LUPUS ERYTHEMATOSIS

GENERAL

Clinical Manifestations	Systemic: Lupus erythematosis is a type of autoimmune, connective tissue disease. Skin lesions Fresh, red colored, macular patches with sticky scales Mostly found over the nasal and cheek regions May be fused into a butterfly shape Mouth ulcers Loss of scalp hair Fever Arthralgia The Heart, Kidneys, Liver and other organs may be simultaneously involved May also be found on the: Frontal and mandibular regions Scalp Ears Auditory canals Limbs Trunk Chronic disciform: Atrophic, depressed erythema with distinct borders Mostly found over the nasal and cheek regions May be fused into a butterfly shape Telangiectasis Adhesive scaling More or less symmetrical distribution The labial mucosa may exhibit grayish-white ulcerations with shallow festering Slow progression No systemic symptoms May also be found on the: Frontal and mandibular regions Scalp Lips Ears Auditory canals Limbs Trunk
Treatment Principle
Herb Formulas	Topical: Huang Lian Gao Grind 20g Hb. Artemisiae Annuae Qing Hao into a fine powder and mix thoroughly with 80g petroleum jelly and apply to the lesions.
Points	LI-4, LI-11, LI-20, PC-3, ST-2, every fifth session bleed DU-10 Ear: Heart, Liver, Lung, Adrenal, Shenmen

SHAO YANG JING WITH CONGESTED FLUIDS

Clinical Manifestations	Alternating chills and fever (chills predominate) or Chills without fever Sensation of irritability in the chest Sweating from the head Fatigue Gastrointestinal weakness Heavy head Neuralgia Epigastric distension Lower abdominal pain Tension around pubic bone Periumbilical pain Urinary difficulty T: Moist C: White and slippery P: Superficial and wiry
Treatment Principle	Disperse Clumping Harmonize the Shao Yang Warm the Interior Dispel Cold
Herb Formulas	Chai Ling Tang
Points	GB-41, SJ-5, moxa or moxa needle REN-4, REN-6, REN-8, REN-12, SJ-6, ST-25, ST-36

WEI STAGE 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	Chai Ling Tang
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

QI STAGE: LUNG AND STOMACH HEAT INJURING QI AND FLUIDS

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

YING STAGE HEAT (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

XUE STAGE EXCESS HEAT CAUSES BLEEDING AND/ OR WIND

Clinical Manifestations	High fever or Continuous fever that will not recede Confusion of mind Delirium Mania Dark yellow urine Excessive skin rashes all over body Maybe Blood blisters Lack of strength Muscle and joint aching and pain Vexation Agitation Insomnia Anxiety and worry Spasms and contractions Thirst with a desire for cold drinks Dry, bound stools Red eyes Red lips A sore, swollen throat Hemorrhage: Hematemesis Hemoptysis Epistaxis Hemafecia Hematuria T: Deep red, dry or Purple red C: None or Yellow or Dry yellow or Yellow and slimy or Yellow and white or Smooth and bare P: Wiry and rapid or Rapid or Thready and rapid or Thready and feeble
Treatment Principle	Cool the Blood Dispel Heat and Toxins from the Xue Stage Nourish Yin Promote Blood Circulation Disperse macules
Herb Formulas	Qing Wen Bai Du San modified
Points	DU-10, LI-4, PC-3, Shixuan, UB -40 With a clouded Spirit: + DU-26 With a very high fever: + DU-14, LI-11, SJ-5 With dark purple skin lesions: + LI-11, SP-10 With muscle and joint aching and pain: + GB-34, GB-39 \With severe lack of strength: + ST-36 With vexation or agitation: + PC-7 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

