TCM INTERNAL MEDICINE MIDTERM Flashcards
Symptoms: severe aversion to cold, mild fever, no perspiration, headache, body ache, stuffy/runny nose, scratchy throat, cough with white clear phlegm
Tongue: thin white coating, moist
Pulse: floating or floating and tight
WIND COLD BINDING THE SUPERFICIES
WIND COLD BINDING THE SUPERFICIES pathogenesis
Pathogenesis: wind cold fettering the superficies, defensive yang qi gets obstructed, skin and pores are blocked, affecting the lung qi’s dispersing
WIND COLD BINDING THE SUPERFICIES formula
Jing Fang Bai Du San
Wind cold symptoms plus: Additional symptoms: heavy head and body, distention headache, painful joints, arthririts, spondylitis, low muffled cough, sticky profuse nasal discharge, white greasy tongue coating, soggy pulse
Qiang Huo Sheng Shi Tang
Symptoms: obvious fever, mild aversion to wind, sweating, distention headache, distention in the eyes and flushed face, turbid nasal discharge, sore throat and dry mouth
Tongue: thin yellow coating
Pulse: floating rapid
WIND HEAT ATTACKING THE SUPERFICIES SYNDROME
WIND HEAT ATTACKING THE SUPERFICIES SYNDROME pathogenesis
Pathogenesis: wind heat attacking the lung defense, heat obstructs inside the skin/superficies, affects the lung qi’s dispersing and descending, causing a disharmony with the lung defense
WIND HEAT ATTACKING THE SUPERFICIES SYNDROME formula
Yin Qiao San
Symptoms: occur in the summer, obvious fever, mild aversion to wind, mild sweating, distention and heavy headache, heavy sore body, irritability, thirsty, no desire to drink, sticky mouth, chest oppression,
Tongue: thin yellow, greasy coating
Pulse: soggy rapid
SUMMER DAMP HEAT
SUMMER DAMP HEAT pathogenesis
Pathogenesis: summer damp heat attacking the defensive qi, affecting the middle burner and obstructing the free flow of lung qi
SUMMER DAMP HEAT formula
Xin Jia Xiang Ru Yin
Symptoms: exterior wind cold symptoms with epigastric and abdominal bloating and fullness, belching, nausea, acid reflux, diarrhea
Tongue: red, white greasy thick coating
Pulse: floating, slippery, or deep slippery
STOMACH INTESTINE TYPE COMMON COLD aka Cold Type Stomach Flu
STOMACH INTESTINE TYPE COMMON COLD formula
Huo Xiang Zheng Qi San and Bao He Wan
Symptoms: occur in the autumn, wind heat or wind cold with dry nose and throat, cough without phlegm or little phlegm, thirsty
AUTUMN DRYNESS
AUTUMN COOL DRYNESS formula
Xin Su San
AUTUMN WARM DRYNESS formula
Sang Xing Tan
Symptoms: weak body constitution/weak defensive qi, recurrent onset, difficult to heal completely. Severe aversion to wind, mild fever, no perspiration, headache, body ache, cough white sputum, weak expectoration, fatigue, shortness of breath, dislike speaking, recurrent onset
Tongue: pale, white coating
Pulse: floating, weak
DEFICIENCY TYPE COMMON COLD: QI DEFICIENCY
DEFICIENCY TYPE COMMON COLD: QI DEFICIENCY pathogenesis
Pathogenesis: defensive qi is not firm, general qi deficiency not able to dispel the evil qi (wind cold) out
DEFICIENCY TYPE COMMON COLD: QI DEFICIENCY formula
Shen Su Yin (Si Jun Zi Tang with Er Chen Tang and release the exterior)
Symptoms: severe fever, mild aversion to wind, scanty perspiration, dry cough, scanty sputum, irritability, dizziness, dry mouth
Tongue: red, no coating
Pulse: thready rapid
DEFICIENCY TYPE COMMON COLD: YIN DEFICIENCY
DEFICIENCY TYPE COMMON COLD: YIN DEFICIENCY pathogenesis
Pathogenesis: depleted yin fluids, not enough fluids can be used to supply sweat to dispel wind heat
DEFICIENCY TYPE COMMON COLD: YIN DEFICIENCY formula
Jia Jian Wei Rui Tang
Symptoms: severe aversion to cold, very mild fever, headache, body ache, no sweating, pale face, weak voice, cold limbs, spontaneous sweat
Tongue: pale, puffy, white coating
Pulse: deep, weak
DEFICIENCY TYPE COMMON COLD: YANG DEFICIENCY
DEFICIENCY TYPE COMMON COLD: YANG DEFICIENCY formula
Ma Huang Fu Zi Xi Xin Tang
DEFICIENCY TYPE COMMON COLD: YANG DEFICIENCY treatment principle
Treatment Principle: *boost yang, release exterior
Symptoms: headache, fever, mild aversion to wind, little or no sweat, pale face, lips and nails, palpitations, dizziness. Usually occurs after child labor, bleeding disease, heavy menstruation, bloody stool etc.
