Dr. Zhijiang Chen s Chinese Herbal Remedies Series. Basic Theory of Internal Diseases of Chinese Herbal Remedies (CHR) Chapter One: Diseases

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1 Dr. Zhijiang Chen s Chinese Herbal Remedies Series Basic Theory of Internal Diseases of Chinese Herbal Remedies (CHR) Chapter One: Diseases Section One: Basic Information 1. Definition of internal diseases The definition of internal disease is the disorder or incorrect functioning of organs, parts, structures, or systems; which is resulting from the effect of external and internal genetic, pathogenic contagious microorganism infection, chemical acting poisons or toxicity, physical unfavorable and abnormal environmental factors, injury from physical and psychological damage; life energy property mutation and release of negative gene information heat, and chronic accumulating inflammation heat to cause body circulation and lubrication liquid deficiency, dehydration, and blood heat conditions. The weak immune function and material is a reason to cause body being easily attack by pathogens; aging is one of the main reasons to cause weak immune function and deficiency of immune materials; the external and internal of pathogens are important reasons to directly cause diseases; the pathogenesis is a main key to control the development of diseases; the pathogen and pathogenesis phenomenon of diseases usually is shown by the location, direction, property, degree, stages, conditions, and situations. The main indications of diseases are negative objective signs and subjective symptoms. The main indications and manifestations of disease are multiple negative signs, symptoms, and patterns in one disease. The internal disease is part of the aging process; the main pathogens and pathogenesis of internal disease are dry heat and yin liquid deficiency. The many pathogenesis can cause one disease; one of the main pathogenesis can cause many diseases. The purpose of internal diseases is to make the body ill and take away life. We cannot keep life going on forever, but we can try to keep diseases away from the physical body and mental mind. 2. The location of pathogen and pathogenesis of phenomenon of disease The pathogens and pathogenesis can be located at the upper or lower, front or back, internal or external, left or right, left upper or right lower area, right upper and left lower area of the body. 3. Direction of pathogen and pathogenesis of phenomenon of disease The direction of pathogens and pathogenesis can be spreading or astringent, rising or seeking down, toward external or internal, toward left or right, toward front or back, toward left upper or right lower, toward right upper or left lower, opening or closing, transferring or blocking. 1

2 4. Property of pathogen and pathogenesis phenomenon of disease The property of pathogens and pathogenesis can be dry or dry with cold, heat, damp. It can be cold or cold with heat, dry, damp. It can be heat, or heat with cold, dry, damp. It can be damp, or damp with cold, heat, dry. It can be damp heat with damp cold, dry heat with dry cold, dry heat with damp heat, dry heat with damp cold, dry cold with damp cold, dry cold with damp heat. 5. Degree of pathogen and pathogenesis phenomenon of disease The degree of pathogens and pathogenesis can be hyper or hypo, hyper with hypo, hyper reaction or hypo none reaction, hyper glycaemia or hypo glycaemia, excess or deficiency, excess with deficiency, high temperature or low temperature, high temperature with low temperature, high temperature with cold sensation, low temperature with hot flush, dehydration or edema, dehydration with edema, forceful pulse with slow pulse, fast pulse with weak pulse, insomnia or tiredness, insomnia with tiredness condition. 1. Common classification of diseases Section Two: Classification of Diseases 1.1 Contagious Diseases Bacteria, virus, rckettsiosis, chlamydial, mycoplasma, fungi, syphilis, parasite. 1.2 Chemical Factors Diseases Medication poisoning, any kinds chemical poisoning, smoking poisoning, alcohol poisoning, drug poisoning, animal bite poisoning, plant poisoning, occupational sickness. 1.3 Physics Factors Diseases High altitude sickness, decompression disease, radiation diseases, heat stroke, accidental hypothermia, drowning, electrical injury, noise injury, motion sickness, occupational sickness, catch abnormal six weather factors (wind, cold, damp heat, damp, dryness, heat). 1.4 Injury (physical and psychology) Sport (over and lack), wound, over sex activity, over nutrition, deficiency nutrition, emotion factors, psyche factors. 1.5 Genetic Diseases Diseases directly caused by heredity before birth According to (http//en.wikipedia.org) A genetic disorder is an illness caused by one or more abnormalities in the genome, especially a condition that is present from birth (congenital). Most genetic disorders are quite rare and affect one person in every several thousands or millions. [1] 2

3 Diseases indirectly caused by heredity after birth Cancer, heart diseases, diabetes, asthma, over weight. 1.6 Internal Diseases Include all systems diseases, metabolisms diseases and mental diseases. 2. Classification of diseases base on pathogens 2.1 Cold pathogens and pathogenesis (warm yang energy deficiency) Common cold, accidental hypothermia, frosty bite, motion sickness. 2.2 Excess heat pathogens and pathogenesis (cold yin energy deficiency) (heat stroke) 2.3 Dampness pathogens and pathogenesis (dry energy deficiency) Excess Water Damp cold pathogens and pathogenesis (warm and dry energy deficiency) Bacteria s diseases (candidiasis) Virus s diseases (stomach flu) Damp heat pathogens and pathogenesis (cold and dry energy deficiency) Virus s diseases (hepatitis A, shingle, herpes simplex) Bacteria s Diseases Tonsillitis, bronchitis, pneumonia, enterogastritis, food poisoning, dysentery, mastadenitis, boil, septicemia, candidiasis. 3. Dry pathogens and pathogenesis 3.1 Excess mineral 3.2 Excess air 3.3 Dry heat pathogens and pathogenesis (cold and moisture energy deficiency) Virus s Diseases Virus flu, hepatitis B, C; shingle, herpes simplex, infectious mononucleosis, AIDS (Acquired Immune Deficiency Syndrome) Borrelia burgforferi (lyme disease) Poisoning (drug addiction, chemical poisoning, alcoholic intoxication, smoking) Physics factors (radiation sickness, noise sickness) 4. Energy deficiency (protein, fatty, sugar, vitamin and other mineral nutrition) 5. Energy excess (protein, fatty, sugar, vitamin and other mineral nutrition) 6. Energy carrier deficiency (oxygen, body water, minerals) 7. Excess energy carrier (oxygen, carbon dioxide, body water, minerals) 1. Definition (use colitis as an example) 2. Symptoms of disease Section Three: Study Items of Internal Diseases 3

