ZF 2 Final Flashcards
What are the ID patterns of the 4 levels?
WEI
QI
YING
XUE
Within the 4 levels there is Wei level, what are the 4 types of heat and what is the most common?
wind heat (the most common)
damp heat
summerheat
dry heat
Out of the 4 levels what level is the Qi level and what are the are types of patterns within this level?
the pathogenic factor has moved from exterior to interior and transferred to heat, but it’s the most superficial of the interior layers.
there is the LU heat stomach heat ints. dry heat GB heat and damp heat in the SP & ST
in the ying level, what are the 2 patterns?
Heat in the ying Qi level
& heat in the pericardium
Xue level patterns?
heat makes the blood move recklessly
heat stirs wind
empty wind agitating the interior
collapse of yin and collapse of yang
6 stages of Pattern ID: what are the different stages?
Greater Yang Taiyang (Exterior) (UB & SI)
Bright Yang Yangming (Qi level ST & INTS)
Lesser Yang Shaoyang (alt between interior/exterior) (GB&SJ)
Greater Yin Taiyin (interior def cold) (LU,SP)
Lesser Yin Shaoyin (most critical) (HT, KD)
Terminal Yin Jueyin (LV, PC)
With the Greater Yang stage (Taiyang) what are the 4 patterns?
Invasion of Wind Cold with prevalence of Wind
Invasion of Wind Cold with prevalence of Cold
Accumulation of Water
Accumulation of Blood
What are the s/sx of Taiyang wind cold attack with emphasis on wind?
sl. aversion to cold, aversion to WIND, sl fever, sl. sweating, headache & stiff neck, sneezing, floating slow pulse
what are the s/sx of Taiyang wind cold attack with emphasis on cold?
aversion to cold, sl fever, NO sweating, headache and stiff neck, sneezing runny nose with white discharge, breathlessness, floating tight pulse.
S/Sx of Accumulation of Water in the Taiyang level?
aversion to cold, fever, retention of urine, sl thirst, vomiting of fluids soon after drinking. Floating rapid pulse
(Although the Taiyang is not in the interior the pathogenic factor is in the UB while there’s still s/sx on the exterior in this pattern)
S/Sx of Accumulation of Blood in the Taiyang stage?
hypogastric distention, fullness & urgency, blood in urine, mental restlessness & reddish purple tongue w/ coat, deep fine rapid or deep & choppy pulse.
bright yang stage ( Yangming) is in what organs and what are the s/sx?
ST & L.I.
HIGH FEVER, profuse sweating, intense thirst, red face,, feeling of heat, irratability, delirium, red tongue w/ yellow coat. overflowing rapid pulse
(@ this stage the pathogen has transferred into the interior and transformed into heat - pattern is FULL HOT)
What are the 2 types in the Yangming stage?
Yangming channel pattern (4 BIGS)
Yangming organ pattern (interior heat in the ST & INTS. However, the heat is more intense & has injured the body fluids and caused dryness
Lesser Yang (Shaoyang stage) s/sx?
oscillating from exterior to interior
** it is important to note that the aversion to cold & feeling of heat alternate & are not simultaneous as in the Greater Yang pattern
alternation of shivers (or cold feeling) & fever (or feeling of heat), bitter taste, dry throat, blurred vision, hypochondriac fullness & distention, no desire to eat or drink, irritability, nausea, vomiting, unilateral thin white coating. Wiry - fine pulse
Greater Yin (Taiyin) stage s/sx? (1st stage of the yin patterns)
abdominal fullness, feeling cold, vomitting, no appetite, no thirst, diarrhea, tiredness, pale T, sticky white coat.
Deep- weak pulse
(this pattern is characterized by SP yang def with cold)
Lesser Yin Stage (Shaoyin) has how many patterns and what are they?
Cold transformation=
feeling cold, chills, lying w/ body curled up, desire to sleep, listlessness, cold limbs, diarrhea, no thirst, frequent pale urine. Pale wet Tongue with coat. Deep-slow-weak pulse
(the pathology of this pattern is essentially KD yang def w/cold)
Heat transformation=
feeling of heat, irritability, insomnia, feverish sensation in 5 center areas, nights sweats, dry mouth-throat, little coat red tongue, thready rapid pulse.
