Introduction: Atopic dermatitis (eczema) is a common chronic inflammatory skin disease, affecting 15-30% of children in developed countries. It can occur at any age, as there is no definitive cure for this chronic disease, that may also be accompanied by asthma or hay fever. As the treatment with corticosteroids is not completely successful, patients often seek complementary therapeutic options, such as Traditional Chinese Medicine (TCM). TCM comprises numerous treatment modalities for the management of atopic dermatitis that can relieve itching and prevent new outbreaks.

Purpose: The purpose of this study is to demonstrate that atopic dermatitis can be treated without the use of any kind of corticosteroids.

Methods: The study analyzed the literature regarding diagnosis and treatment of atopic dermatitis and two case studies. The first: An 11-yearold boy that had been treated since the age of four. He had chronic red and itchy lesions throughout his entire body. The second: A 12-year-old girl with dry skin, itchy and painful lesions throughout her body, being treated since the age of one. Both patients had already been treated with corticosteroids with little or non-success and also experienced side effects. Both patients sought treatment suspending medications, using auricular acupuncture, Chinese dietary recommendations, radiesthesia, homeopathy and crystal-based medications.

Results: Both patients were able to completely suspend the use of corticosteroids with the treatment instituted. There was almost total regression of the skin lesions. These results were achieved because the patients were being treated in the physical, emotional and dietary aspects.

Conclusion: Atopic dermatitis can be treated without using corticosteroid medication. For this result, the patient needs to be seen as a whole, at the energy level. The physician has to look at the emotional aspects, dietary habits and environmental factors.

Atopic Dermatitis, Corticosteroids, Traditional Chinese Medicine, Diet Regulation, Acupuncture, Energy, Radiesthesia, Homeopathy.

Introduction: Atopic dermatitis (eczema) is a common chronic inflammatory skin disease, affecting 15-30% of children in developed countries. It can occur at any age, as there is no definitive cure for this chronic disease, that may also be accompanied by asthma or hay fever. As the treatment with corticosteroids is not completely successful, patients often seek complementary therapeutic options, such as Traditional Chinese Medicine (TCM). TCM comprises numerous treatment modalities for the management of atopic dermatitis that can relieve itching and prevent new outbreaks.

Purpose: The purpose of this study is to demonstrate that atopic dermatitis can be treated without the use of any kind of corticosteroids.

Methods: The study analyzed the literature regarding diagnosis and treatment of atopic dermatitis and two case studies. The first: An 11-yearold boy that had been treated since the age of four. He had chronic red and itchy lesions throughout his entire body. The second: A 12-year-old girl with dry skin, itchy and painful lesions throughout her body, being treated since the age of one. Both patients had already been treated with corticosteroids with little or non-success and also experienced side effects. Both patients sought treatment suspending medications, using auricular acupuncture, Chinese dietary recommendations, radiesthesia, homeopathy and crystal-based medications.

Results: Both patients were able to completely suspend the use of corticosteroids with the treatment instituted. There was almost total regression of the skin lesions. These results were achieved because the patients were being treated in the physical, emotional and dietary aspects.

Conclusion: Atopic dermatitis can be treated without using corticosteroid medication. For this result, the patient needs to be seen as a whole, at the energy level. The physician has to look at the emotional aspects, dietary habits and environmental factors.

Atopic Dermatitis, Corticosteroids, Traditional Chinese Medicine, Diet Regulation, Acupuncture, Energy, Radiesthesia, Homeopathy.

Atopic dermatitis (eczema) is a common chronic inflammatory skin disease, affecting 15-30% of children in developed countries. [1,2] Despite being more common in children, it may occur in any age. There is no definitive cure for this chronic disease, which may be accompanied by asthma or hay fever [2,3]. The diagnosis is done through physical examination, and no laboratorial tests are needed to confirm the pathology. The disease is very persistent, and it may take months or even years to be controlled [2]. In Western Medicine point of view, the patients are often submitted to different treatment combinations, as inhibitors [4]. According to Francis in the article Atopic Dermatitis: Natural History, Diagnosis and Treatment, the main goal of an atopic dermatitis treatment is to reduce symptoms: the number of exacerbations (flares) and the duration and degree of these exacerbations. The treatment in Western Medicine has the main goal of managing the atopic dermatitis lesions themselves, as several literature studies demonstrated. Other studies demonstrate the effectiveness of other therapies, such as Traditional Chinese Medicine (TCM) and homeopathy use. These techniques are useful in the management of atopic dermatitis, as they can relieve itching and prevent new outbreaks [5-8].

In the two case reports studied, the author used two methods not usually used in the treatment of atopic dermatitis, with great success. The methods were the use of chakras measurement, through the use of radiesthesia, and the use of crystal-based medications to restore the energy of the chakras, as, in the conception of the author, the chakras energy imbalance could be the cause of the development of atopic dermatitis symptoms.

