Deficiency and excess pattern differentiation is unique characteristic of traditional oriental medicine on diagnosis and treatment. This differentiation is accomplished through pulse, tongue diagnosis and question examination, but most of these processes need to be objectified for efficacious treatment and traditional medicine development. In this study, we developed the deficiency and excess pattern questionnaire for objectification of question examination. The deficiency and excess pattern questionnaire was made out through The Traditional Oriental Medical Literature with Delphi Technique. Patients who visited oriental medical hospital filled out the questionnaire by themselves. Diagnosis of deficiency and excess pattern are conducted separately by oriental medical doctors with more than 5 years' clinical experience. Various physical condition factors were derived for the deficiency and excess pattern questionnaire. (Ordinary health degree, pain pattern, fatigue, weight change, sweating, uncomfortable awareness on chest and abdomen) Deficiency symptoms group acquired internal consistency, but excess symptoms group did not. (Cronbach's ${\alpha}$ > 0.6) There were significant associations between doctor's diagnosis and deficiency and excess symptoms in 'ordinary heath degree', 'voice weakening', and 'chest distress' (p-value < 0.1) There were significant differences between deficiency and excess syndrome patients groups in deficiency questionnaire score but there were no significant differences between deficiency and excess syndrome patients groups in excess questionnaire score. We acquired the internal consistency and significant result of deficiency pattern questionnaire, but we can find out some difficulties in development of the excess pattern questionnaire. These difficulties are associated with insufficiency description of traditional literature and small number of patients diagnosed as excess pattern.
1. Objectives This study is purposed to classify deficiency syndrome(虛證) and Excess syndrome(實證) of chief lung-disorder diseases. 2. Methods It was researched on the comparative and literal study about the relation to Yeong-Chu Gyeong-maek Chapter (${\ulcorner}$靈樞 經脈編${\Ircorner}$) and Dongui-Bogam (${\ulcorner}$東醫寶鑑${\Ircorner}$) and Dongui-Susebowon (${\ulcorner}$東醫壽世保元${\Ircorner}$) in chief lung-disorder symptoms or diseases. 3. Results and Conclusions (1) The chief lung-disorder diseases of Yeong-Chu Gyeong-maek Chapter (${\ulcorner}$靈樞 經脈編${\Ircorner}$), Dongui-Bogam (${\ulcorner}$東醫寶鑑${\Ircorner}$) and Dongui-Susebowon (${\ulcorner}$東醫壽世保元${\Ircorner}$) are asthma(喘), coughing(咳), fullness in the chest(胸滿), sweating symptoms(汗出), cold-heat symptoms(寒熱), dysphoria(煩躁) and sneezing. (2) Asthma symptom(喘) was shown to Soeumin's 4 exterior deficiency diseases, Taeumin's 1 exterior deficiency disease and 1 interior excess disease, and Soyangin's 1 interior excess disease. (3) Coughing symptom(咳) was shown to Soeumin's 1 extrerior deficiency disease and Taeumin's 1 interior excess disease. (4) Fullness in the chest(胸滿) was shown co Soyangin's 4 exterior excess diseases. (5) Sweating symptoms(汗出) was shown to Soeumin's 10 exterior deficiency diseases, Taeumins's 1 exterior deficiency disease, and Soyangin's 1 exterior defecieny disease. (6) Cold-heat symptoms(寒熱) was shown to Soyangin's 4 exterior excess diseases. (7) Dysphoria(煩躁) was shown co Soeumin's 1 exterior deficiency disease and 8 interior deficiency diseases, Taeumin's 1 interior excess disease, and Soyangin's 4 exterior excess and interior excess diseases. (8) Sneezing symptom was shown to Taeumin's 1 exterior excess disease.
