Insomnia, Defecation, Urine, Menses Flashcards
INSOMNIA
- Restless sleep, easily frightened and getting palpitations, mental restlessness, dizziness, chest oppression, bitter mouth, nausea, wiry pulse
- History of overeating, epigastric and abdominal distention, belching, thick and greasy tongue coating, slippery pulse
- Dream disturbed sleep, palpitations, tongue ulcer, dark and hot burning urine
- Dream disturbed sleep, irritability, anger, red eyes, tinnitus, wiry and rapid pulse
- Phlegm heat in the GB
- Food stagnation/retention
- Heart Fire
- Liver Fire
DEFECATION
What does a normal stool look like?
- each day, one time per day, in morning
- thick, long, and well formed
- comes very easily (no straining or waiting) and completely (feel abdomen is empty afterwards)
- not dry or sticky (wipe one time is enough)
DEFECATION
- Dry
- Sticky
- Foul Smell
- Insufficient fluids/poor circulation of fluids (blood, yin, Jin-ye)
- Dampness
- Heat
DEFECATION
Constipation (4)
- Large Intestine yin deficiency [more DRY, hard; “not enough water to float the boat”]
- Qi, Blood, and/or body fluid deficiency [undigested, loose, when you DO go]
- Heat accumulating in intestines [burning, can be smelly]
- Cold obstructing intestinal Qi [obstructs circulation, Excess Cold – slow, tight pulse] *Bai Zhu
DEFECATION
Diarrhea (5)
- Spleen Qi or Yang deficiency [can’t ascend, can’t transform – undigested food]
- Kidney Yang deficiency - Five Gong Diarrhea [watery, loose, in the morning]
- Food Stagnation [little burning, foul, sticky]
- Invasion of external pathogen - Damp Cold/Damp Heat [*add LI damp heat – urgent, explosive, burning, mucus, pus]
- Emotional disturbance - Liver attacking Spleen
URINATION
What does normal look like?
- Pale, yellow, clear: pale in winter, darker in summer [not sweating in winter, not losing fluids]
- Moderate frequency: more in winter, less in summer
- Not much odor
URINATION - quantity
What does copious indicate? (1)
What does scant indicate? (2)
COPIOUS
1. Kidney yang deficiency [+ excess cold] – [cold doesn’t DAMAGE the fluids, might not be “well transformed”] – [any kid xu can cause freq urination]
SCANT - [heat]
- Deficiency of body fluids/yin [yang xu]
- Retention of body fluids - not moving/metabolizing for various reasons
URINATION - frequency
Too frequent (2)
- Heat or damp heat in the lower Jiao/UB
- Heart Fire [SI, Bladder]
- Damp Heat in UB – [irritating UT]- [DAMP - frothy, cloudy; HEAT - dark, hot, painful, scant, concentrated]
- Kidney Qi/Yang Deficiency
- Kid Qi controls the two lower orifices [any Kid xu can cause freq urination]
MENSTRUATION
Early - 7-9+ days early for more than 2 consecutive months
- Flow: deep, red, thick, heavy
- Flow: pale, thin, heavy
- Heat in Blood [deep red/thick - cooked and concentrated; heavy - heat makes blood move wrecklessly]
- Qi deficiency –[Yang xu] [heavy - Qi not holding the blood – generally Spleen Qi Xu]
* Heat makes menstruation come early – moving blood
MENSTRUATION
Delayed menstruation - 7-9+ days late for more than 2 consecutive months
- Flow: pale, thin scant
- Flow: purple, dark, clots, scant
- Flow: deep red, clots, scant
- Blood deficiency [don’t have much OF it]
- (Cold) congealing Blood [Blood xu makes the menstruation come late]
- Blood stasis [can also be purple]
MENSTRUATION
Irregular Menstruation - 7-9+ days early or late
- Flow: purple-red, clots, scant: mastalgia (breast pain)
- Flow: pale-red, thin, uncertain amount
- Liver Qi constraint/stagnation [cramping, PMS, moodiness]
- Spleen and Kidney Xu
- disorder of Chong and Ren
- Spleen xu: early, heavy
- Kidney and Blood xu: late, scant [kid ESSENCE: reproductive function]
