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Chapter Six
Diagnostics

Diagnostics of Sinomedicine is the science discussing the basic theories,methods and skills of diagnosing diseases and differentiating syndromes in Sinomedicine .

The main contents of diagnostic of Sinomedicine are four methods of examination and differentiation of syndromes . The doctors of Sinomedicine collect the informations about the symptoms felt by the patients and the objective external manifestations about the symptoms felt by the patients and the objective external manifestation of them through four methods of examination ,that is ,inspection ,auscultation and olfaction ,inquiring,and palpation and pulse-feeling ,then analyse and induce these informations under the guidance of principles of differentiation of syndromes ,to differentiate the nature,degree of seriousness and region of the diseases.

1.Four Methods of Examination

Four methods of examination are the means of collecting clinic informations and obtaining data of condition of diseases by the doctors of Sinomedicine .

[1].Inspection

Outside of human body relates closely to the five zang-organs and six fu-organs ,and the changes of vital energy , blood , yin and yang of the zang-organs and fu-organs usually reflect on the body surface .Inspection is observating the changes on the relevant regions of the sufferers' body and the changes of excretion of them ,to understand the states of pathological changes.

(1).Inspection of Vitality and Mental State

Observing physical condition,facial expression ,state of movement ,posture and others briefly,we can know prosperity and decline of healthy energy in the organism,and degree of seriousness of the diseases.

(2).Inspection of Skin Colour

The colour and luster of the face,lip and nail,especially those of the face are external reflections of prosperity and decline of vital energy and blood in human body.

Normal facial colour of the Chinese is slight yellow with slight ruddiness and luster , and it is called normal colour .Abnormal colours and lusters in the sufferers are reflections of pathological changes ,and they are called morbid colours . The five colours ,that is , white ,yellow,red,green and black relate to natures of diseases and prosperity and decline of the five zang-organs in certain degree.

White : indicating asthenia-cold syndrome and loss of blood.
Yellow : indicating asthenia syndrome and wetness syndrome.
Red : indicating heat syndrome.
Green : indicating cold syndrome, pain syndrome ,stasis syndrome and infantile convlsion.
Blck : indicating syndrome of asthenia of kidney and syndrome of retention of body fluid.

(3).Inspection of Physical Condition

Inspection of physical condition is observing the sufferer's build and posture.

(4).Inspection of the Tongue

Inspection of the tongue,or examination of the tongue is the process of diagnosis of understanding the changes of yin ,yang,vital energy and blood of the zang-organs and fu-organs , natures of evils,degree of seriousness of condition of diseases,and existence or disappearance of stomach-energy.

A.Relation of the Tongue with the Zang-organs and Fu-organs

The tongue can be divided into four parts,that is ,tip of the tongue ,center of that,root of that and margin of that.Tip of the tongue reflects pathological changes of the heart and lung;center of that reflects pathological changes of the spleen and stomach;margin of that reflects pathological changes of the liver and gallbladder ; and root of that reflects pathological changes of the kidney . For hyperactivity of heart-fire , only red tip of the tongue can be found ; for hyperactivity of stomach-fire , yellow fur on center of the tongue can be found.

B.Body of the Tongue

Body of the tongue in common person is light red,moist , moderate sized ,and free moving . The changes of the tongue include those of shape , state and colour of the tongue.

(A).Shape of the Tongue

The changes of shape of the tongue include those of shrinkage , tenderness , corpulence , gauntness , fissure , rough and prickly fur , and others.

(B).State of the Tongue

The changes of state of the tongue include stiffness ,tremor , deviation and others.

(C).Colors on Body of the Tongue

Pathological colors on body of the tongue are light white,red , crimson , blue or purple.

C.Fur on the Tongue

The changes of characters and colours of fur on the tongue can reflect nature of evils and condition of body fluid.

(A).Characters of Fur on the Tongue

Characters of fur on the tongue refer mainly to the changes ,such as thick fur ,thin fur , moist fur , dry fur ,curdy fur,greasy fur ,and existence or disappearance of fur.

(B).Colors of Fur on the Tongue

Colors of fur on the tongue are mainly white fur , yellowish fur and greyish black fur.

[2].Auscultation and Olfaction

Auscultation and olfaction include two aspects --auscultation of voice and olfaction of odor.

(1).Auscultation of Voice

Auscultation of voice is hearing the changes in sounds of speech and breath of the sufferers.

