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1、手三阴手三阴Differentiation of syndromes(4)Basic Theory of Traditional Chinese Basic Theory of Traditional Chinese Basic Theory of Traditional Chinese MedicineMedicineMedicine中医学英文DifferentiationofsyndromDifferentiation of syndromes according to the pathological changes of zang-fu organs中医学英文Differentiati
2、onofsyndromvTCM was not founded on the basis of precise anatomy. Internal organs, more accurately called zang-fu organs, actually refer to the major functional systems of the human body. vIn the progress of TCM , no patho-anatomy was studied. 中医学英文DifferentiationofsyndromvTherefore, the pathological
3、 changes of the internal organs should not be misunderstood as the patho-anatomical changes of organs and tissues on which the western diagnosis of diseases is based. vThey are the pathophysiological changes of the functional systems recognized in the light of tradition Chinese medical theories.中医学英
4、文DifferentiationofsyndromvDiagnosing pathological changes of the internal (zang-fu) organs is the most important component of differentiation of syndromes, for it is often a comprehensive analysis of the pathogenesis in a given cases, vincluding its location, nature, and the condition of confrontati
5、on between the anti-pathogenic and pathogenic factors. 中医学英文DifferentiationofsyndromvIn combination with the eight general parameters, determination of the pathogenic factors and the state of qi, blood and body fluids, determining the pathological changes of the internal organs usually makes a compl
6、ete syndrome diagnosis, not only for non-febrile diseases in internal medicine, but also for most diseases in other branches of clinical medicine.中医学英文Differentiationofsyndrom1.stagnation and obstruction of heart blood（1）vSummarize:this often results from insufficiency of heart qi and heart yang, ca
7、uses retardation of blood flow in the heart，occurs in angina pectoris and myocardial infarction in western medicine. 中医学英文Differentiationofsyndrom1.stagnation and obstruction of heart blood（2）vClinical manifestations:precordial or substernal pain, stabbing or dull in character, often reaching the sh
8、oulder and arm,accompanied by palpitations, dark-purplish tongue or purple spots on the tongue, deep, hesitant or irregular pulse, cyanosis of the face, lips and nails, cold limbs and spontaneous sweating.中医学英文Differentiationofsyndrom1.stagnation and obstruction of heart blood（3）vSyndrome analysis:
9、stagnation of blood in the heart produces cardiac pain and palpitations. As the heart meridian of hand-shaoyang traverses the shoulder and the medial aspect of the arm, the above pain occurs. Dark-purplish tongue or purple spots on the tongue, and a deep, hesitant or irregular pulse are signs of blo
10、od stagnation. In severe cases, the overall blood circulation is also retarded, leading to cyanosis. Serious deficiency of qi and yang causes spontaneous sweating and cold limbs.中医学英文Differentiationofsyndrom1.stagnation and obstruction of heart blood（4）vHerbal formula :vXuefu zhuyu tang (p285) v(dec
11、oction for removing blood stasis in chest)中医学英文Differentiationofsyndrom2.clouding of the heart by phlegm（1）v Summarize:characterized by mental derangement or loss of consciousness, is not infrequently encountered in depressive episode, epilepsy, stoke and the critical stage of a chronic disease.中医学英
12、文Differentiationofsyndrom2.clouding of the heart by phlegm:（2）vClinical manifestations:impaired consciousness with inconerent speech and rattling of phlegm in the throat, as observed in strokes; low spiritedness with a feeling of hopelessness, apathy, muttering to oneself, 中医学英文Differentiationofsynd
13、rom2.clouding of the heart by phlegm:（2）other abnormal behavior as observed in depression; sudden loss of consciousness with convulsions and rattling in the throat as observed in epilepsy. a pale tongue with a white greasy coating a slippery pulse are also the symptoms中医学英文Differentiationofsyndrom2.
