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GOITER

GENERAL

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	Hai Zao Yu Hu Tang modified San Zhong Kui Jian Tang #1 Chai Hu Jia long Gu Mu Li Tang modified
Points	GB-20, DU-14, DU-4, UB-11, REN-22, ST-10, SJ-3 UB-10, UB-12, DU-12, DU-3, REN-23, ST-9, GB-26 ST-9 through to SI-17, LI-4, ST-36, Zeqian, KI-3, PC-6, SP-6 Ahshi points around goiter (four points inserted on the top, bottom, left and right of the thyroid, oblique towards the center), PC-5, PC-6, ST-36, SP-6 Local points: ST-11, REN-22, REN-23, LI-17, ST-9, LI-18, SI-17, ST-10 , extra point Pingying (0.7 cun lateral to the space between 4th and 5th cervical vertebrae), extra point Shangtianzhu (0.5 cun above BL-10) Huatuojiaji points Ancient Acupuncture Prescriptions: Zhen Jiu Jia Yi Jing (The ABC Classic of Acupuncture and Moxibustion): SI-17 Zhen Jiu Da Quan ( Complete Works of Acupuncture and Moxibustion): LU-7, LI-18, REN-22, LI-17, ST-12, KI-27, REN-1, LI-4, bleed Shixuan Qian Jin Yao Fang (Prescriptions worth a Thousand in Gold for Every Emergency): SJ-13 , LU-3 , ST-11 Zhen Jiu Zi Sheng Jing (Classic of Nourishing Life with Acupuncture and Moxibustion): GB-10, ST-11

SPLEEN QI DEFICIENCY

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	Bu Zhong Yi Qi Tang modified With Phlegm-Dampness: Dao Tan Tang
Points	Moxa St-36, SP-3, SP-6, needle ST- 12, ST-9, SI-16 With Liver Qi Stagnation: LIV-3 With Blood Deficiency: UB-17, UB-20 With facial edema: SP-9, DU-26 With constipation: ST-25 With Wind-Cold-Damp Invasion: LI-11, SP-9 + Ahshi Points With depressive Heat: ST-44, or GB-34 With cold hands and feet: SJ-5, UB-57 REN-4 + moxa, above UB-10 With facial edema: SP-9, DU-26 With generalized edema: SP-6, SP-9, REN-9

**SPLEEN AND KIDNEY YANG DEFICIENCY**

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	Jia Wei Shen Qi Wan With Phlegm: Shi Liu Wei Liu Qi Yin
Points	UB-20, UB-23 + moxa, DU-4 + moxa With constipation: ST-25 With loose stools: St-36 With spine and low back pain and cold sensations: DU-14, DU-6, DU-1 With heart palpitations: PC-6 With abdominal distention: REN-12, ST-25 With anorexia: ST-36 With marked fatigue and weakness: ST-36 With Yin Deficiency: KI-7 With Liver Qi Stagnation: LIV-3 through to KI-1 With goiter: ST-12, ST-9 or SI-16 With Wind-Cold–Damp: LI-11, SP-9, Ahshi points With depressive Heat: ST-44 or GB-34 With cold hands and feet: SJ-5, UB-57

**HEART AND LIVER YIN DEFICIENCY WITH PHLEGM**

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	Tian Wang Bu Xin Dan Tian Wang Bu Xin Dan + Yi Guan Jian Ping Ying Fu Fang Fu Fang Jia Kang Gao Goiter #2 Er Chen Tang Dao Tan Tang Patent: Hai Zao Jing
Points	Ahshi points, PC-6, ST-36, LI-4, LI-17, HT-7, LIV-3, SP-6, REN-4, KI-6, LU-7 Ahshi points (4 needle technique) ST-9, ST-10, ST-11, REN-22, REN-23, LI-17, LI-18, Pingying (.7 cun lateral to the space between the 4th and 5th cervical vertebra), Shangtianzhu (.5 cun above UB-10) SI-17 LU-7, LI-4, LI-17, LI-18, REN-17, REN-22, ST-12, KI-27, Bleed Shixuan SJ-13, LU-3, ST-11. GB-10, SI-17 SJ-13, LI-4, LI-17, ST-36, SI-17, REN-22 Ear: Endocrine, Thyroid, Shenmen, Neck Moxibustion: 1. GB-20, DU-14, LI-14, Extra point (1.5 cun below DU-14) 2. REN-22, REN-17, UB-7, LU-2, LU-3, LI-14, LIV-4, GB-20, DU-14, ST-11, ST-42

