1
Q
What is etiology?
A
The study of the causes of disease
2
Q
What are four categories of disease causing factors?
A
- Internal
- External
- Non-Internal/External
- Miscellaneous
3
Q
Pathogens that invade the body from outside (the environment)
A
External Factors
4
Q
What are the six exterior pathogenic factors?
A
- Wind
- Cold
- Damp
- Dryness
- Fire (Warmth, Heat)
- Summer-Heat
5
Q
What are the six fundamentals of Six EPF’s?
A
- The Six Qi become the Six Evils when they are excessive or unseasonal, or the climate changes suddenly
- EPF’s can only invade if the Zheng-Qi is weak
- All EPF’s, when affecting the body, invade through the skin, nose or mouth
- Disease due to the Six EPF’s is closely related to seasonal changes in the weather and to living environment
- Each of the Six EPF’s may affect the body singly or in combination
- The Six EPF’s may, during the process of disease and under certain circumstances, transform into each other.
6
Q
What is the season of Wind?
A
Spring
7
Q
When can wind easily invade the body?
A
After sweating or while sleeping
8
Q
What is the primary EPF in causing disease?
A
Wind
9
Q
Which EPF does cold, damp, dryness and heat depend on to invade the body?
A
Wind
10
Q
What is the leading causative factor of the “hundred diseases?”
A
Wind
11
Q
Is Wind a yin or yang EPF?
A
Yang
12
Q
What movements characterize Wind?
A
upward and outward dispersion
13
Q
This EPF blows in gusts and is characterized by rapid changes.
A
Wind
14
Q
This EPF is characterized by constant movement.
A
Wind
15
Q
What is the season of Cold?
A
Winter
16
Q
Is Cold a yin or yang EPF?
A
Yin (and consumes Yang-Qi)
17
Q
Which EPF causes contraction and stagnation?
A
Cold
18
Q
What is the season of Damp?
A
Late-Summer
19
Q
Which EPF is characterized by heaviness and turbidity?
A
Damp
20
Q
This EPF is characterized by viscosity/”stickiness,” lingering and stagnation.
A
Damp
21
Q
Is Damp a yin or yang EPF?
A
Yin (impairs yang and obstructs Qi circulation)
22
Q
This EPF tends to descend and easily resides in yin areas of the body.
A
Damp
23
Q
What is the season of Dryness?
A
Autumn
24
Q
Which EPF causes drying and consumes body-fluids?
A
Dryness
25
This EPF easily damages the Lung.
Dryness
26
What is the season of Heat?
Summer
27
Is Heat a yin or yang EPF?
Yang
28
This EPF is characterized by burning and upward direction.
Heat
29
This EPF often consumes yin/fluid.
Heat
30
This EPF affects the Liver and deprives sinews and vessels of nourishment, stirring Liver-wind.
Heat
31
Which EPF stirs up wind and disturbs blood?
Heat
32
What is the season of Summer-Heat?
Summer
33
This EPF is only seen in its own season.
Summer-Heat
34
Is Summer-Heat a yin or yang EPF?
Yang (extreme heat, transformed from fire)
35
Which EPF is characterized by upward direction, dispersion and consumption of body fluids?
Summer-Heat
36
Which EPF frequently combines with dampness?
Summer-Heat
37
Internal factors are the ________.
Emotions
38
What are the Seven Emotions?
1. Joy
2. Anger
3. Worry
4. Sadness
5. Pensiveness
6. Fear
7. Fright
39
How does the Seven Emotions become disease causing factors?
when the Seven Emotions become....
| sudden and severe, chronic, or the body's ability to tolerate and self-regulate is impared
40
Which organ does the Seven Emotions affect?
Heart (and Shen)
41
Does the Seven Emotions directly or indirectly affect the organs?
Directly
42
True or False: The Seven Emotions can cause illness and/or aggravate existing illness.
True
43
What are the five miscellaneous factors of disease?
