Flashcards in Week 4 - Lyndsay Deck (111):
What are the 2 categories of herbs that Release the Exterior?
Warm Acrid - treat Wind Cold
Cool Acrid - treat Wind Heat
What are the general characteristics of herbs that Release the Exterior?
- tend to be pungent/spicy and acrid
- their functional qualities tend to be light and ascending
- often cooked for short periods of time
- many cause diaphoresis (sweating)
What are the most common EPF (external pathogenic factors) treated with herbs that Release the Exterior?
Wind Cold attack
Wind Heat Attack
Wind Damp Attack
What are the 2 different types of Tai Yang Channel Syndromes and their alternate names?
Tai Yang Syndromes (UB & SI channels):
- Tai Yang Excess
- Wind Cold Excess
- Tai Yang Deficiency
- Wind Cold Deficiency
- Wind Strike
[for now, be familiar with these terms]
What channel syndromes can be treated with herbs that Release the Exterior?
Tai Yang Syndrome (UB & SI channels)
What is the most superficial of the Six Channels?
Tai Yang Channel:
- UB (Foot Tai Yang)
- SI (Arm Tai Yang)
What is the most superficial Zang organ?
- relation to Wei Qi
- disperses fluids to the surface
What are the 10 s/s (signs & symptoms) and characteristics of a Wind Cold Excess Pattern as given in the class slides?
- aversion to cold; put on extra clothes and don't feel better
- fever (fighting the pathogen causes heat) & chills (chills predominant)
- floating tight pulse
- tongue: normal body; thin white coat
- no sweat (bc pores are on lockdown)
- contraction of Qi and Blood not circulating well
- general ache & body pain
- clear or white secretions
- no thirst
When a pattern is Wind Cold Excess... What does the word EXCESS refer to? And will this manifest in more or less obvious symptoms?
- Excess refers to the patient, not the pathogen. It states that the patient is Excess in relation to being Deficient.
- This will manifest in a greater more obvious amount of symptoms. Strong Patient (excess) + Strong Pathogen (wind) = Big Fight (more symptoms)
In a Wind Cold Excess pattern, will a patient have an aversion or affinity to either hot or cold?
an aversion to cold
In a Wind Cold Excess pattern, will a patient have alternating chills & fever, or chills & fever simultaneously?
(simultaneous chills & fever indicates Tai Yang syndrome; whereas alternating chills & fever indicates Shao Yang syndrome)
In a Wind Cold Excess pattern, what pulse will you detect?
Floating & Tight
- Wind pathogen is always a floating pulse
- Tight because the body is locked down and not moving; trying to keep the wind pathogen in the external aspect of the body
In a Wind Cold Excess pattern, what tongue body and coat will a patient have?
Normal body & thin white coat
Because tongue doesn't not change as quickly as pulse
In a Wind Cold Excess pattern, will a patient sweat?
because the pores will be locked down tight to keep the pathogen in the external aspect of the body.
(No sweat is how you distinguish Wind Cold Excess from Wind Cold Deficiency)
In a Wind Cold Excess pattern, what signs of pain will a patient have?
- general ache & body pains
- contraction of Qi & Blood not circulating well because of lockdown --> causing pain
In a Wind Cold Excess pattern, will a patient have thirst?
In a Wind Cold Excess pattern, what color secretions will a patient have?
clear or white secretions
What herb functions should the herbs used to treat Wind Cold Excess have and why?
- use strong herbs to open the pores and let the evils out (bc patient is strong/excess, OK to use strong herbs)
- induce sweating to let the pathogenic influence out of the body
For treating Wind Cold Excess pattern, what treatment principle or category should the herbs have or belong to?
Treatment Principle: Release the Exterior
What are the 11 s/s (signs and symptoms) and characteristics of a Wind Cold Deficiency Pattern as given in the class slides?
