Eczemaaccording to TCM
Symptom families: Dermatological Conditions & Symptoms, Eczema, Dermatitis and Itchy Conditions of the Skin, Skin Inflammation & Swelling
Sub-symptom(s): Periaural Eczema Scrotum Eczema Ear Eczema Hand Eczema Vulvar Eczema
Did you mean? Atopic Dermatitis
What is Eczema?
Eczema, also known as atopic dermatitis, is a common skin condition characterized by itchy, inflamed, and sometimes blistering and weeping patches of skin. It can vary in severity, affecting individuals differently, with symptoms ranging from mild dryness and redness to severe itching and inflammation that can lead to discomfort and sleep disturbances. Eczema is often a chronic condition and can be exacerbated by various triggers, including environmental factors, stress, and allergens.
How does TCM view Eczema?
Traditional Chinese Medicine (TCM) offers a unique perspective on eczema, contrasting with Western medicine's focus on external triggers and immune responses. TCM sees eczema as a manifestation of internal imbalances in the body, particularly involving the Liver, Spleen, and Lung systems.
It emphasizes that the root causes of eczema are as crucial as the visible symptoms, and it focuses on restoring the body's overall balance to treat the condition. TCM practitioners identify specific patterns of disharmony within the body, determining treatment based on these patterns.
Root Causes of Eczema in TCM
In TCM, several underlying patterns are recognized as contributing to eczema. Three common categories of pattern include Heat, Blood Deficiency, and Cold. Heat in the Blood can lead to symptoms like red skin eruptions and a feeling of heat, often treated with formulations like Xi Jiao Di Huang Tang, which cools the Blood.
Blood Deficiency, especially when combined with External Wind, presents with itchy skin and red eruptions, addressed with formulas like Dang Gui Yin Zi that nourish the blood and dispel wind.
Damp-Cold patterns, characterized by symptoms like cold extremities and abdominal pain, are treated with formulas like Wei Ling Tang, which expel dampness. These patterns illustrate the TCM approach of treating eczema based on the individual's specific symptoms and overall health condition.
Explore below more details about what might cause Eczema according to TCM.
Heat
In TCM "Heat" signifies an excess of Yang energy, leading to an imbalance where heat predominates over the body's cool Yin aspects. This condition is metaphorically akin to an internal over-heating. Symptoms indicative of Heat can include feelings of warmth, fever, sweating, irritability, red face, thirst with a preference for cold drinks, and a rapid pulse. The tongue may appear red with a yellow coating. Unlike the common interpretation of heat in terms of temperature, in TCM, it represents a state of hyperactivity or inflammation in the body.... see more
Heat Patterns That Can Lead to Eczema
Common Symptoms: Fever Dark Urine Red Skin Eruptions Thirst Constipation Feeling Hot Boils Abdominal Pain
| Pattern Name | Relevant Symptoms | Relevant Formulas |
|---|---|---|
| Heat in the Blood | Eczema, Feeling hot, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia, Hematuria, Vomiting blood, Hemoptysis, Nosebleeds, Excessive menstruation... see more | Xi Jiao Di Huang Tang | Gu Jing Wan | Shi Hui San | Bai He Di Huang Tang | Hua Ban Tang | Qing Ying Tang | Qing Re Gu Jing Tang |
| Toxic-Heat | Eczema, Fever, Edema, Pus and discharge, Boils, Carbuncles, Pustule, Red skin eruptions, Sore throat, Perineum swollen, Prostate swollen, Testicular swelling, Mouth ulcers, Tonsil swelling... see more | Xi Jiao Di Huang Tang | Qing Ying Tang | Long Dan Xie Gan Tang | Shi Wei Bai Du San | Yin Qiao San | Sang Ju Yin | Bai Hu Tang | Huang Lian Jie Du Tang | Xin Yi Qing Fei Yin | Gan Lu Xiao Du Dan | San Zhong Kui Jian Tang | Zi Dang Gao | Er Qing Gao | Bing Peng San | Pu Ji Xiao Du Yin |
