Guest guest Posted November 4, 2003 Report Share Posted November 4, 2003 Marco, You're right, we should never use the term inflammation when discussing differential diagnosis, because it is not a Chinese term. However, the fact is that when the four signs of redness, palpable heat, swelling and pain occur together, from an Oriental differential diagnosis it would always be a heat pattern, no? We know, of course, that there are patterns of pain and swelling which are not heat patterns, but by definition, would it not be a heat pattern when a patient has palpable heat and/or redness? Therefore, I think that your original question is misplaced, and by asking if there is always inflammation when there is heat, is mixing apples and oranges. However, if you are asking do the phenomena of inflammation (the four cardinal signs) always manifest as heat, then I think you have to respond that it depends: that if the two heat signs mentioned above present themselves, along with swelling and pain, then for sure, yes, but if just swelling and pain are the only manifestations, then of course, no. Am I understanding your question correctly? Yehuda ______________ The best thing to hit the internet in years - Juno SpeedBand! Surf the web up to FIVE TIMES FASTER! Only $14.95/ month - visit www.juno.com to sign up today! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 4, 2003 Report Share Posted November 4, 2003 Just a note here. Pain in both WM and CM arises from " stasis " or could be said to be a sign of " stasis " . You can check it out in the various texts. Kind of an interesting commonality. At any rate if it's pain with swelling then it usually also involves heat. Pain can be without heat ... just a result of stasis. Respectfully, Emmanuel Segmen Merritt College - Tuesday, November 04, 2003 2:12 PM Re: inflammation always heat? Marco, You're right, we should never use the term inflammation when discussing differential diagnosis, because it is not a Chinese term. However, the fact is that when the four signs of redness, palpable heat, swelling and pain occur together, from an Oriental differential diagnosis it would always be a heat pattern, no? We know, of course, that there are patterns of pain and swelling which are not heat patterns, but by definition, would it not be a heat pattern when a patient has palpable heat and/or redness? Therefore, I think that your original question is misplaced, and by asking if there is always inflammation when there is heat, is mixing apples and oranges. However, if you are asking do the phenomena of inflammation (the four cardinal signs) always manifest as heat, then I think you have to respond that it depends: that if the two heat signs mentioned above present themselves, along with swelling and pain, then for sure, yes, but if just swelling and pain are the only manifestations, then of course, no. Am I understanding your question correctly? Yehuda ______________ The best thing to hit the internet in years - Juno SpeedBand! Surf the web up to FIVE TIMES FASTER! Only $14.95/ month - visit www.juno.com to sign up today! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 4, 2003 Report Share Posted November 4, 2003 Can you give me examples? Yehuda On Tue, 4 Nov 2003 16:36:57 -0600 " Alon Marcus " <alonmarcus writes: > pain, redness, swelling and heat. Was I taught wrong? > >>>These are signs of most acute inflammations. However, there are > conditions in which one finds " inflammatory cells " in which there is > not heat, swelling, redness or pain. > Alon > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 5, 2003 Report Share Posted November 5, 2003 Very interesting and absolutely correct, Emmanuel! So let's now look at the four signs from an Oriental perspective, what they mean: palpable heat is obviously heat, pain is qualitatively either qi or xue stasis, redness, again is heat, and swelling would be damp accumulation. So my teachers, if I am right, inflammation we would call localized damp heat with qi/xue stasis. And would we treat accordingly? Yehuda On Tue, 4 Nov 2003 14:26:17 -0800 " Emmanuel Segmen " <susegmen writes: > Just a note here. Pain in both WM and CM arises from " stasis " or > could be said to be a sign of " stasis " . You can check it out in the > various texts. Kind of an interesting commonality. At any rate if > it's pain with swelling then it usually also involves heat. Pain > can be without heat ... just a result of stasis. > > Respectfully, > Emmanuel Segmen > Merritt College > > - > > > Tuesday, November 04, 2003 2:12 PM > Re: inflammation always heat? > > > > Marco, > > You're right, we should never use the term inflammation when > discussing differential diagnosis, because it is not a Chinese term. > However, the fact is that when the four signs of redness, palpable > heat, swelling and pain occur together, from an Oriental > differential diagnosis it would always be a heat pattern, no? We > know, of course, that there are patterns of pain and swelling which > are not heat patterns, but by definition, would it not be a heat > pattern when a patient has palpable heat and/or