GOITER

Clinical Manifestations
 
Qi Goiter
  • Initially, no prominent systemic symptoms
  • Gradual neck swelling
  • No skin discoloration
  • Mass tends to be flaccid
  • Skin droops locally with a heavy sensation
  • Anger
  • Hoarseness and dyspnea with swelling of the mass
  • Alleviated by feelings of well being
Flesh Goiter
  • Most common among women ages 20-30
  • No systemic symptoms
  • One or more glossy semi-circular nodules around the thyroid
  • The nodules move up and down when the person swallows
  • Pain only with pressure
  • Occasional:
      Impatience
      Sweats easily
      Thoracic constriction
      Heart palpitations
      Tachycardia
      Menstrual irregularity
      Enlargement may cause difficult breathing
Stone Goiter
  • Most common in women ages 40-70
  • The mass is hard with a rough surface
  • The mass grows suddenly and reduces the ability to swallow
  • The mass does not move aside when pressed
  • When critical, the prognosis is poor:
      Pain in the ears, occipital bone and shoulders
      Difficulty breathing
      Impaired speech
      Hoarseness
Blood Goiter
  • Purple skin
  • Veins and red threads visible beneath the skin
  • Profuse bleeding when bruised
  • Painless
Sinew Goiter
  • Associated with Liver Fire
  • Sinews and veins exposed on goiter
  • No aching
Herb Formulas
Points
Clinical Manifestations
  • Lymph adenoid goiter
  • Fatigue
  • Cold hands and feet
  • Obesity
  • Puffy edema
  • Pale face
  • Loose stools
  • T: Thick, pale with teeth marks
  • C: Thin white
  • P: Weak or Soggy
Treatment Principle
  • Strengthen the Middle
  • Tonify Qi
Herb Formulas
Points
Clinical Manifestations
  • Lymph adenoid goiter
  • Fatigue
  • Cold hands and feet
  • Obesity
  • Puffy edema
  • Pale face
  • Loose stools
  • Dizziness
  • Tinnitus
  • Decreased sexual desire
  • Impotence
  • Sterility
  • Menstrual irregularity
  • Infertility
  • Low back pain and weakness
  • Knee pain and weakness
  • Nocturnal polyuria
  • Fear of cold
  • Colder feet than hands
  • T: Thick, pale with teeth marks
  • C: Thin white
  • P: Weak or Soggy
Treatment Principle
  • Strengthen the Middle
  • Tonify Qi
  • Supplement the Kidneys
  • Tonify Yang
Herb Formulas
Points
Clinical Manifestations
  • The lump is small or large, relatively soft with a slow onset.
  • Palpitations
  • Restlessness
  • Anxiety
  • Fidgeting
  • Hypochondriac pain
  • Insomnia
  • Afternoon fever
  • Night sweats
  • Hand tremors
  • Dry eyes
  • Dry mouth
  • Blurred vision
  • Tiredness
  • T: Red
  • C: Little or none
  • P: Floating and empty, relatively overflowing on left cun or Thready and rapid
Treatment Principle
  • Nourish Yin
  • Nourish the Heart and Liver
  • Nourish Liver Blood
  • Calm the mind
  • Soften the Liver
  • Resolve Phlegm
  • Soften hardness
  • Dissolve the goiter
Herb Formulas
Points
Clinical Manifestations
  • Goiter
  • Irritability
  • Palpitations
  • Anxiety
  • Fatigue
  • Insomnia
  • Very restless sleep
  • Inability to think or concentrate even for short periods
  • Nocturnal emissions
  • Forgetfulness
  • Dry stools
  • Mouth sores
  • Tongue sores
  • Low grade afternoon fever
  • Dream disturbed sleep
  • Night sweats
  • Constipation
  • T: Red
  • C: Little
  • P: Rapid or Thready and rapid
Treatment Principle
  • Enrich the Yin
  • Nourish the Blood
  • Tonify the Heart
  • Calm the Shen
  • Clear Heat
Herb Formulas
Points
Clinical Manifestations
  • The lump is soft and not painful and becomes larger or smaller according to the emotional situation
  • The edges are indistinct
  • A swollen feeling in the front of the throat
  • A plum pit sensation in the back of the throat
  • Dysphagia
  • Neck ache
  • Oppressive feeling in the chest
  • Sighing
  • Hypochondriac distention and pain
  • Irritability
  • A tendency toward anger
  • Depression
  • With Heart involvement:
      Palpitations
      Anxiety
      Wheezing
      Feelings of constriction in the throat
      Chest discomfort
  • With Lung involvement:
      Dry cough
      Slight breathlessness
      Sadness
  • Due to worry and sorrow:
    Enlarged thyroid
    Wheezing
    Dysphagia
    Respiratory problems
    Deafness
    Disorders of taste
  • T: Normal or Swollen
  • C: Slimy, white
  • P: Wiry, Slippery
Treatment Principle
  • Regulate Qi
  • Eliminate Stagnation
  • Sooth the Liver
  • Descend Lung Qi
  • Resolve Phlegm
  • Dissolve goiter
  • Descend Heart Qi
Herb Formulas
Points
Clinical Manifestations
  • The lump is soft and not painful and becomes larger or smaller according to the emotional situation
  • The edges are indistinct
  • A swollen feeling in the front of the throat
