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TCM Diagnosis 1 Fina
| Question | Answer |
|---|---|
| Chills | feel cold but cannot be relieved by warmth |
| cold | feel cold but can be warmed up |
| fever | temperature is higher than normal |
| warm | feel warm, temperature may be higher than normal or normal |
| normal temperature | 98.6 F = 37 C |
| Chills accompanied by fever indicates | Exterior (superficial) syndrome, chills are present = exterior syndrome (more chills, more fever) |
| Cold without fever indicates | cold syndrome (excess or deficiency) |
| Cold evil invasion, abdominal pain, likes warmth, dislikes pressure | Excess cold syndrome |
| Loose stool, abdominal pain, likes warmth and pressure, weak pulse | Yang deficiency |
| Fever (warm) without cold | heat syndrome (excess or deficiency) |
| High fever | > 39 C |
| Tidal fever | a fever that occurs or becomes worse at a fixed time of the day, just like the sea waves |
| Slight fever | Temp < 38 C |
| High fever, profuse sweating, severe thrist, flooding pulse | Excess heat syndrome (Yang ming channel syndrome) The big 4s |
| Afternoon fever (between 3-5pm) with constipation and fullness and pain in the abdomen | Excess heat syndrome (Yang ming fu syndrome) "yang ming tidal fever" |
| Tidal fever in the afternoon or evening, night sweating, malar flush, red tongue with little coating, rapid and weak pulse | Yin deficiency (yin deficiency tidal fever) |
| slight fever, fatigue, poor appetite, weak pulse | qi deficiency |
| slight fever, heavy in the head and body, red tongue with a thick coating | heat damp syndrome |
| Alternating chills and fever | half exterior and half interior syndrome |
| Fever (high fever) that alternates with chills at regular intervals | half exterior and half interior syndrome; malaria |
| Fever that alternates with chills at irregular intervals, bitter taste in the mouth, thirst, fullness in the chest and hypochondrium | half exterior and half interior syndrome; Shao yang disease |
| Exterior syndrome without sweating | exterior EXCESS syndrome, exterior COLD syndrome (same thing) |
| Exterior syndrome with sweating indicates | Exterior deficiency syndrome (Tai yang wind syndrome) |
| Controversy: exterior heat syndrome | with sweating and without sweating (so we say both) |
| Interior syndrome (3 features) | - Spontaneous sweating - Night sweating - Profuse sweating |
| Spontaneous sweating (sweating while awake) that is worse with exertion and accompanied by fatigue indicates | Qi deficiency (without cold symptoms) Yang deficiency (with cold symptoms) |
| Night sweating (sweating during sleep, stopping when awake), malar flush, tidal fever or warm indicates | yin deficiency |
| profuse sweating, high fever, severe thirst, flooding pulse (big 4s) indicates | excess heat syndrome (Yang ming channel syndrome) |
| Profuse cold sweating, pale complexion, cold limbs, feeble pulse that is Barely palpable indicates | yang collapse (exhausted) |
| feels distended and painful, often seen in the chest, epigastric, hypochondrial and abdominal regions indicates | qi stagnation |
| feels distended and painful in teh head indicates | liver fire or liver yang rising |
| Feels heavy and painful and often seen in the head and four limbs indicates | dampness or damp bi |
| pain that is unfixed in the joints at the four limbs indicates | wind bi |
| pain that moves from place to place with a distended sensation in the chest, hypochondrial or abdominal region indicates | qi stagnation |
| a pain that feels like being pricked indicates | blood stasis |
| a pain that is very sharp and violent indicates | substantial pathogenic factors obstructing the qi |
| Heart attack | chest bi |
| a pain with a burning sensation indicates | heat or fire syndrome |
| shingles | heat or fire syndrome |
| pain with a cold sensation that is relieved by warmth | cold evil invasion; yang deficiency |
| a lingering pain that is not severe | deficiency syndrome |
| pain with a hollow sensation | qi and blood deficiency |
| pain that is aggravated by pressure or dislikes pressure | exterior evils invasion, qi or blood stagnation, substantial pathognieic obstruction (food, stone, etc). |
| Pain that is alleviated by pressure and likes pressure | qi, blood, or yang deficiency |
| back of the head and neck pain indicates | tai yang channel (UB) |
| forehead pain indicates | yang ming channel (ST) |
| sides of the head, especially at the temples | shao yang channel (SJ) |
| Vertex pain indicates | Jue yin channel (LV) |
