TCM organs Flashcards
What are the TCM organs?
It is the same as the western ones but they are in different locations some. Liver, Heart, lung, spleen, kidney for the Yin organs. Gallbladder, Small intestine, Stomach, Large intestine, and Urinary bladder for the Yin organs.
What are the Yin Organs?
Remember WFEMW in that order it will make TCM wayyyy easier as each organ corresponds to this mnemonic which represents the elements Wood, Fire, Earth, Metal
Liver, Heart, Spleen, Lung, and Kidney
What are the Yang organs
Gallbladder, Small Intestine, Stomach, Large Intestine, Urinary Bladder
What organ stores Blood for physical purposes; and ensure smooth Qi flow?
A. Liver
B. Heart
C. Spleen
D. Stomach
Liver
B. Heart - store blood for mental, emotional, focus, memory, basically shen
C. Spleen- holds Blood in the vessels, thus preventing bleeding; it makes Blood from food Qi Transforms and transports food and water (it likes dryness)
D. Stomach - The origin of Qi and Blood as Food-Qi (Gu-Qi) is extracted from the Stomach
What are the Elements noted in TCM?
A. Wood, Fire, Earth, Metal, Water
B. Wind, Fire, Earth, Metal, Water
C. Wind, Wood, Earth, Water, Metal
D. Wood, Fire, Wind, Metal, Water
A. Wood, fire, Earth, Metal, Water
Too much fire causes the metal to deplete or melt & too little the metal is not controlled enough
Since everything is relevant you find out what is wrong with the patient by choosing the element with the MOST symptoms
In TCM what cause a fire condition?
In Traditional Chinese Medicine (TCM), a fire condition refers to an imbalance of excess heat within an organ system. This is often associated with a hyperactivity of that organ’s energy or excessive yang. When an organ is affected by fire, it leads to symptoms of intense heat or inflammation, which may also present as agitation, dryness, redness, and other fiery qualities.
Key Points to Remember
Fire conditions are most commonly associated with Heart, Liver, Stomach, and sometimes Large Intestine or Gallbladder.
Organs that cannot have fire syndromes include:
Kidneys (heat comes from Yin Deficiency, not fire).
Spleen (susceptible to dampness, not fire).
Urinary Bladder (heat is categorized as Damp-Heat, not fire).
Triple Warmer (a functional pathway, not a heat generator).
Lungs (prone to Lung Heat or Phlegm-Heat, but rarely fire).
1. Heart Fire
Symptoms:
Restlessness, irritability, anxiety
Insomnia, difficulty sleeping
Thirst, dry mouth
Red face, red eyes
Tongue: Red, with a yellow coating
Symptoms of Kidney Fire
- Lower Back Pain or Weakness: Core symptom due to the Kidney’s inability to sustain its role in supporting the body.
- Tinnitus or Fullness in Ears: Heat disturbing the Kidney’s connection to hearing.
- Night Sweats: Classic Yin deficiency symptom aggravated by Fire.
- Dry Mouth/Throat at Night: A classic Yin-deficiency symptom, worsened by internal Fire.
- Hot Flashes, particularly in the evening: Aggravated by Kidney Yin’s inability to cool the system.
- Premature Ejaculation: Heat drives excessive sexual activity or loss of Jing.
- Increased Libido: Due to unrestrained Yang.
- Scanty, Dark Urine: Fire in the Lower Jiao dries the fluids.
- Difficulty Sleeping: Restlessness or heat causing Shen agitation.
- Heat in the Palms, Soles, or Chest (“5-center heat”): Classic of Yin deficiency with Fire.
Scanty, dark, or burning urination
Tongue and Pulse
Tongue: Red with a scanty or peeled coating (indicating Yin deficiency and heat).
Pulse: Rapid, thin (from Yin deficiency) or possibly wiry (if combined with emotional factors).
2. Liver Fire
Symptoms:
Key Symptoms
1. Headache (Vertex or Temporal):
A hallmark symptom of Liver Fire, especially intense and burning in nature.
Vertex Headaches, vertex pain refers to the top of the head (crown), which is classically associated with the Liver Channel and conditions like Liver Fire, Liver Yang Rising, or Kidney Deficiency.
Affects the Gallbladder and Liver channels, which traverse the temples and the top of the head.
- Red Eyes and Face:
Liver Fire flares upward to the eyes, causing redness, dryness, or bloodshot appearance.
The face may also appear flushed due to Fire rising. - Bitter Taste in Mouth:
A classic sign of Liver Fire, as heat in the Liver generates this bitterness, especially in the morning. - Thirst for Cold Drinks:
Internal Fire generates heat that the body seeks to cool with cold substances. - Irritability and Anger:
Liver Fire agitates the Shen (mind), causing emotional outbursts or irritability. - Tinnitus or Sudden Deafness/:
Fire rising along the Liver channel to the ears can cause ringing, roaring, or hearing loss.
In Liver Yang Rising, tinnitus is more likely intermittent and accompanied by dizziness/vertigo due to Yang or Qi rushing upward and disrupting balance.
Key Differentiation: Liver-related tinnitus is acute, high-pitched, or intermittent, while Kidney-related tinnitus is chronic and low-pitched. - Dry Stool or Constipation:
Liver Fire dries fluids, leading to difficulty passing stool. - Dark or Scanty Urine:
Heat affects the Lower Jiao, reducing fluid availability.
Irritability, anger, frustration
Tongue: Red with a yellow coating
Pulse: Wiry and rapid
Key Features:
The Liver is responsible for the smooth flow of Qi. Fire in the Liver can lead to Qi stagnation, making emotional expression and physical movement difficult.
Key Features and Etiology
Pathogenesis: Excess Heat/Fire in the Liver, often from emotional stress (anger or frustration) or dietary excess (spicy, greasy foods, alcohol).
Focus: Primarily Excess in nature, with clear upward flaring of heat signs.
Liver Yang Rising
Key Symptoms
1. Headache (Vertex or Temporal):
Also a hallmark symptom but differs in nature:
Throbbing, pulsating pain rather than intense, burning pain.
Often triggered by emotional upset, overwork, or Yin deficiency failing to anchor Yang.
