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|*iIi(ional Chnese Medicine
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D IA G N O S T IC S O F T R A D IT IO N A L C H IN E S E
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Translator-in-Chief Li Zhaoguo
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fe tit 46. 00 7C
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2000 ^ 12 ^ 14 B T & M
Foreword n
Before the existence of the modern medicine,
Imman beings depended solely on herbal medicines
mid other therapeutic methods to treat diseases and
preserve health. Such a practice gave rise to the esl/iblishment of various kinds of traditional medicine
s e ^ r & ie # ^ .
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( hiese medicine,
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cal practitioners to meet the need for primary healthnirc. Even in the countries with advanced modern
medicine' more and more people have begun to acci'pt traditional medicine and other therapeutic meth-
Aw m g
ihy, etc.
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icine.
WHO sensed the importance of traditional medi
cine to human health early in the 1970s and have
1976
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health congresses, a series of resolutions were passed to demand the member countries to develop, utilize and study traditional medicine according to their
specific conditions so as to reduce medical expenses
for the realization of health for all.
W HO has laid great stress on the scientific content, safe and effective application of traditional
medicine. It has published and distributed a series of
l>ooklets on the scientific, safe and effective use of
herbs and acupuncture and moxibustion. It has also
made great contributions to the intemational stand
ardizaron of traditional medical terms. The safe and
effective application of traditional medicine has much
to do with the skills of traditional medical practitioners. That is why W H O has made great efforts to
train them. W H O has run 27 collaborating centers
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and
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ftloruil medicine will certainly further promote the deV*lopment of traditional medicine and traditional
lunlicine will undoubtedly make more and more conIrlliutions to human health in the 21st century.
Zhang Xiaorui
* *
W H O Coordination Officer
December, 2000
2000 i f 12|]
Pre face
The Publishing House of Shanghai University
O TCM published A Practical English-Chinese Li-
1 9 9 0 ^ i ) K T - * < ( ( ^ M ) $
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lile Library.
Nanjing University of TCM and Shanghai Uni[VrMity of TCM are well-known for their advantages
* # * J 7 lM C + E
W H O f g tlk
iUSifefl1
+ E f f B f c t r f t . tfW
264 methods for differentiating syndromes and treating commonly-encountered and frequently-encountered diseases in internal medicine, surgery, gyne-
38
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efforts have been made in the compilation to highlight the gist of TCM through accurate theoretical
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2. Systematic
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Chinese Tuina
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pi'ovements and supplements, systematically introducing therapeutic methods for treating over 200 kinds of
commonly and frequently encountered diseases, foCusing on training basic clinical skills in acupuncture
mui moxibustion, tuina therapy, life cultivation and
Khabilitation with clinical case reports.
4. Standard
(tructure, distinct in categorization, standard in terminology and accurate in translation with full considrrnlion of habitual expressions used in countries and
rcgions with English language as the mother tongue.
n u * e # %
xtudy TCM, but also can serve as authentic textlxx>ks for intemational students in universities and
colleges of TCM in China to study and practice
T( M For those from TCM field who are going to go
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t b a m
Contents
Introduction
................................................................................. ..................................... i
Inspection.................................................................................................................. 8
1.1.1
1. 1. 1. 2 Inspection of complexin
1. 1. 1. 3 Inspection of body
........................................................................ 12
.................................................................................... 17
1. 1. 1. 4 Inspection of postures................................................................................ 19
1. 1. 2
............................................................................ 22
.................................................................... 22
......................................................... 25
1. 1. 2. 3 Inspection of neck
.................................................................................... 30
1. 1. 2. 4 Inspection of skin
................................................................................... 31
................................................................................ 38
................................................................ 44
1. 2. 1
1. 2. 1. 1 Speech ....................................................................................................... 61
1. 2. 1. 2 Respiration ............................................................................................... 63
1. 2. 1. 3 Cough
....................................................................................................... 65
Olfaction
................................................................................ 66
..................................................................................................... *67
&
..................................................................................................................................... i
* - *
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.....................................................................................
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( = ) a f t ................................................................................................................44
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qfy...................................................................................................... 60
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....................................................................................................... 66
l ^ f : ........................................................................................ ............. 67
( - > v& m frZK ...........................................................................................................68
!('x>ntents
Inquiry
.................................................................................................................. 69
1.3.1
1. 3. 2
................................................. 72
................................................................ 73
....................................................................................... 90
........................................................ 97
..................................................... 111
........................................................................ 117
.................................................................... 117
............................................................................ 117
1. 4. 1 Pulse-taking................................................................................................... 118
1.4. 1. 1 Regions and methods for taking pulse..................................................... 119
1. 4.1. 2 Normal pulse .................................................................................. ........ 123
1. 4.1. 3 Morbid pulse ........................................................................................... 125
1.4.2
@ a
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...................................................................................................... 69
w * ........................................................ ............................................. 69
r a - H t s , ................................. ....................................................................... 7fl
................................................................................................... 71
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84
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...................................................................................................... 92
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.............................................................................................................. 97
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.................................................................................... 102
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................................................................................. 114
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......................................................................................................................131
( )
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..................................................................................................
132
.......................................................................................................... 133
............................................................................... .140
................................. ........142
..................................................142
2. 1. 3. 1 Asthenia syndrome
..................................... .145
............................................................................... .145
........................................................ .148
..................................... .154
2. 2. 1
2. 2. 1. 1 Qi asthenia syndrome
........................................................................... .173
.........................................................................174
..................................................176
.......... .181
..................................................183
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............................................................ .222
.................................................... .223
......................................... .233
..............................................235
..............................................239
.....................................................................239
.....................................................................241
..........................................242
............................. .245
................................. .246
..............................................252
..........................................258
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............................................................ .265
23
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................................................................................... .271
23i
f 2. 4. 1. 4 Taiyin syndrome
23j
23
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23
23
24|
24!
241
2. 4. 1. 6 Jueyin syndrome
X. 1.2
................................................................................... .273
............................................................................... .275
24 PNxrtscript ......................................................................................................................279
24
24i
24
241
24!
241
25
25(
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254
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.............................................................................................. 27
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27j
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Introduction
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The diagnostics of TCM has been developed under
llw fuidance of the basic theory of TCM and based on the
i ||ni( ii I practice done by numerous doctors in the past
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IItii| ol meridians, syndrome differentiation of six meridiin. syndrome differentiation of defensive qi, qi, nutrient
Iff,
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i.
Firstly, the human body is composed of various organs, viscera, meridians, constituents and orfices as well
as essence, qi, blood and body fluid. Though possessing
different functions, they are not isolated. Such an integral
association of the human body is accomplished through the
domination of the five zang-organs, supplementation of
the six fu organs, association of the five constituents and
five sensory organs and nine orfices, the extensive distri
bution of the meridians and the transportation of essence,
qi, blood and body fluid by the net of meridians. Therefore disorder of the viscera, essence, qi, blood and body
fluid can be manifested on the superficial tissues and or
gans. The local pathological changes can affect the whole
tf c .A M w z m
S it t ,
v A T m m m e i i >f #%
>M. [fif^
jE a ^ S o
e l
t t A f r r & v m ;x m i T
lm jjo
r A f r i fflTj]b#i1
m.
hllictions and lead to diseases. Therefore, natural and soi lu actors must be taken into consideration in the diagno-
j W Si n[ol M i t i rfn a fe ^
Ih ni diseases.
i .
& M T m n ^ ff
Thus, clinical diagnosis of disease must be done un-
^ 04
t? m m w & *
innei l diagnosis.
2.
2.
ayndrome differentiation
I his ineans to decide the ame of the disease and to
illllei entiate the manifestations of the disease.
m m m m ,
y&f,
s s e o s
it
4
with certain rules caused by destruction of the healthy
state due to certain pathogenic factors. This pathological
development course manifests several special symptoms
$ a e .
e M M
# RfrgMfiEISe.
e .
EP JE
nm
ifisn a g * i -ita w
W W #t J i U M ffl p
jxl
MV-&Z i \
>;
t t IM
wind and coid; the location is in the superficies; the nature is coid; the pathogenesis is wind and coid encumbe
{'/
M;
llf JL
ikm . ;
& , %j t ,%#
j& m
ffio
, w w. m m
wlect the understanding of llir tinturo ol disenso, liowevt't. they emphasize on diforeni aspeis. Disease reflects
lile
i e l liiin
"(lili erent
m w - M u m m s .. 4 rm ai
M #1 N M jE fS tP If1^ N
rn I s ; Wt
lite
em m* m & m i t a
tWiMM'6i,
i|5JAA M ^ ')%r&w
^ f i M t
te
^ m uen t & u *s
ffiL
^ 4-I. M M/K i# M %
> /#: vfa. WJ in f f M ^ #f
M&. o
i . W rt
fJio
3. i# ;- r #
'n # , J i h SiE t
try to collect as detailed as possible the data for comprehensive analysis of the disease. The manifestations of a
disease are mltiple and complicated. The data collected
m m n& m gw M W
with the four diagnostic methods are the evidences for the
differentiation of both disease and syndrome. Whether the
data collected with the four diagnostic methods is accurate
or not directly affect the accuracy of the differentiation of
xm m m *
m m fc m m m m rs m i
im ,
SjJ
1 Diasnostic methods
^ c r
i r o
-g-
zy
jti
st s ai m ^ i* a
I r x B -# <j J t fn W
i# ,
The human body is a organic whole. Under morbid
e t >m h m ^ & m a *
m iu m a m >m , eo, w ra i # ,
^ E , i
ciiliation.
The four diagnostic methods are used to examine disciisc l'rom different angles and they cannot. replace each
iw] kj t i % M ^ 'ft w ra # h
0 jIfc,i|j^i:;& M B i# n m\
s
'Mfc r KM* *
diagnosis.
jii. n m un
% m a i r w ^ jM .i- ^ a n E
m m .
1.1
Inspection
*&
. i?
i T,
7 /
p
ilift
f+
iM
lir&
o
1. 1. I
B P -^j
1.1.1.1
Inspection of spirit
( - ) mw
^ SE -ffcfi # t t
piomote as well as the normal visceral functions to proIm l That is why the spirit is said to be the external man|frntations of the conditions of visceral essence. Inspec-
iit . j f i i i n % & m m
lE#>0
m m w g a ,m m
lin|X)rtant to the analysis as whether the pathological conililions are light or serious and whether the prognosis is
Irnign or malignant.
Inspection of spirit mainly focuses on the examination
ni Hit' mental states and emotional conditions, including
Itilnl expressions, complexin, eye expressions, speech,
fe J H
, in W ^
pS ' $ $
f i
llmulation, etc. Since the visceral essence infuses upwnnl into the eyes and the ocular system is connected with
Br VI,
llir brain, and also because the eye is the orfice related to
lili' liver, governed by the heart and housing the spirit the
#
+*'t
i i .
Itmpi'ction of eye expressions is very important. Inspecllnn of spirit means, by examining of the aspects menllont'd above, to differentiate whether the spirit is in ex-
m iE K w & n ffi s i j m w 3s
lnli'iice, deficient, lost, false or in disorder for the pur|Mii4c of deciding whether the healthy qi is abundant or dellcieiil, the visceral functions are strong or weak, the
INithological conditions are light or serious and the progno
sis is Ix-nign or malignant.
1 .1 .1 .1 .1
Existence of s p irit
i. m n
a & . l A f e $ l'fJ M R
iPo
JKJi?|
, S r ti
,M
i s =
2.
ficiency of spirit
The manifestations are mental consciousness, dispiritedness, pal complexin, dull expressions of eyes, short
of breath. no desire to speak and low voice. These mani
festations suggest mild consumption of healthy qi, weak
visceral functions, more serious disease and better prog
nosis. These manifestations are usually seen in patients at
? # j j
1 .1 .1 .1 .3
3.
tion of spirit
The manifestations are dispiritedness, pal complex
in, dull eye expressions, weak breath or dyspnea, emaciation, difficulty in'movement, retard response or even
unconsciousness; or coma with delirium and floccitation.
The former suggests great impairment of the primordial qi
and decline of the visceral functions, usually seen in chronic disease and serious disease with unfavourable progno
sis. The latter suggests exuberance of pathogenic factors
s i -0 ja t n
x j j #|
1 .1 .1 .1 .4
False spirit
4. PI#
(IV%'
(HIHH * lilfMliH',^^
, S; iR t i H
ig ,
t , 04 TS ^
^ ^
M - ft
m
iI
S * M ^
h]
ffi
* ffi n . M is m m
HWft.iJn
1 .1 .1 .1 .5
Mental derangement
5. m i
E P f ttjS iR m .t L T
ia
W M % m
0 0
Ifi
,T A S # f ,
S l, E J & M .
,JiE
3
S
0^
1.1.1.2
Inspection of complexin
(z ) u s e
'It W i o
1 .1 .1 .2 .1
Normal complexin
i.
The normal and healthy complexin is ruddy and lustrous. indicating exuberance of visceral essence and nor
mal functions of the viscera. Due to difference in constitution and the influence of clima tic and environmental
J S .& tf c IR IR W 'C f c . !
JV;ffli il t .
ili l I * Mi
JEft,
ll fuctors.
(2>
mil nliin
illll h lly
tlm'lush
mil
nuclear.
5HHM.
Ilesides, drinking liquor, excitement and sports ac-
ilt
1 .1 .1 .2 .2
Morbid complexin
'-m
2.
fe ,/ iM # ^ # fe ,m
illtilllio ii
H'llei
(1)
l .M i] F ;J W tf
E f: E
JS'C. a n j e a n MU 51
'fo
ftjE ,^J;
if f i a L,
&
MU
!,
**ll(ll
)#.
Tll:
fct i l
llLlH
M : i^ E J S E o
tlmnpness syndrome.
Yellow colour indicates asthenia of the spleen and aci ilfnulation of dampness.
CRUSed
fif- J ^
35 ,
- 'F
, IJl
IS ffe .
f f i.S
mmm,
U f e : F .,* j
. ^ jE O'I'IxI o
drome.
Bluish colour is a sign of inhibited flow of qi and blood
and stagnation of vessels and meridians. The invasin of
W fe Je K Ja is ' ^ % >
B m m im o
mm
ta
l b , il 'u m. m ; & k m I
U/cai'iw.jBXgtffifesw-o
-f m m , &t m * lis ^ A 0
ra j
M I . f f i f e t l . P j
ffife P
d
i. ffifeJt^W
,^*
M 'g 'iT m m w .w ik
/h J L ^ R o /JnJ L I I ' h] , # !
(dltoRenic heat.
Blackish complexin: Indicating kidney asthenia synilinliit', coid syndrome, blood stasis syndrome and fluid
Ife :
iJEiflS fu E ffl 7jctfcffi
IfUMition syndrome.
hlackish complexin is the sign of kidney asthenia, yin
prtdomination and exuberance of water or stagnation of qi
n M E io
n $ J 7 k :k
7jciX ^
# , l JicJ j . ifil f f
, II
, ifiL
i .
b im
RlN, Blackish colour of the area around the eye socket indi-
7 jc
rm
m, & m m t
a w
Inspection o f body
(= ) mwM
i w
- a
i i i i
$ 1 # , V jm m m w - #
M
The body depends on visceral essence to nourish,
wliile the functions of the viscera and the conditions of
VIm'eral essence may be reflected by the body. Therefore,
lliipection of the body may help doctors to understand the
Imictional states of the viscera, the current conditions of
i. m m m
Inspection of physical strength and weakness may enable one to know the functions of the viscera and the con
M
f
%
f
f
i
t(
D
f
JM
3
f
i^\
tu-
ii H.Jii W ^ K J S M i
mW
'J ,t S1
2.
mmm
m m m w w - M ' r|
( i ) pf-,
fc' XB.
5F
'J'. '>l>MV,l)fr.!|)Ll:lf4Mtc
- , W f i l i t e : S IM i
mina!ion of the body and asthenia of qi, suggesting insuffii'lcncy of yangqi and internal exuberance of phlegmatic
dnmpness as well as susceptibility to vrtigo, apoplexy and
ilhltructive syndrome of the chest. That is why it is said
lilil "tese people are predominant in dampness and
" oIh'sc people are susceptible to wind stroke.
Emaciatiori: Emaciation is characterized by long
<2> A s
. ta
% w b
% w iimts, u i r^i s sy
i ffl ifiL ^ ) , i t k
pulmonary tuberculosis and internal impairment by asllu'iiic overstrain. That is why it is said that thin people
iiiv
# o i t S A # ^ / A
zm m rzL .
,<-ft'J
M
^ h' 'k
WB
Deformity
3.
mn
^ < W Stf i f
fs S
1.1.1.4
Inspection of postures
llvilies.
The postures of the patient in tranquility and action is
(0 ) 2 5
fe M
T 5
15JTPB^ t ti
S :
der the control of the heart spirit and in cise relation with
m j m m m # t w $ m % i
M ll
M tb ^ IhI Kj fl 5I &
l.
and action
Yang governs action and yin tranquility. The sitting,
p r ^, m * # .
lying and walking postures of the patient may be summarized like this: movement, supination and extensin indicate that the disease of yang na ture, usually manifesting
as extemal syndrome, heat syndrome and sthenia syn
drome; quietness, pronation and bending indcate the dis
af
jE . j j Eo
(1)
(2) BH:
W. t 'hi!i) i i i . % i; , $ H b
#4**81
Ihe limbs and refusal to cover quilt and put on clothes indinilcs the syndrome of predominant yang and sthenic heat;
huddling up when lying on bed with preference to put on
mote clothes indicates yin sthenia and yang asthenia or ab
dominal pain; inability to lie down due to cough usually oci ni s in autumn and winter, often caused by internal retenllon of fluid; lying on bed with inability to sit up (sitting
ii|> causes dizziness) indicates asthenia of both qi and
blood.
W alking: Unstable walking with tremor of the limbs
(3)
m - * m w ni ? i m # & #
In lilis case, diagnosis should be made with the aid of othrr ways of examination.
1 .1 .1 .4 .2
\mo
2. w .'x iz m 't
j], H T
S 'M
iJ te $ f f
1 .1. 2
5d
sm .
The pathological changes of the tissues and organs in
the human body are mainly reflected by external manifes
$,
( f t -, i
it.
the disorders of the tissues and organs or the regional ref leetion of the pathological changes of visceral qi and
blood. Theret'ore, inspection of local regions is not only
helpful for diagnosing the pathological changes of the local
t\m
pmmust
m "i va r m m
(- )
M ^nm U o
'i? x f .
*;iai z f c - n z n
J$ P? ^/^Cifii'fc t Z Kl
loiv. inspection of head and hair is helpful for understandIllH the conditions of the kidney, spleen and stomach as
well as qi and blood.
1 .1 .2 .1 .1
Inspection o f head
^ i# M
^ fn
5J;So
(1 )
tlownward looking of the eyes and low intelligence in children is usually caused by insufficiency of kidney essence
and retention of fluid, often seen in children with fluid reUsntion in the brain. Smaller head with round top, earlier
W J L /FJL
closure of fontanel and low intelligence in children is frequently caused by insufficiency of kidney essence and
maldevelopment of the brain. Protrusion of forehead and
U'mporal regions with fat top of head in children often re
&I t .
' M L ^ A I hj
m , m m ^ ^ & , & n m. m
W'&fi S fr% , # E f f n J #
^ tJL o
(2) j i : i
a n
W SL
# Ai ' i ' t
li ilion of the brains. Protrusion of fontanel indicates stheina syndrome, usually caused by virulent heat in exoge-
!Jt.
n jS
AJ 1*17jt tf i i & m a
,#
-n , W 'h W
n-hiM kj K fm n .,
(3)
: JtifcA A s
Inspection o f hair
2. M &
(1)
M A ft
'hJL
(2)
^ 0 JL g M PJf $L.
1.1.2.2
H l i l i
(Z) E ^
2 lt- g rt f l^
# ^ ^ t at
m#
mi m
lile sensory organs themselves based on syndrome differrntiation, but also helpful for understanding the pathologiidl changes of the viscera. The inspection of tongue is dis-
m m m w jm Q ',
,Jg JKfllPHBg;
1. as
The eyes are the orfices related to the liver. HowPVer. all the visceral essence flows upward into the eyes.
, ht a 2
In the ancient time, people divided the eye into five parts
ll) the "theory of five wheels , corresponding to the five
Mlig organs, i. e. the eyelids pertaining to the spleen
liliown as muscle wheel, the canthi pertaining to the heart
Itfjown as blood wheel, the white part pertaining to the
lllliK known as qi wheel, the black part pertaining to the
* * ffc .J iE .
n a T fflig E jfi fw
Uve wheels, inspection of the abnormal changes of differI parts of the eyes can reveal the disorders of the relatwl viscera.
( 1) 0 &
.
t'lilt #
'J'J''
-A, 1*1Hi'r#
1 i ll'li
ness of the white part with reddish veins signifies exuberant fire due to yin asthenia, redness of the whole eyes
shows wind heat in the liver meridian, and red, swelling
and ulcerated eyelids indicates splenic fire or damp heat.
For example, yellowish change of the white part is a sign
of jaundice and pal canthus and eyelids shows insufficien
cy of blood.
