Golden Chamber 4

1. Golden Chamber 4 Violet Song

2. Chapter 9 On Pulse Syndrome Complex and Treatment of Chest Obstruction, heart Pain and Shortness of Breath

3. ChestBi pain obstruction • Heart Pain • Shortness of Breath

4. Xiong Bi • Chest Bi Syndrome, Chest Obstruction • Concept: a kind of disease manifested as fullness, distention, oppressed in chest, possibly with pain.

5. Cause and pathogenesis • Feeble yang pulse, Wiry yin pulse: upper jiao yang deficiency with excessive yin coldyin pathogen occupies yang position and obstructed chest yang【1】 • Pulse • Cun pulse (Yang position) weak  upper JiaoYang deficiency • Chi pulse (Yin position)  wiry Yin cold evils and fluid retention • Ben deficiency with Biao excess • 【1】 • 【2】 • No exterior syndrome • difficult breathing

6. Chief symptoms: panting, coughing, spitting, shortness of breath【3】 • Chief pulse: deep slow of Cun Kou pulse, tight rapid in Guan Shang【3】

7. Differentiation and treatment • Typical pattern • Panting, cough, chest pain radiating to the shoulder, difficult breathing • deep and slow pulse at Cun upper JiaoYang deficiency • tense pulse at Guan Yin cold excess and fluid retain in the middle Jiao • Gua lou xie bai bai jiu tang 栝蔞薤白白酒汤 (disperse obstruction, dredge yang, eliminate phlegm, descend qi ) 【3】 • 栝蔞gua lou (Fructus Trichosanthis) • 薤白xie bai (Bulbus Allii) • Wine/liquor

8. Differentiation and treatment • Phlegm & turbid excess pattern • chest pain radiated to the back • can not lie down • 栝蔞薤白半夏汤gua lou xie bai ban xia tang(disperse obstruction, dredge yang, eliminate phlegm retention, descend qi ) 【4】 • 栝蔞gua lou (Fructus Trichosanthis) • 薤白xie bai (Bulbus Allii) • 半夏ban xia (Rhizoma Pinelliae Ternatae) • Wine

9. Differentiation and treatment • Qi obstruction in chest • Excessive type • Fullness in the chest, hypochondria distention • zhi shi xie bai gui zhi tang 枳实薤白桂枝汤 ( disperse obstruction, dredge yang, dissolve fullness, descend qi) 【5】 • 枳实zhi shi (Fructus Immaturus Aurantii) • 厚朴hou po (Cortex Magnoliae Officinalis) • 薤白xie bai (Bulbus Allii) • 栝蔞gua lou (Fructus Trichosanthis) • 桂枝gui zhi (Ramulus Cinnamomi Cassiae)

10. Differentiation and treatment • Qi obstruction in chest • Deficient type • 人参汤renshen tang(tonify middle jiao, strengthen yang) 【5】 • Regulate the Middle jiao pill 理中丸li zhong wan • 人参renshen (Radix Ginseng) • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 干姜ganjiang (Rhizoma Zingiberis Officinalis) • 白术bai zhu (Rhizoma Atractylodis Macrocephalae)

11. Differentiation and treatment • Mild pattern • Water retention>Qi stagnation • fu ling xing ren gan cao tang茯苓杏仁甘草汤 (disperse Lung, resolve water retention) 【6】 • 茯苓fu ling (Sclerotium Poriae Cocos) • 杏仁xing ren (Semen Pruni Armeniacae)Regulates qi of the chest • 甘草gan cao (Radix Glycyrrhizae Uralensis)Regulates formula

12. Differentiation and treatment • Mild pattern • Water retention<Qi stagnation w/slight damp accum • ju zhi jiang tang橘枳姜汤 (move qi, resolve water retention, ) 【6】 • 陈皮chen pi (Pericarpium Citri Reticulatae)move qi, resolve phlegm • 枳实zhi shi (Fructus Immaturus Aurantii)break qi stagnation • 生姜sheng jiang (Rhizoma Zingiberis Officinalis Recens) harmonize formula

13. Differentiation and treatment • Acute pattern • Yi yi fu zisan薏苡附子散(warm & dredge yang to stop pain, eliminate dampness to disperse Bi syndrome) 【7】 • 薏苡仁yi yi ren (Semen Coicis Lachryma-jobi)eliminate damp, but also disperses bi syndrome. Not a common function. • 附子fu zi (Radix Lateralis Aconiti Carmichaeli Praeparata) pao fu zi – stops pain. Common to use for acute angina.

