CMPR122 > Interrogation > Flashcards

Interrogation Flashcards

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1
Q

What are the underlying causes of full vs empty conditions leading to pain?

A

full may be due to
- Invasion of exterior pathogenic factors
- stagnation of Qi/Blood
- Interior Cold/Hot
- Retention of Food
- obstruction by Phlegm
Empty
- Qi and Blood Xu
- Consumption of Jinye from Yin Xu

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2
Q

How does pressure, food, pain type, bowel movement, vomiting, posture, onset, rest/movement affect pain in an empty vs full condition?

A

empty vs full
Pressure and food - alleviate / aggravate
type - Dull, lingering / Sharp
bowel movement & vomiting - Aggravate / alleviate
posture - better lying down / sitting up
onset - slow, gradual / sudden
rest/movement - better with rest / with movement

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3
Q

How does type, temperature, Bowel movements, vomiting and rest/movement react when with pain in cold vs hot?

A

cold vs hot
type - cramping / burning
temperature - alleviated by heat / cold
Bowels & vomiting - Aggravate / alleviate
Rest/movement - better with movement / worse

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4
Q

Differentiate between Blood stagnation and Blood Xu pain?

A

Blood stagnation
- stabbing, sharp, boring pain
- fixed and localised
- common locations include head, chest, epigastrium, abdomen and uterus
Blood Xu
- cracking and popping of joints (also - joints cracking, yin lacking)
- spasms and cramps
- trembling and numbness

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5
Q

Differentiate between Qi stagnation and Qi Xu pain?

A

Qi stagnation
- distension more than pain, fullness
- no fixed location - loose and undefined
- can alternate b/w sharp, dull and achy. Coming and going pain
- better in the afternoon and with activity
Qi Xu
- deep, dull and achy
- worse in the afternoon
- worse with activity

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6
Q

What type of pain does Liver-Yang rising cause?

A

chronic headaches with a distending, throbbing pain

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7
Q

What type of pain does damp-heat cause?

A

burning pain with a feeling of fullness and heaviness

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8
Q

What type of pain does external wind cause?

A

occipital headache and stiffness

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9
Q

What type of pain does external dampness cause?

A

Pain in joints or epigastrium

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10
Q

What type of pain does retention of food cause?

A

intense pain with feeling of fullness (children more commonly experience this)

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11
Q

What type of pain does phlegm cause?

A

doesn’t usually cause pain, but may do so in joints (think rheumatoid arthritis)

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12
Q

What is the difference between internal and external cold pathogen?

A

Internal
- sensitive to cold - relieved by adding more clothing
- S&S relate to internal organ affected
- obvious changes to tongue body and coating
External
- aversion to cold - subjectively the pt feels cold but their skin is hot to touch and not relieved by putting on more clothing
- tongue and pulse will almost be normal

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13
Q

What is the main symptom of internal cold?
What is the difference between full and empty cold interiorly?
signs, pulses, causes

A

Main sign of internal cold is person easily feels cold and has cold limbs
Full cold
- intense feelings of cold and shivers, body feels cold and hard to touch, full-tight-deep pulse, pain
- usually has sudden onset, due to external cold pathogen invasion eg cold food -> invades channels -> eventually can reach organs
Empty Cold
- due to Yang Xu of any organ -> may cause cold feeling and/or cold limbs (subjective and objectively)
-weak-slow-deep-pulse, no pain
- one feels cold in superficial aspects of the body

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14
Q

What does aversion to cold not relived by extra clothing indicate?

A

External wind
cold pathogen

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15
Q

What does chills without fever indicate vs fever without chills indicate?

A

Chills without fever
- yang Xu, internal cold
- wind cold
Fever without chills
- low grade temp -> blood/yin/qi Xu
- high temp -> with big pulse -> exterior pathogen reaching interior

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16
Q

What does simultaneous chills and fever indicate vs alternating chills and fever?

