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TCM Diagnosis manifests the features of TCM in the concepts of?
Wholism and Differentiations
What are the 4 methods of diagnostic examination?
- 1. Observation
- 2. Auscultation and smelling
- 3. Interrogation
- 4. Pulse feeling and palpation
Who determines the Chief Complaint?
Practitioner decides through pattern differentiation and typically when all questions have been asked
The patient chief complaint should include?
Main symptom and duration
The patients chief complaint should include?
Main symptoms and duration
During the Inquiry portion of intake, what specific questions should be asked with a female patient?
- Number of pregnancies
- Number of births
- Number of miscarriages
- Number of abortions
During the Inquiry portion of intake, what specific questions should be asked with a child patient?
Vaccines (i.e. smallpox, chickenpox, measles, etc)
What are the three specials questions one should ask the patient?
- Work Lifestyle (i.e. stressful?)
- Social (smoking, drugs, alcohol, etc)
- Sexual ability / activity (infertility)
Sudden and temporary
Aversion to cold
Intolerance to cold
What is the difference between Aversion to cold with sweat and Aversion to cold without sweat?
- With sweat - deficiency external pattern
- Without sweat - excessive external pattern
Sweat due to Qi & Yang def.
Spontaneous Sweat (sweating for no reason, cannot hold fluid)
Sweat due to Yin def
Night Sweat (sweat during sleep not necessarily during the night time)
At the point between sick and not sick this type of sweat occurs
Trembling perspiration (physiologically trembling to sweat out pathogens)
Sweat that comes out from all / many orifices possibly cold on touch
Perspiration due to Yang collapse
Sweat is sticky / oily with burning / hot sensation on touch
Perspiration due to Yin collapse
If there is perspiration on the forehead region, which channel is associated?
If there is perspiration on only one side of the body (hemihidrosis), what is that typically due to?
Stroke related (sweat occurs on the non-stroke side of the body)
If there is perspiration located on the palms and soles what is that due to?
Damp-heat or Damp-cold
What are the three deficient type headaches?
- Qi def
- Blood def
- Essence def
What are the three excess type headaches?
- Liver Yang
- Blood Stasis
Headache of the occipital region, involving the nape
Tai Yang Headache
Headache of the forehead region, involving the supraorbital region
Yang Ming Headache
Headache of both sides of the head, involving the ears
Shao Yang Headache
Headache of the top of the head; both eyes may be involved
Jue Yin Headache
Headache involving the teeth. Generally aggravated at night and alleviated by day.
Shao Yin Headache
What is the root cause of Vertigo?
Kidney Yang def
What is the cause of vertigo with distending headache?
Liver Yang Rising
What is the cause of vertigo with sleepiness?
Qi / Blood def
What is the cause of vertigo with dim eyesight?
What is the cause of vertigo with tinnitus?
If one has lumbago pain with signs of vague pain and weakness of the waist which are aggravated in the afternoon, what is that due to?
If one has lumbago pain with signs of cold pain and feeling of heaviness of the waist which is aggravated during overcast or rainy days, what is that due to?
If one has lumbago pain with signs of hot pain, feeling of distension and heaviness of the waist, accompained with frequent micturition (urination), urodynia (painful urination), and deep-colored urine, what is that due to?
Downward flow of Damp-Heat
If one has chest pain with signs of palpitations, what is that due to?
Heart Qi Def
If one has chest pain with Cold signs, what is that due to?
Heart Yang Def
If one has chest pain with signs of insomnia, dizziness, anxiety, pale complexion, what is that due to?
Heart Blood def
If one has chest pain with signs of Heat, 5 palm-heat, night sweat, what is that due to?
Heart Yin def
If one has chest pain with signs of purple nails, purple lips, purple tongue, radiating / stabbing pain, what is that due to?
Signs / Symptoms of Obstruction of Heart collaterals
If one has chest pain with signs of fatigue, cough, no palpitations, what is that due to?
Lung Qi Def
If one has chest pain with signs of sputum, phlegm, distension, fullness, what is that due to?
