acupractice seminars the clinical fundamentals of chinese ...€¦ · 10/23/16 1 acupractice...

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AcuPractice Seminars

The Clinical Fundamentals of Chinese Medicine

AcuPractice Seminars Complete Programs, Classroom Seminars, Online Classes: Online CE.com (ChiroCredit.com) Hands-On Intensive Training

Classroom Protocols and Expectations

Lecture: University of Bridgeport CCEs Hands-on Practice Labs Non-accredited

State Laws

© Dr. Jim Ventresca 2015 2

Eastern Paradigm

•  Ancient Yet Living Medicine •  Nature’s Language •  Macrocosm reflected in the Microcosm •  Confucian Relationships

•  Family / Society


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East vs. West

•  Holistic Western Paradigm

•  Non-Reductionist Holistic Eastern Paradigm


A Very Brief History !of Chinese Medicine I

•  Seminal Works •  Nei Jing

•  Yellow Emperor's Classic of Medicine •  Ling Shu / Su Wen •  Earliest Work

•  Nan Jing •  Classic of Difficult Questions


A Very Brief History !of Chinese Medicine II

•  Zhong Zhong Jing: Shang Han Lun

•  Sun Si Miao: Morality in Medicine

•  Li Shi Zhen

•  Radial Pulse

•  9 Positions / 27 Categories


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TCM !Traditional Chinese Medicine

•  Progression to TCM •  3,000 years of Folk Medicine •  Western Cultural Invasion •  1949 Communist Revolution


•  Acupuncture/Moxibustion

•  Herbal Medicine

•  Diet & Lifestyle

•  Tai Ji & Qi Gong

•  Massage & Manipulation

The Five Branches of Oriental Medicine!


TCM

Japanese

5 Element

Medical/Chiropractic

American

Popular Styles of Acupuncture!


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Tai Ji Symbol

Yin & Yang I


•  Everything Consists of Yin & Yang •  Yin & Yang are Relative Terms •  Yin & Yang Produce One Another •  Yin & Yang are Infinitely Divisible •  At Extremes, Yin Transforms to Yang, & Visa

Versa

Yin & Yang II


•  Clinical Application: •  Explain Physiology & Pathology •  Broad Guide to Diagnosis & Treatment •  Basis of Other Diagnosis

Yin & Yang III


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Clinical Associations of !Yin & Yang !

!!!!

Clinical Associations of YANG

Clinical Associations of YIN

Function SubstanceAction Result Of Action

Happens In The Present Happened In The PastIncipient-Just Beginning, Completing, Sustaining Setting Loose, Setting In

Motion, DynamicResponsive, Static, Quiescent

Transforming, Causing Change

Conserving, Preserving

Dissolving, Dispersing, Expanding

Condensing, Contracting© Dr. Jim Ventresca 2015 13

Clinical Functions of !Yin & Yang I!

Functions of YANG Energy Functions of YIN Energy

Warms Cools

Moves, Activates, Circulates Provides Rest the Ability to Rest

Protects / Provides Defense Provides the Ability to Recover from Disease


Clinical Functions of !Yin & Yang II !

Functions of YANG Energy Functions of YIN Energy

Transforms - Brings About Change

Maintains Structure

Holds Up and In Place: Blood, Fluids, & Organs

Nourishes & Moistens: Blood, Fluids, & Organs


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Associations of Yin & Yang Disorders !

Yang Disorders Yin Disorders

Excess Yang / Deficient Yin Excess Yin / Deficient Yang

Acute / Rapid Onset Chronic / Slow Onset

Activity / Daytime / Insomnia

Rest / Nighttime / Sleepiness

Stretch Out To Sleep - Throws Off Covers

Curls Up In Sleep - Likes To Be Covered

Heat Signs: Red Efflorescences / Rapid Pulse /

Cold Signs: Pale Efflorescences / Slow, or at least Not Rapid Pulse

Thirst: Likes Cold Drinks No Thirst: Sips Warm Drinks

Loud Voice - Extrovert Soft/Weak Voice - Introvert


Yin & Yang !by Position !

Yang Bodily Areas

Yin Bodily Areas

Superior Inferior

Posterior Anterior

Lateral Medial

External Internal


The Eight PrinciplesFour Pair of Yin/Yang Opposites Internal / External Hot / Cold Excess / Deficient Yin / Yang


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Internal / External

Determined by Location OR Etiology


Internal !Locations & Etiologies

Organs Blood Bones


External !Locations & Etiologies

SkinMusclesMeridians(Joint Pain)


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Upper Respiratory InfectionOutside Pernicious InfluenceTreatment Principle: Open the Exterior


The Lungs!Special Case

Hot & Cold!True & False

Condition PathologyDiagnosis

Treatment Principle

Excess Yin True Cold Sedate Yin(Disperse)

Excess Yang True Heat Sedate Yang(Disperse)

Deficiency of Yin False Heat(Heat from Deficiency)

Supplement Yin(Tonify)

Deficiency of Yang False Cold(Cold from Deficiency)

Supplement Yang(Tonify)


True Heat !False Heat

True Heat False Heat / Yin Deficiency

Thirst Dry MouthRed Face Malor Flush

Full Sweat / True Fever Night Sweat / Hot FlashesSore Throat / Cough Dry Throat / Clears Throat

Dark Scanty Urine

Constipation / Hot Diarrhea Constipation / Dry Stool

Full / Strong & Rapid Pulse Thin/Weak & Rapid Pulse

Red Tongue / Yellow Coat Thin Red Tongue / No Coat (Peeled)


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True Cold!False Cold

True Cold False Cold/ Yang Deficiency

Clear Copious UrinePreference for Warm Drinks

Chills Cold Body/Hand/FeetPale Face

Cramping Pain / Better with Heat No Pain

Cold Diarrhea Loose Stools / Undigested Food

Normal Tongue / Thick White Coat Pale Puffy Tongue / Wet Coat

Full & Tight Pulse Weak & Slow Pulse


Excess/ Deficient

OrgansSubstancesMeridians


Yin & Yang !

