DYSPHAGIA (YI GE)

GENERAL

Clinical Manifestations	Please also see: Esophageal cancer Nasopharyngeal cancer Stomach cancer
Treatment Principle
Herb Formulas	For Yin damage following radiotherapy: Wu Zhi An Zhong Yin + Liang Ge San modified Chinese Patent Medicines: Lan Han Guo Chong Ji With Kidney Yin Deficiency: Liu Wei Di Huang Wan With Stomach Qi and Yin Deficiency: Gu Ben Wan
Points	PC-6, REN-22

WIND-COLD INVASION WITH WATER RETENTION DUE TO SPLEEN QI DEFICIENCY

Clinical Manifestations	Fever and chills (chills predominant) Anhidrosis Cough Wheezing (asthma) Copious, white, stringy, difficult to expectorate sputum Stifling sensation in the chest Lacrimation General heaviness (especially upper body) General body aches No thirst Floating edema (severe) Considerable difficulty breathing while lying down (severe) Intolerance of Cold Periorbital edema Dyspnea Vomiting of frothy saliva during pregnancy Chest distention Dry heaves Decreased urine Subcardiac edema Stridor Occasional chills on the back Hiccups Retching Dysphagia Diarrhea Dysuria Decreased urination Flushed face Dizziness Headache Inflammation of the tear ducts T: Pink C: Moist or White and greasy P: Superficial and tight
Treatment Principle	Release the Exterior Transform congested Fluids (Thin Mucus) Transform Phlegm Warm the Lungs Descend Qi Relieve wheezing and cough
Herb Formulas	Xiao Qing Long Tang
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WIND-COLD INVASION WITH WATER RETENTION DUE TO SPLEEN QI DEFICIENCY WITH INTERNAL HEAT

Clinical Manifestations	Fever and chills (chills predominant) Irritability Anhidrosis Cough Wheezing (asthma) Copious, white, stringy, difficult to expectorate sputum Stifling sensation in the chest Lacrimation General heaviness (especially upper body) General body aches No thirst Floating edema (severe) Considerable difficulty breathing while lying down (severe) Intolerance of Cold Periorbital edema Dyspnea Vomiting of frothy saliva during pregnancy Edema Chest and abdominal distention Dry heaves Decreased urine Subcardiac edema Stridor Occasional chills on the back Hiccups Retching Dysphagia Diarrhea Dysuria Flushed face Dizziness Headache Inflammation of the tear ducts Lacrimation T: Pink C: Moist or White and greasy or Yellow and greasy P: Superficial, tight and rapid
Treatment Principle	Release the Exterior Transform congested Fluids (Thin Mucus) Transform Phlegm Warm the Lungs Descend Qi Relieve wheezing and coughing Clear Heat
Herb Formulas	Xiao Qing Long Jia Shi Gao Tang
Points

LUNG AND STOMACH YIN DEFICIENCY

Clinical Manifestations	Severe, dry hacking cough No sputum expectorated Small amounts of difficult to expectorate sputum Blood tinged sputum (when Yin Deficiency Fire is present) Afternoon fever Night sweats Malar flush (especially in afternoon) Five Sole Heat Dry mouth and throat Itching in throat Hoarse voice, low voice or loss of voice Emaciation No appetite or Famished but with no desire to eat Abdominal distention after meals Dry stools Irritability with low grade fever Maybe dry retching or Hiccups T: Red C: Little and dry P: Thready and rapid
Treatment Principle	Clear and Nourish the Lungs and Stomach Generate Fluids Moisten Dryness
Herb Formulas	Wu Zhi An Zhong Yin + Sha Shen Mai Men Dong modified Chinese Patent Medicines: Mai Wei Di Huang Wan
Points	KI-6, KI-27, LI-18, LU-7, REN-14, REN-17, REN-22, SP-6, ST-36 With Stomach Heat: + PC-8, ST-44 Ear: Stomach, Esophagus, Diaphragm, Throat, Kidney, Lung Shenmen

