heat – American Institute of Acupuncture

Systemic Lupus Erythematosus

acuherb — Wed, 22 Aug 2012 18:36:43 +0000

By Dr. Kenneth Wang

Systemic lupus erythematosus (SLE) is a chronic, inflammatory disorder ofÂ connective tissueÂ that usually arises without obvious cause and is regarded as anÂ autoimmune disease. It affects many different organ systems of the body and varies in severity between patients and, over time, within the same patient.

Typical features of SLE are a symmetrical red rash to the face, arthritis and progressive damage to the kidneys.

Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect the joints and many organs of the body, commonly the skin and kidneys. The disease course can range from mildly episodic to severe, and can be fatal. Symptoms vary from individual to individual and are characterized by remission and exacerbation. The complex presentation of the disease can make diagnosis difficult.

No definitive term exists for SLE in the ancient Chinese medical classics. Individuals are diagnosed with different syndromes according to the presentation of symptoms and are treated according to the disharmony patterns displayed under these syndromes.

	Symptoms of fever and skin rash are diagnosed asÂ yin-yang poisoning,Â Prurigo, itching dermatitis of the face, cheek sores and solar dermatitis syndromes.
	Joint pain, muscle pain andÂ Raynaud’s phenomenonÂ are classified asÂ bi-syndrome.
	Heart involvement, causing symptoms of palpitations and shortness of breath, is referred to asÂ palpitationÂ syndrome.
	Nervous system symptoms are grouped asÂ hysteriaÂ syndrome.
	Symptoms resulting from multipleÂ asthenia syndromeÂ organ systems involvement are classified as . This can then lead toÂ consumptive disease.
	Kidney involvement is defined asÂ kidney deficiency.

The kidneys are very important in TCM and are considered (as in Western medicine) to be commonly involved in SLE.

As SLE is a disease that can affect the whole body and involve several organs, different syndromes or disharmony patterns may occur at the same time and present a multiplicity of symptoms.

Causes

The cause of SLE remains unknown, although it is thought that genetic, hormonal, immune and environmental factors have a role. The reasons that support this are:Â

	Relatives of patients with SLE are at increased risk of developing the disease.
	The disease is more often seen in both of a pair of identical twins than it is in fraternal (non-identical) twins.
	Prevalence of the disease in certain races also implies a genetic (inherited) influence in the occurrence of SLE.
	Evidence for hormonal abnormalities is based primarily on the observation that SLE is much more common among women in their childbearing years.

Many abnormalities of theÂ immune systemÂ occur in patients with SLE. The reason for this remains unclear and it is not known which are primary and which are secondary causes. These abnormalities in immune regulation are thought to result from loss of “self” (substances belonging to the body) tolerance. This means that SLE patients are no longer totally tolerant of all their self-antigensÂ and consequently anÂ immune responseÂ develops to these antigens.Â

From the traditional Chinese medicine (TCM) viewpoint, the major cause of SLE is an inborn insufficiency that disturbs the balance ofÂ yin and yang. SLE may be acquired whenÂ environmental pathogensÂ (dryness, dampness, cold, summer-heat, wind and fire evils) affect this balance. Inborn insufficiencies or acquired disorders also lead to depletion of vital energy (qi) and yin fluid. This can cause impaired functioning of the body and a defect in resistance to illness.

Ancient TCM classics like theÂ Jinkui Yaolue (Summary from the Golden Chest)Â refer to diseases that poison the yin-yang balance. Constitutional or bodily weakness enables environmental pathogens to invade the body. This disturbs the harmonious balance of yin and yang and illness results. As an example, over-exposure to sunlight, considered to be a heat evil, causes the accumulation of heat and toxic pathogens in the body, and this in turn triggers organ system damage. Diseases where yang is dominant in the body present withÂ yang-type symptoms, such as flushing of the face, high fever, dislike of heat, dark-colored urine or constipation. Diseases dominated by yin present withÂ yin-type symptoms, such as pallor, cold limbs, an aversion to cold, pale urine or watery stools.

Parallels can be made with Western medicine’s understanding of SLE. For example, SLE is a result of the malfunction of the body’s immune system, which in TCM can be interpreted as a yin and yang imbalance. Genetic and environmental factors are also known to play a role in the development of SLE. It has been suggested that a virus may be partially responsible for its cause. This thinking is in line with the TCM concepts of environmental pathogens and an inborn deficiency being linked to the occurrence of SLE.