| Toxic-Heat Stagnation | Eczema, Pustule, Carbuncles, Fever, Red skin eruptions, Sore throat, Throat pain, Perineum swollen, Prostate swollen, Testicular swelling, Mouth ulcers, Tonsil swelling... see more | Huang Lian Jie Du Tang | Xin Yi Qing Fei Yin |
| Damp-Heat in the Liver | Vulvar eczema, Hypochondrial fullness with warmth relief, Abdominal fullness, Lower abdominal fullness, Bitter taste in the mouth, Sticky taste in the mouth, Lack of appetite, Nausea, Feeling of heaviness, Yellow vaginal discharge, Vaginal itching, Vulvar sores, Bleeding between periods, Midcycle bleeding pain, Red and swollen scrotum, Red and swelling genital, Papules, Itchy vesicular rashes, Urinary dysfunction, Urinary burning, Dark urine... see more | Long Dan Xie Gan Tang | Yin Chen Hao Tang |
Dampness
"Dampness" in TCM is a concept that describes a pattern of disharmony where the body accumulates excess moisture. Imagine the heavy, sticky feeling you get on a very humid day; that's similar to what dampness feels like internally. It can manifest as a sense of heaviness, bloating, sluggishness, or even a foggy mind. This condition is often thought to arise from environmental factors like living in a damp place, dietary habits that promote moisture in the body, or internal imbalances that hinder the body's ability to process fluids properly. In TCM, dampness can obstruct the normal flow of energy and fluids in the body, leading to various symptoms.... see more
Dampness Patterns That Can Lead to Eczema
Common Symptoms: Feeling Of Heaviness Fever Mouth Ulcers White And Watery Sputum Nasal Discharge Sneezing Chills Abdominal Pain
| Pattern Name | Relevant Symptoms | Relevant Formulas |
|---|---|---|
| Damp-Cold | Eczema, Mouth ulcers, White and watery sputum, Nasal discharge, Sneezing, Chills, Abdominal pain, Cold extremities, Arthralgia, Diarrhea, Feeling of heaviness... see more | Wei Ling Tang |
| Damp-Heat in the Liver | Vulvar eczema, Hypochondrial fullness with warmth relief, Abdominal fullness, Lower abdominal fullness, Bitter taste in the mouth, Sticky taste in the mouth, Lack of appetite, Nausea, Feeling of heaviness, Yellow vaginal discharge, Vaginal itching, Vulvar sores, Bleeding between periods, Midcycle bleeding pain, Red and swollen scrotum, Red and swelling genital, Papules, Itchy vesicular rashes, Urinary dysfunction, Urinary burning, Dark urine... see more | Long Dan Xie Gan Tang | Yin Chen Hao Tang |
Blood Deficiency
Blood Deficiency in TCM is like when your body's tank runs low on the vital energy that blood provides. It's not exactly the same as anemia in modern medicine, which is about having too few red blood cells. Instead, Blood Deficiency in TCM is about your body not having enough of the life-giving qualities that blood brings, like nourishment and moisture. This can make you feel tired, look pale, and even feel dizzy or have blurry vision. It's like a garden not getting enough water to stay lush and vibrant. TCM sees this as an imbalance where the body isn't being nourished as it should be, impacting overall health and well-being.... see more
Blood Deficiency Patterns That Can Lead to Eczema
| Pattern Name | Relevant Symptoms | Relevant Formulas |
|---|---|---|
| Blood Deficiency with External Wind | Eczema, Red skin eruptions, Urticaria, Neurodermatitis, Ichthyosis, Psoriasis, Measles, Contact dermatitis, Itchy skin, Hair loss, Carbuncles, Boils, Drug rash, Skin dryness, Itching worsen at nights, Flaking skin... see more | Dang Gui Yin Zi |
Wind
