Syndrome Differentiation of The Zang-Fu Organs - 1

Download as pdf or txt
Download as pdf or txt
You are on page 1of 99

Dr Zijing Hu (M.B. M.

Med)

Chinese Medicine Diagnostics Lecturer: Department of


Complementary Medicine
(Acupuncture)

(Syndrome differentiation of zang-fu organs) Faculty of Health Sciences


University of Johannesburg
Heart

• Location: in the chest above the


diaphragm and is enveloped by the
pericardium
• Meridian: connects with the small intestine
• Orifice: tongue

• Housing the mind


Functions of the heart

• The heart governs the blood and vessels.


• The heart houses the mind.

• The governing of blood and vessels is manifested in that the


heart qi promotes the flow of blood through the vessels.

• Heart qi
• Heart yin
• Heart yang
• The heart houses the mind.

• In a broad sense, it is the outward appearance of the


vital activities of the whole body, manifested through
the expression of the eyes, facial expression, speech
and the movement of a person.

• In a narrow sense, it is consciousness, including


thoughts and emotions.
Heart and its • Joy as emotion of the heart
relationship with • Sweat as the body fluid of the heart
emotions, body • Blood vessels as the body constituents of the heart
fluids, body and complexion as its splendor
constituents and • Tongue as the orifice of the heart
orifices • The heart corresponds to the summer
Syndrome differentiation of the heart

• Heart blood deficiency


• This syndrome manifests as heart blood failing to nourish the heart.
• Signs and symptoms
• These include palpitations, insomnia, dream-disturbed sleep, poor memory, dizziness,
blurred vision, a pale or sallow complexion and pale, white lips.
• The tongue is pale with a white coating. The pulse is thready.
• Key points
• Palpitations, insomnia, dream-disturbed sleep and blood-deficiency symptoms.
• Heart yin deficiency
• This syndrome manifests as internal deficient heat due to heart yin failing to nourish the
heart.
• Signs and symptoms
• These include restlessness, palpitations, insomnia, dream-disturbed sleep, a dry mouth
and throat, feverish sensations in the palm and soles, flushed cheeks, tidal fever, night
sweats and weight loss.
• The tongue is red with scanty coating.
• The pulse is thready and rapid.
• Key points
• Restlessness, palpitations, insomnia and yin-deficiency symptoms
• Heart qi deficiency
• This syndrome manifests as heart qi failing to help with the heart to pump blood.
• Signs and symptoms
• These include palpitations, chest tightness, shortness of breath, reluctance to talk, mental
fatigue, spontaneous sweating and a pale or sallow complexion. The symptoms worsen
upon physical exertion.
• The tongue is pale white with a white coating.
• The pulse is deficient.
• Key points
• Palpitations, chest tightness and qi-deficiency symptoms.
• Heart yang deficiency
• This syndrome manifests as internal cold due to heart yang deficiency.
• Signs and symptoms
• These include palpitations, chest tightness or pain, mental fatigue, shortness of breath,
spontaneous sweating, cold intolerance, cold limbs and a pale complexion with facial
oedema or a dark face and lips.
• The tongue is pale and swollen or dark purple with a white slippery coating.
• The pulse is deep and weak or regular/irregularly intermittent.
• Key points
• Palpitations, chest tightness or pain and yang deficiency symptoms.
• Sudden collapse of heart yang
• This syndrome mainly manifests as a critical condition of extreme exhaustion of the heart.
• Signs and symptoms
• In addition to symptoms of heart yang deficiency, signs and symptoms of this syndrome
include sudden cold sweats, cold limbs, a pale complexion and faint breathing.
• Some patients may present with palpitations, severe cardiac pain, mental confusion or
unconsciousness and dark purple lips.
• The tongue is bluish. The pulse is extremely weak.
• Key points
• Palpitations, severe cardiac pain, cold sweats, cold limbs and an extremely weak pulse.
• Blockage of heart vessels
• This syndrome manifests as blockage of heart vessels due to stagnant blood, phlegm
turbidity, yin cold and qi stagnation. Clinical manifestations vary according to causative
factors.
• Signs and symptoms
• These include chest oppression, tightness and pain, the pain can radiate to the shoulder
and back. In severe cases, patients may experience chest pain radiating to the back or
back pain radiating to the chest.
• Other symptoms include palpitations, shortness of breath and tachypnoea with an inability
to lie flat.
• Some patients may have stabbing pain at night, a gray bluish complexion, a dark purple
tongue or a tongue with ecchymosis and petechiae and a thready and hesitant or
regular/irregularly intermittent pulse.
• Some patients may mostly present with chest oppression, tightness and pain, obesity,
profuse phlegm, fatigue with a heavy sensation of the body, a dark tongue with a white,
greasy coating and a deep and slippery or deep and hesitant pulse.
• Some patients may present with severe pain that worsens with cold and alleviates with
heat, cold intolerance, cold limbs, a pale, dark tongue with a white coating and a deep
slow or tense pulse.
• Some patients may mainly present with a distending pain that is associated with
emotions, distension in the rib area, frequent sighing, a pale, dark tongue with a white
coating and a wiry pulse
• Key points
• Chest oppression, tightness and pain, the pain radiates to the medial side of the shoulder
and back, or even chest pain radiating to the back and back pain radiating to the chest.
• It’s also important to identify the causative factor according to the nature of pain and
associated symptoms.
• Hyperactivity of heart fire
• This syndrome manifests as hyperactive heart fire disturbing the mind and affecting the
mouth/tongue and the small intestine.
• Signs and symptoms
• These include restlessness, insomnia, fever, sweating, a red face, thirst, constipation and
dark yellow urine.
• Alternatively, patients may present with a red, painful mouth or tongue ulcerations, scanty,
dark yellow urine and painful urination with a burning sensation.
• In severe cases, mania, delirium and unclear consciousness may be present.
• The tongue has a deep red tip with a yellow coating. The pulse is rapid and forceful.
• Key points
• Restlessness, mouth and tongue ulcerations and painful urination with a burning
sensation.
• Phlegm misting the heart mind
• This syndrome manifests as a mental abnormality due to phlegm-turbidity misting the
heart mind.
• Signs and symptoms
• These include dull expression, clouding of consciousness, mental confusion, inability to
recognise people, mental depression, apathetic facial expression, muttering to oneself,
being suspicious, strange behavior, a dark complexion, chest tightness, profuse phlegm
and gastric discomfort coupled with nausea and vomiting.
• Alternatively, some patients may experience a sudden collapse, loss of consciousness,
drooling/foaming from the mouth and phlegm sounds in the throat.
• The tongue coating is white and greasy. The pulse is slippery.
• Key points
• Mental depression, confusion and internal phlegm-turbidity symptoms.
• Phlegm fire disturbing the heart mind
• This syndrome manifests as a mental abnormality due to internal phlegm fire disturbing
the heart mind.
• Signs and symptoms
• These include restlessness, insomnia, restlessness, even unconsciousness and delirium.
• Some patients may become manic and take reckless actions such as hitting other people,
damaging things, talking nonsense, crying or laughing for no reason.
• In addition, they may not be able to recognize their family members, experience fever and
a red face.
• Some patients may present with a dry mouth with a desire to drink water, chest tightness,
rapid breathing, phlegm sounds in the throat, expectoration of yellow phlegm, constipation
and dark yellow urine.
• The tongue is red with a yellow, greasy coating.
• The pulse is slippery and rapid
• Key points
• Restlessness, mania, unconsciousness, delirium and phlegm-fire symptoms.
• Stasis obstructing the brain collateral
• This syndrome manifests as a malnourishment of the brain due to stagnant blood
obstructing the brain collateral.
• Signs and symptoms
• These include dizziness, persistent, stabbing headache in a fixed location, insomnia,
palpitations and a dark complexion.
• Some patients may experience transient unconsciousness or a poor memory after the
head trauma. The tongue is dark purple or has ecchymosis/petechiae. The pulse is
thready and hesitant.
• Key points
• Headache, dizziness and blood-stasis symptoms.
Small intestine

