Traditional Chinese Internal Medicine Heart Disorders		tcm.health-info.org
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Internal Medicine – Heart Disorders Back To Internal Medicine Home Page Click below for information… Always Tired Angina Depression and Manic Psychosis Insomnia Palpitation Acupuncture treatment of Chest pain Important: as with all items posted on TCM Health-info, it is very strongly recommended that you seek proper advise from your healthcare professional before administering any form of treatment to yourself. This website is for informational purposes and does not replace the proper diagnosis of your physician. Overview Of Heart Function: The heart governs blood in two different ways. It is the area where food Qi (Gu Qi) is transformed into blood. The heart Qi is the main organ responsible for moving blood within the blood vessels in order to transport blood to all tissues of the body. The heart houses the body’s Shen. Shen indicates the mentality of an individual while it also shows the emotional and spiritual aspects. So it not only relates to the heart but it includes emotions, mentality and spirituality of the bodies overall constitution. Disorders of the heart include, excessive tiredness, angina, insomnia, depression, manic psychosis and palpitations. Click here for more TCM Heart Foundations: Functions of the TCM Heart Always Tired – Duo Mei Top of the Document The patient can sleep anywhere or anytime no matter how much sleep they have received. They may wake up in the morning and keep on sleeping through out the day, fatigue is so bad that patient will be unable to work. Is usually caused by Yang Qi Deficiency. Western Medicine Chronic fatigue, Bi polar or Narcolepsy May Be Caused By: Accumulation of Phlegm and Damp: Phlegm & Dampness (yin pathogens) block yang Qi Spleen Qi Deficiency: Creates Qi & Blood deficiency – body not nourished, whole body becomes flaccid Kidney Yang Deficiency: Old age/chronic illness – bones, mind, essence and spirit all become weak Traumatic Injury/Blood Stasis: Qi & Blood do not circulate creating deficiency Sudden Shock/Fear: Causes Qi stagnation- Qi doesn’t ascend to brain Damp Accumulation (blocks spleen Qi) Heaviness in head and limbs, edema, poor appetite, fullness in chest, nauseous T – greasy, swollen P – soft Treatment: Dry Dampness and strengthen Spleen Qi Formula Tai Wu Shen Zhu San Turbid Phlegm Stagnation Heaviness in head and limbs, poor appetite, fullness in chest, nauseous, over weight T – greasy, swollen, sticky P – slippery Treatment: Eliminate Phlegm and invigorate Spleen. Formula Wen Dai Tang Spleen Qi Deficiency Unable to stay awake after meals, poor appetite, soft stools, spleen Qi deficiency symptoms T – pale, puffy, teeth marks P – soft, weak Treatment: Strengthen spleen Qi and eliminate dampness Formula Xiang Sha Lu Jun Zi Tang Bu Zhong Yi Qi Tang (spleen Qi sinking) Kidney Yang Deficiency Spleen Qi deficiency symptoms with cold symptoms, lack of concentration, poor memory T – pale P – deep, thin Treatment: Nourish Kidney Yang Formula Fu Zi Li Zhong Tang Blood Stasis History of traumatic injuries, H/A, sleepiness with cloudy dizziness T – purple P – uneven Treatment: Promote blood circulation and remove blood stasis Formula Tong Qiao Huo Xue Tang Angina – Heart Pain – Xin Tong Top of the Document Angina is a cramping pain in the chest which can radiate to the shoulder blade, down the left arm and up the throat to the teeth. Heart pain can also be accompanied by palpitations, shortness of breath and a distended or fullness feeling behind chest. Western Medicine: Angina is a lack of oxygen supply to the heart itself causing pain. This is often caused by coronary Heart disease causing Heart Attacks or inflammatory heart diseases. May Be Caused By: External Pathogen Invasions: -Ext. Cold- stagnates Heart meridian Qi -Summer Heat – Injures Heart meridian Qi Emotion -over thinking, worry, anger, joy, sad, fear Diet -injures spleen producing Phlegm which blocks Heart meridian Qi. Deficiency -chronic illness & over work injures Qi & Blood -Liver and Kidney Deficiency – injures Heart Differential Diagnosis: ST Ache -lower pain which does not radiate into the chest and down the left arm. Accompanied by belching, flatulence, acid regurgitation Hypochondriac-Chest Pain -related with cough and febrile disease history, accompanied by liver Qi stagnation symptoms. Heart Meridian Blocked By Cold Sudden onset of heart pain which radiates to back, usually in cold season or sudden cold weather, cold body with cold sweat, palpitations. T – slight purple, thin white coat P – tense Treatment: expel cold and remove stagnation to relieve pain Formula Dang Gui Si Ni Tang Stagnated Fire Attacking Heart Burning heart pain, thirsty, irritable, rough breathing, fever, constipation. T- red, yellow coat P – rapid Treatment: Purge fire, clear heat to remove stagnation and promote blood circulation. Formula Xiao Xian Xiong Tang Qi Stagnation in Heart Fullness in chest and Heart with moving dull pain. Pain agg. By emotional stress. Accompanied by Qi stagnation symptoms. T – pale, purple, red tip P - wiry Treatment: soothe liver and regulate Qi to relieve pain. Formula Chai Hu Shu Gan San Blood Stasis Severe heart pain, stabbing, squeezing fixed pain T – purple veins under tongue P – uneven, irregular Treatment: promote blood circulation and remove blood stasis to relieve pain Formula Xue Fu Zhu Yu Tang Phlegm Stasis Heavy oppression in chest, difficult breathing, agg. During damp weather, productive cough, soft stool, sticky sensation, nautious, phlegm/damp symptoms T – purple, thick greasy coat P – wiry Treatment: Eliminate phlegm, clear heat/wind, invigorate Qi to relieve pain. Formula Gua Lou Xie Bai Ban Xia Tang Wan Dan Tang – Phlegm Heat – dry stool, dysphasia Di Dan Tang - Phlegm Wind – numbness/dizziness Heart Qi Deficiency Dull pain, short of breath, agg. By activity, pale complexion, spontaneous sweat T – pale P – weak, deep Treatment: Nourish heart Qi Formula Bao Yuan Tang Heart Yin Deficiency Dull burning pain, insomnia, dysphasia, palpitations T – red tip, scanty coat P – rapid, thin Treatment: Nourish heart Yin Formula Tian Wang Bu Xin Dan Heart Yang Deficiency Pain and palpitations, almost can’t function, fatigued, cold, agg by cold and exertion T – pale P – weak, deep Treatment: Nourish yang Qi and invigorate heart Yang Formula Ren Shen Tang + Shen Qi Wan - KD yang def. + Zhen Wu Tang - edema Depression And Manic Psychosis – Bipolar Dian Kuang Top of the Document Depression (Dian) is the emotional state of being sad or extreme feelings of dejection, lack of worth and emptiness. Signs of depression (Dian) range from lack of motivation, failure to concentrate, lack of expression on ones face, quiet, and in severe conditions body functions can be effected. Manic Psychosis or Mania (Kuang) is a mood disorder where there is excess excitement, nervousness, excess talking, loud talking, and possible violent – destructive or self-destructive behaviour. May be caused by: Qi Stagnation -Liver/Spleen stagnation produces phlegm & blood stasis blocking Heart meridian and blocks the mind Phlegm -blocks mind Fire -more for Kuang behaviour- fire effects (St/LV/GB) which then attacks Heart and blocks the mind. Blood Stasis -blocks healthy Qi & Blood from nourishing Heart & mind. Depression - Dian Phlegm Stagnation Lack of expression, retarded mental activity, paranoid, talk to themselves, suicidal, poor appetite T – white/greasy coat P – wiry, slippery, deep Treatment: Soothe liver Qi and eliminate phlegm to clear mind Formula Xiao Yao San & Di Tan Tang or Er Chen Tang Qi Deficiency With Phlegm Stagnation Very quiet, dull yellow complexion, soft stools, lack of expression, retarded mental activity, paranoid, talk to themselves, suicidal, poor appetite T – pale, swollen, white/greasy coat P – weak, soft, slip. Treatment: Strengthen spleen Qi