In TCM "Wind" is a concept that represents a pattern of disharmony, often characterized by its sudden and unpredictable nature, much like a gusty wind changing direction without warning. This pattern is associated with symptoms that come and go quickly or move around the body, such as itching, tremors, or even certain types of pain. Wind is considered to be a primary cause of illnesses that have these rapidly changing characteristics. In TCM, external Wind often refers to illnesses that start suddenly, like the common cold, believed to be caused by external pathogenic factors like climatic changes. On the other hand, internal Wind can be linked to internal imbalances and can manifest in conditions like dizziness or spasms. ... see more
Wind Patterns That Can Lead to Eczema
| Pattern Name | Relevant Symptoms | Relevant Formulas |
|---|---|---|
| Blood Deficiency with External Wind | Eczema, Red skin eruptions, Urticaria, Neurodermatitis, Ichthyosis, Psoriasis, Measles, Contact dermatitis, Itchy skin, Hair loss, Carbuncles, Boils, Drug rash, Skin dryness, Itching worsen at nights, Flaking skin... see more | Dang Gui Yin Zi |
Cold
In TCM "Cold" as a pattern of disharmony refers to a specific type of imbalance within the body's systems, often linked to a deficiency or weakness. It's not about feeling physically cold or having a common cold, but rather a metaphorical description of certain symptoms and underlying conditions. When a TCM practitioner says someone suffers from "Cold," it usually implies that the body's Yang energy, which is warm and active, is insufficient or overpowered by Yin energy, which is cool and passive. Symptoms of Cold in TCM can include a general feeling of coldness, cold limbs, pale complexion, low energy, slow metabolism, and a preference for warmth. ... see more
Cold Patterns That Can Lead to Eczema
| Pattern Name | Relevant Symptoms | Relevant Formulas |
|---|---|---|
| Damp-Cold | Eczema, Mouth ulcers, White and watery sputum, Nasal discharge, Sneezing, Chills, Abdominal pain, Cold extremities, Arthralgia, Diarrhea, Feeling of heaviness... see more | Wei Ling Tang |
Liver
In TCM the Liver is viewed as the organ responsible for the smooth flow of Qi, Blood, and emotions throughout the body. It plays a key role in regulating mood, storing blood, supporting digestion, and ensuring the health of tendons and eyes. When the Liver malfunctions or is imbalanced in TCM, it can lead to a range of issues such as irritability, mood swings, menstrual irregularities, eye problems, and muscular stiffness or pain. A malfunctioning Liver in TCM reflects not only physical disturbances but also emotional and mental disharmony, emphasizing the holistic approach of TCM in addressing health and wellness.... see more
Liver Patterns That Can Lead to Eczema
| Pattern Name | Relevant Symptoms | Relevant Formulas |
|---|---|---|
| Damp-Heat in the Liver | Vulvar eczema, Hypochondrial fullness with warmth relief, Abdominal fullness, Lower abdominal fullness, Bitter taste in the mouth, Sticky taste in the mouth, Lack of appetite, Nausea, Feeling of heaviness, Yellow vaginal discharge, Vaginal itching, Vulvar sores, Bleeding between periods, Midcycle bleeding pain, Red and swollen scrotum, Red and swelling genital, Papules, Itchy vesicular rashes, Urinary dysfunction, Urinary burning, Dark urine... see more | Long Dan Xie Gan Tang | Yin Chen Hao Tang |
TCM Herbal Formulas for Eczema
TCM's approach to treating eczema involves a variety of herbal formulas, each tailored to the patient's unique pattern of disharmony. For Heat in the Blood, Xi Jiao Di Huang Tang, with key ingredients like Water Buffalo Horns, is used to clear heat and cool the blood.
In cases of Blood Deficiency with External Wind, Dang Gui Yin Zi, which includes Japanese Catnip, is prescribed to nourish the blood and clear wind. For Damp-Cold patterns, Wei Ling Tang, featuring Water plantain, helps to expel dampness and regulate the body's functions. These herbal treatments reflect TCM's holistic approach, focusing on restoring balance and harmony within the body.
Explore below some TCM herbal formulas used to address eczema, organized by cause and by formula type.
