STROKE (WINDSTROKE, APOPLEXY, CEREBROVASCULAR ACCIDENT, CVA, ACUTE OBSTRUCTIVE CEREBRAL VASCULAR DISEASE)

GENERAL

Clinical Manifestations	Channel Stroke: No coma Visceral Stroke: Coma Warning signs: Liver Yang Rising signs and symptoms + Numbness Spasms
Treatment Principle
Herb Formulas	Yi Yi Ren Tang Ge Gen Tang Chronic: Su He Xiang Wan Thrombotic: Dang Gui Shao Yao San For insomnia: Da Ding Feng Zhu Post-stroke contractures: Shao Yao Gan Cao Tang Prevention: Huo Xue Hua Yu Hypertension #1
Points	DU-24, GB-13, GB-15, UB-3 DU-20, DU-24, DU-16, Yintang, GB-13, PC-7 SI-19 alone or in combination Acute: DU-26, DU-20, Shixuan, KI-1, LIV-3, ST-40 Flaccid: Moxa DU-26, DU-20, Shixuan, KI-1, LIV-3, REN=4, REN-8, ST-40 Chronic: Upper limbs Dingchuan, LI-4, LI-10, LI-11, SJ-3, SJ-4, SJ-5, SJ-14, Bizhong, Zhitan #1 Lower limbs:GB-30, GB-31, GB-39, ST-41, UB-23, UB-25, UB-37 Aphonia: DU-15, HT-5, REN-23 Facial paralysis: REN-24, ST-6, ST-7 Coma: DU-26, LI-4, PC-9 Head: 1. ST-4 through to ST-6, ST-2 through to ST-3, ST-7, GB-14 2. Anmian, GB-20 2. GB-2, ST-4, ST-6 Facial palsy: Opposite side moxa needle ST-6, ST-7, needle LI-4, LIV-3 then repeat the procedure on the same side Facial paralysis: 1. LI-4, SJ-17, ST-2, ST-4, ST-6, Qianzheng, DU-26, GB-14, SI-18, UB-2, Jiachengjiang 2. LI-20, REN-24, ST-4, ST-6, ST-7 Impaired speech: 1. Shanglianquan, DU-15, HT-5, KI-6, REN-22 2. Cutaneous: PC-4, PC-6, DU-15, HT-5, HT-6, REN-23, Huatuojiajifrom T-3 to T-6 and T-8 to S-5, KI-6, KI-1, REN-14, LIV-5 Headache and dizziness: DU-20, GB-20, LIV-3, Sishencong. Taiyang Dysphagia and numbness of the tongue: DU-15, REN-23 Hemiplegia: 1. LI-11, LI-5, LI-4, SJ-3, GB-38, ST-36, UB-60 2. ST-36 opposite side + alternate a. GB-30, UB-40, Bafeng b. UB-57, UB-60, Baxie 3. GB-21, GB-30, GB-34, GB-39, LI-4, LI-10, LI-11, SP-9, SP-10, ST-36, UB-60 4. Electroacupuncture: LI-15, LI-11, LI-4, GB-30, GB-31, GB-34, GB-39 5. Cutaneous: UB-18, UB-23, UB-31, UB-32, UB-33, UB-34, Huatuojiaji from C-5 to S-5, LI-11, LU-9, GB-31, GB-34, GB-39, LIV-1 Arm: 1. Paralyzed side: LI-4 through to PC-8, SI-6, HT-7, PC-6 through to SJ-5, LI-11, LI-15, SJ-14, Jianneiling 2. HT-7, LI-4 through to PC-8, SI-6, Bizhong, LI-15, LI-10, PC-6 through to SJ-5, Taijian, Yingxia 3. Alternate with electroacupuncture: LI-11 to LI-17 with SJ-9 to SJ-12 + LI-4, LI-10, LI-15 Leg: paralyzed side: 1. Paralyzed side: GB-33, GB-34, GB-39, KI-3, SP-6, ST-36, UB-60 2. Paralyzed side: GB-30, GB-31, GB-34, GB-39, GB-41, LIV-3, Lanweixue, ST-41, Jiuneifan, Jiuwaifan #1, ST-36, Jiuwaifan #2, Tanli, Genjin, UB-60, UB-64 3. Shenji, GB-30, GB-31, GB-39, GB-34 through to SP-9, KI-3, SP-6, ST-32, ST-36, Jianxi, Lishang, UB-37, UB-57, UB-60 4. Alternate with electroacupuncture: GB-30 to UB-39 or SP-12 to ST-31 or GB-34 to ST-36 + GB-39, ST-32 Excess conditions: DU-26, GB-20, LI-4, LIV-3, PC-6, PC-8 + the twelve Jing (Well) points Deficiency conditions: DU-20, DU-26, LI-14, PC-6, ST-36, moxa or moxa needle REN-6, REN-8 Ear: 1. Heart, Subcortex, Shenmen, Brain, Sympathetic 2. Kidney, Brain Stem, Shenmen, Heart, Occiput, Subcortex Cupping: GB-30, GB-34, GB-40, LI-5, LI-11, SJ-4, UB-54 Scalp acupuncture Chronic: GB-20, PC-6, SP-6, SP-10

