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HASHIMOTO'S THYROIDITIS

GENERAL

Clinical Manifestations	Autoimmune thyroiditis leading to hypothyroidism Slowly developing persistent inflammation of the thyroid Decreased gland function Primarily in women Generally a family history of the disease Intolerance to Cold Weight gain Fatigue Constipation Enlarged neck or Goiter Joint pain Facial edema There may be signs of hyperthyroidism in the early stages
Treatment Principle
Herb Formulas	For early-stage hyperthyroidism: Qi and Yin Deficiency: Yi Qi yang Yin Zhong Yao Yin Deficiency with Stomach Heat: Yang Yin Qing Re Zhong Yao Liver Qi Stagnation: Shu Gan Liu Qi Zhi Zhong Yao To move the Blood: Li Qi Huo Xue Zhang Yao
Points	Moxa DU-14, DU-4, UB-23 alternate with Moxa REN-17, REN-12, REN-4

SPLEEN QI DEFICIENCY

Clinical Manifestations	Fatigue Cold hands and feet Obesity Puffy edema A Pale face A tendency toward loose stools T: Thick and pale with teethmarks on the edges C: Thin and white P: Weak or Soggy
Treatment Principle	Supplement the Center Boost Qi
Herb Formulas	Bu Zhong Yi Qi Tang modified
Points	Moxa SP-3, SP-6, ST-36 With Liver Qi Stagnation: LIV-3 With Blood Deficiency: UB-17, UB-20 With facial edema: SP-9, DU-26 With constipation: ST-25 With Wind-Cold-Damp Invasion: LI-11, SP-9 + Ahshi Points With depressive Heat: ST-44, or GB-34 With cold hands and feet: SJ-5, UB-57 REN-4 + moxa, above UB-10 With facial edema: SP-9, DU-26 With generalized edema: SP-6, SP-9, REN-9

**SPLEEN AND KIDNEY YANG DEFICIENCY**

Clinical Manifestations	Lymph adenoid goiter Fatigue Cold hands and feet Obesity Puffy edema Pale face Loose stools Dizziness Tinnitus Decreased sexual desire Impotence	Sterility Menstrual irregularity Infertility Low back pain and weakness Knee pain and weakness Nocturnal polyuria Fear of cold Colder feet than hands T: Thick, pale with teeth marks C: Thin white P: Weak or Soggy
Treatment Principle	Strengthen the Middle Tonify Qi Supplement the Kidneys Tonify Yang
Herb Formulas	Jia Wei Shen Qi Wan For Cold with edema: Wen Shen Zu Yang Zhong Yao For goiter: Xian Ying San Jie Zhong Yao
Points	Moxa UB-20, UB-23, REN-4, DU-4 For facial edema: + SP-9, DU-26 For generalized edema: + SP-6, SP-9, DU-9 For constipation: + ST-25 For loose stools: + ST-36 For low back and spine pain with Cold sensations: + DU-14, DU-6, DU-1 For Heart palpitations: + PC-6 For abdominal distention: + REN-12, ST-25 For poor appetite: + ST-36 For marked fatigue and weakness: + ST-36 For concomitant Yin Deficiency: + KI-7 For simultaneous Liver Qi Stagnation: + LIV-3 through to KI-1 For goiter: + ST-12, ST-9 or ST-12, SI-16 For Wind-Cold-Damp: + LI-11, SP-9, Ahshi For Depressive Heat: + ST-44, GB-34 For marked cold extremities: + SJ-5, UB-57

HEART AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Cardiac effusion Heart palpitations An empty sensation in the Heart Shortness of breath Maybe chest oppression or pain Aversion to Cold Cold extremities A pale and puffy face Apathy Mental slowness Fatigue Dizziness Tinnitus Weak limbs Hypersomnia T: Pale C: Thin and white P:Deep, slow and weak or Tight or Regularly intermittent
Treatment Principle	Tonify the Heart and Kidneys Warm Yang
Herb Formulas	Zhi Gan Cao Tang Jia Jian
Points	Moxa DU-4, DU-25, HT-5, HT-7, HT-8, KI-3, PC-3, PC-4, PC-5, PC-6, PC-7, REN-4, REN-14, REN-17, SP-6, ST-36, UB-15, UB-23 Moxa UB-20, UB-23, REN-4, DU-4 For facial edema: + SP-9, DU-26 For generalized edema: + SP-6, SP-9, DU-9 For constipation: + ST-25 For loose stools: + ST-36 For low back and spine pain with Cold sensations: + DU-14, DU-6, DU-1 For Heart palpitations: + PC-6 For abdominal distention: + REN-12, ST-25 For poor appetite: + ST-36 For marked fatigue and weakness: + ST-36 For concomitant Yin Deficiency: + KI-7 For simultaneous Liver Qi Stagnation: + LIV-3 through to KI-1 For goiter: + ST-12, ST-9 or ST-12, SI-16 For Wind-Cold-Damp: + LI-11, SP-9, Ahshi For Depressive Heat: + ST-44, GB-34 For marked cold extremities: + SJ-5, UB-57

