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TCM Diagnosis DIng

Flash Cards for TCM Diagnosis by Dr. Ding at Bastyr

What are the four diagnostic methods? Inspection Auscultation and Olfactory Inquiring Palpation
Describe Sign: Objective and Measured trait of disease
Describe Symptom Subjective experienced trait of disease
Describe Syndrome: A group of signs and symptoms that result from a common cause.
What are the seven methods of differentiation of syndromes in TCM? 1) Eight Principle 2) Qi, Blood and Body fluid 3) Zang Fu 4) Meridians and collaterals 5) Six Channels 6) Wei, Qi, Ying, Xue 7) Three burners
Describe: Comprehensive analysis of all the signs and symptoms by all the diagnostic methods. Using the four methods together, (Inspection, Auscultation and olfaction, Inquiring and Palpation.)
Define Vitality: Vitality is spirit or Shen. Broad meaning is the outward experience of the vital activities of the whole body. Narrow meaning is mentality, consciousness, thinking sleeping and memory.
What are the four conditions of Vitality? 1) Having Vitality 2) Lacking Vitality 3) Pseudo Vitality 4) Abnormal Vitality
Indications of having vitality? Normal condition when a person is ill. Sufficient essence and Qi. The Zang Fu has not fallen into severe disorder.
Indications of lacking vitality? Essence and Qi are exausted Zang Fu function is failing Serious illness
Indications of Pseudo Vitality? - An abnormal sign of a critical patient before impending death. - A sudden temporary "turn for the better" - Impending dissociation of of Yin and Yang.
Indications of Abnormal Vitality? Special diseases such as epilepsy, mania, dementia, etc...
What vitality does a person have if displaying some of these symptoms: Dull eyes with sluggish actions, dark and dusty complexion with a dull expression, hard to move with slow reactions, emaciation, hard breath, disoriented, even unconsciousness Lacking Vitality.
What vitality does a person have if displaying some of these symptoms: An extremely weak patient in critical condition, dull eyes and low and weak voice, dark dusty complexion who suddenly feels better, clear consciousness, bright eyes, stronger voice. Pseudo Vitality
What vitality doe a person have if displaying some of these symptoms: Bright and vivid eyes, lustrous complexion with natural expression, freely movable and elastic body, firm muscles, smooth breath, clear speech and consciousness. Having Vitality
What is the prognosis for a person displaying signs of a strong vitality? Good, Normal person with sufficient essence and qi. Althought the person is Ill the essence and QI have not been exhausted and the Zang Fu have not fallen into severe disorder.
What is the prognosis for a person displaying signs of lacking vitality? Poor, Serious Illness, Qi and Essence are exausted.
What is the prognosis for a person displaying signs of Pseudo Vitality? Critical. Impending dissociation of Yin and Yang.
Why do we observe the facial skin color? 1) Easily Observed 2) Rich in Capillaries 3) Skin is thin and tender 4) Can easily learn the situation of Qi, Blood, Zang Fu and Pathogenic factors.
What are the five colors? Red, Yellow, White, Black, Blue.
The five colors are related to what organs? Red = Heart Yellow = Spleen White = Lung Black = Kidney Blue/Green = Liver
The five colors are related to what elements? Red = Fire Yellow = Earth White = Metal Black = Water Blue/Green = Wood
Describe Normal Skin Color: Lustrous Sheen with natural color. Qi Blood and Body fluid are sufficient. Zang Fu is functioning normally.
What is the Zhu Skin Color? The normal color of the Race.
What is the Ke Skin color? temporary healthy change in skin color due to surroundings, sun season etc.
Describe diseased skin color in general. No lustrous complexion. Pale or dim complexion, perhaps showing the five disease colors.
Red skin indicates: (heart) Heat syndromes,(can be excess, deficiency, or pseudo heat)
Yellow Skin Indicates: (Spleen) Deficiency or Damp syndrome.
