NYCTCM SA 1

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Arjunadawn
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128676
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NYCTCM SA 1
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2012-01-18 14:35:41
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NYCTCM SA
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NYCTCM SA 1
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  1. Syndrome Analysis
    ...a method to ID the nature & location of a Dx & the internal relationships among the different Sx by means of comprehensive analyzing of clinical info collected fr the four diagnostic methods- make TCM dx on basis of differentiation of syndromes.
  2. Signs & Symptoms
    Manifestation directly from disease- four diagnostic methods.
  3. Syndrome
    Result of comprehensive analysis- the theory of yin & yang, five elements, zang fu organs, blood & body fluids, meridians & collaterals, etiology & pathology, internal relationships= TCM Diagnosis.
  4. The purpose of Syndrome analysis
    nature, location & internal relationships- the basis of Tx, the link btw TCM fundementals & clinical medical practice.
  5. Syndrome Analysis includes
    SA according to 8 prinicples; etiology; qi, blood, & body fluids; zang fu organs; meridians & collaterals; six meridians; four level & triple burners.
  6. The Eight Principles (ba gang) are...
    Yin and Yang, Exterior and Interior, Cold and Heat, Deficiency and Excess- 4 pairs.
  7. The Category=
    Yin and Yang
  8. The Depth=
    Exterior or Interior
  9. The Nature=
    Cold or Heat
  10. The Morbid Condition=
    Deficiency or Excess
  11. Yin and Yang biggest category- cover other 3 pairs
    What is 1/2 exterior and 1/2 interior? Btw the two.
  12. Exterior=
    The skin, hair, muscles and their interspace, the superficial portion of the meridians and collaterals- Exterior Syndrome while attacked by pathogenic factors.
  13. Interior=
    The internal organs, marrow and the deeper part of the meridians and collaterals- Interior Syndrome in cases where they are diseased.
  14. Exterior Syndrome:
    Refers to those diseases caused by invasion of 6 EPF via skin, hair, mouth, and nose, and located in the Wei Part.
  15. Early Stage of Exterior Syndrome 2' EPFs characterized by...
    Sudden onset and Short Duration.
  16. Exterior Syndrome Clinical manifestation:
    Fever, Aversion to cold (or wind), H/A, general aching, nasal obstruction, rhinitis, cough, itching & sore throat, thin-white, or thin-yellow tongue coating, & superficial pulse.
  17. Exterior Syndrome Principle of Tx:
    Relieve the Exterior
  18. Exterior Syndrome Fever;
    • Abnormal gathering of Yang (defensive) Qi;
    • Pulse= Floating.
  19. Exterior Syndrome is fighting btw Wei Qi and EPF. Defensive yang usually gathered in Exterior.
    Exterior Syndrome Aversion to Cold 2' to Defensive Yang damaged by EPF.
  20. Exterior Syndrome: Mild or Severe Aversion to Cold:
    Severe Aversion to Cold if EPF is Cold.

    Mild Aversion to Cold if EPF is Warm.
  21. Exterior Syndrome Fever:
    Abnormal gathering of Yang Qi @ superficial part- Fighting.
  22. Exterior Syndrome Tongue:
    Normal in beginning because Dx new.
  23. Exterior Syndrome:
    Fever, Aversion to Cold, Floating Pulse, H/A, (bodyache 2' blockage of meridians 2' invasion of EPFs).
  24. Interior Syndrome:
    • Syndromes in which the Zang Fu organs Qi and Blood and marrow are affected.
    • In the intermediate and late stage of Dx characterized by EPFs OR diseases which result from internal injury.
  25. Interior Syndrome Clinical Manifestations:
    Caustive factors complicated, range of locations wide, so Sx are various.
  26. Main Points in distinguishing Exterior and Interior Syndromes:
    • Changes of cold and heat:
    • Exterior- fever accompanied by aversion to cold.

    Interior- fever WITHOUT aversion to cold OR aversion to cold WITHOUT fever.
  27. Main Points in distinguishing Exterior and Interior Syndromes:
    • Tongue:
    • Exterior- unchanged.
    • Interior- changes in the tongue coating caused by the dysfunction of some zangfu organs.

