ULCER (PEPTIC, GASTRIC OR DUODENAL)

GENERAL

Clinical Manifestations	Duodenal ulcer is usually painful around midnight
Treatment Principle
Herb Formulas	Gui Pi Tang To strengthen the body's resistance and eliminate pathogenic factors: Zhong Yao Yu Wei Fang Ulcer #1 Ulcer #2 Shi Wei Xiao Yang Tang Yi Qi He Wei Jiao Nang Yi Qi Jian Pi For reduced gastric acid secretion: Huang Qi Jian Zhong Tangmodified To increase Blood flow to the tissues: Shi Xiao Sanmodified To increase new Blood vessel formation and reduce inflammation: Qi Fang Wei Tong Jiao Nang To increase the immune response of the mucous membranes: Qing You Yi Wei Ling Pian For suppurative ulcers: Bai Nung Tang For abdominal pain and cramping: Shao Yao Gan Cao Tang For bleeding: Jiao Ai Tang For acute perforation: Powder 3g Da Huang (take 3 times/day - will not cause diarrhea)
Points	GB-20, ST-36, UB-11, UB-17, UB-19, UB-20 GB-21, ST-37, UB-10, UB-17, UB-21, UB-22 DU-6, DU-7, DU-8, DU-9, UB-17, UB-17, UB-19, UB-20, UB-21, UB-22, UB-46, UB-47, UB-48, UB-49, UB-50 PC-6, REN-10, REN-12, REN-13, ST-25, ST-36 LI-4, ST-36, UB-21 LI-10, REN-12, ST-36 HT-7, PC-6, ST-21 ST-21 Peptic ulcer: 1. LIV-13, REN-12, SP-6, ST-36, UB-20, UB-21 2. LI-10, REN-12, ST-21, ST-36 For prickly peptic ulcer: + ST-45 Duodenal ulcer: KI-21, PC-6, REN-12, ST-21, ST-36, UB-11, UB-17, UB-18, UB-20 For acid-base imbalance: KI-5, LU-9 For acute perforation: PC-6, REN-12, REN-13, ST-21, ST-25, ST-36 (retain needles 1/2 hour to 1 hour - may use electroacupuncture - treat every four hours) For severe Stomach pain: UB-17 For chest pain with vomiting: LIV-13 For dry heaves and irritability: LI-4 Ear: Stomach, Abdomen, Shenmen, Subcortex, Sympathetic

WIND-COLD INVASION WITH DAMPNESS 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 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 Ren Shen Bai Du San
Points

TAI YANG WITH TAI YIN

Clinical Manifestations	Fever Chills Headache Joint pains Severe diarrhea Epigastric distention Perspiration Cold body and extremities Weakness of the extremities Upper abdominal palpitations Cold feet Dysuria
Treatment Principle	Release the Exterior Warm the Interior Tonify Qi Relieve distention
Herb Formulas	Gui Zhi Ren Shen Tang
Points

TAI YANG WITH INTERNAL DEFICIENCY COLD

Clinical Manifestations	Abdominal pain Cold extremities Numb hands and feet Generalized body aches Paralysis of the extremities Induration and swelling of the scrotum Hypersalivation Limited movement of the joints Abdominal pain referring to the testis Aversion to Cold A preference for Warmth Loose stools Chills and fever T: Normal C: Thin and white P: Tense and wiry
Treatment Principle	Warm the Interior Reinforce Yang Release the Exterior Regulate the Yin and Wei
Herb Formulas	Wu Tou Gui Zhi Tang
Points

SHAO YANG FU WITH TAI YANG

Clinical Manifestations	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 P: Floating and weak
Treatment Principle	Release the Exterior and muscle layer Harmonize and releases the Shao-Yang Harmonize the Liver, Spleen and Intestines
Herb Formulas	Chai Hu Gui Zhi Tang
Points	To treat the Shao Yang: GB-34, LIV-3, LIV-14, SJ-6 To Treat the Tai Yang: UB-12, GB-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 Hu Gui Zhi Gan Jiang Tang
Points	GB-41, SJ-5, moxa or moxa needle REN-4, REN-6, REN-8, REN-12, SJ-6, ST-25, ST-36

SHAO YANG - YANG MING

Clinical Manifestations	Acute epigastric pain Alternating chills and fever Abdominal pain Constipation or Burning diarrhea Nausea Vomiting Hypochondriac pain Pounding temporal headaches Dizziness Chills Low-grade fever Cold hands and feet Intolerance of Cold Pain in the armpits Unilateral pain in the abdomen and hypochondrium Stiffness and spasms beside and below the umbilicus Pain in the waist and legs T: Normal C: Greasy and white or Greasy and yellow P: Deep, tight and wiry or Wiry and rapid
Treatment Principle	Harmonize and Disperse the Shao Yang Drain Internal Heat Retention
Herb Formulas	Da Chai Hu Tang Chinese Patent Medicines: Qing Fei Yi Huo Pian
Points	Ahshi points along the Stomach channel between ST-36 and ST-39, GB-39, LI-4, PC-7, PC-8, REN-12, SJ-5, ST-21, ST-25, ST-34, ST-36, ST-44 With Yin Deficiency: + UB-21 , UB-23 With vomiting or spitting Blood: + PC-4 With fever: + LI-11 Ear: Stomach, Duodenum, Abdomen, Shenmen, Sympathetic

JUE YIN COLD AND HEAT

Clinical Manifestations	Intermittent attacks of abdominal pain Stifling sensation in the chest and epigastrium A sensation of warmth in the chest and epigastrium Irritability in the chest and epigastrium Vomiting after eating Extremely Cold extremities Vomiting of roundworms Incessant diarrhea Hunger with no desire to eat Vomiting immediately after eating Heat in the Stomach with Cold in the Intestines Bitter taste in the mouth Frequent urination Anxiety Abdominal pain (better with warmth and pressure) Pain beneath the Heart Borborygmus Unquenchable thirst Running piglet Qi Pain and Heat in the Stomach Discharge of small amounts of pus Irritability Recurrent nausea and vomiting Diarrhea Dry throat Turbid urine Polydipsia T: Red or geographic or pale C: White P: Hidden or Wiry and tight
Treatment Principle	Warm the Internal organs Warm the Middle Jiao Warms the Intestines Drains Heat Replenishes Qi Dispels parasites Calms roundworms Drains the Liver Calms the Stomach Promotes Blood circulation Relieves pain
Herb Formulas	Wu Mei Wan
Points	Moxa needle REN-4, REN-6, REN- 8, ST-25, ST-36, needle DU-14, LI-4, LI-11, LIV-3, REN-17

JUE YIN HEAT

Clinical Manifestations	Cold extremities Body hot and feverish due to lack of harmony of Liver Qi Thirst Abdominal distention Fever Dark yellow urine T: Red C: Yellow P: Rapid and slippery
Treatment Principle	Clear Heat Reverse reversals
Herb Formulas	Si Ni San
Points	DU-14, LI-4, LI-11, LIV-2, LIV-3, LIV-14, PC-6, REN-12, P-6

WEI STAGE: SUMMERHEAT WITH DAMP

Clinical Manifestations	Acute epigastric pain Fever and chills, fever more pronounced or Tidal fever Fever unrelieved by sweating Abdominal distention Thirst Sweating Stifling sensation in the chest Restlessness Irritability Heaviness of the head and body Muscle aches Nausea Vomiting Severe diarrhea Scanty urine T: Red tip and edges C: Greasy yellow P: Floating, rapid and soft
Treatment Principle	Disperse Wind Clear Heat Resolve Damp
Herb Formulas	Xin Jia Xiang Ru Yin
Points	Ahshi points along the Stomach channel between ST-36 and ST-39, LI-4, PC-7, PC-8, REN-12, ST-21, ST-34, ST-36, ST-44 With Yin Deficiency: + UB-21 , UB-23 With vomiting or spitting Blood: + PC-4 With fever: + LI-11 Bleed UB-40, needle DU-14, DU-23, DU-24, GB-20, LI-4, LI-11, REN-9, SJ-5, SP-6, SP-9, ST-8, ST-28, Taiyang, UB-12, UB-20 Ear: Stomach, Duodenum, Abdomen, Shenmen, Sympathetic