HEART AND KIDNEY YIN DEFICIENCY

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	Tian Wang Bu Xin Dan
Points	SJ-6, GB-20, GB-34, LIV-3, PC-6, HT-5, LU-7, LI-4, LI-11, GB-20, UB-60, REN-22, ST-40, SP-6, REN-12, UB-18, UB-15, LU-7 and KI-6 (REN channel), SP-4 and PC-6 (Chong channel), Ahshi points (4 needle technique surrounding the goiter), Huatuojiaji, LI-17 With Heart Involvement: HT-5, HT-7, REN-15 With Lung involvement: LU-3, LU-7, LI-4, REN-17 ST-9, ST-10, ST-11, REN-22, REN-23, LI-17, LI-18. Pingying (.7 cun lateral to the space between the 4th and 5th cervical vertebra), Shangtianzhu (.5 cun above UB-10) SI-17 LU-7, LI-4, LI-17, LI-18, REN-17, REN-22, ST-12, KI-27, Bleed Shixuan SJ-13, LU-3, ST-11 GB-10, ST-11 SJ-13, LI-4, LI-17, ST-36, SI-17, REN-22 LIV-3, ST-12, ST-40, SJ-13, SI-16 With neck discomfort: LU-7, KI-6 With depressive Heat: GB-34, LIV-2, eliminate LIV-3 With Spleen Qi Deficiency: ST-36 With Kidney Yang Deficiency: KI-3, KI-10, DU-20, DU-21, REN-22 With mucus: LI-15, GB-20, DU-14, LI-11 LI-4, Ahshi points ST-9, PC-6, LI-4, SJ-13 With hoarseness: SI-17, REN-22 With dry cough: LU-7, HT-6 LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, PC-6, SP-6, SJ-6, UB-14, GB-40, UB-41 REN-17, LIV-3 Ear: Endocrine, Thyroid, Shenmen, Neck Plum blossom swelling Moxibustion: 1. GB-20, DU-14, LI-14, Extra point (1.5 cun below DU-14) 2. REN-22, REN-17, UB-7, LU-2, LU-3, LI-14, LIV-4, GB-20, DU-14, ST-11, ST- 42 3. REN-22, REN-17, LU-2, LU-3, LI-14, LI-11, LIV-4, GB-20, DU-14, ST-11, ST-42, SJ-1