14、clouding of the heart by phlegm:（3）vSyndrome analysis:the heart is clouded by phlegm consciousness will be impaired or lost. The formation of phlegm may be related to stagnation of liver qi due to emotional influences in depression, with apathy, muttering to oneself, and other abnormal behavior. the
15、 phlegm is usually derived from dysfunction of zang-fu organs and hidden in the heart meridian in epilepsy中医学英文Differentiationofsyndrom2.clouding of the heart by phlegm:（3）liver wind is stirred up the phlegm will go upward and cloud the heart the syndrome occurs in paroxysms. clouding of the heart b
16、y an upsurge of phlegm together with endogenous wind loss of consciousness are consistent with the presence of turbid phlegm A pale tongue with a white greasy coating and a slippery pulse 中医学英文Differentiationofsyndrom2.clouding of the heart by phlegm:（4）vHerbal formula :vDitan Tang 中医学英文Differentiat
17、ionofsyndrom3.invasion of the lungs by wind-cold（1）v Summarize:this is an exogenous affection of the lungs by wind-coldusually seen in colds and acute bronchitis.中医学英文Differentiationofsyndrom3.invasion of the lungs by wind-cold（2）vClinical manifestations:Coughing with expectoration of thin and whiti
18、sh sputum,chills and mild fever,no sweating, headache, stuffy and runny nose, white coating of the tongue a floating, tense pulse 中医学英文Differentiationofsyndrom3.invasion of the lungs by wind-cold（3）vSyndrome analysis:Coughing the lungs are invaded by wind-cold. Disturbance of the normal flow of lung
19、 qi leads to coughing, and the sputum is thin and whitish because the pathogenic cold impeding the normal distribution of fluid in the lungs produces phlegm, but does not condense it. The nose is the “specific opening ” of the lungs. Disturbance of the dispersing function of the lungs results in a s
20、tuffed-up nose with watery discharge. The lungs are also in charge of defensive qi, which resists the invading pathogens on the superficial part of the body. 中医学英文Differentiationofsyndrom3.invasion of the lungs by wind-cold（3）When defensive qi is restrained by exogenous pathogens, chills occur; and
21、when defensive qi resists the pathogens, heat is generated. In addition, the pathogenic cold closes the pores. Therefore, there are chills with fever but no sweating. In comparison with pathogenic heat, pathogenic cold only induces mild fever while pathogenic heat may give rise to high fever. Since
22、the pathogenic factor has not been transmitted into the interior, the tongue coating is still normal. A floating, tense pulse indicates superficial affection by cold中医学英文Differentiationofsyndrom3.invasion of the lungs by wind-cold（3）vThis syndrome is very similar to exterior cold syndrome (an exteri
23、or syndrome caused by wind-cold). The difference lies in the fact coughing is the chief symptom in this syndrome, while chills and fever are the main symptoms and coughing is mild or even absent.中医学英文Differentiationofsyndrom3.invasion of the lungs by wind-cold（4）vHerbal formula :vMahuang tang (Decoc
24、tion of Ephedra):v (p260)EphedraCinnamon twigBitter apricot seedLicorice root中医学英文Differentiationofsyndrom4.invasion of the lungs by wind-heat（1）vSummarize: this is an exogenous affection of the lungs caused by wind-heat and usually seen in influenza, upper respiratory infections, acute bronchitis t
25、he early stages of general infectious diseases. 中医学英文Differentiationofsyndrom4.invasion of the lungs by wind-heat（2）vClinical manifestations:Coughing with expectoration of yellow, thick sputum,fever with mild aversion to wind, dryness of the mouth and sore throat, reddened tip and yellow coating of
26、the tongue a rapid, floating pulse.中医学英文Differentiationofsyndrom4.invasion of the lungs by wind-heat（3）vSyndrome analysis:This syndrome is characterized by coughing and exterior syndrome of wind-heat. Invasion of the lungs by exogenous wind-heat impairs the cleansing and descending function of the l
27、ungs, thus causing coughing. By the action of heat, fluids in the lungs are condensed to phlegm which is thick and yellow. 中医学英文Differentiationofsyndrom4.invasion of the lungs by wind-heat（3）Resistance of defensive qi against the invading wind-heat produces fever, and restraint of defensive qi by wi
28、nd at the superficial portion of the body leads to mild aversion to wind. Upward invasion of wind-heat causes sore throat, and impairment of body fluids by heat gives rise to thirst. Reddened tip and yellow coating of the tongue, and rapid, floating pulse indicate the presence of wind-heat.中医学英文Diff
29、erentiationofsyndrom4.invasion of the lungs by wind-heat（3）vThe difference between this syndrome and exterior heat syndrome (an exterior syndrome caused by wind-heat) lies in the fact that the former is marked by coughing with expectoration of thick, yellow sputum, while in the latter coughing and e
30、xpectoration is mild or even absent. Fever may be obvious in both syndromes.中医学英文Differentiationofsyndrom4.invasion of the lungs by wind-heat（4）vHerbal formula :v vSang Ju Yin ( p263)(Decoction of Mulberry Leaf and Chrysanthemum)中医学英文Differentiationofsyndrom5.Invasion of the lungs by heat (heat in t
31、he lungs)(1)vSummarize:vThis is often caused by direct invasion of the lungs by exogenous pathogenic heat or heat transformed from wind-cold or wind-heat when the latter enters the interior. It can be encountered in acute and chronic bronchitis, pneumonia and other respiratory infections in west med
