| TEN ASKING SONG |
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AREA | QUESTIONS | REASONS |
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1) Fever and Chills
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questions
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determines presence or absence of heat and cold
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2) Perspiration
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questions
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determines condition of wei qi, body fluids, and heat in the body
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3) Head and Body (aches)
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head: dizziness, tics and tremors, headaches.
body: pain, numbness, tingling
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determines existance of internal wind, or bi syndromes.
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4) Stools and Urine
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questions
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determines presence or lack of heat and cold in body
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5) Food, Taste, and Appetite
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questions
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mostly focuses on the functions of the middle jiao.
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6) Chest and Abdomen
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questions
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reasons
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7) Ears and Eyes
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questions
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reasons
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8) Thirst and Beverages
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questions
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determines presence or lack of heat or cold
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9) Sleep
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questions
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reasons
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10) Women's Questions
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period: regularity, quantity of flow, color of flow, consistance of flow.
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determines the functions of the Blood and the Liver
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| GLOBAL GENERALITIES |
| Discharges | |
Clear and copious | cold |
| Yellow and scanty | heat |
| Cloudy | damp |
| Pus | toxicity |
| Yellow to green | heat |
| Thin and watery | phlegm damp |
| Hard and difficult to expectorate | dry phlegm |
| Pale pink, red, or purple urine | bleeding
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Sounds
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Loud | excess |
| Soft | deficiency
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Aggravation
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worse with rest | stagnation |
| worse with fatigue | deficiency |
| spicy food | yin or Qi deficiency |
| worse with heat | heat |
| worse with cold | cold |
| worse with pressure | excess |
| increases by eating | excess |
| after sex | kidney deficiency |
| with stress | Liver Qi stagnation |
| before period | Liver Qi stagnation |
| after period | Blood deficiency
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Amelioration
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better with rest | deficiency |
| better with movement | stagnation |
| better with heat | cold |
| better with cold | heat |
| worse with damp weather | damp in the channels |
| better with pressure | deficiency |
| diminishes with eating | deficiency
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Appearances
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Red | heat |
| Pale and flaccid | deficiency |
| Pink or pale red | yin deficiency |
| Nodular or lumpy | stagnation of Qi, Blood, or phlegm (or combination of the three) |
| Red with pus | heat with toxicity
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Pain
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pain migrates | Wind in the channels |
| red, swollen, hot joints | heat in the channels |
| dull, distended, larger area | qi stagnation |
| sharp, fixed, smaller area | blood stagnation |
| heavy pain | damp |
| cramping pain | cold |
| burning pain | heat
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Onset
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Acute onset, short duration | exterior |
| Slow onset, chronic duration | interior |
| excess pathologies tend to run their course quickly and are more intense. |
| deficiency pathologies tend to run chronically and are low-grade.
| | Times 'O The Day |
|---|
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Dawn | shao yang |
| Midday | tai yang |
| Afternoon to dusk | yang ming |
| Dusk to midnight | shao yin |
| Midnight to 3 am | tai yin |
| 3 am to dawn | jue yin
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Age
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elderly | tend to suffer from deficiencies |
| youth | tend to suffer from excesses |
| children | can be excessive or deficient
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Liver Signs
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Pathologies that are coincidental to the period | generally indicate a Liver involvement. |
| Pathologies that are stress induced | generally indicate a Liver involvement.