White Skin Indicates: (Lung) Deficiency Syndrome, Cold syndrome, blood loss.
Black Skin Indicates: (Kidney) Kidney deficiency, cold syndrome, blood stasis, water retention.
Blue/Green Skin indicates: (Liver) Cold, Pain, blood stasis and convulsion syndromes.
Entire face is red accompanied by excess heat signs: Heart Condition - High fever caused by exterior pathogen. - Zang-fu Yang excess
Malar flush accompanied by night sweating: Heart Condition Yin deficiency
Sudden malar flush seen in a "lacking vitality" patient. Heart condition Pseudo heat
Yellow and pale face accompanied by fatigue and poor appetite Spleen qi deficiency, qi and blood not nourishing.
Yellow and puffy face accompanied by fatigue and poor appetite: Spleen qi deficiency, dysfunction of transportation function.
Entire body is yellow, including the eyes, face and skin. Distinguished by yellow sclera: Jaundice, Spleen condition
Jaundice with bright orange: Yang Jaundice
Jaundice with smokey dark, from cold damp: Yin Jaundice
Bright white and puffy complexion: Lung condition Yang deficiency
Pale face lips with pale nails: Lung Condition, Blood deficiency, blood loss
Pale and blueish complexion: Lung condition, Yin excess cold syndrome
Dark and dry face: Kidney yin defficiency
Darkness around the orbit Kidney deficiency Water retention Leukorrhagia due to cold damp
Dark face with scaly skin: Kidney Condition Blood stasis.
Bluish and pale face accompanied by severe pain in the abdomen: Cold invasion or yin excess
Blue and purplish face and lips accompanied by intermittent stabbing chest pain: Liver Condition Heart yang deficiency blood stasis
Blue and purplish face, most obvious at the nose bridge and between the eyebrows accompanied by a high fever in infants: Liver condition Omen of convulsion Convulsion Syndrome
Describe the relationship between appearance and health: - Internal Exuberance leads to External strong appearance. - Internal deficiency leads to external weak appearance.
Corners of eyes? Heart, Blood wheel.
Eyelids? Spleen, Muscle wheel.
Sclera, white of eye. Lung, Qi wheel.
Iris of eye? Liver, wind wheel.
Pupil of eye? Kidney, Water wheel.
What is "Wei syndrome"? Weakness of , motor impairment and muscular atrophy.
What is "Bi syndrome"? Pain, heaviness, swelling, restricted movement in joints, (arthritis).
Describe a normal tongue: Light red tongue with thin white coating. Soft and flexible body. neither too large or too small with normal shape. Thin white coating with clear grains that are evenly scattered and cannot be wiped off. Coating neither wet, or dry; not sticky or greas
Color of normal tongue: Light red.
Color of abnormal tongue: Pale, red, deep red, purple and blue.
Shape of normal tongue: Well defined, neither too large or too small.
Abnormal shape of tongue: Rough and tender; swollen with teeth prints; thin and small; prickled, fissured and mirror tongue.
Motility of normal tongue: Soft, flexible and mobile body
Motility of abnormal tongue: rigid; flaccid; trembling; deviated
What does a pale tongue indicate? deficiency syndrome, (Qi blood or Yang deficiency) Cold syndrome.
What does a red tongue indicate? Heat syndrome. Excess heat or yin deficiency heat.
What does a deep red tongue indicate? Extreme heat syndrome. (Excess heat syndrome, Yin deficiency producing fire. Yin exhausted.)
What does a purple tongue indicate? Excess heat, Cold congealation, blood stasis
What does a blue tongue indicate? Cold congealation, Blood stasis
What does a rough tongue indicate? Rough tongue texture indicates excess syndrome.
What does a tender tongue indicate? Deficiency syndrome.
What does a swollen tongue indicate? Damp and phlegm accumulation. Yang deficiency.
