This is a method to analysis and differentiating the syndromes of qi and blood according
to their physiological and pathological features.
It includes the differentiations of syndromes in qi-disease, blood-disease and qi-blood-disease.
1) Differentiation of Syndromes in Qi-disease
- Qf-disease refers to the syndromes of the abnormal movement of the human body's
functional activities.
- Common syndromes of qi-disease are found in deficiency of qi, collapse of qi, reversed
flow of qi and stagnation of qi.
a) Deficiency of Qi
Deficiency of qi is a syndrome that will occur when the functions of the zang-organs
and fu-organs have weakened.
Etiopathology :
- It is often caused by prolonged illness, or serious diseases, or by qi-impairment
due to overstrain, senile decay and vital-qi decline.
- Qi is regarded as the motivating force for the zang-organs and fu-organs to function
perfectly. Deficiency of qi will lead to the functional decline of the zang-organs
and fu-organs, hence the symptoms and signs involved.
Clinical manifestations :
- Listlessness, lassitude, shortness of breath, unwillingness to speak, dizziness
and blurred vision, spontaneous perspiration, pale tongue and weak pulse.
- All these symptoms become more severe after movements.
- • The syndrome of deficiency of qi is usually found in some chronic diseases, or
in weak constitutions, or during the restoration stage of some acute diseases.
b) Collapse of Qi
It refers to the syndrome that qi is so deficient that it falls instead of rising.
Etiopathology :
- It arises from qi deficiency, or overstrains which leads to the impairment of the
visceral-qi.
- As qi is too weak to rise, the viscera cannot be consolidated and clear qi cannot
ascend.
- Consequently, such symptoms as visceral prolapse and clear-qi-falling will show
up.
Clinical manifestations :
- Tiredness, shortness of breath, dizziness and blurred vision, prolonged diarrhea
and dysentery, bowels being lapse and full, prolapse of the rectum, prolapse of
the uterus; gastroptosis, nephroptosis, pale tongue and feeble pulse.
- The syndrome of collapse of qi may be found in prolapse of the viscera, such as
prolapse of the rectum, gastroptosis, prolapse of the uterus, nephroptosis, chronic
enteritis, and chronic dysentery, disorder of the bowels function, myasthenia gravis,
hypotension and others.
c) Reversed Flow of Qi
- This syndrome occurs when disorder of qi in ascending and descending results in
the upward adverse flow of qi.
- Clinical manifestations indicate that the reversed upward flow of qi is mostly from
the lung, stomach and liver.
Etiopathology :
- Reversed upward flow of the lung-qi is, in most cases, due to the affection of exopathogens,
or to stagnation of phlegm in the lung so that it is unable to keep dispersing and
descending.
- Reversed upward flow of the stomach-qi is also caused by exopathogens, or by indigestion,
phlegm retention of cold type and stagnation of phlegm in the stomach which leads
to its disorder, and failure of the stomach-qi to descend.
- In addition, reversed upward flow of the liver-qi results from the disorder of the
liver brought about by depression and anger so that the liver-qi is too highly activated,
that qi and fire travel reversely upward.
Clinical manifestations :
- When the lung-qi travels upward adversely, cough and dyspnea; when the stomach-qi
flows upward reversely, hiccup, eructation, nausea and vomiting; when the liver-qi
travels upward adversely, dizziness and painful distension in the head, or even
syncope, hematemesis and so on in some serious cases.
- The syndrome of reversed flow of qi may be found in bronchitis, pneumonia, asthma,
gastritis, peptic ulcer, neurosis, ?????postural vertigo, primary hypertension,
cerebrovascular accident, etc.
d) Stagnation of Qi
This syndrome arises from the obstruction of functional activities of qi in some
part of the human body, or in some of the zang-organs and fu-organs.
Etiopathology :
- The unsmooth movement or stagnation of qi may be caused by emotional depression,
irregular eating, and affection by exopathogens, or phlegm retention, blood stasis
and other accumulation of pathological substance in the body.
- Thus, the symptoms due to stagnation of qi may occur.
