Chapter 16 Diagnosis

Front 1

The tip of the tongue
Organs and clinical indication

Back 1

Heart, lung, small intestine;
heart fire, lung qi deficiency

Front 2

Border/Edge of the tongue
Organs and clinical indications

Back 2

Liver, gall bladder;
liver fire, gall bladder heat

Front 3

Center of the tongue
Organs and clinical indications

Back 3

Spleen, stomach;
spleen damp; stomach heat

Front 4

Root of the tongue
Organs and clinical indications

Back 4

Kidney, bladder;
kidney yang deficiency

Front 5

What two properties of the tongue do you observe?

Back 5

The tongue proper--refers to the muscular tissue of the tongue, tongue body;
Tongue coating--refers to the moss over the surface produced by the stomach qi

Front 6

Describe the normal tongue

Back 6

Proper in size, soft in quality, free in motion, slightly red in color, thin layer of white coating which is neither dry nor over moist

Front 7

Tongue coating sticky (greasy, creamy)

Back 7

Turbid damp in intestine and stomach;
retention of turbid damp and phlegm
and food

Front 8

Precautions in tongue diagnosis

Back 8

observe in direct natural light;
food drugs eating or tongue scraping may change the tongue coating;
each disease undergoes a complicated process

Front 9

Tongue coating moist

Back 9

Normal;
Dampness

Front 10

Tongue coating thin

Back 10

Normal;
superficial, mild disease;
exterior syndrome in febrile diseases

Front 11

Tongue coating thick

Back 11

dampness;
phlegm;
food stagnation;
interior syndromes

Front 12

Tongue coating
Dry

Back 12

consumption of Yin fluids due to excessive heat;
consumption of yin fluids leading to no nourishment upward

Front 13

Tongue coating
White

Back 13

normal;
external cold;
internal cold

Front 14

Tongue coating
Yellow

Back 14

Internal and heat

Front 15

Tongue coating
Gray

Back 15

Internal;
retention of damp cold;
retention of phlegm and fluid

Front 16

Tongue coating
Black

Back 16

severe stage of disease;
extreme heat;
excessive cold;
heat evil invading blood stage

Front 17

Tongue color
Pink

Back 17

Normal;
mild disease;
early stage of febrile diseases;
exterior syndromes

Front 18

Tongue color
Pale

Back 18

deficiency, cold;
deficiency of yang qi;
insufficiency of qi and blood

Front 19

Tongue color
Red

Back 19

heat;
excess of internal heat;
yin deficiency heat

Front 20

Tongue color
Deep red

Back 20

extreme heat;
external febrile disease: invasion of the yin and blood by pathological heat;
Yin deficiency leading to hyperactivity of fire

Front 21

Tongue color
Purple

Back 21

stagnation of blood;
heat: a deep purple, dry and lusterless;
cold: a pale purplish and moist tongue;
stagnation of blood: purple spots on the tongue surface

Front 22

Tongue color
Red

Back 22

heat;
excess of internal heat;
yin deficiency heat

Front 23

Tongue shape and size
Swollen
delicate pale w/ tooth mark

Back 23

yang deficiency of spleen and kidney

Front 24

Tongue shape and size
Swollen
deep in red

Back 24

excessive heat in heart and spleen

Front 25

Tongue shape and size
Swollen
purplish and dark

Back 25

toxicosis

Front 26

Tongue shape and size
Thin
Pale

Back 26

deficiency of qi and blood

Front 27

Tongue shape and size
Thin
dry and deep red

Back 27

yin deficiency and hyperactivity of fire lead to consumption of body fluids

Front 28

Tongue shape and size
cracked
deep red

Back 28

excessive heat consuming body fluid

Front 29

Tongue shape and size
cracked
pale

Back 29

deficiency of blood

Front 30

Tongue shape and size
cracked
not deep and remain there all the time, unchanged

Back 30

normal

Front 31

Tongue shape and size
thorny
red

Back 31

accumulation of interior heat

Front 32

Tongue shape and size
thorny
more enlarged and profuse the thorns in tip

Back 32

severe heart fire

Front 33

Tongue shape and size
thorny
thorns in edge

Back 33

liver and gall bladder fire

Front 34

Tongue shape and size
deviated (crooked)

