Exterior/Interior Patterns Flashcards
EXTERIOR PATTERNS
- Invasion of __________?
- Struggle b/w ________ and _________?
FEVER and CHILL (aversion to ____ and ____) present simultaneously
- Invasion of external pathogen
- Struggle b/w Upright Qi and Evil (EPF)
- Fever and chills aversion to WIND/COLD
Fa Re
To feel hot to the touch, but does not necessarily indicate elevated body temperature; “heat effusion”; “fever”
Taiyang Wind Strike
Fever? Chills?
- Aversion to wind (kind of chill), slight feverishness, sweating
- exterior wind invasion with deficiency
- headache, stiff neck
PULSE: floating (exterior) and moderate (normal)
TONGUE: thin, white fur
Taiyang Cold Damage
Fever? Chills?
- More chills than fever, no sweating
- exterior wind-cold excess
- headache, body aches, wheezing
TONGUE: thin white coating
PULSE: floating and tight
Exterior-wind-heat attaching the Defensive level (Exterior wind-heat invasion)
Fever? Chills?
- More fever than chills
- fever, slight aversion to wind or slight chills, slight or no sweating, dry mouth, slight thirst, headache, general body ache (heat affects body fluids), sore throat
TONGUE: red tip with thin white coat
PULSE: floating and rapid (heat)
INTERIOR PATTERNS
- External pathogen has moved from the exterior and entered into the interior of the body
OR - Endogenous cold or heat from excess or deficiency is present in the interior
*Here there is typically no mingling hot and cold sensations simultaneously – one or the other is present
HIGH fever or feeling hot
Interior Heat Pattern– Interior heat excess
- high fever, red complexion, thirst with desire to drink cold water, profuse sweating
TONGUE: red body, thick, dry, yellow coat
PULSE: surging (excess) and rapid
Low Grade Fever
Interior Heat Pattern – Yin deficiency patterns (deficient heat)
- feeling hot mostly at night or in flushes, red cheeks, thirst with only slight desire to drink and a preference for cold water, night sweating, five-palm heat
TONGUE: red body, little or no coat
PULSE: thin, weak, rapid
Name the 3 causes of Tidal Fever
What is tidal fever?
- Yangming Fu (St, LI) disease
- Damp Heat Patterns
- Yin Deficiency Patterns
Tidal Fever - a fever that gets worse or occurs only at certain times
Yangming Fu disease (tidal fever)
Interior Heat Pattern
- high fever that gets worse between 3-5 pm, constipation with dry stool, abdominal fullness and distention, scant yellow urine
TONGUE: red body, dry yellow coat
PULSE: rapid, forceful
Damp Heat Patterns (tidal fever)
Interior Heat Pattern - fever that gets worse in the afternoon (not as high as Yangming fever) and that does not abate with sweating - clammy, heaviness of head and body TONGUE: red body, greasy yellow coat PULSE: rapid, slippery (damp)
Yin Xu Patterns (tidal fever)
Interior Heat Pattern
- low grade “fever” that gets worse in afternoon or evening, steaming bone (sensation of heat in the bones), 5-Palm heat, malar flush, night sweats, emaciation dry mouth and throat
TONGUE: thin and red body with little to no coating
PULSE: thin (yin Xu), rapid, [weak: added in class]
Yang Deficiency (deficiency cold) Interior Cold Pattern
- aversion to cold, cold body and limbs, spontaneous sweats, other yang deficiency symptoms
- chronic diseases
TONGUE: pale, wet
PULSE: deep (interior), slow (cold), weak (Xu)
Interior Cold Excess
Interior Cold Pattern
- exogenous cold which has moved to interior
- strong aversion to cold, absence of thirst, cold and painful abdomen, cold and pain in local areas
PULSE: deep (interior), slow (cold), tight (excess cold), forceful (excess)
Shaoyang Disease
- Alternating chills and fever****
- exogenous cold which is half in the exterior and half in the interior and transforming to heat
- alternating chills and fever, bitter taste, dry mouth, dizziness, blurry vision, fullness and oppression in the costal and hypochondriacal regions, poor appetite (wood overacting on earth), mental restlessness, nausea or vomiting
PULSE: wiry
[constrained Shaoyang Fire (ministerial fire), transforms to pathological heat
Key points when inquiring about SWEAT (5)
- presence or absence
- location
- nature
- time
- quantity
SWEAT and Exterior Patterns
No sweat (1) Sweat (2)
No sweat
- Taiyang Cold Damage (ext wind-cold excess)
- no sweat, chills more than fever, still and painful nape and neck, headache, floating and tight pulse
Sweat
- Taiyang wind-strike
- sweating, aversion to wind, slight feverishness, floating and moderate pulse
- Exterior Wind-Heat Invasion
- sweating, fever more than chills, headache, sore throat, floating and rapid pulse
SWEAT and Interior Patterns
What are the 3 types?