The purpose of this study is to demonstrate that atopic dermatitis can be treated without the use of any kind of corticosteroids.

This research was developed based on two case reports. Both patients had atopic dermatitis since early childhood and were treated with corticosteroids and anti-allergic medications without any improvement. Both patients worsened from their condition with corticosteroids use and started treatment with withdraw of all high-concentrated drugs (corticosteroids, antibiotics, anti-inflammatory and anti-allergic medications), Chinese dietary counselling and auricular acupuncture associated with apex ear bloodletting. Both patients were also submitted to chakras center measurement, through a crystal pendulum, and all their seven chakras were depleted of energy. All patients received treatment for the chakra’s energy deficiency using homeopathy and crystal-based medications, associated to the other treatments proposed.

The Chinese dietary counselling consist in a diet different from common diet prescriptions from immunologists and allergy doctors, basing the recommendations on the energy of the food, for each kind of energy imbalance presented by each patient, in an individualized way, as can be seen in Table 1 and Table 2.

The first case study is of E.C., a four-year-old boy, who first presented a case of repeated sinusitis and tonsillitis. He was under treatment with several antibiotics such as amoxicillin and cephalexin, when he began to present pruritus and the formation of reddish bumps on his body. A medical appointment with an immunologist was recommended, and the family was advised to remove all food that contained red dye in its composition from the patient’s diet.

Although this recommendation was adhered to, the symptoms still appeared and developed into an infectious condition.

The symptoms had advanced to those of an infectious mononucleosis, presenting a great amount of secretion in several upper areas, preventing him from breathing properly. The patient was then taken to an infectious medical practitioner with treatments constructed on the theories of Traditional Chinese Medicine and other ancient traditions. This physician recommended to suspend the use of all high-concentrated medication the patient was taking, including oral and topic corticosteroids, antibiotics and anti-inflammatories, as the use of medication could be maintaining the clinical condition.

It was recommended the avoidance of cold beverages intake, raw foods, sweets and all dairy products. It was also recommended the avoidance of chocolate, fried food, honey, eggs and coconut. Auricular acupuncture sessions associated with apex-ear bloodletting were performed. The patient received auricular acupuncture sessions with mustard seeds, applied with adhesive tape, associated with apex ear bloodletting, done with an insulin needle, squeezing until take out five drops of blood. The patient was also oriented to let the points on the ear for seven days, squeezing the points three times a day minimum. After seven days, the patient has to take the points out before the next application, letting the ear resting between a section and the other and also cleaning it with alcohol. After the first session, when the patient arrived home, he started to present improvement of his general condition. The first sign of improvement was nasal disruption. The patient underwent auricular acupuncture sessions twice a week, at the beginning of the treatment, when the dermatitis was more severe. He had complete improvement of his lesions with three months of treatment. He kept the treatment with auricular acupuncture sessions once a week, in order to maintain the balance of his internal energy and remove the Heat retention, in the points described in Figure 1. He presented significant improvement of his condition after three months of treatment, but still had relapses after eating foods not recommended in his diet.

He continued auricular acupuncture sessions in the last 7 years. As the patient was treated in the energy level, several other imbalances were constantly observed during the years he was treated. When he was 11-year-old, he still had rare relapses after eating not recommended food for his diet, and also reported weakness and difficulty and loss of concentration during classes. He was also constantly feeling too tired to come back from school on foot. The physician, questioning the parents and the patient, find out that the patient was sleeping with his cellphone, and his bed was very close to an always-turned on computer. The physician oriented the parent to at least turn off the computer during the night, and leave the cellphone in airplane mode, at least for sleeping. The physician also recommended the energy measurement of the seven chakras, using a crystal pendulum.

The patient received auricular acupuncture treatment associated with apex ear bloodletting, homeopathy (Sulphur 6CH) and reorientation of all eating habits. With this treatment, he showed improvement, but not complete cure. He still had isolated episodes. These relapses were always associated with the intake of food not recommended for the patient, as chocolate, French fries, ice cream, etc.In these relapses, the patient would feel throat pain, problems in the respiratory tract and fever. In all these episodes, the patient was treated only with acupuncture, dietary counselling and awareness over the exposure to external factors. During these years of treatment, the radiesthesia procedure was not performed. However, in this last year, when he was 11-year-old, and he started feeling tired in the classroom, the physician indicated this procedure to confirm or rule out the possibility of an energy deficiency. After the measurement, the physician confirmed the hypothesis that the patient was energy deficient, because she found a large deficiency of energy in all the chakras measured, from one to eight, considering one the weakest and eight the normal energy level, all of them were rated one.