- Dizziness or Vertigo:
A classic sign of Liver Yang Rising due to Yang or Qi rushing upward and disrupting equilibrium. - Blurred Vision or Floaters:
Deficiency of Yin affecting the Liver’s nourishing function to the eyes. - Tinnitus or Sudden Deafness:
Similar to Liver Fire but more intermittent and less severe. - Restlessness and Insomnia:
Yang rising disturbs the Shen, causing difficulty falling or staying asleep. - Irritability and Emotional Lability:
Less intense than Liver Fire; emotional instability is caused by unanchored Yang.
Secondary Symptoms
Red Eyes: Present but less intense than with Liver Fire.
Dry Throat: A Yin deficiency symptom, not necessarily thirst for cold drinks.
Pulse: Wiry and thin, with some rapidity in cases with heat.
Tongue: Red tongue with scant coating, often without the thick yellow coating of Liver Fire.
Key Features and Etiology
Pathogenesis: Liver Yang Rising occurs due to Yin deficiency, which fails to contain Yang. Often arises from chronic stress, aging, overwork, or constitutional weakness.
Focus: Primarily Deficiency in nature, although the presentation can have Excess-like features (e.g., dizziness, headache).
3. Stomach Fire
Symptoms:
Burning sensation or pain in the stomach
Excessive hunger or desire for spicy food
Acid reflux or belching
Vomiting with a sour taste
Tongue: Red with a yellow coating, bleeding gums or possibly ulcers
Pulse: Rapid, forceful
Key Features:
The Stomach is the organ responsible for digestion. Fire in the Stomach often causes digestive disturbances such as acid, bloating, and discomfort.
Why Bleeding Gums Occur:
The heat in the Stomach can affect the gums, causing them to become more fragile and prone to bleeding. This symptom may be associated with more severe cases of Stomach Fire, particularly when the fire has affected both the tissues and blood.
4. Large Intestine Fire
Symptoms:
Constipation with dry, hard stools
Abdominal distension or pain
Possible fever or chills
Foul-smelling breath and stools
Red face and eyes
Tongue: Red with a yellow coating
Key Features:
Large Intestine fire can impair the transportation function of the intestines, leading to constipation and difficulty eliminating waste.
Large Intestine Fire and Red Eyes:
Large Intestine Fire is a condition where there is excessive heat in the Large Intestine, typically due to stagnant waste or impaired fluid transformation. It can cause symptoms like constipation, abdominal pain, and foul-smelling stools. Red eyes can also appear here due to the excessive heat of the Large Intestine, which affects the body in a similar way that it can affect the Heart—by causing heat-induced inflammation that manifests in the eyes.
5. Bladder Fire
Symptoms:
Burning pain or discomfort during urination
Dark yellow or bloody urine
Frequent urge to urinate, especially at night
Tongue: Red with a yellow coating
Pulse: Rapid and forceful
Key Features:
The Bladder governs the urination process. Fire here can cause inflammation and heat that disrupts the normal elimination of fluids.
6. Kidney Fire (often referred to as Kidney Yin Deficiency with Fire or Kidney Fire Blazing)
Symptoms:
Lower back pain or weakness
Tinnitus or a feeling of fullness in the ears
Night sweats
Dry mouth and throat, especially at night
Hot flashes, particularly in the evening
Tongue: Red with a scanty coating
Pulse: Rapid, thin
Key Features:
Kidney Fire often arises from Kidney Yin deficiency, causing a lack of cooling substance and leading to excessive heat in the body.
7. Spleen Fire
Symptoms:
Heat sensation or feeling of being overheated
Abdominal bloating or discomfort
Diarrhea with a foul smell
Thirst with a preference for cold drinks
Tongue: Red with a yellow coating
Key Features:
The Spleen is responsible for transforming and transporting nutrients. Fire in the Spleen can disrupt digestive processes, leading to nausea, bloating, or even excessive appetite.
8. Heart-Blood Fire (Heart Fire + Blood Deficiency)
Symptoms:
Palpitations, restlessness, and anxiety
Insomnia with disturbing dreams
Agitation, often with difficulty calming down
Tongue: Red with a thin yellow coating
Pulse: Rapid, especially on the left side
Key Features:
Fire can damage Blood in the Heart, disrupting its nourishing functions and creating emotional instability.
General Symptoms of Fire Conditions:
Restlessness, irritability
Redness in the face, eyes, or tongue
Rapid pulse
Thirst, particularly for cold drinks
Dryness, often in the mouth or throat
Heat sensations, especially at night or in the face
How Fire Conditions Develop:
Excessive Yang: Excessive yang can turn into fire, leading to imbalances.
Organ Overactivity: If an organ becomes overactive, it generates excessive heat or fire, overwhelming its normal function.
Qi Stagnation: Often, fire conditions arise from stagnation or blockage of Qi (particularly liver Qi), leading to an internal build-up of heat.
Yin Deficiency: When the nourishing Yin of an organ is insufficient, it fails to cool the body, allowing heat to become excessive and transform into fire.
In TCM, fire conditions can also be caused by external factors like environmental heat, emotional stress, or internal deficiencies (such as Yin deficiency, which cannot cool the body properly).
You said:
why would heart and large intestine have red eyes, and wouldn’t stomach fire have bleeding gums and if so can you fix this
ChatGPT said:
ChatGPT
You are correct in pointing out that some details about the Heart, Large Intestine, and Stomach Fire may need clarification. Let’s revisit each condition and address your concerns:
- Heart Fire and Red Eyes:
Heart Fire is typically characterized by excessive heat in the Heart, which can disturb the Shen (spirit), leading to symptoms like anxiety, restlessness, insomnia, and emotional disturbances. Red eyes in Heart Fire arise because of the excessive heat in the body, which can cause inflammation and blood vessel dilation, leading to bloodshot or red eyes. This is a common manifestation of the heat being too intense and affecting the superficial blood vessels.
Key Symptoms of Heart Fire:
Restlessness, agitation, or emotional instability
Insomnia
Red face, red eyes, and sometimes mouth ulcers
Thirst with a desire for cold drinks
Rapid and forceful pulse
Red tongue with a yellow coating
Why Red Eyes Occur:
The heat from the Heart can cause blood vessels in the eyes to dilate or become inflamed, leading to redness in the eyes. This is not exclusive to the Heart; other conditions like Liver Fire and Stomach Fire can also cause similar symptoms, but in the case of Heart Fire, it is specifically related to the excessive heat affecting the Heart organ.
