Introduction to TCVM Dx Introduction to TCVM Dx with Tongue & Pulsewith Tongue & Pulse

Basic TCVM Diagnostic Basic TCVM Diagnostic EquipmentEquipment

OVERVIEW OF TCVM

Health and disease

Health: the natural state, everything in balance.

Based on energetic physiology:

1. Qi & blood are good quality with normal circulation

2. Zang‑fu organs work properly.

OVERVIEW OF TCVMHealth: Qi & blood are good quality with normal circulation. Created by

Spleen: absorbs Qi from food and liquid DigestionLung: absorbs energy from the air. OxygenKidney: stores constitutional energy. Adrenal

Zang‑fu organs work properly.

Lung Large IntestineKidney Urinary BladderLiver Gall BladderHeart Small IntestineSpleen (Pancreas) Stomach

Disease:

Imbalanced symptoms:

too much heat, cold, damp, dry, etc.

Qi and blood poor quality;

Qi and blood circulation impaired

One or more of the zang‑fu is not working well

Cause of DiseaseEnvironment and climate stress: 6 pathogen qi:

Wind Fire/HeatCold Summer HeatDamp Dryness

Emotional stress: 7 emotions: Joy/Fright --------> HeartAnger --------> LiverSadness/Grief --------> LungWorried -------> SpleenFear/Shock -------> Kidney

Life Style (Diet, daily activity)

Others Toxins (micro‑organisms: virus, bacteria, protozoa)-Heat ToxinPoisonTrauma

Organization Format to Pathophysioloty

1) Eight Principles Yang YinHot ColdExterior InteriorExcess Deficiency

2) Six Stages of Wind Invasion (epidemics by microorganisms)

Taiyang Surface, skinShaoyang Half interior, half exterior (lymph)Yangming Qi level: high feverTaiyin Lung, spleenShaoyin Kidney, heartJueyin Pericardium (CVD), liver

3) Four Levels of Heat Invasion (microbe epidemics):

Wei: superficial, initial stage, exteriorQi: meridiansYing: nerve systemsBlood: internal organs

4) Zang Fu syndromes (internal diseases)

Heart: Cardiovascular, Central Nervous System, mental

Lung: Respiratory, skin, immune

Spleen: Alimentary tract, immune, muscular, endocrine, metabolic

Liver: Hepatobiliary, eyes, endocrine, metabolic,

ligaments and tendons, hooves/paws

Kidney:Reproductive, renal, bone and joints, endocrine, and metabolic

5) Channel pathologies (arthritis, trauma, paralysis)

Diagnosis

1.Pulse: depth, width, height, force, quality

2.Tongue: pathological presentations:

Shapes, body colors, coat colors, coat textures

3.Looking (shen/skin, shapes, eyes, face)

4.Smelling (skin, breath)

5.Listening (voice, respiration)

6.Symptoms and history

Five step methodology

1.Signs/symptoms (patient’s presentation)

2.Diagnosis (Name of disease, western diagnosis)Each disease has 1 to 10 differentiations

3.TCM diagnosis (pattern differentiation)

4.Treatment StrategyBased on the differentiationEnergetic pathophysiology

5. Treatment (herbs or acupuncture)

Normal TongueNormal Tongue PinkPink

RedRed WhiteWhite BlueBlue

MoistMoist

Fits mouthFits mouth

Good toneGood tone

Tongue Changes- -ColorTongue Changes- -Color

Pale Pink RedPale Pink Red

Tongue Changes- -ColorTongue Changes- -Color

PurplePurple

Dark RedDark Red

Black (ashen)Black (ashen)

NormalNormal

Pale TonguePale Tongue

Wet is Qi deficiencyWet is Qi deficiency Dry is Blood DeficiencyDry is Blood Deficiency

Wet, Swollen (teeth Wet, Swollen (teeth marks) & purple is marks) & purple is Yang deficiencyYang deficiency

Red TongueRed Tongue

HEATHEAT

DeficiencyDeficiency ExcessExcess

Purple TonguePurple Tongue

DeficiencyDeficiency ExcessExcess

Yang Deficiency Stagnation ColdYang Deficiency Stagnation Cold

Tongue-Organ RelationshipTongue-Organ Relationship

HeartHeart

LungLung

SpleenSpleen

LiverLiverKidneyKidney

Tongue CoatingsTongue Coatings

White CoatingWhite Coating NormalNormal Excess ColdExcess Cold

Yellow CoatingYellow Coating HeatHeat

Greasy CoatingGreasy Coating Can’t be Scrubbed offCan’t be Scrubbed off DampDamp

Not as important in animals nor as prominentNot as important in animals nor as prominent

PulsesPulses

LeftLeft(Yin & Blood)(Yin & Blood)

RightRight(Qi & Yang)(Qi & Yang)

UpperUpper HeartHeart LungLung

MiddleMiddle LiverLiver SpleenSpleen

LowerLower KidneyKidney

YinYin

KidneyKidney

YangYang

Pulse DepthPulse Depth

SuperficialSuperficial

MiddleMiddle

DeepDeep

ExcessExcess

DeficiencyDeficiency

Pulse CharacterPulse Character

SlowSlow FastFast

ColdCold HotHot

Abnormal PulsesAbnormal Pulses

SlipperySlippery DampDamp

• Like being in a bogLike being in a bog

WiryWiry Liver StagnationLiver Stagnation

• Tight like a wireTight like a wire

IrregularIrregular Heart Qi or BloodHeart Qi or Blood

• arrhythmiaarrhythmia

Using Tongue & PulseUsing Tongue & Pulse

Pulse looks at current eventsPulse looks at current events

Tongue reflects historyTongue reflects history

Together, they help determine the nature, Together, they help determine the nature, location and Zang-Fu involvement in the location and Zang-Fu involvement in the disease processdisease process