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Symptomatic Diagnosis
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Consumer Note: Multiple Sclerosis doesn't really exist in TCM, nor does epilepsy, or ulcerative collitis. All of these things are Western differentiations. Chinese medicine would treat these conditions as perhaps Qi and Blood stagnation in the channels, Liver wind or damp heat in the lower jiao. These treatments are based on the Oriental Medical perspective, not the Western perspective.
This page was uploaded in hopes of helping to demonstrate the different way in which a practitioner of traditional Oriental medicine might approach a condition.
Student note: These are the notes from a class wherin we organized information, not by Zang Fu differentiation, Eight principles, 6 channels, or 4 levels, but by the symptoms themselves.
The class moved rapidly, and I haven't had the chance to organize this information or check the spelling on these formulas as well as I'd like. This page represents an interesting way to organize information, but it should be cross-checked against other sources for more reliable accuracy.
-al stone.
Goiter (Enlargement of the Thyroid gland)
Note: Difference between Chills and Aversion to cold is this: Chills will not be relieved by warm clothing. Aversion to cold is.
Exterior syndrome (99% of the cases)
Fever and chills caused by wind, though it can be combined with other factors.
- Muscle aches, headache
- Wind with cold
- Chills and aches
- Formula:
- Ma Huang Tang (Pungent and warm)
- Wind with heat
- Fever and sore throat
- Formula:
- Yin Qiao San (Pungent and cool)
- Wind with damp
- stuffiness, aching in joints
- Formula:
- Qian Wei Qiang Hua Yin (Warm and dry)
Yang Collapse (Kidney and Heart most effected)
Clinical Manifestations:
- Feeble or faint pulse
- Very low energy
- Confusion and disorientation
- Cold sweat, cold body, cold extremities
- Low blood pressure
- Patient prefers fetal position
- Diarrhea with undigested food
- Clear copious urine
Treatment principle:
- Restore Yang from Collapse
Formula:
Yang Xu (not as severe as collapse) (Heart, Spleen, Kidney)
Clinical Manifestations:
- Aversion to cold
- Fatigue
- Qi Xu Sx + Cold Sx
- Heart Yang Xu
- Palpitations, SOB, fatigue, cyanosis
Formula:
- Gui Zhi Tang with more Zhi Gan Cao
- Spleen Yang Xu, add Li Zhong Tang
- Kidney Yang Xu add Jin Gui Shen Qi Tang AKA Ba Wei Di Huang Wan
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True Heat, Pseudo Cold
An Excess condition due to a variety of etiologies which pushes the yin from the interior to the superficial.
Clinical Manifestations:
- Cold Sx externally
- Aversion to cold
- Cold skin (which warms upon prolonged touch)
- Warm Sx internally
- Doesn't desire warm clothes
- Bad breath, constipation
- T: Red with yellow coat
- P: Forceful and Rapid
Formula:
Phlegm Accumulation
A condition in which a Yin evil blocks the flow of Yang energy, leading to aversion to cold.
Clinical Manifestations:
- Thirst, with no desire to drink
- Aversion to cold
- T: Thick greasy white coat
- P: Slippery
Formula:
Er Chen Tang
-
Exterior syndrome
Sever stagnation caused by exterior factors, skin pores close, Wei Qi pushes up against the closed pores in an attempt to push out the pathogenic factor. This creates shivering.
- Formula:
- Ma Huang is the king herb
- Ma Xing Shi Gan Tang
Febrile Disease
Any attack of pathogenic heat.
According to Wen Bing theory, usually the Wei and Qi stage heat.
-
Shao Yang disease
Clinical Manifestations:
- Bitter taste in mouth
- Dry mouth
- Chest and hypochondriac discomfort
- Irritability
- T: Red tip with thin yellow coat
- P: Wiry
Treatment principle
- "Harmonize interior and exterior" which means disperse exterior and clear interior.
Formula:
-
Malaria
Clinical Manifestations:
- Very regular cycle between fever and chills
- Patient is very week and needs to sleep after each cycle
Formula:
- Qing Hao and Zhong San are king herbs
An interior excess condition effecting the Lung and Stomach
Hot phlegm in Lung (Phenomena, Bronchitis)
Clinical Manifestations:
- Fever
- Cough
- Chest pain
- Sputum is thick and yellow, brown, or green
- Thirst
- Constipation
- One can remove heat from Lungs by purging constipation
- T: Red with thick greasy yellow coat
- P: Rapid and slippery
Formula:
-
Yang Ming Jing (Stomach channel)
No chills because the pathogen is too far interior
Clinical Manifestations:
- "Four Big Symptoms"
- Big thirst
- Big fever
- Big sweating
- Big pulse
Formula:
- Bai Hu Tang (Bitter and cold)
Yang Ming Fu (Large Intestine organ)
Clinical Manifestations:
- Heat leads to...
- Fever
- Constipation
- Bloating
- Palpable hardnesses in abdomen (dry stool)
- P: Deep, strong, slow (slow due to stagnation)
Formula:
Ying or Xue level syndromes (Pericardium)
Clinical Manifestations:
- High fever (104 degrees F. and above)
- Mental manifestations (confusion, delirium, etc...)
- T: Red tongue with scanty, or no coat (Yin deficiency)
Formula:
- King herbs include: Xi Jiao, Ling Yang Jiao and Shui Niu Jiao (Herbs must go to the PC)
5. Tidal fever (Low grade fever which comes and goes... like the tide)
Yin Xu
Clinical Manifestations:
- Low grade fever in the afternoon or evening
- Five center heat
Formula:
-
Qi Xu (Spleen/Stomach Qi Xu
Clinical Manifestations:
- Low grade fever at no regular time
- Fever + Qi Xu symptoms
Formula:
Blood stagnation (Late stage stagnation leads to Blood Xu, as in late stage cancer)
Clinical Manifestations:
- Low grade fever in evening
- Aches
- Dry skin
- Dark circles under eyes
- Tumor formation
- T: Purple
- P: Choppy and thready
Treatment principle:
Yang Ming Fu syndrome (Large Intestine)
Clinical Manifestations:
- Low fever possible, due to stagnation
- Fever
- Constipation
Formulas:
- Da Ching Qi Tang, or any of the related "Ching Qi Tang" formulas.
