Treatment of Disease
(Selected Diseases)
ACR class 6
WINDSTROKE
Wind stroke
• Emergency case
• manifested by falling down in a fit with
loss of consciousness, hemiplegia,
slurred speech and deviated mouth.
• Characterized by abrupt onset with
pathological changes varying quickly like
the wind, from which the term wind
stroke comes.
• Attack on the zang-fu organs
• Tense syndrome: Wind stirred up by
upsurge of liver yang sends qi and
blood upwards, which together with the
accumulated phlegm fire disturb the
mind. Disturbance of the mind by the
phlegm heat or collection of excessive
fire in the heart and liver.
• Flaccid syndrome: Deficiency of the
primary qi or collapse of the kidney
yang
• Attack on the meridians and
collaterals
•
•
•
•
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Tense Syndrome
Clinical manifestations: Collapse with loss of consciousness,
tightly closed hands and clenched jaws, flushed face, coarse
breathing, retention of urine, constipation, red tongue with
thick yellow or dark grey coating, wiry, slippery and forceful
pulse.
Treatment principle: Reduce wind fire, resolve phlegm and
promote resuscitation
Flaccid Syndrome
Clinical manifestations: Collapse with sudden loss of
consciousness with mouth open and eyes closed, feeble
breathing, flaccid paralysis of limbs, incontinence of urine,
flaccid tongue, thready weak pulse and cold limbs, weak or
big floating forceless pulse.
Treatment principle: Restore yang from collapse
• Attack on the meridians and
collaterals
• Clinical manifestations
• Hemiplegia, numbness of the limbs,
deviated mouth , slurring of speech,
accompanied by headache, dizziness,
vertigo, twitching of muscles,
• Treatment principle
• Remove obstruction from meridians
and collaterals and reduce wind
HEADACHE
Etiology and pathology
•
•
External pathogenic factors
• Invasion of wind into the meridians and
collaterals
Endogenous factors
• Hyperfunction of the liver yang
•
•
emotions
overwork
• dampness
• Accidents
•
Blood stasis
• Deficiency of qi and blood
Diagnosis
•
Diagnosis according to channels
• Top of the head, behind eyes -------liver
channel
• Sides of the head-----shaoyang channel
• Forehead------yangming channel
• Back of the head (occiput)------ taiyang
channel
• Diagnosis according to the nature of pain
• Dull ache, hollow pain, feeling of empty
• Feeling of heaviness, heavy, muzzy,
wrapped in a cloth
• Distending pain, throbbing, bursting,
pulsating, wind heat, liver yang rising,
liver fire
• Stiff, occiput: wind cold
• Pulling pain: spasmodic in nature and
short in duration—liver wind
• Stabbing pain: splitting headache--blood
stasis
• Diagnosis according to amelioration and
aggravation
• Time, weather, emotions, posture,
Patterns
• Invasion of pathogenic wind
• Liver yang rising
• Liver fire blazing
• Accumulation of dampness
• Blood stasis
• Qi and blood deficiency
Invasion of
pathogenic wind
•
•
Clinical Manifestations
–
Headache worse on exposure to wind.
The pain may extend to the neck and
back region or with a stiffness on the
occiput. Acute onset, short duration, thin
coat, floating pulse
Treatment principle
–
Release the exterior and remove the
obstruction from the channels
Liver yang rising
•
•
Clinical Manifestations
Distending, bursting or throbbing
headache, irritability, tinnitus and
dizziness, symptoms of liver and
kidney yin deficiency. Wiry pulse
Treatment principle
Pacify liver, nourish Yin and
alleviate pain
–
–
Liver fire blazing
•
•
Clinical Manifestations
Distending, bursting or throbbing
headache, irritability, tinnitus and
dizziness, thirst, bitter taste, scantydark urine, constipation with dry
stools, red eyes, a red tongue with
yellow coating, wiry rapid pulse.
Treatment principle
Pacify liver and clear fire
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–
•
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Accumulation of
dampness
Clinical Manifestations
–
The headache is dull and feels as if the
head is wrapped in a cloth or full of cotton
wool. Sensation of heaviness and difficulty
in thinking. Dizziness. Symptoms worse in
the mornings. Nausea, lack of appetite, a
feeling of fullness of the chest and
epigastrium, loose stool, thick sticky tongue
coating and a slippery pulse.
