ARMS

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Chapter 65

ARMS

Red dorsum of the hands

Numbness/tingling of the hands

Dry, cracked and peeling palms

Venules on the thenar eminence

Atrophy of the thenar eminence

Atrophy of the muscles of the dorsum of the hands

FINGERS

Swollen fingers

Contraction of the fingers

Spoon-shaped fingers

Thin, pointed fingers

Cracked fingers

Thickened fingers

Shrivelled and wrinkled fingers

NAILS

Ridged nails

Thickening of the nails

Coarse and thick nails

Cracked nails

Nails falling off

Indented nails

Thin and brittle nails

Withered and brittle nails

Withered and thickened nails

Curling nails

Flaking nails

Twisted nails

Nails with white spots

Bluish-greenish nails

Dark nails

Purple nails

Small or absent lunulae

Large lunulae

PAIN IN THE ELBOW

Interrogation, Chapter 39

HANDS

Cold hands

Interrogation, Chapter 39

Heart-Yang deficiency

Cold hands, sweaty hands, palpitations, shortness of breath on exertion, tiredness, spontaneous sweating, a slight feeling of discomfort or stuffiness in the heart region, a feeling of cold, bright-pale face, slightly dark lips, Pale tongue, Deep-Weak pulse.

Lung-Yang deficiency

Cold hands, sweaty hands, slight shortness of breath, slight cough with profuse watery sputum, weak voice, spontaneous daytime sweating, dislike of speaking, bright-white complexion, tendency to catch colds, tiredness, dislike of cold, a feeling of cold generally or of the upper back, absence of thirst, Pale and slightly wet tongue, Weak pulse.

Heart-Blood deficiency

Cold hands, palpitations, dizziness, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, dull-pale complexion, pale lips, Pale and Thin tongue, Choppy or Fine pulse.

Spleen-Yang deficiency

Cold hands and often cold feet, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, a feeling of cold, oedema, Pale and wet tongue, Deep-Weak pulse.

Liver-Qi stagnation

Cold hands, especially fingers, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Phlegm in the channels

Cold hands, numbness or tingling of the limbs, a feeling of heaviness, or of oppression of the chest, sputum in the throat, Swollen tongue with sticky coating, Slippery pulse.

Clinical note

• Cold hands are a reliable symptom of Yang deficiency.

Hot hands

Interrogation, Chapter 39

Heart-Fire

Hot hands, especially the dorsum, palpitations, thirst, mouth and tongue ulcers, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Lung-Heat

Hot hands, especially the dorsum, cough, slight breathlessness, a feeling of heat, chest ache, flaring of the nostrils, thirst, red face, Red tongue with yellow coating, Overflowing-Rapid pulse.

Stomach-Heat

Hot hands, especially the dorsum, burning epigastric pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Heart-Yin deficiency with Empty-Heat

Hot palms, five-palm heat, palpitations, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, mental restlessness, uneasiness, ‘feeling hot and bothered’, dry mouth and throat, thirst with a desire to sip fluids, a feeling of heat in the evening, malar flush, night sweating, Red tongue with redder tip and no coating, Floating-Empty and Rapid pulse.

Lung-Yin deficiency with Empty-Heat

Hot palms, five-palm heat, dry cough or with scanty, sticky sputum which could be blood tinged, dry mouth and throat at night, weak/hoarse voice, night sweating, tiredness, malar flush, a feeling of heat or a low-grade fever in the evening, thin body or chest, insomnia, anxiety, Red tongue without coating, Floating-Empty and Rapid pulse.

Stomach-Yin deficiency with Empty-Heat

Hot palms, five-palm heat, dull or burning epigastric pain, a feeling of heat in the afternoon, constipation (dry stools), dry mouth and throat especially in the afternoon, thirst with a desire to drink in small sips, a feeling of hunger but no desire to eat, a slight feeling of fullness after eating, night sweating, five-palm heat, bleeding gums, Red tongue (or Red centre only) without coating in the centre, Floating-Empty and Rapid pulse.

Stomach Damp-Heat

Hot hands (dorsum), swelling and redness of the joints, pain in the hands, a feeling of fullness and pain of the epigastrium, a feeling of heaviness, facial pain, stuffed nose or thick sticky nasal discharge, thirst without a desire to drink, nausea, a feeling of heat, dull-yellow complexion, a sticky taste, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Invasion of Wind

Dorsum of the hands hot to touch, aversion to cold, chills, fever, stiff neck, occipital headache, Floating pulse.

Other symptoms and signs depend on whether it is Wind-Cold or Wind-Heat.

Pale hands

Observation, Chapter 14

Heart-Yang deficiency

Pale hands, cold hands, palpitations, shortness of breath on exertion, tiredness, spontaneous sweating, a slight feeling of discomfort or stuffiness in the heart region, a feeling of cold, bright-pale face, slightly dark lips, Pale tongue, Deep-Weak pulse.