• Location: the small intestine is located in the


abdomen. Its upper end connects with the
stomach and lower end with large intestine..
• Meridian: connect to heart

• Functions of small intestine


• Receiving and digesting food
• Separating the clear from the turbid
Syndrome differentiation of the small intestine

• Excess heat in the small intestine


• This syndrome manifests as a dysfunction of the small intestine in separating the clean
from the turbid due to excessive interior heat.
• Signs and symptoms
• These include scanty, dark-yellow urine, painful urination with a burning sensation or
bloody urine, restlessness, insomnia, red face, thirst with a desire to drink water and
mouth and tongue ulcerations.
• The tongue is red with a yellow coating. The pulse is rapid.
• Key points
• Scanty, dark-yellow urine, painful urination with a burning sensation or bloody urine and
excessive-heat symptoms.
Dr Zijing Hu (M.B. M.Med)
Lecturer: Department of Complementary Medicine
(Acupuncture)
Room 7106d John Orr Building DFC
Faculty of Health Sciences
University of Johannesburg
Tel: 011 559 6999
E-mail: [email protected]
Dr Zijing Hu (M.B. M.Med)

Chinese Medicine Diagnostics Lecturer: Department of


Complementary Medicine
(Acupuncture)

(Syndrome differentiation of zang-fu organs) Faculty of Health Sciences


University of Johannesburg
Lung
• Location: in the thoracic cavity, above the diaphragm, it
communicate with the throat and opens into the nose
and mouth.
• Meridian: connects with the large intestine
• Orifice: nose
• “Florid canopy”
Functions of lung

• The lung governs the qi

• The lung governs dispersing and descending

• The lung governs regulation of the waterways

• The lung links with all vessels

• The lung governs the regulation of qi, blood and body


fluids.
Lung and its relationship with emotions, body
fluids, body constituents and orifices

• Sorrow as emotion of the lung


• Nasal mucus as the body fluid of the lung
• Skin as the body constituents of the lung and body
hair as its splendor
• Nose as the orifice of the lung
• The lung corresponds to the autumn
Syndrome differentiation of the lung

