Traditional Chinese Medicine Pathology

Traditional Chinese Medicine Pathology

Traditional Chinese Medicine Pathology (TCM Pathology) is a branch of science that studies diseases from the perspective of TCM. It is divided into two major groups: Exogenous Diseases and Endogenous Diseases (or Miscellaneous Diseases).

Classification is based on:

• Fundamental theories: TCM relies on the theories of Yin and Yang, Five Elements, and Meridian to explain diseases.

• Clinical practice: Through generations of TCM physicians, valuable experience has been gained in the diagnosis and treatment of diseases.

Exogenous Diseases:

• Theoretical basis: Theories of Typhoid Fever and Warm Diseases.

• Diagnostic methods: Primarily based on the Six Channels and Defense Qi Circulating Blood. Additionally, it relies on Three Jiao, Meridian, and Six Evils.

Endogenous Diseases:

• Theoretical basis: Essentials of the Golden Chamber.

• Diagnostic methods: Zang-Fu organs, Essence-Qi-Blood-Body Fluid.

Symptoms:

• Manifestation: Disturbances in the body, leading to abnormal manifestations such as fever, cough, headache, etc.

• Significance: Reflects the pathological changes in the body.

• Classification: Two groups:

• Functional symptoms: Subjective sensations of the patient such as fever, chills, vomiting, irritability, etc.

• Physical symptoms: Objective data collected by the physician through examination such as yellow tongue coating, deep pulse, etc.

Symptoms are crucial for:

• Disease identification.

• Differentiation of syndromes in clinical practice.

Some clinically significant manifestations in TCM:

• No thirst.

• Indecisiveness.

• Easy to get angry.

• Sleeping with dreams.

Disease:

• Definition: Deviation, disruption of the normal structure or function of any part, organ, system of the body.

• Manifestation: A collection of characteristic symptoms that help determine the cause, pathogenesis, and prognosis.

Pathological process:

• Description: Pathogenic factors affect the body, the body’s vital energy struggles against the pathogenic factors, leading to an imbalance of Yin and Yang, damage to the physical form, function of Zang-Fu organs, or hindering psychological activities.

• Characteristics: There is always a struggle between damage, disorder, and recovery, regulation.

Disease name (Disease designation):

• Significance: A summary of the disease, it can summarize the disease process including the cause, pathogenesis, and symptoms of the disease.

• Value:

• Provides information about the nature of the disease such as prevalence, progression, outcome, from which one can infer the prognosis.

• Supports disease diagnosis and classification.

Naming diseases in TCM is based on:

• Pathological symptoms.

• Disease location.

• Cause of the disease.

The most common naming method:

• Naming according to the symptoms of the disease.

The relationship between “Disease” according to TCM and “Disease” according to Western Medicine:

• “One TCM disease, many Western Medicine diseases; One Western Medicine disease, many TCM diseases”

Syndrome:

• Definition: A combination of symptoms that create a characteristic “picture” reflecting a specific disorder in the body.

• Significance: Reflects comprehensively and specifically the nature and characteristics of a pathology at a given stage.

• Identification: Based on TCM theory to find the characteristic “picture” formed by the clinical symptoms of the patient.

Relationship between Disease and Syndrome:

• “One disease, many syndromes” and “One syndrome, many diseases”

Treatment principles:

• “Same disease, different treatment” (same disease, many ways to treat).

• “Different diseases, same treatment” (different diseases, same treatment).

• Regulate the balance of the body.

• Clearly distinguish between urgent and non-urgent.

• Understand the dynamic changes of the disease.

• Base treatment on climate, region, physique, age, etc.

• Base treatment on the changes of the disease, Prevention before disease, prevention of changes after disease, prevention of recurrence after recovery.

• Emphasize nursing care.

Pathology explanation:

• The process of disease occurrence.

• Changes in the clinical manifestations of the disease.

Diagnostic process:

• Identification.

