BRONCHIECTASIS

GENERAL

Clinical Manifestations	Bronchiectasis is a chronic condition where the walls of the bronchi are thickened from inflammation and infection. People with bronchiectasis have periodic flare-ups of breathing difficulties. The most common symptoms of bronchiectasis are: Coughing up yellow or green mucus every day Shortness of breath that gets worse during exacerbations Feeling run-down or tired, especially during exacerbations Fevers and/or chills, usually developing during exacerbations Wheezing or a whistling sound while you breathe Hemoptysis
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Points	REN-6, REN-12, ST-36, ST-40, UB-13, UB-16, UB-20 DU-9, DU-12, LU-6, SP-15

EARLY STAGE

Clinical Manifestations	Acute, hacking dry cough Cough with scant, sticky white or yellowish, difficult-to-expectorate sputum Acute fever and chills Dry mouth, throat, nose and lips Chest pain which is worse when coughing Painful or wheezing respiration Lethargy Malaise Weakness Anorexia T: Red tip C: Thin and yellow P: Floating and rapid or Slippery
Treatment Principle	Clear Lung Heat Disperse Wind-Heat Eliminate Phlegm Stop cough
Herb Formulas	Yin Qiao San Chinese Patent Medicines: Qing Fei Yi Huo Pian Ma Xing Zhi Ke Pian Niu Huang Jie Du Pian Chuan Ke Ling
Points	DU-14, LI-4, LI-11, LU-5, LU-7, LU-10, SJ-5, UB-13 DU-14, LI-4, LI-11, LU-5, SJ-5, UB-12, UB-13 For a very sore, swollen throat: + LU-11 , SI-17 DU-14, LI-4, LI-11, LU-5, UB-13 LI-4, LU-5, LU-7, UB-13 LI-4, LU-7, SJ-5, UB-12, UB-13 DU-14, DU-16, GB-20, LU-5, LU-7, LU-10, LU-11, SJ-5, UB-12, UB-13 Bleed UB-40, needle Dingchuan, DU-14, DU-16, DU-23, DU-24, GB-20, LI-4, LI-11, LU-5, LU-7, LU-10, REN-22, SJ-5, ST-8, ST-40, Taiyang, UB-12, UB-13 For a mild case with cough, fever is not high, slight thirst: Bleed UB-40, needle DU-14, GB-20, LI-4, LI-11, LU-7, REN-22, SJ-5, UB-12, UB-13

WIND-COLD ATTACKS THE LUNGS

Clinical Manifestations	Itching or tickling in the throat Cough with expectoration of thin, watery or frothy white sputum Chills with low grade fever Tightness in the chest Anhidrosis No thirst Headache Aversion to Wind Blocked and / or runny nose with clear, watery nasal discharge Sneezing General body aches Maybe asthma T: Pink C: Thin, white and moist P: Superficial and tight
Treatment Principle	Expel Wind Dispel Cold Ventilate the Lungs Resolve Phlegm
Herb Formulas	Xiao Qing Long Tang Tong Xuan Li Fei Wan Fu Fang Chuan Bei Jing Pian Severe: Xiao Qing Long Jia Shi Gao Tang
Points	DU-16, GB-20, LI-4 + LU-7 or LI-4 + KI-7, LU-5, UB-12, UB-13

MILD WIND-COLD WITH DRYNESS

Clinical Manifestations	Itching or tickling in the throat Blocked or stuffy nose Sneezing General body aches Coughing with expectoration of thin, watery or frothy white sputum Dry nasal passages Chills with low grade fever Slight headache Nasal obstruction Nausea Drooling Vomiting Dry throat No thirst Intolerance of Cold Anhidrosis Maybe asthma Nasal congestion Sticky nasal discharge Sore throat T: Pink C: Thin, white and dry P: Superficial and wiry or Tight or Wiry
Treatment Principle	Mildly Disperse Cool Dryness Disperse Lung Qi Resolve Phlegm Transform thin mucus Soothe the Lungs Stop s coughing
Herb Formulas	Xing Su San
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WIND-HEAT ATTACKS THE LUNGS

Clinical Manifestations	Cough with thick, sticky, yellow sputum Sore, red, swollen throat Thirst with a desire to drink cold liquids Runny or blocked nose with thick, yellow discharge Fever with perspiration Slight chills Aversion to Wind Headache Maybe dyspnea with flared nostrils Maybe chest pain T: Red tip C: Thin and yellow P: Superficial and rapid
Treatment Principle	Expel Wind Clear Heat Ventilate the Lungs
Herb Formulas	Mild cases: Sang Ju Yin With profuse Phlegm: Ning Sou Wan Severe cases: Ma Xing Shi Gan Tang Yin Qiao San With Dryness: Sang Xing Tang
Points	DU-14, DU-16, GB-20, LI-4 + LU-7 or LI-4 + SJ-5, LU-5, LU-10, LU-11, UB-12, UB-13

