Transcript Heart yang deficiency

Small
intestine
Excess
Heat
Heart
infested
by fire
and
phlegm
Heart Qi
Deficiency
Heart
Yang
Deficiency
Heart
Yang
Collapse
Heart and SI
Syndrome
Differentiation
Phlegm
Impaired
Mental
Facilities
Heart
Blood
Deficiency
Heart Vessels
Obstruction
Heart Yin
Deficiency
Hyperactivity
of Heart Fire
Heart Qi Deficiency Syndrome
心 气虚证
• Caused by chronic diseases; congenital
deficiency; aging; serious disease.
• Clinical manifestations: palpitation; chest distress;
short breath; lassitude; spontaneous sweating,
pale tongue, white coating and weak pulse.
• Insufficient heart qi leads to palpitation, chest
distress , spontaneous sweating and fails to push
blood fails to push blood , heart lacks
nourishment leads to lassitude, pale tongue with
white coating and weak pulse.
Heart Yang Deficiency Syndrome
心阳虚证
Causes
Worsen heart qi
deficiency leads to
cold limbs and other
yang deficiency
symptoms
Clinical
Manifestations
Palpitation, chest distress;
short breath; spontaneous
sweating, aversion to cold,
cold limbs, pale complexion
and pale and enlarged or
purple tongue with white and
slippery coating, faint pulse.
Declining heart yang
and hypo-function of
the heart bring about
palpitation
Syndrome
Analysis
Heart Yang Collapse Syndrome
心阳暴脱证
Distress and
pain in the
chest,
symptoms of
yang
exhaustion
syndrome
Exhaustion of Yang qi leads
to fluid depletion, causing
cold sweat and cold limbs;
failure of blood nourishing
the upper part of the body
leads to pale tongue and
pale complexion; collapse of
yang qi results in severe loss
of pectoral qi; deficient heart
yang causes retention of cold
in the meridians and heart
vessel obstruction, stabbing
pain the chest, cyanotic lips
and purple tongue.
In addition to
manifesting heart
yang deficiency
syndrome, sudden
cold sweat, cold limbs,
faint breath, pale
complexion, or
stabbing pain in the
chest, cyanotic lips or
coma, pale or light
purple tongue and
weak pulse.
Syndrome
Common Points
Heart
Severe
yang
palpitation, chest
deficiency distress and
shortness of
Heart qi
breath, worse
deficiency
when active,
spontaneous
Heart
sweating
yang
collapse
Different
Points
Tongue
Characteristic
and Pulse
Condition
Aversion to
cold and cold
limbs,
headache,
pale
complexion
Pale and
enlarged tongue
with white and
greasy or dark
coating, faint
pulse
Pale
complexion
Pale tongue
with white
coating,
deficient pulse
Cold sweat,
cold limbs,
faint breath,
pale
complexion,
cyanotic lips, or
coma
Pale or light
purple tongue,
faint and thin
pulse.
Heart Blood Deficiency Syndrome
心血虚证
• Palpitation or
severe
palpitation,
insomnia and
disturbed
sleep, dizziness,
pale and sallow
complexion,
pale lips and
tongue, weak
pulse.
• Insufficient blood,
malnutrition and
abnormal heart beat
caused palpitation;
Failure of blood
nourishing the heart
results in insomnia
and disturbed sleep,
dizziness, pale or
sallow complexion,
pale lips and tongue
and weak pulse
• Palpitation,
insomnia,
disturbed
sleep and
other
symptoms
of blood
deficiency
syndrome
Heart Yin Deficiency Syndrome
心阴虚证
• Palpitation or severe palpitation, insomnia and
disturbed sleep, restlessness, heat in the chest,
palms and soles, night sweating, dry mouth and
throat, red tongue with scanty saliva, thin and rapid
pulse.
• Deficiency of heart yin fails to nourish the heart
results in abnormal heart beat and palpitation,
disturbed sleep and restlessness; insufficient yin gave
rise to deficiency-heat , palms and soles, night
sweating, dry mouth and throat, red tongue with
scanty saliva and fine rapid pulse.
• Palpitation, insomnia, disturbed sleep and other
symptoms of yin deficiency syndrome.
Syndrome
Common points
Heart blood Palpitation
deficiency or severe
Heart yin
deficiency
palpitation,
insomnia,
disturbed
sleep
Different points
Tongue and pulse
characteristics
Amnesia,
dizziness, pale
white or
sallow
complexion,
pale lips
Heat in the
chest, palms,
soles, tidal
fever, night
sweating,
flushed cheeks
Pale tongue,
weak pulse
Red tongue
with scanty
saliva, fine and
rapid pulse
Hyperactive Heart Fire Syndrome
心火亢盛证
Restlessness, insomnia, flushed face, thirst, ulcers in the mouth and tongue, red tongue, rapid pulse, or
mania with delirium accompanied with yellowish urine and painful urination and hematuria尿血.
Internal flaming of heart fire disturbs the mind results in insomnia, mania and delirium. Upward flaming of
the fire leads to ulcers in the mouth and tongue and flushed face. Fire also hurts body fluids results in thirst.
When heart fire invades the small intestine, dark urine with painful urination noticed. Injury of blood
vessels by fire caused hematuria.
Abnormal mental activities or ulcers in the mouth and tongue, accompanied with symptoms of excess heat
syndrome.
Obstruction of Heart Vessels Syndrome
心脉痹阻证
Palpitation or severe palpitation, distress and pain in the chest
and shoulder, back and the arm. Obesity patient may manifest
profuse phlegm, heavy body, severe dull pain, white and greasy
tongue tongue, sunken and slippery pulse caused by heart
vessel blocked by phlegm. Cold accumulated in the heart vessel
leads to severe pain, alleviated by warmth, aversion to cold and
cold limbs, pale tongue with white coating, deep slow or deep
tense pulse. Stagnant qi obstructs the heart vessel causes
distending
Deficient heart yang fails to warm and nourish the heart induces
abnormal heart beat and severe inadequate yang cause blood stasis
and phlegm accumulation and obstruct the heart vessel.
Palpitation or severe palpitation, occasional
distress and pain in the chest.
Syndrome
Common points
Different points
Tongue and pulse
characteristics
Heart vessel
blocked by blood
stasis
Palpitation or
severe palpitation,
occasional distress
and pain in the
chest and shoulder,
back and arm could
be affected.
Stabbing pain
Purple tongue, or
with ecchymosis or
spots, fine rough or
knotted
intermittent pulse
Severe distress in
the chest, obesity
with profuse
phlegm, heavy
body and lassitude
White and greasy
coating, deep
slippery pulse
Heart vessel
blocked by phlegm
Phlegm Impaired Mental Facilities
痰蒙心神证
• Dementia, unsound mind, or depression, selftalking, abnormal behavior; wheezing sputum in
the throat, coma, excessive sputum with chest
distress, greasy tongue coating and slippery
pulse.
• When the mind is blocked by phlegm, abnormal
mental activity emerged such as dementia or selftalking or coma.
• Abnormal mental activity, accompanied by
symptoms of internal excessive phlegm
syndrome.
