General Symptoms and Their Meaning in TCM

 Colours of the Face  Chills and Fever

 Appearance  Perspiration
 Eyes  Appetite, Eating, and Taste
 Nose  Defecation and Urination
 Ears  Pain
 Gums  Sleep
 Lips and Mouth  Menses
 Throat

Colours of the Face Meaning

Red (Excess or Xu Heat)

Whole Face Heat from External Evil or Hyperactivity of Zang

Fu (Excess)

Cheeks, Tidal Fever, Night Sweats Internal Heat (Xu)

Pale (Cold or Loss of Blood)

Pale White Yin Excess or Yang Xu

Bright White with Puffy and Bloated Appearance Yang Qi Xu

Withered White Blood Xu

Yellow (Damp or Xu)

Body, Face, Eyes, and Skin Jaundice

Bright Orange Yang Jaundice (Damp Heat)

Colours of the Face Meaning

Smoky Dark Yin Jaundice (Cold Damp or Long Term

Stagnation)

Pale Yellow (Not Bright) Blood and Qi Xu

Blue (Cold, Pain, Blood Stagnation, Convulsions)

Pale with Blue Tinge and Severe Pain in the Excess Yin and Cold
Epigastria and Abdomen

Bluish Purple Face and Lips with Intermittent Pain Stagnation of Heart Blood
Behind the Sternum or Pericardial Region

Bluish Purple Face and Lips with High Fever and Infantile Convulsion
Violent Movement of Limbs in Children

Dark Gray (Blood Stagnation and Kidney Xu)

Pale and Dark with Lumbar Soreness and Cold Feet Kidney Yang Xu

Dark without Brightness with Scaly Skin Prolonged Blood Stagnation

Appearance Meaning

Overweight with Mental Depression Qi Xu and Excess Damp Phlegm

Loss of Weight in Long Term Illness Exhaustion of Essential Qi

Thin with Dry Skin Blood Xu

Extended Neck Excess Lung Syndrome with Excess Phlegm

Facing Downward Qi Xu with Shortness of Breath, Dislike of

Speaking
Appearance Meaning

Violent Movement of Limbs Wind Diseases, Infantile Convulsions

Weakness, Motor Impairment, and Muscular Wei Syndromes

Atrophy of Limbs

Pain, Soreness, Heaviness and Numbness in Bi Syndromes

Tendons, Bones and Muscles, with Swelling and
Restricted Movement of Joints

Numbness or Impaired Movement of Limbs on One Hemiplegic or Wind Stroke

Side of the Body

Eyes Meaning

Redness and Swelling Wind Heat or Liver Fire

Yellow Sclera Jaundice

Ulceration or Canthus Damp Heat

Upward, Straight Forward, or Sideways Staring Liver Wind

Nose Meaning

Flapping of Ala Nasi Heat in the Lungs or Qi Xu of both Lung and

Kidney

Clear Discharge Wind Cold

Turbid Discharge Wind Heat

Prolonged Turbid Discharge, with Stinking Rhinitis or Chronic Sinusitis

Discharge
Ears Meaning

Burnt Black and Dry and Withered Auricles in Consumption of Kidney essence
Severe Illness

Purulent Discharge Damp Heat of Liver and Gall Bladder

Gums Meaning

Pale Gums Blood Xu

Redness and Swelling Stomach Fire

Redness and Swelling with Bleeding Injury of Vessels by Stomach Fire

Lips and Mouth Meaning

Pale Lips Blood Xu

Bluish Purple Lips Retention of Cold or Blood Stagnation

Red and Dry Lips Excess Heat

Sudden Collapse with Open Mouth Xu

Sudden Collapse with Lockjaw Excess

Throat Meaning

Redness, Swelling, and Soreness Lung and Stomach Heat

Redness and Swelling with Yellow or White Ulcer Toxic Heat in Lung and Stomach
Spots
Throat Meaning

Bright Red with Mild Soreness Yin Xu with Hyperactive Fire

False Gray and White Membrane over Throat that is Diphtheria from Heat in the Lung Consuming Yin.
Hard to Remove, and Bleeds Following Removal

Chills and Fever Meaning

Chills Accompanied by Fever (External Pathogen Fighting with Antipathogenic Qi (Zheng Qi))

Severe Chills, Mild Fever, Absence of Sweating, Wind Cold

Headache, General Aching, and a Superficial Tight
Pulse

Mild Chills, Severe Fever, Thirst, Sweating, and a Wind Heat

Superficial Rapid Pulse

Alternating Chills and Fever

Alternating Chills and Fever with a Bitter Taste in Intermediate Syndrome

the Mouth, Thirst, Fullness and Stuffiness in the
Chest and Hypochondrium

Alternating Chills Occurring at Specific Times of Malaria

the Day

Fever without Chills

High Fever with Aversion to Heat, Profuse Excess Heat in the Interior
Sweating, Severe Thirst, and a Surging Pulse

Fever at a Fixed Hour of the Day Tidal Fever

Tidal Fever in the Afternoon or Evening, with Night Yin Xu

Sweating, and a Red Tongue with Little Moisture
Chills and Fever Meaning

Fever more Pronounced in the Afternoon with Yangming Fu Syndrome

Constipation, and Fullness and Pain in the
Abdomen

Chills without Fever

Chilled Appearance, Cold Limbs, and a Deep, Interior Cold Xu

Slow, and Weak Pulse

Perspiration Meaning

Absence of Sweating in Exterior Syndromes Invasion by Pathogenic Cold

Presence of Sweating in Exterior Syndromes Exterior Xu from Exposure to Wind, or Exterior

Heat from Invasion of Pathogenic Wind Heat

Night Sweating (May also have Tidal Fever, and a Yin Xu with Hyperactivity of Yang Heat
Red Tongue with Little Coat

Spontaneous Sweating (May also have Chills, Qi and Yang Xu

Listlessness, and Lassitude)

