A 21-year-old female complains of sneezing with runny nose, mild sweat and increased thirst. Her symptoms started three days ago, and this morning she woke up with a sore throat.
What is the most appropriate pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be useful: LI11, GB20, GV14
hallmark signs of Wei Level – invasion of Wind-Heat (衛分風熱).
Sore throat + thirst → heat.
Sneezing, runny nose, mild sweat → exterior invasion.
Acute onset → exterior level, not interior yet.
Thus, the most appropriate diagnosis is:
Wei Level – Wind-Heat invasion.
Tongue and pulse:
The tongue is expected to be slightly red, especially at the tip and edges, with a thin yellow coat. The pulse would be floating and rapid.
Treatment principle
release the exterior, clear Heat, and restore the Lung’s descending function to stop sneezing and sore throat, and to prevent penetration to the deeper levels.
LI11 clears Heat and reduces fever
GB20 expels Wind from the head and clears sensory orifices
GV14 strongly releases the exterior and clears Heat, supporting the body’s defensive Qi in expelling the pathogen.
A 51-year-old man presents with heaviness in the limbs, nausea, no thirst, and a persistent fever that alternates with chills.
What is the most appropriate spleen pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be useful: SP3, SP6, SP9, ST36
Dampness heat in the spleen
Red tongue with sticky, yellow coat
Soggy, rapid pulse
Clear heat in the Spleen and resolve dampness
SP3 (Tàibái): Yuan-Source point of the Spleen; tonifies Spleen Qi, strengthens transformation and transportation, aids in resolving Damp.
SP6 (Sānyīnjiāo): Meeting point of Spleen, Liver, Kidney; harmonises the Middle Jiao, promotes fluid metabolism, supports resolution of Damp.
SP9 (Yīnlíngquán): Main point to resolve Dampness, regulates water pathways, clears Damp-Heat from the lower Jiao.
ST36 (Zúsānlǐ): Tonifies Spleen and Stomach, strengthens Qi, promotes transformation of food and fluids, harmonises the Middle Jiao to counter nausea.
A 45-year-old man presents with constipation, pain at the abdomen near ST28 both sides. He describes the pain as sharp and fixed. He has a history of admitted into hospital for the pain, delirium and high fever. His overall complexion looks greyish-red.
What is the most appropriate pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be useful: SP10, SP6, LR8, LR6
Key symptoms:
- Constipation
- Sharp, fixed abdominal pain (around ST28 area, lower abdomen, likely Blood stasis/Heat)
- Past hospital admission for delirium and high fever → pathogenic Heat at an interior, deep level
- Greyish-red complexion → suggests Heat damaging fluids and Blood, possible stasis
Blood Level: Sharp, fixed pain in the lower abdomen and greyish-red complexion → strong indicator of Heat in the Blood causing stasis.
Blood Level – Heat in the Blood with Blood stasis in the Lower Jiao.
tongue: Purple or purple spots on tongue
Pulse: Deep, forceful, or choppy
treatment: Drain heat, invigorate blood and remove blood stasis
SP10 (Xuèhǎi): “Sea of Blood” point, strongly invigorates and cools the Blood, disperses stasis.
SP6 (Sānyīnjiāo): Meeting of Spleen, Liver, Kidney channels; regulates Blood, harmonises lower Jiao, alleviates abdominal pain.
LR8 (Qūquán): Tonifies and nourishes Liver Blood, clears Damp-Heat from the lower Jiao, supports resolution of stasis.
LR6 (Zhōngdū): Xi-Cleft point of the Liver; regulates Qi and Blood in the lower Jiao, clears Damp-Heat, stops acute abdominal pain.
A 20-year-old university student presents with swollen glands, thirsty, mild sweat recently. What other questions will you ask / observations will you make to differentiate a specific pattern diagnosis for this patient?
Discuss useful points?
Swollen glands → indicates exterior pathogen, often Wind-Heat (Wei Level).
Thirst → Heat involvement.
Mild sweat → Wei Qi disharmony (surface not fully secured).
