- This is applied to analyze and generalize signs and symptoms of diseases according
to the physiological functions and pathological characteristics of the zang-organs
and fu-organs in order to infer etiopathology, to spot the location and judge the
nature of pathological changes, as well as the state of body resistance in conflict
with pathogenic factors.
- It is the most fundamental method of diagnosis and the foundation for clinical analysis
and differentiation of every disease.
A) Differentiation of syndromes in Heart disease.
Heart diseases are mainly manifested as the abnormalities of the heart, blood, blood
vessels and mentality.
1) Insufficiency of the Heart-Qi
It occurs as a result of insufficiency of the heart-qi and declining functional
activities of the heart.
Etiopathology :
- The cause for this syndrome lies in decline of the heart-qi at an old age, or in
congenital deficiency, or in prolonged illness or sudden illness.
- When there is not enough heart-qi, the heart will beat feebly, the blood will flow
slowly and the body will be malnourished.
- As a result sign and symptoms of declining functions of the heart and the whole
body will appear.
Clinical manifestations :
- Palpitation, shortness of breath and oppression in the chest which becomes aggravated
after movements, pale complexion, listlessness and fatigue, spontaneous perspiration,
pale tongue with white fur, feeble or knotted or intermittent pulse.
- This syndrome is seen in heart disease, arrhythmia, neurosis and heart failure.
2) Insufficiency of the Heart-Yang.
This syndrome refers to symptoms caused by declination of the heart yang and its
failure to warm up.
Etiopathology :
- It arises from insufficiency of the heart-qi.
- Since the heart-yang is in deficiency and declining, blood vessels cannot be warmed,
the stagnation of blood due to accumulation of pathogenic cold cannot fail to occur.
- In this case, insufficiency of the heart-qi becomes more serious; at the same time,
the syndrome of asthenia and coldness will occur for lack of warmth by the yang.
Clinical manifestations :
- All the signs and symptoms due to insufficiency of the heart-qi accompanied with
intolerance of coldness, cold limbs, precordial pain, brightly pale complexion,
edema of limbs, cyanotic lips, pale and swollen tongue with ecchymoses, white, moist
and smooth fur, thready and feeble or knotted pulse.
- This syndrome is found in various heart diseases, heart failure and circulatory
failure caused by some acute or chronic diseases.
3) Deficiency of the Heart-blood.
It refers to the syndrome which occurs when blood is lacking for the heart so that
the latter cannot be nourished.
Etiopathology :
- Prolonged diseases and fatigue from over thinking, internal consumption of the heart-blood,
or anahaematopoiesis due to weakness of both the stomach and the spleen, and heavy
loss of blood all these mentioned above can lead to the deficiency of the heart-blood.
- It, together with lack of preservation of spirit and insufficient supply of blood,
will result in the symptoms of uneasiness and malnutrition of the whole body.
Clinical manifestations :
- Palpitation, or severe palpitation, insomnia, dreaminess, amnesia, dull, pale or
sallow complexion, pale lips and tongue, feeble and thready pulse.
- This syndrome is seen in anemia, neurasthenia and heart disease.
4) Deficiency of the Heart-yin.
This syndrome occurs when the heart-yin is too insufficient to nourish the heart
and when asthenic fire causes internal disturbance.
Etiopathology :
- It usually results from emotional frustration, stagnation of qi and fire, or from
deficiency of yin caused by long-standing case and febrile disease.
- Deficiency of the heart-yin will give rise to ill preservation of the heart; the
failure of yin to keep yang well, to fire of deficiency type.
- So the symptom of fidgets and asthenic fever will present itself.
Clinical manifestations :
- Palpitation and irritability, insomnia and dreaminess, feverish sensation in the
palms and soles, flushing of the zygomatic region, hectic fever, night perspiration,
dry mouth and throat, boils of the lips and the tongue, dry and deep red tongue,
thready and rapid pulse.
- This syndrome is seen in arrthymia, neurasthenia, heart disease and hyperthyroidism.
5) Flaring Heart-fire.
This syndrome occurs as a result of excessive heart-fire due to various causes.
Etiopathology :
- Fire can be generated either from depression of the seven emotions or from exopathic
fire and heat or overeating of pungent food.
- In this case, excessive heart-fire will arise so as to disturb internally the spirit
and make the blood vessels hot.
- Therefore, the symptom of excessive fire in the heart, tongue and pulse
Clinical manifestations :
- Irritability and sleeplessness, boils of the tongue and the lips, flushed face,
thirst, painful and deeply colored urine, dry stool, or even hematemesis and nose
bleeding, delirium or mania in severe cases, red tongue with yellow coating, rapid
pulse.
- This syndrome is seen in neurosis, recurrent boils of the mouth and urinary infection.
6) Obstruction of the Heart-vessels.
It refers to the symptoms caused by blocked heart-vessels.
Etiopathology :
- Obstruction of heart-vessels is often due to old age, prolonged disease and deficiency
of the yang-qi, aggravated by overstrain, affection by coldness, emotional distress
and stagnation of phlegm.
- On account of insufficient yang, blood will flow feebly, so it is easy to bring
about the blocking of blood circulation.
