NYCTCM SA 2

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Arjunadawn
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NYCTCM SA 2
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2012-01-18 16:25:44
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NYCTCM SA 2
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  1. Deficiency and Excess: Deficiency (xu) and Excess (shi) are two principles used to generalize and distinguish the relative strength of the antipathogenic Qi and the pathogenic factors.
    Weakness of body versus exuberance of threat> pathological product> pathogenesis

    • VITAL to Know
    • Which is more important to know?
    • Weakness of Body Resistance OR
    • Exuberance of Patho Product
  2. Deficiency and Excess: Through the differentiation of Def and Excess we can get a better understanding of the relative strength of the antipathogenic Qi and the pathogenic factors, which lays the foundation for treatment.
    • General Principle:
    • Reduce the Excess and
    • Reinforce the Deficiency.

    Correct differentiation enables this treatment goal.
  3. Deficiency Syndrome:
    ...is a generalization of the pathological conditions in which the antipathogenic Qi is insufficient and plays the major role for the onset and developing of the disease.

    • Usually 2' two causes:
    • Congenital Def
    • Acquired Def

    Included in this are the Def of Yin, Yang, Qi, Blood, Essence, Body Fluids, and Zang Fu Organs.
  4. Deficiency Syndrome:
    Clinical Manifestations:
    • Different syndromes of Def give rise to different symptoms.
    • The commonly encounted short breath, chills, cold limbs, spontaneous sweating, incontinence of stools and urine, pale-plump-flacid-tongue, deep-slow-feeble-pulse, burning sensation in the chest, palms, & soles, emaciation, malar flush, dryness of the throat and mouth, night sweating, afternoon fever, red tongue with little coating, and thready-rapid and feeble pulse.
  5. Deficiency Syndrome:
    Principle of Treatment:
    • Reinforce the Def.
    • Reinforce Yang in case of Yang Def and
    • Nourish Yin in case of Yin Def.
  6. Excess Syndrome: Term used to describe the pathological conditions in which exogenous pathogenic factors attack the body or pathologic products accumulate inside the body and become the major cause for onset and developing of the disease.
    • Usually 2'
    • The Invasion of EPF
    • The Dysfunction of ZangFu Organs, leading to retention of pathological products, such as phlegm, dampness, and blood stasis.
  7. Excess Syndrome:
    Clinical Manifestations:
    Commonly: Fever, abd distention and painful areas that the pt is reluctant to be pressed- guarding, fullness in the chest, irritability, coma, delerium, coarse breathing, profuse sputum and saliva, constipation or dysentery, tenesmus, dysuria, urinary dribbling, forceful pulse, rigid tongue, and thick and greasy tongue coating.
  8. Excess Syndrome:
    Principle of Treatment:
    • Reduce the Excess.
    • Different methods of reduction are used depending on the pathogenic factor.
  9. Main Points for distinguishing Def and Excess Syndromes:
    Regarding "Pain;" textbooks use "like" or "dislike;" done use these terms. Use "Less" or "More."
  10. Def Syndrome= Tonnification
    Excess Syndrome= Reducing
  11. Must know Excess or Def to choose proper Tx.
    Which part Def?
    Which part Excess?
    Which is the root/major problem?
    • Pulse tell the truth.
    • Pulse tell weakness/strength of body.
    • Focus on body resistance.
  12. The Complication of Def and Excess Syndrome
    ...is seen in patients who suffer from a prolonged serious excess syndrome in which the antipathogenic Ai has been greately damaged, but the exogenous pathogenic factors still exist, who have a constitutional def again attacked by EPFs.
  13. Transformation of Def and Excess-
  14. True and False Phenomena in Def and Excess
    True Excess with False Def (zhen shi jia xu)
    • Syndrome of Excess type which is accompanied by Sx Sx similar to a Def Syndrome.
    • Ex: Accumulation of Heat in the intestines in which there is a retention of sputum and food, presenting such Sx Sx as: indifference, cold sensation of body, cold limbs, and deep or unsmooth pulse= FALSE DEF

    However, examination will show: sonorous voice, coarse breathing, deep but forceful pulse, and hot sensation in chest and abd= TRUE EXCESS
  15. Distinguishing the True and False Phenomena in Def & Excess Syndromes requires careful attention to the following:
    • Is the pulse forceful or forceless?
    • How does it fit with superficial, moderate, and deep palpation?
    • Is the tongue plump, flaccid, or rigid?
    • Is the voice sonorous or low?
    • Is the constitution weak or strong?
    • What is the caustive factor of the Dx?
    • Is the Dx recent or an old Dx?
    • What course of Tx has been Rx?
  16. The Relationship btw Def and Excess, Ext and Int, and Cold and Heat:(Combo of 8 Principles, 3 pair)
    Exterior Def Syndrome (biao xu zheng): this Syndrome divided into two (2) kinds:

