HEAD, HAIR AND FACE

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Chapter 55

HEAD, HAIR AND FACE

Feeling of heaviness of the head

Headache

Feeling of distension of the head

Feeling of muzziness (fuzziness) of the head

Feeling of cold of the head

Feeling of heat of the head

Numbness of the head

Drooping head

Leaning of the head to one side

Tremor of the head

Brain noise

Swelling of the whole head

Ulcers in the mastoid region

Head tilted backwards

HAIR AND SCALP

Premature greying of the hair

Redness and pain of the scalp

Feeling of heat of the face

Deviation of eye and mouth

Facial paralysis

Papular/macular eruptions

Swelling and redness of the face

Swelling, redness and pain of the cheeks

Ulcers below the zygomatic arch

Lines on the face

HEAD

Drooping head

Stomach- and Spleen-Qi deficiency

Head drooping, poor appetite, tiredness, slight abdominal distension, pale complexion, loose stools, Pale tongue, Empty pulse.

Emptiness of the Sea of Marrow

Head drooping, dizziness, tinnitus, deafness, sore back, poor memory, weak knees, difficulty in walking. This is usually, but not always, accompanied by Kidney-Yin deficiency.

Leaning of the head to one side

Observation, Chapter 5

Spleen-Qi sinking

Leaning of the head to one side, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, depression, tendency to obesity, a bearing-down sensation in the abdomen, prolapse of stomach, uterus, anus or bladder, frequency and urgency of urination, Pale tongue, Weak pulse.

Emptiness of the Sea of Marrow

Leaning of the head to one side, dizziness, tinnitus, deafness, sore back, poor memory, weak knees, difficulty in walking. This is usually, but not always, accompanied by Kidney-Yin deficiency.

Tremor of the head

Observation, Chapters 4 and 5

Liver-Wind

Tremor of the head, vertigo, tremors, severe dizziness, tinnitus, headache, numbness of limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Empty-Wind from Blood deficiency

Slight tremor of the head, slight tremor of the hand, facial tic, dizziness, poor memory, blurred vision, Pale and Thin tongue, Choppy or Fine and slightly Wiry pulse.

Empty-Wind from Yin deficiency

Slight tremor of the head, slight tremor of the hand, dizziness, tinnitus, night sweating, tongue without coating, Floating-Empty or Fine and slightly Wiry pulse.

Brain noise

Interrogation, Chapter 34

‘Brain noise’ is similar to the sound of tinnitus in the ears but it is experienced in the centre of the head. The Chinese name for it is nao ting, which means ‘brain tinnitus’, its old name was lei tou feng, which means ‘thunder head wind’.

Emptiness of the Sea of Marrow

Brain noise like tinnitus, dizziness, tinnitus, brain noise, poor memory, deafness, a feeling of emptiness of the head, blurred vision.

Deficiency of Qi and Blood of the Spleen and Heart

Brain noise like tinnitus, poor memory, dizziness, insomnia, palpitations, poor appetite, loose stools, Pale tongue, Weak or Choppy pulse.

Phlegm-Heat rising

Brain noise like tinnitus, a feeling of heaviness and muzziness of the head, headache, dizziness, blurred vision, nausea, a feeling of oppression of the chest, Red-Swollen tongue with sticky yellow coating, Slippery pulse.

Liver-Qi stagnation

Brain noise like tinnitus, tense neck muscles, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Stagnant Liver-Qi impairs the ascending and descending of Qi, clear Qi cannot rise, and turbid Qi cannot descend so that turbidity accumulates in the head.

Swelling of the whole head

Observation, Chapter 5

‘Big Head Warm Disease’ (invasion of Toxic Heat in the head)

Swelling of the head and face, swollen glands, swelling of the parotid gland, swollen tonsils, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Ulcers in the mastoid region

Observation, Chapter 5

Damp-Heat in the Gall-Bladder channel

Ulcers in the mastoid region, hypochondrial pain, fullness and distension, nausea, vomiting, inability to digest fats, yellow complexion and eyes, dizziness, tin nitus, irritability, a feeling of heaviness, unilateral or bilateral thick, sticky yellow coating, Slippery-Rapid pulse.

Liver-Fire

Ulcers in the mastoid region, 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.

