Tcm Diagnostics Charts - Combination Symptoms

Course:

Diagnostics II Combination Symptoms

Combination Syndrome Qi Deficiency of Heart and Lung

Upper Jiao problem

Deficiency of Heart and Spleen Specific pattern in TCM!!! This is spleen qi xu + Heart Blood Xu. Chief complaint often insomnia.

Middle Jiao problem

Gui Pi Tang is the formula of choice

Date:

Dec 8, 2007

Symptom Palpitation Cough with difficult inhalation, worse on exertion Chest tightness Clear phlegm Pallor of face Dizziness Lassitude Spontaneous sweating Tongue: pale with thin white coat Pulse: deep, weak or irregular Palpitations Poor memory Insomnia, DDS (dream disturbed sleep) Dizziness and vertigo Sallow complexion Reduced appetite Abdominal distention Loose stool, diarrhea Lassitude Bruising Scanty and light menses

Tongue: Pale with white coat Pulse: Thin and weak

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Caused by Indicative of heart problem Cough = lung, exert = Qi xu Phlegm ret, Qi congestion, Dampness MJ, no heat Qi/Yang/Blood Xu or Cold Can be excess, or Blood Deficiency Qi Xu Qi and Yang Xu Deep = interior, weak = deficiency Heart Blood deficiency Heart Qi Xu Heart of Liver Blood Xu (cant stay asleep, esp elder patients) Can be excess, or Blood Deficiency Dampness plus Spleen Qi Xu Spleen Spleen Spleen Qi Xu Qi Xu Spleen Xu, Heat, Trauma Blood Xu (thinner and lighter in color) Yin Xu (redder) If heavy can be blood heat or spleen qi xu

Blood Xu in both Heart and Liver

Very specific manifestationÆ

Palpitations Poor memory Insomnia, DDS

Heart Blood Xu Heart Qi Xu Heart of Liver Blood Xu (cant stay asleep, esp elder pts) Can be excess, or Blood Deficiency Qi/Yang/Blood Xu, Cold Liver Yin Xu Liver Yin Xu advanced to Liver Blood Xu Blood Xu – anemia/malnutr cn b due toblood or qi xu Liver wind

Dizziness and vertigo Pale face Dry eyes Blurred vision Numb limbs ,Tremors

“Different kinds of wind and vertigo belong to liver.” “Blood deficiency generates wind.”

Another symptom of wind: itching, rashes Treatment: tonify the blood. Blood Xu Yin Xu (+nite sweat, 5palm heat, thirst, dk red tongue, little coat)

Little menses

Yang Xu of Heart and Kidney Tricky pattern. Do not confuse with Heart/Kid Disharmony (a yin xu)! Look for cold signs, swollen face, chest tightness w/coldness there. Many chronic ht failure pts have this Always want covers on chest

Tongue: pale with white coat Pulse: thin and weak Palpitations Pale face Aversion to cold, cold limbs Sleepy Edema in face/limbs, esp lwr legs

Cold, soreness/weakness of lumbar and knee joints Pale lips and nails Early morning Diarrhea Tongue: pale with slippery coat Pulse: deep, feeble, slow

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Heart Qi/Blood/Yang Xu, Cold Yang Xu, extreme anger causing Qi congestion Heart Qi Xu usually or Spleen Qi xu after meals Lower limbs = Kidney yang related All 4 limbs = Spleen related Edema that doesn’t stay depressed = Qi edema Kidney Yang deficiency Blood, Qi or Yang Xu Kidney Yang Xu Yang and/or Qi xu with water retention Deep = interior/longterm, Feeble = def, Slow = cold

Disharmony of Heart and Kidney Yin Xu of heart and kidney, but w/ special name in TCM Rel between Ht and Kd = fire and water. One controls the other. When out of balance gets even more out of whack.

