All lessons Module 4: Diagnosis Lesson 6
The 16 questions, part 2
What do you ask about the night, the thermostat and the person, and which answer separates two patterns that look alike?
After this lesson you can ask Maciocia's questions 9 to 16 (sleep, sweating, ears and eyes, cold and heat, emotions, sexual life, women, children) so that the answer decides something, tell aversion to cold from feeling cold, read complaints by their time of day, and ask about the red flags first for each topic. Questions 1 to 8 are in lesson 5.
Know by heart
- Two blocks. Night and regulators: sleep, sweating, ears and eyes, cold and heat. The person: emotions, sexual life, women, children; mnemonic: first the night and the thermostat, then the person.
- Sleep. Cannot fall asleep: Blood (Heart-Blood deficiency, 13). Wakes in the night with night sweats: Yin (11, 14). Wakes early and cannot get back to sleep: Gall-Bladder deficiency (textbook knowledge). Sleepy after eating: Spleen; mnemonic: Blood brings sleep, Yin keeps it.
- Sweating. In the daytime on slight exertion: Qi or Yang deficiency. At night: Yin deficiency. On the head only: Stomach-Heat or Damp-Heat. Cold, clammy sweat in someone seriously ill: emergency.
- Ears and eyes. Tinnitus that is sudden, loud and worse with pressure on the ear: Excess, in Liver-Fire or Liver-Yang. Gradual, soft, better with pressure: Deficiency (Kidneys). Eyes red and burning: Liver-Fire; dry and blurred: Liver-Blood or Kidney-Yin.
- Cold, heat, fever. Aversion to cold that warmth does not relieve, with fever: Exterior. Feels the cold, better for warmth: Yang deficiency. Warm at a set time in the afternoon or at night, with hot palms and soles: Yin deficiency. Alternating fever and chills: Shaoyang; mnemonic: aversion is a fight, feeling cold is a shortfall.
- The person. Emotion: cause or result? Less desire with cold: Kidney-Yang. Period pain before or during and worse with pressure: Excess; after and better with pressure: Deficiency. Children: Spleen weak, Lungs sensitive, quickly hot.
- Red flags. Night sweats with fever or weight loss; sudden hearing loss; low mood with thoughts of death; bleeding after the menopause or after intercourse; erectile dysfunction (vascular risk); fever in a baby under three months: see a doctor first.
The rest of this lesson is reference.
Three practice questions from this lesson
Difficulty falling asleep, palpitations, forgetful; tongue pale and thin.
- Kidney-Yin deficiency
- Heart-Blood deficiency
- Heart-Fire
Answer: Heart-Blood deficiency. Not falling asleep points to Blood (pattern 13). Kidney-Yin deficiency gives waking at night with night sweats, Heart-Fire restlessness with thirst and a red tongue with a yellow coating.
Waking in the night, night sweats, hot soles, dry mouth at night.
- Heart-Blood deficiency
- Kidney-Yin deficiency
- Spleen-Qi deficiency
Answer: Kidney-Yin deficiency. Not staying asleep, with night sweats, points to Yin (pattern 11). Blood brings sleep, Yin keeps it.
Wakes every morning around four, cannot get back to sleep, easily startled and indecisive; no low mood.
- Textbook knowledge: Gall-Bladder deficiency
- Kidney-Yin deficiency with night sweats
- Liver-Fire (pattern 2)
Answer: Textbook knowledge: Gall-Bladder deficiency. In textbooks, waking early and not getting back to sleep, with timidity and indecision, is Gall-Bladder deficiency. Waking early with night sweats points to Yin deficiency; Liver-Fire gives violent dreams. Always ask about low mood too.
The rest of this lesson
In the course you get the step-by-step explanation, 17 case-based practice questions, 22 spaced-repetition flashcards, the pitfalls and the bridge to physiology with evidence grades. This lesson belongs to module 4: Diagnosis.