LIVER QI STAGNATION WITH PHLEGM

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	Si Hai Shu Yu Wan Goiter #2 Er Chen Tang Hai Zao Yu Hu Tang Xia Ku Cao Gao San Zhong Kui Jian Tang Dao Tan Tang Chai Hu Shu Gan Tang Ban Xia Hou Po Tang With Damp-Heat: San Zhong Kui Jian Tang #1 San Zhong Kui Jian Tang #2 With Blood Dryness: Xia Ku Cao Gao Patent: Hai Zao Jing
Points	SJ-6, GB-20, GB-34, LIV-3, PC-6, HT-5, LU-7, LI-4, LI-11, GB-20, UB-60, REN-22, ST-40, SP-6, REN-12, UB-18, UB-15, LU-7 and KI-6 (REN channel), SP-4 and PC-6 (Chong channel), Ahshi points (4 needle technique surrounding the goiter), Huatuojiaji, LI-17 With Heart Involvement: HT-5, HT-7, REN-15 With Lung involvement: LU-3, LU-7, LI-4, REN-17 ST-9, ST-10, ST-11, REN-22, REN-23, LI-17, LI-18. Pingying (.7 cun lateral to the space between the 4th and 5th cervical vertebra), Shangtianzhu (.5 cun above UB-10) SI-17 LU-7, LI-4, LI-17, LI-18, REN-17, REN-22, ST-12, KI-27, Bleed Shixuan SJ-13, LU-3, ST-11 GB-10, ST-11 SJ-13, LI-4, LI-17, ST-36, SI-17, REN-22 LIV-3, ST-12, ST-40, SJ-13, SI-16 With neck discomfort: LU-7, KI-6 With depressive Heat: GB-34, LIV-2, eliminate LIV-3 With Spleen Qi Deficiency: ST-36 With Kidney Yang Deficiency: KI-3, KI-10, DU-20, DU-21, REN-22 With mucus: LI-15, GB-20, DU-14, LI-11 LI-4, Ahshi points ST-9, PC-6, LI-4, SJ-13 With hoarseness: SI-17, REN-22 With dry cough: LU-7, HT-6 LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, PC-6, SP-6, SJ-6, UB-14, GB-40, UB-41 REN-17, LIV-3 Ear: Endocrine, Thyroid, Shenmen, Neck Plum blossom swelling Moxibustion: 1. GB-20, DU-14, LI-14, Extra point (1.5 cun below DU-14) 2. REN-22, REN-17, UB-7, LU-2, LU-3, LI-14, LIV-4, GB-20, DU-14, ST-11, ST- 42 3. REN-22, REN-17, LU-2, LU-3, LI-14, LI-11, LIV-4, GB-20, DU-14, ST-11, ST-42, SJ-13

LIVER QI STAGNATION TURNING TO HEAT WITH UNDERLYING QI AND BLOOD DEFICIENCY

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	Jia Wei Xiao Yao San
Points

LIVER QI STAGNATION WITH SPLEEN QI DEFICIENCY WITH PHLEGM

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	Xiao Yao San + Liu Jun Zi Tang Goiter #2 Er Chen Tang Hai Zao Yu Hu Tang Xia Ku Cao Gao San Zhong Kui Jian Tang Dao Tan Tang Patent: Hai Zao Jing
Points	SJ-6, GB-34, LIV-3, PC-6, REN-12, REN-22, UB-20 Ahshi points (4 needle technique) ST-9, ST-10, ST-11, REN-22, REN-23, LI-17, LI-18, Pingying (.7 cun lateral to the space between the 4th and 5th cervical vertebra), Shangtianzhu (.5 cun above UB-10) SI-17 LU-7, LI-4, LI-17, LI-18, REN-17, REN-22, ST-12, KI-27, Bleed Shixuan SJ-13, LU-3, ST-11 GB-10, ST-11 SJ-13, LI-4, LI-17, ST-36, SI-17, REN-22 Ear: Endocrine, Thyroid, Shenmen, Neck Moxibustion: 1. GB-20, DU-14, LI-14, Extra point (1.5 cun below DU-14) 2. REN-22, REN-17, UB-7, LU-2, LU-3, LI-14, LIV-4, GB-20, DU-14, ST-11, ST- 42

LIVER FIRE BLAZING GENERATING PHLEGM HEAT

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	Goiter #1 Goiter #2 Er Chen Tang Xiao Luo Wan Hai Zao Yu Hu Tang San Zhong Kui Jian Tang Long Dan Xie Gan Tang modified Dao Tan Tang Patent: Hai Zao Jing
Points	LIV-2, LIV-3, HT-7, HT-8, REN-22, LI-4, LI-17, ST-40, SP-6, PC-5, PC-7, KI-6, KI-7 With Stomach Heat: ST-44 With hand tremors: GB-34 If goiter is large: ST-10, Pingying (.7 cun lateral to the space between C4 and C5) With exophthalmos: Shangtianzhu, GB-20 Ahshi points (4 needle technique) ST-9, ST-10, ST-11, REN-22, REN-23, LI-17, LI-18, Pingying (.7 cun lateral to the space between the 4th and 5th cervical vertebra), Shangtianzhu SI-17 LU-7, LI-4, LI-17, LI-18, REN-17, REN-22, ST-12, KI-27, Bleed Shixuan SJ-13, LU-3, ST-11 GB-10, ST-11 SJ-13, LI-4, LI-17, ST-36, SI-17, REN-22 Ear: Endocrine, Thyroid, Shenmen, Neck Moxibustion: 1. GB-20, DU-14, LI-14, Extra point (1.5 cun below DU-14) 2. REN-22, REN-17, UB-7, LU-2, LU-3, LI-14, LIV-4, GB-20, DU-14, ST-11, ST- 42

