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Diagnosis & Pattern Differentiation Flashcards

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Chinese (Mandarin) flashcards
1
Q

What are the four methods of examination?

A

Observation/Inspection
Listening and Smelling
Interrogation
Palpation

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2
Q

What are the traditional 10 questions of enquiry?

A
  1. Chills and Fever
  2. Sweat
  3. Head and body
  4. Stools and urine
  5. Appetite, thirst and taste
  6. Chest and abdomen
  7. Ears and eyes
  8. Sleep
  9. Old illnesses
  10. Lifestyle and emotions
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3
Q

The symptom of ‘thirst without the desire to drink’ is typical of what condition?

A

Excess of damp

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4
Q

What is the urine like with cold and heat conditions?

A

Cold - pale and copious

Heat - Dark and scant

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5
Q

What does spontaneous sweating, night sweats and oily sweating each indicate in interior patterns?

A

Spontaneous sweating - Qi Deficiency
Night sweats - Deficiency of Yin
Oily sweating - Yang deficiency

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6
Q

If the patient has both an excess and deficiency which is treated first?

A

Excess

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7
Q

List the 8 principles for disease patterns (Ba Gang)

A

Exterior/Interior
Deficiency/Excess
Cold/Heat
Yin/Yang

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8
Q

What is the only organ affected by exterior disease?

A

The lungs

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9
Q

What are some characteristic of exterior diseases?

A

Generally acute, sudden onset, short duration and less serious

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10
Q

What are some characteristics of interior diseases?

A

Chronic, gradual onset, more serious. Involves ZangFu, Qi, Blood and body fluids.

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11
Q

What are some causes of interior disease?

A

An exterior evil that is not expelled by the body
Emotions
Irregular food intake
Overstrain/stress

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12
Q

What is the order in which disease penetrates the body? (Starting from superficial layer)

A 
Skin
Flesh (pores)
Muscles 
Blood
Bone
ZangFu organs
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13
Q

What exterior condition are kids more prone to and why?

A

Wind-Heat because they are balls of Yang energy

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14
Q

What are the chief manifestations of exterior disease?

A

An intolerance to cold and wind

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15
Q

Why does wind cause an aversion to cold?

A

Wind obstructs the space between the skin and the muscles where the defensive Qi circulates; as the defensive Qi warms the muscles, when it is obstructed it cannot do so therefore the patient feels cold.

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16
Q

What is classified as exterior and interior of the body?

A

Exterior - skin, muscles and channels

Interior - Organs

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17
Q

What does fever and aversion to cold symptoms that occur simultaneously always indicate?

A

An invasion from an external pathogenic factor

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18
Q

What are the 5 main clinical manifestations of exterior patterns?

A 
Aversion to cold
'Fever'
Aching body
A stiff neck
Floating pulse

Can also have headache, sore or itchy throat, nasal congestion and chills

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19
Q

What are the main clinical manifestations of exterior cold patterns (wind-cold)? (8)

A 
Slight 'fever'
Pronounced aversion to cold
Severe aches in body
Severe stiff neck
No sweating
No thirst
Floating-tight pulse
Thin white tongue coating
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20
Q

What are the main clinical manifestations of exterior hot patterns (Wind-heat)? (6)

A 
'fever'
Aversion to cold
Slight sweating
Thirst
Floating-Rapid pulse
Thin white tongue coating sometimes redness of tongue on the sides and/or front
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21
Q

What is a full condition characterised by?

A

The presence of a pathogenic factor of any kind and by the fact that the body’s Qi is relatively intact.
‘Fullness’ denotes fullness of a pathogenic factor, not fullness of Qi

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22
Q

How do the cold, wind, dampness and heat manifest in Painful Obstructive Syndrome?

A

Cold - Usually only in one joint, pain is severe and relieved by heat
Wind - Pain moves from joint to joint
Dampness - Swelling in joints
Heat - Pain is severe and the joints are hot and swollen

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23
Q

What is the most important symptoms that mark the change from the exterior to the interior stage?