• Complete diagnosis of the disease syndrome.

• Cause of the disease.

• Location of the disease.

• Pathogenesis.

• Appropriate treatment principles.

Diagnostic methods:

• Eight Principles: A method that can be used for all diseases.

• Six Channels, Six Evils, Defense Qi Circulating Blood, Three Jiao: Methods often used in exogenous diseases.

• Qi-Blood-Body Fluid, Zang-Fu organs, Meridian: Methods often used for miscellaneous diseases.

The role of Eight Principles:

• The fundamental foundation in the TCM diagnostic process for all disease syndromes.

Diagnosis of exogenous diseases:

• Cannot be established specifically according to Zang-Fu organ diagnosis.

• Diagnose according to the Eight Principles, then depending on the nature of the Cold-Heat pair, diagnose according to Six Evils, Six Channels diagnosis, or Defense Qi Circulating Blood, Three Jiao.

Diagnosis of endogenous diseases:

• Use Zang-Fu organ diagnosis as the center.

• Combine with Qi-Blood-Body Fluid diagnosis and Meridian diagnosis.

The process of diagnosing disease syndromes is:

• A dynamic process over time of the disease progression.

TCM believes that the body is a system:

• Dynamic balance, Zang-Fu organs inside create a whole that is organically related to each other.

TCM focuses on the pathogenesis of:

• Social factors (emotions, trauma, overwork…) and natural factors (Six Evils, abnormal climate…) that have a close relationship with humans to create the balance of the body.

The holistic concept emphasizes and values:

• Complete regulation of the organs, emphasizing the unity of the body and the external environment.

What does the human body take as the center?

• Five Zang-Fu organs.

According to TCM, how is the body formed by the coordination of various components in the body?

• Five Zang-Fu organs coordinate with the Six Fu organs, through the meridian system connecting the five bodies, five senses, nine orifices, four limbs.

“Pathology of one part reflects the pathology of the whole body, through regulating the balance of the body to help the pathology in … recover, the disease … regress.”

• One part/pathogenic factors

“Diagnosis and treatment of a disease according to TCM is the treatment of local disorders” is true or false?

• False

Diagnosis and treatment of a TCM disease needs to pay attention to:

• Adjusting local disorders and internal and external causes of the body, Zang-Fu organ disorders and their organic relationship in the overall dynamic balance system.

“Urgent” and “non-urgent” are a pair of concepts that are:

• Relative.

“Urgent” and “non-urgent” mainly explain:

• The relationship of primary and secondary contradictions in the disease process.

Speaking of disease, what are “urgent” and “non-urgent”?

• Cause is “non-urgent”, Symptoms are “urgent”.

Speaking of old or newly developed disease, what are “urgent” and “non-urgent”?

• Old disease is “non-urgent”, New disease is “urgent”.

Speaking of the disease that occurs first or later, what are “urgent” and “non-urgent”?

• The disease that occurs first is “non-urgent”, the disease that occurs later is “urgent”.

According to the relationship between the righteous and the evil, can we say what are “urgent” and “non-urgent”?

• The body’s righteous energy is “non-urgent”, External pathogenic factors are “urgent”.

In the case of coughing up blood due to yin deficiency, what are “urgent” and “non-urgent”?

• Coughing up blood is “urgent”, yin deficiency is “non-urgent”.

In clinical practice, it is necessary to clearly distinguish between urgent, non-urgent, delayed, and rapid, and to adopt treatment methods according to which principles?

• “Urgent treatment for the urgent”

• “Delayed treatment for the non-urgent”

• “Treat the urgent and the non-urgent together”

Treating diseases is often divided into three steps:

• Early – Middle – Late.

The stages of the disease include:

• The early stage of the onset of the disease.

• The middle stage of full development.

• The late stage of recovery.

For exogenous diseases, the early stage of the disease is often:

• Pathogenic factors are not yet prevailing, righteous energy is not yet depleted, the disease is relatively mild, superficial.

