1 Wen Bing 1

2 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

3 Features of Wen Bing –specific causes—— warm disease pathogenic factors –infectious, epidemic, seasonal, regional –the development has phases. –common clinical manifestations

4 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

5 Relationship between Wen Bing and Shang Han

6 Causes Commonness –Exogenous –Heat feature –Fast onset –Related with seasons –Different disease locations

7 Onset Onset factors –Body constitution factor –Nature factor –Society factor

8 Infectious Route Air borne infection through respiratory ducts. Food borne infection through mouth Contact infection through skin.

9 Onset types Newly onset Wen Bing Hidden Wen Bing

10 Differentiation Theories Wei-Qi-Ying-Xue differentiation San Jiao Differentiation

11 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

12 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

13 Development –Mild pathogen with undamaged vital qi  push pathogen out. With correct treatment on time, the disease can be cured. –Severe pathogen and weak vital qi, improper or delayed treatment  directly transmit to Ying stage or even to blood stage. Dangerous situation.

14 2. Qi Stage Include half interior and half exterior paten Widely covered the disease in L, St, Sp, intestines, GB, etc.

15 Formation route –Transmit from Wei Stage –Directly invade Qi stage –Hidden warm disease pathogen transmit outwardly –Ying Stage  Qi stage

16 Main symptoms –Excessive heat, no aversion to cold, heavy sweating, thirst desire for cold water, concentrated urine, red tongue body with yellow coating, rapid, forceful pulse. Pathogenesis

17 Development –Severe pathogenic qi vs. strong vital qi, with accurate on time treatment  cured –Vital qi is weaker than pathogenic qi, with improper 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

18 3. Ying Stage Formation –The Qi stage pathogenic heat hasn’t been cleared, or damp-heat transformed into fire  enters Ying Stage –Wei stage  Ying stage –Hidden warm disease pathogen –Directly invade Ying Stage

19 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

20 Development –Ying Stage  Qi Stage –The heat pathogen approaches to Xue Stage  large area of macula, internal bleeding –Convulsion, coma

21 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  directly manifested as Xue Stage syndromes.

22 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

23 Compare Xue Stage and Ying Stage

24 Development –Accurate on time treatment  hope of being cured –Death –Unrecovery damage

25 San Jiao Differentiation Wu Jutong Upper Jiao syndromes: chest, L, Pc Middle Jiao syndromes: abdomen, St, SI, LI, Sp Lower Jiao syndromes: Lower abdomen, K, Liv.

26 Upper Jiao syndromes –Pathogenic factor attacks L –Excessive heat in L –Damp-heat in L –Heat sink into PC –Dampness covers PC

27 Middle Jiao syndromes –Excessive Yangming syndrome –Yangming heat and substantial turbid combination –Damp-heat obstruction in Middle Jiao –Damp-heat and substantial turbid combination –Dampness obstruct in LI

28 Lower Jiao syndromes –K Essense consumption –Deficient wind stirring internally

29 Transmissions in Wen Bing

30 Relationship between Wei-Qi-Ying-Xue Differentiation and San Jiao Differentiation.

31 Diagnostics of Wen Bing

32 Fever, hot sensation Sweating Thirst Shen Convulsion Maculea (Bai Pei)

33 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

34 Influence of Season on the Tongue The Differentiation of Stained Tongue

35 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

36 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

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

38 Black Tongue Coating –Dry, Black Coating with Prickles –Dry, Black CoatingBlack Coating, like Obscure Bituminous Coal –Dry, Black Coating, Pale Tongue Body

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

40 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