WIND-DAMP-HEAT

Clinical Manifestations	Early-stage disease with profuse, severe joint pain, especially in the fingers, toes, ankles and wrists Generalized body aches and pains Migrating pain of several joints Irritability Heavy sensation in the shoulder and back Sore, aching muscles Weak limbs Discomfort or a constricted sensation in the area of the chest and diaphragm Multiple sores, carbuncles furuncles or abscesses Redness Itching Persistent swelling Chest pain Fever Dry throat Thirst Aching and painful extremities Aching and painful joints Unbearable swelling and pain of the lower extremities Shoulder stiffness T: Normal or Red C: Greasy and slightly yellow P: Wiry and rapid or Soft and moderate or Soft, superficial and slow or Slippery and rapid or Deep and tight or Wiry and slippery
Treatment Principle	Resolve Dampness Clear Heat Disperse Wind Stop pain Invigorate the Blood Tonify Qi and Blood Unblock the channels
Herb Formulas	Jia Wei Xuan Bi Tang Xuan Bi Tang Lupus #5 Bai Hu Gui Zhi Tang
Points	DU-14, LI-11, SP-9 + local Ahshi points + bleed Shixuan, UB-40 if necessary For dark, purple skin lesions: + SP-6, SP-10 For irritability and agitation: + PC-7

WIND-DAMP-HEAT WITH BLOOD STAGNATION

Clinical Manifestations	Sore, achy joints The pain moves from joint to joint
Treatment Principle	Clear Heat Dry Dampness Activate the Blood Dispel Wind
Herb Formulas	Shang Zhong Xia Tang Yong Tong Feng Wan
Points

LUNG QI AND YIN DEFICIENCY

Clinical Manifestations	Chronic cough with sparse sputum Sputum difficult to expectorate Shortness of breath Spontaneous perspiration Dry mouth and tongue Palpitations with a stifling sensation in chest Fatigue Irritability Thirst Dry throat Insomnia Listless speech T: Red and dry or Pink and dry C: Thin and dry P: Deficient and rapid or Irregular and slow or Thready and deficient or Consistently irregular
Treatment Principle	Augment Qi Generate Fluids Clear Heat Preserve Yin
Herb Formulas	Sheng Mai San
Points

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Body cold Limbs icy and clammy Complexion white and shiny or Sallow, yellow complexion Aversion to Cold Superficial edema Maybe low-grade or tidal fever Low back, knees and abdomen feel weak, cold and painful Lower abdomen feels cold and painful Joint swelling and pain Abdominal distention (if severe may lead to vomiting and diarrhea) Anorexia Loose stools containing undigested food “Cock-crow” diarrhea (occurs at about 5 am) Edema of face and limbs Weakness Debility Lassitude Reluctance to speak Symptoms worse on exertion Dysuria Scanty urination Pale skin lesions Severe: Abdominal ascites Hydrothorax Palpitations Shortness of breath T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep, thready, weak and maybe slow
Treatment Principle	Warm and Reinforce the Spleen and Kidneys
Herb Formulas	Lupus #4 Er Xian Tang + Wu Ling San Shen Qi Wan modified Topical: Sheng Ji Yu Hong Gao
Points	Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23 Moxa or moxa needle KI-3, REN-4, SP-9, ST-36 With nausea and vomiting: + PC-6, REN-13 With severe edema and inhibited urination: + REN-3, SP-6 With diarrhea: + moxa REN-8