For exogenous diseases, in the early stage, it is often necessary to do what?

• Disperse and eliminate pathogenic factors.

For exogenous diseases, the middle stage of the disease is often:

• Pathogenic factors have invaded deeply, the disease is relatively severe.

For exogenous diseases, in the middle stage, it is often necessary to do what?

• Strengthen the elimination of pathogenic factors, reduce the changes of the disease.

For exogenous diseases, the late stage of the disease is often:

• Pathogenic factors weaken, righteous energy gradually recovers.

For exogenous diseases, in the late stage, it is often necessary to do what?

• Eliminate pathogenic factors, combined with reinforcing righteous energy to help righteous energy recover.

For endogenous diseases, the early stage is often treated:

• Do not use drugs with strong attacking properties.

For endogenous diseases, the middle stage is often treated:

• Most righteous energy is deficient, use tonifying drugs or if due to stagnation of Qi, blood, phlegm, and fire forming solid syndrome, must use strong attacking drugs (short term).

For endogenous diseases, the late stage is often treated:

• Deficiency for a long time leading to damage, regulate Qi and blood, nourish the five Zang-Fu organs, combined with treating accompanying solid syndromes.

In spring and summer, the climate is warm, yang energy ascends and develops, the pores open, it is easy to catch wind-cold, treatment should not use?

• Warm tonifying drugs, too strong dispersion, easy to injure Qi and deplete yin.

“The same type of disease but in different regions will have the same pathogenesis and changes” is true or false?

• False.

In the North, the climate is cold, in the South, the climate is warm, what medicine should be used to treat wind-cold exogenous diseases and what is the dosage?

• Warm tonifying drugs that resolve the exterior, in the North, it can be used more, in the South, it should be used less.

“Different physiques, ages, genders, occupations… of patients will have different treatments” is true or false?

• True.

According to the concept of physique, people with a Qi deficiency physique should prioritize?

• Tonifying Qi.

According to the concept of physique, people with a Yin deficiency physique should prioritize?

• Tonifying Yin.

According to the concept of occupation, people who often worry easily damage … so they should often prioritize …?

• Spleen/Tonifying Spleen.

According to the concept of occupation, people who do manual labor, then … should prioritize …?

• “Hard work hurts the Kidneys”/Tonifying Kidneys.

Dampness-heat stagnation should be treated with what method?

• Actively eliminate stagnation.

Stagnation in the Large Intestine should use what method?

• Descending.

Stagnation in the Stomach should use what method?

• Vomiting or dissolving.

Prevention before disease is the method of:

• Through assisting the body’s righteous energy and preventing the invasion of pathogenic factors to prevent the occurrence of disease.

People with a Qi deficiency physique should drink Jade Screen Powder to?

• Tonify Qi and strengthen the exterior, prevent the invasion of external pathogenic factors.

Prevention of changes after disease is:

• Through early treatment, proper treatment to prevent the disease from changing for the worse.

Treating diseases in the Liver, it is necessary to pay attention to nursing care?

• Spleen and Stomach, to make the Spleen energy strong, to avoid the case of disease in the Liver affecting the function of the Spleen and Stomach.

Prevention of recurrence after recovery is:

• Through regulating the Yin and Yang of the body, maintaining the balance of Yin and Yang to prevent the recurrence of the disease.

In the case of “Stomach-governing pain” (epigastric pain) that has just recovered, the function of the Spleen and Stomach is still poor, one should not eat:

• Too many raw, cold, or greasy foods that affect the function of the Spleen and Stomach.

Emphasize nursing care and support to?

• Help righteous energy recover, eliminate pathogenic factors, promote early recovery.

If one does not pay attention to regulating diet, lifestyle, and mental state, it will affect?

• The recovery of the patient, leading to recurrence of the disease.

