The pathogenesis of zang-fu organs is mainly due to the imbalance of function and temperament, which affects the parts where zang-fu organs live, the meridians along them and the organs where zang-fu organs live, resulting in symptoms of consciousness and paresthesia. These symptoms can be said to be the main focus of syndrome differentiation.
1, syndrome differentiation of lung disease:
The qi in the lung can calm the qi in the nose, which is mainly manifested in the respiratory system. The main symptoms are cough and asthma, as well as changes in phlegm, voice, chest, back, throat and nose. The lung controls the fur, communicates with the waterway, and is opposite to the large intestine. Therefore, when the lung is sick, fur, stool and urine often change accordingly. Because there is a difference between cold and heat, it has different characteristics.
1. 1 deficiency syndrome
1. 1. 1 qi deficiency:
Lung-qi deficiency is mainly manifested as frequent and weak expectoration (different from chest tightness and difficulty in expectoration when coughing due to exogenous wind-cold), frothy sputum, low breath when coughing, difficulty in continuous consciousness, excessive sweating and fear of wind, and slight climate fluctuation-especially when the climate turns cold, that is, cough and wheezing are aggravated, cold, sneezing, runny nose, pale face, mental fatigue, light or fat tongue, and little or thin white fur. The above symptoms can be seen in some stages of pulmonary insufficiency caused by some chronic lung diseases. Some old people shed tears for no reason, or have rectocele at the same time, or can't urinate, or even have secrets. These symptoms also belong to the category of qi deficiency. Qi deficiency is mainly based on invigorating qi, such as Buzhong Yiqi Decoction and Yupingfeng Powder.
1. 1.2 Yin deficiency:
The main manifestations of lung yin deficiency are dry cough, less sticky white sputum, or blood in sputum, shortness of breath, a little more speech, easy to turn dark, dry mouth and little drinking, constipation without abdominal distension, abdominal pain and other pains, emaciation, dull skin, red tongue, thin white or yellow tongue coating and dry pulse. The above symptoms are called lung dryness. For example, these symptoms can appear in the late stage of measles and sometimes in the late stage of respiratory inflammation. Treatment should benefit qi and promote fluid production, such as using Shengmai Powder.
Patients with active pulmonary tuberculosis (physical weakness) are often bored and feverish in the afternoon and evening, and even have hot flashes, night sweats, red cheekbones, chest tightness, hoarseness, expectoration as white as silver, bright tongue tip and rapid pulse at noon in the middle of the night. The above symptoms of tuberculosis also belong to the category of yin deficiency. Treatment should be nourishing, such as asparagus, Radix Rehmanniae Preparata, Rhizoma Bletillae and Colla Corii Asini. Diphtheria patients with dry throat, pain without swelling or gray-white false membrane also belong to the category of yin deficiency, and Ziyin Qingfei Decoction should be used for treatment.
1.2 Experience value:
1.2. 1 cold drink:
The main manifestations are cough, chest pain, thin and white sputum, wheezing in some pharynx, chest tightness, wheezing, and even chest tightness and cough. It is necessary to sit up, not easy to lie down, not thirsty, or like hot drinks, pale face, light or no major changes in tongue quality, white tongue coating and heavy pulse. Some people feel cold in the chest and back, or often feel cold in the back. The above symptoms can be seen in some types of bronchial asthma and bronchitis. Treat with warming lung and resolving phlegm, such as Shegan Mahuang decoction. If the pulse is floating, it is cold and hot, and the head and body are painful, which is caused by exogenous wind and cold. If there is more than exterior syndrome, it is mainly treated from exterior syndrome, such as Xiaoqinglong Decoction.
1.2.2 Hot phlegm:
The main manifestations are fever, cough, expectoration, thick or yellow sputum, or blood in sputum, or red throat, red complexion, red tongue, yellow thick or greasy tongue coating, and rapid pulse. The above symptoms are more common in acute respiratory inflammation, such as extensive infiltration of lung inflammation, which affects lung respiratory function and may be accompanied by chest height, shortness of breath, tangy nose, nasal sound and so on. It is advisable to clear away heat and resolve phlegm, such as Scutellaria baicalensis Georgi, Gypsum Fibrosum, Anemarrhena asphodeloides, Cortex Mori and Fructus Trichosanthis. If you have chills, slippery pulse, high cough and dull pain in your chest at first. Then you often cough up a lot of foul-smelling thick phlegm, which is the manifestation of lung abscess. It also belongs to the scope of heat phlegm. Don't mistake chills for exterior syndrome or cold syndrome. It is advisable to clear away heat and expel pus, such as Houttuynia cordata and Plough Grass, or Lugen Decoction (formerly Qianjin Weijing Decoction).
