PREMENSTRUAL SYNDROME (PMS) (PREMENSTRUAL TENSION)

GENERAL

Clinical Manifestations	It appears 7-14 days before the period Headache Breast full pain Fatigue Emotional changes Insomnia Edema
Treatment Principle
Herb Formulas	For premenstrual acne: Jia Wei Xiao Yao San For premenstrual acne: Zhen Gan Xi Feng Tang
Points	For edema: KI-7 REN-12, REN-6, LI-4, ST-36, SP-6 For headache: GB-20 DU-20, REN-6, REN-4, SP-6, ST-36

SPLEEN QI DEFICIENCY

Clinical Manifestations	Pale face Sallow complexion Anorexia Rolled lips Pale lips Stiff tongue Tired limbs Heavy limbs Abdominal and epigastric distention after meals Maybe bleeding Maybe nausea and vomiting Maybe acid regurgitation Shortness of breath Loose stools or diarrhea Lethargy Thin muscles Low, soft voice Does not like to speak Muscle weakness in arms and legs Maybe enuresis Weak abdomen Maybe borborygmus Epigastric or abdominal pain T: Pale and flabby - may have teeth marks C: White P: Even, forceless and deficient
Treatment Principle	TonifY Qi Strengthen the Spleen and Stomach
Herb Formulas	Si Jun Zi Tang
Points	LIV-13, REN-12, UB-20, SP-3, SP-5, SP-6, ST-36

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Premenstrual edema in the face and limbs Abdominal distension Poor appetite Dizziness Lassitude Drowsiness Loose stools Weak low back and legs T: Pale and swollen C: White P: Deep and weak or Deep and thready
Treatment Principle	Tonify Kidney and Spleen Yang
Herb Formulas	Jin Gui Shen Qi Wan Dang Gui Shao Yao San Jia Wei Jian Gu Tang modified With water flooding: Zhen Wu Tang
Points	Moxa ST-36, UB-20, UB-23, KI-3, SP-6, REN-4

COLD-DAMP DISTRESSES THE SPLEEN

Clinical Manifestations	Distention and fullness of the epigastrium and abdomen Nausea and vomiting Anorexia Loose stools Reduced sensation of taste No thirst or preference for hot drinks Sticky sensation in mouth Borborygmus Lassitude Yin jaundice Heavy head Maybe edema Maybe copious white vaginal discharge Maybe cold limbs, fear of cold, feeling chilled T: Pink C: Thick, white and greasy or sticky P: Deep and slow
Treatment Principle	Warm Cold Transform Dampness Harmonize the Stomach Strengthen the Spleen
Herb Formulas	Ping Wei San
Points	Moxa or moxa needle SP-3, SP-5, SP-6, SP-9, ST-36, UB-20, REN-12 To Regulate Qi and Disperse Dampness: REN-6 For Cold-Damp Vaginal Discharge: Moxa or moxa needle GB-26, UB-30, REN-6, SP-6, REN-4, ST-36

HEART AND SPLEEN BLOOD DEFICIENCY

Clinical Manifestations	Dull, lingering nagging headache Dizziness General aching before, during and after menstruation Poor sleep Insomnia Dream-disturbed sleep Anxiety Depression Palpitations Poor memory Fatigue Shortness of breath Anorexia Pale, puffy face Profuse or scanty menstruation May have menstrual clots T: Pale C: Thin and white P: Thready and weak or Soggy and small
Treatment Principle
Herb Formulas	Gui Pi Tang Gan Mai Da Zao Tang
Points	SP-6, ST-36, PC-6, HT-7, UB-15, UB-20

HEART BLOOD AND SPLEEN QI DEFICIENCY

Clinical Manifestations	Premenstrual palpitations Insomnia Much dreaming Easily startled Poor memory Four limbs tired and lethargic Lack of vitality with weakness Loss of appetite Distention and fullness of the epigastrium and abdomen Loose stools Sallow complexion Copious, pale menses Uterine bleeding or Light menstrual flow or Amenorrhea T: Pale P: Thready and weak
Treatment Principle	Reinforce and Benefit the Heart and Spleen
Herb Formulas	Gui Pi Tang modified
Points	HT-7, REN-4, SP-1, SP-6, ST-36, UB-15, UB-20