- Spontaneous sweating (“self sweat”)
- Night Sweating (“thief sweat)
- Whole body sweating
Spontaneous Sweating (self sweat)
Interior Pattern
- sweating in the daytime that is not related to emotions, temperature or exercise, but is worse with exertion
- QI/YANG DEFICIENCY
- sweating during the day that is worse with exertion
- aversion to wind and cold, weak immunity (easy catching colds), pale complexion, listless and fatigued, thin and weak pulse [deep added in class]
Night Sweating (thief sweat)
- sweating that occurs during sleep
- YIN DEFICIENCY
- night sweats, tidal fever, malar flush, five-palm heat, thin red tongue with little to no coat, thin and rapid pulse
- sleep occurs when yang “enters” yin – when yin is deficient, yang is relatively more and steams the yin, causing night sweats
Whole Body Sweating
2 types
Interior Heat Excess
- (profuse) sweating that occurs over the entire body, fever, thirst with a desire to drink, constipation, dark urine, rapid and forceful pulse
Collapse of Yang, Desertion of Yang Qi
- profuse sweating over entire body, cold limbs, faint pulse
Tongue: ready body, yellow coat
(SEVERE Yang Xu)
Dizziness and Deficiency
QI AND BLOOD XU
- dizziness aggravated by overwork or postural changes, blurry vision, pale complexion, palpitations (not receiving enough Qi and blood), insomnia (blood not nourishing Shen), pale tongue with thin coat, weak [thin] pulse
KIDNEY ESSENCE DEFICIENCY
- dizziness, tinnitus (Kid opens to ear), nocturnal emission, poor memory, sore and weak low back and knees, pale tongue, weak pulse
*Kid stores Essence, Essence generates Marrow, Brain = Sea of Marrow
Dizziness and Excess Patterns
LIVER YANG RISING-POSSIBLY WITH STIRRING OF LIVER WIND
- dizziness, dis tending headache, red complexion and eyes, tinnitus, bitter mouth, dry throat, wiry pulse
PHLEGM DAMP OBSTRUCTING CLEAR-YANG FROM ASCENDING TO NOURISH HEAD – turbid yin
- dizziness, heavy and foggy head, stuffy chest, nausea, vomiting phlegm, greasy tongue coat [puffy, wet]
HEADACHE - Excess and Xu patterns, general
Excess - sudden onset, short duration, constant and more intense pain (e.g. Headache from Exterior wind-cold invasion)
Deficiency - slow, gradual onset, chronic, lingering, intermittent, interior patterns (e.g. Qi and Blood Xu, overtime becomes deficient)
Headache
- Heavy feeling?
- Pain in the Brain?
- Distending, throbbing?
- Sharp, fixed, boring pain?
- With Muzziness, heaviness, and dizziness?
- Dampness or phlegm
- Kid deficiency
- Liver Yang Rising
- Blood Stasis
- Dampness
- Phlegm
HEADACHE - YANG LEVELS
Taiyang, Shaoyang, Yangming Channels
TAIYANG - Occipital, radiate to neck and upper back, stiff neck/shoulders
YANGMING - Frontal, pain in forehead and eyebrows
SHAOYANG - temporal, pain in temples, sides of head, ears
HEADACHE - YIN LEVELS
Taiyin, Shaoyin, Jueyinb Channels
TAIYIN - headache with dizziness and heaviness of head, diarrhea, spontaneous sweating
SHAOYIN - headache with pain in brain and teeth (kidney)
JUEYIN - Vertex headache, radiating to sides of head and behind eyes, sensation of Qi rising, possible nausea and vomiting
- Running Piglet, Wood overacting on Earth
PAIN IN WHOLE BODY
- Sudden onset, with fever and chill
- Ache all over with fatigue
- Post-partum dull pain
- Post-partum severe pain
- Dull ache in muscles, especially limbs, with heaviness
- Exterior wind invasion
- Qi and blood Xu
- Blood deficiency
- Blood stasis
- Dampness
BACKACHE
1. Continuous, dull, better with rest
2. Recent onset, severe, with stiffness
3. Pain that is aggravated by cold and damp, alleviated by warmth
4 Fixed, stabbing pain
5. Pain in the upper back, shoulders, neck
- Kid deficiency
- Blood Stasis due to sprain/strain
- Cold damp
- Blood Stasis
- Exterior Wind invasion
CHEST - Heart disorders
- Stabbing pain
- Chest oppression, pain radiating to back and shoulders
- Blood stasis in heart
2. Heart vessel blocked by blood stasis, phlegm damp, cold, Heart yang deficiency
CHEST - Lung disorders
- Chest pain, cough, high fever, dyspnea, wheezing, nasal flaring
- Chest pain, cough with blood-tinged sputum, night sweats, tidal fever
