1. Syndromes Differentiations
Eight-Principles
Disease-Cause
Qi-Blood and Body Fluid
Zang-Fu Organ
Six-Channel
Defense-Qi-Nutrient-Blood
Triple-Energizer

2. Six Excess Disease –Cause Syndrome Differentiation Pestilence Syndrome
Improper Diet, Over-Exertion, Too much Rest
Wind, Cold, Summer-Heat, Dampness, Dryness, Fire
Disease –Cause Syndrome Differentiation
Six Excess
Pestilence Syndrome
Seven Emotions
Improper Diet, Work and Rest
Overjoy, Fury, Pensiveness, Grief, Fear and Tense

3. Disease-Cause Syndrome
Differentiation
病因辨证

4. Disease-cause syndrome differentiation（病因辨证） mainly consists of differentiation of six evils, pestilence, internal injury to emotions, impairment caused by physical exertion, food indigestion and so on.

5. Clinical Manifestations
Wind Syndrome
Aversion to wind, mild fever, sweating, stuffy nose, sneezing, itching and pain in the throat, cough, thin white tongue coating, floating and moderate pulse, or sudden facial numbness, facial distortion, stiff neck, or wandering pain in joins or sudden swollen face and limbs.
Clinical Manifestations
If wind invades the lung will result in stuffy nose, sneezing, itching, sore throat and cough. If wind resides in the skin and muscles, there will be a sudden itching in the skin or rashes; when wind invades the channels and collaterals, facial numbness, facial distortion, stiff neck, spasm would occur; if wind, cold and dampness block the channels and joints leads to wandering pain limbs and joints; if confrontation between wind and water causing dysfunction of dispersing and descending of lung qi, edema in the face and limbs occur.
Syndrome Analysis
Aversion to wind, sweating, floating and slow pulse; or sudden rashes; or wandering pain in limbs and joints.
Key Points

6. Clinical manifestations
Cold Syndrome
Clinical manifestations
Severe aversion to cold, mild fever, stuffy nose with watery discharge, headache and body ache, thin and white tongue coating, floating and tense pulse; or cough, panting, spitting, white sputum, or cold pain in the stomach and abdomen, vomiting and diarrhea; or cold pain in joints with movement difficulty.
Syndrome Analysis
Cold invades the exterior results in thin and white tongue coating, floating tense pulse; stuffy nose with watery discharge, cough, panting and white sputum due to lung qi fails to diffuse and disperse; blockage of channels and collaterals results in pains in the head and body; when pathogenic cold in the stomach and intestines, cold pain in the stomach and abdomen.
Focal Points
Aversion to cold, absence of sweating, pain in the head and body, or cold pain the stomach and abdomen, or cough, panting and spitting white sputum.

7. Summer-Heat Syndrome
Fever, aversion to heat, sweating, dizziness or headache, acute thirst, lassitude, yellowish urine, red tongue with yellow coating, rapid deficient pulse; or fever, sudden fainting, constant sweating, short breath, even coma and spasm.
Attacked by summer-heat pathogen leads to fever and aversion to heat, sweating, thirst, yellowish urine, lassitude, dizziness and headache and other heat symptoms; fever, sudden fainting, constant sweating, even coma and spasm results when summer-heat disturbs the mind.
Fever, thirst, sweating lassitude, deficient and rapid pulse.

8. Dampness Syndrome
Feeling of heaviness in the head; tastelessness in the mouth without thirst, white and slippery tongue coating, soggy or slow pulse; or aching pain with a heavy feeling in joints, motion difficulty, lassitude; or oppression in the chest and abdomen, poor appetite, nausea, loose stools, thick and greasy tongue coating, or turbid urine.
Dampness leads to feeling heavy in the head, weary body, tastelessness in the mouth, not thirsty, white and greasy tongue coating, soggy or slow pulse. Lassitude, joints ache ; fullness in the chest and abdomen, nausea, loose stools, thick and greasy tongue coating could result from retention of dampness. Turbid urine and excessive leukorrhea （带下）in women are due to pouring down of pathogenic turbid dampness.
Feeling of heaviness in the head , aching pain and motion difficulty; feeling of oppression in the chest and abdomen, poor appetite, nausea, greasy tongue coating and soggy or slow pulse.

