Lecture 1 - Heart & Pericardium Patterns

Vocabulary flashcards summarising key diagnostic concepts, pathogenic factors, Heart & Pericardium functions, and their major Zang-Fu patterns from the lecture notes. Use them to review definitions, clinical features, and related formulas.

Biàn Zhèng (Pattern Identification)

The diagnostic process in Chinese medicine that discerns the underlying disharmony by analysing the overall picture of all signs and symptoms.

Pattern (Syndrome)

A constellation of clinical manifestations that reveals the fundamental disharmony; guides treatment rather than identifying a single ‘cause’.

If a patient complains of poor appetite, loose stools, tiredness, weak voice, propensity to catching colds and dislike to speak, what are the two patterns?

Spleen Qi Deficiency - poor appetite, loose stools

Lung Qi Deficiency - Weak voice, propensity to catching colds (weak wei qi) and dislike to speak (lack of qi in lung)

Tiredness —> spleen qi deficiency and lung qi deficiency

Disease vs. Pattern

A single Western-defined disease can display many CM patterns, and one CM pattern can appear in many diseases.

“Disease” of painful periods may manifest with several different patterns

Qi stagnation - distending pain-wiry. Long term qi stagnation → blood stasis

Blood stasis - stabbing pain, purple, choppy/firm pulse

Cold in the uterus - signs of cold, cold creates qi stagnation

Damp heat in the uterus - signs of heat & damp. Can lead to blood stasis

“Different disease, similar treatment”

CM maxim stating that different diseases with the same pattern receive similar therapy, while the same disease with different patterns is treated differently.

Eight Principles

Yin/Yang, Interior/Exterior, Hot/Cold, Excess/Deficiency—basic axes used to label any pattern.

Tongue Diagnosis (Role)

Offers an overview of internal disharmony; sometimes the only manifestation of a pattern but must be integrated with the whole picture.

Pulse Diagnosis (Role)

Assesses dynamic qualities of Qi-Blood; never used alone to ‘prove’ a preconceived pattern.

Qi Deficiency

Slight shortness of breath, weak voice, spontaneous sweating, poor appetite, loose stools, tiredness, empty pulse.

Sinking (Collapse) of Qi

Qi-deficiency signs plus bearing-down sensation, organ prolapse, mental depression, empty pulse.

Qi Stagnation

Distending/moving pain, feeling of distension, mental depression, irritability, “Gloomy” feeling, frequent mood swings, frequent sighing, wiry pulse, possibly red tongue sides.

Blood Deficiency

Dull-pale complexion, dizziness, numbness, blurred vision, scanty periods, pale dry tongue, choppy/fine pulse.

Blood Stasis

Stabbing fixed pain, dark complexion, purple tongue/lips/nails, wiry or choppy pulse.

Deficiency of Body Fluids

General or organ-specific dryness of skin, mouth, nose, cough, lips, dry tongue.

Lung: dry skin and dry cough

stomach: dry tongue with horizontal cracks and a dry mouth without desire to drink, or with desire to drink in small sips

kidneys: scanty urination, dry mouth at night and dry throat

Large intestine: dry stool

Wind (Pathogenic)

Rapid onset, moving symptoms, tremors, affects upper body/Lungs/Liver, aversion to wind, floating pulse.

Cold (Pathogenic)

Yin factor that injures Yang, causes contracted cramping pain relieved by heat, clear discharges, slow pulse.

Heat (Pathogenic)

Feeling of heat, red face, thirst, mental restlessness, red tongue, rapid overflowing pulse.

Fire

Intense form of Heat that blazes upward, dries fluids, damages Blood & Yin, may cause bleeding and affect mind.

Toxic Heat

Fire transforming into localized swelling, redness, pus, severe heat and pain (e.g., boils, appendicitis).

Summer-Heat

Seasonal pathogen combining exterior Heat with Damp; fever, heaviness, irritability, soggy rapid pulse.

Dampness (Pathogenic)

Sticky, heavy, lingering pathogen that slows Qi, causes heaviness, turbid discharges, slippery or soggy pulse.

Internal Dampness

Fullness in abdomen, heaviness of limbs, lethargy, sticky taste/coating, slippery pulse.

Phlegm (Substantial/Non-substantial)

Congealed fluids causing mental dullness, obesity, rattling throat, greasy skin, thick tongue coat.

