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Kevin Dai L.Ac.

Development of TCM Internal Medicine
The Yellow Emperors Internal Classic

1. A whole conception is stressed

2. Ying-Yang & Five elements

3. Channels & Collaterals

4. Six Exopathic Factors, 7 emotions, diet, internal injuring

5. Four diagnostic methods

6. Therapeutic principles
1. Overeating the fat meat and fine grain can
cause the occurrence of abscesses.

2. Medical classics stated that excessive pattern
should be reduced, and deficient pattern should
be supplemented.

3. Slackness and weakness of the extremities
is caused by the inability of the spleen to spread
the essence.
Six Channel theory of Diagnosis & Treatment

--Determine therapy according to syndrome--
--Give recipe according to therapy--
--Prescribe drugs according recipe--
--Pay attention to influence on curative effect--

Famous formula: MangHuang Tang; GuiZhi Tang;
CaiHu Tang; LiZhong Tang; BaiHu Tang;
GeGengQingLian Tang
Treatise on Febrile Disease
Synopsis of Prescriptions of the Golden Chamber

-- Zhang Zhongjing (150-219 AD )
Sui & Tang Dynasties (581-907 AD):
Good medical education & Court medical school

Song, Jing & Yuan Dynasties (907 - 1368 AD):
Liu WanSu (1120-1200 AD) The theory of pathogenic fire
Zhang ZiHe (1151-1231 AD) Purgation Specialist
Li Gao (1180 - 1251 AD)
Speciality in warming & tonifying spleen and stomach
Zhu DanXi (1281-1358 AD) Tonifying Yin specialist

Ming Dynasty (1368-1644 AD)
Zhang JingYue (1563-1640 AD)
Yang is not usually redundant while the genuine Ying is often

Qing Dynasty (1632 - 1912 AD)
Wu YouKe (1582 - 1652 AD)
Epidemic Febrile Disease

1. Exopathic Factors:

a. Wind
Character: Moving & changeable;Prevails most widely; chief cause for
various disease & often combined with other pathogenic factor
Season: Spring
Attack: Upper Jiao; Yang meridian; Skin
Syndromes: coughing, stuffy or runny nose, headache, dizziness, and

b. Cold
Character: damage bodys yang Qi; cause pain & spasm symptoms
Season: Winter
Attack: skin; meridians & joints; directly attack the interior of the body
Syndromes: fever; avoid cold; headache; body pain; no sweating

C. Summer-heat
Character: Yang pathogen; damage bodys fluid;
Season: only happen in summer
Attack: upper jiao;
Syndromes: high fever; thirsty; big sweating; excess body heat, profuse
sweating, parched mouth and throat, constipation, and heart palpitations

d. Dampness
Characters: heavy & turbid; sticky and difficult to be removed
Season: long summer
Attack: usually attack downside of the body
Syndromes: take long time to be cured; sticky stools; bad appetite

e. Dryness
Characters: damage bodys fluids;
Season: Autumn
Attack: through mouth & nose; easily cause lung damage
Syndromes: fever; headache; less sweating; dryness of nose; coughing but
less phlegm or phlegm with blood

f. Fire
Characters: excess of Yang; damage body fluids; causing wind & hurt the blood
Other five pathogens could be transformed into fire pathogen
Season: any season
Attack: Heart & blood
Syndromes: irritated; coma; blood syndromes
2. Endopathic Factors
<A> Emotions

Qi Organs symptoms
Flow slowly heart Palpitations; over-excitability; insomnia; restlessness; talking a lot & a
red tip of the tongue; slow pulse (slightly overflowing but empty on the
left Front position)
Flow upword Liver Vomiting of blood & diarrhea; headache; tinnitus; dizziness; red face;
thirst; red tongue with red sides & bitter taster; Full & wiry pulse
Deplete Lung Weak voice; tiredness; pale complexion; slight breathlessness;
weeping & feeling of oppression in the chest; weak pulse
Kidney Palpitations; insomnia; night-sweating; dry mouth; a malar flush & a
rapid pulse
Knot Lung &
Lung: uncomfortable feeling of chest; tensing of shoulders; dry
cough; slight breathlessness; tight & wiry on lung pulse;
Spleen: poor appetite; slight epigastric discomfort; abdominal pain;
distension; tiredness;&pale complexion; slightly tight but weak on
spleen pulse
Disorder Kidney&
Kidney: Night sweating, dry mouth; dizziness; tinnitus;
Heart: Palpitations; breathlessness; insomnia; short & slippery pulse
Stagnate Kidney&
Uncomfortable feeling in the chest, epigastric or abdominal pain;
distension; a Fine pulse
<B> Five internal pathogenic factors

