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Chapter 68

BODY

Chapter contents

BODY ACHES

Interrogation, Chapter 37

Body aches include aches in the muscles or joints, or both.

PAIN IN THE JOINTS

Interrogation, Chapter 37

Invasion of Wind in the joints

Pain moving from joint to joint, in acute cases a Floating pulse.

Invasion of Dampness in the joints

Fixed pain, swelling of the joints, a feeling of heaviness and tingling of the joints.

Invasion of Cold in the joints

Fixed, severe pain, usually in one joint, aggravated by exposure to cold and alleviated by application of heat.

Damp-Heat in the joints

Fixed pain, swollen, hot and red joints.

Stagnation of Qi and stasis of Blood

Pain and rigidity of the joints, stiff limbs, pain ameliorated by moderate exercise and aggravated by inactivity, Wiry pulse.

Liver-Blood deficiency

Dull joint ache, worse with exercise or after the period, Pale tongue, Choppy or Fine pulse.

Kidney deficiency

Dull joint ache especially of the lower limbs that is worse with exercise, lower backache, weak knees, weak legs.

LOSS OF FEELING

Paralysis

Observation, Chapter 4

This refers to bilateral paralysis of the arms/legs and of the body itself.

Stomach- and Spleen-Qi deficiency

Paralysis, 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.

In neurological problems such as multiple sclerosis, this pattern corresponds to the middle stage.

Liver- and Kidney-Yin deficiency

Long-term paralysis of slow onset, weak limbs, weak knees, dizziness, tinnitus, hardness of hearing, lower backache, dull occipital or vertical headache, insomnia, numbness/tingling of the limbs, dry eyes, blurred vision, dry throat in the evening, dry hair and skin, brittle nails, night sweating, dry stools, scanty menstruation or amenorrhoea, normal-coloured tongue without coating, Floating-Empty pulse.

In neurological problems such as multiple sclerosis, this pattern corresponds to the late stage.

Liver- and Kidney-Yin deficiency with internal Wind

Long-term paralysis of slow onset, tremor/spasms of limbs, weak limbs, weak knees, numbness/tingling of the limbs, lower backache, dizziness, tinnitus, hardness of hearing, dull occipital or vertical headache, insomnia, dry eyes, blurred vision, dry throat in the evening, dry hair and skin, brittle nails, night sweating, dry stools, scanty menstruation or amenorrhoea, normal-coloured Deviated or Moving tongue without coating, Floating-Empty and slightly Wiry pulse.

In neurological problems such as multiple sclerosis, this pattern corresponds to the final stage.

Kidney-Yang deficiency

Paralysis, lower backache, cold and weak knees, a feeling of cold, bright-white complexion, tiredness, lassitude, abundant clear urination, urination at night, impotence, decreased libido, Pale and wet tongue, Deep-Weak pulse.

Qi and Blood deficiency

Paralysis of the four limbs and body, weak limbs, 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-Blood stasis

Paralysis, stabbing pain in the joints, hypochondrial or 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.

Cold-Dampness

Paralysis, a feeling of heaviness of the limbs, numbness, oedema of the limbs, epigastric fullness, a feeling of heaviness of the head and body, a feeling of cold, cold limbs, sticky white tongue coating, Slippery-Slow pulse.

In neurological problems such as multiple sclerosis, this corresponds to the initial stage.

Damp-Heat

Paralysis of the lower limbs, hot limbs, a feeling of heaviness of the limbs, numbness of the limbs, epigastric fullness, a sticky taste, thirst with no desire to drink, a feeling of heaviness of the head and body, a feeling of heat, sticky yellow tongue coating, Slippery-Rapid pulse.

Liver-Qi stagnation and Liver-Blood deficiency

Paralysis, numbness/tingling of limbs, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, dizziness, blurred vision, floaters, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine and slightly Wiry pulse.

Stomach and Spleen Fluids injured

Paralysis with sudden onset after a febrile disease, weak limbs, inability to grasp with hands, dry skin and mouth.

This pattern corresponds to the aftermath of a febrile disease such as polio.

Hemiplegia

Observation, Chapter 4

This refers to unilateral paralysis of the arm/leg. The first six patterns correspond to different types of Wind-stroke.

Wind in the channels

Hemiplegia, deviation of eye and mouth, aphasia.

Liver-Wind

Hemiplegia, tremors, numbness of limbs, severe dizziness, tinnitus, headache, Stiff, Deviated or Moving tongue, Wiry pulse.

Wind-Phlegm

Hemiplegia, numbness or tingling of the limbs, 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.

Phlegm-Fire

Hemiplegia, numbness of the limbs, sudden unconsciousness, mental confusion, deviation of eye and mouth, contraction of the hands, clenched teeth, red eyes and face, rattling sound in the throat, a feeling of oppression of the chest, expectoration of sticky yellow sputum, Red and Swollen tongue with a sticky yellow coating, Slippery-Rapid pulse.

