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Pericardium Patterns — Teaching Deck (6 patterns)

Heat in the Pericardium

Pericardium PatternFull (Excess) Pattern

Clinical Presentation

Fever at night, mental confusion, incoherent speech or aphasia, delirium, body hot, hands and feet cold, macules.

Tongue: Red and dry without coating. Pulse: Fine-Rapid.
Important symptoms: fever at night, delirium, Red tongue without coating.
Arises from: The only precursor of this pattern is Heat at the Qi level.
Typically develops into: Heat in the Pericardium can progress to the next level, leading to Heat at the Blood Level. At this level, internal Wind may develop, causing convulsions.
Easy clinical tip: Fever at night, delirium and a Red tongue without coating are enough to diagnose Heat in the Pericardium.

Treatment

Principle: clear Nutritive Qi Level Heat

P-9 ↓With P-8, clears Heat in the Pericardium.
P-8 ↓With P-9, clears Heat in the Pericardium.
HE-9 ↓Clears Heat in the Pericardium and clears the Mind.
KI-6 ↑Nourishes fluids to prevent further injury of Yin — the single reinforced point per the pattern's own Method.
SP-6 ↓Also nourishes fluids to prevent further injury of Yin, but is needled with reducing method here, per the pattern's literal Method statement ('reducing method except for KI-6').

Combination Points (and notes)

  • This is a Warm-Disease (Wen Bing) pattern — Heat has penetrated to the Nutritive Qi Level, one stage deeper than the Qi Level, which is why mental confusion and delirium appear alongside fever rather than simple Excess-Heat signs.
  • The Method statement singles out only KI-6 as reinforced even though SP-6 is explained with an identical fluid-nourishing action — worth flagging to students as a point where the stated method and its own explanation don't perfectly align, rather than silently smoothing it over.
Pericardium Patterns — Study Deck

Blood deficiency of the Pericardium

Pericardium PatternEmpty (Deficiency) Pattern

Clinical Presentation

A feeling of stuffiness and discomfort of the chest, dull ache in the chest, very slight shortness of breath, palpitations, anxiety, insomnia, dizziness, dream-disturbed sleep, poor memory, propensity to be startled, dull-pale complexion, pale lips, cold hands, scanty periods, amenorrhoea.

Tongue: Pale, Thin, slightly dry. Pulse: Choppy or Fine, but very slightly hard on the left Front position.
Important symptoms: discomfort of the chest, palpitations, insomnia, Choppy pulse.
Arises from: Heart-Blood deficiency itself may be the precursor of this pattern. A deficiency of Qi and Blood of the Spleen is also a common precursor of this pattern.
Typically develops into: Deficiency of Blood of the Pericardium may lead to Blood stasis in the chest.
Easy clinical tip: Discomfort of the chest, palpitations and insomnia are enough to diagnose Blood deficiency of the Pericardium.

Treatment

Principle: nourish Blood, strengthen the Heart and Pericardium, move Qi and Blood in the chest

P-6 ↑Tonifies the Pericardium and moves Qi.
HE-7 ↑Nourishes Heart-Blood and calms the Mind.
Ren-14 ↑With Ren-15, nourishes Heart-Blood and calms the Mind.
Ren-15 ↑With Ren-14, nourishes Heart-Blood and calms the Mind.
Ren-4 ↑Nourishes Blood in general.
BL-17 ↑With direct moxa, nourishes Blood.
BL-20 ↑Used if there is Spleen deficiency, to nourish Blood.
BL-14 ↑Tonifies the Pericardium.
Ren-17 ↑Tonifies the Heart, Lungs and Pericardium, and moves Qi and Blood in the chest.
SP-4 ↑In combination with P-6, opens the Yin Linking Vessel (Yin Wei Mai), nourishes Blood and calms the Mind.

