Four Aspects

Question 1

What are the Four Aspects, and their general treatment principle?

Answer 1

1) Wei / Defense level - Release exterior
2) Qi level - Clear heat, Generate fluids
3) Ying / Construction level - Outthrust heat to Qi level
4) Xue / Blood level - Cool blood, Stop bleeding

Question 2

Where does pathological change occur at the Wei / Defense level?

Answer 2

Defense / Wei governs the exterior. So pathogen affects the LU, or upper jiao.

Question 3

Where does pathological change occur at the Qi level?

Answer 3

Qi aspect governs the interior. So pathogenic change occurs in organs.

Question 4

Where does pathological change occur at the Ying / Construction level?

Answer 4

Ying / Construction aspect is heat entering the HT. So disease affects HT & PC.

Question 5

Where does pathological change occur at the Xue level?

Answer 5

Xue level heat enters HT, LV, KD. So heat will stir the blood, leading to reckless movement of blood (bleeding).

Question 6

What are the essential characteristics of Warm Diseases?

Answer 6

1) manifest with general symptoms of WH in the early stages
2) always a fever
3) infectious
4) WH penetrates thru mouth
5) pathogenic factor is particularly strong
6) WH has strong tendency to become interior heat
7) once in interior, heat has tendency to dry up body fluids

Question 7

Warm Disease pathogens enter via the ___ & ___.

Answer 7

nose & mouth

Question 8

T or F: Latent or depressed heat can re-emerge as warm diseases.

Answer 8

True

Question 9

T or F: There can be diseases that emerge from interior and move outwards, or start at Blood level and move outward to Qi level.

Answer 9

True

Question 10

What is “simultaneous disease”?

Answer 10

• When over the course of disease, Wei level is not resolved but combines with Qi or Ying level.
• Or, if disease is in the Qi level AND Ying or Blood level at the same time, causing blazing of qi and blood.

Question 11

What are the factors that affect transmuting of disease?

Answer 11

• strength of pathogen
• strength or weakness of body
• proper treatment

Question 12

What are the Defense / Wei aspect patterns?

Answer 12

Wind Warmth Exterior Pattern

only one Defense / Wei level pattern

Question 13

What are the main signs & sx of the Wind Warmth Exterior Pattern? What is the treatment principle?

Answer 13

1) Fever (more than chills)
2) Aversion to wind/cold
3) Slightly sweating
4) SORE, PAINFUL throat
5) Nasal congestion
6) Body aches
7) Slight thirst
8) Tongue: red tip & sides, thin white coat
9) Pulse: floating, rapid
TX: Clear heat, Resolve the exterior

Question 14

What is the #1 symptom of a Wind Warmth Exterior Pattern?

Answer 14

painful, sore throat

Question 15

What are the Qi aspect patterns?

Answer 15

1) Qi Aspect Heat Exuberance
2) Heat Evil Obstructing Lung
3) Binding Heat in Stomach & Intestines

Question 16

What are the main signs & sx of the Qi Aspect Heat Exuberance pattern? What is the treatment principle?

Answer 16

1) Vigorous fever
2) Aversion to heat
3) Sweating
4) Thirst
5) Tongue: red body, dry yellow coat
6) Pulse: surging, large, rapid (4 Bigs)
TX: Clear heat, Drain fire

• Note: Sx & Tx are same as Yang Ming Channel Disease.

Question 17

What are the main signs & sx of Heat Evil Obstructing Lung? What is the treatment principle?

Answer 17

1) High fever
2) Painful, barking cough
3) Thick, yellow phlegm
4) Thirst
5) Chest oppression & pain from cough
6) Tongue: red body, yellow coat
7) Pulse: rapid
TX: Clear heat, Transform phlegm, Subdue cough

Question 18

What are the main signs & sx of Binding Heat in Stomach & Intestines? What is the treatment principle?

Answer 18

1) High fever, or only afternoon tidal fever
2) Constipation or no BM
3) Abdominal fullness, distention
4) May have clouded shen (hallucinating from fever)
5) Thirst
6) Tongue: yellow dry coat, or burnt with prickles
7) Pulse: deep, full
TX: Clear heat, Purge accumulation

Question 19

How do Ying / Construction aspect patterns develop?

Answer 19

• Generally due to Qi level heat sinking deeper.
• Or could be result of LU defense not being resolved, but affecting the PC directly, as a matter of proximity in upper iao.
• Or could be from latent heat emerging in Ying level.

Question 20

What are the Ying / Construction aspect patterns?

Answer 20

1) Heat Damaging Construction/Ying

2) Heat Blocking the Pericardium

Question 21

What are the main signs & sx of Heat Damaging Construction/Ying? What is the treatment principle?

Answer 21

1) Extreme body fever at night
2) Heart vexation
3) Sleeplessness / Insomnia
4) Maculopapular eruptions of skin
5) DRY MOUTH, BUT NO THIRST
6) Tongue: red-crimson tongue body with no coat
7) Pulse: fine, rapid
TX: Clear heat, Outthrust heat to Qi level

Question 22

What is the difference between macules and papules?

Answer 22

• Macules are discolorations of skin that are flat.

- Papules are raised.

Question 23

What are the main signs & sx of Heat Blocking the Pericardium? What is the treatment principle?

Answer 23

1) Extreme heat
2) Night fever
3) Clouded spirit
4) Delirious speech
5) Retraction of tongue
6) Tongue: fresh crimson tongue body, or dry and dusky with no spirit; NO coat (no yin)
TX: Clear heat, Open the orifices

Question 24

How do Xue / Blood aspect patterns develop?

Answer 24

• Emerges from further development of Ying level heat.

- Or develops from heat in the blood.

Question 25

What are the common clinical manifestations of Xue / Blood aspect patterns?

Answer 25

• Stirred blood / reckless movement of blood
• Consumption of blood
• Bleeding
• Yin damage
• Interior wind
• All the severe Ying aspect signs (e.g. dusky or no tongue coat)
• Disease is deep, and recovery is complex
• Vacuity & repletion together

Question 26

What are the Xue / Blood aspect patterns?

Answer 26

1) Blood Loss

2) Blood Amassment

Question 27

What are some signs & sx of Blood Loss? What is the treatment principle?

Answer 27

• Coughing up blood
• Spitting up blood
• Nosebleed
• Blood in urine
• Blood in stool
• Metrorrhagia
• Tongue: deep crimson color
• Pulse: fine, rapid
  TX: Clear heat, Cool blood, Stop bleeding

Question 28

What are the main signs & sx of Blood Amassment? What is the treatment principle?

Answer 28

1) Lower abdominal pain
2) “Manic” behavior
3) Mental restlessness
4) May have blood in urine or BM
5) Tongue: stasis macules
6) Pulse: deep, choppy
TX: Clear heat, purge accumulation

** Note: Xue level Blood Amassment pattern is different from Tai Yang Blood Amassment pattern. Here we’ll see heat signs & macules on tongue.