CHOLILITHIASIS (GALLSTONES)

GENERAL

Clinical Manifestations	Steady, severe pain in the right upper quadrant or Epigastric pain Nausea Vomiting Jaundice Fever
Treatment Principle
Herb Formulas	Chai Hu Gui Zhi Tang Shi Wei San For abdominal pain, cramping and muscle spasms in the calves: Shao Yao Gan Cao Tang
Points	GB-34, LI-11, LIV-4 (right side), PC-4, ST-36, UB-18, UB-19, UB-22 Sedate GB-33, GB-38, ST-3 Dannangxue, SJ-6, ST-36, UB-19 GB-25, (right), LIV-13, REN-13, REN-15, SJ-5, ST-36, UB-22, UB-23, UB-24, UB-25 REN-12, ST-36, UB-19 Dannangxue, GB-34, REN-12, ST-36, UB-19 For pain: + LI-4 For jaundice: + UB-64 For fever: + LI-11 For vomiting: + PC-6 For vomiting: + PC-6 For jaundice: SJ-9 For back pain: + UB-18 For rib pain: GB-40, SJ-3 For biliary colic: 1. Sedate DU-8, GB-23, GB-34, GB-38, GB-40, REN-4, REN-6, SP-4, ST-31, UB-19 2. GB-34, GB-41, LIV-2, SI-4, UB-18, UB-19 For ascariasis in the bile duct: GB-34, LI-20 through to ST-2 For chest pain with turbidity, excess saliva and inability to lie on ones side: REN-13 Ear: Gall Bladder (right), Pancreas (left), Liver, Sympathetic, Shenmen, Subcortex (choose 2-3 points and alternate) Electro-acupuncture: Right side UB-19 connect to the Gall bladder foot points or GB-24 or REN-12 or ST-21 or LIV-3 for 20-30 minutes 2-3 times per day.

TAI YANG WITH INTERNAL DEFICIENCY COLD

Clinical Manifestations	Abdominal pain Cold extremities Numb hands and feet Generalized body aches Paralysis of the extremities Induration and swelling of the scrotum Hypersalivation Limited movement of the joints Abdominal pain referring to the testis Aversion to Cold A preference for Warmth Loose stools Chills and fever T: Normal C: Thin and white P: Tense and wiry
Treatment Principle	Warm the Interior Reinforce Yang Release the Exterior Regulate the Yin and Wei
Herb Formulas	Wu Tou Gui Zhi Tang
Points

SHAO YANG FU WITH TAI YANG

Clinical Manifestations	Joint pain with a crackling sensation Epigastric pain Fatigue Gastrointestinal weakness Headache Heaviness in the head Fever Moderately severe chills Distension beneath the Heart Periumbilical or lower abdominal pain Tenseness around the pubic bone Subcostal pain Epigastric fullness Nausea Mild vomiting Mild thoraco-costal discomfort Costal distress Tension in the rectus abdominus Chest distension Abdominal pain Abdominal distension Constipation Irritability Insomnia Repeated loss of spinal alignment due to muscular tension P: Floating and weak
Treatment Principle	Release the Exterior and muscle layer Harmonize and releases the Shao-Yang Harmonize the Liver, Spleen and Intestines
Herb Formulas	Chai Hu Gui Zhi Tang
Points	To treat the Shao Yang: GB-34, LIV-3, LIV-14, SJ-6 To Treat the Tai Yang: UB-12, GB-20

SHAO YANG FU 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 Hu Gui Zhi Gan Jiang Tang With Phlegm-Heat Stagnation in the chest: Chai Hu Xian Xiong Tang
Points	GB-41, SJ-5, moxa or moxa needle REN-4, REN-6, REN-8, REN-12, SJ-6, ST-25, ST-36

SHAO YANG WITH PHLEGM STAGNATION

Clinical Manifestations	Alternating chills and fever Fullness and focal distention in the chest and diaphragm Pain in the chest and diaphragm with pressure Thick, sticky, difficult-to-expectorate Phlegm Panting A bitter taste in the mouth Chest pain with coughing or on deep inhalation Anorexia T: Normal C: Yellow P: Wiry and rapid
Treatment Principle	Clear Heat Transform Phlegm Expand the chest Release the Shao Yang
Herb Formulas	Chai Xian Tang
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 T: Normal C: Greasy and white or Greasy and yellow P: Deep, tight and wiry or Wiry and rapid
Treatment Principle	Harmonize and Disperse the Shao Yang Drain Internal Heat Retention
Herb Formulas	Da Chai Hu Tang
Points