(2).Olfaction of Odor

Olfaction of odor is smelling the changes of odor of the mouth and odor of the excretion.

[3].Inquiring

Inquiring is asking the sufferer and his or her companion the qestions about the symptoms the sufferer feels , present medical history , past medical history and others.

(1).Inquiring about Chilliness and Fever

Inquiring about chilliness and fever is asking situation concerning aversion to cold ,and fever.

(2).Inquiring about perspiration

Inquiring about perspiration is asking the situation of sweating.

(3).Inquiring about Condition of Head and Trunk

This is asking the symptoms of head and trunk felt by the sufferer.

(4).Inquiring about Defecation and Urination

This is asking the situation of defecation and urination. nfection of the urinary system.

(5).Inquiring about Taste for Food

This is asking the situation of changes of taste for food.

(6).Inquiring about Condition of Chest and Abdomen

This is asking the symptoms of chest and abdomen felt by the sufferer.

(7).Inquiring about Condition of Sleeping

This is asking the situation about changes of sleeping.

(8).Inquiring about Menstruation and Leukorrhea

This is asking the situation about changes of menstruation and leukorrhea in women.

[4].Palpation and Pulse-feeling

This examination includes two parts--palpation and pulse-feeling.

(1).Palpation

Palpation is mainly palpating the chest,abdomen,hands ,feet, skin and other regions.

(2).Pulse-feeling

Pulse-feeling is feeling the sufferers' pulse to determine prosperity or decline of vital energy and blood ,strongness or weakness of the organism ,asthenia or sthenia of the zang-organs and fu-organs,and functional state of the heart.

A.The Locations of Pulse-feeling

According to locations of pulse-feeling,the methods of pulse-feeling can mainly be divided into three types -- pulse-feeling of whole body , pulse-feeling of three regions , and pulse-feeling of cunkou ( the radial arteries ).

a.Pulse-feeling of Whole Body : In this method of pulse-feeling ,the doctor feels pulse of the arteries in the three regions -- the upper region (head), middle region ( hands ) and lower region ( feet )generally , and each region can be divided into three locations -- heaven ( upper ) , human ( middle ) and earth (lower),therefore , this method of pulse-feeling is called method of three regions and nine locations.

In heaven of the upper region ( Taiyang point ) , the arteries on both sides of the forehead indicate state of vital energy in this region .In human of the upper region ( Ermen point ) , the arteries on both sides of the preauricular region indicate state of vital energy in the regions of the ears and eyes . In earth of the upper region ( Juliao point ) , the arteries on both sides of the cheek indicate state of vital energy in the regions of the mouth and teeth.

In heaven of the middle region ( Cunkou area ) ,the arteries on both sides of the hand taiyin channel indicate state of vital energy of the lungs . In human of the middle region ( Shenmen point ) , the arteries on both sides of the hand shaoyin channel indicate state of vital energy of the heart . In earth of the middle region ( Hegu point ) , the arteries on both sides of the hand yangming channel indicate state of vital energy in the chest.

In heaven of the lower region ( Femur wuli point , and Taiyang point ) ,the arteries on both sides of the foot jueyin channel indicate state of vital energy of the liver . In human of the lower region ( Jimen point , and Chongyang point ) , the arteries on both sides of the foot taiyin channel indicate state of vital energy of the spleen ( stomach ) . In earth of the lower region ( Taixi point ) ,the arteries on both sides of the foot shaoyin channel indicate state of vital energy of the kidneys.

b.Pulse-feeling of Three Regions : Renying points ( the arteries on both sides of the neck ) indicate state of vital energy of the stomach ; Cunkou points ( the radial arteries on both sides ) indicate state of vital energy of the twelve channels ; fuyang points ( the dorsal pedal arteries on both sides ) indicate state of vital energy of the stomach ; in addition , the arteries on both sides of the foot shaoyin channel ( taixi points ) indicate state of vital energy of the kidney .

c.Pulse-feeling of Cunkou ( The Radial artery ) : Cunkou is the radial artery behind the wrist . Cunkou can be divided into three regions -- cun , guan , and chi . The region of the raised bone behind the palm ( styloid process of the radius )is guan ,the region in front of guan ( the wrist-end ) is cun ,and the region behindguan ( the elbow-end )is chi . The zang-organs and fu-organs indicated in the regions of cunkou differ slightly from each other in the theories of different shools . Generally speaking , left cun indicates state of the heart and shanzhong ( middle chest ) , left guan indicates state of the liver and gallbladder , and left chi indicates state of the kidney ,urinary bladder and small intestine ; right cun indicates state of the spleen and stomach ,and right chi indicates state of the kidney , gate of life and large intestine .