Lung-Yang deficiency

Pale hands, cold hands, slight shortness of breath, slight cough with profuse watery sputum, weak voice, spontaneous daytime sweating, dislike of speaking, bright-white complexion, tendency to catch colds, tiredness, dislike of cold, a feeling of cold generally or of the upper back, absence of thirst, Pale and slightly wet tongue, Weak pulse.

Liver-Blood deficiency

Pale hands, dizziness, blurred vision, floaters, numbness/tingling of the limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Heart-Blood deficiency

Pale hands, palpitations, dizziness, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, dull-pale complexion, pale lips, Pale and Thin tongue, Choppy or Fine pulse.

Red dorsum of the hands

Observation, Chapter 14

Full-Heat

Red dorsum of the hands, hot hands, a feeling of heat, thirst, red face.

Other symptoms and signs depend on which organ is involved, which may be the Heart, Lungs or Stomach.

Red palms

Observation, Chapter 14

Empty-Heat

Red palms of the hands, hot hands, becoming hotter in the afternoon and evening, a feeling of heat in the afternoon or evening, thirst with a desire to drink in small sips.

Other symptoms and signs depend on which organ is involved, which may be the Heart, Lungs or Stomach.

Sweaty palms

Observation, Chapter 14

Lung-Qi deficiency

Sweaty palms, slight shortness of breath, slight cough, weak voice, spontaneous daytime sweating, dislike of speaking, bright-white complexion, tendency to catch colds, tiredness, dislike of cold, Pale tongue, Empty pulse.

Lung-Yang deficiency

Sweaty palms, pale hands, cold hands, slight shortness of breath, slight cough with profuse watery sputum, weak voice, spontaneous daytime sweating, dislike of speaking, bright-white complexion, tendency to catch colds, tiredness, dislike of cold, a feeling of cold generally or of the upper back, absence of thirst, Pale and slightly wet tongue, Weak pulse.

Lung-Yin deficiency

Sweaty palms which are worse in the afternoon, hot palms, cough which is dry or with scanty sticky sputum, weak/hoarse voice, dry mouth and throat, tickly throat, tiredness, dislike of speaking, thin body or thin chest, night sweating, normal-coloured tongue without coating (or with rootless coating) in the front part, Floating-Empty pulse.

Heart-Qi deficiency

Sweaty palms when nervous, palpitations, shortness of breath on exertion, pale face, tiredness, slight depression, spontaneous sweating, Pale tongue, Empty pulse.

Heart-Yang deficiency

Sweaty palms with cold sweat when nervous, cold hands, palpitations, shortness of breath on exertion, tiredness, spontaneous sweating, a slight feeling of discomfort or stuffiness in the heart region, a feeling of cold, bright-pale face, slightly dark lips, Pale tongue, Deep-Weak pulse.

Heart-Yin deficiency

Sweaty palms which are worse in the evening or when nervous, palpitations, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, mental restlessness, uneasiness, ‘feeling hot and bothered’, dry mouth and throat, night sweating, normal-coloured tongue without coating or with rootless coating, Floating-Empty pulse, especially on the left Front position.

Lung-Heat

Sweaty palms, hot hands, cough, slight breathless-ness, a feeling of heat, chest ache, flaring of the nostrils, thirst, red face, Red tongue with yellow coating, Overflowing-Rapid pulse.

Heart-Fire

Sweaty palms and hot hands, especially when anxious, palpitations, thirst, mouth and tongue ulcers, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Pain in the hands

Interrogation, Chapter 39

Wind

Wandering pain in the hands, fingers and other joints.

Cold

Pain in the hands that is aggravated by exposure to cold and alleviated by application of heat, contraction of fingers, a feeling of cold, cold hands.

Dampness

Ache and swelling of the hand or fingers or both, numbness of the hands.

Damp-Heat in the channels

Pain, swelling and redness of the hands, numbness/tingling of the hands, a feeling of heaviness of the arms, muscle ache.

Liver-Qi stagnation

Pain in the hands (often in feet as well), hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Stagnation of Qi and stasis of Blood

Pain in the hands that is worse at night, rigidity of the fingers, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, abdominal pain, chest pain, Purple tongue, Wiry pulse.

Blood deficiency

Dull ache of the hands, cold hands, dizziness, blurred vision, scanty periods, Pale tongue, Choppy or Fine pulse.

Other symptoms and signs depend on the organ affected, which may be Heart, Liver or Spleen. This pattern is more common in women.

Heart-Yang deficiency

Dull ache in the hands, cold hands, palpitations, shortness of breath on exertion, tiredness, spontaneous sweating, a slight feeling of discomfort or stuffiness in the heart region, a feeling of cold, bright-pale face, slightly dark lips, Pale tongue, Deep-Weak pulse.

Lung-Yang deficiency

Dull ache in the hands, cold hands, slight shortness of breath, slight cough with profuse watery sputum, weak voice, spontaneous daytime sweating, dislike of speaking, bright-white complexion, tendency to catch colds, tiredness, dislike of cold, a feeling of cold generally or of the upper back, absence of thirst, Pale and slightly wet tongue, Weak pulse.