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Gender Specific Issues
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Women tend to suffer from a deficiency of Blood (through menopause, then Yin) |
| Men tend to suffer from a deficiency of Yin or Yang or Jing
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Food and Drink
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desire for warm | cold |
| desire for cold | warm
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Areas of Domination
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flanks | gall bladder |
| hypochondrium (includes back and front) | Liver |
| lumbus (low back) | Kidney |
| epigastric region (below ribs on midline) | Stomach |
| "alternating" things | Shao Yang (GB) |
| one sided things | Shao Yang (GB)
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File under "Duh"
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cough | Lungs |
| palpitations | Heart |
| diarrhea | Spleen
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The Pulse
The Simple Pulse Characteristics
| SPEED | FAST | SLOW |
| STRENGTH | FORCEFUL | FORCELESS |
| LENGTH | LONG | SHORT |
| WIDTH | WIDE | THIN |
| DEPTH | SUPERFICIAL | DEEP |
| RHYTHM | REGULAR | IRREGULAR |
| ABNORMAL PULSE SHAPES |
CHOPPY, WIRY, SLIPPERY |
| FAST AND SLOW |
|
PULSE | INDICATIONS | MECHANISM |
| Fast Pulse | Heat | Heat accelerates movement. |
| fast+forceful | excess heat | |
| fast+thin | deficiency heat | |
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Slow Pulse
Water element pulse | cold | Cold impedes movement. The so-called "Athletic Pulse" is also a slow pulse, but it only indicates cardiac health. |
| FORCEFUL AND FORCELESS |
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PULSE | INDICATIONS | MECHANISM |
| FORCEFUL Pulses | excess | |
Surging Pulse (floating, wide, forceful, comes stronger than it goes)
Fire element pulse |
excessive heat | mechanism presumed to be heat stimulates the Heart's function of commanding the Blood leading to increased cardiac output and the more forceful, surging pulse. |
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| Forceless Pulses | deficiency | deficiency of Qi or Yang gives rise to the forceless pulse. |
| LONG AND SHORT |
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PULSE | INDICATIONS | MECHANISM |
| Long Pulse | excessive heat | Heat accelerates and expands. When the pulse is long and too forceful, this is excessive heat. When the long pulse is moderate in force, this is a healthy pulse. |
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| Short Pulse | | |
| short+forceful | Qi stagnation | Stagnation prevents Blood from filling the vessel. |
| short+forceless | Qi deficiency | Qi can't push Blood hard enough to fill the vessel. |
| WIDE AND THIN |
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PULSE | INDICATIONS | MECHANISM |
| Wide Pulse | heat | |
| wide+forceful | excessive heat | Heat accelerates and expands. |
| wide+forceless | deficiency heat | Yang expands the width of the vessel because Yin is too deficient to anchor it. |
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| Thin Pulse | deficiency of Qi, Blood, or Yin | Qi, Blood, or Yin can't fill the vessel with fluid or pressure to expand the width of the vessel. |
| SUPERFICIAL AND DEEP |
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PULSE | INDICATIONS | MECHANISM |
Superficial Pulse
Metal element pulse |
| superficial+forceful | exterior syndrome | Yang floats to the exterior (as Wei Qi) to fight off invasion of exterior pathogenic factor. This is reflected metaphorically in the superficial pulse. |
| superficial+forceless | Yin deficiency | Yang floats to the exterior because Yin cannot anchor it. This is reflected metaphorically in the superficial pulse. |
|
| Deep Pulse |
| deep+forceful | internal cold | pathological cold both injures Yang and impedes its rising. This is reflected metaphorically in the deep pulse. |
| deep+forceless | Yang deficiency | A deficiency of Yang gives rise to the inability for Qi and Blood to lift upwards. This is reflected metaphorically in the deep pulse. |
| REGULAR AND IRREGULAR |
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PULSE | INDICATIONS | MECHANISM |
| Regular Pulse | health | |
Intermittent Pulse (regularly irregular) | Rather than focusing too much on the indications of this pulse, I want you to remember that this may be a red flag for you and a referral to a cardiologist may be indicated. |
Abrupt Pulse (rapid, irregular rhythm) | heat stagnation or stagnation heat | This pulse indicates stagnation that gives rise to heat, or heat that is causing stagnation. In either case, we have stagnation and heat. |
Knotted Pulse (slow, irregular rhythm) | Blood Stagnation | pathological factors (likely cold) impede movement of Blood |
| ABNORMAL PULSE SHAPES |
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PULSE | INDICATIONS | MECHANISM |
| Choppy Pulse | Blood Stagnation | |
| choppy+forceful | Blood Stagnation | excessive pathological factors impede movement of Blood |
| choppy+forceless | Blood Stagnation | lack of Qi, Blood, or Jing leads to vessels that aren't filled which inhibits free flow of Blood. |
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Wiry Pulse
Wood element pulse | Stagnation | Nei Jing says "tendons are the mother of vessels" which is to say that when the Liver becomes dry, so do the tendons, which leads to a hardness in the pulse as it loses the vessels lose their flexibility.
