傷寒論臨床病案學(xué)習(xí)

1、Shanghan clinical cases study1In the 1980s, People Republic of China2Dr. Zahn Dechaos clinical case張德超醫(yī)案3Food-denying dysenteryMain complains: A 7 year-old boy suffering from severe diarrhea with passage of mucus and blood for five days. 45ManifestationMain signs: more than 10 times of major bloody

2、stools a dayOther symptoms and signs: Abdominal pain, poor appetite, relief of fever after resolving the exterior.6Initial treatments:1)Since fever with severe diarrhea，use the method of ”hauling the boat upstream”(exterior syndrome)7Maybe food accumulation ?2)Since poor appetite may be caused by fo

3、od accumulation, use the method of precipitation to discharge accumulated food.?8Evaluation First treatment is somewhat right, fever relieved, but no effect on diarrhea.Second treatment is completely wrong, more severe diarrhea, vomit and food-denying appears.9Dr. Zahn Dechao s initial impressionPul

4、se: soggy and weak pulse, especially right Guan Pulse. Tongue: red tongue body with white coating . What information those signs give us? 10Pulse LocationLeft right Hand cun hand guan ChiHeartLiverkidneyLungSpleen&StomachVital gate11Soggy and weak pulse meansJust like Air chair is leaking air.12Tong

5、ue Red tongueSince body fluid loses due to diarrhea, it is a kind of physical response.White coatingEvil locates in Qi aspect 13 Mechanism Spleen & Stomach extremely deficiencyand Qi dynamic disorder no exteriorno repletion機(jī)制：脾胃虛極，氣機(jī)失調(diào)（非表非實(shí)）14 Donghan Dynasty the same thing happened15傷寒中風(fēng)，醫(yī)反下之，其人下利日

6、數(shù)十行，谷不化，腹中雷鳴，心下痞硬而滿，干嘔，心煩不得安。（158）With wind stroke of Cold damage, treated by precipitation, the patient showed diarrhea, tens of times a day, indigested food, thunder-like bowel rumbling, glomus Qi with hardness and fullness located in stomach, dry retching, restless vexation. （158）傷寒論In Shang-Han-

7、Lun東漢Donghan(25-220)16Licorice Heart-Draining Decoction Syndrome(LHDDS)甘草瀉心湯證醫(yī)見心下痞，謂病不盡，復(fù)下之，其痞益甚。此非結(jié)熱，但以胃中虛，客氣上逆，故使硬也。甘草瀉心湯主之。（158）Since glomus Qi located in stomach remained, which represented not to recover, and then treated by precipitation again, it became more severe. It is not heat bind, howev

8、er, hardness is caused by stomach deficiency and Guest Qi upward. Licorice Heart-Draining Decoction takes charge of this syndrom.（158）17The same Main complainsSecond inapropriate treatmentMain mechanism of this syndrome驚奇的一致：主證，誤治，主病機(jī)！18Dr. Zahn Dechao s diagnosisBefore second treatment, Spleen and

9、stomach deficiency and Guest Qi (evil) located in Mid Jiao. Therefore it appeared diarrhea due to abnormal upbearing and downbearing. But now Guest Qi goes Upward and leads to food denying.19Herbs and preparation of LHDD Licorice 12g, Pinellia 12g, Scutellaria 9g, Coptis 3g, dried ginger 9g, Jujube

10、4 pieces, Ginseng 9g. 炙甘草12克，半夏9克，黃芩9克，黃連3克，干姜9克，大棗4枚，人參9克。2 L1.5 L-0.6 L0.2 L7 herbs put into waterTaking herbs outDrink one third20Dr. Zahn Dechao s treatmentMain principle:Supplement the center and harmonize the stomach, and clear Damp heat as well.治則：補(bǔ)中和胃，清化濕熱。Licorice 12g, Pinellia 9g, Scutella

11、ria 6g, Coptis 3g, Fresh ginger 9g, Jujube 3 pieces, Codonopsis 9g. 2 formula.甘草6克，黃芩6克，黃連3克，制半夏9克，黨參9克，生姜6克，紅棗3枚。2劑21Curative effect2 formula, vomit and diarrhea got relieved. After 3 more formula with original decoction variant, the patient was cured .2劑，嘔痢均減，更服原方加減，續(xù)服3劑而安。 22The modern medical de

12、scribingConcept: Dysentery is defined as a disease characterized by severe diarrhea with passage of mucus and blood and usually caused by infection.Some symptoms include, intestinal ulceration, diarrhea, painful spasms and the inflammation of the lining of the large intestines. The disease is spread

13、 through the feces of carriers who have the bacteria in their intestines.It is transmitted by eating or drinking from anything contaminated with the bacteria from the feces of these carriers. Even touching something contaminated and then touching the mouth can cause infection. Flies also spread the

14、disease.23Q1:Do the foreigners know what I am talking about ? Q2:Have Shang Han Lun been translated?24Shang Han Lun in foreign countary英文版 德文版 法文版25Q3: We do know about Shang Han Lun outside China, but no Chinese herb permits to prescription legally in our nation.However, acupuncture is OK, can we u

15、se needle to get the same good curative effect ? 26The answer is yes of course.Acupuncture under guide of Shang Han Lun:Licorice Heart-Draining Decoction Syndrome(LHDDS)甘草瀉心湯證27Using Mechanism of Shang Han Lun to pick acupoints運(yùn)用傷寒論病機(jī)選穴Main Mechanism :Stomach deficiency and Guest Qi upward 主病機(jī)：胃中虛，客氣上逆28Herbs and acupointsLicorice stomach deficiency and Guest Qi upwardST-36 GinsengScutellariafood accumulation and vacuity fire generat