GASTROENTERITIS

GENERAL

Clinical Manifestations
Treatment Principle
Herb Formulas	With infection: Chai Hu Shu Gan Tang With weakness and infection: Chai Hu Gui Zhi Tang
Points	Acute: PC-3, bleed UB-40 Acute or chronic: PC-6, SP-4

WIND-COLD WITH QI STAGNATION IN THE INTERIOR (ACUTE)

Clinical Manifestations	Aversion to Cold Fever Headache Anhidrosis Anorexia Belching Aching shoulders Tinnitus Amenorrhea A gasping cough Focal distention in the chest and epigastrium A stifling sensation in the chest and epigastrium Vertigo Nausea T: Normal C: Thin and white P: Floating or Floating and sinking
Treatment Principle	Regulate Qi Release the Exterior
Herb Formulas	Xiang Su San
Points

WIND-COLD WITH INTERNAL COLD (ACUTE)

Clinical Manifestations	Fever and chills without sweat Headache Body aches Stiff neck and back Abdominal pain and Cold Diarrhea with borborygmus A sensation of fullness in the chest and abdomen May be Cold in the lower body with Heat in the upper body Aching at the waist Anhidrosis Loose stools Sciatica Nausea Abdominal distention Borborygmus An aversion to food Vomiting Women: Cold-type epigastric and abdominal pain Menstrual irregularity Dysmenorrhea T: Normal C: White and greasy P: Deep and wiry or Superficial and slow
Treatment Principle	Release the Exterior Warm the Interior Smooth the flow of Qi Transform Phlegm Invigorate the Blood Reduce Accumulations Regulate Qi and Blood
Herb Formulas	Wu Ji San
Points

WIND-COLD WITH INTERNAL DAMPNESS (ACUTE)

Clinical Manifestations	Fever and chills Headache Chest and gastric fullness and oppression Pain in the epigastrium and abdomen Nausea and vomiting Borborygmus Diarrhea Loss of taste Aversion to Cold Cough Indigestion No perspiration Chest discomfort Sore throat Disorientation Madness General lassitude Anorexia Delirious speech Maybe loss of voice Intermittent chills and fever Afternoon fever and tight Sudden turmoil disorder Malarial disorders Loose stools T: Normal C: Greasy and white P: Moderate and soggy or floating and forceful
Treatment Principle	Release the Exterior Transform Dampness Regulate Qi Harmonize the Middle Jiao
Herb Formulas	Huo Xiang Zheng Qi Tang
Points

TAI YANG BIAO FU

Clinical Manifestations	Chills and fever Achiness Stiff neck and shoulders Anhidrosis Headache Stabbing joint pain Itchy throat Cough Asthma Aversion to Cold Maybe frozen shoulder * The Tai Yang symptoms remain for 2-3 days Thirst with no desire to drink May have vomiting immediately after drinking Nausea with epigastric splash on palpation Difficult urination Dribbling urination or An interrupted urinary stream Scanty urination Urinary retention Edema May have upper body edema T: Normal C: White P: Floating and slippery
Treatment Principle	Promote urination Dispel Dampness Expel Wind Expel Cold fro the Tai yang Channels and Bladder
Herb Formulas	Wu Ling San With indigestion and diarrhea: Si Ling San With jaundice and dysuria: Yin Chen Wu Ling San
Points	Moxa or moxa needle KI-3, LI-4, LU-7, REN-3, SP-6, SP-9, UB-13, UB-28 KI-3, SJ-3, ST-28, UB-28, UB-39, UB-64, moxa REN-9 With indigestion and diarrhea: moxa ST-25, ST-36 With jaundice and dysuria: DU-9

TAI YANG - YANG MING WITH INTERIOR EXCESS

Clinical Manifestations	Abdominal fullness Fever Tenesmus Constipation Vomiting P: Floating and rapid
Treatment Principle	Expel Wind from the Exterior and muscle layer Regulate Qi Promote defecation
Herb Formulas	Hou Po Qing Wu Tang
Points

TAI YANG - 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

YANG MING HAN

Clinical Manifestations	History of Yang Ming Jing or Fu No appetite Perspiration on extremities (cold center) Sluggish or difficult urination Constipation moving to long stringy stools moving to diarrhea T: Normal C: Slightly yellow and moist P: Deep and forceful
Treatment Principle	Restore Yang Warm the center
Herb Formulas	Si Ni Tang
Points	Moxa needle REN-4, REN-6, REN-12, ST-25, ST-36