WIND INVASION WITH EMPTINESS OF THE CHANNELS

Clinical Manifestations	Numbness of the extremities Paralysis of the extremities Sudden facial paralysis Dysphagia Arthralgia T: Normal C: White P: Floating and wiry or Thready and wiry
Treatment Principle	Expel Wind Clear Heat or Cold Nourish and invigorate Qi and Blood Unblock the channels
Herb Formulas	Da Qin Jiao Tang Xiao Xu Ming Tang Qian Zheng San Chinese Patent Medicines: Tian Ma Wan Ren Shen Zai Zao Wan Da Huo Luo Dan
Points

WIND-COLD WITH INTERIOR HEAT

Clinical Manifestations	Fever and chills Maybe fever only Achiness Anhidrosis Headache Cough Asthma Aversion to Cold Edema Thirst Restlessness Irritability Fidgeting Constipation Sometimes dry achy eyes T: Normal or red C: Yellow or white P: Floating and tight or Floating and rapid
Treatment Principle	Expel Wind Disperse Cold Cool Heat
Herb Formulas	Da Qing Long Tang
Points	DU-14, DU-16, GB-20, LI-4, LI-11, ST-44, UB-13, sedate LU-7, LU-9, LU-10, SJ-5, UB-12, tonify SP-1, SP-2

TAI YANG - YANG MING

Clinical Manifestations	Fever Sweating Thirst Dysenteric diarrhea Foul-smelling stools A burning sensation around the anus Gasping Ephidrosis Palpitations Tenesmus Maybe red tinged urine Irritability and Heat in the chest and epigastrium Stiffness and spasms at the back of the neck Dry mouth Dyspnea with perspiration Maybe wheezing T: Red C: Yellow (Greasy) P: Rapid
Treatment Principle	Release the Exterior Clear Internal Yang Ming Heat
Herb Formulas	Ge Gen Huang Qin Huang Lian Tang
Points	General points

SHAO YANG FU WITH LIVER QI STAGNATION

Clinical Manifestations	Fullness and distention in the chest Irritability Occasional fright palpitations Urinary difficulty Constipation Delirious speech Insomnia Subcardiac distention Palpitations at the abdomen Melancholia Fear Agitation Unsteadiness Tends toward mania and convulsions Tends toward fatigue and clumsiness of limbs Dysuria Excitability Dizziness Anxiety Tinnitus Deafness Profuse expectoration of Phlegm Bitter taste in the mouth Palpitations Pale face Oliguria A sensation of extreme heaviness of the body Fatigue Inability to rotate the trunk Difficulty moving the body T: Red C: Slippery P: Wiry and rapid
Treatment Principle	Harmonize the Liver and Gall Bladder Harmonize the Shao Yang Unblock the three Yang Stages Sedate and calms the Spirit Relieve the chest and subcardiac regions Alleviate spasms
Herb Formulas	Chai Hu Jia Long Gu Mu Li 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

YANG MING FU

Clinical Manifestations	High fever (sometimes rises and falls) Great thirst Profuse perspiration Aversion to Heat Abdominal pain (worse with pressure) Abdominal distension Dryness Constipation (hard dry knots) Dislikes pressure Restlessness Irritability Mental disturbance: Mentally unclear Delirious speech T: Red and dry, or black and moist C: Thick yellow or dry yellow P: Deep, strong and forceful
Treatment Principle	Purge
Herb Formulas	Da Cheng Qi Tang
Points	For Heat: DU-14, LI-4, LI-11, SJ-5, ST-44 For Stagnation: REN-12, ST-34, ST-36, ST-37, ST-39 For Constipation: SJ-6, ST-25, UB-25

YING STAGE HEAT ATTACKS THE PERICARDIUM

Clinical Manifestations	High fever worse at night Severe irritability Restlessness Thirst Delirium Faint indistinct purpura and erythema Insomnia Maculae T: Scarlet, dry C: Little P: Thready and rapid
Treatment Principle	Clear Heat from the Ying Relieve Fire Toxin Nourish the Yin
Herb Formulas	Qing Ying Tang
Points	HT-3, HT-5, HT-6, HT-7, KI-3, LI-11, PC-7, PC-8, Shixuan(bleed), Sifeng. SP-6

WIND-DAMP

Clinical Manifestations	Joint swelling and pain, especially hands and feet Heaviness of the joints Numbness of the joints Stiffness of the joints Fever Heaviness of the body Coldness of the body Dizziness Likes pressure Fatigue Pale complexion Preference for warmth T: Pale C: Thick and white or Greasy and white P: Thready and slippery
Treatment Principle	Eliminate Wind Resolve Dampness Reduce swelling Move Qi Warm the channels
Herb Formulas	Yi Yi Ren Tang Jia Jian With Dampness Accumulation: Xi Tong Wan With Qi and Blood Deficiency: Ba Xian Tang Jia Wei Ba Xian Tang
Points	General points

WIND-COLD-DAMPNESS

Clinical Manifestations	Aversion to Cold Stuffy nose Neck and back spasms Joint pain Headache Anhidrosis Muscular pain Joint swelling Slight fever Slight expectoration of white Phlegm Heaviness of the body and joints Cold feeling in the joints Cough Heaviness of the head Preference of the joints for warmth Limited movement of the joints T: Normal C: Thin and white or Thin, white and greasy P: Superficial and tight
Treatment Principle	Warm the channels Activate Qi and Blood.
Herb Formulas	Juan Bi Tang Xiao Huo Luo Dan Recurrent (with Heat and hemiplegia): Gui Zhi Shao Yao Zhi Mu Tang For Windstroke Attacking the Extremities: Wu Yao Shun Qi San
Points	Moxa LU-7 + LI-4 or LI-4 + KI-7, DU-16, GB-20, LU-5, SP-6, SP-9 UB-12, UB-13 + general points

