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131 Cards in this Set
- Front
- Back
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What is the Eight Principle Pattern of identification? |
Yin / Yang |
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What does the Eight Pattern of identification tell you?
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Aids in understanding the location and nature of the disease, and the strength of right vs evil. |
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In Wind-Cold syndromes, aversion to cold is:
a) strong b) light, or aversion to wind |
Wind-Cold is Exterior Cold Pattern, aversion to cold is STRONG
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If px is suffering from Wind-Heat, his aversion to cold is:
a) strong b) light, or aversion to wind |
Wind-Heat is an Exterior Heat Pattern with light, or aversion to wind.
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Fever in Wind-Cold Syndrome is ______ (light/strong).
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Fever in Wind-Cold syndrome, an Exterior Cold Pattern is light (more chills than fever).
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Fever in Wind-Heat Syndrome is _______ (light/strong)
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Fever in Wind-Heat Syndrome is STRONG. More fever than chills.
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What is the pulse for px suffering with Wind-Cold Syndrome?
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floating and tight
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What pulse does px have if she suffers from Wind-Heat Syndrome?
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floating and rapid
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What are the functions of Qi?
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Promoting (pushing)
Warming Protection Consolidation Transforming Nourishing |
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What are the different types of Qi?
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Primary (original) Qi - Yuan Qi
Center Qi - Zhong Qi Gathering Qi (Ancestral Qi) - Zong Qi True Qi - Zhen Qi |
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What is Source or Yuan Qi?
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Before-heaven qi. Transformed from jing essence, associated with kidneys or life gate (ming men).
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What is Center Qi or Zhong Qi?
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Sp/St qi, digestive qi.
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What is Gathering (Ancestral) Qi?
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Combination of Grain or Gu Qi and Great (air) or Qing Qi. Gathers in the chest. It is the ancestor of true qi.
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What is True Qi?
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Gathering qi is transformed by source qi into true qi, which is what most of the body uses in the channels and organs. Consists of:
Construction (or nutritive) Qi - Ying Qi Defense Qi - Wei Qi |
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_______ qi is responsible for human growth, development and reproduction.
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Pre-natal Qi - Primary Qi (Yuan Qi)
stored in the Kidney, inherited from parents |
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Postanatal Qi is formed by _______.
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Food essence (Gu Qi) combined with Great (air) or Qing Qi.
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Describe Qi movement.
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Ascending
Descending Exit Enter |
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Qi movement in Zang Fu organs.
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Ht & Lu - descending
Lv & Kd - ascending Sp/St - pivot & hinge Lung exhale (Exit), descending Kidney inhale (Enter) Liver - ascending & dispersing Sp ascending the clear St descending turbidity |
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cold limbs extending up past the elbows and up the body past the knees
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Qi deficiency resulting in Yang deficiency
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cold fingertips
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Qi deficiency resulting in qi stagnation???? Check
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pain better after exercise and movement
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Qi stagnation
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pain worse after movement
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Blood stagnation
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What are the symptoms of Qi deficiency?
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*Shortness of breath* Worse with exertion*
*spontaneous sweating* fatigue* dislike talk, listlessness, dizziness, blurry vision Tongue: Pale and tender Pulse: deficient and weak |
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What are the two types of pathological change of Qi?
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Quantity change (Qi deficiency, Qi sinking, Qi Collapse);
Movement change (Qi stagnation, Qi rebellious, Qi obstruction) |
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What does Qi deficiency mean?
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primary Qi (Yuan Qi) is insufficent
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What are the major reasons causing Qi deficiency?
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insufficient production (improper diet, congenital); excessive consumption (disease, long term physical and mental strain); aging
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What is does a tender tongue indicate?
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Deficiency syndrome:
tender & dry - Qi & blood deficiency tender & glossy - Yang Qi deficiency |
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What are the similarities and differences between Qi deficiency and Yang deficiency?
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Many common symptoms and signs (fatigue, SOB, spontaneous sweating, pale & tender tongue, forceless pulse).