!

Nature of the Disorder!

!

The Rest of the Eight Principles!


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Fire

Earth

MetalWater

Wood

The Theory of The Five Elements


5 Element !!

Diagnosis & Prognosis!

Preferences!

Physical Characteristics!

Emotions!

!© Dr. Jim Ventresca 2015 29

5 Element !Specific Diagnostic Parameters !


Colors!Sounds!Smells!Emotions!Tastes!Tissues!Orifices!Weather / Climate!

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5 Element !Geographical Genesis!

!

Fire

Metal

Water

Wood

Water

Earth


Traditional Arrangement !

Fire

MetalWood

Water

Earth

S

W

N

E


Clinical Arrangement

Fire

Earth

MetalWater

Wood


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5 Element !Body Types!

!

!


5 Element Organs, Meridians, & Points !

All Influence Treatment Options !

!Fire

Earth

MetalWater

Wood


Sheng Cycle!Production / Generation / Mother - Child!

!Fire

Earth

MetalWater

Wood


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Sheng Cycle!1 Deficiency Creates 2 Deficiencies!

!Fire

Earth

MetalWater

Wood


Sheng Cycle!1 Excess Creates 1 Excess!

!Fire

Earth

MetalWater

Wood


Ko Cycle!Control / Restraining/ Grandmother - Grandchild!

!Fire

Earth

MetalWater

Wood


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Ko Cycle!1 Excess Creates 2 Deficiencies!

!Fire

Earth

MetalWater

Wood


Ko Cycle!1 Deficiency Creates 1 Excess!

!Fire

Earth

MetalWater

Wood


The Whole Picture !!

Fire

Earth

MetalWater

Wood


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Elements & Organs

Fire

Earth

MetalWater

Wood

HEART / Sm. Intestine Pericardium / Triple Warmer

LIVER Gall Bladder

KIDNEYBladder

LUNGSLg. Intestine

SPLEENStomach


Diagnostic Frameworks!o Yin/Yang o 8 Principleso 5 Elementso Substanceso Organs o Meridians


Five Element Theory Review

Fire

Earth

MetalWater

Wood


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Category Wood Fire Earth Metal Water

SEASON Spring Summer Late Summer Fall Winter

CYCLE Birth Growth Maturity Harvest Rest / Storage

CLIMATE Wind Heat Damp Dry Cold

Essential Elemental Correspondences ICategory Wood Fire Earth Metal Water

ZANG: Solid / Yin

Organ

Liver HT PC Spleen Lungs Kidney

FU: Hollow / Yang Organ

Gall Bladder SI SJ Stomach Lg. Intestine Bladder



ORIFICE Eyes Tongue Mouth Nose Ears

SENSE Vision Speech Taste

Smell Hearing

BODY FLUID

Tears Sweat Saliva Nasal Mucus Internal Moisture

Essential Elemental Correspondences II


BODY TISSUE

Tendons Sinews

Blood & Blood Vessels

Flesh & Muscles

Skin Teeth, Bone & Marrow

RESIDUES Nails Complexion Lips Body Hair Head Hair

TONGUE AREA

Sides Tip Center Behind Tip Root


Category Wood Fire Earth Metal WaterOFFICE& DUTY

GeneralPlanningPlans &

Decisions

SovereignRuling

Natural Leader

Minister of AgricultureNourishing

Eating & Food

Architect Create Order

Treasurer Store Essence

STORAGE SoulBenevolence

ConsciousnessRighteous

IntentFaith

VitalityDecorum

DeterminationWisdom

Essential Elemental Correspondences III

Category Wood Fire Earth Metal WaterSPIRITS Hun

Persona / Ego:

ShenSpirit

Heart / Mind

YiThoughtsMemory

Recollection

PoIdentification

with the Body

Zhi (Will)

Intention / Commitment

EMOTION DecisivenessControlAnger

Joy+-

HarmonizingPreoccupationObsessive

StrengthGrief

DeterminationFear


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TASTE Sour Bitter Sweet PungentHot/Spicy

Salty

ODOR Sour Burnt Fragrant Putrid Musty

Essential Elemental Correspondences IV


COLOR Cyan (Green) Red Yellow White Black (Blue)

SOUND Shouting(Sighing)

Laughing Singing Weeping Groaning


The Horary CycleOrgan / Meridian Time of Day Most Qi Least Qi

Lung 3 – 5 AM 4 AM 4 PM

Lg. Intestine 5- 7 AM 6 AM 6 PM

Stomach 7 – 9 AM 8 AM 8 PM

Spleen 9 - 11 AM 10 AM 10 PM

Heart 11 AM – 1 PM NOON MIDNIGHT

Sm. Intestine 1 – 3 PM 2 PM 2 AM

Urinary Bladder 3 – 5 PM 4 PM 4 AM

Kidney 5 – 7 PM 6 PM 6 AM

Pericardium 7 – 9 PM 8 PM 8 AM

San Jiao 9 – 11 PM 10 PM 10 AM

Gall Bladder 11 PM – 1 AM MIDNIGHT NOON

Liver 1 – 3 AM 2 AM 2 PM


Time, Organs, & Meridians


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Yin & Yang Organs, & Meridians

YangYin


The Six Divisions


The Essential Substances

Qi

Life forceEnergyPrana


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BloodXueNourishingMoisteningManifestation of Qi



JingEssence

Constitutional Qi



ShenConsciousness

Mind

Stored in the Heart


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FluidsJin Ye

All Physiological Fluids other than Blood


Qi & Blood Production

StomachR & R

Lungs

SpleenT & T

KidneysImpure

Food

PureGu Qi

Zong Qi

Zheng QiYing / Wei

Air

Yuan Qi(Catalyst)

Blood

LI, SI, & UB Separate Pure from Impure


Qi & Blood: The End Products

Zheng QiDifferentiates into

Ying/Nourishing Qi&

Wei/Protective Qi

BloodCreated in the

Heart, by the Same Process as Qi


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Energy & Nurture Qi & Blood!

