diagnosis by inquiry

Pain According to Chinese Medicine

According to Huang Di Neijing pain is due to three main reasons: circulation is impeded, tension, and lack of nourishment

Full Conditions (Etiology & Pathology of Pain)

Invasion of exterior pathogenic factors; Interior Cold or Heat; Stagnation of Qi or Blood; Retention of food; Obstruction by Phlegm.

Empty Conditions (Etiology & Pathology of Pain)

Deficiency of Qi and Blood; Consumption of Body Fluids from Yin deficiency .

Qi stagnation (Causes of Pain)

Distention more than pain, or a distending pain, no fixed location, coming and going.

Blood stasis (Causes of Pain)

Severe, boring or stabbing pain, with a fixed location.

Cold (Full or Empty) (Causes of Pain)

Cramping, spastic pain aggravated by cold weather and cold foods/liquids and alleviated by the application of heat.

Damp-Heat (Causes of Pain)

Burning pain with a feeling of fullness and heaviness

External Wind (Causes of Pain)

Occipital headache and stiffness.

External Dampness (Causes of Pain)

Pain in the joints or epigastrium.

Retention of food (Causes of Pain)

Intense pain with feeling of fullness (more in children).

Phlegm (Causes of Pain)

Does not usually cause pain, but it may do so especially in the joints (as in rheumatoid arthritis).

Wandering Bi Syndrome Pain

Pain moves from joint to joint, caused by pathogenic wind.

Painful Bi Syndrome Pain

Severe pain caused by pathogenic cold.

Fixed Bi Syndrome Pain

Soreness and heaviness caused by pathogenic damp.

Heat Bi Syndrome Pain

Sudden onset with swelling and redness.

Bone (chronic) Bi Syndrome Pain

Pain, swelling and joint deformity. Chronic (interior) condition, as a progression of the four previous types.

Condition relieved by eating

Empty Condition.

Condition aggravated by eating

Full Condition.

Lack of appetite

Spleen-Qi deficiency.

Excessive hunger

Stomach-Heat.

Feeling of fullness

Dampness or retention of food.

Feeling of distention

Qi stagnation.

Lack of taste sensation

Spleen and Stomach deficiency.

Bitter taste

Heat in Liver or Heart.

Sweet taste

Spleen deficiency or Damp-Heat.

Sour taste

Retention of food or Liver invading Stomach.

Salty taste

Kidney-Yin deficiency.

Pungent taste

Lung-Heat.

Sour Vomiting

Liver invading the Stomach.

Bitter Vomiting

Liver and/or Gall Bladder-Heat.

Clear, Watery Vomiting

Cold in Stomach.

Vomiting Soon after eating

Heat in Stomach.

Sudden Vomiting with loud noise

Full Condition.

Slow Vomiting in coming with weak noise

Empty Condition.

Aggravation of a condition after a bowel movement

Empty pattern.

Better after a bowel movement

Full condition.

Constipation with thirst and dry yellow coating

Heat in the Stomach and Intestines.

Constipation in elderly or women after childbirth

Deficiency of Blood.

Constipation with small, dry, bitty stools like deer stools

Indicates stagnation of Liver-Qi and Heat in the Intestines

Difficulty in performing a bowel movement (stools not dry)

Stagnation of Liver-Qi

Constipation with abdominal pain

Internal Cold, which may be Full or Empty Condition.

Constipation with dry stools, dry mouth, desire to drink in small sips

Yin deficiency, usually of Kidneys and/or Stomach.

Alternation of constipation and diarrhea

Stagnant Liver-Qi invading the Spleen.

Chronic loose stools/diarrhea

Spleen and/or Kidney Yang deficiency.

Chronic diarrhea every day in the very early morning

Kidney Yang deficiency.

Diarrhea with abdominal pain

Interior Cold in the Intestines.

Diarrhea with mucus in the stools

Dampness in the Intestines.

Diarrhea with mucus and blood in the stools

Damp-Heat in the Intestines.

Loose stools with undigested food

Spleen-Qi deficiency.

