Patterns 证候

Qi deficiency qì xū · 气虚

Described as tiredness, shortness of breath on exertion, a weak voice, spontaneous sweating and a tendency to catch colds.

Blood deficiency xuè xū · 血虚

Described as pallor, dizziness, palpitations, dry skin, poor sleep and, in the TCM model, sparse menstruation.

Yin deficiency yīn xū · 阴虚

Described as a feeling of heat in the afternoon or evening, night sweats, a dry mouth and throat, and restlessness.

Yang deficiency yáng xū · 阳虚

Described as a persistent cold feeling, cold limbs, low energy, a pale complexion and a preference for warm drinks.

Qi stagnation qì zhì · 气滞

Described as distension, discomfort that moves around, sighing, and symptoms that worsen with emotional stress.

Blood stasis xuè yū · 血瘀

Described as fixed stabbing pain, a dark complexion, dark lips and, in the classical model, masses.

Phlegm-damp tán shī · 痰湿

Described as heaviness, a muzzy head, a sensation of fullness in the chest, a sticky taste and easy weight gain.

Damp-heat shī rè · 湿热

Described as a heavy, hot, sticky feeling, a bitter taste, a yellow coating on the tongue and irritability.

Cold-damp hán shī · 寒湿

Described as cold with heaviness, joints that ache and feel worse in damp weather, and a dislike of cold drinks.

Wind-heat fēng rè · 风热

Described as a sore throat, slight fever, a yellow nasal discharge and a dislike of wind — the classical "common cold, hot type".

Wind-cold fēng hán · 风寒

Described as a marked aversion to cold, an absence of sweating, a clear nasal discharge and aching limbs.

Liver Qi stagnation gān qì yù jié · 肝气郁结

Described as irritability or low mood, a lump-in-the-throat feeling, distension in the sides of the chest, and premenstrual worsening.

Liver Yang rising gān yáng shàng kàng · 肝阳上亢

Described as headache, dizziness, ringing in the ears, a red face and a short temper.

Spleen deficiency pí xū · 脾虚

Described as poor appetite, loose stools, a bloated feeling after eating, tiredness and a sallow complexion.

Kidney Yin deficiency shèn yīn xū · 肾阴虚

Described as lower-back soreness with a feeling of heat, night sweats, ringing in the ears and dry mouth at night.

Kidney Yang deficiency shèn yáng xū · 肾阳虚

Described as a cold lower back, cold limbs, frequent night urination and a general sense of coldness.

Heart fire xīn huǒ · 心火

Described as restlessness, insomnia, a red tongue tip, mouth ulcers (in TCM reasoning) and a feeling of heat in the chest.

Disturbed Shen xīn shén bù níng · 心神不宁

Described as palpitations, anxiety, broken sleep and a sense of not feeling settled — broadly the emotional vocabulary of the Heart system.

Lung Qi deficiency fèi qì xū · 肺气虚

Described as a weak cough, shortness of breath on exertion, a low voice and easy sweating.

Lung heat fèi rè · 肺热

Described as a dry or productive cough with yellow phlegm, thirst, a sore throat and a feeling of heat.

Stomach heat wèi rè · 胃热

Described as a big appetite with a burning sensation, bad breath, thirst and a preference for cold drinks.

Stomach Qi rebelling wèi qì shàng nì · 胃气上逆

Described as nausea, belching, hiccups and a rising sensation after eating — the directional vocabulary of Qi movement made concrete.

Spleen-Stomach disharmony pí wèi bù hé · 脾胃不和

Described as alternating appetite and poor digestion, a bloated abdomen, irregular stool and fatigue after meals.

Liver-Gallbladder damp-heat gān dǎn shī rè · 肝胆湿热

Described as a bitter taste, a sensation of fullness under the ribs, a yellow tongue coating and irritability.

Heart and Spleen deficiency xīn pí liǎng xū · 心脾两虚

Described as palpititations, poor memory, broken sleep, tiredness and poor appetite together — a combined pattern.

Heat above, cold below shàng rè xià hán · 上热下寒

Described as heat symptoms in the upper body together with cold symptoms below — notably, this pattern exists precisely because TCM does not assume one uniform state.

Deficiency of both Yin and Yang yīn yáng liǎng xū · 阴阳两虚

Described as cold signs and heat signs appearing together in a person who is generally depleted — a chronic picture.

Exterior deficiency biǎo xū · 表虚

Described as a weak surface defence: easy sweating, sensitivity to wind and a tendency to catch colds easily.

Interior excess lǐ shí · 里实

Described as constipation, abdominal fullness with pain that worsens on pressure, and a thick tongue coating.

Deficiency of both Qi and Blood qì xuè liǎng xū · 气血两虚

Described as tiredness with pallor, dizziness, palpitations and a weak pulse — the two deficiencies together, common after illness or childbirth.

Spleen and Kidney Yang Deficiency pí shèn yáng xū · 脾肾阳虚

What it describes: a pattern combining a weak Spleen with a weak Kidney, so the warming and transforming functions are described as depleted. Classically recorded: cold limbs, loose stools or early-morning diarrhoea, oedema, a cold lower back, a deep weak pulse.

