TCM internal medicine 2

Causes of Depression: Spleen + lung qi deficiency, Tongue and Pulse

-Tongue: Pale body with white tongue coating -Pulse: thin and weak pulse

Causes of Depression: Kidney yin + heart yin xu note on etiology

-most commonly seen in women, since men do not have a uterus whose channels attach with the kidney and heart

Causes of Depression: Spleen and Kidney yang xu, S/S Part 2

S/S: Kidney yang deficiency WITH obvious water retention -Scanty urine, difficult urination, edema worse below the lower back (Loss of the function of opening [to urinate] that causes water retention) -abdominal fullness (water retention blocks qi movement) -Heart palpitation, cough, asthma, shortness of breath (water retention insults the LU and HT [affects LU and HT function])

Causes of Depression: Kidney yin + Heart yin xu, S/S part 2

S/S: -seminal emission (heat disturbs the house of the essence) -Less menstrual flow or amenorrhea (yin, essence and blood deficiency signs) -OR too much menstrual blood flow or spotting (heat makes the blood move too fast)

Causes of Depression: Liver Qi Stagnation S/S

S/S: -Depression, chest and hypochondriac pain, sighing often, uptight/tense. -Menses: irregular, dysmenorrhea, Amenorrhea (LV qi stagnation effects blood movement -Easily angered (liver qi is not smooth, hence affects emotion) -Plum Pit, Goiter, Cyst or other masses (LV qi blocking with phlegm in the throat, abdomen or other places)

Causes of Depression: Spleen + lung qi deficiency, S/S

S/S: (common in conjunction, both are taiyin) -LU xu signs: Difficulty breathing, cough [weak], coughs up phlegm [profuse, clear and white], asthma, chest fullness -SP xu signs: Weak limbs, loose stool or diarrhea -SP xu signs: Low appetite, abdominal fullness, puffy face and edema in severe cases (SP qi xu causes dampness accumulation and overflow to the skin).

Causes of Depression: Lung + Heart Qi stagnation

S/S: Heart and Lung Qi Stagnation -Constant weeping -Constipation (lung descends qi to the LI, impaired lung function means the LI has less qi to move stools) -Palpitations -chest distention (lung is container of fluids, might also cause plum pit qi) -Plum pit qi (from heart and/or lung qi stagnation) -shortness of breath -hyperkyphosis -protracted shoulders, hunched

Causes of Depression: Yin deficiency manifests in two main ways:

-Failure to nourish and moisten (dry tongue and throat, kidney yin xu tinnitus, skinny figure, dizziness) -Failure to restrain heat (yin xu signs)

Kidney 7 actions

Actions: -Benefits the Kidneys (tonifies kidney yang) -Regulates the water passages and treats oedema (foremost point for strengthening kidneys function of dominating body fluids and regulating urination) -regulates sweating (able to induce sweating for excess, stop sweating for qi deficient, and treat night sweating) -drains damp and clears damp-heat -strengthens lumbar spine

Causes of Depression: Phlegm dampness w/ qi stag, S/S

Actions: -Characterized by a feeling of being 'weighed down' with passive gloominess. -Profuse white phlegm, easy to expectorate (dampness makes phlegm easier to expectorate) -Body heaviness and drowsiness (signs of dampness, and clear yang does not rise) -Congested chest (phlegm and dampness block the upper jiao Qi movement) -Diminished appetite, nausea or vomiting (phlegm and dampness disturb the middle jiao qi movement)

Governing Vessel 4 actions

Actions: -Clear heat (specifically indicated for draining fire, shares emphasis with the back shu of the heart BL15) -regulates the GV -tonifies the kidneys (treats interior or exterior, excess or deficiency patterns) -benefits the lumbar spine

Liver 8 actions

Actions: -Clears damp heat from the lower jiao (all three leg he-sea points are also water points and clear damp-heat) -Benefits the genitals -invigorates blood and benefits the uterus (the liver stores the blood which flows to the CV and penetrating vessels, then to the uterus to form menstrual blood) -Nourishes blood and yin (As the water point, it links the liver to its mother, the kidneys. Therefore, it generates water to submerge wood and nourishes liver yin and blood)

