CARDIAC EDEMA

GENERAL

Clinical Manifestations	Cardiac edema a manifestation of congestive heart failure, due to increased venous and capillary pressures and often associated with renal sodium retention.
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Herb Formulas
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TAI YANG ZHONG FENG

Clinical Manifestations	Aversion to Wind Mild, or severe chills Fever which may be persistent Uneasiness from fever Spontaneous perspiration Headache Nausea Nasal irritation Nasal obstruction Tendency to snore Itchy throat T: Normal C: Thin and white P: Superficial and slow or Moderate and maybe weak
Treatment Principle	Create sweat to relieve the Exterior and expel Wind Harmonize Ying and Wei to protect digestion and nourish Wei Qi
Herb Formulas	Gui Zhi Tang With stiff neck and shoulders: Gui Zhi Jia Ge Gen Tang With dyspnea, asthma and sputum: Gui Zhi Jia Hou Po Xing Ren Tang
Points	Bitong, DU-16, GB-20, KI-7, LI-4, LI-20, LU-7, SJ-5, UB-12, UB-13, Yintang With stiff neck and shoulders: + GB-21 With Dampness: + SP-6, SP-9 With dyspnea, asthma and sputum: Dingchuan, REN-22 With nocturnal emission, excess dreams, Cold lower extremities, dizziness and hair loss: + DU-4, KI-3, UB-23 With continuous perspiration, muscle spasms of the limbs with difficult flexion and extension and difficult urination: + REN-4 With sustained fever of long duration accompanied by severe chills: + DU-14

TAI YANG BIAO FU

Clinical Manifestations	Chills and fever or Fever with no thirst Swollen eyes, limbs abdomen or genitals Achiness Stiff neck and shoulders Anhidrosis Headache Stabbing joint pain Itchy throat Cough Asthma Aversion to Cold Maybe frozen shoulder Dyspnea Vomiting, if the condition is tonified before the Wind is expelled Urinary retention if the condition is reduced before the Wind is expelled Shortness of breath Mild or severe gasping Hiccups Fullness in chest Vomiting Heaviness of the body Edema Dysuria Maybe thirst Maybe diarrhea Maybe scanty urine Maybe lower abdominal fullness T: Normal C: Greasy and white P: Floating and slippery or tight
Treatment Principle	Relieve the Exterior Expel Cold Disperse the Lungs Stop asthma Expel water or Phlegm
Herb Formulas	Xiao Qing Long Tang With Internal Heat and irritability: Xiao Qing Long Jia Shi Gao Tang With indigestion leading to diarrhea: Si Ling San Severe: Wu Pi Yin modified
Points	Moxa Dingchuan, DU-4, REN-4, REN-6, needle DU-16, GB-20, LI-4, LU-7, REN-17, REN-22, SP-6, SP-9, SJ-5, ST-40, UB-12, UB-13 With Internal Heat and irritability: - moxa + LI-11, ST-44 With Qi Deficiency: KI-7, REN-8, REN-9, SP-6, SP-9, ST-28 With Excess type swelling (severe swelling, oliguria, constipation): DU-2, DU-6, LI-4, LU-7, REN-9, SP-6, SP-9, ST-28, ST-36, ST-43, UB-27