B.Normal Pulse Condition

The pulse condition of the healthy person is called normal pulse condition . Normal pulse condition is mild ,vigorous ,evenly rhythmical ,in moderate pulse position , and at moderate pulse rate ,that is ,four times per breathing .

C.Pathological Pulse Conditions

Pulse conditions which occur in human body under the influence of pathological factors are called pathological pulse conditions . Common pathological pulse conditions include twenty eight pulse conditions and ten paradoxical pulse conditions.

The twenty eight pulse conditions can be experienced and recognized by the position , number of times , shape , momentum and others.

¢ñ.Floating Pulse

It can be felt by light touch , growing faint on heavy press.It indicates superficies syndrome.

¢ò.Sunken Pulse

It can not be felt by light touch ,but it can be felt by heavy press.It indicates interior syndrome.

¢ó.Slow Pulse

Three times per breathing . Rise and fall of the pulse are very slow . It indicates cold syndrome.

¢ô.Rapid Pulse

Five to seven times per breathing . It indicates heat syndrome.

¢õ.Feeble Pulse

The pulse is floating ,large ,slow and soft. Feeling of the pulse is feeble on either heavy , medium ,or light press . It indicates asthenia syndrome.

¢ö.Solid Pulse

Feeling of the pulse is forceful on either heavy ,medium ,or light press . The pulse is large and long . It indicates sthenia syndrome.

¢÷.Smooth Pulse

Rise and fall of the pulse are fluent ,feeling of the pulse on the fingers is smooth , and it feels as if pearls roll in a tray .It indicates phlegm syndrome , fluid retention syndrome ,indigestion ,sthenia-heat syndrome ,and pregnancy.

¢ø.Uneven Pulse

Rise and fall of the pulse are difficult , and the pulse is slow and uneven .It indicates deficiency of blood ,consumption of life essence ,stagnation of vital energy , and stasis of blood.

¢ù.Long Pulse

The length of pulsation is very long . Rise and fall of the pulse are even.It indicates overabundant syndromes.

¢ú.Short Pulse

Length of pulsation is very short . It is only palpable at guan site but indistinct at cun and chi sites . It indicates deficiency of blood and weakness of yang.

¢û.Full Pulse

Pulsing vessel is large . Rise of pulse is obvious ,but fall of pulse is indistinct . Pulse is wide ,and pulse amplitude is high .It indicates overabundance of yang and heat.

¢ü.Indistinct Pulse

The pulse is very thready and very soft.On press ,it grows indistinct , and it seems to disappear . It indicates deficiency of both vital energy and blood.

¢ú¢ó.Tense Pulse

The pulse is tense and forceful.Tension of the pulsation is high . It indicates cold and pain.

¢ú¢ô.Moderate Pulse

Four times per breathing . Rise and fall of pulse are sluggish .It indicates wetness syndrome.

¢ú¢õ.Stringlike Pulse

It feels straight and long like a tight string of a musical instrument . It indicates hepatosis ,pain syndromes ,phlegm syndrome and fluid retention syndrome , and malaria.

The pulse feels floating , large and hollow like pressing a tubelike leaf of onion . It indicates loss of blood and damage of yin.

¢ú¢÷.Stringlike and Hollow Pulse

The pulse is floating and hollow , the wall of the arteries is tough . It indicates hemorrhage , emission , abortion and metrorrhagia.

¢ú¢ø.Sturdy Pulse

The pulse feels solid , large ,long and stringlike on heavy press . It indicates yin syndrome , cold syndrome and sthenia syndrome.

¢ú¢ù.Soft and Floating Pulse

The pulse feels asthenic and soft , as well as floating and small . It grows faint on heavy press . It indicates asthenia syndrome and wetness syndrome.

¢ú¢ú.Weak Pulse

The pulse is feeble , sunken and small .It can be felt by heavier press , but it disappear on light press. It indicates insufficiency of vital energy and blood.

¢ú¢ú¢ñ.Scattered Pulse

The pulse is scattered rootlessly , it can be felt by light press , but it becomes indistinctive on heavy press . It indicates exhaustion of primordial energy.