Throat: Sore throat or painful swallowing? (Wind-Heat hallmark)
Fever/chills: Presence of fever, aversion to cold, or alternating chills/fever? (Helps differentiate Wind-Heat, Shaoyang involvement, or Damp-Heat).
Head/eyes: Headache, body aches, eye redness? (External invasion vs Heat signs).
Urination/stool: Dark urine, constipation? (Qi Level Heat).
Tongue/throat inspection: Red tip or edges? Thin white vs thin yellow coating?
Pulse: Floating, rapid vs floating, moderate.
Sweat: Spontaneous vs night sweat? (Deficiency vs exterior invasion).
If the patient also reports sore throat, fever, red tip tongue, floating-rapid pulse → then it’s:
👉 Wei Level: Wind-Heat invasion.
If instead there are stronger systemic Heat signs (high fever, irritability, dark urine, red tongue with yellow coat, rapid-full pulse), it would be:
👉 Qi Level: Heat in the Qi Level (Yangming-type).
LI4 (Hégǔ): Releases the exterior, clears Heat, disperses Wind.
LI11 (Qūchí): Clears Heat, cools the exterior, reduces fever.
LU7 (Lièquē): Releases the exterior, regulates Lung Qi, stops sore throat.
GB20 (Fēngchí): Expels Wind, clears Heat from the head/throat.
GV14 (Dàzhuī): Meeting point of Yang channels, strongly clears Heat, releases exterior.
A 55-year-old woman complains of persistent dry cough accompanied by night sweating and tiredness.
What is the most appropriate lung pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: LU9, LU10, KI6, SP6
Dry cough → suggests Lung Yin Deficiency (vs. Lung Qi Deficiency which usually has a weak cough with sputum).
Night sweating + age (post-menopausal likely) → Yin deficiency with Empty Heat.
Tiredness → may be secondary from Yin failing to nourish Qi, but primary driver is Yin Deficiency.
👉 Diagnosis: Lung Yin Deficiency with Empty Heat
Pulse: floating-empty, or fine-rapid.
Tongue: red (esp. front), no coat, possibly cracks.
Tonify lung-yin, nourish body fluids, clear empty-heat if necessary
LU-9 nourishes Lung Yin and restores descending.
LU-10 clears Empty Heat from the Lungs.
KI-6 nourishes Kidney Yin, benefits throat, moistens dryness.
SP-6 supports Yin of Liver, Spleen, and Kidney, reinforcing KI-6 and addressing systemic Yin deficiency.
An 8-year-old boy presents with sweating and headache. He has a mild fever and a blocked nose.
What is the most appropriate lung pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: LU7, LI4, GB20, TE5.
Mild fever + aversion to wind (implied by headache + blocked nose) → Wind invasion.
Sweating = Defensive Qi not securing exterior → points more to Wind-Heat (or Wind-Cold with Wei Qi disharmony, but Maciocia frames it as Wind-Heat if fever + sweat present).
Blocked nose + headache → common with Wind-Heat obstructing the Lung’s diffusing function.
👉 Diagnosis: Invasion of Lungs by Wind-Heat
Pulse: floating-rapid.
Tongue: slightly red on front or edges, thin yellow coat.
release the exterior, clear heat, stimulate the D&D of lung-qi
LU-7 releases the Exterior, expels Wind, restores Lung descending.
LI-4 releases the Exterior, regulates sweating, clears Heat.
GB-20 expels Wind, benefits the head, relieves headache.
TE-5 releases Exterior, clears Wind-Heat, relieves head/nose symptoms.
A 31-year-old woman complains of chronic cough with fullness in the chest. She is sensitive to cold with cold extremities. On further inquiry you discover her diet is mainly composed of salads daily. She is a full-time office worker.
What is the most appropriate diagnosis for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: LU7, LU5, BL20, ST40
Chronic cough + chest fullness → suggests Phlegm obstructing the Lungs.
Cold sensitivity + cold extremities → Cold involvement.
Diet of raw, cold foods + sedentary lifestyle → Spleen failing to transform fluids → Phlegm accumulation.
Put together → Cold-Phlegm in the Lungs.