Yin deficiency with deficiency heat
Clinical Manifestations:
- Five center heat, which is heat manifesting on the Yin surfaces of the body, such as the palms, bottom of the feet, and the chest.
- Night sweats, hot flashes.
- T: Red, narrow, scanty coat
- P: Thin and rapid
Treatment principle
Formula:
- Liu Wei Di Huang Wan
(Tonifies Yin)
- Zhi Bai Di Huang Wan
(Clears deficiency heat)
Important herbs:
- Huang Bai, Zhi Mu. Bitter and cold, they cool both deficiency and excess heat.
-
Blood deficiency leading to deficiency heat. (Think Liver/Spleen)
Clinical manifestations:
- Five center heat especially in the afternoon and evening.
- Fatigue, poor appetite, palpitations, dizziness, vertigo, pale complexion.
- T: Pale
- P: Thready, soft, or choppy.
Treatment principle:
Formula:
7. Night Sweats (Think Heart, since sweat is the fluid of the heart)
Heart Blood deficiency
Clinical manifestations:
- Night sweats
- Palpitations, insomnia, pale complexion fatigue
- T: Pale
- P: Weak
Treatment principle:
- Tonify Heart Blood, astringe sweat.
Formula
- Si Wu Tang, plus an astringent such as Wu Wei Zi, Long Gu, My Li, Fu Xiao Mai.
- Gui Pi Tang
-
Yin deficiency with deficiency heat.
Clinical manifestations:
- Night sweats
- Palpitations, insomnia, pale complexion fatigue
- T: Pale
- P: Weak
Treatment principle
Formula:
- Liu Wei Di Huang Wan + astringent such as Fu Xiao Mai
Accumulation of Phlegm and Damp (Excess condition)
Clinical manifestations:
- Obesity, XS appetite
- Likes sweet and fatty, greasy food
- heavy sensations in body, foggy thinking
- Aversion to heat
- T: Flabby; thick, greasy coat
- P: Wiry/slippery.
- Wiry can suggest phlegm, heat, or food stagnation.
- Left untreated, the Phlegm can lead to heat, leading to Yin deficiency, leading to Wind, leading to stroke.
Treatment principle
Formula
- Wen Dan Tang + Ping Wei San
- These formulas are combined to lose weight, more gentle and safe than Ma Huang based formulas.
Qi deficiency (Deficiency condition)
Clinical manifestations:
- Fatigue, weak voice, shortness of breath
- Phlegm damp accumulation
- Aversion to cold, edema, puffy face, poor digestion, sleepy, hypofunctions.
- Not necessarily an over eating problem.
- T: Pale with white coating
- P: Thready and weak.
Treatment principle
- Tonify Yang, raise metabolism
Spleen/Stomach Deficiency (Stressed digestive problems)
Clinical manifestations:
- Anemia, malnutrition, indigestion, thin constitution with indigestion. Poor appetite, chronic loose stool, fatigue, shortness of breath, weak voice
- Sallow or pale complexion
- T: Pale
- P: Weak
Treatment principle
Formula
- Si Jun Zi Tang
- Ba Zhen Tang
- Stress carminative herbs
-
Qi and Blood Deficiency (Digestive problems less stressed)
Clinical manifestations:
- Anemia, malnutrition.
- Pale face, nails, tongue, lips
- fatigue, dizziness, vertigo
- Yang Qi and Blood unable to rise to nourish head
- T: Pale
- P: Thready/Weak
Formula
- Ba Zhen Tang
- Stress tonic herbs such as He Shou Wu, E Jiao, Ji Xue Teng
-
Lung Yin Deficiency (Any Yin deficiency leads to a certain amount of emaciation)
Clinical manifestations:
- Thin, emaciated body
- Chronic dry cough, i.e. allergies
- Lung TB, AIDS, both lead to this sort of emaciation
- Cough with blood streaked sputum
- Hematemesis
- Dry mouth, tidal fever, night sweats, five center heat
- T: Red with scanty coat
- P: Thready, rapid
Treatment principle
Formula
- Bai He Gu Jin Tang for Lung Yin deficiency
- Liu Wei Di Huang Wan for any Yin deficiency
-
Stomach Heat (genetic, or acquired, usually chronic)
Clinical manifestations:
- Excessive appetite, hypermetabolism, bad breath, thin constitution
- Craves cold drinks
- Irritability
- Scanty urine, tends to be constipated
- T: Red with dry coat
- P: Thready, rapid, forceful
Formula
- Jing Wei Tang for Stomach heat
- Yu Niu Jiao for Stomach Yin deficiency due to Stomach heat
-
Liver Fire (XS heat)
Clinical manifestations:
- Easily angered
- Chest and hypochondriac pain or burning
- Bitter taste, dry mouth
- Insomnia, restlessness
- Dark yellow urine, constipation
- T: Red with yellow coat
- P: Wiry, rapid, forceful
Formula
Summer heat
Often associated with damp, because the heat weakens the Spleen, leading to production of damp.
Clinical manifestations:
- Symptoms follow excessive sweating, sun stroke, always involved a climatological exposure to heat.
- fatigue and weakness in extremities
- Dehydration, shortness of breath
- fever
- Weak voice, thirst
- Dusky face color if damp is involved
- Possible loose stool
- T: Possible greasy coat
- P: Weak and rapid, may be soft
Formula
-
Acumulation of Damp
Could be associated with a Spleen deficiency if the symptoms stress it.
Clinical manifestations:
- Sluggish and heavy sensations.
- Cloudy, foggy head
- Spleen Qi Def.
- indigestion, loose stool, bloating, low appetite
- T: Greasy coat
- P: Soft and slippery
Treatment principle
- Dry damp, stimulate digestion
Formula
- Ping Wei San
- Then later, tonify spleen
-
Qi and Blood deficiency
Clinical manifestations:
- Fatigue and Pale color
- Pale skin, face, lips, nails... etc.
- Dizziness, palpitations
- T: Pale
- P: Deep thready, weak
Formula
11. Flacidity of Neck and head due to weakened muscles
A serious condition, wherein the patient is unable to raise the head.
Zhong Qi Xu
More often effects children with sever malnutrition, Jing deficiency, Down's syndrome.
Clinical manifestation
- severe emaciation
- Pale or sallow complexion
- disorientation, confusion, extreme fatigue
- indigestion, loose stool
- Middle jiao deficiency leads to Zhong deficiency
-
Bone Marrow Deficiency
A critical condition
Clinical manifestations:
- Comes due to old age, sexual hyperactivity, associated with tinnitis, low back pain, difficulty in walking or straightening back.