Stomach 36 actions

Actions: -Harmonises the stomach -fortifies spleen and resolves dampness (resolves dampness by fortifying spleen) -supports the correct qi and fosters original qi -tonifies qi and nourishes blood and yin (by fortifying the spleens actions of extracting Gu Qi, a component of ying qi) -clears fire and calms the spirit

Heart 7 actions

Actions: -Regulates and tonifies the heart (Can tonify both yin and yang, qi and blood) -calms the spirit (the foremost acupoint for calming the spirit)

Large Intestine 4 actions

Actions: -Regulates defensive qi and adjusts sweating -Expels wind and releases exterior -Regulates the face, eyes, nose, mouth and ears (the single most important acupuncture point for treating disorders of the head and sense organs!!!!!!!) -induces labor -restores yang

Lung 9 actions

Actions: -Tonifies the Lung and transforms phlegm (LU9 is the mother point, shu stream, and yuan source -Promotes the descending function of the lung -Regulates and harmonises the one hundred vessels (the circulation of blood is dependent on gathering qi, formed from the combination of Da and Gu qi) -activates the channel and alleviates pain *****(LU9 is always a good point to use in conjunction with ST36 because it promotes the lungs function of extracting Da qi, which is combined with Gu qi extracted from the spleen to create ying, the material substance from which qi and blood is based)

Kidney 6 actions

Actions: -benefits the throat -nourishes the kidneys and clear deficiency heat (One of kidney 6's main functions is to nourish yin and clear deficiency heat) -regulates yin motility vessel -calms the spirit -regulates the lower jiao

Spleen 6 actions

Actions: -resolve dampness -invigorate blood (promote circulation, cools blood as well) -harmonizes liver and tonifies kidneys (spreads liver qi as well) -tonifies spleen and stomach -primary point for disorders of genitals (spleen sinew channel connects to the genitals) -regulates menstruation and induces labor -calms the spirit

Note about etiology of blood stagnation

Etiology -Blood stagnation inside the blood vessel =qi deficiency cannot push the blood =Cold slows the circulation down =Heat makes the blood thicker and sticky -Blood stagnation outside of the blood vessel =Bleeding causes blood to come out of the vessel. The escaped blood cannot move right away, builds up, and gets blocked in some area

Causes of Depression: Liver Qi Constraint with heat, S/S Part 2

S/S: -Dream disturbed sleep, restlessness, insomnia, easily angered, mania if severe (LV fire disturbs the shen) -Vomiting or coughing up blood, nose or gum bleeding (Fire makes blood move faster and fire injures the blood vessels) -constipation, yellow urine (heat injures the body fluids. Body fluid xu causes constipation, yellow urine is a sign of heat)

Causes of Depression: Liver Yin Xu, S/S

S/S: -Dull hypochondriac pain, dry eyes, night blindness, severe dizziness, less menstrual flow -Yin deficiency heat signs (5 palms heat, insomnia, afternoon tidal fever, malar flush, dry mouth and throat)

Causes of Depression: Blood Stasis, S/S

S/S: -Fixed pain that is sharp and stabbing (Pain could be anywhere) -Worse at night (Blood belongs to yin) -Dizziness, blurred vision, HT palpitations, insomnia (if there is blood deficiency with Blood Stasis) -Amenorrhea (if blood stasis in the uterus) -

Causes of Depression: HT blood + SP qi xu, S/S Part 1

S/S: -General qi xu signs (fatigue, low voice, does not want to talk much) -Loose stool or diarrhea (transforming and transporting function hindered) -Weak limbs (SP xu)

Causes of Depression: Liver Qi Constraint with heat, S/S Part 1

S/S: -Headache, dizziness, ringing ears, red eyes and face and ears (Liver fire flares up to the head) -Hypochondriac pain with burning feeling (burning = fire) -Bitter taste in the mouth, dry throat (Liver fire causes gallbladder qi to rebel, hence bitter taste)

Causes of Depression: Phlegm Heat Misting the Heart Orifices, S/S

S/S: -Heavy head -Restless sleep -Excessively vivid dreams (The hun is disturbed by phlegm)