YANG MING DAMP-HEAT

Clinical Manifestations	High fever Great thirst Anhidrosis Abdominal pain Irritability Restlessness Feverish body parts Red face No constipation No aversion to Cold Scanty urine Jaundice A greasy light colored stool A bitter taste in the mouth T: Red C: Greasy and yellow P: Slippery, wiry and forceful
Treatment Principle	Clear Heat Remove Dampness Regulate Qi flow of the Liver and Gall Bladder to remove jaundice
Herb Formulas	Ge Gen Huang Qin Huang Lian Tang Chinese Patent Medicines: Chuan Xie Lian Kang Yan Pian Yu Dai Wan Huang Lian Su Pian Jia Wei Xiang Lian Pian
Points	DU-9, GB-34, LI-4, LI-11, LIV-3, SJ-6, SP-6, SP-9, ST-25, ST-37, ST-45, UB-19, UB-25 LI-4, LI-11, ST-25, ST-37, ST-44, Zhixie

SHAO YANG JING WITH QI STAGNATION

Clinical Manifestations	Alternating chills and fever Headache in the lateral aspect of the forehead Diminished hearing Vertigo Fullness in the chest and hypochondrium Chest pain Dizziness Hypoacusis Pain of the hypochondrium Parietal headache T: Normal C: White P: R: Wiry and slippery, L: Wiry, floating and large
Treatment Principle	Harmonize and release the Shao Yang Promote the smooth flow of Qi in the chest and diaphragm
Herb Formulas	Chai Hu Zhi Jie Tang
Points	LIV-13, REN-12, ST-25, SP-3, SP-5, SP-15, ST-40 With Spleen Deficiency: + ST-36 With Fluid retention and edema: + ST-28 With sluggish stools or constipation: + SJ-6, ST-37, ST-41 With plum-pit Qi Stagnation: + PC-5 With foggy-headedness: + LIV-3, PC-6 With Wind-Phlegm: + GB-40, ST-8, ST-41 With Cold-Phlegm: + moxa UB-20, UB-21 With muscle aches and heaviness: + SP-21 With somnolence: + KI-6, UB-62

SHAO YANG JING WITH WATER ACCUMULATION

Clinical Manifestations	Alternating chills and fever Thirst A bitter taste in the mouth Anorexia Edema Vomiting and diarrhea with water intake Dysuria Fullness and oppression in the chest and hypochondrium Diarrhea T: Pink C: White P: Superficial and wiry
Treatment Principle	Harmonize the Exterior and the Interior Relieve the Shao Yang Dispel Water Accumulation Resolve Phlegm Accumulation
Herb Formulas	Chai Ling Tang
Points

SHAO YANG FU

Clinical Manifestations	Alternating chills and fever (not so likely) Restlessness Irritability Continuous vomiting Headache (side of head) Hypochondriac pain Epigastric pain Bitter taste in mouth Digestive disruption Anorexia Nausea Acid regurgitation Burning diarrhea or Constipation Menstrual problems Dry throat Heart pain with vomiting Throat pain Hip pain T: Red C: Thin yellow P: Wiry, forceful
Treatment Principle	Harmonize the Liver and Gall Bladder Purge Internal Heat
Herb Formulas	Da Chai Hu Tang
Points	To harmonize the Liver and Gall Bladder: GB-34, LIV-3, LIV-14, SJ-5 For nausea and vomiting: PC-6, SP-4, ST-36 For headache: GB-1, GB-8, GB-14, Taiyang For constipation: SJ-6, ST-25 For fever: DU-13, DU-14 For Stomach Heat: LI-4, LI-11, ST-44 To support the San Jiao and Regulate Yin: PC-5, PC-6 To support Yin: KI-7 To support the Ying: GB-41, SJ-5 , SP-10 To regulate menstruation: SP-6 For Shao Yang Fu with Tai Yang: For the Shao Yang: GB-34, LIV-3, LIV-14, SJ-6 For the Tai Yang: GB-20, UB-12 For Shao Yang Fu with underlying Liver Qi Stagnation: To harmonize the Shao Yang: GB-34, LIV-3, SJ-6 To clear Heat: LI-11, ST-44 To calm the Shen: HT-7, PC-6 Ear: Shenmen, Liver, Gall Bladder, bleed Heat points

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 Intolerance of Cold Abdominal fullness and distention Cannot purge easily due to lack of Qi Dysentery Cold extremities Hernia T: Normal C: Greasy and white or Greasy and yellow P: Deep, tight and wiry or Wiry and rapid or Rolling and forceful or Tight and wiry
Treatment Principle	Warm and Purge Cold retention 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	Moxa or moxa needle GB-41, REN-6, REN-8, REN-12, SJ-5, SJ-6, ST-25, ST-36 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 GB-39, LI-4, PC-4, PC-8, REN-12, SJ-5, SP-4, ST-25, ST-44, ST-45 With epigastric pain: + ST-21, ST-34 With nausea: + PC-6 With constipation: + ST-25, ST-37 With Yin Deficiency: + UB-21 , UB-23 Ear: Stomach, Duodenum, Abdomen, Shenmen, Sympathetic

