Glossary of Chapter 16 Diagnosis

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The tip of the tongue
Organs and clinical indication
Heart, lung, small intestine;
heart fire, lung qi deficiency
Border/Edge of the tongue
Organs and clinical indications
Liver, gall bladder;
liver fire, gall bladder heat
Center of the tongue
Organs and clinical indications
Spleen, stomach;
spleen damp; stomach heat
Root of the tongue
Organs and clinical indications
Kidney, bladder;
kidney yang deficiency
What two properties of the tongue do you observe?
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
Describe the normal tongue
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
Tongue coating sticky (greasy, creamy)
Turbid damp in intestine and stomach;
retention of turbid damp and phlegm
and food
Precautions in tongue diagnosis
observe in direct natural light;
food drugs eating or tongue scraping may change the tongue coating;
each disease undergoes a complicated process
Tongue coating moist
Tongue coating thin
superficial, mild disease;
exterior syndrome in febrile diseases
Tongue coating thick
food stagnation;
interior syndromes
Tongue coating
consumption of Yin fluids due to excessive heat;
consumption of yin fluids leading to no nourishment upward
Tongue coating
external cold;
internal cold
Tongue coating
Internal and heat
Tongue coating
retention of damp cold;
retention of phlegm and fluid
Tongue coating
severe stage of disease;
extreme heat;
excessive cold;
heat evil invading blood stage
Tongue color
mild disease;
early stage of febrile diseases;
exterior syndromes
Tongue color
deficiency, cold;
deficiency of yang qi;
insufficiency of qi and blood
Tongue color
excess of internal heat;
yin deficiency heat
Tongue color
Deep red
extreme heat;
external febrile disease: invasion of the yin and blood by pathological heat;
Yin deficiency leading to hyperactivity of fire
Tongue color
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
Tongue shape and size
delicate pale w/ tooth mark
yang deficiency of spleen and kidney
Tongue shape and size
deep in red
excessive heat in heart and spleen
Tongue shape and size
purplish and dark
Tongue shape and size
deficiency of qi and blood
Tongue shape and size
dry and deep red
yin deficiency and hyperactivity of fire lead to consumption of body fluids
Tongue shape and size
deep red
excessive heat consuming body fluid
Tongue shape and size
deficiency of blood
Tongue shape and size
not deep and remain there all the time, unchanged
Tongue shape and size
accumulation of interior heat
Tongue shape and size
more enlarged and profuse the thorns in tip
severe heart fire
Tongue shape and size
thorns in edge
liver and gall bladder fire
Tongue shape and size
deviated (crooked)
wind stroke (liver wind)
Tongue shape and size
exogenous febrile diseases invade pericardium by heat;
retention of turbid phlegm in the interior;
excessive pathogenic heat consuming body fluid
Tongue shape and size
wind stroke or early sign of wind stroke
Tongue shape and size
weak in motion
extreme deficiency of qi and blood;
consumption of yin fluid
Tongue shape and size
deficiency of qi and blood
Tongue shape and size
deep red
collapse of yin
Smell of secretion or excretion
excess heat
smell of secretion or excretion
less stink
cold deficiency
smell of secretion or excretion
foul and sour
retention of food
bitter taste
hyperactivity of the fire in liver and gall bladder
sweetish taste with sticky mouth
damp heat in spleen and stomach
sour taste (regurgitation)
retention of heat in liver and stomach
unable to taste
deficiency of spleen
constipation, dry stool
heat or consumption of body fluid
loose stools
spleen deficiency or retention of dampness in spleen
watery stools with undigested food
spleen and kidney yang deficiency
bloody stools with mucus and tenesmus
intestines damp heat and stagnation of qi
urine yellow
heat or consumption of body fluid
clear, profuse urine
cold syndromes
scanty yellow urine, urgent and painful
damp heat downward
red urine
heat injury vessels
dribbling or retention of urine
kidney deficiency;
obstructed Bladder qi;
stagnant blood;
watery leukorrhea, whitish in color, profuse in amount
deficiency cold
thick leukorrhea, yellow or red, offensive smell
excess heat
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
qi deficiency
menstruation thin, scanty, light colored flow, dull pain in the lower abdomen during or after period which is alleviated by pressure
blood deficiency
menses shortened cycle, excessive amount, deep red in color, thick in quality
blood heat
prolonged menstrual cycle, scanty purplish dark discharge, blood clots, cold pain in lower abdomen during the period
blood cold stagnation
Secretion,excretion clear,white
deficiency cold
Secretion, excretion turbid yellow
excess heat
Body shape overweight mental depression
deficiency of qi;
excess of phlegm;
irregular menstrual cycle
liver qi stagnation
premenstrual or menstrual pain in the breasts, lower abdomen which intensifies on pressure
qi and blood stagnation
Body shape thin
dry skin
insufficiency of blood
body shape
great loss of weight
long illness
exhaustion of essential qi
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
Exterior cold;
Mild fever
Severe chills
No sweating
No thirst
Exterior heat;
Severe fever;
mild chills;
Intermediate syndrome;
alternate fever
alternate chill
Interior cold;
No fever
alternate chills
no sweating
no thirst
Interior heat;
high fever;
no chills;
Appetite inquiry
Poor appetite; emaciation, loose stools, lassitude, pale tongue, thin white coating
