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End of 4th Semester

This semester is winding down and I didn't even get a chance to make any new posts. Over my vacation starting next week, I'll post some interesting things that I've learned.

I will also return to my regular postings next semester.

Happy Studying!

TCM- Liver Patterns 2 (Test 2)

The formatting won't allow for me to copy the charts here.

But, here is what you need to know for the test:

The Pattern, Clinical Manifestations, Tongue/Pulse of Liver. You do not need to know the etiology or the pathology.

You also only need to know these points for certain patterns:

• Liver Qi Stagnation
• Liver Qi Stagnation turning into Heat
• Liver Fire Blazing
• Liver Blood Stasis
• Liver Blood Deficiency
• Liver Yin Deficiency

TCM- Liver Patterns 1 (Test 2)

Functions of the Liver	General Characteristics of Liver Pathology
· Stores Blood · Ensures the Smooth Flow of Qi · Controls the Sinews · Manifests in the Nails · Opens into the Eyes · Controls Tears · Houses the Ethereal Soul · Affected by Anger	· Rapid changes (eg. in skin diseases) · Up & down fluctuation (eg. level of energy or mood) · Emotionally up and down · Moodiness, irritability · Pain · Eye problems · A feeling of ‘distension’ · GYN problems

TCM- Heart Patterns 2 (Test 2)

Functions of Heart	General Characteristics of Heart Pathology
· Governs Blood · Controls Blood Vessels · Manifests in Complexion · Houses the Mind · Opens into the Tongue · Controls Sweat	· Mental-Emotional symptoms · Pathology of Mind reflected in ‘Shen’ of eyes · Depression, anxiety, insomnia · Palpitations

TCM- Heart Patterns 1 (Test 2)

Pattern	Clinical Manifestations	Tongue/Pulse
Deficient Patterns
Heart Qi Deficiency:	Palpitations, SOB on exertion, sweating, pallor, tiredness, listlessness	Pale or Normal Empty
Heart Yang Deficiency:	Palpitations, SOB on exertion, tiredness, listlessness, sweating, feeling of stuffiness or discomfort in the heart region, feeling of cold, bright-pale face, cold limbs (esp. hands)	Pale, Wet, Swollen Deep-Weak of Knotted
Heart Blood Deficiency:	Palpitations, dizziness, insomnia, dream-disturbed sleep, poor memory, anxiety, propensity to be startled, dull-pale complexion, pale lips	Pale, Thin, slightly Dry Choppy or Fine
Pattern	Clinical Manifestations	Tongue/Pulse
Heart Yin Deficiency:	Palpitations, insomnia, dream-disturbed sleep, propensity to be startled, poor memory, anxiety, mental restlessness, ‘uneasiness’, ‘fidgetiness’, malar flush, low-grade fever or feeling of heat especially in evening, ‘feeling hot & bothered’, night sweating, dry mouth & throat, 5-Palm heat.	Red-Peeled, no coating, Tip redder & swollen w/red points, deep midline crack reaching tip Floating-Empty & Rapid Or Fine & Rapid
Excess Patterns
Heart-Fire Blazing:	Palpitations, thirst, mouth & tongue ulcers, mental restlessness, feeling agitated, ‘impulsiveness’, feeling of heat, insomnia, red face, dark urine or blood in urine and bitter taste.	Red, Tip redder & swollen w/Red pts Yellow t.c. Possible mid-line crack to tip Full-Rapid-Overflowing OR Hasty
Phlegm-Fire Harassing the Heart:	Mental restlessness, palpitations, bitter taste, insomnia, dream-disturbed sleep, propensity to be startled, incoherent speech, mental confusion, rash behavior, tendency to hit or scold people, uncontrolled laughter or cry, agitation, shouting, muttering to oneself, mental depression and dullness; in severe cases aphasia and coma Key: all the various mental symptoms	Red w/yellow-sticky t.c. Midline crack w/yellow prickles Tip may be redder and swollen w/red points Full-Rapid-Slippery OR Rapid-Overflowing-Slippery OR Rapid-Full-Wiry
Phlegm Misting the Heart:	Mental confusion, unconsciousness, lethargic stupor, incoherent speech, slurred speech, aphasia, vomiting of phlegm, rattling sound in the throat, mental depression, very dull eyes	Swollen w/thick, sticky t.c. Midline crack reaching tip Slippery
Heart Qi Stagnation:	Palpitations, a feeling of distention or oppression of the chest, depression, a slight feeling of lump in the throat, slight SOB	Slightly Pale Purple on sides in chest area Empty but slightly Overflowing on HT position
Deficiency-Excess Patterns
Heart-Blood Stasis:	Palpitations, stabbing or pricking pain in chest that may radiate to inner aspect of the left arm or to the chest, cyanosis of lips and nails, cold hands	Whole tongue purple or only on sides in chest area Choppy, Wiry or Knotted

