Module 2: Fever, Aversion to Cold and Fear Cold, Cough

Question 1

Explain the Ba Gang: Eight Principle Pattern Identification

Answer 1

Interior and exterior: Location
Cold and heat: Thermal nature
Deficiency and excess: Zheng vs. Xie
Yin and Yang: Summary

Question 2

What is the key manifestation of external invasions?

Answer 2

fever with simultaneous cold and aversion to cold

Question 3

Are exterior patterns considered full or xu?

Answer 3

Full

Question 4

Are pathogenic factors that invade the channel (bi syndrome/ painful obstructions) full or xu?

Answer 4

full

Question 5

Is bi syndrome interior or exterior? Why?

Answer 5

exterior, it is an external pathogen that invaded the channel

Question 6

What are the three interior pattern causes?

Answer 6

External moved internal
(Direct Strike) When exterior pathogen strikes comprised person
All other patterns not of external diseases and/or direct strike from improper eating, drinking, conduct of life and seven emotions

Question 7

TX principle of interior patterns?

Answer 7

Treatment principle: Harmonize the interior

Question 8

Yang exuberance?

Answer 8

Heat

Question 9

Yin exuberance?

Answer 9

Cold

Question 10

Yang Xu?

Answer 10

Cold

Question 11

Yin Xu?

Answer 11

Heat

Question 12

Aversion to cold (ext and int), liking warmth (all, xu cold), absence of taste (spleen yang gone cold be damp or yang xu), lack of thirst (excess), pale face (bright is full dull is xu), cold limbs (all), desire to curl up (kidney yang deserted (includes spleen yang)), clear and long urination (Yang xu), this and loose stool (yang xu), pale tongue with white fur that is moist and glossy (all), slow or tight pulse (xu slow, tight excess). (Conglomerate of all cold symptoms, these do not happen all together)

What is the pattern and Txc Principle?

Answer 12

Cold pattern, warm the yang and eliminate cold

Question 13

feeling cold, cold limbs, no thirst, bright pale, abdominal pain worse with pressure, like warm liquids, loose stool, clear abundant urination, deep full tight pulse, pale tongue thick coat.

Dx? Etiology?

Answer 13

Full cold

Excess intake cold food and drink, penetration of ext. Pathogen.

Question 14

feeling cold, cold limbs, dull pale face, no thirst, listlessness, sweating, loose stool, clear abundant urnation, deep, slow or week pulse, pale tongue with thin white coat.

Dx? Etiology?

Answer 14

Empty Cold

excess physical work (taxes KD – source of yang qi), dietary imbalance, excess sexual activity for males damages kidneys cause it drains qi, women yin xu taking blood, internal cold injures yang qi.

Question 15

Heat in the afternoon or evening (yin xu, damp heat), dry mouth (yin xu or excess heat), wants small sips (yin xu), dry throat at night (yin xu), night sweating (yin xu), five palm heat (yin xu), dry stool (excess or yin), scant dark urine (both), floating (yang rising) rapid (heat) and empty (yin xu) pulse, red (excess or xu) peeled (xu) tongue

Dx? Tx?

Answer 15

Heat pattern

Nourish yin and clear heat

Question 16

thirst, feeling of heat, red face, mental restlessness, dry stool, scant dark urine, rapid full pulse, red tongue/yellow coat

Dx? Etiology?

Answer 16

Full heat

Emotional imbalance esp. anger, dietary imbalance (overconsumption think flavored, sweet, salty, or acrid food and alcohol), invasion of external pathogenic factors

Question 17

heat in afternoon and evening (yin can anchor in the yang when it’s meant to go in), dry mouth, small sips (when yin in diminished it cannot receive), dry throat at night, night sweat, 5 palm heat, dry stool, scant dark urine, floating rapid empty pulse, peeled tongue.

Dx? Etiology?

Answer 17

Empty heat

Etiology: Overwork, irregular eating, irregular sleep/waking hours, excess sexual activity (women depletes yin essence KD) persistent heavy blood loss

Question 18

preexisting internal heat condition that is exacerbated by exterior wind cold invasion. S/Sx: Exterior wind cold symptoms with irritability and thirst.

Answer 18

Exterior cold/Internal Heat

Question 19

Preexisting internal cold condition that becomes exacerbated by exterior wind/heat invasion. S/Sx: Exterior wind heat symptoms with torpid intake of food and drink, abdomen dist, loose stool.