WIND-COLD-DAMP BI - WIND PREDOMINANT

Clinical Manifestations	Migrating pain in the joints especially the : Shoulders Elbows Knees Wrists Fingers Upper back and neck Multiple joints Pain quality changes May move from soreness to numbness to aching Sensitivity varies Pain often appears abruptly, acutely or paroxysmal and then disappears Limited range of motion Chills and fever Aversion to Wind Symptoms are worse in windy weather Sore throat General body aches Maybe perspiration T: Pink C: Thin and white or Sticky and yellow P: Superficial and moderate
Treatment Principle	Eliminate Wind Warm Cold Expel Damp Clear the Channels
Herb Formulas	Da Qin Jiao Tang modified
Points	GB-30, GB-34, LI-4, LI-11, LI-15, SJ-5, ST-36, ST-41, UB-60 For a fever: + DU-14 For a headache: + GB-20 For body aches: + REN-12 For aversion to Cold: + UB-12 (early stage: treat only points on the affected side, chronic: treat bilaterally) DU-14, GB-39, SJ-6 With a fever: + LI-11 With deformities: + UB-11 To disperse Qi and relieve external symptoms: LI-4, UB-12, SJ-5, GB-31 GB-20 or GB-41, DU-1, LI-11, ST-36, UB-40 or UB-17, SI-12, DU-16, GB-20, UB-12, SJ-17, SP-10, GB-31 or DU-20, GB-20, GB-30 + local points

WIND-PHLEGM OBSTRUCTING THE CHANNELS AND COLLATERALS

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 Tongue stiffness with aphasia Slurred speech Salivation from the corner of the mouth Hemianasthesia Sudden loss of consciousness Facial paralysis Wry mouth Hemiplegia Unsteady gait Severe: Contracture pain T: Normal C:White and slimy P: Thready and wiry or Tight and slippery
Treatment Principle	Nourish Yin Pacify the Liver Subdue Wind Resolve Phlegm
Herb Formulas	Qian Zheng San modified Tian Ma Gou Teng Yin Xiao Xu Ming Tang San Sheng San Chinese patent medicine: Zhi Mi Fu Ling Wan
Points	Bleed the Jing-Well points of Six Hand Channels (Shixuan), DU-20, DU-26, GB-20, GB-34, KI-1, KI-3, LIV-2, LIV-3, PC-8, UB-18, UB-23 DU-15, GB-20, GB-30, GB-34, GB-39, LI-4, LI-11, LI-15, REN-23, ST-4, ST-6, ST-40

PHLEGM OBSTRUCTS THE HEART ORIFICE: YANG OBSTRUCTION (CLOSED -TYPE)

Clinical Manifestations	Sudden collapse with loss of consciousness Lockjaw (trismus) Stiffness oft the tongue Difficult speech Eyes open Deviation of eyes and mouth Both fists clenched Retention of urine Constipation Stiffness and spasm of limbs Red face Body feels hot Coarse breathing Bad breath Restlessness Involuntary movements Hemiplegia T: Pink C: Yellow and greasy P: Slippery, wiry and rapid
Treatment Principle	Resuscitate Clear Phlegm Open the Orifices Calm the Liver Restrain Liver Yang
Herb Formulas	Zhi Bao Dan An Gong Niu Huang Wan Ling Jiao Gou Teng Tang modified San Sheng San Han Shui Long Chi Tang CVA #1 With constipation: Da Cheng Qi Tang For a profuse amount of Phlegm and saliva with a rattling sound in the throat: Jiu Ji Xi Xian San Chinese Patent Medicines: Zhi Bao Dan An Gong Niu Huang Wan Zi Xue Dan
Points	Bleed DU-20, Sishencong, needle DU-26, GB-20, KI-1, LI-4, LIV-3, PC-8, REN-24 For Excess Heat: Bleed the Jing-Well points of the Six Hand channels to clear Heat (Shixuan) Bleed the Jing-Well points of the Six Hand channels to clear Heat (Shixuan), DU-20, DU-26, KI-1, LIV-3, ST-40 Bleed the Jing-Well points of the Six Hand channels to clear Heat (Shixuan), DU-20, DU-26, GB-20, LI-4, LIV-2, PC-8 Bleed the Jing-Well points of the Six Hand channels to clear Heat (Shixuan), bleed Muzhijian, DU-20, KI-1, LI-4, ST-6, DU-14, DU-26, KI-1, LI-4, LIV-3, ST-40, PC-6, Shixuan DU-26, GB-20, KI-1, LI-4, PC-6, PC-8, Shixuan Dingshen, DU-14, GB-20, LI-4, LI-11, LIV-3, LU-11, PC-5, PC-7, PC-8 Shixuan, DU-20, DU-26 DU-26, KI-1, LIV-3, PC-8, Shixuan, ST-40 Bleed the Jing-Well points of the Six Hand channels to clear Heat (Shixuan), DU-20, DU-26, GB-14, GB-20, KI-1, LI-4, LI-20, LU-7, REN-24, SI-18, SJ-17, ST-2, ST-4, ST-6, ST-36, ST-42 DU-16, DU-20, DU-26, GB-20, GB-34, LI-11, PC-7, PC-8, ST-6, ST-40 For gurgling sputum: REN-22, ST-40 Orphans and a stiff tongue: DU-15, REN-23, HT-5