- Large Intestine Fire and Red Eyes:
Large Intestine Fire is a condition where there is excessive heat in the Large Intestine, typically due to stagnant waste or impaired fluid transformation. It can cause symptoms like constipation, abdominal pain, and foul-smelling stools. Red eyes can also appear here due to the excessive heat of the Large Intestine, which affects the body in a similar way that it can affect the Heart—by causing heat-induced inflammation that manifests in the eyes.
Key Symptoms of Large Intestine Fire:
Constipation with dry, hard stools
Abdominal pain, often distension
Foul-smelling breath and stools
Red face and eyes
Red tongue with a yellow coating
Rapid, forceful pulse
Why Red Eyes Occur:
Just as with Heart Fire, Large Intestine Fire can generate heat that affects superficial tissues, like the eyes. Excessive heat in the Large Intestine may cause blood vessel dilation in the eyes, leading to redness.
- Stomach Fire and Bleeding Gums:
You are correct that Stomach Fire often leads to mouth ulcers, bad breath, and can sometimes cause bleeding gums due to the intense heat in the Stomach. However, the key distinguishing symptom in Stomach Fire is the presence of burning sensations in the upper digestive tract, as well as symptoms like acid reflux, nausea, or a strong desire for cold drinks. Bleeding gums in this case can occur because heat can affect the blood, making it more prone to bleeding. Stomach Fire is often associated with excessive heat in the upper digestive tract, which affects both the tissues and blood vessels in the area.
Key Symptoms of Stomach Fire:
Burning sensation or pain in the stomach
Excessive hunger or desire for spicy foods
Acid reflux or belching
Mouth ulcers or bleeding gums
Thirst, especially for cold drinks
Tongue: Red with a yellow coating
Rapid, forceful pulse
Why Bleeding Gums Occur:
The heat in the Stomach can affect the gums, causing them to become more fragile and prone to bleeding. This symptom may be associated with more severe cases of Stomach Fire, particularly when the fire has affected both the tissues and blood.
Summary of Corrections:
Red eyes in Heart Fire: This happens because excessive heat in the Heart can lead to blood vessel dilation and inflammation, affecting the eyes.
Red eyes in Large Intestine Fire: Similar to Heart Fire, Large Intestine Fire can lead to heat-induced inflammation, which may cause redness in the eyes.
Bleeding gums in Stomach Fire: Stomach Fire can lead to mouth ulcers, acid reflux, and bleeding gums due to excessive heat affecting the blood vessels in the mouth.
These conditions reflect how excessive heat (fire) in different organs can manifest in various ways, affecting both the internal organs and external features like the eyes and gums.
Why does fire cause foul smell, or bitter taste or desire for spicy foods. I understand the thirst, and especially for cold drinks and the pulse being rapid as the body is trying to put out the fire so a lot of cold drinks would help mitigate that and the yang will exhibit a forceful pulse as it is out of control. The yellow coat is always representative of a heat condition?
You’ve made an insightful observation, and I’ll expand on why fire causes certain symptoms like foul smell, bitter taste, and desire for spicy foods. These symptoms are often linked to the excessive heat in the body, particularly in certain organs like the Stomach, Liver, and Heart, and can be understood through the concepts of heat and fluid metabolism in Traditional Chinese Medicine (TCM).
- Foul Smell:
Foul smell (such as bad breath or foul-smelling stools) is a result of the heat in the body that causes turbid or stagnated substances to build up. Heat tends to dry out fluids and concentrate waste. When the Stomach or Large Intestine is overheated, the digestive process is impaired, leading to undigested food, bad breath, or foul-smelling stools.
Stomach Fire can cause bad breath (halitosis), as the heat in the Stomach can lead to the accumulation of undigested food particles and the production of heat toxins that result in foul-smelling breath.
In the Large Intestine, excess heat can cause constipation, which leads to the stagnation of waste, contributing to foul-smelling stools and foul body odor.
Why this happens: Heat in the digestive system leads to stagnation, preventing normal fluid and food transformation. The result is undigested or rotting food, producing bad smells.
- Bitter Taste:
A bitter taste is often associated with Liver Fire or Heart Fire in TCM. Both these organ systems can generate excessive heat that rises to affect the mouth and throat, leading to a bitter, sometimes sour, or astringent taste.
Liver Fire can cause bitter taste in the mouth, especially in the morning, due to the overactive yang energy or the reflux of bile.
Heart Fire can also cause a bitter taste, as excessive heat from the Heart can affect the tongue and the upper digestive tract, contributing to a bitter or burning sensation.
Why this happens: Excess heat in the Liver or Heart rises, affecting the taste buds, and can lead to a bitter sensation in the mouth, which is commonly felt during the morning.
- Desire for Spicy Foods:
The desire for spicy foods is often a manifestation of Heat in the body, particularly Stomach Fire or Liver Fire. Spicy foods are known to generate heat and can increase circulation, so when there is excessive internal heat, the body may crave spicy foods as a way to “stoke the fire” and release the heat that is felt as discomfort.
In Stomach Fire, the body may crave spicy foods to stimulate digestion or enhance the warmth that the Stomach feels lacking due to excessive heat. This is a paradoxical craving, as the Stomach is already “hot,” but the fire increases the desire for more of the same.
In Liver Fire, cravings for spicy or hot foods may also occur as the heat in the body creates a feeling of tension or stagnation that the individual attempts to relieve by stimulating the body with more heat (through spicy food).
Why this happens: When the body experiences excessive heat, it craves more stimulation to release the internal tension caused by the fire. Spicy foods, which are known to stimulate digestion and increase circulation, may be instinctively desired to “burn off” the excess heat or bring relief to the body’s uncomfortable heat stagnation.
- Thirst (especially for cold drinks):
Thirst, particularly for cold drinks, is one of the most direct manifestations of heat in the body. When there is excessive heat, it dries up body fluids, leading to the sensation of thirst. Cold drinks can be instinctively craved to cool down the body and temporarily relieve the discomfort caused by the fire. The Body’s Yang, when overactive, feels a strong need to balance the excessive fire with the cooling properties of cold fluids.