Tongue: pale, white coating
Pulse: thready, weak, floating
DEFICIENCY TYPE COMMON COLD: BLOOD DEFICIENCY
DEFICIENCY TYPE COMMON COLD: BLOOD DEFICIENCY treatment principle
Treatment Principle: nourish blood, release exterior
DEFICIENCY TYPE COMMON COLD: BLOOD DEFICIENCY formula
Cong Bai Qi Wei Yin
Cough location
Location: Lung, Liver (restraint relationship), Spleen (child-mother relationship), Kidney (root of qi)
Cough pathological factors
Pathological factors: phlegm and fire
External cough symptoms
External Cough: recent illness, sudden onsent, short duration, lung-defensive systems, excessive, TP: dispel evil qi, benefit lungs, avoid using astringent herbs
Internal cough symptoms
Internal Cough: chronic illness, recurrent attacks, long duration, symptoms involved other systems, pathogenic excessive + healthy qi deficiency, TP: harmonize organs, dispel evil qi and tonify healthy qi, avoid overusing pungent and dispersing herbs
Symptoms: heavy cough sound with muffled voice, white clear sputum, fast breathing, itchy throat, stuffy nose, clear nasal discharge, headache, sore body and limbs, aversion to cold, mild fever, no perspiration
Tongue: thin white coating
Pulse: floating, or floating tight
WIND COLD ATTACKING THE LUNGS COUGH
WIND COLD ATTACKING THE LUNGS COUGH pathogenesis
Pathogenesis: wind cold attacks the lungs, obstructing the lung qi’s dispersing and descending functions
WIND COLD ATTACKING THE LUNGS COUGH treatment principle
TP: disperse wind and cold, expand lungs, relieve cough
WIND COLD ATTACKING THE LUNGS COUGH formula
San Niu Tang (modified Ma Huang Tang) + Zhi Sou San
Symptoms: severe cough, heavy breathing, hoarse voice, cough, dry and sore throat, sticky yellow sputum, yellow nasal discharge, thirsty, headache, sore body, sweat when coughing, aversion to wind, fever
Tongue: red tongue, thin yellow coating
Pulse: floating rapid, or floating slippery
WIND HEAT ATTACKING THE LUNGS COUGH
WIND HEAT ATTACKING THE LUNGS COUGH treatment principle
TP: disperse wind, clear heat, expand lungs, relieve cough
WIND HEAT ATTACKING THE LUNGS COUGH formula
Sang Ju Yin
Throat herbs
Gua Lou Ren, Jie Geng, Niu Bang Zi, She Gan
Symptoms: dry cough, itchy, dry, and sore throat, dry mouth, no sputum or little amount, difficult to spit out, blood streaked sputum, stuffy nose, headache, mild aversion to cold, fever
Tongue: red, dry tongue, thin white or yellow coating
Pulse: floating rapid, or just rapid
WIND DRYNESS DAMAGING THE LUNGS COUGH (late August or early September, mid to late September)
WIND DRYNESS DAMAGING THE LUNGS COUGH pathogenesis
Pathogenesis: wind dryness damages the lung yin, the lungs lack nourishment which affects the normal flow of lung qi
WIND DRYNESS DAMAGING THE LUNGS COUGH treatment principle
TP: disperse wind, clear lungs, lubricate dryness, stop cough
WIND HEAT DRYNESS DAMAGING THE LUNGS COUGH
Sang Xing Tang
WIND COOL DRYNESS DAMAGING THE LUNGS COUGH
Xing Su San
Symptoms: recurrent cough, heavy sound, abundant sticky white sputum, cough can be relieved after expectoration, sputum or little amount, more cough in the morning or after food, especially after eating greasy sweet food, chest oppression, stomach fullness, nausea, poor appetite, fatigue, loose stool
Tongue: white greasy coating
Pulse: soggy, slippery
PHLEGM DAMPNESS OBSTRUCTING THE LUNG COUGH
PHLEGM DAMPNESS OBSTRUCTING THE LUNG COUGH pathogenesis
Pathogenesis: spleen dampness, producing phlegm, obstructing airway and lung, affecting lung qi
PHLEGM DAMPNESS OBSTRUCTING THE LUNG COUGH treatment principle
TP: dry dampness, transform phlegm, regulate qi, stop cough
PHLEGM DAMPNESS OBSTRUCTING THE LUNG COUGH formula
Er Chen Ping Wei San + *San Zi Yang Qin Tang (three seed decoction)
Symptoms: cough, fast breathing, heavy sound or phlegm sounds in the throat, abundant sticky yellow sputum, difficult expectoration, hot foul smelling sputum, spitting out bloody sputum, chest and hypochondriac distention, pain during cough, red face, fever, dry mouth, sticky taste, thirsty.