In the case of Wind-Cold exogenous disease, if one does not pay attention to keeping warm and avoiding wind-cold, it is very easy to get?

• Re-infection.

Jing disease is also called?

• Exogenous Typhoid Fever.

The theory of Typhoid Fever Treatise by?

• The famous physician Zhang Zhongjing.

The famous physician Zhang Zhongjing lived in what era?

• Eastern Han Dynasty of China (2nd – 3rd century).

What did Zhang Zhongjing rely on to propose the Six Channels diagnostic method for exogenous diseases?

• Based on the Chapters Heat Treatise – Plain Questions combined with symptoms, characteristics of disease progression summarized together.

Ye Tianshi lived in what era?

• Qing Dynasty of China (17th – 18th century).

What did Ye Tianshi rely on to supplement the deficiencies in treating various Warm Diseases that cause fever into the book “Exogenous Warm Diseases Chapter”?

• The Inner Canon and Typhoid Fever Treatise.

The author of the book “Exogenous Warm Diseases Chapter” is?

• Ye Tianshi.

The book “Exogenous Warm Diseases Chapter” theorizes according to?

• Defense Qi Circulating Blood.

Who realized that Warm Diseases caused by Dampness-Heat play a major role, progressing in a way that spreads from superficial to deep according to the Three Jiao (Upper, Middle, Lower Jiao)?

• Wu Jutong.

Wu Jutong advocated which theory?

• “Three Jiao syndrome”.

The broad meaning of “Typhoid Fever” is:

• The general name for all exogenous diseases with fever.

The narrow meaning of “Typhoid Fever” is:

• The name for exogenous diseases caused by Wind-Cold pathogenic factors.

In general: Typhoid Fever is:

• Exogenous diseases with predominantly Cold symptoms in the early stage, progressing according to a certain pattern.

The Typhoid Fever Treatise investigates the progression of exogenous diseases according to how many stages?

• 6 stages.

The Typhoid Fever Treatise investigates the progression of exogenous diseases according to 6 stages corresponding to?

• 6 types of syndromes.

The 6 types of syndromes of the Typhoid Fever Treatise are named according to?

• The main meridians (Six Channels).

The 6 types of syndromes of the Typhoid Fever Treatise include:

• Taiyang syndrome, Shao yang syndrome, Yangming syndrome, Taiyin syndrome, Shaoyin syndrome, Jueyin syndrome.

Six Channels include:

• 3 Yin Channels and 3 Yang Channels corresponding to 6 Disease Syndromes according to TCM.

The Yang Channels and Yin Channels of the Six Channels represent:

• The progression and stages of exogenous diseases.

The progression of exogenous diseases has:

• A pattern.

Clinical diseases, if progressing from the outside to the inside, are:

• Diseases from mild to severe and vice versa.

Different stages of the disease reflect different characteristics such as:

• The relationship between resistance (righteous energy), disease-causing agents (pathogenic factors), and the location of the disease in the exterior, interior, or semi-exterior semi-interior.

In exogenous diseases, if the disease is in the 3 Yang Channels, then:

• Pathogenic factors are prevailing, righteous energy is not yet depleted.

In exogenous diseases, if the disease has entered the 3 Yin Channels, then:

• Righteous energy has weakened.

In exogenous diseases, the deeper the location of the disease, then:

• The more severe and more difficult to treat.

In exogenous diseases, if the disease is in the 3 Yang Channels, then it is manifested in:

• Exterior, Fu organs.

In exogenous diseases, if the disease is in the 3 Yang Channels, then the main nature is:

• Heat syndrome, Solid syndrome.

In exogenous diseases, if the disease has entered the 3 Yin Channels, then it is manifested in:

• Interior, Zang organs.

In exogenous diseases, if the disease has entered the 3 Yin Channels, then the main nature is:

• Cold syndrome, Deficiency syndrome.

In exogenous diseases, the disease progresses from the 3 Yang Channels to the 3 Yin Channels, which is called:

• The disease spreading from the exterior to the interior.