PERVERSE DRYNESS ATTACKS THE LUNGS

Clinical Manifestations	Dry cough with little or no sputum Sputum is difficult to expectorate Maybe hemoptysis Cough may cause chest pain Dry or sore throat Hoarse voice Dry lips and mouth Thirst Dryness in nose Epistaxis Chills and fever Headache Anhidrosis Dry skin and hair Constipation T: Red tip C: Thin, yellow and dry P: Superficial, maybe rapid
Treatment Principle	Clear the Lungs Moisten Dryness
Herb Formulas	Qing Zao Jiu Fei Tang With profuse Phlegm: Ning Sou Wan If symptoms persist for a long time: Yang Yin Qing Fei Tang
Points	KI-3, LU-1, LU-6, SP-6, UB-13

QI STAGE: LUNG HEAT

Clinical Manifestations	High fever No chills Aversion to Heat Cough Asthma Restlessness Thirst Dark yellow urine Dyspnea Chest pain Shortness of breath Thick yellow Phlegm T: Red C: Thick and yellow, maybe dry and sticky P: Rapid, maybe slippery, maybe forceful
Treatment Principle	Clear Heat in Lungs Strengthen when weak or elderly
Herb Formulas	Ma Xing Shi Gan Tang Zhi Sou Ding Chuan Wan
Points	Dingchuan, DU-13, DU-14, LI-11, LU-5, LU-10, ST-44. UB-13

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 T: Red C: Yellow P: Rapid or Forceful and rapid
Treatment Principle	Clear Heat Remove Obstructions
Herb Formulas	Zhi Zi Chi Tang Zhi Shi Zhi Zi Chi Tang Zhi Zi Gan Cao Chi Tang Zhi Zi Sheng Jiang Chi Tang
Points	DU-14, HT-7, LI-11, PC-6, ST-44

YING STAGE: YING RE

Clinical Manifestations	High fever, worse at night Insomnia Irritability Mild thirst with no desire to drink Mental disturbance Speech disturbance Red, dry, painful rashes T: Deep red C: Little or None P: Thready and rapid
Treatment Principle	Reduce Heat in the Ying Detoxify
Herb Formulas	Qing Ying Tang
Points	HT-3, HT-5, HT-6, HT-7, KI-3, LI-11, PC-7, PC-8, bleed Shixuan, Sifeng, SP-6

YING STAGE: HEAT ATTACKS THE PERICARDIUM

Clinical Manifestations	High fever worse at night Thirst Insomnia Major mental problems Dramatic change of personality Delirium Speech difficulty Aphasia Poor memory Dizziness Maybe fainting Maybe coma Feverish extremities T: Deep red P: Thready and rapid
Treatment Principle	Clear Heat in Pericardium
Herb Formulas	An Gong Niu Huang Wan Zi Xue Dan Zhi Bao Dan
Points	To Clear Heat from the Heart: HT-3, PC-8, Sifeng, bleed Shixuan For delirium: PC-7 To detoxify: LI-11 To Pacify Heart and calm the Shen: HT-5, HT-6, HT-7 To Nourish Yin: KI-3, SP-6

XUE STAGE: 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 Xi Jiao Di Huang Tang
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

MIDDLE STAGE

Clinical Manifestations	High fever with or without chills A hacking, painful cough with copious, purulent, malodorous mucus The mucus may be Blood-streaked Restricted movement of the chest Labored breathing Sweating Dry mouth and throat Irritability Restlessness Lethargy Malaise T: Red C: Greasy and yellow P: Slippery and rapid or Flooding and rapid
Treatment Principle	Clear Heat and toxins Disperse pus accumulation Disperse Blood Stasis
Herb Formulas	Wei Jing Tang modified Chinese patent medicines: Niu Huang Xiao Yan Wan Wan Shi Niu Huang Qing Xin Wan Xi Ling Jie Du Pian Chuan Ke Ling
Points	DU-12, DU-14, LU-1, LU-6, PC-7, REN-17, SJ-6, ST-40, UB-13 With severe Heat: bleed LI-1, LU-11