Stools not loose or only slightly loose but very frequent, patient cannot hold them easily

Deficiency of Central Qi, i.e. the Qi of Stomach and Spleen with sinking of Spleen-Qi.

Black or very dark stools

Stasis of Blood.

Blood comes first, bright-red, splashing in all directions

Heat in the Blood Damp-Heat in the Intestines

Blood comes first and is turbid and the anus feels heavy & painful

Damp-Heat in the Intestines.

Stools come first and then the blood, which is watery

Spleen Qi is deficient and unable to hold Blood.

Pain accompanying diarrhea

Liver involvement or Heat.

Foul-smelling stools

Heat.

Absence of smell

Cold.

Borborygmus with loose stools

Spleen deficiency.

Borborygmus with abdominal distention and without loose stools

Stagnation of Liver-Qi.

Flatulence

Stagnation of Liver-Qi.

Flatulence with foul smell

Damp-Heat in the Spleen or Heat in Intestines.

Flatulence without smell

Interior Cold from Spleen-Yang deficiency.

Burning sensation in the anus while passing stools

Heat.

Enuresis or incontinence of urine

Kidney deficiency.

Retention of urine

Dampness in the Bladder or occasionally Lung Qi deficiency.

Difficulty in urination

Either Dampness in the Bladder or deficiency of Kidney (the latter is more common in old people).

Pain before urination

Qi Stagnation in the Lower Burner .

Pain during urination

Damp-Heat in the Bladder.

Pain after urination

Qi Deficiency.

Pale(clear) urine

Cold.

Dark urine

Heat.

Turbid/cloudy urine

Dampness.

Copious, clear and pale urination during an exterior invasion of Wind-Cold or Wind-Heat

Pathogenic factor has not penetrated into the Interior.

Very frequent and copious urination

Kidney-Yang deficiency.

Frequent and scanty urination

Qi deficiency.

Scanty and dark urine

Kidney-Yin deficiency.

Desire to drink cold liquids

Heat.

Desire to drink warm liquids

Cold.

Thirst with desire to drink large amounts of cold water

Presence of Heat

Absence of thirst

Presence of Cold.

Thirst but with no desire to drink

Damp Heat.

Chronic tiredness, desire to lie down, poor appetite, loose stools

Spleen-Qi or Spleen-Yang deficiency.

Chronic tiredness, weak voice, propensity to catching colds

Lung-Qi or Lung-Yang deficiency.

Chronic tiredness, backache, feeling cold, frequent urination

Kidney-Yang deficiency.

Chronic tiredness, dizziness, blurred vision, scanty periods

Liver-Blood deficiency.

Chronic tiredness, anxiety, dry mouth at night, tongue without coating

Kidney-Yin deficiency

Chronic tiredness, feeling of heaviness

Dampness

Chronic tiredness, feeling of heaviness, muzziness, dizziness

Phlegm

Chronic tiredness, abdominal distention, irritability, Wiry pulse

Liver-Qi stagnation.

Short-term tiredness, alternating hot and cold feeling, irritability, unilateral tongue coating, Wiry pulse

Lesser Yang pattern

Recent onset, short duration (Headache Onset and Time of Day)

Headache from exterior attack of Wind-Cold

Gradual onset, in attacks

Interior type (Headache Onset and Time of Day)

Daytime (Headache Onset and Time of Day)

Qi or Yang deficiency

Evening (Headache Onset and Time of Day)

Blood or Yin deficiency

Night-time (Headache Onset and Time of Day)

Blood stasis

Nape of neck (Headache Location)

Tai Yang channels (can be from exterior invasion of Wind-Cold, or from interior Kidney deficiency).

Forehead (Headache Location)

Yang Ming channels (can be from Stomach-Heat or Blood deficiency).

Temples and sides of head (Headache Location)

Shao Yang channels (can be from exterior Wind in the Lesser Yang, or from interior Liver and Gall Bladder Fire rising).

Vertex (Headache Location)

Jue Yin channels (usually from deficiency of Liver-Blood).

Whole head (Headache Location)

Exterior invasion of Wind-Cold.