4 2.1 Main symptoms Bloody diarrhea is one of main symptom Abdominal pain is one of main symptom. 2.2 Digestion symptoms 2.3 Other symptoms 2.4 Symptoms characters Family, Age, Sex, Nationality, Emotion and spirit, Geography, Season, Weather, Diet, Life habit, Stage characters, Western Medical Examination, Inducement (the factors cause flare up), Complication, Transfer direction, Progression or Prognosis. 3. Symptoms Analysis 3.1 Main symptoms Bloody diarrhea is one of main symptom Abdominal pain is one of main symptom. 3.2 Digestion symptoms 3.3 Other symptoms 3.4 Symptoms characters Family... this is reflecting gene heat condition Age this is reflecting life energy timing and degree condition Sex this is reflect energy yin and yang property Emotion and spirit this is reflecting brain energy condition Geography this is reflecting earth seven elements energy material condition Season this is reflecting universal energy time table condition Weather this is reflecting sky energy condition Diet this is reflecting postnatal energy property condition Life habit this is reflecting postnatal energy activity condition Stage characters this is reflecting a stage of a disease condition Western Medical Examination Inducement (the factors cause flare up) Complication Prognosis 4. Evaluation information and explanation Pulse this is mainly reflecting external area energy condition Tongue this is reflecting blood liquid condition Coating this is mainly reflecting digestion system condition Hand nail this is mainly reflecting upper body internal condition Toe nail this is mainly reflecting lower body internal condition Iridology this is mainly reflect internal and deep body area condition 4

5 5. Disease Location 6. Disease Property 7. Disease Condition 8. Pathogens 9. Pathogenesis 10. Discuss & Analysis Disease 11. Main patterns 12. Principle of Remedy 13. Formulas 14. Combination 15. Diet Suggestion 15.1 Diet: try not to over eat, drink, or take 15.2 Activities client doing: 15.3 Suggestions doing: 16. Other Source 16.1 Common symptoms in Traditional Chinese Medicine 16.2 Other Pathogens 16.3 Other Pathogenesis 16.4 Other Patterns 16.5 Other Remedy Principle 16.6 Other Formulas 16.7 Other solutions relate use herbal formulas 17. Precaution 18. Prevention 18.1 Prevention for do not catch ulceration colitis Early symptoms Early signs Early prevention principle Early prevention remedies 18.2 Prevention for already catch ulceration colitis Early symptoms Early signs Early prevention principle Early prevention remedies Section Four: Pathogenesis Stages of Internal Diseases 1. Generation & Creation The generation of pathogenesis is a phase or form in the pathogen s life cycle of a type of dryness and heat. Past generation life catches and carry pathogen heat can minimize into microcosmic size, and transfer to the next generation by giving birth. Only dry and heat can be minimized, damp heat and cold pathogens cannot. 5

6 So, the generation of pathogenesis is referring to the gene s dry heat, or heredity dryness and heat. When past generation has any kind of severe diseases, these severe diseases will leave pathogens in the body; and body will record and store the pathogen s property and characters and transfer to the next generation. This is a first step of disease for the next generation. The body immune function is above 95% amount. 2. Accumulation and Incubation Accumulation is an act or process of collecting together or becoming collected. Incubation is an act of warming eggs in order to hatch them, as by a bird sitting upon a clutch of eggs in a nest. This procedure has two kinds of activities: one is dryness and heat, or other kind of property pathogens, which continues to accumulate in the genes heat storage area; two is dryness and heat pathogens accumulated in the body outside of the gene heat storage area. The body immune function is above 90% amount. 3. Stagnation Stagnation is a state of inactivity situation. It is a procedure of continue accumulation; it is a procedure of gaining power for pathogens. It is a way to avoid immune qi and yin liquid to clear out of the body; it is a way to disturb and reduce body normal physiology activities and good warm energy, nutrition yin liquid, and to create more abnormal heat. The body immune function is above 85% amount. 4. Dissemination and Variation Dissemination is to spread widely, as in sowing seeds. It is indicating pathogen dryness and heat amount increase to high level; it is indicating pathogen dry and heat starting to move to external area from internal area. Variation is something slightly different from the same type. It is indicating pathogen dry and heat releasing to different systems and areas, and then becoming a different type of heat; such as dry heat goes into the blood and becomes blood heat; dry heat going into body liquid and becomes damp heat; dry heat going into different organs and becomes different organ heat. The body immune function is above 80% amount. 5. Radiation Radiation is emission of pathogen dry heat in the form of rays or waves showing on the body surface; such as dry skin, rash, red or dark spot. This is indicating pathogen dry heat going into shining stage from dark stage; this is indicating pathogen dry heat going into high level of consuming body liquid from low level consuming body liquid stage. The body immune function is above 75% amount. 6. Stimulation Stimulation is to increase the activity of pathogens, and cause excite and invigorate situation and condition; such as over drinking alcohol, sweet, carbon dioxide and energy drinking; over eating too sweet, too salty, too spicy food, too much fruit; over doing too much exercise. All this stimulations will deplete the body s cold energy and yin liquid, and increase up pathogen dry heat amount and property. 6

