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Oct 27
1. Recurrent Aphtha 复发性口疮
Etiology/Pathology
Symptoms/signs: - ulcers/boils: superficial, isolated, few, light red with greyish white in the base - on lips, cheeks, tongue edges/tip/bottom, gums - dry throat/mouth, burning pain - recurrent, chronic - triggered by stress
Syndrome/treatment
Nourish yin and anchor fire
Formula: gui shao tian di jian Dang gui 15, bai shao 15, tian men dong 15, shu di 18 Shan zhu yu 9, shan yao 30, huang bai 9, huang qin 9 Fu ling 15
If long lasting, + wu bei zi 9g If heat, + zhi mu 9, niu xi 15 If tasteless in mouth, + bei lan 9, shi chang pu 9
Patent Formula: liu wei di huang wan Zhi bai di huang wan
Other treatment: egg yolk -- smear Wu zhu yu powder + vinegar -- KI 1 (acupoint)
2. Acute Gingivitis 急性牙龈炎Etiology/Pathology
Symptoms/signs:
Syndrome/treatment
Clear heat, purge fire
Formula: qing re jie du tang
Jin yin hua 30, lian qian 15, sheng di 9, dan pi 9 Huang qin 9, han cao 6, sheng shi gao 30, zhi mu 9, da huang 9
If thirst, bad mouth, + sheng ma9, tian hua fen 18, xuan shen 15 If pus, + yi yi ren 30, bai zhi 18 If bleeding, + bai mai gen 30
Patent herbs: san huang pian (三黄片)
Mouthwash: jing jie tang (jing jie15, bo he 15, sheng ma 9, xi xin 6, decoction)
3. Acute Laryngitis 急性喉炎
normal
Etiology/Pathology
Symptoms/signs:
Syndrome/treatment
1
1) Wind cold attack Symptoms: Treatment Principle:
formula/herbs:
San ao tang
Ma huang 9, xing ren 9, zhi gan cao 6, su ye 9 Can tui 4.5, ban da hai 9, jie geng 6
If very severe, + xi xin 3 If cough with phlegm, + she gan 9, zi wan 15, kuan dong hua 15 If heat, - ma huang, + jin ying hua 30
Other treatment: niu ban zi 9, can tui 4.5, sheng gan cao 6
2) Wind heat attack Symptoms: Treatment Principle:
formula/herbs: yin qiao san Jin yin hua 30, lian qiao 15, niu banb zi 15, jing jie 9 Huang qin 9, bo he 4.5, zhu ye 9, can tui 4.5 Gan cao 6
If heat severe, + shi gao 30, dan pi 15 If pain and swelling, + xuan shen 15, ban nan gen 30, zi hua di ding 18 If cough with thick yellow phlegm, + ze bei mu 9, gua lou 18
Patent herbs: niu huang jie du pian, 6 tablets, Bid Bing peng san 冰硼散 (bing pian, peng sha, zhu sha, mang xiao)
2
4. Chronic simple Pharyngitis 慢性咽炎Etiology/Pathology
Symptoms/signs:
Syndrome/treatment
1) yin defSymptom:Treatment p: Formula and herbs: Zhi bo di huang wan -- for KI yin def
Zhi mu 9, huang 9, sheng di 12, shan zhu yu 12 Dan pi 9, ze xie 9, gou qi zi 12, shan yao 15
Yang yin qing fei tang -- for LU yin def
Sheng di 12, sha shen 15, chuan bei mu 9, dan pi 9 Bai shao 12, bo he 6, sheng gan cao 6
2) yang defSymptom:Treatment p: Formula and herbs:
Jin gui shen qi wan
Sheng di 12, shan yao 15, shan zhu yu 15, ze xie 9 Dan pi 9, gui zhi 9, fu zi 9, Other treatment: Jing yin hua 30, pang da hai 30, mai dong 30, decoction
3
Nov 3
5. Allergic Rhinitis 过敏性鼻炎
Etiology/Pathology
Pathogen -- --LU – dispersing/descending --- SP /KI turbid f
Symptoms/signs:
Syndrome/treatment
Treatment p: tonify SP qi, open nose orifice,
formula/herbs: bu zhong yi qi tang
Zhi huang qi 18, zhi gan cao 9, dang shen 15, dang gui 12 Chen pi 12, sheng ma 9, chai hu 9, bai zhu 15
If qi def severe: increase huangqi to 30g, + fang feng 12 If profuse thin secretion: + bai zhi 15, wu wei zi 9
6. Acute Sinusitis /bi yuan
Nasal sinuses mucosa -- acute inflammation
Bi Yuan
4
Etiology and Pathogenesis
Ext Toxin + Int heat (LU, SP, GB) → nose
Symptoms/signs
- Nasal obstruction -- smelling sense ↓- nasal discharge: profuse, purulent, stinking- headache: splitting, or distension- pain in corresponding area; mucous membrane swelling; profuse mucous
Syndrome and treatment
1) LU channel wind heat
Chief complaint: stuffy nose, profuse mucuou, smell ? Fever, aversion to cold, Tongue slight red, c thin yellow, pulse floating rapid
Treatment principle: disperse wind, clear heat, open orifices with aromatic
Formula and herbs: qing kong gao
