The causes of diseases are various, generally including the so-called six excesses, seven emotional factors, improper diet, imbalance between work and rest and traumatic injury. In traditional Chinese medicine (TCM), there are many terms related to these five aspects. However in WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region［1］ (abbreviated as WPRO Standard), only 60 terms related to six excesses and traumatic injury are included and almost no terms associated with emotional changes, improper diet and imbalance work and rest can be found in it. In this article, the author is trying to analyze the English translation and international standardization of the related terms according to WPRO Standard and International Standard Chinese-English Basic Nomenclature of Chinese Medicine compiled by World Federation of Chinese Medicine Societies［2］ (abbreviated as WFCMS Standard) on the basis of the studies made in the book entitled International Standardization of English Translation of Traditional Chinese Medicine: Study of Theory, Summarization of Practice and Exploration of Methods［3］.
病因辨证disease cause pattern identification/syndrome differentiation: categorization of patterns/syndromes according to pathological conditions attributable to different kinds of causal factors for making diagnosis
The Chinese term病因辨证is also frequently translated as “etiological differentiation of syndromes”, sounding more concise than “disease cause pattern identification/syndrome differentiation”.
外风证external wind pattern/syndrome: a general term for patterns/syndromes caused by external wind pathogen alone or together with other pathogenic factors such as dampness, heat, or pestilent toxin
In this definition, “pestilent toxin” may be the translation of the Chinese term邪毒which is sometimes rendered as “pathogenic toxin” because the Chinese character邪is often translated as “pathogenic”, such as pathogenic wind (风邪), pathogenic dampness (湿邪) and pathogenic dryness (燥邪). However, comparatively speaking, “pestilent toxin” sounds much better than “pathogenic toxin” in collocation and semantics.
内风证internal wind pattern/syndrome: any pattern/syndrome of internal wind stirring in the interior, manifested by dizziness and blurred vision, numbness of the limbs, tremors, convulsions or pruritus
In this definition, the expression “internal wind stirring in the interior” sounds quite alien in terms of TCM theory. It is true in TCM that there are some terms about wind stirring, such as “internal stirring of deficiency-wind” (虚风内动) and “internal stirring of liver-wind” (肝风内动) etc. However it seems that there is no such an expression as “internal wind stirring in the interior”.
中风闭证 wind-stroke block pattern/syndrome: a pattern/syndrome of wind-stroke characterized by blockage of the orifices manifested by sudden loss of consciousness, hemiplegia, clenched jaw and clenched hands
The Chinese term中风is quite similar to the English term apoplexy. That is why中风is frequently translated as “apoplexy”. Comparatively speaking, “wind-stroke” sounds more unique because it clearly reflects the idea about the pathogenesis of this problem in TCM.
中风脱证wind-stroke collapse pattern/syndrome: a pattern/syndrome of wind-stroke characterized by desertion of yang qi, manifested by sudden loss of consciousness, closed eyes with opened mouth, faint breathing, flaccid paralysis of the limbs, profuse cold sweats, and incontinence of urine and feces
In this Chinese term中风脱证, the Chinese character脱means loss, such as loss of consciousness, loss of breath or loss of normal control of certain activities including movement of the eyes, mouth and limbs. Sometimes the Chinese character脱also refers to profuse sweating and incontinence of urine and feces. Thus it is difficult to find an accurate equivalent in English. In the current translation field, it is often translated as “collapse”, “loss” or “prostration”.
实热证excess heat pattern/syndrome: a pattern/syndrome caused by excessive pathogenic heat while the body resistance is still sufficient with intense reaction, marked by high fever with restlessness, constipation, large or slippery rapid pulse
The Chinese term实热证simply refers to the syndromes caused by excessive heat inside certain part of the body, such as syndrome of excess heat in intestines (肠道实热证) caused by superabundant heat in the intestines that leads to obstruction of qi in the fu-organs with the common clinical manifestations of fever, thirst, constipation, distension, rigidity, fullness and pain of abdomen, reddish tongue with yellow coating with scanty fluid, rapid and deep pulse, and syndrome of excess heat in small intestine (小肠实热证) caused by superabundant heart fire that moves downward to the small intestine, or accumulation of damp-heat and pathogenic fire in the small intestine with the common clinical manifestations of fever, thirst, dysphoria, insomnia, ulcer of mouth and tongue, scanty brownish urine, burning sensation and pain of urination, even hematuria, reddish tongue with yellow coating, and rapid pulse, etc.
