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72 Cards in this Set
- Front
- Back
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Inflammation
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A localized physical condition in which parto of the body becomes reddened, swollen, hot, and often painful, esp. as a REACTION to injury or infection.
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How does inflammation explain most heat Patterns in TCM?
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Stagnation --> Swelling --> Blocking
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Why does stagnation often become Heat (+ stagnation)?
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Blocked --> Friction --> Heat
Vasodilatation, Metabolic Activity |
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Why does dampness and / or phlegm often become hot dampness or hot phlegm?
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Blocking --> Swamp building --> building ground for more activity
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Pain in TCM
(3 different types) |
1. QI STAGNATION PAIN: moving, dull, better with movement
2. BLOOD STASIS PAIN: Fixed, stabbing, pain with movement, better laying down, heat helps 3. DAMPNESS 4. COLD STAGNATION |
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Wind
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Generally most pernicious & almost always in combination.
Soreness, pain in muscles & joints, limited movement, moves from joint to joint P: floating & slightly rapid in acute cases |
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Damp
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Fixed pain with soreness & swelling, heavy, numb feeling, worse with damp weather
P: slow & slightly slippery in acute cases |
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Heat
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often with u/l yin xu
Severe Pain, red hot & swollen, accompanied by dampness, thirst, mb fever that is not better with sweating P: slippery, rapid |
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Cold
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Severe pain, usually unilateral
P: Tight in acute cases |
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Key differentiation in Bi, and additional Factors:
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EPF's = External pathogenic factors
+ excessive physical stress u/l blood or yin xu trauma emotional problems |
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Persistent obstruction (worsened by LVR / KD xu) causes ..... .. .... ....., which can turn into ........
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Persistent obstruction (worsened by LVR / KD xu) causes retention of body fluids, which can turn into phlegm.
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Consistent obstruction of joints, muscles, channels leading to blood stasis & local lack of nourishment can turn into:
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an internal syndrome affecting internal organs
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CTS = Carpal Tunnel Syndrome
TCM Differentiation |
- Blood Xu not nourishing the sinews
- Qi stagnation & Blood stasis - Wind Damp Bi |
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CTS
Blood Xu not nourishing the sinews |
Tingling
Numbness in Fingers - mb u/l or b/l T: pale P: thin, weak, (choppy if there is stagnation |
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CTS
Qi stagnation & Blood stasis |
Relatively severe wrist pain, worse at night
T: dusky, purple, accum. in the vessels on the underside P: choppy, wiry, tense |
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CTS
Wind Damp Bi |
Wrist pain that comes and goes, or migrates up the arm
Numbness / heaviness of the hand and fingers Somewhat inhibited finger joints Pain worse with cold or damp exposure / rainy weather P: slippery, floating, (intermittent on the affected side) |
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Lateral Epicondylitis
Sx |
Pain in lateral elbow that may radiate into forearm or hand, achy at rest, pain with grasping, sense of weakness
Inflammation d/t repetitive motion or from sudden violent injury Occasional bone spurs or calcium deposits present on X-ray Often accompanied by LVR Qi Stagnation (adult, frustration) Patient needs to refrain from activity / strain while healing Ice generally contraindicated d/t the presence of cold. Warming liniments & compresses helpful. Moxa also helpful for cold. |
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Lateral Epicondylitis
TCM Differentiation |
Qi and Blood deficiency with Wind Cold Bi
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Periarthritis of Shoulder
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Pain is earliest symptom, generally made worse with exercise. Also: stiffness following inactivity which improves with activity. As the disease progresses, ROM decreases with possible flexion contractures, tenderness, crepitus / grating sensation.
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Periarthritis of Shoulder
TCM Differentiation |
- External Contraction of Wind Cold
- Invasion of Wind Damp - Blood Stasis (Blocking Network Vessels) - Phlegm Dampness (Blocking Network Vessels) - Qi and Blood deficiency - LVR - KD (Yin, Qi Essence) Deficiency - Frozen Shoulder - Combination of Wind Cold Bi & Blood Xu, & blood stasis |
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Periarthritis of Shoulder
External Contraction of Wind Cold |
Minor pain is in shoulder, possible local numbness, may go into upper back as well, or anterior upper arm, tight & cold sensation, very little ROM restriction.
P: Deep, wiry |
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Periarthritis of Shoulder
Invasion of Wind Damp |
More severe pain which may cause sweating, disturbance of sleep / work / eating.
As disease progresses, ROM starts to be limited. |
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Periarthritis of Shoulder
Blood Stasis (Blocking Network Vessels) |
Severe & sharp pain leading to restriction of movement, less relief from warming the channels & scattering cold / dispelling wind dampness.
Local Ashi points if pattern is d/t trauma. |
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Periarthritis of Shoulder
Phlegm Dampness (Blocking Network Vessels) |
Severe pain in the sinews & muscles of the shoulder.