- On the other hand, the stagnation of yin-cold, accumulation of phlegm and hindrance
of functional activities of qi are unfavorable for the heart-vessels and circulation
of blood and qi.
- Consequently, the syndrome of obstruction of the heart-vessels will arise.
Clinical manifestations :
- Oppression and pain in the chest and the precardium that will radiate to the shoulder,
back and medial aspect of the upper arms may attack fitfully.
- This syndrome of obstruction of the heart-vessels is manifested as localized twinge
pain which becomes more severe at night, dark purple tongue with ecchymoses, thready
and uneven or knotted and intermittent pulse.
- The manifestation of obstruction of phlegm includes stiffing oppression in the chest,
fatness, abundant expectoration, heavy weight, greasy fur and slippery pulse.
- Obstruction of coldness of yin type is manifested as sudden attack of severe pain
which can be relieved by warmth, intolerance of coldness, cold limbs, and pale tongue
with white fur, deep and slow or tense pulse.
- In the case of obstruction of qi, the symptoms comprise distending pain and oppression
in the chest, the onset of which is related with emotions, reddish tongue with thin
and white fur and taut pulse.
- The syndrome of obstruction of the heart vessels may be seen in coronary heart disease,
angina pectoris and myocardial infarction.
7) Mental Confusion due to Phlegm.
It refers to signs and symptoms which occur when the heart is confused by phlegm.
Etiopathology :
- Accumulation of phlegm in the heart because of emotional depression and external
affection of pathogenic dampness may bring about miscellaneous signs and symptoms
of abnormal mental state.
Clinical manifestations :
- Dementia, haziness, distress, apathy, abnormal behavior, and divagation, abrupt
coma with saliva coming out of the mouth and sputum rumbling in the throat, or dull
complexion, oppression in the abdomen, abundant expectoration, unconsciousness,
whitish and greasy coating of the tongue, slippery pulse.
- This syndrome is seen in epilepsy, hysteria, depressive psychosis, neurosis, and
coma etc.
8) Heart Disturbed by Phlegm-Fire.
It means mental disturbance due to accumulation of phlegm-fire in the heart.
Etiopathology :
- It usually arises from emotional provocation and disorder of the liver caused by
depression and anger.
- In some cases, the depression of qi may produce fire, which, in turn, brings about
phlegm by burning the body fluid.
- Then phlegm-fire may consequently result in internal disturbance and mental disorder.
- This accounts for the syndrome of heart disturbance by phlegm-fire.
Clinical manifestations :
- Palpitation, fidgets, insomnia, and dreaminess, propensity to be frightened.
- In some serious cases, delirium, being capricious in laughing and crying, mania,
dry and bitter mouth, flushed faces, oppression in the chest, abundant expectoration,
dark red urine, dry stool, red tongue with yellow and greasy coating, slippery and
rapid pulse.
- This syndrome is often seen in schizophrenia, hysteria, neurosis and menopausal
syndrome.
B) Differentiation of Syndromes in Lung Disease.
Pathological changes of the lung are mainly manifested as dysfunction in commanding
qi, controlling respiration and withstanding exopathogens.
1) Insufficiency of the Lung-Qi.
It arises from hypo function of the lung.
Etiopathology :
- The causes for this syndrome usually lie in impairment of the lung-qi due to prolonged
cough and dyspnoea, insufficient inter promoting of the elements due to deficiency
of the spleen and stomach.
- When the lung-qi is declining, the lung cannot generate sufficient the pectoral
qi, so occur hypo function of respiration, inability to open the inhibited qi, ineffective
protection against exopathogens and hypo function of the whole body..
Clinical manifestations :
- Feeble cough and dyspnoea which become even more serious after movements, unwillingness
to speak, fatigue, pale complexion, spontaneous perspiration, aversion to wind,
liability to catch cold, thin sputum, pale tongue with white fur, weak pulse.
- This syndrome is found in chronic bronchitis, pulmonary emphysema, prolonged TB
of lung and pulmonary heart disease.
2) Deficiency of the Lung-Yin.
It is caused by internal asthenic heat due to deficiency of the lung-yin.
Etiopathology :
- It is caused by impairment of the lung yin due to prolonged cough, or febrile disease
at its later period.
- It also occurs when the lung is attacked by the germs of tuberculosis so that the
lung-yin is impaired.
- As the lung yin is too deficient to nourish the lung, asthenic fire will come up
internally and the lung-qi cannot be kept pure and descendant, thus causing cough
without sputum and the symptoms of hyperactivity of fire due to yin deficiency.
Clinical manifestations :
- Cough without sputum, or with a small amount of glutinous sputum, or blood-stained
sputum, dry throat, hoarseness, the cheeks turning flushed in the afternoon, hectic
fever and night sweat, dysphoria with feverish sensation in the chest, palms and
soles, red tongue with little fur, thready and rapid pulse.
- This syndrome is often seen in TB of lung, chronic bronchitis and so on.
3) Wind-Cold Pathogens tightening the Lung
This syndrome occurs as a result of the tightening of the lung by external wind-cold
pathogen and the consequent obstruction of the lung-qi.
Etiopathology :
- If pathogenic wind-coldness invades the body and stays in the lung, the defensive
mechanism will be damaged, unable to protect the body externally, so the lung qi
will be inhibited.
