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6.10 Apoplexy
6. 10. I What are the similatities and differences between apoplexy involving the channels and collaterals and that involving the Zang and Fu organs in their symptoms and pathogeneses?
Apoplexy involving the channels and collaterals (mild state of illness): Seized by pathogenic factor due to the deficiency of channels- only blood vessels, channels and col laterals affected without pathological changes in Zang and Fit organs and mental symptoms.
Apoplexy involving the Zong and Fit organs (serious state of Ilness): Hyperactivity of the liver Yang, invasion of phlegm to the seven orifices, floating of Yang with exhaustion of Yin-affection extending to viscera accompanied by mental variations.

6. 10 .2 What is excess syndrome of stroke? And what is prc-itration syndrome and the differences between them?
Excess syndrome of stroke-dominating of pathogen and loss of consciousnes as its main symptoms-excess syndrome-eliminat ng the pathogenic factor for urgent case. The case is marked by sudden fainting, loss of consciousness, trismus, clenched fists, eonstipaton and dysuria, and spasm of limbs.
Prostration syndrome Yang- Qi about to collapse as its chatacteristic-deficiericy syndrome?asirengthcni ng the body res stance for urgent case1 The case is marked by sudden fainting, unconsciousness, closed eyes with open mouth, snores, feeble breath, cold limbs with relaxed hands, polyhidrosis, incontinence of urine arid faeces , paralysed body.
6. 103 How are the treatments for apoplexy in its convalecenr
stage?
Hemiplegia. weak-feeling in the Limbs accompanied with, on affected side, edema in the hand and foot, distortion of the lace, sallow complexion, pale tongue and fine and weak pulse, bebngng to the morbid condition of deficiency of Qi and stagnation of blood, and stasis in vessels and cotlaterals. rrh treatments for the disease are invigorating Qi and promoting blood circulation; and clearing and activaling the channels and coLlaterals with the recipe Ru Yang Huan Wa Tang.
(2)Dysphasia
The symptoms of rigidity of the tongue with stammer, numbness of limbs, and wiry and shppery pulse show a morbid state of stagnation in collaterais due to phlegm by wind. The recipe for it is Jie Yu Dun to induce resuscitaflon, promote Qi circulation and remove obstruction in the collaterals.
In case of dysphasia, palpitatiom shortness of breath, soreness of the loins and knees, which are the symptoms of deficiency of the kidney essence, use Di Huang Yin Zi with substraction of Cortex Onnarnorni and Radix Aconiti praeparata, and addition of Semen Arnieniacae Amarurn, Radix Plaiyccxii and Semen Oroxyli to recover voice and induce resuscitation.
(3 )Distortion of the face
The state is caused by accumulation of phlegm and wind in wilaterals , The treatmeni for it is expelling the wind, removing phlegm and clearing obstruction in the collaterals with the recipe of Qian Zheng San.
(1) Meridian being attacked
Sclect points mainly from the Yang meridians on the affected side.. Points from flu and Ren meridians are selected to improve shared speech. The even method of needling isused.
[Prescription]
Herniplegia: Baihul, Fengchi
The upper limbs: Jiunyu, Quchi, Waiguan, and Hegu. rIhe lower limbs: Huantian, Yang/ingquan and Zuscznti. eviation of eye and mouth: Yungbai, liking, and Jiache. Slurred speech: Luinquan Yarnen, Jinjin, and Yuyin Obstruction of collaterals by bhEd stasis and phlegm: Zhong Wan, Fenglong, Xuehai and Sanyiniao.
Hyperactivity of liver Yang Taiyang, Taichong and Taixi
Select points mainly from the flu meridian and twelve Jing-. ?(well) points. The reducing method of needing is used.
[Prescription]
Renzhmig, the twelve fin?бе-( weH.) points, 7}tichong, Fcnmug, lalogong.

(3) Flaccid type
[Treatment ]
Pomis of tonification on the Rni Meridian are selected as main points to restore yang and prevent collapse. Moxibustion is recommended.
[Prescription]
Guanyuan , Shenque , Qihai , Baihui
6.11 Convnlsive Disease
6. 11. 1 What are th major oathogenescs of convulsive disease?
The major pathogeneses of convulsive dscase arc accumulaiion of pathogens in channels and coltaterals causing the stagnation of Qi and blood, consumption of Yin and blood causing the want of nourishment.

6.11.2 What are the respective treHtments and recipes for convulsion coused by accumulation of pathogen in channels and collaterals, convuision due to intense heat and that due to deficiency of Yin and blood?