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 Kidney Yin Deficiency
- Kidney water not nourishing/controlling Heart fire
MENSTRUATION
Painful (Dysmenorrhea)
- Before Menstruation
- After Menstruation
- Excess
- Qi Stagnation
- Blood Stagnation - Deficiency
- Qi
- Blood
- Kidney
Menstruation
Amenorrhea or “Menstrual Block” (3)
- Blood Stasis
- Liver Qi “depression” and “binding”
- Deficiency – Deficiency Taxation (Kid & Blood xu?) XU LAO - [“you did too much activity, made yourself deficient]
MENSTRUATION
Leukorrhea - Abnormal Discharge (usually dampness)
- Profuse, thin, white discharge with no odor
- Profuse, thick yellow discharge with odor
- Cold Damp
- Spleen and Kid yang deficiency with downward flow of cold damp - Damp Heat
- downward flow of damp-heat due to long term stasis of dap transforming into damp-heat
Hands and Feet
- Hot hands and/or feet
- Cold hands and/or feet
- Cold body, hands, and feet
- Hot body, cold hands and feet
- Yang Excess, Yin Xu [HEAT]
- Yang Xu, Yin Excess [COLD] [Yin “blocks” Yang Qi]
- Cold Reversal – Collapse of Yang [very weak, sweating– XU]
- Heat Reversal – Heat stagnant in interior obstructing circulation to extremities -Liver Qi constraint, Wiry; people get nervous and get cold hands, warm body]
ABDOMEN
- Press and pain is made better
- Press and pain is made worse
- Hard, immobile masses with fixed pain
- Formless “masses” which come and go, pain not fixed
- Deficiency
- Excess
- Blood Stasis
- Qi stasis
PULSE positions
Where?
What are the positions?
- pulsation of the radial artery in the area around the styloid process, about 2 fun in length
Position Left Right
Cun Heart Lung, Chest
Guan Liv, GB Spleen, Stomach
Chi Kid Yin Kid Yang
LEFT: Blood and Yin
Right: Qi and Yang
What does a normal pulse look like?
- can be felt in all 3 positions, four (to five) beats per breath
- neither too superficial nor too deep, neither too large nor too small
- moderate and peaceful, flexible and forceful with heavy pressure in the chi position
- “normal” will change depending on physical activity and season/weather
Three Characteristics of a Normal Pulse
- With Stomach Qi (peaceful and moderate feeling, even rhythm)
- With Shen (with strength)
- With Root (deep portion of chi position is even and moderate and doesn’t disappear with heavy pressure) - [longevity]
Seasons and Normal Pulse
- Spring
- Summer
- Autumn
- Winter
- Wiry
- Surging
- Floating
- Deep
Normal Pulse and Gender
- Male
- Female
Age
- Forceful
- Soft, fine, a bit rapid
The younger the age, the faster the pulse
Constitution Pulse
- Heavy person
- Thin person
- Tall person
- Short Person
- Deep and fine [fine (thin, constraint?): dampness, yin pushing down on yang]
- Floating and large
- Long pulse
- Short pulse
Variations of Normal Pulse EMOTION: 1. Excess Joy 2. Anger 3. Fright
DIET:
- After eating
- Hungry
- Moderate and slack [slow down]
- Wiry
- Rapid and jumpy/stirring
- Rapid and forceful
- Slow and weak
Groups
Depth (2)
Rate (2)
Strength (2)
Depth: floating, deep
Rate: rapid, slow
Strength: strong, weak
FLOATING pulse
Description
Indications (2)
Mechanism
- Floating and tight
- Floating and moderate
- Floating and Rapid
- Floating, large, forceless
- Felt easily and with light pressure
- superficial, like a piece of wood floating on the water
Indications: Exterior Patterns
- Taiyang Cold Damage
- Taiyang Wind Strike
- Exterior Wind Heat
Deficiency Patterns
4. Floating, Large, forceless - (Xu Mai)
Mechanism: External Pathogen in the exterior, Zheng Qi fighting pathogen, pulse floats: Xu leads to yin unable to hold yang, Xu yang floats up
SURGING PULSE
Description
Indications (2)
Mechanism
Normal When?