Profuse Sweating with High Fever, Mental Excess Interior Heat

Restlessness, Thirst for Cold Drinks, and a Surging
Pulse

Profuse Sweating with Listlessness, Feeble Energy, Total Exhaustion of Yang Qi

Cold Limbs, and a Deep Thread Pulse in a Severe
Case

Appetite, Eating, and Taste Meaning

Poor Appetite in a Prolonged Illness with Spleen and Stomach Weakness

Emaciation, Loose Stools, Lassitude, and a Pale
Tongue with Thin White Coat

Poor Appetite with Stuffiness in the Chest, Fullness Stagnation of Qi of the Spleen and Stomach Caused
Appetite, Eating, and Taste Meaning

in the Abdomen, and a Thick Sticky Tongue Coat by Retention of Food or Dampness

Excessive Appetite and Easily Hungry in a Skinny Excess Stomach Fire

Patient

Hunger with no Desire to Eat, or Eating Small Impairment of Stomach Yin, Producing Internal Xu
Amounts of Food Heat

Lack of Thirst During an Illness Body Fluids are not Consumed (Usually present in
a Cold Syndrome, or where Heat is not Noticeable)

Presence of Thirst During an Illness Consumption of Body Fluid or Retention of Phlegm

Damp in the Interior Preventing Fluid from
Ascending

Bitter Taste in the Mouth Liver and Gallbladder Fire

Sweet Taste in the Mouth Damp Heat in the Spleen and Stomach

Sour Regurgitation Retention of Heat in the Liver and Stomach

Tastelessness Spleen Xu

Defecation and Urination Meaning

Constipation from Dryness of the Stool Accumulation of Heat or Consumption of Body

Fluids

Loose Stools Spleen Xu, or Damp Retention in the Spleen

Watery Stool with Undigested Food Spleen and Kidney Yang Xu

Bloody Stool with Mucus and Tenesmus Damp Heat in the Intestines and Stagnation of Qi in
the Intestinal Tract

Yellow Urine Heat Syndrome

Clear and Profuse Urine Absence of Pathogenic Heat, or Cold Syndrome

Defecation and Urination Meaning

Turbid Urine Damp Heat Pouring Downward, or Downward

Leakage of Turbid Essence.

Red Urine Injury of Vessels by Heat

Clear Urine with Increased Volume Infirmity of Kidney Qi, and Bladder Dysfunction in
Controlling Urine

Scanty, Yellow Urine, with Urgent and Painful Downward Movement of Damp Heat in to the
Urination Bladder

Dribbling Urination or Retention of Urine in Severe Exhausted Kidney Qi (Xu) or Stagnant Bladder Qi
Cases (Excess) due to the Downward Infusion of Damp
Heat, Stagnant Blood, or Stones.

Pain Meaning

Severe Dissention and Mild Pain Moving from Qi Stagnation

Place to Place, Often Occurring in the Chest,
Epigastria, Hypochondriac, and Abdomen

Headache with Distending Sensation in the Head Upward Disturbance by Fire and Heat

Prickling Pain, Sharp and Fixed in Location, Often Blood Stagnation

Occurring in the Chest, Epigastria, Hypochondriac,
and Lower Abdominal Regions.

Pain with and Heavy Sensation (Weighty Pain), Dampness Blocking Qi and Blood
Often Occurring in the Head, Four Limbs and
Lumbar Regions

Colicky Pain Abrupt Obstruction of the Qi by Substantial

Pathogenic Factors

Pulling Pain which is Spasmodic in Nature and Liver Wind

Short in Duration
Pain Meaning

Burning Pain with a Burning Sensation and a Invasion of the Collaterals by Pathogenic Fire and
Preference for Coolness, Often Occurring in the Heat or from Excessive Yang Heat due to Yin Xu
Hypochondriac regions on Both Sides, and in the
Epigastria Region

Pain with a Cold Sensation and a Preference for Pathogenic Cold Blocking the Collaterals or Lack
Warmth, Often Occurring in the Head, Lumbar, of Warmth and Nourishment in the Zang Fu and
Epigastric, and Abdominal Regions. Meridians due to Yang Qi Xu

Dull Pain that is not severe, lingers, and lasts for a Xu Cold Syndrome
long time

Headaches 1. Disturbance of the Clear Yang by Pathogenic

Factors (Usually Excess) 2. Stagnation of Qi and
Blood in Endogenous Diseases Blocking the
Meridians and Depriving the Brain of Nourishment
3. Blood and Qi Xu Failing to Nourish the Head,
and the Sea of Marrow Becomes Empty.

Chest Pain Pathological Change in the Heart and Lungs

Hypochondriac Pain Obstruction or Undernourishment of the Liver and

Gallbladder Meridians

Epigastric Pain (Upper, Middle. Lower) Invasion of the Stomach by Pathogenic Cold,
Retention of Food in the Stomach, or Invasion of
the Stomach by Liver Qi

Abdominal Pain Excess Causes: Retention of Cold, Accumulation of

Heat, Stagnation of Qi, Stagnation of Blood,
- Upper is SP
- Lower is KI, BL, LI, SI, Uterus Retention of Food or Parasitic Diseases
- Sides are LIV
Xu Causes: Qi Xu, Blood, Xu, Deficiency of Cold

Lumbago Obstruction of the Kidney Meridian or Deficiency

of the Kidney Failing to Nourish the Lumbar
Region

Pain in the Limbs (Joints, Muscles, or Meridians) Retardation of Qi and Blood Circulation due to
Invasion of the Exogenous Pathogenic Factors
Pain Meaning

Persistent Pain in a Recent Disease or Pain that is Excess Condition

Aggravated by Pressure

Intermittent Pain that is Alleviated by Pressure Xu Condition

Sleep Meaning

Insomnia with Palpitations and Dizziness Failure of Blood to Nourish the Heart due to Heart
and Spleen Xu

Insomnia with a Restless Mind, and Dream Hyperactive Heart Fire

Disturbed Sleep

Difficulty Falling Asleep due to an Uncomfortable Derangement of Stomach Qi Leading to Mental

and Empty Sensation in the Stomach or Gastric Restlessness
Discomfort After a Full Meal

Lethargy Accompanied by Dizziness Phlegm Damp in the Interior

Half Asleep with General Lassitude Heart and Kidney Yang Xu

Menses Meaning

Menses of Shortened Cycle, Excessive in Amount, Excess Heat in the Blood

Deep Red in Colour, and Thick in Quality

Menses that are Light Colour, Profuse in Amount, Failure of Qi to Command Blood
and Thin in Quality