- By Cause
- By Formula Type
- Heat
- Dampness
- Blood Deficiency
- Wind
- Cold
- View More Causes
- External formulas for external disorders
- Formulas that dredge and disperse external wind
- Formulas that invigorate blood and dispel blood stagnation
- Formulas that clear wind-Cold
- Formulas that clear nutritive-level heat
- Formulas that clear heat from deficiency
- Formulas that clear wind-Heat
- Formulas that clear heat from the organs
- Formulas that clear external abscesses and sores
- Formulas that clear heat and resolve toxicity
- Formulas that clear heat and expel dampness
- Formulas that nourish yin and tonify
- Formulas that warm and purge
- Formulas that expel dampness
- Formulas that dispel wind-Damp
- Formulas that release the exterior and clear the interior
- Formulas that secure irregular uterine bleeding and stop vaginal discharge
- Formulas that stop bleeding
- Formulas that clear heat from qi and blood
- Formulas that clear qi-level heat
- Formulas that clear internal abscesses and sores
- Formulas that harmonize lesser yang-warp disorders
Top Formula for Heat:
Xi Jiao Di Huang Tang
Suitable for Heat patterns that may cause eczema, such as Heat in the Blood or Toxic-Heat
Learn moreAll Formulas Recommended for Eczema Caused by Heat
| Formula | Patterns Suitable For |
|---|---|
| Xi Jiao Di Huang Tang | Heat in the Blood, Toxic-Heat |
| Qing Ying Tang | Heat in the Blood, Toxic-Heat |
| Long Dan Xie Gan Tang | Toxic-Heat, Damp-Heat in the Liver |
| Huang Lian Jie Du Tang | Toxic-Heat, Toxic-Heat Stagnation |
| Xin Yi Qing Fei Yin | Toxic-Heat, Toxic-Heat Stagnation |
| Gu Jing Wan | Heat in the Blood |
| Shi Hui San | Heat in the Blood |
| Bai He Di Huang Tang | Heat in the Blood |
| Hua Ban Tang | Heat in the Blood |
| Qing Re Gu Jing Tang | Heat in the Blood |
| Shi Wei Bai Du San | Toxic-Heat |
| Yin Qiao San | Toxic-Heat |
| Sang Ju Yin | Toxic-Heat |
| Bai Hu Tang | Toxic-Heat |
| Gan Lu Xiao Du Dan | Toxic-Heat |
| San Zhong Kui Jian Tang | Toxic-Heat |
| Zi Dang Gao | Toxic-Heat |
| Er Qing Gao | Toxic-Heat |
| Bing Peng San | Toxic-Heat |
| Pu Ji Xiao Du Yin | Toxic-Heat |
| Yin Chen Hao Tang | Damp-Heat in the Liver |
Top Formula for Dampness:
Long Dan Xie Gan Tang
Suitable for Dampness patterns that may cause eczema, such as Damp-Heat in the Liver
Learn moreAll Formulas Recommended for Eczema Caused by Dampness
| Formula | Patterns Suitable For |
|---|---|
| Long Dan Xie Gan Tang | Damp-Heat in the Liver |
| Wei Ling Tang | Damp-Cold |
| Yin Chen Hao Tang | Damp-Heat in the Liver |
Top Formula for Blood Deficiency:
Dang Gui Yin Zi
Suitable for Blood Deficiency patterns that may cause eczema, such as Blood Deficiency with External Wind
Learn more
Top Formula for Wind:
Dang Gui Yin Zi
Suitable for Wind patterns that may cause eczema, such as Blood Deficiency with External Wind
Learn more
Top Formula for Cold:
Wei Ling Tang
Suitable for Cold patterns that may cause eczema, such as Damp-Cold
Learn moreFormulas that clear Heat from the Organs
These formulas are suitable for some eczema-causing patterns like Toxic-Heat or Damp-Heat in the Liver.
One such formula is Long Dan Xie Gan Tang, with chinese gentian as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that clear heat from the organs" recommended for eczema
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Long Dan Xie Gan Tang | Toxic-Heat, Damp-Heat in the Liver |
| Xin Yi Qing Fei Yin | Toxic-Heat, Toxic-Heat Stagnation |
Formulas that clear nutritive-level Heat
These formulas are suitable for some eczema-causing patterns like Heat in the Blood or Toxic-Heat.
