OBESITY

GENERAL

Clinical Manifestations
Treatment Principle
Herb Formulas	Jiang Zhi Jian Fei Yin Jiang Zhi Jian Fei Yin #2 Jiang Zhi Jian Fei Yin #4 Jiang Zhi Jian Fei Wan Huang Qi Gui Zhi Wu Wu Tang To resolve Phlegm: Er Chen Tang Ping Wei San San Zi Yang Qin Tang Kong Xian Dan To dispel Water: Wu Pi Yin Dao Shui Fu Ling Tang Zhou Che Wan Shi Zao Tang For freeing the bowels: Xiao Cheng Qi Tang Tiao Wei Cheng Qi Tang For transforming Accumulations: Bao He Wan For dredging the Liver and disinhibiting the Gall Bladder: Wen Dan Tang Shu Gan Yin For strengthening the Spleen: Yi Gong San Zhi Zhu Wan Wu Ling San Shen Ling Bai Zhu San For warming Yang: Shen Qi Wan Gan Cao Fu Zi Tang Female obesity: Si Ni San Fang Ji Huang Qi Tang Zuo Gui Wan You Gui Wan Male obesity: Fang Feng Tong Sheng San San Huang Xie Xin Tang Zuo Gui Wan You Gui Wan Er Zhi Wan Chinese Patent Medicines: Yue Jian Cao You Jiao Nang Jiao Gu Lan Zong Dai Jiao Nang Fang Feng Tong Sheng Wan Yi Qing Jiao Nang Qing Shen Jiang Zhi Pian Jian Fei Jiang Zhi Ling Fu Fang Shan Jia Jiang Zhi Wan
Points	PC-6, ST-25, ST-40, REN-4, SP-6, LU-7

QI STAGE: SPLEEN AND STOMACH DAMP-HEAT

Clinical Manifestations	Fever Pressure headache - like a bandage Gastric distension Poor appetite Heaviness Body aches Chest distension Diarrhea Dysentery T: Red C: Greasy and yellow P: Soft and rapid or Soft and slow or Wiry thin and soft
Treatment Principle	Clean Damp-Heat and toxins
Herb Formulas	An Ho Tea
Points	LI-4, LI-11, SP-6, SP-9, ST-25, ST-36

LUNG AND SPLEEN 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 T: Pale C: White P: Thready and weak
Treatment Principle	Reinforce the Spleen Benefit the Lungs Warm and transform Phlegm-Dampness
Herb Formulas	Liu Jun Zi Tang Shen Ling Bai Zhu San Bu Zhong Yi Qi Tang
Points	PC-6, ST-25, ST-40, REN-4, SP-6, LU-7

LARGE INTESTINE EXCESS HEAT

Clinical Manifestations	Knotted constipation or Watery, thin diarrhea (Heat knots or flows) Burning hot sensation in the anus Abdominal distention and pain (dislikes pressure) High fever or infantile tidal fever Hands and feet dripping with perspiration Vomiting Irritating thirst Delirium T: Pink, maybe prickles (swollen papillae on the tongue that look like thorns and are very sensitive to the touch) or Red C: Thick, yellow and dry P: Deep and Shi
Treatment Principle	Strongly purge Heat accumulation
Herb Formulas	Da Cheng Qi Tang
Points	ST-25, ST-37, ST-44, SJ-6, LI-11, UB-25

SPLEEN QI DEFICIENCY

Clinical Manifestations	Obesity with a long history of a bad diet Dislike of speaking Sweating on exertion Aversion to Cold Puffy face Poor appetite Abdominal fullness after eating Fatigued spirit Weakness of the extremities Somnolence Loose stools Clear, thin vaginal discharge Bland taste in the mouth T: Pale with teethmarks C: White P: Fine and weak
Treatment Principle	Boost Qi Tonify the Spleen Open the water passages Percolate Dampness
Herb Formulas	Obesity #4 Bu Zhong Yi Qi Tang Bao Jian Mei Jian Fei Cha For diarrhea and sliminess in the mouth: Shen Ling Bai Zhu Sanmodified For Dampness: Wu Ling San Ping Wei San Qi Pi Wan For Qi Deficient constipation: Huang Qi Tang With Heart Blood Deficiency: Gui Pi Tang With Food Stagnation and Phlegm: Obesity #1
Points	UB-20, UB-23, REN-6, ST-36, SP-6 For decreased sexual desire: + Moxa DU-4, REN-4 UB-20, UB-23, REN-12, ST-36, SP-6

