IRRITABLE BOWEL SYNDROME (SPASTIC COLON)

GENERAL

Clinical Manifestations	Abdominal pain (triggered by eating, relieved by defecation) Constipation or Diarrhea Bloating Flatulence Nausea Mucus in the stool A feeling of incomplete defecation Pain in the anus or rectum Headache Fatigue Lassitude Depression Anxiety Poor concentration
Treatment Principle
Herb Formulas	IBS-C: Tao Ren Cong Rong Wan + Xiao Chai Hu Tang Tao Ren Cong Rong Wan + Xiao Yao San Tao Ren Cong Rong Wan + Si Ni San
Points	ST-25, ST-37, UB-25

YANG MING FLUID XU

Clinical Manifestations	Previous history of Yin, Jin Ye, or Blood Deficiency Previous history of Yang Ming Fluid and Yin depleted Anhidrosis Numbness Weakness Dryness Constipation T: Red C: Yellow and dry P: Weak and thready
Treatment Principle	Moisten and Lubricate Nourish Yin and Fluids
Herb Formulas	Ma Zi Ren Tang Zeng Ye Cheng Qi Tang
Points	K-6, LI-11, SJ-6, ST-25, ST-37, ST-45, UB-25

SHAO YANG JING

Clinical Manifestations	Alternating chills and fever Restlessness Irritability Anorexia Sometimes fatigue Nausea Occasional vomiting Headaches (side of head) Hypochondriac pain Rib pain Achiness Ear infection Hearing difficulty Red eyes Stiff shoulders Throat pain Hip pain T: Normal with bumps or dots on side C: Thin white P: Wiry
Treatment Principle	Harmonize the Liver and Gall Bladder
Herb Formulas	Xiao Chai Hu Tang
Points	GB-41, SJ-5 To harmonize the Liver and Gall Bladder: GB-34, LIV-3, LIV-14, SJ-5 To stop nausea and vomiting: PC-6, SP-4, ST-36 To treat headache: GB-1, GB-8, GB-14, Taiyang To treat constipation: SJ-6, ST-25 To treat fever: DU-13, DU-14 To support the San Jiao and Regulate Yin: PC-5, PC-6 To support Yin: KI-7 To support the Ying: SP-10 Head: GB-8, SJ-20, Yintang Eyes: GB-14, GB-20, ST-1, UB-1, UB-2 Ear: GB-2, SJ-5, SJ-17, SJ-21 Hypochondriac area: GB-34, GB-40 Ear: Shenmen, Gall Bladder, Point 0

TAI YIN EXCESS

Clinical Manifestations	Nausea Clear, frequent urination Lack of thirst Anorexia Vomiting of clear fluid Abdominal distension and pain (sharp) Diarrhea or loose stool Prefers warmth T: Pale or pink C: White P: Slow and tight or Soft
Treatment Principle	Regulate the middle Warm the Middle Jiao Disperse Cold Relieve pain
Herb Formulas	Gui Zhi Jia Shao Yao Tang With Excess Cold: Fu Zi Li Zhong Tang With a need to purge: Fu Gui Li Zhong Tang
Points	Moxa or moxa needle DU-4, LU-9, REN-4, REN-6, REN-12, SP-6, ST-36, UB-20 For pain and Cold: moxa the abdomen To strengthen the Spleen and Stomach: LIV-13, REN-10, ST-36, UB-20, UB-21 (moxa if severe) For abdominal pain and nausea: PC-6, SP-4, ST-25 For frequent, clear urination: moxa REN-4, REN-6, UB-23 For diarrhea: moxa REN-8 Use few needles with deep insertion and moxa

TAI YIN DEFICIENCY

Clinical Manifestations	Clear, frequent urination Abdominal distension Anorexia Nausea Vomiting clear fluid Dull abdominal pain Diarrhea or loose stools Prefers warmth and pressure T: Pale C: White P: Slow and sinking or Soft and weak
Treatment Principle	Regulate the Middle Warm the Middle Jiao Disperse Cold
Herb Formulas	Li Zhong Tang With Excess Cold: Fu Zi Li Zhong Tang With a need to purge: Fu Gui Li Zhong Tang
Points	Moxa or moxa needle DU-4, LU-9, REN-4, REN-6, REN-12, SP-6, ST-36, UB-20 For pain and Cold: moxa the abdomen To strengthen the Spleen and Stomach: LIV-13, REN-10, ST-36, UB-20, UB-21 (moxa if severe) For abdominal pain and nausea: PC-6, SP-4, ST-25 For frequent, clear urination: moxa REN-4, REN-6, UB-23 For diarrhea: moxa REN-8 Use few needles with deep insertion and moxa

