TCM patterns behind skin conditions
A pattern is the internal picture a practitioner identifies from signs, tongue and pulse. These are the patterns that matter in skin practice, each with the conditions it appears in and the treatment it points to.
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Bladder Deficient and Cold膀胱虚寒
A pattern in which the Bladder has lost the warmth it needs to hold and release urine. Kidney Yang supplies that warmth, so when it declines the Bladder cannot close the gate: urine comes…
Blood Deficiency血虚
The nourishing substance of the body is low. Blood is described as what colours the complexion, moistens the skin and hair, and houses the spirit, so when it is deficient the picture is…
Blood Deficiency with disharmony of Liver and Spleen肝脾不和血虚
Blood deficiency with the Liver and Spleen pulling against each other. The Liver affects the Spleen through emotional constraint and the Spleen fails to produce enough Blood to nourish the…
Blood Deficiency with External Wind血虚生风
Blood is what keeps skin supple. When it runs low the skin dries, flakes and loses colour, and the tradition describes the resulting restlessness as Wind: itch that moves from place to…
Blood Stagnation血瘀
Blood that no longer moves freely. The tradition reads stasis by three signs: pain that is fixed and stabbing rather than moving, a dusky tinge to the complexion or lips, and a purple or…
Blood Stagnation in the Directing and Penetrating Vessels冲任瘀阻
Blood stasis in the two vessels that govern menstruation, the Chong and the Ren. The pain is fixed and stabbing in the lower abdomen and worst on the first days of the period, the menstrual…
Blood Stagnation with Heat瘀热
Blood that has pooled and then heated. The stasis gives fixed, night-worse pain and a purple tongue; the Heat adds restlessness, a reddish tinge to the purple, and bleeding that comes dark…
Body Fluids Deficiency津液亏虚
The lighter fluids of the body are low. This is more specific than Yin deficiency: it is the moisture that lubricates the mouth, skin, eyes and bowels that has been used up, usually by…
Bright Yang Stomach Heat阳明胃热
The classic fever picture of the tradition: sustained high fever, profuse sweating that brings no relief, intense thirst for cold drinks, and a surging pulse. It is Heat concentrated in the…
Cold invading the Channels (Joints and Muscles)寒痹
Cold that has lodged in the channels and joints. The pain is severe and fixed in one place, the joint feels cold to the touch rather than hot, and warmth relieves it. It is the cold type of…
Cold-Damp invading the Spleen寒湿困脾
Cold and Dampness obstructing the Spleen. The middle feels cold, full and heavy, the stools are loose or watery, and the tongue is pale, swollen and thickly white-coated with an excessively…
Collapse of Yang亡阳
A critical loss of the body's warming force. The picture is cold and quiet rather than hot and agitated: profuse cold sweat, ice-cold hands and feet, an ashen-white face, and a pulse that…
Collapse of Yin亡阴
A critical loss of the body's cooling and moistening substance. It follows severe fluid loss, from high fever, heavy sweating, vomiting, diarrhoea or bleeding, and it presents as a hot,…
Damp-Cold寒湿
Cold and Dampness together. The body feels heavy and cold, the limbs are cold, the stools are loose and the tongue has a thick white greasy coat that looks wet. It is the general cold-damp…
Damp-Heat湿热
Two influences acting together: Dampness, which is heavy, sticky and slow, and Heat, which is red, active and inflammatory. Their combination gives the skin a particular look: red, weepy,…
Damp-Heat in Stomach and Spleen脾胃湿热
Damp-Heat settled in the digestive centre. The result is a middle that feels blocked and sticky: bloating and fullness after eating, stools that are sticky or incomplete, a bitter or sticky…
Damp-Heat in the Liver肝经湿热
Damp-Heat travelling along the Liver channel. The rib-side pain and bitter taste are Liver signs, and because the Liver channel runs through the lower body, the pattern often shows there…
Damp-Heat in the Liver Channel肝胆湿热
Damp-Heat travelling along the Liver channel. It shows where that channel runs: the genitals, the groin, the rib area and the eyes. There is redness, itching, swelling or discharge, a…
Damp-Heat in the Lower Burner下焦湿热
Damp-Heat collected in the lower part of the body. It shows in the urine, the bowels and the genital area: dark scanty or painful urination, a heavy feeling low down, discharges that smell…
Damp-Heat invading the Spleen湿热困脾
Damp-Heat that has settled in the Spleen itself. The middle feels blocked: stuffiness and fullness in the upper abdomen, poor appetite with nausea, and a thick yellow greasy coating. It is…
Damp-Phlegm痰湿
The heavy, sticky form of Phlegm that comes from Dampness. It is not the hot yellow Phlegm of infection but a white, plentiful, easy-to-cough mucus, together with heaviness, chest and…
