JAUNDICE

GENERAL

Clinical Manifestations
Treatment Principle
Herb Formulas	For obstruction of the bile duct: Da Chai Hu Tang Wu Mei Wan
Points	GB-21, KI-7, LI-2, LI-4, LI-13, LIV-4, LIV-8, PC-7, REN-12, SI-14, ST-44, UB-48 GB-38, GB-40, LIV-8, SI-8, SP-5, SP-10, UB-40, UB-43 DU-9, SI-4 DU-9. DU-12, SP-6, UB-11, UB-17, UB-18, UB-20 , UB-47, UB-48 PC-8, SI-3 LIV-2, LIV-3 DU-9, GB-24, SP-9, ST-36, UB-19, UB-20 Yang jaundice: + GB-34, KI-1, LIV-3 Yin jaundice: + LIV-13, UB-20 Cold induced: KI-1, SI-4, SJ-5, UB-62 Infectious: DU-9, DU-12, LI-10, SI-4, ST-36, ST-40. ST-44, UB-20, UB-48, UB-50 Yang jaundice: 1. GB-34, LIV-3, SP-9, ST-44, UB-19 With anorexia and epigastric lumps: + PC-6, ST-36 With chest and epigastric oppression, nausea and vomiting: + PC-6, SP-4 With abdominal distention and constipation: + ST-25, UB-25 2. DU-9, DU-14, LI-4, LIV-4, PC-6, PC-8, REN-12, SI-3, SP-4, SI-3, UB-19 3. DU-9, GB-34, Huatoujiaji from T-7-T-10, LIV-3 Yin jaundice: 1. DU-9, REN-12, SP-6, ST-36, UB-11, UB-20 , UB-21 2. DU-9, REN-12, SP-6, ST-36, UB-19, UB-20 With despondency and aversion to Cold: + DU-4, REN-6 With loose stools: + REN-4, ST-25 3. REN-4, REN-12, SP-4, SP-6, ST-25, ST-36, UB-20 , UB-21 , UB-23 4. REN-4, REN-12, SP-6, ST-25, ST-36

SHAO YANG JING

Clinical Manifestations	Alternating chills and fever Restlessness Irritability Anorexia Sometimes fatigue Nausea Occasional vomiting Jaundice Headaches (side of head) Hypochondriac pain Rib pain Achiness Ear infection Hearing difficulty Red eyes Stiff shoulders Throat pain Hip pain T: Normal with bumps or dots on side C: Thin white P: Wiry
Treatment Principle	Harmonize the Liver and Gall Bladder
Herb Formulas	Xiao Chai Hu Tang
Points	GB-41, SJ-5 To harmonize the Liver and Gall Bladder: GB-34, LIV-3, LIV-14, SJ-5 To stop nausea and vomiting: PC-6, SP-4, ST-36 To treat headache: GB-1, GB-8, GB-14, Taiyang To treat constipation: SJ-6, ST-25 To treat fever: DU-13, DU-14 To support the San Jiao and Regulate Yin: PC-5, PC-6 To support Yin: KI-7 To support the Ying: SP-10 Head: GB-8, SJ-20, Yintang Eyes: GB-14, GB-20, ST-1, UB-1, UB-2 Ear: GB-2, SJ-5, SJ-17, SJ-21 Hypochondriac area: GB-34, GB-40 Ear: Shenmen, Gall Bladder, Point 0

SHAO YANG FU

Clinical Manifestations	Alternating chills and fever (not so likely) Restlessness Irritability Continuous vomiting Headache (side of head) Hypochondriac pain Epigastric pain Bitter taste in mouth Digestive disruption Anorexia Nausea Acid regurgitation Burning diarrhea or Constipation Menstrual problems Dry throat Heart pain with vomiting Throat pain Hip pain T: Red C: Thin yellow P: Wiry, forceful
Treatment Principle	Harmonize the Liver and Gall Bladder Purge Internal Heat
Herb Formulas	Da Chai Hu Tang For Shao Yang Fu with Tai Yang manifesting as joint pain with a crackling sensation (symptoms are more external): Chai Hu Gui Zhi Tang
Points	To harmonize the Liver and Gall Bladder: GB-34, LIV-3, LIV-14, SJ-5 For nausea and vomiting: PC-6, SP-4, ST-36 For headache: GB-1, GB-8, GB-14, Taiyang For constipation: SJ-6, ST-25 For fever: DU-13, DU-14 For Stomach Heat: LI-4, LI-11, ST-44 To support the San Jiao and Regulate Yin: PC-5, PC-6 To support Yin: KI-7 To support the Ying: GB-41, SJ-5 , SP-10 To regulate menstruation: SP-6 For Shao Yang Fu with Tai Yang: For the Shao Yang: GB-34, LIV-3, LIV-14, SJ-6 For the Tai Yang: GB-20, UB-12

