wen bing 2

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Wen Bing 2

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Wen Bing Treatment

• Principles– Etiology– Pathology– Pathogen vs. Vital qi

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Treatment methods

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

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• 1-1 expel wind and disperse heat– Beginning of Wind warmth, wind heat in LU an

d Wei stage– Sx: Fever, slightly aversion to wind cold, no s

weating 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)

Release Wei syndrome and disperse exterior – cont’d

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• 1-2 Disperse exterior cold, eliminate interior Summer dampness– Summer dampness– Sx: Aversion to cold, fever, headache, sorene

ss in body, no sweating, thirst, restlessness– Rx: Xin Jia Xiang Ru Yin

Release Wei syndrome and disperse exterior – cont’d

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• 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

Release Wei syndrome and disperse exterior – cont’d

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• 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

Release Wei syndrome and disperse exterior – cont’d

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• 2. Clear heat in Qi stage– Unshaped pathogenic heat

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• 2-1 slight clear and disperse Qi syndrome– Qi stage heat with slight heat obstructing the

diaphragm– Sx: Fever, slightly thirst, restlessness, thin yell

ow coating, rapid pulse– Rx: Zhi Zi Chi Tang

Clear heat in the Qi stage – cont’d

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• 2-2 Use acrid cold to Clear Qi heat stage– Equates to Yangming qi stage– Sx: 4 Bigs - Strong fever, sweating, restlessne

ss, thirst desire for cold water, dry yellow coating, flooding rapid pulse

– Rx: Bai Hu Tang

Clear heat in the Qi stage – cont’d

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• 2-3 Clear heat and purge fire– Pathogenic heat accumulation which transfor

ms into fire– Sx: Fever, bitter taste, thirst, restlessness, co

ncentrated urine, red tongue with yellow coating, rapid pulse

– Rx: Huang Qin Tang

Clear heat in the Qi stage – cont’d

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• 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.

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• 3-1 Clear Shaoyang– Pathogen is in Shaoyang, there is Stomach dy

sfunction– 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

Harmonize exterior and interior – cont’d

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• 3-2 Separately elimination through 3 Jiao– San Jiao heat and Phlegm damp– Sx: Alternate chills and fever, epigastria and a

bdominal bloating, concentrated urine, greasy coating

– Rx: Wen Dan Tang

Harmonize exterior and interior – cont’d

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• 3-3 Open Mu Yuan– Pathogen stays in Mu Yuan. This is an early s

tage of damp warmth or damp heat– Sx: More chills than fever, bloating, severe he

aviness in body, white greasy coating like chalk powder. Deep red or purple red tongue

– Rx: Da Yuan Yin

Harmonize exterior and interior – cont’d

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• 4. Eliminate Damp and Clear Heat• Focus on eliminate damp• Damp heat• Aromatic to resolve, bitter to dry, bland to drain

Eliminate damp, clear heat – cont’d

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• 4-1 Disperse qi and resolve damp– Beginning of damp warmth– Sx: Hiding fever that is more severe in afterno

on, can’t be solved after sweating, slight aversion to cold, epigastria distention, concentrated urine, white greasy coating, slow soft pulse

– Rx: San Ren Tang

Eliminate damp, clear heat – cont’d

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• 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

Eliminate damp, clear heat – cont’d

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• 4-3 Drain damp– Damp heat in Lower Jiao– Sx: Vomiting, dizzy, little or no urine, thirst but drinks v

ery little, white greasy coating– Fu Ling Pi Tang

• Fu Ling Pi• Yi Yi Ren• Zhu Ling• Da Fu Pi• Tong Cao• Dan Zhu Ye

Eliminate damp, clear heat – cont’d

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• 4-4 Warm to resolve dampness• Dampness obstructing Middle Jiao• Add earth, Dig ditch, Air through, aromatic to resol

ve

Eliminate damp, clear heat – cont’d

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

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• 5-1 Purge Fu Organ to drain heat– Heat and turbid combination in Yangming cha

nnel– Sx: Tidal fever, delirium, abdominal fullness, h

ardness, impalpable, constipation, dark yellow coating, deep excess pulse

– Rx: Tiao Wei Cheng Qi Tang Da Cheng Qi Tang

Purge downward to eliminate pathogen – cont’d

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• 5-2 Eliminate damp and purge– Damp heat with turbidity– Sx: Fever, bloating, nausea, loose stools, yellowish re

