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Golden Chamber 1. Violet Song. Structure of Jin Gui Yao Lue. Chapter 1 General Introduction Chapter 2-17 Internal Miscellaneous Diseases Chapter 18 External Miscellaneous Diseases Chapter 19 Non category Miscellaneous Diseases Chapter 20-22 Gynecology Miscellaneous Diseases
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Golden Chamber 1 Violet Song
Structure of Jin Gui Yao Lue • Chapter 1 General Introduction • Chapter 2-17 Internal Miscellaneous Diseases • Chapter 18 External Miscellaneous Diseases • Chapter 19 Non category Miscellaneous Diseases • Chapter 20-22 Gynecology Miscellaneous Diseases • Chapter 23-25 Food therapy and caution
22 chapters : 205 formulas, 166 herbs • Formula without ingredients: • Xing Zi Tang • Fu Zi Tang • Jiao Jiang Tang • Huang Lian Fen • Li Lu Gan Cao Tang
1.Discusses disease in different chapters • Multiple diseases in 1 chapter • Similar pathogenesis, symptoms, location • Non category Miscellaneous Diseases • Departments • 1 disease in 1 chapter ( chapter 8, 12, 14, 15)
3. Provide formulas according to syndrome • Detail in formula but brief in symptoms • Detail in syndromes but without formulas
4. Metric system of Han Dynasty • Weight • 1 Jin (250g)= 16 Liang(15.625g) • 1 Liang = 24 Zhu (0.65g) • Volume • Dou (2000ml) • Sheng (200ml) • He (20ml)
Chapter 1 On Pulse Syndrome Complex and Transmission of the Disease of Viscera, Bowels, Channels and Collaterals
Prevention and causes • 1.Prevention • Prevent from onset: 【1】【2】 • Prevent from transforming and transferring【1】 • Early treatment 【2】
2.Treat deficient and excessive diseases differently • Liver excessive pattern——strengthen Sp • Liver deficient pattern——sour, scorched, bitter and sweet
The example of preventive treatment is: when (superior doctor)saw liver disease, he would know liver disease will pass to spleen, so consolidate spleen first. • It is not necessary to tonify spleen, if (patient ) has strong spleen function at all the four season • Mediocre (middle level) doctor do not know the pass of disease. When treat liver disease do not understand to consolidate spleen, only focus on liver.
Relationship of liver & spleen • Physiology • Five element • Clinic facts
3.Causes • Pathogenic factors • Channels been attacked by pathogenic factors Zang Fu(Interior)【2】 • 4 extremities and 9 body orifices Exterior【2】 • Intermperance in sexual life, various traumata, animal and insect bites【2】 • Abnormal climate【8】 • Five pathogenic factors(wind, cold, damp, fog, improper food)【13】
2.Pathogenesis • Exuberant yang 【10】
3. Four examination samples • Observation • Vitality and complexion –Face and nose【3】 • Formation【6】 • Hearing and Smelling • Hearing【4】 • Smelling(Chapter 7) • Inquiry——【16】 • Palpation——【9】 • Combine 4 examinations——【7】
4.Treatment principles • 1.Prevention • 2.Treat excessive pattern and deficient pattern differently • 3.Exterior and interior pattern coexist【14】 • 4.Old (chronic) and new (acute) disease coexist【15】 • 5. food therapy and nursing【16】 • 6. Differentiation based on analysis of causes【17】
5. Transmission and Prognosis • Cu Jue【11】 • Jin yin chuang【12】
Chapter 2 On Pulse Syndrome Complex and Treatment of Jing, Humidity, and Ye Disease
Jing (Convulsion) • Concept【7】 • Cause and pathogenesis • Internal:constitutional body fluid insufficient or improper body fluid transportation • External:external wind cold attack or mistreatment • Location:tendon and sinew • Pulse:【9】
Classification • Gang Jing【1】 wind cold excess syndrome • fever • no sweating • aversion to cold • Rou Jing【2】wind cold deficiency syndrome • fever • sweating • no aversion to cold
Main symptoms 【7】 • Fever throughout the body with cold feet • Rigid neck • Aversion to cold • fever in the head • red face • blood shot eyes • tremble head • 口噤 trismus (牙关紧闭) • opisthotonus 角弓反涨
Differentiation and treatment • no promoting (heavy) sweat treatment【7】 • If promote sweat • Heavy sweating: entangle of cold with dampness • Heavy sweating: weaken the defensive Qi more aversion to cold • Proper sweating: Snake pulse 蛇脉 uneven pulse • If pt has moxa ulcer difficult to treat Yin and blood deficiency 【10】
