Herpes zoster is a viral skin disease that is most prevalent in the spring and is caused by the varicella-zoster virus infection, which is latent in the body and causes clusters of herpes in bands along the innervated areas of the skin, accompanied by neuralgia. The elderly and people with chronic wasting diseases are susceptible to herpes zoster, and the disease is more severe once contracted. The folklore of this disease is known as “string waist dragon”, and in the literature it is called “tangled waist fire dan”, because herpes zoster that affects the chest and waist area accounts for more than 60% of the incidence of this disease. In fact, the disease can also invade the head, face, ears and upper and lower limbs. As the virus is nerve-friendly, it always develops along the nerves in a band, hence the name “herpes zoster”. In Chinese medicine, herpes zoster is thought to be caused by a strong fire in the liver and gallbladder and a long period of spleen and dampness, and is caused by external poison. Modern medicine has learned that the virus is invaded by respiratory infection and latent in the nerve cells of the posterior root ganglion of the spinal nerve or other sites of disease. This virus usually does not develop, but due to the elderly and the long-ill and weak people, the systemic resistance is reduced, and then encounter physical exertion, cold and other triggers, then prone to this disease. Pathogenesis: Primary infection can occur in people with no or low immunity (mostly children) after virus infection, i.e. chickenpox. When the immunity of the body decreases (e.g., trauma, cold, cancer, immune system diseases, etc.), the latent virus multiplies and causes inflammation and necrosis of the ganglion, resulting in pain in the patient. The virus travels down the nerve pathway to the area innervated by that nerve and causes segmental herpes. The virus can also infect motor neurons, causing muscle weakness and motor paralysis, but this is rare. At the beginning of the disease, the main symptoms are generalized fatigue and weakness, loss of appetite, mild fever, and soon a burning, throbbing pain at the site of the attack. If it occurs in the chest or lower back, it is often misdiagnosed as heart disease or acute abdomen, etc. When you get herpes zoster, 1 to 3 days later, the skin at the onset site appears as green pea-sized, very tense papules and blisters, which are distributed along the nerves and arranged in clusters in a striped pattern. If it occurs on the chest or waist, it is more likely to occur from the side of the spine diagonally downward, and rarely symmetrically. The folklore that a circle of herpes around the waist is life-threatening is not reliable. In mild cases, each cluster can be spaced with normal skin, but in severe cases, they can be fused into a large band-like distribution, and after a few days, they can change from clear blisters to cloudy pustules, and some can break down to form vesicles. In the elderly, the disease is often characterized by large, bloody blisters and even necrosis. In mild cases, the blisters dry up naturally in about three weeks and crust over, leaving no scar after shedding; in severe cases, the course of the disease can extend to more than one month. Elderly patients often have severe pain that affects sleep, and if not treated promptly, the pain remains after the lesions have subsided and does not completely subside for months. If herpes zoster appears on the head and face, be alert for headaches and facial paralysis due to invasion of the head and facial nerves. If the cornea of the eye is invaded, it can even lead to blindness. The condition can be more severe in older, weaker people and those with chronic diseases such as tumors. It is important to note that there is also an incomplete form of herpes zoster, where the blisters do not appear or appear rarely, except for severe pain at the onset of the disease, which can be easily misdiagnosed and should be taken seriously to avoid delaying treatment and finding serious consequences. Patients with herpes zoster should ask their doctor to confirm the diagnosis and actively treat them when they do not have pain at the site. Treatment I. The main treatment is general and symptomatic. Principles: antiviral, pain reduction, prevention of secondary infection, and shortening the course of the disease. ①Neuralgia: pain relievers such as aspirin, anacin, anti-inflammatory pain, ibuprofen and Xinhuang tablets can be given. For post-herpetic neuralgia, analgesic and sedative should be used together, such as doxepin 25mg, taken orally 3 times a day; meclizine 0.2g, dexamethasone 1.5mg, cycloheximide 2mg, taken orally 3 times a day, vitamin B12 100 micrograms injected intramuscularly once a day for 10 days. ② local skin care treatment; phthalamide rub or furnace glycolic lotion applied externally, 3-5 times a day. For vesicles, apply 2% gentian violet solution or apply neomycin furosemide paste. Or ultraviolet light irradiation, audio electrotherapy, laser irradiation (helium-neon or carbon dioxide beam expansion irradiation), TDP spectrum irradiation, etc. Herpes zoster in the eye: use herpes net or acyclic guanosine solution for eye drops, and use atropine to dilate the pupil in order to prevent corneal adhesion; II. Anti-viral therapy Mainly used for immunodeficient or immunosuppressed patients, aconitine or acyclic guanosine Oral high potency antiviral drugs: acyclovir, vanamycin, etc. (clinical hint: acyclovir is not effective in the treatment of posterior neuralgia) Topical acyclovir eye drops are applied to the affected area. Oral antibacterial medication or topical erythromycin ointment can be applied to the affected area. If the blister ruptures, 2.5% gentian violet solution can be applied to the affected area. Corticosteroids: short-term application, always be cautious! Third, for patients who are using cytotoxic, immunosuppressive or metabolic antagonists, the dose should be reduced or discontinued as much as possible because of the tendency to produce viral spread. Fourth, it can be combined with heat-clearing and detoxifying herbs and acupuncture therapy. Recommended Chinese medicines include Gentian and Liver Pill for liver fire; Stomach Ling Pill or Ginseng and Atractylodes Pill for spleen deficiency and dampness; Blood and Qi Stagnation Pill for blood stagnation. The dosage and usage of the above drugs should be in accordance with the doctor’s prescription.