Four Levels Flashcards
What is the nature of warm diseases?
Warm diseases are caused by external Wind-Heat.
- They all manifest with fever
- The pathogenic factor enters through the nose and mouth
- They are infectious
- The pathological developments are rapid
- The pathogenic factor of warm diseases tends to injure yin
What are the four levels?
- Defensive Qi level (Wei)
- Qi level
- Nutritive Qi level (Ying)
- Blood level (Xue)
What is Wei Qi Level?
Is the beginning stage of invasions of wind heat, it is the only exterior level.
There are four different patterns: Wind-Heat, Summer-Heat, Damp-heat and dry-heat
What is the Qi Level?
The Qi level is interior, the pathogenic factor has moved into the interior and has transformed into heat.
What is the Qi level characterised by?
Full interior heat with symptoms of fever, thirst, feeling of heat, mental restlessness, red tongue with thick yellow coating. Rapid full pulse.
What is the nutritive qi level? Ying level.
Heat has penetrated into a deeper energetic layer and begun to injure the yin.
Heat is obstructing the mind and pericardium.
What differentiates the Ying and Qi level?
In the Ying level, the tongue is deep-red without coating.
What are the two patterns at nutritive qi level?
- Heat in nutritive qi level
2. Heat in the pericardium
What is the Xue Level?
Heat is affecting the blood.
Macules are a definite sign that heat has reached the blood level.
What are the 5 patterns of the blood level?
- Heat victorious moving blood
- Heat victorious stirring Wind
- Empty-Wind agitating in the interior
- Collapse of Yin
- Collapse of Yang
What are vesicles?
Blister like spots filled with clear fluid, they always indicate damp.
What are palpules?
Palpules are red solid spots that indicate heat at the qi level, especially in the lungs and stomach.
What are malcules?
Malcules are spots under the skin that cannot be felt on palpation. They indicate heat at nutritive qi or blood level.
What are the S&S of Wei level?
Exterior pattern Fever: Slight Fever, aversion to cold Thirst: Slight Sweat: Slight Mental state: Unchanged Tongue: Red sides/front. Thin white coat Pulse: Floating rapid
What are the S&S of Qi level?
Interior pattern with strong upright Qi
Fever: High fever with feelings of heat
Thirst: Intense thirst, desires cold drinks
Sweat: Profuse
Mental state: Generally mind is clear
Tongue: Red body, thick yellow coat
Pulse: Big, rapid pulse or slippery rapid pulse
What are the S&S of Ying / Xue level?
Interior pattern with weak upright Qi Fever: Fever at night Thirst: Dry mouth, desire to sip water Sweat: Night sweats Mental state: Delirium, fainting, confusion Tongue: Red body, no coat Pulse: Fine rapid pulse
What are the S&S for wind heat at the Wei Level?
Fever
Aversion to cold
Headache
Slight sweat
Sore throat
Runny nose with yellow discharge
Swollen tonsils
Body aches
What is the tongue, pulse and treatment principle for Wind Heat at Wei Level?
T: Dry with thin white coat
P: Floating rapid
TP: Release exterior, expel wind heat.
What are the S&S of Dry Heat at Wei Level?
Fever
Aversion to cold
Headache
Slight sweat
Sore throat
Dry – skin, nose, throat, mouth
Dry Cough
What is the tongue, pulse, and treatment principle of Dry Heat at Wei Level?
T: Dry with thin white coat
P: floating rapid
TP: Release exterior, clear heat, promote fluids
What are the S&S of Damp heat at the Wei Level?
Fever – worse in arvo
Aversion to cold
Headache
Heaviness
Uncomfortable epigastrium
Swollen glands
Thirst, no desire to drink
Hot body
What is the tongue, pulse and treatment principle of Damp Heat at Wei Level?
T: Sticky white or yellowish coat
P: Soggy
TP: Release exterior, resolve damp heat
What are the S&S of Summer Heat at Wei Level?
Fever
Aversion to cold
Headache
Slight sweat
Sore throat
Uncomfortable epigastrium
Irritability
Thirst
What is the tongue, pulse and treatment principle of Summer Heat at Wei Level?
T: Red with sticky white coat
P: Soggy rapid
TP: Release exterior, expel summer heat
What are the S&S of Lung Heat at Qi level?