Head tilted backwards

Observation, Chapter 5

Internal Wind in acute febrile diseases

Head tilted backwards, with eyes rolled up, opisthotonos, fever at night, convulsions, macular rash, Red tongue without coating, Fine and Wiry pulse.

Hair and scalp

Premature greying of the hair

Observation, Chapter 5

Liver-Blood deficiency

Premature greying of the hair especially on the vertex, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Liver and Kidney deficiency

Premature greying of the hair over the whole head, balding, dizziness, tinnitus, blurred vision, backache, decreased libido. Other clinical manifestations depend on whether there is Kidney-Yin or Kidney-Yang deficiency.

Kidney-Yin deficiency with Empty-Heat

Premature greying of the hair, balding, dizziness, tinnitus, hardness of hearing, night sweating, dry mouth at night, five-palm heat, a feeling of heat in the evening, malar flush, thirst with a desire to drink in small sips, lower backache, dark scanty urine, insomnia, Red tongue without coating, Floating-Empty and Rapid pulse.

Kidney-Essence deficiency

Premature greying of the hair, poor bone development in children, softening of the bones in adults, deafness, weakness of the knees and legs, poor memory, loose teeth, falling hair or premature greying of the hair, weakness from 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.

Deficiency of Qi and Blood

Premature greying of the hair, 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- and Heart-Fire

Hair turning white suddenly after a shock or a very intense emotional upset such as anger, headaches, bloodshot eyes, dizziness, tinnitus, irritability, red face, thirst, bitter taste, palpitations, agitation, insomnia, dream-disturbed sleep, a feeling of heat, Red tongue with redder sides and tip and dry yellow coating, Wiry-Overflowing-Rapid pulse.

Liver-Qi stagnation

Premature greying of the hair in patches which may appear in a relatively short time, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

This pattern is due to worry, pensiveness or anger causing Qi stagnation, which turns into Heat, which, in turn, damages Yin.

Hair falling out

Observation, Chapter 5

This refers to hair falling out gradually and uniformly (as opposed to in clumps).

Liver-Blood deficiency

Gradual loss of hair, dull headache, dizziness, blurred vision, floaters, numbness or tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Kidney deficiency

Gradual loss of hair, which may improve during pregnancy, dizziness, tinnitus, backache, tiredness.

Other symptoms and signs, including pulse and tongue, depend on whether there is a deficiency of Kidney-Yin, Kidney-Yang or Kidney-Essence.

Blood-Heat from Liver-Fire

Gradual loss of hair especially on the vertex, red face, bloodshot eyes, 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.

Alopecia

Observation, Chapter 5

Alopecia refers to the loss of hair falling out in clumps.

Empty Liver-Wind from Blood deficiency

Sudden loss of hair in clumps, 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.

Full Liver-Wind

Sudden loss of hair in clumps, tremors, severe dizziness, tinnitus, headache, numbness of limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Blood Heat from Liver-Fire

Hair falling out in clumps, dry hair, 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

Hair falling out in clumps, 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.

clinical note

• Remember: as a rule of thumb, if the hair falls gradually it is due to a deficiency (of Liver-Blood or Kidneys), whereas if it falls out in clumps it is due to a Fullness (often internal Wind).

Dry and brittle hair

Observation, Chapter 5

Liver-Blood deficiency

Dry hair without lustre, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Kidney-Yin deficiency

Dry hair without lustre, dizziness, tinnitus, hardness of hearing, poor memory, hardness of hearing, night sweating, vertigo, dry mouth and throat at night, lower backache, ache in bones, nocturnal emissions, constipation, dark scanty urine, infertility, premature ejaculation, tiredness, lassitude, depression, slight anxiety, normal-coloured tongue without coating, Floating-Empty pulse.

Deficiency of Qi and Blood

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

Stomach- and Spleen-Qi deficiency

Thin and brittle hair, 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 taste sensation, Pale tongue, Empty pulse.

Loss of Blood

Dry and lifeless hair without lustre, dry skin, pale complexion, menorrhagia, Pale and dry tongue, Hollow pulse.

clinical note

• In women patients, I always observe the hair early on during the consultation to check the state of Liver-Blood.

