Qi Stagnation

Pirog:

*Pain and distention w/sensations of oppression

*changes in intensity; location

*accompanied by emotional changes

*scurrying (moves away from site of obstrxn)

*oppression in chest and abdomen may be temp.   relieved by passing gas

*abd. lump are soft to touch and disperse/reform periodically

P: wiry, tight, or other stagnant types

T: may be dark

Liver, heart stomach

Blood Stasis

*pain fixed in location confined to the obstrxn

*stabbing pain

*hard, fixed lumps and masses

*bruises

*recurring, frequent hemorrhages (menstrual, postpartum, dark purple clotted blood

*dark comlexion

*dry, rough, lusterluss skin

*purple macules

P: rough or fine

T: cyan-purple with stasis speckles, lips as well

liver, heart, lungs

counterflow qi

evolution of stagnant qi; qi is not only blocked by moving in an unnatural direction

Lung: cough

Stomach: vomit, regurg, hiccup, belch

Liver-spleen disharmony: epigastric pain, often ass'd with emotional change, abdominal distention, diarrhea

Pulse and tongue: same as stagnant qi

Blood Heat

symptoms of frenetic blood movement

*retching of blood

*expectoration of blood

*hemafecia/hematochezia

*epistaxis

*menorrhagia--bleeding is often profuse and either bright red or purple-black

*red papules or macules

Possibly:

restlessness

thirst

T: red

rapid pulse

coma

Wind invasion

initial stage

exogenous pathogen

fever and chills

itchy throat

cough with varying amounts of phlegm

headache

sweating

stuffed nose

P: floating

T: thin white fur

exterior signs:

chills worse than fever

little or no sweat

head and body aches

lack of thirst

Specific lung sings:

dyspnea

nasal obstruction

watery nasal d/c

cough with exp. of thin, clear sputum

P: floating and tight

T: thin white fur

Wind Heat invading the Lungs

exogenous pathogen

exterior signs:

high fever, chills

possibly more sweat

thirst with desire to drink

headache

dark urine

Lung Signs:

red, sore, swollen throat

dyspnea with rough, rapid respiration

full cough with yellow, sticky phlegn, sometimes finely streaked with blood

runny nose with yellow phlegm

OR dry nose with flared nostrils +/- bleeding

P: floating and rapid

T: deep red, rough yellow fur

Dry Heat

exogenous pathogen

dry cough with little or no phlegm

dry pharynx

loss of voice

Damp Phlegm obstructs the lung (damp phlegm)

*general signs of phlegm-damp and splenic transformation failure

*retching and nausea

*fatigued, cumbersome limbs

Lung Signs:

*cough, dyspnea with copious white phlegm

*rattling of phlegm in throat or chest

*thoracic glomus

*increased dyspnea when lying down

P: slipper

T: thick, slimy coat

General signs of cold: cold form and frigid limbs

Lung signs:

cough with expectoration of clear thin white phlegm

P: slightly wiry

T:  moist white fur

If pre-existing cold-rheum ascends and invades the lungs following contraction of exogenous pathogen the above signs may include:

cough

dyspnea w/white foam, phlegm, frog rattle

somber white complexion

wiry pulse

glossy white fur

general signs of heat:

fever

dry mouth

Lung signs

*cough and rapid breathing

phlegm is either thick and yellow or white, gluey and difficult to expectorate

P: rapid, slippery

T: red with yellow fur

brewing phlegm damp: cough, thick sticky phlegm, oppression of chest, slimy tongue fur and slippery pulse

General Signs:

*emaciation

*marked ill health

Specific Lung signs:

*dry cough with little phlegm; phlegm may contain blood

*dry mouth and pharynx

*low, hoarse voice

*rapid breathing

P: fine, rapid

T: distinctly red

in addition to lung yin deficiency symptoms:

red cheeks

tidal fever

night sweating

low back pain

seminal emission

General signs of qi and blood deficiency:

*lusterless complexion

*exhaustion

Specific Spleen Signs:

discomfort of dull pain in abdomen

thin stool or diarrhea

With disharmony of stomach qi:

reduced food intake

discomfort after eating

clamoring stomach

eructation

P: soft, soggy

T: relatively pale

General signs of Spleen Qi Def but with pronounced cold signs:

*drained, white complexion

*spiritual fatigue

cold form

Specific Spleen Signs:

*abdominal pain relieved by warmth and pressure

*diarrhea with undigested food in stool

P: deep and weak

T: pale with white fur

Spleen Qi Fall

Center Qi Fall

General signs of Qi Deficiency:

emaciation

weakness

Specific Spleen Signs:

sagging and distention of the abdomen

distention after eating

enduring diarrhea

prolapse of rectum or uterus

P: soggy

T: pale, enlarged

Qi Containment Failure

Blood Management Failure

General signs of qi and blood deficiency:

somber white or withered yellow complexion

weakness

spiritual fatigue

dizziness

palpitations

shortness of breath

Specific Spleen Signs--spleen yang deficient signs

+

hemafecia/hematochezia

metrorrhagia

P: fine and soggy

T: pale

spleen-stomach qi/yang def. symptoms combined with damp symptoms:

loss of appetite: no thought of food or drink

indigestion

oppression in the chest

abdominal distention

thin stool or diarrhea

short micturition with scant urine

sickly, bland or sweet taste in the mouth

limbs are cumbersome and fatigued

P: soggy or moderate

T: thinck and slimy

endogenous:

*results from pre-existing spleen qi/yang def which fails to transfomr endogenous fluids

*spleen-stomach def. symptoms are more prominent

*cold damp is usually endogenous with abdominal fullness and diarrhea or phlegm-rheum and water swelling

exogenous:

*usually ass'd with smmer or late summer

*s/s relieved by autumn

*sometimes low fever

*stomach: nausea, vomiting

*harassing the upper body: dizziness

*heart portals: palpitations, clouding of the spirit, mania and withdrawal

*Chest and lateral costal region: fullness in the chest with dyspnea and cough causing pain in the chest, labored breathing, pain when turning over in bed, rapid breathing

*lungs: coughing, wheezing with copious phlegm in the chest, nose, throat, sinuses (phlegm in this pattern is the cause and the result of failure of the dispersing fxn of the lungs)

*limbs: local numbness, pain without bi or blood deficiency signs

*channels: soft, mobile swellings, scrofulous swellings, phlegm nodules, struma

*throat: glomus in the throat

wind phlegm: grand mal seizures

P: wiry, slippery

T: moist, glossy, slimy tongue fur

General Damp-heat signs:

*fever

*pain and distention in the chest and lateral costal region

*nausea and vomiting

*poor appetite

*thirst with little desire to drink

*short micturation with scant, yellow or dark urine

Spenogastric signs:

*painful distention/oppression in the abd. or pain brought on by pressure

*sickly or bitter taste in mouth

*hard stool or diarrhea with foul smell

P: rapid and either soggy or slippery

T: red at tip and edges, white or yellow slimy, thick fur

*severe dizziness sometimes preventing pt from standing    OR

*mental dizziness, pressure in the head, heavy-headedness

*insomnia

*oppression in chest

*retching and nausea

*little thought of food and drink

*non-transformation of ingested food

If heat, then restless, bitter taste in mouth

P: slippery, possibly wiry

T: slimy yellow or white

General Qi Deficiency signs:

lusterless complexion

aversion to cold

lack of warmth in extremities

Specific Stomach Signs:

*Ventral pain usually ocurring on an empty stomach and relieved by pressure or eating

*eructation and acid upflow

*sometimes vomit of clear, cold sour fluid

P: soggy, but may b/c wiry or tight during pain attacks

T: pale, enlarged

no thought of food

dry mouth

definciency glomus

retching

constipation

P: rapid, thin

T: red, mirror tongue

persistent diarrhea with periodic incontinence or prolapse from bowel movements

(see center qi fall)

General:

bitter taste in mouth

halitosis

dry mouth

may present with one or more of the following symptom groups:

*ingestion: hyperpepsi with rapid hungering

*gastric downbearing: pain or burning sensations in the belly, vomiting, clamoring stomach, hard stool

*upstreaming of stomach heat: painful swelling, cracking and putrefaction of gums or periodontal dz with bleeding gums

P: slipper

T: distinctly red with dry, yellow fur

counter flow stomach qi

(cold)

Pale tongue

white complexion

vomit of clear fluid

vomit in the evening of food ingested in the morning

general signs:

nausea

 vomiting

eructation

hiccup

counter flow stomach qi

(phlegm)

slimy tongue fur

repeated ejection of phlegm-drool

occasional dizziness

counterflow stomach qi

(heat)

red tongue with yellow fur

vomit of sour or bitter fluid

immediate vomiting of ingested food

counterflow stomach qi

(foul turbidity)

usually in hot weather

sudden onset

abdominal pain

ungratified desire to vomit

agonizing distention and oppression of belly

counterflow stomach qi

(stomach=intestine qi stagnation)

thoracic glomus

abdominal pain

eructation

counterflow stomach qi

(Digestate stagnation)

history of ingesta damage

sour, putrid vomit

improvement brought by vomiting

General signs of blood deficiency and fluid depletion

hard, dry stools wh. are difficult to evacuate

no pronounced abdominal distention or pain

weak general health

post partum complication, in the aged, and as a sequel to exogenous heat dz.

*aversion to food

*eructation

*painful bloating of the abd.

*foul smelling stool and flatus

*nausea and vomiting

*putrid smelling v and gas

*diarrhea or constipation

*relief from pain and distention after defecation or passing gas

T: slimy and either thick or yellow fur

same symptoms of ingesta damage

+

painful distention exacerbated by pressure

palpable accumulation lumps in abdomen

no thought of food and drink

yellow complexion

emaciation

general damp heat signs

fever

bitter taste in mouth

specific LI signs

abdominal pain

diarrhea

discomfort unrelieved by defecation

foul smelling stool

OR

blood and pus in stool, frequent movements

abdominal pain

tenesmus

burning sensation in rectum

T: slimy, yellow fur