A

The disappearance of aversion to cold and onset of aversion to heat

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24
Q

What are the chief manifestations of half exterior - half interior (Shao Yang disharmony)?

A 
Alternating chills and fever 
Sense of fullness in the chest
Nausea
Bitter taste
Blurred vision
Dry throat
Belching
Wiry pulse
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25
Q

What are some common causes of Full Heat?

A

Invasion of yang evil
Invasion of external pathogenic factors such as cold which turns into heat in the body
Over consumption of yang foods or long standing emotional disorders leading to qi/blood stagnation which overtime generates heat

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26
Q

What are some common causes of Deficient Heat?

A 
Chronic illness
Overwork
Excessive sexual activity
Depletion of body fluids
Loss of blood
Dry environment
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27
Q

What is in excess/deficiency in Full Heat, Full Cold, deficient heat and deficient cold?

A

Full Heat - Excess Yang
Full Cold - Excess Yin
Deficient Heat - deficient Yin
Deficient Cold - deficient Yang

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28
Q

What are some symptoms of Cold deficiency “false cold’?

A 
Cold limbs
Light shivering
Mild aversion to cold
Preference of warmth
Pain alleviated by pressure (dull pain)
Slow weak movement
Spontaneous sweating
Clear frequent copious urination
Loose stool with food particles
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29
Q

How does the tongue present with cold deficiency?

A

Pale, swollen, teeth marks, thin white wet coat

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30
Q

How does the tongue present with full cold?

A

Pale, thick white coat

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31
Q

How does the pulse differ from false cold to full cold?

A

False: Slow, weak
Full: Deep, slow, full

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32
Q

How does pain differ from false cold to full cold?

A

False: alleviated by pressure
Full: Aggravated by pressure

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33
Q

What are some symptoms of excess Cold “full cold”?

A 
Cold limbs and body
Strong shivering
Marked aversion to cold
Marked preference of warmth
Pain aggravated by pressure (sharp pain)
Strong forceful movement
Little or no sweating
Clear frequent copious urination
Loose stool
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34
Q

How does the tongue present in empty heat and full heat?

A

Empty: Small red, peeled coat
Full: Red, large, thick yellow coat

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35
Q

How does the pulse differ from deficient heat to full heat?

A

Deficient: Thin, rapid
Full: Full, rapid

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36
Q

What are some symptoms of Empty Heat?

A 
Tidal fever, afternoon 'temperature'
Night sweats
Malar flush; 5 palm heat (chest, palms and soles)
Desire to drink in small sips
Better with cold and pressure
Weak rapid movement
No bitter taste
Feeling of heat in afternoon or evening
Fidgety, wakes frequently
Vague anxieties
Flat scarlet blotches or indented ulcers
Bleeding not so profuse
Dark scanty urination
Dry stool
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37
Q

What are some symptoms of full heat?

A 
Fever
Sweating
Whole face red, hot face and body
Desire to drink cold
Better with cold, worse with pressure
Strong rapid movement
Bitter taste in mouth
Feeling of heat all day
Very restless, insomnia
Irritable, delirium
Red hot raised skin lesions
Bleeding profuse
Dark scanty urination
Dry stool or explosive diarrhoea
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38
Q

Why are there usually signs of Spleen Yang deficiency in Deficient cold?

A

Because the Kidneys are the root of all Yin and Yang and if the Kidney Yang is weak then the Kidneys will fail to support the Spleen

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39
Q

What is the difference in internal patterns for deficiency and excess?

A

Deficiency - Generally refers to chronic internal patterns associated with deficiency with one or more of the substances, and one or more of the Zang Fu organs

Excess - Generally more acute and refers to the invasion of the body by external disease factors, or the over activity of one or more Zang Fu, or local obstruction of Qi, Blood, Body fluids or emotions, improper diet and lifestyle

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40
Q

Which Qi is weak in deficiency?