Greasy hair

Observation, Chapter 5

Dampness

Greasy hair, a feeling of heaviness of the head and body, epigastric fullness, a sticky taste, a feeling of oppression of the chest, excessive vaginal discharge, sticky tongue coating, Slippery or Soggy pulse.

Damp-Heat

Greasy hair, 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.

Phlegm

Greasy hair, a feeling of oppression of the chest, sputum in the throat, Swollen tongue with sticky coating, Slippery pulse.

Dandruff

Observation, Chapter 5

Liver-Blood deficient and dry

Dandruff, dry hair, dry skin, dry eyes, dizziness, blurred vision, floaters, numbness/tingling of limbs, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Liver-Blood deficiency with Liver-Wind

Dandruff, dry hair, 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.

Liver-Fire

Dandruff, a feeling of heat of the head, 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.

Damp-Heat in the Liver

Dandruff, greasy hair, yellow eyes, excessive ear wax production, fullness of the hypochondrium, abdomen or hypogastrium, bitter taste, nausea, a feeling of heaviness of the body, excessive vaginal discharge and itching, mid-cycle bleeding/pain, genital papular or vesicular skin rashes and itching, urinary difficulty, burning on urination with dark urine, Red tongue with redder sides and sticky yellow coating, Slippery-Wiry-Rapid pulse.

Toxic Heat

Dandruff, scalp skin infections, boils on the head, a feeling of heat of the head, red eyes, thirst, Red tongue with red points and thick, dry yellow coating, Slippery-Overflowing-Rapid pulse.

Invasion of Wind-Heat with Dryness

Dandruff with acute onset, dry cough, aversion to cold, fever, dry throat, tickly throat, dry nose, discomfort of the chest, thin, dry white coating, Floating pulse.

Itchy scalp

Interrogation, Chapter 34

Liver-Blood deficiency

Itchy scalp, dandruff, dry scalp and hair, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Liver-Blood deficiency with Liver-Wind

Itchy scalp, dandruff, dry scalp and hair, 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.

Liver-Yin deficiency

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

Liver-Fire

Itchy scalp, feeling of heat of the head, dry scalp, 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.

Damp-Heat in the Liver channel

Itchy scalp, skin eruptions on the scalp, psoriasis of scalp, fullness of the hypochondrium, abdomen or hypogastrium, bitter taste, nausea, feeling of heaviness of the body, yellow vaginal discharge, vaginal itching, mid-cycle bleeding/pain, genital papular or vesicular shin rashes and itching, urinary difficulty, burning on urination, dark urine, Red tongue with redder sides and sticky yellow coating, Slippery-Wiry-Rapid pulse.

Dry scalp

Observation, Chapter 5

Liver-Yin deficiency

Dry scalp, dry hair, dandruff, blurred vision, floaters, dry eyes, dizziness, numbness/tingling of the limbs, scanty menstruation, withered and brittle nails, normal colour tongue without coating, Fine or Floating-Empty pulse.

Kidney-Yin deficiency

Dry scalp, dry hair, dandruff, blurred vision, floaters, dry eyes, dizziness, tinnitus, poor memory, hardness of hearing, night sweating, dry mouth and throat at night, lower backache, dry stools, dark scanty urine, normal-coloured tongue without coating, Floating-Empty pulse.

Redness and pain of the scalp

Observation, Chapter 5

Invasion of Wind-Heat

Acute redness and pain of the scalp, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Liver-Fire

Redness and pain of the scalp, 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.

Boils on the scalp

Observation, Chapter 5

Liver-Fire

Chronic boils on the scalp, 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.

Damp-Heat in the Liver channel

Chronic boils on the scalp, fullness of the hypochondrium, abdomen or hypogastrium, bitter taste, poor appetite, nausea, feeling of heaviness of the body, yellow vaginal discharge, vaginal itching, urinary difficulty, burning on urination, dark urine, Red tongue with redder sides and a sticky yellow coating, Slippery-Wiry-Rapid pulse.

Toxic Heat in the head

Acute boils on the scalp, redness, pain and swelling of the scalp, headache, swollen glands, red and swollen tonsils, aversion to cold, fever, thirst, tongue that is Red on the front with red points and a thick, sticky yellow coating, Slippery-Overflowing-Rapid pulse.