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 Revive Yang
Herb Formulas	Wu Mei Wan
Points	To clear worms: Moxa needle REN-4, REN-6, REN-8, ST-25 To clear Heat: DU-14, LI-11, LI-4, LIV-3 To revive Yang: Moxa REN-4, REN-6, REN-8, ST-36 To regulate the Qi of the chest: 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, SP-6

QI STAGE GALL BLADDER HEAT

Clinical Manifestations	Alternating chills and fever Constipation with Heat in the Upper Jiao Bitter taste in mouth Thirst Dry throat Rib pain (doesn't like touch) Hypochondriac pain Nausea/vomiting Hypogastric pain and distension T: Red C: Yellow P: Rapid and wiry
Treatment Principle	Relieve Gall Bladder Heat Pacify The Liver and Gall Bladder
Herb Formulas	Liang Ge San
Points	To Pacify the Liver and Gall Bladder: LIV-3, LIV-4, LIV-13, LIV-14. To Relieve Gall Bladder Heat: Lanweixue, LI-11, LIV-2, GB-34

DAMP-HEAT IN THE SPLEEN AND STOMACH

Clinical Manifestations	Recurrent acid reflux and heartburn Anorexia Epigastric and abdominal distention and discomfort A dry mouth Acne or A tendency toward boils and sores Greasy skin Strong body odor 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 or Slippery and rapid
Treatment Principle	Clear Heat Benefit Dampness
Herb Formulas	San Huang Xie Xin Tang modified
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 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	Warm Yang Strengthen the Spleen Warm the Center Dispel Cold
Herb Formulas	Xiao Jian Zhong Tang With Damp-Turbidity clumping in the Stomach: Fu Ling Yin
Points	Moxa and/or warm-needle UB-20, UB-21, LIV-13, REN-12, SP-3, SP-6, ST-36

STOMACH AND LIVER HEAT

Clinical Manifestations	Recurrent or relentless acid reflux and heartburn, aggravated by coffee, chocolate and alcohol or stress The patient may wake in the middle of the night (1-2 am) with discomfort and reflux Sour or bitter belching Epigastric discomfort or burning sensation Indeterminate, gnawing hunger Foul stools Dry mouth Thirst Irritability Quick temper T: Red with red edges C: Yellow P: Wiry and/or slippery, maybe rapid
Treatment Principle	Clear Heat from the Stomach and Liver Harmonize the Stomach Descend Stomach Qi
Herb Formulas	Hua Gan Jian Jia Wei Severe cases: Zuo Jin Wan modified When Stomach Heat is primary: Qing Wei San modified Chinese Patent Medicines: Jia Wei Xiao Yao San Wen Dan Wan Wei Te Ling Xiang Lian Wan
Points	GB-34, LI-11, LIV-2, PC-8, REN-12, REN-13, REN-17, ST-36, ST-44 With severe Heat: + SJ-2, ST-45 With constipation: + SJ-6, ST-25 With Lung and Stomach Heat: + LU-5 With nausea: + PC-6 Ear: Esophagus, Pylorus, Liver, Spleen, Stomach, Shenmen, Subcortex, Sympathetic

DISHARMONY BETWEEN THE STOMACH AND INTESTINES

Clinical Manifestations	Genital warts Anal warts Epigastric focal distention Fullness and tightness with very slight or no pain Dry heaves Vomiting Borborygmus D Diarrhea Anorexia Stomach pain Abdominal pain Subcardiac distention Heartburn Resistance below the Heart Soft epigastrium Nausea Ascites Gurgling sounds T: Normal or with a red tip C: Thin, yellow and greasy P: Wiry and rapid or Wiry, tight and rapid
Treatment Principle	Harmonizes the Stomach Descends Rebellious Qi Disperses clumping Eliminates focal distention due to Cold and Heat factors
Herb Formulas	Ban Xia Xie Xin Tangmodified
Points