Symptoms

The onset of SLE can be highly variable, as can be the progression of the disease. Early symptoms may be non-specific and include muscular pain, nausea, vomiting, headaches, depression and easy bruising. Sometimes symptoms are more specific and more than one may be present. Symptoms may be mild or severe, fleeting or persistent.

General symptoms

	FatigueÂ occurs in virtually all patients with SLE and may be experienced with the onset of SLE or only with a relapse of the disorder.
	Swelling of the ankles is common.
	There is often a gain or loss in body-weight.
	Low-grade fever is seen in 80 per cent of patients.
	It is usually an episodic disease (occurs from time to time).

Skin and mucous membranes
The skin is affected in over 70 per cent of cases. Often, rashes occur after exposure to ultraviolet light and such exposure may lead to major flares involving other organ systems as well. Abnormal sensitivity to sunlight is experienced by about half of all patients with SLE and is more common in those who are fair and light-skinned.

Typical ”butterfly” distribution facial rash seen in SLE.

A classical characteristic of SLE is the “butterfly” rash that occurs across the face. Hair-loss is also common. Mouth ulcers occur frequently in active disease, but they may be relatively painless. A painful throat may accompany a flare.

Vascular system (blood vessels)Â
A disorder of the vascular system known asÂ Raynaud’s phenomenonÂ occurs in 20 to 30 per cent of patients. Classically, the fingers turn white followed by a bluish cyanotic hue, finally replaced by a red flush as dilatation of the blood vessels occurs. The full three-color change does not always happen, but excessive sensitivity of the hands to the cold is common.

Musculoskeletal system
Painful and arthritic joints are the most common symptoms of SLE and experienced by almost all patients. Symptoms can occur in any joint and often clear up in one to three days. Fingers, hands wrists and knees are the most commonly affected. Less frequently, ankles, elbows, shoulders and hips are involved. Stiffness on waking can last several minutes.

Renal system
In 50 per cent of SLE patients, the kidneys become involved. There may be rapid onset of an acute and painful kidney inflammation or traces of blood or protein may be found on analysis of the urine. Urinary tract infections are common.

Nervous systemÂ
Nervous disorders occur in virtually all SLE patients. Anxiety and/or depression are common in response to the illness and the threat of loss of health, family and job. The prospect of disability and dependency can be very distressing.

Symptoms may include insomnia, loss of appetite, constipation, palpitations, diarrhea, over-breathing, memory loss, emotional instability, confusion and decreased concentration. Seizures (convulsions) occur in more than 10 per cent of patients. The incidence of stroke, with resulting abnormalities of sensation and power, is similar.

Headaches are a frequent complaint and are usually due to stress and tension. Migraine occurs in 20 per cent of patients.

Cardiorespiratory systemÂ
Chest pain, cough and breathlessness occur frequently. These result from a variety of processes involving the lungs, the lining of the chest wall and diaphragm. Pain on breathing is commonly experienced and is often accompanied by chest discomfort. It may be worsened by lying down.

Gastrointestinal tract
Involvement of the gastrointestinal tract is common. Up to 25 per cent of patients have esophageal complaints, including difficulty swallowing. Indigestion, abdominal pain, nausea and vomiting are also common.

Blood
Anemia occurs in at least 50 per cent of patients. On laboratory analysis, abnormalities in the blood cells and clotting mechanisms are commonly found.

TCM practitioners will examine the sufferer and categorize the symptoms under special syndrome groups known as “disharmony patterns.” Certain disharmony patterns are present during different stages of the disease. The presentation of SLE is often complicated, but some common patterns can be classified:

	Excessive toxic heat accumulation
	Individuals present with persistent high-grade fevers, the appearance of a rash on the face or other areas, joint pain, muscle soreness or pain, fatigue, thirst and a desire for cold drinks. Irritability, insomnia, constipation and production of dark-colored, scanty urine are also common. In severe cases, loss of consciousness, delirium, muscle spasms, bruising or petechiae (small, flat blood spots under the skin), the spitting up of blood and the presence of blood in the urine or stool may also occur. Exposure to sunlight and the ingestion of certain foods or drugs are factors that can exacerbate the disease and induce flare-ups.
	bloodÂ yin deficiency
	In this deficiency there is a persistent low-grade fever, a hot sensation in the chest, palms and soles of the feet, irritability, fatigue and a reluctance to speak. There is general swelling of tissues, redness of the face, spontaneous perspiration and night sweats, and loin and joint pain.
	Toxic factor attacking theÂ heart
	Symptoms include palpitations, shortness of breath, chest fullness with a feeling of oppression and local heat, spontaneous perspiration, pallor and cold limbs.
	KidneyÂ yin deficiency
	Individuals usually experience pain in the back, legs and feet, limb weakness and a sensation of hotness in the face. In more serious cases, sores appear in the mouth and on the tongue, hot sensations are felt in the chest, palms and soles of the feet, and the individual feels emotionless. Sometimes low-grade fever and swelling may be present.
	Impairment of theÂ liverÂ due to heat
	In this disharmony pattern, pain in the upper sides of the abdomen, abdominal distension, irregular and painful menstruation in females, skin rashes, bruising, insomnia, dizziness and loss of appetite are commonly experienced.