Purpose: Dysmenorrhea mostly depends on the causative factor, which usually falls under the categories of Deficiency and Excess pattern in traditional Oriental medical theories and diagnosis. Thus, we investigated menstruation symptom and sign related to dysmenorrhea and verified the validity of Deficiency and Excess pattern identification. Methods: We investigated menstruation symptom and sign related to dysmenorrhea in total 14 gynecology-medical books including the book ${\ll}$Exemplar Of Korean Medicine (Dongui Bogam)${\gg}$ and whole body symptom and sign identifying Deficiency and Excess pattern at the same time. A survey based on this investigation was carried out targeting women of childbearing age. Results: Total of 14 gynecology-medical books have mostly narrated pre-menstrual and mid & post-menstrual pelvic pain depending on the time of its manifestation for identifying Deficiency and Excess pattern. Dysmenorrhea in pre-menstrual period belonged to Excess pattern and dysmenorrhea in mid & post-menstrual period belonged to Deficiency pattern. Among a total of 343 women, 196 subjects suffered from dysmenorrhea. The number of dysmenorrhea in pre-menstrual period (Excess pattern) was 116 people and in mid & post-menstrual period (Deficiency pattern) was 80 people. Deficiency and Excess pattern of dysmenorrhea in menstrual period significantly correlated to Deficiency and Excess pattern of whole body symptom and sign in the statistics(P-value < 0.05). Conclusion: The results suggest that pre-menstrual and mid & post-menstrual pelvic pain depending on the time of its manifestation is preferentially utilized as symptom and sign related to dysmenorrhea identifying Deficiency and Excess pattern.
Objectives : This study aims to examine the background of how the theory of there being no excess pattern of the Kidney has been carried on by looking at contents on Kidney excess patterns pre-Qianyi and at those negating the possibility of Kidney excess post-Qianyi. The history of the Kidney draining method for Kidney excess patterns was studied as well. Methods : Key words such as 腎實(kidney excess), 腎無實(no excess of the kidney), 瀉腎(draning the kidney) were entered into major database such as the Sikuquanshu to excavate contents on both Kidney excess and non-excess from medical classics. Results & Conclusion :In the Neijing, there are few mentions of symptoms due to Kidney excess. The theory of Kidney non-excess marks its beginning with Qianyi, who argued that Kidney manages deficiency in children only. Afterwards, some doctors expanded this theory beyond children and applied it as a general principle of the body. Based on the theory of there being no excess of the Kidney, it could be thought that while there could be excess symptoms of the Kidney, the root mechanism lies in Kidney deficiency. The importance of the Kidney as the basis of heaven-bestowed life, which is responsible for reproduction, growth and development, is what motivated the theories on the Kidney as what needs to be preserved and never drained. It could also be argued that the symptoms of Kidney excess, which were mentioned post-Neijing, got dealt with within the context of other Zhangfu differentiation patterns and deficiency symptoms, and became increasingly less designated to Kidney excess.
Objectives Based on related literature, cold and heat, deficiency and excess, true and false, and actually used formulas, paradoxical treatments presented in the 『Plain Questions of Inner Canon of Yellow Emperor』 including ‘treating pseudo-heat symptoms and real cold syndrome with cold herbs, treating pseudo-heat symptoms and real cold syndrome with cold herbs’ were analyzed.Methods Out of literature, paradoxical treatment related classics and papers were investigated and analyzed. Among diseases and syndromes, real cold syndrome with pseudo-heat symptoms, real heat syndrome with pseudo-cold symptoms, real deficiency syndrome with pseudo-excess symptoms, and real excess syndrome with pseudo-deficiency symptoms were reviewed. Among formulas, typical examples of the above mentioned paradoxical treatments were used as examples to analyze paradoxical treatments.Results Treating pseudo-heat symptoms and real cold syndrome with cold herbs is a method that uses herbs with cool and cold nature to treat real cold syndrome with pseudo-heat symptoms and Tongmaeksayeokgajeodamjeuptang is suitable for this method. Treating pseudo-cold symptoms and real heat syndrome with hot herbs is a method that uses herbs with warm and hot nature to treat real heat syndrome with pseudo-cold symptoms and Baekhogainsamtang is suitable for this method.Conclusions Based on the related literature, cold and heat, deficiency and excess, true and false, and actually used formulas examined as mentioned above, the paradoxical treatments presented in the 『Plain Questions of Inner Canon of Yellow Emperor』 are thought to be reasonable paradoxical treatments that fit the diseases and syndromes that actually appeared in our bodies.