Shape o f the eyes: Sunken orbit is often due to loss
(2)
g & f ,:
of body fluid resulting from excessive vomiting and diarrhea, or due to decline of visceral essence resulting from
(3)
s i a s t
and obliquely during the course of a disease mostly indicates internal disturbance of liver wind. Immobile straight
o w ii
MfiE, H it
ti) o iis ~ Jz ,
yt & fk $
ii.tfe ja T ^ & ^ o
H ttj
$Sj4l
brain.
1 .1 .2 .2 .2
The ears are the orifices related to the ears and the
places where all meridians converge. Besides, the shaoyang meridians of both the hand and the foot flows anterior
2. I ?
B*;
to (he ears and the taiyang and yangming meridians disIrihute over the ears. So the ears are closely eonnected
with the whoie body through meridians and collaterals.
Therefore, many visceral disorders can be reflected over
the ears. Generally speaking. inspection of the ears is
l'hiefly helpful for understanding the conditions of the kid
ney essence and the pathological changes of the gallbladd t'i.
Inspection of the ears should concntrate on the colOUi
ple
(1)
Itiid moist luster, which are the signs of sufficiency of kidliey essence. Whitish colour of the whole ears indicate
t f e a m ff i; f e w i ? n i i
IT Iffi.
^ l^ lf ^ r f n T tt , H
lually seen in pain syndrome. Thin and dry ears are a sign
of insufficiency of kidney essence; scorching dry and black
colour of the ears signifies extreme loss of kidney esO'iice.
Pathological changes inside the ears: Pathological
(2 )
^[*5
n m
% %
o yellowish pus and white pus is all due to prolonged stagIWtion of damp heat in the liver and gallbladder.
1 .1 .2 .2 .3
3. i *
m x \m
I f l M
(I)
ff*WV$dcifiL
It f e , M
* . 'Xbu
%o ffn
KiiF.o
(2)
m m ,
1 .1 .2 .2 .4
4. M C L H
:# l
m v i, & m P
(1)
JSfeU
^JM %JLMM t M fe l
m m ni
(2)
%P
MZxftt'MJ&vE;
P ff fff^FfI
JIM
P rfi
lenia sydnrome.
1 .1 .2 .2 .5
5. 1 I
Inspection of gums
m.r.7 m - % je #. gg
H M X
h ^ o trS
Inspection of throat
6. MH0P
i'w
SSc.
^ ,1 1
, pj
itiJi.fiSBPg
1.1.2.3
(= )
Inspection of neck
jE # A f 3 9 S S .m i
symmetrical with the trachea located on the middle. Laryngeal protuberance is prominent in the male and invisible in the
female. The neck can be rotated, bent and raised freely in
standing and sitting position. So inspection of neck con-
M#
i.
( i)
Klffl'J^ W ffl'JM W $ i P , i
, ni 15 A0$
MMo
Wt,
Jfeis
(2)
:M o
m f : w m & t w
mm.
Changes of movement
2.
M xh& M
it
( i) =
(2)
m ttssifraji
m m fe # *&
9 f f l.
B8R
m . as-
lacking the neck. Stiffness of neck with high fever, headache and vomiting is usually due to heat virulence in fe-
g s m g * '-'i.
mmwo
w,
im
ir e .f lr w s f lr in ^ .iE ia jR
ik ini fe m . m r
&a # tu
m u
1.1.2.4
Inspection of skin
(E3) M R ;
Skin is distributed over the surface of the body, connected with the lung with weiqi circulating inside. Skin is
the defending barrier of the body and nourished by qi,
blood and body fluid through meridians. So the disorders
of the skin itself and the disorders of viscera can be reflec
tad by the skin. Inspection of the skin is not only helpful
for diagnosing skin disorders, but also helpful for underNtanding the nature of the disease, the conditions of the
viscera and the states of qi and blood.
Hi
m ftm ,
iu fr
Inspection of colour
1. M f e j f
1 .1 .2 .4 .2
Inspection of shape
2.
'ilM
; & K T M
sence and blood; dry and rough skin like scales is called
squamous skin due to mixture of blood asthenia with blood
stagnation and malnutrition of the muscles and skin.
J U lte fg ,^ E im i M ,l
te # 0 r L
1 .1 .2 .4 .3
3.
ja iw i r m i
J ift:
Inspection o f macules; Macules refer to reddish or
( i)
K m .,#
E te tB iM d
it iM T m M iJ s m R m B ,
fe m o
M , SS 5 ^ ifc.>E $ ^
H H,
S ifo. . S Jfc ^
.
(2)
^ s fe la :,
/h M , M in ie n ,
0 ! J lT g f t 'f iiE , n
Measles is an acute epidemic eruptive disease in pediiiIl ies, usually due to attack by exogenous morbillous toxln. Measles is characterized by pink pockmarks which ap
licar first over the hairline and face, gradually extending
lo Ihe Irunk and four limbs and disappearing after full eI npl ion. Pink-colored and evenly-distributed measles with
orderly eruption, orderly disappearance, abatement of fe-
f .
% M t}
U lE d l
/ h M ,
m rfn ,
m Bt& o
(3)
-fJft&K I:
!* !# H
comes out when scatched. The blisters are distributed over the neck, chest and abdomen, occasionally over the
m* ti,
(4 )
H\R,
^ 0 & X % l*l H . % J.
L:
S $ -~S 'P m # ,
K ffi.
. JR
ifi.1? , ^ fM M i f , JeM, # rt
rf:
, m e m jk , m
m m i
li^fifnjio
m m , rw a
* g , & jk ^
T jy it t ,
fnfiKo
1.1.2.5
(E)
veins
Inspection of infantile ndex finger veins means to
ffl/J'JLtffilIJcft.tfc#
K M .E M M M o
ifo
(Effl 1)
L ife pass
Qi pass
Wind pass
Fig. 1
ffll
The normal infantile index finger vein is light red and
slinhtly purplish. dimly visible within the wind pass, usu
ally not quite clear or even indistinct. The vein usually
IE#/hJL
So i
-IxrFn^f&L
1. M / J ' J L t - l M f i
J j)
li^ht and the doctor grasps the end of the infantile index
finger with the left hand and pushes the infantile index
finger from the anterior palmar margin of the index finger
lo the palm direction for several times with the side of the
hkB JLlstH $ S B U S i \
i
KM:
Hufficiency of qi and blood; reddish vein indicates exogenous wind and coid; deep red or purplish vein indicates intemal exuberance of heat; bluish vein indicates pain syn
drome or convulsin; cyanotic or purplish dark vein indicates stagnation of blood collaterals and critical condition.
Floating and sinking: Visible and floating vein indicates that the pathogenic factors are in the superficial and
that the disease has just occurred; deep and indistinct vein
means that the pathogenic factors are in the interior as in
n-.
mvEo
nal impairment.
Lightness and stagnancy: Light-coloured vein indicates insufficiency of qi and blood; deep and dull colour of
vein indicates excess of pathogenic factors and stagnaton
of qi and blood.
Form: Thin vein indicates asthenia and coid syn
dromes; thick vein indicates sthenia and heat syndromes;
single and oblique vein indicates mild disease; mltiple
E,#ViiEo i
&B
; ^
i l , ^
II
0:
m i i r t U f i . m ffi Se m %
If .
1.1.2.6
Inspection of excreta
(A ) m m m
WWlVnKj &
. i: g fe t m,
m\
yu. l a i i t . i i t M t t i . si]
vat
W M tiW n . 1:
Inspection of sputum
i.
KOurce of sputum, while the lung is the container of sputuin. The production of sputum may bring about various
(lineases. So it is said that sputum is produced by disea-
Whitish,
l i f f i , l i 'A^'tWo
>
it
40
-si
2. W M M
secretion
in the mouth.
/ J 'J L g # P
qi to transform fluid or insufficiency o kidney yin. Frequent salivation from the corners of the mouth in infant is
&
g # p g j
to
Inspection of snive
3. a s
w di
m r m % m % fft
Turbid
and
yellowish
snivel
indicates
Inspection of vomitus
4. MPR!$J
tK u m m y jT ff
fP E g 0 r& . Pgn
1.1. 3
Inspection of tongue
'>m'ii'&zsi
OT 5
Jfil
^ fu )S f
@ jtt, A t t M W S
m & .m t i w * m -^
mx
1.1.3.1
( - ) M S M B
r 4=, # # r
, r ffi, k m >
Inspection of the tongue mainly includes the examination of the tongue proper and the tongue fur.
The body of the tongue is composed of muscles and
Vessels. In the ancient times some people believed that
m m o hu
E W iift.
That is to say the tip of the tongue reflects the pathologit'iil changes of the heart and lung, the center of the tongue
reflects the pathological changes of the spleen and stom-
i x efe
k m n w m $ , s- m m
^ s u f e f f F . i a w ^ d L 2).
ces of the kidney and the margins of the tongue reflect the
&#
-JEMA
. / , L
K id n ey '|f
M dium groove
Spleen ( s t o m a c h ) ( P f )
L iv er (gallbladder) f f g i
Heart (lung)'ll'(/J$)
Fig. 2
m m it m iiitR-tr
1.1.3.2
(Z ) E 5 i
IE #
sfr S i n . ^ fe
( ' J i m 1 Do
1.1.3.3
(= ) a s *
i f
i-
( 1) j&r--:
% tfc US-o
I I ifiS # ,
J E ^ A ^ ^ u ii^ M ^ f
JE -
Mdch as primary stage of exogenous disease, mild pathological conditions, or mild internal impairment. indicating
Ihiil qi, blood, yin, yang and viscera are not involved.
L ig h t-w h itis h tongue: The colour of the tongue is
(2)
f r S iE #
2 )a
anease
f f f i'h # , M
(3)
JE#-S
Iluin that in the usual condition ( see colour Fig. 3). The
ilffcp or dull red tongue is called deep-red tongue (see
( J a l s i3 )0 m i f i M M
4 )o
Irnl.
M tiE /K W fe o
Red or deep-red tongue is caused by superabundance
/ l , $ ^.li a i ,
.tS T fr ,
WJ m I S
E; fkl
^ P n:sSc% ^ # JS A ft fiE,
ii'lthonia-heat syndrome seen at the advanced stage of extillcnous febrile disease with consumption of yin fluid or in
IMlicnts with yin asthenia and superabundance of fire due
lo Internal impairment and chronic disease.
E & JX t t M
(4)
, skin
5), $
;j 0 T & 2 f l5 JtP>,
liE H if H f P H I S .
!ll ' t$ % Jc % B M
#3 # JU
stasis. Light-purplish or dull purplish tongue with moisture is caused by inhibited flow of qi and blood due to yang
asthenia and yin exuberance; purplish red or deep-purplish
and dry tongue is caused by superabundant heat consuming
fluid and stagnation of qi and blood; dull purplish tongue
z'u e.
Shape of tongue
2.
IUTJL#:
(1)
mm
(2) #*.--!
mm
JtV U t
. 7jc M f f f f l, M
(3) fltL--s
wu a m m m m # t *, s s
-s- m m m
Up|xT,
iillil
tu (u-U i l M fi't'K*
- fH S
(4)
fi'S 'hl}i,
mm 7).
MW
-r(BL
cansas#,
in K 'f iJ s i rfi S M
iii
(5)
8 ). -
a *
A m is ta :, n
s . g ^ & m m . iit % m v
tongue fur.
Prickly tongue; The tongue is covered with reddish
(6) #']-:
9 ).
e m ffi
'll'A /L ; f f 4 ^ f M * !
JfFJEA,
(7)
are printed with tooth marks (see colour Fig. 10), indicaling qi asthenia or yang asthenia and internal retention of
(m m w o
(lumpness.
The spleen govems transportation and transformatlon. The decline of the spleen qi or spleen yang will lead
Id dysfunction in transportation and transformation as well
1 .1 .3 .3 .3
3. -S-&
it'#?
f, <4- 4}W
it . iE t s & m m z j
VI K J L # :
(1) M
ni Itiff and immobile. Such a change of the tongue is usunlly seen in exogenous diseases due to exuberant heat con-
MLT1
m , sjc m
JtL
If the
(2) M $j4 r
)\m
#,
/ L
, A M M
To SP'S'fefclMIK^Jj.JS^
rfifV' W 11
# , ffi MI
, JaL=f
fifi ;
i) , JAl f
, # ik s ,
(3)
&
# -s- is-m
fa ffi, # * a
I 4 ^ ( J aL
ii>-, iiJ'PJxUH
s .
(4)
'P
Tffi
4t % !>] J t k Bi B
I I .
i S T
m vu
a i i t ,
(5)
protrude. or cannot even reach the teeth, usually indicatnn critical condi tion. Such a syndrome is either of coid or
O heat nature.
*S IS-
f e * w ffi
&wm
m m ; si M
'M
se a u m M . a
fr ttiftM o
U ur& n
Vessels of the tongue. Light-whitish or cyanotic, pur|)|lsli. moist and shrunk tongue is due to stagnation of coid
In the musculature and vessels of the tongue; deep-red,
iliy and shrunk tongue is due to extreme heat consuming
fluid; bulgy and shrunk tongue with greasy fur is due to
llVri wind complicated by phlegm.
j;
km m m ,
m m m m m m s k ',
B s M f t t i n A s A R P i
, nir H /K I f t
lie jE %
1.1.3.4
(0 ) M S S
m i T m m w m m jm m
i.
t f
( i ) 4J$x s f lftW WP
4aL ft o ** 4 ' RL te
')'} te . l
Jfcfc,
(2 )
W -uftljVA KJL#:
t 7jc # i f J Z M ', $
S H U N T S * .#
m -k/t<
ffc
T'J
? '
iI.i W 8 .
(3) M :
m z s u M M 'f Z iM & a a
Fig. 12). While the tongue fur loose, sparse and easy to
mm i2) ;M M * M
(4)
ftn ,
M lS o
Exfoliation of the tongue fur is usually due to failure
til deficient gastric qi to fumigate the tongue or due to failurc of the exhausted gastric yin to moisten the tongue.
Therefore the exfoliation of the tongue fur can tell whethPl
the gastric qi and yin still exist or not and how the
/a-.
xi fe: 4'
rThk M
Wllh root means that the fur is closely attached to the surlili it
|Nllr<l
lilil
'If $r M ; S-? f] M
J s .M k m
The tongue fur w ith root is formed by accumulalln n o f g a s tric qi w ith turbid pathogenic factors on
Ifw tongue: the tongue fur without root is due to failure
uf nimli ic qi too exhausted to produce new fur and inability
uf llic original fur to continu on the tongue. Inspecting
Whilhei the tongue fur is with or without fur is helpful for
ir ,
f'r
The appearance of
s i.
i SE
JWiua
1
a te rra # ,
r fc g .M fjg iiiS l
1 .1 .3 .4 .2
2. g fe
f.
( 1)
2/3o
P, rj4c
^ %J M I* ^ l:
rlt
al
m .
a i4).
m m M
w. rtM-uiW ii.
liictors and heat toxin, usually seen in pestilence and in(irnal abscess.
Yellow tongue fur: Yellow tongue fur usually indiCBles internal syndrome and heat syndrome.
(2)
S U M 'f o
^ S H ^ Ho
15).
w a ts .
rough tongue fur is often caused by pathogenic heat consuming body fluid or by retention of heat in the intestines.
But if the tongue fur is yellow. slippery and moist and the
tongue is light-white and bulgy, it is due to decline of yan
gqi and failure of dampness and water to transform.
Grayish black tongue fu r : Grayish black tongue fur
(3)
jE W
S E,
16,17)
t itir a ,
m m n
a n is a n ] ,
1. 3. 5
(35) S t t S S S M f a
, fi'e n j ij j
M % ,
Jl fj $ M ; ^ ^
Ule body of the tongue and the tongue fur and their indicatlons, we have to further understand the relation between
lile body of the tongue and the tongue fur and make com|)H'lii'!isive analysis of the changes of the body of the
nigue and the tongue fur.
I Isually the changes of the body of the tongue and the
tongue fur are the same, and so is their pathogenesis and
W $ t S M
|W !,^-SCo p M i
M #L +11
jt.m
timos the changes of the tongue and the tongue fur are difliirunt. In such a case, comprehensive analysis should be
HhmIc of the causes, pathogenesis and the interrelation.
Pin example, if the tongue is light-white and the tongue
ifiLV J; ^ M M , % ffi $
lili In yellow and greasy, light-white tongue indicates defii IriU'y of qi and blood, while yellow and greasy tongue fur
lti X i
Mlggests internal accumulation of damp-heat. ComprehenpVtf nnalysis shows that such changes of the tongue and
M B 2: JfPWj $ %
3 U ii:
&a m
mm m & x
D I; g M % 'M M rt $
MiLo
1k R
B.,XieM, &tfcrfRfllL
*u tn ^ i
(tingue fur suggests internal exuberance of phlegm-dampor internal retention of food. In exogenous febrile
illuoimc. such an analysis indicates heat in the nutrient
filiiido .ind dampness in the qi phase; in miscellaneous dis-
tiltil
and fire exuberance accompanied by phlegmor retention of food. The above analysis shows
SCH,
# & m #
l-J
m # va w m 'i!
tii.
1.2
3 ? -^
m - ip
a t #
w rm m m m m x m
#15j * 4 d
# # T * t fP K
of the viscera.
1. 2. J
Listening to sounds
r* t it;
1*1 ftfl H Mt
filil
k ' c , m1i
. w i- n 'rc .f t
A f f f M t ,
$ i t . m# tffisij m j 'S-li'#
1 . 2. 1 .1
(- ) mm
Speech
j E
i f t
iMtl. The speech of normal people is natural in pronunciallun. smooth in tone, clear in expression and consistent in
IWtids. Since the viscera, constitution and physical build-
j&.
Ifff-/# , J L S W
z x m p w m ecjt. - u
, iE S A
j6
p ^
t c
1.2.1.1.1
Voice
, ;i m b wj p ;i m
^ ,s
1.
(1 ) # 5 # !
ij /l # in r f S n, W i l , M
SS
g r , J a f iE ,& f iE ; j* f
Vitli r willi quietness and oligologia indicates asthenia synoine and coid syndrome.
Doop and heavy v o ic e : Deep and heavy voice is u-
(2) t M f c : f P W M
Miitllv caused by failure of pulmonary qi to disperse and obliliclion ol Ihe nose due to exogenous pathogenic wind,
imlil nuil dampness, or by obstruction of the airway due to
litMlMlion of dampness.
Honrseness and aphonia; Hoarseness means harshVtilrr. while aphonia means complete ioss of voice.
(3)
t f ,
ft. ffi/
If
'fy P # m LS . S ^ r J
U'f, sX
fi. S ffi,
ir, e p f t n r ^ o
W Di S %
# ,
J E, #
vm m
xm
ttM -fw
ii KP }jffin
. ma
* m asa
^ na
Paraphasia
2. f s fg S L
% b P
, in
( 1 ) i^ ia -:
invasin of pathogenic factors into the pericardium in seasonai febrile disease or sthenia syndrome of yangming
fu-organ.
Fading murmurng; Fading murmuring is marked by
(2) % p ,
l i l i .
(3) m :
m fn SL
Ion.
talking to oneself,
m i
* ffc. in % ffc A .
% hm
Ht'fkin >f ift
, s 'l> 7 (, k *
(4 ) t :
ouling and sonorous voice usually due to phlegm fire atIflt'king the heart.
SL=f19Lk$tL'#i&m.
(5)
m H SL. m fs S 5a A lt ,
2 .1 .1 . 3
Slurred speech
3.
Slurred speech is marked by unclear and slow exllh'ssion without fluency, usually seen in wind stroke
m m m w . w ^ @ mrnm, %
E T ^ J4
4 114 Js iS S , M M
R espiration
( Z ) B?}
J l# :
1-
arete:, z
tlhiuir and sthenia syndrome; the disease with long durallmi. weak breath and shortness of breath in movement
|i Imiis
JS E ,S iiE 0
1 .2 .1 .2 .2
2.
m m ,it m n m * $ , & m a
m m $ io
ng,i
a se.I
3.
ni!
til qi.
Weak breath is marked by feeble and short breath and
IllW voice. It is not discontinuous like the manifestation in
kluil lness of breath. Weak breath is usually due to insuffil lrm y of visceral qi, especially asthenia of lung and kid-
Wy qi.
Hesides, This conditions is accompanied by sighs due
ti) i'host oppression and depression resulting from emoliiMinl upsets and depression of liver qi.
1.2.1.3
Cough
{= .) m u
i,
$ , is tu ni m n
&
^ 1 p
*i li'iislics of voice in cough, understand the time and duhtllnn of cough and differentiate the syndromes in the
llKlH of Ihe colour, nature and quantity of sputum as well
ollicr
complications.
1% F f i
M # , t-
j M - i a is $ M o
EM
a .
S ^ , JU
>fij ;VT
@ H d l
1.2.1.4
. M
F r L
(eg) niE j5 ig n
Hiccup
1. i
Hiccup is marked by upward rise of qi and involuntary gurgling noise in the throat. Syndrome differ
entiation of hiccup is done according to the hiccup
sounds, dura tion and other complications.
IW J K &
nm vE .
p\ m .
iW* |s]
Qonditions.
1 .2 .1 .4 .2
Belching
2. t n
a m
m w j*
& r h ij .
