TRADITIONAL CHINESE MEDECINE

a 2500 years old holistic system
The Chinese approach is a more holistic consideration of health and disease and of the delicate interplay between these opposing forces.
The Chinese physician directs his or her attention to the complete physiological and psychological individual.
All relevant information, including the symptom as well as the patient’s other general characteristics, is gathered and woven together until it forms what Chinese medicine calls a “pattern of disharmony.”
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looks at the whole, inter-related web of interactions and relationships
The total configurations, the patterns of disharmony, provide the framework for treatment.
The therapy then attempts to bring the configuration into balance, to restore harmony to the individual.
To Western medicine, understanding an illness means uncovering a distinct entity that is separate from the patient’s being; to Chinese medicine,
understanding means perceiving the relationships among all the patient’s signs and symptoms in the context of his or her life.
The Chinese method is based on the idea that no single part can be understood except in its relation to the whole.
includes modalities such as acupuncture, herbal medicine, various forms of massage and bodywork, exercises, and food therapy
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The key-word in Chinese thought is Order and above all Pattern
Things behave in particular ways not necessarily because of prior actions or impulsions of other things,
but because their position in the ever-moving cyclical universe was such that they were endowed with intrinsic natures which made that behavior inevitable for them. . . .
The Chinese assume that the universe is continuously changing.
Its movement is the result not of a first cause or creator, but of an inner dynamic of cyclical patterns.
Just as the sun maps out four distinct seasons in its yearly round,
so all biological organisms go through four seasons in a lifetime: birth, maturation, decline, and death.
For the Chinese, that web has no weaver, no creator; in the West the final concern is always the creator or cause and the phenomenon is merely its reflection.
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the Chinese think of each person as a cosmos in miniature.
The Yang or fire aspects of the person are the dynamic and transforming,
while the Yin or Water aspects are the more yielding and nourishing.
In each person, as in every landscape, there are signs that, when balanced, define health or beauty.
If the signs are out of balance, the person is ill or the painting does not work.
So the Chinese physician looks at a patient the way a painter looks at a landscape—as a particular arrangement of being, behavior, interaction, and life signs in which the essence of the whole can be seen.
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Yin-Yang theory is based on the philosophical construct of two polar complements, called Yin and Yang.
they are convenient labels used to describe how things function in relation to each other and to the universe.
They are used to explain the continuous process of natural change.
The Yin and Yang are often described metaphorically as Water and fire.
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All things have two facets: a Yin aspect and a Yang aspect.
time can be divided into night and day, place into earth and heaven, season into inactive periods (fall and winter) and active periods (spring and summer),species into female and male, temperature into cold and hot, weight into light and heavy, and so on.
Inside and outside, down and up, passive and active, empty and full are all examples of Yin-Yang categories.

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a.YIN CHARACTERISTICS

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The character for Yin originally meant the shady side of a slope.
It is associated with such qualities as cold, rest, responsiveness, passivity, darkness, interiority, downwardness, inwardness, decrease, satiation, tranquility, and quiescence.
Yin is acceptance, responsiveness, repose, and responsibility.
Illnesses that are characterized by weakness, slowness, coldness, and underactivity are Yin;
In terms of the body, the front is considered Yin and the back Yang.

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b.YANG CHARACTERISTICS

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The original meaning of Yang was the sunny side of a slope.
The term implies brightness and is part of one common Chinese expression for the sun.
Yang is associated with qualities such as heat, stimulation, movement, activity, excitement, vigor, light, exteriority, upwardness, outwardness, and increase.
It is arousal, beginning, and dynamic potential.
terms of the psyche, willfulness, desire, and assertiveness are Yang
illnesses that manifest strength, forceful movements, heat, and overactivity are Yang.
The upper part of the body is considered more Yang than the lower part; the outer parts of the body (skin, hair, etc.)

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c.5 PRINCIPLES

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Any Yin or Yang aspect can be further divided into Yin and Yang.
This means that within each Yin and Yang category, another Yin and Yang category can be distinguished.
For example, temperature can be divided into cold (Yin) and hot (Yang), but cold can be divided further into icy cold (Yin) and moderately cold (Yang).
the body, the front of the trunk is Yin compared with the back, but the front can be divided further so that the abdomen is Yin in relation to the chest.
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Yin and Yang mutually create each other.
Although Yin and Yang can be distinguished, they cannot be separated.
They depend on each other for definition.
For instance, one cannot speak of temperature apart from its Yin and Yang aspects, cold and heat.
Another example might be the relationship between a couple in which one partner can be (relatively) passive only if the other partner is (relatively) aggressive,
Passivity and aggression can be measured only in comparison with each other.
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Yin and Yang control each other.
Yin is excessive, then Yang will be too weak, and vice versa.
If the temperature is neither too cold nor too hot, then both cold and hot aspects are mutually controlled and held in check.
If it is too cold, then there is not enough heat, and vice versa. Yin and Yang balance each other.
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Yin and Yang transform into each other.
It suggests two types of transformations: changes that occur harmoniously, in the normal course of events,
and the sudden ruptures and transformations characteristic of extremely disharmonious situations.
Because Yin and Yang create each other in even the most stable relationships, Yin and Yang are always subtly supporting, repairing, and transforming into each other.
This constant transformation is the source of all change.
It is a give-and-take relationship that is life activity itself.
inhalation is followed by exhalation, or periods of activity and exertion must be succeeded by nourishment and rest.
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A deficiency of one aspect implies an excess of the other.
In clinical practice, one of these three kinds of transformation is always possible.
For example, when a patient has a pattern with very high fever and much sweating (considered an excess of Yang, or fire), the patient may be in danger of suddenly going into shock (an extreme Yin, or Cold, condition).
This is because Yang cannot continue to exist in such extreme relation to Yin without some transformation occurring. Either a gradual transformation, a rebalancing, must take place—medication and healing; or a radical transformation will occur—shock; or Yin and Yang will separate and existence will cease—death.
Harmony means that the proportions of Yin and Yang are relatively balanced; disharmony means that the proportions are unequal and there is imbalance.

• Water, Fire, Wood, Metal and Earth.
Water moistens downwards, Fire flares upwards, Wood can be bent and straightened, Metal can be moulded and can harden, Earth permits sowing, growing and reaping."

•Each element is related to
an organ system,
a set of meridians,
and other characteristics such as color, sound, smell, and emotion.

•5 phases of a cycle and each element describes a point where energy changes
i.e Cyclical of the season.
Winter as Water - energy moves downward, time of rest, represent decay
Spring as Wood - time for grow and expanding out, birth and new beginning
Summer as Fire - Rise upward, connection, growth and expression
Late Summer as Earth - time of balance and nourishment, represent Maturity
Fall as Metal - Time to haverst, declining or maturing state, contraction

•Gives rise to each other
Water gives rise to Wood to Fire to Earth to Metal
From Decay to Birth to Expansion to Maturity to Contraction and back to Decay

• And Control each other
Water puts out Fire; Wood breaks apart Earth; Fire melts Metal; Earth contains Water; Metal cuts Wood.

•Water is the most Yin, cold, dark and slow
Fire is the most Yang, fast, fiery and bright

“The Spleen rules transformation and transportation.”
Most closely associated with Qi and intimate relationship to Blood.
The Spleen is the crucial link in the process by which food is transformed into Qi and Blood.
The Spleen extracts the pure nutritive essences of ingested food and fluids and transforms them into what will become Qi and Blood.
If the Spleen is in disharmony, then the whole body, or some part of it, may develop Deficient Qi or Deficient Blood.
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The Spleen helps to create the Blood
and also governs the Blood in the sense that it keeps the Blood flowing in its proper paths.
If the Spleen Qi is weak, the Spleens governing function loses its harmony, and the Blood can escape its pathways and “move recklessly.”
This leads to symptoms such as vomiting blood, blood in the stool, blood under the skin, menorrhagia, or uterine bleeding.
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“The Spleen stores the Consciousness of Potentials (Yi).”
Spleen is responsible for considerations of options, pondering, possibilities, and making final decisions.
It is the source of motivation and creativity.
If the Spleen is healthy, a person has clear thoughts, can make decisions, and has the insight to faithfully support the needs of other people and situ-ations. A harmonious Spleen enthusiastically engages the world.
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Disharmonies of Spleen
vomiting blood, blood in the stool
worry easily,
have difficulty making decisions,
be mentally unclear and confused,
be excessively helpful,
feel bored and uninterested.
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“The Spleen rules the muscles, flesh and the four limbs.“
Not only is the Spleen the origin of Qi and Blood, but the Spleen also transports these substances to the muscles and flesh.
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“The Spleen opens into the mouth.”
“The Spleen’s brilliance is manifested in the lips.”15
The mouth and lips are closely related to the Spleen.

