Forum - Article 4 / if exo-yang-disorder worsened

Translated by Dr. Lim Siow Jin @ 2014 all rights reserved.

4. During the first day of exogenous sickness, when the disorder is exo-yang, if the pulse is stable and the symptoms remain exogenous, it means the disorder does not aggravate further. If the patient is suffering from severe nausea, restlessness and is agitated, pulse fast and beating strong, it means the pathogenic disorder has advanced into the body, it is no longer a simple exo-yang disorder.

Notes:

When a person is experiencing exo-yang disorder it is normally not life threatening. However, we should treat the patient carefully so that the disorder does not advance into endo-yang, which may be serious. Or when the patient is experiencing exo-yang disorder and exhibits the tell tale signs that the disorder is going to worsen, then we should take immediate measures to prevent the disorder from advancing into the body. In future chapters Zhang discusses more on this.

How do we know that the symptom is going to get worse? We should check the pulse, if it is stable then it is ok. If it started to beat fast and become stronger, the fever is advancing into the body.

We should check for nausea. If there is simple nausea with chill and float pulse it is ok. If strong nausea with chill and fever-without-chill alternating with each other, mouth feeling bitter, the side of the body feels full and uncomfortable, then exo-yang is advancing into intero-yang. At this state the patient still remains calm and there is no restlessness or agitation.

If the patient experiences great thirst, high fever without chill, is restless and agitated, sometimes removes the cloth to expose the body, is talking loudly and sometimes yelling, the pulse is fast and forceful, has severe constipation, then exo-yang has advanced into endo-yang. Warm herbs should never be used now.

It is not necessary that exo-yang will advance into intero-yang before going into endo-yang. From exo-yang the disorder can advance into any meridian, including the exo-yin etc. You need not worry about the treatment now, it will be explained in great details in Shanghan Lun.