PERSONALIDAD DEL CONSUMIDOR

Yin and Yang form a pair of principles used to generalize categories of syndromes.

Plain Questions states: ‘An experienced doctor differentiates Yin and Yang first when he observes and palpates the patient.’

Yin syndrome: Interior, Cold, Deficiency syndromes.

Yang syndrome: Exterior, Heat, Excess syndromes.

Yin syndrome

Symptoms: Dark complexion, listlessness, curved lying, cold limbs, no thirst, stools with a fishy smell, clear and increased volume of urine, a pale flabby tender tongue, and a deep slow weak thready hesitant pulse.

Pathogenesis:

• Deficiency syndrome: Pale dark complexion, listlessness, tiredness, low voice.

• Interior Cold syndrome: Cold limbs, no thirst, loose stools with bad smell, clear and increased volume of urine.

• Deficiency Cold syndrome: Pale flabby tender tongue, deep slow or thready hesitant pulse.

analysis: Listlessness, tiredness and low voice indicate a Deficiency syndrome. cold limbs, no thirst, loose fish-smelling stools, clear and increased volume of urine in-dicate an interior Cold syndrome. A pale flabby tender tongue, a deep slow weak thready hesitant pulse are the signs of a deficiency Cold.

Yang syndrome

Symptoms: Red face, fever, hot skin, restlessness, loud voice, coarse breathing, abrupt breathing with Phlegm gurgling in the throat, thirst, stinking stools, yellow scanty urine, dark red tongue, burnt black thorny coating, superficial rapid surging rolling forceful pulse.

Pathogenesis:

• Heat syndrome: Red face, fever, hot skin, restlessness, thirst.

• Excess syndrome: Loud voice, coarse breathing, abrupt breathing with Phlegm gurgling in the throat, constipation with stinking stools, scanty yellow urine.

• Excess Heat syndrome: Dark red tongue, burnt black thorny coating, superficial rapid surging rolling forceful pulse.

analysis: Red face, restlessness, hot skin and thirst indicate Heat syndrome. Loud voice, abrupt breathing, Phlegm gurgling in the throat, and constipation indicate Excess syndrome. Dark red tongue, burnt black thorny coating, and surging rolling forceful pulse indicate Excess Heat syndrome.

Differentiation

Yin syndrome Yang syndrome

Inspection Pale dark complexion, lying in a curved position, tiredness, listlessness, pale flabby tender tongue, moistened slippery coating

Red face, hot skin, restlessness, dry mouth, dark red or black thorny tongue, dry yellow coating

Auscultation and olfaction

Low voice, inactive in talking, weak respiration, shortness of breath

Loud voice, talkative, coarse breathing, abrupt breathing with Phlegm rattling in throat, mania Inquiring Fishy stools, tastelessness, poor

appetite, no thirst or preferring hot drinks, increased or scanty urine

Constipation with dry and stinking stools, anorexia, dry mouth, thirst, scanty yellow urine

Palpation Abdominal pain that is better on pressure, Cold skin, deep weak thready hesitant slow pulse

Abdominal pain that is worse on pressure, hot skin, superficial surging rapid big rolling forceful slow pulse

A. Real Yin deficiency, Real Yang deficiency real Yin deficiency: Kidney Yin deficiency.

real Yang deficiency: Kidney Yang deficiency.

real Yin deficiency real Yang deficiency Symptoms Emaciation, hot sensation in

palms and soles, steaming Heat in bones, tidal fever, flushed cheeks, night

sweating, irritability, insomnia, dizziness, tinnitus, yellow scanty urine, constipation, red tongue, little coating, thready rapid pulse

cold limbs, lying in a curved position, sleepiness, listlessness, shortness of breath, dislike of talking, pale complexion, spontaneous sweating, no thirst or preferring hot drinks, clear and increased volume of urine, loose stools, or with undigested food in the stools, pale flabby tongue, white slippery coating, deep slow weak pulse

Pathogenesis With Yin deficiency, the internal Heat is produced, depriving Zang Fu of nourishment

With Yang deficiency, the internal Cold is produced, causing the failure of Yang to warm, transport and transform, and control

B. Collapse of yin, Collapse of yang

Collapse of Yin: Pathological conditions resulting from massive consumption of Yin fluid.

Collapse of Yang: Pathological conditions caused by extreme exhaustion of Yang Qi in the body.

