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Diagnosis - Class 01
Chinese Medicine Diagnostic Systems
By: David Botton

Eight Principles

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Eight Principle Diagnosis

Interior vs. Exterior

depth of disease

not it's cause

direction of development

depth increases as a result of 

defeat of Wei Qi

hyperactivity of pathogen

delayed / incorrect treatment

decrease of depth

patient is recovering

as depth increasing possible to see both interior and external symptoms

possible to be suffering from an internal disease and an external attack

interior

zang fu

exterior

skin, hair, muscles, superficial meridians

syndromes

interior

attack at level of zang fu

some direct attack of organ by pathogen

direct affect of varying causes (emotions)

further differentiation

deficiency vs. excess

internal organ differentiation

usually

fever with no aversion to cold

or aversion to cold with no fever

pulse not superficial

changes on tongue indicate depth

exterior

sudden onset

short duration

intolerance to cold / wind

fever / chills at same time

thin tongue coat

superficial pulse

headache

cough

general ache

nasal obstruction

further differentiation

cold

severe chills

fever is mild

no sweating

no thirst

thin, moist, white tongue

superficial and tense pulse

body aches

heat

mild chills

severe fever

thirst

thin, yellow tongue

thin white with red tip and sides at first

superficial and rapid pulse

some sweating

sore throat

mild body aches

deficiency

sweating

excess

no sweating

intermediate / shao yang

alternating chills and fever

discomfort/fullness of chest and/or hypochondrium

vomiting

anorexia = not eating

bitter taste in mouth and dry throat

blurred vision

string-taut / wiry pulse

bi syndrom (painful obstruction syndrome)

painful invasion of channels

cold

painful

relief with heat

wind

moving pain

damp

swelling

heaviness

heat

inflammation

relief with cold

Yin vs Yang

collapse

most extreme case

complete separation of yin and yang

cad cause death

yin

excessive exhaustion of fluids

severe vomiting

severe diaghrea

aggravation of deficient yin

symptoms

sticky sweat

feverish

warm limbs

shortness of breath

irritable and restless

thirst

red dry coat / peeled short dry

thready rapid weak

yang

extreme exhaustion of yang Qi in body

profuse sweating

aggravation of deficient yang

symptoms

profuse cold sweat

cool

cold limbs

feeble breathing

listlessness

desire for warm intake

swollen pale moist tongue

fading pulse

Deficiency/Empty/Vacuous vs. Excess/Full/Replete

strength of pathogenic factors vs anti-pathogenic Qi

Excess

Pain worse with pressure

tenesmus 

pathogenic factor

sufficient anti-pathogenic qi

exterior

cold

wind

damp

heat

all internal

if there is any anti-pathogenic Qi

cold

heat

damp

wind

fire

phlegm

stagnation of Qi

stagnation of Blood

Defiency

Pain relieved by pressure

lack of anti-pathogenic Qi

deficient

Qi

Blood

Yin

afternoon fever

malar flush

five palm heat

night sweats

dryness (throat and mouth)

yellow urine

dry stools

red with little or no coat on tongue

rapid or thready pulse

Yang

chills

cold limbs

listlessness / lassitude

spontaneous sweating

no thirst

clear copious urine

loose stool

pale delicate tongue with white coat

weak (and deep) pulse

True Excess with False Deficiency

Excess with some signs similar to deficiency

dryness and heat in intestines and stomach hindering circulation

like deficiency

cold limbs

deep slow pulse

excess

forceful pulse

distention and fullness in abdomen

red tongue with burnt yellow coating

throaty voice

True Deficiency and False Excesx

Deficency with some signs similar to excess

deficiency of intestines and stomach

like excess

distention

fullness

pain

Wiry

deficiency

weak pulse

pressure on stomach reduces pain

Cold vs Hot

cold

aversion to cold

preference for warmth

tastelessness in the mouth

absence of thirst

pail complexion or even blue tinge

cold limbs

lying with body curled up

loose stools

voluminous clear urine

pale (or bluish) moist tongue

slow or tense pulse

exposure to cold = excess yin, deficient yang

hot

red complexion

irritable and restless

fever

thirst

preference for cold

constipation

deep yellow scanty urine

red tongue, yellow and dry coating

rapid pulse

invasion of heat = excess yang, deficient yin

heat above cold below

suffocation and heat in chest

desire to vomit

thirst and mouth ulcers

abdominal pain that is better with heat

loose stools

exterior cold and interior heat

invasion of cold with yin deficiency

exterior heat and interior cold

invasion of heat with yang deficiency

cold can transform in to heat and heat to cold

true heat, false cold

heat on the interior and signs of cold on the exterior

feverish, flushed face and thirst with superficial pulse

wants to cover body, drink warm drinks and pulse also weak

clear urine

pale tongue

white coating

true cold, false heat

cold on the interior and signs of heat on the exterior

cold limbs

burning sensation in chest and abdomen, aversion to heat, deep forceful pulse, cold drinks

irritability

dry throat

scanty urine

constipation

deep red tongue with yellow dry coat


(c) 2005 All Rights Reserved - David Botton