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CUSHING'S SYNDROME - HYPERCORTISOLISM

GENERAL

Clinical Manifestations	Cushing's syndrome happens when the body has abnormally high levels of cortisol. This can happen for a variety of reasons, the most common of which is overuse of corticosteroid medications. Symptoms include: A a round-shaped face Upper body weight gain Skin that bruises easily Women: Increased body hair Menstrual irregularities Men: Erectile and fertility problems Children: Often obese A slowed rate of growth. There is no single definitive test for Cushing's syndrome. In addition to a physical examination, blood, saliva, and urine tests are usually required. After diagnosis, additional tests are needed to identify the cause.
Treatment Principle
Herb Formulas
Points

SPLEEN QI DEFICIENCY WITH PHLEGM-DAMP RETENTION

Clinical Manifestations	Obesity Edema Fatigue Weakness Lassitude Abdominal and ductal glomus and distention Reduced food intake Cold hands and feet Loose stools A pale facial complexion T: Pale and swollen C: Slimy P: Thready and weak
Treatment Principle	Supplement the Spleen Promote Transportation Transform Phlegm Eliminate Dampness
Herb Formulas	Zhi Shi Xiao Pi Wan modified
Points	REN-4, SP-9, ST-36 With a headache and dizziness: + DU-20 With constipation: + SJ-6 With Kidney Yang Deficiency: + moxa or moxa needle UB-23 With severe fatigue, weakness and lassitude: + SP-3 With abdominal glomus and distention: + ST-25 With severe edema: + REN-9

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	A somber, white facial complexion Whole body edema Dizziness Aversion to Cold A preference for warmth Body cold Limbs icy Fatigue Weak limbs Palpitations Sweats easily Reduced appetite Scanty stools but profuse urine Low back, knees and abdomen feel cold and painful Lower abdomen feels cold and painful Loose stools containing undigested food “Cock-crow” diarrhea (occurs at about 5 am) Dysuria Reduced libido Impotence Lusterless hair Soft bones Severe: Abdominal ascites T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep and soft or Deep, thready, weak and maybe slow
Treatment Principle	Warm and Reinforce the Spleen and Kidneys
Herb Formulas	Huang Qi Yi Yi Ren Fu Zi Tang
Points	Moxa or moxa needle DU-4, KI-7, REN-4, SP-6, ST-36 With marked Dampness: + SP-9 For dizziness: + DU-20 For tinnitus: + GB-2 For palpitations and insomnia: + HT-7 For persistent vaginal discharge: + GB-26 For impotence and premature ejaculation: + UB-52 For amenorrhea: + ST-29 Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23

LIVER QI STAGNATION INVADES THE SPLEEN WITH PHLEGM-DAMPNESS

Clinical Manifestations	Obesity Edema or Pitting edema Bright, shiny skin Chest oppression Palpitations Shortness of breath Dizziness Head distention Fatigue Hypersomnia or Somnolence Abdominal distention and pain Gas Borborygmus Dry stools Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Scanty menstruation or Amenorrhea Dysmenorrhea Breast distention and pain before and during menses Scanty urination T: Swollen C: White and greasy P: Slippery and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen Transform Phlegm Eliminate Dampness
Herb Formulas	Cushing's #1
Points	LIV-3, LIV-13, PC-6, REN-4, SP-6, SP-9, ST-25, ST-36, ST-37 With a headache and dizziness: + DU-20 With constipation: + SJ-6 With Kidney Yang Deficiency: + moxa or moxa needle UB-23 With severe fatigue, weakness and lassitude: + SP-3 With abdominal glomus and distention: + ST-25 With severe edema: + REN-9

LIVER QI STAGNATION INVADES THE SPLEEN WITH DEFICIENCY HEAT

Clinical Manifestations	An obese torso Emaciation of the limbs A red facial complexion Facial acne A headache Dizziness Tremor of the hands Abdominal distention and pain Gas Borborygmus Diarrhea Anorexia Loose stools Nausea abdominal distention Distention and pain in the sides or flanks Suffocating sensation in the chest Maybe a bitter taste in the mouth Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Red edges and tip C: White P: Thready and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Jia Wei Xiao Yao San modified
Points	LI-4, LIV-3, LIV-13, REN-4, SP-6, SP-9, ST-25, ST-36, ST-37 With a headache and dizziness: + DU-20 With constipation: + SJ-6 With Kidney Yang Deficiency: + moxa or moxa needle UB-23 With severe fatigue, weakness and lassitude: + SP-3 With abdominal glomus and distention: + ST-25 With severe edema: + REN-9 LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