Because patient is Deficient, the patient's Wei Qi is not as strong as in Excess pattern so the s/s appear less severe:
- aversion to wind
- chills & fever - chills predominant; fever less strong than in Excess pattern
- pain and aches (but less severe than Excess pattern)
- pathogen may go deeper into the muscle layer
- floating & moderate (weak) pulse
- tongue: body normal, thin white coat
- clear or white secretions
- sweating (pores open with loss of fluid & mild sweat)
- disharmony of yin and yang (ying and wei), leading to fluid loss
- edema (bc not enough yang to transform fluids)
- Yang Shui or Yang Edema
In a Wind Cold Deficiency Pattern, are you likely to see an aversion to wind that is more or less than in a Wind Cold Excess pattern?
A stronger aversion to wind
In a Wind Cold Deficiency Pattern, are you likely to see fever and chills, and how do they compare to a Wind Cold Excess pattern?
Yes, but the fever will be less as the body can't fight as strongly. Chills will be predominant.
In a Wind Cold Deficiency Pattern, where does the pathogen reside, in the exterior or in the muscle layer?
in the muscle layer
In a Wind Cold Deficiency Pattern, what pulse will you see?
Floating & Moderate
- floating pulse because it is Wind
- moderate as a bad translation from the Chinese. More accurately it is LESS TIGHT than in a Wind Cold Excess pattern.
In a Wind Cold Deficiency Pattern, will you see aches and pains?
yes, but not so severe
In a Wind Cold Deficiency Pattern, what is the tongue body and coat?
thin, white coat
In a Wind Cold Deficiency Pattern, what color secretions will you see?
clear or white
What herb functions should the herbs used to treat Wind Cold deficiency have and why?
- herbs that are not as strong because the patient is weaker and you don't want to disperse and sweat too much
- herbs that stabilize the exterior to dispel the pathogen
- herbs that Harmonize Ying and Wei (to fix the functional problem that allowed this to be a deficiency instead of an excess to begin with)
Does Edema develop in a Wind Cold Deficiency Pattern or a Wind Cold Excess Pattern? What kind of Edema?
Edema can form in a Wind Cold Deficiency pattern.
Lung Qi dysfunction (from wind attack) can lead to Yang Shui or Yang Edema.
What is a Yang Shui?
Yang Edema (or Yang Shui) is facial edema, swelling in the upper eye area.
If unresolved it will travel down the body.
It manifests from Lung Qi Dysfunction.
What other (besides Wind Cold Deficiency and Excess patterns) conditions are Release the Exterior herbs appropriate for?
> Cough and Asthma
- occurring when Lung Qi cannot disperse
- if cough and/or asthma is due to wind/cold attack
> Bi Syndromes
- joint syndromes, Rheumatism, Arthritis
- either wind, cold, or damp will be predominant:
if Wind - pain travels
if Cold - fixed pain, very painful
if Damp - swollen, heavy body
> Skin Conditions (more common with Wind Heat Conditions)
- to promote eruptions not yet suppurated or expressed (with measles) and let toxins out ASAP
- Carbuncles in initial stage
What is the Pin Yin spelling of Ephedrae Herba?
What is the Latin name for Ma Huang?
What category does Ma Huang belong to?
Warm Acrid Release the Exterior
What channel(s) do(es) Ma Haung enter?
UB is Tai Yang - Ma Haung is used in treating Tai Yang Syndromes
What are Ma Huang's properties? (taste and temperature)
- Slightly Bitter
(Note that the Lung functions to disperse & descend. Acrid & bitter flavors tend to disperse & descend. Therefore Ma Huang restores lung function.)
What are Ma Huang's 3 key shorthand characteristics?
- induces sweating (disperses)
- calms wheezing
- promotes urination (descends)
What are Ma Huang's contraindications?
- spontaneous sweating from exterior deficiency
- night sweating from yin deficiency
- kidney deficiency asthma
- cannot use long term
- cannot use with hypertension
What is the 1st function of Ma Huang & accompanying indications?
- Induces sweating and releases the exterior (for patterns of wind-cold exterior excess - aka tai yang cold damage).
For chills, fever, headache, absence of sweating, tight & floating pulse (opens pores & interstices to release the exterior).
What is the 2nd function of Ma Huang & accompanying indications?
- Disseminates and facilitates the Lung Qi, calms wheezing, and stops coughing (for cough & wheezing due to wind-cold obstructing the lungs).
Encourages the Lung Qi to flow more easily and directs it downward.