JUE YIN COLD AND HEAT

Clinical Manifestations	Delirium Heat in upper body Cold in lower body Sensation of Qi rushing to the chest Vomits worms Persistent thirst Feverishness Anorexia (hungry but can't eat) Chronic diarrhea Cold extremities Maybe edema Vertex headache Vomits food Cardiac Heat with pain T: Red or pink or pale and flabby C: Thick and greasy or thin P: Deep, thready and weak or wiry
Treatment Principle	Clear worms Clear Heat (Do not purge, create diaphoresis, or create emesis) Revive Yang
Herb Formulas	Wu Mei Wan
Points	Moxa needle REN-4, REN-6, REN- 8, ST-25, ST-36, needle DU-14, LI-4, LI-11, LIV-3, REN-17

DAMP-HEAT IN THE LARGE INTESTINE

Clinical Manifestations	Diarrhea with tenesmus which intensifies after defecation 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 Urine short and red Sustained fever despite profuse perspiration or Raging fever in the afternoon 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 Transform Dampness Stop dysentery
Herb Formulas	Shao Yao Tang Bai Tou Weng Tang Huang Lian Jie Du Tang modified Wu Hua Tang
Points	LI-4, LI-11, SP-9, ST-25, ST-37, ST-44, UB-25

LARGE INTESTINE COLD

Clinical Manifestations	Constipation Difficulty in passing stools Dull pains and cold sensations in abdomen Preference for warmth; dislike of Cold Cold hands and feet Abundant clear urine T: Pale C: Thick, white and moist P: Deep and slow
Treatment Principle	Warm the Cold Relieve constipation
Herb Formulas	Fu Zi Li Zhong Wan
Points	Moxa or moxa needle REN-6, REN-8, SJ-6, ST-25, ST-37, UB-25 Moxa needle REN-4, REN-12, SJ-6, SP-6, ST-25, ST-36, UB-25

LARGE INTESTINE EXCESS HEAT

Clinical Manifestations	Knotted constipation or Watery, thin diarrhea (Heat knots or flows) A sensation of fullness in the chest and upper abdomen Burning hot sensation in the anus Abdominal distention and pain (dislikes pressure) Worse with pressure High fever or infantile tidal fever Hands and feet dripping with perspiration Vomiting Irritating thirst Irritability Scanty urination 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 Excess or Rapid and slippery
Treatment Principle	Clear Excess Heat with bitter, cold, strong purgative herbs
Herb Formulas	Xiao Cheng Qi Tang Da Cheng Qi Tang
Points	LI-4, LI-11, LIV-2, REN-6, REN-12, SP-14, ST-37 With fever: + ST-44 With Yin Deficiency: + KI-6 With constipation: + SJ-6, ST-25 ST-25, ST-37, ST-44, UB-25, SJ-6, LI-4, LI-11 PC-6, ST-36, ST-43, ST-44

DEFICIENCY OF FLUID IN THE LARGE INTESTINE

Clinical Manifestations	Dry stools Knotted constipation or bowel movements once a day Difficulty passing stools Dizziness Bad breath Mouth and throat dry T: Red C: Little P: Thready and rapid
Treatment Principle	Lubricate the Intestines Relieve constipation
Herb Formulas	Zeng Ye Tang Ma Zi Ren Wan Wu Ren Wan
Points	KI-1, KI-3, KI-6, SJ-6, SP-15, ST-25, ST-37, UB-25