Damp-Phlegm

Hemiplegia, numbness of the limbs, sudden unconsciousness, mental confusion, phlegm in the throat, clenched teeth, a feeling of oppression of the chest, expectoration of profuse, sticky sputum, pasty-white complexion, cold limbs, Swollen tongue with a sticky white coating, Slippery pulse.

Qi deficiency and Blood stasis

Hemiplegia, dull skin colour, oedema, rigidity of the tendons, contraction of the upper limbs, lower limbs relaxed and stretched, stretching of the upper limbs or bending of the lower limbs causes pain, tiredness, poor appetite, loose stools, weak voice, slight shortness of breath, pale complexion, Bluish-Purple tongue, Weak or Choppy pulse.

This corresponds to the sequelae stage of Wind-stroke.

Liver and Kidney deficiency

Hemiplegia, lower backache, soft limbs, dizziness, tinnitus, poor memory, blurred vision, mental confusion.

This pattern may be associated with a Yin and or Yang deficiency and the tongue may be Red or Pale respectively. This pattern also corresponds to the sequelae stage of Wind-stroke.

Collapse of Yang

Hemiplegia, sudden unconsciousness, mental confusion, eyes shut, mouth and hands open, urinary incontinence, weak breathing, cold limbs, bright-white complexion, sweating on the forehead, Pale and Short tongue, Hidden or Scattered pulse.

This corresponds to an acute stage of Wind-stroke.

Collapse of Yin

Hemiplegia, sudden unconsciousness, deviation of eye and mouth, eyes shut, mouth and hands open, cold limbs but red face, weak breathing, Red tongue without coating, Minute pulse.

This corresponds to an acute stage of Wind-stroke.

Numbness/tingling

Interrogation, Chapter 37

‘Numbness’ includes numbness itself or a tingling sensation, or both together. Numbness is more common in Phlegm and Wind, whereas tingling is more common in deficiency patterns such as Liver-Blood deficiency. However, this is only a broad rule.

Liver-Blood deficiency

Tingling of limbs, dizziness, blurred vision, floaters, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

This is a very common cause of numbness/tingling and it occurs more frequently in women.

Phlegm in the channels

Numbness, a feeling of heaviness, a feeling of oppression of the chest, phlegm in the throat, Swollen tongue with a sticky coating, Slippery pulse.

Dampness in the channels

Numbness/tingling, swollen joints, a feeling of heaviness of the body and limbs, sticky tongue coating, Slippery pulse.

Other symptoms and signs depend on whether the Dampness is associated with Cold or Heat.

Internal Wind

Unilateral numbness of a limb, tremors, severe dizziness, tinnitus, headache, numbness of the limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Wind-Phlegm

Unilateral numbness of a limb, tingling, tremors, 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.

Stagnation of Qi and stasis of Blood

Numbness/tingling of limbs, joint pain that is ameliorated by moderate exercise and aggravated by inactivity, tiredness, poor appetite, loose stools, weak voice, slight shortness of breath, pale complexion, Bluish-Purple tongue, Weak or Choppy pulse.

Numbness of half the body

Numbness of half the body usually occurs in the limbs.

Liver-Blood deficiency

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

This numbness often occurs on the left side and more frequently in women.

Damp-Phlegm

Numbness of half the body, chronic cough with expectoration of profuse, sticky white sputum which is easy to expectorate, a feeling of oppression of the chest, dizziness, blurred vision, somnolence, nausea, sputum in the throat, muzziness of the head, Swollen tongue with sticky coating, Slippery pulse.

Liver-Wind

Numbness of half the body and a hand, tremors, severe dizziness, tinnitus, headache, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

This pattern is more likely to occur in old people. In the elderly, numbness of half the body may herald Wind-stroke.

Deficiency of Central Qi

Numbness of half the body, soft and weak limbs, 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.

This pattern is due to a deficiency of Stomach and Spleen and the numbness often occurs on the right side.

Dampness

Numbness of half the body, a feeling of heaviness of the limbs, swelling of the limbs/joints, muscle ache, sticky tongue coating, Slippery pulse.

Other symptoms and signs depend on whether the Dampness is associated with Cold or Heat.

ITCHING

Interrogation, Chapter 37

Wind in the skin

Intense itching in the whole body or moving from place to place, more in the upper body, an unbearable desire to scratch, dry skin.

Dampness in the skin

Localized itching often in the lower part of the body, vesicles on the skin, oozing a fluid.

Damp-Heat in the skin

Localized itching, yellow vesicles oozing a yellow fluid, red papules or pustules, oozing blood on scratching, more in the lower part of the body.

Blood-Heat

Generalized itching, red rash, red papules, feeling of agitation, thirst.

Blood deficiency

Mild generalized itching, dry skin, scaly skin (with white scales), dry hair, possibly pale wheals.

Toxic Heat

Localized or generalized intense itching, pustules oozing pus and blood, festering skin, fever.

This kind of itching is seen in chronic eczema when the skin becomes infected.