A

Simultaneous
- exterior pathogen at surface
Alternating
- pathogen is lodged b/w interior and exterior
- shaoyang stage cold attack

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17
Q

What is the main symptom of internal heat?
What is the difference between full and empty heat interiorly?
signs, pulses, causes

A

feeling of heat
Full-heat
- excess yang due to chronic distress -> qi stagnates ->heat, external pathogen penetrating internal
- bitter taste, feeling hot all day, dream disturbed restless sleep, full-rapid-overflowing pulse
- constipation with abdo pain
Empty-heat
- low grade temp in afternoon or temp worsening in afternoon indicates Yin Xu
- no bitter taste, frequently waking during night/early morning,
- full-empty-rapid pulse
- dry stools with no abdo pain

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18
Q

What does a constant low-grade temp indicate?

A

Dampness heat

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19
Q

What are the causes of sweating in full and empty conditions?

A

Full - heat or damp heat
Empty - Yang/Yin Xu

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20
Q

What is the indication of sweating in different body locations?
Head, Forehead, Arms and legs, Hands, Whole body (spontaneous), Five-palm sweat

A

Head - heat in stomach or damp-heat
Forehead - Collapse of Yang if oily, clammy, beady
Arms & legs - stomach and spleen Xu
Hands - lung-Qi or Heart-qi Xu
Whole body - Lung-Qi Xu/collapse (if spontaneous, Qi-xu - Wei Qi is weak, so sweat escapes easily or wind heat)
Five-palm sweat - palms/soles/chest -> Yin Xu

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21
Q

What does no sweating mean?

A

Cold obstructing pores

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22
Q

What are the different location of headaches and indications?

A

Shaoyang - temporal headache -> exterior wind in shaoyang or interior liver & GB fire rising
Jueyin - Vertex headache -> usually Liver-blood Xu (Liver is the only yin channel to go to the head)
Yangming - forehead/frontal headache -> stomach heat or blood Xu
Taiyang - occipital headache -> exterior invasion of wind-cold or interior Kidney Xu

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23
Q

What does the onset of a headache indicate?

What about the time of day

A

gradual onset, in attacks - interior type
recent onset, short duration - exterior attack of wind-cold

Worse during the day - Qi/Yang Xu
Worse in the evening - Blood/Yin Xu
Worse at night - blood stasis

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24
Q

What does the quality of headache indicate?
heaviness
muzzy
dizzy
boring
distending/throbbing
acute vs chronic
worse with fatigue

A

Heaviness - dampness/phlegm
- if muzzy & heavy -> damp
- if there is dizziness as well -> phlegm
Boring pain - blood stasis
Distending/throbbing - Liver-yang rising (worse with emotional stress)
Acute - wind cold attack
Chronic - internal pattern
Worse with fatigue - Qi Xu