9. Dry cough in autumn, dry mouth, nose, lips, throat and skin.
Dryness Syndrome
Dry skin, mouth, nose, lips and throat, dry cough with no or little but sticky sputum, dry stools, severe aversion to cold, mild sweating, mild fever, thin, white and dry tongue coating, floating and tense pulse;
Dryness tends to injure body fluids and the lung. Dry skin, mouth, nose, lips, throat, dry cough with no or little but stick sputum, dry stools.
Dry cough in autumn, dry mouth, nose, lips, throat and skin.

10. Fire Syndrome
High fever and prefer cold, agitation, flushed face and bloodshot eyes; prefer cold drinks, sweating, constipation, scanty dark urine, even coma and delirium, or spiting blood, nosebleed, red or deep-red tongue, with yellow and dry or grayish and black tongue coating and surging rapid or slippery pulse.
Invasion of heat pathogen leads to fever; Flaming of heat brings about rising qi and blood, so there is flushed face and bloodshot eyes.
High fever, thirst and fondness of cold drinks, local swollen hot pain, red tongue with yellow coating, and rapid pulse.

11. Pestilence Syndrome Differentiation
Pestilence refers to various infectious diseases caused by pestilent viruses.
They are highly infectious and epidemics, high specificity and similar symptoms.
They have rapid onset and are often in critical conditions.

12. Pestilence Syndrome Differentiation
Dry-heat pestilence
Damp- heat pestilence
when the pestilent pathogens invade the head - intense headache; gather in the throat - sore and ulcerous throat results;
invaded the blood - spiting blood occurred;
when invaded the intestinal tract- pain in bowels and abdomen occurred;
when the mind is disturbed, coma or irritation and delirium would occur;
when heat pathogen in the interior attacks the Liver Channel and liver wind is stirred up, there will occur muscular spasm; deep-red tongue with brown or gray and dry coating, and rapid pulse
When lung and stomach are invaded by damp-heat, fever without chills would get worse in the afternoon; when it represses qi and blood, head and body-ache would occur; when it blocks the San-jiao causing the spleen and stomach failing to ascend and descend, abdominal pain, vomiting and diarrhea would occur. When it invades the skin, jaundice will occur suddenly; when it disturbs the mind, there will be coma and delirium, greasy or white-powdered tongue. Soggy and rapid pulse are all manifestations of interior exuberance of damp-heat.

13. Emotion Syndrome Differentiation
It refers to analysis and differentiation of the existence and specific manifestations due to emotional problems in the current illness.

14. Syndrome due to Overjoy
Ceaseless laughing, absent-mindedness, incoherent speech and abnormal behavior.
Joy is the emotion of the heart and excessive joy would affect the mind and in turn results in dysfunction of the heart.
Laughing ceaselessly, anxiety and absent- mindedness.

15. Syndrome due to Pensiveness
Clinical Manifestations
Sadness and weeping, low spirits, constant sighing, pallor, lassitude, shortness of breath and reluctant to talk.
Syndrome Analysis
Sadness impairs the mind leads to weeping, low spirits and constant sighing. When lung qi is dissipating, pallor, lassitude, lack of qi and reluctant to talk.
Focal Points
Sadness and weeping, constant sighing and lassitude.

16. Syndrome due to Fear and Terror
Fear and terror, uneasy mind, palpitation and insomnia, nightmare, even mental disorder, urinary and fecal incontinence, weak legs and body, seminal emission and spermatorrhea,遗精 involuntary emission滑精
Fear and terror injure the heart and kidney. Terror leads to adverse rising of heart qi, palpitation and insomnia, nightmare, even mental disorder. When fear and terror impair the kidney, urinary and fecal incontinence, weak limbs, spermatorrhea, and involuntary emission.
Easily frightened and uneasy mind, seminal emission and spermatorrhea.