Clinical note

• To treat itching with acupuncture, apart from using points that expel Wind (TB-6 Zhigou and GB-31 Fengshi), I use points on the Heart channel.

OEDEMA

Spleen-Yang deficiency

Chronic pitting oedema of the abdomen or limbs, slow onset, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, a feeling of cold, cold limbs, oedema, Pale and wet tongue, Deep-Weak pulse.

Kidney-Yang deficiency

Pitting oedema of the whole body starting from the legs, worse on the ankles, lower backache, cold knees, a feeling of cold, bright-white complexion, weak knees, tiredness, lassitude, abundant clear urination, urination at night, impotence, decreased libido, Pale and wet tongue, Deep-Weak pulse.

This is probably the most common cause of chronic oedema and it is nearly always associated with Spleen-Yang deficiency.

Deficiency of Qi and Blood

Oedema starting on the face and limbs, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Dampness

Oedema of the limbs and abdomen, slow onset, tiredness, a feeling of heaviness of the body and limbs, a feeling of fullness of the epigastrium, ache in the muscles, sticky tongue coating, Slippery pulse.

Wind-Water invading the Lungs

Sudden swelling of eyes, face and hands 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.

This is an acute type of oedema and this pattern is a type of external Wind-Cold.

Qi stagnation

Non-pitting oedema of the body or limbs, irritability, a feeling of distension especially of the limbs, Wiry pulse.

Qi deficiency and Blood stasis

Oedema of the body or limbs, cold hands and feet, numbness of the limbs, muscular weakness, purple colour of hands/feet, tiredness, poor appetite, loose stools, weak voice, Bluish-Purple tongue, Choppy pulse.

WEIGHT CHANGE

Obesity

Observation, Chapter 1; Interrogation, Chapter 37

Obesity in Chinese medicine is always due to Dampness or Phlegm (deriving from Qi or Yang deficiency) retained in the space between the skin and muscles.

Damp-Phlegm with Qi deficiency

Obesity, chronic cough with expectoration of profuse, sticky white sputum which is easy to expectorate, a feeling of oppression of the chest, dizziness, blurred vision, somnolence, nausea, sputum in the throat, muzziness of the head, tiredness, poor appetite, loose stools, weak voice, slight shortness of breath, pale complexion, Pale and Swollen tongue with sticky coating, Soggy pulse.

Loss of weight

Observation, Chapter 1; Interrogation, Chapter 37

Yin deficiency

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

This may be Yin deficiency of various organs such as Lungs, Stomach, Heart, Kidneys, Liver and Spleen.

Liver-Blood deficiency

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

Stomach- and Spleen-Qi deficiency

Loss of weight, 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 sensation, Pale tongue, Empty pulse.

Normally Stomach- and Spleen-Qi deficiency leads to obesity but it may also lead to weight loss because the Food Essences are not absorbed by the body.

Liver-Fire

Loss of weight, 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.

Stomach-Heat

Loss of weight, burning epigastric pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

JAUNDICE

Observation, Chapter 3

Damp-Heat in the Gall-Bladder

Jaundice, yellow eyes, bright-yellow complexion, hypochondrial pain, fullness and distension, nausea, vomiting, inability to digest fats, yellow sclera, scanty dark- yellow urine, thirst without a desire to drink, bitter taste, irritability, headache, a feeling of heaviness of the body, a feeling of heat, thick, sticky yellow tongue coating, either bilateral in two strips or unilateral, Slippery-Wiry-Rapid pulse.

Cold-Dampness in the Gall-Bladder

Jaundice, dull-yellow eyes and skin, hypochondrial pain, fullness and distension, nausea, vomiting, an inability to digest fats, dull-yellow sclera, turbid urine, no thirst, sticky taste, dull headache, a feeling of heaviness of the body, a feeling of cold, thick, sticky white tongue coating, either bilateral in two strips or unilateral, Slippery-Wiry-Slow pulse.

Blood stasis

Jaundice, dull-yellow skin, dark complexion, a feeling of mass in the hypochondrium, hypochondrial or abdominal pain, lines on the skin like a spider’s web, dark stools, Purple tongue, Wiry pulse.

Spleen-Qi deficiency and Blood deficiency

Jaundice, dull-yellow skin, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

This pattern is due Liver-Blood deficiency which leads to Liver-Qi stagnation and bile not flowing; this is a deficient type of jaundice.

TWITCHING OF MUSCLES

Observation, Chapter 4

Spleen- and Kidney-Yang deficiency

Twitching of muscles, 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.

Heart- or Lung-Yang deficiency with Water overflowing

Twitching of muscles, 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, Pale, Swollen and wet tongue, Deep-Wiry or Deep-Fine-Slippery pulse.

Deficiency of Qi and Blood

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

OPISTHOTONOS

Observation, Chapter 4

Liver-Wind

Opisthotonos, tremors, severe dizziness, tinnitus, headache, numbness of limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Diagnosis in Chinese Medicine A Comprehensive Guide

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