| Back of the head and neck pain, chills and fever, floating pulse indicate | exterior syndrome (Tai yang disease = UB) |
| Chest pain | heart or lung disease |
| colic pain in the chest | Chest Bi (heart attack) |
| stabbing pain in teh chest | heart blood stasis |
| chest pain, night sweating, cough with a little blood in the sputum | lung yin deficiency |
| hypochondrial pain | liver or gall bladder disease |
| hypochondriac area feels distended with pain moving from place to place, irritability, wiry pulse indicates | liver qi stagnation |
| hypochondriac pain, jaundice, thick yellow tongue coating indicates | heat and damp in the liver and gall bladder |
| stabbing pain in the hypochondriac region with scaly skin and purplish tongue indicates | liver blood stasis |
| burning pain in the hypochondriac region with vesicular skin eruptions indicates | liver fire and damp (shingles) |
| Epigastric pain (WAN = middle) | stomach and spleen disease |
| distended epigastric pain that is alleviated by belching or flatus indicates | qi stagnation |
| a dull, lingering epigastric pain that is alleviated by pressure indicates | deficiency syndrome |
| epigastric pain that is alleviated by warmth, refuses pressure indicates | cold invading the stomach |
| abdominal pain | spleen, LI, UB B/L lower abdominal pain = LV channel |
| dull abdominal pain that is alleviated by warmth and pressure, loose stools, fatigue indicates | spleen yang deficiency |
| distended b/l lower abdominal pain indicates | liver qi stagnation |
| lumbago | kidney or UB disease or injury |
| lower back pain with fatigue indicates | kidney deficiency syndrome |
| lower back colic pain that radiates to the perineum, bloody urine indicates | kidney stone stone obstruction and qi stagnation |
| fixed pain at the lower back with a history of injury indicates | local qi stagnation and blood stasis |
| Limb pain, joint pain | joint pain = bi syndrome |
| joint pain that is unfixed in the four limbs | wind bi |
| joint pain with a heavy sensation indicates | damp bi |
| joint pain that is fixed and severe indicates | cold bi |
| joint pain with redness and swelling indicates | heat bi |
| thirsty and wants to drink | may be caused by profuse sweating, vomitting, diarrhea, or loss of body fluids |
| severe thirst, high fever, profuse sweating, flooding pulse indicates | excess heat syndrome (yang ming channel syndrome) |
| thirsty but does not want to drink, with malar flush, tidal fever, night sweating indicates | yin deficiency |
| thirst but drinks very little, with a heavy sensation in the head and limbs, red tongue, thick yellow coating indicates | heat and damp syndrome |
| thirsty but can only gargle and not swallow, with a purplish tongue, hesitant pulse | blood stasis |
| Poor appetite, fatigue, abdominal distention, loose stool, weak pulse indicates | spleen qi deficiency |
| Anorexia, jaundice, hypochondriac pain, thick yellow tongue coating | heat damp in the liver and gall bladder |
| poor appetite with a heavy sensation in the head and limbs, thick tongue coating indicates | damp invading the spleen |
| excessive appetite with mouth odor, red and swollen gums, constipation indicates | stomach fire |
| excessive apetite, excessive thierst, excessive urination, emaciation indicates | TCM = xiao ke; WM = dm |
| hungry but doesnt want to eat with a burning sensation in teh stomach, red tongue indicates | stomach yin deficiency |
| tasteless (can still taste but just doesnt taste good) | spleen qi deficiency |
| sweetish taste or stickiness | heat damp syndrome |
| sour regurgitation | liver stomach heat |
| bitter taste | liver and gb heat |
| salty taste | kidney deficiency or cold syndrome |
| prefers warm food or drink | cold syndrome |
| prefers cold food or drink | heat syndrome |
| Insomnia with palpitations, night sweating, red tongue with little coating, rapid and weak pulse indicates: | Heart yin deficiency |
| Insomnia with palpitations, lower back soreness, night sweating, red tongue indicates | Disharmony between the heart and kidney |
| INsomnia with palpitations, poor appetite, fatigue, pale tongue, weak pulse indicates | Heart and spleen deficiency |
| Insomnia with a restless mind, dream disturbed sleep, red tongue tip indicates: | Heart fire hyperactive |
| Lethargy with a heavy sensation in the head and limbs, thick coating, slippery pulse indicates | Phlegm damp syndrome |
| Sleepiness especially after eating, fatigue, poor appetite indicates | Spleen qi deficiency |
| Half asleep with general lassitude, cold limbs indicates | Heart and kidney yang deficiency |