weakness of spleen and stomach
Appetite inquiry;
Poor appetite; stuffiness in chest; fullness in abdomen; red tongue; thick, sticky coating
stagnation of spleen and stomach; food dampness retention
Appetite inquiry;
Excessive appetite, hungry, skinny
excessive stomach fire
Appetite inquiry;
Hunger, no desire to eat, or eats small amounts
Stomach yin deficiency
Sleep inquiry;
Insomnia with dizziness and palpitations
blood deficiency of heart due to spleen and heart deficiency
Sleep inquiry;
insomnia, restlessness, dream-disturbed sleep
hyperactivity of heart fire
Sleep inquiry;
difficulty in falling asleep, uncomfortable, empty sensation after a full meal
derangement (mixed up) of stomach qi
sleep inquiry;
lethargy, with dizziness and palpitation
damp-phlegm in the interior
sleep inquiry;
light sleeper, general lassitude
yang deficiency of heart and kidney
Bi syndrome;
wandering pain in the joints
Wind bi
Bi syndrome;
severe stabbing pain, cold and fixed
Cold bi
Bi syndrome;
numbness and heavy sensation
Damp Bi
Bi syndrome;
local burning sensation with redness
Heat bi
Bi syndrome;
chronic and difficult pain in bones and joints
Deficiency bi of blood and qi
Bi syndrome;
muscular stiffness and spasm
deficiency bi of yin and blood
Left cun
Heart and small intestine qi
Right cun
lung and liver blood
left guan
liver and gall bladder qi
right guan
spleen and stomach blood
left chi
kidney, bladder qi
right chi
kidney (mingmen), bladder blood
Normal pulse
smooth, even, forceful, four beats per breath
Pulse--floating group
floating superficial
external syndrome
Pulse--floating group;
excessive heat
Pulse--floating group;
soft, soggy
deficiency; dampness
Pulse--Deep group;
interior syndrome
Pulse--deep group;
deficiency of qi and blood
Pulse--rapid group;
heat syndromes
Pulse--rapid group;
cu mai;
hurried, rapid, irregular missed beat
Pulse--slow group;
cold syndromes
Pulse--slow group;
qi stagnation;
blood stasis
Pulse--slow group;
jie mai;
slow, irregular missed beats
Pulse--deficiency group;
deficiency syndromes
Pulse--deficiency group;
deficiency due to overstrain and stress; deficiency of blood and qi
Pulse--deficiency group;
regularly intermittent
dai mai;
slow, weak, missed beats at regular intervals
Pulse--excess group;
excess syndromes;
heat stagnation
Pulse--excess group;
slippery, rolling
pregnant pulse;
Pulse--excess group;
wiry, string taut
liver and gall bladder diseases;
Pulse--excess group;
Index fingerprint for an infant
ming guan (tip)
qi guan (middle)
feng guan (inner segment)
The eight principles
Yin and yang
Interior and exterior
Cold and heat
Deficiency and excess
The categories of interior and exterior are used to determine...
the depth of the disease
Exterior syndrome
aversion to cold; fever; thin tongue coating; superficial pulse
Interior syndrome
high fever; no aversion to cold; thirst; dark tongue; sinking pulse
Intermediate syndromes
alternating fever and chill; fullness and discomfort in chest and hypochondriac region; bitter taste; dry throat; wiry pulse
Cold syndromes are from...
exogenous pathogenic cold or deficiency of yang
Heat syndromes are from...
exogenous pathogenic heat or deficiency of yin
Cold syndrome
pale face; aversion to cold; not real thirsty; loose stools; clear urine, increased in volume; pale tongue; white moist coating; slow pulse
Heat syndrome
Red face; fever; preference for cold drink; constipation; scanty, deep-yellow urine; red tongue; yellow and dry coating; rapid pulse
Deficiency refers to...
insufficiency of the anti-pathogenic qi
Excess refers to ...
hyperactivity of the pathogenic factor
Deficiency syndrome
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
Excess syndrome
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
Yin's other three principles
Yang's other three principles
Yin syndromes result from...
deficiency of yang qi in the body and retention of pathogenic cold
Yang syndromes result from...
hyperactivity of yang qi in the body and excess of pathogenic heat
Yin (blood) deficiency syndrome symptoms
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
Yang deficiency syndrome symptoms
follows cold syndrome; chill; spontaneous sweating; clear urine with increased volume; loose stools; pale tongue with white coating; weak pulse
Qi deficiency symptoms
pale face; shortness of breath; low voice; lassitude; spontaneous sweating; pale tongue with little coating; weak pulse
Qi sinking symptoms
dizziness; blurred vision; lassitude; prolapse of internal organs; pale tongue with little coating; weak pulse
Qi stagnation symptoms
distention; wandering pain; normal or white tongue; wiry soggy pulse (Pulse most important)
Rebellious Qi symptoms
cough; asthmatic breathing; vomiting; hiccup; normal or white tongue; wiry soggy pulse
Blood stagnation symptoms
stable local sharp pain and masses, hemorrhage; tongue purple with dark spots (most important); thin, soggy pulse
Blood deficiency symptoms
pale face and lips; lassitude; numbness; dizziness; palpitations; pale tongue with little coating; thin weak pulse
Blood heat symptoms
Irritability, dry mouth; hemorrage; prouse and red menses; fever; red tongue; rapid pulse
Jin Ye deficiency symptoms
dryness in mouth and skin; desire to drink; dry stools; fever; scanty urine; tongue red without coating; thin rapid pulse
Jin Ye retention symptoms
cough, profuse sputum (Lung); palpitations (heart); abdominal distentions (spleen or stomach); edema (spleen or kidney); white, moist tongue with moist coating; wiry sinking pulse

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