SPLEEN YANG DEFICIENCY WITH PHLEGM ACCUMULATION

Clinical Manifestations	Difficulty swallowing Sallow complexion Anorexia (maybe with vomiting) Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools or watery stools containing undigested food Shortness of breath Pain in the epigastrium with cold sensations (pain is relieved by warmth) Cold limbs Feeling chilled Frequent, clear urination Mental fatigue Maybe scanty urine with edema Maybe clear, watery vaginal discharge T: Pale C: Thin and white P: Deep and weak
Treatment Principle	Warm the Center Dispel Cold
Herb Formulas	Fu Zi Li Zhong Wan modified Chinese Patent Medicines: Fu Zi Li Zhong Wan
Points	Moxa LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20 Moxa or moxa needle KI-4, REN-4, REN-6, REN-12, ST-36, UB-17, UB-20, needle LU-9, PC-6, REN-14, REN-17, REN-22 With severe Kidney Yang Deficiency: + moxa or moxa needle DU-4, UB-23

SPLEEN AND STOMACH DEFICIENCY COLD

Clinical Manifestations	Progressive dysphagia Vomiting after eating Frequent epigastric and abdominal distention and fullness which is worse after eating Vomiting of partially digested food about twelve hours after eating Vomiting relieves the abdominal discomfort The vomitus may have thick or thin frothy mucus Maybe epigastric masses and/or splash on palpation Stuffiness in the chest General weakness Acid regurgitation Nausea Mild constant epigastric pain; relieved by warmth and pressure Anorexia Loose, unformed stools Excessive salivation Cold limbs Lassitude Weakness Sallow or pale, dull complexion Maybe edema Maybe scanty urination Maybe clear, watery, copious vaginal discharge T: Pale C: White and greasy P: Deep, thready and forceless
Treatment Principle	Strengthen the Spleen Warm Yang Warm the Center Dispel Cold
Herb Formulas	Zhi Ye San
Points	Moxa or moxa needle LIV-13, REN-12, SP-3, SP-6, ST-36, UB-20, UB-21

STOMACH AND LUNG YIN DEFICIENCY

Clinical Manifestations	Dysphagia Esophagus obstructed and swollen Emaciation Dry skin Hot sensations in the Stomach Dry throat Thirst Hacking cough with scanty sputum Low grade fever Epigastric pain Dry stools Constipation Scanty urination Restlessness T: Red C: Little, maybe dry P: Thready and rapid
Treatment Principle	Clear and Nourish the Lungs and Stomach Generate Fluids Moisten Dryness
Herb Formulas	Sha Shen Mai Men Dong Tang
Points	KI-3, PC-6, REN-12, REN-21, REN-22, SP-4, SP-6, SP-9, ST-36

LIVER QI STAGNATION: PHLEGM AND QI STAGNANT AND BLOCKED

Clinical Manifestations	Feeling of obstruction in throat as if a slice of roast meat were stuck there which cannot be coughed up nor swallowed down. This sensation becomes more prominent during emotional upset and subsides when relaxed Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: Thin and white P: Slippery and wiry (slippery due to Phlegm)
Treatment Principle	Spread Qi Resolve Phlegm
Herb Formulas	Ban Xia Hou Po Tang
Points	LI-18, LIV-3, PC-5, SI-17, SJ-6

LIVER WIND STIRRING INTERNALLY: LIVER YANG (FIRE) GENERATES WIND

Clinical Manifestations	Dizziness and vertigo to the point of falling over Headache with a drawing sensation Numbness and tremor of limbs Twitching and involuntary writhing of hands and feet Dysphasia Unsteady gait With Wind-Stroke: Sudden loss of consciousness Tongue stiffness with aphasia Facial paralysis Hemiplegia Maybe coma Sometimes death T: Red P: Thready and wiry
Treatment Principle	Nourish Yin Pacify the Liver Subdue Wind
Herb Formulas	Zhen Gan Xi Feng Tang
Points	Bleed the Jing-Well points of Six Hand Channels, needle DU-20, DU-26, GB-20, GB-34, KI-1, KI-3, LIV-2, LIV-3, PC-8, UB-18, UB-23

KIDNEY YANG DEFICIENCY

Clinical Manifestations	Difficulty swallowing Lumbago: low back feels cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Pale face Urinary frequency with abundant, clear urine or Oliguria with edema Maybe nocturia Lassitude Withdrawn, subdued behavior Knees feel cold and aching Dizziness Tinnitus Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow
Treatment Principle	Warm and Reinforce Kidney Yang
Herb Formulas	You Gui Wan Chinese Patent Medicines: Jin Gui Shen Qi Wan
Points	Moxa or moxa needle DU-4, KI-3, REN-4, UB-23 For chronic diarrhea, rectal prolapse and Vanquished Yang: + moxa DU-20, REN-8 For Kidney Yang Deficiency impotence: moxa or moxa needle DU-4, DU-20, KI-3, REN-4, UB-23 For Kidney Yang Deficiency (Cock Crow) Diarrhea: moxa or moxa needle DU-20, KI-3, REN-4, UB-23

