Syndrome differentiation of Zang-Fu organs

Pathologic changes of the heart

a. Insufficiency of cardiac Qi

2.

3.

The symptoms commonly seen in deficiency of cardiac Qi are characterized by general hypofunction of the heart Pallor, shortness of breath, disinclination to talk, spontaneous sweating,lassitude, weakness, pale tongue, white tongue coat, and thready and weak pulse. Deficiency of cardiac Qi affects the function of the heart in housing the mind and then causes palpitation, anxiety, insomnia, and amnesia. Treatment: reinforce the cardiac Qi

b. Insufficiency of cardiac blood
 2. 3. 4. 5.

6. 

The main points for differentiation are the common symptoms of heart and the symptoms of blood deficiency. Deficiency of the heart blood causes failure in nourishing the mind, causing palpitation or anxiety. Disturbance of the mind due to deficiency of blood give rise to irascibility, insomnia and dreaming. If the brain marrow is malnourished, amnesia, dizziness, and blurring of vision may occur. The pale and lusterless complexion, and pale tongue and lips are due to deficiency of blood which causes failure in nourishing the part s of the body. The weak and thready pulse results from insufficiency blood in the vessels. Treatment: replenish the cardiac blood, tranquilize the mind

c. Excess of cardiac fire

2. 3. 4.

5. 

The main points for differentiation are the symptoms which show excess fire in the heart, tongue, pulse, and other related tissues. The heart houses the mind, once the mind is disturbed by fire, mental uneasiness, insomnia take place. Thirst, flushed face, dark color urine, and rapid pulse are all signs of internal heat. The heart open into the tongue, if the heart fire is hyperactivity and flare up, red tongue and oral ulcer may result. The heart control the blood vessels, in cases where fire is excessive, there will be blood extravasation. Treatment: dissipate cardiac fire

d. Phlegm confuses the mind

2. 3.

Mental disorder due to pathologic changes in which “phlegm” as pathologic product mingles and disturbs the mind. Depressive mental disorder Epilepsy

The main points for differentiation are loss of consciousness, rattle in the throat, and white and sticky tongue coat.  Signs of heat and deficiency should be excluded from consideration.

 Treatment:

resolve phlegm for resuscitation

e. Phlegm and fire disturb the mind

The main points for differentiation are the symptoms such as high fever, excessive phlegm, and loss of consciousness.

 Main

manifestations: raving, delirium, abusing or hitting people, flushed face, pink eyes, thirst, coarse breath, sleeplessness, red tongue with yellow thick coat.  Treatment: clear away the cardiac fire, resolve phlegm, open the cardiac portal

Pathologic changes of the lung

a. Deficiency of the pulmonary Qi

2. 3. 4.

5. 

The main points for differentiating deficiency of pulmonary Qi are feeble cough, short breath, and general hypofunction. Deficiency of Qi leads to cough wearily, shortness of breath, hush and feebleness. Deficiency of pulmonary Qi fails to disperse the defensive Qi to the muscle and skin, spontaneous sweat occurs. Since the defending function is hypoactive, the body is likely to attacked by exogenous pathogenic factors, and thus is susceptible to cold. Pale tongue with white coat, weak pulse are signs of Qi deficiency. Treatment: reinforce the pulmonary Qi

b. Deficiency of lung Yin

2. 3. 4. 5. 6. 7. 

The main points for differentiating deficiency of lung Yin are the common symptoms of lung diseases and symptoms of deficiency of Yin lead to internal heat. dry cough with little or no sputum, Afternoon fever is due to deficiency heat Night sweat results from disturbance of nutrient Yin by heat Malar flush is caused by flaring-up of deficiency heat In severe case, once the blood vessels of the lung are damaged, cough with bloody sputum occurs. Red tongue less moist, thready rapid pulse are of deficiency of Yin lead to internal heat. Treatment: enrich Yin, moisten lung

c. Pathogenic wind-cold attack the lung

2. 3. 4. 5. 6. 7. 

The main points for differentiating pathogenic wind-cold attack the lung are cough accompanied by the exterior symptoms of windcold. The invasion of body surface by wind-cold impairs the lung’s function in dispersing and descending, thus producing cough. Since cold pertains to Yin, the sputum is dilute and white. The dysfunction of lung in dispersing gives rise to nasal obstruction or runny nose. The obstruction of defensive Qi leads to aversion to cold. Because pathogenic factors have not been transmitted into interior, the tongue coat remain unchanged. Superficial pulse indicates exterior syndrome and tense pulse implies cold syndrome. Treatment: expel pathogenic wind-cold, promote dispersion function of lung.

d. Pathogenic wind-heat invades the lung
 2.