Clinical manifestations :
- Cough, white and thin sputum, profuse watery nasal discharge, slight aversion to
cold, mild fever without sweating, headache and body ache, thin and white coating
of the tongue, superficial and tense pulse.
- This syndrome is seen in cold, acute bronchitis and so on.
4) Invasion of the Lung by Wind-heat.
4) Invasion of the Lung by Wind-heat.
Etiopathology :
- The lung-qi will be inhibited, failing to keep pure and descendant when pathogenic
wind-heat attacks the lung and the body surface.
- Consequently, the superficial resistance will fall into disorder, hence this syndrome
of invasion of the lung by wind-heat.
Clinical manifestations :
- Cough with a small amount of sputum which is yellow and thick, sore throat, dry
mouth and turbid nasal discharge, fever, slight aversion to cold, red tongue tip
with thin and yellow fur, superficial and rapid pulse.
- This syndrome is seen in cold, acute bronchitis and pneumonia.
5) Retention of Pathogenic Heat in the Lung
It occurs when pathogenic heat stops up in the lung.
Etiopathology :
- It arises when pathogenic heat attacks the lung, or when pathogenic wind-cold stagnates
in the lung so long as to turn into heat.
- On account of excessive heat in the lung, qi is inhibited, therefore the following
symptoms show up.
Clinical manifestations :
- Cough, dyspnoea, yellow and thick sputum, or cough with foul pus and blood, fever,
thirst; pain in the chest, dry stool and deep-colored urine, red tongue with yellow
fur, slippery and rapid pulse.
- It is seen in acute or chronic bronchitis, pneumonia, infection complicated by bronchiectasis,
pulmonary abscess, asthmatic bronchitis, bronchial asthma, etc.
6) Accumulation of Phlegm-dampness in the Lung.
This refers to the signs and symptoms caused by the accumulation of phlegm dampness
in the lung, which obstructs the passage of the lung-qi.
Etiopathology :
- Prolonged illness of cough and dyspneoa leads to the impairment of the lung-qi so
that the lung fails to distribute its fluid over the body, so dampness gathers and
turns into sputum.
- In other cases, improper diet leads to the disorder of the spleen, which becomes
too weak to be responsible for transport and conversion, so dampness accumulates
and soaks into the lung.
- The accumulation of damp phlegm and the consequent inhibited the lung-qi finally
result in this syndrome.
Clinical manifestations :
- Cough with profuse thin sputum, easy to be expectorated, sensation of oppression
and fullness in the chest, or dyspnoea with rumbling of sputum in the throat, pale
tongue with white and greasy fur, slippery pulse.
- This syndrome may be found in chronic bronchitis, bronchiectasis, bronchial asthma,
and pulmonary abscess.
C) Differentiation of Spleen Syndromes in Disease.
Spleen disease is mainly characterized by deficiency of the spleen-qi, dysfunction
of the spleen in transport and transformation, and the consequent stagnation of
wetness and failure of the spleen to govern blood.
1) Insufficiency of the Spleen-Qi.
It refers to the signs and symptoms caused by the weakness of the spleen-qi that
makes the spleen fail in transport and transformation.
Etiopathology :
- It is brought about by irregular diet and weariness due to over thinking, or by
impairment of the spleen due to prolonged illness.
- When the spleen-qi is deficient, the function of transport and transformation will
decline, and consequently, the function of digestion will be reduced, the production
of qi and blood will not be promoted and the dampness will be stored up within the
body, thus this syndrome appears.
Clinical manifestations :
- When the spleen-qi is deficient, the function of transport and transformation will
decline, and consequently, the function of digestion will be reduced, the production
of qi and blood will not be promoted and the dampness will be stored up within the
body, thus this syndrome appears.
- This syndrome is often found in chronic gastritis, chronic enteritis, chronic hepatitis,
cirrhosis of liver, gastrointestinal dysfunction and peptic ulcer, etc.
2) Insufficiency of the Spleen-Yang.
It refers to the signs and symptoms of the failure of the spleen in transport and
transformation because of the insufficiency and decline of the spleen-yang.
Etiopathology :
- This syndrome is developed from the syndrome of spleen-qi insufficiency that affects
yang.
- In some cases, it is caused by eating cold food and the coldness attacks and impairs
the spleen-yang.
- When the spleen yang is declining, the spleen is dysfunction in transport and transformation,
and unable to warm up.
- So coldness comes up internally and yin cold gets exuberant, hence the cold syndrome
of insufficiency of the spleen yang occurs.
Clinical manifestations :
- Poor appetite, abdominal distention and dull abdominal pain with preference for
warmth and pressing, clear and loose stool, intolerance of coldness, cold extremities,
dropsical limbs, profuse and leucorrhea, plump pale tongue with white fur, deep
and feeble pulse.
- This syndrome is found in chronic gastritis, gastric and duodenal ulcer, functional
disorder of the stomach and the intestines, chronic enteritis, chronic hepatitis,
cirrhosis of liver and chronic nephritis, etc.
3) Sinking of Qi of the Middle-jiao.
This syndrome refers to the signs and symptoms that occur when the spleen-qi is
so insufficient that, instead of lifting up, it falls abnormally.
