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Traditional Chinese Medicine Final
Terms in this set (106)
Five Element diagnosis, 8 Principles, internal organs, pathogenic factors, the vital substances, or other diagnostic processes
Interior (deep pulse)
Deficient (weak pulse)
Exterior (superficial pulse)
Excess (overly strong pulse)
Sudden onset affecting the exterior of the body, sensitivity to Cold or Wind, slight fever, thin coating on the tongue and a superficial pulse.
Often related to an infectious or contagious disease.
Longer term onset as the pathogen works its way into the interior of the body. In most cases the internal organs are affected and signs and symptoms of channel and organ disharmony are seen. (See symptoms of each organ system disharmony.)
Chronic conditions and often concern a person's constitutional tendencies or basic emotional life.
Aversion to Cold, pale tongue, preference for hot drinks, pale face, thin pulse.
Aversion to heat, red tongue, preference for cold drinks, flushed face, full pulse.
Not enough Qi to ward off pathogenic factors. Deficiency manifests in the body in different ways including deficiency of Qi, deficiency of Blood, Deficiency of Yin or Yang.
Are usually chronic in nature.
Symptoms are varied but include; emaciation (abnormal thinness caused my lack of nutrition or by disease), listlessness, feeble breathing, loss of strength, shortness of breath, spontaneous sweating, night sweats, incontinence, and pain that is alleviated by pressure.
Frail and weak movement; ashen, pale, or sallow face; partial and incomplete engagement w/life; shallow breathing; pain that is relieved by pressure; spontaneous sweating; copious urination or incontinence; pale tongue material w/little or no moss; and an empty, thin, or otherwise weak pulse
hyperactivity of Qi in the body. Manifests in the body in different ways including excess Qi, excess Blood, Excess Yin or Yang.
Can be either chronic or acute.
symptoms are varied but include; agitation, loud voice, heavy breathing, fullness and/or bloating in the chest and/or abdomen, pain aggravated by pressure, constipation, irritability, thick tongue coating and full pulse (wiry, slippery, or strong).
Yin & Yang
are a pair of principals used to generalize categories of syndromes
Three positions on each wrist
Qi: Kidney Yin
Qi: Kidney Yang
(Three Levels or Depths of the Pulse)
Reflects state of qi, indicates an exterior pathogen, provides insight to the functions of the Heart and Lungs.
(Three Levels or Depths of the Pulse)
Reflects the state of the qi and indicates disharmony of the Stomach and Spleen
(Three Levels or Depths of the Pulse)
State of yin, interior organs, interior diseases, reflects condition of the Liver and Kidneys
one of the original set of four diagnostic methods that are described as an essential part of traditional Chinese medical practice
general observations of the patient, including facial expression; skin color and texture; general appearance, and the shape, color, and distinctive markings of the tongue and the nature of its coating; and smelling (noting any unusual smell of the body, mouth, or urine)
to the quality of speech (including responsiveness to questions, rapidity of talking, volume of the voice); to the respiration; and to sounds of illness, such as coughing, gurgling from the intestines
obtaining information about the patient's medical history and their symptoms & signs, such as chills/fever, perspiration, appetite and dietary habits, elimination, sleep, and any pains; also, for women inquiring about menstruation, pregnancy, leukorrhea and other gyno-obstetric concerns.
Inspection Shen (Spirit)
Observing and tuning in to a patient's ____ is particularly important to help determine the overall state and prognosis of an imbalance. The ____ gives vital information about vitality, and mental, emotional, and spiritual well being. The _____ shows in the eyes, complexion, and state of mind.
Appearance and Demeanor
Includes posture and movement of body as a whole and of individual parts, e.g. eyes, face, mouth, limbs, fingers.
-relates to Blood or Kidney Jing.
-Hair loss and premature graying of the hair may be due to Blood Deficiency or Kidney Jing Deficiency.
-Dandruff usually relates to Liver Blood or Yin Deficiency
-Two light and shallow lines between the eyebrows indicates a healthy Liver.
-Two deep lines or three line between the eyebrows can indicate a Liver problem, such as frequent anger
-A single line can indicate a more serious Liver problem. This can occur after considerable hardship
Represents the strength of the Qi and Blood of the Zang Fu organs, and especially the Heart. The complexion should be moist and lustrous
-The eyes reflect the state of the Shen and Jing. It is said, "The Jing of the five Yin and six Yang organs ascends to the eyes." We observe the "expression" of the eyes to see the spirit.