3. 4.

5. 6. 7. 

The main points for differentiating pathogenic wind-heat attack the lung are cough accompanied by the exterior symptoms of wind-heat. The invasion of body surface by wind-heat impairs the lung’s function in dispersing and descending, thus producing cough. Since heat pertains to Yin, the sputum is yellow and and thick. The dysfunction of lung in dispersing gives rise to nasal obstruction and thick and yellow nasal discharge. The obstruction of defensive Qi leads to aversion to cold. A thin and yellow tongue coat is a sign of the presence of heat. Superficial pulse indicates exterior syndrome and rapid pulse implies heat syndrome. Treatment: clear away the heat, dissolve phlegm, relieve cough, sooth asthmatic breathing.

Pathologic changes of the spleen

a. Deficiency of spleen Qi

2.

3.

4.

The main points for differentiating deficiency of spleen Qi are hypofunction of digestion and transportation and the symptoms of Qi deficiency. Loss of appetite, diarrhea, abdominal distention more remarkable after having meal, lassitude, sallow complexion, due to the descent of Qi in the middle Jiao, frequent urination, chronic diarrhea, prolapse of the rectum and of the uterus in woman, gastroptosis, dizziness; if the spleen fails to control blood, the following symptoms are often seen: hematuria, hemafecia, metrorrhagia, subcutaneous bleeding. Treatment: replenish spleen, reinforce Qi.

Pathologic changes of the liver

a. Depression of hepatic Qi

2.

3. 4.

The main points for differentiating depression of hepatic Qi are mental depression, distension and pain along the course of the liver meridian, and abnormal menstruation in females. Stagnation of liver Qi leads to retardation of Qi circulation, thus causing distending or wandering pain in the chest and hypochondrium, in the breasts, or in the lower abdomen. Stagnation of Qi impairs the function of the liver in promoting the free flow of Qi and blood, thus mental depression appear. Stagnation of Qi produces phlegm, which goes upward with the adverse Qi along the meridian, and then combines in the throat, hence goiter globus hystericus. Treatment: disperse the depressed hepatic Qi and sooth the liver.

b. Upward-flaming of hepatic fire

2. 3. 4. 5. 

The main points for differentiating upward-flaming of hepatic fire are symptoms caused by excess fire in the head, eyes, ears, and hypochondriac region, through which the liver meridians travels. The liver fire attacks the head along the meridian, headache, vertigo, flushed face, pink eyes will happen. When the liver fire attacks the ear along the meridian, tinnitus like the sound of waves may occur. The consumption of fluid by excessive heat results in constipation, red dark urine. Red tongue with yellow coat, wiry pulse are signs of excess fire in the liver meridian. Treatment: clear away the hepatic fire, sooth the liver.

c. Deficiency of liver blood

2.

3.

The main points for differentiating Deficiency of liver blood are the undernourishment of the tendons, nails, eyes, muscles, and skin by blood, and symptoms caused by general deficiency of blood. Deficiency of liver blood causes failure in nourishing the head and face and brings about dizziness and vertigo, as well as pale and lusterless complexion. And dryness of eyes, night blindness, spasm of tendons, numbness of limbs, failing of vision, in woman, irregular menstruation with scanty light discharge, pale tongue, thready pulse. Treatment: nourish the liver blood.

Deficiency of liver Yin

The main points for differentiating Deficiency of liver Yin are the symptoms of liver diseases and the symptoms caused by deficiency of Yin.

1.

2. 3. 4.

5. 6.

7.

Deficiency of liver Yin causes failure in nourishing the head and eyes and brings about dizziness, tinnitus, and dryness of the eyes. The flaring-up of deficiency-fire results in a sensation of heat on the face, flushed face. Dull pain in hypochondriac region, Steaming of deficiency-heat in the interior leads to feverish sensation in palms, soles, and chest, afternoon fever The disturbance of nutrient Yin by deficiency-fire creates night sweat Deficiency of Yin fluid leads to failure in nourishing the upper part of the body, thus dryness in the mouth and throat Red tongue less moist and wiry rapid pulse imply Yin deficiency.