实寒证excess cold pattern/syndrome: any pattern/syndrome due to contraction of yin cold
The Chinese term实寒证just refers to syndromes caused by excessive cold inside certain parts of the body, such as syndrome of excess cold in the liver meridian (肝经实寒证) caused by invasion of pathogenic cold that stagnates in the liver meridian with the clinical manifestations of cold pain of lower abdomen, or contraction pain of external genitalia, or parietal headache that can be aggravated by cold and relieved by warmth, aversion to cold, cold limbs, vomiting of saliva, white tongue coating, wiry and tight pulse, and syndrome of pathogenic cold invading stomach (寒邪犯胃证) caused by invasion of pathogenic cold into the stomach and epigastrium that prevents the stomach from descending normally with the common clinical manifestations of sharp cold pain of stomach and epigastrium with preference for warmth, vomiting of clear fluid, aversion to cold, cold limbs, white tongue coating, and wiry pulse, etc.
中寒证pattern/syndrome of cold in the middle: a deficiency-cold pattern/syndrome of the middle energizer arising from insufficiency of yang qi and impaired splenic transportation and transformation, manifested by abdominal pain that can be relieved by warmth and pressure, cold limbs, reduced food intake, and loose stool, etc.
In this definition, “splenic”, the adjective of spleen, is used to describe the basic functions of the spleen. However such a use is quite rare in the current translation practice. In order to make a distinction between the concepts between TCM and modern medicine, translators tend to use the noun form of words like heart, liver, spleen, lung and kidney to describe the related Chinese terms, such as heart qi instead of cardiac qi, liver qi instead of hepatic qi and lung qi instead of pulmonary qi. In WFCMS Standard, the Chinese term中寒证is translated as “internal cold syndrome/pattern”, sounding more concise than “pattern/syndrome of cold in the middle”.
暑证summerheat pattern/syndrome: any pattern/syndrome resulting from contraction of summerheat and marked by high fever with sweating, thirst, shortness of breath, lassitude, cumbersome limbs, short voidings of dark-colored urine, reddened tongue and rapid vacuous pulse
In this definition, the expression “short voiding of dark-colored urine” seems to be the translation of the Chinese term小便短赤which actually means “scanty brown urine”. In this term the Chinese character短literally means “short” but actually means “scanty”. The expression “rapid vacuous pulse” seems to be the translation of the Chinese expression脉虚疾which means that the pulse is rapid and weak. In this expression the Chinese character虚means “weakness” or “feebleness”, and cannot be understood as “vacuous” or “empty”.
湿证dampness pattern/syndrome: any pattern/syndrome resulting from contraction of external dampness or arising from internal dampness, marked by physical fatigue, heavy cumbersome limbs, heavy-headedness, poor appetite, abdominal distention, sloppy stool, slippery and slimy tongue coating, and soggy relaxed pulse
In TCM, 湿证is seldom taken as an independent syndrome. In fact it is often mingled with other syndromes as seen in syndrome of blood heat mixed with dampness (血热夹湿证), syndrome of phlegm dampness due to spleen deficiency (脾虚痰湿证), syndrome of cold dampness in intestine (肠道寒湿证) and syndrome of phlegm and dampness in flesh wheel (肉轮痰湿证). In this definition, the expression “soggy relaxed pulse” seems to be the translation of the Chinese expression脉濡缓in which濡means soft or soggy and缓means slow or moderate. To translate the Chinese character缓in this expression as “relaxed” seems quite inaccurate.
外燥证external dryness pattern/syndrome: a general term for patterns/syndromes caused by climatic dryness, commonly manifested by dry skin, dry nose, mouth and throat or dry cough
The pathogenesis of外燥证is excessive consumption of body fluid caused by invasion of climatic dryness, causing dryness of the skin, mouth, nose and throat.
内燥证internal dryness pattern/syndrome: any pattern/syndrome of dryness due to consumption of body fluids, manifested by emaciation, withered skin, dry throat, parched lips, thirst, oliguria, constipation, furless reddened tongue and rapid fine pulse
The cause of内燥证is usually deficiency of yin. If yin is deficient, it tends to produce internal heat which consequently causes internal dryness and results in various symptoms and signs of dryness.
凉燥证cool dryness pattern/syndrome: pattern/syndrome due to coolness and dryness in autumn, marked by headache, more chills than fever, absence of sweating, dryness of the nasal cavity and lips, cough with scanty expectoration, thin and dry whitish tongue fur, and floating and tense pulse
The pathogenesis of凉燥证is invasion of pathogenic coolness and dryness in autumn which attacks the exterior and impairs the lung, leading to corresponding symptoms and signs.