Another mechanism is Qi stagnation prevents Blood from circulating outward and so the pressure remains high in the vessels causing the hard (wiry) pulse. |
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Slippery Pulse
Earth element pulse | Dampness | Dampness in the Blood increases its viscosity giving rise to a pulse that lacks corners. |
| Heat | Heat accelerates the movement of the Blood giving rise to the perception of the pulse losing its corners. |
| Tongue Body Color |
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COLOR | INDICATIONS | MECHANISM |
| Pale | deficiency | Qi and/or Blood unable to fill tongue body |
| deficiency of Qi | Qi too deficient to guide Blood to tongue to give it pink color. |
| deficiency of Blood | Lack of Blood can't give tongue pink color |
| deficiency of Yang | Lack of Yang can't lift Qi and Blood to tongue to give it pink color. |
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| Pink | normal | Pink means adequate Qi and Blood. |
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| Red | heat | Heat accelerates and expands movement of Blood which fills tongue with more red color. |
| excess heat | Often found with a thicker tongue coating, likely yellow. |
| deficiency heat | Often found with a thin or scanty tongue coating. |
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| Crimson (dark red) | Ying or Blood level heat. Blood stagnation with heat | Heat damages yin, causes the red to become more concentrated and darker. Blood stagnation with heat Blood stagnation causes purple color, heat makes it more red. |
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| Purple | Blood stagnation | The slower the Blood moves, the more depleted of oxygen it will become, giving rise to a tendency toward the blue color. Purple is a transitory color between pink and blue. |
| Blue-Purple | Blood stagnation with, or due to cold. | Cold (blue) impedes movement which causes Blood stagnation (purple) |
| Pale Purple ("dusky") | Blood stagnation with or due to deficiency of Qi, Blood, or Yang | Blood stagnation is purple, pale is deficiency. |
| Blue | Internal cold | Cold impedes movement which allows red blood to lose its oxygen giving rise to the blue color. (western explaination) |
| Tongue Body Shape
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SIZE | INDICATIONS | MECHANISM |
| Small tongue body | deficiency of Blood or Yin | Lack of fluids causes tongue to shrink in size. |
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| Swollen tongue body (vertically enlarged) | excess heat or alcohol/drug toxicity | Heat pushes more Blood into tongue body to increase its size. |
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| Flabby tongue body (horizontally enlarged) | damp or phlegm | fluids fill tongue and enlarge it horizontally. |
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| Teeth marks | damp or phlegm | a continuation of the flabby tongue in which the teeth indentations are visible. |
| Tongue Body Cracks
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CRACKS | INDICATIONS | MECHANISM |
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Cracks in tongue body | Blood or Yin deficiency | Fluids unable to moisten and nourish tongue body giving rise to cracks like dried earth. |
| +red | Yin deficiency | Fluids unable to moisten and nourish tongue body. |
| +pale | Blood deficiency | Fluids unable to moisten and nourish tongue body. |
+teeth marks cracks on lateral sides, look like fish's gills | dampness | Damp prevents fluids from rising up to tongue to nourish it. |
| Prickles, dots, spots |
|
SPOTS | INDICATIONS | MECHANISM |
| Prickles, dots, spots | heat or stagnation | |
| +red | heat | Heat causes too much Qi and Blood to rise to the tongue where it causes the body to develop dots, points, spots, etc. |
| +purple (brown, dark) | Blood stagnation | Blood stagnation always looks purple. |
| Tongue Bearing Issues |
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BEARING | INDICATIONS | MECHANISM |
| Stiff tongue | Spasm due to internal wind | Excess heat, or a deficiency of Liver Yin or Blood can cause wind causing the tongue body to become stiff. |
| Limp tongue | deficiency of Qi, Blood, or Yin. | Lack of nutrients cause the tongue to become limp. |