 Treatment:

nourish liver Yin.

Rise of excessive liver Yang

The main points for differentiating Rise of excessive liver Yang are the symptoms of hyperactivity of liver Yang in the upper part of the body.

Main manifestation:
1.

2. 3.

4.

5.

The upward rushing of Qi and blood results in dizziness, tinnitus, extending pain in the head and eyes, flushed face, pink eyes. The loss of the liver’s softness leads to irritability and inclination to become angry. Undernourishment of the heart due to deficiency of Yin disturbs the mind, thus palpitations, amnesia, excessive dreaming, insomnia occur. The lumbar region is the place where the kidneys are located, and the knees are regarded as the residence of the tendons. Deficiency of Yin of the liver and kidney deprives the tendons of nourishment, hence soreness and weakness of the lumbar region and knees joints. Red tongue, wiry forceful pulse and wiry thready and rapid pulse.

Treatment: nourish Yin, sooth the liver, check Yang.

Pathologic changes of the kidney

Deficiency of kidney Yin

The main points for differentiating Deficiency of kidney Yin are the symptoms of kidney diseases and internal heat due to Yin deficiency.

 Deficiency

of kidney Yin leads to deficiencyheat, therefore, dizziness, tinnitus, emission, dry mouth, sore throat, amnesia, insomnia, constipation, in woman, scanty menstruation, amenorrhea, red tongue with little or no coat, rapid but thready and weak pulse appear.  Treatment: nourish kidney Yin

Deficiency of kidney Yang

2.

3. 4. 

The main points for differentiating Deficiency of kidney Yang are the general hypofunction associated with cold. The lumbar region is the place where the kidneys are located, and the kidney dominates the bones, kidney Yang, when deficient, may fail to warm up the lumbar region and bones, thus soreness and weakness of the lumbar region and knees joints result. If the kidney fails to warm up the skin, aversion to cold, cold limbs may occur. Pale tongue and weak pulse are signs of deficiency of kidney Yang and weakness of Qi and blood circulation. Treatment: mildly warm and invigorate kidney Yang

Three-Jiao
 In

the whole process of the transportation and transformation of water and food,  the three-Jiao dominates Qi transformation and Qi movement of the whole body.  And the book also advanced a viewpoint that "The three-Jiao exists in name only but is not the entity".

 Its

main functions are to pass various kinds of Qi and to serve as the pathway for body fluid.  It is divided into three parts:  upper Jiao  middle Jiao  lower Jiao

Upper Jiao
   

The upper Jiao refers usually to the part above the diaphragm, including the heart, lungs and head as well. Its main physiological function is to distribute essence-Qi throughout the body. In other words, in combination with the heart and the lung, the upper jiao distributes essence-Qi to the whole body to warm and nourish the skin and muscles, tendons and bones.

Middle Jiao

 

The middle Jiao refers mainly to the abdominal part between the diaphragm and umbilicus, and includes such Zang-Fu organs as the spleen, stomach, liver and gallbladder. Its main physiological functions are to decompose food and transform nutrient substances into Qi and blood, and to discharge the wastes and steam body fluid.

Lower Jiao
 The

lower Jiao refers, generally, to the portion located below the stomach,  including the small intestine, large intestine, kidneys, urinary bladder,etc.  Its main function is to discharge food residues and urine.

Conclusion
 In

short, the three Jiao dominates all kinds of Qi and Qi transformation of the human body, and serves as the pathway for water.  Therefore, Essential Questions says: "The three Jiao, as the waterways, is an organ in charge of the water circulation, flowing along the waterways."

The Physiologic and Pathologic Relations Among the Zang-Fu Organs

The heart and kidney under communication failure
     

Normal state Heart belongs to fire category Kidney belongs to water category They are communicating and regulating each other. Abnormal state: If heart Yang is excessive, which is known as “the excessive cardiac fire” and fails to descend to the kidney. The kidney water is insufficient and can not ascend to the heart, then it will lead to a breakdown of the normal physiologic coordination between heart and kidney.

The heart and kidney under communication failure

The main points for differentiating The heart and kidney under communication failure are hyperactivity

of cardiac fire and deficiency of kidney water.  Insomnia is the main symptom  Principle of treatment: nourish Yin, reduce fire.