Stomach-Yang deficiency

Dull ache in the hands, cold hands (and often feet), discomfort or dull pain in the epigastrium, better after eating and with pressure or massage, no appetite, preference for warm drinks and foods, vomiting of clear fluid, absence of thirst, cold and weak limbs, tiredness, pale complexion, Pale and wet tongue, Deep-Weak pulse.

Heart-Yin deficiency

Dull ache in the hands that is worse in the evening, hot palms, palpitations, insomnia, dream-disturbed sleep, poor memory, anxiety, a tendency to be easily startled, mental restlessness, uneasiness, ‘feeling hot and bothered’, dry mouth and throat, night sweating, normal-coloured tongue without coating or with rootless coating, Floating-Empty pulse, especially on the left Front position.

Lung-Yin deficiency

Dull ache in the hands that is worse in the evening, hot palms, dry cough, weak voice, dry throat with a desire to sip water, hoarse voice, night sweating, tiredness, tongue without coating in the front, Floating-Empty pulse.

Itchy hands

Interrogation, Chapter 39

Dampness

Itchy hands, swollen fingers with small white vesicles, fungal infections, sticky tongue coating, Slippery pulse.

Damp-Heat

Itchy hands, swollen and red fingers, small yellow vesicles, fungal infections, sticky yellow tongue coating, Slippery-Rapid pulse.

Invasion of Wind

Itchy hands with acute onset, itching spreading up the arms and towards the face, red rash on hands.

Blood deficiency leading to Wind in the skin

Itchy hands, pale and cold hands, tingling of the hands, Pale tongue, Choppy or Fine pulse.

Numbness/tingling of the hands

Interrogation, Chapter 39

Liver-Blood deficiency

Numbness/tingling of the hands and limbs, more tingling than numbness, dizziness, blurred vision, floaters, numbness or tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Phlegm

Numbness/tingling of the hands and limbs, more numbness than tingling, dizziness, feeling of heavi-ness of the body, sputum in the throat, a feeling of oppression of the chest, Swollen tongue, Slippery pulse.

Wind-Phlegm

Unilateral numbness of a hand and especially the first three fingers, severe dizziness, blurred vision, tremors, tinnitus, nausea, sputum in the throat, a feeling of oppression of the chest, Stiff or Deviated and Swollen tongue, Wiry-Slippery pulse.

Liver-Wind

Unilateral numbness of a hand and especially the first three fingers, tremors, severe dizziness, tinnitus, headache, numbness of limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Dampness

Numbness/tingling of the hands, swelling of the fingers, muscle ache, a feeling of heaviness of the limbs, sticky tongue coating, Slippery pulse.

Damp-Heat

Numbness/tingling of the hands, hot and swollen fingers, redness of the hands and fingers, ache in the wrist, muscle ache, a feeling of heaviness of the limbs, sticky yellow tongue coating, Slippery-Rapid pulse.

Stagnation of Qi and stasis of Blood

Numbness/tingling of the hands, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, abdominal pain, chest pain, painful periods, dark complexion, Purple tongue, Wiry pulse.

Invasion of external Wind

Numbness/tingling of the hands with acute onset, aversion to cold, fever, stiff neck, occipital headache, Floating pulse.

Other symptoms and signs depend on whether it is Wind-Cold or Wind-Heat.

Tremor of the hands

Observation, Chapter 14

Liver-Wind

Tremor of the hands, unilateral numbness/tingling of a hand, severe dizziness, tinnitus, headache, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Liver-Wind with Phlegm

Tremor of the hands, swollen hands, unilateral numbness/tingling of a hand, severe dizziness, blurred vision, tinnitus, nausea, sputum in the throat, a feeling of oppression of the chest, Stiff or Deviated and Swollen tongue, Wiry-Slippery pulse.

Liver-Blood or Liver-Yin deficiency leading to Wind

Mild tremor of the hands, numbness/tingling of the hands or limbs, dizziness, blurred vision, floaters, scanty menstruation, dull-pale complexion, dry eyes, night sweating, Pale or normal-coloured tongue, Choppy or Fine pulse.

Heat generating Wind

Tremor of hands, convulsions, twitching of limbs, high fever, fainting, rigidity of neck, opisthotonos, macular rash, eyeballs turning up, clenching of teeth, Dark-Red tongue without coating, Wiry-Rapid pulse.

Oedema of the hands

Observation, Chapter 18; Interrogation, Chapter 39; Symptoms and Signs, Chapters 64, 68

Lung-Yang deficiency

Oedema of the hands with slight pitting, cold hands, slight shortness of breath, slight cough, weak voice, spontaneous daytime sweating, dislike of speaking, bright-white complexion, tendency to catch colds, tiredness, a feeling of cold, Pale and wet tongue, Deep-Weak pulse.

Spleen-Yang deficiency

Pitting oedema of the hands, cold limbs, weakness of the limbs, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, loose stools, a feeling of cold, Pale and wet tongue, Deep-Weak pulse.

Liver-Qi stagnation

Non-pitting oedema of the hands, cold fingers and toes, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Deformed knuckles

Observation, Chapter 14

Chronic Painful Obstruction Syndrome with Phlegm

Deformed knuckles, pain in the fingers, numbness/tingling of the hands. If Phlegm is combined with Heat, the fingers will be red and hot to the touch.