This study was performed to develop cold-heat and deficiency-excess pattern identification for dementia, as well as for standard Korean medicine diagnosis and treatment. Five experts comprised of 4 neuropsychiatrists of Korean medicine and 1 statistician to develop cold-heat and deficiency-excess pattern identification for dementia. We searched studies about pattern identification and selected 507 articles using Oasis search terms provided by the KIOM. As a result, 10 pattern identification research study were recruited. Moreover, we analyzed neuropsychological assessments for dementia that evaluate Behavioral and Psychological Symptoms of Dementia (BPSD) and cognitive function using experts conferences and we selected neuropsychological instruments using pattern identification. Six cold patterns, six heat patterns, ten deficiency patterns, and four excess patterns were identified according to the cold-heat and deficiency-excess pattern identification of dementia. We selected the Caregiver-Administered Neuropsychiatric Inventory and the Korean Mini-Mental State Examination as neuropsychological assessments of dementia, which examine behavioral symptoms and cognitive function, suspectively. We formed positive and negative correlation between Korean medicine pattern identification and neuropsychological assessments for dementia. We developed and suggested a forecast module of pattern identification for dementia. But, it is necessary to perform additional clinical trials to verify its validity and accuracy.
After researching on infantile diseases in Hyungsang medicine, the writer got the conclusions as follows. The infants who are excess of the Yang energy need to nourish the Eum- blood. The main causes of the infantile disorders are congenital defect and malfunction of internal organs by nature, as results of these they suffer from mental disorders or being undergrown. And after birth they get ill from internal injury or external affections, mainly epilepsy by retention of undigested food, fever, cough, asthma, nasal obstruction, dermatopathia, and affection by cold, etc. In Hyungsang medicine Dam-body is apt to get ill from deficiency of Eum-blood and bangkwang-body from deficiency of Yang-energy. And infants are hare to be moderate in food, so they become to diseases of the Spleen and stomach, especially infants with Yangmyung type get to epilepsy, cough, skin disorders, and obese for the reasonof overeating. Among main infantile symptoms congenital defects, infantile mental disorders, and convulsive diseases come from congenital defect and malfunciton of internal organs, so it must be treated the symptoms following the reasons. Above all infantile mental disorders are treated not to separate the spirit from the body. And fever, cough and asthma, affection by cold, skin diseases, poor appetite, and obese come from deficiency of Kidney or the deficiency and excess of the Spleen and stomach. In order to prevent from infantile diseases right antenatal training, taking medicine rightly, exercise and eating good habits are needed to give guidance. Seeing through the clinical cases in Hyungsang medicine, we come to know that the infantile mental disorders come out primarily for the reasons of the congenital defect, and the infantile epilepsy come from malfunction of internal organs, and the nasal obstruction and skin diseases come from deficiency of Kidney or the deficiency and excess of the Spleen and stomach.