SPLEEN AND KIDNEY YANG DEFICIENCY WITH WATER FLOODING

Clinical Manifestations	Abdominal pain aggravated by Cold Urinary difficulty Deep, aching heaviness in the extremities Generalized edema Loose stools Dizziness Heavy sensation in the head Palpitations Cough Epigastric palpitations Aversion to Cold Watery diarrhea No thirst Leukorrhea Hiccup Profuse perspiration Cold limbs Headaches A husky voice Hair loss Asthma Generalized twitching Tidal flushing of the genitals by Dampness Water buildup leading to hernia Impotence Prone to infections Prone to allergies Prone to Wind erysipelas Diarrhea Constipation Chest pain Mental and emotional disorders Light-headedness Nasal obstruction with clear mucus Impaired visual acuity Prone to dormant papules A sensation of something being stuck in the throat Incessant sneezing Swelling and pain of the teeth or gums Feeling of unsteadiness as if one were about to fall Distended or heavy sensation of the head Palpitations Gradual weight gain Dyspnea Abdominal distention and fullness Pitting edema Scanty urination or Frequent, clear, abundant urination at night Chills Weak knees Seminal emissions Flaccid abdomen Muscular aching Chronic lower back pain Nausea Cyclic vomiting Fever, perspiration does not reduce fever Vertigo Impaired memory Shivering and trembling Catches cold easily Severe fatigue Aches and pains in the body or extremities Flank pain Wheezing T: Pale or Dark purple and swollen with teeth marks C: White and slippery P: Deep, thready and forceless or Deep and thready
Treatment Principle	Warm Yang Promote urination
Herb Formulas	Zhen Wu Tang Topical: Sheng Ji Yu Hong Gao Mi Tuo Seng San
Points

STOMACH HEAT

Clinical Manifestations	Scleroderma Intermittent epigastric and abdominal distention and fullness after eating followed 12 hours later by vomiting of partially digested food, which relieves the distention Vomitus may be sour and offensive Irritability Restlessness Red complexion and lips Halitosis Thirst Dry mouth and lips Tendency toward constipation and rarely, diarrhea Concentrated urine T: Red and dry C: Thick and yellow or Thick, greasy and yellow P: Slippery and rapid
Treatment Principle	Clear Heat from the Stomach Harmonize the Stomach Descend Qi
Herb Formulas	Zhu Ru Tang With damage to Qi and Yin: Da Ban Xia Tang modified With excessive alcohol consumption creating Damp-Heat: Ge Hua Jie Cheng San For Heat, Cold and Deficiency with a sensation of blockage, distention, fullness and discomfort in the epigastrium: Ban Xia Xie Xin Tang Chinese Patent Medicine: With Damp-Heat: Huang Lian Jie Du Wan With Phlegm-Heat: Wen Dan Wan With constipation: Niu Huang Qing Huo Wan
Points	PC-6, PC-8, REN-12, REN-14, REN-17, ST-36, ST-44 With severe Heat: + LI-4, LI-11 or SJ-2, ST-45 With constipation: + SJ-6, ST-25 With Phlegm-Heat: + PC-5, ST-40 Ear: Esophagus, Pylorus, Stomach Duodenum, Spleen, Sympathetic, Shenmen

HEAT INVADING THE HEART

Clinical Manifestations	Found in patients with Heart disease Palpitations Dyspnea Choking sensations in the chest Spontaneous perspiration Insomnia Restlessness A pale complexion Clammy hands T: Pale C: White P: Weak and irregular or Slow and irregular
Treatment Principle	Tonify Qi Nourish the Heart Calm the Shen
Herb Formulas	Yang Xin Tangmodified
Points

HEART BLOOD AND SPLEEN QI DEFICIENCY

Clinical Manifestations	Palpitations Insomnia Much dreaming Easily startled Poor memory Shortness of breath Chest oppression Profuse sweating Four limbs tired and lethargic Cold extremities Weakness Emaciation Weak voice Disinclination to speak Low grade fever Loss of appetite Distention and fullness of the epigastrium and abdomen Loose stools Sallow complexion Copious, pale menses Uterine bleeding or Light menstrual flow or Amenorrhea T: Pale or Pale and swollen C: White P: Thready and weak, maybe rapid or Possibly Tight and choppy
Treatment Principle	Reinforce and Benefit the Heart and Spleen
Herb Formulas	Gui Pi Tang Lupus #7 With spontaneous perspiration: Zhi Gan Cao Tang modified With Heart Yang Deficiency with spontaneous perspiration and cold limbs: Shen Fu Tang modified
Points	HT-7, REN-4, SP-1, SP-6, ST-36, UB-15, UB-20 HT-7, ST-36 With spontaneous perspiration: + KI-7, LI-4 With Heart palpitations: + PC-5 With chest pain: + LI-4, PC-6

