Journal of Acuherb in Medicine


Huang Di Nei Jing (the yellow emperor internal classics)

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The concept of four Chinese medical diagnosis methods originated from Huang Di Nei Jing (the yellow emperor internal classics)
Which book especially mentioned feeling pulse at Cun Kou (radial pulse) Nan Jing (difficult classics)
In Jin Dynasty, who was the first one mentioning about 24 kinds of pulse Wang Shu He
Who wrote “Shi Wen Gou” (Ten Inquiring song) Wang Shu He
The first Book about tongue diagnosis is Ou shi yan she fa (master ou methods of examining tongue)
Which book did mention about observing venules at index finger of child below 2 years old in order to diagnose disease You you xin shu (a new book on pediatrics)
Shen is specially manifested on Eyes
A patient hasliver disease, which complexion indicates MORE GOOD at better prognosis BLACK
A patient has iritis, which indicates disease of the LIVER
Dry, wither and black ear lobes indicate KIDNEY QI EXHAUSTION
Examination of venules on the index fingers is for diagnosing children under age of 2
Venules appear beyond the gate of wind Mild case * Exterior syndrome
If the venules extend beyond the gate of life, this indicated Life-threatening disease
A red color of canthus indicates disease of the Heart
Green or blue tip of nose indicates Abdominal pain
Swelling and pain in the ear with yellow and thick discharge indicates Damp heat
If the teeth are dry and grayish or white like bone indicates Kidney yin xu with empty fire
A patient has liver disease, in spring, his condition should be Fair
A patient has heart disease which complexion indicates less good at better prognosis Yellow
A patient has spleen disease, which complexion indicates less bad at Worse prognosis Black
A patient has kidney disease, which complexion indicates more bad WORSE prognosis Yellow
A thin and emaciated body usually indicates Deficiency of blood * Empty fire
A fat body usually indicates Deficiency of spleen yang * Retention of dampness or phlegm
Prematurely gray hair indicates Decline of kidney essence
Qi edema (no mark is left on the swollen skin by pressure of a finger) indicates Qi stagnation
A bright and clear yellow skin color (yang jaundice) is due to Damp heat
A dull-yellow skin color (yin jaundice) is due to Damp cold
Skin eruption lesions discrete, progress from macula to papule to vesicle to crusting due to virus infection is Chicken pox
A child has fever for three days, with cough, conjunctivitis, kopliks spots on mouth, red vein on the back of ear and cold at root of ear, and maculopapular around ears, on face and neck and body Measles
A skin eruption begins at puberty and due to hormones and bacteria (heat in the blood) Acne
A superficial cellulitisdue to heat toxin and appears mostly on leg with pain and swollen Erysipelas
Skin disease with red, swelling, hot and pain is Yong (swelling abscess)
The skin disease due to qi and blood xu, or cold accumulation in the body is Ju (flat abscess)
The skin due to liver fire, or damp-heat at the LIV / GB and mostly at the waist, chest & hypochondria is Herpes zoster
Clear thin and white sputum Cold phlegm
White, big qty, easily expectorated sputum Damp phlegm
Yellow and thick sputum Heat phlegm
Saliva dripping from mouth corners and worse at night is SPLEEN deficiency
A lot of spittle is Kidney deficiency
Turbid vomiting product with foul smelling Heat at stomach
Yellow and green vomiting product with bitter taste is Liver attacking stomach
Tongue body indicates condition of yin organs
Tongue coating indicates condition of yang organs
Tongue moisture indicates condition of body fluids
Normal Tongue is NOT Pale and tender
Pale, swollen body w/ teeth marks with white coat yang xu
Pale and thin body with thin white coat xue xu
Red tongue with scant coat yin xu
Reddish-purple heat and blood stasis
Red with lots of red thorns on the sides liver heat
Healthy person can also have Cracked
Red tongue with long deep midline crack reaching the tip with yellow coat HEART HEAT
Red and thin body and mirrored ST Yin Xu
Deviated internal wind
Bluish purple with black spots toward the middle section blood stasis at chest
Pale with teeth marks and thin white coat SP qi xu
Red tongue with yellow thick greasy coat heat phlegm
Pale purple with grey and black moist coating indicates extreme cold
Red with grey and black dry coating indicates extreme heat
