How to distinguish dampness, cold and heat in traditional Chinese medicine?

episode 8: analysis from the etiology: whether it is cold-dampness or damp-heat, it can be divided into endogenous and exogenous aspects. Among endogenous damp diseases, cold-dampness diseases are mostly caused by deficiency of yang in zang-fu organs, and cold-dampness is endogenous; Damp-heat disease is mostly caused by visceral dysfunction, endogenous damp pathogen, stagnation and heat transformation, or by the simultaneous production of damp-heat pathogen. Its pathogenic way: in nature, the moisture on the ground is turned into water vapor under the action of hot air, which rises into the air and aggregates into clouds. Therefore, the movement path of damp-heat qi is from bottom to top, and the damp-heat qi has an obvious upward trend. Because of the rising characteristics of damp-heat qi, the evil of damp-heat invades the human body mostly from the upper part and from the nose and mouth. It is said that "it hurts the weather first, and then it hurts the atmosphere." It is also said that it is very hot when it is wet. " This is the way to feel the evil of damp heat. On the contrary, the evil of cold and dampness is characterized by the fact that both cold and dampness are yin evils. When they are combined, the dampness evil tends to descend, so the evil of cold and dampness mostly invades the human body from the lower part of the human body. It means "first hurt the ground gas, then the weather." Analysis from the pathogenesis: Cold-dampness disease is mainly due to the suppression or deficiency of yang in healthy qi, and yin evil (cold evil) and yin evil (wet evil) * * * mainly exist in human body, and the nature of the disease is relatively simple, belonging to yin syndrome and cold syndrome. On the other hand, the pathogenic factors of damp-heat disease are characterized by the coexistence of yin and yang (dampness and heat) * * *, which are intertwined and complicated. Because the yang attribute of heat is more prominent than the yin attribute of damp-heat, the overall pathogenicity of damp-heat disease belongs to yang syndrome and heat syndrome. From the aspect of vital qi, wet fever may have yang and body fluid damage in the aspect of vital qi, but due to the characteristics of wet disease itself, yang is still the main damage. In terms of disease location, the disease location of damp-heat disease will be wider than that of cold-dampness disease, because "hot steaming leads to wet movement, cold depression leads to wet coagulation", and dampness is affected by cold pathogen, so the disease location is concentrated; Dampness is caused by heat, while steaming is caused by dampness and strong activity, so the disease location is extensive. This makes the treatment of damp-heat disease more complicated and difficult than that of cold-dampness disease. In clinical manifestations, cold-dampness disease is mainly the manifestation and cold image of general damp disease, which is easy to identify, while wet fever has some complicated manifestations caused by the entanglement of damp-heat pathogens besides wet disease. In terms of treatment, cold-dampness diseases are mainly warm and dry. Because of the same nature of dampness and cold, it is easier to remove them at the same time, and it is also easier to regulate yang qi. Damp-heat disease is mainly about clearing away heat and removing dampness, and clearing away heat with cold and cool drugs, while eliminating dampness with warm and dry drugs. It is more complicated to apply two drugs with opposite properties together, and it is more difficult to regulate healthy qi. Episode 9: Human beings live in the natural environment, and all the factors of nature are closely related to human beings. The greatest influence of nature on human beings is the change of water, soil and weather. Water is the source of life, and all living things, whether low or high, are inseparable from water. The knowledge of water in traditional Chinese medicine can be traced back at least 2 years ago. The earliest literature records are Huangdi Neijing during the Spring and Autumn Period and the Warring States Period. The nature, source, etiology and pathogenesis, clinical manifestations, treatment rules and preventive measures of dampness have been recorded in a detailed and complete way. After that, physicians in past dynasties continued to study, deepened their understanding of dampness and improved the methods of treating dampness. In the long history of development, Chinese medicine has accumulated rich experience and formed a unique medical system for treating diseases and preventing diseases, which is the most powerful pillar of human health. The Japanese people's exposition of water was first seen in the theory of "Qi, blood and water" by the famous Japanese doctor Ji Yi Nanya. His age was equivalent to that of Qing Dynasty in China. He put forward the view that all diseases were caused by gas poisoning, blood poisoning and water poisoning. The definition of water toxicity is: water that stays or accumulates in tissues and organs under normal circumstances, that is, non-physiological body fluids. His view is similar to that of traditional Chinese medicine on dampness. According to the latest viewpoint of Chinese medicine