and eliminate phlegm to clear mind Formula Si Jun Zi Tang + Di Tang Tang Qi & Blood Deficiency Pale, fatigued, lack of concentration, easily shocked, palpitations, easily sad, easily cry, no courage, disturbed sleeping patter, HT/SP deficient patterns T – pale, teeth marks, thin/greasy coat P – weak, thin Treatment: Nourish Qi/Blood/Heart & spleen to clear mind Formula Yang Xin Tang Manic Psychosis - Kuang Phlegm Fire Acute onset, insomnia, H/A, irritable, red complexion, red eyes, angry eyes Severe case – violent, sweating, shouting T – red, yellow/greasy coat P – slippery, rapid Treatment: Induce vomit then – Purge bowel movement to eliminate phlegm Formula San Sheng Tang = induce vomit Xie Xin Tang + Gun Tan Wan = purge phlegm Yin Deficiency With Hyperactive Fire Fatigued with irritability, anxious, insomnia, easily shocked, red complexion, emaciation T – red, thin coat P – thin, rapid Treatment: Nourish yin and descend fire to calm the mind Formula Er yin Jian + Din g Zhi Wan Qi & Blood Stagnation May occur after traumatic injury or related to menses, H/A, heavy menses with clots, severe PMS, abdominal pain, irritability, insomnia, red complexion T – purple, thin/yellow coat P – thin, wiry, rapid Treatment: Promote blood circulation and regulate Qi to relieve stagnation Formula Dian Kuang Meng Xing Tang + Tao Hong Si Wu Tang (mild) Or + Da Huang Zhi Cong Wan (severe) Insomnia – Shi Mian Top of the Document Insomnia is the chronic inability to sleep not being able to achieve deep sleep. Most people who suffer insomnia will be unable to sleep through out the night with ought waking frequently. The primary organ affecting sleep is the heart, which is usually accompanied by a secondary organ which is dysfunctional. May Be Caused By: Emotions: All 7 emotions may cause dysfunction–Joy (HT)has most impact on sleep HT – Joy – shen/spirit doesn’t calm at night – HT looses control LV – Anger – can’t store blood – liver turns to fire attacking HT SP – Worry/Sad – SP Qi stagnates and can’t T&T Blood to nourish HT Spleen Deficiency: Caused by diet/poor digestion or over working – can’t produce blood to nourish HT Heart & Kidney Disharmony: Causes a disharmony between kidney water and heart fire Liver Blood Deficiency: Liver can’t store ethereal soul – soul becomes active and eyes will not shut Heart & Gall Bladder Qi Deficiency: Impairs heart function – GB can’t ascend or disperse – timid person Phlegm Heat in the Liver / Heart: Phlegm heat entraps heart and mind Disharmony of Stomach Qi: Follows divergent meridian impairing heart Heart & Spleen Deficiency Difficulty falling asleep, excessive dreaming, easily awakened, hard to fall back to sleep, HT blood def. symptoms with SP Qi def. symptoms T – pale, white coat P – weak, thin Treatment: Nourish Heart and Spleen to calm the mind Formula Gui Pi Tang Liu Jun Zi Tang – more SP Qi def. symptoms Suan Zao Ren Tang – more HT Blood def. symptoms Heart Yin Deficiency with Hyperactive Fire Difficult sleeping with irritability, chest dysphoria, yin def. symptoms, dry throat, thirsty, mouth sores, cankers T – red, dry coat P – thin, rapid Treatment: Nourish Yin, clear Heart fire and calm the mind Formula Tian Wang Wu Bu Xin Dan Heart and Kidney Disharmony Difficult sleeping with dysphoria, reproductive disorders, lower back/knee weakness and pain, KD essence def. symptoms. T – red tip, scanty coat P – thin rapid Treatment: Strengthen Kidney to balance Kidney and Heart to calm mind Formula Jiao Tai Wan Liver Blood Deficiency Difficult sleeping, wakes frequently with great difficulty falling back asleep, excessive dreaming, easily angered, hypochondriac/chest pain/fullness, liver stagnation symptoms T – red sides, white/yellow coat P – wiry, rapid (if heat) Treatment: Nourish Liver Blood and sooth Liver to calm the mind Formula Suan Zao Ren Tang Dan Zhi Xiao Yao San + calming herbs (Liver Heat Turns to fire) Heart & Gall Bladder Qi Deficiency Difficult sleeping, timid