Lung Qi Stag
If one has chest pain with signs of long term disease, tidal fever, what is that due to?
Consumptive Disease (TB)
If one has chest pain with signs of pneumonia, rusty-brown sputum, what is that due to?
If one has chest pain with signs of the"4 Bigs", what is that due to?
Exuberance of Lung Heat
If one has epigastric pain with signs of relief with heat, pain on pressure, clear saliva, what is that due to?
Excessive Cold in Stomach
If one has epigastric pain with signs of big appetite, always hungry, no weight gain, what is that due to?
Flaming up of Stomach Fire
If one has epigastric pain with signs of relief on heat and pressure, clear saliva, what is that due to?
Stomach Yang Def
If one has epigastric pain with signs of vague pain, dry mouth, dry stool, skinny body type, hunger but no appetite, what is that due to?
Stomach Yin def
If one has epigastric pain with signs of sharp-stabbing pain, distension, what is that due to?
Blood stasis in gastric collaterals
If one has hypochondriac pain with signs of red face, red lips, red eyes, tinnitus, headache, what is that due to?
Liver Yang Rising
If one has hypochondriac pain with signs of irritability, poor appetite, sadness, depression, short temper, what is that due to?
Liver Qi Stag
If one has hypochondriac pain with signs of thick yellow greasy coating, bitter taste, red eyes, red face, red tongue, irritability, what is that due to?
If one has hypochondriac pain with signs of constipation, short temper, thick yellow greasy coating, red tongue, bitter taste, what is that due to?
Stag of Damp-Heat in LR / GB
If one has abdominal pain with signs of diarrhea with undigested food, cold intolerance, what is that due to?
Spleen Yang Def
If one has abdominal pain with signs of indigestion, fatigue, poor appetite, malnutrition, what is that due to?
SP / ST Qi Def
If one has abdominal pain with signs of movement on palpation, what is that due to?
Parasitic Infection (mostly found in rural areas)
What time does the body regenerate RBC's?
9 pm - 3 am
What is a better question to ask than the number of ours patients sleep?
The exact time interval they sleep
If one has insomnia with signs of annoyance, frustration, hotness in palms and soles (5 palm heat), soreness and weakness of the waist and knees, what is that due to?
Heart and Kidney Disharmony
If one wakes easily from sleep with signs of palpitation, amnesia, anorexia, feebleness, possibly poor appetite and / or fatigue, what is that due to?
Heart and Spleen Def and / or Blood def
If one has insomnia with signs of fullness, distension, oppression in the epigastric region, belching with putrid and sour odor, thick greasy coating of tongue, bad breath, what is that due to?
Food Stagnation (late dinners may also cause this)
If one has dream-disturbed sleep with signs of palpitation, edema, what is that due to?
Heart and Kidney Yang def
1. Spleen Yang def with damp accumulation
2. Spleen Qi def after a meal
3. Heat attacking Pericardium
Drowsiness or Lethargy
What are the four types of defecation?
- Heat Constipation
- Cold Constipation
- Deficient Constipation
- Constipation due to depression and stagnation of Liver energy
- (constipation can be heat or cold signs, excess or def signs)
- *Boat in Intestines example
What are the four types of Diarrhea?
- Deficient cold (Yang Qi def, slippery boat due to ice)
- Damp-Heat (tenesmus - always feel the need to go)
- Improper eating (food poisoning / allergy)
- Depression and stagnation of Liver Energy (IBS)
Essence and Qi are not impaired
Presence of Vitality
Essence and Qi of internal organs have been impaired during the course of an illness
Absence of Vitality
Appears in patient whose condition is severe, or who is even dying. It manifests itself as a sudden short-lived improvement and then sharp decline soon after.
