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exterior and interior, cold and heat, deficiency Ï£¬ÕâЩ֤ºò³£Ï໥ת»¯¡£

and excess syndromes are usually found ÀýÈ磬±íа¿ÉÒÔÈëÀ·´Ö®simultaneously. For instance, the disease with ÒàÈ»£»º®Ö¤¿ÉÒÔ»¯ÈÈ£¬·´Ö®both the exterior and interior syndromes; the ÒàÈ»£»ÐéÖ¤¿ÉÒÔתʵ£¬·´Ö®deficiency syndrome mingling with excess ÒàÈ»¡£¼²²¡¹ý³ÌÖУ¬Ò»Ð©Óësyndromes; intertwinement of the cold and heat ¼²²¡ÐÔÖÊÏà·´µÄ¼ÙÏó»á³ösyndromes. Under certain conditions these ÏÖ¡£Òò´Ë£¬Ò½Éú¸ù¾Ý°Ë¸Ù±æsyndromes are often transformed into one ֤ʱ£¬²»½ö±ØÐ뾫ȷµÄÕÆÎÕanother. For example, the exogenous pathogens ÿһÖÖÖ¤ºòµÄÌØµã£¬Ò²Òª×¢may invade the interior and vice versa the cold ÒâËüÃÇÖ®¼äµÄ¹²´æ¡¢½»´í¡¢syndrome may be transformed into heat syndrome ת»¯ºÍÕæ¼Ù×´¿ö£¬Òò´Ë²ÅÄÜand vice versa; the deficiency syndrome may be ¶Ô¼²²¡ÓÐÈ«ÃæµÄÁ˽⣬´Ó¶øtransformed into the excess syndrome and vice ΪÖÎÁÆÌṩ¿É¿¿µÄÒÀ¾Ý¡£ versa. With the progress of disease, some false appearances contrary to its nature may appear. e. g. ,cold syndrome with pseudo-heat symptoms and vice versa, deficiency syndrome with pseudo-excess symptoms and vice versa. Thus, when applying differentiation of syndrome according to the eight principles, physicians are required not only to have a masterly command of the characteristics of each syndrome, but also to pay attention to their coexisting, interlacing, transforming, and true or false conditions, so and so only can the disease be understood in an all-round way. Thereby, providing reliable basis for treatment. Yin and yang are a pair of principles used to summarize the other three pairs of principles

and are also the key principles in the eight ÒõÑôÊÇÒ»¶Ô¿ÉÒÔ×ܽáprinciples. So the other three pairs of ÆäËüÈý¶ÔÔ­ÔòµÄÔ­Ôò£¬Ò²ÊÇprinciples are classified under either yin or °Ë¸ÙÖÐ×îÖØÒªµÄÔ­Ôò¡£ËùÒÔyang. Exterior, heat and excess syndromes are ÆäËüÈý¶ÔÔ­Ôò¿É±»¹éÄÉΪclassified into the category of yang, while Òõ»òÑô¡£±í¡¢ÈȺÍʵ֤¹éΪinterior, cold and deficiency syndromes fall Ñô£¬¶øÀï¡¢º®¡¢ÐéÖ¤Ôò¹éΪinto the category of yin. Yin syndrome is Òõ¡£ÒõÖ¤ÒÔÌåÄÚÑôÐéÒõʢΪcharacterized by deficiency of yang-qi and ÌØµã¡£ÑôÖ¤ÒÔÓÉÌåÄÚÑôÈȹýexcess of yin in the body. Yang syndrome in Ê¢ÒýÆðÑô¿ººÍÔอ¹¦ÄÜ¿ºcharacterized by the hyperactivity of yang-qi ½øÎªÌص㡣ÒõÑôҲͨ³£ÓÃÓÚand hyperfunctions of the zang fu-organs, ½âÊÍÔอÆ÷¹ÙµÄ²¡Àí±ä»¯£¬resulting from excess of yang-heat in the body. ÀýÈ磬ÒõÑô¾ãÐé¡¢ÒõÐéºÍÑôYin and yang are also used to explain the ÐéµÈ¡£ pathological changes of the zang-fu organ, eg. yin depletion, yang depletion, yin deficiency

and yang deficiency, etc.

