• Title/Summary/Keyword: external contraction

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A Study on the Pyo-bon(標本) concept based on the verse "The Principal and secondary aspects must first be decided(標本須明後先)." in the Sanghan(傷寒) Chapter of "Yixuerumen(醫學入門)" ("의학입문.상한편(醫學入門.傷寒篇)"의 "표본수명후선(標本須明後先)" 조문(條文)에서 나타난 삼음삼양병(三陰三陽病)의 표본(標本) 개념에 대한 고찰)

  • Shin, Sang-Won;Jeong, Chang-Hyun;Baik, You-Sang;Jang, Woo-Chang
    • Journal of Korean Medical classics
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    • v.25 no.1
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    • pp.1-16
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    • 2012
  • "Yixuerumen" is a comprehensive medical text published in the Ming-dynasty by Li Chan(李梴). In this text, Sanghan(傷寒, cold damage) is categorized among external contraction(外感) with much emphasis. The subject of this study is the verse "The Principal and secondary aspects must first be decided." and its annotations in the in the Sanghan chapter of "Yixuerumen". The complex theoretical structure of this verse was firstly analyzed, together with the historical background of how and why Li Chan adopted this concept. The Pyo-Bon concept is the contrast between phenomena(標) and its underlying source of motivation(本). The methodology for this study was to compare and analyze this main verse with contents on Sanghan and Un-gi(運氣) within the text, while reviewing historical theories explaining the physiology and pathology of the human body in terms of the Pyo-bon(標本) concept. As a result, we discovered that the Pyo-bon(標本) concept used in the aforementioned verse of "Yixuerumen" matches the Three Eum Three Yang(三陰三陽)-標本中氣(pyo-bon-jung gi)-gi transformation(氣化) theory of Un-gi(運氣). Li Chan created the connecting link in understanding the Three Eum Three Yang diagnosis system through the viscera/bowels theory(臟腑論) by adopting the Three Eum Three Yang(三陰三陽)-標本中氣(pyo-bon-jung gi)-gi transformation(氣化) theory from Un-gi. Li's work lead to several changes in the field of Sanghan. First, Li understood the disease pattern of Sanghan by using the accumulated knowledge of the viscera/bowel theory during the Jin-Yuan dynasty, and developed a medical perspective that observes the disease pattern based on the body's essence gi(精氣). Second, he set the category of the Sanghan-Three Eum Three Yang disease pattern, establishing a separate guideline. Third, by adding knowledge of herbs to the accumulated knowledge of the viscera/bowel theory, the process of diagnosis and herbal application were made explicable. On the other hand, in the process of interpreting the 三陰三陽 diagnosis system with viscera/bowels theory, theoretical inconsistencies appeared, of which Li tried to mend by several means. The results of the research on "Yixuerumen(醫學入門) the Sanghan chapter(傷寒篇)" calls for further studies, as it has effected both "Dongeuibogam(東醫寶鑑) the Sanghan part(寒門)" and "Dongeuisoosebowon(東醫壽世保元)" as well.

Effect of Abdominal Draw In Maneuver in Sitting Position (앉은자세에서 실시하는 복부드로우인기법의 효과)

  • Kim, Seon-Chil;Kim, Shin-Gyun;Kim, Chang-sook
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.11 no.3
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    • pp.207-214
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    • 2017
  • The problem of trunk stability is a major factor in back pain.. Abdominal draw in maneuver(ADIM), One of the trunk stabilization exercises to relieve lumbar instability, is a method of inducing selective contraction of the transverse abdominis associated with anticipatory posture control among the abdominal stabilization muscles. ADIM is usually performed with a visual feedback by applying a pressure biofeedback unit(PBU) under the lumbar at the supine position, which is not functional compared to the sitting position. This study was conducted to investigate the effect of ADIM applied in supine and sitting position on 31 healthy men and women. In each posture, muscle activity was measured by rectal abdominis (RA), external oblique (EO), transverse abdominis (TrA)/internal obilique (IO) and erector spinae (ES) using wireless EMG. In the result, there was no significant difference between RA and EO between the two postures and there was a significant difference between TrA / IO and ES. In both postures, the activity of TrA/IO was higher than that of RA, and the effect of ADIM was shown to be the same, whereas TrA/IO and ES showed higher activity in sitting position. This means that the activity of the muscles involved in the postural stability and lumbar stability is increased further in the sitting position. Therefore, ADIM in sitting, which can be applied more easily in daily life, is useful for improving lumbar stability.