    *Sweating is key to Def Syndrome 2' Defensive Qi Def*
    • 1. Exogenous Exterior Def: H/A, stiff neck, fever, sweating, aversion to wind, and superficial and retarded pulse (retarded=moderate/normal 4:1,but each pulse moves weakly & slowly. Retarded pulse=Wei Qi Def; floating at Yang, weak at Yin).
    • Real Exterior Syndrome: a. Def Qi/Yang Def (major reason for this Dx); b. Invasion of Wind EPF
  17. The Relationship btw Def and Excess, Ext and Int, and Cold and Heat:(Combo of 8 Principles, 3 pair)
    Exterior Def Syndrome (biao xu zheng): this Syndrome divided into two (2) kinds:

    *Sweating is key to Def Syndrome 2' Defensive Qi Def*
    2. Endogenous Exterior Def: Generally spontaneous sweating, susceptible to cold, accompanied by Sx of Qi Def such as pallor, short breath, lassitude, poor appetite, loose stools, pale tongue, white tongue coating, and weak and thready pulse.
  18. The Relationship btw Def and Excess, Ext and Int, and Cold and Heat:(Combo of 8 Principles, 3 pair)Exterior Def Syndrome (biao xu zheng):
    Principle of Treatment:

    *Sweating is key to Def Syndrome 2' Defensive Qi Def*
    • Principle of Treatment: Regulate the Ying (nutrient) and Wei (defensive) systems.
    • Replenish Qi to strengthen the resistance of the body surface.
  19. The Relationship btw Def and Excess, Ext and Int, and Cold and Heat:(Combo of 8 Principles, 3 pair)
    Exterior Excess Syndrome (biao shi zheng):

    Clinical Manifestations:
    Fever, aversion to cold, h/a, pain of bones & joints, absence of sweating, and superficial and tense pulse.
  20. The Relationship btw Def and Excess, Ext and Int, and Cold and Heat:(Combo of 8 Principles, 3 pair)
    Exterior Excess Syndrome (biao shi zheng):

    Principle of Tx:
    Relieve the Exterior Syndrome with Rx pungent in flavor and warm in property.
  21. The Relationship btw Def and Excess, Ext and Int, and Cold and Heat:(Combo of 8 Principles, 3 pair)

    Interior Def Syndrome (li xu zheng):
    Def of ZangFu organs, meridians and collaterals, Yin and Yang, and Qi and Blood fall in the category of Def Syndrome.

    If divided along theories of Cold and Heat, there will also be Def-Cold and Def-Heat Syndrome.
  22. The Relationship btw Def and Excess, Ext and Int, and Cold and Heat:(Combo of 8 Principles, 3 pair)

    Interior Excess Syndrome (li shi zheng):
    Int-Excess Syndromeis caused by excess pathogenic factors in the interior of the body.

    Tx depends on which ZangFu and meridians are affected, and which pathogenic factors are involved.

    • Excess of ZangFu, meridians, & various pathogenic factors fall in category Excess Syndromes.
    • Interior Excess Syndrome may be classified into Cold and Heat types, directly into Excess Cold or Excess Heat Syndrome.
  23. The Relationship btw Def and Excess, Ext and Int, and Cold and Heat:(Combo of 8 Principles, 3 pair)

    Def Cold Syndrome (xu han zheng):
    Caused by Def of Yang Qi in the interior of the body.

    • Clinical Manifestations:
    • Listlessness, pallor, aversion to cold, cold limbs, abd pain which can be alleviated with pressure, loose stools, increased clear urine, lassitude, pale tongue, and faint or deep, slow, forceless pulse.

    • Principle of Tx:
    • Warm and reinforce Yang Qi.
  24. The Relationship btw Def and Excess, Ext and Int, and Cold and Heat:(Combo of 8 Principles, 3 pair)

    Def Heat Syndrome (xu re zheng):
    Caused by the Def of Yin Fluid in the interior of the body.

    • Clinical Manifestations:
    • Malar flush, emaciation, afternoon fever, night sweating, burning sensation in the chest, palms, and soles; dry mouth and throat, red tongue with little coating, and thready and rapid pulse.

    • Principle of Tx:
    • Nourish Yin to reduce Heat.
  25. The Relationship btw Def and Excess, Ext and Int, and Cold and Heat:(Combo of 8 Principles, 3 pair)

    Excess Cold Syndrome (shi han zheng):
    • Clinical Manifestations:
    • Aversion to Cold, preference for warmth, pallor, cold limbs, abd pain which is aggravated by pressure, borborygmus, diarrhea, rattle in the throat, asthmatic breathing, cough, tastelessness in the mouth, profuse saliva, increased clear urine, white and moist tongue coating, and slow or tense pulse.

    • Principle of Tx:
    • Warm and dispel the Cold.
  26. The Relationship btw Def and Excess, Ext and Int, and Cold and Heat:(Combo of 8 Principles, 3 pair)

    Excess Heat Syndrome (shi re zheng):
    • Clinical Manifestations:
    • Aversion to Heat, preference for Cold, thirst with desire to have cold drinks, flushed face, red eyes, irritability, coma or delerium, distention, fullness and pain in the abd with guarding, constipation, deep-yellow scanty urine, red tongue, yellow and dry coating, and bounding, smooth, and rapid pulse.

    • Principle of Tx:
    • Clear Heat and reduce Fire.

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