- T: Pale with scanty coating
- P: Deep, very weak, or feeble
Treatment principle
Formulas
- Herbs made of animal products to quickly tonify.
-
Liver Wind, Liver Fire (Acute excess condition)
Clinical manifestations:
- Twitching, acute, dizziness, bodily twitches in extremities especially.
- Red face, eyes, bitter taste in mouth
- T: Red with yellow coat
- P: Rapid and wiry
Formula
- Ling Jiao Gou Teng Tang
- Removes wind, clears heat
-
Liver wind (Chronic deficiency condition) i.e. Parkinson's Dz.
Clinical manifestations:
- Tidal Fever, Night sweats, insomnia, fatigue
- T: Red with scanty coat
- P: Thready and rapid
Treatment principle
- Tonify Yin, soothe Liver, disperse wind
Formula
Bone marrow deficiency
Clinical Manefestations
- Tinnitis
- Weakness/soreness in the lower back and/or knees.
- Vertigo/Dizziness
- Possibly associated with ear tinnitis
- T: Pale with scanty coat
- P: Deep, thready, weak
Etiology
- Constitution, age, over sexed, Jing deficiency fails to produce Jing
Treatment Principle:
Formula:
- Zhou Gui Wan
- He Che Da Zao Wan
- Animal products are good for Jing Xu
-
Damp Heat accumulation
Clinical Manifestations
- Tinnitis
- Headache, heavy sensation in head
- Naseau/Vomiting
- Low appetite
- Dizziness
- Chuan Yang (carbuncles on head)
- T: Red with greasy yellow coat
- P: Slippery, rapid
Etiology
- Excess conditions due to diet of sweet, greasy, alcohol, or over indulgence creates damp heat in channels which obstructs the flow of Yang Qi.
- Obstruction in upper Jiao effects the head channels.
Treatment Principle
Formula:
- Huang Lian Jie Tu Tang plus blood activators for sharp fixed pain.
-
Liver Qi stagnation
Clinical Manifestations
- Tinnitis triggered by anger or emotion.
- Distention or pain in the hypochondrium, chest tightness
- Bitter taste in mouth
- Irritablility, restlessness
- T: Normal
- P: Wiry and rapid
Etilogy
- Anger leads to disturbanc in flow of Qi leads to stagnation of Qi in the head.
Treatment Principle
Formula
- Xiao Yao Wan
- Long Dan Xie Gan Tang if Fire is present.
-
Deficiency of Kidney and Spleen (teeth and gums)
Clinical Manifestations
- Sore gums aggrevated mostly by cold drinks and weather, sometimes hot drinks as well.
- Teeth feel weak while chewing.
- T: Pale
- P: Deep and Weak
Etiology
- Old age, chronic conditions.
Treatment Principle
Formula
- Zuo Gui Yin
- Ruo Gui Yin
- Liu Wei Di Huang Wan
- Ba Wei Di Huang Wan
- Chew and eat walnuts (Hu Tao Ren)
-
Wind Cold
Clinical Manifestations
- Sore gums, prefer warm drinks and food to cold
- T: White slippery coat (slightly greasy)
- P: Floating and Tense
Formula
- Xi Xin (individual herb) can be chewed raw, or decocted as a tea.
- Ma Huang Xi Xin Fu Zi Tang
15. Bleeding Gums (ulcerative gingivitis)
-
Heat & Fire in Stomach/Large Intestine (excess condition, acute)
Clinical Manifestations
- Swollen, red aching bleeding gums
- Fresh, bright red blood
- Bad breath, preferes cold drinks, constipation
- T: Red body, thick yellow coat
- P: Forceful and rapid
Formula
- Qing Wei Tang + Yu Niu Jiao + herbs to cool and activate Blood
-
Stomach Yin Deficiency (deficiency condition, chronic)
Clinical Manifestations
- Swollen gums with pale blood, gums not bright red, sometimes painful, sometimes not.
- T: Red with scanty coat
- P: Slippery, rapid, thready
Formula
- Yu Niu Jiao + herbs to cool and activate Blood
-
Kidney Yin deficiency with excess heat (associated with old age, a chronic condition)
Clinical Manifestations
- Slighty sore gums combined with loose teeth.
- Dizziness, tinnitis
- Sore back and weak knees
- T: Red body with scanty coat
- P: Thready and rapid
Formulas
- (with heat) Zhi Bei Di Huang + Gu Sui Bu and/or Xu Duan
- (without heat) Rou Gui Yin or Zuo Gui Yin + Gu Sui Bu and/or Xu Duan
-
Spleen Qi deficiency (Spleen unable to govern blood, chronic condition)
Clinical Manifestations
- Pale gums, lips, and nails due to Blood deficiency
- Easily bruised
- T: Pale with white coat
- P: Soft, weak
Formula: - Gui Pi Tang (#1 formula for purpura-bruising)
16. Dark Black Teeth (Black from inside of teeth, not a stain due to coffee etc.)
-
Xue stage heat in the lower Jiao
Clinical Manifestations
- High fever, delerium, semi-conscious, coma, convulsions
- Irritability
- Shrivelling and dry lips
- T: Red with very dry coat, shrunken
- P: Extremely rapid
Etilology
- Heat has damaged Yin and Jin/Ye, Stomach Qi damaged (shrunken mouth). Kidney unable to nourish teeth, turning them black, the color of the Kidneys.
Formula
- Salty, cold, sweet and moist herbs
- Fu Mai Tang
- Pa Ting Fen Zhu Tang
-
Wind Cold
Clinical Manifestations
- More chills than fever, etc.
- T: White slippery coat (slightly greasy)
- P: Floating and Tense
Formula
-
Wind Cold Damp (a Bi syndrome such as arthritis)
Clinical Manifestations
- Heavy sensation in the head, head ache, aching joints, fever/chills sometimes
- T: Greasy coat
- P: Floating and slippery
Formula
- Ge Gen Tang + Qiang Huo, Jian Huang and/or Sang Zhi
-
Xue Stage Heat
Clinical Manifestations
- High fever, stiffness of head
- Irritablilty, delerium
- Possibly associated with convulsions, muscle spasms
- "Extreme Heat leads to Liver Wind"
Formula
18. Goiter (Enlargement of the Thyroid gland)
Acumulation of Phlegm and Qi Stagnation
Clinical Manifestations
- Swelling of thyroid, which is soft without pain
- Sense of obstruction in throat
- Chest constriction and hypochondriac distending pain
- Irritability
- T: Greasy white coat
- P: Wiry and slippery
Etiology
- Stress leads to Qi stagnation leading to impairment of body fluid metabolism, leading to phlegm congealing in throat.