Heart infested by fire and phlegm
痰火扰神证
• Coma, delirium and agitation can be externally
contracted where flaming of internal heat leads to
constipation and yellow urine.
• Vomiting or coughing of yellow sputum or wheezing in
the throat can be caused by internal exuberance of
phlegm and fire.
• Behavior indicating personality order such as violent
action, laughing and weeping without restraint can be
noticed.
• High fever, excessive phlegm, coma or restlessness,
insomnia and mania are key points in syndrome
differentiation.
Syndrome
Common points
Different
points
Phlegm
Impaired
Mental
Facilities
Abnormal
mental
activities,
accompanied
by internal
excessive
phlegm
Depressive
psychosis,
epilepsy,
dementia but
absence of
fire syndrome
Heart
infested by
fire and
phlegm
Restlessness,
agitation and
obvious heat
syndrome.
Tongue and
pulse
characteristics
Greasy tongue
coating,
slippery pulse
Red tongue
with yellow
greasy coating,
slippery and
rapid pulse.
Heart
infested by
fire and
phlegm
Phlegm
Impaired Mental
Facilities
Heart Qi
Deficiency
Heart Yang
Deficiency
Heart
Syndrome
Differentiation
Obstruction
of Heart
Vessels
Caused by
blood
stasis
Caused by
phlegm
Caused by
Accumulation of
Heart Blood
Deficiency
Hyperactive
Heart Yang
Caused by
Accumulation of
cold
qi
Collapse
of Heart
Yang
Heart Yin
Deficiency
Excess Heat of Small Intestine Syndrome
小肠实热证
Restlessness, insomnia, flushed face, dry mouth and throat, dark urine, pain in
the urinary duct, hematuria, red tongue with white coating and rapid pulse.
The heart and small intestine are interior-exterior related. Downward movement of
heat causes dysfunction of the small intestine and manifestations of heat symptoms.
Dark urine with burning pain and other symptoms of excess heart fire.
Small
intestine
Excess
Heat
Heart
infested
by fire
and
phlegm
Heart Qi
Deficiency
Heart
Yang
Deficiency
Heart
Yang
Collapse
Heart and SI
Syndrome
Differentiation
Phlegm
Impaired
Mental
Facilities
Heart
Blood
Deficiency
Heart Vessels
Obstruction
Heart Yin
Deficiency
Hyperactivity
of Heart Fire
Small
intestine
Excess
Heat
Heart
infested
by fire
and
phlegm
Heart Qi
Deficiency
Heart
Yang
Deficiency
Heart
Yang
Collapse
Heart and SI
Syndrome
Differentiation
Phlegm
Impaired
Mental
Facilities
Heart
Blood
Deficiency
Heart Vessels
Obstruction
Heart Yin
Deficiency
Hyperactivity
of Heart Fire
Incessant
Diarrhea
caused by
Deficient
Large Intestine
Qi
fluid
Deficiency
of the
Large
Intestine
Lung Qi
Deficiency
Lung Yin
Deficiency
Wind-Cold
Restraining
the Lung
Lung and
Large
Intestine
Syndrome
DampHeat of
the Large
Intestine
PhlegmDampness
Obstructing
the Lung
Dryness
Invading
the Lung
WindHeat
Invading
the Lung
Accumulated
Heat in the
Lung
Lung Qi Deficiency Syndrome
肺气虚证
Clinical
Manifestations
• Weak coughing and panting, lassitude, weak voice, aversion to
cold, pale complexion, spontaneous sweating, pale tongue and
deficient pulse.
Syndrome
Analysis
• Insufficient lung qi leads to easy contraction of cough and
panting; Weak disperse of lung qi results in aversion to cold and
spontaneous sweating; Weak flow of qi and blood fails to
nourish the face leads to pale complexion.
Focal Points
• Weak coughing and panting, clear and thin
phlegm and other symptoms of qi deficiency.
Lung Yin Deficiency Syndrome
肺阴虚证
Dry cough with
scanty but sticky
sputum, dry mouth
and throat, tidal
fever, heat in the
chest, palms and
soles, night
sweating, flushed
cheeks, sometimes
coughing bloody
sputum, hoarse
voice, red tongue
with scanty coating
and fine, rapid
pulse.
Insufficient lung yin and internal generation of
deficiency-heat leads to adverse qi rising and
coughing. Body fluids are scorched into
sputum and hence scanty sticky sputum.
Failure of Lung yin to rise to moisten the
throat and mouth caused dryness, tidal fever
and heat symptoms.
Heat attacked the lung vessels induce bloody
sputum.
When the throat lacks moistening from yin
fluid cause hoarse voice, red tongue with
scanty saliva, and fine and rapid pulse.
Dry cough
with no or
scanty but
sticky
sputum and
other
symptoms of
yin
deficiency
syndrome.
Wind-Cold Restraining the Lung syndrome
风寒束肺证
Clinical Manifestations
Syndrome Analysis
Key Characteristics
White thin and clear
sputum, stuffy nose
with watery
discharge, slight
aversion to cold,
mild fever, absence
of sweating, thin and
white tongue
coating, floating and
tense pulse.
Cold invaded the lung
channel restrains lung qi
from dispersing; adverse
flow of qi results in
cough, stuffy nose with
watery discharge.
Defensive qi obstructed
by wind-cold leads to
aversion to cold and
tense pulse;
confrontation between
healthy qi and pathogens
induced fire ; absence of
sweating is due to
obstruction of follicular
orifices.
Coughing,
panting, white
and thin sputum,
and other
symptoms of the
wind-cold
exterior
syndrome.
Wind-Heat Invading the Lung
Syndrome风热犯肺证
• Coughing thick yellow sputum, stuffy nose with yellow
and turbid discharge, fever, mild aversion to wind-cold,
dry mouth and sore throat, red tongue tip, thin yellow
tongue coating and floating rapid pulse.
• Wind-heat invaded the lung causing failure of lung qi to
disperse and descend and results in thick yellow
sputum, sore throat and stuffy nose; disorders of
defensive qi leads to fever and aversion to wind-heat;
• Cough, thick yellow sputum and other symptoms of
wind-heat.
Accumulating Heat in the Lung
Syndrome热邪壅肺证
• Expectoration of thick and yellow sputum, heavy
breath, high fever, or flaring of nares or chest pain,
expectoration of bloody pus and fishy smell sputum,
dry stools, dark urine, red tongue with white coating,
and slippery rapid pulse.
• Fever, cough and heavy breath are due to exuberance
of lung heat and dysfunction of ling qi in dispersion and
descent. Chest pain and flaring of nares, spitting of
fishy smell sputum are due to burning lung heat.
• Cough, excessive sputum and other symptoms of
interior excess heat syndrome.
Dryness Invading the Lung Syndrome
燥邪犯肺证
Dryness invasion of the lung results
in deficient body fluids, fever and
aversion to cold; lung lacks
moistening and lung qi fails to
descend and disperse caused dry
cough and little but sticky sputum
and difficult to expectorate; chest
pain and hemoptysis are due to fire
in the lung vessels. Injury to body
fluids by dry-heat results in rapid
pulse. Floating rapid pulse is seen in
the exterior syndrome
Dry cough,
scanty sputum
and other
symptoms of
dryness with
scanty body
fluids.