A

The right Qi

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41
Q

What are the conditions of Yin and Yang patterns?

A

Collapse of Yin Yang
Exhaustion of Yin Yang
Separation of Yin Yang

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42
Q

How does the tongue appear differently in Yin deficiency alone and Yin deficiency with Empty Heat?

A

Yin Deficiency: lacks a coating and colour is normal

Empty Heat: lacks a coating and colour is red

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43
Q

What are the 5 combinations of combined Hot and Cold?

A

Cold on the Exterior and Heat in the Interior
Heat on the Exterior and Cold in the Interior
Heat above and Cold below
Combination of Heat and Cold patterns
False Heat - True Cold and False Cold - True Heat

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44
Q

What is an Empty condition characterised by?

A

Weakness of the body’s Qi and the absence of a pathogenic factor

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45
Q

What is a Full-Empty condition characterised by?

A

An Emptiness of the Upright Qi with the presence of a lingering pathogenic factor that the Upright Qi is not fighting effectively

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46
Q

What is Upright Qi?

A

All types of Qi that play a role in the defence of the body from invasion by external pathogenic factors
Defensive Qi, Nutritive Qi and Kidney-Essence

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47
Q

What are the 4 types of Emptiness that can be distinguished?

A

Empty Qi
Empty Yang
Empty Blood
Empty Yin

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48
Q

What are the main manifestations of collapse of Yin?

A 
Abundant perspiration
Dry throat
Thirst
Restlessness and agitation
Thin, dry skin
Scant urine
Skin hot too touch
Tongue is red and dry with scant or absence coat
Pulse is rapid, weak, and thin or thready
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49
Q

What are the main manifestations of collapse of Yang?

A 
Feverishness
Aversion to cold
Profuse oily sweating
Frequent, profuse urination or incontinence 
Cold limbs
Preference for lying curled up
No thirst 
Pale, moist, swollen tongue
Pulse is thready, weak and fading
50
Q

What are the six divisions and what organs do they each organs do each contain?

A 
Tai Yang - Bladder, SI
Yang Ming - Stomach, LI
Shao Yang - Gall Bladder, San Jiao
Tai Yin - Lung, Spleen
Shao Yin - Heart, Kidney
Jue Yin - Liver, Pericardium
51
Q

Which of the six divisions are exterior?

A

Tai Yang

Shao Yang - is both exterior/interior

52
Q

What are the 4 categories of penetration for the six divisions?

A
  1. Two or more divisions affected simultaneously
  2. The disease of on division is not cured and another division is affected
  3. Disease is transmitted to next division
  4. Direct invasion of Yin division, no preceding yang disease
53
Q

What two organs are most affected by Blood deficiency?

A

Heart and the Liver

54
Q

What does the exterior/interior principle measure?

A
  • Location and depth of disease
  • Direction of development of the disease
  • Prognosis of disease
55
Q

Why do you get a Floating pulse in exterior diseases?

A

Because the Qi and Blood of the body moves to the exterior to try and expel the exterior pathogen causing the pulse to feel as if it is Floating

56
Q

What is Tai Yang division affected by and what are 3 essential symptoms?

A

Wind-cold.

Aversion to cold
Headache and stiff neck
Floating pulse

57
Q

How does pathogenic factor enter the Yang Ming division?

A

Pathogenic factor enters the interior directly or passes from the Tai Yang and has transformed into Heat

58
Q

In which division do you see the 4 Bigs - big pulse, big sweat, big thirst and big fever?

A

2nd division - Yang Ming

59
Q

What symptoms do you see in the Yang Ming stage?

A 
Heat scorches fluids leading to:
Fever
Constipation
Thirst
Sweating
Abdominal pain

Irritability and Delirium because the heat disturbs the Shen

60
Q

Where is the pathogenic factor in the Shao Yang division?