SHAO YIN COLD

Clinical Manifestations	Aversion to Cold Curls up a lot Doesn't like to talk Tired (disoriented) No spirit Dull Shen Cold extremities Diarrhea or loose stools or undigested food Clear, frequent urine Maybe nausea (wants to vomit but can't) No thirst Likes warm drinks Severe edema in chest Yin jaundice T: Pale C: White P: Sinking and weak
Treatment Principle	Restore Yang Reverse inward energy Expel Cold
Herb Formulas	Si Ni Tang With Exterior Heat: Tong Mai Si Ni Tang
Points	Moxa DU-4, DU-20, KI-3, KI-7, LI-4. REN-4, REN-6, REN-8, SP-6, ST-36. UB-15, UB23 For loss of consciousness or shock: DU-26, KI-1

WEI STAGE: DAMP-HEAT

Clinical Manifestations	Headache (wrapping) Distention and heaviness of the head Fever and chills, fever more pronounced or Chills with afternoon fever Heavy extremities Heavy sensations in the body Stifling sensation in the chest Generalized myalgia Anorexia Nausea Dizziness Gastric and abdominal distension Epigastric fullness and discomfort Sticky mouth No thirst Mild jaundice Fatigue Lethargy Concentrated urine Aversion to cigarette smoke T: Normal C: Greasy, white or Greasy, yellow or Thin and greasy P: Soft and rapid or Soft and slow or Wiry thin and soft or Floating and rapid or Floating and wiry
Treatment Principle	Clear the Exterior Clear Damp-Heat Promote urination
Herb Formulas	Ma Huang Lian Qiao Chi Xiao Dou Tang + Gan Lu Xiao Du Dan Chinese patent medicines: Ji Gu Cao Wan Li Dan Pian Long Dan Xie Gan Wan Huo Xiang Zheng Qi Pian
Points	LI-4, LU-6, REN-12, SJ-6, ST-36 For severe dampness: + SP-9 For fever: + DU-14, LI-11 For diarrhea: + ST-25, Zhixie For fever: DU-14, bleed UB-40 For Wind-Heat: GB-20, LI-4, or SJ-5, LI-11, UB-12 For headache: DU-23, DU-24, ST-8, Taiyang For Dampness: REN-9, SP-6, SP-9, ST-28, UB-20

QI STAGE: OBSTRUCTION OF THE CHEST BY HEAT

Clinical Manifestations	High fever or Fever Aversion to Heat Irritability Restlessness (neither activity nor resting brings relief) Heat sensation in the chest Thirst Has urge to vomit but cannot May have dark yellow urine Acute icteric jaundice T: Red C: Yellow P: Rapid or Forceful and rapid
Treatment Principle	Clear Heat Remove Obstructions
Herb Formulas	Zhi Zi Chi Tang Zhi Zi Gan Cao Chi Tang With vomiting: Zhi Zi Sheng Jiang Chi Tang With Food Stagnation: Zhi Shi Zhi Zi Chi Tang
Points	DU-14, HT-7, LI-11, PC-6, ST-44

QI STAGE SPLEEN AND STOMACH DAMP-HEAT

Clinical Manifestations	Fever Pressure headache - like a bandage Gastric distension Poor appetite Heaviness Body aches Chest distension Diarrhea Dysentery T: Red C: Greasy and yellow P: Soft and rapid or Soft and slow or Wiry thin and soft
Treatment Principle	Clean Damp-Heat and toxins
Herb Formulas	Gan Lu Xiao Du Dan Long Dan Xie Gan Tang
Points	LI-4, LI-11, SP-6, SP-9, ST-25, ST-36

QI STAGE: GALL BLADDER HEAT

Clinical Manifestations	Alternating chills and fever Bitter taste in mouth Thirst Dry throat Rib pain (doesn't like touch) Hypochondriac pain Nausea Vomiting Jaundice Hypogastric pain and distension T: Red C: Yellow P: Rapid and wiry
Treatment Principle	Relieve Gall Bladder Heat Pacify the Liver and Gall Bladder
Herb Formulas	Liang Ge San
Points	GB-34, Lanweixue, LI-11, LIV-2, LIV-3, LIV-4, LIV-13, LIV-14

SEVERE FIRE IN THE QI AND XUE LEVELS (YANG) (ACUTE)

Clinical Manifestations	Intense fever Strong thirst Dry heaves Severe, stabbing headache Extreme irritability Delirious speech (severe) Rash (severe) Epistaxis (severe) Severe icteric jaundice Maculae Mania Convulsions Lips chapped, dark and scorched Coma Hematemesis Extreme coldness of the extremities Restlessness Spasms or convulsions Blurred vision T: Dark red C: Dry or prickly P: Deep, thin and rapid or Floating, large and rapid
Treatment Principle	Clear Heat Relieve toxicity Cool the Blood Drain Fire Stop bleeding
Herb Formulas	Qing Wen Bai Du Yin
Points

WIND-DAMP WITH SPLEEN DEFICIENCY

Clinical Manifestations	Jaundice Edema Maybe perspiration 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	Expel Wind Resolve Dampness Tonify the spleen
Herb Formulas	Yue Bi Jia Zhu Tang With Damp-Heat: Yin Chen Wu Ling San
Points