Yang deficiency pattern developed from Qi deficiency pattern. Yang deficiency is more SEVERE. Yang deficiency - there is fear of cold, cold limbs, flabby tongue, white moist coating, deep & slow pulse. |
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What is more severe, Qi deficiency or Yang deficiency?
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Yang deficiency
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What organ is most involved in Yang Deficiency? Qi deficiency?
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Yang deficiency - Kidney
Qi deficiency - Spleen |
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What is the tx strategy and method for Qi deficiency?
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Tonify and supplement the Qi
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What is the governing formula used for Qi deficiency?
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Si Jun Zi Tang
(Four Gentlemen Decoction) |
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Px has dizziness, blurred vision, low energy, chronic loose stool, sagging and distended sensation in abdominal area. Px also has prolapsed of the rectum. What is the pattern identification?
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Qi Sinking Pattern
aka middle Qi sinking or Spleen Qi Sinking |
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What is the reason that Qi sinking occurs?
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Qi is severely deficient and unable to perform its lifting and holding function. Clear Yang Qi is sinking downward instead of rising upward. This may result in prolapse of the Zang Fu organs.
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prolapse of the organs
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Qi sinking pattern
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What is the etiology behind the symptoms of dizziness & blurry vision, chronic diarrhea or loose stools?
What is the reason why organs are prolapsed? |
Failure of clear yang to rise because of qi deficiency.
When Qi deficiency gets worse, Spleen qi is especially affected. Spleen Qi has fxn of lifting and holding, so if deficient, causes clear yang NOT to rise. Organ prolapse occurs in Qi sinking. If Sp Qi fails to hold, then it results in internal organ prolapse. |
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Px suddenly collapses after profuse bleeding. He has feeble breath, profuse spontaneous sweating, hand open, limb flaccid. He has incontinence. The tongue is pale. Pulse is floating without root.
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Qi collapse pattern
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What are the symptoms of Qi collapse pattern?
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Sudden loss of consciousness with eye closed but mouth open, feeble breath, profuse spontaneous cold sweating, open hands, flaccid limbs, incontinence
Tongue: pale Pulse: floating pulse without root, or scattered, or minute pulse |
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What are the possible pulses for Qi collapse pattern?
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floating pulse without root, or
scattered, or minute pulse |
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What kind of pain is associated with Qi stagnation pattern?
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Distention;
pain moves from place to place; or throbbing pain; paroxysmal pain; tightness pain; or distention pain. |
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What are key symptoms of Qi stagnation pattern?
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Distention and unfixed pain, depression, irritability, wiry pulse. Symptoms induce or aggravated by emotional stress.
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Px has throbbing pain on the side of his chest that comes and goes. He is frequently irritable, has mood swings and sighs a lot, with a wiry pulse. He says his symptoms are worse when he is stressed. What is the most likely pattern identification?
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Qi stagnation
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What are the primary pathogenic factors that cause Qi stagnation?
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Emotional stress; improper diet; exopathogenic factors; or traumatic injury or surgery.
Aging or chronic illness can cause yang Qi insufficiency, or cold accumulation can slow down Qi movement. |
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What are secondary pathogenic factors of Qi stagnation?
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phlegm, blood stagnation, or stones
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masses or lumps that do not move
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Blood Stagnation
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Px has distended pain in an unfixed location. He suffers from frequent belching, gas, and borborygmi. He is irritable and suffers from depression. Symptoms are worse with stress. What is the most likely pattern identification?
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Qi stagnation - Lv Qi stagnation
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What is the tx strategy and method for Qi stagnation?
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Rectify and move the Qi
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Which organ is most likely involved if Qi stagnation symptoms include lower abdominal twisting pain, which may extend to back, distention, dislike pressure, borborygmi and flatulence?
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Small Intestine Qi Stagnation
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Which organs are the most affected by Qi rebellion?
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Lung, Stomach, Liver
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What are the symptoms of Liver Qi rebellion?
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headache, dizziness, or fainting. In serious cases there can be nosebleed, vomiting of blood.
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What are the symptoms of Lung Qi rebellion?
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cough, panting, hasty breathing
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What are symptoms of Stomach Qi rebellion?