(KD yin def w empty heat)
Terminal Yin Stage or Jueyin s/sx?
persistent thirst, feeling of energy rising to the chest, pain & heat sensation in the heart region, hungry but no desire to eat, cold limbs, diarrhea, vomiting or vomit of roundworms, wiry pulse.
(this pattern is characterized by heat above and cold below)
What 4 bigs characterize the Yangming channel?
Big sweat, big thirst, big fever, big pulse
How does the pulse differ between the Bright Yang channel and the organ pattern?
The pulse in the channel pattern is overflowing and rapid or Big & rapid.
The organ pattern would have a deep -full -slippery-rapid, which represents the deeper location of the fire.
Which organ pattern does the greater Yin pattern most resemble?
SP yang deficiency
What tongue & pulse would you expect in the lesser Yin pattern?
pale wet tongue with white coating. Deep weak slow pulse. ( KD Yang def)
Give one symptom of each in the heat above and cold below of the terminal yin stage?
Heat above: thirst, feeling of energy rising in the chest, pain and heat sensation in the chest, hunger
Cold below: no desire to eat, vomiting, diarrhea, cold limbs
Who formulated and set down the theory for of ID patterns for the 4 levels and what was his book called?
Te Tian Shi
Study of Warm Dz (Wen Bing Lun) 18th century
Give the 5 special characteristics of warm dz?
the all manifest with a fever they enter through the nose and mouth they are infectious the pathogenic factors are rapid the pathogenic factor has a strong tendency to injure yn
Give 3 general s/sx of a pathogenic factor at the Qi level?
fever, thirst, feeling of heat, mental restlessness, red tongue with thick yellow coat and rapid full pulse
Give 2 general symptoms which differentiate Ying level from Qi level?
fever at night and a deep red tongue w/o coat
Which symptom is a definite sign that the heat has reached the blood level?
macules
What 3 pathogenic factors characterize an invasion of summer heat?
external wind, dampness and interior heat
How would you expect the tongue look with heat in the nutritive level
red without coating (heat has injure d the yin)
What are the 3 general symptoms which characterize heat in the blood level?
fever @ night, bleeding, internal wind
What are the 3 main patterns of Latent Heat and give their levels
Lesser yang (Qi level) Bright yang (Qi level) Lesser Yin (blood level)
Which organ pattern corresponds to the pattern of wood not generating fire?
deficient gall bladder
Describe the symptoms and their pathology caused when earth does not generate metal?
PHL in the chest, cough and tiredness caused by a deficient SP, leading to the accumulation of PHL which obstructs the LU’s
Identify the clinical manifestations in terms of their 5 element sequence pattern: dizziness
blurred vision
headaches and vertigo
water not generating wood
If a patient has multiple symptoms involving the LU’s but has a yellow face?
in the earth element (the face color usually shows the origin of the disharmony
Which internal organ pattern corresponds to the pattern of fire insulting water?
KD & HT are not harmonized. or KD or HT yin deficiency with empty heat
Wood overacting on Earth?
LV & SP/ST disharmony
LV Qi stagnation w/ SP Qi def
Water not generating wood?
KD yin def w/ LV yang rising
(low back/knee pain, tinnitus, seminal emissions, dizziness, blurred vision, vertigo, headache, irritability
Water insulting earth?
KD & SP yang def
(pale complexion, cold limbs and body, chronic loose stools or cocks crow, watery stool w undigested particles, edema, difficult urination. pale tender tongue with slippery coat. deep slow weak pulse)
How does identification of patterns according to the 3 Burners relate to that of the 4 levels?
The patterns of the middle burner are essentially the same as those of the Qi level and those of the lower burner are essentially as some of those of the blood level.The patterns of the of the upper burner occur at 3 depths: Wei, Qi and Ying.
At which of the 4 levels is the pattern Heat in the LU’s?
@ the Qi level
Give 3 examples of Heat in the pericardium
high fever @ night, a burning sensation of the epigastrium, cold limbs, delirium and aphasia
You suspect a diagnosis of Heat in the bright Yang. The patient has a high fever, thirst, feels hot and has no aversion to cold. Do these s/sx support your diagnosis?
yes
describe the tongue and pulse for the pattern Heat in the KD’s
Deep red tongue without coating. Floating empty pulse and rapid pulse
What is Etiological pattern identification?
analysis of the s/sx and bodily
evidence of the disease as well as any
objective reasons in order to grasp the disease cause, differentiate the nature of the pattern
and determine the treatment method
What are pathogenic factors?
