BAD BREATH, HALITOSIS, OZOSTOMIA

GENERAL

Clinical Manifestations
Treatment Principle
Herb Formulas
Points

YANG MING JING WITH QI AND BODY FLUID DEFICIENCY

Clinical Manifestations	High fever Profuse sweat Generalized weakness Severe chills Aversion to Heat Red face Severe thirst Thirst may be unquenchable Irritability Anxiety Pruritis Headache Toothache Gum bleeding Epistaxis Dry lips Dry tongue Dry mouth May be sensitive to Cold in the upper back Polyuria Delusions Eye congestion Burning sensation on the skin Itching skin Abdominal fullness without resistance Dry, course skin Listlessness May be heavy labored breathing Delirious speech (serious cases) Mania (serious cases) T: Red tip and sides C: Yellow, dry or white P: Large and forceless
Treatment Principle	Clear Heat Harmonize the Stomach Strengthen Qi Promote Body Fluids
Herb Formulas	Bai Hu Jia Ren Shen Tang
Points	DU-14, KI-3, LI-11, PC-6, SP-4, SP-6

QI STAGE: LUNG AND STOMACH HEAT INJURING THE YIN AND FLUIDS

Clinical Manifestations	Bad breath Lingering fever from a febrile disease Vomiting Irritability Thirst with a desire to drink Parched mouth, lips and throat Choking cough Restlessness Insomnia Nausea Anorexia Profuse perspiration A dry mouth Indigestion Listlessness Chest oppression Ulcerations of the mouth Coarse skin Cough Night sweats Stifling sensation in the chest or epigastrium T: Red C: Little or None P: Rapid and Deficient or Thready and rapid
Treatment Principle	Clear Heat Generate fluids Tonify Qi Harmonize the Stomach
Herb Formulas	Zhu Ye Shi Gao Tang
Points

LUNG HEAT

Clinical Manifestations	Coughing (high and clear sounding) Wheezing Fever Skin that feels hot to the touch Symptoms worse in the late afternoon Dry mouth Bad breath Little or difficult to expectorate sputum Burning pain in the chest and hypochondrium Yellow sputum Hemoptysis A warm steaming sensation from the skin that is most prominent in the late afternoon Maybe constipation Impatience Dry throat Hurried respiration leading to dyspnea Irritability Dyspnea Afternoon fever Anhidrosis Dizziness Conjunctival congestion Dry, bitter taste in the mouth T: Red C: Yellow P: Thready and rapid - maybe wiry
Treatment Principle	Drain Heat from the Lungs Calm wheezing (asthma) Stop coughing Relieve dyspnea
Herb Formulas	Xie Bai San With Lung Yin Deficiency: Qing Fei Tang
Points

LARGE INTESTINE FLUID DEFICIENCY

Clinical Manifestations	Dry stools Knotted constipation or bowel movements once a day Difficulty passing stools Dizziness Bad breath Mouth and throat dry T: Red C: Little P: Thready and rapid
Treatment Principle	Lubricate the Intestines Relieve constipation
Herb Formulas	Zeng Ye Tang Ma Zi Ren Wan Wu Ren Wan Ma Zi Ren Wan
Points	KI-1, KI-3, KI-6, SJ-6, SP-15, ST-25, ST-37, UB-25

COLD-DAMP DISTRESSES THE SPLEEN

Clinical Manifestations	Distention and fullness in epigastrium and abdomen Loss of taste and appetite Heavy sensation in the limbs and body Loose stools or diarrhea after eating Easily fatigued Increased desire to sleep Nausea Vomiting Belching Feeling lazy with a preference for inactivity Lethargy Acid regurgitation Cough with sputum Borborygmus Shortness of breath Fullness in the chest Persistent bitter taste in mouth Headache triggered by strong smells T: Pale and swollen C: Thick, white and greasy P: Slippery and even or Slow or Moderate
Treatment Principle	Warm Cold Transform Dampness Harmonize the Stomach Strengthen the Spleen
Herb Formulas	Ping Wei San
Points	Moxa or moxa needle REN-6, REN-12, SP-6, SP-9, ST-36, UB-20 Cold-Damp Dysentery: Moxa or moxa needle LI-4, REN-6, REN-12, SP-6, ST-25, ST-37 Cold-Damp Diarrhea: Moxa or moxa needle REN-6, REN-12, ST-25, ST-36, ST-37, UB-25 Cold-Damp Vaginal Discharge: Moxa or moxa needle GB-26, REN-4, REN-6, SP-6, ST-36, UB-30 Cold-Damp Jaundice (Yin Jaundice): Moxa or moxa needle DU-9, GB-24, LIV-13, SP-9, ST-36, UB-19, UB-20 , UB-48

DAMP-HEAT IN THE SPLEEN AND STOMACH

Clinical Manifestations	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
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