LIVER QI STAGNATION WITH PHLEGM

Clinical Manifestations	Swollen lumps in the front of the throat which are soft and painless A swollen feeling in the front of the throat or A plum pit sensation in the back of the throat A tendency towards anger Chest oppression Sighing Possible chest or flank pain T: Normal or Dusky C: White and greasy P: Wiry
Treatment Principle	Rectify Qi Soothe Stagnation Transform Phlegm Scatter nodulation
Herb Formulas	Si Hai Shu Yu Wan modified
Points	LIV-3, ST-12, ST-40, SJ-13, SI-16 With neck discomfort: LU-7, KI-6 With depressive Heat: GB-34, LIV-2, eliminate LIV-3 With Spleen Qi Deficiency: ST-36 With Kidney Yang Deficiency: KI-3, KI-10, DU-20, DU-21, REN-22 With mucus: LI-15, GB-20, DU-14, LI-11

QI DEFICIENCY WITH BLOOD STAGANTION

Clinical Manifestations	Pain in the lower abdomen and pelvic region Spotting between periods or before periods Abdominal swelling Low back pain Sometimes no symptoms at all Periods that are either heavy or scanty, with light-colored, watery menses Infertility Sometimes no symptoms at all A preference for warmth Feels better with pressure on the abdomen or Dislikes pressure Large clots Fatigue Bloating Soft bowel movements A pale complexion Lethargy Headaches Low grade fevers Depression Anxiety T: Pale and Swollen with teethmarks and/or Purple C: White P: Deep, thin and weak or Thin, soft and weak
Treatment Principle	Tonify Qi Invigorate the Blood
Herb Formulas	Liu Jun Zi Tang modified
Points	Moxa or moxa needle UB-17, UB-20, UB-23, REN-12, ST-36, SP-6, SP-10, DU-20 With neck discomfort: LU-7, KI-6 With depressive Heat: GB-34, LIV-2, eliminate LIV-3 With Spleen Qi Deficiency: ST-36 With Kidney Yang Deficiency: KI-3, KI-10, DU-20, DU-21, REN-22 With mucus: LI-15, GB-20, DU-14, LI-11

QI AND YIN DEFICIENCY

Clinical Manifestations	Chronic cough or Dry cough Insomnia Night sweats Spontaneous perspiration Weakness Palpitations Shortness of breath Fever Irritability T: Red and dry or Red and swollen C: Little or None P: Thready and weak
Treatment Principle	Tonify Qi Nourish Yin
Herb Formulas	Sheng Mai Yin Wan modified
Points	UB-15, UB-18, UB-20, UB-23, SJ-13, SI-16, SI-17, LI-17 With marked Heart Yin Deficiency: HT-7 With marked Liver and Kidney Yin Deficiency: KI-7 With marked Spleen Qi Deficiency: ST-36 With lassitude fatigue and poor memory: Sishencong With dizziness: GB-20 With rough eyes and/or blurred vision: GB-37 With facial hot flashes: HT-6, DU-14 With tinnitus: GB-2 With low back and knee soreness and weakness: UB-52 With exophthalmos and distention in the eyes: UB-1, GB-20, Taiyang With marked heart palpitations: PC-6 With increased appetite: REN-12, ST-44 With tremors of the hands or fingers: LI-4, LIV-3 With a sensation of throat obstruction: REN-23, HT-5 With profuse sweating: LI-4, KI-7 PC-5, SP-6, Qiying (Do not retain) With Excess sweat: HT-6, KI-7 With palpitations and insomnia: HT-7, Anmian With sexual irritability and flushed face: LIV-3, GB-20 With protruding eyes: UB-20, ST-2, Shangtianzhu With tachycardia: PC-6 Ear: Shenmen, Subcortex, Endocrine, Stop wheezing, Heart, Lung Moxa: 50 cones @ LIV-3 and Ahshi points around goiter Cutaneous: tap from T-5-T-10, UB-18, LIV-3, SP-3, REN-22, ST-36, LI-11, LI-4, SJ-17, LI-18, LI-4, REN-17, REN-22, SI-16, ST-12, KI-27, LU-1, LU-7, bleed Shixuan With goiter and swollen throat: LU-3, SJ-13, ST-11 Alternate between: a. GB-20, DU-4, DU-14, UB-11, REN-22, ST-10, SJ-3 b. UB-10, UB-12, DU-3, DU-12, REN-23, ST-9, GB-22 ST-9 through goiter, REN-22, LI-4, ST-36, Zeqian, KI-3, SP-6, PC-6 With insomnia: Anmian, Taiyang, GB-20 DU-14, UB-13, UB-15, UB-23, GB-21, LI-11, ST-36, SP-6, REN-22, SI-14, HT-7 + indirect moxa for 5 min. PC-4, Qiying, SP-6 ST-36, SP-4, SP-6, KI-3, PC-6, REN-6 With Spleen Qi Deficiency: + UB-20, UB-23, REN-6 With Liver Fire: + LIV-2 With insomnia: + KI-7 To transform Phlegm, open the vessels and remove stasis: SJ-10, LI-11, ST-40, SP-10, UB-7 To clear the Liver and drain the Fire: GB 34, LIV-2 through to LIV-3, UB-18, SP-6, SP-9