LACK OF COMMUNICATION BETWEEN THE HEART AND KIDNEYS

Clinical Manifestations	Depression Weepiness Irritability Frustration Tendency to anger Insomnia Breast distention and/or swelling Breast and/or nipple pain with dislike of pressure (severe cases may begin around ovulation) Lumps or nodules which disappear after the on set of menstruation or enlarge or reduce according to the cycle Suffocating sensation in the chest with difficulty taking a satisfying breath Undue consciousness of breathing Sighing Headache Neck ache Shoulder pain Skin eruptions Rashes Desire to stretch the body Desire to yawn Lower abdominal distention or pain which is relieved at onset Irregular menstruation (may be early or late) Dream disturbed sleep Constipation Anxiety Hard to control emotions Emotional changes Hypochondria full pain T: Normal or Darkish and/or Purplish edges C: Normal P: Wiry
Treatment Principle	Soothe Liver Qi Eliminate Stagnation Calm the Spirit
Herb Formulas	Xiao Yao San modified Chai Hu Shu Gan Tang Xiao Chai Hu Tang With more severe Blood Deficiency: Hei Xiao Yao San for breast distention: Chai Hu Shu Gan Tang modified
Points	LIV-3, LIV-14, PC-6, UB-18, SP-6, GB-41 For depression and weeping: HT-5, HT-7, UB-15, LU-3 For breast pain: REN-17, ST-18, ST-34, LIV-14, GB-21 For Shao Yang headache: Taiyang, GB-8, GB38, SJ-5 For stiff neck: GB-20, GB-21, GB-39 For lower abdominal distention: REN-6 For irregular menstruation: GB-26, SP-10, LIV-5 For dream-disturbed sleep and insomnia: HT-7, UB-19, GB-12, GB-44 For constipation: SJ-6, SP-15 LIV-3, KI-3, REN-6, REN-17, UB-18, SP-6

HEART AND LIVER FIRE WITH PHLEGM BLOCKING THE ORIFICES

Clinical Manifestations	Depression Weepiness Irritability Frustration Positively: Greater assertiveness Greater creativity Greater clarity Less passivity Breast distention and/or swelling Breast and/or nipple pain with dislike of pressure (severe cases may begin around ovulation) Lumps or nodules which disappear after the on set of menstruation or enlarge or reduce according to the cycle Suffocating sensation in the chest with difficulty taking a satisfying breath Undue consciousness of breathing Sighing Headache Neck ache Shoulder pain Desire to stretch the body Desire to yawn Lower abdominal distention or pain which is relieved at onset Irregular menstruation (may be early or late) Dream disturbed sleep Constipation Restlessness Thirst Angry outbursts maybe alternating with crying and depression Dizziness Tinnitus Extreme emotional disturbance: Hopelessness Confusion Suicidal depression Murderous rage Thirst Constipation T: Normal or Darkish and/or Purplish edges or Red edges and tip C: Normal or Yellow or white and dry or greasy P: Wiry or Wiry, slippery and rapid
Treatment Principle
Herb Formulas
Points	LIV-3, LIV-13, LIV-14, PC-5, PC-6, PC-7, UB-18, UB-20, SP-6, SP-9, GB-25, GB-41, ST-34, ST-36, ST-40, KI-7 For depression and weeping: HT-5, HT-7, UB-15, LU-3 For breast pain: REN-17, ST-18, ST-34, LIV-14, GB-21 For Shao Yang headache: Taiyang, GB-8, GB38, SJ-5 For stiff neck: GB-20, GB-21, GB-39 For lower abdominal distention: REN-6 For irregular menstruation: GB-26, SP-10, LIV-5 For dream-disturbed sleep and insomnia: HT-7, UB-19, GB-12, GB-44 For constipation: SJ-6, SP-15

HEART AND GALL BLADDER QI DEFICIENCY

Clinical Manifestations	Insomnia or frequent waking, often early in the morning Unable to fall back to sleep Easily frightened or startled Easily unsettled by seeming trivial events Anxiety Palpitations Shortness of breath Lethargy Fatigue Depression Spontaneous sweating T: Normal or Pale (chronic or congenital cases may show a deep narrow crack to the tip C: Thin and white P: wiry and thready
Treatment Principle	Strengthen Qi Calm the Shen Alleviate fearfulness
Herb Formulas	An Shen Ding Zhi Tang Ding Zhi Wan Gui Zhi Jia Long Gu Mu Li Tang Chinese Patent Medicines: Bai Zi Yang Xin Wan Ding Xin Wan Yang Xin Ning Shen Wan Bu Nan Wan Jian Nao Wan
Points	GB-40, HT-7, LIV-3, LIV-5, PC-7, REN-15 DU-19, DU-20, DU-24, GB-40, HT-5, HT-7, HT-9, PC-6, REN-14, UB-7, UB-15 Anmian, DU-20, GB-40, HT-7, PC-7, ST-36, UB-7, UB-23, UB-47, UB-52, Yintang

