CHRONIC FATIGUE SYNDROME (CFIDS, POST-VIRAL FATIGUE SYNDROME)

GENERAL

Clinical Manifestations	Chronic Fatigue Syndrome is a chronic disease characterized by: Disabling fatigue Exhaustion Muscle pain Headaches Joint pain Confusion Poor concentration Poor memory Insomnia Light-headedness Dizziness Blurred vision Eye pain Light sensitivity Gastrointestinal disturbances Abdominal pain Depression Fever Chills Night sweats A recurrent sore throat Lymph node tenderness Skin rashes Neurological complaints It frequently follows a viral infection It can occur as a sequela to: Otitis media Hepatitis Glandular fever Acute Stage: Continuous or repeated flu-like symptoms Pharyngalgia Blocked or runny nose Chills Swollen glands Nausea Vomiting Diarrhea Cough Genera; fatigue Lack of energy Exhaustion Weariness Lack of expression Memory loss Lack of concentration Reduced capacity for work Insomnia dizziness Nervousness General migratory soreness and pain in the: Muscles Neck Head Body Stomach Costal and hypochondriac regions Abdomen Chronic Stage: The acute symptoms may recur occasionally General exhaustion Fatigue Insomnia Drowsiness Forgetfulness Reduced or lost capacity for work Easily infected by pathogenic factors Aching or pain in the muscles (worse with Dampness)
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EXTERNAL WIND-COLD INVASION WITH QI DEFICIENCY

Clinical Manifestations	Mild chills and fever Headache Sweating Nasal obstruction Coughing with white or clear mucus Recurrent mild sore throat Swollen cervical lymph nodes Fatigue Lethargy Weakness A Low voice Reluctance to speak Shortness of breath All symptoms worse with exertion The cold tends to linger or is recurrent T: Pale C: White P: Floating and weak
Treatment Principle	Clear the Exterior Support Qi
Herb Formulas	Shen Su Yin For frequent colds and flu, difficulty recovering from External invasion and Mild Exterior symptoms when fatigued: Yu Ping Feng San Chinese Patent Medicines: Shen Su Yin Yu Ping Feng San
Points	GB-20, LI-4, LU-7, REN-4, ST-36, UB-12 In between colds: DU-14, ST-36

SHAO YANG JING

Clinical Manifestations	Acute onset of a severe, swollen throat Alternating chills and fever Alternating sweating and anhidrosis Restlessness Irritability Anorexia Fatigue Muscle aches Lack of strength Anorexia Nausea Occasional vomiting Headaches (side of head) Hypochondriac pain Rib pain Achiness Ear infection Hearing difficulty Red eyes Stiff shoulders Throat pain Hip pain T: Normal with bumps or dots on side or Pale and fat with teethmarks C: Thin white or yellow P: Wiry and slightly rapid
Treatment Principle	Harmonize the Liver and Gall Bladder
Herb Formulas	Xiao Chai Hu Tang modified
Points	DU-14, LI-4, ST-36, UB-12 With marked swelling of the lymph nodes: + SJ-13, ST-12 With Blood Deficiency or the patient catches colds during menstruation: + SP-6 With nasal congestion: + Yintang With marked muscle or joint pain: + LI-11, SP-9 With high fever and thirst: + LI-11, SJ-5 GB-41, SJ-5 To harmonize the Liver and Gall Bladder: GB-34, LIV-3, LIV-14, SJ-5 To stop nausea and vomiting: PC-6, SP-4, ST-36 To treat headache: GB-1, GB-8, GB-14, Taiyang To treat constipation: SJ-6, ST-25 To treat fever: DU-13, DU-14 To support the San Jiao and Regulate Yin: PC-5, PC-6 To support Yin: KI-7 To support the Ying: SP-10 Head: GB-8, SJ-20, Yintang Eyes: GB-14, GB-20, ST-1, UB-1, UB-2 Ear: GB-2, SJ-5, SJ-17, SJ-21 Hypochondriac area: GB-34, GB-40 Ear: Shenmen, Gall Bladder, Point 0