LIVER QI STAGNATION

Clinical Manifestations	Hypochondriac pain and distention Dull pain in the right upper quadrant Pain may radiate to the upper back and right shoulder Chest and ductal oppression Sometimes chills and fever or Alternating fever and chills Depression Easily angered Emotional tension Nausea Vomiting Dry mouth Irregular bowel movements or Constipation Anorexia Aversion to oily, slimy foods Belching Slight abdominal tenderness Murphy's sign positive Bitter taste in mouth Fidgeting Maybe a slight fever Abdominal pain and cramps Breast distention and pain Irritability Dysmenorrhea Irregular menstruation Amenorrhea T: Pink or maybe Red C: Thin and white or yellow P: Wiry or Tight or Wiry and rapid
Treatment Principle	Spread Liver Qi Promote Qi circulation Harmonize the Blood Open the Gall Bladder Dissolve stone Alleviate pain
Herb Formulas	Chai Hu Shu Gan Tang Xiao Chai Hu Tang Da Chai Hu Tang modified Da Jian Zhong Tang Cholelithiasis #2 Dan Dou Pai Shi Fang #1 Yue Ju Wan For Heat greater than Dampness: Yin Chen Hao Tang + Long Dan Xie Gan Tang modified With chronic sluggish stools or constipation: Liu Mo Tang With Food Stagnation and sluggish bowels: Mu Xiang Shun Qi Wan With Spleen Qi Deficiency and Cold and Heat: Zhi Shi Xiao Pi Wan Chinese Patent medicines: Chai Hu Shu Gan Wan Li Dan Pi (five tabs once a day for 2 months) With sluggish or incomplete bowel movements: Mu Xiang Shun Qi Wan With constipation: Chen Xiang Hua Qi Wan With Spleen Deficiency and dampness: Xiao Yao Wan
Points	Dannangxue, GB-24, GB-34, SJ-6, UB-19 For severe pain: + LI-4, LIV-14 For jaundice: + DU-9 For abdominal distention and pain: + ST-36 For nausea and vomiting: + PC-6 For fever and chills: + LI-4, LI-11 GB-34, LIV-3, LIV-5, LIV-13, PC-6, REN-6, REN-12, ST-25 To calm the Shen: + DU-19, DU-24, Yintang With Blood or Yin Deficiency: + SP-6, ST-36, UB-18, UB-23 With Phlegm or plum-pit throat: + PC-5, SP-3, ST-40 With fat intolerance, pale or pasty stools, and right sided hypochondriac pain and distention: + Dannangxue, GB-24, GB-40 Ear: Liver, Spleen, Stomach, Large Intestine, Small Intestine, Abdomen

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 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	Si Ni San During remissions: Xiao Yao San modified Chronic with Qi Deficiency and Yin Deficiency Heat: Sheng Yang Yi Wei Tang
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

LIVER QI STAGNATION INVADES THE STOMACH

Clinical Manifestations	Chest and abdominal distention A stifling sensation in the chest and abdomen Fixed pain in the hypochondria Belching with a fetid odor Nausea Vomiting Headache Epigastric and abdominal fullness and pain Acid reflux Mild coughing with copious sputum Reduced appetite Indigestion T: Normal C: Thin and white or Greasy or Slippery, P: Wiry and taut or Running
Treatment Principle	Regulate Qi Release Stagnation
Herb Formulas	Yue Ju Wan Chai Hu Shu Gan Tang For chronic sluggish bowels or constipation: Liu Mo Tang For Qi and Food Stagnation: Mu Xiang Shun Qi Wan During remissions: Xiao Yao San modified Chinese patent medicines: Chai Hu Shu Gan Wan Xiao Yao Wan For chronic sluggish bowels or constipation: Mu Xiang Shun Qi Wan For constipation: Chen Xiang Hua Qi Wan For Spleen Deficiency and Dampness: Xiang Sha Yang Wei Wan
Points	LIV-3, LIV-14, PC-6, REN-12 + general points GB-34, LIV-3, LIV-5, LIV-13, PC-6, REN-6, REN-12, ST-25 For calming the Shen: + DU-19, DU-24, Yintang For Blood or Yin Deficiency: + SP-6, ST-36, UB-18, UB-23 For Phlegm or plum pit Qi Stagnation: + PC-5, SP-3, ST-40 For fat intolerance, pale or pasty stools, and right side hypochondriac pain and distention: + Dannangxue, GB-24, GB-40