👉 Diagnosis: Cold-Phlegm obstructing the Lungs
Pulse: slippery–slow.
Tongue: swollen, wet, with thick sticky white coat.
Resolve phlegm, expel cold, warm yang, restore the descending of lung-qi
LU-7 restores Lung descending, relieves cough.
LU-5 clears Phlegm from Lungs and chest.
BL-20 tonifies Spleen to prevent Phlegm formation.
ST-40 strongly resolves Phlegm and clears obstruction.
A woman in her 40s visits your clinic for general health maintenance. On observation you notice she has a pale complexion. She has a very weak voice that you must strain to hear her words. She reports she gets breathless very easily and that she has been experiencing grief for the past 5 years as few of her family members have passed away.
What is the most appropriate diagnosis for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: LU9, ST36, CV6, BL13.
Weak voice + breathlessness + pale complexion → hallmark of Lung Qi Deficiency.
Grief → directly weakens Lung Qi (classic emotion–organ link).
No heat signs, no dryness, no phlegm → rules out Yin Deficiency or Phlegm patterns.
👉 Diagnosis: Lung Qi Deficiency
Pulse: weak (especially right front).
Tongue: pale, possibly thin coat.
tonify lung-qi, warm yang
LU-9 tonifies Lung Qi and restores descending.
ST-36 strengthens postnatal Qi to support the Lung.
CV-6 reinforces Qi and treats chronic deficiency.
BL-13 tonifies Lung Qi and regulates the Lung, addressing both physical and emotional aspects.
An 8-year-old girl presents with cough that started 2 days ago. She has a mild fever and a blocked nose. You ask her mother for further information, and you discover her nasal discharge has been clear and runny and that she has been curling up in bed with her blanket. What is the most appropriate diagnosis for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: LU7, BL12, GV16.
Mild fever + aversion to cold + clear runny nasal discharge + blocked nose + cough → Invasion of Wind-Cold obstructing the Lung.
Key differentiation:
Wind-Heat → yellow mucus, sore throat, higher fever.
Wind-Cold → clear mucus, chills/aversion to cold, curled up in blanket.
👉 Diagnosis: Wind-Cold invading the Lungs
Pulse: Floating and tight (classic for Wind-Cold).
Tongue: Thin white coat, possibly normal body.
release the exterior, expel cold, stimulate the D&D of lung-qi
LU-7 releases the Exterior, disperses Wind, and restores Lung Qi.
BL-12 expels Wind-Cold and strengthens Wei Qi.
GV-16 expels Wind from the Exterior, especially Wind-Cold.
A 25-year-old man presents to you with persistent shoulder pain. On further enquiry you discover that the pain is cold in nature, and it runs down the arm along the outer aspect of the biceps. He reports constant fullness in the chest area which makes him cough.
What is the most appropriate lung pattern for this patient?
What further questions do you need to ask to clarify?
What is the treatment principle for this case? Discuss why the following points may be indicated: LU7, LU5, BL20, ST40.
Cold, heavy shoulder pain along Lung channel → Cold or Phlegm obstructing the Lung channel.
Fullness in chest + cough → failure of Lung Qi to descend due to Phlegm retention in the Lungs.
Very likely: Phlegm-Cold obstructing the Lungs.
👉 Diagnosis: Phlegm-Cold obstructing the Lungs
Sputum: Is it white, watery, and copious? (would confirm Phlegm-Cold).
Temperature sensation: Is he easily chilled? Aversion to cold? (Cold obstructing Yang).
Breathing: Any wheezing or difficulty breathing?
Aggravating factors: Does the shoulder pain worsen with cold exposure? Improve with warmth?
Tongue: expect pale with thick white greasy coat.
Pulse: slippery and possibly tight.
resolve phlegm, expel cold, warm yang, restore the descending of lung-qi
LU-7 restores descending of Lung Qi and releases channel obstruction.
LU-5 clears Phlegm and regulates the Lungs.
BL-20 tonifies Spleen Qi to prevent Phlegm formation.
ST-40 transforms existing Phlegm and clears chest fullness.