The literatural study of investigating the contents associated with the neuropsychosis in the medical books published in the times of Chinese dynasty of Jin and Yuan (금원시대(金元時代)의 의서(醫書)에 나타난 신경정신질환(神經精神疾患)에 대한 고찰(考察))

  • Choi, Jong Geol;Lee, Sang Ryong
    • Journal of Haehwa Medicine
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    • v.9 no.1
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    • pp.725-743
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    • 2000
  • This study was intended to investigate the contents associated with the neuropsychosis in the medical books published in the times of Chinese dynasty of Jin and Yuan. As a result, the following findings were drawn. 1. As for palpitation from fright and severe palpitation, the medical schools in the times of Chinese Jin and Yuan dynasties viewed their causes as heart-fire, shuiqichengxin, blood vacuity, phlegm and so on and presented a prescription for each cause for them. 2. As for psychosis, medical books published in the times of Chinese Jin and Yuan dynasties accurately divided and discussed epilepsy and viewed their causes largely as Yangming heat, phlegm of chest and heart-fire. And a number of medical schools made use of such therapeutics as sweating, vomiting and diarrhea therapies. 3. As for headache, medical books published in the times of Chinese Jin and Yuan dynasties presented their causes as fire and heat, phlegm heat, phlegm and so on and classified the aspect of headache in detail. As for vacuity rexation and dysphoria, medical books at that time saw their causes as fire and heat, heart-fire, blood vacuity and so forth and presented a prescription for them accordingly. 4. Liu Wan Su was the Hanliang school. He viewed the etiological cause for psychopathy as fire and heat and prescribed largely the medication of cold nature for it. 5. Zhang Cong Zheng belonged to the Gongxia School. He viewed the etiological cause for psychopathy as fire, phlegm and so forth and made use of sweating, vomiting and diarrhea therapies. Especially, he used the 'Jingzhepingzhe' therapy as a method to treat the symptom of fright. 6. Li Gao did not any specific mention of psychopathy and divided headache due to internal injury and headache due to external contraction. 7. Zhu Zhen Heng viewed most of the etiological causes for psychopathy as phlegm, fire and deficiency of blood and attached importance to such its therapeutics as resolving phlegm, cleaning away fire and nourishing Yin. 8. Wang Hao Gu did not present the specifically common etiological cause and prescription for psychopathy but described the cause and prescription for headache, dysphoria, maniac speech, palpitation and so forth. Luo Tian Yi presented the process of psychosis due to abnormal therapy for cold demage and prescription of it. 9. Wang Lu made a detailed explanation about the therapeutics of five types of stagnated syndrome and said that stagnated syndrome became the major cause for them in the occurrence of such psychopathy. Wei Yi Lin presented the prescription and medication for comparatively diverse mental diseases such zhong-qi, severe palpitation, palpitation for fright, impaired memory, vacuity rexation, headache, psychosis.

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Effect of Close kinetic chain and Open kinetic chain Position on Proprioceptive Neuromuscular Facilitation Applied to the Unilateral Upper Extremity on the Muscle Activation of Lower Extremity (닫힌사슬과 열린사슬 자세에서 편측상지에 적용된 PNF가 양측 하지의 근 활성도에 미치는 영향)

  • Han, Hyang-Wan;Kim, Sang-Soo
    • PNF and Movement
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    • v.7 no.3
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    • pp.17-27
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    • 2009
  • The purpose of this study was to investigate the effect of close kinetic chain(CKC) and open kinetic chain(OKC) posion on proprioceptive neuromuscular facilitation applied to the unilateral upper extremity on the muscle activation of lower extremity. All subjects were randomly assigned to two groups: open kinetic chain group(n=5),closed kinetic chain group(n=5). All participants were PNF patterns applied on the unilateral upper extremity in all subjects were the kinetic chain(CKC) and open kinetic chain(OKC) posion on flexion/abduction/external rotation. The hold and approximation techniques for the irradiation were applied to end range. All measurements for each subject took the following tests: pre-test, post - test in 4weeks, post-testin 8weeks. EMG data was collected from the vastus medialis, tibialis anterior, biceps femoris, and gastrocnemius muscle of both lower extreamity using surface EMG system, Each EMG value in individual muscle was normalized for maximal voluntary contraction. The data were analyzed using Two-way analysis of variance(ANOVA) with repeated measures to determine the statistical significances. The results of this study are summarized as follows. First, during for close kinetic chain(CKC) and open kinetic chain(OKC) posion on PNF pattern application, all of the %MVIC values of close kinetic chain and open kinetic chain posion increased sign ificantly compared(p<0.05). Second, The close kinetic chain(CKC) and open kinetic chain(OKC) posion on PNF pattern application was significantly increased with in the intervention period(p<.05). Third, there was a no significant open kinetic chain posion on PNF pattern application of sing muscle group with in the intervention period.(p<0.05) there was a significant close kinetic chain posion on PNF pattern application of sing muscle group with with in the intervention period(p<0.05). Forth, interaction of the exercise position and muscle was also significant. Post-hoc tests revealed that the activation levels of vastus medialis muscle and tibialis anterior muscle was higher in the closed kinetic chain position(p<.05). that the activation levels of vastus medialis and gastrocnemius muscle was higher in the open kinetic chain position(p<.05). In conclusion, it was found that the application of PNF patterns to the unilateral upper extremity effect on the muscle activation of lower extremity and both open kinetic chain exercise and closed kinetic chain exercise was significantly increased muscle activity. Further studies are needed to analyzed long term effects and subjects resulting from these changed.

