TCM THEORY - SYNDROMES Flashcards
How would you treat Heart Qi Deficiency?
Tonify Heart Qi
TONIFICATION
What is the pathology and aetiology for Heart Qi Deficiency?
Pathology: Palpitation/ awareness of the heartbeat occurs when the Heart qi is not strong enough to adequately pump blood. Other symptoms due to general qi deficiency. Spontaneous sweating is due to Wei qi not holding in fluids. Shortness of breath is due to weak Zong qi impairing respiration. Lassitude is due to the deficient qi failing to transform and transport properly, thereby not sufficiently nourishing all the other organs of the body.
Aetiology: a) Blood loss. b) Emotional problems (especially lack of joy or sadness). c) Chronic
illness.
Key symptoms:
Palpitations/ awareness of heartbeat which is worse during the day, when tired or on exertion, tiredness, shortness of breath on exertion
Other symptoms: pale face, lassitude, inappropriate joy or lack of joy, spontaneous sweating
Pulse: deficient, especially in front, left position
Tongue body: pale or normal
Heart Qi deficiency
Key symptoms: Palpitations/awareness of the heartbeat which is worse when tired, cold or on exertion, feeling cold, spiritual fatigue, shortness of breath on exertion.
Accompanying symptoms: Spontaneous sweating, bright white complexion, slightly dark lips, mild
stuffy feeling in heart area, cold hands.
Pulse: Deep, Weak, especially front left position, and Slow. Knotted in severe cases.
Tongue Body: Pale, Wet, Swollen.
Heart Yang Deficiency
What is the pathology and aetiology for Heart Yang Deficiency?
Heart Qi Deficiency symptoms (as Qi is part of Yang). Feeling of cold and cold hands are
due to Heart Yang not transporting Blood to extremeties to warm them. Mild stuffy feeling in chest is
due to Heart Yang failing to move Qi leading to Qi stagnation in chest. Lips may be slightly dark
because deficient Yang fails to move Qi and Blood which leads to slight Blood stasis.
Aetiology: a) Emotional problems (especially lack of joy or sadness). b) Chronic illness. c) Kidney-
Yang Deficiency. d) Heavy blood loss.
How would you treat Heart Yang Deficiency?
Tonify and Warm Heart Yang.
TONIFICATION
Key symptoms: Insomnia (difficulty falling asleep), poor memory, anxiety, easily startled.
Accompanying symptoms: Palpitations/awareness of the heartbeat which is worse during the
afternoon and evening and when at rest and when anxious, dizziness, dull pale complexion, pale lips,
feeling uneasy.
Pulse: Thin or Choppy, especially front left position.
Tongue Body: Pale, Dry. May be Thin in severe cases.
Heart Blood Deficiency
What is the pathology and aetiology for Heart Blood deficiency?
Pathology: Insomnia, anxiety, easily startled and poor memory due to Shen being deprived of its ‘residence’. In cases of Heart Blood Deficiency the Heart Qi is not rooted, causing
palpitations/awareness of the heartbeat. Dizziness is caused by the Blood not nourishing the brain.
Aetiology: a) Poor diet – irregular eating habits and not enough Blood nourishing foods. b) Anxiety
and worry. c). Heavy blood loss.
How would you treat Heart Blood Deficiency?
Nourish Heart Blood. Pacify Shen.
TONIFICATION
Key symptoms: Palpitations/awareness of the heartbeat which gets worse as the day goes on and
during the night and when at rest, insomnia (waking up during the night), feeling of heat (hot and
bothered), easily startled, poor memory, anxiety.
Accompanying symptoms: Dream-disturbed sleep, mental restlessness, fidgeting, malar flush, feeling
of heat in the afternoon and evening, night sweats, dry mouth and throat, 5-palm heat.
Pulse: Floating, Empty, esp front-left position and Rapid.
Tongue Body: Red tip; partially Peeled, or Peeled; possibly Mid-line Crack reaching to the tip.
Heart Yin Deficiency
What is the pathology and aetiology for Heart Yin Deficiency?
Pathology: Heart Yin Deficiency includes Heart Blood Deficiency (Blood is a part of Yin) leading to
symptoms of Shen disturbance such as insomnia, dream-disturbed sleep, easily startled, poor memory,
anxiety. Malar flush, five-palm heat and feeling of heat are due to Empty Heat which arises from long-
standing Yin Deficiency.