Differentiation of syndromes according to the theory of qi, blood and body fluid is a differentiating method to analyse and identify the pathological changes of qi, blood and body

fluid according to the theory of qi, blood and ÆøÑª½òÒº±æÖ¤ÊÇÒ»ÖÖbody fluid. Qi, blood, and body fluid, are the ¸ù¾ÝÆøÑª½òÒºÀíÂÛ·ÖÎöºÍmaterial basis for the functional activities of È·¶¨ÆøÑª½òÒº²¡Àí±ä»¯µÄthe zang-fu organs, their formation and ±æÖ¤·½·¨¡£ÆøÑª½òÒºÊÇÔอcirculation depend upon the normal functions of ¹¦ÄܻµÄÎïÖÊ»ù´¡£¬ËüÃÇthe zang fu organs. Therefore the pathological µÄÐγɺÍÑ­ÐÐÒÀÀµÓÚÔอchanges of qi, blood and body fluid may bring ¹¦ÄܵÄÕý³£¡£Òò´Ë£¬ÆøÑª½òabout the dysfunction of the zang-fu organs, and ÒºµÄ²¡Àí¸Ä±ä¿ÉÒÔÒýÆðÔàthe dysfunction of the zang-fu organs will be ¸­¹¦ÄܵÄÒì³££¬Í¬Ê±£¬Ôอbound to cause the pathological changes of qi, ¹¦ÄܵÄÒì³£Ò²±ØÈ»»áµ¼ÖÂblood and body fluid. Hence, both of them should ÆøÑª½òÒºµÄ²¡Àí¸Ä±ä¡£Òòclosely coordinate and complement each other. Qi ´Ë£¬ËüÃÇÁ½ÕßÓ¦½ôÃÜЭµ÷Ïàhas many syndromes, which are usually classified »¥²¹³ä¡£ÆøÓÐÐí¶àÖ¤ºò£¬Í¨into four classes: qi deficiency, qi sinking, qi ³£±»·ÖΪËÄÖÖÀàÐÍ£ºÆøÐé¡¢stagnation and reversed flow of qi. As concerns ÆøÏÝ¡¢ÆøÖÍºÍÆøÄæ¡£¾ÍѪ֤blood syndromes, TCM tends to group them under ¶øÑÔ£¬ÖÐÒ½ÊÔͼ½«Æä¹éΪËÄfour heads: blood deficiency, blood stasis, heat ÀࣺѪÐ顢Ѫðö¡¢ÑªÈȺÍѪin blood and cold in blood. \º®¡£ÔÚÉúÀíÉÏ£¬ËüÃÇÏ໥²¹they complement each other and, pathologically, ³ä£»ÔÚ²¡ÀíÉÏ£¬ËüÃÇÏ໥Ӱ

affect each other. Thereby, forming Ïì¡£Òò´ËÐγÉÁËͬһ¼²²¡µÄdifferentiation of syndromes of the same disease ÆøÑª±æÖ¤¡£ÁÙ´²ÉÏ£¬ÓÐÆøÖÍof qi and blood. Clinically, there is qi Ѫðö¡¢Æø²»ÉãѪ¡¢ÆøÑª¿÷Ðé¡¢stagnation and blood stasis, qi deficiency and ÆøÐéѪðöºÍÆøËæÑªÍÑ¡£½òÒºblood loss, deficiency of both qi and blood, qi µÄÖ¤ºò¿ÉÒÔ¹éΪÁ½Àࣺ½òÒºdeficiency and blood stasis, and qi prostration ¿÷ÐéºÍˮҺ´¢Áô¡£½òÒº¿÷Ðéresulting from hemorrhage. Syndromes of body ¿ÉÒÔµ¼ÖÂÒÔϵÄÁÙ´²±íÏÖ£ºfluid may be classified into two categories: ¿Ú¸É¡¢Ñʸɡ¢´½Éà¸ÉÔï¡¢ÑÛinsufficiency of body fluid and water retention. ¿ô°¼ÏÝ£¬Æ¤·ô¸ÉÔï¡¢ÄòÉÙ¡¢Insufficiency of body fluid may cause the ±ãÃØ¡¢ÉàºìÉÙ̦ºÍÂöϸÊý¡£clinical manifestations: dryness of the mouth ¶øË®Òº´¢Áô¿ÉÒÔÓÉÈçÍ£ÖÍand throat, dry lips and tongue, subsidence of µÄˮʪ̵ÒûµÄ²¡ÀíÎïÖÊÒýeyes, dry skin, scanty urine, constipation, a Æð¡£Í¨³£¼ûÓÚË®Öס¢¹ÄÕͺÍred tongue with scanty saliva and thready, rapid ̵Äý¡£ pulse. Whereas, retention of water may form such pathological substances as water, dampness and phlegm retention. Usually seen in edema,