PHLEGM OBSTRUCTS THE HEART ORIFICE: YIN OBSTRUCTION

Clinical Manifestations	Sudden collapse with loss of consciousness Coma Lockjaw (trismus) Eyes open Breath cold Both fists clenched Retention of urine Constipation Stiffness and spasm of limbs Pale face Purple or blue lips Limbs cold, pale and still Lying peacefully Excess Phlegm and salivation Fullness, extreme pain, and a cold sensation in the chest and abdomen Diarrhea Vomiting An urge to vomit and defecate without doing either Abdominal pain with chest distention Mental upset Paraphasia T: Pink or Pale C: White and slippery or greasy P: Deep and slippery or Deep, Excess and slow or Wiry, tight and Excess
Treatment Principle	Open the Heart Orifice with Pungent Warming Herbs Eliminate Phlegm Subdue Wind Moves Qi Expel dirt Transform turbidity
Herb Formulas	Su He Xiang Wan Di Tan Tang modified Stroke #2 CVA #2 Chinese patent medicine: Su He Xiang Wan
Points	(Shixuan), DU-20, DU-26, KI-1, LIV-3, PC-5, ST-40, UB-20 Dingshen, DU-14, GB-20, LI-4, LI-11, LIV-3, LU-11, PC-5, PC-7, PC-8 DU-20, DU-26, KI-1, LI-4, LU-7, ST-6, ST-36, ST-40 DU-26, KI-1, LIV-3, PC-8, Shixuan, ST-40 DU-20, DU-26, GB-20, KI-1, LI-4, LIV-3, PC-8, REN-24, Sishencong For Excess Heat: Bleed the Jing-Well points of the Six Hand channels to clear Heat (Shixuan)

PHLEGM OBSTRUCTS THE HEART ORIFICE: EXHAUSTION SYNDROME

Clinical Manifestations	Sudden collapse with loss of consciousness Mouth open Hands relaxed Weak breathing Deviation of the eyes and mouth Eyes closed Limbs cold Hemiplegia (flaccid) Snoring with a weak sound Perspiration ("flows like oil") Incontinence of urine and feces T: Pale and flaccid C: Thin and white P: Minute and thready - about to collapse or Superficial and big but with no root (with red face)
Treatment Principle	Support Zheng Qi Consolidate Exhaustion Strengthen Qi Return Yang
Herb Formulas	Shen Fu Tang Di Huang Yin Zi Du Shen Tang Shen Fu Tang + Sheng Mai San modified Li Zhong Tang + Sheng Mai San modified CVA #3 Chinese Patent medicine: Shen Mai Zhen
Points	Moxa REN-4, REN-6, REN-8, ST-36 Moxa REN-8, moxa needle REN-4, REN-6, DU-4, DU-26, UB-23, ST-36 Moxa REN-4, REN-6, REN-8, tonify PC-6 Moxa DU-14, DU-16, LI-4, LIV-3, ST-36, UB-10 Moxa DU-20, DU-25, KI-7, LI-4, LU-9, PC-8, REN-4, REN-6, ST-36 Moxa REN-4, REN-6, ST-36 Moxa PC-9, SJ-1 Moxa REN-4, REN-8, ST-36 until sweating has stopped and pulse is restored, then needle DU-4, KI-1, REN-12, SP-6 Moxa DU-20, KI-1, PC-6, REN-4, REN-6, REN-8, ST-36 Strong needling on DU-25, KI-1, PC-6 manipulate continuously for 30 minutes If insufficient: + DU-26, LI-4, ST-36

PHLEGM-FIRE DISTURBS THE HEART

Clinical Manifestations	Mania (Kuang)-Withdrawal (Dian) Palpitations Anxiety Maybe severe continuous palpitations leading to coma Insomnia Coughing and wheezing Thick, viscous, yellow sputum Distention of chest and epigastrium Stifling sensation of chest and epigastrium Dizziness Vertigo Tinnitus Facial tics Sudden, deep joint pain that is difficult to describe Peristalsis-like movements of the eyes and mouth Constipation Severe, stabbing pain in the joints Very strange dreams Impaired consciousness Nodules in the neck Choking sensation Restlessness Agitation Continuous shouting or singing Maybe violent behavior Dull complexion Incoherent speech Disinterest in food Fright Blank stare Insanity T: Red tip C: Thick, yellow and greasy P: Slippery, Excess and rapid or Wiry and rapid
Treatment Principle	Drain Fire Drive out Phlegm
Herb Formulas	Gun Tan Wan Xiao Xian Xiong Tang Huang Lian Wen Dan Tang Wen Dan Tang
Points	HT-7, PC-5, PC-6, PC-7, PC-8, REN-14, ST-40, UB-15 + general points

LIVER QI STAGNATION WITH HEAT

Clinical Manifestations	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 YANG RISING (RELIEF STAGE)

Clinical Manifestations	Hemiplegia Deviation of the eyes and mouth Headache Dizziness Stiffness of the tongue Insomnia Restlessness Difficulty swallowing T: Red C: Thin and yellow P: Wiry
Treatment Principle	Calm the Liver Restrain Yang Strengthen Yin
Herb Formulas	Zhen Gan Xi Feng Tang modified
Points	LIV-3, LIV-14, SP-6, SP-9 + general points GB-41, SJ-5 + general points

