Module 4: Pain

Question 1

Aversion to cold, fever, cough, itchy throat. Slight breathlessness, blocked or runny nose with clear watery
discharge, sneezing, occipital headache, body aches.
Tongue: thin white coating.
Pulse: Floating-Tight.
Key symptoms: aversion to cold, sneezing, Floating
pulse.

Answer 1

GIO Ext Invasion of Wind-Cold in the Lung (p. 550)

Question 2

1. Feeling of distension of hypochondrium, chest, epigastrium or abdomen, sighing.
2. Melancholy, depression, moodiness, fluctuation of mental state. ‘feeling wound-up’, feeling of a lump in
   the throat.
3. Irregular periods, distension of breasts before the periods, premenstrual tension and irritability
   Tongue: the body colour may be normal. In severe cases, it may be slightly Red on the sides.
   Pulse: Wiry, especially on the left side.

Answer 2

Liver Qi Stagnation (GIO 503):

Question 3

Irritability, propensity to outbursts of anger, tinnitus, deafness, temporal headache, dizziness, red face and eyes,
thirst. bitter taste, dream-disturbed sleep, constipation
with dry stools, dark-yellow urine, epistaxis, haematemesis, haemoptysis.
Tongue: Red body. redder on the sides, dry yellow
coating.
Pulse: Full-Wiry-Rapid.
Key symptoms: headache, irritability, red face, red eyes, Red tongue with yellow coating.

Answer 3

3. Liver Fire Flaring * (GIO 513):

Question 4

Dizziness, tinnitus. vertigo, poor memory, hardness of hearing, night sweating, dry mouth and throat at night,
lower backache, ache in bones, nocturnal emissions, constipation. dark scanty urine, infertility, premature
ejaculation, tiredness, lassitude, depression, slight anxiety
Tongue: normal coloured without coating.
Pulse: Floating-Empty.
Key symptoms: backache, night sweating.

Answer 4

Kidney Yin Deficiency with Deficiency Heat * (GIO 593)

Question 5

Five-palm heat, a feeling of heat in the evening, malar, flush, menopausal hot !lushes, thirst with a desire to drink
in small sips, pronounced anxiety in the evening, nocturnal emissions with dreams.
Tongue: Red without coating; in severe cases also cracked.
Pulse: Floating-Empty and slightly Rapid.

Answer 5

Deficiency Heat

Question 6

Pain with distention
in the same
location

Sudden onset,
comes and goes,
pain relieved by
passing gas

Answer 6

Distending pain

Qi stagnation

Question 7

Pain with sensation
of being needled or
stabbed

Fixed in location,
sharp in character,
small area

Answer 7

Stabbing

Blood stagnation

Question 8

Severe pain as if the
body is being
twisted

Larger area, a
violent cut or
twisted pain

Answer 8

Colicky

Obstruction of an
excess pathogenic
factor

Question 9

Migrating pain that
moves without
definite location

Migrates without
stable location

Answer 9

Unfixed

Pathogenic wind
attacking the body

Question 10

Pain with pulling
sensation

Radiating pain, with
starting point and
pulling feeling

Answer 10

Retraction

Malnutrition of
tendons

Question 11

Pain feels as if one
is being burned

Heat and burning
sensation at
location with a
preference for cold

Answer 11

Scorching

Pathogenic heat
injuring the
channels

Question 12

Pain feels as if one
is being frozen

Cold sensation at
location of pain,
relieved by warmth

Answer 12

Cold

Pathogenic cold
constricting channel

Question 13

Pain with a
sensation of
heaviness

Heaviness of the
limbs with achy
sensation

Answer 13

Heavy

Pathogenic
dampness in the channel

Question 14

Pain with sensation
of emptiness

Empty and light
feeling with a
preference for
pressure and
warming

Answer 14

Hollow

Deficiency of blood,
essence, yin and
yang

Question 15

Pain lingering and
mild

Tolerable pain that
lingers for along
period of time

Answer 15

Dull

Deficiency of qi,
blood, yin or yang

Question 16

Pain that aches,
accompanied by
weariness

Mild, may be
accompanied by
other pain such as
heavy or dull

Answer 16

Aching

Exterior dampness
or kidney deficiency

Question 17

Etiology of pain

Answer 17

The first is stagnation, which can be causedby zang fu dysfunction, local trauma or wind-cold invasion.
The second is deficiency of qi,blood, body fluids or essence, which will result in a lack of nourishment and nutrition to thetissues of the body.

Question 18

Pain has three basic levels:

Answer 18

• Mild Pain: patient can ignore the sensation
• Moderate Pain: interferes with tasks or concentration
• Severe Pain: interferes with basic needs or requires bedrest

Question 19

Mild pain

Answer 19

patient can ignore the sensation

Question 20

Moderate

Answer 20

interferes with tasks or concentration

Question 21

Severe

Answer 21

interferes with basic needs or requires bedrest

Question 22

Headache is the meeting place of what?

Answer 22

All yang channels and h

Question 23

Headache is the meeting place of what?

Answer 23

All yang channels

Question 24

Headache is the meeting place of what?

Answer 24

All yang channels and houses the brian

Question 25

What happens if pathogenic factors invade the head?

Answer 25

block the clear yang (external), or if stagnation of qi and blood in
endogenous disease blocks the channels (internal) and deprives the brain or nourishment, headache will ensue.

