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TCM Diagnosis 1 - Qian

inspection, smelling and hearing for TCM diagnosis
STUDY
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Su Wen - simplified location Fore head
HT
Su Wen - simplified location Left cheek
LIV
Su Wen - simplified location Right cheek
LU
Su Wen - simplified location Nose
SP
Su Wen - simplified location Chin
KID
Ling Shu - complicated location Forehead
throat
Ling Shu - complicated location Between eyebrow
LU
Ling Shu - complicated location Between intercanthus
HT
Ling Shu - complicated location Bridge of the Nose
LIV
Ling Shu - complicated location Tip of nose
SP
Ling Shu - complicated location Sides of the nose (alna Nasi)
ST
Ling Shu - complicated location Sides of the nose
SI
Ling Shu - complicated location On cheeks
LI
Ling Shu - complicated location Close to the ear
KID
Ling Shu - complicated location Filtrum
Uterus
Ling Shu - complicated location The sides of filtrum
UB
Skinny, tall, most common to get LQS, can easily to turn into fire, lots of movement (wind changes) or more likely to have ADHD, more likely to generate heat
WOOD
round in the middle & pointed at the top (like a flame), less hair on the top of the head, (fire burned the hair away), happy, not serious person, h&s & feet are small, walk fast. Easily has HTN & HT diseases, vain, materialistic. Runs hot, can be dry.
FIRE
Big Jaw, mouth, thigh - very round & heavy, very generous comparatively to other types, tendency to have damp, edema, easy to gain weight, muscle is sluggish, easily tired. Like to eat, less ambitious.
EARTH
squared off, rigid, rational. Broad & squared shoulders, good voice (good zhong qi) singer or speaker, tendency to Asthma or Crohn's/colitis. Dependable
METAL
personality is flexible, very sympathetic, long torso, shorter legs. Emotional, psychic. People pleaser, lying to cover painful truths. Good lawyer, politicians. Typical complaint could be UTI or edema, joint problems, infertility, flattened filtrum
WATER
metal & wood types, yin Xu w/ empty heat - looks nice, not good to be with. Generous & happy with life
Thin
Earth & Water - shi (yin) damp & phlegm - damaging qi & yang - wont punch back (sweet temperament)
Over weight
KID essence Xu
Small head
smart, but if its out of proportion can be brain damage (down's)
Big head
swollen brain, shi heat in the brain
Elevated fontanel
Depressed
xu & cold
Flexible movement of head
normal
Non-stop movement of head
LIV wind
Stiff neck of head
wind cold or stagnation of qi & xue
Shiny & thick hair
normal (KID essence is strong)
Grey / white hair early
KID essence Xu
Grey / white hair @ teen age
shi heat due to too much testosterone
Dry & knotted hair
poor nutrition
Suddenly loss of hair
LQS or Trauma
Patches in the hair
LQS (chemo)
Eyes sparkling & free moving
with shen
Eyes dull & not moving
without shen
Pupil of the eyes reflects what zhang fu
KID
Iris of the eyes reflects what zhang fu
LIV
Iritis
LIV Fire or Damp Heat
Brown Spots in the iris of the eyes reflects what zhang fu
fat deposit
Sclera of the eyes reflects what zhang fu
LU
If color of the eyes becomes RED
LU Heat or LI Heat
Canthus of the eyes reflects what zhang fu
HT
If eye color becomes red w/ yellow discharge
HT heat
Eye Lid of the eyes reflects what zhang fu
SP
If Swollen & soft eyelids of the eyes reflects what zhang fu
SP xu w/Damp
Protruding eyes (hyperthyroidism)
Heat at the LIV
Child has high fever (eye sunken in)
Heat damaging body fluids (LU SP KID become weak)
Red & Swollen eyes (conjunctivitis)
LU Heat (virus / wind heat)
Color of the nose reflects the
GI system (connects to all the GI Meridians)
Tip of nose reflects the
SP
Red nose
heat in the abdomen
Blue & green nose
abdominal pain
Swollen nose
shi water
Swollen + yellow or red nose
damp heat
Swollen & pale nose
damp cold
Alna nasi is flapping
(yang shi) LU heat
White, copious, thin/watery Nasal discharge, no odor
LU qi xu or wind cold (URI, allergies)
Yellow, big/small, thick, odor nasal discharge
wind heat or phlegm heat in LU (URI, sinusitis)
Big mouth
likes to eat
Pink /red & shiny lips
normal
Pale lips
xu (SP qi xu) (cold in SP)
Red lips
Heat @ SP (damp heat usually)
Purple lips
xue Stagnation/Stasis (HT xue stasis, Cold constriction, or LQS)
Swollen lips
shi
Swollen + red lips
shi heat
Swollen + pale lips
shi cold & damp
Atrophy of the lips
xu
Atrophy + pale lips
SP qi xu or qi + xue xu (malnutrition)
Atrophy + yellow + dry lips
xue xu + SP qi xu (hemorrhage- dysfunctional uterine bleeding)
Atrophy + pale + cracks in the lips
yin xu or body fluid xu
xu conditions with the teeth &/or gums
tonify the KID
Shi conditions with the teeth &/or gums
Balance the ST & LI (keep yang (fu) organs open by sedating or purging)
Upper Gums correlate to what Zhang Fu?
ST
Lower Gums correlate to what Zhang Fu?
LI
Pale (dead bone, no luster) teeth or black teeth & dry
KID xu or KID qi exhaustion
Yellow & dry Teeth w/ swelling & red gums
shi heat @ ST & LI (gingivitis or Smoker, or heavy coffee drinker)
Pale teeth with no specific gum pain, with lose teeth sensation
KID xu
The throat reflects the condition of the three organs
LU, ST, KID
Bright red throat
shi (ext wind heat LU or toxic heat in ST)
Pink red Throat
xu heat (KID or LU yin xu)
Swollen Throat
ext wind heat LU or toxic heat in ST
Red, swollen throat with secretions
damp heat or phlegm heat in LU (tonsilitis)
The tip of ear reflects what Zang Fu?