Dryness (Pathogenic)

Dry throat, lips, skin, stools, scanty urine—often injures Lung Yin and fluids.

Heart – Governs Blood

Heart Qi propels Blood; healthy circulation relies on Heart Yang and Qi.

Heart – Houses the Shen

Mind-Spirit resides in Heart Blood/Yin; emotional balance depends on Heart nourishment.

Heart – Manifests in Complexion

Sufficient Heart Blood gives rosy complexion; pale or purple face indicates Heart disharmony.

Heart Qi Deficiency

Palpitations, shortness of breath on exertion, spontaneous sweat, tiredness, pale tongue, empty pulse.

Heart Yang Deficiency

Heart-Qi-deficiency signs plus cold hands, chest discomfort, bright-pale face, deep weak pulse.

Heart Yang Collapse

Severe Yang deficiency with profuse sweating, cold limbs, cyanosis, coma, hidden minute pulse.

Heart Blood Deficiency

Palpitations, insomnia, poor memory, anxiety, pale lips, thin dry tongue, choppy/fine pulse.

Heart Yin Deficiency

Palpitations, night sweat, mental restlessness, dry mouth, red tongue without coat, floating-empty rapid pulse.

Heart Fire Blazing

Ulcers on tongue, thirst, agitation, dark/bloody urine, red swollen tip tongue, full-rapid overflowing pulse.

Phlegm-Fire Harassing Heart

Heart-Fire signs plus phlegm (rattling throat, incoherent speech, mania), red swollen sticky-coated tongue, slippery rapid pulse.

Phlegm Misting the Mind

Mental confusion, lethargic stupor, slurred speech, swollen tongue with thick coat, slippery pulse.

Heart Qi Stagnation

Chest oppression, sighing, mild depression, lump-throat feeling, slightly purple sides of tongue, empty-overflowing pulse.

Heart Vessel Obstructed

Stabbing periodic chest pain worse with cold, heaviness, phlegm, purple swollen tongue, wiry/choppy/knotted pulse.

Heart Blood Stasis

Severe stabbing chest pain radiating to arm, cyanotic lips/nails, entire tongue purple, choppy or knotted pulse.

Shén (Spirit)

The visible vitality arising from harmonious Qi-Blood; governs consciousness, emotions, and insight.

Possession (Guǐ)

Traditional concept of external spirit obstructing Shen; modern CM frames as severe Shen disturbance.

Sun Sīmiǎo’s 13 Ghost Points

Classical acupuncture set used to free obstructed Shen in possession-like disorders.

Internal Dragons

Five points (incl. extra below Ren 15, ST 25/32/41) used when Shen is inaccessible and patient feels internally ‘possessed’.

Pericardium (Xin Bao)

‘Heart Protector’; envelopes the Heart, shares Heart functions, and governs chest Qi.

Pericardium Channel

Hand Jue-Yin pathway treating chest disorders, Shen issues, and ministerial fire.

Pericardium & Minister Fire

PC disperses and contains emotional heat of Minister Fire, helping balance joy and agitation.

Pericardium & Uterus

The PC channel links Heart and Uterus, influencing menstruation and fertility through Blood circulation.

Heat in Pericardium

Febrile disease stage: night fever, delirium, incoherent speech, hot body with cold extremities, red dry tongue, fine-rapid pulse.

Pericardium Blood Deficiency

Chest stuffiness, slight SOB, palpitations, anxiety, insomnia, cold hands, scanty periods, pale thin tongue.

Pericardium Fire

Chest heat/tightness, ulcers, insomnia, bitter taste, heavy menses, red swollen tip tongue, full rapid pulse.

Phlegm-Fire Harassing PC

PC-Fire signs with phlegm, mental derangement, rattling throat, red swollen sticky tongue, slippery rapid pulse.

Qi Stagnation in Pericardium

Distension/tight chest, sighing, lump-throat, irritability, purple chest-area tongue edges, empty-overflowing pulse.

Blood Stasis of Pericardium

Severe pricking chest pain radiating to arm, cyanotic lips, painful menses with dark clots, purple tongue, choppy/wiry pulse.

Minister Fire

Physiological fire arising from Kidney-Yang that warms Heart & SJ; overactivity shows as PC/Heart Fire.

