treatment 3) bleeding under the skin a) blood heat signs & symptoms: –main sym. : suddenly...
TRANSCRIPT
TreatmentTreatment 3) Bleeding under the skin
A) Blood heatSigns & Symptoms:
– Main Sym. : Suddenly onset, purple spots or plague in skin– Concurrent sym.: blood from other sites such as nose, intestines
or bladder, mental restlessness, thirsty, constipation, fever at night.
– Tongue: red body without coating, red points all over
– Pulse: rapid & fine
• Treatment Protocol:
– Expel poison– Clear away heat– Cool blood to stop bleeding
Formula:
Modifications:
Harmonize blood (stop bleeding, eliminate stasis, calm & nourish blood)
-- Qian Cao Geng, Di Yu, Gou Qi ZiAstringe
-- Shan Zhu YuAbdomen pain + hematochezia
-- Mai Dong, Yu Zhu , Tian hua fengBlood heat is very pronounced
-- Zi Cao
Xi Jiao Di Huang Tang
Shui Niu Jiao Shen Di Mu Dan Pi Chi Shao Shi Gao Zhi Mui
Zhi Zi Ce Pai Ye Gan Cao
TreatmentTreatment 3) Bleeding under the skin
B) Yin def. type empty heatSigns & Symptoms:
– Main Sym. : purple spots or plague under the skin– Concurrent sym.: blood from other sites such as nose, intestines
or bladder, flush cheek, restless, hot sensation in the palms & soles. Thirsty, lower fever, night sweating.
– Tongue: red body without coating, red points all over
– Pulse: floating-empty or slightly-rapid
• Treatment Protocol:
– Nourish Yin– Clear empty heat– Stop bleeding
Formula:
Modifications:
Yin Def.
-- Gui Ban, Bie Jia, xuan sheng, nu zhen zi, han lian cao
Kidney Yin Def.
-- Liu Wei Di Huang Wan
Qian Gen San
Qian Cao Gen Huang Qi Er Jiao Ce Bai Ye
TreatmentTreatment 3) Bleeding under the skin
C) Qi Def. fail to govern the bloodSigns & Symptoms:
– Main Sym. : Chronic purple spots or plague under the skin opens from time to time
– Concurrent sym.: dizziness, poor appetite, mental & physical lassitude, pale or swallow complexion
– Tongue: swollen light color with white thin fur
– Pulse: thready & weak
• Treatment Protocol:
– Tonify Qi to govern blood
Formula:
Modifications:
Stop Bleeding -- Xian He Cao, Zhong Lu Tan, San Qi, Pu
Huang, Qian Geng Tan, Xue Yu TanLoose stools
-- Shan Yao, Lian Zi rou, Qian ShiKid Def.
-- Tu Si Zi, Shan Yu Rou, Xu DuanKid Yang Def.
-- Xian Mao, Rou Gui
Gui Pi Tang
Dang Shen Huang Qi Bai Zhu Dang Gui Fu Ling Suan Zhao Ren
Long Yan Mu Xiang Yuan Zhi Sheng Jiang Da Zhao
TreatmentTreatment 4) Coughing blood
A) Wind-Dry-HeatSigns & Symptoms:
– Main Sym. : Itchy throat, cough with blood-tinged sputum– Concurrent sym.: dry mouth & nose, light aversion to cold, stuff
nose & headache, nosebleed, – Tongue:
Red on the sides and front part, dry– Pulse:
Floating rapid
• Treatment Protocol:
– Expel wind– Clear heat– Stop bleeding
Formula:
Modifications:
Lung heat -- Shi Gao
Stop bleeding-- Qian Cao, Ou Jie
Wind-heat-- Yin Hua, Lian Qiao, Niu Pang Zi, Ju Hua
Fluid damage-- Mai Dong, Xuan Shen, Tian Hua Feng
Sang Xing Tang
Sang Ye Xing Ren Sha Shen Bei Mu Zhi Mu Huang Qin
Shan Zhi Zi Sang Bai Pi Ce Bai ye Bai Mao Gen
Dan Dou chi
TreatmentTreatment 4) Coughing blood
B) Liver fire invading lungSigns & Symptoms:
– Main Sym. : Cough with fresh-red blood in sputum– Concurrent sym.: Hypochondrial pain, irritability, easily lose
temper, a bitter taste– Tongue:
Red with yellow coating– Pulse:
wiry & rapid
• Treatment Protocol:
– Clear Liver-Fire– Clear the lungs– Cool blood to stop bleeding
