Course: Diagnostics II Date: Dec 8, 2007 Combination Symptoms Combination Syndrome Symptom Caused by Qi Deficiency of Heart and Lung Palpitation Indicative of heart problem Cough with difficult inhalation, worse Cough = lung, exert = Qi xu on exertion Chest tightness Phlegm ret, Qi congestion, Clear phlegm Dampness MJ, no heat Upper Jiao problem Pallor of face Qi/Yang/Blood Xu or Cold Dizziness Can be excess, or Blood Deficiency Lassitude Qi Xu Spontaneous sweating Qi and Yang Xu Tongue: pale with thin white coat Pulse: deep, weak or irregular Deep = interior, weak = deficiency Deficiency of Heart and Palpitations Heart Blood deficiency Specific pattern in TCM!!! This is spleen qi xu + Heart Blood Xu. Insomnia, DDS (dream disturbed sleep) Heart Qi Xu Heart of Liver Blood Xu (cant stay asleep, esp elder patients) Chief complaint often insomnia. Dizziness and vertigo Can be excess, or Blood Deficiency Sallow complexion Dampness plus Reduced appetite Loose stool, diarrhea Lassitude Qi Xu Middle Jiao problem Bruising Xu, Heat, Trauma Scanty and light menses Tongue: Pale with white coat Gui Pi Tang is the formula of choice Pulse: Thin and weak Blood Xu (thinner and lighter in color) (redder) If heavy can be blood heat or spleen qi xu Page 1 of 5
Blood Xu in both Heart and Liver Palpitations Heart Blood Xu Insomnia, DDS Heart Qi Xu Heart of Liver Blood Xu (cant stay asleep, esp elder pts) Dizziness and vertigo Can be excess, or Blood Deficiency Pale face Qi/Yang/Blood Xu, Cold Dry eyes Liver Blurred vision Liver advanced to Liver Blood Xu Numb limbs Blood Xu anemia/malnutr cn b due toblood or qi xu Very specific manifestation Tremors Liver wind Different kinds of wind and vertigo belong to liver. Blood deficiency generates wind. Another symptom of wind: itching, rashes Treatment: tonify the blood. Little menses Blood Xu (+nite sweat, 5palm heat, thirst, dk red tongue, little coat) Tongue: pale with white coat Pulse: thin and weak Yang Xu of Heart and Kidney Palpitations Heart Pale face Qi/Blood/Yang Xu, Cold Tricky pattern. Do not confuse with Aversion to cold, cold limbs Yang Xu, extreme anger causing Qi congestion Heart/Kid Disharmony (a yin xu)! Sleepy Heart Qi Xu usually or Qi xu after meals Look for cold signs, swollen face, chest tightness w/coldness there. Edema in face/limbs, esp lwr legs Lower limbs = Kidney yang related All 4 limbs = related Edema that doesn t stay depressed = Qi edema Many chronic ht failure pts have this Cold, soreness/weakness of lumbar Kidney Yang deficiency Always want covers on chest and knee joints Pale lips and nails Blood, Qi or Yang Xu Early morning Diarrhea Kidney Yang Xu Tongue: pale with slippery coat Yang and/or Qi xu with water retention Pulse: deep, feeble, slow Deep = interior/longterm, Feeble = def, Slow = cold Page 2 of 5
Disharmony of Heart and Kidney Palpitations Heart Insomnia Blood deficiency of heart and kidney, but w/ Restlessness, irritability Heart fire/liver fire special name in TCM Heart yin/blood Xu Dizziness and vertigo Yin def in L. Jiao so yang goes upward Rel between Ht and Kd = fire and Tinnitus Kidney yin deficiency water. One controls the other. When Dry throat Kidney channel which goes to bk of throat out of balance gets even more out of Tidal fever whack. Night sweating Soreness of lumbar and waist Kidney Spermatorrhea in dreams Kidney Xu Tongue: red with little coating Deficient heat Pulse: thin and rapid Deficiency + heat Qi Deficiency of Lung and