2. Syndrome differentiation of heart (with heart capsule) diseases:
Heart governs blood vessels and spirit. Heart disease is the main symptom of traditional Chinese medicine, such as heartache, heartbeat and unconsciousness. Its performance area is heart and blood. Its discrimination is also different from cold and heat. However, deficiency syndrome involves spleen and kidney. As for positivism, in feudal society, it is absurd to compare the heart to a "monarch" and the envelope of the heart to a "minister", saying that "the heart is a monarch, and righteousness is not affected by evil", so the disease and evil attack the heart (as follows, warm and adverse changes, turbid phlegm causing blindness, etc. ) all summed up as pericardium.
2. 1 deficiency syndrome:
2. 1. 1 blood deficiency (mostly spleen and stomach)
Consciously uneasy, easily frightened, unbearable fatigue, palpitation, asthma, hyperhidrosis during the day, fatigue and drowsiness at night, restless and sleepless, hungry and noisy, or noisy in the middle of the night, pale complexion, reddish and dark lips, thin tongue coating, thin or weak pulse, or knot instead. The above symptoms can be seen in patients with physical weakness, certain types of neurosis and some anemia after illness. It is a manifestation of deficiency of both heart and spleen. It is advisable to nourish the heart and spleen, such as Guipi Decoction.
Deficiency heat leads to anxiety, conscious palm fever, obscure or dry stool, dry mouth, emaciation, pale complexion, red lips and tongue, or red tongue tip, thin yellow fur and dry and thin pulse. It is advisable to nourish blood and clear heat, such as Rhizoma Coptidis and Colla Corii Asini.
2. 1.2 Yang deficiency (mostly kidney deficiency)
(1) Water vapor rushing to the heart: palpitation, oppressive feeling, cough, scanty phlegm, asthma, hyperhidrosis, dysuria, even edema, accompanied by cold back, cold limbs, drowsiness, conscious muscle and tendon jumping, feeling of falling due to vibration, pale face, pale lips and white tongue, and delayed or thin pulse. Because yang deficiency can't be warm and warm, water stops water and gas rushes to the heart, which is more common in heart failure in clinic. It is advisable to warm yang water, such as Zhenwu decoction.
(2) Stagnation of Yin-cold: Yang deficiency leads to internal cold, and cold pathogen blocks heart-yang, leading to stagnation of Yin-cold. Its symptoms are chest tightness and heartache, and even sudden and violent attacks of heartache radiate to the hands, shoulders and back, and the hands and feet are blue and cold until the knees and elbows. The above symptoms are similar to angina pectoris, and the treatment should be warm and smooth, such as Fructus Trichosanthis, Bulbus Allii Macrostemi and Ramulus Cinnamomi.
You have to breathe when you move. When you gasp, you open your mouth and lift your shoulders. If you can't lie flat, your throat will be full of phlegm and sweat. His face is gloomy, his lips are black, and his pulse is weak. If the pulse is weak and excessive, or the fingers are strung together (the pulse is too strong, which encourages the doctor's fingers), it is a sign of extreme danger. The above symptoms are similar to acute myocardial infarction, so it is advisable to restore yang to save the adverse, such as Shenfu decoction, and take other emergency measures.
(3) Lack of spirit: after a long illness, I am in a trance, my language is low and repetitive, and I am occasionally confused. I can find it immediately myself, and even laugh for no reason. This kind of deficiency is seen in the late stage of serious illness, which is a sign of yin-yang separation and critical illness. We should pay special attention to this situation.
2.2 empirical
2.2. 1 Wenxin (the so-called reverse pericardium in the past).
High fever, upset, even delirious, delirious, hands and feet make unconscious movements such as twisting clothes and touching the bed. It is more common in the severe stage of acute infectious diseases such as damp-heat (intestinal fever), Japanese encephalitis, meningitis and septicemia. Treatment should clear away heat and toxic materials, and be fragrant and enlightened, such as Zixuedan and Angong Niuhuang Pill.
Exogenous heat toxin is mostly caused by sores, redness, swelling and heat pain, such as sores on the mouth and tongue and red pain on the tip of the tongue. It is advisable to clear away heat and toxic materials, such as Coptidis Rhizoma, Gardenia Fructus, Forsythia Fructus and Plough Head.