17. Syndrome due to Grief
Sorrowful, melancholy low spirits, constant sighing, pale complexion, dislike talking and lassitude
When grief affects the heart and lung, sadness and low spirits would be prevalent; lassitude and pale complexion are symptoms of lung qi being consumed.
Sorrowful, melancholy and lassitude

18. Syndrome due to Fury
Irritability, bad temper, oppression and fullness in the chest and hypochondrium, distending pain in the head, flushed face and bloodshot eyes, dizziness, even vomiting or spitting blood, mania and coma
Fury causes dysfunction of liver qi, leading to oppression in the chest or the hychondrium and bad temper; Upward movement of liver qi stirs blood and results in distending pain in the head, flushed face and bloodshot eyes, dizziness, even vomiting or spitting blood; coma occur in severe case. When liver yang turns into fire and invades the mind, mania occur.
Oppression and fullness in the chest or hypochondrium, irritability and bad temper, headache and bloodshot eyes.

19. The Seven Deadly Emotions (Excess Joy, Anger, Grief, Anxiety, Sadness, Fear and Shock)

20. Toxic emotions and health
TCM has acknowledged the role of emotions in health and well-being for over 2000 years.
Increasingly, scientific studies are backing up the ideas that negative emotions can cause serious health issues.

21. Anger and rage
Unresolved anger causes flaring up of the liver fire and can lead to hypertension and stroke
Anger makes the energy - or qi - rise. In the context of TCM, anger includes other emotional traits such as resentment, frustration, irritability and explosive rage.
Physically, it can manifest itself in violence and fighting, in rows, and in the breakdown of relationships.
As with all things, there is a positive side to anger, when expressed healthily and to a resolution. If left to fester without expression, it causes problems of physical ill-health, but can also transform emotionally into depression.
So it is long-term and unresolved feelings of anger and resentment that are poisonous to well-being causing ill-health.

22. Grief and excessive sadness
The cause of Lung disharmonies.
Sudden or shocking grief can increase the risk of heart attack.
Grief consumes and weakens the Lung qi. In Chinese medicine, this emotion includes sorrow, regret, sadness, and senses of loss or remorse. Like anger, grief can have a very strong effect on health.
The symptoms are usually concerned with the respiratory system, such as bronchitis or asthmatic problems, especially after a bereavement. And chesty coughs are common in people seeking alternative therapies for being unhappy.

23. Fear and Shock Causes of disharmonies of the kidneys and heart
Fear & fright cause bedwetting in infants, and panic attacks
Fear causes the qi to descend, and Shock causes it to scatter.
The reversal of the normal upward flow of Kidney qi can lead to loss of control of urination and other problems, such as lower back pain, listlessness and a desire for solitude.
Fear can also be the emotion responsible in children who suffer from bedwetting - and also the related symptoms of shyness and timidity.
Fright and shock can affect the heart causing Heart qi to scatter .

24. Worry and Over-thinking
Cause of Spleen and Stomach disharmonies
Worry and over-thinking cause qi to stagnate. This emotion also includes too much studying, obsessive thinking or continually working something over in your mind.
Worry is a particularly insidious emotion as it can eat away at some people, even though there is nothing to be worried about.
More often than not, the worries are unfounded, but the afflicted person is ruled by the emotion.

25. Joy and over-stimulation
Cause of Heart disharmonies
To have enough is happiness. To have more than enough is harmful
Joy causes the qi to slow down and relax. Over-exuberance can scatter the Heart qi, damaging the heart.
It may be surprising that joy can be a cause for concern emotionally, and therefore a burden on health.
What is really meant here is over-stimulation or rowdy over-exuberance.
It might also be the state of elation of somebody winning the lottery!
Such excessive elation can lead to problems later on, usually the opposite feelings to joy.

26. EMOTIONS AND ORGANS七情与五脏
Anger impairs the liver
Excess joy impairs the heart
Grief impairs the lung
Fear impairs the kidney
Anxiety impairs the spleen

27. Syndrome due to Improper Diet
It refers to the syndrome due to injury to the stomach and intestines by improper diet.
Food retention in the stomach with qi retention will cause pain or fullness in the stomach and abdomen.
When food accumulation blocks stomach qi from descending, turbid qi, thick and greasy tongue coating .
Distending pain in the stomach and abdomen, eructation with a fetid odor and acid regurgitation and stinking stools.