K i.iS M
titH J s fo
g , m
plH caused by invasin of liver qi into the stomach. BelclllHK With deep voice and acid-putrid odor accompanied by
Hm tanto for food, light-coloured tongue and weak pulse is
l to weakness of the spleen and stomach, usually seen
||l ilhronic diseases or the aged. Occasional belching after
IMiil is usually due to overeating and is not morbid.
m te .
i , 2. 2
- x
lfaction
mnm
]E'AffiJDfmtjE'ft\
I iIikmI
AL*
Ktco s j k .
m&m.
tJ
and sore.
I t l W
1.2.2.1
1 .2 .2 .1 .1
(- )
Foul breath
1.
5 iL f
Afiff [; P
f t iP J ilS
Wrto
1 .2 .2 .1 .2
2.
Stinking and foul sputum with pus and blood is usually seen n exuberance of heat toxin or accumulation of heat toxin into lung abscess. Odorless thin
m.
mm,
Body odor
3.
m m m tm m ,
Ar
4.
~\
'
'
/V.
a o
MhK stool suggests asthenia-cold in the spleen and inliINtincs. Sour, putrid and foul odor of stool or foul
lliilus indicates retention of food and indigestin.
1 .2 .2 .1 .5
Z o
5. m & Z H
Menstruation odor
e M
I hL
WllK'cr.
1 .2 .2 .2
(z) m m mzt
w . * a # m w % , m Ai
L 'f'i;
4\1ILM /=l , /K B
t i i H . jit A ~ $
1.3
Inquiry
M F><
M N !&
T IS if M
5t,l
Jft.f]^J&
flffi K l'l
the patient.
i J f .B E
# . W S M 'l l ,
wk m w a !
vi m
'S. k M ,
fin i
% t o
U > #\ M M i , M -Se$
1.3.1
General information
r a - M
T < f f f l a . E # B r iJ
ftllil
tyllid
P mime specific areas certain kinds of endema and epii. mu diseases are commonly encountered.
Ik'sides, the information mentioned above is also imftltlmi! for writing medical record, recording and surveyyi Ihe procedure of diagnosis and treatment as well as
vpmg contact with the patients and their relatives.
[i ti. 2
y? -j m m 't
fsi ' w
^ , |n]
1.3.2.1
( - ) q liiJ f
m i l la!
the patient comes to the doctor and the chief sympB R til the illness.
fs .g p E o
Accurate chief complaint is key to further underHfKlllig of the pathological conditions of the patient. So
complaint is helpful for primary classification and di-
j lu
of the disease. And it is also an important eviPli> for mvestigation, cognition, analysis and treatment
t .
|| illwnses.
Ciireliil recording must be made of the symptoms inillulnl ni ihe chief complaint or the location, nature, deiilid lime of signs. The recording to the chief comU|tii||l must be concise and avoid any ambiguity.
f iE W W f M B L ig f iM t tf
1.3.2.2
(z)
ness
The history of present illness refers to the whole
course of the onset, development and changes of illness
from its occurrence to the time that the patient comes to
the doctor. The inquiry of the history of present illness
a w i g a i.
1- swtHyi
Occurrence
TM
1 .3 .2 .2 .2
Development of disease
2-
3.
ir& vt
ment
Inquiry of the procedure of diagnosis and treat
E .f lf t M t S S t .S S f f l
i-:fWa.fi v i
mi
bren taken and what the curative effect is, etc. Such
and treatment.
I, l. 3
@m t m m
m ,w
ll .IIINC.
fr
I The present symptoms are the reflections of the
f/L^ ^ lu f
MU-nt pathological changes and are the important evifpiHCH for the diagnosis and syndrome differentiation. InlUlrv of the present symptoms (including the location. na-
f., iHifij"]
h h
M M &M
. I K 7 m
m
.. m t t , m ih
WSWfTITL
K.i, I, disease has its specific main symptoms and secHltilHiv symptoms. So inquiry of the present symptoms
ptlilil concntrate on both the systemic content of inquiry
^|fl lile basis of chief complaint and the main symptoms.
H jH:.
I] M #. ni
H' S W T M N %
f tf'l % M I , X W
S M
'/F J
bulln and urie and symptoms over the head and face
u ipfc,
mmm , n
fs] ^
I 1.3.1
. "l
.
l'o]#314
f>l
( - ) p I S ^
f J M & B iJ M f h.
IW IifitS .
, in H 'L 'M
PHSSj
% , m & w m w aj a .1
& W g f i , iU i W b m fq j f
i| M & W M
!*)
i.
s]0^?a-J+ifi5ifn & . 5L F
u n
ymiK to warm the muscles; fever is caused by pathoPliic factors encumbering the superficies and resist-
SiJo
lIliTe are three types of aversin to cold and fever acBlllding to their degree.
( 1)
fever is
|Nll'(l.
Serious fever and m ild aversin to c o ld : Serious
InviM and mild aversin to cold indcate external syndrome
mm;
mm m%
(3)
,m
va &
M iE ll
iEi l
2. U S T O
% ^ IS i *
ES'Jo
M M M SI
(1)
M M fc & T M f l rg C o
All A
(2)
g m '%
ai
3.
llulilus heat. Such a problem usually pertains to in(pinal heat syndrome caused by exuberance of yang or
tatlrnia of yin. According to the degree, time and
liWlures. fever can be further divided into high fever,
(lilil ever and mild fever.
High fe v e r: High fever means that the patient suf-
( 1)
i .
z m jA m A m t 's U M
su
W'i>, |Hi laining to internal sthenia-heat syndrome, usual|y mcompanied by flushed cheeks, profuse sweating, dys(tltulin. tliirst and preference for coid drinks.
m & ' i m m e.
(2)
% m m & zk
Yangming afternoon fever: It is marked by continuous fever and severity in the afternoon ( 3 - 5 oclock in
the afternoon)
when
qi
in yangming meridian is
(T^F 3 5
superabundant, accompanied by constipation and unpressable abdominal hardness and pain due to invasin of path
ogenic heat into yangming, retention of dry-heat in stom
ach and intesties as well as obstruction of intestinal qi.
M W a flr a .
^ B P ^ * W ) > ;M .M f
W Z o
(3)
X f ft fa '
f i, M
k m
tP
# * ! * & til
l|| Ntagnation.
1 .3 .3 .1 .4
4.
m r n *
llvelopment and abatement of coid and fever. Irregul.ii li ltrnate coid and fever is seen in shaoyang disease
# 3 t4 M itE ,0 3 f| $ JE * 0 ^ ,1 5
k b
. , m va m m H
tH'iix factors. The predomination of pathogenic faclui* leads to aversin to coid, while the predomination
a u n ,
W A A f r 'V t m T m & Z
ilV m once two and three days, accompanied by se[|>ie headache, thirst and profuse sweating, pertains
lll miliaria.
a .ttf w & .
1.3.3.2
Inquiry of sweating
(Z )
iJ I 'W
o
% n , & ?r w m i's]. m
% 'P W l,
1 .3 .3 .2 .1
Anhidrosis
i.
^nwww m
( 1) A i f c i t :
m m jm 'm o
ifiL . E, PH di i l
I
1 .3 .3 .2 .2
Hidrosis
2. W f
Sweating can be caused by exogenous coid atlit'k. or wind-heat invading the superficies, or exulirrnnce of endogenous heat, or endogenous heat due
lo yin asthenia, or weakness of weiqi due to qi astheliln. or excretion of body fluid due to sudden loss of
y.mgqi.
Hidrosis in external syndrome: This condition is
( 1)
To t $ : g ; J x L J ) * v
l\'
(2)
^JALTM
-fMRiiiE
s^i .<i fs m a ^
% i ff o
Itllen seen in qi asthenia syndrome and yang asthenia synllmrrie. Since asthenia of yangqi fails to protect the superlli les, the sweat pores will become loose and body fluid
Will excrete. That is why sweat is constant. Since physi-
ihe
H M f tBMSc
lljltre serious.
Night sweating: Night sweating refers to sweating
iMitniing when the patient falls asleep but stopping after
intff: A fcfcjgffM i.
( S W iJ fF it.ft^ fe ff. f 'AL
ffio
si
it ,
gqi returns to the superficies, the muscular interstices become tense. Under this condition, endogenous heat with
yin asthenia cannot steam the body fluid to excrete. That
is why sweating stops after people wake up. Asthenia of
both qi and yin usually lead to both spontaneous sweating
and night sweating.
AfF:
& % , M
fr'x m n . m & # % na # t
i t 0f i
@ $ T :
T di ili 05
* t , is ir a iix jB
h|)|kmi s
V m io u s ,
wln* li drives body fluid to excrete in the upper, often acl'ompanied by reddish complexin and thirst; accumulation
ni damp heat in the middle energizer in which the stagnatlnn of dampness and steaming of heat drive the body fluid
10 excrete in the upper, often accompanied by abdominal
tull ess, heaviness of the head and body; prolonged and
UPiious disease with primordial qi on the verge to exhaust
lli which asthenic yang floats upward and the body fluid
tfltcretes in the upper together with yang, often accompaitlcd by pal complexin and coid limbs. Besides. exuberifli e of yangqi due to extravagant intake of pungent food
ni hot soup and drinking of wine may drive heat to steam
lli the upper and lead to head sweating. But head sweating
l|i this case is not pathological.
Ilemihidrosis; Hemihidrosis means sweating appears
KVir half of the body, either the upper or the lower, the
l|t side or the right side. The location of disease is on the
ffi'l, b J c f >6'i 1
!
t m w / p
k t u.
x-/r-t<j t # o ^ jal
Ti;,
I W lfJ ft.
dysphoria,
insomnia,
dreaminess and
i l f c ^ . M T l S v T Mi
/iMl&sK l*l
fr SS[o
Inquiry of pain
( = ) ftm m
?
& lltfi
_t
llL frj I
%. T'i ay
(1)
ik t :
I hitnd and oot are directly connected with the head, the
llvt r meridian also extends to the head, the other yin meI fldians are indirectly connected with the head. The loca-
i K
I (ion of pain over the head can enable one to decide which
M - ^ ffiM f .
^ m
+a
An A f f i i 1!! ,
M t i % ffi, m 'p ra , ^ j n
a ^fitP iii X
liendache are various. Headache of sthenia syndrome is ummlly caused by such factors like attack by exogenous
5m m s a m a w
tE o
n u k ffi
ffi. m
jjg R
(2) f&It:
tm
, ffi An i t m , 0 % iil m
o
nP
ffi, w/i-:
S ,
iiI.IK iilW
/L
foul sputum mingled with pus and blood indicates lung ab-
fr o
f t j j r
l .
' (
lili
f f i .
(3 ) M
m .
p
B S J M
if] o
(4)
low the xiphoid process where the stomach is located. Epigastric pain is usually caused by failure of the stomach to
descend food and stagnant flow of qi due to cold, heat. re
tention of food in the stomach and qi stagnation, etc.
Stagnation leads to pain. If pain becomes worsened after
intake of food, it is a sthenia syndrome; if pain becomes
alleviated after intake of food, it is an asthenia syndrome.
Abdominal pain Abdomen may be further divided
eI jE.
(5> tuf-, m m m m
s u # , i^TJRr
/M u .
# ?/M m m
M .'p m
E ;n > I L
zm m vE .
(6 )
fM :
x ph*5i* fn ; m
(7) m k-. w f t m
, ki
%m
Dfffp a -m , m m ti m m *
(8> w /jt# ,: z m r m u
l'nused by invasin of wind, cold and dampness, or by ac umulation of damp heat which obstruets the circulation of
<|l and blood. Pain of the limbs may result from weakness
W f f c & T MU*
& m & um
^ t% o
(9)
n m , m % a . vX $ % mi%
SflSjg- :
l'Ji] lili )A|
2.
tfl
#>
H A *
t.ttS-H&.HiN&B i h . J S i
, % SI J S f f i , M liffio I
<l) IM S :
M r i I t . M-H f W
(2 ) M :
-o
(3) A ' J ) : t m m
S o
P )K K | S |
(4) 1
(.r,)
i,1i'VffiHl
preference
for
(6>
(7 )
m am o
is mm,
1*1mnmm
ll, i olic pain of the epigastrium and abdomen due to in!'" i O pathogenic coid into the stomach and intestines.
f Dull pan: Dull pain means that the pain is not sharp
ll'l lnlcrable, but constant. Dull pain often appears over
(8) :
m -f ni e w -i m % * w .
Iiiiid. chest, hypochondrium, epigastrium and abdotyl din' lo consumption of essence and blood. or msuffipH v o yangqi and endogenous exuberance of yin coid
a ,
I I M
rt is. tr,
(J
o ) m -. m m m m
0
fFP
E
I
/l,H . J
(10)
ftr .
iitMM , & M
R ifc
ib
Ifffl
( 11)
1 .3 .3 .4
Inquiry of sleep
m .
(ES)
r]fillS
itt,
H Jfli M M VI 7k - 6 , %
sai
N IS IR
|'h] M
, A B 1*1
jffiW SU S.
Insomnia
i.
u iih ^ a w .# ^ # .
S ifii ^ M W \ ;k $ , L- W \
reddish longue with scanty fur, it is caused by insufficienl'y of heart yin; if difficulty in sleeping is accompanied by
inllpitation and aching flaccidity of the loins and knees, it
In caused by imbalance between the heart and the kidney;
II easiness to wake up is accompanied by palpitation, reiluced appetite, pal tongue and weak pulse, it is caused
liy asthenia of both the heart and the spleen; if insomnia is
Itcompanied by profuse sputum and yellowish greasy fur,
II 8 caused by phlegmatic heat disturbing the heart; if disliirk'd sleep is accompanied by dizziness, timidity, nausea
mui bitter taste in the mouth, it is caused by gallbladder
drpression and phlegm disturbance.
1 .3 .3 .4 .2
Dreaminess
2.
l'he cause and pathogenesis of dreaminess are alItliit the same as that of insomnia. Dreaminess and
lliHomnia usually appear at the same time and can be
in ated with the same kind of drugs. Therefore, diagIKims of dreaminess can be made according to that of
luuomnia.
1 .3 .3 .4 .3
Somnolence
3 . P f is
t& m .
3P.
i#
ZM
. :
ti B E H
f f i
'j] JZ
: $J N f t P ' -t
ftlttlM
11
di
l.
P iS J ig P T S W M
P S ^ S t f c P 'F f
wm
vrx? k m
(1) a :f X) V :: P ^ w
# j , E T- m Id:, M
ffi, c%
ft fj f ffi
(2 )
a M iik
ifti
T asase;
, El
p^i p i ,
lluill.
% l &
, *
-fi ffi i r
E , gl
M ifi X /K S g
8k t HaTf. $ ; p g ,
P f , {O
ja
# $
2.
Appetite refers to the demand for food and enjoyable sensation of taking food. Repast refers to the ac
tual amount of food being taken. Inquiry of appetite
and repast is significant in understanding the condi
tions of the spleen and stomach and the prognosis of
m w m u R m m w m is n
disease.
Reduced a p p e tite ; The meaning of reduced appetite
( i)
f lw .0 x * f 5 ^ | s ] o ff
duced appetite in new disease is a sign of healthy qi fighting against pathogenic factors, indicating mild morbid con
dition and favourable prognosis. Reduced appetite in pro
longed disease accompanied by spiritual lassitude, sallow
complexin, pal tongue and weak pulse is usually caused
by weakness of the stomach and spleen to transport and
transform. Reduced appetite and indigestin accompanied
by heaviness of head and body, distending oppression of
the epigastrium and abdomen as well as yellowish greasy
fur is often caused by failure of the spleen to transform
and transport due to dampness encumbering the spleen.
Anorexia: Anorexia means aversin to food or to the
(2) B U t:
ris
i . ih m s l . u r m z t o M
(3)
B tJ L
(4 ) P i t i b U L , * . *
at*
(5)
ti m
i*Jtt0 o .X\HHi W
UM T
E7jc Q - M tl i l ,
M , # M iff i f , J S % ff\
in o X f !>T((j \ . )ii 4-
increase of appetite or even crapulence in the patients suffet ing from prolonged illness or serious disease with ano
rexia or even inability to eat is known as exhaustion of
the gastriosplenic qi .
1 .3 .3 .5 .3
Taste
3.
nm
p ^ J if p tW .
(1) trj*.: B P f t jg g j lf l
J % j B %
*iIE,&JLT#ffio
(2) o # :
ifiJ3fSC.
(3) o # : B P gftntl
SUR*,
P M o PSHI
9zMJJxWio
(4) o
BP S & t
^ W K I c . a E P S * . ili
(5) o t t :
B P S II
M\
(6) ViZL: B P P ^ g
|J]0ih91o
0 ra.
'M i
<8) 17
IC,
y~j
1*1
^ jfnft, 'J
1.3.3.6
( A
p I ^
Defecation, though directly governed by the large in(pnlliir. is closely related to the functions of the spleen
M i FJr f] R
^ ^ jfij Sil
t J f Wes,tii;, ^ n w
^
/j'
iii
til tf
F/r
Hl llir lung to cleanse and descend. Urination, though dilllv governed by the bladder, is in cise relation with
M f, 8$ iW%
fq
||
i l ]
&)itfe. &
Hlllillons of the triple energizer to reglate water pasfty* So the inquiry of urination and defecation not only is
MUDV lo directly understand the digestive function of the
lolv Mid metabolism of fluid, but also is an important eviWlt
*' lo determine whether the disease is coid or heat and
co
^ ii
'|fr
, /jl'
l'].JI'5] A '
Defecation
l.
i E # A - M 0 A f-
(1 )
(D M
J if A W
tion or prolonged defecation or even no defecation in several days due to dry feces. Constipation is usually caused
by retention of heat in the intestines, or consumption of
51 -
m.
M . i?
S .
S , * P 0 I ^ 5 , l ^ F J
*%^
ifi;
HM
lips and
t i , Wi}c
M % j
,1 , 1 , frM S ,
* jfill ; ,P P g m *.
mm-.
|| nnd failure of the spleen to transport and transform; diIfrliea ollowing abdominal pain before dawn, marked by
Idlihe stool with indigested food, is called moming diarrtli'H. usually resulting from decline of fire in mingmen
l VIInl gate) and internal accumulation of yin coid and
ilmii|>turbidity; diarrhea following abdominal pain and of(>li worsened by emotional upsets is frequently caused by
H ,# a i
(2 )
g m w w & m m n f n
t .
m m n fto
. $
, f-F % ffc l I , M *
ifiL-feM/p
-!
ifil U a J
(3)
often
lij
tiifii
a ir
Urination
2. /Jn
times in the
0|bJ # 3 ~ 5
film discharged in a day and a night is 1,200 Olio mi. The frequency and volume of urie are af-
o~
200 -
2000 mi0 j^ n ^ M ^ :t :7 c ,
IPfo
(1)
/hfiiHsc
ff
w a fls
(2 )
:w m m
So
f ilm a d
M 'F ti
a s t r a l
E.
Obstructive
(3)
K * fe i i
'M M
0 r a .J / M o
/hfJSd
1 .3 .3 .7
(t)
il
a i#
Vrtigo
i.
k m
ffFAiJT|SH
M A S IS # . ,
5 ti,
, il ^ H S , 0
, ffi J
H ^ F r r fn iiJ r ,
accompanied
by
lassitude,
shortness of
iMtli, lethargy to speak, pal complexin, light collll nf tongue and aggravation after overstrain, is due
||lnI iislhenia and blood deficiency which fail to nourMii lile upper part; vrtigo, accompanied by vacuity
PlNnImn. tinnitus. amnesia and aching flaccidity of
loins and knees, is frequently caused by asthenia
klilney essence.
1 .3 .3 .7 .2
Tinnitus
2. 5 1 ^
J if M p W M Q W
w|, ^ A fti i , sS ba
p , tk
z ^ p ^ m ,m % v E , m n \ :
4'. illlW'S.M:
3.
^ j i j e , ^ W f i''u iR
1
Dizziness
mt
4.
usually
appear
simultaneously.
Dizziness
!
w m
m *
?M #
PJf . M 1/41
5. g f
Ocular itching
w . >* t f
ffio
; i: f l
I it- ,t- x . |
M
i yin.
1 3 - 3 7 .6
Ocular pain
6.
lf
@ !<; M @ ! Mo
A rliicli is usually of sthenia syndrome. Unbearable ocB l u r pain, accompanied by red eyes, bitter taste in
lile mouth, irritability and susceptibility to anger is uBlUiilly caused by up-tlaming of liver fire.
Red and
^ P 'fllin g pain of eyes with photophobia and ocular ex| ffrla is a sign of wind heat disturbing the upper, usuH lly seen in fulminant conjunctivitis or epidemic con|lilx tivitis.
1.3 .3 .7 .7
llplopia
7- @ ff >]i\j<l
vff
@ Pf0 [j H t IE
they share the same cause and pathogenesis, uHmIIv caused by asthenia of the liver and kidney, in flrien cy of essence and blood and malnutrition of
hS
Wty} ( f ^ ? f 0 @
mm w m $ , # w #
h
I 1.3.3.7.8
*
8. S l S . f f iS
#i * * isi, ^ a
#UB,jfcTSJ0rSfe. 3-JftnJ
FJtr n .
106
1.3.3.8
(A ) H M & f t
m sp w se
SnT.