Question 26

3 pathogeneses

Answer 26

1.) Headache that is persistent and severe + chills and fever, cough, seasonal, acute and short
course: excess, exterior: phlegm, cold or blood stasis obstructs the channels or pathogenic
heat disturbs the head
2.) Headache that is persistent and severe + longer duration with excess type pulse image:
excess, interior: phlegm, cold or blood stasis obstructs the channels or pathogenic heat
disturbs the head
3.) Chronic headache, pain is intermittent and mild: deficiency, interior: Qi, blood, essence or
body fluids deficiency fails to nourish the brain and head.

Question 27

Occipital, radiating to nape

Answer 27

Tai Yang

Question 28

Forehead and periocular region

Answer 28

Yang Ming, over thinking

Question 29

Lateral aspect of head

Answer 29

Shaoyang, stresss headache

Question 30

Vertex

Answer 30

Jue Yin, common for xu type

Question 31

Sides of head which radiates to teeth and throat

Answer 31

Shao Yin, Kidney channel xu

Question 32

Headache with heavy sensation and diarrhea

Answer 32

Tai Yin

Question 33

Distending pain is caused by

Answer 33

Qi Stag

Question 34

Stabbing pain is caused by

Answer 34

Blood Stasis

Question 35

Colicky pain is caused by

Answer 35

Obstruction of an
excess pathogenic
factor

Question 36

Unfixed pain is caused by

Answer 36

Pathogenic wind
attacking the body

Question 37

Retraction pain is caused by

Answer 37

Malnutrition of
tendons

Question 38

Scorching

Question 39

Scorching pain is caused by

Answer 39

Pathogenic heat
injuring the
channels

Question 40

Cold

Question 41

Cold pain is caused by

Answer 41

Pathogenic cold
constricting
channels

Question 42

Heavy pain is caused by

Answer 42

Pathogenic
dampness in the
channels

Question 43

Hollow pain is caused by

Answer 43

Deficiency of blood,
essence, yin and
yang

Question 44

Dull pain is caused by

Answer 44

Deficiency of qi,
blood, yin or yang

Question 45

Aching pain is caused by

Question 46

Aching pain is caused by

Answer 46

Exterior dampness
or kidney deficiency

Question 47

Aching pain is caused by

Answer 47

Exterior dampness
or kidney deficiency

Question 48

Headache that is persistent and severe + chills and fever, cough, seasonal, acute and short course

Answer 48

Excess exterior: phlegm, cold or blood stasis obstructs the channels or pathogenic heat disturbs the head

Question 49

Headache that is persistent and severe + longer duration with excess type pulse image

Answer 49

Excess interior: phlegm, cold or blood stasis obstructs the channels or pathogenic heat disturbs the head

Question 50

Chronic headache, pain is intermittent and mild

Answer 50

deficiency, interior
Qi, blood, essence or
body fluids deficiency fails to nourish the brain and head.

Question 51

Aching pain is caused by

Answer 51

Exterior dampness
or kidney deficiency

Question 51

Chronic headache, pain is intermittent and mild

Answer 51

deficiency, interior
Qi, blood, essence or
body fluids deficiency fails to nourish the brain and head.

Question 51

Headache temporal, eyes, or lateral side of head, dizziness, tinnitus, deafness, blurred vision, dry mouth and throat, insomnia, irritability, feeling worked up, propensity to outbursts, stiff neck
Pulse: wiry

Answer 51

Liver yang rising

Question 52

Aching pain is caused by

Answer 52

Exterior dampness
or kidney deficiency

Question 53

dizziness, numbness or tingling in limbs, insomnia, blurred vision, floaters, diminished night vision, scanty menstruation, dull/pale complexion without luster, pale lips, muscle weakness, cramps, brittle nails, dry hair and skin, depression, aimlessness
Pulse: choppy or fine

Answer 53

Liver Blood Xu

Question 54

fine tremor, facial tic, dizziness, blurred vision, numbness or tingling or limbs, poor memory, insomnia, scant period
Tongue: pale, thin
Pulse: wiry, fine

Answer 54

Liver Blood Xu generating wind

Question 55

Poor appetite, slight abdominal distention after eating, tiredness, lassitude, desire to lie down, pale complexion, weak limbs, loose stool
Tongue: pale
Pulse: empty

Answer 55

Spleen Qi Xu/ Qu Xu

Question 56

Poor appetite, slight abdominal distention after eating, tiredness, lassitude, desire to lie curled up, pale complexion, weakness in limbs, loose stool, feeling cold, cold limbs, edema.

Tongue: pale and wet
Pulse: weak-deep

Answer 56

Spleen Yang Xu/ Yang Xu

Question 57

Chronic cough, sticky white sputum, easy to expectorate, white pasty complexion, phlegm in throat, feeling of chest oppression, SOB, dislike lying down, wheezing, nausea, heaviness, fuzziness, dizziness
Tongue: Swollen with sticky white coat
Pulse: slippery/ soggy

Answer 57

Lung Phlegm Damp/ Phlegm Turbidity

Question 58

dark complexion, purple lips, boring pain, fixed and stabbing, abdominal masses, purple nails, bleeding with dark blood clots

Tongue: purple
Pulse: wiry, firm, choppy

Answer 58

Liver Blood Stasis/ Blood Stasis

Question 59

Headache that is persistent and severe + chills and fever, cough, seasonal, acute and short course

Answer 59

excess, exterior

Question 60

Headache that is persistent and severe + longer duration with excess type pulse image

Answer 60

excess, interior

Question 61

Chronic headache, pain is intermittent and mild

Answer 61

deficiency, interior