experts, the cause of all human diseases is water, and the easiest and most effective way to treat any disease is to adjust the water in the human body to keep the water in the human body in the most appropriate amount and unblocked. Nowadays, all diseases, whether they are common colds or complicated visceral diseases, diabetes and hypertension that Western medicine thinks must be controlled for life, or even cancer that Western medicine regards as incurable, can be cured by Chinese medicine (patients who have been treated by Western medicine will affect the curative effect). The normal humidity in the air of nature is moisture, which is not called "wet evil" by Chinese medicine, but only abnormally high humidity is called "wet evil". The water existing in the human body in physiological condition is body fluid, that is, body fluid. Traditional Chinese medicine does not call body fluid "moisture", but refers to the pathological products formed by the metabolic disorder of body fluid as "endogenous dampness evil". Body fluid is a general term for maintaining normal physiological functions of human body, which is widely found in the tissues and cells of organs such as viscera, body and orifices, and between tissues and cells. Body fluid plays a very important role in human body: 1. Moisturize and nourish the cells and tissues of the whole body; 2. Metaphysical blood; 3. Adjust the balance of yin and yang of the body, such as body temperature; 4. Carrying the qi of the whole body and carrying nutrients; 5. excrete metabolites and maintain normal life activities. Episode 1: The production, transportation and excretion of body fluid is a complex physiological activity involving many viscera. The production of body fluid mainly comes from diet, which is generated by digestion and absorption of nutrients and water in the diet by the spleen and stomach, small intestine and large intestine. The transport of body fluid mainly depends on the comprehensive function of the physiological functions of viscera such as spleen, lung, liver, kidney and triple energizer. The dysfunction of any of these viscera may lead to the generation of "endogenous dampness evil". Spleen is the center of body fluid metabolism. Lung is the source of Mizunokami, and the spreading and descending of lung qi distributes body fluid to the body surface, kidney, bladder and whole body. Kidney plays a dominant role in the transport of body fluid. Under the gasification of kidney, the clear transpiration in body fluid is transported to the lungs through triple energizer, and the turbid one is transformed into urine, which is injected into the bladder and excreted. The liver governs the release of qi, so that the triple energizer can be smoothly regulated, and the movement of qi leads to the movement of body fluid, thus promoting the smooth delivery and distribution of body fluid. Sanjiao is the space where body fluid flows and distributes in the body. The excretion of body fluid also depends on the comprehensive work of spleen, lung, liver, kidney, triple energizer and other viscera, and it is excreted through sweat, exhalation, urine, stool and other ways. They are also the main ways to eliminate dampness when treating dampness. Episode 11: To cure dampness, we must first understand the characteristics of water. There are three forms of water in nature: liquid, gas and solid, and the main factor that causes water to become different forms is temperature! When the temperature is very low, water becomes solid ice, and when the ice is heated, it will melt into water; If the temperature continues to rise, it will evaporate and become water vapor; If heated to the boiling point, water will boil and all will become steam. The flowing air will accelerate the evaporation of water, which is what Chinese medicine calls "wind conquers dampness". There are living things and abiotic things that affect the form of water. Water should move normally in nature, from liquid to gas or solid, and mix with all living things or abiotic things in nature to make nature full of vitality. However, there are evil spirits in nature. When abnormal temperature, radiation or magnetic fields interfere with water, disasters will occur, such as storms, rainstorms, floods, droughts, earthquakes, tsunamis, tornadoes, sandstorms, ice storms and other natural "diseases". The water existing in the human body also has changes similar to those in nature. The water absorbed into the human body is mixed with the nutrient essence in the human body to become body fluid. The normal body fluid is in a constantly flowing liquid state in the human body, and under the influence of body temperature, part of it becomes gaseous body fluid, and the flowing body fluid and the gaseous body fluid maintain the physiological activities of cells and tissues. Different from nature, the living body has a normal relatively stable temperature, so there is no solid ice in water, but there is still a solid or similar solid water mixture, that is, a mixture of body fluid and pathological products. The mixture of body fluid and pathological products is the damp evil in human body. Sweat, phlegm, phlegm nuclei, induration, tumor, cancer, etc., which are mixed by damp evil and cold evil or heat evil, will cause various diseases in human body, such as inflammation, pain, paralysis, numbness, endocrine disorders, various acute and chronic diseases, etc. Abnormal water mixture in human body is called dampness evil in Chinese medicine, and dampness evil has the following pathogenic characteristics: 1. Dampness is yin evil, which is easy to block qi activity and damage yang qi. This is because dampness is a tangible evil, blocking any part will affect the circulation of qi and blood there, making the function unfavorable. If it is blocked in the chest, it will cause poor breathing and chest tightness; If it is blocked in the spleen and stomach, it will cause indigestion, abdominal distension, and uncomfortable stool. 