Aetiology: a) Long-standing anxiety and worry. b) Overwork - always on the go. b) After effect of
external attack of Heat. c) May stem from Kidney Yin Deficiency (as deficient Kidney Yin cannot rise
to nourish and cool the Heart).
How would you treat Heart Yin Deficiency?
Nourish Heart Yin. Nourish Kidney Yin if necessary. Clear Empty Heat (if
necessary). Pacify Shen.
TONIFICATION
Key symptoms: Strong palpitations/awareness of the heartbeat which tends to be worse when
agitated, pronounced mental restless, panic attacks, agitation, insomnia, dream-disturbed sleep.
Accompanying symptoms: Thirst, mouth and tongue ulcers which are red and painful, bitter taste
after a bad night’s sleep, red face, feels hot, in severe cases dark urine or blood in urine.
Pulse: Full, Overflowing, especially front left position, Rapid.
Tongue Body: Red, Redder tip with Red Spots. May be a Midline Crack reaching the tip.
Tongue Coat: Yellow.
Heart Fire Blazing
What is the pathology and aetiology for Heart Fire Blazing?
Pathology: Symptoms of Heat are thirst, red face and feeling hot. Mental restlessness and dream-
disturbed sleep are due to Heat in the Heart disturbing the Shen. Ulcers due to Heat rising up to the
tongue from the Heart. Heart opens into the tongue and controls taste therefore Heat may lead to a
bitter taste. Heart Fire transfers to Small Intestine, and then Bladder, causing urinary symptoms.
Aetiology: a) Emotional problems, especially chronic anxiety, worry or depression. b) Poor diet –
excessive consumption of spicy foods and alcohol. c) Recreational drugs d) Transferred from Liver
Fire.
How would you treat Heart Fire Blazing?
Clear Heart Fire. Pacify Shen.
EVEN OR REDUCTION
There is a spectrum of signs and symptoms found in people with this syndrome and we will
more commonly see patients who are less extreme.
Key symptoms:
Palpitations/awareness of the heartbeat which may be worse when agitated, mental restlessness and
agitation, sometimes alternating with depression and dullness, confusion.
Accompanying symptoms:
In severe cases: Manic behaviour, incessant talking, over activity. red face, dream-disturbed sleep, bitter
taste, thirst, feeling of oppression in the chest, expectoration of phlegm, rattling sound in the throat.
In less severe cases: Joy seems out of context, a tendency to be a bit ‘up’, some insomnia and slight
agitation.
Pulse: Full, Slippery, Wiry or Overflowing, especially in front left position, and Rapid.
Tongue Body: Red, Swollen, may be a deep Midline Crack which reaches to the tip.
Tongue Coat: Yellow, Sticky. Thickness of coating depends on severity
Phlegm-Fire Harassing the Heart
What is the pathology and aetiology of Phlegm Fire Harassing the Heart
Pathology: All symptoms due to Fire and/or Phlegm. Mental symptoms due to the Heart orifices
being obstructed by Phlegm, resulting in no resting place for the Shen. Phlegm derives from deficient
Spleen Qi being unable to transform and transport fluids, which accumulate into Phlegm. Interior Heat
facilitates this process by condensing fluids. Other symptoms due to Fire in the Heart. Phlegm leads to
lack of clarity and Heat to manic behaviour.
Aetiology: a) Severe emotional problems. b) Poor diet - too much hot greasy food.
How would you treat Phlegm Fire Harassing the Heart
Clear Heart Fire. Resolve Phlegm. Pacify Shen. Open the Heart’s orifices.
EVEN OR REDUCTION
There is a spectrum of signs and symptoms found in people with this syndrome and we will
more commonly see patients who are less extreme.
Key symptoms:
In severe: cases: Very dull eyes, confusion, consciousness diminished and severe depression.
In less severe: cases: Doesn’t think clearly, poor chain of thoughts, may be slightly depressed.
Accompanying symptoms: Palpitations/awareness of the heartbeat.
In severe cases rattling sound in throat, incoherent speech or aphasia, heavy feeling chest,
unconsciousness, lethargic stupor, vomiting of phlegm.