Combination Points (and notes)

  • P-6 + SP-4 opening the Yin Wei Mai is worth remembering as a combination distinct from the more familiar P-6 + SP-4 pairing used elsewhere for the Chong Mai — the Extraordinary Vessel being opened depends on the paired point (here, P-6 pairs with SP-4 for Yin Wei Mai).
  • BL-20 is conditional, not routine — added only when Spleen deficiency is actually contributing to the Blood deficiency, reflecting the Spleen's role producing Blood.
Pericardium Patterns — Study Deck

Pericardium-Fire

Pericardium PatternFull (Excess) Pattern

Clinical Presentation

Palpitations, a feeling of tightness and heat of the chest, slight chest ache, rapid breathing, thirst, mouth and tongue ulcers, mental restlessness, feeling agitated, feeling of heat, insomnia, dream-disturbed sleep, red face, bitter taste (after a bad night's sleep), heavy periods.

Tongue: Red, tip redder and swollen with red points, yellow coating. There may be a midline crack reaching to the tip. Pulse: Full-Rapid-Overflowing especially on the left Front position. Could also be Hasty (Rapid and stopping at irregular intervals).
Important symptoms: palpitations, a feeling of tightness of the chest, thirst, bitter taste, insomnia.
Arises from: Liver-Fire may be a precursor of this pattern, given the relationship between the Liver and Pericardium channels; conversely, Pericardium-Fire may also lead to Liver-Fire.
Easy clinical tip: Palpitations, a feeling of tightness of the chest, bitter taste and insomnia are enough to diagnose Pericardium-Fire.

Treatment

Principle: drain Fire of the Heart and Pericardium

P-8 ↓With HE-8, drains Fire of the Pericardium and Heart.
HE-8 ↓With P-8, drains Fire of the Pericardium and Heart.
BL-14 ↓Clears Pericardium-Heat.
Ren-14 ↓With Ren-15, clears Heart-Heat and calms the Mind.
Ren-15 ↓With Ren-14, clears Heart-Heat and calms the Mind.
Ren-17 ↓Front-Collecting point of the Pericardium — clears Pericardium-Heat.
L.I.-11 ↓Used to clear Heat if the symptoms of Fire are very pronounced.
Du-24 ↓With Du-19, calms the Mind.
Du-19 ↓With Du-24, calms the Mind.
SP-6 ↑Nourishes Yin to reduce Fire.
LIV-2 ↓Drains Liver-Fire and helps drain Pericardium-Fire, given the Liver-Pericardium relationship — particularly useful if the pattern is caused by anger, frustration or resentment.

Combination Points (and notes)

  • The mental-emotional picture here is described as distinctly more plethoric and agitated than in Blood deficiency of the Pericardium — a useful contrast when the two patterns otherwise share palpitations and insomnia.
  • LIV-2's inclusion reflects the Liver-Pericardium relationship within the Terminal Yin — reach for it specifically when anger, frustration or resentment (rather than sadness or grief) is the driving emotional cause.
Pericardium Patterns — Study Deck

Phlegm-Fire harassing the Pericardium

Pericardium PatternFull (Excess) Pattern

Clinical Presentation

Palpitations, feeling of oppression and heat of the chest, chest pain, rapid breathing, thirst, red face, bitter taste, expectoration of phlegm, rattling sound in the throat, mental restlessness, insomnia, dream-disturbed sleep, agitation, incoherent speech, mental confusion, rash behaviour, tendency to hit or scold people, uncontrolled laughter or crying, shouting, muttering to oneself, mental depression and dullness, manic behaviour.

Tongue: Red, Swollen with yellow, dry sticky coating, deep Heart crack. The tip may be redder and swollen with red points. Pulse: Full-Rapid-Slippery, or Rapid-Overflowing-Slippery, or Rapid-Full-Wiry.
Important symptoms: feeling of oppression and pain of the chest, all the mental symptoms, Red and Swollen tongue with sticky yellow coating.
Arises from: A Spleen deficiency leading to the formation of Phlegm is often the precursor of this pattern. Fire, by condensing Body Fluids, also contributes to the formation of Phlegm.
Typically develops into: This pattern may have several pathological developments. Pericardium-Fire may injure Yin and lead to Yin deficiency, producing a complex clinical picture combining Fire, Phlegm and Yin deficiency. Phlegm obstructs Qi and may lead to (or aggravate) Spleen-Qi deficiency; as a pathological accumulation of Body Fluids, Phlegm may also lead to dryness. Finally, since Fire condenses Blood and Phlegm is connected to Blood through Body Fluids, both may lead to Blood stasis, further obstructing the Mind.
Easy clinical tip: A feeling of oppression and pain of the chest, all the mental symptoms, and a Red and Swollen tongue with a sticky yellow coating are enough to diagnose Phlegm-Fire harassing the Pericardium.