28. Syndrome due to Over-Exertion
It is caused by too much physical and mental labor or excessive sexual activities.
Fatigue and weakness, aches in muscles and bones; or palpitation and insomnia, poor appetite, abdominal distension; dizziness, tinnitus, lassitude, impotence, irregular menstruation.
Over-work consumes spleen qi and affects muscles and bones; too much mental labor injures the heart and spleen; excessive sexual activities injures the kidney, causing consumption of yin fluid and yang qi.

29. Syndrome due to Too Much Rest
Too much rest results in impeded moving of qi and blood and dysfunction of the zang-fu organs.
Pain all over the body; panting and gasping when active, weak limbs, obesity.
Too much rest impeded moving of qi and blood.

30. Syndrome Differentiation of Qi-Blood and Body Fluid
气血津液辨证

31. Differentiation of Qi-Diseases
Qi Deficiency
Qi Sinking
Qi Stagnation
Reverse Flow of Qi
Qi Collapse
Qi Blockage

32. Syndrome Differentiation of Qi-Blood and Body Fluid
Pathological changes of qi and blood can be summarized as two aspects:
One is deficiency of qi, blood and body fluids, which is the deficiency syndrome while the other is metabolic disturbance of qi, blood and body fluids, which the excess syndrome.

33. Differentiation of Qi-Diseases
Types of Syndrome
Symptoms
Syndrome Analysis
Qi Deficiency Syndrome
Dislike talking, lassitude, dizziness, spontaneous sweating, pale tongue with white coating and weak pulse.
Qi deficiency and reduced functions of the organs. Qi deficiency and failure of yang qi to ascend causing dizziness; Qi deficiency unable propel blood to nourish the tongue causing pale tongue and weak pulse.
Qi Sinking Syndrome
Dizziness, Qi deficient, regular bowel movement; chronic diarrhea, straining feeling of the abdomen, lower back, vagina and anus, pale tongue with white coating and weak pulse.
Deficient of genuine qi causes impairment of the spleen function, failure of yang to ascend and sinking of qi causing regular bowel movement; failure of deficient qi to ascend results in drooping feeling of the abdomen, lower back, vagina and anus. In severe case, prolapse of the uterus and rectum can occur.

34. Differentiation of Qi-Diseases
Types of Syndrome
Symptoms
Syndrome Analysis
Qi Stagnation
Syndrome
Distending pain the chest, breasts, hypochondria, stomach and abdomen, which wanders here and there in different severity, alleviated when belching, worry, anxiety and anger, wiry pulse and normal tongue coating.
Stagnation of qi causes distension. In mild cases, there is distension, in severe cases, there is wandering pain. Low spirits cause stagnation of qi. Wiry pulse is the sign of qi disorder.
Qi Collapse Syndrome
Weak and irregular breath, constant sweating, pallor, mouth open with closed eyes, weak body and limbs, urinary and fecal incontinence, unclear mind, pale tongue with moist and white coating, and faint pulse.
Extreme deficiency of genuine qi and inability of the lung to breathe cause weak and irregular breath. Unclear mind, fainting or syncope are due to qi collapse and failure of the heart to be nourished. Constant sweating and urinary and fecal incontinence are due to exhaustion of qi. Pallor is due to failure of qi to flow upward to nourish the face.

35. Differentiation of Qi-Diseases
Types of Syndrome
Symptoms
Syndrome Analysis
Syndrome of Reverse Flow of Qi
Cough, gasping when active, hiccuping, belching, nausea, vomiting, headache, dizziness.
When lung qi fails to descend, cough and gasping are found. When stomach qi fails to descend and flows upward, it causes hiccuping, belching, nausea and vomiting. Hyperactivity of liver qi and flaming of liver fire leads to headache and dizziness. Blood flows upward along with reversed flow of qi, results in fainting.
Qi Blockage syndrome
Sudden syncope, cold limbs, or colicky pain, retention of urine and constipation, harsh breath, thick tongue coating, and deep, excess, forceful pulse.
Excessive emotional stimulation leads to adverse flow of qi, obstruction of the heart, sudden syncope or fainting. When qi is blocked and lung qi fails to diffuse, harsh breath may occur. When blood stasis, stones and phlegm obstruct channels and orifices, colicky pain, retention of urine and constipation present. Cold limbs are caused by blockage of qi and failure of yang to reach the exterior.