TAI YANG SHANG HAN WITH FLIUID RETENTION IN THE LUNGS

Clinical Manifestations	Distention and fullness of epigastrium and abdomen Nausea Vomiting Anorexia Loose stools Diarrhea Reduced sensation of taste No thirst or preference for hot drinks Sticky sensation in mouth Borborygmus Lassitude Yin jaundice Heavy head Maybe edema Maybe copious white vaginal discharge Maybe cold limbs, fear of Cold or feeling chilled T: Pink C: Thick, white and greasy or sticky P: Deep and slow
Treatment Principle	Warm Cold Transform Dampness Harmonize the Stomach Strengthen the Spleen
Herb Formulas	Wei Ling Tang Wu Pi Yin modified
Points	Moxa or moxa needle REN-6, REN-12, SP-6, SP-9, ST-36, UB-20 Moxa or moxa needle REN-6, REN-12, SP-3, SP-5, SP-6, SP-9, ST-36, UB-20 Cold-Damp Dysentery: Moxa or moxa needle LI-4, REN-6, REN-12, SP-6, ST-25, ST-37 Cold-Damp Diarrhea: Moxa or moxa needle REN-6, REN-12, ST-25, ST-36, ST-37, UB-25 Cold-Damp Vaginal Discharge: Moxa or moxa needle GB-26, REN-4, REN-6, SP-6, ST-36, UB-30 Cold-Damp Jaundice (Yin Jaundice): Moxa or moxa needle DU-9, GB-24, LIV-13, SP-9, ST-36, UB-19, UB-20 , UB-48

SHAO YIN HEAT

Clinical Manifestations	Urinary difficulty Thirst with a desire to drink Fever worse at night Cough Nausea/vomiting Irritability Insomnia Restlessness Diarrhea Anxiety Edema Lower abdominal distention and pain Maybe hematuria Painful urination with Yin Deficiency Urinary dribbling Decreased urination Dry skin Sunken eyes Dry throat and/or mouth Chronic sore throat (not acute) Restlessness Malar flush Insomnia Disturbed speech Low grade fever, worse in afternoon Yellow urine Irritability with a sensation of Heat in the chest Palpitations with anxiety Sores in the mouth or on the tongue More Heat than in Yin Deficiency (chronic low grade fever) T: Red or Dark red and dry C: None or Thin and yellow P: Deep, thready and rapid or Thready and rapid or forceful and rapid
Treatment Principle	Promote urination Clear Heat Nourish Yin
Herb Formulas	Zhu Ling Tang
Points	DU-14, HT-5, HT-7, KI-3, KI-6, KI-7, LIV-3, SP-6, UB-10, UB-15, UB-23

WIND-DAMP

Clinical Manifestations	Aversion to Wind and Cold Facial edema moving to generalized edema Slight fever or fever and chills Thirst Slight but continuous perspiration Sore, heavy limbs Decreased urination Headache Edematous orbits A red, swollen sore throat Weak abdomen Belching Cough Asthma Dyspnea Bulging eyes Severe cough Weak, aching feet Skin problems T: Normal C: White or Thin white P: Floating or Floating and big
Treatment Principle	Promote perspiration Disseminate Lung Qi Clear Heat Move water Suppress asthma
Herb Formulas	Fang Ji Huang Qi Tang
Points

PHLEGM ACCUMULATION IN THE LUNGS

Clinical Manifestations	Lung abscess Coughing Wheezing Fullness and distention in the chest Profuse Phlegm and saliva Dysuria Edema Nasal congestion Clear, watery rhinorrhea Oliguria Loss of taste and smell Dyspnea Edema of the face and eyes Insomnia T: Swollen C: White and greasy P: Slippery
Treatment Principle	Drain the Lungs Move Fluids Drive out Phlegm Stop cough Calm wheezing
Herb Formulas	Ting Li Da Zao Xie Fei Tang
Points

COLD-DAMP DISTRESSES THE SPLEEN

Clinical Manifestations	Edema in limbs, especially lower limbs Maybe anasarca Maybe abdominal distention Loose stools Physical and mental fatigue T: Pale C: White and moist P: Soft and even
Treatment Principle	Warm Yang Strengthen the Spleen Benefit Qi Move water
Herb Formulas	Shi Pi Yin
Points	REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23

DAMP-HEAT INJURES THE SPLEEN

Clinical Manifestations	Anorexia Abdominal distention and discomfort Suffocating sensation in the chest Epigastric mass Maybe abdominal pain on palpation Yang jaundice (sclera and skin are bright yellow) Dislike of oily foods Nausea Vomiting Lassitude Scanty, dark urine Maybe thirst or thirst with no desire to drink Diarrhea with foul smell or Constipation Fever Sweet sticky taste or bitter taste in mouth T: Pink C: Thick, yellow and greasy (maybe sticky) P: Soft and rapid
Treatment Principle	Clear Heat Benefit Dampness
Herb Formulas	Yin Chen Wu Ling San
Points	LI-11, REN-12, SP-9, ST-36, ST-44, UB-20 For Damp-Heat Diarrhea: LI-4, SP-9, ST-25, ST-36, ST-44, UB-25 For Damp-Heat Dysentery: LI-4, LI-11, SP-9, ST-25, ST-37, ST-44