32、icine.中医学英文Differentiationofsyndrom5.Invasion of the lungs by heat (heat in the lungs)(2)vClinical manifestations:Coughing with expectoration of thick, yellow sputum,dyspnea with coarse breathing or flaring of the nares, high fever with thirst, restlessness, 中医学英文Differentiationofsyndrom5.Invasion o
33、f the lungs by heat (heat in the lungs)(2)epistaxis, hemoptysis, constipation,scanty concentrated urine,reddened tongue with yellow coating,a rapid pulse.中医学英文Differentiationofsyndrom5.Invasion of the lungs by heat (heat in the lungs)(3)vSyndrome analysis:The syndrome is characterized by common symp
34、toms of lung diseases in combination with manifestations of interior heat. Accumulation of pathogenic heat in the lungs induces upward perversion of lung qi, resulting in coughing. The phlegm is formed due to condensation of fluids by heat, and so is thick and yellow. The pathogenic heat and phlegm
35、impede the descending function of the lungs, giving rise to dyspnea with coarse breathing. 中医学英文Differentiationofsyndrom5.Invasion of the lungs by heat (heat in the lungs)(3)The heat causes fever and impairs the body fluids, resulting in thirst, constipation and scanty, concentraded urine. The heat
36、may also disturb the mind, causing restlessness. If blood vessels are injured by heat, there is epistaxis or hemoptysis. A reddened tongue with a yellow coating and rapid pulse indicates heat in the interior. 中医学英文Differentiationofsyndrom5.Invasion of the lungs by heat (heat in the lungs)(4)vHerbal
37、formula :vMa xing shi gan tang (p264)v(decoction of ephedra, apricot seed, gypsum and licorice root)中医学英文Differentiationofsyndrom6.Invasion of the lungs by dryness (dryness of the lungs)(1)vSummarize:vThis syndrome can be encountered in patients with colds or bronchitis in dry seasons.中医学英文Different
38、iationofsyndrom6.Invasion of the lungs by dryness (dryness of the lungs)(2)vClinical manifestations:Dry cough or cough accompanied by scanty, sticky sputum difficult to expectorate, dry nose, lips, tongue and throat;chills and fever, or chest pain with hemoptysis. Reddened tongue (or tip of the tong
39、ue) with thin white or yellow coating, a rapid pulse.中医学英文Differentiationofsyndrom6.Invasion of the lungs by dryness (dryness of the lungs)(3)vSyndrome analysis:vThis syndrome is an exogenous affection characterized by dryness of the respiratory system, and at the early stage it may be accompanied b
40、y an exterior syndrome manifested by chills and fever. Dryness is apt to be transformed into heat or fire, which goes deep into the lungs or injures the blood vessels, thus causing chest pain and hemoptysis. In the early stage, when the pathogenic dryness stays chiefly in the upper portion of the lu
41、ngs, only the tip of the tongue is reddened中医学英文Differentiationofsyndrom6.Invasion of the lungs by dryness (dryness of the lungs)(3)but when it goes deep into the lungs, the whole tongue is reddened. The white and yellow colors of the tongue coating depend upon the intensity of the heat into which t
42、he pathogenic dryness has been transformed. The rapidity of the pulse also corresponds to the intensity of the heat中医学英文Differentiationofsyndrom6.Invasion of the lungs by dryness (dryness of the lungs)(3)vBoth invasion of the lungs by dryness and deficiency of lung yin are characterized by dryness s
43、ymptoms, but the former is acute while the latter is chronic. If there is any fever in the exogenous affection of the lungs by dryness, it only persists for a short period and is often accompanied by chills, but in deficiency of lung yin there is usually long-standing afternoon fever accompanied by
44、malar flush and heat sensation in the chest, palms and soles.中医学英文Differentiationofsyndrom6.Invasion of the lungs by dryness (dryness of the lungs)(4)vHerbal formula :vSangxing Tang 中医学英文Differentiationofsyndrom7.Deficiency of fluid in the large intestine (1)vSummarize:vThis is a syndrome of yin def
45、iciency, either constitutional, or occurring during a chronic disease with impairment of yin fluid or after a febrile disease when the consumed fluid has not yet been restored. It may also take place after excessive postpartum hemorrhage. As a constitutional disorder, it is most frequently manifeste
46、d as habitual constipation.中医学英文Differentiationofsyndrom7.Deficiency of fluid in the large intestine (2)vClinical manifestations:Hard fecal mass with difficult infrequent elimination dryness of the mouth and throat,Accompanied by foul breath and dizzinessDry reddened tongue Thready, hesitant pulse.中
47、医学英文Differentiationofsyndrom7.Deficiency of fluid in the large intestine (3)vSyndrome analysis:Deficiency of fluid in the large intestine makes the fecal mass hard and difficult to eliminate. The defecation is often infrequent-once every three or five days or even more than ten days. Yin deficiency
48、causes dryness of the mouth and throat.Retention of the fecal mass in the large intestine may lead to upward flow of turbid qi, resulting in foul breath and dizziness. Deficiency of yin is accompanied by relative exuberance of yang, and hence the tongue is dry and reddened. Thready and hesitant puls
49、e is due to insufficient fluid in the arteries.中医学英文Differentiationofsyndrom7.Deficiency of fluid in the large intestine (4)vHerbal formula :vZengye Chengqi Tang中医学英文Differentiationofsyndrom8.Sinking of spleen qi (1)vSummarize:vThis is also called “sinking of the qi of the middle energizer” or simpl
50、y “sinking of middle qi.” it is often a further development of deficiency of spleen qi and may occur in some cases of chronic colitis, functional disorders of the intestines, prelapse of the rectum or uterus, and probably also in gastroptosis and other visceroptosis in west medicine.中医学英文Differentia