温燥证warm dryness pattern/syndrome: pattern/syndrome caused by exopathic warmth and dryness in autumn, marked by fever with slight aversion to wind and cold, dryness of the nasal cavity and lips, thirst, dry cough with scanty expectoration, fidgetiness, thin yellowish tongue fur, and rapid and floating pulse
The pathogenesis of温燥证is invasion of pathogenic warmth and dryness which consumes yin fluid and causes various corresponding symptoms and signs. The common clinical manifestations, apart from that mentioned in the definition above, still include dry skin and throat, scanty and yellow urine, etc.
燥干清窍证pattern/syndrome of dryness affecting the clear orifices: a pattern/syndrome marked by dry nose, mouth and eyes with lack of nasal mucus, saliva and tears
The Chinese term清窍refers to the seven upper orifices which appear sensitive and acute and that is what the Chinese character清actually means. Usually 清窍is simply translated as “upper orifices” or “seven orifices”, failing to reveal the underlined meaning of清. Comparatively speaking, WPRO’s version “clear orifices” seems more expressible.
燥结证dryness bind pattern/syndrome: a pattern/syndrome marked by constipation due to deficiency of fluids in the gastrointestinal tract
In the Chinese term燥结证, the Chinese character结means retention of feces due to excessive dryness in the intestines. This Chinese character sometimes is translated as “bind”. However, “bind” is a verb. In the above translation “dryness bind pattern/syndrome”, “bind” seems to be used as a noun. But such a use is really rare in English.
实火证excess fire pattern/syndrome: a pattern/syndrome caused by intense pathogenic fire, most commonly affecting the stomach and intestines or the liver and gallbladder, and characterized by high fever, headache, red eyes, bitter taste in the mouth, dry mouth and thirst for cold drink
The pathogenesis of实火证is internal superabundance of fire and heat. And the common clinical manifestations, apart from the ones mentioned in the above definition, also include burning sensation in the chest and abdomen, reddish face and eyes, constipation, scanty yellow urine, reddish tongue with yellow and dry coating, rapid and surging pulse, etc.
火热证fire-heat pattern/syndrome: any pattern/syndrome of heat and fire, contracted either externally or engendered internally
The pathogenesis of火热证is superabundant fire and heat that disturb the heart and kidney. The common clinical manifestations include fever, thirst, dysphoria, insomnia, even coma and delirium, brownish urine, burning sensation，lumbago, reddish tongue with yellow coating and rapid pulse, etc.
虚火上炎证pattern/syndrome of deficiency fire flaming upward: a pattern/syndrome arising when insufficient yin fails to inhibit fire, marked by dry and sore throat, vexation, insomnia, dizziness, tinnitus, forgetfulness, heat in the palms and soles, night sweating, or red eyes, ulcers of the tongue or mouth, reddened tender-soft tongue and rapid fine pulse
The pathogenesis of虚火上炎is certainly related to insufficiency of yin. However, to be more specific, it is caused by insufficiency of yin in the liver and kidney that gives rise to upward flaming of deficiency-fire.
脓证pus pattern/syndrome: a pattern/syndrome marked by purulent discharge from an ulcerative lesion with stinking fetid smell, accompanied by fever, thirst, curdy and slimy tongue coating, and rapid slippery pulse
Pus or suppuration is a symptom that can be found in various diseases or syndromes, such as syndrome of suppuration due to excessive heat (热盛酿脓证) caused by stagnation of pathogenic heat that leads to putrefaction of blood and muscle, resulting in carbuncle and suppuration. To take it as an independent syndrome is quite rare in TCM.
食积证food accumulation pattern/syndrome: a pattern/syndrome marked by epigastric and abdominal distention, vomiting of sour matter, anorexia, offensive odor of stools, curdy and slimy tongue coating, the same as the food stagnation pattern/syndrome
In the Chinese term食积证, the Chinese character积means retention. So the better translation of食积may be food retention. The clinical manifestations of this syndrome, apart from the ones mentioned in the above definition, also include difficulty in defecation, wiry and slippery pulse, etc.
虫积证worm accumulation pattern/syndrome: a general term for patterns/syndromes caused by intestinal accumulation of parasitic worms, often marked by abdominal distention or pain, emaciation, lack of strength and sallow complexion
The Chinese term虫积is also frequently translated as “parasitic infestation” as done in WFCMS Standard. Comparatively speaking, parasitic infestation seems better than worm accumulation in revealing the meaning of the original Chinese term.
