Download Dampness

Etiology
Dr. Lau Kah Yong
2011
1
Dynamic balance
Nature
(Environment)
Dynamic
Balance
Internal
Steady
State
2
Steady State
肝Gan
Wood
Liver
Nature
(Environment)
Dynamic
肾Sheng
心Xin
Water
Kidney
Fire
Heart
Balance
肺Fei
脾Pi
Metal
Lung
Earth
Spleen
3
Xie邪 ( Etiogical factors)
Xie 邪
Pathogenic factors
Etiological factors
Evil
Cause
Upset
Dynamic
Balance
Unsteady state
（Disease state）
4
Establishment of etiology
• Analyzing the clinical manifestation of
disease
Deduce
• Nature & features of different pathogenic
factors
5
Establishment of etiology
Nature &
features of
pathogenic
factors
Clinical
manifestations
Analyze
deduce
6
Establishment of etiology
Xie (邪)
Pathogenic factors
Functional
disorder
Zheng (正)
Clinical
signs &
symptoms
syndrome
Differentiation
Antipathogenic
factors
Seeking the cause of disease by analyzing the manifestations
7
Classification of etiological factors
Primary factors
Secondary factors
• Exogenous
six climatic factors
Pestilence
• Endogenous
•Phlegm
•Fluid retention
•Blood stasis
•Stone formation
Seven emotions
Dietary
Over working or resting
• Others
Traumatic injuries
Injuries caused by physical or chemical factors
Injuries caused by insects & animals
Hereditary
8
Six climatic factors六气
•
•
•
•
•
•
Wind 风
Cold 寒
Summer-heat 暑
Dampness 湿
Dryness 燥
Heat （fire）火
9
Six pathogenic factors
Six natural
climatic factors
Harmonious
relationship
Extreme
or
sudden
changes
Human
body
Change in
adaptability
Six pathogenic factors
10
Establishment of six pathogenic factors
Sign &
symptoms
Compare
Climate
things
phenomena
in nature
Generalize
classify
deduce
Nature &
Characteristics
11
Establishment of six pathogenic factors
e.g.
Climate
Pathogenic Common
factor
features
Clinical symptoms
Wind
Wind
Migrating pain
Tremor of limbs
Dizziness
Dampness
Dampness
Mobile
Migrating
Moving
upwards
Heavy
Sticky
Flowing
downwards
Edema of the lower limbs
Heavy
Sticky excretion
12
Six pathogenic factors
Characteristics
• Season & environment related
• May individually or collectively cause
disease
• Can be transformed into other factors
• Route of transmission may be cutaneous
nasal, or orally
13
Six pathogenic factors
• Season & environment related
Spring Summer
Late
summer
Wind
风
Dampness Dryness Cold
湿
燥
寒
Summer heat
暑
Heat (fire) 火
Autumn Winter
14
Six pathogenic factors
• May individually or collectively cause disease
e.g.
Wind + Heat = Wind heat 风热
Wind + Cold = Wind cold 风寒
Dampness + Heat = Damp heat 湿热
Dampness + Cold = Damp cold 寒湿
15
Six pathogenic factors
• Nature of disease caused may be
transformable under certain circumstances
e.g. Cold pathogen
invades deeper
Heat
Transform into
pathogens
Accumulation of
Dampness pathogen
16
Six pathogenic factors
Due to difference in body constitution
Persistent
1. Abundance of
yang
+
Exogenous
pathogens
Heat
2. Deficiency of
Yin
17
Six pathogenic factors
Due to difference in body constitution
Persistent
1. Abundance of
yin
+
Exogenous
pathogens
Cold
2. Deficiency of
Yang
18
Six pathogenic factors
Due to difference in body constitution
Persistent
1. Abundance of
dampness
+
Exogenous
pathogens
Dampness
2. Deficiency of
Spleen
19
Five endogenous pathogenic factors
• Due to dysfunction of viscera and , or
indirectly related to the six climatic factors
• Manifestation appeared are similar to those
caused by six climatic factors
• Namely endogenous heat, wind ,dampness,
dryness and cold
20
Wind tends to float
Floating
features
Attack upper
part of body
Dispersing
features
Attack skin
Headache
