METRORRHAGIA (UTERINE BLEEDING) (METROSTAXIS) (FUNCTIONAL UTERINE BLEEDING)

GENERAL

Clinical Manifestations	Metrorrhagia: Uterine bleeding at irregular intervals, particularly between the expected menstrual periods. Metrostaxis: Small but continuous hemorrhage of the uterine mucous membrane.
Treatment Principle
Herb Formulas	For Yin Exhaustion: Sheng Mai San For Yang Collapse: Shen Fu Tang For collapse due to Blood loss: Ju Yuan Jian During pregnancy: Ba Zhen Tang Due to abortion or miscarriage: Shi Xiao San Yao Liu An Jiao Nang
Points	REN-4, SP-6 SP-4, SP-10, LIV-2, LIV-3, ST-36, DU-4, PC-6 LIV-3, ST-30, ST-36, SP-6 , UB-43, four fingers below McBurney’s point SP-1, SP-2, LIV-3, HT-1, HT-5, REN-6, UB-40. UB-55, ST-18 ST-36, SP-6 , REN-3, REN-4, KI-3, LU-6 UB-23, UB-31, UB-32, UB-33, UB-34, ST-36, SP-6 , SP-9, SP-10, REN-4 REN-3, REN-4, SP-6 , SP-10, Zigong REN-3, REN-4, REN-6, LIV-1, LIV-3, KI-2, KI-10, SP-2, SP-6, SP-10, ST-12, HT-1, PC-3, UB-40 REN-3, REN-6, LIV-1, LIV-3, KI-2, KI-10, SP-6 REN-3, Zigong LIV-3, SP-6 SP-1, SP-6 , SP-10, REN-6 SP-1, ST-36 REN-4, SP-1, SP-10, ST-36 HT-3, LIV-2, PC-6 LIV-2, LIV-3 HT-7, KI-3, PC-7, SP-1 For Excess bleeding (heavy and sudden): REN-3, REN-4, REN-6, SP-1, SP-6 , LIV-1 For dripping (spotting): REN-4, UB-23, moxa: UB-20, SP-6, LIV-3, SP-1, SP-10 For precocious bleeding: SP-10, LIV-2 For delayed menstruation: ST-36, SP-4 For continuous bleeding: Moxa: UB-17, UB-18, UB-23, DU-4, REN-3, REN-6, PC-5, SP-10, KI-10, LIV-2 Functional Uterine Bleeding: a. UB-24, Shiqizhuixia, SP-6 b. UB-31, UB-32, UB-33, UB-34, ST-36, SP-2, SP-6 , SP-10, Zigong, REN-4, REN-6 Ear: a. Ovary, Kidney, Internal Secretion, Uterus b. Uterus, Subcortex, Endocrine, Ovaries – 1-2 hours with periodic stimulation Cutaneous: SP-1, SP-3, SP-4, SP-6 , SP-10, UB-15, UB-17, UB-18, UB-20, UB-22, UB-23, UB-31, UB-32, UB-33, UB-34, DU-20, REN-4, REN-6, PC-6, LIV-1, Huatuojiaji from T-1-S-4 Head: Reproduction, Bladder Moxa: a. 3 cones – Zigong, SP-1, SP-6 If there is spotting 1 ½ days after bleeding stops: 5 cones – REN-4, REN-6, SP-6 b. REN-7, SP-1, SP-6, UB-18, UB-20 (Choose 1-3 points per treatment) For Spleen Deficiency: + DU-4, REN-4 For Blood Heat: + LI-1, SP-10 For scanty menstruation: + DU-20 Cutaneous acupuncture: DU-20, Huatuojiaji from T-1 to S-4, LI-1, PC-6, REN-4, REN-6, SP-1, SP-3, SP-4, SP-6, SP-10, UB-15, UB-17, UB-18, UB-20, UB-22, UB-23, UB-31, UB-32, UB-33, UB-34

JUE YIN COLD AND HEAT

Clinical Manifestations	Intermittent attacks of abdominal pain Stifling sensation in the chest and epigastrium A sensation of warmth in the chest and epigastrium Irritability in the chest and epigastrium Vomiting after eating Extremely Cold extremities Vomiting of roundworms Incessant diarrhea Hunger with no desire to eat Vomiting immediately after eating Heat in the Stomach with Cold in the Intestines Bitter taste in the mouth Frequent urination Anxiety Abdominal pain (better with warmth and pressure) Pain beneath the Heart Borborygmus Unquenchable thirst Running piglet Qi Pain and Heat in the Stomach Discharge of small amounts of pus Irritability Recurrent nausea and vomiting Diarrhea Dry throat Turbid urine Polydipsia T: Red or geographic or pale C: White P: Hidden or Wiry and tight
Treatment Principle	Warm the Internal organs Warm the Middle Jiao Warms the Intestines Drains Heat Replenishes Qi Dispels parasites Calms roundworms Drains the Liver Calms the Stomach Promotes Blood circulation Relieves pain
Herb Formulas	Wu Mei Wan
Points