A 12-year-old boy complains of watery diarrhea after recovering from a cold a week ago. He has abdominal pain that is relieved by heat. He has a pale complexion and reports being nauseous. What is the most appropriate LI pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: ST36, ST37, ST25, SP6
This points to Large Intestine Cold (Empty-Cold).
- watery diarrhea and abdominal pain better with warmth are hallmarks of Cold.
(Pale complexion + nausea suggests Spleen Yang deficiency as the underlying terrain)
Tongue: Pale body, thin white coat (possibly wet).
Pulse: Deep, Weak, and Slow.
tonify & warm large intestine & spleen
ST36 (Zúsānlǐ) – Tonifies Spleen & Stomach, regulates intestines, stops diarrhea
ST37 (Shàngjùxū) – Lower He-Sea of LI, clears and regulates LI, abdominal pain/diarrhea
ST25 (Tiānshū) – Front-Mu of LI, regulates intestines, resolves Cold, stops diarrhea
SP6 (Sānyīnjiāo) – Tonifies Spleen & Kidney Yang, warms interior, alleviates nausea, supports fluid transformation
A 31-year-old woman complains of dizziness, shortness of breath accompanied by bearing down sensation in the lower abdomen ever since giving birth 2 years ago.
What is the most appropriate spleen pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: GV20, CV6, ST21.
Key symptoms:
Dizziness + shortness of breath → suggests Qi/Xue deficiency.
Bearing-down sensation in lower abdomen (after childbirth, 2 years ago, chronic) → classic sign of Spleen Qi Sinking.
Postpartum → predisposition to Qi and Blood deficiency.
👉 The most appropriate pattern here is Spleen Qi Sinking
Pulse: Weak (deficient), possibly empty, especially in the middle position.
Tongue: Pale, possibly swollen, may have teeth marks; thin white coat.
tonify spleen-qi, raise qi
GV20 lifts Yang/Qi and treats prolapse.
CV6 tonifies Qi and strengthens the root.
ST21 strengthens the Middle Jiao and raises Qi, addressing abdominal prolapse and bearing down.
A 51-year-old man presents with chronic loose stools and lack of energy. Recently he frequently gets nauseous, and he reports that he has poor appetite.
What is the most appropriate spleen pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: SP9, SP6, SP3, CV12.
Chronic loose stools, fatigue, poor appetite → Spleen Qi Xu.
Nausea (recent, frequent) → points toward turbid Damp obstructing the Middle Jiao, preventing Stomach Qi from descending.
So, the most appropriate pattern here = Spleen Qi Xu with Damp Encumbrance
Pulse: Weak and possibly slippery (reflecting both deficiency and Damp).
Tongue: Pale, swollen, with a thick, greasy coat (often white).
tonify spleen qi, resolve damp
SP9 clears Damp.
SP6 supports Spleen Qi and transformation.
SP3 reinforces Spleen Qi (root of problem).
CV12 harmonizes Stomach, relieves nausea, and boosts appetite.
A 45-year-old woman presents with chronic pain in the abdomen. She describes the pain as distending and full. She has a history of nausea and vomits when it gets bad. On observation she is overweight especially around the middle. Her tongue is quite red.
What is the most appropriate spleen pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: SP6, SP9, LI11, BL20.
Chronic abdominal pain, distension, fullness → Damp obstructing the Middle Jiao.
Nausea, vomiting → Damp turbidity affecting the Stomach, Qi not descending.
Overweight, central obesity → long-standing Damp/Phlegm accumulation.
Red tongue → indicates Heat is involved, not just Cold-Damp.
👉 The most appropriate pattern here is Damp-Heat Invading the Spleen
Pulse: Slippery and rapid (showing Damp + Heat).
Tongue: Red with a thick, yellow, greasy coat.
resolve damp, clear heat
SP6, SP9 → strengthen Spleen, resolve Damp.
LI11 → clears Heat, targets red tongue and Heat signs.
BL20 → tonifies Spleen Qi to treat root cause of Damp accumulation.
A 21-year-old university student presents with indigestion and recently sudden weight loss. He reports postural dizziness and chronic tiredness. On observation you notice his has a sallow face with dull complexion.