TAI YIN EXCESS

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

TAI YIN DEFICIENCY

Clinical Manifestations	Clear, frequent urination Abdominal distension Anorexia Nausea Vomiting clear fluid Dull abdominal pain Diarrhea or loose stools Prefers warmth and pressure T: Pale C: White P: Slow and sinking or Soft and weak
Treatment Principle	Regulate the Middle Warm the Middle Jiao Disperse Cold
Herb Formulas	Li Zhong Tang With Excess Cold: Fu Zi Li Zhong Tang With a need to purge: Fu Gui Li Zhong Tang
Points	For pain and Cold: moxa the abdomen To strengthen the Spleen and Stomach: LIV-13, REN-10, ST-36, UB-20, UB-21 (moxa if severe) For abdominal pain and nausea: PC-6, SP-4, ST-25 For frequent, clear urination: moxa REN-4, REN-6, UB-23 For diarrhea: moxa REN-8 Use few needles with deep insertion and moxa

SHAO YIN COLD

Clinical Manifestations	Aversion to Cold Curls up a lot Doesn't like to talk Tired (disoriented) No spirit Dull Shen Cold extremities Diarrhea or loose stools or undigested food Clear, frequent urine Maybe nausea (wants to vomit but can't) No thirst Likes warm drinks Severe edema in chest T: Pale C: White P: Sinking and weak
Treatment Principle	Restore Yang Reverse inward energy Expel Cold
Herb Formulas	Si Ni Tang If Cold is less severe: Wu Zhu Yu Tang
Points	Moxa DU-4, DU-20, KI-3, KI-7, LI-4, REN-4, REN-6, REN-8, SP-6, ST-36. UB-15, UB23 For loss of consciousness or shock: DU-26, KI-1

SHAO YIN HEAT

Clinical Manifestations	Dry throat and/or mouth Chronic sore throat (not acute) Restlessness Malar flush Insomnia Disturbed speech Low grade fever, worse in afternoon Yellow urine Irritability with a sensation of Heat in the chest Palpitations with anxiety Sores in the mouth or on the tongue More Heat than in Yin Deficiency (chronic low grade fever) T: Red, deep red C: None P: Deep, thready and rapid
Treatment Principle	Nourish Yin Reduce Heat
Herb Formulas	Zhu Ling Tang
Points	DU-14, HT-5, HT-7, KI-3, KI-6, KI-7, LIV-3, SP-6, UB-10, UB-15, UB-23

JUE YIN COLD

Clinical Manifestations	Vomits clear fluid Vertex headache Body cold Diarrhea Complete exhaustion of Yang T: Pale C: White P: Weak.
Treatment Principle	Warm Yang especially in the Liver and Stomach Descend turbidity
Herb Formulas	Da Jian Zhong Tang Wu Zhu Yu Tang
Points	Moxa REN-4, REN-6, REN-8, REN-9, REN-12, ST-25 DU-20, LIV-3, PC-6, REN-12, ST-36

JUE YIN COLD AND HEAT

Clinical Manifestations	Delirium Heat in upper body Cold in lower body Sensation of Qi rushing to the chest Vomits worms Persistent thirst Feverishness Anorexia (hungry but can't eat) Chronic diarrhea Cold extremities Maybe edema Vertex headache Vomits food Cardiac Heat with pain T: Red or pink or pale and flabby C: Thick and greasy or thin P: Deep, thready and weak or wiry
Treatment Principle	Clear worms Clear Heat (Do not purge, create diaphoresis, or create emesis) Revive Yang
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

EXTREME YANG DEFICIENCY IN THE TAI YIN, SHAO YIN AND JUE YIN

Clinical Manifestations	Severe aversion to Cold Body curled up Icy cold extremities Vomiting Diarrhea Absence of thirst Abdominal pain Lack of energy A constant desire to sleep Shivering Foaming at the mouth Lips and nails purplish T: Pale C: White P: Deep and thready or Impalpable
Treatment Principle	Rescue Yang (emergency) Strengthen Qi Generate the pulse
Herb Formulas	Hui Yang Jiu Ji Tang
Points