Bao Mai (Uterus Vessel)

Extra vessel linking Heart/PC to Uterus; explains emotional influence on menstruation.

Empty Heat

Heat symptoms arising from Yin deficiency: five-palm heat, night sweat, red-peeled tongue, thin rapid pulse.

Full Heat

Excess Yang pathogen: high fever, thirst, red face, yellow coat, full rapid pulse.

Full Cold

Acute Yin pathogen invading: severe cold pain, thick white coat, tight slow pulse.

Empty Cold

Yang deficiency producing cold sensations, pale wet tongue, deep weak slow pulse.

Damp-Heat

Combination pathogen causing heaviness, sticky yellow secretions, slippery rapid pulse.

Wind-Heat

Acute exterior syndrome: fever, mild aversion to wind, sore throat, floating rapid pulse.

Wind-Cold

Exterior invasion: chills, occipital stiffness, no thirst, floating tight pulse.

Ghost Palace (DU 26)

Key Sun Sīmiǎo point to revive consciousness and release Shen possession.

Gui Xin (PC 7)

‘Ghost Heart’ point used to calm the Shen and clear internal possession heat.

Huang Lian Wen Dan Tang

Formula that clears Phlegm-Heat from Heart/GB, treating phlegm-fire disturbing Shen.

Dao Chi San

‘Guide Out the Red Powder’—clears Heart Fire via SI, treats ulcers and dark urine.

Shen Fu Tang

Ginseng & Aconite decoction; rescues devastated Yang (Heart Yang collapse).

Xue Fu Zhu Yu Tang

‘Blood Mansion Stasis-Expelling Decoction’—moves Blood in chest, treats heart pain and PC blood stasis.

Qing Ying Tang

‘Clear the Nutritive Level Decoction’—cools Ying level heat, especially Heat in the Pericardium.

Si Wu Tang

‘Four Substances Decoction’; basic formula to nourish Blood (e.g., Heart/PC Blood deficiency).

Tian Wang Bu Xin Dan

‘Heavenly Emperor Heart Tonic’—nourishes Heart Yin & Blood, calms Shen.

Wu Shen (Five Spirits)

Hun, Po, Yi, Zhi, Shen—five spiritual aspects governed or influenced by Heart and other Zang.

Hun & Po at Death

Hun ascends to Heaven; Po returns to Earth—unresolved attachments may create Guǐ (restless spirits).

Knotted Pulse

Slow irregular pulse often seen in Heart Yang deficiency or Heart Blood stasis.

Overflowing Pulse

Full surging pulse indicating Heat or Fire in the Qi level or Heart/PC channel.

Slippery Pulse

Rounded smooth pulse suggesting Phlegm or Damp accumulation, or pregnancy.

Choppy Pulse

Rough irregular pulse signifying Blood deficiency or Blood stasis.

Wiry Pulse

Taut string-like pulse linked to Qi/Blood stagnation, Pain, or Liver disorders.

Empty Pulse

Big but soft; denotes Qi deficiency, often seen in Heart Qi deficiency.

Hidden Pulse

Deep faint pulse felt with heavy pressure, characteristic of Yang collapse.

Shen Disturbance

Generic term for insomnia, palpitations, anxiety, mania—often from Heart/PC patterns.

Minister Fire Agitation

Overwarmed Shen with agitation, insomnia, mouth sores—manifesting as Heart/PC Fire.

Bao Yuan Tang

‘Preserving the Source Decoction’; tonifies Heart Qi/Yang deficiency with fatigue and palpitations.

Rou Fu Bao Yuan Tang

Cinnamon & Aconite variant for stronger warming of Heart Yang deficiency.

Mu Xiang Liu Qi Yin

Herbal drink that moves Qi in chest; used for Heart/PC Qi stagnation.

Ban Xia Hou Po Tang

Pinellia & Magnolia formula resolving phlegm and Qi stagnation, treats globus hystericus.

Dao Tan Tang

‘Scouring Phlegm Decoction’—resolves phlegm misting the mind.

Ghost Market (REN 24)

Sun Sīmiǎo ghost point that releases rebellious speech and treats mania.

Ghost Pillow (DU 16)

Ghost point to drive out internal wind and clear spirit-disturbing factors.