LIVER QI STAGNATION

Clinical Manifestations	Depression Weepiness Irritability Frustration Tendency to anger Insomnia Breast distention and/or swelling Breast and/or nipple pain with dislike of pressure (severe cases may begin around ovulation) Lumps or nodules which disappear after the on set of menstruation or enlarge or reduce according to the cycle Suffocating sensation in the chest with difficulty taking a satisfying breath Undue consciousness of breathing Sighing Headache Neck ache Shoulder pain Skin eruptions Rashes Desire to stretch the body Desire to yawn Lower abdominal distention or pain which is relieved at onset Irregular menstruation (may be early or late) Dream disturbed sleep Constipation Anxiety Hard to control emotions Emotional changes Hypochondria full pain T: Normal or Darkish and/or Purplish edges C: Normal P: Wiry
Treatment Principle	Soothe Liver Qi Eliminate Stagnation Calm the Spirit
Herb Formulas	Xiao Yao San modified Chai Hu Shu Gan Tang modified Xiao Chai Hu Tang Tian Tai Wu Yao San modified With more severe Blood Deficiency: Hei Xiao Yao San For breast distention: Chai Hu Shu Gan Tang modified 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 Chinese Patent Medicines: Chai Hu Shu Gan Wan With sluggish bowels and Food Stagnation: Mu Xiang Shun Qi Wan With constipation: Chen Xiang Hua Qi Wan For Qi Stagnation type pain: Shu Gan Wan With Qi and Blood Deficiency: Xiao Yao Wan
Points	LIV-3, LIV-14, PC-6, UB-18, SP-6, GB-41 For depression and weeping: HT-5, HT-7, UB-15, LU-3 For breast pain: REN-17, ST-18, ST-34, LIV-14, GB-21 For Shao Yang headache: Taiyang, GB-8, GB38, SJ-5 For stiff neck: GB-20, GB-21, GB-39 For lower abdominal distention: REN-6 For irregular menstruation: GB-26, SP-10, LIV-5 For dream-disturbed sleep and insomnia: HT-7, UB-19, GB-12, GB-44 For constipation: SJ-6, SP-15 LIV-3, KI-3, REN-6, REN-17, UB-18, SP-6 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: Shenmen, Liver, Abdomen, Stomach, Large Intestine, Small Intestine, Subcortex, Endocrine, Sympathetic

LIVER QI STAGNATION WITH HEAT

Clinical Manifestations	Difficulty falling asleep Insomnia, worse when stressed Dream-disturbed sleep Waking in the early hours of the morning Frontal or temporal headaches Neck and shoulder tension Teeth grinding at night Frequent sighing Dizziness Red eyes Facial flushing Depression Irritability Moodiness Easily angered Hypochondriac tension or discomfort Continuous or sustained nasal congestion Transient, declining sense of smell or loss of sense of smell Nasal swelling Sinus pain Generally severe frontal, maxillary or temporal headache Chronic sinus inflammation and congestion which is worse with stress or emotional upset A sensation of something caught in the throat May have pain or sinus pressure May have occasional postnasal discharge Bitter taste in the mouth Irregular menstruation Premenstrual syndrome Breast tenderness Poor appetite alternation constipation and diarrhea T: Red edges with spots C: Thin and yellow P: Wiry and possibly rapid
Treatment Principle	Soothe the Liver Qi Clear Heat Open the nose
Herb Formulas	Xiao Yao San modified Jia Wei Xiao Yao San modified Long Dan Xie Gan Tang modified Si Ni San With underlying Qi and Blood Deficiency: Jia Wei Xiao Yao San Patent Medicines: Xiao Yao Wan Shu Gan Wan Long Dan Xie Gan Wan Chai Hu Shu Gan Wan Bi Yuan Wan (combine with one of the above) Bi Yan Pian (combine with one of the first two) Huo Dan Wan (combine with one of the first two)
Points	Anmian, GB-20, HT-7, LIV-3, PC-6, UB-15, UB-18, Yintang With a lateral headache: + GB-39, SJ-5 With teeth grinding and an aching jaw: + ST-6 With digestive weakness: + SP-6 With plum-pit Qi Stagnation: + PC-5 With Heat or Fire: + GB-44, LIV-2 For sinus problems: LIV-2, LIV-3, LI-4, LI-20, GB-20, SI-3, DU-23, UB-2, Yintang, Taiyang, Bitong

