The Treatment of Modern Western - Biblio.nhat-nam.ru

61PNEUMONIAPneumonia or pneumonitis refers to an acute infection of thelung parenchyma, including the alveolar spaces (bronchopneumonia)and interstitial tissues (interstitial pneumonia). Itmay also affect an entire lobe (lobar pneumonia) or a segmentof a lobe (segemental or lobular pneumonia). Approximatelytwo million Americans develop pneumonia per year and 40-70,000 of these die from this disease. It is the most commonhospital-acquired infection and the sixth most common causeof death in the U.S. of all disease categories. Infectious agentscausing pneumonia include bacteria, such as Streptococcuspneumoniae, Staphylococcus aureus, Haemophilus influenzae,and Chlamydia pneumoniae, Mycoplasma pneumoniae, a bacteria-likeorganism, mycobacteria, such as Mycobacteriumtuberculosis, fungi, such as Pneumocystis carinii, and rickettsiae,such as Coxiella burnetii. Parainfluenza virus and influenzaviruses A and B may also cause pneumonia. Less frequently,varicella-zoster virus, Epstein-Barr virus, Coxsackie virus,and Hanta virus may be at fault. These are all air-borne,inhaled pathogens. Predisposing factors include upper respiratoryviral infections, alcoholism, institutionalization, cigarette-smoking,heart failure, chronic obstructive airway disease,age extremes (in either direction), debility, immunocompromise,as in diabetes mellitus, compromised consciousness,dysphagia, and exposure to transmissable agents.The symptoms of pneumonia include cough, fever, and mucusproduction usually developing over days and possibly accompaniedby pleurisy. Physical examination may detect tachypneaand crackles with the bronchial breath sounds. TheWestern medical diagnosis of pneumonia is based on thesecharacteristic symptoms plus the presence of infiltrates onchest X-ray. Pathogens are identified by culturing expectoratedsputum. However, 30-50% of patients have no identifiablepathogen. Western medical treatment consists of respiratorysupport, including oxygen if indicated, plus antibiotics selectedon the basis of Gram stain results, the patient’s age, epidemiology,host risk factors, and the severity of the illness.CHINESE DISEASE CATEGORIZATION: In Chinesemedicine, this disease is discussed under chuan ke, pantingand cough, fei zhang, lung distention, fei yong, lung abscess(when there is pus production), shang han, damage due tocold, and wen bing, warm disease.DISEASE CAUSES: External contraction of evilsDISEASE MECHANISMS: Wind warm evils may enterthe mouth and nose, invade the region of the lungs, anddevelop into this disease. This is what is meant by the saying,“Warm evils contracted above first invade the lungs.”However, external invasion by wind cold may also cause thisdisease. In that case, depression transforms into heat. Thisheat then congests in the lungs. After external evils invade,they pass from the exterior to the interior and from thesuperficial part to the deep region. This generally developsaccording to the warm disease theory of defensive, qi, constructive,and blood. At first, evils are in the lung defensiveand an exterior pattern and lung symptoms appear. Thenthey enter the qi division and there is great heat. At thisstage, symptoms of phlegm heat congesting in the lungsappear. If the disease develops further, evils enter and burnthe constructive. If these evils are severe, the righteous maynot vanquish these evils. Evil heat may thus damage true yinand true yang. In that case, yin fluids are consumed andexhausted or yang qi may become vacuous and desert.TREATMENT BASED ON PATTERNDISCRIMINATION:1. WIND HEAT EXTERNAL CONTRACTION PATTERNMAIN SYMPTOMS: During the initial stage of pneumonia,there is slight aversion to cold, emission of heat (i.e., fever),slight sweating, cough with white phlegm, possible rapidbreathing, chest and rib-side pain, headache, possible nasal