Answer 19

Exterior Heat/ Interior Cold

Question 20

Range of symptoms and patterns that all come from fundamental imbalance between yin and yang, qi and essence, qi and blood of the body. The things that should ascend and descend (yin and yang). S/Sx: foul breath, thirst with desire for fluids, swell in teeth (stomach heat above) with loose stool, abdominal pain that likes warmth (spleen cold below).

Answer 20

Heat Above with Cold Below

Question 21

body heat but desired too be covered, thirst for warm liquids in small sips , red face, large forceless pulse, cold limbs clear urine, loose stool, pale tongue with white fur.

Answer 21

True Cold False Heat

Question 22

Cold limbs, body heat, aversion to heat, thirst , vexation, preference for cold fluids, red tongue with yellow fur, short voiding of red urine , dry stool

Answer 22

True Heat False ColdF

Question 23

Full vs Empty?

Answer 23

Full refers to repletion of pathogenic qi, empty refers to deficiency of antipathogenic qi.
Full is defined by pathogen. When pathogen is dominating Zheng qi and pattern is characterized by dominating pathogen is Full. Empty is defined by Zheng qi.

Question 24

listless (blood xu, qi or yang), white face, malar flush in afternoon (yin xu), bodily fatigue (xu or yang xu), lack of strength (St or SP xu), emaciated form (yin xu or blood xu), heart palp. (any heart xu), short breath (lung qi xu), physical cold with cold limbs (Xu qi and yang), 5 palm vexing heat (yin xu), spont. Sweating or night sweat (yin xu), loose stool (sp, k, yang or qi), frequent urination, urinary incont (k yang or qi), pale and tender tongue with diminished or no fur (yang xu), vacuous pulse with no force (yang zu) or fine rapid pulse (yin xu).

Answer 24

Empty

Question 25

Pale face, weak voice, sweats easily, tired, SIB, loose stool, decreased appetite (sp), empty pulse (any qi)

Answer 25

Qi Xu

Question 26

Dull pale face, pale lips, blurry vision, dry hair and fatigue, poor memory (ht blood short term, K long term), numbness and tingling (shun/feeling travels with blood and can’t reach the extremities), insomnia (Ht needs blood for Shen to descend), scant period, fine/choppy pulse. (vessels not full), pale thin dry (when blood xu fluids xu) tongue

Answer 26

Blood Xu

Question 27

Qi Xu plus cold signs and more severe signs of xu like curled up, bright pale face, no thirst, loose stool with undigested food (today more often damp phlegm block*), forceless pulse, pale wet tongue.

Answer 27

Yang Xu

Question 28

Heat in afternoon, evening, dry throat (lung yin), dry eyes (liver yin), night sweats, floating/empty pulse, tongue with no coat (red means heat), low grade fever, irritability, vexation, trouble sleeping.
Tongue coat is turbidity of the stomach, steaming upward off turbid yin
Has to be somewhat turbid for stomach to receive, so no coat lack intestinal flora, thick coat is too much accumulation in intestines

Answer 28

Yin Xu

Question 29

Xu Tx?

Answer 29

Supplement vacuity and support the right (warm the yang, boost qi, nourish blood enrich yin.)

Question 30

Patterns are due to a surplus of hyperactivity and exuberant evil qi, or internal disease-causing stag of bodily resources.

Answer 30

Full

Question 31

Vexation of spirit, agitation (phlegm blocking heart), hasty breathing, distention and fullness of chest (qi stag), ribside and abdomen, pain that increases with pressure (Excess), rough and painful urination (excess), dribbling or inhibited urine, bound stool with constipation (excess heat), withered tongue body (extreme excess blocking basic circulation of qi and blood), replete and forceful pulse.

Answer 31

Ful

Question 32

Full Rx?

Answer 32

Drain the repletion and expel pathogen

Question 33

Excess and Xu are caused by?

Answer 33

Excess always pathogenetic, Xu always zheng qi

Question 34

6 evils

Answer 34

Wind, wood, Jueyin
Heat, Fire, imperial fire, Shaoyin
Summer heat, Fire, ministerial fire, Shaoyang
Damp, Earth, Taiyin
Dry, Metal, Yangming
Cold, Water, Taiyang
Should match 6 channels, 6 fu

Question 35

Etiology and pathomechanism of “fear of cold”

Answer 35

some kind of pathogenic cold, yin excess or yang xu

Question 36

Fever causes?