- Chest oppression, cough with copious white phlegm, dyspnea
- Chest oppression, cough with copious yellow phlegm, dyspnea
- Chest oppression, weak cough, dyspnea, fatigue
- Excess heat in Lung
- Lung yin Xu
- Phlegm damp accumulating in Lung
- Phlegm heat accumulating in Lung
- Lung Qi deficiency
HYPOCHONDRIUM (flanks: Liv, GB) [or Shaoyang]
- Distending pain in the chest and hypochondrium, sighing, irritability, wiry pulse
- Burning pain in hypochondrium, red complexion and eyes, wiry and rapid pulse
- Dis tending and heavy or burning pain in hypochondrium, yang-type jaundice, wiry and slippery pulse
- Fixed and stabbing hypochondrium pain that is worse at night
- Fullness and oppression in hypochondrium, alternating fever and chills, bitter mouth, dizziness, blurry vision, restlessness, nausea, wiry pulse
- Liver Qi stagnation
- Depressed-fire from Liver Qi stagnation
- Damp heat in Liver and GB
- Blood Stasis
- Shaoyang Disease
EPIGASTRIUM (Cold and Heat)
- Cold and paroxysmal epigastric pain relieved by warmth and aggravated by cold
- Burning pain in epigastrium, excessive hunger, foul breath, constipation with dry stool
- Invasion of pathogenic cold in Stomach
2. Stomach fire
EPIGASTRIUM (Qi and Blood)
- Distending pain aggravated by anger/stress/emotions, belching, hiccough
- Stabbing pain in fixed location that is worse at night
- Liver Qi stagnation with liver overacting on Stomach
2. Blood stasis in Stomach
EPIGASTRIUM (Yin and Yang)
- Dull, epigastrium pain relieved by warmth and pressure
- Burning sensation in epigastrium, hunger but inability to eat much, red tongue with little to no coating, thin rapid pulse
- Stomach yang Xu
2. Stomach yin Xu with deficiency heat
ABDOMEN Excess Deficiency Cold Heat Blood Stasis Liver Qi Stagnation
Excess - pain: acute, more severe, worse with pressure
Xu - pain: chronic, less severe, better with pressure
Cold - worse with cold, better with heat
Heat - worse with heat, better with cold
Blood Stasis - fixed and sharp/stabbing pain, worse @ night
Liv Qi stagnation - dis tending and moving pain, possibly worse with stress/emotional upset
EARS (tinnitus)
- Begins gradually, low pitch, off and on, reduced when cover ears with hands (pressure)
- Sudden onset, loud, louder when cover ears with hands
- Kidney Xu
2. Liver and GB fire
EARS (deafness)
- Gradual hearing impairment or deafness that occurs after long illness or in elderly
- Sudden hearing loss or deafness, with bitter mouth and rib-side/flank/hypochondrium pain
- Kidney deficiency
2. Liver and GB fire
EYES
- Red and painful
- Red without much pain
- Blurry vision, dry eyes
- Excess heat
- Deficient heat
- Liver yin or blood deficiency, Kidney yin or essence deficiency
THIRST and fluid intake
- No thirst
- Dry mouth with little to no desire to drink, or only desire to sip (4)
- Cold patterns
2.
- Yin Deficiency (deficient-heat, deficiency so not want to drink to much)
- Damp Heat (heat makes dry/thirst, damp subdues desire to drink)
- Retention of phlegm fluids (body fluids not evenly distributed leads to thirst, retention of fluids, subdues desire to drink)
- Blood Stasis (body fluids not evenly distributed leads to thirst, stasis of fluids subdues desire to drink)
APPETITE and food intake Reduced Appetite (3) No appetite (2)
Reduced
- spleen and stomach Qi Xu
- accumulation of dampness in spleen
- damp heat in liver and GB
No appetite
- food stagnation
- morning sickness
APPETITE and food intake
- Excessive Hunger
- Hunger without much desire to eat, or can only eat a small amount
- Cravings for strange things
- Stomach Fire – thirsty, can eat
- Stomach Yin Xu
- Parasites, Pregnancy
Insomnia
- easily waking in the middle of the night, palpitations, poor memory, poor appetite, fatigue, digestive weakness, loose stools, pale tongue, weak pulse
- Difficulty falling asleep, mental restlessness, dream disturbed sleep, tidal fever, night sweats, sore and weak lumbar region and knees
- DEFICIENCY OF SPLEEN QI AND HEART BLOOD
- HEART AND KID NOT COMMUNICATING
- Ht and Kid YIN Xu
- Kid water not nourishing/controlling Heart fire