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| Trembling tongue | Spasm due to internal wind | Excess heat, or a deficiency of Liver Yin or Blood can cause wind causing the tongue body to tremble. NOTE: all tongues move, this sign is EXCESSIVE movement. |
| Deviated tongue | Internal wind, phlegm in channels | Something is blocking the channels and collaterals on one side of the tongue preventing its movement. This is also a "check in with a neurologist" indication due to the possibility of a tumor impinging a cranial nerve. |
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| Engorged Sublingual Veins | Qi and/or Blood stagnation | Blood flow is impeded, giving rise to the appearance of backed-up Blood beneath the tongue. |
| Coating Color
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COLOR | INDICATIONS | MECHANISM |
| White | cold | White and clear things in TCM are dilute and cold. |
| Yellow | heat | Yellow things in TCM are more concentrated due to heat damaging the Yin. |
| Gray | interior cold or heat | heat or cold is damaging the interior. |
| Black | extreme interior cold or heat | a further exasperation of the gray coating |
| Coating thickness
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THICKNESS | INDICATIONS | MECHANISM |
| Thin coating | exterior syndrome or normal | If you can see through the coating to the body of the tongue, it is thin. |
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| Thick coating | excessive condition, interior, damp, phlegm, food stagnation | Coating is the "smoke" of the stomach. Pathological factors rise with the Stomach Qi to the tongue coating. |
| Coating Moistness |
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MOISTNESS | INDICATIONS | MECHANISM |
| Moist coating | normal | the coating is neither excessively wet, dripping, or dry |
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| Glossy (excessively shiny or wet) coating | internal cold, Yang deficiency | Yang deficiency or cold that damages Yang impedes the transformation of fluids giving rise to the accumulation of dampness or phlegm which shows up on the tongue in the form of the excessively wet coating. |
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| Dry coating | dryness, heat, Yin deficiency, Yang deficiency | Here, we have a variety of factors that damage the body fluids including heat and dryness. Yin deficiency is obviously a form of internal dryness, and Yang deficiency can give rise to dryness in the body if the Yang is too weak to transform dietary water into body fluids. |
| Coating Distribution
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DISTRIBUTION | INDICATIONS | MECHANISM |
| Even coating | phlegm-damp accumulation in the middle Jiao | The tongue indicates the conditions throughout the entire body, but also focuses on the Spleen and Stomach in particular. One map that is laid atop the tongue suggests that the entire tongue indicates the condition of the Spleen and Stomach only. So, a coating that covers the entire tongue can sometimes indicate only a pathology of the middle Jiao. |
| Coating on the anterior third (front third) | superficial invasion of pathogenic factor | The anterior third of the tongue is related to the Lungs and Heart. When a pathogenic factor enters the body, it generally enters through the Lungs, and so this thick coating on the anterior third of the tongue indicates this superficial invasion. |
| Coating in the middle only. | Phlegm and/or damp in the middle Jiao | Middle of the tongue is related to the middle Jiao. |
| Coating on one side or the other. | Shao Yang disease | Most pathologies that are one-sided or have symptoms that flip-flop between opposites (i.e. alternating chills and fever) indicate that the pathological factor has found its way to the Shao Yang channel, level, or organ (GB). |
| Peeled/Scanty/Coatless | Stomach Yin or Kidney Yin deficiency | Because the tongue coating is the smoke of the Stomach, and this smoke requires some Yin to evaporate up toward the tongue, a lack of Yin will cause a lack of smoke to rise and a lack of coating. |
| Geographic coating | Stomach Yin or Stomach Qi deficiency | Coating is the smoke of the Stomach. The Yin is what is heated to cause the smoke, while the Qi is that heating activity. In the absence of either of these factors, the coating can appear missing on portions of the tongue. |
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