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nausea, vomiting, belching and hiccups
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What is Qi obstruction pattern?
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Severe; interior EXCESS pattern; acute onset, quick & severe, change is manifested w/ coma, fainting & cold limbs.
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What are the symptoms of Qi obstruction?
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Sudden loss of consciousness, fainting, or coma; harsh breathing; gurgling w/sputum; clenched fist and jaws; no urinary or bowel incontinence.
Pulse: forceful, slippery and rapid; or wiry and rapid pulse; or hidden pulse |
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Px lost consciousness and is in a coma. His mouth and hands are open; he has incontinence and has no control over his bowel movements; feeble breath, profuse sweating, minute and scattered pulse. What is the pattern identification?
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Qi collapse
-due to severe DEFICIENCY causing an inability to nourish, promote movement and consolidate the body. - Spirit (Shen) is not nourished and Body Fluid leaks out |
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Px lost consciousness and is in a coma. His jaws are clenched, mouth and hands are closed tightly; no urinary incontence or BM; harsh breath; little or no sweating; forceful pulse.
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Qi obstruction
- EXCESSIVE amounts of Qi stagnation prevents circulation inside the body. - Heart orifice congested, leading to fainting or coma. |
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What is blood and what is it composed of?
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Blood is part of yin, a very dense form of qi.
Composed of: Nutritive Qi (Ying Qi) Body Fluids (Jin Ye) |
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*What are the functions of blood?
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Nourishes the body.
Moistens (eyes, sinews, skin, hair) Material foundation for Shen (spirit, mind). Ht blood houses and anchors the shen. Hair is surplus of blood |
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What are the materials for blood generation?
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food essences, Ying qi (nutritive qi), Jin Ye (body fluids), & Kidney essences
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Which Zang Fu organ keeps blood inside the vessels?
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Spleen - controls blood
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Which Zang Fu organ soothes qi and stores blood?
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Liver
soothes qi - promotes blood circulation storage blood - regulates blood volume |
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Which Zang Fu organ governs the blood and promotes blood circulation
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Heart
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Which Zang fu organ assists the heart to promote blood circulation?
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Lungs - helps heart qi circulate blood.
Governs the qi of the whole body. Qi moves blood. Lungs are in charge of orderly flow (prime minister) - Pushes qi-blood through the vessels and channels. |
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What are the symptoms and signs of Blood Deficiency?
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*Pale face* without luster;
or withered yellow face; pale lips and nails; dizziness; blurry vision; palpitations, insomnia; numbness & tingling sensation in hands & feet; Women - there may be abnormal menses (light, scanty, delay or even absent) Tongue: Pale Pulse: thready and weak |
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What are the indications if someone has numbness and tingling sensation:
(a) in both hands and feet; and (b) only on one side |
(a) Blood deficiency
(b) Blood stagnation |
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What are the organs that are most affected by blood deficiency?
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Heart and Liver
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Px suffers from palpitations, restlessness, insomnia, dream disturbed sleep and poor memory. He has a pale face, pale lips and nails, pale tongue with a thready and weak pulse. What is the pattern identification?
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Blood Deficiency Pattern
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What are symptoms associated with Liver Blood deficiency?
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Pale and sallow complexion, pale lips & nails, pale tongue, thready and weak pulse.
Dry eyes, blurred vision or night blindness, dizziness, muscle twitching, numbness of limbs, scanty light menses, or amenorrhea, brittle and fragile nails. |
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What is the pulse for person that has blood deficiency?
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thready and weak pulse -
blood fails to fill vessels |
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What is the treatment strategy for Blood Deficiency?
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Tonify and replenish blood.
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If px has sharp and fixed pain that is resistant to pressure; she has a dark complexion, with a purple tongue and a choppy pulse. What is the most likely pattern identification?
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Blood stagnation
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What are the characteristics of pain due to Blood Stagnation?
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Pain (piercing, boring, or stabbing);
WORSE at night, resistant to pressure, fixed location **worse with movement** |
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What are symptoms of blood stagnation?