After the radiesthesia procedure, the physician recommended homeopathic medication, according to the “Constitutional Homeopathy of the Five Elements based on Traditional Chinese Medicine”, a theory developed by the author in 2015, presented in several world congresses of homeopathy. The patient also received a recommendation of crystal-based medications for being taken during one year period, also with the goal of restoring the energy of the chakras. After this new treatment, there were no more atopic dermatitis relapses. The patient is still using crystal medication and homeopathy and undergoing auricular acupuncture with apex-ear-bloodletting treatment, together with dietary counselling. Currently, his diet is not that restrictive. The patient reported feeling freer to eat, and there were no relapses in his condition. After the use of auricular acupuncture associated apex ear bloodletting, Chinese dietary counselling, homeopathy and crystal-based medications to restore the energy of the seven chakras, the patient never again needed to use corticosteroids, antiinflammatory or antibiotics drugs.

G.M.S was a 12-year-old female patient, when her parents sought TCM treatment because she had insomnia, difficulty in eating and start of a depression condition. The patient had a background of atopic dermatitis since the age of one. In her first year of life, many red bubbles started appearing in her skin, that would itch a lot. The mother started taking her to a dermatologist, where she was initially diagnosed with atopic dermatitis. When she aged four, she had the skin all open, with ruptures, very dry skin and the itching was unbearable. A specific pediatrician got interested in her case and requested some blood tests, which showed allergy to lactose. After, she was taken to another city near hers and other exams were performed, detecting other allergies, such as gluten, eggs and soya.

After these exams, she took corticosteroids during five years until she had an allergic reaction to them also, and as a consequence, she stopped eating properly. In this occasion, the mother found a homeopathy physician, who made a process of detoxification with the use of homeopathy and continued this natural treatment for two years. In these two years, the patient started to present progressive improvement of her atopic dermatitis condition. After this period, she restarted to eat normally. When she had her first period (menarche), the allergies came back stronger than before, and she started being treated with a physician specialized in allergies and immunology. Once more, the medications recommended would make her worse. The mother reported she had the impression the majority of the doctors never had faced a case as severe as her daughter’s was. There were days in which the patient was not able to get up of bed, because her skin was so dry and so rough, that making any movement would create ruptures on it. She had fever 24 hours a day and constant pain in her body, as well as severe itching. She would not be able to sleep or eat, because she felt too much pain and the medications were too strong for her organism.

She would cry all the time and spend the majority of her time isolated in her room. She was getting into a depression state, and the mother had already scheduled a consultation with a physiologist. The doctor she was seeing back in that time decided to suspend the use of all medications and start ciclosporin, a high-cost medication that the parents of the patient would only be able to acquire in São Paulo (five hours away from the city they live). There was no improvement with the medication, and it was so strong the mother reported the patient even fainted once.

She was then indicated to another doctor who looked into her case and changed all her diet. He requested the parents to suspend all medications and started a treatment with marigold soap, an oil for itching and a cream for restructure her skin as well as loratadine only three days to diminish the itching and return the skin to normal. Three days were enough for her to get better, but her skin was still dry and hurt. When she sought for the TCM treatment in order to treat her insomnia and other symptoms, she also perceived improvement in her skin condition. The skin of the patient in the beginning of TCM treatment was registered in Figure 2. Already in the first session, the patient received indication of auricular acupuncture with apex ear bloodletting, Chinese dietary counselling, systemic acupuncture, chakras energy measurement, radiesthesia, homeopathy and crystal-based medications.

In the chakras energy measurement, the physician found a deep lack of energy in all chakras of the patient. In the author’s opinion, that is the main cause of atopic dermatitis.

Differently from the first case, the patient received crystal-based medications and homeopathy to restore the energy of the chakras since the beginning of the treatment. In the same way of the first patient, the patient received auricular acupuncture sessions with mustard seeds, applied with adhesive tape, associated with apex ear bloodletting, done with an insulin needle, squeezing until take out five drops of blood. The patient was also oriented to let the points on the ear for seven days, squeezing the points three times a day minimum. After seven days, the patient has to take the points out before the next application, letting the ear resting between a section and the other and also cleaning it with alcohol. The patient also received systemic acupuncture, in the LI11 and G20 point, bilateral, with steel needle (25 x 40). The needles were maintained in the points for 15 minutes.

With the auricular acupuncture sessions associated with apex ear bloodletting, systemic acupuncture, Chinese dietary counselling, use of high-diluted drugs such as homeopathy and crystal-based medications to replenish the energy of the seven chakras, the patient had a significant improvement in the appearance of her skin, and the superficial lesions she still had disappeared in the first 30 days of treatment. Her sleep went back to normal, the patient started to eat better and felt emotionally stronger. The result in the patient’s skin was documented in Figure 3 and 4. In the case of the second patient, the treatment was performed with all the tools her improvement was way faster than the first patient, one of the reasons was that the first patient only used homeopathy and crystal-based medications years later starting the treatment with auricular acupuncture, apex ear bloodletting and Chinese dietary counselling. The appearance of the second patients’ skin suffered great improvement, but the skin still feels rough in touch, and the patient is still being treated.