- floating, large, full; arrives with force, departs weakly
- surges like a wave, coming in strongly, departing weakly
Normal - summertime
Excess HEAT - surging, rapid, forceful pulse, high fever, strong thirst, profuse sweating, scant and yellow urine, constipation with dry stool, red tongue with dry, yellow coat
Mechanism: internal heat excess, Qi abundant, blood surging, blood vessels dilated
SOGGY pulse
Description
Indications (3)
1. Soggy and Moderate
2. Soggy and rapid
Mechanism
- floating, thin, soft; disappears when pressing deeply
- like a soggy cotton ball floating on surface of water
Deficiency patterns - especially BLOOD Xu, also QI Xu - Sp Qi Xu Deficiency and Dampness - Sp Qi Xu and dampness [makes pulse squishy; Xu makes pulse thin and weak] Dampness 1. Cold damp accumulating in Spleen 3. Damp heat accumulating in Spleen
Mechanism: Xu of Qi and Blood, can’t fill the vessels. Dampness pressing down on vessels
DEEP pulse
Description
Indications (2)
1. Deep and forceful
2. Deep and weak
Mechanism
- located deeply; can not be felt with light or medium pressure - only felt with heavy pressure
- like a stone sunk to bottom of river
NORMAL - in winter, overweight people
INTERIOR PATTERNS
1. Interior excess
2. Interior deficiency
Mechanism: excess pathogen constrained internally, Qi and blood stagnate and can’t circulate and go through vessels, pulse is deep, forceful. Organs, Qi, blood deficient - no strength to lift the pulse up, pulse is deep and weak
WEAK pulse
Description
Indications (1)
Mechanism
- deep, thin, soft
- if press very hard it disappears
- extremely soft and thin, like a thread, with no force, and deep
DEFICIENCY - Qi, blood
Mechanism: insufficient blood to fill vessels, insufficient Qi so pulse is weak
SLOW pulse
Description Indications (2) 1. Slow and forceful 2. Slow and weak Mechanism
- less than 4 beats per breath
- arrives and departs very slowly
NORMAL - slow and with good strength: common in athletes
COLD PATTERNS
1. Excess cold (includes tight)
2. Deficiency cold [yang deficiency]
MODERATE pulse
Description Indications (3) 1. Moderate, has strength, not floating or deep, regular rhythm 2. Moderate and weak 3. Moderate, not lifting up much
Mechanism
- four beats per breath (approx 60 bpm) comes and goes leisurely
- slightly faster than slow pulse - on verge of being slow
- NORMAL pulse, “have stomach Qi”
- SP and ST Xu, often with dampness
- DAMPNESS
Mechanism: Sp and St Xu leads to Qi and blood Xu, no strength to move pulse. Dampness obstructs the vessels and inhibits movement of Qi and blood.
CHOPPY pulse
Description Indications (2) 1. Choppy and weak 2. Choppy and strong Mechanism
- slow (in general), rough and uneven
- like a knife scraping lightly on a piece of bamboo: rough, jagged
- DAMAGED ESSENCE, WEAK BLOOD
- STAGNATION OF QI AND BLOOD
Mechanism: Xu of Blood and Essence can’t moisten vessels. Qi and blood stasis impairs movement of blood in vessels
KNOTTED pulse
Description
Indications (3)
Mechanism
- slow or moderate. Stops irregularly (irregularly irregular)
- slow and relaxed with irregular pulses
- EXCESS COLD with knotting of Qi
- COLD PHLEGM knotting and stagnating
- STAGNATION of Qi and/or blood due to cold
Mechanism: cold congealing, Qi stagnating, phlegm knotting, then Qi and blood are impaired, vessel Qi impaired/stagnate, pulse comes moderately and occasionally stops
RAPID pulse
Description Indications (1) 1. Rapid and forceful 2. Rapid and weak Mechanism
- about 6-7 beats per breath (>90 bpm)
- EXCESS HEAT
- DEFICIENCY HEAT
Mechanism: heat excess quickens Qi and blood circulation, pulse is rapid and forceful. Deficient yin can’t restrain yang, unrestrained yang quickens pulse, pulse is rapid and weak.