Deficiency of both heart and spleen
     

Normal: spleen is the source of Qi and blood formation, and its function is to control blood. Heart control blood and vessels. Illness: Splenic Qi is deficiency, the blood formation will be reduced and become insufficiency. Deficiency of slpenic Qi fails to control the blood, then the blood may extravasate, and this may result in the depletion of cardiac blood.

Deficiency of both heart and spleen

The main points for differentiating Deficiency of both heart and spleen are palpitation, insomnia, sallow complexion, lassitude, anorexia, abdominal distension, loose stools, and chronic hemorrhage.

 Principle

of treatment: replenish both heart and spleen.

Depletion of both cardiac blood and liver blood
   

Normal: the heart governs blood and vessels the liver stores blood. Illness: if the liver has got not enough blood to store, or its blood storage function is impaired, then the amount of blood inside the vessels will become less, causing the depletion of cardiac blood and disorder of blood circulation, and finally it will lead to the depletion of both cardiac blood and liver blood.

Depletion of both cardiac blood and liver blood

The main points for differentiating Deficiency of both heart and spleen are the symptoms of heart and liver diseases, in addition to the symptoms of deficiency of blood.

 Principle

of treatment: nourish liver blood and cardiac blood.

Depletion of both pulmonary Qi and splenic Qi
 The

relationship between lung and spleen focus on the formation of Qi and body fluid, and the distribution of fluid.
The main points for differentiating Depletion of both pulmonary Qi and splenic Qi are cough, asthma, poor appetite, abdominal distention, and loose stools, in addition to the symptoms of deficiency of Qi.

 Principle

of treatment: reinforce spleen, resolve damp and phlegm, replenish lung.

Deficiency of both splenic Yang and renal Yang
 Normal:

spleen is the capital of the acquired constitution  kidney is the origin of the congenital constitution.  Abnormal: They are influencing each other.

Deficiency of both splenic Yang and renal Yang

The main points for differentiating Depletion of both pulmonary Qi and splenic Qi are cold pain of lumbar region and knee joints or the lower abdomen, chronic diarrhea, and edema, in addition to the cold syndrome.

 Principle

of treatment: mildly invigorate and warm kidney and spleen.

Deficiency of both liver Yin and kidney Yin
     

Normal: liver and kidney are from the same source, they are under mutual promotion. They are influencing each other, because of theirs “mother-child” relationship. Abnormal: Deficiency of liver Yin may affect kidney Yin, the disorder of son organ involves the mother If kidney Yin is insufficient and fails to nourish liver wood, then liver Yin may also become deficient, the disorder of mother organ affects son.

Deficiency of both liver Yin and kidney Yin

The main points for differentiating Deficiency of both liver Yin and kidney Yin are hypochondriac pain, burning sensation in the chest, palms, and soles, malar flush, night sweating, nocturnal emissions, oligomenorrhea, red tongue with little coating, and thready and rapid pulse.

 Principle

of treatment: enrich kidney water, replenish liver Yin.

Disharmony between liver and spleen
 

 

Normal: The discharge and free-flowing function of the liver are beneficial to the transportation and transformation functions of the spleen; On the other hand, if the transformation and transportation functions of the spleen are normal and Qi dynamic is free, it is helpful to the discharge and free-flowing functions of the liver. Abnormal If the discharge and free-flowing function of the liver are impaired and Qi dynamic is disturbed, then the transportation and transformation functions of the spleen may be affected The splenic transportation and transformation malfunction, cause Qi retardation in the middle and damp retention in the body, and lead to discharge and free-flow failure.

Disharmony between liver and spleen

The main points for differentiating Disharmony between liver and spleen are distension, fullness and wandering pain in the chest and hypochondriac region, irritability, poor appetite, abdominal distension, and loose stools.
Principle of treatment: sooth liver, promote spleen.

Incoordination between liver and stomach
     

normal: the function of the liver is to discharge and ensure free-flowing of Qi, while the function of stomach is to receive and to propel downward motion. The normal function of hepatic Qi is quite helpful to the downward motion of gastric Qi Abnormal: Disharmony of the liver and stomach often occurs when the stomach is rather poor and hepatic Qi is depressed, For the discharge and free-flowing impairment may affect the downward of motion of the gastric Qi

Incoordination between liver and stomach

The main points for differentiating Incoordination between liver and stomach are burning pain of the chest and hypochondrium, irritability, red eyes, bitter taste of the mouth.

 Principle

of treatment: sooth liver, harmonize

stomach.

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