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All Courses by Ni Haixia
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Complete Guide to TCM Treatments for Common Diseases
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Focused Study on TCM Topics
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Online Reading of TCM Learning Books
The Shang Han Lun (Treatise on Cold Damage) is originally a comprehensive discussion on the progression of exogenous diseases, with a clear hierarchical structure. However, since the Han and Tang dynasties, people have preferred to break down the entire text into 398 fragmented articles, mixing in formulas. While this facilitates localized study, it hinders the grasp of the overall concept, which should always take precedence over the details. This is my experience in studying Shang Han. Therefore, the correct approach should be to first master the overall framework and then analyze each detail. Thus, I have combined the 398 articles into one, dividing them into chapters and sentences according to their inherent meanings, aiming for a comprehensive understanding of Zhang Zhongjing’s thought.
This is the first point;
Secondly, the Shang Han Lun contains over 20,000 characters and is extremely difficult to understand. It is essential for a physician to deeply comprehend and memorize it. However, memorizing over 20,000 complex characters is quite challenging. To resolve this contradiction for beginners, I have created this concise version of over 6,000 characters, serving as the first step to comprehensively grasp and memorize the Shang Han Lun. Of course, this concise version may overlook some details compared to the complete version, but it has already covered more than half of the essential formulas. Please consider this when studying.
Distinguishing the Taiyang Disease Pulse and Symptoms, Volume One
Taiyang disease manifests with a floating pulse, headache, stiff neck, and aversion to cold.. Taiyang disease with fever, sweating, aversion to wind, and a slow pulse is called Wind Stroke. Taiyang disease, whether it has already developed fever or not, must have aversion to cold, body aches, nausea, and a pulse that is tight in both yin and yang, is called Cold Damage. Taiyang disease with fever and thirst, but no aversion to cold, is termed Warm Disease; if sweating has occurred and the body feels hot, it is called Wind-Warmth. The symptoms of Wind-Warmth include a floating pulse, spontaneous sweating, heaviness of the body, excessive sleep, snoring, and difficulty in speaking.(–General Discussion on Taiyang Disease, which is divided into three categories: Wind Stroke, Warm Disease, and Cold Damage)
If Taiyang disease presents with headache, fever, sweating, and aversion to wind, Gui Zhi Tang is the main treatment. If Taiyang disease presents with stiffness in the neck and back, with sweating and aversion to wind, Gui Zhi Jia Ge Gen Tang is the main treatment.(–Taiyang Wind Stroke and Concurrent Symptoms)
If Taiyang disease has been treated with purgation and the qi rises, Gui Zhi Tang can be used as before; if it does not rise, do not use it. Patients who consume alcohol should not take Gui Zhi Tang, as it will cause vomiting. For patients with asthma, use Gui Zhi Tang Jia Hou Po Xing Ren. If Taiyang disease has been treated with sweating and the sweating does not stop, and the patient has aversion to wind, difficulty urinating, and slight urgency in the limbs, Gui Zhi Jia Fu Zi Tang is the main treatment. If Taiyang disease has been treated with purgation and the pulse is rapid with fullness in the chest, Gui Zhi Qu Shao Yao Tang is the main treatment; if there is slight aversion to cold, Gui Zhi Qu Shao Yao Jia Fu Zi Tang is the main treatment. If Taiyang disease presents with symptoms resembling malaria, with a weak pulse and aversion to cold, this indicates deficiency in both yin and yang, and further sweating, purging, or vomiting is not advisable. If the complexion is red, it indicates that the patient is not ready to resolve the condition, as they cannot sweat out and will feel itchy; Gui Zhi Ma Huang Ge Ban Tang is recommended.