Diagnosis

The diagnosis of systemic lupus erythematosus can be difficult. The disease may present in many different ways and most of the laboratory tests carried out on patients with SLE are not specific. For these reasons, other diseases have to be carefully considered before a diagnosis of SLE can be made. Physicians should always consider the possibility of SLE in a disease which is affecting many systems of the body, especially those involving the skin and joints of young women.

In 1982, the American College of Rheumatology compiled a list of 11 criteria, at least four of which should be present, not necessarily at the same time, to make a diagnosis of SLE. In some patients, only one or two criteria may be present initially and after several weeks, months or even years do the others appear. These criteria are:

	Characteristic “butterfly” rash on the face
	Generalized skin rash
	Mouth ulcers
	Arthritis
	Sensitivity to ultraviolet light
	Inflammation of the lining of the chest wall or the membrane surrounding the heart
	Renal (kidney) disorder
	Nervous system disorder
	Low red or white blood cell count
	Positive antinuclear antibodies
	Positive lupus anticoagulant

These last two are immunologic laboratory tests.

Diagnosis in TCM places importance on determining the circumstances and manifestations of a disease through inquiry and symptom observation. Diagnosis is based on the traditional four examination techniques:

	Questioning: The TCM practitioner will establish the medical history of both the patient and his family.
	Observation: Examination of the physical features of the body, such as the face, tongue, hair, nails, sputum (mucus that is coughed up), and location of pain, all offer clues to the problem. The tongue is a particularly useful indicator of the functioning of the internal organs.
	Listening and swelling: The smelling of sputum and breath and listening to the sounds produced by the chest offer additional clues to the patient’s health.
	Touching: Feeling the pulse is a cornerstone of TCM diagnosis and gives the practitioner much information about any bodily imbalance.

In SLE, the disharmony patterns present at different stages during the course of the disease and can be described as follows: :

	Excessive toxic heat accumulation
	In TCM, it is held that the occurrence of SLE is closely related to over-heating of theÂ heart meridian. The heart controls the blood and blood vessels. When the heart pumps, blood is transported within the vessels around the entire body. The heart,Â bloodÂ and blood vessels are thus united by their common activities. When heat pathogens are congested in the heart meridian, it means a serious invasion of the internal organs has occurred. The qi and blood bring these pathogens to every part of the body, damaging internal organs, muscles and skin along the way. On examination, the tongue appears red or dark red and ulcerated, or sores may be present on the inside of the mouth. The tongue may be coated with a fur that is greasy and yellow, dry and yellow, greasy and white, or the fur may be absent altogether. The pulse feels taut and rapid.
	Blood yin deficiency
	When the body accumulates too many heat pathogens over a period of time, the body fluids dry up and organs will not function properly. This decreases the production of blood andÂ kidney essenceÂ and leads to a morbid condition of general weakness with sweating, low-grade fevers and hot sensations in the palms and soles of the feet.On examination, the tongue appears red with a white fur coating or with no coating. The pulse sign feels thready, rapid and weak.
	Toxic factor attacking the heart
	Impairment of the functioning of several internalÂ organsÂ signals involvement of the heart and a serious effect to the bloodflow. Individuals present with pallor, palpitations and cold extremities.On examination, the tongue is pale and coated with thin white fur. The pulse feels thready, weak, or choppy.
	Kidney yin deficiency
	This occurs usually in a late stage of the disease when the pathogens finally invade the kidney. Kidney-yin refers to the fluid andÂ essenceÂ stored in the kidneys. The invading pathogens cause a deficiency in the amount of this fluid and essence and the kidneys begin to over-function. This is the yang part of the kidney compensating for the loss of yin and creates aÂ virtual fireÂ in the kidneys. This produces back pain, limb weakness and heatsymptoms such as fever or tongue sores.On examination, the tongue appears bulky, moist and pale. The tip of the tongue may also be red. The pulse feels deep, thready and weak.
	Impairment of the liver due to heat
	Heat pathogens dry up body fluid and this leads to inadequate nourishment for theÂ liver. In TCM thinking, the liver helps regulate qi and blood movement, and the digestive function of theÂ spleen. Individuals with this disharmony pattern present with pain in the liver region, bleeding problems or loss of appetite.On examination, an enlarged liver and spleen may be palpable.