Most closely connected with the Blood and at the same time tempers and “softens” the Qi
Exquisitely sensitive to boundaries and demarcations and maintains the smoothness and harmony of movement throughout the body.
The Nei Jing metaphorically calls the Liver “the general of an army”17
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“The Liver stores the Blood.”
The Liver’s Blood is responsible for the repetitive cycles of human life.
A woman’s menstrual cycle depends on the Liver’s Blood, and disharmonious Liver Blood can make an irregular or painful menstruation.
This may be accompanied by such digestive problems as abdominal pain, nausea, belching, intestinal rumbling, or diarrhea.*
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“The Liver stores the Non-Corporeal Soul (Hun).”
Because the Non-Corporeal Soul is responsible for human kindness or benevolence, it is sensitive to the boundaries that make for the recognition of self and others.
The acknowledgment of the humanity, whether in others or in oneself, depends on the receptivity of the Hun. When the Hun “takes too much ground,” a person can easily be angry, belligerent, or stubborn or “fly off the handle.” When the Hun is insufficiently assertive, it can lead to a lack of self-worth or self-esteem.
The Nei Jing implies this dual aspect of the Hun when it says Liver Blood excess leads to anger and its deficiency leads to a sense of absence.25
The Non-Corporeal Soul (Hun) and Blood also concerns the capacity to be sensitive to pain.
The ability to stay “soft” while experiencing pain, to not tense up, to give pain “more room,” depends on the Liver’s Blood and Hun.
Without this capacity, a person can be numb or insensitive to either his or her own physical or spiritual suffering or that of others.
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“The Liver rules the tendons and is manifest in the nails.
If the Liver’s Blood is insufficient and incapable of nourishing the tendons, symptoms such as spasms, tightness, numbness of the limbs, and difficulty in bending or stretching may result.
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“The Liver opens into the eyes.”
All of the Yin and Yang Organs contribute the purest part of their energy to the eyes;
“When the Liver is harmonized, the eyes can distinguish the five colors,”29 and “When the Liver receives Blood, the eyes can see.”
Therefore, many disorders of the eyes and of vision are taken to be Liver-related.

”The Kidneys rule birth, development, and maturation”
Concep-tion is made possible by the power of Essence;
growth to maturity is the blossoming of Essence;
and the decline into old age reflects the physical decline of Essence.
As time passes, the Essence decreases because the Kidneys store Essence, all these processes are governed by the Kidneys.
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“The Kidneys store the Essence (Life-Force)”.
Essence is the texture most closely associated with life itself; it is the source of life and its unfolding.
It is the stuff of growth and development.
Essence, in one form or another, is the primordial seed of the life process, the life process itself, and life’s final fruit.
Thus, the Kidneys are the “root of life.”
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“The Kidneys store the Will.”
The Yang Will, the forceful assertions that shape the course of decades.
The big shifts, decisive efforts, and fundamental commitments that allow a person to take responsibility for his or her life.
The Yang Will is the most dynamic assertive aspect of a person, the ultimate Fire.
The Yin Will is the other side of Will.
It is the deeper encounter with the inexorable and ultimate destiny that already exists hidden in the undifferentiated seed.
It is the recognition that the deepest force requires no effort.
The Yin Will is elusive, almost intangible. It is noticed in stillness.
It is about fate and destiny. It is about the unknown and death.
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Fear and Wisdom share a similar energetic—both are an encounter of the unknown.
Fear, however, cannot embrace the unknown with trust; fear cannot recognize the inevitability of the unknown.
Wisdom, on the other hand, acknowledges the profound truth and tranquility of the unknown.
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Disharmonies of Kidneys
Reproductive problems such as sterility or impotence or lack of sexual maturation.
Developmental disorders like retarded growth
Premature aging is premature, or if it lacks the dignity of a sense of completion, it may be the result of Kidney Essence irregularities.
Soft bones.
Weak legs and knees.
Hearing problems
Issues in teeth.
Chronic asthma
Uncontrollable fear or a dread of death, existential anxiety, or inability to feel the gracefulness of becoming older.
Being deeply locked in grief and fear.
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“The Kidneys rule the bones ( and teeth) and produce the marrow.”
The Kidneys store the Essence, and it is said that the Essence produces marrow.
The marrow, in turn, is responsible for creating and supporting bones.
In a child, insufficient Kidney Essence may result in soft bones or incomplete closure of the bones of the skull.
In an adult, insufficient Kidney Essence can produce weak legs and knees, brittle bones.
The teeth are considered the surplus of the bones, and so they too are ruled by the Kidneys.
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The Kidneys manifest in the head hair and ears
Many hearing problems are treated through the Kidneys.
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“The Kidneys rule the grasping of Qi.”
The Kidneys enable the Natural Air Qi to penetrate deeply, completing the inhalation process by what is called “grasping the Qi.”
Kidneys are thus the “root of Qi,” while the Lungs are the “foundation of Qi.”
Proper breathing thus depends on the Kidneys; and Kidney disharmonies may result in respiratory problems, especially chronic asthma or being deeply locked in grief and fear.

The Heart regulates the flow of Blood.
When the Heart Qi (partly related to the heartbeat) and Heart Blood (which are mutually dependent on each other) are abundant and normal, then the pulse will be even and regular.
The Heart Organ moves in a time frame that is of very short duration; it is situational and contextual.
This contrasts with the Kidneys whose trajetory marks the developmental stages in life and the Spleen and Liver whose time frame is shorter than the Kidneys’ but longer than the Heart’s.
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“The Heart stores the Spirit (Shen).
The Heart guarantees connection and stores the small Spirit component of the persons entire Spirit.
The Heart Spirit ensures that whatever consciousness, intention, volition, thought, reflection, and self-awareness exist within the large composite Spirit intersects and “clicks” with the world of time and space.
The Heart is responsible for appropriate behavior, timely interactions, and being suitable to the context.
Being respectful, helpful, thoughtful, or emotional is only virtuous when the Heart Spirit ensures that the moment is right.
The Heart Spirit guides the larger Spirit into the world of manifestation. The Heart Spirit ensures the timing.
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Disharmonies of the Heart
When the Heart Spirit is disturbed, one has symptoms such as insomnia, situational anxiety, and inappropriate or even bizarre behavior.
Discomfort with situations and people often has to do with the Heart, as do the somatic correlates of anxiety, such as sweating, blushing, being flustered, and palpitations. When the Heart Spirit is intact, one connects with propriety and tact.
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“The Heart opens into the tongue.”
The Hearts brilliance manifests in the face.”46 The tradition also says that “the tongue is the sprout of the Heart.”
The ability to choose words precisely, to convey meaning well, and to connect in dialogue belongs to the Heart Spirit’s relation with the tongue. Expressing warmth and appropriate engagement through facial expression is another Heart function.