SPLEEN QI DEFICIENCY WITH DAMPNESS AND QI STAGNATION

Clinical Manifestations	Generalized edema Sensation of heaviness, distention and fullness in the epigastrium and abdomen Labored, heavy breathing Urinary difficulty Asthma Chest distention General edema in summer Gasping Rapid breathing T: Normal C: White and slippery P: Thready and moderate or slipper
Treatment Principle	Resolve Dampness Reduce edema Regulate Qi Strengthen the Kidneys Reduce swelling
Herb Formulas	Wu Pi Yin Wu Pi San
Points

SPLEEN DEFICIENCY EDEMA

Clinical Manifestations	Edema of whole body particularly at and below the waist Pitting edema Low back pain, aching and heaviness Abdominal distention with full sensations Oliguria Cold limbs Face gray and congested or pale Feeling nervous and cold with mental weariness In severe cases: Ascites Edema of scrotum T: Pale and swollen C: Thin, white or Thick, white and sticky P: Deep and thready With Water Flooding the Lungs: Cough with copious, thin watery phlegm Asthma with phlegmy sound (wheezing) Dyspnea Facial edema Edema of limbs Dysuria T: Pale and swollen C: White and moist or White and greasy P: Superficial and tight
Treatment Principle	Warm Kidneys Promote diuresis
Herb Formulas	Zhen Wu Tang
Points	KI-7, REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23, UB-39

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Body cold Limbs icy Complexion white and shiny Low back, knees and abdomen feel cold and painful Lower abdomen feels cold and painful Loose stools containing undigested food “Cock-crow” diarrhea (occurs at about 5 am) Edema of face and limbs Dysuria Severe: Abdominal ascites T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep, thready, weak and maybe slow
Treatment Principle	Warm and Reinforce the Spleen and Kidneys
Herb Formulas	Zhen Wu Tang With Water Flooding: Shi Pi Yin
Points	Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23

HEART YANG NOT VIGOROUS: WATER QI INSULTS THE HEART WITH LUNG AND SPLEEN QI DEFICIENCY

Clinical Manifestations	Palpitations Shortness of breath Dizziness Epigastric fullness and contravection Reflux vomiting Sensation of Qi rushing upward to the chest (Running Piglet) Suffocating sensation in chest Weak cough Expectorating watery white Phlegm T: Pale C: White P: Deep and wiry
Treatment Principle	Clear Yang Transform Harmful Fluid
Herb Formulas	Ling Gui Zhu Gan Tang
Points	Moxa or moxa needle LU-9, REN-12, REN-17, ST-36, ST-40, UB-13, UB-20, UB-43

HEART YANG NOT VIGOROUS: WATER QI INSULTS THE HEART WITH KIDNEY YANG DEFICIENCY

Clinical Manifestations	Edema of whole body particularly at and below the waist Pitting edema Low back pain, aching and heaviness Abdominal distention with full sensations Oliguria Cold limbs Face gray and congested or pale Feeling nervous and cold with mental weariness In severe cases: Ascites Edema of scrotum T: Pale and swollen C: Thin, white or Thick, white and sticky P: Deep and thready With Water Flooding the Lungs: Cough with copious, thin watery phlegm Asthma with phlegmy sound (wheezing) Dyspnea Facial edema Edema of limbs Dysuria T: Pale and swollen C: White and moist or White and greasy P: Superficial and tight
Treatment Principle	Warm Kidneys Promote diuresis
Herb Formulas	Zhen Wu Tang
Points	KI-7, REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23, UB-39 DU-4, KI-3, KI-7, PC-5, PC-6, REN-4, REN-6, REN-9, REN-17, SP-6, SP-9, UB-15, UB-23