Clinical manifestations :
- Oppression and distending, tin ????? localized and fluctuating pain in the chest,
hypochondrium and????? abdomen, which will subside after eructation, fart and borborygmus,
but will be aggravated when the patient feels depressed.
- This syndrome may be found in neurosis, chronic gastritis, peptic ulcer, chronic
cholecystitis and chronic hepatitis.
2) Differentiation of Syndromes in Blood-disease
- Blood-disease is identified as blood deficiency and the disorder of its circulation.
- Its common syndromes comprise deficiency of blood, blood stasis, blood-heat and
blood-coldness.
a) Deficiency of Blood
Deficiency of blood refers to the insufficient blood supply in which the zang fu
organs, channels and collaterals, and the tissues fail to be nourished.
Etiopathology :
- Chronic and acute bleedings in various forms, hypofunction of the spleen and stomach,
weariness caused by over thinking, impairment of prolonged illness, homatopoietic
disorder due to internal stagnation of blood all these may result in deficiency
of blood, malnutrition of the interal organs and tissues in the whole body.
Clinical manifestations :
- Pale, dim or sallow complexion; pale lips, tongue and fingernails; dizziness and
blurred vision; palpitation, insomnia, numbness of limbs, rough skin; laypomenorrhea
with light color; delayed menstruation or amenorrhea; thready and feeble pulse.
- This syndrome is often seen in many kinds of chronic and consumptive diseases, anemia,
neurasthenia and irregular menstruation.
b) Blood Stasis
- This syndrome occurs as a result of unsmooth circulation, or stagnation of blood
and retention of bled blood inside of the body.
Etiopathology :
- It usually results from qi stagnation, qi deficiency and accumulation of pathogenic
coldness.
- Qi stagnation leads to the blocking of blood circulation; qi deficiency, to the
weakness in blood circulation; accumulation of pathogenic coldness, to unsmooth
blood flow; retention of bled blood inside of the body, to obstruction of the circulation
of qi and blood.
- Consequently, the syndrome of blood stasis characterized by pains, cakings???, bleeding
and dark purple lips and tongue will occur.
Clinical manifestations :
- Stabbing pain fixed at certain region and aggravated by pressing or at night; hard
and fixed masses in the abdomen; subcutaneous hematoma and pelidnoma?????; bleeding
of caked and dark purple blood; darkish complexion, squamous and dry skin, cyanotic
lips and nails, amenorrhea in women's cases; dark purple tongue or if with ecchymoses
and petechiae, thready and uneven pulse.
- This syndrome is usually found in angina pectoris, tumor, purpura, hepatosplenomegaly,
hemorrhagic diseases, Buerger's disease, dysmenorrhea, exfetation ???and blood stasis
due to trauma.
c) Blood-Heat
This refers to signs and symptoms which will occur when Vpathogenic excessive fire
spreads to the blood.
Etiopathology :
- Affection by exogenous heat and fire brought about by disorder of five emotions,
alcohol, pungent food as well as internal burning of pathogenic fire affecting \
blood — all these may give rise to the syndrome of blood-heat, which, in turn, causes
blood to circulate so rashly and wildly that it will inevitably bleed, hence various
bleeding syndromes.
Clinical manifestations :
- Hemoptysis, hematemesis; bleedings from the eye, ear, nose, mouth or subcutaneous
tissues;( hematuria, hematochezia, preceded menstral cycle, menorr' hagia, vexation;
thirst; crimson tongue, slippery and rapid' pulse.
- This syndrome is seen in bleedings caused by allergic purpura, thrombopenic purpura,
leukemia, epidemic hemorrhagic fever, bronchiectasis, pneumonia and bronchitis,
acute gastritis, rupture of esophageal varicose vein, acute nephritis, urinary infection
and stone.
d) Blood-Cold
The signs and symptoms of this syndrome indicate the accumulation of pathogenic
cold in the blood vessels, which N../ causes the blood to flow unsmoothly.
Etiopathology :
- This syndrome occurs when stagnation of affected pathogenic cold in the blood vessels
results in obstruction of yang-qi and stagnation of qi and blood.