Etiopathology :
- It is often due to the further development of insufficiency of the spleen-qi, or
due to prolonged diarrhea, or dysentery, or due to overstrain and impairment of
the spleen-qi.
- Insufficiency of the spleen and its inability to lift up may lead to the abnormal
sinking of clear qi and prolaps of the viscera,
Clinical manifestations :
- Epigastric sag and distention which becomes more serious after meals or work, continuous
diarrhea and dysentery, prolapse of the anus, prolapse of the uterus, gastroptosis,
nephroptosis, vertigo and blurred vision, weariness, shortness of breath, unwillingness
to speak, pale tongue with white fur, feeble pulse.
- This syndrome is found in chronic enteritis, chronic dysentery, and functional disorder
of the intestine and prolapsed of the viscera.
4) Failure of the spleen to keep the blood flowing within the vessels.
This syndrome is caused by insufficiency of the spleen qi which leads to the spleen’s
inability to keep blood flowing within the blood vessels.
Etiopathology :
- It is brought about in most cases, by prolonged illness, or by impairment of the
spleen due to overstrain.
- The insufficiency of the spleen qi makes the spleen unable to govern blood so that
the blood leaks out instead of running in the vessels.
- Therefore, various signs and symptoms of bleeding occur.
Clinical manifestations :
- Hemafecia, hematuria, subcutaneous hemorrhage, menorrhagia, metrorrhagia, and metrostaxis,
accompanied with dull complexion, weariness shortness of breath, unwilling to speak,
poor appetite, loose stools, pale tongue, thread and feeble pulse.
- This syndrome is found in thrombocytopenic purpura, allergic prpura, aplastic anemia,
and dysfunctional uterine bleeding.
5) Splenic disorder due to retention of cold dampness.
This syndrome is caused by the excessive cold dampness which leads to the dysfunction
of the spleen yang.
Etiopathology :
- It is due to improper diet, over eating of cold food and consequent retention of
cold dampness in the spleen or due to wading in water during rain, or due to living
in damp places so that dampness penetrates into the body.
- When cold-dampness gets excessive, it will block the spleen-yang; the dysfunction
of the spleen yang, in turn, will result in the stagnation of dampness, the obstruction
of functional activities of qi and the disorder of the spleen and stomach in ascending
and descending.
Clinical manifestations :
- Sensation of fullness in the abdomen, stickiness in the mouth, anorexia, loose stool,
nausea and readiness to vomiting, feeling heavy in the head and body, dusky yellow
complexion or yellow tint of the skin, pale tongue with white greasy fur, relaxed
and soft pulse.
- This syndrome is found in chronic gastritis, chronic enteritis, and chronic hepatitis,
cirrhosis of liver and chronic nephritis.
6) Retention of Damp-heat in the Spleen
This syndrome indicates symptoms caused by the stagnation of damp-heat pathogens
in the middle-jiao.
Etiopathology :
- It occurs as a result of exogenous affection of pathogenic damp-heat, or by overeating
fat, sweet food or milk products, or over drinking alcohol so that damp-heat is
generated internally.
- When damp-heat stagnates in the middle-jiao, obstructs the function of the stomach
and the spleen, and affects the liver, the gallbladder and the skin, it will inevitably
lead to the failure of the spleen and the stomach in transport and digestion, to
their failure to ascend and descend normally, and to the impaired dispersion of
the liver and gallbladder.
Clinical manifestations :
- Sensation of oppression and fullness in epigastrium, nausea, anorexia, heavy sensation
in limbs and body, sticky and bitter taste in the mouth, yellow brown tint of the
skin and sclera, hectic fever not relieved after sweating, loose and foul stool,
scanty and brownish urine, red tongue with yellow and greasy fur, rapid and soft
pulse.
- It is found in acute hepatitis, acute cholecystitis, etc.
D) Differentiation of Syndromes in Liver Disease.
- Pathologic changes of the liver are mainly manifested as disorder in governing the
flow of qi and storing blood.
- Common symptoms often appear in the liver region, emotions, tendons, eyes, and the
place where its channels pass
1) Stagnancy of the Liver-qi.
It refers to signs and symptoms when the liver fails to govern the flow of qi so
that the functional activities of qi stagnate.
Etiopathology :
- It is caused, in most cases, by emotional depression and anger which lead to the
disorder of the flow of liver-qi.
- Stagnation of the liver-qi is unfavorable for its activities, or even liable to
cause stagnation of qi, accumulation of sputum and blood stasis.
Clinical manifestations :
- Distending pain in the hypochondrium and in the lower abdomen, sensation of oppression
in the chest, preference for sighing, depression or anger, and taut pulse.
- In some cases, globus hystericus in the throat, or goiter in the neck.
- In cases of women, distending pain in the breasts, dysmenorrheal and irregular menstruation.
- This syndrome is found in chronic hepatitis, chronic cholecystitis, chronic gastritis,
gastric ulcer and duodenal ulcer, menopausal syndrome and neurosis.
2) Flaming-up of Liver-fire.
This syndrome is caused by the adverse flow of qi and fire in the liver channel.