1. Improper diet
2. Overstrain, stress
3. Lack of physical exercise
4. Traumatic injury and insect or animal bites
5. Incorrect medical treatment
44
This miscellaneous EPF stems from overeating and malnutrition.
Improper Diet
45
Overeating can damage which organs?
Stomach and Intestines
46
What are four ways that someone can be overindulgent in particular foods?
1. One type of food
2. Wrong types of foods
3. Cold or raw foods and drinks
4. Alcohol, sweet, greasy, rich
47
What are three ways that overstrain and stress can occur?
1. Excessive physical labor
2. Excessive mental labor
3. Excessive sexual activity
48
How does excessive physical labor affect the body?
Consumes the Qi
49
How does excessive mental work affect the body?
Excessive mental activity consumes Heart-Blood and damages Spleen-Qi (Spleen governs pensiveness and heart stores Shen)
50
How does excessive sexual activity affect the body?
Excessive sexual activity consumes and damages Kidney essence (Kidney stores essence)
51
How does lack of exercise affect the body?
Causes impairment of Qi and Blood circulation and weakens the body
Negatively affects Spleen (Spleen governs the Four Limbs)
52
How does traumatic injuries, insect or animal bites affect the body?
Traumatic injuries tend to cause blood stagnation and insect or animal bites may result in toxcosis
53
Define Pathologically-Generated Etiological Factor
Pathological substances that are generated within the body through various pathogenic processes
54
What are two types of PGEF?
1. Pathological water, dampness, phlegm, and rheum
| 2. Blood stasis
55
How does pathological water, dampness, phlegm and rheum occur?
When the body's water-metabolism functions are impaired
56
What is the thickest fluid of the fluid PGEF's?
Phlegm
57
What are the two fluid PGEF's that are thinner than Phlegm?
Rheum and Water
58
Is pathological water, dampness, phlegm and rheum a yin or yang pathogen?
Yin (derived from fluids)
59
This PGEF is characterized by an obstruction of Qi-mechanism and impairs circulation of Qi and Blood
Pathological water, dampness, phlegm, and rheum
60
This PGEF results in illnesses that tend to be stubborn and "sticky," and disease-course tends to be long
Pathological water, dampness, phlegm, and rheum
61
True or False: Pathological water, dampness, phlegm, and rheum easily disturbs the Shen.
True
62
Pathological water, dampness, phlegm and rheum presents itself with what characteristics on the tongue?
Slippery and greasy tongue coating
63
What is Blood Stasis?
Blood that has accumulated and stagnated and can no longer circulate normally
64
What are the four dysfunctions of Qi and Blood?
1. Qi-xu causing blood-stasis
2. Qi-stasis causing blood-stasis
3. Blood-cold causing blood-stasis
4. Blood-heat causing blood-stasis
65
Which PGEF is characterized by a fixed, sharp and stabbing pain with pain worse at night and with pressure?
Blood stasis
66
Which PGEF is characterized by a fixed, immobile mass that is purple, blue-green near the surface of the body?
Blood stasis
67
Blood stasis presents itself with what characteristics on the tongue?
Purple, dark tongue body often with stasis macules and with purple, distended sublingual veins
68
This is a treatment principle is the basic/fundamental principle which guides all treatment
Zhi Ze
69
What are the six principles behind Zhi Ze?
1. Treat early and prevent change and development
2. To treat disease one must search for the root
3. Support Right and dispel Evil
4. Treatment of Root and Branch
5. Regulate Yin and Yang
6. Treatment of disease according to climate and seasonal conditions, geographical location, and individual conditions
70
What are the three ways to support Right and dispel Evil (under Zhi Ze principle)?
1. Tonify Right: when there is xu/emptiness
2. Dispel Evil: when there is excess/fullness
3. Both tonify Right and Evil: when there are both xu and excess
71
In what type of condition should the root be treated?
Moderate conditions, generally in more chronic conditions
72
In what type of condition should the branch be treated?