Treatment principle
–
Resolve dampness and ascend clear yang
LIN SYNDROME
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Heat Lin
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Pathogenesis
Full type: full heat
Empty type: empty heat
Stone Lin
•
Full type: damp-heat
Qi Lin
•
•
Full type: stagnation of qi
Empty type: qi deficiency or qi sinking
Blood Lin
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Full type: blood heat
Empty type: blood or qi deficiency
Sticky (Cloudy) Lin
•
•
Full type: dampness
Empty type: dampness with qi deficiency
Heat Lin
• Clinical manifestations:
• frequent, scanty and difficult urination,
burning pain on urination, dark urine with a
strong smell, bitter taste in the mouth, pain
on the sacrum, constipation, thirst. Red
tongue, yellow sticky coating, rapid slippery
pulse.
• Treatment principle:
• Clear heat, drain dampness, and open the
water passages
Stone Lin
• Clinical manifestations:
• stone or sand in the urine, difficult
•
urination which may stop suddenly,
sacral pain, blood in urine, red
tongue with thick-sticky coating.
Rapid, wiry pulse.
Treatment principle:
Open the water passages and expel
the stones
•
Qi
Lin
• Clinical manifestations:
• Full type: difficult and painful urination,
hypochondrium pain and distension,
irritability, wiry and deep pulse.
• Empty type: difficult urination, weak
constitution, tiredness, pale tongue, week
pulse
• Treatment principle:
• Full type: move qi, eliminate stagnation,
open the water passage
• Empty type: tonify and raise qi, open the
water passage
Blood Lin
•
Clinical manifestations:
•
•
•
Full type: difficult urination, burning pain on urination, blood
in the urine which could take the form of small clots, mental
restlessness, red tongue and rapid pulse.
Empty type: blood in urine, slight pain on urination, low
back pain, 5-palms heat, hot flushes. Red tongue without
coating, thin rapid pulse.
Treatment principle:
•
•
Full type: Clear heat, cool blood, stop bleeding and open
the water passage
Empty type: nourish yin, clear heat, stop bleeding and open
the water passage
Cloudy Lin
•
Clinical manifestations:
•
•
•
Full type: turbid or cloudy urine like rice soup,
difficult urination, a sticky tongue coating and a
slippery pulse
Empty type: turbid or cloudy urine like rice soup,
slight difficult urination, tiredness, dizziness, lower
back pain, pale tongue with sticky tongue coating
and a weak pulse
Treatment principle:
•
•
Full type: drain dampness, separate the clear from
the turbid, open the water passages
Empty type: tonify qi, strengthen kidneys, separate
the clear from the turbid, open the water passages
Painful Obstruction Syndrome
(Bi Syndrome)
• Bi syndrome indicates pain, soreness or
numbness of muscles, tendons and
joints from invasion of external wind,
cold, heat or dampness.
Etiology and
pathogenesis
• Invasion of external pathogenic factors
such as Wind, Cold, Heat and
Dampness causes obstruction in the
circulation of Qi and Blood in the
channels
•
Differentiation
According to the predominant pathogenic factor
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•
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Wandering Bi: pain move from joint to joint and caused chiefly by
pathogenic wind
Fixed Bi: fixed pain with soreness, heaviness, numbness and
swelling of joints and caused chiefly by pathogenic damp
Painful Bi: severe pain and caused chiefly by pathogenic cold
Heat Bi: severe pain with swollen hot red joints and caused by
heat
According to the locality of diseased area
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Skin Bi
Muscle Bi
Tendon Bi
Vessel Bi
Bone Bi
Wandering Bi
• Clinical manifestations:
• Wandering pain in the joints, especially
the wrists, elbows, knees and ankles,
limitation of movement, chills and fevers,
thin and sticky tongue coating, superficial
and tight or superficial and slow pulse.
• Treatment principle:
• Dispel wind, clear the collaterals.
• Activating and nourishing the blood,
based on the principle: “wind will be
naturally eliminated if blood circulates
smoothly”
Fixed Bi
• Clinical manifestations:
• Numbness and heavy sensation of the
limbs, soreness and fixed pain of the
joints, aggravated on cloudy and rainy
days, white and sticky tongue coating
and soft pulse.