| Lethargic stupor, skin with visible macules or papules, deep red tongue, rapid pulse indicates | - Heat invading the pericardium - Blood fen (xue fen) |
| Constipation with a high fever, distended abdomen, red tongue with a yellow and dry coating indicates: | excess heat syndrome |
| constipation with a pale face, cold limbs, prefers warm drinks, and a deep slow pulse indicates: | cold syndrome |
| Constipation or a dry stool with a red tongue with little coating, rapid and thready pulse indicates | yin deficiency |
| constipation or a dry stool seen with fatigue in a long term disease or in an elderly patient or postpardum woman indcates | qi and body fluid deficiency |
| Loose stool, poor appetite, abdominal distention with a dull pain in the abdomen indicates: | spleen qi deficiency |
| diarrhea before dawn, abdominal pain, borborygmus, relieved by defecation, low back soreness, cold in teh limbs indicates: | kidney yang deficiency |
| diarrhea with a foul smell, sour vomit with an odor and undigested food, abdominal pain that is relieved by defecation or vomiting indicates | food stagnation |
| abdominal pain with diarrhea, relieved by defecation, relating to emotional change | imbalance between the liver and the spleen |
| Undigested food in the stool indicates | spleen or kidney deficiency |
| alternating constipation and loose stools indicates | imbalance between liver and spleen |
| a stool that is dry first, then becomes loose | spleen deficiency |
| bloody stool with large mucous and tenesmus with a burning sensation at the anus indicates | large intestine heat damp (dysentery) |
| black stool indicates | distal blood |
| tenesmus indicates | large intestine heat damp |
| heavy sensation at the anus or prolapse of the anus indicates | spleen qi deficiency |
| Clear and profuse urine, cold limbs, likes warmth | yang deficiency |
| profuse urine, excessive appetite, excessive thirst, emaciation | xiao ke |
| yellow urine in small amounts | excess heat syndrome (dehydration) |
| small amount of urine with edema | lung, spleen, kidney disease (kidney failure) |
| Dark or bloody scanty urine, colic pain in the lower back or abdomen | shi lin (kidney stone) |
| Yellow, scanty, frequent, urgent painful urination | UB heat damp (UTI) |
| Excessive urine at night indicates | kidney deficiency |
| retention or difficult, dribbling urination in an elderly patient indicates | kidney deficiency |
| incontinence in an elderly patient indicates | kidney qi deficiency |
| Vertigo with fatigue, pale face, and lips, pale tongue, weak pulse | Qi and blood deficiency (deficiency) |
| Vertigo with a heavy sensation in the head and limbs, thick coating indicates | damp and phlegm syndrome (exess) |
| Vertigo with severe headache, red eyes, and wiry pulse indicates | liver yang hyperactive & wind syndrome or omen of a stroke (mixed excess and deficiency) |
| sudden onset, high pitch noise tinnitus that is agravated by pressure indcates | excess syndrome of liver fire |
| gradual onset, low pitch tinnitus that is alleviated by pressure indicates | kidney deficiency |
| sudden onset deafness indicates | excess syndrome |
| gradual onset deafness indicates | deficiency syndrome (commonly seen in the elderly) |
| red eyes with blurred vision, headache, tinnitus, lower back soreness indicates | kidney yin deficiency liver yang hyperactive |
| dry eyes with decreased vision indicates | liver blood deficiency; liver and kidney yin deficiency |
| palpitation + Qi deficiency (big 5) sxs indicate | heart qi deficiency |
| palpitation + yang deficiency (big 5 + cold) sxs | heart yang deficiency |
| Palpitations + blood deficiency (PPPPP) sxs | heart blood deficiency |
| Palpitations + yin deficiency (night sweats, malar flush, etc.) sxs | heart yin deficiency |
| Normal menstruation | 21-35 days |
| Shortened menstrual cycle | < 21 days |
| Lengthened menstrual cycle | > 35 days |
| Irregular menses | you never know |
| Amenorrhea | no period for 6 months |
| Profuse flow with a bright red color, red tongue indicates | heat syndrome |
| Profuse flow with a light red color, fatigue, pale tongue, weak pulse indicates | qi deficiency |
| scanty amount with a light red color indicates | blood deficiency |
| purplish color with cloths, lower abdominal stabbing indicates | blood stasis |
| leukorrhea normal | should have no odor |
| Condition of the arterial pulse is felt by the finger tips | True |
| Pulse formation is associated with __, __, and __ | zang fu, qi and blood |
| Pulse formatinon is controlled to the heart, vessels, zong qi, ying qi, lung spleen, stomach, liver, kidney | True |
