Head and Face

Question 1

head distention and pain, usually caused by anger, accompanied by fever, dry mouth, bitter taste, bulging of superficial veins over forehead, red face or red painful swollen eyes, agitation, insomnia, even deafness

t: red w/ yellow coating
p: wiry or rapid

Answer 1

LV fire blazing

pathogenesis: because of anger, repressed emotions, or excessive consumption of spicy foods, LV qi is stagnated and turned into fire; LV fire flares upward to disturb the clear mind causing head distention and headache

Question 2

head distending discomfort w/ feeling of heaviness and muzziness as if being wrapped by a piece of cloth, accompanied by chest oppression, epigastric fullness, abdominal distending pain, vomiting, no desire to eat, heaviness of body and limbs

t: white greasy coating
p: soggy or slippery

Answer 2

dampness obstruction and qi stagnation

pathogenesis: living in a wet environment for a long time or going out in the rain; dampness invades and blocks the meridians; non-ascending of clear yang and non-descending of turbid yin cause head distention

Question 3

head distending discomfort together w/ headache, aggravated by heat, accompanied by fever, aversion to wind, red face, sore and swollen throat, dry mouth and thirst

t: red tip w/ thin yellow coating
p: floating-rapid

Answer 3

wind heat attack

pathogenesis: yang meridians attacked by invading wind-heat evil, resulting in head distention

Question 4

vertigo w/ distending headache, aggravated by anger, heavy head, light feet, irritability, restlessness, insomnia w/ lots of dreams, dry mouth, bitter taste

t: red w/ yellow coating
p: wiry-rapid

Answer 4

LV yang hyperactivity

pathogenesis: because of repressed emotions and anger, LV qi is stagnated and transforms into fire; fire injures LV yin, resulting in hyperactive LY yang flaring upward to disturb clear mind, causing vertigo and head distention

Question 5

vertigo w/ blurred vision, aggravated by overthinking, sallow lustreless facial complexion, pale lips, palpitations, fatigue, breathlessness, weakness, insomnia, poor appetite, loose stool

t: pale
p: thready-weak

Answer 5

HT-SP qi-blood xu

pathogenesis: insufficient qi and blood to nourish the head and eyes leads to vertigo and blurred vision

Question 6

vertigo w/ tinnitus, blurred vision, listlessness, mental fatigue, poor memory, premature senility, hair loss, sore and weak lower back and knees, seminal emission, impotence

t: thin, pale red
p: deep-thin; thready-weak in Chi position

Answer 6

KD essence xu

pathogenesis: brain is the sea of marrow, KD is the root of pre-heaven essence; KD stores essence and produces marrow; brain is not fully filled in case of KD essence xu

Question 7

dizziness w/ heavy head sensation, fullness of chest and epigastrium, nausea, vomiting, no desire to eat or drink, heaviness of body and limbs, may have somnolence or strong desire to sleep

t: white greasy coating
p: soggy-slippery or wiry-slippery

Answer 7

dampness and phlegm obstructing middle jiao

pathogenesis: due to obstruction of m. jiao, clear yang cannot ascend and turbid yin can not descend, leading to vertigo, somnolence, and heavy head feeling

Question 8

dizziness, vertigo, 5 centre heat, agitation, insomnia, sore and weak lower back and knees, may have tremor or numbness of limbs

t: red w/ little coating
p: thready-rapid

Answer 8

LV-KD yin xu

pathogenesis: due to hyperactive LV yang and deficient fire rising to disturb the mind

Question 9

dizziness, tinnitus, vertigo, headache, dull expression, forgetfulness, retarded movement, disturbed sleep, fecal and urinary incontinence

t: pale w/ thin white coating
p: deep-thready

Answer 9

KD essence xu

pathogenesis: due to insufficient marrow production to fill up the brain, because of essence deficiency in old-age, over-worked patients

Question 10

dizziness, fatigue, weakness, lustreless facial complexion, dull sluggish spirit, flaccid limbs

t: pale dull w/ stasis patches, thin white coating
p: thready-soggy

Answer 10

qi xu and blood stagnation

pathogenesis: usually seen in patients w/ chronic illness, severe blood loss, external head injury

Question 11

headache w/ vertigo located at temple and vertex, aggravated by anger, irritability, tinnitus, insomnia, hypochondriac pain, dry mouth, red face

t: red w/ little coating
p: wiry or thready-rapid

Answer 11

LV yang hyperactivity

pathogenesis: LV fire from suppressed emotions or LV yang due to yin deficiency disturbs the clear orifice, leading to headache w/ vertigo; usually aggravated by anger