Shallow Looking Complexion
Deep Looking Complexion
Clear and Smooth Looking Complexion
Dusky and Haggard Looking Complexion
Pale Looking Complexion
Dark Looking Complexion
Evenly Distributed Complexion
Congested Looking Complexion
Lingering illness process
Bright and Moist Looking Complexion
Dull and Dry Looking Complexion
Natural Facial Expression
Bright, Moist Complexion
Correct in Normal Voice (Speech)
Coordinated in Action
Good Muscle Tone
Presence of Vitality
Dull Looking Eyes
Indifferent Facial Expression
Dim, Dry Complexion
Confuse in Mind
Incoherent in Low / High Voice (Speech)
Disharmonious in Action
Dull / Poor in Reaction
Weak and Flaccid Muscle
Absence of Vitality
If one has a weak body physique, what is that due to?
If one has an obese body physique, what is that due to?
- Spleen Qi / Yang def
If one has a slender body physique, what is that due to?
- Kidney Yin / Essence Def
- Def Heat
Congenital defects or the deficiency of Kidney Essence (genetic)
What are the five kinds of developmental retardation?
- Teeth - Calcium def (avg. ~8 months)
- Speech - possibly congenital (avg. ~1 year)
- Standing (avg. ~10 months)
- Walking (avg. ~12 months)
- Sitting - Calcium def (avg. ~5 months)
Shaking of the Head is due to?
Qi and Blood Def / Exhaustion due to Internal Wind
This type of edema causes wrinkles to disappear and skin look smooth.
Qi Type Edema
This type of edema is sudden onset, starts in the face and works its way down
Yang Type Edema
This type of edema is slow (takes months to years) onset, starts at the ankles and works its way up to the knees
Yin Type Edema (if it makes its way to the knees it is considered a serious / critical condition)
The neck is a filter of what?
Clear and Turbid Qi, normally only Clear Qi goes to the head
Orifices of the face are termed?
Orifices of the lower body are termed?
Thick, sleek and glossy hair are indicative of?
Abundant Blood and Kidney Essence
Dry, sparse, or withered hair and hair falling is indicative of?
Kidney Essence Def
Alopecia areata is indicative of?
Wind attacking due to Blood Def
Thin, sparse hair and the liability of its falling in young or middle aged people is indicative of?
- Blood Heat (cause obstruction due to "burning" away of fluid which in turn obstructs any way for the hair to obtain nutrients which is why the hair fall out)
- Kidney Def
Hair entangled like tassels are indicative of?
Acute onset is typically considered
If Qi stag and Phlegm accumulation is found in the neck, what condition is this?
Phlegm nodules found in the neck due to Def Fire induced by Yin Def is indicative of?
Opisthotonus (neck spasms) are indicative of?
Wind-Fire in stroke
Flaccid neck with drooping head is indicative of?
Identify each, by Name, Anatomical Site, and Organ
- 1. Eyelid
- 2. Whites of eye
- 3. Pupil
- 4. Color of Eye
- 5. Canthus
Conjunctive congestion with swelling and pain is due to?
Excessive Heat syndrome (depending on where the redness is located it will effect certain organs; Five Orbiculus - for the exception of Liver Heat where the redness is found all over the eye)
Pale conjunctiva and canthus is due to?
Bright / Gold / Orange colored conjunctiva due to Jaundice
Yang Type Jaundice due to Damp-Heat
Smoky yellow color conjunctiva due to Jaundice
Yin Type Jaundice due to Cold-Damp
If ones nose is pale at the apex, what is that due to?
Loss of Blood
If ones nose is yellow, what is that due to?
Exuberance of Damp-Heat
If ones nose is blue, what is that due to?
If ones nose is red, what is that due to?
Heat in SP and LU
If ones nose is light black, what is that due to?
Retention of Body Fluids
If ones nose is Black with Dried Nostrils, what is that due to?
Rosacea is due to?
Blood Heat in the Lung
Flared nostrils (nares) are due to?
Exhaustion of Lung Qi
If ones nose has clear secretions, what is that due to?
If ones nose has turbid secretions, what is that due to?
Ruddy (reddish) lips signify what?
Exuberant Stomach Qi (manifest on lips, 5 phase chart)
Pale lips signify what?