Formula
- Ban Xia Huo Po Tang +Hai Zao and Kun Bu
-
Qi and Blood Stagnation
Clinical Manifestations
- Tumors or cancer of the thyroid gland developing from accumulation of Phlegm and Qi stagnation (see above)
- Swelling is harder than simple phlegm and Qi stagnation
- More defined pain and sense of obstruction effecting ability to breath and/or swollow.
- Chest constriction and hypochondriac distending pain
- Irritability
- T: Dark purple
- P: Deep and choppy
Etiology
- Prolonged Qi stagnation with phlegm leads to hardening of the phlegm leading to tumor formation
Formula
- Ban Xia Huo Po Tang + Blood activators such as E Zhu, San Lin, Dan Shen, Ru Xiang, Mo Ya and anti-cancer herbs
-
Yin Xu of the Heart and Liver
Clinical Manifestations
- Typical hyperthyroidism, swollen thyroid, though not hard
- Palpitations, insomnia, nervous, trembling
- Easily sweats, shortness of breath, irritbility,
- dizziness/vertigo
- Dry eyes, hot flashes, night sweats
- Nocturnal emissions, premature ejaculation
- irregular menstration
- T: Red with scanty coat
- P: Wiry and rapid, or thready and rapid
Treatment principle
- Tonify Yin and clear fire
Formulas
- Suan Zao Ren Tang
- Zhi Bai Di Huang
- Tian Wang Bu xing Tang
- Yi Guan Jiang
-
Accumulation of Heat and Damp ("Heat Bi")
Clinical Manifestations
- Edema in small joints
- Acute achy swollen arthritis
- Combined wiht fever, thirst and irritability
- T: Red body with yellow greasy coat
- P: Slippery and rapid
Formula
- Bai Hu Tang + Gui Zhi and Cang Zhu
-
Accumulation of Cold and Damp ("Cold Bi")
Clinical Manifestations
- Cold, achy arthritis with edema
- T: Greasy white coat
- P: Slow
Formula
-
Qi Stagnation
Clinical Manifestations
- Pitting edema
- Chest constriction and hypochondriac distending pain
- T: Pale with white coating
- P: Wiry
Etiology
- Because this a channel pathology, the etiology is often an external pathogen associated with Wind.
Treatment Principle
- Harmonize Ying and Wei Qi
Formula
- Xiang Su San
- Xiang Fu activates Qi
- Su Ye expells wind
-
Qi and Blood Stagnation (Post stroke sequellae, paralysis, hemiplegia)
Clinical Manifestations
- Edema (mostly lower extremeties), weakness, numbness
- Color of the skin at affected site is purple
- T: Pale with purple spots
- P: Wiry, choppy
Etiology
- Phlegm remaining in channels after stroke
Formula
Wind Cold and Damp
Clinical Manifestations
- Cold, achy arthritis
- T: Greasy white coat
- P: Slow
Formula
-
Heat and Phlegm
Clinical Manifestations
- High fever, stiffness of extremities
- Irritablilty, delerium
- Possibly associated with convulsions, muscle spasms
- "Extreme Heat leads to Liver Wind"
Formula
Usually without pain.
-
Body Damaged by Lung Heat
Clinical manifestations
- Follows febrile diesease
- Usually Lower extremities
- Low grade fever and yin impairment
- T: Red with yellow or scanty coat
Treatment Principle
Formula
- Shao Shen Mail Men Dong Tang + San Miao San
- Qing Zao Jie Fei Tang
Acupuncture points:
- Yang Ming points. Stomach channel for legs, L.I. for arms.
-
Qi deficiency of the Spleen/Stomach
Clinical manifestations
- Weakness (not paralysis) of limbs, normal movement, but very weak.
- Bloating, indigestion, loose stool, aversion to cold, pale complexion.
- T: Pale
- P: Thready and weak
- Prevailent during post illness recovery period.
Formula:
-
Deficiency of Liver and Kidney
Clinical manifestations
- Old age, or following illness.
- Hyposensitivity of extremeties leading to weakness leading to paralysis
- Sore lower back, dysmennorrhea, premature ejaculation
- Dizziness, vertigo, fatigue
- T: Pale
- P: Deep, thready, weak
- Jing Deficiency, soemtimes combined with Qi or Yin Xu.
Treatment Principle
- Tonifiy Jing and Liver (for tendons)
Formula:
- Zuo Gui Yin
- You Gin Gui Yin
- Da Bu Yin Wan
-
Blood Stagnation
Clinical manifestations
- Weakness leading to numbness
- Possible spasm leading to paralysis
- T: Purple
- P: Choppy, thready
Etiology
- Post stroke sequellae or tissue trauma
- Plegm remains in channels after stroke
Treatment Principle
- Promote Blood circulation.
Formula
Accumulation of heat and damp (acute condition)
Clinical manifestations
- Vericose viens are combined with red, swollen legs. Veins are hot and burning
- Fever, bitter taste in the mouth, irregular bowel movements
- T: Red with yellow greasy coating
- P: Wiry/rapid
Etiology
- Excessive alcohal intake, damp and heat producing foods
Treatment Principle
Formula
Points
- Local points that are inserted around the vericose veins like Hua Toe Jia Jie Points around the spine. Needles are considered more effective than herbs for this sort of vericose condition.
-
Accumulation of Cold and Damp (chronic condition)
Clinical manifestations
- Vericose veins are combined with heavy extremities and distension.
- Blue or puple veins, chronic
- Copius urine, loose stools
- T: White Greasy coat
- P: Soft
Etiology
- Standing up too much, working environment
Treatment Principle
Formula
-
Qi deficiency and Blood stagnation
Clinical manifestations
- Chronic physical weakness or Qi deficiency
- Chronically carrying heavy things and/or standing for a long time.
- Purple veins. Not as "big" as in damp/cold accumulation.