•  Substances Reviewo Qi & Blood

• Subject of this Classo Jing, Shen, & Fluids


Qi

Energy – Prana – Life ForceManifests in the Body

Circulates Within & Outside of the Meridians© Dr. Jim Ventresca 2015 62

The Origin & Functions of Qi

Constitution - Food – Environment

“Subset of Yang”Activates / MovesWarmsTransformsDefendsContains


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The 4 Directions of Qi!Up Bearing

Down Bearing

Entering & Exiting

Qi Circulates via the Meridians & in the Blood


Deficient Qi !Qi Xu

Fatigue / MalaisePale FaceWeak PulsePale & Swollen TongueOrgan Dysfunction


Other Imbalances of Qi •  Collapsed Qi

•  Prolapse

•  Stagnant Qi•  Dull Achy Pain / Unfixed

•  Rebellious Qi•  Moves in the wrong direction


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Blood!

Xue

Yin in Relation to Qi

Fluid & Qi

Contains Ying Qi© Dr. Jim Ventresca 2015 67

Functions of Blood!!

Nourishes & Moistens Maintains Structure

Cools & Calms the Body & Mind

Provide for Rest & Recovery


Relationships of Blood!!

Heart Originates & Moves Blood

Liver Stores & Releases Blood

Spleen Produces & Holds


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Deficient Blood Xue Xu

Qi Xu – (Nourishment & Moisture) = Xue Xu Lusterless FaceThin PulseThin TongueDry Skin, Hair & EyesScanty MensesInsomniaTics, Twitches, & Tremors


Other Imbalances of Blood

•  Stagnant Blood•  Fixed, Sharp, Stabbing, Pain•  Tumors/ Cysts •  Hematoma

•  Hot Blood•  Red Skin, Rashes, Pimples•  Hemorrhage of Fresh Red Blood


Jing

Pre-Heaven Qi / Constitutional Qi

Formed at Conception

Parents - In Utero - At the Moment of Birth© Dr. Jim Ventresca 2015 72

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Jing Governs

Birth

Growth

Development

Aging


Jing Storage

In the Kidneys

Zang/Yin Organs


Jing & Yuan Qi

JingYuan Qi


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Jing Deficiency

Poor DevelopmentConcentration / MemoryReproductive DisordersTeeth & BonesGrey/Thinning HairSenility


Rest, Restraint, & Repose

Jing Can Not Replaced

Treatment is Aimed at Conservation

AppropriateDiet, Exercise, RestModeration in All Things


Shen

Consciousness

Stored in the HeartReflected in the Eyes

Most Insubstantial of Substances© Dr. Jim Ventresca 2015 78

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Shen

Formed at Birth

Acquired from Life Experience


Disturbed Shen

Psycho-Spiritual-Emotional Disorders

Muddled Personality – Psychosis

Bipolar Disorders - A Continuum


Jin Ye Fluids

All Normal Bodily Fluids Except Blood

Lubricate the Body

Flow Within and Without the Blood


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Jin Ye Fluids

Jin

Clear, Yang, WateryProvides Moisture to the SurfaceSkinFleshMucous MembranesSweat


Jin Ye Fluids

Ye

Thick, More Yin

Lubricates the InteriorOrgansJointsBrainBones


Jin Ye Fluid Production

Lungs

SpleenT & T

Kidneys

StomachR & R

Impure

Food & Drink

Pure

LI, SI, & UB Separate Pure from Impure


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Jin Ye Fluid Pathology

Deficiency

Jin: Thirst & Dryness

Ye: More Serious Conditions



Excess

Jin: Dampness, Swelling

Ye: Mucous & Phlegm



Cause & Effect

Lungs: Upper Warmer

Spleen: Middle warmer

Kidneys: Lower Warmer© Dr. Jim Ventresca 2015 87

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External Pathogenic Factors!The Evil Winds

Wind, Cold , Dampness, Dryness, Heat, & Summer Heat

OPIInternal Causes & Manifestations


Wind•  OPI

•  All OPIs are “Wind”•  Most Common•  Combines with other Pathogens•  Early Stage OPI

•  Internal:•  Associated with Liver•  Signs & Symptoms


Cold

•  OPI•  Lungs•  Meridians•  Uterus

•  Internal•  Yang Xu


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Heat/Fire

•  Heat vs. Fire•  OPI

•  Internal•  Liver•  Yin Xu


Dampness

OPISpleen Xu

Internal & External Manifestations

Heavy / Lingering / DistendingSwelling, Fluid-filled

Sticky, Cloudy, Murky

Combines with Cold & Heat© Dr. Jim Ventresca 2015 92

Dryness

OPIYin Xu

Internal & External Manifestations

DryLungs – Throat – Sinus

Skin – Hair - Eyes


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Summer Heat

Excessive Heat Invades

OPIHeat Exhaustion / Heat Stroke

The IntestinesHot Dysentery


Internal Pathogenic Factors!The Emotions

Normal Presentationsvs.

Pathological Presentations


AngerDecisiveness / ControlLiver / Wood


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JoyAppropriate Responses

Heart / Fire


GriefStrength In the Face of Adversity

Lungs/ Metal


OverthinkingDeep Thinking / Strong Memory

Spleen/ Earth


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FearPerseverance/ Survival Kidneys/ Water


Miscellaneous Pathogenic Factors!

InappropriateDiet - Exercise - Timing

Parasites - Insect & Animal BitesTrauma

EpidemicsWrong Treatment

Excess Sex – OverworkEnvironment - Drugs…


The Zang Fu: !Introduction to the Organs

NAMES

Zang / FuSolid / Hollow

Yin / Yang

Western NamesEastern Functions

Licle Overlap

Capitalization Convention© Dr. Jim Ventresca 2015 102

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Spheres of Influence

Complex System of Relationships

Requires Only a Handful of Systems

Clinically Effective


!Zang Fu Diagnosis

Most Common Diagnostic Framework

Combined with 8 PrinciplesSubstances


Primary Organ Diagnosis

Any Organ’s main job is easily & often affected by Any Disharmony within said Organ.