In exogenous diseases, how many causes govern the progression of the disease?

• 3 causes.

In exogenous diseases, the 3 causes that govern the progression of the disease are:

• The prevalence and decline of righteous energy.

• The prevalence and decline of pathogenic factors.

• Treatment methods.

In exogenous diseases, if righteous energy is weakened, then pathogenic factors will:

• Easily spread deeper, to the 3 Yin Channels, causing severe disease, difficult to treat.

Among the causes governing exogenous diseases, the prevalence and decline of righteous energy affect:

• If righteous energy is strong, pathogenic factors cannot spread deep, only spreading to the 3 Yang Channels (mild disease) and vice versa.

Among the causes governing exogenous diseases, the prevalence and decline of pathogenic factors affect:

• Strong pathogenic factors easily cause the risk of the disease spreading deeper, causing severe disease.

Among the causes governing exogenous diseases, treatment methods affect:

• Inappropriate treatment methods can cause the disease to spread deeper into the body, the disease becomes more severe and difficult to treat.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise has which types?

• Circulating Channels (Channel spreading), Direct hit, Interior syndrome transforming to exterior syndrome, Nature of the disease, Combined diseases.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, circulating channels is:

• The most common type, exogenous diseases spread from one channel to another, progressing from mild to severe.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, the process of circulating channels usually starts in which channel?

• Taiyang.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, the process of circulating channels occurs:

• Starting from the Taiyang Channel to the Shao yang Channel and then spreading in sequence Yangming, Taiyin, Shaoyin, and finally Jueyin.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, when the circulating channels disease spreads from any Yang channel to the Yin channel system, it is called:

• Exterior-interior spreading or exterior-interior transmission.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, direct hit is:

• The disease pathogenic factors directly enter the Yin channel, without going through the 3 Yang Channels.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, the cause of direct hit is:

• Weak body, depleted righteous energy, allowing external pathogenic factors to directly invade the three Yin.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, Taiyin syndrome direct hit has the symptoms:

• Sudden vomiting, diarrhea, cold hands and feet, abdominal distention, no thirst.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, the cause of Taiyin syndrome direct hit is:

• Weak body, lack of yang energy, depleted righteous energy, allowing external pathogenic factors to directly invade the Taiyin Channel.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, Interior syndrome transforming to exterior syndrome is:

• The disease pathogenic factors spread from the 3 Yin Channels to the 3 Yang Channels due to the gradual recovery of righteous energy, the disease progresses well.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, Taiyin syndrome direct hit has the symptoms of vomiting, diarrhea, after a period of treatment, then:

• Diarrhea stops, constipation, fever, thirst.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, Taiyin syndrome direct hit has the symptoms of vomiting, diarrhea, after a period of treatment, then diarrhea stops, constipation, fever, thirst, is because:

• Taiyin disease, thanks to the recovery of yang energy in the Stomach, but the pathogenic factors remain, so it transforms into Yangming syndrome.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, the nature of the disease is:

• The symptoms of one channel have not completely subsided, symptoms of another channel appear, the cause is due to spreading.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, Taiyang syndrome has not subsided yet, Yangming syndrome appears again because:

• Pathogenic factors spread from the Taiyang Channel to the Yangming Channel.

The pattern of spreading of Six Channels diseases according to Typhoid Fever Treatise, combined diseases is:

• 2-3 channels are invaded by pathogenic factors simultaneously, not due to spreading.

The Taiyang Channel includes:

• Bladder Foot-Taiyang, Small Intestine Hand-Taiyang.

The Taiyang Channel has a Yin-Yang relationship with which channel?

• Heart and Kidney Foot-Shaoyin.

The channel with the largest coverage is?

• The Taiyang Channel.

The function of the Taiyang Channel is:

• To govern the exterior of the whole body, to command the nourishing and defending Qis, to resist external pathogenic factors.