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 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	With congestion in the chest and epigastrium: Zhi Zi Chi Tang With vomiting: Zhi Zi Sheng Jiang Chi Tang With short, rapid breathing: Zhi Zi Gan Cao Chi Tang With Food Stagnation: Zhi Shi Zhi Zi Chi Tang
Points	To Pacify the Liver and Gall Bladder: LIV-3, LIV-4, LIV-13, LIV-14. To Relieve Gall Bladder Heat: Lanweixue, LI-11, LIV-2, GB-34

XUE LEVEL: EXCESS HEAT CAUSES BLEEDING

Clinical Manifestations	High fever Confusion of mind Delirium Mania Dark yellow urine Excessive skin rashes all over body Hemorrhage: Hematemesis Hemoptysis Epistaxis Hemafecia Hematuria T: Deep red, dry or Purple red C: None P: Rapid or Thready and rapid or Thready and feeble
Treatment Principle	Cool the Blood Dispel Heat and Toxins from the Xue Stage Promote Blood Circulation
Herb Formulas	Si Sheng Wan
Points	To clear Heat and Toxins: Bleed the Jing Well points, DU-14, LI-11, ST-44 To promote Blood circulation: SP-10, UB-17 To treat hemafecia: SP-1, ST-25, ST-37 To restore consciousness: DU-26, K-1 To nourish Yin: KI-3, SP-6 To calm the Shen: HT-7

SPLEEN NOT GOVERNING THE BLOOD

Clinical Manifestations	Mild bleeding of dark, purplish Blood or, less commonly, red Blood preceding or following defecation or Black, tarry, sticky stools or occult Blood discovered in testing Intermittent dull abdominal pain, alleviated by pressure Easily satiated Nausea Waxy, sallow or pale complexion Anorexia Fatigue Weakness Four limbs feel tired and heavy Physical and mental exhaustion Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose or unformed stools or Diarrhea Shortness of breath Spontaneous sweating Dizziness Light-headedness Palpitations Functional Uterine Bleeding Purpura Epistaxis Hemafecia Hematuria Menorrhagia Metrorrhagia T: Pale and flabby - may have toothmarks With Blood Deficiency: Pale and thin C: White P: Thready and weak or Moderate
Treatment Principle	Strengthen the Spleen Benefit Qi Nourish the Blood Stop bleeding
Herb Formulas	Bu Zhong Yi Qi Tang modified Gui Pi Tang Gui Pi Tang + Jiao Ai Tang For persistent bleeding: Gu Chong Tang modified Chinese Patent Medicines: Bu Zhong Yi Qi Wan Sheng Tan Qi Yun Nan Bai Yao
Points	DU-20, REN-6, REN-12, SP-1, SP-4, SP-6, ST-25, ST-36, UB-20, UB-25 SP-1, SP-3, ST-36, UB-20 Ear: Spleen, Stomach, Large Intestine, Small Intestine, Subcortex, Adrenal, Shenmen

SPLEEN YANG DEFICIENCY

Clinical Manifestations	Chronic loose stools or diarrhea which may contain undigested food The stools may be urgent Early morning diarrhea Dark, purplish or pale Blood preceding, following or Black, tarry or Blood-streaked loose stools (the bleeding may also be occult) Dull, persistent abdominal or epigastric cold-pain which improves with warmth and pressure Sallow complexion Anorexia (maybe with vomiting) Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Intolerance to Cold Shortness of breath Cold abdomen Cold limbs Feeling chilled Frequent, clear urination Mental fatigue Weakness Exhaustion Maybe scanty urine with edema Maybe clear, watery vaginal discharge T: Pale, wet and swollen with toothmarks C: Thin and white P: Deep and weak or Deep, weak and slow
Treatment Principle	Warm the Center Dispel Cold
Herb Formulas	Fu Zi Li Zhong Wan Huang Qi Jian Zhong Tang modified Li Zhong Tang With relatively severe bleeding: Huang Tu Tang modified With relatively mild bleeding: Fu Zi Li Zhong Wan modified When the bleeding has stopped: Bu Zhong Yi Qi Tang Si Jun Zi Tang Chinese Patent Medicines: For Spleen Yang Deficiency with severe Cold: Fu Zi Li Zhong Wan For Spleen Yang Deficiency: Li Zhong Wan For bleeding: Yun Nan Bai Yao Sheng Tian Qi Pian Chinese Patent Medicines: Li Zhong Wan With severe Cold: Fu Zi Li Zhong Wan With Spleen and Stomach Qi Deficiency and Phlegm-Damp: Xiang Sha Liu Jun Zi Tang With Food Stagnation: Zi Sheng Wan
Points	Moxa LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

SPLEEN AND STOMACH DISHARMONY

Clinical Manifestations	Anorexia Loss of the sense of taste Inability to eat more than a little at a time Bloating after eating Focal distention Epigastric discomfort Generalized weakness T: Pale C: White P: Deep and soft
Treatment Principle	Strengthen and harmonize the Spleen and Stomach Resolve Dampness Improve the appetite
Herb Formulas	Xiang Sha Yang Wei Tang
Points

SPLEEN AND STOMACH QI DEFICIENCY

Clinical Manifestations	Slight clamoring in the Stomach which is worse when hungry and better after eating warm foods and worse after eating Cold or raw foods Possible vomiting of clear water with a sour taste which is worse after eating Cold or raw foods Abdominal distention after eating Poor appetite A bland taste or lack of taste in the mouth Spontaneous perspiration Shortness of breath Occasional fevers Dyspnea Abdominal pain and spasms due to Cold Pain is better with warmth and pressure Pale face or a sallow, dull complexion Fatigue Weak limbs Fidgeting Lethargy Dry mouth Aversion to Cold Frequent, clear urination Loose stools or Constipation Cold extremities Dry throat Hematemesis Irritability Carbuncles Palpitations Hemorrhoids Fever with a preference for hot drinks Dry skin T: Pale C: White P: Minute, thready and weak or Deep and slow or Floating, large and weak
Treatment Principle	Warm and tonify the Spleen and Stomach Replenish Qi Harmonize the Interior Alleviate pain
Herb Formulas	Huang Qi Jian Zhong Tang Shen Ling Bai Zhu San Liu Jun Zi Tang Gu Chong Tang Li Zhong Tang Si Jun Zi Tang Xiang Sha Liu Jun Zi Tang modified Wen Pi Tang With Accumulation of Phlegm-Damp: Ling Gui Zhu Gan Tang With Qi Stagnation: Zhi Zhu Wan With Deficiency Cold: Wen Wei Yin With Cold and Heat in the Interior: Gan Cao Xie Xin Tang With Food Stagnation: Jian Pi Wan With Blood Stagnation: Shi Wei Xiao Yang Tang With acid regurgitation: Grind Endoconcha Sepiae Hai Piao Xiao and Bul. Fritillariae Thunbergii Zhe Bei Mu at a 4:3 ratio into a fine powder. Take 3-5g after each meal in addition to Xiang Sha Liu Jun Zi Tang. If there are additional digestive side effects add 1g Massa Medicata Fermentata Shen Qu and 1g Fr. Hordei Germinatus Mai Ya.
Points	LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20 REN-12, ST-36, UB-20 REN-12, ST-36, UB-20, UB-21 With cold pain in the Stomach: + ST-34 With acid regurgitation and vomiting of clear water: + Lineiting With Stomach and abdominal glomus and fullness: + PC-6, SP-4

SPLEEN AND STOMACH EXCESS HEAT

Clinical Manifestations	Epistaxis Hemoptysis Hematemesis Bright red Blood Sudden onset T: Red P: Rapid
Treatment Principle	Clear Heat Cool the Blood Stop bleeding
Herb Formulas	Shi Hui San
Points

SPLEEN AND STOMACH DAMP-HEAT

Clinical Manifestations	Epigastric focal distention Fullness and tightness with very slight or no pain Dry heaves Vomiting Borborygmus D Diarrhea Anorexia Stomach pain Abdominal pain Subcardiac distention Heartburn Resistance below the Heart Soft epigastrium Nausea Ascites Gurgling sounds T: Normal or with a red tip C: Thin, yellow and greasy P: Wiry and rapid or Wiry, tight and rapid
Treatment Principle	Clear Damp-Heat Harmonizes the Stomach Descends Rebellious Qi
Herb Formulas	Ban Xia Xie Xin Tang
Points