SPLEEN QI DEFICIENCY

Clinical Manifestations	Pale, sallow complexion and lips Fatigue Weakness Fatigue may increase after eating Anorexia Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Maybe diarrhea with mucus The diarrhea may be may be constant or intermittent and aggravated by fatigue, over exertion or food sensitivity Maybe alternating diarrhea and constipation Easy satiety Decreased sense of taste The bowels move soon after eating Nausea Shortness of breath Puffiness around the eyes and fingers T: Pale and flabby - may have teethmarks C: White P: Even, forceless and Deficient or Weak, thready, deficient and moderate
Treatment Principle	Strengthen the Spleen Benefit Qi Dry Dampness
Herb Formulas	Si Jun Zi Tang Shen Ling Bai Zhu San Bu Zhong Yi Qi Tang With Cold and Dampness: Xiang Sha Liu Jun Zi Tang With Dampness: Qi Pi Wan Ping Wei San modified Liu Jun Zi Tang With Liver Qi Stagnation and Dampness in the Lower Jiao: Wan Dai Tang With constipation: + Tao Ren Cong Rong Wan Chinese patent medicines: Children: Shen Ling Bai Zhu Wan With Phlegm-Damp: Xiang Sha Liu Jun Zi Wan With Food Stagnation: Jian Pi Wan With Spleen Yang Deficiency: Fu Zi Li Zhong Wan For Deep-lying Dampness: Xing Jun San Huo Xiang Zhen Qing Pian
Points	LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20 REN-12, SP-5, SP-6, SP-9, ST-25, ST-36, UB-20, UB-21, UB-25, Zhixie With abdominal pain: SP-4 With severe diarrhea: strongly moxa DU-20 With severe abdominal distention: SP-3, SP-15 Ear: Spleen, Stomach, Large Intestine, Small Intestine, Abdomen, Sympathetic

CENTRAL QI SINKING

Clinical Manifestations	Prolapse of one or more organs Sallow complexion 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 or Soft and thready
Treatment Principle	Strengthen the Spleen Benefit Qi Reinforce the Center Invigorate Yang
Herb Formulas	Bu Zhong Yi Qi Tang
Points	DU-20, LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

SPLEEN YANG DEFICIENCY

Clinical Manifestations	Upper abdominal pain which is better with warmth and pressure and ingesting warm fluids Waxy, pale or sallow lusterless complexion Anorexia (maybe with vomiting) Easily satiated Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools or watery stools containing undigested food Occasionally constipation Shortness of breath Pain in the epigastrium with cold sensations relieved by warmth Intolerance of Cold Cold limbs Feeling chilled Lethargy Fatigue Mental fatigue Depression Low spirits Copious, clear urine Maybe scanty urine with edema Maybe clear, watery vaginal discharge T: Pale maybe swollen C: White or Thin and white P: Deep and weak or Deep, slow and thready
Treatment Principle	Warm the Center Supplement Qi and Yang Dispel Cold Strengthen the Spleen and Stomach
Herb Formulas	Li Zhong Tang Fu Zi Li Zhong Wan Huang Qi Jian Zhong Tang With constipation: Wen Pi Tang Chinese patent medicines: Fu Zi Li Zhong Wan
Points	Moxa LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

COLD-DAMP DISTRESSES THE SPLEEN

Clinical Manifestations	Distention and fullness of epigastrium and abdomen Dull abdominal pain which is better with warmth but worse with pressure Nausea Vomiting Anorexia Loose stools Diarrhea Reduced sensation of taste Anorexia No thirst or preference for hot drinks Sticky sensation in mouth Borborygmus Lassitude Lethargy Heavy head and body Foggy-headedness Clear urine Tenesmus Maybe edema Maybe copious white vaginal discharge Maybe cold limbs, fear of Cold, feeling chilled T: Pink or Pale C:Thick, white and greasy or sticky P: Deep and slow or Soft and moderate or Soft and slippery With remnants of External pathogens: Chills Mild fever Muscle aches Anhidrosis P: Floating
Treatment Principle	Warm Cold Transform Dampness Harmonize the Stomach Strengthen the Spleen Regulate Qi
Herb Formulas	Hou Po Wen Zhong Tang Wei Ling Tangmodified With remnants of External Wind-Cold: + Jing Fang Bai Du San With remnants of External Summerdamp: + Huo Xiang Zheng Qi Tang Chinese Patent Medicines: Ping Wei San Xiang Xia Liu Jun Zi Wan Fu Zi Li Zhong Wan Xing Jun San
Points	Moxa or moxa needle REN-6, REN-12, SP-6, SP-9, ST-36, UB-20 Moxa or moxa needle SP-3, SP-6, SP-9, ST-25, ST-36, ST-37, ST-40, UB-25, UB-27, Zhixie With nausea: + PC-6 Ear: Spleen, Large Intestine, Small Intestine, Sympathetic, Distal Segment Rectum 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