“The Lungs rule Qi.”
The Lungs are the arena in which the outside Qi meets the inside Qi.
Inhalation, taking the outside Qi in and propelling it downward.
Exhalation, to “disseminate” and “make things go round,” and expel “impure” air.
When the Lungs are healthy, the Natural Air Qi enters and leaves smoothly, and respiration is even and regular.
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“The Lungs concern the momentary and ephemeral“
Traditionally, the Lungs are called the “tender organ” because they are easily affected by fleeting events, whether it is respiration, an acute cold or flu. Healthy Lungs allow for a single moment or any singular episode of time to become complete.
Delicate integrity of the temporal world.
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“The Lungs store the Animal Soul (Po).”
The Animal Soul is the animation, emotional reactivity, and pressing urges of human life.
It can be erratic and untamed. It lacks the deliberation of reason.
An intact Po is flexible and reactive but quickly regains composure and sees the entire situation.
Sensitive to mourning and grief and disturbances in gaining a sense of completion.
Experience loss and longing easily.
Receive flashes of inspiration, which can be the source of understanding and intuition when taken into other Organs.
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“Disharmonies of the Lungs”
emotionless or hysterical.
problems of urination or in edema
respiratory problems
constantly get colds
nose and throat disorders
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“the Lungs regulate the secretion of sweat”
Regulate the secretion of sweat, the moistening of the skin, and resistance to External Pernicious Influences.
If the Lung Qi is weak, there may be too much or too little sweat, and the resistance of the Protective Qi will be poor.
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“The Lungs open into the nose.”
The nose is the “thoroughfare for respiration'
The throat is said to be the “door” of the Lungs and the “home” of the vocal cords, so both the throat and the vocal cords are also related to the Lungs. Many common nose and throat disorders are therefore treated through the Lungs.
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“The Lungs move and adjust the Water Channel.”
The Lungs have a role in the movement and transformation of water in the body.
The Lungs move the water in two directions. By “descending and liquefying” (su-jiang), the Lungs move water to the Kidneys.
By “disseminating” (xuan), the Lungs circulate and scatter water vapor throughout the body, particularly through the skin and pores.
Disharmonies of the Lungs’ Water-descending function are likely to result in problems of urination or in edema, particularly edema in the upper part of the body. Disturbances involving the disseminating function may produce respiratory problems.
Fluids are received by the Stomach, which begins a process of separation, by which the unusable portions of food are sent to the intestines as waste and the pure Water is extracted. This process is continued by the Spleen, which then sends the pure Fluids in a vaporized state upward to the Lungs. The Lungs circulate the clear part of the Fluids throughout the body, but liquefy whatever has become impure through use and send it downward to the Kidneys. In the Kidneys, the impure part is further separated into relatively “clean” and “turbid” parts. The clear part is transformed into a mist and sent upward to the Lungs, where it rejoins the cycle. The final impure portion goes into the Bladder, where it is stored and subsequently excreted.

The Stomach is responsible for “receiving” and “ripening” ingested food and fluids. It is therefore called “the sea of food and fluid.”
Food begins its decomposition in the Stomach. The “pure” part is then sent to the Spleen, which transforms it into the raw material for Qi and Blood. The “turbid” part is sent to the Small Intestine for further digestion.
If the Stomach’s receiving and descending functions are impaired, symptoms such as nausea, stomachache, distention, belching, or vomiting may ensue.
While the Spleen rules “ascending,” the Stomach rules “descending”

stores and secretes bile and sends bile downward, where it pours into the Intestines and aids the digestive process.
Disharmonies of the Gall Bladder will affect the Liver, possibly resulting in such symptoms as vomiting bitter fluid.
Bile is a bitter yellow fluid continuously produced by the surplus Blood and Qi of the Liver.
Bladder rules courage and decisiveness.
Behavior characterized by anger and rash decisions may be due to an excess of Gall Bladder Qi.
Timidity and fear of particular places and things (such as a dark room or bugs) may be a sign of Gall Bladder disharmony and weakness.*

The function of the Bladder is to receive and excrete the urine.
Urine is produced in the Kidneys, out of the final portion of the turbid fluids transmitted from the Lungs, Small Intestine, and Large Intestine.
The Bladder may lead to urinary problems such as incontinence, burning urination, or difficulty in urinating.

The Small Intestine rules the separation of the “pure” from the “turbid.”
It receives what the Stomach has not completely decomposed and continues the process of separation and absorption.
The “clear” part is extracted by the Small Intestine and sent to the Spleen,“turbid” part continues downward to the Large Intestine.
Disharmonies involving the Small Intestine may produce abdominal pain, intestinal rumblings, diarrhea, or constipation.

The Large Intestine continues to move the turbid parts of the food and fluids downward, while at the same time absorbing water from this waste material. At the end of this process, the feces are formed and eliminated under the control of the Large Intestine.
If the Large Intestine loses its harmony, abdominal pain, intestinal rumblings, diarrhea, or constipation may result.

Internally, it originates in the middle portion of the body cavity (I) and runs downward to connect with the Large Intestine
Emerging at the surface of the body under the clavicle.
Descend along the medial aspect of the upper arm to reach the elbow crease
Travel down the anterior portion of the forearm and emerges at the radial side of the tip of the thumb
Acupressure Point at LUNG7 at the inner side of of the wrist

Posterior,begins at the tip of the index finger
Runs upward along the radial side of the index finger and between the thumb and index finger.
Continues upward along the lateral aspect of the forearm to the lateral side of the elbow.
Ascends along the anterior border of the upper arm to the highest point of the shoulder.
On top of the shoulder, the Meridian divides into two branches.
Internal branche travels to the Lungs, diaphragm, and Large Intestine.
Other branche travels externally along the neck, passes the cheek and enter internally the lower teeth and gum.
Finishing to the opposite side of the nose.
Acupressure Point at LARGE INTESTINE 4 located in the centre area between index finger and thumb)

Start under the eye
Descend beneath cheekbones and curves around the mouth to the jawline.
Then ascend in font of the ear to the anterior hairline
An (internal) branch descends from the lower jaw to the diaphragm, stomach and spleen.
Another (external) branch leaves the lower jaw, crossing down over the neck, chest, and abdomen, and terminating in the groin.
From the groin, it runs downward over the front of the thigh to the outer side of the knee,
it continues down to the center for the lower leg to the lateral tip of the second toe.
Acupressure Point at STOMACH 36 located below knee cap on the lateral side

Begins at the inner side of the big toe
Travelling up along the inner edge of the foot, up along the inner leg.
From there continue to travel up the posterior inner leg to the inner groin.
Briefly travel internally (secondary channel) and continue to travel up along the front of the body to another internal pathway travelling up to the spleen and stomach and up to the diaphragm, throat and tongue.
Primary channel travelling on the lateral side of the chest along the side ribs for the final points beneath the armpit.
Acupressure Point Spleen 6 (Measure 4 finger widths above the inner ankle)

Internal pathway begins at the heart, travelling down to the diaphgram, to the small intestine.
Another one (internal) travelling upward toward the face, crossing the cheeks and connecting to the eyes.
Another one starting from the heart and travelling to the lungs toward the armpit.
Primary channel beginning at the armpit, travelling along the inner edge of the arm to the peaky side of the wrist crest (HEART 7) and finishing to the edge of the peaky finger.

Begins on the inside of the peaky finger to the knuckle of the peaky finger (small intestine 3)
From here, travel up along the outer arm, all the way up to the shoulder.
At this point it zigzags across the upper back and loops around to the front of the body
From here, internal pathway travelling down to the heart, stomach and small intestine and continue down through the leg to small intestine point.
Primary channel goes up to the side of the neck to the cheek finishing the final point right in front of the ear.

Begins at the center of the chest
Internal pathway traveling downward to the diaphragm and abdomen.
Primary channel begins at the inside of the chest and travel along all the way down through the center of the inner arm to Pericardium 6. Continuing travelling through the center of the palm of the hand and finishing to the ring finger.

Begins at the outside of the ring finger, travelling to the back of the hand to San Jaio 5 and 6
Keep on travelling up through the back side of the arm up to the shoulder.
Loops to the back of the body, on the shoulder blade, above the scapulae.
Loops back to the front of the body,
travelling internally to the pericardium, down to the abdomen.
Primary channel travels up and around the outside of the ear and finishing to the outer corner of the eye.

Begins at the inside corner of the big toe
Travel along the top of the foot (Liver 3)
Continue to travel up along the inner leg all the way to the inner groin
Circle the genital and goes all the way up to the chest
Internal pathway curls around the stomach, enters the liver and connect with the gallbladder and travel upward crossing the lungs to the throat, nose, eyes.