UB
In front of the ear reflects what zang Fu?
ST
Damp or watery discharge
SP & KID disfunction (SP = shi & KID = xu)
Meneres disease (edema in the inner ear)
SP & KID disfunction (SP = shi & KID = xu)
Pale ears
xu or cold
Red at tip of the ears with red veins but the root of the ear is cold
LU heat (measles)
Gray & dark ears
pain, or KID exhaustion (poor prognosis)
Black spots on the ear
cancer (deep xue stasis)
Big, long ear lobes
strong KID - longevity, stronger health (Good essence)
Atrophy of the ear lobes
loss of KID essence
Deep grooves on the ear lobes
obstruction (coronary artery diseases)
Top of the ear atrophy with grey black color with dark spots
xue stasis (Cancer)
Swollen ear lobes
Damp
Secretion from the ears
COLOR, QTY, Quality, smell
White, thin, Big qty, no smell Secretion from the ears + fatigue
xu cold (KID qi or yang xu)
Yellow, Big Qty, Thick, Smelly Secretion from the ears + fever
damp heat (SP)
shi earwax
shi heat
Yellow, Big Qty, Thick, Smelly Secretion from the ears + fever + IRRITABILITY
LIV/GB damp heat
Strong muscles
strong SP, QI, & xue
Major Thenar eminence (thumb)
LU & LI master of qi & xue
Swollen Major Thenar eminence
shi
Minor Thenar eminence (pinky)
HT & SI xue circulation & metabolism
Purple or dark Minor Thenar eminence
Cardiovascular
Green Minor Thenar eminence
GI disorders
Index finger tells you
condition of the LU for kids under 2 years old
which index finger do you observe for Boys
left side of the body (yang side)
which index finger do you observe for Girl
right side of the Body (yin side)
If you can see the radial index finger vein at the Tip of finger
Life (Ming) - Most severe (Tou Guan She Jia - through all gates radiating to the tip of the nail)
If you can see the radial index finger vein at the Middle
Qi (qi) severe/deeper - internal condition
If you can see the radial index finger vein at the Bottom
wind gate (feng) - Mild, usually wind cold or wind heat
Color changes to the the radial index finger vein
normal is slightly red & slightly purple (venules) One single vein
Any changes of color or number of veins
pathological
Purple red radial index finger vein
Heat
Bright red radial index finger vein
ext syndrome
Greenish color radial index finger vein
pain syndrome / internal wind condition
Pale radial index finger vein
xu
Dark purple the radial index finger vein
xue stasis / severe condition
Pale + thin + shorter radial index finger vein
cold
Thicker / swollen & longer radial index finger vein
heat & shi
Thin & shorter radial index finger vein
xu cold
Slightly deviated radial index finger vein
mild condition
Circled/bended/many branches radial index finger vein
severe conditions
Center of the Palms correlate to what zang fu
HT, Pc, KID, LIV
Green Center of the Palms
damp heat in the LIV
Red Center of the Palms
heat in HT, PC, LIV
Pale red Center of the Palms
KID xu heat
Daytime Sweat + fatigue + cold body
qi & yang xu
Sweat at night
KID yin xu & HT Qi xu
Sweat when stressed
LIV & HT heat
NAILS are extension of the
sinews (LIV)
Yellow, grey, thick nails & not smooth
damp heat in LIV or SP
Pale, unsmooth nails with ridges, that easily breaks
LIV xue Xu (anemia)
SKIN reflects the condition of
LU, xue (LIV & HT) Connection to emotions & stress
Normal Skin Color
should be normal for race + shiny
Bright Yellow skin
Yang Jaundice (Damp heat) (+sclera & urine will be bright yellow) LIV/GB
Dusky Yellow skin
Yin Jaundice (damp cold) SP & ST
Purple skin
xue stasis
Pale skin
qi & xue xu
Dry skin
xu
skin Swelling that Bounce back from depression
qi stagnation
skin Swelling that when depressed, stays when finger is removed
damp retention (pitting edema)
(Dou chuang) skin rashes with blisters *ex. chicken pox, small pox
HEAT TOXIN (LU)
Macular Eruptions are
skin color change (flat skin lesion)
Red Maculopapular eruptions
yang macular (roseca)
Pale & dark maculopapular eruptions
yin macular (vitiligo or age spots)
Measles (skin rashes with fever) K sounds symptoms (what are they)
cough, conjunctivitis, coryza (runny nose), koplik's spots (grey/white patches in the mouth lining)
Urticaria skin rash
allergic reactions to the weather, food, drugs
White skin rash
wind cold (weather change)
Red skin rash after food
shi heat at the SP & ST
Red skin rash after drugs
toxic heat in the LIV or SP/ST (if taken orally)
Scarlet red (skin lesion with fever + tongue that looks like strawberry)
toxic heat in the LU
Milliaria (prickly heat In the summer) Can be red, or white
SUMMER DAMP HEAT
Erysiplelas (Lesion is red, shinny, swelling, hot & painful)
Group A hemolytic streptococus infection (Toxic heat, toxic fire)
Chan Yao Huo Dan (Herpes Zoster) around the waist fire red
Fire toxin or damp heat
Chronic Eczema
shi zhen (wet rashes) = damp cold (SP qi xu with xue xu)
Acute Eczema
shi zhen (wet rashes) = damp heat
Acne
Xue heat (LU, ST, SP, LIV)
Yong (yang type) red, swelling, hot, painful abscess
Fire toxin or Heat toxin or Shi xue heat
Erysipelas, herpes zoster, scarlet fever, acne if infected
Yong (Yang Type)
deep rooted Pale & hard boil w/ a red line connected with lesion area = Heat toxin obstruct qi & xue circulation
Ding (yang type)
