Week 2: Internal Damage Fever, Jaundice, Bleeding Disorders, Consumptive Disease.

Question 1

A client comes to an acupuncturist. Describe the TCM logic or brain process to go through in order to arrive at a treatment.

Answer 1

Signs and symptoms first.
Tongue and pulse second.
Syndrome differentiation third.
Treatment principles fourth.
Acupuncture point selection fifth.

Question 2

Red eyes are typically ______________ syndrome differentiation in TCM?

Answer 2

Liver fire.

Question 3

Clinically characterized by slow onset, long duration, low or high fever, self-conscious fever or five center heat?

Answer 3

Internal damage fever.

Question 4

Kind of internal damaged fever? Do a syndrome differentiation.

Low grade fever, tidal fever in the afternoon, comes and goes with emotions, depression, distention in the chest and hypochondriac, irregular menstruation, and distention in the breast.
Irritability, dry mouth, bitter taste in the mouth.
T: yellow coating.
P: wiry-rapid.

Answer 4

Liver qi stagnation.

Question 5

Kind of internal damaged fever? Do a syndrome differentiation.

Fever in the afternoon or night, or self-consciousness of fever at certain local area of the body.
Dry mouth and throat without much desire to drink.
Pain or swelling in the torso or limbs, fixed location.
Scaly skin, sallow or dark complexion.
T: dark purplish, ecchymosis, petechiae.
P: choppy.

Answer 5

Blood stasis.

Question 6

Kind of internal damaged fever? Do a syndrome differentiation.

Low grade fever, worse in the afternoon.
Stuffy chest, heavy body.
Poor appetite, thirst without desire to drink, even nausea, vomiting.
T: white-greasy, or yellow-greasy coating.
P: soggy-rapid.

Answer 6

Damp-heat.

Question 7

Kind of internal damaged fever? Do a syndrome differentiation.

High- or low-grade fever. Worse with exhaustion. Dizziness, fatigue, SOB, dislike talking.
Spontaneous sweating, easily catch cold.
Poor appetite, loose stool.
T: pale, thin-white coating.
P: weak.

Answer 7

Qi deficiency.

Question 8

Kind of internal damaged fever? Do a syndrome differentiation.

Low grade fever. Dizziness, blurred vision.
Palpitation, anxiety. Lusterless complexion, pale lips.
T: pale.
P: weak.

Answer 8

Blood deficiency.

Question 9

Kind of internal damaged fever? Do a syndrome differentiation.

Chills, cold limbs, SOB, dislike talking, dizziness, likes staying in bed.
Poor appetite, loose stool.
Bright-white complexion.
T: pale, thin-white coating.
P: weak.

Answer 9

Yang deficiency.

Question 10

Clinically characterized by yellow eyes, yellow skin and yellow urine. Yellow eyes is the main basis for diagnosis.

Answer 10

Jaundice (icterus) - accumulation of bilirubin in the bloodstream.

Question 11

Do a syndrome differentiation for jaundice:

Yellow eyes and skin (fresh yellow).
Fever, thirsty, scanty & dark urine.
Abdominal distention, constipation.
Restlessness, dry mouth, bitter taste, nausea.
T: yellow-greasy coating.
P: wiry-rapid.

Answer 11

Yang jaundice (heat is greater that dampness).

Question 12

Do a syndrome differentiation for jaundice:

Yellow eyes and skin.
Heavy sensation in the head and body.
Fullness in chest and abdomen, poor
appetite, nausea, vomiting, loose stool.
T: thick-greasy coating, or slight yellow.
P: soggy-slippery, wiry-slippery.

Answer 12

Yang jaundice (dampness is greater than heat).

Question 13

Do a syndrome differentiation for jaundice:

Yellow eyes and skin (dull yellowish like smoky).
Poor appetite, abdominal distention, loose stool, no thirst.
Lassitude, aversion to cold.
T: Pale, white-greasy coating.
P: soggy-moderate, deep-slow.