• Lung qi deficiency
• This syndrome manifests as dysfunctions of the lung in dominating qi and wei-defense.
• Signs and symptoms
• These include weak coughing and tachypnoea, expectoration of thin, clear phlegm,
shallow breathing, reluctance to talk, a low voice, general fatigue, a pale white
complexion, spontaneous sweating, wind intolerance and susceptibility to common colds.
The symptoms worsen upon physical exertion.
• The tongue is pale with a white coating. The pulse is weak.
• Key points
• Coughing and tachypnoea with thin, clear phlegm, susceptibility to common colds,
spontaneous sweating and qi-deficiency symptoms.
• Lung yin deficiency
• This syndrome manifests as dysfunction of lung qi in dispersing and descending due to
lung yin deficiency.
• Signs and symptoms
• These include unproductive cough or coughing with scanty, sticky phlegm or blood-
stained phlegm, a dry mouth and throat, a hoarse voice, weight loss, feverish sensations
in the palms, soles and chest, tidal fever, night sweats and flushed cheeks.
• The tongue has a red scanty coating. The pulse is thready and rapid.
• Key points
• Unproductive cough or coughing with scanty, sticky phlegm and yin-deficiency symptoms.
• Wind-cold attacking the lung
• This syndrome manifests as wind cold affecting the wei-defense.
• Signs and symptoms
• These include coughing with thin, white phlegm, tachypnoea, chills, fever, nasal
obstruction, clear nasal discharge, headache, body ache and absence of sweating.
• The tongue coating is thin and white. The pulse is superficial and tense.
• Key points
• Coughing with thin, clear phlegm and symptom of exterior wind-cold syndrome.
• Wind-heat attacking the lung
• This syndrome manifests as wind heat affecting the dispersing of lung qi.
• Signs and symptoms
• These include coughing with thick, yellow phlegm, tachypnoea, fever, mild aversion to
wind cold, nasal obstruction, turbid nasal discharge, a dry mouth with mild thirst and sore
and swollen throat.
• The tongue has a red tip with a thin, yellow coating. The pulse is superficial and rapid.
• Key points
• Coughing with thick, yellow phlegm and symptoms of wind-heat exterior syndrome.
• Dryness attacking the lung
• This syndrome manifests as dryness affecting the functions of the lung in clearing and
moistening.
• Signs and symptoms
• These include unproductive coughs or difficult expectoration of scanty, sticky phlegm and
dry lips, tongue, nose, throat and skin.
• Fever, chills and scanty or absence of sweating may also be present.
• The tongue coating is dry and thin. The pulse is superficial and rapid or superficial and
tense.
• Key points
• Unproductive coughs, scanty, sticky phlegm, dry lips, tongue, nose, throat and skin as
well as exterior syndrome symptoms.
• Exuberance of lung heat
• This syndrome manifests as heat affecting the dispersing and descending of lung qi.
• Signs and symptoms
• These include coughing, tachypnoea, hot breath, chest pain, red, sore and swollen throat,
fever, thirst, constipation and scanty, dark yellow urine.
• The tongue is red with a yellow coating. The pulse is rapid.
• Key points
• Acute coughing, tachypnoea and symptoms of interior excess syndrome.
• Phlegm heat accumulating in the lung
• This syndrome manifests as phlegm heat affecting the dispersing and descending of lung
qi.
• Signs and symptoms
• These include coughing with thick, yellow, profuse phlegm, tachypnoea, rapid breathing,
coughing with foul-smelling pus and blood in the phlegm, phlegm sounds in the throat,
chest tightness and pain, red, sore and swollen throat, a high-grade fever, thirst, scanty,
dark yellow urine and constipation.
• The tongue is red with a yellow, greasy coating. The pulse is slippery and rapid.
• Key points
• Coughing with thick, yellow phlegm, tachypnoea, rapid breathing, foul-smelling pus and
blood in the phlegm, phlegm sounds in the throat and symptoms of interior excess heat.
• Cold phlegm affecting the lung
• This syndrome manifests as cold phlegm obstructing the dispersing and descending of
lung qi.
• Signs and symptoms
• These include coughing, tachypnoea, and wheezing sounds in the throat, sticky, profuse
or thin, clear phlegm, chest tightness, cold intolerance and cold limbs.
• The tongue is pale with a white, greasy or white, slippery coating.
• The pulse is soft, delayed or slippery.
• Key points
• tachypnoea, coughing with white phlegm, wheezing sounds in the throat and symptoms of
internal cold phlegm.
• Phlegm dampness affecting the lung
• This syndrome manifests as phlegm dampness affecting the dispersing and descending
of lung qi.
• Signs and symptoms
• These include coughing with white, sticky, profuse phlegm and chest tightness. In severe
cases, tachypnoea and phlegm sounds may be present.
• The tongue is pale with a white, greasy coating. The pulse is slippery.
• Key points
• Cough and a white, sticky, profuse phlegm.
Large intestine
• Location: the large intestine is located in the abdomen,
connected to the small intestine at the top and the anus at
the bottom.
• Meridian: connects with the lung

• Functions of large intestine


• Receiving and conveying the waste material sent down
from the small intestine, absorbs its fluid content, and
forms the remainder into faeces to be excreted.
• Governing body fluids
Syndrome differentiation of the large intestine
• Damp-heat in the large intestine
• This syndrome manifests as damp-heat obstructing the functions of large intestine in
recieving and transporting waste.
• Signs and symptoms
• These include abdominal pain, diarrhoea with foul-smelling, yellow stools or blood and
mucus in the stools, tenesmus, a burning sensation around the anus, thirst and scanty,
dark yellow urine.
• Alternatively, concurrent chills and fever or fever alone may be present.
• The tongue is red with a yellow, greasy coating. The pulse is slippery and rapid or soft
and rapid.
• Key points
• Abdominal pain, diarrhoea, dysentery with blood and mucus in the stools and symptoms
of internal damp heat.
• Excess heat in the large intestine
• This syndrome, also known as Yangming fu organ syndrome, manifests as heat entering the
interior (intestine) to mingle with the dry faeces.
• Signs and symptoms
• These include a high-grade fever or tidal fever which is more pronounced in the afternoon,
abdominal fullness, hardness and pain that aggravates upon pressure, constipation or foul-
smelling, watery diarrhoea, sweating, thirst and scanty, dark yellow urine.
• In severe cases, unconsciousness, delirium, and insanity may be present.
• The tongue is red with a dry, thick, yellow coating or a burnt-yellow coating with thorns on
the tongue. The pulse is deep, rapid and forceful or deep, slow and forceful.
• Key points
• Abdominal fullness, hardness and pain, constipation and symptoms of interior excess heat.
• Intestinal dryness due to fluid insufficiency
• This syndrome manifests as fluid failing to moisten the large intestine.
• Signs and symptoms
• These include dry stools like sheep’s droppings, one bowel movement in a couple of
days, abdominal distension and pain, abdominal masses on the left side, a dry mouth or
foul breath and dizziness.
• The tongue is dry and red with a dry, yellow coating. The pulse is thready and hesitant.
• Key points
• Dry stools and fluid-insufficiency symptoms.
• Deficiency cold of the large intestine
• This syndrome manifests as yang qi of the large intestine failing to hold and constrain.
• Signs and symptoms
• These include severe diarrhoea, bowel incontinence, dull abdominal pain that alleviates
with warmth and pressure, cold intolerance and mental fatigue.
• In severe cases, rectal prolapse may be present.
• The tongue is pale with a white, slippery coating. The pulse is weak.
• Key points
• Severe diarrhoea, bowel incontinence and deficiency cold symptoms.
Dr Zijing Hu (M.B. M.Med)
Lecturer: Department of Complementary Medicine
(Acupuncture)
Room 7106d John Orr Building DFC
Faculty of Health Sciences
University of Johannesburg
Tel: 011 559 6999
E-mail: [email protected]
Dr Zijing Hu (M.B. M.Med)