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	Yin Qiao San
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

SUMMERHEAT WITH DAMPNESS

Clinical Manifestations	Fever and chills, fever more pronounced or Tidal fever Abdominal distention Thirst Sweat Stifling sensation in the chest Restlessness Gastric disturbances: Heaviness Nausea Severe diarrhea Scanty urine T: Red tip and edges C: Greasy white or yellow P: Rapid and soft
Treatment Principle	Disperse Wind Clear Heat Resolve Damp
Herb Formulas	Xing Ren Hua Shi Tang Yin Qiao San modified Qing Xu Yi Qi Tang Superimposed with Wind-Cold: Xin Jia Xiang Ru Yin
Points	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

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	Sheng Mai Yin 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

COLD-DAMPNESS DISTRESSES THE SPLEEN

Clinical Manifestations	Distention and fullness of chest, epigastrium and abdomen Nausea Acid reflux Vomiting Anorexia Loose stools Diarrhea Reduced sensation of taste No thirst or preference for hot drinks Sticky sensation in mouth Borborygmus Dizziness Heavy, tired extremities Lassitude Somnolence particularly after eating Maybe insomnia at night Variable fatigue, may feel better for activity and exertion Yin jaundice Heavy head Difficulty concentrating Maybe edema Maybe copious white vaginal discharge Maybe cold limbs, fear of Cold or feeling chilled T: Pink and swollen C: Thick, white and greasy or sticky P: Deep and slow or Soft or Slippery
Treatment Principle	Warm Cold Transform Dampness Harmonize the Stomach Strengthen the Spleen
Herb Formulas	Ping Wei San modified Wei Ling Tang Chinese Patent Medicines: Er Chen Wan Xiang Sha Liu Jun Zi Wan
Points	Moxa or moxa needle REN-6, REN-12, SP-6, SP-9, ST-36, UB-20 DU-20, GB-20, KI-6, REN-12, SP-3, SP-6, SP-9, ST-36, ST-40, UB-62 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

SPLEEN QI DEFICIENCY

Clinical Manifestations	Sallow or pale complexion Fatigue Lack of vitality Anorexia Picky eating Chronic sore throat which is worse in the morning and when tired the throat is slightly red or pale and swollen with a possible sheen or mucus Frequent or continual swollen glands in the neck Frequent colds and upper respiratory tract infections Runny nose Puffy eyes Mild edema Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation Nausea Vomiting Loose stools or Diarrhea Shortness of breath T: Pale and flabby - may have teethmarks C: White P: Even, forceless and deficient
Treatment Principle	Strengthen the Spleen Benefit Qi Dry Dampness
Herb Formulas	Si Jun Zi Tang Shen Ling Bai Zhu San modified Chinese Patent Medicines: Shen Ling Bai Zhu Wan Ren Shen Jian Pi Wan Fu Zi Li Zhong Wan
Points	LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20 For a sore throat: LI-11, LU-9, REN-12, ST-36, UB-13, UB-20 With Phlegm: + ST-40 With frequent colds: + DU-14

SPLEEN QI AND BLOOD DEFICIENCY

Clinical Manifestations	Sallow, pale complexion Mental and physical fatigue Daytime drowsiness and a desire for sleep worse with exertion and after meals May be Blood deficient insomnia at night Anorexia Nausea Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath T: Pale and flabby - may have teethmarks C: White P: Even, forceless and Deficient or Deficient and weak
Treatment Principle	Strengthen the Spleen Benefit Qi Dry Dampness if necessary
Herb Formulas	Xiang Sha Liu Jun Zi Tang modified Ren Shen Yang Rong Tang Shi Quan Da Bu Tang With Spleen Qi Sinking: Bu Zhong Yi Qi Tang Chinese Patent Medicines: Bu Zhong Yi Qi Wan Ba Zhen Wan Ren Shen Yang Ying Tang
Points	DU-20, KI-6, REN-12, Sishencong, SP-3, SP-6, ST-36, ST-40, UB-62 LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