KIDNEY YANG DEFICIENY WITH WATER FLOODING

Clinical Manifestations	Cardiac edema Generalized edema Sensation of heaviness, distention and fullness in the epigastrium and abdomen Labored, heavy breathing Urinary difficulty Asthma Chest distention General edema in summer Gasping Rapid breathing T: Normal C: White and slippery P: Thready and moderate or slipper
Treatment Principle	Resolve Dampness Reduce edema Regulate Qi Strengthen the Kidneys Reduce swelling
Herb Formulas	Wu Pi Yin
Points

QI AND YANG DEFICIENCY

Clinical Manifestations	Pitting edema, worse in the extremities A sensation of heaviness in the body and extremities Fibrillations in the skin and muscles of the extremities Dysuria T: Normal C: White and slippery P: Floating
Treatment Principle	Augment Qi Unblock Yang Promote urination Reduce edema
Herb Formulas	Fang Ji Fu Ling Tang
Points

ACCUMULATION OF WATER IN THE STOMACH AND INTESTINES WITH QI STAGNATION

Clinical Manifestations	Abdominal distention Borborygmus A dry mouth and tongue Constipation Reduced urination Diarrhea T: Normal C: Yellow and greasy P: Wiry and slippery or Deep, full and slightly rapid
Treatment Principle	Dry Dampness Scour out Thin Mucus Move Qi Reduce distention
Herb Formulas	Ji Jiao Li Huang Wan
Points

TURBID DAMPNESS IN THE SAN JIAO

Clinical Manifestations	General edema of the body and extremities Dysuria Oliguria Orthopnea Pitting edema Dyspnea Gasping Anorexia Abdominal fullness and pain T: Thick C: White and thick P: Slow or Wiry
Treatment Principle	Dispel Stagnant Water Dry Dampness Eliminate water from the Lungs Harmonizes the Spleen Relieve edema Move Qi
Herb Formulas	Dao Shui Fu Ling Tang
Points

TAN YIN

Clinical Manifestations	Chills and fever Achiness Stiff neck and shoulders Anhidrosis Headache Stabbing joint pain Itchy throat Cough Asthma Aversion to Cold Maybe frozen shoulder * The Tai Yang symptoms remain for 2-3 days Thirst with no desire to drink May have vomiting immediately after drinking Difficult urination May have upper body edema T: Normal C: White P: Floating and slippery
Treatment Principle	Promote urination Dispel Dampness Expel Wind
Herb Formulas	Wu Ling San With indigestion and diarrhea: Si Ling San With jaundice and dysuria: Yin Chen Wu Ling San
Points	Moxa or moxa needle KI-3, LI-4, LU-7, REN-3, SP-6, SP-9, UB-13, UB-28 With indigestion and diarrhea: moxa ST-25, ST-36 With jaundice and dysuria: DU-9

YI YIN

Clinical Manifestations	Anorexia Edema Abdominal distention Chest and hypochondriac distention Dizziness Nausea Vomiting Vertigo Thirst with no desire to drink Maybe no thirst Palpitations Shortness of Breath T: Normal C: Thick and slippery P: Slippery, full and maybe wiry
Treatment Principle	Warm and Dissolve Tan Yin
Herb Formulas	Ling Gui Zhu Gan Tang Wu Ling San With indigestion, diarrhea and decreased urination: Si Ling San With jaundice and dysuria: Yin Chen Wu Ling San
Points	PC-6, SJ-6, SP-6, SP-9, ST-40, UB-13, UB-20, UB-23

ZHI YIN

Clinical Manifestations	Cough Asthma Shortness of breath which is worse when lying down Abdominal distention with water retention Edema in the lower extremities Facial edema T: White bubbles C: Thick, greasy and white P: Thready
Treatment Principle	Regulate the Lungs Purge Yin
Herb Formulas	Wu Ling San Xiao Qing Long Tang
Points	LU-7, SP-6, SP-9, UB-13

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