A 34-year-old woman has a wiry pulse and pale tongue. What is the diagnosis?

The diagnosis of "Metal not controlling Wood" is determined by the symptoms presented: a wiry pulse and pale tongue. In Traditional Chinese Medicine (TCM), the pulse quality and tongue color can provide significant insights into the underlying disharmony within the body.

A wiry pulse is often associated with stagnation or overactivity of one of the organs, specifically the Liver in this case, which is represented by Wood. When Wood is excessive, it can lead to disharmony, and in this context, Metal (representing the Lungs and the function of control) is not able to regulate or control the overactivity of Wood, resulting in excessive Liver energy. The pale tongue indicates a potential deficiency, often related to a lack of nourishment or blood, suggesting that the Metal element is weak and cannot adequately control the Wood.

The concepts involved in this diagnosis reflect the relationship between the elements in TCM. Specifically, the Metal element is responsible for regulating Wood. Therefore, when Metal is deficient, it may not effectively regulate the Liver's activity, leading to a state of imbalance characterized by a wiry pulse.

Understanding this relationship helps clarify the patient’s condition, allowing for a more targeted treatment approach to restore balance among the elements.