LIVER YANG RISING WITH BLOOD STAGNATION

Clinical Manifestations	Motor impairment Numbness or complete loss of sensation Paralysis Hemiplegia Headache Dizziness Tinnitus Facial flushing Irritability Hypertension T: Red C: Little of None P: Wiry and slippery or Thready, wiry and rapid
Treatment Principle	Sedate Liver Yang Extinguish Wind Strengthen Yin Unblock the channels
Herb Formulas	Zhen Gan Xi Feng Tang Chinese Patent Medicines: Ren Shen Zai Zao Wan Niu Huang Qing Xin Wan Niu Huang Jiang Ya Wan
Points	LIV-3, LIV-14, SP-6, SP-9, SP-10, UB-17 + general points Upper limb: LI-4, LI-11, LI-15, SI-9, SJ-4, SJ-5, SJ-14 Lower limb: DU-3, GB-30, GB-34, GB-39, ST-36, ST-41, UB-60 With Qi Deficiency: Moxa With Liver Yang Excess: + LIV-3

LIVER FIRE

Clinical Manifestations	Rage Coma No deviation of the eyes and mouth No hemiplegia 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 tip and edges C: Thick, yellow, dry and rough P: Wiry, Shi and rapid
Treatment Principle	Clear the Liver Purge Fire
Herb Formulas	Qu Feng Zhi Bao Dan
Points	DU-20, ST-9, KI-1

LIVER WIND STIRRING INTERNALLY: EXTREME HEAT GENERATES WIND

Clinical Manifestations	High fever Contractures Spasms Neck stiffness Convulsions Oculogyric crises Opisthotonos Coma Possibly death T: Red or Deep red P: Wiry and rapid
Treatment Principle	Clear Heat Cool the Liver Subdue Wind
Herb Formulas	Ling (Yang) Jiao Gou Teng Tang Qing Re Xi Feng Tang Zhi Jing San Feng Yin Tang
Points	Bleed the Jing-Well points of Six Hand Channels, needle DU-14, DU-16, DU-20, DU-26, LI-11, LIV-2, LIV-3

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

Clinical Manifestations	Dizziness and vertigo to the point of falling over Headache with a drawing sensation Severe headache Pressure headache behind the eyes Numbness and tremor of limbs Paralysis of the limbs Twitching and involuntary writhing of hands and feet Dysphagia Unsteady gait Convulsions Sudden loss of consciousness Tongue stiffness with aphasia Facial paralysis Hemiplegia Tinnitus Blurred vision Sudden blindness in one eye Flushed face Irritability Restlessness Insomnia Dream-disturbed sleep Lower back pain Progressive unilateral motor dysfunction Hypertension T: Red C: Little or None P: Thready, wiry and rapid
Treatment Principle	Nourish Yin Pacify the Liver Subdue Wind
Herb Formulas	Zhen Gan Xi Feng Tang Tian Ma Gou Teng Yin modified Xu Ming Tang Xi Feng Tang Chinese Patent Medicines: Ren Shen Zai Zao Wan Niu Huang Qing Xin Wan Niu Huang Jiang Ya Wan Jiang Ya Wan Jiang Ya Ping Pian
Points	LIV-2, LIV-14, Ear Shenmen + general points Bleed the Jing-Well points of Six Hand Channels to reduce Heat (Shixuan), DU-20, DU-26, GB-20, GB-34, KI-1, KI-3, LIV-2, LIV-3, PC-8, UB-18, UB-23 + general points DU-26, GB-20, GB-34, KI-1, LI-4, LIV-3, PC-6, PC-8, Shixuan DU-16, DU-26, GB-20, LIV-3 With Kidney and Liver Yin Deficiency: KI-7, LIV-8 Bleed the Jing-Well points of Six Hand Channels to reduce Heat (Shixuan), DU-14, DU-16, GB-20, LI-4, LIV-3 Upper limb: LI-4, LI-11, LI-15, SI-9, SJ-4, SJ-5, SJ-14 Lower limb: DU-3, GB-30, GB-34, GB-39, ST-36, ST-41, UB-60 With Qi Deficiency: Moxa With Liver Yang Excess: + LIV-3 Anmian, GB-20, GB-21, GB-31, GB-34, GB-39, GB-41, LI-4, LI-11, LIV-2, LIV-3, PC-6, SJ-5, ST-36, ST-40, Yintang Ear: Apex, Lower Blood Pressure Groove

PHLEGM IN THE LIVER AND GALLBLADDER

Clinical Manifestations	Fullness and distention in the chest Irritability Occasional fright palpitations Urinary difficulty Constipation Delirious speech Insomnia Subcardiac distention Palpitations at the abdomen Melancholia Fear Agitation Unsteadiness Tends toward mania and convulsions Tends toward fatigue and clumsiness of limbs Dysuria Excitability Dizziness Anxiety Tinnitus Deafness Profuse expectoration of Phlegm Bitter taste in the mouth Palpitations Pale face Oliguria A sensation of extreme heaviness of the body Fatigue Inability to rotate the trunk Difficulty moving the body T: Red C: Slippery P: Wiry and rapid
Treatment Principle	Harmonize the Shao Yang Unblock the three Yang Levels Sedate and calms the Spirit Relieve the chest and subcardiac regions Alleviate spasms
Herb Formulas	Chai Hu Jia Long Gu Mu Li Tang
Points

