• Title/Summary/Keyword: Viral Food Poisoning

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Big Data Study about the Effects of Weather Factors on Food Poisoning Incidence (기상요인과 식중독 발병의 연관성에 대한 빅 데이터 분석)

  • Park, Ji-Ae;Kim, Jang-Mook;Lee, Ho-Sung;Lee, He-Jin
    • Journal of Digital Convergence
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    • v.14 no.3
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    • pp.319-327
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    • 2016
  • This research attempts an analysis that fuses the big data concerning weather variation and health care from January 1, 2011 to December 31, 2014; it gives the weather factor as to what kind of influence there is for the incidence of food poisoning, and also endeavors to be helpful regarding national health prevention. By using R, the Logistic and Lasso Logistic Regression were analyzed. The main factor germ generating the food poisoning was classified and the incidence was confirmed for the germ of bacteria and virus. According to the result of the analysis of Logistic Regression, we found that the incidence of bacterial food poisoning was affected by the following influences: the average temperature, amount of sunshine deviation, and deviation of temperature. Furthermore, the weather factors, having an effect on the incidence of viral food poisoning, were: the minimum vapor pressure, amount of sunshine deviation and deviation of temperature. This study confirmed the correlation of meteorological factors and incidence of food poisoning. It was also found out that even if the incidence from two causes were influenced by the same weather factor, the incidence might be oppositely affected by the characteristic of the germs.

Analysis of the Causes of a Large Food Poisoning Outbreak Attributable to Bacillus cereus (Bacillus cereus에 의한 대규모 집단식중독 원인 분석)

  • Hyunah Lee;Youngeun Ko;Dayeon Lee;KyungA Yun;Hyeonjeung Kim;Ok Kim;Junhyuk Park
    • Journal of Food Hygiene and Safety
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    • v.39 no.2
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    • pp.102-108
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    • 2024
  • This study was performed to establish the epidemiological features of a food poisoning outbreak that occurred in the cafeteria of a company in Chungcheongnam-do Province, Korea, in October 2020, and to recommend measures to prevent similar outbreaks. Twenty-one patients with acute gastroenteritis, three food handlers, seven cooking utensils, and 12 preserved food samples were subjected to viral and bacterial analyses based on procedures described in the "Manual for Detection of Foodborne Pathogens at Outbreaks". Among 135 individuals who had been served the meals, 21 (15.6%) showed symptoms of nausea and vomiting within an hour of consuming the food. Bacillus cereus were isolated from 11 (52.4%) of the 21 patients, one food service employee, one item of cooking ware, and 12 preserved food samples. In addition, we confirmed the toxin genes CER, nheA, and entFM from the isolated B. cereus strains. Pulsed-field gel electrophoresis results indicated that all of the isolated B. cereus strains were closely related, with the exception of strains obtained from one patient and one sample of preserved food. These findings provide evidence to indicate that the isolated B. cereus originated from preserved foods and an unhygienic eating environment. This outbreak highlights that the provision of food in non-commercial food systems must be thoroughly managed. In addition, it emphasizes the necessity for the correct and timely identification of causal pathogens for tracing the cause of food poisoning outbreaks, and the need to preserve food under appropriate conditions. To prevent similar cases of food poisoning, it is necessary to investigate cases based on an epidemiological approach and share the findings.

Is This Symptom Even a Food Allergy?: Clinical Types of Food Protein-induced Enterocolitis Syndrome

  • Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.2
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    • pp.74-79
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    • 2014
  • Food protein-induced enterocolitis syndrome (FPIES) is an under-recognized non-IgE-mediated gastrointestinal food allergy. The diagnosis of FPIES is based on clinical history, sequential symptoms and the timing, after excluding other possible causes. It is definitively diagnosed by an oral food challenge test. Unfortunately, the diagnosis of FPIES is frequently delayed because of non-specific symptoms and insufficient definitive diagnostic biomarkers. FPIES is not well recognized by clinicians; the affected infants are often mismanaged as having viral gastroenteritis, food poisoning, sepsis, or a surgical disease. Familiarity with the clinical features of FPIES and awareness of the indexes of suspicion for FPIES are important to diagnose FPIES. Understanding the recently defined clinical terms and types of FPIES is mandatory to suspect and correctly diagnose FPIES. The aim of this review is to provide a case-driven presentation as a guide of how to recognize the clinical features of FPIES to improve diagnosis and management of patients with FPIES.