As previously said, the major goal of this study is to state a favorable hypothesis to the use of Traditional Chinese Medicine and other ancient traditions reasoning in the treatment of patients with atopic dermatitis. The study is based on the analysis of literature regarding the study of atopic dermatitis, what is known about the prognosis and treatment of this disease in different points of view. At last, the author aims to compare the analysis done in literature to two case studies of severe atopic dermatitis. In both cases, there was no success with the treatment with corticosteroids and patients demonstrated improvement of their conditions when high-concentred medications were withdrawn, homeopathy and crystal-based medications were used to restore the energy of the chakras and other TCM tools were used to treat energy imbalances. Traditional Chinese Medicine main principles will also be explained, to create a more solid image of the treatment proposed, explaining the process of diagnose and treatment. Traditional Chinese Medicine and other ancient traditions, such as Hippocrates theories, focus in the treatment of the patient as a whole and not only the disease. At first, let’s comprehend the different origins of the two medical perspectives analyzed: Western and Traditional Chinese Medicine.

There are major differences between the medicine practiced currently, and the medicine practiced in the antiquity. According to Hippocrates oath, all the previous traditions within medicine have to be considered when treating patients: [9]

“I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.” (HIPPOCRATES).

These differences can be understood through the two different physicians of major importance to medicine’s history. What is believed and practiced nowadays by Western medicine comes from the studies of Galen, a Greek physician, born in 129 BC. He wrote several studies on the anatomy and functioning of the human body, to which he dedicated all his life. In his studies, he would emphasize that all systems or organs of the body work independently, and when an organ becomes ill, the focus of treatment and cure should be the diseased organ. When this organ is cured, the whole body would become healthy again. [10,11] The major influence of Galen is Hippocrates, born in 460 B.C, 500 years before Galen. He is considered the father of medicine, and the ethical medical code is based on his oath. [10,11] In his varied studies, Hippocrates created the Humourism. In his theory, the body is formed by four humors: blood, yellow bile, black bile and phlegm. Each humor corresponds to an element: Air, Fire, Earth and Water, respectively. Each of these elements, also have a temperament, and these temperaments are sanguine, choleric, melancholic and phlegmatic, respectively. [11] Regarding the organs, the four humors are related to four specific organs: Liver, Spleen, Gall bladder and Lungs. All these ideas are described in Figure 5 [12].

A person may have characteristics from a combination of the temperaments. [13] The Humorism proposes the interconnection of the energies of the body in the same way of Traditional Chinese Medicine. In TCM, this interconnection is ruled by the theories of Yin and Yang and Five Elements Theory. In both cases, imbalances in one organ of the body can cause imbalances in other organs of the body, different to what is proposed by Galen. The organs are interconnected and not isolated.

To better understand the differences between the perspectives of Western Medicine and Traditional Chinese Medicine, the schematic drawing of a tree will be used. In Figure 6, it is possible to see the root, trunk, and several branches. Coming out of each of these branches, leaves. [14,15]. The schematic drawing can be used as a metaphor for the relation between Western and Traditional Chinese Medicine. In this representation, each medical specialty is represented by a branch, and the leaves of each branch represent the symptoms and diseases related to each specialty. In the specific case of atopic dermatitis, dermatology is represented by one branch of the tree and atopic dermatitis is represented by one leaf. In the metaphor, the diagnosis and treatment in Western medicine is focused in the leaves level, therefore, treatment is centered on the patient’s symptoms. [14,15]. Traditional Chinese Medicine would treat the whole tree. Looking from a different perspective, TCM is able to see the roots of the tree, usually invisible to the naked eye. In Figure 3, the Yin and Yang symbol and the Five Element Theory appear in the roots, representing the energy level. [14,15]. Prioritizing the energy imbalances, various symptoms of different specialties can be treated at the same time, once the energy imbalances are the root of the problem. The focus of the studies in this article is the whole tree, considering the atopic dermatitis a symptom of an energy imbalance.

Before a disease is diagnosed at the laboratory, through the radiological level or by complementary tests, there has already been an alteration in energy levels, the patients have symptoms but the tests are still normal (Table 3). Elizabeth Craik, in the book Hippocratic Corpus, quotes that Hippocrates would give extreme importance to the early diagnosis of all diseases. As stated in the book, acting wrong or not acting in the beginning of the diseases could difficult the cure [13]. The disease progresses in various phases in a healthy body. During phases 1 to 3, only a slowing of the organ functions occurs because of energy imbalances, and the patient has and complains of symptoms, but the results of laboratory exams are normal (Table 3). At phase 4 the laboratory exams show some alterations, and the disease is still curable, and at phase 5, the exams are very altered, and the cellular damage is irreversible and the disease incurable (Table 3). The discussion about the phase of the diseases was more widely demonstrated in the article Why Patients Still Catch Hospital Infections Despite Control Programs? published by the Acta Scientific Journal, in April 2018.