风痰证wind-phlegm pattern/syndrome: a pattern/syndrome attributable either to external wind with phlegm or to liver wind with phlegm, marked by expectoration of foamy sputum, fullness and oppression in the chest, dizziness, and distending pain of the head and eyes, or marked by phlegmatic sounds in the throat, numbness of limbs, and even loss of consciousness with aphasia, and deviated eye and mouth
The clinical manifestations of wind-phlegm syndrome, apart from the ones mentioned in the above definition, also include white greasy coating, wiry and slippery pulse.
寒痰证cold-phlegm pattern/syndrome: a pattern/syndrome marked by cough with whitish expectoration, dyspnea or wheezing, aversion to cold with cold limbs, white slimy tongue coating, and wiry slippery or tense pulse
寒痰证is caused by coagulation of pathogenic cold and turbid phlegm. The common clinical manifestations include expectoration of whitish sputum, chest distress, stuffiness of epigastrium, asthma with wheeze, aversion to cold, cold limbs, white greasy coating, wiry and slippery or wiry and tight pulse, etc.
热痰证heat-phlegm pattern/syndrome: a pattern/syndrome arising when turbid phlegm combined with pathogenic heat accumulates in the lung and harasses the heart, marked by cough with yellowish expectoration, vexing stuffiness in the chest, fever, thirst, palpitations, insomnia, short voidings of deep-colored urine, reddened tongue with yellow greasy slimy coating and rapid slippery pulse
热痰证is caused by mixture of turbid phlegm and pathogenic heat. In this definition, the expression “vexing stuffiness in the chest” seems to be the translation of the Chinese expression胸中烦闷which is often rendered as “dysphoria” which sounds more concise. Besides, the expression “short voiding of deep-colored urine” seems to be another translation of the Chinese term小便短赤which actually means “scanty brown urine” as analyzed in summerheat pattern/syndrome (暑证).
燥痰证dryness-phlegm pattern/syndrome: a pattern/syndrome due to accumulation of dryness-heat and phlegm-turbidity in the lung, marked by cough with scanty sticky sputum difficult to spit out, or blood streaked sputum, chest pain with oppression feeling, dry nose and mouth, tongue with scanty moisture but slimy coating, and thin choppy pulse
In this definition, the expression “blood streaked sputum” seems to be the translation of the Chinese expression痰有血丝which is sometimes generally rendered as “blood in sputum” or “bloody sputum”. Obviously “blood streaked sputum” is much more clearer and accurate than “blood in sputum” or “bloody sputum”.
瘀痰证blood stasis-phlegm pattern/syndrome: a pattern/syndrome arising when turbid phlegm combined with static blood obstructs the qi movement, marked by formation of masses with local stabbing pain, or numbness and wilting of the limb, oppression in the chest with expectoration of profuse sputum or dark bloody sputum, purple tongue or purple spots on the tongue, slimy coating and string-like rough pulse
The Chinese term瘀痰证is actually rarely used in clinical practice. This syndrome is caused by stagnation of phlegm with blood stasis complex and results in various clinical manifestations as listed above. In this definition, the expression “wilting of the limb” may be the translation of the Chinese term肢体痿软which is often rendered as “flaccidity of limbs” or “weakness of limbs”. And the expression “string-like rough pulse” may be the translation of the Chinese term脉弦涩which actually refers to two kinds of pulse, namely弦脉, which is often translated as “taut pulse” or “wiry pulse”, and涩脉, which is frequently translated as “unsmooth pulse”.
脓痰证purulent phlegm pattern/syndrome: a pattern/syndrome marked by expectoration of pus or purulent sputum
In TCM, 痰can be classified into two different categories, visible and invisible. Invisible 痰refers to thick humor that may exist in different parts of the body causing obstruction and stagnation. While visible痰just refers to the substance discharged from the throat. To make a distinctive difference between these two kinds of痰in TCM, visible痰is usually translated as “sputum” while invisible痰is often rendered as “phlegm”. According to such a differentiation, 痰in脓痰证obviously refers to visible痰and therefore should be translated as “sputum” instead of “phlegm”.
湿痰证dampness-phlegm pattern/syndrome: a pattern/syndrome due to accumulation of dampness phlegm in the lung, marked by cough with profuse expectoration, heaviness sensation of the limbs, feeling of stuffiness in the chest, reduced food intake, stickiness of the mouth, white slimy tongue coating and slippery pulse
In this definition, the expression “white slimy tongue coating” may be the translation of the Chinese expression苔白腻. When describing the condition of tongue coating, the Chinese character腻is frequently translated as “greasy” and苔is sometimes rendered as “fur”.