LIVER QI STAGNATION TRANSFORMS INTO FIRE

Clinical Manifestations	Depression Weepiness Irritability Frustration Positively: Greater assertiveness Greater creativity Greater clarity Less passivity Breast distention and/or swelling Breast and/or nipple pain with dislike of pressure (severe cases may begin around ovulation) Lumps or nodules which disappear after the on set of menstruation or enlarge or reduce according to the cycle Suffocating sensation in the chest with difficulty taking a satisfying breath Undue consciousness of breathing Sighing Headache Neck ache Shoulder pain Desire to stretch the body Desire to yawn Lower abdominal distention or pain which is relieved at onset Irregular menstruation (may be early or late) Dream disturbed sleep Constipation Early or profuse menstruation Restlessness Thirst Angry outbursts maybe alternating with crying and depression Dizziness Tinnitus Insomnia Fearful dreams T: Red sides and tip C: Normal P: Wiry and rapid
Treatment Principle	Pacify the Liver Spread Liver Qi Strengthen the Spleen Nourish Blood and Yin Regulate menstruation Sedate the Heart Clear Heat
Herb Formulas	Jia Wei Xiao Yao San
Points	LIV-2, LIV-3, LIV-14, PC-6, PC-8, UB-18, SP-6, GB-41, GB-43, LU-3, KI-1 For depression and weeping: HT-5, HT-7, UB-15, LU-3 For breast pain: REN-17, ST-18, ST-34, LIV-14, GB-21 For Shao Yang headache: Taiyang, GB-8, GB38, SJ-5 For stiff neck: GB-20, GB-21, GB-39 For lower abdominal distention: REN-6 For irregular menstruation: GB-26, SP-10, LIV-5 For dream-disturbed sleep and insomnia: HT-7, UB-19, GB-12, GB-44 For constipation: SJ-6, SP-15

LIVER QI STAGNATION WITH SPLEEN QI DEFICIENCY CAUSING SPLEEN DAMP

Clinical Manifestations	Weepiness Irritability Frustration Positively: Greater assertiveness Greater creativity Greater clarity Less passivity Breast distention and/or swelling Breast and/or nipple pain with dislike of pressure (severe cases may begin around ovulation) Lumps or nodules which disappear after the on set of menstruation or enlarge or reduce according to the cycle Suffocating sensation in the chest with difficulty taking a satisfying breath Undue consciousness of breathing Sighing Headache Neck ache Shoulder pain Desire to stretch the body Desire to yawn Lower abdominal distention or pain which is relieved at onset Irregular menstruation (may be early or late) Dream disturbed sleep Constipation Edema of the face, eyelids, ankles May be whole body edema Abdominal distention and bloating Chest and epigastric heaviness and oppression Clumsiness Anorexia Loose stools Diarrhea Nausea Craving sweets Cold extremities Pallor Fatigue Listlessness Sighing With Kidney Yang Deficiency: Cold limbs and body Weak or aching low back and knees T: Swollen and pale with teethmarks, may be pale or purple spots on the edges C: White and sticky P: Wiry and slippery or soggy
Treatment Principle
Herb Formulas
Points	LIV-2, LIV-3, LIV-14, PC-6, PC-8, UB-18, SP-6, GB-41, GB-43, LU-3, KI-1 For depression and weeping: HT-5, HT-7, UB-15, LU-3 For breast pain: REN-17, ST-18, ST-34, LIV-14, GB-21 For Shao Yang headache: Taiyang, GB-8, GB38, SJ-5 For stiff neck: GB-20, GB-21, GB-39 For lower abdominal distention: REN-6 For irregular menstruation: GB-26, SP-10, LIV-5 For dream-disturbed sleep and insomnia: HT-7, UB-19, GB-12, GB-44 For constipation: SJ-6, SP-15