2. Wet and turbid, showing the characteristics of being heavy and heavy. Clinically, it can be seen that the whole body is sleepy, the limbs are tired, the head is as heavy as a bundle, the joints are heavy with arthralgia, and the secretions and excretions are turbid. 3. Wet viscosity, characterized by sticky stagnation. For example, the tongue coating is sticky, the urine is stagnant, the stool is sticky and uncomfortable, and the condition is lingering and difficult to heal. 4. Dampness tends to descend, which is easy to attack the yin position. Dampness is water evil and has downward inertia. Dampness is easy to suffer from lower body of human body, such as edema, stranguria, diarrhea, leukorrhagia, ulcer and varicose veins of lower limbs. Episode 12: The diagnosis method of Chinese medicine for diseases is "seeing, hearing and asking". The diagnosis of wet diseases also starts from the observation, observing the patient's mental state, facial color, body dynamics, tongue picture, skin, five senses and nine orifices, among which the tongue picture is more important. Looking at the tongue is of great value in the diagnosis of wet disease, because the tongue picture is the epitome of the whole human body, and the shape, quality, color and coating of the tongue can directly reflect the storage, distribution and energy change of substances and water in the body. The size, width, thickness, length, height, softness and dryness of the tongue can represent the rise and fall of qi and blood, the amount of substances, the level of water content, the strength of internal organs, the resistance of circulation and so on. Tongue substance represents the substance in cells, and tongue coating represents the energy running between cells. The existence and thickness of tongue coating is a symbol of the change of space energy and water vapor profit and loss. Tongue color can also explain the cold and heat in the body. The diagnosis of wet disease mainly depends on the tongue coating, tongue color and tongue moistening. The normal tongue should be reddish and moist, while the tongue coating should be thin, white and even, with a little thick coating in the middle and root of the tongue. Abnormal tongues include: yellow greasy wet coating indicates wet turbidity between cells, which belongs to damp-heat syndrome; The yellow and dry fur indicates that the cells are hot and dry, and the dampness evil has turned into dryness and hurt the yin, which belongs to the syndrome of dryness and heat caused by body fluid injury; White fur is mostly exterior syndrome, while white greasy fur indicates cold and dampness between cells, and spleen and stomach are blocked by cold and dampness, which belongs to exterior syndrome of cold and dampness; White and dry fur means that cells are dry, which is mostly due to dampness and evil, and body fluid can not be carried over. Because of cold, dryness is the exterior syndrome of cold and dryness, and because of heat, dryness is the exterior syndrome of dryness and heat. Black wet coating indicates that the water between cells is wet and heavy, and kidney yang deficiency and failure belong to cold-dampness syndrome; Black and dry fur indicates that the cells are turbid and extremely hot, which is a heat syndrome of excessive heat and yin injury; No moss means that the cell movement is unfavorable, and water and subtle substances are lacking. A large and soft tongue means that there is too much water in human cells. The moistening of tongue represents the water content between human cells. If the water content is too low, the cells will not be moistened. Too high water content will hinder the smooth operation of human energy. Many infectious diseases are often attributed by western medicine to various viruses and germs, while Chinese medicine believes that they are caused by dryness or dampness in the human body. If diseases appear on the chest diaphragm, such as brain diseases accompanied by high fever, they are mostly caused by dryness; If the disease occurs below the diaphragm, such as intestinal diseases accompanied by high fever, it is mostly caused by dampness. Whether the human body is wet or dry, it will be reflected on the tongue. Wet tongue means that water stays in the outer space of the cell and cannot enter the cell to replenish intracellular substances; Dry tongue means that the water content in the outer space of cells is low, and patients are often accompanied by dry stool symptoms. Episode 13: Looking at the figure, Zhu Danxi in Yuan Dynasty said: "Fat people are wet, thin people are full of fire", and those who are full of internal