Vomiting with loud noise: Full pattern, sometimes also with Heat (Stomach heat, e.g.) with low noise: Empty pattern (Stomach deficient and cold, e.g.

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1 Four Methods of Diagnosis Reference Charts: Zen Shiatsu III Bo Shin - Observing Bun Shin - Listening/Smelling Mon Shin - Questioning Setsu Shin - Feeling Bo Shin Energy and Postural Patterns - visual contours of kyo and jitsu Bun Shin Voice Loud Voice: Full Pattern, usually of Liver Qi Weak Voice: Empty Pattern, usually of Lung Qi Reluctance to talk: Cold pattern or Lung Qi Deficiency (lung kyo) Excessive talking: Heat Shouting voice: Liver disharmony Laughing voice: Heart disharmony Singing voice: Spleen disharmony Weepy voice: Lung disharmony Groaning voice: Kidney disharmony Sudden loss of voice: Wind-heat Gradual loss of voice: Lung-Qi or Lung-Yin deficiency Breathing Coarse, loud breathing: Full pattern Weak, thin breathing: Empty pattern Coughing Loud, explosive cough: Full pattern, possibly wind-heat or phlegm Weak cough: Empty pattern Dry cough: Lung-Yin deficiency Vomiting with loud noise: Full pattern, sometimes also with Heat (Stomach heat, e.g.) with low noise: Empty pattern (Stomach deficient and cold, e.g.) Hiccup with loud noise: Full pattern. With quiet, low sound: Empty pattern Borborygmi (intestinal gurgling) Loud sound: Full pattern. Low sound: Empty pattern

2 Sighing Usually Qi stagnation in Liver or Lung - sourced in physical stagnation and repressed frustration if Liver, sadness if lungs Belching Loud: Full. (usually Stomach jitsu) Soft: Empty. (usually stomach or spleen kyo) Mon Shin: Questioning 1. Pain 2. Food and Taste 3. Stools and Urine 4. Thirst and Drink 5. Energy levels 6. Head/face/body 7. Chest/abdomen 8. Limbs 9. Sleep 10. Sweating 11. Ears and Eyes 12. Feeling of cold, feeling of heat, fever 13. Emotional Symptoms 14. Sexual Symptoms 15. Womenʼs Symptoms 1. Pain Pain is very commonly a sign of kyo or jitsu conditions of a given meridian, especially when it is localized to certain acupoints or radiates along meridian lines. Additionally, here are a few systemic pain signs: Qi Stagnation: a distending pain, difficult to fix to a specific location; often comes and goes according to emotional state. This can include abdominal bloating. Usually relates to Liver Qi Stagnation. Stasis of blood: severe stabbing pain with a fixed location in a small area Liver Yang Rising: chronic headaches with distending, throbbing pain Cold: Pain from cold is cramping, aggravated by cold and relieved by heat. Damp-heat: pain from damp-heat is burning and accompanied by fullness and heaviness. 2. Food and Taste

3 Condition relieved by food: of an Empty nature aggravated by eating: Full nature Lack of appetite: Spleen Qi Deficiency (spleen kyo, usually) always hungry: heat in the Stomach (stomach jitsu, usually) bloating and distension after eating: Spleen Qi deficiency and/or Liver Qi Stagnation heaviness and fatigue after eating: Dampness and Spleen Qi deficiency preference for hot food: Cold pattern preference for cold food: Hot pattern 3. Stools and Urine Constipation Aggravated of a condition after a bowel movement: full pattern Relief of a condition after a bowel movement: empty pattern Acute constipation w/ thirst and dry yellow stool coating: heat in stomach and intestines Constipation in old people or women after childbirth: blood deficiency Constipation with small, dry, bitty stools like goat/rabbit: Liver Qi Stagnation + Heat in intestines Difficulty in performing bowel movement, stools not dry: Liver Qi Stagnation Constipation with dry stool, dry mouth, desire to drink in small sips: Yin deficiency (kidney/stomach) Alternating constipation/diarrhea: Stagnant Liver Qi invading Spleen Diarrhea Chronic loose stools: Spleen and/or Kidney yang deficiency Chronic diarrhea every day in very early morning: Kidney-Yang deficiency Loose stools w/ undigested food: Spleen Qi deficiency Stools not loose but very frequent, canʼt hold easily: Spleen Qi Sinking Diarrhea w/ abdominal pain and fullness, undigested food: Cold in Intestines Black stools: stasis of Blood Diarrhea w/ mucus in stools: Dampness in Intestines Blood comes first, is turbid, anus feels heavy and painful: Heat in Blood Stools come first then watery blood: deficient Spleen Qi failing to hold blood Painful accompanying diarrhea: Liver involvement or Heat Burning sensation in anus while passing stool; foul smelling stool: Heat Flatulence w/ foul smell: Damp-Heat in Spleen or Heat in Intestines Flatulence without smell: interior cold from Spleen-Yang deficiency 4. Thirst and Drink Thirst: desire to drink large amounts of cold water: Full-Heat (usually in Stomach) Thirst: desire to drink in small sips: Yin Deficiency (Stomach/Kidney)

