Whether the secondary or the principal aspects and the deficiency or the excess is predominant or not should be determined first. The secondary excess predominates in syndromes such as stagnation of heart blood, obstruction of turbid phlegm and accumulation of yin cold, and the principal deficiency in those such as yin deficiency of the heart and kidney, deficiency of qi and yin and deficiency of yang qi. The idea of "Treating the secondary first and the principal later" should be followed as the therapeutic principle. Treatment methods for the secondary excess include expelling cold, eliminating phlegm, promoting blood circulation and removing blood stasis, and those for the principal deficiency include invigorating qi, warming yang and nourishing yin which are applied to relevant organs. In the case of intermingled deficiency and excess, treatment should be mainly on the principal aspect. Click to learn TCM Treatment Evaluation for Coronary Arteriosclerotic Cardiopathy.
(1) Stagnation of Heart Blood
Chief Manifestations: Localized stabbing chest pain aggravated at night, palpitation, restlessness, dark purple tongue, and deep and unsmooth pulse.
(2) Obstruction of Turbid Phlegm
Chief Manifestations: Suffocative sensation in the chest, chest pain radiating toward the shoulder and back, shortness of breath, general heavy sensation, obesity, profuse sputum, turbid and greasy tongue coating, and smooth pulse.
(3) Accumulation of Yin Cold
Chief Manifestations: Chest pain radiating to the back aggravated by cold, feeling of oppression in the chest, palpitation, shortness of breath with inability to lie flat in severe cases, pale complexion, extremely cold limbs, white tongue coating, and deep and thready pulse.
(4) Yin Deficiency of the Heart and Kidney
Chief Manifestations: Chest pain and oppression, restlessness, insomnia, palpitation, night sweating, lumbago, weak waist and knees, dizziness, tinnitus, red tongue with ecchymosis, and thready and rapid or thready and unsmooth pulse.
(5) Deficiency of Oi and Yin
Chief Manifestations: Feeling of oppression in the chest, shortness of breath, paroxysmal dull pain in the chest which is aggravated by exertion, palpitation, lassitude, dizziness, reddish tongue with teeth marks, and thready and weak, slow-irregular or intermittent pulse.
(6) Deficiency of Yang Qi
Chief Manifestations: Feeling of oppression in the chest, shortness of breath, chest pain radiating toward the back, palpitation, sweating, aversion to cold, cold limbs, pale complexion, pale or purple lips, tongue in light color or dark purple, deep and thready or deep and indistinct pulse.
