WEEK 6 Class 11 : Eight Principles Flashcards
What is Bian Zheng?
Pattern Identification / syndrome identification
SOAP
TCM Treatment
S Subjective Symtoms (pain, tingling, etc.)
O Objective (swelling, redness, lump, red eyes etc.)
A Assesment (Find disease / location and pattern)
P Plan
How to differentiate a pattern?
FIND
- Nature of disease (hot/ cold or def/excess)
- Location (tissues? Meridian? organs?)
- Course and direction of disease development (how and when…. onset and how long, etc.)
Not just “liver problem” - we need to know what is happening with Liver. Qi stagnation? Excess? Def pattern? etc.
Methods to Differentiate patterns
8 principles (Bā Gang Biàn Zhèng) -> General guiding principle
Causative Factors (Bing Yin Biàn Zhèng) -> external/ internal pathogenic factors
Internal Organs (most important) (Zàng Fû Biàn Zhèng)
Qi Blood and Body Fluids
4 Levels (Wei, Qi, Ying, Blood)
Six Channels (Liù Jīng Biàn Zhèng)
San Jiao Biàn Zhèng
5 Elements
12 Meridians (if pain is along the meridian we may look at the organ)
8 principles (Bā Gang Biàn Zhèng)
- Yin / Yang
(general guiding principles, but too vague on its own) - Interior / Exterior
(roughly where the problem is, externally generated or internally generated) - Cold / Heat
(nature of temperature.) Ex. Is the heat def or excess? - Deficiency / Excess
Relative strength of pathogenic factor and upright Qi, Course of the disease
What is Upright Qi?
” Zhēn Qì “
Upright, True Qi.
This is the body’s energy, and the body’s ability to cope with disease.
If upright Qi is weak, pathogenic factors can invade. (Weak immunity.) People who always get sick have weak Defensive / Wei Qi and Zhen Qi.
Yin / Yang pattern differentiation used for
nature and location, general
too general. need more info
Cold / Heat
nature
Deficiency / Excess
nature
Yang Yin basic nature
int/ext. temp, def/ex
yang : exterior, heat and excess
yin : interior, cold, def
(It mostly refers back to heat, temperature)
A person has fever and feels hot, that’s Yang.
If person feels cold, that’s a Yin syndrome.
Yin and Yang to specific organs
Yin def. and Yang def. can specify the status of the energy of the organ.
Yin syndromes / patterns show these symtoms
No “shen”, sallow skin, pale, inhibition, hypo-activity, quiescence (being quiet or dormant)
Yang or Qi deficiency (They feel cold, empty cold.)
Retention of excess cold pathogen / excess cold / may retain phlegm
Yang syndrome
- hyper, easily agitated, bright complexion
- Yang or Qi hyperactive
- accumulation of yang pathogenic factors (heat), dryness, wind can also be a heat factor
Clinical characteristics of Yin pattern
Yang Def. or too much Yin.
Insufficiency of body’s ability
Slow metabolism, body shut down
Cold gong into the interior (someone who is exposed to too much cold may not want to talk, may shut down)
Diet can affect Yin (both cold food in nature and cold food in temperature. May have digestive issues.) Consumes Yang.
Too much YIn:
May have phlegm, thick coating on tongue, gain weight, feel heavy.
Old age: We tend to have more Yin patterns. Less movement.
Weak constitution. Not enough Yang or Qi. Genetic Yin pattern.
*Yin patterns tend to be seen as Empty cold pattern (Yang def.)
Symptoms and Signs (S&S for Yin pattern)
- cold body and limbs, pale tongue with moist white covering, pale white or dark and somber complexion, withered essence/spirit, S.hortness Of B.reath, no desire to speak, bland taste in mouth, lack of thirst, desire for warm fluids, cleat and long urine, loose stools, and deep, slow and forceless pulse
Treatment for Yin Pattern
Warm Yang and disperse the cold
Yang pattern characteristics
Hyperactive body function
high metabolism, desire for spicy, acrid, pungent dry food
- transformation of exterior pathogen to heat
- tendency towards hyperactivity of Yang qi of the zang fu
(Spleen and Kidney never have hyperactivity. )
Liver tends to be hyper as Liver Yang Rising or Liver Qi Stagnation.
Symptoms and Signs of Yang Pattern
Fever, no aversion to cold, aversion to heat, cold drinks, less clothing, red eyes, irritability, agitated, lots of movement, talk a lot, quick breathing, loud voice, bitter taste in the mouth, lots of water, dark urine, dry stools, red tongue body, yellow and dry tongue coating, surging and rapid pulse (over 90 - rapid pulse.)
Empty heat Yin deficiency signs
Yin deficiency:
Still hot / fever but it’s not from excess yang.
Red face may just be cheeks.
Afternoon fever or evening fever.
Pulse may be thin and rapid instead of forceful and rapid.
Yin collapse : Critical condition
critical condition - so def. cannot be nourished or notified can develop into Yin collapse.
massive loss of Yin fluids, severe vomiting and great loss of blood, eventually leads to Yang collapse. Empty heat signs: sticky sweats, thirsty but don’t want to drink, irritability, rapid and feeble pulse
Yang collapse : Critical condition
May develop from extreme Yang or Qi consumption
- profuse sweating or blood loss
Leads to yin collapse eventually.
Empty cold signs: body cold to touch, listless, cold sweat like pearls, no thirst, pale and moist tongue, thin and fading pulse. slower than yin collapse pulse.
EXTERIOR AND INTERIOR depth
Location and depth of disease.
exterior = superficial, interior = deeper
What is the “exterior”?
Hair, skin, muscles, interspaces, superficial meridians and collaterals
what is “interior”?
Zang Fu organs
How can we see the course of disease through interior/ exterior?
If pathogen goes to the interior… it’s getting worse.
If it goes towards the exterior, patient is getting better
Exterior Syndrome / Pattern
Invasion of external pathogen from exterior
S&S of Exterior Syndrome
- fast onset / chills and fever, short course of disease (like a cold or flu)
Headache, general aching, pain, nasal stuffiness, runny nose, sore throat (wind heat), skin, itchiness in throat (wind cold)
defensive qi warming the exterior layers, fighting… we have fever
Exterior pattern can be
Cold, heat, deficiency or excess in the superficial layer
Fever
Upright Qi and pathogen fight each other
Pain
Qi Stagnation
Interior Syndrome / Pattern Causes
- Unresolved exterior pattern moving inside
- Direct attack of exogenous pathogen to interior (meningitis)
- Dysfunction of Zang-Fu themselves
Interior VS Exterior
Exterior: fever and aversion to cold
Interior: fever with no aversion to cold. OR aversion to cold with no fever
Pulse Exterior vs Interior
Exterior: floating;
Interior: not floating (unless critical: Yin/Yang are separating)