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25
What do the different eye complaints indicate? pain, swelling and redness feeling of pressure blurred vision and floaters dry eyes
pain, swelling and redness - liver fire or wind heat feeling of pressure - kidney yin Xu blurred vision and floaters - liver blood Xu dry eyes - liver/kidney yin Xu
26
Dizziness with these factors indicate what? loss of balance (feeling of swaying) throbbing headache heaviness in head worse with fatigue sudden onset gradual onset
loss of balance (feeling of swaying) - internal wind throbbing headache - Liver Yang rising heaviness in head - Phlegm obstruction worse with fatigue - Qi/blood Xu sudden onset - excess pattern gradual onset - Xu pattern
27
What are the 5 main causes of facial pain?
Invasion of wind-heat or wind-cold, damp-heat, liver-fire, Qi Xu with blood stasis
28
What are the 4 causes of bleeding gums?
Spleen-Qi Xu not holding blood stomach full-heat or empty heat Kidney-Yin Xu with empty-heat
29
How does one differentiate b/w these types of body pain? External wind attack Qi-Blood Xu Stomach Heat Dampness Kidney Xu Liver-Qi stagnation
External wind attack - sudden onset with fever and chills Qi-Blood Xu - body aches with fatigue Stomach Heat - pain in all muscles, with hot sensation in muscles & flesh Dampness - dull ache in muscles, especially limbs, with a feeling of heaviness Kidney Xu - dull, constant backache which is better with rest Liver-Qi stagnation - pain in arms & shoulders only when walking
30
How would one differentiate b/w the different types of joint pain? Internal wind Cold Dampness Dampness heat Blood stasis
Internal wind - wandering joint pain Cold - fixed and intense Dampness - fixed, with swelling and numbness Dampness heat - with swelling and redness of joints Blood stasis - severe stabbing pain with rigidity
31
What is the TCM interpretation, common pattern and key signs of dry, hard stools?
Interpretation - heat/yin Xu drying up fluids Common pattern - stomach or intestine heat, yin Xu, Qi Xu failing to move stools Key signs - thirst, dry mouth, red tongue with scanty coat
32
What is the TCM interpretation, common pattern and key signs of loose/unformed stools?
Interpretation - Spleen Qi Xu or dampness Common pattern - Spleen Qi Xu, damp accumulation Key signs - poor appetite, fatigue, pale tongue, soft/soggy pulse
33
What is the TCM interpretation, common pattern and key signs of watery diarrhoea?
Interpretation - cold damp or Yang Xu Common pattern - Spleen or Kidney Yang Xu, external cold invasion Key signs - cold limbs, abdo pain, undigested food in stools
34
What is the TCM interpretation, common pattern and key signs of sticky or greasy stools?
Interpretation - damp-heat in intestines Common pattern - damp-heat, improper diet Key signs - foul odour, burning anus, yellow greasy tongue coat
35
What is the TCM interpretation, common pattern and key signs of IBS?
Interpretation - Liver-spleen disharmony (wood invading earth) Common pattern - Liver Qi stagnating Spleen Key signs - emotional stress, sighing, wiry pulse
36
What is the TCM interpretation, common pattern and key signs of tenesmus (frequent but incomplete stool, persistent - often painful - ineffective urge to defecate, even when empty)?
Interpretation - damp heat or Qi stagnation Common pattern - heat in large intestine, Qi sinking Key signs - abdo cramping, urgency, red tongue, rapid or wiry pulse
37
What is the TCM interpretation, common pattern and key signs of undigested food in stools?
Interpretation - Spleen or Kidney Xu Common pattern - Spleen Qi Xu or Kidney Yang Xu Key signs - cold limbs, fatigue, pale and swollen tongue
38
What is the TCM interpretation, common pattern and key signs of greenish/bluish stools (esp. in infants)?
Interpretation - cold in intestines Common pattern - cold stagnation Key signs - crying, abdo pain, cold signs
39
What is the TCM interpretation, common pattern and key signs of blood in stools?
Interpretation - heat or blood stasis in intestines Common pattern - damp-heat, blood-heat, Qi not holding blood Key signs - bright red blood (heat), dark clots (stasis), slippery or rapid pulse