1 .3 .3 .8 .1
Chest oppression
a # i? ^ #i
1. J&H
Palpitation
2.
B 'iMf- % irK,
'F
'll'
^ ; t iftL
l- * '' M I
\
W? P fi.
III. f
, )
, fiE
tt'o
Ilim- conditions all may cause palpitation. fright palpitallun and severe palpitation, which should be analyzed acluriling to the characteristics of palpitation and the accomL (iiicil symptoms.
1 .3 .3 .8 .3
Hypochondriac distensin
3.
fra i
(llH'omfort over one side or both sides of hypochondrir |ni. usually seen in disorders of the liver and gallbladtfri
I 1 .3 .3 .8 .4
Epigastrio distress
lpigastric mass refers to subjective feeling of opftUiNion and discomfort in the epigastrium, usually
IflfrMt in disorders of the spleen and stomach. EpigasnP* nmss with acid regurgitation is often due to retenB | n l l(x)d in the stomach; epigastrio oppression with
m l i i m l appetite and loose stool is usually caused by
^ M k n rs s of the spleen and stomach.
1 3 .3 .8 .5
Abdominal distensin
5. fltJK
ia y i3 w . m n n , # r b
M ft, H
P J
T ft
IR
1 M i, Jd$ ft |Aj
H tJl 'H
N[
Borborygm us
6. JPJ
04
I H If- H .,
f i >M
W-, M
, JFF I f
>*
CVL* fu Wt a o1
internal retention of fluid and disharmony of qi activity in the intestines. Borborygmus with diarrhea, continuous abdominal pain and preference for warmth and
pressure is caused by asthenia of splenic yang; borbo
rygmus with abdominal prolpase sensation is caused
by prolapse of gastrosplenic qi; borborygmus with
f'jA k'tnitM jB .
Pj S nUfrffi.
ii
.)
f l^ io
AW
M tt, tfetzaBiMo
1 .3 .3 .9
( A ) f M Q & fl tt
r p r r a jfc W f tt.M
1 .3 .3 .9 .1
1. m
0 M R , i P 0 1 | 5 f J , s ! t
Aching loins
2.
mm
3.
is , d c 'f ^ 7 jc ,7 X j2 m K 0 f
ti W i f1!1
4. H J g f i* *
I Numbness of the four limbs refers to hypoesthe;(p til1 disappearance of the sense of muscles on the
l f i .
S iz .
stagnation.
I 1.3.10
*
(+ )
Impotence
. ph
ii
W P fP II f M.'PfW
2. aTS
Seminal emission
il.
nocturnal emission; seminal emission without dream or even in conscious state is called spontaneous emission. Se
minal emission is usually caused by yin asthenia and exuberant fire, hyperactivity of the kidney fire. or by weak
ness of kidney qi. or by invasin of damp heat, etc. Semi
nal emission, accompanied by easiness to erect, hectic fever and night sweating as well as aching weakness of the
loins and knees,.is usually caused by deficiency of kidney
yin and hyperactivity of kidney fire; seminal emission, ac
companied by aversin to coid, coid limbs and aching coid
of loins and knees, is usually caused by decline of kidney
yang and weakness of kidney qi; seminal emission, ac
companied by dripping and painful urination and pudendal
itching, is frequently due to invasin of damp heat.
^ .JR
1 .3 .3 .1 0 .3
ll
Immature ejaculation
3. p ffi
gm nm & sfi,
(+ - ) ta m m u
l'hysiologically, women are characterized by menIttuilon. leukorrhea, pregnancy and delivery of baby.
honn.il conditions of menstruation and leukorrhea are
A ) l'immionly encountered diseases in women. which are
m ,a a
# m$ $
3
1*. St Jef]
Inquiry of menstruation
1.
ft % L
s i s a m , ; j$ i & f H * .
B|lto|iaus('.
Altnormal menstrual cycle; Normally menstruation
HUm once overy 28 days and lasts for 3 - 5 days. If
( i) m X - t:
n 28
menstrua tion occurs 8-9 days in advance, it is called advanced menstrua tion, usually due to qi asthenia and weakness of the thoroughfare and conception vessels, or due to
i , va
mi l
jfg jl
A', Al
Vu
.j$U
n A;l A 'J;!il^
fiEScH'rS^; i a n f f l j t *
(2) H N M h
^)Wffliii<jiii.srt.
loo mi.di j N l A A l i A ^ J f l
sol
vm w
Ht , f; 'f-j f I t i H % o ^ 0 jl ff\
V A i K v A A M : !']
I''I v; la
ii A
il rS A
uti,
r v i - f i'iiil
0rS .
(3 )
il
AlfilIEA.
< A I1: iii i '1
'A A A
W) I
i m \ .h h m >
iaSJo
iB j^ a F U K b J iiL .^
T jd. , #
J h # , ffc % $ iS..
fmfiise uterine bleeding is called uterine burst of bleedP lli gradual uterine bleeding with modera te amount of
Ii|h m I
STo
mM
fcflivasation of blood.
Am enorrhea: Amenorrhea refers to stoppage of
(5)
iM Ifco
(6)
ii:
illln menstruation, or pain involving the waist and satlliim, or even unbearable pain. Regular lower abdominal
illwlending pain or sharp pain during or before menstruation
mm*
p m insto
. 'Hw
tSsjcra . o
m m .
uterus.
1 .3 .3 .1 1 .2
2. f f T
Inqui ry of leukorrhea
w -m rnm m m M ftm , m
iS T S M .
heat.
1 .3 .3 .1 2
(+ z) quiafitt
jJ L ( 1 ' M M 3 J 3#)
JS fi
rnling, sitting, crawling, standing, walking, erup]) o! tooth and learning to speak so as to understand the
M 7 m 'b JLIs a
/h JL 6 t f l I 5
| At (> rnonths to 5 years of age, infantile immunity obIftlmtd from the mothers body gradually disappears while
pOHtnatal immunity has not fully developed. During
|Bl
i s s a , M i a fru %-s is
, Jc % B
m m t
ht Ihm ind contraction of the disease in infants. There i llie aspects of inquiry mentioned above can be used
|| ltn|>oi tant evidences in making diagnosis.
f
'hJLK
an
l.
24HM gNit3e,!l!lBH
F ir i.
2. /J\JL 5E I
W.
m H - m m m p m .
3. /JxJLEig
TE
walking, growth of hair, eruption of teeth and speech, usually caused by congenital defects, asthenia of kidney es
m w m t.
Wtflfrt
4. /JnJL S:
1. 3. 4
Inquiry of anamnesis
ra, s ia i
Mlllv Inducios the constitution of the patient and previl* tiiiitiaclion of diseases.
1, 3. 4 . 1
( - ) lqlEEi$M)yj/52
IV
P |mcw'i11 illness. For example, if the physique is usualI I m i i k . the disease is often sthenic; if the physique is
(Z )
lliqmry of previous illness includes the category, re i present treatment, present manifestations and re-
M l'"J H
S "j f t % tfe
. i'A fh ; t i I ^
^ M .
t fnf t 1 ' A
p T ^
ffi]]o
tuses.
m tsem w
. *j 'i
1.4
ra ^5-
im
tt
tM - M
o
tion.
1. 4.1
Puise-taking
% f t k i#
jt #
^ \
tLw ffikja;, m #
is
%i
n % U\Sk*LkZm; m
"W HLME M
IfiS c ffi- i
llic Ixnly.
VXWY
lili -
,W
'J
^C ii
is fr
in.,
W-
ii
f W U . f [5j vi 1;
M ti i s
Ib]g M
I . 4 . 1 .1
I 1 .4 . 1 . 1.1
()
i- i m
m a
n.
-'] p
f
^ P bT B p , BP
J| fe --J i'K # J] 'ibo
- tn
p ;
n k m m m m ,m
4 M f^
i f j'i
!k tk ik Z M ,fs3 z2 .*,tS iT t
P T W S B ts n w a fl.
-f-
L i
-T m g
||| llie Iwclve meridians starts from and ends at the lung
Hfrililimi. linally converging over cunkou. That is why
^ ,
chi pulse (see Fig. 3). Both hands have three divisions of
J s ( M ) * K ( M
Ir. i W f~
tt AnPft o
l' ig. 3
) *
-* 1*1
3)1
Tj" >& . R
m r t h \ " K & F MI
p j . B P ( m # i ( #1
) , F (K )W fc " F (jJ
body:
T o P ) ,^ r ^ r t 0 " F :
/t/'J'M:
' f f i : JU M H **.
^ i:
.- R :
2.
VA JL * o
(1) B+)b]:
puhir taking, the patient should rest for a while to tranIhe heart and breath before the taking of pulse,
pulse should be taken at least for one minute each
lS ilW llo
B la] M 'P t 1
CMl*1,
ft
VA , VAm
(2) + 4 :
m ]i
f+ 1 6 ~ 1 8 ? ^ , ^ n f P c ^ j 4
)k l'n]
|Nai minute.
5 f t .B P - J l.ia E M .
n 60-90
(3)
ghm ff
a ^ IE ^ i'S c W
|f| The wrist is put straight. the palm turns over and
li l I H r r s
* 't P pP f t
% lin
(4 )
ffi f
'i!
guan pulse (proximal to the heart regin). The arrangement of the fingers is made according to the conditions of
p.
(5 )
n a ^ i'[
(6)
e ^ I II'I
Mi
(7)
tfc ,
f fc M S S ;fn g ) ,M < lM
Vln
llrength of pulse.
i*
im 'n E .
1 .4 .1 .2
Norm al pulse
(Z )
1. 4 . 1 . 2 . 1
1. i z m m m
m ra s M (6 o ~
9Q & / # # ) ,
c jh . t f i t a f s h m v w
1 . 4 . 1 . 2. 2
2.
pulse
The normal pulse is marked by gastric qi, spirit
|Wl root. Gastric qi means that the pulse is located at
lite middle, neither floating or sunken, regular in
Iting, moderate in size, gentle in sensation and
Honting. Spirit means that the pulse is soft, powerful
mui rhythmic. Root means that the chi pulse is pow01lu and constantly beating under heavy pressure.
S fJ o
r.
1*1 eparated. Simultaneous appearance of the three reflwi-t strong functions of the viscera and sufficiency of qi
lllri blood.
% Jfil
fs irS M
1.
4 .1 . 2. 3
pulse
The normal pulse may vary with physiological and
psychological factors in the human body and the environ-
% t
UfT # E nTVAiti M -
(1)
in J L M / M S t .W 'l '
(2 )
-ir H i r : to is h - IS I f -M I
jsj;
B t , 1$ nt
(3 )
< :$ .,
@t :
t J ( Wi)
m i
g 0 m s /?m a h ,
YXIfrj m
m Mi
fP
-t P T v R L E t j i
p w i r i 'i -
W L B M L itin w k M ik i
H Pf t >
fi
S Ht)
1.4.1.3
Morbid pulse
(= ) m
rn m b
mum* b f
41,
I*]. M
# #, sJc H-
* ffl |5]N-
iRission;
1 .4 .1 .3 .1
Floating pulse
i-
significance:
Floating pulse
Indicates
f f [/i
it
Scattered pulse
2. m m
m m m
u m jk % . m m ay % , m %
Clinical significance; Indicating depletion of primorHlftl (|t. visceral essence at the verge to exhaust and exterllMl floating of asthenic yang.
1 .4 .1 .3 .3
H o llo w pulse
3. t lf t
B m m - . u '\ 'V 'H u
S i l .
t t B U B m f 'B M
k iiiW -
MW
Sunken pulse
4.
Bm m -. &
M iiE o S tw
'HI
M
ternal syndrome.
1 .4 .1 .3 .5
5. ififlfc
Slow pulse
<i,f$
ffcMX-.
T 5L E3 M ( < 60 ( X a
jSill
t 1} % % M M i t i i % tic
t % # l s
m jv.
6.
Moderate pulse
mm
J j.
S I N . .(6 0 - 7 0 f c / f r # ) .
Fast pulse
7.
im w m - .
. 1
B 3 l A M ( 9 0 110 I k / f t v M
T-mm m s e .
1 .4 .1 .3 .8
Swift pulse
s. mi&
I,t s ( > 1 4 0 fc / ^ ) .
Clinical significance; Indicating loss of control of hyIpriictive yang. declina tion of kidney yin and near depleAlou of primordial qi.
1 .4 .1 .3 .9
9. JJ&
Weak pulse
Bmm-.
j
%h
W jG3l
r t - A 'M im m m m 'H , .
Clinical significance; Indicating asthenia syndrome,
niiilly seen in asthenia of both qi and blood, especially in
flW ft,
M sthenia.
1 .4 .1 .3 .1 0
Powerful pulse
H ).
mm m-.
lkf^ffi. M tJj
iJE
m m
iffcJiC: l-tEo
1.4.1.3.11
SIippery pulse
11. T i
M 3^. t flh : fte
M t J , 'V.
MBUB
/^znt
Clinical significance: Indicating retention of phlegm
tiltl fluid, dyspepsia and sthenia heat. Such a pulse condiIIiiii
XtM.
to
1 .4 .1 .3 .1 2
Astringent pulse
12. M
B M W :
M m y JtW r
W ttm i/f: i)
J.'!?.
blood.
1 .4 .1 .3 .1 3
13.
Full pulse
t , 'M'MWb
l . f l .
WMVU-M
ebbing.
f* ,
Clinical significance: Indica ting exuberant internal
heat.
1 .4 .1 .3 .1 4
14. M
Thin pulse
15. jf lf t
Soft pulse
rm m , i
ffiilEo
16.
Feeble pulse
wm m -.
n j a c w f i[ ii, a c & n
M
1 .4 .1 .3 .1 7
Indistinct pulse
17. $
Taut pulse
18.
r a n s i* .
m m m - . a & .*
m vaT , in fie l .
& m it.
% & a i
si *
M .
Clinical significance; Indicating disorders of the liver
gallbladder, pain syndrome and retention of phlegm
iKflciKX:
itF.. fAtk
|fluid.
1.4 .1 .3 .1 9
Tense pulse
19. m m
B m m - . i * * ,
t s m '}]'%%% t %
Clinical significance: Indicating coid syndrome, pain
virme and retention of food.
1 .4 .1 .3 .2 0
20.
Clinical significance:
u m m
rL ^
, in #5. ^
1.4.1.3.21
lM 'P
21. ]}*
E t t H :
irregular intermittence.
W 'ti h . j h s j i K . m m i m
iKSflcj&X.:
ij'll
ful pulse indicates predominance of yin. qi stagnation, retention of phlegm and blood stasis; while slow, intermit
i^J L to
Slow-intermittent-regular pulse
22.
m m m -.
longer intermittence.
Long pulse
23. fcfl*
Bm m -.
fffljg i 'i .
:M o
3jE
24.
Short pulse
BM -W at: E M . j & J f i
i r t
'x
m [fn x n m
, fPiE w
f l'T 'li/f'Yt: ii
mB.
P:
B | , For example, floating pulse indicates external syndriiitif and fast pulse signifies heat syndrome, so floating
f|ll fiist pulse shows external heat syndrome; floating
|hilrM* indicates external syndrome and tense pulse signifies
IMilil syndrome, so floating and tense pulse manifests extpni.il coid syndrome; taut pulse indicates disorder of the
llvi'i lid gallbladder and fast pulse signifies heat synIhiiiit', so taut and fast pulse manifests liver depression
PNMWforming into fire or damp heat in the liver and galll||(|ili*i, etc.
| On Ihe whole, all related factors should be taken into
dHiltli lera Iion in differentiating pulse for making correct
lili' .ti diagnosis.
I I 2
P alpation
-Jf ffi $ i t ,
itMft%\\!hmmMWvE
f i#
& N N B ftif..
1 .4 .2 .1
1 .4 .2 .1 .1
m t t m m .n m & m m m
(- )
Postures
1. m m m t
gM
M * PTin
o
* mM
- B & # m 4* t w
B K .
When the patient is seated, the doctor stands or sits
in front of the patient, holding the patient with the left
hand and palpating local regions of the patient with the
# JH
2.
-HSirJMuBS,,JBE,pp
M:
m-.
iw .
E: VAf-
BP;
J|
t i& u f e o
m a
$ su & ft,
m&o
The methods mentioned above emphasize on different
rfis s . rm
5feisTit!!
m n*m .
1 .4 .2 .2
1 .4 .2 .2 .1
(Z ) & M
i.
c W W r w T iii^ iin
J.f'l'.'/: f
/i ii/j
rssfc
fifiB S D
ftJE f !
is
precordium is especially useful when cunkou pulse is difficult to take in critical cases. Normally, the pulsation over
^ rfrTT'Ig,
ffii T & .1
* y i
L 'K lE i ti 7J\
i'r
the precordium is sensible and beating smoothly, moderately and rhythmically. indicating exuberance of heart qi.
accumulation of thoracic qi in the chest and no signs of
pathological changes. Weak and indistinct pulsation over
the precordium suggests asthenia of the thoracic qi. Pow
erful pulsation over the precordium vibrating the clothes is
hyperactivity of precordial beating. a sign of outburst of
the thoracic qi.
1 .4 .2 .2 .2
2.
mm "i
va t
M tm
ffj tfF fc J H r F W fc M ,
3. m m m
w ^$ o
, Je /Je tk
fi-j, %
^ s pn
H & s r u A S i & m m .
, te fe s
Mli skin, visible veins over the abdominal wall and emaciallitll
%Wi.
tolllpanites.
Inimobile abdominal
lumps
with
ixed
pain
is
if,
ifn lifc.f.i'i
'ifef'Vl T~, Vi'/ W, J
)Va #11 tyj
1 .4 .2 . 3
CE)
1 .4 .2 .3 .1
i.
; I i M. ^ M # ^
w n a .t i
i i w
mm.
^ $
f n mmm #I
s
i ,
ni
liEo
2.
g. M 5$ f i & W tik n
% w 't i
3. m m
M i e s f , 3 ^ * 1 6 Hpew,
1 .4 . 2 .4
Palpation of acupoints
(0 ) S ft
Pressing certain
f-
be ^
/V L , fll $ >t
Kl$ i t
^iiHo
ni) / t
Im? M y t f
m .m t 'V A R t
S f it . i :
>( Zhongfu (LU 1) usually indcate lung disease; tendernwover Ganshu (BL 18) and QimenCLR 14) shows liver
yx s
n /X r n
^ ^ if-
S ^ ; E / C ^ il
i .
2 Differentiation of
syndrome
Differentiation of syndrome means to analyzing and
judging the data obtained from the four diagnostic methods
so as to differentiate the nature of the disease and make
clear the naming of the syndrome.
There are various methods for differentiating syn
drome. This chapter mainly introduces syndrome differ
entiation with eight principies, syndrome differentiation
of qi, blood and body fluid, syndrome differentiation of
g + .A M E
e,
tfiurniK
8HE.
& ^ |0]
2.1
Syndrome differentiation
with eight principies
s ffl,
M hK
# W 3*J fn t , M
i m f r m w m m , A m m jhm
w m m -m .w
e m m
DfiEo
fcfiidromes.
The eight principies concntrate on specific syntulties respectively. However, they are inseparable and
A m frt
fi't: ff i m * l ) J
o t
/l
Kxtornal and internal are two principies used to difHpliliJite the location of diseases and the tendency of
lllolo^ical changes.
t i i ; / Vffl # ffi g W
mm*
. t m lEfeM ^ m & ik
iPM m *
a itt,
e i,x s & m fn
I I, I
t .
ni
- s
while
r i M x .
a lia r a
ses. This is because the disorder due to internal impairment starts from the interior and does not show the course
A MM
JS f1h 53 m?S?$!
'h Si
P i' ^ A
j , JB tc U ffi o Bfi M
t#r
often invade the human body, they first attack the super
ficies. In this case, the healthy qi fights against the patho
genic factors, giving rise to the formation of external syn
drome. With the development of the pathological condi
iW4
^ M iA iAO i l 3
iiW
S I K i'S
( - ) mu e
E xtern al syndrom e
IE J b 7nl- l
= 6 , 0 # # A ^ .
M ffl 9 1 Pif S
@t
S o ^ jE M: t i M & i
li M :
/?.!
n "fe..
,# S
t-"W
41' W $ h . W
, * jxt Xk .
fu;
i ik
I$ j ; , # % M ^ , H[Ajtlf '}]
# M M B , nft Hit\.
f r a , -
lile
1.2
Interna! syndrom e
( Z ) M E
Internal syndrome refers to the symptoms in disorB>l" w'*h deep location (such as disorders of viscera, qi
mui bl(K)d and bone marrow), usually seen at the middle
lu
y * 11*"'
H jE M o SI F n - M M
Is M fu \H ' h
iTj i a g ,
,
M
iiEKiM$ . i l W H # ' | f
jll'His liave contributed to the formation of internal syn|uiiir: further development of exogenous disease due to
^^IIk ii transmission of pathogenic factors from the exte-
S ;
'. al- ,
III'ncIs.
i
f ffitSf Vi fg ijj, % i(a ^ Tpnifij
'fc'Ro
11"
n w iis *
mm ; x
i
s ffi
t n
! g Z h f M 'i lili, i |f /A Z
# ^
M P 'i rj I tfc |
S-r.|
Pf:
ME
syndrom e
Half external and half internal syndrome refers to
the symptoms appearing in exogenous disease at the stage
M W ffiB o
m m a.