  • A plum pit sensation in the back of the throat
  • Dysphagia
  • Neck ache
  • 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
Points
Clinical Manifestations
  • Feeling of a lump in the throat
  • The lump is soft and becomes larger or smaller according to the emotional situation
  • The edges are indistinct
  • Oppressive feeling in the chest and hypochondrium
  • Difficulty swallowing
  • Loose stools
  • Irregular menstruation
  • Pre-menstrual tension
  • Nausea
  • Vomiting
  • Loose stools
  • Weakness
  • T: Pale or dusky
  • C: White or greasy white
  • P: Wiry or Smooth and soft
Treatment Principle
  • Soothe the Liver
  • Move Qi
  • Tonify Spleen Qi
  • Soften masses
  • Resolve Phlegm
Herb Formulas
Points
Clinical Manifestations
  • The lump is small or medium sized, relatively soft and slippery
  • Restlessness
  • Insomnia
  • Thirst
  • Feeling of Heat
  • Irritability
  • Red eyes
  • Red face
  • Tremor of the hands
  • Bitter taste in the mouth
  • Exophthalmos
  • Aversion to Heat
  • Profuse sweating
  • Conjunctival congestion
  • T: Red with red tip and edges
  • C: Dry and yellow
  • P: Wiry and rapid
Treatment Principle
  • Drain Fire
  • Clear the Liver
  • Resolve Phlegm
  • Soften hardness
  • Dissolve the goiter
  • Calm the mind
Herb Formulas
Points
Clinical Manifestations
  • Aversion to Cold
  • Edema of whole body particularly at and below the waist
  • Cold extremities
  • Scanty urination
  • Abdominal distention with full sensations
  • Edema of the legs
  • Cold sensations in the lower body
  • Sensory numbness
  • Low back pain, aching and heaviness
  • Severe pitting edema
  • Fatigue
  • Feeling nervous and cold with mental weariness
  • Face gray and congested or pale
  • Urinary difficulties
  • Oliguria
  • Severe:
    Ascites
    Edema of scrotum
  • T: Pale and swollen with teethmarks
  • C: White and slippery or Thin and white or Thick, white and sticky
  • P: Deep and wiry or Deep and thready
Treatment Principle
  • Warm Yang
  • TonifY the Kidneys
  • Aid water transformation
  • Promote urination
  • Reduce edema
Herb Formulas
Points
Clinical Manifestations
  • Goiter with nodulations
  • Dizziness
  • Palpitations
  • Insomnia
  • Dry skin
  • Dry hair
  • Poor memory
  • Paleness
  • Fatigue
  • Scanty periods
  • 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
  • Blurred vision
  • Pain that is fixed, stabbing and /or severe or
  • Pains that move around
  • Distention
  • Depression
  • Irritability
  • 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: Pale red or purplish
  • C: Little or None or Thin, white and dry
  • P: Thready and rapid or Weak or Thready, wiry, choppy and rapid
Treatment Principle
  • Nourish Yin and Blood
  • Circulate Qi
  • Invigorate the Blood
  • Resolve Phlegm
  • Eliminate nodulations
Herb Formulas
Points
Clinical Manifestations
  • Noxious swellings
  • Abscesses
  • Flat abscesses
  • Red face
  • Chest pain
  • Ulceration of the tumor
  • Maybe a bloody secretion
  • Foul odor
  • Short urine
  • T: Reddish purple
  • C: Little or Yellow
  • P: Wiry and rapid or Flooding or Tight or Thin
Treatment Principle
  • Move Qi
  • Invigorate the Blood
  • Break up Stasis
  • Clear Heat
  • Resolve toxicity
Herb Formulas
Points
Clinical Manifestations
  • Tiredness
  • Weakness
  • Aversion to speaking
  • Slowness
  • Palpitations
  • Sallow complexion
  • Loose stools
  • Dry skin
  • Amenorrhea
  • Cold Limbs
  • T: Pale
  • P: Weak
Treatment Principle
  • Tonify Qi
  • Nourish Blood
Herb Formulas
Points
Clinical Manifestations
  • Goiter develops quickly
  • Pain
  • Redness
  • Ulceration
  • Discharge of yellow or bloody, foul-smelling fluid
  • Fatigue
  • Fever
  • Anxiety
  • Dry mouth
  • Thirst
  • Dark urine
  • Bitter taste
  • Red eyes
  • Insomnia
  • T: Red
  • C: White or Yellow and greasy or Thick, sticky, dry and yellow
  • P: Wiry or Rolling and rapid or Wiry, overflowing and rapid
Treatment Principle
  • Clear Heat
  • Relieve toxicity
  • Strengthen Zheng Qi
Herb Formulas
Points
Clinical Manifestations
  • Neck swelling
  • The lump is a hard nodular mass that is immovable and grows rapidly
  • The lumps have an irregular surface
  • The lump may move slightly when swallowing
  • The skin over the mass is dark and painful
  • A feeling of chest oppression
  • Palpitations
  • Shortness of breath
  • Exophthalmos
  • Irascibility
  • Insomnia
  • Anxiety
  • Hoarse voice
  • T: Swollen and purple
  • C: Sticky
  • P: Wiry and/or choppy or Wiry and Rolling
Treatment Principle
  • Regulate Qi
  • Invigorate Blood
  • Eliminate Stasis
  • Resolve Phlegm
  • Soften hardness
  • Dissolve goiter
Herb Formulas
Points