What is the most appropriate spleen pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: SP3, ST36, CV12, BL20.
Indigestion + chronic tiredness → Spleen Qi not transforming/transporting properly.
Sudden weight loss → Spleen failing to extract Gu Qi (food essence) → malnourishment.
Postural dizziness → Qi and Blood not being generated sufficiently.
Sallow face, dull complexion → hallmark of Qi and Blood deficiency, especially Spleen Qi Xu leading to poor nourishment of tissues.
👉 The most appropriate diagnosis here is Spleen Qi Deficiency (脾气虚), with early progression toward Spleen Blood Deficiency due to lack of production.
Pulse: Weak, possibly empty, especially in the right Guan position.
Tongue: Pale (sometimes swollen with teeth marks), thin white coat.
tonify spleen-qi, nourish blood
SP3 strengthens Spleen at its source.
ST36 boosts Qi and Blood, improves energy.
CV12 harmonizes digestion and improves appetite.
BL20 reinforces Spleen Qi tonification at the root level.
A 32-year-old woman has scanty and irregular periods. You observe her face is pale and lackluster. She constantly apologies for being forgetful and clumsy.
What is the most appropriate heart pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: HT7, CV14, CV15, BL17, BL20
Main signs:
Scanty, irregular periods
Pale, lackluster complexion
Forgetfulness, clumsiness (poor memory, lack of concentration, Shen not housed properly)
Constant apologizing → timidity, low Shen vitality
Patient profile: young woman, reproductive system (Blood aspect) affected
Heart Blood Deficiency
Scanty/irregular menses = insufficient Blood to fill Ren/Chong.
Pale face = classic Blood Xu sign.
Forgetfulness, poor concentration, timidity = Shen not housed properly due to lack of Heart Blood.
Clumsiness = poor nourishment of sinews from insufficient Blood.
Tongue: pale, thin; possibly slight dryness; thin white coat.
Pulse: choppy (hesitant) or fine/thready (Xi), weak on left front position (Heart).
nourish blood, tonify heart, calm the mind
HT-7 (Shénmén)
Tonifies Heart Blood, calms the Shen → addresses forgetfulness, timidity, poor memory.
CV-14 (Jùquè)
Tonifies Heart, calms Shen, clears deficiency anxiety.
CV-15 (Jiūwěi)
Luo-Connecting point of Ren, spreads in the abdomen and connects with Heart.
Calms Shen, benefits Heart, clears restlessness.
BL-17 (Géshù)
Tonifies and nourishes Blood, important for scanty/irregular menses.
BL-20 (Píshù)
Tonifies Spleen Qi to promote Blood production.
A 65-year-old woman complains of recurring palpitations ever since the death of her husband 8 months ago. She feels pressure in the chest that makes her breathless. Her doctor referred her to a heart specialist, and nothing abnormal was detected. Her only other symptom is that she is sensitive to cold.
What is the most appropriate heart pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: HT5, BL15, CV17, PC6
Heart Yang Xu because:
Palpitations, chest oppression, breathlessness = Heart failing to circulate Qi and Blood.
Sensitivity to cold = hallmark of Yang deficiency.
Bereavement weakened Shen → Heart Qi collapsed into Yang deficiency over time.
Tongue: pale, possibly swollen; wet with thin white coat.
Pulse: deep, weak, slow — especially at left front (Heart position).
Tonify & warm Heart-yang
HT-5 (Tōnglǐ)
- Tonifies Heart Qi, benefits rhythm and circulation.
- Calms Shen, useful for palpitations with emotional cause.
BL-15 (Xīnshū)
- Tonifies and nourishes Heart, strengthens Heart Yang.
- Regulates Heart Qi and Blood in chest.
CV-17 (Shānzhōng)
- Opens chest, regulates Qi, relieves oppression and breathlessness.
- Assists Heart Yang to mobilise Qi circulation.
PC-6 (Nèiguān)
- Opens chest, regulates Qi, calms Shen.
-Excellent for emotional aetiology (grief, anxiety) manifesting as chest tightness and palpitations.