51、tionofsyndrom8.Sinking of spleen qi (2)vClinical manifestations:Deficiency of spleen qi (or yang) plus bearing-down sensation in the abdomen,Incessant diarrhea, Dripping of urine after urinationProlapse of the rectum or uterus.中医学英文Differentiationofsyndrom8.Sinking of spleen qi (3)vSyndrome analysis
52、:vAll the manifestations listed above in addition to deficiency of spleen qi are due to failure of the spleen in its lifting function.中医学英文Differentiationofsyndrom8.Sinking of spleen qi (4)vHerbal formula :vSijunzi Tang (p288)中医学英文Differentiationofsyndrom9.Failure of the spleen to control blood (1)v
53、Summarize:vThis is characterized by chronic bleeding, particularly in the lower part of the body, and is often seen in functional uterine bleeding, hematochezia, hematuria and hemorrhagic diseases.中医学英文Differentiationofsyndrom9.Failure of the spleen to control blood (2)vClinical manifestations:Menor
54、rhagiaHematocheziaHematuria Subcutaneous hemorrhageOther chronic hemorrhagesPale tongueThready, weak pulse.中医学英文Differentiationofsyndrom9.Failure of the spleen to control blood (3)vSyndrome analysis:The spleen has the function of keeping the blood flowing within the blood vessels.If deficiency of sp
55、leen qi affects this function, blood will escape from the blood vessels.Since the bleeding is due to chronic deficiency of spleen qi, which is often accompanied by loss of its ascending power or lifting function, the bleeding is often chronic and chief occurring in the lower part of the body. 中医学英文D
56、ifferentiationofsyndrom9.Failure of the spleen to control blood (4)vHerbal formula :vGuipi Tang (p295)中医学英文Differentiationofsyndrom10.Stagnation of food in the stomach (1)vSummarize:vThis is a syndrome caused by impaired digestive function of the stomach with stagnation of undigested food. In most c
57、ases, it occurs in indigestion due to improper diet, particularly due to taking too much food and drink at one meal. It may also be attributed to weakness of the stomach. 中医学英文Differentiationofsyndrom10.Stagnation of food in the stomach (2)vClinical manifestations:Epigastric fullness, distension or
58、painBelching with fetid odor Acid eructation or vomiting of sour fetid gastric contents (with alleviation of epigastric distension or pain after vomiting), or flatus and loose bowels with sour fetid stools; thick greasy tongue coating and slippery pulse.中医学英文Differentiationofsyndrom10.Stagnation of
59、food in the stomach (3)vSyndrome analysis:Stagnation of undigested food in the stomach causes epigastric fullness, distension or pain. Disturbance in the descending function of the stomach leads to upward perversion, and so there is belching with fetid odor, acid eructation or vomiting of sour fetid
60、 undigested food. 中医学英文Differentiationofsyndrom10.Stagnation of food in the stomach (3)After vomiting the pathogenic factor (undigested food) is removed, and so the distension and pain are alleviated. Stagnation of undigested food leads to formation of endogenous damp and impairment of the intestine
61、 function, and thus frequent flatus and loose stools with sour fetid odor. Stagnation of undigested food in the stomach forces the turbid qi to ascend, thus forming the thick greasy tongue coating. Slippery pulse in food stagnation suggests excess of the pathogenic factor (undigested food) confronte
62、d by powerful qi and surging blood.中医学英文Differentiationofsyndrom10.Stagnation of food in the stomach (4)vHerbal formula :vBaohe Wan (p301)中医学英文Differentiationofsyndrom11.Fire in the stomach ( stomach fire) (1)vSummarize:vThis is usually due to partiality for spicy hot food which produces heat and fi
63、re, emotional depression which leads to transformation of stagnated qi into fire, or invasion of the stomach by exogenous pathogenic heat. Clinically, the syndrome may be seen in gastritis, ulcerative stomatitis, periondontal diseases and diabetes mellitus.中医学英文Differentiationofsyndrom11.Fire in the
64、 stomach ( stomach fire) (2)vClinical manifestations:Burning pain in the epigastrium accompanied by acid regurgitation or vomiting right after eating; thirst with desire for cold drinks.polyphagia with frequent hunger; foul breath, ulceration in the mouth, swollen, painful and bleeding gums. Constip
65、ation and scanty concentraded urine, reddened tongue with a yellow coating, slippery, rapid pulse.中医学英文Differentiationofsyndrom11.Fire in the stomach ( stomach fire) (3)vSyndrome analysis:vFire in the stomach causes burning pain. It also leads stomach qi adversely upwards, and so there is vomiting r
66、ight after eating. However, stomach fire also means hyperactivity of the stomach, and so in some cases the patient complains of excessive desire for food. The stomach meridian sends its branches to the gums. Fire of the stomach leads to ulceration in the mouth, and swollen, painful, bleeding gums, a
67、nd forces turbid qi in the stomach to flow upwards, causing foul breath. 中医学英文Differentiationofsyndrom11.Fire in the stomach ( stomach fire) (3)vFire due to emotional depression usually comes from stagnant qi in the liver (which produces acid according to the five elements theory), and hence causes
68、acid regurgitation. Constipation, scanty, concentrated urine and reddened tongue with a yellow coating are signs indicating the exuberance of fire. Fire expedites blood flow, and so the pulse is not only rapid but also slippery中医学英文Differentiationofsyndrom11.Fire in the stomach ( stomach fire) (4)vH