Collapse of Yin Collapse of Yang

Hot salty sweat, red face, warm limbs, red dry tongue, surging forceful rapid pulse which is forceless when pressed, restlessness, delirium, hot skin, coarse breathing, thirst with preference for Cold drinks

Cold sweat, pale face, cold limbs, white moistened tongue, superficial rapid hollow or feeble pulse, dull expression or coma, Cold skin, feeble breathing, no thirst, preference for hot drinks

Prolonged disease with an extreme Yin deficiency, high fever, serious sweating, vomiting, diarrhoea, big loss of Blood – exhaustion of Yin fluid, deficiency Fire in the inside, malnutrition of the Zang Fu organs

Prolonged disease with an extreme Yang deficiency, serious damage of Yang Qi by excessive Yin Cold, serious sweating, big loss of Blood. Yang is vanished in the exhaustion of Yin – collapse of Yang, accumulation of Yin Cold in the inside, hypofunction of the Zang Fu organs

relations between the syndromes

A. relationship between Cold–Heat and exterior–interior Symptoms Severe chills, mild

fever, headache, mouth, slight thirst, or sweating, red tongue tip and borders, superficial rapid pulse

cold limbs, pale

complexion, no thirst, or preference for hot drinks, inactive in talking, clear and increased volume of urine, loose stools, pale tongue, white moist tongue-coating, deep slow pulse

Red face, hot skin, thirst, irritability, preference for Cold drinks, restlessness, talkative, yellow urine, constipation, red tongue with yellow coating, rapid pulse

Pathogenesis

exterior Cold syndrome exterior heat syndrome

Interior Cold syndrome

Interior heat syndrome Invasion of Cold damaging

Wei-defence Yang,

dysfunction of the Lungs in dispersing and descending

Invasion of Heat, Wei-defence Qi being obstructed

Direct invasion of Cold to Zang Fu, or deficiency of Yang Qi

Internal Heat consuming the Body Fluid

analysis which fails to warm the body surface, leading to chills. In the struggle between the antipathogenic Qi and pathogenic factor, Yang Qi is obstructed, leading to fever.

Cold stagnated in the vessels, causing headache and general aching. Cold is characterized by contraction, the skin pores are closed, leading to superficial tense blocked, leading to fever and chills. Heat is a Yang pathogenic factor, so there is severe fever and mild chills, dry mouth and slight thirst. Heat is characterized by upward and outward movement, the skin pores opening, leading to sweating.

Heat affects upward, leading to headache.

Heat stays in the exterior, leading to red tongue tip and borders, and superficial rapid pulse

The direct invasion of Cold damages Yang Qi, which fails to warm the body, leading to cold limbs and pale complexion.

Yin Cold is in the inside without damaging Body Fluid, so there is no thirst, or thirst with a preference for hot drinks.

Yin Cold creates hypofunction, resulting in little talking. Clear urine and loose stools, pale tongue with white moist coating, and deep slow pulse are the signs of interior Cold

The interior Heat steams the skin, leading to red face and hot skin. Body Fluid is damaged, leading to thirst with a preference for Cold drinks.

Yang Heat creates hyperfunction, causing restlessness with active talking.

Body Fluid is damaged by Heat, leading to scanty yellow urine. The Body Fluid of the intestines is damaged, leading to dry stools. Red tongue with yellow coating and rapid pulse are the signs of interior Heat

B. Relationship between Deficiency–Excess, exterior–interior and to Wind, superficial pulse that is a bit

Wind obstructs the Taiyang Meridian, leading to a headache and stiff neck. Yang Qi goes outward and upward, leading to fever. Body surface is loose, with the skin pores opened by the Wind, leading to sweating and aversion to Wind. Wind stays on the body surface, so the pulse is a bit slow Endogenous by pale complexion, shortness of breath which is worse on exertion, tiredness, poor appetite, loose stools, pale tongue, white coating,

The Lungs dominate the skin and hair and the Spleen dominates the muscles. When Qi is deficient, the body surface becomes weak with unconsolidation of Wei-defence, leading to spontaneous sweating.