What is the 3rd function of Ma Huang & accompanying indications?
- Promotes urination and reduces edema (by opening lung at the top).
Especially for edema that accompanies an exterior condition (in case of Yang Shui, open the Lung Qi and water can flow down).
What is the 4th function of Ma Huang & accompanying indications?
- Warms and disperses cold pathogens.
Useful for wind-damp painful obstruction and deep rooted toxic sores that have not expressed out yet (do NOT use Ma Huang after wind cold has expressed itself).
What are the two common preparations of Ma Huang?
1. Sheng Ma Huang (raw)
- induces sweating
2. Zhi Ma Huang (prepared with honey)
- stops cough & asthma due to wind cold invasion
- cannot be used for deficiency asthma!
What are the 4 functions of Ma Huang? (summarize)
1. Induces sweating & releases the exterior
2. Disseminates & facilitates the Lung Qi, calms wheezing, and stops coughing
3. Promotes urination & reduces edema
4. Warms & disperses cold pathogens
What is the pin yin name for Cinnamomi Ramulus and how do you spell it?
What category does Gui Zhi belong to?
Warm Acrid Release the Exterior
(Gui Zhi mostly used for wind cold deficiency, as well as emotional pbx)
What is the Latin name for Gui Zhi?
What channel(s) do(es) Gui Zhi enter?
What are Gui Zhi's properties? (taste and temperature)
What are the 3 key shorthand characteristics of Gui Zhi?
- Light & Warm - releases the muscle layer
- Unblocks Yang Qi
- Warms the middle
What are Gui Zhi's contraindications?
- In cases of warm-heat pathogen disease
- Yin deficiency with heat
- Heat in the blood with vomiting
- Small dose for pregnancy or excessive menstruation
What is the 1st function of Gui Zhi?
- Releases the exterior and assists the Yang
Note: In Ma Huang Tang formula, Ma Huang is the lead herb and Gui Zhi is used as an assistant herb to treat wind-cold excess. Otherwise, if Gui Zhi is lead herb, used to treat wind-cold deficiency.
What is the 2nd function of Gui Zhi & accompanying indications?
- Warms and unblocks the channels & collaterals (zhi = twig, and like treats like).
For wind-cold-damp painful obstruction (e.g. arthritis).
For pain due to blood stasis or cold (i.e. chest yang - cold attack w stagnation; rheumatism, amenorrhea).
What is the 3rd function of Gui Zhi & accompanying indications?
- Warms the Yang and transforms thin mucus.
For lack of transformation of fluids due to Yang Deficiency with such symptoms as edema w/urinary dysfunction or dizziness & palpitations.
What is the 4th function of Gui Zhi & accompanying indications?
- Assists the Heart Yang & unblocks the Yang Qi of the chest.
For listless chest yang together with upward movement of phlegm & thin mucus & loss of the orderly descent of the Lung Qi with SOB, chest pain, or palpitations.
What is the 5th function of Gui Zhi & accompanying indications?
- Warms the channels, vessels & collaterals.
Removes painful obstruction & warms the blood vessels to remove stagnation & regulate the menses.
What is the 6th function of Gui Zhi & accompanying indications?
- Warms the middle & directs turbid yin downward.
For cold from deficiency of the middle burner (Gui Zhi has more of an affinity for the HT, but does have some affect on middle jiao).
What are the 6 functions of Gui Zhi? (summarize)
1. Releases the exterior & assists the yang
2. Warms & unblocks the channels & collaterals
3. Warms the yang & transforms thin mucus
4. Assists the Heart yang & unblocks the yang qi of the chest
5. Warms the channels, vessels & collaterals
6. Warms the middle & directs turbid yin downward
What are the constituents in Ma Huang Tang?
Xing Ren (apricot seed)
Zhi Gan Cao
What is the chief constituent in Ma Haung Tang?
What is the deputy constituent in Ma Huang Tang?
What is the major action and pattern treated by Ma Huang Tang?
- Action: Releases the Exterior and Arrests Wheezing
- Pattern: Exterior Excess, Wind Cold
What are the indications of Ma Huang Tang?
