Wen Bing 2

Wen Bing Treatment Principles Etiology Pathology Pathogen vs. Vital qi

Treatment methods 1. Release Wei syndrome and disperse exterior Binning of Wen Bing Pathogen in Wei Stage Diaphoresis, release exterior, vent rashes

1-1 expel wind and disperse heat Release Wei syndrome and disperse exterior – cont’d 1-1 expel wind and disperse heat Beginning of Wind warmth, wind heat in LU and Wei stage Sx: Fever, slightly aversion to wind cold, no sweating or little sweating, slightly thirst, or with cough, sore throat, thin white coating, red tongue tip and edge, floating rapid pulse. Rx: Sang Ju Yin (w/cough), Yin Qiao San (w/o cough)

1-2 Disperse exterior cold, eliminate interior Summer dampness Release Wei syndrome and disperse exterior – cont’d 1-2 Disperse exterior cold, eliminate interior Summer dampness Summer dampness Sx: Aversion to cold, fever, headache, soreness in body, no sweating, thirst, restlessness Rx: Xin Jia Xiang Ru Yin

1-3 Disperse exterior damp Release Wei syndrome and disperse exterior – cont’d 1-3 Disperse exterior damp Damp Warmth in Wei stage Sx: Aversion to cold, slightly fever, heaviness in head and body, little sweating, oppressed chest and epigastria, white greasy coating, slow soft pulse Rx: Huo Pu Xia Ling Tang

1-4 Disperse exterior and moisten dryness Release Wei syndrome and disperse exterior – cont’d 1-4 Disperse exterior and moisten dryness Beginning of Autumn dryness Sx: Fever, cough with little phlegm, dry throat, sore throat, dry nose, headache, thin white lack of moisten coating, red tongue tip and edge Rx: Sang Xing Tang

2. Clear heat in Qi stage Unshaped pathogenic heat

2-1 slight clear and disperse Qi syndrome Clear heat in the Qi stage – cont’d 2-1 slight clear and disperse Qi syndrome Qi stage heat with slight heat obstructing the diaphragm Sx: Fever, slightly thirst, restlessness, thin yellow coating, rapid pulse Rx: Zhi Zi Chi Tang

2-2 Use acrid cold to Clear Qi heat stage Clear heat in the Qi stage – cont’d 2-2 Use acrid cold to Clear Qi heat stage Equates to Yangming qi stage Sx: 4 Bigs - Strong fever, sweating, restlessness, thirst desire for cold water, dry yellow coating, flooding rapid pulse Rx: Bai Hu Tang

2-3 Clear heat and purge fire Clear heat in the Qi stage – cont’d 2-3 Clear heat and purge fire Pathogenic heat accumulation which transforms into fire Sx: Fever, bitter taste, thirst, restlessness, concentrated urine, red tongue with yellow coating, rapid pulse Rx: Huang Qin Tang

3. Harmonize exterior and interior Harmonize, soothe, eliminate pathogen in half exterior and interior Shaoyang, San Jiao, Mo Yuan Mo Yuan is also called the membrane source. Equates to the Shaoyang stage in the Six Channel Theory. The Wei level is the exterior, the Qi level is interior, but is the most external layer of the internal zones. When a pathogen is trying to gain entry to the Ying level it has to pass through the membrane source, the Mo Yuan.

Harmonize exterior and interior – cont’d 3-1 Clear Shaoyang Pathogen is in Shaoyang, there is Stomach dysfunction Rx: Chills and fever alternative, bitter taste, rib pain, thirst, concentrated urine, distention in epigastria, nausea, red tongue with yellow greasy coating, wiry rapid pulse Sx: Hao Qin Qing Dan Tang

3-2 Separately elimination through 3 Jiao Harmonize exterior and interior – cont’d 3-2 Separately elimination through 3 Jiao San Jiao heat and Phlegm damp Sx: Alternate chills and fever, epigastria and abdominal bloating, concentrated urine, greasy coating Rx: Wen Dan Tang

Harmonize exterior and interior – cont’d 3-3 Open Mu Yuan Pathogen stays in Mu Yuan. This is an early stage of damp warmth or damp heat Sx: More chills than fever, bloating, severe heaviness in body, white greasy coating like chalk powder. Deep red or purple red tongue Rx: Da Yuan Yin