In less extreme cases, inert or deadened, going blank.
Pulse: Slippery, especially front left position.
Tongue Body: Swollen, Midline Crack reaching the tip.
Tongue Coat: Thick, Sticky. . Thickness of coating depends on severity
Phlegm Misting the Heart
What is the pathology and aetiology of Phlegm Misting the Heart?
Pathology: All symptoms due to Phlegm (no Fire symptoms). Heart opens into the tongue and
Phlegm prevents the tongue from moving causing aphasia. Phlegm obstructs the Heart orifices causing
mental symptoms. Vomiting and rattling sound in the throat caused by Phlegm obstructing the chest.
There is normally a background of Spleen Qi Deficiency which contributes to the formation of Phlegm.
Aetiology: a) Children – constitutional. b) Adults – i) Poor diet - excess cold, greasy, raw food ii)
long-standing emotional problems. c) May occur after an attack of Wind-stroke.
How would you treat Phlegm Harassing the Heart?
Treatment Principles: Open the Heart’s Orifices. Resolve Phlegm. If necessary restore
Consciousness.
EVEN OR REDUCTION
Key symptoms: Stabbing or pricking pain in heart region which may radiate to inside left arm or to
shoulder, pain comes in bouts and is elicited by exertion or cold weather.
Accompanying symptoms: Strong palpitations/awareness of the heartbeat, stuffiness, discomfort,
oppression or constriction of chest, cyanosis of lips and nails, cold hands.
Pulse: Knotted, Choppy or Wiry, especially front left position.
Tongue Body: Purple.
Heart Blood Stagnation
What is the pathology and aetiology of Heart Blood Stagnation?
Pathology: Arises from other Heart patterns, usually Heart Yang Deficiency or Heart Blood
Deficiency. Symptoms will vary according to underlying patterns. If Heart Yang is deficient, it fails to
move Blood which stagnates and causes pain and constriction. Cyanosis of lips and nails and cold
hands are due to stagnant Heart Blood not reaching the face and hands.
Aetiology: a) Long-term emotional problems, particularly anxiety, grief or worry. d) Long term
overwork. c) Heart Yang Deficiency. d) Heart Blood Deficiency.
How would you treat Heart Blood stagnation?
Regulate Blood. Tonify and Warm Heart Yang or nourish Heart Blood. Pacify
Shen.
During an attack – Reduction.
Between attacks – Even or Tonification.
Key symptoms: Tiredness, loose stools, undigested food in the stools, poor or abnormal appetite.
Accompanying symptoms: Abdominal distension after eating, lassitude, desire to lie down, pale
complexion, weakness of limbs, inappropriate sympathy, over-thinking and worry.
Pulse: Deficient, especially right, middle position.
Tongue Body: Pale or Normal, Quivering, Swollen. If chronic, sides may have transverse
cracks.
Spleen Qi Deficiency
What is the pathology and aetiology of Spleen Qi Deficiency?
Pathology: Digestive symptoms are due to breakdown of Spleen’s Transformation and
Transportation (T & T) function. The Spleen failing to transport Food Qi (Gu Qi) to the 4 limbs causes
them to be weak. The Spleen also transports Food Qi (Gu Qi) throughout the body. Hence tiredness,
lassitude and desire to lie down therefore result when Spleen Qi is weak.
Aetiology: a) Poor diet – too much raw and/or damp-forming food, and irregular eating habits. b)
Mental strain and over-thinking. c) Damp environment. d) Chronic illness.
How would you treat Spleen Qi Deficiency?
Treatment Principle: Tonify Spleen Qi.
TONIFCATION
Key symptoms: Tiredness, loose stools, undigested food in the stools, poor or abnormal appetite,
feeling cold.
Accompanying symptoms: Oedema, desire to lie down curled up, cold limbs, tendency to obesity,
spiritual fatigue.
Pulse: Deep, Weak, especially right, middle position, Slow.
Tongue Body: Pale, Wet, Swollen.
Spleen Yang Deficiency
What is the pathology and aetiology for Spleen Yang Deficiency?