TCM- Body Fluid Pattern Identification (Test 2)

Patterns:
1. Deficiency of Body Fluids
2. Edema

• Edema arises from deficiency of Spleen, Lungs or Kidneys or all three of them. Lungs, Spleen and Kidneys are the three organs that are most involved in the transformation and transportation of fluids. If one or two or three of these organs is deficient, the Body Fluids are not transformed properly, they overflow out of the channels and settle in the space under the skin. This is the origin of edema.
  
  If edema is caused by Lung Qi deficiency it will affect the top part of the body such as face and hands. This type of edema can also be caused by invasion of exterior Wind-Cold interfering with the Lung function of dispersing and descending the Body Fluids.
  
  Edema from Spleen-Qi deficiency tends to affect the middle part of the body, such as the abdomen (ascites).
  
  If edema is caused by Kidney-Yang deficiency, it will affect the lower part of the body such as the legs and ankles.

3. Phlegm

• The main cause for the formation of Phlegm is Spleen deficiency. If the Spleen fails to transform and transport Body Fluids, these will accumulate and change into Phlegm. The Lungs and Kidneys are also involved in the formation of Phlegm. If the Lungs fail to disperse and lower fluids and if the Kidneys fail to transform and excrete fluids, these may accumulate into Phlegm. However, the Spleen is always the primary factor in the formation of Phlegm.

Non Substantial Phlegm:

-Under the Skin

-In the Channels

- Misting the Mind

- In Gall Bladder and/or Kidneys

- In the joints

Phlegm can assume different forms, according to its associations with other pathogenic factors.

• Wind-Phlegm
• Phlegm-Heat
• Cold Phlegm
• Damp-Phlegm

Qi-Phlegm: This type of Phlegm is non-substantial and is manifested with a feeling of swelling the throat (but no actual swelling), a difficulty in swallowing and a feeling of stuffiness of chest and diaphragm.
This form of Phlegm is usually associated with stagnation of Qi in the throat. It is caused by emotional problems giving rise to (or deriving from) stagnation of Liver Qi. The typical feeling of constriction of the throat is called “plum stone syndrome” in Chinese medicine and this feeling appears and disappears according to mood swings.

Phlegm-Fluids: Phlegm fluid results from accumulation of body fluid due to dysfunction of the Lung, Spleen and Kidney and impairment of water metabolism. Phlegm is turbid and thick, while retained fluid is clear and dilute. The term Phlegm-fluid is the short form of the combination of the two. This is a type of substantial Phlegm is characterized by very watery and thin sputum. It can actually heard splashing in the body.

Extra Points

Zigongxue- 3 cun lateral to Ren-3 (located on the midline of the abdomen, 4 cun below the umbilicus).

Xiyan- A pair of points located in the two depressions, medial and lateral to the patellar ligament, found with the knee flexed.

Lanweixue- The tender spot about 2 cun below St-36

NaoQing- 2 cun proximal to ST 41, on a line connecting ST41 and ST35 (right leg only)

Bafeng- On the dorsum of the feet between the toes, in the depressions proximal to the margins of the webs, four points on each foot.

Shimian- Midpoint of the heel.

Kidney- Shaoyin

The Kidney channel travels from underneath the small toe to the medial malleolus, up the inner leg to the groin. There is connects with GV1 and enters the lower spine. It then connects to its yang pair the Bladder, and the Kidney at the lumbar region.
Throughout other branches the Kidney channel connects to the Liver, Lungs, and Heart.