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Primary Organ Responsibilities

Lungs – Rule Respiration

Spleen – Orchestrates Digestion

Heart - Stores the Shen

Liver – Spreads the Qi Kidney - Stores the Jing, Yin, & Yang


Primary Organ Disharmonies

Lungs – OPI, Qi Xu, Yin Xu

Spleen – Qi/Yang Xu, Xue Xu, Dampness

Heart - Xue Xu, Yin Xu, Xue Yu, Shen Disturbance

Liver – Qi Yu, Xue Yu Kidney – Qi/Yang Xu, Yin Xu, Jing Xu


Organ Associations I•  Mainly Yin Organs - as per the 5 Elements•  Body

•  Paired & Other Organs•  Meridians (many)•  Tissues, Orifices, Residues…

•  Mind•  Thoughts & Thought Process

•  Spirit•  Interpretation


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Organ Associations IILungsLg. IntestineThroatNose SinusMeridianSkin

Fire

Earth

MetalWater

Wood


Yin vs. Yang Organs

Most Physiology & Pathologies Focus on Yin Organs

Yang Organs Support Yin Organs

Yin Organs and 5 Element Correspondences© Dr. Jim Ventresca 2015 110

Organs & Meridians I

Associated Bilateral MeridiansShare NameSome Pathology & Physiology Overlap


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Organs & Meridians IIYang Meridians Treat ChannelsPain Along The Pathway

Yin Meridians Treat Organs


Organ Pairing IHusband / WifeInternal/ External Some Very Close Relationships

Fire

Earth

MetalWater

Wood

Element Yin Organ Yang Organ

Wood Liver Gall Bladder

Emperor Fire Heart Sm. Intestine

Minister Fire Pericardium San Jiao

Earth Spleen Stomach

Metal Lungs Lg. Intestine

Water Kidney U. Bladder


Organ Pairing IISix Divisions

Division (Ch.) Organs/Meridians

Tai Yang U. BladderSm. Intestine

Xiao Yang Gall BladderSan Jiao

Yang Ming

StomachLg. Intestine

Tai Yin LungsSpleen

Jue Yin

PericardiumLiver

Xiao Yin

HeartKidney


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Organ Pairing IIISix DivisionsProgression of DiseaseTreatment of Pain

Division (Ch.) Division (Eng.) Organs/Meridians

Tai Yang Major YangGreater

U. BladderSm. Intestine

Xiao Yang Minor YangLesser

San JiaoGall Bladder

Yang Ming

Yang BrightnessEffulgence

StomachLg. intestine

Tai Yin Major yinGreater

SpleenLungs

Xiao Yin Minor YinLesser

HeartKidney

Jue Yin Terminal YinYielding

LiverPericardium


Lungs / Large Intestine

•  Lungs AKA: •  Fei•  Wife of the Large Intestine•  The Tender Organ•  The Bright Lid of the Internal Organs•  The Official Who is the Master of Qi

•  Large Intestine AKA:•  Da Chong•  Husband of the Lungs•  The Official In Charge of the Dregs


The Big PictureLungsLg. IntestineThroatNose SinusMeridianSkin

Fire

Earth

MetalWater

Wood


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The Good & The Bad

When the Lungs are functioning well, the individual is vital and strong. In disharmony, we see respiratory problems like COPD, shortness of breath, and a tendency towards upper respiratory infections.


Names & Meanings

The Tender OrganMost Easily Affected by OPI

The Bright Lid of the Internal OrgansProtects the Internal Organs

The Official Who is the Master of QiCreates the Zong QiOpens To the Nose

Dislikes Cold & DryHome of The Po & The Voice


Metal Element !

•  Dryness•  Nose, Smell•  Mucus•  Skin•  Pungent Taste•  Putrid Odor•  Identification w/ Body•  Vitality, Strength, Sustainability•  Grief & Sadness

•  Taking In & Lecing Go


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Governance

•  Respiration

•  Qi Production

•  The ExteriorSkin & Body Hair Distributes Wei Qi

•  The Water PassagesLiquefy, Descend, & DisseminateKeeps Sweating In Check


Common SymptomsAcute & Chronic

•  Respiratory •  Sinus•  Skin•  Cold & Flu•  Seasonal Allergy•  Fatigue & Malaise


Pin Yin Glossary/ReviewPin Yin English

Xu DeficiencyShi ExcessYu StagnationBi ObstructionQi Life Force / Energy

Xue Blood


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Tissues & Substances

•  Bronchial Passageways, Nose & Sinus

•  The Skin

•  Nasal Mucous

•  Qi


Common Disharmonies•  Outside Pernicious Influences: Wind,

Heat, Cold, Dry, Damp: •  S & S•  Treatment Principle (Tx Pr)

•  Open the Exterior•  Qi Xu:

•  S & S•  Tx Pr: Tonify Lung Qi (LU /SP/ KD)

•  Yin Xu: •  S & S •  Tx Pr: Tonify Yin (LU / KD)


Secondary Disharmonies•  Qi Yu:

•  S & S•  Move Qi (LU / LR)

•  Yang Xu:•  S & S•  Tonify Yang (LU /KD)

•  Heat / Fire: •  S & S•  Cool Heat in Lungs

•  Accumulation of Dampness: •  S & S•  Disperse, Resolve, and/or Vaporize Damp•  LU /SP /KD


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Large Intestine (Da Chang)!•  The Official In Charge Of The Dregs

•  Dependent Upon Fei For Descending

•  Governs Body Fluids

•  Receives Waste From Small Intestine

•  Absorbs Fluids

•  Excretes Feces© Dr. Jim Ventresca 2015 127

Large Intestine Disharmonies

•  Dryness: S & S, Moisten the Intestines

•  Summer Heat: S & S, Cool Heat / Quell Fire

•  Liver Invading: S & S, Course the Liver Qi


Clinical Organ Relationships!Lungs/Large Intestine

Lungs Circulate & Descend the Qi To Assist Moving Feces Downward

Lung Heat Can Dry Out Stools

Stagnation in the Large Intestine Can Lead to Dyspnea

Treat The Large Intestine Meridian To Disperse Lung Heat


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Meridian SymptomologyLarge Intestine Meridian