Prolonged Cycle with Scanty Purplish Dark Stagnation of Blood due to Cold
Discharge or Clots

Thin, Scanty, Light Colour Flow Blood Xu

Irregular Menstrual Cycle Disharmony of the Flush and Conception Vessels

due to Obstruction of Liver Qi
Menses Meaning

Premenstrual or Menstrual Distending Pain in the Stagnation of Blood due to Cold

Breasts and Lower Abdomen which Intensifies on
Pressure During Menses

Dull Pain in the Lower Abdomen During or After Qi and Blood Xu

Menses which is Alleviated by Pressure
 General Deficiency and Excess of Yin and Yang
Quality of: Excess Yang - Yin Xu - Chronic Excess Yin - Acute Yang Xu -
Acute (Deficient Heat (Excess Chronic
(Excess Heat Condition) Cold/Dampness (Deficient
Condition) Condition) Cold
Condition)

Pulse Rapid, Strong. Rapid, Weak. Slow. Slow, Weak.

Normal:
Moderate - Could Be
Thinner

Tongue Red Body, Yellow Red Body, Pale/Pink Or Pale Body,

Normal: Coat Thin/No Coat Purplish/Bluish Thin/White
Pink/Light Red Body. Coat
Notes:
Notes: (Normal),
Yellow Due To
Light Mild - Poss. Thick Coat Flaccid.
Heat Burning
Heat/Slow Boiling
Body Fluids. - Poss. Teeth
Heat. - Poss. Swollen
Marks Over
Map Coating
Months Or
(Partial Peel: Only Notes:
Years
Part Of Tongue Thickness Due To
Has Coat). Excess Body
Fluids. Notes:
Not Excess Or
Additive Cold,
More Of A Xu
Cold.
Has Nothing
To Do W/Yin
Fluids.
Water
Metabolism
Slows,
Causing
Chronic Water
Retention
Problem.

Face Red. Only Cheeks Red. Pale. Pale.

Quality of: Excess Yang - Yin Xu - Chronic Excess Yin - Acute Yang Xu -
Acute (Deficient Heat (Excess Chronic
(Excess Heat Condition) Cold/Dampness (Deficient
Condition) Condition) Cold
Condition)

- Poss. Dryness - Poss. Dryness - Poss. Swollen

Eyes Red. Red, Dry. Edema Around Dark Circles.

Eyes.
Notes: Notes:
Notes:
If Inflammation Is Dryness Due To
Dark Circles
Involved There Fluid Xu, And
Due To
Will Be Burning Heat Excess.
Slow/Poor
Sensation.
Circulation.
Any Burning
Kidney
Sensation Is
Involved:
Usually
Kidney Qi Xu,
Associated
Or Kidney
W/Heat.
Yang Xu.

Skin Red, Inflamed. Dry Skin. Oily Skin, Body Spontaneous

Odor, Pale. Sweat W/Wo
- Poss. Skin - Poss. Rash, But
Exertion.
Rashes No Puss Or - Poss. Rashes
Wounds W/Puss If There Is Notes: Door Is
Dampness Open,
Notes:
Functional
If Patient Sweats, - Poss. Sweat, But
Yang Energy
It Will Be A Only In Late - Poss. Cysts,
Xu, So Sweat
Profuse Sweat. Afternoon, Or At Masts, Edema Due
Leaks Out.
Night To Fatty Tissue
Stagnation

- Poss. Five Palm Notes:

Heat If There Is Sweat,
It Will Be Greasy
And Oily.
Dampness Tries
To Protect The
Evil By Pulling It
Down, Inhibiting
Sweat From
Quality of: Excess Yang - Yin Xu - Chronic Excess Yin - Acute Yang Xu -
Acute (Deficient Heat (Excess Chronic
(Excess Heat Condition) Cold/Dampness (Deficient
Condition) Condition) Cold
Condition)

Benefiting Fever
Condition.

Lungs Strong/Loud Weak/Dry Cough. Profuse Thick Shortness Of

Cough W/Phlegm. White/Clear Breath,
- Poss. Aftermath
Phlegm. Difficulty
Of Illness
Breathing, Or
- Poss. Yellow,
Notes: Weak Shallow
Green, Or Brown
Smokers Cough. Breathing.
Phlegm. Indicates
Infectious Disease Notes:
Asthma Has
- Poss. Blood Both Lung
And Kidney
Xu.

Heart Very Rapid/Weak Beat. Very Poor Blood Weak Heart

Rapid/Strong Circulation. And Low
- Poss.
Beat. Functional
Discomfort/Pain - Poss. Heart Pain
Energy, Lots
Notes: Around The Heart
Of Heart
Stimulants Such - Congestion:
Problems.
As Coffee & Blood Clots Due
Cigarettes Are To Blood - Poss.
Excess Yang Stagnation Skipping
Additives Into The Heart Rates
Notes:
System.
Heart Failure - Poss.
Prevalent. Cardiac Pain,
And Cardiac
When There Is
Failure
Stagnation There
Is Pain, No
Stagnation, No
Pain.

Angina.
Quality of: Excess Yang - Yin Xu - Chronic Excess Yin - Acute Yang Xu -
Acute (Deficient Heat (Excess Chronic
(Excess Heat Condition) Cold/Dampness (Deficient
Condition) Condition) Cold
Condition)

Appetite High. Hungry, But Can Very Low Very Low

Not Eat. Appetite. Appetite, No
Notes:
Energy To
Notes:
Patient May Eat A Eat/Digest.
- Poss. Gas,
Lot, But Do Not Crave Foods That
Bloating, - Poss.
Gain Weight Create Dampness,
Abdominal Pain, Undigested
Such As Raw Or
Nausea, Food In Stool
Greasy Foods,
Vomiting,
Makes Patient Feel
Diarrhea
Comfortable.
Could Be Cause
Notes: Of Illness.
Deficient Fluids
(Insufficient To
Digest Food).

Thirst High Thirst, Likes Thirsty, Sips Cool Might/Might Not Low Thirst,
High Quantity Of Drinks, But Can Have Low Thirst. Likes Warm
Cold Drinks. Not Drink Very Water.
Much.