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Begins at the outside corner of the eye to the front of the ear
Loops around the ear and move upward in zigzag pattern across the skull
Travelling down the side of the neck
Internally move to the back of the neck and continue up to the eyes and cheeks
Another internal channel moves down connecting the liver and gallbladder, circle the genital and emerge out from the sacrum.
Primary channel continue travelling downward from the neck in a zigzag pattern along the side of the body
and down the lateral outside aspect of the leg, all the way down to the side of the foot, between the pinky toe and the 4 toe (gallbladder 41 and 42), finishing at the edge of the 4th toe.

Yin Signs quiet; withdrawn; slow, frail manner; patient is tired and weak, likes to lie down curled up; excretions and secretions are watery and thin; tongue material is pale, puffy, and moist; tongue moss is thin and white
Yang Signs agitated, restless, active manner; rapid, forceful movement; red face; patient likes to stretch when lying down; tongue material is red or scarlet, and dry;tongue moss is yellow and thick.
In Looking, the physician attends to at least 4 characteristics:
The first is general appearance, including the patient’s physical shape, the patient’s manner, the way he or she behaves during the clinical encounter,and the quality of the patient-physician interaction.The second is facial color. The third characteristic is the tongue, including the material of the tongue itself, the coating of the tongue, and its shape and movement. The fourth is the bodily secretions and excretions.
Tongue is the most important, then facial color, secretions and general appearance
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Appearance of patient’s physical shape is an indication of his or her health
A person whose appearance is strong and robust is likely to have strong Organs.
When disharmonies occur in such a person, they are likely to be those of Excess.
A weak-looking, frail individual is more likely to have weak Organs and therefore to have disharmonies of Deficiency.
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Kapha person prone to Deficient Qi, Vata person to Deficient Yin or Blood.
Someone who is overweight (Kapha) is often prone to Deficient Qi, all the more so if he or she tends to be pale and swollen. Heaviness can also be a sign of tendency toward Excess Mucus or Dampness.
A thin person, especially one with a shallow complexion, narrow chest, and dry skin—a dried prune appearance (Vata)—is often prone to Deficient Yin or Blood.
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Examining a patient’s manner and emotions.
The Nei Jing states, “Yang is movement, Yin is quiescence.”
A person who is agitated, outward, talkative, aggressive, and irritable is usually manifesting a Yang tendency.
A passive, inward, quiet manner is usually Yin.
Heavy, forceful, ponderous movement is typically part of a disharmony of Excess;
Frail and weak movement usually indicates a Deficiency.
Quick movement is usually part of a Heat pattern; slow, deliberate movement is generally part of a Cold pattern.
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If the patient, when in bed, stretches his feet, removes the covers, or moves away from heat, he may well be suffering from a Heat disharmony.
If, on the other hand, the patient curls up in bed, likes to be covered, or wants to be near heat, the doctor would suspect a Cold condition.
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How does the patient communicate?
if the patient tries to take care of the physician, the physician suspects Dampness.
If the patient cannot explain the symptoms clearly, Mucus is probably present.
If the physician feels unreasonably pressured by the patient, a Liver excess is likely.
If the patient presents complaints with deep angst that seems disproportionately fearful, a Kidney disharmony may be lurking.
If the patient seems extremely shy or vulnerable, easily blushes, or touches the wrist of the physician in an effort to make human contact, the Heart Organ is likely to have a disharmony.
A patient’s sensitivity to the physician’s expression of worry or sympathy may mean Spleen, a reaction to assertiveness implies the Liver,
Heightened responsiveness to fear may reveal the Kidneys, inappropriate shifts in discussion relate to the Heart, and a deep and easy recognition of sadness may indicate a Lung disharmony.
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Facial Color - The color of the face, its expressiveness, and its moistness are closely related to the body’s Qi and Blood.
In general, healthy face is shiny and moist.
If an individual is ill, but the face appears healthy, it suggests that the Qi and Blood are not weakened and that the illness is not serious. A withered face implies weakness of the vital textures and a less favorable prognosis.
White is associated with disharmonies of Deficiency or of Cold.
Red appears with Excess and Heat and Fire.
Yellow indicates Dampness or Deficiency
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Tongue Observing
It is often the clearest indication of the nature of a disharmony and its pattern.
A normal tongue is pale red and somewhat moist.
The characteristic healthy color is the result of abundant Blood carried to the tongue by smoothly moving Qi. If the tongue maintains its normal color during an illness, it is a sign that the Qi and Blood have not been injured.
A pale tongue indicate Deficiency in Blood (if dry) or Qi (if wet).
A red tongue is redder than a normal tongue, and points to Heat.
A scarlet tongue is deeper red than a red tongue, and points to an extreme Heat condition.
A purple tongue usually indicates that the Qi and Blood are not moving harmoniously (Stagnant Qi or Congealed Blood). Moist is due to Cold ; Dry if due to Heat. Can be also associated with Liver Failure.
A tongue with a dark tinge signifies some form of stagnation.
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The coating, fur, or moss on the surface of the tongue is due to Spleen activity.
During its vaporization of pure essences, the Spleen also causes small amounts of impure substances to ascend, like smoke. These substances come out in the tongue.
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The moss is intimately related to digestion
The tongue moss covers the whole surface or patches of the surface of the tongue.
It can vary in thickness, color, texture, and general appearance.
In a healthy individual the density of moss is relatively uniform, it is thin, whitish, and moist, and the tongue can be seen through it.
A thin moss can be normal, but during an illness it may be a sign of Deficiency.
A very thick moss is nearly always a sign of Excess.
A dry moss that or sandpaperlike is a sign of Excess Yang or Fire.
A moss that is firmly implanted on the tongue body signifies strong Spleen and Stomach Qi.
A moss that appears floating is a sign of weak Spleen and Stomach Qi.
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White moss, though also the color of normal moss, can appear in illness and signifies Cold (especially if there is excessive moisture in the tongue material)
A yellow moss points to Heat: the deeper the yellow, the greater the Heat.
A black or gray moss is a sign of either extreme Heat or Cold—extreme Heat if the tongue material is red, extreme Cold if it is pale.
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Secretions and Excretions
The principal secretions and excretions are phlegm, vomit, urine, and stool.
Clear, thin phlegm exuding from the nose and throat is usually part of a Cold pattern.
If the phlegm is yellow and sticky, it is a sign of Heat.
A large amount of phlegm easily coughed usually indicates Dampness.
Bloody phlegm is commonly a sign of Heat injuring the Lungs.

Yin Signs voice is low and without strength; few words; respiration is shallow and weak; shortness of breath; acrid odor
Yang Signs voice is coarse, rough, and strong; patient is talkative; respiration is full and deep; putrid odor
Voice and respiration are the first.
Coarse, strong respiration may signify Excess.
Weak respiration or shortness of breath, accompanied by weak, low voice and little speech, suggests Deficiency.
A heavy cough or a sudden and violent one is a sign of Excess.
A dry, hacking cough suggests Heat or Dryness.
A weak cough is usually part of a Deficiency pattern.
Loss of voice suggests an External Pernicious Influence,
Chronic loss of voice is usually a sign of Deficiency.
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Smelling
Two main kinds of bodily odors that are present during illness.
Heat is foul, rotten, and nauseating, like the odor of rancid meat or rotten eggs.
Cold and Deficiency is less nauseating but more pungent or fishy, and may seem to hurt the nose.