Running nose
Itchy throat
Fever
Sweating
Aversion to cold
21
Wind tends to move
Migrating
character
Migrating
Migrating pain
s/s
Tremor
Motility
Convulsion
Spasm
Dizziness
22
Wind tends to change
Changing
tendency
Rapid
Onset &
Recovery
Urticaria 风疹
23
Wind Leader of all disease
Leader of
other
pathogens
Associate with
Syndrome produced
Cold
Wind cold 风寒
Dampness
Wind dampness 风湿
Heat
Wind heat 风热
Dryness
Wind dryness 风燥
24
Cold
• Prevalent in cold environment
• Two types of diseases caused:
Superficial :-attacked by cold on the superficies
Internal :- attacked zangfu & impaired yang qi
• Two types of pathogenic cold
Exogenous: attacked by exogenous cold
Endogenous : result of impaired yang qi
Mutually
affecting
25
Cold tends to impair yang
Cold pertains to yin pathogen
Superficies
Stagnated defensive
(yang) qi
Aversion to cold
fever, anhidrosis 无汗
Internal :
Yang qi of viscera
Spleen, stomach
Cold pain, vomiting,
diarrhea
Heart, kidney
Aversion of cold
curling posture,
languid/spiritless
cold limbs
diarrhea with undigested
food,
profuse & clear urine
thin & indistinct pulse
26
Cold tends to coagulate
Stagnated flow or
obstruction of qi,
blood & body fluid
Meridians & vessels : Pain
Head: headache
Viscera : abdominal pain
Muscles & joints : severe pain
pain
27
Cold tends to contract
Restrain activity of
qi
Spasm of vessels
Stagnation of qi &
blood
Contraction of
meridians
Inward movement of
qi
Contraction of
muscles tendons,
meridians & vessels
Closing of the
striae of muscles
Inability of
defensive qi to
disperse
Headache
pantalgia（全身痛）
Tense pulse
Numbness
stiffness spasm
& coldness of
limbs
Chills
Fever
Anhidrosis （无汗）
Papules
28
Dampness
• Exogenous dampness
Predominant in late summer
Other predispose situations
• Wet climate
• Drench
• Living in damp area
• Endogenous dampness
Cause by failure of Spleen to transform & transport
water
29
Dampness
• Heavy
• Heavy body or limbs
• Heavy head
• Lassitude
• Turbid
•
•
•
•
•
•
Turbid secreta & excreta
Dirty complexion
Sticky lacrima
Loose stool, mucous & bloody dysentery
Turbid urine
Oozing eczema
30
Dampness tends to obstruct
Qi
• Heaviness
Tends to retain in the viscera and meridians
Disharmony of ascending & descending Qi
Obstruction of meridians
Obstructs & disrupts activities of qi
Tight chest and bloated abdomen
Scanty & unsmooth urination
Inhibited defecation
31
Dampness tends to impair yang qi
Impairs spleen & yang qi
(Spleen like dryness & dislike dampness)
Irregular water metabolism
Diarrhea, oliguria （尿少）, edema, ascites（腹水）
32
Dampness
• Sticky & stagnant
Diseases caused usually present with
Unsmooth discharge of secretions & excretion
Long course of disease & tends to recur
e.g. eczema, arthralgia （关节痛）
33
Dampness
• Tends to descend
Tends to invade lower part & yin portions of body
e.g. Stranguria（淋浊） , leukorrhea （带下）,
diarrhea
Edema is usually more severe on the lower limbs
34
Dryness
• Predominant in autumn
• Early autumn – warm dry
• Late autumn – cool dry
35
Dryness
• Xerotic （干燥） & rough
• Tends to deplete body fluid
–
–
–
–
Dry mouth, nose, throat, skin,
Cracked skin & lips
Scanty urine
Retention of dry feces
36
Dryness
• Tends to impair lung
• Depletes lung fluid
• Affect depurating & descending functions
–
–
–
–
Dry cough with scanty phlegm
Sticky sputum which is difficult to expectorate
Bloody sputum
Dyspnea （呼吸困难） & chest pain
37
Heat (fire)
• Predominant in summer
• Tends to flare up
– High fever, red face, red tongue, aversion to heat,
extreme thirst, sweating, full pulse.