40
What is the pattern behind infrequent bowel movement, stools not dry?
Liver Qi stagnation
41
What does absence of smell of stools indicate?
Cold
42
What does early morning diarrhoea indicate?
Kidney Yang Xu aka cock-crow diarrhoea or 5th-hour diarrhoea
43
What is the TCM interpretation and common pattern of frequent urination?
Interpretation - Qi Xu, Damp-heat or Kidney Xu Common pattern - Kidney/Spleen Qi Xu, Damp-heat in Bladder
44
What is the TCM interpretation and common pattern of scanty urination?
Interpretation - heat damaging fluids, Yin Xu or Qi stagnation Common pattern - Yin Xu, Blood Stasis, damp-heat
45
What is the TCM interpretation and common pattern of profuse urination?
Interpretation - Kidney Yang Xu failing to control fluids Common pattern - Kidney Yang Xu, Spleen/Kidney Qi Xu
46
What is the TCM interpretation of nocturia?
Interpretation - Kidney Yang or Yin Xu
47
What is painful urination indicative of? pre during post
pre - stagnation of Qi in Lower Jiao During - damp-heat in bladder Post - deficiency of Qi
48
What is the TCM interpretation and common pattern of difficult urination (hestitant/dribbling)?
Interpretation - Qi stagnation/Xu, cold obstruction Common pattern - Qi/Liver Qi Xu, damp-cold
49
What are 3 common patterns of incontinence/dribbling?
Kidney Qi Kidney Yang Xu Sinking Spleen Qi
50
What is the TCM interpretation and common pattern of burning urination?
Interpretation - heat in bladder Common pattern - damp-heat in bladder
51
What is the TCM interpretation and common pattern of dark-yellow urination?
Interpretation - heat or Yin Xu Common pattern - damp-heat, Yin Xu with empty heat
51
What is the TCM interpretation and common pattern of clear urination?
Interpretation - cold/yang Xu Common pattern - Kidney Yang Xu, exterior cold
52
What is the TCM interpretation and common pattern of cloudy/milky urination?
Interpretation -dampness, spermatorrhoea or essence leakage Common pattern -damp-heat, kidney essence Xu
53
What does stabbing CP, CP accompanied by cough with profuse yellow sputum and feeling of oppression in chest indicate?
stabbing CP - heart-blood stagnation CP accompanied with cough - lung-heat Feeling of oppression - phlegm in lungs or severe Liver-Qi stagnation
53
What does stomach heat, spleen Qi Xu and dampness/food retention do to appetite?
ST heat - excessive hunger. If hungry but can't eat, Stomach Yin Xu causing heat SP Qi Xu - lack of appetite Dampness - heaviness dampness/food retention - fullness and heaviness
53
What do the different tastes reveal? Lack of taste Sour Bitter Sweet Pungent Salty
Lack of taste - spleen and stomach Xu Sour - food retention, wood invading earth Bitter - heat in Liver or Heart Sweet - Spleen Xu or damp-heat Pungent - lung-heat Salty - Kidney-Yin Xu
54
What does epigastric pain and it's types indicate? severe dull fullness distension
Severe epigastric pain - full patterns eg retention of food in stomach, stomach-heat, damp-heat in stomach, fire or phlegm-fire in Stomach, blood stasis in stomach, liver-qi invading stomach Dull epigastric pain - stomach qi Xu or empty-cold in stomach Feeling of fullness - dampness Distension - Liver-qi stagnation
54
What does abnormalities in the hypochondrium indicate?
Liver issues if a feeling of distension - Liver-Qi stagnation If stabbing pain - Liver-blood stasis
55
Causes of lower abdo pain?
internal cold, stagnation of liver-qi or liver-blood, damp-heat, stasis of blood in intestines/uterus
55
Causes of hypogastric pain?
damp-heat in bladder or liver-fire infusing downwards towards bladder
55
What does the sudden onset of tinnitus vs gradual onset indicate?
Sudden - excess pattern, Liver fire/wind, Liver-yang rising gradual - Xu pattern, Kidney Xu
55
What does the pitch of tinnitus indicate?
High pitch, loud, whistle like - liver-yang, liver-fire, liver-wind Low pitched, like rushing water - Kidney Xu
56
How can one utilise pressure to determine whether ear issues are excess/Xu?
press one's hands on the ears - if it makes it worse - excess pattern, if it alleviates the noise, Xu pattern
56