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Pain (piercing, boring, or stabbing), aggravated at night, resistant to pressure, fixed location;
Dark complexion Purple lips Masses or lumps that do not move Bleeding with dark blood and dark clots Squamous and dry skin Menorrhagea, amenorrhea or dysmenorrhea Tongue: purple or dark spot on the side of tongue, possibly distended and purple veins under tongue Pulse: choppy, irregular pulse |
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What can cause blood stagnation?
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Qi stagnation, Qi deficiency, trauma injury, Blood deficiency, Cold, Heat
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Px is suffering from stabbing or pricking pain n the chest, palpitations, cyanosis of lips and nails, cold limbs. She has a dark complexion, with a purple spot on front of the tongue with a choppy pulse. What is the pattern identification?
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Heart Blood stagnation
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What are the key points in identifying a Bloo-Heat Pattern?
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bleeding; deep red tongue; wiry and rapid, forceful pulse
other symptoms and signs: hemoptysis, hematemesis, all kinds of bleeding, hematuria, hematochezia, preceded mens cycle, menorrhagia, vexation, thirst, fever |
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What are the symptoms and signs of Blood-Cold Syndrome?
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Pain & coldness in the hands, feet, & lower abdomen, can be relieved by warmth;
irregular menstrual cycle; dysmenorrhea, menses in dark purple color with clots Tongue: pale Pulse: deep & slow or wiry & choppy |
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Px has severe local pain on his leg, with swollen or blue purple color in that area, relieved by warmth. His pulse is deep and slow. What is the pattern identification?
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Blood-Cold Syndrome
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What is the main difference between Blood Stagnation pattern and Blood-Cold Syndrome?
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Blood-Cold Syndrome is part of blood stagnation pattern, only happens when exopathogenic cold attacks the vessels; and only hands and feet or Chong/Ren channels are involved.
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What are the key points for identifying a combined pattern of Qi stagnation and Blood stagnation?
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Distention, migratory pain or masses w/ fixed location & sharp pain following liver channel, purple tongue & choppy pulse
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Px complains of fullness and distended pain in the chest and hypochondrium. She has a mass on her abdomen which is painful and resistant to pressure. She has irritability and depression. She gets PMS with painful periods. Her tongue is dark purple with petchiae. Her pulse is choppy. What is the pattern identification?
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Qi & Blood Stagnation
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What does it indicate when pain is resistant to pressure?
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blood stagnation
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Sharp fixed pain.
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blood stagnation
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Px has pale dark complexion and suffers from fatigue, listlessness, shortness of breath, & dislikes talking. She has sharp fixed pain in the chest that is resistant to pressure. She has a purple tongue with a deep and choppy pulse. What is the pattern identification?
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Qi deficiency with blood stagnation
- key points: Qi deficiency symptoms plus blood stagnation signs |
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Px has dizziness and vertigo, fatigue, SOB, dislikes to speak, spontaneous sweating with palpitations, insomnia, pale or sallow complexion, pale tender tongue, with a thready and feeble pulse. What is the pattern diagnosis?
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Qi & Blood deficiency Pattern
Qi deficiency: fatigue, SOB, spontaneous sweating, dislike speaking Blood deficiency: Palpitations, insomnia; pale nails, lips & face; dizziness, vertigo |
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What causes bleeding due to Qi deficiency?
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Bleeding arises from the failure of deficient qi to govern blood.
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What are the signs and symptoms of Bleeding due to Qi deficiency?
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Hemafecia (purulent bloody stools);
Hematemesis (vomiting of blood); Ecchymoses (bruise); Teeth & gum bleeding; Metrorrhagia (bleeding b/w menstrual periods); Metrostaxis (continous uterine bleeding) with Shortness of breath; Spontaneous sweating; Fatigue Pale complexion Tongue: Pale Pulse: Thready & Feeble |
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How can you differentiate the pattern of bleeding due to Qi deficiency?
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Chronic bleeding plus Qi deficiency signs and symptoms.
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Px has an acute onset of fever and is irritable and restless. He is constantly thirsty. His nose is bleeding and the color is bright & thick. His tongue is deep red, with a wiry and rapid pulse. What is the pattern diagnosis?