Answer 36

Fever = pathogenic heat = yang excess or yin xu

Question 37

Aversion to wind, aversion to cold, intolerance to (fear of) cold

Answer 37

Chills without fever

Question 38

low grade fever, tidal fever, high fever

Answer 38

Fever without chills

Question 39

Simultaneous chills and fever vs
Alternating chills and fever

Answer 39

always exterior
vs
always shaoyang

Question 40

Must present with fever, fever onset with rapid onset of chills, after which two simultaneous. Manifests as aversion to cold, wind, and wind cold or cold after soaking. After comes nasal obstructions (lung), sniveling (lung qi counterflow), sneezing (lung qi counter flow), headache (, body aches, thin tongue fur, and floating pulse.

Answer 40

Fear of cold

Question 41

Can’t fight as strongly and opens pores to sweat from xi wei

Answer 41

Xu cold

Question 42

: alt. chills and fever, bitter taste, dry throat, blurred vision, hypochondrial fullness and distension, lack of desire to eat or drink , irritability, nausea, vomiting, unilateral thin white coat, wiry fine pulse,

Answer 42

Shaoyang

Question 43

Aversion to cold, fear of cold, cough panting (lung). Sound is strong and turbid, phlegm thin white or grey white and thick (cold in the phlegm) (excess is string cough, faint is xu and doesn’t go away). Cough causes pain in chest. Pale white complexion, bland taste (taste is impaired from nose blocked from lungs), no thirst (cold block yang qi, yang qi transforms fluids), cold limb, white tongue fur, slow or tight pulse (slow in xu, tight in excess) Pathogen in excess but interior is xu then slow but if inside isn’t xu then tight. Slow= xu cold

Answer 43

Interior patterns of cold evil settling in the lungs

Question 44

Aversion to cold, nausea (stomach needs to go down for spleen to go down, pivot is off from cold damp blocking spleen ascension affects stomach), abdominal pain and rumbling (excess cold and dampness from sp qi xu or qi dysregulation in stomach), thin and sloppy stool (spleen moving down, untransformed bowels, fluid hasn’t been assimilated), reduced food intake and drink (lack of appetite spleen qi xu or its blocked), distension (always means qi stag) and fullness of stomach and abdomen (damp/cold stagnation), heaviness (always damp) of head and bodily fatigue, bland taste in mouth (spleen yang is interrupted), no thirst (cold damp encumbers the spleen) and pale tongue with white fur and slow (xu) or soggy (damp excess) moderate (xu cold) pulse.

Answer 44

Cold damp encumbering the spleen (taiyang stage disease):

Question 45

Aversion to cold, fear of cold, cold in 4 limbs. Cold retained in liver channel as well as qi and blood stag. Tenseness and contracture of lower abdomen (liver channel related), sagging and distension of testicles (liver channel sign, binding in groin), cold contractions of testicles, irregular menstruation, painful menstruation, distending or stabbing pain of chest (more common than vomiting), or vertex of the head, dry vomiting or retching (qi counterflow affecting stomach) (all liver channel). All made worse with cold and better with heat. Tongue fur is white pulse is slow (xu) and wiry.

Answer 45

Cold congealing in the liver channel pattern:

Question 46

Sign of yang vacuity and yin exuberance such as aversion to cold, cold limbs, withered essence spirit (jing shen- brain, not alert, not responsive, flat affect, catatonic), desire to sleep accompanies with bodily swelling (edema and won’t get out of bed and cold, very serious), vomiting (no middle jiao transformation), clear diarrhea with indigested food in stool, clear urination and deep faint minute (does not have a clear coming and going -shen, last thing before scattered pulse) pulse.

Answer 46

Shaoyin cold transformation (shaoyin stage disease):

Question 47

Fear of cold manifests as aversion to cold and in severe cases cold shivering. Heat is accumulated in interior and stagnated so yang qi can’t move out. No desire for clothes but aversion to cold. Chest and cold scorching hot. Signs of internal exuberance of replete heat such as vexing thirst with desire for cold drinks, loud rough breathing, constipation, dark urine, red togue with scorched yellow dry tongue fur and pulse that is deep and slippery, rapid and forceful.

Answer 47

True heat, false cold (heat reversal pattern)