CENTRAL QI SINKING

Clinical Manifestations	Prolapse of one or more organs Sallow complexion Anorexia Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath T: Pale and flabby - may have teethmarks C: White P: Even or Soft and thready
Treatment Principle	Strengthen the Spleen Benefit Qi Reinforce the Center Invigorate Yang
Herb Formulas	Bu Zhong Yi Qi Tang
Points	DU-20, other points are selected according to the type of prolapse

SPLEEN QI AND HEART BLOOD DEFICIENCY

Clinical Manifestations	Palpitations Insomnia Much dreaming Easily startled Poor memory Panic attacks Anxiety Nervousness Fatigue Low spirits Four limbs tired and lethargic Loss of appetite Distention and fullness of the epigastrium and abdomen Loose stools Sallow or pale, lusterless complexion Copious, pale menses Uterine bleeding or Light menstrual flow or Amenorrhea Inability to get or maintain an erection Impotence, worse with fatigue Clammy palms T: Pale C: White P: Thready and weak
Treatment Principle	Reinforce and Benefit the Heart and Spleen
Herb Formulas	Gui Pi Tang modified
Points	HT-7, REN-4, SP-1, SP-6, ST-36, UB-15, UB-20 DU-19, DU-24, HT-7, REN-4, REN-6, ST-36, UB-15, UB-20, UB-23, Yintang With insomnia: + Anmian With abdominal distention: + ST-25

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Severe fatigue Constant drowsiness and a desire to sleep Sleeps curled up Apathy A soft voice Reluctance to speak Forgetfulness Low back pain Sore throat Headache Muscle aches Depression Lymphadenopathy Sinus pain Vertigo Low libido Impotence Digestive weakness Cold intolerance Cold extremities All symptoms are worse with stress T: Pale or Bluish and swollen C: White or Thin an moist P: Weak and thready or Deep, thready and weak
Treatment Principle	Strengthen the Spleen Tonify the Kidneys Warm Yang
Herb Formulas	Bu Zhong Yi Qi Tang + Ba Wei Di Huang Wan With Spleen Yang Deficiency prominent: Fu Zi Li Zhong Tang With Kidney Yang Deficiency prominent: Ba Wei Di Huang Wan With Water Flooding: Zhen Wu Tang With Liver Qi Stagnation or herpes: + Yin Qiao San + Xiao Yao San Chinese Patent Medicines: Fu Zi Li Zhong Wan Ba Wei Di Huang Wan
Points	LI-4, REN-6, SP-6, St-36, Ear: Spleen, moxa REN-12 With Liver Qi Stagnation: + LIV-2, LIV-3, Ear: Shenmen Moxa or moxa needle DU-4, DU-20, KI-3, KI-6, UB-20, UB-23, UB-52, UB-62

HEART QI AND BLOOD DEFICIENCY WITH LIVER QI STAGNATION

Clinical Manifestations	A long period of extreme fatigue Depression Impaired memory Insomnia Sighing Shortness of breath A faint, weak voice Disinclination to speak Palpitations Anorexia A lack of strength Flabby muscles Possible joint soreness and pain T: Pale red and fat C: White P: Thready and wiry
Treatment Principle	Supplement Heart Qi and Blood Strengthen the Spleen Tonify Qi Regulate Liver Qi Resolve depression Calm the Shen
Herb Formulas	Bu Gan Yi Qi Tang
Points	HT-7, LIV-3, REN-17, SP-6, ST-36, UB-15 For marked Liver Qi Stagnation: + LI-4 For flank distention: + LIV-13, LIV-14 For Heat in the Heart: + PC-7 For Liver Yang Rising: + - LIV-3, + LIV-2 For Stomach Heat : + ST-44 For palpitations: + PC-5, PC-6 For night sweats: + HT-6 For loose stools or diarrhea due to Spleen Qi Deficiency : + UB-20, UB-21 For muscle and/or joint pain: + GB-34, UB-17, local AhShi points For accompanying Kidney Yang Deficiency: + moxa or moxa-needle DU-4, UB-23

