The patient, a 43-year-old female, visited out hospital on April 23, 2014. The patient’s medical history and other pertinent information were obtained (Table 1), and after an examination, the patient was admitted to acupuncture & moxibustion department at Semyung university hospital of Oriental medicine (Je-cheon, Korea). Three days later, on April 26, the symptoms of facial hypoesthesia were still the same. In the morning two days later, April 28, a decision was made to use SBV. That afternoon (1:25 pm) SBV treatment was started, with 0.05 cc of SBV being injected at each of the following 8 acupoints, for a total dose of 0.40 cc: Jichang (ST4), Daeyeong (ST5), Hyeopgeo (ST6), Hagwan (ST7), Yepung (TE17), Imun (TE21), Cheonghoe (GB2), and Gwallyeo (SI18). Almost immediately after the SBV treatment (2:25 pm), the patient complained of hot flashes in her palms and face. She also complained of itchy palms and soles. No other complaints, such as edema, dyspnea, or sweating, were noted. An ice pack was applied.
She was going to be sent to a ward for her condition to stabilize, but suddenly she sat down and complained of abdominal pain. Her vital signs were as follows: a blood pressure of 100/60, a pulse rate of 84 beats per minute, a respiration rate of 20 breaths per minute, and a temperature of 36.5°C (100/60, 84, 20, 36.5). She complained of nausea with lower abdominal pain and a squeezing feeling. She could not stand up because of dizziness and general body weakness, she was perspiring profusely, and her complexion was pale. She was taken to the emergency room on a stretcher (2:30 pm).
In the emergency room, epinephrine, 1 mg/mL, was injected intramuscularly. The patient remained mentally alert, but her vital signs had changed (40/-, 58, 22, 36.5). The patient was unable to straighten her legs while lying on her side because of abdominal pain. She continued to complain of nausea, chest discomfort and dyspnea. Dexamethasone, 5 mg/mL, was injected intramuscularly. The patient remained mentally alert, with vital signs of 40/-, 54, 24, 36.3 and oxygen saturation (SPO2) of 98%. The patient still complained of abdominal pain, nausea, chest discomfort and dyspnea, and she was perspiring profusely over her entire body. Buscopan, 20 mg/mL, was injected intramuscularly, and oxygen (O2) inhalation therapy at 1 L/minutes via a nasal prong was administered (2:45 pm). Her blood pressure improved to 80/60, her other vital signs were 52, 24, 36.2, and her SPO2 remained at 98%. She still complained of abdominal pain and coldness in her body, but her rate of perspiration was reduced.
Slightly later (3:00 pm), although she continued to complain of abdominal pain, nausea, and coldness, her rate of perspiration was reduced, and her chest discomfort and dyspnea had disappeared. At that time, her vital signs were 130/80, 110, 24, 35.8. Because the patient continued to complain of severe abdominal pain, nausea, and coldness, a hot bad was applied (3:15 pm), followed 15 minutes later by infrared treatment (3:30 pm). About one-half hour later (4:00 pm), she continued to complain of abdominal pain, coldness and nausea, but the abdominal pain was slightly relieved. The patient then complained of palpitations, so an electrocardiography (EKG) was done and showed sinus arrhythmia, varied rate 49 ─ 76, borderline st elevation, and inferior leads. After another one-half hour (4:30 pm), the abdominal pain was reduced, the nasal prong was removed, and the supine position was possible; however, she still complained of coldness, so the infrared treatment was continued. Thirty minutes later (5:00 pm), her SPO2 dropped, so the nasal prong was re-inserted and O2 inhalation at 1.5 L/minutes was started for the second time. However, the patient continued to complain of whole body weakness, so 1-L of normal saline was administered via intravascular injection (5:10 pm). By 6:00 pm, the abdominal pain, nausea and coldness were relieved so the infrared treatment was stopped. However, because the patient still complained of entire body weakness, the normal saline intra- vascular injection was continued. By 6:30 pm, the patient experienced only a stabbing pain around her navel, and she was capable of autonomous postural changes. At 7:00 pm, only a slight abdominal pain remained, and the nasal prong was removed. At that time, her vital signs were 100/60, 68, 20, 36.5.
Over the next several hours, her symptoms continued to reduce in severity. By 7:30 pm, her nausea had disappeared, and at 8:30 pm, she autonomously changed positions in bed. By 9:30 pm, her chest discomfort had disappeared, at which time her vital signs were 100/60, 80, 20, 36.6. At 1:30 am, although a little abdominal pain remained, the patients tried to sleep. At 2:00 am, the patient was asleep, and her respiration was stable. Her vital signs at that time were 100/70, 78, 20, 36.6.