（病因）
also cause of disease, are pathogens, etiological factors, or
causative factors, which refers to the reasons
for breaking up the state of relative balance in
the body and leading to development of
disease. Such as pathogenic wind, heat,
coldness, or blood stasis, phlegm, or parasite,
and trauma injury, etc.
What are the primary pathogenic factors
Exopathogenic factors
Endopathogenic factors
What are the secondary pathogenic factors?
PHL
Blood stasis
Stone
In pathogenic factors that aren’t primary or secondary factors what are some other factors?
trauma injury, parasites, genetic factor, toxicity etc
What are the differences between endopathogens and exopathogens
Endopathogens are the 7 emotions, improper diet, overstrain.
Exopathogens are 6 evils Qi & pestilence (fatal or epidemic dz)
The conditions for six climatic factors to
transform into six pathogenic factors, what are they?
– Sudden or extremely, or appear in wrong season
– Antipathogenic qi insufficient
pattern caused by wind,
wind attack s/sx?
wind, cold, heat, damp & dryness
Wind Bi s/ sx according to Etiology Pattern ID
joint pain, goiter, arthritis
Wind water according to Etiology Pattern ID s/sx
wind prevents the LU from opening the water passages to diffuse and descend fluids. Edema, swollen eyelids, superficial pulse
wind blocks the collaterals according to Etiology Pattern ID s/sx
blocks Qi circulation, causing issues with muscle and tendons
Cold Pattern according to Etiology Pattern ID s/sx and what season?
Winter or summer from AC’s
Yin pathogen damage yang Qi (could be exterior or ZF)
loose stools, afraid of or aversion to cold, cold limbs, and cold pain, joint stiffness, aching or pain, spasms in the limbs. tight or slow pulse
cold attack of the exterior would have sweating or no sweating and what other 2 important symptoms?
No sweating, chills and fever
cold attack in the interior would look like what?
and cold relieved by warmth, vomiting clear fluids, borborygmus & loose stools (Qi & dampness accumulate)
deep tight or wiry pulse
cold bi looks like what?
Especially for elderly or someone who lives in a cold environment
joint pain, cramping, difficult bending or stretching
Summerheat pattern s/sx? Is it internal or external? What season?
ALWAYS EXTERNAL, it cannot be internal
early summer (hot & humid) YANG Pathogen
high fever, irritability, surging pulse, red face and eyes, dizziness, blurred vision, restlessness or even coma, sweating, SOB, thirsty, red tongue, fatigue (dampness)
UNSURFACED FEVER
what is a unsurfaced fever?
the longer you feel someones skin or forehead the more heat you feel. (this is the dampness holding back at first touch)
wind rashes cause?
pathogenic wind lodged in interstitial
space
Wind can combine and usually does with heat, cold, damp that attack the body surface, the defensive Qi rises up to fight the pathogens, LU Qi dispersing and descending function is impaired. What s/sx do you start to see?
ALL have chills and fever with a superficial pulse.
heat= sore throat, sweating, rapid pulse
cold= headache, cough w/ thin white sputum, body ache, tight pulse
damp= wrapped headache, body ache, heaviness, PHL & slippery pulse
Summer Warm pathology and s/sx
heat invade and transfer into the body rapidly, impair body fluids and qi, generate wind, Consume body fluids and impairs qi Acute onset with high fever, profuse sweating, irritability, restless, sever thirst, headache, or manic, coma, convulsion or even opisthotonus
sun stroke cause and s/sx
Long time exposure to sun with physical activities, or staying in a hot and poor ventilation place. Heat upward disturb Heart spirit, damage body fluids
Restlessness, irritability, vexation,
Sudden fever, profuse sweating,
thirst and hasty breathing, Fainting,
loss consciousness, and cold limbs
damp is a yin type pathogen, what are it’s characteristics and s/sx?
impairs yang Qi and obstructs Qi circulation,
s/sx are Full sensation in the chest,
epigastric distention, difficult and
scanty urination, edema, poor
appetite, loose stool, etc
Dampness that is heavy and stagnates can impair the SP what are the six?