XUE LEVEL: EXCESS HEAT CAUSES BLEEDING

Clinical Manifestations	High fever Confusion of mind Delirium Mania Dark yellow urine Excessive skin rashes all over body Hemorrhage: Hematemesis Hemoptysis Epistaxis Hemafecia Hematuria T: Deep red, dry or Purple red C: None P: Rapid or Thready and rapid or Thready and feeble
Treatment Principle	Cool the Blood Dispel Heat and Toxins from the Xue Stage Promote Blood Circulation
Herb Formulas	Si Sheng Wan
Points	To clear Heat and Toxins: Bleed the Jing Well points, DU-14, LI-11, ST-44 To promote Blood circulation: SP-10, UB-17 To treat hemafecia: SP-1, ST-25, ST-37 To restore consciousness: DU-26, K-1 To nourish Yin: KI-3, SP-6 To calm the Shen: HT-7

WIND-DAMP INVASION

Clinical Manifestations	Leaking of malignant blood in women Irregular menstruation Sudden incessant flooding of menstrual Blood Copious discharge of viscous fluid Lassitude A desire to lie down Loss of use of the limbs A lack of [physical] strength Shortness of breath Ascension of Qi P: Moderate - When pressed, Flooding and large - yet still present upon deeper palpation If Dampness is predominant: Blood mixed with mucus Sallow or yellowish complexion Slightly puffy face Heavy head Dizziness Listlessness Stuffy chest and epigastrium Sticky sensation in the mouth T: Normal C: Thin whitish and sticky P: Slippery and Choppy If Heat is predominant: Profuse purplish vaginal Hemorrhage Repulsive odor Flushing or Heat sensations Spontaneous sweating Bitter taste in mouth Thirst Dark, scanty urine Constipation or diarrhea T: Red C: Sticky and yellow P: Slippery and rapid
Treatment Principle	Eliminate Dampness Clear Heat Eliminate Wind Boost Qi
Herb Formulas	Sheng Yang Chu Shi Tang
Points

LUNG AND SPLEEN QI DEFICIENCY

Clinical Manifestations	Protracted, incessant cough Expectoration of copious, clear, watery or white Phlegm Short, weak, breathing Asthma Four limbs tired Anorexia General lassitude Distention and pain of the epigastrium and abdomen Loose stools Severe cases: Frightens easily T: Pale C: White P: Thready and weak
Treatment Principle	Reinforce the Spleen Benefit the Lungs Warm and transform Phlegm-Dampness
Herb Formulas	Shen Ling Bai Zhu San
Points	LU-9, REN-17, SP-3, ST-36, UB-13, UB-20, UB-43

LUNG AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Calcaneus pain May be bone spur Unproductive cough or Scanty, sticky phlegm or Sometimes blood-streaked sputum Dry mouth Dry throat Low back and knees sore and weak "Steaming Bone" tidal fever Night sweats Malar flush Maybe hoarse voice Maybe pain in shin, foot, and heel Spermatorrhea Irregular menses T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Lungs and Kidneys
Herb Formulas	Ba Xian Chang Shou Wan
Points	HT-6, KI-3, KI-6, LU-6, LU-9, UB-13, UB-23

CENTRAL QI SINKING

Clinical Manifestations	Pale-red to normal Blood color Thin and watery Blood with clots Irregular menstruation Frequent, scanty, forceless and inhibited urination Maybe a desire to urinate without success Fatigue Lassitude Weakness A weak voice Sagging and distention in the lower abdomen and perineal area 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 or Thready and weak
Treatment Principle	Strengthen the Spleen Benefit Qi Reinforce the Center Invigorate Yang
Herb Formulas	Bu Zhong Yi Qi Tang
Points	DU-20, REN-1, REN-4, REN-6, SP-6, ST-36 For inhibited urination or desire to urinate without success: + SP-9 For dribbling urination: + UB-52 For accompanying Damp-Heat: + SP-9, ST-44 For sagging pain in the genitals: + moxa LIV-1 For distention and pain in the lower abdomen, groin and genitals: + LIV-8 For Food Stagnation : + ST-21 For accompanying Kidney Qi Deficiency: + KI-3 For accompanying Kidney Yin Deficiency: + KI-7 For Heart and Spleen Deficiency: + HT-7 For severe Qi Deficiency: + SP-3

