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This profile can be used as an educational device as well as a diagnostic tool to aid you in becoming acquainted with the categories of Chinese medicine. Check all of the symptoms you have experienced during the last six months. Check those symptoms that have been most troublesome.
PATTERNS OF DEPLETION
Deficient Qi	Deficient Blood
Weakness, lethargy or weariness	Restless fatigue
Lowered libido	Irritability
Decreased motivation	Insomnia and anxious sleep
Dull thinking or feeling	Itching, prickling skin and scalp
Poor appetite	Dryness without thirst
Weak digestion	Blurres or weak vision
Susceptible to colds or flu	Loss or thinning of hair
Prolonged recovery following illness	Dizziness
Pasty, pale complexion	Dry or hard stool
Limp hair	Anemia
Shortness of breath	Numbness of hands and feet
Aversion to talking	Muscle cramps
Perspires easily with exertion	Lack of semen
Weak muscles	Scanty or irregular menstruation
Chills easily	Pale, waxy, swallow complexion
Frequent, profuse urination	Easy bruising
Infertility	Poor skin healing
Miscarriage	Palpitations
	Postpartum weakness or anemia
	Emotionally Sensitive
Slack Qi	Slack Blood
Atony or prolapse of stomach, intestines, anus	Bleeding from skin, nose, lungs, stomach
Fecal incontinence or constant diarrhea	Ulcers of skin, mucous membrane, stomach
Hemorrhoids	Excessive bleeding during menses, pregnancy or postpartum
Dizzy or weak after meal or bowel movement	Bleeding hemorrhoids
Loose or flaccid muscles	Anemia associated with inflammation of stomach, small intestine or large intestine
Deficient Moisture	Diminished Essence
Dry and thirsty	Generalized fatigue, weakness and stiffness
Dryness of mucous membranes	Increased flaccidity of muscles
Scant secretions an urination	Sagging or wrinkling
Constipation	Diminished or absent sexual arousal and pleasure
Uncomfortable feeling of heat in the body	Premature infertility or menopause
Restlessness and insomnia	Repeated miscarriages
Low fever in the afternoon or evening	Loosening or increased loss of teeth
Parched and cracked skin	Thinning, graying and drying of head and pubic hair
Emotional liability	Weakening of bones and loss of elasticity or tendons or ligaments
Hot flashes	Decline of memory, vision and hearing
Night sweats	Progressive loss of weight or emaciation
Constant hunger
Unstable blood sugar
Persistent dry cough
Dry sore throat
Flushed face with dry skin and lips
Slack Moisture	Stagnant Blood
Excessive secretions from eyes, nose, mouth, skin, vagina	Mottling or chilling of limbs from poor circulation
Seminal incontinence or premature ejaculation	Sharp pains in head, eyes, joints, internal organs
Frequent urination, enuresis or incontinence	Irregular or painful menses
Dizzy or weak after sex	Premenstrual pain and hardness of breasts
Disturbed Shen	Obstructed Blood
Extreme Restlessness, agitation or loquaciousness	Traumatic bruises, swellings and sprains
Labial emotions (easily moved to tears or laughter)	Persistent stabbing, or throbbing pains (esp. in joints or viscera)
Extreme hypersensitivity to pain or insult	Pain aggravated at night or from inactivity
Hysterical outbursts of shouting, laughing or grief	Severe cramping numbness or paralysis
Overwhelming hopelessness, sadness or grief	Severe headaches
Constant anxiety or incessant worry	Dark red complexion
Easily startled or frightened	Red or purple lesions on the skin and mucous membrane
Morbid thoughts or impulses	Angina
Erratic sleep, stubborn insomnia or disturbing dreams	Severe menstrual cramps with dark blood or clots
	Pain worse from pressure or massage
	Hard lumps or masses
Blood	Adverse Climate or Conditions Heat
Uncontrolable rage	Difficulty swallowing
Incoherent speech or babbling	Pained by sensation of heat or burning
Dull glazed or bizarre look to eyes and face	Sores or infections with green or yellow pus
	Yellow or green mucous discharges from ears, nose, throat, anus, vagina or urethra
	Extreme thurst with craving for cold foods and liquids
	Redding of eyes, ears, nose, lips, face
	Skin mucous membrane or tongue
Patterns of Congestion Stagnant Qi	Obstructed Qi
Head feels stuffy	Belching or flatulence
Mild nausea	Wheezing
Distension or fullness in chest or abdomen	Generalized discomfort, fullness, pressure in head, chest, limbs or abdomen
Gas pains, cramps, tension in stomach or intestines	Stitch or acute pain in abdomen
Hiccups, belching or flatulence	Sense of fullness under ribs
Constipation with gas
Vague or intermittent pains
Stagnant Moisture	Cold
Soft or loose stools	Cold feeling in limbs, head, chest or abdomen
Bloating with water retention	Inertia or weakness with pallor, cold or clammy forehead, and/or hands, etc.
