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CROHN'S DISEASE (REGIONAL ILEITIS)

GENERAL

Clinical Manifestations	Inflammatory reaction through the bowel wall Diarrhea Abdominal pain Anemia Weight loss Fistula formation Intestinal blockage Soft, grayish or brown stools
Treatment Principle
Herb Formulas
Points	ST-25, ST-37, UB-25

YANG MING FU

Clinical Manifestations	Abdominal pain (worse with pressure) The skin over the pain may feel warmer to the touch High fever (sometimes rises and falls) Great thirst A dry mouth Profuse perspiration Aversion to Heat Abdominal fullness and distension (worse with pressure) Dryness Constipation (hard dry knots) Dislikes pressure Restlessness Irritability Concentrated urine Mental disturbances: 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 Xiao Cheng Qi Tang Tiao Wei Cheng Qi Tang With Qi and Blood Deficiency: Huang Long Tang Chinese Patent Medicines: Niu Huang Qing Huo Wan Qing Fei Yi Huo Pian
Points	DU-14, LI-4, LI-11, REN-12. ST-25, ST-34, ST-36, ST-37, ST-39, ST-44, SJ-5, SJ-6, UB-25 Ahshi points on the Bladder channel between UB-18 and UB-28, ST-25, ST-37, ST-39, ST-44, UB-25 With severe pain: + ST-34 With fever: + DU-14, LI-4, LI-11 With Shao Yang symptoms: + GB-34, GB-39, SJ-5 With constipation: +SJ-6 With diarrhea: + LI-11 Ear: Abdomen, Subcortex, Large Intestine, Small Intestine, Shenmen, Sympathetic

WEI STAGE: SUMMERHEAT

Clinical Manifestations	Acute abdominal pain Fever and chills, fever more pronounced or Tidal fever Fever is unrelieved by sweating Abdominal distention Thirst Sweat Stifling sensation in the chest Restlessness Foggy headaches Irritability Heaviness Nausea Severe diarrhea Scanty urine T: Red tip and edges C: Greasy white or yellow P: Floating or Rapid and soft
Treatment Principle	Disperse Wind Clear Heat Resolve Damp
Herb Formulas	Huang Lian Xiang Ru Yin
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

DAMP-HEAT IN THE LARGE INTESTINE

Clinical Manifestations	Diarrhea with tenesmus which intensifies after defecation Dysentery Frequent stools which are small in quantity Stools are yellow or brown, thin, watery, with foul smell or sticky and pasty like jam or sticky fluid or containing pus and blood Burning hot sensation in anus Abdominal pain Severe lateral or central abdominal pain Urine short and red Sustained fever despite profuse perspiration or raging fever in the afternoon or in severe cases, high fever and coma Mouth dry but no desire to drink Body heavy Limbs tired Fullness in chest Lump in epigastrium Anorexia Vomiting T: Red C: Yellow and greasy P: Slippery and rapid
Treatment Principle	Clear Heat Eliminate toxins Transform Dampness Stop dysentery
Herb Formulas	Shao Yao Tang Bai Tou Weng Tang Chinese Patent Medicines: Huang Lian Jie Du Wan Huang Lian Su Pian Chuan Xin Lian Kang Yan Pian Long Dan Xie Gan Wan
Points	ST-25, ST-37, ST-44, UB-25, LI-4, LI-11, SP-9

LARGE INTESTINE DEFICIENCY WITH SLIPPERY PROLAPSE

Clinical Manifestations	Chronic dysentery or Chronic diarrhea or Rectal prolapse Dull abdominal pain with liking for warmth and pressure Borborygmus Cold limbs Poor appetite Mental fatigue T: Pale C: White P: Minute, thready and forceless
Treatment Principle	Benefit the Intestines Consolidate and astringe
Herb Formulas	Zhen Ren Yang Zang Tang
Points	Chronic diarrhea: 1. LIV-13, REN-12, ST-25, ST-36, UB-20 2. LIV-13, REN-12, SP-3, UB-20 Chronic dysentery: 1. LI-4, ST-25, ST-37, UB-20, UB-21 Kidney Yang Deficiency: 1. REN-4, UB-23 2. REN-12, ST-36, UB-20, UB-21 Rectal prolapse: 1. DU-1, DU-20, UB-25 2. DU-1, DU-20, UB-30, UB-57