• Disturbs mental activities
– Dysphoria （烦躁）, insomnia, mania （狂躁）, coma,
delirium （谵妄）
• Irritability & rapid movement
– Diseases caused has rapid onset & transmission
38
Heat (fire)
• Consume qi & impair body fluid
depletes
Heat
fluid
consume
Qi
Sweating
Thirst
dry throat dry
tongue scanty
urine
Dry feces or
constipation
Qi Deficiency
39
Heat (fire)
• Tends to cause endogenous wind
Heat
Scorch liver meridian
deplete fluid
deprive nourishment
of tendons
Liver wind
High fever
epistaxis （鼻衄）
coma
delirium
convulsion
stiff neck
opisthotonos （弓
角反张） eyeball
rolling upwards
40
Heat (fire)
• Tends to agitate blood
Blood
Flow faster
Flow out of vessels
Vessels
Scorched
Heat
Hemorrhage
hematemesis
hematochezia
hematuria,
Skin eruptions
profuse
menorrhea,
sudden profuse
uterine
bleeding
41
Heat (fire)
• Cause swelling & ulceration
Heat
Putrefy
blood &
muscles
Abscess
Furuncle
Ulceration
Redness
swelling
heat
pain
42
Summer-heat 暑热
• Hot in nature
• Pertains to yang evil
• Appears after summer solstice (夏至 Jun21-Jun22）
& before autumn solstice （立秋Aug 7-Aug 8）
• No corresponding endogenous evil
43
Summer-heat
Produces yang symptoms
•
•
•
•
•
High fever
Dysphoria
Reddish complexion
Thirst with preference for cold drink
Full & large pulse
44
Summer-heat
• Tends to:
• Disperse
• Induces sweating
• Consumes body fluid
• Elevate
• Disturbs mind
Thirst
reddish & scanty urine
lost of qi
shortness of breath
lassitude
dysphoria,
dizziness
comma
45
Summer-heat
• Often complicated by dampness
•
•
•
•
•
•
•
Persistent fever （持续高热）
Extreme thirst but less intake of water
Heaviness of the body
Lassitude of limbs
Chest fullness
Nausea or vomiting
Loose stool or diarrhea
46
Pestilence (Epidemic exogenous pathogen)
Group of pathogenic
factors with strong
infectious property
(Toxic pathogen 温毒)
Wen Yi （瘟疫 ）
(infectious disease)
Yi Li （疫疬）
(fulminating infectious disease)
暴发性传染病
47
Pestilence
• Similar to heat in the six climatic pathogens
but more potent and infectious.
• Spreads by air or direct contamination
• Enter body through nose and mouth
• Related to the environment, diet & sanitary
condition
• Also related to economic & cultural
environment of the society
48
Pestilence
• Diseases caused usually have :
–
–
–
–
–
–
Sudden onset
Progress rapidly
Severe pathological condition
Similar manifestations on infected patients
Spread fast & easily
High mortality rate
49
Five endogenous pathogenic factors
Dysfunction
of viscera
Wind
Cold
Dampness
Dryness
Heat (Fire)
50
Endogenous wind 1
• Produced in Liver
Liver Wind
Internal disturbance of liver wind
• Caused by:
1.
2.
3.
4.
Extreme heat
Transformation of liver yang
Yin deficiency
Blood deficiency
51
Endogenous wind 2
Extreme heat
scorch
Liver yin
热极生风
Hyperactivity of liver yang
Deprives tendons of nourishment
Symptoms
of mobility
Convulsion, tremor, rigidity of neck,
opisthotonos 弓角反张, up-rolling of
eyeballs, complicated by high fever,
coma or delirium
52
Endogenous wind 3
Emotional
disturbances
or over fatigue
Impairment of
liver or kidney
yin
肝阳化风
Excess Liver
yang transform
into wind
Yin unable
to restrict
yang
Disturbs upper
orifices
Facial palsy
Dizziness
Muscle cramp or
spasm
Convulsion
Hemiplegia 偏瘫
Syncope
53
Endogenous wind 4
Protracted
diseases or later
stage of febrile
diseases
阴虚生风
Failure of yin
to control yang
& nourish
tendons
Depleting Yin
Convulsion
Muscular spasm
Involuntary movement of limbs
Signs of heat due to yin deficiency
54
Endogenous wind 5
Inadequate
production or
excessive lost
of blood
Blood
deficiency
血虚生风
Failure to
nourish liver
tendons &
meridians
Muscular tremor
Numbness
Rigidity of limbs
Convulsion
55
Endogenous wind 6
Protracted disease
Old Age
Malnutrition
Blood stasis
Impairment of yin
exhaustion of blood
depletion of body
fluid & essence
血燥生风
Dryness
Lost of nourishment
in skin＆ muscle
Disharmony of
meridians
Dry skin, itching
Desquamation or
squamous 鳞状 & dry
skin
56
Endogenous cold
Congenital
deficiency
寒从中生
Malnutrition
Protracted
diseases
