Heart Patterns
Differentiation and Treatment
Deficiency patterns
HEART-QI DEFICIENCY
Palpitations, shortness of breath on exertion, sweating, pallor, tiredness, listlessness. Tongue: Pale or normal color. Severe cases: midline crack reaching the tip with swelling on either side. Pulse: Empty. Severe cases: Overflowing and Empty (very superficial and somewhat pounding with light pressure but empty with heavier pressure). Key symptoms: palpitations, tiredness, Empty pulse.
HEART-YANG DEFICIENCY
Palpitations, shortness of breath on exertion, tiredness, listlessness, sweating, feeling of stuffiness or discomfort in the heart region, feeling of cold, bright-pale face, cold limbs (especially hands).
HEART-YANG COLLAPSE
Palpitations, shortness of breath, weak and shallow breathing, profuse sweating, cold limbs, cyanosis of lips, severe cases coma.
HEART-BLOOD DEFICIENCY
Palpitations, dizziness, insomnia, dreamdisturbed sleep, poor memory, anxiety, propensity to be startled, dull-pale complexion, pale lips. Tongue: Pale, Thin, slightly dry.
Palpitations, dizziness, insomnia, dreamdisturbed sleep, poor memory, anxiety, propensity to be startled, dull-pale complexion, pale lips, tiredness, weak muscles, loose stools, poor appetite, scanty menstruation. Tongue: Pale, Thin, slightly dry. Pulse: Choppy or Fine. Key symptoms: palpitations, insomnia, poor memory, Pale tongue.
HEART-YIN DEFICIENCY
Palpitations, insomnia, dream-disturbed sleep, propensity to be startled, poor memory, anxiety, mental restlessness, "uneasiness", "fidgetiness", malar flush, feeling of heat especially in the evening, night sweating, dry mouth and throat, 5-palm heat.
Tongue: Red, no coating, tip redder and swollen with red points, deep midline crack reaching the tip.
Pulse: Floating-Empty-Rapid or FineRapid. May be Overflowing in Front and Weak in Rear positions. Key symptoms: palpitations, mental restlessness, feeling of heat, malar flush, Red-Peeled tongue, deep midline crack.
Tongue: Red-Peeled, tip redder, midline crack reaching tip. Pulse: Floating-Empty, Rapid or Deep weak rear with front Overflowing. Key symptoms: palpitations, insomnia, night sweating, Red-Peeled tongue with redder tip and midline crack.
Excess patterns
HEART-FIRE BLAZING
Palpitations, thirst, mouth and tongue ulcers, mental restlessness, feeling agitated, "impulsiveness", feeling of heat, insomnia, red face, dark urine or blood in urine and bitter taste. Tongue: Red, tip redder and swollen with red points, yellow coating; may be midline crack reaching to the tip. Pulse: Full-Rapid-Overflowing especially on the left Front position. It could also be Hasty. Key symptoms: tongue ulcers, thirst, palpitations, Red tongue.
ulcers, pain in the throat, deafness, uncomfortable feeling and heat sensation in the chest, abdominal pain, thirst for cold liquids, scanty and dark urine, burning painful urination, blood in urine.
Tongue: Red with redder and swollen tip, yellow coating. Pulse: Rapid, Overflowing, especially in the Front position. Urinary symptoms, will be wiry in rear. Key symptoms: abdominal pain, tongue ulcers, scanty-dark-painful urination.
Tongue: Red, yellow-sticky coating, midline crack with yellow prickles in it. Tip may be redder and swollen with red points. Pulse: Full-Rapid-Slippery or Rapid-OverflowingSlippery or Rapid-Full-Wiry.
HEART-BLOOD STAGNANT
Palpitations, pain in the heart region which may radiate to the inner aspect of the left arm or to the shoulder, discomfort or feeling of oppression or constriction of the chest, cyanosis of lips and nails, cold hands. Tongue: Purple.
Pulse: Knotted.
Key symptoms: pain in the heart region, cyanosis of lips, purple tongue.
Liver Patterns
b. Melancholy, depression, moodiness, fluctuation of mental state, "feeling wound-up", feeling of lump in the throat. c. Irregular periods, painful periods, distension of breasts before the periods, pre-menstrual tension and irritability. Tongue: the body color may be normal, or with red sides. Pulse: Wiry, especially on the left side. Key symptoms: hypochondriac and chest distension, depression, moodiness, Wiry pulse.