Treatment

The management of SLE should be comprehensive and include drug and non-drug treatment. Therapy is individualized for each patient depending on the manifestations of disease and their severity.Â

Corticosteroids
SystemicÂ corticosteroidÂ therapy is the mainstay of treatment in SLE. However, not all patients require steroids, and steroids can do more harm than good. When needed, oral maintenance doses of prednisone or prednisolone are usually prescribed.

Severe symptoms affecting the whole body, such as sustained high fevers and severe blood disorders, often need to be treated with higher doses of corticosteroids. Involvement of organs such as the heart, lungs, and central nervous system also usually requires treatment with corticosteroids.

A topical steroid is usually prescribed for skin rashes.

NSAIDs
Mild symptoms of arthritis and muscular pain are usually managed with non-steroidal anti-inflammatory drugs (NSAIDs), such as indomethacin, naproxen and ketoprofen. More severe symptoms may need an antimalarial agent and occasionally low doses of corticosteroids may be required.

Antimalarials
The antimalarials chloroquine and hydroxychloroquine possess anti-inflammatory properties and have been found of benefit in treating inflammatory conditions which have an immunologic basis. They are usually used when other first-line therapies (such as NSAIDs) fail. They are prescribed for more severe skin and joint manifestations of SLE.

Immunosuppressants
As long-term corticosteroid therapy, particularly at the higher doses, tends to cause side-effects, immunosuppressants such as azothiaprine, cyclophosphamide and methotrexate are sometimes added in an attempt to lower the dose of corticosteriod required. These drugs suppress theÂ immune response. As immunosuppressants themselves pose a risk of long-term toxicity they need to used with care, but can be useful in the treatment of acute and severe organ involvement.

Psychiatric support
The threat of a chronic disease can be very stressful. Visiting a doctor frequently and having many laboratory tests with long waits for the results can be an emotional burden.Â Emotional support in the treatment of SLE is essential. It is also important that patients have extensive rest.

Preventive measuresÂ
All possible means to prevent provocation or exacerbation of SLE should be undertaken. Â As SLE is an episodic disease and is characterized by exacerbation and remission, it is extremely important to withdraw therapy slowly when an exacerbation has quieted down. This avoids unnecessary drug toxicity.

Patients with SLE need a to see their doctors at least once every three to six months, even if the disease is inactive.Â Patients with active disease must be assessed more frequently.

Treatment of SLE from a TCM perspective will depend on the symptoms of the individual patient. In addition to herbalÂ decoctionsÂ used to alleviate disharmony pattern symptoms, treatment may include acupuncture for relieving pain and stiffness in the joints, andÂ qi-gongÂ to help focus the energy of the body in fighting the disease and strengthening the mind.

Examples of decoctions used for the different disharmony patterns

Excessive toxic heat accumulation

Therapeutic aim:To clear away heat and toxins, cool down the blood, protect theÂ yin, remove obstructions in theÂ meridiansÂ and clear up rashes.

Prescription:Â Qingying decoction

shi gao	gypsum
shu di huang	processed rehmannia root
mai dong	dwarf lilyturf tuber
zhi mu	common anemarrhena root
niu xi	achyranthes root

For individuals with high fever, poor concentration and delirium, the dosages of heat-clearing drugs should be increased or the following added:

shang shi gao	unprocessed gypsum
huang lian	golden thread
da huang	rhubarb

Some patent Chinese medicines likeÂ Purple Snowy Pill, Bezoar Bolus for ResurrectionandÂ Treasured BolusÂ can be taken at the same time.

Yin blood deficiency

Therapeutic aim:To replenish the yin, nourish and cool down theÂ blood, and eliminate toxins.