Question 12

headache w/ hollow pain, aggravated by over-working, fatigue, weakness, poor appetite, breathlessness, loose stool

t: thin white coating
p: empty-forceless

Answer 12

SP qi xu

pathogenesis: non-ascending of clear yang and non-descending of turbid yin due to qi deficiency are not good for the clear orifice, leading to persisting headache

Question 13

vague headache w/ vertigo, palpitations, insomnia, dry eyes, blurred vision, white facial complexion, pale lips

t: pale
p: thready-weak

Answer 13

yin blood xu

pathogenesis: head lacks blood nourishment, leading to vague headache w/ vertigo

Question 14

chronic stabbing headache w/ fixed location, maybe hx of external head injury

t: purple
p: thready or thready-soggy

Answer 14

blood stasis obstructing head

pathogenesis: stagnated blood blocking the meridian causes pain

Question 15

headache w/ drowsiness, vertigo, chest oppression, epigastric fullness, vomiting of phlegm and saliva, poor appetite

t: white greasy coating
p: wiry-slippery

Answer 15

turbid phlegm obstructing head

pathogenesis: SP-ST dysfunction due to improper eating habits leads to phlegm production; turbid phlegm ascends to mist clear orifice, causing drowsiness and dull headache

Question 16

distending headache w/ vertigo, dry eyes, tinnitus, irritability, disturbed sleep, hypochondriac pain, dry mouth, red face

t: red w/ little coating
p: wiry or thready-rapid

Answer 16

LV yang hyperactivity

pathogenesis: because of repressed emotions, LV qi is stagnated and transformed into fire; fire injured LV yin; resulting hyperactive LV yang flares upward to disturb clear mind causing migraine headache that is aggravated by emotional fluctuation

Question 17

chronic headache of fixed location and stabbing in nature, forgetfulness, palpitations, irregular menstruation

t: dull purple, purple patches
p: wiry or deep-soggy

Answer 17

blood stagnation affecting head

pathogenesis: blood stasis usually result of qi stagnation; with time, stasis enters and blocks meridian; patient may have hx of concussion, chronic illness, surgery

Question 18

dull headache w/ drowsiness, fullness of chest and epigastrium, stomach pain likes warmth, vomiting out saliva and phlegm, reversal coldness of four limbs, poor appetite

t: white greasy coating
p: wiry-slippery

Answer 18

phlegm-fluid obstruction

pathogenesis: long-standing SP yang dysfunction leads to dampness and fluid retention; phlegm-fluid blocks meridian and impedes ascending of clear yang, causing drowsiness and dull headache

Question 19

more tingling than numbness over scalp, lustreless facial complexion, dizziness, palpitations, pale lips, pale nails

t: pale w/ thin coating
p: thready-forceless

Answer 19

blood xu

pathogenesis: skin lacks nourishment due to blood deficiency

Question 20

more numbness than tingling over scalp, vertigo, tiredness of body and limbs, fullness of chest and epigastrium, vomiting out saliva and phlegm

t: thick greasy coating
p: wiry-slippery

Answer 20

dampness and phlegm obstructing meridian

pathogenesis: qi and blood circulation in meridians impeded by damp and phlegm obstruction, thus skin lacking nourishment

Question 21

head drooping w/ sallow facial complexion, emaciation, fatigue, weakness of limbs, breathlessness, unwilling to talk, poor appetite, loose stool

t: pale puffy w/ teeth marks
p: thready-forceless

Answer 21

SP qi depletion

pathogenesis: w/ SP qi deficiency, inability of clear yang to ascend leads to head drooping

Question 22

head drooping w/ tinnitus, deafness, soreness and weakness of lower back and knees, difficulty in standing and walking, unstable gait, seminal emission, impotence

t: pale w/ little coating
p: deep-minute

Answer 22

marrow depletion

pathogenesis: brain is the sea of marrow; marrow is closely related to KD as KD essence is origin of marrow; brain is not fully filled due to KD deficiency, leading to head drooping and deafness

Question 23

involuntary head shaking w/ dizziness, body trunk and limb tremors, red face, red eyes, bitter taste, dry throat

t: red w/ yellow coating
p: wiry-rapid

Answer 23

LV yang rising generating wind

pathogenesis: LV related to wood and wind, wind is moving and shaking; head will shake involuntarily in case of internal wind stirring due to LV yang rising
ex. Parkinson’s

Question 24

involuntary head movement, agitation, hot feeling, night sweating, insomnia, low spirit and weakness; usually occurs at late stage of febrile disease

t: red w/ little coating
p: thready-rapid

Answer 24

LV yin xu stirring wind

pathogenesis: in a yin deficient constitution, LV lacks nourishment from LV yin; internal wind due to LV yin xu harasses upward, causing head shaking;
not enough fluid to nourish tendons;
water unable to nourish wood