Internal
dispersion of
cold pathogen
Depletion
of Yang qi
Lost of warming &
transformative effect
Hypo function of
viscera & tissues
Excessive yin
Cold
57
Endogenous cold
Yang deficiency
Deficiency of
Kidney yang
Deficiency of
Spleen yang
Cold
Deficiency of
Heart yang
58
Endogenous cold
Yang
deficiency
Fail to
restraint
yin
Excessive
yin
Decline of
warming
effect
Aversion to cold , Cold limbs
Pallor, Diarrhea
Loose stools
Moist tongue
Decline of
steaming
effects
Water retention, phlegm, edema
Frequent, profuse & clear urine
Thin, cold & clear saliva,
sputum & nasal discharge
59
Endogenous dampness
Protracted
diseases
Deficiency of
kidney yang
Excessive
intake of
raw, cold,
greasy &
fatty food
Impaired
spleen
Fail to
transform
&
transport
food &
water
湿浊内困
Disturbed
body fluid
metabolism
Excessive
phlegm or
dampness
60
Endogenous dampness
Positions of obstruction
by dampness
Meridians
Signs & symptoms
Upper energizer
Chest distention, cough
Middle energizer
Fullness & distention in the
epigastric region or abdomen
Abdominal distention, loose
stools, oliguria.少尿
edema
Lower energizer
Skin & muscle
Heavy head, limbs, inflexibility.
61
Endogenous dryness
• Caused by impairment of yin
–
–
–
–
Heat pathogen impairing body fluid
Over-use of diaphoresics 发汗剂
Severe vomiting or diarrhea
Lost of blood or essence
62
Endogenous dryness
Yin
deficiency
Body fluid
deficiency
Intestine, Stomach, Lung, Orifices
Dry nose, throat, tongue, eyes, lips dry &
lusterless skin, desquamation or even cracked
skin, constipation, dry feces, scanty dark urine,
dry cough without sputum.
63
Endogenous heat (fire)
• Fire transformed from
– Excessive yang
– Stagnated pathogens
• Exogenous: e.g. wind cold dryness, heat etc.
• Endogenous : e.g. qi, blood stasis. Phlegm etc
– Emotional stress
– Yin deficiency
64
Endogenous heat (fire)
• Types of endogenous heat (fire ）
– Excessive type
– Deficient type
65
Endogenous heat (fire)
Excessive yang
Stagnated
pathogens
Excessive type
of endogenous
fire
Rapid progression
Short course
High fever, red face
Thirst & desire for cold drink
Dark urine, constipation
Oral ulcer or erosion
Red eyes
Yellow & dry tongue coating
Full & rapid pulse
Or coma, mania
66
Endogenous heat (fire)
Depletion of essence
& blood
Hyperactivity of
yang
Deficiency type
of endogenous fire
Hot sensation in the soles,
palm & chest
Tidal fever
Malar flush in the afternoon
Insomnia, tinnitus
Red tongue with little coating
Fine & rapid pulse
Slow progress
long disease course
67
The seven emotions
Environmental
stimuli
Body
Seven
emotions
Joy
Anger
Anxiety
Contemplation
Grief
Fear
Terror
68
The seven emotions
Sudden, violent, persistent
Emotional stimuli
Exceed adaptive
capacity of the body
Disturb
Flow of Qi,
Harmony of Yin & Yang,
Coordination of Qi & Blood of Zangfu
69
The seven emotions
Seven emotions
Zangfu
Qi
Blood
Yin
Yang
Physiological responses
affect
Joy
Anger
Anxiety
Contemplation
Grief
Fear
Terror
70
The seven emotions
Zangfu
Emotions
Heart
Joy
Liver
Anger
Spleen
Contemplation
Lung
Grief
Kidney
Terror
Terror & anxiety are also closely related to the activity of qi in the five zangs
71
Mechanism of Effects
• Direct injury
• Disturb activity of Qi
• Affect harmony between Qi & Blood
72
Direct injury
Emotions
affect
Zangfu
Joy
Heart
Anger
Liver
Contemplation
Spleen
Grief
Lung
Terror
Kidney
73
Direct injury
Liver
Heart
Spleen
(master)
Lung
Kidney
74
Direct injury
Heart
dominates blood &
house spirit
disturbs
Emotional
injury
Qi &
Blood
Liver
stores blood & governs
free flow of Qi
Spleen
source of qi & blood & pivot of
qi’s movement
75
Disordering the activity of Qi’s
Disorder of
activity of Qi
Excessive
emotional
fluctuation
Fire
Disorder of
blood
circulation
Disharmony
between ying
& yang
76
Excessive Joy affects heart
dismiss qi
Normal effect
Relief emotional stress
Promotes flow of the defensive and nutritive Qi
Over joy
Dismissed Heart Qi
Heart fails to house spirit
Inability to concentration
or even dementia and mania.