痰气互结证pattern/syndrome of binding of phlegm and qi: a pattern/syndrome marked by depressed mood, insomnia, dream-disturbed sleep, a sensation of a foreign body in the throat which can be neither swallowed nor ejected, fullness and oppression in the chest, and profuse sputum; white and slimy tongue coating, and slippery string-like pulse
This syndrome is also frequently caused by liver depression and qi stagnation, and disharmony of thoroughfare and conception vessels, or drinking unsanitary water that leads to accumulation of phlegm and qi in the throat. In WFCMS Standard, 痰气互结证is translated as “syndrome/pattern of combined phlegm and qi”. The Chinese character结means to mix or to bind.
痰热内扰证pattern/syndrome of internal harassment of phlegm-heat: a pattern/syndrome arising when phlegm-heat disturbs the spirit and impedes the qi movement, marked by cough with yellow thick expectoration, dyspnea, fever, thirst, vexation, insomnia, dream-disturbed sleeping, reddened tongue with yellow slimy coating and rapid slippery pulse
In WFCMS Standard, the term痰热内扰证is rendered as “syndrome/pattern of phlegm-fire harassing internally”. If it is changed into “syndrome/pattern of phlegm-fire harassing the internal”, it may sound better in structure. Besides, the Chinese character扰in 痰热内扰证is often translated as “disturbing” in current translation practice.
痰热内闭证pattern/syndrome of internal block of phlegm-heat: a pattern/syndrome arising when phlegm-heat in the interior obstructs and blocks the heart-spirit, manifested by impaired consciousness, delirium or mania associated with fullness, oppression and scorching pain in the chest, cough, dyspnea and expectoration of yellow thick sputum, fever, and thirst, or in some cases, sudden onset of unconsciousness with whizzing in the throat, reddened tongue with yellow slimy coating and slippery pulse
The Chinese character闭in痰热内闭证means to block, to obstruct or to close. Since “block” is a verb, “internal block of phlegm-heat” may be rationally changed into “internal blockage of phlegm-heat” or “internal obstruction of phlegm-heat”. Of course in English language the word “block” can be used as a noun, but the meaning seems different.
痰热动风证pattern/syndrome of phlegm-heat stirring wind: a pattern/syndrome marked by convulsions or vertigo associated with fullness and oppression in the chest, cough, dyspnea and expectoration of yellow thick sputum, fever, thirst, or nausea and vomiting, reddened tongue with yellow slimy coating and rapid slippery pulse
This syndrome is usually caused by internal superabundance of phlegm and heat that stirs liver wind to cause various clinical symptoms and signs as mentioned above. The common clinical manifestations, apart from the ones mentioned above, still include distension and oppression of chest and hypochondrium, asthma, wheezy phlegm in the throat, spasm of limbs, or dizziness, vomiting and nausea.
痰核留结证pattern/syndrome of lingering phlegm: a pattern/syndrome marked by lumps below the skin particularly of the neck, which are movable, round, firm and slippery under the finger, without redness, hotness or pain
To translate痰核留结into “lingering phlegm” is understandable, but the concept of结in the original Chinese term is lost. In the current translation practice, 痰核留结is frequently rendered as “lingering phlegm nodule” which is not necessarily the best translation, but at least has revealed some of the underlined meaning of结in the original term. This syndrome is caused by agglomeration of turbid phlegm that is retained inside and the common clinical manifestations, apart from that mentioned above, still include wiry and slippery pulse.
血瘀风燥证pattern/syndrome of blood stasis with wind-dryness: a pattern/syndrome arising when internally retained static blood gives rise to dryness and wind, and manifested by encrusted skin, desquamation and itching, associated with vertigo, numbness of the limb, purplish tongue or appearance of purple spots on the tongue, and fine choppy pulse
The so-called血瘀风燥is caused by internal obstruction of blood stasis that leads to transformation of wind and dryness and failure of blood to be produced. That is to say that 瘀血is the cause and风燥is the effect. That is why this term is often translated as “wind-dryness due to/caused by blood stasis”.
血瘀水停证pattern/syndrome of blood stasis with water retention: a pattern/syndrome marked by formation of mass in the abdomen with stabbing pain, enlarged and distended abdomen, inhibited urination, purplish tongue or appearance of purple spots on the tongue, and fine choppy pulse
This syndrome is caused by internal obstruction of blood stasis which leads to retention of water and fluid. The common clinical manifestations, apart from that mentioned above, still include dysuria, amenorrhea, dropsy, local extensive bluish and purplish swelling and distending pain.