4 Thirst: no desire to drink: Damp-Heat Absence of Thirst: Cold pattern; usually Stomach or Spleen Desire to drink cold liquids: Heat Desire to drink warm liquids: Cold 5. Energy Levels / Tiredness Chronic tiredness, desire to lie down, poor appetite, loose stools: Spleen Qi deficiency Above + cold symptoms: Spleen-Yang deficiency Chronic tiredness, weak voice, tendency to catch colds: Lung-Qi deficiency Above + cold symptoms: Lung-Yang deficiency Chronic tiredness, backache, feeling of cold, depression, frequent urination: Kidney-Yang deficiency Chronic tiredness, slight depression, dizziness, scant periods: Liver-Blood Deficiency Chronic tiredness, anxiety, insomnia, dry mouth at night: Kidney-Yin deficiency Chronic tiredness, feeling of heaviness in body, muzziness: Dampness Chronic tiredness, anxiety, muscular tenseness: stagnation of Liver Qi Tiredness in the morning; morning blahs during the Stomach/Spleen hours: Stomach Qi Deficiency Lethargy Sleepiness after eating: Spleen-Qi deficiency Lethargy and heaviness of body: Dampness Extreme lethargy and lassitude with feeling of cold: Kidney-Yang deficiency 6. Head/Face/Body Headache Onset Recent onset, short duration: exterior attack of wind-cold Gradual onset, in attacks : interior causes Time of day daytime: qi or yang deficiency Evening: blood or yin deficiency night-time: blood stasis Location Nape of neck: usual site of wind-cold invasion lodging in Bladder channel; if chronic, it is a stress headache due to overwork and/or dehydration affecting BL. Forehead: Stomach-heat or Blood deficiency Temples and side of head: Liver/Gallbladder pattern Vertex (crown of head): usually Liver Blood Deficiency Whole-head: invasion of wind-cold Character

5 Heavy feeling: dampness or phlegm Pain inside head, hurting the brain : Kidney deficiency Distending, throbbing: Liver-Yang rising, affecting Gallbladder channel Boring, like a nail in a small point: stasis of Blood With feeling of muzziness/heaviness: Dampness Condition Aggravated by fatigue, improved by rest: Qi/Yang deficiency, typical of Bladder headaches. Aggravated by emotional tension: Liver/Gallbladder Dizziness Severe giddiness, loss of balance: internal Wind Dizziness with throbbing headache: Liver-Yang rising Dizziness w/ feeling of heaviness/muzziness: Dampness Slight dizziness aggravated when tired: Blood deficiency Sudden onset: Full pattern Gradual onset: Empty pattern Body Pain Pain in whole body Sudden onset, w/ aversion to cold, + fever: exterior Wind invasion Ache all over, with feeling of tiredness: Qi or Blood deficiency Dull pain in women after childbirth: Blood deficiency Severe pain in women after childbirth: Blood stasis Pain in all muscles, hot sensation of flesh: Stomach-heat Pain in all muscles, lack of flexibility: Liver Qi Stagnation Dull ache in muscles with feeling of heaviness: Dampness obstructing muscles Pain in joints Wandering from joint to joint: Wind Fixed and very painful: Cold Fixed w/ swelling and numbness: Dampness With swelling and redness: Damp-heat Severe stabbing pain w/ rigidity: Blood stasis Backache Always think first about back diagnostic areas and yu points where the ache is localized Low back ache, continuous, dull, better with rest: Kidney deficiency Middle back ache: Possible Liver and/or Spleen blood deficiency Upper back tightness, possibly extending into shoulders: may be invasion of Wind