QI AND BLOOD STAGNATION

Clinical Manifestations	Facial color dark and dull Emaciation Sides and ribs distended on both sides (maybe with sharp pain) Enlargement of Liver and Spleen Suffocating sensation in chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Dark purple (maybe purple spots on edge of tongue) C: Normal P: Wiry, choppy and slow
Treatment Principle	Move Qi Invigorate the Blood Dispel Stasis
Herb Formulas	Hashimoto's Thyroiditis #1 Hashimoto's Thyroiditis #2 With Qi and Blood Deficiency and Phlegm: Fu Zheng Xiao Ying Fang
Points	LI-4, LI-17, SI-17, REN-22 With neck discomfort: LU-7, KI-6 With depressive Heat: GB-34, LIV-2, eliminate LIV-3 With Spleen Qi Deficiency: ST-36 With Kidney Yang Deficiency: KI-3, KI-10, DU-20, DU-21, REN-22 With mucus: LI-15, GB-20, DU-14, LI-11

YANG DEFICIENCY

Clinical Manifestations	Aversion to Cold Watery stools with undigested food Lower back pain Weakness of the lower extremities A cold sensation in the lower half of the body Tenseness in the lower abdomen Pain and cramps in the lower abdomen Panting and irritability to the point of having difficulty lying down Will breathe most comfortably while leaning against something Nocturia May be numbness in the lower abdomen Urinary difficulty with edema or Spasmodic pain in the lower abdomen Excessive urination If severe, may be incontinence of urine May have persistent diarrhea Dysuria May have flushed face (Yang floating upward) Thirst with frequent, copious urination (Xiao Ke) Fatigue (severe) May have severe perspiration (Yang floating upward) Constipation Lassitude Pale face Edema of the face and feet Severe edema of the legs (may prevent walking) Maybe cough Maybe asthma T: Pale, may be swollen C: Thin, white and moist P: Deep, Deep and thready and/or Weak and slow
Treatment Principle	Warm and Tonify Kidney Yang
Herb Formulas	Jin Gui Shen Qi Wan
Points	Moxa DU-4, DU-25, HT-5, HT-7, HT-8, KI-3, PC-3, PC-4, PC-5, PC-6, PC-7, REN-4, REN-14, REN-17, SP-6, ST-36, UB-15, UB-23 Moxa UB-20, UB-23, REN-4, DU-4 For facial edema: + SP-9, DU-26 For generalized edema: + SP-6, SP-9, DU-9 For constipation: + ST-25 For loose stools: + ST-36 For low back and spine pain with Cold sensations: + DU-14, DU-6, DU-1 For Heart palpitations: + PC-6 For abdominal distention: + REN-12, ST-25 For poor appetite: + ST-36 For marked fatigue and weakness: + ST-36 For concomitant Yin Deficiency: + KI-7 For simultaneous Liver Qi Stagnation: + LIV-3 through to KI-1 For goiter: + ST-12, ST-9 or ST-12, SI-16 For Wind-Cold-Damp: + LI-11, SP-9, Ahshi For Depressive Heat: + ST-44, GB-34 For marked cold extremities: + SJ-5, UB-57

YANG DEFICIENCY WITH COLD STAGNATION

Clinical Manifestations	Localized painful swellings without a head that bleed into the surrounding tissues and do not affect the color or texture of the skin The swellings are not hot to the touch No thirst Swollen and painful joints Wasting of the muscles of the thigh and calf T: Very pale or Pale-pink C: White P: Thready and forceless or Deep and slow
Treatment Principle	Warm the Yang Tonify the Blood Disperse Cold Eliminate Stagnation
Herb Formulas	Yang He Tang modified
Points	Moxa DU-4, DU-25, HT-5, HT-7, HT-8, KI-3, PC-3, PC-4, PC-5, PC-6, PC-7, REN-4, REN-14, REN-17, SP-6, ST-36, UB-15, UB-23 Moxa UB-20, UB-23, REN-4, DU-4 For facial edema: + SP-9, DU-26 For generalized edema: + SP-6, SP-9, DU-9 For constipation: + ST-25 For loose stools: + ST-36 For low back and spine pain with Cold sensations: + DU-14, DU-6, DU-1 For Heart palpitations: + PC-6 For abdominal distention: + REN-12, ST-25 For poor appetite: + ST-36 For marked fatigue and weakness: + ST-36 For concomitant Yin Deficiency: + KI-7 For simultaneous Liver Qi Stagnation: + LIV-3 through to KI-1 For goiter: + ST-12, ST-9 or ST-12, SI-16 For Wind-Cold-Damp: + LI-11, SP-9, Ahshi For Depressive Heat: + ST-44, GB-34 For marked cold extremities: + SJ-5, UB-57