(1) Accumulation of pothogens in channels and coflaterals
[Treatmcnt] Expelling wind and cold; and regulating the Yin and rernovng dampness.
[Recipe] Qiang Huo Sheng Shi Tang
(2)Convulsion due to intense heat
[Treatment] Purging intense heaL to store body fluid; and nourishing Yin to increase body fluid.
[Recipe] Zeng Ye Cheng Qi Tang
(3)Deficiency of Yin and blood
[Treatment] Nourishing Yin and blood -
[Recipe] Si Wu Tang and Da Ding Feng Zhu
6. 12 Headache
6.12.1 What are the symptomatic differences between the headache caused by exopathy and internal injury?
Affection by exopathogen-Acute onset, sharp pain and fever manifested as cramping pain, jumping pain, buring pain, swollen pain and lasting pain. Most under excessive pattern.
Internal injury-Slow onset, slight pain arid fever marked by vague pain, void pain, dizzy pain, long-lastng, aggravated with overstrain, onset by fits and starts. Most under deficient pattern.

6.12.2 Try to describe respectively the symptomatic features,
treatments and recipes of headaches caused by hyperactivit of the her-Yang, deficiency of blood, stagnation of
phlegm and accumulaton of blood stasis.
(1)Headache caused by the liver-Yang
[Main points of differentiation] Headache with dizziness, restlessness, irritability, hypochondriac pain, bitter taste, and wiry puise.
[Treatment] Calming the liver and suppressing hyperactivity of Yang.
[Recipe] Than Ma Gou Teng Yin

(2)Headache caused by deficiency of blood
[Main points of differentation] Headache with dizziness, pale complexion, palpitation, pale tongue and weak pulse.
[Treatment] Nourishing Qi and blood.
[Pecipe] Jia Wei Si Wu Tang

(3)Headache caused by stagnation of phlegm
[Main points of differentiation] Headache with dizziness, vomiting of sputum and saliva whitish greasy fur, slippery pulse.
[Treatment] Resolving phlegm and lowering the adverse flow of Qi.
[Recipe] Ban Xai Bai Zhu Tian Ma Tang

(4 ) Headache caused by blood stasis
[Main points of differentation] Lasting headache with fixed aching-spot as pain a being drilled, purplish tongue or with ecchymosis.
[Treatment] Promoting blood circulation to remove blood stasis.
[Pecipe] Tong Qian Huo Xue Tang
6.12.3 Acupuncture Treatment
(1) Invasion of wind-cold
Select points on the Foot-Taiyang and Hand- Yangining meridians as main point. The necIncinz method of needling is used. In some cases, moxibustion is applicable.
[Prescription]
Dazhu, Fengmen, Tianzhu, Hegu, and Lieque

(2) Invasion of wind-heat
[Treatment]
Select points mainly from the Yangzning meridians and use the reducing method.
[Prescription]
Hegu, Quchi, Neiting, and Touwei

(3) Hyperactivity of liver Yang
[Treatment]
Select points on the Foot-Jueyin and Foot-Shangyang meridians as points.The reducing method of needling is used.
[Prescription]
Fengchi Xuanlu Taichong Xiaxi
(4) Phlegm
[Treatment]
Select points on the Foot-Yangming and Ren meridians as main points.The reducing method of needling is applied. [Presription]
Fenghi Yintang Zhongwan and Fenglang

(5) Blood deficiency
[Treatment]
Select points on the Foot-Yangrning meridian and back Shu points as main points. The reinforcing method is applied. Moxibustion is applicable at the same time.
[Prescription]
Baihui Ganshu Pishu Zusanli and Sanyinjiao
(6) Blood stasis
[Treament]
Select points from the Hand-Yangming, Foot-Taiyin and Foot-Jueyin meridian as main points. The reducing method of necding is used. Pricking to cause bleeding is applicable when necessary
[Prescription]
Hegu, Taichchong, Xuehai Taiyang and Ashi points

6-13 Vertigo
6.13.1 What are the pathogeneses of vertigo?
Hyperactivity of the liver-Yang to disturb the head; deliciency of Qi and Blood, unable to nourish the brain; deficiency of the kidney-essence, deficiency in the sea of marrow; stagnation of phlegm in middle-jiao, blocking the mentality.
?
6.13.2 Try to describe the maui symptoms treatments and recipes of vertigo caused by hyperactivity of the liver-Yang. deficieney Qi and blood deficiency of the kidney-essence and stagnation of phlegm in middle-Jiao.

(1 )Hyperactivity of die Lver-Yang
[Symptoms] Dizzinness tinnirus, headache with distension, aggravated by vexation,interrnitrent fIushed face, restlessness, irritability insomnia, dreamful sleep, bitter taste, red tongue with yellowish fur and wiry pulse.
[Treatment] Calming the liver; and nourishing the liver and kidney.
[Recipe] Tian Ma Cou Teng Yin

(2 )Deficiency of Qi and blood
[Symptoms] Dizziness aggravated by moving, onset with tiredness, pale cumplexion, pale lips and nails, glossiless hair, palpitation, inmnia, listlessness, disinclination to talk, decreased diet, pale tongue, and thready and weak pulse.
[Treatment] Tonifying Qi qwtba and blood, and strengthening the spleen and stomach.
[Recipe] Gui Pi Tang