36. Differentiation of Qi-Diseases
Qi-Deficiency
Qi Sinking
Qi Stagnation
Reverse Flow of Qi
Qi Collapse
Qi Blockage

37. Syndrome Differentiation
Blood-Disease
Syndrome Differentiation
血病辨证

38. Blood-Disease Differentiation
Blood Deficiency
Blood Stasis
Blood Cold
Blood Heat

39. Blood Deficiency Syndrome
Pale or sallow face, pale eyelids, lips and nails, dizziness, blurred vision, palpitation and insomnia, limb numbness, scanty menses with light color, delayed periods or amenorrhea, pale tongue with white coating, and thin pulse.
Blood deficiency leads to pale face and eyelids, lips and nails. Blood deficiency also results in poor nourishment of the brain and dizziness and blurred vision occurred, palpitation, insomnia, numbness, scanty menstrual blood and light color, delayed periods, amenorrhea.
Pale complexion, lips, eyelids, and nails, dizziness, pale tongue and fine pulse.

40. Blood Stasis Syndrome Clinical Manifestations Syndrome Analysis
Focal points
Fixed spots of stabbing pain; The lump on the body surface appears cyanotic, while the lump in the body feels hard and immobile when touched; Frequent hemorrhage with dark color or black color stools; Dark complexion, cyanotic lips and nails, scaly skin. Blood-shot eyes or bluish veins of the abdominal wall, dark and purple tongue with thin, rough or knotted and intermittent pulse.
Blood stasis blocks collaterals and channels and stabbing pain appeared. Stagnant blood failed to disperse and bruise occur. Blood fails to circulate in blood vessels and leaks out, so frequent hemorrhage may occur.
Stabbing pain, pain with fixed locations, lump, hemorrhage, cyanotic lips, tongue and nails and rough pulse.

41. Blood Cold Syndrome Clinical Manifestations Syndrome Analysis
Focal Points
Cold pain and contracture of limbs and lower abdomen, alleviated with warmth, worse when exposed to cold, purple, dark and cold skin, cold body and limbs, delayed periods, purple and dark menstrual blood mixed with blood clots, light purple tongue with white coating, deep, slow pulse or rough tense pulse.
Cold in blood vessels impedes smooth flow of blood as vessels contract, leading to cold and contracture of limbs, purple cold skin. Cold accumulates in the uterus, resulting in cold pain in the abdomen, delayed periods, purple and dark menstrual blood with clots. Cold injures yang leading to cold body and limbs. Light purple tongue with white coating, and deep, slow and rough or tense pulse are due to internal exuberance of yin cold, and unsmooth flow of blood.
Local cold pain and limbs, purple skin, cold body and limbs, deep, slow and rough or tense pulse.

42. Blood Heat Syndrome
Coughing up blood, spitting blood, nosebleed, hematuria, blood in the urine and stool, excessive menstrual flow with bright red and sticky blood, feverish sensation all over the body, flushed face, thirst, restlessness, insomnia or local carbuncles, red, swollen and painful sensation, deep-red tongue, slippery and rapid pulse or wiry and rapid pulse.
Internal exuberance of fire causes acute bleeding with bright red and sticky blood, burning body fluids, feverish sensation of the body, flushed face and thirst. Heat in blood disturbs the mind and leads to restlessness and insomnia. Carbuncles and painful sensation are caused by local fire. Deep-red tongue, slippery and rapid pulse or wiry and rapid pulse, are all manifestations of flaming or blood heat.
Acute bleeding with bright red and sticky blood, feverish sensation all over the body, thirst, local redness, swelling, sense of heat and pain, deep-red tongue, rapid and forceful pulse.