Yin Signs feels cold; no taste in mouth; desires warmth and touch; copious and clear urine; pressure relieves discomfort; scanty, pale menses
Yang Signs patient feels hot; dislikes heat or touch; constipation; scanty, dark urine; dry mouth; thirst
asking about sensations of cold or hot; perspiration; headaches and dizziness; quality and location of pain; urination and stool; thirst; appetite and tastes; sleep; gynecological concerns; and personal background (including medical and psychosocial history).
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Questions about hot and cold, pain, and medical history are generally the most important.
Sensations of Cold and Hot In general, Cold corresponds to Yin and Hot to Yang, for internally generated disorders.
Subjective sensations of Heat, feeling warm to the touch, or a dislike of hot weather or hot places can be a sign of Heat.
Cold is signified by the opposite—constant chills or a preference for warm places, for instance.
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Fever
A low-grade fever especially noticeable in the afternoon or heat felt only in the palms of the hands, soles of the feet, and the sternum (known collectively to the Chinese as the “five hearts”) indicates insufficient Yin.
If the patient has no fever yet fears Cold, he or she is usually suffering from Deficient Yang or Deficient Qi, especially if the condition is chronic.
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Perspiration
Perspiration occurs when the pores are open but not when the pores are closed.
daytime perspiration with little engagement in physical activity (spontaneous sweating) indicates Deficient Yang or Deficient Qi (Protective Qi is not properly regulating the pore)
Excessive perspiration during sleep (night sweating)signifies Deficient Yin.
If no perspiration occurs during an illness with fever the Pernicious Influence is probably Cold that has obstructed the pores.
If there is perspiration during such an illness, it suggests External Heat opening the pores, or perhaps a Deficiency of Qi hampering the proper regulation of the pores.
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Headaches and Dizziness
Headaches may accompany any of the patterns of disharmony,but some broad distinctions between types of headaches can be helpful.
Sudden headaches often appear with External Pernicious Influences, which disturb the Yang or Qi of the head. Chronic headaches more often accompany Internal disharmonies.
Severe headaches may be a sign of Excess, while slight, annoying headaches are usually signs of Deficiency.
The Organ most associated with headaches is the Liver, because Liver Qi often rises when the Liver is in disharmony.
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Pain Location
Pain manifesting in a particular part of the body indicates a disharmony in that area.
Pain in the chest, for instance, indicates disharmony in the Heart or Lungs;
Pain in the flank and rib cage indicates Liver and Gall Bladder disharmony;
Pain in the epigastrum (solar plexus) indicates Stomach and Spleen disharmony;
Abdominal pain above the navel indicates disharmony of the Spleen and Intestines;
Abdominal pain around and below the navel indicates disharmonies of the Intestines, Bladder, Uterus, or Kidney; groin, genital-area, and hypogastrium (lower abdomen)
Lower back pain signals Kidney disharmony.
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Urine and Stool
Clear urine is usually a Cold pattern, while dark yellow or reddish urine indicates Heat.
Copious urine and frequent nighttime urination suggest that the Kidneys are not properly vaporizing
Scanty (little) urination is usually a sign of some type of Excess (Dampness or Heat obstructing the Bladder Qi) although it can be a sign of Deficient Fluids.
Frequent, scanty, dark, and painful urination indicate Dampness and Heat in the Bladder.
Inability to complete urination, dribbling, or a lack of force in urination often signifies Deficient Qi, Cold, or Dampness.
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Infrequent, dry, or hard stools can be part of a configuration of Heat Excess,
Frequent watery or unformed stools usually signify Deficient Yang, Deficient Qi, or Dampness.
Urgent diarrhea, especially when yellowish and accompanied by a burning sensation in the anus, is a sign of Heat or Liver excess. Stools that are first dry and then wet suggest Deficiency.
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Thirst, Appetite, and Tastes
Chinese physicians commonly ask patients whether they are thirsty.
This is because thirst is often a sign of Heat, while lack of thirst often signifies Cold.
Thirst without desire to drink is a sign of Deficient Yin or of Dampness.
Appetite disorders (e.g., eating too much or too little) usually signify a Stomach or Spleen disharmony due to Deficient Qi or Dampness.
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Sleep
Too little or too much indicates imbalance and disharmony.
Insomnia is described in Chinese texts as “Yang unable to enter Yin”—the active unable to become passive. This usually means that Blood or Yin or both are Deficient and incapable of nourishing the Spirit stored in the Heart.
There is therefore a relative excess of Yang, which is not balanced and is unable to quiet down.
Excess Yang or Fire in any other Organ can also cause insomnia.
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Gynecological Concerns
Chinese physicians routinely ask female patients about gynecological matters.
If a woman’s menstrual periods arrive earlier than usual,might be Heat causing reckless movement of Blood or that Deficient Qi cannot govern Blood.
Late menstrual periods suggest Deficient Blood or Cold causing Stagnation.
Irregular menstruation is often a sign that Liver Qi is not moving harmoniously.
Excessive menstrual flow may signify Heat in the Blood or Deficient Qi.
Insufficient flow or lack of menses (except during pregnancy) may mean Deficient Blood, Cold obstructing the Blood, or Congealed Blood.
Pale and thin menstrual blood points to a Deficient condition.
Very dark blood suggests Heat, and blood that is purplish, especially if clotted, may indicate Congealed Blood.
Copious, clear or white, and thin discharges (leukorrhea) usually signify Deficiency and Dampness.
Discharges that are thick and yellow, or accompanied by itching or soreness of the vagina, are often signs of Heat and Dampness.
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Personal Background
The Chinese physician wants to have a complete medical history of each patient.
Acute illnesses are associated with patterns of Excess, and chronic illnesses with patterns of Deficiency.
Older people tend to have Deficiency patterns, whereas younger people are inclined toward Excesses.
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Inquiry concerning life behaviors such as the balance of activity, rest, diet, and food habits is important.
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Life purpose and meaning
the physician needs to know what animates a person, “what makes him or her tick,”
what are the sources of strength and weakness, and what gives his or her life purpose and meaning.
The physician may need to know about significant relationships, sources of pleasure and self-worth,
major disappointments, major successes, important learning experiences, and how a person managed earlier illness.
Major illness is an uninvited opportunity for self-revelation and growth, and the physician must be alert to this possibility in the current situation.
The physician cannot be afraid to ask “heavy” questions—“are you thinking or dealing with the possibility of death? disability? being a burden? losses? unfinished work or relationships?”

Yin Signs frail, minute, thin, empty, or otherwise weak pulse
Yang Signs full, rapid, slippery, wiry, floating, or otherwise strong pulse
is considered the most important, as the heart of it is the feeling of the pulse
Chinese pulse theory gives meaning to the pulse as it is felt in each position on the wrist,
At the first or superficial level, the skin is lightly touched; at the second or middle level,
a moderate amount of pressure is applied; at the third or deep level, the physician presses quite hard. A normal or harmoniously balanced pulse is felt mainly at the middle level.
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amounting to about seventy to seventy-five pulse beats per minute.
Normal speed is between four and five beats per complete respiration (one inhalation and one exhalation)
The quality of a normal pulse is elastic and “lively,” neither hard and unyielding nor flaccid and indistinct.
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Disharmonies in the human landscape leave a clear imprint on the pulse.
The codifications and discussions variously cite twenty-four, twenty-seven, twenty-eight, or thirty pulse types.
The distinctions between pulses that are most commonly made by physicians are depth (the level at which the pulse is perceptible), speed, width, strength, overall shape and quality, rhythm, and length.