WIND-DAMP-HEAT

Clinical Manifestations	Early-Stage Yang Jaundice Slightly yellow eyes and possibly body Aversion to Cold Fever Heavy-headedness Generalized pain Fatigue Stomach oppression Yellow urine T: Normal C: Thin and slimy P: Floating and wiry or Floating and rapid
Treatment Principle	Resolve the Exterior Clear Heat Eliminate Dampness
Herb Formulas	Ma Huang Lian Qiao Chi Xiao Dou Tang modified
Points	GB-34, GB-40, LI-4, LIV-3, SJ-5

COLD-DAMP DISTRESSES THE SPLEEN (YIN)

Clinical Manifestations	Yin jaundice (dull yellow) which may be hard to see in artificial light More noticeable on the palms and plantar creases 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 Generalized itching Lassitude Fatigue Malaise Lethargy Somnolence Heavy head Maybe edema Maybe copious white vaginal discharge Cold body Cold, heavy limbs Aversion to Cold Feeling chilled Inhibited urination T: Pale and swollen C: Thick, white and greasy or sticky P: Deep and slow or Deep, thready and slow or Soft and moderate
Treatment Principle	Warm Cold Transform Dampness Harmonize the Stomach Strengthen the Spleen
Herb Formulas	Wei Ling Tang Yin Chen Si Ni Tang modified Yin Chen Zhu Fu Tang modified For Spleen Qi Deficiency with predominant fatigue, reduced appetite, and loose stools: Xiang Sha Liu Jun Zi Tang modified Chinese Patent Medicines: Mu Xiang Shen Qi Wan Chen Xiang Hua Qi Wan Fu Zi Li Zhong Wan After the jaundice has been resolved, tonify Qi with: Shen Ling Bai Zhu San Bu Zhong Yi Qi Tang Huang Qi Jiang Zhong Tang:
Points	Moxa or moxa needle REN-6, REN-12, SP-6, SP-9, ST-36, UB-20 Moxa or moxa needle DU-9, GB-24, LIV-13, REN-12, SP-9, ST-36, UB-19, UB-20, UB-48 Moxa or moxa needle DU-9, GB-24, LIV-13, SP-9, ST-36, UB-19, UB-20, UB-48 Moxa or moxa needle DU-9, LI-4, REN-11, REN-12, SP-4, ST-36, UB-18, UB-19, UB-20 , UB-49 SI-3, moxa REN-4, REN-12, ST-25, UB-20, UB-21, UB-23, moxa needle SP-4, SP-6, ST-36 Moxa or moxa needle DU-9, REN-12, SI-4, SP-6, SP-9, ST-36, UB-20, UB-23 Moxa or moxa needle DU-9, REN-12, SP-6, SP-9, ST-36, UB-19, UB-20 Moxa or moxa needle DU-4, REN-4, REN-12, SP-6, ST-36, UB-20, UB-21, UB-22 With nausea and vomiting: + PC-6 With flank distention: + LIV-14 With profuse, clear vaginal discharge: + GB-26

DAMP-HEAT DISTRESSES THE SPLEEN (YANG)

Clinical Manifestations	Jaundice 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 Gan Lu Yin Yin Zhi Hu Qin Tang Nei Shu Huang Lian Tang With unexpelled Exterior symptoms: Ma Huang Lian Qiao Chi Xiao Dou Tang
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 AND BLOOD DEFICIENCY (YIN)

Clinical Manifestations	Yin jaundice The face, eye and skin are a dull, lusterless yellow or very pale or sallow Dull abdominal pain Fatigue Lethargy Weakness in the extremities Poor muscle tone Loose stools or Diarrhea Poor appetite Dizziness Pale face Weak voice Reluctance to speak Sweating with little or no exertion Palpitations Insomnia Shortness of breath Dry skin Dry hair Poor memory Pale nails Scanty periods Yellow urine T: Pale and swollen or Pale, thin and dry C: Thin and white P: Weak or Thin and choppy or Soft and thin
Treatment Principle	Strengthen the Spleen Warm the Middle Jiao Tonify Qi Nourish the Blood
Herb Formulas	Huang Qi Jian Zhong Tang Xiao Jian Zhong Tang modified For Spleen Deficiency coupled with Kidney Yin Deficiency: Liu Wei Di Huang Wan modified Chinese Patent Medicines: Wu Ji Bai Feng Wan Shi Chuan Da Bu Wan Bu Zhong Yi Qi Wan
Points	DU-4, DU-9, REN-4, REN-6, REN-12, ST-36, UB-19 KI-3, LIV-3, LU-9, SP-6, ST-36, UB-11, UB-17 LIV-3, ST-36, UB-17, UB-18, UB-20, UB-21

SPLEEN QI AND HEART BLOOD DEFICIENCY (YIN)

Clinical Manifestations	Yin jaundice Palpitations Insomnia Much dreaming Easily startled Poor memory Four limbs tired and lethargic Loss of appetite Distention and fullness of the epigastrium and abdomen Loose stools Sallow complexion Copious, pale menses Uterine bleeding or Light menstrual flow or Amenorrhea T: Pale P: Thready and weak
Treatment Principle	Reinforce and Benefit the Heart and Spleen
Herb Formulas	Gui Pi Tang
Points	HT-7, REN-4, SP-1, SP-6, ST-36, UB-15, UB-20