寒湿内阻证pattern/syndrome of internal obstruction of cold-dampness: a pattern/syndrome marked by heaviness feeling of the head and body, joint pain with inhibited bending and stretching, absence of sweat, or edema of the face and limbs, loose stools, and dysuria; white and moistened tongue coating and slippery pulse
In this definition, the expression “heaviness feeling of the head and body” is obviously the translation of the Chinese expression头身困重which just means “heaviness of the head and body” or “heavy feeling of the head and body”. To use “heaviness” to modify “feeling” sounds a little awkward.
寒凝血瘀证pattern/syndrome of congealing cold with blood stasis: a pattern/syndrome arising when pathogenic cold obstructs qi movement and blood flow, manifested by pain aggravated by cold and alleviated by warmth, cold and cyanotic limbs, and delayed menstruation, painful periods, menstrual discharge of dark purple blood with clots, dark purple tongue with white coating, and sunken, slow and choppy pulse
In the term寒凝血瘀证, the Chinese character凝is frequently translated as “coagulation” in such cases. This syndrome is caused by obstruction of blood circulation due to qi stagnation by pathogenic cold. The common clinical manifestations also include aversion to cold. In this definition, the Chinese expression涩脉is rendered as “choppy pulse”. In other places in WPRO Standard, 涩脉is rendered as “rough pulse”.
血寒证blood cold pattern/syndrome: a pattern/syndrome that arises when congealing cold and qi stagnation inhibit the movement of blood and give rise to blood stasis, commonly manifested by cold pain of the extremities with dark purple skin or cramps in the lesser abdomen that are relieved by warmth and exacerbated by cold, delayed menstruation and dark purple menstrual discharge with blood clots, white tongue coating and sunken, slow and choppy pulse
In this definition, the expression “lesser abdomen” is obviously the translation of the Chinese term小腹which literally means “small abdomen” and actually is the same with another Chinese term少腹which literally means “lesser abdomen”. In fact, both小腹and少腹just refer to “lower abdomen”. Thus it is unnecessary to render小腹or少腹as “lesser abdomen”.
湿热毒蕴证pattern/syndrome of retained dampness-heat toxin: a pattern/syndrome marked by redness, swelling, ulceration and exudation of the hand, foot, ear, nose, head, face or genital region, or by fever, jaundice, impaired consciousness, eruptions, reddened tongue and rapid soggy pulse
The syndrome of湿热毒蕴is caused by stagnation of pathogenic damp toxin and pathogenic heat toxin that accumulate in the body. The common clinical manifestations, apart from that mentioned above, still include coma, macula， difficult urination and yellow greasy tongue coating. The Chinese character蕴in this term not only means to retain, but also to increase the amount. So the better translation of蕴in this term may be accumulation.
湿热下注证pattern/syndrome of dampness-heat pouring downward: a pattern/syndrome marked by frequent and painful urination, or yellow fetid discharge from the vagina, or ulceration of the leg with purulent discharge
This syndrome is caused by pathogenic dampness and heat that move downwards into the intestinal tracts, bladder, uterus, pudendum and lower limbs, etc. The common clinical manifestations also include eczema and pruritus at pudendum, or sore of lower limbs, ulceration and effusion. In the current translation practice, the Chinese term湿热下注is often translated as “downward flow of damp-heat”. To render下注as “pouring downward” sounds far more serious than the reality.
瘟毒下注证pattern/syndrome of pestilential toxin pouring downward: a pattern/syndrome marked by downward pouring of the pestilential toxin, e.g., painful swelling of the testis in mumps
This syndrome is usually caused by warm and heat toxin, such as mumps with swollen and painful scrotum, that moves downwards. The main clinical manifestations also include abscess of inferior part due to spread of carbuncle, gangrene, or ulceration and burning pain of lower limbs. As analyzed in湿热下注证, the Chinese expression下注in this term can be simply rendered as “moving downwards”. The Chinese character注in this term sounds like “pouring”, actually it just means “(to move) directly”.