In conditions like Stomach Fire, Liver Fire, or Heart Fire, there’s a constant craving for cold drinks, as the heat causes a dry mouth and throat, signaling the body to cool down.
Why this happens: Heat generates thirst, and the body naturally desires cooling substances to counterbalance the excessive fire.
- Rapid Pulse:
A rapid pulse is a common sign of excessive heat (fire) in TCM. When heat accumulates in the body, it causes the blood to move more quickly, which results in a fast, forceful pulse. This pulse is a yang response, where the body is trying to push out the fire, similar to a flame that requires a large flow of air to burn more intensely.
Why this happens: Heat increases the circulation of blood and stimulates yang energy, which causes the pulse to become rapid and forceful. It is the body’s attempt to expel the fire and regulate the excess heat.
- Yellow Coating on Tongue:
A yellow coating on the tongue is often seen in heat conditions like Stomach Fire, Liver Fire, or Heart Fire, and signifies the presence of excess heat in the body. This yellow coating is produced by heat in the digestive system or other organs, which leads to the accumulation of turbid, sticky fluids. The coating is generally thicker and greasy in severe heat cases, indicating that the body is trying to expel heat through the tongue.
Why this happens: The yellow coat is typically indicative of heat accumulation in the digestive organs, particularly the Stomach. The yellow color comes from the body’s efforts to eliminate excessive heat and toxins, which also cause a change in the tongue’s appearance.
Summary:
Foul smell arises due to the stagnation of fluids and undigested material, which creates bad odors.
A bitter taste reflects Liver or Heart Fire affecting the mouth and taste buds, often due to the reflux of bile or heat rising.
The desire for spicy foods is the body’s instinct to stimulate and cool down internal fire through external heat, increasing circulation and digestion.
Thirst for cold drinks is the body’s response to dryness caused by heat.
Rapid pulse and yellow tongue coating are typical signs of heat or fire, signaling excessive yang or an imbalance in the body.
Why Some Organs Are Commonly Associated with Fire?
Fire represents excessive heat and hyperactivity of yang, often due to emotional, dietary, or external pathogen factors. Organs with naturally stronger yang functions or those involved in metabolic and digestive processes are more prone to developing fire syndromes.
Liver Fire:
The Liver is associated with yang, movement, and emotional factors like anger.
Its fire arises when yang energy becomes excessive or stagnant, leading to symptoms such as red eyes, bitter taste, and irritability.
Emotional stress and dietary heat (e.g., spicy, greasy food) often aggravate Liver Fire.
Heart Fire:
The Heart governs the Shen (mind) and blood. Its fire is associated with emotional excess (e.g., anxiety, overthinking, or mania) and symptoms like restlessness, insomnia, and mouth ulcers.
Because the Heart is a yang organ, its pathological heat tends to rise and disturb the mind and tongue.
Stomach Fire:
The Stomach plays a central role in digestion and fluid metabolism, where excessive yang or improper diet (e.g., alcohol, spicy food) can lead to fire.
Stomach Fire manifests as thirst, burning pain, bad breath, and sometimes bleeding gums.
Large Intestine Fire:
The Large Intestine can develop fire due to prolonged heat in the digestive system or Liver Fire transferring to the intestines.
Symptoms include dry stools, constipation, and burning sensation during defecation.
Spleen Fire (rare):
The Spleen is traditionally associated with dampness, but in rare cases, heat or fire can arise due to prolonged consumption of hot, spicy foods or transfer of heat from other organs (e.g., Stomach Fire).
This can lead to symptoms like thirst, mouth ulcers, and a dry, sticky yellow tongue coat.
Why Kidneys Are Not Typically Associated with Fire, small intestine, triple warmer and urinary bladder not typically associated with fire?
The Kidneys are the foundation of yin and yang in the body, but they are fundamentally a yin organ. Fire is rarely mentioned in relation to the Kidneys because:
Yin Dominance:
The Kidneys store essence (Jing) and govern water metabolism. They are considered a yin organ, focusing on nourishing, cooling, and stabilizing functions.
The Kidneys are more prone to deficient heat (from Kidney Yin Deficiency) rather than fire. Fire implies an excessive yang condition, which is rare in the Kidneys.
Balance of Kidney Yin and Yang:
Kidney Yang governs warmth and metabolic functions, but when yang becomes excessive, it is not called “Kidney Fire.” Instead, it is typically referred to as Kidney Yang Excess or seen as Liver or Heart Fire affecting the Kidneys.
If the Kidneys are involved in a fire-like condition, it is often secondary to other organs (e.g., Liver Fire damaging Kidney Yin).
No Role in Fire Pathology:
The Kidneys’ primary function is to store and regulate essence and fluids, making them less likely to directly generate fire, which is an outward and active pathology.
Small Intestine
The Small Intestine’s primary function is to separate the “clear” from the “turbid” (clean fluids from waste).
Fire Association:
Small Intestine Fire is rarely mentioned in isolation but is often a manifestation of Heart Fire transferring to the Small Intestine, given the close relationship between these two organs in TCM.
This transfer results in symptoms like scanty, dark urine, burning pain during urination, and ulcers on the tongue. These symptoms are more commonly treated as part of Heart Fire rather than an independent Small Intestine Fire.
Why It Doesn’t Develop Independent Fire:
The Small Intestine is primarily a processing and separating organ, without a strong role in heat generation. Fire pathology in this organ is almost always secondary to another organ’s dysfunction, such as Heart Fire.
Triple Warmer (San Jiao)
The Triple Warmer is more of a functional system than a physical organ. It regulates the pathways for water, qi, and heat distribution across the upper, middle, and lower burners.
Fire Association:
The Triple Warmer is rarely described as having fire syndromes. Instead, it can act as a conduit for fire or heat generated in other organs, such as Heart Fire or Liver Fire, to affect other parts of the body.
For example, Liver Fire affecting the Lower Burner might manifest as urinary symptoms or genital inflammation, but the Triple Warmer itself is not considered the source of the fire.
Why It Doesn’t Develop Independent Fire:
The Triple Warmer does not have a direct physiological counterpart or a specific yang energy imbalance that would lead to a fire condition.
It acts more as a pathway or mechanism for the movement of qi, fluids, and heat, rather than being a primary source of pathology.
Urinary Bladder
The Urinary Bladder stores and excretes urine, a process closely related to Kidney function.