2.2.2 Obstruction due to turbid phlegm (confused by phlegm)
Self-conscious depression, sticky phlegm in the throat, difficult to cough up, even dementia, language disorder, crying and laughing, but no violent movements, or sudden fainting, unconsciousness, irregular pulse and tongue, excessive wind phlegm, stringy pulse and slippery tongue coating. Some mental patients with the above symptoms are blinded by phlegm. Treatment should be phlegm, such as Acorus calamus, bamboo juice, alum and turmeric.
3. Syndrome differentiation of liver disease:
The liver governs the wind, and the wind moves wildly, which is manifested in the leader and tendons; Moreover, due to the dereliction of duty in blood storage and drainage, its symptoms mostly involve the intestine, stomach, spleen, kidney, flank, abdomen and fingernails. Although syndrome differentiation is also divided into deficiency and excess, many of them are mixed with deficiency and excess, so the outline is classified as partial deficiency and partial reality, which is slightly different from it.
3. 1 deviation
3. 1. 1 blood deficiency and qi stagnation
(1) stagnation of liver-qi: hypochondriac swelling or pain, belching and farting (ascending qi) make you feel a little relieved; Abdominal distension and pain in women are often accompanied by lower abdomen (abdomen), irregular menstruation, and some breasts swell during menstruation. These are common symptoms of blood deficiency and qi stagnation. It is advisable to nourish blood and soothe the liver, such as Xiaoyao San.
Deficiency heat: irritability in my heart, dreaminess in sleep, inability to eat when I am hungry and inability to drink when I am thirsty. Women's menstruation is dark red, or purple fascia, with a large amount, or a small amount, which is difficult to clean. The tip of the tongue is red, with little or white fur, or yellowish, and the pulse is thin and thin. It is advisable to nourish blood, soothe the liver and clear heat, such as Danzhi Xiaoyao Powder.
(2) Liver-qi invading the stomach: epigastric pain, loss of appetite, even nausea and acid regurgitation, poor stool, sallow complexion, emaciated expression, white tongue coating and thready pulse. The above symptoms can be seen in peptic ulcer and chronic gastritis. Treatment should soothe the liver and stomach. Such as Alpinia officinarum and Cyperus rotundus.
Deficiency and cold at the same time: headache or fainting due to upward countercurrent. Cold stomach pain, retching, foaming at the mouth, even cold hands and feet, pale face, pale tongue, less white fur, heavy and thin pulse, and late string. It is advisable to warm the liver and stomach, such as Wuzhuyu Decoction.
3. 1.2 yin deficiency and yang hyperactivity
Dizziness, dizziness, headache. Or headache, sometimes the muscles and veins of the whole body feel sore, even heavy head, unstable movements, numbness of the middle finger or forefinger, dry throat, constipation, red face and tongue, or chapped, thready pulse or two hard images. The above is the manifestation of liver wind moving internally, which is a symptom of hypertension. It is advisable to nourish yin and calm the wind, such as Concha Haliotidis, Polygonum Multiflori Radix, Radix Paeoniae Alba and Uncaria. If the wind blows hard, you will suddenly faint, be unconscious, be paralyzed, have a crooked mouth and eyes (a symptom of facial paralysis), and be paraplegic. The situation is critical. It is a symptom of cerebrovascular accident, commonly known as stroke. According to the situation at that time, judge whether it is partial or partial, and rescue it in time.
3.2 Part of reality
3.2. 1 Hot rod generates wind
High fever, dizziness, headache, stiff neck and acute vomiting. In severe cases, hand and foot convulsions, angular arch varus, tongue rolling and scrotal contraction (saccular contraction) soon appear; Some of them were in a coma because of the long-term heat, and their faces were red. What's more, due to peripheral circulation disorder, the higher the fever, the colder (deep heat) the hands and feet, the blue or red complexion, the red tongue with thick coating, or self-sliding, or yellow-black dry thickness, or even rapid shedding, bright red, swollen tongue body, or thin volume, strong pulse string number, or thin and hard.
The above symptoms are more common in febrile convulsions caused by acute infectious diseases. Because the child's brain development is not perfect, it is easy to happen, which is called convulsion. More common in epidemic meningitis, Japanese encephalitis and other diseases. Treatment should focus on calming wind and clearing heat, such as antelope hanging vine drink, snake gall, dried tangerine peel and concha Haliotidis combined with Qingwen Baidu drink.
3.2.2 Wind and fire prevention
Headache, dizziness, even burning on the top of the head, pain can not be approached, bitter taste, tinnitus. Taking the top as the common symptom of wind and fire escape. Or there is pus in the ear (otitis media), or nosebleeds, or eyes are red, swollen and painful. The forced landing may have dysentery (red dysentery), which is urgent and then severe, dozens of times a day, dry mouth, or muddy urine, burning pain, and women may have purple and Huang Zhi colors. It is suitable for purging liver and gallbladder wind and fire, such as Radix Gentianae purging liver, Radix Pulsatillae, Radix Angelicae Sinensis, etc.