Prescription:Â Modified Zhibai Dihuang pill

zhi mu	common anemarrhena root
huang bai	amur cork-tree
shu di	processed rhemannia root
shan yu rou	Asiatic cornelian cherry fruit
shan yao	common yam root
ze xie	oriental water-plantain root
dan pi	tree peony bark
fu ling	Indian bread

For individuals withÂ spleenÂ deficiency add:

bai zhi	large head atractylodes root
chen pi	dried tangerine peel
fu ling	Indian bread

In cases of very high fever add:

yin hua

honeysuckle flower

For dizziness add:

ju hua	chrysanthemum flower
chuan xiong	Szechwan lovage root

Toxic factor attacking the heart

Therapeutic aim:To nourish the yin, replenish theÂ qi, calm the mind, and clear away heat and toxins.

Prescription:Â Modified Huanglian antidote decoction

huang lian	golden thread
huang qin	baical skullcap root
huang bai	amur cork tree
zhi zi	Cape jasmine fruit

For spleen deficiency add:

dang shen	pilose asiabell root
bai zhi	large head atractylodes root

For individuals with a feeling of chest fullness add:

hou po	magnolia bark
su geng	perilla stem

For yin deficiency add:

yu zhu	fragrant Solomon’s seal rhizome
huang jing	agastache or Solomon’s seed
dong chong xia cao	Chinese caterpillar fungus

Kidney yin deficiency

Therapeutic aim:To nourish the yin, tonify theÂ kidneys, activate the blood circulation and eliminate toxins.

Prescription:Â Modified Siwu decoction

dang gui	Chinese angelica
chuan xiong	Szechwan lovage root
shu di	processed rehmannia root
bai shao	white peony root

For dampness-heat symptoms in the lower burner add:

che qian zi	plantain seed
Bi xie	long yam
qu mai	Chinese pink herb

For individuals with backache add:

tu si zi	dodder seed
chuan duan	Himalayan teasel root

For joint pain add:

ji xue teng	suberect spatholobus stem
shen jin cao	common club-moss herb
liu ji nu	diverse wormwood herb
xu chang qing	paniculated swallow-wort root

Impairment of the liver due to heat

Therapeutic aim:To nourish the yin, cool down the blood, eliminate toxins, activate the blood circulation, clear away blood stasis and remove obstructions in the meridians.

Prescription:Â Modified Xiefu Zhuyu decoction

tao ren	peach seed
hong hua	safflower flower
dang gui	Chinese angelica
sheng di	common yam root
chuan xiong	Szechwan lovage root
chia hao	red peony root
niu xi	achyranthes root
jie geng	platycodon root
chai hu	Chinese tororwax root
zhi qiao	orange fruit
gan cao	liquorice root

For individuals with severe blood stasis add:

san leng	bur-reed tuber
e zhu	zedoary rhizome
yi mu cao	motherwort herb
chuan xin lian	andrographis herb
gui jian yu	winged spindle tree

For severe abdominal distention and pain below the ribs add:

hou po	magnolia bark
chen pi	dried tangerine peel
xiang fu	nut-grass

For qi deficiency and residual heat toxins add:

huang qi	milk-vetch root
qin jiao	large-leafed gentian
wu she	black snake

For over heated blood and a well-defined rash add:

ji guan hua	cockscomb
mei gui hua	rose
ling xiao hua	trumpet creeper flower

Dr. Wang who is expert on treatment of SLE Â RA with his spacial prepared herb medicine in over thirty year experience in clinic and Â with Acupuncture treatment can very good control the disease and stop pain joint swollen.

Six Evils

acuherb — Mon, 02 Jul 2012 19:22:11 +0000

By Dr. Wang

The Six Evils or Six Pernicious Influences

The evils are external in origin, but can penetrate deeply into the body.

The Six Evils are:

Wind

Cold

Damp

Heat

Summer Heat

Dryness

Wind

(Associated with Liver, Wood, Spring, Yang evil)

Wind is involved with movement and activity, and brings other evil Qi in with it. It is the most important evil as it is the cause of the “100 diseases”.