Pain Along It’s Own (Yang Ming) PathwayThumb – Radial Forearm – Deltoid –SCM – Head & Face

Lung Meridian Treats the Lungs


Spleen / Stomach•  Spleen AKA:

•  Pi•  Wife of the Stomach•  The Minister Of Agriculture•  The Official In Charge of T & T

•  Stomach AKA:•  Wei•  Husband of the Spleen•  The Official In Charge of the Rocing & Ripening•  The Most Important Fu•  Source of All Fluids / Yin


The Big Picture Spleen

Stomach

OrchestrateAll Digestive ProcessesMouthMuscles & FleshDampness

Fire

Earth

MetalWater

Wood


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The Good & The Bad

When the Spleen is functioning well, the individual has solid digestion and Qi & Xue are sufficient. When the Spleen in disharmony, food and fluids are not fully processed, Qi & Xue become weak, digestive problems become apparent & Damp accumulates.


Names & MeaningsThe Minister Of Agriculture

The Official In Charge of Transformation & Transportation

Opens To the Mouth

Manifests in the Lips

Dislikes Damp & Cold

Houses The Yi & Thoughts© Dr. Jim Ventresca 2015 134

Earth Element !

•  Dampness•  Mouth, Taste•  Lips•  Flesh•  Sweet Taste•  Fragrant Odor•  Digestion, Nourishment, •  Harmonizing, Thinking•  Overthinking / Worry•  Dislikes Dampness


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Governance

•  Transportation & Transformation•  Food

•  Qi & Xue

•  Fluids•  Water Transformation

•  Up Bearing•  Holding Up & Sending Up


Common Symptoms I•  Overweight / Underweight•  Digestive Disorders•  Dampness Accumulating•  Mucous / Phlegm•  Fatigue & Malaise•  Depression (Xue Xu)


Common Symptoms II•  Bloating, Gas•  Loose Stools•  Mucous/Blood in Stools•  Excess or Deficient Menstrual Bleeding•  Excessive Bruising•  Deficient Bleeding•  Hemorrhoids•  Muscle weakness/atrophy•  Prolapses


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Tissues & Substances

•  The Muscles & Flesh

•  4 Limbs

•  The BloodProducingHolding: SP Xu vs. Hot Blood


Common Disharmonies•  Qi/Yang Xu:

•  S & S: •  Tx Pr: Tonify Qi/Yang (SP/ KD)

•  Xue Xu: •  S & S: •  Tx Pr: Tonify SP Xue

•  Dampness: •  S & S: •  Tx Pr: (Tonify Spleen) Resolve Damp


Wood Overacting on EarthLiver Invading Spleen

and/or Liver Invading Stomach

•  Emotional Trigger•  Horary Connection•  IBS : Spleen•  Ulcer : Stomach•  Tx Pr: Move LR Qi / Course the LR


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Stomach (Wei)!•  The Official In Charge Of Rotting &

Ripening•  Prepares Food & Drink for the Spleen

•  Governs Early Digestive Processes

•  Initial Separation of Pure &Impure


Stomach Disharmonies•  Rebellious Stomach Qi:

•  S & S: Nausea/Vomiting / Heartburn etc.

•  Tx Pr: Rectify/Descend the St Qi

•  Heat in the Stomach: •  S & S: Heartburn etc. •  Tx Pr: Cool Heat / Quell Fire

•  Liver Invading


Stomach Symptoms •  Stomach Pain / Distention•  Nausea•  Vomiting•  Belching•  Acid Regurgitation , Heartburn,

Ulcers•  Bad Breath •  Increased/Decreased Appetite


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Clinical Organ RelationshipsSpleen Moves Upwards / Stomach Descends

Stomach Orchestrates Early DigestionSpleen Orchestrates Later Digestion

A few Important Stomach Meridian Points Treat The Spleen


Meridian SymptomologyStomach Meridian

Pain Along It’s Own (Yang Ming) PathwayANTERIOR SURFACE

Head – Jaw – Teeth– Breast –Leg– Top of Foot

Spleen Meridian Treats SP / KD / LR© Dr. Jim Ventresca 2015 146

Heart - Small Intestine !

Pericardium – San Jiao

•  4 Fire Element Organs•  Yin

•  Heart & Pericardium

•  Yang•  Small Intestine •  San Jiao


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Heart - Small Intestine•  Heart AKA:

•  Xin•  Wife of the Sm. Intestine•  The Emperor

•  Small Intestine AKA:•  Xiao Chang•  Husband of the Heart•  The Official In Charge of the Separating the

Pure from the Impure


Pericardium – San Jiao•  Pericardium AKA:

•  Xin Bao Luo•  The Prime Minister who Insulates, Screens,

Protects & Maintains the Order of the Heart

•  San Jiao AKA:•  Triple Warmer•  Triple Heater•  Triple Energizer•  Three Burning Spaces•  The Official In Charge of Irrigation© Dr. Jim Ventresca 2015 149

The Good & The Bad

When the Fire Element is functioning well, the individual acts from a clear and functional view of the self and the outside world.

When the Heart is in disharmony, the Shen is disturbed and the individual’s sense of self and others become distorted.


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Names & MeaningsHeart

Emperor / Supreme RulerEmperor Fire

Opens To the TongueManifests in the Complexion

Houses The Shen

PericardiumPrime MinisterMinisterial Fire

Insulates & Sets the Order of the HeartTreat the Heart with the Pericardium

(Don’t bother the Emperor unless you have to.)


Names & MeaningsSan Jiao

The Official In Charge Of Irrigation

Classically Described As A System Of Sluices Or Waterways

The Form Of The Water Is Different In Each Warmer.

More Later…


Fire Element !