6 7. Chest and Abdomen Chest Stabbing pain: stasis of Blood in heart Pain accompanied by cough w/ profuse yellow phlegm: Lung-Heat Feeling of oppression: phlegm in Lungs, Liver-Qi stagnation or PC kyo or jitsu Hypochondrium Feeling of distension: Liver Qi Stagnation Stabbing pain: Liver Blood Stasis Epigastrum Dull Pain alleviated by eating: Empty type Severe pain aggravated by eating: Full type Severe pain: Full (stomach heat, liver qi invading stomach, retention of food in stomach) Dull pain: Empty (Stomach qi deficiency, empty-cold in stomach) Feeling of fullness: Dampness Feeling of distension: Liver Qi Stagnation Abdomen Refer to hara assessment areas and bo points Pain everywhere in hara: Spleen Qi or Blood deficiency 8. Limbs Weakness/numbness/tingling Weakness: Stomach qi deficiency, general qi and blood deficiency, deficiency of Kidney Yang More tingling than numbness: Blood deficiency More numbness, often unilateral: Wind Numbness w/ feeling of heaviness: Dampness/Phlegm Numbness w/ swelling: Damp-Heat Numbness w/ pain: stagnation of qi and blood Difficulty in Walking Beginning stages: Stomach and Spleen Qi Deficiency Atrophy: Liver and Kidney yin deficiency Cold Hands Cold hands ameliorated by heat: Yang deficiency (Spleen or Kidney)

7 Cold hands w/ palpitations and dizziness: Heart-Blood deficiency Cold fingers and toes: Liver-Qi stagnation 9. Sleep Insomnia Very restless w/ feeling of heat, agitation and excessive dreaming: Full type (Liver/Stomach/Heart) Not able to fall or stay asleep, without any of the above heat symptoms: Empty type Difficulty falling asleep: Blood deficiency of Heart, Spleen or Liver Waking up many times during the night: Deficiency of Yin (Heart, Liver or Kidney) Insomnia w/ anxiety, dream-disturbed sleep and other symptoms of Qi/Blood deficiency: Deficiency of Blood of Heart and Spleen Insomnia w/ difficulty in falling asleep, dizziness, blurred vision: Liver-Blood Deficiency Insomnia, waking frequently during night w/ excessive dreams, night sweats, palpitations: Liver and Heart Blood Deficiency Dream-Disturbed Sleep: Liver Fire or Heart Fire Waking up early in morning and failing to fall asleep again: deficiency of Gallbladder 10. Sweating Area of Body Only on head: Heat in stomach or damp-heat Oily sweat on forehead: collapse of Yang Only on arms and legs: Stomach and Spleen deficiency Whole body: Lung-Qi Deficiency On palms, soles of feet and chest: Yin deficiency (called five-palm sweat ) Time of Day In daytime: Yang deficiency At nighttime: Yin deficiency (or in some cases from damp-heat) Quality of Sweat Oily: severe Yang deficiency Yellow: damp-heat 11. Ears and Eyes Ears : Tinnitus Onset Sudden: Full condition, usually Liver-Fire, Liver-Yang rising or Liver-Wind Gradual Onset: Empty condition, usually Kidney deficiency