LIVER QI STAGNATION ATTACKING 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 Hepatosplenomegaly Poor appetite Nausea Vomiting Jaundice Dizziness Insomnia Irregular menses Dysmenorrhea Breast distention and pain before and during menses Amenorrhea T: Pink or Dark C: White and greasy P: Slippery and wiry or Thready and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Xiao Yao San modified With chest and flank pain and marked hepatosplenomegaly: Chai Hu Shu Gan Tang modified
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37 LI-4, LIV-3, SP-6, ST-36 With marked chest oppression: + PC-6, REN-17 With severe Blood Stasis: + SP-10, UB-17 With abdominal distention: + REN-12, REN-13 With anorexia due to Food Stagnation: + ST-21, ST-44 With Heat: + GB-34, - LIV-3, + LIV-2 With marked diarrhea: + UB-20, UB-21 With nausea and vomiting: + PC-6, REN-12 With menstrual irregularities: + REN-6, ST-29

LIVER FIRE

Clinical Manifestations	Hypochondriac pain Headache Dizziness Red sore eyes Hearing loss Swelling in the ears Bitter taste in the mouth Irritability Short temper Difficult and painful urination with a heat sensation in the urethra Swollen and itchy genitalia Yellow, foul smelling leukorrhea Short menstrual cycle with reddish-purple blood Ear discharge Yellow urine Chest pain Constipation Turbid urine Dry throat Hematuria Pain in the armpits Sweating in the groin T: Red or Red edges C: Yellow or Yellow and greasy P: Wiry, Excess and rapid
Treatment Principle	Drain Excess Fire from the Liver and Gallbladder
Herb Formulas	Long Dan Xie Gan Tang Chinese Patent Medicines: Long Dan Xie Gan Wan Qian Lie Xian Wan Chuan Xin Lian Kang Yan Pian Te Xiao Pai Shi Wan With hematuria: Yun Nan Bai Yao (take along with any of the above formulas)
Points	UB-28, REN-3, SJ-6, LIV-5, LIV-3, LIV-2

LIVER WIND STIRRING INTERNALLY: EXTREME HEAT GENERATES WIND

Clinical Manifestations	Persistent high fever Vexation Agitation Restlessness Deranged speech Crying and laughing without constancy Seizures Spasms Hemiplegia or Paraplegia Neck stiffness Convulsions Oculogyric crises Opisthotonos Clouded Spirit Coma Urinary incontinence or Urinary retention T: Red or Deep red None or Scorched yellow P: Wiry and rapid or wiry and thready
Treatment Principle	Clear Heat Cool the Liver Subdue Wind Calm the Shen
Herb Formulas	Ling Jiao Gou Teng Tang modified
Points	Bleed the Jing-Well points of Six Hand Channels, needle DU-14, DU-16, DU-20, DU-26, LI-11, LIV-2, LIV-3 GB-20, GB-34, LI-11, LIV-3 With dizziness, vertigo, agitations and restlessness: + DU-20, Yintang With persistent high fever: + DU-20, Yintang, Bleed DU-14, Shixuan With Phlegm Fire: + PC-8, ST-40 With loss of consciousness: +DU-26

HEAT STAGNATION IN THE LIVER CHANNEL

Clinical Manifestations	Aching and pain in the Liver area Chest, flank, gastric or abdominal glomus, fullness, distention or pain Heart vexation A quick temper Depression Dysphoria Red or purple dark colored skin lesions Dysmenorrhea or Amenorrhea or Irregular menstruation With Spleen Channel Deficiency: Aversion to Cold with emission of Heat Poor appetite Weakness Fatigue Dizziness Insomnia Maybe High Blood pressure Maybe hepatosplenomegaly Maybe functional Liver impairment T: Crimson, maybe with macules C: Thin and white or Thin and yellow P: Thready and tight or Wiry and rapid
Treatment Principle	Regulate the Liver Clear Heat Invigorate the Blood Transform Stasis
Herb Formulas	Yi Guan Jian + Si Miao Yong An Tang modified
Points	GB-34, LI-4, LIV-2, SP-6 With hepatosplenomegaly and Liver area aching and pain: + LIV-13, LIV-14 With severe Blood Stagnation: + UB-17 With pronounced Spleen Deficiency: + ST-36 With ascending Toxic Heat: + LI-11, GB-43