The Spleen rules transmutation and is the essential focus for the transformative dynamic of Qi in human life.
The Spleen allows food to become the textures and activities of human life and is responsible for the creative change in life.
The Spleen is about engagement, possibilities, and creativity.
Li Dong-yuan (II80-I25I C.E.), one of the greatest physicians in Chinese history, described the Spleen’s Qi as giving human beings the power to “meet pleasurable affairs, encounter the environment as balmy and suitable, find food agreeable and tasty, see desirable and lovable things, and make a person intelligent and alert.” Spleen Qi is the zest that moves life.
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Spleen disharmonies can have two aspects: Deficient or Excess.
Deficiency has to do with insufficient Qi; Excess has to do with the accumulation of Dampness.
Sometimes, the Spleen has both Deficiency and Excess together.
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Patterns of Deficient Spleen Qi
Following signs such as appetite disorders, slight abdominal pain and distention that are relieved by touching (insufficient Qi to move food), and loose stools (insufficient Qi to complete digestion).
If the Consciousness of Potentials (Yi) is affected, the person can have poor motivation, lack excitement, be bored, be despondent, or avoid activities that were once pleasurable.
He or she is not interested in the world nor engaged in creative transformation.
In addition, there are the other signs of Deficient Qi, primarily lethargy, lack of dynamic tension, a pale tongue with thin white moss, and an empty pulse.
From this pattern, Western physicians might diagnose gastric or duodenal ulcers, gastritis, hepatitis, chronic dysentery, anemia, or psychiatric disorders including major depressive disorders.8
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Pattern of Deficient Spleen Yang
is deeper and more serious disharmony than that of Deficient Spleen Qi.
It is associated with signs of the appearance of Cold, especially cold limbs; swollen, moist, pale tongue; and slow, frail pulse.
Also, certain of the Spleen-specific signs will be more extreme or Cold in nature (for instance, watery stools containing undigested food and abdominal distention or pain that responds favorably to heat as well as pressure).
The Consciousness of Potentials (Yi) might exhibit lack of resolution or defeatism.
Deficient Spleen Yang may also affect the movement of water in the body, producing such symptoms as edema, difficulty in urination, and leukorrhea.
Patients with Deficient Spleen Yang might be diagnosed in the West as having such chronic diseases as gastric or duodenal ulcers, gastritis, enteritis, hepatitis, dysentery, nephritis,9 or psychiatric disorders. A Spleen Yang pattern can merge with a Kidney Yang disharmony (see below).
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Pattern of Spleen Qi Sinking
Deficient Spleen Qi and Deficient Spleen Yang occur when the Qi cannot perform its function of retaining things in their proper place.
This pattern is also sometimes called Middle Burner Collapsing.
Following signs associated with falling, such as hemorrhoids, prolapse of the uterus, extreme chronic diarrhea, or urinary incontinence.
If the Consciousness of Potentials is affected, there can be an exaggerated sense of disability, mislabeled somatic sensation, or converting inconvenience into catastrophe.
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Pattern of Spleen Unable to Govern the Blood
It occurs when the Yang Qi of the Spleen cannot hold the Blood in place.
Various kinds of chronic bleeding result: blood in the stool, bloody nose, chronic subcutaneous hemorrhaging, excessive menses, or uterine bleeding.
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Pattern of Dampness Distressing the Spleen
Dampness is accumulations that the Spleen has not successfully moved from one state of being to another. One can say that Dampness is an incomplete transformation, the unfinished creation of the Spleen. Dampness is the possibility of change and creativity that, instead of going from one state to another, has instead piled up and created a kind of “stagnant or swampy pool.”
The Spleen is said to like “dryness” and dislike “dampness.”
The Spleen likes clarity, definition, and a distinct movement from one state of being to another.
Dampness is what happens when the possibility of transmutation becomes the burden of unfinished business, marked by a sense of “heaviness” and clutter.
Food that is incompletely transformed “sits” and becomes the physical aspect of Dampness, causing distention and bloat. Ideas get stuck and become the worry aspect of Dampness.
On a physical level, Dampness may be indicated by such signs as appetite disorders, sticky-watery stool, nausea, and a feeling of fullness in the abdomen or head, or skin eruptions containing fluids. On a psychological level, Dampness is indicated by excessive worry, ruminations, feelings of being trapped by multiple good possibilities, indecision, having many unfinished projects, procrastination, inability to make clear distinctions (or even clean one’s room), excessively taking care of others without the ability to take care of the self.
A slippery or soggy pulse and a thick, greasy tongue moss are then important signs of Dampness.
In Western terms, this pattern might translate into chronic gastroenteritis, chronic dysentery, chronic hepatitis, or various obsessive-compulsive disorders.11
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External Dampness Obstructing
Dampness and Cold are both Yin, and so Dampness patterns are likely to manifest signs of Cold.
However, Dampness can also be Hot, and if Heat signs are present, a distinct, common pattern may be perceived.
A Western physician examining a patient with the pattern of Damp Heat Collecting in the Spleen might diagnose acute gastric inflammation, acute hepatitic infection, cholecystitis, or cirrhosis of the liver
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Patterns of Mucus
The Spleen is said to be “the mother of Mucus.”
Mucus is a kind of concentrated “cooked” Dampness, it is heavier and more obstructive than Dampness.
Mucus in the stool, relatively soft, mobile swellings, lumps, or tumors (such as goiter, lymphadenopathy, and sebaceous cysts) and a phlegm cough can all be signs of Mucus.
Mucus in the Consciousness of Potential makes a person feel deeply confused and mentally blocked.
Ruminations get fixed on particular ideas and, in the extreme, a person becomes unconnected to reality.
A greasy, thick tongue moss and very slippery pulse are often important signs of Mucus.
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The Liver stores the Blood and is responsible for the smooth movement of Qi.
The Liver’s Blood softens, moistens, tempers and relaxes.
The Liver’s Qi is assertive but flexible.
The Liver is sensitive to boundaries; it likes softness.
The Liver is exquisitely reactive to being blocked and obstructed and sensitive to the distinction of self and other.
The Liver’s Blood is responsible for basic repose, unhurried cyclical movements, a gentle milieu, the absence of a need to go anywhere, and the easy sense of self-acknowledgement.
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Disharmonies of the Liver are associated with stagnation, confrontation, and distortions in boundaries between self and other.
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Pattern of Constrained Liver Qi
The Liver likes the unimpeded but gentle movement of Qi, a “free and easy” environment.
The Pattern of Constrained Liver Qi, which is the most common form of Stagnant Qi, is probably the most common pattern of Liver disharmony.
The sensation of pain is its most common physical characteristic, and the feeling of frustration or being blocked is its most common psychological sign. It is like feeling a wall in the pathway of movement.
Following signs, especially in relationship to the Liver’s storing the Blood, can lead to menstrual pain, irregular menses, and swelling of the breasts during menses.
If Constrained Liver Qi involves the throat, the patient may feel a lump in the throat.
In the Liver Meridians along the groin, breasts, or flank, Constrained Liver Qi is associated with distention, pain, or lumps; in the neck, there may also be lumps.
Constrained Liver Qi can present as mainly emotional tension and stress.
A person who usually feels hampered (while other people in the same situation might not) or easily annoyed, a person who is grumpy and easily becomes a curmudgeon, or a person who sees problems as mainly being the obstacle “others” put in the way, is often exhibiting a Constrained Liver Qi pattern.
Patients with Constrained Liver Qi could be diagnosed in Western terms as suffering from an extremely wide range of disorders, including mastitis, scrofula, digestive disorders, psychological problems, various menstrual problems, and even the stress of ordinary living.
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Pattern of Liver Invading the Spleen
Constrained Liver Qi can affect the Spleen, creating a subpattern known as Liver Invading the Spleen (gan-fan-pi) which has such signs as nausea, vomiting, sour belching, abdominal pain, and diarrhea.
Since these digestive signs also characterize patterns of Spleen disharmony, one must distinguish the pattern of Liver Invading the Spleen by the landscape context of the symptoms.
The Spleen pattern would have more tiredness, confusion, and worry; the tongue might be paler and the pulse either empty or slippery.
The Liver pattern would be accompanied with more tension and frustration, and the tongue might be darkish or purple (or even normal, if the disharmony is not too chronic), and the pulse manifests as wiry or tight.
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Pattern of Deficient Liver Blood
When the Liver’s Blood is deficient, a person will be inappropriately tense, feel confined, nervously fidget, have tight tendons, stiff joints, or spasmodic movement.
Menstrual problems such as scanty menses, amenorrhea, irregular periods, and painful menstruation can be due to Deficient Blood.
Deficient Liver Blood may also manifest as hazy vision or spots in the field of vision (the Liver opens into the eyes) or pale fingernails (since the Liver manifests in the nails).