- fever & chills (chills predominant) without sweating
- general body aches
- cough & wheeze
- floating tight pulse
What are the constituents in Gui Zhi Tang?
Sheng Jiang (ginger)
Da Zao (red date)
Zhi Gan Cao (licorice)
What is the Chief constituent in Gui Zhi Tang?
What is the major action and pattern treated by Gui Zhi Tang?
- Actions: Releases pathogenic influences from the muscle layer and regulates the Ying & the Wei Qi
- Pattern: Exterior Deficiency, Wind Cold
What are the indications for Gui Zhi Tang?
- fever & chills unrelieved by sweating
- aversion to wind
- stiff neck
- nasal congetions
- dry heaves
- no particular thirst
- thin, white, and moist tongue coat
- floating pulse that is moderate or frail
What are the general characteristics of a Wind Heat Pattern? (not Sx)
- they go to the wei level (the most superficial of the 4 levels)
- a disease caused by heat entering through the mouth & nose (whereas Tai Yang syndromes enter through pores)
How do we treat Exterior Wind Heat Patterns and why?
using cool acrid herbs because they induce sweating, but not as profusely as warm acrid herbs
What are the Signs and Symptoms (Sx) of a Wind Heat Pattern?
- fever & mild chills (with fever predominant) (mild compared to Wind Cold chills)
- more sweat (therefore less need to induce sweating)
- swollen red painful throat (sore throat assoc. with wind heat)
- thirst & dry throat & cough
- headache & body aches
- yellow secretions
- red eye (pink eye, conjunctivitis)
- measles / rashes
What is the tongue and pulse associated with Wind Heat Pattern?
- pulse: floating & rapid pulse
- tongue: may still have normal body, possible red tip or beginning to turn more red
- tongue coat coat: thin yellow
What channels do Cool Acrid Herbs enter?
LU & LV channels
- Lung - superficial; controls the skin & pores
- Liver - heat symptoms; stagnation of Liver Qi; emotional symptoms; need to disperse & cool for free flow of Qi (Heat aggravates Liver, which leads to Liver Qi stagnation)
How do you spell the pin yin for Menthae Haplocalycis Herba?
What is the Latin name for Bo He?
Menthae Haplocalycis Herba
What category does Bo He belong to?
Cool Acrid Release the Exterior
What channels does Bo He enter?
What are the properties of Bo He? (taste & temperature)
What are the general key characteristics of Bo He?
- facilitates the dispersal of upper burner wind-heat
- cools and clears the eyes and head
- soothes the throat
- facilitates the flow of liver qi
- expels turbid filth (from unclean food or water)
What are the contraindications of Bo He?
- can deplete qi (if disperse too much)
- do not use in debilitated patients with profuse sweating
- do not use in patients with ascendant liver yang (bc heat's already rising & what they need is sedation)
What is the 1st function of Bo He & accompanying indications?
- Disperses wind-heat; clears and benefits the head, eyes & throat.
For patterns of wind-heat with fever, cough, headache, red eyes and sore throat.
What is the 2nd function of Bo He & accompanying indications?
- Vents Rashes.
Used in early stages of rashes to INDUCE THE RASH TO COME TO THE SURFACE (as a means of venting the wind and heat, and therefore speeding recovery).
Sometimes used for eczema.
What is the 3rd function of Bo He & accompanying indications?
- Allows constrained Liver Qi to flow freely.
For constrained Liver Qi with the following SX: pressure in the chest or flanks, emotional instability, or gynecological problems.
What is the 4th function of Bo He & accompanying indications?
- Expels turbid filth.
For pbx such as summertime exposure to unclean qi leading to summerheat gastric disturbance w/ abdominal pain, vomiting, diarrhea, and thick greasy yellow tongue coating.
What is turbid filth?
unclean food and water
What is the special concern in preparation of Bo He?
- do not cook too long (bc aromatic)
- decoct at the end for 5 - 10 minutes
How do you spell the pin yin for Bupleuri Radix?
What is the Latin name for Chai Hu?
What category of herbs does Chai Hu belong to?
Cool Acrid Release the Exterior
What channels does Chai Hu enter?
