Diagnosis by 4 Levels and San Jiao Mary Anne Matta

DIAGNOSIS BY 4 LEVELS AND SAN JIAO MARY ANNE MATTA

4 LEVELS - WARM DISEASES WEN BING Overall Characteristics: Key Characteristics by Level: Fever/intense heat Wei: fever, aversion to cold enters through the nose or mouth Qi: fever, no aversion to cold, Big 4 heat signs, tongue maintains a coat virulent/infectious Ying: night fever, mental changes, no thirst, no tongue coat spreads quickly (Wen Yi) Blood: bleeding, night fever, macules, wind injures the Yin

Wei Heat EPF Wind Heat (most common) : fever, some chills, slight thirst, aversion to cold, floating Wind Heat – LI 4, LI 11, TB 5, DU 14, BL 12, LU 11 Level invades rapid pulse

Summer Heat: occurs in summer & combines with Damp so sx of heaviness and Summer Heat – LI 4, LI 11, TB 5, DU 14, DU 26, BL 40, PC 9 sticky tongue coat; also fever, aversion to cold, irritability, headache

Damp Heat: fever worse in afternoon, skin is hot to the touch, frontal H/A, aversion Damp Heat – LI 4, LI 11, SP 6, REN 12, SP 9 to cold, Damp signs

Dry Heat: dryness, averson to cold, floating rapid pulse Dry Heat - LI 4, LI 11, SP 6, REN 12, LU 9, ST 36, TB 5 Qi Level Interior Full Lung Heat: heat in chest and diaphragm, high fever, no aversion to cold, SOB, Lung Heat – LU 5, LU 10, DU 14, LI 11, LU 1, BL 13 Heat cough, yellow sputum, red tongue with yellow coat

Stomach Heat: high fever especially in the afternoon, profuse sweating, overflowing Stomach Heat – ST 44, ST 34, ST 21, ST 43, LI 11, ST 25 rapid pulse, thirst (Big 4)

Intestinal Dry Heat: high fever especially in the afternoon, constipation, abdominal Intestinal Dry Heat – LI 11, ST 25, SP 15, ST 37, ST 39 pain (Big 4 + constipation)

Gall Bladder Heat: alternating hot and cold with prevalence of heat, unilateral sticky Gall Bladder Heat – GB 34, GB 43, TB 6, TB 5 yellow tongue coat, hypochondrial pain, wiry rapid pulse.

Damp Heat in SP/ST: continuous fever that is alleviated after sweating but then gets Damp Heat in SP/ST – REN 12, SP 9, SP 6, REN 9, ST 36, LI 11, worse again, loose stools, heaviness, abdominal fullness REN 12, BL 20, BL 22 Ying Heat Heat in Nutritive Level: Yang Ming heat is injuring ying qi. Night fever, dry mouth, Heat in the Ying Level – PC 8, PC 9, HT 9, KD 6, Shixuan Level burning Yin no desire to drink, delirium, aphasia, garbled speech, insomnia, red tongue, no coat

Heat in the Mind & PC: night fever, body is hot to the touch, cold hands and feet (sign of false cold, when actually heat is obstructing circulation). More mental Heat in the Mind/PC - PC 8, PC 9, HT 9, KD 6, PC 3 changes than Ying level heat, possible coma

*The tongue is reddish purple with prickles at the Yin and Blood levels. Blood Yin Heat Victorious moving Blood: bleeding through urine, stools, nose, vomit, and Heat moving Blood – LI 11, LV 2, KD 6, HT 9, SP 10, Shixuan, Level Deficiency blood vessels. Macules erupt on the skin, high fever, mania, restlessness, dark red BL 17, LV 5, SP 4 tongue with no coat, wiry rapid pulse

Heat Victorious stirring Wind: high fever, sudden loss of consciousness, looks like a Heat stirring Wind – LI 11, LV 2, KD 6, HT 9, SP 10, Shixuan, stroke, clenched teeth, wiry rapid pulse LV 3, DU 16, GB 20, SI 3, BL 62

Empty Wind agitating the Interior: low grade fever, weight loss, listless, twitching, Empty Wind – LV 3, DU 16, GB 20, SI 3, BL 62, LV 8, KD 6, KD 3, tremor, fine rapid pulse SP 6

Collapse of Yin: low grade fever, night sweats, desire for small sips, emaciation, 5 Yin Collapse – ST 36, SP 6, KD 3, KD 6, REN 4, palm heat, malar flush

Collapse of Yang: feeling cold/cold limbs, bright white face, profuse sweating on Yang Collapse – ST 36, REN 6, REN 4, REN 8, MOXA the forehead, listless, pale swollen short tongue, hidden-slow-scattered pulse

**** Pathogen Lesser Yang: alternating fever and chills, bitter taste in the mouth, unilateral tongue coat Latent skips the Bright Yang: Big 4 in Channel pattern; Big 4 + constipation in the Organ pattern Heat exterior Lesser Yin: weariness, headache, irritability, dry mouth. In the Nutritive Level, there is oily beads on the forehead, delirium, bloody urine. In the Blood stage and Level, there is bleeding, macules, fainting, dryness goes deep PULSE DIAGNOSIS Stomach 9 Measures external disease If ST 9 is stronger à EPF was airborne Lung 9 Measures internal disease If LU 9 is stronger à EPF was ingested

SAN JIAO PATTERNS - Heat always combines with Damp - Patterns Affects: Principle Point General Sx Patterns

Upper Jiao Damp Heat Affects the head – LU, PC, HT Clear heat CV 17 Sinus infections, heavy Wind Heat – Wei Level & causes respiratory problems head, red eyes LU Heat – Qi Level PC Heat – Ying Level Middle Jiao Damp Heat Affects the abdomen – SP, LV, ST Clear heat CV 12 Jaundice, bloating, Yang Ming Heat & causes digestive problems & drain damp heaviness, distention SP Damp Heat Lower Jiao Damp Heat Affects the pelvis – KD Clear heat CV 3 Uterine bleeding, Heat in KD & causes reproductive/gyn problems & drain damp or leucorrhea, prostatitis, LV Heat à Wind (high fever) CV 6 pelvic inflammatory dx LV Heat à Empty Wind (low fever, feeling cold)