DAMP-HEAT INJURES THE SPLEEN

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	Tong Xie Yao Fang + Xiao Chai Hu Tang + Ban Xia Xie Xin 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

PHLEGM-DAMP OBSTRUCTS THE SPLEEN

Clinical Manifestations	Relatively severe abdominal and epigastric distention, fullness and discomfort that is apparent upon waking Fatigue Lethargy Tiredness Above symptoms are worse in the morning Increased desire to sleep Heaviness in the body Heavy, tired limbs Foggy-headedness Anorexia Loss of the sense of taste Nausea and vomiting often worse in the morning Belching Acid reflux Loose stools Dizziness that can be triggered by strong smells Headaches that can be triggered by strong smells Stifling sensation in the chest Maybe chronic mucus production from the sinuses and Lungs Greasy skin Musty body odor Tendency toward obesity Pear shape T: Possibly swollen or flabby C: Thick, greasy and white P: Slippery or Wiry or Moderate
Treatment Principle	Dry Dampness Transform Phlegm Regulate Qi Harmonize the Stomach
Herb Formulas	Ping Wei San For resistant distention with Stomach Qi Deficiency: Xuan Fu Dai Zhe Tang For concurrent Wind-Cold: Xing Su San For concurrent Shao Yang syndrome: Chai Hu Zhi Jie Tang Chinese patent medicines: Ping Wei San Er Chen Wan Xiang Sha Yang Wei Wan Xiao Chai Hu Wan
Points	LIV-13, REN-12, ST-25, SP-3, SP-5, SP-15, ST-40 With Spleen Deficiency: + ST-36 With Fluid retention and edema: + ST-28 With sluggish stools or constipation: + SJ-6, ST-37, ST-41 With plum-pit Qi Stagnation: + PC-5 With foggy-headedness: + LIV-3, PC-6 With Wind-Phlegm: + GB-40, ST-8, ST-41 With Cold-Phlegm: + moxa UB-20, UB-21 With muscle aches and heaviness: + SP-21 With somnolence: + KI-6, UB-62 Ear: Spleen, Stomach, Large Intestine, Small Intestine, Liver, Abdomen

SPLEEN AND STOMACH DEFICIENCY COLD

Clinical Manifestations	Chronic, intermittent, dull abdominal pain which is better with warmth and pressure and ingesting warm fluids Waxy, pale or sallow lusterless complexion Anorexia (maybe with vomiting) Easily satiated Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools or watery stools containing undigested food Shortness of breath Pain in the epigastrium with cold sensations relieved by warmth Intolerance of Cold Cold limbs Feeling chilled Lethargy Fatigue Mental fatigue Depression Low spirits Maybe scanty urine with edema Maybe clear, watery vaginal discharge T: Pale maybe swollen C: White or Thin and white or White and greasy P: Deep, thready and forceless or Deep and weak or Thready and weak
Treatment Principle	Strengthen the Spleen Warm Yang Warm the Center Dispel Cold
Herb Formulas	Fu Zi Li Zhong Wan Xiao Jian Zhong Tang Gan Jiang Ren Shen Ban Xia Wan Huang Qi Jian Zhong Tang Chinese patent medicines: Li Zhong Wan With Kidney Yang Deficiency: Jin Kui Shen Qi Wan With Qi and Blood Deficiency: Shi Quan Da Bu Wan
Points	Moxa or moxa needle LIV-13, REN-12, SP-3, SP-6, ST-36, UB-20, UB-21 Moxa or moxa needle KI-3, LI-11, REN-4, REN-6, REN-7, REN-12, SP-4, SP-6, ST-25, ST-30, ST-36 With nausea: + PC-6 With severe pain or diarrhea : + strong moxa REN-8 Ear: Abdomen, Large Intestine, Small Intestine, Stomach,Spleen, Shenmen, Adrenal, Sympathetic

DISHARMONY BETWEEN THE STOMACH AND INTESTINES WITH COLD AND HEAT

Clinical Manifestations	Epigastric focal distention Fullness and tightness with very slight or no pain Dry heaves Vomiting Borborygmus Diarrhea Anorexia Stomach pain Abdominal pain Subcardiac distention Heartburn Resistance below the Heart Soft epigastrium Nausea Ascites Gurgling sounds T: Normal or with a red tip C: Thin, yellow and greasy P: Wiry and rapid or Wiry, tight and rapid
Treatment Principle	Harmonize the Stomach Descend Rebellious Qi Disperse clumping Eliminate focal distention due to Cold and Heat factors
Herb Formulas	Ban Xia Xie Xin Tang
Points