Damp-Phlegm in the Lungs痰湿阻肺
Damp-Phlegm settled in the Lungs. The cough produces copious white sticky phlegm that is easy to bring up, the chest feels full and heavy, and the tongue has a thick white greasy coat. It…
Damp-Warmth湿温
A febrile illness where Dampness holds the Heat down. The fever is low-grade and feels muffled rather than burning, the body feels heavy and tired, the chest and upper abdomen are stuffy,…
Dampness invading the Channels (Joints and Muscles)湿痹
Dampness lodged in the channels, with Dampness as the leading factor. The pain is heavy and aching rather than sharp, fixed in one place, with swelling and often numbness. The limbs feel…
Deficiency of the Liver and Kidney Yin肝肾阴虚
The deeper Yin of the Liver and Kidney is low together. The Kidney side gives a sore weak lower back, tinnitus and night sweats; the Liver side gives dry eyes, blurred vision and dizziness.…
Disharmony between Heart and Kidneys心肾不交
The Heart and Kidney have lost their connection. Normally the Kidney's water rises to cool the Heart and the Heart's fire descends to warm the Kidney; when that exchange fails, there is…
Dry-Wind风燥
Autumn dryness carried in on the Wind. It arrives as a dry cough with little or no phlegm, a dry nose, mouth and throat, and a mild chill with low-grade fever. It is the autumn counterpart…
Empty-Heat caused by Yin Deficiency阴虚内热
Heat that comes from lack, not excess. When the cooling, moistening side of the body runs low, warmth is no longer held in check and a low-grade heat builds: afternoon flushing, night…
Excess-Heat实热
Full Heat with nothing deficient behind it. The signs are strong and obvious: high fever or a strong sense of body heat, intense thirst for cold drinks, a red face and a rapid forceful…
Greater Yang Attack of Wind太阳中风
The classic Wind pattern of the Taiyang stage in the classical literature. Unlike Wind-Cold, the pores are open rather than closed, so the person sweats spontaneously and is sensitive to…
Heart Blood Stagnation心血瘀阻
Blood stasis in the vessels of the Heart. It presents with stabbing chest pain in a fixed spot, dark lips and nails, a purple tongue and a choppy or knotted pulse. Of all the patterns in…
Heart Fire blazing心火上炎
Heat concentrated in the Heart. The signs are all in the chest and the mouth: palpitations, restlessness and agitation, mouth or tongue ulcers, and sleep that is broken and full of dreams.…
Heart Yang Deficiency心阳虚
The Heart has lost its warmth and driving force. Beyond the palpitations and fatigue of Heart Qi deficiency, there is cold: cold limbs, a bright pale face, a feeling of stuffiness or…
Heat and Blood Stagnation in the Lower Burner下焦蓄血
Stagnant Blood with Heat, pooled in the lower abdomen. The signs are a fixed sharp pain that worsens on pressure, hardness or fullness low down, dark blood, and often an odd mental…
Heat in Pericardium热入心包
Heat that has reached the Pericardium, the layer described as guarding the Heart. The signs are neurological as much as febrile: high fever with loss of consciousness, delirium or…
Heat in the Blood血热
Heat that has gone into the Blood itself. Rather than sitting on the surface, it moves with the Blood, producing bleeding where it forces vessels open, redness that is deep rather than…
Heat in the Ying Level热入营分
Heat that has moved from the Qi level into the Ying, the nutritive level. The signature is a fever that worsens at night with a crimson tongue, mental restlessness and a fine rapid pulse.…
Heat invading the Channels (Joints and Muscles)热痹
The hot form of painful obstruction. The joints are red, swollen and hot to the touch, and pain is relieved by cold rather than warmth. It is the pattern that flares in hot weather and…
Heat victorious agitating Blood热盛动血
Heat so intense that it drives the Blood out of its vessels and unsettles the spirit. It presents as high fever with bleeding from several sites, dark or purplish skin rashes, and…
Kidney and Liver Yin Deficiency肝肾阴虚
The deep Yin reserves of both Kidney and Liver are low. The Kidney supplies the body's foundational Yin and the Liver stores the Blood that moistens the eyes, sinews and skin. When both are…
Kidney and Liver Yin Deficiency causing Heat in the Blood肝肾阴虚血热
Yin deficiency that has become hot enough to drive the Blood. The deep Yin signs are there - lower back weakness, night sweats, dry mouth - and with them the signs of Blood Heat:…
Kidney and Spleen Yang Deficiency脾肾阳虚
The warming systems are depleted together. The Kidney supplies the body's deepest warmth and the Spleen depends on it to digest; when both are weak, the picture is cold and slow: cold…
Kidney Essence Deficiency肾精不足
The deepest reserve is depleted. Essence is described as the substance behind growth, reproduction and the ageing process, so when it is low the signs are about development and decline:…