Puffy eyes, face, hands or ankles	Loose stool after eating raw or cold foods
Frequent but scant urination	Profuse urination or swelling of face or limbs upon exposure to cold climate or after drinking cold liquids
Feels swollen, tender, lethargic in humid weather	Craving for warm cooked foods and drinks
Soft swelling or enlarged lymph nodes	Pain in head, chest, limbs or joints when exposed to cold air
Premenstrual soreness and swelling of breasts	Pale skin, nail bed, lips, tongue and mucous membrane
	Weak or blurred vision elimination, dry or hard stool, tense colon
	Whistling or loud ringing in the ears (tinnitus)
	Weak, dizzy, flushed from hunger, tension or anger*
	Burning, oozing sores, boils, pimples, blister or rash-queasiness from hunger or fatigue
	Genital organ hypersensitivity
Obstructed Moisture	Heart Network (Emotions, Sleep, Depleted Moisture or Blood, Congested Blood)
Swollen or heavy head, limbs or abdomen	Easily overheats and over chills*
Tender muscles and joints	Easy blushing of face and ears
Thick or sticky saliva or phlegm	Burning sensitivity or irritaion of mouth, tongue, urethra, vagina or anus*
Nodules or cysts	Dry mouth or throat
Congestion in eyes and sinuses	Hot flashes
Sticky slimy stool	Restlessness and fatigue*
Scanty urine	Frequent urination and bowel movements from nervousness
Generalized water retention	Palpitations when nervous, upset or exhausted
Edema of hands and feet	Easily confused
This nauseated feeling in mouth and stomach	Anxiety*
	Mood swings (laughs easily, cries easily)
	Insomnia if nervous, worried or overtired
	Excitement, anxiety and fatigue cause light
	Restless sleep and vivid dreams-nightmares
	Craving for cool drinks and juicy foods
	Slight exertion or exciement causes hear, perspiration
Damp Heat	Spleen Network (Digestion, Appetite, Attitude and Attention, Depleted Qi, Congested Moisture)
Dryness or thirst without desire or ability to drink, elimination, dry or hard	Overwhelemed by details*
Queasiness with nauseating taste in the mouth	Upset by changes*
Sticky yellow mucous in the nose, throat or bronchi	Lethargy and inertia
Fever or a sensation of heat that is not relieved by perspiring or taking fluids	Prolapse of stomach, intestines, uterus, vagina and bladder
Loose or sticky stool streaked with blood, musuc or pus	Hemmorrhoids
Burning, oozing sores, boils, pimples, blister or rashes	Lack of muscle tone or strength, especially of abdomen, back and neck
Queasiness from hunger or fatigue	Water retention and puffiness*
Heavy, dull distended feeling in the head, chest, abdomen or limbs	Heaviness of head and limbs*
Worse from heat, humidity, and sweet, spicy or oily foods	Tender muscles*
	Frequent but scanty urination
	Easy or frequent bruising
	Slow digestion or indigestion
External Wind	Excitement, anxiety and fatigue cause light
Itching, prickling sensation of the skin	Indigestion with nausea, bloating, flatulence, belching
Migrating pains appear or retreat suddenly and predictable blood (Congested Blood)	Erratic elimination with constipation or diarrhea
Dizziness	Spasm of esphagus
Itchy, painful ears, eyes, nose, sneezing, headache, muscle soreness or shivering when exposed to wind or drafts or irritation of mouth	Dryness and water retention
Neck stiffness or spasm	Thirst for alternatively cold and hot liquids
Worse from drafts and changing temperatures or chaning from lying to upright posture	Sensitivity and/or aversion to strong flavors
	Craving fatty, sour, sweet or sticky foods
	Erratic appetite with difficulty knowing what to eat or feeling dissatisfied with food
Phlegm (Congealed Moisture)	Tenderness, tension or heaviness in muscles especially head, neck, shoulders, jaw, arms or legs