WEI STAGE: SUMMERHEAT WITH DAMPNESS

Clinical Manifestations	Fever and chills, fever more pronounced or Tidal fever Fever is undiminished by sweating Abdominal distention Thirst Sweating, often oozy and sticky Stifling sensation in the chest Restlessness Wooly headedness like being wrapped in a wet towel Fatigue Lethargy Irritability Gastric disturbances: Heaviness Nausea Vomiting Severe diarrhea Scanty, concentrated urine Generally all symptoms are worse in the mid-afternoon T: Red tip and edges C: Greasy white or yellow P: Rapid and soft
Treatment Principle	Disperse Wind Clear Heat Resolve Damp
Herb Formulas	Chai Ling Tang Xing Ren Hua Shi Tang San Wu Xiang Ru Yin Lian Po Yin Liu Yi San With Cold complications: Huo Xiang Zheng Qi Tang Superimposed with Wind-Cold: Xin Jia Xiang Ru Yin modified With Exterior Cold and Interior Dampness: Xiang Ru San With Internal Stagnation of water and Dampness: Gui Ling Gan Lu Yin With Liver and Gall Bladder Heat: Bi Yu San Due to improper diet: Liu He Tang Qi Stage Summerheat with Dampness: San Shi Tang Chinese Patent Medicines: Huo Xiang Zheng Qi Pian Xing Jun San Liu Shen Shui Bao Ji Wan Shen Qu Cha
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 LI-4, LU-6, REN-12, SJ-6, SP-9, ST-36 With a high fever: + DU-14 With nausea: + PC-6 With diarrhea: + UB-25, Zhixie With myalgia: + SP-21 LI-4, LI-11, SP-9, ST-25, ST-37, UB-25, Zhixie With a high fever: + DU-14, SJ-5 With chills and an occipital headache: + DU-14, LI-4, UB-13 With myalgia: + SP-21 With foggy headedness: + DU-20, Yintang With sudden, sever diarrhea, fever and vomiting: + bleed PC-3, UB-40 Ear: Lungs, Large Intestine, Small Intestine,, Spleen, Abdomen, sympathetic

YING STAGE: PHLEGM-FIRE ENTERING THE PERICARDIUM (CHILDHOOD)

Clinical Manifestations	Fever Impaired consciousness Childhood convulsions Irritability Restlessness Wheezing Nausea Night crying Vomiting milk Diarrhea Abdominal pain Excessive secretion of mucus and saliva Sounds of mucus in the throat Fidgeting Delirium Dyspnea Coughing with sputum
Treatment Principle	Open the Sensory Orifices Arrest spasms and convulsions Clear Heat Transform Phlegm
Herb Formulas	Hui Chun Dan
Points

LARGE INTESTINE EXCESS HEAT (ACUTE)

Clinical Manifestations	Knotted constipation or Watery, thin diarrhea Burning hot sensation in the anus Abdominal distention and pain (dislikes pressure) High fever or infantile tidal fever Hands and feet dripping with perspiration Vomiting Irritating thirst Delirium T: Pink, maybe prickles or Red C: Thick, yellow and dry P: Deep and Excess
Treatment Principle	Clear Excess Heat with bitter, cold, strong purgative herbs
Herb Formulas	Tiao Wei Cheng Qi Tang Xiao Cheng Qi Tang
Points	LI-11, SJ-6, ST-25, ST-37, ST-44

LARGE INTESTINE DAMP-HEAT

Clinical Manifestations	Abdominal pain Tenesmus A burning sensation around the anus Leukorrhea with a reddish discharge Diarrhea containing more blood than pus Thirst with a desire to drink Maybe short, dark urination T: Red C: Yellow P: Wiry and rapid
Treatment Principle	Clear Heat Relieve toxicity Cool the Blood Alleviate dysenteric disorders
Herb Formulas	Bai Tou Weng Tang
Points

COLD-DAMP DISTRESSES THE SPLEEN

Clinical Manifestations	Distention and fullness of epigastrium and abdomen Nausea Vomiting Anorexia Loose stools Diarrhea Reduced sensation of taste No thirst or preference for hot drinks Sticky sensation in mouth Borborygmus Lassitude Yin jaundice Heavy head Maybe edema Maybe copious white vaginal discharge Maybe cold limbs, fear of Cold or feeling chilled T: Pink C: Thick, white and greasy or sticky P: Deep and slow
Treatment Principle	Warm Cold Transform Dampness Harmonize the Stomach Strengthen the Spleen
Herb Formulas	Ping Wei San Wei Ling Tang Yin Chen Si Ni Tang With Spleen Yang Deficiency: Li Zhong Tang Chinese Patent Medicines: Ping Wei San With Spleen Qi Deficiency: Xiang Sha Liu Ju Zi Wan With Spleen Yang Deficiency: Fu Zi Li Zhong Wan For recalcitrant cases: Xing Jun San
Points	Moxa or moxa needle REN-6, REN-12, SP-6, SP-9, ST-36, UB-20 SP-3, SP-6, SP-9, ST-25, ST-36, ST-37, UB-25, Zhixie With nausea: + PC-6 Ear: Large Intestine, Small Intestine, Spleen, Abdomen, Distal Segment Rectum, Sympathetic 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 INJURES THE SPLEEN