Wei-defence is weak in protection, leading to frequent catching of Cold. Pale complexion, shortness of breath which is worse on exertion, tiredness, poor appetite, loose stools, pale tongue, white coating, thready weak pulse are due to Qi deficiency of the Lungs and Spleen

exterior excess syndrome

Symptoms Pathogenesis and analysis

Symptoms of exterior syndrome and no sweating, general aching, superficial tense pulse

In invasion of Cold, Yang Qi comes to the body surface, struggling with the pathogenic Qi, the body surface is strong and pores are closed. Seen in the exterior Cold syndrome

Interior Deficiency syndrome

Symptoms Pathogenesis analysis

Interior Deficiency Cold syndrome is of Yang Deficiency syndrome, manifested as cold limbs, lying in a curved position, sleepiness, listlessness, tiredness, shortness of breath, being inactive in talking, pale complexion, spontaneous sweating, no thirst, preference for hot drinks, clear and increased volume of urine, loose stools, with undigested food in the stools, pale flabby tongue, white slippery coating, deep slow forceless pulse

With Yang Qi deficiency, internal Cold is produced, causing the failure of warming, Qi activities and controlling. Same as that in the deficiency Cold syndrome

Same as that in the Deficiency Cold syndrome

Interior excess syndrome

Cold pain that is alleviated by warmth, pale complexion, cold limbs, abdominal pain that is made worse by pressure, cough with Phlegm rattling in the throat, salivation, clear and increased volume of urine, white moist tongue-coating, slow or tense pulse

Preponderance of internal Cold results in obstruction of Yang Qi

Pathogenic Cold blocks Yang Qi, producing Cold pain that is better on warmth, and cold limbs. Stagnation of Cold blocks the meridians and collaterals, causing abdominal pain that is worse on pressure. Yang Qi in deficiency is unable to nourish the face, so there is a pale complexion.

Cold makes the Spleen low in transportation and transformation owing to the disturbance of Spleen Yang, leading to borborygmus and diarrhoea. Cold attacks the Lungs, producing cough and Phlegm, salivation, clear and increased volume of urine, and white moist tongue-coating. Cold makes the Blood circulation slow, so slow pulse Interior

Excess Heat syndrome

High fever, thirst, preference for Cold drinks, red face and eyes, restlessness, coma, delirium, abdominal distention and pain that is worse on pressure, constipation, yellow scanty urine, red tongue, yellow dry coating, surging rolling rapid forceful pulse

Internal Heat consumes the Body Fluid

The internal Heat is strong, leading to high fever. Fire flares, leading to red face and eyes. Heat disturbs the Mind stored in the Heart, leading to restlessness, coma and delirium. Heat stagnates in the intestines, leading to abdominal distention and pain that is worse on pressure, and constipation.

Yin fluid is consumes by Heat, causing yellow scanty urine, thirst, and preference for Cold drinks. Red tongue and yellow coating indicates Heat inside. Heat is likely to disturb the Blood and vessels, leading to a surging rolling rapid forceful pulse

Deficiency Cold syndrome

Symptoms Pathogenesis analysis

Listlessness, pale complexion, cold limbs, abdominal pain which is better on pressure, loose stools, clear and increased volume of urine, tiredness, pale tender tongue, weak deep slow pulse

With Yang Qi

deficiency, internal Cold is produced, causing the failure of warming, Qi activities and controlling. Same as that in the interior deficiency Cold syndrome

With Yang Qi deficiency, the function of Qi is weak, leading to listlessness, a pale complexion, tiredness, pale tender tongue, and weak deep slow pulse. Without the warmth of Yang Qi, the manifestations will be cold limbs, abdominal pain that is better on pressure, loose stools, and clear and increased volume of urine

Deficiency heat syndrome

Symptoms Pathogenesis analysis Flushed cheeks,

emaciation, tidal fever, night sweating, hot sensation in palms and soles, dry throat, red tongue, little coating, thready rapid pulse

Exhaustion of Yin fluid produces

emaciation, tidal fever and night sweating.

Deficiency Fire flares up, causing flushed cheeks, dry throat, red tongue and little coating. Yin Blood is deficient, leading to a thready pulse. Deficiency Heat inside leads to thready rapid pulse

ii. DiffErEnTiATion of synDroMEs ACCorDing To THE THEory of AETiology

The purpose of the differentiation of syndromes according to the Theory of Aaetiology is to identify the causative factors of diseases by analysing the clinical manifestations, which is known as ‘seeking the causative factors by differentiating symptoms and signs’.

1. DIFFErEnTIATIOn OF SYnDrOMES ACCOrDInG TO ThE