LATENT FIRE IN THE SPLEEN AND STOMACH

Clinical Manifestations	Mouth ulcers Bad breath Thirst Frequent hunger Dry mouth and lips Epistaxis Tongue thrusting in children Irritability T: Red C: Normal or Yellow P: Rapid
Treatment Principle	Drain Latent Fire from the Spleen and Stomach
Herb Formulas	Xie Huang San
Points

SPLEEN QI DEFICIENCY WITH HEAT

Clinical Manifestations	Obesity Hungers easily after eating Fatigue Lack of strength Tends toward alternating loose stools and constipation Red facial complexion Dry mouth with a desire to drink Bitter taste in the mouth Bad breath T: Enlarged C: Yellow P: Slippery and wiry
Treatment Principle	Strengthen the Spleen Tonify Qi Clear Heat Eliminate Dampness Unblock the stool
Herb Formulas	Fei Pang Fang
Points

SPLEEN QI DEFICIENCY WITH BLOOD STAGNATION AND HEAT

Clinical Manifestations	Obesity with a long history of a bad diet Dislike of speaking Sweating on exertion Aversion to Cold Puffy face Poor appetite Abdominal fullness after eating Fatigued spirit Weakness of the extremities Somnolence Clear, thin vaginal discharge Bland taste in the mouth Hungers easily after eating Fatigue Lack of strength Tends toward alternating Loose stools and constipation Red facial complexion Dry mouth with a desire to drink Bitter taste in the mouth Bad breath Emotional problems Chest oppression Flank pain Bitter taste in the mouth T: Normal or Pale with teethmarks or Enlarged C: White or Yellow P: Wiry or Slippery and wiry or Fine and weak
Treatment Principle	Invigorate Blood circulation Tonify Qi Drain Heat Reduce Phlegm
Herb Formulas	Jiang Zhi Jian Fei Yin
Points

SPLEEN QI DEFICIENCY WITH FOOD, QI AND BLOOD STAGNATION AND DAMP -HEAT

Clinical Manifestations	Obesity with a long history of a bad diet Dislike of speaking Sweating on exertion Aversion to Cold Puffy face Poor appetite Abdominal fullness after eating Fatigued spirit Weakness of the extremities Somnolence Clear, thin vaginal discharge Bland taste in the mouth Hungers easily after eating Fatigue Lack of strength Tends toward alternating Loose stools and constipation Red facial complexion Dry mouth with a desire to drink Bitter taste in the mouth Bad breath T: Pale with teethmarks or Enlarged C: White or Yellow P: Slippery and wiry or Fine and weak
Treatment Principle	Reduce and guide out Food Stagnation Transform accumulations Transform Blood Stasis Invigorate Blood circulation Promote the movement of Qi Tonify Qi and Blood Clear Damp-Heat
Herb Formulas	Jiang Zhi Jian Fei Wan Jiang Zhi Jian Fei Yin #2 Jiang Zhi Jian Fei Yin #3 With Liver Heat: Jiang Zhi Jian Fei Yin #4
Points

SPLEEN AND STOMACH DEFICIENCY COLD WITH QI AND BLOOD STAGNATION

Clinical Manifestations	Cramps and pain in the epigastrium Fullness and distention of the chest and hypochondrium Acid reflux Nausea/Vomiting Mild constant epigastric pain; relieved by warmth and pressure Anorexia Abdominal pain and fullness after meals Fatigue Poor muscle tone A flabby abdomen 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 and/or Moist C: White and greasy P: Deep, thready and forceless or Large and faint
Treatment Principle	Strengthen the Spleen Warm Yang Warm the Center Dispel Cold
Herb Formulas	An Zhong San
Points	Moxa or moxa needle LIV-13, REN-12, SP-3, SP-6, ST-36, UB-20, UB-21

STOMACH FIRE

Clinical Manifestations	Burning Heat and pain in the epigastrium Abdominal pain 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 Thiurst Toothache 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
Treatment Principle	Clear and Purge Stomach Fire
Herb Formulas	Qing Wei San modified San Huang Xie Xin Tang Mai Men Dong Tang Zhu Ye Shi Gao Tang Qing Xin Li Ge Tang
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, REN-12, ST-36, ST-44, UB-21 LU-7, PC-6, REN-12, ST-25, ST-36, ST-44 LI-4, LI-11, LIV-3, PC-6, PC-8, REN-12, ST-6, ST-21, ST-34, ST-43, ST-44, ST-45

FOOD STAGNATION IN THE STOMACH

Clinical Manifestations	Epigastric fullness, distention and pain with dislike of pressure Belching with rotten food smell Bad breath Acid regurgitation Detests food or Vomits after eating Distention is reduced after vomiting Unformed stools or Knotted constipation T: Pink C: Thick and greasy P: Slippery
Treatment Principle	Clear Food Conduct Stagnation
Herb Formulas	Bao He Wan Zhi Shi Dao Zhi Wan Jia Wei Ping Wei 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