Applicability Evaluation of Male-Specific Coliphage-Based Detection Methods for Microbial Contamination Tracking

  • Kim, Gyungcheon;Park, Gwoncheol;Kang, Seohyun;Lee, Sanghee;Park, Jiyoung;Ha, Jina;Park, Kunbawui;Kang, Minseok;Cho, Min;Shin, Hakdong
    • Journal of Microbiology and Biotechnology
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    • v.31 no.12
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    • pp.1709-1715
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    • 2021
  • Outbreaks of food poisoning due to the consumption of norovirus-contaminated shellfish continue to occur. Male-specific (F+) coliphage has been suggested as an indicator of viral species due to the association with animal and human wastes. Here, we compared two methods, the double agar overlay and the quantitative real-time PCR (RT-PCR)-based method, for evaluating the applicability of F+ coliphage-based detection technique in microbial contamination tracking of shellfish samples. The RT-PCR-based method showed 1.6-39 times higher coliphage PFU values from spiked shellfish samples, in relation to the double agar overlay method. These differences indicated that the RT-PCR-based technique can detect both intact viruses and non-particle-protected viral DNA/RNA, suggesting that the RT-PCR based method could be a more efficient tool for tracking microbial contamination in shellfish. However, the virome information on F+ coliphage-contaminated oyster samples revealed that the high specificity of the RT-PCR- based method has a limitation in microbial contamination tracking due to the genomic diversity of F+ coliphages. Further research on the development of appropriate primer sets for microbial contamination tracking is therefore necessary. This study provides preliminary insight that should be examined in the search for suitable microbial contamination tracking methods to control the sanitation of shellfish and related seawater.

Molecular epidemiology of norovirus in South Korea

  • Lee, Sung-Geun;Cho, Han-Gil;Paik, Soon-Young
    • BMB Reports
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    • v.48 no.2
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    • pp.61-67
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    • 2015
  • Norovirus is a major cause of viral gastroenteritis and a common cause of foodborne and waterborne outbreaks. Norovirus outbreaks are responsible for economic losses, most notably to the public health and food industry field. Norovirus has characteristics such as low infectious dose, prolonged shedding period, strong stability, great diversity, and frequent genome mutations. Besides these characteristics, they are known for rapid and extensive spread in closed settings such as hospitals, hotels, and schools. Norovirus is well known as a major agent of food-poisoning in diverse settings in South Korea. For these reasons, nationwide surveillance for norovirus is active in both clinical and environmental settings in South Korea. Recent studies have reported the emergence of variants and novel recombinants of norovirus. In this review, we summarized studies on the molecular epidemiology and nationwide surveillance of norovirus in South Korea. This review will provide information for vaccine development and prediction of new emerging variants of norovirus in South Korea.

Viability Loss of Bacteriophage MS2 Exposed to Bronze Alloy Yugi

  • Hwang, Ji-Yeon;Ryu, Tae-Hwa;Lee, Young-Duck;Park, Jong-Hyun
    • Food Science and Biotechnology
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    • v.18 no.4
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    • pp.1022-1026
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    • 2009
  • Cross contamination of foodborne virus via food utensils can be an important route of virus propagation. Bacteriophage MS2 was used as a surrogate for norovirus. The viability loss of bacteriophage MS2 attached to 4 kinds of metal surfaces was investigated at different temperatures and relative humidities (RH). The rate of viability loss was higher at $22^{\circ}C$ than at $10^{\circ}C$ and was higher at 75% RH than at 40% RH. The viability loss of the virus attached to copper or bronze surface was faster than on stainless steel or tin surface. Also the beef juice applied with the virus inoculum on the metal surfaces lowered the rate of viability loss. Although bronze was not as effective as copper in resulting the viability loss, it has been extensively used as a traditional Korean kitchen utensil and could be used more widely to decrease the viral poisoning at food processing environment and hospitals.