Chronic Painful Obstruction Syndrome with Phlegm and Blood stasis

Deformed knuckles, severe pain in the fingers, dark complexion, rigidity of the finger joints.

Chronic Painful Obstruction Syndrome with Phlegm and Qi/Yin deficiency

Deformed knuckles, dull ache in the fingers, shiny skin, atrophy of muscles of the dorsum of the hand, tiredness, loose stools, poor appetite, dry skin, night sweating.

The pulse and tongue depend on whether deficiency of Qi or Yin predominates.

Tinea (ringworm)

Observation, Chapter 14

External invasion of Wind-Heat

Tinea of the hands, dry skin, itchy skin.

External invasion of Damp-Heat

Tinea of the hands, itchy skin, swollen hands, vesicles.

Toxic Heat in the skin

Tinea of the hands, intensely red rash with red papules that spreads quickly, unbearable itching, Red tongue with red points and thick, sticky yellow coating, Overflowing-Slippery-Rapid pulse.

Dry, cracked and peeling palms

Observation, Chapter 14

Blood deficiency

Dry, cracked and peeling palms, dry and brittle nails, dry skin, dizziness, tiredness, Pale tongue, Choppy or Fine pulse.

Other symptoms and signs depend on whether there is Liver-Blood or Heart-Blood deficiency.

Blood deficiency with Wind

Dry, cracked and peeling palms, severe itching, dry and brittle nails, dry skin, slight tremor of the head or hand or both, facial tic, dizziness, blurred vision, unilateral numbness/tingling of a limb, Pale and Thin tongue, Choppy or Fine and slightly Wiry pulse.

Venules on the thenar eminence

Observation, Chapter 14

Cold in the Stomach

Bluish or bluish-purple venules on the thenar eminence, pain in the epigastrium, a feeling of cold, cold limbs, preference for warmth, vomiting of clear fluids (which may alleviate the pain), nausea, feeling worse after swallowing cold fluids which are quickly vomited, preference for warm liquids, tongue with thick white coating, Deep-Tight-Slow pulse.

Stomach deficient and cold

Short, bluish venules on the thenar eminence, discomfort or dull pain in the epigastrium, better after eating and better with pressure or massage, no appetite, preference for warm drinks and foods, vomiting of clear fluid, no thirst, cold and weak limbs, tiredness, pale complexion, Pale and wet tongue, Deep-Weak-Slow pulse.

Full-Heat

Reddish venules on the thenar eminence, hot hands, red hands, thirst, a feeling of heat, red face.

Other symptoms and signs depend on which organ is involved, which may be the Stomach or Lungs.

Empty-Heat

Reddish venules on the thenar eminence, worse in the afternoon and evening, malar flush, a feeling of heat in the evening, night sweating, five-palm heat.

Other symptoms and signs depend on which organ is involved, which may be the Stomach or Lungs.

Blood stasis in the Stomach

Reddish-purple venules on the thenar eminence, severe, stabbing epigastric pain that may be worse at night, dislike of pressure, nausea, vomiting, possibly of blood, vomiting of food looking like coffee grounds, Purple tongue, Wiry pulse.

Damp-Heat in the Stomach

Yellowish-red venules on the thenar eminence, a feeling of fullness and pain of the epigastrium, a feeling of heaviness, facial pain, stuffed nose or thick sticky nasal discharge, thirst without a desire to drink, nausea, a feeling of heat, dull-yellow complexion, a sticky taste, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Atrophy of the thenar eminence

Observation, Chapter 14

Liver-Blood deficiency

Atrophy of the thenar eminence, dizziness, blurred vision, floaters, numbness or tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Kidney-Yin deficiency

Atrophy of the thenar eminence, dizziness, tinnitus, hardness of hearing, poor memory, night sweating, dry mouth and throat at night, lower backache, constipation, scanty dark urine, tiredness, normal-coloured tongue without coating, Floating-Empty pulse.

Stomach and Spleen-Qi deficiency

Atrophy of the thenar eminence, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, an uncomfortable feeling in the epigastrium, lack of sense of taste, Pale tongue, Empty pulse.

Atrophy of the muscles of the dorsum of the hands

Observation, Chapter 14

Liver-Blood deficiency

Atrophy of the muscles of the dorsum of the hands, dizziness, blurred vision, floaters, numbness/tingling of the limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Kidney-Yin deficiency

Atrophy of the muscles of the dorsum of the hand, dizziness, tinnitus, hardness of hearing, poor memory, night sweating, dry mouth and throat at night, lower backache, constipation, scanty dark urine, tiredness, normal-coloured tongue without coating, Floating-Empty pulse.

Stomach and Spleen-Qi deficiency

Atrophy of the muscles of the dorsum of the hand, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, uncomfortable feeling in the epigastrium, lack of sense of taste, Pale tongue, Empty pulse.