8 Pressure Noise aggravated by pressing with hands: Full Noise alleviated by pressing: Empty Character of Noise Loud, high-pitched noise like whistle: Liver Low-pitched noise like rushing water: Kidney Ears: Deafness Sudden onset: Full condition, usually Liver-Fire Gradual onset: Empty condition, usually deficiency of Kidney, Heart-Blood, Yang, Upper Burner Eyes: Eye Pain Pain, swelling and redness: invasion of wind-heat or internal Liver-Fire Feeling of pressure: Kidney-Yin Deficiency Eyes: Blurred Vision Blurred vision and floaters : Deficiency of Liver Blood, Liver Yin or Kidney Yin. Aversion to light: Liver blood deficiency Dry Eyes Liver and/or Kidney Yin Deficiency 12. Feeling of Cold, Feeling of Heat Feeling of cold/cold limbs Yang-Deficiency of Heart and/or Lungs: cold hands, sweaty hands Spleen-Yang / Stomach-Yang deficiency: cold limbs, hands, feet and abdomen Kidney-yang deficiency: cold legs, knees, feet, low back Qi stagnation: cold hands and feet, and especially the fingers Heart-Blood Deficiency: cold hands and chest Liver-Blood Deficiency: cold feet Feeling of heat Feeling of heat in the afternoon or evening: Empty-Heat Low-grade fever getting worse in afternoon or only occurring in afternoon: Yin deficiency Constant low-grade temperature: Damp-Heat Fever in middle of night: in adult, Yin Deficiency. In child, retention of food

9 13. Emotional Symptoms Refer to Kyo/Jitsu psychological patterns and five-phase associations 14. Sexual Symptoms Menʼs: Impotence Kidney Yang Deficiency: impotence, feeling cold, backache, weak knees, dizziness, tinnitus, poor memory, abundant clear urine Heart-Blood Deficiency: impotence, dizziness, palpitation Heart-Fire: impotence, palpitations, insomnia, dream-disturbed sleep Damp-Heat in Liver Channel: impotence, heaviness of scrotum, urethral discharge Menʼs: Lack of Libido Deficiency of Qi or Yang of Kidneys or Deficiency of Spleen, Heart or Lungs or Liver Qi Stagnation Menʼs: Premature Ejaculation Kidney-Qi not Firm or Heart-Qi Deficiency or Heart-Blood Deficiency Menʼs: Tiredness and dizziness after ejaculation Deficiency of Kidneys Womenʼs: Lack of Libido Lack of libido or an inability to reach orgasm: Kidney or Heart Deficiency, particularly Kidney Yang and Pericardium Excessive sexual desire: Fire of Liver or Heart and Empty-Heat deriving from Kidney-Yin Deficiency Womenʼs: Headache soon after orgasm Rebellious Qi of Penetrating Vessel (treat through Spleen/Stomach), or Heart-Fire 15. Womenʼs Symptoms Menstruation Cycle Always early: Heat in Blood or Qi Deficiency Always late: Blood deficiency or stagnation of Blood Irregular: stagnation of Liver-Qi or Liver Blood, or Spleen Deficiency Amount Heavy blood loss: Heat in Blood or Qi Deficiency (usually Spleen failing to control blood)

10 Scanty periods: Blood deficiency, usually of the Spleen or Liver Color Dark red or bright red: Heat in Blood Pale: Blood deficiency Purple or blackish: stasis of Blood or Cold Quality Congealed w/ clots: stasis of Blood or Cold Watery blood: Blood or Yin Deficiency Turbid blood: Blood-Heat Pain Pain before periods: Stagnation of Qi or Blood (usually Liver-Qi Stagnation) Pain during periods: Blood-Heat, Cold or Blood stasis Pain after periods: Blood deficiency Leucorrhoea (vaginal discharge) Colour White discharge: cold from spleen or Kidney yang deficiency Yellow discharge: Heat, usually Damp-Heat in lower burner Greenish discharge: Damp-Heat in Liver Red and white discharge: Damp-Heat Yellow discharge w/ pus and blood after menopause: Toxic damp-heat in uterus Consistency Watery: Cold-Damp Thick: Damp-Heat Smell Fishy: Damp-Cold Leathery: Damp-Heat Pregnancy Infertility: Blood or Kidney-Essence deficiency, or damp-heat in lower burner Vomiting during pregnancy: Stomach and Penetrating Vessel deficiency Miscarriage before 3 months: Blood or Essence Deficiency, Kidney deficiency (or Spleen or Liver) Miscarriage after 3 months: Liver-Blood stasis or sinking of Spleen Qi Childbirth Post-natal depression: Heart-Blood deficiency