Zang Fu organs: Common patterns

A pattern is a sentence

It is built from three pieces: which substance is short or in excess, of what nature, and in which organ. Whoever knows the grammar can name patterns they have never memorised.

Substance

qi, blood, yin, yang, damp, phlegm

Nature

deficiency or excess; cold or heat

Organ

where it shows

Example

Spleen qi deficiency

Common mistake: Learning patterns as a closed list. They are combinations, and the list only collects the commonest ones.

Spleen qi deficiency

Probably the commonest pattern in all of clinic. Everything the Spleen does gets half done: little transforming, little holding, little producing.

Digestive

bloating after eating, loose stools

General

fatigue, especially mornings and after meals

Tongue

pale, swollen, with tooth marks

Pulse

weak, especially in the right middle position

Common mistake: Confusing it with damp. Here the problem is missing strength; damp is what piles up afterwards if it is not corrected.

Liver qi stagnation

Nothing is missing: something is not circulating. That is why the hallmark is not fatigue but a sense of tightness that comes and goes and shifts with mood.

Sensation

tightness in chest or flanks, sighing

Character of the symptom

changeable, migratory, worse when held in

Cycle

breast tenderness and pain before the period

Pulse

wiry, especially in the left middle position

Common mistake: Tonifying. Stagnation does not need more qi: it needs the qi there to move.

Kidney yang deficiency

The root of the whole body's warmth has fallen short. That is why the cold is not only in the back: it shows in digestion, in urination and in mood.

Local

dull low back pain and cold in the lower area

Urination

copious, clear and at night

General

coldness, apathy, worse in winter

Tongue

pale, wet and swollen

Common mistake: Looking only for low back pain. Clear night urination is a far more specific sign.

Bloating after meals, loose stools, fatigue and a pale tongue with tooth marks. Build the name.

Two patients with abdominal distension. Which datum best separates Spleen deficiency from Liver stagnation?

1. How much wind there is
2. Whether there is fatigue or not
3. Whether the distension shifts with mood and eases on belching, or always follows meals and goes with loose stools