d 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

Purge downward to eliminate pathogen – cont’d

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• 5-3 Promote fluid to purge– Intestinal dryness– Sx: Fever, constipation, dry lips, dry red tongu

e with little coating– Rx: Zeng Ye Cheng Qi Tang

Purge downward to eliminate pathogen – cont’d

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• 5-4 Purge and break blood stagnation– Combination of heat and blood stasis– Sx: Fever, lower abdominal pain with hardnes

s, normal urine, constipation, mania, purplish tongue, deep excess pulse

– Rx: Tao He Cheng Qi Tang

Purge downward to eliminate pathogen – cont’d

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• 6. Clear Ying Stage and Cool Blood– Pathogen in Ying Stage and Blood Stage

Clear Ying, cool blood – cont’d

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• 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

Clear Ying, cool blood – cont’d

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• 6-2 Cool blood and release stasis– Heat in blood plus stasis– Sx: Fever, restlessness, mania, delirium, mac

ula, blood in urine and stools, vomiting blood, nasal bleeding, dark purple or crimson tongue

– Rx: Xi Jiao Di Huang Tang

Clear Ying, cool blood – cont’d

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• 6-3 Clear heat from Qi and Ying (Blood) Stages– Heat in Qi, Ying/ Blood stages– Sx: Strong fever, thirst, restlessness, coma, d

elirium, 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

Clear Ying, cool blood – cont’d

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• 7. Open orifice and extinguish Wind– Shen disorder

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• 7-1 Clear Heart and Open Orifice– Heart heat with Shen disorder– Sx: Fever, dizzy, delirium, deep red tongue, th

in rapid pulse– Rx’s:

• An Gong Niu Huang Wan• Zhi Bao Dan• Zi Xue Dan

Open orifices and extinguish wind (Shen disorder) – cont’d

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• 7-2 Eliminate Phlegm to open orifice– Damp covers orifice– Sx: Fever, dizziness, unconsciousness, delirium, red t

ongue 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

Open orifices and extinguish wind (Shen disorder) – cont’d

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• 7-3 Cool Liver to extinguish Wind– Liver Heat generating inner wind– Sx: Fever, cold limbs, convulsions, opisthoton

os, coma, red tongue yellow coating, wiry rapid pulse

– Rx: Ling Jiao Gou Teng Tang

Open orifices and extinguish wind (Shen disorder) – cont’d

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• 7-4 Nourish Yin to extinguish Wind– Late stage of Wen Bing, yin damage leading t

o empty heat and deficient wind– Sx: Low degree fever, fever in five centers (fiv

e palm heat), red cheeks (malar flush), finger spasms, fatigue, dry deep red tongue, weak thin pulse

– Rx: Da Ding Feng Zhu

Open orifices and extinguish wind (Shen disorder) – cont’d

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• 8. Nourish Yin and promote fluid– Later stage of Wen Bing, yin damage

Nourish Yin and promote fluids – cont’d

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• 8-1 Nourish LU and ST– LU ST yin fluid damage– Sx: Dry throat, non-productive dry cough, nau

sea, poor appetite, red tongue without coating– Rx: Sha Shen Mai Men Dong Tang

Nourish Yin and promote fluids – cont’d

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• 8-2 Promote fluid to moisten Intestines– Later stage of Wen Bing, yin damage, dryness

in Intestines– Sx: Constipation, dry throat and mouth, dry re

d tongue– Rx: Zeng Ye Tang

Nourish Yin and promote fluids – cont’d

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• 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 pal

ms 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,

Nourish Yin and promote fluids – cont’d

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• 9. Rescue Prolapsed– Prolapsed/collapse of Yin or Yang

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• 9-1 Tonify qi and consolidate Yin– Qi and yin severe damage, prolapsed– Sx: Fever suddenly decreased, heavy sweatin

g, wheezing, fatigue, scattered large pulse, lack of tongue coating

– Rx: Sheng Mai San

Rescue prolapse/collapse of Yin/Yang – cont’d

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• 9-2 Rescue Prolapsed Yang– Yang qi sudden prolapsed– Sx: Cold limbs, heavy sweating, fatigue, pale f

ace, pale watery tongue, feeble pulse– Rx: Shen Fu Long Mu Tang

Modifications: • Shen Fu Tang• Mu Li• Long Gu

Rescue prolapse/collapse of Yin/Yang – cont’d

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• 10. External Methods– Bath– Emema– Liniment– Nasal Method