redness? > > Therefore, I think that your original question is misplaced, and > by asking if there is always inflammation when there is heat, is > mixing apples and oranges. However, if you are asking do the > phenomena of inflammation (the four cardinal signs) always manifest > as heat, then I think you have to respond that it depends: that if > the two heat signs mentioned above present themselves, along with > swelling and pain, then for sure, yes, but if just swelling and pain > are the only manifestations, then of course, no. > > Am I understanding your question correctly? > > Yehuda > > ______________ > The best thing to hit the internet in years - Juno SpeedBand! > Surf the web up to FIVE TIMES FASTER! > Only $14.95/ month - visit www.juno.com to sign up today! > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 5, 2003 Report Share Posted November 5, 2003 Always use the 4 examinations, all 4. I heard many cases from teachers in China where the WM trained TCM'ers tried to equate Heat with inflammation. Even when the patient was feeling cold and had other signs of cold, they always used Cold herbs in the presence of inflammation. Often, there is heat, in which this strategy would be ok, but when cold is the main factor, you can make the problem worse. This goes either way - for instance, a teacher treated a bad case of RA with Bai Hu Tang, when WM TCM'ers often use hot herbs for RA. However, the patient had a rapid pulse, red tongue body, red joints, etc. Geoff yehuda l frischman < wrote: Can you give me examples? Yehuda On Tue, 4 Nov 2003 16:36:57 -0600 " Alon Marcus " <alonmarcus writes: > pain, redness, swelling and heat. Was I taught wrong? > >>>These are signs of most acute inflammations. However, there are > conditions in which one finds " inflammatory cells " in which there is > not heat, swelling, redness or pain. > Alon > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 5, 2003 Report Share Posted November 5, 2003 Chronic inflammation can evolve from acute inflammation or occur without an acute phase. Histologically, chronic inflammation has two main features: The presence of granulation tissue and mononuclear predominance. Mononuclear predominance can also be seen in the latter part of acute inflammation as mononuclear phagocytes or macrophages. The combination of new blood vessels, fibroblasts, and extracellular matrix is termed granulation tissue. In comparison to ordinary loose connective tissue, granulation tissue is more cellular and contains neutrophils, inflammatory cells and fibroblasts. Granulation tissue is more vascular and has " leaky " capillaries. The formation of granulation tissue is the response of connective tissue and vessels to irritation. In some forms of chronic inflammation, other cell types appear. This suggests the development of immunologic reactions that may include lymphocytes, eosinophils and plasma cells. In other forms where no immune response is present, the mononuclear cells are almost entirely macrophages. When inflammation is chronic, the vascular component, vasodilation and exudation is minimal and therefore clinically manifests with less or no redness and heat. Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 5, 2003 Report Share Posted November 5, 2003 > > On Tue, 4 Nov 2003 16:36:57 -0600 " Alon Marcus " <alonmarcus@w...> > writes: > > pain, redness, swelling and heat. Was I taught wrong? > > >>>These are signs of most acute inflammations. However, there are > > conditions in which one finds " inflammatory cells " in which there is > > not heat, swelling, redness or pain. what conditions? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 5, 2003 Report Share Posted November 5, 2003 , Geoff <yingsuke2002> wrote: > > On Tue, 4 Nov 2003 16:36:57 -0600 " Alon Marcus " <alonmarcus@w...> > writes: > > pain, redness, swelling and heat. Was I taught wrong? > > >>>These are signs of most acute inflammations. However, there are > > conditions in which one finds " inflammatory cells " in which there is > > not heat, swelling, redness or pain. and the chinese could not have seen any redness unless it was exterior. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 5, 2003 Report Share Posted November 5, 2003 That brings up another element, Todd. Do we also add, since the phenomena of inflammation are always felt on the surface that there is an element of wind as well and that the swelling is either wind-damp cold deficiency or wind damp heat excess? Yehuda On Wed, 05 Nov 2003 16:07:02 -0000 " " < writes: > , Geoff <yingsuke2002> > wrote: > > > > > On Tue, 4 Nov 2003 16:36:57 -0600 " Alon Marcus " <alonmarcus@w...> > > writes: > > > pain, redness, swelling and heat. Was I taught wrong? > > > >>>These are signs of most acute inflammations. However, there > are > > > conditions in which one finds " inflammatory cells " in which > there is > > > not heat, swelling, redness or pain. > > > and the chinese could not have seen any redness unless it was > exterior. > > > > Quote Link to comment Share on other sites More sharing options...
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