- Achy, but not distended.
- Fatigue, shortness of breath, pale complexion.
- T: Pale
- P: Weak
Treatment Principle
- Harmonize Ying, tonify Qi, Activate Blood
Formula
-
Liver and Kidney deficiency (old age, jing xu)
Clinical manifestations
- Pain in heal (key symptom)
- No skin change
- Pain worsoned by walking or fatigue
- Tinnitus, Sore back
Formula
- Hu Jian Wan (Patent formula)
-
Accumulation of cold and damp
Clinical manifestations
- Achy joints exasperated by cold and damp
- T: White coat
- P: Soft
Formula
-
Accumulation of cold and damp (bi syndrome)
Clinical manifestations
- Pain which can radiate to neck
- back feels heavy, stiff.
- symptoms aggrevated by cold damp weather.
Formula
- Qiang Huo Ji Sheng Tang
- Qi and Blood stagnation due to recent trauma (acute)
Clinical manifestations
- Sudden onset of pain
- Limited range of motion, acute symptoms
- P: Tense
- Could develope into chronic pain...
Formula
- Yuen Lian Bai Yao
- Huo Lou Xiao Ling Dan
-
Qi and Blood stagnation due to past trauma (chronic)
- Dull aching on & off, numbness aggrevated by rest (deficiency beneath)
- T: Purple
- P: Thready and/or choppy
Treatment Principle
- Tonify and activate Qi and Blood
Formula
- Du Huo Ji Sheng Wan + Tao Ren and Hong Hua
-
Kidney/Liver deficiency
Formulas
- Zuo Gui Wan
- Rou Gui Wan
- Bao Wei Di Huang Want
- Liu Wei Di Huang Wan
-
Jing deficiency
Clinical manifestations
- Infertility, tinnitius, vertigo, sore back, premature ejaculation, amenorrhea, grey hair, premature aging
Formulas
- Kidney/Liver formulas plus Zi He Che, Lu Rong
-
Yin deficiency
Clinical manifestations
- Emaciation, tidal fever, heat signs, five center heat.
Formulas
- Kidney/Liver formulas plus Huang Bai, Zhi Mu
-
Yang defiency
Clinical manifestations
- Cold signs such as cold hands and feet.
Formula
- Kidney/Liver tonic formulas plus Fu Zi, Ba Ji Tian, Bu Gu Zi
-
Qi deficiency
Clinical manifestations
- Weakness of the lower gates (Urethra, colon, etc.) incontenance, premature ejaculation, urination problems
Formula
- Kidney/Liver tonic formulas plus astringent herbs such as Sang Pian Xiao, Yi Zhi Ren, Wu Wei Zi, Fu Peng Zi
26. Chest Pain (often connected to the heart)
Heart Qi Deficiency
Clinical manifestations
- Mild pain
- Neurosis, heart condition,
- dull achy chest pain on one or both sides.
- Chest congestion, palpitations
- Sponteneous sweating, fatigue
- T: Pale
- P: Weak and thready
Treatment Principle
Formula
-
Cold accumulation (Yang deficiency) Painful
Clinical manifestations
- Coronary Heart Disease,
- chest pain, usually on the left side which could radiate tot he right, back shoulder, and arm.
- Pale complexion, sponteneous sweating, cold extremities.
- T: Pale, swollen, teeth marks
- P: Deep, slow, knotty and intermittent
Treatment Principle
- Tonify heart Yang, promote circulation of blood
Formula
- Gua Luo Xie Bai Bai Jiu Tang
-
Heart Blood Stagnation (still a form of Yang Xu)
Clinical manifestations
- Typical Angina pectoris. Intense pain that can make the patient lose consciousness due to its intensity
- Sponteneous cold sweating, fear, fatigue
- T: Pale purple
- P: Deep, thready, choppy, knotty, intermittent
Herb:
Formula
- Xue Fu Zhu Yu Tang
- Ge Xian Zhu Yu Tang
-
Phlegm accumulation (Involving the Lungs)
Clinical manifestations
- Cough
- Excess phlegm, pain with cough
-
Qi and Xue Stagnation
Clinical manifestations
- Enlargement of the Liver and Spleen
- Abdominal mass begins soft, but becomes harder as time goes by.
- Distention, emaciation, fatigue,
- Dark dull facial complexion
- low appetite, dry skin
- T: Purple spots
- P: Wiry, tense
- Cancerous tumors tend to be more blood stagnation than Qi stagnation
Treatment Principle
- Activate Blood, Yin difeciency unimportant now
Formula
- Ge Xian Zhu Yu Tang + Shi Xiao San
-
Phlegm Stagnation
Clinical manifestations
- Abdominal mass, no pain yet distended and uncomfortable..
- Mass is movable and soft, but patient dislikes touch.
- T: Pale
- P: soft and Slipppery
Formula
-
Zhong Qi Xu (sinking, or organ prolapse)
Clinical manifestations
- Pulling down, or bearing down sensation
- Qi Deficiency symptoms
Formula
-
Accumulation of damp, heat, and toxic heat
Clinical manifestations
- Tenesemus, diarrhea, abdominal pain, blood and mucus in stool.
- Pus and burning sensation in anus, possible fever
- Yellow scanty urine
- T: Red with yellow coat
- P: Slippery and rapid
Formula
-
Yang Ming Heat (Yang Ming Fu-L.I.)
Clinical manifestations
- Fever, constipation, abdominal discomfort,
- dislikes palpation
- feels mass in abdomen
- P: Deep, strong and slow due to stagnation
Treatment Principle
- Purge heat and stagnation
Formula
-
Qi Stagnation
Clinical manifestations
- Constipation
- depression, easily angered, chest congestion discomfort in hypochrndrium,
- distention and discomfort in breast, water retention (due to digestive problems, secondary to the stagnation)
Formula
- Chai Hu Su Gan Tang + lubricative herbs such as Tao Ren or Huo Ma Ren
-
Qi Deficiency
Clinical manifestations
- Constipation, sometimes loose
- extreme fatgue especially after a bowel movement
- Weak voice
- possible rectal prolapse
- T: Pale with white coat
- P: Weak
Formula
-
Blood and Yin Xu
Clinical manifestations
- Chronic, old age patients
- Constipation, emaciation, dry skin
- palpitations, pale complexion
- T: Pale, or Red or Narrow
- P: Thready and rapid
Herbs:
- Dang Gui, Sheng Di Huang, Rou Cong Ren
Formula
- Wu Ren Wan
- Sheng Ye Cheng Qi Tang
-
Accumulation of heat and toxins.