Dry cough, with a little but sticky
sputum or having difficulty to
expectorate; dry lips, tongue,
mouth, nose, throat and skin, or
fever with aversion to cold, or
chest pain, dry tongue with thin
coating and rapid pulse
Syndrome
Main
symptoms
Wind-heat Cough with
invading
thick and
the lung
yellow sputum
Other symptoms
Tongue
characteristics
Pulse condition
Stuffy nose with
yellow and turbid
discharge, fever,
aversion to wind,
dry mouth and
sore throat
Red tongue tip, Floating rapid
with thin and
pulse
yellow tongue
coating
Accumulat Cough, panting, Thirst, restlessness, Red tongue
ion of heat yellow sputum flaring of nares,
with yellow
in the lung
nosebleed or
coating
hemoptysis, chest
pain, expectoration
of bloody pus and
fishy smell sputum
Slippery rapid
pulse
Dryness
invading
the lung
Rapid pulse
Dry cough with
a little but
sticky sputum
or no sputum
Dry mouth, tongue, Dry tongue
throat and skin,
with thin
scanty sweating
coating, scanty
saliva
Phlegm-Dampness Obstructing the
Lung Syndrome痰湿阻肺证
• Cough, excessive sticky and easy to expectorate white
sputum, chest distress, panting and wheezing in severe
case, pale tongue with white greasy coating and
slippery pulse.
• Phlegm-dampness obstructs the lung leading to
dysfunction in dispersion and descent, manifesting
coughing and excessive sticky and white phlegm.
Obstruction of the air passage by phlegm-dampness
and stagnation of qi leads to chest distress, panting and
wheezing in severe case.
• Cough, profuse, sticky and easy to expectorate white
sputum and white greasy tongue coating.
Large Intestine Damp-Heat Syndrome
大肠湿热证
Abdominal pain, red and whitish stools in diarrhea, severe diarrhea with yellow and fetid stools, accompanied
by burning feeling around the anus, dark urine, thirst, or aversion to cold, fever without chills, red tongue with
yellow greasy coating, soggy rapid or slippery and rapid pulse.
Damp-heat invasion of the large intestine obstructs movement of qi causing abdominal pain; when damp-heat fumigates the
intestinal tract caused sticky blood stools or yellow and watery stools. When the intestinal tract is attacked, burning heat occurs
around the anus. Dark urine due to water loss in diarrhea. Fever and aversion to cold can be seen with exterior syndrome. When
heat remains inside, there is fever without chills. Red tongue with yellow greasy coating points to damp-heat.
Abdominal pain, dysentery, symptoms of diarrhea ad other symptoms of the damp-heat
syndrome
Large Intestine Fluid Deficiency
Syndrome大肠液亏证
Syndrome
Analysis
• Constipation,
dizziness, foul
breath, read tongue
with scanty saliva,
dry yellow tongue
coating and rough
pulse.
Clinical
manifestations
• Insufficient fluid in
the large intestine
fails to moisten the
intestinal tract
resulting
constipation, rough
pulse and yellow dry
tongue coating with
scanty saliva;
obstructed qi of the
large intestine
disturbs the stomach
qi from descending
causing foul breath
and dizziness;
• Constipation, and
other symptoms
of insufficient
body fluid.
Focal Points
Incessant Diarrhea Associated With Deficient
Large Intestine Qi Syndrome
肠虚滑泄证
Clinical Manifestations
Syndrome Analysis
Chronic and incessant
diarrhea, dull
abdominal pain,
alleviated by heat or
pressure, pale tongue
with white slippery
coating and weak
pulse.
Focal points
Incessant diarrhea exhaust
yang qi and caused fecal
incontinence; Yang qi
deficiency in the large
intestine leads to cold
coagulation and qi
stagnation and dull
abdominal pain, pale
tongue with white slippery
coating and weak pulse.
Fecal
incontinence and
other symptoms
of deficiency-cold.
Incessant
Diarrhea
caused by
Deficient
Large Intestine
Qi
fluid
Deficiency
of the
Large
Intestine
Lung Qi
Deficiency
Lung Yin
Deficiency
Wind-Cold
Restraining
the Lung
Lung and
Large
Intestine
Syndrome
DampHeat of
the Large
Intestine
PhlegmDampness
Obstructing
the Lung
Dryness
Invading
the Lung
WindHeat
Invading
the Lung
Accumulated
Heat in the
Lung
Spleen-Stomach Disease Syndrome
Differentiation脾胃病辨证
Food
Retention
in Stomach
食积胃脘
Spleen Qi
Deficiency
脾气虚
Cold
Stagnating
in Stomach
寒滞胃脘
Spleen
Yang
Deficiency
脾阳虚
Spleen
Deficiency
and Sinking
of Qi脾虚气
陷
Spleen &
Stomach
Disease
Syndrome
Differentiation
Intense
Stomach
Fire胃火炽
盛
Failure of
the Spleen
to Control
Blood脾不
统血
Colddampness
Accumulating
in the Spleen
寒湿困脾
Stomach
Yin
Deficiency
胃阴虚
Stomach
Yang
Deficiency
胃阳虚
Stomach
Qi
Deficiency
胃气虚
Damp-Heat
Accumulating
in the Spleen
湿热蕴脾
Spleen Qi Deficiency Syndrome
脾气虚证
• Abdominal distension, poor appetite, aggravated after eating, loose stools,
lassitude, shortness of breath, dislike talking, sallow complexion, or obesity, or
edema, pale tongue with white coating, or pale and enlarged tongue with tooth
Clinical
mark, slow and weak pulse.
manfestations
Syndrome
Analysis
• Insufficient spleen qi leads to poor digestion of the stomach marked by abdominal
distension, poor appetite, water retention, loose stools; insufficient qi brings about
lassitude, dislike to talk, sallow complexion, pale tongue, slow and weak pulse. Enlarged
tongue with tooth-mark, edema caused by water and phlegm-fluid accumulation.
• Poor appetite, abdominal distension, loose stools and
other symptoms of qi deficiency syndrome.
Spleen Yang Deficiency Syndrome
脾阳虚证
• Abdominal distension and pain, alleviated by warmth and pressure,
poor appetite, loose stools or stools with undigested food stuff,
aversion to cold and cold limbs, tastelessness, not thirsty, or edema,
or large volume of clear urine, pale and enlarged tongue with tooth
mark, white slippery or white greasy coating and deep, slow weak
pulse.
• Weak spleen yang generates cold results in abdominal distension,
poor appetite and loose stools; when water flows over the skin
edema occur and large volume of urine when it flows downward;
Yang deficiency and internal accumulation of cold-dampness caused
enlarged tongue with tooth mark, white slippery or white greasy
tongue coating, deep slow and weak pulse.
• Cold pain in the abdomen, alleviated by heat and pressure,
abdominal distension, loose stools and other symptoms of
deficiency-cold.
Spleen Deficiency and Sinking of
Spleen Qi Syndrome 脾虚气陷证
• Feeling of
distension in the
stomach and
abdomen,
aggravated after
eating; drooping
and distension in
the anus,
persistent
diarrhea,
lassitude,
dizziness, poor
appetite, loose
stools, pale
tongue with white
coating and weak
pulse.