In acute conditions, generally in acute or emergency conditions
73
In what type of condition should the root and branch both be treated?
In mixed acute/chronic conditions, treat simultaneously
74
This is a treatment method that is specific and used to treat a specific condition
Zhi Fa
75
What are the four methods of examination?
1. Wang/Visual Inspection
2. Wen/Listening and Smelling
3. Wen/Inquiry
4. Qie/Palpation
76
Why does physical examination give us the information needed to understand the condition of the body?
Interior manifests in the exterior
77
What are the two basic conditions of Shen?
Spirited or Spiritless
78
Describe the characteristics of a Spirited Shen
strong, healthy body, well developed muscles, abundant energy, moist, and bright complexion
sufficient upright qi, strong function of zang-fu
mild disease, good prognosis
79
Describe the characteristics of a Spiritless Shen
thin, weak body, emaciated muscles, listless and fatigued, dull grey or excessively bright complexion
xu of upright qi, poor function of zang fu
severe disease, poor prognosis
80
Describe the characteristics of Spirited Eyes
sparkling, agile movement of eyeballs
81
Describe the characteristics of Spiritless Eyes
dull, lack of sparkle and spirit, slow movement of eyeballs or straight/blank staring
82
Describe the characteristics of a Spirited Mind
clear and sharp mind, active and appropriate responses to environment
83
Describe the characteristics of a Spiritless Mind
confused, not clear, agitated, abnormal response to environment
84
Describe the characteristics of Spirited Speech
calm, even, well-regulated breathing
| correct, clear speech
85
Describe the characteristics of Spiritless Speech
faint, weak breath, panting
| abnormal speech
86
What is False Shen?
When a patient suddenly goes from spiritless to spirited (separation of yin and yang, yin is exhausted and cannot restrain yang, the yang floats up and gives rise to false shen)
Critical sign, usually seen soon before death
87
What is a Clouded Shen?
When consciousness is obscured or lost
88
What is a Disordered Shen?
A disturbance in Shen (ie., mania, withdrawal, epilepsy, etc.)
89
Why does the face reflect the condition of the body?
The blood and qi of the 12 channels and 365 collaterals rises to the face and enters the orifices
90
Describe a normal complexion
slightly rosy
| moist, sheen, lustrous
91
An individual's normal color
Primary Color
92
Normal changes in an individual's color due to: season, weather, temperature; situation and activity, age, emotions, etc.
Guest Color
93
Describe the color and pathologic complexion of a benign disease
abnormal change in color, but there is still luster
organs, qi essence and blood still in decent shape
good prognosis
94
Describe the color and pathologic complexion of a malignant disease
abnormal change in color, lusterless
organs, qi, essence and blood damaged
poor prognosis
95
What color is associated with cold, pain, blood stasis and liver wind?
Blue-Green
96
Diagnose: pale blue-green, black blue-green complexion, sharp and cold abdominal pain
Cold excess
97
Diagnose: gray-blue complexion, cyanotic lips, stabbing chest pain
Chest painful obstruction due to Heart yang xu
98
Diagnose: blue-green in area between eyebrows, bridge of nose, and borders of lips
Liver wind or on verge of liver wind
99
Diagnose: blue-green complexion, poor appetite, irritability/anger, abdominal pain with diarrhea, irregular mensturation
Liver and Spleen disharmony
100
What does the color red govern?
Heat
101
What does heat cause?
An abundance of qi and blood to circulate in vessels
102
Diagnose: entire face is red
excess heat (interior or exterior)
103
Diagnose: red cheeks
deficiency heat
104
Diagnose: pasty/sallow complexion with red cheeks looking like makeup
"Upcast" yang, false shen
105
What does the color yellow govern?
deficiency and dampness
106
Diagnose: sallow yellow, pale yellow
Spleen and Stomach qi xu with subsequent qi/blood xu
| weak transformation and transportation; essence of food can't rise up to nourish face
107
Diagnose: yellow complexion, often with swelling or overweight
dampness
| accumulation of dampness, often due to Spleen weakness with impaired transportation and transformation
108
Diagnose: dusky/smoky yellow complexion and eyes
yin-yellow (yin-type jaundice)
| cold damp obstructs Spleen, bile obstructed by dampness and overflows to skin
109
Diagnose: bright-yellow complexion and eyes
yang-yellow (yang-type jaundice)
| damp-heat obstructs Liver and Gall-bladder, bile overflows
110
What does the color white govern?