Chinese Medicine Diagnostics Lecturer: Department of


Complementary Medicine
(Acupuncture)

(Syndrome differentiation of zang-fu organs) Faculty of Health Sciences


University of Johannesburg
Spleen

• Location: the spleen is located in the middle


jiao. This is the region between the
diaphragm and umbilicus.
• Meridian: connects with the stomach
• Orifice: Mouth
Functions of the spleen

• The spleen governs transportation and


transformation
• Transformation and transportation of food
• Transformation and transportation of body fluids

• The spleen controls blood in the vessels

• The characteristics of the spleen


• The spleen governs the rise of the clear (qi)
• The spleen prefers dryness and dislikes dampness
Spleen and its relationship with emotions, body fluids, body
constituents and orifices

• Worry as it’s emotion


• Saliva as the body fluid of the spleen
• Muscles/ flesh and four limbs as the body constituents of the spleen
• Mouth as the orifice of the spleen and lips as its splendor
• The spleen corresponds to the season of late summer
Syndrome differentiation of the spleen

• Spleen qi deficiency
• This syndrome manifests as weakness of spleen qi in transportation and transformation.
• Signs and symptoms
• These include reduced food intake, a poor appetite, abdominal distension (especially after
eating food), loose stools (or dry stools followed by loose stools), lassitude, shallow
breathing, reluctance to talk, a sallow complexion and weight loss or oedema.
• The tongue is pale with a white coating. The pulse is delayed and weak.
• Key points
• Reduced food intake, abdominal distension, loose stools and qi deficiency symptoms.
• Spleen yang deficiency
• This syndrome manifests as internal deficiency cold due to spleen yang deficiency.
• Signs and symptoms
• These include a poor appetite, abdominal distension and pain with preference for warmth
and pressure, loose stools, cold intolerance and cold limbs.
• Some patients may present with general oedema, heaviness of the body, dysuria or thin,
clear, profuse leucorrhoea.
• The tongue is pale, swollen and tender. The pulse is deep, slow and weak.
• Key points
• A poor appetite, abdominal distension/pain, loose stools and yang-deficiency symptoms.
• Spleen qi sinking
• This syndrome manifests as spleen qi failing to ascend.
• Signs and symptoms
• These include down-bearing sensation of the abdomen, especially after eating food,
lassitude, low voice with a reluctance to talk, fatigue, dizziness, blurred vision, a sallow
complexion, weight loss, reduced food intake and loose stools.
• Alternatively, frequent urges to have bowel movements, down-bearing sensation of the
anus, chronic diarrhoea or dysentery, rectal prolapse, uterine prolapse and turbid rice-
water urine may be present.
• The tongue is pale with a white coating. The pulse is delayed and weak.
• Key points
• Down-bearing sensation of the abdomen, prolapsed internal organs and symptoms of
spleen qi deficiency.
• Spleen failing to constrain blood within the vessels
• This syndrome manifests as bleeding due to spleen qi deficiency.
• Signs and symptoms
• These include bloody stools, bloody urine, mucocutaneous haemorrhage, gum bleeding,
nosebleeds, heavy menstruation and uterine bleeding.
• Other associated symptoms include reduced food intake, loose stools, general fatigue,
shallow breathing, reluctance to talk and a sallow complexion.
• The tongue is pale with a white coating. The pulse is thready.
• Key points
• Various chronic bleeding conditions and symptoms of spleen qi deficiency.
• Cold dampness affecting the spleen
• This syndrome manifests as cold dampness affecting the function of the spleen and stomach
in transportation and transformation.
• Signs and symptoms
• These include gastric or abdominal discomfort, stuffiness, distension and pain, reduced food
intake, a poor appetite, loose stools with a sensation of incomplete bowel evacuation, nausea,
vomiting, tastelessness with no thirst, heaviness of the head and body and a dark, sallow
complexion.
• Profuse leucorrhoea, oedema of the limbs and scanty urine may also be present.
• The tongue is pale white with a white, greasy coating. The pulse is soft and moderate.
• Key points
• Gastric or abdominal discomfort, stuffiness, distension and pain, loose stools with a sensation
of incomplete bowel evacuation, nausea, vomiting and symptoms of cold-dampness.
• Damp-heat accumulating in the spleen
• This syndrome, also known as damp-heat in the spleen and stomach, manifests as damp-
heat affecting the function of the spleen and stomach in transportation and transformation.
• Signs and symptoms
• These include gastric and abdominal discomfort, stuffiness, distension and pain, reduced
food intake, a poor appetite, nausea, vomiting, loose stools with a sensation of incomplete
bowel evacuation, heaviness of the limbs, dark yellow urine and persistent fever that
cannot be resolved after sweating.
• The tongue is red with a yellow, greasy coating. The pulse is slippery and rapid or soft
and rapid.
• Key points
• Gastric and abdominal discomfort, stuffiness, distension and pain, nausea/vomiting, loose
stools with a sensation of incomplete bowel evacuation and damp-heat symptoms.
Stomach

• Location: the stomach is situated beneath the


diaphragm.
• Meridian: connect to spleen

• Functions of stomach
• Receiving and decomposing food and water
• Dominates descending

• The characteristics of stomach


• The stomach prefers moisture and dislikes
dryness
Syndrome differentiation of the stomach