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 With Damp-Heat: Sheng Yang Yi Wei Tang
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

SPLEEN QI DEFICIENCY WITH DAMPNESS (CHRONIC)

Clinical Manifestations	Loose stools or watery diarrhea Weak extremities Weight loss Distention and a stifling sensation in chest and epigastrium Pale wan complexion Abdominal distention Indigestion Vomiting Fatigue Chills Maybe vomiting Leukorrhea Reduced appetite Borborygmus Edema Reduced appetite Diarrhea with onset of menstrual flow Cough with copious sputum Leukorrhea in obese women T: Pale or Pale red C: White - maybe greasy P: Thready and even or Even and Deficient
Treatment Principle	Augment Qi Strengthen the Spleen Resolve Dampness Stop diarrhea
Herb Formulas	Shen Ling Bai Zhu San With Damp-Heat: Sheng Yang Yi Wei Tang
Points

SPLEEN DEFICIENCY EDEMA

Clinical Manifestations	Edema in limbs, especially lower limbs Maybe anasarca Maybe abdominal distention Loose stools Physical and mental fatigue T: Pale C: White and moist P: Soft and even
Treatment Principle	Warm Yang Strengthen the Spleen Benefit Qi Move water
Herb Formulas	Si Ling San
Points	REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23

SPLEEN QI DEFICIENCY WITH QI AND FOOD STAGNATION

Clinical Manifestations	Chest, epigastric and abdominal focal distention Acid regurgitation Sallow complexion Fatigue 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 or Yellow and greasy P: Deficient or Slippery
Treatment Principle	Strengthen the Spleen Benefit Qi
Herb Formulas	Zhi Zhu Wan
Points	LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

SPLEEN YANG DEFICIENCY

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 Feeling chilled Frequent, clear urination Mental fatigue Maybe scanty urine with edema Maybe clear, watery vaginal discharge T: Pale C: Thin and white P: Deep and weak
Treatment Principle	Warm the Center Dispel Cold
Herb Formulas	Li Zhong Tang Fu Zi Li Zhong Wan With Dampness: Fu Ling Si Ni Tang
Points	Moxa LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

SPLEEN AND STOMACH DEFICIENCY COLD

Clinical Manifestations	Mild constant epigastric pain; relieved by warmth and pressure Anorexia Abdominal pain and fullness after meals Nausea Vomiting 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 C: White and greasy P: Deep, thready and forceless
Treatment Principle	Strengthen the Spleen Warm Yang Warm the Center Dispel Cold
Herb Formulas	Fu Zi Li Zhong Wan Li Zhong Tang Xiao Jian Zhong Tang Gan Jiang Ren Shen Ban Xia Wan Zhi Shi Li Zhong Wan Bu Zhong Yi Qi Tang Lian Li Tang
Points	Moxa or moxa needle LIV-13, REN-12, SP-3, SP-6, ST-36, UB-20, UB-21

DISHARMONY BETWEEN THE SPLEEN AND STOMACH WITH DAMPNESS

Clinical Manifestations	Anorexia Loss of the sense of taste Inability to eat more than a little at a time Bloating after eating Focal distention Diarrhea Nausea/Vomiting Indigestion Epigastric discomfort Generalized weakness Maybe chest distention 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

STOMACH QI DEFICIENCY

Clinical Manifestations	Epigastric fullness and distention No desire for food and drink Frequent belching Borborygmus Loss of sensation of taste Stools not solid Urine clear and abundant T: Pale C: Thin and white P: Weak and Deficient
Treatment Principle	Strengthen Qi Invigorate the Spleen and Stomach
Herb Formulas	Liu Jun Zi Tang Xiang Sha Liu Jun Zi Tang Huang Qi Jian Zhong Tang With Turbid Phlegm Obstruction: Xuan Fu Dai Zhe Tang
Points	REN-6, REN-12, SP-6, ST-21, ST-36, UB-20, UB-21

STOMACH QI DEFICIENCY WITH COLD AND HEAT IN THE INTERIOR

Clinical Manifestations	Epigastric distention, fullness and hardness Dry heaves Nausea/Vomiting Irritability Borborygmus Diarrhea with undigested food Hysteria Fatigue Erosions of the throat Insomnia with difficulty falling asleep Frequent waking Talking in one's sleep Sleepwalking Dream disturbed sleep T: Pink C: Yellowish P: Wiry and rapid
Treatment Principle	Benefit Qi Harmonize the Stomach Relieve epigastric distention Disperse lumps and hardness Stop diarrhea
Herb Formulas	Gan Cao Xie Xin Tang
Points

