1. Introduction to TCVM Dx with Tongue & Pulse Basic TCVM Diagnostic Equipment

2. OVERVIEW OF TCVM Health and disease Health: the natural state, everything in balance. Based on energetic physiology: 1.Qi & blood are good quality with normal circulation 2.Zang ‑ fu organs work properly.

3. OVERVIEW OF TCVM Health: Qi & blood are good quality with normal circulation. Created by Spleen: absorbs Qi from food and liquidDigestion Lung: absorbs energy from the air.Oxygen Kidney: stores constitutional energy.Adrenal Zang ‑ fu organs work properly. LungLarge Intestine KidneyUrinary Bladder LiverGall Bladder HeartSmall Intestine Spleen (Pancreas)Stomach

4. Disease: Imbalanced symptoms: too much heat, cold, damp, dry, etc. Qi and blood poor quality; Qi and blood circulation impaired One or more of the zang ‑ fu is not working well

5. Cause of Disease Environment and climate stress: 6 pathogen qi: WindFire/Heat Cold Summer Heat Damp Dryness Emotional stress: 7 emotions: Joy/Fright--------> Heart Anger--------> Liver Sadness/Grief--------> Lung Worried -------> Spleen Fear/Shock-------> Kidney Life Style (Diet, daily activity) Others Toxins (micro ‑ organisms: virus, bacteria, protozoa)-Heat Toxin Poison Trauma

6. Organization Format to Pathophysioloty 1) Eight Principles YangYin HotCold ExteriorInterior ExcessDeficiency 2) Six Stages of Wind Invasion (epidemics by microorganisms) TaiyangSurface, skin ShaoyangHalf interior, half exterior (lymph) YangmingQi level: high fever TaiyinLung, spleen ShaoyinKidney, heart JueyinPericardium (CVD), liver

7. 3) Four Levels of Heat Invasion (microbe epidemics): Wei: superficial, initial stage, exterior Qi: meridians Ying: nerve systems Blood: internal organs 4) Zang Fu syndromes (internal diseases) Heart: Cardiovascular, Central Nervous System, mental Lung: Respiratory, skin, immune Spleen: Alimentary tract, immune, muscular, endocrine, metabolic Liver: Hepatobiliary, eyes, endocrine, metabolic, ligaments and tendons, hooves/paws Kidney: Reproductive, renal, bone and joints, endocrine, and metabolic 5) Channel pathologies (arthritis, trauma, paralysis)

8. Diagnosis 1.Pulse: depth, width, height, force, quality 2.Tongue: pathological presentations: Shapes, body colors, coat colors, coat textures 3.Looking (shen/skin, shapes, eyes, face) 4.Smelling (skin, breath) 5.Listening (voice, respiration) 6.Symptoms and history

9. Five step methodology 1.Signs/symptoms (patient’s presentation) 2.Diagnosis (Name of disease, western diagnosis) Each disease has 1 to 10 differentiations 3.TCM diagnosis (pattern differentiation) 4.Treatment Strategy Based on the differentiation Energetic pathophysiology 5. Treatment (herbs or acupuncture)

10. Normal Tongue  Pink Red Red White White Blue Blue  Moist  Fits mouth  Good tone

11. Tongue Changes- -Color Pale Pink Red

12. Tongue Changes- -Color  Purple  Dark Red  Black (ashen)  Normal

13. Pale Tongue Wet is Qi deficiency Dry is Blood Deficiency Wet, Swollen (teeth marks) & purple is Yang deficiency

14. Red Tongue HEAT DeficiencyExcess

15. Purple Tongue DeficiencyExcess Yang Deficiency Stagnation Cold

16. Tongue-Organ Relationship Heart Lung Spleen Liver Kidney

17. Tongue Coatings  White Coating Normal Normal Excess Cold Excess Cold  Yellow Coating Heat Heat  Greasy Coating Can’t be Scrubbed off Damp Not as important in animals nor as prominent

18. Pulses Left (Yin & Blood) Right (Qi & Yang) UpperHeartLung MiddleLiverSpleen LowerKidneyYinKidneyYang

19. Pulse Depth Superficial Middle DeepExcessDeficiency

20. Pulse Character SlowFast ColdHot

21. Abnormal Pulses  Slippery Damp Damp Like being in a bogLike being in a bog  Wiry Liver Stagnation Liver Stagnation Tight like a wireTight like a wire  Irregular Heart Qi or Blood Heart Qi or Blood arrhythmiaarrhythmia

22. Using Tongue & Pulse  Pulse looks at current events  Tongue reflects history  Together, they help determine the nature, location and Zang-Fu involvement in the disease process