PHLEGM-DAMP OBSTRUCTS THE LUNGS

Clinical Manifestations	Cough with copious, thin, white, frothy sputum Chest congestion with a full feeling Dyspnea which is worse when lying down Sometimes asthma T: Pink C: Thick, white and greasy or sticky P: Slippery
Treatment Principle	Activate the Spleen Dry Dampness Expel Phlegm Purge the Lungs
Herb Formulas	Er Chen Tang modified Su Zi Jiang Qi Tang Er Chen Tang + Ping Wei San Er Chen Tang + San Zi Yang Qin Tang In the elderly: Qi Guan Yan Pian With Spleen Qi Deficiency prominent: Liu Jun Zi Tang modified
Points	LU-9, REN-12, REN-17, REN-22, ST-36, ST-40, UB-13, UB-20 LI-4, LU-9, ST-44, UB-12, UB-13 With Heat: + DU-14, LI-11, LU-11 With Cold: + moxa or moxa needle UB-20, UB-23 With nausea: + PC-6, REN-12, SP-4 LIV-13, LU-5, LU-7, LU-9, SP-3, SP-6, ST-36, ST-40, moxa UB-13, UB-20, UB-43 With wheezing: + Dingchuan With fullness in the chest: + PC-5

PHLEGM-HEAT CONGESTS THE LUNGS

Clinical Manifestations	Cough with expectoration of copious thick, purulent, yellow-green sputum or blood-flecked, foul-smelling pus (as in Lung abscess) Dyspnea Asthma Pain in the ribs Maybe chills and fever T: Scarlet C: Yellow and smooth P: Slippery and rapid
Treatment Principle	Clear Heat Counteract Toxin Transform Stasis Drain Pus Resolve Phlegm (The use of Clear Heat / Counteract Toxin herbs and the principle of "Draining Pus" are only relevant when foul-smelling pus is being expectorated such as in pulmonary abscess) Soothe asthma in case of asthma
Herb Formulas	Wei Jing Tang modified Xiao Xian Xiong Tang Qing Jin Hua Tan Wan modified Ma Xing Shi Gan Tang modified Gua Lou Zhi Shi Tang Qing Qi Hua Tan Wan With profuse Phlegm: Ning Sou Wan Chinese Patent Medicines: Zhi Ke Pi Pa Chong Ji Ke Chuan Pian Ke Chuan Chong Ji Xiao Ke Chuan
Points	Dingchuan, LU-1, LU-5, LU-6, LU-10, REN-17, REN-22, ST-40, UB-13 LI-11, LU-1, LU-5, LU-6, LU-7, LU-10, REN-17, ST-40, UB-13 With wheezing: + Dingchuan With fullness in the chest: + PC-5 KI-3, KI-6, LU-5, LU-7, LU-9, UB-13, UB-23 With severe Heat: + LU-10

LUNG AND STOMACH HEAT

Clinical Manifestations	Cough Yellow Phlegm Dry mouth Thirst with a desire to drink Constipation Sore throat Hematemesis Hemoptysis T: Red and dry C: Yellow P: Rapid
Treatment Principle	Clear and purge Lung Heat Transform Phlegm Stop cough and asthma
Herb Formulas	Qing Fei Yi Huo Hua Tan Wan Qing Qi Hua Tan Wan
Points

LUNG HEAT GENERATING LUNG YIN DEFICIENCY

Clinical Manifestations	Chronic, incessant coughing Chronic hoarseness Throat lesions Itching throat Fever 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 Five Sole Heat Physical and mental overexertion Phlegm Dry mouth T: Reddish and dry C: Little or None P: Thready and rapid or Deep and rapid
Treatment Principle	Clear the Lungs Transform Phlegm Relieve cough Drain Fire Moisten Dryness
Herb Formulas	Qing Fei Tang
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LUNG YIN DEFICIENCY

Clinical Manifestations	Severe, dry hacking cough No sputum expectorated Small amounts of difficult to expectorate sputum Blood tinged sputum (when Yin Deficiency Fire is present) Afternoon fever Night sweats Malar flush (especially in afternoon) Five Sole Heat Dry mouth and throat Itching in throat Hoarse voice, low voice or loss of voice Emaciation T: Red and dry C: None P: Thready and rapid
Treatment Principle	Nourish Yin Moisten the Lungs
Herb Formulas	Bai He Gu Jin Tang Yang Yin Qing Fei Tang Mai Men Dong Tang Yue Hua Wan With Heat: Bu Fei E Jiao Tang Chinese Patent Medicines: Bai He Gu Jin Tang Li Gao Mai Wei Di Huang Wan Li Fei Pian Yang Yin Qing Fei Wan
Points	KI-3, KI-6, LU-1, LU-5, LU-6, LU-7, LU-9, LU-10, ST-36, UB-13, UB-17, UB-23, UB-43 KI-6, LU-1, LU-7, LU-9, ST-36, UB-13, UB-17, UB-43 DU-14, HT-6, HT-7, KI-3, LU-1, LU-6, SP-6, UB-13, UB-17