Disperses Qi upward and outward

Yang energy wants to rise and expand

Illnesses manifest in upper and outer parts of the body in early stage: head, sense organs and skin

Rashes Common: itchy, come and go quickly, spread quickly

Sweating common: causes opening of pores (Qi and fluids lost)

Rapid onset and rapid changes

Acute illnesses with rapid progression such as fever, infectious diseases

Creates abnormal or sudden movement

spasms, convulsions, twitches

Creates abnormal positions

Stroke

Stiff neck with flu

Most common in spring

Wind Syndromes – External Wind

1.) Wind-Cold

chills more than fever
aversion to cold
occipital headache
stiff neck
sneezing
mucous will be clear and copious
runny nose
body aches that move around
tongue: slightly pale, thin white coat

Excess Type External Wind

Little or no sweating

pulse: floating, slow, tight

Wei Qi is strong so pores are held closed

warm relieve surface treatment is used to sweat

out evil and excess Wind and Cold

Ma Huang Tang

Xu Type External Wind

Sweating

Pulse: floating, slow, Xu

Wei Qi is weak. There is sweating but it does not release the Exterior

Harmonize Ying and Wei Qi. Ying nourishes Wei to gently strengthen it, without tonifying Evil Qi

Gui Zhi Tang

2.) Wind-Heat

fever more than chills
sore throat
cough with thick, yellow mucous
thirst for cold drinks
frontal headache; can be stronger, pounding (Yang Ming)
redness or inflammation of eyes
sinusitis
earache
red face
Pulse: Floating, rapid
Tongue: slightly red in early stage, yellow coat, thorns on lung area

3.) Wind-Damp

sensitivity to wind
fever and chills with fever more pronounced in the afternoon
strong body aches
body and head feel heavy
copious phlegm – runny nose, congestion, stuffiness, sinusitis
sinus headache
foggy headed, difficult thinking
Pulse: slippery
Tongue: swollen, likely to be a thick coat, could be greasy

4.) Wind-Damp Bi Pain

Arthritis, nerve pain, and numbness that is worse with cold and damp
weather
Pulse: slippery
Tongue: swollen, thick coat
Treat by opening channels and mildly relieving surface

5.) Wind-Water

disruption of Jin-Ye
anything with sudden Edema
acute onset
frequently occurs in the face
Treat by relieving surface, eliminating water
causes include allergic reaction, rash, acute nephritis
Pulse: slippery
Tongue: swollen, greasy coat

6) Wind-Rash

acute onset
moves around to different parts of body
will appear and disappear
Pulse: floating, rapid
Tongue: red with yellow coat

Wind Syndromes – Internal WindÂ

Associated with the Liver, and causes diseases of shaking and abnormal body positions.
It is usually chronic, where external wind is usually acute.
It combines easily with phlegm, as in Deviation (Wind blows it out of position and the phlegm makes it stick in an abnormal position).

Symptoms of Internal Wind

spasms and abnormal muscle contractions

convulsions

Parkinson’s

post-stroke sequelae

seizures(epilepsy)

shaking from anger

migraine (Wind blowing in head)

Pulse: wiry usually rapid

Tongue: shaking or deviated

Causes of Liver Wind

Excess fire affecting the Liver

Fire creates Wind

enters the Blood level

high fever (diseases such as meningitis)

poisons, toxins, radiation, drugs, alcohol

constitutional Liver Fire

Pulse: rapid, wiry, excess

Tongue: red, yellow coat; shaking or stiff

Liver Yin Xu, Yang KanÂ – Long-standing Yin deficiency with Heat

long term use of drugs, alcohol

chronic Yin Xu fevers

Pulse: Wiry, rapid, thin

Tongue: red, no coat, shaking

Liver Blood Deficiency

1) Blood Xu makes Heat
2) Blood not nourishing the “General”

Numbness of limbs common

Pulse: thready or hollow

Tongue: pale with white or yellow coat

Liver wind mixing with Phlegm

Wind blows it into an abnormal position and phlegm makes it stick. It affects Liver (Wind) and Heart (Phlegm misting). There is rigidity especially of limbs, neck, tongue, and stiffness in tongue (May affect the Speech)

Neurological conditions

brain disorders

Alzheimer’s, senility

Stroke

brain tumors

Fire and Phlegm occurring together

more sweating than with internal wind alone

rapidly changing emotions

commonly occurs with long term alcohol and drug use

red face

Pulse: Rapid, slippery, full

Tongue: red, particularly at tip, may be skewed to one side

[Â Top of PageÂ ]

Cold

(Associated with Kidney, Winter, Water element, Yin evil)

Damages the Yang
Impairs ability to maintain body temp
Weakens and slows life activities
Feeling of cold
Symptoms better with warmth
causes Qi and Blood to contract and congeal which creates stagnation, pain, stiffness
Easily effects the low back and knees, joints
Easily effects the Stomach, Intestines, Liver
Thin, watery, pale, cold discharges urine, stools, blood etc.