• Deficient spleen qi
leads to sinking of
middle qi and
prolapse of
stomach, rectum
and uterus; failure
of distributing
usable substances
leads to turbid
urine; failure of
rising spleen yang
caused dizziness,
lassitude,
reluctant to talk,
pale tongue and
weak pulse.
• Sense of
drooping in the
abdomen and
stomach,
persisted
diarrhea or
prolapse of
internal organs
and other
symptoms of
spleen qi
deficiency.
Failure of Spleen to Control Blood
Syndrome脾不统血证
• Muscular bleeding, gum bleeding, nosebleed, or
accompanied by poor appetite, abdominal distension,
loose stools, pale or sallow complexion, lassitude,
dislike talking, pale tongue with white coating and
weak pulse.
• Blood leaking out of the vessels and failure of spleen qi
to govern blood caused bleeding in the stomach,
intestine, urinary bladder, skin and orifices; poor
appetite and loose stools result from disturbed
transportation of spleen qi.
• Chronic hemorrhage and other symptoms of spleen qi
deficiency.
Four Syndromes of Spleen Deficiency
Syndrome
Common Points
Deficiency of
Spleen Qi
Abdominal distension, Obesity or edema
poor appetite,
aggravated after
eating, loose stools,
lassitude, shortness of
breath, reluctant to
talk, sallow complexion
Deficiency of
Spleen Yang
Different Points
Abdominal cold
pain and
distension, loose
stools or stools
with undigested
food stuff, aversion
to cold and cold
limbs, or edema of
large volume of
urine
Tongue and Pulse
Characteristics
Pale tongue with
white coating,
moderate and
weak pulse
Pale and enlarged
tongue with tooth
mark, white
slippery or white
greasy coating,
deep, slow and
weak pulse.
Four Syndromes of Spleen Deficiency
Syndrome
Common Points
Different Points
Spleen Deficiency
and Sinking of
Spleen Qi
Abdominal
distension, poor
appetite,
aggravated after
eating, loose
stools, lassitude,
shortness of
breath, reluctant to
talk, sallow
complexion
Sense of drooping
Pale tongue with
and distension in
white coating,
the stomach,
weak pulse
abdomen and anus,
or persisted
diarrhea, rectal
prolapse, or turbid
urine, dizziness
Deficiency of
Spleen fails to
control outflow of
blood
Excessive
menorrhea,
nosebleed, gum
bleeding and
muscular bleeding.
Tongue and Pulse
Characteristics
Pale tongue with
white coating,
weak pulse.
Cold-Dampness Accumulated in the
Spleen Syndrome寒湿困脾证
Distress and pain in the abdomen and stomach, anorexia, loose stools, nausea,
tastelessness, no desire to drink water, heavy head and body, or edema, or yellow eyes,
sallow complexion, enlarged tongue, white greasy or white slippery coating soggy and slow
pulse
Accumulation of Cold-Dampness causing dysfunction of the spleen and stomach in
transporting, transforming, ascending and descending and unsmooth qi flow, marked
by distress and pain in the abdomen and stomach, anorexia, loose stools and nausea.
Cold-dampness obstructs yang, leading to heaviness in the head and body. Yellow eys
and sallow complexion due to overflow of bile. Enlarged tongue , white greasy or white
slippery coating, soggy and slow pulse indicate accumulation of cold-dampness
Distress and pain in the abdomen and stomach, anorexia, loose stools
nausea and other symptoms of internal accumulation of colddampness.
Accumulation of Damp-Heat in the
Spleen Syndrome湿热蕴脾证
Distress and pain in
the abdomen and
stomach, anorexia,
nausea, loose and
sticky stools,
heaviness in the
head and body,
thirsty, no desire
for drinks, mild
fever, or bright
yellow skin and
eyes, red tongue
with yellow greasy
coating and soggy
rapid pulse.
Accumulation of damp-heat leads to dysfunction of
the spleen and stomach in receiving, transporting,
ascending and descending, marked by distress and
pain in the abdomen and stomach, anorexia and
nausea. Damp-heat invaded the large intestine
results in loose and sticky stools; dampness
accumulated in the body caused heaviness in the
head and body and thirsty but no desire for drinks
and mild fever. Bright yellow skin and eys are caused
by leak of bile. Red tongue with yellow greasy
coating, soggy rapid pulse all indicate internal
accumulation of damp-heat.
Distress and
pain in the
abdomen
and
stomach,
anorexia,
nausea, and
other
symptoms
of internal
accumulatio
n of dampheat.
Syndrome
Common Points
Different Points
Tongue and Pulse
Characteristics
Accumulation of
Damp-heat in the
Spleen
Distress and pain in
the abdomen and
stomach, anorexia,
nausea, loose and
sticky stools,
heaviness in the
head and body,
yellow face and
eyes
Mild fever, thirst,
no desire for drinks
, loose stools ,
scanty urine.
Red tongue with
yellow greasy
coating, soggy
rapid pulse.
Abdominal pain,
alleviated by
warmth,
tastelessness, no
desire for drinks,
loose stools, large
volume of urine or
edema.
Enlarged tongue,
white greasy or
white slippery
coating, soggy slow
pulse.
Accumulation of
Cold-Dampness in
the Spleen
Stomach Qi Deficiency Syndrome
胃气虚证
• Fullness and distension in the stomach, aggravated
after eating, belching or dull pain in the stomach,
lassitude, dim complexion, thin white tongue coating,
and weak pulse.
• Deficient stomach qi leads to poor digestion and
fullness and pain in the stomach; Unsmooth flow of
stomach qi leads to poor appetite and belching; Qi
deficiency results in lassitude, dim complexion, thin
white tongue coating and weak and deficient pulse.
• Fullness and pain in the stomach, poor appetite,
belching and other symptoms of qi deficiency.
Stomach Yin Deficiency Syndrome
胃阴虚证
Gastric discomfort and acid regurgitation, no desire to
eat, or fullness in the stomach with dull pain, nausea,
hiccup, dry mouth and throat, dry stools, red tongue with
scanty coating and saliva and thready rapid pulse.
Insufficient stomach qi generated internal deficiency-heat leads
to gastric discomfort and acid regurgitation and no desire to eat;
nausea and hiccup are caused by reversed ascending of stomach
qi; dry mouth and throat caused by yin deficiency; intestinal tract
lacks moistening resulting dry stools; red tongue with scanty
coating and saliva, thready and rapid pulse indicate internal
exuberance of heat and yin deficiency.
Gastric discomfort, acid regurgitation
burning pain, no desire to eat and other
symptoms of deficiency-heat.
Intense Stomach Fire Syndrome
胃火炽盛证
Clinical Manifestations
Syndrome Analysis
Focal Points
Abnormal increased
appetite with frequent
hunger, gastric discomfort,
acid regurgitation, or
burning pain in the
stomach, or foul breath,
swollen gum bleeding,
desire for cold drinks,
constipation, yellow urine,
red tongue with yellow
coating, slippery and rapid
pulse.