SPLEEN QI DEFICIENCY WITH STOMACH HEAT

Clinical Manifestations	Obesity with a long history of a bad diet Dislike of speaking Sweating on exertion Aversion to Cold Puffy face Poor appetite Abdominal fullness after eating Fatigued spirit Weakness of the extremities Somnolence Loose stools Clear, thin vaginal discharge Bland taste in the mouth T: Pale with teethmarks C: White P: Fine and weak
Treatment Principle	Boost Qi Tonify the Spleen Open the water passages Percolate Dampness
Herb Formulas	Obesity #4 Bu Zhong Yi Qi Tang Bao Jian Mei Jian Fei Cha Fei Pang Fang For diarrhea and sliminess in the mouth: Shen Ling Bai Zhu Sanmodified For Dampness: Wu Ling San Ping Wei San For Qi Deficient constipation: Huang Qi Tang With Food Stagnation: Xiao Cheng Qi Tang + Bao He Wan
Points	UB-20, UB-23, REN-6, ST-36, SP-6 UB-20, UB-23, REN-12, ST-36, SP-6 For decreased sexual desire: Moxa DU-4, REN-4

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Obesity which is more severe below the waist Poor appetite Abdominal distention after eating Fatigued spirit Weakness of the extremities Dislike of movement Aversion to Cold Cold extremities Wheezing Short voidings of clear urine Frequent urination Clear urination at night Low back pain Edema of lower extremities with inhibited urination Loose stools T: Pale and enlarged C: Thin white P: Deep, fine and weak
Treatment Principle	Supplement the Kidneys Invigorate Yang Fortify the Spleen Disperse swelling
Herb Formulas	Jing Gui Shen Qi Wan modified Li Zhong Wan With Water Flooding: Zhen Wu Tang
Points	REN-4, DU-4, UB-20, UB-23, ST-36, SP-6 For marked Phlegm-Dampness: + ST-40, REN-12 For Food Stagnation: + REN-12, ST-21 For marked edema: + SP-9, REN-7

LIVER QI STAGNATION

Clinical Manifestations	Emotional problems Chest oppression Flank pain Bitter taste in the mouth T: Normal P: Wiry
Treatment Principle	Course the Liver Disinhibit the Gallbladder Move Stagnation
Herb Formulas	Shu Gan Xiao Fei Tang Xiao Yao San
Points	PC-6, ST-25, ST-40, REN-4, SP-6, LU-7

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
Points	GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19

LIVER AND STOMACH HEAT

Clinical Manifestations	Burning Heat and pain in the epigastrium Irritating thirst: drinks copious fluids and prefers cold drinks Excessive appetite: hungry again quickly after eating (as if food vanishes) Swelling, pain, ulceration and bleeding of gums Foul breath Toothache Maybe vomiting right after eating Vomiting acid or undigested food Maybe scanty, red urine 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 or Red tip and edges C: Thick, yellow and dry or Thick, yellow, dry and rough P: Slippery, big, Excess and rapid or Wiry, Excess and rapid
Treatment Principle	Clear and Purge Stomach Fire Soothe the Liver Invigorate the Spleen
Herb Formulas	Long Dan Xie Gan Tang Jia Wei Xiao Yao San
Points	PC-6, ST-25, ST-40, REN-4, SP-6, LU-7

KIDNEY YANG DEFICIENCY

Clinical Manifestations	Lumbago: low back feels cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Pale face Urinary frequency with abundant, clear urine or Oliguria with edema Maybe nocturia Lassitude Withdrawn, subdued behavior Knees feel cold and aching Dizziness Tinnitus Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow
Treatment Principle	Warm and Reinforce Kidney Yang
Herb Formulas	Jin Gui Shen Qi Wan (Ba Wei Di Huang Wan)
Points	Moxa or moxa needle DU-4, KI-3, REN-4, UB-23 For chronic diarrhea, rectal prolapse and Vanquished Yang: + moxa DU-20, REN-8 For Kidney Yang Deficiency impotence: moxa or moxa needle DU-4, DU-20, KI-3, REN-4, UB-23 For Kidney Yang Deficiency (Cock Crow) Diarrhea: moxa or moxa needle DU-20, KI-3, REN-4, UB-23

KIDNEY YANG DEFICIENCY WITH WATER FLOODING

Clinical Manifestations	Edema of whole body particularly at and below the waist Pitting edema Lumbago: low back feels cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Pale face Urinary frequency with abundant, clear urine or Oliguria with edema Abdominal distention with full sensations Oliguria Dry skin Maybe nocturia Lassitude Withdrawn, subdued behavior Knees feel cold and aching Dizziness Tinnitus Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea Face gray and congested or pale Feeling nervous and cold with mental weariness T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow In severe cases: Ascites Edema of scrotum T: Pale and swollen C: Thin, white or Thick, white and sticky P: Deep and thready
Treatment Principle	Warm and Reinforce Kidney Yang Promote diuresis
Herb Formulas	Ji Sheng Shen Qi Wan+ Ling Gui Zhu Gan Tang
Points	Moxa or moxa needle DU-4, KI-3, REN-4, UB-23 KI-7, REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23, UB-39