What causes sudden deafness and what is the clinical significance and common patterns?
Usually caused by external pathogenic factors or qi/blood stagnation clinical significance - Qi/blood blockage impairs ear function or wind heat Common patterns - liver qi stagnation, blood stasis, wind heat
57
Chronic causes of deafness x4
Kidney Xu heart-blood Xu Xu of Qi in upper jiao Yang Qi Xu
58
What causes hearing hypersensitivity and what is the clinical significance and common patterns?
excessive Liver Yang or heat disturbing Shen Clinical significance - liver yang or heat causing irritability affecting hearing Common patterns - Liver/heart fire
59
What does thirst with a desire to drink large amounts of cold water indicate vs thirst with a desire to drink in small sips?
Large gulps - indicates full-heat pattern (and could be any organ) - heat consuming body fluids small sips - indicates yin Xu with dryness (usually stomach or kidneys)
59
What does information regarding thirst reveal?
The state of the Jinye and it's transformations within the body disease of yin/blood is usually indicated here
59
What does no thirst/desire to drink vs thirst but no desire to drink indicate?
No thirst - cold pattern (usually stomach/spleen) or damp obstructing fluids - fluid movement is impaired ->fluids not consumed Thirst - Dampness heat - heat with body fluid retention or phlegm causing obstruction - heat has damaged fluids but body resists drinking due to obstruction
60
What does thirst with irritability indicate?
Liver/Stomach fire causing internal heat - fire causes dryness and thirst, usually accompanied with irritability
60
What would fire in blood do to thirst?
The patient only wants to rinse mouth out with water, but not swallow
60
What does signs and symptoms at and after menses, at ovulation and pre-menstrual general indicate?
at - movement of blood after - blood and yin Xu. Capacity of spleen and stomach to rebuild Ovulation - strength of kidneys, health of jing, yin & yang Pre-menstrual - movement of liver-qi
60
What do the different issues with cycles indicate? Always early Always late/scanty bleeding IRR - sometimes late, sometimes early
Early - Blood/heat or Qi Xu (Spleen Qi Xu) Late - Blood Xu/stagnation or cold IRR - Liver qi/blood stagnation or Spleen Xu
61
What does the different qualities of period blood indicate? Congealed blood with clots watery blood turbid blood
Congealed blood with clots - blood stasis/cold watery blood - blood/yin Xu turbid blood - blood-heat or stagnation of cold
61
What does a heavy period indicate?
Blood/heat or Qi Xu (same as period always being early)
61
What do the different period blood colours indicate? dark-red pale purplish/blackish fresh-red
dark-red: Blood heat Pale: Blood Xu Purple/blackish: blood stasis/cold Fresh-red: empty-heat from yin Xu
62
What does pain during period cycle indicate?
Before - Qi/Blood stagnation After - Blood Xu During - Blood-heat or stagnation of cold
63
What do the different colours of Leucorrhoea indicate? White Yellow greenish red & white Yellow with pus and blood after menopause
White - cold, spleen/kidney Yang Xu or exterior cold-damp Yellow - damp-heat in lower jiao greenish - damp-heat in liver channel red & white - indicates damp-heat Yellow with pus and blood after menopause - toxic damp-heat in uterus
63
How does damp-cold and damp-heat show up in smell and consistency of leucorrhoea?
damp-cold: fishy smell and watery Damp-heat: leathery and thick
63
What does vomiting during pregnancy indicate?
stomach and penetrating vessel Xu
64
What does infertility indicate?
Blood or Kidney-essence Xu damp-phlegm in lower jiao blood stasis in uterus
65
What does miscarriage indicate? Both before and after 3 months?
Before: blood or essence Xu After: Liver-blood stasis or sinking of spleen Qi
65
What does nausea & heavy bleeding after delivery indicate?
exhaustion of penetrating vessel
65
What does sweating and fever after delivery indicate?
exhaustion of Qi and blood
66
What does postnatal depression indicate?
heart-blood Xu
66
What does abdo pain in children indicate? Vomiting of milk and colic in babies?