-The Liver opens to the eyes (sense organ associated with Wood element)
-Eyesight changes tend to relate to the Liver
Teeth and Gums
Teeth are considered an extension of bone and are influenced by Kidneys. Gums are influenced by the Stomach.
-Observe color, discharge, skin tone, any spots or discoloration.
Flesh around wrists and ankles should be a good color and firm: indicates a good condition of the fluids
-relates to the Lungs in Five Element Theory.
-indicates the condition of the Blood (and therefore the Liver, which stores Blood).
● Many ____conditions relate to Heat in the Blood or stasis of Blood and may relate to Liver.
● ____disease can also relate to Heat in the Stomach which can cause Blood Heat
Sound of the Voice
● A loud and course voice indicated an Excess pattern
● A weak and low voice indicates a Deficient pattern
● A lack of desire to speak indicates a Deficient Cold pattern
● Incessant talking indicates a Heat pattern
Hoarse Voice or Loss of Voice
● Acute onset of a hoarse voice is usually indicative of Exterior Pathogenic Wind, especially if the throat is red and sore.
● A chronic or recurrent hoarse voice usually indicates an interior disease such as Deficient Lung Qi or Lung Yin
● A gradual loss of voice also usually indicates Deficient Lung Qi or Yin
Loud Voice with Incoherent Speech
● This is usually accompanied by impaired mental function and indicates Heat is disturbing the Shen (Spirit/Mind)
5 Element Associations in the Voice
● Shouting is a Liver imbalance
● Constant Laughing is a Heart imbalance
● Chronic weeping, whimpering, sadness is an Spleen imbalance
● Groaning is a Kidney imbalance
● Coughing is usually related to Lung's ability to properly disperse and descend Lung Qi, leading to rebellious Lung Qi
● Wheezing or rattling from the Lung is usually mucus or Phlegm in the Lung
● Explosive or very loud coughing indicates an excess pattern
● A weak cough indicates a Deficient pattern
● A dry hacking cough is usually indicative of Heat and Dryness in the Lung
● An unproductive cough with small amounts of sticky sputum indicates Heat scorching the fluids
● Loud and coarse breathing indicates an Excess pattern
● Shortness of breath, weak and/or difficult breathing may indicate the Kidney is too weak to grasp the Qi. This would include a Deficient type asthma.
● Loud and coarse breathing w/ a preference for exhaling indicates pathogens retained in the Lung. This would include Excess type asthma
Usually related to Liver Qi Stagnation
Usually related to Rebellious Stomach Qi
● Usually related to Deficient Spleen Qi or Deficient Spleen Yang, especially if there is loose stools and bloating.
● This can also be due to Liver Qi Stagnation invading the Intestines
In general, secretions and excretions related to Excess Heat type patterns have a foul odor. Less odorous secretions and excretions usually relate to Cold and Deficiency type pattern
● Urgent diarrhea w/foul stools indicates Damp-Heat in the Large Intestine.
● Belching w/a foul or sour odor indicates retention of food.
● Leucorrhoea w/a strong or foul odor indicates Damp-Heat in the Lower Jiao affecting the Uterus.
● Chronic Halitosis (Bad breath) indicates Stomach Heat
5 Element Associations of Smell
● Rancid "goatish" odors are related to the Liver
● Scorched or burned odors are related to the Heart
● Fragrant, sweet, or cloying odors are related to the Spleen
● Rank or Rotten odors are related to the Lung
● Putrid odors are related to the Kidney
Questioning or interviewing a patient during intake covers many topics, including:
● Past medical history
● Origin of the current problem
● Living and environmental conditions
● Current and past emotional issues, including family relationships, partner relationships, work issues etc.
● Eating patterns and Diet
● Specific questions relating to bodily systems
Ten areas of questioning
Chills and Fever
· Head and Body
· Thorax and Abdomen
· Food and Taste
· Stools and Urine
· Ears and Eyes
· Thirst and Drink
· Gynecological Conditions
· Pregnancy and Childbirth
Lower Jiao (Tongue Diagnosis)
The Base of the tongue corresponds to the Kidney, Urinary Bladder, Large Intestine and Small Intestine Meridians.
Middle Jiao (Tongue Diagnosis)
The sides of the tongue correspond to the Liver and Gall Bladder meridians. Some theories place the Gall Bladder on the patients left side and the Liver on the patients right side.
Middle of the tongue (Tongue Diagnosis)
corresponds to the Stomach and Spleen Meridians.