风毒证wind-toxin pattern/syndrome: a pattern/syndrome due to wind-toxin attack on the skin and flesh, marked by sudden onset of edema, with numbness, itching and pain, or appearance of wheals, redness and swelling of face, eyes, nose and mouth
风火热毒证wind-fire-heat toxin pattern/syndrome: a pattern/syndrome due to accumulation of wind-fire-heat toxin in the skin and flesh, marked by formation of boils, abscess or carbuncle accompanied by itching, numbness and scorching pain or suppuration and ulceration accompanied by high fever, crimson tongue with brownish yellow coating and rapid surging pulse
The Chinese term风火热毒证implies that this syndrome is caused by stagnation and accumulation of toxin transformed from pathogenic wind, fire and heat in the skin and muscle. Sometimes风火热毒also can be understood as four individual pathogenic factors, i.e. wind, fire, heat and toxin. The common clinical manifestations include purulence, ulceration, or red swelling and pain of head, face, mouth, nose and eyes, fever, even coma and delirium, constipation and yellow urine.
火毒证fire toxin pattern/syndrome: a pattern/syndrome caused by toxin derived from exuberant heat-fire retaining in the skin and subcutaneous tissue, marked by local redness, swelling and burning pain, followed by abscess formation and accompanied by fever, thirst, reddened tongue with yellow coating, and rapid pulse
The so-called fire toxin in TCM just refers to skin or subcutaneous abscess caused by retention and accumulation of pathogenic fire or heat in the skin or tissue. The expression “burning pain” in this definition is also frequently described as “scorching pain” in TCM.
火毒内陷证pattern/syndrome of inward invasion of fire toxin: a syndrome arising when exuberant fire-heat toxin penetrates into the internal organs, usually manifested by high fever with thirst, delirium, constipation, dark-colored urine, crimson tongue with yellow coating and rapid sunken pulse
The so-called火毒内陷证in TCM refers to the syndrome caused by fire toxin that penetrates into the internal organs or sinks into the deep part of the body. For this reason, the Chinese expression内陷in this term is often translated as “internal sinking” or “internal penetration”.
阴毒证yin toxin pattern/syndrome: a pattern/syndrome arising when toxin derived from yin-cold accumulates, usually manifested by local diffuse swelling with cold pain that is relieved by warmth and failure to suppurate and rupture, or contains thin foul-smelling pus, accompanied by aversion to cold and cold limbs, white tongue coating and sunken pulse
The so-called阴毒证is rarely used as an independent syndrome in TCM. In fact it is often used as an element in other complicated cases such as阴毒伤寒which means cold attack caused by yin toxin or yin cold accumulation.
蛇毒内攻证pattern/syndrome of inward attack of snake venom: a pattern/syndrome arising after snake-bite when the snake venom invades the internal organs, marked by headache and dizziness, oppression in the chest, dyspnea, cold sweats and cold limbs, or loss of consciousness
In the current translation practice, the Chinese expression内攻in蛇毒内攻is often rendered as “internal attack” which is caused by invasion of snake venom into the viscera after being bit by venomous snake. The common clinical manifestations also include macula, hemorrhage, or mental confusion.
石阻证calculus obstruction pattern/syndrome: a pattern/syndrome caused by calculus obstruction, marked by distending pain or colicky pain in the right hypochondrium or in the lumbar region referring to the lesser abdomen
Sometimes石阻证is simply translated as “stone obstruction syndrome”. However, calculus obstruction syndrome sounds more technical. The symptoms of this syndrome vary due to the location of calculus.
风寒证wind-cold pattern/syndrome: a pattern/syndrome caused by externally contracted wind and cold, and manifested by pronounced aversion to cold with mild fever, headache, generalized pain, absence of sweating, stuffy and runny nose with watery discharge, thin white and moistened tongue coating, and floating pulse
The so-called风寒证is usually caused by invasion of exogenous pathogenic wind and cold into the body, leading to various symptoms and signs as listed above. However, 风寒is usually taken as part of the cause of a syndrome, such as syndrome of wind-cold blocking lung (风寒闭肺证), syndrome of wind-cold fettering the exterior (风寒束表证) and exterior syndrome of wind-cold (风寒表证), seldom used as a dependent syndrome in TCM.
风热证wind-heat pattern/syndrome: a pattern/syndrome caused by externally contracted wind and heat, and manifested by pronounced fever and mild aversion to cold, cough, thirst, reddened tongue margins and tip, slightly yellow coating and rapid floating pulse
In TCM, 风热is often taken as an mingled pathogenic factor causing varied syndromes, such as syndrome of wind-heat in lung meridian (肺经风热证), syndrome of wind-heat in spleen meridian (脾经风热证) and syndrome of wind-heat in liver meridian (肝经风热证), seldom used as an independent syndrome in TCM.