Differentiation and treatment • Rou Jing: • wind cold deficiency • Taiyang syndrome • Rigid felling through the body • deep and slow pulse insufficient of body fluid • Gua Lou Gui Zhi Tang【11】 • 天花粉tian hua fen (Radix Trichosanthis Kirilowii) clear heat and promote body fluid production • Cinnamon Twig Decoction 桂枝汤 (Gui Zhi Tang) . regulate Ying and Wei • 桂枝gui zhi (Ramulus Cinnamomi Cassiae) • 白芍bai shao (Radix Paeoniae Lactiflorae) • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 生姜sheng jiang (Rhizoma Zingiberis Officinalis Recens) • 大枣da zao (Fructus Zizyphi Jujubae)
Differentiation and treatment • Gang Jing About to onset • wind cold excess • No sweat wind cold excess • Scanty urine body fluid depletion • qi rush up to the chest • 口噤 trismus(牙关紧闭) • Ge Gen Tang【12】 • 麻黄ma huang (Herba Ephedrae) • 葛根ge gen (Radix Puerariae) • Cinnamon Twig Decoction 桂枝汤 (Gui Zhi Tang) • 桂枝gui zhi (Ramulus Cinnamomi Cassiae) • 白芍bai shao (Radix Paeoniae Lactiflorae) • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 生姜sheng jiang (Rhizoma Zingiberis Officinalis Recens) • 大枣da zao (Fructus Zizyphi Jujubae)
Differentiation and treatment • Jing caused by interior heat • Yangming organ disease with痉Jing syndrome excess heat over consume body fluid • 胸满Fullness in the chest interior excess retention • Excess heat over comsume Yin and body fluid fail to nourish sinew • 口噤 trismus • 卧不着席opisthotonus • 脚挛急cramping in the leg and feet • 介齿grinding of teeth • Purging to rescue the body fluid • Da Cheng Qi Tang【13】 • 大黄da huang (Radix et Rhizoma Rhei) • 厚朴hou po (Cortex Magnoliae Officinalis) • 枳实zhi shi (Fructus Immaturus Aurantii) • 芒硝mang xiao (Mirabilitum)
Mistreatment and transformed pattern【3】【4】【5】【6】【8】【10】
Shi (Humidity/ Dampness) • Concept:a kind of disease manifested as fever, heavy sensation in body and pain in joints. • Cause and pathogenesis • Exterior:external damp attack, or combined with wind or cold • Interior:constitutional yang deficiency, Sp deficiency • Classification:Exterior type and interior type • Location:Muscle, joints
Treatment principles • Internal type--dysuria and smooth stool ——diuretic”【14】 • Symptom and treatment for damp Bi • painful joint and irritable (annoying/suffering ) 因痛而烦 • deep pulse interior • thready pulse dampness • loose stool • difficult urine • Treatment promote urine • Five Ingredient Powder with Poria 五苓散 wu ling san • 茯苓fu ling (Sclerotium Poriae Cocos) • 猪苓zhu ling (Sclerotium Polypori Umbellati) • 泽泻ze xie (Rhizoma Alismatis Orientalis) • 白术bai zhu (Rhizoma Atractylodis Macrocephalae) • 桂枝gui zhi (Ramulus Cinnamomi Cassiae)
Treatment principles • External type——“slight diaphoresis”【18】 • the whole body achy dampness inhibit YangQi circulation • Should promote sweat to resolve exterior pathogen • Worse during a rainy day more humid • Dampness sticky • Sweat too much still dampness • Moderate sweating
Differentiation and treatment • Excessive Pattern • 1.Damp cold in head——nasal intake herbs【19】 • cold damp in upper Jiao • pale complexion • difficult breath • headache with stuffy nose and irritable (lack of oxygen) • dampness did not interfere interior normal apatite
Differentiation and treatment • Excessive Pattern • 2.Exterior Damp cold ——Ma Huang Jia Zhu Tang (promote sweating to release exterior, expel cold and damp)【20】 • exterior cold damp • body ache and irritable • no fire treatment • 麻黄加术汤 Ma Huang jia Zhu Tang • Ephedra Decoction 麻黄汤 Ma Huang Tang • 麻黄ma huang (Herba Ephedrae) • 桂枝gui zhi (Ramulus Cinnamomi Cassiae) • 杏仁xing ren (Semen Pruni Armeniacae) • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 白术bai zhu (Rhizoma Atractylodis Macrocephalae) 苍术cang zhu (Rhizoma Atractylodis)
Differentiation and treatment • Excessive Pattern • 3. Exterior Wind damp——Ma Xing Yi Gan Tang (expel and resolve exterior damp)【21】 • causes and treatment of wind damp disease • body achy • fever severe in the late afternoon • causes expose when sweat, over take cold food • 麻黄杏仁薏苡甘草汤ma huang xing renyi yi gan cao tang • 麻黄ma huang (Herba Ephedrae) • 薏苡仁yi yi ren (Semen Coicis Lachryma-jobi) • 杏仁xing ren (Semen Pruni Armeniacae) • 甘草gan cao (Radix Glycyrrhizae Uralensis)