According to Traditional Chinese Medicine, inside the body there are Yin, Yang, Qi and Blood energies, as demonstrated in Figure 7 [14,15]. This theory was presented by the author in 2015 at an Acupuncture Research Conference at Harvard Medical School, in Boston, USA. These energies suffer external, emotional and dietary influences [12], which may cause energy imbalances, developing the diseases. The energy imbalances that can cause the atopic dermatitis condition are usually associated with a deficiency or excess of one or more energies. In this situation, the imbalance of these energies leads to another condition, which is the Internal Heat or Fire, as demonstrated in Figure 8. This Heat generates the hyperemia symptoms. This Fire also results in an Internal Wind that can cause the symptoms of itching, associated with atopic dermatitis. [14,15] That is why patients complain that sometimes the itching appears in several different places, as the wind does not stand still, and it traverses the body, producing the itching symptoms. The Heat is also responsible for the symptom of redness in the skin. The Internal Heat can also be generated by emotional factors, such as anger, and the consumption of food with hot energy.

It is impossible to understand Traditional Chinese Medicine (TCM) without understanding the main concepts of Yin and Yang. These concepts, together with the Five Elements theory, are the base of Traditional Chinese Medicine in terms of treatment and cure of pathologies. Present in varied literature books, Yin and Yang is still being used to perform diagnose and treatment, as well as helping in the creation of diets [16,17,18]. According to the I-Ching and other literature regarding TCM, Chinese wise men were able to observe the archetype of the complementary opposites observing the nature. The phenomenon of the complementary opposites is present all over the universe and can be observed in nature. Day and night, male and female or darkness and light are examples. Figure 9, the Yin and Yang symbol, demonstrates the symmetrical arrangement of dark Yin and light Yang. The points of opposite color present in both sides of the symbol represent the idea of a dynamic balance [16,17,18].

According to TCM, Yin and Yang are energy forces that rule the world. Everything in the universe is composed of Yin and Yang, including our body [16,17,18]. The five Yin organs (Heart, Liver, Spleen, Lungs and Kidneys) are solid organs and mainly responsible for the storage of essence and Qi (relatively Yin function); while the six Yang organs (Gallbladder, Stomach, Large intestine, Small intestine, Bladder and Triple burners) are hollow organs and mainly responsible for digestion, transmission and excretion of the body (relatively Yang functions). Normal physiological functions are based on interdependent and interactive relationships between the Yin and Yang organs [16,17,18]. Opposites are complementary. To be healthy, we aim for a state of equilibrium between Yin and Yang energies. If there are imbalances between these two energies, symptoms occur, and if not properly treated, they can consolidate diseases in the future [16-18].

The second main theory basing Traditional Chinese Medicine is the Five Elements theory. The Five Elements theory states that there are five elements present in everything in the world, including our bodies. These elements are Water, Wood, Fire, Earth and Metal. Inside our bodies, these elements will be represented by specific organs. These organs are considered the massive organs, and they have extreme important parts in the well-functioning of the body [19]. The Wood element corresponds to the Liver, the Fire element corresponds to the Heart, the Earth element corresponds to the Spleen, the Metal element corresponds to the Lungs, and the Water element corresponds to the Kidney, as represented in Figure 10. These main organs will support and control each other in the Five Elements cycles. There are two important cycles in the relation of the Five Elements; they are the Cycle of Generation and the Cycle of Control [16]. In the Generating Cycle, the generating interactions of the elements is exposed. As showed in Figure 10 and 11, Wood fuels Fire, Fire forms Earth (volcanoes, ash, etc.), Earth contains Metal, Metal carries Water (buckets, pipes, etc.), Water feeds Wood (trees, plants, etc.) [16].

The Wood element corresponds to the Liver, and has the eye as its external sensory organ, being responsible for vision. The emotion that unbalances the Liver is anger. The taste of the Wood element is sour [16].The Fire Element corresponds to the Heart, representing the tongue and subsequently language. The emotion that unbalances the Heart is excessive joy. The taste of the Fire element is bitter [16]. The Earth Element corresponds to the Spleen, representing the mouth and being responsible for taste. The emotion that unbalances the Spleen is excessive worry. The taste of the Earth element is sweet [16]. The Air Element corresponds to the Lungs, represents the nose, being responsible for the sense of smell. The emotion that unbalances the Lungs is grief. The taste of the Air element is spicy [16]. Finally, the Water Element corresponds to the Kidney and represents the ears and hearing. The emotion that unbalances the Kidney is fear. The taste of the Water element is salty [16]. All these relationships are described in Figure 10 and 11.

