2 Internal syndrome
Internal syndrome refers to the symptoms in disorders with deep location (such as disorders of viscera, qi and blood and bone marrow), usually seen at the middle and advanced stages of exogenous disease and the whole course of diseases due to internal impairment. Three conditions have contributed to the formation of internal syndrome, further development of exogenous disease due to interior transmission of pathogenic factors from the exterior and invasion of the viscera by the pathogenic factors; direct attack of the viscera by pathogenic factors; dysfunctions of the viscera and the imbalance between qi and blood due to impairment of the viscera caused by emotional upsets, improper diet and improper daily life.
Clinical manifestations: The clinical manifestations of internal syndrome are different due to different causes and location. Since syndrome is either cold or heat and asthenia or sthenia and since disease is due to the disorders of either qi or blood or body fluid, clinical manifestations of internal syndrome are various. However, the basic clinical manifestation is dysfunction of the viscera which
will be discussed in the following sections. Here sthenic internal heat syndrome in exogenous disease is taken as an example to illustrate the clinical manifestations of internal syndrome. The basic manifestations are high fever, aversion to heat, restlessness, even coma with delirium, thirst with profuse drinking of water, scanty and brownish urine, retention of feces, reddish tongue with yellowish
fur and fast and powerful pulse.
Analysis of symptoms: Exuberance of internal heat leads to high fever and aversion to heat; heat disturbing the heart spirit causes restlessness or even coma with delirium; consumption of body fluid by exuberant heat leads to thirst with profuse drinking of water, scanty brownish urine and retention of feces; reddish tongue with yellow fur and fast powerful pulse is the sign of exuberance of internal heat and confliction between healthy qi and pathogenic factors.
Appendix: Half external and half internal syndrome
Half external and half internal syndrome refers to the symptoms appearing in exogenous disease at the stage marked by confliction of healthy qi and pathogenic factors between the exterior and interior phases, and is usually caused by transmission of pathogenic factors from the exterior to the interior but still lingering between the exterior and interior phases. The manifestations are alternation of cold and fever, oppression and distress over the chest and hypochondrium, dysphoria, susceptibility to belching, silence, anorexia, bitter taste in the mouth, dry throat,dizziness and taut pulse, etc. (see shaoyang syndrome in syndrome differentiation of six meridians).