Digestion Bloating, Stool Dry Hard Stool Sticky Stool Weak/Slow

Will Be Dry, (Chronic). Dull, W/Mucus, Poorly Digestion.
W/Difficult Bowel Achy Abdominal Formed. Mild, Dull,
Movement, Pain, W/A Little Abdominal Pain. Achy
Extending Pain, Burning Does Not Like Abdominal
Sharp Pain, Does Sensation. Likes Pressure. Likes Pain. Likes
Not Like Pressure, Pressure, Does Heat. Heat, Likes
Does Not Like Not Like Heat. Pressure.
- Poss. Diarrhea
Heat.
- Poss. Early
Morning
- Poss. Burning Diarrhea.
Diarrhea Lowest
Associated Environmental
W/Damp Heat Or Yang.
From Extreme
Heat Stagnation.
Quality of: Excess Yang - Yin Xu - Chronic Excess Yin - Acute Yang Xu -
Acute (Deficient Heat (Excess Chronic
(Excess Heat Condition) Cold/Dampness (Deficient
Condition) Condition) Cold
Condition)

Truly A
Constipation
Condition Where
Only Fluids Can
Be Passed
(Appears To Be
Diarrhoea), But
Solids Are Not
Passed

Notes:

Do Not Give
Patients Warm
Water Or Spicy
Foods.

Kidney / Dark, Scant, Scant, Light Copious Urination, Copious,

Bladder Yellow Urine, Yellow Urine, Light/Whitish Clear,
(Water Strong Urinary Low Grade UTI. Colour. Frequent,
Metabolism) Track Usually Night
- Poss. Chronic - Poss. Cloudy Or
Inflammation Urination.
W/Puss Due To
(UTI).
Dampness - Poss. Feeling
- Poss. Of Not Being
Extending/Sharp Finished, Due
Pain To Lack Of
Functional
Notes:
Energy
UTI Symptoms:
Notes:
Urgency,
Frequency, And Kidney Yang
Burning Deficiency
Sensation. Problem.

Reproduction Strong/Excess Sex Slightly Higher Prone To STD's, Low Sex

Drive Sex Drive, But Yeast, Infections, Drive, Can't
Tires Easily (Hard Warts, Cysts. Perform.
- Poss. High
Quality of: Excess Yang - Yin Xu - Chronic Excess Yin - Acute Yang Xu -
Acute (Deficient Heat (Excess Chronic
(Excess Heat Condition) Cold/Dampness (Deficient
Condition) Condition) Cold
Condition)

Chance Of Time Performing). - Poss.

Contracting Infertility,
- Poss. Vaginal
Illness (Fatigue, Premature
Dryness
PID's, STD's, Ejaculation,
Prostatitis) Nocturnal
Emissions,
- Poss. Hormone
Low Sperm
Imbalance
Count

Menses Very Red Color, Brown Or Dark Dark Purplish, Long Cycle,
Normal: Short Cycle. Red, Scanty. Long Period Or No Thin, Or Light
Regular, No Period Due To Colored,
- Poss. Early
PMS, No Excess Fluids Or Delayed
Menstruation (5
Cramps, No Cold Respectively Menstruation.
To 7 Days)
Clots, No
- Poss. Blood Clots - Poss.
Spotting Notes:
Skipping
Blood Is Either Cycle (No
Dried Up In A Cycle)
Short Cycle, Or
Heavy Due To
Pushing Force Of
Heat.

Sleep Does Not Like To Trouble Falling Wants To Sleep, Wants To

Sleep, Toss And Asleep, Groggy After Sleep A Lot,
Turn, Restless. Symptoms Worse Sleep. Likes To Take
At Night. Naps, And
Notes: Notes:
Always Feels
- Poss. Day Time
Coffee Is A Good Clear Yang Gets Better After
Naps, Easier To
Example Of Pulled Down By Sleep.
Fall Asleep
Excess Functional Dampness.
Energy Added To Notes:
The System.
Blood Deficiency.

Energy High Level Of Restless, But Often Feel Tired, Weak, Due To
Exhausted. Tired, Lethargic w/no No Functional
Quality of: Excess Yang - Yin Xu - Chronic Excess Yin - Acute Yang Xu -
Acute (Deficient Heat (Excess Chronic
(Excess Heat Condition) Cold/Dampness (Deficient
Condition) Condition) Cold
Condition)

Energy, Restless. But Cannot Sleep. Motivation. Energy, True

Weakness.

Emotions Angry, Anxious, Angry And Clinical, Mental, Sad,

Agitated, Restless Anxious, But Less Or Neurological Depressed, No
All The Time. Energy Behind Disorders. Motivation,
The Emotion. Cannot
Interact,
Notes:
Afraid, Low
Self Esteem.
Two Types Of
Mental Illness.
Phlegm Misting
The Heart: Not
Social, Hide In A
Corner. Phlegm
Heat
Attacks/Invades
The Heart.

Speech Loud, Rapid, Speaks Quickly, Slow Speech, Slow And

Talks A Lot. But Not Loud Or Heavy Or Phlegmy Weak. Mainly
Strong. Voice, Speech Yes Or No
Disorders, Esp. Answers.
W/Tongue
Swelling.

Body Hot, High Fever, Low Grade Fever, Cold, Sensitive To Very Cold,
Temperature Sensitive To Heat. 5 Palm Heat (Also Cold. Sensitive To
called 5 Center Cold.
Heat).
 Causes of Illness - 6 Evils
The Six Evils or Six Pernicious Influences in Chinese
Medicine
The evils are external in origin, but can penetrate deeply into the body.

The Six Evils are:

 Wind

 Cold

 Damp

 Heat

 Summer Heat

 Dryness
Wind

(Associated with Liver, Wood, Spring, Yang evil)

Wind is involved with movement and activity, and brings other evil Qi in with it. It is the most
important evil as it is the cause of the "100 diseases".

