VAGINITIS

GENERAL

Clinical Manifestations	Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. The cause is usually a change in the normal balance of vaginal bacteria or an infection. Reduced estrogen levels after menopause and some skin disorders can also cause vaginitis. Symptoms: Change in color, odor or amount of discharge from your vagina Vaginal itching or irritation Pain during intercourse Painful urination Light vaginal bleeding or spotting
Treatment Principle
Herb Formulas	Herbal douche: Decoct equal amounts of HB. Epimedii Yin Yang Huo, Cx. Dictamni Xu Duan and Rx. Sophorae Flavescentis Ku Shen and use as a douche 3 times daily. For vaginal flatulence: Shi Quan Da Bu Tang For vaginal bleeding due to intercourse: Gui Pi Tang modified Fumigant and wash for a swollen vagina: Qi Ai Fang Feng Da Ji Ao Tang
Points	GB-26, REN-6, SP-6 For Spleen Qi Deficiency: + ST-36, UB-20 For Spleen Yang Deficiency: + moxa or moxa needle REN-12, ST-36, UB-20 For Spleen Dampness: + GB-34, SP-5 For Phlegm Dampness: + REN-12, ST-36, ST-40 For Liver Qi Stagnation: + LIV-3, LIV-5 For Liver Fire: + LIV-2, LIV-6, LIV-8 For Kidney Yang Deficiency: + DU-4, REN-4, UB-23 For External Damp-Heat: + REN-3, SP-9, SP-10 For Internal Damp-Heat: + REN-3, SP-9, LIV-5 For Yin Deficiency vulvar pruritis: + KI-3, KI-10, KI-11, LIV-3 DU-2, DU-4, REN-3, REN-6, SP-6, SP-9, ST-30 KI-12, LIV-4, REN-3, SP-6, SP-10, UB -31, UB-32, UB-33, UB-34 For vaginal pain: KI-6, LU-7, REN-1 With swelling: + SP-6

WIND-COLD

Clinical Manifestations	White vaginal discharge Vulvar itching Maybe an odor
Treatment Principle
Herb Formulas
Points	Moxa LIV-2

WIND-HEAT WITH UNDERLYING SPLEEN AND STOMACH HEAT

Clinical Manifestations	Vaginitis Severe sore and swollen throat High fever with convulsions in infants Difficulty swallowing Carbuncles Acute localized infection Lymphangitis Furuncles Boils Abscesses T: Red C: Greasy and yellow P: Rapid
Treatment Principle	Relieve Toxic Heat Reduce swelling Alleviate pain
Herb Formulas	Liu Shen Wan
Points

YANG MING FU

Clinical Manifestations	Vaginitis High fever (sometimes rises and falls) Great thirst Profuse perspiration Aversion to Heat Abdominal pain (worse with pressure) Abdominal distension Dryness Constipation (hard dry knots) Dislikes pressure Restlessness Irritability Mental disturbance: Mentally unclear Delirious speech T: Red and dry, or black and moist C: Thick yellow or dry yellow P: Deep, strong and forceful
Treatment Principle	Purge
Herb Formulas	Da Cheng Qi Tang
Points	For Heat: DU-14, LI-4, LI-11, SJ-5, ST-44 For Stagnation: REN-12, ST-34, ST-36, ST-37, ST-39 For Constipation: SJ-6, ST-25, UB-25

CENTRAL QI SINKING

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

SPLEEN QI DEFICIENCY AND LIVER QI STAGNATION WITH DAMPNESS IN THE LOWER JIAO

Clinical Manifestations	Profuse vaginal discharge that is white or pale-yellow The discharge is thin in consistency, not foul smelling and usually continuous Fatigue Lethargy A shiny, pale complexion Loose stools Diarrhea T: Pale C: White P: Soggy and frail or Moderate or Slow or Soft and floating
Treatment Principle	Tonify the Spleen Disperse Liver Qi Stagnation Transform Dampness Stop vaginal discharge
Herb Formulas	Wan Dai Tang
Points

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Continuous cramping pain in the abdomen Pain is not severe Pain is relieved by pressure Edema of the feet Urinary difficulty Slight edema (primarily of the lower limbs) Symptoms generally occur during pregnancy Pale face Fatigue Heaviness of head Lassitude Lower abdominal pain Dizziness Tinnitus Lumbago Edema Abdominal pain with edema during pregnancy due to Blood Deficiency and abnormal water circulation Oliguria	Palpitations Cold feet Extreme coldness of the hands and feet Vertigo Weakness and numbness of lower back and legs during pregnancy or postpartum Mal position of the fetus Dysmenorrhea Irregular menstruation Right upper quadrant pain Hepatomegaly Anemia Lack of energy Sore back Thirst with no desire to drink T: Pale or pink maybe petechiae on margin C: Thin or Greasy white P: Deep and weak or Soft, floating, small and slow or Wiry and small or Wiry and rough
Treatment Principle	Strengthen the Spleen and Kidneys Resolve Dampness
Herb Formulas	Ba Wei Di Huang Wan modified
Points