Pathology: Spleen Qi Deficiency PLUS Yang Deficiency. Digestive symptoms are due to breakdown of Spleen’s transformation and transportation (T & T) function. The Spleen failing to transport Food Qi (Gu Qi) to the 4 limbs causes them to be weak. The Spleen also transports Food Qi (Gu Qi) throughout the body. Hence tiredness, lassitude and desire to lie down result when Spleen Qi is weak. Feeling cold and cold limbs are due to the failure of Spleen Yang to warm the body. Oedema is due to a breakdown
in the T & T function of the Spleen – fluids which are not transformed may accumulate under the skin as oedema. Tendency to obesity is also due to a breakdown in the T & T function of the Spleen, which may lead to a build up of fluids in the form of Dampness.
Aetiology: a) Poor diet – too much raw and/or damp-forming food, and irregular eating habits. b)
Mental strain and over-thinking. c) Damp and cold environment. d) Chronic illness.
How would you treat Spleen Yang Deficiency?
Tonify and Warm Spleen Yang.
TONIFICATION
Key symptoms: Tiredness, loose stools, undigested food in the stools, poor or abnormal appetite,
bearing down sensation in abdomen.
Accompanying symptoms: Prolapse of stomach, uterus, anus or vagina, frequent/urgent urination,
menorrhagia.
Pulse: Deficient, especially right, middle position.
Tongue Body: Pale or Normal.
Spleen Qi Sinking
What is the pathology and aetiology for Spleen Qi Sinking?
Pathology: Same as Spleen Qi Deficiency PLUS impaired function of Spleen Raising Qi. Digestive
symptoms are due to breakdown of Spleen’s Transformation and Transportation (T & T) function. The Spleen failing to transport Food Qi (Gu Qi) to the 4 limbs causes them to be weak. The Spleen also transports Food Qi (Gu Qi) throughout the body. Hence tiredness, lassitude and desire to lie down result when Spleen Qi is weak. Frequent/urgent urination and menorrhagia usually occur only when there is Kidney Qi Xu too.
Aetiology: a) Poor diet – too much raw and/or damp-forming food, and irregular eating habits. b)
Mental strain and over-thinking. c) Damp environment. d) Chronic disease. e) Standing for long periods of time.
How would you treat Spleen Qi Sinking?
Tonify Spleen Qi. Raise Qi.
TONIFICATION
Key symptoms: Tiredness, loose stools, undigested food in the stools, poor or abnormal appetite,
menorrhagia or metrorrhagia.
Accompanying symptoms: Purpura, blood spots under skin (petechiae), blood in urine or stools,
bruises easily, sallow pale complexion, abdominal distension after eating, lassitude, desire to lie down, pale complexion, weakness of limbs, inappropriate sympathy, over-thinking and worry.
Pulse: Deficient or Thin, especially right, middle position.
Tongue body: Pale or Normal.
Spleen not Controlling Blood
What is the pathology and aetiology for Spleen Not Controlling The Blood?
Pathology: All symptoms due to impaired function of Spleen controlling Blood. Deficient Spleen Qi
cannot hold Blood in the vessels and bleeding appears from various sources, such as under the skin, in the stools or urine and from the uterus.
Aetiology: a) Poor diet – too much raw and/or damp-forming food, and irregular eating habits. b)
Mental strain and over-thinking. c) Damp environment. d) Chronic disease.
How would you treat Spleen Not Controlling the Blood?
Tonify Spleen Qi
TONIFICATION
Key symptoms: Tiredness, loose stools, undigested food in the stools, poor or abnormal appetite,
abdominal distension after eating, heavy limbs.
Accompanying symptoms: Lassitude, desire to lie down, pale complexion, weakness of limbs,
inappropriate sympathy, over-thinking and worry, nausea, stuffy chest and epigastrium, muzzy head.
Pulse: Weak-Floating or Deficient and Slippery, especially right, middle position.
Tongue body: Pale or Normal and Swollen, especially on the sides.
Spleen Qi Deficiency with Dampness
What is the pathology and aetiology for Spleen Qi deficiency with Dampness?
Pathology: Digestive symptoms are due to breakdown of Spleen’s transformation and transportation (T & T) function. The Spleen failing to transport Food Qi (Gu Qi) to the 4 limbs causes them to be weak. The Spleen also transports Food Qi throughout the body. Tiredness, lassitude and desire to lie down therefore result when Spleen Qi is weak. Dampness arises from lack of T & T of Body Fluids and may block the descending of Stomach Qi causing nausea, or reach the head via the Stomach channel causing a muzzy head.