COLD-DAMP DISTRESSES THE SPLEEN

Clinical Manifestations	Distention and fullness of epigastrium and abdomen Nausea Vomiting Anorexia Loose stools Diarrhea Reduced sensation of taste No thirst or preference for hot drinks Sticky sensation in mouth Borborygmus Lassitude Yin jaundice Heavy head Maybe edema Maybe copious white vaginal discharge Maybe cold limbs, fear of Cold or feeling chilled T: Pink C: Thick, white and greasy or sticky P: Deep and slow
Treatment Principle	Warm Cold Transform Dampness Harmonize the Stomach Strengthen the Spleen
Herb Formulas	Wei Ling Tang
Points	Moxa or moxa needle REN-6, REN-12, SP-6, SP-9, ST-36, UB-20 Cold-Damp Dysentery: Moxa or moxa needle LI-4, REN-6, REN-12, SP-6, ST-25, ST-37 Cold-Damp Diarrhea: Moxa or moxa needle REN-6, REN-12, ST-25, ST-36, ST-37, UB-25 Cold-Damp Vaginal Discharge: Moxa or moxa needle GB-26, REN-4, REN-6, SP-6, ST-36, UB-30

SPLEEN QI DEFICIENCY

Clinical Manifestations	Sallow complexion Fatigue 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, forceless and Deficient
Treatment Principle	Strengthen the Spleen Benefit Qi
Herb Formulas	Bu Zhong Yi Qi Tang Zi Sheng Wan
Points	LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

SPLEEN NOT GOVERNING THE BLOOD

Clinical Manifestations	Mild bleeding of dark, purplish Blood or, less commonly, red Blood preceding or following defecation or Black, tarry, sticky stools or occult Blood discovered in testing Intermittent dull abdominal pain, alleviated by pressure Easily satiated Nausea Waxy, sallow or pale complexion Anorexia Fatigue Weakness Four limbs feel tired and heavy Physical and mental exhaustion Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose or unformed stools or Diarrhea Shortness of breath Spontaneous sweating Dizziness Light-headedness Palpitations Functional Uterine Bleeding Purpura Epistaxis Hemafecia Hematuria Menorrhagia Metrorrhagia T: Pale and flabby - may have toothmarks With Blood Deficiency: Pale and thin C: White P: Thready and weak or Moderate
Treatment Principle	Strengthen the Spleen Benefit Qi Nourish the Blood Stop bleeding
Herb Formulas	Bu Zhong Yi Qi Tang modified Gui Pi Tang Gui Pi Tang + Jiao Ai Tang For persistent bleeding: Gu Chong Tangmodified Chinese Patent Medicines: Bu Zhong Yi Qi Wan Sheng Tan Qi Yun Nan Bai Yao
Points	DU-20, REN-6, REN-12, SP-1, SP-4, SP-6, ST-25, ST-36, UB-20, UB-25 SP-1, SP-3, ST-36, UB-20 Ear: Spleen, Stomach, Large Intestine, Small Intestine, Subcortex, Adrenal, Shenmen