| __ locations of palpating the TCM pulse | 3 |
| Universal palpation | pulse is taken on the head, upper limbs, and lower limbs. Each of those parts are further divided into upper, middle, and lower portions "3 parts and 9 portions" |
| Three parts palpation | Renying pulse: carotid pulse Cunkou pulse: radial pulse Fuyang pulse: dorsal pulse |
| Renying pulse | carotid pulse |
| cunkou pulse | radial pulse (most common) |
| fuyang pulse | dorsal pulse |
| Cunkou palpitation | Most common - palpating the radial artery on both wrists, divided into 3 parts: cun, guan, chi |
| Normal pulse differentiated by: | depth, speed, strength, shape, rhythm |
| Normal pulse has 3 characteristics | Stomach qi, vitality (shen) and root at the moderate level, is even and smooth at cun, guan, and chi; has moderate force and regular rhythm , 4-5 beats per breath |
| athlete's pulse | slower |
| child's pulse | faster |
| obese person's pulse | deeper |
| thin person's pulse | more superficial |
| woman's pulse | softer and slighlty faster |
| pregnant woman's pulse | slippery pulse |
| spring pulse | wiry |
| summer pulse | flooding |
| Right hand is stronger than left pulse | baby girl |
| left hand is stronger than right pulse | baby boy |
| autumn pulse | floating pulse |
| winter pulse | sinking pulse |
| Pulse can be felt with light palpation but is relatively weak with deep palpation | floating, superficial pulse |
| Floating superficial pulse indicates: | exterior (superficial) syndrome or deficiency syndrome (yang qi floating out) |
| pulse floating, large and weak pulse - seen in: | prolonged illness and weakened condition |
| Pulse is felt only with heavy pressure | sinking, deep pulse |
| Sinking, deep pulse is an __ syndrome | interior |
| Deep and forceful sinking deep pulse | interior excess syndrome |
| Deep and weak sinking deep pulse | interior deficiency syndrome |
| slow pulse | the rate is slow with less than 4 beats per breath (< 60 bpm)` |
| slow pulse indicates | cold syndrome |
| slow and forceful pulse | excess cold syndrome |
| slow and weak | deficiency cold syndrome (Yang syndrome) |
| The rate is rast, with more than 5 beats per breath (> 90 beats per minute) | rapid pulse |
| Rapid pulse indicates | Heat syndrome |
| Rapid pulse and forceful | excess heat syndrome |
| Rapid pulse and weak | deficiency heat syndrome (Yin deficiency) |
| teh rate is very fast with 7-8 beats per breath (140-180 bpm) | swift pulse |
| Swift pulse | extreme heat and yin exhausted, approaching qi collapse |
| The pulse is felt weak at all 3 levels of pressure | Empty pulse |
| Empty pulse, fatigue, spontaneous sweating, light red tongue or with teeth marks indicates | |
| Empty pulse, pale face, lips, nails, and tongue indicates | blood deficiency |
| Empty and slow pulse, spontaneous sweating, cold limbs, likes warmth, swollen tongue indicates | Yang deficiency |
| Empty and rapid pulse, night sweating, malar flush, red tongue with little coating or no coating indicates | Yin deficiency |
| The pulse is felt strong and forceful at all 3 levels of pressure | excess, forceful, strong pulse |
| Excess cold, excess heat, food stagnation phlem and qi and blood stagnation | excess syndrome |
| Excess xie qi and strong zheng qi | excess syndrome |
| The pulse is felt smooth and flowing like beads (pearls) rolling on a plate | Slippery, rolling pulse |
| Sloppery rolling pulse indicates | phlegm and fluid retention, food stagnation, excess heat, women during pregnancy |
| The pulse is felt rough, uneven, unsmooth | Hesitant, choppy, rough pulse |
| Hesitant and forceful pulse | Qi or blood stagnation; food stagnation, phlegm retention |
| Hesitant and weak pulse | Essence impairment and blood deficiency |
| The pulse is broad, large and forceful like roaring waves which come on powerfully and fade away | Flooding, tidal pulse |
| Flooding or tidal pulse indicates | excess heat |
| Excess heat in the flooding or tidal pulse is seen in | yang ming channel syndrome or Qi Fen Syndrome; also seen in prolonged disease (a weak constitution with a flooding pulse indicates a critical conditions) |
| The pulse is broad and large with NO forceful, roaring waves | big, large pulse |
| Pulse is big and forceful | excess syndrome |
| Pulse is big and weak | deficiency syndrome |
| The pulse is felt like a fine thready but is very distinct and clear "as thin as a thread" | thin, thready pulse |
| Thin and thready pulse | Qi, blood and yin deficiency OR dam syndrome |
| Small, fine pulse | same as thin and thready pulse |