Kidney xu, stasis pain, water-rheum
111
Diagnose: dim/dusky cheeks and forehead
Kidney yang xu
| yang xu and cold, ming-men fire can't warm and nourish the vessels, qi and blood stagnate
112
Diagnose: dry, burnt black cheeks and forehead
Kidney essence/yin xu
| essence/yin can't nourish face
113
What does the color black govern?
Kidney xu, stasis pain and water-rheum
114
Diagnose: purple-black, blue-green-black, rough skin
Stasis pain: qi and blood stasis causing pain, cold and other possible etiologies
115
Diagnose: black eye sockets, puffy under eye
Qi and blood impaired by stagnant fluids
| Spleen and Kidney qi/yang xu causing impaired metabolism and circulation of fluids
116
Floating or Deep?: Visible on the surface of the skin and disease in exterior, in bowels
Floating
117
Floating or Deep?: color deeper in skin, disease in interior, in vescera
Deep
118
Clear or Turbid?: color and sheen are clear and distinct, yang syndromes
Clear
119
Clear or Turbid?: colors are dark and turbid, yin syndromes
Turbid
120
Are clear syndromes yin or yang?
Yang
121
Are turbid syndromes yin or yang?
Yin
122
Faint or Extreme?: color and sheen are shallow and light, xu of Zheng Qi
Faint
123
Faint or Extreme?: colors and sheen are deep and thick, excess Evil Qi
Extreme
124
Scattered or Concentrated?: color is dispersed or scanty, illness is new, mild or resolving
Scattered
125
Scattered or Concentrated?: color is concentrated, illness is enduring or serious
Concentrated
126
Sheen or Perishing?: color is moist, viscera and essence not depleted, mild illness, good prognosis
Sheen
127
Sheen or Perishing?: color is dry and withered, viscera and essence depleted, severe illness, poor prognosis
Perishing
128
What body type is described as being exuberant of qi and blood with solid zang-fu organs?
Robust
129
What body type is described as being insufficient of qi and blood with hypofunction of the zang-fu organs?
Weak
130
Are overweight people yin or yang deficient?
Yang xu
131
Are skinny people yin or yang deficient?
Yin xu
132
Yin or Yang: Arching Backward
Yang
133
Yin or Yang: Curving forward
Yin
134
Yin or Yang: face turned outward, legs outstretched, clothes torn off, bedcovers discarded, desire for cold
Yang
135
Yin or Yang: face turned inward, bundled up wearing clothes, with bedcovers, desire for heat
Yin
136
Where is the meeting place of yang and the residence of essence-spirit?
Head
137
Diagnose: head size that is too large or too small, possibly with mental insufficiency
Kidney essence xu (pre-heaving xu)
138
Diagnose: bulging head
excess heat
139
Diagnose: sunken head
xu cold (slightly sunken is normal within first six months)
140
Diagnose: delayed closure of head
kidney xu
141
Diagnose: uncontrollable movement of head
internal wind
142
What are the signs of yang type facial swelling (edema)?
excess pattern
abrupt onset
wind, cold, damp attack Lung and Spleen
143
What are the signs of yin type facial swelling (edema)?
xu pattern
slow onset
Spleen and Kidney qi or yang xu
144
What are the characteristics of healthy, normal hair?
