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[level-membership-for-complementary-medicine-category]Chapter 91

HEART

Chapter contents

HEART-QI DEFICIENCY

HEART-YANG DEFICIENCY PATTERNS

Heart-yang deficiency

Clinical manifestations

Palpitations, shortness of breath on exertion, tiredness, slight depression, spontaneous sweating, a slight feeling of discomfort or stuffiness in the heart region, a feeling of cold, cold hands, bright-pale face, slightly dark lips.

Tongue

Pale.

Pulse

Deep-Weak, in severe cases Knotted.

Acupuncture

HE-5 Tongli, P-6 Neiguan, BL-15 Xinshu, Ren-17 Shanzhong, Ren-6 Qihai, Du-14 Dazhui.

Prescription

Rou Fu Bao Yuan Tang Cinnamomum-Aconitum Preserving the Source Decoction.

Heart-Yang deficiency with Phlegm

Clinical manifestations

Palpitations, a feeling of oppression of the chest, sputum in the throat, dizziness, tiredness, cold hands, numbness of the limbs, oedema of the hands, muzziness (fuzziness) of the head, poor memory, a feeling of heaviness, depression.

Tongue

Pale, wet and Swollen.

Pulse

Weak but slightly Slippery.

Acupuncture

Ren-6 Qihai, Ren-4 Guanyuan, Ren-8 Shenque, Du-4 Mingmen, ST-36 Zusanli, P-6 Neiguan, BL-23 Shenshu, Du-14 Dazhui, BL-15 Xinshu, ST-40 Fenglong, Ren-12 Zhongwan, P-5 Jianshi, Ren-17 Shanzhong.

Prescription

Ling Gui Zhu Gan Tang Poria-Ramulus Cinnamomi-Atractylodes-Glycyrrhiza Decoction plus Yi Yi Ren Semen Coicis lachryma jobi.

HEART-YANG COLLAPSE

Clinical manifestations

Palpitations, shortness of breath, weak and shallow breathing, profuse sweating, cold limbs, cyanosis of the lips, greyish-white complexion, in severe cases coma.

Tongue

Very Pale or Bluish-Purple, Short.

Pulse

Hidden-Minute.

Acupuncture

Ren-6 Qihai, Ren-4 Guanyuan, Ren-8 Shenque, Du-4 Mingmen, ST-36 Zusanli, P-6 Neiguan, BL-23 Shenshu, Du-20 Baihui, Du-14 Dazhui, BL-15 Xinshu. Moxa is applicable.

Prescription

Shen Fu Tang Ginseng-Aconitum Decoction.

HEART-BLOOD DEFICIENCY

Clinical manifestations

Palpitations, dizziness, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, dull-pale complexion, pale lips.

Tongue

Pale and Thin.

Pulse

Choppy or Fine.

Acupuncture

HE-7 Shenmen, P-6 Neiguan, Ren-14 Juque, Ren-15 Jiuwei, Ren-4 Guanyuan, BL-17 Geshu (with moxa), BL-20 Pishu.

Prescription

Shen Qi Si Wu Tang Ginseng-Astragalus Four Substances Decoction.

HEART-QI AND HEART-BLOOD DEFICIENCY

Clinical manifestations

Palpitations, shortness of breath, spontaneous sweating, depression, anxiety, tiredness, dull-pale complexion, insomnia.

Tongue

Pale and Thin.

Pulse

Weak or Choppy.

Acupuncture

HE-5 Tongli, HE-7 Shenmen, P-6 Neiguan, Ren-14 Juque, Ren-15 Jiuwei, Ren-4 Guanyuan, BL-17 Geshu (with moxa), BL-20 Pishu, BL-15 Xinshu.

Prescription

Ba Zhen Tang Eight Precious Decoction

Gui Pi Tang Tonifying the Spleen Decoction.

HEART-YIN DEFICIENCY PATTERNS

Heart-Yin deficiency

Clinical manifestations

Palpitations, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, mental restlessness, uneasiness, dry mouth and throat in the afternoon or evening.

Tongue

Normal-coloured without coating or with rootless coating.

Pulse

Floating-Empty, especially in the left- Front position.

Acupuncture

HE-7 Shenmen, P-6 Neiguan, Ren-14 Juque, Ren-15 Jiuwei, Ren-4 Guanyuan, HE-6 Yinxi, SP-6 Sanyinjiao, KI-7 Fuliu, KI-6 Zhaohai.

Prescription

Tian Wang Bu Xin Dan Heavenly Emperor Tonifying the Heart Pill.