Formula:
Modifications:
Lung heat -- Huang Qin, Zhi Mu, Shi Gao
Stop bleeding-- Ce Bai Ye, Bai Mao Geng, Han Lian Cao, Da Ji, Xiao Ji,
Qian Cao, Ou JieLiver Fire
-- Dan Pi, Zhi Zi, Huang QinAbundant fresh-red color blood
-- Xi Jiao Di Huang Tang + San Qi, Da Huang To treat Qi Rebellion
-- Mu Li, Niu Xi
Xie Bai San + Dai Ge San
Sang Bai Pi Di Gu Pi Gan Cao Jin Mi Qin Dai Hai Ge Ke
TreatmentTreatment 4) Coughing blood
C) Lung-Yin Def. with empty heatSigns & Symptoms:
– Main Sym. : Cough with scanty blood-tinged sputum– Concurrent sym.: dry throat, afternoon fever or feeling of heat,
night sweating, 5-palm heat– Tongue:
Red without coating, dry– Pulse:
float empty
• Treatment Protocol:
– Nourish Lung Yin– Clear empty-heat– Stop bleeding
Formula:
Modifications:
Lung heat -- Bai Wei, Qin Hao, Bie Jia
Stop bleeding-- Ce Bai Ye
Night sweating-- Ru Dao Geng, Fu xiao mai, wu wei zi, Mu li
Bai He Gu Jing Wan
Bai He Sheng di Mai Dong Xuan Shen Bai shao Di Gu Pi
Bei Mu Ce bai ye Bai Mao gen Bai Ji Gan Cao Dang Gui
Case History
1. Female 67 years Medical history:Medical history: She had TB of the lungs for 40 years, had been suffering from breathlessness for many years. First visiting:First visiting:
Main complain: coughing of blood-specked sputum breathlessness on exertion, general exhaustion and
coughing of blood sputum. Night sweating, dry throat, and fever in the afternoon, was very prone to cold which immediately affected her chest and caused bronchitis with the expectoration of profuse yellow-greenish sputum. Overweight body type,
Tongue: slightly red, swollen with a rootless coating in the front part Pulse: Slippery
TCM diagnose: Lung Yin Def. + Spleen Qi Def.
Treatment protocol:Nourish Lu. Yin, Clear Empty-heat, Tonify Sp Qi &
resolve Phlegm Formula:
Bai He Gu Jing Wan
TreatmentTreatment 5) Blood in the stools
A) Damp-heat in the intestinesSigns & Symptoms:
– Main Sym. : Fresh blood in the stools– Concurrent sym.: loose and frequent stools with mucus, burning
sensation in the anus, abdominal pain– Tongue:
Red with yellow-sticky coating on root, with red spots– Pulse:
slippery-rapid
• Treatment Protocol:
– Resolve dampness– Clear heat– Stop bleeding
Formula:
Modifications:
Yin Def.
-- Bai Shao, E Jiao, Shen Di
Stop bleeding
-- Bai Ji
Di Yu San
Di Yu Qian Cao Geng Huang Qin Huang Lian Zhi Zi Fu ling
TreatmentTreatment 5) Blood in the stools
B) Stomach & Spleen Def.Signs & Symptoms:
– Main Sym. : Profuse fresh blood in the stools– Concurrent sym.: slight abdominal pain, pale face, exhaustion,
depression, loose & frequent stools with mucus– Tongue:
pale tongue– Pulse:
thready weak
• Treatment Protocol:
– Strength the spleen– Warm the centre– Stop bleeding
Formula:
Modifications:
Yang Def.
-- Lu Jiao Shuang, Pao Jiang, Ai Ye
Stop bleeding
-- Bai Ji, Wu Zei Gu
Huang Tu Tang
Zao Xing Tu Gan Cao Shen Di Huang Bai Zhu Fu Zi Er Jiao
Huang Qin
Case History
1. male 60 years First visiting:First visiting:
Main complain: Blood in the stools for 2 years No abdomen pain and his bowl movements were loose and
very frequent. The blood was fresh-red and haemorrhoids were excluded as a cause of bleeding. He felt very tired most of the time and felt the cold very much. Even in summertime on a hot day when he came for his consultation he had a jumper and a jacket on.