KIDNEY AND LIVER YIN DEFICIENCY GENERATES WIND

Clinical Manifestations	Fatigue Muscle spasms with alternating flexion and extension of the extremities Prostration Clonic convulsions Dizziness - worse with stress or anger Tinnitus Aphonia Insomnia Dream-disturbed sleep Sore low back and knees Nocturnal emissions Often the patient is on the verge of shock Hemiatrophy of the muscles Hemiplegia Hemianasthesia Flaccidity of the legs T: Deep red maybe flaccid C: Thin or Peeled P: Weak and faint
Treatment Principle	Nourish Yin of the Liver and Kidneys Extinguish Endogenous Wind Nourish the muscles
Herb Formulas	Da Ding Feng Zhu Stroke #1 Qi Ju Di Huang Wan Yi Gan San With Yang Rising: Ling Yang Jiao Tang Chinese Patent Medicine: Qi Ju Di Huang Wan
Points	GB-30, GB-31, KI-3, LI-4, LI-10, LI-11, REN-4, ST-36, ST-41 For wry mouth and distorted eyes: LI-4, LIV-3, ST-4, ST-6 For tongue stiffness and slurred speech: HT-5, REN-23, SJ-1, ST-36, ST-40 General points

YANG DEFICIENCY WITH INTERNAL COLD-DAMP

Clinical Manifestations	Lower abdominal pain and Cold Abdomen feels chilled Aching bones and joints Muscle ache Whole body pain Aversion to Cold, especially at the back Cold limbs No Thirst Lower abdominal pain and Cold Abdomen feels chilled Maybe fever No thirst T: Normal C: White and slippery P: Deep and faint or Forceless or Choppy and slow or Wiry
Treatment Principle	Dispel Cold Warm the channels Assist Yang Dispel Dampness Relieve pain
Herb Formulas	Fu Zi Tang
Points

YUAN QI DEFICIENCY

Clinical Manifestations	Cold limbs Sweating Shortness of breath Panting
Treatment Principle	Tonify Yuan Qi
Herb Formulas
Points	Warm needle DU-4, REN-17, UB-23, needle DU-26, KI-1, LI-4, GB-20, PC-6, PC-8, Shixuan

QI AND BLOOD STAGNATION

Clinical Manifestations	Heart pain Headache Stomach pain Abdominal pain Back pain Leg pain Arm pain Bruising and swelling due to traumatic injury Rheumatic pain Fixed abdominal masses Internal or external ulcerations Dark or echymosis spots Scrofula T: Dark or Purple with purple spots C: Normal P: Wiry or Choppy
Treatment Principle	Invigorate the Blood Dispel Blood Stasis Unblock the collaterals Alleviate pain
Herb Formulas	Huo Luo Xiao Ling Dan
Points

QI DEFICIENCY WITH BLOOD STAGNATION

Clinical Manifestations	Headache Weakness Malaise Dizziness Numbness of the extremities Stiffness of the tongue Slurred speech Dysphagia Hemiplegia Hemianasthesia Sialism (drooling) Palpitations T: Dark or Purplish spots C: Thin and white P: Thready and weak or Thready and choppy
Treatment Principle	Strengthen Qi Invigorate the Blood Eliminate Stagnation
Herb Formulas	Bu Yang Huan Wu Tang modified Chinese Patent Medicines: Bu Zhong Yi Qi Wan + Fu Fang Dan Shen Pian Ren Shen Zai Zao Wan Niu Huang Qing Xin Wan Niu Huang Jiang Ya Wan
Points	SP-10, REN-6, REN-17, ST-36, UB-17 + general points REN-6, REN-17, ST-36, UB-43 + general points REN-4, REN-6, ST-36 + general points Upper limb: LI-4, LI-11, LI-15, SI-9, SJ-4, SJ-5, SJ-14 Lower limb: DU-3, GB-30, GB-34, GB-39, ST-36, ST-41, UB-60 With Qi Deficiency: Moxa With Liver Yang Excess: + LIV-3

QI REBELLION

Clinical Manifestations	Partial coma No deviation of the eyes or mouth No hemiplegia Raving Irrational speech Livid, discolored, bluish or greenish-black face
Treatment Principle	Descend Qi
Herb Formulas
Points	Tonify DU- 20, KI-1, SP-1, ST-9, ST-36 moxa REN-8, PC-5

BLOOD STAGNATION

Clinical Manifestations	Sudden collapse with loss of consciousness Lockjaw (trismus) Eyes open Both fists clenched Retention of urine Constipation Stiffness and spasm of limbs Pale face with bluish lips Limbs cold, pale and still Lying peacefully T: Pink C: White and greasy P: Deep, slippery and even
Treatment Principle	Open the Heart Orifice with Pungent Warming Herbs Eliminate Phlegm Subdue Wind
Herb Formulas	Su He Xiang Wan Di Tan Tang Tong Qiao Huo Xue Tang Guan Xin Er Hao Tong Mai Tang Xue Fu Zhu Yu Tang Huo Luo Xiao Ling Dan Dai Di Dang Wan modified With Blood Deficiency: Tao Hong Si Wu Tang Due to Qi Deficiency: Bu Yang Huan Wu Tang With Heat: Tong Cheng Qi Tang With Qi and Blood Deficiencies with Heat: Tong Mai Shu Luo Ye With a mild attack of Wind-Cold: Huang Qi Gui Zhi Wu Wu Tang
Points	Bleed the Jing-Well points of the Six Hand channels to clear Heat (Shixuan), DU-20, DU-26, KI-1, LIV-3, PC-5, ST-40, UB-20