SPLEEN QI DEFICIENCY: SPLEEN NOT GOVERNING BLOOD

Clinical Manifestations	Sudden, severe uterine bleeding The Blood is pale and watery Light-headedness Fatigue Cold extremities Shortness of breath A stifling sensation in the chest Loose stools Persistent uterine bleeding with continuous spotting A shiny, pale complexion Slight facial edema T: Pale and swollen with teethmarks C: Thin and white P: Thin and frail or Hollow
Treatment Principle	Tonify the Blood Augment Qi Stops bleeding
Herb Formulas	Gu Ben Zhi Beng Tang Gui Pi Tang Ba Zhen Tang Shen Ling Bai Zhu San Ju Yuan Jian Si Jun Zi Tang Dang Gui Bu Xue Tang Jiao Ai Tang Bu Zhong Yi Qi Tang modified Bu Wei Fang Xiong Gui Jiao Ai Tang Si Wu Tang modified Shou Pi Jian With Inconsolidation of the Chong and Ren channels: Gu Chong Tang
Points	REN-6, ST-36, SP-1, SP-8, UB-20, KI-3, LIV-3 For very cold/pale patient: Moxa REN-4

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	Tao Hua Tang Gan Cao Gan Jiang Tang
Points	Moxa or moxa needle LIV-13, REN-12, SP-3, SP-6, ST-36, UB-20, UB-21

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Body cold Limbs icy Complexion white and shiny Low back, knees and abdomen feel cold and painful Lower abdomen feels cold and painful Loose stools containing undigested food Cock-crow diarrhea (occurs at about 5 am) Edema of face and limbs Dysuria T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep, thready, weak and maybe slow
Treatment Principle	Tonify Spleen and Kidney Yang
Herb Formulas	Dang Gui Shao Yao San Ju Yuan Jian Shi Quan Da Bu Tang Li Zhong Tang Gu Yin Jian Huang Tu Tang
Points	Moxa UB-20, UB-23, ST-36, SP-6, SP-9, REN-4, REN-12

HEART YANG DEFICIENCY EXHAUSTION: VANQUISHED YANG

Clinical Manifestations	Palpitations Shortness of breath Drenched with perspiration Above symptoms worse with exertion Four limbs cold Cyanosis of mouth and lips Faint, weak respiration P: Minute (on the point of collapse)
Treatment Principle	Return Yang Consolidate exhaustion.
Herb Formulas	Shen Fu Tang
Points	Moxa REN-8, REN-6, REN-4, ST-36, , needle DU-25, DU-26, PC-6

HEART BLOOD AND SPLEEN QI DEFICIENCY

Clinical Manifestations	Palpitations Insomnia Much dreaming Easily startled Poor memory Four limbs tired and lethargic 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 C: White P: Thready and weak
Treatment Principle	Reinforce and Benefit the Heart and Spleen
Herb Formulas	Gui Pi Tang
Points	UB-15, UB-20, ST-36, SP-1, SP-6, REN-4, HT-7

HEART AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Insomnia with much dreaming Irritability Easily startled Palpitations Poor memory Dizziness Tinnitus Low back soreness Legs weak Tidal fever Night sweats Dry mouth Red cheeks Urine short and red T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Reduce Fire Make Heart and Kidney communicate.
Herb Formulas	Ba Xian Chang Shou Wan With palpitations, frequent dreaming, insomnia, and a poor memory: Tian Wang Bu Xin Dan modified
Points	HT-7, KI-3, PC-6, PC-7, UB-15, UB-23

LIVER QI STAGNATION WITH HEAT

Clinical Manifestations	Irritability Short temper Restlessness Fever or tidal fever Red eyes Dry mouth and throat Palpitations Lower abdominal pain Difficult urination Painful urination Increased menstrual flow Uterine bleeding Early menstruation Aching in limbs Dizziness Mental instability Red face Thirst Turbid urine Alternating chills and fever Red cheeks Wheezing Nervousness Headache Red eyes Dry mouth Anorexia Infertility Abdominal pain Spontaneous sweating or night sweats with fever Anxiety Dry eyes Hypochondriac pain Somnolence Insomnia Aching shoulders Five Sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude Depression Restlessness Constipation with flushing up Pale complexion Bitter taste in mouth Vertigo Abdominal distention near the umbilicus Epistaxis Irregular menstruation Heaviness in the lower abdomen T:Red or Red edges C: Thin and yellow P: Thready, rapid and wiry or Wiry and tight and rapid
Treatment Principle	Pacify the Liver Spread Liver Qi Strengthen the Spleen Nourish the Blood and Yin Regulate menstruation Sedate the Heart Clear Heat
Herb Formulas	Jia Wei Xiao Yao San
Points