FINGERS

Swollen fingers

Observation, Chapter 14

Cold-Dampness Painful Obstruction Syndrome

Swelling and pain of the fingers, which is aggravated by exposure to cold and damp weather and alleviated by the application of heat or by exposure to dry weather, cold hands.

Damp-Heat Painful Obstruction Syndrome

Swelling, heat and pain of the fingers, which is aggravated by exposure to damp weather and alleviated in dry weather.

Wind-Dampness Painful Obstruction Syndrome

Swelling and pain of the fingers, which is aggravated by damp weather, itching of the hands, vesicles on the skin of the hands.

Lung and Spleen-Yang deficiency

Swelling of the fingers and hands, cold and pale hands, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, a feeling of cold, slight shortness of breath, slight cough with profuse watery sputum, weak voice, spontaneous daytime sweating, dislike of speaking, bright-white complexion, tendency to catch colds, tiredness, dislike of cold, a feeling of cold generally or of the upper back, absence of thirst, Pale and slightly wet tongue, Deep-Weak pulse.

Qi stagnation

Swelling of the fingers before the period in women, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Blood stasis

Swelling and severe pain of the fingers, contraction of the fingers, dark complexion, purple nails, Purple tongue, Wiry or Choppy pulse.

Other symptoms and signs depend on the organ involved, which, in this case, may be the Liver or Heart.

Liver and Kidney-Yin deficiency with Blood-Heat

Swollen, red and hot fingers, aggravated by exposure to heat, numbness/tingling of limbs, dizziness, tinnitus, hardness of hearing, dull occipital or vertical headache, insomnia, malar flush, dry eyes, blurred vision, lower backache, dry throat, dry hair and skin, brittle nails, night sweating, dry stools, scanty menstruation or amenorrhoea, five-palm heat, a feeling of heat in the evening, Red tongue without coating, Floating-Empty and Rapid pulse.

Wind-Water invading the Lungs

Sudden swelling of fingers and face gradually spreading to the whole body, bright-shiny complexion, scanty and pale urination, aversion to wind, fever, cough, slight breathlessness, sticky white tongue coating, Floating-Slippery pulse.

Contraction of the fingers

Observation, Chapter 14

Liver-Blood deficiency

Contraction of the fingers, cold hands, tingling of limbs, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Liver-Yin deficiency

Contraction of the fingers, thinning of muscles, hot palms, tingling of the limbs, dizziness, blurred vision, floaters in eyes, dry eyes, scanty menstruation, dull-pale complexion but with red cheekbones, withered and brittle nails, dry skin and hair, night sweating, normal-coloured tongue without coating, Fine or Floating-Empty pulse.

Blood stasis

Contraction of the fingers, pain in the hands that is worse at night, rigidity of the limbs, Purple tongue, Wiry or Choppy pulse.

Liver-Wind

Unilateral contraction of the fingers, unilateral numbness/tingling of a hand, tremors, severe dizziness, tinnitus, headache, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Wind-Phlegm

Unilateral contraction of the fingers, unilateral numbness of a hand, severe dizziness, blurred vision, tremors, numbness/tingling of the limbs, tinnitus, nausea, sputum in the throat, a feeling of oppression of the chest, Stiff or Deviated and Swollen tongue, Wiry-Slippery pulse.

Cold-Dampness

Contraction and swelling of the fingers, numbness, a feeling of heaviness, cold hands.

Liver-Qi stagnation

Contraction of the fingers that comes and goes according to emotional moods, hypochondrial/epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Invasion of external Wind-Cold

Contraction of the fingers with acute onset, aversion to cold, fever, occipital headache, stiff neck, Floating pulse.

Spoon-shaped fingers

Observation, Chapter 14

Cold-Phlegm in the Lungs

Spoon-shaped fingers, cough with expectoration of watery white sputum, a feeling of cold, cold hands and feet, nausea, vomiting, a feeling of oppression of the chest and epigastrium, dull-white complexion, pale urine, Pale and Swollen tongue with wet-white coating, Slippery-Slow pulse.

Phlegm-Heat in the Lungs

Spoon-shaped fingers, hot fingers, barking cough with profuse, sticky yellow or green sputum, shortness of breath, wheezing, a feeling of oppression of the chest, a feeling of heat, thirst, insomnia, agitation, Red and Swollen tongue with a sticky yellow coating, Slippery-Rapid pulse.

Lung and Kidney-Yin deficiency

Spoon-shaped fingers, dry cough which is worse in the evening, dry throat and mouth, thin body, breathlessness on exertion, lower backache, night sweating, dizziness, tinnitus, hardness of hearing, scanty urination, normal-coloured tongue without coating, Floating-Empty pulse.

Thin, pointed fingers

Observation, Chapter 14

Cold-Dampness in the Stomach

Thin, pointed fingers, pain and distension in the abdomen, a feeling of cold in the abdomen, worsened by ingestion of cold liquids, a feeling of fullness and pain in the epigastrium, a sticky taste, sticky white tongue coating, Slippery-Slow pulse.