| The pulse is felt tight and forceful like a stretched rope | Tight, tense pulse |
| Tight and tense pulse indicates | Cold syndrome, pain, or food stagnation |
| The pulse rate is 4 beats per breath | Moderate, leisurely pulse |
| Indications for a moderate, leisurely pulse | Normal pulse, damp syndrome, spleen and stomach deficiency, qi or blood deficiency, morbid (diseased) moderate = sluggish |
| The pulse is long and straight | Long pulse |
| Normal pulse [long and gentle], liver yang hyperactive, excess heat syndrome, morbid (diseased) long [long and wiry] | Long pulse |
| The pulse is short, only felt distinctly at the guan position | Short pulse |
| Pulse is short and forceful | qi stagnation |
| Pulse is short and weak | Qi deficiency |
| the pulse is felt taut, straight, and long, feels like the "string of a violin" | wiry, stringy pulse |
| Wiry, stringy pulse indicates | Liver and gall bladders disease, phlegm and damp retention, pain, and malaria |
| The pulse is felt at a superficial and deep level, empty at the middle "feeling like an onion stalk" | Hollow, onion stalk pulse |
| Indications for hollow, onion stalk pulse | loss of blood, impairment of yin |
| The pulse is felt at the superficial level, large, hollow, and taught "lke feeling the surface of a drum" | Leather, tympanic pulse |
| Indications for leather, tympanic pulse | loss of blood, impairment of essence |
| The pulse is felt at the deep level, long, taught, and forceful | Confined, fixed, prison pulse |
| Indications for confined, fixed, prison pulse | cold accumulation, qi or blood stagnation |
| The pulse is felt at the very deepest level (pressing to the bone), thready, feeble, and hardly palpable | Hidden pulse |
| Indications for hidden pulse | Pathogens in the interior, jue syndrome (syncope, cold limbs), severe pain |
| The pulse has a round shape like a bean, feeling short, slippery, rapid and forceful | Moving, spinning bean pulse |
| Indications for a moving, spinning bean pulse | pain and fright |
| THe pulse is felt at the superficial level, thready and soft | Soggy, soft pulse |
| Indications for the soggy and soft pulse | deficiency syndrome and damp |
| The pulse feels extremely thready, feebile, barely palpable | Minute pulse |
| Indications for a minute pulse | deficiency syndrome |
| The pulse is felt at the deep level, thready, and very soft | Frail, weak pulse |
| Indication for a frail and weak pulse | qi and blood deficiency |
| The pulse is felt at the superficial level, scattered and uneven | Scattered pulse |
| Indication for scattered pulse | Qi is exhausted |
| The pulse is rapid with irregularly missed beats | hurried, abrupt pulse |
| Indications for hurried and abrupt pulse | excess heat syndrome, qi and blood stagnation, phlegm retention, food stagnation, prostration (CVD) |
| The pulse is slow with irregularly missed beats | knotted pulse |
| Indications for knotted pulse | Excessive yin, qi stagnation, cold phlegm, blood stagnation |
| The pulse is missing beats at regular intervals | intermittent, regularly intermittent pulse |
| Indications for an intermittent, regularly intermittent pulse | Zang qi defciency, wind syndrome, pain, emotional fear and fright, injury, CVD |
| Floating pulse | exterior syndrome |
| sinking pulse | interior syndrome |
| Slow pulse | cold syndrome |
| rapid pulse | heat syndrome |
| Weak pulse | deficiency syndrome |
| forceful pulse | excess syndrome |
| Prolonged disease, weak condition with a moderate pulse | condition is getting better |
| prolonged disease, weak condition with a flooding pulse | critical condition |
| Exterior syndrome with a moderate pulse | condition is getting bette |
| exteriro syndrome with a rapid pulse | may change to an interior syndrome |
| Floating and rapid pulse | exterior (superficial) heat syndrome |
| floating tight pulse | exterior (superficial) cold syndrome |
| Thready rapid pulse | heat deficiency syndrome (yin deficiency) |
| forceful and rapid pulse | excess heat syndrome |
| Rapid, slippery, wiry pulse | heat phlegm syndrome |
| Cold | cold syndrome |
| warm | warm syndrome |
| soft and likes pressure | deficiency syndrome |
| hard and refuses (dislikes) pressure | excess syndrome |
| 5 heart heat (heat sensation in the palms, soles, and chest) | yin deficiency syndrome |
| local edema | pitting edema |
| local qi distention | non-pitting edema |
| zheng | ji - pain or a lump with a fixed position indicates blood stagnation |
| jia | ju - pain or a lump with an unfixed position indicates qi stagnation |
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