Erosion of the scalp

Observation, Chapter 5

Damp-Heat in the Liver channel

Erosion of the scalp with itching and oozing of fluid, fullness of the hypochondrium, abdomen or hypogastrium, bitter taste, poor appetite, nausea, a feeling of heaviness of the body, yellow vaginal discharge, urinary difficulty, burning on urination, dark urine, Red tongue with redder sides and a sticky yellow coating, Slippery-Wiry-Rapid pulse.

Ulcers on the scalp

Observation, Chapter 5

Liver-Fire

Chronic ulcers on the scalp, 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.

Damp-Heat in the Liver channel

Chronic ulcers on the scalp, fullness of the hypochondrium, abdomen or hypogastrium, bitter taste, poor appetite, nausea, a feeling of heaviness of the body, yellow vaginal discharge, vaginal itching, urinary difficulty, burning on urination, dark urine, Red tongue with redder sides and a sticky yellow coating, Slippery-Wiry-Rapid pulse.

Heat in the Governing Vessel

Ulcers on the crown of the head, a feeling of heat in the head, redness of the scalp, headache, insomnia, dark scanty urine, Red tongue with yellow coating, Floating-Rapid pulse on all three positions on the left.

Face

Acne

Observation, Chapter 5; Symptoms and Signs, Chapter 77

Damp-Heat in the skin

Facial acne with red, papular eruptions, greasy skin, puffy face, sticky yellow tongue coating, Slippery-Rapid pulse.

This is the most common pattern causing acne in young people.

Toxic Heat in the skin

Facial acne with large, red, pustular eruptions that are painful, a feeling of heat, red face, red eyes, Red tongue with red points and thick, sticky yellow coating, Slippery-Overflowing-Rapid pulse.

Toxic Heat with Blood stasis in the skin

Facial acne with large, dark red or purple, pustular eruptions that are painful, a feeling of heat, dark face, red eyes, Reddish-Purple tongue with red points and thick, sticky yellow coating, Slippery-Overflowing-Wiry-Rapid pulse.

Spleen-Qi deficiency with Dampness

Chronic, facial acne with pale-red, papular or vesicular eruptions which take a long time to come to a head, greasy skin, dull-pale complexion, Pale tongue with sticky coating, Soggy pulse.

Heat in the Stomach and Lungs

Facial acne with small, red, papular eruptions, on the face, chest and upper back, dry skin, blackheads, red face, a feeling of heat, Red tongue with dry yellow coating, Overflowing-Rapid pulse.

Damp-Phlegm in the skin

Facial acne with large, pale, vesicular eruptions, greasy skin, puffy face, greasy hair, Swollen tongue with sticky coating, Slippery pulse.

Damp-Phlegm with Blood stasis in the skin

Facial acne with large, dark, purple, papular eruptions, dark complexion, puffy face, dry skin if Blood stasis predominates, or greasy skin if Damp-Phlegm predominates, Purple and Swollen tongue, Slippery-Wiry pulse.

Disharmony of Penetrating and Directing Vessels

Facial acne that starts with puberty, especially on the chin, greasy skin, papular eruptions which are aggravated before the period in girls.

Rather than being a separate pattern causing acne, a disharmony of the Penetrating and Directing Vessels is the condition underlying the development of acne at puberty time and one that continues to be an underlying condition when the acne persists for several years, especially in women.

clinical note

• When treating acne, I always harmonize the Directing and Penetrating Vessels, irrespective of the pattern, in order to balance the hormone levels.

Feeling of heat of the face

Interrogation, Chapter 35

A feeling of heat of the face includes menopausal hot flushes.

Liver-Yang rising

A feeling of heat of the face, red face, headache, dizziness, tinnitus, irritability, propensity to outbursts of anger, Wiry pulse.

Liver-Fire

A feeling of heat of the face and head, worse when anxious or upset, red face, red eyes, 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.

Heart-Fire

A feeling of heat of the face, 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.

Heart-Yin deficiency with Empty-Heat

A feeling of heat of the face in the afternoon and evening, malar flush, 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, five-palm heat, Red tongue, redder on the tip, no coating, Floating-Empty and Rapid pulse.