High Fever
Thirst
Sweating
Feels hot
Cough with yellow sputum
SOB
What is the tongue, pulse and treatment principle of Lung Heat at Qi level?
T: Red with yellow coat
P: Slippery rapid
TP: clear lung heat, resolve phlegm, promote D&D of Lung
What are the S&S of Stomach Heat at Qi level?
High fever – worse in arvo
Big thirst
Big Sweat
Feels hot
This is Yang Ming Channel Pattern in 6 Division theory
What is the tongue, pulse and treatment principle of Stomach heat at Qi level?
T: Red with yellow coat
P: Overflowing rapid
TP: Clear stomach heat, clear Qi.
What are the S&S of intestine dry heat at Qi level?
High Fever – worse in arvo
Constipation
Abdominal pain and fullness
Irritability
Delirium
This is Yang Ming Organ Pattern in 6 division theory
What are is the tongue, pulse and treatment principle of Intestines dry heat?
T: Red with thick yellow dry coat
P: Full rapid
TP: Drain fire, clear stomach and intestines, move downwards
What are the S&S of Gall Bladder heat at Qi level?
High Fever – worse in arvo
Thirst
Nausea
Oppression of chest and epigastrium
Bitter taste
Dry throat
Pain of hypochondria
What is the tongue, pulse and treatment principle in gall bladder heat at Qi level?
T: Red with unilateral sticky yellow coat
P: Wiry rapid
TP: Clear GB heat, harmonise Shao Yang.
What are the S&S of Damp Heat in Stomach and Spleen?
Fever – decreases with sweat and returns
Nausea
Oppression of chest and epigastrium
Loose stools
Heavy body
What is the tongue, pulse and TP in damp heat in stomach and spleen at Qi level?
T: Red with sticky yellow coat
P: Slippery rapid or soggy rapid
TP: Clear damp from the Spleen and Stomach.
What are the S&S of Heat in Nutritive Qi level?
Fever at night Delirium Incoherent speech or aphasia Mental restlessness Insomnia Macules (usually associated with blood heat)
What is the tongue, pulse and treatment principle of Heat in Ying Qi level?
T: Red without coat
P: Fine and rapid
TP: Clear heat from nutritive qi, promote fluids
What are the S&S of heat in pericardium in Ying Qi level?
Fever at night Delirium Incoherent speech or aphasia Mental confusion Hot body with cold hands and feet
What is the tongue, pulse, and TP in Heat in Pericardium at Ying Level?
T: Red without coat
P: Fine and rapid
TP: Clear heat from pericardium, restore consciousness and promote fluids.
What are the S&S of Heat Victories agitates blood in Blood level?
High fever Mental restlessness/mania Dark macules Vomiting blood Blood in stools Blood in urine Epistaxis
What is the tongue, pulse, and TP in Heat victorious agitates Blood?
T: Dark red, no coat
P: Wiry rapid
TP: Clear blood heat, stop bleeding
What are the S&S in heat victories stirring wind in Blood level?
High fever Twitching of limbs Fainting Convulsions Opisthotonos Neck or jaw rigidity Eyeballs turning up
What is the tongue, pulse and TP in Heat victorious stirring Wind?
T: Dark red, no coat
P: Wiry rapid
TP: Clear blood heat. Extinguish wind
What are the S&S of Empty Wind agitating the interior?
Low grade fever Twitching or tremors Weight loss Malar flush Listlessness
What is the tongue, pulse and TP of Empty Wind agitating the interior?
T: Dark red, no coat, dry
P: Fine rapid
TP: Clear blood heat, nourish Liver and Kidney Yin, extinguish wind.
What are the S&S of Collapse of Yin?
Low grade fever
Night sweats
Mental restlessness
Malar flush
Fire palm heat
Dry mouth with thirst for small sips
Emaciation
What is the tongue, pulse and TP in Collapse of Yin?
T: Dark red, dry, no coat
P: Fine rapid
TP: rescue Yin
What are the S&S in Collapse of Yang?
Feeling cold, cold limbs
Profuse sweating on forehead
Listlessness
White complexion
What is the tongue, pulse and TP in Collapse of Yang?
T: Pale, swollen and short
P: Hidden and slow
TP: Rescue Yang
What is Latent heat?
Occurs when an external pathogenic factor penetrates the body without causing apparent symptoms at the time.