Kidney Yang Deficiency肾阳虚
The deepest warming reserve is low. Kidney Yang is described as the body's pilot light: it warms the lower back and legs, drives fluid transformation and supports sexual and reproductive…
Kidney Yang Deficiency with Water overflowing肾阳虚水泛
Kidney Yang too weak to move water. Fluid that should be transformed and excreted instead accumulates: swelling of the legs and ankles, scanty difficult urination, a cold lower body, and a…
Kidney Yin Deficiency With Empty-Heat Blazing肾阴虚火旺
The Kidney's deep cooling reserve is depleted and the resulting Heat is pronounced. The pattern is dry and warm: night sweats, heat in the palms, soles and chest, tinnitus, a sore lower…
Liver and Gallbladder Damp-Heat肝胆湿热
Damp-Heat settled in the Liver and Gallbladder. It shows on the right side under the ribs, with distension or pain, a bitter taste, dark yellow urine and a thick yellow greasy coating.…
Liver Blood Deficiency肝血虚
Blood deficiency showing through the Liver. The Liver stores Blood and opens to the eyes, so when its Blood is low the signs are visual and cyclical: dizziness, blurred or diminished…
Liver Blood Stagnation肝血瘀滞
Blood stasis in the Liver channel. It shows as fixed stabbing pain in the ribs or abdomen, a purple tongue with stasis spots, dark clotted periods, and a wiry choppy pulse. It is the stasis…
Liver Fire Blazing肝火上炎
Intense Liver Heat that rises upward. The signs are all in the upper body: throbbing headache at the temples or crown, red painful eyes, a bitter taste, sudden ringing in the ears, and a…
Liver Qi Stagnation肝气郁结
A blockage rather than a deficiency: the free flow of Qi through the Liver system is stuck. The signs are distension along the ribs and flanks, irritability or low mood, frequent sighing,…
Liver Qi Stagnation that transforms into Heat肝郁化火
Stuck Liver Qi that has heated up. The original picture is tension, irritability and distending rib pain; when the stagnation persists it is said to transform into Heat, adding a bitter…
Liver Wind agitating Internally due to Liver Blood Deficiency肝血虚生风
Internal Wind that arises from a lack of Blood. Unlike the external Wind of a cold, this Wind comes from within: the tendons and sinews are undernourished, so they tremble, twitch and go…
Lung Heat肺热
Heat settled in the Lungs. The cough is productive with thick yellow phlegm, and there is fever and thirst. It is the deeper stage of a Wind-Heat invasion, or the result of Heat that has…
Painful Obstruction due to Damp Heat in Channels湿热痹阻
Damp-Heat lodged in the channels and joints. The sign that separates it from other joint patterns is heat: the joint is red, swollen and hot to the touch, and it is worse with warmth and…
Painful Obstruction with Liver and Kidney Deficiency肝肾亏虚痹证
Joint pain that has become chronic and has depleted the Liver and Kidney. The obstruction is still there, which is why cold and damp weather still worsens the pain, but the person is now…
Painful Obstruction with Qi and Blood Deficiency气血亏虚痹证
Joint pain in someone who is depleted. The pain is a lingering dull ache that is worse after exertion, and it comes with numbness, fatigue and pallor. It is the painful obstruction pattern…
Painful Obstruction with Wind-Cold-Damp风寒湿痹
All three external pathogens in one joint picture. Wind gives pain that moves, Cold gives pain that is fixed and worse with cold, and Dampness gives heaviness and swelling. Together they…
Phlegm in the Channels (Joints and Muscles)痰阻经络
Phlegm that has settled in the channels, joints and muscles. It produces pain that is fixed and stabbing, swelling that feels hard rather than soft, numbness or heaviness, and a purple…
Phlegm-Dampness in the Middle-Burner痰湿中阻
Phlegm and Dampness blocking the middle. The upper abdomen feels full and stuffy, there is nausea, the body feels heavy, and the tongue has a thick greasy sticky coat. It is the…
Phlegm-Heat痰热
Phlegm with Heat in it. The phlegm is thick, sticky and yellow, the chest feels full and oppressed, and the person is restless or irritable. The tongue has a yellow greasy coat and the…
Phlegm-Heat in the Lungs痰热壅肺
Phlegm and Heat congesting the Lungs. The cough brings up copious yellow sticky sputum, breathing is short or rapid, the chest feels tight, and there is fever or a sensation of heat. It is…
Protective Qi Deficiency卫气虚
The body's outer defence is weak. Protective Qi, the layer that holds the surface closed and keeps pathogens out, is what fails here: the person sweats without exertion, catches colds…
Qi and Blood Deficiency气血两虚
Both of the body's main resources are low at once. Qi gives energy, warmth and the push behind function; Blood gives substance, colour and moisture. When both are deficient the picture is…
Qi And Blood Stagnation气滞血瘀
Two blockages together: Qi that no longer moves freely and Blood that has pooled behind it. The pain has both qualities at once, distending and fixed, and it shifts with stress. The tongue…