Damp-Heat in the Stomach

Thin, pointed fingers, a feeling of fullness and pain of the epigastrium, a feeling of heaviness, facial pain, stuffed nose or thick sticky nasal discharge, thirst without a desire to drink, nausea, a feeling of heat, dull-yellow complexion, a sticky taste, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Stomach and Spleen-Qi deficiency

Thin, pointed fingers, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, an uncomfortable feeling in the epigastrium, lack of sense of taste, Pale tongue, Empty pulse.

Cracked fingers

Observation, Chapter 14

Liver-Blood deficiency

Cracked fingers, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Liver-Blood stasis

Cracked fingers, purplish hands, hypochondrial/abdominal pain, painful periods, dark and clotted menstrual blood, masses in abdomen, purple nails and lips, purple or dark complexion, Purple tongue, Wiry or Firm pulse.

Yang deficiency with Empty-Cold

Cracked fingers, cold and pale hands, a feeling of cold, a slight feeling of discomfort in the chest, Pale and wet tongue, Deep-Weak pulse.

Yang deficiency with Empty-Cold causing cracked fingers may be either of the Heart or of the Lungs.

Thickened fingers

Observation, Chapter 14

Deficiency of Qi and Blood

Thickened fingers, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Shrivelled and wrinkled fingers

Observation, Chapter 14

Loss of Body Fluids

Shrivelled and wrinkled fingers, dry skin, pale complexion, dry stools.

This is a state of Dryness that may occur after a prolonged spell of vomiting, sweating or diarrhoea.

NAILS

Ridged nails

Observation, Chapter 15

Liver-Blood deficiency

Ridged nails, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Liver-Yin deficiency

Ridged, withered and brittle nails, dry nails, dizziness, numbness/tingling of the limbs, insomnia, blurred vision, floaters in eyes, dry eyes, diminished night vision, scanty menstruation or amenorrhoea, dull-pale complexion without lustre but with red cheekbones, muscular weakness, cramps, very dry skin and hair, night sweating, depression, a feeling of aimlessness, normal-coloured tongue without coating, Fine or Floating-Empty pulse.

Thickening of the nails

Observation, Chapter 15

Liver-Fire

Thickening of the nails, headache, red face, dizziness, tinnitus, irritability, propensity to outbursts of anger, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Liver-Blood stasis

Thickening of the nails, dark nails, hypochondrial/abdominal pain, painful periods, dark and clotted menstrual blood, masses in abdomen, purple lips, purple or dark complexion, Purple tongue, Wiry or Firm pulse.

Phlegm

Thickening of the nails, yellowish nails, swollen hands, a feeling of heaviness of the limbs, sputum in the throat, a feeling of oppression of the chest, Swollen tongue, Slippery pulse.

Coarse and thick nails

Observation, Chapter 15

Qi and Blood deficiency with dryness of Blood generating Wind

Coarse and thick nails, ridged nails, dizziness, blurred vision, floaters, numbness/tingling of limbs, dull-pale complexion, dry skin, Pale and dry tongue, Choppy or Fine pulse.

Cracked nails

Observation, Chapter 15

Qi and Blood deficiency with dryness of Blood

Cracked, coarse and thick nails, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, dry skin, Pale and dry tongue, Weak or Choppy pulse.

Yin deficiency

Cracked nails, night sweating, dry mouth with a desire to drink in small sips, dry throat in the evening, scanty dark urine, dry stools, normal-coloured tongue without coating, Floating-Empty pulse.

Liver-Blood stasis

Cracked and dark-purplish nails, hypochondrial/abdominal pain, painful periods, dark and clotted menstrual blood, masses in the abdomen, purple lips, purple or dark complexion, Purple tongue, Wiry or Firm pulse.

Nails falling off

Observation, Chapter 15

Toxic Heat in the Liver

Nails falling off, swollen, hot and painful nails, pus in the nails, a feeling of heat, mental restlessness, thirst, Red tongue with red points and thick, sticky yellow coating, Overflowing-Slippery-Rapid pulse.

Indented nails

Observation, Chapter 15

Liver-Blood deficient and dry

Indented nails, brittle nails, withered nails, dry skin, dizziness, blurred vision, floaters, numbness/tingling of limbs, dull-pale complexion, scanty menstruation, Pale and dry tongue, Choppy or Fine pulse.

This is often seen in chronic skin diseases such as eczema and psoriasis.

Deficiency of Qi and Blood

Indented nails, brittle nails, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Heat injuring Body Fluids

Indented nails, dry nails, a feeling of heat, thirst, mental restlessness, dry skin, Red tongue with dry yellow coating, Overflowing-Rapid pulse.

Other symptoms and signs depend on the organ involved.

Thin and brittle nails

Observation, Chapter 15

Qi and Blood deficiency

Thin and brittle nails, dry nails, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Liver-Yin deficiency

Thin and brittle nails, dry nails, dry skin, dry eyes, dizziness, numbness/tingling of the limbs, insomnia, blurred vision, floaters in eyes, scanty menstruation or amenorrhoea, dull-pale complexion without lustre but with red cheekbones, cramps, night sweating, normal-coloured tongue without coating, Fine or Floating-Empty pulse.