What does a tongue with teeth prints indicate? damp and phlegm accumulation Qi deficiency Yang deficiency normal person.
What does a thin and small tongue indicate? Qi and blood deficiency, Yin deficiency
What does a prickled tongue indicate? Heat syndrome.
What does a fissured (cracked) tongue indicate? Yin deficiency, blood deficiency, heat syndrome, healthy person.
What does a mirror tongue indicate? Stomach qi or stomach yin exausted. Serious condition.
What does a rigid tongue indicate? heat invading the pericardium Excess heat impairing the body fluids Phlegm accumulation Wind stroke
What does a flaccid tongue indicate? Qi blood and yin deficiency heat impairing the body fluids
What does a Trembling or uncontrollable tongue indicate? Qi blood or Yang deficiency. Extreme heat producing wind.
What does a tongue deviated to one side indicate? Wind stroke, Threatening sign of wind stroke.
What is the normal coating for a tongue? Thin and white coating with clear grains which are evenly scattered and cannot be wiped off. Neither too wet or too dry. Not sticky or greasy.
What is a thin coating on the tongue? The tongue proper can be seen through the tongue.
What is a thick coating on the tongue? The tongue proper can not be seen through the coating.
A thin coating on the tongue indicates: Normal person, Exterior syndrome, Light interior syndrome.
A thick coating on the tongue indicates: Interior syndrome, damp and phlegm accumulation, Food stagnation.
Describe a sticky coating: Turbid, fine greasy coating which is difficult to scrape off.
Describe a curdy coating: Coarse, loose and thick like soy bean curds... easy to scrape off.
Sticky coating indicates: Damp and phlegm accumulation. Food stagnation.
Curdy coating indicates: Phlegm, food stagnation, heat damp.
A dry coating indicates: Heat impairing the body fluids, Yin deficiency.
A slippery (Excessive moisture) coating indicates: cold damp, yang deficiency, water retention.
Describe mirrored tongue: Without coating like a mirror.
A mirrored tongue indicates: Stomach qi or stomach yin exausted. Serious condition.
Describe geographic tongue: Part of the coating is peeled and looks like a map.
Geographic tongue indicates: Stomach qi and stomach yin deficiency.
Normal condition under the tongue: Two veins under the tongue, Should not have branches and no blue or purple spots around the veins.
Describe abnormal condition under the tongue: Lots of branches and distended, blue, purple or red spots around the veins. (Caviar tongue) Indicates blood stasis, or cardiovascular disease.
What three parts of the tongue are inspected? Tongue proper Coating Underneath
Why do we inspect the tongue. 1) The tongue is the mirror of the Zang fu. 2) The tongue connects connects directly and indirectly with many Zang Fu organs through channels and collaterals.
What meridians connect to the tongue? 1) Deep branch of the heart meridian 2) Spleen meridian 3) Kidney meridian
What forms the tongue coating? The rising of stomach qi.
Describe what you inspect on different parts of the tongue? Tip: heart and lung Central: spleen and stomach Root: kidneys Border: liver and gall bladder
How do you judge interior or exterior syndromes? Thin coating, exterior coating or onset of disease. Thick coating, interior syndrome or severe syndrome. No coating: more severe interior syndrome.
Overweight: Phlegm Damp
Describe: Ying Liu. Diffuse swelling on one or both sides of the neck without a distinct boundary, soft, moves when pt swallows. May vary in size when patient swallows.
TCM Diagnosis of Ying Liu: Liver qi stagnation, phlegm fire accumulating.
Describe Lou li: Cervical lymph nodes infected by Tuburculosis.
TCM Diagnosis lou li: Lung and kidney Yin deficiency, phlegm accumulation, wind and toxin invasion.
Clear nasal discharge: wind cold syndrome
Turbid nasal discharge: wind heat syndrome
Which Zang Fu associated with the Nose? Lung opens into the nose, ST and LI pass through nose.
