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Jin Gui

Yao Lue -

金匱要略

Jin Gui Yao Lue - 金匱要略 Essential Prescriptions of the Golden Cabinet

Essential Prescriptions of the Golden Cabinet

Chapter 3 Bai He, Hu Huo, and Yin Yang Du Disease

Chapter 3

Bai He, Hu Huo, and Yin Yang Du Disease

Pulses, Patterns, and Treatment of Bai He, Hu Huo, and Yin Yang Toxin Disease

This chapter discusses pattern identification and

treatment of Bai He, Hu Huo, and Yin Yang Toxin

disease.

Although each condition displays distinctive

characteristics, all cases are related to contraction

of evil heat. They also share a number of common manifestations, and are therefore grouped together

here for discussion.

Bai He disease Hundred-union disease”

Bai He disease “ Hundred- union disease”  Bai He disease often results from the normal

Bai He disease often results from the normal

progression of febrile disease where residual heat

continues to damage yin, but it an also result from emotional frustration that leads to internal fire

scorching LU and HT yin.

Essential signs include abstraction of the spirit-mind, bitterness of the mouth, reddish urine, and faint

rapid pulses.

Bai He disease “Hundred-union disease”

It is a literal translation of the Chinese Bai Hé Bìng.

Three reasons have been posited for this disease name.

The first is that “hundred-union” means the “the hundred vessels,” in reference to the locus of the disease.

The disease is characterized by HT-LU vacuity heat. As

we know, the HT governs the blood and vessels, while the LU assembles the hundred vessels. Thus, the disease involves the vessels in their relationship to the HT and

LU. This interpretation is supported by the opening line

of the chapter: “It is said that hundred union disease [is so-called because] the hundred vessels [share] one [and the same] ancestors and all cause the disease.”

Bai He disease Hundred-union disease”

A second explanation of the name rests on the fact

that “hundred-union” or Bai Hé is also the Chinese

name for the lily bulb, the medicinal that is primarily used to treat this disease. The lily bulb is called

“hundred-union” in allusion to its being composed of

manifold converging layers.

to its being composed of manifold converging layers.  A third is that “hundred - union”

A third is that “hundred-union” refers to the

complexity of the disease.

Hu Huo disease “Fox-Creeper Disease “

Hu Huo disease “Fox - Creeper Disease “  Hu Huo refers to the specific locations

Hu Huo refers to the specific locations of

pathological manifestation.

“Hu” refers to the yin region of the body, and involves ulceration of the genitals. Huorefers to the

yang region, associated with ulceration of the throat.

Hu Huo disease can result from patterns of damp- heat and also from worm poisoning.

Symptoms and signs include redness of the eyes, ulceration of the throat, and ulceration of the anterior and posterior yin organs.

Yin Yang Toxin Disease Yīn Yáng Dú Disease”

Yin Yang Toxin Disease “ Y ī n Yáng Dú Disease”  Regarding Yin Yang Toxin,

Regarding Yin Yang Toxin, the term Du is translated

as toxin, and yin yang refers generally to both yin

and yang types.

Du-toxin belongs to the category of acute heat

disease, with manifestations resulting from the

contraction of epidemic disease. It is caused by contraction of epidemic toxin that invades the

blood. The main symptoms include maculopapular eruptions and a sore throat.

SCHEMATIC OVERVIEW

Ba He Disease-Hundred Union Disease

1.

a)

b)

c)

Causes:

The signs may appear before any cold damage

febrile disease (excessive emotional stimulus), or four or five days after the onset of disease, or gradually over twenty days or a month after the onset of disease. Each case is treated according

to the signs.

Ba He Disease-Hundred Union Disease

2. Pathomechanism:

The hundred vessels have a single ancestor, which can cause disease everywhere

(HT-LU Yin vacuity with internal heat depriving the hundred vessels of nourishment)

 3. Signs:  a)The disease manifests in desire but inability to eat; frequent taciturnity;

3. Signs:

a)The disease manifests in desire but inability to eat; frequent

taciturnity; desire but inability to sleep; desire but inability to walk; desire to eat and drink yet finding some foods delicious and others not even tolerable to smell; [signs] resembling a cold condition but without cold; [signs] resembling a heat condition but

without heat; bitter taste in the mouth; and red urine. None of the

various medicines can treat it. Taking medicine results in violent vomiting and diarrhea, as if the patient were possessed by a spirit. The physical form seems to be in harmony and the pulse is

slightly rapid.

b)Bitter taste in the mouth and red urine.