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Chronic, relentless dysenteric diarrhea which is thin, watery and mucoid Diarrhea may contain pus and Blood Diarrhea is worse with exposure to Cold and cold foods Body cold Limbs icy Complexion white and shiny or sallow Aversion to Cold Watery cough Dizziness Anorexia Fatigue Listlessness Depression Exhaustion Low back, knees and abdomen feel cold and painful Mild, persistent abdominal pain worse with Cold and better with warmth and pressure Lower abdomen feels cold and painful Mild tenesmus or A dragging sensation in the lower abdomen which is relieved by the diarrhea Loose stools containing undigested food “Cock-crow” diarrhea (occurs at about 5 am) Edema of face and limbs Heaviness and aching of the limbs and head Palpitations Dysuria Scanty urination Severe: Abdominal ascites Incontinence of stools Rectal prolapse T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep, thready, weak and maybe slow
Treatment Principle	Warm and Reinforce the Spleen and Kidneys Promote urination
Herb Formulas	Fu Zi Li Zhong Wan modified Si Shen Wan Zhen Ren Yang Zang Tang + Tao Hua Tang Qi Hai Yao Fang Fu Tu Dan With edema: Zhen Wu Tang Chinese patent medicines: Fu Zi Li Zhong Wan Bu Zhong Yi Qi Tang Jin Kui Shen Qi Wan Retention enema: Retention Enema #2
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 Ear: Spleen, Large Intestine, Small Intestine, Sympathetic, Adrenal, Distal Segment Rectum

SPLEEN, STOMACH AND KIDNEY YANG DEFICIENCY WITH ACCUMULATION OF COLD

Clinical Manifestations	Diarrhea with undigested food Aversion to Cold or Daybreak (Cock Crow) diarrhea Cold and stiff extremities Back pain Reduced appetite Fullness in the epigastrium and abdomen (likes pressure) Lack of thirst Vomiting Loose stools Trismus T: Pale, may be moist C: White P:Deep, slow and weak
Treatment Principle	Warm and Tonify the Spleen, Stomach and Kidneys Dispel Cold Replenish Yang
Herb Formulas	Fu Gui Li Zhong Tang
Points

STOMACH COLD

Clinical Manifestations	General signs and symptoms: Epigastrium cold with pain No thirst Mild cases: Constant pain Severe cases: Sudden bouts of sharp pain Pain is aggravated by Cold and pressure and relieved by warmth and hot drinks Cold hands and feet Cold Penetrates the Stomach and Intestines: Pain is sudden and sharp Pain is relieved by warmth Nausea Diarrhea Loose stools T: Pink C: White P: Deep and tight or Wiry or Tight and slow Retention of Fluid in the Stomach due to Cold: Pain is dull Pain is relieved by warmth Succussion sound in the epigastrium on palpation Vomiting of clear, watery fluid Hypersalivation T: Pink C: White and sticky P: Thready or Thready and slow Stomach Deficiency with Stagnation of Cold: Pain is dull Pain is relieved by warmth and pressure Vomiting clear, watery fluid T: Pale C: Thin and white P: Deep and slow or Deep and thready If accompanied by Wind-Cold Damp: Fever and chills Myalgia Headache P: Floating and tight
Treatment Principle	Warm the Stomach Warm Cold Stop pain
Herb Formulas	Liang Fu Wan modified Liang Fu Wan + Zheng Qi Tian Xiang San Mild cases: Gan Jiang Ren Shen Ban Xia Wan Severe cases: Xiang Sha Liu Jun Zi Tang + Liang Fu Wan Chinese Patent Medicines: Li Zhong Wan Liang Fu Wan For severe Cold and severe pain: Fu Zi Li Zhong Wan For pain associated with Wind-Cold-Damp: Xing Jun San Huo Xiang Zheng Qi Pian
Points	Moxa or moxa needle PC-6, REN-6, REN-12, SP-4, ST-21, ST-36, UB-20, UB-21 Moxa or moxa needle REN-12, SP-4, ST-21, ST-34, ST-36, UB-20 For nausea: + PC-6 For Dampness: + SP-3 For abdominal distention: + SP-3, SP-15 GB-34, LI-4, REN-6, REN-12, SP-4, ST-36 For pain above the umbilicus: ST-24, REN-10 For pain below the umbilicus: ST-27 For pain associated with the sides of the abdomen: LIV-13 For around the umbilicus: REN-7, REN-9, ST-25 For pain in the lower abdomen: REN-14 For severe pain: moxa or moxa needle REN-6, SP-6 Ear: Stomach, Spleen, Abdomen, Shenmen, Sympathetic