Tongue: Pale swollen and had a white-sticky coating Pulse: Generally weak, especially so on the right-middle position
TCM diagnose: Spleen Yang Def. + Internal cold
Treatment protocol:Tonify & warm Sp yang
Formula:Li Zhong Tang
TreatmentTreatment 6) Blood in the Urine
A) Bladder HeatSigns & Symptoms:
– Main Sym. : Scanty-dark urine with fresh blood– Concurrent sym.: Mental restlessness, thirsty, insomnia,
red face, tongue ulcers, bitter taste– Tongue:
Red with redder tip, with yellow spots, or red spots on the root
– Pulse: Rapid, slightly overflowing
• Treatment Protocol:
– Clear heat from bladder– Stop bleeding
Formula:
Modifications:
Xiao Ji Ying Zi
Sheng Di Xiao Ji Hua Shi Tong Cao Pu Huang Dan Zu Ye
Ou Jie Dang Gui Shan Zhi Zi Gan Cao
TreatmentTreatment 6) Blood in the Urine
B) Kidney Yin def. with empty-heatSigns & Symptoms:
– Main Sym. : Scanty-dark urine with blood– Concurrent sym.: dizziness, tinnitus, back-ache, exhaustion,
feeling fever in the afternoon, night sweating– Tongue:
Red without coating– Pulse:
floating-empty
• Treatment Protocol:
– Nourish kidney Yin– Clear empty heat– Stop bleeding
Formula:
Modifications:Empty Heat
-- Han Lian Cao, Qing Hao
Zhi Pai Di Huang Wan
Zhi Mu Huang Bai Shu di Shan yao Ze xie Fu ling
Mu Dan Pi Zhi Mu
TreatmentTreatment 6) Blood in the Urine
C) Spleen Def. not controlling bloodSigns & Symptoms:
– Main Sym. : Chronic bleeding in the urine– Concurrent sym.: dizziness, tiredness, pale face, no
appetite, depression– Tongue:
Pale– Pulse:
weak
• Treatment Protocol:
– Tonify the spleen – Stop bleeding
Formula:
Modifications:
Stop Bleeding -- Xian He Cao, Zhong Lu Tan, San Qi, Pu
Huang, Qian Geng Tan, Xue Yu TanLoose stools
-- Shan Yao, Lian Zi rou, Qian ShiTo treat Qi
-- Shen Ma, Cai Hu
Gui Pi Tang
Dang Shen Huang Qi Bai Zhu Dang Gui Fu Ling Suan Zhao Ren
Long Yan Mu Xiang Dang Gui Yuan Zhi Sheng Jiang Da Zhao
TreatmentTreatment 6) Blood in the Urine
B) Kidney Qi not firmSigns & Symptoms:
– Main Sym. : Chronic bleeding in the urine with pale blood– Concurrent sym.: dizziness, tinnitus, sore-back,
exhaustion– Tongue:
Pale & swollen– Pulse:
weak
• Treatment Protocol:
– Tonify kidney Yang– Stop bleeding
Formula:
Modifications:
Stop Bleeding
-- Xian He Cao, Zhong Lu Tan, San Qi, Pu Huang, Qian Geng Tan, Xue Yu Tan
Wu Bi Shang Yao Wan
Shao Yao Rou Cong Rong Tu Si Zi Ba Ji Tian Du Zhong Shu Di
Niu Xi Shan Zhu Yu Ze Xie Wu Wei Zi Chi Shi Zhi Fu Shen
Case History
1. Male 75 years First visiting:First visiting:
Main complain: bleeding in the urine for 3 months no pain on urination and the blood was dark,
sometimes with tiny clots. He felt generally hot and his mouth felt very dry and hot
Tongue: Red dry and nearly completely peeled Pulse: Floating-empty
TCM diagnose: Kid. Yin def. + empty fire
Treatment protocol:Nourish Kidney yin, clear empty fire, stop
bleeding Formula:
Sheng di 6, Shan Zhu Yu 3, Shan Yao 6, Ze Xie 4, Fu Ling 6, Mu Dan Pi 6, Zhi Mu 4, Huang Bo4, Xiao Ji 6, Pu Huang 4, Dang Gui 6, Mu Li 12
PalpitationPalpitation TCM Diagnoses and Treatments Palpitation involves pavor and severe palpitation which
denote the subjective symptoms of the patients: pulsation, terror & unease
Etiology & Pathology:Main pathogenesis of bleeding: The focus of the disease is at Heart (Sp. Kid. Liv.
Lu.)1) Lacking of self-confidence & timid2) Heart blood insufficient3) Hyperactivity of fire due to Yin
def.4) Heart Yang Def.5) Excessive fluid invades the heart6) Blood stasis blocked channels
TreatmentTreatment 1) Timid
Signs & Symptoms:
– Main Sym. : Palpitation, usually frightened and liable to anger
– Concurrent sym.: feel restless, sleeplessness, dreaminess
– Tongue: thin and whitish fur or normal
– Pulse: weakly rapid, knotted or intermittent or string-like
• Treatment Protocol:
– Calming the mind– Nourish the heart
Formula:
Modifications:
Calm the mind -- Ci Shi, Hu Po,
Heart Qi Def.-- Dang Shen, Zhi Gan Cao
Heart Yin Def.-- Bo Zi Ren, Wu Wei Zi, Suan Zhao Ren
An Shen ding Zhi Wan
Fu Ling Fu Shen Yuan Zhi Ren Sheng Shi Chang Pu Long Chi
TreatmentTreatment 2) Heart blood insufficient
Signs & Symptoms:
– Main Sym. : Palpitation, dizziness & weakness
– Concurrent sym.: pale complexion, tiredness, fatigue– Tongue:
light red– Pulse:
thin & weak
• Treatment Protocol:
– Nourish heart blood– Calm down mind
Formula:
Modifications:
Tonify heart Qi
-- Zhi Gan Cao
Gui Pi Tang
Dang Shen Huang Qi Bai Zhu Dang Gui Fu Ling Suan Zhao Ren
Long Yan Mu Xiang Dang Gui Yuan Zhi Sheng Jiang Da Zhao
TreatmentTreatment 3) Hyperactivity of fire due to Yin def.