69、erbal formula :vYunu Jian (p506)中医学英文Differentiationofsyndrom12.Stagnation of liver qi (or “liver qi” for short) (1)vSummarize:vStagnation of liver qi is characterized by disturbance in the function of smoothing and regulating the flow of qi and blood. It is often induced by emotional depression or
70、violent psychic stimulation, but may be caused by invasion of certain exogenous pathogenic factors. From the western medical perspective, this syndrome may occur in anxiety disorders, de pression, hepatitis, cholecystitis, and menstrual disorders.中医学英文Differentiationofsyndrom12.Stagnation of liver q
71、i (or “liver qi” for short) (2)vClinical manifestations:Depressed mood, irritability and irascibility, distension and pain in the lateral pectoral, hypochondriac and lower abdominal regions traversed by the liver meridian, discomfort in chest, frequent sighing, feeling of a lump in the throat, and i
72、n women distending pain of the breast, dysmenorrhea, irregular menstruation or even amenorrhea; stringy pulse.中医学英文Differentiationofsyndrom12.Stagnation of liver qi (or “liver qi” for short) (3)vSyndrome analysis:The liver has the function of smoothing and regulation the flow of qi. Qi is not confin
73、ed to energy for bodily activities; it also involves mental activities and emotions. Therefore, when liver qi is depressed and stagnant, there is a depressed or irritable mood. Distension and pain in the lateral pectoral, hypochondriac and lower abdominal regions are symptoms caused by stagnation of
74、 liver qi along the liver meridian. Stagnant liver qi may also impede the functional activities of the lungs, leading to discomfort in the chest and frequent sighing. 中医学英文Differentiationofsyndrom12.Stagnation of liver qi (or “liver qi” for short) (3)If stagnant liver qi promotes the production of p
75、hlegm, and the phlegm together with stagnant qi moves upward along the liver meridian to the throat, the accumulated phlegm and stagnant qi will be felt as a foreign body in the throat. The liver meridian is connected with the thoroughfare vessel, which controls menstruation in women. Stagnation of
76、liver qi often impairs the normal flow of blood in the thoroughfare vessel, thus causing menstrual disorders. A stringy pulse suggests a disease of the liver中医学英文Differentiationofsyndrom12.Stagnation of liver qi (or “liver qi” for short) (4)vHerbal formula :vChaihu Sugan San (p282)中医学英文Differentiati
77、onofsyndrom13.stirring-up of the liver wind (or “liver wind” for short) vSyndromes characterized by “shaking” symptoms, such as tremors, convulsions and dizziness as if about to swoon, belong to the condition know as “stirring-up of liver wind.” clinically, they can be classified into three patterns
78、:Transformation of exuberant liver fire into wind, Production of internal wind due to extreme heat,Production of internal wind due to deficiency of yin. 中医学英文Differentiationofsyndrom13.stirring-up of the liver wind (Transformation of exuberant liver fire into wind) (1)v(1)Transformation of exuberant
79、 liver fire into wind:vSummarize:vThis often occurs in cases of deficiency of liver yin with exuberant yang. The exuberance of liver yang to its extreme may turn into internal wind as seen in cerebrovascular accidents.中医学英文Differentiationofsyndrom13.stirring-up of the liver wind (Transformation of e
80、xuberant liver fire into wind) (2)vClinical manifestations:vSudden onset of dizziness, fainting, stiffness of the limbs, aphasia, hemiplegia or even total loss of consciousness; reddened tongue with a white or greasy coating, and a stringy, forceful pulse.中医学英文Differentiationofsyndrom13.stirring-up
81、of the liver wind (Transformation of exuberant liver fire into wind) (3)vSyndrome analysis:vThe syndrome usually occurs in a case of chronic deficiency of liver yin with exuberant yang. Once the exuberant yang is transformed into internal wind, a sudden rising of the wind disturbs the normal flow of
82、 qi and blood, resulting in dizziness and fainting. The liver meridian is connected with the root of the tongue. Ascent of the wind along the meridian to the tongue impairs speech. If the liver wind rises together with phlegm, the heart will be clouded, and loss of consciousness ensues. Reddening of
83、 the tongue is due to yin deficiency. Since there is no fire, the coating is still white, but it may be greasy if the wind is combined with phlegm. A stringy and forceful pulse signifies up-stirring of yang and wind.中医学英文Differentiationofsyndrom13.stirring-up of the liver wind (Production of interna
84、l wind due to extreme heat) (1)vSummarize:vThis refers to febrile convulsions. 中医学英文Differentiationofsyndrom13.stirring-up of the liver wind (Production of internal wind due to extreme heat) (2)vClinical manifestations:vHigh fever with delirium or loss of consciousness and opisthotonos; reddened or
85、deep-red tongue and stringy, rapid pulse.中医学英文Differentiationofsyndrom13.stirring-up of the liver wind (Production of internal wind due to extreme heat) (3)vSyndrome analysis:vIn this syndrome the internal wind is derived from extreme heat. Treme pathogenic heat often invades the percardium, leading
86、 to delirium or loss of consciousness. When the heat invades the liver meridian, it induces internal wind, resulting in convulsions and opisthotonos. A reddened or deep-red tongue and a stringy and rapid pulse are consistent with invasion of the liver by heat.中医学英文Differentiationofsyndrom13.stirring