Kidney-Yin deficiency with Empty-Heat

A feeling of heat of the face in the afternoon or evening, dizziness, tinnitus, hardness of hearing, night sweating, dry mouth at night, five-palm heat, a feeling of heat in the evening, malar flush, thirst with a desire to drink in small sips, lower backache, dark scanty urine, insomnia, Red tongue without coating, Floating-Empty and Rapid pulse.

Lung-Heat

A feeling of heat of the face, redness of the right cheek, cough, slight breathlessness, feeling of heat, chest ache, flaring of nostrils, thirst, red face, Red tongue with yellow coating, Overflowing-Rapid pulse.

Lung-Yin deficiency with Empty-Heat

A feeling of heat of the face in the afternoon and evening, malar flush, 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, five-palm heat, thin body or thin chest, insomnia, anxiety, Red tongue without coating, Floating-Empty and Rapid pulse.

Stomach-Heat

A feeling of heat of the face, worse after eating, burning epigastric pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Stomach-Yin deficiency with Empty-Heat

A feeling of heat of the face in the afternoon and evening, dull or burning epigastric pain, feeling of heat in the afternoon, dry mouth and throat especially in the afternoon, thirst with desire to drink in small sips, dry stools, 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.

Damp-Heat in the Spleen

A feeling of heat of the face, sticky taste, thirst with no desire to drink, a feeling of fullness of the epigastrium, epigastric or abdominal pain, poor appetite, a feeling of heaviness of the body, nausea, vomiting, loose stools with offensive odour, a feeling of heat, scanty dark urine, headache with a feeling of heaviness of the head, dull-yellow complexion, bitter taste, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Spleen-Heat

A feeling of heat of the face, red and dry lips, red tip of the nose, burning epigastric/abdominal pain, excessive hunger, mouth ulcers, thirst, dry stools, a feeling of heat, scanty dark urine, yellow complexion, Red tongue with dry yellow coating, Overflowing-Rapid pulse.

Spleen-Yin deficiency with Empty-Heat

A feeling of heat of the face in the afternoon and evening, poor appetite, poor digestion, retching, gnawing hunger, loss of taste, slight epigastric pain, dry mouth and lips, dry stools, thin body, sallow complexion with red tip of the nose, night sweating, malar flush, a feeling of heat in the evening, Red tongue without coating and transversal cracks on the sides, Floating-Empty and Rapid pulse.

Yin Fire

A feeling of heat of the face but cold limbs, slightly red face or pale face with a floating red colour on the cheeks, intermittent sore throat, dry mouth, dry lips, mouth ulcers, exhaustion, poor appetite, poor digestion, weak limbs, Pale tongue, Weak or Overflowing-Empty pulse.

Yin Fire is a pathological Minister Fire that arises when the Original Qi (Yuan Qi) becomes depleted from overwork. Since the Minister Fire and the Original Qi reside in the same place, the pathological Minister Fire ‘robs’ the Original Qi and rises to the head. This pattern is treated by tonifying the Original Qi and lightly clearing Heat; the representative prescription is Bu Zhong Yi Qi Tang Tonifying the Centre and Benefiting Qi Decoction.

clinical note

• In women, a feeling of heat of the face by no means always indicates Heat. In women, a feeling of heat of the face contradicting other symptoms and signs is very common. In particular, it may be due to:

– a simultaneous deficiency of Kidney-Yin and Kidney-Yang

– Empty-Heat from Blood deficiency

– Yin Fire.

Facial pain

Interrogation, Chapter 35

Facial pain such as in trigeminal neuralgia is often due to invasion of Wind in the channels of the face. This is an invasion of Wind purely in the channels of the face and it is not accompanied by the symptoms of invasion of Wind in the Lung Defensive-Qi system (as in common cold and influenza). The pattern of Wind in the channels causing facial pain may be associated with any of the other patterns listed; for example, the association of invasion of Wind in the channels of the face with Yin deficiency is a common cause of facial pain, especially in the elderly.

Invasion of Wind-Cold in the channels

Facial pain in repeated bouts, spastic, unbearable pain, face becoming ashen-pale during a bout of pain, aggravated by exposure to cold and alleviated by heat, Pale tongue, Tight pulse.