Treatment

Principle: drain Fire of the Pericardium and Heart, resolve Phlegm, open the Mind's orifices, calm the Mind

P-5 ↓Resolves Phlegm from the Heart and clears its orifices.
HE-7 ↓Calms the Mind.
HE-8 ↓With HE-9, clears Heart-Fire.
HE-9 ↓With HE-8, clears Heart-Fire.
P-7 ↓Calms the Mind and clears Heart-Fire.
Ren-15 ↓Calms the Mind.
BL-14 ↓With Ren-17, the Back-Transporting and Front-Collecting points of the Pericardium — drains Fire and calms the Mind.
Ren-17 ↓With BL-14, drains Fire and calms the Mind.
Ren-12 ↑Tonifies the Spleen to resolve Phlegm.
ST-40 ↓Resolves Phlegm.
SP-6 ↓Resolves Phlegm and calms the Mind.
BL-20 ↑Tonifies the Spleen to resolve Phlegm.
LIV-2 ↓Subdues Fire to conduct it downwards.
G.B.-13 ↓With Du-24, calms the Mind.
Du-24 ↓With G.B.-13, calms the Mind.
G.B.-17 ↓Opens the Mind's orifices.

Combination Points (and notes)

  • The identical Ren-12/BL-20-reinforced-rest-reduced structure recurs here exactly as in Phlegm-Fire harassing the Heart — cutting off Phlegm production at the Spleen while clearing the Fire and Phlegm already obstructing the Mind.
  • In practice, this pattern's symptoms are often milder than the full-blown manic presentation described — patients not currently in an acute episode may show a considerably softer version of the same picture.
Pericardium Patterns — Study Deck

Qi stagnation in the Pericardium

Pericardium PatternFull (Excess) Pattern

Clinical Presentation

A feeling of distension and slight pain of the chest, feeling of tightness of the chest, slight shortness of breath, sighing, a feeling of a lump in the throat, palpitations, depression, irritability, poor appetite, weak and cold limbs, slightly purple lips, pale complexion.

Tongue: Slightly Pale-Purple on the sides in the chest area. Pulse: Empty but very slightly Overflowing on the left Front position.
Important symptoms: palpitations, a feeling of distension of the chest.
Arises from: Liver-Qi stagnation may be a precursor of this pattern.
Typically develops into: If it is not a precursor of it, stagnation of Qi in the Pericardium may lead to Liver-Qi stagnation. Longterm Qi stagnation may also lead to Blood stasis and this is even more likely to happen when Qi stagnation affects the Pericardium as well as the Heart.
Easy clinical tip: Palpitations and a feeling of distension of the chest are enough to diagnose Qi stagnation in the Pericardium.

Treatment

Principle: move Qi in the chest, regulate the Pericardium and Heart, calm the Mind

P-6 ↓Opens the chest, moves Qi and calms the Mind.
HE-5 ↓Moves Heart-Qi and calms the Mind.
HE-7 ↓Calms the Mind.
Ren-14 ↓With Ren-15, opens the chest and calms the Mind.
Ren-15 ↓With Ren-14, opens the chest and calms the Mind.
Ren-17 ↓Front-Collecting point of the Pericardium — moves Qi in the Pericardium channel in the chest.
BL-14 ↓Back-Transporting point of the Pericardium — moves Qi in the Pericardium.
LU-7 ↓Moves Qi in the chest.
ST-40 ↓Used here not to resolve Phlegm but to open the chest and move Qi in the chest.
L.I.-4 ↓Regulates the ascending and descending of Qi and therefore moves Qi.