abdo pain - cold in stomach and intestines, qi stagnation vomiting - food retention
67
What do these respiratory symptoms in children indicate? 1. Cough, wheeze, earache 2. chronic cough, wheezing 3. chronic earache 4. chronic mucus, blocked nose, cough, 'glue ear'
1. invasion of wind 2. residual phlegm in lungs 3. residual damp-heat in GB channel 4. residual dampness
68
What do these symptoms indicate? 1. disturbed sleep with crying in babies 2. subdued crying at night 3. disturbed sleep in older children
1. retention of food or stomach heat 2. prenatal shock 3. liver-fire, stomach-heat
68
What does the different types of tiredness indicate? 1. chronic with desire to lie down, poor appetite, loose stools 2. chronic with weak voice, propensity to catching colds 3. chronic with backache, feeling cold, frequent urination 4. chronic with dizziness, blurred vision, scanty periods 5. Chronic with anxiety, dry mouth at night, tongue without coating
1. Spleen Qi/Yang Xu 2. Lung Qi/Yang Xu 3. Kidney Yang Xu 4. Liver-blood Xu 5. Kidney-yin Xu
69
What does the different types of tiredness indicate? 6. chronic with feeling of heaviness 7. chronic with feeling of heaviness plus muzziness, dizziness 8. chronic with abdo distension, irritability, wiry pulse 9. short-term with alternating hot-cold, irritability, unilateral tongue coating, wiry pulse
6. dampness 7. phelgm 8. Liver-qi stagnation 9. Shaoyang pattern
70
What is necessary for good sleep?
Shen and ethereal soul (hun) to be anchored in heart/liver-blood
70
What does difficulty falling asleep indicate vs waking up many times during the night?
- Heart-blood Xu - Yin Xu which may be of heart/liver/kidneys
70
What do these different symptoms indicate 1. feeling sleepy after eating 2. general feeling of lethargy and heaviness of body 3. above plus dizziness 4. extreme lethargy & lassitude with a feeling of cold 5. lethargic stupor with exterior heat symptoms 6. lethargic stupor with rattling in throat, slippery pulse, sticky tongue coating
1. Spleen-Qi Xu 2. dampness retention 3. phlegm 4. Kidney-yang Xu 5. heat invasion of pericardium 6. blurring of the mind by phlegm
70
What causes excessive vs lack of movement of the Hun? Listed Excessive - 2 pathogenic factors, 2 patterns Lack of - 3 patterns
excessive - fire, phlegm-fire, liver-blood and/or liver-yin Xu lack of - liver qi stagnation, Liver blood and qi Xu, spleen and kidney Xu
70
What are 6 full patterns accompanying depression?
Liver-Qi stagnation Stagnant Liver-Qi turning into heat Liver-Qi stagnation with Qi-phlegm Phlegm-fire harassing the Mind Blood stasis Gallbladder-heat
71
What are 5 main empty patterns accompanying depression?
Spleen & Heart-Blood Xu Heart-Yang Xu Liver-blood Xu Kidney and Heart-Yin Xu with empty-heat Kidney-Yang Xu
72
What are 6 of the main empty patterns accompanying fear/anxiety?
Xu of Liver/heart blood/yin Kidney Yin Xu Heart/GB Qi Xu
73
What are the main full/empty patterns accompanying fear/anxiety?
Kidney and heart-yin Xu with heart empty-heat - anxiety that is worse in the evenings, dizziness, tinnitus, palpitations Heart-yin Xu with empty-heat - anxiety that is worse in evenings, palpitations, red tongue without coating
73
What are 7 of the main full patterns accompanying fear/anxiety?
Heart fire/blood stasis Phlegm-fire harassing the mind Liver qi stagnation/fire/yang rising Rebellious Qi of penetrating vessel Diaphragm-heat
74
What 6 patterns can cause irritability/anger?
Qi stagnation blood stasis/Xu Liver-yang rising Yin Xu (with or without empty-heat) Heat/damp-heat Empty-heat
74
What 6 patterns cause worry/overthinking?
Heart and spleen Qi Xu Lung-Qi Xu/stagnation Heart-blood Xu Liver-blood Xu Heart-yin Xu -/+ empty heat
75
What patterns cause sadness?
Lung and heart-Qi Xu Liver-blood Xu Heart-blood Xu Lung-Qi stagnation
76
What is an essential symptom of Qi stagnation?
Distension - abnormal swelling / enlargement of body part due to internal pressure
77
Liver-fire vs Heart-fire bitter taste in mouth timing?
Liver-fire - occurs every day heart-fire -- only after a bad night's sleep
CMPR122
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