14. Xin Tong • Heart Pain?No, refers to epigastrium area. • Concept: a type of disease with chief symptom of pain in the area below the Heart (epigastria). • Cause and pathogenesis: Feeble yang pulse, Wiry yin pulse

15. Differentiation and treatment • Adversely upward qi flowing due to cold & water retention coagulation • Epi/Heart pain  fluid retention • gui zhi sheng jiang zhi shi tang桂枝生姜枳实汤 (Warm & dissolve water retention, descend adversely upward flow qi) 【8】 • 桂枝gui zhi (Ramulus Cinnamomi Cassiae) • 生姜sheng jiang (Rhizoma Zingiberis Officinalis Recens) • 枳实zhi shi (Fructus Immaturus Aurantii)opens blockage

16. Differentiation and treatment • Cold coagulation • Severe pain from heart to chest, from chest to heart • wu tou chi shi zhi wan乌头赤石脂丸 (warm yang, disperse cold, eliminate yin pathogen) 【9】 • 川椒chuan jiao (Pericarpium Zanthoxyli Bungeani) • 乌头wu tou (Radix Aconiti)very strong to treat pain, esp due to cold. • 附子fu zi (Radix Lateralis Aconiti Carmichaeli Praeparata) • 干姜ganjiang (Rhizoma Zingiberis Officinalis) • 赤石脂chi shi zhi (Halloysitum Rubrum)

17. Chapter 13 On Pulse Syndrome Complex and Treatment of Xiaoke (Diabetes), Dysuria and urinary disturbance.

18. Xiao Ke • Wasting thirst, Consumptive thirst, Diabetes. • Concept: a type of diseases manifested as drink too much, eat too much, too much urine and thin body form.

19. Classification: Upper Xiao, Middle Xiao, Lower Xiao • Upper Jiao thirsty  lung • Middle Jiao hungry  stomach • Lower Jiao diuresis  kidney

20. Causes and pathogenesis 【2】 • Ying and Yin deficiency with interior heat • Cun kou pulse  upper Jiao lung & heart • Lung Wei Qi • Heart Ying and blood • Floating  deficient Yang up floating • Slow  insufficient t Ying and blood • FuYang pulse 趺阳脉 Jiexi (St 41 解溪) area  Stomach • Floating  stomach Qi • Rapid  hyperactive of stomach heat • Symptom • Frequent urine • Constipation

21. Differentiation and Treatment • Upper Xiao 【12】 • heat evil impair body fluid  thirsty • thirst • dry mouth • 白虎加人参汤 bai hu jia ren shen tang • 石膏shi gao (Gypsum) • 知母zhi mu (Radix Anemarrhenae Asphodeloidis) • 粳米jing mi (Nonglutinous Rice) • 甘草gan cao (Radix Glycyrrhizae Uralensis) • 人参renshen (Radix Ginseng)

22. Differentiation and Treatment • Middle Xiao【8】 • pathogenesis for xiao ke  stomach heat • FuYang pulse Jiexi (St 41 解溪)  rapid  stomach heat • Over ate • Constipation • frequent urine