i: internal wind
cause: hyperactivity of Liver-Yang; deficiency of Yin & excess of phlegm-fire
Sym: dizziness; convulsion; syncope; numbness & muscle spasm
ii: internal cold
cause: deficiency of Qi & Yang
Sym: pain in the abdomen; diarrhea; cold limbs; weak pulse
iii: internal dampness
cause: overeating fatty diet; raw fruit, sweet & greasy food; external dampness
Sym: oppressed feeling in the chest; epigastric distention & stuffiness; nausea;
vomiting; scanty urine; loose stool; edema
iv: internal dryness
cause: depletion of blood fluid & blood after febrile disease; overtaking warm &
hot drugs, profuse sweating & excessive vomit and purgation
Sym: dry skin & eyes; thirst; dry throat; constipation; parched lips
v: internal fire
cause: hyper-function of 5 Zang organs; deficiency of yin-blood
Sym: insomnia; constipation; bitter taste; dizziness; headache; hematemesis;
yellow phlegm; dark urine; sore throat;
hectic fever; night-sweat; flushed checks; tinnitus; vexation & insomnia
<C> Diet
Overeating can impair the intestine & stomach
Cause dampness, phlegm, heat, parasitosis

<C> Retention of Phlegm & Fluid
Dysfunction of the lung, spleen & kidney

<D> Blood Stasis
Stagnation of Qi, Deficiency of Qi, Blood cold or heat, deficiency of
yin-blood, insufficiency of yang-qi and external injury

3. Non-endo-expopathic factors

<A> Excessive Fatigue or Leisure

<B> External Injury
(I) Six Principles

1. Exterior & Interior

(A) Exterior
Pathology: exterior pathogenic factors (wind & cold) attack
skin, muscle and the superficial portion of
meridians (Tai Yang)
Clinical Sym: Chills, fever, headache, general aching
Tongue: thin fur Pulse: superficial

(B) Interior
Pathology: transmission of exogenous pathogenic factors
to the interior of the body to affect zang-fu
organs or from the functional disturbances of
Zang-fu organs.
Clinical Sym: see Zang-fu organs theory
Tongue: Pulse

2. Cold & Heat

(A) Cold
Pathology: exogenous pathogenic cold or Deficiency of Yang
Clinical Sym: Pallor, aversion to cold, absence of thirst or
drinking a little hot drinks, loose stools, clear
urine increased in volume
Tongue: Pale body with white & moist coating Pulse: Slow & tight

(B) Heat
Pathology: exogenous pathogenic heat or Deficiency of Ying
Clinical Sym: Red complexion, fever, thirst with perference
for cold drinks, constipation
Tongue: Red body with yellow & dry coating Pulse Rapid

3. Deficiency & Excess

(A) Deficiency
Pathology: consumption of essential Qi cause deficiency
Clinical Sym: Emaciation, listlessness, lassitude, feeble breathing, dislike of
speaking, pallor, palpitations, shortness of breath, insomnia,
poor memory, spontaneous & night sweating, nocturnal
emission, nocturnal enuresis, pain alleviated by pressure
Tongue: Dry body with no or little coating Pulse Pulse of deficiency type

(B) Excess
Pathology: Hyperactivity of the pathogenic factor cause excess
Clinical Sym: Sturdiness, agitation, sonorous voice, coarse breathing,
distension and fullness in the chest and abdomen, pain
aggravated by pressure, constipation or tenesmus, dysuria

Tongue: Thick & Stick coating Pulse all excess type
II Qi & Blood theory

(A) Qi

(a) Deficiency of Qi
Pathology: weakness after long illnessbad nutrition
Clinical Sym: dizziness, blurring of vision, dislike of speaking,
lassitude, spontaneous sweating
Tongue: pale Pulse weak or thin