LIVER FIRE

Clinical Manifestations	Severe, splitting headaches with dizziness Sudden tinnitus or 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 T: Red tip and edges C: Thick, yellow, dry and rough P: Wiry, Shi and rapid In severe cases (due to Liver Fire damaging the Luo Mai): Mania. Bleeding of Shi Heat type: Hemoptysis Hematemesis Epistaxis
Treatment Principle	Clear Heat Descend Liver Fire
Herb Formulas	Long Dan Xie Gan Tang For Liver Qi Stagnation turning to Heat: Ping Gan Kai Yu Zhi Xue Tang Jia Wei Xiao Yan San
Points	LIV-2, GB-20, Bleed UB-20, Taiyang and KI-1

DAMP-HEAT IN THE LIVER AND GALL BLADDER

Clinical Manifestations	Yang jaundice (sclera and skin bright yellow) Pain and fullness in ribs on both sides Maybe pain in the right hypochondrium Bitter taste in mouth Nausea Vomiting sour and bitter fluids Anorexia Maybe alternating chills and fever Concentrated, dark urine Abdominal distention Women: Yellow vaginal discharge with foul smell Pruritis vulvae Men: Pain, swelling and burning sensations of testicles T: Pink C: Yellow and greasy or sticky P: Wiry and rapid or Slippery and rapid
Treatment Principle	Clear Dampness Purge Heat from Liver and Gall Bladder
Herb Formulas	Yin Chen Hao Tang Long Dan Xie Gan Tang
Points	Dannangxue, DU-9, GB-24, GB-34, LIV-14, SI-4, SP-9, UB-18, UB-19, UB-48

LIVER QI AND BLOOD STAGNATION

Clinical Manifestations	Bleeding between periods Scanty or normal Blood flow If no Heat the color is normal If there is Heat the color is deep red and thick The flow starts and stops during menses There are small clots Distended pain in the lower abdomen 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 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 Flatulence T: Red edges C:Thin white or yellow P: Wiry and Deficient or Wiry, tight and Deficient
Treatment Principle	Regulate Liver Qi and Blood Remove Stagnation Regulate menstruation
Herb Formulas	Xiao Yao San Shi Xiao San With more severe Blood Deficiency: Hei Xiao Yao San
Points

LIVER WIND STIRRING INTERNALLY: LIVER BLOOD DEFICIENCY GENERATES WIND

Clinical Manifestations	Pale complexion Pale lips Blurred or failing vision Spots before eyes Dizziness Dry eyes Pale nail beds Irritability Frightens easily Insomnia with much dreaming Tinnitus Numbness of limbs Tremor, spasms or involuntary movements (chorea) Involuntary shaking of head Light menses or amenorrhea Late menses Tic or tremor of hands and feet Maybe trismus T: Pale C: Little P: Thready and wiry
Treatment Principle	Nourish the Blood Subdue Wind
Herb Formulas	Si Wu Tang
Points	DU-16, DU-20, GB-20, LIV-3, REN-4, SP-6, ST-36, UB-17, UB-18, UB-20

LIVER BLOOD DEFICIENCY

Clinical Manifestations	Pale complexion Pale lips Blurred or failing vision Spots before the eyes Dizziness Dry eyes Pale nail beds Irritability Frightens easily Insomnia with much dreaming Tinnitus Numbness of the limbs Light menses or Amenorrhea Late menses T: Pale C: Little P: Thready
Treatment Principle	Nourish the Liver Reinforce the Blood
Herb Formulas	Si Wu Tang For menstrual disorders: Hei Xiao Yao San
Points	Moxa or needle LIV-3, REN-4, SP-6, ST-36, UB-17, UB-18, UB-20

KIDNEY YIN DEFICIENCY

Clinical Manifestations	Light-headedness Vertigo Tinnitus Soreness and weakness in low back and legs Spontaneous and nocturnal emissions Night sweats Dry mouth and throat Thirst with a desire to drink Dizziness Forgetfulness Deafness Rhinitis Dizziness	Dribbling of urine Malar flush Five sole heat Insomnia Hair loss Loss of teeth Infertility Amenorrhea Uterine bleeding Spontaneous perspiration Spermatorrhea Poor vision T: Red and shiny C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Tonify the Kidneys Supplement Jing Benefit Marrow
Herb Formulas	Zuo Gui Wan modified Liu Wei Di Huang Wan Liang Di Tang modified With Heat: Gu Jing Wan Post-menopausal: Zuo Gui Yin modified Zhi Bai Di Huang Wan
Points	REN-4, REN-6, KI-2, KI-6, KI-10, LIV-8, LU-7, UB-18, UB-23 HT-6, KI-6, SP-1, Duanhong (between the knuckles of the second and third fingers - Master Tung Point)