Geography tongue coating indicates ST qi and yin xu
Turbid greasy coat like bean curds food stagnation
Exterior syndrome which of the following is the most important Chills
Which indicates the exterior syndrome Chills and fever
Which indicated the interior heat syndrome Fever without chills
Which indicated the interior cold syndrome Chills without fever
Which indicated the shao yang syndrome Alternate chills and fever
A patient has more chills than fever, no sweating, thin white coating and superficial and tight pulse exterior wind Cold
A patient has chills that are alleviated by covering himself up, a pale swollen tongue with teeth marks and thin white and slippery coating and deep weak slow pulse interior xu cold
Constant high-grade fever, a lot of sweating with constipation and red tongue with yellow thick dry coat interior shi heat
Low grade fever getting worse in the afternoon or night or only occurring in the afternoon indicates yin xu
Constant low-grade fever that does not drop after sweating indicates damp-heat
A fever with spontaneous sweat and lassitude indicates qi xu
Yin xu syndrome often companies with night sweating
HT & KID yin xu can especially have sweating at the palms and soles
Which sweating can indicated turning point of disease process zhan han (sweating following shivering)
Oily sweat on forehead, or profuse cold sweat or pearl-like drop sweat with cold extremities during a severe illness indicates collapse of yang
Sticky greasy and profuse sweating with warm body and extremities indicated collapse of yin
Sweating appearing in the day time indicates yang xu
Distending headache is due to Liver yang rising
Heavy abdominal pain with thick and greasy coating is due to dampness
Stabbing chest pain with a purplish tongue is due to blood stasis
Dull pain all over with feeling of tiredness is due to qi and xue xu
Fixed joint pain with swelling, heavy and numbness indicates dampness
Wandering joint pain from joint to joint indicates wind
Fixed and very painful joint cold
Hot and swelling joint paint indicates heat
Severe dizziness when everything seems to sway and the person loses balance due to internal wind
Severe lower back pain aggravated during cold and damp weather, alleviated by application of heat is due to external wind and damp
Continuous and dull lower back pain is due to KID xu
Sudden onset of tinnitus, aggravated by pressing ears and a red tongue with yellow coat indicates liver fire
Insomnia in the sense of not being able to fall asleep with soreness and weakness at the lower back, night sweats, and poor memory disharmony between HT & KID
Insomnia in the sense of waking up many times during the night with poor appetite, lassitude, and loose stool indicates SP & HT xu
Insomnia in the sense of waking up during the night with scaring, palpitation, anxiety and bitter taste in the mouth indicates disorder of the GB
Insomnia in the sense of restless sleep during the night with epigastrium and abdominal distention and this greasy coating indicates retention of food
Falling asleep after eating indicates SP qi xu
A general somnolence with heavy sensation of body and greasy and white coating indicates retention of dampness
Extreme somnolence with lassitude and cold body and limbs indicates KID yang xu
Alternation of constipation and diarrhea indicates LIV overacting on SP
Cock-crow diarrhea or early morning diarrhea indicates KID and SP yang xu
Constipation with small, bitty stool like goat’s stools indicates LQS & heat in the LI
Diarrhea with mucus in the stool and tenesmus indicates damp heat in the LI
Enuresis or incontinence of urine or very frequent and copious urination indicates kidney xu
White leucorrhea with no smell indicates Damp cold and SP qi xu
Painful urination and difficult urination with blood or hot sensation indicates damp heat in UB
A yellow leucorrhea with foul smelling indicates damp heat in the uterus
A yellow leucorrhea with pus and blood in a woman after menopause indicates toxic damp heat in the uterus (cancer)
Vomiting during pregnancy indicates disorders of ST and Chong meridians
Miscarriage with dizziness, tinnitus, and lower back pain indicates KID xu
A heavy menstruation with thirst and feverish body indicates heat in the blood
A child with five retardation indicates KID xu
Overall examination (head, upper and lower limbs) of the pulse diagnosis comes from the Huang Di Nei Jing