thick, luxuriant, evenly distributed, moist with sheen
145
Diagnose: dry, withered, thin hair-loss
xu of blood, essence, kidney
blood heat
after severe illness, extreme taxation-fatigue, port-partum
146
Diagnose: sudden hair loss
xu blood with internal wind
147
Diagnose: graying hair
```
can be normal
Kidney xu (poor memory, sore and weak knees)
```
148
The essence-qi of the five viscera and six bowels ascends to the ____.
eyes
149
Liver opens to the ______.
eyes
150
What are the characteristics of spirited eyes?
bright, shiny
clear and correct vision
flexible and lively movement
151
What are the characteristics of spiritless eyes?
dull and/or turbid sclera
lack of brightness
blurred vision
inflexible movement, staring forwards or upwards
152
Diagnose: red canthus
heat fire
153
Diagnose: red sclera
Lung fire
154
Diagnose: entire eye red
Liver fire, Liver channel wind
155
Diagnose: red, swollen eyelids
damp-heat Spleen/Stomach
| Damp-heat in LIver/GB
156
Diagnose: yellow sclera
damp-heat
| damp-cold
157
Diagnose: green-blue sclera
LIver wind
158
The color red governs what?
Heat/Fire
159
The color yellow governs what?
dampness
160
The color green-blue governs what?
wind
161
The color white governs what?
xu
162
diagnose: pale white blood vessels in canthus or interior aspect of lower eyelids
blood xu
| qi and blood xu
163
The color black governs what?
water
164
Diagnose: black eye sockets
Spleen and Kidney xu
| water-dampness
165
Diagnose: drooping eyelids
Spleen qi xu
166
Diagnose: incomplete closure of the eyes
Spleen xu, qi and blood xu
167
Diagnose: strabismus (eyes not properly aligned)
Liver wind
168
Diagnose: styes (eyes)
wind heat
| Spleen and Stomach heat
169
Diagnose: clear, watery, white nasal discharge
invasion of the Lung by wind-cold (nasal congestion with frequent sneezing)
170
Diagnose: thick-yellow or turbid nasal discharges
invasion of the Lung by wind-heat
| phlegm-heat
171
Diagnose: nosebleed
invasion of the Lung by wind-heat
| Lung heat, Stomach fire, Liver fire, traumatic injury
172
What part of the body is the open passage to the Lung and Stomach?
throat
173
What channel connects to the throat?
Kidney channel
174
Diagnose: red, swollen, painful throat
excess heat
175
Diagnose: dry, red painful throat
heat damaging Lung fluids
176
Diagnose: tender-red, mild pain
Kidney yin xu with deficient heat flaring up
177
What describes a normal state of the lips?
bright, red, moist
178
Diagnose: red-purple lips
heat
179
Diagnose: red and dry lips
heat damaging fluids
180
Diagnose: fresh-red lips
Yin xu heat
181
Diagnose: pale lips
blood xu
182
Diagnose: blue-green lips
pain
183
What describes a normal tongue?