Exuberance of stomach fire
leads to hyperactivity of
digestion, and abnormal
increased appetite with
frequent hunger. Burning
pain in the stomach due to
stomach qi failing to
descend. Four breath,
swollen gum bleeding are
caused by vessels scorched
by stomach fire. Flaming of
fire impairs body fluids,
resulting in thirst with a
desire for cold drinks,
constipation and yellow
urine.
Gastric discomfort, acid
regurgitation, burning pain
in the stomach, swollen
gum bleeding and other
symptoms of internal
flaming of fire.
Cold Stagnating in Stomach Syndrome
寒滞胃脘证
Clinical Manifestations
Syndrome Analysis
Focal Points
Acute cold pain in the
stomach, worse when
exposed to cold, better
when exposed to heat,
hiccup or belching,
tastelessness in the mouth,
thirsty or vomiting clear
water, cold body and limbs,
white moist coating, deep
and tense or wiry pulse.
Cold evil invaded the
stomach impeded qi flow
and leads to acute cold
pain in the stomach.
Adverse rise of stomach qi
results in hiccup or
belching, tastelessness in
the mouth, thirsty, or
vomiting clear water result
from stomach yang qi
injured by cold. Cold body
and limbs, white moist
tongue coating, and deep
tense or wiry pulse indicate
internal exuberance of
cold.
Severe cold pain in the
stomach, and other
symptoms of the excess
cold syndrome.
Food Retention in Stomach Syndrome
食积胃脘证
Clinical Manifestations
Syndrome Analysis
Focal Point
Fullness in the stomach
and abdomen, or
distending pain, anorexia,
fetid eructation, or
vomiting undigested food
stuff, relieved after
vomiting, fetid stools, thick
greasy tongue coating and
slippery pulse.
Food retention in the
stomach obstructs qi flow,
leading to fullness in the
stomach and abdomen, or
distending pain and
anorexia. Undigested food
causes reversed rise of qi in
the stomach, resulting in
fetid eructation, thick and
greasy tongue coating.
Fetid stools are due to
dysfunction of the large
intestine.
Fullness in the stomach
and abdomen, distending
pain, anorexia and fetid
eructation.
Food
Retention
in
Stomach
Spleen Qi
Deficiency
Spleen
Yang
Deficiency
Spleen
Deficiency
and
Sinking of
Qi
Cold
Stagnating
in Stomach
Spleen &
Stomach
Disease
Syndrome
Differentiation
Intense
Stomach
Fire
Failure of
the
Spleen to
Control
Blood
Colddampness
Accumula
ting in the
Spleen
Stomach
Yin
Deficiency
Stomach
Yang
Deficiency
Stomach
Qi
Deficiency
DampHeat
Accumula
ting in the
Spleen
Gallbladder
Qi
Obstruction
with Phlegm
disturbance
Cold
Stagnating
in the Liver
Meridian
Liver
Yang
Transfor
ming into
Wind
Liver
Blood
Deficiency
Liver Yin
Deficiency
Liver-Gallbladder
Disease
Syndrome
Differentiation
Liver &
Gallbladder
Damp-Heat
Blazing of
Liver Fire
Stirring of
Liver Wind
Extreme Heat
Generate Wind
Blood
Deficiency
Generate Wind
Liver Qi
Stagnation
Hyperactivity
of Liver Yang
Liver Blood Deficiency Syndrome
肝血虚证
• Dizziness, pale complexion, blurred vision or
night blindness, pale nails, numbness of limbs,
convulsion, joint motion problem, scanty
menses with light color, pale tongue with
white coating and fine pulse.
• Insufficient liver blood caused dizziness, pale
complexion, scanty menses and so on. Internal
stirring of wind leads to limb numbness,
convulsion, joint motion problem.
Liver Yin Deficiency Syndrome
肝阴虚证
• Dizziness, dry eyes, visual problem dull burning pain in
the hypochondrium, or convulsion, hot face , heat in
the chest, palms and soles, tidal fever, night sweating,
dry mouth and throat, red tongue with scanty saliva
and fine rapid pulse.
• Failure of insufficient liver yin to moisten the head and
eyes leads to dizziness, dry eyes. Malnutrition of the
liver and internal deficiency –fire causes dull burning
pain in the hypochondrium. Internal stirring of
deficiency-wind leads to malnutrition of the tendons
and vessels. Hot face, heat in the chest, palms and
soles, tidal fever, night sweat, dry mouth are
manifestations of yin deficiency.
Liver Qi Stagnation Syndrome
肝郁气滞证
• Distending pain in the chest or breasts,
depressed or irritable, frequent sighing, thin
white coating, wiry pulse, irregular menses,.
• Dysfunction and obstruction of liver qi results
in distending pain in the chest, irritable or
depressed. Thin white coating and wiry pulse
indicate liver qi stagnation.
Blazing of Liver Fire Syndrome
肝火炽盛证
• Dizziness with distending pain in the head, flushed face
and bloodshot eyes, irritable, bitter taste and dry
mouth, yellow urine, dry stools, red tongue with yellow
dry coating, wiry rapid pulse, or sudden tinnitus and
deafness, insomnia, dream-disturbed sleep, or spitting
blood and nosebleed.
• Blazing of liver fire attack the head and eyes; liver fire
hurts body fluids causes bitter taste and dryness in the
mouth; interior fire causes insomnia; when liver heat
enters the ear results in sudden tinnitus and deafness;
spitting blood and nosebleed are due abnormal flow of
blood.
Hyperactivity of Liver Yang Syndrome
肝阳上亢证
• Dizziness, tinnitus, distending pain in the head
and eyes, flushed face and bloodshot eyes,
irritable, insomnia and dream-disturbed
sleeps weakness in the lower back and knees,
heavy head and frail feet, red tongue with
scanty saliva, wiry powerful rapid pulse.
• Upward disturbance of liver yang.
Stirring of Liver Wind Syndrome
肝风内动证
1. Liver Yang Transforming into Wind Syndrome
肝阳化风证:
Dizziness, involuntary head twitching and pain,
numbness and tremor, unsteady walking or
conscious with partial facial paralysis , or sudden
loss of consciousness, red tongue with greasy or
yellow greasy coating and wiry powerful pulse.
Hyperactive liver transformed into wind causing qi
and blood to flow upward leads to dizziness,
involuntary head twitching and unsteady walking.
Stirring of Liver Wind Syndrome
肝风内动证
2. Extreme Heat Generate Wind Syndrome:热极
生风证
High fever, convulsion, stiff neck, upward rolling
of eyes, lockjaw, or coma and delirium, dark-red
tongue with white dry coating and wiry rapid
pulse.
Liver channel scorched by blazing fire. When fire
disturbs the mind results in restlessness coma
and delirium.
Stirring of Liver Wind Syndrome
肝风内动证
3. Blood Deficiency Generate Wind Syndrome血
虚生风证:
Numbness and tremor of limbs, muscular
spasm, dysfunction of joints, dizziness, tinnitus,
pale complexion, nails and tongue and fine
pulse.
Insufficient liver blood caused the above
symptoms.