The skin has a close relationship with all the Five Elements’ organs, they all have the function of maintaining the skin healthy, as the skin is the body’s first line of defense [16]. The skin is a protective barrier to the environment and a mirror to the internal health. In TCM, energy imbalances of Qi, Blood, Yin and Yang and or aggression by the pathogenic factors, such as dampness, dryness and wind, can appear in the body as skin disorders [20]. When the body cannot eliminate toxins, the result can manifest itself as symptoms on the skin. When the energies of body are balanced, it can eliminate toxins (ingested from diet and from the environment). A person with energy imbalances, on the other hand, cannot eliminate these toxins adequately, resulting in skin disorders, such as atopic dermatitis, eczema, furunculosis and acne [21].

In the daily practice of the author, the patients are submitted to several questions to evaluate their level of energy (Yin, Yang, Qi, Blood and Heat Retention). The questionnaire done is exposed in Table 4, and was previously showed in the article Why Are Diabetic Patients Still Having Hyperglycemia despite Diet Regulation, Antiglycemic Medication and Insulin?, published by the International Journal of Diabetes & Metabolic Disorders, in March 2019.

One cause of energy imbalance are the eating habits. As everything in the world is made of energy, different foods will have different energies as well. In Western traditional diets, as there is little awareness of the energy present in the food, there is also little concern regarding diets in this sense. Therefore, with regards to Brazilian diets, there are many foods responsible for energy imbalances and a range of pathologies could be easily treated through diet changes [17,18].

As Hippocrates stated: “Make your food your medicine, and your medicine your food”. This sentence emphasizes the importance of a correct diet to maintain a healthy body, and to cure diseases. In the same way there are diets responsible for energy imbalances, there are also diets able to rebalance and restore the health of the body [17,18]. When Spleen-pancreas is imbalanced, the nutrient absorption is compromised, affecting the blood production, generating Blood deficiency. The Blood deficiency can cause Internal Heat build-up that may reflect in the body as itching symptoms and redness in the skin, in this case, symptoms of atopic dermatitis. [17,18]. Foods that have hot energy may increase the chance of Internal Heat build-up and cause Gall-bladder heat retention, besides retention of Heat in other parts of the body. The foods that can imbalance the gall-bladder meridian was exposed in Table 5, and the other condiments associated with Heat retention are: pepper, ginger, clove, cinnamon, etc. It is important to avoid these condiments during the treatment of atopic dermatitis patients.

Energy imbalances can also be caused by emotional problems [11]. Different organs are affected in different ways by different emotions [16]. These emotions, when affecting the patient chronically, and not properly treated, in the future, may consolidate an organic lesion in the organ that corresponds to the emotion. According to the Hippocratic Corpus from Elizabeth Craik, Hippocrates stated that emotions have in interplay with the physical health of the body, one will always be associated with the other [11]. In the case of atopic dermatitis, the emotion associated with the condition is anger. Anger generates an excess of Yang in the Liver, leading to the formation of Internal Heat [20]. Another common emotion associated with the disease is excessive worry, because it will cause deficiency in the Spleen-Pancreas, causing in the future, deficiency of Blood that can generate Internal Heat build-up, and consequently begin or consolidate atopic dermatitis symptoms.

External factors also have a major influence in the body’s health, according to TCM. Patients have to be precautious to avoid the entrance of external energies in the body. When suffering from energy imbalances, the body becomes more vulnerable to the influence of external energies, continuing the process of energy imbalances, creating an unhealthy cycle. The main external factors that influence the body are heat, dampness, cold, dryness and wind [16]. Also, in the Hippocratic Corpus it is stated the importance of having awareness regarding the changing seasons and climates with the body. Also, in the I-Ching, a traditional book from ancient Chinese cultures, external factors are considered to influence the cycles of life [13,16-19]. In order to avoid these pathologies, different precautions may apply.

Both patients were oriented to be aware of the influence of the external factors: take baths with the door closed, do not walk barefoot, do not sleep with the window opened or with the hair wet, etc. In case studied 1, this orientation, at the beginning, was not to treat the atopic dermatitis. The external pathogenic factors were maintaining the infections of the upper respiratory tract, presented by the patient when he started the treatment. External factors can cause an imbalance in the internal energy, because when these factors penetrate the body of a patient with an energy imbalance, they can cause a stagnation on the energy flow, leading to the formation of more Internal Heat, what can worse the symptoms of atopic dermatitis [16]. In case studied 2, despite the patient not having upper respiratory tract infections, she was oriented to be aware of the influence of external factors, in order to avoid stagnation on the energy flow, as previously explained.