SPLEEN AND KIDNEY YANG DEFICIENCY WITH COLD-DAMPNESS (SENILE VAGINITIS)

Clinical Manifestations	Excessive, pale colored menstruation Excessive white, watery vaginal discharge Low back ache Fatigue Weakness Aversion to cold Cold hands and feet Dizziness Vertigo Excessive nocturia T: Pale C: White P: Thready and soft
Treatment Principle	Warm and supplement the Spleen and Kidneys Warm Cold Transform Dampness
Herb Formulas	Senile Vaginitis #1
Points

HEART FIRE WITH QI AND YIN DEFICIENCY AND DAMP-HEAT IN THE LOWER JIAO

Clinical Manifestations	Restlessness Irritability Thirst Nocturnal emission Insomnia Dream disturbed sleep Lack of spirit Fatigue Low back pain Tinnitus Dysuria Depression Turbid urine Abnormal uterine bleeding Polyuria Enuresis Seminal emission Leukorrhea Blood tinged leukorrhea Anorexia Dry mouth Dry Tongue Five Sole Heat Fever Physical and mental overexertion T: Red C: Little or None P: Deep and rapid
Treatment Principle	Clear Heart Fire Disperse Damp-Heat Benefit Qi and Yin Promote urination
Herb Formulas	Qing Xin Lian Zi Yin modified
Points

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 Anxiety	Spontaneous sweating or night sweats with fever Dry eyes Hypochondriac pain Anorexia 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 Blood and Yin Regulate menstruation Sedate the Heart Clear Heat
Herb Formulas	Jia Wei Xiao Yao San Long Dan Xie Gan Tang
Points

LIVER FIRE

Clinical Manifestations	A swollen vagina 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 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	Long Dan Xie Gan Tang Dang Gui Long Hui Wan
Points	GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19

LIVER AND GALLBLADDER DAMP-HEAT (TRICHOMONAS VAGINITIS)

Clinical Manifestations	Vaginitis Yellow vaginal discharge with foul smell Pruritis vulvae Pain in severe cases Sometimes the pain can spread around the anus Restlessness Profuse vaginal discharge which looks like yellow or yellowish red pus 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 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	Long Dan Xie Gan Tang Bei Xie Shen Shi Tang modified
Points	Dannangxue, DU-9, GB-24, GB-34, LIV-14, SI-4, SP-9, UB-18, UB-19, UB-48

KIDNEY YIN DEFICIENCY WITH FIRE FLARING (SENILE VAGINITIS) (ATROPHIC VAGINITIS)

Clinical Manifestations	The skin of the upper vagina becomes brittle and flimsy A burning, scorching sensation in the vagina Itching of the genitalia Excessive yellow, pussy vaginal discharge Vaginal discharge may also be red and white A sticky, gluey, moist, red vagina Maybe breakthrough bleeding or Spotting or bleeding on intercourse Dizziness Vertigo 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: Blurred vision Irritability T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zhi Bai Di Huang Wan modified Topical: She Chuang Zi San
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

DAMP-HEAT IN THE UTERUS

Clinical Manifestations	Vaginitis Lower abdominal pain Thick, yellow, malodorous vaginal discharge Constipation Fullness and distention of the abdomen that is worse with pressure Fever In acute cases, maybe chills or shivering Dry mouth Thirst Restlessness Irritability Sweating Concentrated urine T: Red or Red spots C: Greasy or Brown and dry or Yellow P:Strong, bounding, slippery and rapid or Deep and strong
Treatment Principle	Clear Heat by purging Dry dampness Clear Damp-Heat
Herb Formulas	Da Cheng Qi Tang As a douche for severe Damp-Heat: She Chuang Zi Chong Xi Ji
Points	GB-26, KI-7, LIV-5, REN-3, SP-8, Ahshi points between UB-31 and UB-34, Zigong With a fever: + DU-14, LI-4, LI-11 With Shao Yang symptoms: + GB-34, GB-39, SJ-5 With vaginal discharge and itching: + LIV-8, SP-9 With nausea: + PC-6 Ear: Abdomen, Stomach, Large Intestine, Small Intestine, Uterus, Ovary, Sympathetic, Subcortex, Shenmen

YIN DEFICICENCY WITH DAMP-HEAT (SENILE VAGINITIS)

Clinical Manifestations	A burning feeling in the vagina Achy pain in the lower abdomen Occasional pricking pain on urination, extending from the outer genitalia into the vagina Copious vaginal discharge Occasional gluey, sticky Blood T: Red C: Thin and yellow P: Deep, small and rapid
Treatment Principle	Enrich the Kidneys Nourish Yin Clear Heat Purge Fire Resolve Dampness
Herb Formulas	Zhi Bai Di Huang Wan modified Topical: Vaginal Wash #3
Points