SPLEEN AND STOMACH DEFICIENCY COLD

Clinical Manifestations	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 A sallow complexion Feeling chilled Mental fatigue Lassitude Weakness Maybe scanty urine with edema Maybe clear, watery vaginal discharge T: Pale and flabby - may have ethers C: Thin and white P: Even or Soft and thready or Deep and weak
Treatment Principle	Warm the Center Dispel Cold
Herb Formulas	Li Zhong Tang Fu Zi Li Zhong Wan Xiao Jian Zhong Tang Huang Tu Tang Wen Pi Tang Tao Hua Tang Fu Gui Li Zhong Tang Si Jun Zi Tang modified Huang Qi Jian Zhong Tang modified Gan Cao Gan Jiang Tang With severe Cold: Da Jian Zhong Tang (short-term) With a complex of Heat, Cold and Deficiency: Ban Xia Xie Xin Tang With abdominal distention: Zhi Shi Li Zhong Wan With Accumulation of Phlegm-Damp: Ling Gui Zhu Gan Tang With Blood Stagnation: An Zhong San Qi Fang Wei Tong Jiao Nang Chinese patent medicines: Fu Zi Li Zhong Wan Li Zhong Wan With Food Stagnation: Zi Sheng Wan
Points	Moxa SP-3, SP-5, SP-6, ST-36, UB-20, LIV-13, REN-12, DU-20 Moxa LIV-13, REN-12, SP-3, SP-6, ST-36, UB-20, UB-21 With abdominal distention: moxa or moxa needle DU-4, REN-4, REN-6, REN-12, SP-6, SP-15, ST-25, ST-36, UB-20, UB-21, UB-23 With severe distention: + SP-1 With fluid retention and edema: + REN-9, SP-9 With Liver Qi Stagnation: + LIV-3, PC-6 Moxa or moxa needle LI-11, LU-9, REN-122, REN-13, SP-6, ST-36, UB-20, UB-21 With obvious bleeding or occult blood in the stool: + moxa SP-1 With loose stools or diarrhea: + Zhixie With Fluid Retention and edema: + REN-9, SP-9 With heaviness: + SP-3, ST-40 With nausea: + PC-6 With Phlegm-Damp: + SP-3, PC-5 Ear: Spleen. Stomach, Large Intestine, Abdomen, Adrenal

SPLEEN, STOMACH AND KIDNEY YANG DEFICIENCY WITH ACCUMULATION OF COLD

Clinical Manifestations	Diarrhea with undigested food Aversion to Cold or Daybreak (Cock Crow) diarrhea Cold and stiff extremities Back pain Reduced appetite Fullness in the epigastrium and abdomen (likes pressure) Lack of thirst Vomiting Loose stools Trismus T: Pale, may be moist C: White P:Deep, slow and weak
Treatment Principle	Warm and TonifY the Spleen, Stomach and Kidneys Dispel Cold Replenish Yang
Herb Formulas	Fu Gui Li Zhong Tang Wen Pi Tang With Dampness: Dang Gui Shao Yao San
Points

DAMP STAGNATION IN THE SPLEEN AND STOMACH

Clinical Manifestations	Indigestion A sensation of oppression in the chest Abdominal pain Nausea Vomiting Diarrhea Postpartum abdominal fullness and distention Abdominal fullness and distention with nausea and vomiting T: Pale and swollen C: Thick, white and greasy P: Slippery and even or Slow or Moderate
Treatment Principle	Strengthen the Spleen and Stomach Harmonize the Middle Jiao
Herb Formulas	Jia Wei Ping Wei San
Points

COLD-DAMPNESS INJURING THE SPLEEN AND STOMACH

Clinical Manifestations	Epigastric and abdominal distention and fullness Loss of appetite Tired extremities Loose stools or diarrhea Abdominal pain Flatulence Vomiting of clear liquid Leukorrhagia Lethargy T: Pale C: White and slippery P: Deep and wiry or Slippery and thready
Treatment Principle	Promote the movement of Qi Eliminate fullness Dry Dampness Warm the Middle Jiao
Herb Formulas	Hou Po Wen Zhong Tang Wen Pi Tang
Points

STOMACH YIN DEFICIENCY

Clinical Manifestations	Hiccup Shortness of breath Dry mouth 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 Thirst Anxiety T: Red C: Little and dry P: Thready and rapid
Treatment Principle	Nourish Yin Nourish the Stomach
Herb Formulas	Yi Wei Tang modified With anorexia: Ju Pi Zhu Ru Tang
Points	KI-3, REN-12, SP-6, ST-36, UB-21 For epigastric pain: KI-3, KI-6, REN-4, REN-12, SP-6, ST-36, UB-20, UB-21, UB-23 With deficient Heat: + KI-2, ST-43 With sharp pain: + KI-2 With nausea: + PC-6 Ear: Stomach, Spleen, Abdomen, Kidney, Shenmen, Sympathetic

STOMACH YIN DEFICIENCY WITH HEAT

Clinical Manifestations	No appetite or Famished but with no desire to eat or Indeterminate gnawing hunger Persistent, dull, nagging epigastric pain Heartburn Morning nausea Abdominal distention after meals Black, sticky or tarry, dry stools Irritability with low grade fever Maybe dry retching or Hiccups Thirst Dry skin, hair and mucous membranes Tendency toward constipation or pellet-like stools Facial flushing Malar flush Night sweats Five-sole-Heat With Kidney Yin Deficiency: Dizziness Tinnitus Low back and knee weakness and pain T: Red or Slightly red with a peeled center or Red and dry C: Little and dry or Peeled in the center or Shiny P: Thready and rapid
Treatment Principle	Nourish Yin Clear Heat Nourish the Stomach Cool the Blood Stop bleeding
Herb Formulas	Yu Nu Jian modified Chinese Patent Medicines: With Stomach Qi and Yin Deficiency: Gu Ben Wan With marked Deficient Heat: Zhi Bai Ba Wei Wan With Stomach Qi and Yin Deficiency: Sheng Mai San Wan With Kidney Yin Deficiency: Liu Wei Di Huang Wan With bleeding: + Yun Nan Bai Yao + Sheng Tian Qi Pian
Points	KI-3, REN-12, SP-6, ST-36, UB-21 With hemafecia: KI-3, KI-6, REN-4, REN-12, SP-6, ST-25, ST-36, UB-20, UB-21, UB-23, UB-25 Ear: Stomach, Kidney, Large Intestine, Distal Segment Rectum, Shenmen, Sympathetic With hematemesis: KI-3, KI-6, REN-4, REN-12, SP-6, ST-36, UB-20, UB-21, UB-23 Ear: Stomach, Duodenum, Adrenal, Esophagus, Shenmen, Subcortex

STOMACH QI DEFICIENCY

Clinical Manifestations	Continuous pain in the Stomach Epigastric fullness and distention Likes pressure Reduced appetite Frequent belching Loss of sensation of taste Borborygmus Pale face Stools not solid Urine clear and abundant T: Pale C: Thin and white P: Empty, Weak an Slow or Weak and Deficient
Treatment Principle	Warm and tonify the Spleen and Stomach Replenish Qi Harmonize the Interior Alleviate pain
Herb Formulas	Liu Jun Zi Tang Xiang Sha Liu Jun Zi Tang With turbid Phlegm: Xuan Fu Dai Zhe Tang
Points	UB-18, UB-20, UB-21 PC-6, REN-12, ST-36