Ba He Disease-Hundred Union Disease

4. Prognosis:

a)

If urination is always accompanied by

headache, the patient will recover in sixty days.

b)

If urination is never accompanied by headache

but there is aversion to cold as if the patient were wet, the patient will recover in 40 days.

c)

If urination is fast and merely accompanied by

dizziness, the patient will recover in twenty days.

Prognosis

Observing symptomatic reactions affecting the head

during urination can be useful to determine the severity

and prognosis of the disease.

The LU governs management and regulation of the waterways and also conveys turbid fluids to the

bladder, and the bladder channel ascends to the head

where it is connected with the brain. That explain the signs of headache, aversion to wind, or dizziness that occur unration. The numbers of days required for

recovery are approximate figures and should not be taken literally.

Ba He Disease-Hundred Union Disease

5.

“If no vomiting, precipitation, or swelling therapy

Regular Treatment:

has been applied and the disease appears the same as in the beginning.

Bai Hè Dí Huáng Tang (Lily Bulb and Rehmannia

Decoction) governs.”

Bai He : sweet / mild to nourish Yin, moisten LU,

clear deficiency heat in Qi aspect

Sheng Di Huang Zhi: cooling heat in blood aspect

Clinical application:

Neurological disorders Mental disorders

Menopausal (depression)

Sleep walking (somnambulism)

+ Gan Mai Da Zao Tang (Licorice.wheat and Jujube Decoction) and Chai Hu Shu Gan San (Bupleurum Liver- Soothing Powder)

+ Long Gu (Fossil;ia Ossis Mastodi); Mu Li (Concha Ostreae); Ci Shi (Magnetitum); Bai Zi Ren (Semen Platycladi), and He Huang Hua (Flos Albiziae)

Ba He Disease-Hundred Union Disease

6.

a) After promotion of sweating: Bai Hè Zhī Mu Tang (Lily Bulb and Anemarrhena Decoction) to enrich the LU/ST, to engender liquid, and to downbear

Treatment after adverse treatment:

counter flow.

The line discuss Bai He disease following improper application of sweating method. The treatment method

here is to clear heat and moisten LU.

Zhi Mu: acts to enrich yin and clear heat

Ba He Disease-Hundred Union Disease

6.

b) After precipitation: Hua Shi Dai Zhe Tang (Talcum and

Treatment after adverse treatment:

Hermatite Decoction) to nourish yīn and clear heat and to harmonize the ST and downbear counter flow.

This line discuss Bai He disease following improper application of

the purgation method. The signs include aggravated internal heat and loss of yin-fluids through the stool, manifesting with inhibited short voiding of reddish urine. The other is damage ST qi leading to vomiting.

Treatment method: nourish yin, clear heat, downbear counterflow. Hau Shi: promotion urination, clear heat Dai Zhe Shi: downbears counterflow, harmonize ST

Ba He Disease-Hundred Union Disease

6.

c)After ejection: Bai He Ji Zi Tang (Lily Bulb and Egg

Treatment after adverse treatment:

Yolk Decoction) to nourish the LU and ST, to engender liquid, and downbear counter flow.

This line discuss Bai He following inappropriate ejection. When yin becomes more deficiency and vexing heat is aggravated; the signs include palpitation, deficiency vexation, and sleeplessness. When ST Qi is disharmony, the sings will show as dry retching, clamoring ST , abdominal discomfort. Ji Zi (egg yolk): enrich yin and clear heat to calm the spirit. Support MJ and harmonize ST.

Ba He Disease-Hundred Union Disease

7.

a)Thirst: If the disease persists for a month without resolving

Treatment of transmuted patterns:

and thirst appears, use Bai He Xi Fang (Lily Bulb Wash) to nourish yīn and engender liquid, as well as Gua Lou Mu Li Tang (Trichosanthes and Oyster Shell Powder).

Bai He Xi Fang is for external wash. (should take with Bai He Di Haung Tang internally)

If the sings of thirst remain, than, Gua Lou Mu Li Tang should be added.

Gou Lou Gen: engender fluids to relieve thirst

Mu Li: alleviate thirst and protect against the scorching of yin fluids in throat by conducting heat downward

Ba He Disease-Hundred Union Disease

7.

Treatment of transmuted patterns:

b)Heat effusion: Bai He Hua Shi San (Lily Bulb and Talcum Powder) to nourish yīn, clear heat, and inhibit urine.