Dizziness or fullness in head with mucus	Abdominal tension or distention with belching or flatulence
Congestion or nausea	Vacillates between nervous tension and languid lethargy between being irritable and hostile, tolerant and sympathetic
Nausea or difficulty breathing with fullness in upper abdomen, perspiration or chest	Fullness or pressure in head or behind eyes
Thick, sticky secretions or discharges from skin, mucous marked above (*)	Headaches with nausea, visual disturbances
	Sensitivity to or aversion to light noise, heat (Reproduction, genito-urinary joints depleted Qi, congested and humitity
Organ Network Disturbances Liver Network (Nerves, Muscles, Congested or Depleted Blood)	Hypoglycemia
Irritable "things get on my nerves"	Diabetes
Touchiness from hearing wind, noise	Cirrhosis
Numbness or tingling of limbs when asleep or inactive	Lack of sexual secretions
Muscle cramps on lawer abdomen, hips, calves, feet	Jandice/hepatitis
Pain from tension in shoulders and neck or in hips*	Eating disorders
Sticking pains under diaphragm, in ribs, groin or pelvis region*	Food allergies
Easy chilling of arms, hands, legs feet*	Hives
Coarse, brittle nails or hair	Colitis
Dry eyes	Migrane
Spleen Network	Spleen-Kidney Disharmony
Frequent abdominal gas and bloating*	Slow digestion and sluggish intestines
Loose stool from raw or cold foods, cold liquids	Weak gums and loose teeth
Excess or deficient appetite	Dryness of skin and mouth
Lingering hunger after meals	Sore or swollen joints or muscles, especially of face and hands
Hard to gain, lose or regulate weight	Heaviness of head and limbs
Easily worried	Weakness or soreness of low back or sacrum
Difficulty focusing, jumps from one thing to another	Feet, legs and back tire easily
	Diarrhea or dry, small stool with bloating
	Frequent, scanty or difficult urination
Lung Network ( Respiration, Skin, Depleted or Congested Moisture)	Alternatively strong and diminished libido
Frequent colds or coughs	Easy chill or back, legs and arms
Frequent runny nose or stuffy sinuses*	Constipation and water retention follow overeating
Frequent throat clearing or laryngitis*	Craves salty or sweet foods
Morning attacks of coughing or sneezing with clear phlegm or mucous discharge*	Chronic vaginitis
Shortness of breath, chest pain, or wheezing in chest from fatigue or exertion	Edema
Allergies	Rheumatism
Dryness of mucous	Adrenal Insufficiency (Addison's Disease)
Dry skin*	Leucorrhea
Itchiness or rashes of skin	Chronic gingivitis
Easily disappointed or offended*	Chronic cystitis or urethritis
Sensitive to wind, cold, and dryness*	Prostatic hypertrophy or prostatitits
	Nervous and distractible
	Apathetic and insecure
Kidney Network (Reproduction, Genito-Urinary, Joints, Depleted Qi, Congested and Humidity Moisture)	Lung-Liver Disharmony
Difficulty conceiving or carrying to term	Tension and stiffness of muscles in neck, shoulder, chest, abdomen and hips
Diminished libido*	Irregular, bowel movements
Lack of sexual secretions	Irregular, heavy or shallow breathing
Jaundice/ hepatitis	Wheezing or sighing
Loss or thinning of pubic hair	Sensitive, easily inflamed skin or mucous membranes of upper respiratory or genito-urinary tissue
Amenorrhea	Sensitivity or aversion to heat, dryness, wind, droughts or sudden changes in weather
Excess or scanty urination	Awkward and stiff expression of feelings
Frequent or difficult urination	Unpredictable reactive or indifferent, angry or sad, friendly or distant
Pain in low back, sacrum or hips*	Craving for fatty and spicy foods
Weakness or soreness of hips, knees, ankles or feet	Sexually excitable but difficult to sustain desire
	Asthma