Answer 13

Yin jaundice.

Question 14

Do a syndrome differentiation for jaundice:

Rapid onset, yellow eyes and skin
(golden yellowish, high fever, big thirst).
Pain in hypochondria and abdomen.
Coma, delirium.
Nose bleeding, bloody stool, ecchymosis.
T: dark red, yellow-dry coating.
P: wiry-rapid, thready-rapid.

Answer 14

Acute jaundice.

Question 15

Treatment principle for acute jaundice?

Answer 15

Clear Heat.
Detoxification.
Cool blood.

Question 16

Kind of jaundice that we use xi cleft and ying spring points for?

Answer 16

Acute jaundice.

Question 17

Bleeding disorders - epistaxis syndrome differentiation?

Epistaxis, dry nose, dry mouth and throat.
Fever.
Cough, scanty sputum.
T: red.
P: rapid.

Answer 17

Lung heat.

Question 18

Bleeding disorders - epistaxis syndrome differentiation?

Epistaxis, may have teeth bleeding, fresh red blood.
Dry nose, dry mouth with desire to drink.
Constipation.
T: red, yellow coating.
P: rapid.

Answer 18

Stomach heat.

Question 19

Bleeding disorders - epistaxis syndrome differentiation?

Epistaxis, headache, blurred vision.
Red eyes, bitter taste, irritability.
T: red.
P: wiry-rapid.

Answer 19

Liver fire.

Question 20

Bleeding disorders - epistaxis syndrome differentiation?

Epistaxis, teeth bleeding, bruises, chronic dizziness, tinnitus.
Fatigue, lassitude, palpitation.
Bright-white complexion.
T: pale.
P: thready.

Answer 20

Qi and blood deficiency.

Question 21

Bleeding disorders - epistaxis syndrome differentiation?

Epistaxis, teeth bleeding, fresh red or pale red, chronic 5 center heat, dry mouth.
T: red little coating.
P: thready-rapid.

Answer 21

Yin deficiency.

Question 22

Gum bleeding syndrome differentiation:

Fresh red blood, swollen and painful gum.
Headache, foul breath.
Constipation.
T: red, yellow coating.
P: rapid.

Answer 22

Stomach heat.

Question 23

Gum bleeding syndrome differentiation:

Teeth bleeding, chronic.
Worse with external heat invasion or exhaustion.
Loose tooth.
T: red little coating.
P: thready-rapid.

Answer 23

Yin deficiency.

Question 24

Define hematochezia.

Answer 24

Blood in the stool.

Question 25

Define hemoptysis.

Answer 25

Coughing blood.

Question 26

Hemoptysis syndrome differentiation:

Cough, bloody sputum, dry mouth, dry nose.
Fever.
T: red, little coating, thin-yellow coating.
P: rapid.

Answer 26

Lung heat.

Question 27

Hemoptysis syndrome differentiation:

Paroxysmal cough, bloody sputum, fresh red.
Distending pain in hypochondria.
Bitter taste, restlessness, irritability.
T: red, thin-yellow coating.
P: wiry-rapid.

Answer 27

Liver fire harassing lungs.

Question 28

Hemoptysis syndrome differentiation:

Cough, scanty sputum, may have blood in sputum, or recurrent hemoptysis.
Dry mouth and throat.
Tidal fever, hot flush, night sweating.
T: red.
P: thready-rapid.

Answer 28

Yin deficiency.

Question 29

Define epistaxis.

Answer 29

Bleeding from the nose.

Question 30

Hematemesis syndrome differentiation:

Distention in abdomen, or pain.
Hematemesis, dark red blood, may be mixed with food.
Foul breath.
Constipation, dark stool.
T: red, yellow-greasy coating.
P: slippery - rapid.

Answer 30

Stomach heat.

Question 31

Hematemesis syndrome differentiation:

Hematemesis, red or purplish.
Hypochondriac pain.
Bitter taste, restlessness, irritability.
Insomnia, dreams.
T: red.
P: wiry-rapid.