tympanites and phlegm-retention. Differentiation of syndromes according to ÎÀÆøÓªÑª±æÖ¤ÊÇÊÊÓÃthe theory of wei (defensive), qi (vital-qi), ÓÚ·ÖÎöºÍ±æÖ¤Íâ¸ÐÈȲ¡µÄ

ying (nutrient) and xue (blood) is a Ò»ÖÖ±æÖ¤·½·¨¡£ËüÊÇÇå´úÒ¶differentiating method applied to analysing ÌìÊ¿´´½¨ºÍ·¢Õ¹ÆðÀ´µÄ¡£Ëüand differentiating exogenous febrile diseases. ²¹³äÁËÁù¾­±æÖ¤ÀíÂÛ£¬·á¸»It was developed and created by YeTianshi in the ÁËÖÐÒ½¶ÔÍâ¸ÐÈȲ¡µÄ±æÖ¤

Qing Dynasty. It supplements the ÂÛÖΡ£Õâ¸öÀíÂÛÊÇÇø·ÖÖ¤

differentiation of syndromes by the theory of ºò¡¢È·¶¨±ä»¯ºÍ¾ö¶¨ÖÎÁƵÄ

the six meridians and enriches the »ù´¡¡£ÎÀÆøÓªÑªÀíÂÛÓм«¸ßdifferentiation of syndromes and treatment for µÄʵ¼ù¼ÛÖµ£¬ÒòΪ£¬Ò»·½Ã棬exogenous febrile diseases in TCM. This theory Ëü½«Íâ¸Ð²¡µÄ²¡Àí±ä»¯¹éis the basis used to classify syndromes, to ΪËÄÖÖÖ¤ºò£ºÎÀ·Ö¡¢Æø·Ö¡¢identify transformation and determine Óª·ÖºÍѪ·Ö¡£ÁíÒ»·½Ã棬Ëütreatment. The theory of wei, qi, ying and xue ´ú±íÁËËĸö²»Í¬µÄ½×¶Î£ºÍâis of great practical value because, for one ¸ÐÈȲ¡·¢Õ¹ÖеÄdzÉîºÍÇáthing, it generalizes the pathological changes ÖØ½×¶Î¡£ËüÒ²±»ÈÏΪÊÇÍâ¸Ðof febrile dis-eases as the four kinds of ÈȲ¡·¢Õ¹±ä»¯µÄ¹æÔò¡£ÎÀÆøsyndromes: weifen, qifen, yingfen and xuefen, ½×¶ÎµÄ¼²²¡Çádz£¬¶øÓªÑª½×for another, it represents the four different ¶ÎµÄ¼²²¡ÔòÉîÖØ¡£ stages: superficial or deep and mild or serious in the development of exogenous febrile diseases. It is also believed as a law of the development and changes of exogenous febrile diseases. Diseases of the wei and qi stages are mild and superficial, whereas those of the ying

and xue stages are deep and serious. Differentiation of syndromes according to the zang-fu theories a differential method by which symptoms and signs are analysed to clarity

the cause, the location and nature of disease as Ôอ±æÖ¤ÊÇÒ»ÖÖ¸ù¾Ýwell as the conditions between vital qi and ÔàÏó¡¢ÒõÑôºÍÎåÐÐÀíÂÛͨ¹ýpathogens in light of the theories viscera Ö¢×´ºÍÕ÷Ïó¶Ô¼²²¡µÄ¸ùÔ´¡¢figure (manifestation) , yin yang and five λÖúÍÐÔÖÊÒÔ¼°Õýа״̬elements. It is the basis of various hinds of ½øÐзÖÎöºÍ¹éÀàµÄ±æÖ¤·½differentiation of syndromes and the basic ·¨¡£ËüÊÇÆäËü±æÖ¤µÄ»ù´¡£¬diagnostic method of all clinical branches of Ò²ÊÇËùÓÐÖÐÒ½ÁÙ´²·Ö֧ѧTCM, and an important component part of all ¿ÆµÄ¼²²¡Õï¶Ï·½·¨£¬ÊÇÖÐÒ½differential system in TCM. Differentiation of ±æÖ¤ÏµÍ³µÄÖØÒª×é³É²¿·Ö¡£syndromes according to the theory of the zang-fu Ôอ±æÖ¤°üÀ¨Ôಡ±æÖ¤£¬¸­organs includes differentiating syndromes of ²¡±æÖ¤ºÍÔอ±æÖ¤¡£ zang-organs diseases, fu-organ diseases and complicated diseases of both zang-organs with