SPLEEN YANG DEFICIENCY

Clinical Manifestations	Chronic loose stools or diarrhea which may contain undigested food The stools may be urgent Early morning diarrhea Dark, purplish or pale Blood preceding, following or Black, tarry or Blood-streaked loose stools (the bleeding may also be occult) Dull, persistent abdominal or epigastric cold-pain which improves with warmth and pressure Sallow complexion Anorexia (maybe with vomiting) Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Intolerance to Cold Shortness of breath Cold abdomen Cold limbs Feeling chilled Frequent, clear urination Mental fatigue Weakness Exhaustion Maybe scanty urine with edema Maybe clear, watery vaginal discharge T: Pale, wet and swollen with toothmarks C: Thin and white P: Deep and weak or Deep, weak and slow
Treatment Principle	Warm the Center Dispel Cold Nourish the Blood Stop bleeding
Herb Formulas	With relatively severe bleeding: Huang Tu Tang modified With relatively mild bleeding: Fu Zi Li Zhong Wan modified When the bleeding has stopped: Bu Zhong Yi Qi Tang Si Jun Zi Tang Chinese Patent Medicines: For Spleen Yang Deficiency with severe Cold: Fu Zi Li Zhong Wan For Spleen Yang Deficiency: Li Zhong Wan For bleeding: Yun Nan Bai Yao Sheng Tian Qi Pian
Points	Moxa or moxa needle DU-20, REN-6, REN-12, SP-1, SP-6, ST-25, ST-36, UB-20, UB-25, needle SP-4 With Kidney Yang Deficiency: + moxa or moxa needle REN-4, UB-23 Moxa box REN-8 Moxa LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20 Ear: Spleen, Stomach, Large Intestine, Small Intestine, Adrenal, Subcortex, Shenmen

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	Li Zhong Tang Zhen Ren Yang Zang Tang Tao Hua Tang
Points	Moxa or moxa needle LIV-13, REN-12, SP-3, SP-6, ST-36, UB-20, UB-21

SPLEEN AND STOMACH DAMP-HEAT

Clinical Manifestations	Anorexia Abdominal distention and discomfort 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
Treatment Principle	Clear Heat Benefit Dampness
Herb Formulas	Ge Gen Huang Lian Huang Qin Tang
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 KIDNEY YANG DEFICIENCY

Clinical Manifestations	“Cock-crow” diarrhea (occurs at about 5 am) The diarrhea is often watery with undigested food borborygmus and/or periumbilical pain may precede the diarrhea and ease after defecation The patient may be exhausted Body cold Limbs icy Complexion white and shiny Low back, knees and abdomen feel cold and painful Lower abdomen feels cold and painful, better with warmth and pressure Intolerance of Cold Anorexia Poor digestion Abdominal distention Copious, clear urine Nocturia Fatigue Exhaustion General disinterest Increased desire to sleep Loose stools containing undigested food Edema of face and limbs Dysuria Severe: Abdominal ascites Fecal incontinence T: Pale, moist and swollen with toothmarks 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	Fu Zi Li Zhong Wan + Si Shen Wan With Water Flooding: Zhen Wu Tang Chinese patent medicines: Fu Zi Li Zhong Wan Li Zhong Tang Bu Zhong Yi Qi Tang Jin Kui Shen Qi Wan Ba Ji Yin Yang Wan
Points	Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23 Moxa or moxa needle DU-4, DU-20, KI-3, REN-4, REN-8, SP-6, ST-36, UB-20, UB-23, UB-25

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 P: Thready and weak
Treatment Principle	Reinforce and Benefit the Heart and Spleen
Herb Formulas	Gui Pi Tang modified Chinese Patent Medicines: Gui Pi Wan With Cold or Spleen Yang Deficiency: Li Zhong Wan
Points	HT-7, REN-4, SP-1, SP-6, ST-36, UB-15, UB-20

BLOOD STAGNATION

Clinical Manifestations	Pain that is fixed, stabbing and /or severe Pan is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas, Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the Blood Dispel Blood Stasis Spread Liver Qi Unblock the channels Stop pain
Herb Formulas	Xue Fu Zhu Yu Tang Shao Fu Zhu Yu Tang With Heat: Shao Yao Tang Chinese Patent Medicines: Xue Fu Zhu Yu Wan Fu Ke Wu Jin Wan With bleeding: add Sheng Tian Qi Pian to either of the above formulas
Points	SP-6, SP-10, ST-36, UB-17, UB-40 Ahshi points over the abdomen, Ahshi points along the Stomach channel between ST-36 to ST-39, LI-4, LIV-3, REN-6, SP-6, SP-8, SP-10, ST-25, UB-17, UB-25 With Bleeding: + Ahshi points over the Ba Liao on the sacrum With Cold: + Moxa Ear: Large Intestine, Distal Segment Rectum, Abdomen, Sanjiao, Shenmen, Adrenal