BLOOD STAGNATION DUE TO COLD WITH DEFICIENCY COLD OF THE CHONG AND REN

Clinical Manifestations	Vaginitis Mild persistent uterine bleeding Irregular menstruation (either early or late) Prolonged menstruation Skipped period Metrorrhagia Extended or continuous menstrual flow Pain Lower abdominal distention Lower abdominal Cold Lower abdominal pain Infertility Dry lips Dry mouth Spermatorrhea Pale complexion Leukorrhea Amenorrhea Bleeding between periods Low grade fever at dusk Irritability Five Sole Heat No desire to drink Distending breast pain Low back coldness and pain Loose stools Cold limbs Aversion to Cold T: Purple with petechiae P: Thready and choppy
Treatment Principle	Warm the menses Regulate menstruation Dispel Cold Warm the channels Nourish the Blood Dispel Blood Stasis
Herb Formulas	Wen Jing Tang
Points

EXCESS HEAT IN THE LOWER JIAO

Clinical Manifestations	Lower abdominal distention and pain (usually on right) Pain increases on pressure with rebound tenderness Guarding of the abdominal musculature Groin pain resembling urinary dysfunction without urinary difficulty Groin pain relieved by flexing hip and knee Groin pain intensified by extending hip Perspiration Irregular or intermittent fever followed by chills and perspiration May be mass in lower right quadrant of abdomen Aversion to Cold Hard lumps T: Pink C: Thin, white or yellow and greasy P: Slippery and rapid or Tight or Wiry and tight or Tight and rapid
Treatment Principle	Drain Heat Break up Blood Stasis Invigorate the Blood Disperse nodules Reduce swelling
Herb Formulas	Da Huang Mu Dan Tang
Points

DAMP-HEAT (TRICHOMONAS VAGINITIS), (HEMOPHILUS VAGINALIS VAGINITIS)

Clinical Manifestations	Trichomonas Vaginitis: Yellow vaginal discharge Discharge is spongy and frothy Discharge may cloudy or turbid Discharge may be accompanied by a foul smell Intense vaginal itching which is difficult to bear Short, reddish urination T: Reddish C: Yellow P: Slippery Hemophilus Vaginalis Vaginitis (Monilia Albicans infection): Frequently occurs in pregnant women, diabetics, those who wear the same undergarments for a long time and those who habitually use antibiotics The vaginal discharge is milky white The discharge is lumpy like tofu dregs or curdy Itching and burning Heat from the vagina to the outer genitals Itchy which does not diminish with pressure Yellowish urination T: Reddish C: Yellow P: Slippery
Treatment Principle	Trichomonas Vaginitis: Clear Heat Eliminate Dampness Kill parasites Stop vaginal discharge Hemophilus Vaginalis Vaginitis (Monilia Albicans infection): Clear Heat Resolve toxins Eliminate Dampness Stop vaginal discharge
Herb Formulas	Ba Wei Dai Xia Fang With much Heat: Ba Zheng San Trichomonas Vaginitis: Wu Mei Yin Chen Tang Topical: Trichomonas Vaginitis Wash Vaginal suppository: Xiong She Wan Hemophilus Vaginalis Vaginitis (Monilia Albicans infection): Long Dan Xie Gan Tang modified Topical: Hemophilus Vaginalis Vaginitis External Wash Vaginal suppository: Vaginal Suppository #1 Chinese Patent Medicine: Trisnake Itch Removing Pill
Points	Trichomonas Vaginitis: KI-3, KI-7, REN-6, ST-29

TOXIC HEAT IN THE UTERUS

Clinical Manifestations	An acute invasion of Heat or cold that transforms into Heat Acute lower abdominal or suprapubic pain The area of pain feels hot to the touch and is worse with pressure High fever Chills or shivering Thirst Copious malodorous vaginal discharge with Blood and/or pus Constipation Concentrated urine T: Normal C: Thick, greasy and yellow P: Slippery or Wiry and rapid
Treatment Principle	Clear Toxic Heat Invigorate the Blood Dispel Blood Stasis
Herb Formulas	Yin Qiao Hong Jiang Jie Du Tang
Points

TOXIC HEAT IN THE SAN JIAO (TRICHOMONAS VAGINITIS)

Clinical Manifestations	Vaginitis 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

TOXIC HEAT WITH QI AND BLOOD STAGNATION

Clinical Manifestations	Local redness Swelling and pain Maybe fever and chills T: Normal C: Thin white or yellow P: Rapid and forceful
Treatment Principle	Clear Heat Eliminate toxins Reduce swelling Soften hardness Invigorate Blood circulation Stop pain
Herb Formulas	Xian Fang Huo Ming Yin modified
Points

PARASITES

Clinical Manifestations	Vaginitis (vaginal itch) Altered bowel habits Loose, watery stools or Constipation Rectal itching and burning especially at night Excessive appetite Food allergies Symptoms improve after eating Epigastric pain Heartburn Swelling around the umbilicus Respiratory symptoms with hepatomegaly Hepatobiliary symptoms Depression Foul intestinal gas Weight loss Breast swelling and tenderness unrelated to menstruation
Treatment Principle
Herb Formulas	For swelling and pain: Si Wu Tang modified For festering sores and watery discharge and pain: Jia Wei Xiao Yao San modified With aching and dragging feelings in the lower abdomen: Bu Zhong Yi Qi Tang
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