How it is read: as a pattern, not a disease. Conventional medicine has no equivalent category - the same symptoms would first be investigated for thyroid, kidney, gut and other causes.

What this is not: something you can diagnose from a symptom list, and not a reason to self-prescribe warming herbs.

Liver and Kidney Yin Deficiency gān shèn yīn xū · 肝肾阴虚

What it describes: depletion of the yin aspect of the Liver and Kidney systems - described as dryness, heat at night, dizziness, ringing in the ears, weakness in the lower back, and a thin rapid pulse.

How it is read: as a pattern that groups several symptoms the practitioner takes together, rather than one by one. It is not a disease and does not by itself tell you what you have.

What this is not: a self-diagnosis. Most of these symptoms have treatable medical causes and should be checked first.

Phlegm-Dampness Obstructing tán shī nèi zǔ · 痰湿内阻

What it describes: heaviness, a muzzy or foggy head, a feeling of fullness, a sticky taste in the mouth, loose or sluggish stools - grouped as phlegm and dampness obstructing the interior.

Note this carefully: the word phlegm here is a theoretical category, not sputum you can see. This is one of the most common sources of confusion for English readers, and one of the most common claims in health advertising.

How it is read: as a pattern of several symptoms taken together. Claims such as 'removes dampness' by themselves carry no measurable meaning and should not be treated as a diagnosis.

The six channels — an introduction liù jīng biàn zhèng · 六经辨证入门

The six-channel framework from the Shanghan Lun sorts illness into six stages: Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin and Jueyin. Taiyang is the exterior and the earliest stage, Yangming is interior heat, and Shaoyang is the half-exterior half-interior stage between them.

Its importance is historical as much as clinical. It is the earliest systematic attempt in Chinese medicine to describe illness as a process that moves over time, rather than a fixed label, and modern discussion of cold damage still uses its vocabulary.

The four levels (wei, qi, ying, xue) wèi qì yíng xuè · 卫气营血辨证

A framework from the warm-disease school that describes the depth of an acute febrile illness in four levels: wei (defence, at the surface), qi (the active stage with marked fever), ying (nutritive, with deeper disturbance), and xue (Blood, the deepest, with bleeding or rash).

It is essentially a severity ladder, and it was built to reason about epidemics. That is why it reads more like a staging system than the static patterns used elsewhere in TCM.

The three burners as a pattern framework sān jiāo biàn zhèng · 三焦辨证

A second warm-disease framework, dividing illness by the three burners: upper (Lung and Heart), middle (Spleen and Stomach) and lower (Liver and Kidney). Its logic is depth from above downward, and it is usually used alongside the four levels rather than instead of them.

For a reader new to TCM it is a useful reminder that Chinese medicine has no single unified diagnostic system. Different schools built different maps for different problems, and knowing which map is being used is part of reading the literature honestly.

Exterior cold with interior heat biǎo hán lǐ rè · 表寒里热

A mixed pattern in which signs described as exterior cold, such as chills, absence of sweating and body aches, appear together with signs described as interior heat, such as thirst, a red tongue or a rapid pulse.

Mixed patterns are the norm rather than the exception in real consultations, and this is why formulas are so often modified: a single label rarely fits the whole person. Presentation of this kind should still be medically assessed, since chills with fever of unclear cause is not something to manage at home.

Mixed Cold and Heat hán rè cuò zá · 寒热错杂

In this framework cold and heat signs are not opposites that exclude each other - they can appear together in the same person, and often in different parts of the body.

Classical descriptions include heat above with cold below, cold in the interior with heat on the surface, and intermingled cold and heat in the middle. The reason it matters is practical: treating it as if it were simply hot, or simply cold, tends to make part of the picture worse.

What it is not: a diagnosis, and not something to sort out alone. Cold and heat here are pattern descriptions, not temperatures. Persistent or worsening symptoms belong with a clinician.

True and False Cold or Heat hán rè zhēn jiǎ · 寒热真假

A classical caution about appearances: a picture that looks like heat can in fact be cold at root, and the reverse also occurs. The tradition uses this to argue that the most obvious sign is not always the decisive one.

Criteria proposed in the classical literature include whether the person wants to be covered or uncovered, whether they want cold drinks, the character of the pulse, and how the tongue looks. None of these is decisive alone.

This is the clearest example of why the library does not do diagnosis. What looks like one thing and is another is exactly the situation where self-assessment is most likely to be wrong. If someone is very unwell, the answer is medical care, not pattern analysis.

Mixed Deficiency and Excess xū shí jiā zá · 虚实夹杂

Classical writing treats deficiency and excess as a pair that frequently coexists rather than as a strict either-or. A person may be depleted while also carrying something that needs to be cleared.

The practical consequence is a well-known classical warning: tonifying too early can strengthen the wrong thing, and draining too hard can leave the person weaker than before. This is why the order of approach is discussed at length in the texts.

What it is not: a self-check list. Deciding which is dominant, and in what order to work, is precisely the judgement that requires training and a full examination.