北京中医药大学：《中医诊断学》课程教学资源（课件讲稿）Eight Principle Syndrome Differentiation

6 Eight Principle Syndrome Differentiation Introduction Basic syndromes > Relationship among the eight principle syndromes 2016/11/5 Tianfangwang BUCM

6 Eight Principle Syndrome Differentiation  Introduction  Basic syndromes  Relationship among the eight principle syndromes 2016/11/5 Tianfangwang BUCM 1

6.2 Relationship among the eight principle syndromes Relationship Concurrent Complexity Mutual True or false syndrome of syndrome transformation syndrome (相兼) 错杂) ( (转化) (真假)？？ Two types of combined syndrome 2016/11/5 Tianfang Wang BUCM 2

6.2 Relationship among the eight principle syndromes Relationship Complexity of syndrome （错杂） Mutual transformation （转化） Concurrent syndrome （相兼） True or false syndrome （真假）?? Tianfang Wang BUCM 2 Two types of combined syndrome 2016/11/5

6.2.1 Concurrent syndrome √In a broad Exterior excess-cold sense,it refers Exterior excess-heat to different syndromes Interior excess-heat coexist According to√ together. the definition Interior excess-cold √In a narrow sense,there are no Interior deficiency-cold opposite syndromes Interior deficiency-heat Manifestations? 2016/11/5 Tianfang Wang BUCM 3

6.2.1 Concurrent syndrome 3  In a broad sense, it refers to different syndromes coexist together. In a narrow sense, there are no opposite syndromes According to the definition Exterior excess-cold Exterior excess-heat Interior deficiency-cold Interior deficiency-heat Interior excess-cold Interior excess-heat Tianfang Wang BUCM Manifestations？ 2016/11/5

Usually,the clinical manifestations of concurrent syndromes are the superposition of many relevant syndromes. For example: exterior Exterior cold syndrome cold exterior Exterior heat syndrome heat 2016/11/5 Tianfang Wang BUCM

Usually, the clinical manifestations of concurrent syndromes are the superposition of many relevant syndromes. For example： Exterior cold syndrome Exterior heat syndrome cold exterior heat exterior Tianfang Wang BUCM 4 2016/11/5

Does an exterior deficiency syndrome exist according to the meaning of Xu and Shi 2016/11/5 Tianfangwang BUCM 5

Does an exterior deficiency syndrome exist according to the meaning of Xu and Shi ? 2016/11/5 Tianfangwang BUCM 5

Two conditions are called exterior deficiency syndrome habitually. Exterior Syndrome of Wind-Cold (Attack of Wind)----Guizhi Decoction On the exterior but not Xu. Compare to Exterior Syndrome of Wind-Cold (Attack of Cold)----Mahuang Decoction Qi deficiency of lung and spleen. ----Yupingfeng Powder Xu but not on the exterior. 2016/11/5 Tianfang Wang BUCM 6

Two conditions are called exterior deficiency syndrome habitually. • Exterior Syndrome of Wind-Cold （Attack of Wind）----Guizhi Decoction On the exterior but not Xu. Compare to Exterior Syndrome of Wind- Cold (Attack of Cold)----Mahuang Decoction • Qi deficiency of lung and spleen. ----Yupingfeng Powder Xu but not on the exterior. 2016/11/5 Tianfang Wang BUCM 6

6.2.2 Complexity of syndromes It refers to the emergence of two opposite syndromes at a certain stage of a disease. Dual Exterior-Interior syndrome Combined Exterior and Interior syndromes Interlocking of Cold-Heat Syndrome Combined Cold and Heat syndromes Interlocking of Deficiency-Excess Syndrome Combined Deficiency and Excess syndromes 2016/11/5 Tianfang Wang BUCM 7

6.2.2 Complexity of syndromes It refers to the emergence of two opposite syndromes at a certain stage of a disease.  Dual Exterior-Interior syndrome Combined Exterior and Interior syndromes  Interlocking of Cold-Heat Syndrome Combined Cold and Heat syndromes  Interlocking of Deficiency-Excess Syndrome Combined Deficiency and Excess syndromes 2016/11/5 Tianfang Wang BUCM 7

6.2.2.1 Combined exterior and interior syndrome It refers to appearance of both the exterior and interior syndromes in the same patient. 201611/5 Tianfang Wang BUCM 8

8 It refers to appearance of both the exterior and interior syndromes in the same patient. 6.2.2.1 Combined exterior and interior syndrome 2016/11/5 Tianfang Wang BUCM 8

6.2.2.1 Combined exterior and interior syndrome Both exterior and interior at initial stage Exterior-interior cold Exterior-interior heat An unrelieved exterior Exterior cold and interior heat syndrome transmitting into the interior Exterior heat and interior cold Patients with unhealed Exterior-interior excess internal injury are Exterior excess and interior attacked by exogenous pathogenic factors deficiency Both exterior and interior 2016/11/5 are affected Tianfang Wang BUCM

9 6.2.2.1 Combined exterior and interior syndrome Tianfang Wang BUCM Both exterior and interior at initial stage An unrelieved exterior syndrome transmitting into the interior Patients with unhealed internal injury are attacked by exogenous pathogenic factors Both exterior and interior are affected Exterior-interior cold Exterior-interior heat Exterior cold and interior heat Exterior heat and interior cold Exterior-interior excess Exterior excess and interior deficiency 2016/11/5

severe aversion to cold,mild Exterior-interior fever,headache,pain over the cold body,clear nasal discharge gastric and abdominal cold pain, loose stools floating and tight pulse or slow pulse. high fever,mild aversion to cold. Exterior-interior heat painful throat, cough,panting,constipation, yellow urine,red tongue with yellow coating, floating and rapid pulse or rapid pulse. 2016/11/5 Tianfang Wang BUCM 10

Exterior-interior cold • severe aversion to cold, mild fever, headache, pain over the body, clear nasal discharge • gastric and abdominal cold pain, loose stools • floating and tight pulse or slow pulse. Exterior-interior heat • high fever, mild aversion to cold, painful throat, • cough, panting, constipation, yellow urine, red tongue with yellow coating, • floating and rapid pulse or rapid pulse. Tianfang Wang BUCM 10 2016/11/5