Deficient Blood, through the Non-Corporeal Soul (Hun), might hinder a person from having an easy sense of self-acceptance, self-worth, and self-esteem.
Deficient Blood may be recognized by a person who is always kind to others but fails to be compassionate toward self.
Deficient Blood will also tend to manifest general Deficient Blood signs such as pale, lusterless face, poor memory, thin pulse, and dizziness.
In the world of biomedicine, this pattern might be seen as anemia, menstrual problems, emotional conflicts, chronic muscular skeletal problems, chronic pain syndromes, or various chronic eye problems such as retinitis.16
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The Liver’s Blood provides also for the capacity to feel and experience pain.
Blood allows for acceptance; the Liver’s Blood creates tolerance and “more room” for the limitations and boundaries imposed on human existence.
Insufficient Blood wants to make things different and causes a person to tense up or excessively resist or react to inevitable pain.
Insufficient Blood may also make a person physically numb to pain (e.g., numbness in the limbs) or psychologically incapable of tolerating or being compassionate toward his or her own personal suffering.
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Pattern of Liver Fire Blazing Upward
When the Liver’s Blood loses its softening quality and/or the Liver’s Qi is obstructed, it easily gets constrained, pent up, and the landscape can finally “explode.”
The agitated and pressured movement is often upward and outward and called the Pattern of Liver Fire Blazing.
The Fire of this pattern can be recognized by such signs as splitting headaches, dizziness, red face and eyes, dry mouth, deafness, or sudden ringing in the ears.
Inability to control anger, outbursts of hostility and vitriolic abhorrence, explosive, belligerent, and aggressive behavior can also characterize this pattern.
The pattern would also have general signs of Excess/Heat (constipation; dark, scanty urine; red tongue with rough yellow moss; and a rapid and full as well as wiry pulse).
Liver Fire often injures the Blood Vessels, causing various bleeding symptoms.
Patients manifesting this pattern might be diagnosed in the West as suffering from essential hypertension, migraine headaches, bleeding of the upper digestive tract, menopausal complaints, eye diseases such as acute conjunctivitis and glaucoma, or ear disturbances such as labyrinthitis, Ménière’s disease, or serious psychological problems.
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Pattern of Deficient Liver Yin
The pattern of Deficient Liver Yin is an Empty Fire pattern (the appearance of Heat in a Deficient Yin pattern), woven from the usual symptoms of Deficient Yin such as red cheeks, hot flashes, hot palms and soles, nervousness, reddish tongue, and thin, fast pulse. It has the signs of Yin not being able to embrace the Yang that are characterized by weakness, agitation, and uncontrolled heat signs.
Liver pattern also has Liver-specific signs such as dizziness (a general Deficient Yin symptom, but especially associated with the Liver), muddled vision, dry eyes and other eye problems, fidgety nervousness, restlessness, poor self-esteem, and self-deprecation.
A Western physician confronting patients with this pattern may diagnose essential hypertension, nervous disorders, chronic eye ailments, and menopausal complaints.
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Pattern of Arrogant Liver Yang Ascending
This pattern is a label for a place that is recognized between Liver Fire Blazing Upward and Deficient Liver Yin.
It exists between Excess Fire (Excess Yang) and Empty Fire (Deficient Yin).
The three patterns—Arrogant Yang, Liver Blazing, and Deficient Liver Yin—as well as Constrained Liver Qi and Deficient Blood, can be seen as generatively interrelated.
For example, the stagnation of Liver Qi easily transforms into Liver Fire.
This Fire, over a period of time, can damage Liver Yin and produce Arrogant Liver Yang Ascending or Deficient Liver Yin.
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Pattern of Liver Wind Moving Internally
This pattern occurs when Liver Fire or Liver Yang precipitates uncontrollable and/or sudden movement or rigidity in the body.
Its signs include those of other Liver disharmonies, with the addition of Wind signs such as trembling, difficulty in speaking, extreme stiff neck or tetany, spasms and convulsions, pulsating headaches, extreme dizziness, ringing in the ears, sudden facial rigidity or twitching, and unconsciousness (as in apoplexy).
Liver Wind usually develops out of an extreme form of some other Liver pattern. Thus, if the Liver Wind were a result of Constrained Liver Qi, there would be a dark or purplish tongue.
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Pattern of Cold Stagnating in the Liver Meridian
This pattern arises when Cold obstructs the Liver Meridian in the area of the groin.
include pain and distention in the lower side and groin; a swollen scrotum, which feels as if it were being pulled downward; moist tongue with white moss; deep, wiry, slow pulse; and discomfort relieved by heat.
In the West, this pattern would be seen as one type of hernia (a term used in both Western and Chinese medicine) or as a urogenital disorder such as pelvic inflammatory disease.
The most common signs are headache, vomiting, inability to express anger, and hostility turned inward on the self.
The outward appearance of such a person tends to be absolutely without aggression and classical sources mention suicidal ideation.
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The Kidneys are the root of Water (Yin) and Fire (Yang).
The Kidneys store the Essence (Jing) and are responsible for profound beginning and ultimate endings.
The Kidneys allow for the inexorable unfolding of the life cycle.
Depletion in the Kidneys is often linked to disruptions in other Organs, either preliminary to those disharmonies or as a final consequence of them.
The Kidneys rarely are described as Excess; the Organs connected to Kidney disharmony can be either Deficiency or Excess.
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Pattern of Deficient Kidney Essence
Deficient Kidney Essence tends to display signs relating to development, maturation, or reproduction.
Any distortions in the gracefulness of these processes often relate to Deficient Kidney Essence.
In a child, signs pointing to such a pattern include slow physical or mental development, late or incomplete fontanel closure, or poor general skeletal development.
Sexual dysfunction such as sexual anxiety and pain or discomfort with intercourse often belongs to Essence Deficiency.
For example, in the area of sexual problems, a pattern of Deficient Essence somewhat more Deficient on the Yang side might lead to impotence in a man and a lack of sexual interest in a woman because there is a lack of the Fire that arouses.
Deficient Essence weighted toward the side of Deficient Yin, however, might lead to premature ejaculation or insufficient vaginal secretions since the Yin cannot properly embrace the Yang.
Premature aging or senility, bad teeth, poor long-term memory, and brittle bones are common signs of Essence depletion.
Anguished fear of death, not being able to experience old age as a “ripening” into self-awareness, or the absence of a sense of trustful recognition are important signs that the Kidneys’ Essence has not enabled the Will to find an ultimate Wisdom in life.
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Pattern of Deficient Kidney Yin
The Yin of the Kidney is the source of the quiescence and deepest tranquillity in a person’s long-term being and behavior.
The pattern of Deficient Kidney Yin (also called Kidney Water Exhausted) is a condition of Empty Fire.
The Water cannot embrace the Fire, so Fire inappropriately flutters.
This pattern also shares the general signs of Deficient Yin such as thin or shriveled constitution, dry throat, dry skin, hot palms and soles, red cheeks, heat flashes, night sweats, reddish tongue with little moss, and a thin, rapid pulse.
A Kidney Yin person can be riddled with fear, existential angst, and dread of death. The fear produces a frantic movement of flight and a restless assertion against the inevitable.
A person begins to “will” what is impossible and runs around in a kind of existential frenzy and dizziness that makes a caricature of the timelessness and wisdom that old age can offer a person. Western doctors might correlate Deficient Kidney Yin with essential hypertension, lumbago, chronic ear problems, diabetes, chronic urogenital infections or dysfunction, menopausal complaints, or the general physical or psychological debilities people can have with aging.
Kidney-specific signs might include ringing in the ears or loss of hearing (the Kidneys open to the ears); weak, sore back; premature ejaculation; long-term forgetfulness; and vertigo.
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Pattern of Deficient Kidney Yang
The Kidney Yang is the Fire in human life. It is the ultimate resolution and the most powerful assertion of will.Kidney’s Yang is the deep resolution that propels and targets the major episodes in the life cycle.
Following signs of Empty Fire such as bright white or darkish face; wet skin; subdued, quiet manner; fear of cold; and cold limbs.
As a constitutional longterm tendency, such people turn the thermostat up, wear extra clothes, and prefer the summer to the winter.
Kidney-specific signs could include a cold and sore lower back, lack of libido, sexual anxiety, sterility, loose teeth, and deafness or loss of hearing.
In addition, there might be copious, clear urine; night urination; or dripping urine.
A Kidney Yang Deficient person can be paralyzed by fear. The unknown incapacitates his or her ability to move and mobilize.
Such a person will tend toward passivity and lack an ability to assert himself or herself.
He or she can be controlled by other people or institutions, easily take blame, and feel guilty.