A

The pathogenic factor oscillates between the exterior (Tai Yang) and the interior (Yang Ming)

61
Q

When do fever and chills alternate in the Shao Yang stage?

A 
Fever = strong Zhen Qi (True Qi) and more of Yang Ming stage
Chills = strong Xie Qi (Evil Qi) and more of Tai Yang stage
62
Q

What is the Tai Yin pattern characterised by?

A

Spleen Yang deficiency with Cold

63
Q

What are some symptoms of Tai Yin division?

A 
Lack of appetite
Diarrhoea
No thirst
Tiredness
Phlegm
Pale, greasy tongue
64
Q

What is the pathology of the Shao Yin divison?

A

Kidney Yang deficiency or Kidney Yin deficiency

65
Q

What is the Jeu Yin stage characterised by?

A 
Yin and Yang fail to connect therefore person develops
Heat above (thirst, mania, heat sensation, insomnia) and Cold below (Cold extremeties, diarrhoea, lack of appetite, vomiting)
66
Q

What are some symptoms seen in the Shao Yin stage?

A 
Aversion to cold
Cold limbs
Tired
Undigested food in stool
No thirst
Desire for warm drinks
Clear copious urination
Pale, swollen tongue
67
Q

What are the forms of Excess (Shi)?

A 
Qi stagnation
Blood stagnation
Damp accumulation
Phlegm accumulation
Food stagnation
Heat/Fire
Liver Yang rising
Cold
68
Q

What are some common causes of Deficiency (Xu)?

A 
Stress
Lifestyle
Emotions
Diet
Illness
Accidents/trauma
Surgery
Treatment
Hereditary
69
Q

What organ is never in excess?

A

The Kidneys

70
Q

Why is Damp and Phlegm accumulation with Yin deficiency so difficult to treat?

A

Because most herbs that treat Yin deficiency are damp herbs. Damp needs to be treated with Yang herbs that will dry the damp and leave the deficiency for after the damp is fixed

71
Q

What are some symptoms of excess Phlegm?

A 
Numbness
Tingling
Cloudy head
Slippery pulse
Incoherent speech
72
Q

What are some symptoms of Food stagnation?

A 
Pain
Reflux
Burping 
Constipation
Aversion to food
Tongue: Full and slippery
73
Q

What are some symptoms of Qi deficiency?

A 
Pale bright face
SOB
Cough
Aversion to cold
Dizziness
Blurred vision
Lack of energy
Poor appetite
Weak voice
Bloating
Spontaneous sweating (during daytime)
Loose stool or constipation
Palpitations
Excessive urination
Heavy bleeding
Prolapse
Pulse superficial and weak
74
Q

What are some symptoms of Blood deficiency?

A 
Pale dull face
Insomnia
Palpitations
Numbness
Weakness
Dizziness
Dry skin
Blurred vision
Poor memory
Scanty, irregular periods
Insufficient lactation
Tongue: pale and dry
Pulse: Weak, deep, choppy and thin
75
Q

What organs are mostly affected by Blood deficiency?

A

Heart and Liver

76
Q

What are some symptoms of Qi stagnation?

A 
Irritability
Distension
Chest pain
Feeling better with movement
Depression
Alternating diarrhoea and constipation
Distending pain that is better with massage
Dull and wandering pain
Hypochondriac pain 
Belching
Irregular periods
Mood swings
Migraines
Hypertension
Dysmenorrhoea
Tongue: Red or purple
Pulse: Wiry
77
Q

What are some symptoms of Blood stasis?

A 
Dark skin blotches
Stabbing pain of fixed nature that is consistent and worse with pressure
Abdominal masses
Cardiac pain
Migraines
CVA
Endometriosis
Excessive menstruation with dark blood and clots
Intermittent flow
Tongue: Purple
Pulse: Wiry, knotted, choppy
78
Q

What organ is most prone to Qi stagnation?