LIVER QI STAGNATION: PHLEGM AND QI STAGNANT AND BLOCKED

Clinical Manifestations	Feeling of obstruction in throat as if a slice of roast meat were stuck there which cannot be coughed up nor swallowed down. This sensation becomes more prominent during emotional upset and subsides when relaxed 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: Thin and white P: Slippery and wiry (slippery due to Phlegm)
Treatment Principle	Spread Qi Resolve Phlegm
Herb Formulas	Ban Xia Hou Po Tang
Points	LI-18, LIV-3, PC-5, SI-17, SJ-6

LIVER QI STAGNATION INVADES 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 Women: 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	Xiao Yao San Hei Xiao Yao San Si Ni San
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

LIVER QI STAGNATION INVADES THE STOMACH

Clinical Manifestations	Epigastric pain (worse when emotionally upset) Belching with acid regurgitation Nausea Vomiting Anorexia Epigastric distention 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: Thin and white P: Wiry
Treatment Principle	Soothe the Liver Harmonize the Stomach
Herb Formulas	Xiao Yao San Hei Xiao Yao San
Points	LIV-3, LIV-14, PC-6, REN-12

LIVER QI STAGNATION WITH BLOOD DEFICIENCY

Clinical Manifestations	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 Rib pain Anxiety 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 T: Pink C: Thin white or yellow P: Wiry and Deficient or Wiry, tight and Deficient
Treatment Principle	Soothe the Liver Nourish the Blood
Herb Formulas	Xiao Yao San Hei Xiao Yao San Generating Heat: Jian Wei Xiao Yao San
Points

LIVER YIN AND BLOOD DEFICIENCY

Clinical Manifestations	Headache Dizziness Tinnitus Dry eyes Photophobia Blurred vision Irritability Numbness Bad temper Muscle twitches Malar flush T: Pale or Red and dry C: Little P: Thready and rapid or Thready wiry and rapid or Wiry
Treatment Principle	Tonify and Regulate Blood Nourish Liver Yin
Herb Formulas	Bu Gan Tang
Points

KIDNEY YIN DEFICIENCY

Clinical Manifestations	Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of low back Spermatorrhea or premature ejaculation Aching in bones Aching in leg and heel T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Reinforce the Kidneys
Herb Formulas	Liu Wei Di Huang Wan modified For Yin and Blood Deficiency: Si Wu Tang modified For Qi and Yin Deficiency: Si Jun Zi Tang modified Chinese Patent Medicines: Liu Wei Di Huang Wan Zhi Bai Di Huang Wan Mai Wei Di Huang Wan Li Fu Yang Yin Qing Fei Tang Jiang Qing Yin Wan Jin Gui Shen Qi Wan
Points	KI-1, KI-3, KI-6, REN-4, SP-6, UB-23 For a sore throat: Bailao, KI-3, KI-6, LI-4, LI-11, LI-18, LU- 7, LU-9, LU-10, ST-6, ST-36, UB-13, UB-23

KIDNEY YANG DEFICIENCY

Clinical Manifestations	Lumbago: low back feels cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Pale face Urinary frequency with abundant, clear urine or Oliguria with edema Maybe nocturia Lassitude Withdrawn, subdued behavior Knees feel cold and aching Dizziness Tinnitus Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow
Treatment Principle	Warm and Reinforce Kidney Yang
Herb Formulas	Jin Gui Shen Qi Wan (Ba Wei Di Huang Wan)
Points	Moxa or moxa needle DU-4, KI-3, REN-4, UB-23 For chronic diarrhea, rectal prolapse and Vanquished Yang: + moxa DU-20, REN-8 For Kidney Yang Deficiency impotence: moxa or moxa needle DU-4, DU-20, KI-3, REN-4, UB-23 For Kidney Yang Deficiency (Cock Crow) Diarrhea: moxa or moxa needle DU-20, KI-3, REN-4, UB-23