According to TCM, the diseases are associated with perturbations in the flow of Qi energy. The goal of acupuncture is to restore balance, correcting perturbations in the flow, using points close to the skin. Acupuncture is an important part of Traditional Chinese Medicine for more than 2,500 years. Acupuncture has been considered a medical specialty in Brazil by the Federal Medical Council since 1995. In the last decades, acupuncture has demonstrated to have a positive effect on immunity [8]. Auricular acupuncture has the goal of diagnosing and treating any medical condition in different areas of the body using acupuncture points on the external ear surface. The ear map has the form of an inverted fetus, representing both the anatomical and emotional body, and auricular acupuncture uses these representations and this microsystem to treat a wide range of diseases [20]. The auricular points used in both cases studied were related to the Five Elements: Liver, Spleen, Lung, Kidney and Heart points, to regulate the flow of Yin, Yang, Qi and Blood energies [20]. The auricular acupuncture points used were important in the treatment of atopic dermatitis, but the apex-ear-bloodletting procedure has a major part in the treatment, as it removes Heat Retention. If the treatment is done without using apex ear bloodletting, the patient’s condition may worsen. The practice of apex ear bloodletting is done on the ear apex, and it treats different conditions. According to TCM, the procedure discharges the Heat from the body, relaxing tension and relieving pain. This procedure is one of the more important procedures in the treatment of atopic dermatitis.

Chakras are main points of energy concentration. There are seven main chakras present in the body and their relationship among each other is of extreme importance for the body’s health. The chakras subject was more widely explained in the article Why Are Diabetic Patients Still Having Hyperglycemia despite Diet Regulation, Antiglycemic Medication and Insulin?, published by the author, in the International Journal of Diabetes & Metabolic Disorders, in March 2019. There, the author exposes a theory explained by the Brazilian physician Osvaldo Coimbra, relating the chakras and the Five Elements of Traditional Chinese Medicine. Even though there are seven chakras and five organs in the Five Elements theory, there is a relation between them. The correspondence between the Chakras and the Five Elements in described in Figure 12.

The radiesthesia procedure was more widely explained in the article Why Are Diabetic Patients Still Having Hyperglycemia despite Diet Regulation, Antiglycemic Medication and Insulin?, published by the author, in the International Journal of Diabetes & Metabolic Disorders, in March 2019. The radiesthesia procedure constitute of measuring the energy of the patients with a pendulum. In the case of the patients studied, the pendulum was used to measure the energy levels of the patients’ seven chakras correspondent to the energy of each organ of the Five Elements theory. The pendulum is placed in front of each chakra, and the movement of the pendulum denotes different meanings. The pendulum rotates around itself. It might rotate in clockwise or counterclockwise movements. Depending on the arc it generates, it is possible to measure the energy level, which varies from 1 to 8, 1 being no energy at all and 8 a normal energy level. In the case of the patients studied, all chakras measurements resulted in 1 (the lowest energy level), which explained the lack of energy they were both facing.

The recurrent episodes of atopic dermatitis could be explained by this result and could be the root of the problem, generating internal Heat build-up that was maintaining the atopic dermatitis symptoms, and worsening with the use of high-concentrated medications (the use of corticosteroids in both cases), as will be better explained bellow in the Arndt- Schultz section [16].

Homeopathy medications based on the theory “Constitutional Homeopathy of the Five Elements based on Traditional Chinese Medicine” were used in both cases. This theory was developed by the author, as previously explained in the article widely explained in the article Why Are Diabetic Patients Still Having Hyperglycemia despite Diet Regulation, Antiglycemic Medication and Insulin?, published by the author, in the International Journal of Diabetes & Metabolic Disorders, in March 2019.The energy deficiency of the five massive organs composing the Five Elements Theory or the Chakras theory corresponds to the root of the problem that can be the origin of the majority of the physical and emotional symptoms, in this case, the atopic dermatitis symptoms. When using homeopathy medications with this new way of thinking, the physician will be dealing with the root of the problem.

Nowadays, even in the homeopathy treatments, the analysis of the symptoms is done in the leaf level, according to the scheme of the tree, described in Figure 6. This new theory proposes a treatment in a deeper level, treating the disharmony and deficiencies of the five massive organs composing the Five Element Theory [14].

The decision of the author on choosing homeopathy medications instead of use of high concentrated medications, such as the corticosteroids, is better explained in the Arndt- Schultz law section. In Table 6, the author aimed to summarize the treatment done and the theory proposed. As explained in the chakras section, the author considers a correspondence relationship between the chakras and the five elements. Using this relationship, the author developed a treatment with high-diluted medications: homeopathy and crystalbased medications. The homeopathies and crystals chosen for the treatment of each chakra or massive organ in the Five Elements theory are described in Table 6. The homeopathy chosen and their relationship to the Five Elements massive organs, according to the Contitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine Theory were described in Figure 13.