7 This stimulation usually is coming from outside of the body; this is foreign risk factors. This stimulation will boost pathogen property and power amount and ability. Over stimulation is an indication of excess dry heat turning into massive attack on the body s good energy; this is a last chance to isolate and clear out the dry heat; this is a last chance to prevent excess dry heat changing to basic malignant condition. The body immune function is about 70% amount. 7. Mutation Mutation is a negative change procedure; it is pathogen property changing to malignant condition from benign condition; it is pathogen amount changing to huge amount from small amount; it is pathogen direction changing to ready to open position from close position; it is pathogen situation changing to ready to attack from not ready to attack; it is pathogen condition changing to unsteady from steady; it is pathogen condition changing to detect from not be able to detect; it is pathogen image changing to showing from stealth; it is pathogen image changing to clear and three dimensional shape from cloudy chaos. In this condition and situation, one can only reduce pathogen amount, but cannot change the malignant property back to negative property. The body immune function is above 55% amount. 8. Initiation Initiation is an action of none contagious disease which sets off a chain reaction in pathogen dry heat which has reached to the critical state. The initiation is an action of disease onset or flare up; initiation is a sign of pathogen dry heat completing the procedure of build up a disease or diseases; risk factors of initiation are bone fracture; catch severe cold or wind heat with high fever; lost blood liquid; lost body liquid. The body immune function is below 50% amount. 9. Manifestation Manifestation is an act of demonstrating; it is a clear visible appearance of abnormal indications. Usually it is indicated by symptoms and abnormal signs. The manifestation has two kinds of action: one is acute, and another is chronic. The common acute manifestations are severe pain, high fever, lost consciousness, severe spasm, large amount bleeding, difficulty breath, severe dizzy, palpitation, severe diarrhea, sudden severe lose weight, and severe tiredness. The chronic manifestations are mild pain, spasm, diarrhea, lose weight, tiredness, low degree fever, low amount bleeding. The body immune function is below 50% amount. 10. Promotion Promotion is an action of encouragement, development, and increase up pathogen dry heat property, amount, and attack ability to cause body resistant ability and immune function to drop down. Because all the manifestation will reduced the good energy qi and yin liquid, the pathogen dry heat will naturally be stronger and generate more pathogen dry heat. The attacking ability will increase up quickly to have a second time attacking action. Promotion is a second time attacking action from pathogen dry heat. The body immune function is below 40% amount. 7

8 11. Excitation Excitation is a state of extreme hyper condition, which is resulted from hyper emotionally pathogen dry heat after attacking the body. The symptoms and signs are intense; for example, high degree of pain or chronic pain; but the symptoms and signs still stay the same; this is a third wave of attacking action from pathogen dry heat. The body immune function is below 35% amount. 12. Complication It is a secondary disease; it is a disease or disorder arising as a complex consequence of another disease; it is a negative reaction occurring during the course of an illness, and it usually aggravates the original illness. Such as diabetes lead to having infection, heart disease, or poor blood circulation. The body immune function is below 30% amount. 13. Malignantion (Depravation) Malignantion is a later stage of disease, which is threatening to life; it is indicating disease turning to difficulty condition; it is indicating good energy and good yin liquid have difficulty returning back to their normal level; it is indicating the life in the dying situation; it is indicating any remedies solution would be difficulty to make the condition better, but this does not mean there is not any hope. The body immune function is below 20% amount. 14. Destination Destination is later stage of dying life; it is a moment of lost life; it is severe deficiency of physical and spirit life; the body immune function is below 5% amount. There are two types of destination: one is sudden destination; another is chronic destination. Sudden destination is the sudden loss of life sign, such as loss heartbeat, loss breath, loss blood pressure, loss conscious in a short time; the situation is like heart attack, severe stroke, severe bleeding, or air way obstruction. Chronic destination is the slowly loss of heartbeat, weaker talking ability, weaker breath, lower blood pressure, lower body temperature; body slowly losses good energy and yin liquid, and slowly loss physical and mental function; the situation like cancer, multiple sclerosis, chronic obstructive pulmonary disease, chronic heart failure, chronic kidney failure, liver cirrhosis, or diabetes. 8