3.2.3 Blood stasis (mostly involving spleen and kidney)
Jaundice often arises from blood stasis and heat. Blood stasis is often manifested as hypochondriac swelling, or the blue veins in the abdomen are exposed, with dull complexion, dark purple tongue, dry and thick fingernails, and heavy, hard or astringent pulse. The above are the symptoms of liver cirrhosis, and the treatment should be both soft and hard to break the blood, such as Rhizoma Sparganii, Rhizoma Curcumae and Carapax Trionycis.
Women with amenorrhea and fullness should be treated by removing blood stasis, such as soup.
The pathogenesis of zang-fu organs is mainly due to the imbalance of function and temperament, which affects the parts where zang-fu organs live, the meridians along them and the organs where zang-fu organs live, resulting in symptoms of consciousness and paresthesia. These symptoms can be said to be the main focus of syndrome differentiation. (Continued from Yao Hesheng's Syndrome Differentiation of Zang-fu Organs (1))
4, spleen disease syndrome differentiation:
Spleen lesions are mostly caused by transport or control dereliction, and the main symptoms are abnormal diet and defecation; Its appearance is mostly changes in abdomen, limbs, muscles and lips. The clinical manifestations of deficiency syndrome are deficiency of middle qi, inability to produce blood, cold and dampness. Qi deficiency and spleen-yin deficiency are rare; Damp-heat and turbidity are more common in the empirical study, and insect food accumulation is more common.
4. 1 deficiency syndrome
4. 1. 1 Insufficient gas:
Tired and sleepy, limb weakness, loss of appetite, soft stool or diarrhea; Because of qi deficiency, the abdomen consciously falls and swells, the wind and rain are difficult to smooth, and even the skin is swollen or dissipated, with less urine, pale complexion, emaciation, pale lips and pale tongue (the relationship between qi deficiency and blood production), thin and white tongue coating and weak pulse (similar to "soft" sound and meaning). The above-mentioned symptoms of weakness of spleen yang and dysfunction of transport and transformation can be seen in some stages of many chronic diseases. Treatment should be based on strengthening the spleen, such as Liujunzi Decoction.
Spleen deficiency can't absorb blood, bloody stool and bleeding gums. Women have metrorrhagia, metrorrhagia, dim color and thin quality. Some women also have dark red (not purple) blood clots, and some women have dark black spots on their skin and their faces are sallow. Some white eyeballs also have yellow eyes and weak pulse. The above symptoms can be seen in various clinical hematological diseases. Treatment should focus on strengthening the spleen, such as Huang Tu decoction, Zhenpi decoction, Guiqi Jianzhong, etc.
If spleen deficiency is accompanied by cold and dampness, the mouth is pale, and even the mouth vomits clear water, diarrhea in stool, or vomiting. If you have more colds, abdominal pain will continue, and you will like to press. Wet people have loose stools, unfavorable urination, abdominal distension and abdominal distension; Even the head, limbs and waist feel heavy, painful, cold and even edema, and some faces appear dark yellow; Those who are blocked by damp phlegm often feel dizzy (dizzy), want to vomit, and some can vomit phlegm and spit. White (cold) or yellow (wet) complexion, stagnant complexion, white or slippery tongue coating, stagnant or weak pulse. Treatment should be invigorating spleen, warming yang and eliminating dampness, such as Atractylodes macrocephala, dried ginger, Poria, and aconite. And Wei Ping powder, Astragalus membranaceus Wuwu, Astragalus membranaceus Ji Fang, Artemisia capillaris Wuwu, Tianma Banxia Baizhu decoction, etc.
4. 1.2 spleen yin deficiency
The stool will be dry when it is often secret, but there is no pain such as swelling, burning and abdominal pain. , the color is almost normal or slightly blue. Treatment is mainly based on moistening and guiding, such as centaur.
After a long illness, qi and blood are seriously injured, muscles are extremely emaciated, excess meat (leg and hip muscles) is completely removed, lips are turned back (lips are lifted up) or shortened, roots are exposed, tongue is pale, pulse is thin, or there is a feeling of astringency. The above symptoms are manifestations of cachexia caused by extreme weakness after a long illness, and should be actively treated according to different conditions of the disease.
