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Internal Medicine II from Alexis > Exam #3- other questions > Flashcards

Flashcards in Exam #3- other questions Deck (28):

Definition of Tian Gui:

"Tenth Layer of Heaven," for women it refers to the material substances to induce body growth, sexual maturity, menstrual blood, and fertility. It originates from the pre-natal essences, stored in the KDs, nourished by the post-heave essences.


Definition of Bao Gong:

directly translated as "uterus," but has a broad definition in TCM, encompassing structures beyond the uterus, including ovaries, fallopian tubes. it is the female reproductive organs
-Extra organ = shape of a yang organ (hollow) – menstruation and labor are expressions of discharge function but functions as a yin organ (storage) – stores blood and nourishes fetus


Ren Mai and Bao Gong:

"sea of yin channels" closely connected to the yin, essence, blood and fluids. supports the Bao Gong and impacts female's physiological processed, including puberty, conception, pregnancy, childbirth, and menopause. Bao Gong receives yin, essence, fluids, qi and blood from the LV, KD, SP and ST through connections of Ren Mai


Chong Mai and Bao Gong:

most important extraordinary vessel for women's physiology. women's physiology is rooted in the blood, Chong= "SEA OF BLOOD," "SEA OF 12 CHANNELS"
-has deep influence on menstruation, the supply and proper movement if blood in the Uterus, controlling all aspects of menstruation and reproduction


KDs and Bao Gong

-Uterus related to KD via Bao Luo (Uterus channel). Uterus relies on support from qi, yang qi, yin, essence of KD
-KD are root of original qi. Bao Gong’s reproductive function dominated by KD qi. KD influence on reproductive system thru Chong, Ren, Du Mai, thus they deeply influence Bao Gong.
-KD are root of pre-natal essence. KD store essence which is origin for formation of Tian Gui (basic material menstrual blood). KD essence important for puberty, fertility, conception, pregnancy, menopause.
-KD yang, fire of Gate of Life, warms Bao Gong and balances yin influences. KD fire makes conception possible and influences sexual desire.
-KD yin nourishes Bao Gong and as the source of menstrual blood. It balances yang influences.


LV and Bao Gong

-Bao Gong connects LR thru LR channel connecting with Chong Mai at SP6, Ren Mai at CV2, Du Mai at GV20.
-LR stores blood, regulates blood volume in body including regulating and supplying blood to Bao Gong. LR blood has a prime significance in menstruation, conception, breast feeding.
-LR qi flow affects women’s physiology due to qi-blood relationship. LR qi has important function of moving blood via qi.


Amenorrhea- LV and KD Xu

-Hereditary weakness of KD essence, overwork, too many childbirths, chronic illness
-KD essence origin of menstrual blood, LV stores the blood, this xu leads to undernourishment of Uterus, Chong, and Ren, causing sea of blood to be empty and menstrual periods to stop.


Amenorrhea- Qi and Blood Xu

-improper diet, constitutional SP xu, loss of blood, chronic diseases, overwork, repeated miscarriages, breast-feeding for too long, excessive worry/pensiveness
-deficient qi and blood fail to fill and nourish the Uterus, Chong, and Ren Mai. Sea of blood become empty, menstrual period stops.


Amenorrhea- Yin xu and dried-up blood

-constitutional yin xu, loss of blood, long, chronic diseases, overwork
-yin xu w/ dried-up blood will fail to nourish Chong and Ren Mai, and lead to the sea of blood being empty.


Amenorrhea- Qi stagnation and blood stasis

-emotional stress, anger, irritation, frustration, resentment, worry, or anxiety. Long term qi stag -> blood stasis.
-qi and xue stag may obstruct the qi and blood flow in Ren and Chong.


Amenorrhea- Cold in the blood w/ blood stasis

-exposures to cold, or excessive indulgence in cold food during menstruation or after childbirth.
-Cold enters Chong and Ren obstructs Qi and xue flow in Uterus, Chong, and Ren.


Amenorrhea- Damp-phlegm obstructing the Uterus

-excessive consumption of cold, raw, and dairy, or greasy food, SP xu, excessive constitutional damp-phlegm, over weight.
-Damp-phlegm obstructs Uterus, Chong, Ren, and impairs qi and xue flow.