LIVER 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	Activate Blood circulation Soften hardness
Herb Formulas	Ge Xia Zhu Yu Tang
Points	PC-6, ST-36, REN-17, LIV-3, LIV-14 LIV-3, LIV-14, LIV-13, SP-6, UB-17

LIVER FIRE

Clinical Manifestations	Alternating fever and chills Fullness in the chest and hypochondrium (with or without pain) Bitter taste in mouth Nausea Continuous vomiting Hard focal distension in the epigastrium Fullness and pain in the epigastrium Burning diarrhea or no bowel movement Despondency Slight fidgeting Slight irritability Headache Constipation or discharge of fluids rectally Tinnitus Diminished hearing Diminished vision Red eyes Manic behavior Asthma Mental instability T: Normal or red C: Yellow or Thick and yellow P: Wiry and forceful or Wiry tight and forceful
Treatment Principle	Harmonizes and Disperses the Shao Yang Drains Internal Heat Retention
Herb Formulas	Da Chai Hu Tang Long Dan Xie Gan Tang
Points	GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19

LIVER AND GALL BLADDER DAMP-HEAT

Clinical Manifestations	Right-sided rib distention and pain Abdominal distention and fullness Palpable pain in the Gall Bladder region Nausea Vomiting Sluggish intake Dry mouth with a bitter taste Thirst with no desire to drink Alternating chills and fever If Heat is Internal, only fever Right upper quadrant pain There may be Yang jaundice that is bright and sometimes itches Anorexia Tendency toward Liver enlargement Dry stools Yellow urine Jaundice Hepatomegaly T: Normal or Red C: Greasy and yellow or Dry and yellow (more Heat) P: Wiry, slippery and rapid or Rolling and rapid or Slippery and rapid Heat greater than Dampness: Maybe Yang jaundice (sclera, mucosal membranes and skin bright orange-yellow) Fever or Alternating fever and chills Thirst with a desire to drink cold fluids An uncomfortable, burning sensation in the chest and epigastrium Concentrated, scanty urination Constipation or Loose stools Nausea Vomiting Aversion to cigarette smoke T: Pink C: Greasy and yellow P: Wiry and rapid or Greasy Slippery and rapid Dampness greater than Heat: Jaundice No fever or Mild fever The head is heavy and full Wrapping headache A sensation of obstruction, fullness, or discomfort in the chest and epigastrium Anorexia Nausea Vomiting Abdominal distention Loose stools Thirst with no desire to drink Scanty, concentrated urine Aversion to cigarette smoke T: Flabby C: Thick and yellow or Whitish and greasy P: Soggy and moderate or Wiry and slippery
Treatment Principle	Clear Heat Drain Dampness Clear the Gall Bladder Regulate Qi Expel stones
Herb Formulas	For Heat greater than Dampness: Yin Chen Hao Tang modified Bai Shi Tang Long Dan Xie Gan Tang Hao Qi Qing Dan Tang Da Cheng Qi Tang Cholelithiasis #1 Dan Dao Pai Shi Fang #2 For Liver and Spleen Damp-Heat with Blood Stasis: Liu Jun Zi Tang + Ge Xia Zhu Yu Tang For Damp-Heat Damaging Qi and Yin: Yi Qi Ruan Gan Tang Chinese patent medicines: Ji Gu Gan Cao Wan Li Dan Pian Long Dan Xie Gan Wan Ji Gu Cao Chong Ji
Points	Dannangxue, GB-34, Gall Bladder point (1 to 1.5 cun below the rib on the edge of the rectus abdominus, LI-11, LIV-2, SP-6, ST-44 Ear: Liver, Gall Bladder GB-24 (right side), GB-34, SJ-6, UB-19, Dannangxue For severe pain: + LI-4, LIV-14 For jaundice: + DU-9 For abdominal distention and pain: + ST-36 For nausea and vomiting: + PC-6, REN-12 For fever and chills: + LI-11, LI-4 GB-24, GB-34, LI-11, LIV-2, SP-6, ST-44, UB-18, UB-19, Gall Bladder point DU-9. GB-24, GB-34, LIV-14, SI-4, SP-9, UB-18, UB-19 Dannangxue, GB-24, GB-34, PC-6, SP-6, SP-9, ST-36, Huatuojiaji at T-8 and T-9 GB-24, GB-34, GB-43, LIV-3, LIV-14, SJ-6, UB-18, UB-19 With severe fever: + DU-14, LI-11 With alternating chills and fever: + GB-39, SJ-5 With nausea: + PC-6 With jaundice: + DU-9 For jaundice: GB-24, UB-19, UB-48 For Heat greater than Dampness: DU-9, GB-34, LIV-3, SI-4, SP-9, UB-19 With severe fever: + DU-14, LI-11 With nausea: + PC-6 With hypochondriac pain: + LIV-13, LIV-14, SJ-6