YIN DEFICIENCY WITH DAMPNESS

Clinical Manifestations	Epigastric distress A dry mouth A dull complexion Weight loss Afternoon or evening tidal fever Irritability Insomnia T: Deep red C: Scanty and white P: Thready
Treatment Principle	Tonify Yin Eliminate Dampness
Herb Formulas	Shen Ling Bai Zhu San Liu Wei Di Huang Wan For a stronger effect: Shen Ling Bai Zhu San + Liu Wei Di Huang Wan
Points

YANG DEFICIENCY WITH DAMPNESS

Clinical Manifestations	Lack of energy Fatigue Heaviness of the whole body Edema in the lower legs Thin Leukorrhea T: Pale and fat with teethmarks C: White P: Weak and thready
Treatment Principle	Warm Yang Purge water
Herb Formulas	Zhen Wu Tang modified You Gui Wan modified
Points

QI DEFICIENCY WITH DAMPNESS

Clinical Manifestations	A bloated sensation with pain in the Stomach Abdominal distention Borborygmus A poor appetite Loose stools Lack of energy Drowsiness Shortness of breath Disinclination to speak A pale complexion A puffy face T: Pale C: White P: Thready and slippery
Treatment Principle	Reinforce Qi Dry or drain Dampness
Herb Formulas	Xiang Sha Liu Jun Zi Tang modified
Points

QI AND YIN DEFICIENCY WITH EMPTY FIRE RISING AND LIVER QI STAGNATION

Clinical Manifestations	Chronic extreme fatigue especially after eating Shortly spaced intermittent episodes Recurrent low-grade fever Abdominal bloating after eating Loose stools or Constipation Cold extremities Lack of strength in the four extremities Dizziness when standing up Easily bruised Catches cold easily Night sweats Hot flashes Five Sole Heat Tinnitus Thirst or A dry mouth Little or no desire to drink A recurrent, dry, sore throat especially in the evening or upon waking Malar or auricular flushing in the afternoon or early evening Stiffness of the sinews Numbness or tingling of the extremities Early morning insomnia Premenstrual lower abdominal distention Lower abdominal cramping Premenstrual breast distention and pain Irritability Depression T: Swollen with teethmarks or Pale red or Pale with a red tip C: White or Little or P: Thready and soft or Thready and rapid or Floating and surging or Wiry
Treatment Principle	Supplement Deficiency Regulate the Liver Tonify Qi
Herb Formulas	Bu Zhong Yi Qi Tang modified
Points	DU-14, KI-7, LI-4, PC-5, ST-36 With severe fatigue: + UB-20, UB-21 With marked Liver Stagnation: + LIV-3 With marked Liver and Kidney Yin Deficiency: + UB-18, UB-23 With abdominal bloating after eating: + SP-3, SP-9 With night sweats, hot flashes and Five Sole Heat: + HT-6 With a recurrent, dry, sore throat in the evening: + KI-6, LU-7 With stiffness of the sinews and tingling and numbness of the extremities: + SJ-5, UB-57 With early morning insomnia: + DU-24, HT-7 With premenstrual and menstrual lower abdominal distention and cramping, breast distention and pain, irritability and depression: - KI-7 + LIV-5, SP-6, ST-29

QI, BLOOD AND YANG DEFICIENCY

Clinical Manifestations	Anemia Uterine bleeding Cold extremities Pale or sallow face Dizziness General fatigue Coarse skin Nocturnal emissions Weak knees Fatigue Dyspnea Night sweats Irregular menstruation Insomnia Intolerance of Cold Decreased eyesight after a prolonged illness Anxiety Intermittent fever Jaundice Deficient cough Shortness of breath Palpitations Anorexia Listlessness Lassitude Spontaneous sweating Spermatorrhea Continuous spotting Leukorrhea Weak legs and knees T: Pale C: Thin and white P: Thready and weak
Treatment Principle	Replenish Yang Warm and tonify Qi and Blood
Herb Formulas	Shi Quan Da Bu Tang Ren Shen Yang Rong Tang
Points