(b) Sinking of Qi
Pathology: due to weakness of Qi
Clinical Sym: prolapse of the anus or uterus, gastroptosis
Tongue: pale Pulse weak

(C) Stagnation of Qi

Pathology: mental depression; improper diet; invasion of
exogenous pathogenic factors; sprains & contusions
Clinical Sym: distension & pain
Tongue: Pulse string

(D) Perversion of Qi
Pathology: Lung, Stomach & Liver
Clinical Sym: coughing & asthma; belching, hiccups, nausea &
vomiting; headache, dizziness & vertigo, coma
Tongue: Pulse

(III) Zang-Fu Organs Theory

1. The Heart ( Small Intestine)
Pathology: disturbance of blood circulation & abnormality of thinking activities

Clinical Sym: Palpitation; cardialgia; amnesia; insomnia; spermatorrhea;
madness; coma; asthma; haematemesis; boil of tongue; hematuria

(1) Deficiency Syndrome:
(a) Heart-Yang (Qi) deficiency
Pathology: Heart-Qi defi & excessive mental activity
Clinical Sym: palpitation; asthma; oppressed feeling in the chest
+ Yang deficiency symptoms
Tangue: whitish & slip fur Pulse: thready & feeble
(b) Heart-Yin (blood) deficiency
Pathology: excessive mental activity damage the blood, depletion of yin-essence
Clinical Sym: heart symptoms + Yin deficiency
Tangue: scanty fur or dry red tongue tip Pulse: thready & fast

(2) Excessive syndrome:
(a) Mental disorder due to excessive Phlegm-fire
Pathology: long retention of damp phlegm to cause fire-transmission
Clinical Sym: + phlegm-fire symptoms
Tongue: red dry tongue & yellow fur Pulse slippery & rapid

(b) Stagnation of heart-blood
Pathology: stagnation of heart-blood & disorder of collaterals
Clinical Sym: +restlessness, prickling pain in the chest
Tongue: dark red with purple spot; scanty fur Pulse uneven

(C) Obstruction heart-yang due to Fluid Retention
Pathology: long retention of water in the chest
Clinical Sym: + oppressed feeling in chest, dizziness, vomiting,
Tongue: white & greasy fur Pulse slippery or deep&tense

2. Lung ( Large Intestine)

Pathology: insufficiency of Zong qi & dysfunctions n respiration,
dispersing & descending. First organ to be affected when

(1) Excessive
(a) Wind (cold / heat) invasion lung
Pathology: impairs lungs function in dispersing & descending;
disharmony of ying qi & wei qi
Clinical Sym: cough with sputum, watery nasal discharge, fever,
chills, headache; (/ thirst, sore throat, yellow phlegm)
Tongue: thin white coating or yellow Pulse superficial, tense or

(b) Retention of phlegm damp in the lung
Pathology: phlegm blocks the passage of qi & impairs lung qi
Clinical Sym: cough with phlegm, stuffiness in the chest, asthma
Tongue: white sticky coating Pulse rolling

(c) retention of phlegm heat in the lung
Pathology : invasion of wind cold turns into heat
Clinic sym: cough, asthmatic breathing, chest pain & yellow stick
sputum, dryness of the mouth & yellow urine, constipation
tongue: yellow stick coating Pulse: rolling, rapid


(d) Deficiency of lung qi
Pathology : prolonged cough or illness
Clinic sym: feeble cough, shortness of breath, clear sputum, lack of
desire to talk, low voice, aversion to wind
tongue: thin white coating Pulse: weak

(e) insufficiency of the lung yin
Pathology : prolonged cough which consumes the lung yin;
dryness damages yin;
Clinic sym: small amount of sputum, dryness, cough produces
blood tinged sputum + yin deficiency sym..
tongue: red body less coating Pulse: thready rapid

3. Spleen & Stomach

Pathology: dysfunction in transportation & transformation
Clinic Sym: poor appetite, abdominal distention & fullness, loose

