ASM202: Lecture 3 (cont’d) and 4 September 28,2006

Lecture 3 continued:

Qi disorders:
Qi deficiency:
• Qi is Yang in nature – deficiency will be energetic in nature
• Yang Deficiency = Cold Sx + Qi deficiency
• Underactivity of Zangfu organs
• Improper diet (cannot refine ying and wei qi)
• lack of physical activity; a signal to the body that “I don’t need this energy”…
keep in mind that you cannot get the energy back as easily when you are older
• Any emotional stress can lower Qi – it depends on your perception of emotional
o Eg. Grief – two people can have the same amount of grief, but how each
person handles it will reflect organ functions; it depends on THEIR
perspective
• Which organ system is taking the brunt of repression? – the ability to overcome
this reflects organ function; cannot release an emotion? it will go in and affect a
physical channel
• Overwork lowers qi
• Old age lower Qi – don’t have as much resources become they have been depleted
over time – this is not always the case, but it’s common
• you will often see the same characteristics with qi deficiencies in almost all
organs (the six mentioned in this slide)

S/Sx:
• The first 5 S/Sx on the list = the BIG FIVE – you will see these in every organ
system in Qi deficiency
o Ie. Spontaneous sweating – lack of ability to control Wei Qi (like in
external deficiencies-pores cannot stay open)

Qi Sinking:
• Yang generally moves up
• sinking is a pathological condition
• Will only see Qi sinking in the Spleen, because spleen energy always moves up;
communication between LU and SP is huge here (fluids and energy).
• Gu Qi prevented from moving up in a real SERIOUS depletion of SP
o Sinking sensation in abdomen
• Prolapse of organs; mucosal tissue outside of anus/vagina…rule out food allergies
• Prolonged diarrhea
• Miscarriages (habitual) associated with sinking
Qi Stagnation:
• Liver is the only station affected because its job is to circulate Qi smoothly around
body
• If it’s not circulating, some areas will not receive Qi
• traveling wind: not as violent as wind, not localized in the head and neck…still
lots of yang
• distention: dysmenorrheal or abdominal pains that are worse with pressure
• traveling wind and distension are KEY
• There will be a normal amount of qi in areas receiving Qi, but these will be
relatively in excess due to lack of Qi in other areas
• Students = liver Qi stag’n + spleen-Qi deficiency + poor diet
• STUDENTS: add relaxation activities into exam time routine…

Qi Rebellion:
• Stomach energy moves down – it sends impure substances down to the Small
intestine which further moves impure to Large intestine and out
• Qi rebellion in the ST causes hiccups, vomiting, belching, nausea
• LU Qi rebellion (moving up) – cough
• Rebellion is not a stand alone disorder – it’s usually secondary to another disorder

Blood Disorders:
Blood deficiency:
o Can develop from over meditating; trying to build too much substance in mind
(yin is needed to solidify thoughts)
o Blood stagnation causes accumulation of blood in areas of the body

S/Sx:
o 4 pales + 1 tongue – loss of blood and pale tongue
o Ht and liver are the only system that it affects
o Hypertonic muscles – night cramps
o Oligomenorrhea – sparse flow every few months
o Hemmorhage: poor clotting factors
o heart controls the mind=deficiency is more mental aspect. LIV=def. of blood is
more physical aspects
o dizziness is a lack of yin

Blood Stag’n:
o Cold usually leads to stag’n rather than heat
o Fixed pain, stabbing, < at night
o night is yin, therefore will only add to the already Yin nature of the stagnation
o cyanosis of lips and nails = stag’n so serious that Qi also becomes stagnant
o very focal and localized
o hemorrhage…poor clotting factors
S/SX:
o fixed pain that does not like pressure-pain is in the same spot every time…very
indicative of yin disorders
o agg. at night…night time is yin time
o mass in abdomen: ex. endometriosis, cysts, fibroids

Blood heat:
o Something inside’s on fire, have to let it out
o Bleeding from orfices is very characteristic

Blood cold:
o Does not stay for very long because it eventually turns to stagnation
o pain in hands and feet: similar sx to reynauds

Fluid def:
o Notes Yin Deficiency somewhere
o Dr. Kasaam said do not worry about this

Edema:
o Yang type: affects upper body
o Lung and spleen affected because this is where you have the most fluid
movement, especially towards the skin
o Acute in nature compared to Yin
o Yin type: affects lower
o Ki and spleen affected; more gradual onset
o note bilateral non-pitting edema
o Chronic in nature compared to Yang

Phelgm – always an internal condition

KEY:
substantial phlegm: coughing up, like a cyst type of phlegm
insubstantial phlegm: “the feeling” like something is there…more in the mind
These both come into play with pathologies
Lecture 4:

Why Pulses?
o (yin) tongue changes are more gradual…interventions tend to take longer (ie diet
changes)
o (yang) pulses change fast..will see acute changes during tx.
o preventative care: are things arising that the patient doesn’t feel yet

Pulses:
o Always use the radial artery
o Superficial, middle, deep positions for each organ – 9 types of pulses for
each hand
**types of pulses not until week 8
o right side: more qi side and energetics
o left side-more blood and yin side

Palpation:
o protect your pulse fingers
o you should have a little bit of spread between fingertips, depending on the size of
the patient
o pregnant women will always have a slippery pulse; gender=you can tell viea
which side of the pulse is stronger…right side stronger is a girl…can tell around
around five months. The right side is yang, that’s why the right side is stronger,
because yin (or left side) is being used to produce the female child.

Pulse speed
o superficial, yang, exterior is heart and lung
o middle normal is spleen and liver
o deep, yin, interior is Kidney on either side

Tongue
Diagnosis:
o all organ systems are represented here
o Heart controls motor function of tongue (speech)
o St control taste
o Ki controls both and can override anything ST + HT can do on the tongue
Inspection:
o Best is under natural light
o Incandescent, or all spectrum light better than fluorescent light
o Patient in reproducible position
o Make sure the tongue is not shot out when making actually tongue diagnosis –
however, the act itself can tell you a lot about the character of the person about
how they stick out their tongue, so don’t prevent patient from doing this
o Make sure the you don’t keep the patient’s tongue out for longer than 20 secs
because it’s uncomfortable
o Look at the underside of the tongue – make sure tongue is not pushing against the
teeth
o Ask patient not to brush tongue for 3 days prior to visit
o Tongue represents the entire GI system and all the bacteria in it