87、-up of the liver wind (Production of internal wind due to deficiency of yin) (1)vSummarize:vThis is often encountered in chronic neurological diseases marked by involuntary movements. 中医学英文Differentiationofsyndrom13.stirring-up of the liver wind (Production of internal wind due to deficiency of yin)
88、 (2)vClinical manifestations:vTremors or numbness of the limbs, involuntary head shaking, pale tongue and stringy, thready pulse.中医学英文Differentiationofsyndrom13.stirring-up of the liver wind (Production of internal wind due to deficiency of yin) (3)vSyndrome analysis:vThe liver supplies blood to nou
89、rish the tendons. Deficiency of liver blood impairs the normal functioning of the tendons, resulting in numbness and involuntary movements. A pale tongue with a stringy pulse indicates deficiency of liver blood.中医学英文Differentiationofsyndrom13.stirring-up of the liver wind (or “liver wind” for short)
90、 (4)vHerbal formula :vTianma Gouteng yin (p306)中医学英文Differentiationofsyndrom14.damp-heat in the liver and gallbladder(1)vSummarize:vThe damp-heat that invades the liver and gallbladder may be either exogenous or endogenous. The endogenous damp-heat comes from excessive intake of greasy food. The syn
91、drome often occurs in icteric jaundice, acute cholecystitis and cholelithiasis in western medicine.中医学英文Differentiationofsyndrom14.damp-heat in the liver and gallbladder(2)vClinical manifestations:vHypochondriac distension and pain, better taste in the mouth, poor appetite, nausea, vomiting, abdomin
92、al distension, scanty and dark-yellow urine, yellow sticky or greasy tongue coating and a stringy, rapid pulse. In addition, there may be alternate chills and fever, or yellow discoloration of the sclera and skin. Eczema of the scrotum, swelling and burning pain in the testis or yellow, foul leukorr
93、hea with pruritus of the vulva also suggest damp-heat in the liver meridian. 中医学英文Differentiationofsyndrom14.damp-heat in the liver and gallbladder(3)vSyndrome analysis:vDamp-heat impairs the free flow of qi in the liver and gallbladder, causing hypochondriac distension and pain. The upward flow of
94、gallbladder qi gives rise to a bitter taste in the mouth. The accumulation of damp-heat also impairs the functions of the spleen and the stomach in ascending and descending, causing poor appetite, nausea, vomiting and abdominal distension. Scanty and dark-yellow urine is due to downward infusion of
95、damp-heat into the bladder. yellow sticky or greasy tongue coating with a stringy and rapid pulse is consistent with damp-heat in the liver and gallbladder. 中医学英文Differentiationofsyndrom14.damp-heat in the liver and gallbladder(3)vWhen the damp-heat leads to confrontation between the anti-pathogenic
96、 and pathogenic factors in the gallbladder, alternate chills and fever arise. If the normal flow of bile is obstructed by damp-heat, the bile will spread to the exterior portion of the body and result in yellow discoloration of the sclera and skin. Since the liver meridian curves around the external
97、 genitalia, downward infusion of damp-heat may result eczema of the scrotum, or swelling of and a burning pain in the testis in men, and yellow, foul leukorrhea with pruritus of the vulva in women. 中医学英文Differentiationofsyndrom14.damp-heat in the liver and gallbladder(4)vHerbal formula:vLongdan Xieg
98、an Tang (p269)v(Decoction of Gentian to Purge the Liver)中医学英文Differentiationofsyndrom15.Deficiency of kidney yin (1)vSummarize:vThe common causes of deficient kidney yin include impairment of the kidneys by a protracted disease, weak constitution or poor natural endowment, sexual overindulgence and
99、excessive use of warming, desiccating drugs. The syndrome is often seen in chronic debility, tuberculosis, diabetes mellitus, chronic nephritis, disorders of the sexual function, sterility.中医学英文Differentiationofsyndrom15.Deficiency of kidney yin (2)vClinical manifestations:vSoreness and weakness of
100、the loins and knees, impaired hearing, tinnitus; seminal emission, oligospermia and sterility in men, and amenorrhea and infertility in women; afternoon fever, malar flush, heat sensation in the chest, palms and soles, night sweating, reddened tongue with scanty or no coating, and a deep, thready pu
101、lse.中医学英文Differentiationofsyndrom15.Deficiency of kidney yin (3)vSyndrome analysis:vThe syndrome is characterized by common symptoms of kidney disorders and deficiency of yin with endogenous heat. Because the kidneys replenish marrow, which is believed to be the substance that nourishes the bones, a
102、nd particularly because the loins are where the kidneys are located, deficiency of kidney yin usually brings about soreness and weakness of the loins and knees. The kidneys have a specific relationship with the ears, so deficiency of kidney yin often causes tinnitus and impairs the hearing. 中医学英文Dif
103、ferentiationofsyndrom15.Deficiency of kidney yin (3)vSince kidney yin includes the reproductive essence, deficiency of kidney yin may be associated with oligospermia and sterility in males, and amenorrhea and infertility in females. Deficiency of kidney yin often leads to exuberance of endogenous he
104、at and “ministerial fire.” afternoon fever, malar flush, and heat in the chest, palms and soles are general manifestations of endogenous heat. Exuberant ministerial fire disturbs the storage of essence, causing seminal emissions. Kidney yin deficiency makes the resource of menstrual blood insufficie