Upper Jiao (Tongue Diagnosis)
The tip of the tongue corresponds to the Lung and the Heart Meridians.
- The Luo connecting channel connects to the root of the tongue.
- An internal branch of the primary channel spreads over the lover surface of the tongue.
- The tongue is penetrated by the ______Divergent channel
- An internal branch of the primary channel terminates at the base of the tongue.
- A branch of the muscle/sinew channel binds to the root of the tongue
San Jiao Channel
A branch of the San Jiao muscle channel links with the root of the tongue
will give the most accurate color of the tongue body and coat. If sunlight is not available, use a second light source such as a small flashlight to compare the tongue color to the original light source
The tongue should be extended in a relaxed manner, and should not be held out for an extended duration.
Food and Drink
such as coffee, green tea, and candy may alter the color of the tongue coating.
Some patients may brush their tongue to help freshen their breath or as an Ayurvedic practice. Ask the patient not to brush their tongue, at least the day of their TCM tongue diagnosis
there may be more Dampness present in the tongue coating, leaving it slightly thicker and light yellow.
Fall or Autumn
the tongue may be thinner w/a coating that is more dry.
there may also be more moist or damp presenting in the tongue.
the tongue should be normal.
Time of Day
The coating of the tongue usually becomes thinner as the day progresses, while the color of the tongue body becomes more red and shiny.
In the elderly, Qi and Blood Deficiency is more common, so the tongue may present with dryness and cracks.
Infants tend to have white thick coating that is easily removed, peeled tongues are also common
patients usually have more Damp and/or Phlegm and therefore their tongues may be larger and lighter in color.
patients tend towards redder tongues
approach is the understanding of self development and self cultivation. Without this emphasis on healing oneself, a person could not develop the insight and intuitive understanding to penetrate the subtleties of perception
Huang Di Nei Jing
"Maintaining order rather than correcting disorder is the ultimate prinicpal of wisdom. To cure disease after it has happened is like digging a well when one already feels thirsty, or forging weapons after the war has begun."
The circulating pathways of the 12 Meridians flow from the face to the feet, from the feet to the chest, from the chest into the hands, and from the hands back to the face.
pass along the inward side of the limbs and along the front of the body. It has already been mentioned that the pathways leading to or from the arms are called Hand Meridians, and those that descend to the legs or ascend from the legs are the Foot Meridians.
three Yin foot meridians
(Liver, Kidney, and Spleen) travel from the foot to the chest. This describes the circulation of energy over the entire body and delineates the pathways in which Qi flows.
three Yin hand meridians
(Lung, Heart, and Pericardium) will flow from the chest to the fingertips, upward along the forward portion of the arm
flow along the outward side of the limbs and along the back of the body.
three Yang foot meridians
(Gallbladder, Urinary Bladder, Stomach) travel from the head to the foot.
three Yang Hand Meridians
(Large Intestine, Small Intestine, and the San Jiao) will be flowing from the fingertips, downward on the back part of the arm, to end their flow in the face.
The one exception. it is a Yang Meridian, it runs on the front of the body with the Yin Meridians, instead of up the back like the rest of the Yang Meridians.
Governor Vessel (Du)
The other exception. which is a Yang Meridian in the center of the back, in which energy flows upward as opposed to the rest of the major Yang Meridians in which energy flows downward
Governor Vessel (Du Mai, Du or GV)
follows the spine upward on the back, travels over the head and ends on the inner surface of the upper lip. It has no direct connections to any internal organ. Its energy flow is Yang and ascends from the bottom of the pathway beginning near the anus. It connects with all the Yang Meridians of the body, and is important in many conditions requiring manipulation of the Yang energy of the body.
Conception Vessel (Ren Mai, CV or Ren)
travels up the midline in front of the body. It runs from near the anus to the mouth, and its energy is Yin, ascending from the lower body to the upper, as does the Governing Vessel. In effect, these two meridians vertically encircle the body on its midline, front and back.
Ren and Du
These two Vessels are not bilateral. They do not form a direct part of the organ meridian's energy circulation network, nor are they associated with any one organ. They belong to the eight Extra Vessels.
through the Primary Meridians, it alternates in coupled pairs of Yin and Yang Meridians, staying for two hours in the Yin and two hours in the Yang, in a smooth alternating rhythm.