Stirring of Liver Wind Syndrome
肝风内动证
4. Yin Deficiency Stirring Wind Syndrome阴虚动
风证:
Tremor of limbs, dizziness, tinnitus, tidal fever,
night sweat, flushed cheeks, dry throat, red
tongue with scanty coating and rapid pulse.
Failure of insufficient liver yin to moisten the
head and eyes leads to dizziness, dry eyes.
Liver and Gallbladder Damp-Heat Syndrome
肝胆湿热证
• Intense heat and distending pain in the chest,
anorexia, abdominal distension, nausea, bitter
taste in the mouth, or vomiting yellow-green
bitter fluid, constipation, dark urine, red
tongue with yellow greasy coating, wiry rapid
pulse, or alternate chills and fever, yellow skin
and eyes, or eczema of scrotum.
Cold Stagnating in the Liver Channel Syndrome
寒滞肝脉证
• Cold pain in the lower abdomen with the
genitals involved, or pain in the scrotum
during contracture, or cold pain on the top of
head, aggravated by cold and alleviated by
warmth, cold limbs, while moist tongue and
deep wiry pulse.
• The Liver Meridian surrounds the genitals.
When cold accumulates the Liver Meridian,
unsmooth flow of qi and blood occurred.
Gallbladder Qi Obstruction with Phlegm
Disturbance Syndrome
胆郁痰扰证
• Fear, palpitation, restlessness, insomnia and dreamdisturbed sleep, dizziness, tinnitus, distress and
suffocation in the chest , bitter taste in the mouth, red
tongue with yellow greasy coating and wiry rapid pulse.
• Internal phlegm-heat disturbs gallbladder qi results in
fear and palpitation, restlessness, insomnia, dreamdisturbed sleep. Failure of gallbladder’s dispersion
results in unsmooth qi flow, distress and suffocation in
the chest, bitter taste in the mouth and nausea
reversed rise of stomach qi from gallbladder heat.
Gallbladder
Qi
Obstruction
with Phlegm
disturbance
Cold
Stagnating
in the Liver
Meridian
Liver
Yang
Transfor
ming into
Wind
Liver
Blood
Deficiency
Liver Yin
Deficiency
Liver-Gallbladder
Disease
Syndrome
Differentiation
Liver &
Gallbladder
Damp-Heat
Blazing of
Liver Fire
Stirring of
Liver Wind
Extreme Heat
Generate Wind
Blood
Deficiency
Generate Wind
Liver Qi
Stagnation
Hyperactivity
of Liver Yang
Kidney-Urinary Bladder Disease
Syndrome Differentiation
肾与膀胱病辨证
Kidney
Yang
Deficiency
Bladder
DampHeat
Loose
Kidney
Essence
Kidney-Urinary
Bladder Disease
Syndrome
Differentiation
Kidney Yin
Deficiency
Insufficient
Kidney
Essence
Kidney Yang Deficiency Syndrome
肾阳虚证
• Weakness and pain in the lower back and knees,
cold limbs, sallow complexion, lassitude, low
sexual desire, impotence, cold sperms, cold
uterus, or chronic diarrhea with undigested food
stuff, or diarrhea before dawn, frequent urination
and edema, accompanied by palpitation and
shortness of breath, wheezing, enlarge pale
tongue with tooth mark, white slippery coating,
deep weak pulse.
• Failure of kidney yang to warm the body.
Kidney Yin Deficiency Syndrome
肾阴虚证
• Dizziness, tinnitus, weakness and pain in the
lower back and knees, insomnia and dreamdisturbed sleep, hyper-sexuality, nocturnal
emission梦遗泄精,metrorrhagia and metrostaxis
崩漏, flushed cheeks, heat in the chest, palms
and soles, tidal fever and night sweat, dry mouth
and throat, red tongue with scanty saliva and fine
rapid pulse.
• Internal generation of deficiency-heat.
Insufficient Kidney Essence Syndrome
肾精不足证
• Retarded development of children, feeble
bones, mental retardation, infertility, poor
sexual function, hair loss and loose teeth,
tinnitus or deafnessand weak feet.
• Decreased function in growth, development
and reproduction because of kidney essence
deficiency.
Loose Kidney Qi Syndrome
肾气不固证
• Pale complexion， lassitude, hearing problem,
weakness in the lower back and knees,
frequent urination, or urine incontinence, or
continuous urine dribbling after urination, or
miscarriage, pale tongue with white coating
and weak pulse.
• Insufficient or deficient kidney qi.
Syndrome
Similar
Different Manifestations
Manifestati
ons
Tongue and Pulse
Characteristics
Kidney yang
deficiency
Weakness
in the
lower back
and knees
Cold body and limbs, impotence,
cold sperms, cold uterus or
diarrhea before dawn.
Enlarged pale
tongue, white
slippery coating,
weak pulse.
Kidney yin
deficiency
Dizziness, tinnitus, insomnia and
dream-disturbed sleep, hyper
sexual desire, night sweat, dry
mouth and throat.
Red tongue with
scanty saliva, fine
and rapid pulse.
Insufficient
kidney
essence
Retarded growth, feeble bones in
children, hair loss, loose teeth,
deafness, weak feet.
Pale tongue with
white coating, weak
pulse.
Loose kidney
qi
Hearing problem, frequent
urination, incontinence of urine,
or dribbling after urination,
miscarriage
Pale tongue with
white coating,
weak pulse.
Bladder Damp-Heat Syndrome
膀胱湿热证
• Frequent urination, burning pain on urination,
bloated lower abdomen, or urinary stone, or
accompanied by fever and lower back pain,
red tongue with yellow and greasy coating and
rapid pulse.
• Bladder attacked and disturbed by heat.
Kidney
Yang
Deficiency
Bladder
DampHeat
Loose
Kidney
Essence
Kidney-Urinary
Bladder Disease
Syndrome
Differentiation
Kidney Yin
Deficiency
Insufficient
Kidney
Essence
Heart-Kidney Disharmony Syndrome
心肾不交证
• Restlessness, insomnia, palpitation, dreamdisturbed sleep, dizziness, tinnitus, amnesia,
weakness in the lower back and knees, heat in
the chest, palms and soles, tidal fever, night
sweat, dry mouth and throat, red tongue with
scanty coating and fine and rapid pulse.
Heart-Liver Blood Deficiency
Syndrome心肝血虚证
• Palpitation, insomnia, dream-disturbed sleep,
dizziness, pale and sallow complexion, dry
eyes, blurred vision, pale nails, numbness or
tremor of limbs, scanty menstruation with
thin and light-color menses, pale tongue with
white coating and fine pulse.
Heart-Kidney Yang Deficiency
Syndrome心肾阳虚证
• Cold body and limbs, palpitation or severe
palpitation, difficulty in urination, cyanosed
lips and nails, pale purple tongue with white
and slippery coating and faint pulse.
HeartSpleen
Deficiency
Heart-Kidney
disharmony
Heart & Other
Organs
Simultaneously
ill
HeartKidney
Yang
Deficiency
HeartLiver
Blood
Deficiency
Heart-Lung Qi Deficiency Syndrome
心肺气虚证
• Palpitation, short breath, coughing and
panting, chest distress, vomiting of clear and
thin sputum, pale complexion, lassitude,
dislike to talk, spontaneous sweating, pale
tongue with white coating and weak pulse.