SPLEEN AND STOMACH DEFICIENCY COLD (YIN)

Clinical Manifestations	Mild constant epigastric pain; relieved by warmth and pressure Anorexia Abdominal pain and fullness after meals Nausea Vomiting Jaundice 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	Xiao Jian Zhong Tang With severe Qi Deficiency: Huang Qi Jian Zhong tang
Points	Moxa or moxa needle LIV-13, REN-12, SP-3, SP-6, ST-36, UB-20, UB-21

LIVER QI AND BLOOD STAGNATIN (YIN)

Clinical Manifestations	Yin jaundice with dull yellowing of the body A blue-green, purple or soot-black facial complexion Possible uncomfortable or painful lumps in the hypochondrium Possible lower abdominal distention and pain with uninhibited urination Possible spider naevi under the skin Possible low-grade fever Possible black stools T: Dark purple with possible static macules or spots C: Thin and white P: Thready, wiry and choppy or Thready and choppy
Treatment Principle	Invigorate the Blood Transform Stasis Soften hardness Disperse binding
Herb Formulas	Ge Xia Zhu Yu Tang modified
Points	GB-34, LIV-3, LIV-14, SP-10, SP-21, UB-17, UB-18, UB-19 For dull flank pain: + LIV-13 For stabbing in the chest and flanks which is worse with pressure: + LI-4, SP-6

DAMP-HEAT IN THE LIVER AND GALL BLADDER (YANG) (ACUTE)

Clinical Manifestations	Yang jaundice (sclera and skin bright yellow) Severe, sudden right-sided rib pain Pain and fullness in ribs on both sides Epigastric fullness Maybe pain in the right hypochondrium Possible high fever with aversion to Cold and shivering Bitter taste in mouth Nausea Vomiting sour and bitter fluids Belching Anorexia Dislikes greasy foods Maybe fever or alternating chills and fever Scanty, concentrated, dark urine Abdominal distention and fullness Aversion to oily, greasy and fatty foods Thirst Fatigue The body feels heavy Dry stools Constipation Women: Yellow vaginal discharge with foul smell Pruritis vulvae Men: Pain, swelling and burning sensations of testicles T: Pink or Red C: Yellow and greasy or sticky P: Wiry and rapid or Slippery and rapid or Deep, slippery and full Heat greater than Dampness: Yang jaundice (sclera, mucosal membranes and skin bright orange-yellow) Fever or Alternating fever and chills Thirst with a desire to drink cold fluids An uncomfortable, burning sensation in the chest and epigastrium Concentrated, scanty urination Dry stools or Constipation or Loose stools Nausea Vomiting Aversion to cigarette smoke T: Pink or Red C: Greasy and yellow P: Wiry and rapid or Slippery and rapid Dampness greater than Heat: Jaundice No fever or Mild fever The head is heavy and full Heaviness of the body Wrapping headache A sensation of obstruction, fullness, or discomfort in the chest and epigastrium Anorexia Nausea Vomiting Abdominal distention Fatigue Lack of strength Loose stools with difficult defecation Thirst with no desire to drink Aversion to oily, greasy foods Scanty, concentrated urine Aversion to cigarette smoke T: Flabby C: Thick and yellow or Whitish and greasy P: Soggy and moderate or Wiry and slippery
Treatment Principle	Clear Dampness Purge Heat from Liver and Gall Bladder
Herb Formulas	Long Dan Xie Gan Tang Dan Dao Pai Shi Fang #2 Yin Chen Hao Tang + Da Chai Hu Tang For Heat greater than Dampness: Yin Chen Hao Tang modified Chinese patent medicines: Ji Gu Gan Cao Wan Li Dan Pian Long Dan Xie Gan Wan For Dampness greater than Heat: Yin Chen Wu Ling San modified For more Dampness than Heat and Turbidity Accumulating in the Center with loss of taste or a sweet taste in the mouth, nausea, Stomach fullness, loose stools and a grayish white tongue coat: Yin Chen Wei Ling Tang Chinese patent medicines: Ji Gu Gan Cao Wan Li Dan Pian Long Dan Xie Gan Wan Xing Jun San With Fire toxicity: Jaundice #1
Points	Dannangxue, DU-9, GB-24, GB-34, LIV-14, SI-4, SP-9, UB-18, UB-19, UB-48 Dannangxue, DU-9, GB-24, PC-6, SI-5, UB-19, UB-48 GB-34, KI-1, LIV-3, LIV-14, SP-6, SP-9, ST-36, ST-44, UB-18 GB-34, PC-6, PC-8, REN-11, REN-12, ST-36, UB-18, UB-19, UB-20, UB-48 Light pricking on the inner wall of the eyelids. Do not bleed, wait for yellow fluid. PC-8, REN-12, SI-4, SP-9, ST-36, ST-44, UB-10, UB-19 Dannangxue, DU-9, GB-24, GB-34, LIV-14, REN-11, REN-12, SI-4, SP-9, ST-36, ST-44, UB-18, UB-19, UB-20, UB-48 Dannangxue, GB-24, GB-34, PC-6, SP-6, SP-9, ST-36 DU-9, DU-14, GB-34, REN-12, SP-4, ST-36, ST-44, UB-19 GB-24, GB-43, LIV-2, LIV-14 With severe pain: + LI-4 With a high fever: + LI-11 For severe jaundice: + DU-9 With vomiting: + PC-6 With cholecystitis: + Dannangxue For Heat greater than Dampness: 1. DU-9, GB-34, LIV-3, SI-4, SP-9, UB-19 With severe fever: + DU-14, LI-11 With nausea: + PC-6 With hypochondriac pain: + LIV-13, LIV-14, SJ-6 2. DU-9, GB-24, GB-34, LIV-3, ST-36, ST-44 With a bitter taste in the mouth: + GB-43 With Heart vexation and insomnia: + PC-5 For Dampness greater than Heat: 1. DU-9, GB-34, LIV-3, REN-12, ST-36, UB-19, UB-39 With nausea: + PC-6 With hypochondriac pain: + LIV-13, LIV-14, SJ-6 2. GB-34, GB-40, LI-4, LIV-3, SJ-5