Disperses Qi upward and outward

 Yang energy wants to rise and expand

 Illnesses manifest in upper and outer parts of the body in early stage: head, sense organs and
skin

 Rashes Common: itchy, come and go quickly, spread quickly

 Sweating common: causes opening of pores (Qi and fluids lost)

Rapid onset and rapid changes

 Acute illnesses with rapid progression such as fever, infectious diseases

Creates abnormal or sudden movement

 spasms, convulsions, twitches

Creates abnormal positions

 Stroke

 Stiff neck with flu

Most common in spring
 Wind Syndromes - External Wind
1.) Wind-Cold

 chills more than fever

 aversion to cold

 occipital headache

 stiff neck

 sneezing

 mucous will be clear and copious

 runny nose

 body aches that move around

 tongue: slightly pale, thin white coat

Excess Type External Wind

 Little or no sweating

 pulse: floating, slow, tight

 Wei Qi is strong so pores are held closed

 warm relieve surface treatment is used to sweat

 out evil and excess Wind and Cold

 Ma Huang Tang
Xu Type External Wind

 Sweating

 Pulse: floating, slow, Xu

 Wei Qi is weak. There is sweating but it does not release the Exterior

 Harmonize Ying and Wei Qi. Ying nourishes Wei to gently strengthen it, without tonifying Evil Qi

 Gui Zhi Tang

2.) Wind-Heat

 fever more than chills

 sore throat

 cough with thick, yellow mucous

 thirst for cold drinks

 frontal headache; can be stronger, pounding (Yang Ming)

 redness or inflammation of eyes

 sinusitis

 earache

 red face

 Pulse: Floating, rapid

 Tongue: slightly red in early stage, yellow coat, thorns on lung area
3.) Wind-Damp

 sensitivity to wind

 fever and chills with fever more pronounced in the afternoon

 strong body aches

 body and head feel heavy

 copious phlegm - runny nose, congestion, stuffiness, sinusitis

 sinus headache

 foggy headed, difficult thinking

 Pulse: slippery

 Tongue: swollen, likely to be a thick coat, could be greasy

4.) Wind-Damp Bi Pain

 Arthritis, nerve pain, and numbness that is worse with cold and damp

 weather

 Pulse: slippery

 Tongue: swollen, thick coat

 Treat by opening channels and mildly relieving surface

5.) Wind-Water

 disruption of Jin-Ye

 anything with sudden Oedema

 acute onset

 frequently occurs in the face

 Treat by relieving surface, eliminating water

 causes include allergic reaction, rash, acute nephritis

 Pulse: slippery

 Tongue: swollen, greasy coat

 6) Wind-Rash

 acute onset

 moves around to different parts of body

 will appear and disappear

 Pulse: floating, rapid

 Tongue: red with yellow coat


Wind Syndromes - Internal Wind

 Associated with the Liver, and causes diseases of shaking and abnormal body positions.

 It is usually chronic, where external wind is usually acute.

 It combines easily with phlegm, as in Deviation (Wind blows it out of position and the phlegm
makes it stick in an abnormal position).
Symptoms of Internal Wind

 spasms and abnormal muscle contractions

 convulsions

 Parkinson's

 post-stroke squeal

 seizures(epilepsy)

 shaking from anger

 migraine (Wind blowing in head)

 Pulse: wiry usually rapid

 Tongue: shaking or deviated

Causes of Liver Wind

Excess fire affecting the Liver

 Fire creates Wind

 enters the Blood level

 high fever (diseases such as meningitis)

 poisons, toxins, radiation, drugs, alcohol

 constitutional Liver Fire

 Pulse: rapid, wiry, excess

 Tongue: red, yellow coat; shaking or stiff

 Liver Yin Xu, Yang Kan - Long-standing Yin deficiency with Heat

 long term use of drugs, alcohol

 chronic Yin Xu fevers

 Pulse: Wiry, rapid, thin

 Tongue: red, no coat, shaking

Liver Blood Deficiency

1) Blood Xu makes Heat

2) Blood not nourishing the "General"

 Numbness of limbs common

 Pulse: thready or hollow

 Tongue: pale with white or yellow coat

Liver wind mixing with Phlegm

Wind blows it into an abnormal position and phlegm makes it stick. It affects Liver (Wind) and
Heart (Phlegm misting). There is rigidity especially of limbs, neck, tongue, and stiffness in tongue
(May affect the Speech)

Neurological conditions

 brain disorders

 Alzheimer's, senility

 Stroke

 brain tumours
Fire and Phlegm occurring together

 more sweating than with internal wind alone

 rapidly changing emotions

 commonly occurs with long term alcohol and drug use

 red face

 Pulse: Rapid, slippery, full

 Tongue: red, particularly at tip, may be skewed to one side

Cold

(Associated with Kidney, Winter, Water element, Yin evil)

 Damages the Yang

 Impairs ability to maintain body temp

 Weakens and slows life activities

 Feeling of cold

 Symptoms better with warmth

 causes Qi and Blood to contract and congeal which creates stagnation, pain, stiffness

 Easily effects the low back and knees, joints

 Easily effects the Stomach, Intestines, Liver

 Thin, watery, pale, cold discharges urine, stools, blood etc.


Syndromes of Cold
Wind Cold
 chills more than fever

 aversion to cold

 occipital headache

 stiff neck

 clear copious phlegm

 runny nose

 sneezing

 mild body aches

Excess type

o little or no sweating

o Pulse: Floating, slow, tight

o Tongue: slightly pale, thin white coat

Deficiency type

o sweating

o Pulse: Floating, slow, Xu

o Tongue: slightly pale, thin white coat

Cold attacking the Spleen and Stomach

Looks like spleen Qi Cut but the cause is external (Examples are living by the ocean or eating
cold foods). Phlegm and Dampness can also collect and cause dizziness.

 diarrhoea

 loose stools

 watery stools

 bloating
 poor digestion

 nausea

 vomiting

 stomach or abdominal pain that is worse with cold

 loss of appetite

 fatigue

 Pulse: slow

 Tongue: pale
Cold evil damaging both spleen and Kidney Yang

Can be acute, as in hypothermia, or chronic, as in a cold climate damaging spleen and kidneys.

Symptoms as in previous syndrome with:

 watery stools

 undigested food in stools

 bird stools

 aversion to cold

 feeling of cold in entire body

 profuse urination or oedema

 strong fatigue

 pale face

 possibly green or purple lips

 Purple or black under eyes if the Kidney Yang is damaged

 Pulse: slow, weak

 Tongue: pale, white coat, tooth marks

Cold contracting the Qi and Blood

Cold slows circulation, contracts, congeals, stagnates

Liver Qi Stagnation

 abdominal bloating

 depression, irritability

 Pulse: wiry

 Tongue: light purple

Blood stagnation
 pain that is sharp, stabbing, needle-like, constant

 purple lips, complexion etc.