Qi and Blood Def
Deep red lips signify what?
Deep red and dry lips signify what?
Exuberance of Heat and depletion of Yin
Cyanotic lips signify what?
Black color around the mouth signify what?
Exhaustion of Kidney Qi / Essence
Black, dry, and curled lips are an ominous sign of what?
Spleen failure (Water Insults Earth)
Dry mouth with cracked lips is due to?
Erosion of the mouth is due to?
Damp-Heat in Spleen-Stomach
Redness, hotness, swelling, itching, or pain on mouth and lips is due to?
Twitching of the oral corner is due to?
Stirring of Liver Wind
Deviation of the mouth and eyes is due to?
Facial paralysis or apoplexy (bleeding in stroke)
Aphtha (sores in mouth ("canker sore" - fei ji) is due to what?
Acc Heat in Heart-Spleen
Mycotic stomatitis (sores / patches of white in and / or around mouth (canker sore type)) or thrush is due to?
Hidden Heat in Heart-Spleen
Slobbering along corner of the mouth is due to?
Spleen Def (Spleen is one of the organs in charge of water metabolism, def of spleen cannot control the water / slobber)
Pale gums are due to what?
Withered gums are due to?
- Exuberance of Heat
- Depletion of Yin
- Exhaustion of Essence and Vital Energy
Swelling, pain, and bleeding of the gums are due to?
Pale shriveling gum with wizened teeth are due to?
Exhaustion of Kidney Yin
Slackened teeth with exposed dental roots are due to?
Flaming up of Excessive Fire due to Kidney Yin Def
Delayed Growth of permanent teeth in children is due to?
Kidney Qi def
Teeth grinding in sleep is due to?
- Stomach Heat
- Parasitic Infestation
- Dyspepsia (indigestion / upset stomach)
Involuntary teeth gnashing is due to?
Swelling, pain, ulcers, yellowish white pus in the throat is due to?
Tender redness with slight pain, or dry redness without swelling is due to?
Pale redness with diffuse swelling is due to?
Acc of Phlegm-Dampness
Epidemic Heat Pathogen
Epidemic Heat Pathogen
Ruddy, Scattered, Brighter
Pale Red or Dim Purple
Herpes Zoster is due to?
LR / GB issues
Eczema is due to?
Identify the following concerning SVIF
Thickening of SVIF indicates?
Heat or Excess syndrome
Thinning of SVIF indicates?
Cold or Def syndrome
Superficial and evident SVIF indicates?
Deep and Hidden SVIF indicates?
Bright Red SVIF indicates?
Purplish-Red SVIF indicates?
Interior Heat syndrome
Pale Yellow SVIF indicates?
Blue SVIF indicates?
Wind or Pain
Purplish Black SVIF indicates?
Blockage of Blood Circulation
Pale and Lusterless SVIF indicates?
Deep, dim colored and Stagnated SVIF indicates?
Clear, dilute, frothy phlegm accompanied with dizziness, oppressed feeling in the chest is due to what type of discharge?
White, slippery, abundant phlegm is apt to be expectorated is due to what type of discharge?
Scanty, sticky phlegm which is difficult to be expectorated is due to what type of discharge?
Phlegm tinged with bright red blood is due to what type of discharge?
Damage of Lung Collaterals by Heat
Stench phlegm with pus and blood is due to what type of discharge?
Turbid nasal discharge is due to what?
Clear nasal discharge is due to what?
Protracted, incessant, turbid nasal discharge is due to what?
Incessant clear slobbering is due to what?
Spleen Asthenia (Def) or Cold syndrome of Spleen
Involuntary slobbering, esp during sleep is due to what?
- Spleen Def
- Parasitic Infection
- Stomach Heat (in children)
Spitting of copious frothy saliva is due to what?
- Wetness-Cold in Stomach
- Kidney Yang Def
Clear, dilute vomit without acid and offensive odor is due to what?
- Stomach Def
- Cold Syndrome of Stomach
Filthy, turbid, sour, stinking vomits is due to what?