Question 25

sometimes all hair turns white, some may have thinning of hair, accompanied by vertigo, blurred vision, tinnitus, decreased hearing power, sore weak lower back and knees, nocturia t: dull red p: thready-weak

Answer 25

LV-KD xu pathogenesis: KD stores essence, hair relies on nourishment of KD essence to grow; LV stores blood, hair is an extension of blood; hair lacks nourishment in case of KD essence xu and LV blood xu, resulting in early greying of hair; usually occurs in middle aged people

Question 26

greying of hair w/ white dandruff falling off, emaciation, palpitations, agitation, insomnia, dreaming a lot, declining memory t: red p: thready-rapid

Answer 26

Ying blood deficiency heat (HT blood xu w/ deficient heat) pathogenesis: pensiveness injures HT blood, causing blood xu w/ deficient heat formation; hair lacks nourishment as blood is burnt by heat; situation usually occurs in younger people

Question 27

sudden greying of hair in short period of time, suppressed emotions, oppression and fullness of chest and hypochondrium, frequent sighing, irritability, no desire to eat or drink t: red p: wiry-rapid

Answer 27

LV qi stagnation pathogenesis: disruption of smooth qi flow in LV leads to qi stagnation which transforms into heat; hair lacks nourishment as yin blood is burnt by heat, causing greying hair in short period of time

Question 28

paroxysmal attack of intolerable burning or sharp facial pain; there may be a trigger area at the side of the nose or lips; accidental touching can cause sudden intense pain, pain occurs at lower part of face mostly, usually unilateral and seldom involves both sides, aggravated by heat, alleviated by cold, face turns red when in pain, together w/ sweating, fever, dry mouth, dark urine t: red w/ dry yellow coating p: wiry-rapid in case of phlegm-fire obstruction, there will be dizziness, chest oppression, numbness and tingling of limbs t: red w/ yellow greasy coating p: slippery-rapid

Answer 28

meridian obstruction due to phlegm carried by wind-heat pathogenesis: SP deficient constitution w/ phlegm dampness accumulation; attacked by wind-cold or wind-heat evils; phlegm carried by wind disrupts meridians; blockage of meridians causes pain

Question 29

mostly sudden onset of spasmodic facial pain which is severe and intolerable, pain aggravated by cold, alleviated by warmth, face turns pale when in pain t: pale w/ thin white coating p: tight in case of cold-phlegm obstruction, there will be puffy face and head heaviness as if wrapped by a cloth t: pale, puffy w/ thick white greasy coating p: soggy-slippery

Answer 29

wind-cold and phlegm obstructing meridian pathogenesis: SP deficient constitution w/ phlegm dampness accumulation; attacked by wind-cold or wind-heat evils; phlegm carried by wind disrupts meridians; blockage of meridians causes pain

Question 30

sudden onset of burning facial pain due to emotions, aggravated by heat, bitter mouth taste, dry mouth and throat, anger, dark yellow urine, dry stools t: red w/ dry yellow coating p: wiry-rapid

Answer 30

LV qi stagnation w/ fire transformation pathogenesis: LV fire blazing upward

Question 31

chronic facial pain, on/off, duration of pain lasts longer, pain is stabbing in nature w/ fixed location, dull complexion, dry and scaly skin, aversion to wind, spontaneous sweating, weak voice, unwilling to talk, facial cramping t: pale w/ pale purple spots p: deep-thready-weak

Answer 31

qi xu and blood stasis pathogenesis: 1. chronic illness causing insufficient qi and blood; not enough qi to move blood 2. evil qi entering luo collaterals, leading to blood stasis

Question 32

puffy face w/ pale-white complexion, breathlessness, dyspnea on exertion, weak voice, cold feeling, aversion to wind, spontaneous sweating, unstoppable chronic cough t: pale w/ thin white coating p: weak-forceless

Answer 32

LU qi xu pathogenesis: chronic cough injures LU D+D function

Question 33

puffy face w/ sallow yellow complexion, subjective feeling of a swollen face, lassitude, fatigue, cold limbs, poor appetite, abdominal distention, loose stool, wasting muscle mass t: pale, tender w/ teeth marks w/ thin white coating p: weak

Answer 33

SP yang xu pathogenesis: developed from SP qi xu; SP T+T function impaired, so clear yang cannot ascend, leading to puffy face

Question 34

dirty complexion, dry nose and mouth, dry, red, painful eyes, dry and painful throat, red and swollen gums t: red w/ yellow coating p: thready-rapid