(a) Deficiency of Spleen Qi
Pathology : prolonged illness; improper diet;
Clinic sym: sallow complexion, emaciation, lassitude, dislike of
speaking, prolapse of the anus
tongue: pale Pulse: slowing-down weak or soft

(b) Deficiency of Spleen Yang
Pathology : raw, cold, greasy & sweat food; herbs of cold nature;
Clinic sym: cold limbs; dull abdominal pain but prefer warmth &
tongue: pale Pulse: deep-slow

(d) Damp-cold invades spleen

Pathology : damp environment, raw & cold food,
Clinic sym: sticky saliva, heaviness of the head & body,
tongue: white sticky coating Pulse: soft

(e) Damp-heat in Spleen & Stomach

Pathology : exogenous pathogenic damp heat; greasy & sweat food;
alcoholic drinking;
Clinic sym: nausea, vomiting, bitter taste & stickiness in the mouse,
heaviness of the body, scanty yellow urine
tongue: yellow sticky coating Pulse: soft rapid

(f) Hyperactivity of fire in the stomach

Pathology : excessive eating of hot & greasy food; liver fire invasion
Clinic sym: burning sensation & pain; getting hungry easily; foul breath;
bleeding gums; constipation; scanty yellow urine
tongue: red body with yellow coating Pulse: rapid

4 Liver & Gallbladder

Pathology : in dysfunction of the liver in storing blood, promoting the free
flow of qi, and in disorders of the tendons
Clinic sym: pain in the costal & hypochondriac regions + digestion problems

(a) Stagnation of the liver Qi
Pathology : mental irritation
Clinic sym: depression; irritability; irregular menstruation & dysmenorrhea in
tongue: purplish dark or spots Pulse: string-taut

(b) excessive liver fire
Pathology :
Clinic sym: headache; dizziness; vertigo; redness, swelling & pain of the
eyes; bitter taste & dryness in the mouth; tinnitus like the sound of waves;
yellow urine & constipation
tongue: red body & yellow coating Pulse: string-taut rapid

(c) Rising of the liver yang
Pathology :
Clinic sym: distending headache; dizziness; vertigo; tinnitus; flushed face & red
eyes; irritability; insomnia; palpitations; poor memory; soreness & weakness of
the low back & knees
tongue: red body Pulse: string-taut thready rapid

(d) Insufficiency of the liver blood
Pathology : insufficient production of blood; prolonged illness
Clinic sym: pallor; dizziness & vertigo; blurring of vision; dry eye; night
blindness; numbness of limbs; spasms of the tendons; scanty menstrual flow;
tongue: pale Pulse: thready

(e) Damp heat in the liver & gallbladder
Pathology : Exogenous pathogenic damp heat; greasy food
Clinic sym: bitter taste in the mouth; scanty & yellow urine; yellow sclera & skin;
tongue: yellow sticky coating Pulse: string-taut rapid pulse

5. Kidney and Bladder
Pathology: Dysfunction in storing essence, disturbance in water
metabolism, abnormality in growth, development & reproduction
Clinic Sym: soreness & weakness of the lumber region & knee joints;
abnormal urination; dizziness; tinnitus

(a) Deficiency of the kidney Yang
Pathology : Constitutional deficiency of yang, or in old age,
prolonged illness; or to excessive sexual activity
Clinic sym: cold limbs; infertility;
tongue: pale body with white coating Pulse: deep weak pulse

(b) Insufficiency of Kidney Yin
Pathology :
Clinic sym: insomnia; poor memory; nocturnal emission; dry mouth;
afternoon fever; malar flush; night sweating; yellow urine; constipation
tongue: red body with little coating Pulse: thready rapid

IV Complicated Syndromes of Zang-Fu Organs

1. Disharmony between the Heart & lung
2. Deficiency of the qi of the lung & kidney
3. Deficiency of the Lung Yin & Kidney Yin
4. Deficiency of the Liver Yin & Kidney Yin
5. Deficiency of Spleen Yang & Kidney Yang
6. Deficiency of Lung Qi & Spleen Qi
7. Imbalance between Liver & Spleen
8. Disharmony between Liver & Stomach
9. Deficiency of both the heart & Spleen
10. Invasion of the lung by the liver fire