Kidney Disharmony	Irritable bowel syndrome
Lack of stamina, runs out of steam quickly	Generalized Pruritis
Needs to sleep a lot*	Allergic sinusitis or rhinitis
Diminished motivation	Seasonal hay fever
Forgetfulness and dull minded	Craves salty, spicy food and stimulants (nicotine and caffeine)
Puffiness or swelling of feet and ankles	Bursitis
Low humming in ears (tinnitus)	Headaches involving eyes and sinuses
Sore throat from fatigue*	Severe or chronic neck spasms
Easily defeated and disgruntled	Depression characterized by quiet melancholy or passive rage
	Chronic endrometritis/ cervicitis/ urethritis
Conflicts Between Organ Networks Liver-Spleen Disharmony
Cold hands and feet
Kidney-Heart Disharmony	Heart-Lung Disharmony
Insomnia or restless sleeping alternating with heavy slumber	Sensitivity to changes in temperature and humidity
Difficulty awakening and arising from bed	Easily overheated but can’t sweat
Nervousness and mood swing with fatigue, lumbar weakness	Dry cough
Easily overheated or chilled	Flushes when coughing
Hot chest, head and hands with cold buttocks and feet	Coughing when nervous or embarrassed
Depressed or melancholy after sustained mental or physical activity	Anxiety with laryngitis, chest pain or wheezing
Sexually excitable but difficult to sustain desire or achieve satisfactory release	Heat triggers sneezing, itchy throat or rashes
Lack of muscle tone and joint mobility	Dry skin with cracking, redness and itching, especially upper back, elbows, knees and hands
Anxiety and apathy	Light sleeper and wakes easily
Tension and weakness of muscles along spine	Itching and inflammation of vagina, urethra w/o discharge
Nausea, diarrhea, urinary frequency associated with anxiety	Alternately euphoric and melancholic
Craves salty, spicy food and stimulants (nicotine and caffeine)	Emotionally hypersensitive yet reserved
Bursitis	Craves spicy, hot foods and stimulants
Manic-depressive syndrome	Acne or dry eczema
Ileitis (Crohn’s disease)	Sun allergy
Bulemia	Psoriasis
Chronic endrometritis/ cervicitis/ urethritis	Asthma
Chronic sleep disturbances	Hyper-thyrodism
Hyper/ hypothyroid syndrome	Hysteria
	Chronic phyrngitis/rhinitis
Check all the following qualities that apply to you:
Wood Archetype: The Pioneer	Metal Archetype: The Alchemist
Feels confident and act assertively	Maintain a neat and orderly personal life
Enjoy being competitive and ambitious	Enjoy a convivial but undemanding social life
Feel powerful and invulnerable	Am in control of my environment and the way I do things
Reluctantly acknowledge other people as my equal	Am strongly committed to my moral
Openly discuss my abilities and achievements with others	Feel secure  and comfortable in my work when I know everyone is following proper procedures
Am comfortable with conflict or pressure	Enjoy tasks that require logical, analytic, and systematic approaches to problem solving
Enjoy being first, best, unique, even outlandish	Appreciate being thought of as meticulous and discriminating
Act with assurance and confidence, regardless of what others may think or feel	Think of myself as being impeccable and above approach
Am comfortable with difficult tasks or emergencies that require “thinking on my feet”	Self-contained and not overly involved in other people’s affairs
Feel that I’m right, even if others strongly disagree with or disapprove of me	Work easily and efficiently in situations where goals and guidelines are well defined
Can be direct or provocative, even when it causes discomfort or embarrassment t others	Like to be judged according to objective criteria rather than personal biases or intuitions