Superficial hair follicle infection /boil Localized, red, hot, swelling, pain = heat toxin or damp heat
Jie (yang type)
Chronic flat abscess w/ Clear, non smelling discharge = Qi & xue xu, with damp cold phlegm
Ju (Yin Type)
Small genitals
KID Jing xu
Large genitals
Strong KID xu
Swl & hot genitals
damp heat (infection) LIV & GB (Shi)
Swl, red, large, painful Anus
Damp heat in the LI
Prolapse of the anus
SP qi sinking
Coughing or vomiting out white, copious, clear Sputum
Cold phlegm
Coughing or vomiting out White, sticky, copious, easily to expectorate Sputum
Damp phlegm
Coughing or vomiting out White, copious, with bubbles & clear Sputum
Wind phlegm
Coughing or vomiting out Yellow (green &/or xue), sticky, difficult to expectorate Sputum
Heat phlegm
Coughing or vomiting out very small qty, sticky, difficult to expectorate Sputum
Dry phlegm
A lot of tears (without crying)
Shi heat (wind heat)
Dry eyes
xu (LIV xue or yin xu)
Watery, clear, copious nasal discharge
cold or qi xu
Thick, yellow, smelling nasal discharge
damp heat or wind heat in the LU
Watery mouth or drooling
SP qi xu
Dryness at the bottom of the tongue
KID yin or essence xu
Spittle coming out while talking
KID qi or yang xu
Vomit
ST qi rebels
Tremulous or deviation or Stiff tongue
LIV WIND, wind phlegm block the meridian (early sign of stroke)
Swl tongue
damp
Red tongue
Heat
meridians with a direct connection to the tongue
KID, HT, SP, LIV, UB, GB
Left side of the Tongue correlates with what Zang fu
GB
Right Side of the Tongue correlates with what Zang fu
LIV
First third (tip) of the Tongue correlates with what Zang fu
UJ HT, LU
Middle third of the Tongue correlates with what Zang fu
MJ, SP/ST
Last third of the Tongue correlates with what Zang fu
LJ: KID, UB, SI, LI
Winter what would the tongue look like
body: more pale & coating: more white
Summer what would the tongue look like
body: more Red
Late evening what would the tongue look like
more pale Tongue (due to exhaustion)
Younger people have what kind of tongue?
Red tongue
Older people have what kind of tongue?
pale & old
Skinny People have what kind of tongue?
pale & thin body
Overweight People have what kind of tongue?
swl with thick body
TONGUE BODY reflects the condition of the
YIN ORGANS, Qi, xue, essence & body fluids)
Pale Tongue body
xu or cold
Red Tongue body
Heat (Shi or xu)
Purple Tongue body
Stag (xue or qi)
Green/blue Tongue body
poisoning (very rare)
Tough tongue shape
Shi
Tender or Delicate tongue shape
xu
Swl tongue
Shi
Swl tongue WITHOUT teeth marks
Shi heat/fire
Swl tongue With teeth marks
Shi damp or phlegm
Thin Tongue
xu
Cracked at the tip of the tongue
HT yin xu
Cracked at the root of the tongue
KID yin xu
Cracked in the middle of the tongue
ST yin xu
Thorny (papular) tongue
Shi
Pale spots on the tongue
cold or xu
Purple spots on the tongue
stasis
Red spots on the tongue
heat
Teeth marks on the tongue
damp, water, phlegm retention
Tongue sores on the tongue
obstruction/Stag (pain)
Red & painful sores on the tongue
heat
Pale not severe pain (Ju) on the tongue
xu
Mirror tongue (no coating, very shiny)
ST yin xu
Veins below the tongue reflect the condition of the
Qi & xue circulation
Light blue Veins below the tongue
normal
Deep purple & engorged Veins below the tongue
xue stasis (shi)
Purple dark & constricted Veins below the tongue
xue stasis due to cold
Stiffness of the tongue
Shi, cold, or obstruction (possible HTN)
Flaccid tongue
Xu of the Qi, xue & yang
Trembling tongue
internal LIV wind
Deviation of the tongue
LIV wind
Short tongue
COLD or qi & xue xu
Protrusion or playing with the tongue
shen disorder & KID (congenital disorder = downs)
Palsy of the tongue (paralysis)
xu
Long tongue
Shi & heat
TONGUE COATING reflects the condition of the
Yang /Fu organs, ST usually
White tongue coat
xu or cold
Yellow tongue coat
heat or Shi
Grey / black tongue coat
severe condition (KID)
Grey black & dry tongue coat
extreme heat
Grey black & moist tongue coat
extreme cold
Thin tongue coating
ext synd or Internal xu condition (ST)
Thick tongue coating
Int shi syndrome or shi pathogen moving deeper inside
Moist tongue coating
Shi Body fluids (damp, water, phlegm)
Dry tongue coating
Xu of body fluids or Shi heat
Sticky greasy tongue coating
Damp phlegm (yin type)
Granular or lose bean curd tongue coating
Food stag or Damp phlegm (yang type)
Middle peeled or geographic tongue coating
ST yin & qi xu
Tip peeled or geographic tongue coating
HT yin xu
Pale, thin body, thin white coating
qi & xue xu
Red tongue, thin body, scanty coating
yin xu heat
Red tongue, swl with teeth marks, thick & yellow, greasy coating
damp heat or phlegm heat
Purple red, purple dark spots, thin white
xue Stag
Red , mirror tongue
yin & qi exhaustion
Pale, swl, teeth marks, tender/delicate, thin white, watery coating
xu with water retentions
Significance of tongue diagnosis
To determine condition of anti-pathogenic qi; To Judge location of disease; To differentiate nature of disease; To estimate prognosis of disease
Pale tongue with thin white coat
xu
Red tongue with yellow coat
shi
Pale tongue, thin white coating, with chills & fever
ext wind cold
Pale tongue, thin, white coating with fatigue SOB
LU qi xu
Pale tongue, yellow coating
xu & heat
