Mumps is a contagious disease characterized by fever, swelling and pain of unilateral or bilateral parotids, so it is also known as an "epidemic disease that causes a swollen head," or "epidemic disease with redness and swelling of the cheeks." It often occurs in children more than three years old and is commonly complicated by encephalitis and orchitis.

Etiology and Pathogenesis

Mumps are due to the invasion of wind-warm evil through the mouth or nose, which obstructs the shaoyang meridians and leads to the stagnation of qi and blood circulation and involves the parotid, causing swelling and pain. Physiologically, shaoyang and jueyin meridians are exterior-interiorly related and the Foot Jueyin meridians pass through the lower abdomen and connect with the testes. In serious cases, the evil may go downward along the meridian and elicit lower abdominal pain and orchitis. Moreover, the evil may involve the heart and yingfen and irritate the liver-wind, and high fever, coma and convulsions may ensue.

Syndrome Differentiation and Therapeutic Principles

A. Syndrome differentiation

(a) Local manifestations: The case which has a swollen parotid that is soft and subsides readily is usually attributed to a superficies-syndrome, while that with a swollen parotid that is indurated and does not subside readily usually indicates an interior-syndrome.

(b) General manifestations: A case with marked general symptoms such as high fever, chilliness, headache, vomiting, restlessness, sore throat, etc., indicates an interior-syndrome with retention of heat-toxin, while that with mild general symptoms such as low fever or absence of fever denotes a superficies-syndrome.

B. Therapeutic principles The main therapy for mumps is to clear away heat and toxic materials. This is supplemented by dissipating the mass and softening the induration. For cases with superficies-syndrome, the therapy of expelling wind should be supplemented, and for cases with interior-syndrome, external treatment may be applied in addition to the above therapies.

Classification and Treatment

A. Warm evil in the superficies

Manifestations: Mild fever and chilliness or no fever, cough, diffuse swelling and pain of unilateral or bilateral parotids, difficulty in chewing, thin, white or yellowish tongue coating and floating and rapid pulse.

Therapeutic principles: Expel wind and clear away heat, dissipate the mass, and relieve swelling.  

Prescription: The Modified Powder of Forsythiae and Lonicerae

Flos Lonicerae 10 g
Fructus Forsythiae 10 g
Radix Isatidis 10 g
Fructus Arctii 10 g
Herba Menthae (decocted later) 3 g
Bombyx Batryticatus 6 g
Radix Platycodi 5 g
Spica Prunellae 10 g
 

External application: Powder of Ruyijinhuang mixed with vinegar.

B. Accumulation of heat-toxin in the interior

Manifestations: High fever, headache, restlessness, thirst, poor appetite, vomiting, swollen and indurated parotid with pain and tenderness, difficulty in chewing, redness of throat, sore throat, red tongue with yellow coating and smooth and rapid pulse.

Therapeutic principles: Clear away heat and toxic materials, dissipated the mass, and soften the induration.

Prescription: The Modification of General Antiphlogistic Decoction

Radix Isatidis 10 g
Herba Taraxaci 10 g
Radix Scutellariae 10 g
Rhizoma Coptidis 3 g
Fructus Arctii 10 g
Radix Scrophulariae 10 g
Lasiosphaera seu Calvatia 5 g
Bombyx Batryticatus 6 g
Gypsum Fibrosum (decocted first) 30 g
Spica Prunellae 10 g
 

Remarks: Add Sargassum (10 g), Thallus Eckloniae (10 g) and Bulbus Gemastrae (10 g) for cases with diffusely swollen and indurated parotid. Add Radix et Rhizoma Rhei (3 g) and Natrii Sulfas Exsiccatus (6 g) for cases with constipation due to accumulation of heat toxin. Add Rhizoma Pinelliae (5 g) and Caulis Bambusae in Taeniam (10 g) for those with nausea and vomiting. Add Ramulus Uncariae cum Uncis (10 g), Lumbricus (10 g) and Scorpio (3 g) or Purple Snow Pill (1.5 g) twice daily for those with coma and convulsions due to the involvement of heart and liver. Add Semen Citri Reticulatae (10 g), Rhizoma Corydalis (10 g), Semen Litchi (10 g) and Radix Gentianae (10 g) for those with orchitis. Add Rhizoma Corydalis (10 g) and Fructus Aurantii for those with lower abdominal pain.

Experiential Prescriptions

A. Flos Chrysanthemi Indici (15 g); prepared as decoction; taken as daily drink for seven days.

B. Fructus Evodiae (10 g), Rhizoma Picrorrhizae (6 g), Radix et Rhizoma Rhei (5 g) and Rhizoma Arisaema cum Bile (3 g); prepared as powder and mixed with vinegar for external application on Yongquan point (K. 1) on both sides; dosage is six grams for children under five years old, 10 grams for six to 10 years old, 12 grams for those over 10 years old; dressing is changed daily for two to three days.

C. Fresh Radix et Caulis Opuntiae Dillenii with thorns removed; sliced or crushed; for external application; changed daily.

Copyright 1995 Hopkins Technology