• Stomach qi deficiency
• This syndrome manifests as stomach qi weakness and failure of stomach qi to descend.
• Signs and symptoms
• These include gastric discomfort and distension or a dull stomachache that alleviates with
pressure, a poor appetite, belching, a sallow complexion, lassitude, shortness of breath
and a reluctance to talk.
• The tongue is pale with a white coating. The pulse is weak.
• Key points
• Gastric discomfort, distension or pain, reduced food intake, belching and qi deficiency
symptoms.
• Stomach yang deficiency
• This syndrome manifests as stomach yang failing to warm and nourish the stomach.
• Signs and symptoms
• These include lingering stomachache with a cold sensation, preference for warmth and
pressure, reduced food intake, gastric discomfort, vomiting of watery fluid, cold
intolerance, cold limbs and lassitude.
• The tongue is pale, swollen and tender with a white, moist coating.
• The pulse is deep, slow and weak.
• Key points
• Stomachache with a cold sensation, vomiting of watery fluid and deficiency-cold
symptoms.
• Stomach yin deficiency
• This syndrome manifests as stomach yin failing to nourish and moisten the stomach.
• Signs and symptoms
• These include a dull stomachache, hunger with no desire to eat, a dry mouth and throat,
dry stools and scanty urine.
• Alternatively, gastric discomfort, retching and hiccups may be present.
• The tongue is red with scanty coating. The pulse is thready and rapid.
• Key points
• Dull stomachache, hunger but no desire to eat, gastric discomfort, retching, hiccups and
yin-deficiency symptoms.
• Food retention in the stomach
• This syndrome manifests as food retention affecting the function of the stomach in
receiving and decomposing food.
• Signs and symptoms
• These include gastric distension, stuffiness and pain, no appetite, belching and acid
reflux, vomiting of rotten food (the distension and pain are relieve after vomiting). Foul-
smelling flatulence and foul-smelling stools may be present.
• The tongue coating is thick and greasy. The pulse is slippery.
• Key points
• A history of improper diet, gastric distension, stuffiness and pain, belching and acid reflux.
• Exuberance of stomach fire
• This syndrome, also known as stomach heat or stomach fire, manifests as dysfunction of
the stomach in receiving and decomposing food due to internal exuberance of stomach
fire.
• Signs and symptoms
• These include stomachache with a burning sensation, gastric upset, acid reflux, thirst with
desire for cold water, scanty, dark yellow urine and constipation.
• Alternatively, hunger returning rapidly after eating, a foul breath, swelling and pain of the
gum, gum bleeding and haematemesis may also be present.
• The tongue is red with a yellow coating. The pulse is slippery and rapid.
• Key points
• Stomachache with a burning sensation, gastric upset, acid reflux, hunger returning rapidly
after eating, a foul breath, swelling and pain of the gum and heat symptoms.
• Cold retention in the stomach
• This syndrome, also known as stomach cold, manifests as cold attacking and remaining
in the stomach.
• Signs and symptoms
• These include sudden, severe stomachache with a cold sensation, the pain worsens with
cold and alleviates with warmth, absence of thirst, vomiting of watery fluid, cold
intolerance and cold limbs.
• The tongue coating is white and moist. The pulse is wiry or wiry and tense.
• Key points
• Stomachache with a cold sensation and symptoms of excess cold.
Dr Zijing Hu (M.B. M.Med)
Lecturer: Department of Complementary Medicine
(Acupuncture)
Room 7106d John Orr Building DFC
Faculty of Health Sciences
University of Johannesburg
Tel: 011 559 6999
E-mail: [email protected]
Dr Zijing Hu (M.B. M.Med)

Chinese Medicine Diagnostics Lecturer: Department of


Complementary Medicine
(Acupuncture)

(Syndrome differentiation of zang-fu organs) Faculty of Health Sciences


University of Johannesburg
Liver

• Location: in the abdominal region just


below the diaphragm within the right side of
the body.
• Meridian: connects with the gallbladder
• Orifice: eyes
Functions of the liver

• The liver governs the flow of qi (qi regulation)

• Regulating qi movement
• Regulating smooth flow of blood and water metabolism
• Promoting digestive functions of the spleen and stomach
• Regulation of emotions
• Promoting the reproduction in humans
• The liver stores the blood

• Storing Liver qi
• Regulating the volume of blood
• Nourishing the liver and eyes
• The source of menstruation
• Prevents bleeding
Liver and its relationship with emotions, body fluids, body constituents
and orifices

• Anger as the emotion of the liver


• Tears as the body fluid of the liver
• Sinews as the body constituents of the liver
and nails as its splendor
• Eyes as the orifice of the liver
• The liver corresponds to the spring
Syndrome differentiation of the liver