4. Eliminate Damp and Clear Heat Eliminate damp, clear heat – cont’d 4. Eliminate Damp and Clear Heat Focus on eliminate damp Damp heat Aromatic to resolve, bitter to dry, bland to drain

4-1 Disperse qi and resolve damp Eliminate damp, clear heat – cont’d 4-1 Disperse qi and resolve damp Beginning of damp warmth Sx: Hiding fever that is more severe in afternoon, can’t be solved after sweating, slight aversion to cold, epigastria distention, concentrated urine, white greasy coating, slow soft pulse Rx: San Ren Tang

4-2 Dry damp and clear heat Eliminate damp, clear heat – cont’d 4-2 Dry damp and clear heat Damp-heat in Middle Jiao Sx: Fever which is not resolved after sweating, thirst without desire to drink, bloating, restlessness, nausea, loose stools, concentrated urine, yellow greasy coating Rx: Wang’s Lian Po Yin

4-3 Drain damp Eliminate damp, clear heat – cont’d Damp heat in Lower Jiao Sx: Vomiting, dizzy, little or no urine, thirst but drinks very little, white greasy coating Fu Ling Pi Tang Fu Ling Pi Yi Yi Ren Zhu Ling Da Fu Pi Tong Cao Dan Zhu Ye

4-4 Warm to resolve dampness Eliminate damp, clear heat – cont’d 4-4 Warm to resolve dampness Dampness obstructing Middle Jiao Add earth, Dig ditch, Air through, aromatic to resolve

5. Purge down to eliminate pathogen Shaped pathogen Heat, damp, blood stasis

5-1 Purge Fu Organ to drain heat Purge downward to eliminate pathogen – cont’d 5-1 Purge Fu Organ to drain heat Heat and turbid combination in Yangming channel Sx: Tidal fever, delirium, abdominal fullness, hardness, impalpable, constipation, dark yellow coating, deep excess pulse Rx: Tiao Wei Cheng Qi Tang Da Cheng Qi Tang

5-2 Eliminate damp and purge Purge downward to eliminate pathogen – cont’d 5-2 Eliminate damp and purge Damp heat with turbidity Sx: Fever, bloating, nausea, loose stools, yellowish red color stools, yellow turbid coating, slippery rapid pulse Rx: Zhi Shi Dao Zhi Tang Zhi Shi Da Huang Shan Zha Bing Lang Hou Po Huang Lian Shen Qu Zi Cao Mu Tong Lian Qiao Gan Cao

5-3 Promote fluid to purge Purge downward to eliminate pathogen – cont’d 5-3 Promote fluid to purge Intestinal dryness Sx: Fever, constipation, dry lips, dry red tongue with little coating Rx: Zeng Ye Cheng Qi Tang

5-4 Purge and break blood stagnation Purge downward to eliminate pathogen – cont’d 5-4 Purge and break blood stagnation Combination of heat and blood stasis Sx: Fever, lower abdominal pain with hardness, normal urine, constipation, mania, purplish tongue, deep excess pulse Rx: Tao He Cheng Qi Tang

6. Clear Ying Stage and Cool Blood Clear Ying, cool blood – cont’d 6. Clear Ying Stage and Cool Blood Pathogen in Ying Stage and Blood Stage

6-1 Clear Ying Stage Heat Pathogenic heat starts to enter Ying stage Clear Ying, cool blood – cont’d 6-1 Clear Ying Stage Heat Pathogenic heat starts to enter Ying stage Sx: Fever more severe at night, restlessness, delirium, scattered macula, deep red tongue Rx: Qing Ying Tang

6-2 Cool blood and release stasis Clear Ying, cool blood – cont’d 6-2 Cool blood and release stasis Heat in blood plus stasis Sx: Fever, restlessness, mania, delirium, macula, blood in urine and stools, vomiting blood, nasal bleeding, dark purple or crimson tongue Rx: Xi Jiao Di Huang Tang