Spleen-Lung Qi Deficiency Syndrome
脾肺气虚证
• Anorexia, fullness in the abdomen, loose
stools, chronic cough, vomiting of clear and
thin sputum, sallow complexion, lassitude,
short breath, dislike talking, or edema in the
face and limbs, pale tongue with white coating
and weak pulse.
Spleen-Kidney Yang Deficiency
Syndrome脾肾阳虚证
• Cold body and limbs, sallow complexion, cold
pain in the lower back, knees and lower
abdomen, chronic diarrhea, or diarrhea before
dawn, stools with undigested food stuff, or
edema in the face and limbs, difficulty in
urination, pale and enlarged tongue with
white slippery coating and deep pulse.
Lung-Kidney Yin Deficiency Syndrome
肺肾阴虚证
• Cough with scanty sputum, bloody sputum, or
hoarse voice, tidal fever, flushed cheeks, night
sweat, dry mouth and throat, scanty menses,
red tongue with scanty coating and fine rapid
pulse.
Lung-Kidney Qi Deficiency Syndrome
肺肾气虚证
• Weak coughing and panting, need to take
deep breath, profuse and thin sputum,
weakness in the lower back and knees, or
urine out on coughing, lassitude, feeble voice,
short breath, spontaneous sweating, pale
tongue with weak pulse.
Liver-Kidney Yin Deficiency Syndrome
肝肾阴虚证
• Dizziness, tinnitus, weakness in the lower back
and knees, dry mouth and throat, insomnia,
dream-disturbed sleep, heat in the chest,
palms and soles, flushed cheeks, night sweat,
scanty menses, red tongue with scanty coating
and rapid fine pulse.
Liver-Spleen Disharmony Syndrome
肝脾不调证
• Scurrying and distending pain in the chest and
hypochondrium, sigh frequently, depressed or
irritable, anorexia, fullness in the abdomen,
loose stools, alleviated after diarrhea, pale red
tongue with white coating and wiry pulse.
Liver-Stomach Disharmony Syndrome
肝胃不和证
• Dull scurrying and distending pain in the chest
and stomach, belching, hiccup, gastric
discomfort and acid regurgitation, depressed
or irritable, red pale tongue with thin white
coating, wiry pulse, or red tongue with yellow
coating and wiry rapid pulse.
Lung Invaded by Liver Fire Syndrome
肝火犯肺证
• Burning pain in the chest, dizziness with
distending pain in the head, irritable,
bloodshot eyes, bitter taste in the mouth, red
tongue with yellow dry coating, and wiry rapid
pulse.
Six-Channel Syndromes
• Put forward by Zhang Zhongjing张仲景, the
famous physician of the Eastern Han dynasty
in Shang Han Za Bing Lun.
• The syndromes present in the course of an
externally contracted disease are divided into
Taiyang disease syndrome, Shaoyang disease
syndrome, Yangming disease syndrome, Taiyin
disease syndrome, Shaoyin disease syndrome
and Jueyin disease syndrome.
Classification of the Six-Channel
Syndromes
•
•
•
•
•
•
•
Taiyang channel太阳病证
Shaoyang channel少阳病证
Yangming channel阳明病证
Taiyin channel太阴病证
Shaoyin channel少阴病证
Jueyin channel 厥阴病证
The three yang channels take the pathological changes of
the six fu organs as their basis, characterized by the excess
condition;
• The three yin channels take the pathological changes of the
five zang organs as their basis, characterized by the
deficiency condition or interlocking of deficiency and excess
Taiyang Disease Syndromes太阳病证
• Exogenous pathogens usually attack the human
body through the Taiyang channels and the
healthy qi of the body rises against them in the
superficial part of the body.
• Taiyang disease appears with such symptoms as
rigidity and pain in the neck, fever, aversion to
cold and floating pulse.
• Taiyang disease can be divided into the Taiyang
wind-induced syndrome and Taiyang coldinduced syndrome
Taiyang Wind-Induced Syndrome
太阳中风证
• Fever, aversion to wind, rigidity and pain in
the neck, spontaneous sweating, floating and
moderate pulse.
Yangming Channel Syndrome
• Excessive heat throughout the body in the
exterior and interior.
Cold-Induced Syndrome
太阳伤寒证
• Fever, aversion to cold, rigidity and pain in the
neck and joints, absence of sweating, floating
and tight pulse.
Yangming Disease Syndromes阳明病证
• It is an interior excess heat syndrome with
excessive heat in the Yangming channels and
heat accumulation in the intestines and
stomach.
• It can be divided into two categories: the
Yangming Channel Syndrome and Yangming
Fu-organ Syndrome
Yangming Channel Syndrome阳明经在
• Characterized by excessive heat throughout
the body in the exterior and interior.
• High fever, profuse sweating, extreme thirst,
flushed face, restlessness, yellow, dry tongue
coating and surging pulse.
Yangming Fu-organ Syndrome阳明腑证
• High fever in the afternoon, sweating in the
hands and feet, abdominal pain and
distension, constipation, irritable, delirium,
red tongue with yellow dry coating or dark
yellow cracked coating and deep, forceful
pulse.
Shaoyang Disease Syndrome少阳病
证
• Alternate cold and fever, fullness in the chest
region, loss of appetite, restlessness, vomiting,
bitter taste in the mouth dry throat, vertigo
and wiry pulse.
Taiyin Disease Syndromes太阴病证
• Fullness in the abdomen, vomiting, poor
appetite, diarrhea, not feeling thirsty,
abdominal pain, pale tongue with white,
greasy coating and moderate and weak pulse.
Shaoyin Disease Syndromes少阴病证
• It is a deficiency syndrome due to hypofunction of the heart and kidney.
• Cold and heat can be found in a Shaoyin
disease.
Shaoyin Cold Syndrome少阴寒化证
• Chills, huddling up, lassitude, cold limbs,
diarrhea with undigested food stuff, vomiting
and anorexia , pale tongue with white coating
and deep, thin and faint pulse.
Shaoyin Heat Syndrome少阴热化证
• Restlessness, insomnia, dry mouth and throat,
red tongue with scanty coating, thin and deep
pulse.
Jueyin Disease Syndromes厥阴病证
• Persistent thirst, chest pain with a sensation of
heat, hunger with poor appetite, vomiting
roundworms and red tongue will scanty
coating.
Transmission of the Six-Channel
Disease Syndromes
• Combined Syndromes合病 – simultaneous
diseases syndromes of two or three channels
e.g. combined syndromes of Taiyang and
Yangming, Taiyang and Shaoyang and etc.
• Interlapping of Syndromes并病 – syndromes
of two channels appearing in sequence, e.g.
interlapping of Taiyang and Shaoyang, Taiyang
and Yangming.
Transmission of the Six-Channel
Disease Syndromes
• Channel Transmission传经 -One channel
syndrome transmitting to another one.
• Direct Attack 直中– attack of external
pathogens directly to the three yin channels
instead of transmission from yang channels
caused by insufficient healthy qi which fails to
fight against pathogens.