BLOOD STAGNATION IN THE STOMACH

Clinical Manifestations	Bleeding ulcer Sharp, stabbing epigastric pain with fixed location Pain is severe after eating Dislike of pressure and heat on epigastrium Pain predominates over distention or Pain but no distention Epigastric rumbling Vomiting purple/black blood Stools with blood like tar (melaena) May be abdominal or epigastric lumps or masses Abdominal or epigastric pain which may radiate upwards to the back or scapula Poor appetite Shortness of breath Nausea Hypochondriac pain Heart pain Stomach pain Hiccups Stuffiness in chest Constipation Anorexia T: T: Dark purple with purple spots or dots C: Normal P: Choppy or Wiry and tight or Wiry and choppy
Treatment Principle	Invigorate the Blood Relieve Stasis Stop pain
Herb Formulas	Dan Shen Yin modified Shi Xiao San modified For epigastric pain and hemafecia: Shi Xiao San + Dan Shen Yin modified Ge Xia Zhu Yu Tang For hematemesis: Xue Fu Zhu Yu Tang modified For hematemesis with Heat: Da Huang Huang Qin Xie Xin Tang For hemafecia with abdominal masses: Ge Xia Zhu Yu Tang modified With hemafecia and Cold in the lower abdomen: Shao Fu Zhu Yu Tang modified For Deficiency Cold: Huang Tu Tang For hemafecia with severe Blood Stagnation in the Intestines and Heat: Tao He Cheng Qi Tangmodified With indeterminate gnawing hunger: Dang Gui Si Ni Tang modified
Points	SP-4, SP-6, SP-10, ST-21, ST-34, UB-17 With pain: PC-6, ST-36 PC-6, SP-4, SP-6, ST-36, UB-17 For epigastric pain: Ahshi, DU-8, REN-12, SP-4, SP-6, SP-10, ST-21, ST-34, ST-36, UB-17, UB-18, UB-21 With nausea and vomiting: + PC-6 With Liver Qi Invading the Stomach: + LIV-13 With irritability or depression: + LIV-1 or LIV-3 With severe pain: LI-4, LIV-5 Ear: Shenmen, Stomach, Duodenum, Liver, Sympathetic For hematemesis: Ahshi points, PC-4, PC-6, REN-12, SP-4, SP-10, ST-21, UB-17, UB-21 With severe pain: LI-4, LIV-5 With irritability or depression: + LIV-1, Taiyang or LIV-3 Ear: Stomach, Duodenum, Large Intestine, Small Intestine, Liver, Adrenal, Subcortex, Shenmen For hemafecia: Ahshi points between ST-36 and ST-39 and between UB-17 and UB-25, SP-6, SP-8, SP-10, ST-25, UB-25 With spider naevi: prick the vessels to bleed Ear: Stomach, Duodenum, Large Intestine, Small Intestine, Liver, Adrenal, Subcortex, Shenmen For indeterminate gnawing hunger: REN-12, SP-6, SP-10, ST-21, ST-36, UB-17, UB-18, UB-21 With nausea and vomiting: + PC-6 With Liver Qi Invading the Stomach: + LIV-13 With irritability or depression: + LIV-1, Taiyang or LIV-3 Ear: Stomach, Liver, Sympathetic, Subcortex, Shenmen

STOMACH FIRE BLAZING

Clinical Manifestations	Dark, purple Blood in the stools or Black, tarry, sticky stools Epigastric or abdominal distention Burning Heat and pain in the epigastrium Epigastric or abdominal distention Dry mouth Irritating thirst: drinks copious fluids and prefers cold drinks Excessive appetite: hungry again quickly after eating (as if food vanishes) Swelling, pain, ulceration and bleeding of gums Foul breath Bitter taste in the mouth Acid reflux Heartburn Belching Toothache Irritability Restlessness Maybe vomiting right after eating Vomiting acid or undigested food Constipation Maybe scanty, red urine T: Red C: Thick, yellow and dry P: Slippery, big, Excess and rapid or Wiry and rapid or Slippery and rapid
Treatment Principle	Clear and Purge Stomach Fire
Herb Formulas	Mai Men Dong Tang modified San Huang Xie Xin Tang + Shi Hui San modified Qing Wei San modified With Damp-Heat: Huang Lian Jie Du Tang With Yin Deficiency: Yu Nu Jian Huang Lian E Jiao Tang modified With Bleeding: Yu Nu Jian With severe bleeding precipitating collapse of Yang: Shen Fu Tang With a mixture of Heat and Cold: Sheng Jiang Xie Xin Tang modified Chinese Patent Medicines: With mouth ulcers: Niu Huang Jie Du Pian With constipation: Niu Huang Qing Huo Wan
Points	LI-4, LI-11, PC-6, PC-8, ST-6, ST-34, ST-36, ST-43, ST-44, ST-45, UB-21 LI-4, LI-11, PC-8, REN-12, SP-10, ST-37, ST-44, ST-45 With epigastric pain: + ST-34 With Yin Deficiency: + UB-21, UB-23 With hematemesis: + PC-4 With Phlegm-Heat: + ST-40 With Shao Yang - Yang Ming: + GB-39, SJ-5, ST-25 LIV-3, REN-12, ST-21, ST-44 GB-29, UB-17, UB-18, UB-20 Ahshi points along the Stomach channel between ST-36 and ST-39, LI-4, PC-7, PC-8, REN-12, ST-21, ST-34, ST-36, ST-44 With Yin Deficiency: + UB-21 , UB-23 With vomiting or spitting Blood: + PC-4 With fever: + LI-11 Ear: Stomach, Duodenum, Large Intestine, Liver, Subcortex, Shenmen

STOMACH COLD

Clinical Manifestations	General signs and symptoms: Epigastrium cold with pain No thirst Mild cases: Constant pain Severe cases: Sudden bouts of sharp pain Pain is aggravated by Cold and pressure and relieved by warmth and hot drinks Cold hands and feet Cold Penetrates the Stomach and Intestines: Pain is sudden and sharp Pain is relieved by warmth Nausea Diarrhea Loose stools T: Pink C: White P: Deep and tight or Wiry or Tight and slow Retention of Fluid in the Stomach due to Cold: Pain is dull Pain is relieved by warmth Succussion sound in the epigastrium on palpation Vomiting of clear, watery fluid Hypersalivation T: Pink C: White and sticky P: Thready or Thready and slow Stomach Deficiency with Stagnation of Cold: Pain is dull Pain is relieved by warmth and pressure Vomiting clear, watery fluid T: Pale C: Thin and white P: Deep and slow or Deep and thready If accompanied by Wind-Cold Damp: Fever and chills Myalgia Headache P: Floating and tight
Treatment Principle	Warm the Stomach Warm Cold Stop pain
Herb Formulas	Liang Fu Wan modified Liang Fu Wan + Zheng Qi Tian Xiang San Gui Zhi Sheng Jiang Zhi Shi Tang Li Zhong Tang Fu Zi Li Zhong Wan Fu Gui Li Zhong Tang Mild cases: Gan Jiang Ren Shen Ban Xia Wan Severe cases: Xiang Sha Liu Jun Zi Tang + Liang Fu Wan Chinese Patent Medicines: Li Zhong Wan For severe Cold and severe pain: Fu Zi Li Zhong Wan For pain associated with Wind-Cold-Damp: Xing Jun San Huo Xiang Zheng Qi Pian
Points	Moxa or moxa needle PC-6, REN-6, REN-12, SP-4, ST-21, ST-36, UB-20, UB-21 Moxa or moxa needle REN-12, SP-4, ST-21, ST-34, ST-36, UB-20 For nausea: + PC-6 For Dampness: + SP-3 For abdominal distention: + SP-3, SP-15 Ear: Stomach, Spleen, Abdomen, Shenmen, Sympathetic

STOMACH COLD TRANSFORMING INTO HEAT

Clinical Manifestations	Chronic epigastric discomfort A sensation of blockage and distention in the epigastrium Anorexia Nausea Vomiting or Dry retching Borborygmus Diarrhea T: Normal C: Thin, yellow and greasy P: Soft and/or rapid
Treatment Principle	Harmonize the Stomach Regulate Qi Descend Qi
Herb Formulas	Ban Xia Xie Xin Tang
Points

COLD STAGNATION IN THE STOMACH AND LIVER

Clinical Manifestations	Peptic ulcer Hypertension Vomiting immediately after eating Indeterminate gnawing hunger Acid regurgitation Belching May be epigastric pain Dry heaves or spitting of clear fluids with vertex headache Vomiting and diarrhea with cold hands and feet Restlessness Severe fidgeting Irritability So agitated, the patient wants to die Habitual headache Subcardiac distention A feeling of fullness and distention in the chest and diaphragm T: Pale C: White and slippery P: Slow and weak or Sinking or slow and thin or slow and wiry
Treatment Principle	Warm and tonify the Stomach and Liver Descends Rebellious Qi Alleviate pain
Herb Formulas	Wu Zhu Yu Tang Ping We San
Points

DAMP-HEAT IN THE STOMACH

Clinical Manifestations	Vomiting copious amounts of fresh, red Blood or dark, lumpy coffee ground like material Epigastric and abdominal fullness, discomfort and pain Frequent nausea Anorexia A bitter taste in the mouth Concentrated urine A tendency toward constipation or Sticky, black, tarry stools T: Red C: Thick, yellow and greasy P: Slippery and rapid or Soft and rapid
Treatment Principle	Clear Damp-Heat from the Stomach Cool the Blood Stop bleeding
Herb Formulas	Zhi Shi Dao Zhi Wan modified Chinese Patent Medicines: Huang Lian Jie Du Wan With constipation: Niu Huang Qing Huo Wan With toxic Heat: Bei Jing Niu Huang Jie Du Pian For bleeding: + Sheng Tian Qi Pian Yun Nan Bai Yao
Points	Ahshi points along the UB Channel between UB-17 and UB-21, LI-4, LI-11, PC-4, REN-12, SP-9, ST-36, ST-37, ST-44 With epigastric pain: + ST-21, ST-34 With acid reflux or heartburn: + LI-10 With Yin Deficiency: + UB-21, UB-23 For Shao Yang Fu: + GB-39, SJ-5, ST-25 Ear: Stomach, Duodenum, Liver, Large Intestine, Adrenal, Subcortex, Shenmen