Heart-Yin deficiency with Empty-Heat

Clinical manifestations

Palpitations, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, mental restlessness, uneasiness, ‘feeling hot and bothered’, dry mouth and throat in the evening, thirst with a desire to drink in small sips, a feeling of heat in the evening, malar flush, night sweating, five-palm heat.

Tongue

Red, redder on the tip, without coating.

Pulse

Floating-Empty, especially on the left-Front position and Rapid.

Acupuncture

HE-7 Shenmen, P-6 Neiguan, Ren-14 Juque, Ren-15 Jiuwei, Ren-4 Guanyuan, HE-6 Yinxi, SP-6 Sanyinjiao, KI-7 Fuliu, KI-6 Zhaohai, P-7 Daling, LI-11 Quchi, HE-9 Shaochong.

Prescription

Tian Wang Bu Xin Dan Heavenly Emperor Tonifying the Heart Pill plus Mu Dan Pi Cortex Moutan radicis.

HEART-QI AND HEART-YIN DEFICIENCY

Clinical manifestations

Palpitations, anxiety, tendency to be easily startled, slight breathlessness, tiredness, insomnia, mental restlessness, sweating on exertion, dry throat, night sweating.

Tongue

Normal-coloured without coating.

Pulse

Floating-Empty.

Acupuncture

HE-5 Tongli, HE-7 Shenmen, P-6 Neiguan, Ren-14 Juque, Ren-15 Jiuwei, Ren-4 Guanyuan, HE-6 Yinxi, SP-6 Sanyinjiao, BL-15 Xinshu.

Prescription

Zhi Gan Cao Tang Glycyrrhiza Decoction

Sheng Mai San Generating the Pulse Powder.

DEFICIENCY OF BOTH HEART-YANG AND HEART-YIN

Clinical manifestations

Palpitations, tendency to be easily startled, shortness of breath, a slight feeling of oppression of the chest, a feeling of cold, cold limbs, mental restlessness, night sweating, poor memory, malar flush.

Tongue

Pale or Red without coating depending on whether Yang or Yin deficiency predominates.

Pulse

Weak or Floating-Empty.

Acupuncture

HE-5 Tongli, HE-7 Shenmen, Ren-17 Shanzhong, BL-15 Xinshu, Ren-15 Jiuwei, SP-6 Sanyinjiao, ST-36 Zusanli.

Prescription

Zhi Gan Cao Tang Glycyrrhiza Decoction.

HEART-QI STAGNATION

Clinical manifestations

Palpitations, a feeling of distension or oppression of the chest, depression, a slight feeling of a lump in the throat, slight shortness of breath, sighing, poor appetite, chest and upper epigastric distension, dislike of lying down, weak and cold limbs, slightly purple lips, pale complexion.

Tongue

Slightly Pale-Purple on the sides in the chest area.

Pulse

Empty but very slightly Overflowing on the left Front position.

Acupuncture

HE-5 Tongli, HE-7 Shenmen, P-6 Neiguan, Ren-15 Jiuwei, Ren-17 Shanzhong, LU-7 Lieque, ST-40 Fenglong, LI-4 Hegu.

Prescription

Mu Xiang Liu Qi Yin Aucklandia Flowing Qi Decoction

Ban Xia Hou Po Tang Pinellia-Magnolia Decoction.

HEART-FIRE BLAZING

Clinical manifestations

Palpitations, thirst, mouth and tongue ulcers, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, dark urine or blood in the urine, bitter taste (after a bad night’ sleep).

Tongue

Red with redder tip and yellow coating. In more severe cases the tip could also be swollen.

Pulse

Overflowing-Rapid especially on the left Front position. It could also be Hasty (rapid and stopping at irregular intervals).

Acupuncture

HE-9 Shaochong, HE-8 Shaofu, HE-7 Shenmen, Ren-15 Jiuwei, SP-6 Sanyinjiao, KI-6 Zhaohai, LI-11 Quchi, Du-24 Shenting, Du-19 Houding.

Prescription

Xie Xin Tang Draining the Heart Decoction.

PHLEGM PATTERNS

Phlegm-Fire harassing the Heart

Clinical manifestations

Palpitations, mental restlessness, thirst, red face, a feeling of oppression of the chest, dark urine, expectoration of phlegm, rattling sound in the throat, bitter taste, insomnia, dream-disturbed sleep, a feeling of agitation, mental confusion, incoherent speech, rash behaviour, tendency to hit or scold people, uncontrolled laughter or crying, shouting, muttering to oneself, depression, manic behaviour.

Tongue

Red with redder and swollen tip and a sticky yellow coating. In severe cases there will be a deep Heart crack with a sticky, dry yellow coating inside it.

