Lecture 4 Study Guide Flashcards
Mu Huang (Ephedrae Herba) Gui Zhi (Cinnamoni Ramulus) Bo He (Menthae Haplocalysis Herba) Chai Hu (Bupleuri Radix)
Herbs that Release the Exterior are broken down into what 2 categories?
Warm Acrid - Treats Wind Cold
Cool Acrid - Treats Wind Heat
What does EPF stand for?
External Pathogen Factors
What are the general characteristics of herbs that Release the Exterior?
- Herbs that tend to be Pungent/Spicy and Acrid
- The functional qualities tend to be light and ascending
- Often cooked for short periods of time
- Many cause diaphoresis (sweating)
What are the 6 Evils?
Wind Cold Fire Damp Dryness Summerheat
What are the common EPF factors (external pathogenic factors/excess conditions) treated with these herbs?
Wind Cold Fire Damp Dryness Summerheat
What are the Common Cold Exterior Invading Conditions?
Wind Cold Attack
Wind Heat Attack
Wind Damp Attack
Summerheat (Wind/Damp/Heat)
What are the Common Cold Deficiency Conditions?
Qi, Blood, Yin and/or Yang deficiency
Tai Yang Channel syndromes Break down into two types. What are they and what are their different names?
Cold
- Tai Yang Excess
- Wind Cold Excess
Wind
- Tai Yang Deficiency
- Wind Cold Deficiency
- Wind Strike
What are the Tai Yang Organ Syndromes?
UB - Water Amassment
SI - Blood Amassment
What is the most superficial of the 6 Channels?
UB - Tai Yang Channel
- Covers the back and neck
- Connection to Mingmen to warm the superficial
- Tai Yang Fu (organ) - inhibited urination - accumulation of fluids in lower jiao
What is the most superficial Zang organ?
Lung (most external)
- Relation to Wei Qi
- Disperses fluids to surface
What are the general signs/symptoms and characteristics of a Wind Cold Excess Pattern?
- Aversion to Cold
- Fever & Chills (predominant chills)
- Floating and Tight Pulse
- Tongue, normal body, thin, white coat
- No sweat (pores closed)
- Contraction of Qi and Blood not circulating well
- General aches and body pains
- Headache
- Clear and white secretions
- No thirst
What are the common Exterior signs and symptoms?
Chills and Fever (simultaneously)
Headache
Body Aches (stiff neck)
Floating Pulse
What is the Tx Principle for Wind Cold Excess?
- Treatment Principle - Release the Exterior
- Using strong herbs to open the pores and let the evils out
- Induce sweating to let the pathogenic influence out of the body
What are the general signs/symptoms and characteristics of a Wind Cold Deficiency Pattern?
- Wei Qi not as strong as in Wind Cold Excess pattern
- Chills and Fever, but less fever than in excess pattern (body is fighting, but not as strong). Chills still predominant
- Aversion to Wind
- Pain and ache not so severe
- Because the patient is deficient - can’t have a big battle with pathogen
- Pathogen wins and gets a stronger foothold, affecting the muscle layer
- Floating and moderate pulse
- tongue: body is normal, thin, white coat
- Clear and white secretions
- Sweating (pores open with loss of fluid and mild sweat)
- Disharmony of Yin and Yang (Ying and Wei) - Fluid is lost = leakage
- Edema (water metabolism problem)
- Wind attack leads to Lung Qi dysfunction. This can lead to Yang Shui (water) or Yang Edema
What is the Tx Principle for Wind Cold Deficiency?
- Herbs are not as strong because the patient is weaker and you don’t want to disperse and sweat too much
- stabilize the exterior to dispel the pathogen
- Harmonize Ying (nutritive Qi) and Wei (defensive Qi)
What is Yang Shui (Yang Edema)? How does it manifest?
- swollen in the upper eye area
- facial edema
- if not resolved will travel down the body
(Yin Shui or Yin Edema - more internal and a result of Kidney deficiency)
Is it sometimes appropriate to use these herbs to treat Cough and Asthma, Bi Syndromes and Skin conditions, especially if related to Exterior Pathogenic Invasion?
Cough and asthma
- Lung Qi cannot disperse
- These herbs can be used if the cough or asthma is due to Wind/Cold attack
Bi Syndromes (Joint syndromes, rheumatism, arthritis -Wind/Cold/Damp attach If primarily: -Wind - pain travels -Cold - fixed pain, very painful -Damp - swollen, heavy body
Skin conditions** that have not yet expressed (see this more with Wind Heat conditions)
Measles - toxic Wind
-pungent herbs to promote eruption, otherwise it will go in and become pneumonia
-Let toxins out ASAP
Carbuncles
- skin boils, eruptions, skin infection
- heat toxin evil - initial stage – let the evil out
Ma Huang (Ephedrae Herba)
Category: Warm Acrid Herbs that Release the Exterior
What channel does it enter? LU UB
What are its properties (taste and temperature)? Acrid, Slightly Bitter, Warm
What are the contraindications?