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The Influence of Angle Change of the Forefoot's Adhesive Outsole Designs on the Electromyographic Activity of the Erector Spinae and Selected Lower Limb Muscles during Downhill Walking (내리막 보행시 발 전족부 부착형 아웃솔의 각도 변화가 척추기립근과 하지근의 근활성도에 미치는 영향)

  • Lee, Haeng-Seob;Chae, Woen-Sik;Jung, Jea-Hu;Kim, Dong-Soo;Lim, Young-Tae;Jang, Jea-Ik
    • Korean Journal of Applied Biomechanics
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    • v.24 no.2
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    • pp.139-149
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    • 2014
  • The purpose of this study was to evaluate the effect of angle change of forefoot's adhesive outsole on the electromyographic activity (EMG) of the erector spinae and selected lower limbs muscle during downhill walking over $-20^{\circ}$ ramp. Thirteen male university students (age: $25.4{\pm}3.9$ yrs, height: $176.2{\pm}5.1$ cm, weight: $717.4{\pm}105.0$ N) who have no musculoskeletal disorder were recruited as the subjects. To assess the myoelectric activities of selected muscles, six of surface EMG electrodes with on-site pre-amplification circuitry were attached to erector spinae (ES), rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), lateral gastrocnemius (LG), and medial gastrocnemius (MG). To obtain maximum EMG levels of the selected muscles for normalization, five maximum effort isometric contraction were performed before the experimental trials. Each subject walked over $0^{\circ}$ and $20^{\circ}$ ramp with three different forefeet's EVA outsole (0, 10, $20^{\circ}$) in random order at a speed of $1.2{\pm}0.1$ m/s. For each trial being analyzed, five critical instants and four phases were identified from the recording. The results of this study showed that the average muscle activities of MG and LG decreased in $20^{\circ}$ shoes compared to $0^{\circ}$ and $10^{\circ}$ ones in the initial double limb stance (IDLS). In initial single limb stance (ISLS) phase, the average muscle activities of ES increased with the angle of forefoot's adhesive outsole, indicating that the increment of shoes' angle induce upper body to flex anteriorly in order to maintain balance of trunk. In terminal double limb stance (TDLS) phase, average muscle activities of TA significantly increased in $20^{\circ}$ outsole compared to $0^{\circ}$ and $10^{\circ}$ ones. There was no external forces acting on the right foot other than the gravity during terminal single limb stance (TSLS) phase, all muscles maintained moderate levels of activity.

Effect of abdominal drawing in maneuver with pelvic floor exercise on abdominal muscle thickness measured by ultrasonography (골반 바닥근육 운동을 이용한 복부 드로잉-인이 초음파 측정 방법을 이용한 복부 근육 두께에 미치는 영향)

  • Choi, You-Jeong;Son, A-Reum;Hong, Ji-Heon;Yu, Jae-Ho;Kim, Jin-Seop;Lee, Dong-Yeop
    • Journal of the Korea Convergence Society
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    • v.10 no.7
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    • pp.93-100
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    • 2019
  • The purpose of this study is to measure abdominal muscle thickness when Pelvic Floor contraction (PFC) and Abdominal Drawing-In Maneuver (ADIM) were separately applied and combined exercise was applied and to compare the effects of the exercise. After the pre-investigation, the subjects were given a explanation of the purpose and the method of the research and then an experiment was conducted targeting a total of 30 subjects, who voluntarily agreed with this. Thicknesses of internal oblique (IO), transverse abdominis (TrA) and external oblique (EO) were measured during a break and then three types of exercise. All the measured values of the experiment were processed using Repeated measure ANOVA, and Bonferroni method was applied. As a result, the three types of exercise showed significant differences in thicknesses of IO, TrA and EO. In conclusion, the subjects had the thickest muscles and muscular activity increased during PFC+ADIM, compared to PFC and ADIM.