Signs & Symptoms:
– Main Sym. : Palpitation, unease, vexation, sleeplessness
– Concurrent sym.: feverish sensation in the palms and soles, soreness of waist, tinnitus, dizziness,
– Tongue: red tongue, without coating
– Pulse: thin & rapid
• Treatment Protocol:
– Nourish yin & purging fire– Calm down mind
Formula:
Modifications:
Empty fire of heart sym. ( dry mouth, throat, restless)-- Huang Lian, or Zhi Bai Di Huang Wan
Heart Qi Def.-- Dang Shen, Zhi Gan Cao
Heart Yin Def.-- Bo Zi Ren, Wu Wei Zi, Suan Zhao Ren
Tian Wang Bu Xing Dan
Ren Sheng Dan Sheng Fu Ling Wu Wei Zi Yuan Zhi Jie Geng
Dang gui Tian Dong Mai Dong Bo Zi Ren Suan Zhao Ren Shen Di
TreatmentTreatment 4) Heart Yang Def.
Signs & Symptoms:
– Main Sym. : Palpitation, restlessness, oppressed feeling in chest, shortness of breath
– Concurrent sym.: pale complexion, cold limbs– Tongue:
light whitish tongue, – Pulse:
weak or deep thin or infrequent, knotted or intermittent
• Treatment Protocol:
– Warm heart yang– Calm down mind
Formula:
Modifications:Warm Yang
-- Fu Zhi, Gan Jiang
Tonify Heart Qi
-- Huang Qi, Huang Jing
Gui Zhi Gan Cao Long Gu Mu Li Tang
Gui Zhi Long Gu Mu Li Gan Cao
TreatmentTreatment 5) Excessive fluid invades heart.
Signs & Symptoms:
– Main Sym. : Palpitation, restlessness, oppressed feeling in chest, dyspnea, edema
– Concurrent sym.: dizziness, cold limbs, feeling of stuffiness and fullness in the chest, thirst, nausea and vomiting of water fluid
– Tongue: whitish & slippery coating,
– Pulse: taut & slippery pulse
• Treatment Protocol:
– Activating the heart yang– Promoting the circulation of qi to induce diuresis
Formula:
Modifications:Nausea & vomiting
-- Ban Xia, Chen Pi, Sheng JiangKidney Yang def.
-- Zhen Wu Tang
Lin Gui Zhu Gan Tang
Gui Zhi Fu Ling Bai Zhu Gan Cao
TreatmentTreatment 6) Heart blood stasis
Signs & Symptoms:
– Main Sym. : Palpitation, restlessness, chest pain
– Concurrent sym.: oppressed feeling in chest, unease, dark purple lips and nails
– Tongue: dark purple ,
– Pulse: knotted, intermittent or uneven
• Treatment Protocol:
– Remove blood stasis
Formula:
Modifications:Warm heart Yang
-- Gui Zhi, Gan CaoCalm mind
-- Long Gu, Mu LiPhlegm block the channel
-- Gua Lou xie bai Ban Xia Tang
Tao Ren Hong Hua Tang
Tao Ren Hong Hua Dan shen Chi Shao Chuan Xiong Yuan Hu
Xiang Fu Qing Pi Shen Di Dang Gui
Case History
1. Female 54 yearsMedical History:Medical History: Patient had a fever 2 month ago, after the fever was gone, patient started feeling palpitation. She had looked for several doctors, but no one can help her, which caused her feel depressed. She could sit whole day quietly without talking to anyone… First visiting:First visiting:
Main complainMain complain: Palpitation for 2 month Insomnia, lower fever sometimes, small quantity of menstrual
flow with light color blood Tongue:Tongue: Pale body with thin white coating PulsePulse: Floating-empty
TCM diagnoseTCM diagnose: Depression damage Sp. FunctionSp Qi & Heart Blood Def.
Treatment protocolTreatment protocol:Tonify Sp Qi & heart blood
Formula:Formula:Ren Shen 5, Bai Zhu 10, Huang Qi 10, Zhi Gan Cao
10, Dang Gui 10, Fu Shen 10, Yuan Zhi 10, Suan zhao ren 30, Mu Xiang 3, Ye Jiao Teng 15, Bai shao 15, Sheng Jiang 5 p, Da Zhao 3 p