Week 12

Review of Diagnosis
Case Study + Treatment Principles + Treatment Plan

34 Year old Female, Tai Yin with Shao Yang
Insomnia, Onset and Magnitudial
Nightmares, Anxiety, wakes up in a fright
Fatigue
No appetite
Stress induces Diarrhea
Reoccuring Yeast Infection, thick, copious, yellow, odor discharge
Grinds teeth at night
Complexion - Malar flushing, pale lips, acne,
Tongue - Red, distended, LV/GB area, Toothmarks, Red in the anterior
Thick yellow greasy coating
Pulse - Sp- soggy wiry, LV - Forceful wiry, HT - Faint - KD - Hidden

Ht-Sp Dual Vacuity - Magnitudial Insomnia
Liver Fire - Onset Insomnia
Wood - Earth Disharmony - Diarrhea with Stress
Damp Heat - Bowels + Vaginal discharge
Phlegm - Plumpit throat


Gui Pi Tang
Jia Wei Xao Yao San
Er Miao San
Er Chen Tang


Huang Qi + add Qi in the exterior, moves
Ren Shen + add Qi to the Center, static
Dang Gui + moving blood nourisher
Chen Pi + regulates Qi, harmonizes stomach
Chai Hu + Courses the Chai Hu, plunders Qi
Bai Zhu - Constructs Sp
Huang Lian + Clears Lv Fire, Gb fire St Fire (light doses, bitter, cold, and draining)
Ban Sha + Dries transform phlegm, downbears the turbid
Fu Ling - Constructs Sp, Bai Zhu + Fu Ling, Perculates Damp, Calms Shen
Bai Shao + Nourishes the LV Blood, astringes to temper Chai Hu
Sheng Jiang + Warms st, Wei Qi
Da Zao + Supplements Sp, Ying Qi
Zhi Gan Cao + Harmonizer
Long Gu + Drain Liver Fire
Mu Li + Drain Liver Fire
Wu Mei + Attacking, Supplementing, Heat Clearing, and Calming

Suan Zao Ren - Heart Lv Hun
Bai Zi Ren - Heart Liver Lungs Po
Fu Shen - Calm spirit
Zhi Mu - Clears heat moistens, Yin vacuity with vacuity heat
Yuan Zhi - Calms Spirit, Transform phlegm misting the portals, reinstate connection of Heart and Kidney
Huang Lian - drain liver
Long Yan Rou - Supplements Qi and Blood, Sp, Special use for damage by overthinking
Bai He - Nourish Yin, Clear Heat for severe vexation (bored stubbornness)
He Shou Wu - Nourishes KD Yin, Calms the Spirit, Moisten intestines
Long Gu - Drain Liver
Mu Li - Drain Liver


P 8
St 36, ST 40
St 44
Lv-3 to Kd-1
Gb 41?


Children Physiology and pathology is different than adults
Onset of Puberty = Onset of Adult physiology
Organs are weak and tender
5 Zang and 6 Fu = Forming and not complete, and not complete, not vigorous
Ministerial Fire is entrusted to the Gall Bladder Sanjiao and Pericardium
Children have the young yin and young yang.
Under 3, the body is pure yang.
Children go through growth spurts, each spurt = flaring of Ministerial Fire
2 = first Flare.
As they age, the Yin is engendered and flourishes.
Easily damaged by food and drink. the Yang Ming is fragile
Sinews and Tendons are tender so easily invaded by wind and cold.
Liver has Surplus
Liver Qi Stagnation easy.
Easy to transform Wind
Children are extremely reactive, responds quickly.
Food stagnation is pretty common
Causes of Disease is simple
Observe Shen
JingShen is lively, and flexible
Tendacy to sleep prone = food stagnation or parasites
Map tongue is common.
Sp/St vacuity problem
Moldy coat = food stagnation sign
Sloppy stool with white clots = trouble digesting milk
Diarrhea from Wind Cold - frothy bubbles
Febrile diseases have papules and rashes (measles)
If wind-heat invasion, the back of the mouth has white dots, then about to invade blood level
Papules start back of the neck
Bo He will vent rashes, prevent sinking of measle toxins, will express through the legs
Look for masses in neck lymph nodes
Ear Infections
Rooted in Food stagnation
St-Int = Weak
Often includes nausea and vomitting
Bad food = Sugar, Cheese, Nut Butters, Wheat and Corn products, uncooked chilled foods
In general, no high allergic food for children
Soy based formulas are bad, too cold.
Sp vacuity
+ Heat = Phlegm
+ Heat + Phlegm = Yang + San Jiao
Post Antibiotic Spleen Vacuity Syndrome?