STOMACH COLD TRANSFORMING INTO HEAT

Clinical Manifestations	Chronic epigastric discomfort A sensation of blockage and distention in the epigastrium Anorexia Nausea Vomiting or Dry retching Borborygmus Diarrhea T: Normal C: Thin, yellow and greasy P: Soft and/or rapid
Treatment Principle	Harmonize the Stomach Regulate Qi Descend Qi
Herb Formulas	Ban Xia Xie Xin Tang
Points

LIVER QI STAGNATION

Clinical Manifestations	Abdominal pain, especially in stressful situations Lower abdominal pain Distention and pain in the sides or flanks Suffocating sensation in the chest A sense of fullness in the chest and hypochondrium Tendency to sigh Melancholy Depression Anorexia Irritability Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses Irregular bowel movements Maybe diarrhea alternating with constipation T: Pink C: Thin and white P: Wiry
Treatment Principle	Soothe Liver Clear Stagnation Stop abdominal pain
Herb Formulas	Chai Hu Shu Gan Tang Chai Hu Shu Gan Tang + Liu Mo Tang With chronic sluggish stools or constipation: Liu Mo Tang With Food Stagnation and sluggish bowels: Mu Xiang Shun Qi Wan Chinese Patent medicines: Shu Gan Wan Chai Hu Shu Gan Wan With significant heartburn: + Wei Te Ling With sluggish or incomplete bowel movements: Mu Xiang Shun Qi Wan With constipation: Chen Xiang Hua Qi Wan With Spleen Deficiency and dampness: Xiao Yao Wan With stagnant Heat: Jia Wei Xiao Yao Wan
Points	LIV-3, LIV-13, LIV-14, PC-6, REN-12, REN-17, ST-25, ST-36 For pain above the navel: + REN-10 For pain below the navel: + REN-6 LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, UB-18, SP-6, GB-40, GB-41, PC-6, SJ-6 GB-34, LIV-3, LIV-5, LIV-13, PC-6, REN-6, REN-12, ST-25 To calm the Shen: + DU-19, DU-24, Yintang With Blood or Yin Deficiency: + SP-6, ST-36, UB-18, UB-23 With Phlegm or plum-pit throat: + PC-5, SP-3, ST-40 With fat intolerance, pale or pasty stools, and right sided hypochondriac pain and distention: + Dannangxue, GB-24, GB-40 GB-34, LIV-3, LIV-13, PC-6, REN-12, ST-21, ST-34, ST-36, UB-18, UB-20, UB-21 For severe pain: + LIV-5, SP-4, SP-8 With hypochondriac pain or tenderness: + LIV-14 For Liver and Stomach Heat: + LIV-2 For calming the Shen: + DU-19, DU-24, Yintang Ear: Liver, Spleen, Stomach, Large Intestine, Small Intestine, Abdomen

LIVER QI STAGNATION INVADING THE SPLEEN (LIVER AND SPLEEN DISHARMONY)