4.2 Empirical research
4.2. 1 damp heat
The abdomen is full, the mouth is sticky, and some feel sweet; Don't drink too much when you are thirsty, or like hot drinks; Don't want to eat, some vomiting; Poor urination, dark yellow or turbid color; The stool is thick and sticky, or burning. Its color is yellow. The face is dark yellow and greasy; Red tongue with yellow coating and thick turbidity; Number of soft pulses. The above are common symptoms of spleen damp-heat, which are more common in dysentery and hepatobiliary diseases. It is advisable to clear away heat and promote diuresis, such as wormwood, gardenia and phellodendron bark.
Stagnation and turbidity: some have persistent cold and heat, others often have cold and heat, hypochondriac fullness, abdominal distension, dark yellow complexion and rapid pulse. The above symptoms of hepatosplenomegaly can be seen in the late stage of malaria (the mass is called malaria mother), schistosomiasis and hepatitis. Treatment should be clearing away heat and promoting diuresis, removing blood stasis and turbidity, such as Paeonia Rubra and Carapax Trionycis.
Insect food accumulation
(1) Worm knot: The abdomen often swells and aches, and it fluctuates up and down. When the pain stops, the lump expands and the pain subsides. The stool is often loose, sometimes it has dark knots, or it is common to have worms. Normal diet is poor, but I often want to eat snacks and sweets. Itching nose, erosion of mouth, red tongue with white or yellow coating, and red spots on the tongue surface (the spots are flat, which is different from stinging). These are the symptoms of ascariasis, so it is advisable to use anthelmintics, such as neem root bark and gentleman, and western medicine anthelmintics.
(2) food accumulation: those with prominent large veins in the abdomen have emaciated limbs, yellow hair and wrinkles; Or the gums are bleeding and smelly (sloppy); The face is white and red, even the face is brown and thin; The tongue coating spots are strip patterns; Most fingerprints are stagnant and the pulse number is thin. These are the symptoms of malnutrition. It is advisable to strengthen the spleen and promote digestion, such as using calcined rock, picrorhiza rhizome, endothelium corneum gigeriae galli, five-grain worms, ginseng, surgery, poria cocos and grass. Horse malnutrition can be treated with arsenic and red dates.
(3) If the abdomen is swollen, the skin is yellow and swollen, the eyes are not yellow, the lips are pale and the normal diet is poor, but eating raw rice, soil and charcoal is also a symbol of insects and water. These are the symptoms of hookworm disease, such as needle sand and dried alum.
5. Nephropathy syndrome differentiation:
Kidney is dirty water, governing five fluids and storing essence; Renal lesions are mainly due to the changes of body fluid and essence, and their manifestations are mostly in the waist, knees, lower abdomen, bones, brain, pupils and other parts. Nephropathy can be divided into yang deficiency and yin deficiency, and there are also syndromes of insufficient essence, that is, yin and yang deficiency. Chinese medicine believes that the kidney is located in the deepest part of the five internal organs, and the disease is very serious when it goes deep into the kidney, so there is a saying that the kidney is the root of yin and yang. Deficiency syndrome of nephropathy is more common than other dirty diseases, so it is generally considered that there is no evidence of nephropathy. In fact, although there are few cases of kidney disease, it is not absolute. At the same time, the deficiency syndrome of kidney disease often contains some empirical evidence.
5. 1 deficiency syndrome
5. 1. 1 yang deficiency
Frequent colds (cold skin, different from exogenous chills and body heat), cold limbs, or cold back, waist, knees and lower abdomen. Spontaneous cold sweat (including cold sweat during sleep), unobstructed urination, or nocturia, loose stools, dull complexion, pale lips and tongue, and weak or weak pulse. The above symptoms are manifestations of internal cold caused by spleen and kidney yang deficiency, which can be seen in some stages of chronic diseases (such as chronic enteritis, intestinal tuberculosis, dyspepsia, etc.). ), and the treatment should be warming and tonifying kidney yang, such as aconite, dried ginger and licorice. What's more, it's true that you want to get close to clothes when it's hot. You have to cure aconite and dried ginger. Or drink one or two cups to quench your thirst (the total amount of urine is more than the water you drink in a day), which is diabetes insipidus. It should be treated by warming and tonifying methods, such as Guipi Pill. Or diarrhea at dawn, the treatment should be warm and firm, such as Shen Si Pill.
Cold and dampness can cause numbness or severe pain in the waist and knees; At the same time, the water was stopped, and my face and feet were swollen. Small abdominal distension is full, and both of them often have trouble urinating.