P -I?- BS f - i * |i
lsiiE) o
2.1. 2
m m m ie
Mi
lili' nature of diseases.
|M)
t f M f l Mi m * it* ),t
mi
if
Coid syndrom e
( - ) SE
11# 4
sthenia or yin predomination due to invasin of coid pathIgenic factors or various other factors. This syndrome is
|Usua11y caused by internal exuberance of coid due to inva|on of coid pathogenic factors or excessive intake of coid
4' '/"v M fe C K ^
4 At i
(d i rit
xl. or by consumption of yangqi dufc to internal impairnt and chronic disease. Coid syndrome may be further
Ivided into external coid syndrome. internal coid synfome asthenic coid syndrome and sthenic coid syndrome
Ccording to the causes and location of pathological changes.
Clinical manifestations; The clinical manifestations
Hnry with different types of coid syndromes. The usual
lies are aversin to coid or aversin to coid with prefer
ti-.
i m m f:
M M i* i
;m
W-i
I S . wy n
i'ej
m u it * . i'x
1W J Vf iif
m
transform fluid leads to clear sputum, snivel, saliva and
urie; encumbrance of the spleen by pathogenic coid or
asthenia of splenic yang causes loose stool. Light colored
tongue with whitish slippery and moist fur and slow or
tense pulse are the signs of yang asthenia and internal prcdominance of yin coid.
2.1.2.2
( Z ) &tvE
Heat syndrom e
fe ffi, f J g P B fe l((
i M fe w & * A )
ffi H
t fe A f i -t 'i# a
it
k
a k fijV A l 5? ' rt f
; a S c t
.e i"
ge.
S |] , fe
fe , ? fe ^ fe ^ f
til-. X " i
f'i *
jfe fftl:
f e
' t i i ^
P4 fi & tfc M S
'k K
MM |
. .
or yin asthenia and yang sthenia leads to internal exuberance of asthenic heat and causes fever and aversin to heat
with preference for coid; fire tends to fame up drives qi
H PPJ 5 L i & WL M i I
te M fe t t
S i ^
B K ; W- M
JUi l f i ;
J )(
M M fi-J,
W1
1 I. 3
Asthenia and sthenia are two principies to differentiI" ^lc> conditions ot healthy qi and pathogenic factors.
Asthenia refers to insufficiency of healthy qi, while
I tirina refers to exuberance of pathogenic factors. Synroiiic differentiation of asthenia and sthenia is helpful for
IMHcistanding whether pathogenic factors are in predomi-
js * . ia ja ^ j iiE , r iu T
w * m$ * ,
s *
ffl h i i t t IF. rn P fe
ffl M ffi
P * 1111' ()l decline so as to decide to select therapy for comidriiiciiting asthenia and strengthening healthy qi or therajW lu purging sthenia and eliminating pathogenic factors.
2.1.3.1
Asthenia syndrome
( - ) iiE
t E
jjsj
l&iEfiM
l'Ali k
; bJc X
TF.^C^ijiif
llfiil/f; A; J:!t: |l| I
,
|| '
uE
body mainly includes yangqi, yin fluid, essence, blood and
body fluid, all of which are closely related to the viscera.
m m -
# ) iiEM i| 1* ^ M S S <
f f i ; Jf
f - 31 L- M
t t M , /J' f f ki 'P . A %:
im
m &
desire to drink, dry skin. scanty urie and dry feces, ten
der tongue with thin fur or little fur and weak pulse, etc.
Analysis of symptoms: Fatigue, shortness of breath
i'CvJi.*
w m m zxM
mm.
r ;j & B
il
ii t: r .
HK. w m
i-iWAK. M
/ K - i S t e f i-i M
I*
. fft
p ; x m ik p m < m k ' t i \
( Z ) IEE
Sth en ia syndrom e
f f i M U B (iiiE
ffi: - m f A A f t ; - *
v m m k ,* .
m.
r t*
|ly.
Clinical manifestations: The clinical manifestations
l'V with different types of sthenia syndrome due to the
(lillei' nce of pathogenic factors and the invading and accu-
J lf F
thogenic coid manifests coid syndrome, while exuberllti c <>l pathogenic heat manifests sthenic heat syndrome.
-(.
E m an m % m % %
* ffi; i t t!i ll
K, ?KS , ti*
f f i, K iis * ^ a itii# w w
mil also vary in clinical manifestations which will be disMmu'd in the following sections. Here the common symp M iin
KfS E & A f M
WU mc breath, exuberance of phlegm and drool. unpalpallli p.iin of abdomen, retention of dry feces, or dysentery
fllh hlood and pus, tenesmus, inhibited urination, or
(Mlliliil stringuria. tough tongue, thick or greasy fur and
I I I ii 'Ii k
pulse, etc.
m m m m .
; 2% h #'J
jHg^>#f:
ifil
!?$('[> t PJ f f
R T fu & .ii
T ET fJJK J L,'
l'fi t , frJ/ sK W. J
2. I. 4
IEPBDE
yann
Yin and yang are the principies for categorizing dis
AHflKl
2 .1 .4 .1
KtitrPHo
( - ) R9EWBBE
(llvided into lwo aspects known as yin and yang, genera li-
f e t i l i M M M *j|SJ|il w m iii
* ^ - , i|j
ii:isii.
JWW.RI1NI
\. "I W
^ctSM
Yin syndrome
1. R^iiE
MMWlWl E
-m
m .
z t i , m b .n , a p
\ m m f: m # , 3 * .
f , % m , m % m m mf m m tu
n.
t ,
% mmui-wi
fiEfc.
2 .1 .4 .1 .2
Yang syndrome
2. P0E
iiiik
i iil . W
< a ^ is P 0 iH # g ^ a ftii
\{&/7Wx:
L I/fc, # f e l M II1
;n k f i .
M ;p A
A'
te # X
f . s i X
i t ' & %% fe ni
2.1.
4. 2
( Z ) REjgEW M E
asthenia syndrome
2 .1. 4.2. 1
Yin asthenia syndrome refers to asthenic heat symptoms due to failure of yin to control yang resulting from
deficiency of yin fluid.
Clinical manifestations; Emaciation. dry mouth and
throat, dizziness, palpitation, insomnia, scanty tongue
fur, thin pulse, or even feverish sensation over the five
centers ( palms, soles and chest), tidal fever, flushed
cheeks, night sweating, deep reddish tongue with scanty
fur and thin and fast pulse.
Analysis of symptoms: Emaciation, dry mouth and
throat, dizziness, palpitation. insomnia, scanty tongue
fur and thin pulse are due to malnutrition of the body,
1. M
il
, iS
(h Iu iv
2 .1 .4 . 2.2
2. PBjE
Yang asthenia syndrome refers to asthenic coid sympImns due to failure of insufficient yangqi to control yin.
[ti
m m wa m * m mm m m m
Clinical manifestations: Pal complexin, dispiritedlim . fatigue, shortness of breath. no desire to speak. aV p i s i o h to coid with coid limbs. spontaneous sweating.
mouth without thirst, or thirst with preference for
, g fF . p
, K
MM- t i . 4' f r f j x , Je M #
fit.lc f E ig ^ c * .
m m v f: p b ^ j ,#
to propeI and nourish leads to hypofunction of vistVin and tissues, giving rise to such symptoms like pal
. W ifif fe t\jt , $j
'if ph , an % fx, 7k
m,
ti
S fff, B 1 K E ) l
2 .1 .4 .3
(= ) t l tin tB f iE
depletion syndrome
2. 1. 4. 3. 1
i.
rrR E E
t [55ilE
Fh ^
M1
iiF.Mo ^ 0 ^ l l l f e ^ t t f e
i l . A ' f , J i?! nt
; bX j
Tt .$!>)$
m i^ m ii
S J t t lU 'h $ I RLFFfefcrt
un
'p . f f i n fi
ilF.flx'/H/ : l!il M
j 4' libfi'l l>lI Jfe iMK. i&1
,:j )S A -J1f
MIIJ LK T j
S A
2.
rrP B iiE
P B iE f lH i
t ffi
@fUSI M MiiH
u A T ii J
ri.ScWjfii'ffit.WKlPiDIfti
R ti flt i. l r c r t t
;m
m m n i.-i>
^ m
B hZ,
u
l linical manifestations: Apart from severe symptoms
B prunary disease, there are still some other manifestaHw,. such as profuse coid sweating. pal complexin.
||Nl<l skin. coid limbs, bland taste in the mouth without
IU ^ H
j J/i^ f |;
,l
i
l
i &l'f. )
U
lte
8
, H
U
i#-, 11 jf yp
fe ^C, wf
. if
. ir
M y||, B ' i
Gkio
i m f r t f: r a n M ,
w-i m . wj n f m
iNti lid pal tongue are due to decline of yangqi that fails
r a tl'iuisport blood upwards; coid skin and limbs is due to
B l l u c of yangqi that fails to warim bland taste in the
jfllittilli without thirst or with thirst and preference for hot
ra % ^ . m % i^i j g , jna m
' f M M M % fe i k ; W % ^ ffl,
'U f J l^ .W J u f - t R i ^ ;
a # A
Bf #
. w f t #
m*
Jt A
kio
Jj
Molli yin depletion syndrome and yang depletion synIpiHiii1inav appear at the critical stage of diseases. InaccuH p (III lerentia tion of syndrome or delayed treatment will
M . S tfc n
,It
WS PJI
llu
M , ffi U t: lJJ
IHWBtt: ffl
:MM.
t PH til "
R itt t o
2. 1. 5
A ff l E f tS J W
syndromes
In syndrome differentiation of eight principies, com
plicated diseases are generalized into four pairs of princi
pal syndromes, i. e. external and internal syndromes,
ij Im-
h ;
;j
;.! . *!!: ,A
ir ii. il
t </ -m
Z M f i M m f r . ^J' ^ i j . i
lO T ilW - f K'i-iHSiJA J
2.1.
5.1
(- )
pies in a pair
The relationship between two principies in a pair
manifests as combina tion or mixture of the syndromes.
transforma tion of syndromes and false manifestations in
- / ^ m 'I i b i m J
-V *
- 'H W t 'l
-'iV.iii-n'JHtfii V.^iil-KHTB
certain syndromes.
2. 1. 5. 1. 1
1. 3 l E M E l t t * :l
internal syndromes
During the course of disease and under certain condi
tions, there may appear simultaneous internal and exter
W ^ T . T tia ^ M l^ l
(1)
0'W].
^ llll
)fd |
M i l i t JSH fM T JL ttl
(2)
ItJ IB
S illf t .
A ili:, fs
m a E, jfff A E Pif!
p m ic and external syndrome disappears with the appear^p ol llie internal syndrome. Such a morbid condition is
a i.
^
fL
-3% lE
m><\
% Sei'1
HtyN'ri hy hyperactivity of pathogenic factors. or by frenptil deliciency of healthy qi, or by improper nursing, or
tli'lnved or erroneous treatment that reduces resistance
0 lile body and leads to transmission of pathogenic factors
fffiWWLo
& f i I 1O #] bu : w.
k ii h k
y-j'Ntf,
h u i1
,* : * # a a ,| i
- f f j& f r .iW A M i i
M E H i lW & .f c f t M J M
U , ]|I| f vf fr , ^ f'S|
m m m
h t iM s * . mn:
m m .m w , & # m m , m n l i
. j* M | l|
t i S ' S l i t i A W f l j
I S M
1. 5. 1. 2
2.
^ jE li^ U iH M W ^ ) ( |
m t.m m ^ m \ m tM
t "fy'M iil'-i /l;(
(1)
-h'r.
IhiiI and lower cold, upper cold and lower heat, external
jt'C
-t' tjM
Mlil.
4 j: ft KM , j :
ft, # !*LM
.k
o
IJA KJ iiE: !& # >j]ll' h
'm'A'fy, i'W-kmtMi?'!
iii-:m , >j h f # Ho m #n:
of the body accompanied by cold symptoms like abtminal pain and preference for warmth and loose stool in
lile lower part of the body.
m ,a i m m $ t * m s
, i l t 1 . A K^iiHo
m m w m .
Hf,
KW iiHo ^iJSU:
m.
t m w
N lllle i .
FA til:.
Kxlernal heat and internal cold syndrome; This syn-
,#|nlHH
feo
mzfp;skm&vE0 a m m
ma-,
zffi<
#'J t, x.
, i-
2. 1. 5
i .
^ b] *
! l r'ft
f f i j i i i f : ba ^ f f i . K f f i 'jI-iii
syndromes
In syndrome differentiation of eight principies, com
plicated diseases are generalized into four pairs of princi
1W ^ t t f f i M #
OH))
z i'V im m -
A %
fi .
2.1.5.1
ll'
i.lfj11 j i iifJ i
( - )
pies in a p air
The relationship between two principies in a pair
|h]
iiH flN M
certain syndromes.
2.1.5.1.1
I.
internal syndromes
During the course of disease and under certain condi
^ $.
u.
exterior into the interior and from the interior to the exte
rior.
Simultaneous external and internal disorder; At
(1)
| L l]# h
- 0 $ , g U M f f i . x;l|
M | W J# fW H rW T iL ^, i
b h \
(2 )
E S ti
A f P A M : J tf ft/U S
M v E f s t} SE M E, ffl A E I?
M ia
. Jg ^A
f f i . t u a as
Nllly seen in the course of exogenous diseases. For exM))li i external syndrome manifests such symptoms like
i" iHion to cold, fever, headache and body pain, whitish
n H 3 lt
^ , B P * / A P . , k iil
W& W T
? RAM it J
Mis-.
. m n , t m , m nt1
l'E3^
-'ira
E Pifl3
ta.
Hj
fe f t W
Wl^ M S L o
2.
ffi fi f A Jflj
in nature, are-correlated. They may simultaneously appear in one patient and manifest as mixture of coid and
M\
ffi, sjc
ffi
t % % ffi!
fjll.
Mix ture of coid and heat Coid syndrome and heat
^1 idl ome appear at the same time in one patient. It may
|H' ni ir stage at the development of a disease or signify two
fc/fldiomes in one patient, i. e. a coid syndrome and a heat
fylldmme. The commonly encountered ones are upper
L ^ 'Ml ;,,|d lower coid. upper coid and lower heat. external
^lil and intemal heat as well as external heat and internal
X/ HKi
A ffi, m % %
Ih tn o % ft 4/V
? j VJ, ^
^ ^
jj; |i,!
,# %
, 3? !aLfj
(nld.
w.
Upper heat and lower coid syndrome; For example,
ffifee, % h t t F ^ i i E
B # SE 5A
- . ^ w ^ e , x a im
f f i# m , ffi # t * hj &
itfcjk F.
MiWi
M t t , p ^ , if
E 0
tM F ^ ffi:
m iM
m , T M M * tt M
B # M B. i Be W ffi x# 'P , BR
0 ? t 8 ;t ^ ff i. X /M fe
F M i(J
kldri
ft 'I_h ^ h
.je 0
l'.xlernal heat and internal coid syndrome: This synftmir is usually caused by frequent existence of internal
m* *
fs
3&ZB-, s S c ^ ttffi 0
i? t /
m m m
a IM mZ>(
n ph *%m m i&..
m a-.
z w . K m m t i M j m M , if 1Jfm f . X l
%
l$
: mi
rlu-a with indigested food complicated by fever, slight avorsion to wind and coid. headache and swelling soreIhroat, etc.
HSMfeijE: I f P I
fe
- -.14
M ; . '
W tf j.u tfn P W A
i<J
m X E
gp
t 1
'km
M fe ffio
I i f 4 % % ffi t & t t M d i
ii
M I^ S fe iE M
MfeEo
*1
ffi-^fejE|S]Bt#JAL!lli
drome and heat syndrome, triis should be made to distinguish the upper and the lower as well as the external and
H % t * fe I & &
o W1
m . f ff
ffl m w $ m <1
(2>
A fl
* * it E ^ f e iiE . JifltftGH m i
tfiS R o
II
tions, the states of yin and yang in the body vary. The
cold or heat nature of the syndrome changes accordingly.
jjijj iiE M f * fe M t t
fll i
m ito
Transformation of cold syndrome into heat syndrome:
fc^/feilE:
!&$M
I ii<
drome.
I lltiicked by pathogenic cold and shows symptoms of exterflitl coid syndrome, such as aversin to cold, fever, head-
M M , fcb M m
* i# m
t ^
fe -
m n w
m m a , m w a - $
L tense pulse. As the pathological conditions further devel|pt> Ihe cold pathogenic factors transmit into the interior
L l lid
e M ,
M , f
m fe ie . m tu m m e , m a
A fe E ^ ft %M Eo g f + f t
i nfe# 0 A , P0
S
iiff tW ig .
to ^ fe l?
t t t f i f f i, K
m m
i m
m , m jk m
iptliN. pal complexin and indistinct pulse. This trans|ht iHUi Iion is sudden.
I lie transformation between cold syndrome and heat
pifliiltoiiu' lies in the confliction between pathogenic facP
^ E i t %fe E, M A [ jK (
VMl 'ivndrome indicates that the healthy qi is strong, yan I In exuk'rant and pathogenic factors transforms into
pinl with yang. Such a morbid condition. though indicaHhu Imtlier development of the pathological conditions,
P*K<'ls....-mal strength of the healthy qi that is capable
K hiiikIi ol
f e ,S M j , tiM W
M ffi
t i
^SEiiF., H #1
ifCffl;
f e
til: $$
iH
it
JE % J H , |||
Jl \i ffl I<J . l
i E j . ii; f iri W . Mi ti'i
Transformation of heat syndrome into cold syndrome indicates decline of the healthy qi. consumption of yangqi and
no strength to resist pathogenic factors, suggesting predominance of pathogenic factors and asthenia of healthy
qi. failure of the healthy qi to dominate over pathogenic
factors and worsening of the pathological conditions.
False and true m anifestations o f cold and h e a t;
In the development of certain diseases, especially at the
critical stage of some severe diseases, cold syndrome or
fm mz m a js&e irsm
ttS M
l Kl-
JC & ffigkF ..
M $ i 0 \'J * , f EVi
f;j e m o
/i
m to Jti- f -a
* ill: Al #
rine and pal tongue with white fur together with the
symptoms like heat syndrome, such as flushed complex
i ti
p M,
5]{XM^lIIP#C,0f|
M p $S p # * t:. fitft
I M I B .
u m m t:
1" '
rtjiiiiMo
\* a !ii
iivm ni
'i:>'h'i ki.4 , A
[ f W * r Vt .|n|iM
jWi<Mo MH<M
.Y
\
ii. )li
ifcfL-ilJ^ifW h
a M ili JJ |J|.
und powerful. This is due to internal exuberant heat staglUites yangqi and prevents it to reach the limbs. Such a
J-^K Hjifc./j);
t , BPJTriW
;' . iy
fe, l,LlIIi ,
I<J^
l'f M & VA f
i ffi f)
k .r k im i'- ) m \ A w i\ n 'i
a i f f i i j f i f f i il i:.
B $ S f f iS J E J & * M f i
y.
i'U 4( ill
j&
3.
Itfc, J E -^T VI m . 4
.tiM X j VI F*
(i)
f - k
^ t^ F .o % H M % % E .3
4 ;
W
L % i iE. IE
^ &.
of healthy qi, or by accumulation of pathological substances in the body due to deficiency of healthy qi and dysfunction of viscera in an asthenia syndrome. Mixture of
asthenia and sthenia may be a stage in the development of
a disease or may appear as two syndromes at the same
time in a patient in which one is asthenia and the other
iB
le] B B fi W#
ME |
i.
M M M t j E , n-t X t i
t'imdilion is due to consumption o l)ody fluid by predomitliinl lieal and exuberance of pathogenic heat.
Asthenia syndrome complicated by sthenia: This
: JTrt l'i ll / t V
u I-,
i i ! . Jjt
f J
feffio
i l i % W % 'k
FJfMffltfl
- D I 'n liM
fiibW-
lIlH' lo failure of asthenic spleen and kidney yang to transIIin qi and transport fluid is marked by manifestations of
lili.liia syndrome like drum-like abdomen and scanty urie
I Well as by symptoms of asthenia syndrome like aversin
(luid, cold limbs, pal complexin, aching weakness of
a-
k . kk % $ # S Kj j# %
(2 )
M J $ $ I t o ilffi
# 5L M i\
|felllii11a and sthenia. Such a transformation usually appNii'i as transformation of sthenia into asthenia and devel..... ni o asthenia into sthenia in clinical practice.
liansformation of sthenia syndrome into asthenia:
Milu liansormation is marked by sthenia syndrome
M E ,,
i l j g j l
p b h t
. i
(iiEo
T s ^ iitii
T E n * * J iM f r
tt.H P *0 d s a . m a
t*
i f Eftl til-: ,T , i t 1
]
^ fu M $ flx iiH M
m E H't K a M hk g 4k fi l;. k-
(fue slhenia and false asthenia syndrome. In the difierenlint ion of syndromes, triis should be made to distinguish
llir .1Ise from the true in the complicated manifestations
Mi i i s
lo
True sthenia and false asthenia syndrome; The disHw is essentially sthenic with the manifestations of some
JUllirmc symptoms. Such a syndrome is usually caused by re-
iiE^TSL
r a n c ia
l|! Nlid blood from warming and nourishing the body. For
B miiiIiIc . in the sthenic heat syndrome due to retention of
' F ib K .M 'iJif
(Imlm. loose stool and deep and slow pulse are like the
\m m M o
fig , I f S
K#7K,
, ijft z Jio n i ;
t 'i;
1-j
tE
The
E l * E : M i m il f
m jgftE. p m m % in t-
M PH
J > M Jl ) j . l'X
4. r,,;
I lowever, sthenic pathogenic factors have not been developed yet. For example, insufficiency of gastrosplenic qi
and dysfunction of the spleen bring about some sthenia-
yi
f f i ,
s i t i i " .