FOOD STAGNATION IN THE STOMACH

Clinical Manifestations	Epigastric fullness, distention and pain with dislike of pressure Chest and diaphragm oppression Full, painful abdomen A clamoring Stomach which gets better after vomiting Belching with rotten food smell Acid regurgitation Detests food or Vomits after eating Vomiting sour, rotten food Distention is reduced after vomiting Unformed stools or Knotted constipation or Stools are hot and foul-smelling Dislikes the smell of food Diarrhea Anorexia Foul gas T: Pink C: Thick and greasy P: Slippery
Treatment Principle	Clear Food Conduct Stagnation
Herb Formulas	Jia Wei Ping Wei San Bao He Wan For Stomach fullness and pain: Yue Ju Bao He Wan
Points	LIV-13, LIV-14, PC-6, REN-11, REN-12, SP-4, ST-21, ST-36, ST-44 GB-34, LI-4, LIV-13, PC-6, REN-12, REN-21, SP-4, ST-36 Jinjin-Yuye, PC-6, REN-12, SP-4, ST-25, ST-36 Lineiting, REN-12, REN-21, ST-21, ST-36 With abdominal pain: + ST-25 With stomachache: + ST-34 With diarrhea: + SP-4, ST-37 With meaty Food Accumulation: - ST-21, + ST-24 Epigastric pain: 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

DISHARMONY BETWEEN THE STOMACH AND INTESTINES WITH COLD AND HEAT

Clinical Manifestations	Indigestion Epigastric focal distention which is soft and not tender to the touch Fullness and tightness with very slight or no pain Dry heaves Vomiting Borborygmus Diarrhea Anorexia Stomach pain Abdominal pain Subcardiac distention Heartburn Resistance below the Heart Soft epigastrium Mild nausea in the morning Ascites Gurgling sounds A tendency toward diarrhea or loose stools T: Normal or with a red tip C: Thin, yellow and greasy or mixed white and yellow P:Soft, slippery, slightly wiry and rapid or Wiry and rapid or Wiry, tight and rapid
Treatment Principle	Harmonize the Stomach Descend Rebellious Qi Disperse clumping Eliminate focal distention due to Cold and Heat factors
Herb Formulas	Ban Xia Xie Xin Tang Chinese Patent Medicines: Chen Xiang Hua Qi Wan
Points	LI-11, LIV-13, PC-6, REN-6, REN-12, ST-25, ST-36, ST-37 For excessive Stomach Heat: + LI-4, ST-44 With Dampness: + SP-6, SP-9 With Phlegm or Plum-Pit Qi Stagnation: + PC-5, SP-3, ST-40 With fat intolerance, pale or pasty stools and right hypochondriac pain or distention: + GB-24, GB-40, Dannangxue With Shao Yang symptoms: + GB-34, GB-39, SJ-5 Ear: Spleen, Stomach, Liver, Large Intestine, Small Intestine Sympathetic

STOMACH YIN DEFICIENCY

Clinical Manifestations	No appetite or Famished but with no desire to eat Dry lips and mouth Difficulty swallowing A clamoring Stomach Acid regurgitation A burning sensation in the epigastrium Abdominal distention after meals Dry stools Constipation Irritability with low grade fever Maybe dry retching or Hiccups Vomiting T: Red C: Little and dry P: Thready and rapid
Treatment Principle	Nourish Yin Nourish the Stomach
Herb Formulas	Sha Shen Mai Men Dong Tang Yi Wei Tang modified Mai Men Dong Tang
Points	KI-3, REN-12, SP-6, ST-36, UB-21 REN-6, REN-12, PC-6, SP-6, ST-44 With hematemesis: + HT-6, SP-1 With black stools: + PC-4, SP-1 With dry stools and constipation: + SJ-6 With vomiting, frequent belching, hiccups gastric spasms or acid Stomach: + ST-34 With enduring, recurrent Stomach distention and pain, lassitude and weakness: + UB-20, UB-21

STOMACH AND LIVER YIN DEFICIENCY

Clinical Manifestations	Chronic acid reflux, hyperacidity and heartburn Symptoms may be worse in the evening and with stress The patient may wake with symptoms during the night which may be temporarily relieved by eating Mild, dull epigastric or hypochondriac pain or discomfort Anorexia or Intermittent gnawing hunger Dry mouth and throat Dry stools or Constipation T: Red and dry C: Little or None P: Thready, wiry and rapid
Treatment Principle	Nourish and supplement Liver and Stomach Yin Regulate Qi Descend Qi Harmonize the Stomach
Herb Formulas	Yi Guan Jian modified Chinese Patent Medicines: Gu Ben Wan With Excess acid: Wei Te Ling (combine with any of the above) For symptomatic relief: Xiang Lian Wan (combine with any of the above)
Points	KI-9, LIV-13, PC-6, REN-12, ST-36, UB-20, UB-21 Ear: Esophagus, Pylorus, Spleen, Liver, Stomach, Shenmen, Subcortex, Sympathetic

HEART AND STOMACH FIRE

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	Drain Fire Relieve toxicity Drain Dampness Dispel noxious Heat and toxins from the Heart and Stomach
Herb Formulas	San Huang Xie Xin Tang
Points

PHLEGM-FIRE DISTURBS THE HEART

Clinical Manifestations	Insomnia Dream-disturbed sleep with unusual dreams Wakes easily Palpitations Anxiety Nervousness Dizziness Vertigo Heavy or foggy headedness Profuse white foamy sputum Nausea/Vomiting Restlessness Easily startled Indeterminate gnawing hunger Seizures accompanied by copious sputum Flushing up Chest distention Expectoration of yellow Phlegm Bitter taste in the mouth Chills and fever Abdominal distention Frequent dark, scanty urine Irritability Depression Slight thirst Anorexia Belching Acid reflux Unsatisfying bowel movements T: Pink or Red tip or Red C: Yellow and greasy P: Slippery and rapid or Wiry and rapid or Rolling and rapid
Treatment Principle	Clear the Heart Break through Phlegm
Herb Formulas	Wen Dan Tang modified For recalcitrant cases: Qing Huo Di Tan Tang
Points	Bleed the Jing-Well points of the six Hand channels, Anmian, Dingshen, DU-14, DU-16, DU-20, DU-26, HT-7, PC-5, PC-6, PC-7, PC-8, REN-14, SP-1, ST-40, UB-15

HEART BLOOD AND SPLEEN QI DEFICIENCY

Clinical Manifestations	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 modified Chinese Patent Medicines: Gui Pi Wan With Cold or Spleen Yang Deficiency: Li Zhong Wan
Points	HT-7, REN-4, SP-1, SP-6, ST-36, UB-15, UB-20

SMALL INTESTINE QI PAIN

Clinical Manifestations	Lower abdominal pain radiating to the testicles May be localized sensation of Cold Menstrual pain and hardness Hypochondriac pain Abdominal pain Mobile abdominal masses Swollen or distended testicles Flank pain Leukorrhea T: Pale C: White P: Deep and slow or Wiry and tight
Treatment Principle	Promote Qi movement Spread Liver Qi Scatter Cold Alleviate pain
Herb Formulas	Tian Tai Wu Yao San
Points	Moxa or moxa-needle ST-39, REN-4, SP-6, LIV-1, LIV-4, LIV-5, LIV-8