BLOOD STAGNATION WITH QI DEFICIENCY

Clinical Manifestations	Hemiplegia as a sequela to Wind-Stroke Insensitivity of the skin Possible stabbing pain on the affected side Hypertonicity of the sinews Possible deviation of the mouth and eyes wit sluggish speech A somber, white facial complexion Dry, scaly skin Weakness Disinclination to speak Spontaneous perspiration Lassitude Frequent urination or Enuresis T: Pale or Dark with possible maculae C: White P: Wiry and Thready or Empty and choppy
Treatment Principle	Tonify the Spleen Boost Qi Invigorates the Blood Transform Stasis
Herb Formulas	Bu Yang Huan Wu Tang modified
Points	GB-30, GB-34, LI-4, LI-11, LI-15, REN-6, SJ-5, SP-6, ST-36, ST-41, UB-60 For a fever: + DU-14 For a headache: + GB-20 For body aches: + REN-12 For aversion to Cold: + UB-12 For frequent urination: + REN-3 For a deviated mouth and eyes: + SJ-23, ST-4, ST-6 For difficult, sluggish speech: + REN-23 For constipation: + SJ-6 (early stage: treat only points on the affected side, chronic: treat bilaterally)

EXCESS HEAT GENERATES WIND

Clinical Manifestations	Hemiplegia Deviation of the eyes and mouth No coma Headache Dizziness Tinnitus Numbness of the extremities Tongue stiffness Unclear speech T: Red C: Normal P: Slippery and rapid or Wiry and rapid
Treatment Principle	Calm the Liver Restrain Yang
Herb Formulas	Tian Ma Gou Teng Yin Huang Lian Jie Du Tang
Points	LIV-2, LIV-14, Ear Shenmen + general points

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

DRY HEAT WITH BLOOD AND PHLEGM STAGNATION (METABOLIC SYNDROME)

Clinical Manifestations	Channel Stroke: No coma Visceral Stroke: Coma Warning signs: Liver Yang Rising signs and symptoms + Numbness Spasms 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	Head: ST-4 through to ST-6, ST-2 through to ST-3, ST-7, GB-14 Arm: paralyzed side: LI-4 through to PC-8, SI-6, HT-7, PC-6 through to SJ-5, LI-11, LI-15, SJ-14, Jianneiling Leg: paralyzed side: GB-33, GB-34, GB-39, KI-3, SP-6, ST-36, UB-60 Scalp acupuncture

FIRE

Clinical Manifestations	Flushed face Thirst Irritability Constipation
Treatment Principle	Clear Fire
Herb Formulas	San Huang Xie Xin Tang
Points	DU-26, GB-20, KI-1, LI-4, LIV-2, PC-6, PC-7, PC-8, ST-25, ST-37, Shixuan

COLD

Clinical Manifestations	Coma No deviation of the eyes or mouth No hemiplegia Icy limbs
Treatment Principle
Herb Formulas
Points	Tonify DU- 20, KI-1, ST-9, moxa REN-6, REN-8

PHLEGM STAGNATION

Clinical Manifestations	Dizziness Stiff tongue Deviation of the eyes and mouth Hemiplegia Fullness of the chest or Masses or Distended abdomen Heavy limbs Nausea Vomiting T: Pink C: Sticky and yellow P: Slippery
Treatment Principle	Eliminate Phlegm Remove Stasis
Herb Formulas	Chen Tan Tang Luo Yin Er Chen Tang
Points	DU- 20, SP-9, ST-36, ST-40, UB-20 Bleed DU- 20, UB-40, HT-9, PC-9 + needle and alternate each day (needle the opposite side first, then the same side) 1. GB-20, GB-34, KI-1, LI-4, UB-17 2. GB-21, GB-31, LI-11, LIV-3, ST-36, ST-40, bleed Jinjin-Yuye Moxa REN-4, REN-6, ST-36 REN-22, PC-6, ST-40

PHLEGM-HEAT WITH WIND-PHLEGM

Clinical Manifestations	Sudden heaviness Numbness or paralysis of the extremities on one side of the body Facial paralysis Dysphagia Disordered consciousness Dry stools Constipation Dizziness Copious Phlegm Drooling T: Stiff and quivering or Deviated C: Greasy and yellow P: Wiry and slippery
Treatment Principle	Expel Phlegm-Heat through the bowels
Herb Formulas	Xing Lou Cheng Qi Tang Chinese Patent Medicines: Niu Huang Qing Xin Wan Niu Huang Jiang Ya Wan Jiang Ya Wan Jiang Ya Ping Pian
Points	Anmian, GB-20, GB-21, GB-31, GB-34, GB-39, GB-41, LI-4, LI-11, LIV-2, LIV-3, PC-6, SJ-5, ST-36, ST-40, Yintang Ear: Apex, Lower Blood Pressure Groove

WIND-PHLEGM OBSTRUCTING THE CHANNELS (FENG TAN)

Clinical Manifestations	Dizziness Vertigo (possibly severe) Headaches (may be recurrent) A stifling sensation in the chest Facial paralysis Difficulty speaking Intolerance of Cold Spasms of the limbs Deviation of the eyes and mouth Paralysis of the skin Continuous, uncontrolled salivation Fever Sore, painful joints Nausea Vomiting Copious sputum Spots before the eyes Heaviness of the head Lockjaw Sinus congestion Cold feet Fatigue Abdominal distention Weakness of hands and feet May be edema Sudden loss of consciousness Excess salivation Compulsive sleeping after eating T: Normal C: White and greasy P: Soft and slippery or Wiry or Taut and thready or Floating and rapid
Treatment Principle	Strengthen the Spleen Dispel Dampness Transform Phlegm Soothe the Liver Extinguish Wind Stop spasms
Herb Formulas	Ban Xia Bai Zhu Tian Ma Tang Di Tan Tang Hua Tan San Jie Tang For Wind-Phlegm Obstructing the channels of the head and face: Qian Zheng San For dysphagia: Jie Yu Dan modified
Points	HT-5, LI-4, LI-11, REN-23, Shanglianquan, SJ-6, SP-6, ST-40 + general points