Effects of Pelvic Floor Muscle Exercise According to Support Surface on Maximum Inspiratory Pressure and Maximum Expiratory Pressure and Abdominal Muscle Thickness in Female College Students in Their 20s (지지면에 따른 골반 바닥 근육 운동이 20대 여대생들의 최대 들숨 압력, 최대 날숨 압력 그리고 배 근육 두께에 미치는 영향)

  • Han-Kyu Park;Yun-Hui Kim;Si-Yun Lee;Jeong-In Lee;Su-Jin Oh;Ji-Young Hwang
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.4
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    • pp.51-60
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    • 2023
  • Purpose : The purpose of this study was to determine the effect of pelvic floor muscle exercise (PFME) on an unstable support surface on maximal inspiratory pressure (MIP), maximum expiratory pressure (MEP), and abdominal muscle thickness as a method for effective PFME. Methods : This study was performed on 22 subjects. They were matched and divided into two groups based on body mass index; the experimental group (EG) performed PFME on a foam roller (n= 11), the control group (CG) performed PFME on a stable support surface (n= 11). Kegel exercise was performed with 10 seconds of contraction, 10 seconds of relaxation, and 4 sets of 10 reps per set. Both of group executed the exercise 3 times a week for 2 weeks. MIP and MEP was measured using a spirometer. Abdominal muscle thickness was measured using ultrasound. The paired t-test was used to compare difference on each group and the comparison between groups was analyzed using the independent t-test. A significance level of α= .05 was used to verify statistical significance. Results : The EG showed a significant increase in the MEP (p<.05). The CG showed a significant increase in the MEP (p<.05). There was no significant difference in the two groups (p>.05). The EG showed a significant increase in the external oblique, internal oblique and transverse abdominis (p<.05). The CG showed a significant increase in the internal oblique (p<.05). There was no significant difference in the two groups (p>.05). Conclusion : Based on the results of this study, additional research should be conducted to correct the limitations of this study to confirm that PFME performed on a foam roller has a positive effect on respiratory muscle strength and abdominal muscle thickness.

Material Properties Depending on the Maximum Aggregate Size and Fineness Modulus for Concrete Repair Materials (콘크리트 단면복구용 보수재료의 굵은 골재 최대치수 및 조립률에 따른 재료적 특성)

  • Sun-Mok Lee;Byung-Je Lee;Yun-Yong Kim
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.27 no.6
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    • pp.62-69
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    • 2023
  • Re-damage is frequently occurring for various reasons, including material factors, external factors, and factors caused by poor construction in concrete cross-section restoration work, so it is necessary to identify the cause and improve it. Cement-based materials are the most commonly used maintenance materials for concrete structures, and in particular, additional cross-sectional restoration work may be carried out due to re-damage such as cracks and excitement due to dry contraction of the repair material. In this study, a basic study was conducted to identify the characteristics of concrete while diversifying the maximum dimensions and assembly rate of thick aggregates to examine the effects of using thick aggregates in repair materials. As a result, the slump of concrete increased as the maximum size of thick aggregates increased, and the amount of air content was measured 1.88 to 2.35 times higher in the mixing using aggregates with a maximum aggregate size of 5 mm or more compared to the mixing group with a maximum aggregate size of 10 mm or more. It was found that compressive strength was greatly affected by the performance rate of thick aggregates. The compressive strength was measured the highest in the mixture using thick aggregates with the highest performance rate of 20 mm, and the compressive strength of the mixture with the lowest performance rate was more than 45%. As a result of the dry shrinkage measurement, the dry shrinkage was the lowest as the performance rate of the thick aggregate increased according to the change in the maximum dimensions and assembly rate of the thick aggregate, and the lowest performance rate was the largest in the mix. Through this study, it was confirmed that adjusting the particle size by diversifying the maximum dimensions and assembly rate of thick aggregates used in concrete structure repair materials can improve strength and workability and reduce dry shrinkage.