¢ú¢ú¢ò.Thready Pulse

The pulse is small like thread , but it can be felt obviously ,and it does not disappear on heavy press .It indicates various asthenias , internal impairment caused by overstrain , and wetness evil attacking the lower warmer.

¢ú¢ú¢ó.Deep-sited Pulse

Pulse position is deep , the pulse is near the bone ,it can be felt by heavy press , or it can not be felt .It indicates sthenia-type coma caused by evil , syncope syndrome , and cold-type pain.

¢ú¢ú¢ô.Strong and Rapid Pulse

The pulse feels like rolling beans ,and it is smooth ,rapid and strong.It indicates pain ,fright ,diarrhea or dysentery ,and muscular stiffness.

¢ú¢ú¢õ.Abrupt and Irregular Pulse

The pulse is hasty and rapid with irregular intervals.It indicates sthenia-heat syndrome , stagnation of vital energy , and blood stasis.

¢ú¢ú¢ö.Slow and Irregular Intermittence Pulse

The pulse is slow with irregular intervals .It indicates overabundance of yin and stagnation of vital energy , cold-type phlegm syndrome and blood stasis syndrome.

¢ú¢ú¢÷.Intermittent Pulse

The pulse pauses at regular intervals for a while ,then ,it appears again .It indicates exhaustion of visceral vital energy ,insufficiency of original yang ,abdominal pain , diarrhea or dysentery ,wind-syndrome ,pain-syndrome , and asthenia of vital energy nourishing the fetus.

¢ú¢ú¢ø.Swift Pulse

The pulse is swift , and it is seven to eight times per minute .It indicates overabundance of yang with exhaustion of yin ,and exhausting of primordial energy.

Ten paradoxical pulse conditions are mostly found in critical stage.

¢ñ.Boiling Pulse

The pulse is extremely superficial , rapid , weak and rootless as if water is boiling in a cauldron .It indicates syndrome of heat-overabundance without yin in three yang channels.

¢ò.Fish-swimming Pulse

The pulse is superficial , vague and extremely feeble like the state of swimming of fish . It indicates syndrome of cold-overabundance in three yin channels , or syndrome of yang exhaustion.

¢ó.Knocking-stone Pulse

The pulse is deep-sited and solid with a sensation of knocking a stone by fingers.It is a pulse condition indicating exhaustion of vital energy in kidney channel.

¢ô.Untieing-knot Pulse

The pulse is middle-sited ,and rate and rhythm of the pulse change frequently like the state of untieing a tangled rope.It indicates exhaustion of vital energy of kidney and gate of life.

¢õ.Roof-leaking Pulse

The pulse is middle-sited , and it is slow as if water leaks from the roof.It indicates exhaustion of stomach-energy , nutritional energy and defending energy.

¢ö.Shrimp-swimming Pulse

The pulse is superficial ,weak and indistinct with long intervals , as if the state that a shrimp swims slowly and leaps suddenly to disappear.

¢÷.Bird-pecking Pulse

The pulse is middle-sited with rapid rhythm . After three or five beats , the pulse pauses suddenly for a long interval ,then ,the pulse appears again as if a bird pecks food . It indicates that primordial energy of spleen and essential substances from cereals exhaust inside body.

¢ø.Supine-knife Pulse

The pulse feels as if it is a supine blade .It feels small and rapid on light press but solid , large and rapid on heavy press .This is a dangerous pulse conditon of liver.

¢ù.Bean-rolling Pulse

The pulse feels clustered like touching Job's tears.It is a dangerous pulse condition of heart.

¢ú.Rapid Sesame-seeds-like Pulse

The pulse is extremly slight and chaotic like sesame seeds . It is a dangerous indication of exhaustion of defending-energy and stagnancy of nutritional-energy and blood.

2.Differentiation of Syndromes

Differentiation of syndromes is differentiating syndromes , that is , analysing ,synthesizing and inducing the data obtained from four methods of examination to determine cause of disease , region of pathological change and nature of disease , thus making a correct diagnosis to supply basis for treatment of the disease.

Syndromes are pathological summarizations on causes of diseases ,regions of pathological changes and natures of diseases as well as changes of growth and decline in struggle of healthy energy and evils , being response state in human body as a while.

There exist many methods of differentiation of syndromes .The most basic methods of differentiation of syndromes are differentiation of pathological conditions in accordance with the eight principlal syndromes ,differentiation of syndromes according to state of vital energy , blood , and thick and thin body fluid , and differentiation of syndromes according to pathological conditions of zang-organs and fu-organs , and others.