Huang qin 15g, fang feng 15g, qiang huo 9, huang lian 12Chai hu 15, chuang xiong 9, sheng gan cao 6
If cough with profuse phlegm, + xing ren 9, pi ba ye 12If nose obstruction, + bai zhi 15, xin yi hua 9If profuse/yellow, + yu xing cao 15, zhao jiao chi 15If headache, top, + gao ben Front head, + bai zhi 15, man jing zi 12 Back, + ge gen 24; Side, + chai hu, dan pi 12
5
2) GB stagnated heat
Chief complaint: obstructed nose, yellow thick purulent mucous, smelling lose, Headache, Fever, bitter, dry throat, dizziness/blurred vission, Tongue red, coating yellow, rapid wiry p
Treatment principle: purge GB heat, eliminate damp, unblock oriffice
Formula and herbs: long dan xie gan tang Long dan cao, huang qin, zhi zi
3) SP channel damp heat
Chief complaint: profuse yellow running mucous, severe obstruction, loss of smelling, Headache, heavy head, abdominal distension; C yellow greasy, P smooth rapid pulse
Treatment principle: clear/purge SP heat, drain dampness, resolve zhou/turbid
Formula and herbs: huang qin hua shi tang
H q 12, hua shi 24, mu tong 6, fu ling 15, zhu ling 12Da fu pi 15, bai dou kou 6
7. Chronic Sinusitis
Acute → chronic
Etiology and Pathogenesis
SP/LU def, defensive qi weakness --- pathogen lingering --- qi/blood blockage (in nose) -- turbid dampness gathering in nose orifice
6
Symptoms/signs
- profuse white mucous, no stinking smelling, nasal obstruction (comes and goes), worsen by wind cold- nasal mucous membrane red, swelling- drowsy, brain power ↓ fatigue, shortness of breath
Syndrome and treatment
Chief complaint:
Treatment principle: tonify LU qi, disperse wind cold
Formula and herbs: wen fei tang
Huang qi 18, sheng ma 12, ge gen 15, qiang huo 9Fang feng 12, zhi ma huang 3, ding xiang 6, gan cao 6
If headache/drowsiness: + bai zhi 15, chuang xiong 9If obstruction; + xin yi yua 9, cang er zi 12If yellow thick, + ju hua 15, huang qin 12
If qi def severe, shen ling bai zhu san
If headache/dizziness severe, + bai zhi 15, chuang xiong 9If obstructed nose severe, + xin yi hua 9, cang er zi 12If discharge yellow purulent, + ju hua 15, huang qin 12
8. Atrophic Rhinitis
Mucosa: dry, atrophicNasal cavity: enlarged, drySense: stinking
7
Etiology and Pathogenesis
Symptoms/signs- dry nose, burning pain, nasal obstruction- stinking odor, yellowish, purulent and turbid discharge, or bloody - smell less- enlarged nasal cavity, atrophy of nasal mucosa,
Syndrome and treatment
1) LU yin def
Chief complaint:
Treatment principle: nourish yin, moisten dryness, disperse LU and expell EPI
Formula and herbs: qing zao jiu fei tang
Sang ye 12g, shi gao 24, e jiao 9, mai men dong 12 Hu mao ren9, dang shen 15, gan cao 6, xing ren 9Pi pa ya 12
If nose mouth dry: + sha shen 15, shi hu 12
2) SP qi def
Chief complaint:
Treatment principle:
Formula and herbs: bu zhong yi qi tang
8
If sticky smell, + huang bai, 9, huo xiang 12
If loss smelling, + bo he 9, xin yi hua
3) LU and KI yin def
Chief complaint: dry, shrink, dry throat, sore throat, headache, five center
Treatment principle:
Formula and herbs: bai he gu jin tang
Shen di 15, shu di 12, mai m d 12, bai he 18, chuan bei mu 9, bai shao 15Xuan shen 15, dan gui 12, ji geng 9
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9
Class 3/Nov 11
LV, 5 Eelids 眼睑疾病5.1 Hordeolum 麦粒肿5.3 Palpebral erysipelas 眼睑丹毒5.4 Paljpebral Eczema 眼睑湿疹5.7 Ptosis (Blepharoptosis)上眼睑下垂7 Conjunctiva 结膜疾病7.1 Trachoma 沙眼7.2 Acute Catarrhal Conjunctivitis 急性卡他性结膜炎11Lens 晶状体疾病11.1 Senile Cataract 老年性白内障12 Glaucoma 青光眼12.1 Acute Angle Closure Glaucoma 急性闭塞型青光眼
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5 Eelids 眼睑疾病5.1 Hordeolum 麦粒肿5.3 Palpebral erysipelas 眼睑丹毒5.4 Paljpebral Eczema 眼睑湿疹5.7 Ptosis (Blepharoptosis)上眼睑下垂
10
7 Conjunctiva 结膜疾病7.2 Acute Catarrhal Conjunctivitis 急性卡他性结膜炎
Congestion of bulbar conjunctivaMuco-purulent dischargeBacteria infection
Etiology and PathogenesisWind heat – LU – wind heat -- eyes
Manifestations
