Diagnostics cont. - 2/16 Flashcards
Inspection of the Face
Yang Type Edema
Yin Type Edema
YANG-type:
- excess pattern
- abrupt onset
- wind, cold, damp attack Lung, Spleen
- Lung dec/diff impaired, body fluids accumulate
YIN-type:
- deficiency pattern
- slow onset
- Spleen and Kidney Qi or yang deficiency
Inspection of the hair can tell us about:
What doesn normal look like?
What does abnormal look like?
- condition of qi, blood, kidney
Normal: thick luxuriant, evenly distributed, moist, with sheen – (normal exbuerance of essence and blood)
Abnormal:
- Dry, withered, thin, hair loss
- Xu of blood, essence, Kidney; blood heat; after severe illness, extreme taxation-fatigue, post-partum - Sudden hair loss
- xu blood with internal wind - Graying
- can be normal; kidney xu (poor memory, sore, weak knees)
Ling Shu: “The essence-qi of the five viscera and six bowels ascends to _____”
“_____ opens to the eyes”
What can inspection (of the eyes) tell us about?
- eyes
- eyes
- inspection can tell us the condition of the Mind (shen), organs, and essence
Spirited Eyes vs. Spiritless Eyes
What do they look like?
What do they indicate?
Spirited
- bright, shiny; clear and correct vision; flexible and lively movement
- indicates: absence of disease; mild disease that is relatively easy to treat
Spiritless
- dull and/or turbid sclera; lack of brightness; blurred vision; inflexible movement, staring forward or upwards
- indicates: presence of disease; disease is relatively severe and more difficult treat
Inspection of the Eyes: Congruencies
**Need to Memorize
Pupil
Iris
Sclera
Corners
Eyelids
Congruency + Color =
Pupil: Kidney
Iris: Liver
Sclera: Lung
Corners: Heart
Eyelids: Spleen
(upper: Spleen, lower: Stomach)
- Congruency + color helps determine location and nature of illness (e.g. red sclera = lung heat)
RED eyes
Governs
Red Canthus
Red Sclera
Entire Red Eye
Red, Swollen Eyelids
Governs - Heat/Fire
Red Canthus - Heart Fire
Red Sclera - Lung Fire
Entire Red Eye - Liver Fire, Liver channel wind-heat
Red, Swollen Eyelids - damp-heat Sp/St, damp-heat in Liver/GB
Yellow Eyes
Green-Blue Eyes
White Eyes
Black Eyes
Yellow - (dampness) damp heat; damp cold
Green-Blue - (wind) Liver wind
White - (deficiency) - pale white blood vessels in canthus or interior aspect of lower eyelids – blood xu, qi and blood deficiency
Black - (water) Spleen and Kidney xu; Water-dampness
Form and Bearing of Eyelids
Drooping Eyelids
Incomplete Closure of the Eyes
Strabismus (eyes not properly aligned)
Styes
Drooping - Spleen qi xu
Incomplete closure - Spleen xu, qi and blood xu
Strabismus - Liver wind
Styes - wind heat; Sp and St heat
Inspection of the NOSE
- Clear, watery white nasal discharge
- Thick-yellow or turbid nasal discharge
- Nosebleed
- Invasion of Lung by wind-cold (nasal congestion with frequent sneezing)
- Invasion of the Lung by wind-heat
- Phlegm heat - Invasion of the lung by wind-heat
- Lung heat, stomach fire, liver fire, traumatic injury
Inspection of the THROAT
- Red, swollen, painful throat
- Dry, red, painful
- Tender-red, mild pain
“Open passage to Lung and Stomach”
- Kidney channel connects to the throat
1. excess heat
2. heat damaging Lung fluids
3. Kidney yin xu with deficient heat flaring up
Inspection of the LIPS
- Red-purple
- Red and dry
- Fresh-red
- Pale
- Blue-green
“Luster of the Spleen” - normal: bright, red, moist
- heat
- heat damaging fluids
- yin deficiency heat
- blood deficiency
- pain
TONGUE CORRESPONDENCES
**need to memorize
tip
center
root
margins/sides
Tip: Heart and Lung
Center: Sp and St
Root: Kidney
Margins/sides: Liver (right), GB (left)
NORMAL TONGUE
- pale red, thin white coat,
Pale or White Tongue
Image
Significance
- lighter in color than a normal pale-red/pink tongue; may not even have any red coloration at all
SIGNIFICANCE:
- Deficiency Cold pattern (Yang xu)
- Excess Cold pattern
- Deficiency or exhaustion of qi and blood (Qi xu)
Red Tongue
Image
Significance
- more red than a normal tongue, or with bright red color
SIGNIFICANCE:
- heat pattern
- deficiency heat pattern (yin xu) - (bright red, THIN or fissured, little to no coating) tongue body small
- excess heat pattern (bright red, rough or even prickled tongue, a thick yellow gray or black dry tongue coating
Crimson/Scarlet Red Tongue
Image
Significance
- deep red color, deeper than the red tongue
SIGNIFICANCE:
-
heat pattern
- excess heat - crimson tongue with possible prickles or red spots, a yellow and dry coating
- deficiency heat - crimson tongue with little coating or without coating, possible fissures
- blood stasis with heat - crimson tongue with purple dots
Blue-Green-Purple Tongue
Image
Significance
- ranges from blue-green to purple to purple-red in color
SIGNIFICANCE:
- blood stasis - due to a variety of causes
- qi stagnation (added in class) bc it causes blood stagnation
TONGUE
- Crimson-purple, dry, possibly with cracks =
- Pale-purple, slippery, wet =
- Blue-green-purple, dim, stasis molecules =
