Pathogenesis and remedies: piman, Chinese woodcut, late Ming

Chart tabulating in detail the clinical signs and symptoms, disease mechanisms and therapies of piman (sensation of tightness and fullness). Several types of piman are distinguished according to their clinical presentation, e.g. xiong man er ying (fullness and hardness in the chest), xiong man er ru (fullness and sogginess in the chest) and zhijie. Xiong man er ying can be further sub-divided into conditions treatable with Major Bupleurum decoction (da chaihu tang), cassia twig and ginseng decoction (guizhi renshen tang), monkshood root heart-purging decoction (fuzi xiexin tang), and liquorice heart-purging decoction (gancao xiexin tang). Xiong man er ru can be sub-divided into conditions treatable with pinellia heart-purging decoction (banxia xiexin tang), Inula-Haematite decoction (xuanfu dai zhe tang), Minor Bupleurum decoction with dried ginger and oyster shell (xiao chaihu jia ganjiang muli tang), liquorice heart-purging decoction (gancao xiexin tang), fresh ginger heart-purging decoction (shengjiang xiexin tang), clay and limonitum decoction (shizhi yuyuliang tang), and decoction of Platycodon grandiflorum and trifoliate orange peel (jiegeng zhike tang). Zhijie can be sub-divided into conditions treatable with Minor pinellia and poria decoction (xiao banxia fuling tang), Minor Bupleurum decoction with cassia (xiao chaihu jia gui tang), and Five Drugs and Poria powder (wuling san).

IMAGE TITLE: Illustration of piman (sensation of tightness and fullness). OTHER LETTERING: Piman (sensation of tightness and fullness); xiong man er ying (fullness and hardness in the chest); xiong man er ru (fullness and sogginess in the chest); zhijie