Pulse

Slippery-Rapid or Slippery-Overflowing-Rapid.

Acupuncture

P-5 Jianshi, HE-7 Shenmen, HE-8 Shaofu, HE-9 Shaochong, P-7 Daling, Ren-15 Jiuwei, BL-15 Xinshu, Ren-12 Zhongwan, ST-40 Fenglong, SP-6 Sanyinjiao, BL-20 Pishu, Du-20 Baihui, GB-13 Benshen, GB-17 Zhengying, Du-24 Shenting.

Prescription

Wen Dan Tang Warming the Gall-Bladder Decoction.

Phlegm misting the Mind

Clinical manifestations

Mental confusion, lethargic stupor, unconsciousness, incoherent speech, vomiting of phlegm, rattling sound in the throat, aphasia, mental depression, emotional lability, very dull eyes.

Tongue

Swollen with sticky coating.

Pulse

Slippery.

Acupuncture

HE-9 Shaochong, P-5 Jianshi, BL-15 Xinshu, ST-40 Fenglong, Du-26 Renzhong, Ren-12 Zhongwan, BL-20 Pishu, Du-20 Baihui, Du-14 Dazhui.

Prescription

Di Tan Tang Scouring Phlegm Decoction

Gun Tan Wan Vapourizing Phlegm Pill.

HEART-BLOOD STASIS

Clinical manifestations

Palpitations, stabbing or pricking chest pain which may radiate to the inner aspect of the left arm or to the shoulder, a feeling of oppression or constriction of the chest, cyanosis of lips and nails, cold hands.

Tongue

Purple in its entirety or only on the sides in the chest areas.

Pulse

Choppy, Wiry or Knotted. The pulse will be Knotted if Heart-Blood stasis occurs against a background of severe Heart-Yang deficiency.

Acupuncture

P-6 Neiguan, P-4 Ximen, HE-7 Shenmen, Ren-17 Shanzhong, BL-14 Jueyinshu, BL-17 Geshu, SP-10 Xuehai, KI-25 Shencang.

Prescription

Xue Fu Zhu Yu Tang Blood-Mansion Eliminating Stasis Decoction.

HEART VESSEL OBSTRUCTION

Clinical manifestations

Palpitations, shortness of breath with an inability to lie down, depression, mental restlessness, a feeling of stuffiness under the hypochondrium, a flustered feeling, a feeling of oppression of the chest, stabbing or pricking pain in the heart region which comes and goes, and which may radiate to the upper back or shoulder, pain aggravated by exposure to cold and alleviated by heat, expectoration of phlegm, epigastric or hypochondrial distension, a feeling of heaviness, dislike of speaking, cold hands, sighing, purple lips, face and nails.

Tongue

Purple on the sides in the chest areas, Swollen with a sticky coating.

Pulse

Wiry, Choppy or Knotted. It could also be Slippery if Phlegm is predominant.

This is a complex pattern due to Qi stagnation, Blood stasis, Cold and Phlegm occurring simultaneously.

Acupuncture

P-6 Neiguan, LU-7 Lieque, P-5 Jianshi, Ren-17 Shanzhong, LI-4 Hegu, ST-40 Fenglong, Ren-12 Zhongwan, Ren-15 Jiuwei, Ren-14 Juque, BL-17 Geshu, BL-14 Jueyinshu, Du-14 Dazhui (with moxa).

Prescription

Zhi Shi Gua Lou Gui Zhi Tang Citrus-Trichosantes-Ramulus Cinnamomi Decoction plus Dan Shen Radix Salviae miltiorrhizae.

WATER OVERFLOWING TO THE HEART

Clinical manifestations

Palpitations, dizziness, nausea, vomiting of watery, frothy white fluid, a feeling of cold, cold limbs, severe shortness of breath, a feeling of fullness and stuffiness of the chest and epigastrium, thirst with no desire to drink, urinary retention.

Tongue

Pale, Swollen and wet.

Pulse

Deep-Wiry or Deep-Fine-Slippery.

This pattern is seen only in the elderly.

Acupuncture

HE-5 Tongli, HE-6 Yinxi, BL-15 Xinshu, Ren-12 Zhongwan, Ren-9 Shuifen, KI-7 Fuliu, Ren-17 Shanzhong. Moxa is applicable.

Prescription

Ling Gui Zhu Gan Tang Poria-Ramulus Cinnamomi-Atractylodes-Glycyrrhiza Decoction.

Zhen Wu Tang True Warrior Decoction.