LIVER QI STAGNATION WITH KIDNEY YIN DEFICIENCY

Clinical Manifestations	Depression Weepiness Irritability Frustration Positively: Greater assertiveness Greater creativity Greater clarity Less passivity Breast distention and/or swelling Breast and/or nipple pain with dislike of pressure (severe cases may begin around ovulation) Lumps or nodules which disappear after the on set of menstruation or enlarge or reduce according to the cycle Suffocating sensation in the chest with difficulty taking a satisfying breath Undue consciousness of breathing	Sighing Headache Neck ache Shoulder pain Desire to stretch the body Desire to yawn Lower abdominal distention or pain which is relieved at onset Irregular menstruation (may be early or late) Dream disturbed sleep Constipation Sore back and knees Dizziness Frequent urination Hot flashes Night sweats Vaginal dryness Insomnia Anxiety T: Red and dry C: Scanty P: Rapid, thin and wiry
Treatment Principle	Enrich Kidney and Liver Yin Spread Liver Qi
Herb Formulas	Yi Guan Jian
Points	LIV-3, LIV-14, PC-6, UB-18, SP-6, GB-41, KI-3, REN-4 For depression and weeping: HT-5, HT-7, UB-15, LU-3 For breast pain: REN-17, ST-18, ST-34, LIV-14, GB-21 For Shao Yang headache: Taiyang, GB-8, GB38, SJ-5 For stiff neck: GB-20, GB-21, GB-39 For lower abdominal distention: REN-6 For irregular menstruation: GB-26, SP-10, LIV-5 For dream-disturbed sleep and insomnia: HT-7, UB-19, GB-12, GB-44 For constipation: SJ-6, SP-15 For hot flashes and night sweats: KI-2, KI-7, HT-6

LIVER QI STAGNATION WITH BLOOD DEFICIENCY

Clinical Manifestations	Depression Weepiness Irritability Frustration Positively: Greater assertiveness Greater creativity Greater clarity Less passivity Breast distention and/or swelling Breast and/or nipple pain with dislike of pressure (severe cases may begin around ovulation) Lumps or nodules which disappear after the on set of menstruation or enlarge or reduce according to the cycle Suffocating sensation in the chest with difficulty taking a satisfying breath Undue consciousness of breathing Sighing Headache Migraines before period Neck ache Shoulder pain Desire to stretch the body Desire to yawn Lower abdominal distention or pain which is relieved at onset Irregular menstruation (may be early or late) Dream disturbed sleep Constipation Scanty or delayed menstruation Dream disturbed sleep Constipation Pallor Dizziness Insomnia Fatigue Cold body and extremities Neck, shoulder and upper back pain Hard or knotted muscles T: Normal or Darkish and/or Purplish edges or Pale, worse on the edges C: Normal P: Wiry or Thin and wiry
Treatment Principle	Regulate Qi Nourish the Blood
Herb Formulas	Hei Xiao Yao San Qi Ju Di Huang Wan
Points	LIV-3, LIV-14, PC-5, PC-6, PC-8, UB-17, UB-18, UB-20, SP-6, GB-41, ST-36, ST-40, DU-26 For depression and weeping: HT-5, HT-7, UB-15, LU-3 For breast pain: REN-17, ST-18, ST-34, LIV-14, GB-21 For Shao Yang headache: Taiyang, GB-8, GB38, SJ-5 For stiff neck: GB-20, GB-21, GB-39 For lower abdominal distention: REN-6 For irregular menstruation: GB-26, SP-10, LIV-5 For dream-disturbed sleep and insomnia: HT-7, UB-19, GB-12, GB-44 For constipation: SJ-6, SP-15

LIVER QI STAGNATION ATTACKS THE SPLEEN

Clinical Manifestations	Abdominal distention and pain Gas Borborygmus Diarrhea 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: White and greasy P: Slippery and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Si Ni San Chai Hu Shu Gan San With Heat and Heart Blood Deficiency: Chai Hu Gui Zhi Tang modified
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