Poor appetite, loose stool,
bloating snd distention
If dampness is turbid and lingers, it is difficult to cure, recurrent or has a long course you would get s/sx that look like?
Eczema, osteoarthritis,
damp fever (intestinal
thyphoid), etc.
What are the patterns caused by Dampness?
Dampness attack body exterior Invade by dampness Damp-Bi Damp-warm Damp-rash (Eczema)
Dampness attack
the exterior characteristics and s/sx?
External dampness invading suppress
defensive qi, obstruct the Lung qi,
impair the Spleen qi, and restrict the
yang qi ascending and outward
Aversion to cold, fever, wrapped and
heavy headache, suffocated sensation in
the chest, poor appetite, bloating, nausea,
no thirst, heavy and aching limbs, general
lassitude and heaviness, greasy coating,
superficial and slippery or soft pulse
Invade by dampness characteristics s/sx?
Dampness obstruct qi circulation, clear
yang not able to ascend and reach out
Wrapped heavy headache, heavy and
aching limbs, general lassitude
dampness Bi characteristics and s/sx?
Dampness obstruct channels and
collaterals, lodge in lower extremities
joints
Joint pain, numbness, stiffness with heavy
sensation, may have some degree of
swelling, worse in the low extremities
Damp warm characteristics & s/sx?
Damp-warm hidden in the qi level or in the middle burner, dampness and heat mixed and lock in each other, heat accumulates inside dampness, and dampness constraints the heat from radiating out and emitting to the surface
Un-surfaced fever, fever aggravated in the
afternoon, and not relieves after sweating,
it may linger for days or weeks. Bloating,
nausea, lassitude, heavy limbs, poor
appetite, sticky stool and incomplete
feeling after defecation.
Damp rashes Eczema characteristics & s/sx?
Damp-heat accumulates on body
surface area, with attack by exterior
wind
Small, fluid-filled bumps that become
moist and ooze. And red, crusted, or open
lesions may appear on any area affected
Dry pathogen characteristics and S/sx?
Consumes body fluids Dry mouth and lips, dry nose and throat, dry and chapped skin, scanty urine, and dry stool Apt impair lung, cause lung lost its dispersing and descending function
Dry cough without phlegm, or with phlegm but difficult expectorate, or with blood stained sputum, or even with hasty breathing and chest distress or chest pain
There are two pattern for Dryness which occurs during what season and is yang or yin?
Yang, Winter (heater high) or autumn dryness (early warm, late cool)
Warm dryness
Cool dryness
Pathogenisis & S/sx of cool dryness?
Cool dryness attack lung cause lung lost its dispersing and descending function Slight headache, aversion to cold, no sweating, cough with little sputum, itching throat, nasal congestion, dry nose and mouth, white coating, superficial pulse
Warm dryness pathogenesis & s/sx?
Dryness heat attacks lung cause
lung lost its dispersing and
descending function
Fever with sweating, thirst, dry throat, cough with chest pain, or with little sticky bloody sputum, scanty urine and dry stool. Dry yellow coating, and superficial rapid pulse
Excess Fire (yang pattern) different pathogenesis:
Fire in the Qi level
Fire in the Ying level
Fire in the Xue level
Fire disturb heart spirit
Fire exuberance stirring wind
What do all fire pathogenesis have in common as far as s/sx?
red face, sweating, thirst and desire for cold drink, yellow urination, red tongue with yellow coat and rapid pulse
Fire in the Qi level, what are the s/sx?
High fever worse between 3-5 pm,
sweating, thirst and desire for cold
drink, irritability, constipation,
surging pulse
Fire in the Ying level
Fever worse in the evening, thirst but
no desire to drink, irritability,
insomnia, deep red or crimson
tongue, rapid pulse
Fire in the blood level s/sx?
Various types of bleeding or macule
papule eruptions
Fire disturb Heart spirit s/sx?
Irritability, uneasiness, Coma,
delirium
Fire exuberance stirring
wind
Convulsion
Heat Toxic / Fire or Heat accumulate in local area spoils and ulcerates the flesh
Boils, sores, skin ulcers, abscesses, with local
redness and sswelling