Norovirus Quantification in Oysters Crassostrea gigas Collected from Tongyeoung, Korea (통영시 연안의 양식굴(Crassostrea gigas)에서 검출된 노로바이러스의 정량분석)

  • Shin, Soon Bum;Oh, Eun-Gyoung;Lee, Hee-Jung;Kim, Yeon Kye;Lee, Tae Seek;Kim, Ji-Hoe
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.47 no.5
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    • pp.501-507
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    • 2014
  • Norovirus (NoV) is a major cause of food poisoning outbreaks in Korea. Most NoV outbreaks originate from environmental contamination, but bivalves such as oysters are also important vectors. Oyster Crassostrea gigas contamination by NoV has been reported in Korea, but no quantitative analyses of NoV have been performed. We investigated the NoV concentration in 21 oyster samples from a Korean commercial oyster-growing area with confirmed fecal contamination from January to December 2012, using real-time reverse transcription-polymerase chain reaction. Additionally, we assessed the NoV concentration after heating to investigate the effects of heat treatment on NoV-infected oysters. In NoV-positive samples, the cycle threshold (Ct) values were 37.43-39.41 and 36.77-39.30, while viral concentrations were $8.97{\times}10^2-2.24{\times}10^2$ and $3.05{\times}10^2-7.47{\times}10^1$ copies/g for genogroups I and II, respectively. After heat treatment, NoV genogroup I decreased by 83.4%, 88.0%, 89.4% and 100% at $60^{\circ}C$, $68^{\circ}C$, $70^{\circ}C$, and $100^{\circ}C$, respectively, for 15 min, while genogroup II respectively decreased by 67.3%, 76.3%, 80.1%, and 89.8% under the same conditions.

Norovirus Food Poisoning and Laboratory Surveillance for Viral Gastroenteritis (바이러스성 식중독의 특성 및 예방법)

  • Jee, Young-Mee
    • Food Industry And Nutrition
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    • v.11 no.3
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    • pp.6-11
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    • 2006
  • 바이러스성 식중독은 장염을 일으키는 원인 병원체 중 노로바이러스에 의해 흔히 발생하며 이외에도 아스트로바이러스나 로타바이러스에 의한 집단 설사 사례가 국내에서 보고된 바 있다. 노로바이러스는 식중독과 관련하여 특히 오염된 식수와 굴 등 어패류의 생식을 통한 감염 사례가 많이 보고되어 있으나 사람 간 전파도 흔히 일어나는 전염력이 매우 높은 바이러스이다. 국내에서는 1999년 이후 보고가 되고 있으며 최근 집단 급식과 관련된 대형 식중독 사례들이 보고되면서 학교급식이 사회적인 이슈로 대두되고 있다. 2000년 이후 질병관리본부는 바이러스성 설사의 국내 발생현황을 파악하기 위하여 전국의 17개 시도보건환경 연구원과 노로바이러스를 포함한 4종의 바이러스성 장염원인 병원체에 대한 전국적인 실험실 감시체계를 운영한 결과 바이러스성 병원체가 확인된 사례의 약 18%에서 노로바이러스가 검출되었고, 집단설사 사례에서는 대부분 노로바이러스가 원인병원체로 확인되었다. 또한 노로바이러스의 조기 검출을 위해 질병관리본부는 2004년 중 노로바이러스 유전자 검출 kit를 자체적으로 제작하여 이를 전국의 시도 보건환경연구원을 연계한 감시체계에서 적극 활용함으로써 노로바이러스 집단설사사례의 조기 검출이 가능하게 되었고 지역내 노로바이러스 검출율을 높이는데 기여하였다. 국립보건연구원은 2003년과 2006년에 발생한 대규모 노로바이러스 식중독 사례 이외에도 산발적으로 지속적으로 발생하는 사례들을 조기에 탐지하고 국내에서 검출되는 설사바이러스 유전형 분포양상과 새로운 유전자형이나 변이주를 조기에 검출하고자 전국적인 노로바이러스 실험실 감시망을 강화하여 운영하고 있으며, 집단설사 발생시 각 사례의 연관성을 신속하게 분석할 수 있는 실시간 분자역학적 유전자 분석체계를 단계적으로 도입하고 있다. 실험실 감시체계 운영과 함께 집단 식중독 유발 병원체의 효율적인 관리를 위해 질병관리본부는 노로바이러스를 포함한 설사 유발 병원체를 신고대상 병원체로 지정(2006.06.12)하여 병원체 검출시 보고하도록 하고 관련 지침을 마련하였다. 노로바이러스가 지정전염병 병원체로 추가로 지정됨에 따라 집단 사례 및 실험실 감시사업을 통해 검출되는 병원체에 대한 보고가 강화되고 전파 방지와 2차 감염 사례 감소에도 기여할 수 있을 것으로 사료되며 전국의 실험실 감시망을 연결하는 국가 차원의 노로바이러스 실시간 분자역학적 분석체계 도입을 통해 노로바이러스 2차 감염을 줄이고 대규모 집단발병 및 유행의 조기 차단 효과를 가져올 수 있을 것이다.