•  Dislikes Heat•  Tongue Speech•  Complexion•  Blood & Vessels•  Bicer Taste•  Consciousness•  Righteousness•  Joy / + or - / > or <


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Governance

•  The Consciousness•  Communication Between

Oneself and Others

•  Maintain the Waterways•  Communication Within an

Individual


Common Symptoms•  Disorders of

• Mind• Spirit• Consciousness• Memory• Thinking• Sleep

•  Malaise•  Depression•  Anxiety


Common Disharmonies•  Heart Xue Xu:

•  S & S: •  Tx Pr: Tonify HT Xue (SP)

•  Heart (Pericardium) Yin Xu: •  S & S: •  Tx Pr: Tonify Yin (HT /KD / LR)

•  Xue Yu : Blood Stagnation in the Heart / Chest: •  S & S: •  Tx Pr: Move Xue (HT / LR)


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Wood Assaulting FireLiver Assaulting the Heart

•  LR Generates Heat the Assaults the Heart

•  Emotional Trigger

•  Horary Connection

•  Anger / Irrational Behavior

•  Course the LR / Cool the Heat© Dr. Jim Ventresca 2015 157

Small Intestine

•  The Official In Charge Of Separating the Pure form the

Impure

Little Relationship to the Heart, Pericardium and San Jiao


San Jiao•  Three Burning Spaces •  Name But No Form•  Upper Jiao

•  LU & HT•  Respiration & Circulation

•  Middle Jiao•  SP & ST•  Digestion & Assimilation

•  Lower Jiao•  KD, UB & Reproductive Organs•  Elimination & Reproduction


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San Jiao•  Three Jiaos Are Collectively Responsible

for Water Metabolism •  Classically Described As A System Of

Sluices Or Waterways•  Lung Adjusts Water

•  D & D •  Spleen Transforms Water

•  T & T•  Kidney

•  P & P


Meridian SymptomologySan Jiao & Sm. Intestine Meridians

Pain Along Their Own Pathways SJ / Xiao Yang: Lateral Upper Body SI /Tai Yang: Posterior Upper Body

Heart Meridian: Seldom Used Pericardium Meridian: Treats HT /PC /LR


Liver /Gall Bladder•  Liver AKA:

•  Gan•  Wife Of The Gall Bladder•  The General•  Free & Easy Wanderer (Xiao Yao)

•  Gall Bladder AKA:•  Dan•  Husband Of The Liver•  The Official In Charge Of Decision

Making•  Very Close Relationship


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The Good & The Bad

When The Liver Is Functioning Well, Qi, Blood, And Emotions, Flow Smoothly Throughout The Individual. When The Liver Is In Disharmony, Qi Becomes Stuck, Giving Rise To Blood Stagnation, Emotional Instability, Wind, And Heat, All Of Which Can Disturb Muscles, Tendons, Organs, & Systems.


Names & MeaningsLiver

General Of The ArmyFree & Easy Wanderer

Sea Of BloodMaster Alchemist

House Of The Hun

Gall BladderOfficial In Charge Of Decision Making

Resides Within The Liver© Dr. Jim Ventresca 2015 164

Wood Element !

•  Dislikes & Engenders Wind•  Eyes / Vision•  Muscles & Tendons•  Manifests In The Nails•  Sour Taste & Smell•  Hun / Ethereal Soul / Persona / Sense Of Self•  Benevolence, Anger, Control, & Decision

Making© Dr. Jim Ventresca 2015 165

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The General

Excels at PlanningIs Benevolent

Even TemperedQuick to Anger

Willing to AttackCapable of Inciting Violence


Free & Easy Wanderer

•  Smooth & Easy Flow of Qi•  Directs Qi Uniformly in All Directions•  Promotes Normal Qi Flow

•  Organs – Meridians - Systems

•  Stores the Blood•  Smooth & Easy Flow of Blood•  Regulates the Menses

•  Smooth & Easy Flow of Emotions•  Harmonizes the Emotions


Sea of Xue !Stores & Releases the Blood that …

•  Nourishes The Tendons & Muscles•  Moistens the Tendons (T,T,&T) •  Regulates Contractility of the Muscles

•  Nourishes The Eyes•  Lacrimation, Eyesight, Vision, Outlook

•  Nourishes the Menses•  Stores & Releases The Tian Kwei


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Common Symptoms!Shi (Excessive) Disharmonies !

•  Excessive Muscular Tension•  Quick to Anger / Violent Outbursts•  PMS•  Red Tearing Eyes•  Excitability/ Insomnia /Compulsive

Energy•  Moodiness•  Wiry Pulse •  Purple Effloresces


Common Shi Disharmonies

•  Liver Qi Yu (stagnation)•  Most Common•  Accompanies other LR Disharmonies

•  Liver Xue Yu: •  Liver Wind: •  Liver Fire: •  Damp Heat in the Liver/Gall Bladder:


Wood Over-Controlling Earth/Metal!Liver Invading !

Spleen / Stomach Lungs / Large Intestine

LR Qi Yu + Emotional Trigger + SP/ST/LU/LI Disharmony = Liver Invading…


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Wood Assaulting FireLiver Assaulting the Heart

•  LR Qi Generates Heat that Assaults the Heart

•  Emotional Trigger

•  Horary Connection

•  Anger / Irrational Behavior

•  Course the LR / Cool the Heat© Dr. Jim Ventresca 2015 172

Common Xu Disharmonies

Liver Xue Xu

Liver Yin Xu


Common Symptoms!Xu(Deficient) Disharmonies!

!Weakness In Muscles And Tendons (esp. the Legs)Tics, Twitches, & Tremors Difficulty Standing/ WalkingVertigo/ DizzinessInsomniaDry EyesWeak VisionExcessive Sighing.