QI AND BLOOD STAGNATION

Clinical Manifestations	Dizziness Numbness of the extremities T: Dark with spots P: Choppy
Treatment Principle	Move the Blood Transform Stasis Move Stagnation
Herb Formulas	Xue Fu Zhu Yu Tangmodified Tao Hong Si Wu Tang + Chai Hu Shu Gan Tang
Points	PC-6, ST-25, ST-40, REN-4, SP-6, LU-7

JING AND BLOOD DEFICIENCY DUE TO KIDNEY, HEART AND SPLEEN 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

DRY HEAT WITH BLOOD AND PHLRGM STAGNATION (METABOIC SYNDROME)

Clinical Manifestations	Early-Stage: Food Stagnation + Qi and Blood Stagnation with Heat 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 Middle-Stage: Both Excess and Deficiency + Qi and Blood or Qi and Yin Deficiency of multiple organs + External Excess or Phlegm Stagnation or Blood stagnation Lassitude Fatigue Shortness of breath Dizziness Tinnitus Palpitations Emaciation Lack of strength Dry, rough eyes Possible distended feeling in eyes A pale, lusterless face Possible malar flush Restless Insomnia Poor memory Dry, parched throat Tasteless feeling in the mouth Low back and knee soreness and weakness Low grade fever Five sole heat Possible sweating Possible tremors of the hands and tongue Scanty intake Abdominal distention after meal Loose stools T: Red C: Thin or Peeled P: Empty and rapid or Thready and rapid
Treatment Principle	Early-Stage: Relive Stagnation Clear Heat Middle-Stage: Reduce Excess Tonify Deficiency Resolve Phlegm Invigorate the Blood Dispel Stasis
Herb Formulas	Early-Stage: Da Chai Hu Tang Metabolic Syndrome #1 Huo Xue Hua Yu Shu Gan Li Dan Middle-Stage: Yi Qi Yang Yin Huo Xue Fang Qi Deficiency: Si Jun Zi Tang Qi and Yin Deficiency: Shen Qi Di Huang Tang Kidney and Liver Yin Deficiency: Qi Ju Di Huang Tang Liu Wei Di Huang Wan Kidney Yang Deficiency: Jin Gui Shen Qi Wan Kidney Yin and Yang Deficiency: Di Huang Yin Zi Blood Stagnation with Heat: Di Dang Tang
Points

DAMP ACCUMULATION

Clinical Manifestations	Heavy sensation in the body Superficial edema Urinary difficulty Knee pain Abdominal bloating Edema in lower legs Fatigue Edema in women with constitutional Deficiency Severe vertigo Excess fluid in the epigastrium Dizziness Habitual headache T: Pale C: White or Swollen and moist P: Floating and weak, or soft and thready
Treatment Principle	Augment Qi Strengthen the Spleen Promote urination Reduce edema Regulate water circulation
Herb Formulas	Fang Ji Huang Qi Tang Ze Xie Tang Jia Wei Ping We San
Points	PC-6, ST-25, ST-40, REN-4, SP-6, SP-9, LU-7

DAMP ACCUMULATION WITH WEI QI DEFICIENCY

Clinical Manifestations	Obesity Sweating with aversion to Wind Heavy sensation in the body Superficial edema Urinary difficulty Knee pain Abdominal bloating Edema in lower legs Fatigue Edema in women with constitutional Deficiency T: Pale C: White or Swollen and moist P: Floating and weak, or soft and thready
Treatment Principle	Augment Qi Strengthen the Spleen Release the exterior Promote urination Reduce edema Regulate water circulation
Herb Formulas	Fang Ji Huang Qi Tang
Points	PC-6, ST-25, ST-40, REN-4, SP-6, LU-7

DAMP-HEAT

Clinical Manifestations	With Dampness predominating: Alternating fever and chills Anorexia Inability to differentiate flavors T: Normal or Slightly red C: White P: Soggy and slightly rapid
Treatment Principle	Open Damp Stagnation Clear Heat
Herb Formulas	Da Yuan Yin Jia Jian Yin Chen Wu Ling San With dizziness: San Ren Tang
Points	PC-6, ST-25, ST-40, REN-4, SP-6, LU-7

