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HABITUAL MISCARRIAGE (SPONTANEOUS ABORTION)

GENERAL

Clinical Manifestations
Treatment Principle
Herb Formulas	Ma Huang Jia Zhu Tang To Stabilize the womb: Gu Chong Tang Gu Jing Wan Zhen Ling Dan Wan Dai Tang Yi Huang Tang For prevention: Bao Chan Wu You Fang For prevention without Heat or Cold signs: Tai Yuan Yin modified
Points	DU-4, REN-3, ST-27, ST-28, SP-10, SP-6 SP-6, REN-4, REN-6, ST-36, UB-17, UB-20, UB-23 SP-6, SP-9, REN-3, UB-15, UB-18, UB-20

SHAO YANG FU WITH CONGESTED FLUIDS

Clinical Manifestations	Alternating chills and fever (chills predominate) or Chills without fever Sensation of irritability in the chest Sweating from the head Fatigue Gastrointestinal weakness Heavy head Neuralgia Epigastric distension Lower abdominal pain Tension around pubic bone Periumbilical pain Urinary difficulty T: Moist C: White and slippery P: Superficial and wiry
Treatment Principle	Disperse Clumping Harmonize the Shao Yang Warm the Interior Dispel Cold
Herb Formulas	Chai Ling Tang
Points	GB-41, SJ-5, moxa or moxa needle REN-4, REN-6, REN-8, REN-12, SJ-6, ST-25, ST-36

SPLEEN QI DEFICIENCY

Clinical Manifestations	Habitual miscarriage Pale-red to normal Blood color Thin and watery Blood with clots Irregular menstruation Sallow complexion Fatigue Anorexia Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath May be much Blood due to Spleen Not Governing Blood May be little Blood due to Spleen Qi Sinking The Blood is pale-red in color and watery An empty feeling in the lower abdomen Spleen Not Governing Blood: Shortness of breath Dizziness Palpitations Functional Uterine Bleeding Purpura Epistaxis Hemafecia Hematuria Menorrhagia Metrorrhagia Spleen Qi Sinking: Prolapse of one or more organs T: Pale and flabby - may have teethmarks C: White P: Even, forceless and deficient
Treatment Principle	Nourish the Middle Jiao Qi Keep the Blood in the Chong and Ren channels
Herb Formulas	Bu Zhong Yi Qi Tang
Points

SPLEEN NOT GOVERNING THE BLOOD

Clinical Manifestations	Abdominal pain Uterine bleeding (metrorrhagia) Excessive menstruation Menstruation with constant spotting Postpartum bleeding Bleeding during pregnancy The Blood is pale and thin without clots Weakness Sore lower back Post abortion bleeding Dull complexion Weakness and pain of the legs Light red, unelevated and indistinct eruptions T: Pale C: Thin and white or Whitish and moist P: Thready and weak
Treatment Principle	Nourish and warm the Blood Stop bleeding Regulate menstruation Calm the fetus Prevent miscarriage
Herb Formulas	Jiao Ai Tang Xiong Gui Jiao Ai Tang
Points	SP-1, SP-3, SP-10, UB-17, UB-20, ST-36, other points are selected according to signs and symptoms

SPLEEN AND KIDNEY DEFICIENCY

Clinical Manifestations	Continuous cramping pain in the abdomen Pain not severe Pain relieved by pressure Edema of the feet Urinary difficulty Slight edema (primarily of the lower limbs) Symptoms generally occur during pregnancy Pale face Fatigue Heaviness of head Lassitude Lower abdominal pain Dizziness Tinnitus Lumbago Palpitations Cold feet Vertigo Weakness and numbness of lower back and legs during pregnancy or postpartum Thirst with no desire to drink Malposition of the fetus Dysmenorrhea Right upper quadrant pain Irregular menstruation Hepatomegaly T: Pale or pink maybe petechiae on the edges C: Thin or Greasy white P: Deep and weak or Soft, floating, small and slow or Wiry and small or Wiry and rough
Treatment Principle
Herb Formulas	Dang Gui Shao Yao San An Tai Yin #3 modified
Points

KIDNEY YIN DEFICIENCY WITH HEAT

Clinical Manifestations	Continuous menstruation or Uterine bleeding that alternates between spotting and gushing The Blood is very red, thick and sticky and may contain dark-purple clots A sensation of Heat and irritability in the chest Menstruation may be delayed Dry mouth Leukorrhea Dysuria Abdominal pain Dark urine Red urine Red face Difficulty defecating T: Red C: Normal or Yellow P: Wiry or Wiry and rapid or Tight and rapid or Slippery and rapid
Treatment Principle	Enrich Yin Clear Heat Clear Deficiency Heat Stop bleeding Stabilize the Menses
Herb Formulas	Bao Yin Jian An Tai Yin #2 An Tai Yin #3 modified Liu Wei Di Huang Wan modified Gu Jing Wan
Points

KIDNEY YANG DEFICIENCY

Clinical Manifestations	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	Bu Shen Gu Chong Wan An Tai Yin #2
Points