KIDNEY YANG DEFICIENCY WITH UPWARD ATTACK OF PHLEGM AND TURBIDITY

Clinical Manifestations	Difficulty swallowing Aphasia Leg paralysis A stiff tongue A dry mouth with no desire to drink Loss of speech T: Pink or Pale C: Moist or Greasy P: Deep, thready and weak or Deep slow, thready and weak
Treatment Principle	Enrich Kidney Yin Tonify Kidney Yang Resolve Phlegm Open the Orifices
Herb Formulas	Di Huang Yin Zi
Points

YIN AND BLOOD DEFICIENCY WITH EMPTY FIRE RISING

Clinical Manifestations	Difficulty swallowing Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of the low back Spermatorrhea or Premature ejaculation Aching in the bones Aching in the leg and heel Dry mouth Thirst Night sweats Five Sole Heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Urine short and red Heightened libido Blurred vision Palpitations Insomnia Dry skin Dry hair Poor memory Paleness Fatigue Scanty periods T: Variable C: Thin, white and dry or Little or None P: Thready and rapid or Weak
Treatment Principle	Tonify Qi Nourish Yin Nourish Blood Invigorate the Blood Clear Heat Clear Deficiency Fire Astringe Fluids
Herb Formulas	Ye Zhong Wan
Points

YIN AND FLUID DEFICIENCY OF THE THROAT AND ESOPHAGUS DUE TO HEAT

Clinical Manifestations	Difficulty swallowing maybe with a burning of painful sensation Food is difficult to swallow but Fluids are easy After eating, the bulk of the ingested food may be vomited up, possibly mixed with mucus Gradual weight loss Dryness oft the mouth and throat Dry skin Thirst Pain in the chest and upper back An uncomfortable burning sensation in the epigastrium A hoarse or croaky voice Five-Sole-Heat Low-grade afternoon fever Nightsweats Facial flushing A tendency toward constipation T: Red and dry with multiple surface cracks C: Maybe yellow P: Wiry, thready and rapid
Treatment Principle	Nourish and moisten Yin and Fluids Clear Heat Disperse accumulations
Herb Formulas	Wu Zhi An Zhong Yin With severe Dryness, constipation and lack of saliva: + Zeng Ye Tang modified Chinese Patent Medicines: Lan Han Guo Chong Ji With Kidney Yin Deficiency: Liu Wei Di Huang Wan With Stomach Qi and Yin Deficiency: Gu Ben Wan
Points	KI-6, KI-27, LI-18, LU-7, REN-14, REN-17, REN-22, SP-6, ST-36 With Stomach Heat: + PC-8, ST-44 Ear: Stomach, Esophagus, Diaphragm, Throat, Kidney, Lung Shenmen

QI AND YANG DEFICIENCY

Clinical Manifestations	Difficulty swallowing Food obstructing the esophagus May only be able to ingest Fluids Frequent spitting of saliva and gastric fluids Weight loss Emaciation Severe fatigue, exhaustion and weakness Pale, sallow complexion Cold intolerance Cold extremities Hyper-salivation Drooling Shortness of breath Edema of the face and ankles or Generalized edema Abdominal distension Chronic difficulty swallowing food and fluid Pale-white face Tiredness Shortness of breath Excessive phlegm Frequent belching with clear mucus Cold body Face and ankle swelling Sometimes abdominal swelling T: Pale and swollen C: White P:Thready, weak and imperceptible
Treatment Principle	Tonify Qi Strengthen the Spleen Harmonize the Stomach Clear Damp
Herb Formulas	Bu Qi Yun Pi Tang Bu Qi Yun Pi Tang Jia Jian
Points	Moxa or moxa needle KI-4, REN-4, REN-6, REN-12, ST-36, UB-17, UB-20, needle LU-9, PC-6, REN-14, REN-17, REN-22 With severe Kidney Yang Deficiency: + moxa or moxa needle DU-4, UB-23 DU-20, LIV-13, REN-6, REN-17, REN-22, SP-4, UB-20 Ear: Spleen, Stomach, Kidney, Lungs, Esophagus, Shenmen