(3) Insufficiency of the kidney-essence
[Symptoms]? Dizeiness with listlessness, insomnia and dreamfu1 sleep, amissia, soreness and weakness of the loins and knees, nocturnal emission and tinnitis. When it shows dominant deficiency of Yin, one can see the svniptonis of dysphoria with feverish sensaticri in chest, paJrns arid scies, red tongue, wiry, thready and rapid pulse; and when it shows dominant defleieiicy of Yang- , the syrnptonis will be coa] limbs, pale tongue thready, deep and we;ik pulse.
[Treatment] Replenishing Yin to tonify the kidney for dcficiency of Yin; reinforcing the kidney and supporting Yang for deficiericy of Yang.
[Recipe[ Zuo Gui Wan for deficiency of Yin; You Gui Wan for deficiency of Yang
(4)Stagnation of phlegm
[Symptoms] Dizziness with feeling of heaviness in the head as if covered by something, suppression and fullness of the chest, nuasea, poor appetite and somnolence, whitish and greasy fur , slippery and soft-floating pulse.
[Treament] Eliminating dampness and removing phlegm; and strengthening the spleen and stomach.
[Recipe] Ban Xia Bai ZhuTian Ma Tang
6. 13. 3 Acupuncture treatment
(1) Hyperactivity of Liver yang
[Treatment]
Select points mainly from the liver and Gallbladder meridians. The reducing method of needling is used.
[Prescription]
Fengchi , Ganshu , Shenshu , Taichong and Xiaxi
(2) Retention of turbid phlegm
[Treatment]
Select points of Foot- Yangming meridian as main points. The even method of needling is used.
[Prescription]
Touwei, Zhongwan, Fenglong, Jiexi, Neguan
(3) Deficiency of qi and blood
The hack Shu points are selected as chief points. The reinforcing method of needling is rccommended
[Prescription]
Guanshu , Pishu Baihui , Qihai and Zusanli
(4) Empty kidney essnce
[Treatment]
Select back Shu points and points of the Foot- Shaoyin meridian. The reinforcing method of needling is used. Moxibustion is applicabie when kidney Yang is deficent.
[Prescription]
Baihui, Ganshu, Shenshu, Guanyuan, Taixi, Sanyinjiao, and Xuanzhong
6.14 Insomnia
6.14.1 What are the pathogenic fautors of insomnia?
(1) Over-anxiety and over-tiredness hurting the heart and the spleen.
(2) Yang and Yin failling in coordination and the same case being with the heart and the kidney.
(3)Hyperactivity of fire caused by Yin deficiency up-stirring of the liver-Yang
(4)lnsufficiency of the heart and gallbladder Qi, mental upset. (5 ) Disordcr of the stomach-Qi and restless sleep.

6.14.2 Try to describe main points of differentiation, therapeutic methods and recipes of fire by stagnation of the liver-Qi and deficiency of both the heart and spleen.

(1) Deficiency of both the heart and spleen
[Main points of differentiation] Excessive dreaming and aptness to wake during sleep,palpitataion, amnesia, poor appetite, tiredness in limbs, pale tongure and weak r)11l.
[Treatrnent]? Invigorating the heart and spleen to promote Production of Qi and blood
[Recipe] Gui Pi Tang
(2)Fire caused by stagnation of the liver-Qi
[Main points of diflerentiaiion] Insomnia, irritability, red eyes, bitter taste, wiry and rapid pulse.
[Treatment] Relieving the depressed liver, arid removing heat. assisted with tranquilliaing the mind.
[Recipe] Long Dan Xie Gun Tang
6. 14.3 Acupuncture treatment
(1) Deficiency of heart anc spleen
[Treatment]
Select points on the Hand-Shaoyin , Foot- Taiyin meridians and back Shu points as main points. The reinforcing method of needling is advised and moxibListion is applicable at same time.
[Prescription]
Pishu, Xinshu ,Shenmen and Sanyinjiao

(2) Disharmony between heart and kidney
[Treatment]
Select points on the Sliaoyin and jueyin meridians as main
points to nourish Yin and purge empty fire. Both of the reinforeing and reducing methods of needling are used.
[Prescrrption]
Daling, Taixi,Shenmen and Taichong

(3) Disharmony between spleen and stomach
[Treatment]
Select points on theRen and Foot- Yanjrining and Taiyin meridans as main points to harmonize the stomach and resolve phlegm. The reducing method of needling is used.
[Prescripdon]
Zhongwan ?Fenglong, Lidui and Yinbai
(4) Upward disturbance of liver fire
[Treatment]
Select points on Foot- Shuowng, Foot-Jueyin and Hand- Shaoyin meridians as main points to othe the liver and subdue liver fire. The reducing rnethod of needling is used.
[Prescription]
Xingjian , Zuqiaoyin , Fengchi and Shenmen
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