Invasion of Wind-Heat in the channels

Facial pain with a burning sensation in repeated bouts, stabbing, unbearable pain, pain in nose and lips, touching the face may suddenly provoke the pain, the pain is more often along the central axis of the face rather than on the right and left sides, face becomes red during a bout of pain, sweating, pain alleviated by exposure to cold and aggravated by exposure to heat, a feeling of heat, thirst, yellow tongue coating, Rapid pulse.

Liver-Fire

Burning facial pain that comes and goes according to emotional moods, pain aggravated by exposure to heat, red face, bloodshot eyes, headache, 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.

Damp-Heat

Severe pain in the cheeks and forehead accompanied by a sticky yellow or greenish nasal discharge, 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.

Deficiency of Qi and Blood

Chronic, dull facial pain that is aggravated by overexertion and alleviated by rest, pale face, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Blood stasis

Stabbing facial pain, dark complexion, headache, purple lips, dark rings under the eyes, Purple tongue, Wiry or Choppy pulse.

This is Blood stasis affecting the channels of the face, which may occur against a background of Heart- or Liver-Blood deficiency.

Yin deficiency with Empty-Heat

Facial pain, malar flush, dry mouth with no desire to drink, a feeling of heat in the evening, night sweating, Red tongue without coating, Floating-Empty and Rapid pulse.

Other symptoms and signs depend on the organ involved.

Yin deficiency with Empty-Heat and internal Wind

Facial pain aggravated by exposure to wind, malar flush, dry mouth with no desire to drink, a feeling of heat in the evening, night sweating, vertigo, facial tics, tremor, Stiff, Red tongue without coating, Floating-Empty, Rapid and slightly Wiry pulse.

Phlegm-Heat

Facial pain, a feeling of heaviness and muzziness of the head, a feeling of heat, red face, swelling of the face, dark rings under the eyes, greasy skin, a feeling of oppression of the chest, sputum in the throat, expectoration of yellow sputum, dizziness, nausea, Red and Swollen tongue with sticky yellow coating, Slippery-Rapid pulse.

Yin deficiency with Phlegm-Heat

Facial pain, malar flush, dry mouth with no desire to drink, a feeling of heat in the evening, night sweating, a feeling of heat, red face, a feeling of heaviness and muzziness of the head, swelling of the face, greasy skin, dizziness, nausea, a feeling of oppression of the chest, sputum in the throat, Red, Swollen tongue with coating, Floating-Empty or Fine and slightly Slippery pulse.

clinical note

• In the elderly with facial pain (often trigeminal neuralgia), Yin deficiency is nearly always the background for an invasion of Wind.

Numbness of the face

Interrogation, Chapter 35

Blood deficiency

Mild numbness of the face, dull-pale complexion, dull headache, blurred vision, dizziness, Pale tongue, Choppy or Fine pulse.

Other symptoms and signs depend on the organs involved (which may be the Liver or Heart).

Liver-Wind

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

Stomach-Fire

Numbness of the face, bleeding gums, burning epigastric pain, intense thirst with desire to drink cold liquids, mental restlessness, dry mouth, mouth ulcers, dry stools, sour regurgitation, foul breath, nausea, vomiting soon after eating, a feeling of heat, sour regurgitation, tongue Red with a thick, dry, dark-yellow coating, Deep-Full-Rapid pulse.

Wind-Phlegm

Numbness of the face, deviation of the mouth, slurred speech, 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.

Invasion of Wind

Numbness of the face with a sudden onset and short duration, deviation of eye and mouth, Floating pulse.

Oedema of the face

Observation, Chapter 5

Lung-Qi deficiency

Oedema of the face and hands, 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.

Spleen-Yang deficiency

Oedema of the face, abdomen and legs, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, slight depression, tendency to obesity, a feeling of cold, cold limbs, oedema, Pale and wet tongue, Deep-Weak pulse.

Wind-Water invading the Lungs

Oedema of the face and hands with sudden onset, bright-shiny complexion, scanty and pale urination, aversion to wind, fever, cough, slight breathlessness, sticky white tongue coating, Floating-Slippery pulse.

Tic

Observation, Chapter 4

‘Tic’ indicates an involuntary, recurrent twitching of facial muscles, usually involving the eyes or mouth, or both.

Liver-Wind

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

Liver-Blood deficiency leading to Liver-Wind

Occasional facial tic, slight tremor of the head/hand, dizziness, blurred vision, unilateral numbness/tingling of a limb, Pale and Thin tongue, Choppy or Fine and slightly Wiry pulse.