Answer 31

Liver fire harassing stomach.

Question 32

Hematemesis syndrome differentiation:

Hematemesis, constant, mild or severe, dull pale color.
Fatigue, lassitude, palpitation, SOB
Pale complexion.
T: pale.
P: thready - weak.

Answer 32

Qi deficiency.

Question 33

Hematochezia syndrome differentiation:

Fresh red blood.
Constipation or loose stool.
Abdominal pain.
Bitter taste.
T: red, yellow-greasy coating.
P: soggy-rapid.

Answer 33

Damp-heat in the intestines.

Question 34

Hematochezia syndrome differentiation:

Red or purplish blood.
Poor appetite, fatigue, sallow complexion.
Palpitation, insomnia.
T: pale.
P: thready.

Answer 34

Qi deficiency.

Question 35

Hematochezia syndrome differentiation:

Purplish blood or dark stool.
Dull pain in abdomen, loose stool.
Preference to warmth and hot drink.
Lusterless complexion, fatigue,
dislike talking.
T: pale.
P: thready.

Answer 35

Spleen and stomach empty cold.

Question 36

Hematuria syndrome differentiation:

Dark urine, burning sensation, fresh red blood.
Restlessness, insomnia.
Red face, mouth ulcer.
T: red.
P: rapid.

Answer 36

Heat in the lower jiao.

Question 37

Hematuria syndrome differentiation:

Scanty and dark urine.
Dizziness, tinnitus.
Fatigue, lassitude, low back and
knee soreness and weakness.
Hot flush, tidal fever.
T: red.
P: thready-rapid.

Answer 37

Kidney yin deficiency.

Question 38

Hematuria syndrome differentiation:

Chronic hematuria, may be accompanied by teeth bleeding, skin bruises.
Poor appetite, fatigue, SOB, low voice.
Lusterless complexion.
T: pale.
P: thready-weak.

Answer 38

Spleen is unable to hold blood.

Question 39

Hematuria syndrome differentiation:

Chronic hematuria, pale red color.
Dizziness, tinnitus.
Lassitude, fatigue, low back soreness.
T: pale.
P: deep-weak.

Answer 39

Kidney qi deficiency.

Question 40

Purpura syndrome differentiation:

Purpura, ecchymosis.
May be accompanied by epistaxis, teeth.
bleeding, hematuria, hematochezia.
Fever, dry mouth, constipation.
T: red, yellow coating.
P: wiry-rapid.

Answer 40

Blood heat.

Question 41

Purpura syndrome differentiation:

Purpura, comes and goes.
May be accompanied by epistaxis,
teeth bleeding, menorrhagia.
Hot flush, 5 center heat, tidal fever,
night sweating.
Restlessness.
T: red, little coating.
P: thready-rapid.

Answer 41

Yin deficiency.

Question 42

Purpura syndrome differentiation:

Recurrent purpura, long-term, worse by
exhaustion.
Poor appetite.
Fatigue, lassitude, dizziness, blurred vision,
palpitation, SOB.
Pale complexion.
T: pale.
P: thready-weak.

Answer 42

Qi not able to hold blood.

Question 43

Consumptive disease syndrome differentiation:

Fatigue,
low voice,
dislike talking.
T: pale.
P: weak.

Answer 43

Qi deficiency.

Question 44

Consumptive disease syndrome differentiation:

Dizziness, blurred vision, lusterless complexion,
pale lips.
T: pale.
P: thready.

Answer 44

Blood deficiency.

Question 45

Consumptive disease syndrome differentiation:

Tidal fever, 5 center heat, malar flush, dry mouth.
T: red, little coating.
P: thready-rapid.

Answer 45

Yin deficiency.

Question 46

Consumptive disease syndrome differentiation:

Fatigue, somnolence, SOB, dislike talking, chills, cold limbs, profuse and clear urine, pale complexion.
T: pale, swollen.
P: weak-feeble.

Answer 46

Yang deficiency.