pale-red, thin white coat, moist
184
Diagnose: pale or white tongue
deficiency-cold pattern
excess cold pattern
deficiency or exhaustion of qi and blood
185
Diagnose: red tongue
heat pattern
186
Diagnose: bright red, think or fissured tongue, little or no tongue coating
deficiency heat pattern
187
Diagnose: bright red, rough or even prickled tongue, a thick yellow, gray or black, and dry tongue coating
excess-heat pattern
188
Diagnose: crimson tongue with possible prickles or red spots, a yellow and dry coating
excess heat
189
Diagnose: crimson tongue with little coating or without coating, with possible fissures
deficiency heat
190
Diagnose: crimson tongue with purple dots
blood stasis with heat
191
Diagnose: crimson-purple tongue, dry, possibly with cracks
interior heat excess
192
Diagnose: pale-purple, slippery wet tongue
interior cold excess
193
Diagnose: blue-green-purple, dim, "stasis macules" of tongue
blood stagnation
194
Diagnose: bigger than normal tongue (puffy), or even filling the entire mouth, usually with tooth-marks
retention of dampness, phlegm, phlegm-fluid
195
Diagnose: think, small and withered tongue (length, width, depth/thickness)
deficiency of both qi and blood (small, pale-red tongue)
| yin xu with empty fire (emaciated, dry, crimson/red tongue, and little or no coating)
196
Diagnose: tongue with prominent spots (red, purple, black) commonly seen on the tongue tip and sides
toxic-heat entering the blood level (the larger and greater the quantity or prickles, the stronger the heat)
197
Diagnose: bluish-purple or purplish-black patches on tongue
blood stasis
198
Diagnose: dry, crimson, scant coat, and cracks on tongue
heat damaging yin fluids
199
Diagnose: red, scant coat, and cracks on tongue
yin xu
200
Diagnose: pale (red), smooth, cracks
blood xu, usually in elderly
201
Diagnose: pale-white tongue with cracks
dryness due to blood xu
202
Diagnose: pale-white, wet, slippery white coat; tooth marks on tongue
retention of dampess
203
Diagnose: pale (red), smooth tongue with tooth marks
Spleen qi xu
204
A stiff tongue exhibits loss of flexibility, difficulty in stretching or retracting, or even rigidity with the inability to move, and slurred speech. What is the patient's cause of a stiff tongue?
Invasion of the pericardium by exuberant pathogenic heat (dark-red or crimson, stiff and dry tongue)
Wind-phlegm obstructing collaterals in the tongue (pale-red or green-blue, puffy and stiff tongue with thick, greasy coating, unconsciousness, deviated mouth and eye, hemiplegia)
205
Diagnose: flaccid tongue (soft without strength, and inability to move easily)
xu patterns (yin, qi, and blood, body fluids)
206
Diagnose: trembling tongue (involuntary trembling, rapid movement when extended)
Liver wind
207
Diagnose: trembling tongue, crimson, purple and quivering tongue)
(exuberant) Heat
208
Diagnose: pale or white, slightly trembling tongue
Qi and blood xu
209
Diagnose: red, quivering tongue with little or no tongue coating
Yin xu
210
Diagnose: deviated, pale-red tongue, facial paralysis, inability to raise the eyebrows
external wind obstructing collaterals
211
Diagnose: purplish-red and deviated tongue, dizziness, numbness, spasms
Internal wind
212
How is the tongue coat/fur generated?
Stomach qi
213
What describes a normal tongue coat/fur?
thin, white, moist
214
Diagnose: white coating of the tongue
exterior patterns, cold patterns
215
Diagnose: yellow coating of the tongue
heat pattern (shi), interior patterns
216
Diagnose: gray coating of the tongue
interior patterns, heat, and cold (all xu)
217
Diagnose: black coating of the tongue
interior patterns, extreme heat, and extreme cold
218
Diagnose: slippery tongue coating, excessive fluids on tongue, tendency to flow downward when the tongue is protruded
yang xu with retention of phlegm-fluid and water-damp
219
Diagnose: dry tongue coating
body fluids damaged by heat
yin xu
yang qi xu failing to steam fluids upward
pathogenic dryness attacking the Lung
220
Diagnose: greasy tongue coating, relatively small and fine particles, sticking together making a shiny surface, can not be scraped away easily
exuberance of phlegm-damp which inhibits yang-qi
| turbid dampness/phlegm-fluids/food retention/damp-heat
221
Diagnose: curd-like tongue coating, relatively rough, large, granular, loose, and thick, as if bean curd is piled on the surface of the tongue, can easily be scraped away
phlegm-dampness without/weakened yang-qi and/or heat (food retention causing damp heat, phlegm dampness with heat)
222
Diagnose: sublingual veins that are purple, black, distended
blood stasis
223
Diagnose: sublingual veins that are dark-purple and thin
yin xu
224
Diagnose: sublingual veins that are very pale or not visible
qi and blood xu
225
Diagnose: sublingual veins that are filmy, creamy
dampness
TCM Theory
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