character, always thinking, can’t make decisions, depression, spontaneous sweat, palpitations, short of breath T – pale P – thin, wiry Treatment: Nourish Ht and Gall Bladder Qi to calm the mind Formula An Shen Ding Zhi Wan + Ren Shen + Fu Ling (to nourish Qi) Phlegm Heat Difficult sleeping with dizziness, blurred vision, fullness in chest, bitter taste, nauseous, phlegm vomit, belching, overweight T – red, greasy yellow coat P – slippery, rapid Treatment: Eliminate Phlegm and clear Heat to calm the mind. Formula Wen Dan Tang Stomach Qi Disharmony Difficult sleeping, nauseous, vomit, bloating, irregular bowel movement, abdominal distension/pain, irregular diet T – greasy coat P – slippery Treatment: Remove Stagnation in Stomach, promote digestion and harmonize ST Qi to calm the mind. Formula Bao He Wan + Chen Qi Tang (constipation) Palpitations – Xin Ji Top of the Document Palpitations are the pounding or racing of the heart and may be accompanied by shortness of breath, fatigue and an irregular pulse which may be short and fast or rapid. Palpitations are usually due to lack of support from another organ creating a Heart deficiency or an external pathogenic factor blocking the Heart meridian. May Be Caused By: Primary Causes General Body Qi Def - giving rise to HT deficiency Emotional Stress - causes LV Qi Stag – impairs HT function - causing LV Qi Stag – blood stag. – blocks HT meridian – impairs HT function -dysfunction of SP – damp/phlegm blocks meridian – SP can’t produce blood to nourish HT Chronic Illness -consumes HT Qi & Yin Secondary Causes Chronic Bi Syndrome - pathogens follows meridian and enters HT Acute/Chronic Bleeding - blood Def. – HT isn’t nourished Epidemic Febrile Disease - Toxic heat – attacks HT Chronic Cough/Asthma -LU Qi/Yang Def. with Phlegm – creates HT Qi Def. Differentiate Between: Running Piglet Syndrome – feeling starts in L. Jiao and goes up to throat - Kidney Disorder Heart Qi Deficiency Heart can’t push blood and can’t nourish itself Palpitations with shortness of breath, dizziness, fatigue, spontaneous sweat, agg. by activity and amel. By rest. T – pale P – thin, weak Treatment: Nourish heart Qi and nourish Yin Formula Wu Wei Zi Tang Heart Yang Deficiency Palpitations, aversion to cold, scanty urine, edema, cold symptoms, shortness of breath, dizziness, fatigue, spontaneous sweat T - P – deep Treatment: Warm and Strengthen Heart Yang Formula Bao Yuan Tang Ling Gui Zhu Gan Tang – induce diresis if edema Heart Yin Deficiency Palpitations induced by fear with insomnia, dysphoria, 5-centre heat sensation, fever, night sweat, yin def. symptoms T – red, scanty dry coat P – thin, rapid Treatment: Nourish heart Yin and calm heart to relieve palpitations Formula Tian Wang Bu Xin Dan Heart and Spleen Deficiency Palpitations with shortness of breath, dizziness, insomnia, poor appetite, soft stools, pale face T – pale, puffy P – weak Treatment: Nourish heart & spleen Formula Gui Pi Tang Heart Qi / Blood Deficiency Palpitations, shortness of breath, dizziness, short of breath, pale Treatment: Nourish heart Qi & Blood Formula Zhi Gan Cao Tang Liver and Kidney Yin Deficiency Palpitations with insomnia, 5-centre heat sensation, back/knee ache/weakness, dizziness, tinnitus, blurred vision, reproductive disorders, LV/KD Yin Def. Symptoms. T – red, thin coat P – thin, rapid Treatment: Nourish Liver – Kidney & Heart to calm the mind Formula Yi Guan Jian - nourish liver & kidney + Suan Zao Ren Tang - nourish heart Spleen and Kidney Yang Deficiency Palpitations with fatigue, tired, aversion to cold, cold limbs, cold body, poor appetite, soft stool, scanty urine T – swollen, pale, white coat P – deep, thin, retarded Treatment: Warm Spleen and Kidney and Induce diresis to calm heart Formula Li Zhong Tang + Zhen Wu Tang (induce diresis) Heart and Gall Bladder Qi Deficiency Palpitations with fear, timid person, lots of dreams, fearful of lights and sounds, poor appetite T - pale P – thin, wiry