[1].Differentiation of Pathological Conditions in accordance with the Eight Principle Syndromes

Differentiation of pathological conditions in accordance with the eight principle syndromes is a method of diagnosis of main syndromes through analysis and induction of regions and natures of diseases , and states of growth and decline of struggle of differentiation of syndromes ,superficies and interior , cold and heat , asthenia and sthenia , and yin and yang . Differentiation of pathological conditions in accordance with the eight principle syndromes is the general program of differentiation of syndromes and highly summarization of the common substance of various methods of differentiation of syndromes.

(1).Superficies and Interior

Superficies and interior are two programs to differentiate depth of regions of pathological changes and degree of seriousness of diseases.

A.Superficies Syndrome

Superficies syndrome is a syndrome due to that the body surface is attacked by evils.

B.Interior Syndrome

Interior syndrome is a syndrome that the locations of pathological changes are in the zang-organs and fu-organs.

C.Half-superficies and Half-interior Syndrome

Half-superficies and half-interior syndrome is a special syndrome in the situation that evils have left the superficies ,but they have not entered the interior , and they are in the position between the superficies and interior.

(2).Cold and Heat

Cold and heat are two programs to differentiate natures of the diseases.

A.Cold Syndrome

Cold syndrome is a syndrome due to weakness of yang energy.

B.Heat Syndrome

Heat syndrome is a syndrome due to overabundance of yang energy.

C.Internal Cold Syndrome

Internal cold syndrome is generally a syndrome showing in the situation that cold evil attacks the internal organs ,or yang-energy in organism is asthenic , and yin or cold evil is overabundant in the interior.

D.Internal Heat Syndrome

Internal heat syndrome is mostly a syndrome showing in the situation that superficial evil invades the interior and changes into heat ,or heat evil invades the internal organs ,thus causing hyperfunction in the organism.

(3).Asthenia and Sthenia

Asthenia and sthenia are two programs to differentiate overabundance and weakness of healthy energy and evils in the patient's body.

A.Asthenia Syndrome

Asthenia syndrome is a syndrome showing in the situation that healthy energy in human body is weak.

B.Sthenia Syndrome

Sthenia syndrome is a syndrome showing in the situation that evils are excessive , struggle of healthy energy and evils is violent ,or pathological products accumulate and stagnate inside body.

C.Asthenia Cold Syndrome

Asthenia cold syndrome is a syndrome showing in the situation that yang energy in body is deficient.

D.Sthenic Cold Syndrome

Sthenic cold syndrome is a syndrome showing in the situation of obstruction and overabundance of cold evil.

E.Asthenic Heat Syndrome

Asthenic heat syndrome is a syndrome showing in the situation of loss and deficiency of yin fluid inside body.

F.Sthenic Heat Syndrome

Sthenic heat syndrome is a syndrome showing in the situation of flowing of heat-evil.

(4).Yin and Yang

Yin and yang are programs of classification of syndromes . Superficies syndrome , heat syndrome and sthenia syndrome are classified into the category of yang syndrome ; interior syndrome ,cold syndrome and asthenia syndrome are classified into the category of yin syndrome .Therefore , yin and yang are general programs of eight principal syndromes.

Except yin and yang as general programs , clinically concrete syndromes ,such as yin syndrome , yang syndrome , yin-deficiency syndrome , yang-deficiency syndrome , yin-depletion syndrome and yang-depletion syndrome are determined in Sinomedicine as well.

A.Yin Syndrome

Yin syndrome refer generally to asthenic cold syndrome ,being a syndrome showing in situation of deficiency of yang energy.

B.Yang Syndrome

Yang syndrome refers generally to sthenic heat syndrome ,being a syndrome showing in the situation of flaming of heat-evil.

C.Yin-deficiency Syndrome

Yin-deficiency syndrome is the asthenic heat syndrome showing in the situation that yin fails to inhibit yang because of loss and deficiency of yin fluid.

D.Yang-deficiency Syndrome

Yang-deficiency syndrome is the asthenic cold syndrome showing in the situation that yang fails to inhibit yin because of loss and deficiency of yang energy.

E.Yang-depletion Syndrome

Yang-depletion syndrome is a syndrome showing in situation of sudden exhaustion of yang energy.

F.Yin-depletion Syndrome

Yin-depletion syndrome is a syndrome showing in situation of sudden exhaustion of yin fluid.