Cun Kou (wrist Pulse) of the pulse diagnosis comes from the Nan Jing
Left wrist pulse diagnosis is for (qi or blood) BLOOD
Cun (near wrist crease) Left wrist pulse diagnosis is for (qi or blood) HT
Guang (middle) Left wrist pulse diagnosis is for (qi or blood) LIV
Chi (most proximal) Left wrist pulse diagnosis is for (qi or blood) KID (UB & SI)
Right wrist pulse diagnosis is for (qi or blood) QI
Cun (near wrist crease) Right wrist pulse diagnosis is for LU
Guang (middle) Right wrist pulse diagnosis is for SP
Chi (most proximal) Right wrist pulse diagnosis is for KID (UB & LI)
Push deeper into the wrist pulse to check condition of the zang organs
Push more shallow into the wrist pulse to check condition of the fu organs
Position of patient for pulse diagnosis sitting or laying down (use pillow under wrist)
Spring affects the pulses by slightly wiry (LIV GB)
Summer affects the pulses by speeds up (rapid due to HT fire)
Autumn affects the pulses by Floating (LU is superficial)
Winter affects the pulses by slow and deep
Men’s pulse is strong and slower
Woman’s pulse is Weak and fast
Student weak and wiry
Construction strong
Mountains affects the pulses by slow and tight (due to cold)
Desert affects the pulses by speeds up
Being younger affects the pulses b faster
Being older affects the pulses by slower
Being skinny thready and rapid (empty fire)
Being heavy affects the pulses by slow and slippery
Being angry affects the pulses by rapid and wiry
The Pulse is not superficial, not deep, not fast, not slow, 4 beats per on breath in and out, Consistent, regular, soft, calm good ST qi
The pulse is soft, vessels shouldn’t be big or small good spirit (HT)
Pulse could be detected at the regular positions good root (Kidney
When touching the wrist pulse – gently touching skin, you get a clear picture of pulse & when heavy force is used, pulse becomes weaker “Wood on water” (Skin level) Superficial Pulse (Fu Mai)*
Indication of Superficial Pulse (Fu Mai)* exterior syndrome
When touching the wrist pulse you feel stone on water (deeper level) Deep pulse (Chen Mai)*
Indication of Deep pulse (Chen Mai)* interior syndrome
When touching the wrist pulse you feel less than 4 beats for one breath in and out Slow Pulse (Chi Mai)*
Indication of Slow Pulse (Chi Mai)* Cold
When touching the wrist pulse you feel more than 4 beats for one breath in and out Rapid Pulse (Shu Mai)*
Indication of Rapid Pulse (Shu Mai)* Heat
When touching the wrist pulse you feel all three positions are weak Empty pulse (Xu Mai)*
Indication of Empty pulse (Xu Mai)* Xu
When touching the wrist pulse you feel all three positions are strong Full pulse (Shi Mai)*
Indication of Full pulse (Shi Mai)* Shi
When touching the wrist pulse you feel very smooth like water on the floor “pearls on plate” (mostly middle level) Slippery/ Rolling pulse (Hua Mai)*
Indication of Slippery/ Rolling pulse (Hua Mai)* damp Phlegm water retentionPregnancy excess heat food stagnation
When touching the wrist pulse you feel Stopping, not smooth (middle level) Hesitant pulse (Se mai)*
Indication of Hesitant pulse (Se mai)* Blood Stagnation or stasis * severely damaged body fluids, essence & yin
When touching the wrist pulse you feel extends past the index and ring finger Long Pulse (Chang Mai)
Indication of Long Pulse (Chang Mai) excess and heat
When touching the wrist pulse you feel shorter than the index and ring finger Short pulse (Duan Mai)
Indication of Short pulse (Duan Mai) cold
When touching the wrist pulse you feel sea waves – comes in strong, fades weakly (mostly middle level) Surging (over flowing) Pulse (Hong Mai)*
Indication of Surging (over flowing) Pulse (Hong Mai)* Stomach heat or yang ming syndrome
When touching the wrist pulse you feel Thin and fine Thready (thin or fine) pulse (Xi Mai)*
Indication of Thready (thin or fine) pulse (Xi Mai)* Xu (qi, xue, yin, and yang), retention of water or damp (usually with edema)
When touching the wrist pulse you feel very thready very soft if you push softly, it disappears Minute Pulse (Wei mai)
Indication of Minute Pulse (Wei mai) severe Xu
When touching the wrist pulse you feel like twisted ropes – short and constricted Tense (Tight) Pulse (Jin Mai)
Indication of Tense (Tight) Pulse (Jin Mai) cold & pain
When touching the wrist pulse you feel like string instruments – straight and long String-taught (wiry) pulse (Xuan Mai)
Indication of String-taught (wiry) pulse (Xuan Mai) Liver Qi Stagnation GB disordersPain retention of the damp and phlegm obstructing qimalaria *