Fire Association:
The Urinary Bladder can develop heat or damp-heat, often caused by external pathogens (e.g., a urinary tract infection). Symptoms include burning urination, frequent urination, and lower abdominal pain.
These conditions are referred to as Damp-Heat in the Bladder, not as Bladder Fire. The fire terminology is generally avoided for this organ because the pathology arises from heat combined with dampness, not pure fire.
Why It Doesn’t Develop Independent Fire:
The Urinary Bladder is a storage organ primarily concerned with water metabolism, making it prone to conditions of dampness or damp-heat rather than yang overactivity or fire.
Heat in the Bladder is often attributed to external damp-heat or dysfunction in the Kidneys or Liver (e.g., Liver Fire transferring downward).
Why Liver Fire Causes Vertex Headaches?
In Traditional Chinese Medicine (TCM), vertex headaches (pain at the top of the head) are specifically associated with Liver Fire or Liver Yang Rising. The Liver channel connects to the vertex of the head (via its branch to the Du Mai), making it particularly susceptible to pathology in this area. Here’s why:
Connection to the Vertex:
The Liver channel runs through the sides of the body, ascending to the vertex of the head. When Liver Fire flares upward, it follows the channel to this point, leading to pain or throbbing at the vertex.
Excessive Yang Energy:
Liver Fire represents extreme yang energy, which tends to rise. As it ascends to the head, it manifests as dizziness, red eyes, and headaches, with the vertex being the focal point due to the channel’s influence.
Stress and Emotional Factors:
The Liver is strongly associated with emotions like anger and frustration. Emotional stress can cause Liver Qi Stagnation, which may transform into Liver Fire, further exacerbating upward symptoms like headaches.
Heat Rising:
Fire is inherently hot and active, and in the case of Liver Fire, it rises unchecked to the upper regions of the body, particularly the head, resulting in heat sensations, bitter taste, and intense headaches.
Other Organs and Vertex Headaches
While the Liver is the primary organ associated with vertex headaches, other organ imbalances could indirectly cause pain in this area:
Kidneys:
In cases of Kidney Yin Deficiency, deficient Yin fails to anchor Yang, allowing it to rise to the head. This can lead to headaches, though the pain is often described as dull or chronic rather than acute or throbbing, and may affect the vertex.
Heart:
Heart Fire or Heart Yin Deficiency with Heat can indirectly contribute to headaches if the Shen is disturbed and fire rises, but it typically manifests with other symptoms like insomnia, palpitations, and mental restlessness.
Gallbladder Fire:
The Gallbladder channel passes near the sides of the head but can indirectly influence the top of the head due to its relationship with the Liver. This would be rare and is more likely to involve temporal or parietal headaches.
Summary
Liver Fire is the primary cause of vertex headaches due to the direct path of the Liver channel to the top of the head and its upward-rising fire energy.
Kidney Yin Deficiency or Heart Fire may contribute to vertex pain but typically manifest differently.
Treating vertex headaches requires addressing the underlying cause (e.g., cooling Liver Fire or nourishing Kidney Yin).
Information about tongue, what does tongue coating mean and what does the color signify?
1) Body color
* Color of tongue itself (beneath coating)
* Condition of Yin organs as well as blood and nutritive qi (vital life force)
* Reflects true condition irrespective of temporary conditions like physical exertion or emotions
* **Whatever is happening to you temporarily does not affect tongue but does affect your pulse (anxiety attack or physical exertion increases pulse as heart beats faster)
* e.g. pale tongue vs red one (more hot)
2) Body Shape
* Contours, consistency, texture and mobility (does it stick out/straight/stay stable or does it move to side or quiver?
* Thin/swollen
* Long/short
* Swollen?
* Cracks?
E.g. tongue on left is swollen and cracks in middle, right one is thinner but some areas are swollen (middle and near tip), crack near center and a big dip in the tongue
e.g. thin tongue and some swelling on outside
3) Tongue Coating
* Fur or moss
* Tips of papillae of tongue (byproduct of stomach digestion)
* more coating can be reflected of ability/inability of stomach to digest
* e.g. White coat on tongue
- Tongue moisture – indication of hydration/dehydration
- Tells you of bodies fluids
- Dry/moist/wet and damp
- Moist gives a shiny look
Normal Tongue:
* Pale red, fresh looking (not too red because inflamed but not too pale either)
* Supple and moves easily (not flabby or stiff)
* No cracks
* Does not tremble or quiver when extended
* Not swollen nor thin
* Thin and white coating
* Slightly moist (not too dry/wet)
* Spirit/Shen: Radiant and brilliant (not dull looking)
- Qi Excess
Tongue Color: Red (if there is heat associated with Qi stagnation or Qi rebellion).
Tongue Coating:
Thick yellow coating (indicating heat in the body).
Greasy coating (if dampness or phlegm heat is present). - Blood Deficiency
Tongue Color:
Pale is the classic presentation for Blood Deficiency.
Red might appear if there is a secondary heat component due to Yin failing to contain Yang or prolonged Blood Deficiency generating heat.
Tongue Coating:
Thin white coating (classic for Blood Deficiency).
Scant or no coating if dryness is prominent, often overlapping with Yin Deficiency. - Yin Deficiency
Tongue Color: Red (due to deficient heat from Yin failing to anchor Yang).
Tongue Coating:
No coating (a hallmark of Yin Deficiency due to depletion of fluids).
Thin or patchy coating during transitional stages of Yin depletion. - Yang Excess
Tongue Color: Bright red (from intense heat generated by excessive Yang).
Tongue Coating:
Thick yellow coating (indicating heat and excess).
Dry coating if the heat is consuming fluids. - Other Conditions Where the Tongue Might Be Red:
Liver Yang Rising / Liver Fire
Tongue Color: Red or deep red (especially on the sides or tip).
Tongue Coating:
Thin yellow coating (if mild heat).
Thick yellow or dry coating (if severe heat or fire).
Heart Fire
Tongue Color: Red, especially at the tip.
Tongue Coating: Thin yellow or no coating (if fluids are depleted).
Stomach Fire
Tongue Color: Red (especially in the center).
Tongue Coating: Thick yellow or dry coating (if fluids are damaged).