Mobility is restricted but better briefly with movement and warmth & worse with cold & damp |
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Periarthritis of Shoulder
Qi and Blood deficiency |
Aching pain around the shoulder, inhibited bending & stretching.
Pain worse after prolonged inactivity, better with use, but worse with overuse. Weakness in the shoulder area. |
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LBP = Periarthritis of Shoulder
LVR - KD (Yin, Qi Essence) Deficiency |
Marked limitation of ROM.
Less severe aching & pain. Lack of strength in lifting and possibly walking. Loss of teeth if extreme. |
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Periarthritis of Shoulder
Frozen Shoulder - Combination of Wind Cold Bi & Blood Xu, & blood stasis |
Pain triggered by shoulder movement, as well as significant restriction in movement.
Worsening ability to raise shoulder. Generally worse at night & disruptive to sleep. Occasionally severe pain with light touch. Muscles around shoulder may eventually atrophy with sinews becoming more and more inflexible. Cold sensation in shoulder. Spontaneous sweating in Palms. |
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Lumbar Pain (incl. Sciatica, Piriformis Syndrome)
TCM Differentiation |
- Cold Dampness
- Damp Heat - Overstrain / Qi & Blood Stagnation - KD Deficiency |
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Lumbar Pain (incl. Sciatica, Piriformis Syndrome)
Cold Dampness |
Hx of exposure to cold & damp cxs
Lower back heaviness / pain / soreness / numbness / stiffness & cramping Pain can involve sacrum, hip, thigh, back of knee Pain not constant Worse with rain, cold T: thick white coat P: slow, slippery, mb deep |
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Lumbar Pain (incl. Sciatica, Piriformis Syndrome)
Damp Heat |
Hx of exposure to dam & heat cxs
Pain with hot sensation Worse with heat or dampness T: thick yellow coat P: rapid, slippery |
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Lumbar Pain (incl. Sciatica, Piriformis Syndrome)
Overstrain / Qi & Blood Stagnation |
Hx of trauma or overwork
Soreness & stiffness Worse with overuse or tiredness Fixed pain Difficult to rotate body / lie down / stand up T: dusky --> purple P: choppy, wiry |
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Lumbar Pain (incl. Sciatica, Piriformis Syndrome)
KD Deficiency |
Dull, often aching pain and weakness
* Need to specify type of KD xu involved. This mb a dx of LBP alone, but is often an u/l factor in the other patterns |
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RA = Rheumatoid Arthritis
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Chronic Autoimmune Disease of Unknown Etiology
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RA
Characterized by non-specific usually symmetrical ..... |
inflammation of peripheral joints
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RA
Progressive destruction of ..... |
articular & peri-articular structures
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RA
Suspected contributing factors / associations: |
- Leaky gut
- Genetic susceptibility - Lifestyle factors - Micro-organisms - Possible association with abnormal bowel function |
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RA
Affects ..... million people world wide. Affects more men or women? Usual onset between age? |
2.1 million
women 20 & 50 |
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RA
Onset is? |
insidious onset
can also be aprupt |
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RA
Joints affected: |
Simultaneous inflammation of several joints --> TTP
Most commonly PIP & MCP joints |
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RA
Progression and Sx |
Eventual synovial thickening
Stiffness > 30 min after prolonged inactivity Early afternoon fatigue / malaise s/t low grade fever Progression leads to joint tissue degeneration Advanced dz: subQ nodules Additional ssxs may include: visceral nodules, leg ulcers, pleural or pericardial effusion, lymphadenopathy |
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RA
Western Txs |
Rest
NSAIDs Corticosteroids Immuno-suppressive drugs Exercise PT Surgery |
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RA
TCM causes |
- Habitual bodily righteous qi xu with external invasion of evils
- Long living in damp environment & contraction of win, cold, damp & / or heat |
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RA
TCM patterns |
- Wind Cold Damp
- Wind Damp Heat - Enduring Blockage Transforms Heat & Damages Yin - Qi & Blood Xu with Phlegm & Stasis - LVR Blood - KD Yin & Yang Deficiency With Phlegm & Stasis |
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RA
Wind Cold Damp SSx |
- Swollen painful joints without redness or heat. May feel cold
- Early morning stiffness / heaviness / numbness / restricted movement - Worse with cold, better with heat - Pain follows weather changes - Possible aversion to cold - Loose stools - Clear long urination - Initial stage: fever, chills, lack of sweating may accompany severe joint pain T: pale with thin white coat P: deep bowstring or deep tight |
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RA
Wind Cold Damp Tx Principles & Tx |
Expel Wind, Dispel Dampness, Warm the Channels, Scatter Cold
GB-20: Drain to release the exterior UB-17: Drain to quicken the blood UB-23: Moxa to warm & supplement the yang to scatter cold Drain local points to free flow of network vessels |
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RA
Wind Cold Damp Notes |
This pattern is characteristic of early stage RA.