5. 1.2 Yin deficiency
Muscle emaciation, conscious hand, foot and heart fever, and frequent facial shine; Dry throat and dry mouth, don't drink too much, and drinking water can't relieve it. Dizziness and headache, small tinnitus (different from wind and fire), dry eyes, unfavorable frequency of urination, and sometimes conscious burning; The stool is often secret, the waist and feet are sore, the face is thin and red, and the tongue is thin and red with little moss; The pulse is thin, heavy, weak or multi-chord. The above symptoms are common in chronic wasting diseases. It is advisable to nourish yin and clear heat, such as Baizhi Bawei Pill. What's more, the bone is steaming and burning (it feels bitter in the bone when you have a fever), and the lack of fire often leads to hematuria, or the body is cold and you don't want to get close to clothes. This is true heat and false cold.
5. 1.3 deficit
Brain empty pain or conscious abdominal distension, brain ringing, dizziness and forgetfulness; The feet are swollen and thin, and the action is weak; Even the bones are weak and can't climb up; Heat is yin deficiency, and cold is yang deficiency. The above symptoms are all bone flaccidity in the late stage of illness, and the treatment should be to replenish essence and marrow, such as turtle deer glue.
Congenital dysplasia in children, the fontanel is still wide over one year old, the skull is not straight, and five latent symptoms (sitting late, walking late, teething late, talking late, and getting dense late) belong to the range of insufficient essence. The treatment can be tortoise-deer glue and calcium tablets.
5.2 Empirical research
Nephrotic syndrome is rare, but it does exist. For example, some patients refuse to press the waist (different from those who like to press or hit the waist because of deficiency syndrome), the number of urination is unfavorable, the urine color is dark yellow or turbid, and the urethra has a burning sensation when urinating; The pulse is heavy and fine. The above symptoms are nephrotic syndrome, which can be seen in a certain stage such as pyelonephritis and can be treated by different drinks. Another example is the phenomenon of virtual and real inclusion.
6. Syndrome differentiation of gallbladder disease:
Bile belongs to liver, so the pathological changes of gallbladder and fu organs are closely related to the pathological changes of liver, and many symptoms are difficult to distinguish. But it also has its own characteristics, such as hypochondriac pain, many liver diseases are connected with the lower abdomen, and gallbladder diseases are only under the right costal margin. Generally speaking, liver diseases are mostly deficiency, and gallbladder diseases are mostly excess, which is roughly the same as other viscera.
6. 1 Empirical study
6. 1. 1 fire king
Bitter mouth, dry throat, dizziness and tinnitus (loud voice) can be treated with Qin Huang Decoction. Even deafness, red eyes; Hot in the heart, irritable; The head swells and the face is red, and the night is uneasy; Headaches are mostly on both sides, sometimes reaching the top of the head (shaoyang and Jueyin meridians are exterior-interior relations), and they are hot and refuse to press; Or behind the ear, swelling and pain in the ear, pus in the ear; Or there is often a yellow and smelly snot in the nose; The face is red, the lips are red, the tongue is red, the tongue coating is yellow and thick, and the pulse string is strong. The above symptoms of liver and gallbladder fire are similar to hypertension and headache, as well as inflammation of the five senses. It is advisable to treat bitter cold and reduce fire, such as Gan Long Xiegan Decoction.
6. 1.2 stagnation of heat
(1) Heat is cold and depressed, which often leads to pain in the chest, hypochondrium and upper abdomen, upset and vomiting, or acid and bitter vomiting, even yellowish green and bitter taste; Poor stool, or knot, or secret; Noisy and hungry and can't eat any more; When it hurts, it is hot, sweaty, cold and annoying; The tip of the tongue is red with white or yellowish fur; Pulse train. Treatment should be bitter, such as Wendan decoction; Xiaochaihu decoction is used to treat cold and heat; It's hard to feel full in the stomach.
(2) Damp-heat stagnation, jaundice, unfavorable urination, yellow turbidity and burning; The pain in the middle of the cup is unbearable to the right, and the pain is too full to press. Pain often recurs, sometimes accompanied by cold and fever, yellow and stagnant complexion, like being covered with dust, sometimes blue, red or dark lips and tongue, yellow and greasy fur, heavy and heavy pulse, and some of them feel pain. The above symptoms can appear when the biliary tract is inflamed, and it is appropriate to treat bitter cold and heat, such as Chen Yin, Gardenia, Scutellaria baicalensis, Cortex Phellodendri and Longdan Xiegan Decoction.
Even when it hurts, you sweat, your hands and feet are cold, or you faint. The above symptoms are more common in biliary ascariasis, which is called ascariasis. Can be cured with ebony, coptis root and Sichuan pepper.
6.2 deficiency syndrome
Although gallbladder disease has deficiency syndrome, such as insufficient bile, it has little clinical significance and is omitted here.
