9g Caoheche 9g Raw Rehmannia 15g Herba 9g Luffa 6g Horn needle 9g Raw licorice 3g

External treatment: Erbao Dan medicine line drainage, external application of golden ointment. 7 posts. : After drainage through the medical thread, the pus can be discharged smoothly and the swelling and pain of the fingers are relieved. X-rays showed: bone destruction was visible in the distal phalanx of the right middle finger, and fracture fragments were visible at the base. The coating is thin and moist, the tip of the tongue is red, and the pulse is moist and frequent (84 times/min). It is recommended to clear and remove the toxin.

Oral administration: Viola purpurea 30g wild chrysanthemum 6g Scutellaria baicalensis 15g red peony root 9g honeysuckle 15g paeonol 9g Caoheche 9g raw rehmannia 15g Sheepwort 9g loofah 6g saponaria needle 9g raw licorice 3g

External treatment: use pattern forceps to remove the dead bone of the distal phalanx from the sore, leaving the bone hollow like moth-eaten form. Apply externally red ointment and Jiuyi Dan.

The sores healed and he was discharged from hospital after 1 week.

Note: Gu believes that the most vulnerable to muscle and bone damage is the seventh to tenth day of snake head boils. This is because the poisonous fire in boils is strong and cannot be purged externally, and the muscles and bones can be damaged internally. Referring to modern human anatomy, the distal segments of the fingers are closed structures. Once inflammation invades, the swelling will compress the blood vessels that nourish the phalanges, causing ischemic necrosis of the phalanges. It shows that Gu's experience is scientifically based. It also reminds us that when treating this disease, we should control inflammation as early as possible and pay attention to incision and drainage to avoid damage to the phalanges.