LIVER YANG RISING WITH PHLEGM-FIRE

Clinical Manifestations	Obesity A red flushed, face Head distention Dizziness Vertigo A throbbing headache Irritability Irascibility Chest oppression Heart vexation Profuse dreams Thirst Constipation T: Normal C: Slimy and yellow P: Slippery, wiry and rapid
Treatment Principle	Calm the Liver Subdue Yang Transform Phlegm-Heat
Herb Formulas	Er Ke Tang
Points	GB-20, GB-43, KI-1, LIV-3, ST-40 For head distention, dizziness and vertigo: + DU-20 For a throbbing headache: + SJ-5, Taiyang For irritability or irascibility: + UB-18, UB-47

LIVER AND KIDNEY YIN DEFICIENCY WITH LIVER YANG RISING

Clinical Manifestations	Obesity Dizziness or Vertigo Impaired vision Night blindness Tinnitus Irascibility Throbbing headache with distended feeling Flushed face or Malar flush Blurred vision Red, dry eyes with feeling of grit in eye Dry mouth and throat with bitter taste in mouth Palpitations Headache Clouded consciousness Low back and knee weakness and pain Hungers easily Nervousness Insomnia with much dreaming Thirst Five Sole Heat (palms, soles and center of chest) Night sweats Light or late menses or Amenorrhea T: Red and dry C: Little or None P: Thready, wiry and rapid
Treatment Principle	Nourish Yin Pacify the Liver Subdue Yang
Herb Formulas	Liu Wei Di Huang Wan modified
Points	GB-20, KI-7, LIV-3, SP-6 For a bitter taste in the mouth and a quick temper: + GB-34 For a headache or dizziness: + DU-20 For a clouded Shen: + Sishencong For tinnitus: + GB-2, SJ-17 For rapid hungering: + REN-12, ST-44 For severe low back and knee weakness and pain: + UB-23 , UB-52 For insomnia: + HT-7 For night sweats: + HT-6 DU-20, GB-20, GB-34, GB-43, KI-3, LIV-2, LIV-3, UB-18, UB-23

KIDNEY YIN DEFICIENCY WITH FIRE FLARING

Clinical Manifestations	An obese torso with emaciation of the limbs A red, rounded, moon-like face Hot flashes in the face Purple macules on the lower abdomen and lower limbs Dizziness 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 and throat 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 Restlessness Insomnia Frequent dreams Palpitations Scanty menstruation or Amenorrhea Constipation If Liver Yang also Rises: Blurred vision T: Red especially on the tip C: Little or None P: Thready, deep and rapid
Treatment Principle	Nourish Yin Supplement the Kidneys Subdue Fire
Herb Formulas	Zhi Bai Di Huang Wan modified
Points	DU-20, KI-2, KI-7, SP-6 For Liver Yang Rising with a headache and dizziness: + GB-20 For insomnia, profuse dreams, restlessness and impaired memory: + HT-7 For constipation: + SJ-6 For restless legs: + LI-4, LIV-3 With Spleen Qi Deficiency: + ST-36 For purple striae or maculae on the lower abdomen and limbs or scanty menstruation or amenorrhea: + SP-10 For tinnitus: + GB-2, SJ-17 For severe low back weakness and pain: + UB-23 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

YIN DEFICIENCY WITH TOXIC HEAT

Clinical Manifestations	Suppurative pharyngitis Pneumonia Pleuritis Erysipelas Fever and chills Generalized body pain Thirst A dry mouth and throat Reduced food intake T: Red C: Yellow P: Rapid
Treatment Principle	Nourish Yin Clear Heat Activate the blood Resolve Toxins
Herb Formulas	Wu Wei Xiao Du Yin modified
Points	LI-4, SJ-5, SP-6 For suppurative pharyngitis: + LI-1, LU-11 For pneumonia: + LU-5, UB-12, UB-13 For pleuritis: + LI-11, LIV-14, REN-17 For erysipelas: + LI-11, SP-10, UB-40

YIN AND YANG DEFICIENCY

Clinical Manifestations	A red face and eyes Malar flushing A fat face An edematous body, especially in the lower limbs Spontaneous sweating Night sweats Dizziness Tinnitus Palpitations Insomnia Weakness of the limbs Low back and knee weakness and pain Vexatious Heat Cold feet Nocturia Persistent vaginal discharge Impotence Premature ejaculation Amenorrhea T: Pale, swollen and tender with a red tip or Red C: Little or None P: Thready, wiry and maybe rapid and maybe deep in either or both cubit positions
Treatment Principle	Tonify the Kidneys Nourishes the Liver Enrich Yin Tonify Yang
Herb Formulas	Er Xian Tang modified
Points	DU-4, KI-3, KI-7, REN-4 With marked Qi Deficiency: + ST-36 With spontaneous perspiration and night sweats: + LI-4 With dizziness: + DU-20 For tinnitus: + GB-2 For palpitations and insomnia: + HT-7 For persistent vaginal discharge: + GB-26 For impotence and premature ejaculation: + UB-52 For amenorrhea: + ST-29