DISHARMONY BETWEEN THE LIVER AND SPLEEN

Clinical Manifestations	Jaundice Joint pain with a crackling sensation Epigastric pain Fatigue Gastrointestinal weakness Headache Heaviness in the head Fever Moderately severe chills Distension beneath the Heart Periumbilical or lower abdominal pain Tenseness around the pubic bone Subcostal pain Epigastric fullness Nausea Mild vomiting Mild thoraco-costal discomfort Costal distress Tension in the rectus abdominus Chest distension Abdominal pain Abdominal distension Constipation Irritability Insomnia Repeated loss of spinal alignment due to muscular tension T: Normal C: Thin and white P: Floating and weak
Treatment Principle	Harmonize the Liver, Spleen and Intestines
Herb Formulas	Chai Hu Gui Zhi Tang With predominant Qi Stagnation: Dan Dou Pai Shi Fang #1
Points

LIVER AND GALL BLADDER STAGNANT HEAT (BILE DUCT OBSTRUCTION WITH HEAT)

Clinical Manifestations	Quickly developing jaundice Severe, colicky, recurrent right-sided hypochondriac pain Pain may radiate to the shoulder and upper back Fever and chills or Alternating fever and chills Bitter taste in the mouth Dry throat and mouth Nausea Anorexia Aversion to fats and oils Abdominal distention Pale, sticky stools Scanty, concentrated urine Dysuria T: Red C: Yellow P: Wiry and rapid
Treatment Principle	Soothe the Liver Drain the Gall Bladder Clear Heat Relieve fullness
Herb Formulas	Qing Dan Xie Huo Tangmodified For sudden jaundice with ascariasis: Dan Dao Qi Hui Tang Chinese patent medicines: Ji Gu Cao Wan Li Dan Pian Long Dan Xie Gan Wan
Points	DU-9. GB-24, GB-34, LIV-3, LIV-14, SI-4, UB-19 With worms in the bile duct: + LI-20 through to ST-2 With fever : + DU-14, LI-11 With alternating fever and chills: + GB-41, SJ-5 With nausea : + PC-6

OBSTRUCTION OF THE GALL BLADDER CHANNEL

Clinical Manifestations	Rapid onset of jaundice Sever rib pain which radiates to the back Usually a previous history of attacks in the right hypochondrium Fever and chills or Alternating chills and fever A bitter taste in the mouth A dry throat Nausea Abdominal distention Anorexia White or grayish stools Oliguria Dark, burning urination T: Red C: Thick and yellow P: Wiry and rapid
Treatment Principle	Drain the Liver and Gall Bladder Clear Heat Eliminate Stagnation
Herb Formulas	Da Chai Hu Tang modified With rapid onset, alternating chills and fever, intermittent pain and vomiting of worms: Wu Mei Wan modified With abundance of Fire Toxin with severe abdominal distention and constipation: Zhi Zi Jin Hua Tang With severe fever: Wu Mei Wan modified
Points	GB-34, LIV-14, REN-12, ST-36 With rapid onset, alternating chills and fever, intermittent pain and vomiting of worms: + Baichongwo, bleed Sifeng With abundance of Fire Toxin with severe abdominal distention and constipation: + REN-12, SJ-6, ST-25 With severe fever: DU-14, GB-34, LIV-3, REN-12

DAMP-HEAT IN THE URINARY BLADDER

Clinical Manifestations	Oliguria Fever Thirst Dry mouth Low back pain In Damp-Heat Crystallizes in Urinary Bladder there may also be: Colicky pain in the low back, possibly radiating to the groin T: Red C: Yellow P: Slippery and rapid
Treatment Principle	Clear Heat Eliminate Dampness by diuresis
Herb Formulas	Tao He Cheng Qi Tang modified Zhu Ling San modified
Points	KI-7, LIV-2, PC-8, REN-3, REN-12, SI-4, SP-6, SP-9, ST-36, ST-44, UB-10, UB-19 UB-23, UB-28, UB-39