9 1. Definition of symptoms Chapter Two: Symptoms Section One: Basic Information The symptom is a client s subjective unhealthy evidence; the symptom is a client s abnormal health feeling and sensation; the symptom is one of negative, abnormal health indication; the symptom is indicated by reflexive abnormal metabolism, abnormal physical function, and abnormal body tissue structure condition and situation. The symptom has subjective, sensation, negative, invisible, client s touch, hearing, smelling and taste sensation; it may not be able to repeat, not be able to measure, and not be easy to keep record its characters; the symptom can be an early stage indication or a later stage indication; the symptoms can be indicating mild condition or severe condition. The symptom includes invisible emotion and spirit (shen) indication, and invisible zang and fu organs activities and conditions. Symptom usually is dependent on the client s talking; information that will indicate the presence or history of abnormality, invisible, activity or inactivity, motion or motionless, malfunction, warm property or cold property, dry property or moisture property, external or internal, negative, tempestuous or everlasting, acute, or chronic condition and situation. 1.2 Common symptoms Nerve meridian system Pain, numbness, burning, shooting, tingling, vibration, distention, hot or cold feeling, dizzy, heavy, brain and ear tinnitus, abnormal taste sensation, depression, anxious, stressed, sleepy Invisible seven emotions and shen (brain) Sad, worry, over thinking, depression, anxious, dreaming, urgency, desire, forgetful Muscle system Tiredness, body weak, ache, numbness, ant climb sensation, heavy, restrained sensation Skin system Hot or cold feeling, itching, burning, swelling, distension and dry sensation. 3. Common seven Zang and Fu organs symptoms 3.1 Heart: Chest pain, chest distention, chest pressure, anxiety, and depression. 3.2 Lung Nose congestion, dry nose, sore throat, dry throat, chest pain, chest distention, chest pressure, difficulty breath, shortness breath, aversion heat and cold. 3.3 Pancreas: Left side costal region pain, thirsty, dry mouth. 3.4 Liver Headache, dizzy, tiredness, right side costal region pain, or burning pain and distention, brain tinnitus, nerve meridian tingling, burning and ant climbing. 9

10 3.5 Kidney yin: Low back pain, weak leg, hot flush. 3.6 Kidney yang: Bone steam sensation, hand and feet feel hot. 3.7 Spleen: Ear tinnitus, dry, burning and itching skin. 3.8 Stomach Heart burn, acid reflux, difficulty swallow food, nausea, poor appetite, craving and upper abdominal pain, reverse qi rising up from lower abdominal to throat, blood vessel bounding under umbilicus area; stomach uncomfortable sensation. 3.9 Small intestine: Middle abdominal bloating and pain Large intestine: Lower abdominal bloating and pain, cramping sensation Gallbladder: Bitter mouth taste, right side costal region pain and distention Bladder: Urination urgency, burning and painful urination, and lower abdominal distention Diaphragm: Shortness breath, tiredness San Jiao: Thirsty, dry mouth and lips, dry skin and nail. 4. Parameters of symptom (Use sweating parameter as an example) 4.1 Sweat definition (http//en.wikipedia.org) [2] Sweat is a thin liquid of body that is excreted and discharged by the sweat gland. The sweat gland is located under the skin surface; the sweat liquid can possibly come from blood liquid and lymph liquid; the main and primary ingredient of sweat liquid is water. The solid material usually is salt. It has thin texture, easy running, and clear characters. Sweat liquid carries waste heat out of body; the waste heat contained smelling material to cause body odor. Sweat liquid carries dry energy materials out of body, usually is carries salt out of body that is why sweat has salty taste. 4.2 Sweating definition Sweating, another word is perspiration. Sweating is a process, which is expelling inside body liquid to the outside of body by going through skin. Sweating can be constant or not constant; but it is never sweating forever; usually it is for a few minute or a few hours. The purpose of sweating is to carry heat from the inside to outside the body, and cool down the body high temperature or high level property heat. Sweating has cooling effect due to evaporation of body liquid to the outside of the body. Sweating can be locally or whole body; usually when the body feels warm and hot, the first area to sweat is head (top, front or back) and face. Sweating is increased by nervousness, and decreased by cold. The male starts sweating may quicker than female due to the male s body water ratio is higher than female. The common way to sweating is slowly becoming liquid drops, the sweat drops can be small, big, or running out without form to drops. Mild sweating with small portion body liquid leaking out is a physiology situation; severe sweating with large amount of body liquid leaking out is a pathogenesis condition 4.3 Sweating timing Morning sweat without known reason is usually energy qi deficiency indication 10

11 Afternoon sweat without known reason is usually excess heat indication Night time sweating is usually yin liquid deficiency with excess dry heat indication Sweating with fever during the spring season is usually catching wind heat indication Sweating during the summer season is usually catching excess damp heat indication Sweating with dry cough, mouth is usually catching wind with dryness indication. 4.4 Sweating smelling Usually sweating does not have smelling odor When sweating without odor usually is deficiency indication When sweating with odor is excess heat indication 4.5 Sweating color Most sweat does not have color or pigment attached with body liquid Sweat liquid colored clothes with yellow pigment - that is damp heat, jaundice indication. Sweat liquid with pink pigment - that may be relate to blood leaking out with the sweat. 4.6 Sweat amount Small portion sweating Small portion sweating is referring to parts of the body sweating; it is indicated by the wet part of one s clothing; it is a healthy and mild unhealthy condition indication Large portion sweating Large portion sweating is referring to whole body sweating; it is indicated by the wetting of both upper and lower clothing; it is an unhealthy condition indication; it is a severe unhealthy condition indication 4.7 Sweat texture Thin texture sweat is a deficiency and excess condition indication Thin, cold, a large amount of sweat with critical condition is good yang qi deficiency with internal dry heat condition Life escape sweat condition Sticky, thicker, and oily texture is a deficiency with critical condition indication 4.8 Sweat sensation Sweat liquid feel warm Warm sweat usually is an excess and heat indication Sweat liquid feel not warm and not cool It is an energy qi deficiency and excess heat indication Sweat liquid feel cold Cold sweat usually is a general yang qi deficiency with excess heat indication Sweat liquid feel thin 11