On acupuncture charts
the meridians appear as thin surface lines connecting a series of dots that represent the acupuncture points. Every Channel has an inner pathway and an outer pathway, and it is usually the outer pathway with its acupuncture points that is shown on most charts or drawings, and the inner pathways are not accessible to manipulation by needling.
is connected to all the tissues, organs and functions over which its acupuncture points have an influence or produce an effect, whether in the immediate area of the points or at a much distant area.
polarity of Yin and Yang
These pairs are coupled ie., Lung with Large Intestine, Spleen with Stomach, Heart with Small Intestine, Kidneys with Bladder, Pericardium with San Jiao, and Liver with Gall Bladder.
Yin (Zang Organs)
Lung, spleen, heart, kidneys, liver, pericardium
yang (Fu Organs)
Large intestine, small intestine, stomach, bladder, gallbladder, san jiao
Functions of Meridians/Collaterals
1) Transport Qi and blood and regulates yin and yang
2) Resist pathogens and reflect symptoms and signs (may transmit pathogens deeper) Internal diseases may also "show" along meridians/collaterals.
3) Transmits needle sensation and regulates deficient and excess conditions
treatment is to regulate yin and yang
Arrival of Qi is essential to obtaining therapeutic effects. Both patient and physician should feel Qi come to needle
is a point on the Lung meridian (Metal Element). It helps to clear out old debris, allowing a fresh perspective
is the first point on the Kidney meridian (Water Element). This point is where our feet come into contact with the earth. A bubbling spring refreshes, vitalizes, and cleanses.
is a point on the Kidney meridian (Water Element) that serves as the transition between the Metal and Water Elements. It helps to allow the wisdom to flow freely once the letting go has occurred.
major cause is emotional stress: whatever the emotion, they all upset the proper flow of Qi in the Qi mechanism and lead to Qi stagnation. Each emotion has a certain effect on Qi (e.g sadness depletes Qi, worry knots Qi, etc), but, after a short time they all lead to some Qi stagnation, even those that deplete Qi
essentially a disruption of the Qi mechanism (Qi Ji) which means it affects the whole body
Qi mechanism - the flow of Qi in all organs of the body and all cavities, joints, skin, muscles, Fat, Membranes, etc.
Implicit in the Qi mechanism is the flow of Qi in the proper direction in each place or organ: the flow of Qi in and out of organs, in and out of cavities, in and out of joints, and so on. The Qi mechanism is like a vast system of roads and motorways where traffic needs to be regulated by one-way streets.
Two essential movements of Qi need to be coordinated
the ascending and descending of Qi, and the entering and exiting of Qi.
1. Governs the Blood. The Blood Vessels (tissue associated with the Heart and part of the whole system of the Heart in TCM) are where it circulates.
2. The Blood is made in the Heart, via the Heart Fire (Yang). Blood on the other hand, cools the Fire and prevents it from flaring up
1. Produces Food Qi, which is the basis for the formation of Blood.
2. Keeps the Blood in the Vessels so that it does not extravasate.
(Deficient Spleen Qi can result in Qi being unable to hold the Blood, resulting in hemorrhages.)
-Stores the Blood.
-When person is active, Blood flows to the muscles and tendons (governed by the Liver). When person lies down, Blood flows back to Liver.
-Liver Blood moistens the eyes, ensuring good eyesight and also moistens the sinews, promoting flexibility of joints.
-Liver Blood supplies the uterus with Blood, together with the Penetrating Vessel (Chong Mai - one of the eight Extraordinary or Ancestral Vessels), with which it is closely related. Therefore Liver Blood is very important for regular and healthy menstruation
1. Assist Spleen in sending Food Qi to the Heart to form Blood.
2. Control the channels and Blood Vessels by filling the Blood Vessels with Qi to assist the Heart's pushing action.
1. Original Qi (stored in Kidneys) is needed to transform Food Qi into Blood.
2. Kidney stores Jing, which produces Marrow. Marrow generates bone marrow, which contributes to the formation of Blood.
In TCM, we must therefore tonify (increase energy of) the Spleen and Kidneys.
Heart, Spleen & Liver
have the most direct relationship with the Blood: Heart governs Blood, Spleen holds Blood in the Vessels, and the Liver stores Blood.
"Solid": constantly active, involved in production and storage of the body's vital Substances (Qi Blood, Body Fluids, Essence)
"Hollow": receive and circulate but do not store, involved in digestion, transformation, and excretion.
Forms of Qi
Yuan Qi, Zong Qi, Zhen Qi, Zhong Qi,Ying Qi,Wei Qi.
Functions and Movement of Qi
Qi can transform, transport, hold, raise, protect, and warm. Qi also has a normal flow or direction of movement associated with each Yin Yang organ.
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