伤寒论临床病案学习.ppt

Shanghan clinical cases study In the 1980’s, People Republic of China Dr. Zahn Dechao‘s clinical case张德超医案 Food-denying dysentery Main complains: A 7 year-old boy suffering from severe diarrhea with passage of mucus and blood for five days. Manifestation Main signs: more than 10 times of major bloody stools a day Other symptoms and signs: Abdominal pain, poor appetite, relief of fever after resolving the exterior. Initial treatments: 1)Since fever with severe diarrhea， use the method of ”hauling the boat upstream” (exterior syndrome) Maybe food accumulation ? 2)Since poor appetite may be caused by food accumulation, use the method of precipitation to discharge accumulated food. Evaluation 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. Dr. Zahn Dechao’ s initial impression Pulse: soggy and weak pulse, especially right Guan Pulse. Tongue: red tongue body with white coating . What information those signs give us? Pulse Location Left right Hand cun hand guan Chi Soggy and weak pulse means Just like Air chair is leaking air. Tongue Red tongue＝ Since body fluid loses due to diarrhea, it is a kind of physical response. White coating＝ Evil locates in Qi aspect  伤寒论In Shang-Han-Lun东汉Donghan(25-220) 伤寒中风，医反下之，其人下利日数十行，谷不化，腹中雷鸣，心下痞硬而满，干呕，心烦不得安。（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） Licorice Heart-Draining Decoction Syndrome(LHDDS)甘草泻心汤证 医见心下痞，谓病不尽，复下之，其痞益甚。此