Taking Gui Zhi Tang if the symptoms resemble malaria and recur twice daily, sweating must resolve; Gui Zhi Er Ma Huang Yi Tang is indicated. If taking Gui Zhi Tang results in excessive sweating, severe thirst that does not resolve, and a large pulse, Bai Hu Jia Ren Shen Tang is the main treatment. If Taiyang disease presents with fever and aversion to cold, with more heat than cold, this indicates a lack of yang, and sweating is not advisable; Gui Zhi Er Yue Bi Yi Tang is recommended. If taking Gui Zhi Tang or purging still shows exterior symptoms, and urination is not smooth, Gui Zhi Qu Gui Jia Fu Ling Bai Zhu Tang is the main treatment.(–Taiyang Wind Stroke Transformation Symptoms)
If Taiyang disease presents with stiffness in the neck and back, no sweating, and aversion to wind, Ge Gen Tang is the main treatment. If Taiyang and Yangming diseases occur together, there will be diarrhea; Ge Gen Tang is the main treatment; if Taiyang and Shaoyang diseases occur together, with not only diarrhea but also vomiting, Ge Gen Jia Ban Xia Tang is the main treatment. If Taiyang disease presents with symptoms of Gui Zhi, and the physician mistakenly purges, resulting in continuous diarrhea, with a rapid pulse, this indicates that the exterior has not resolved; if there is wheezing and sweating, Ge Gen Huang Qin Huang Lian Tang is the main treatment.(–Taiyang Warm Disease and Transformation Symptoms)
If Taiyang disease presents with headache, fever, body aches, low back pain, joint pain, aversion to wind, no sweating, and wheezing, Ma Huang Tang is the main treatment. If Cold Damage presents with a floating pulse and no sweating, Da Qing Long Tang is the main treatment; if Cold Damage presents with unresolved exterior symptoms and water retention in the chest, Xiao Qing Long Tang is the main treatment.(–Taiyang Cold Damage and Transformation Symptoms)
Distinguishing the Taiyang Disease Pulse and Symptoms, Volume Two
If Taiyang disease has been treated with sweating and the symptoms do not resolve, and the pulse is floating, it indicates that the exterior is still present; Gui Zhi Tang is the main treatment. If the pulse is floating and tight, it indicates that the body is in pain, and sweating should resolve it; if the pulse is slow, sweating is not advisable. How do we know this? It is due to insufficient nutritive qi and blood.(–Floating Pulse Indicates Exterior Resolution, Weak Pulse Not Suitable for Sweating)
If the patient often sweats spontaneously, this indicates that the nutritive qi is harmonized. When the nutritive qi is harmonized, the exterior is not in harmony, as the defensive qi does not harmonize with the nutritive qi. The nutritive qi circulates in the pulse, while the defensive qi circulates outside. If sweating occurs again, the harmonization of the nutritive and defensive qi will resolve the condition; Gui Zhi Tang is indicated. If the patient has no other diseases but experiences intermittent fever and spontaneous sweating that does not resolve, this indicates disharmony of the defensive qi; if sweating occurs at that time, it will resolve; Gui Zhi Tang is the main treatment.(–Spontaneous Sweating Indicates Disharmony of Nutritive and Defensive Qi)
In general, if sweating, vomiting, or purging leads to a loss of body fluids, and yin and yang are harmonized, the patient will recover. If after purging, sweating occurs again, and urination is not smooth, this is due to a loss of body fluids; do not treat it; if urination becomes smooth, the patient will recover. If after purging, sweating occurs again, the patient will experience chills, a weak pulse, and fine pulse; this is due to deficiency in both interior and exterior.(–Sweating, Vomiting, and Purging Often Damage Body Fluids, Leading to Deficiency in Interior and Exterior)
If the patient is restless during the day and cannot sleep, but is calm at night, Gan Jiang Fu Zi Tang is the main treatment. If sweating occurs after treatment, and the pulse is deep and slow, Gui Zhi Jia Shao Yao Sheng Jiang Yi Liang Ren Shen San is the main treatment. If sweating occurs and wheezing is present, but there is no high fever, Ma Huang Xing Ren Gan Cao Shi Gao Tang is indicated. If excessive sweating occurs, and the patient feels cold and has palpitations, Gui Zhi Gan Cao Tang is the main treatment. If after sweating, the patient experiences palpitations below the navel, and feels like a running piglet, Fu Ling Gui Zhi Gan Cao Da Zao Tang is the main treatment. If the abdomen is distended and full, Hou Po Sheng Jiang Gan Cao Ban Xia Ren Shen Tang is the main treatment. If qi rises and rushes to the chest, causing dizziness, with a tight and deep pulse, and sweating causes movement in the meridians, the body shakes, Fu Ling Gui Zhi Bai Zhu Gan Cao Tang is the main treatment. If sweating occurs and the condition does not resolve, and the patient has aversion to cold, Shao Yao Gan Cao Fu Zi Tang is the main treatment. If sweating occurs after purging, and the condition does not resolve, and the patient is restless, Fu Ling Si Ni Tang is the main treatment. If the pulse is floating, urination is not smooth, and there is slight heat and thirst, Wu Ling San is the main treatment.