Back 34

wind stroke (liver wind)

Front 35

Tongue shape and size
rigid
exogenous

Back 35

exogenous febrile diseases invade pericardium by heat;
retention of turbid phlegm in the interior;
excessive pathogenic heat consuming body fluid

Front 36

Tongue shape and size
rigid
endogenous

Back 36

wind stroke or early sign of wind stroke

Front 37

Tongue shape and size
flaccid
weak in motion

Back 37

extreme deficiency of qi and blood;
consumption of yin fluid

Front 38

Tongue shape and size
flaccid
pale

Back 38

deficiency of qi and blood

Front 39

Tongue shape and size
flaccid
deep red

Back 39

collapse of yin

Front 40

Smell of secretion or excretion
stench

Back 40

excess heat

Front 41

smell of secretion or excretion
less stink

Back 41

cold deficiency

Front 42

smell of secretion or excretion
foul and sour

Back 42

retention of food

Front 43

bitter taste

Back 43

hyperactivity of the fire in liver and gall bladder

Front 44

sweetish taste with sticky mouth

Back 44

damp heat in spleen and stomach

Front 45

sour taste (regurgitation)

Back 45

retention of heat in liver and stomach

Front 46

unable to taste

Back 46

deficiency of spleen

Front 47

constipation, dry stool

Back 47

heat or consumption of body fluid

Front 48

loose stools

Back 48

spleen deficiency or retention of dampness in spleen

Front 49

watery stools with undigested food

Back 49

spleen and kidney yang deficiency

Front 50

bloody stools with mucus and tenesmus

Back 50

intestines damp heat and stagnation of qi

Front 51

urine yellow

Back 51

heat or consumption of body fluid

Front 52

clear, profuse urine

Back 52

cold syndromes

Front 53

scanty yellow urine, urgent and painful

Back 53

damp heat downward

Front 54

red urine

Back 54

heat injury vessels

Front 55

dribbling or retention of urine

Back 55

kidney deficiency;
damp-heat;
obstructed Bladder qi;
stagnant blood;
stones

Front 56

watery leukorrhea, whitish in color, profuse in amount

Back 56

deficiency cold

Front 57

thick leukorrhea, yellow or red, offensive smell

Back 57

excess heat

Front 58

menstruation light in color, flow profuse amount, thin in quality, dull pain in the lower abdomen during or after period which is alleviated by pressure

Back 58

qi deficiency

Front 59

menstruation thin, scanty, light colored flow, dull pain in the lower abdomen during or after period which is alleviated by pressure

Back 59

blood deficiency

Front 60

menses shortened cycle, excessive amount, deep red in color, thick in quality

Back 60

blood heat

Front 61

prolonged menstrual cycle, scanty purplish dark discharge, blood clots, cold pain in lower abdomen during the period

Back 61

blood cold stagnation

Front 62

Secretion,excretion clear,white

Back 62

deficiency cold

Front 63

Secretion, excretion turbid yellow

Back 63

excess heat

Front 64

Body shape overweight mental depression

Back 64

deficiency of qi;
excess of phlegm;
damp

Front 65

irregular menstrual cycle

Back 65

liver qi stagnation

Front 66

premenstrual or menstrual pain in the breasts, lower abdomen which intensifies on pressure

Back 66

qi and blood stagnation

Front 67

Body shape thin
dry skin

Back 67

insufficiency of blood

Front 68

body shape
great loss of weight
long illness

Back 68

exhaustion of essential qi

Front 69

Inquiring

Back 69

To ask the patient or the patient's companion about the disease condition in order to understand the pathological process; made systematically w/ questions focused on the chief complaint of the patient, according to the knowledge in differentiation of syndromes

Front 70

Exterior cold;
Fever
Chills
Sweating
Thirst

Back 70

Mild fever
Severe chills
No sweating
No thirst

Front 71

Exterior heat;
fever
chills
sweating
thirst

Back 71

Severe fever;
mild chills;
sweating
thirst

Front 72

Intermediate syndrome;
fever
chills
sweating
thirst

Back 72

alternate fever
alternate chill
thirst

Front 73

Interior cold;
fever
chills
sweating
thirst

Back 73

No fever
alternate chills
no sweating
no thirst

Front 74

Interior heat;
fever
chills
sweating
thirst

Back 74

high fever;
no chills;
thirst

Front 75

Appetite inquiry
Poor appetite; emaciation, loose stools, lassitude, pale tongue, thin white coating