- Spontaneous sweating for exterior deficiency
- Night Sweating from Yin deficiency
- Kidney deficiency asthma
- Cannot use longterm
- Cannot use with hypertension
Functions and accompanying indications:
1. Induces sweating and releases the exterior; for patterns of wind-cold exterior excess (greater yang cold damage)
(Chills, fever, headache, absence of sweating, and a tight floating pulse. Opens pores and interstices to release exterior)
- Disseminates and facilitates Lung Qi, calms wheezing, and stops coughing; for cough and wheezing due to wind-cold obstructing the Lungs
(Encourages the Lung Qi to flow more easily and directs it downward. Important for treating either externally contracted or internally generated wheezing) - Promotes urination and reduces edema.
(Especially for edema that accompanies an exterior condition. This is Yang Shui - open the Lung Qi and water can flow down. Easier to flow if the top and bottom are open – drinking straw trick) - Warms and disperses cold pathogens
(Useful for wind-damp painful obstruction and deep-rooted toxic sores without a head)
Preparations:
Sheng Ma Huang (raw)
-induces sweating
Zhi Ma Huang (prepared with honey)
- Stops cough and asthma
- Cannot use for deficiency asthma
Gui Zhi (Cinnamoni Ramulus)
Category: Warm, Acrid Herbs that Release the Exterior
What Channel does it enter? HT, LU, UB
What are its properties (taste and temperature)? Acrid, sweet, warm
What are the contraindications?
- In cases of warm-heat pathogen disease
- Yin deficiency with heat
- Heat in the blood with vomiting
- (small does for pregnancy or excessive menstruation)
Functions and accompanying indications:
1. Releases the exterior and assists the yang
(For exterior wind-cold regardless of whether it is deficiency or excess (excess - assists Ma Huang; deficiency - use Bai Shao)
- Warms and unblocks the channels and collaterals
(For wind-cold-damp painful obstruction pain due to blood stasis or cold. (i.e. chest yang - cold attack w/stagnation; rheumatism, amennorrhea) - Warms the Yang and transforms thin mucous
(For lack of transformation of fluids due to yang deficiency with such symptoms as edema and urinary dysfunction or dizziness & palpitations, as in Wu Ling San & Ling Gui Zhu Gan Tang) - Assists the Heart Yang and unblocks the Yang Qi of the chest
(For listless chest yang together with upward movement of phlegm and thin mucous and the loss of the orderly decent of the Lung Qi with SOB, chest pain, or palpitations, as in Zhi Gan Cao Tang) - Warms the channels, vessels and collaterals
(removes painful obstruction and warms the blood vessels to remove stagnation and regulate the menses, as in Wen Jing Tang and Gui Zhi Fu Ling Wan) - Warms the middle and directs turbid Yin downward
(for cold from deficiency of the middle burner, as in Minor Construct the Middle Decoction)
Ma Huang Tang
What is the Chief herb? Ma Huang
What is the Deputy? Gui Zhi
Actions: Releases the Exterior & Arrests Wheezing
Pattern: Exterior Excess, Wind Cold
Indications: Fever and Chills (chills predominant) without sweating, headache, general body aches, cough and wheeze, floating and tight pulse
Gui Zhi Tang (Cinnamon Twig Decoction)
What is the Chief Herb? Gui Zhi
Actions: Releases pathogenic influences from the muscle layer and regulates the Ying and the Wei Qi
Pattern: Exterior Deficiency, Wind Cold
Indications: Fever and chills unrelieved by sweating, headache, aversion to wind, stiff neck, nasal congestion, dry heaves, no particular thirst, a thin, white and moist tongue coating, floating pulse that is either moderate or frail.
What are the general signs and symptoms of Wind Heat?
- Go to the Wei level – the most superficial of the four levels from the Wen Bing Xue (Warm Disease School)
- Disease caused by heat enters through the mouth and nose
- Fever and mild chills (fever predominant)
- More sweat
- Swollen red painful throat
- Thirst & dry throat & cough
- Headache
- Bodyaches
- Yellow secretions
- Red eye (pink eye, conjunctivitis)
- Measles/Rashes
- Floating and Rapid pulse
- Tongue: may still have a normal body, possible red tip or beginning to turn more red. Think yellow tongue coat
What are the properties of the herbs used to treat Wind Heat?
- Using Acrid and Cool Herbs
- Can induce sweat, but not as strongly as acrid/pungent warm herbs