Damp-Heat Conditions (e.g., Spleen or Large Intestine Damp-Heat)
Tongue Color: Red.
Tongue Coating: Thick, greasy, yellow coating.
Exterior Heat Conditions (e.g., Wind-Heat)
Tongue Color: Red at the tip or edges.
Tongue Coating: Thin yellow coating (early stages of heat invasion).
Blood Heat
Tongue Color: Crimson red (from intense heat in the Blood level).
Tongue Coating: Scant or no coating (if fluids are damaged).
How to Diagnose TCM Pulse:
* State of qi, blood, yin/yang, constitution
* Feel state of yin organs
* We care about Rate (fast/slow), strength (strong/weak), fullness (thick/thin), location
* radial pulse beneath traverse crease
The normal amount is 5 beats per breath.
* Wiry and thready is very similar however thready is the absence of substance
**3 fingers on radial artery, patient should be relaxed, middle level of practitioner should be at level of styloid process of the patient
Point selection cases
Do not take pulse as soon as someone comes in as they could of ran to get to appointment or w/e. Instead take it after some time to make more of an accurate measurement.
Pulse palpation
1. Locate the styloid process of the radius using the opposite hand from the one you are palpating.
- This marks the spot for your middle finger.
- Your index and ring finger should fall on the first and third positions, respectively.
- Be sure to leave enough room between fingers based on the size of the patient. More room for taller and less room for shorter patients.
- Once you have located the 3 positions, arch your fingers as though you are playing a guitar or violin. The tips of your fingers are more sensitive than the pads. You can feel subtle changes in the pulse with this technique.
- The 1st position is known as the cun, the 2nd as the guan and the 3rd as the chi. Remember CGC and 1 is cun as 1 cun is the 1st position if that helps
- After arching your fingers onto the radial artery of both hands, compare the two sides.
With all three fingers staying on the same level, begin palpating the superficial level than middle followed by deep.
- You are looking for pulses that stand out for being different from the others at that level.
- Now you can palpate the cun pulse at all 3 levels.
- Remember that if one of these pulses stood out from earlier, you may want to palpate another pulse at the same time to use as a reference.
- Follow the same procedure for the guan and chi pulses.
Normal Variations of Pulses
- Athletes tend to slower
- Women tend to softer & faster
Cause they have more estrogen and yin - Children tend to faster
Have more yang - Heavier set individual will be deep & slow
- Thin set individual will be superficial
- Fasting individuals will have a deficient/weak pulse
Seasonal Changes - Spring – Wood Element – Wiry
- Summer – Fire Element – Flooding
- Late summer – Earth Element – Slippery
- Autumn – Metal Element – Floating
- Winter – Water Element – Sinking
Initial Variables
* Speed
Fast: >90 bpm = Heat
Slow: <60 bpm = Cold
Moderate: 60 – 90 bpm
- Depth
Superficial – Yang - Exterior
Middle – Normal
Deep – Yin – Interior - Intensity
Strong – Excess
Weak – Deficiency
Types of Pulses
* Floating
Exterior, Yang syndrome. Exterior influences are usu. excess in nature.
May also be an interior deficiency whereby the yin is not rooting the yang and it is floating up.
Felt only at the superficial level.
- Sinking
Interior, Yin syndrome. Can be deficient or excess.
Deep & weak = Interior Deficiency
Deep & Strong = Interior Excess
Only felt on deep palpation. - Slow
Cold syndrome. Can be excess or deficient.
< 60 bpm or < 4 beats per breath.
Slow & Forceful = Cold excess
Slow & Weak = Cold deficiency
The normal amount is 5 beats per breath.
- Rapid
Heat syndrome. Can be excess or deficient.
> 90 bpm or > 5 beats per breath.
Rapid & Forceful = Heat Excess
Rapid & Weak = Heat Deficiency - Swift
Extreme heat and yin exhaustion. Nearing Qi collapse.
140 -180 bpm or 7-8 beats per breath. - Empty
Deficiency syndrome. Can be Qi, Blood, Yang or Yin.
Check with the symptoms
Weak at all three levels.
If it was 1 in all levels - Strong
Excess syndrome. Can be cold, heat, phlegm Qi, blood or food stagnation.
Forceful at all three levels.
If it was 3 at all levels - Minute
Deficiency syndrome.
Barely palpable at any level. - Frail
Qi and Blood Deficiency.
Only palpable at the deep level. - Hidden
Thready feeble and hardly palpable
Pathogens in the interior
Jue Syndrome (syncope, cold limbs)
Severe pain
Felt only a the very deep level
Finger goes down and you have to look for it, a person who just collapsed
Case 1
A 35-year-old woman presents with chest tightness, frequent sighing, irritability, and an irregular menstrual cycle. She recently experienced a significant amount of stress at work. Her pulse is wiry.
Question: What is the most likely diagnosis?
Answer: Liver Qi Stagnation
Explanation:
The symptoms of chest tightness, frequent sighing, irritability, and irregular menstruation are classic signs of Liver Qi Stagnation. Stress is a major contributing factor.
The wiry pulse is characteristic of Liver Qi Stagnation, reflecting the tension and obstruction in the Liver meridian.
Case 2
A 50-year-old man complains of chronic fatigue, shortness of breath, spontaneous sweating, and feeling cold most of the time. He works long hours and feels physically drained by mid-afternoon every day. His pulse is deep and weak.
Question: What is the most likely diagnosis
Answer: Spleen and Kidney Yang Deficiency
Explanation:
Chronic fatigue, shortness of breath, spontaneous sweating, and feeling cold all point to a Yang deficiency. The Spleen governs energy production, and its weakness leads to fatigue and digestive symptoms. Kidney Yang Deficiency exacerbates the cold sensations and profound exhaustion.
The deep and weak pulse reflects an internal deficiency, particularly of Yang energy.
Case 3
A 28-year-old woman reports a high fever, a red tongue with a yellow coating, intense thirst for cold drinks, and profuse sweating. She also complains of constipation and abdominal discomfort. Her pulse is rapid and forceful.
Question: What is the most likely diagnosis?
Answer: Excess Heat in the Stomach and Intestines
Explanation:
The symptoms of high fever, thirst for cold drinks, red tongue with yellow coating, constipation, and abdominal discomfort indicate excess heat in the digestive tract.
