tongue fur, "slippery" pulse. Dryness (燥; zào): dry cough, dry mouth, dry throat, dry lips, nosebleeds, dry skin, dry stools. Summerheat (暑; shǔ): either Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. A large share of its claims are pseudoscientific, with the majority of treatments having no robust evidence of effectiveness or logical mechanism of action. Some TCM ingredients are known to be toxic and cause disease, including cancer. Medicine in traditional China encompassed a range o Wind (风; fēng): rapid onset of symptoms, wandering location of symptoms, itching, nasal congestion, "floating" pulse; tremor, paralysis, convulsion. Cold (寒; hán): cold sensations, aversion to cold, relief of symptoms by warmth, watery/clear excreta, severe pain, abdominal pain, contracture/hypertonicity of muscles, (slimy) white tongue fur, "deep"/"hidden" or "string-like" pulse, or slow pulse. Fire/Heat (火; huǒ): aversion to heat, high fever, thirst, concentrated urine, red face, red tongue, yellow tongue fur, rapid pulse. (Fire and heat are basically seen to be the same) Dampness (湿; shī): sensation of heaviness, sensation of fullness, symptoms of Spleen dysfunction, greasy tongue fur, "slippery" pulse. Dryness (燥; zào): dry cough, dry mouth, dry throat, dry lips, nosebleeds, dry skin, dry stools. Summerheat (暑; shǔ): either heat or mixed damp-heat symptoms. Six-Excesses-patterns can consist of only one or a combination of Excesses (e.g., wind-cold, wind-damp-heat). They can also transform from one into another. Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. A large share of its claims are pseudoscientific, with the majority of treatments having no robust evidence of effectiveness or logical mechanism of action. Some TCM ingredients are known to be toxic and cause disease, including cancer. Medicine in traditional China encompassed a range of sometimes competing health and healing practices, folk beliefs, literati theory, Taoist and Confucian philosophy, herbal remedies, food, diet, exercise, medical specializations, and schools of thought. TCM as it exists today has been Wind (风; fēng): rapid onset of symptoms, wandering location of symptoms, itching, nasal congestion, "floating" pulse; tremor, paralysis, convulsion. Cold (寒; hán): cold sensations, aversion to cold, relief of symptoms by warmth, watery/clear excreta, severe pain, abdominal pain, contracture/hypertonicity of muscles, (slimy) white tongue fur, "deep"/"hidden" or "string-like" pulse, or slow pulse. Fire/Heat (火; huǒ): aversion to heat, high fever, thirst, concentrated urine, red face, red tongue, yellow tongue fur, rapid pulse. (Fire and heat are basically seen to be the same) Dampness (湿; shī): sensation of heaviness, sensation of fullness, symptoms of Spleen dysfunction, greasy tongue fur, "slippery" pulse. Dryness (燥; zào): dry cough, dry mouth, dry throat, dry lips, nosebleeds, dry skin, dry stools. Summerheat (暑; shǔ): either heat or mixed damp-heat symptoms. Six-Excesses-patterns can consist of only one or a combination of Excesses (e.g., wind-cold, wind-damp-heat). They can also transform from one into another. "Upflaming Liver fire" (肝火上炎; gānhuǒ shàng yán): Headache, red face, reddened eyes, dry mouth, nosebleeds, constipation, dry or hard stools, profuse menstruation, sudden tinnitus or deafness, vomiting of sour or bitter fluids, expectoration of blood, irascibility, impatience; red tongue with dry yellow fur; slippery and string-like pulse. Yin and yang are universal aspects all things can be classified under, this includes diseases in general as well as the Eight Principles' first three couples. For example, cold is identified to be a yin aspect, while heat is attributed to yang. Since descriptions of patterns in terms of yin and yang lack complexity and clinical practicality, though, patterns are usually not labeled this way anymore. Exceptions are vacuity-cold and repletion-heat patterns, who are sometimes referred to as "yin patterns" and "yang patterns" respectively. Exterior (表; biǎo) refers to a disease manifesting in the superficial layers of the body – skin, hair, flesh, and meridians. It is characterized by aversion to cold and/or wind, headache, muscle ache, mild fever, a "floating" pulse, and a normal tongue appearance. Interior (里; lǐ) refers to disease manifestation in the zàng-fǔ, or (in a wider sense) to any disease that can not be counted as exterior. There are no generalized characteristic symptoms of interior patterns, since they'll be determined by the affected zàng or fǔ entity. Cold (寒; hán) is generally characterized by aversion to cold, absence of thirst, and a white tongue fur. More detailed characterization depends on whether cold is coupled with vacuity or repletion. Heat (热; rè) is characterized by an absence of aversion to cold, a red and painful throat, a dry tongue fur and a rapid and floating pulse if it falls together with an exterior pattern. In all other cases, symptoms depend on whether heat is coupled with vacuity or repletion. Deficiency (虚; xū), can be further differentiated into deficiency of qi, xuě, yin and yang, with all their respective characteristic symptoms. Yin deficiency can also cause "empty-heat". Excess (实; shí) generally refers to any disease that cannot be identified as a deficient pattern, and usually indicates the presence of one of the Six Excesses, or a pattern of stagnation (of qi, xuě, etc.). In a concurrent exterior pattern, excess is characterized by the absence of sweating. After the fundamental nature of a disease in terms of the Eight Principles is determined, the investigation focuses on more specific aspects. By evaluating the present signs and symptoms against the background of typical disharmony patterns of the various entities, evidence is collected whether or how specific entities are affected. This evaluation can be done