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Meridian SymptomologyGall Bladder Meridian

Pain Along It’s Own Xiao Yang Pathway(Lateral Surface)

Liver Is An Exceptional Yin Meridian


Liver Disharmonies

Manifest Along It’s Pathway

MeridiansHerpes

Distribution

LIVERGALL BLADDER

EyesMouthThroat

Breast

ReproductionGenitals


Clinical Organ Relationships

Liver & Gall Bladder Act Almost As One UnitDifficult To Distinguish Between Them

Treat The Liver With The Gall Bladder& Visa Versa


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Liver / Gall Bladder Treatment

•  Soothe The Liver•  Acupuncture •  Stress Reduction Techniques •  Gentle Stretching Of The Tendons

•  Yoga, Tai Chi, Qi Gong •  Coffee & Alcohol Directly Affect The

Liver•  Remove or Significantly Reduce


Kidneys / Urinary Bladder•  Kidneys AKA:

•  Shen•  Wife Of The Urinary Bladder•  The Treasurer•  The Strong Official •  The Laborers

•  Urinary Bladder AKA:•  Pang Guang•  Bladder (UB / BL) •  Husband Of The Kidneys•  The Official In Charge Of The District


Names & Meanings

KidneyThe Treasurer

The Strong Official The Laborer

House Of The Zhi

Urinary BladderThe Official In Charge Of The District


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Water Element !

•  Growth - Development - Aging •  Dislikes Cold •  Ears/ Hearing •  Internal Moisture •  Manifests In The Head Hair •  Musty Odor •  Will / Commitment / Follow Through •  Determination / Wisdom


Governance I•  Stores Jing

•  Regulate Constitutional Energies •  Birth, Growth & Reproduction

•  Houses the Will

•  Rules the Bones

•  Governs The Low Back•  Responsible for Low Back Strength


Governance II

•  Responsible for Yin and Yang Balance •  Nourishes & Warms The Lower Warmer

•  Supplies Yin & Yang •  Reproductive Function

•  Enables Conception •  Urogenital •  Sexual Functions


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Treasurer Stores the Essence!(Jing)

•  The Essence is Precious•  One Cannot Have Too Much

•  All Kidney Disharmonies Are Deficiencies

•  Never in Excess


The Roots of the Body

Pre-Heaven

Life

Yin & Yang

Qi


Common Symptoms•  Fatigue•  Low Back Pain & Weakness (Sciatica)•  Pain & Weakness of the Legs, Knees, & Ankles•  Impotence and Infertility•  Incontinence / Polyuria•  Lowered / Hyper Libido •  Lower Body Edema•  Problems of Growth and Development•  Premature Aging •  Loss of Hearing / Tinnitus•  Fearfulness & Lack of Will


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Common Disharmonies

•  Kidney Qi Xu

•  Kidney Yang Xu

•  Kidney Yin Xu

•  Kidney Jing Xu


Urinary Bladder

The Official In Charge of the District

Transforms and Excreting Fluids via the Power of the Kidney Qi


Meridian SymptomologyUrinary Bladder Meridian

Pain Along It’s Own Tai Yang Pathway(Posterior Surface)

Kidney Meridian Treats The Kidney (SP & LU Qi/Yang – HT & LR Yin)


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Bladder Meridian!Pathway !


Clinical Organ Relationships

Kidney Supplies Qi to Bladder

Xu Bladder Disharmonies are Treated Through the Kidney

Shi Bladder Disorders (UTIs) Are Treated Through the Urinary Bladder


Kidney Treatment •  Always Tonification•  Acupuncture & Moxibustion•  Diet•  Lifestyle•  Herbs


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Essential Tongue DiagnosisDiagnostic Frameworks

Yin/Yang 8 Principles 5 Elements

Organs Substances Meridians

Tongue & Pulse Diagnosis

Clinical Tools Confirm Diagnosis


Tongue Diagnostic Areas!Elements

WO

OD

WO

OD

METAL

FIRE

EARTH

WATER

WEST

SOUTH

EASTCENTER

NORTH


Abdomen Diagnostic Areas!Elements

WOOD

WOOD

METAL

FIRE

EARTH

WATER

X. Process

S. Pubis

WO

ODW

OO

D

METALFIRE

EARTH

WATER

WEST

SOUTH

CENTER

NORTH

EAST

195

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Tongue Diagnostic Areas!Organs

LIV

ERG

ALL

BLA

DD

ER

LIVER

GA

LL BLAD

DER

LUNG

HEART

SPLEEN

STOMACH

KIDNEY


Tongue Diagnostic Areas!WarmersLower Warmer

Middle Warmer

Upper Warmer


Tongue Diagnostic Areas!Warmers (Alt.)

Lower Warmer

Middle Warmer

Upper Warmer© Dr. Jim Ventresca 2015 198

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Tongue CreaseThe Tongue Crease Pertains to the Heart


4 Basic Parameters!Color, Shape, Coat & Movement

•  Color Indicates •  Excess & Deficiency •  Hot & Cold •  Stagnation of Qi or Blood

•  Shape Indicates Deficiency of Function or Substance

•  Coat Indicates •  Hot & Cold •  Deficiency of Yin or Yang •  Dampness

•  Movement Indicates Wind


Normal Tongue

•  Shape •  Does not quite touch the sides of

the mouth •  No Scalloped Edges •  Uniform Thickness •  “U” Shaped

•  Color •  Normal Red to Pink

•  Coat •  Thin White •  Can Clearly See Tongue Body


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Color!Pale, Red & Purple

•  Pale •  Deficiency

•  Qi, Yang, or Blood

•  Red •  Heat

•  True or False

•  Purple •  Stagnation

•  Qi or Blood


Shape!Thin & Swollen

•  Thin •  Lack of Substance •  Deficient Yin or Blood

•  Swollen •  Lack of Function T & T •  Deficient Qi or Yang

•  Scalloped Edges •  Long Term Qi/Yang Deficiency


Coat !(Color & Thickness)

•  Thin White Coat (L) = Normal •  Thick White Coat (R) = True Cold

•  Thin to Thick Yellow Coat

•  True Heat

•  Peeled / No Coat •  Yin Deficiency (Red)

•  Wet Coat = Yang Deficiency (Pale)

•  Greasy Coat = Dampness/Phlegm


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Shape Color Coat ConditionNormal Normal Red Thin White NormalSwollen Pale Thin White Qi DeficiencySwollen Pale Wet Yang DeficiencySwollen