The rapid and forceful pulse is typical of an excess condition involving heat.
Case 4
A 60-year-old woman complains of hot flashes, night sweats, a dry throat, and insomnia. She often feels tired during the day and has noticed a decrease in her appetite. Her pulse is rapid but weak.
Question: What is the most likely diagnosis?
Answer: Yin Deficiency with Empty Heat
Explanation:
Hot flashes, night sweats, dry throat, and insomnia are all signs of Yin Deficiency leading to internal heat. The tiredness and decreased appetite may reflect general deficiency of Yin and Qi.
The rapid but weak pulse suggests heat (rapid) in the presence of an underlying deficiency (weak).
Case 5
A 25-year-old man presents with chills, fever, body aches, a stiff neck, and no sweating. He recently started feeling sick after walking home on a windy evening. His pulse is floating and tight.
Question: What is the most likely diagnosis?
Answer: Wind-Cold Invasion
Explanation:
The symptoms of chills, fever, body aches, stiff neck, and no sweating are classic for an exterior Wind-Cold attack. The lack of sweating differentiates this from Wind-Heat.
The floating and tight pulse is characteristic of an exterior (floating) cold (tight) syndrome.
Key symptoms of Qi Deficiency
Key Symptoms:
Fatigue, lack of energy: Insufficient Qi results in the body not having the vitality needed to sustain activity.
Shortness of breath, especially upon exertion: Qi is responsible for respiration and distributing oxygen, so a deficiency affects breathing.
Weak voice or reluctance to speak: Qi governs sound production; deficiency leads to a weak voice.
Spontaneous sweating: Qi controls the pores. When weak, it fails to keep them closed.
Poor appetite: Spleen Qi governs digestion, and a deficiency weakens this function.
Pale complexion and loose stools: Qi deficiency affects blood flow and digestion, leading to pallor and poor stool formation.
Tendency to catch colds easily: Wei Qi (defensive Qi) is weak, impairing immunity.
Tongue:
Pale body: Indicates reduced Qi or Blood.
Thin white coating: Suggests an absence of pathogenic factors but general weakness.
A flabby tongue in Qi deficiency occurs because the body’s energy is insufficient to move fluids effectively, leading to stagnation and swelling. The tongue may also have teeth marks (scalloped edges), further indicating Qi weakness
Pulse:
Weak or empty, particularly in the right hand: Reflects insufficient Qi to generate a strong pulse.
The worsening of edema by the end of the day suggests that the body’s Qi (energy) is insufficient to properly circulate fluids and control their movement. When Qi is weak, it cannot adequately transform and transport fluids, leading to fluid accumulation, especially in the lower part of the body.
Key symptoms of Dampness
The swelling (pitting edema) and heavy sensation are classic signs of Dampness in TCM. Dampness often results from the body’s inability to metabolize fluids properly, leading to retention of moisture in the tissues. This can manifest as swelling, heaviness, and feelings of sluggishness, particularly in the lower limbs.
Key symptoms of Yang deficiency
Just think of Qi deficiency but with cold
Key Symptoms:
Fatigue with cold intolerance: Yang represents warmth and activity; a deficiency leads to cold and fatigue.
Cold hands and feet: Without sufficient Yang, the body fails to warm the extremities.
Preference for warmth: Yang deficiency creates an aversion to cold environments.
Pale complexion: Reduced Yang Qi causes poor blood circulation.
Weakness in the lumbar and knees: Often associated with Kidney Yang, which supports the spine and lower body.
Clear, copious urine: Weak Yang fails to transform fluids properly.
Loose stools, especially in the morning: The Spleen and Kidney Yang cannot warm and transform food.
Tongue:
Pale and swollen with teeth marks: Cold and fluid accumulation due to weak Yang.
Wet or moist coating: Indicates water metabolism issues related to Yang Qi deficiency.
Pulse:
Deep, weak, and slow: Reflects internal cold and deficient Yang.
Key symptoms of Yin Deficiency
Key Symptoms:
Low-grade fever or heat in the afternoon/evening: Yin normally cools the body. Its deficiency leads to heat symptoms.
Night sweats: Heat from Yin deficiency pushes fluids outward.
Dry mouth and throat: Lack of Yin fluids causes dryness.
Thirst with preference for small sips: Indicates dryness without the ability to handle large amounts of water.
Restlessness or insomnia: Yin anchors the mind (Shen). When deficient, the mind becomes unsettled.
Tinnitus: Reflects Kidney Yin depletion, which fails to nourish the ears.
Scanty urine or dry stools: Fluids are insufficient due to Yin depletion.
Tongue:
Red body with little/no coating: Heat from Yin deficiency dries the coating and reddens the tongue.
Cracks: Chronic fluid deficiency creates fissures.
Pulse:
Thin, rapid: Thin indicates deficiency; rapid reflects heat from Yin depletion.
Key symptoms of Blood deficiency
Key Symptoms:
Dizziness or light-headedness: Blood deficiency fails to nourish the brain.
Pale/sallow complexion: Blood provides color and vitality.
Palpitations: Blood nourishes the heart. Deficiency destabilizes it.
Blurred vision or floaters: Liver Blood deficiency fails to nourish the eyes.
Poor memory and concentration: Blood deficiency cannot sustain Shen.
Numbness or tingling: Insufficient blood fails to nourish the tissues.
Scanty or absent menstruation: Blood deficiency affects menstrual flow.
Tongue:
Pale and thin body: Lack of blood causes a pale appearance.
Dry coating: Indicates fluid depletion accompanying blood deficiency.
Pulse:
Thin or choppy: Reflects reduced or stagnant blood circulation.
Key symptoms of yin excess
Key Symptoms:
Heaviness in the body or limbs: Dampness caused by excess fluids (Yin).
Cloudy thinking or lethargy: Damp obstructs clear Qi from reaching the head.
Sticky sensation in the mouth: Damp heat produces phlegm or stickiness.
Fullness in the chest or abdomen: Dampness causes obstruction.
Tongue:
Pale, swollen, thick, greasy white coating: Reflects damp accumulation from excessive Yin.
Pulse:
Slippery and slow: Excessive fluids obstruct Qi flow.
Key symptoms of Yang excess
Key Symptoms:
High fever or flushed complexion: Excess Yang creates heat.
