Pericardium patterns

Question 1

What differentiates Pericardium from Heart patterns?

Answer 1

1. Is the involvement of the Pericardium as a channel in the chest.
   Pericardium patterns generated by mental-emotional strain, the pathology is reflected with symptoms at the chest level such as a feeling of stuffiness in the chest.
2. The involvement of the Lung channel. The pericardium is in the centre of the thorax, where it influences both heart and lungs, therefore gathering qi (Zong Qi). Pericardium patterns may present with like SOB and cold hands.
3. Latter patterns often involve the Liver channel as well. Due to 1. Liver and Pericardium are related with Jue Yin (terminal yin) channels, 2. In its upward rising, the minister fire affects the Liver, Gall Bladder and Pericardium.

Question 2

What are the three main areas of Pericardium pathology?

Answer 2

1. The pericardium protects the heart: invasions of exterior pathogenic factors
2. Pericardium houses the mind (Shen): mental-emotional problems. Blood deficiency of the pericardium, pericardium fire and phlegm-fire harassing the pericardium.
3. Pericardium as the centre of the thorax, channel pathology. Qi stagnation in the pericardium, Blood stasis in the pericardium.

Question 3

What are the signs and symptoms of heat in the pericardium?

Answer 3

Fever at night 
Mental confusion 
Incoherent speech or aphasia 
Delirium 
Hot body 
Hands and feet cold 
Macules

This pattern is from exterior pathogenic attack and reflects a rapid and acute invasion

In four level theory it relates to heat at the nutritive (Ying) level.

Question 4

What is the tongue and pulse in Heat in the Pericardium?

Answer 4

T: Red and dry without coating

P: Fine and rapid

Question 5

What is the treatment principle of heat in the pericardium?

Answer 5

TP: Clear heat from the nutritive level.

Question 6

What is the aetiology of Heat in the pericardium?

Answer 6

1. Due to the invasion of Wind-Heat that penetrates the interior and transforms into interior heat, going through the defensive qi and qi levels before reaching the nutritive qi level.

Question 7

What is the pathology of heat in the pericardium?

Answer 7

1. Heat at the nutritive level (Ying Level). When heat penetrates this level, it has begun to injure yin and dry up the body fluids (hence the tongue has no coating and is dry).
2. Heat clouds the mind and creates delirium.
3. The hands and feet are cold due to false cold: heat is so intense that it impairs the circulation of Qi to the limbs.

Question 8

What are the signs and symptoms of Blood deficiency of pericardium?

Answer 8

Palpitations
Insomnia
Dream disturbed sleep

Stuffiness and discomfort of chest 
Very slight SOB
Anxiety 
Dizziness 
Poor memory 
Easily startled 
Dull pale complexion 
Pale lips 
Cold hands 
Scanty periods, amenorrhoea

Question 9

What is the tongue and pulse in blood deficiency of pericardium?

Answer 9

T: Pale, thin and slightly dry

P: Fine (but slightly hard at left front) or fine and choppy

Question 10

What is the treatment principle of blood deficiency of pericardium?

Answer 10

TP: Tonify blood, nourish the pericardium, support the movement of qi and blood in the chest.

Question 11

What is the aetiology of blood deficiency of pericardium?

Answer 11

Emotional strain such as sadness and grief.

Question 12

What is the pathology of blood deficiency of pericardium?

Answer 12

1. Heart and pericardium house the mind: when blood of these two organs are deficient, the mind lacks residence therefore it is agitated. This results in insomnia, dream disturbed sleep, propensity to be startled and anxiety.
2. When blood is deficient, qi and blood fail to circulate properly in the pericardium channel, which leads to a feeling of stuffiness and discomfort in the chest.
3. The relationship between the uterus and pericardium will cause scanty periods or amenorrhoea.

Question 13

What are the signs and symptoms of pericardium fire?

Answer 13

Palpitations
Insomnia
Dream disturbed sleep

Tightness and heat of chest 
Slight ache of chest 
Rapid breathing 
Thirst 
Mouth and tongue ulcers 
Mental restlessness 
Agitation 
Red face 
Bitter taste (after bad sleep)
Heavy periods

Question 14

What is the tongue and pulse in pericardium fire?

Answer 14

T: Red, tip redder, red papillae, yellow coat, possible midline crack

P: Full, rapid and overflowing (could be hasty = rapid and irregular) esp. left front.

Question 15

What is the treatment principle of pericardium fire?

Answer 15

TP: Drain fire from the pericardium.

Question 16

What are the signs and symptoms of phlegm fire harassing the pericardium?

Answer 16

Palpitations
Insomnia
Dream disturbed sleep

Oppression and heat of chest 
Chest pain 
Rapid breathing 
Thirst 
Coughing phlegm 
Mental restlessness and confusion 
Agitation with rash behaviour 
Red face 
Bitter taste
Manic behaviour 
Incoherent speech

Question 17

What is the tongue and pulse in phlegm fire harassing the pericardium?

Answer 17

T: Red and swollen and with a yellow dry sticky coating. Tip may be redder with red papillae.

P: Full, rapid, and slippery or rapid, overflowing slippery or rapid, full and wiry.

Question 18

What is the treatment principle of Phlegm fire harassing the pericardium?

Answer 18

TP: Drain fire from the pericardium and resolve phlegm. Open the orifices and calm the shen.

Question 19

What are the signs and symptoms of Qi stagnation in the pericardium?

Answer 19

Palpitations
Distension, tightness and slight pain in the chest
Slight SOB

Sighing 
Plumstone 
Depression 
Irritability 
Poor appetite 
Weak and cold limbs 
Slightly purple lips 
Pale complexion

Question 20

What is the tongue and pulse in qi stagnation of the pericardium?

Answer 20

T: Slightly pale and purple on sides and chest area

P: Empty, very slightly overflowing in left front position

Question 21

What is the treatment principle of Qi stagnation in the pericardium?

Answer 21

TP: Move Qi in the chest, regulate pericardium, calm the shen

Question 22

What are the signs and symptoms of blood stasis of the pericardium?

Answer 22

Palpitations 
Oppression or constriction of chest 
Stabbing or pricking pain (may radiate to inner aspect of left arm or to shoulder)
SOB
Cold hands 

Cyanosis of lips and nails
Painful periods with dark clots

Question 23

What is the tongue and pulse in blood stasis in the pericardium?

Answer 23

T: Purple entirely, or just on sides and chest area

P: Choppy, knotted or wiry

Question 24

What is the treatment principle of blood stasis of the pericardium?

Answer 24

TP: Move blood in the chest and resolve stasis, regulate pericardium, calm the shen.