LIVER-YANG RISING
Headache which may be on the temples, eyes or lateral side of the head, dizziness, tinnitus, deafness, dry mouth and throat, insomnia, irritability, feeling worked-up, shouting in anger.
Tongue: Red, especially on the sides, though may vary with underlying condition.
Pulse: Wiry.
Fullness and pain of hypochondrium, chest, DAMP-HEAT IN LIVER abdomen or hypogastrium, bitter or sticky taste,
nausea, vomiting, poor appetite, feeling of heaviness, yellow vaginal discharge, vulvar eczema or sores, mid-cycle bleeding or pain, pain-redness-swelling of scrotum, vaginal or genital itching or rashes, dark urine, dysuria, burning urination.
Tongue: Red body, sticky-yellow coating. Pulse: Slippery-Wiry-Rapid. Key symptoms: fullness in abdomen and hypochondrium, feeling of heaviness, nausea, bitter or sticky taste, sticky yellow coating, Slippery pulse.
STASIS OF LIVER-BLOOD
Vomiting of blood, epistaxis, painful periods, irregular periods, menstrual blood dark and clotted, abdominal pain, "masses" in abdomen, purple nails, purple lips, purple complexion, dry skin (in severe cases), petechiae. Tongue: Purple especially on the sides, with purplish spots. Pulse: Wiry. Key symptoms: dark and clotted menstrual blood, Purple tongue.
Fullness and distension of the hypogastrium with pain which refers to the scrotum and testis. Straining of the testis or contraction of the scrotum. In women there can be shrinking of the vagina. The pain is alleviated by warmth.
Deficiency Patterns
DEFICIENCY OF LIVERBLOOD
Dizziness, numbness of limbs, insomnia, blurred vision,"floaters" in eyes, scanty menstruation or amenorrhea, dull-pale complexion, pale lips, muscular weakness, muscle spasms, cramps, withered and brittle nails, dry hair and skin.
Tongue: Pale especially on the sides which can assume an orange color, and Dry.
Pulse: Choppy or Fine. Key symptoms: blurred vision, scanty periods, dull-pale complexion, Pale tongue.
LIVER-YIN DEFICIENCY
Dizziness, numbness or tingling of limbs, insomnia, blurred vision,"floaters" in eyes, diminished night vision, scanty menstruation or amenorrhea, dull-pale complexion without luster but with red cheekbones, muscular weakness, cramps, withered and brittle nails, very dry hair and skin, depression, feeling of aimlessness.
Tongue: normal color, no coating or with rootless coating.
Tongue: Normal or Red with rootless or no coating. Pulse: Floating-Empty (or Choppy). Key symptoms: dry eyes, dry throat, night sweating, scanty menstruation, Red-Peeled tongue.
Deficiency/Excess Patterns
LIVER-WIND
The general clinical manifestations of LiverWind are: tremor, tic, numbness, dizziness, vertigo, headache and convulsions or paralysis.
Internal Wind signs are characterized by movement or the absence of it, hence the tremor and convulsions or paralysis (as in Wind-stroke).
b) LiverYang Rising deriving from Liver and Kidney-Yin Deficiency same as above but with backache, scanty urine, night sweats Tongue: Normal colored without coating Pulse: Wiry-Fine
Lung Patterns
DSY class 4
Deficiency Patterns
LUNG-QI DEFICIENCY
Slight shortness of breath, slight cough, weak voice, spontaneous daytime sweating, dislike of speaking, bright-pale complexion, propensity to catching colds, tiredness, dislike of cold. Tongue: Pale.
Shortness of breath on exertion, rapid and weak breathing, difficulty in inhaling, cough, asthma, sweating, cold limbs, cold limbs after sweating, swelling of the face, thin body, mental listlessness, clear urination during asthma attack, soreness of the back.
Tongue: Pale. Pulse: Weak, Tight, Deep. Key symptoms: shortness of breath on exertion, sweating, clear urination.
LUNG-YIN DEFICIENCY
Cough which is dry or with scanty sticky sputum, weak and/or hoarse voice, dry mouth and throat, tickly throat, tiredness, dislike of speaking, thin body or chest, night sweating. Tongue: Normal color, dry without coating or rootless coating in front. Pulse: Floating-Empty and Rapid.