dampness are swollen and obese. Obesity and swelling are more common in patients with endogenous dampness, while patients with exogenous dampness have no obvious physical characteristics, because thin people can also feel exogenous dampness. The symptoms of wet pathogen are different in different parts of the body: when wet pathogen is injected into the lower part of the human body, the tibia of the foot is swollen, the muscles are soft as mud, and it can't afford to sag, and it is flaccid and weak. Dampness and evil in the skin will cause heavy swelling. Damp pathogen is blocked in meridians, qi and blood are not running smoothly, and muscles are lack of nutrition, which leads to stiff neck and limbs and unfavorable activities. "All spasms and rigidity belong to dampness". However, we must pay attention to the fact that the spasms caused by dampness are strong, which are completely different from the angular arch inversion and neck stiffness caused by liver wind. The two must not be confused. The spasms caused by dampness are strong, mainly manifested as the stiffness of the neck, hands and feet, unfavorable activities, local numbness, and accompanied by wet resistance such as heavy head and greasy fur. However, the internal movement of liver wind is characterized by "shaking" signs such as joint tension, muscle twitching and tremor, accompanied by other symptoms of liver wind. In the patient's dynamic aspect, the action belongs to yang, the quick action is full of yang, the slow action is insufficient of yang, and the dampness is yin evil, which is easy to hinder the yang, so the patients with wet disease often have the symptoms of fatigue, laziness, difficulty in walking, unfavorable physical activity, and lying down. However, due to proper activities, the blood circulation can be accelerated and the blood vessels can be unblocked. Therefore, most patients with wet disease feel refreshed after proper activities, and their symptoms are alleviated. Although patients feel tired, their strength is not significantly reduced during work, and there is no performance of shortness of breath and fatigue after exercise. It is different from fatigue and shortness of breath in patients with deficiency syndrome, so we should pay attention to the difference. Episode 14: Obstruction of meridians by dampness is likely to cause arthralgia and poor stretching. In clinic, arthralgia can be divided into wind, cold and dampness, but all of them are mixed with dampness, which can be described as "no dampness is not arthralgia". Arthralgia syndrome with severe damp pathogen is characterized by heavy pain and immobility in the affected area. Damp-evil is also the main cause of flaccidity. Flaccidity is characterized by weakness of hands and feet, inflexible and painless movements. Damp-evil is blocked in muscles and meridians, which prevents qi, blood, body fluids from nourishing and moistening tissues, leading to flaccidity. The pathogen of dampness is usually edema of face or body and limbs, but the swelling potential caused by internal dampness, external dampness, cold dampness and damp heat will be different. The main way of exogenous damp-heat pathogens is through the nose and mouth fur, so the head and face are swollen first; Damp-heat is the yang evil in yin, so the swelling is also from the head and face first; Internal dampness is mostly caused by spleen and kidney dysfunction, and the dampness is endogenous, so the swelling potential starts from the abdomen and lower limbs; Cold and dampness are the yin evil in yin, so the swelling starts from the abdomen and lower limbs and gradually spreads to the whole body. If the damp heat is accumulated in the spleen meridian, you can see that the eye cells are red, swollen and wet, the eyelids are drooping, the eyes are difficult to open, and the nose is red, swollen and festering. If the triple energizer of the liver and gallbladder is damp and hot, you can see sores and rashes around the ears, or yellow and white pus often flows in the ears. If damp heat gathers under the mucous membrane of the oral cavity, it is easy to cause oral ulcer. The throat is swollen and reddish, and those who feel uncomfortable with obstruction are mostly caused by wet phlegm condensation. Episode 15: Damp-fever often leads to various skin diseases, such as "miliaria" in summer, which is caused by needle-sized or millet-shaped red papules or water boils on the sweaty parts of the human body, such as the head, neck, breasts and shoulders. Eczema is also a common disease caused by wet heat soaking in the skin, which can occur in every part of the body, with itchy red chestnut papules, and chronic skin thickening will not heal for years. Because the damp pathogen is heavy and turbid, it is easy to flow into the lower limbs, causing leg ulceration and yellow water, itching if there are insects. The dermatosis caused by damp-heat has some * * * same manifestations. There are many watery or swollen areas in the affected areas, and the secretions are mostly yellow and sticky, with a long course of disease. If there is a sore in the lower vulva, those with swelling and heat pain are damp-heat in the liver meridian, and those with no swelling and pain are mostly caused by downward injection of water and dampness. Modern medicine