HEAT IN THE LIVER AND GALL BLADDER CHANNELS

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

LIVER AND KIDNEY YIN DEFICIENCY WITH EMPTY FIRE RISING

Clinical Manifestations	Remission stage Red papular lesions The lesions are few and scattered but increase with exertion Persistent low-grade fever in the afternoon which is worse with exertion Dysphoria with Five Sole Heat Tidal redness of the facial region Malar flush Restlessness A headache Weakness Insomnia Fatigue Dizziness Vertigo Tinnitus or deafness Poor memory Blurred vision Impaired vision Dry eyes Night blindness Aching, soreness or weakness of the low back Spermatorrhea or Premature ejaculation Joint aching and pain Aching in the bones Aching in the leg and heel Dry mouth and lips Dry lusterless hair which is falling out Thirst Alopecia Night sweats or Spontaneous perspiration Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Urine short and red Heightened libido Light menses or Late menses or Amenorrhea T: Red C: Thin and yellow or Little or None P: Thready and rapid or Weak and rapid or Thready, wiry and rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zi Gan Bu Shen Fang Sheng Di Yang Yin Qing Re Fang Lupus #3 Zhi Bai Di Huang Wan modified Da Bu Yin Wan + Si Wu Tang modified Chronic disciform: Liu Wei Di Huang Wan Topical: Qing Dai Gao Apply a 20% solution of Rx. Glycyrrhizae Gan Cao to the lesions.
Points	HT-6, KI-2, KI-7, UB-23 With severe Qi Deficiency: + ST-36 With marked tidal fevers and Five-Sole-Heat: + DU-14 For Blood Stagnation with marked skin lesions: + DU-10, UB-17 For joint aching and pain: + LI-11, SP-9 For dizziness and vertigo: + DU-20, GB-20 For menstrual irregularities: + SP-6 KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23 If Heart Fire also Flares: HT-7, PC-7, UB-15 If Liver Yang also Rises: LIV-3, UB-18

LIVER AND KIDNEY YIN DEFICIENCY WITH FOOD STAGNATION AND HEART FIRE

Clinical Manifestations	Red butterfly shaped patches over the face Aching pain of the low back and knees Burning pain or aching of the hypochondria Persistent low-grade fever Listlessness Ulceration of the buccal mucosa Ulceration of the tongue Dysphoria Five Sole Heat Dizziness Insomnia Abdominal distention Abdominal distention Anorexia T: Red with echymoses C: Little or None P: Deep, thready and rapid
Treatment Principle	Nourish Liver and Kidney Yin Clear Heat Break up Blood Stasis
Herb Formulas	Zhi Bai Di Huang Wan modified Chinese Patent Medicine: Liu Wei Di Huang Wan
Points	KI-3, LIV-2, LU-5, SP-6, UB-18, UB-23 With Qi Deficiency: + moxa REN-4 With arthralgia: + GB-34, LI-11 With abdominal distention: + ST-36, ST-44

YIN DEFICIENCY HEAT

Clinical Manifestations	Night fever with morning coolness No sweating Emaciation Tidal fever in the afternoon Steaming bone disorder Night sweats Spontaneous seminal emissions Irritability Heat and pain in the knees (maybe with weakness) Atrophy and weakness of the knees and legs Red face Restless fever Hematemesis Sore knees Sore lower back Maybe hemoptysis May be constant hunger Maybe constipation Hot flashes Restlessness Fidgeting Insomnia with frequent dreams Productive bloody cough Easily angered Nightmares Sore feet with flaccidity Tinnitus Burning sensation over Kidneys Dizziness or vertigo Five Sole Heat Cough T: Red C:Little P: Thready and rapid
Treatment Principle	Nourish Yin Clear Deficiency Heat
Herb Formulas	Qing Hao Bie Jia Tang + Da Bu Yin Wan
Points