YANG DEFICIENCY WITH DAMPNESS

Clinical Manifestations	Chills Cold limbs Inability to get warm Loose stools Diarrhea Vomiting Abdominal distention Palpitations Anxiety due to stress Edema Profuse clear urine Spontaneous sweating Lassitude T: Pale C: White P: Slow, deep and weak or Slow, deep and soft
Treatment Principle	Warm Yang Eliminate Dampness
Herb Formulas	Fu Ling Si Ni Tang
Points	Moxa or moxa needle DU-4, KI-3, REN-4, REN-6, SP-3, SP-6, SP-9, ST-36, UB-23

QI, YANG AND BLOOD DEFICIENCY

Clinical Manifestations	Jaundice Amnesia Palpitations Feverishness Anorexia Emaciation Pale face Insomnia Dyspnea on mild exertion Fatigue Shortness of breath Weight loss Dry skin Dry mouth Dry throat Dry lips Uterine bleeding Irregular menstruation May suddenly lose consciousness Slack jaw Restless at night Lassitude Tendency toward being frightened easily Weakness Sallow complexion Dizziness Tremors in the limbs Spontaneous perspiration Fever and severe chills General debility Mental instability Coughing and gasping Night sweats Amnesia Diarrhea Turbid urine Nocturnal emission Impotence Constipation Feeble breathing Tired limbs T: Pale C:White P: Thready and weak or thready, rapid and weak or Deep and weak
Treatment Principle	Tonify Qi Nourish the Blood Warm Yang Strengthen the Spleen and Lungs Nourish the Heart Calm the Shen
Herb Formulas	Ren Shen Yang Rong Tang
Points

QI AND BLOOD DEFICIENCY (YIN)

Clinical Manifestations	Slight jaundice Fatigue Palpitations Insomnia Dizziness Lusterless hair and nails T: Pale C: Thin and white P: Thready and soft
Treatment Principle	Tonify the Spleen Augment Qi Nourish the Blood
Herb Formulas	Shi Quan Da Bu Tang Dang Gui Jian Zhong Tang
Points	GB-24, PC-6, REN-17, SI-5, SP-4, ST-36, UB-17, UB-19, UB-20, UB-21, UB-48

BLOOD STAGNATION (YIN)

Clinical Manifestations	Jaundice with a dark color Fixed, stabbing hypochondriac pain which is worse at night and with pressure Hepatosplenomegaly Dark or purplish spider naevi on the ribs, face and on the inner ankle and knee Dark ashen, sallow or purplish complexion Dark purplish lips and conjunctiva Dark rings under the eyes Easily bruised Purpura Mild fever, worse at night Pain in the iliac fossa on palpation Dry mouth and throat with a desire to drink Emaciation Abdominal fullness and pain Anorexia Rough, dry and scaly skin May be localized abdominal pain and tenderness Amenorrhea A dull, dark appearance of the eyes Tidal fever Maybe dry stools Maybe black, tarry stools Maybe an epigastric mass T: Petechiae or Purplish or Reddish C: Little or None P: Wiry and choppy or Wiry, small and smooth or Thready and choppy
Treatment Principle	Invigorate the Blood Remove Stasis Alleviate jaundice Calm the Liver
Herb Formulas	Da Huang Zhe Chong Wan Bie Jia Jian Wan Ge Xia Zhu Yu Tangmodified For Blood Stagnation with Damp-Heat, Qi Stagnation and Qi, Blood and Yin Deficiency: Jaundice #2 For Spleen Deficiency with anorexia before using harsh Blood invigorators first use: Huang Qi Jian Zhong Tang modified Chinese patent medicines: Qi Li San Bie Jia Jian Wan
Points	DU-9, LI-4, REN-11, REN-12, SP-4, ST-36, UB-18, UB-19, UB-20, UB-48 Tonify SI-3, moxa REN-4, REN-12, ST-25, UB-20, UB-21, UB-23, moxa needle SP-4, SP-6, ST-36 GB-24, LI-4, LIV-14, SP-6, SP-7, SP-10, UB-17, UB-18, UB-19, UB-20

TOXIC HEAT (YANG) (ACUTE)