Shao Yang (GB & SJ)
Jue Yin (LV & PC)
Wood (GB & LV)
What are the properties of Chai Hu? (taste & temperature)
What are the general key characteristics of Chai Hu?
- treats alternating chills & fever (indicative of Shao Yang disorders)
- releases heat in the muscle layer
- harmonizes lesser yang stage disorder
- raises the clear qi of the ST & GB
- relieves Liver Qi constraint
What are the contraindications of Chai Hu?
Because it is a rising & dispersing herb, do not use:
- when true yin has been severely damaged
- with hyperactivity of LV Yang
What pharmaceutical is contraindicated to use with Chai Hu?
What is the 1st function for Chai Hu & accompanying indications?
- Resolves lesser yang disorders and reduces fever.
For heat signs: Alternating chills & fevers accompanied by a bitter taste, flank pain, irritability, vomiting, and a stifling sensation in the chest associated with the lesser yang stage of externally contracted diseases. Also used as an auxiliary herb for heat from deficiency.
What are the 2 channels of the Shao Yang Channel?
SJ & GB channels
SJ: controls waterway & heat
GB: pathogenic wind cold goes to GB (usu. enters body at GB 20 at the occiput) and creates stasis
What are some typical Sx of Shao Yang disorders?
- Shao Yang disorder: alternating fever & chills, dry throat, bitter or sour taste in mouth, dizziness, irritability, sensation of fullness in the chest and hypochondria (difficulty taking a deep breath), heartburn, nausea & vomiting, reduced appetite
- Shao Yang is 1/2 external & 1/2 internal (where pathogen starts to go deeper)
What is the 2nd function of Chai Hu & accompanying indications? (this is the one that is indicated for Shao Yang Disorder)
- Spreads Liver Qi and relieves constraint.
For issues with Liver Qi:
- Constrained Liver Qi with dizziness, vertigo, chest & flank pain, emotional instability or menstrual problems.
- Disharmony between the LV & SP with such symptoms as epigastric and flank pain, stifling sensation in the chest, abdominal bloating, nausea & indigestion.
What is the 3rd function of Chai Hu & accompanying indications?
- Raises Yang Qi (bc Chai Hu can "lift up")
When SP Qi is deficient and there is a collapse of SP Qi.
For prolapse of organs: uterus, rectum, hemorrhoids (SP Qi controls movement of blood).
What is meant by "alternating chills and fever"?
Chills from what?
Fever from what?
Fever from Yang Ming & Chills from Tai Yang.
(L. Flowers says: This puts alternating chills & fever, which is characteristic of Shao Yang, in the middle between Yang Ming & Tai Yang.)
(Wiseman says: Alternating fever & chills are explained by the struggle between right & evil qi. And Shao Yang disease is commonly termed a "midstage pattern" -- it can resolve outwardly through "drizzling sweat;" or it can pass to the Yang Ming to form an interior pattern; or it may pass to the yin channels, giving rise to vacuity patterns)
In an Exterior Wind Heat Pattern will you see fever & chills, fever & mild chills, fever w/ no chills, or alternating fever & chills?
fever & mild chills
In a Wind Heat Pattern will you see more sweat, less sweat or no sweat? (in comparison with Wind Cold patterns)
What kind of throat symptoms will you see in a Wind Heat Pattern?
swollen red painful throat
(according to L. Flowers - a sore throat w/EPF is always heat)
In a Wind Heat Pattern does the patient experience thirst?
In a Wind Heat Pattern, the patient experiences thirst along with what kind of throat? And is it accompanied by a cough?
A dry throat & cough
In a Wind Heat Pattern what sorts of achy pains can the patient experience?
What color are secretions in a Wind Heat Pattern?
In what way can the eyes be affected in a Wind Heat Pattern?
Red eye, pink eye, conjunctivitis
(eyes relate to the LV; heat signs rise upward)
Can you see symptoms of Wind Heat Pattern manifesting on the skin?
Yes, as measles or rashes
What kind of pulse will you see in a Wind Heat Pattern?
floating & rapid pulse
What kind of tongue will you see in a Wind Heat Pattern?
- Tongue: normal body, possible red tip or beginning to turn more red
- Coat: thin yellow