Clinical manifestations
- Xue level heat and toxin
- High fever, dilerium
- Semi consciousness, coma, XS diarrhea with pus and blood
- T: Red with yellow coat
- P: Rapid
Treatment Principle
Formula
-
Spleen, Kidney Yang Xu
Clinical manifestations
- Chronic Diarrhea/dysentary
- Diarrhea with mucus, incontenence of feces
- Fatigue, cold, low back pain,
- T: Pale
- P: Deep, thready, weak
Formula
- Zheng Ren Yang Zhong Tang
-
Spleen Qi Sinking (Extreme weak condition)
Clinical manifestations
- Incontenence of feces, rectal prolapse, tired disoreiented
- T: Pale
- P: Feeble
Formula
-
Kidney Qi Deficiency
Common among the elderly and those recovering for serious illness.
Clinical Manifestations
- Frequent urination and incontenance, mostly in the evening.
- Kidney Qi and/or Yang Xu symptoms
- T: Pale
- P: Deep, weak especially in the kidney positions.
-
Lung and Spleen Qi Xu
The problem begins with Spleen Qi sinking and is worsened by the spasmatic action of the abdomen with coughing.
-
Accumulation of Damp Heat (XS turbid damp, acute)
Clinical Manifestations
- Cloudy urine with white or yellow urine.
- Frequent, burning, urgent, painful urination
- fever, thirst
- T: Red with yellow coat
- P: Wiry and thready
Formula
- Ba Zheng San + Shi Chang Pu
- Pi Xie Feng Qing Yin
-
Kidney Yin or Yang deficiency (Deficiency syndrome in which the essence leaks out with the urine)
Clinical Manifestations
- Chronic cloudy urine
- Yin xu symptoms,
- Scanty yellow urine
- T: Red
- P: Thready and rapid
- or Yang xu symptoms
- Copious clear urine
- T: Pale
- P: Deep and weak
-
Kidneys are unable to govern the essence in the Kidneys
Treatment principle
- Tonify kidneys
- Astringe essence
Formulas
- For Kidney Yin Xu
-
- Zhi Bai Di Huang Wan + Pi Xia, Fu Pen Zi, Wu Wei Zi, Tu Si Zi (all astringents)
- For Kidney Yang Xu
-
- You Gui Yin or Wan + Pi Xia, Fu Pen Zi, Wu Wei Zi, Tu Si Zi (all astringents)
often found in the elderly
-
Kidney Qi Xu
-
Kidney Yang Xu
Formulas
- Sang Piao Xie San + You Gui Wan
- for prostate problems: Kai Kit Wan
Damp heat
- Clinical Manifestations
- Cloudy yellow urine
- Frequent, burning, urgent, painful urination
- incontenence
Formula
- Ba Zheng San + Shi Chang Pu
- Pi Xie Feng Qing Yin
-
Lung Qi Stagnation (Lungs unable to descend the water)
Clinical Manifestations
- Cough, dyspnea, chest congestion, constipation
- T: Red
- P: Soft and rapid
Formula
-
Zhong Qi Xu (Spleen Qi Sinking)
Clinical Manifestations
- Urination lacking strength, sluggish stream
- fatigue, bearing down sense
- Urine, frequent but small amounts
- Loose stool
- T: Pale
- P: Thready and weak
Formula
-
Kidney Qi Xu
Clinical Manifestations
- difficult urination, slugish stream, inconentence.
- frequent urination
- Kidney problems in Western medicine.
Treatment Principle
Formula
-
Stagnation of Urinary Tract (common after abdominal surgery or trauma)
Clinical Manifestations
- Sluggish, difficult urination
- Abdominal distention of pain
- T: Purple, possible with raised purple bumps
- P: Choppy
Formula
Accumulation of Damp Heat
This section is what the Western world would call a STD, or sexually transmitted disease.
Clinical Manifestations
- Frequent, cloudy, sluggish, burning urine
- White sticky discharge following urination
- Bitter taste in mouth
- Thirst, chest congestion, sluggish BM
- T: Red with Yellow greasy coat
- P: Soft and rapid (if more damp), or Slippery and rapid (if more heat)
Treatment Principle
Formula
-
Kidney Yin Xu with empty heat
Clinical Manifestations
- Frequent, cloudy, burning urine
- White or red discharge after urination
- Dizziness, vertigo, insomnia, restlessness
- Tidal fever, Yin Xu symptoms
- T: Red with dry coat
- P: Thready and rapid
Treatment Principle
Formula
- Shi Bai Di Huang Wan + astringents such as Tu Si Zi, Jing Yin Zi, Wu Wei Zi.
-
Kidney Qi or Yang Xu (Very weak people, not an STD)
Clinical Manifestations
- Frequent, copius, clear urine
- seminal fluid discharge following urination
- Premature ejaculation, impotence, nocturnal emissions.
- T: Pale
- P: Deep and weak
Formula
- You Gui Wan and astringents
-
Yin deficiency with intense empty heat
Clinical Manifestations
- Blood in ejaculate
- Distention & pain in testes or penis
- Burning sensation in urinary tract
- emaciation
- thirst, irritability
- T: Red with scanty coat
- P: Thready and rapid
Treatment Principle
- Tonify Yin, clear fire, harmonize Blood, stop the Bleeding.
Formula
- Zhi Bai Di Huang Wan or Da Bu yin Wen + E Jiao or bleeding.
-
Damp Heat accumulation (STD)
Clinical Manifestations
- Blood in ejaculate
- Frequent painful urination
- Pain, burning, itching in U.T.