STOMACH COLD

Clinical Manifestations	General signs and symptoms: Epigastrium Cold with pain Mild cases: Constant pain Severe cases: Sudden bouts of sharp pain Pain is aggravated by Cold 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 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 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
Treatment Principle	Warm the Stomach Warm Cold
Herb Formulas	Liang Fu Wan modified Fu Zi Li Zhong Wan 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 WITH HEAT IN THE CHEST

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

STOMACH FIRE

Clinical Manifestations	Burning Heat and pain in the epigastrium 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 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	San Huang Xie Xin Tang Qing Wei San modified With acute pain from Summerheat: Xin Jia Xiang Ru Yin With Phlegm-Heat: Xiao Xian Xiong Tang modified
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, PC-4, PC-8, REN-12, SP-4, ST-44, ST-45 With epigastric pain: + ST-21, ST-34 With nausea: + PC-6 With constipation: + ST-25, ST-37 With Yin Deficiency: + UB-21 , UB-23 With Shao Yang Fu: + GB-39, SJ-5, ST-25

FOOD STAGNATION IN THE STOMACH

Clinical Manifestations	Epigastric fullness, distention and pain with dislike of pressure Belching with rotten food smell 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 Mu Xiang Bing Lang Wan
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

FOOD STAGNATION IN THE STOMACH TRANSFORMING INTO DAMP-HEAT WITH INTESTINAL OBSTRUCTION

Clinical Manifestations	Abdominal pain (worse with pressure) Abdominal and epigastric distention Dysentery Scanty dark urine Constipation T: Red C: Yellow and greasy or slippery P: Deep and forceful
Treatment Principle	Reduce and guide out Stagnation and Accumulation Clear Heat Dispel Dampness
Herb Formulas	Zhi Shi Dao Zhi Wan
Points

FLUID ACCUMULATION IN THE STOMACH

Clinical Manifestations	Nausea Sudden vomiting of Thin Mucus or clear Fluids Absence of thirst May feel thirsty Palpitations Vertigo Dizziness Dysuria Focal distention of the epigastrium Hiccups T: Normal C: White and Slippery P: Wiry
Treatment Principle	Harmonize the Stomach Stop vomiting Dispel Phlegm Regulate water circulation Disperse Stagnation
Herb Formulas	Xiao Ban Xia Jia Fu Ling Tang
Points

DISHARMONY BETWEEN THE STOMACH AND INTESTINES WITH COLD, HEAT AND DAMPNESS ACCUMULATION

Clinical Manifestations	Food stagnation 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 Qi
Herb Formulas	Sheng Jiang Xie Xin Tang
Points

SMALL INTESTINE DEFICIENCY COLD

Clinical Manifestations	Vague lower abdominal pain Feelings of cold and heaviness Fond of warmth and pressure Abdominal fullness intermittently Borborygmus Unformed, loose stools or Chronic, incessant diarrhea Urinary frequency T: Pale C: Thin and white P: Deep and even
Treatment Principle	Warm and Clear the Small Intestine
Herb Formulas	Li Zhong Tang
Points	LIV-13, REN-4, REN-12, SP-3, ST-25, ST-36, ST-37, ST-39, UB-20, UB-27

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 Tong Xie Yao Fang Hei Xiao Yao San
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

LIVER AND GALL BLADDER FIRE

Clinical Manifestations	Severe, splitting headaches with dizziness Sudden tinnitus or Sudden deafness Flushed face Red, swollen, painful eyes Irascibility with violent angry outbursts Dry mouth Bitter taste in mouth Thirst Vomiting sour or bitter liquid Insomnia Restlessness Constipation or dry stools Maybe rib pain In severe cases: Mania Hemoptysis Hematemesis Epistaxis Liver Fire Attacks the Lungs: Hemoptysis Rib pain which is severe when coughing Liver Fire Attacks the Stomach: Hematemesis T: Red tip and edges C: Thick, yellow, dry and rough P: Wiry, Excess and rapid
Treatment Principle	Clear the Liver Purge Fire
Herb Formulas	Dang Gui Long Hui Wan Da Chai Hu Tang
Points	GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19

KIDNEY YANG DEFICIENCY WITH INTERNAL COLD

Clinical Manifestations	Extremely cold extremities Aversion to Cold Sleeping with knees drawn up Lethargy with a constant desire to sleep Vomiting Diarrhea with undigested food Abdominal pain and Cold Lack of thirst Coma Indigestion Edema Pale face Superficial fever Red face Cyanosis of the lips and nails T: Pale or Dark purple C: White and slippery P: Deep and thready or Deep and slow or Deep and faint
Treatment Principle	Rescue Yang Warm the Middle Jiao Warm the Kidneys Disperse Internal Cold Stop diarrhea
Herb Formulas	Si Ni Tang Si Ni Jia Ren Shen Tang
Points