12 Thin sweat liquid is usually a defense qi deficiency indication, a general yang qi deficiency indication, and an excess heat indication Sweat liquid feel sticky Sticky sweat liquid with oily sensation is usually is a heart yang qi deficiency indication Sticky sweat liquid with bad smelling odor is usually an excess heat indication Sticky sweat liquid with yellow color is usually an excess damp heat indication 4.9 Sweat location Sweat on head-brain, neck, face-stomach and heart; hands-stomach and spleen; underarm-liver, heart, lung; chest-heart and lung; private area-kidney and liver; low backkidney; feet-stomach and spleen; whole body; one side of body Sweating situation Sweating due to eating Eating is a process of body intake of good nutrition; life activity is yang energy running and consuming activity; the life engine is the heart - the heart has to keep the life engine running without stopping or taking breaks; this requires the intake of a lot yang property food materials to break down to the small parts and burning, and also release the warm and dry energy materials to the life engine and keep the life engine running. This process requires intake of a lot yin property food materials to maintain life engine, keeping it cool and moisture at the same time. The eating is a yang process. It will create a lot of heat to force the body liquid out. The eating process is happening in the spirit heart area, which is in the head; that is why the eating sweating location is on the head and face with warm sensation of sweat liquid Sweating due to eat hot and spicy Hot and spicy food have hot property characters; it has pungent function; it will stimulate body stored yang qi area, to let cooling and moisture yin materials lost bonding yang qi and protect yang qi function; so the stored yang qi will naturally come out with the body liquid carrier. This is the reason when eating hot and spicy food, it causes sweating Sweating due to drinking hot temperature liquid The hot temperature liquid contains the temperature yang property materials; it will stimulate and assist the storage yang qi to wake up and to be in the active state in the body; the activity yang qi will push the body liquid toward to the outside of body to cause sweating. The sweating will carry out extra heat to balance the internal body temperature Sweating due to drinking alcohol Alcohol is concentrated sugar; sugar is dry heat materials. When the concentrate dry heat gets into body, the body will lose the yin and yang balance, the sugar dry heat will force cooling and moisture yin liquid out of body; one of body reactions is sweating from the head because the alcohol dry heat will first rise to the brain area to damage brain yin liquid and tissue to cause sweating on the head and face. 12

13 Sweating due to covering by too many layers or dress too warmly. The skin has the venting heat out of the body function; when the body is covered by too much layers, it will obstructed and blocked the body heat venting out process; the waste heat will accumulate in the body, which increased up the heat level and amount; and lead to waste heat to push the body liquid to expel out of the body which causes sweating Sweating due to emotion disturbing Bad news. Excite situation (speech, augment, angry, nervousness, anxiety). Night time walking in the dark. Life threaten condition (such as in the war zone) Sweating due to warm weather or high room temperature Summer season. he temperature is high more than. Different body constitution may be sensitive to different levels of temperature degree One who lives in the warm and hot region permanently may have high level of tolerance for high temperature without sweating One who lives in the cool and cold region permanently may have low level of tolerance for high temperature without sweating Sweating due to lower level blood sugar The low level of blood sugar is an energy qi deficiency condition; the one of main functions for energy qi is to hold good body liquid without escape out. When the blood sugar is in the low level (under 72 mg/dl), and the body will develop palpitation with weak and fast pulse, pale face, hand shaking, faint, sweating with cool liquid symptoms and signs. Another explanation is one of the function of the good yang qi is to keep the internal dry heat to stay inside the body; when the blood sugar is in the low level, the deficiency energy qi cannot keep internal dry heat stay in the deep body, the flare up dry heat will force body liquid to the surface of body, and cause sweating Sweating due to defense yang qi recovery This happens when the body catches a lot of wind cold pathogens, the wind cold is in the dominate position; when the body s defense yang qi gradually recovers and increases up the warm property level; the defense yang qi will start to fight with wind cold to cause trembling and shivering; when the defense yang qi reduced the wind cold pathogen level, the defense yang qi goes back to be in charge; the defense yang qi will start to push the body liquid out of the body to cause the sweating process; this sweating is to carry the wind cold pathogens out of the body, and the sweating purpose is to expel out wind cold Sweating due to menopause Menopause is a good kidney yang qi deficiency condition; when the weak good kidney yang qi cannot keep the internal dry heat to stay in the deep body area; the dry heat will flare up to attack the body liquid to cause sweating; the sweat could be warm or cold sensation; special during night time; night time is when dry heat flares up, even during one s healthy condition. 13