A 17-year-old boy has recurring mouth ulcers especially when he gets stressed with schoolwork. His mother reports he doesn’t eat or sleep well when he gets stressed and is prone to outbursts of anger.
What is the most appropriate heart pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: HT7, HT8, HT9, SP6, KI6
Heart Fire Blazing
Mouth ulcers on the tongue and mouth are the hallmark of Heart Fire.
Poor sleep, irritability, anger → Shen disturbed by Fire.
Stress (Liver Qi stagnation) transforms into Fire and transfers to the Heart, which explains why symptoms flare under pressure.
(If it were purely Yin Xu → mouth/tongue ulcers would be more chronic, less fiery/red, with night sweats/dry mouth. Here the acute fiery flare-up points more to Heart Fire Blazing.)
Tongue: red, especially tip; possibly redder swollen papillae on tip; yellow coat.
Pulse: rapid, overflowing (especially left front position).
Clear the heart, drain fire, calm the mind
HT-7 (Shénmén)
Calms Shen, nourishes Heart Yin/Blood.
Balances out the overactive Fire.
HT-8 (Shàofǔ)
Clears Heart Fire directly (esp. ulcers on tongue/mouth).
Regulates Heart Qi, calm Shen.
HT-9 (Shàochōng)
Clears Heat, restores consciousness (in extreme Fire).
Good adjunct for acute ulcer flare-ups.
SP-6 (Sānyīnjiāo)
Nourishes Yin and Blood to support Heart.
Indirectly calms Shen by strengthening Yin.
KI-6 (Zhàohǎi)
Nourishes Kidney Yin, anchors Heart Fire.
Useful for insomnia, irritability, restlessness.
A 37-year-old man has chronic depression and anxiety from exacerbated by work. He is medicated and recently noticed he has bouts of profuse sweating despite no activity. On observation you notice he has pale face and lack of ‘shen’ in his demeanor and speech.
What is the most appropriate heart pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: HT5, PC6, CV17, BL15
Heart Qi Deficiency
Palpitations, anxiety, depression, spontaneous sweating, pale face, lassitude of Shen → textbook Heart Qi Xu.
If cold intolerance were present, we might shift toward Heart Yang Deficiency. Here, no mention of cold → more consistent with Qi Xu.
Profuse sweating is the clincher: Qi fails to secure pores → Heart Qi deficiency.
Tongue: pale, possibly midline crack in Heart area.
Pulse: empty/weak, especially on left front (Heart position).
Tonify heart-qi
HT-5 (Tōnglǐ)
Tonifies Heart Qi, regulates Heart rhythm, calms Shen.
Useful for palpitations, anxiety, and profuse sweating (Heart Qi not securing).
PC6 (Nèiguān)
Opens chest, regulates Qi, calms Shen.
Excellent for emotional depression/anxiety and chest oppression.
CV-17 (Shānzhōng)
Tonifies Gathering Qi (Zong Qi) in the chest, strengthens Heart and Lung Qi.
Regulates chest Qi to ease oppression/anxiety.
BL-15 (Xīnshū)
Tonifies and nourishes Heart Qi (and Yang if needed).
Calms Shen, strengthens Heart’s governance of Blood and Mind.
Your patient tells you about her mother who suddenly developed aphasia and delirium especially at night. You find out she has been going through difficult process of divorce. She feels hot and restless.
What is the most appropriate HT/PC pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What is the treatment principle for this case? Discuss why the following points may be indicated: PC8, PC6, KI6, HT9
Pattern: Pericardium/Heart Fire or Phlegm-Fire Harassing the Mind.
Aphasia and delirium = Shen disturbance.
Restlessness and heat sensation = Excess Heat.
Emotional stress → may have contributed to Liver-Fire invading Heart, or Phlegm-Fire accumulating in the PC.
Acute onset + mental confusion fits Phlegm-Fire Harassing the Heart/Pericardium rather than just Yin deficiency.
If Phlegm-Fire harassing the Heart:
Tongue: Red with yellow, sticky coating, possibly swollen or deviated.
Pulse: Rapid, slippery, and possibly overflowing (Excess + Phlegm).