[2].Differentiation of Syndromes according to State of Qi (Vital Energy ), Blood , and Jinye ( Thick and Thin Body Fluid )

Vital energy , blood and thick and thin body fluid are the substance basis of life activities , and they should be abundant and harmonious and move normally.

The syndromes in vital energy , blood and thick and thin body fluid generally can be divided into two aspects . One is loss and deficiency of vital energy , blood and thick and thin body fluid , belonging to category of asthenia syndrome; the other is disturbance of movement and metabolism of vital energy ,blood and thick and thin body fluid , its manifestations are stagnation of vital energy ,abnormal rising of vital energy , blood stasis ,retention of body fluid and others , belonging to category of sthenia syndrome.

(1).Differentiation of Syndromes in Qi( Vital Energy )-disease

Syndromes of qi-disease can be divided into deficiency of vital energy ,stagnation of vital energy and abnormal rising of vital energy.

A.Deficiency of Vital Energy

Deficiency of vital energy is a syndrome showing in the situation that decay of functions of whole body or certain zang-organs and fu-organs.

B.Stagnation of Vital Energy

Obstruction of flowing of vital energy caused by local pathological changes in human body is called stagnation of vital energy.

C.Abnormal Rising of Vital Energy

Abnormal rising of vital energy si a syndrome of abnormal rising of zang-organs-and-fu-organs-energy .

(2).Differentiation of Syndromes in Blood Disease

The syndromes related to blood are mainly blood deficiency , blood stasis and hemorrhage.

A.Blood Deficiency

Blood deficiency is a syndrome caused by excessive loss of blood , weakness of function of the spleen and stomach ,deficiency of sanguification , or disturbance of sanguification because of blood stasis and stagnation.

B.Blood Stasis

Obstruction of bloodstream in certain regions of human body caused by surgical trauma , stagnation of vital energy ,gathering of cold-evil and others , or stagnation of sludging blood in certain regions is called blood stasis.

C.Hemorrhage

The causes resulting in hemorrhage are mainly fire-heat and sthenic-evil forcing the blood to go astray ; vital energy being too deficient to govern the blood ; inwardly generating deficiency-fire due to deficiency of kidney-yin damaging the micrangium ; mental stimulation causing emotions to change into fire ; blood stasis hindering normal movement of the blood ; and excessive fatigue , surgical trauma and others.

(3).Differentiation of Syndromes in Jinye ( Thick and Thin Body Fluid ) Disease

The syndromes in jinye disease include loss and deficiency of jinye and retention of water two aspects.

A.Deficiency of Jinye

Deficiency of jinye is mostly caused by hyperpyrexia , hidrorrhea , hemorrhage , emesis , diarrhea , polyuria and others . Manifestation of the slight patient is consumption of body fluid , and that of the heavy patient is damage of yin.

B.Retention of Water

Disturbance of transportation and metabolism of water in the lung ,spleen and kidney three zang-organs occurs ,the retentive fluid remains in certain regions or inundates whole body , and it can cause the diseases , such as phlegm and fluid retention diseases , edema and others .

[3].Differentiation of Syndromes according to Pathological Conditions of Zang-organs and Fu-organs

Differentiation of syndromes according to pathological conditions of zang-organs and fu-organs is a method of differentiation which analyses and sums up the pathological manifestations of the zang-organs and fu-organs , finds out the causes and natures of the diseases , makes correct diagnosis ,and directs the clinical treatment by taking the theory of viscera-state as basis.

(1).Differentiation of Syndromes of the Heart and Small Intestine

A.Deficiency of Heart-energy and Deficiency of Heart-yang

Deficiency of heart-energy is the syndrome of consumption of heart-energy . Deficiency of heart-yang is the syndrome of failure of heart-yang .

B.Deficiency of Heart-blood and Deficiency of Heart-yin

Deficiency of heart-blood is the syndrome of insufficiency of heart-blood . Deficiency of heart-yin is the syndrome of decline of heart-yin is the syndrome of decline of heart-yin.

C.Heart-blood Stasis

This is the syndrome of obstruction of heart-blood caused by stagnation of vital energy and stasis of blood.

D.Heart Confused by Phlegm

Heart confused by phlegm is the syndrome of mental disorder due to stagnation of phlegm-wetness in the heart.

E.Excessive Heart-fire Flaming up , and the Heart Passing the Evil Heat to the Small Intestine

This is a syndrome caused by heart-heat moving downwardly to the small intestine.