QI AND BLOOD DEFICIENCY

Clinical Manifestations	Difficulty swallowing Pallid or sallow complexion Palpitations with anxiety that may be continuous Reduced appetite Shortness of breath Laconic speech Easily fatigued extremities Light-headedness and/or vertigo Dizziness Anorexia Thirst Course skin Headache Blurred vision Lassitude Severe chills and fever Under weight Midline pain in women Lower abdominal pain Lower abdominal distention Lumbago in women Severe chills and fever Irregular menstruation Weight loss Abscesses that neither suppurate nor improve Continuous spotting from uterine bleeding Weakness of the limbs Itching T: Pale C: Thin and white P: Thin and frail or Large and Deficient without strength
Treatment Principle	Tonify and augment Qi and Blood
Herb Formulas	Ba Zhen Tang modified
Points

REBELLIOUS QI

Clinical Manifestations	Progressive dysphagia Vomiting after eating Dry stools Chest distention General debility A localized pricking sensation in the chest and back Maybe hematemesis Melaena T: Dark blue or red with echymoses C: Thick and greasy P: Deep, sluggish and choppy or Choppy and uneven
Treatment Principle	Purge accumulations Moisten the Intestines Invigorate the Blood Promote the movement of Qi Descend Rebellious Qi Clear Heat Relieve toxicity Alleviate pain
Herb Formulas	Ye Ge Yan Fang
Points

BLOOD STAGNATION WITH BLOOD DEFICIENCY AND HEAT

Clinical Manifestations	Progressive dysphagia Ingestion of food is prevented Vomiting immediately after eating Vomiting of saliva and undigested food Vomiting with constipation (severe) Chest pain (severe) Swallowing eventually becomes impossible Emaciation with dry skin (severe) Loss of appetite, especially for meat Stomach distention A sensation of obstruction in the throat Diminished saliva Maybe fever due to pulmonary infection Maybe aortic erosion Liquids or semi-solids are sustained Dizziness Dry muscles and skin Definite obstruction between the pharynx and diaphragm Hard stools Dull pain Burning pain A rancid taste in the mouth Precordial discomfort Constipation A pale complexion Pale nails Pale lips Maybe severe coughing Maybe aspiration of Fluids T: Normal or Cyanotic or Red or Pale C: Little or Non P: Weak and choppy or Thready and rapid
Treatment Principle	Nourish the Blood Invigorate the Blood Dispel Blood Stasis Clear Heat Cool the Blood
Herb Formulas	Tong You Tang
Points	PC-6, REN-12, REN-17, REN-21, REN-22, SP-10. ST-36

PHLEGM AND QI OBSTRUCTION

Clinical Manifestations	Difficult to swallow food (often with an emotional component) Swallowing with a choking sensation Swallowing eventually becomes impossible Dull or burning pain Distention with indistinct pain that is relieved by belching, dry retching or spitting up of Phlegm or mucus A feeling of esophageal constriction Dry mouth and throat Focal distention of the chest and diaphragm or Dull chest pain Hiccups Acid reflux Vomiting of a mucus-like material of food streaked with mucus dry mouth and throat Difficult bowel movements Severe weight loss Gradual emaciation Sometimes acute pain Maybe severe coughing Maybe aspiration of fluids Maybe fever Maybe aortic erosion T: Normal or Red or Red with red edges C: White or Greasy and white or Greasy and yellow P: Thready and wiry or Wiry and slippery or Thready and rapid
Treatment Principle	Regulate Qi Soothe and soften the Liver Moisten Dryness Clear Heat
Herb Formulas	Qi Ge San Ban Xia Hou Po Tang With Liver Qi Stagnation dominant: Xiao Yao San modified With rebellious Stomach Qi: Xuan Fu Dai Zhe Tang modified Chinese Patent Medicines: Xiao Yao Wan Jia Wei Xiao Yao Wan For Phlegm masses: + Hai Zao Wan For Phlegm and blood Stagnation masses: + Nei Xiao Lan Li Wan
Points	KI-4, KI-27, LI-18, PC-5, PC-6, REN-14, REN-17, REN-22, ST-40 With Lung involvement associated with long-term sadness or grief: + LU-3, LU-7 PC-6, REN-12, REN-17, REN-21, REN-22, ST-36 Ear: Liver, Stomach Esophagus, Throat, Shenmen