YIN DEFICIENCY

Clinical Manifestations	Goiter Irritability Palpitations Anxiety Fatigue Insomnia Very restless sleep Inability to think or concentrate even for short periods Nocturnal emissions Forgetfulness Dry stools Mouth sores Tongue sores Low grade afternoon fever Dream disturbed sleep Night sweats Constipation T: Red C: Little P: Rapid or Thready and rapid
Treatment Principle	Enrich the Yin
Herb Formulas	Liu Wei Di Huang Wan modified
Points	UB-15, UB-18, UB-20, UB-23, SJ-13, SI-16, SI-17, LI-17 With marked Heart Yin Deficiency: HT-7 With marked Liver and Kidney Yin Deficiency: KI-7 With marked Spleen Qi Deficiency: ST-36 With lassitude fatigue and poor memory: Sishencong With dizziness: GB-20 With rough eyes and/or blurred vision: GB-37 With facial hot flashes: HT-6, DU-14 With tinnitus: GB-2 With low back and knee soreness and weakness: UB-52 With exophthalmos and distention in the eyes: UB-1, GB-20, Taiyang With marked heart palpitations: PC-6 With increased appetite: REN-12, ST-44 With tremors of the hands or fingers: LI-4, LIV-3 With a sensation of throat obstruction: REN-23, HT-5 With profuse sweating: LI-4, KI-7 PC-5, SP-6, Qiying (Do not retain) With Excess sweat: HT-6, KI-7 With palpitations and insomnia: HT-7, Anmian With sexual irritability and flushed face: LIV-3, GB-20 With protruding eyes: UB-20, ST-2, Shangtianzhu With tachycardia: PC-6 Ear: Shenmen, Subcortex, Endocrine, Stop wheezing, Heart, Lung Moxa: 50 cones @ LIV-3 and Ahshi points around goiter Cutaneous: tap from T-5-T-10, UB-18, LIV-3, SP-3, REN-22, ST-36, LI-11, LI-4, SJ-17, LI-18, LI-4, REN-17, REN-22, SI-16, ST-12, KI-27, LU-1, LU-7, bleed Shixuan With goiter and swollen throat: LU-3, SJ-13, ST-11 Alternate between: a. GB-20, DU-4, DU-14, UB-11, REN-22, ST-10, SJ-3 b. UB-10, UB-12, DU-3, DU-12, REN-23, ST-9, GB-22 ST-9 through goiter, REN-22, LI-4, ST-36, Zeqian, KI-3, SP-6, PC-6 With insomnia: Anmian, Taiyang, GB-20 DU-14, UB-13, UB-15, UB-23, GB-21, LI-11, ST-36, SP-6, REN-22, SI-14, HT-7 + indirect moxa for 5 min. PC-4, Qiying, SP-6 ST-36, SP-4, SP-6, KI-3, PC-6, REN-6 With Spleen Qi Deficiency: + UB-20, UB-23, REN-6 With Liver Fire: + LIV-2 With insomnia: + KI-7 To transform Phlegm, open the vessels and remove stasis: SJ-10, LI-11, ST-40, SP-10, UB-7 To clear the Liver and drain the Fire: GB 34, LIV-2 through to LIV-3, UB-18, SP-6, SP-9

PHLEGM STAGNATION WITH BLOOD STASIS

Clinical Manifestations	Hard goiter like a stone which is immovable May move slightly when swallowing Goiter is heavy and dense Goiter is large Irregular surface May be aching and pain Hoarse voice T: Normal C: Thin and white P: Wiry and maybe choppy
Treatment Principle	Invigorate the Blood Transform Stasis Soften the hardness Scatter nodulation
Herb Formulas	Hai Zu Yu Hu Tang modified
Points	LI-4, LI-17, SI-17, REN-22 With neck discomfort: LU-7, KI-6 With depressive Heat: GB-34, LIV-2, eliminate LIV-3 With Spleen Qi Deficiency: ST-36 With Kidney Yang Deficiency: KI-3, KI-10, DU-20, DU-21, REN-22 With mucus: LI-15, GB-20, DU-14, LI-11