Red eyes: Heat rising from excess Yang affects the Liver.
Irritability or restlessness: Heat agitates the Shen.
Bitter taste in the mouth: Heat in the Liver and Gallbladder produces bitterness.
Thirst with preference for cold drinks: Heat drives thirst for cooling fluids.
Constipation or dry stools: Heat dries the fluids in the intestines.
Scanty, dark urine: Heat condenses and darkens urine.
Tongue:
Red body with thick yellow coating: Indicates heat excess.
Pulse:
Rapid, forceful: Yang energy is excessive and drives a stronger, faster pulse.
What is sighing or feeling of a lump in the throat a common symptom of?
Sighing:
Sighing is a common symptom of Liver Qi Stagnation.
Rationale:
The Liver governs the smooth flow of Qi in the body. When Liver Qi becomes stagnant, it creates a sense of frustration or emotional constraint. Sighing acts as a mechanism to relieve this stagnation by releasing pent-up tension and Qi. It’s often accompanied by other symptoms such as irritability, a feeling of distension in the chest or hypochondriac region, and mood swings.
Sighing is a natural mechanism for releasing pent-up tension in Qi, particularly when it is related to Liver Qi Stagnation. Here’s how it works:
- The Role of Qi in TCM
In Traditional Chinese Medicine (TCM), Qi (vital energy) flows throughout the body in channels or meridians. Smooth and unobstructed Qi flow is essential for physical and emotional well-being.
The Liver is responsible for regulating the smooth flow of Qi. Emotional stress, frustration, or anger can cause Liver Qi Stagnation, leading to tension, irritability, and physical symptoms like chest tightness or a “suffocating” feeling. - What Happens During Sighing?
When you sigh, the following physiological and energetic processes occur:
Deep Inhalation: A deep breath increases oxygen intake and momentarily expands the chest. This expansion creates a sensation of space, both physically and energetically, relieving the feeling of oppression often caused by stagnated Liver Qi.
Exhalation: A prolonged exhalation allows for the release of pent-up energy and tension. In TCM terms, it helps disperse the stagnated Qi, especially in the chest and diaphragm, areas commonly affected by Liver Qi Stagnation.
- Emotional Release
Sighing is often a subconscious expression of emotions like frustration, sadness, or relief. From a TCM perspective, these emotions are associated with the Liver and can exacerbate Qi Stagnation if not expressed or resolved.
The act of sighing can serve as an emotional release, reducing the internal buildup of tension that disrupts Qi flow. - Connection to the Diaphragm and Chest
The diaphragm is anatomically and energetically linked to the Liver. In TCM, stagnated Qi often accumulates around the diaphragm, creating sensations of tightness or fullness in the chest.
Sighing stimulates the diaphragm, helping to “unstick” Qi in the region and promote movement. - Why It Feels Better After Sighing
Sighing provides momentary relief because:
It resets breathing patterns, which may have become shallow or irregular due to stress.
It releases physical tension in the chest and diaphragm.
It alleviates emotional stagnation, even if temporarily.
Summary
Sighing is a natural response to Liver Qi Stagnation and an effective way to restore smooth Qi flow, especially in the chest and diaphragm. It represents the body’s intuitive attempt to relieve emotional and energetic tension, making it an important diagnostic sign in TCM.
Feeling of a Lump in the Throat:
The sensation of a lump in the throat, often referred to as Plum-Pit Qi (Globus Hystericus), is associated with Liver Qi Stagnation and/or Phlegm Retention.
Rationale:
Liver Qi Stagnation: Emotional factors like stress, frustration, or repressed emotions disrupt the Liver’s ability to regulate Qi. This leads to Qi stagnation in the throat, creating a sensation of a lump.
Phlegm Retention: Chronic Qi stagnation can lead to poor fluid metabolism, causing the accumulation of Phlegm. This Phlegm combines with stagnant Qi, further contributing to the sensation of obstruction in the throat.
Despite the sensation, there is no physical lump present when checked, differentiating this from structural causes like thyroid issues.
Differentiation:
Both symptoms can occur together as they share a common underlying pattern of Liver Qi Stagnation, but the lump in the throat is often more pronounced when Phlegm is also involved.
Key Points:
Sighing: Liver Qi Stagnation (emotional release).
Lump in throat: Liver Qi Stagnation ± Phlegm Retention (emotional + physiological obstruction).
Tongue and Pulse:
Tongue: Normal or slightly red edges for Liver Qi Stagnation; greasy coating if Phlegm is present.
Pulse: Wiry (Liver Qi Stagnation) and possibly slippery (Phlegm).
Which of the following describes an optimal bowel movement in Traditional Chinese Medicine (TCM)?
A) Small, hard pellets, requiring straining
B) Loose stools that do not hold form when flushed
C) Formed, easy to pass, minimal wiping, and occurs ≤ 3 times/day
D) Urgent, explosive diarrhea that leaves a burning sensation
Correct Answer: C
✅ C is correct because in TCM, an optimal bowel movement is well-formed, easy to pass, requires minimal wiping, and occurs at a frequency that matches food intake (ideally once per day but up to three times per day).
❌ A is incorrect because small, hard pellets suggest Liver Qi stagnation or Blood/Yin deficiency.
❌ B is incorrect because unformed, loose stools suggest Spleen Qi deficiency or Dampness.
❌ D is incorrect because urgent, explosive diarrhea with burning indicates Damp-Heat in the intestines.
A patient presents with dry stools, thirst, dark scanty urine, epigastric pain, and a red tongue. What is the most likely TCM pattern?
A) Damp-Heat
B) Liver Qi Stagnation
C) Heat in the Stomach and Large Intestine
D) Spleen Yang Deficiency
Correct Answer: C
✅ C is correct because dry stools, thirst, dark urine, and epigastric pain point to Heat in the Stomach and Large Intestine. This can lead to constipation and a burning sensation in the anus.
❌ A is incorrect because Damp-Heat would present with diarrhea, foul-smelling stools, and burning, rather than constipation.
❌ B is incorrect because Liver Qi stagnation typically causes alternating constipation and diarrhea, bloating, and emotional distress.
❌ D is incorrect because Spleen Yang Deficiency would cause loose stools, cold intolerance, and fatigue, not dry stools and heat signs.
