Wen Bing 2, 3

Chapter 7  Warm-heat diseases

 (warm diseases,  wen re bing)

 

Content

1) feng wen (wind —- winter/spring)

2) chun wen (incubated heat —- spring)

3) shu wen     (summer heat —- summer)

4) qiu zao (dryness —- fall)

Feng wen (wind warm disease)

Concept, Aetiology, Pathogenesis, Syndrome and treatment

——————-

Concept

– epi?     Wind warmth

– location?      Wei level, LU         —–  ST, or  PC

– manifestation?   (at early stage) fever, mild aversion to c, mild thirst, cough

– seasons?    mostly in —  spring + winter (called: dong wen, ie, winter warmth)

– dong wen (winter-warm disease)?

– counterparts in western m?

Etiology and parthenogenesis

– Occurrence

Spring wind warmth 

attack body

 

APF ↓  unconsolidated superficial

 

occurrence

Winter wind warmth

(abnormal climate change)

 

– Pathogenesis

 

 

 

Wind heat −→

 

LU (wei)

 

        PC       −→          yang qi collapse

(reverse transmission)

(routine transmission)

*Qi −→ *yang ming −→ ying −→ blood

lingered PF + LU/ST yin def

(later stage)

 

*Qi:

– LU heat

– LU heat and fu excess

– LU heat transforming in to intestine

– skin rash due to LU heat

 

*Yang ming:

– heat in yang ming

– heat in Intestines

– ST heat and yin def

 

Diagnosis

Seasons:

Manifestations:

Early stage:

Middle stage:

Later stage:

Severe condition: reverse transmission–  PC

 

Syndrome and treatment

1) PF attacking LU/wei

Manifestations:

Treatment principle:

Formula:

yin qiao san

sang ju yin

 

2) LU heat

  1. a) LU heat excess

Manifestations:   + bloody phlegm, chest pain +

Treatment principle:

Formula: ma xing shi gan tang

 

  1. b) LU heat and fu excess (shi)

Manifestations:

Treatment principle:

Formula:     Xuan bai cheng qi tang:

shi gao 5 qian, da huang 3q, xing ren 2q, gua lou pi 1.5 q

 

  1. c) LU heat transmitting into intestine

Manifestations: fever, cough, thirst, diarrhea (smelly, hot sensation in anus), abd pain,

Treatment principle:

Formula: ge gen qin lian tang

Ge gen , huang qin, huang lian, gan cao

 

  1. d) LU heat and skin rashes

Manifestations: fever,

Treatment principle:

Formula: yin qiao san removing tan dou chi,

adding sheng di, mu dan pi, da qing ye, xuan shen

 

3) Phlegm heat in LU

 

Manifestations:

Treatment principle:

Formula: xiao xian xiong (tang) jia (add) zhi shi tang

 

Ban xia, huang lian, gua luo

 

4) heat in yang ming

  1. a) excess heat in yang ming

Manifestations:

Treatment principle: clear heat, protect b fluid

Formula: bai hu tang

 

  1. b) excess heat in intestine

Manifestations: + diarhea (watery, stinky), t-black dry with cracks

Treatment principle:

Formula: tiao wei cheng qi tang

 

Da huang

Meng xiao

Gan cao

 

  1. c) ST heat and yin damage

Manifestations:

Treatment principle:

Formula: zhu ye shi gao tang

 

+ Ren shen, Main men dong,

 

5) heat entering PC

 

  1. a) heat entering PC

Manifestations: delirium, fever, red, rapid thin p, cold limbs

Treatment principle:

Formula: qing ying tang,

an gong niu huang wan, zi xue dan, zhi bao dan

 

  1. b) heat entering PC and yang ming excess

Manifestations: + abd pain,(mass /) constipation, crimson t, deep rapid p

Treatment principle:

Formula: niu huang cheng qi tang

 

An gong niu huang wan + da huang

 

6) collapse of zheng qi

 

Manifestations: fever, low grade of consciousness, sweating; or

Treatment principle:

Formula: sheng mai san, shen fu tan,

 

7) lingered pathogen

 

Manifestations: fever (low grade, or no fever),  red t, scant c, thin p

Treatment principle:

Formula: sha shen mai men dong tang


Chun Wen (Spring Warm Diseases)

 Concept

– epi?  Latent

– location?                internal

– manifestation?   Fever, thirst, irritability, red t, yellow c, …….

– seasons?  spring

– occurrence features?  No external signs

– counterparts in western m?

Etiology and pathogenesis

– occurrence?   Xie qi exc + Zheng qi def

– location?

– by new xie qi triggering h xie qi?

– progress?

Diagnosis

– seasons:

– occurrence feature:

– features in later stage:   damage yin + wind/blood (convulsion, bleeding)

Syndrome and treatment

– location:    qi level, ying level, or xue level

– trigger factor: wind cold, or wind heat

– zheng qi vs xie qi:

 

1. early stage

a) heat in qi levelb) wei and qi level

c) heat burning ying yin — qing ying tang

d) pathogen in wei and ying

 

2. excess heat in qi level

a) heat stagnated in chest/diaphragm

b) heat blazing in chest/diaphragm —– liang ge san

c) yang ming ————————————– bai hu tang

d) yang ming + Int yin damage ——— zeng ye cheng qi tang

e) yang ming + qi and b fluid def

f) yang ming + SI heat

 

3. excess heat in ying and xue level

a) pathogen in qi and ying (blood) —- yu nu jian + xuan shen, sheng di

b) heat moving blood ——— xi jiao di huang tang

c) heat + blood stasis —- tao he cheng qi tang

d) heat producing wind —— ling jiao gou teng tang

 

4. heat blocking PC

See feng wen part

 

5. collapse of yang qi

 

6. heat burning true yin

– true yin def

– wind due to yin def

– fire due to yin def    —-  huang lian e jiao tang

 

7. heat lingering in yin phase —– qing hao bie jia tang


shu wen (summer-heat warm disease)            

 

Concept

– epi

– location: no wei level

– manifestations: early stage – high body temperature, extreme thirst, profuse sweating

(qi level)

– seasons: summer

Etiology and pathogenesis

Damage b fluid/consume qi + “closing of HT orifice”, wind, and collapse

Diagnosis
Syndrome and treatment

qiu zao (autumn dryness)

 

 Concept

– epi?

– location?     LU, LI

– manifestation?

– seasons?

– occurrence features?

– counterparts in western m?

Etiology and pathogenesis

– occurrence?

– location?

– progress?   —

LU—ST/Int:

Diagnosis

– seasons:

– occurrence feature:

– features in later stage:

Treatment principle

– early stage

– middle stage

– later stage

 

“shang zao zhi qi, zhong zao zeng ye, xia zao zhi blood ”

upper: qi

middle: body fluid

lower: blood/bleeding