Qi Deficiency of Lung and Spleen

Liver Fire Insulting Lung

Palpitations Insomnia Restlessness, irritability Poor memory Dizziness and vertigo Tinnitus Dry throat Tidal fever Night sweating Soreness of lumbar and waist Spermatorrhea in dreams Tongue: red with little coating Pulse: thin and rapid Chronic, constant cough with profuse, clear phlegm Shortness of breath Poor appetite Abdominal distention Loose stools, diarrhea Burning pain or distention in costal/hypochondriac region Quick temper, irritability Restlessness Dizziness Red eyes Bitter taste in mouth Violent, intermittent cough Little sticky yellow phlegm, spitting blood Hot sensation in chest Tongue: red w/thin yellow coat Pulse: wiry, rapid

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Heart Blood deficiency Heart fire/liver fire Heart yin/blood Xu Yin def in L. Jiao so yang goes upward Kidney yin deficiency Kidney channel – which goes to bk of throat Yin Xu Yin Xu Kidney Kidney Xu Deficient heat Deficiency + heat Cough = Lung, phlegm = Spleen Chronic = deficient, clear = no heat Lung Xu Spleen Spleen Spleen Qi Xu Indicates Liver Liver + heat Liver fire longterm affects Heart/shen (Mother/son rel) Wind due to the heat Liver fire. If sclera is red liver fire is insulting the lung Liver, stomach, or GB fire Violent = excess condition All indicates heat

Heat Wiry = liver, rapid = heat

Yin Xu of Lung and Kidney

Yin Xu of Liver and Kidney

*Don’t let the heart looking symptoms throw you off…is blood/shen relation.

Difference between this & Heart and Kidney Disharmony: -no palpitations -presence of dry eyes, hypochon pain

Cough + little or bloody sputum Dry mouth, sore/dry throat Hoarseness Losing weight, emaciation Soreness/weakness of lumbar and knee joints Tidal fever, malar flush Night sweats Nocturnal emissions Less menses Possibly, tinnitus w/high pitch Tongue: red with little coating Pulse: thin and rapid Dizziness and vertigo Tinnitus Dull hypochondriac pain Poor memory *Insomnia, DDS Dry throat, eye, mouth Loosing weight, emaciation Soreness/weakness of lumbar or knee joints Malar flush, night sweats, 5 palm heat, etc. Nocturnal emissions Scanty menses flow Tongue: red with little coat Pulse: Thin, rapid

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Cough = lung, little = deficient, bloody = def heat Dry = yin or body fluid xu, sore throat = lu/kd meridian Lung yin Xu Yin Xu Kidney Xu Yin Xu Yin Xu Kidney Yin Xu Yin Xu Kidney Yin Xu Red = heat, little coating = deficiency Thin = deficiency, rapid = heat Wind – blood xu, yin xu, or heat excess Kidney deficiency Dull = deficiency, hypochondriac area = liver If short term memory: Heart Bld xu If long term memory: Kidney xu Liver Blood Xu or Heart Blood Xu Liver Yin xu Kidney Yin Xu Kidney yin xu Yin xu of kidney and perhaps liver Red = heat, little coating = deficient Thin = deficiency, rapid = heat

Yang Xu of Spleen and Kidney

Pallor of face Poor appetite Aversion to cold, cold limbs Cold, soreness and weakness of lumbar and knee joints Loose stools or diarrhea at dawn Chronic diarrhea Incontinence of urine Facial puffiness or edema of limbs

Tongue: pale, swollen, slippery white coat Pulse: deep, feeble, slow Group the following 2 together Disharmony of Liver/Spleen

Liver overacting on spleen

Disharmony btwn Liver/Stomach Can be 1) liver qi stag Æ fire and affecting st or 2) retained cold affecting liver and stomach

Distention/fullness, pain in costal and/or hypochrondriac area Sighing Poor appetite Abdominal distention Depression, irritability Loose stools/constipation Tongue: white or greasy coating Pulse: wiry Distention/fullness, pain in costal and/or hypochondriac area Belching, hiccupping, acid reflux Should also have constipation Irritability Tongue: red body, thin yellow coating Pulse: wiry and rapid

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Yang/Qi/Blood /Xu, cold Spleen Qi Xu Cold limbs = Spleen Yang Xu Kidney and Kidney Yang Xu Dawn = Kidney Yang Xu Chronic = interior/long term Kidney Qi or Yang Xu Edema of limbs = Spleen Edema above waist = yang edema. Lung, Spleen Edema below waist = yin edema. Spleen, Kidney Spleen Qi Xu Æ Spleen Yang Xu Æ Sp/Kid Yang Xu Deep = interior, feeble = defic, slow = cold Liver Liver Qi Stagnation Spleen Qi Xu Spleen Qi Xu Liver fire Spleen Qi Xu Liver

Stomach Qi cannot go down, rebelling upwards

heat Wiry = liver, rapid = heat