 Pulse: choppy

 Tongue: deep purple, possibly purple spots

Wind cold damp Bi pain

 arthritis (more commonly Osteoarthritis) with cold, stiff, contracted joints

 sensitivity to cold is strongest symptom

 can be nerve or muscle involvement

 symptoms better with warm weather, heat therapy, saunas

Cold contracting the liver meridian

 pain on inside of legs, genital area along liver meridian

 severe menstrual pain

 endometriosis

 hernia

 muscular problems i.e. groin pull

 testicular problems

 sperm production

 may be infertility

 will exhibit signs of liver blood stagnation

 Pulse: choppy

 Tongue: pale and purple


Damp

(Associated with spleen, late summer, Earth element, Yin evil)

Dampness is heavy, tenacious, difficult to treat, and lasts a long time. It tends to move
downwards in the body.

Sticky, greasy, oily, dirty, bad smell

 "looks like water or mud, "looks and smells dirty

 greasy hair and face

 greasy skin: acne, pus, oozing wound

 mucous or discharge anywhere in body

 bad body odour, bad breath, smelly perspiration

 bad smelling diarrhoea with mucous (if mixed with heat, there can be cloudy urine)

 thick or bad smelling vaginal discharge as in STD

 copious nasal discharge

 oedema or swelling

 arthritis with swollen joints

 fluid coming out of anywhere

 Candida, fungus, yeast

Damages the Yang of body

 worse in cold, damp weather

 Spleen works to transform Damp; Kidney supports Spleen

Creates stagnation

 Stagnate fluids will also stagnate Qi and Blood

Syndromes of Damp
Wind-Damp
Acute condition, but has the slowest onset of all winds. It is affected by damp and cold weather.
Symptoms can reflect a respiratory infection with copious phlegm or a gastrointestinal flu.

 strong generalized body aches

 heavy feeling in head and body

 foggy headed, unclear thinking, band headache

 copious phlegm, can be runny or thick

 sneezing

 afternoon fever

 nausea, vomiting

 diarrhoea, possibly with mucous

 Pulse: slippery, slowing down pulse

 Tongue: swollen with thick, greasy coat

Wind-Damp Bi pain

 swelling of joints

 oedema

 Pulse: slippery

 Tongue: swollen with thick, greasy coat


 Damp poison in skin

 discharge: pus, carbuncles, boils, acne, oozing

 infection after wound

 warts, fungus, yeast

Damp heat

Infection or inflammation that can affect many places, such as the Liver, Gallbladder, Urinary
Bladder, Intestines, Sinuses, etc.

"itis" Diseases

 Bronchitis

 Hepatitis

 Virginities

 Prostitutes

 Colitis

 Pulse: slippery, rapid (which quality is greater?)

 Tongue: red, thick yellow coat, swollen (how thick, how swollen, how red?)
Internal dampness arising in the body

Dampness arising from Spleen Xu: Dampness is the main factor, the Xu is secondary. It often
compromises immunity due to congestion of lymphatic system, autoimmune conditions in
particular. If severe, it becomes Phlegm. A long term chronic situation is often due to damp, cold,
raw foods.

Symptoms may be associated with a wide variety of diseases: Chronic Fatigue, Fibromyalgia,
Candida, Lymphoma, Etc.

 bloating

 nausea

 vomiting

 diarrhoea

 heaviness of head and body

 dizziness

 low appetite
 Heat

(Associated with the Heart, summertime, Fire element, Yang Evil)

Damages Yin

 dries fluids, easily leads to Yin Xu

Heat rises

 diseases most common on face, eyes, and nose

Causes redness

 the more red, the more heat

Easily produces wind

 when heat affects the Liver

Speeds things up

 agitation, restlessness

 can be bleeding: Blood moves so fast it leaves the vessels

Easily affects the skin

 red, itchy, painful rashes


Syndromes of Heat
Wind-Heat

 fever more than chills

 sore throat

 frontal headache (yang Ming channels)

 big thirst

 sinus infection

 red eyes, conjunctivitis

 cough with yellow, green or brown phlegm

 Tongue: red and raised dots in lung area (thorns)

 Pulse: rapid, floating

 Damp Heat

 Upper Jiao - Affects face and chest

 Middle Jiao - Affects Spleen and Liver

 Lower Jiao - Intestines, bladder, genitals, etc.

Excess Fire

Strong heat that reaches deep in to organs. It can have an external or internal origin.

Symptoms

 big thirst

 redness

 restlessness

 symptoms are loud and forceful (cough, diarrhoea etc.)


Syndromes of Fire
Lung fire

 can be loud, forceful cough with blood (fire has burnt off protection of mucous membranes so
capillaries have burst)

 mucous is yellow, green , brown

 red, painful rash

Stomach fire

 burning ulcer, heartburn)

 Stomach channel problems: toothache (infection), frontal headache strong pain or burning on
channel
Heart fire

 strong anxiety

 restlessness

 insomnia

 mania
Liver fire

 anger

 shingles in costal region

 burning pain in genital area as from STD's

 Large Intestine fire

 dysentery

 toothache (channel pain) -> Kidney fire

 long term alcohol or drug abuse

 bone infection

 meningitis (affects Marrow)

Deficient Fire

Yin Xu, Yang Kan, Heat is deep in the body: Ying level. Pattern of mixed Xu and excess.
Treatment must include quelling fire as well as nourishing yin

 smouldering heat especially at night

 low grade rashes

 severe restlessness

 slight bleeding

 Tongue: scarlet

 Pulse: thready, rapid

Summer Heat

(Associated with the Heart, Fire Element, Summer, Yang Evil)

Syndromes of Summer Heat

Summer heat

 high fever

 restlessness

 thirst with strong desire to drink

 can go up and affect the head

 dizziness

 blurred vision

 headache

 constipation

 scant yellow urine

 coma

 Yin collapse
 profuse sweating

 Tongue: dry, red

 Pulse: surging (flooding - strong, big waves)

Summer Heat combined with Dampness

A person with a Damp constitution experiencing Summer Heat, or a person who eats Damp
foods in summer (ice cream, cold soda).