- Heat Syndrome of Stomach
Sour and putrid vomits with undigested food is due to what?
Dyspepsia (indigestion) due to over-eating or improper diet
Yellowish green, bitter, watery vomits is due to what?
Heat in LR / GB
Spitting of bright red or dim purple blood mixed with food is due to what?
Damage of Stomach collaterals
Sudden onset high tone tinnitus usually caused by?
Hyperactive Liver Yang
The 4 properties of Tongue Inspection
Which organ is considered a 3 Jiao organ?
Liver (*tree example)
Under what conditions is it best to inspect the tongue?
Under natural light
When is the best time to check to tongue?
Early in the morning before eating
Very thick coating is indicative of what?
When inspecting the tongue, what are signs of good Shen?
- Parabolic shape
- Symmetrical shape
- Not too much coating, Not too little coating
In general, cracks on the tongue are indicative of what?
Consumption of Yin
Taste buds of the tongue are indicative of what?
If the Wei level is being attacked, what signs that are present on the tongue?
Tongue Tip Red
If the Qi level is being attacked, what signs that are present on the tongue?
- Red Tongue body
- Thick Yellow coating
If the Ying level is being attacked, what signs that are present on the tongue?
No / Scanty coating (damage to Taste Buds)
If the Blood level is being attacked, what signs that are present on the tongue?
Blood Spots / Bleeding
If "peeling" is found on the whole tongue, what is that due to?
Stomach Qi exhaustion (very Def)
If "peeling' is found on portions of the tongue, what is that due to?
Stomach Yin exhaustion (very Def)
Tremors and Stiffness of Tongue indicate?
Wind (external wind invading and inducing internal wind)
Tremors, dryness and redness of Tongue indicate?
Liver Wind (extreme Heat stirring up Liver Wind)
Tremors and Paleness of Tongue indicate?
Deficiency syndrome (Qi / Blood / Yang leading to poor nourishment / circulation)
Repeated and Involuntary extension of Tongue and licking lips indicates?
Liver Wind (upward stirring of Spleen and Heart Heat)
Playing with the tongue is due to what?
- Exuberance of Heat in the Heart and Spleen, generally\
- Poor Mental development in infants (convulsions)
Wagging of Tongue is due to what?
- Cerebral hypoplasia in children (underdevelopment)
- Febrile disease involving Central Nervous System
Flaccid Tongue and unable to curl and protrude tongue (weakness), is due to what?
- Qi and Blood Exhausion (very Def)
- Yin / Fluid depletion
Numb tongue is due to what?
Qi and Blood Def
Thin, short, light red with less branching of sublingual veins is indicative of what?
Qi / Blood Def
Thick purple / dark blue with branching of sublingual veins is indicative of what?
Qi / Yin exhaustion
What are the 4 abnormal voices?
- 1. Loudness - loud (excess), weak (def)
- 2. Intonation (pitch) - emotional (voice goes lower in sadness)
- 3. Groaning - pain (release stagnation)
- 4. Husky voice / muteness
Taciturnity (shyness) of speech is indicative of what?
def, cold syndrome
Fretfulness and talkativeness in speech is indicative of what?
excess, heat syndrome
Fading murmuring in speech is indicative of what?
Delirium in speech is indicative of what?
Soliloquy in speech is indicative of what?
- Yin sydrome
- Obstruction of Heart by phlegm condensation
Ravings in speech is indicative of what?
Dysphasia in speech is indicative of what?
- Obstruction of vessel collaterals due to Wind-phlegm
Excess gasping is indicative of what?
- excess Lung Heat
- retention of Phlegm-fluid in chest
Def gasping is indicative of what?
Lung-Kidney Qi def
What are the components of a TCM pulse?
8 qualities of pulse diagnosis
Cun-Guan-Chi on both sides is congenitally deep and thready without disorder
Six Yin Pulse
Cun-Guan-Chi on both sides is congentially full and large without disorder
Six Yang Pulse
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