Deficiency Pattern • 1. Exterior wind damp pattern——Fang Ji Huang Qi Tang (strengthen qi to consolidate exterior, eliminate damp)【22】 • wind damp attack with exterior (Wei qi) deficiency • Floating pulse Wei Qi deficiency • Heavy sensation over the body dampness • Spontaneous sweating • Aversion to wind • 防己黄芪汤fang ji huang qi tang • 防己 fang ji (Radix Stephaniae Tetrandrae) • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 白术bai zhu (Rhizoma Atractylodis Macrocephalae) • 黄芪huang qi (Radix Astragali Membrnacei) Fang ji + bai zhu Strengthens vital qi
Deficiency Pattern • 2. Wind damp pattern • 2-1.Exterior yang deficiency • (1). Wind>Damp—Gui Zhi Fu Zi Tang (warm channel, strengthen yang, expel wind, resolve damp)【23】 • wind damp with exterior Yang deficiency • severe body achy, even can not make turns • no vomiting, no thirsty dampness did not interfere stomach • floating and weak pulse • 桂枝附子汤 Gui Zhi fu ziTang • 桂枝gui zhi (Ramulus Cinnamomi Cassiae) • 生姜sheng jiang (Rhizoma Zingiberis Officinalis Recens) • 附子fu zi (Radix Lateralis Aconiti Carmichaeli Praeparata) • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 大枣da zao (Fructus Zizyphi Jujubae) • (2). Damp>Wind—Bai Zhu Fu Zi Tang (eliminate damp, warm channel)【23】 • firm stool ( not constipation) • no difficult urine • Take out 桂枝gui zhi (Ramulus Cinnamomi Cassiae) • add 白术bai zhu (Rhizoma Atractylodis Macrocephalae)
Deficiency Pattern • Wind damp pattern • 2-2. Exterior & Interior yang deficiency, Wind=Damp—Gan Cao Fu Zi Tang (warm channel, strengthen yang, expel wind, eliminate damp)【24】 • wind damp with both exterior and interior Yang deficiency • severe joint radiating pain • refuse to be touched / tender to touch • sweating • shortness of breath • difficult urination • aversion to wind • edema • 甘草附子汤gan caofu zi tang • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 白术bai zhu (Rhizoma Atractylodis Macrocephalae) • 附子fu zi (Radix Lateralis Aconiti Carmichaeli Praeparata) • 桂枝gui zhi (Ramulus Cinnamomi Cassiae)
Yellow complexion due to damp heat【15】 • damp heat jaundice • the whole body ache • fever • jaundice like been smokeddamp severe than heat
Mistreatment and transformed pattern • 【16】dampness constitution patient affect by exterior cold damp • sweat only on the head dampness restrict Yang releasing rush up to head (weak) • stiff back dampness inhibit meridian Qi cieculation • prefer heavy clothing and warmth Yang deficiency • if purging further impair Yang • dry heaves stomach • fullness in the chest • difficult urine • thick tongue coating • Thirst but do not want to drink • Dry mouth • Irritable thirst / hea • 【17】dampness disease easy to inhibit and damage Yang • if purging severely impair Qi and Yang • forehead sweating deficient Yang upward escaping • panting • fatal case • frequent urine • continuous diarrhea
Ye • Concept:summer heat attack【25】 • symptom and treatment for summer heat (中暍zhong ye) • impairment of both Qi and Yin • fever, chills • heavy and body achy • wiry, thready and hollow pulse • more chill (quivering after urination) • cold hand and feet • fever on exertion • Dry teeth
Differentiation and treatment • 1. Yangming excessive heat damage fluid——Bai Hu Jia Ren Shen Tang (clear summer heat, promote body fluid, strengthen qi) 【26】 • summer heat impair Qi and Yin • sweat • aversion to cold • fever • Thirst • 白虎汤加人参 bai hu jia ren shen tang • White Tiger Decoction 白虎汤bai hu tang • 石膏shi gao (Gypsum) • 知母zhi mu (Radix Anemarrhenae Asphodeloidis) • 粳米jing mi (Nonglutinous Rice) • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 人参renshen (Radix Ginseng) • 2. Summer heat attack with damp——Yi Wu Gua Di San (eliminate damp and dispel water)【27】
Mistreatment and transformed pattern【25】 • if sweating further impair Yang • more aversion to cold • if using warm needle more impair Yin and body fluid • more fever • if purging more impair Yin and body fluid • difficult urination