Dampness turns into phlegm because of heat

 nausea

 vomiting

 loose stools or diarrhoea

 poor appetite and fatigue

 phlegm can rise to head

 dizziness

 heavy head

 foggy thinking

 suffocating feeling in chest

 tightness in chest

 sweating, but not as much as Summer Heat without Dampness

Dryness

(Associated with the Lung, Autumn, Metal Element, Yang evil)

Exterior in origin (not yin Xu, not internal)

Easily damages body fluids

 Dry skin

 Dry hair

 Dry eyes

 Dry lips

 Dry throat or low grade sore throat

 Dry stools

 Scant urine

 Thirst
Easily damages lungs
 Could be from dry climate or smoking

 Dry cough and dry phlegm (thick, sticky, hard to expel)


Syndromes of Dryness
Warm Dryness

Symptoms

 Fever

 Headache

 Thirst

 Dry Mouth

 Dry Nasal Passages

 Dry cough with Dry Phlegm

 Tongue: red with thin or no coat

 Pulse: rapid
Treatment

 acute: treat as wind-heat

 chronic: tonify yin

Cool dryness (Example: Dried out from air conditioning)

Symptoms

 Dry phlegm (thick, doesn't move)

 Sensitive to cold

 Chills

 Mild fever

 Headache

 Dry cough

 Dry mouth

 Dry nasal passages with stuffiness

 Tongue: thin, white

 Pulse: tight, slow

Treatment

 Acute: Treat as wind-cold

Causes of Illness - 7 Emotions

The Seven Emotions in Chinese Medicine

Emotional related diseases factors, which effect the organ associated with the emotion as well as
organs that have a Five Element relationship with that elements emotion.

The Seven Emotions are:

Anger

Fear

Fright

Grief

Joy

Worry and Pensiveness

Joy (Over-excitement, Manic) - Heart and Fire Element

Slows the Qi - Fear controls Joy (Water controls Fire)

Palpitations

Insomnia

Unclear Thinking

Mania, Disturbed Shen (possibly manic, risk-taking)

Heart Attack

Example: Migraine headache caused by sudden joy from receiving good news.

Anger (Rage, Resentment, Frustration) - Liver and Wood Element

Makes Qi Ascend - Grief controls Anger (Metal controls Wood)

Vertex Headache

Dizziness

Blurry Vision

Blood Pressure is Raised

Stroke

Internal Wind (trembling from anger or an onset of Wind symptoms such as a seizure)

Pain in the Coastal Region Especially in the Liver

Liver attacks Spleen and Stomach

Spleen Qi Xu

Rebellious Stomach Qi

Bleeding

a. Nosebleeds common because Qi is ascending

b. Vessels Burst Because Spleen is Weak

Liver counterattacks Lung

Asthma

Liver can harm Gall Bladder (Yin Yang paired Organ)

Inability to make decisions (I'm so angry, I can't think straight)

Grief or Sadness - Lung and Metal Element

Weakens, Depletes, or Dissolves the Qi - Joy Controls Grief (Fire controls Metal)

Tightness in the Chest (SOB)Excessive Crying

Asthma

Frequent Colds and Flu (Wei Qi is weakened)

Skin problems

Grief Affecting the Heart

Zong Qi is weakened affecting Heart

Metal counterattacking Fire

Circulation Becomes Impaired

Worry and Pensiveness - Spleen and Earth Element

Stagnates or Knots the Qi - Wood controls Earth (Anger controls Worry and Pensiveness)

Harms the Heart

Son depleting the Mother, and ultimately the Shen

Palpitations

Spleen Qi Deficiency
Heart Blood Deficiency

Fright (Terror, Shock) - Gallbladder and Wood Element

Fright Confuses or Scatters the Qi - Grief controls Fright (Metal controls Wood)

Note: There is a difference between fear and fright: Fright: startling, scared by things that are
present. Fear: deeper, more chronic; scared by things not present

Indecisive

Confused

Lack Courage

Harms the Kidneys

Son depleting mother; Wood depleting Water

Long-term fright turns to fear (child abused once causes fright; ongoing abuse leads to fear of when
it will happen again)

Harms Liver

Gallbladder and Liver are Yin Yang paired organs

become angry at what frightened us (a mother becomes angry with a child that loves to startle her
as a joke)

Harms the Heart

Wood fails to nourish Fire, Fright un roots the Shen

Fear - Kidneys and Water Element

Makes Qi Descend - Concentration and thinking controls Fear (Earth Controls Water)

Note: Less sudden, more chronic and internal than fright

Kidneys are weakened when living in fear

might lose bladder control

Harms Liver and Gallbladder

Water not nourishing Wood)

Depression

Indecisive

Confused

Lack Courage
Harms the Heart

Water not controlling Fire

Heart Fire blazes out of control

anxiety, restlessness
Weak Constitution

Constitution depends on:

Parents' health in general, especially at conception

Mother's health in pregnancy

Adverse Factors:

Conception in state of drunkenness

Mother conceiving when too old

Consuming alcohol or smoking during pregnancy

Receiving a shock during pregnancy (affects fatal Heart Qi)

A person's basic constitution is largely determined at conception, and it can also be affected during
the mother's pregnancy.

At conception, fusion of Qi of "heaven and earth" produces human being.

Ancestral Energy of parents is passed to fetes.

Constitution is largely fixed at this time.

However, those with weak constitution can develop Qi by balanced lifestyle, avoidance of stress and
excess (work or sexual activity), adequate rest, right nutrition, breathing exercises, and
strengthening "inner" exercises such as Qi Gong and Tai Ji Quan (that originated in ancient Taoist
longevity and immortality practices but are still applicable for health promotion).

Assessment of constitution in clinic: detailed history including childhood diseases (especially

peruses; indicates inherited weakness of Lungs)

Appearance: small ears indicate weak constitution

Pulse: scattered, minute or leather pulse: weak constitution

Tongue: very flabby, with no "spirit"

Assessment of constitution is essential for accurate prognosis; what can realistically be expected
from treatments.
Over Exertion

Common cause of disease in West.

Need to have balance of rest and exercise.

When we work or exercise we use up Qi; when we rest we restore Qi.

(Post-Heaven Qi, i.e., Qi transformed from food and drink on a daily basis).