Key symptoms: dry cough, weak-hoarse voice, dry throat, night sweating.
Excess Patterns
Tongue: slightly Red on the sides or tip, possibly thin white or yellow coating. Pulse: Floating-Rapid. Key symptoms: Fever, aversion to cold, sore throat, Floating-Rapid pulse.
Tongue: White-sticky coating. Pulse: Floating-Slippery. Key symptoms: sudden swelling of face, aversion to Wind, Floating-Slippery pulse.
LUNG HEAT
Cough, slight breathlessness, feeling of heat, chest ache, flaring of nostrils, thirst, red face. Tongue: Red with yellow coating. Pulse: Overflowing-Rapid. Key symptoms: cough, feeling of heat, thirst, red tongue with yellow coating.
Tongue: Red, redder on the sides, swollen in the front part, yellow coating. Pulse: Wiry and Slippery. Key symptoms: breathlessness, asthma, fullness of hypochondrium, headache, Wiry pulse.
Barking cough, profuse sticky yellow or green sputum, shortness of breath, wheezing, feeling of oppression of the chest, feeling of heat, thirst, insomnia, agitation, dizziness and heaviness of the head.
Tongue: Red, swollen, thick-sticky yellow coating. Pulse: Slippery-Rapid-Full. Key symptoms: cough, yellow or green sputum, thick-sticky yellow coating, RapidSlippery pulse.
Cough with expectoration of whitewatery sputum, aggravated by exposure to cold, cold feeling, cold hands, phlegm in the throat, dizziness, feeling of oppression and/or cold in the chest, feeling of heaviness, heaviness in the head. Tongue: Swollen, wet with sticky white coating.
Pulse: Slippery-Slow.
Spleen Patterns
DSY class 5
Deficiency patterns
SPLEEN-QI DEFICIENCY
Poor appetite, abdominal distension after eating, tiredness, lassitude, desire to lie down, pale complexion, weakness of the limbs, loose stools, depression, tendency to obesity.
Tongue: Pale.
Pulse: Empty. Key symptoms: Poor appetite, tiredness, loose stools.
SPLEEN-YANG DEFICIENCY
Poor appetite, slight abdominal distension after eating, tiredness, lassitude, desire to lie down curled up, pale complexion, weakness of the four limbs, loose stools, edema, feeling cold, cold limbs. Tongue: Pale, wet. Pulse: Weak, Deep. Key symptoms: loose stools, feeling cold, cold limbs and tiredness.
SPLEEN-QI SINKING
Any of the symptoms and signs of Spleen-Qi deficiency with the addition of: bearing down sensation in the abdomen, prolapse of stomach, uterus, anus or vagina, frequency and urgency of urination, menorrhagia.
Tongue: Pale. Pulse: Weak. Key symptoms: bearing down sensation, Weak Pulse.
Tongue: Pale.
Pulse: Weak or Fine. Key symptoms: Fine Pulse, Pale tongue and bleeding.
Excess Patterns
DAMP-HEAT INVADING THE SPLEEN Fullness of epigastrium & lower abdomen, poor
appetite, feeling of heaviness, thirst without desire to drink, nausea, vomiting, loose stools with offensive odor, burning sensation of the anus, scanty dark-yellow urination, feeling of heat, low-grade fever, dull headache with heaviness of the head, yellow complexion, yellow sclera of eyes, oily sweat, bitter taste, itchy skin or skin eruptions, sweating which does not reduce fever.
Tongue: Red, sticky-yellow coating. Pulse: Slippery-Rapid. Key symptoms: abdominal fullness, feeling of
Combined Patterns
SPLEEN-(QI) AND HEARTBLOOD DEFICIENCY Palpitations, dizziness, insomnia, dreamdisturbed sleep, poor memory, anxiety, propensity to be startled, dull-pale complexion, pale lips, tiredness, weak muscles, loose stools, poor appetite, scanty menstruation.
Tongue: Pale, Thin, slightly dry. Pulse: Choppy or Fine. Key symptoms: palpitations, insomnia, poor memory, Pale tongue.
Kidney Patterns
DSY class 6
Tongue: Pale, Wet. Pulse: Deep-Weak. Key symptoms: cold in the back, abundant-clear urination, Pale tongue, Deep Pulse.