Etiopathology :
- When one feel depressed, depression of the liver will generate pathogenic fire,
sometimes, pathogenic fire heat will attack the liver channel.
- In both cases, this syndrome will occur.
- As qi and fire rise along the channel, signs and symptoms of sthenic fire in the
head, eyes, and the regions of the liver channels circulation will appear.
Clinical manifestations :
- Dizziness, distending pain in the head, flushed face, conjunctival congestion, bitter
taste and dryness in the mouth, irritability, burning pains in the chest and hypochondrium,
insomnia and dreaminess, sudden tinnitus and deafness, dry stool and yellow urine,
nose bleeding and hematemesis, red tongue with yellow fur, taut and rapid pulse.
- This syndrome is often seen in essential hypertension, inflammation in the hepato-biliary
system, menopausal syndrome, bleeding of the upper digestive tract and acute conjunctivitis.
3) Deficiency of the Liver Blood.
It refers to symptoms caused by the deficiency of the liver blood.
Etiopathology :
- It is due to deficiency of the spleen and stomach which results in insufficient
production and digestion or due to over bleeding, or exhaustion by prolonged illness.
- If the liver blood is deficient, the head, eyes, tendons and channels, nails, muscle
and skin will not be properly nourished.
Clinical manifestations :
- Dizziness, tinnitus, dull and sallow complexion, emaciation, dryness in the eyes,
poor eyesight, night blindness, numb limbs and tense tendons, pale nails, trembling
of hands and feet.
- In case of women, menstruation with scanty and light colored discharge, or even
amenorrhea, pale lips and tongue with white fur, taut and thready pulse.
- This syndrome is found in chronic hepatitis, anemia, neurosis, night blindness,
and menstrual disorder.
4) Deficiency of the Liver-Yin.
It occurs when there is not enough yin-fluid in the liver.
Etiopathology :
- When one is in low spirits, liver depression will bring about fire so as to impair
yin.
- Sometimes, prolonged liver disease and febrile diseases may lead to the impairment
of the liver-yin; sometimes, the liver (wood of the five elements) may not be moistened
by the kidney water because of deficiency of the kidney yin.
- All these mentioned above may give rise to this syndrome.
- Deficiency of the liver yin not only makes it impossible for the liver to be nourished
but also impossible for yin to control yang, so fire of asthenic type comes up inwardly.
Clinical manifestations :
- Dizziness, tinnitus, dryness of the eyes, blurred vision, scorching sensation of
the face, dysphoria with feverish sensation in the chest, palms and soles, hectic
fever and night sweat, trembling of hands and feet, red tongue with little saliva,
taut rapid and thread pulse.
- This syndrome is found in hypertension, eye diseases, chronic hepatitis, neurosis,
and menopausal syndrome.
5) Hyperactivity of Liver yang.
It refers to symptoms caused by the hyperactivity of the liver yang due to yin deficiency
of liver and kidney.
Etiopathology :
- The yin deficiency of the liver and kidney leads to hyperactivity of liver yang.
- Anxiety causes excessive dispersion of the liver qi which may cause hyperactivity
of the liver yang.
- As well as impairment of yin of the liver and kidney.
- All these may bring about this syndrome characterized by excess in the upper and
deficiency in the lower part of the body, and excess of yang and deficiency of yin.
Clinical manifestations :
- Dizziness, tinnitus, distending pain in the head and eyes, flushed face, congested
eyes, vexation, lassitude in the loins and legs, feeling heavy in the head, insomnia,
and dreaminess, amnesia, reddened tongue, forceful and taut pulse or thread pulse.
- This syndrome is found in hypertension, neurosis, menopausal syndrome, hyperthyroidism
and anemia.
6) Up-stirring of Liver wind.
- Serious dizziness, convulsions, trembling, and numbness, all these are characteristic
of the signs and symptoms of this syndrome.
- It is usually classified as wind syndrome caused by hyperactivity of the liver-yang,
wind syndrome due to extreme pathogenic heat, wind-stirring syndrome caused by yin
deficiency, and endopathic wind due to blood deficiency.
Etiopathology :
- Wind syndrome caused by hyperactivity of the liver yang is often associated with
long-standing yin deficiency of the liver and kidney, which makes the abnormal rising
of the liver-yang so uncontrollable that liver-wind is stirred, so wind syndrome
occurs.
- Wind syndrome due to pathogenic heat is brought about by excess of pathogenic heat
which ignites the liver channel.
- The syndrome of wind-stirring caused by yin deficiency occurs in most cases at the
late period of febrile diseases in which yin-fluid has been exhausted, tendons and
vessels are not nourished and wind is stirred.
- The syndrome of endopathic wind caused by blood deficiency is due to loss of blood,
or blood deficiency on account of prolonged illness as tendons cannot be nourished
by blood.
Clinical manifestations :
- In wind syndrome caused by hyperactivity of the liver yang: serious dizziness, feeling
heavy in the head, and headache when one shakes one's head, stiff neck and numb
limbs, trembling of hands and feet, inarticulateness, red tongue, taut and thready
pulse, sometimes, sudden fall into a swoon with contraction of hands and feet, or
convulsion, facial paralysis, and hemiplegia.