LIVER QI STAGNATION

Clinical Manifestations	Alternating chills and fever Dry throat Bitter or sour taste in the mouth Dizziness Sensation of fullness in the chest and hypochondrium Irritability Heartburn Chest distention Difficulty taking deep breaths Hardness beneath the Heart Hypochondriac pain with pressure Stress Being downcast with no desire to eat Anorexia Vertigo May be palpitations Dysphoria Retching Abdominal pain Stomach ache Reduced appetite Subcostal bloating Depression Amenorrhea Tendency to diarrhea Nervousness Nausea Vomiting May be urinary dysfunction Restlessness Sometimes fatigue Nausea/vomiting (occasional) Headaches (side of head) Rib pain Achiness Ear infection Hearing difficulty Red eyes Stiff shoulders Throat pain Hip pain T: Pink C: Thin and white P: Wiry
Treatment Principle	Relieve the Liver Harmonize the Liver and Spleen
Herb Formulas	Jian Wei Yu Yang Ke Li Chai Hu Shu Gan Tang Xiao Chai Hu Tang Chai Hu Shu Gan Tang + Liu Mo Tang With chronic sluggish stools or constipation: Liu Mo Tang With Food Stagnation and sluggish bowels: Mu Xiang Shun Qi Wan Chinese Patent medicines: Shu Gan Wan Chai Hu Shu Gan Wan With significant heartburn: + Wei Te Ling With sluggish or incomplete bowel movements: Mu Xiang Shun Qi Wan With constipation: Chen Xiang Hua Qi Wan With Spleen Deficiency and dampness: Xiao Yao Wan With stagnant Heat: Jia Wei Xiao Yao Wan
Points	LIV-3, LIV-14, PC-6, REN-1 GB-34, LIV-3, LIV-13, PC-6, REN-12, ST-21, ST-34, ST-36, UB-18, UB-20, UB-21 For severe pain: + LIV-5, SP-4, SP-8 With hypochondriac pain or tenderness: + LIV-14 For Liver and Stomach Heat: + LIV-2 For calming the Shen: + DU-19, DU-24, Yintang Ear: Liver, Spleen, Stomach, Large Intestine, Small Intestine, Abdomen

LIVER QI STAGNATION ATTACKS THE SPLEEN

Clinical Manifestations	Abdominal distention and pain Gas Borborygmus Diarrhea 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: White and greasy P: Slippery and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Si Ni San modified Yue Ju Wan Chai Hu Shu Gan Tang With more severe Blood Deficiency: Hei Xiao Yao San For chronic sluggish bowels or constipation: Liu Mo Tang For Qi and Food Stagnation: Mu Xiang Shun Qi Wan Chinese patent medicines: Chai Hu Shu Gan Wan Xiao Yao Wan For chronic sluggish bowels or constipation: Mu Xiang Shun Qi Wan For constipation: Chen Xiang Hua Qi Wan For Spleen Deficiency and Dampness: Xiang Sha Yang Wei Wan
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37\ GB-34, LIV-3, LIV-5, LIV-13, PC-6, REN-6, REN-12, ST-25 For calming the Shen: + DU-19, DU-24, Yintang For Blood or Yin Deficiency: + SP-6, ST-36, UB-18, UB-23 For Phlegm or plum pit Qi Stagnation: + PC-5, SP-3, ST-40 For fat intolerance, pale or pasty stools, and right side hypochondriac pain and distention: + Dannangxue, GB-24, GB-40

LIVER QI STAGNATION ATTACKS THE STOMACH

Clinical Manifestations	Stomach distention and pain which is worse with emotional upset Distended pain in the lower abdomen Hypochondriac pain Headache Vertigo Bitter taste in the mouth Dizziness Frequent sighing Epigastric pain and distention Flatulence Dry mouth and throat Fatigue Anorexia Alternating chills and fever Irregular menstruation Breast distention Lassitude Insomnia Shoulder and back pain Bilateral rib and flank pain	Tightness or fullness in the chest Cold extremities Pain in the arms and legs Heaviness of the head Night sweats Bloating and pain at the umbilicus and abdomen Diarrhea alternating with constipation Five Sole heat Palpitations Malar flush Depression Irritability Increased desire to sleep Belching and burping Poor appetite A tendency to sigh T: Dark with red edges C:Thin white or yellow P: Wiry and Deficient or Wiry, tight and Deficient
Treatment Principle	Pacifies the Liver Spreads Liver Qi Harmonizes the Liver and Stomach
Herb Formulas	Xiao Yao San Mu Xiang Cheng Qi Wan Yue Ju Wan Liang Fu Wan Chai Hu Shu Gan Tang Si Ni San modified With more severe Blood Deficiency: Hei Xiao Yao San With Heat: Si Ni San Jia Wei Xiao Yao San modified With Stomach Heat: Zuo Jin Wan With persistent or severe vomiting: Xuan Fu Dai Zhe Tang With Phlegm : Qi Ge San modified For complex or confusing patterns with multiple pathology: Yue Ju Wan + Zuo Jin Wan Chinese Patent Medicines: Xiang Xia Yang Wei Wan Xia Yao Wan With pain: Shu Gan Wan For robust patients: Chai Hu Shu Gan Wan With constipation: Chen Xiang Hua Qi Wan With Stagnant Heat: Jia Wei Xiao Yao Wan With Spleen and Stomach Deficiency: Xiang Sha Yang Wei Wan With severe Damp-Heat in the Stomach: Huang Lian Jie Du Wan
Points	LIV-3, LIV-14, PC-6, REN-12, ST-36, ST-44 GB-40, LIV-8 GB-34, LIV-3, LIV-13, REN-12, SP-4 With severe vomiting: + ST-40 With Gall Bladder involvement or vomiting bile: + Dannangxue, GB-40 With Spleen Deficiency: + ST-36, UB-20 With Phlegm or Plum-Pit throat: + PC-5, SP-3, ST-40 With alternating chills and fever: + GB-39, SJ-5 With dizziness: +GB-39 To calm the Shen: + DU-19, DU-24, HT-7, Yintang LI-10, LIV-3, PC-6, REN-12, REN-13, REN-17, ST-36, UB-18, UB-19, UB-21 With lateral headaches and neck tension: + GB-34 With hypochondriac pain: + LIV-14 With Gall Bladder involvement: + Dannangxue, GB-24, GB-40 With Heat in the Liver: + LIV-2 With Spleen Deficiency: + UB-20 With Phlegm or Plum-Pit Qi Stagnation: + PC-5, SP-3, ST-40 With dizziness: + GB-20 With Shen disturbance: + one or two of the following: DU-19, DU-24, HT-7, Yintang LIV-3, PC-6, REN-12, ST-36 With vomiting, frequent belching, gastric spasm or acid Stomach: + GB-34 With irregular bowel movements: + SJ-6 With Food Stagnation: + REN-21 or ST-21 With enduring, recurrent Stomach distention and pain, lassitude and weakness due to Spleen Qi Deficiency: + UB-20, UB-21 With pain, heaviness or tension in the solar plexus or diaphragmatic area: + REN-15 With rib, flank or Stomach pain: + LIV-14 With acid regurgitation: + GB-24 With hiccups: + UB-17 Ear: Esophagus, Pylorus, Liver, Spleen, Stomach, Shenmen, Subcortex, Sympathetic

LIVER QI STAGNATION INVADES THE STOMACH WITH STAGNANT HEAT OR FIRE

Clinical Manifestations	Epigastric bleeding of dark, purplish or occasionally fresh, red Blood from the rectum Epigastric pain The bleeding and pain may be worse when emotionally upset or may appear premenstrually Belching with acid regurgitation Intermittent clamoring of the Stomach which is worse with emotional upset or stress Chest oppression Heartburn Nausea Vomiting Anorexia Epigastric, abdominal or hypochondriac, distention and/or pain Distention and pain in the sides or flanks Suffocating sensation in the chest A bitter taste in the mouth Tendency to sigh Melancholy Depression Irritability Inappropriate anger Temporal and frontal headaches Red, sore eyes Facial flushing A dry mouth Thirst Irregular menses Dysmenorrhea Breast distention and pain before and during menses A tendency toward constipation or Alternating constipation and diarrhea T: Red or Red edges or Red spots on the edges C: Thin and yellow P: Wiry and rapid or Wiry, slippery and rapid
Treatment Principle	Soothe the Liver Harmonize the Stomach Clear Heat from the Liver and Stomach Cool the Blood Stop bleeding
Herb Formulas	Jia Wei Xiao Yao San modified Xiao Yao San + Zuo Jin Wan Without Heat: Chai Hu Shu Gan Tang modified With less severe Liver Qi Stagnation and more Dampness: Qi Yu Tang With more pronounced Stomach Heat: Wen Dan Tang modified With enduring Heat damaging the Yin and Fluids: Sha Shen Mai Men Dong Tang modified Chinese Patent Medicines: Jia Wei Xiao Yao Wan For Liver Fire: Long Dan Xie Gan Wan Without Heat: Chai Hu Shu Gan Wan For bleeding: + Yun Nan Bai Yao + Sheng Tian Qi Pian
Points	Ahshi points, LI-4, LI-11, LIV-2, LIV-13, SP-10, ST-25, ST-44 PC-6, REN-12, SP-4, ST-34, ST-36 For severe Heat in the Liver and Stomach: + GB-34, ST-44 For burning pain in the Stomach: + ST-37 For bleeding gums: + LI-3 For swift digestion with rapid hungering: + SP-6 For a poor appetite, Stomach glomus, vexatious Heat in the chest, a bitter taste, sliminess in the mouth, a thin, slimy, yellow tongue coat and a rapid pulse: + GB-43, ST-40 For constipation: + SJ-6 For Food Stagnation: + REN-21 or ST-21 For enduring, recurrent Stomach distention and pain, lassitude and weakness due to Qi Deficiency: + UB-20, UB-21 For heaviness pain or tension the solar plexus or diaphragmatic area: + REN-15 For rib, flank and Stomach pain: + LIV-14 For acid regurgitation or a sour taste in the mouth: + GB-24 For frequent belching or hiccups: + UB-17 Ear: Stomach, Liver, Large Intestine, Subcortex, Shenmen