14 Sweating due to deficiency condition Sweating due to defense qi deficiency This situation usually is called spontaneous sweating; the spontaneous sweating is a a natural sweating condition; it is not relate to exercises, laborious work, the hot weather, over dress, or eating spicy, hot food, or medicine. The character of defense qi deficiency sweating is sweating accompanied with feeling tired, shortness of breath; when one has physical activity, it causes more sweating than usual. When the body caught wind cold pathogen, the wind cold will damage defense qi warm property, protect defense yin liquid function, and loses the closing skin pores function. The defense yin liquid-sweat liquid will escaped out of the body to cause sweating; the character of this type of sweating is when one does not like wind blowing at the body Sweating due to general yang qi deficiency The yang qi deficiency type of sweating is one type of spontaneous sweating; the general yang qi deficiency of sweating is when one generally is afraid of the cold wind, and plus one is feeling tired, when one has physical activities and causes more sweating Sweating due to after surgery There is easy sweating condition due to after surgery; the character of sweating is sweating with the feeling of tired, shortness of breath, palpitation with weak pulse. The reason to cause sweating is because of damaged qi, blood, and yang qi due to surgery Sweating due to hungry Sweating due to hunger is sweating with the hungry sensation, pale face, hands shaking, and palpitation with weak pulse. It is a stomach yang qi deficiency indication Sweating due to urination Sweating due to urination is a defense yang qi deficiency indication; when the bladder is focus to force urine liquid out of body, this process requires defense yang qi to push turbid liquid out of bladder. When the defense yang qi is in the normal level, the skin pores will be closing. The defense yang qi is able to focus to push urine liquid out of body. When the defense yang qi is in the deficiency condition, the skin pores will lose the defense yang qi protection, and lose closing function due to the transfer of yang qi back to the base the bladder Sweating due to suffering pain The indication of cold type of pain is muscle spasm; the muscle spasm will generate a lot of heat; the pathogen heat will force body liquid to go out of the skin to cause sweating. The heat type of pain is muscle and blood vessel spasm; it will cause sweating. The pathogen heat can directly force body liquid out of the skin to cause sweating. The pain can cause anxiousness, nervousness, which generates heat and cause sweating Sweating due to too heavy labor or exercises Heavy labor and exercises will generate a lot of heat in the body; excess heat will force body liquid out of the skin to cause sweating Sweating due to excess condition 14

15 Summer heat excess condition During the summer season, high level of heat and humidity will force deep body yang energy qi to rise to the body surface, and cause too much heat accumulation condition; the excess heat will force body liquid to carry heat out of the body and cause sweating. This type of sweating will have warm sensation, a large amount of body liquid sweating out of the skin with frequent, even none stop characters Yang Ming Jing Pattern or Qi Stage of Warm Disease The heat property of pathogens created a lot of heat in the qi level and stomach area; the main indication is sweating with a lot of liquid, high fever, thirstiness and forceful pulse Rheumatic Arthritis The pathogen of Rheumatic Arthritis has excess heat property and characters; the excess heat will force the liquid out of the skin to keep the pathogen heat staying strong condition because usually the liquid carries good cold and moisture energy materials Sweating due to critical condition Lower level of blood sugar. Acute chest pain. Severe vomit. Severe diarrhea. Trauma. Life ending situation Sweat property The warm sweat is a heat condition indication The neutral sweat is an energy qi deficiency indication The cold sweat is a general yang qi deficiency indication The thin sweat with salty taste is a dry heat indication The sticky sweat is dehydration indication The sticky sweat with oily is deep heart yin leak without yang qi protection indication 4.12 Sweat shape Small drop sweat liquid Small drop sweat is a slow speed sweating indication; it is a low level heat indication; it is a slightly energy qi deficiency indication; it is a mild condition indication Big drop sweat liquid Big drop sweat is a medium speed sweating indication; it is a medium or severe level heat indication; it is an obvious energy qi or yang qi deficiency indication; it is a severe condition indication Running sweat liquid Running sweat is a high speed sweating indication; it is a severe level heat indication; it is a general and heart yang qi deficiency indication; it is a very severe condition Accompany symptoms Sweating with fever, pain, hot flush, itching, trembling, impatient, panic attack, nightmare, asthma, difficulty breath, delivery or after delivery baby, seizure, night time emission during the sleep. 15

16 1. Definition of symptom 2. Symptom describes Section Two: Study Items of Symptom Such as: headache indication, pain face expression with uncomfortable activity, anxious, cannot focus, use comb often to stimulate head and combed head. 3. Symptom location: Such as head, zang of fu organ, upper, lower, left, right, front, back 4. Symptom belongs to which system: Digestion system. 5. Symptom pathogens: Wind, cold, damp heat, dampness, dry, excess heat. 6. Symptom pathogenesis Qi amount deficiency condition to cause tiredness, Qi warm property deficiency condition to cause the feeling of coldness, Qi poor quality condition to cause good deficiency sign or other qi deficiency symptoms 7. Symptom related to how many patterns: Qi deficiency with blood stagnation 8. Symptom property Excess or deficiency cold, excess or deficiency heat, dry, excess dampness or liquid /moisture yin deficiency, dehydration or hydration. 9. Symptom condition Excess or deficiency, external or internal, stagnation or diffusion, infectious or inflammation, malignant or benign, acute or chronic, temporary or everlasting. 10. Symptom position: Main symptom or side symptom, early symptoms or later symptom. 11. Symptom situation Simplicity or complicated, hyper or hypo, suddenly flare up or slowly coming out, emergency or none emergency, life threaten or life safe, dying or none dying. 12. Symptom direction Over rising or seeking down, expending to front or back, expending to left or right, leaking out or astringent to internal, opening or closing, transfer in or transfer out. 13. Symptom characters (a distinguishing quality, state) Excess or deficiency, hard or soft, aggressive or none aggressive, stubborn or none stubborn, complicate or none complicate. 14. What kind of diseases includes the cough symptom? 15. What kind of principle to choose for? 16. What kind of remedies will apply? 17. What kind of formulas should be used? 18. What kind of symptom is more common or not common to see in the practice? 19. What kind of symptom is more difficulty or easy to take care of? 20. History information of symptom 16