(2).Differentiation of Syndromes of the Liver and Gallbladder

A.Depression of Liver-energy

This is a syndrome caused by abnormality of dispersion of the liver.

B.Sthenic Fire in the Liver Channel

Sthenic fire in the liver channel means sthenia syndrome due to liver-fire.

C.Sthenia of Liver-yang

This is the syndrome caused by asthenic kidney ( water)failing to nourish liver ( wood ) , or yin failing to antagonize yang because of deficiency of liver-yin.

D.Liver-wind Stirring Inside

This is syndrome caused by wind due to overabundance of heat , wind due to sthenic liver-yang , stirring of wind due to yin-deficiency , wind due to blood-deficiency and others.

E.Wetness-heat of Liver and Gallbladder

This is a pathological change due to retention of wetness-heat evil in the liver and gallbladder.

(3).Differentiation of Syndromes of the Spleen and Stomach

A.Deficiency of Spleen-energy and Stomach-energy

This is a syndrome that deficiency of spleen-energy exists simultaneously with deficiency of stomach-energy.

B.Collapse of Middle-warmer Energy

This is a syndrome that weakness of spleen and stomach exists simultaneously with abdominal distention with tenesmus ,and visceroptosis.

C.Asthenia-cold of Spleen and Stomach

This is a syndrome that weakness of spleen and stomach exists simultaneously with cold.

D.Spleen-yang Being Stagnated by Wetness-evil

This is a syndrome that wetness-evil influence on the functions of transport and conversion of spleen-yang.

E.Spleen Failing to Govern Blood

This is a syndrome that spleen fails to govern blood because of deficiency of spleen-energy , thus causing blood to spill over the vessels.

F.Insufficiency of Stomach-yin

This is the syndrome that stomach fluid is insufficient.

G.Flaming of Stomach-fire

This is the syndrome of dryness-heat evil in stomach caused by fire-evil's attacking on stomach ,or overeating of fried food.

(4).Differentiation of Syndromes of the Lung and Large Intestine

This is a syndrome showing in the situation of insufficiency of lung-energy and unstableness of defending (vital)energy in superficies.

B.Deficiency of Lung-yin

This is a syndrome showing in the situation that deficiency of lung-yin causes asthenic fever to occur interiorly.

C.Lung-heat Syndrome

This is a syndrome caused by attack of heat-evil on the lung.

D.Cough due to Lung-dryness

This is a syndrome caused by attack of dryness-evil on the lung.

E.Attack of Cold Evil and Wetness Evil on the Lung

This is a syndrome caused by attack of cold evil on the lung.

F.Stagnation of Phlegm-turbidness in the Lung

This is a syndrome showing in the situation of stagnation and accumulation of phlegm-turbidness in the lung.

G.Wetness-heat of Large Intestine

This is a syndrome caused by that wetness-heat invades the large intestine.

(5).Differentiation of Syndromes of the Kidney and Urinary Bladder

A.Deficiency of Kidney-yin

This is a syndrome of deficiency-heat showing in the situation that kidney-yin is insufficient , and deficiency-fire disturbs inside.

B.Deficiency of Kidney-yang

This is a syndrome showing in the situation of insufficiency of kidney-yang or fire in gate of life.

C.Edema Caused by Kidney-asthenia

This is a syndrome caused by disturbance of water metabolism due to deficiency of kidney-yang.

D.Wetness-heat of the Urinary Bladder

This is a syndrome caused by attack of wetness-heat on the urinary bladder.

(6).Differentiation of Syndromes in Disease of both Heart and Kidney

A.Imbalance between the Heart and the Kidney

This is a syndrome showing in the situation that kidney-water is too deficient to inhibit heart-fire.

(7).Differentiation of Syndromes in Disease of both Liver and Spleen-stomach

A.Attach of Dominant Liver-energy on Stomach

This is a syndrome showing in the situation that depressed liver-energy attacks the stomach contrary to caused disorder and undescent of stomach-energy.

B.Uncoordination of liver and Spleen

This is a syndrome showing in the situation that the liver fails to disperse and the spleen fails to transport and convert.

(8).Differentiation of Syndromes in Disease of both Lung and Kidney

A.Incapacity of Deficient Kidney-energy in Promoting Inspiration of the Lung

This is a syndrme showing in the situation of deficiency of vital energy in the lung and kidney.

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