Aetiology: a) Poor diet – too much raw and/or damp-forming food, and irregular eating habits. b)
Mental strain and over-thinking. c) Damp environment. d) Chronic disease.
How would you treat Spleen Qi Deficiency with Dampness?
Tonify Spleen Qi. TONIFCATION
Resolve Dampness. EVEN OR REDUCTION
Key symptoms: Stuffiness in chest, abdomen and/or epigastrium, feeling of heaviness in the head and body.
Accompanying symptoms: Poor appetite, loose stools, feeling cold in the epigastrium – better with
warmth, nausea, sweet taste or loss of taste, no thirst, or thirst with no desire to drink, white vaginal discharge, lassitude.
Pulse: Slippery, especially right, middle positions, and may be Slow.
Tongue coat: Sticky, Thick, White.
Cold-Damp Invading the Spleen
What is the pathology and aetiology for Cold Damp Invading the Spleen
Pathology: Excess Syndrome. Can be acute or chronic - symptoms listed above due to acute stage. Feeling of stuffiness is due to Damp obstructing the movement of Qi. Feeling of heaviness is from Damp obstructing the muscles. Damp prevents the clear Yang from ascending causing the feeling of heaviness of the head. Dampness prevents Stomach Qi from descending causing nausea. Spleen opens into the mouth, therefore Dampness obstructing Spleen affects the taste. Vaginal discharge may occur because Dampness is heavy and has a tendency to sink downwards.
Aetiology: a) Invasion by External Pathogenic Damp – from climate or living conditions. b) Poor
Diet – eating too much cold and/or damp-forming food.
How would you treat Cold-Damp Invading the Spleen?
Resolve Damp. EVEN OR REDUCTION
Key symptoms: Poor appetite, feeling of heaviness.
Accompanying symptoms: Stuffiness in epigastrium and/or lower abdomen, thirst with no desire to drink, nausea, vomiting, abdominal pain, loose stools with offensive odour, burning sensation in anus, scanty dark yellow urine, low grade fever, dull headache with a feeling of heaviness in the head, skin eruptions, sweating that does not relieve fever.
Pulse: Slippery, especially right, middle position and Rapid.
Tongue Coat: Thick, Sticky, Yellow.
Damp-Heat Invading the Spleen
What is the pathology and aetiology for Damp Heat Invading the Spleen?
Pathology: Excess syndrome, similar pathology to previous syndrome but with Heat. Feeling of
fullness, feeling of heaviness and nausea are all due to Dampness. Low-grade fever is caused by the steaming of Damp-Heat. Offensive odour of stools, bitter taste, burning sensation of the anus and scanty, dark yellow urination are all indicative of Heat.
Aetiology: a) Invasion by External Pathogenic Damp-Heat (hot and humid weather). b) Eating
unclean or contaminated food.
How would you treat Damp-Heat invading the Spleen?
Resolve Damp. Clear Heat. EVEN OR REDUCTION
Key symptoms: Uncomfortable feeling in the epigastrium, poor or abnormal appetite, tiredness
especially in the morning.
Accompanying symptoms: Weak limbs, lack of taste sensation, loose stools, inappropriate
sympathy, over-thinking and worry.
Pulse: Deficient, especially in right, middle position.
Tongue Body: Pale.
Stomach Qi Deficiency
What is the Pathogy and aetiology for Stomach Qi Deficiency?
Pathology: Most symptoms arise from Stomach Qi Deficiency. Stomach is the root of Post-Heaven
Qi and the beginning stage in the production of Qi from food. Therefore if the Stomach is deficient all
other organs will suffer. Consequently, tiredness is the key symptom of Stomach Qi Deficiency. An
uncomfortable feeling in the epigastrium is caused by weak Stomach Qi failing to descend. Weak limbs are due to Stomach Qi failing to transport the food essences to the limbs. Loose stools, no appetite, and lack of taste are due to Spleen Qi Deficiency.
Aetiology: a) Poor diet – undereating, irregular eating habits. b) Chronic disease.