Wen Bing 3

Damp Heat Diseases

Shi Re Bing

 

Shi Wen (damp warmth)

Shu shi (summer heat + damp)

Fu shu  (incubated summer heat)

Syndrome patterns and treatment

 

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 Shi Wen Wen Bing

(Damp-warm warm diseases)

Concept: 

PF:  damp – heat(/warm)

Location: SP/ST

Manifestations: (initial stage):

fever (low grade),

aversion to cold,

heavy body/head,  stuffy chest, full abd,

greasy C, slow P

Seasons:  summer- fall + other seasons

 

Etiology, Pathogenesis

External factor (shu re/shu shi) + internal factor (SP/ST) → shu shi bing

 

Damp heat →nose/mouth → wei→ middle jiao (damp>heat)→ (damp=heat)

↓                                  ↓

Lower jiao                (heat>damp)

(heat-dryness)

Bleeding

Qi collapse

 

Diagnosis

– seasons: rainy

– slow onset (damp) → fever ↑ (persistent)

– long lasting, less transformation, bleeding (int, later stage)

 

 

Differentiation key:

1) Damp vs heat

Initial: damp>heat

Later stage: heat>damp

 

2) Location:

upper jiao:

lower j:

middle j:

 

3) SP/ST VS wei, qi, ying, xue

 

Syndrome differentiation/treatment

1) Damp > heat

2) Damp = heat

3) Damp < heat

4) dryness transformation


Shu shi wen bing

[summer-heat warm disease]

 

Concept:

shu (summer heat) shi  à feverish diseases (re bing)

Features:  similar to shi wen

Seasons:  just in late-summer

Onset: rapid

 

Etiology, Pathogenesis

Etiology: external f, internal f

Pathogenesis:

–  Initial stage:

–  Qi level: various locaton

–  Ying-xue level:

–  late stage: lingered PF

 

Diagnosis

–  by end of summer, at beginning of fall,        —- “hot  weather” —-

–  acute (quick) onset,

–  fever (low or high?), anxiety/irritability, dark urine  +  heavy body, greasy coating, ..  jaundice, bleeding

–  jaundice, bleeding

 

Syndrome differentiation/treatment

Initial (LU-wei)

LU-Qi:

Middle jiao:

ST/Int:

Triple jio:

Ying xue à dryness:

HT orifice:

Later stage:

Recovery:  PF       aromatic

 


Fu shu  Wen Bing

(Incubated summer heat)

Concept

PF: summer heat/damp

Season: fall-winter

Onset: rapid

Manifestation:  initial stage

  • from qi

fever (high), irritability, thirst, fullness of abd, greasy t coating, or

  • from ying/xue

high fever, irritability, dry mouth (not drinking),  deep red t, scanty coating

 

Etiology, Pathogenesis

Course

– initial:  wei+qi level; wei + ying level

– qi level:  Shao yang;  SP/SP; Int

– ying level:  HT heat à SI

– xu level:  heat-blood stasis à PC; à Low jiao

– later:  qi / ying def, 

– sequela?:     tremor,    

 

Diagnosis

– season: fall, winter,

– rapid onset, severe condition,   —- qi level; ying level —-      + wei

– in very severe case:  no urine or loss of contral of UB,

 

Syndromes / treatment

1)  initial stage

– wei -qi

– wei –ying

2) qi level

– shu-shi à shao yang

– shu-shi à Int

– fire à damage yin

3) ying xue level

-heat in HT/SI

-heat blocking PC, blood stasis

4)  qi collapse

5) KI qi un-consolidation