If pure Heart Fire:
Tongue: Red tip, may have yellow coating.
Pulse: Rapid, full, forceful.
Clear Heart/Pericardium Heat, Calm the Shen, Resolve Phlegm if present, Support Yin if deficient
PC8 (Laogong)
- Clears Heat from the Pericardium, calms the Shen, good for agitation, delirium, and aphasia.
PC6 (Neiguan)
- Opens the chest, regulates Heart Qi, calms the Shen, harmonises the Stomach (often used for emotional stress affecting the Heart).
KI6 (Zhaohai)
- Nourishes Yin, clears deficiency Heat, especially useful at night for restlessness.
HT9 (Shaochong)
- Clears excess Heart heat, revives consciousness in acute cases, can be used in febrile or delirious conditions.
Discuss with the class the presentations of heart attacks, myocardial infarction, angina pectoris, precordial catch syndrome etc.
What is the most appropriate HT/PC patterns for these conditions?
What is the treatment principle for this case? Discuss why the following points may be indicated: PC6, HT5, CV17, BL17
MI/Angina = Heart Blood stasis (sometimes with Yang collapse/Phlegm).
Precordial catch = more Qi stagnation, functional.
Treatment principle: move Qi & Blood, open chest, calm Shen.
Acupuncture = supportive therapy only, not first-line in emergencies.
PC6 (Nèiguān, “Inner Gate”)
One of the main points for chest pain. Opens chest Qi, regulates Heart rhythm, calms Shen.
Used clinically in angina, palpitations, anxiety.
HT5 (Tōnglǐ, “Connecting Li”)
Tonifies Heart Qi, regulates rhythm, benefits the tongue/speech.
Useful for palpitations, arrhythmias, and chest pain with emotional component.
CV17 (Shānzhōng, “Chest Centre”)
Strong for moving Qi in the chest, relieving oppression, supporting Zong Qi (gathering Qi for Heart and Lung).
Indicated for chest tightness, angina, shortness of breath.
BL17 (Géshù, “Diaphragm Shu”)
Important for invigorating Blood, removing stasis, especially in the chest.
Key point for Heart Blood stasis (angina, MI recovery).
You walk past a homeless man on the street who is raving incoherently. He is agitated, confused and manic.
What is the most appropriate HT/PC pattern for this behaviour?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? Discuss the socio-cultural context of this presentation. What is the treatment principle for this case? Discuss why the following points may be indicated: PC5, HT7, PC7, ST40
Raving incoherently, agitation, confusion, mania → severe disturbance of the Shen, suggesting excess Heat, Phlegm-Fire, or Wind in the Heart/Pericardium.
Acute onset with agitation and manic behavior → more likely Excess pattern, not deficiency.
Possible chronic stress, social deprivation → may contribute to Liver-Fire or Phlegm accumulation affecting the Heart.
Phlegm-Fire Harassing the Heart (Pericardium)
Rationale:
Mental confusion, mania, and incoherent speech = Shen disturbance.
Agitation and hyperactivity = Excess Heat.
Incoherent speech and delirium = Phlegm obstructing the Mind (orifices of the Heart).
Social context: homelessness, stress, substance use, poor nutrition may contribute to Phlegm accumulation.
Tongue: Red, swollen, with yellow, sticky coating (Phlegm-Heat).
Pulse: Rapid, slippery, and possibly overflowing (Excess + Phlegm).
clear the heart, drain fire, resolve phlegm, calm the mind, open the mind’s orificies
PC5 (Jianshi)
- Transforms Phlegm, clears Heat from the Pericardium, calms Shen in mania or delirium.
HT7 (Shenmen)
- Calms the Shen, reduces agitation, regulates Heart.
PC7 (Daling)
- Clears Heat from the Pericardium, resolves Phlegm, calms the Mind.
ST40 (Fenglong)
- Main point to resolve Phlegm, both physical and mental (obstructing the Mind).