Causes of Depression HT blood + SP qi xu Part 2

S/S: -Pale or yellow dry face, pale lips, dizziness, blurred vision, (Blood xu signs, blood isn't properly nourishing the head, face, and eyes) -Palpitations, poor memory, insomnia, dream disturbed sleep (symptoms shared by both HT blood and HT yin xu. In relation to blood xu, you get palpitations because the heart lacks blood to nourish and insomnia because the shen has no house [blood is the house of the shen]) -Brooding/fretting (OCD)

Causes of Depression: Kidney yin + Heart yin xu, S/S Part 1

S/S: -Palpitations, poor memory, insomnia, dream disturbed sleep (symptoms shared by both HT blood and HT yin xu) -General yin xu signs (night sweats, 5 palm heat, afternoon fever, insomnia) -ringing in the ears, dizziness, poor vision, skinny figure, dry throat and tongue (kidney yin xu signs)

Causes of Depression: Heart Yang Xu, S/S

S/S: -Palpitations, shortness of breath, symptoms worsen after exertion (Both heart qi and yang deficiency signs) -Cold limbs, aversion to cold, prefers warm drinks, likes to curl up (Yang deficiency signs)

Causes of Depression: Spleen and Kidney yang xu, S/S Part 1

S/S: Kidney yang deficiency without obvious water retension ***** no drive or will power -Pale face, cold limbs, low energy (general yang deficiency signs) -Lower back and knees are sore and cold (lower back is the house of the kidney. Deficient kidneys cannot support and warm the bones in the lower back and knees). -Impotence, infertility (Kidney yang controls sexual energy and reproduction)

Causes of Depression: Spleen and Kidney yang xu, S/S Part 3

S/S: Spleen yang deficiency -Diminished appetite, abdominal fullness, loose stool, or diarrhea (SP qi xu signs) -abdominal pain that is decreased by warmth, prefers warm foods, drinks and environment, cold limbs (preference for warmth and cold limbs are clear yang xu signs) -Edema, difficult urination, or leukorrhea (clear, large volume vaginal discharge (SP yang and qi xu signs, dampness accumulation and flows downward or flows to the skin[edema])

Causes of Depression: Blood Stasis, T/P and points

T/P: Invigorate Blood Points: -SP10 + BL17 (Always go to points for blood stasis) -SP6 (key point for invigorating blood)

Causes of Depression: Liver Qi Stagnation T/P and points

T/P: Move Liver Qi Points: (reduce all points, stagnation is excess) -LV3 (spreads LV qi) -LV14 (front mu of LV, spreads LV qi) -GB34 (Spreads LV qi) -SP6

General Depression (T/P, points)

T/P: Move stagnation, relieve depression Points: -PC6 (go to for depression, luo connecting) -Du20 (connects with the brain) -LI4 (Clears the consciousness, command point for face and HEAD). -Du24/GB13/ST8 (all .5 cun posterior of hairline, all calm the shen)

Causes of Depression: HT blood and SP qi xu, T/P and pulse

T/P: Nourish heart blood and tonify spleen qi Points: -SP6 + ST36 (always use for SP qi xu) -SP3 (tonifies spleen) -UB20 (back shu of spleen, tonifies spleen yang and qi) -4 flowers (BL17+BL19+BL43+huanmen) -HT7 (essential point for tonifying heart qi and calming shen)

Causes of Depression: Kidney yin + Heart yin xu, T/P and points

T/P: Nourish kidney and heart yin Points: -Kidney 6 (nourishes kidney yin and clears deficiency heat) -Heart 6 (nourishes heart yin) -Kidney 3 ( Principle point for treating kidney yin or yang deficiency, nourishes kidney yin as well as liver and heart yin)

Causes of Depression: Liver yin xu, T/P and points

T/P: Nourish liver yin and blood Points: -LV 8 (Nourishes blood and yin) -ST36 (Nourishes blood and yin by virtue of fortifying the spleens function of T+T) -SP6 (Nourishes yin) -KD6(Nourishes yin and clears deficiency heat)

Causes of Depression: Lung + Heart Qi Stagnation, T/P and points

T/P: Open chest, move lung + heart Qi Points: -Ren 17 (unbinds chest) -LU3 (clears lung heat, descends lung qi, calms corporeal soul) -HT 5 (Strong point for calming the shen) -Small intestine 4 (host guest with HT5)

