Foundations: Deficiency and excess

Abdominal pain improves with pressure and local warmth. Deficiency or excess?

1. Deficiency: pressure and warmth relieve it
2. Excess: all abdominal pain is
3. You can't tell without the pulse

Sort each finding into deficiency or excess.

• Weak voice, speaks littleDeficiencyExcess
• Loud voice, talks a lotDeficiencyExcess
• Worse on exertionDeficiencyExcess
• Worse at rest, better with movementDeficiencyExcess
• Spontaneous daytime sweatingDeficiencyExcess
• Fixed pain that refuses touchDeficiencyExcess

The pulse feels strong, broad and pushes back at the finger. What does it say?

1. Deficiency: the strength is only apparent
2. Excess: something in surplus is pushing
3. Nothing on its own: the pulse does not report this

Pale, swollen tongue with teeth marks along the edges. Deficiency or excess?

1. Deficiency: no strength left to move and hold
2. Excess: the swelling indicates fullness
3. Excess heat: the marks are inflammation

Two headaches. One is dull, comes and goes and worsens by the end of the day; the other is stabbing, fixed and cannot bear touch. How do you read them?

1. Both excess: pain always is
2. Both deficiency: neither has fever
3. The first deficiency, the second excess

Sort each case: pure deficiency, pure excess, or both at once.

• Years of fatigue, no pain, thin pulseDeficiencyExcessMixed
• Yesterday's high fever with thirst and a full pulseDeficiencyExcessMixed
• Years of fatigue with bouts of distension and painDeficiencyExcessMixed
• Faint voice, easy sweating, loose stoolsDeficiencyExcessMixed
• Fixed pain with clots and a purple tongueDeficiencyExcessMixed
• Weak background digestion with bloating that comes and goesDeficiencyExcessMixed

A very weak base plus an acute attack of external cold with fever. Where do you start?

1. With the base: nothing holds without it
2. With the acute layer, taking care not to drain the base further
3. With both at equal strength at the same time

Match each finding with its reading.

Sweats a lot, and afterwards is exhausted and chilled. What does that indicate?

1. Deficiency: the sweat carries off what little there was
2. Excess heat: sweating is how it is expelled
3. Nothing: sweating is normal

Order the questions that separate deficiency from excess, from most decisive to fine detail.

1. How long have you had it?↑↓
2. Better or worse with exertion?↑↓
3. Does it accept or refuse pressure?↑↓
4. What are the voice and breath like?↑↓
5. What do the tongue and pulse say?↑↓

Background fatigue with bloating that comes and goes. Build the mixed diagnosis.

A very exhausted person suddenly turns euphoric, flushed and full of energy. What should you think?

1. They have improved and the treatment is working
2. A new heat excess has appeared
3. It may be apparent fullness on top of a serious deficiency

Sort each action by the picture it belongs to.

• Tonify with short, gentle sessionsDone in deficiencyDone in excess
• Disperse and release what has piled upDone in deficiencyDone in excess
• Support digestion so more is producedDone in deficiencyDone in excess
• Move what has come to a standstillDone in deficiencyDone in excess
• Reduce stimulation if the person tiresDone in deficiencyDone in excess
• Increase stimulation if the response is smallDone in deficiencyDone in excess

Why does the duration of a picture point so strongly toward deficiency or excess?

1. Because chronic pictures are always deficiency
2. Because acute usually comes from surplus, and long-standing eventually spends
3. Because time is irrelevant: only intensity counts

Match each pain with what lies behind it.