43. Qi-Blood Deficieny Qi Deficiency and Blood Stasis
Qi-Blood Disease
Qi-Blood Deficieny
Qi Deficiency and Blood Stasis
Qi Stagnation and Blood Stasis
Failure of Qi to Control Blood
Collapse of qi due to Hemorrhage

44. Qi-Blood Deficiency Syndrome
Dizziness, dislike talking, lassitude, spontaneous sweating, pale or sallow complexion, pale and white lips and nails, palpitation and insomnia, pale and tender tongue, thin and weak pulse.
Deficiency of qi leads to low energy to talk, lassitude and spontaneous sweating. Deficiency of blood fails to nourish the heart causing palpitation and insomnia. When the channels and collaterals fails to get nourishment, pale lips and nails, thin and weak pulse occur. The deficient qi and blood fails to nourish the face and tongue so dizziness, pale or sallow complexion and tender tongue noticed.
Coexistence of qi and blood deficiency syndrome

45. Qi Deficiency and Blood Stasis
Lassitude, dislike to talk, spontaneous sweating, local fixed stabbing pain, worse when active, pale complexion, light purple tongue with ecchymosis, thin and rough pulse or deep and rough pulse.
Deficiency of qi leads to lassitude, spontaneous sweating, pale complexion and tongue. Deficiency of blood fails to push blood flow and results in blood stasis. Thus, local stabbing pain, light purple tongue occur.
Co-existence of qi deficiency and blood stasis syndrome.

46. Qi stagnation and Blood Stasis Syndrome
Fullness and pain in the chest and hypochondriam, distending pain in the breasts, bad temper, painful abdominal mass, delayed periods, purple menstrual blood with clots, amenorrhea, purple and dark tongue, wiry and rough pulse.
Emotional problems lead to failure of liver qi to flow freely and stagnation of qi, marked by fullness and pain in the chest and hypochondria, distending pain in the breasts. Qi commands blood, stagnation of qi causes blood stasis and abdominal mass, delayed periods and purple menses and clots.
Coexistence of qi stagnation and blood stasis syndrome.

47. Failure of Qi to Control Blood Syndrome气不摄血证
Clinical Manifestations
Syndrome Analysis
Focal Points
Spitting blood, hematochezia, metrorrhagia and metrostaxis and subcutaneous hemorrhage nosebleed,
Short breath, lassitude, pale complexion, pale tongue and weak pulse.
When qi fails to command blood, blood leaks out of the vessels into the stomach and intestine, which results in spitting blood. When the Chong and Ren Meridians, If blood leaks into the nasal cavity, nosebleed occurs. When it leaks into muscles and kin, subcutaneous hemorrhage results. Deficiency of qi leads to shortness of breath and lassitude. Pale complexion is due to qi and blood deficiency.
Hemorrhage and qi deficiency.

48. Hemorrhage Causing Qi To Collapse Syndrome气随血脱证
When massive bleeding occurs, profuse sweating, pale complexion, cold limbs, faint breath, even syncope, pale and white tongue and faint pulse occure.
Qi has nothing to depend on when blood collapses. Since qi depletion leads to exhaustion of yang which causes cold sweat. Cold limbs are due to failure of yang qi to warm the limbs. Qi and blood can’t nourish the upper part of the body, resulting in pale complexion, pale tongue, even syncope. Blood vessels fail to be supported by qi and blood, so there may occur faint pulse.
Massive bleeding and symptoms of yang exhaustion syndrome.

49. Body-Fluid Disorder Syndrome Differentiation
津液病辨证

50. Water and Body Fluid Retention Syndrome
Phlegm Syndrome
Fluid-Retention Syndrome
Water Retention Syndrome
Body Fluid Deficiency

51. Body Fluid Deficiency Syndrome
Dry mouth and throat, craving to drink, parched lips, dry nostrils, dry skin, dry and hard stools, red tongue with scanty saliva, thread and rapid pulse.
Deficient body fluids fail to moist and nourish tissues and orifices, leading to dry mouth and throat, craving to drink, parched lips, dry nostrils. When body fluids fails to nourish the skin, the skin gets dry and withered. Dry and hard stools are due to less production of urine and moistening the intestines. Deficiency of body fluids fail to restrain yang, which results in red tongue with scanty saliva, thready and rapid pulse.
Dry mouth, throat, lips, nose, tongue, skin, and dry stools.