KIDNEY YIN DEFICIENCY WITH FIRE RISING

Clinical Manifestations	Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of the low back Spermatorrhea or Premature ejaculation Aching in the bones Aching in the leg and heel Dry mouth Thirst Night sweats Five Sole Heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Urine short and red Heightened libido If Heart Fire also Flares: Insomnia Frequent dreams Palpitations If Liver Yang also Rises: Dizziness Blurred vision T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zhi Bai Di Huang Wan With Liver Yang Rising: Er Zhi Wan modified Jia Wei Xiao Yao San modified
Points	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

KIDNEY YANG DEFICIENCY

Clinical Manifestations	Edema of whole body particularly at and below the waist Pitting edema Lumbago: low back feels cold, weak and aching Abdominal distention with full sensations Feeling chilled Aversion to cold Cold limbs General debility Pale face Urinary frequency with abundant, clear urine or Oliguria with edema Maybe nocturia Vaginal discharge Lassitude Withdrawn, subdued behavior Knees feel cold and aching Dizziness Tinnitus Impotence Low libido Infertility (“uterus cold and infertile”) Dribbling after urination Incontinence of urine Face gray and congested or pale Feeling nervous and cold with mental weariness Hearing deficit Maybe anorexia Maybe loose stools Maybe chronic diarrhea or “cock crow” diarrhea T: Pale and swollen C: Thin and white or Thick, white and sticky P: Deep and thready - maybe slow
Treatment Principle	Warm Kidney Yang Stop the bleeding
Herb Formulas	You Gui Wan modified You Gui Wan + Li Zhong Tang Da Bu Yuan Jian modified Shi Quan Da Bu Tang Ba Wei Di Huang Wan With Internal Cold: Si Ni Tang
Points	SP-6, REN-4, REN-12, KI-8, KI-7, DU-4, UB-23 Moxa REN-4, REN-6, ST-36, KI-3, KI-10, SP-1, SP-8, UB-23, UB-52, DU-4

KIDNEY QI DEFICIENCY (KIDNEY YIN AND YANG DEFICIENCY)

Clinical Manifestations	Early period May be much Blood due to Inconsolidation of the Chong and Ren channels May be little Blood due to Jing Deficiency The Blood is pale-brown red in color, clear thin and watery Frequent urination Copious amounts of clear urine Incontinence of urine Enuresis Abortion or miscarriage Either a tendency towards being too hot of too cold Shortness of breath Asthma Cold limbs Weak back and knees T: Pale C: White P: Deep, weak possibly tight
Treatment Principle	Tonify Kidney Qi Consolidate the Chong and Ren channels
Herb Formulas	Shen Qi Wan To stimulate ovulation: Yu Lin Zhu With Heat sometimes and Cold sometimes, dizziness, tinnitus, a thin tongue coat, a thready pulse and lumbar and leg pain: Zuo Gui Yin + Er Zhi Wan
Points

KIDNEY AND LIVER YIN DEFICIENCY

Clinical Manifestations	Vertigo Headache Anger Insomnia Malar flush Five sole heat Painful flanks Sore back Maybe hemiplegia T: Red C: Little P: Thin, wiry and rapid
Treatment Principle	Nourish Kidney and Liver Yin
Herb Formulas	Qi Ju Di Huang Wan Yi Guan Jian Zuo Gui Wan modified Mai Wei Di Huang Wan Liu Wei Di Huang Wan With Liver Qi Stagnation Transforming in to Fire: Zi Shui Qing Gan Yin With Fire Rising and Blood Deficiency: Dang Gui Liu Huang Wan
Points	UB-18, UB-23, LIV-3, KI-3, SP-6

KIDNEY, SPLEEN AND HEART DEFICIENCY

Clinical Manifestations	Irregular periods Scanty bleeding Clots in the menstrual Blood Abdominal distention Breast distention Premenstrual tension Depression Sighing Irritability T: Normal or Slightly red on the sides C: Normal P: Wiry
Treatment Principle	Nourish the Blood Invigorate the Blood Regulate menstruation Tonify the Kidneys Benefit the Spleen
Herb Formulas	Ding Jing Tang
Points

QI AND BLOOD DEFICIENCY

Clinical Manifestations	Pale, watery Blood Bleeding may be abrupt and profuse or lingering and scanty Palpitations Shortness of breath Laconic speech A sinking sensation in the lower abdomen Fatigue Dizziness Lower abdominal Cold Chilliness A shiny, pale complexion Abdominal fullness Lower back pain Pale face Pale lips T: Pale C: Moist and thin P: Deficient and frail or Weak and smooth
Treatment Principle	Tonify Qi Nourish Blood
Herb Formulas	Ju Yuan Jian Si Wu Tang Gu Ben Zhi Beng Tang With Cold: Shi Quan Da Bu Tang With Blood Stagnation: Xiong Gui Tiao Xie Tang With Yang Deficiency: Ren Shen Yang Rong Tang
Points	UB-20, ST-36, SP-6, SP-9, SP-10, REN-4, REN-12 DU-20, REN-4, SJ-4, SP-1 Ear: Uterus, Subcortex, Endocrine