BLOOD STAGNATION WITH DAMP-HEAT IN THE INTESTINE

Clinical Manifestations	Chronic diarrhea with a feeling of incomplete evacuation or tenesmus Purple or black stools which are sticky or tarry bloody or pussy diarrhea Heat Fever Fixed or localized sharp or stabbing abdominal pain (usually in the lower left quadrant) which is worse with pressure Abdominal pain with rigidity Burning around the anus A dark complexion Dark rings around the eyes Purple nails Spider naevi or vesicular abnormalities over the abdomen, face and legs (inner knee and ankle) T: Purple or Brown or Purple stasis spots, maybe dark, distended sublingual veins C: Greasy and yellow P: Wiry or Choppy or Thready
Treatment Principle	Transform and eliminate Blood Stagnation from the Intestines Clear Heat
Herb Formulas	Shao Yao Tang
Points

TOXIC HEAT

Clinical Manifestations	Sudden onset of frequent, explosive diarrhea with copious fresh red, dark red or purple Blood The Blood may contain mucus and pus There may be diarrhea like bloody water High fever (abrupt onset) Thirst Dryness Dehydration Pounding headache Restlessness Irritability Severe abdominal pain Tenesmus Red, purple Blood and pus in the stool Malaise Red lips Diarrhea without eating Prefers cold drinks Trismus Nausea Vomiting Severe: Delirium Confusion Muscular spasms Convulsions Cold limbs Skin rashes Respiratory problems T: Deep red C: Yellow and dry P: Forceful and rapid (if shock, weakens or disappears) or Slippery and rapid
Treatment Principle	Disperse Heat Detoxify Cool the Blood Stop dysentery
Herb Formulas	Wu Wei Xiao Du Yin Xiao Cheng Qi Tang For Toxic Heat in the Uterus: Yin Qiao Hong Jiang Jie Du Tang With chronic Damp-Heat and Blood Stagnation: Qing Re Jie Du Hua Yu Tang
Points	LI-4, LI-11, ST-25, ST-37, ST-44 With high fever: + DU-14 With Dampness prominent: + SP-9 With nausea: + PC-6, REN-12 With tenesmus : + DU-1, REN-4, UB-30 For shock: DU-24, DU-26, UB-29 KI-7, REN-12, SP-4, ST-25, UB-20, UB-21 Ear: Large Intestine, Small Intestine, Subcortex, Sympathetic, Lower Portion of the Rectum

DAMP-HEAT STASIS (INTESTINAL ABSCESS)

Clinical Manifestations	Right-sided lower abdominal pain which is worse with pressure A palpable lump in the lower right quadrant Possibly distended skin in the affected area A tendency to curl up Aversion to Cold Fever Nausea Vomiting Anorexia Maybe difficult or blocked defecation T: Red C: Yellow P: Wiry, slippery and rapid
Treatment Principle	Clear Heat Eliminate Dampness Invigorate the Blood Transform Stasis
Herb Formulas	Da Huang Mu Dan Tangmodified
Points	Lanweixue, LI-4, SP-6, ST-25, ST-36, ST-44 For enduring abscess with imminent attacks: - ST-44, + SP-10, UB-17 For high fever: + LI-11

DAMP-HEAT FESTERING (FISSURES AND FISTULAS)

Clinical Manifestations	Anal pain Dripping of fresh Blood while defecating A sagging, distended sensation in the anus Sticky stools A small amount of pus in the fissures Dampness and maybe itching around the anus T: Red C: Thick and slimy Wiry and rapid
Treatment Principle	Clear Heat Eliminate Dampness
Herb Formulas	Bei Xie Shen Shi Tang modified Topical: For marked anal itching, Dampness and swelling: Anal Itch Powder For predominant bleeding: Finely powder Rz. Bletillae Bai Ji, mix with petroleum jelly (50%-50%) and apply to the affected area
Points	DU-1, SP-6, SP-9, UB-25, UB-57 For fever and aversion to Cold: + LI-4 For anorexia: + REN-12 For abdominal pain: + ST-36