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Excess heat in the blood
(see p. 85 ppt comparison chart) |
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What are the symptoms of Qi collapse due to bleeding?
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Heavy bleeding;
Face sudenly turns pale; Profuse sweating; Cold limbs; Feeble breath, even syncope; Tongue: Pale Pulse: Thready & Minute or Scattered |
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What is body fluid?
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Basic material that makes up the body and maintains life activities of the body.
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What is the function of body fluids?
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Moisten first;
Nourish secondarily also helps anchor qi |
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Jin
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thin & clear;
strong mobility; Skin, muscles & orifices; able to permeate into blood vessels; MOISTENS |
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Ye
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thick and turbid;
weak mobility; Joints, viscera, brain & marrow; NOURISHES |
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Zang Fu organ that transforms water into body fluids; distributes body fluids to entire body; and transfers body fluids up to the Lungs.
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Spleen
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Zang Fu organ that is in charge of descending and dispersing qi and body fluids.
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Lungs - upper source of water;
- descends fluids to the Kidneys & UB & helps with urinary function; - Lungs dispers fluids to moisten the skin, like a mist |
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Zang Fu organ governs the water of the whole body; governs fluid metabolism; evaporates and transforms.
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Kidney - water organ
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Zang Fu organ that is the passage for distributing body fluids.
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San Jiao
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Zang Fu organ that governs blood; body fluid is a major component of blood.
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Heart
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Zang Fu organ that ensures the smooth flow of qi, "water moves when qi moves;" promotes body fluid circulation.
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Liver
also stores blood |
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What is the Qi action on body fluids?
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Qi generates body fluid
Qi promotes body fluid circulation Qi consolidates body fluid (failure will cause profuse & spontaneous sweating; polyuria or incontinence) |
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What is the body fluid action on Qi?
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Body fluids generate qi (nourishing and moistening)
Body fluids carry qi |
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Fluid Pattern Identification
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Two types:
Insufficiency (Body Fluid Insufficiency) Stagnation or accumulation of fluids Excess: (Phlegm & Rheum) |
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What are the symptoms and signs of Body Fluid insufficient pattern?
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Internal dryness pattern.
Dry mouth & throat, dry & cracked lips; dry & rough & itchy skin; dry hair; thirst & desire to drink; Scanty & dark yellow urine, dry stool, flaccidity; Tongue: Red w/ dry yellow coat Pulse: Thready & Rapid |
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What is Retention of Fluid pattern?
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Pattern due to water accumulation inside the body, which may result from exopathogen attack or emotional stress, leads to internal organ dysfunction, affects the body fluid distribution and excretion.
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What are the two types of Retention Fluid Patterns?
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Edema (Yang edema & Yin edema)
Phlegm & Rheum |
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What is edema?
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Swelling caused by fluid retention - excess fluid is trapped in the body's tissues.
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What is pitting edema?
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After pressing finger on the swollen area, an indentation persists for some time after the release of pressure.
Indicates water retention. |
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What is "baloon" edema?
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If you press on the swollen area, does not make an indentation but goes back like a "balloon."
Indicates qi stagnation. |
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If px has acute onset of edema that starts from face, with heavy limbs, and abdominal distention. He has chills & fever. Tongue has white greasy coat, and pulse is superficial. What is the pattern identification?
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Retention of Fluid Pattern - Yang Edema
- heat, excess |
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Px has chronic illness and physical overstrain. He suffers from edema that starts from the ankles. He has intolerance of cold, fatigue, low back ache, and poor appetite. His tongue is pale and tender, with slippery coating. His pulse is deep, slow, and forceless. What is the pattern identification?
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Retention of Fluid Pattern - Yin Edema
- chronic; cold, deficiency |
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What does intolerance of cold mean, and what does it indicate?
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Intolerance of cold - cannot tolerate cold, sensation relieved by more clothes or external heat source.
Indicates interior cold due to yang deficiency. |
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Px has edema, acute onset, starts from eyelid and then spreads to the whole body. She has difficulty urination. She has fever, aversion to cold with NO sweating. Tongue has white coat and a superficial and tight pulse. What is the pattern identification?