• Treatment principle:
• Dispel dampness, clear the collaterals
Heat Bi
• Clinical manifestations:
•
Arthralgia involving one or several joints,
local redness, swelling and excruciating
pain with limitation of movement,
accompanied by fever and thirst, yellow
tongue coating, rolling and rapid pulse.
• Treatment principle:
•
Drain heat, clear the collaterals
Painful Bi
• Clinical manifestations:
•
Severe stabbing pain in the joints,
alleviated by warmth and aggravated by
cold, with fixed localization but no local
redness and hotness, thin and white
tongue coating, string-taut and tense
pulse.
• Treatment principle:
•
Dissipate cold, clear the collaterals
Infertility
• Etiology and pathology
• Kidney deficiency
• Liver stagnation
• Phlegm and dampness
• Blood stasis
Pattern Identification
• A. Kidney
Deficiency
and Treatment
• Clinical Manifestations: Failure to get
pregnant long after marriage, delayed
menstruation, sparse and light colored
menses or amenorrhea, hyposexuality, dark
and lusterless face, soreness of the loins and
knees, a feeling of coldness in the lower
abdomen, thin and clear leucorrhea, profuse
thin urine, loose stools, pale tongue with
whitish coating, a deep fine or deep slow
pulse.
• Treatment principle: Tonify kidney and
• B. Liver Qi stagnation
• Clinical Manifestations: Infertility, Irregular
menstruation, premenstrual syndrome, painful
period, distension at the hypochondrium
region, hot temper, depression, dark red
tongue with ecchymosis, wiry pulse.
• Treatment Principle: Soothe liver, move qi and
promote conception
• C. Accumulation of Dampness
• Clinical Manifestations
• Obesity, late scanty period or amenorrhea,
hirsute, leukorrhagia, dizziness, stuffiness at
the chest and epigastrium, nausea, pale
swollen tongue, white sticky tongue coating,
slippery pulse.
• Treatment Principle
• Drain dampness, move stagnation and
regulate periods
• D. Blood Stasis
• Clinical Manifestations: Infertility, painful
period, menses is dark in color, with
clots. Metrostaxis, postcoital bleeding,
painful coitus, dark red tongue with
spots, thin wiry pulse
• Treatment principle: Remove blood
stasis, regulate periods and promote
conception
Diabetes (Wasting
Thirst)
• Differentiation:
• Classical Differentiation of Wasting & Thirsting
disorder (Xiao Ke):
• Classically, Yin Deficiency with Empty Heat is
the root cause of wasting & thirsting disorder.
The differentiation is according to the 3 jiao as
described below.
• Upper Wasting - LU Heat
• Middle Wasting - ST Dryness
• Lower Wasting - KD Yin & Jing Deficiency
• Modern Differentiations of Conditions
involved with Type-II Diabetes:
• These tend to be more lifestyle related
involving poor diets &/or lack of exercise
among other factors.
• SP Qi Deficiency alone, w/dampness or
w/damp-heat
• LV Qi Stagnation alone or w/fire
Upper Wasting - LU
Heat
• Signs & Symptoms:
• Dry throat and mouth, thirst,
frequent urination.
• Tongue: Red w/dry yellow coat
• Pulse: Rapid
Middle Wasting - ST
Dryness
• Signs & Symptoms:
• Excessive appetite, thirst, epigastric
pain, constipation.
• Tongue: Yellow dry coat
• Pulse: Rapid
Lower Wasting - KD
Yin/Jing Xu
• Signs & Symptoms:
• Sore back/knees, weak lower body,
dizziness, blurry vision, frequent copious
urination, dry mouth.
• Tongue: Red w/no coat
• Pulse: Fine, rapid
SP Qi Deficiency
• Signs & Symptoms:
• Fatigue, weakness, poor appetite, loose
stools. May also generate dampness
over time, which may combine with heat.
• Tongue:
Pale w/scallops ( thick coating if
dampness)
• Pulse:
Empty (slippery if dampness)
LR Qi Stagnation
• Signs & Symptoms:
• Depression, easily angered,
belching or gas, PMS, menstrual
irregularities.
• Tongue:
Normal or Purple (red
w/yellow coat with LR Fire)
• Pulse:
Wiry (w/rapid with LR Fire)