- Spasms of pain in testicles
- Blood in urine
- T: Greasy yellow coat
- P: Slippery, wiry, rapid
Formula
- Bai Zhen San + Da Qing Ye, Huang Qin, Huang Bai, Zhi Zi, Bai Bu
Western differentiation: low sperm count
-
Kidney Qi deficiency, or Kidney Yang deficiency
Clinical Manifestations
- infertility, very chronic fatigue, pale complexion, sore or weak lower back, senility, hair loss and loose teeth, hearing loss, frequent urination-especially in the evening
- T: Pale
- P: weak in Kidney position
Treatment principle
- Tonify Kidney Qi, Yang, and essence
Formula
-
Cold stagnation (a Yang deficiency condition)
Clinical Manifestations
- Scanty semen
- infertility, very chronic fatigue, pale complexion, sore or weak lower back, senility, hair loss and loose teeth, hearing loss, frequent urination-especially in the evening
- Cold extremities, testicles
Formula
- You Gui Wan + Fu Zi, Ba Ji Tian, Suo Yang
Yin deficiency with empty heat
Clinical Manifestations
- distention in scrotum
- Possible nocturnal emissions, irritability, scanty urine, constipation, thirst
- T: Red
- P: Thready and rapid
Treatment Principle
- Tonify Yin to move stagnation
Formula
- Zhi Bai Di Huang Wan + Mu Tong, Wang Bu Liu Xin
-
Blood stagnation due to chronic stress
Qi stagnation leading to Blood stagnation. Liver stagnates Qi, and the channel passes through the gonads.
Clinical Manifestations
- easily angered, chest congestion
- Vericoses of scrotum (vericoseal)
- T: Purple
- P: Deep and choppy
Formula
- Xu Fu Zhu Yu Tang + Jiu Zi, Chi Cuang Zi
-
Kidney Qi or Yang Xu
Clinical Manifestations
- impotance, sore back, hair loss, loose teeth, senility
- T: Pale
- P: weak at kidney point
Formula
- You Gui Wan, Ba Wei Di Huang Wan
-
Deficiency of Heart and Spleen
Clinical Manifestations
- Neurosis (if there's a psychological component)
- Impotence, emaciation, fatigue, pale complexion
- Palpitations, insomnia, forgetfullness
- indigestion
- T: Pale
- P: Weak
Formula
40. Nocturnal Emissions (more heat)/Spermatorrhea (more cold)
-
Heart and Spleen deficiency
Clinical Manifestations
- Impotence, emaciation, fatigue, pale complexion
- Palpitations, insomnia, forgetfullness
- indigestion
- T: Pink or red
- P: Weak or thready
Treatment principle
- Clear heat, subdue fire and calm shen. Astringe essence.
Formula
- Tian Wan Bu Xing Tang + Bai Shao, E Jiao
-
Liver Fire (nocturnal emissions)
Clinical Manifestations
- Bitter taste in mouth
- Dark urine
- Easily angered
- P: Wiry
Formula
-
Kidney Qi Xu (Spermatorrhea)
Clinical Manifestations
- Tinnitis, dizziness, fatgue, sore or weak lower back.
Formula
- You Gui Wan + astringent herbs
-
Accumulation of damp heat
Clinical Manifestations
- Irritability, fever, itching
- burning sensation in lower abdomen, or testicles.
- Scanty yellow urine
- T: Yellow greasy coat
- P: Wiry, slippery
Formula
- Long Dan Xie Gan Tang + Ba Zhen Tang
-
Kidney Yang Xu
Clinical Manifestations
- Cold testes, soreness and weakness in the lower back and knees.
- Poor memory, hearing and hair loss, loose teeth, aversion to cold and cold extermeties
- Qi Xu symptoms
- T: Pale and swollen with teeth marks.
- P: Deep thready, weak, especially in Kidney positions.
Etiology
- Age, too much sexual activity, constitutional weakness
Treatment principle
- Warm and stimulate Kidney Yang
Formula
-
Heart/Spleen deficiency
Psychogenic, in Western terms
Clinical Manifestations
- Palpitations, shortness of breath, emaciation, insomnia, restlessness, vivid dreams, fatigue, indigestion, bloating, loose stools
- T: Pale
- P: Thready
Etiology
- Thinking or worrying too much creates the Spleen Zi deficiency which leads to Qi and Blood deficiency which creates a Heart Blood deficiency leading to various neurosis. Plus, the Qi and blood can't support the essence, which leads to impotence.
Treatment Principle
Formula
- Gui Pi Tang + Kideny tonic herbs which will warm the Spleen such as Bu Gu Zi, Ba Ji Tian, Xian Ma.
-
Impotence due to fear
Clinical Manifestations
- frustration, easily panicked, insomnia, vivid dreams and nighmares, erection up until intercourse begins.
- Tongue and Pulse can be normal
Treatment Principle
Formula
- Ting Zhi Wan + Shi Chang Pu, Ren Shen, Yuan Zhi
-
Damp heat in Liver (lasts days or even months)
Clinical Manifestations
- Penis is dark purple, distended pain, difficult urination, scanty dark yellow urine, fear, bitter taste in mouth, thirst, constipation.
- T: Red with yellow coat
- P: Wiry, slippery, rapid
Treatment Principle
Formula
-
Yin Xu with intense empty heat
Clinical Manifestations
- emaciation, high sex drive, distention and pain, though slight compared to damp heat in Liver.
- Sometimes scanty urine
- Malar flush, nervousness, hyperactive, easily anxious.
- T: Red and narrow, scanty coat
- P: Thready and rapid
Treatment principle
Formula
-
Kidney Yang Xu with interior cold or Ming Men Xu
Clinical Manefestations
- Kidney Yang Xu Symptoms
- Imptence, premature ejaculation (male)
- Low sexual desire (female)
- T: Pale with teeth marks
- P: Deep, slow and weak
Formula
- Ba Hui Di Huang Wan + Lu Rong and Wu Zhu Yu
-
Cold stagnation
Clinical Manefestations
- Cold extremities and body, purple lips, sever muscle aches and abdominal cramping, maybe diarrhea
- T: Normal
- P: Deep, slow and weak, or deep, slow and tense.
Etiology
- Constitutional Yang Xu + pathogenic cold or just pathogenic cold in the Liver channel leading to cold stagnation which blocks Qi and Blood in the channels that pass through the genital area.
Treatment principle
- Warm and remove cold stagnation
Formula
- Wu Zhu Yu Tang or Dang Gui Si Ni Tang
-
Yang Collapse
This is a critical condition, the Liver is dying.
Clinical Manefestations
- Spontaneous cold sweating
- Semiconsciousness or unconsciousness
Treatment Principle
- Obviously the penile retraction will be secondary to the more immediate need to rescure and restore the Yang before the patient expires.