Syndromes of Cold

Wind Cold

chills more than fever
aversion to cold
occipital headache
stiff neck
clear copious phlegm
runny nose
sneezing
mild body aches
Excess type
- little or no sweating
- Pulse: Floating, slow, tight
- Tongue: slightly pale, thin white coat
Deficiency type
- sweating
- Pulse: Floating, slow, Xu
- Tongue: slightly pale, thin white coat

Cold attacking the Spleen and Stomach

Looks like spleen Qi Xu but the cause is external (Examples are living by the ocean or eating cold foods). Phlegm and Dampness can also collect and cause dizziness.

diarrhea

loose stools

watery stools

bloating

poor digestion

nausea

vomiting

stomach or abdominal pain that is worse with cold

loss of appetite

fatigue

Pulse: slow

Tongue: pale

Cold evil damaging both spleen and Kidney Yang

Can be acute, as in hypothermia, or chronic, as in a cold climate damaging spleen and kidneys.

Symptoms as in previous syndrome with:

watery stools
undigested food in stools
bird stools
aversion to cold
feeling of cold in entire body
profuse urination or edema
strong fatigue
pale face
possibly green or purple lips
Purple or black under eyes if the Kidney Yang is damaged
Pulse: slow, weak
Tongue: pale, white coat, tooth marks

Cold contracting the Qi and Blood

Cold slows circulation, contracts, congeals, stagnates

Liver Qi Stagnation

abdominal bloating

depression, irritability

Pulse: wiry

Tongue: light purple

Blood stagnation

pain that is sharp, stabbing, needle-like, constant

purple lips, complexion etc.

Pulse: choppy

Tongue: deep purple, possibly purple spots

Wind cold damp Bi pain

arthritis (more commonly Osteoarthritis) with cold, stiff, contracted joints

sensitivity to cold is strongest symptom

can be nerve or muscle involvement

symptoms better with warm weather, heat therapy, saunas

Cold contracting the liver meridian

pain on inside of legs, genital area along liver meridian

severe menstrual pain

endometriosis

hernia

muscular problems i.e. groin pull

testicular problems

sperm production

may be infertility

will exhibit signs of liver blood stagnation

Pulse: choppy

Tongue: pale and purple

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Damp

(Associated with spleen, late summer, Earth element, Yin evil)

Dampness is heavy, tenacious, difficult to treat, and lasts a long time. It tends to move downwards in the body.

Sticky, greasy, oily, dirty, bad smell

“looks like water or mud, “looks and smells dirty

greasy hair and face

greasy skin: acne, pus, oozing wound

mucous or discharge anywhere in body

bad body odor, bad breath, smelly perspiration

bad smelling diarrhea with mucous (if mixed with heat, there can be cloudy urine)

thick or bad smelling vaginal discharge as in STD

copious nasal discharge

edema or swelling

arthritis with swollen joints

fluid coming out of anywhere

candida, fungus, yeast

Damages the Yang of body

worse in cold, damp weather

Spleen works to transform Damp; Kidney supports Spleen

Creates stagnation

Stagnate fluids will also stagnate Qi and Blood

Syndromes of damp

Wind-Damp
Acute condition, but has the slowest onset of all winds. It is affected by damp and cold weather. Symptoms can reflect a respiratory infection with copious phlegm or a gastrointestinal flu.

strong generalized body aches

heavy feeling in head and body

foggy headed, unclear thinking, band headache

copious phlegm, can be runny or thick

sneezing

afternoon fever

nausea, vomiting

diarrhea, possibly with mucous

Pulse: slippery, slowing down pulse

Tongue: swollen with thick, greasy coat

Wind-Damp Bi pain

swelling of joints

edema

Pulse: slippery

Tongue: swollen with thick, greasy coat

Damp poison in skin

discharge: pus, carbuncles, boils, acne, oozing

infection after wound

warts, fungus, yeast

Damp heat

Infection or inflammation that can affect many places, such as the Liver, Gallbladder, Urinary Bladder, Intestines, Sinuses, etc.

“itis” Diseases

Bronchitis

Hepatitis

Vaginitis

Prostatitis

Colitis

Pulse: slippery, rapid (which quality is greater?)

Tongue: red, thick yellow coat, swollen (how thick, how swollen, how red?)