^ 0 iM ge % W )& % * & H I
JtJg
m A 0f l'i
f f i BP
n s M a J
411 F :
CD ir\
J'r \ ' M
r h>l t
>A
u m itiW f
V - i:: .! : Je
>jrfgiiKo
Jj
:L
Il
P * , *
;i
t Jj o
i-V/j :
m & m ,m
mm m,
J f f i; ^ #
Ij-l \')l,
-mm z i M
(Z )
lli'rlS
rt w n nr n . f g m to l # & w s t i
E,$tf>jU T:
i.
r a
;n m
ftT#
H 'J - S ff
'PtM r i
i f i 'M . B
if
2. 3 t & i l
SE
f i , l t i fF P T
flfl
ilHfec-
: W -& & t f l
ver are due to wind and heat attacking the surface of the
body and the fact that heat is a pathogenic factor of yang
nature; headache and swelling sore-throat are due to up
per disturbance by pathogenic heat; sweating is due to up
per floating of pathogenic heat that loosens the muscular
interstices; slight thirst is due to mild impairment of body
fluid by pathogenic heat; red margin and tip of tongue as
well as floating and fast pulse are signs of wind and heat
attacking the surface of the body.
2 .1 .5 .2 .3
3.
fgo vammirt
m .
4. ^J iiE
n m im % i9 M
M M I*
^ f S a j# ni - %
m ik m w
f&vEo
m H & k
(picnic qi.
Clinical manifestations; Light fever, aversin to
Bullid, headache. sweating, whitish thin tongue fur, float-
J&ff
iT li.g M .
m t - n w f n . i a i f e . a
,4j M S M ;
rkifM % H
KjE
li are
i .
^ ?JRf tR ; W- I-i'
Ihe
s #j ib s >fic rl mf i .
# H l(i
W:
ffi l, P7l'<M<
a i i ^ iS .d
6 JE. M
. .
6. HJSiE
WLPHffio
7. M^SVE
&
\H&J
iti: M:
fclll I
hy internal invasin of pathogenic yang heat, or by pathoLpt'iiu cold transforming into heat and invading the inter
fer or by emotional impairment and emotional transfor
m ion of fire, or by improper diet which accumulates into
Ir u t .
l|
: S F IjScJtri
Alt* Vii ious due to difference in causes. The usual ones are
lllitlied
mx
P
i ^
i ffl , jJA L: 0 i :
a , MWM & , p f #
.#i
Hlilis. restlessness, or even coma with delirium, yellowjli tliick sputum and snivel, vomiting blood and epistaxis,
W , n iil t t i l . B. J3f S I % II i
rftT-,
, m m . Jc
Ltfa, it lli
T A irtlfiL
m IIL;
ffiflo
M ltiition of heat in the intestines and stagnation of intesHti"l <|ii reddish tongue with yellow fur and full, slippery,
l l mid sthenic pulse conditions are signs of internal heat.
?. 1. 5. 2. 8
8. M J M
M j M , J f J ^Ni^j
Wi ^ J Z Jf k M tfl 'ni: fe .. u
2 .2
Syndrome differentiation
H. lam
'fe^ a
@+a
M it.I
>jl ,, e
t W
A &ffi li A
f f i ^ ^ f f i^ J S ^ o
hti,ifiiji
H ft
porta tion and distribution of qi, blood and body fluid are
ii ^ t c R m ' M tp x
rfi /ji<j
i 4 - , nj va ve p m J
in .
mw
frd^ffc: n f n . il>
$ , ni # m
pfi 3\wi
m $
m h
m. m
ffi * m |
2. 2. 1
t WS ' i-Mii J * t |
J ffi -% \
'4'\iiE
if / ( l lili' j
2.2. 1.1
(- ) I I I
Qi asthenia syndrome
t f f s
lu/u'(
fflllty.
ff^SC o
/s il e fin :,
ft, B A f f i o
v E M 'fr tif: j
. fifi
$ r M l s i& : J ju S o
r ^ J l/ f ;
% t i , H, iil
ItldUiic and weak pulse are signs of qi asthenia and insuffiHt'hi v ol qi and blood.
Key points for syndrome differentiation: The essen-
m v E g & : * F .W '> H .
II. 2 . 1 . 2
Qi sinking syndrome
lcffio
(z> npBi
/ c f i i i : i Ao.i a,
mwm.
il S M n f ffio
m i
,& x m
M t M lj
astil
\\m-M:
fflg&Afcit
t iltil,
m m .
F U . U Vf F S R i J / f R i & f l
' k' t; . r
^ Jl Jj , rf I
F
' i 4< )\ifiil'
lucid yang to rise; pal tongue, whitish thin fur and weak
pulse are signs of the decline of the functions of the body
due to qi asthenia.
2.2.1.3
( = ) niw E
.j j
M. 4 1
Dllil Hllacking pain are felt over the chest, hypochondrium - epigastrium and abdomen. The location of pain and
lllhl elisin is usually unfixed. The distensin cannot be felt
ifcy |miIpntion but is alleviated after sighing. borborygmus
|(Ul breaking wind. It may be attenuated or worsened with
ptr changes of emotions.
Analysis of symptoms: Normally qi should be free and
plHNilh in flowing, stagnation will lead to distending op-
v E m ft# ?: h i l i m m t j
m ,- t m
, g ro m & .
a m ns
k s m utic.&.&
0 |luin is not fixed, pain is now serious and then light and
iNiiiiof be felt by palpation; sighing, borborygmus and
iwlung wind smooth the flow of qi, that is why disten-
m x m i, - f i & w . j f f w
roR'W $!&f&li.
|Mlil is due to stagnation of gastric and intestinal qi; opMMion and pain over the chest is due to obstruction of
Bfiri qi and inhibited flow of blood in vessels.
I Key points for syndrome differentiation: Local dishrilng oppression and pain. The symptoms are usually
rluiiH due to different causes of qi stagnation and patho-
* m,
1.2 . 1. 4
w # * , $ & frm m n
ffi
Qi reversin syndrome
(ES) n i$ E
J^ f-S P W ijE fe o
4m i I
MtikF*3# .
Jlf M * i . Sfcflril,
liver qi.
Clinical manifestations: Cough and asthmatic breath
in upward reversin of pulmonary qi: hiccup. belching,
QlL
3 % I J! Wl) I
kmymm. m
n h lir c
ifn
J
gt I % T fo ffi $ >JWm
i
i j M i i s & f i i r . a 't
jf p .i''t U ^ t ^ I R T i - l
fe#
scending and drives it to flow adversely upwards; headache. dizziness and even coma are due to emotional upsets
k m $. I : ; - i f t A I I - M K
oKlfito
i1-1
.: v V K : iii ^ J
moves up to disturb the head and eyes along the meridians; hematemesis is due to upward flow of blood with ad
verse running of qi and impairment of yang collaterals.
Key points for syndrome differentiation: Upward ad
verse flow of lung. stomach and liver qi.
2. 2. 2
-a
i M-idiI
:! ;
f' - Ifu
2.2.2.1
'))
%J !!L#k .
Jlt-W , l i l i l
( ) ito iS E
if iij i- jM iM
^ '.i
4m
; i if ii;
iIi
tt
ig * ^ &
- Sf K JI; WL
K Mi
fffi ^L; c W- f
'I
Ifil
J S s K tfc ,
v E m m f:
Kll? J F l : IlLJ^r [1 lk
# , M ifrt f k
5L
, /IV tp fe
: tfj] M
BM
Je f j , It il iM Jcl'fci T B M
m
HffiW A :
tiEVA
T i f # , VA
# 4 Bb M K % 3% Wr
W
2 2 . 2.2
(z) m e
M
ii m
m n m ..
{ I1 :
n r-% .BM T
III A j f
M Vi 'di
il fc
M M U A J L # , JfiLftJW
J M T J f f l.S P f t S S g .f B c . f )
B&mm.
Analysis of symptoms: Stabbing pain with fixed posi
tion is due to obstruction by blood stasis; severe and un
M1J f i , Wln fs p t M
\7J wi
ftliM
f f i fe & m Pil 1
iil W IR
i l .
fl
179
I ) fferciitiat on o f nyntlrotnc
. a n K X f f .n a K
s m s m
.H d & m .
W ife , J f l J l L t f W.
| 2.2.2.3
(.= .) tnSE
fe
t&ilJLft};
lliin.
Clinical manifestations: Local cold pain which alleviDlt'N with warmth and aggravates with cold, cyanotic and
, Hll'l skin over the affected part. delayed menstruation,
f is?, >
k iJ
' M >2
il*'
Analysis of symptoms: Local cold, preference for
Efe^-tff: B M M M \
[Hfiii inlli and purplish and cold skin are due to stagnation of
n mui blood resulting from pathogenic cold. or due to inM
lill r il
n iiK lo warm vessels and transport blood; delayed mentlniiilion, purplish menorrhea with clot, dysmenorrhea or
BVili imenorrhea are due to retention of cold in the uteh i i, disorder of thoroughfare and conception vessels and
iHllli.iiK'y of blood in circulation; purplish tongue with
filil
l E , ^ Jii i
t l .
mu
2.2.2.4
(E S ) JfllSViiE
t ffc fc J S lr
fS S tJ l: [^JL,^cnJL,
vEmMfr-.
MJhjfiLffif: M sW & . iJ
1.
-i> M
S - P iU J L 'S 't E ^ ;
f f i J a S i
>
f t j i i i r J
l l
longue and makes the tongue appear deep red; heat proprls blood and leads to fast pulse.
Key points for syndrome differentiation: This synW*ome is marked by various bleeding accompanied by
K E 5 /S :
ifilS tf 0f
BJttL, m )k
2. 2. 3
=-s
H LW \m m v E
n|nj.
-til e +
jm .
x & ju i .
% JI IrI^ E ^ , JilE M % jl ij
2 .2 .3 .1
( - ) n im s i^ u E
182
Analysis of symptoms: Lack of qi, no desire to
iB m t r : l i l i l !
I Ro
pal and tender tongue as well as thin and weak pulse are
signs of qi and blood asthenia.
f fiiu
Key points for syndrome differentiation: Hypofunction of the viscera due to qi asthenia and inability to nour
S 1S
S &
i fu j4lJ 4?!
2.2 .3 .2
(z)
drome
Qi asthenia and hemorrhagia syndrome refers to syn
MIU (ti j f t J
Efe. * v E A
H.S.
,i * t iJ ilW | s | W ,^ l
k & W J t K m S M . Z
It * ^ ?S ^ ifim i ] JlV M
( = ) nien Q fE
drome
Depletion of qi with bleeding refers to syndrome in
n B tJ fo J H jE J tf :* :*
Clinical manifestations: Massive bleeding accompaflied by pal complexin, profuse sweating, coid limbs,
LMPI&t,#LBfe:8 I.*
h*,WJJL?TM;L&
1(11
, 7 t H 9 i f e , J0c % % &
tu .
6MEft.
c.*
2 .2 .3 .4
(BS) n ^ fln K E
mtLMEJ6f'Hl*:B
l* * , # a ln &wm&m
W E f .
% t i , ffiW
BOL o
Br
k m
iJ j is f
M *
m tm
3: t i*
2. 2. 3. 5
( E ) ngM UKfiE
syndrome
Qi stagnation and blood stasis syndrome refers to
syndrome caused by stagnation of qi and stasis of blood.
This syndrome is usually caused by emotional upsets, or
by invasin of pathogenic cold and stagnation of qi and
"^T
l, j M c % ^ J f [ L :F A {fc rt
whmmm: t t i i
dysmenorrhea, purplish
mm o
s "H'W i M i* |(||
1f W1? ^ M M , W
I LS Kf l ;
Jjfc
,t
11 ^
2. 2. 4
f P
L t
IS . ^
fe ) ^
)) j (
K]
ni
A W E l i ; % - j, u
edema. The former is caused by insufficiency of the production of body fluid or excessive loss of body fluid, the
latter is caused by dysfunction of the viscera and disturbftnce of the distribution and excretion of body fluid which
leads to the retention and accumulation of fluid.
2 . 2 .4 .1
lj jji. ||
(- )
mmmmm
n ,
fif;
. SfeSttS *JW
2.2.4.2
Phlegm syndrome
( Z ) &E
U d S fl. f W A S ,
, g <0
i i t
$ ^
, wl t w
?fe. i PR'FJK W
Jtr @
s fS S * a ,] & I : 5 ,f
* . /hu M
te-fe. SS
le
ms .
Analysis of symptoms: Dry mouth, lips, tongue,
f:
/ B ,f
PJMe
EWn JS,
2.2.4.2
Phlegm syndrome
( Z ) &E
t B - ^ T l- S A S .
g T *
iil n,
a ro * , a
H& 4EI
im
su
M & R n m a L v E im *
2.2.4.3
( .= ) tM E
Fluid-retention syndrome
weakness.
Clinical manifestations: Epigastric and abdominal
fullness and distensin, borborygmus, vomiting of clear
t $S.
t t 7jc,
tt* C
m .
pb*
w.yMLl
fuirfl/K -if
g S t T r a t e m K .M t e f r f .
uw .
E#U
I $ 3
tillness, distending pain, aggravation of pain due to spitting, cough or rotation of the body; sustained fluid-reten
tion is marked by cough and asthma, profuse and thin spu
m w m m m .
T0$itciS.
2.2.4.4
Edema
(ES) 2 k
M im w m E .
Yang edema
1. P07Je
5 I E . 5 l i t 'S , ^ S a .
J U T ^ I M tR W .
mm.
*
BvcMitually involving the whole body with rapid developHHfit. smooth and bright skin, scanty urie, accompanied
Hty Irver, aversin to wind and cold, aching pain of limbs,
mi i'-lliroat, thin fur and floating pulse; or dropsy of the
Wholr body with slow development, depression under
Hfi'NNiirC' heaviness of the limbs, epigastric and abdominal
Iflllliu'ss and oppression, poor appetite, nausea and regurg itiftlo n ,
llnw pulse.
W, # te W BS s i . 1
.S .
genic wind invading the lung and failure of the lung to dis
perse; general edema and heaviness of limbs are due to
encumbrance of the spleen by fluid and dampness which
te n a te ,
* , $ n 0 H U K .i^
i,
Yin edema
2. K7K
w . g m m iK iE ,
7 m s .n l
E fe fttlf: M i U i s A ,
# ) f t $ .8 J B ! $ ,f f if e S i
>7|C
, J|JK MI
distensin and
g l I lM J f tM jS X ij.J iP B I!
g ? E f ? : ^ v E W m i i
2 .3
Syndrome differentiation of
viscera
w # .* js lw p
iiie I
2.3.1
Pathological changes of the heart refer to the dysfunction of the heart and its functions to govern the mind
and blood vessels, clinically marked by palpitation, heart
T *>7F ? T-Sr. 0
. iP f * , g - f f - .
|J3M T'Ci'
i'J W
tK in as
# a * % , -i>H
J U f c f c lt f r * .
A sth en ia of heart qi
( - ) /isnffi
-L' 'n, i$ . iF t rti f
f lJ g a iK '
T%
Si
, sK
t S
zhla
i n
f e lf c
jRL
-f M
$5
14 'L' K
primary myocardiopathy,
1 4 - B. l i Ha J1 ,
It
chronic pulmonary
^ @
l to qi asthenia and weakness of weiqi to protect the sulflicies; aggravation after movement is due to consumpIIimi of qi after movement; pal complexin, pal tongue
N IH l
*EI
, n # m m >ffi %} s jjn t
( Z ) ifo B M il
< ifij i i S i
ilSSiSS!: -frtP
T J A L T g ttiti) *
>'C.' 5)
f >
jA*EPBS!filfeJUJcjl
and cold limbs are due to yang asthenia and lack of proper
warming; spontaneous sweating is due to weakness of
-i>PBi S is 5t t , Jfilt
a .
S ! ,
ni
2. 3 . 1 . 3
(E ) IOBBRBE
drome
Sudden loss of heart yang is a critical condition due to
'L'PH&KESS't'W*
extreme exhaustion of heart yang and sudden loss of yanK<|i. This syndrome is the further development of heart
fg. * i E r a n e t a
fti
hy phlegm.
S t# o
PBs fE
ffi. M 'll' ? Wi
teflcSS: E'OPBJiiEk
.n m
w m
. ar a
mmse s
- s s t t M
s. vv
' n . S t r , 7F- S JR
itC W
f f i , i f t f e b J 4 l
ir Is; sharp heart pain and cyanotic lips are due to inhibited
nrculation of blood and stagnation of blood in the heart
* iJ
a .D I fl.
^.*PBnfWiMEL
PEWiC: EK-L'Wtf!
2.3.1.4
ffi
(B3) /MUfiiSE
'h ifiL J: i ^ a i i 'Li'
^ W*M
of heart blood and lack of proper moisture and nourishment of the heart. This syndrome is caused by weakness
vEfco
=f &
& jfiL*
JfiLtJ fB *1 *
& It JI4
3UC
sumptive diseases.
Analysis of symptoms: Palpitation is due to insuffi
f & # *tkS L fc# i
jfiL> 5 #
a j t . j R S R jiiL '!? !
asthenic blood to nourish the head and face; thin and weak
pulse is due to insufficiency of blood in the vessels.
Key points for syndrome differentiation: The syn
IjE
2.3.1.5
( E ) M M tiE
'C?
l ^ '^ 1
o * fiE H IlJ S $ r # ;*
= f^ m to
l|il
-11'fes |l'
, 'k
j fevM
iS Ifc t t
|A|||(!
sf # ><i>sti
',
m *i>1$ i
-il' ^ W # , ii. l ft He
' T ' S , JTOJ ' l l ' M ,
BK,
, 'C,' f t
0 & , )
fteart, asthenic heat disturbing the heart and anxiety; feVimish sensatin over the five centers, afternoon tidal fe m-, flushed cheeks and night sweating are due to failure
yin to control yang and internal generation of asthenic
W S S I.
lint; reddish tongue with scanty saliva and thin and fast
ifalne are signs of yin asthenia and internal heat.
Key points for syndrome differentiation.. Palpitation,
K E S j t,
2. 3. 1. 6
tltome
( 7 \)
-6 c
H ffi H ta T
H t b E W * fp-KE tf>,
K'
'C ,'E ,
sTJE
with white fur, sunken and slow pulse or sunken and tense
pulse; or pain and distensin, hypochondriac distensin,
sighing, light reddish tongue and taut pulse. Such symp
toms are usually seen in coronary atherosclerotic cardiopathy, angina pectoris, myocardiac infarction and primary
cardiac myopathy, etc.
Analysis of symptoms: Palpitation is due to inactiva tion of heart yang, lack of warmth and irregular heart
E frflr: -il'PB*;
ft
T S # , K J S U 'li
W f.
distribu tes directly to the lung, comes out from the armpit
.#I
and moves along the inner side of the arm. Stasis in the
heart vessels is marked by dull pain, usually accompanied
by dull or purplish tongue with petechiae, thin and astrin
gent pulse or knotted pulse and slow regular intermittent
pulse;obstruction of heart vessels by phlegm is marked by
dull pain,
profuse
D ? f f i ^ : ;ffil^C.'1$fo
1*1
ffi A i# Wr ffc
Jf
f i i D
j c I S
puse.
2.3.1.7
( t ) t W K iS E
-i>k % ffi ffi * t T 'll'
k rt M S S a M ft ffi f-
This syndrome is caused by mental depression, transforftmtion of fire from qi stagnation, or internal invasin of
pathogenic heat and fire, or excessive intake of acrid, hot
Niid tonic food, transformation of fire from prolonged acirnulation in the heart.
Clinical
manifestations:
Dysphoria,
insomnia,
-frS&BR, ||
ife n 58 <#
I lile * deep reddish tongue tip, yellow fur and fast pulse;
>tH l J t <"S
W ulceration and pain of tongue, or hematemesis, hemorHjpgia, or even mania, delirium and unconsciousness, uftlly seen in hypertension, thyroidism, endocarditis, pe-
W:
*rt tr i X
rt W tft
D j f l L ; igfu& 'jsR , m nt
2.3.1.8
( A ) S5j*/ISS3iE
?r& ,
stance.
BtWCc
c u a t i s ff
A * , o n g j* ,itr ^ ^ .
whitish greasy fur, slippery pulse. Such symptoms are usually seen in craniocerebral infection and depressive
schizophrenia, etc.
