PSME3 and hyperinsulinemic hypoglycemia, familial, 4: Compared with normal morphology, swelling, atrophy, tooth marks, and cracks indicate water retention and Ki (Qi) deficiency, Ki (Qi) deficiency and Ketsu deficiency, Sui retention and/or Ki (Qi) deficiency, and Ketsu deficiency and/or lack of Sui, respectively (4, 5).