Which Zang Fu associated with the mouth and lips? Spleen opens into the mouth and manifests on the lips.
Which Zang Fu is associated with the Ear: Kidney opens into the ears. All meridians connect with the ears.
Pale gums mean: blood deficiency.
Red gums mean: Heat. Deficient or Excess.
Which Zang Fu associated with the Throat? Door of the lung or stomach.
What does it mean if it feels like there is a lump in the throat. Liver Qi Stagnation.
Skin squamous and dry: Blood stasis.
Skin connected to what Zang Fu: Epidermis connected to the lungs. Dermis connected to the Spleen.
Yang Edema: Exterior invasion, lung not ventilating.
Yin Edema: Spleen or Kidney Yang deficiency.
Yang deficiency is: Qi deficiency with cold.
Yang excess is: Qi Excess with heat.
Yin Deficiency is: Heat with dry.
Yin excess is: Cold with wet or damp.
What does a thick coating mean? Dampness.
What is auscultation? Listening to the sound emitted by the patient.
What are the three gates: Gates of health on infants finger. (Under 3)
Which of the three gates is most proximal? Gate of wind.
Which of the three gates is most distal? Gate of life.
Which of the three gates is in the middle? Qi Gate.
What do the three gates mean. The more distal the abnormal venules the more severe the condition.
What are four abnormal conditions in relation to the three gates? Shallow: Exterior syndrome. Deep: Interior syndrome. Red color: Heat syndrome. Pale color: Deficiency syndrome.
Extr Heat Syn Heat factor invade Extr of body
Intr Def cold Def of Yang Qi
Intr Excess Cold severe cold at Intr of body & obstruction of Yang Qi
Intr Def Heat Yin def lead to Intn heat production
Intn Exc Heat acum/exub of heat in Body
Extr Heat Syn Heat factor invade Extr of body
Extr Def Syn Wind factor invade Intr
Ext Exc Cold Syn WIND COLD= chills>fever no thirst no sweat
causes of ext syndrm ext patho invade superficial region of the body ruled by LU= WC, WH (allergy like) channel synd- patho invade and obstruct the superficial channels and collateral= Bi syn
Skin, muscles and channels. Called Exterior What affect exterior conditions and how are they called ?
Internal organs Zang-Fu. Called Interior What affects interior conditions and how are they called ?
Lung-Defensive-Qi portion How is called an external diseases from Wind ?
Interior Where pattern are manifesting due to chronic skin problems ?
Exterior, affecting skin and muscles and caused by exterior pathogenic factor with acute onset To what condition correspond Wind-Cold or Wind-Heat.
Exterior, affecting the channels with slower onset To what condition correspond Painful Obstruction Syndrome
Invasion of exterior pathogenic factor What indicates Fever and Adversion to cold ?
Fever w/ chills "aversion to Cold", aching body, acute onset, and superficial pulse Main symptoms of an ext pattern
Cold or Heat, Empty or Full On what other characters depend the character Exterior Pattern ?
Exterior-Wind-Cold What exterior condition has the following symptom, slight or absent fever, aversion to cold, severe bodyaches, severe stiff neck, chilliness, no sweating, no thirst, itching throat, floating-tight pulse and thin-white tongue coating ?
Exterior-Wind-Heat What exterior condition has the following symptom, fever, aversion to cold, slight swetting, thirst, sore throat, floating-rapid pulse and thin-yellow tongue coating ?
Exterior-Wind-Cold-Empty What exterior condition has the following symptom, slight or no fever, aversion to wind, sweating, slight body-aches,Floating-slow pulse and thin-white tongue coating ?
Exterior-Wind-Cold-Full What exterior condition has the following symptom, fever, aversion to cold, no sweating, severe body-aches,floating-tight pulse and thin-white tongue coating ?
Cold, Dampness, Heat and Wind obstructing circulation of Qi in channels What characterize invasion of pathogenic factor on the channels ?