Red tongue, yellow coating
heat
tongue Coating: thin to thicker
getting worse
Mirrored to patchy to thin white coating
getting better
Thin white & watery/slippery - to thin white without water
getting better
Normal Voice
Even tone & natural, Non-emotional (relaxed status)
Wood - Liv sounds
(Jiao) Shouting
Fire - HT sounds
(Zhi) Laughing
Earth - SP sounds
(Gong) Singing
Metal - LU sounds
(Shang) Wimpering
Water - KID sounds
(Nii) Groaning
Sudden or ext pathogen triggered Hoarseness
LU shi
Gradual loss of voice
KID xu or LU xu (smokers)
Loud Voice
shi & heat (HT or LU)
Low & inconsistently voice
HT, LU & KID qi xu
Child Crying @ High volume, high qty
shi (Too much food)
Child Crying @ Low & incontinuously
xu
Groaning
KID Xu
Groaning due to Chest pain
HT
Snoring
Damp phlegm block airway (shi) = sleep apnea
Snoring during Sickness & older
SP qi & LU qi xu
Reluctance to talk
HT Qi xuA
Slurred Speech
Shen blocked by Phlegm obstructing the HT orifices
Zheng Shen - repeated speech in feeble voice (mumbling)
HT qi xu
Delirious Speech - nonsense w/out clear consciousness @ high volume
HT heat or Fire
Talking to oneself
HT qi xu - HT cannot keep shen inside
Manic & deranged speech
HT heat or fire
Breathing reflect the condition what zang fu
LU, KID, HT, LIV
Chronic Panting w/ more exhalation less inhalation
KID xu cannot grasp LU qi (xu)
Acute Panting
LIV insulting the LU (shi)
Wheezing + Phlegm obstructing the airway (shi)
LU & LIV
Wheezing + Xu condition
LU & KID
Coughing + shi LU QI rebel
damp phlegm obstructing the LU
Chronic Cough + Xu
LU Yin xu w/ heat
Shortness of Breath
KID, LU, or SP qi xu
Feeble breathing, low voice or incontinuous talking (weak qi)
LU qi xu
Sighing
LIV QI STAGNATION
Loud & continuously cough
shi heat in LU
Loud & continuously Cough w/ yellow phlegm
shi heat in LU
Low & incontinuously cough
qi xu
Low & incontinuously cough w/ copious phlegm
LU QI XU w/ Cold
Vomiting
ST QI rebellion
Loud & continuously vomiting
shi heat in ST
Low & incontinuously vomiting
cold in the ST or ST xu
Continuous vomiting clear liquid
Cold in SP or ST
Suddenly & loud & continuously hiccup
shi heat in ST
Gradual onset, long duration hiccup, inconsistently other severe diseases
Kid & ST xu
Belching
ST QI rebel (due to LQS or SP QI Xu)
Sneezing due to seasonal changes or when pt wakes up (allergy)
wei, LU, SP or KID qi xu
Borborygmus w/ no significant pathology
hungry (empty ST)
Borborygmus -Not hungry w/ sounds in ST (usually w/ vomits too)
damp phlegm shi or water retention in the ST
Borborygmus Not hungry w/ sounds in SI
cold damp or xu of the SI (cannot separate clear / turbid fluids) - SP yang XU)
Wood pathological smells
rancid
Fire pathological smells
burned
Earth pathological smells
sweetened
Metal pathological smells
rank (bad fishy)
Water pathological smells
putrid (dead rat)
Bad Breath
heat/shi LU, SP/ST
No smell to Breath
xu or cold
Smelling Sweat
Shi of damp heat
No smelling copious sweat
HT qi xu
No smell of night sweat
yin xu
Phlegm & nasal mucus Clear, copious, no smell
cold & xu
Phlegm & nasal mucus Yellow & purellent
damp heat
Smelly Urine & stool
damp heat
Non smelly Urine & stool
xu & cold
Very bad Smelling Menstrual & Vaginal discharge
shi damp heat
Non smelly Menstrual & Vaginal discharge
xu & cold
Sickroom smells like Rotten apples (acetone)
(diabetes) internal yin xu w/ dryness
Sickroom smells like Ammonia
(KID failure) KID yin, yang & qi xu
Sickroom smells like xue
(xue disorder) leukemia
Acute leukemia
xue heat
Chronic leukemia
xue xu
Chills (covering up does not help with the feeling of cold)
ext condition
Fever (Pt feels hot, but doesn't always show up on the thermometer)
xu heat
Consistent heat measured on the thermometer
Shi heat
Chills & fever accompanied together
ext syndrome
More chills than fever
ext wind cold
More fever than chills
ext wind heat
Both mild chills & fever & adversion to wind + sweating
ext wind
Alternating chills & fever
half int/ half ext (shao yang syndrome)
Fever without chills
internal heat
High fever without chills
shi internal heat
With constipation
yang ming shi heat
With sweat, thirst, big pulse
qi level stomach heat
The longer you touch the skin, the higher the temperature you feel
Damp heat
Low fever without chills
xu internal heat
Low fever without chills Worse at late afternoon or at night (night sweat)
xu tidal fever
Chills without Fever
internal cold
Intense or sharp pain (worse with pressure)
Shi cold
Dull pain (better with pressure)
Xu cold
Without sweat + ext syndrome
ext wind cold (shang han) use Ma Huang Tang
With sweat + ext syndrome
ext wind heat or ext wind attack
Spontaneous sweat (on exertion) at daytime or when pt is awake
qi or yang xu (HT or SP qi xu)
Night sweats (or at night) with 5 center heat sensation
yin xu (HT, KID, LIV Yin xu)
Profuse Thick or sticky sweat
Shi heat
Temp does not drop with sweating (+ constipation)
damp heat
Profuse Thin & cold sweat w/ big pearl like sweat drops (cold body & limbs )
Yang Collapse
Profuse Oily & sticky sweat with warm body & thin constitution
Yin collapse with empty heat
Zhan Han (sweating following shivering)
pathogen & anti-pathogen are fighting strongly
Sweating mostly at the head
middle jiao pain.