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Retention of Fluid Pattern - Yang Edema -
Wind Water Pattern |
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Px has edema, acute onset, starts from eyelid and then spreads to the whole body. She has difficulty urination. She has fever, with sore throat, with a red tongue and superficial and rapid pulse. What is the pattern identification?
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Retention of Fluid Pattern - Yang Edema -
Wind Water Pattern |
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Px has pitting edema in the entire body, sub-acute onset, body, limbs are heavy and weak; scanty urine, abdominal distention, poor appetite, nausea & vomiting. Tongue has white greasy coating, with a deep pulse. What is the pattern identification?
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Retention of Fluid Pattern - Yang Edema -
Dampness accumulates in Spleen Pattern |
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Px has pitting edema in the entire body, sub-acute onset, body, limbs are heavy and weak; with yellow scanty urine, abdominal distention, poor appetite, nausea & vomiting. Px has a red tongue w/ yellow greasy coating. Pulse is deep and rapid. What is the pattern identification?
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Retention of Fluid Pattern - Yang Edema -
Dampness accumulates in Spleen Pattern |
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Edema that is more chronic
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Yin edema
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Edema that is accompanied by exterior syndromes.
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Yang edema - acute; heat, excess
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Phlegm is ______ (thick/thin) fluid.
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Phlegm is thick & turbid fluid;
created when there is qi or fire steaming; affects entire body & many locations; can combine with other pathogens, causes variety of symptoms; Long course & difficult to treat yin type pathogen |
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Rheum is ______ (thick/thin) fluid.
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Rheum is clear & thin fluid;
flows easily & accumulates in space within organs & tissues; yin type pathogen -impairs & obstructs yang qi; Tongue: White greasy or slippery coating Pulse: slippery & wiry |
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Px is 50 year olds and overweight. He has profuse thin white sputum that is easy to expectorate, worse at night and in late summer. What is the pattern due to phlegm?
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Damp Phlegm Pattern
- Spleen qi deficiency leads to accumulation of damp, which transforms into phlegm |
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Thin white/clear sputum, easy to expectorate, worse at night and in winter, often seen in elderly patient.
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Cold Phlegm Pattern
- Sp or Kd yang deficiency causes dysfunctions of water metabolism |
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Thick yellow sputum, difficult to expectorate.
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Heat Phlegm Pattern
- Intense fire scorches the fluids & transforms into phlegm |
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Viscous white sputum, possibly blood-streaked, very difficult to expectorate, worse in Autumn, most often seen in older patients, or in yin deficiency condition.
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Dry Phlegm Pattern
- Lu dryness or Lung and Kd deficiency w/ deficiency heat, which consumes the fluids and produces phlegm |
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Copious, foamy white sputum, easy expectoration, cough, chills & fever
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External Wind-Phlegm Pattern
- External wind invades the lungs, disrupts fluid distribution & produces phlegm. |
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Copious, foamy white sputum, dizziness, vertigo
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Internal Wind-Phlegm Pattern
- Sp deficiency causes phlegm that accumulates with the stirring of Liver wind |
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Chest oppression, cough with profuse clear, thin sputum, shortness of breath or dyspnea and inability to lie down flat. Edema worse on the legs. (Congestive heart failure in biomedicine)
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Propping Rheum Pattern - Lung
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Chest pain & distention, induced or aggravated by cough, sneezing or deep breath, maybe only one side or both.
(Pleurisy in biomedicine) |
Suspended Rheum Pattern - Chest & rib
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Abdominal bloating & distention, borborygmus, vomiting w/ clear & sticky fluids.
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Phlegm-rheum Pattern - St/Intestine
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Limbs edema, heaviness of body, no sweating, scanty urination.
(Uremia in biomedicine) |
Spillage Rheum Pattern - Skin & Muscle
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Abdominal swelling & distention, taut, and navel is flat or even pushed out. Scanty urine.
(Ascites in biomedicine) |
Abdominal Water Pattern - Abdomen
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