What differentiates Pericardium from Heart patterns?
- Is the involvement of the Pericardium as a channel in the chest.
Pericardium patterns generated by mental-emotional strain, the pathology is reflected with symptoms at the chest level such as a feeling of stuffiness in the chest. - The involvement of the Lung channel. The pericardium is in the centre of the thorax, where it influences both heart and lungs, therefore gathering qi (Zong Qi). Pericardium patterns may present with like SOB and cold hands.
- Latter patterns often involve the Liver channel as well. Due to 1. Liver and Pericardium are related with Jue Yin (terminal yin) channels, 2. In its upward rising, the minister fire affects the Liver, Gall Bladder and Pericardium.
What are the three main areas of Pericardium pathology?
- The pericardium protects the heart: invasions of exterior pathogenic factors
- Pericardium houses the mind (Shen): mental-emotional problems. Blood deficiency of the pericardium, pericardium fire and phlegm-fire harassing the pericardium.
- Pericardium as the centre of the thorax, channel pathology. Qi stagnation in the pericardium, Blood stasis in the pericardium.
What are the signs and symptoms of heat in the pericardium?
Fever at night Mental confusion Incoherent speech or aphasia Delirium Hot body Hands and feet cold Macules
This pattern is from exterior pathogenic attack and reflects a rapid and acute invasion
In four level theory it relates to heat at the nutritive (Ying) level.
What is the tongue and pulse in Heat in the Pericardium?
T: Red and dry without coating
P: Fine and rapid
What is the treatment principle of heat in the pericardium?
TP: Clear heat from the nutritive level.
What is the aetiology of Heat in the pericardium?
- Due to the invasion of Wind-Heat that penetrates the interior and transforms into interior heat, going through the defensive qi and qi levels before reaching the nutritive qi level.
What is the pathology of heat in the pericardium?
- Heat at the nutritive level (Ying Level). When heat penetrates this level, it has begun to injure yin and dry up the body fluids (hence the tongue has no coating and is dry).
- Heat clouds the mind and creates delirium.
- The hands and feet are cold due to false cold: heat is so intense that it impairs the circulation of Qi to the limbs.
What are the signs and symptoms of Blood deficiency of pericardium?
Palpitations
Insomnia
Dream disturbed sleep
Stuffiness and discomfort of chest Very slight SOB Anxiety Dizziness Poor memory Easily startled Dull pale complexion Pale lips Cold hands Scanty periods, amenorrhoea
What is the tongue and pulse in blood deficiency of pericardium?
T: Pale, thin and slightly dry
P: Fine (but slightly hard at left front) or fine and choppy
What is the treatment principle of blood deficiency of pericardium?
TP: Tonify blood, nourish the pericardium, support the movement of qi and blood in the chest.
What is the aetiology of blood deficiency of pericardium?
Emotional strain such as sadness and grief.
What is the pathology of blood deficiency of pericardium?
- Heart and pericardium house the mind: when blood of these two organs are deficient, the mind lacks residence therefore it is agitated. This results in insomnia, dream disturbed sleep, propensity to be startled and anxiety.
- When blood is deficient, qi and blood fail to circulate properly in the pericardium channel, which leads to a feeling of stuffiness and discomfort in the chest.
- The relationship between the uterus and pericardium will cause scanty periods or amenorrhoea.
What are the signs and symptoms of pericardium fire?
Palpitations
Insomnia
Dream disturbed sleep
Tightness and heat of chest Slight ache of chest Rapid breathing Thirst Mouth and tongue ulcers Mental restlessness Agitation Red face Bitter taste (after bad sleep) Heavy periods
What is the tongue and pulse in pericardium fire?
T: Red, tip redder, red papillae, yellow coat, possible midline crack
P: Full, rapid and overflowing (could be hasty = rapid and irregular) esp. left front.
What is the treatment principle of pericardium fire?
TP: Drain fire from the pericardium.
What are the signs and symptoms of phlegm fire harassing the pericardium?
Palpitations
Insomnia
Dream disturbed sleep
Oppression and heat of chest Chest pain Rapid breathing Thirst Coughing phlegm Mental restlessness and confusion Agitation with rash behaviour Red face Bitter taste Manic behaviour Incoherent speech
What is the tongue and pulse in phlegm fire harassing the pericardium?
T: Red and swollen and with a yellow dry sticky coating. Tip may be redder with red papillae.
P: Full, rapid, and slippery or rapid, overflowing slippery or rapid, full and wiry.
What is the treatment principle of Phlegm fire harassing the pericardium?
TP: Drain fire from the pericardium and resolve phlegm. Open the orifices and calm the shen.
What are the signs and symptoms of Qi stagnation in the pericardium?
Palpitations
Distension, tightness and slight pain in the chest
Slight SOB
Sighing Plumstone Depression Irritability Poor appetite Weak and cold limbs Slightly purple lips Pale complexion
What is the tongue and pulse in qi stagnation of the pericardium?
T: Slightly pale and purple on sides and chest area
P: Empty, very slightly overflowing in left front position
What is the treatment principle of Qi stagnation in the pericardium?
TP: Move Qi in the chest, regulate pericardium, calm the shen
What are the signs and symptoms of blood stasis of the pericardium?
Palpitations Oppression or constriction of chest Stabbing or pricking pain (may radiate to inner aspect of left arm or to shoulder) SOB Cold hands
Cyanosis of lips and nails
Painful periods with dark clots
What is the tongue and pulse in blood stasis in the pericardium?
T: Purple entirely, or just on sides and chest area
P: Choppy, knotted or wiry
What is the treatment principle of blood stasis of the pericardium?
TP: Move blood in the chest and resolve stasis, regulate pericardium, calm the shen.
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Chinese medical pathophysiology50
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Tongue diagnosis22
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Inspection of Shen & Face14
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Inspection of body types13
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Pulse diagnosis & palpation46
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Inquiry7
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Listening and smelling22
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The Lung channel84
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The Spleen channel44
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Stomach channel62
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Large intestine channel38
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Small Intestine channel22
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Liver channel65
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Gall Bladder channel30
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Kidney Channel30
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General symptoms17
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Bladder channel14
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Heart pattern51
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Pericardium patterns24
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San Jiao / Triple energiser channel29
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Wu Xing (5 elements)35
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Vital substances25
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External Pathogenic Factors35
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Six Divisions43
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Four Levels49