fu-organs. Differentiation of syndromes acording to the Áù¾­±æÖ¤ÊÇÖÐÒ½±æÖ¤

theory of six meridians is a method of Íâ¸Ð²¡µÄÒ»ÖÖ±æÖ¤·½·¨¡£Ëüdifferentiating exogenous diseases in TCM. It ÊǶ«ººÊ±ÆÚһλ½Ü³öµÄÒ½

was put forward in Treatise on Febrile Diseases Éú¡ªÕÅÖÙ¾°ÔÚ¡¶É˺®ÔÓ²¡by Zhang Zhonjing-a distinguished physician in ÂÛ¡·ÖÐÌá³öµÄ¡£¸ù¾ÝÒõÑôÀíthe Eastern Han Dynasty. In Light of the yin-yang ÂÛ£¬Áù¾­Ö¤ºò¿ÉÒÔ·ÖΪÈýÑôtheory, the syndromes of the six meridians may Ö¤¡ªÌ«Ñô¡¢ÑôÃ÷ºÍÉÙÑôÒÔ¼°be divided into three yang syndromes-taiyang, ÈýÒõÖ¤¡ªÌ«Òõ£¬ÉÙÒõºÍØÊ

yangming and shaoyang and three yin Òõ£¬´Ó¶øÎª±æÖ¤ÂÛÖÎÌṩ»ùsyndromes-taiyin, shaoyin and Jueyin. Thereby ´¡¡£Áù¾­Ö¤ÊÇÔอ¾­Â粡Àíproviding a basis for differential diagnosis and ±ä»¯µÄ·´Ó¦£¬ÈýÑôÖ¤ÒÔÁù¸­treatment. Six meridians syndromes are the µÄ²¡Àí±ä»¯Îª»ù´¡£¬¶øÈýÒõreflections of pathological changes in the Ö¤ÒÔÎåÔàµÄ²¡Àí±ä»¯Îª»ùzang-fu organs and meridians, among which three ´¡¡£ yang syndromes take the pathological changes of

the six fu organs as their basis, while three yin

syndromes take the pathological changes of the

five zang organs as the their basis. Besides differentiating syndrome in light of the theory of triple energizer is one of methods of differential diagnosis for febrile diseases, put forward by Wu Jutong, a distinguished

physician of the Qing Dynasty. Wu Shi takes Èý½¹±æÖ¤ÊDZæÖ¤ÈȲ¡triple energizer as the guiding principle of µÄÒ»ÖÖ·½·¨£¬ÓÉÇå´úµÄһλdifferentiation of syndromes of seasonal ½Ü³öµÄÒ½Éú¡ªÎâ¾ÏͨÌá³öfebrile disease in conjunction with µÄ¡£ÎâÊÏÒÔÈý½¹½áºÏÎÀÆøÓªdifferentiation of syndromes according to the Ѫ±æÖ¤Îª±æÖ¤Î²¡µÄÖ¸µ¼theory of wei, qi, ying and xue, to emphasizes Ô­Ôò£¬Ç¿µ÷β¡ÖÐÓëÈý½¹Ïàthe pathological changes of the zang-fu organs ¹ØÔอµÄ²¡Àí±ä»¯¡¢Ö¤ºòÌØrelated to triple energizer during the course of µãºÍת»¯¹æÂÉ¡£Î²¡ÊÇÓÉËÄseasonal febrile diseases£¬the characteristics ¼¾Öв»Í¬µÄÎÂÈÈ֮аÒýÆðof syndromes and the law of transmission and µÄËùÓм±ÐÔÈȲ¡µÄ×ܳơ£Èýtransformation. Seasonal febrile disease is a ½¹±æÖ¤Ò²ÊÇÖÎÁƵÄǰÌáºÍgeneral term for all acute febrile diseases »ù´¡¡£ resulting from various warm-heat pathogens in the four seasons. Differentiation of syndromes by the theory of triple energizer is also the

premise and foundation of treatment. As a whole, conditions of differentiating

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syndromes are complex, what has been discussed

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in this unit is only those common, typical

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differentiating syndromes, they should be

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applied flexibly so as to decide the therapeutic

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principle on the basis of correct

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differentiating syndromes.