KIDNEY YANG DEFICIENCY WITH WATER FLOODING

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	Ji Sheng Shen Qi Wan Zhen Wu Tang Jia Wei Shen Qi Wan
Points	REN-6, REN-9, UB-20, UB-22, UB-23, UB-39, ST-28, ST-36, SP-6, SP-9, KI-7 General points

YIN AND BLOOD DEFICIENCY WITH QI AND BLOOD STAGNATION AND NODULATION

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	Ping Ying Fu Fang
Points

QI, BLOOD AND PHLEGM STAGNATION

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	Shi Liu Wei Liu Qi Yin Qi, Blood and Phlegm Stagnation #1
Points

QI AND BLOOD DEFICIENCY

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	Deng Shi Jia Yi Fang Xu Shi Zhi Jian Fang
Points	UB-20, UB-23, REN-12, ST-36, SP-6, DU-20

TOXIC HEAT

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	Xiao Jian Wan
Points

PHLEGM AND BLOOD STASIS OR QI STAGNATION DUE TO PATHOGENIC INVASION

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	Hai Zao Yu Hu Tang Jia Shi Jia Kang Fang Goiter #2 Er Chen Tang Xia Ku Cao Gao Dao Tan Tang Patent: Hai Zao Jing
Points	SJ-6, GB-34, LIV-3, PC-6, SP-4, REN-12, REN-22, SP-10, UB-17, UB-18, ST-40, LI-17 Ahshi points (4 needle technique) ST-9, ST-10, ST-11, REN-22, REN-23, LI-17, LI-18, Pingying (.7 cun lateral to the space between the 4th and 5th cervical vertebra), Shangtianzhu (.5 cun above UB-10) SI-17 LU-7, LI-4, LI-17, LI-18, REN-17, REN-22, ST-12, KI-27, Bleed Shixuan SJ-13, LU-3, ST-11 GB-10, ST-11 SJ-13, LI-4, LI-17, ST-36, SI-17, REN-22 LI-4, LI-17, SP-6, SI-17, REN-22 With neck discomfort: LU-7, KI-6 With depressive Heat: GB-34, LIV-2, eliminate LIV-3 With Spleen Qi Deficiency: ST-36 With Kidney Yang Deficiency: KI-3 SJ-13, LI-4, LI-17, ST-36, SI-17, REN-22 Ahshi points With palpitations: PC-6, HT-7 With Excess sweat: LI-4 With swollen eyes: UB-1, UB-2, UB-5, ST-2, GB-20, DU-20 With high blood pressure: DU-20 Qiying, LI-4, LI-11, Huatuojiaji Points from C-3 to C-5, REN-22, GB-20, SJ-3, Center of mass (no retention) Growth on the front of the neck: REN-22, UB-7, SJ-12, DU-17 Peak of goiter, REN-22, LI-11 (no retention) Zeqian, REN-22, LI-4, LI-11, ST-9, ST-10, plum blossom over affected area Ear: Endocrine, Thyroid, Shenmen, Neck Moxibustion: 1. GB-20, DU-14, LI-14, Extra point (1.5 cun below DU-14) 2. REN-22, REN-17, UB-7, LU-2, LU-3, LI-14, LIV-4, GB-20, DU-1, ST-11, ST-42, SJ-13 4. Growth on the front of the neck: GB-20, 10 cones, borderline of one ear, DU-14, 30 cones, 1.5 cun lateral to DU-14, 30 cones, LI-14, 1 cone for each year of age