The Arndt-Schulz’s law, originally formulated in 1888, states the effects of different drug concentrations on an individual basis. The rule states that for all substances, small doses stimulate, moderate doses inhibit, and overdoses kill [13,14]. According to this law, highly diluted drugs improve organic processes, while high concentrations harm health. In both cases presented in the study, the use of highconcentrated medications such as corticosteroids will be reducing the vital energy, and will generate more internal Heat formation, worsening the atopic dermatitis symptoms. The second reason to avoid high-concentrated drugs is that they can directly affect the Liver energy, increasing the Heat retention in the Liver and Gall Bladder meridian, leading to a worsening of atopic dermatitis symptoms [13,22].

When the patient arrives with a chronic condition of atopic dermatitis and is using corticosteroids or other medications in high concentrations, the usual advice of the author is to gradually withdraw the medication to avoid the negative effects associated with the energy deficiency that this kind of medication can cause at the energy level. The choice of using homeopathy and crystal-based medications was based on the idea of not generating more energy deficiency, and fortifying the energy of the patients, which appeared extremely low in the radiesthesia procedure (both patients’ energy was rated 1, considering 1 the lowest level and 8 the normal level). When maintaining the use of the high-concentrated medication, the energy of the patients would only get worse, generating more internal Heat buildup, consolidating the atopic dermatitis symptoms, in a vicious unhealthy cycle.

When using homeopathy and crystal-based medication, the author is aiming to strength the energy of the patients, breaking the vicious cycle, inducing an improvement of both patients’ condition. In the case of the first patient, after receiving the crystal-based medication, the patient stopped to have relapses in his atopic dermatitis symptoms, even in the situations where he would not follow his diet strictly. The patient reported to feel freer to eat, comparing with the beginning of the treatment, using only acupuncture and Chinese dietary counselling. After including the homeopathy and crystal-based medications in the treatment of the first patient, he reported to feel more active, less tired and more concentrated in school.

The author gave preference to a treatment without the use of highly concentrated medications, such as corticosteroids, with the main goal of increasing the energy levels of the patients, restoring the energy balance, improving health and not causing side effects in the energy level, such as reduction of vital energy. With this treatment, the formation of internal Heat was reduced, and the symptoms of atopic dermatitis diminished, as the main cause of atopic dermatitis in the energy level is internal Heat formation, according to TCM [23,24]. As demonstrated in both cases, the use of highconcentrated medications in the start of the treatment was negative for both patients, resulting in a worsening of the symptoms of atopic dermatitis.

In her daily practice in the clinic, the author usually orient her patients to avoid the excessive use of cellphones, computers and microwaves. The excessive use of these devices can have a negative influence in the body’s health. In the study Effects of visual fatigue caused by smartphones on balance function in healthy adults, published by Young- Hyun Park in 2017 in the Journal of Physical Therapy Science, the author states the symptoms of excessive use of smartphones: visual fatigue and tiredness. In other study, entitled The Impact of Using Cell Phones After Light-Out on Sleep Quality, Headache, Tiredness, and Distractibility Among Students of a University in North of Iran, published by Mehran Zarghami, she demonstrated a lack in sleep quality, as well as headaches and more fatigue in the students of Iran who used smartphones before going to bed.

According to the author, these symptoms associated to visual fatigue may be attributed to deficiency in the energy level. Because of that, she usually recommends her patients in both case studies to avoid the excessive use of smartphones, avoid sleeping with the computer and the Wi- Fi on, with the cellphone too near to the body and eating ISSN: 2581-7493 19 food from microwave ovens.

The harmful effects of eating microwaved food were better described in the article of the same author entitled Why Are Diabetic Patients Still Having Hyperglycemia despite Diet Regulation, Antiglycemic Medication and Insulin?, previously quoted.

In the case of the patients study, the excessive use of these devices would weaken their energy and this could induce relapses in the atopic dermatitis symptoms. For this reason, both patients were advised to avoid sleeping with the computer, cellphone and with the Wi-Fi on, and reducing the use during the day [25,26].

The conclusion is that atopic dermatitis can be treated without the use of corticosteroids. To achieve this goal, it is important to have a holistic view of the patient in the energy, nutritional, environmental and emotional points of view, not only considering the skin symptoms. The proposal of the author is that the skin symptoms presented in atopic dermatitis condition is only a reflex of the internal body energy imbalance.

In the case of atopic dermatitis, most of the time, the energy deficiency is what is creating the formation of Internal Heat. Therefore, the key to success in treating patients with atopic dermatitis is to remove Internal Heat build-up by replenishing the energy that is lacking, through either proper nutrition, acupuncture, highly diluted medication, as in homeopathy and crystal-based medications. All these processes increase vital energy, without causing side effects and without causing the vicious cycle responsible for the relapses in the usual atopic dermatitis treatment with highconcentrated drugs, such as corticosteroids.