Comparison of Kinematics and Myoelectrical Activity during Deadlift, with and without Variable Banded Resistance, in Healthy, Trained Athletes

  • Everett B. Lohman;Mansoor Alameri;Fulden Cakir;Chih Chieh Chia;Maxine Shih;Owee Mulay;Kezia Marceline;Simran Jaisinghani;Gurinder Bains;Michael DeLeon;Noha Daher
    • Physical Therapy Rehabilitation Science
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    • v.13 no.1
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    • pp.53-70
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    • 2024
  • Background: The conventional deadlift is a popular exercise for enhancing trunk, core, and lower extremity strength. However, its use in sports medicine is constrained by concerns of lumbar injuries, despite evidence supporting its safety and rehabilitative benefits. To optimize muscle activation using resistive bands in variable resistance therapy, we explored their feasibility in the deadlift. Design: Comparative experimental design Methods: Surface electromyography recorded muscle activity in the trunk and lower extremities during lifting, with normalization to the isometric Floor Lift using Maximal Voluntary Contraction. Kinematics were measured using inclinometer sensors to track hip and trunk sagittal plane angles. To prevent fatigue, each subject only used one of the three pairs of bands employed in the study. Results: Our study involved 45 healthy subjects (mean age: 30.4 ± 6.3 years) with similar baseline characteristics, except for years of lifting and strength-to-years-of-lifting ratio. Various resistance band groups exhibited significantly higher muscle activity than conventional deadlifts during different phases. The minimal resistance band group had notably higher muscle activity in the trunk, core, and lower extremity muscles, particularly in the end phase. The moderate resistance band group showed increased muscle activity in the mid-and end-phases. The maximum resistance band group demonstrated greater muscle activity in specific muscles during the early phase and overall higher activity in all trunk and lower extremity muscles in the mid and end phases of the deadlift (p<0.05). Conclusion: Our findings provide valuable insights into muscle activation with various resistance bands during deadlift exercise in clinical and gym settings. There appears to be a dose-response relationship between increased resistance bandwidth, external load, myoelectric activation, and range.

The Literatual Study on the Wea symptom in the View of Western and Oriental Medicine (위증에 대한 동서의학적(東西醫學的) 고찰(考察))