SKIPPING pulse
Description
Indications (3)
Mechanism
- rapid with irregular pauses
- “arrives and departs rapidly, sometimes with a pause in its arrival”
- QI AND BLOOD STAGNATION with heat
- PHLEGM AND/OR FOOD RETENTION
- EXCESS HEAT
Mechanism: stasis of Qi, blood, phlegm, food transform into heat, yang excess can’t harmonize with yin, pulse is rapid and out of control, vessel-Qi can’t maintain regularity so sometimes stops
DEFICIENT pulse
Description (combines what 4 forms?)
Indications(1)
Mechanism
- combines four forms: floating, large, slow, soft
- feels soft and empty
DEFICIENCY PATTERNS - Qi, blood, organs
Mechanism: Qi weak, no strength to command blood, pulse comes slow and large. Blood weak, can’t fill vessels, so pulse is empty and soft
[when you push, nothing underneath it]
THIN/FINE pulse
Description
Indications (2)
Mechanism
- feels fine like a thread, but can be felt distinctly
- “fine is straight and soft, like a silken thread. It is larger than a faint pulse”
DEFICIENCY PATTERNS - Qi, blood, “deficiency taxation” Xu Lao
DAMPNESS - [less so than xu]
Mechanism: Qi and Blood weak so can’t fill the vessels. Dampness pushing down on the vessels.
REGULARLY INTERMITTENT PULSE (Dai Mai)
Description Indications (2) 1. Dai and weak 2. Dai and strong Mechanism
- relatively moderate pulse with stops that occur at regular intervals and last a relatively long time
- Xu of ORGANS (esp. Heart Qi Xu)
- Internal Wind, pain, traumatic injury (Blood stasis)
Mechanism: Xu of organs leads to weakness of Qi and Blood, weakness of Vessel Qi leads to inability to regulate heart rhythm
[HAS to have a prob with rhythm to be Dai Mai, could be with choppy, weak, slippery, etc.]
EXCESS/REPLETE pulse
Description
Indications (2)
Mechanism
- long, large, strong, and slightly wiry in all 3 positions and all 3 depths
Excess and Rapid: EXCESS HEAT
Excess and Slow: EXCESS COLD
Mechanism: pathogen is replete and Zheng Qi is not deficient, so they fight, causing Qi and blood to move in large amount and fill the vessels
SLIPPERY PULSE
Description
Indications (2)
Mechanism
- arrives and departs smoothly; round and smooth/slippery. Like a ball bearing or greasy round ball sliding under the fingers
NORMAL - slippery and harmonious
- slippery and strong (pregnancy)
PHLEGM-RHEUM/fluids, food stagnation, excess heat
Mechanism: phlegm, food, and heat stagnate in the interior, cause Qi and blood to move vigorously. In pregnancy, Qi and blood are full and harmonious and blood moves in larger amounts in order to nourish the fetus
TIGHT pulse
Description
Indications (3)
Mechanism
- feels tight/tense (strong tensile strength) and strong
- “a tight pulse has strength, it snaps left and right, like a large twisted rope or a tight, cutting string.”
EXCESS COLD
- floating and tight: exterior cold excess pattern
- deep and tight: interior cold excess pattern
PAIN WITH COLD, BLOOD STASIS
FOOD STAGNATION with cold
Mechanism: cold and pain cause contraction and tightening of the vessels
WIRY pulse
Description
Indications (5)
Mechanism
- LONG, straight and stiff/hard (without vibrating to the left or right, or giving any wave-like sensation under the fingers)
- like pressing on a guitar string
NORMAL (wiry and moderate) - healthy person in springtime LIV/GB DISORDERS PHLEGM-RHEUM FLUIDS PAIN MALARIA DISORDER *SHAOYANG
Mechanism: Liver’s shu xie (coursing and moving) function impaired, vessels contract and become tense