17 1. Definition of signs Chapter Three: Signs Section One: Basic Information The sign is a client s objective healthy and unhealthy evidence; the sign is a client s health phenomena and manifestation; the sign is one of the positive or negative, normal or abnormal health indications; the sign indicates and reflect normal or abnormal metabolism, physical function, and the body tissue structure condition and situation. The sign has objective, phenomena, positive or negative, visible, touchable, hearing, smelling, be able to repeat, be able to measure and easy to keep record characters; the sign can be an early stage indication or later stage indication; the sign can be indicated by mild condition or severe condition. The sign includes visible emotion and spirit (shen) indication, energy qi or sound indication, body liquid or secretion indication, body solid shape material indication, body activity indication, body inactivity indication, and skin indication. Sign usually is detected by Chinese herbal medicine evaluation checks, or western medicine physical checks; or go through western medicine laboratory different tests or x- rays, image and other high technology reports, that indicates the body present or history of normal or abnormality, visible and invisible, quantity and quality, activity or inactivity, motion or motionless, physical function or malfunction, warm property or cold property, dry property or moisture property, external or internal, positive or negative, peaceful or harmful, temporary or everlasting, acute or chronic condition and situation. 2. Common signs 2.1 Sign of emotion and shen The common sign of abnormal seven emotions and shen system are abnormal laugh, cry, angry, fear, impatient, insomnia, and too much sleep, dementia, delirious speech, selftalking, loses speech ability, and maniac behavior, unconsciousness, coma. 2.2 Sign of energy Qi and sound The common sign of abnormal energy qi or sound are sigh, yawn, sneezing, hoarse voice, lose voice, cough, wheezing, spit phlegm sound; hiccup, burping, belching, choking, gassy, borborygmus, visible bloating, distention. 17

18 2.3 Sign of body liquid The common sign of abnormal body liquid is abnormal sweating, skin secretion, orifices secretion (tear, saliva, foam phlegm, nose discharge, ear pus), bleeding, irregular menstruation, discharge, abnormal nursing, abnormal ejaculation, diarrhea, frequent urination, bed wetting, dehydration, leakage, and edema, incontinence, retention, vomit, constipation, phlegm, blood clots, retention of the lochia. 2.4 Sign of solid shape material The common sign of abnormal body solid shape is vomit, constipation, phlegm, blood clots, retention of the lochia, boil, node, tumor, mass, or malignant mass. 2.5 Sign of body activity The common sign of abnormal body activity is cramping, twitching, shaking, jumping, tremor, spasm, shivering, and seizure. 2.6 Sign of body inactivity The common sign of body abnormal inactivity is tilting, bend, devious, roll up, range motion restrained, constrained, rigidity, atrophy, palsy, paralysis, or fetal position. 2.7 Sign of skin condition The common sign of abnormal skin condition include body surface, shape, texture, complexion and color The common sign of abnormal body surface are bumping, node, mass, fatty tumor, ulceration, blister, acne, or boils The common sign of abnormal body shape are skinny, over size, or swelling The common sign of abnormal skin texture are tightness, softness, looseness, cracking, peeling, or shrinking The common sign of abnormal body surface complexion are bright or dark; shining or dull; red or pale; slightly yellow or jaundice (face, eye, hand, feet) The common sign of abnormal skin color are purple red or dark red, white pale or dull pale; slightly yellow or jaundice; slightly brown or iron brown; slightly gray or real dark Common sign of mild condition Low grade fever, temporary fever, hot flush, day time sweat, slight sweating 18

19 small amount bleeding temporary over sleeping, numbness, tingling, tremor, depression, temporary faint, temporary cough with phlegm, temporary spit phlegm, or temporary wheezing. temporary edema, leg edema a few times vomit, a few times diarrhea, or temporary lose weight Sprain, benign tumor, cyst, small joints deformation, small size and amount of vein float up Common sign of severe condition High grade fever, constantly fever, night time sweat, or large amount sweat large amount bleeding constantly over sleeping, paralysis, shaking, spasm, seizure, maniac, or unconsciousness cough with blood, constantly spit phlegm, or constantly wheezing chronic edema, or abdominal edema multiple times of vomiting, multiple times diarrhea, constantly loses weight fracture, malignant mass, fibrosis tumor, large joints deformation, large size and amount of vein float up Common peaceful signs Sclera bleeding, external ear redness, runny nose, canker core, acne, freckles, skin with red dot Common harmful signs Internal eye bleeding, internal ear pus secretion, nose bleeding, mouth lichen, internal tissue abscess, skin boil, dark mole (melanoma), skin bruise, and abscess 3. Common seven Zang organs and Fu organs signs 3.1 Common activity sign of zang organs The common action signs of heart are palpitation, heart beat pounding, maniac, abnormal speaking and laugh The common action signs of lung are sneezing, running nose, nose congestion, cough, wheezing, weak and shortness breath, or abnormal cry The common action signs of liver are seizure, spasm, twitching, shaking, paralysis, restrained ranger motion, or abnormal angry The common action signs of kidney yang are abnormal fear or weak voice 3.2 Common activity symptoms of fu organs 19