105、nt, resulting in oligomenorrhea or even amenorrhea. A reddened tongue with a scanty or no coating and a deep, thready pulse are signs of yin deficiency with endogenous heat.中医学英文Differentiationofsyndrom15.Deficiency of kidney yin (4)vHerbal formula :vLiuwei Dihuang Tang (p296)v(Decoction of Six Ingr
106、edients with Rehmannia)中医学英文Differentiationofsyndrom16.Deficiency of kidney yang(1)vSummarize:vThis is often due to constitutional weakness, old age, chronic diseases involving the kidneys and overindulgence in sex. It occurs chiefly in debility after a protracted disease, general weakness in the ag
107、ed, lumbago, chronic nephritis, adrenocortical insufficiency, hypothyroidism and sexual dysfunction.中医学英文Differentiationofsyndrom16.Deficiency of kidney yang(2)vClinical manifestations:vSoreness and weakness of the back and loins, aversion to cold with cold limbs, listlessness, hyposexuality, impote
108、nce, premature ejaculation, oliguria and edema, chronic diarrhea, pale and puffy or darkened and dull complexion, pale, plump tongue with a thin, white coating, and a deep, thready pulse. 中医学英文Differentiationofsyndrom16.Deficiency of kidney yang(3)vSyndrome analysis:vThe loins are where the kidneys
109、are located, and the kidneys dominate the bones. Decline of kidney yang impairs the nourishment of the bones, causing soreness and weakness in the back, particularly marked in the lumbar region. Kidney yang supplies vital fire (heat energy) to warm up the body. Deficient kidney yang leads to slow vi
110、tal fire, hence the patient is averse to cold and has cold limbs. The kidneys are in charge of reproduction. The part of vital fire for sexual potency is called “ministerial fire.” in deficiency of kidney yang, the “ministerial fire.” also declines, and so there is hyposexuality, impotence, or prema
111、ture ejaculation.中医学英文Differentiationofsyndrom16.Deficiency of kidney yang(3)vThe above are the general manifestations of kidney yang deficiency. The kidneys are also in charge of water metabolism, and supply vital fire for digestion. Deficiency of kidney yang may give rise to edema and diarrhea as
112、well, but if these disorders are prominent, the diagnosis should be specified as deficiency of kidney yang with water in flood or with chronic diarrhea.中医学英文Differentiationofsyndrom16.Deficiency of kidney yang(3)vDeficiency of yang is usually associated with lack of vigor, and so the patient is list
113、less. Pale and puffy complexion, pale, plump tongue with thin, white coating and deep, thready pulse are common signs consistent with yang deficiency. If kidney yang is in a state of extreme deficiency, the turbid yin will indiltrate the surface of the body, making the complexion darkened and dull.
114、中医学英文Differentiationofsyndrom16.Deficiency of kidney yang(4)vHerbal formula:vJingui Shenqi Wan (p298) (Kidney-Qi Pill of Golden Chamber)中医学英文Differentiationofsyndrom17.Deficiency of kidney yang with water in flood(1)vSummarize:vThis is a specific pattern of kidney yang deficiency characterized by di
115、sordered water metabolism. It is chiefly encountered in nephrotic syndrome and congestive heart failure.中医学英文Differentiationofsyndrom17.Deficiency of kidney yang with water in flood(2)vClinical manifestations:vGeneral manifestations of deficiency of kidney yang combined with anasarca, particularly r
116、emarkable below the waist, accompanied by oliguria and abdominal distension. Sometimes edema occurs, accompanied by cardiac palpitations, shortness of breath, orthopnea and expectoration of profuse, thin sputum, plump tongue with a thin, white or thick, greasy coating, and a deep, thready pulse. 中医学
117、英文Differentiationofsyndrom17.Deficiency of kidney yang with water in flood(3)vSyndrome analysis:vThe kidneys dominate the water metabolism. In deficiency of kidney yang, the opening of the “sluice-valve” may be impaired, resulting in oliguria, edema and even ascites with abdominal distension. If the
118、 retained water attacks the heart, cardiac palpitations occur as well as shortness of breath and orthopnea. Retained water may turn into phlegm, leading to profuse expectoration. A plump tongue with a thin, white coating and a deep, thready pulse indicate deficiency-cold, but excessive water-damp ma
119、y also give rise to a thick, greasy coating. 中医学英文Differentiationofsyndrom17.Deficiency of kidney yang with water in flood(4)vHerbal formula:vZhenwu Tang（p493）中医学英文Differentiationofsyndrom18.Incoordination of the heart and the kidneys(1)vSummarize:vThis is often causes by impairment of yin in chroni
120、c diseases, overindulgence in sex, too much worrying or emotional depression. It may be encountered in anxiety states, anemia and chronic consumptive diseases.中医学英文Differentiationofsyndrom18.Incoordination of the heart and the kidneys(2)vClinical manifestations:vInsomnia, palpitations, fidgetiness,
121、dizziness, tinnitus, hypomnesis, soreness of the loins, nocturnal emission, heat in the chest, palms and soles, dryness of the throat and mouth; reddened tongue and a thready, rapid pulse.中医学英文Differentiationofsyndrom18.Incoordination of the heart and the kidneys(3)vSyndrome analysis:vNormally, hear
122、t fire (yang) comes down to warm the kidneys and the kidney water (yin) goes up to irrigate the heart. Breakdown of this balanced condition is called “incoordination of the heart and the kidneys,” which is characterized by insomnia accompanied by exuberance of heart fire (manifested by fidgetiness a
123、nd palpitations) and deficiency of kidney yin (manifested by dizziness, tinnitus and hypomnesis due to inadequate replenishing of the marrow and brain). 中医学英文Differentiationofsyndrom18.Incoordination of the heart and the kidneys(3)vThe basic pathological change of this symdrome is deficiency of yin