Tongue: red, thin yellow greasy coating
Pulse: rapid, slippery
PHLEGM HEAT ACCUMULATING IN THE LUNGS COUGH
PHLEGM HEAT ACCUMULATING IN THE LUNGS COUGH pathogenesis
Pathogenesis: retention of phlegm heat obstructs the lung qi and affects its descending function
PHLEGM HEAT ACCUMULATING IN THE LUNGS COUGH treatment principle
TP: clear heat, transform phlegm, down bear lung qi, stop cough
PHLEGM HEAT ACCUMULATING IN THE LUNGS COUGH formula
Qing Jin Hua Tan Tang
Symptoms: frequent cough, red face, dry mouth, bitter taste, difficult expectoration, sticky and scanty sputum, distending pain in the chest and hypochondriac area that gets worse during cough, all symptoms change with emotional fluctuations.
Tongue: red tongue, yellow dry coating
Pulse: rapid, wiry
LIVER FIRE ATTACKING THE LUNGS COUGH
LIVER FIRE ATTACKING THE LUNGS COUGH pathogenesis
Pathogenesis: liver qi stagnation transforms into fire, then the fire travels upward to affect the lung’s function in descending leading to rebellious lung qi and subsequently cough
LIVER FIRE ATTACKING THE LUNGS COUGH treatment principle
TP: clear lungs, soothe the liver, push down upsurging qi, sedate fire, stop cough
LIVER FIRE ATTACKING THE LUNGS COUGH formula
Formula: Dai Ge San (clear liver, remove phlegm) + Xie Bai San (clear lung heat)
Symptoms: dry cough, short and abrupt coughing sound, scanty sputum, blood streaked sputum, hoarseness, dry mouth and throat, tidal fever in the afternoon, red cheeks, night sweats, loss of weight, fatigue
Tongue: red tongue, no coating
Pulse: rapid, thready
LUNG YIN DEFICIENCY COUGH
LUNG YIN DEFICIENCY COUGH pathogenesis
Pathogenesis: lung yin deficiency, empty heat burns inside, the lungs lose moisture and there is cough
LUNG YIN DEFICIENCY COUGH treatment principle
TP: nourish yin, lubricate lungs, transform phlegm, stop cough
LUNG YIN DEFICIENCY COUGH formula
Sha Shen Mai Dong Tang
Asthma definition
Asthma is a paroxysmal condition clinically characterized by rapid and difficult breathing, wheezing sound in the throat, inability to lie flat, dyspnea
Basis of asthma
Hidden phlegm
How is phlegm produced?
Dysfunction of LU SP and KD
Internal causes of asthma
Cold or heat phlegm retention in the lung with weak constitution and lung qi deficiency
External causes of asthma
External pathogenic factors, improper diet, emotional factors
Astham pathogenesis
The internal or external causes trigger the hidden phlegm and the upward movement of phlegm along with the unhealthy qi creates a narrowed airway with wheezing/asthma episode
Difference between Wheezing and Dyspnea
Wheezing: reccurent and intermittent onset with obvious inducing factors, sound in the throat, always occurs with dyspnea
Dyspnea: progressive aggravation and persistent without obvious inducing factor, gasping and rapid breathing, does not necessarily occur with wheezing, no sound in the throat
Symptoms: shortness of breath, wheezing, water sounding gurgle with white clear/bubbly sputum, cough, chest tightness, coldness on upper back, pale complexion
Pulse: floating and tight or just tight
Tongue: pale, white slippery coating
ASTHMA DUE TO COLD
ASTHMA DUE TO COLD treatment principle
TP: warm the lung, disperse cold, dispel phlegm, stop wheezing and relieve asthma
ASTHMA DUE TO COLD formula
She Gan Ma Huang Tang (profuse sputum/phlegm with sore throat type of asthma) or *Xiao Qing Long Tang (with a lot of cold)
Symptoms: shortness of breath, wheezing, loud , rough sound, sticky yellow sputum, chest tightness, wind heat symptoms, thirsty, fever, constipation
Pulse: rapid, slippery or wiry, slippery
Tongue: red, yellow and greasy coating
ASTHMA DUE TO HEAT
ASTHMA DUE TO HEAT treatment principle
TP: clear heat, resolve phlegm, stop wheezing and relieve asthma
ASTHMA DUE TO HEAT formula
Ding Chuan Tang or Yue Bi Jia Ban Xia Tang