Ear aches 2-3
strep throat in 3-5
tonsillitis,
bronchitis
long term asthma


Crystal Geyser Lemon Water will remove the taste of herbs

Week 11

Somnolence - Jing Shen - Alertness, consciousness, body/mind
Yang Qi
Yang Governs activity, Yin governs rest
If Yang is Xu, then there is going to be less activity - Weak Pusle,
Or If Yang is repressed - Confined Pulse
Its going to be combinations of both.
Yang Xu due to qi xu
Engenders damp, etc, giving excess

Yang functions to warm and nourish
1) Limbs
2) Spirit Light - Jing Shen

Yang Qi is rooted in the Kidneys, Spleen, Heart, and Brain
Patterns
Spleen Qi Xu
Spleen Upbears Clear Qi to empower the Jing Shen
Use herbs to boost the qi right after the eating if postpernial somnolence

Heart blood sp qi xu = magnitudial insomnia
Insufficient Essence = Severe disease or over-rioteousness
Spleen encumbered by damp/phlegm - usually with the others

Ht-Kd dual vacuity

Ht-GB vacuity - susceptible to fear and fright

ht-lv - susceptible to stress

Sp-1 treats profuse dreaming.

LV-Sp disharmony lv 3, li 4, lv 13, sp 14

week 8

Appetite
and Poor Appetite

Wood-Earth Disharmony vs Liver Qi and Sp Qi Xu
LV Qi + Sp Qi Xu = LV Qi attack with stress, and Sp Qi Xu symptoms because of Sp Qi Xu
Wood-Earth = Earth problems because of Stress
Tong Xue Yao Fan = Painful Diarrhea Miracle Cure, = LV-Sp
- Sp = \/
- St = /\
- Wood /\ + Heat = St heat /\ Appetite

St Yin Xu
Hunger without appetite
Clamouring St = Bensky indeterminate gnawing hunger

Sp-St Yang Xu
Undigested food particles (with KD yang)
Cold Hands/Cold Nose
Dull abdominal pain with worse with cold

Sp-St Damp Heat
Loose Stools with stronger smell
Heavy feeling in limbs,
sticky fever,
dry mouth, no desire to drink
worse with alcohol, greasy food
- Food Stagnation - Dual pattern = food that is borderline bad, unclean food

Food Stagnation
Too much food, poor digestible food.
Digestion = all process of passing through body
Meaty foods, Oils, Nuts, Greasy Fried Fatty = hard to digest
Eating too fast
episodic.
Particular in babies/elderly
belching, ab distension, pain, poor appetite

Signs of strange food (raw rice, dirt, etc)
Signs of Chong, Malnutrition due to Chong

Taste
Lack of taste/tastes like cardboard = poor appetite
Sp-St Qi Xu,
When Earth is strong, the tongue can distinguish the 5 flavors
Suspect 1) Depression
2) Diabetes
Central Qi Vacuity + damp
Use Bai Kou Ren

Sour Taste, Acidic taste
LV-Sp with Heat

Bitter Taste
Lv-GB
Heart Fire
Shao Yang

Bland = earth/qi xu, cold, + lack of taste

Sweet Taste
Sp Damp Heat, more damp than heat

Salty
Kidney problem
Vacuity heat
Cold in UB - wu ling san

Greasy/slimy - Sp encumbered by Damp

Hot taste = yin vacuity, vacuity heat

metallic taste = ancient times peppery/acrid taste
Lung Heat - Huang Qin - small dose.

Foul Breath
1) Food Stagnation
2) ST heat
3) Lung Heat

Foul smell
Abcess

Absence of Thirst
With bland Taste = Cold

Thirst with dryness
Damp with deep lingering heat

Dry mouth - Statis, binds Wet
2 Blood Thirst = Heat leating to blood stasis.