PHLEGM AND BLOOD STAGNATION

Clinical Manifestations	Difficulty swallowing In severe cases, the patient is unable to eat solid food at all Even Fluids may be difficult to swallow Vomiting may follow attempts to eat The vomitus may be watery and red or brown tinged Localized, possibly sharp or piercing chest pain A tendency toward constipation Hard, dry stools Possibly black, tarry stools Weight loss Emaciation Dry, scaly skin Brittle, pitted nails Spider naevi on the face and chest Dark, distended vessels on the legs and abdomen A dull, sallow or darkish complexion Dark or purplish lips and conjunctiva Dark rings around the eyes T: Purplish or Purple with brown petechial spots with distended, dark sublingual veins C: Little or None P: Thready and choppy
Treatment Principle	Invigorate the Blood Break up Blood Stasis Disperse masses Nourish and supplement Yin and Blood
Herb Formulas	Tong You Tang Chinese Patent Medicines: Xue Fu Zhu Yu Wan She Dan Chuan Bei Ye For Phlegm and Blood Stagnation masses: Nei Xiao Lan Li Wan For Phlegm masses: Hai Zao Wan
Points	KI-27, LI-18, PC-5, PC-6, REN-14, REN-17, REN-22, ST-36, UB-17, UB-46 Ear: Stomach, Esophagus, Liver, Throat, Diaphragm, Shenmen

PHLEGM-DAMPNESS (TAN YIN)

Clinical Manifestations	Upper abdominal pain Discomfort in the upper abdomen Anorexia Nausea Vomiting Sticky sputum Weight loss Melaena Edema Abdominal distention Chest and hypochondriac distention Dizziness Nausea Vomiting Vertigo Ascites Anemia Difficulty swallowing food Hepatomegaly Abdominal tumor The tumor is firm and irregular 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	Dry Dampness Transform Phlegm Warm the channels Descend Rebellious Qi Stop vomiting Harmonize the Stomach Dissipate nodules Reduce Stagnation
Herb Formulas	Li Ge Tang
Points	PC-6, SJ-6, SP-6, SP-9, ST-40, UB-13, UB-20, UB-23

WIND PHLEGM (FENG TAN)

Clinical Manifestations	Difficulty swallowing Paralysis Numbness Slurred speech Deviated eyes Deviated mouth (wry mouth) Dizziness Tinnitus Sputum in the throat Chest fullness and distention Epigastric fullness and distention Hypertension Stroke T: Deviated and trembling C: Thick P: Slippery and maybe wiry
Treatment Principle	Resolve Phlegm Subdue Wind
Herb Formulas	Jie Yu Dan
Points	Pre-stroke: ST-40, UB-40 Stroke (emergency): DU-26, KI-1, PC-9, Ting Points Post-stroke: Arm: LI-4, LI-11, LI-15, SI-3, SJ-5 Leg: GB-34, GB-35, UB-40, UB-60 Scalp: Motor area (contralateral - upper one-fifth)

PHLEGM-HEAT (RE TAN)

Clinical Manifestations	Difficulty swallowing Cough with sticky, yellow, difficult to expectorate sputum Rapid breathing with a harsh voice Focal distention in the chest and epigastrium with or without nodules which is painful when pressed Burning epigastric pain Retrosternal discomfort Heartburn A bitter taste in the mouth Restless fever Sore throat Constipation Dry stools Mania Shortness of breath Dyspnea Nausea Vomiting Chest and/or epigastric fullness Pain in the ribs T: Scarlet C: Yellow or Yellow and greasy or Yellow and smooth P: Rapid and smooth or Slippery and rapid
Treatment Principle	Clear Heat Resolve Phlegm
Herb Formulas	Xiao Xian Xiong Tang With Wind-Phlegm (Feng Tan): Xing Lou Cheng Qi Tang
Points	LI-11, LU-5, ST-40, UB-13

WIND PREDOMINANT BI SYNDROME

Clinical Manifestations	Whole body numbness Deviation of mouth and eyes Numbness of skin Dysphagia due to stiffness of the tongue Hemiplegia Rigidity of the extremities Spasms of the extremities Aversion to Cold Fever Chills Aching joints Tingling of the skin Paralysis of the extremities Numbness and lack of sensation in the hands and feet Common cold (with above symptoms) Inability to walk Wandering joints pain T: Pink or Red C: White or Thin yellow P: Superficial or Superficial and wiry or superficial and tight or Wiry and thin
Treatment Principle	Dispel Wind Clear Heat Circulate Qi Dredge the channels Nourish and invigorate the Blood Harmonize the Ying and Wei
Herb Formulas	Da Qin Jiao Tang
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DYSPHAGIA (YI GE)

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