Study On The Law Of Heat Syndrome Differentiation And Treatment Of Sun Disease

ObjectiveThroughout history, the Shang Han Lun has undergone vigorous literature study and clinical analysis from various perspectives on the treatment of febrile diseases. This dissertation will analyse and explore the pathomechanism and pattern manifestations of various formulas in the Shang Han Lun to compare the differences in disease location, imbalances of Qi and Blood. This dissertation will also discuss the modifications and combinations of these formulas to explore the various ways of how Zhang Zhong Jing approaches diseases and their pathologies. Zhang Zhong Jing is also known to have compiled various formulas from before his time, and strictly applied these formulas with his varying degrees of confidence, hence in the Shang Han Lun, when formulas are assigned to different diseases or symptoms, emphasis is placed on whether this formula "governs", or "is appropriate", or "can be given" to a disease in each case, which demonstrates the way he distinguishes the clinical applications of each formula. Hence, due to the subtle literary distinctions made in the Shang Han Lun, later generations have researched how this relates to the differences in pathology, diseases and medicinal formulations.This thesis compiles the relevant lines relating to fever in the Tai Yang Bing chapters, and compares and explores their differences in pathomechanism, disease differentiation, herbal formulation and treatment strategies. The purpose of this is to demonstrate Zhang Zhong Jing’s clinical perspective on diseases and juxtapose how he constructed formulas with a minimal amount of medicines and yet achieve excellent clinical outcomes.MethodFirst, this thesis defines the symptom of fever, which outlines the differences between an actual raise in body temperature and the sensation of feeling feverish. In Exterior patterns, pathogenic Qi and zheng Qi are in a conflict, manifesting as fever; with this, we may measure the strength of a person’s zheng Qi. The symptom of fever discussed by Zhang Zhong Jing refers mainly to the sensation of feeling hot and feverish which may or may not manifest in a raise of body temperature. By compiling and analysing the lines in the Tai Yang Bing chapter that discuss fever, it can be concluded that fever is mainly associated with the three Yang channels with a blockage of the channels. In the Shang Han Lun, fever is subdivided into the following:fever with an aversion to cold, fever that is worse in the afternoon, alternating chills and fever, non-receding fever and slight fever with thirst.In this thesis, the following formulas associated with fever are categorised according to their disease location and their pathomechanism:Tai Yang Exterior diseases include Gui Zhi Tang and Ma Huang Tang related formulas; Heat patterns in the muscles and interstices include Bai Hu Tang and Bai Hu Jia Ren Shen Tang; fever due to Yang deficiency include Si Ni Tang and Gan Jiang Fu Zi Tang; mild Exterior patterns include Gui Zhi Ma Huang Ge Ban Tang, Gui Zhi Er Ma Huang Yi Tang, Gui Zhi Er Yue Bi Yi Tang; Xiao Qing Long fang; Interior Heat patterns include Tiao Wei Cheng Qi Tang, Da Xian Xiong Tang (Wan). Shi Zao Tang, Tao He Cheng Qi Tang, Di Dang Tang (Wan); Shao Yang diseases include Chao Hu Tang related formulas; Heat stagnation patterns include Zhi Zi Tang related formulas, Gua Di San and Wu Ling San. A discussion of each formula’s contraindications and cautions has been included.ResultBy carefully differentiating the different types of fever, one may conclude the disease location, pathomechanism and prognosis. Local symptoms may also contribute to the manifestations of different patterns of fever. Clinically, differentiating the type of fever should be a top priority, to distinguish the disease location within the San Jiao and the Interior and Exterior. Mainly, bitter medicines are applied to treat fever:in Tai Yang diseases, bitter and pungent medicines are applied to disperse and unblock; in Yang Ming diseases, Da Huang and Mang Xiao are combined with different medicines depending on how the pathogen has knotted in the Interior, to purge the pathogen; in Shao Yang diseases, Chai Hu and Huang Qin are combined with different medicines to help move the Qi mechanism. Furthermore, Bai Hu Tang, Zhi Zi Tang related formulas, Wu Ling San and Gua Di San all treat a form of impediment and stagnation in the mechanism of Qi, which slightly differ from the patterns of the three Yang channels.ConclusionFever can be major or minor symptoms, as it sometimes represent the stage and significant of disease, complete diagnosis is necessary on clinical practice, and pathomechanism is always the main consideration, and the patterns are just further indication besides.