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In the West diagnosed as a very wide range of disorders, including chronic nephritis, lumbago, sexual dysfunction, chronic urinary and prostate problems, chronic ear disorders, adrenal gland hypoactivity, hypothyroidism, or the general physical or psychological problems associated with aging.
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The Heart is responsible for a human being’s timely interaction in time and place. It allows for manners, ceremony, and propriety.
The Heart is about appropriate connection in terms of place, person, or project. The Heart stores the Heart Spirit and also rules the Blood and is responsible for the evenness of the pulse.
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Patterns of Deficient Heart Blood and Deficient Heart Yin
Both disharmony patterns share overlapping signs: heart palpitation, sweating, forgetfulness, insomnia, anxiety with situations and people.
These signs are thought of as the Blood or Yin unable to embrace the Qi or Yang.
Heart Blood and Heart Yin both have discomfort and a feeling of unease that is related to particular situations.
Heart Blood patterns are likely to have shyness and a sense of vulnerability or a wanting to withdraw;
Heart Yin patterns are likely to be a person who is visibly jumpy or chatty or who makes a determined effort to conceal anxiety.
Both patterns can have signs of inappropriate behavior. But Deficient Blood is closer to awkwardness; Deficient Yin is more flighty and restless.
Both patterns can have signs of insomnia. But Deficient Blood tends to have trouble falling asleep; Deficient Yin will often awake in the night.
Both patterns will have trouble with speaking in public; but Blood patterns may tend to forget the words while a person with Deficient Yin in haste may say unintended words.
Both patterns tend to forget. But Heart Blood forgets routine things like the keys while Heart Yin forgets the name of a place or person.
The Blood pattern will have a pale face and a thin pulse; while the Yin pattern will have a reddish face, a thin, rapid pulse.
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Deficient Heart Blood is often associated with Deficient Spleen Qi because the Spleen produces the Blood, while Deficient Heart Yin is usually related to Deficient Kidney Yin because the Kidneys are the source of the Yin of the Organs.
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When Western doctors examine patients exhibiting Deficient Blood or Yin of the Heart, they often find cardiovascular disorders characterized by tachycardia, arrhythmia or anemia, hypertension, hyperthyroidism, and anxiety disorders
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Patterns of Deficient Heart Qi and Deficient Heart Yang
Patterns of Deficiency of the Heart Qi or Heart Yang have to do with the effort needed to ensure the evenness of the pulse.
The signs of either are associated with irregular pulse types such as knotted or intermittent.
These patterns can be associated with the absence of the tension or assertion needed to make a connection with people.
Most commonly, Deficient Heart Qi or Yang is an associated pattern with Deficient Kidney Yang (the Kidney are the root of Yang) or Deficient Lung Qi (because there is a link to the “sea of the Qi” in the chest).
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Following signs may include lacking warmth in connecting to people, being unable to sustain a conversation, being unable to communicate one’s meaning or intention, or being too slow to express oneself.
An absence of joy may also be a sign of Heart Qi or Yang being depleted.
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Western doctors who examine patients displaying Deficient Heart Qi or Yang (usually with a Kidney or Lung pattern) often observe cardiac insufficiency, coronary atherosclerosis, angina pectoris, or anxiety disorders.
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Patterns of Congealed Heart Blood
Insufficient Heart Qi or Heart Yang to move the Blood in the chest often precedes and accompanies the pattern of Congealed Heart Blood
In either case, Congealed Heart Blood will manifest Yang signs of stabbing pain and purple face and tongue, along with such Yin signs as lassitude, palpitations, and shortness of breath.
Mucus may also contribute to the obstruction of Blood,obstructing the Heart and Congealed Blood pattern would have accompanying Mucus signs, such as thick, greasy tongue moss.
Patients manifesting the pattern of Congealed Blood are often diagnosed in Western terms as suffering from angina pectoris, pericarditis, or coronary artery disease.
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Patterns of Cold Mucus Confusing the Heart Openings
Mucus affecting the Heart implies that the Heart’s connection to time and space is occluded and seriously disrupted.
The person is disoriented and not relating to ordinary reality.
From a Western perspective, these mucus patterns imply serious mental disease.
Cold Mucus Confusing the Heart Orifice is often a seriously mentally ill person who cannot function in a normal social environment.
Since Cold Mucus is Yin, the behavioral signs might include an inward, restrained, foolish manner; muttering to oneself, delusions, staring at walls; and sudden blackouts.
Other signs such as coldness, passivity, fixations, a white, thickly coated tongue, and a slippery pulse are likely to be present.
and such signs as disorientation, lack of logical thinking, confused thoughts, or thoughtless or just sloppy behavior.
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Pattern of Mucus Fire Agitating the Heart is Yang.
The person is assertive, agitated and aggressive, and may incessantly talk.
Harm can easily be inflicted on others as the delusions have a quality of persistent resentment or belligerent hostility.
Western disease entities as gramnegative sepsis and encephalitis, when they affect cerebral functions, or apoplexy, or epilepsy
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The Lungs are the “tender Organ” and most susceptible to External Pernicious Influences.
The Lungs are also the Organ concerned with activity in moment-to-moment units of time.
Disturbances in inhalation and exhalation (such as cough or asthma) and excessive grief (inability to experience the preciousness of a complete event) are salient characteristics of Lung disharmonies.
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The Pattern of Cold Violating the Lungs
This is an External Cold Pernicious Influence pattern that especially affects the Lungs.
It is likely to be woven together by such signs of External Cold as chills, a slight fever, head and body aches, and, since the pores are blocked by Cold, a lack of perspiration.
Also expected would be a thin, white tongue moss, and a floating, tight pulse.
These signs will be accompanied by Lung disharmony symptoms such as stuffy or runny nose, asthma, or a cough with a thin, watery sputum.
In the West, patients with this pattern would often be diagnosed as suffering from the common cold, acute or chronic bronchitis, bronchial asthma, or emphysema.
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The Pattern of Heat Clogging the Lungs
This pattern manifests the usual signs of an External Heat Pernicious Influence such as fever, slight chills, perspiration, thirst, constipation, dark urine, red tongue with dry, yellow moss, and fast pulse.
In addition, there will be Lung-specific signs such as a red, sore, swollen throat, asthmatic breathing, or a full cough with a yellow, sticky expectorant.
There may be a runny nose with thick yellow phlegm or, since Heat can injure fluids and cause Blood to move recklessly, a dry or bleeding nose.
A Western doctor, looking at patients with this pattern, might diagnose the common cold, acute or chronic bronchitis, pneumonia, tonsillitis, or pulmonary abscess.
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The Pattern of Mucus Dampness Hindering the Lungs
While it can be generated by an External Damp Pernicious Influence, more often it is the result of any External Influence invading the body and encountering a preexisting chronic disharmony with tendencies toward Mucus accumulation.
Chronically Deficient Spleen or Kidney Qi, for example, may lead to Dampness and Mucus buildup, predisposing the body to this pattern of disharmony.
Common signs include full, high-pitched coughing, wheezing, or asthma with copious phlegm; chest and flank distention and soreness; increased difficulty in breathing when lying down,thick, greasy tongue moss that is either white or yellow depending on whether the obstructing Mucus is Cold or Hot.
In the West this pattern would be perceived most often as chronic bronchitis or bronchial asthma.
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The Pattern of Deficient Lung Yin
This pattern can occur when chronically Deficient Yin, usually of the Kidneys, affects the Yin of the Lungs.
Signs include a dry cough with little or no phlegm, bloody sputum (if Heat has injured the Blood Vessels), and such general signs as an emaciated appearance, low voice, red cheeks, afternoon fever, night sweats, reddish tongue with a small amount of dry moss, and a thin, rapid pulse.
In Western terms these conditions might be diagnosed as pulmonary tuberculosis, chronic pharyngitis, bronchiectasis, or chronic bronchitis.38 Deficient Lungs can
If it accompanies a Deficient Liver Yin pattern, a person can be a high-performance person yet feel sad, disappointed, unsatisfied, and restless with a tendency to be easily annoyed.
If it accompanies a Deficient Kidney Yin pattern, the person can have longstanding unresolved grief accompanied by fear and angst.
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Deficient Lung Qi
This pattern usually occurs either as the result of an External Pernicious Influence remaining in the Lungs for a long period and injuring the Qi
The signs of this pattern are exhausted appearance and Spirit, low voice and lack of desire to talk, and weak respiration.
If a cough is present, it is weak.
A sad affect may be present.
If the Protective Qi has also been weakened, there are other signs such as daytime sweats and lowered resistance to colds.
In Western terms such symptoms might point to emphysema, chronic bronchitis, pulmonary tuberculosis, allergies, longstanding depression, or chronic bereavement.39