A

The Liver

79
Q

What organs are most prone to Qi deficiency?

A

Spleen and Lungs

- because they are the source of Qi

80
Q

What are some causes of Qi deficiency?

A 
Severe, chronic disease
Overwork
Excessive exercise
Over thinking
Old age
Weak constitution
Injury to Spleen/Stomach by inappropriate diet
81
Q

What are some symptoms of Qi sinking?

A 
Chronic diarrhoea
Prolapse
Fatigue
Bearing/dragging down sensation
Heavy bleeding
Easily bruised
82
Q

What are some causes of Qi stagnation?

A

Emotions - stop the free flow of Qi
Overeating
Trauma causing local stagnation

83
Q

What are some causes of Rebellious Qi?

A

Obstruction of the Lungs in dispersing and descending by phlegm or pathogenic factor
Inappropriate eating
Emotional constraint disrupts the Liver generating fire that ascends upwards
Yin deficiency may lead to rising of Yang

84
Q

What are some symptoms of Rebellious Qi?

A 
Hiccups
Belching
Vomiting
Nausea
Dizziness
Headache
Irritability
Cough
Insomnia
Prolapse
85
Q

What are some causes of Blood stagnation?

A

Trauma or surgery
Loss of Blood
Qi deficiency (Qi fails to drive blood)

86
Q

What are some causes of Blood deficiency?

A 
Loss of blood
Blood stagnation
Diet
Dehydration
Heat pathogens
Insufficient intake of blood building foods
Weak Spleen or Stomach
Overthinking/worrying damages Heart and Spleen blood
87
Q

Why do you see tremors, spasms and dizziness in Liver Blood deficiency?

A

Because wind enters the empty spaces in the blood vessels causing an internal wind

88
Q

What does heat in the Blood cause?

A

The reckless movement of blood and scorches the blood vessels causing them to rupture

89
Q

What 3 organs are responsible for moving body fluid?

A

Lungs, Kidneys and Spleen

90
Q

What are the symptoms of Body fluid deficiency?

A 
Dry mouth
Dry skin
Thirst
Shortened urination
Dry stools
Dry cough
91
Q

What are some causes of Body fluid deficiency?

A

Fluid loss due to sweating, diarrhoea or vomiting
Severe, chronic blood deficiency
Dietary irregularities such as too many drying foods (baked goods)

92
Q

What is Body fluid stagnation due to?

A

A Yang deficiency of the Spleen, Kidneys and/or Lungs

93
Q

How do wind-cold and wind-heat evils invade differently?

A

Cold - Back of the neck and shoulders

Warm - Via the nose and mouth

94
Q

What are some symptoms of Wei level invasion of wind-heat?

A 
Strong fever
Mild aversion to cold
Slight sweating
Slight thirst
Frontal headache
Sore throat
Tongue: Red, thin white tongue with red dots on Lung area (tip)
Pulse: floating, rapid
95
Q

What are some symptoms of Qi level invasion of wind-heat?

A 
The 4 bigs - sweat, thirst, pulse and fever
Aversion to heat
Thirst
Tongue: dry yellow
Pulse: Rapid
96
Q

What are some symptoms of Construction (Ying) level invasion of wind-heat?

A 
Fever grows stronger at night
Thirst
Insomnia
Delirious
Unsurfaced skin blotches (macules)
Tongue: red
Pulse: Fine, rapid
97
Q

What are some symptoms of Blood level invasion of wind-heat?

A 
**Bleeding (vomit, stolls, urine, nose, chest)
Fever
Agitation
Tongue: Crimson red with no coat
Pulse: Wiry, rapid
98
Q

What are the different diagnosis’ of insomnia?