52. Phlegm Syndrome Clinical Manifestations Syndrome Analysis Focal Points
Chest distress, cough, panting, sticky sputum, wheezing; painful abdominal and gastric fullness, anorexia and nausea, vomiting or spitting sputum, dizziness, coma, limb and body numbness, delirium, scrofula and goiter瘰疬瘿瘤,sensation of choking throat, greasy tongue coatings and slippery pulse.
When sputum retains in the lung, cough and panting, vomiting or spitting sputum occur; chest distress due to qi gets obstructed by phlegm; adverse qi flow caused wheezing; sputum gets stuck in the stomach, dysfunction of receiving food, painful gastric fullness and anorexia appear; rising of sputum along with adverse rising of stomach qi caused nausea and spiting sputum; dizziness results from retention of phlegm in the middle-energizer; when phlegm accumulates under the skin or in the muscles, local qi and blood flow is impeded, leading to scrofula and goiter; when phlegm is in the limbs, hyperplasia of mammary glands and a sensation of foreign object in the throat will occur. Greasy tongue coating with slippery pulse points to internal obstruction by phlegm.
Cough and vomiting or spitting sputum, chest distress, nausea, lumps, greasy tongue coating and slippery pulse.

53. Fluid-Retention Syndrome
Clinical Manifestations
Syndrome Analysis
Focal Points
Pain and fullness in the stomach and abdomen, sound of water shaking in the stomach, coughing and panting, abundant clear and thin sputum, wheezing, chest distress, unable to lie face-up, distending pain in the chest, worse when coughing, edema, sense of heaviness and stabbing pain, unsmooth flow of urine, white and slippery tongue coating, deep and wiry or slippery pulse.
Fluid retention syndrome can be divided into four types according to their locations:
Phlegm-fluid retention (retention in the stomach and intestine); pleural-fluid retention (retention in the chest and hychondrium); thoracic-fluid retention (retention in the chest and the lung); subcutaneous fluid retention (retention in the limbs).
Vomiting or spitting clear water, thin sputum and saliva, sound of water shaking in the stomach, profuse sputum, unable to lie flat, fullness and distending pain in the chest ，slippery tongue coating and wiry pulse.

54. Water Retention Syndrome
Clinical Manifestations
Syndrome Analysis
Focal Points
Edema in the face, limbs or even all over the body, heaviness of the body, or puffiness of the abdomen, unsmooth flow of urine, enlarged tongue with white slippery coating, deep and wiry pulse.
Accumulated water flows over the muscles leads to local or general edema and heaviness of the body. When it accumulates in the abdominal cavity, puffiness and fullness in the abdomen occur. Dysfunction of the urinary bladder results in unsmooth flow of urine. Enlarged tongue with white coating, deep and rapid pulse indicate interior retention of water.
Edema, unsmooth flow of urine, enlarged tongue and white and slippery tongue coating.

55. Phlegm Syndrome Indifference and delirium are due to phlegm retention,
When sputum retains in the lung, cough and panting, and vomiting or spitting sputum occur.
When qi gets obstructed by phlegm,, chest distress may occur.
Wheezing is due to blockage of the qi tract by sputum
When sputum gets stuck in the stomach, disharmony of stomach qi and dysfunction of receiving food,
Nausea and spitting sputum are due to rising of sputum along with adverse rising of stomach qi.
Dizziness results from retention of phlegm in the stomach, which affects yang rise.
Indifference and delirium are due to phlegm retention,
When phlegm accumulates under the skin or in the muscles, local qi and blood flow is impeded leading to scrofula and goiter.
when phlegm is in the limbs, hyperplasia of mammary glands and a sensation of foreign body in the throat will occur
Greasy tongue coating with slippery pulse points to internal obstruction by phlegm

56. Body Fluid Deficiency Syndrome
Dry mouth and throat, a desire to drink water, parched lips, dry nostrils, dry skin without luster, dry and hard stools, red tongue with scanty saliva, thread and rapid pulse.
Deficient body fluids fail to moist and nourish tissues and orifices, leading to dry mouth and throat, parched lips. Deficiency body fluids fail to restrain yang, results in red tongue with scanty saliva, thready and rapid pulse.