77
Excessive anger affects liver
drives qi upwards
Drives Liver
qi & blood
upwards
Excessive
anger
Liver qi
flow
adversely
Dizziness
distending headache
reddish complexion
redness of eyes
hematemesis
or even syncope
Transversely attacks
spleen & stomach
Anorexia chest
oppression
belching or even
78
Excessive contemplation affects spleen
stagnates qi
Excessive
contemplation
Stagnation
of
Spleen Qi
prolong
Consumes
yin blood
Deprives
Heart
Blood
Spleen fail to transforms & transports
Stomach fail to receives & ripens
Anorexia
Gastric & abdominal fullness
loose stool.
Palpitation
Insomnia
amnesia
insomnia
79
Excessive grief affects lung
exhausts qi
Excessive
grief
Exhaust
lung qi
Dizziness
lassitude
dispiritedness
Lung fail to
depurate
disperse
descend
Fail to distribute nutrient qi
Consume pectoral qi
80
Excessive terror affects kidney
drives qi downwards
Sudden
terror
kidney qi
fail to fixate
Incontinence of
urine & feces
kidney
fail to store
essence
Weakness &
atrophy of bones
seminal emission
Drives qi
downwards
prolong
Failure
of qi to
elevate
Decline of visceral functions and
inability of healthy qi to defend
81
Excessive fear disturb qi
Disturb
heart qi
Derangement of mind
indecision
bewilderment 困惑
Disorder of qi
Disharmony
between qi &
blood
Weakened
defensive qi
invasion of pathogens
Excessive
fear
82
Excessive anxiety inhibits qi
Depression of
lung qi
Chest compression
Unsmooth breath
Stagnation of
liver qi
Hypochondriac
distension or pain
unhappiness
reduce appetite
Excessive
anxiety
83
Causes or aggravates diseases
Pre existing disorder (sub-clinical)
sudden emotional fluctuation
Diseases (clinical)
84
example
Superabundance of liver yang
sudden violent rage
Hyperactivity of liver yang
Syncope ,unconsciousness,
paralysis, distorted face
85
example
Sudden
terror
Causes or
aggravates
Heart
diseases
86
Improper Diet
• Starvation
Prolonged (continuously) lack of food
Protracted insufficient intake of food
• Overeating
Crapulence 暴饮暴食
Protracted excessive intake of food
• Unhygienic food & water
• Food partiality
Partiality to cold or hot food
Partiality to the flavors
87
Starvation
Prolonged (continuously) lack of food
Protracted inadequate intake of food
Insufficient production of Qi & Blood
Declination of functions of the viscera
Lower body’s immunity to diseases
88
Overeating
Crapulence
暴饮暴食
Protracted excessive
intake of food
Impair Spleen
& Stomach
Delayed or
failure of
transformation
of nutrients into
Qi & Blood
Failure to
digest
transform &
transport
Produce
phlegm
& hinder
flow of
Qi &
Blood
89
Unhygienic food
Poisoning
Unhygienic
food or
contaminated
water
Gastrointestinal
disorders
Parasitic
diseases
Abdominal pain
diarrhea
vomiting
dysentery
Coma