BLOOD STAGNATION

Clinical Manifestations	Uterine bleeding is unexpected, in large or small amounts but persistent The menses are dark purple and contain clots Pain in the lower abdomen, with guarding Sacroiliac pain Dizziness Exhaustion Sadness Thirst T: Cyanotic or speckled with purpuric spots C: Normal P: Choppy or Weak and small
Treatment Principle	Invigorate the Blood Eliminate Stasis Strengthen the Chong channel Stop bleeding
Herb Formulas	Zhu Yu Zhi Ben Tang Zhu Yu Zhi Ben Tang + Shi Xiao San Zhe Cong Yin With Kidney Deficiency: Ding Jing Tang Zhi Lou Tang With Qi Deficiency: Xiong Gui Tiao Xue Yin
Points	REN-3, REN-4, Zigong, SP-6, SP-8, SP-10, LIV-3, PC-6 DU-20, REN-4, REN-6, SP-1, SP-10, ST-36 With Heat: + LIV-1 With Damp-Heat: + 1. LI-4, ST-25 2. LIV-3, ST-25, UB-20 With piercing pain in the lower abdomen: + SP-8 With fullness in the chest, emotional distress and a wiry pulse: + LIV-2, LIV-3 With constipation: + UB-25

BLOOD STAGNATION WITH BLOOD DEFICIENCY

Clinical Manifestations	Copious bleeding of dark purple blood The blood is sticky during menstruation May or may not have clots Menstrual cycle is shortened (early menstruation) Palpitations Dizziness Blurred vision Pale, lusterless complexion Pale nails Abdominal pain Fixed lower abdominal pain Irregular menstruation with little flow Vertigo Tinnitus Pale lips May be amenorrhea Insomnia Menstruation may also be accompanied by distention and pain T: Pale C: Normal P: Thin and weak or Thin and choppy
Treatment Principle	Tonify and Invigorates the Blood Regulate Blood Circulation Break up Stagnation Eliminate Blood Stagnation Regulate menstruation Alleviate pain
Herb Formulas	Shi Xiao Si Wu Tang Tao Hong Si Wu Tang modified Si Wu Tang modified
Points	SP-8, SP-10, SP-12, REN-3, REN-4, REN-6 Ear Points: Zigong, Internal circulation

BLOOD HEAT

Clinical Manifestations	Spotting or bleeding between periods Flooding Blood, before period should begin or Trickling blood for a long time after the end of the period Fatigue Bright red or dark red menstrual blood The Blood has a foul odor Low back pain Red face Thirst Dizziness Fatigue Agitation Irritability General feeling of Heat Dark yellow urine Constipation T: Red C: Dry-Yellow P: Rapid (thin if Deficiency Heat) or Forceful, rapid and overflowing
Treatment Principle	Clear Full-Heat and Fire Cool the Blood Stop bleeding Nourish the Yin fluids
Herb Formulas	Bao Yin Jian Qing Re Gu Jing Tang modified Shi Hui San
Points	REN-6, SP-8, SP-10, LI-11 With Liver Qi Stagnation: + LIV-2, LIV-3, SJ-5, GB-34 KI-2, LIV-3. REN-4, SP-1 Ear: Uterus, Subcortex, Endocrine With Damp-Heat: REN-6, SP-1, SP-6, SP-9, LIV-5

BLOOD HEAT DUE TO SPLEEN QI DEFICIENCY

Etiology	Overeating Over thinking
Clinical Manifestations	Continuous small amount of bleeding (spotting) Sometimes a lot Blood is thin and light red in color May be Yang Xu (Cold) symptoms Lassitude Weariness Poor appetite Loose stools Sallow face Spontaneous perspiration Desires to lie down Maybe palpitations Arms ache Greenish-yellow complexion No saliva White lips T: Pale and shiny with teethmarks P: Thready and forceless or Fine and weak
Treatment Principle	Tonify the Spleen Replenish Qi
Herb Formulas	Gu Ben Zhi Beng Tang modified
Points	REN-7, SP-6, UB-20, ST-36, Moxa DU-4 and REN-4, Ear: Subcortex, Endocrine, Ovary, Uterus LIV-1, SP-1, SP-6, REN-4, REN-6, Moxa DU-4 and REN-3 REN-4, UB-20, SP-5, SP-6, KI-2 SP-6, SP-10, Moxa REN-4, ST-36 UB-20, REN-6, LIV-13, SP-6 REN-7, Moxa SP-1, SP-6, UB-20, UB-18, DU-4, REN-4 SP-6, REN-4, REN-6, ST-36, UB-20, UB-21