Qi and Yin Deficiency气阴两虚
Both the push and the moisture are low. Qi deficiency gives fatigue and breathlessness; Yin deficiency gives dryness and a low-grade heat. Together they produce a particular picture: tired…
Qi Deficiency causing Blood Stagnation气虚血瘀
Stasis that comes from weakness rather than blockage. Qi is what pushes Blood along; when Qi is too weak to do that, Blood slows and pools. The picture therefore combines stasis and…
Qi not controlling Blood气不摄血
Bleeding caused by weakness rather than by Heat. Qi is described as holding Blood inside the vessels; when Qi is too weak to hold it, bleeding happens from various sites: nosebleeds,…
Spleen and Kidney Qi Deficiency脾肾气虚
Both the Spleen and the Kidney are low in Qi. The Spleen side gives poor appetite, loose stools and fatigue; the Kidney side gives a sore weak lower back, frequent urination and deep…
Spleen and Stomach Qi Deficiency脾胃气虚
The digestive centre is simply weak. The Stomach receives food and the Spleen transforms it, and when both are low the result is a poor appetite, bloating after eating, loose stools and…
Spleen Blood Deficiency脾血虚
Blood deficiency with the Spleen clearly at its root. There is the pallor and dizziness of Blood deficiency, but also the digestive weakness that caused it: poor appetite, loose stools and…
Spleen Deficiency with Dampness脾虚湿困
A pattern built on two layers that feed each other. The Spleen is too weak to transform food and move fluids, so fluids pool into Dampness; the Dampness is heavy and obstructive, and it…
Spleen not controlling Blood脾不统血
Bleeding because the Spleen is too weak to keep Blood in its place. The blood can come from the stool, urine, skin or uterus, and it is chronic and low-grade rather than sudden. Alongside…
Spleen Yang Deficiency脾阳虚
The Spleen has lost its warmth. Beyond the poor appetite and loose stools of simple Spleen deficiency, there is cold: dull abdominal pain that warmth and pressure relieve, cold hands and…
Summer Heat with Dampness暑湿
The particular heaviness of summer illness. Heat and Dampness arrive together in hot humid weather, so the picture is not simply hot: there is fever with a heavy body, a stuffy chest and…
Toxic-Heat热毒
Heat concentrated past the point of ordinary inflammation. Where Heat is red and hot, toxic Heat is red, hot, swollen, painful and often purulent: boils, abscesses, infected sores, a badly…
Toxic-Heat Stagnation热毒壅滞
Toxic Heat that has become stuck in one place. It is the localised, concentrated form: a single area that is red, swollen, hot and painful, with pus forming or already discharging,…
Wind-Cold风寒
The common cold in its cold form. Wind brings it on suddenly and affects the surface; Cold gives pronounced chills, little fever, no sweating, a runny nose with clear discharge, and body…
Wind-Cold-Damp风寒湿
Wind, Cold and Dampness together, settled in the channels. The pain moves because of the Wind, is sharp and worse with cold because of the Cold, and feels heavy and stiff because of the…
Wind-Cold-Water invading the Lungs风寒水饮犯肺
Wind and Cold driving water-fluid into the Lungs. The cough produces copious thin white frothy sputum, breathing wheezes or shortens, and the person is chilled. It is the pattern behind the…
Wind-Damp风湿
Wind and Dampness together. Wind makes the pain wander from joint to joint; Dampness makes the limbs feel heavy and the tissues swollen. It is the pattern behind joint and muscle pain that…
Wind-Heat风热
The early stage of a heat-type cold. Wind brings the suddenness, the moving quality and the surface symptoms; Heat brings the sore throat, the fever and the redness. It is the pattern…
Wind-Heat invading the Lungs风热犯肺
Wind-Heat that has moved from the surface into the Lungs. The sore throat and fever of the early stage are joined by a cough, and the Lungs become the centre of the picture. It is the…
Yang Deficiency with Cold-Damp阳虚寒湿
Weakness combined with cold and dampness. Yang is too low to warm and dry the body, so Cold and Damp settle in: coldness along the back, aching joints, cold hands and feet, and no thirst,…
Yin and Blood Deficiency阴血亏虚
Two related deficiencies at once. Blood is the nourishing substance and Yin is the cooling, moistening half of the body; when both are low the picture is dry, pale and restless: dizziness,…
Yin Deficiency阴虚
The body's cooling and moistening half is low. It shows as dryness and a low-grade heat that is worse at night: a dry mouth and throat, night sweats, heat in the palms, soles and chest, a…
Ying-Wei Disharmony营卫不和
The two surface layers are out of step. Nutritive Qi (Ying) and Protective Qi (Wei) are meant to work together at the surface; when their relationship is disturbed, the result is a leaky…
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