One such formula is Xi Jiao Di Huang Tang, with water buffalo horn as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that clear nutritive-level heat" recommended for eczema
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Xi Jiao Di Huang Tang | Heat in the Blood, Toxic-Heat |
| Qing Ying Tang | Heat in the Blood, Toxic-Heat |
Formulas that clear Heat and resolve toxicity
These formulas are suitable for some eczema-causing patterns like Toxic-Heat or Toxic-Heat Stagnation.
One such formula is Huang Lian Jie Du Tang, with goldthread rhizome as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that clear heat and resolve toxicity" recommended for eczema
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Huang Lian Jie Du Tang | Toxic-Heat, Toxic-Heat Stagnation |
| Pu Ji Xiao Du Yin | Toxic-Heat |
Formulas that clear Heat and expel dampness
These formulas are suitable for some eczema-causing patterns like Toxic-Heat.
One such formula is Gan Lu Xiao Du Dan, with baikal skullcap root as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that clear heat and expel dampness" recommended for eczema
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Gan Lu Xiao Du Dan | Toxic-Heat |
| Yin Chen Hao Tang | Damp-Heat in the Liver |
External formulas for External disorders
These formulas are suitable for some eczema-causing patterns like Toxic-Heat.
One such formula is Yin Qiao San, with honeysuckle flowers as a key herb.
Other formulas of this category are listed in the table below.
All "external formulas for external disorders" recommended for eczema
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Yin Qiao San | Toxic-Heat |
| Zi Dang Gao | Toxic-Heat |
| Er Qing Gao | Toxic-Heat |
| Bing Peng San | Toxic-Heat |
| Jing Fang Bai Du San | Not applicable |
| Ren Shen Bai Du San | Not applicable |
Formulas that dredge and disperse External Wind
These formulas are suitable for some eczema-causing patterns like Blood Deficiency with External Wind.
One such formula is Dang Gui Yin Zi, with japanese catnip as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that dredge and disperse external wind" recommended for eczema
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Dang Gui Yin Zi | Blood Deficiency with External Wind |
| Xiao Feng San | Not applicable |
Formulas that clear Heat from Deficiency
These formulas are suitable for some eczema-causing patterns like Heat in the Blood.
One such formula is Bai He Di Huang Tang, with lily bulb as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that clear heat from deficiency" recommended for eczema
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Bai He Di Huang Tang | Heat in the Blood |
| Qing Re Gu Jing Tang | Heat in the Blood |
Formulas that clear Wind-Heat
These formulas are suitable for some eczema-causing patterns like Toxic-Heat.
One such formula is Sang Ju Yin, with mulberry leaves as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that clear wind-Heat" recommended for eczema
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Sang Ju Yin | Toxic-Heat |
| Jing Jie Lian Qiao Tang | Not applicable |
Formulas that clear external abscesses and sores
These formulas are suitable for some eczema-causing patterns like Toxic-Heat.
One such formula is Shi Wei Bai Du San, with saposhnikovia root as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that clear external abscesses and sores" recommended for eczema
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Shi Wei Bai Du San | Toxic-Heat |
| San Zhong Kui Jian Tang | Toxic-Heat |
Formulas that expel Dampness
These formulas are suitable for some eczema-causing patterns like Damp-Cold.
One such formula is Wei Ling Tang, with water plantain as a key herb.
Formulas that secure irregular uterine bleeding and stop vaginal discharge
These formulas are suitable for some eczema-causing patterns like Heat in the Blood.
One such formula is Gu Jing Wan, with tortoise plastron as a key herb.
Formulas that stop bleeding
These formulas are suitable for some eczema-causing patterns like Heat in the Blood.
One such formula is Shi Hui San, with japanese thistle as a key herb.
Formulas that clear Heat from Qi and Blood
These formulas are suitable for some eczema-causing patterns like Heat in the Blood.
One such formula is Hua Ban Tang, with gypsum as a key herb.
Formulas that clear Qi-level Heat
These formulas are suitable for some eczema-causing patterns like Toxic-Heat.