Back 75

weakness of spleen and stomach

Front 76

Appetite inquiry;
Poor appetite; stuffiness in chest; fullness in abdomen; red tongue; thick, sticky coating

Back 76

stagnation of spleen and stomach; food dampness retention

Front 77

Appetite inquiry;
Excessive appetite, hungry, skinny

Back 77

excessive stomach fire

Front 78

Appetite inquiry;
Hunger, no desire to eat, or eats small amounts

Back 78

Stomach yin deficiency

Front 79

Sleep inquiry;
Insomnia with dizziness and palpitations

Back 79

blood deficiency of heart due to spleen and heart deficiency

Front 80

Sleep inquiry;
insomnia, restlessness, dream-disturbed sleep

Back 80

hyperactivity of heart fire

Front 81

Sleep inquiry;
difficulty in falling asleep, uncomfortable, empty sensation after a full meal

Back 81

derangement (mixed up) of stomach qi

Front 82

sleep inquiry;
lethargy, with dizziness and palpitation

Back 82

damp-phlegm in the interior

Front 83

sleep inquiry;
light sleeper, general lassitude

Back 83

yang deficiency of heart and kidney

Front 84

Bi syndrome;
wandering pain in the joints

Back 84

Wind bi

Front 85

Bi syndrome;
severe stabbing pain, cold and fixed

Back 85

Cold bi

Front 86

Bi syndrome;
numbness and heavy sensation

Back 86

Damp Bi

Front 87

Bi syndrome;
local burning sensation with redness

Back 87

Heat bi

Front 88

Bi syndrome;
chronic and difficult pain in bones and joints

Back 88

Deficiency bi of blood and qi

Front 89

Bi syndrome;
muscular stiffness and spasm

Back 89

deficiency bi of yin and blood

Front 90

Left cun

Back 90

Heart and small intestine qi

Front 91

Right cun

Back 91

lung and liver blood

Front 92

left guan

Back 92

liver and gall bladder qi

Front 93

right guan

Back 93

spleen and stomach blood

Front 94

left chi

Back 94

kidney, bladder qi

Front 95

right chi

Back 95

kidney (mingmen), bladder blood

Front 96

Normal pulse

Back 96

smooth, even, forceful, four beats per breath

Front 97

Pulse--floating group
floating superficial

Back 97

external syndrome

Front 98

Pulse--floating group;
surging/flooding

Back 98

excessive heat

Front 99

Pulse--floating group;
soft, soggy

Back 99

deficiency; dampness

Front 100

Pulse--Deep group;
deep

Back 100

interior syndrome

Front 101

Pulse--deep group;
weak

Back 101

deficiency of qi and blood

Front 102

Pulse--rapid group;
rapid

Back 102

heat syndromes

Front 103

Pulse--rapid group;
abrupt

Back 103

cu mai;
hurried, rapid, irregular missed beat

Front 104

Pulse--slow group;
slow

Back 104

cold syndromes

Front 105

Pulse--slow group;
hesitant

Back 105

qi stagnation;
blood stasis

Front 106

Pulse--slow group;
knotted

Back 106

jie mai;
slow, irregular missed beats

Front 107

Pulse--deficiency group;
deficiency

Back 107

deficiency syndromes

Front 108

Pulse--deficiency group;
thready

Back 108

deficiency due to overstrain and stress; deficiency of blood and qi

Front 109

Pulse--deficiency group;
regularly intermittent

Back 109

dai mai;
slow, weak, missed beats at regular intervals

Front 110

Pulse--excess group;
excess

Back 110

excess syndromes;
heat stagnation

Front 111

Pulse--excess group;
slippery, rolling

Back 111

pregnant pulse;
phlegm

Front 112

Pulse--excess group;
wiry, string taut

Back 112

liver and gall bladder diseases;
pain

Front 113

Pulse--excess group;
tense

Back 113

cold;
pain

Front 114

Index fingerprint for an infant

Back 114

ming guan (tip)
qi guan (middle)
feng guan (inner segment)

Front 115

The eight principles

Back 115

Yin and yang
Interior and exterior
Cold and heat
Deficiency and excess

Front 116

The categories of interior and exterior are used to determine...