• It is a method of syndrome differentiation for
warm diseases, established by Ye Tianshi,叶天士
a physician specialized in warm diseases of the
Qing dynasty, on the basis of Huangdi Nei Jing，
Huangdi Classic of Inner Medicine, 黄帝内经 and
Shang Han Za Bing Lun, Treatise on Cold
Pathogenic and Miscellaneous Diseases,伤寒杂
病论.
• Its establishment supplements the six-channel
syndrome differentiation theory.
• According to it, warm diseases can be divided into four
stages:
• The defense system syndrome卫分证; qi system syndrome
气分证, nutrient system syndrome营分证 and blood
system syndrome血分证.
• The first two system syndromes indicate the early and
middle stages of a warm disease, in which there is a violent
conflict between the strong healthy qi and pathogenic
factors.
• The latter two system syndromes indicate the middle and
late stages when the healthy qi is injured to some extent
and pathogenic factors overwhelm the healthy qi.
Defense System Syndrome
• It refers to the syndrome of the initial stage of
a warm disease when warm-heat invades the
defense system.
• Fever, slight aversion to wind-cold, headache,
coughing, slight thirst, sore swollen throat, red
tongue edge, and floating and rapid pulse.
Qi System Syndrome
• Fever, thirst, sweating, red tongue with yellow
coating and rapid pulse, or high fever, profuse
sweating, thirst and preference for cold drinks
and surging pulse, or restlessness; or coughing
and panting, sensation of oppression in the
chest or chest pain, coughing of yellow and
thick sputum, or diarrhea with yellow and foul
feces, burning sensation of the anus.
Nutrient System Syndrome
• It refers to the syndrome caused by deep invasion
of the heat pathogen which injures yin and
disturbs the mind. There are three routes for the
heat pathogen to enter the nutrient system:
- Inward transmission from the qi system;
- Penetration into the nutrient system from the
defense system, not via the qi system;
- Direct penetration into the nutrient system
without involving the defense system and qi
system.
Nutrient System Syndrome
• It is a critical condition of a warm disease.
• There is consumption of yin as well as rampancy
of heat.
• It is a syndrome of interlocking of deficiency and
excess or it is an excess syndrome.
• It is characterized by injury to yin and disturbance
of the mind.
• Fever, restlessness, dry mouth and throat with
moderate thirst, or delirium crimson tongue and
rapid pulse.
Blood System Syndrome
• It is either orderly transmitted from the nutrient
system or directly from the qi system without the
nutrient system.
• It is a critical condition of a warm disease, which
is induced by exuberance of the pathogenic
factors or deficiency of the healthy qi of no
treatment and improper treatment.
• The heat pathogen invades the blood system and
injures the zang and fu organs, channels,
characterized by bleeding and stirring-up of wind
and injury to yin.
Blood System Syndrome
• Fever, worse at night, restlessness, dense skin
eruption, delirium, hematemesis吐血,
epistaxis流鼻血, hematuria尿血, hemafecia便
血, crimson tongue and rapid pulse, or rigidity
in the neck and back, convulsion, or persistent
low fever, heat in the palms, soles and chest,
tinnitus and deafness, red tongue with scanty
saliva and deficient and rapid pulse.
Transmission and Change of the DefenseQi-Nutrient-Blood System Syndrome
• Normal Transmission- it means transmission
of a disease in the normal sequence, i.e. from
the superficial part to the interior, from
shallow to deep and from mild to serious.
• This pattern follows the transmission order of
the defense-qi-nutrient-blood systems.
• It suggests a relatively simple and mild
disease.
Transmission and Change of the DefenseQi-Nutrient-Blood System Syndrome
• Abnormal Transmission – it means transmission
of a disease not in the normal sequence e.g. from
the defense system directly to the nutrient
system and blood system instead by the way of qi
system.
• It indicates a critical condition.
• There are three causes: the over-abundance of
pathogenic factors, deficiency of the healthy qi
and no treatment and improper treatment.
• It is a method of syndrome differentiation for warm
diseases put forward by Wu Jutong吴鞠通, a
specialist of warm diseases of the Qing dynasty in
Wen Bing Tiao Bian温病条辨 (Analysis of Warm
Diseases)
• In this system, the syndromes of externally
contracted warm diseases are classified into three
types: the upper-energizer syndrome, middleenergizer syndrome and lower-energizer syndrome
to illustrate the pathological changes, manifestations
and the transmission rule to guide treatment.
Syndrome of the Upper-Energizer
• It is caused by warm-heat attacking the Lung
Channel of Hand-Taiyin and Pericardium Channel
of Hand-Jueyin.
• Fever, slight aversion of wind and cold, coughing,
sweating, thirst, headache, red tongue edge,
floating and rapid pulse, or fever without
aversion to cold, coughing, panting, sweating,
thirst, yellow coating and rapid pulse; or high
fever, delirium, rigid tongue, cold limbs and
crimson tongue.
Syndrome of the Middle-Energizer
• It refers to the pathological changes caused by
the heat pathogen entering the spleen from
the upper-energizer, marked by the dryness
and dampness syndromes.
• They may transform into the dry-heat
syndrome and damp-heat syndrome, known
as the Yangming dryness syndrome and Taiyin
damp-heat syndrome.
Syndrome of the Middle-Energizer
• Fever, flushed cheeks, harsh breathing,
abdominal fullness, constipation, thirst and
preference for cold drinks, dry mouth and
cracked lips, dark urine, red tongue with
yellow dry coating or dark yellow coating with
prickles, deep excess and forceful pulse, heavy
sensation of the body, suffocating feeling in
the gastric region, nausea, difficult defecation
or loose stools, red tongue with yellow greasy
coating, and soggy and rapid pulse.
Syndrome of the Lower-Energizer
• It is the late stage of warm diseases in which
the heat pathogen invades the lowerenergizer and injures liver yin and kidney yin.
• Fever, flushed cheeks, feverish sensation in
hands and feet, more serious in palms and
soles, dry mouth and throat, lassitude,
deafness or poor hearing, crimson tongue
with scanty coating and deficient pulse.
Transmission of the Triple-Energizer
Syndromes
• Start from the Lung Channel of Hand-Taiyin to
the middle-energizer and lower-energizer.
• It is a pathological process from the upper to
lower, from superficial to deep, and from mild
to severe, called normal transmission.
• When they are too strong and the healthy qi is
weak, the pathogenic factors invade the
Pericardium Channel of Hand-Jueyin from the
defense system.
Transmission of the Triple-Energizer
Syndromes
• Transmission from the upper to lower is a
common rule.
• When pathogenic factors attack the upperenergizer and they are eliminated soon, so there
is no transmission; or the syndrome of the
middle-energizer occurs when the syndrome of
the upper-energizer remains;
• Or the pathogenic factors transmit directly into
the lower-energizer from the upper-energizer;
Transmission of the Triple-Energizer
Syndromes
• Or the syndrome of the lower-energizer appears
when that of the middle –energizer remains;
• Or disorder occurs in the middle-energizer of the
lower-energizer;
• Or interlocking of syndromes are found in the
upper-energizer and middle-energizer.
• An overall analysis of the clinical data is needed
to decide the condition of the syndromes of the
triple energizer.