LIVER QI STAGNATION TRANSFORMS INTO HEAT

Clinical Manifestations	Intermittent chest, epigastric or hypogastric pain Hernia pain The pain is aggravated by ingestion of hot food or drink Dysmenorrhea Irritability A bitter taste in the mouth T: Red C: Yellow P: Wiry and rapid
Treatment Principle	Spread Liver Qi Soothe the Liver Drain Heat Invigorate the Blood Alleviate pain
Herb Formulas	Jin Ling Zi San Zuo Jin Wan With damage to Stomach Yin: Yi Guan Jian modified
Points

LIVER FIRE

Clinical Manifestations	Alternating fever and chills Fullness in the chest and hypochondrium (with or without pain) Bitter taste in mouth Nausea Continuous vomiting Hard focal distension in the epigastrium Fullness and pain in the epigastrium Burning diarrhea or no bowel movement Despondency Slight fidgeting Slight irritability Headache Constipation or discharge of fluids rectally Tinnitus Diminished hearing Diminished vision Red eyes Manic behavior Asthma Mental instability T: Normal or red C: Yellow or Thick and yellow P: Wiry and forceful or Wiry tight and forceful
Treatment Principle	Harmonizes and Disperses the Shao Yang Drains Internal Heat Retention
Herb Formulas	Da Chai Hu Tang
Points	GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19

LIVER FIRE INVADES THE STOMACH

Clinical Manifestations	Vomiting of fresh red or purple Blood or Vomitus stained with Blood or Vomitus containing Blood clots Episodes will often be associated with stress or emotional turmoil Hypochondriac distention and pain Insomnia Restlessness Emotional problems Irritability Dream disturbed sleep A quick temper Pounding temporal headaches Red, sore eyes Chest pain A bitter taste in the mouth T: Deep red or Red edges C: Yellow or None P: Wiry and Rapid
Treatment Principle	Reduce Liver Fire Stop bleeding
Herb Formulas	Jia Wei Xiao Yao San Long Dan Xie Gan Tang modified Chinese Patent Medicines: Long Dan Xie Gan Wan For bleeding: + Sheng Tian Qi Pian Yun Nan Bai Yao
Points	LIV-2, LIV-13, PC-8, REN-12, SP-4, ST-19, ST-21, ST-36, ST-44 With severe bleeding: + PC-4 With nausea: + PC-6 With epigastric pain: + ST-34 With hypochondriac pain: + GB-34, LIV-14 LIV-13, PC-6, REN-12, SP-4 For Liver Fire: + LIV-2, LIV-4 Ear: Liver, Stomach Shenmen, Large Intestine, Lungs, Adrenal, Subcortex

DISHARMONY BETWEEN THE GALL BLADDER AND STOMACH WITH PHLEGM HEAT

Clinical Manifestations	Dizziness Vertigo Nausea and vomiting Insomnia Dream-disturbed sleep with unusual dreams Palpitations Anxiety Profuse white foamy sputum Restlessness Timidity Indecisiveness Indeterminate gnawing hunger Seizures accompanied by copious sputum Flushing up Chest distention Expectoration of yellow Phlegm Bitter taste in the mouth Chills and fever Abdominal distention Frequent dark, scanty urine Irritability Depression Slight thirst Anorexia after serious illness T: Pink or Red tip C: Yellow and greasy P: Slippery and rapid or Wiry and rapid
Treatment Principle	Regulate Qi Transform Phlegm Clear the Gall Bladder Harmonize the Stomach Dry Dampness Dispel Heat
Herb Formulas	Wen Dan Tang Huang Lian Wen Dan Tang
Points

KIDNEY AND LIVER YIN DEFICIENCY WITH LIVER QI STAGNATION

Clinical Manifestations	Hypochondriac and chest pain Dry, parched mouth and throat Bitter taste in mouth Acid regurgitation Epigastric and abdominal distention T: Red and dry P: Thready and weak or Wiry and Deficient
Treatment Principle	Enrich Kidney and Liver Yin Spread Liver Qi
Herb Formulas	Yi Guan Jian
Points

QI AND YIN DEFICIENCY

Clinical Manifestations	Epigastric pain Chronic cough or Dry cough Insomnia Night sweats Spontaneous perspiration Weakness Palpitations Shortness of breath Fever Irritability T: Red and dry or Red and swollen C: Little or None P: Thready and weak
Treatment Principle	Tonify Qi Nourish Yin
Herb Formulas	Yu Ye Tang
Points

QI AND BLOOD STAGNATION

Clinical Manifestations	Abdominal masses which are visible when lying down Piercing hypochondriac pain Irritability Indigestion Constipation Dysmenorrhea Amenorrhea Chronic diarrhea Daybreak diarrhea Palpable abdominal masses Irregular menstruation Breast distention Abdominal tumors Hypochondriac distention T: Purple with purple spots on the side P: Wiry, choppy and tight
Treatment Principle	Invigorates Blood Dispels Blood Stasis Moves Qi Alleviates pain
Herb Formulas	Ge Xia Zhu Yu Tang Shi Xiao San
Points

QI AND BLOOD DEFICIENCY

Clinical Manifestations	May be preceded by prolonged or massive hemorrhaging Clamoring in the Stomach, especially when it is empty which is better with food A lusterless facial complexion Fatigue Loose stools Poor appetite Dizziness Pale face Pale lips Weak voice Shortness of breath Reluctance to speak Sweating with little or no exertion Palpitations Insomnia Dry skin Dry hair Poor memory Lassitude Weakness Scanty periods T: Pale or Pale, thin and dry C: Thin and white P: Weak or Thready and weak or Thin and choppy
Treatment Principle	Strengthen Qi Nourish the Blood
Herb Formulas	Gui Pi Tang modified Ba Zhen Tang
Points	GB-40, GB-41, LIV-3, LIV-14, PC-6, SJ-6, SP-6, SP-10, ST-36, UB-17, UB-18, UB-40 REN-12, ST-36, UB-17, UB-20, UB-21 For retching: + PC-6 For hiccups: + REN-14 For dull pain in the Stomach: +SP-6 For hunger with no desire to eat: + KI=3 For hematemesis: + HT-6, SP-1, SP-6 For dry stools and constipation: + SJ-6 For black stools: + PC-4, SP-1, SP-6

QI, YANG AND BLOOD DEFICIENCY

Clinical Manifestations	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 Strengthen the Spleen and Lungs Nourish the Heart Calm the Shen
Herb Formulas	Ren Shen Yang Rong Tang Shi Quan Da Bu Tang
Points	Moxa SP-6, REN-4, REN-6, ST-36, UB-17, UB-20, UB-23

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 Relieve spasmodic pain
Herb Formulas	Dang Gui Jian Zhong Tang With Heat: Wen Qing Yin
Points

BLOOD STAGNATION

Clinical Manifestations	Stomach pain that is fixed, stabbing and /or severe Pan is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots or dark, purplish-black Blood Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas, Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the Blood Break up Stagnation
Herb Formulas	Xue Fu Zhu Yu Tang Wu Ji San Shi Xiao San Ge Xia Zhu Yu Tang Ulcer #3
Points	SP-6, SP-10, ST-36, UB-17, UB-40 REN-10, REN-12, REN-13, UB-17, UB-21 With hematemesis: + HT-6, SP-1, SP-6 With black stools: + PC-4, SP-1, SP-6 With retching, hiccup or nausea: + PC-6 With dry stools and constipation: + SJ-6 With vomiting, frequent belching, hiccups gastric spasms or acid Stomach: + ST-34 With enduring, recurrent Stomach distention and pain, lassitude and weakness: + UB-20, UB-21