When touching the wrist pulse you feel Sluggish but not SLOW yet Slow-down pulse (Huan Mai)
Indication of Slow-down pulse (Huan Mai) SP xu, Early condition of damp
When touching the wrist pulse you feel Big and Empty (fresh green onion stalks) Hollow pulse (Kou Mai)
Indication of Hollow pulse (Kou Mai) essence, blood and Yin xu
When touching the wrist pulse you feel empty drum (empty inside) Leather pulse (Ge Mai)
Indication of Leather pulse (Ge Mai) loss of blood or essence (post natal or post abortion)
When touching the wrist pulse you feel Very Very Deep (can touch the bone deep*) Firm pulse (lao mai)
Indication of Firm pulse (lao mai) cold or severe diseases (cancer)
When touching the wrist pulse you feel on the superficial level Soft (weak-floating) pulse (Ru Mai)*
Indication of Soft (weak-floating) pulse (Ru Mai)* Qi xu, Yang Xu, Blood Xu
When touching the wrist pulse you feel deep thready and weak (deeper level) Weak pulse (Ruo Mai)*
Indication of Weak pulse (Ruo Mai)* internal xu
When touching the wrist pulse you feel no root, superficial, fast Scattered pulse (san Mai)*
Indication of Scattered pulse (san Mai)* severe xu of source qi (KID qi exhaustion)
When touching the wrist pulse you feel cannot find the pulses easily (very deep) Hidden Pulse (Fu Mai)
Indication of Hidden Pulse (Fu Mai) Severe pain, or extreme yin shi/ extreme yang shi
When touching the wrist pulse you feel jumping beans under finger Moving pulse (Dong Mai)
Indication of Moving pulse (Dong Mai) shi, heat, wind, sudden fright
When touching the wrist pulse you feel one breath in, one breath out with 7-8 beats Hasty Pulse (Ji Mai)
Indication of Hasty Pulse (Ji Mai) severe tachycardia (yin/yang separation), extreme heat
When touching the wrist pulse you feel Slow, irregular missing beats Knotted Pulse (Jie Mai)
Indication of Knotted Pulse (Jie Mai) HT – spirit (cold with blood stasis or qi stagnation)
When touching the wrist pulse you feel fast irregular missing beats Abrupt (hurried) pulse (Cu Mai)
Indication of Abrupt (hurried) pulse (Cu Mai) excess heat with qi and xue stagnation
When touching the wrist pulse you feel slow regularly missing beats Regularly intermittent pulse (Dai Mai)
Indication of Regularly intermittent pulse (Dai Mai) cold or xu (HT qi xu) early stages of heart failure
Superficial + slow down pulse exterior syndrome with SP qi xu
Wiry + slippery + cu mai (fast irregular missing beats) pulse liver fire with qi & blood stagnation
Thready + rapid pulse yin xu with heat
Tight + wiry pulse cold with LQS
Wiry + slippery + rapid pulse Liver Damp Heat
Menstrual pulse slippery during, thready after
Pregnancy pulse Slippery (amnion fluid and baby is a “phlegm ball”)
Giving birth pulse Tight and rapid (pain)
Dead fetus pulse (sad pulse) wiry, choppy or firm (stagnation)
Palpation of skin Diagnosis external or internal (LU)
Palpation of hands, feet, and limbs Diagnosis condition of the SP
Palpation of the chest – xu li Heart beat (Zong Qi)-condition of respiration and blood circulation (HT & LU)
Bloated and hard epigastrium (dislikes touch) excess
Bloated and hard epigastrium (likes touch) xu
Palpation of the abdomen above the umbilicus (Da Fu) SP & ST
Palpation of the abdomen below the umbilicus (Shao Fu) SI & LI
Palpation of the abdomen the sides of the umbilicus (Ce Fu) LIV, LI, GB, KID
Palpation of Special acupuncture points – five shu points, back shu points, front mu, Yuan source, xi cleft points, luo connecting Condition of zang fu organs according to Patients reaction to palpating
In pulse diagnosis, cun (front) position indicates qi, upper jiao, heart-lung
In pulse diagnosis Guan (middle) position indicates blood, middle jiao, ST/SP
In pulse diagnosis Chi (rear) position indicates yin, lower jiao, kidneys
In spring the pulse is usually wiry
In winter the pulse usually is deep
The normal pulse has quality of having ST qi, Spirit & root (all of them)
The pulse being soft, gentle, calm, and 4 beats per respiratory cycle indicates having stomach Qi
The pulse being soft but with strength, neither big or small and regular indicates having Spirit
Superficial, tight and slippery pulse indicates wind-cold-dampness
Rapid and slippery pulse indicates damp heat
Superficial and rapid pulse indicates wind heat
Superficial and tight pulse indicates wind cold

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