The line discuss the treatment of Bai He disease transmuting into heat effusion. The signs include tidal fever, vexing heat in the five hearts, and short rough voiding of scant reddish urine.

The treatment method is to enrich yin and clear heat.

Bai He: nourish yin

Hua Shi: drain heat downward through urination

Hu Huo disease-“Fox-Creeper Disease “

Hu Huo disease- “Fox - Creeper Disease “

Hu Huo disease-Fox-Creeper Disease “

1.

a)

Cause: Damp-heat arising from worm toxin.

Arising after febrile disease, when residual heat

has not been cleared.

b)

Arising after measles, when residual heat is still

present

2.

Damp-heat and worm toxin causing erosion

Pathomechanism:

Hu Huo disease-Fox-Creeper Disease “

3.

Clearing heat and disinhibiting dampness; killing worms and resolving toxin.

4. Signs:

Symptoms resembling cold damage, taciturnity and desire to sleep, inability to close the eyes and disquietude whether lying down or being up. If it erodes the throat, it is called creeper, if it erodes the

Principles of treatment:

yin, it is called fox. It further manifests with no desire to

eat or drink, aversion to the odor of food, and face and eyes that ae now red, now block, now white.

Hu Huo disease-Fox-Creeper Disease “

5. Pattern Identification:

a) Erosion in the upper body (throat): Husky voice.

Gan Cao Xie Xin Tang (Licorice Heart-Draining Decoction) : clear heat and transform dampness and to quiet the center and resolve toxin.

Gan Cao

Huang Qin

Ren Shen

Gan Jiang

Huang Lian

Da Zao

Ban Xia

Clinical Application

Stomach ulcers

Herpes

Modification:

Dampness+ Zhu Ling (Polyporus); Fu Ling Pi (Cutis Poriae)

Inflammation of eyes + Ju Hua ( Flos Chrysanthemi); Gu

Jing Cao (Flos Eriocauli); Mi Meng Hua (Flos Buddlejae)

Mouth ulcers + Bing Peng San (Bornrol and Borax Powder); Xi Lei San (Tin-Like Powder) externally

Ulceration of genitals and anus + Di Fu Zi (Fructus

Kochiae); Bai Xian Pi (Cortex Dictamni); Huang Bai (Cortex Phelloderdri Chinensis) and apply Ku Shen (Flavescent Sophora ) externally.

Hu Huo disease-Fox-Creeper Disease “

5. Pattern Identification:

b)Erosion in the lower body.

Anterior Yin: Ulceration of the genitals. Wash with

Ku Shen Tang (Flavescent Sophora Decoction) to

clear heat and eliminate dampness and to kill worms and resolve toxin.

Posterior Yin: Erosion of the anus. Fumigate with Xióng Huáng(realgar) to dry dampness, kill worms, and resolve toxin.

Hu Huo disease-“Fox-Creeper Disease “

6.

a) Signs:

Rapid pulse, absence of heat, slight vexation, taciturnity, desire only to sleep, and sweating. Initially, when this condition has lasted for only three to four days, the eyes

Giving rise to welling-abscesses and suppuration.

become red like those of a turtledove. After seven or eight

days, the four canthi of the eyes turn black. If the patient is able to eat, this indicated that pus has formed.

b) Treatment:

Chi Xiao Dou Dang Gui San (Rive Bean and Chinese Angelica Powder) to percolate dampness, clear heat, quicken the blood and expel pus.

Yin Yang Toxin Disease-Yīn Yáng Dú

Yin Yang Toxin Disease- “ Y ī n Yáng Dú ”

Yin Yang Toxin Disease-Yīn Yáng Dú

1.

Contraction of epidemic toxin.

2.

Epidemic toxin entering the blood aspect:

a)

Causes:

Pathomechanism:

Exuberant heat in blood toxin entering the blood

aspect:

Internal putrefaction giving rise to pus: Yang toxin.

b)

Static blood congealing and causing obstruction:

c)

Yin toxin.

Yin Yang Toxin Disease-Yīn Yáng Dú

3.

a)

Pattern Identification:

Yáng toxin: Face red with patches like brocade,

sore throat, spitting of pus and blood.

b)

Yīn toxin: Green-blue face and eye,

generalized pain as though having been beaten by

a stick, sore throat.

4.

Prognosis:

Within the first five days: treatable.

a)

b)

By the seventh day: not treatable

Yin Yang Toxin Disease-Yīn Yáng Dú

5.

a)

Treatment.

Yáng toxin: Sheng Ma Bei Jia Tang (Cimicifuga

and Turtle Shell Decoction) to clear heat, resolve toxin, and disperse stasis.