KIDNEY YANG DEFICIENCY WITH WATER FLOODING

Clinical Manifestations	Edema of whole body particularly at and below the waist Pitting edema Low back pain, aching and heaviness Abdominal distention with full sensations Oliguria Cold limbs Face gray and congested or pale Feeling nervous and cold with mental weariness In severe cases: Ascites Edema of scrotum T: Pale and swollen C: Thin, white or Thick, white and sticky P: Deep and thready With Water Flooding the Lungs: Cough with copious, thin watery phlegm Asthma with phlegmy sound (wheezing) Dyspnea Facial edema Edema of limbs Dysuria T: Pale and swollen C: White and moist or White and greasy P: Superficial and tight
Treatment Principle	Warm Kidneys Promote diuresis
Herb Formulas	Zhen Wu Tang
Points	KI-7, REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23, UB-39

DAMP-HEAT

Clinical Manifestations	Headache Chills Afternoon fever Heavy sensation in the body Generalized pain Pale yellow (sallow) complexion Stifling sensation in chest Loss of appetite Feverishness and pain of the body Fatigue Lack of thirst or thirst with no desire to drink Chest and abdominal fullness Maybe aversion to Cold Nausea Heaviness of the head T: Normal C: White or Greasy and white P: Wiry, thin and soggy or soft or Superficial and soft
Treatment Principle	Spread Qi Facilitate Qi Clear Damp-Heat
Herb Formulas	San Ren Tang San Huang Xie Xin Tang Ge Gen Huang Qin Huang Lian Tang Wei Ling Tang Ping Wei San Shao Yao Tang modified With Cold and Heat factors: Ban Xia Xie Xin Tang With spurious diarrhea: Huang Long Tang With Heat greater than Dampness: Bai Tou Weng Tang With Intestinal Dryness and Yin damage: He Jian Shao Yao Huang Lian Tang Chinese patent medicines: Qing Fei Yi Huo Pian Lian Qiao Bai Du Pian Huang Lian Jie Du Wan Huang Lian Su Pian Chuan Xin Lian Fu Fang Na Ban Lan Gen Pian
Points	LI-11, SP-9, ST-25, ST-37, ST-44, Zhixie With a high fever: + DU-14, LI-4 With nausea: + PC-6 With sudden, severe diarrhea, vomiting and fever: + bleed PC-3, UB-40 LI-4, LI-11, ST-25, ST-37, ST-44, Zhixie, Ahshi points between ST-36 and ST-39 (one or two treatments daily for severe cases) For nausea: + PC-6, REN-12 For high fever: DU-14 For prominent Dampness: + SP-9 For tenesmus: + DU-1, REN-4, UB-30 Ear: Large Intestine, Small Intestine, Spleen, Abdomen, Distal Segment Rectum, Sympathetic

DAMP-HEAT SUDDEN TURMOIL DISORDER

Clinical Manifestations	Vomiting Diarrhea Spasms Cramps Thirst Irritability Oliguria with reddish urine Restlessness Arthralgia with a burning sensation, redness and swelling Abdominal pain T: Pink C: Thick, dry and yellow or Yellow and greasy P: Soggy and rapid or Floating and rapid or Floating, soft and rapid
Treatment Principle	Clear Heat Resolve Dampness Separate the clear from the turbid
Herb Formulas	Can Shi Tang
Points

PHLEGM-DAMP

Clinical Manifestations	Anorexia Edema Abdominal distention Chest and hypochondriac distention Dizziness Nausea Vomiting Vertigo Thirst with no desire to drink Maybe no thirst Palpitations Shortness of Breath T: Normal C: Thick and slippery P: Slippery, full and maybe wiry
Treatment Principle	Warm and Dissolve Tan Yin
Herb Formulas	Ling Gui Zhu Gan Tang Wu Ling San Ping Wei San With indigestion, diarrhea and decreased urination: Si Ling San With jaundice and dysuria: Yin Chen Wu Ling San With distention and Stomach Qi Deficiency: Xuan Fu Dai Zhe Tang
Points	PC-6, SJ-6, SP-6, SP-9, ST-40, UB-13, UB-20, UB-23