QI AND YIN DEFICIENCY WITH DEFICIENCY HEAT

Clinical Manifestations	Remission stage Fatigue Long-standing low-grade fever A pale face Poor appetite Loose stools or Constipation Dizziness Weak voice/reluctance to speak Malar flush Night sweats Anxiety Hot flashes Dysphoria with Five Sole Heat General malaise Spontaneous perspiration or Night sweats Chest oppression Shortness of breath Lack of Spirit Red patches on the face Arthralgia Palpitations Hair loss T: Red or Pale or Pale red C: Thin white, Little or None P: Deep and weak or Thready and rapid or Thready, rapid and forceless
Treatment Principle	Tonify Qi Nourish Yin Clear Deficiency Heat
Herb Formulas	Qin Jiao Bie Jia San + Bao Yuan Dan modified Lupus #1 Sheng Mai Sanmodified Chinese Patent Medicine: Bu Zhong Yi Qi Wan + Zhi Bai Di Huang Wan
Points	DU-14, LIV-2, LU-5, SP-6, UB-13, UB-20, UB-23, moxa REN-4

QI DEFICIENCY WITH BLOOD STASIS

Clinical Manifestations	Widespread purple lesions The lesions are often atrophied Joint pain Occasional low-grade fever Maybe Raynaud's disease Hepatosplenomegaly Arthralgia in the sternocostal region Abdominal distention Menstrual disorders T: Pale or Dark red with echymosis C: Thin and white P: Thready and choppy or Taut and weak
Treatment Principle	Tonify Qi Stabilize Yuan Qi Invigorate the Blood Reduce spots
Herb Formulas	Bu Pi Wei Xie Yin Huo Sheng Yang Tang Jia Jian Chai Hu Shu Gan Tang + Tong Qiao Huo Xue Tang Take 30g Rx. Astragali Huang Qi 1-2 times daily for the first 2-3 weeks. Increase the dosage to 60g for the next 4 weeks and the 90g thereafter. Chinese Patent Medicines: Huo Xue Qu Yu Pian With Yin Deficiency: Liu Wei Di Huang Wan Qing Gao Mi Wan
Points

QI AND BLOOD STAGNATION

Clinical Manifestations	Cyanosis of the tips of the extremities or a mixture of somber white and greenish-purple Purple colored skin macules Disciform, deep abnormally colored skin lesion Scaly, cracked skin Joint and muscle aching and pain Menstrual irregularity with depression Dysmenorrhea or Amenorrhea T: Purple-red with static, engorged sublingual veins C: Normal P: Choppy or Choppy and wiry
Treatment Principle	Invigorate the Blood Transform Stasis Regulate Qi Unblock the channels
Herb Formulas	Xue Fu Zhu Yu Tang modified
Points	DU-10, LI-4, SP-6, UB-17 For cyanosis and pain at the tips of the toes: + Bafeng For cyanosis and pain at the tips of the fingers: + Baxie For marked Liver Qi Stagnation: + LIV-3, PC-6 With more Qi Stagnation and somber, white tips and coldness of the extremities: + moxa or moxa needle REN-4 With pronounced joint and extremity aching and pain: + LI-11, SP-9

