TCM Synchronous Learning - Lecture 3 PDF

NMT100: TRADITIONAL CHINESE MEDICINE – LECTURE 3 8 P R I N C I P L E S A N D 6 PAT H O G E N I C FA C TO R S Author: Dr. Romi Fung, ND, M.Sc, Ph.D (cand.) IN TODAY’S LECTURE Identification of patterns according to the Eight Principles Recognizing Exterior-Interior, Heat and Cold, Full and Empty patt...

NMT100: TRADITIONAL CHINESE MEDICINE – LECTURE 3 8 P R I N C I P L E S A N D 6 PAT H O G E N I C FA C TO R S Author: Dr. Romi Fung, ND, M.Sc, Ph.D (cand.) IN TODAY’S LECTURE Identification of patterns according to the Eight Principles Recognizing Exterior-Interior, Heat and Cold, Full and Empty patterns and manifestations Symptoms and Signs of Exterior Pathogenic Factor Patterns PATTERN DIFFERENTIATIONS Rather than a symptom or a diagnosis, TCM looks at the whole picture of the patient to determine a pattern that could then be treated PATTERN DIFFERENTIATIONS The 8 principles: Yin-Yang, Heat-Cold, Internal-External, Excess-Deficiency. The 5 Elements and their sequences. (Controlling, generating, insulting). The Vital Substances: Qi, Blood , Body Fluids, Essence. The Zang-Fu Organs: 5 Yin and 6 Yang Organs, and 6 Extraordinary Organs. Pathogenic Factors: Wind, Cold, Heat/Fire, Dampness, Dryness, Summer-heat. The 6 Stages: Tai Yang, Yang Ming, Shao Yang, Tai Yin, Shao Yin, Jue Yin. The 4 Levels: Wei, Qi, Ying, Blood. 3 Jiao (Burners). Upper, Middle and Lower Jiao. The Meridians. THE EIGHT PRINCIPLES Exterior and Interior Heat and Cold Excess and Deficiency Yin and Yang 8 PRINCIPLES EXTERIOR EXTERIOR Exterior comprises the skin, muscles and channels Space between skin and muscles where Wei Qi and sweat and located and first invaded by external pathogenic factors Patterns include aversion to cold, ‘fever’, aching body, stiff neck and a floating pulse CAUSES OF EXTERIOR CONDITIONS INTERIOR When the Internal Organs are affected May have arisen from an exterior pathogenic factor, but once the disease penetrates into the Interior, it is defined as Interior Treating the Internal Organ patterns CAUSES OF INTERIOR PATTERNS OF DISEASE HEAT Feeling hot; fever Sweating Thirst Empty- vs. Full-Heat? All dependent on if it is a manifestation of Excess of Yang or if Yang is relatively in Excess FULL-VS. EMPTY-HEAT Full Heat Emtpy Heat Face Whole face red Malar Flush Thirst Desire to drink cold Desire to drink in small sips Eyelid Red all over inside eyelid Thin red line inside eyelid Taste Bitter taste No bitter taste Feeling of heat All day In the afternoon and evening Fever High fever Low grade fever in the afternoon Mind Very restless and agitated Vague anxiety, fridgeting Bowels Constipation, abdominal pain Dry stools, no abdominal pain Bleeding Profuse Slight Sleep Dream disturbed, very restless Waking up frequently durin the night or early morning Skin Red, hot painful skin eruptions Scarlet red, not raised painless eruptions Pulse Full rapid overflowing Floating empty rapid Tongue Red and yellow coating Red and peeled Treatment Method Clear Heat Nourish yin clear empty heat COLD Feeling of cold Cold limbs Absence of thirst Full- or Empty-Cold? This time depends on Yin, if it is in Excess or Relative Excess of Yin Full – Cold FULL- VS. EMPTY-COLD Face Bright-white Dull-White Pain Sharp, worse with pressure Dull, better on pressure Bowels Better after bowel movement Worse after bowel movement Pulse Full Tight Deep Weak-Slow Deep Tongue Thick White Coating Thin white coating DEFICIENCY VS EXCESS EXCESS Characterized by the presence of a pathogenic factor while Upright Qi is relatively intact and actively fighting against the pathogenic factor Pain worse with pressure Pain that is acute in onset Irritability, restlessness Strong voice DEFICIENCY Characterized by Emptiness of the Upright Qi and the absence of a pathogenic factor Empty Qi: Pale face, weak voice, slight sweating, slight shortness of breath, fatigue, loose stools, poor appetite Empty Yang: Bright pale face, cold limbs, absence of thirst, desire for hot drinks, frequent pale urination Empty Yin: Heat in the afternoon, dry throat at night, night sweats Empty Blood: Dull-pale face, pale lips, dry hair, blurred