Clinical Manifestations	Abdominal and epigastric distention, fullness, discomfort and pain worse with stress or emotional upset Hypochondriac discomfort, ache or tightness, generally worse on the right side Gas Belching Frequent sighing Borborygmus Anorexia Indigestion Acid reflux Heartburn Painful diarrhea worse with stress or emotional upset Alternating constipation and diarrhea Distention and pain in the chest, sides or flanks Suffocating sensation in the chest Melancholy Depression Irritability Moodiness Fatigue Lack of strength Cold hands and feet Orthostatic hypotension Easy bruising Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink or Pale, dark and maybe swollen C: White and greasy or Thin and white P: Slippery and wiry or Thready and wiry or Wiry
Treatment Principle	Soothe the Liver Regulate Qi Strengthen the Spleen Tonify Qi Disperse accumulation Ease distention
Herb Formulas	Yue Ju Wan Xiao Yao San Tong Xie Yao Fang modified Hei Xiao Yao San Chai Hu Shu Gan Tang Chai Hu Shu Gan Tang + Liu Mo Tang Si Ni San Shu Gan Tang For more severe physical than emotional symptoms: Xiao Chai Hu Tang For more severe emotional than physical symptoms: Chai Hu Jia Long Gu Mu Li tang For chronic sluggish bowels or constipation: Liu Mo Tang For Qi and Food Stagnation: Mu Xiang Shun Qi Wan For Spleen Qi Stagnation with constipation: Liu Mo Tang With pain and urgent diarrhea: Tong Xie Yao Fang With Qi and Blood Deficiency: Xiao Yao San Affecting the Liver channel and genitals: Tian Tai Wu Yao San With Heat: Jia Wei Xiao Yao San Chinese patent medicines: Chai Hu Shu Gan Wan Xiao Yao Wan Mu Xiang Shun Qi Wan Shu Gan Wan For chronic sluggish bowels or constipation: Mu Xiang Shun Qi Wan For constipation: Chen Xiang Hua Qi Wan For Spleen Deficiency and Dampness: Xiang Sha Yang Wei Wan
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37 GB-34, LIV-3, LIV-5, LIV-13, PC-6, REN-6, REN-12, ST-25 For calming the Shen: + DU-19, DU-24, Yintang For Blood or Yin Deficiency: + SP-6, ST-36, UB-18, UB-23 For Phlegm or plum pit Qi Stagnation: + PC-5, SP-3, ST-40 For fat intolerance, pale or pasty stools, and right side hypochondriac pain and distention: + Dannangxue, GB-24, GB-40 LIV-3, PC-6, REN-6, REN-9, Sishencong, ST-25, ST-36 For diarrhea: + SP-9 For constipation: + SJ-6 For Cold: moxa REN-6, REN-9, ST-25, ST-36 For Heat: - REN-6, ST-36 + ST-37, ST-44 For Damp-Heat: - REN-6 + SP-9, ST-44 For severe spleen Qi Deficiency: + SP-3 For Food Stagnation: + REN-21, ST-21 For Kidney Qi or Yang Deficiency: + moxa DU-4 For Kidney Yin Deficiency: + KI-7 For Liver Qi Stagnation Transforming into Fire: - LIV-3, PC-6 + GB-34, LIV-2 For severe emotional tension and a tendency toward depression: + DU-24, HT-7 GB-34, LIV-3, LIV-13, PC-6, REN-6, SJ-6, ST-21, ST-25, ST-36 With Blood or Yin Deficiency: + SP-6, UB-18, UB-23 With severe pain: + LIV-5, SP-8 With testicular pain: + LIV-5 With nervousness, anxiety or tension: + HT-7, Yintang Ear: 1. Shenmen, Liver, Abdomen, Stomach, Large Intestine, Small Intestine, Subcortex, Endocrine, Sympathetic 2, Liver, Spleen, Stomach,Large Intestine, Small Intestine, Abdomen

LIVER QI STAGNATION INVADING THE STOMACH

Clinical Manifestations	Spasmodic epigastric pain, distention, fullness and discomfort (worse when emotionally upset) Belching with acid regurgitation fullness and tightness in the chest Frequent sighing Flatulence Nausea Vomiting Variable appetite Bloating Acid reflux Heartburn Tension headache Dizziness Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Moodiness Inappropriate anger Irregular menses Dysmenorrhea Irregular menstruation Premenstrual syndrome Breast distention and pain before and during menses Dysmenorrhea Poor circulation Cold fingers and toes Alternating constipation and diarrhea With Heat: Burning epigastric pain Indeterminate, gnawing hunger Severe heartburn Severe restlessness and irritability A quick temper A bitter taste in the mouth Thirst Constipation Concentrated urine T: Pink or Dark With Heat: Red or Red edges C: Thin and white With Heat: Yellow and dry P: Wiry With Heat: Wiry and rapid
Treatment Principle	Soothe the Liver Harmonize the Stomach Clear Heat
Herb Formulas	Chai Hu Shu Gan Tang With Heat: Jia Wei Xiao Yao San
Points	LIV-3, LIV-14, PC-6, REN-12