Yīn toxin: (-) Xiong Huang (realgar) and Shu

Jiao ( zanthoxylum ) to resolve toxin, quicken the

b)

blood and disperse stasis.

Sheng Ma Bei Jia Tang (Cimicifuga and Turtle Shell Decoction)

Sheng Ma Dang Gui

Hua Jiao

Gan Cao

Xiong Huang ½ Liang

Bai Jia

2 Liang

1 Liang

1 Liang 2 Liang

finger sized pc

Clinical application:

Lupus Leukemia

Psoriasis

Modification:

Blood stasis + Dan Shen (Radix Rhizoma Salviae); Chi Shao (Radix Paeoniae); Mu Dan Pi (Cortex Moutan)

SUMMARY

Disease

Associated

Signs and

Principles of Treatment

Formula

Pattern

Pathomechanisms

Symptoms

Bai He

Yin deficiency with heat affecting the heart and lung

Vexation, bitterness in the mouth, reddish urine

Cleat internal heat, nourish yin

Bai He Huang Tang (Lily Bulb and Rehmannia Decoction)

Disease

 

Yin damage

Vexation, dry

Cleat heat, nourish

Bai He Zhu Mu

resulting from improper sweating

mouth

yin, moisten the lung

Tang (Lily Bulb and Anemarrhena Decoction)

 

Yin-fluid damage

Inhibited short

Nourish Yin, clear

Bai Shi Dai Zhe

and stomach disharmony resulting from improper purgation

voiding of

heat, downbear counterflow, disinhibit urine

Tang (Talcum and Hematite

reddish

urination,

Decoction)

vomiting

 

Disease

Associated

Signs and

Principles of Treatment

Formula

Pattern

Pathomechanisms

Symptoms

Bai He

Yin-fluid damage resulting from improper ejection

Deficiency vexation, palpitation, insomnia, dry retching

Nourish the lung and stomach, engender fluids, and calm the spirit

Bai He Ji Zi Tang (Lily Bulb and Egg Yolk Decoction)

Disease

 

Bai he disease with predominant thirst,

Thirst, dry

Nourish yin, cleat heat

Bai He Xi Fang (Lily Bulb wash

mouth

yin deficiency,

 

formula)

exuberant heat damaging fluids

Gua Lou Mu Li San (Trichosanthes Root and Oyster Shell Powder)

 

Bai he with predominant heat effusion due to

Tidal heat, vexing heat in the five hearts,

Enrich yin, clear heat

Bai He Hua Shi San (Lily Bulb and Talcum Powder)

chronic heat

rough voiding

constraint and yin deficiency

of scant reddish urine

Disease

Associated

Signs and

Principles of Treatment

Formula

Pattern

Pathomechanisms

Symptoms

Hu Huo

Damp-heat

Alternating cold

Clear heat, dry

Gan Cao Xie Xin

Disease

brewing internally,

and heat,

dampness, resolve

Tang(Licorice

upright qi

insomnia, erosion of the flesh, ulceration

toxin, support the upright

Heart-Draining

deficiency

Decoction)

 

Heat toxin brewing

Abscesses with

Cleat heat,

Chi Dou Dang Gui

and binding in the

pus formation

eliminate damp-

San (Rice Bean and

blood aspect

ness, dispel stasis, expel pus

Chinese Angelica Powder)

 

Static damp-heat toxin in the liver

Genital ulceration, dry

Clear heat, resolve toxin, eliminate

Ku Shen (Flavescent Sophora Decoction)

channel

throat

dampness

 

Static damp-heat toxin

Anal ulceration, dry throat

Clear heat, resolve toxin

Fumigation with Xiong Huang

Disease

Associated

Signs and

Principles of

Formula

Pattern

Pathomechanisms

Symptoms

Treatment

Yang Du

Blood aspect static heat, internal heat

Brocade-like red macules on

Clear heat, resolve toxin, move blood,

Sheng Ma Bie Jia Tang (Cimicifuga

scorching the throat

the face, sore

and dispel stasis

and Turtle Shell

throat, spitting of purulent blood

Dec-oction)

Yin Du

Static blood, toxin binding in the throat

Blue-green complexion generalized pain, sore throat

Resolve toxin, dispel stasis

Sheng Ma Bie Jia Tang (Cimicifuga and Turtle Shell Decoction) minus Xiong huang

(Realgar) and Hua

Jiao (Pericarpoium

Zanthoxyli)