Or even death
90
Food partiality
Excessive
cold or
uncooked
food
Impair
yang Qi
of Spleen
&
Stomach
Endogenous
colddampness
Abdominal pain
Diarrhea
91
Food partiality
Excessive
hot , warm
or dry food
Heat
accumulation
in Stomach
Thirst
Abdominal fullness
Distension & pain
Constipation
Hemorrhoids
92
Partiality to flavors
Flavor
Zang Fu
Sour
Liver
Bitter
Heart
Sweet
Spleen
Acrid 辛
Lung
Salty
Kidney
93
Five flavors & five zangs
Sour
Liver
Salty
Kidney
Inter-promoting
Acrid
Lung
bitter
Heart
sweet
Spleen
Inter-restraint
94
Partiality to salty flavor
Salty
Kidney
bitter
Heart
Restricts
Water
Fire
Stagnation
of vessels
95
Partiality to sweet flavor
Salty
Kidney
Sweet
Spleen
Less
transformation
of essence into
marrow & blood
Restricts
Earth
Water
Osteodynia 骨痛
loss of hair
early senility
96
Partiality to bitter flavor
Bitter
Heart
Acrid
Lung
Restricts
Fire
Metal
Hypoactive of lung
qi
Retention of food
nutrients in the
middle energizer
Malnutrition of
skin & hair
97
Partiality to acrid flavor
Acrid
Lung
Metal
Restricts
Sour
Liver
Hypoactive liver qi
Liver blood fail to
nourish tendons
Wood
Spasm
Flaccidity of tendons
98
Partiality to sour flavor
Sour
Liver
Wood
Restricts
sweet
Spleen
Weakened spleen
qi
Earth
Abdominal distension
loose stool
poor appetite
99
Overwork
• Excessive physical fatigue
consume Qi & blood
• Excessive mental fatigue
consume heart- blood & impair spleen- Qi
• Excessive sexual activity
consumes kidney-essence, weakens Qi & blood
100
Excessive physical fatigue
Consume Qi & Blood
•Deficiency of qi & blood
•Reduce physical strength
•Listlessness 倦怠
•Emaciation
101
Excessive mental fatigue
• Consume
Heart- blood
Malnourishment
of heart spirit
Palpitation
Forgetfulness
Insomnia
Dream disturbing
sleep
• Impair
Spleen- Qi
Fail to transform
& transport
Anorexia
abdominal fullness
Loose stool
102
Excessive sexual activity
Kidney deficiency
Early senility
Consumes Kidney-essence
weakens Qi & Blood
Malnourishment of five
zangs
Ache & weakness of waist
& knees
Dizziness, tinnitus
listlessness
Decline of sexual functions
Nocturnal emission
Premature ejaculation
Impotence
103
Over-rest (Deficient of physical activity)
Hypofunction
of visera
Prolonged
lack of
activity
Sluggish
flow of
Qi &
Blood
Production of
phlegm, dampness
& blood stasis
Various
diseases
Diminished immunity to
exogenous pathogens
104
Secondary pathogenic factors
Primary
pathogens
Diseases
• Phlegm & rheum
• Blood stasis
More diseases
105
Phlegm & Rheum
Diseases
Disturbed
water &
fluid
metabolism
Phlegm
Rheum
(thicker type)
(thinner type)
Abnormal
accumulation
of fluid
106
Types of Phlegm
• Substantial form
Visible, palpable, audible
e.g. sputum, scrofula (淋巴结核) & nodules in skin or
muscles, borborygmus 腹鸣.