Sweating on one side of the body
yin / yang imbalance
Sweating on the right side
yin
Sweating on the right side
yang
Sweat on the limbs only
SP
Sweat on the Palms or soles
kidney & heart
Distending (bloating) pain
Shi
Distending pain in the hypocondrial
LQS
Distending headache
Liver Yang Rising or GB heat
Heavy pain
Damp
Heavy pain in epigastric, & lower jiao
SP damp
Heavy pain in the limbs
SP damp
Stabbing pain
xue stasis
Stabbing pain in the chest or hypochondria
HT or LIV xue stasis
Cancer
xue stasis
colic pain (intense stretching pain coming in waves)
Stag of qi & xue (Kidney stone or Parasites)
Burning Pain
heat (shi or xu)
Dull burning pain
xu heat
Strong burning pain
shi heat
Cold Pain
cold or yang deficiency
Sharp stabbing & spastic
Cold Pain
Dull Pain
xu condition
Comes & goes
dull pain
Referring Pain
Qi traveling throughout dermatome
Pain in the Chest through jaw & arm
HT xue Stag
Hypocondrial Pain more on the left side (which Zang fu involved)
SP
Headache
all YANG Ch go to the head + Du + LIV
Frontal Headache (which Zang fu involved)
ST & LI
Side Headache (which Zang fu involved)
GB
Back Headache (which Zang fu involved)
UB
Top Headache
DU & LIV
Chest pain (which Zang fu involved)
HT & LU
Chest pain on the Left side w/ pressure
HT xue stasis
Chest pain while breathing
LU qi xu
Hypochondria pain (which Zang fu involved)
LIV & GB
Distending & wondering
LQS
Fixed & stabbing
xue stasis
Colic worse w/ greasy food
GB stones
Pain so intense they want to kill themselves
parasites
On the left side
pancreas/SP (acute pancreatitis)
Epigastria pain (which Zang fu involved)
ST
Pain after a big meal
Food Stag
Pain after raw or cold food
cold in the ST
Emotions affecting digestion
LIV overacting on SP/ST
Hunger w/ no desire for food
ST yin xu (atrophic gastritis)
Abdomen pain (which Zang fu involved)
SP/ ST
(Da Fu) Abdomen pain above the umbilicus area @ center (which Zang fu involved)
SP/ ST
(Xiao Fu) Abdomen pain Below the umbilicus area @ center (which Zang fu involved)
SI, UB, LI
(Shao Fu) Abdomen pain Lateral abdomen (which Zang fu involved)
LIV, GB & LI (uterus w/ menstruation)
Back pain (which Zang fu involved)
KID
Limb pain (which Zang fu involved)
SP (muscles)
Heavy sensation
damp
Dull pain
qi or xue xu
Joint pain (which Zang fu involved)
LIV
Xing bi (moves from joint to joint)
WIND
Tong bi (painful & contracting Joint pain)
COLD
Zhuo bi (fixed & heavy Joint pain)
Damp
Re bi
heat
Acute onset body pain w/ chills & fever
exterior
Chronic body pain w/ gradual onset
internal disorder
Eye pain (which Zang fu involved)
LIV
Eye pain + vision damage
glaucoma
Dizziness & vertigo
LIV wind caused LIV yang rising, xue xu, extreme heat, wind phlegm, live yin xu
Numbness
SP Qi xu &/or LIV xue xu, Phlegm or damp obstruction
Heavy sensation
Damp retention, water retention, Phlegm retention
Bloating
SP qi xu or food accumulation or LQS
Ears (connected to which Zang fu)
KID, GB, SJ, LIV, SI, SP
Tinnitus xu type -Low volume, High Pitch- (which Zang fu involved)
KID
Tinnitus Shi type -High volume, Low Pitch- (which Zang fu involved)
GB, SJ, LIV, SI, SP
Acute Tinnitus
LIV fire blocks the GB & SJ Ch
Congenital Tinnitus
KID essence xu
Chronic Tinnitus
KID essence decline (used KID TONIC)
Eye (which Zang fu involved mostly)
LIV
Blurred vision
LIV xue xu & KID essence xu
Photophobia (migraine)
LQS or LIV yang Rising or LIV heat
Conjunctivitis
wind heat affecting the LU or LU heat
Pressure in the eyes
LIV Yang Rising or LIV Fire
If the vision changes plus pressure in eye
send to specialist
Dryness of the eyes
Yin xu or Heat or LIV Xue xu
Appetite involves mostly
GI system (SP/ST)
Condition improves after eating
xu conditions
Condition gets worse after eating
shi conditions
If pt likes to eat cold food
hot
If pt likes to eat hot food
cold
Poor appetite
SP dysfunction
Shi appetite & getting hungry easily
ST fire (or LIV affecting the SP)