7, stomach disease syndrome differentiation
There are many pathological changes in the stomach, which are often difficult to be separated from the spleen, large intestine and small intestine. But spleen disease is more deficiency and stomach disease is more solid; Splenic abdominal pain (abdominal pain), epigastric pain (epigastric pain); Dysuria is the main symptom in the spleen, large intestine and small intestine, and thirst and vomiting are the main symptoms in the stomach.
7. 1 empirical study
7. 1. 1 hot and dry
(1) High fever, sweating and thirst lead to drinking (drinking plenty of water), while drinking is cold (drinking cold water); Disturbed, unable to sleep with eyes open (eyes often open); What's more, people are unconscious (nonsense), and their hands and feet are cold (the distal ends of their hands and feet are cold). The face is red, the lips and tongue are red, and the coating is thick or yellow or white; Pulse flood is large, or slippery number is strong. When all kinds of fever have the above symptoms, drugs such as Baihu Decoction or Liangge Powder can be used to clear away heat.
(2) If body fluid is injured at the same time, the mouth is dry, the tongue coating is thick and even falling off, and the pulse is weak, and the pulse is heavy and suffocating (the pulse is large, but it is empty when pressed to/at 0, much like touching the onion tube). The dehydration symptoms caused by the above fever should be mainly based on benefiting qi and promoting fluid production, and can be treated with Baihu Decoction plus ginseng soup or Zengye Decoction.
If you have a fever, sweating is not prominent, but it can quench your thirst (drinking a lot of water still can't quench your thirst) and eliminate hunger (eating a lot still can't stop hunger). At the same time, dark yellow urine, constipation, rapid muscle wasting and rapid pulse can occur, which are the symptoms of excluding diabetes. Diabetes can be seen in the above symptoms, and the treatment should be clearing away heat, moistening dryness and nourishing yin, such as Anemarrhena asphodeloides, gypsum, Polygonatum odoratum and Radix Rehmanniae.
7. 1.2 Damp heat
At first, the wet temperature and fever do not go away, especially in the afternoon, or the body warms up cold, sweating, nausea, loose stool discomfort, dark yellow color, or no loose stool, dark yellow urine is unfavorable; I can eat a little without feeling hungry. Longing for hot drinks, or catching a cold but unable to drink more, ignorance (dull and vague phenomenon), drowsy but actually not asleep; After the initial pulse, the pulse is white or yellow. The above symptoms are the manifestations of dampness and temperature from the outside to the inside. It is suitable for treating bitter cold and clearing heat, and is suitable for Pogostemon cablin, Eupatorium odoratum, Radix Curcumae, Rhizoma Phragmitis, Coicis Semen, talc, etc. Heavy ones such as wormwood, gardenia, rhubarb (wormwood soup) and so on.
Some people don't necessarily have a fever, but they often have recurrent epigastric pain, or feel hot in the upper abdominal cavity and want to eat a cold diet. Rot, acid swallowing (belching has a strange smell, acid regurgitation to the pharynx, which must be swallowed back), yellow and turbid vomiting. All the above are symptoms of stomach heat stagnation, which should be treated with bitter drugs, such as Gardenia and Magnolia officinalis.
Blood-related diseases include gingival swelling and pain, erosive bleeding, halitosis, and even vomiting blood; Some have dark yellow faces, red tongues and thick greasy fur; The pulse is even slippery. Or rash, such as Rhinoceros Horn Dihuang Decoction, Mylabris Decoction, etc.
7. 1.3 freezing
This syndrome may be caused by overeating, catching a cold and being sticky. , blocking the upper abdominal cavity, causing sudden swelling and pain in the chest, or stopping cold and dampness by gastrin, and the diet can not be digested well, causing frequent swelling and pain in the upper abdominal cavity. My mouth is white, I don't want to eat, and my stomach swells after dinner or in the afternoon. I like to eat spicy food. If I eat cold food, I immediately feel stuffy pain, vomiting, phlegm and water with food residue. Some have yellow complexion, white and thick tongue coating, and some have a thready pulse. Treating bitter and warm, such as Xiangsha Wei Ping Powder and Baohe Pill.
7.2 Deficiency syndrome
7.2. 1 Insufficient body fluid
Often dry throat, dry mouth, and don't drink much when you want to drink cold drinks; Noisy and hungry, but can't eat more, the food is more like light; Sometimes I have a stomachache, but it is not sour; The above is the performance of insufficient body fluid; Sometimes hiccups are repeated and loud. What's more, constipation is particularly severe, and I have to vomit immediately every time I eat. Thin body, white face, red tongue, thin fur, white or yellow, dry. What's more, the center is hairless, the pulse is weak, and even the strings are thin. The above are the manifestations of stomach yin deficiency, and the treatment should be nourishing stomach yin, such as Polygonatum odoratum, Ophiopogon japonicus and Dendrobium nobile. Choke diaphragm (pyloric spasm), also can use zengye decoction.