Bi syndrome, painful obstruction in channels and joints What indicates a Wind-Cold-Dampness disease ?
Wandering Bi syndrome, pain moves from joint to joint What indicates a Wind-Cold-Dampnes with prevalence of Wind disease ?
Painful Bi, usually only one joint affected, severe pain, relieved by Heat What indicates a Wind-Cold-Dampnes with prevalence of Cold disease ?
Fixed Bi, swelling of the joints What indicates a Wind-Cold-Dampnes with prevalence of Dampness disease ?
Heat Bi, severe pain swollen joint and hot What indicates a Wind-Cold-Dampnes with prevalence of Heat disease ?
Interior-Full-Heat What indicates fever, thirst, red (face and eyes), constipation, scanty-dark urine, yellow discharge, rapid-full pulse and red tongue with yellow coating ?
Loss of large quantities of dark-red blood What indicates Blood-Heat ?
Heart-Heat Extreme restlessness or maniac behaviour
Excess of Yang When arise the Full-Heat ?
Interior-Empty-Heat What indicates mental restlessness, Insomnia, irritablility, fever or feeling or Heat, dry mouth/throat, sweat at night, heat in chest, palm and soles (5-palm Heat), dry stools, scanty dark urine, floating-empty pulse and red-peeled tongue coating ?
Interior-Full-Heat Desire to drink cold water
Interior-Full-Heat Red all over inside eyelid
Interior-Full-Heat Bitter Taste
Interior-Full-Heat High Fever
Interior-Full-Heat Very restless and agitated
Interior-Full-Heat Constipation, abdominal pain
Interior-Full-Heat Profuse Bleeding
Interior-Full-Heat Dream-disturbed, very restless
Interior-Full-Heat Red-Hot-painful skin eruption
Interior-Full-Heat Full-rapid-overflowing pulse
Clear Heat Treatment method for Full-Heat
Empty-Heat Desire to drink warm water, or cold water in small sip
Empty-Heat Thin red line inside eyelid
Empty-Heat No bitter taste
Empty-Heat Feeling of heat in the afternoon
Empty-Heat Low-grade fever in the afternoon
Empty-Heat Vague anxiety, fidgeting
Empty-Heat Dry stools no abdominal pain
Empty-Heat Slight bleeding
Empty-Heat Waking up frecuently during the night or early morning
Empty-Heat Scarled-red, not rised, painless skin eruptions
Empty-Heat Floating-empty-rapid pulse
Empty-Heat Red-peeled or thin coating
Nourish Yin, clear Empty-Heat Treatment method for Empty-Heat
Kidney-Yin From what organ frequently arise Empty-Heat ?
Full-Cold chillness, cold limbs, no thirst, pale face,abdominal pain with sudden onset, aggravated on pressure, desire to drink warm liquids, loose stools, clear-abundant urination, deep-full-tight pulse and pale tongue with thick white coating
Full-Cold Abdominal pain that contracts and obstructs, white, concave, bluish-purple tongue, and bluish lips or fingers or toes
Stomach causing vomiting and epigastric pain, intestines causing diarrhea and abdominal pain, and uterus causing dysmenorrhea. Named the three only cases of Exterior-Cold invading the interior
Full-Cold From the Yin and Yang point of view, what arise from Execess of Yin
Empty-Cold What indicates chillness, cold limbs, dull-pale face, no thirst, listlessness, constipation, sweating, loose stools, clear-abundant urination, deep-slow-weak pulse, pale tongue with thin white coating
Empty-Cold From the Yin and Yang point of view, what arise from Deficiency of Yang,
Internal Dampness What arise from Spleen-Yang condition with sign of weight-gain and swollen (tongue and thyroid gland) ?
Exterior-Cold and Interior-Heat*pre existing)attack by WC What indicates fever with aversion to Cold, no sweating, headache and stiff neck, bodyache, irritability and thirst P-superficial T red
Created by: Bastyr40