Take pleasure in public recognition and admiration of my talents and achievements	Accept the authority of those with more competence
Am comfortable directing or leading others	Am systematic and methodical in my work
Follow my own hunches about what is right or wrong	Enjoy the process of solving puzzles and mysteries
Take the lead when it is necessary to get things done quickly and effectively	Put virtue and principals before pleasure  and fulfillment
Act boldly and decisively, even when I don’t have all the expertise or information I need	Restrain myself in expressing my feelings or opinions
Enjoy for its own sake the process of striving against the odds	Enjoy temperance and moderation
Want to reject or argue with other people’s appraisals of me	Am tasteful and discriminating
Fire Archetype: The Wizard	Water Archetype: The Philosopher
Am animated and enthusiastic	Am cautious and sensible
Enjoy the pleasure of my senses	Enjoy frequent periods of solitude and introspection
Easily know what another thinks and feels	Enjoy indulging my imagination and curiosity
Enjoy physical contact and emotional intimacy	Keep my feelings, thoughts and opinions to myself
Am comfortable in very stimulating environments	Am content being anonymous or on the periphery of social events
Openly share my innermost feelings and desires	Am considered unusual or eccentric
Live in the here-and-now and don’t worry about the future of principals and standards or conduct dwell on the past	Am content with a few good friends and minimal social activities
See the humorous side of life	Involve myself in intellectual pursuits
Thoroughly enjoy getting what I want and need	Am content figuring things out for myself
Can be tender intimate and vulnerable with another person	Am careful about what I reveal other people
Enjoy being moved emotionally	Can be a stubborn defender of truth as I see it
Become easily and completely involved in the events going on around me	Am patient and preserving in spite of defeats or dead ends
Am emotionally sensitive, responsive, and intuitive	Am objective and dispassionate
Remain optimistic and hopeful despite what others may say or believe	Enjoy being relied upon for reassurance and help
Can be completely open and exposed	Feel "self"
Identify and sympathize with another’s joy and pain	Enjoy being the hub of my social network and family network
Am unabashed in showing enthusiasm and excitement	Enjoy settling disputes so that all parties are satisfied
Enjoy being attractive and magnetic	Am agreeable and accommodating
	Help people work together in a harmonious manner
	Get involved in other people’s lives
	Can be diplomatic and tactful
	Create a relaxed and comfortable environment in which very different people can enjoy being together
Earth Archetype:  The Peacemaker	Am loyal and accessible to my friends, relations and people involved in some way in my life and work
Am nurturing and supportive	Rely on the skills and intelligence of others
Put the needs of others before my own	Sympathize w/ the circumstances of others
Enjoy frequent socializing with friends and family	Accept other people’s characterizations of who I am
	Enjoy being in the company of other people
	Get close enough to need another person
	Am comfortable and sociable with people I don’t know well
Please list any other health concerns you would like your practicioner to be aware of:
* PMS characterized by symptoms marked above with asterisk
This health profile is an excerpt from Between Heaven & Earth: A Guide to Chinese Medicine, Beinfield & Korngold, Ballantine, 1991 -  good resource to help you understand more about Chinese medicine.  This book is available in your local bookstore or through your practitioner.