Analysis of symptoms: Mental confusion and coma
are due to phlegmatic turbid substance confusing mind and
T J & T S IM
* > fif tt W f p, l i m
. Mim
a m.
un
f t . -t;
^ . 3 , i l r a # n E . S t T i
K,
i* r t f t
m atic fire
Disturbance of the heart by phlegmatic fire refers to
the syndrome of mental derangement due to fire, heat and
phlegmatic turbid substance disturbing the heart spirit.
& 1 f.t
, ^ P - S / C lll'W
? r. M I'bJ^ S. )WW *
sairs u s .
r .w a M . .
--i 'al
* .
E;M
ja l i f s m > i s t a I
P J n ^ W ,S ; i l'B ] ^ .W
f f i I S M T A S t lo
ssw sa.
Reddish
2. 3. 2
asthmatic breath,
expectoration,
stuffy
. N
2.3.2.1
(- ) l i n a s
J-^1fS iiE l: T J Al
M r n ir tH
yzm m .
ti>
D l'fi M m tk M o
2.3.2.2
( Z ) HRBffiuE
f lK & E J iB S T M f W
iiE s m i , s ^ a
m a m ?,
, mm .
ft
fTf jf^; . Ak
it j;
. PJ
05 S
&
W JfiLs S
f)> lili
& IW
# ,P J
thenic fire; dry mouth and throat and emaciation are due
to insufficiency of lung yin and lack of nutrition; aftemoon
lfl l#
2. 3 . 2 . 3
( - ) JxlS^ffifiE
ring lung
Syndrome of wind cold encumbering lung refers to
the syndrome of failure of pulmonary qi to disperse due to
wind cold attacking the lung. This syndrome is usually
j i
*w m , * # * *
iii
6 S 1 :
i .J J c ? !K . r L hii'P
vE m frffi:
tum, stuffy nose with clear snivel and throat itching are
due to failure of pulmonary qi to disperse resulting from
wind cold encumbering the lung; aversin to cold, fever,
body pain, no sweating, whitish thin tongue fur and float
ing and tense pulse are due to wind cold attacking the su
, J
perficies, stagnation of weiqi, lack of warmth of the surface of the body and obstruction of the muscular inter
stices.
Key points for syndrome differentiation: Cough, thin
and clear sputum, aversin to cold, fever, pain of head
and body as well as no sweating.
2.3.2.4
(0) H t t S I K E
m Eo
v E ^ m iL frv E o g m t m i i
lhh
a , # * , # .
TJL^
tst.
miE * j :
m m
2. 3. 2. 5
e#
( 5 ) i3B3BSiBfiE
lung
Syndrome of dryness attacking the lung refers to the
syndrome of consumption of fluid in the lung system due
to invasin of pathogenic dryness into the lung. This syn
w e
g g fi
U .W M Z ft,
, x K Jtfsi c ^ n s i) W-:..
i .g m &
,
i S
I .
. I f f S
I .
'S T 'a T B t j t ^ * J i | (
2. 3. 2. 6
Syndrome of accumulation of pa
( 7 \ ) S t 3 BtlffiE
JMCE.
lis ia s >
ja ,S ! a y # 4 n * S r . f l: ilf
& M
t &
L P M . /h M M # . A f MI
fe .
B tfn Iffl * 1
"J 'aL 1
im f r t f : m m m m ii
Q
l *
&
K 'tfl; )|i|
PJM
* 5JBfc W * m f M
It
$, $
* IT ffi Wi
m v E W ti:
\ m m ko
( t ) SlSKflSfiE
HMention in lung
Syndrome of phlegmatic dampness retention in lung
M'frrs to the syndrome due to failure of the lung to dis|hm c
ptTipness in the lung. This syndrome is caused by retenlldli of phlegm coagulating from fluid in the lung due to
E t J ir ^ i t E
S !* . .
I l J f l I o
iE0s#0f: m m
ffifeo
2. 3. 2. 8
u\) r*m n e
*EEJ T P07jc m
isgfeiR,
Ultacking the lung and failure of the lung to disperse, de(MtMid and reglate water passage which give rise to stagimtion of wind, retention of fluid, confliction between
blnd and fluid as well as extravasation of fluid in the skin.
HfiJ
mi|d face, eventual edema of the whole body with rapid de-
i.
Hkpment, thin and bright skin, scanty urie, accompaiiumI by aversin to cold, fever, no sweating, whitish thin
J S L *# & .
S # * l *
# S ; K t iL n H i W * ,- S *
X . B * # # o b J J a L M iI '#
M l/ h f iW
X ff.
fi
ZuEo
onset of edema of the eyelids and face first with quick involvement of the whole body, scanty urie, accompanied
by aversin to cold and fever, etc.
2 . 3.3
m s
IJ IE
r $
3f f i f e E i l
JLW?6IBfe#aif
m
*fig
m tB i i y? ^ al in-^ o
& /h 1
lo.; % e ^ a tfc #
i?
2.3.3.1
(- )
SfSc o
vi
*
W *K
. lin ft
e ,jm m 0
iEmfttfr-. W ^ l ^ . B
irc
Poor
2.
3.3. 2
f i . -3? "n, Mi
t, W
(Z ) M ltS E
yang
Syndrome of asthenia of splenic yang refers to the
Hyndrome due to asthenia of splenic yang and intemal exil
iaranee of yin cold. This syndrome is caused by further
ilvelopment of the asthenia of splenic qi; or by excessive
Intake of uncooked or cold food; or by asthenia of splenic
V.mg and failure of fire (heart) to generate (promote)
(nirth (spleen).
Clinical manifestations: Poor appetite. abdominal
llmlension, lingering abdominal cold pain, preference for
wiiimth and palpation, aversin to cold. cold sensation of
W P B d l E Jil
n m M vEm , +
Poor
a i#
ma 9i'
2.3.3.3
( = ) W n T P 8 iI
I Syndrome of sinking of splenic qi refers to the synJonii* due to asthenia of splenic qi and failure of splenic qi
i im*. This syndrome is mainly caused by further devel-
&,
ms t mmmm
WiiEo
m s
M c ., i j a T i i ' i f
|k pulse. Such manifestations are usually seen in chrognstritis, digestive ulceration, chronic enteritis, mal>fption syndrome, Crohns disease, irritable intestinal
iilrome, gastroptosis, hepatoptosis, nephroptosis and
T S . f T S > f f T f .
Mleroptosis, etc.
Analysis of symptoms: Prolapsing sensation and dis-
vEmfrtir-.
Jto nnd chronic diarrhea are due to insufficiency of spleni|i, failure of transformation and transportation, sinking
Mlllenic qi resulting from weakness to rise; gastroptoi prolapse of rectum and hysteroptosis are due to insufrfti'y of splenic qi and failure of the viscera to remain in
l|r normal position; turbid urie is due to failure of the
Itltiii}'. splenic qi to transport cereal nutrient, separa te
w
|mli ol (|i, fatigue, lassitude of limbs, low voice, no deiln lo s|>eak, dizziness, pal tongue with white fur and
pulse are signs of insufficiency of gastrosplenic qi,
0 m
* e im m
2.3.3.4
(B 3 ) R E S U M E
govern blood
Syndrome of failure of the spleen to govern blood re
fers to the syndrome of bleeding due to failure of the
spleen to control blood caused by asthenia of the spleen.
This syndrome is usually caused by spleen asthenia due to
chronic disease, or by overstrain and impairment of the
spleen which lead to asthenia of the splenic qi.
Clinical manifestations*. Hematemesis, or hema
tochezia, or hematuria, or hematohidrosis, or epistaxis,
lis i m M : B E j t . S f r f l i
sScic.tfD. .sSEflJLiWl.
"VI
STETS--bit fci(iUJl M ,|
>Jfo. # ! > t l t6 %
tjjflit L m w m m it'i
J lS J lfE M K J f o .M J illl
f i f i , JL a #
3?
S # M . f|*
maturia ; extravasation of blood in the muscles leads to hematohidrosis; extravasation of blood in the nose leads to
epistaxis; weakness of the thoroughfare and conception
vessels leads to hypermenorrhea and profuse uterine
i t z m j W M g i & * .<
# * * ; * . It.
V .lJ
i<
j
tlnmt production of qi and blood lead to sallow or lusterMN complexin, lack of qi and no desire to speak; pal
h i( u c , thin and weak pulse are signs of asthenia of both
blood.
<|i l i t u l
2.3.3.5
( E ) S a B M t iE
S S H W E lr f T
s r t . s . + r o s i i i i s n w i
iiftpold
^ . # f f i# 7 jc ,A J g S f c , l t
exuberance of dampness.
te * * ? :
s # @
vEifttir: SiSrt.'!1
ppiBHsion, poor appetite, nausea and vomiting, abdomiHl pain and loose stool are caused by exuberance of interp l Cold and dampness which leads to encumbrance of
2.3.3.6
( A ) ^ a iS E
w m m m ttiv E f ' * a i l
HE t r , S S , 16 S >V.
JfSc.
piltritis, chronic gastritis, acute enteritis, chronic enterHIh. indigestive ulcera tion, viral hepatitis, chronic hepati
tis cirrhosis of liver, gastrocarcinoma and liver cncer as
well as some infectious diseases, such as typhoid fever and
[ptiratyphoid fever.
Analysis of the symptoms: Fullness and oppression in
he epigastrium and abdomen, anorexia, vomiting, nauseN, lose stool and unsmooth defecation are caused by dysfifection of the spleen and stomach as well as abnormal
Muiilges in ascending and descending due to retention of
.limp heat in the middle energizer? heaviness of the limbs
l caused by stagnancy of qi activity due to encumbrance of
llmpness; dull fever, failure to relieve fever after swealintf, thirst with oligodipsia and scanty-yellowish urie are
Clused
llon
2.
JS L tt.
jlW K iS T J ffff
^JF o
j E ^
, IJct: I)
mi^ ;
( - ) ffFKtldEfiE
JfF ilild lE JiS T tl
drome is usually caused by insufficiency of blood production due to asthenia of the spleen and stomach, or by con
& ^ , iS T S , a r f lt f
fflo 1 0 L T # # ffljlU iU lL S j
#ScMW0Lo
ilry and
of joints and tremor of hands and feet are caused by malputrition of the nails and tendons and vessels due to blood
pHhenia; scanty and light-coloured menstruation or even
it
. t t n -k
'> fe
ttfcnorrhea are caused by deficiency of thoroughfare ves||| and insufficiency of blood source due to insufficiency of
hvcr blood.
Key points for syndrome differentiation: Malnutrition
nf head, eyes, nails, tendons and vessels as well as geni'i.il malnutrition due to blood asthenia.
) 2.3.4.2
cz)
Syndrome of liver yin asthenia is the syndrome resul[Ihu; from failure of yin to control yang due to consumption
ol
liver
vEUo | l i
III
2.3.4.3
< = ) S fn S B ^ E
ill
t IM
IVessels.
Clinical manifestations: Emotional depression, miMWtory pain in the chest, hypochondria or lower abdo
men, chest oppression, frequent sigh, thin and white
: . jjJc'aL
SJaLI^T
; f k rTaL^L )M
m0 r j a T t t s * * ,
B u'Ii symptoms are usually seen in neurasthenia, depresllon, throat-esophagus neurosis, hyperthyroidism, simple
Iliyroid enlargement, chronic hepatitis and climacteric
nyndrome, etc.
Analysis of the symptoms: Depression and frequent
|lt(li
Hvcm * dispersin;
XM ,
, tt
B^pochondria, breast and lower abdomen is caused by livf depression, qi stagnation and inhibited flow of meridian
*I1 sensation of foreign body in the throat, or goiter,
B^ofula and hypochondriac lump are caused by retention
tl|phlegm transformed from qi stagnation in the throat,
Mti< and hypochondria; irregular menstruation, dysmenortlrn* or even amenorrhea are caused by liver depression,
i ( Mlagnation and inhibited circulation of blood because the
Ver is fundamental in woman; thin and whitish tongue
fiE * .
If nnd taut pulse are the signs of the liver that fails to act
fcely and disperse normally.
Key points for syndrome differentiation: Emotional
m ue h /S :
*|>iession, migra tory distending pain in the chest, hypoinndria, breast and lower abdomen as well as irregular
m , ft- kR
piMiMtruation.
2.3.4.4
(BU) BW i& iE
jft& m nt
MtiEM. I
'If
-f t U t
o r
b y
b flffl
the liver.
Clinical manifestations: Dizziness, distending headache,
f lu s h e d
11
1
& B # , S O T - M B f r M
p M g ,
t , & f I & T i* L SI
#f
S W, Si ffl1fiPffi, ta 3fc ^
J) J* W. i t & , M $ I* - f l
climacteric syndrome.
vE'j^Vf:
headache, flushed face and red eyes. bitter taste and dry-
D,
i 'i
@# H B O "Pf X
turbing the upper part of the body along the liver meridian; insomnia or nightmare is caused by mental distraction
i ;O P f f t l ^
Z M , PJ
fff M -MJ-ftll W i ; *
lfilS T >iJ t lf in f iH , i f o f l
M U ; X #3 f i i , M
W ^ j & '/ X X I I j H
fl
ffi.
S fiE S .:
1, ^ U ffi # tfr & >M
,i
S IiS P
2.3.4.5
a g u i s o
(E )
ff F R B / L E ; J i S j )i
i o
l&FJrt t . A
laching pain and weakness of loins and knees, top-heaviIness, reddish tongue with scanty fluid, taut pulse or taut
\
t
I nnd thin pulse. Such symptoms are usually seen in hyperI tensin, cerebral arteriosclerosis, Parkinsons disease,
hyperthyroidism, neurasthenia, manic depression, mifraine and climacteric syndrome, etc.
Analysis of the symptoms: Distending headache, diziness, tinnitus, flushed cheeks and red eyes, irritability
f[ 1$ i
ii^,
ifu
m /c m m 0
m\e j S :
2.3.4.6
(A ) BmrtSjfiE
l- i
MvEm
3. 4. 6 .1
1. IffffltfcJxlffi
M.Ec
te * * } :
A *.H
in the throat. Such symptoms are usually seen in hypertension, cerebral arteriosclerosis, cerebral infarction,
cerebral hemorrhage, cerebrovascular accident sequela,
Parkinsons disease, epilepsy and injury of spinal cord.
etc.
Analysis of the symptoms: Dizziness, shaking head
and headache are caused by hyperactive liver yang trans
forming into wind and disturbing the upper part of the
h. t f . t S tfF M rt Ib ffii
i? . S U , I
PH/LHlffiio
liver and kidney yin; red tongue with white or greasy fur
JfiUSL.IFM
i?
A * ,
WE5.U
B|i
2.3.4.6.2
2. *M KJ5UE
tlng wind
vSyndrome of extreme heat genera ting wind refers to
a a fc W iE J i- lf T W
)xl
m m m a . M aarw ,
liver wind.
Clinical manifestations: Continuous high fever, rest
lessness, spasm of hands and feet, stiff necks, upward
staring of eyes, even episthotonos, lackjaw, unconscious
ness, deep reddish tongue, yellowish dry fur and taut and
rapid pulse. Such symptoms are usually seen in epidemic
encephalitis B, epidemic cerebrospinal meningitis, brain
S O a ^ a t T tt S # f lK
-14tb it a j i a , j* m in
ffi u
8 t E S : ^ iiE K f f it t .
m k T ' o fe ja ra s
. /fj ^
3.
M il
to yin asthenia
Syndrome of endogenous wind due to yin asthenia re
W ^ M ,iE J i 1 ia j
JxlE.
ft w . j .
vEMfrtfr: HfWMm-'j
# , j M f t b . i J it.
or bone-steaming fever,
t Migue with scanty fluid and thin and rapid pulse are
niused by yin asthenia, yang hyperactivity and upward
lliiming of asthenic fire.
Key points for syndrome differentiation: This syniliDme is marked by tremor of hands and feet accompanied
fssO, A
2.3.4.6.4
4. jflLjtME
tlng wind
Syndrome of blood asthenia generating wind refers to
jfiLJxlffiJf I iln
Ihr syndrome due to consumption of blood and malnutriIion of tendons and vessels. This syndrome is usually
H vEM ,
j i , g K t . , f i t t ^ j i , a t f 'f i i i i
W m k M :
fascicular twitching, numbness of limbs, dizziness. tinnitus, pal complexin, light coloured nails, whitish tongue
and thin and weak pulse.
Analysis of the symptoms: Tremor of hands and feet,
fascicular twitching and numbness of limbs are caused by
consumption of blood, malnutrition of tendons and vessels
and endogenous asthenia wind; dizziness and tinnitus are
caused by failure of blood asthenia to nourish the head;
pal complexin, light coloured nails, whitish tongue and
thin and weak pulse are caused by failure of blood asthenia
s s i f t \ftikmwio
2.3.4.7
( t ? ) SffFBSiiE
liver meridian
Syndrome of coid stagnation in the liver meridian re
fers to the syndrome due to coid pain in the distributing
regin of liver meridian caused by stagnation of pathogenic
coid in the liver vessels. This syndrome is usually caused
by pathogenic coid attack, stagnation of qi and blood in the
liver meridian, inhibted circulation of qi and blood as well
spaw a.
*rl
,r.
Hl! caused by pathogenic cold attack on the body and stagktttion of yangqi from developing outwards; light coloured
liMigue with whitish and moist fur, sinking and tense pulse
of taut and tense pulse are the signs of internal exuberwilce of yin cold.
Key points for syndrome differentiation: This syn
drome is marked by cold pain in the lower abdomen, puilWidum and vertex as well as cold limbs and body.
J,3.5
W , 7 J c > # I M ; iik I.
i>. /1 ^
ti*
fllici enuresis, incontinence of urie or oliguria and edeIIin. early morning diarrhea, dyspnea and more exhalation
tinrl less inhalation.
Kidney disease is usually of asthenia na ture and freHiiriitly caused by constitutional asthenia, or insufficiency
ol r isence during childhood, or consumption of essence in
2.3.5.1
( - ) MBBuE
' f r o U E f T f f l j l
ilEM .
ishing the body. This syndrome is usually caused by constitutional asthenia of yang, or decline of Mingmen fire in
the aged, or impairment of kidney yang due to chronic
disease, or involvement of the kidney in the disorders of
the other visceral yang, or intemperance of sexual life and
consumption of kidney yang.
Clinical manifestations: Aching and cold sensation in
ilSiSSL:
impotence,
immature ejaculation,
cold
sperm, infertility due to cold in the uterus, sexual hypoesthesia, or loose stool, early morning diarrhea, or fre
quent micturition, clear and profuse urie, profuse noctural urie, bright whitish or blackish complexin and
light coloured tongue with white fur as well as sinking,
deep and weak (especially over chi regin) pulse. These
. i is i
symptoms are usually seen in hypothyroidism, hypoadrenocorticism, hypogonadism and chronic nephritis, etc.
Analysis of the symptoms: Aching and cold sensation
in the loins and knees, cold limbs and body, dispiritedness
and lassitude are caused by asthenia of kidney yang and its
failure in nourishing the body; bright whitish or blackish
complexin is caused by asthenia and weakness of the kid
ney to warm and transport qi and blood, leading to inter
P n te n
sfrf ] ik H '
L 2.3.5.2
( Z ) f7j<j$i
Itthenia
Syndrome of edema due to kidney asthenia refers to
E J lJo
W S T W m.
E # # r :
s rt
js j / h
' j - ' .
ff-
2.3.5.3
( = ) SfiBf E
B H E ftf T W H
m m i i f . * w g :f m
* ^ n S ,f e lR < S .IIa * .
nesia, seminal emission, scanty menstruation or amenorrhea, or metrorrhagia and metrostaxis, flushed cheeks in
the afternoon, bone-steaming tidal fever, night sweating,
dry mouth and throat, emaciation, yellowish and scanty
urie, reddish tongue with scanty fur and thin and rapid
n ru L fl
vE & frV it
JR?T JJ H M ; A D c 'll'
Ciency of blood in the thoroughfare and conception vesrls; metrorrhagia and metrostaxis are caused by extra vation of blood due to asthenic fire; restlessness, fever
iltd insomnia are caused by asthenic fire disturbing mind;
pnaciation, bone-steaming tidal fever, flushed cheeks and
higlit sweating, dry mouth and throat as well as yellow
# .
2.3.5.4
(ES) W R T S E
ficiency
Syndrome of kidney essence insufficiency refers to
the symptoms of retard growth, decline in reproduction
And senilism due to consumption of kidney essence. This
pyndrome is mainly caused by congenital defect, postnatal
malnutrition and insufficiency of primordial qi; or by im
pairment due to chronic disease, intemperance of sexual
M ffilsS . ^ J E ^ eiT
f w m m c.
Infantile retardation of
, a n s a .
Ki
ttlJ
m&To
a n is a ,# # .# !
T o
,-k r m
2.3.5.5
(E ) n * @ E
weakness in the aged and asthenia of kidney qi; or by conUrnital defect and insufficiency of kidney qi; or by conUmption of kidney qi due to chronic disease and overptrain.
Clinical manifestations: Aching and weakness of loins
Miid knees, dizziness and tinnitus, frequent clear urie, or
iliipping urination, or enuresis, or frequent noctural uriliition, or incontinence of urie in man, seminal emisHi(>n, immature ejaculation, dripping menstruation, or
thin and profuse leukorrhagia, or excessive movement of
and susceptibility to abortion, light-coloured tongue
M u s
IWith whitish fur and weak pulse. Such symptoms are usu-
B U ? J i^ S ,ttJ i I l
MlHy seen in prostate hyperplasia, hypogonadism, metronilxis due to dysfunction and habitual abortion, etc.