23. Differentiation and Treatment • Lower Xiao【3】 • Symptom and treatment for kidney Yang deficiency xiao ke消渴disease  Lower Jiao diuresis多尿 • Thirsty • More urine • Kidney Qi Pill from the Golden Cabinet 金匮肾气丸jin Gui shen qi wan 【3】 • 熟地黄shu di huang (Radix Rehmanniae Glutinosae Conquitae) • 山药shan yao (Radix Dioscoreae Oppositae) • 山茱萸shan zhu yu (Fructus Corni Officinalis) • 泽泻ze xie (Rhizoma Alismatis Orientalis) • 茯苓fu ling (Sclerotium Poriae Cocos) • 牡丹皮mu dan pi (Cortex Moutan Radicis) • 桂枝gui zhi (Ramulus Cinnamomi Cassiae) • 附子fu zi (Radix Lateralis Aconiti Carmichaeli Praeparata)

24. Lin Disease • Lin Syndrome • Concept: a kind of disease manifested as drops of urine, urine pain, even stabbing pain.

25. Lin Disease • Classification: Shi Lin (Stone), Xue Lin (Bleeding), Re Lin (Heat), Gao Lin (Cloudy), Lao Lin (Overstrain) • Shi lin 石淋stone lin • Xue lin 血淋blood lin • Gao lin 膏淋cloudy lin • Qi lin 气淋 • when fatigue  deficiency syndrome • when stress  excess syndrome • Lao lin 劳淋on exertion

26. Main symptoms of Stone Lin 【7】 • symptom of stone lin  • painful urine • radiate to lower abdomen • Cautions: should not promote sweating 【9】 • Urinary Disturbance disease 淋家kidney deficiency with bladder damp heat Yin fluid deficiency  contraindicated for sweating  bloody Lin . • no sweating  bloody urine

27. Urinary Disturbance • Concept: a kin of disease manifested as difficulty in urinary, drops or little urine, without pain. • symptom of many diseases

28. Urinary Disturbance • Differentiation and Treatment • Lower cold with upper dryness • treatment for kidney Qi deficiency  difficult urine with thirsty • difficult urine • thirst • 栝蔞瞿麦丸 wua lou qu mai wan【10】 • 天花粉tian hua fen (Radix Trichosanthis Kirilowii) • 茯苓fu ling (Sclerotium Poriae Cocos) • 山药shan yao (Radix Dioscoreae Oppositae) • 附子fu zi (Radix Lateralis Aconiti Carmichaeli Praeparata) • 瞿麦qu mai (Herba Dianthi)

29. Urinary Disturbance • Differentiation and Treatment • Damp heat with blood stasis, SP K deficiency 【11】 • 蒲灰散 pu hui san • 蒲黄pu huang (Pollen Typhae) • 滑石hua shi (Talcum) • 滑石白鱼方 hua shi bai yu fang • 滑石hua shi (Talcum) • xue yu tang • fish ？ • 茯苓戎盐方 fu ling rong yan fang • 茯苓fu ling (Sclerotium Poriae Cocos) • 白术bai zhu (Rhizoma Atractylodis Macrocephalae) • salt

30. Urinary Disturbance • Differentiation and Treatment • Difficulty in urine with UB qi transforming dysfunction • Treatment for difficult urine  Dysuria Qi fail to disperse bodyfluid  water retention • not xiao ke disease • floating pulse • difficult urine • slightly fever • thirst • vomiting when drink • Five Ingredient Powder with Poria 五苓散 wu ling san 【4】 【5】 • 茯苓fu ling (Sclerotium Poriae Cocos) • 猪苓zhu ling (Sclerotium Polypori Umbellati) • 泽泻ze xie (Rhizoma Alismatis Orientalis) • 白术bai zhu (Rhizoma Atractylodis Macrocephalae) • 桂枝gui zhi (Ramulus Cinnamomi Cassiae)

31. Urinary Disturbance • Differentiation and Treatment • Difficulty in urine with Heat injures yin • water retention with heat  damage Yin • floating pulse • fever • thirst • difficult urine • Polyporus Decoction 猪苓汤 zhu ling tang 【13】 • 猪苓zhu ling (Sclerotium Polypori Umbellati) • 茯苓fu ling (Sclerotium Poriae Cocos) • 阿胶e jiao (Gelatinum Corii Asini) • 滑石hua shi (Talcum) • 泽泻ze xie (Rhizoma Alismatis Orientalis)