LIVER FIRE ATTACKS THE LUNG AND STOMACH

Clinical Manifestations	Depression Weepiness Irritability Frustration Positively: Greater assertiveness Greater creativity Greater clarity Less passivity Breast distention and/or swelling Breast and/or nipple pain with dislike of pressure (severe cases may begin around ovulation) Lumps or nodules which disappear after the on set of menstruation or enlarge or reduce according to the cycle Suffocating sensation in the chest with difficulty taking a satisfying breath Undue consciousness of breathing Sighing Headache Neck ache Shoulder pain Desire to stretch the body Desire to yawn Lower abdominal distention or pain which is relieved at onset Irregular menstruation (may be early or late) Dream disturbed sleep Constipation Restlessness Thirst Insomnia	Angry outbursts maybe alternating with crying and depression Severe, possibly sharp breast pain Fearful dreams Itchy nipples Hypersensitive nipples Heat sensations in the breasts Irritability Restlessness Excessive leukorrhea 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 Excessive thirst Vomiting sour or bitter liquid Constipation or dry stools Maybe rib pain Facial acne If attacking Stomach: More digestive symptoms Thicker tongue coat If attacking the Lungs: Premenstrual facial swelling Swelling of the hands and feet Oppressive sensation in chest T: Darkish red C: Thick, yellow, dry and rough P: Wiry, Excess and rapid
Treatment Principle
Herb Formulas
Points	LIV-3, LIV-14, PC-6, PC-7, UB-18, SP-6, GB-41, ST-44, LI-11, LU-10 For depression and weeping: HT-5, HT-7, UB-15, LU-3 For breast pain: REN-17, ST-18, ST-34, LIV-14, GB-21 For Shao Yang headache: Taiyang, GB-8, GB38, SJ-5 For stiff neck: GB-20, GB-21, GB-39 For lower abdominal distention: REN-6 For irregular menstruation: GB-26, SP-10, LIV-5 For dream-disturbed sleep and insomnia: HT-7, UB-19, GB-12, GB-44 For constipation: SJ-6, SP-15

LIVER WIND STIRRING INTERNALLY: LIVER FIRE (YANG) GENRATES WIND

Clinical Manifestations	Dizziness and vertigo to the point of falling over Headache with a drawing sensation Numbness and tremor of limbs Twitching and involuntary writhing of hands and feet Dysphagia Unsteady gait With Wind-Stroke: Sudden loss of consciousness Tongue stiffness with aphasia Facial paralysis Hemiplegia Maybe coma Sometimes death T: Red P: Thready and wiry
Treatment Principle	Nourish Yin Pacify the Liver Subdue Wind
Herb Formulas	Zhen Gan Xi Feng Tang
Points	Bleed the Jing-Well points of Six Hand Channels, needle DU-20, DU-26, GB-20, GB-34, KI-1, KI-3, LIV-2, LIV-3, PC-8, UB-18, UB-23

LIVER AND STOMACH FIRE

Clinical Manifestations	Depression Weepiness Irritability Frustration Positively: Greater assertiveness Greater creativity Greater clarity Less passivity Breast distention and/or swelling Breast and/or nipple pain with dislike of pressure (severe cases may begin around ovulation) Lumps or nodules which disappear after the on set of menstruation or enlarge or reduce according to the cycle Suffocating sensation in the chest with difficulty taking a satisfying breath Undue consciousness of breathing Sighing Headache Neck ache Shoulder pain Desire to stretch the body Desire to yawn Lower abdominal distention or pain which is relieved at onset Irregular menstruation (may be early or late) Dream disturbed sleep Constipation Restlessness Thirst Angry outbursts maybe alternating with crying and depression Dizziness Tinnitus Severe, possibly sharp breast pain Insomnia Fearful dreams Itchy nipples Hypersensitive nipples Heat sensations in the breasts Irritability Restlessness Dry mouth Thirst Excessive leukorrhea T: Red C: Yellow and dry P: Wiry and rapid
Treatment Principle
Herb Formulas
Points	LIV-3, LIV-14, PC-6, PC-7, UB-18, SP-6, GB-41, ST-34 For depression and weeping: HT-5, HT-7, UB-15, LU-3 For breast pain: REN-17, ST-18, ST-34, LIV-14, GB-21 For Shao Yang headache: Taiyang, GB-8, GB38, SJ-5 For stiff neck: GB-20, GB-21, GB-39 For lower abdominal distention: REN-6 For irregular menstruation: GB-26, SP-10, LIV-5 For dream-disturbed sleep and insomnia: HT-7, UB-19, GB-12, GB-44 For constipation: SJ-6, SP-15