Drinks
Thirst for Cold Drinks
Heat
- St Heat
Febrile Disease

Warm drinks
Yang Xu
- Damp obstruction
Water-Rhuem repletion

Drink then Vomit
Water-rhuem in the stomach/intestines

Vomit then desire to drink
St fluid damaged

Thirst with Polydypsia and Polyuria
Xiao Ke = Wasting and thirsting/wasting thirst
Diabetes/Diabetic disease
3 Stages
Upper/Middle/Lower
Manifestation is delayed for signs and symptoms
Upper = Increased Intake/Thirst Normal Appetite
Middle = Increased Intake/Thirst, Above Average Appetite
Lower = Late stage Diabetes
Upper Stage = Qi and Yin Dual Vacuity
Qi tonics = heating harms Yin, Yin tonics = slimy/damp harms Sp

2) Insufficient Jin Ye - abnormal sweating/liquid loss



Thirst with Little or No Drinking

Yin Xu- tidal fever, malar flush, night sweats
Damp-Heat - Sticky Fever, heavy sensation
Water-Rhuem in the LI = Thirst with no drinking
Blood stasis = Blood Thirst

Sleep
1)Time and Quantity of Sleep
When you go to bed is important.
Sun cycle lecture - Consider going to bed by 10, do deep sleep by the time the sun is on the other side of the world. Yang super charges Yin.
Wake up by Sunrise
2) Time to fall asleep
a) staying asleep
b) 15 minutes to fall asleep. not more not less
3) Somnolance
4) soundness, solidity
5) awoken by fever

Insomnia
Heart -Kidney
Heart Yin/Blood Xu
Ht-Sp Dual
Ht-GB Qi timidity
Ht-Fire
Phlegm Fire
Liver Fire
Liver blood w/ Heat
Food Stagnation
Retained Heat

2 types
1) can't fall asleep - typically replete - evil qi
2) staying asleep - typically vacuity - insufficient righteous qi
a) vivid dreams
Liver treasures blood - Shen/Hun
Hun turns inward when carried back tot he LV during sleep, and dreams
Shen goes to Heart (5 patterns)
Hun goes to Liver (3 patterns)
when not getting good results, think of stasis complicating the patterns.
Ht-Sp
Ask for loss of strength as a sign of Sp Qi Xu
Post prenial somnlence
loose stools

Ht-Kid - nightmare insomnia
steaming bone
trouble falling asleep, stays awake, then falls asleep only to wake up again
Replete above, vacuity below
E Jiao - Huang Lian

Ht-GB qi timidity
Waking in a fright/variations of
not wanting to sleep alone
look for hot phlegm
Wan Dan Tang

Liver-Fire
Long Dan Xie Gan Tang

Liver-Blood
Suan Zao Ren Tang

Midterm Review Diagnosis

Review face
Review Eye map
Jokes = to entertain Steve, not the class.


1)Inferility
2) Heat harassing the portals
3) Pre-cordial pain
4) Loss of strength of arms
5) Insomnia (inner canthus = heart area)
6) Intercranial Tumor
7) Cause
8) Blood Vacuity
9) Sp
10) Heart
11) Bi
12) Phlegm
13)Frequent Dark Urine
14) Food Stag
15) Blood Xu
16) Straitened Sp
17) Kid Yin
18) Lu-Sp Qi Xu
19) Lu-Qi

Case Studies... Don't forget to state the "Stop" part
Stop Diarrhea, Stop Sweat, Free Flow of Stools
Patterns don't have to involve Organs

Qi = Supplement, Fortify, Boost
Blood = Nourish
Yin = Enrich
Yang - Warm, Warm/Invigorate


Dampheat in LI, Clear Heat, Drain Damp, Stop Diarrhea

Sp qi Xu, Fortify Sp, Stop Diarrhea

Water-Rheum in the Intestines, Fortify Sp, Free Yang, Transform Phlegm

Lu-Sp Qi Xu, Supplement LU Qi, Fortify Sp, Free Flow of Stools

(part 2 incomplete)

Liver Fire, Drain Fire

Side Notes

Treatment Principles, precise
Example:

Disease = Constipation
Pattern: Liver Qi Stagnation
Principle: Move Liver Qi, Free Stools.