Hunger with no desire to eat or eating a small amount of food
ST yin xu
Difficulty in swallowing
qi stagnation (LIV overacting on ST or ST qi xu)
Indulgence by children in raw rice, soil etc (PICA)
Parasites in the intestines
Xu zhong (middle jiao qi gradually disappearing)
post natal foundation disappearing (dying patient)
Tasteless
xu of SP
Sour taste in mouth
LIV over acting on the SP/ST
Bitter taste in mouth
HT (worse at the morning) or LIV/GB (bitter all day long) *heat & shi for both HT & GB)
Sweet taste in mouth
SP xu
Sticky & greasy & SWEET taste in mouth
damp obstructing SP
Pungent taste in mouth
LU qi xu or shi condition
Salty taste in mouth
KID (any) xu
Greasy taste in mouth
damp heat (fried foods)
Hot taste in mouth
heat condition
Foul taste in mouth
ST heat
Fishy taste in mouth
KID xu with water retention or Phlegm/damp in the lung
Metallic taste in mouth
respiratory disorder OR antibiotics
Urine taste in mouth
KID disorder (renal failure or severe diabetes)
Lack of thirst
body fluid is not damaged (COLD condition)
Thirst & drinking a lot
shi heat
Thirst & wasting syndrome xiao ke (diabetes)
internal dryness (yin xu)
Thirst w/ drinking very little or w/out drinking
blockage prevents proper water distribution (Due to damp heat damp &/or water &/or phlegm retention xue Stasis * yin xu with sipping water)
Vomit
ST qi rebels
Sour vomiting
LIV overacting on ST
Bitter Vomiting
GB/LIV heat overacting on ST
Clear-watery vomiting
water retention in the ST
Vomiting soon after eating
Food Stagnation
Morning sickness
ST qi rebel & CHONG meridian qi rebel
Insomnia
HT xu (cannot house the shen) empty fire
Wake up early in the morning & cannot fall back asleep
HT & KID yin xu
Tossing/turning & waking up with a bad mood
LIV & HT xue xu with LIV heat
Waking up in the middle of the night with worry & thinking (student syndrome)
HT xue xu & SP qi xu
Waking up at the night w/ scaring sensation w/ palpitation & anxiety
HT & GB dysfunction
Never sleep (schizophrenia)
HT & LIV fire
Insomnia + Epigastric bloating, distention & pain after meal
food stagnation
Somnolence (too easy to sleep)
yang xu (too much yin)
Somnolence due to Shi
Food stagnation with damp & phlegm retention (shi yin) * Constitutional (narcolepsy & sleep apnea)
Somnolence due to Xu
(HYPOthyroid) SP qi & SP yang xu * KID Yang xu
Urine that is Copious, clear, often
KID qi/yang xu
Urine that is Big qty, Nocturnal, clear
KID qi/yang xu (BPH-benign prostate hyperplasia)
Urine that is Big qty, freq, cloudy, big appetite, big thirst, weight loss
xiao ke
Urine that is Small qty, frequent, urgent, painful, stream stops in the middle, deep yellow color or with blood
damp heat in the UB (urinary stone)
Urine that is Scanty, urgent, painful, blood, + irritable, insomnia, ulcer on tongue
HT fire transfering heat to the SI
Stool (which Zang fu involved mostly)
SP, ST, LI, SI, KID, LIV
Normal stool frequency
once a day once every other day or twice a day
Normal stool shape
smooth
Constipation is less frequent than
every other day
Constipation can indicate
heat qi xu dryness LQS xue/body fluid xu * cold
Diarrhea is BM more than
twice a day (loose or watery)
Diarrhea can indicate
damp KID yang xu Damp heat emotional stimulation fear anger Food stagnation
Alternating diarrhea/constipation
anger (LIV)
BM with burning sensation @ anus
HEAT
BM with tenesmus (bowel doesn't feel empty)
damp heat @ LI
BM with incontinence of stool
SP qi & KID yang xu
BM with prolapse of the anus
SP qi xu - sp qi sinking
BM with xue and mucus
Damp heat
BM with undigested food with no smell
SP qi xu or cold (SP yang xu or KID yang xu)
BM with undigested food with smell
food stagnation
Menstruation (which Zang fu and meridians involved)
KID LIV SP HT Uterus * Chong & Ren meridian
At what age do women have menstruation in TCM
14-49 years old
Reproductive age in USA
12-52 yo
Black women can have period at what age?