124、with exuberant fire. Since the fire is of the deficiency type, it causes feverishness in the chest, palms and soles, dryness of the throat and mouth, reddened tongue, and thready, rapid pulse. When the storage of reproductive essence os disturbed by the fire, there is nocturnal emission. The loins a
125、re the seat where the kidneys are located. Soreness of the loins signifies that the kidneys are involved in the syndrome.中医学英文Differentiationofsyndrom18.Incoordination of the heart and the kidneys(4)vHerbal formula:vJiaotai Wan中医学英文Differentiationofsyndrom19.Yin deficiency of the liver and the kidne
126、ys(1)vSummarize:vThis is a combined deficiency syndrome of liver yin and kidney yin. Clinically, it may be encountered in anemia, hypertension, chronic hepatitis, anxiety states, menstrual disorders.中医学英文Differentiationofsyndrom19.Yin deficiency of the liver and the kidneys(2)vClinical manifestation
127、s:vVertigo, blurred vision, tinnitus, irritability, irascibility, weakness and soreness of the loins and knees, hypochondriac pain, hot sensation in the chest, palms and soles, malar flush, night sweating, seminal emission in men and oligomenorrhea or amenorrhea in women, reddened tongue with scanty
128、 coating, and a thready, rapid pulse.中医学英文Differentiationofsyndrom19.Yin deficiency of the liver and the kidneys(3)vSyndrome analysis:vThe mutual promotion of yin between the liver and the kidneys is so close that the two organs are said to have the same source. If liver yin is abundant, the surplus
129、 yin is stored in the kidneys, and if kidney yin is abundant, it constantly nourishes the liver. In addition, the essence (pertaining to yin) stored in the kidneys and the blood (pertaining to yin) stored in the liver are mutually convertible. Therefore, deficiency of the yin of one is often accompa
130、nied by deficiency of the yin of the other.中医学英文Differentiationofsyndrom19.Yin deficiency of the liver and the kidneys(3)vDeficiency of liver yin usually leads to exuberance of liver yang, which, going upwards, causes vertigo, blurred vision, tinnitus, and irascibility. It also brings about pain alo
131、ng the liver meridian, particularly in the hypochondriac regions. Deficiency of kidney yin leads to generation of endogenous heat and exuberance of endogenous fire (“ministerial fire”), resulting in malar flush, and heat in the chest, palms and soles, and night sweating. If the exuberant ministerial
132、 fire agitates the reproductive essence in men, there will be seminal emissions. In women, deficiency of the liver and kidney yin empties the thoroughfare and conception vessels, resulting in oligomenorrhea. A reddened tongue with scanty coating and a thready, rapid pulse are signs of yin deficiency
133、.中医学英文Differentiationofsyndrom19.Yin deficiency of the liver and the kidneys(4)vHerbal formula :vZuogui Wan (p487)中医学英文Differentiationofsyndrom20.Disharmony of the liver and the spleen(1)vSummarize:vThis is a combined syndrome of stagnation of liver qi and impaird transporting and transforming funct
134、ion of the spleen. If stagnation of liver qi is primary, it is usually caused by emotional depression with anger, which injures the liver; if dysfunction of the spleen is primary, it is usually due to improper diet or over-strain that injures the spleen. Clinically, it is often encountered in functi
135、onal gastro-intestinal disorders, hepatitis, liver cirrhosis, peptic ulcer chronic gastritis, and other chronic digestive diseases.中医学英文Differentiationofsyndrom20.Disharmony of the liver and the spleen(2)vClinical manifestations:vDistension, fullness and shifting pain in the chest and hypochondrium,
136、 frequent sighing, low spiritedness or irascibility, anorexia, abdominal distension, loose stools, borborygmi with flatus, or abdominal pain which is alleviated after diarrhea; white or greasy tongue coating, and a stringy pulse.中医学英文Differentiationofsyndrom20.Disharmony of the liver and the spleen(
137、3)vSyndrome analysis:vDistension, fullness and shifting pain in the chest and hypochondrium, frequent sighing, low spiritedness or irascibility are caused by stagnation of liver qi. Anorexia, abdominal distension, loose stools, borborygmi with flatus, or abdominal pain which is alleviated after diar
138、rhea impairment of the transporting and transforming function of the spleen. Abdominal pain is due to stagnation of qi in the abdomen. After defecation the stagnated qi is removed and hence the abdominal pain is relieved. Stagnated liver qi tends to impair the spleen function. 中医学英文Differentiationof
139、syndrom20.Disharmony of the liver and the spleen(3)vThis is called “wood overchecks earth” according to the five elements theory. On the other hand, dysfunction of the spleen in transportation and transformation often causes stagnation of qi and damp in the middle energizer, which may also impair th
140、e function of the liver in smoothing and regulating the flow of qi. This is called “earth counterchecks wood.” since there is no marked manifestation of heat or fire, the tongue coating is white, but it may be greasy because of accumulation of damp due to dysfunction of the spleen. A stringy pulse is a sign showing the stagnation of liver qi.中医学英文Differentiationofsyndrom20.Disharmony of the liver and the spleen(4)vHerbal formula :vXiaoyao San (Ease Powder)v(p280)中医学英文Differentiationofsyndrom谢谢中医学英文Differentiationofsyndrom中医学英文Differentiationofsyndrom