WIND ATTACKS THE LUO VESSELS

Clinical Manifestations	Deviation of the mouth and eyes Numb flesh and skin Movement causes pain Anxiety P: Floating and wiry
Treatment Principle	Extinguish Wind Clear the Luo
Herb Formulas
Points	DU-26, GB-14, GB-20, LI-4, LI-20, LU-7, REN-24, SI-18, SJ-17, ST-2, ST-4, ST-6, ST-36, ST-42

WIND ATTACKS THE CHANNELS

Clinical Manifestations	Hands and feet paralyzed T: Feeble P: Deep and wiry
Treatment Principle	Extinguish Wind Clear the channels
Herb Formulas
Points	DU-16, DU-20, GB-20, GB-21, GB-30, GB-31, GB-34, GB-39, LI-4, LI-10, LI-11, LI-15, SI-3, SJ-5, ST-36, UB-60

TOXIC HEAT IN THE SAN JIAO

Clinical Manifestations	High fever Irritability Fidgeting Dry mouth Dry throat Incoherent speech Insomnia Dark urine Deep-rooted boils Maculae Carbuncles Hematemesis Hemoptysis Palpitations Furuncles Tinnitus Purpura Red face Rashes Deep-rooted boils Red eyes Itchy skin Fidgeting Dry lips Delirium Dysentery with fever Jaundice Epistaxis Hematuria Cloudy mind Diarrhea T: Red C: Yellow P: Rapid and forceful
Treatment Principle	Clear Heat Drain Fire Relieve toxicity from all three Jiaos Relieve inflammation
Herb Formulas	Huang Lian Jie Du Tang
Points

LOWER JIAO BLOOD STAGNATION WITH HEAT

Clinical Manifestations	Contractures Spasms Neck stiffness Convulsions Oculogyric crises Opisthotonos Acute lower abdominal pain Incontinence of urine Night fevers Delirious speech Irritability Restlessness Thirst May be mania (severe) Dysmenorrhea Amenorrhea Hard stool Dark red complexion Headache Vertigo Tinnitus Insomnia Palpitations Constipation Frequent urination Emotional instability Chills in the waist and feet Tremors Excruciating abdominal pain with cold Black stool May be chills and fever Hemoptysis Hematuria Red eyes Pain and distention of the head Toothache Irregular menstruation Lochioschesis Severe wheezing Distention of the chest T: Red and dry or Red or Deep red C: Yellow P: Deep and forceful or Choppy or Wiry and rapid
Treatment Principle	Clear Heat Cool the Liver Subdue Wind
Herb Formulas	Qing Re Xi Feng Tang Tao He Cheng Qi Tang Dai Di Dang Wan
Points	DU-14, DU-16, DU-20, DU-26, LI-11, LIV-2

FOOD POISONING

Clinical Manifestations	Coma No deviation of the eyes or mouth No hemiplegia Abdominal pain with indigestion Fullness of the chest
Treatment Principle
Herb Formulas
Points	Tonify DU- 20, KI-1, REN-12, ST-9, ST-25, ST-36

APOPLECTIFORM ATTACK ON THE YANG ORGANS

Clinical Manifestations	Hands and feet paralyzed Epigastric distention and fullness Constipation Foul breath Anorexia T: Red C: Yellow, thick and slimy P: Slippery and rapid
Treatment Principle	Purge the bowels Clear Heat Resolve Phlegm Normalize the Yang organs
Herb Formulas	San Hua Tang Chinese patent medicines: Niu HUang Qing Xin Wan + Da Huang Pian
Points	DU-16, LI-4, LIV-1, SP-15, ST-25, ST-40, ST-44

WEI SYNDROME DUE TO KIDNEY AND LIVER YIN AND BLOOD DEFICIENCY

Clinical Manifestations	Slow and gradual onset Weak and flaccid lower limbs Muscle twitching Soreness and weakness of the lower back and spine Inability to stand for a long time Total loss of mobility and severe loss of muscle mass can result with exacerbation Dizziness Vertigo Hair loss Dry throat Tinnitus Fatigue Nocturnal emissions Enuresis Fecal and urinary incontinence Irregular menstruation Dysmenorrhea T: Red C: Little or None P: Thready and rapid
Treatment Principle	Tonify the Liver and Kidneys Nourish Yin Clear Heat
Herb Formulas	Hu Qian Wan modified Liu Wei Di Huang Wan With Yang Deficiency: Ba Wei Di Huang Wan
Points	General points + KI-3, LIV-3, REN-4, SP-6, UB-18, UB-23 Huatuojiaji, KI-3, LIV-3, LIV-8, REN-4, SP-6, ST-31 to ST-41, UB-23

STROKE (WINDSTROKE, APOPLEXY, CEREBROVASCULAR ACCIDENT, CVA, ACUTE OBSTRUCTIVE CEREBRAL VASCULAR DISEASE)

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