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4.1.4 Nature and pathogenicity of dryness and fire课程教案、知识点、字幕

同学们好

下面我们继续学习燥邪的性质和致病特点

燥邪是指的自然界具有干燥 收敛清肃特性的外邪

燥邪为秋季的主气

燥邪侵犯人体 通常从口鼻而入 侵犯人体肺卫

燥邪可以分为凉燥和温燥

温燥 见于初秋 是燥与热的相合

凉燥 见于深秋 是燥与寒的相合

燥邪的性质和致病特点

主要有两个

燥性干涩 易伤津液 燥易伤肺

第一个是 燥性干涩 易伤津液

燥性干涩的特点 与热邪不太一样

热邪引起的病症主要是以出汗为主

而燥邪 损伤津液于无形之中

燥邪不会引起出汗

燥邪损伤津液 导致了津液亏虚

津液不足会导致孔窍 皮毛 二便的干涩

表现出口鼻干燥

咽干 口干 舌干 皮肤干

毛发干枯 小便短少 大便干结等等

一系列干涩症状

燥邪第二个致病特点 就是燥易伤肺

因为肺为娇脏 喜润而恶燥

所以 燥最容易损伤肺的津液

当肺津液不足 宣降失职的时候

就会表现出 咳嗽或无痰

咳嗽无痰 我们称为干咳

痰 是由津液化生

而燥损伤津液之后 痰量是非常非常少的

这种痰非常粘

非常难以咯出来

甚至在咳嗽的时候

会痰中带有少量的血丝

同时伴有喘息 胸痛的症状

以上是燥邪的性质和致病特点

下面我们来学习一下火热之邪的性质和致病特点

火热之邪

是指自然界中 具有火之炎热 升腾特性的外邪

火热主要是夏季的主气

它没有明显的季节性

春夏秋冬 其实都有火热之邪

冬天为什么也会有火热之邪

比如 我们穿的太多 我们吃的太好

都可能会导致火热之邪

火与温与热 它们之间有什么样的相同点和不同点

火邪 热邪和温邪

它们都是阳热过盛所化生的

他们都没有明显的季节性

火为温之渐

通常为内生 比如 心火 肝火 胆火

它们会表现出 全身发热 弥漫性的发热症状

热为温之渐 多为外感

所以我们称为外热

比如 风热 暑热 湿热

所以热邪引起的病症 多表现为局部的症状

比如 红肿热痛 口舌生疮 目赤肿痛等等

温邪类似于火热之邪

一般仅在温病学中运用

火热之邪的性质和致病特点又是什么

它主要有四个性质和致病特点

火热为阳邪 其性炎上 易扰心神

火易伤津耗气 火易生风动血

火易致肿疡

首先 火热的第一个性质和致病特点是

火热为阳邪

其性炎上 易扰心神

火为阳热之邪

所以 火热之邪引起的病变

以阳热亢盛的发烧(又称高热)

恶热 口渴 汗出

脉洪数等症状为特征

同时 火性炎上 易扰心神的特征

使火热证 会表现出头面的症状和心神的症状

头面的症状会表现为头痛 面红目赤

口舌糜烂生疮 牙龈肿痛等等

心神不宁的症状 会出现心烦失眠 躁动不安

或者心神失宁的狂躁不安 神昏谵语

或者神志昏迷的重症

火热的第二个性质和致病特点是

火热之邪 易伤津耗气

伤津 主要是火热之邪

直接灼伤津液 会表现出高热 大汗

同时出汗之后会损伤津液

所以会表现出口干 口渴 小便黄 大便干的症状

津液通过汗泄而损伤

而气也随之汗泄而耗损

所以火热之邪不仅可以直接耗气

也可以由于气随津泄

而导致气的耗损

所以火热之邪不仅可以出现高热症状

还会表现出气虚症状 比如

倦怠乏力 少气懒言 等等

这是火热的第二个性质和致病特点

由于火为阳邪 容易伤津耗气

这是每一种火热之邪都会出现的必然的症状

比如高热 出汗 以及神疲乏力等等

火热的第三个性质和致病特点是

火热之邪 易生风动血

火热生风

主要是通过伤津液 耗血 灼伤肝阴

导致了肝的筋脉失养

从而引起了筋脉抽搐

这种抽搐的症状 我们称为肝风内动

所以火热引起的肝风内动 称为热极生风

主要表现为 持续高烧 伴四肢抽搐

颈项强直

角弓反张 目睛上视等等一些抽搐的症状

这是火热之邪容易导致肝风内动

火热动血 是指火热之邪能迫血妄行

使血脉运行加速

而灼伤血脉而引起出血症

所以火热动血 除了高热症状外

还会出现出血症

比如 吐血 衄血 便血 尿血

月经过多 或崩漏等等

虽然我们这里面讲到了火热之邪易生风动血

虽然有一个易

但只有高热(而不是所有的火热之邪)