  • Kim, Yong Seong;Kim, Chul Jung
    • Journal of Haehwa Medicine
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    • v.8 no.2
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    • pp.211-243
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    • 2000
  • This study was performed to investigate the cause, symptom, treatment, medicine of Wei symptom through the literature of oriental and western medicine. The results obtained were as follows: 1. Wei symptom is the symptom that reveals muscle relaxation without contraction and muscle relaxation occures in the lower limb or upper limb, in severe case, leads to death. 2. Since the pathology and etiology of Wei symptom was first described as "pe-yeol-yeop-cho"(肺熱葉焦) in Hung Ti Nei Ching(黃帝內經), for generations most doctors had have accepted it. but after Dan Ge(丹溪), it had been classified into seven causes, damp-heat(濕熱), phlegm-damp(濕痰), deficiency of qi(氣虛), deficiency of blood(血虛), deficiency of yin(陰處), stagnant blood(死血), stagnant food(食積). Chang Gyeng Ag(張景岳) added the cause of deficiency of source qi(元氣). 3. The concept of "To treat Yangming, most of all"(獨治陽明) was emphasized in the treatment of Wei symptom and contains nourishment of middle warmer energy(補益中氣), clearance of yangming-damp-heat(淸化陽明濕熱). 4. Since Nei-ching era(內經時代), Wei and Bi symptom(痺症) is differenciated according to the existence of pain. After Ming era(明代) appeared theory of co-existence of Wei symptom and pain or numbness but they were accepted as a sign of Wei symptom caused by the pathological factor phelgm(痰), damp(濕), stagnancy(瘀). 5. In the western medical point of view, Wei symptom is like paraplegia, or tetraplegia. and according to the causative disease, it is accompanied by dysesthesia, paresthsia, pain. thus it is more recommended to use hwal-hyel-hwa-ae(活血化瘀) method considering damp-heat(濕熱), qi deficiency of spleen and stornach(脾胃氣虛) as pathological basis than to simply differenciate Wei and Bi symptom according to the existence of pain. 6. The cause of Gullian-Barre syndrome(GBS) is consist of two factors, internal and external. Internal factors include asthenia of spleen and stomach, and of liver and kidney. External factors include summur-damp(暑濕), damp-heat(濕熱), cold-damp(寒濕) and on the basis of "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治), the cause of GBS is classified into injury of body fluid by lung heat(肺熱傷津), infiltration of damp-heat(濕熱浸淫), asthenia of spleen and kidney(脾腎兩虛), asthenia of spleen and stomach(脾胃虛弱), asthenia of liver and kidney (肝腎兩虛). 7. The cause of GBS is divided by according to the disease developing stage: Early stage include dryness-heat(燥熱), damp(濕邪), phlegm(痰濁), stagnant blood(瘀血), and major treatment is reducing of excess(瀉實). Late stage include deficiency of essence(精虛), deficiency with excess(虛中挾實), and essencial deficiency of liver and kidney(肝腎精不足) is major point of treatment. 8. Following is the herbal medicine of GBS according to the stage. In case of summur-damp(暑濕), chung-seu-iki-tang(淸暑益氣湯) is used which helps cooling and drainage of summer-damp(淸利暑濕), reinforcement of qi and passage of collateral channels(補氣通絡). In case of damp-heat, used kun-bo-hwan(健步丸), In case of cool-damp(寒濕), used 'Mahwang-buja-sesin-tang with sam-chul-tang'(麻黃附子細辛湯合蓼朮湯). In case of asthenia of spleen and kidney, used 'Sam-lyeng-baik-chul san'(蔘笭白朮散), In case of asthenia of liver and kidney, used 'Hojam-hwan'(虎潛丸). 9. Following is the herbal medicine of GBS according to the "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治). In the case of injury of body fluid by lung heat(肺熱傷津), 'Chung-jo-gu-pae-tang'(淸燥救肺湯) is used. In case of 'infiltration of damp-heat'(濕熱浸淫), us-ed 'Yi-myo-hwan'(二妙丸), In case of 'infiltration of cool-damp'(寒濕浸淫), us-ed 'Yui-lyung-tang', In case of asthenia of spleen, used 'Sam-lyung-bak-chul-san'. In case of yin-deficiency of liver and kidney(肝腎陰虛), used 'Ji-bak-ji-hwang-hwan'(知柏地黃丸), or 'Ho-jam-hwan'(虎潛丸). 10. Cervical spondylosis with myelopathy is occuered by compression or ischemia of spinal cord. 11. The cause of cervical spondylosis with myelopathy consist of 'flow disturbance of the channel points of tai-yang'(太陽經兪不利), 'stagnancy of cool-damp'(寒濕凝聚), 'congestion of phlegm-damp stagnant substances'(痰濕膠阻), 'impairment of liver and kidney'(肝腎虛損). 12. In treatment of cervical spondylosis with myelopathy, are used 'Ge-ji-ga-gal-geun-tang-gagam'(桂枝加葛根湯加減), 'So-hwal-lack-dan-hap-do-hong-eum-gagam(小活絡丹合桃紅飮加減), 'Sin-tong-chuck-ue-tang-gagam(身痛逐瘀湯加減), 'Do-dam-tang-hap-sa-mul-tang-gagam'(導痰湯合四物湯加減), 'Ik-sin-yang-hyel-guen-bo-tang'(益腎養血健步湯加減), 'Nok-gakyo-hwan-gagam'(鹿角膠丸加減). 13. The cause of muscle dystropy is related with 'the impairement of vital qi'(元氣損傷), and 'impairement of five Zang organ'(五臟敗傷). Symptoms and signs are classified into asthenia of spleen and stomach, deficiency with excess, 'deficiency of liver and kidney'(肝腎不足) infiltration of damp-heat, 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 14. 'Bo-jung-ik-gi-tang'(補中益氣湯), 'Gum-gang-hwan'(金剛丸), 'Yi-gong-san-hap-sam-myo-hwan'(異功散合三妙丸), 'Ja-hyel-yang-gun-tang'(滋血養筋湯), 'Ho-jam-hwan'(虎潛丸) are used for muscle dystropy. 15. The causes of myasthenia gravis are classified into 'insufficiency of middle warmer energy'(中氣不足), 'deficiency of qi and yin of spleen and kidney'(脾腎兩處), 'asthenia of qi of spleen'(脾氣虛弱), 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 16. 'Bo-jung-ik-gi-tang-gagam'(補中益氣湯加減), 'Sa-gun-ja-tang-hap-gi-guk-yang-hyel-tang'(四君子湯合杞菊地黃湯), 'Sa-gun-ja-tang-hap-u-gyi-eum-gagam'(四君子湯合右歸飮加減), 'Pal-jin-tang'(八珍湯), 'U-gyi-eum'(右歸飮) are used for myasthenia gravis.

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