If the patient is thirsty and wants to drink water, but vomits when water is ingested, this is called water reversal; Wu Ling San is the main treatment. If sweating, vomiting, or purging occurs, and the patient is restless and cannot sleep, if severe, they will experience repeated fainting, and feel vexed in the heart, Zhi Zi Chi Tang is the main treatment. In general, if using Zhi Zi Tang, if the patient has a history of slight diarrhea, do not administer it. If sweating occurs and the condition does not resolve, and the patient still has fever, with palpitations and dizziness, and the body shakes, Zhen Wu Tang is the main treatment.(–Possible Transformation Symptoms After Sweating)
If the throat is dry, do not induce sweating. If the patient has a history of dysuria, do not induce sweating. If the patient has sores, although they have body aches, do not induce sweating. If the patient has a history of blood loss, do not induce sweating. If the patient has cold and then induces sweating, the stomach will be cold and will cause vomiting of roundworms.(–Contraindications for Sweating)
If a patient with Cold Damage is treated with purging and continues to have diarrhea with clear stools, and body aches, urgent treatment is needed for the interior; if the body aches and the stools are self-regulating, urgent treatment is needed for the exterior. For interior treatment, Si Ni Tang is indicated; for exterior treatment, Gui Zhi Tang is indicated. If the patient has fever and headache, with a deep pulse, and abdominal pain, urgent treatment for the interior is needed; Si Ni Tang is the main treatment.(–Urgency of Treating Interior and Exterior Symptoms)
If Cold Damage presents with alternating chills and fever, fullness in the chest and hypochondria, disinterest in food and drink, and irritability with a tendency to vomit, Xiao Chai Hu Tang is the main treatment. If the blood is weak and the qi is deficient, the pores open, and the pathogenic qi enters and clashes with the righteous qi, causing pain in the hypochondria, the pain must be relieved; if the pathogenic qi is high, the pain will be below, causing vomiting; Xiao Chai Hu Tang is the main treatment. If after taking Xiao Chai Hu Tang, the patient is thirsty, this indicates a Yangming condition, and treatment should be administered accordingly. If Cold Damage presents with a tight pulse in the Yang pulse and a string-like pulse in the Yin pulse, this indicates urgent abdominal pain; first administer Xiao Jian Zhong Tang, and if there is no improvement, administer Xiao Chai Hu Tang.
If Cold Damage persists for two to three days, and the patient experiences palpitations and irritability, Xiao Jian Zhong Tang is the main treatment. If Taiyang disease has progressed for more than ten days and the symptoms of Chai Hu still persist, first administer Xiao Chai Hu Tang; if vomiting does not stop, and there is urgency in the heart, with slight irritability, this indicates that the condition has not resolved; Da Chai Hu Tang will resolve it. If Cold Damage does not resolve, and the patient has fullness in the chest and hypochondria, with vomiting, and experiences tidal fever in the afternoon, followed by slight diarrhea, this indicates a solid condition; first, Xiao Chai Hu Tang should be administered to resolve the exterior, followed by Chai Hu Jia Mang Xiao Tang as the main treatment. If Cold Damage has been purged, and the patient has fullness in the chest, restlessness, difficulty urinating, delirium, and heaviness throughout the body, Chai Hu Jia Long Gu Mu Li Tang is the main treatment.(–Handling Taiyang Symptoms Transitioning to Shaoyang)
If Cold Damage does not resolve, and there is heat accumulation in the bladder, with difficulty urinating, and the patient appears manic, if the exterior has resolved but there is still urgency in the lower abdomen, it is advisable to attack; Tao Ren Cheng Qi Tang is the main treatment.(–Bladder Blood Accumulation Symptoms)
If the pulse is floating, it is advisable to resolve it with sweating; if the fire is strong, the disease will be heavy and obstructed below, which is called Fire Reversal. If Cold Damage presents with a floating pulse, and the physician uses fire to forcefully extract it, this will lead to a loss of yang, causing the patient to become manic and restless; Gui Zhi Qu Shao Yao Jia Shu Qi Long Gu Mu Li Jiu Ni Tang is the main treatment. If burning needles induce sweating, and the needle site becomes cold and red, this will lead to a running piglet; if qi rises from the lower abdomen to the heart, Gui Zhi Jia Gui Tang is the main treatment. If Fire Reversal is purged, and the patient becomes restless due to burning needles, Gui Zhi Gan Cao Long Gu Mu Li Tang is the main treatment.(–Three Symptoms of Fire Reversal)
Distinguishing the Taiyang Disease Pulse and Symptoms, Volume Three
If Taiyang disease presents with jaundice, a deep and tight pulse, hardness in the lower abdomen, and difficulty urinating, this indicates a lack of blood; if urination is smooth, and the patient appears manic, this indicates a blood condition; Di Dang Tang is the main treatment. If Cold Damage presents with heat and fullness in the lower abdomen, it is advisable to treat the difficulty urinating; if the patient has diarrhea, this indicates a blood condition, and purging is not advisable; Di Dang Wan is the main treatment.(–Distinction Between Chest Congestion and Abdominal Congestion)