KD1: On the sole of the foot, between the 2nd and 3rd metatarsals. One third distance between the base of the second metatarsal and the posterior border of the heel.
KD2: In a depression distal and inferior to the navicular tuberosity.
KD3: In a depression between the medial malleolus and the Achilles tendon, level with the prominence of the medial malleolus.
KD4: Approximately .5 cun posterior to the midpoint of a line drawn between KD3 and KD5, at the anterior border of the Achilles tendon.
KD5: 1 cun inferior to KD3, superior to the calcaneus
KD6: 1 cun below the prominence of the medial malleolus, in the groove formed by two ligamentous bundles
KD7: 2 cun superior to KD3, on the anterior border of the Achilles tendon.
KD8: On the medial aspect of the lower leg, 2 cun superior to KD3, .5 cun anterior to KD7, posterior to the medial crest of the tibia
KD9: ON the medial aspect of the lower leg, 5 cun superior to KD 3, on a line drawn from KD3 to KD10
KD10: At the medial end of the popliteal crease, between the tendons of semimembranosss and semitendinosis, found with the knee slightly flexed.
KD11: On the lower abdomen, 5 cun below the umbilicus, .5 cun lateral.
KD12: On the lower abdomen, 4 cun below the umbilicus, .5 cun lateral.
KD13: On the lower abdomen, 3 cun below the umbilicus, .5 cun lateral.
KD14: On the lower abdomen, 2 cun below the umbilicus, .5 cun lateral.
KD15: On the lower abdomen, 1 cun below the umbilicus, .5 cun lateral.
KD16: On the lower abdomen, level with the umbilicus, .5 cun lateral.
KD17: On the upper abdomen, 2 cun superior to the umbilicus, .5 cun lateral.
KD18: On the upper abdomen, 3 cun superior to the umbilicus, .5 cun lateral.
KD19: On the upper abdomen, 4 cun superior to the umbilicus, .5 cun lateral.
KD20: On the upper abdomen, 5 cun superior to the umbilicus, .5 cun lateral.
KD21: On the upper abdomen, 6 cun superior to the umbilicus, .5 cun lateral.
KD22: In the 5th intercostal space, 2 cun lateral to the AML.
KD23: In the 4th intercostal space, 2 cun lateral to the AML.
KD24: In the 3th intercostal space, 2 cun lateral to the AML.
KD25: In the 2th intercostal space, 2 cun lateral to the AML.
KD26: In the 1th intercostal space, 2 cun lateral to the AML.
KD27: 2 cun lateral to the AML, on the lower border of the clavicle.




images taken from yinyanghouse.com

Stomach Channel

The stomach channel is also known as the foot Yangming. Internally this channel connects with it's Yin Paired Organ, the Spleen. There are 45 points on this Earth Channel.