Six Channels disease syndromes (Six Channels clinical manifestations), the main syndrome of Taiyang is:

• To govern the exterior, the earliest action to resist external pathogenic factors.

Six Channels disease syndromes (Six Channels clinical manifestations), the main clinical manifestation of Taiyang?

• The person has fever, chills, stiffness and pain in the head and neck, floating pulse.

Six Channels disease syndromes (Six Channels clinical manifestations), the pathogenesis is?

• Wind-Cold pathogenic factors invade the exterior (skin and fur) causing stagnation of the pores, unable to sweat, defense Qi is injured, so there is fear of cold.

Six Channels disease syndromes (Six Channels clinical manifestations), when righteous energy and pathogenic factors fight, they produce?

• Fever.

Six Channels disease syndromes (Six Channels clinical manifestations), Qi and blood rush to the outside to block pathogenic factors, which leads to?

• Floating pulse.

Six Channels disease syndromes (Six Channels clinical manifestations), pathogenic factors invading the Taiyang Channel dominate the channel, which leads to?

• Stagnation causing stiffness and pain in the head and neck.

Six Channels disease syndromes (Six Channels clinical manifestations), the progression of Taiyang disease has different degrees due to?

• Different righteous energy, different reactions of the patient’s body.

Six Channels disease syndromes (Six Channels clinical manifestations), Clinically, Taiyang is divided into 2 types: ?

• Taiyang Channel syndrome (including Taiyang Typhoid Fever or Taiyang Exterior Solid and Taiyang Wind-Stroke or Taiyang Exterior Deficiency), Taiyang Fu organ syndrome.

Six Channels disease syndromes (Six Channels clinical manifestations), The common symptoms of Taiyang Channel syndrome are?

• Fear of cold, fever, stiffness and pain in the head and neck, thin white tongue coating, floating pulse.

Six Channels disease syndromes (Six Channels clinical manifestations), Taiyang Channel syndrome includes 2 groups of diseases: ?

• Taiyang Wind-Stroke (Exterior Deficiency) and Taiyang Typhoid Fever (Exterior Solid).

Six Channels disease syndromes (Six Channels clinical manifestations), The symptoms of Taiyang Wind-Stroke usually occur in people who?

• Have deficient righteous energy.

Six Channels disease syndromes (Six Channels clinical manifestations), The symptoms of Taiyang Wind-Stroke are?

• Headache, fever, cough, sweating, fear of wind, thin white tongue coating, floating and slow pulse.

Six Channels disease syndromes (Six Channels clinical manifestations), The symptoms of Taiyang Typhoid Fever usually occur in people who?

• Are healthy.

Six Channels disease syndromes (Six Channels clinical manifestations), The symptoms of Taiyang Typhoid Fever are?

• Aching, no sweating, coughing and wheezing, thin white tongue coating, floating and tight pulse.

Six Channels disease syndromes (Six Channels clinical manifestations), Pathogenic factors invading the skin and fur lead to?

• Stagnation of the pores, unable to sweat, fever but not feeling comfortable, aching, TCWC Lung governs the skin and hair and Lung governs descending to the feet, causing coughing and wheezing.

Six Channels disease syndromes (Six Channels clinical manifestations), Taiyang Fu organ syndrome is due to?

• Exterior pathogenic factors cannot be resolved, they spread inward affecting the function of the Bladder Fu organ.

Six Channels disease syndromes (Six Channels clinical manifestations), Taiyang Fu organ syndrome includes 2 groups of diseases: ?

• Taiyang accumulation of water and Taiyang accumulation of blood.

Six Channels disease syndromes (Six Channels clinical manifestations), The symptoms of Taiyang accumulation of water are?

• Fever, fever with episodes in the afternoon, restlessness, difficult urination, thirst, when drinking water, it vomits out, the area from below the heart to the lower abdomen is tense and painful, no n