HEART FIRE

Clinical Manifestations	Ulceration, erosion, and pain of mouth and tongue Thirst with a desire for cold drinks Irritability Iirascibility Feeling of Heat and disturbance in the Heart Insomnia Flushed face Bitter taste in the mouth T: Red tip with ulcers especially on the tip P: Excess and rapid
Treatment Principle	Clear Heat Purge Fire Calm the Shen
Herb Formulas	Dao Chi (Re) San San Huang Xie Xin Tang Liang Ge San
Points	HT-7, HT-8, PC-7, PC-8, UB-15

PHLEGM OBSTRUCTS THE HEART ORIFICES: YANG OBSTRUCTION

Clinical Manifestations	Sudden collapse with loss of consciousness Lockjaw (trismus) Eyes open Both fists clenched Retention of urine Constipation Stiffness and spasm of limbs Red face Body feels hot Coarse breathing Bad breath Restlessness Involuntary movements Usual sequelae of C.V.A. such as: Hemiplegia Aphasia Facial paralysis T: Pink C: Yellow and greasy P: Slippery, wiry and rapid
Treatment Principle	Clear Phlegm Open the Orifices
Herb Formulas	(Ju Fang) Zhi Bao Dan An Gong Niu Huang Wan Ling (Yang) Jiao Gou Teng Tang modified
Points	Bleed the Jing-Well points of the Six Hand channels, needle DU-20, DU-26, KI-1, LIV-3, ST-40

FLUID AND HEAT STAGNATION

Clinical Manifestations	Food stagnation Foul breath Firm epigastric focal distention Dry heaves with a foul odor The sound of Fluids in the hypochondria Diarrhea Very loud borborygmus Nausea Vomiting Fullness and oppression in the chest and abdomen Heartburn Acid regurgitation Ascites T: Normal C: Thin, yellow and greasy P: Wiry, taut and rapid
Treatment Principle	Harmonize the Stomach Reduce focal distention Disperse clumping Expel water Descend s Qi
Herb Formulas	Sheng Jiang Xie Xin Tang
Points

TOXIC HEAT

Clinical Manifestations	Severe localized pain or Pain that is spreading to involve the whole abdomen Abdominal rigidity Abdominal guarding Epigastric and abdominal hardness and distention Constipation No passing of gas High fever or Chills and fever Thirst Dry mouth, throat and lips A red complexion Red eyes Malaise A headache Nausea/Vomiting Halitosis Concentrated urine T: Deep red or Scarlet C: Greasy and yellow or Dry and yellow P: Flooding and rapid
Treatment Principle	Clear Toxic Heat Invigorate the Blood Break up Blood Stasis Dissipate accumulation
Herb Formulas	Lan Wei Jie Du Tang
Points

TOXIC HEAT IN THE SAN JIAO

Clinical Manifestations	High fever Irritability Fidgeting Dry mouth Bad breath Dry throat Incoherent speech Insomnia Dark urine Deep-rooted boils Maculae Carbuncles Hematemesis Hemoptysis Palpitations Furuncles Tinnitus Purpura Red face Rashes Deep-rooted boils Red eyes Itchy skin Fidgeting Dry lips Delirium Dysentery with fever Jaundice Epistaxis Hematuria Cloudy mind Diarrhea T: Red C: Yellow P: Rapid and forceful
Treatment Principle	Clear Heat Drain Fire Relieve toxicity from all three Jiaos Relieve inflammation Stop bleeding Purge Damp-Heat Purge the Gallbladder
Herb Formulas	Huang Lian Jie Du Tang
Points

HEAT IN THE UPPER AND MIDDLE JIAOS

Clinical Manifestations	Thirst Restlessness Foul breath A dry throat T: Dry
Treatment Principle	Clear Heat from the Upper and Middle Jiaos
Herb Formulas	Qing Liang Yin
Points

HEAT IN THE LIVER AND GALL BLADDER CHANNELS

Clinical Manifestations	Fever Chills Severe headache Flushed cheeks Bad breath Tinnitus Hearing loss Irritability Insomnia Coughing up viscous, thick sputum Dark urine Swollen lymph nodes Abdominal tension and itching Darkened skin Epistaxis Itching Formation of cellulitis T: Red C: Normal or Yellow P: Wiry and rapid
Treatment Principle	Drain Fire Relieve toxicity Spread the Liver Qi Strengthen the Spleen Disperse Wind-Heat
Herb Formulas	Chai Hu Qing Gan Tang
Points

PARASITES

Clinical Manifestations	Intermittent abdominal pain Indigestion Emaciation Loose stools Feverishness Foul breath A sallow complexion A large, distended abdomen Anorexia Decreased intake of food Weak constitution Constant fatigue Maybe nausea and vomiting Dry mouth Thirst
Treatment Principle	Kill parasites Reduce accumulations Strengthen the Spleen Clear Heat
Herb Formulas	Fei Er Wan
Points

BAD BREATH, HALITOSIS, OZOSTOMIA

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