One such formula is Bai Hu Tang, with gypsum as a key herb.
Formulas that invigorate Blood and dispel Blood Stagnation
Eczema can be treated by these formulas if it arises from poor blood circulation or stagnation of blood, which often manifests in pain or swelling.
One such formula is Dang Gui Shao Yao San, with white peony root as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that invigorate blood and dispel blood stagnation" recommended for eczema
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Dang Gui Shao Yao San | Not applicable |
| Tao He Cheng Qi Tang | Not applicable |
Formulas that clear Wind-Cold
Eczema can be treated by these formulas when it stems from external pathogenic influences characterized by cold and wind symptoms.
One such formula is Gui Zhi Tang, with cinnamon twigs as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that clear wind-Cold" recommended for eczema
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Gui Zhi Tang | Not applicable |
| Ma Huang Tang | Not applicable |
Formulas that nourish Yin and tonify
Eczema can be treated by these formulas when it arises from a deficiency in Yin energy, needing nourishment and strengthening of the body's vital essence.
One such formula is Ba Wei Di Huang Wan, with prepared rehmannia as a key herb.
Formulas that warm and purge
Eczema can be treated by these formulas if it stems from cold accumulation coupled with excess conditions, necessitating warming and purging actions.
One such formula is Da Huang Fu Zi Tang, with prepared aconite as a key herb.
Formulas that dispel Wind-Damp
Eczema can be treated by these formulas when it arises from a pathogenic influence of wind combined with dampness, which often obstructs the flow of Qi and Blood.
One such formula is Du Huo Ji Sheng Tang, with pubescent angelica root as a key herb.
Formulas that Release the Exterior and Clear the Interior
Eczema can be treated by these formulas when it arises from external pathogenic factors affecting the body's surface, coupled with internal disharmony.
One such formula is Ge Geng Huang Qin Huang Lian Tang, with kudzu root as a key herb.
Formulas that clear internal abscesses and sores
Eczema can be treated by these formulas if it is related to internal heat causing abscesses and sores.
One such formula is Yi Yi Fu Zi Bai Jiang San, with job's tears as a key herb.
Formulas that harmonize lesser Yang-warp disorders
Eczema can be treated by these formulas in cases of imbalances in the lesser Yang (Shao Yang) phase, which often involve alternating hot and cold sensations.
One such formula is Xiao Chai Hu Tang, with bupleurum root as a key herb.
Acupoints for Eczema
TCM also incorporates acupuncture as a treatment for eczema. Key acupoints include Huantiao GB-30 on the Gall Bladder Channel, which helps remove obstructions and resolve dampness and wind, and Quchi LI-11 on the Large Intestine Channel, effective for clearing heat, cooling blood, and resolving dampness.
Additionally, Xuehai SP-10 on the Spleen Channel is used to cool and invigorate the blood, which can be beneficial for the skin. These acupoints are selected based on their ability to address the specific patterns of disharmony associated with eczema, demonstrating TCM's comprehensive approach to treatment.
Explore below some acupoints used to address eczema, organized by meridian.
- By Meridian
- Spleen Channel
- Gall Bladder Channel
- Large Intestine Channel
- Triple Burner Channel
- Pericardium Channel
Xuehai SP-10
When knee is flexed, Xuehai SP-10 is 2 cun above the medial upper border of the patella, in a depression on the vastus medialis muscle.
Huantiao GB-30
At the junction of the middle and lateral third of the distance between the great trochanter and Yaoshu DU-2 of the hiatus of the sacrum. When locating the point, put the patient in lateral recumbent position with the thigh flexed.
Quchi LI-11
When the elbow is flexed, Quchi LI-11 is in the depression at the lateral end of the cubital crease, midway between Chize LU-5 and the lateral epicondyle of the humerus.
Guanchong TB-1
On the lateral side of the ring finger, about 0.1 cun posterior to the corner of the nail.
Daling P-7
In the depression in the middle of the transverse crease of the wrist, between the tendons of palmaris longus and flexor carpi radialis muscle.