Liver-Wind and Phlegm

Facial tic, 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.

This condition is more common in old people.

Liver-Qi stagnation

Eye tic, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

External invasion of Wind-Cold in the channels of the face

Short-lasting tic with sudden onset, stiff neck, occipital headache, Floating-Tight pulse.

Deviation of eye and mouth

Observation, Chapters 4 and 5

Liver-Wind

Deviation of eye and mouth, tremors, severe dizziness, tinnitus, headache, numbness of limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

This corresponds to Wind-stroke.

Liver-Wind and Phlegm

Deviation of eye and mouth, hypertension, tremors, severe dizziness, tinnitus, headache, numbness of limbs, tics, a feeling of oppression of the chest, expectoration of sputum, Deviated or Stiff and Swollen tongue with a sticky coating, Wiry-Slippery pulse.

This condition is more common in old people.

External invasion of Wind-Cold in the channels of the face

Sudden deviation of mouth and eye, incomplete closure of the eye, inability to raise the eyebrow. This corresponds to facial paralysis (Bell’s palsy) and it is due to an invasion of Wind-Cold, not in the Lung’s Defensive-Qi portion (as in the common cold and influenza), but in the channels of the face.

Liver-Qi stagnation

Intermittent deviation of eye and mouth depending on emotional moods, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Deficiency of Qi and Blood

Slight deviation of eye and mouth, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dullpale complexion, Pale tongue, Weak or Choppy pulse.

Toxic Heat in the channels of the face

Deviation of mouth only, thirst, bitter taste, swelling and pain of the face, toothache, headache, red eyes, Red tongue with red points with thick, sticky, yellow coating, Overflowing-Slippery-Rapid pulse.

Facial paralysis

Observation, Chapter 4

External invasion of Wind-Cold in the channels of the face

Facial paralysis with a sudden onset, incomplete closure of the eye, inability to raise eyebrow.

This corresponds to facial paralysis (Bell’s palsy) and it is due to an invasion of Wind-Cold, not in the Lung’s Defensive-Qi portion (as in the common cold and influenza), but in the channels of the face.

Papular/macular eruptions

Observation, Chapter 5

Lung-Heat

Papular eruptions on the face and nose, cough, slight breathlessness, a feeling of heat, chest ache, flaring of nostrils, thirst, red face, Red tongue with yellow coating, Overflowing-Rapid pulse.

Blood-Heat

Macular eruptions on the face, red face, a feeling of heat of the head, thirst, insomnia, agitation, heavy periods, Red tongue, Overflowing-Rapid pulse.

Swelling and redness of the face

Observation, Chapter 5

Invasion of Toxic Heat

Acute swelling and redness of the face, swollen tonsils, swollen glands, swelling of the parotid gland, aversion to cold, fever, headache, tongue Red in the front with red points and thick, sticky yellow coating, Overflowing-Slippery-Rapid pulse.

Swelling, redness and pain of the cheeks

Observation, Chapter 5

Toxic Heat in the face

Swelling, redness and pain of the cheeks, thirst, bitter taste, toothache, headache, red eyes, Red tongue with red points with thick, sticky yellow coating, Overflowing-Slippery-Rapid pulse.

Ulcers below the zygomatic arch

Observation, Chapter 5

Toxic Heat in the Stomach

Ulcers below the zygomatic arch, swelling and redness of the cheeks, red and swollen tonsils, burning epigastric pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, Red tongue with a thick, sticky yellow coating and red points, Overflowing-Slippery-Rapid pulse.

Lines on the face

Observation, Chapter 5

Blood deficiency

Lines on the face, dry skin of the face, dry scalp and hair, dry eyes, floaters, blurred vision, numbness/tingling of the limbs, scanty menstruation, Pale and Thin tongue, Fine or Choppy pulse.

Heat with Dryness

Lines on the face, dry skin of the face, dry scalp and hair, red face, dry mouth, dry eyes, thirst, a feeling of heat, Red tongue with yellow coating, Overflowing-Rapid pulse.

Other symptoms and signs depend on the organ involved.

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HEAD, HAIR AND FACE

HEAD, HAIR AND FACE