A 42-year-old woman presents with chronic abdominal pain that is worse in the morning. She works in a stressful corporate environment and does not eat regularly through the week. She is sensitive to cold and get diarrhea easily. What is the most appropriate SI pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue? What are the treatment principles for this case? Discuss why the following points may be indicated: CV26, ST25, ST36, BL27
Small Intestine Deficient Cold (SI Yang Deficiency)
Sometimes called Cold in the Small Intestine or SI Deficiency Cold, often associated with Spleen and Kidney Yang deficiency.
Rationale:
Chronic diarrhea → inability to transform fluids.
Cold sensitivity → insufficient Yang to warm the intestines.
Morning abdominal pain → typical for Yang deficiency, as Yang is weaker in the morning.
Stress/irregular eating contributes to Spleen Qi deficiency, further impairing SI function.
Pulse: Deep, weak, slow (especially rear position reflecting SI/Kidney).
Possibly thin if there is Qi deficiency.
Tongue: Pale, possibly slightly swollen.
White coating, thin or moist (due to Cold and damp accumulation).
Expel Cold, warm the intestines, Tonify spleen-yang
CV6 - Tonifies original Qi, warms Yang. (If CV26 is used, usually for acute abdominal pain or resuscitation.)
ST25 - Regulates intestines, alleviates abdominal pain and diarrhea.
ST36 - Tonifies Spleen/Stomach, boosts Qi and Yang, supports SI function.
BL27- Directly tonifies SI, warms Yang, regulates SI Qi.
A 37-year-old woman seeks treatment for irregular menstruation ever since coming off contraceptive pills 2 years ago. On observation she has a thin body type and flushed cheeks. She reports getting postural dizziness and prone to fatigue.
What is the most appropriate kidney pattern for this patient?
Based on your diagnosis what is the expected presentations of the patient’s pulse and tongue?
What is the treatment principle for this case? Discuss why the following points may be indicated: CV4, KI3, KI6, KI10, SP6
This presentation best fits Kidney Yin Deficiency.
Irregular menstruation: often linked to Kidney deficiency, as Kidneys govern reproduction and menstruation.
Thin body type: common in Yin deficiency, lack of fluids/substance.
Flushed cheeks: hallmark of Yin deficiency with empty-heat signs (5-centre heat, malar flush)
Postural dizziness: deficiency of Yin fails to nourish the Brain/Marrow.
Fatigue: general feature of Kidney deficiency (Yin not anchoring Yang, failing to produce Qi).
Tongue: Red, little or no coating, may be cracked in severe cases
Pulse: Floating-empty
Nourish Kidney-Yin, Clear empty heat if necessary
CV4 (Guanyuan)
Tonifies Kidneys, nourishes Blood and Yin.
Important for regulating menstruation through the Ren Mai.
KI3 (Taixi)
Strongly nourishes Kidney Yin (and also Kidney Yang if indicated).
Anchors Yang and benefits lumbar and reproductive function.
KI6 (Zhaohai)
Nourishes Kidney Yin, clears deficiency heat.
Opens Ren Mai → directly influences menstruation and uterus.
Useful for irregular menstruation due to Yin deficiency.
KI10 (Yingu)
He-Sea point, clears Damp-Heat from Lower Jiao, but also helps tonify Kidney Yin.
Useful when Yin deficiency creates heat disturbing the cycle.
SP6 (Sanyinjiao)
Nourishes Yin (esp. Kidney, Liver, Spleen), regulates menstruation.
Important for gynaecology: harmonises cycle, tonifies Blood and Yin.
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Tongue diagnosis51
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Random CMPR122 nuggets20
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Inspection99
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Body movements9
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Listening and smelling22
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Interrogation104
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Palpation31
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Ba Gang & vital substances35
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Lung Pattern39
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Spleen Patterns26
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Stomach Patterns32
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Heart and Pericardium Patterns53
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LI patterns33
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SI patterns21
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Liver & GB patterns69
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Kidney patterns31
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Bladder patterns12
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Identifcation of Patterns according to the 12 channels16
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Identification of patterns according to the 3 Jiao28
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Wu Xing pattern Differentiation15
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External Pattern Differentiation58
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Six divisions + Wk 1163
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Four Level Pattern Differentiation62
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Case studies from lectures33