Western patients tent to have SP xu & LVR depression in addition to the wind cld damp. The SP qi xu leads to wei qi u which allows invasion of wind / cold / damp. |
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RA
Wind Damp Heat SSx |
- Joint swelling with pain heaviness, restricted movement
- Joints are red & hot - Better with cold - Fever - Sweating - Aversion to wind - Thirsty - Possible vomiting T: red body with thin yellow coat P: soggy, rapid or slippery rapid |
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RA
Wind Damp Heat Tx Principles & Tx |
Clear Heat. Disinhibit Dampness. Dispel Wind. Free the Flow of Network Vessels.
DU-14: (Bleed) to clear heat & dispel wind LI-11 & LI-4: Drain to clear heat from the entire body. SJ-5: Drain to course wind & clear heat. Local points |
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RA
Wind Damp Heat Notes |
This pattern is characteristic of acute active of RA.
In Western practice, we tend to see more SP xu and LV depression, creating internal dampness and heat. |
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RA
Enduring Blockage Transforms Heat & Damages Yin SSx |
- Joint redness, swelling, heat, pain
- Joint stiffness & inflexibility - No longer relieved with cold - mb relieved with warmth - Dry mouth - Bitter taste - Parched throat - Insomnia - Agitation T: red with yellow coat, mb slimy P: fine, rapid, bowstring |
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RA
Enduring Blockage Transforms Heat & Damages Yin Tx Principles & Tx |
Scatter Cold. Eliminate Dampness. Clear Heat. Free flow of Network Vessels.
LI-11 & LI-4: Lift and thrust, draining to clear heat from the entire body. Ren-4: Even technique leads Yang back down to lower source to scatter cold & warm the channels. Local points |
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RA
Enduring Blockage Transforms Heat & Damages Yin Notes |
No longer early stage. Not only acute flare.
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RA
Qi & Blood Xu with Phlegm & Stasis SSx |
- Aching, painful, swollen, distended, deformed joints with inhibited movement
- Somber white complexion - Palpations - SOB - Body fatigue - Lassitude T: pale with white coat P: deep, fine, bowstring, & / or tight |
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RA
Qi & Blood Xu with Phlegm & Stasis Tx Principles & Tx |
Boost the Qi. Nourish Blood. Transform Phlegm. Dispel Stasis. Free the Flow of Channels and Quicken the Network Vessels.
ST-36: Supplementing, lifting & thrusting boosts the qi SP-6: Supplementing, lifting & thrusting nourishes the blood. Local points |
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RA
Qi & Blood Xu with Phlegm & Stasis Notes |
This generally characterizes later stages of RA with joint rigidity and deformation.
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RA
LVR Blood - KD Yin & Yang Deficiency With Phlegm & Stasis SSx |
- Joint & muscular atrophy
- Joint stiffness, inflexible, deformity - Unceasing aching & pain - worse with cold, better with warmth - Dizziness - Tinnitus - Long, clear frequent urination - Nocturia - Low back & knee pain & chill T: pale with white coat P: deep, weak, slow |
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RA
LVR Blood - KD Yin & Yang Deficiency With Phlegm & Stasis Tx Principles & Tx |
Supplement the KD & invigorate Yang. Nourish LVR & soothe sinews. Scatter nodulation & quicken network vessels.
Even technique on UB-23, DU-4, Ren-4, followed by moxa to warm and supplement source Yang so it can scatter cold & warm the channels. Local points |
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RA
LVR Blood - KD Yin & Yang Deficiency With Phlegm & Stasis Notes |
More pronounced KD Yang xu sxs
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RA diet:
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- decrease or eliminate sugars / sweets
- decrease raw or chilled foods / drinks - decrease foods that endanger fluids (dairy, animal products in general) and enrich Yin - With damp heat: Maintain a clear, bland, yeast-free, hypo-allergenic diet |
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OA = Osteoarthritis
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- Joint disease characterized by loss of articular cartilage and hypertrophy of bone
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OA
Affects: May begin asymptomatically (age): Some apthological tissue changes by (age) Extremely common by (age) |
Men and women equally
20s to 30s 40s 70 |
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OA
Common long term sequelae: |
Osteophytes / bone spurs
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OA
TCM causes |
Externally contracted wind, cold, damp + bodily weakness / xu or ageing
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OA
Patterns and Progression |
- Predominant Wind
- Predominant Cold - Predominant Damp - Predominant Heat - Phlegm & Stasis Obstructing - Qi & Blood Xu - Kidney Yin Xu - SP & KD Yang Xu |
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OA
Predominant Wind |
Moving pain in particular joints
Hard to pinpoint |
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OA
Predominant Cold |
Cold limbs
Paleness Dull pain Sense of constriction Tight Less mobile |
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OA
Predominant Damp |
Heaviness
Accumulation Numbness |
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OA
Predominant Heat |
Redness
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OA
Phlegm & Stasis Obstructing |
Nodules
Decreased Function Numbness |
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OA
Qi & Blood Xu |
Paleness
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OA
Kidney Yin Xu |
Hot
Weak limbs |
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OA
SP & KD Yang Xu |
Bruising
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