TURBID DAMPNESS SURROUNDING THE HEART

Clinical manifestations

Palpitations, cold hands, scanty urination, oedema of the ankles, sleepiness, mental confusion, sallow complexion, dizziness, frontal headache, blurred vision, nausea, vomiting, a feeling of oppression of the chest, poor appetite, abdominal fullness, loose stools, excessive salivation.

Tongue

Pale, Swollen with sticky white coating.

Pulse

Soggy or Deep-Slippery.

Acupuncture

HE-5 Tongli, BL-15 Xinshu, Ren-17 Shanzhong, Ren-12 Zhongwan, Ren-9 Shuifen, ST-28 Shuidao, SP-9 Yinlingquan, SP-6 Sanyinjiao.

Prescription

Wen Pi Tang Warming the Spleen Decoction plus Su He Xiang Wan Styrax Pill.

COMBINED PATTERNS

The Heart combined patterns are:

• Heart- and Liver-Blood deficiency (see under Liver combined patterns)

• Heart- and Spleen-Blood deficiency (see under Spleen combined patterns)

• Heart- and Kidney-Yin deficiency with Heart Empty-Heat (see ‘Heart and Kidneys not harmonized’ under Kidney combined patterns)

• Heart- and Lung-Qi deficiency (see under Lung combined patterns).

[/level-membership-for-complementary-medicine-category][not-level-membership-for-complementary-medicine-category]Chapter 91

HEART

Chapter contents

HEART-QI DEFICIENCY

Clinical manifestations

Palpitations, shortness of breath on exertion, pale face, tiredness, slight depression, spontaneous sweating.

Tongue

Pale.

Pulse

Empty.

Acupuncture

HE-5 Tongli, P-6 Neiguan, BL-15 Xinshu, Ren-17 Shanzhong, Ren-6 Qihai.

Prescription

Bao Yuan Tang Preserving the Source Decoction.

HEART-YANG DEFICIENCY PATTERNS

Heart-yang deficiency

Clinical manifestations

Tongue

Pale.

Pulse

Deep-Weak, in severe cases Knotted.

Acupuncture

HE-5 Tongli, P-6 Neiguan, BL-15 Xinshu, Ren-17 Shanzhong, Ren-6 Qihai, Du-14 Dazhui.

Prescription

Rou Fu Bao Yuan Tang Cinnamomum-Aconitum Preserving the Source Decoction.

Heart-Yang deficiency with Phlegm

Clinical manifestations

Tongue

Pale, wet and Swollen.

Pulse

Weak but slightly Slippery.

Acupuncture

Ren-6 Qihai, Ren-4 Guanyuan, Ren-8 Shenque, Du-4 Mingmen, ST-36 Zusanli, P-6 Neiguan, BL-23 Shenshu, Du-14 Dazhui, BL-15 Xinshu, ST-40 Fenglong, Ren-12 Zhongwan, P-5 Jianshi, Ren-17 Shanzhong.

Prescription

Ling Gui Zhu Gan Tang Poria-Ramulus Cinnamomi-Atractylodes-Glycyrrhiza Decoction plus Yi Yi Ren Semen Coicis lachryma jobi.

HEART-YANG COLLAPSE

Clinical manifestations

Palpitations, shortness of breath, weak and shallow breathing, profuse sweating, cold limbs, cyanosis of the lips, greyish-white complexion, in severe cases coma.

Tongue

Very Pale or Bluish-Purple, Short.

Pulse

Hidden-Minute.

Acupuncture

Ren-6 Qihai, Ren-4 Guanyuan, Ren-8 Shenque, Du-4 Mingmen, ST-36 Zusanli, P-6 Neiguan, BL-23 Shenshu, Du-20 Baihui, Du-14 Dazhui, BL-15 Xinshu. Moxa is applicable.

Prescription

Shen Fu Tang Ginseng-Aconitum Decoction.

HEART-BLOOD DEFICIENCY

Clinical manifestations

Palpitations, dizziness, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, dull-pale complexion, pale lips.

Tongue

Pale and Thin.

Pulse

Choppy or Fine.

Acupuncture

HE-7 Shenmen, P-6 Neiguan, Ren-14 Juque, Ren-15 Jiuwei, Ren-4 Guanyuan, BL-17 Geshu (with moxa), BL-20 Pishu.

Prescription

Shen Qi Si Wu Tang Ginseng-Astragalus Four Substances Decoction.

HEART-QI AND HEART-BLOOD DEFICIENCY

Clinical manifestations

Palpitations, shortness of breath, spontaneous sweating, depression, anxiety, tiredness, dull-pale complexion, insomnia.

Tongue

Pale and Thin.

Pulse

Weak or Choppy.

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