Cardiovascular: Palpitation, orthostatic hypotension. Digestive: Gastrointestinal cramps, dry mouth, constipation, heartburn. Musculoskeletal: Back pain, shoulder pain, knee pain, back strain, myalgia, foot pain. Nervous/Psychiatric: Decreased libido, vertigo, depression, somnolence. Respiratory: Common cold, nasal congestion, influenza, bronchitis, pharyngeal pain, dyspnea, pulmonary congestion, chronic sinusitis, allergic rhinitis, pharyngeal discomfort. Skin: Flushing, pruritus, skin inflammation, diaphoresis, cutaneous pseudolymphoma. Special Senses: Blurred vision, tinnitus, otalgia. Urogenital: Urinary tract infection. Angioedema: Angioedema of the face, extremities, lips, tongue, glottis and/or larynx has been reported (See WARNINGS ). In rare cases, intestinal angioedema has been reported in post marketing experience. Hypotension: In clinical trials, adverse effects relating to hypotension occurred as follows: hypotension (1.4%), orthostatic hypotension (0.5%), other orthostatic effects (3.2%). In addition syncope occurred in 0.8% of patients. (See WARNINGS ). Cough: See PRECAUTIONS , Cough . Clinical Laboratory Test Findings Serum Electrolytes: (See PRECAUTIONS ) . The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly. Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Head and Neck Angioedema: Angioedema of the face, extremities, lips, tongue, glottis and/or larynx has been reported in patients treated with angiotensin-converting enzyme inhibitors, including lisinopril. This may occur at any time during treatment. ACE inhibitors have been associated with a higher rate of angioedema in black than in nonblack patients. Lisinopril and hydrochlorothiazide should be promptly discontinued and the appropriate therapy and monitoring should be provided until complete and sustained resolution of signs and symptoms has occurred. Where there is involvement of the tongue, glottis or larynx, likely to cause airway obstruction, subcutaneous epinephrine solution 1:1000 (0.3 mL to 0.5 mL) and/or measures necessary to ensure a patent airway, should be promptly provided (See ADVERSE REACTIONS ). Patients receiving coadministration of ACE inhibitor and mTOR (mammalian target of rapamycin) inhibitor (e.g., temsirolimus, sirolimus, everolimus) therapy or a neprilysin inhibitor may be at increased risk for angioedema (see PRECAUTIONS ). Intestinal Angioedema: Intestinal angioedema has been reported in patients treated with ACE inhibitors. Leukopenia/Neutropenia/Agranulocytosis: Another angiotensin converting enzyme inhibitor, captopril, has been shown to cause agranulocytosis and bone marrow depression, rarely in uncomplicated patients but more frequently in patients with renal impairment, especially if they also have a collagen vascular disease. Available data from clinical trials of lisinopril are insufficient to show that lisinopril does not cause agranulocytosis at similar rates. Marketing experience has revealed rare cases of leukopenia/neutropenia and bone marrow depression in which a Warning signs or symptoms of fluid and electrolyte imbalance, irrespective of cause, include dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, confusion, seizures, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, and gastrointestinal disturbances such as nausea and vomiting. Hypokalemia may develop, especially with brisk diuresis, when severe cirrhosis is present, or after prolonged therapy. Interference with adequate oral electrolyte intake will also contribute to hypokalemia. Increases in cholesterol and triglyceride levels may be associated with thiazide diuretic therapy. Information for Patients Angioedema: Angioedema, including laryngeal edema may occur at any time during treatment with angiotensin converting enzyme inhibitors, including lisinopril and hydrochlorothiazide. Patients should be so advised and told to report immediately any signs or symptoms suggesting angioedema (swelling of face, extremities, eyes, lips, tongue, difficulty in swallowing or breathing) and to take no more drug until they have consulted with the prescribing physician. Symptomatic Hypotension: Patients should be cautioned to report lightheadedness especially during the first few days of therapy. If actual syncope occurs, the patients should be told to discontinue the drug until they have consulted with the prescribing physician. All patients should be cautioned that excessive perspiration and dehydration may lead to an excessive fall in blood pressure because of reduction in fluid volume. Other causes of volume depletion such as vomiting or diarrhea may also lead to a fall in blood pressure; patients should be advised to consult with their physician. (See WARNINGS, Anaphylactoid reactions during membrane exposure .) Hydrochlorothiazide Oral administration of a single oral dose of 10 g/kg to mice and rats was not lethal. The most common signs and symptoms observed are those caused by electrolyte depletion (hypokalemia, hypochloremia, hyponatremia) and dehydration resulting from excessive diuresis. The side effects (see WARNINGS ) of lisinopril are generally rare and apparently independent of dose; those of hydrochlorothiazide are a mixture of dose-dependent phenomena (primarily hypokalemia) and dose-independent phenomena (e.g., pancreatitis), the former much more common than the latter. Therapy with any combination of lisinopril and hydrochlorothiazide may be associated with either or both dose-independent or dose-dependent side effects, but addition of lisinopril in clinical trials blunted the hypokalemia normally seen with diuretics.