6-3 Clear heat from Qi and Ying (Blood) Stages Clear Ying, cool blood – cont’d 6-3 Clear heat from Qi and Ying (Blood) Stages Heat in Qi, Ying/ Blood stages Sx: Strong fever, thirst, restlessness, coma, delirium, pain in bones like patient has taken a beating, macula, blood in stools, urine and vomit, nasal bleeding, dry yellow or dark black coating, crimson tongue Rx’s: Yu Nu Jian Bai Hu Tang+ Xi Jiao, Xuan Shen Qing Wen Bai Du Yin

7. Open orifice and extinguish Wind Shen disorder

7-1 Clear Heart and Open Orifice Open orifices and extinguish wind (Shen disorder) – cont’d 7-1 Clear Heart and Open Orifice Heart heat with Shen disorder Sx: Fever, dizzy, delirium, deep red tongue, thin rapid pulse Rx’s: An Gong Niu Huang Wan Zhi Bao Dan Zi Xue Dan

7-2 Eliminate Phlegm to open orifice Open orifices and extinguish wind (Shen disorder) – cont’d 7-2 Eliminate Phlegm to open orifice Damp covers orifice Sx: Fever, dizziness, unconsciousness, delirium, red tongue with white greasy or yellow greasy coating, soft rapid pulse Chang Pu Yu Jin Tang Shi Chang Pu Yu Jin Zhi ZI Lian Qiao Ju Hua Hua Shi Zhu Ye Mu Dan Pi Niu Bang Zi Zhu Li Jiang Zhi

7-3 Cool Liver to extinguish Wind Open orifices and extinguish wind (Shen disorder) – cont’d 7-3 Cool Liver to extinguish Wind Liver Heat generating inner wind Sx: Fever, cold limbs, convulsions, opisthotonos, coma, red tongue yellow coating, wiry rapid pulse Rx: Ling Jiao Gou Teng Tang

7-4 Nourish Yin to extinguish Wind Open orifices and extinguish wind (Shen disorder) – cont’d 7-4 Nourish Yin to extinguish Wind Late stage of Wen Bing, yin damage leading to empty heat and deficient wind Sx: Low degree fever, fever in five centers (five palm heat), red cheeks (malar flush), finger spasms, fatigue, dry deep red tongue, weak thin pulse Rx: Da Ding Feng Zhu

8. Nourish Yin and promote fluid Nourish Yin and promote fluids – cont’d 8. Nourish Yin and promote fluid Later stage of Wen Bing, yin damage

8-1 Nourish LU and ST LU ST yin fluid damage Nourish Yin and promote fluids – cont’d 8-1 Nourish LU and ST LU ST yin fluid damage Sx: Dry throat, non-productive dry cough, nausea, poor appetite, red tongue without coating Rx: Sha Shen Mai Men Dong Tang

8-2 Promote fluid to moisten Intestines Nourish Yin and promote fluids – cont’d 8-2 Promote fluid to moisten Intestines Later stage of Wen Bing, yin damage, dryness in Intestines Sx: Constipation, dry throat and mouth, dry red tongue Rx: Zeng Ye Tang

8-3 Tonify True Yin essence Nourish Yin and promote fluids – cont’d 8-3 Tonify True Yin essence Later stage of Wen Bing, Liv and Ki yin damage Sx: Low degree fever, red complexion, more hot in palms than the back of hand, dry mouth and throat, fatigue, sleepiness, dry deep red tongue, lack of coating, weak thin pulse Rx: Jia Jian Fu Mai Tang Zhi Gan Cao Sheng Di Bai Shao Mai Dong E Jiao Hu Ma Ren,

9. Rescue Prolapsed Prolapsed/collapse of Yin or Yang

9-1 Tonify qi and consolidate Yin Rescue prolapse/collapse of Yin/Yang – cont’d 9-1 Tonify qi and consolidate Yin Qi and yin severe damage, prolapsed Sx: Fever suddenly decreased, heavy sweating, wheezing, fatigue, scattered large pulse, lack of tongue coating Rx: Sheng Mai San

9-2 Rescue Prolapsed Yang Rescue prolapse/collapse of Yin/Yang – cont’d 9-2 Rescue Prolapsed Yang Yang qi sudden prolapsed Sx: Cold limbs, heavy sweating, fatigue, pale face, pale watery tongue, feeble pulse Rx: Shen Fu Long Mu Tang Modifications: Shen Fu Tang Mu Li Long Gu

10. External Methods Bath Emema Liniment Nasal Method