LIVER QI STAGNATION: PHLEGM AND QI STAGNANT AND BLOCKED

Clinical Manifestations	Feeling of obstruction in throat as if a slice of roast meat were stuck there which cannot be coughed up nor swallowed down. This sensation becomes more prominent during emotional upset and subsides when relaxed Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: Thin and white P: Slippery and wiry (slippery due to Phlegm)
Treatment Principle	Spread Qi Resolve Phlegm
Herb Formulas	Ban Xia Hou Po Tang
Points	LI-18, LIV-3, PC-5, SI-17, SJ-6

COLD STAGNATION IN THE LIVER CHANNEL

Clinical Manifestations	Swelling and pain in scrotum as if testicles were being pulled downward or Swollen or distended testicles or Contractions and cold sensations of scrotum which are alleviated by warmth Pain, distention, fullness and cold sensation in lower abdomen Cold limbs Dislike of cold and preference for warmth Lower abdominal pain radiating to the testicles May be localized sensation of Cold Menstrual pain and hardness Hypochondriac pain Abdominal pain Mobile abdominal masses Flank pain Leukorrhea T: Pale C: White or White no greasy P: Deep and slow or Wiry and tight or Deep and wiry or Slow or Deep and Excess
Treatment Principle	Warm the Liver Dispel Cold.
Herb Formulas	Tian Tai Wu Yao San Nuan Gan Jian
Points	Moxa or moxa-needle REN-4. SP-6, LIV-1

LIVER AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome), weakness Tinnitus, deafness Forgetfulness Low back and knees sore and painful Throat dry and painful Five sole Heat Low-grade fever Night sweats Irritability Insomnia Stools difficult to pass Constipation Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Liver and Kidneys
Herb Formulas	Yi Guan Jian
Points	KI-3, LIV-3, SP-6, UB-18, UB-23

YIN DEFICIENCY WITH HEAT IN THE YANG MING

Clinical Manifestations	Constipation Dry throat Thirst Tuberculosis of the Colon Hemorrhoids Chronic pancreatitis Erysipelas T: Dark red C: Dry and yellow P: Sinking and weak
Treatment Principle	Nourish Yin Clear Heat
Herb Formulas	Zeng Ye Tang With severe constipation: Zeng Ye Cheng Qi Tang
Points

MIXED EXCESS AND DEFICIENCY

Clinical Manifestations	Chronic intermittent diarrhea with variable mixtures of pus and Blood Triggered or aggravated by overexertion, colds fatigue and stress or May be no obvious trigger Active phase: Diarrhea may occur many times daily Fatigue Tiredness Tenesmus Abdominal distention Mild abdominal pain which is better with warmth and maybe pressure Anorexia Loss of sense of taste Long-standing cases: Emaciation Sallow or pale complexion Listlessness Lethargy Increased desire to sleep Intolerance of Cold Cold extremities T: Normal or Pale or Red C: Greasy P: Thready and choppy or Soft and weak
Treatment Principle	Strengthen the Spleen Tonify Qi Regulate Qi Clear Damp-Heat or Clear Cold-Damp or Clear Toxic Heat
Herb Formulas	Zi Sheng Wan modified Wu Mei Wan With Liver Qi Stagnation: Jia Wei Xiao Yao San With Damp-Heat: Shao Yao Tang With Damp-Heat and abdominal distention: Zhong Man Fen Xiao Wan For treatment between episodes: With Phlegm-Damp: + Xiang Sha Liu Jun Zi Tang With anxiety, worry phobias, panic attacks and insomnia: + Gui Pi Tang With Liver Attacking the Spleen and Intestines: + Tong Xie Yao Fang + Xiao Yao San + Jia Wei Xiao Yao San + Chai Hu Shu Gan Tang With Spleen Yang Deficiency: + Wen Dan Tang Chinese patent medicines: Zi Sheng Wan Xiang Lian Wan
Points	LIV-13, REN-12, SP-6, ST-25, ST-36, ST-37, ST-39, UB-20, UB-21, UB-25 + Ahshi points + moxa if no Heat With bleeding: + LIV-1, SP-1 With mucus: + SP-3, ST-40 With Qi Stagnation: + GB-34, LIV-3 With Stagnant Heat: + LIV-2 With hypochondriac pain: + LIV-14 With tension, stress insomnia and a lateral headaches: DU-24, GB-39, SJ-5 Ear: Spleen, Large Intestine, Small Intestine, Subcortex, Sympathetic, Distal segment rectum

IRRITABLE BOWEL SYNDROME (SPASTIC COLON)

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