    • Pulse:
    • Exterior- superficial.
    • Interior- deep.
  28. Relationship btw Exterior and Interior Syndromes:
    • Both Ext and Int being affected simultaneously.
    • Transmission of pathogenic factors from Exterior to Interior- aggravation.
    • Transmission of pathogenic factors from Interior to Exterior- alleviation.
  29. Cold and Heat:
    • Cold and Heat are the principles used to differeniate the NATURE of a disease. The syndromes of cold and heat reflect the predominance and discomfort of Yin and Yang of the body.
    • Yin in predominance is a Cold Syndrome.
    • Yang in predominance if a Heat Syndrome.
  30. Cold Syndrome:
    Cold Syndrome (han zheng) refers to pathological conditions which result from the invasion of exogenous pathogenic cold OR accumulation of Cold Nature pathological products OR from Def of Yang in the body.
  31. Cold Syndrome Clinical Manifestations:
    Common Sx: Aversion to Cold, preference for warmth, pallor, cold limbs, lying in curled-up posture, tasteless mouth, absence of thirst, clear suptum, saliva, & nasal disharge, increased clear urine, loose stools, pale tongue and moist coating, and slow or tense pulse.
  32. Cold Syndrome Principle of Treatment:
    Warm or Expel Cold.
  33. Heat Syndrome:
    Heat Syndrome (re zheng) refers to pathological conditons caused by invasion of exogenous pathogenic heat OR by excessive Yang OR Def of Yin in the body.

    Included are Ext-Heat Syndrome, Int-Heat Syndrome, Def-Heat Syndrome, & Excess Heat Syndrome.
  34. Heat Syndrome Clinical Manifestations:
    Commonly: Aversion to Heat, Preference for Cold, thrist with preference for cold drinks, flushed face, red eyes, irritability, restlessness, yellow and thick sputum and nasal dc, hematoemesis, epistaxis, deep-yellow and scanty urine, constipation, red tongue, yellow-dry tongue coating, and rapid pulse.
  35. Heat Syndrome Principle of Treatment:
    Clear away Heat and Reduce Fire.
  36. Main Points for distinguishing between Cold and Heat Syndromes:
  37. Relationship btw Cold and Heat Syndrome;
    Complicated Syndrome of Cold and Heat:
    • a. Heat in the Upper and Cold in the Lower.
    • b. Cold in the Upper and Heat in the Lower. (This shows Cold in the ST and Heat in the BL).
    • c. Ext-Cold and Int-Heat. (These are often 2' Interior Heat constitution being attacked by exogenous Wind-Cold).
    • d. Ext-Heat and Int-Cold. (It is seen in cases of Int-Cold, yet complicated by invasion of exogenous pathogenic Wind-Heat, OR cases of Ext-Heat which are affected by Cold after taking too much Rx of Cold Nature that damages the SP and ST).
  38. Relationship btw Cold and Heat Syndrome;
    Transformation of Cold and Heat Syndromes:
    • a. Transformation of Cold Syndrome into Heat Syndrome. (The Cold Syndrome occurs 1st and gradually changes into Heat Syndrome).
    • b. Transformation of Heat Syndrome into Cold Syndrome. (The Heat Syndrome occurs 1st and gradually changes into Cold Syndrome).
  39. True and False Phenomena in Cold & Heat Syndromes:
    • True= Valid Sx & Sx
    • False= Not match with Syndrome (i.e., Heat Sx in Cold Syndrome, Fever in Cold Syndrome).
  40. True and False Phenomena in Cold & Heat Syndromes:
    When a Cold or Heat Syndrome develops to its limit, some false phenomena opposite to the nature of the Dx may occur.
  41. True and False Phenomena in Cold & Heat Syndromes:
    • a. True Heat with False Cold (zhen re jia han, i.e., True Interior Heat and False Exterior Cold.
    • Manifested as:
    • Cold Limbs, deep pluse= False Cold (the excessive internal heat hinders the Yang Qi from reaching the exterior-Stagnant Heat in Trunk),