KIDNEY YIN AND YANG DEFICIENCY

Clinical Manifestations	Lower back soreness and distention A sensation of collapse in the lower abdomen Vaginal bleeding during pregnancy Dizziness Tinnitus Weak legs Frequent urination to the point of incontinence T: Pale C: Slippery and white P: Deep and frail at the rear position
Treatment Principle	Stabilize the Kidneys Calm the fetus
Herb Formulas	Shou Tai Wan With Blood Deficiency: Bu Shen Si Wu Tang Chinese Patent Medicines: Zi Shen Yu Tai Wan
Points

QI AND BLOOD DEFICIENCY

Clinical Manifestations	Miscarriage after several months or premature delivery Lassitude Dizziness Blurred vision Palpitations Insomnia Anorexia Loose stools Weak limbs Abdominal distention Lumbar soreness Frequent, clear urine Clear, watery vaginal discharge T: Pale C: Thin and white P: Weak in the Qi position
Treatment Principle	Tonify Qi and Blood
Herb Formulas	Bao Chan Wu You Fang Tai Yuan Yin modified An Tai Yin #3 modified Ba Zhen Tang With Cold: Shi Quan Da Bu Tang For Spleen Deficiency: Qian Jin Bao Tai Wan For Kidney Deficiency: Liu Wei Di Huang Wan modified
Points	SP-6, REN-4, REN-6, ST-36, UB-17, UB-20, UB-23

BLOOD DEFICIENCY

Clinical Manifestations	A history of miscarriage or threatened miscarriage Fatigue Anorexia Restless fetus General weakness Light red Blood Constant lower abdominal pain Insomnia A pale or sallow complexion Lassitude Palpitations Ptosis of the viscera Dizziness T: Pale C: Slippery or Thin and white P: Slippery and forceless or Deep and weak
Treatment Principle	Nourish the Blood
Herb Formulas	Dang Gui Sanmodified Tai Shan Pan Shi San Jiao Ai Tang An Tai Yin #3 Dang Gui Ai Ye Tang
Points

BLOOD DEFICIENCY WITH BLOOD HEAT

Clinical Manifestations	Repeated miscarriage Facial flushing Thirst with a desire to drink Dry stool Lumbar soreness P: Large and empty, especially in the Qi position.
Treatment Principle	Clear Heat Tonify Deficiency
Herb Formulas	Dang Gui San
Points	SP-6, SP-9, REN-3, UB-15, UB-18, UB-20

BLOOD STAGNATION

Clinical Manifestations	Miscarriage or spontaneous abortion Unchecked bleeding or Continuous spotting afterward Abdominal pain which is worse with pressure Slightly grayish gums Pain Masses or tumors Hemorrhage Echymosis
Treatment Principle	Invigorate the Blood Eliminate Stasis
Herb Formulas	Shao Fu Zhu Yu Tang Zhe Chong Yin Shi Xiao San + Sheng Hua Tang modified
Points	REN-4, SP-6, SP-10, ST-29, UB-25

LOWER JIAO BLOOD STAGNATION WITH HEAT

Clinical Manifestations	Acute lower abdominal pain Incontinence of urine Night fevers Delirious speech Irritability Restlessness Thirst May be mania (severe) Dysmenorrhea Amenorrhea Hard stool Dark red complexion Headache Vertigo Tinnitus Insomnia Palpitations Constipation Frequent urination Emotional instability Chills in the waist and feet Tremors Excruciating abdominal pain with cold Black stool May be chills and fever Hemoptysis Hematuria Red eyes Pain and distention of the head Toothache Irregular menstruation Lochioschesis Severe wheezing Distention of the chest T: Red and dry C: Yellow P: Deep and forceful or Choppy
Treatment Principle	Drain Heat Break up Blood Stasis
Herb Formulas	Tao He Cheng Qi Tang
Points

BLOOD STAGNATION DUE TO COAGULATED BLOOD

Clinical Manifestations	Scanty or no lochia after miscarriage or spontaneous abortion Distending pain in the lower abdomen which is worse with pressure T: Greenish P: Deep and choppy
Treatment Principle	Invigorate the Blood Eliminate Stasis
Herb Formulas	Shi Xiao San + Sheng Hua Tang modified If caused by Wind-Cold: Wen Jing Tang
Points	LIV-3, REN-4, SP-6, SP-10, ST-30, UB-25, UB-34, Zigong

DEFICIENCY COLD OF THE CHONG AND REN CHANNELS

Clinical Manifestations	Habitual miscarriage Afternoon fever Five sole heat Dry mouth Thirst Cold abdominal pain Infertility Dysmenorrhea Uterine bleeding Chronic pelvic inflammation Menopause
Treatment Principle	Warms the vessels Comforts the Womb Nourishes and invigorates the Blood
Herb Formulas	Wen Jing Tang Zhen Ling Dan
Points

INJURY TO THE CHONG AND REN

Clinical Manifestations	Miscarriage or spontaneous abortion Heavy Blood loss Fainting spells Unchecked dribbling of Blood (serious) Low back pain Weakness of the limbs Abdominal pain which is better with pressure T: Pale C: Thin P: Weak
Treatment Principle	Tonify Qi and Blood
Herb Formulas	Si Sheng Wan Gui Pi Tang modified
Points	LIV-3, REN-4, REN-6, SP-6, ST-36, UB-20, UB-23