- In occurrence of wind syndrome in case of overabundance of pathogenic heat: high
fever and coma, stiffness of the neck, convulsion, opisthotonos with eyes looking
upward, and teeth closed tightly, deep red tongue with yellow fur, taut and rapid
pulse.
- In wind-stirring syndrome caused by yin deficiency: hands and feet trembling accompanied
with symptoms of deficiency of the liver-yin.
- In endopathic wind syndrome caused by blood deficiency: numbness of the limbs and
stiffness of the joints, trembling of hands and feet accompanied with symptoms of
deficiency of the liver blood.
- This syndrome is found in hypertension, cerebrovascular accident, epilepsy, hyperpyretic
convulsion, encephalitis, epidemic encephalomyelitis fever and some diseases of
nervous system.
7) Accumulation of Cold in the Liver Channel.
It refers to symptoms caused by the stagnation of pathogenic cold in the liver channel.
Etiopathology :
- It is brought about by affection of cold pathogens.
- When pathogenic cold accumulates and obliterates the liver channel, yang-qi will
be impeded, so there will be muscular spasm and impeded circulation of blood and
qi.
Clinical manifestations :
- Distending, dragging and cold pain in the pudendum and the lower abdomen, or pain
from contraction of scrotum which becomes more serious when that region is exposed
to cold, but becomes relieved when that region is warmed, white and slippery coating
of the tongue, deep taut or slow pulse.
- This syndrome is found in inguinal hernia, tuberculous orchitis, and intestinal
adhesion.
8) Dampness and Heat in the Liver Channel.
This arises from stagnation of dampness and heat in the liver channel.
Etiopathology :
- It occurs usually because of exogenous affection of damp-heat, or because of overeating
sweet and greasy food, which generates damp-heat; or because of the spleen's failure
in transport and transformation with production of dampness which transforms into
damp-heat.
- Stagnation of damp heat in the liver channel is unfavorable for the dispersion of
the qi of the liver and the gallbladder.
- It may also lead to the disorder in ascending and descending function of the spleen
and stomach, resulting in the disorder of digestion and transformation.
Clinical manifestations :
- Distending pain in the hypochondrium, anorexia, sensation of fullness in the abdomen,
bitter taste in the mouth, nausea and vomiting tendency, yellow sclera and skin,
alternate attacks of chills and fever, swelling and hot pain in the testis.
- In women cases, marked by foul and yellow-colored leukorrhagia and itch in the vulva,
red tongue with yellow and greasy fur, rapid and taut pulse.
- Swollen tongue with white fur, deep and thready pulse.
- This syndrome is found in adrenocortical failure, chronic nephritis, chronic enteritis,
sexual neurosis, and hypothyroidism.
9) Deficiency of the Kidney-Yin.
This syndrome occurs when yin-fluid in the kidney becomes insufficient
Etiopathology :
- It results from impairment of the kidney due to overstrain of sexual intercourse
and prolonged illness, or from impairment of the kidney-yin due to febrile disease
at its late period.
- If the kidney-yin is deficient, the viscera and the body will not be nourished,
brains marrow and bones will not be replenished. Therefore, asthenic heat will be
produced in the interior and results in hyperactivity of ministerial fire.
Clinical manifestations :
- Lassitude in the loins and knees, dizziness, and tinnitus, insomnia, amnesia, dysphoria
with feverish sensation in the chest, palms and soles, dry mouth and throat, hectic
fever and night sweating, emaciation.
- In cases of male, penis erecting easily, nocturnal emission or oligospermia.
- In cases of female, dream of intercourse, scanty menstruation, amenorrhea, or metrorrohagia,
and metrostaxis, red tongue with little fur, thready and rapid pulse.
- This syndrome is found in tuberculosis, diabetes mellitus, sterility, sexual neurosis,
and chronic nephritis.
10) Deficiency of the Kidney Essence.
This syndrome is caused by the exhaustion of the kidney essence.
Etiopathology :
- It occurs because of congenital deficiency or poor-nourishment after birth, or because
of overstrains which leads to deficiency of the kidney essence and the decline of
reproductive function, or because of retarded growth in children and senilism in
adults.
Clinical manifestations :
- Retarded growth in children, blunt in mentality and activity, rickets, late closure
of fontanel.
- In cases of adult’s, senilism, alopecia, shaken teeth, dull looking, tinnitus or
deafness, amnesia, flaccidity of feet.
- In cases of males, oligospermia, sterility.
- In cases of females, amenorrhea, sterility, lowered sexual function.
- This syndrome is found in hypothyroidism, anterior pituitary hypo function, and
malnutrition in children.
- Un consolidation of the Kidney yin
- This syndrome indicates symptoms arising from insufficiency of the kidney-qi with
decline of its reinforcing and astringent functions.
Etiopathology :
- This syndrome is present in old people whose kidney-qi becomes deficient, or in
youth whose kidney-qi is not yet reinforced.
- Sometimes, it is also brought about by impairment of the kidney-qi due to excessive
sexual intercourse and prolonged illness.
- These impair the reinforcing and astringent functions of the kidney and make it
impossible for the kidney to be responsible for the preservation of qi and essence.
- Moreover, the loss of control of the urinary bladder and anus, debility of the essence
gate and chong and ren channels occur.