Question: What are the symptoms of chest congestion and abdominal congestion? Answer: If palpated, it is painful, with a floating pulse and a tight pulse, this is called chest congestion; if it resembles chest congestion, with normal appetite, and intermittent diarrhea, with a floating pulse and a tight pulse, this is called abdominal congestion.(–Distinction Between Chest Congestion and Abdominal Congestion)
If the disease arises from the yang and is then purged, heat enters and causes chest congestion; if the disease arises from the yin and is then purged, it causes fullness, leading to chest congestion; thus, purging too early causes chest congestion. If the pulse is floating and large, purging is not advisable; if the pulse is floating and the patient is restless, this indicates death.(–Concept of Chest Congestion)
If chest congestion presents with stiffness in the neck, it is advisable to purge; Da Xian Xiong Wan is the main treatment. If Cold Damage persists for more than ten days, with heat accumulation in the interior, and alternating chills and fever, this indicates water accumulation in the chest and hypochondria; Da Chai Hu Tang is the main treatment. If there is pain below the heart and hardness in the lower abdomen, Da Xian Xiong Tang is the main treatment. If the pain is located below the heart, and palpation causes pain, with a floating and slippery pulse, Xiao Xian Xiong Tang is the main treatment. If there is cold accumulation in the chest without heat symptoms, San Wu Xiao Bai San is the main treatment.(–Five Symptoms of Chest Congestion: Da Xian Xiong Wan, Da Xian Xiong Tang, Xiao Xian Xiong Tang, Water Accumulation Symptoms, Cold Accumulation Symptoms)
If a woman experiences wind stroke during menstruation, with fullness below the chest resembling chest congestion, and delirium, this indicates heat entering the blood chamber, and it occurs intermittently; Xiao Chai Hu Tang is the main treatment.(–Women’s Heat Entering Blood Chamber Symptoms)
If Cold Damage presents with Shaoyang symptoms, and the exterior symptoms have not resolved, Chai Hu Gui Zhi Tang is the main treatment. If Cold Damage has been treated with sweating and then purged, with fullness in the chest and hypochondria, slight hardness, difficulty urinating, thirst without vomiting, but sweating occurs only on the head, with alternating chills and fever, and irritability, this indicates that the condition has not resolved; Chai Hu Gui Zhi Gan Jiang Tang is the main treatment.(–Two Major Concurrent Symptoms of Shaoyang)
If Cold Damage presents with fullness and hardness in the heart, this indicates chest congestion; Da Xian Xiong Tang is the main treatment; if there is fullness without pain, this indicates fullness, and Ban Xia Xie Xin Tang is the main treatment. If Taiyang Wind Stroke presents with diarrhea and vomiting, the exterior must be resolved before attacking; Shi Zao Tang is the main treatment. If there is fullness in the heart, and palpation reveals a soft pulse, with a floating pulse, Da Huang Huang Lian Xie Xin Tang is the main treatment. If there is fullness in the heart with aversion to cold and sweating, Fu Zi Xie Xin Tang is the main treatment. If there is fullness in the heart with Xie Xin Tang, and the fullness does not resolve, with thirst and dry mouth, and difficulty urinating, Wu Ling San is the main treatment. If there is fullness in the heart with water retention in the hypochondria, and the abdomen rumbles with diarrhea, Sheng Jiang Xie Xin Tang is the main treatment. If there is fullness in the heart with hardness, and the patient has diarrhea for several days, with undigested food and abdominal rumbling, Gan Cao Xie Xin Tang is the main treatment.(–Symptoms of Fullness in the Heart and Five Major Xie Xin Tang)
If after taking Xie Xin Tang, the patient continues to take other medications and diarrhea does not stop, the physician should administer Li Zhong Tang, which is very effective; Li Zhong refers to the middle burner, and this treatment is effective in the lower burner; Chi Shi Zhi Yu Yu Liang Tang is the main treatment for continued diarrhea. If the patient has fullness in the heart, and the gas does not resolve, Xuan Fu Dai Zhe Shi Tang is the main treatment. If Taiyang disease has not resolved, and the exterior symptoms have not cleared, and the patient has been purged multiple times, resulting in heat and diarrhea, and the fullness in the heart is hard, with unresolved exterior symptoms, Gui Zhi Ren Shen Tang is the main treatment. If the fullness in the heart is accompanied by aversion to cold, the exterior has not resolved, and it is not advisable to attack the fullness; first resolve the exterior with Gui Zhi Tang, and then attack the fullness with Da Huang Huang Lian Xie Xin Tang. If Cold Damage presents with fever, sweating, and unresolved symptoms, with fullness in the heart, vomiting, and diarrhea, Da Chai Hu Tang is the main treatment. If the condition resembles Gui Zhi symptoms, with no headache or stiffness in the neck, a slightly floating pulse, and fullness in the heart, this indicates cold in the chest, and it should be purged; Gua Di San is the main treatment. If Taiyang and Shaoyang diseases occur together, resulting in diarrhea, Huang Qin Tang is the main treatment; if vomiting occurs, Huang Qin Jia Ban Xia Sheng Jiang Tang is the main treatment.(–Symptoms of Fullness in the Heart and Similar Symptoms)