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The emergency patients analysis of 1339 Emergency Medical Information Center received during the holidays - New Year's Day & Thanksgiving Day of Gwangju & Jeonnam region in 2007 - (연휴동안 1339 응급의료정보센터에 접수된 응급환자 현황 분석 - 광주·전남지역의 2007년 구정과 추석을 중심으로 -)

  • Park, Si-Goo;Park, Hee-Jin
    • The Korean Journal of Emergency Medical Services
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    • v.12 no.1
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    • pp.69-80
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    • 2008
  • During New year's day and Thanksgiving holiday, the 1339 Information Center in Gwangju and Jeonnam received an emergency medical situation and carried out the analysis as follows ; 1. The reason for the higher phone guidance(72%) of the hospital was based on the simple query for the pain control rather than emergency care. This was explained by the unfamiliar environment of the holiday movers. Pharmaceutical guidance(12.6%) in rural area was also given during the holidays. 2. The disease counselling(2.4%) and emergency treatment instruction(First Aid)(1.6%) decreased because of the small number of request for the diseases. This explained the decrease of the disease counselling. 3. The phone calls increased 8-13 times more than usual. Five-day holidays could have more emergency patients than three-day holidays. During New year's day and Thanksgiving day, the number of received phone calls was 6,444(25.7%) and this accounted for one fourth of the total number in 2007. 4. The number of the patients increased on New year's day and Thanksgiving day because most of the medical institutions and pharmacy were off duty. 5. The patients were centered in Internal medicine and pediatrics. This showed the food-borne diseases and air-borne infection such as common cold. 6. During Thanksgiving day, ophthalmologic patients having viral keratoconjunctivitis(Apollo eye disease) increased 8 folds than in New year's day. It was estimated from the continuous epidemic of Apollo eye disease. 7. There broke out the traffic accidents, food poisoning, infectious diseases, dermatological diseases due to seasonal and environmental changes during the holiday move.

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A Literature Study of Dermatosurgical Diseases in the ImJeungJiNamUiAn (臨證指南醫案에 나타난 피부외과 질환에 대한 문헌고찰)