- Darkish complexion, squamous and dry skin, cyanotic lips and nails, amenorrhea in
women's cases; dark purple tongue or if with ecchymoses and petechiae, thready and
uneven pulse.
- This syndrome is usually found in angina pectoris, tumor, purpura, hepatosplenomegaly,
hemorrhagic diseases, Buerger's disease, dysmenorrhea, exfetation and blood stasis
due to trauma.
3) Blood-Heat
This refers to signs and symptoms which will occur when Vpathogenic excessive fire
spreads to the blood.
Etiopathology :
- Affection by exogenous heat and fire brought about by disorder of five emotions,
alcohol, pungent food as well as internal burning of pathogenic fire affecting \
blood — all these may give rise to the syndrome of blood-heat, which, in turn, causes
blood to circulate so rashly and wildly that it will inevitably bleed, hence various
bleeding syndromes.
Clinical manifestations :
- Hemoptysis, hematemesis; bleedings from the eye, ear, nose, mouth or subcutaneous
tissues;( hematuria, hematochezia, preceded menstral cycle, menorr' hagia, vexation;
thirst; crimson tongue, slippery and rapid' pulse.
- This syndrome is seen in bleedings caused by allergic purpura, thrombopenic purpura,
leukemia, epidemic hemorrhagic fever, bronchiectasis, pneumonia and bronchitis,
acute gastritis, rupture of esophageal varicose vein, acute nephritis, urinary infection
and stone.
4) Blood-Cold
The signs and symptoms of this syndrome indicate the accumulation of pathogenic
cold in the blood vessels, which N../ causes the blood to flow unsmoothly.
Etiopathology :
- This syndrome occurs when stagnation of affected pathogenic cold in the blood vessels
results in obstruction of yang-qi and stagnation of qi and blood.
- Aversion to pressing, distending pain in the breast before menstruation, dysmenorrhea,
dark purple menstruation with blood lumps, or amenorrhea in a serious case, dark
purplish tongue with petechiae, taut and uneven pulse.
- This syndrome is found in chronic hepatitis, cirrhosis, coronary heart disease,
gastric and duodenal ulcer, neurosis and dysmenorrhea.
a) Deficiency of both Blood and Qi
Etiopathology :
- Prolonged illness will give rise to deficiency of qi and blood; deficiency of blood
will not produce qi, and vice versa.
Clinical manifestations :
- Shortness of breath and unwillingness to speak, fatigue, vertigo, blurred vision,
spontaneous perspiration, palpitation, insomnia, pale or sallow complexion, pale
and tender tongue, thready and feeble pulse.
- This syndrome is seen in anemia, neurasthenia and chronic consumptive diseases.
b) Hemorrhage due -to Deficiency of Qi
Mainly characterized by bleedings, this syndrome arises / from the failure of qi
in deficient condition to govern blood.
Etiopathology :
- Impairment of the spleen due to prolong- led illness and tiredness results in the,deficiency
of qi so that it 1 fails to govern blood. Consequently, the blood flows out of the
blood vessels, causing various syndromes of hemorrhage.
Clinical manifestations :
- Impairment of the spleen due to prolong- led illness and tiredness results in the,deficiency
of qi so that it 1 fails to govern blood. Consequently, the blood flows out of the
blood vessels, causing various syndromes of hemorrhage.
- This syndrome is seen in bleeding caused by dysfunctional uterine bleeding, thrombopenic
purpura, allergic purpura, aplastic anemia, vitamin. deficiency and heart disease.
c) Exhaustion of Qi Resulting from Hemorrhea.
It refers to signs and symptoms of qi exhaustion brought about by hemorrhea.
Etiopathology :
- Such abrupt hemorrhage as trauma, profuse metrorrhagia in delivery, or visceral
damage often brings about this syndrome. Because of excessive bleeding, qi will
find nowhere to attach so it is exhausted.
Clinical manifestations :
- Heavy bleeding, the face suddenly turning pale, profuse sweat, cold limbs, feeble
breath, or even syncope, pale tongue, thready and barely perceptible pulse, or floating
and scattered pulse.
- This syndrome is seen in hemorrhagic shock.