7-8
Normal menstruation Cycle
28 days +/- 7 (21-35 days)
Early Menstruation is less than
21 days
Early Menstruation can be caused by
Heat or SP qi xu
Late Menstruation is more than
35 days
Late menstruation can be caused by
LQS Xue xu / jing xu Cold
Irregular Menstruation diagnosis is considered
no routine for periods to come
Irregular Menstruation can be caused by
LQS * KID essence xu
Excess heat can cause the amount of menstruation to become
large
Xu heat can cause the amount of menstruation to become
scant
SP Qi can cause the amount of menstruation to become xu
large
LQS can cause the amount of menstruation to become
scant
Xue xu / jing xu can cause the amount of menstruation to become
scanty
Excess Cold can cause the amount of menstruation to become
scanty
Xu cold can cause the amount of menstruation to become
large
LQS (LIV fire) can cause the amount of menstruation to become
large
KID essence xu can cause the amount of menstruation to become
Scant or large
Excess heat can cause the menstruation color to become
bright red
Xu heat can cause the menstruation color to become
pale red
SP Qi xu can cause the menstruation color to become
pale red
LQS can cause the menstruation color to become
purple/red
Xue xu / jing xu can cause the menstruation color to become
pale
Excess Cold can cause the menstruation color to become
brown red
Xu cold can cause the menstruation color to become
pale red
LQS (LIV fire) can cause the menstruation color to become
bright red
KID essence xu can cause the menstruation color to become
pale
Excess heat can cause the menstruation quality to become
thick
Xu heat can cause the menstruation quality to become
thin
SP Qi xu can cause the menstruation quality to become
thin
LQS can cause the menstruation quality to become
thick with clots
Xue xu / jing xu can cause the menstruation quality to become
thin
Excess Cold can cause the menstruation quality to become
thick with clots
Xu cold can cause the menstruation quality to become
thin
LQS (LIV fire) can cause the menstruation quality to become
thick
KID essence xu can cause the menstruation quality to become
thin
Excess Cold will cause the menstrual pain
worse with pressure
Xu cold will cause the menstrual pain
Better with pressure
Leucorrhea in general is considered
Dampness
Normal Leucorrhea can be described as
Thin white during ovulation only
Damp cold causes leucorrhea plus
heavy sensation in the body and cold sensation
Damp Heat causes leucorrhea plus
heavy sensation or itchy / burning - could have fever
Toxic damp heat with leucorrhea
cervical cancer(HPV) or endometrial cancer in menopausal
SP Qi xu with damp causes leucorrhea plus
fatigue poor appetite diarrhea
Damp cold can cause the color of the leucorrhea to be
white
Damp Heat can cause the color of the leucorrhea to be
yellow
SP Qi xu with damp can cause the color of the leucorrhea to be
white
Damp cold can cause the amount of the leucorrhea to be
big
Damp Heat can cause the amount of the leucorrhea to be
Big
SP Qi xu with damp can cause the amount of the leucorrhea to be
big
Damp cold can cause the smell of the leucorrhea to be
less odor
Damp Heat can cause the smell of the leucorrhea to be
Bad smell
SP Qi xu with damp can cause the smell of the leucorrhea to be
no odor
Damp cold can cause the consistency of the leucorrhea to be
thick
Damp Heat can cause the consistency of the leucorrhea to be
thick
SP Qi xu with damp can cause the consistency of the leucorrhea to be
Thin
Good pregnancy (which Zang fu involved mostly)
good KID LIV SP HT Uterus * Chong & Ren meridian
Morning sickness is considered to be
ST * Chong and Ren QI Rebellion
Morning sickness w/ jaundice and tachycardia is considered to be
mom's health is at risk
Wu Ruan - five softness (Head, Neck, Limb, Muscle, Mouth - cannot latch)
qi and xue xu
Wu Chi - Five retardation (Standing Walking Hair eruption teeth eruption speech)
KID jing xu (down syndrome) - easily have HT and/or LIV Fire - high emotional state
Left wrist pulse (on the patient) shows the condition of the
Blood
Left Cun (near wrist crease) pulse (index finger) - shows the condition of the
HT
Left Guang (middle) pulse (middle finger) - shows the condition of the
LIV
Left Chi (most proximal) pulse (ring finger) - shows the condition of the
KID (UB & SI)
Right wrist pulse (on the patient) shows the condition of the
QI
Right Cun (near wrist crease) pulse (index finger) - shows the condition of the
LU
Right Guang (middle) pulse (middle finger) - shows the condition of the
SP
Right Chi (most proximal) pulse (ring finger) - shows the condition of the
KID (UB & LI)
Push deeper into the wrist pulses to check condition of the
zang organs
Push more shallow into the wrist pulses to check the
fu organs
Light Finger force of practitioner
weight of 3 beans
Middle Finger force of practitioner
weight of 6 beans
Heavy Finger force of practitioner
weight of 9 beans
Spring affects the pulses by
slightly wiry (LIV GB)
Summer affects the pulses by
speeds up (rapid due to HT fire)
Autumn affects the pulses by
Floating (LU is superficial)
Winter affects the pulses by
slow and deep
Men's pulse is generally
strong and slower
Woman's pulse is generally
Weak and fast
Younger patients have what type of pulse?
faster
Old patients have what type of pulse?
slower
Skinny patients have what type of pulse?
thready and rapid (empty fire)
Heavy patients have what type of pulse?
slow and slippery
Angry patients have what type of pulse?
rapid and wiry
Patients that are happy have what type of pulse?