LIVER YIN DEFICIENCY WITH LIVER YANG RISING

Clinical Manifestations	Dizziness Impaired vision Night blindness Tinnitus Irascibility Throbbing headache with distended feeling Flushed face Blurred vision Red, dry eyes with feeling of grit in eye Dry mouth and throat with bitter taste in mouth Palpitations Headache Nervousness Insomnia with much dreaming Dry throat 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 and wiry or Wiry and rapid (when Yang is Rising and Excess, pulse is forceful) or Thready and rapid when Yang is not prominent
Treatment Principle	Nourish Yin Pacify the Liver Subdue Yang
Herb Formulas	Qi Ju Di Huang Wan modified
Points	DU-20, GB-20, GB-34, GB-43, KI-3, LIV-2, LIV-3, UB-18, UB-23

LIVER YIN DEFICIENCY WITH BLOOD DEFICIENCY

Clinical Manifestations	Pale complexion Pale lips Blurred or failing vision Spots before the eyes Dizziness Dry eyes Pale nail beds Irritability A quick temper Poor memory Frightens easily Insomnia with difficulty falling asleep or frequent waking Much dreaming Restless sleep Maybe talking during sleep Severe: Sleep walking Tinnitus Waking with a dry throat or thirst Palpitations Numbness of the limbs Light menses or Amenorrhea Late menses T: Red and dry C: Little or None P: Wiry or Thready and rapid
Treatment Principle	Nourish the Liver Reinforce the Blood Nourish Yin Calm the Hun Clear Heat
Herb Formulas	Suan Zao Ren Tang With Liver Qi Stagnation: Yi Guan Jian Chinese Patent Medicines: An Shen Bu Niao Wan Suan Zao Ren Tang Pian
Points	Moxa or needle LIV-3, REN-4, SP-6, ST-36, UB-17, UB-18, UB-20 Anmian, GB-20, HT-7, LIV-3, PC-6, UB-15, UB-17, UB-18, UB-23, Yintang

QI AND BLOOD DEFICIENCY

Clinical Manifestations	The menses is light-colored and thin A constant ache in the lower abdomen that occurs during or just after menstruation The pain responds favorably to pressure Pale or sallow complexion Dizziness with blurred vision Vertigo Palpitations Shortness of breath, Thirst Listlessness Lethargy Anorexia Weak limbs Withdrawn behavior Restlessness Insomnia Sensation of Heat Lusterless hair and skin Loose stools T: Pale C: Thin white P: Thin and frail or Empty or Deep and even or Deep and retarded Due to severe postpartum hemorrhage: Lack of interest Vaginal dryness Vulvar and axillary hair loss Reduced libido Genital atrophy
Treatment Principle	Tonify Qi and Blood Promote menstruation
Herb Formulas	Nu Ke Ba Zhen Wan
Points	REN-4, REN-6, SP-6, ST-36, KI-3, UB-13, UB-15, UB-17, UB-18, UB-20, UB-23, PC-6, HT-7 Ear Points: Ovary, Kidney, Zigong

BLOOD STAGNATION

Clinical Manifestations	Chronic stabbing pain in the chest Pain in the hypochondrium Chronic, stubborn headache with a fixed, piercing quality Palpitations Chronic incessant hiccups Five sole Heat Choking sensation when drinking Dry heaves Depression or low spirits with a sensation of warmth in the chest Chest distention Dry, scaly skin Dark rings under the eyes Spider naevi on the cheeks, nose, trunk, inner knee and ankle Dizziness Chronic tinnitus Chronic gum disease with dark, purplish, patchy or dark, red atrophic gums Loose teeth Painful receding gums Frequently bleeding gums Vomiting after intake of water Palpitations Persistent daytime drowsiness Insomnia (persistent with much dreaming) Restless sleep Forgetfulness Irritability Fidgeting A bad temper Extreme mood swings Evening tidal fever Dark or purplish lips, conjunctiva or nail beds Dark complexion Dark sclera Hair loss on the head and body T: Dark-red with purple spots on the edges P: Choppy or Wiry and tight or Wiry and choppy or thready or Deep and choppy or Wiry
Treatment Principle	Invigorate the Blood Dispel Blood Stasis Unblock the channels Stop pain
Herb Formulas	Xue Fu Zhu Yu Tang
Points