Symptoms: weak, low wheezing, expectoration with clear, dilute, or white sputum, wheezing i s always triggered by weather changes, pale face, spontaneous sweating, wind intolerance, susceptibility to common cold, sneezes, runny nose prior to attack
Tongue: pale with a white and thin coating
Pulse: weak
ASTHMA REMISSION STAGE - Lung Deficiency
ASTHMA REMISSION STAGE - Lung Deficiency treatment principle
TP: tonify the lungs, strengthen the superficies
ASTHMA REMISSION STAGE - Lung Deficiency formula
Yu Ping Feng San (Huang Qi, Bai Zhu, Fang Feng)
Symptoms: abundant sputum, fatigue, shortness of breath, dislike to talk, wheezing is always triggered by improper diet, dull yellow face, poor appetite, abdominal bloating, loose stools
Tongue: pale, thin greasy or white and glossy coating
Pulse: thready and weak
ASTHMA REMISSION STAGE - Spleen Deficiency
ASTHMA REMISSION STAGE - Spleen Deficiency treatment principle
TP: strengthen the spleen qi to eliminate phlegm
ASTHMA REMISSION STAGE - Spleen Deficiency formula
Liu Jun Zi Tang (Ren Shen, Bai Zhu, Fu Ling, Zhi Gan Cao, Chen Pi, Zhi Ban Xia)
Symptoms: Severe, frequent shortness of breath and panting during rest, get worse after physical exertion, more exhalation than inhalation, soreness and weakness in the lower back area and knee, wheezing is always triggered by movement
Tongue: pale, puffy and tender tongue
Pulse: thready and deep, thready rapid pulse
ASTHMA REMISSION STAGE - Kidney Deficiency
ASTHMA REMISSION STAGE - Kidney Deficiency treatment principle
TP: tonify the kidney qi to eliminate the phlegm
ASTHMA REMISSION STAGE - Kidney Deficiency formula
Jin Gui Shen Qi Wan - yang deficiency or Qi Wei Du Wi Wan - yin deficiency
Dyspnea definition
A pulmonary disease clinically characterized by difficulty in breathing, even breathing with raised shoulders and open mouth, flaring nostrils and inability to lie down or even collapse in severe cases
Dyspnea subjective symptoms
Patient has a few sensations such as fright, not able to get enough air, intense tightening in the chest or suffocation
Dyspnea objective symptoms
Abnormal breathing frequency, rhythm, and depth
Major dyspnea symptoms
Symptoms: difficulty in breathing, expectoration or no expectoration or no expectoration, breathing with raised shoulders and open mouth, *flaring nostrils, inability to lie down.
Dyspnea location
Location: Lung, Kidney (also related to Liver, Spleen)
Dyspnea etiology and pathogenesis
Key is obstruction of the lung (by qi, not necessarily phlegm) and rebelling of lung qi, upper excess and lower deficient, no hidden phlegm like asthma
Dyspnea key point
Obstruction of lung qi, rebellious lung qi, failing of kidney accepting lung qi
Distinguishing short of breath from dyspnea
Shortness of breath is a beginning stage or compensation stage, dyspnea is a decompensation stage
Symptoms: dyspnea, fast breathing, chest oppression and fullness, cough, white clear sputum, stuffy nose, clear nasal discharge, headache, sore body and limbs, aversion to cold, mild fever, no perspiration, short duration (couple days to one week maximum)
Tongue: thin white or slippery coating
Pulse: floating tight
WIND COLD OBSTRUCTING THE LUNG DYSPNEA
WIND COLD OBSTRUCTING THE LUNG DYSPNEA treatment principle
TP: expand the lungs, disperse wind and cold, stop dyspnea
WIND COLD OBSTRUCTING THE LUNG DYSPNEA formula
Ma Huang Tang
WIND COLD OBSTRUCTING THE LUNG DYSPNEA pathogenesis
Pathogenesis: wind cold attacks the lungs, obstructing the lung qi’s dispersing and descending
Symptoms: dyspnea, wheezing, chest distention or pain, heavy breathing, flaring of nostrils, cough, sticky phlegm, aversion cold, fever, irritability, painful body, sweating or no sweating, thirsty, yellow urination, dry stool
Tongue: red, thin white coating or yellow coating
Pulse: floating rapid or slippery
EXTERIOR WIND COLD INTERIOR PHLEGM HEAT DYSPNEA