  • Cho, Jae-Hun;Chae, Byung-Yoon;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.15 no.2
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    • pp.271-288
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    • 2002
  • Authors investigated the pathogenesis and treatment of dennatosurgical diseases in the ImJeungJiNamUiAn(臨證指南醫案). 1. The symptoms and diseases of dermatosurgery were as follows; 1) BanSaJinRa(반사진라) : eczema, atopic dermatitis, seborrheic dermatitis, psoriasis, lichen planus, pityriasis rosea, hives, dermographism, angioedema, cholinergic urticaria, urticaria pigmentosa, acne, milium, syringoma, keratosis pilaris, discoid lupus erythematosus, hypersensitivity vasculitis, drug eruption, polymorphic light eruption, rheumatic fever, juvenile rheumatoid arthritis(Still's disease), acute febrile neutrophilic dermatosis(Sweet's syndrome), Paget's disease, folliculitis, viral exanthems, molluscum contagiosum, tinea, tinea versicolor, lymphoma, lymphadenitis, lymphangitis, granuloma annulare, cherry angioma 2) ChangYang(瘡瘍) : acute stage eczema, seborrheic dermatitis, stasis ulcer, intertrigo, xerosis, psoriasis, lichen planus, ichthyosis, pityriasis rosea, rosacea, acne, keratosis pilaris, dyshidrosis, dermatitis herpetiformis, herpes gestationis, bullae in diabetics, pemphigus, lupus erythematosus, fixed drug eruption, erythema multiforme, toxic epidermal necrolysis, toxic shock syndrome, staphylococcal scaled skin syndrome, scarlet fever, folliculitis, impetigo, pyoderma gangrenosum, tinea, candidiasis, scabies, herpes simplex, herpes zoster, chicken pox, Kawasaki syndrome, lipoma, goiter, thyroid nodule, thyroiditis, hyperthyroidism, thyroid cancer, benign breast disorder, breast carcinoma, hepatic abscess, appendicitis, hemorrhoid 3) Yeok(疫) : scarlet fever, chicken pox, measles, rubella, exanthem subitum, erythema infectiosum, Epstein-Barr virus infection, cytomegalovirus infection, hand-foot-mouth disease, Kawasaki disease 4) Han(汗) : hyperhidrosis 2. The pathogenesis and treatment of dermatosurgery were as follows; 1) When the pathogenesis of BalSa(발사), BalJin(發疹), BalLa(발라) and HangJong(項腫) are wind-warm(風溫), exogenous cold with endogenous heat(外寒內熱), wind-damp(風濕), the treatment of evaporation(解表) with Menthae Herba(薄荷), Arctii Fructus(牛蒡子), Forsythiae Fructus(連翹) Mori Cortex(桑白皮), Fritillariae Cirrhosae Bulbus(貝母), Armeniaoae Amarum Semen(杏仁), Ephedrae Herba(麻黃), Cinnamomi Ramulus(桂枝), Curcumae Longae Rhizoma(薑黃), etc can be applied. 2) When the pathogenesis of BuYang(부양), ChangI(瘡痍) and ChangJilGaeSeon(瘡疾疥癬) are wind-heat(風熱), blood fever with wind transformation(血熱風動), wind-damp(風濕), the treatment of wind-dispelling(疏風) with Arctii Fructus(牛蒡子), Schizonepetae Herba(荊芥), Ledebouriellae Radix(防風), Dictamni Radicis Cortex(白鮮皮), Bombyx Batrytioatus(白??), etc can be applied. 3) When the pathogenesis of SaHuHaeSu(사후해수), SaJin(사진), BalJin(發疹), EunJin(은진) and BuYang(부양) are wind-heat(風熱), exogenous cold with endogenous heat(外寒內熱), exogenous warm pathogen with endogenous damp-heat(溫邪外感 濕熱內蘊), warm pathogen's penetration(溫邪內陷), insidious heat's penetration of pericardium(伏熱入包絡), the treatment of Ki-cooling(淸氣) with TongSeongHwan(通聖丸), Praeparatum(豆?), Phyllostachys Folium(竹葉), Mori Cortex(桑白皮), Tetrapanacis Medulla(通草), etc can be applied. 4) When the pathogenesis of JeokBan(적반), BalLa(발라), GuChang(久瘡), GyeolHaek(結核), DamHaek(痰核), Yeong(?), YuJu(流注), Breast Diseases(乳房疾患) and DoHan(盜汗) are stagnancy's injury of Ki and blood(鬱傷氣血), gallbladder fire with stomach damp(膽火胃濕), deficiency of Yin in stomach with Kwolum's check (胃陰虛 厥陰乘), heat's penetration of blood collaterals with disharmony of liver and stomach(熱入血絡 肝胃不和), insidious pathogen in Kwolum(邪伏厥陰), the treatment of mediation(和解) with Prunellae Spica(夏枯草), Chrysanthemi Flos(菊花), Mori Folium (桑葉), Bupleuri Radix(柴胡), Coptidis Rhizoma(黃連), Scutellariae Radix(黃芩), Gardeniae Fructus(梔子), Cyperi Rhizoma(香附子), Toosendan Fructus(川?