• Liver blood deficiency


• This syndrome manifests as malnourishment of Iiver-related tissues and organs.
• Signs and symptoms
• These include dizziness, blurred vision, visual deterioration, night blindness, numbness of
the limbs, tremors of the hands and feet, joint contracture, muscle twitching, skin itch,
insomnia, dream-disturbed sleep, scanty menstruation with a pale colour or amenorrhoea,
pale face and lips and dry nails.
• The tongue is pale with a white coating.
• The pulse is wiry and thready.
• Key points
• These include dizziness, blurred vision, numbness of the limbs and common blood-
deficiency symptoms.
• Liver yin deficiency
• The syndrome manifests as yin failing to control yang and an internal disturbance of
deficient heat.
• Signs and symptoms
• These include dizziness, blurred vision, dry eyes, dry mouth and throat, flushed cheeks,
feverish sensation in the palms, soles and chest, tidal fever and night sweats.
• Patients may also present with a dull, burning pain in the rib area.
• The tongue is red with a scanty coating.
• The pulse is wiry, thready and rapid.
• Key points
• These include dizziness, dry eyes and common yin-deficiency symptoms.
• Liver qi stagnation
• This syndrome manifests as the liver failing to maintain the free flow of qi.
• Signs and symptoms
• These include emotional depression or irritability, frequent sighing and distension, fullness
or migratory pain in the chest, rib area and lower, lateral abdomen.
• Some patients may present with globus hystericus, goiter, scrofula, breast pain,
distension or nodules, dysmenorrhoea and irregular menstruation.
• The tongue coating is thin and white.
• The pulse is wiry.
• This condition closely relates to the emotional fluctuations.
• Key points
• These include emotional depression, distending pain in the chest, rib area and lower,
lateral abdomen and irregular menstruation.
• Up-flaming of liver fire
• This syndrome, also known as an exuberance of liver fire or excessive fire in liver
meridian, manifests as exuberant fire-heat disturbing the liver.
• Signs and symptoms
• These include dizziness, severe, distending headache, red face and eyes, restlessness,
irritability, a dry mouth with a bitter taste and high-pitched tinnitus.
• Some patients may experience sudden deafness, insomnia, nightmares, burning pain in
the rib area, haematemesis, nosebleed, scanty, yellow urine and constipation. The tongue
is red with a yellow coating. The pulse is wiry and rapid.
• Key points
• Headache, restlessness, tinnitus, pain in the rib area and excessive-heat symptoms.
• Hyperactivity of liver yang
• This syndrome manifests as hyperactivity of liver yang (excess) due to yin deficiency of
the liver and kidney.
• Signs and symptoms
• These include vertigo, tinnitus, distension and pain of the eyes and head, red face ike a
flushed face from alcohol, restlessness, irritability, insomnia, dream-disturbed sleep, light-
headedness and soreness and weakness in the waist and knees.
• The tongue is dry and red with a scanty coating. The pulse is wiry or wiry, thready and
rapid.
• Key points
• The include vertigo, tinnitus, distension and pain of eyes and head, red flushed face,
soreness and weakness in the waist and knees and unstable walking.
• Internal stirring of liver wind
• Liver yang transforming into wind
• This syndrome manifests as internal stirring of liver wind due to hyperactivity of liver yang.
• Signs and symptoms
• These include vertigo, feeling like fainting, unstable walking, head tremors or a distending
headache, neck rigidity, tremor of the limbs, numbness of the hands and feet,
restlessness, irritability, red face and eyes and tinnitus.
• In severe cases, patients may experience a sudden collapse, deviation of the mouth and
eyes, hemiplegia, tongue stiffness, slurred speech, and phlegm sounds in the throat.
• The tongue is red with a greasy coating. The pulse is wiry and forceful.
• Key points
• Vertigo, tremor or numbness of the limbs and a distending headache.
• Extreme heat generating wind
• This syndrome manifests as liver wind stirring due to exuberant heat.
• Signs and symptoms
• These include a high-grade fever, neck rigidity, eyes fixed upward, convulsions of the
limbs, opisthotonos, trismus, restlessness, unconsciousness or delirium, and thirst.
• The tongue is deep red with a dry, yellow coating.
• The pulse is wiry and rapid.
• Key points
• A high-grade fever and wind-stirring symptoms.
• Wind stirring due to yin deficiency
• This syndrome manifests as internal liver wind and malnourishment of the tendons and
vessels due to liver yin deficiency.
• Signs and symptoms
• These include twitching or tremors of the hands and feet, convulsions of the limbs,
dizziness, tinnitus, a dry mouth and throat, weight loss, feverish sensations in the palms,
soles and chest, tidal fever and flushed cheeks.
• The tongue is red with a scanty coating.
• The pulse is wiry, thready and rapid.
• Key points
• Tremor or twitching of hands and feet due to wind stirring and deficiency-heat symptoms.
• Blood deficiency generating wind
• This syndrome manifests as an internal stirring of wind and malnutrition of tendons or
vessels due to liver blood deficiency.
• Signs and symptoms
• These include tremors or numbness of the limbs, contracture of hands and feet, muscle
twitching, skin itch, dizziness, blurred vision, visual deterioration, night blindness,
insomnia, dream-disturbed sleep, a pale face and lips and dry nails.
• The tongue is pale with a white coating. The pulse is wiry and thready.
• Key points
• Tremor or numbness of the limbs, contracture of hands and feet, muscle twitching and
blood-deficiency symptoms.
• Cold retention in the liver meridian
• This syndrome manifests as cold attacking and remaining in the liver meridian.
• Signs and symptoms
• These include cold pain in the lower, lateral abdomen and distending pain in the genital
area coupled with a down-bearing sensation.
• Some patients may present with contracture-induced pain of the external genitalia or a
parietal headache with a cold sensation.
• The pain worsens with cold and relieves with warmth.
• Other symptoms include cold intolerance and cold limbs.
• The tongue is pale with a white coating. The pulse is deep and tense or wiry and tense.
• Key points
• Cold pain in the Iower, lateral abdomen, genital area and top of the head and excessive-
cold symptoms.
Gallbladder