In daily activities we use Qi: Jing provides material base for long term changes but is foundation of
our inner strength and vitality.

Qi used in normal work and exercise is quickly replenished by proper food and rest. (If your patient
appears weak and depleted, ask about recent excesses of work or study or lack of sleep).

Qi is used up quickly but rapidly restored.

If overwork occurs over months or years, Qi cannot be restored quickly enough by Spleen. Person
then draws on the Jing as a reserve. This way the Jing can become depleted and signs of Deficiency
of Yin may begin to appear. This situation takes a long time to remedy.

Mental Overwork

Very common in western society: long hours of stress and mental activity very common together
with irregular meals taken in hurry. These things affect Stomach, Spleen and Kidneys. Irregular diet
(or eating late at night) can cause deficient Stomach Qi or Stomach Yin.

Physical Overwork

Depletes primarily Spleen Qi (SP dominates flesh and muscles). However, excessive physical exercise
also demands that the Liver supply its Blood and Yin to the tendons/muscles; therefore excessive
exercise can deplete Liver Blood and Yin (including workouts).

Excessive use of one part of body (i.e., repetitive movement) can cause Qi to stagnate in that part.

Excessive lifting weakens Kidneys and lower back.

Excessive standing weakens the Kidneys.

The Classics discuss the 'Five Taxations':

Excessive use of the eyes injures the Blood (the Heart)

Excessive lying down injures Qi (the Lungs)

Excessive sitting injures the muscles (the Spleen)

Excessive standing injures the bones (the Kidneys)

Excessive exercise injures the sinews (the Liver)

Excessive Physical Exercise

Exercising to exhaustion depletes Qi, also Liver Blood and Yin.

Especially bad during puberty for girls (leads to later menstrual problems).

Certain types of exercise can cause stagnation of Qi in one area

E.g. Weightlifting: lower back

E.g. Jogging: knees

E.g. Tennis: elbows

Lack of Exercise

Regular exercise ensures proper circulation of Qi.

Lack of exercise can lead to stagnation of Qi.

Certain exercises (e.g., Yoga and Tai Ji Quan) are aimed at developing Qi rather than muscles and are
useful for those with Deficient Qi who have to little energy for Western style exercises.

Excessive Sexual Activity

i.e., leading to ejaculation or orgasm

Depletes Kidney Jing, mostly in males.

Male sexual fluids are external manifestation of Kidney Jing: hence loss of these lead to temporary
loss of Kidney Jing. Female sexual fluids primarily Jin-Ye.

Normally this is made up (by postnatal Jing) and does not lead to depletion. However, when sexual
activity is excessive, body does not have time to restore the Jing.

What is "excessive" = resulting in marked fatigue, especially if accompanied by dizziness, blurring of

vision, low back pain, weak knees, and frequent urination.

Adjust sexual activity according to constitution, age, physical condition. (See chart in book pg. 138 as
broad guideline).
Seasons: increase in Spring; decrease in Winter.

In treating sexual problems, i.e., impotence, often a decrease in sexual activity is important.

In men, the Kidney Jing is depleted by excessive sexual activity; in women it is depleted by repeated
childbirth.

Lack of sexual activity can traditionally be a cause of disease.

Sexual desire is measure of strong Kidney Qi and Kidney Yang.

Deficient Kidney Yang: lack of libido.

Deficient Kidney Yin: excessive interest in sex and inability to be satisfied, erotic dreams and
nocturnal emissions.

Other important causes of unsatisfactory sexual life: (e.g., lack of warmth and love, relationship
issues) can be causes of disease especially where they cause a lot of anxiety and unhappiness.

Diet and Nutrition

Important cause of disease

However, Chinese dietary theories do not take into account our modern food preservatives,
colourings, pesticide residues, etc.

Dietary habits can cause disease: e.g., poor quality or imbalanced quantity of food. Malnutrition not
only in 3rd world countries but also in the west, from poverty and "fad" diets.

Trying to slim by "starving" weakens SP Qi and can actually cause increase in weight because SP will
be too weak to transform and transport fluids and food. Proper foods need to be eaten to
strengthen SP & St.

Overeating also weakens SP & ST and leads to accumulation of Phlegm and stagnation of food.

Excessive consumption of cold energy and raw food can weaken the Spleen.

Refrigerated food and iced water, ice cream are contraindicated.

Raw vegetables, salads and fruit in excess can weaken Spleen Yang:

Contraindicated in those with pre existing weakness in this area.

Excessive consumption of hot energy and spicy foods (curry, chilli, hot sauce, lamb, beef) causes
Heat especially of Stomach and Liver.

Excessive consumption of greasy/fried foods (deep fried foods, milk, cheese, cream, butter, bananas,
fatty meats, nuts) cause Phlegm or Damp which can obstruct Spleen function of transformation and
transportation.
How food is consumed is important.

Eating in a hurry, eating late in evening, eating when upset, discussing work while eating, etc.,
interfere with digestion and cause deficiency of Stomach Yin.

NOTE: Foods, like herbs, have their own energetic properties and can be used therapeutically to
strengthen the body and treat disease. It is very useful to understand Chinese dietary therapy in
order to be able to suggest to the patient the foods they should eat and those they should avoid.

Physical Trauma

Cause local stagnation of Blood & Qi

Slight trauma causes stagnation of Qi

Severe trauma causes stagnation of Blood

(Both produce swelling, bruising and pain)

Trauma can affect an area for a long time and produce local stagnation of Qi and/or Blood.

Old accidents/falls can cause or contribute to current disease especially if compounded by later re-
injury or later contraction of pathogen (e.g., Wind Damp will often invade a previously injured area
where there is an underlying weakness in the circulation of Blood & Qi).

Parasites and Poisons

Infestation of worms is more common in children.

Contributory factor: poor diet, especially excessive consumption of greasy and sweet food which
leads to Dampness (perfect breeding ground for worms and also Candidacies).

Incorrect Treatment

Acupuncture can cause ill effects.

Incorrect use of moxa (i.e., use where heat is present) can aggravate a heat condition. Chinese herbs
however have more specific effect than acupuncture.

E.g., if one tonifies Yang (heating herbs) by mistake when there is deficient Yin (producing heat signs)
one can seriously aggravate the condition.