Principle is Main action for the pattern + specific actions for the disease.
Add in immediate resolutions.
Stop -
Bleeding
Coughing
Sweating
Vomiting
Diarrhea
Urination
Pain
Constipation (free)

week 7

Diarrhea
Wind Cold
Sudden onset
Wind = Invasion, exterior, Centered by change
Cold = Constrain, Constrict, Congeal, Clear fluids,
Cold vs Heat, Palative vs Provocative
No Smell, or Strong Fishy Smell
Tx Principle: Resolve the Ext, Warm the Intestines
Use Ge Gen, Zi Su ye

Cold Damp
Sudden Onset
Cold, Clear, Damp/Wet, No Smell, Heavy Body, Fatigue, Poor Appetite..-> Sp Damp
Tx Warm and Scatter Cold, Dispel Damp/Disinhibit
Zhi Zhong Ju

Damp Heat
Sudden Onset
Frequent, Urgent Burning, Painful.
Explosive, Foul Smell, burning anus
Yellow color
Tenesmus
Generalized signs, Sticky fever, Dry Mouth, little thirst, sticky stool

Food Stagnation
Sudden Onset
Ab-pain
Borborygmus
Undigested food, unbearably bad smell, rotten eggs.
After bowel movement, feels better.
lactose intolerance = food stagnation

Liver Qi - Diarrhea, Emotions
Sudden onset, but predictable
Stress, Story of Diarrhea on first dates.

Kidney Yang Xu (Sp-Kd Yang Xu)
Older, Bright White, Weak, Low back pain, Poor flesh tone, puts on weight
Cold Feet, maybe Kidneys
Swill Diarrhea = Food in it, Due to Lack of Fire
5th Watch, 5 Am, Cock's Crow Diarrhea,
Insidious onset
Tx Astringe Intestines, + Supplement Kidney/Sp

Phlegm (Rhuem/Water Rhuem) in Intestines (and St/aka Yang Ming)
Enduring
Clear and Watery
Borborygmus
Vomit clear fluids, possibly triggered by cold drinks
Possible sloshly sound in the abdomen
Tx Warm and transform fluids


Constipation
Yang Ming - Lots of Qi, Lots of Blood... pathogens Transform Heat, becomes Exuberant Heat
becomes 4 bigs
Qi Division - Middle Jiao - no bowel movements for 5-8 days
Heat Binding the Stools.. Scorching the stools itself.
Glomus (focal distension) Fullness, Pain, dryness,
Tongue - Red, Thick dry, yellow, old looking
Da Cheng Qi Tang - Hospital useage
Possible Diarrhea with circumfulence

Dry Heat in St-Inst
Dry, Bound Stools, Heat,
Dark urine, frequent urination
Sores around Mouth/tongue
Red complexion,
Dry Earth/metal with heat.
Tx Moisten + purge heat
Ma Zi Ren Wan
Too much baked food, not enough liquids, too much fried foods.

Liver Fire/GB Fire
Enduring Lv Qi Stag + Depressive Heat + Yin Xu
Dizzines, vertigo, irrascible, constipation
Tx Drain Fire, Free the stool
Use Lu Hui, Lv2, SJ6,

Sp/Lu Qi Xu
Pale, bright white complexion
sweat easily
struggles to defecate
not much discomfort
constipation
frequent desire to defecate, but not much
poor zhong qi

Yang Xu
Dark complexion
flatulance
constipation
frequent voiding,
long, clear urine,
frequent nocturia
terminal dribbling
cold limbs, likes warmth, fear cold
tx Warm the Yang, or Warm and Invigorate
1) Fu zi, Rou Gui, Gan Jiang, 2) Ro Song Rong

LV-Sp
Spleen qi weak + emotional = LV getting stuck, unable to discharge LI
All organs relies on the LV to discharge and course for their own Qi Ji.
Desire to defecate..
Belches a lot.
Bad breath
Tx principle, Move Qi. Abduct Stagnation, Free Stools.
Chen pi
6 milled ingredients, liu