Liver-Blood stasis

Thin and brittle nails, dark nails, thick nails, dry skin, hypochondrial/abdominal pain, painful periods, dark and clotted menstrual blood, masses in the abdomen, purple nails and lips, purple or dark complexion, Purple tongue, Wiry or Firm pulse.

Phlegm in the joints

Thin and brittle nails, dry nails, swollen and painful joints, joint deformities.

Kidney-Essence deficiency

Thin and brittle nails, poor bone development in children, softening of bones in adults, deafness, weakness of knees and legs, poor memory, loose teeth, falling hair or premature greying of the hair, weakness of sexual activity, lower backache, infertility, sterility, dizziness, tinnitus, normal-coloured tongue and Floating-Empty or Leather pulse if Kidney-Essence deficiency occurs against a background of Kidney-Yin deficiency, or Pale tongue and Deep-Weak pulse if against a background of Kidney-Yang deficiency.

Withered and brittle nails

Observation, Chapter 15

Liver-Blood deficiency

Withered and brittle nails, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Liver-Yin deficiency

Withered and brittle nails, dizziness, numbness/tingling of limbs, blurred vision, floaters, dry eyes, scanty menstruation, dry skin and hair, night sweating, normal-coloured tongue without coating, Fine or Floating-Empty pulse.

Liver-Blood stasis

Withered and brittle nails, purple nails and lips, hypochondrial/abdominal pain, painful periods, dark and clotted menstrual blood, masses in the abdomen, purple or dark complexion, Purple tongue, Wiry or Firm pulse.

Liver-Blood stasis may cause Dryness and withered and brittle nails only in severe and advanced cases.

Liver-Fire

Withered and brittle nails, headache, red face, dizziness, tinnitus, irritability, propensity to outbursts of anger, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Kidney-Yin deficiency

Withered and brittle nails, dizziness, tinnitus, hardness of hearing, poor memory, night sweating, vertigo, dry mouth and throat at night, lower backache, ache in bones, constipation, scanty dark urine, tiredness, lassitude, normal-coloured tongue without coating, Floating-Empty pulse.

Phlegm

Withered and brittle nails, thickened and yellow nails, numbness of the limbs, sputum in the throat, a feeling of oppression of the chest, Swollen tongue with sticky coating, Slippery pulse.

Blood Dryness and Empty-Heat in acute febrile diseases

Withered and brittle nails with acute onset in the aftermath of an acute febrile disease with high temperature reaching the Blood level, Red tongue without coating, Fine-Rapid pulse.

Withered and thickened nails

Observation, Chapter 15

Severe Stomach and Spleen-Qi deficiency

Withered and thickened nails, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, an uncomfortable feeling in the epigastrium, lack of sense of taste, Pale tongue, Empty pulse.

Liver-Blood deficient and dry

Withered and thickened nails, brittle nails, dry skin, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale and dry tongue, Choppy or Fine pulse.

Liver-Yin deficiency

Withered and thickened but brittle nails, dry nails, dizziness, numbness/tingling of the limbs, insomnia, blurred vision, floaters in eyes, dry eyes, scanty menstruation or amenorrhoea, dull-pale complexion without lustre but with red cheekbones, cramps, dry skin and hair, night sweating, normal-coloured tongue without coating, Fine or Floating-Empty pulse.

Damp-Heat with Toxic Heat

Withered and thickened nails, nail infections, red nails, swollen junction of the nail and finger, swollen and painful fingers, a feeling of heat, sticky taste, thirst, mental restlessness, Red tongue with red points and thick, sticky yellow coating, Overflowing-Slippery-Rapid pulse.

Curling nails

Observation, Chapter 15

Qi and Blood deficiency with Blood stasis

Curling nails, purple nails, pain in the hands, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of the limbs, palpitations, dark complexion, Pale or Purple tongue, Weak or Choppy pulse.

Flaking nails

Observation, Chapter 15

Spleen and Kidney deficiency with Dampness

Flaking nails, lower backache, cold and weak knees, a feeling of cold, bright-white complexion, impotence, decreased libido, tiredness, lassitude, abundant clear urination, urination at night, loose stools, poor appetite, slight abdominal distension, a desire to lie down, early-morning diarrhoea, Pale and wet tongue, Deep-Weak pulse.

Twisted nails

Observation, Chapter 15

Liver-Blood deficiency

Twisted nails, ridged nails, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Nails with white spots

Observation, Chapter 15

Qi deficiency

Nails with white spots, tiredness, loose stools, shortness of breath, weak voice, weak limbs, Pale tongue, Empty pulse.

This may be Qi deficiency of the Spleen, Heart, Lungs, Liver or Kidneys.

Pale-white nails

Observation, Chapter 15

Liver and Spleen-Blood deficiency

Pale white nails, pale hands, cold hands, poor appetite, slight abdominal distension after eating, tiredness, lassitude, dull-pale complexion, weakness of the limbs, loose stools, thin body, scanty periods or amenorrhoea, insomnia, dizziness, numbness of the limbs, blurred vision, floaters, diminished night vision, pale lips, muscular weakness, cramps, withered and brittle nails, dry hair and skin, slight depression, a feeling of aimlessness, Pale tongue especially on the sides, Choppy or Fine pulse.