Clinical Manifestations	Jaundice is acute and worsens quickly Dark yellow or gold colored skin High fever Thirst Restlessness Delirium Epistaxis Bleeding from the mouth Bruises easily T: Deep red C: Dry yellow P: Rapid
Treatment Principle	Clear Heat Detoxify
Herb Formulas	Xi Jiao Tang Huang Lian Jie Du Tang + Yin Chen Hao Tang + Wu Wei Xiao Du Yin modified Xi Jiao San modified With roundworms in the bile duct (sudden jaundice, intermittent boring upper right quadrant pain vomiting of worms): Dan Dao Qu Hui Tang For delirium, loss of consciousness and confusion: An Gong Niu Huang Wan Zhi Bao Dan * If the patient is unconscious, the powder is blown into the nose or given via a nasogastric tube. For constipation, muscular spasms or convulsions: Zi Xue Dan For severe abdominal distention and constipation: Zhi Zi Jin Hua Tang Chinese patent medicines: An Gong Niu Huang Wan Zi Xue Dan Wan Shi Niu Huang Qing Xin Wan
Points	DU-20, DU-26, GB-34, GB-40, LI-11, LIV-3, UB-19, UB-40 With impaired consciousness: bleed Shixuan GB-34, LI-4, PC-6, SP-6, SP-10, UB-19 For verbal delirium, loss of consciousness and obsession: + DU-26 For severe abdominal distention and constipation: + REN-12, SJ-6, ST-25, ST-36

DAMP-HEAT WITH STALE FOOD

Clinical Manifestations	Stomach bitter Dizziness after eating Heat in the body and face T: Normal C: Greasy and slippery P:Slippery
Treatment Principle
Herb Formulas
Points	LI-4, LU-7, PC-6, REN-12, ST-36, ST-44, UB-19, UB-20, UB-21

SAN JIAO: MIDDLE JIAO DAMP-HEAT

Clinical Manifestations	Lethargy Anorexia Maybe jaundice No thirst or Thirst with no desire to drink Nausea Vomiting Afternoon fever Body aches A sallow complexion Scanty urination Diarrhea Chest discomfort Epigastric pain and distention Dull appearance Maybe disorientation Loose stools Maybe skin vesicles Heavy extremities T: Pink C: Greasy and yellow P: Soft and rapid
Treatment Principle	Clear Heat Resolve Damp and turbidity
Herb Formulas	Gan Lu Xiao Du Dan San Jiao #1 Long Dan Xie Gan Tang
Points	REN-6, REN-12, SP-9, ST-25, ST-36

SAN JIAO: MIDDLE JIAO DAMP-HEAT WITH HEAT PREDOMINANT

Clinical Manifestations	Systemic Yang jaundice Lethargy Anorexia Thirst Nausea Vomiting A sensation of oppression which is worse with pressure General discomfort Fever Body aches A sallow complexion Scanty urination Abdominal distention which is worse with pressure Constipation Chest discomfort Epigastric pain and distention Dull appearance Maybe disorientation Maybe skin vesicles Heavy extremities Oliguria with dark urine T: Pink C: Greasy and yellow P: Wiry, rapid and forceful
Treatment Principle	Clear Heat Resolve Damp and turbidity Move the bowels
Herb Formulas	Yin Chen Hao Tang modified
Points	DU-14, GB-34, LI-11, LIV-3, SP-9, ST-44, UB-19 With severe nausea and vomiting: + PC-6, ST-36 With drum-like abdominal distention: + REN-12, SP-6 With severe rib and flank pain: + LIV-4, LIV-14 With hyperthermia and a yellow tongue coat or Xue Stage Heat: + SJ-6, ST-25, UB-25 With the signs and symptoms returning to normal: + REN-12, ST-36 DU-9, LIV-13, SI-4, ST-44 With severe nausea and vomiting: + PC-6, ST-36 With drum-like abdominal distention: + REN-12, SP-6 With severe rib and flank pain: + LIV-4, LIV-14 With hyperthermia and a yellow tongue coat or Xue Stage Heat: + LI-11, SJ-6, ST-25, UB-25 With the signs and symptoms returning to normal: + REN-12, ST-36

SAN JIAO: MIDDLE JIAO DAMP-HEAT WITH DAMP PREDOMINANT

Clinical Manifestations	Systemic jaundice Anorexia Fatigue A heavy head Slight fever An insipid taste in the mouth No thirst A sensation of fullness Epigastric masses which may sometimes be felt on palpation Aversion to fatty foods Soft, loose stools T: Pink C: Thick and greasy or Yellow P: Soft, rapid and moderate
Treatment Principle	Clear Heat Resolve Damp and turbidity
Herb Formulas	Yin Chen Hao Tang modified
Points	GB-34, REN-12, SP-1, SP-4, SP-6, SP-9, ST-36, UB-19, UB-20 With nausea and vomiting: + PC-6 With severe abdominal distention: + REN-6, ST-25

SAN JIAO: MIDDLE JIAO YANG DEFICIENCY

Clinical Manifestations	Excruciating epigastric and abdominal pain to the point of not being able to to be touched May be borborygmus. Vomiting to the point of not being able to eat Superficial skin pulsations throughout the abdomen May be fluid sounds May be cold limbs Strong sensation of Cold in the chest and epigastrium. Severe pain in the head and feet T: Pale or Dark purple C: White and greasy or Slippery P: Thin and tight or slow and wiry or Deep and thready or Hidden
Treatment Principle	Warm and tonify Middle Jiao Yang Direct rebellious Qi downward Relieve pain
Herb Formulas	Da Jian Zhong Tang
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DAMP-HEAT IN THE SAN JIAO