LUNG QI AND YIN DEFICIENCY

Clinical Manifestations	Chronic, unremitting coughing Wheezing A shiny-white complexion Shortness of breath Dyspnea Spontaneous sweating T: Red and tender P: Deficient and rapid
Treatment Principle	Restrain the Lungs Stop coughing Tonify Qi Nourish Yin
Herb Formulas	Jiu Xian San Qiong Yu Gao
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LUNG AND STOMACH YIN DEFICIENCY

Clinical Manifestations	Dry throat Thirst Hacking cough with scanty sputum Low grade fever Night sweats Epigastric pain T: Red C: Little, maybe dry P: Thready and rapid
Treatment Principle	Clear and Nourish the Lungs and Stomach Generate Fluids Moisten Dryness
Herb Formulas	Sha Shen Mai Men Dong Tang
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LUNG AND HEART YIN DEFICIENCY

Clinical Manifestations	Severe, dry hacking cough No sputum expectorated Small amounts of difficult to expectorate sputum Blood tinged sputum (when Yin Deficiency Fire is present) Afternoon fever Night sweats Malar flush (especially in afternoon) Five sole Heat Dry mouth and throat Itching in throat Hoarse voice, low voice or loss of voice Emaciation Palpitations Irritability Easily startled Insomnia Much dreaming Poor memory Low grade fever Restlessness Thirst T: Red and dry C: Little or None P: Thready and rapid
Treatment Principle	Clear Heat Nourish Yin Moisten the Lungs Nourish the Heart Calm the Shen Stop cough
Herb Formulas	Xuan Miao San
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LUNG AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Unproductive cough or Scanty, sticky phlegm or Sometimes blood-streaked sputum Dry mouth Dry throat Low back and knees sore and weak "Steaming Bone" tidal fever Night sweats Malar flush Maybe hoarse voice Maybe pain in shin, foot, and heel Sterility Spermatorrhea T: Red and dry C: None P: Thready and rapid
Treatment Principle	Nourish Yin Moisten the Lungs Reinforce the Kidneys
Herb Formulas	Bai He Gu Jin Tang Ba Xian Chang Shou Wan Yang Yin Qing Fei Tang + Da Bu Yin Wan Qiong Yu Gao
Points	HT-6, KI-3, KI-6, LU-6, LU-9, UB-13, UB-23

LUNG AND KIDNEY YIN DEFICIENCY WITH HEAT

Clinical Manifestations	Dry, weak, chronic cough with blood streaked sputum Wheezing Chest oppression and pain Expectoration of small amounts of thick, sticky sputum Dry mouth Dry, sore throat Dry, burning sensation on the skin Five Sole Heat Afternoon fever Low grade fever Night sweats Malar flush Irritability Insomnia Shortness of breath Nocturnal emission Steaming bones Vivid dreaming Fatigue Anorexia Tinnitus Dizziness Dyspnea Dysphoria Hoarseness Restlessness Emaciation Irregular menstruation Dry stools Low back pain T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Moisten the Lungs Transform Phlegm Stop Cough Clear Heat Nourish the Blood Stop bleeding
Herb Formulas	Bai He Gu Jin Tang Yang Yin Qing Fei Tang Ba Xian Chang Shou Wan + Da Bu Yin Wan With chest pain: Yue Hua Wan modified With mild Heat and Qi Deficiency: Zheng Yin Li Lao Tang With laryngitis or hoarseness: Mai Wei Di Huang Wan Chinese Patent Medicines: Yang Yin Qing Fei Tang Jiang Da Bu Yin Wan Mai Wei Di Huang Wan Li Fei Yun Nan Bai Yao (may be added to any of the above formulas)
Points	HT-6, KI-3, KI-6, LU-6, LU-9, UB-13, UB-23 KI-2, KI-3, KI-6, LU-6, LU-9, UB-13, UB-23 KI-3, LU-1, LU-5, LU-6, SP-6, UB-13 With palpitations: + PC-6 With Heart pain: + REN-17, UB-14 KI-2, KI-3, LU-1, LU-5, LU-9, UB-13, UB-23, UB-43 With severe hemoptysis: + LU-6 With severe Heat: + LU-10

LARGE INTESTINE HEAT

Clinical Manifestations	Dry stools Knotted constipation Mouth parched Sensation of burning heat, swelling and pain of anus Urine short and dark T: Pink C: Yellow and dry P: Slippery and rapid
Treatment Principle	Clear Heat Purge constipation
Herb Formulas	Liang Ge San
Points	LI-4, LI-11, SJ-6, ST-25, ST-37, ST-44, UB-25