Flooding & Trickling: General Tx Principles

1. Stop bleeding to arrest blood loss:
-Tx Flooding: stabilize & raise; avoid acrid-warm herbs to move blood
-Tx Trickling: nourish blood & regulate qi; avoid over binding herbs (leads to stasis)
2. Treat the root
3. Restore the health


Infertility: Tx Strategies

1. Regulate menses to treat early, late, irregular, heavy, or scanty periods
2. W. medical dx may give us clues to set up tx plans.
3. Tx can be based on four phases of menstrual cycle
4. Tx based on patterns


Infertility: 4 phases of menstrual cycle

Period phase: regulate menses
Post-menstrual phase: nourish blood, tonify KD
Mid-cycle phase: tonify KD, consolidate Chong-Ren Mai
Pre-menstrual phase: tonify yang, move LR qi


Threatened Miscarriage: Tx Principles

-calm the fetus, secure the Chong and Ren (use proper ingred.)
-Treat the underlying causes according to patterns: Tonify KD, Tonify and raise the qi, Clear heat and cool the blood, Stop bleeding


calm the fetus ingredients

-Du zhong, xu duan, tu si zi, sang ji sheng
-E jiao
-Ai Ye
-Bazi zhu, huang qi, sha ren
-Huang qin
-zi su ye


Habitual miscarriage: Tx Principles

1. Addressing underlying conditions that lead to miscarriage: Tonify KD, Nourish blood, tonify and raise SP qi, Regulate and consolidate Chong and Ren
2. Continuously treat once pregnant, and treat beyond the time that the previous miscarriage occurred.
3. Suggest: Don't attempt to get pregnant for at least 6 months, or even one year after the last miscarriage.


Ingredients in GE XIA ZHU YU TANG

(12) Wu ling zhi, wu yao, dang gui, chi shao, mu dan pi, Chuan Xiong, Tao Ren, Hong Hua, Xiang Fu, Zhi Ke, Yan Hu Suo, Gan Cao- 6g for all


Ingredients for Wen Jing Tang

(10) Wu Zhu Yu, Gui Zhi (warming), Dang Gui, Bai Shao, Mu Dan Pi, Mai Men Dong, E Jiao (tonify Yin and Blood) Chuan Xiong, Ren Shen, Gan Cao- 6g for all


Ingredients for TIAO GAN TANG

(7): Dang Gui, Bai Shao, E Jiao, Ba Ji Tian, Shan Zhu Yu, Shan Yao (12g), Gan Cao(6g)- 9g for all others


Ingredients for QING RE TIAO XUE TANG

(11): Huang Lian, Mu Dan Pi, Sheng Di Huang, Dang Gui, Bai Shao, Chuan Xiong, Tao Ren, Hong Hua, Xiang Fu, E Zhu, Yan Hu Suo +Hong Teng, Bai Jiang Cao, Yi Yi Ren

-similar ingr. to GE XIA ZHU YU TANG



(9): Huang Qi (15), Yi Tang (15), Gui Zhi (10), Bai Shao (15), Sheng Jiang (10), Da Zao (5), ZGC (3 musketeers!) + Dang Gui, Dang Shen(6g for last 3 ingr.)


Menstrual Irregularities: SP Qi Xu

pale, watery, diluted, if late can be scanty (SP cannot transform enough blood), heavy if SP qi not holding, w/out clots, volume is heavy if period is early GYN: internal organ prolapse, esp. uterine prolapse, leukorrhea, excessive vaginal discharge, during period have pulling down sensation PMS: loose stool, water retention, craving sweets, fatigue, gain weight


Menstrual Irregularities: LV Qi Stag

difficult to start (spotting too long), hesitant (not smooth, "start/stop"), scanty or varies, may have small clots, dark or fresh red (often w/ some heat) color, during period: bloating, and distention, fullness, feeling swollen and tight and pain, PMS- breast tenderness, irritability, emotional sensitive, depression


Menstrual Irregularities: Blood Xu

watery, volume scanty, pale, dilute thin menstrual period, dry lips/skin/mouth, skin dull not bright GYN: more fatigue, dizziness, lightheadedness, anxiety, low spirit, sleep issues prior to period


Menstrual Irregularities: Blood Heat- Excess

Excess- bright, fresh or dark red, smelly, heavy bleeding, thick blood, constipation, hunger, feeling hot or warm, if heavy and thick may have some clots, PMS- anxiety, anger, irritability, restless, sleep issue feels hot, constipated


Menstrual Irregularities: Blood Heat-Deficiency

Deficiency- what is the age? how long have they have this issue? not much clots, variable consistency could be light or thick, red, fresh/bright, often scanty (yin xu), may be heavy (heat is temporarily stronger) PMS: insomnia, night sweats, irritability, hot at night, may have 5 palm heat, constipation, lightheadedness, dizziness, low back weakness and pain