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RENAL TUBERCULOSIS, NEPHROTUBERCULOSIS (TUBERCULOSIS OF THE KIDNEYS)

TAI YIN EXCESS

Clinical Manifestations	Nausea Clear, frequent urination Lack of thirst Anorexia Vomiting of clear fluid Abdominal distension and pain (sharp) Diarrhea or loose stool Prefers warmth T: Pale or pink C: White P: Slow and tight or Soft
Treatment Principle	Regulate the middle Warm the Middle Jiao Disperse Cold Relieve pain
Herb Formulas	Li Zhong Wan
Points	For pain and Cold: moxa the abdomen To strengthen the Spleen and Stomach: LIV-13, REN-10, ST-36, UB-20, UB-21 (moxa if severe) For abdominal pain and nausea: PC-6, SP-4, ST-25 For frequent, clear urination: moxa REN-4, REN-6, UB-23 For diarrhea: moxa REN-8 Use few needles with deep insertion and moxa

HEART FIRE WITH QI AND YIN DEFICIENCY AND DAMP-HEAT IN THE LOWER JIAO

Clinical Manifestations	Restlessness Irritability Thirst Nocturnal emission Insomnia Dream disturbed sleep Lack of spirit Fatigue Low back pain Tinnitus Dysuria Depression Turbid urine Abnormal uterine bleeding Polyuria Enuresis Seminal emission Leukorrhea Blood tinged leukorrhea Anorexia Dry mouth Dry Tongue Five Sole Heat Fever Physical and mental overexertion T: Red C: Little or None P: Deep and rapid
Treatment Principle	Clear Heart Fire Disperse Damp-Heat Benefit Qi and Yin Promote urination
Herb Formulas	Qing Xin Lian Zi Yin modified
Points

LIVER AND KIDNEY YIN DEFICIENCY WITH FIRE FLARING

Clinical Manifestations	Steaming bone disorder Afternoon fever Tidal fever Night sweats Spontaneous seminal emissions Irritability Heat and pain in the knees (maybe with weakness) Atrophy and weakness of the knees and legs Red face Restless fever Hematemesis Sore knees Sore lower back Maybe hemoptysis May be constant hunger Maybe constipation Hot flashes Restlessness Fidgeting Insomnia with frequent dreams Productive bloody cough Easily angered Nightmares Sore feet with flaccidity Tinnitus Burning sensation over Kidneys Dizziness or vertigo Five Sole Heat Cough T: Red C: Little or None P: Thready, Excess and rapid in the Chi position
Treatment Principle	Nourish Yin Descend Fire
Herb Formulas	Da Bu Yin Wan
Points

KIDNEY YIN DEFICIENCY

Clinical Manifestations	Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of low back Spermatorrhea or premature ejaculation Aching in bones Aching in leg and heel T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Reinforce the Kidneys
Herb Formulas	Qing Hao Bie Jia Tang With Jing Deficiency: Zuo Gui Yin
Points	KI-1, KI-3, KI-6, REN-4, SP-6, UB-23

KIDNEY YIN DEFICIENCY WITH FIRE FLARING

Clinical Manifestations	Chronic cloudy, scanty, yellow urine or Opaque urine like rice-water 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 If Heart Fire also Flares: Insomnia Frequent dreams Palpitations If Liver Yang also Rises: Dizziness Blurred vision T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zi Yin Jiang Huo Tang Zhi Bai Di Huang Wan Da Bu Yin Wan Chinese Patent Medicines: Liu Wei Di Huang Wan Zhi Bai Di Huang Wan Da Bu Yin Wan
Points	KI-2, KI-6, REN-4, ST-28, UB-23 KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23 If Heart Fire also Flares: HT-7, PC-7, UB-15 If Liver Yang also Rises: LIV-3, UB-18

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	Jin Gui Shen Qi Wan (Ba Wei Di Huang Wan) Niu Che 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 JING DEFICIENCY

Clinical Manifestations	Uterine prolapse Soreness and weakness in the lower back Severe lower abdominal distention Urinary frequency which is worse at night Tinnitus Nocturnal emission Profuse pink menstrual discharge Nocturia Hearing loss Dizziness Forgetfulness Weakness of the lower limbs Lack of spirit T: Pale-red C: Normal P: Deep and frail or Deep and slow
Treatment Principle	Tonify Yin and Blood Benefit Yang and Qi Strengthen Kidney Jing Invigorate the Spleen
Herb Formulas	Da Bu Yuan Jian
Points

BLOOD DEFICIENCY

Clinical Manifestations	Postpartum emaciation and weakness Persistent, tight abdominal pain Abdominal pain with spasms or radiates to back and waist Cannot eat Shortness of breath Dyspnea Pale face Intermittent spasmodic abdominal pain which is better with Heat and pressure Epigastric pain Lusterless complexion Fidgeting Reduced appetite Maybe low-grade fever Palpitations Irritability Cold and sore extremities Nonspecific discomfort Dry mouth and throat Nocturnal emission Five sole Heat Debilitated constitution in children Enuresis in children Insomnia Fatigue Anemia Bleeding Abdominal weakness Epistaxis Habitual constipation Maybe warm extremities Night sweats Tired limbs Frequent urination Night crying Diarrhea in children Habitual headache in children Hernia pain in children Chronic constipation Purpura Asthma T: Pale C: White P: Weak and slow or Thready, wiry and even or Thready and weak
Treatment Principle	Warm and tonify the Spleen and Stomach Tonify the Blood
Herb Formulas	Dang Gui Jian Zhong Tang
Points

DAMP-HEAT IN THE URINARY BLADDER

Clinical Manifestations	Urinary frequency Urinary urgency Painful urination or Continuous dripping of urine or Sudden interruption to the urinary stream Turbid urine or Pus and blood in the urine or Sand and stones in the urine In Damp-Heat Pouring Downward there may also be: 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	Xiao Ji Yin Zi
Points	KI-7, LIV-2, REN-3, SP-6, SP-9, UB-23, UB-28, UB-39 For retention of urine: 1. REN-3, SP-6, SP-9, UB-28 2. REN-3, SP-6, SP-9, UB-39 For Blood Lin: 1. KI-3, LIV-2, REN-3, SP-6, SP-9, SP-10, UB-28 2. KI-1, KI-7, LIV-3, REN-3, SP-10, UB-17, UB-23, UB-27 For Stone Lin: 1. KI-2, KI-3, LIV-2, REN-3, SP-9, UB-28, UB-39 2. KI-1, LIV-1, REN-4, UB-23, UB-28, UB-40 For Milky Lin: 1. KI-3, KI-6, LIV-2, REN-3, SP-9, UB-23, UB-28 2. REN-4, REN-6, SP-6, SP-9, UB-22, UB-27, UB-28

JING AND BLOOD DEFICIENCY DUE TO KIDNEY, SPLEEN AND HEART DEFICIENCY

Clinical Manifestations	Fatigue Heavy and painful lower back Dream-disturbed sleep General weakness Lack of interest in food or drink Fever Night sweats Seminal emission Forgetfulness Toothache Dizziness Gum swelling General pitted edema which is worse in the lower body Vaginal discharge Discharge of rice-water like urination without dysuria Aversion to Cold Impotence Decreased libido Emaciation Loose teeth Signs of premature aging Abdominal Cold Easily frightened T: Pale or Pale and thick C: Smooth and white P: Moderate and weak or Deep and weak
Treatment Principle	Tonify the Spleen and Kidneys Nourish the Heart Enrich Yin Nourish the Blood and Yang Augment Qi
Herb Formulas	Huan Shao Dan
Points