风火证wind-fire pattern/syndrome: a pattern/syndrome caused by externally contracted wind and fire in combination
As analyzed in风热证, in TCM风火is just a mingled pathogenic factor as in terms like syndromes of wind-fire invading teeth (风火犯齿), coagulation and binding of wind-fire (风火凝结) and wind-fire disturbing the upper (风火上扰), etc. The same is also true with the terms listed below like风湿证, 风燥证and热毒证, etc.
风湿证wind-dampness pattern/syndrome: a pattern/syndrome caused by externally contracted wind and dampness in combination, manifested by generalized pain, heaviness feeling of the body, joint pain with inhibited articular movement
In this definition, the expression “inhibited articular movement” may be a translation of the Chinese expression关节活动受限which is also frequently translated as “limited movement of joint”.
风燥证wind-dryness pattern/syndrome: a pattern/syndrome caused by externally contracted wind and dryness in combination, and manifested by headache, fever, aversion to wind, absence of sweating, dry nose, lips, throat and skin, dry cough, thin and dry tongue coating
The so-called风燥证, though seldom used as a single syndrome in TCM, is caused by invasion of exogenous pathogenic wind and dryness that are mingled with each other in attacking the body.
热毒证heat toxin pattern/syndrome: a pattern/syndrome arising when accumulated pathogenic fire-heat is transformed into toxin and manifesting in boils, sores, and eruptive diseases
湿毒证dampness toxin pattern/syndrome: a pattern/syndrome arising when accumulated dampness turns into toxin and marked by a lingering course difficult to cure, and presence of turbid secretions
In this definition, the expression “a lingering course difficult to cure” sounds a little awkward in structure. The rational structure might be “lingering course and difficulty to cure”.
寒湿证cold-dampness pattern/syndrome: (1) a pattern/syndrome that arises when the movement of qi and blood is impeded by cold and dampness in combination, and is marked by joint, muscle and bone pains; (2) a pattern/syndrome that arises when dampness harasses the spleen and stomach and cold causes damage to spleen yang, or water-fluid retained in a case of spleen-kidney yang deficiency, and is marked by aversion to cold, cold limbs, abdominal distension, diarrhea or edema dampness-heat
Though carefully and neatly defined above, 寒湿证is seldom used as a single syndrome in TCM. In fact, 寒湿is often the cause of some syndromes, such as syndrome of cold-dampness obstructing middle energizer (寒湿中阻证), syndrome of cold-dampness in intestine (肠道寒湿证) and syndrome of cold dampness due to kidney deficiency (肾虚寒湿证), etc.
湿热证dampness-heat pattern/syndrome: a pattern/syndrome caused by a combination of dampness and heat, either of external or of internal origin, with different manifestations according to location, e.g., jaundice when dampness-heat accumulates in the liver and gallbladder, leukorrhea when dampness-heat pours down, and diarrhea for dampness-heat in the intestines
Similarly湿热is taken as the cause of some syndromes rather than a single syndrome itself in TCM, as seen in syndromes like syndrome of dampness-heat in kidney meridian (肾经湿热证), syndrome of dampness-heat in bladder (膀胱湿热证) and syndrome of dampness-heat in uterus (胞宫湿热证).
阴暑证yin summerheat pattern/syndrome: a pattern/syndrome that results from exposure to wind or drafts or to excessive consumption of cold drinks in the hot summer, and is manifested by fever, headache, aversion to cold, absence of sweating, and generalized pain; and in some cases, vomiting, diarrhea and abdominal pain
The so-called阴暑证can be found in TCM, but it is seldom used in clinical practice because such a problem is often mingled with other symptoms in the concerned syndromes. As mentioned above, the cause of such a syndrome is usually attack of wind or excessive drinking of cold water in summer.
痰湿证phlegm-dampness pattern/syndrome: a pattern/syndrome that arises when dampness gathers to form phlegm, with different manifestations according to location: cough with profuse whitish expectoration and oppression in chest if phlegm obstructs the lung, and epigastric stuffiness, reduced food intake, and greasy taste in the mouth if phlegm accumulates in the spleen. The general signs of phlegm-dampness are white slimy tongue coating and slippery pulse
As mentioned above, 痰湿is a commonly encountered cause in TCM etiology. However it is often used as the cause of certain syndromes rather than an independent syndrome, such as syndrome of phlegm-dampness due to spleen deficiency (脾虚痰湿证), syndrome of phlegm-dampness in skin (肌肤痰湿证) and syndrome of phlegm-dampness in flesh wheel (肉轮痰湿证). | |