WIND-PHLEGM

Clinical Manifestations	Paralysis Numbness Slurred speech Deviated eyes Deviated mouth (wry mouth) Dizziness Tinnitus Sputum in the throat Chest fullness and distention Epigastric fullness and distention Hypertension Stroke T: Deviated and trembling C: Thick P: Slippery and maybe wiry
Treatment Principle	Resolve Phlegm Subdue Wind
Herb Formulas	Ban Xia Bai Zhu Tian Ma Tang Er Chen Tang modified
Points	Pre-stroke: ST-40, UB-40 Stroke (emergency): DU-26, KI-1, PC-9, Ting Points Post-stroke: Arm: LI-4, LI-11, LI-15, SI-3, SJ-5 Leg: GB-34, GB-35, UB-40, UB-60 Scalp: Motor area (contralateral - upper one-fifth)

DAMP-PHLEGM

Clinical Manifestations	Dizziness Vertigo Mental cloudiness Heavy head Heavy sensation in the body Cough with Excess sputum Chest and epigastric distention Suffocating sensation in the chest and epigastrium Nausea Profuse sputum Vomiting Anorexia Fatigue Borborygmus Tinnitus Mouth glutinous No thirst Likes to sleep Maybe palpitations T: Thick C: White and greasy or Sticky and white P: Rolling or Wiry and slippery
Treatment Principle	Strengthen the Spleen Harmonize the Stomach Eliminate Dampness Resolve Phlegm
Herb Formulas	Ban Xia Bai Zhu Tian Ma Tang Er Chen Tang
Points	GB-34, LIV-13, REN-12, ST-36, ST-40 PC-6, REN-12, ST-8, ST-40, UB-20 DU-20, DU-23, GB-20, GB-34, LI-4, REN-12, ST-36, ST-40, ST-41 REN-12, PC-6, ST-41

TOXIC HEAT OBSTRUCTING 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 Relieve inflammation Stop bleeding Purge Damp-Heat Purge the Gallbladder
Herb Formulas	Huang Lian Jie Du Tang
Points

SAN JIAO: MIDDLE JIAO DAMP-HEAT (ACUTE)

Clinical Manifestations	Fever (may be unremitting) Achy limbs A stifling sensation in the chest Abdominal distention Nausea and vomiting Dark, scanty, turbid or red urine Diarrhea or constipation Malaise Sore throat Jaundice Thirst with no desire to drink No perspiration Chest discomfort Swollen throat Pressure headache Anorexia Vomiting and diarrhea Unremitting fever Swelling of the lower cheeks Lumbago Heaviness Sweat Orange-yellow body Jaundice Fatigue Lethargy Low back pain Headache Oliguria Irritability Persistent low grade fever Dysentery Simultaneous bitter and sweet tastes in mouth Bowel dysfunction T: Red or normal or Pale white C: Thick greasy and white or Dry and yellow P: Soft and rapid
Treatment Principle	Resolve Dampness Transform turbidity Clear Heat Relieve toxicity
Herb Formulas	Gan Lu Xiao Du Dan Lian Po Yin
Points

DAMP-TURBIDITY OBSTRUCTING THE MIDDLE JIAO WITH WIND-COLD ATTACKING THE EXTERIOR

Clinical Manifestations	Vomiting Abdominal distention and fullness Fever and chills Diarrhea with mucus Headache Melaena T: Pink C: Thick, white and greasy P: Soft or Floating tight and soft or Weak
Treatment Principle	Activate Qi Dry Dampness Transform turbidity Descend Qi Harmonize the Stomach Stop vomiting
Herb Formulas	Bu Huan Jin Zheng Qi Tang
Points

MIDDLE JIAO DEFICIENCY WITH FOOD STAGNATION AND DAMPNESS (CHRONIC)

Clinical Manifestations	No desire to eat or drink Diarrhea Abdominal pain Nausea Vomiting Belching with a rotten or sour smell T: Pale and thick C: Greasy or Turbid P: Weak and soggy
Treatment Principle	Augment the Spleen Transform Dampness Harmonize the Stomach Dispel Food Stagnation Relieve diarrhea and vomiting
Herb Formulas	Qi Pi Wan
Points

LOWER JIAO COLD-DAMP

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

SAN JIAO: LOWER JIAO DAMP-HEAT WITH LINGERING EXTERNAL PATHOGENS (ACUTE)

Clinical Manifestations	Fever Sweating Thirst Dysenteric diarrhea Foul-smelling stools A burning sensation around the anus Gasping Ephidrosis Palpitations Tenesmus Maybe red tinged urine Irritability and Heat in the chest and epigastrium Stiffness and spasms at the back of the neck Dry mouth Dyspnea with perspiration Maybe wheezing T: Red C: Yellow (Greasy) P: Rapid
Treatment Principle	Release the Exterior Clear Internal Yang Ming Heat Raise Yang to stop diarrhea
Herb Formulas	Ge Gen Huang Qin Huang Lian Tang
Points

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