QI, YANG AND BLOOD DEFICIENCY

Clinical Manifestations	Amnesia Palpitations Feverishness Anorexia Emaciation Pale face Insomnia Dyspnea on mild exertion Fatigue Shortness of breath. Weight loss Dry skin Dry mouth Dry throat Dry lips Uterine bleeding Irregular menstruation May suddenly lose consciousness Slack jaw Restless at night Lassitude Tendency toward being frightened easily Weakness Sallow complexion Dizziness Tremors in the limbs Spontaneous perspiration Fever and severe chills General debility Mental instability Coughing and gasping. Night sweats Amnesia. Diarrhea Turbid urine Nocturnal emission Impotence Constipation Feeble breathing. Tired limbs T: Pale C:White P: Thready and weak or thready, rapid and weak or Deep and weak
Treatment Principle	Tonify Qi Nourish the Blood Strengthen the Spleen and Lungs Nourish the Heart
Herb Formulas	Ren Shan Yang Rong Tang
Points

BLOOD DEFICIENCY WITH HEAT

Clinical Manifestations	Chronic, continuous uterine bleeding A pale complexion Stabbing pain in the abdomen Alternating chills and fever Irregular menstruation with profuse bleeding Abdominal pain Fever Thirst Itchy skin Heat in the upper body with Cold in the lower body Irritability and restlessness despite fatigue and exhaustion Mood swings A sallow complexion Emaciation T: Dry with a red tip C: Thin white P: Deep and rapid
Treatment Principle	Drain Fire Resolve toxicity Tonify the Blood Stop bleeding Warm the menses Cool the Blood
Herb Formulas	Wen Qing Yin
Points

TOXIC HEAT

Etiology	Toxic Wind-Heat invades the Yin and Blood which impedes the flow of Blood and impairs the function of the joints.
Clinical Manifestations	High fever Red, edematous maculae over the face and other parts of the body General aching of the joints Restlessness Insomnia Thirst with a preference for cold drinks Malaise (often trance-like) Absent mindedness Dark urine Constipation Delirium Coma Convulsions Echymosis Hemoptysis Hematochezia Epistaxis T: Deep red or Purple C: Yellow and slimy P: Slippery and rapid or Tight and rapid or Full
Treatment Principle	Clear Heat Resolve toxicity Cool the Blood Open the channels
Herb Formulas	Qing Wen Bai Du Yin modified Xi Jiao Di Huang Tang modified Hua Ban Tang With Yin Deficiency: Lupus #2 Chinese Patent Medicines: Xi Ling Jie Du Pian Niu Huang Qing Xin Wan
Points	DU-14, LI-4, LI-11, SJ-5, ST-43 With Excess Heat and coma: + bleed Shixuan, UB-40

HEAT DAMAGING QI AND YIN

Clinical Manifestations	Vexatious Heat Spontaneous perspiration Palpitations Chest oppression Shortness of Breath Cough Yin Deficiency insomnia Irritation and agitation, possibly severe Lips may be greenish-purple Facial complexion may be somber white Maybe cold extremities Weak limbs Listlessness Fatigue There may be cardiopulmonary or central nervous system damage T: Pale C: Thin and white P: Thready and weak or Choppy or Regularly intermittent
Treatment Principle	Clear Heat Nourish Yin Tonify Qi Calm the Shen
Herb Formulas	Lupus #6
Points	KI-7, LI-4, LU-9, PC-6, ST-36 With night sweats: + HT-6 With irritability, agitation and insomnia: + DU-24, HT-7 With cold extremities, weakness and fatigue: + moxa or moxa needle REN-4

XUAN YIN

Clinical Manifestations	Cough with sharp pain in the chest and hypochondrium Hypochondriac distention and pain Hard focal distention in the epigastrium Dry heaves Shortness of breath Headache Abdominal distention Wheezing Fullness in the chest Dyspnea caused by extreme chest and back pain Dizziness Vertigo Asthma Rapid breathing Generalized edema which is worse in the lower body Difficult urination and defecation T: Normal or Dark C: Thick, greasy and white P: Deep and wiry
Treatment Principle	Attack and Dispel water
Herb Formulas	Shi Zao Tang
Points	KI-3, LI-4, LI-11, PC-6, REN-11, REN-12, ST-36, UB-13, UB-20, UB-23

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