Shanghan clinical cases study

1. Shanghan clinical cases study

2. In the 1980’s, People Republic of China

3. Dr. Zahn Dechao‘s clinical case张德超医案

4. Food-denying dysentery • Main complains: A 7 year-old boy suffering from severe diarrhea with passage of mucus and blood for five days.

6. Manifestation • Main signs: more than 10 times of major bloody stools a day • Other symptoms and signs: Abdominal pain, poor appetite, relief of fever after resolving the exterior.

7. Initial treatments: 1)Since fever with severe diarrhea， use the method of ”hauling the boat upstream” (exterior syndrome)

8. Maybe food accumulation ? ? 2)Since poor appetite may be caused by food accumulation, use the method of precipitation to discharge accumulated food.

9. Evaluation • First treatment is somewhat right, fever relieved, but no effect on diarrhea. • Second treatment is completely wrong, more severe diarrhea, vomit and food-denying appears.

10. Dr. Zahn Dechao’ s initial impression • Pulse: soggy and weak pulse, especially right Guan Pulse. • Tongue: red tongue body with white coating . What information those signs give us?

11. Pulse Location • Left right • Hand cun hand • guan • Chi Heart Liver kidney Lung Spleen &Stomach Vital gate

12. Soggy and weak pulse means • Just like Air chair is leaking air.

13. Tongue • Red tongue＝ Since body fluid loses due to diarrhea, it is a kind of physical response. • White coating＝ Evil locates in Qi aspect

14. Mechanism Spleen & Stomach extremely deficiency and Qi dynamic disorderno exteriorno repletion 机制：脾胃虚极，气机失调（非表非实）

15. Donghan Dynasty the same thing happened

16. 伤寒论In Shang-Han-Lun东汉Donghan(25-220) • 伤寒中风，医反下之，其人下利日数十行，谷不化，腹中雷鸣，心下痞硬而满，干呕，心烦不得安。（158） • With wind stroke of Cold damage, treated by precipitation, the patient showed diarrhea, tens of times a day, indigested food, thunder-like bowel rumbling, glomus Qi with hardness and fullness located in stomach, dry retching, restless vexation.（158）

17. Licorice Heart-Draining Decoction Syndrome(LHDDS)甘草泻心汤证 • 医见心下痞，谓病不尽，复下之，其痞益甚。此非结热，但以胃中虚，客气上逆，故使硬也。甘草泻心汤主之。（158） • Since glomus Qi located in stomach remained, which represented not to recover, and then treated by precipitation again, it became more severe. It is not heat bind, however, hardness is caused by stomach deficiency and Guest Qi upward. Licorice Heart-Draining Decoction takes charge of this syndrom.（158）

18. ！ The same • Main complains • Second inapropriate treatment • Main mechanism of this syndrome 惊奇的一致：主证，误治，主病机

19. Dr. Zahn Dechao’ s diagnosis • Before second treatment, Spleen and stomach deficiency and Guest Qi (evil) located in Mid Jiao. Therefore it appeared diarrhea due to abnormal upbearing and downbearing. • But now Guest Qi goes Upward and leads to food denying.

20. Herbs and preparation of LHDD • Licorice 12g, Pinellia 12g, Scutellaria 9g, Coptis 3g, dried ginger 9g, Jujube 4 pieces, Ginseng 9g. • 炙甘草12克，半夏9克，黄芩9克，黄连3克，干姜9克，大枣4枚，人参9克。 • 2 L——1.5 L---0.6 L———》0.2 L 7 herbs put into water Taking herbs out Drink one third

21. Dr. Zahn Dechao’ s treatment • Main principle: Supplement the center and harmonize the stomach, and clear Damp heat as well. 治则：补中和胃，清化湿热。 Licorice 12g, Pinellia 9g, Scutellaria 6g, Coptis 3g, Fresh ginger 9g, Jujube 3 pieces, Codonopsis 9g. 2 formula. 甘草6克，黄芩6克，黄连3克，制半夏9克，党参9克，生姜6克，红枣3枚。 2剂

22. Curative effect • 2 formula, vomit and diarrhea got relieved. After 3 more formula with original decoction variant, the patient was cured . 2剂，呕痢均减，更服原方加减，续服3剂而安。

23. The modern medical describing • Concept: Dysentery is defined as a disease characterized by severe diarrhea with passage of mucus and blood and usually caused by infection. • Some symptoms include, intestinal ulceration, diarrhea, painful spasms and the inflammation of the lining of the large intestines. The disease is spread through the feces of carriers who have the bacteria in their intestines. • It is transmitted by eating or drinking from anything contaminated with the bacteria from the feces of these carriers. Even touching something contaminated and then touching the mouth can cause infection. Flies also spread the disease.

24. Q1:Do the foreigners know what I am talking about ? Q2:Have Shang Han Lun been translated?

25. Shang Han Lun in foreign countary 英文版 德文版 法文版

26. Q3: We do know about Shang Han Lun outside China, but no Chinese herb permits to prescription legally in our nation.However, acupuncture is OK, can we use needle to get the same good curative effect ?

27. The answer is yes of course. Acupuncture under guide of Shang Han Lun: Licorice Heart-Draining Decoction Syndrome(LHDDS) 甘草泻心汤证

28. Using Mechanism of Shang Han Lun to pick acupoints运用伤寒论病机选穴 • Main Mechanism :Stomach deficiency and Guest Qi upward 主病机：胃中虚，客气上逆

29. Herbs and acupoints • Licorice stomach deficiency and Guest Qi upward－ST-36 • Ginseng • Scutellaria－－－food accumulation and vacuity fire generate－－－ST-44 • Coptis－－－clear heart fire and relieve vacuity vexation－HT-7 • Pinelli－－spleen deficiency and engender phlegm－ST-37 • dried ginger－－－warm interior－－－SI-3 • Jujube－－－supplement blood－－－SP-6

30. 药物及对应穴位 • 甘草 人参－胃中虚，客气上逆－足三里 • 黄芩－－－食积虚火－－内庭 • 黄连－－－清心火，止虚烦－－神门 • 半夏－－－脾虚生痰－－丰隆 • 干姜－－－温里－－－后溪 • 大枣－－－补血－－－三阴交

31. Thank you