INTERNAL COLD CAUSING PHLEGM AND FLUID STAGNATION

Clinical Manifestations	Chest pain Shoulder stiffness Abdominal distention and pain Constipation Cold feet An aversion to Cold Pale face Fatigue Headaches with heavy headedness Abdominal weakness Anorexia T: Pale C: Greasy, white P: Weak or Weak and wiry
Treatment Principle	Tonify Qi Break up Stagnant Qi Reduce accumulation Descend Qi Warm the Middle Jiao Disperse Cold Transform Phlegm
Herb Formulas	Yan Nian Ban Xia Tang
Points

COLD WITH BLOOD STAGNATION IN THE CHANNELS

Clinical Manifestations	Abdominal pain with icy cold hands and feet Extremities are cyanotic and difficult to warm up P: Thready or Imperceptible
Treatment Principle	Warm the channels Disperse Cold Nourish the Blood Unblock the channels
Herb Formulas	Dang Gui Si Ni Tang
Points

PHLEGM-DAMP RETENTION

Clinical Manifestations	A clamoring Stomach Cough with copious, dilute, white frothy or lumpy sputum Chest and epigastric congestion Chest and abdominal oppression Palpitations Headache Pain and full feeling in chest Dyspnea - worse lying down Profuse Phlegm Asthma Throat rattle \Reduced appetite Maybe anorexia Lassitude Fatigue, especially after eating Somnolence, especially after eating Nausea / vomiting Dizziness / vertigo Shortness of breath Wheezing Acute attack of panting with high pitched sound and rapid exhalation Head distention Facial edema Weak extremities T: Pale C: Thick, white and greasy or sticky P: Slippery or Soft or Slippery and wiry
Treatment Principle	Dry Dampness Transform Phlegm Regulate Qi Harmonize the Middle Jiao
Herb Formulas	Er Chen Tang Ling Gui Zhu Gan Tang Wu Ji San Ping Wei San Bai Zhu Wan Jia Jian With Heat: Wen Dan Tang Chinese Patent Medicines: With Spleen and Stomach Qi Deficiency and Phlegm-Damp: Xiang Sha Liu Jun Zi Tang With Food Stagnation: Zi Sheng Wan
Points	PC-6, SJ-6, SP-6, SP-9, ST-40, UB-13, UB-20, UB-23 REN-10, REN-12, REN-13, ST-36, ST-40 With vomiting, frequent belching, gastric spasm or acid Stomach: + ST-34 With irregular bowel movements: + SJ-6 With enduring, recurrent Stomach distention and pain, lassitude and weakness: + UB-20, UB-21 With hiccups: + UB-17 With a bitter taste in the mouth: + GB-38

PHLEGM-HEAT STAGNATION IN THE CHEST

Clinical Manifestations	Focal distention in the chest and epigastrium with or without nodules which is painful when pressed Coughing up yellow, viscous sputum Constipation A bitter taste in the mouth T: Normal C: Yellow and greasy P: Slippery and floating or Slippery and rapid
Treatment Principle	Clear Heat Transform Phlegm Expand the chest Dissipate Stagnation
Herb Formulas	Xiao Xian Xiong Tang
Points

TOXIC HEAT WITH BLOOD STAGNATION

Clinical Manifestations	Swelling and pain Maybe fever and chills T: Normal C: Thin white or yellow P: Rapid and forceful
Treatment Principle	Clear Heat Eliminate toxins Reduce swelling Activate Blood circulation Stop pain
Herb Formulas	Xian Fang Huo Ming Yin San Huang Xie Xin Tang Zhen Ren Huo Ming Yin Er Chen Tang modified With Stomach Yin Deficiency: Sha Shen Mai Men Dong Tang modified With severe symptoms of Blood Stagnation: Dan Shen Yin modified
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TURBID DAMPNESS IN THE SAN JIAO

Clinical Manifestations	General edema of the body and extremities Dysuria Oliguria Orthopnea Pitting edema Dyspnea 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 Harmonize the Spleen Relieve edema Move Qi
Herb Formulas	Dao Shui Fu Ling Tang
Points

MIDDLE JIAO YANG DEFICIENCY WITH COLD RETENTION

Clinical Manifestations	Excruciating epigastric and abdominal pain to the point of not being able to to be touched Gastric and Intestinal spasms May be borborygmus. Vomiting to the point of not being able to eat Superficial skin pulsations throughout the abdomen 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 Descend rebellious Qi Relieve pain
Herb Formulas	Da Jian Zhong Tang Tao Hua Tang
Points

DAMP-HEAT IN THE MIDDLE JIAO

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	Lian Po Yin Yi Zi Tang
Points	REN-6, REN-12, SP-9, ST-25, ST-36

COLD-DAMPNESS IN THE LOWER JIAO

Clinical Manifestations	Cold pain in the lower back and body Sciatica Copious urination Extreme heavy sensation in the lower back Absence of thirst T: Pale C: White P: Deep, thready and moderate
Treatment Principle	Warm Yang Strengthen the Spleen Dispel Cold Eliminate Dampness
Herb Formulas	Gan Cao Gan Jiang Fu Ling Bai Zhu Tang
Points

HEAT ABOVE AND COLD BELOW

Clinical Manifestations	Stifling sensation and irritability in the chest Nausea with an urge to vomit Abdominal pain Fever with slight chills Diarrhea Vexation Borborygmus Thirst T: Pink C: White and greasy P: Wiry
Treatment Principle	Regulate Cold and Heat Harmonize the Stomach Descend Rebellious Qi
Herb Formulas	Huang Lian Tang
Points

PHLEGM-HEAT

Clinical Manifestations	Prolonged, nagging epigastric pain and distention Patient tends to be overweight Cough with sticky, yellow, difficult to expectorate sputum Rapid breathing with a harsh voice Restless fever Sore throat Constipation Thirst with no desire to drink Dry stools Alternating constipation and diarrhea Variable appetite Mania Shortness of breath Dyspnea Nausea Vomiting Chest and/or epigastric fullness A heavy sensation in the body Lethargy 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 Soothe the Liver Harmonize the Stomach
Herb Formulas	Xiao Xian Xiong Tang modified Chinese Patent Medicines: Qing Qi Hua Tan Wan Wen Dan Wan
Points	Ahshi points along the Stomach channel between ST-36 and ST-39, LI-4, PC-7, PC-8, REN-12, ST-21, ST-34, ST-36, ST-40, ST-44 With Yin Deficiency: + UB-21 , UB-23 With vomiting or spitting Blood: + PC-4 With fever: + LI-11 LI-11, LU-5, ST-40, UB-13 Ear: Stomach, Duodenum, Abdomen, Shenmen, Sympathetic

PHLEGM ACCUMULATION ABOVE THE DIAPHRAGM AND BELOW THE HEART

Clinical Manifestations	Violent nausea and vomiting Severe vomiting of Phlegm and/or thin fluids Severe pain Migrating and shooting pain throughout the upper and lower back Chest pain Precordial pain T: Pale C: Greasy and white P: Deep and wiry
Treatment Principle	Dry Dampness Dissolve Phlegm Regulate Qi Subdue Rebellious Qi Relieve pain
Herb Formulas	Zhi Suo Er Chen Tang
Points

INSUFFICIENCY OF THE CHONG AND REN CHANNELS

Clinical Manifestations	Mild persistent uterine bleeding Irregular menstruation (either early or late) Prolonged menstruation Skipped period Metrorrhagia Extended or continuous menstrual flow Pain Lower abdominal distention Lower abdominal Cold Lower abdominal pain Infertility Dry lips Dry mouth Spermatorrhea Pale complexion Leukorrhea Amenorrhea Bleeding between periods Low grade fever at dusk Irritability Five sole Heat No desire to drink Distending breast pain Low back coldness and pain Loose stools Cold limbs Aversion to Cold T: Purple with petechiae P: Thready and choppy
Treatment Principle	Warm the menses Regulate menstruation Dispel Cold Warm the channels Nourish the Blood Dispel Blood Stasis
Herb Formulas	Wen Jing Tang
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ULCER (PEPTIC, GASTRIC OR DUODENAL)

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