7.2.2 Qi deficiency ascending and descending
The cup is stuffy and soft (some are as hard as a thin plate) and does not hurt; Dry food stinks (smells like food) and does not cause acid regurgitation and vomiting; Some people often burp, and their voices are not high. Pale and emaciated, with almost unchanged tongue color and weak pulse. Treatment should reduce adverse qi, such as Inula, rather than ochre soup. Deficiency and cold can cause dull pain in the upper abdomen, which is intermittent and unbearable. Some people feel cold and hot in the upper abdomen, while others feel cold when they spit. What's more, vomiting at dusk (vomiting in the evening after eating in the morning and vomiting in the morning after eating in the evening), after eating, the face is pale, the lips are pale, and the pulse is weak. The above are the symptoms of pyloric obstruction, and the treatment should be warming the middle warmer and regulating qi, such as using Dingkou Lizhong decoction.
8. Syndrome Differentiation of Colorectal Diseases
The function of the large intestine is mainly to conduct dregs, so its main symptom is irregular stool. However, the mechanism of defecation disorder involves a wide range, which does not exclude the responsibility of the large intestine and a viscera. At present, only the main contradiction is the large intestine, and the rest are divided into various zang-fu organs, so it is not appropriate to repeat them.
8. 1 Empirical study
8. 1. 1 dry knot
It is constipation caused by dryness and heat. The main manifestations are constipation, difficulty in dry stool, and more importantly, abdominal distension and pain, and even a fecal lump when touched, which makes you feel a little bloated and painful, and you don't like to press it, and your fart (breath) stinks. Urine is unobstructed, yellow in color, crimson in lips and tongue, brown in moss, and deep and powerful in pulse. Some patients have hot flashes and talk nonsense loudly. Although a few patients have yellow and smelly diarrhea, they have the above symptoms and still belong to the scope of dryness syndrome. Treat bitter cold diarrhea, such as rhubarb, mirabilite and other drugs.
8. 1.2 Damp heat
More common in acute enteritis and dysentery. Generally, loose stool (porridge-like stool with yellow mucus) is uncomfortable (sticky when defecating), or before loose stool, the stool is hard, or loose, and the color is dark yellow, which is not good for dark yellow urine (small amount and few times), or both stools have burning sensation, abdominal distension and tightness, or pain. If you enter the blood at the same time, there will be pus and blood mixed in it, which is urgent and heavy. The fur is yellow and greasy or white and dry, and the pulse is wet or excessive. Clinically, bitter and cold medicines such as Scutellaria baicalensis Georgi and Coptidis Rhizoma, and sweet and flat medicines such as Coix seed and talc can be used to clear away heat and promote diuresis.
In addition, there is blood before defecation, and its color is bright red, close to blood; Some anus is swollen and painful, the affected part is bleeding, or bleeding is like an arrow, or anal pruritus is erosive, and the blood is sticky. The above symptoms can be seen in diseases such as hemorrhoids and anal fissure. It also belongs to the hot and humid range.
8. 1.3 freezing
Abdominal pain, bowel sounds and diarrhea are sour, and the pain is easily relieved, and then the pain is relieved and I don't want to eat. Some diarrhea is not very serious, but it lingers and it is not easy to have diarrhea. Abdominal distension, yellow complexion, thick white tongue coating and delayed pulse. The above symptoms can be seen in indigestion caused by food injury, which is treated with Baohe Pill.
8.2 Deficiency syndrome
(1) Body fluids were not recovered.
After a long period of fever or diarrhea, all the symptoms disappear, and the diet and sleep are close to ordinary people. But the stool is difficult to understand or dry, and there is no pain in the abdomen. This is because the body fluid in the intestine has not returned to fashion, and it can heal itself after a few days of diet conditioning.
(2) Qi deficiency subsidence
Chronic dysentery with purulent blood is thin and dull, or suffocating, or difficult to recover from rectocele, or accompanied by abdominal pain. Even the cold sweat came out, my hands and feet were cold; The face is white, the lips are dark and the tongue is dark, the fur is white and moist, and the pulse is weak or thin, so the method of warming and nourishing should be used.
This article is selected from Yao Hesheng's Syndrome Differentiation of Zang-fu Organs.