Analysis of the symptoms: Aching and weakness of
loins and knees, dizziness and tinnitus are caused by asIhrnia of kidney qi and insufficient nutrition; frequent
rifar urie, or dripping urination, or enuresis, or fref|tient noctural urination, or incontinence of urie in man
mk caused by asthenia of kidney qi and dysfunction of
li!|ddcr; seminal emission and immature ejaculation are
liHcd by asthenia of kidney qi and its failure in storage,
Hpping menstruation, or thin and profuse leukorrhagia,
i excessive movement of fetus and susceptibility to aborllim. are caused by insufficiency of kidney qi, dysfunction
I the thoroughfare and conception vessels as well as
Mkness of the belt vessel; light-coloured tongue with
hitish fur and weak pulse are the signs of qi asthenia.
' Key points for syndrome differentiation: This synh o iiic
h r c s , frequent and clear urie or dripping urination, seinln il emission, immature ejaculation, dripping menstruaIihi. thin and profuse leukon'hagia and weakness of the
Itlldder.
t- v E m m tk
&
f
b
J - i t t . V fi i i . k
&m
!\
2.3 .5 .6
(A ) If^flnE
ceive qi
Syndrome of kidney failing to receive qi refers to the
symptoms of dyspnea and shortness of breath due to asthe
nia of the kidney qi and its failure to receive qi and direct
it to its source. This syndrome is usually caused by con
sumption of pulmonary qi and impairment of the kidney
due to cough in chronic disease; or by consumption of kid
ney qi due to overstrain; or by congenital deficiency of
primordial qi and malnutrition of the kidney; or by asthe
nia of kidney qi in the aged.
Clinical manifestations: Dyspnea and shortness of
breath, more exhalation and less inhala tion, aggravation
p j
> i g
t t l .
jhhS o
ija T iii *
W * . Uf
%%L.
!B t >l'J
.
H:
2 * *
f e , l til
lassitude, aching and weakness of loins and knees, lightcoloured tongue and weak pulse are caused by asthenia of
g tP B , S . P E im f
f f i w , r r t i
cffio
2. 3. 6
2.3.6.1
( - ) S5E
* f fip t T * 5 M I
So J J & T t t S
ta Mi
+ bJP&I
n ? ? f7 jc 0
(.-) HftfiE
S & i E J l : f l T S 4 *
?tiL m T & w . m
IIP
m e h ,6=
2.3.6.3
(E)
stomach
Syndrome of food retention in the stomach refers to
B J f ilE J ilf *
m . W M W M l &
M U I ! : J f J K M I
o 15TJS
> n.
A S
. 1 ( t $S # t ! . l H
2.3.6.4
(BS) RBlE
IK ftE Jlr f lP Jf
Jnnptoms due to insufficiency of gastric yin, loss of proptr moistening and descending of the stomach as well as inlc>i nal disturbance of asthenic heat. This syndrome is usuiillv caused by prolonged stomach di-sease; or by con-
f f i^ M ;
kimption of yin fluid at the advanced stage of seasonal feItlilc disease; or by consumption of body fluid due to exItwsive vomiting and diarrhea; or by excessive intake of
UliKent, fragrant and dry foods; or by excessive taking of
hftrm and dry drugs; or by consumption of gastric fluid
illir to emotional depression and fire transformed from qi
MttKnation.
ffipm >&
ffi
m il m & T m tf& n
ff: i
MU?. Sr4>.J4ffll?TfEj
m vE w & :
mm.
2. 3. 7
- t . m m m idE
f l S f W t t E J i ! i3
B r t/c ,I iS * J 9 * 3 1 lW iE
fio
jiyndrome is mainly caused by emotional depression and inIttirnal disturbance of the gallbladder by a mixture of
r t tM J W J L
pjllegm and heat due to fire transformed from qi stagnaIion which scorches fluid into phlegm.
Clinical manifestations: Timidity and susceptibility to
l i s * * : J f i f ^ 1t,t(
fcight, palpitation and restlessness, insomnia and dreamimws, dysphoria, difficulty in making decisin, thoracic
iX t^ fe , m m n m , # , i .
S J tK .ttK J f.
2.3. 8
i m
intestinal disease
Small intestinal disease reflects the disorder of the
small intestine and the pathological changes of its func
tions in receiving and digesting food as well as in separating lucid substance from turbid substance. Clinically the
symptoms of small intestinal disease are abdominal disten
sin, borborygmus and loose stool.
In the theory of viscera and their manifestations, the
digestive and absorptive functions of the small intestine
are attributed to the spleen. So the disorders of the small
w m n i*i . m w /W& tf
A:
im m fto v
0 il^ T ^ h M iB f S C i
t,
tA filo
flSBifrf il i L S f f t MUtlfiLo
2. 3. 9
A ,
jzM /fW tH E
tinal disease
Large intestinal disorder mainly reflects the dysfunc
tion of the large intestine proper and the pathological
changes in its functions in transporta tion and transforma
tion. The clinical symptoms of large intestinal disorder
me usually constipa tion, diarrhea and purulent and bloody
lysentery.
Large intestinal disorder is either asthenic or sthenii
m&.
2.3.9.1
(- )
consumption
Syndrome of large intestinal fluid consumption refers
to the symptoms of retention of dry feces and difficulty in
defecation due to consumption of large intestinal fluid and
inhibited transportation. This syndrome is usually caused
by congenital yin deficiency, or by insufficiency of blood
in the aged, or by excessive vomiting and diarrhea, or by
consumption of yin due to chronic disease, or by non-restoration of consumed fluid at the advanced stage of febrile
disease, or by excessive hemorrhage, etc.
Clinical manifestations: Dry feces and difficulty in
defecation, defecation once in several days, dry mouth
ff.n i
&o T E T i a
jt .it P B t t t f t ,n & * r .i a,
2.3.9.2
(~ )
heat
Syndrome of large intestinal damp-heat refers to the
ymptoms of diarrhea and dysentery due to invasin of
rinmp heat into the intestinal tract and failure of the intestlne to transport. This syndrome is mainly caused by invaMion of pathogenic damp-heat in summer and autumn into
m m .m
ffCo
fcrstinal tract.
Clinical manifestations: Abdominal pain, yellowish
te * * :
m m i , s m e s , / j'f iM s t .
longue fur as well as slippery and rapid pulse. Such sympionis are usually seen in acute enteritis, dysentery, ulcerHIive colitis, intestinal tuberculosis and tumor in the intestln.'il tract.
Analysis of the symptoms: Abdominal pain, yellowish
[ttld foul fulminant diarrhea are caused by retention of
d,imp-heat in the large intestine, stagnation of qi in the
Intestinal tract and failure of the intestine to transport;
n<orching
SSSBo
2. 3. 10
+ s
disease
Bladder disease mainly reflects the disorder of the
bladder proper and the pathological changes of its func
tions in storing and excreting urie. The clinical manifes
tations are frequent urination, urgency in urination, pain
in urination and anuria as well as brownish and turbid urine, hematuria and sandy urie, etc.
Bladder disease is often of sthenic nature due to re
tention of damp heat in the bladder and inhibited transfor
mation of qi in the bladder. The asthenic disease of the
Se.
bladder is usually caused by asthenic cold in the lower enrgizer and unconsolidation of the bladder due to asthenia
?Kfo
of kidney yang.
M 9 f ,R
StSUfiL,
I * , /M i! t4 il
5 , fj
P J 'M a J M ;
rt H W-Wl
* v v m m %
prome is marked by frequent and urgent urination, burnflliK pain in urethra during urination and yellowish and
fcownish urie.
2,3.11
+ - x
m z m , - e n m
h j
, t n BI ffi 2 S * ffi 4:
i#*S.
The accompanying diseases of viscera are pathologinilly related to each other and affect each other. For exmuple, accompanying diseases usually occur among the
Viniera internally and externally related to each other or
#J*L,
g , if a g i t i s
sponding symptoms.
SSEo
2. 3 . 1 1 . 1
(- ) A H IA IE
lung qi
Asthenia syndrome of heart and lung qi refers to the
symptoms of palpitation, cough and dyspnea due to simul
taneous asthenia of heart and lung qi. This syndrome is usually caused by consumption of pulmonary qi with the involvement of the heart due to cough and dyspnea in chron
.';
0fSfc.
& . i 3? <
jfl
Sito IJ&TIlttlfigttHili
% >JJ$lf5|>
, W'n.f'Wi
*n,Jlf?S3If3. JWI&f It
A ,i-n
S f f E.J j ; d j W
i|
m i
|x>ntaneous sweating and lassitude are caused by hypoaclvity of the body due to asthenia of qi; aggravation after
movement is due to consumption of qi; pal complexin,
light-coloured tongue with whitish fur, or light purplish
tongue and lips, sinking and weak or knotted pulse and inIrrmittent pulse are the signs of asthenia of heart and lung
()i which is weak in transporting blood.
Key points for syndrome differentitation: The major
fnanifestations are both palpitation, cough, asthma and
lymptoms due to qi deficiency and weakened functional
(ctivity.
2.3.11.2
(z ) i m m f u
pleen
Asthenia syndrome of heart and spleen refers to the
lymptoms of malnutrition of the heart, dysfunction of the
leen and weakness of the spleen in controlling blood.
This syndrome is usually caused by improper regulation in
prolonged disease, or by excessive contempla tion, or by
Intemperance of food and impairment of the spleen and
Itomach, or by acute and chronic hemorrhage leading to
JfiL*
mm o
V S 'L '
JL ^ J f f i
pJjjiL
well as thin and weak pulse. These symptoms are usuIIv seen in arrhythmia, cardiac neurosis, chronic gastritis,
tliucslive ulcer, hemorrhage from upper digestive tract,
m.il;il)sorption syndrome, iron-deficiency anemia, aplastic
I*.
* 4 fc d lJ lu iR # c * ft *
vE frV i: 'frjfiL'T'.S.'C,'
J8I
he
H f e ? S , 'f , f c
je *
E l i l 'C , '# * 1
2 .3 .1 1.3
( .= )
/CiiSfflMiiE
kidney yang
Asthenia syndrome of heart and kidney yang refers to
the symptoms of blood stagnation and retention of fluid
due to decline of heart and kidney yangqi. This syndrome
is mainly caused by decline of heart yang and prolonged
disease involving the kidney; or by retention of fluid at
tacking on the heart due to deficiency of kidney yang and
failure of qi transformation.
Clinical manifestations; Palpitation, cold body and
limbs, dispiritedness and lassitude, edema of limbs, dysuria, cyanosis of the lips and nails, light-coloured, dull and
purplish tongue, whitish and slippery fur as well as sink
ing, thin and indistinct pulse. Such symptoms are usually
'h * f<J, B
S J 1*1
it.jfciifflmJ i
heart disease, chronic nephritis, systemic lupus erythematosus, diabetes, hypothyroidism and epidemic hemor-
IE
M 'ilV k fj Jfoft 3? % #
rhagic fever.
Analysis of the symptoms: Palpitation is caused by
PBril.'C;
r o ^ f t , K V c K .,
,ma.%t<sSsL'^%-W\ IH
(ES)
BMH'
E # fl
j a W >3S 'C.' M Si iW
S M f c H . j E T M
R * P J S f f i o
I l '>
JABflftElo
m iE 5 j :
2.3.11.5
asthenia
Syndrome of lung and spleen qi asthenia refers to the
symptoms of asthenia due to asthenia of lung and spleen
qi, failure of the lung to disperse and descend as well as
* iiE
ifj
2. 3 . 1 1 . 6
(A )
B BBffiE
yang asthenia
Syndrome of spleen and kidney yang asthenic refers
J J T J f P B .f E J S f T J I *
i l f e , * E ^ T X Mi fli ' I
B U & X tio
bTJLTU
fifis * * ,
2.3.11.7
( t ) BTf BlffifiE
asthenia
Syndrome of kidney and liver yin asthenia refers to
symptoms of interior disturbance of asthenia-heat due to
consumption of liver and kidney yin fluid and failure of yin
Hfc&rtimMvEmo * v f .
BHft v )# r
0 X J f 'I f IS S fr S jlW t.
g S 's E g H ,i* I ,P ) l
^ IS t t L BE K H>.
I-:
Ig ^ w y U ffF flli ,* i
the loins and knees are caused by asthenia of liver and kid
ney yin and lack of proper nourishment; insomnia and
IM& rt
. Dfc3L' fr # . I I & HK
due to yin asthenia; seminal emission is caused by asthenia-fire disturbing essence source; scanty menstruation or
amenorrhea is caused by asthenia of liver and kidney yin
to replenish the thoroughfare and conception vessels; meIrorrhagia and metrostaxis are caused by superabundance
o fire disturbing the thoroughfare and conception vessels
tlue to yin asthenia; dry mouth and throat, feverish sensa-
P&HT, 2'.>*&, S
tion over the five centers (palms, soles and chest), night
sweating and flushed cheeks, reddish tongue with scanty fur,
thin and rapid pulse are the signs of lack of moistening due to
yin asthenia and interior exuberance of asthenia fire.
Key points for syndrome differentiation: This syn
drome is marked by aching and weakness of the loins and
knees, hypochondriac pain, dizziness, tinnitus and semi
nal emission as well as interior heat due to yin asthenia.
2.3 .1 1.8
mm*
(A ) KFKSffiE
lung
mm,
> 3 b tj j!s c .
R W E & .
(T i)
M , JKJR >
iil \\>
m i% m A :
* ,
A , l i JMUfl, a m \
m m 0
A n***?
M E # ..
2.3.11.10
Syndrome of incoordination be
3: J f t j N i J f t f l t
it# #
W 'M W tM Ig '
"i m
ii E 4 M f : JFF^ciBKtW
mental depres
P E B jS : * E i m
rfKfilo
retching.
2 . 3 . 1 1 . 11
( + - ) ffiiSftfiE
and gallbladder
Syndrome of damp-heat in liver aifr gallbladder refers
to the symptoms of dysfunction in d is ^ ersin and conveyance due to accumulation of damp-he^at in the liver and
gallbladder. This syndrome is usually caused by pathogen
ic damp-heat; or by partiality to greasy and sweet foods
which causes internal generation of dar^np-heat; or by dyslunction of the stomach and spleen which leads to internal
IS fF M to
production of dampness and the spleer*1 reversely restraining the liver, resulting in accumulation of damp-heat in
the liver and gallbladder.
Clinical manifestations: Hypochono driac scorching dislending pain,
)IK.
K .a w flM E S .a ffT fe it
\ m W :
ir , ^
jfiLt
m,
mrnrn.
2 .4
aS-Eg-^r
-JfTttiWE.
methods
2. 4.1
- s
&
# e e*
differentiation
Six-meridians syndrome differentiation, a method developed by Zhang Zhongjing, a celebrated doctor in the
Han Dynasty, is the principie for syndrome differentiation
and treatment in Treatise on Seasonal Febrile Disease and
is the basis of syndrome differentiation for the later gen
era tions.
Six-meridians syndrome differentiation categorizes
the stages of exogenous febrile diseases into six types for
selection of treatment according to the main principie of
W EBS,
S . H PJi
IM f -
Hl..
#t-g65io ffiT
-A
HA
2.4.1.1
Taiyang syndrome
se
( - ) *BBiiE
So
jS f f io
l.
syndrome: A syndrome
( 1) *.F0
JxU.IJt M fP M . S J1&
m jm m m m
IffSiSS:
j,
AW
ws* a, j
im o
m m
external asthenia.
Taiyang c o ld -a tta ck syndrome: The disease caused
by invasin of pathogenic cold into the superficies, ob
(2)
Jk
ro sa.
Jirafa'
Taiyang fu syndrome
2 . P 0 1 t i E
( 1)
iJ I
S7jcEM *P0gEX<W . #
t fc ft S E s
fiPt.l.
iiE t e | S 0 &
k l
m ..
(2)
AK
W d a f f i J i f A ffl
it s * * :
i- 'p m . a i >> m , m , s m m
genic heat into the internal and its mixture with blood in
ffi; s? rt . d-li' # -t ja
# feffrSLinE;
Jf.', ^
it
E iiS lE 5 ig r ,* fi5 3 ^ B .
2.4.1.2
Yangming syndrome
( = ) B0B^E
HJIfaiiEjtfJPAIspJ!,
im .
#! W&
g A ffl
1. PBflflSiiE
iEo
b, x n 3 1<*.
r ^ M ifc * W
ffijfiLiSJSlliSfefco
Yangming fu syndrome
2.
rnrnvt
m m m m o
the intestines.
Clinical manifestations: Fever, afternoon tidal fever,
0W I
continuous sweating over hands and feet, abdominal hardness and fullness with unpressable pain, constipation,
restlessness, even delirium, yellowish dry tongue fur or
brownish tongue fur, tongue with prickles, deep and pow-
iB S c ,
I I #
2.
4 . 1 . 5.1
i.
drome
Shaoyin cold-transformation syndrome refers to the
syndrome due to asthenia of heart and kidney yang and
pathogenic factors transforming into coid following the na
S E io ^ iiE ^ @ ^
4 . 1 . 5. 2.
drome
Shaoyin heat-transformation syndrome refers to the
syndrome of asthenia-heat due to asthenia of heart and
kidney yin, hyperactivity of heart and kidney yang as well
as pathogenic factors transforming into heat from yang.
2.
'M m vcfc
x m m m ..
Em f t V r :
Jueyin syndrom e
Jueyin syndrome appears in the advanced stage of six[meridians disorders due to cold-attack, marked by complex changes and mixture of cold and heat in pathogenesis.
I Upper-heat and lower-cold syndrome is taken as an exam|pie to show the characteristics of this syndrome. Jueyin
llyndrome is usually evolved from the disease lingering in
Ihe other meridians.
Clinical manifestations: Thirst, qi rushing up into the
heart, pain and feverish sensation in the heart, hunger
without appetite, postcibal vomiting of ascaris, cold exIrnnities and diarrhea.
Analysis of the symptoms: Jueyin meridian pertains
10 the liver and distributes beside the stomach and through
11ir diaphragm. So jueyin disease is marked by dysfunction
( A
mmm.
i^ o /J H c
2. 4. 2
ASM,
t J a H e
i-JE^
lil
KM
2.4.2.1
( - ) E tt E
t- ii \
vEMM
m w m .
2.4.2.2
Qi phase syndrome
(Z )
JKj'lj n t *'L**j$ i ~P
# . m & m , m m m m , &
2.4.2.3
(= )
mme
S iS ^ f l S A
f M
f t f M
I l t t .
S tS K fc ,l!ln *a a ii
2.4.2.4
<ea> h u m e
J4 l4 H E Jtf ia & JS S S
A M L ,# I ^ J U 3 & J x L f K
* i E *
and rapid pulse; or convulsin, stiffness of neck, episthotonos, upward staring of eyes, lockjaw and taut and
rapid pulse; or continuous low fever, evening fever with
alleviation in the morning, feverish sensation over the
five centers (palms, soles and chest), emaciation and
dispiritedness, deafness and thin pulse; or tremor of
hands and feet and flaccidity.
M flL.
W.iftL, 3 - f e U &-.
JL$?, MI JiL
\ mn.i m i .
T 3 E # , ro m
, m ; &
PostScript
J s
T&
The Compilation of A Newly Compiled English-Chinese Library o f TCM was started in 2000 and published in
2002. In order to demnstrate the academic theory and
2000
2002
X m &}%}*&'
if % fum
^ if u
x m * e mi
W * * > E * I f c ,r # l f * K * *
4, E 5 * # f * E I r 5 l f (
Professor She
ix t
fiJiSUL
With the coming of the new century, we have presented this Library to the readers all over the world,
# iin B rt f>Y+ E
Zuo Yanfu
1 t
2002 pfo)#
!olour Fig.
formal State;
he tongue
lour Fig. 2
kht-whitish
ligue
lE t,1
\\m
Colour Fig. 3
Red tongue
m m 3
n:,'r
Colour Fig. 4
Deep-red tongue
OT4
Colour Fig. 5
Cyanotic and
purplish tongue
35
30
Colour Fig. 6
Bulgy tongue
m f 16
ol
s b iib
Atlas
Colour Fig. 7
Thin and emaciated
tongue
Colour Fig. X
Fissured tongu
m m i
mm
Colour Fig. 10
Tooth-marked
tongue
Colour Fig. 9
Prickly tongue
m@9
05110
Colpur Fig. 11
Deviated tongue
&11
Colour Fig. 12
Greasy tongue fur
% m n
m x:
M fv
tf& i1!
Colour Fit
Patchcd o>
i te tongue f U r
S 5I14
Colour Fig. 15
Yellow tongue fl
Colour Fig. 16
Grayish tongue fur
#@ 16
Note:
M g
colour Fig.
6,7,8,9,10
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j o i n t l y publishod
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7 1? * n s - i # tt t m m ?
&
'ii
m m m j
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>t
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techniques.
m m x m n m w ,
) f Wj T,
fttMMM
m m x * \ m "& = F m r
$\s\m
t m u i.
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