Back 116

the depth of the disease

Front 117

Exterior syndrome

Back 117

aversion to cold; fever; thin tongue coating; superficial pulse

Front 118

Interior syndrome

Back 118

high fever; no aversion to cold; thirst; dark tongue; sinking pulse

Front 119

Intermediate syndromes

Back 119

alternating fever and chill; fullness and discomfort in chest and hypochondriac region; bitter taste; dry throat; wiry pulse

Front 120

Cold syndromes are from...

Back 120

exogenous pathogenic cold or deficiency of yang

Front 121

Heat syndromes are from...

Back 121

exogenous pathogenic heat or deficiency of yin

Front 122

Cold syndrome

Back 122

pale face; aversion to cold; not real thirsty; loose stools; clear urine, increased in volume; pale tongue; white moist coating; slow pulse

Front 123

Heat syndrome

Back 123

Red face; fever; preference for cold drink; constipation; scanty, deep-yellow urine; red tongue; yellow and dry coating; rapid pulse

Front 124

Deficiency refers to...

Back 124

insufficiency of the anti-pathogenic qi

Front 125

Excess refers to ...

Back 125

hyperactivity of the pathogenic factor

Front 126

Deficiency syndrome

Back 126

long-term, chronic; weak; dull pain, likes pressure; lassitude, talklessness with low voice; shortness of breath; clear urine; loose stools; tongue pale with little coating; thin-weak pulse

Front 127

Excess syndrome

Back 127

short-term, acute; strong body; dislikes pressure; hyperactivity; high voice; strong breath sound; scanty yellow urine; dry stools; red tongue w/ greasy coating; forceful pulse

Front 128

Yin's other three principles

Back 128

interior;
cold;
deficiency

Front 129

Yang's other three principles

Back 129

exterior;
heat;
excess

Front 130

Yin syndromes result from...

Back 130

deficiency of yang qi in the body and retention of pathogenic cold

Front 131

Yang syndromes result from...

Back 131

hyperactivity of yang qi in the body and excess of pathogenic heat

Front 132

Yin (blood) deficiency syndrome symptoms

Back 132

follows heat syndrome; afternoon fever; heat sensation in palms and soles, malar flush; night sweating; thirsty, dry throat and mouth, cold drinks; yellow urine; dry stools; red tongue with little coating; thin rapid pulse

Front 133

Yang deficiency syndrome symptoms

Back 133

follows cold syndrome; chill; spontaneous sweating; clear urine with increased volume; loose stools; pale tongue with white coating; weak pulse

Front 134

Qi deficiency symptoms

Back 134

pale face; shortness of breath; low voice; lassitude; spontaneous sweating; pale tongue with little coating; weak pulse

Front 135

Qi sinking symptoms

Back 135

dizziness; blurred vision; lassitude; prolapse of internal organs; pale tongue with little coating; weak pulse

Front 136

Qi stagnation symptoms

Back 136

distention; wandering pain; normal or white tongue; wiry soggy pulse (Pulse most important)

Front 137

Rebellious Qi symptoms

Back 137

cough; asthmatic breathing; vomiting; hiccup; normal or white tongue; wiry soggy pulse

Front 138

Blood stagnation symptoms

Back 138

stable local sharp pain and masses, hemorrhage; tongue purple with dark spots (most important); thin, soggy pulse

Front 139

Blood deficiency symptoms

Back 139

pale face and lips; lassitude; numbness; dizziness; palpitations; pale tongue with little coating; thin weak pulse

Front 140

Blood heat symptoms

Back 140

Irritability, dry mouth; hemorrage; prouse and red menses; fever; red tongue; rapid pulse

Front 141

Jin Ye deficiency symptoms

Back 141

dryness in mouth and skin; desire to drink; dry stools; fever; scanty urine; tongue red without coating; thin rapid pulse

Front 142

Jin Ye retention symptoms

Back 142

cough, profuse sputum (Lung); palpitations (heart); abdominal distentions (spleen or stomach); edema (spleen or kidney); white, moist tongue with moist coating; wiry sinking pulse