Combination Points (and notes)

  • BL-14 and Ren-17 (the Pericardium's own Back-Transporting and Front-Collecting points) anchor every Pericardium pattern here — worth learning as the two channel-specific points before the pattern-specific additions.
  • ST-40 reappears here purely to open the chest and move Qi, not for its usual Phlegm-resolving role — the same teaching point already made in the Heart-Qi stagnation pattern.
Pericardium Patterns — Study Deck

Blood stasis of the Pericardium

Pericardium PatternFull (Excess) Pattern

Clinical Presentation

Palpitations, stabbing or pricking pain in the chest which may radiate to the inner aspect of the left arm or to the shoulder, a feeling of oppression or constriction of the chest, shortness of breath, cyanosis of lips and nails, cold hands, painful periods with dark clots.

Tongue: Purple in its entirety or only on the sides in the chest area. Pulse: Choppy, Wiry or Knotted.
Important symptoms: stabbing chest pain, purple lips.
Arises from: Qi stagnation in the Pericardium channel is nearly always the precursor of this pattern; Liver-Qi stagnation may also be a precursor to this pattern. The Liver channel affects the chest and the loss of the free flow of Liver-Qi may easily affect the Pericardium (to which the Liver is related within the Terminal Yin channels) leading to Qi stagnation first and then Blood stasis.
Typically develops into: Blood stasis in the Pericardium may lead to the formation of Phlegm because of the interaction between these two pathogenic factors. A long-term consequence of Blood stasis, especially in the elderly, can be dryness. Blood stasis in the Pericardium may also lead to Blood stasis in the Liver due to the relationship between these two channels within the Terminal Yin (Jue Yin) channels.
Easy clinical tip: Stabbing chest pain and purple lips are enough to diagnose Blood stasis in the Pericardium.

Treatment

Principle: move Blood in the chest, regulate the Pericardium and Heart, calm the Mind

P-6 ↓Moves Blood in the Pericardium channel and opens the chest — the main point for this pattern.
P-4 ↓Accumulation point — particularly useful to stop chest pain.
HE-7 ↓Calms the Mind.
Ren-14 ↓Moves Heart-Blood.
Ren-17 ↓Front-Collecting point of the Pericardium — moves Qi and Blood in the chest and stimulates the circulation of Gathering Qi.
BL-14 ↓Back-Transporting point of the Pericardium — moves Blood in the Pericardium.
BL-17 ↓Moves Blood and eliminates stasis.
SP-10 ↓Moves Blood.

Combination Points (and notes)

  • Nearly identical point set and clinical picture to Heart-Blood stasis (same chest pain radiating to the left arm, cyanotic lips, cold hands) — the Pericardium-specific points (P-6, P-4, BL-14, Ren-17) are what distinguish treatment here from the Heart pattern.
  • Painful periods with dark clots appear specifically in this pattern (not in Heart-Blood stasis) — a reminder of the Pericardium's documented relationship with the Uterus.
Pericardium Patterns — Study Deck

Pericardium Patterns — At a Glance

Diagnostic Tip, Pattern by Pattern

Heat in the PericardiumFever at night, delirium and a Red tongue without coating.
Blood deficiency of the PericardiumDiscomfort of the chest, palpitations and insomnia.
Pericardium-FirePalpitations, tightness of the chest, thirst, bitter taste and insomnia.
Phlegm-Fire harassing the PericardiumOppression and pain of the chest, mental symptoms, and a Red and Swollen tongue with a sticky yellow coating.
Qi stagnation in the PericardiumPalpitations and a feeling of distension of the chest.
Blood stasis of the PericardiumStabbing chest pain and purple lips.

How to Think About It (reasoning framework)

  • The Pericardium is framed as the 'House of the Mind' alongside the Heart: its Minister Fire protects the Heart's Emperor Fire, and two things distinguish Pericardium patterns from the equivalent Heart patterns — involvement of the Pericardium channel in the chest, and mental-emotional strain specifically from relationship problems (via the Pericardium's Terminal-Yin link to the Liver and the Ethereal Soul's movement toward others).
  • The Pericardium is also framed as the 'Centre of the Thorax' (Shan Zhong) — every pattern here shares chest-channel involvement (tightness, distension, oppression or pain of the chest) because the Pericardium here governs the Gathering Qi shared by the Heart and Lungs.
Pericardium Patterns — Study Deck