SPLEEN QI DEFICEINCY WITH DAMPNESS

Clinical Manifestations	Coughing Nausea and vomiting Emaciation Sallow complexion Anorexia with a full feeling after very little food Weak abdomen Belching Abdominal distention or pain (subtle) Rolled lips Pale lips Stiff tongue Tired limbs Heavy limbs Chest fullness Acid regurgitation Epigastric distention or pain Muscle weakness in arms and legs Loose stools or diarrhea Maybe bleeding Thin muscles. Lethargy-fatigue Does not like to speak Weak, soft voice Maybe enuresis Maybe abundant clear urine Maybe cold extremities Maybe borborygmus T: Pale and flabby - may have teeth marks C: Thin and white. P: Weak and Deficient
Treatment Principle	Tonify Qi Strengthen the Spleen Harmonize the Stomach Regulate Qi Stop pain Stop coughing
Herb Formulas	Xiang Sha Liu Jun Zi Tang Chuan Si Jun Zi Tang
Points

STOMACH QI DEFICIENCY WITH TURBID PHLEGM OBSTRUCTION

Clinical Manifestations	Unremitting belching Unremitting Hiccup Unremitting regurgitation Unremitting nausea and vomiting of saliva and Phlegm Vomiting soon after eating Hard epigastric distention Abdominal firmness and distention Frequent salivation Frequent urination T: Normal C: White and Slippery or White and smooth P: Wiry and deficient or Wiry, taut and feeble
Treatment Principle	Descend Qi Transform Phlegm Augment Qi Harmonize the Stomach
Herb Formulas	Xuan Fu Dai Zhe Tang
Points

PHLEGM OBSTRUCTS THE HEART ORIFICE: YIN 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 Pale face with bluish lips Limbs cold, pale and still Lying peacefully Usual sequelae of C.V.A. such as: Hemiplegia Aphasia Facial paralysis T: Pink C: White and greasy P: Deep, slippery and even
Treatment Principle	Open the Heart Orifices with Pungent Warming Herbs Eliminate Phlegm Subdue Wind
Herb Formulas	Su He Xiang Wan Di Tan Tang
Points	Bleed the Jing-Well points of the Six Hand channels, needle DU-20, DU-26, KI-1, LIV-3, PC-5, ST-40, UB-20

LIVER FIRE SCORCHES THE LUNGS

Clinical Manifestations	Coughing fits with hemoptysis Burning pain in chest and sides Dizziness Face and eyes red Bitter taste in mouth Dry lips Short-tempered Irascibility Restlessness Maybe dark urine Maybe constipation T: Red C: Thin, yellow and dry P: Wiry and rapid
Treatment Principle	Clear Liver Fire Purge the Lungs
Herb Formulas	Xie Bai San Dai Ge San Da Bu Yin Wan Ke Xue Fang
Points	LIV-2, LU-5, LU-6, LU-10, PC-6, UB-13, UB-18

KIDNEYS UNABLE TO GRASP QI

Clinical Manifestations	Dyspnea which is worse on exertion Difficult to inhale but not to exhale Shortness of breath, shallow breathing Soft voice Perspiration In chronic cases: Thin physique Mental weariness Urinary incontinence on coughing Cold limbs Facial edema of Deficiency type T: Pale and swollen C: Thin and white P: Superficial and Deficient or Deep and thready
Treatment Principle	Reinforce the Kidneys to Grasp Qi
Herb Formulas	Ren Shen Ge Jie San Hei Xi Dan Chinese Patent Medicines: Ren Shen Bao Fei Wan
Points	DU-4, KI-3, LU-9, REN-6, ST-36, UB-13, UB-23, UB-43

YIN AND YANG DEFICIENCY

Clinical Manifestations	Abdominal pain Irritability Slight chills Spasms of the calf muscles Cramps in the hands Weak legs Hypertonicity of the extremities characterized by difficult flexion and extension Wheezing Coughing Hiccup Constipation Vomiting Diarrhea Sciatic pain Severe and painful muscle spasms in the Stomach, bronchi, Gallbladder and uterus. Intestines Shoulder pain Pain in the head, body or limbs due to arterial spasms characterized by a severe pulling pain T: Normal or Reddish C: None or Yellowish P: Wiry and rapid or Thready and rapid
Treatment Principle	Soften the Liver Nourish the Blood Nourish Yin Relieve pain Harmonize the Middle Jiao Replenish Body Fluids
Herb Formulas	Shao Yao Gan Cao Tang
Points

UPPER AND MIDDLE JIAO FIRE

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