• Location: The gallbladder is located under


the liver.
• Meridian: connect to liver

• Functions of gallbladder
• Storing and excreting the bile
• Dominating decision - making and
regulating emotions
Syndrome differentiation of the gallbladder
• Damp-heat in the liver and gallbladder
• This syndrome manifests as damp-heat disturbing gallbladder qi
• Signs and symptoms
• These include distending pain in the rib area, (bright) yellow eyes and yellowish
pigmentation of the skin, a bitter taste, a poor appetite, aversion to greasy food, nausea,
vomiting, abdominal fullness and distension, irregular bowel movements and scanty,
yellow urine.
• Some patients may present with itching, eczema or excessive sweating in the genital
area, swelling and pain of the external genitalia, thick, yellow and smelly leucorrhoea, and
fever or alternating fever and chills.
• The tongue is red with a yellow, greasy coating. The pulse is wiry, slippery and rapid.
• Key points
• Distending pain in the rib area, yellow eyes, yellowish pigmentation of the skin and damp-
heat symptoms.
• Gallbladder qi stagnation coupled with phlegm
• This syndrome manifests as phlegm-heat or phlegm-turbidity disturbing gallbladder qi.
• Signs and symptoms
• These include timidity, fearfulness, nervousness or easily startled, palpitations, insomnia,
restlessness, distension and tightness in the chest and rib area, dizziness, blurred vision,
a bitter taste, nausea and vomiting.
• The tongue is red with a white, greasy or yellow, greasy coating. The pulse is wiry,
slippery and rapid.
• Key points
• Timidity, fearfulness, nervousness or easily startled, insomnia, a bitter taste and phlegm-
heat symptoms.
Dr Zijing Hu (M.B. M.Med)
Lecturer: Department of Complementary Medicine
(Acupuncture)
Room 7106d John Orr Building DFC
Faculty of Health Sciences
University of Johannesburg
Tel: 011 559 6999
E-mail: [email protected]
Dr Zijing Hu (M.B. M.Med)

Chinese Medicine Diagnostics Lecturer: Department of


Complementary Medicine
(Acupuncture)

(Syndrome differentiation of zang-fu organs) Faculty of Health Sciences


University of Johannesburg
Kidney

• Location: in the lumbus, consisting of the two parts,


on left and the right side to the spine

• Meridian: connects with the urinary bladder

• Orifice: Ear, urethra meatus, external genitalia &


anus
Functions of the kidney

• The kidney stores essence, dominates development and reproduction


• Storing essence
• Dominating development and reproduction
• The kidney dominates human growth and development
• The kidney dominates human's reproduction
• The kidney yin and kidney yang are the roots of whole body's yin and yang

• The kidney governs water metabolism

• The kidney receives qi


Kidney and its relationship with emotions, body fluids,
body constituents and orifices

• Fear as the emotion of the kidney


• Spittle as the body fluid of the kidney
• Bones as the body constituents of the kidney and hair as its splendor
• Ear, anterior and posterior orifices as the opening of the kidney
• The kidney corresponds to the winter
Syndrome differentiation of the kidney

• Kidney yang deficiency


• This syndrome manifests as kidney yang failing to warm the body and transform qi.
• Signs and symptoms
• These include soreness and cold pain in the waist and knees, impotence,
spermatorrhoea, premature ejaculation, infertility due to cold retention in the uterus, loss
of interest in sex, a pale complexion with facial oedema or a dark complexion, cold
intolerance, cold limbs, low spirit, clear profuse urine and frequent urination at night or
scanty urine or dysuria, chronic diarrhoea with stools containing undigested food,
diarrhoea before dawn, oedema in the lower limbs, abdominal fullness and distension,
palpitations, shortness of breath, coughing, tachypnoea and phlegm sounds in the throat.
• The tongue is pale and enlarged with a white, slippery coating. The pulse is deep, slow
and weak, especially in the Chi region.

• Key points
• This include soreness and cold pain in the waist and knees, loss of interest in sex,
frequent urination at night, chronic diarrhoea, oedema and yang-deficiency symptoms.
• Kidney yin deficiency
• This syndrome manifests as internal deficient heat due to kidney yin deficiency.
• Signs and symptoms
• These include soreness and weakness in the waist and knees, dizziness, tinnitus, dream-
disturbed sleep, persistent erection of the penis, nocturnal emissions, premature
ejaculation, scanty menstruation, amenorrhoea or uterine bleeding, weight loss, flushed
cheeks, a dry throat, feverish sensations in the palms, soles and chest, tidal fever, night
sweats, dark yellow urine and dry stools.
• The tongue is red with a scanty coating. The pulse is thready and rapid.
• Key points
• Soreness and weakness in the waist and knees, dizziness, tinnitus, nocturnal emissions,
irregular menstruation and yin-deficiency symptoms.
• Kidney essence deficiency
• This syndrome manifests as hypofunctions in growth, development and reproduction due
to kidney essence deficiency.
• Signs and symptoms
• These include delayed growth and development, a short stature, delayed fontanel
closure, skeletal muscle flaccidity and motor retardation in children.
• In adults, premature aging, soreness and weakness in the waist and knees, flaccidity of
the feet, tinnitus, deafness, loose teeth, hair loss, poor memory, absent-mindedness and a
dull expression.
• Patients may also have sterility and infertility. The tongue is pale and the pulse is weak.
• Key points
• Delayed growth and development, reduced reproductive function, premature aging and
essence-deficiency symptoms.
• Kidney qi insecurity
• This syndrome manifests as kidney qi failing to store and hold the essence.
• Signs and symptoms
• These include soreness and weakness in the waist and knees, spermatorrhoea,
premature ejaculation, dribbling menstruation, thin, clear, profuse leucorrhoea, possible
miscarriage, clear, profuse urine, frequent urination at night, dribbling urination, enuresis,
urinary incontinence, tinnitus, deafness and mental fatigue.
• The tongue is pale with a white coating. The pulse is thready and weak.
• Key points
• Soreness and weakness in the waist and knees, frequent spermatorrhoea, dribbling
menstruation, miscarriage and symptom of kidney-qi deficiency.
• Kidney failing to receive qi
• This syndrome manifests as qi failing to return to its origin due to kidney qi failure.
• Signs and symptoms
• These include chronic coughing, tachypnoea, more exhalation than inhalation and
shortness of breath that worsens upon physical exertion, soreness and weakness in the
waist and knees, a soft voice, spontaneous sweating and mental fatigue.
• In severe cases, patients may experience urinary incontinence when coughing.
• The tongue is pale with a white coating. The pulse is weak.
• In some patients, gasping, cold sweats, cold limbs, a bluish face and a big, superficial and
rootless or superficial, rapid and rootless pulse may be present.
• In some patients, shortness of breath, flushed cheeks, restlessness, a dry mouth and
throat, a red tongue with scanty coating and a thready, rapid pulse may be present.
• Key points
• Chronic coughing, tachypnoea, more exhalation than inhalation and shortness of breath
that aggravates upon physical exertion and symptoms of qi deficiency of the lung and
kidney.
Urinary bladder

