Wen Bing Differentiation Syndromes Flashcards
Febrile Disease
What is the 4 Levels differentiation also known as?
‘Wen Bing’
What does the 4 Levels differentiation refer to?
Theory of Warm Disease or Fever or Febrile Diseases
What external factors are involved in the 4 Levels differentiation?
Invasion of Warm Heat External Evil or Pestilence
What are the four levels used to differentiate syndromes?
Wei, Qi, Ying, Xue or Blood
What is the purpose of the 4 Levels differentiation?
Used to diagnose epidemic or pestilent febrile diseases
What does the method of 4 Levels differentiation explain?
The course of development and transmission from shallow to deep and mild to severe based on symptoms in each of the 4 levels
What are the two types of transmission?
Regular and Irregular
What is the sequence for Regular transmission?
Wei - Qi - Ying - Blood
What are the sequences for Irregular transmission?
Wei - Ying, Qi - Blood, Wei - Blood
The following are S/sx of which level?
Fever ( approx 38.5c)
Slight aversion to Wind or Cold
Commonly accompanied by:
Headache
Cough
Mild thirst
Sore throat
T: Red tip, maybe edges
P: Floating + Rapid
Wei Level
(Exterior Level ie: common cold, measles in children)
Due to Wind-Heat or Wind-Warm
What are the main points in treating Wei Level?
BL-12
GB-20
LI-4 + LU-7
What are the best points for treating Qi Level?
Clear Heat
DU-14 + LI-11
LI-4 + LR-3
What are the best points for treating Qi Level: Heat in Lungs?
LU-5 + LU-7
PC-6 + REN-17 + Dingchuan
What are the best points for treating Qi Level Heat in Chest + Diaphragm?
PC-8 + HT-8
PC-6 + HT-7
What are the best points for treating Qi Level Heat in ST?
ST-44 + ST-45 + ST-36
What are the best points for treating Qi Level Heat in ST + LI?
ST-44 + LI-11 + LI-4
St-36 + ST-37 + ST-39
What are the best points for treating Qi Level- Heat in GB?
LR-2 + GB-34 + GB-43 + PC-6
What are the best points for treating Qi Level- Damp-Heat?
SP-9 + GB-34 + LI-11 + REN-17
The following are S/sx of which level?
High fever without chills (<39c)
Aversion to heat
Thirst w/ desire for cold drink
Profuse sweating
T: Red w/ yellow coating
P: Forceful + Rapid
Qi Level
(Wei is fighting hard with Evil)
The following are S/sx of which level?
Cough
Asthma
Dyspnea
Nasal flaring
Pain in chest
Yellow sputum
Maybe wheezing
Maybe convulsion (Heat stirs up internal wind)
Qi Level- Heat in Lung (Lung Heat)
The following are S/sx of which level?
Restlessness
Severe vexation
Chest distress
Nausea
P: Rapid
Qi Level-
Heat Retention in Chest + Diaphragm
The following are S/sx of which level?
Tidal Fever (Yangming)
Abdominal pain w/ distension + hardness
Aggravated by pressure
Constipation or heat-fecaloma w. greenish-watery stool
T: Thick + dry yellow or even brown coating w/ thorns
P: Forceful
Qi Level-
Heat Retention in Intestines/Stomach
The following are S/sx of which level?
High fever
Profuse sweating
Extreme thirst w/ desire for cold
P: Surging
Qi Level-
Heat Retention in Stomach
The following are S/sx of which level?
Bitter taste in the mouth
Hypochondria pain
Nausea
Restlessness
Scanty, yellow urine
Jaundice
Qi Level-
Heat Retention in Gallbladder
(Early stage of hepatitis or GB Stone in W/med)
The following are S/sx of which level?
Lassitude
Stuffy Chest
Abdomninal distention
Scanty urine
Thirsty w/ no desire to drink
P: Soggy + Rapid
Qi Level w/ Damp-Heat
Which 2 organs are sensitive to Blood?
HT + LR
How is the Healthy Qi affected in the Ying Level?
Healthy Qi is damaged and Evil has penetrated deeper into the Ying level
The following are S/sx of which level?
Fever, peaking at night (Ying Qi is higher at night)
Slight thirst or no thirst (Ying Qi is scorched)
Restlessness
Insomnia
Dim skin rashes
T: Crimson or purple w/out coating
P: Thready + Rapid
If evil spreads to PC:
Possible delirium or coma + cold limbs
T: Purple or dark-red
Ying Level
What Western Med diseases are seen in Ying Level?
Chicken Pox
Measles
What are the main points for treating Ying Level?
Tonify Ying Qi + Nourish Yin
SP-6 + SP-10 + BL-17
KI-6 + KI-3 (or REN-7: Tonify Yin)
Clear Heat:
LI-4 + PC-8 + PC-9 (restlessness + insomnia)
KI-1 + Jing-well
The following are S/sx of which level?
1) Overflowing of hot blood:
Fever peaked at night, restlessness, madness or unconsciousness or quietness after rash comes out, developed skin rashes w/ bubbles, spitting blood, epistaxis, hematuria, hematochezia, endmetrorrghia
T: Purple or crimson w/ no coating
P: Rapid
2) Stirring up of wind by Blood-Heat:
High fever, coma, convulsion, nick stiffness, opisthotonus, fixed eyes, lockjaw (seen in very strong constitutions)
T: Purple or crimson w/ no coating
P: Rapid
3) Consumption of Original Yin:
Tidal fever + hectic cheek in the afternoon, 5-center heat, steaming bone, dry mouth, dry throat, palpitations, fatigue, sunken + faint eyes, twitching of limbs, hoarseness, emaciation, dry teeth, shrinkage of dry lips, or even coma (seen in normal to weak constitutions)
T: Purple or crimson w/ no coating
P: Rapid + Weak
Blood Level
(Yin + Yang exhausted= death)
What are the main points for treating Xue Level?
Awaken Shen + Clear Blood Heat + Stop Bleeding + Save Life
1) SP-6 + SP-10 + BL-17 + SP-1
HT-8 + PC-8 + DU-14
2) SP-6 + SP-10 + BL-17 + SP-1
HT-8 + PC-8 + DU-14
Jing-well + LR-3
3) Tonify Original Yin:
BL-23 + REN-9 + SP-6 + BL-43
How to differentiate Ying and Blood Level S/sx?
Rash- under skin: Ying Level
Rash- everywhere on the body: Blood Level
Shen- delirium, pt still has clear Shen: Ying Level
Shen- highly affected, coma: Blood Level
Pulse: Thready + Rapid: Ying Level
Pulse: Weak + Feeble + Rapid: Blood Level
Tongue- Deep red: Ying Level
Tongue- Purple: Blood Level