PHLEGM-DAMP

Clinical Manifestations	Obesity Predilection for sweet, fatty foods, dairy products and alcohol Chest and Stomach glomus Chest and Stomach oppression Nausea Profuse Phlegm Dizziness Palpitations Heavy, fatigued limbs Somnolence T: Enlarged C: Thick and slimy P: Wiry, slippery and forceful
Treatment Principle	Transform Phlegm Dry Dampness Reduce accumulation Disperse food
Herb Formulas	Ling Gui Zhu Gan Tang Bao Jian Mei Jian Fei Cha Kai Yu Er Chen Tang Dao Tan Tang Ping Chen Tang modified Xiang Sha Liu Jun Zi Tang
Points	SP-9, SP-6, ST-36, ST-40, REN-10, REN-9 For profuse sweating: LI-4, KI-7 For somnolence with dislike of movement: Moxa UB-22

PHLEGM-STAGNATION

Clinical Manifestations	Poor muscle tone Muttering to oneself Dull spirit Lusterless eyes Dark around eyes Poor eyesight Increased secretions and body odor in genital and axillary areas Drowsiness Heavy head Dizziness Chest oppression Fullness in the epigastrium Restlessness Irritability Depression T: Normal C: Sticky P: Wiry, slippery, deep and forceful
Treatment Principle	Dry Dampness Transform Phlegm Regulate Qi Harmonize the Middle Jiao
Herb Formulas	Er Chen Tang Ping Wei San San Zi Yang Qin Tang
Points	PC-6, ST-25, ST-40, REN-4, SP-6, LU-7

PHLEGM-HEAT GENERATES WIND (RE TAN)

Clinical Manifestations	Mild or severe tremors of the head and extremities Sometimes the tremors can be stopped by conscious effort Fullness and stiffness of the chest and epigastrium A dry mouth Dizziness Vertigo Sweating Yellow Phlegm A tendency toward obesity T: Normal or Red C: Greasy and yellow P: Wiry, slippery and rapid
Treatment Principle	Clear Heat Transform Phlegm Extinguish Wind
Herb Formulas	Dao Tan Tangmodified With severe Phlegm, Heat and tremors: Cui Gan Wan Chinese Patent Medicines: An Gong Niu Huang Wan Wan Shi Niu Huang Qing Xin Wan Hu Po Bao Long Wan
Points	DU-12, GB-13, LIV-3, PC-5, REN-15, ST-25, ST-40 If worse at night: + KI-6 If worse during the day: + UB-62

PHLEGM OBSTRUCTION

Clinical Manifestations	Chronic and continuous somnolence Heavy sleep Difficult to rouse Tendency toward obesity Glossy or greasy skin Foggy headedness (like the head being wrapped in a damp towel) Poor concentration Dizziness Heavy and tired limbs Fullness and distention or a feeling of blockage in the chest and epigastrium T: Flabby C: Thick and greasy P: Slippery
Treatment Principle	Transform Phlegm Open the channels to the head
Herb Formulas	Di Tan Tangmodified Tan Pi Tang Chinese Patent Medicines: Er Chen Wan Xiang Sha Liu Jun Zi Wan
Points	DU-20, GB-20, KI-6, LIV-3, REN-12, SP-3, SP-6, SP-9, ST-25, ST-36, ST-40, UB-20, UB-62

PHLEGM OBSTRUCTION WITH QI STAGNATION

Clinical Manifestations	Profuse Phlegm Chest oppression T: Normal C: Slimy P: Wiry
Treatment Principle	Eliminate Phlegm Move Stagnation
Herb Formulas	Er Chen Tang + Shu Gan Tang
Points	PC-6, ST-25, ST-40, REN-4, SP-6, LU-7

HEAT EXCESS IN THE EXTERIOR AND INTERIOR

Clinical Manifestations	Dizziness Red, sore eyes Difficulty swallowing Nasal congestion Thick, sticky nasal discharge and saliva Bitter taste in the mouth Dry mouth Focal distention in the chest and diaphragm Stifling sensation in the chest and diaphragm Manic behavior Carbuncles Heat rash Headache Sore throat Skin ruptures or ulcers Tense abdomen Shoulder stiffness Numb extremities Fatigue Constipation Dysuria with reddish urine Dark, rough urination Obesity Heaviness in the head T: Red C: White or yellow, greasy P: Flooding and rapid or Wiry and slippery or Floating, smooth and rapid
Treatment Principle	Disperse Wind Release the Exterior Drain Heat Unblock the bowels
Herb Formulas	Fang Feng Tong Sheng San
Points	PC-6, ST-25, ST-40, REN-4, SP-6, LU-7

OBESITY

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