Internal dampness arising in the body

Dampness arising from Spleen Xu: Dampness is the main factor, the Xu is secondary. It often compromises immunity due to congestion of lymphatic system, autoimmune conditions in particular. If severe, it becomes Phlegm. A long term chronic situation is often due to damp, cold, raw foods.

Symptoms may be associated with a wide variety of diseases: Chronic Fatigue, Fibromyalgia, Candida, Lymphoma, Etc.

bloating

nausea

vomiting

diarrhea

heaviness of head and body

dizziness

low appetite

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Heat

(Associated with the Heart, summertime, Fire element, Yang Evil)

Damages Yin

dries fluids, easily leads to Yin Xu

Heat rises

diseases most common on face, eyes, and nose

Causes redness

the more red, the more heat

Easily produces wind

when heat affects the Liver

Speeds things up

agitation, restlessness

can be bleeding: Blood moves so fast it leaves the vessels

Easily affects the skin

red, itchy, painful rashes

Syndromes of Heat

Wind-Heat

fever more than chills

sore throat

frontal headache (yang Ming channels)

big thirst

sinus infection

red eyes, conjunctivitis

cough with yellow, green or brown phlegm

Tongue: red and raised dots in lung area (thorns)

Pulse: rapid, floating

Damp Heat

Upper Jiao – Affects face and chest

Middle Jiao – Affects Spleen and Liver

Lower Jiao – Intestines, bladder, genitals, etc.

Excess Fire

Strong heat that reaches deep in to organs. It can have an external or internal origin.

Symptoms

big thirst

redness

restlessness

symptoms are loud and forceful (cough, diarrhea etc.)

Syndromes

Lung fire

can be loud, forceful cough with blood (fire has burnt off protection of mucous membranes so capillaries have burst)

mucous is yellow, green , brown

red, painful rash

Stomach fire

burning ulcer, heartburn)

Stomach channel problems: toothache (infection), frontal headache strong pain or burning on channel

Heart fire

strong anxiety

restlessness

insomnia

mania

Liver fire

anger

shingles in costal region

burning pain in genital area as from STD’s

Large Intestine fire

dysentery

toothache (channel pain) -> Kidney fire

long term alcohol or drug abuse

bone infection

meningitis (affects Marrow)

Deficient Fire

Yin Xu, Yang Kan, Heat is deep in the body: Ying level. Pattern of mixed Xu and excess. Treatment must include quelling fire as well as nourishing yin

smoldering heat especially at night

low grade rashes

severe restlessness

slight bleeding

Tongue: scarlet

Pulse: thready, rapid

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Summer Heat

(Associated with the Heart, Fire Element, Summer, Yang Evil)

Syndromes of Summer Heat

Summer heat

high fever

restlessness

thirst with strong desire to drink

can go up and affect the head

dizziness

blurred vision

headache

constipation

scant yellow urine

coma

Yin collapse

profuse sweating

Tongue: dry, red

Pulse: surging (flooding – strong, big waves)

Summer Heat combined with Dampness

A person with a Damp constitution experiencing Summer Heat, or a person who eats Damp foods in summer (ice cream, cold soda).

Dampness turns into phlegm because of heat

nausea

vomiting

loose stools or diarrhea

poor appetite and fatigue

phlegm can rise to head

dizziness

heavy head

foggy thinking

suffocating feeling in chest

tightness in chest

sweating, but not as much as Summer Heat without Dampness

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Dryness

(Associated with the Lung, Autumn, Metal Element, Yang evil)

Exterior in origin (not yin Xu, not internal)

Easily damages body fluids

Dry skin

Dry hair

Dry eyes

Dry lips

Dry throat or low grade sore throat

Dry stools

Scant urine

Thirst

Easily damages lungs

Could be from dry climate or smoking

Dry cough and dry phlegm (thick, sticky, hard to expel)

Syndromes of Dryness

Warm Dryness

Symptoms

Fever

Headache

Thirst

Dry Mouth

Dry Nasal Passages

Dry cough with Dry Phlegm

Tongue: red with thin or no coat

Pulse: rapid

Treatment

acute: treat as wind-heat

chronic: tonify yin

Cool drynessÂ (Example: Dried out from air conditioning)

Symptoms

Dry phlegm (thick, doesn’t move)

Sensitive to cold

Chills

Mild fever

Headache

Dry cough

Dry mouth

Dry nasal passages with stuffiness

Tongue: thin, white

Pulse: tight, slow

Treatment

Acute: Treat as wind-cold