BLOOD HEAT DUE TO KIDNEY YIN DEFICIENCY WITH EMPTY FIRE RISING

Etiology	Early sex Multiple deliveries Sexual strain
Clinical Manifestations	Continuous small amount of bleeding (spotting) Bright red blood Tinnitus Restlessness Tidal fever Dizziness Chest and ribs swollen Limbs and loins ache Dry throat Face bluish yellow Eyes red at first then white T: Red or Shiny C: Thin or None P: Thready and rapid
Treatment Principle	Clear Heat Cool the Blood Nourish Kidney Yin Regulate menstruation Stop bleeding
Herb Formulas	Metrorrhagia #1 Liang Di Tang Liang Di Tang + Sheng Mai San + Er Zhi Wan + Concha Ostreae Mu Li Zuo Gui Wan modified Qing Re Zhi Beng Tang + Liu Wei Di Huang Wan Qing Re Gu Jing Tang Bao Yin Jian Zhi Bai Di Huang Tang
Points	REN-7, SP-6, SP-10, Ear: Uterus SP-6, REN-4, KI-2, KI-8, KI-10, UB-23 REN-4, REN-6, SP-1, SP-8, KI-2, KI-10, UB-23, DU-4 With night sweating: + HT-6 Sedate, KI-7 Tonify or Even With insomnia: + KI-6, UB-62 Sedate Ear: Subcortex, Endocrine, Ovary, Uterus

BLOOD HEAT WITH BLOOD DEFICIENCY

Clinical Manifestations	Short menstrual cycle Early menstruation Purple Blood Heavy flow Red, sticky vaginal discharge Tidal fever Greenish complexion Metrorrhagia with thick blood Dizziness Blurred vision Palpitations Insomnia Irritability T: Red C: Yellow P: Rapid or Thready, forceful and rapid
Treatment Principle	Tonify the Blood Drain Heat
Herb Formulas	Qin Lian Si Wu Tang Wen Qing Yin Liang Di Tang
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BLOOD HEAT DUE TO EXCESS HEAT

Etiology	Long standing predominance of Yang Excess pungent, spicy food Stagnant emotions generating Liver Fire
Clinical Manifestations	Continuous small amount of bleeding Sudden heavy bleeding Blood Is deep red Blood maybe purple Blood is foul smelling Small clots Thirst Flushed face Insomnia Headaches Dizziness Dry mouth Irritability Easily angered Breast distention Constipation Swollen, painful lower abdomen T: Deep red C: Yellow dry P: Slippery or Wiry and rapid, or Thready
Treatment Principle	Clear Heat Cool and replenish Blood
Herb Formulas	Metrorrhagia #2 Qing Re Zhi Beng Tang modified Qing Re Gu Jing Tang modified
Points	REN-7, SP-6, SP-10, LIV-1, LIV-2 LIV-1, SP-1, SP-6, SP-10, REN-4, REN-6, UB-17, UB-18, UB-23 Moxa: REN-4, SP-1, SP-6, UB-20, UB-23, DU-20 SP-10, LIV-1 KI-14, REN-3, SP-6, SP-10 REN-7, SP-1, SP-6, SP-10, LIV-1, UB-18, UB-20 With heavy bleeding: DU-20 SP-1, SP-6, SP-10, REN-6, KI-5 REN-6, SP-8, SP-10, LI-11 With Damp-Heat:REN-6, SP-1, SP-6, SP-9, LIV-5 With Liver Qi Stagnation: + LIV-2, LIV-3, SJ-5, GB-34 Ear: Uterus, Subcortex, Endocrine, Ovary

BLOOD HEAT DUE TO BLOOD STAGNATION

Etiology	Sex during menstruation External invasion during menstruation
Clinical Manifestations	Continuous bleeding Blood is purple-black Lower abdominal pain Pain is better after heavy bleeding T: Purple or black spots C: Thin white P: Deep and wiry or Tight and Choppy
Treatment Principle	Eliminate Stagnation to stop bleeding
Herb Formulas	Metrorrhagia #3 Si Wu Tang + Shi Xiao Tang modified Shao Fu Zhu Yu Tang Zhu Yu Zhi Xue Tang
Points	REN-7, SP-6, SP-10 LIV-1, LIV-3, SP-1, SP-6, REN-4, REN-6, ST-30 SP-1, SP-6, SP-8, SP-12, REN-6, ST-30 LIV-3, ST-30 REN-3, REN-4, Zigong, SP-6, SP-8, SP-10 , LIV-3, PC-6 Ear: Uterus, Subcortex, Endocrine, Ovary