Clinical manifestations :
- Fatigue, tinnitus, lassitude in the loins and knees, frequent and clear urine, or
dripping urine, enuresis, incontinence of urine, polyuria at night; incontinence
of feces, or lingering diarrhea; in cases of males, emission, premature ejaculation;
in case of females, thin and profuse menses, metrostaxis, threatened abortion; pale
tongue, deep and thready pulse.
- This syndrome is found in senility, late stage of chronic nephritis, enuresis, diabetes
insipidus, and sexual neurasthenia.
11) Failure of the Kidney to maintain normal inspiration.
This syndrome refers to symptoms caused by deficiency of the kidney-qi, and its
failure to keep the breathing qi into the kidney.
Etiopathology :
- It occurs to the patients with prolonged cough and dyspneoa when the asthenia of
the lung has affected the kidney.
- It is also because of congenital deficiency, or asthenia of the kidney at old age,
or impairment of the kidney by overstrains.
- When the kidney-qi is deficient, it is unlikely to maintain normal inspiration,
thus causing shortness of breath and dyspneoa.
Clinical manifestations :
- Shortness of breath or dyspneoa, breathing out more than breathing in, broken respiration
which becomes more serious with movement, spontaneous perspiration, listlessness,
low voice, lassitude in the loins and knees, pale tongue with white fur, deep and
feeble pulse.
- This syndrome is found in pulmonary emphysema, cor-pulmonale, chronic congestive
heart failure, prolonged illness and senility.
12) Differentiation of Syndromes in Stomach Disease.
- Pathologic changes of the stomach are characterized by functional disorder of receiving
food and digestion, and adverse flow of the stomach-qi.
- Deficiency of the Stomach-Yin
- It arises from deficiency of the stomach-yin.
Etiopathology :
- It occurs because of prolonged stomach heat and stagnation of the liver-qi which
turns into fire, or because of overeating warm and dry food resulting in the impairment
of the stomach-yin.
- When there is not enough the stomach-yin for nourishment, the disorder or adverse
flow of the stomach-qi will occur.
Clinical manifestations :
- Dull stomachache, gastric discomfort with acid regurgitation, hungry but unwilling
to eat; dry mouth and throat, dry stool, feeling of fullness in the upper abdomen
retching and hiccup, red tongue with little fur, thready and rapid pulse.
- This syndrome is found in atrophic gastritis, diabetes mellitus, and febrile disease
at its late stage, and gastric neurosis.
13) Retention of indigested Food in the Stomach
This syndrome indicates the manifestation due to retention of indigested food in
the stomach.
Etiopathology :
- As improper diet, excessive eating or drinking, and deficiency of the stomach-qi
lead to indigestion, functional activities of qi will be obstructed and it will
fall into disorder, unable to descend. Consequently, this syndrome will occur.
Clinical manifestations :
- Oppression, fullness, or even pain in the epigastrium, eructation with fetid odor
and acid regurgitation, distending pain relieved after vomiting, borborygmus, putrid
and offensive smelling stool, thick and greasy fur, slippery pulse.
- This syndrome is often found in indigestion and acute gastritis.
14) Cold Syndrome of the Stomach.
It refers to signs and symptoms caused by stagnation of coldness in the stomach.
Etiopathology :
- When the gastric region is attacked by coldness, or excess intake of cold food,
pathogenic cold will accumulate in the stomach, and the stomach-yang will be hindered.
- Overstrain and prolonged illness may also induce deficiency of stomach-yang.
- In that case, the stomach is affected with pathogenic cold, and it will lose warmth,
so yin-cold will become excessive.
- Stagnation of cold will lead to that of qi; retention of fluid will bring forth
the decline of qi as a result, this syndrome occurs.
Clinical manifestations :
- Cold pain in epigastrium, which lingers if it is not so serious, but becomes severe
when accompanied with the affection of coldness, and gets alleviated when warmed;
weariness; intolerance of coldness; cold limbs; in the case of stomachache, the
pain relieved when pressed, or after taking some food, rumbling sound of water in
the epigastrium, regurgitation of some clear fluid, pale tongue with white and slippery
fur, slow or taut pulse.
- This syndrome is found in chronic gastritis, gastric and dudenal ulcer, and pyloric
obstruction.
15) Heat Syndrome of the Stomach
It is heat syndrome of sthenic type caused by exuberance of stomach-fire.
Etiopathology :
- It occurs as the stomach is attacked by pathogenic heat, the five emotions overact,
or depression of qi generates fire and affects the stomach, or one has eaten too
much pungent, hot and dry food.
- Fire-heat gathers and stagnates in the stomach, burns the body fluid so as to set
the stomach-qi steaming up; consequently, the symptoms of excessive fire-heat occur.
Clinical manifestations :
- Feelings of hungry, preference for cold drinks, burning pain in the epigastrium,
foul smell in the mouth, dry stool, swelling in the gums, erosion of lips, gum bleeding,
red tongue with yellow fur, slippery and rapid pulse.
- This syndrome is found in acute gastritis, diabetes mellitus, periodontitis, and
ulcerations of oral cavity.
E) Differentiation of Syndromes in Gallbladder Disease.