ScallopedPale Thin White /

WetLong Standing Xu

Qi /YangThin Pale Thin White Blood DeficiencyThin Red None/Peeled Yin Deficiency

Normal Red Yellow True Heat

Usual Tongue Combinations I


Shape Color Coat ConditionNormal Normal Greasy White Cold DampNormal Red Greasy Yellow Damp HeatNormalSlightly Purple Thin White Qi StagnationNormal Dark Purple Thin White Blood StagnationNormal Red Tip Thin Yellow OPI Heat

Usual Tongue Combinations II


Essential Pulse Diagnosis•  The Radial Pulse

•  Li Shi Zhen •  3 Positions at 3 Levels

•  Diagnostic Confirmation •  8 Principles •  5 Organs •  3 Warmers

•  Pulse Diagnosis •  Easily Detected Basic

Parameters •  May Take Years to Master •  Clinically Useful in Minutes

•  P


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Finding The PulseThumb

Radial PulseFingers

Styloid Process Radial Bone


Palpating the Pulse!3 Positions

Index Middle Ring


Palpating the Pulse!3 Positions

Index Middle Ring

1st Position “Cun”

2nd Position “Guan”

3rd Position

“Chi”


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3 Positions X 3 Levels! = Nine Diagnostic Areas

1st Position

2nd Position

3rd Position

Index Middle Ring

SuperficialLevel

MiddleLevel

DeepLevel


S M D

Pulses and Warmers I

Index Middle Ring


1st 2nd 3rd

S M D

Upper Warmer

Middle Warmer

Lower Warmer

Pulses and Warmers II


Middle Warmer

Lower Warmer

Upper Warmer

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Pulses and Warmers III

Upper Warmer

Middle Warmer

Lower Warmer

Upper Warmer

Middle Warmer

Lower Warmer


1st 2nd 3rd

S M D

HeartSmall. Intestine

LiverGall Bladder

Kidney Urinary Bladder

Clinical - Contemporary !Organs Associations!

of the LEFT Hand Pulse


S M D

1st 2nd 3rd

Clinical - Contemporary !Organs Associations!

of the RIGHT Hand Pulse

LungLg. Intestine

SpleenStomach



1st 2nd 3rd

S M D

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Mai Jing Classical Organ Associations !Urinary Bladder

Kidney

Lg. Intestine

Lung

Stomach

Spleen

San Jiao

Pericardium

LEFT

RIGHT


Sm. Intestine

Heart

Gall Bladder

Liver

1st 2nd 3rd

Clinical - Contemporary !Pulse Organ Associations !

LEFT

RIGHT LungLg. Intestine

SpleenStomach


LiverGall Bladder



HeartSmall. Intestine

1st 2nd 3rd

Normal Pulse•  60 – 80 Beat Per Minute (BPM) •  Fills the Middle Level •  Touches Into The Superficial and Deep Levels •  Sufficient Strength w/Well-Defined Boundaries •  Slightly Slippery (Fluid)


S M D

1st 2nd 3rd

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Full (Excess) Pulse•  Feels Excessive in Strength and/or Size •  Well-Defined Boundaries •  Otherwise Normal Size/Speed •  Indicates Excess Condition


S M D

1st 2nd 3rd

•  Feels Insufficient in Strength •  Ill-Defined Boundaries •  Otherwise Normal Size/Speed •  Indicates Deficiency

Weak (Deficient) Pulse


S M D

1st 2nd 3rd

Slow Pulse•  Less Than 60 BPM •  Indicates Deficiency

•  Therefore is Also Weak •  Otherwise Normal •  Weak & Slow Indicates Yang Deficiency


1st 2nd 3rd

S M D

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Rapid Pulse•  Greater than 80 BPM •  Otherwise Normal •  Indicates Heat

© Dr. Jim Ventresca 2015 223 1st 2nd 3rd

S M D

Thin Pulse

S M D

1st 2nd 3rd

•  Feels Thin in Diameter •  Indicates Deficiency of Substance

•  Yin or Blood •  Therefore is Also Weak

•  Otherwise Normal


Sinking (Deep) Pulse•  Found Only in The Deep Level •  Indicates

•  Yang Deficiency and/or •  Disorder In the Lower Warmer


S M D

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Floating (Superficial) Pulse•  Found Only or Mostly in The Superficial Level•  Indicates

•  Yang Disorder •  OPI and/or •  Disorder In the Upper Warmer


S M D

Minute Pulse•  Found Only in The Deep Level•  Very Thin and Very Weak•  Indicates Deep Seated /Long Term

Deficiency (Qi & Yang)


S M D

•  Li Shi Zhen: 28 Qualities •  Slippery/Rolling / “Pearls in a Basin”

•  Indicates Dampness •  Wiry / “Guitar String”

•  Indicates Stagnation

Pulse Qualities

Slippery

Wiry!© Dr. Jim Ventresca 2015 228

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Pulse Description IndicationWeak DeficiencyFull ExcessThin Deficiency of SubstanceSlow ColdRapid Heat

Floating Superficial /Upper Warmer DisharmonySinking Internal / Lower Warmer Disharmony

Slippery/Rolling Dampness / PregnancyWiry Stagnation

Simple Pulse Parameters


Pulse Description Indication TongueWeak Qi Deficiency Pale Swollen

Weak & Slow(Sinking)

Yang Deficiency Pale Swollen Wet

Weak & Thin Blood Deficiency Pale ThinWeak Thin & Rapid Yin Deficiency Red Thin Peeled

Weak & Slippery Spleen Deficiency w/Damp

Pale Greasy

Clinical Pulse Diagnostics I!(Deficient Pulses)

Include Organ Associations When Detected© Dr. Jim Ventresca 2015 230

Pulse Description Indication TongueFull & Rapid True Heat Red / Yellow Coat

Floating OPI Wind NormalFloating & Rapid OPI Heat Thin Yellow CoatSlippery & Rapid Damp Heat Greasy Yellow

Slightly Wiry Qi Stagnation(Liver)

Slightly Purple

Definitely Wiry Blood Stagnation Dark Purple (Spots)

Clinical Pulse Diagnostics II!(Excessive Pulses)

Include Organ Associations When Detected


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