ST1: below the center of the pupil when person is looking forward, between the eyeball and the infra orbital ridge.
ST2: below the center of the pupil when person is looking forward, in infra orbital foramen
ST3: below the center of the pupil when person is looking forward, level with the lower border of the ala nasi
ST4: .4 cun lateral to the corner of the mouth
ST5: anterior to the angle of the jaw, on the anterior border of the masseter
ST6: 1 finger breadth superior and anterior to the angle of the jaw at the prominence of the masseter muscle
ST7: In the depression below the lower border of the zygomatic arch, anterior to the condyloid process
ST8: at the corner of the forehead, 4.5 cun lateral to GV 24
ST9: level with the high point of the laryngeal prominence at the anterior border of the SCM (avoid carotid artery)
ST10: at the anterior border of the SCM midway between ST 9 and ST 11
ST11: superior to the clavicle , lateral to the sternal head of the SCM
ST12: Posterior to the superior border of the clavicle, 4 cun lateral to AML
ST13: below the inferior border of the clavicle, 4 cun lateral to the AML
ST14: level with the 1st intercostal space , 4 cun lateral to the AML
ST15: level with the 2nd intercostal space, 4 cun lateral to the AML
ST16: level with the 3rd intercostal space, 4 cun lateral to the AML
ST17: level with the 4th intercostal space, 4 cun lateral to the AML
ST18: level with the 5th intercostal space, 4 cun lateral to the AML
ST19: 6 cun superior to CV8, 2 cun lateral
ST20: 5 cun superior to CV8, 2 cun lateral
ST21: 4 cun superior to CV8, 2 cun lateral
ST22: 3 cun superior to CV8, 2 cun lateral
ST23: 2 cun superior to CV8, 2 cun lateral
ST24: 1 cun superior to CV8, 2 cun lateral
ST25: level with CV8, 2 cun lateral
ST26: 4 cun superior to CV2, 2 cun lateral
ST27: 3 cun superior to CV2, 2 cun lateral
ST28: 2 cun superior to CV2, 2 cun lateral
ST29: 1 cun superior to CV2, 2 cun lateral
ST30: level with CV2, 2 cun lateral
ST31: on upper thigh , in depression lateral to the sartorius muscle, in depression inferior to the ASIS, level with the lower border of the pubic symphasis
ST32: on the thigh, on a line drawn between the lateral border of the patella and the ASIS, 6 cun proximal to the superior border of the patella ( 2 hand cun)
ST33: On the thigh, on a line drawn between the lateral border of the patella and the ASIS, 3 cun proximal to the superior border of the patella
ST34: on the thigh, on a line drawn between the lateral border of the patella and the ASIS, 2 cun proximal two the superior border of the patella
ST35: on the knee, in a hollow formed when the knee is flexed, inferior tot he patella and lateral to the patellar ligament
ST36: below the knee, 3 cun inferior to ST35, one finger breadth lateral to the anterior crest of the tibia
ST37: on the lower leg, 6 cun inferior to ST 35, one finder breadth lateral to the anterior crest of the tibia
ST38: on the lower leg, midway between the tibiofemoral joint and the prominence of the lateral malleolus, one finger breath lateral to the anterior crest of the tibia.
ST39: On the lower leg, 1 cun inferior to ST38, one finger breadth lateral to the anterior crest
ST40: On lower leg, midway between the tibiofemoral joint and the lateral malleolus, 2 finger breadths lateral to the anterior crest of the tibia
ST41: on the ankle, level with the lateral malleolus prominence, in depression between tendons of extensor hallucis longus and extensors digitorum longus
ST42: on the dorsum of the foot, in a depression formed by the junction of the second and third metatarsal bones and the cuneiform bones, 1.5 cun distal to ST 41, on a line between ST41 and ST 43, at the point where pulsation of the dorsalis pedis artery may be palpated
ST43: on the dorsum of the foot, between the 2nd and 3rd metatarsal bones, in a depression approximately 1 cun proximal to ST 44
ST44: on the dorsum of the foot, between the 3nd and 3rd toes, .5 cun proximal to the margin of the web
ST45: on the dorsal aspect of the 2nd toe, at the junction of lines drawn along the lateral border of the nail and the base of the nail, .1 cun from the corner.


This is shown here:



diagrams taken from yinyanghouse.com

TCM- ID of Patterns According to Internal Organs (Exam 1)

Stasis of Blood

Stasis of Blood can derive from (VERY IMPORTANT):

· Stagnation of Qi: this is the most common cause of Stasis of Blood. Qi moves Blood, if Qi stagnates, Blood congeals

· Deficiency of Qi: deficiency of Qi over a long period of time may cause stasis of Blood as Qi becomes too weak to move Blood

· Heat in the Blood: Heat in the Blood may cause the Blood to coagulate and stagnate

· Blood Deficiency: if Blood is deficient over a long period of time, it will induce Qi deficiency and subsequently stasis of Blood, form impairment of the Qi moving function

· Interior Cold: this slows down the circulation of Blood

Qi Pattern Identification
Pattern	Clinical Manifestations
Qi Deficiency:	Breathlessness, weak voice, spontaneous sweating, no appetite, loose stools, tiredness, Empty pulse	LU & SP symptoms are most common signs of Qi deficiency. HT Qià palpitations KD Qià frequent urination
Sinking Qi:	Feeling of bearing down, tiredness, listlessness, mental depression, prolapse of organs (stomach, uterus, intestines, anus, vagina or bladder), Empty pulse	This is a particular aspect of Qi deficiency (holding and raising functions are impaired). This pattern may also include any other Qi deficient signs.
Qi Stagnation:	Feeling of distention, distending pain that moves from place to place, abdominal masses that appear and disappear, mental depression, irritability, gloomy feeling, frequent mood swings, frequent sighing, Wiry or Tight pulse, slightly purple tongue. Emotional symptoms common	Other symptoms and which part of the body is affected depend on which organ is involved.
Rebellious Qi:	Qi reverses its normal flow in the Qi mechanism. Signs and symptoms vary according to which organ involved.	Examples: Belching, vomiting, hiccoughing, coughing.