LIVER AND GALL BLADDER STAGNANT HEAT (BILE DUCT OBSTRUCTION WITH HEAT)

Clinical Manifestations	Quickly developing jaundice Severe, colicky, recurrent right-sided hypochondriac pain Pain may radiate to the shoulder and upper back Fever and chills or Alternating fever and chills Bitter taste in the mouth Dry throat and mouth Nausea Anorexia Aversion to fats and oils Abdominal distention Pale, sticky stools Scanty, concentrated urine Dysuria T: Red C: Yellow P: Wiry and rapid
Treatment Principle	Soothe the Liver Drain the Gall Bladder Clear Heat Relieve fullness
Herb Formulas	Qing Dan Xie Huo Tangmodified Chinese patent medicines: Ji Gu Cao Wan Li Dan Pian Long Dan Xie Gan Wan
Points	DU-9. GB-24, GB-34, LIV-3, LIV-14, SI-4, UB-19 With worms in the bile duct: + LI-20 through to ST-2 With fever : + DU-14, LI-11 With alternating fever and chills: + GB-41, SJ-5 With nausea : + PC-6

DISHARMONY BETWEEN THE GALLBLADDER AND STOMACH WITH PHLEGM-HEAT

Clinical Manifestations	Acid reflux or Heartburn Nausea Vomiting Indeterminate gnawing hunger Insomnia Anxiety T: Normal C: Yellow and greasy P: Slippery and rapid
Treatment Principle	Resolve Phlegm-Heat Descend Qi Stop reflux
Herb Formulas	Wen Dan Tang modified
Points

QI AND YIN DEFICIENCY

Clinical Manifestations	Insidious flank pain Fatigue Weakness Anorexia Abdominal distention after meals Patients usually over forty years of age Dry mouth Bitter taste in the mouth Constipation T: Fat or Swollen with teethmarks and a red tip with cracks in the center C: Scanty or Peeled P: Thready, wiry and rapid
Treatment Principle	Nourish Yin Tonify Qi Clear Heat Eliminate Dampness Move the Qi
Herb Formulas	Yi Qi Ruan Gan Tang For Liver Blood and Kidney Yin Deficiency with Qi Stagnation but no Qi Deficiency: Yi Guan Jian modified
Points	GB-24, GB-34, UB-17, UB-18, UB-20 For severe Yin Deficiency: + KI-7 For severe Qi Deficiency: + ST-36 For suspected stones in the bile duct: + Dannangxue For yellow eyes or skin: + DU-9, ST-36 For abdominal distention and pain: + REN-12 For nausea and vomiting: + PC-6