Week 6

Painful Urination
1 UB Damp Heat
Frequent Urgent Burning Painful
Damp from SP Xu, Heat from LV
External Invasion = Hygene or disease
thick yellow greasy tongue coat, slipper rapid pulse
sticky fever, heaviness in limbs
Tx Clear Heat, Disinhibit Damp
scanty dark, urine reddish like food dye
2 Exuberant HT Fire
Blazing LV Fire... causing HT Fire
Palpitations, bitter taste, red prickles on tongue
Sores on the tongue, heat scorches the blood, causing puss
Tx Drain HT fire through Urination: Use Chi Dao San Guide Red Down Formula
HT fire potential sure sign is the HT crack
3 Kidney Yin Xu, Xu Re
Low back and knees weak and sore, + Vacuity Heat signs
Xu Re in KD leads to UB heat.
4 LV Qi Stagnation
6 Depressions
5 Blood Stasis
6 Depressions

Case example
Disease = Freq Urination
Pattern = Liv Qi stag
Tx principle = Course LV, Recitfy the Qi, eliminate damp, disinhibit damp
LV 3, Ren 3, UB 32,


Frequent Urination
UB Damp Heat
LV Qi Stagnation
Straitened Spleen ( Dry Heat ST or Intestines [Yang Ming]) + Sp Yin Xu
Blood stasis
Blood stasis inhibits the Qi Dynamic, and the Qi Dynamic is what voids the bladder, and blood stasis will stop urination.
Kidney Yin Xu
Kidney Qi Xu, Not Securing Front Yin



Stool
Color
Food will change color of stool. Salts will make it darker, Beets can dye red. Blueberries turn purple.
Stable diet, stable color.
dark with yellow = heat binding in the intestines
black tar like stool = melanoma = far bleeding from anus.
Red and white = dysentery (10x a day diarrhea)
SHOULD BE baby turd brown. ideally clean getaway.
in the morning, around sunrise (LI time)

Feeling
Should be able to relax, and comes out quickly with 1 breath
Burning = heat
unsmooth feeling, like sticky, difficult to discharge, = damp
pebbly, hard "tips" is from incomplete movements due to damp. (ungratifying)
stickiness + heat + smell = damp heat.
LV attacking = IBS
Tenesmus
Ab. pain w/ uneasy passage of feces
- urgent desire to defecate w/ heavy sensation in the rectum, possible delayed bowel movement
- TCM mechanisms evils combine with and obstruct the free flow of qi and blood, congesting and stagnating the intestines - this affects the conveynce and conducting
- a)internal urgency b) heavy sensations (burning sensation, explosive diarrhea, foul smell)
- Evils = A) damp heat (burning sensation, explosive diarrhea, foul smell)
B) epidemic toxins (heavy, sagging sensation, red and pus)
C) cold damp

Heat in the LI
Dry and Dark, water can be yellow
Blood Vacuity
Extremely Dry and Hard
Body fluid insufficiency
Extremely Dry and Hard
SP/ST vacuity
loose stools, shapeless (breaks up in water, cloudy water)
Damp Heat in the LI
Front part dry, hard pebbles, + soft, shapeless rear part.
Lv-Sp Disharmony
Possibly irregular, alternating diarrhea and constipation, relates to stress.
Sp-Kd yang vacuity
Undigested food, less smell, maybe fishy/clammy.
Food stagnation
Undigested food, rotten, foul smell.

If there is pus, sign of pus. Bai jiang sao
Go to MD.
Dysentery
Blood and Pus, Red and White, 10x a day.

Diarrhea vs loose stools
Urgency, consistency, thin, possible liquid

Damp Heat
Rich, spicy, thick, greasy, fried foods + alcohol = irritation of damp heat
More Heat = Dry bound
More Damp = Diarrhea
GB 34 = DampHeat in Lower Jiao
with ST 25 Alarm point
more Heat = LI-11 ST 44?
Huang Lian
Hou Po
Ban Shao
Mu Xiang

Food stagnation
poorly digested food, putrid belching, acid regurgitation, st distention, pain, poor appetite, nausea, loose fowl smelling food.
food stagnation = hard to digest foods, or hasty eating.
Tx principles: Abduct food stagnation (UFP [undigested food particles] Adbudction)
ST 21, Ren 12/10,
"you're right if it works" - multiple ways to treat same problem
Ji Nei Jing
Shang Jiang,
Shan Ja


LV-SP disharmony
Sp fails to upbear the clear qi + sp fail to circulate the body fluids, acomlinating in damp peculating down.
Lv-3 with Sp 6
+ st 36
ST 25,
Tong She