Foreign body sensationBurning painPhotophobiaLacrimation and profuse eye secretionConjuctival congestionSwellingbulbar conjuctival congestion or edema eyelid
Syndromes and treatment
1) wind heatEye lids + headache
Qu feng san re yin ziNiu bang zi 12, qiang huo 9, fang feng 12, bo he 9, ju hua, Sang ye9, lian qian 12, zhi zi 9, da huang 3, chi shao 9Dang gui 9, chuang xiong 6,
2)
3)
11
12
11Lens 晶状体疾病11.1 Senile Cataract 老年性白内障
Etiology/pathogenesis
Aging – LV/KI – essence/blood def – SP – blood def --
ManifestationsBlack shadows, monocular diplopia, polyopia, refraction change
A. Cortical cataract
4 stages
13
- initial stage: wedged opacities (equator)
- immature stage: wedged opacities (papillary zone)anterior chamber↓ vision↓ len↑
- mature stage: Cortex of len panopacity, iris shadow cast (disappeared), anterior chamber (regain depth), mere light perception,
- Hypermature stage: Cloudy cortex – milky liquefaction,calcification or cholesterin depositsNucleus sinksUpper part of anterior chamber deeper
B. Senile nuclear cataract
Lens brown or amber opacity --- blackCortex transparentVision ↓
Syndrome and treatment
1) LV/KI yin def
SymptomsAging, blurred, dizzy, tinun, lower b p, sore kn
Treatment P
Formula and herbs Qi ju di huang wan
14
2) SP qi def
SymptomsBlurred v, tiredness, pale c, poor appetite, loose s,
Treatment PYi qi cong ming tang
Man jing zi, huang qi 6, ren shen 6, huang bai 9, bai shao 9, zhi gan cao 3, ge geng 3
Formula and herbs
3) Yin def + damp heat
SymptomsBlur v, dry eyes, feverish s, bad breath, dry m, poor appetite, stool loose, t c yellow greasy
Treatment P
Formula and herbs
Gan lu yinSheng di 9, shu di 9, shih u 9, tian men dong, 12, mai men dong 12, huang qin 9, yin chen huao 9, gan cao 6, bi pa ye 24
Patent herbs: shi hu ye guang wan Bu zhong yi qi
15
2 Glaucoma 青光眼12.1 Acute Angle Closure Glaucoma 急性闭塞型青光眼
Two sides, eyes distention, conjunctival congestion, sudden weakening of vision, + nausea, vomiting
Etio logy/PathogenesisEmotion – LV qi – fire – eyesLV/GB fire – wind Phlegm damp – fire – Over work – def yin --- yang hyper
16
Manifestations
4 stages- preclinical stage: Mild headache, eyes distension, iridizations,
- attack: intraocular pressure↑, distending pain in eyeball, severe headache, nausea, vomiting, vision loss, Exam: mixed congestion, corneal edema, shallow anterior chamber, iridoatrophy, mydriasis, loss of photoreaction, anterior chamber angles closed
- remission:
- chronic: Vision weakened
Syndromes and treatment
1) LV qi stagnation
Symptoms: red, distending, ir? Vision decr, + emotion, headache,
17
Tongue: red, c – thin white, P: wiry, thin
Treatment P: sooth Lv, move qi, clear heat, suppress wind
Formulas and herbs
Dan zhi xiao yao san
Chai hu, dan pi, zhi zi, bai zhu, fu ling, gan cao, -- 9gBai shao, dang gui, ban xia, bai zhi, ju hua, --- 12gShan zhu yu 30
2) LV fire disturbing upwards
Symptoms: --nausea vomiting, aversion to cold??, fever???, darkish urine, dry stool, red t, yellow c, wiry rapid pulse
Treatment P: clear heat, purge fire
Formulas and herbsLu feng ling yang yin
Huang qin, zhi mu, da huang, fang feng, ze xie, xia ku cao, -- 9Xuan shen, fu ling, che qian zi, -- 12Ling yang jiao fen 3
3) Phlegm fire disturbing upwards
Symptoms: red, distending, blurried, headache, nausea, vomiting, dizziness (whenever move) + dry stool, red t, yellow greasy c, wiry rapid p
18
Treatment P:
Formulas and herbsBan xia ling yang jiao san
Ling yang jiao, bo he, qiang huo, fang feng, ban xian, chuan xiong, ze xie, chen pi, -- 9Man jing zi, ju hua, jue ming zi, --- 12Che qian zi 15
4) Yin def and yang hyper
Symptoms: disending, headache, blurred v, irritability, tinnitus, dry mouth/throat, t red, c less, p thin rapid
Treatment P:
Formulas and herbsLing yang gou teng yin
Gou teng, sang ye, yu hua, fu ling – 12 gSheng di, bai shao, 15Ban xia, zhu ru, gan cao 9Ling yang jiao 3
19
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