才可能会导致肝风内动

或者引起出血症

所以这个生风动血

并不是火热之邪引起的病症中必须有的症状

火热的第四个性质和特点就是

火热之邪易致肿疡

主要是因为火热入血 聚于营血 腐败血肉

导致了痈肿疮疡

所以局部会表现为红肿热痛的症状

也就是说

当我们身上看到一种长包长疮

比如说有些脸上的痘痘

它表现出红肿热痛的局部的表现

我们都可以认为与火热之邪有关

可以从火热论治

以上是火热之邪性质和致病的特点

本次课就学习到这里

Diagnostics in Chinese Medicine课程列表:

Week 1 Introduction

-Introductory remark

--Introductory remark

--QQ groups、WeChat public account

-Introduction

--Introduction

--【Discussion 1】Why do you want to take this course?

-Unit test for Introduction

Week 1 Basic Theory of Chinese Medicine 1:Yin-Yang and Five Elements Theory

-1.1 Yin-yang theory

--1.1 Yin-yang theory

-1.2 The theory of five elements

--1.2.1 The theory of five elements

--1.2.2 Application of the theory of five elements

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 1

Week 2 Basic Theory of Chinese Medicine 2:Zang-Fu Theory

-2.0 Outline

--2.0 Outline

--【Discussion 2】How to understand the holistic view centered on the Zang Fu theory?

-2.1 Liver

--2.1 Liver

--【Discussion 3】Why is repose more important than vigorous exercise in recuperation for patients with

-2.2 Heart

--2.2 Heart

-2.3 Spleen

--2.3 Spleen

-2.4 Lung

--2.4 Lung

-2.5 Kidney

--2.5 Kidney

-2.6 Six fu organs

--2.6 Six fu organs

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 2

Week 3 Basic Theory of Chinese Medicine 3:Qi,Blood and Body Fluid Theory

-3.1 Qi

--3.1 Qi

-3.2 Blood

--3.2 Blood

-3.3 Body fluid

--3.3 Body fluid

-3.4 The relationship of qi, blood and body fluid

--3.4 The relationship of qi, blood and body fluid

--【Discussion 4】A discussion about the theory of qi, blood and body fluid

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 3

Week 4 Basic Theory of Chinese Medicine 4: The theory of etiologic factor

-4.0 Outline

--4.0 Outline

-4.1 Six exogenous factors

--4.1.1 Six exogenous factors

--4.1.2 Nature and pathogenicity of wind and cold

--4.1.3 Nature and pathogenicity of summer heat and damp

--4.1.4 Nature and pathogenicity of dryness and fire

-4.2 Etiology of visceral impairment

--4.2 Etiology of visceral impairment

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 4

Week 5 Diagnosis methods: Inquiry (1)

-5.0 Outline of inquiry

--5.0.1 Outline of inquiry(1)

--5.0.2 Outline of inquiry(2)

--【Discussion 5】If you were a patient, how would you describe your condition to your doctor first?

-5.1 Inquiry of Chills and fever

--5.1.1 Chills and fever(Aversion to cold with fever)

--5.1.2 Chills and fever(Chills without fever)

--5.1.3 Chills and fever(Fever without chills)

--5.1.4 Chills and fever(Alternative chills and fever)

--【Discussion 6】How to understand "if you have clinical manifestations of cold, that is exterior syndr

-5.2 Inquiry of perspiration

--5.2 Inquiry of perspiration

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 5

Week 6 Diagnosis methods: Inquiry (2)

-5.3 Inquiring of pain

--5.3 Inquiring of pain

--【Discussion 7】How to understand "stagnation leading to pain and innourish leading to pain"?

-5.4 Inquiring of head, body, thorax and abdomen

--5.4 Inquiring of head, body, thorax and abdomen

-5.5 Inquiring of ears and eyes

--5.5 Inquiring of ears and eyes

-5.6 Inquiring of sleep

--5.6 Inquiring of sleep

-5.7 Inquiring of food and drink, appetite and taste

--5.7 Inquiring of food and drink, appetite and taste

-5.8 Inquiring of defecation and urination

--5.8.1 Inquiring of defecation

--5.8.2 Inquiring of urination

-5.9 Inquiring of infantile and women's disease

--5.9 Inquiring of infantile and women's disease

-Unit test for week 6

Week 7 Diagnosis methods: Observation (1)

-6.0 Outline of Observation

--6.0 Outline of Observation

--【Discussion 8】Please use the whole body inspection (including the expression, complexion and figure)

-6.1.1 Observation of vitality

--6.1.1 Observation of vitality

-6.1.2 Observation of the color

--6.1.2.1 The content, principles of inspection of the color

--6.1.2.2 Indication of diseases by five colors

--【Discussion 9】How do you understand the normal complexion of a normal people?