Clinical Manifestations	Fever Irritability Restlessness Anxiety Flushed face Constipation Abdominal distention Delirious speech Epigastric distention Jaundice Gastric distention Dysenteric disorders Hematemesis Epistaxis Red, swollen, painful eyes Chest oppression Red, swollen ears Restlessness Insomnia Thirst Dark, concentrated urine Tinnitus Hemoptysis Vomiting Shoulder stiffness Bleeding Diarrhea Suppurative skin infection Tongue and mouth ulcerations T: Red tip C: Yellow and greasy P: Rapid
Treatment Principle	Drains Fire Relieves toxicity Drains Dampness
Herb Formulas	San Huang Xie Xin Tang An Gong Niu Huang Wan
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TOXIC HEAT IN THE SAN JIAO (YANG) (ACUTE)

Clinical Manifestations	Rapidly developing jaundice that quickly deepens in color to orange or gold both in the body and conjunctiva High fever Irritability Agitation Restlessness Thirst Dry mouth Dry throat Foul breath Chest oppression with a feeling of suffocation and Heat Frequent vomiting Abdominal distention and pain that is worse with pressure Flank pain Insomnia Dark urine Palpitations Tinnitus Purpura Red face Rashes Deep-rooted boils Red eyes Itchy skin Dry lips Dysentery with fever Scanty urine or Anuria Dark urine Constipation or Diarrhea Drowsiness Ascites Severe: Epistaxis Maculae Melaena Carbuncles Hematemesis Hemoptysis Hematuria Cloudy mind Delirium Obsession Furuncles Incoherent speech Bleeding gums Muscle spasms Convulsions Loss of consciousness T: Dark red C: Dark yellow P: Wiry and rapid or Rapid and forceful or Thready and rapid
Treatment Principle	Clear Heat Drain Fire Relieve toxicity from all three Jiaos Cool the Blood Nourish Yin Relieve inflammation Stop bleeding Purge Damp-Heat Purge the Gallbladder
Herb Formulas	Huang Lian Jie Du Tang Xi Jiao San modified For verbal delirium, loss of consciousness and obsession: An Gong Niu Huang Wan For severe abdominal distention and constipation: Zhi Zi Jin Hua Tang
Points	GB-34, LI-4, PC-6, SP-6, SP-10, UB-19 For verbal delirium, loss of consciousness and obsession: + DU-26 For severe abdominal distention and constipation: + REN-12, SJ-6, ST-25, ST-36 DU-14, GB-34, GB-43, HT-8, LIV-2, PC-3, UB-19, bleed UB-40 With a clouded Spirit: + bleed DU-26 With flank pain and abdominal fullness: + LIV-13 With epistaxis: + DU-23 With hematemesis: + PC-4, ST-34 With constipation: + ST-44 With frequent vomiting: +PC-6

FOOD STAGNATION WITH PHLEGM

Clinical Manifestations	Epigastric fullness, distention and pain with dislike of pressure Difficult breathing due to a sensation of Qi rushing to the throat Belching with rotten food smell Acid regurgitation Nausea Detests food or Vomits after eating Distention is reduced after vomiting Unformed stools or Knotted constipation Firm areas of focal distention in the chest Epigastric hardness and distention Anguish Vexation Irritability T: Pink C: Thick and greasy P: Slippery
Treatment Principle	Clear Food Conduct Stagnation
Herb Formulas	Gua Di San
Points	LIV-13, LIV-14, PC-6, REN-11, REN-12, SP-4, ST-21, ST-36, ST-44 Epigastric pain due to Food Stagnation in the Stomach: 1. LIV-13, PC-6, REN-12, ST-36, ST-44 2. LIV-13, ST-21, ST-44 3. PC-6, REN-11, ST-36 4. PC-6, REN-10, REN-12, SP-4, ST-21, ST-36 Vomiting due to Food Stagnation in the Stomach: PC-6, REN-12, SP-4, ST-25, ST-36

ALCOHOL ABUSE

Clinical Manifestations	Body and face yellow Heart disturbance Stomach may be painful and hot May be unable to eat Maybe vomiting Hot soles of the feet Dysuria T: Normal C: Slippery and greasy P: Wiry and slippery
Treatment Principle
Herb Formulas
Points	DU-9, REN-12, SI-4, SP-4, SP-9, ST-36, UB-19, UB-27, UB-28, UB-40

PARASITES

Clinical Manifestations	Hookworm larva: Yellowing and swelling of the face Jaundice of the whole body White lines and itchy, red papules on the skin Increased appetite Abdominal distention after eating A predilection for eating strange things (uncooked cereals, tea, charcoal) Weak limbs T: Pale C: White P: Soft Roundworms in the biliary tract: Acute attacks of severe abdominal pain Jaundice after the attack Nausea Vomiting (sometimes of roundworms) Return to apparently normal health after an attack
Treatment Principle	Clear parasites Eliminate jaundice
Herb Formulas	Hookworm larva: Huang Bing Jiang Fan Wan Jia Jian Roundworms in the biliary tract: Wu Mei Wan
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