QI AND BLOOD DEFICIENCY WITH PHLEGM STAGNATION

Clinical Manifestations	Yellowing of the eyes and body which is sometimes worse and sometimes better Dizziness Vertigo A shiny greenish blue facial complexion Fatigue Lassitude Weakness Disinclination to speak Flank fullness, oppression, distention and discomfort or Insidious pain which comes and goes Anorexia Severe: Phlegm lumps below the flanks T: Pale and dark with possible macules or spots Engorged, distended, tortuous sublingual veins C: White P: Thready and wiry or Wiry and choppy
Treatment Principle	Tonify the Spleen Dispel Dampness Tonify Qi Harmonize the Blood
Herb Formulas	Si Jun Zi Tang + Ge Xia Zhu Yu Tang
Points	GB-24, LIV-3, ST-36, UB-19 For suspected gallstones: + Dannangxue, GB-34 For concretion lumps below the flanks: + GB-34, LIV-14 For severe jaundice: + DU-9 For abdominal distention and pain: + REN-12 For nausea and vomiting: + PC-6

BLOOD STAGNATION

Clinical Manifestations	Abdominal masses which are visible when lying down Piercing hypochondriac pain Irritability Indigestion Constipation Dysmenorrhea Amenorrhea Chronic diarrhea Daybreak diarrhea Palpable abdominal masses Irregular menstruation Breast distention Abdominal tumors Hypochondriac distention T: Purple with purple spots on the side C: Normal P: Wiry, choppy and tight
Treatment Principle	Invigorate Blood Dispel Blood Stasis Move Qi Alleviates pain
Herb Formulas	Ge Xia Zhu Yu Tang
Points	LIV-3, LIV-13, SP-6, ST-36, ST-25, ST-37

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
Points

INTERNAL COLD

Clinical Manifestations	Abdominal pain Constipation Hypochondriac pain 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 T: Normal C: Greasy and white P: Deep, tight and wiry
Treatment Principle	Warm the Interior Disperse Cold Unblock the bowels Alleviate pain
Herb Formulas	Da Huang Fu Zi Tang
Points

PHLEGM-HEAT STAGNATION IN THE CHEST

Clinical Manifestations	Focal distention in the chest and epigastrium with or without nodules which is painful when pressed Coughing up yellow, viscous sputum Constipation A bitter taste in the mouth T: Normal C: Yellow and greasy P: Slippery and floating or Slippery and rapid
Treatment Principle	Clear Heat Transform Phlegm Expand the chest Dissipate Stagnation
Herb Formulas	Xiao Xian Xiong Tang
Points

TOXIC HEAT

Clinical Manifestations	Alternating chills and fever Colic Abdominal pain Jaundice Nausea Vomiting Delirium Toxic shock (acute obstructive suppurative cholecystitis) Exhausted Yang: Shortness of breath Profuse perspiration Cold skin Peritonitis Tenderness Guarding Blumberg's sign T: Deep red C: Dry and yellow P: Thready and rapid or Disappearing (low Blood pressure)
Treatment Principle	Clear Heat Purge Fire Relieve toxicity Cool the Blood
Herb Formulas	Wu Wei Xiao Du Yin Huang Lian Jie Du Tang Qing Ying Tang For Yang Desertion: Shen Fu Tang + Sheng Mai San
Points	Dannangxue, DU-14, DU-26, GB-24, GB-34, KI-1, LI-11, PC-6, ST-36, UB-19, UB-48 Gall Bladder point (under the ribcage at the lateral end of the rectus abdominus) Dannangxue, GB-24, GB-34, SJ-6, UB-19 For severe pain: + LI-4, LIV-14 For jaundice: + ST-36 For nausea and vomiting: + PC-6 For fever and chills: + LI-4, LI-11

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 With Phlegm: Bo Shi Tang
Points

ROUNDWORMS IN THE BILE DUCT

Clinical Manifestations	Intermittent attacks of Stomach, ductal and flank pain Chest oppression Irritability Vexatious Heat Vomiting after eating and/or Vomiting of roundworms Cold hands and feet T: Red C: Slimy and white P: Slippery and wiry or Deep, thready and wiry
Treatment Principle	Warm the viscera Clear Heat Drain pathogens Quiet roundworms
Herb Formulas	Wu Mei Wan modified
Points	GB-34, LI-20, REN-12, REN-13, ST-4, UB-19 For nausea: + PC-6 For severe pain: + electroacupuncture all points except LI-20 For fatigue and loose stools: + ST-36, UB-20 For children: + prick to bleed Sifeng

CHOLILITHIASIS (GALLSTONES)

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas

Points

Clinical Manifestations

Treatment Principle

Herb Formulas