Formula
Damp heat in the Liver channel
Clinical Manifestations
- Burning, dificult, dark, painful and frequent urination
- cloudy urine, fever thirst
- T: Yellow greasy
- P: Sippery, wiry, rapid
Treatment principle
Formula
-
Heat and fire accumulation
Clinical Manefestations
- Burning and heat in genitals, fever, mouth ulcers, thirst, more heat symptoms
- T: Red, especially the tip
- P: Rapid
Treatment Principle
Formula
-
Blood stagnation
Clinical Manifestations
- Severe, excrutiating pain, burning in urinary tract
- Kidney, or urinary tract stones, bloody urine, cloudy urine.
- Pain referred to the abdomen or lower back.
- T: Purple spots
- P: Deep and choppy
Formula
- Tao Hong Si Wu Tang + Ba Zhen San
-
Qi and Blood xu
Clinical Manifestations
- Lite flow, delayed cycle,
- abdominal aching, fatigue, dizziness
- T: Pale
- P: Thready
- Anemia
- Heavy flow possible in the case of Qi Xu with no Blood Xu.
Formula
-
Accumulation of Phlegm Damp
Clinical Manifestations
- Lite flow, obese paitent, irregular cycles,
- heavy sensation in body
- T: Swollen tongue body wtih greasy coat
- P: Soft and slippery
Formula:
-
Qi and Blood stagnation
Clinical Manifestations
- Dark purple flow with clots, sever abdominal pain, sever PMS symptoms
- T: Purple
- P: Choppy
Formula
-
Heat and Blood stagnation
Clinical Manifestations
- Thick dark clotty flow
- Severe abdominal pain, fever, mentle symptoms
Formula
-
Cold stagnation leading to Blood stagnation
Clinical Manefestations
- Thick dark clotty flow
- Severe abdominal pain, fever, mentle symptoms
- Lower back cold, patient preferes warmth
- T: White coat
- P: Deep and tense
Formula
-
Qi and Blood stagnation
Clinical Manifestations
- Dark purple flow with clots, sever abdominal pain, sever PMS symptoms
- T: Purple
- P: Choppy
Formula
-
Heat and Blood stagnation
Clinical Manifestations
- Thick dark clotty flow
- Severe abdominal pain, fever, mentle symptoms
Formula
-
Cold stagnation leading to Blood stagnation
Clinical Manifestations
- Thick dark clotty flow
- Severe abdominal pain, fever, mentle symptoms
- Lower back cold, patient preferes warmth
- T: White coat
- P: Deep and tense
Formula
-
Damp Heat accumulation
Clinical Manifestations
- Dark thick flow, strange oder, burning and itching in the vaginal region.
- Plhegm accumulation
- Clinical Manefestations
- Thick, though not dark flow. Congestion, dizziness, leukorrhea
- T: Greasy coat
- P: Slippery
49. Thin flow (the quality of the blood, see "light" flow).
50. Early menstruation (early in the month, not early in life)
-
Blood heat
Clinical Manifestations
- Bright red, copius flow. Could lead eventually to very dark red if the heat goes untreated.
-
Yin deficiency heat in the blood
Clinical Manifestations
-
Blood stagnation leading to heat in the blood.
Clinical Manifestations
- Clots, abdominal pain
- Early or late period, heavy or light amount, spotting,
-
Qi Deficiency
Clinical Manifestations
- Lite and thin flow.
- Abdominal pulling or bearing down sensation, fatigue
- P: Weak
-
Cold and Blood stagnation
Clinical Manifestations
- Abdominal pain, patient desires warmth, flow with clots.
- T: Purple
- P: Deep, slow, possibly choppy.
-
Phlegm/Damp accumulation
Clinical Manifestations
- Delayed, or lack of menses
- Pale red thick flow
- Obesity, indigestion
- T: Greasy coat
- P: Soft
-
Deficiency of Qi and Blood
52. Amenorrhea (Lack of period)
-
Kidney Qi deficiency
Clinical Manifestations
- Congenital Kidney Qi deficiency (Primary amenorrhea)
- No period as of the 15th birthday
- Emaciation, Lower back pain, fatigue,
- slow development
- P: Weak
- T: Pale
Treatment principle
-
Qi and Blood deficiency
Clinical Manifestations
- Usually found after an illness or post partum
- No pain, no period
- Palpitations
- Fatigue, weakness
- P: Weak
Treatment principle
Formula
-
Qi and Blood stagnation
Clinical Manifestations
- Amenorrhea following traumatic injury or stress.
- Lots of distention and pain
- fatigue, depression, anger
- T: Varies
- P: Deep and wiry
-
Damp and Phlegm accumulation
Clinical Manifestations
- Menopausal symptoms
- Delayed cycle, quantity of flow is light.
- Amenorrhea, weight gain, water retention
- T: Pale with white greasy coat
- P: Soft and slippery
-
Qi and Blood deficiency
Clinical Manifestations
- Heavy quantity, thin quality and light color.
-
Heat in blood
Clinical Manefestations
- Dark Red flow
- Blood stagnation
- Clinical Manefestations
- Irregular flow, spoting, dark purple color clots, pain in abdomen, which gets better after the onset of the flow.
- T: Purple
- P: Deep and choppy, or wiry and slippery
-
Liver Qi stagnation (accounts for 95% of cases)
Formula
-
Kidney Qi Deficiency
-
Liver Qi stagnation with Liver fire (most common)
Clinical Manifestations
- Fever alternating with chills, more often before period, sometimes during.
- Early or irregular cycle, irritation, dizziness
- Thirst, dry mouth
- T: Red with yellow coat
- P: Wiry and Rapid
Yin deficiency Fever
Clinical Manifestations
- Fever following illness of post partum.
- This fever tends to happen before or during the period.
- Emaciation, irritibility, dry mouth, thirst.
- T: Red and thin
- P: Thready and rapid
-
Wind cold
Clinical Manifestations
- Chong and Ren channels are weak just prior to menses
- Tai Yang syndrome
Formula
- Gui Pi Tang even if there's no sweating.
- Xiao Chai Hu Tang if fever is also associated with chills.
-
Blood stagnation before or during period
Clinical Manifestations
- Abdominal pain, dark complexion
- Flow is purple with clots.
Formula
-
Qi deficiency or Qi and Blood deficiency fever
Clinical Manifestations
- Fever before or during the period
- Light color and thin quality, scanty quantity
- T: Pale
- P: Weak
Formula