vision, tiredness, poor memory, insomnia, scanty periods CAUSES OF DISEASE Disease can be caused by external factors or internal factors External factors thought of as pathogens that attack the body from the outside. Internal factors are often from stress and emotional “problems” that can damage individual organ systems, and from organ impairment which leads to lack of functioning. Organ impairment can be caused by diet, drugs, alcohol, medication, overwork, emotional factors or external pathogens that penetrate into the interior and begin to damage organ systems. CAUSES OF DISEASE PATHOGENIC FACTORS Also known as the 6 External Pernicious (Pathogenic) Influences/Factors 6 PATHOGENIC FACTORS Wind Cold Heat Dampness Dryness Summer Heat WIND Yang in nature Usually used as a source for other factors to enter Arises quickly and changes rapidly Moves around Lungs are affected first (External Wind) Liver affected for Internal Wind Causes tremors or convulsions, stiffness, paralysis WIND When Wind invades the muscles and channels: Stiffness, rigidity, contraction of the muscles with sudden onset When Wind invades the joints: Pain that moves from joint to joint, especially the upper part of the body DDX: WIND COLD Aversion to Cold/Wind Chills Sneezing Cough white white discharge Runny nose with white discharge Body stiffness and aches Pulses: maybe Floating, but often no change from normal Tongue: no change from normal DDX: WIND HEAT Aversion to Wind/Heat Fever Sneezing Cough with yellow discharge Runny nose with yellow mucus Itchy and/or sore throat Swollen tonsils, red back of throat Pulses: maybe superficial, but usually no change Tongue: no change from normal INTERNAL WIND Tremors, Tics Itchy – Lung involved as well because of skin Severe dizziness, vertigo Severe cases convulsions, unconsciousness, hemiplegia, Deviation of mouth/tongue COLD Injures Yang Contracts and congeals Causes clear discharge COLD Sleepiness Severe localized pain improved by heat – Excess or Deficiency ? White tongue coating and body discharges Slow pulse Craves warmth, aversion to cold, feels cold Pale complexion Lack of thirst Loose stool Clear and profuse urine – “not heat” Day or night (any at night too much depending on age) HEAT Yang in nature Blazes upwards Drying - damages Blood and Yin May cause bleeding Potential to generate Wind when severe Affects the mind HEAT High fever, desires cold, aversion to heat, heat sensation Redness - skin, face, eyes & complexion Thirst Constipation (complicated) or foul smelling diarrhea; foul smelling discharge Scanty, dark yellow urine Restlessness, irritability Bleeding symptoms - cough, vomit, nose, gums, urine, stool, skin Rapid anything – including pulse, breathing rate Yellow tongue coating (full heat) and other body discharges, red tongue body DAMPNESS Excess of Yin From damp environments: clothes, living, wading, diet, lack of movement Sticky and difficult to get rid of HEAVY & SLOW DAMPNESS Feeling of heaviness, pain or anything worse with damp, Anything swollen and/or oozing No appetite, bloating, made worse with food Cloudiness of discharges Pulses: Slippery Tongue: Sticky coat and/or fat, swollen tongue DRYNESS Usually from very dry and/or hot weather, internal heat, dry warming foods and/or herbs, lack of fluid intake, not enough fruit and veggies, salty processes food etc. All symptoms are DRY Internal dryness is a form of Yin deficiency without heat signs or symptoms Can result from Heat too SUMMER HEAT Yang in nature Only in the “summer” Like a heat stroke Combo of Heat and Damp Usually only encounter in 1st aid situation SUMMER HEAT Aversion to heat Sweating/ no Headache Scanty dark urine Dry lips Feeling of heaviness Irritability Thirst, no thirst if severe Pulses: Rapid Tongue: Red on the sides and tip May see delirium, slurred speech and unconsciousness REFERENCES Kaptchuk, Ted. The Web That Has No Weaver. Chicago, IL: Congdon & Weed, Inc, 1983. Maciocia, Giovanni. The Foundations of Chinese Medicine. 2ed. New York, NY: Churchill Livingstone, 2005. pp. 427 Maciocia, Giovanni. The Foundations of Chinese Medicine. 2ed. New York, NY: Churchill Livingstone, 2005. pp. 255-266.