• Location: the urinary bladder is located at the lower


abdomen region. It is connected upward to the
kidney and downward to the urinary tract.
• Meridian: connects with the kidney

• Functions of the bladder


• Storing and discharging urine
Syndrome differentiation of the bladder

• Damp heat in the urinary bladder


• This syndrome manifests as damp heat affecting the qi transformation of the urinary
bladder.
• Signs and symptoms
• These include frequent and urgent urination, a painful urination with a burning sensation
and scanty, dark yellow or turbid urine, bloody urine, urine containing stones, distending
or pulling pain in the lower abdomen or lower back and fever.
• The tongue is red with a yellow, greasy coating.
• The pulse is slippery and rapid or soft and rapid.
• Key points
• Frequent and urgent of urination, painful urination with a burning sensation as well as
damp-heat symptoms.
Dr Zijing Hu (M.B. M.Med)
Lecturer: Department of Complementary Medicine
(Acupuncture)
Room 7106d John Orr Building DFC
Faculty of Health Sciences
University of Johannesburg
Tel: 011 559 6999
E-mail: [email protected]
Dr Zijing Hu (M.B. M.Med)

Chinese Medicine Diagnostics Lecturer: Department of


Complementary Medicine
(Acupuncture)

(Syndrome differentiation of the zang-fu organs) Faculty of Health Sciences


University of Johannesburg
• Yin deficiency of the lung and kidney
• This syndrome manifests as internal deficient heat due to yin fluid deficiency of the lung
and kidney.
• Signs and symptoms
• These include an unproductive cough or blood-stained phlegm, a hoarse voice, soreness
and weakness in the waist and knees, a dry mouth and throat, bone-steaming tidal fever,
night sweats, flushed cheeks, weight loss, nocturnal emissions and scanty menstruation.
• The tongue is red with a scanty coating.
• The pulse is thready and rapid.
• Key points
• An unproductive cough, lumbar soreness, nocturnal emissions and deficiency heat
symptoms.
• Liver fire affecting the lung
• This syndrome manifests as liver fire affecting the function of the lung in dispersing and
descending.
• Signs and symptoms
• These include burning pain in the chest and rib area, restlessness, irritability, head
distension, dizziness, a red face and eyes, vexation, a bitter taste, paroxysmal coughs
with thick, yellow phlegm and even haemoptysis.
• The tongue is red with a thin, yellow coating.
• The pulse is wiry and rapid.
• Key points
• Burning pain in the chest and rib area, irritability, cough with thick yellow phlegm and
excess-heat symptoms.
• Disharmony between the liver and stomach
• This syndrome manifests as liver qi stagnation or liver fire affecting the descending of
stomach qi.
• Signs and symptoms
• These include distending or migratory pain in the rib area and stomach, hiccups, belching,
vomiting, a poor appetite, depression and frequent sighing.
• The tongue is pale red with a white coating and the pulse is wiry.
• Alternatively, burning pain in the rib area and stomach, restlessness, irritability, acid reflux,
gastric upset, a red tongue with a yellow coating and a wiry, rapid pulse may be present.
• Key points
• Distending pain in the stomach and rib area, belching, hiccups, vomiting and depression.
• Liver qi stagnation with spleen deficiency
• This syndrome manifests as stagnant liver qi affecting the function of the spleen in
transportation and transformation.
• Signs and symptoms
• These include fullness, distension and migratory pain in the rib area, depression, frequent
sighing, restlessness, irritability, a poor appetite, abdominal distension, loose stools with a
sensation of incomplete bowel evacuation, bowel sounds and flatulence or alternating dry
and loose stools, or abdominal pain that alleviates after bowel movements.
• The tongue coating is white.
• The pulse is wiry or moderate.
Liver qi stagnation affects the function of the
spleen in transportation and transformation Abdominal pain that alleviates
after bowel movements
Bowel movements can temporarily
allow free flow of qi

• Key points
• These include distending pain in the rib area, depression, abdominal distension and loose
stools.
• Yin deficiency of the liver and kidney
• This syndrome manifests as internal deficient heat due to yin fluid deficiency of the liver
and kidney.
• Signs and symptoms
• These include soreness and weakness in the waist and knees, dull pain in the rib area,
dizziness, blurred vision, tinnitus, poor memory, insomnia, dream-disturbed sleep, a dry
mouth and throat, feverish sensations in the palms, soles and chest, nocturnal emissions
and scanty menstruation.
• The tongue is red with a scanty coating.
• The pulse is thready and rapid.
• Key points
• Soreness and weakness in the waist and knees, pain in the rib area, dizziness, tinnitus
and deficiency-heat symptoms.
• Yang deficiency of the spleen and kidney
• This syndrome manifests as yang of the spleen and kidney failing to warm the body and
transform qi.
• Signs and symptoms
• These include cold pain in the waist, knees and lower abdomen, persistent diarrhoea or
dysentery, diarrhoea before dawn with clear stools containing undigested food, general
oedema, dysuria, cold intolerance, cold limbs and a pale complexion with facial oedema.
• The tongue is pale and enlarged with a white, slippery coating.
• The pulse is deep, slow and weak.
• Key points
• Cold pain in the waist and lower abdomen, persistent diarrhoea or dysentery, oedema and
deficiency-cold symptoms.
Dr Zijing Hu (M.B. M.Med)
Lecturer: Department of Complementary Medicine
(Acupuncture)
Room 7106d John Orr Building DFC
Faculty of Health Sciences
University of Johannesburg
Tel: 011 559 6999
E-mail: [email protected]

You might also like