BLOOD DEFICIENCY

Clinical Manifestations	Postpartum emaciation and weakness Persistent, tight abdominal pain Abdominal pain with spasms or radiates to back and waist Cannot eat Shortness of breath Dyspnea Pale face Intermittent spasmodic abdominal pain which is better with Heat and pressure Epigastric pain Lusterless complexion Fidgeting Reduced appetite Maybe low-grade fever Palpitations Irritability Cold and sore extremities Nonspecific discomfort Dry mouth and throat Nocturnal emission Five sole Heat	Debilitated constitution in children Enuresis in children Insomnia Fatigue Anemia Bleeding Abdominal weakness Epistaxis Habitual constipation Maybe warm extremities Night sweats Tired limbs Frequent urination Night crying Diarrhea in children Habitual headache in children Hernia pain in children Chronic constipation Purpura Asthma T: Pale C: White. P: Weak and slow or Thready, wiry and even or Thready and weak
Treatment Principle	Warm and tonify the Spleen and Stomach Relieve spasmodic pain
Herb Formulas	Dang Gui Jian Zhong Tang Si Wu Tang Jia Wei With Heat: Wen Qing Yin
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JING AND BLOOD DEFICIENCY DUE TO KIDNEY, SPLEEN AND HEART DEFICIENCY

Clinical Manifestations	Fatigue Heavy and painful lower back Dream-disturbed sleep General weakness Lack of interest in food or drink Fever Night sweats Seminal emission Forgetfulness Toothache Dizziness Gum swelling General pitted edema which is worse in the lower body Vaginal discharge Discharge of rice-water like urination without dysuria Aversion to Cold Impotence Decreased libido Emaciation Loose teeth Signs of premature aging Abdominal Cold Easily frightened T: Pale or Pale and thick C: Smooth and white P: Moderate and weak or Deep and weak
Treatment Principle	Tonify the Spleen and Kidneys Nourish the Heart Enrich Yin Nourish the Blood and Yang Augment Qi
Herb Formulas	Huan Shao Dan
Points

DAMP-HEAT

Etiology	Lingering of Dampness and Heat Unregulated intake of drink and food Taxation damaging the body Heart Qi insufficiency.
Clinical Manifestations	If Dampness is predominant: Blood mixed with mucus Sallow or yellowish complexion Slightly puffy face Heavy head Dizziness Listlessness Stuffy chest and epigastrium Sticky sensation in the mouth T: Normal C: Thin whitish and sticky P: Slippery and Choppy If Heat is predominant: Profuse purplish vaginal Hemorrhage Repulsive odor Flushing or Heat sensations Spontaneous sweating Bitter taste in mouth Thirst Dark, scanty urine Constipation or diarrhea T: Red C: Sticky and yellow P: Slippery and rapid
Treatment Principle	Clear Heat Resolve Dampness
Herb Formulas	Jia Wei Xiao Yao San modified Sheng Yang Chu Shi Tang modified Yin Chen Hao Tang San Miao Hong Teng Tang San Huang Xie Xin Tang Zhu Ling Tang Yi Zi Tang With damage to Yin and Blood: Qing Gan Zhi Ling Tang To induce diuresis to stop bleeding: Ba Zheng San For restoring Qi and Yang once the pathogen has been eliminated: Bu Zhong Yi Qi Tang
Points	SP-1, SP-6, SP-9, REN-3, REN-6 Moxa SP-10 SP-1, SP-9, SP-8, LIV-5, ST-36, REN-7, REN-9, UB-22, UB-32

LOWER JIAO BLOOD STAGNATION WITH HEAT

Clinical Manifestations	Acute lower abdominal pain Incontinence of urine Night fevers Delirious speech Irritability Restlessness Thirst May be mania (severe) Dysmenorrhea Amenorrhea Hard stool Dark red complexion Headache Vertigo Tinnitus Insomnia Palpitations Constipation Frequent urination Emotional instability Chills in the waist and feet Tremors Excruciating abdominal pain with cold Black stool May be chills and fever Hemoptysis Hematuria Red eyes Pain and distention of the head Toothache Irregular menstruation Lochioschesis Severe wheezing Distention of the chest T: Red and dry C: Yellow P: Deep and forceful or Choppy
Treatment Principle	Drain Heat Break up Blood Stasis
Herb Formulas	Tao He Cheng Qi Tang
Points

COLD WITH DEFICIENCY OF THE CHONG AND REN CHANNELS

Clinical Manifestations	Constant flow Light color Afternoon fever Five sole heat Dry mouth Thirst Cold abdominal pain Infertility Dysmenorrhea Uterine bleeding Chronic pelvic inflammation Menopause Habitual abortion
Treatment Principle	Warm the Cold Consolidate the Chong and REN channels
Herb Formulas	Wen Jing Tang modified With Blood Stasis in the uterus: Zhen Ling Dan
Points	Moxa SP-6, REN-4, REN-12, KI-8, KI-7, DU-4, UB-23 Moxa UB-20, UB-23, ST-36, SP-6, SP-9, REN-4, REN-12

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