- As the gallbladder is located under the liver, the diseases developed from the two
organs usually occur simultaneously.
- Gallbladder diseases are usually manifested as inability of decision.
1) Disturbance of Phlegm due to Stagnation of the Gallbladder
It is caused by stagnation of the gallbladder-qi and interior disturbance of phlegm-heat.
Etiopathology :
- When one is dejected, his gallbladder will fail to regulate the dispersion of qi.
- So stasis of qi will generate phlegm and fire, thus causing internal disturbance
by phlegm-fire and the upset of gallbladder.
- These symptoms are often manifestations of disorders in neuropsychiatric system.
Clinical manifestations :
- Vexation and restlessness, palpitation with fear, insomnia, timidity and hesitation,
bitter taste in the mouth, oppression in the chest and fullness in the hypochondrium,
vertigo, tinnitus, yellow and greasy coating of the tongue, taut and slippery pulse.
- This syndrome is found in neurosis, Meniere's disease, hypertension, and menopausal
syndrome, etc.
2) Differentiation of Syndromes in Large Intestine Disease.
Pathologic changes of the large intestine consist of the large intestines failure
in transport and the subsequent irregular defecation.
Etiopathology :
- This syndrome arises because the large intestine is affected with damp-heat pathogens,
or because improper diet produces damp-heat.
- Diarrhea comes from invasion of damp-heat into the large intestine leading to the
disorder of its transportation.
- If accumulated damp-heat cannot be dissolved, if it impairs intestine vessels, there
will be stagnation and deterioration of qi and blood.
- Consequently, this will cause symptoms such as mucus pus and blood in the stool,
and dysentery.
Clinical manifestations :
- Pain in the abdomen, abrupt and violent diarrhea with foul smell and yellow color,
or dysentery with mucopus or blood in the stool and tenesmus, hot sensation in the
anus, scanty and dark urine, fever, thirst, red tongue with yellow and greasy fur,
slippery and rapid pulse.
- This syndrome is often found in acute enteritis, acute bacillary dysentery, acute
episode of chronic dysentery and amebic dysentery.
3) Deficiency of fluid in the Large Intestine.
This refers to symptoms in which the fluid of the large intestine is too deficient
to nourish the large intestine.
Etiopathology :
- It results from deficiency of yin-blood in old people, exhaustion of yin-blood in
febrile disease, or post-partum hemorrhage.
- When yin-blood is in deficiency, the large intestine will not be properly moistened
this is unfavorable for transportation, so very dry stool results.
Clinical manifestations :
- Dry stool and difficulty in defecation, or only one bowel movement in several days,
dry mouth with foul smell, dizziness, red tongue with little saliva and dry yellow
fur, thready and uneven pulse.
- This syndrome is found in habitual constipation, convalescence of inflammation of
the intestinal canal, or in constipation that occurs to patients with anorectal
diseases or febrile diseases.
4) Lingering Diarrhea due to Asthenia of the Large Intestine.
This syndrome refers to symptoms caused by insufficiency of yang-qi of the large
intestine and the subsequent out of in defecation.
Etiopathology :
- Prolonged diarrhea and dysentery will impair yang-qi, which leads to insufficiency
and exhaustion of yang-qi of the spleen and the kidney, the large intestine's loss
of reinforcement and restraint, the abnormal fall of clear qi, and the incontinence
of lingering diarrhea.
Clinical manifestations :
- Severe diarrhea, incontinence of feces, prolapse of the anus, dull pain in the abdomen
relieved by pressing and warmth, pale tongue with white and slippery fur, deep and
feeble pulse.
- This syndrome is found in chronic enteritis, chronic dysentery and ulcerative colitis.
F) Differentiation of Syndromes in the Small Intestine Disease.
1) Excessive Heat in the Small Intestine
It refers to symptoms and sign of excessive heat in the small intestine.
Etiopathology :
- Excessive heat of the small intestine comes from fire that is generated by five
emotions, or from exogenous affection of fire-heat pathogens, or from excessive
heart-fire that moves along the channel down into the small intestine.
- This syndrome is mainly manifested as abnormal micturation.
Clinical manifestations :
- Scanty and dark urine, burning pain in micturation, hematuria, flushed face, thirst,
insomnia and irritability, aphthae of mouth and tongue, red tongue, tip with yellow
and dry fur, and rapid pulse.
- This syndrome is found in urinary infection, neurasthenia and ulcer in the oral
cavity.
G) Differentiation of Syndromes in Bladder Disease.
1) Damp-Heat in the Bladder
This syndrome occurs when damp heat accumulates in the bladder.
Etiopathology :
- This syndrome is due to exogenous affection of damp-heat pathogens and improper diet which gives rise to internal production of damp-heat, and its invasion into the bladder.
- When damp-heat stagnates, the abnormal activities of the bladder will affect the urethra and the kidney, thus inducing abnormality in micturation.
Clinical manifestations :
- Frequent micturation, dripping and difficulty in micturation with burning pain in urethra; yellowish and turbid urine, hematuria, calculi in urine accompanied with fever and pain in the waist, red tongue with yellow fur, rapid pulse.
- This syndrome is found in urinary infection, urinary calculi and prostatitis.