DAMP-HEAT IN THE LIVER CHANNEL

Clinical Manifestations	Premenstrual diarrhea with a strong, unpleasant smell Burning sensation in the anus Lower abdominal pain and/or heaviness Dark urine Dark menstrual blood Irritability Easily angered Excessive white or yellow vaginal discharge with unpleasant smell and irritation Bitter taste in the mouth Red face Lower back and/or hip pain T: Red C: Yellow dry or greasy (especially at the root) P: Wiry slippery and rapid
Treatment Principle
Herb Formulas
Points	LIV-3, LIV-8, LIV-14, PC-6, PC-7, UB-18, SP-6, GB-26, GB-41, REN-3, ST-25 For depression and weeping: HT-5, HT-7, UB-15, LU-3 For breast pain: REN-17, ST-18, ST-34, LIV-14, GB-21 For Shao Yang headache: Taiyang, GB-8, GB38, SJ-5 For stiff neck: GB-20, GB-21, GB-39 For lower abdominal distention: REN-6 For irregular menstruation: GB-26, SP-10, LIV-5 For dream-disturbed sleep and insomnia: HT-7, UB-19, GB-12, GB-44 For constipation: SJ-6, SP-15

PHLEGM-HEAT

Clinical Manifestations	Dizziness Vertigo Nausea and vomiting Insomnia Dream-disturbed sleep with unusual dreams Palpitations Anxiety Profuse white foamy sputum Restlessness Timidity Indecisiveness Indeterminate gnawing hunger Seizures accompanied by copious sputum Chest distention Expectoration of yellow Phlegm Bitter taste in the mouth Chills and fever Abdominal distention Frequent dark, scanty urine Irritability Depression Slight thirst Anorexia after serious illness T: Pink or Red tip C: Yellow and greasy P: Slippery and rapid or Wiry and rapid
Treatment Principle	Regulate Qi Transform Phlegm Clear the Gallbladder Harmonize the Stomach Clear Heat
Herb Formulas	Huang Lian Wen Dan Tang
Points	LIV-3, LIV-8, LIV-14, PC-6, PC-7, UB-18, SP-6, GB-26, GB-41, REN-3, ST-25 For depression and weeping: HT-5, HT-7, UB-15, LU-3 For breast pain: REN-17, ST-18, ST-34, LIV-14, GB-21 For Shao Yang headache: Taiyang, GB-8, GB38, SJ-5 For stiff neck: GB-20, GB-21, GB-39 For lower abdominal distention: REN-6 For irregular menstruation: GB-26, SP-10, LIV-5 For dream-disturbed sleep and insomnia: HT-7, UB-19, GB-12, GB-44 For constipation: SJ-6, SP-15

PHLEGM AND BLOOD STAGNATION

Clinical Manifestations	Mild, persistent uterine bleeding of purple and black blood during pregnancy Abdominal pain that is worse with pressure Abdominal spasms and tension Immobile masses in the lower abdomen with pain and tenderness Amenorrhea with distention and pain Dysmenorrhea Headache Sinus congestion Constipation Excess weight in the pelvis Lower back ache Irregular menstruation Nervousness Fatigue Fetal instability Skin eruptions Scanty menstrual flow Scaly, dry skin Retention of lochia Headache Shoulder stiffness Vertigo Cold low body and feet Flushed face Protruding abdomen T: Dark purple or with echymoses or petechiae or pale with purplish spots C: White P: Choppy or Tense and deep and slow
Treatment Principle	Invigorate Blood Transform Blood Stasis Soften lumps Reduces fixed abdominal pain
Herb Formulas	Gui Zhi Fu Ling Wan
Points	LIV-3, LIV-8, LIV-14, PC-6, PC-7, UB-18, SP-6, GB-26, GB-41, REN-3, ST-25 For depression and weeping: HT-5, HT-7, UB-15, LU-3 For breast pain: REN-17, ST-18, ST-34, LIV-14, GB-21 For Shao Yang headache: Taiyang, GB-8, GB38, SJ-5 For stiff neck: GB-20, GB-21, GB-39 For lower abdominal distention: REN-6 For irregular menstruation: GB-26, SP-10, LIV-5 For dream-disturbed sleep and insomnia: HT-7, UB-19, GB-12, GB-44 For constipation: SJ-6, SP-15

PREMENSTRUAL SYNDROME (PMS) (PREMENSTRUAL TENSION)

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