    fever, absence of aversion to cold but aversion to heat, and a deep but rapid and forceful pulse & accompanied by thirst with preference for cold drinks, red tongue, yellow coating, yellow & scanty urine, constipation=TRUE HEAT
  42. True and False Phenomena in Cold & Heat Syndromes:
    • True Cold with False Heat (zhen han jia re), i.e., TRUE Interior Cold and False Exterior Heat.
    • Manifests as:
    • Fever, thirst, flushed face, and full pulse=FALSE HEAT (The excessive Yin Cold forces Yang to the Exterior).

    Wants to cover up body in spite of fever, prefers warm drinks in spite of great thirst, has full but forceless pulse, cold limbs, clear urine, loose stools, and pale tongue with white coating= TRUE COLD.
  43. True and False Phenomena in Cold & Heat Syndromes:
    Main points for distinguishing True or False Cold and Heat:
    • The False Phenomena-- Four Limbs, Skin and Hair, or Complexion.
    • The Nature of a Disease-- ZangFu Organs, Qi & Blood, & Body Fluids.
    • The Tongue and Pulse are the most important for differentiation.
  44. True and False Phenomena in Cold & Heat Syndromes:
    Main points for distinguishing True or False Cold and Heat:
    • The Flushed face of
    • False Heat: in the cheeks=light pink, appearing superficially and intermittantly.
    • True Heat: Red all over the face.

    • The Cold Limbs in
    • FALSE COLD: absence of desire for warmth; a hot sensation in the chest and abdomen.
    • TRUE COLD: prefers to lie in curled-up posture and craves warmth.
  45. Relationship btw Cold-Heat and Exterior-Interior Syndromes:
    Exterior-Cold Syndrome (biao han zhen); cold in nature EPF; Stagnant & Contracting- make everything tight.
    Clinical Manifestations:
    • Serious aversion to cold, low fever, h/a, general aching, absence of sweating, thin, white and moist tongue coating, and superficial and tense pulse. (Floating & Tight, Panalgia=obstruction of meridians-stagnant/constrict0.
    • NO SWEATING! (Pores closed 2' constriction.

    Principle of Tx: Eliminate Cold to relieve the Exterior Syndrome.
  46. Relationship btw Cold-Heat and Exterior-Interior Syndromes:
    Exterior Heat Syndrome (biao re zheng); Invasion of EPF that is Heat in Nature.
    Clinical Manifestations:
    • Fever, slight aversion to Wind-Cold, h/a, dry mouth with slight thirst, red sides and tip of tongue, and superficial and rapid pulse.
    • Thirsty in beginning, mouth dry, tip of tongue red.
    • High Fever.
    • Pulse: Floating and Rapid.
    • Not to much body pain.

    Principle of Tx: Reduce Heat to relieve Exterior Syndrome.
  47. Relationship btw Cold-Heat and Exterior-Interior Syndromes:
    Interior Cold Syndrome (li han zheng); many syndromes fall in this category.
    Clinical Manifestations:
    Chills, cold limbs, pallor, tastelessness in mouth, absence of thirst or thrist with preference for hot drinks, quietness, disinclination to speak, increased volume of clear urine, loose stools, pale tongue, white-moist tongue coating, and deep and slow pulse.

    Principle of Tx: Warm the Interior to Dispel Cold.
  48. Relationship btw Cold-Heat and Exterior-Interior Syndromes:
    Interior Heat Syndrome (li re zheng); many syndromes fall in this category.
    Clinical Manifestations: See Separate sections
    Principle of Treatment: Clear away Heat and Reduce Fire.
  49. Heat and Cold just tell use Nature of Dx; sometimes not relevant to EPF.
    Constitutional Make-up influence reaction to EPF, i.e., seasonal flu may cause Ext-Cold OR Ext-Heat syndrome in different ppl.
    Generally, Exterior Syndrome > Interior x7 days.

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