• Insubstantial form
Invisible, impalpable, inaudible
107
Classic categorization of phlegm
Classify according to location of phlegm
(1) Abdomen – Phlegm rheum 痰饮
(2) Chest & diaphragm – Suspending rheum 悬饮
(3) Ribs – Sustaining rheum 支饮
(4) Skin & muscles – Overflowing rheum 溢饮
Jingui Yaolue (Synopsis of Golden Chamber)
108
Formation of Phlegm & rheum
Spleen
Transportation & transformation of water
& dampness
Lung
Regulates water passage
Kidney
Governs water
Normal
Water
metabolism
Liver
Promote metabolism of water & fluid
Triple energizer
Serves as water passage
109
Formation of Phlegm & rheum
Abnormal
water
metabolism
Viscera
Dysfunction
Production
of Phlegm
& Rheum
110
Formation of Phlegm & rheum
Cold
Pathogenic
factors
Exogenous
Disharmony
of viscera
yin & yang
Slow
transformation
of water & fluid
Endogenous
Production
of rheum
or Phlegm
Heat
Scorches fluid
111
Characteristics of diseases cause by
Phlegm & Rheum
• Hinder flow of Qi & Blood
• Hinder ascending & descending movement
of Qi
• Confuse mind frequently
• Cause varying & complicated symptoms
112
Hinder flow of Qi & Blood
flow of Qi & Blood
Meridians
Numbness &
stiffness of limbs
Phlegm
\Rheum
Localized
Scrofula 瘰疬
Subcutaneous
nodules
Cold abscess 阴疽流注
113
Hinder ascending & descending
movement of Qi
Disturbed
water
metabolism
Retention
of water &
dampness
Hinder
movement of
Qi
Various
symptoms
Affects
function of
viscera
114
Confuse mind frequently
Invades
head
Blocks heart
With or
without
transforming
into fire
Dizziness
Chest
congestion
Palpitation
Coma
Delirium
Mania
115
Cause varying & complicated
symptoms
Phlegm
& Rheum
follow
Movement
of Q1
Changes
with
movement
of Qi
reaches
Anywhere
in the body
Affects various
parts &
produce
various
symptoms
116
Various symptoms cause
by phlegm & Rheum
Location
Symptoms
Lung
Asthma with sputum
Heart
Stomach
Tight chest , palpitation, coma, delirium,
mania.
Vomiting, abdominal distension
Meridians,
collateral,
tendons, bones
Head
Scrofula, subcutaneous nodule, numbness
of limbs, hemiplaralysis, gangrenous
symptoms.
Diszziness, mental confusion
Throat
Feeling of obstruction
117
Blood Stasis
Pathogenic
factors
Stagnated
Blood
circulation
Retention
of blood
in vessels
or viscera
Blood
stasis
Blood
overflow
out of
vessels
118
Blood Stasis
Substantial
form
Blood clot
Subcutaneous
purpura
Lumps
Insubstantial
form
Pain
Palpitation
mania
Blood
stasis
119
Formation of blood stasis
•
•
•
•
•
•
Qi stagnation
Qi deficiency
Blood- cold
Blood- heat
Traumatic injury
Hemorrhage
120
Qi stagnation
Exogenous cold
Dampness
Excessive anxiety
Failure of liver Qi
to disperse
Phlegm blockage
Stagnated flow
of Qi
Stagnated
blood flow
Blood stasis
121
Qi deficiency
Hypo-function
of viscera
Consumptive
disease
Overstrain
Improper diet
Protracted
diseases
Puerperium 产后期
Deficiency
of Qi
Failure to
drive blood
flow
Blood stasis
122
Blood- cold
Exogenous cold
in vessels
Dampness
Excessive intake
of cold food
Decline of fire in
kidney
Insufficient
primordial qi
Damage of
yang qi
Blood
stasis
Coagulation
of blood
123
Blood- heat
Blood
overflow
Excessive
heat
Blood
stasis
Condense
blood
124
Trauma
Injury
to
vessels
Blood
stasis
Trauma
Retained
blood in
the body
125
Hemorrhage
Viscera
dysfunction
Spleen
Liver
Qi deficiency
Abnormal flow
of blood
Hemorrhage
Blood stasis
Transformation of
excessive emotions
into fire
Heat
Trauma
126
Characteristics of blood stasis
•
•
•
•
•
•
Pain
Lump
Hemorrhage
Cyanosis
Tongue features
Pulse features
127
Pain cause by blood stasis
• Characteristics of pain due to blood stasis:
Stabbing pain, fix location, aggravate on
palpation, worsening at night.
• Characteristic of pain due to qi & blood
deficiency:
Vague & lingering pain
128
Lump
Subcutaneous
Protracted
blood
stasis
Lump
Cyanotic skin
Hard &
localized
Viscera
Hard mass
129
Cyanosis
• Cyanotic
– Complexion
– Lips
– Nails
130
Tongue features
• Cyanotic
• Ecchymosis 瘀斑
• Petechia 瘀点
131
Pulse features
•
•
•
•
•
Thin
Unsmooth
Deep & taut
Knotted
Slow, regular and intermittent
132
Other features
•
•
•
•
•
Dark or black complexion
Squamous & dry skin
Purpura 紫斑
Amnesia
Mania
133
Other diagnostic leads
• History of trauma, hemorrhage,
menstruation, pregnancy or labor.
• No response to all other treatment methods
other than blood stasis resolving therapy.
• Protracted diseases usually cause blood
stasis in collaterals.
134