KIDNEY-YANG DEFICIENT, WATER OVERFLOWING Edema especially of legs and ankles, cold
feeling in legs and back, fullness and distension of abdomen, soreness of lower back, feeling cold, scanty-clear urination.
1. Water overflowing to the Heart: the above symptoms plus palpitations, breathlessness, cold hands. 2. Water overflowing to the Lungs: the above symptoms plus thin-watery-frothy sputum, cough, asthma and breathlessness on exertion.
Shortness of breath on exertion, rapid and weak breathing, difficulty in inhaling, cough, asthma, sweating, cold limbs, cold limbs after sweating, swelling of the face, thin body, mental listlessness, clear urination during asthma attack, soreness of the back.
Tongue: Pale. Pulse: Weak, Tight, Deep. Key symptoms: shortness of breath on exertion, sweating, clear urination.
Malar flush, mental restlessness, nightsweating, low-grade fever, afternoon fever, feeling of heat in the afternoon/evening, insomnia, scanty-dark urine, blood in the urine, dry throat especially at night, thirst with desire to drink in small sips, lower backache, deafness, tinnitus, nocturnal emissions with dreams, excessive sexual desire, dry stools. Tongue: Red-Peeled, cracked, red tip. Pulse: Floating-Empty, Rapid. Key symptoms: malar flush, mental restlessness, dry throat at night, feeling of heat
In adults: softening of bones, weakness of knees and legs, poor memory, loose teeth, falling hair or premature greying of hair, weakness of sexual activity, lower backache, infertility (M/F), dizziness, tinnitus, dull mental function. Tongue: Pale (Yang xu) or no coating (Yin xu). Pulse: Floating-Empty or Leather. Key symptoms: children: poor bone development; adults: weak knees, falling hair,
COMBINED PATTERNS
Tongue: Normal or Red with rootless or no coating. Pulse: Floating-Empty (or Choppy). Key symptoms: dry eyes, dry throat, night sweating, scanty menstruation, Red-Peeled tongue.
Stomach Patterns
DSY class 7
Deficiency patterns
Sudden pain in the epigastrium, feeling cold, preference for warmth, vomiting of clear fluid, feeling worse after swallowing cold fluids which are quickly vomited, preference for warm liquids. Tongue: thick-white coating. Pulse: Deep, Slow, Tight. Key symptoms: sudden pain in epigastrium, vomiting, feeling cold, Deep-Tight Pulse.
STOMACH-YIN DEFICIENCY
No appetite or slight hunger with no desire to eat, constipation (dry stools), dull or slightly burning epigastric pain, dry mouth and throat especially in the afternoon, desire to drink in small sips, slight feeling of fullness after eating.
Tongue: Peeled in the centre, or with coating "without root" Pulse: Floating-Empty on the right Middle position.
Burning epigastric pain, intense thirst with desire to drink cold liquids, excessive hunger, mental restlessness, swelling and pain in the gums, bleeding gums, sour regurgitation, dry stools, nausea, vomiting soon after eating, bad breath, feeling of heat. In case of Phlegm-Fire: feeling of oppression of epigastrium, less thirst, mucus in stools, expectoration of phlegm, mental derangement.
Tongue: Red center, yellow-dry coating (in case of Phlegm-Fire: yellow-sticky coating).
Pulse: Rapid Overflowing right middle position (in case of PhlegmFire: Slippery, Overflowing, Rapid). Key symptoms: burning sensation in epigastrium, thirst with desire to drink cold liquids, thickyellow coating, Red tongue.
Fullness and pain of the epigastrium, feeling of heaviness, facial pain, blocked nose or thick sticky nasal discharge, thirst without desire to drink, nausea, feeling of heat, yellow complexion, sticky taste. Tongue: Red, sticky-yellow coating. Pulse: Slippery-Rapid. Key symptoms: epigastric fullness, feeling of heaviness, nausea, sticky-yellow coating.
Tongue: Red with redder and swollen tip, yellow coating. Pulse: Rapid, Overflowing, especially in the Front position. Urinary symptoms, will be wiry in rear. Key symptoms: abdominal pain, tongue ulcers, scanty-dark-painful urination.
Tongue: thick coating (which could be white or yellow). Pulse: Full, Slippery. Key symptoms: epigastric fullness, sour regurgitation, thick coating.
Tongue: Purple.
Pulse: Wiry. Key symptoms: stabbing pain in the epigastrium, vomiting of dark blood.