over relaxed and slow
Not superficial, not deep, not fast, not slow Pulse
the normal pulse
Pulse rate that is 4 beats per on breath in and out (60-100 beats per minute)
the normal pulse
Consistent, regular, soft, calm pulse
the normal pulse
When gently touching skin, you get a clear picture of pulse & when heavy force is used, PULSE becomes weaker "Wood on water" (Skin level)
Superficial Pulse (Fu Mai)*
Superficial Pulse (Fu Mai)*Indicates
exterior syndrome
"Stone on water" pulse
Deep pulse (Chen Mai)*
Location of "stone on water" pulse
deeper level
Deep pulse (Chen Mai)* Indicates
interior syndrome
A pulse with less than 4 beats for one breath in and out
Slow Pulse (Chi Mai)*
Slow Pulse (Chi Mai)* Indicates
Cold
More than 4 beats for one breath in and out
Rapid Pulse (Shu Mai)
Rapid Pulse (Shu Mai) Indicates
Heat
All three pulse positions are weak
Empty pulse (Xu Mai)*
Empty pulse (Xu Mai)* Indicates
Xu
All three positions of the pulse are strong
Full pulse (Shi Mai)*
Full pulse (Shi Mai)* Indicates
Shi
very smooth like water on the floor "pearls on plate"pulse @ any level (mostly middle level)
Slippery/ Rolling pulse (Hua Mai)*
Slippery/ Rolling pulse (Hua Mai)* Indication of pulse
damp Phlegm water retention Pregnancy excess heat food stagnation Yang within Yin
Stopping, not smooth pulse
Hesitant pulse (Se mai)*
Location of Hesitant pulse (Se mai)*
Middle level
Indication of Hesitant pulse (Se mai)*
Blood Stagnation or stasis * Severely damaged body fluids, essence and yin
pulse extends past the index and ring finger
Long Pulse (Chang Mai)
Indication of Long Pulse (Chang Mai)
excess and heat
Pulse that is shorter than the index and ring finger
Short pulse (Duan Mai)
Indication of Short pulse (Duan Mai)
cold
Pulse that feels like sea waves - comes in strong, fades weakly
Surging (over flowing) Pulse (Hong Mai)*
Location of Surging (over flowing) Pulse (Hong Mai)*
mostly in the middle
Indication of Surging (over flowing) Pulse (Hong Mai)*
Stomach heat or yang ming syndrome
Thin and fine pulse
Thready (thin or fine) pulse (Xi Mai)*
Indication of Thready (thin or fine) pulse (Xi Mai)*
Xu (qi, xue, yin, and yang), retention of water or damp (usually with edema)
very thready very soft if you push softly on the pulse, it disappears
Minute Pulse (Wei mai)
Indication of Minute Pulse (Wei mai)
severe Xu
Description of Tense (Tight) Pulse ( Jin Mai)*
like twisted ropes - short and constricted
Indication of Tense (Tight) Pulse ( Jin Mai)*
cold & pain
A pulse like string instruments - straight and long
Description of String-taught (wiry) pulse (Xuan Mai)
Indication of String-taught (wiry) pulse (Xuan Mai)
Liver Qi Stagnation GB disorders Pain retention of the damp and phlegm obstructing qi malaria *
Exterior syndrome which of the following is the most important
Chills
Which indicates the exterior syndrome
Chills and fever
Which indicated the interior heat syndrome
Fever without chills
Which indicated the interior cold syndrome
Chills without fever
Which indicated the shao yang syndrome
Alternate chills and fever
A patient has more chills than fever, no sweating, thin white coating and superficial and tight pulse
exterior wind Cold
A patient has chills that are alleviated by covering himself up, a pale swollen tongue with teeth marks and thin white and slippery coating and deep weak slow pulse
interior xu cold
Constant high-grade fever, a lot of sweating with constipation and red tongue with yellow thick dry coat
interior shi heat
Low grade fever getting worse in the afternoon or night or only occurring in the afternoon indicates
yin xu
Constant low-grade fever that does not drop after sweating indicates
damp-heat
A fever with spontaneous sweat and lassitude indicates
qi xu
Yin xu syndrome often companies with
night sweating
HT & KID yin xu can especially have
sweating at the palms and soles
Which sweating can indicated turning point of disease process
zhan han (sweating following shivering)
Oily sweat on forehead, or profuse cold sweat or pearl-like drop sweat with cold extremities during a severe illness indicates
collapse of yang
Sticky greasy and profuse sweating with warm body and extremities indicated
collapse of yin
Sweating appearing in the day time indicates
yang xu
Distending headache is due to
Liver yang rising
Heavy abdominal pain with thick and greasy coating is due to
dampness
Stabbing chest pain with a purplish tongue is due to
blood stasis
Dull pain all over with feeling of tiredness is due to
qi and xue xu
Fixed joint pain with swelling, heavy and numbness indicates
dampness
Wandering joint pain from joint to joint indicates
wind
Fixed and very painful joint
cold
Hot and swelling joint paint indicates
heat
Severe dizziness when everything seems to sway and the person loses balance due to
internal wind
Severe lower back pain aggravated during cold and damp weather, alleviated by application of heat is due to
external wind and damp
Continuous and dull lower back pain is due to
KID xu
Sudden onset of tinnitus, aggravated by pressing ears and a red tongue with yellow coat indicates
liver fire
Insomnia in the sense of not being able to fall asleep with soreness and weakness at the lower back, night sweats, and poor memory
disharmony between HT & KID
Insomnia in the sense of waking up many times during the night with poor appetite, lassitude, and loose stool indicates
SP & HT xu
Insomnia in the sense of waking up during the night with scaring, palpitation, anxiety and bitter taste in the mouth indicates
disorder of the GB
Insomnia in the sense of restless sleep during the night with epigastrium and abdominal distention and this greasy coating indicates
retention of food
Falling asleep after eating indicates
SP qi xu
A general somnolence with heavy sensation of body and greasy and white coating indicates
retention of dampness
Extreme somnolence with lassitude and cold body and limbs indicates
KID yang xu
Alternation of constipation and diarrhea indicates
LIV overacting on SP
Cock-crow diarrhea or early morning diarrhea indicates
KID and SP yang xu
Constipation with small, bitty stool like goat's stools indicates
LQS & heat in the LI
Diarrhea with mucus in the stool and tenesmus indicates
damp heat in the LI
Enuresis or incontinence of urine or very frequent and copious urination indicates
kidney xu
White leucorrhea with no smell indicates
Damp cold and SP qi xu
Painful urination and difficult urination with blood or hot sensation indicates
damp heat in UB
A yellow leucorrhea with foul smelling indicates
damp heat in the uterus
A yellow leucorrhea with pus and blood in a woman after menopause indicates
toxic damp heat in the uterus (cancer)
Vomiting during pregnancy indicates
disorders of ST and Chong meridians
Miscarriage with dizziness, tinnitus, and lower back pain indicates
KID xu
A heavy menstruation with thirst and feverish body indicates
heat in the blood
A child with five retardation indicates
KID xu