20 3.2.1 The common action signs of stomach are loose teeth, vomit, burping The common action signs of diaphragm are hiccup, paralysis, or weakness The common action signs of large intestine are diarrhea, bloody stool, or constipation The common action signs of bladder are frequent urination, wet bedding, urine dripping, bleeding urine, and retention of urine. 4. Parameters of signs (Use bowel movement as an example) 4.1 Feces definition Feces is a solid shape waste material of animal and human life; feces is food, water liquid and air go through the stomach, small intestine and large intestine become solid shape waste material; feces is containing waste material, property, gas, liquid mineral, fiber and microorganism, special abnormal heat and dryness; feces has various shape, amount, texture property, color, smell, turbid degree, containment, accompany symptoms, ratio of liquid, solid, and gas characters. In normal condition and circumstances, the purpose of feces is to carry waste heat and dryness out of body on time, keep body warm and cool energy in healthy balance condition, and keep body dry and moisture energy in healthy balance condition, which is refer to as keeping body s purity with turbidity ratio in healthy balance situation; feces is a solution to keep purify body liquid amount greater more than turbid body liquid amount. In abnormal condition and circumstances, the purpose of feces is to carry good yang warm energy qi and yin cold energy qi out of the body, and urine is to carry good yang dry energy material and yin moisture energy liquid out of body. And it keeps body stay in the pathogen heat and cold in charge condition and situation; keep body stay pathogen dryness and turbid dampness in charge condition and situation; until life lost living material supply and functional ability. 4.2 Bowel movement definition The bowel movement is a process of body cleansing waste heat, waste abnormal dryness material. The bowel movement is start at food, water liquid and air goes through stomach, small intestine and large intestine digestion procedurals, then become to feces, the feces is stored in the large intestine and discharge and elimination through the rectum and anus to outside of body. The bowel movement has when, how many times, alternation, sound, shape, and sensation characters. 4.3 Timing It is related when have bowel movement, how many times bowel movement in a day, how long the alternation of bowel movement is; this is describing when the body has bowel movement. When will have bowel movement? 20

21 Best time have bowel movement is day time and morning between 7:00 to 8:00 am. How many times of bowel movement in a day? A best time is one to two times a day with soft and form shape. (Page-270) [3] How long the alternation of bowel movement is? The best alternation of bowel movement is each 24 hours. 4.4 Shape Shape is a character of material or thing, which describes the outline or contour, surface, and size of a material of thing. 4.5 Sound Sound is vibrations transmitted through an elastic solid or a liquid or gas, with frequencies in the approximate range of 20 to 20,000 hertz, capable of being listened to by human ears. This is describing the power of the amount of matter moving down. Bowel movement sound is describing the power the body pushing the fecal matter down; it is related to how loud, and how much time it takes to finish the bowel movement action. Also, it has three kinds of sounds during the bowel movement; the throat and mouth will make sound, the low abdominal area will make sound, when the feces drop down into the toilet bowl, it will be make sound. 4.6 Sensation Sensation is a physical condition or experience resulting from the stimulation of one of the sense organs or body tissue. Bowel movement sensation is referred to as the urge to have bowel movement situation. The feeling of the fecal matter passing through large intestine, rectum, anus, and other body area feeling. This is describing the body s feeling during the bowel movement. 4.7 Amount First, the amount of feces is referring to the daily total quantity of feces material expelled out of the body from the large intestine; second, amount is referring to the quantity of each time feces expelled out of the body from the large intestine. This is describing the weight of bowel movement. Healthy adult feces amount is grams/day (Page-270) [3] 21

22 4.8 Texture property Texture property is referred to a property perceived by touch or by looking; usually words to describe texture are thick, thin, sticky, soupy, mucus, soft, hard, banana or around shape, acid and alkaline. This is describing the tactile feeling of feces. Healthy adult s feces texture should be soft with banana shape characters. 4.9 Color Color is the appearance of the material in the objects, which involves the hue and brightness. The urine color is referring to three characteristics: the urine liquid which contains pigment material (dye, what kind color), luminosity of hue (brightness), and consistency (saturation) of hue. This is describing the pigment condition of the feces. The healthy adult s feces color is yellow brown color. he healthy adult s feces luminosity of hue condition is dull. he healthy adult s feces consistency of hue is slightly condensed Smell Smelling perceives the scent or odor of a substance by the nose and nerve meridians. The normal urine smelling has little smells or slightly foul odor. Stronger foul odor indicated more abnormal heat. This is describing the volatilization condition of the feces Turbid degree Turbid describes a chaos kind of condition of the liquid state, which has suspension of particles that got stirred up. It has muddy, heavy, dark, dense, thick, smoke and cloudy characters. This is used for describing abnormal bowel movement condition Containment Containment means to hold or be capable of holding. Feces contained abnormal waste material such as pigment, blood, mucus, pus, parasite, sand, even small stone Ratio of liquid, solid and gas. Ratio refers to a measure of the relative size and amount of two classes expressible as a proportion. The feces material is mainly solid material, but it contains some liquid and gas in the feces; it will have ratio relative relationship of these three state materials. This is describing the percentage of feces material. 22