A

Difficulty getting to sleep - Spleen and Heart blood deficiency or Liver overacting on Spleen

Waking in the middle of the night (normally 1-3am) - Liver Yang rising or Liver fire

Tossing and turning all night - Heart and Kidney yin deficiency

Nightmares:
Reoccurring - Gallbladder Qi deficiency
Frequent but change - Heart Phlegm fire

99
Q

What are the different diagnosis’ of chronic sweating?

A

Sweats when anxious - Heart Qi deficiency
Night sweats - Heart Yin deficiency
Never sweats - Heart Yin and Heart Blood deficiency

100
Q

How should the pulse feel different in the different seasons?

A

Summer - Superficial and overflowing (more Yang in nature)
Winter - Deep (Yin time, everything draws inwards)
Spring - Wiry (Young Yang, wood phase)
Autumn - Softer (Yang is decreasing, Yin increasing)

101
Q

How does the pulse vary in gender?

A

Male - stronger on left and cun position

Female - stronger on right and chi position

102
Q

How does the pulse feel before and after mensturation?

A

Before - slippery

Post - Weak

103
Q

What type of pulse can indicate the threat of miscarriage?

A

Choppy pulse

104
Q

What side is Qi and Blood reflected in the pulse?

A

Qi - Right wrist

Xue - Land wrist

105
Q

What are the two ways the pulse presents after a person has just eaten?

A

Fuller and slippery in the right guan position - because of an accumulation of food and Qi in the stomach
Weaker in the right guan position - because Spleen Qi is burdened by having to transform the food

106
Q

How does the pulse feel when a female is pregnant?

A

More slippery

107
Q

A deep and weak pulse in the rear or chi position is a sign of what condition?

A

Kidney Blood condition

108
Q

What do the 3 levels of pulse represent?

A

Superficial - Qi and Yang (and all Yang organs) - Lung and Heart
Middle - Blood - Stomach and Spleen
Deep - Yin (and all Yin organs) - Liver and Kidney

109
Q

What is the pulse model for the organs?

A

Cun:
Left - Heart and Chest
Right - Lung and chest

Guan:
Left - Liver and Gall Bladder
Right - Stomach and Spleen

Chi:
Left - Kidney (yin), Bladder, SI
Right - Kidney (yang), LI

110
Q

What qualities should be noted when feeling the pulse?

A
  • Whether the pulse has shen, stomach and root
  • the depth
  • the width
  • the strength
  • the rate
  • the rhythm
  • other qualities
  • the cun, guan and chi positions
111
Q

What is meant by the pulse having stomach?

A

That the pulse is relatively slow (60-66bpm) is calm and soft

112
Q

What is meant by the pulse having root?

A

The pulse can be felt at the deepest level and in the chi position.
The Kidneys give the pulse root

113
Q

What are the 8 qualities of a Pulse?

A 
Depth
Frequency
Length
Width
Strength
Smoothness
Tension
Rhythm
114
Q

What is the Ben and Biao in diagnosis?

A

Ben - is the root cause (Primary)

Biao - means ‘to which it is arising’ = the symptoms (Secondary)

115
Q

How do joy, sadness, anger and grief affect the Heart?

A

Joy - slows down Heart and makes it larger
Sadness - depletes Heart Qi
Anger - may cause Heart Fire
Worry - Causes Heart Qi stagnation

116
Q

What does Heart-Yang Collapse derive from?

A

A chronic and severe deficiency of Kidney Yang

117
Q

The total collapse of Qi always derives from what?

A

The collapse of Kidney energy (Kidney Yin or Kidney Yang)

118
Q

How do palpitations differ in Heart Blood def and Heart Qi def?

A

Blood - Occur more commonly in the afternoon/evening

Qi - Occur more in the daytime

119
Q

How does the taste of bitterness differ in Liver fire and Heart fire?

A

Liver fire - Occurs every day

Heart fire - occurs only after a bad nights sleep

120
Q

Clinically what is an AMI diagnosed as in TCM?

A

Heart Yang collapse

Chinese Medicine (4 decks)

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