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Wen Bing 1

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General Introduction

• History of Wen Bing

• The well-known TCM doctor from Wen Bing school: Wu Youke, Ye Tianshi, Xue Shengbai, Wu Jutong, Wang Mengying

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• Features of Wen Bing – specific causes—— warm disease pathogenic

factors– infectious, epidemic, seasonal, regional– the development has phases.– common clinical manifestations

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• Classification of Wen Bing– According to dominating qi – According to season– According to onset features– According to infectious degree– According to syndrome features– According to disease loacation

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• Relationship between Wen Bing and Shang Han

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Causes

• Commonness

– Exogenous

– Heat feature

– Fast onset

– Related with seasons

– Different disease locations

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Onset

• Onset factors

– Body constitution factor

– Nature factor

– Society factor

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Infectious Route

• Air borne infection through respiratory ducts.

• Food borne infection through mouth• Contact infection through skin.

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Onset types

• Newly onset Wen Bing

• Hidden Wen Bing

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Differentiation Theories

• Wei-Qi-Ying-Xue differentiation

• San Jiao Differentiation

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Wei-Qi-Ying-Xue Differentiation

Warm disease pathogen invades body

Stimulates the body defensive function and a set of reactions occurs.

Physically damages related Zang-Fu organs and their functions

Ye Tianshi

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1.Wei Stage

•Main symptoms：　　 fever, slightly aversion to wind-cold, headache, no sweating or with little sweat, or with cough, slightly thirsty, thin white tongue coating, red tongue tip and edge, floating rapid pulse.

•Pathogenesis

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•Development– Mild pathogen with undamaged vital qi p

ush pathogen out. With correct treatment on time, the disease can be cured.

– Severe pathogen and weak vital qi, improper or delayed treatmentdirectly transmit to Ying stage or even to blood stage. Dangerous situation.

　　

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2. Qi Stage

Include half interior and half exterior paten

Widely covered the disease in L, St, Sp, intestines, GB, etc.

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• Formation route– Transmit from Wei Stage– Directly invade Qi stage– Hidden warm disease pathogen transmit out

wardly– Ying Stage Qi stage

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•Main symptoms– Excessive heat, no aversion to cold, heavy sweat

ing, thirst desire for cold water, concentrated urine, red tongue body with yellow coating, rapid, forceful pulse.

•Pathogenesis

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•Development– Severe pathogenic qi vs. strong vital qi, with acc

urate on time treatment cured– Vital qi is weaker than pathogenic qi, with impr

oper treatment developed into Ying, Blood stage, worsened.

– After the battle, both pathogenic qi, especially yin fluid, and vital qi reduced vital qi can be recovered after a period time of treatment cured

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3. Ying Stage

• Formation– The Qi stage pathogenic heat hasn’t been clear

ed, or damp-heat transformed into fire enters Ying Stage

– Wei stage Ying stage– Hidden warm disease pathogen– Directly invade Ying Stage

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•Main symptoms– Fever worsen at night, thirst but not desire for

drink, restlessness, insomnia, delirium , macula scattered, deep red tongue body, thin rapid pulse 　

•Pathogenesis

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•Development – Ying Stage Qi Stage– The heat pathogen approaches to Xue Stage

large area of macula, internal bleeding– Convulsion, coma

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4.Xue Stage (Blood stage )

•Formation

– Unsolved Ying stage heat Xue Stage

– Wei Stage, Qi Stage Xue Stage

– Hidden Warm diseas pathogen in Xue Stage direct

ly manifested as Xue Stage syndromes.

　　

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•Main symptoms– Fever with burning feeling on examiner ‘s

hand, restlessness, even in coma or mania, vomit blood, blood in stools, urine, large area covered by macula, crimson tongue

•Pathogenesis

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•Compare Xue Stage and Ying Stage

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•Development

– Accurate on time treatment hope of being cur

ed

– Death

– Unrecovery damage

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San Jiao Differentiation

　　Wu Jutong

•Upper Jiao syndromes: chest, L, Pc

•Middle Jiao syndromes: abdomen, St, SI, LI, S

p

•Lower Jiao syndromes: Lower abdomen, K, Li

v.

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•Upper Jiao syndromes

– Pathogenic factor attacks L

– Excessive heat in L

– Damp-heat in L

– Heat sink into PC

– Dampness covers PC

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•Middle Jiao syndromes

– Excessive Yangming syndrome

– Yangming heat and substantial turbid combinatio

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– Damp-heat obstruction in Middle Jiao

– Damp-heat and substantial turbid combination

– Dampness obstruct in LI

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•Lower Jiao syndromes

– K Essense consumption

– Deficient wind stirring internally　　

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Transmissions in Wen Bing

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　 Relationship between Wei-Qi-Ying-Xue Differentiati

on and San Jiao Differentiation.

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Diagnostics of Wen Bing

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• Fever , hot sensation

• Sweating

• Thirst

• Shen

• Convulsion

• Maculea (Bai Pei)

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Tongue Examination

• Dynamic Change of Tongue Phenomenon– Color of Tongue Coating – Thin or Thick of Tongue Coating – Dry or Moist Tongue Coating – Color of Tongue Body – Shallow or Lustrous of Tongue Body

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• Influence of Season on the Tongue

• The Differentiation of Stained Tongue

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• White Tongue Coating.– Thin white tongue coating without moisture, red

margin and tip of tongue.– Dry, thin and white coating– Thick, sticky greasy white coating– Dry thick white coating– Deep-Red tongue with white greasy coating– Accumulated powder like glossy and greasy, thick

white coating– Alkali like white coating– White sand like coating (Crystal coating) .– Glossy white coating

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• Yellow Tongue Coating – Thin yellow coating without dryness – Dry, thin yellow coating – Concurrent yellow coating and white coating.– More white than yellow Coating – Half yellow and half white coating – More yellow than white coating – Dry yellow coating – Deep-yellow coating – Deep-yellow coating without fluid – Pale tongue with deep-yellow coating – Turbid yellow coating – Yellow greasy coating – Thin greasy yellow coating – Thick greasy yellow coating – Suffusion greasy yellow coating – Pale tongue with greasy yellow coating – Dry thick yellow coating

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• Gray Tongue Coating – Dry, Gray Coating – Greasy, Gray Coating – Thin, Greasy, Gray Coating – Thick, Greasy, Gray Coating – Glossy, Gray Coating

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• Black Tongue Coating– Dry, Black Coating with Prickles– Dry, Black CoatingBlack Coating, like Obscure Bi

tuminous Coal – Dry, Black Coating, Pale Tongue Body

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• Red Tongue Body – Red tongue tip – Red tongue with red spot – Red and tender tongue without coating – Red tongue with greasy tongue coating

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• Deep Red Tongue Body – Deep luster and red tongue – Dry deep red tongue – Deep red tongue with whitish yellow tongue coating – Deep red tongue with greasy and turbid tongue coating – Deep red and moist tongue with greasy tongue coating – Deep red and lusterless tongue with greasy tongue coating

..– Deep red and dry tongue with greasy tongue coating – Deep red and mirror-like tongue – Dry, dull and flaccid, deep red tongue – Tongue with deep red and dry center – Deep red tongue