This study draws pattern differentiations of headache disorders on the ground of modern clinical applications and Korean medical literature. Categorization and symptoms of headache disorders are based on International Classification of Headache Disorders 3rd edition(beta version). And clinical papers are searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI). In the aspect of eight principle pattern identification, primary headache occurs due to lots of yang qi and has more inner pattern rather than exterior pattern, heat pattern rather than cold pattern, excess pattern rather than deficiency pattern. And primary headache is related with liver in the aspect of visceral pattern identification and blood stasis, wind and phlegm are relevant mechanisms. Migraine without aura is associated with ascendant hyperactivity of liver yang, phlegm turbidity, sunken spleen qi, wind-heat, blood deficiency or yin deficiency. Migraine with aura is mainly related with wind and it's major mechanisms are ascendant hyperactivity of liver yang, liver fire, yin deficiency of liver and kidney, blood deficiency or liver depression and qi stagnation. High repetition rate of tension-type headache can be identified as heat pattern or excess pattern. And trigeminal autonomic cephalalgias can also be accepted as heat pattern or excess pattern when the occurrence frequency is high and is relevant to combined pattern with excess pattern of external contraction and deficiency pattern of internal damage based on facial symptoms by external contraction and nervous and anxious status by liver deficiency. This study can be expected to be Korean medical basis of clinical practice guidelines on headache by proposing pattern identifications corresponding to the western classifications of headache disorders.
Objectives Eyes, one of visual inspection regions, present important clues to pathological patterns including deficiency and excess patterns to the clinicians. The purpose of this study was to develop Eyes Inspection Questionnaire (EIQ) and to examine which items among the EIQ were more predictive of clinicians' determination for the deficiency and excess patterns. Methods Nine questionnaire items for Visual Inspection of Eyes were extracted through the literature review. These items were presented to the 4 Korean medical doctors who are specialized in visual inspection to conduct the Delphi method. The Korean medical doctors were asked to rate the importance of each items for the corresponding Visual Inspection of Eyes, using a Likert 5-point scale(the 3 points of importance as a cut-off point). Then, out of 75 photographs submitted to the Society of HyungSang Medicine in 2009, 30 portrait pictures were selected as samples. The samples were copied to make 60 sample pictures, and then randomly assigned to 4 clinicians. The 4 clinicians evaluated the 60 samples for excess and deficiency of the eyes and were asked to check the 6 questionnaire items. The results were recorded as 5-points-scale, and their average and standard deviations were calculated. Intra- class reliability test and multi regression test were performed using SPSS 13. Results Intra-class correlation coefficient (ICC) was between 0.750 to 0.841 (P<0.05). Indices for visual inspection of the eyes were: endowment of the bone structure around the eyes; brightness of the eyes; upward deviation of the eyes; eye shapes; and definition of iris. 76.92% of deficiency symptom patterns and 86.42% of the excess symptom patterns matched the patterns predicted by the visual inspection of the eyes, according to the frequency analysis. According to the multiple regression analysis, were significantly related to the excessive symptoms, and to the deficiency symptoms. Conclusion This study is the first attempt of development for checklist of excess and deficiency of Visual Inspection of Eyes and quantitative measurement of excess and deficiency using the Visual Inspection of Eyes by the visual inspection experts. Still, additional studies are needed regarding the relationship visual inspection methods have with existing standards of diagnosis.
In order to secure practising rapid pattern(證, zheng) differentiation against acute infectious diseases like corona virus disease-19(COVID-19) showing rapid variation and contagion, a simplified classification of stages centering on the exterior-interior pattern identification with 2 step-subdivision by cold, heat, deficiency, excess pattern and pathogens is proposed. Pattern differentiation by compound patterns of 8 principles is made for the non-severe stage of general cold and the early mild stage of epidemic disease. Compound pattern's names of 8 principles about external infectious diseases are composed of three stages, that is disease site-characters-etiology. Based on early stage symptoms of fever or chilling etc., exterior, interior and half exterior and half interior patterns are determined first, and then cold, heat, deficiency, excess patterns of exterior and interior pattern respectively are determined, and then more concrete differentiation on pathogens of wind, dryness, dampness and dearth of qi, blood, yin, yang accompanied with constitutional and personal illness factors. Summarizing above descriptions, 4 patterns of exterior cold, exterior heat, exterior deficiency, exterior excess and their secondary compound patterns of exterior cold deficiency and exterior cold excess and so on are classified together with treatment method and available decoction for a standard measure of eight principle pattern differentiation.
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