-6.1.3 Observation of the appearance

--6.1.3 Observation of the appearance

-6.1.4 Observation of figure and posture

--6.1.4 Observation of figure and posture

-Unit test for week 7

Week 8 Diagnosis methods: Observation (2)

-6.2.1 Observation of head and face

--6.2.1 Observation of head and face

-6.2.2 Observation of five sensory organs

--6.2.2.1Observation of five sensory organs(observation of eyes,ears,nose)

--6.2.2.2Observation of five sensory organs(observation of lips,teeth and gums,throat)

-6.2.3 Observation of body

--6.2.3 Observation of body

-6.2.4 Observation of limbs

--6.2.4 Observation of limbs

-6.2.5 Observation of two lower orifices

--6.2.5 Observation of two lower orifices

-6.2.6 Observation of skin

--6.2.6 Observation of skin

-6.3 Observation of excreta

--6.3 Observation of excreta

-6.4 Observation of infantile fingerprints

--6.4 Observation of infantile fingerprints

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 8

Week 9 Diagnosis methods: Inspection of tongue

-7.1 Outline of tongue inspection

--7.1.1 The morphology and structure of the tongue

--7.1.2 The principle of tongue examination

--7.1.3 The method and precaution of tongue examination

--7.1.4 The content of tongue examination, normal tongue

-7.2 Inspection of tongue structure

--7.2.1 Observe the color of tongue

--7.2.2 Observe the shape of tongue

--7.2.3 Observe the states of tongue

--7.2.4 Observation of sublingual vein

-7.3 Observation of tongue coating

--7.3.1 Observation of coating texture

--7.3.2 Observe the color of coating

-7.4 Clinical significance of tongue diagnosis

--7.4 Clinical significance of tongue diagnosis

--【Discussion 10】Why to observe the tongue can be used to diagnose disease?

-Unit test for week 9

Week 10 Diagnosis methods::Pulse examination

-8.1 The principle of pulse examination

--8.1 The principle of pulse examination

-8.2 The regions and methods of pulse examination

--8.2 The regions and methods of pulse examination

-8.3 The elements of pulse examination and the normal pulse

--8.3 The elements of pulse examination and the normal pulse

-8.4 Characteristics and significance of pulse

--8.4.1 Superficial pulse, deep pulse, slow pulse, rapid pulse

--8.4.2 Surging pulse, thin pulse, long pulse, short pulse

--8.4.3 Feeble pulse, forceful pulse, slippery pulse, uneven

--8.4.4 Taut pulse, tense pulse,soggy pulse, moderate pulse

--8.4.5 Knotted, slow-regular-intermittent, irregularly abrupt

-8.5 Similar pulse, concurrent pulse, pulse indicating deterioration of visceral qi۞

--8.5 Similar pulse, concurrent pulse, pulse indicating deterioration of visceral qi۞

--【Discussion 11】Why is complex pulse more common than single-factor pulse?

-8.6 Women’s pulse, children’s pulse

--8.6 Women’s pulse, children’s pulse

-8.7 The clinical significance of pulse diagnosis

--8.7 The clinical significance of pulse diagnosis

-Unit test for week 10

Week 11 Diagnosis methods:Listening and smelling examination

-9.1 Listening

--9.1 Listening

-9.2.1 Abnormal sound

--9.2.1 Abnormal sound

-9.2.2 Abnormal language

--9.2.2 Abnormal language

-9.2.3 Respiratory abnormality

--9.2.3 Respiratory abnormality

-9.2.4 Cough

--9.2.4 Cough

--【Discussion 12】How to observe the patient's cough sound and sputum changes to determine whether the

-9.2.5 Abnormal sounds of the stomach and intestines

--9.2.5 Abnormal sounds of the stomach and intestines

-9.3 Smelling

--9.3 Smelling

--【Discussion 13】How to diagnose by smelling?

-Unit test for week 11

Week 12 Diagnosis methods:Palpation

-10.1 The method, meaning and precautions of palpation

--10.1 The method, meaning and precautions of palpation

-10.2 Contents of palpation

--10.2.1 Palpating chest and hypochondrium

--10.2.2 Palpating stomach and abdomen

--10.2.3 Palpating skin

--10.2.4 Palpating hands and feet, palpating acupoints

--【Discussion 14】How to determine whether external or internal injuries?

-Unit test for week 12

Conclusion

-Conclusion

--Conclusion

Final Exam

-Final Exam

--Final Exam

4.1.4 Nature and pathogenicity of dryness and fire笔记与讨论

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