- interior heat excess (heat leads to abundance of blood in vessels, with blood stasis and damage to body fluids)
- interior cold excess (cold leads to stasis of blood)
- blood stagnation
**Yin deficiency doesn’t make the blood stagnate
PUFFY tongue
Image
Significance
PALE, PUFFY, WET =
PALE, PUFFY, TOOTHMARKS =
- bigger than normal, or even filling the entire mouth, usually with tooth-marks
SIG: retention of dampness, phlegm, phlegm fluid
PALE PUFFY WET = Yang xu
PALE PUFFY TOOTHMARKS = Spleen Qi xu
Small Tongue
Image
Significance
RED, THIN BODY, DRY =
- thin, small and withered tongue (length, width, depth/thickness)
SIGNIFICANCE:
- deficiency of both qi and blood (small, pale-red tongue)
- yin deficiency with empty fire (emaciated, dry, crimson tongue, and little or no coating)
RED THIN DRY = yin xu
Prickled Tongue
Image
Significance
- tongue with prominent spots (red, purple, black) commonly seen on the tongue tip and sides
SIGNIFICANCE:
- toxic-heat entering the blood level (the larger and greater the quantity of prickles, the stronger the heat)
- heat (added in class)
- blood stasis (added in class)
Tongue with patches/spots (“stasis macules”)
Image
Significance
- bluish-purple or purplish black patches
SIGNIFICANCE:
- blood stasis
Cracked/Fissured tongue
Image
Significance
- Dry, crimson, scant coat, cracks
- Red, scant coat, cracks
- Pale-red, smooth, cracks
- Pale-white, cracks
- tongue with cracks/fissures of varying shapes and depths on the surface
SIGNIFICANCE
- heat damaging yin fluids (yin: blood, body fluids)
- yin deficiency
- blood, deficiency (usually in elderly)
- dryness due to blood deficiency
Tooth-marked Tongue
- Pale white, slippery white coat, tooth-marks =
- Pale-red, smooth, toothmarks =
- top and sides of the tongue body have clear impressions made by the teeth (usually seen together with a puffy tongue)
1. retention of dampness
2. Spleen Qi xu
STIFF tongue
Image
Significance
- loss of flexibility, difficulty in stretching or retracting, or even rigidity with the inability to move, slurred speech
SIGNIFICANCE
- invasion of the pericardium by exuberant pathogenic heat (dark-red or crimson, stiff and dry tongue)
- wind-phlegm obstructing collaterals in the tongue (pale-red or green-blue, puffy and stiff tongue with thick, greasy coating, unconsciousness, deviated mouth and eye, hemiphlegia)
FLACCID tongue
Image
Significance
- soft without strength, and inability to move easily
SIGNIFICANCE:
- deficiency patterns (yin, qi and blood, body fluids)
- channel obstruction (added in class)
TREMBLING tongue
Image
Significance
- involuntary trembling, rapid movement when extended
SIGNIFICANCE
- Liver-wind
- Exuberant heat (crimson, purple and quivering tongue)
- Qi and blood xu (pale or white, slightly trembling tongue)
- Yin xu (red, quivering tongue with little or no coat)
DEVIATED tongue
Image
Significance
- tongue deviating to one side when extended
SIGNIFICANCE
- wind patterns
- deviated (pale-red tongue), facial paralysis, inability to raise the eyebrows
- external wind obstructing collaterals
- purplish-red and deviated tongue, dizziness, numbness, spasms
- internal wind
What is tongue coat/fur generated by?
What does normal look like?
- Stomach qi
- thin, white, moist
WHITE coating represents what 2 kinds of patterns?
- Exterior patterns
- Cold patterns
YELLOW coating represents what 2 kinds of patterns?
- Heat patterns
- Interior patterns
GRAY coat represents what 3 kinds of patterns?
- Interior patterns
- Heat
- Cold
BLACK coating represents what 3 kinds of patterns?
- Interior patterns
- Extreme heat
- Extreme cold
THICKNESS of the tongue coating
differences between Thin and Thick
- depth and severity of diseases
THIN - normal, disease in EXTERIOR, mild disease, Evil qi on surface
THICK - disease in INTERIOR, more severe disease, Evil qi deeper in body
MOISTURE of the tongue coating
Moist vs Slippery vs Dry
- existence or collapse of body fluids
Moist - normal
Slippery
- excessive fluids on tongue, tendency to flow downward when the tongue is protruded
- yang xu with retention of phlegm-fluid and water damp
Dry
- body fluids damaged by heat
- yin xu
- yang qi xu failing to steam fluids upward
- pathogenic dryness attacking the lung
GREASY tongue coating
Exuberance of what?
- relatively small and fine particles, sticking together making a shiny surface, can not be scraped away easily
EXUBERANCE OF PHLEGM-DAMP which inhibits yang-qi
- turbid dampness
- phlegm-fluids
- food retention
- damp-heat
CURD-LIKE tongue coating
- relatively rough, large, granular, loose, and thick, as if bean curd is piled on the surface of the tongue, can easily be scraped away
PHLEGM DAMPNESS without weak yang-qi and/or heat
- food retention causing damp heat
- phlegm dampness with heat
SUBLINGUAL VEINS
- Purple, black, distended
- Dark purple and thin
- Very pale or not visible
- Filmy, creamy
- blood stasis
- yin xu
- qi and blood xu
- dampness