Causes of Depression: Liver Qi Constraint with heat, T/P and points

T/P: Sooth liver, clear heat Points: -Liver 2 (Fire point, clears liver heat, spreads liver qi) -Liver 3 (Subdues LV yang, spreads liver qi) -Liver 5+6 (Both spread liver qi, LV5 is luo = shen issues from heat) -GB43 (clears heat from head, ears and eyes)

Causes of Depression: Spleen + lungs qi deficiency, T/P and points

T/P: Tonify lung + spleen qi Points: -LU1 (Meeting point of the lung and spleen, front mu of lung) -ST36 (tonifies spleen function of T+T, resolves dampness, enhances function of extracting gu qi) -SP6 (tonifies spleen qi, resolves dampness) -LU9 (Tonifies lung qi, promotes descending function of lung)

Causes of Depression: Phlegm dampness w/ qi stag, T/P and points

T/P: Transform phlegm and tonify spleen qi Points: -ST40 (foremost point to resolve phlegm) -SP9 (Regulates spleen and resolves dampness, opens and moves the water passages) -SP3 (Tonifies spleen qi and resolves dampness) -Ren12 (Treats all diseases and symptoms of the stomach and spleen)

Causes of Depression: Heart Yang Xu, T/P and points

T/P: Warm heart yang Points: ***Warming kidney yang warms all yang of the body -CV4 (warms kidney yang) -CV6 (Warms kidney yang) Moxa all three of these points -CV8 (Warms yang) -HT7(warms yang)

Causes of Depression: Spleen and kidney yang xu, T/P and points

T/P: Warm spleen and kidney yang Points: -Moxa CV 4,6,8 ( 4+6 warm kidney yang and 8 warms all warm, but 4+6 warm all yang as well by virtue of warming kidney yang, the root of all the bodies yang) -DU4 (mingmen) -BL 23 (Warms kidney yang) -KD7 (tonifies kidney yang)

Causes of Depression: Phlegm Heat Misting the Heart Orifices, T/P and points

T/P:Transform phlegm, clear heat, open orifices Points: -ST40 (transform phlegm, especially in the lower jiao. luo connecting point to calm shen) -PC5 (clear

Causes of Depression: HT blood + SP qi xu, Tongue and pulse

Tongue: Pale Pulse: Thin, weak

Causes of Depression: Spleen and Kidney yang xu, Tongue and pulse

Tongue: Pale with white tongue coating that is wet/slippery. The tongue will be swollen as well, because of the accumulation of body fluids in the tongue itself Pulse: Weak, slow, maybe deep, weaker in the Chi position.

Causes of Depression: Heart Yang Xu, Tongue and pulse

Tongue: Pale, swollen sides, wet Pulse: Thin and weak, or knotted, or intermittent pulse

Causes of Depression: Blood Stasis, Tongue and Pulse

Tongue: Purple tongue body, purple spots Pulse: Choppy

Causes of Depression: Phlegm Heat Misting the Heart Orifices, Tongue and Pulse

Tongue: Red + swollen, red with thick yellow coat

Causes of Depression: Liver Qi Constraint with heat, Tongue and Pulse

Tongue: Red sides, corset tongue (constricted), possibly yellow and dry tongue coat. Pulse: Wiry, rapid

Causes of Depression: Liver Qi Stagnation Tongue and Pulse

Tongue: Red sides, red edges, no coating on the sides Pulse: Wiry

Causes of Depression: Kidney yin + Heart yin xu, Tongue and Pulse

Tongue: Red, no coat Pulse: thin, rapid, floating

Causes of Depression: Liver yin xu, Tongue and Pulse

Tongue: Red, peeled or no coat Pulse: Rapid, thin, wiry, floating (if accompanied with LV yang rising)

Causes of Depression: Phlegm dampness w/ qi stag, Tongue and Pulse

Tongue: Swollen, thick and greasy coat Pulse: Slippery

Causes of Depression: Lung + Heart Qi Stagnation, Tongue and Pulse

Tongue: bulbous tip or red tip (stagnation leads to heat), could also be pale and swollen on the anterior portion Pulse: Full/Forceful in Cun position (left wrist)