Dull-white nails

Observation, Chapter 15

Spleen and Kidney-Yang deficiency

Dull-white nails, pale hands, cold hands, lower backache, cold knees, a feeling of cold generally or in the back, weak legs, bright-white complexion, weak knees, impotence, premature ejaculation, low sperm count, cold and thin sperm, decreased libido, tiredness, lassitude, abundant clear or scanty clear urination, urination at night, apathy, oedema of the lower legs, infertility in women, loose stools, depression, poor appetite, slight abdominal distension, a desire to lie down, early-morning or chronic diarrhoea, Pale and wet tongue, Deep-Weak pulse.

Loss of Body Fluids

Dull-white, dry nails after profuse sweating, vomiting or diarrhoea, dry skin.

Red nails

Observation, Chapter 15

Full-Heat

Red nails, red dorsum of the hands, hot hands, a feeling of heat, mental restlessness, thirst, Red tongue with dry yellow coating, Overflowing-Rapid pulse.

Other symptoms and signs depend on the organ involved.

Yellow nails

Observation, Chapter 15

Damp-Heat in the Stomach and Spleen

Yellow nails, swollen fingers, painful joints, a feeling of fullness and pain of the epigastrium and lower abdomen, poor appetite, a feeling of heaviness, thirst without a desire to drink, nausea, loose stools with offensive odour, a feeling of heat, dull-yellow complexion, sticky taste, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Damp-Heat in the Liver and Gall-Bladder

Yellow nails, swollen fingers, painful joints, fullness/pain of the hypochondrium, abdomen or epigastrium, bitter taste, poor appetite, nausea, a feeling of heaviness of the body, yellow vaginal discharge, vaginal itching, mid-cycle bleeding/pain, burning on urination, dark urine, yellow complexion and eyes, vomiting, Red tongue with redder sides and unilateral or bilateral sticky yellow coating, Wiry-Slippery-Rapid pulse.

Phlegm

Yellowish and thick nails, a feeling of heaviness of the limbs, swollen hands, sputum in the throat, a feeling of oppression of the chest, Swollen tongue with sticky coating, Slippery pulse.

Bluish-greenish nails

Observation, Chapter 15

Liver-Blood deficiency with internal Cold

Bluish nails, dry nails, pale and cold hands, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, a feeling of cold, Pale tongue, Choppy or Fine pulse and Slow pulse.

Severe Spleen-Qi deficiency with internal Wind (children)

Greenish nails, thin fingers, poor appetite, thin body, retarded development, flaccid muscles, fine tremor of limbs, Pale tongue, Weak pulse.

Liver-Blood stasis

Dark, bluish-green nails, pain in the hands, rigidity of the fingers, hypochondrial/abdominal pain, painful periods, dark and clotted menstrual blood, masses in the abdomen, purple nails and lips, purple or dark complexion, Purple tongue, Wiry or Firm pulse.

Dark nails

Observation, Chapter 15

Kidney deficiency

Dark nails, lower backache, dizziness, tinnitus.

Other symptoms and signs depend on whether there is a deficiency of Kidney-Yin or Kidney-Yang.

Blood stasis

Dark nails, joint pain, dry nails, abdominal pain, dark complexion, Purple tongue, Wiry or Choppy pulse.

Purple nails

Observation, Chapter 15

Liver-Blood stasis

Purple nails, hypochondrial/abdominal pain, painful periods, dark and clotted menstrual blood, masses in the abdomen, purple lips, purple or dark complexion, Purple tongue, Wiry or Firm pulse.

Heat at the Blood level

Purple nails, fever at night, macular rash, bleeding, mental confusion, Red tongue without coating, Fine and Rapid pulse.

Small or absent lunulae

Observation, Chapter 15

Chronic Qi and Blood deficiency

Small or absent lunulae, ridged nails, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Yang deficiency

Small or absent lunulae, a feeling of cold, cold limbs, loose stools, abundant pale urination, tiredness, Pale and wet tongue, Deep-Weak pulse.

Other symptoms and signs depend on the organ affected by Yang deficiency, which may be of the Stomach, Spleen, Heart, Kidneys or Lungs.

Internal Cold

Small or absent lunulae, a feeling of cold, cold limbs, abdominal pain which improves with the application of warmth, Pale tongue, Tight-Slow pulse.

Large lunulae

Observation, Chapter 15

Yin deficiency with Empty-Heat

Large lunulae, brittle nails, dry throat at night, a feeling of heat in the evening, night sweating, five-palm heat, malar flush, insomnia, anxiety, dry mouth with a desire to drink in small sips, Red tongue without coating, Floating-Empty and Rapid pulse.

Other symptoms and signs depend on the organ involved, which may be the Liver, Lungs, Heart, Stomach or Kidneys.

Diagnosis in Chinese Medicine A Comprehensive Guide

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