Answer 34

dryness disrupting clear orifices pathogenesis: dryness and heat attacking upper jiao, body fluid cannot nourish orifices

Question 35

dirty complexion, painful and swollen gums, foul breath, thirst w/ desire to drink cold water, epigastric burning pain, constant hunger, constipation; might have rosacea or acne around nose t: red w/ yellow coating p: slippery-rapid

Answer 35

ST heat blazing upward

Question 36

dirty complexion, dizziness, tinnitus, dry mouth, dry throat, five centre heat, soreness of knees and lower back, emaciation t: red w/ little coating p: thready-wiry-rapid

Answer 36

LV-KD yin xu pathogenesis: deficient fluids unable to nourish skin

Question 37

facial twitching, dizziness, tinnitus, agitation or impatience or even crying and screaming t: red w/ thin white coating p: wiry-moderate

Answer 37

LV qi stagnation pathogenesis: chronic, slow onset, on/off, mild twitching

Question 38

pale complexion, face, nails, blurred/decreased vision, dizziness, facial twitching t: pale w/ scanty coating p: wiry-thready-forceless

Answer 38

LV blood xu pathogenesis: chronic, slow onset, on/off, mild twitching; long term LV qi stagnation consumes blood; blood unable to nourish, resulting in twitching

Question 39

sudden onset of facial twitching, accompanied by numbness, headache, stuffy nose, aversion to wind and cold, tearing t: pale red w/ thin white coating p: floating

Answer 39

wind attacking collaterals pathogenesis: direct wind attack

Question 40

facial twitching w/ dizziness, twitching aggravated by anger, headache t: dark red w/ thin yellow slightly dry coating p: wiry-thready-forceful; weak at deep level

Answer 40

LV wind stirring inside pathogenesis: due to LV yang hyperactivity

Question 41

facial twitching w/ numbness, accompanied by facial puffiness, dizziness, drooling at angle of mouth, dry mouth, no desire to drink t: puffy w/ thin white greasy coating p: wiry-slippery

Answer 41

wind and phlegm attacking collaterals pathogenesis: phlegm body type gets wind attack; or wind and phlegm already lingering in collaterals, resulting in twitching and numbness

Question 42

facial deviation usually triggered by emotional disturbance, sighing, hypochondriac distention, no desire to eat or drink, depression, melancholy, propensity to crying t: thin white coating p: wiry

Answer 42

LV qi stagnation

Question 43

facial deviation, slack facial muscles, drooping eyelids, breathlessness, unwilling to talk, stiff hands and legs t: pale, tender w/ thin white coating p: thready-forceless

Answer 43

qi-blood xu generating wind

Question 44

sudden onset of facial deviation w/ weird feeling over face, accompanied by aversion to wind, fever, headache, stuffy nose, stiff and tight neck t: thin white coating p: floating

Answer 44

exterior wind attack

Question 45

sudden onset of facial deviation, accompanied by red face, numbness or tingling of limbs, distending pain around ears, severe dizziness, heavy-headedness w/ unstable light sensation of legs t: dull, red w/ yellow or little coating, lacking fluid p: wiry-rapid-forceful

Answer 45

LV wind stirring inside

Question 46

facial deviation, numbness and tingling over facial muscles, slurred speech, phlegm sound in throat, stiff sensation of tongue t: white greasy coating p: wiry-slippery or wiry-moderate

Answer 46

wind and phlegm attacking collaterals

Question 47

coldness at forehead and vertex that may connect w/ back vertebral column, varying in intensity, can be relieved by warmth, cannot be cured, persisting, pale complexion w/o lustre, cold limbs t: pale w/ white coating p: deep-thready or deep

Answer 47

DU meridian deficient cold pathogenesis: due to severe KD yang xu, over-taxation, chronic illness, or damp-cold invasion; DU meridian lacks nourishment b/c of blood and essence xu, resulting in deficiency cold

Question 48

head coldness feeling accompanied by vertex headache, desire to be covered, dull cyanotic facial complexion, reversal coldness of four limbs, vomiting out clear saliva and frothy sputum t: white coating p: deep-tight

Answer 48

Jue Yin direct cold attack pathogenesis: cold evil reaches jue yin meridian either by direct invasion or from the exterior; head symptoms b/c jue yin meridian reaches vertex; vomiting saliva b/c of cold turbidity attacking ST

Question 49

head coldness feeling w/ head and nape stiffness and pain, aversion to cold, fever, body ache t: pink, thin coating p: floating-tight

Answer 49

Tai Yang wind-cold attack