子), Curcumae Radix(鬱金), Moutan Cortex(牧丹皮), Paeoniae Radix Rubra(赤芍藥), Unoariae Ramulus Et Uncus(釣鉤藤), Cinnamorni Ramulus(桂枝), Paeoniae Radix Alba(白芍藥), Polygoni Multiflori Radix (何首烏), Cannabis Fructus (胡麻子), Ostreae Concha(牡蠣), Zizyphi Spinosae Semen(酸棗仁), Pinelliae Rhizoma(半夏), Poria(백복령). etc can be applied. 5) When the pathogenesis of BanJin(반진), BalLa(발라), ChangI(瘡痍), NamgChang(膿瘡). ChangJilGaeSeon(瘡疾疥癬), ChangYang(瘡瘍), SeoYang(署瘍), NongYang(膿瘍) and GweYang(潰瘍) are wind-damp(風濕), summer heat-damp(暑濕), damp-warm(濕溫), downward flow of damp-heat(濕熱下垂), damp-heat with phlegm transformation(濕熱化痰), gallbladder fire with stomach damp(膽火胃濕), overdose of cold herbs(寒凉之樂 過服), the treatment of damp-resolving(化濕) with Pinelliae Rhizoma(半夏), armeniacae Amarum Semen(杏仁), Arecae Pericarpium(大腹皮), Poria(백복령), Coicis Semen(薏苡仁), Talcum(滑石), Glauberitum(寒水石), Dioscoreae Tokoro Rhizoma(??), Alismatis Rhizoma(澤瀉), Phellodendri Cortex(黃柏), Phaseoli Radiati Semen(?豆皮), Bombycis Excrementum(?沙), Bombyx Batryticatus(白??), Stephaniae Tetrandrae Radix(防己), etc can be applied. 6) When the pathogenesis of ChangPo(瘡泡), hepatic abscess(肝癰) and appendicitis(腸癰) are food poisoning(食物中毒), Ki obstruction & blood stasis in the interior(기비혈어재과), damp-heat stagnation with six Bu organs suspension(濕熱結聚 六腑不通), the treatment of purgation(通下) with DaeHwangMokDanPiTang(大黃牧丹皮湯), Manitis Squama(穿山甲), Curcumae Radix(鬱金), Curcumae Longae Rhizoma(薑黃), Tetrapanacis Medulla(通草), etc can be applied. 7) When the pathogenesis of JeokBan(적반), BanJin(반진), EunJin(은진). BuYang(부양), ChangI(瘡痍), ChangPo(瘡泡), GuChang(久瘡), NongYang(膿瘍), GweYang(潰瘍), Jeong(정), Jeol(癤), YeokRyeo(疫?) and YeokRyeolpDan(疫?入?) are wind-heat stagnation(風熱久未解), blood fever in Yangmyong(陽明血熱), blood fever with transformation(血熱風動), heat's penetration of blood collaterals(熱入血絡). fever in blood(血分有熱), insidious heat in triple energizer(三焦伏熱), pathogen's penetration of pericardium(心包受邪), deficiency of Yong(營虛), epidemic pathogen(感受穢濁), the treatment of Yong & blood-cooling(淸營凉血) with SeoGakJiHwangTang(犀角地黃湯), Scrophulariae Radix(玄參), Salviae Miltiorrhizae Radix(丹參), Angelicae Gigantis Radix(當歸), Polygoni Multiflori Radix(何首烏), Cannabis Fructus(胡麻子), Biotae Semen(柏子仁), Liriopis Tuber(麥門冬), Phaseoli Semen(赤豆皮), Forsythiae Fructus(連翹), SaJin(사진), YangDok(瘍毒) and YeokRyeoIpDan(역려입단) are insidious heat's penetration of pericardium(伏熱入包絡), damp-warm's penetration of blood collaterals(濕溫入血絡), epidemic pathogen's penetration of pericardium(심포감수역려), the treatment of resuscitation(開竅) with JiBoDan(至寶丹), UHwangHwan(牛黃丸), Forsythiae Fructus(連翹), Curcumae Radix(鬱金), Tetrapanacis Medulla(通草), Acori Graminei Rhizoma(石菖蒲), etc can be applied. 9) When the pathogenesis of SaHuSinTong(사후신통), SaHuYeolBuJi(사후열부지), ChangI(瘡痍), YangSon(瘍損) and DoHan(盜汗) are deficiency of Yin in Yangmyong stomach(陽明胃陰虛), deficiency of Yin(陰虛), the treatment of Yin-replenishing(滋陰) with MaekMunDongTang(麥門冬湯), GyeongOkGo(瓊玉膏), Schizandrae Fructus(五味子), Adenophorae Radix(沙參), Lycii Radicis Cortex (地骨皮), Polygonati Odorati Rhizoma(玉竹), Dindrobii Herba(石斛), Paeoniae Radix Alba(白芍藥), Ligustri Lucidi Fructus (女貞子), etc can be applied. 10) When the pathogenesis of RuYang(漏瘍) is endogenous wind in Yang collaterals(陽絡內風), the treatment of endogenous wind-calming(息風) with Mume Fructus(烏梅), Paeoniae Radix Alba (白芍藥), etc be applied. 11) When the pathogenesis of GuChang(久瘡), GweYang(潰瘍), RuYang(漏瘍), ChiChang(痔瘡), JaHan(自汗) and OSimHan(五心汗) are consumption of stomach(胃損), consumption of Ki & blood(氣血耗盡), overexertion of heart vitality(勞傷心神), deficiency of Yong(營虛), deficiency of Wi(衛虛), deficiency of Yang(陽虛), the treatment of Yang-restoring & exhaustion-arresting(回陽固脫) with RijungTang(理中湯), jinMuTang(眞武湯), SaengMaekSaGunjaTang(生脈四君子湯), Astragali Radix (황기), Ledebouriellae Radix(防風), Cinnamomi Ramulus(桂枝), Angelicae Gigantis Radix(當歸), Ostreae Concha(牡蠣), Zanthoxyli Fructus(川椒), Cuscutae Semen(兎絲子), etc can be applied.

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