DAMP-HEAT IN THE SAN JIAO

Clinical Manifestations	A poor appetite Fullness and distention in the abdomen Loose stools or Diarrhea or Constipation Nausea Aching, heaviness and stiffness in the limbs and back A weary feeling in the whole body Lack of energy Scanty urine Leukorrhea A dull, blank complexion Dull responses T: Red C: Yellow and greasy P: Slippery
Treatment Principle	Expel Heat Drain Dampness Clear the water passages of the San Jiao
Herb Formulas	Chang Pu Yu Jin Tang Jia Wei modified
Points

TOXIC HEAT IN THE SAN JIAO

Clinical Manifestations	High fever Irritability Fidgeting Dry mouth 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
Herb Formulas	Huang Lian Jie Du Tang
Points

UPPER JIAO DAMP-HEAT (ACUTE)

Clinical Manifestations	A dry, sore throat Turbid nasal discharge Tinnitus Headache Pain in the: Shoulders Neck Back T: Light red C: Thin, yellow and greasy P: Soft
Treatment Principle	Clear Lung Heat Resolve Exterior Dampness
Herb Formulas	Huo Po Xia Ling Tang modified Yin Qiao San modified
Points

MIDDLE JIAO DAMP-HEAT (ACUTE)

Clinical Manifestations	A dry, sore throat Turbid nasal discharge Tinnitus Headache Pain in the: Shoulders Neck Back T: Light red C: Thin, yellow and greasy P: Soft
Treatment Principle	Clear Lung Heat Resolve Exterior Dampness
Herb Formulas	Huo Po Xia Ling Tang modified Yin Qiao San modified Ban Xia Xie Xin Tang
Points

DAMPNESS ACCUMULATION IN THE INTERIOR

Clinical Manifestations	Whole body soreness and stiffness Vague aches and pains Drowsiness Insomnia Poor memory Blurred vision Dizziness Loose stools Leukorrhea T: Pale red C: Greasy and white P: Slippery
Treatment Principle	Drain Dampness Regulate Qi
Herb Formulas	San Ren Tang
Points

COLD-DAMP IN THE INTERIOR

Clinical Manifestations	Blurred vision Dizziness A feeling of distention and pain in the Stomach Cold limbs Loose stools or Diarrhea A cold sensation in the lower abdomen Soreness and aching of the whole body Lack of energy Fatigue Drowsiness Insomnia A poor memory T: Pale C: White P: Slow and slippery
Treatment Principle	Warm Cold Dispel Dampness
Herb Formulas	Ling Gui Zhu Gan Tang modified
Points

DAMP-HEAT IN THE INTERIOR WITH HEAT PREDOMINANT

Clinical Manifestations	Not much Dampness Pain and heaviness in the head and body irritability Insomnia Tinnitus Bitter taste and smell in the mouth Fullness and distention of the chest Constipation Hiccups Frequent sighing Fullness and pain in the hypochondria region, chest and back A dry, gritty sensation in the eyes T: Red C: Yellow and greasy P: Wiry and Rapid
Treatment Principle	Clear Heat Dry Dampness
Herb Formulas	Long Dan Xie Gan Tang Shao Yao Tang
Points

PHLEGM OBSTRUCTION

Clinical Manifestations	Chronic and continuous somnolence Heavy sleep Difficult to rouse Tendency toward obesity Glossy or greasy skin Foggy headedness (like the head being wrapped in a damp towel) Poor concentration Dizziness Heavy and tired limbs Fullness and distention or a feeling of blockage in the chest and epigastrium T: Flabby C: Thick and greasy P: Slippery
Treatment Principle	Transform Phlegm Open the channels to the head
Herb Formulas	Di Tan Tang modified Chinese Patent Medicines: Er Chen Wan Xiang Sha Liu Jun Zi Wan
Points	DU-20, GB-20, KI-6, LIV-3, REN-12, SP-3, SP-6, SP-9, ST-25, ST-36, ST-40, UB-20, UB-62

CHRONIC FATIGUE SYNDROME (CFIDS, POST-VIRAL FATIGUE SYNDROME)

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