Wen Bing Differentiation Syndromes Flashcards by Emily Tratt

What is the 4 Levels differentiation also known as?

‘Wen Bing’

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What does the 4 Levels differentiation refer to?

Theory of Warm Disease or Fever or Febrile Diseases

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What external factors are involved in the 4 Levels differentiation?

Invasion of Warm Heat External Evil or Pestilence

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What are the four levels used to differentiate syndromes?

Wei, Qi, Ying, Xue or Blood

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What is the purpose of the 4 Levels differentiation?

Used to diagnose epidemic or pestilent febrile diseases

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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

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What are the two types of transmission?

Regular and Irregular

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What is the sequence for Regular transmission?

Wei - Qi - Ying - Blood

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What are the sequences for Irregular transmission?

Wei - Ying, Qi - Blood, Wei - Blood

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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

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What are the main points in treating Wei Level?

BL-12
GB-20
LI-4 + LU-7

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What are the best points for treating Qi Level?

Clear Heat

DU-14 + LI-11
LI-4 + LR-3

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What are the best points for treating Qi Level: Heat in Lungs?

LU-5 + LU-7
PC-6 + REN-17 + Dingchuan

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What are the best points for treating Qi Level Heat in Chest + Diaphragm?

PC-8 + HT-8
PC-6 + HT-7

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What are the best points for treating Qi Level Heat in ST?

ST-44 + ST-45 + ST-36

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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