Chronic, constant cough with profuse, clear phlegm Cough = Lung, phlegm = Chronic = deficient, clear = no heat Shortness of breath Lung Xu Poor appetite Loose stools, diarrhea Liver Fire Insulting Lung Burning pain or distention in Indicates Liver costal/hypochondriac region Quick temper, irritability Liver + heat Restlessness Liver fire longterm affects Heart/shen (Mother/son rel) Dizziness Wind due to the heat Red eyes Liver fire. If sclera is red liver fire is insulting the lung Bitter taste in mouth Liver, stomach, or GB fire Violent, intermittent cough Violent = excess condition Little sticky yellow phlegm, All indicates heat spitting blood Hot sensation in chest Tongue: red w/thin yellow coat Heat Pulse: wiry, rapid Wiry = liver, rapid = heat Page 3 of 5
of Lung and Kidney Cough + little or bloody sputum Cough = lung, little = deficient, bloody = def heat Dry mouth, sore/dry throat Dry = yin or body fluid xu, sore throat = lu/kd meridian Hoarseness Lung yin Xu Losing weight, emaciation Soreness/weakness of lumbar and Kidney Xu knee joints Tidal fever, malar flush Night sweats Nocturnal emissions Kidney Less menses Possibly, tinnitus w/high pitch Kidney Tongue: red with little coating Red = heat, little coating = deficiency Pulse: thin and rapid Thin = deficiency, rapid = heat of Liver and Kidney Dizziness and vertigo Wind blood xu, yin xu, or heat excess Tinnitus Kidney deficiency Dull hypochondriac pain Dull = deficiency, hypochondriac area = liver If short term memory: Heart Bld xu If long term memory: Kidney xu *Don t let the heart looking symptoms *Insomnia, DDS Liver Blood Xu or Heart Blood Xu throw you off is blood/shen relation. Dry throat, eye, mouth Liver Loosing weight, emaciation Yin xu Soreness/weakness of lumbar or knee Kidney joints Difference between this & Heart and Malar flush, night sweats, 5 palm heat, Kidney Disharmony: etc. -no palpitations Nocturnal emissions Kidney yin xu -presence of dry eyes, hypochon pain Scanty menses flow Yin xu of kidney and perhaps liver Tongue: red with little coat Red = heat, little coating = deficient Pulse: Thin, rapid Thin = deficiency, rapid = heat Page 4 of 5
Yang Xu of and Kidney Pallor of face Yang/Qi/Blood /Xu, cold Poor appetite Aversion to cold, cold limbs Cold limbs = Yang Xu Cold, soreness and weakness of Kidney and Kidney Yang Xu lumbar and knee joints Loose stools or diarrhea at dawn Chronic diarrhea Dawn = Kidney Yang Xu Chronic = interior/long term Incontinence of urine Kidney Qi or Yang Xu Facial puffiness or edema of limbs Edema of limbs = Edema above waist = yang edema. Lung, Edema below waist = yin edema., Kidney Tongue: pale, swollen, slippery white Yang Xu Sp/Kid Yang Xu coat Pulse: deep, feeble, slow Deep = interior, feeble = defic, slow = cold Group the following 2 together Disharmony of Liver/ Distention/fullness, pain in costal Liver and/or hypochrondriac area Sighing Liver Qi Stagnation Liver overacting on spleen Poor appetite Depression, irritability Liver fire Loose stools/constipation Tongue: white or greasy coating Pulse: wiry Liver Disharmony btwn Liver/Stomach Distention/fullness, pain in costal and/or hypochondriac area Can be 1) liver qi stag fire and Belching, hiccupping, acid reflux Stomach Qi cannot go down, rebelling upwards affecting st or 2) retained cold Should also have constipation affecting liver and stomach Irritability Tongue: red body, thin yellow coating heat Pulse: wiry and rapid Wiry = liver, rapid = heat Page 5 of 5