Acupuncture (AP) in Traditional Chinese Medicine (TCM)

GENERAL CONCEPTS (6/7)

20.        Stiffness of the extremities
Wind-Cold and Damp: Cold, achy arthritis. T: Greasy white coat. P: Slow. Formula: Gui Zhi Tang, Ge Gen Tang.

Heat and Phlegm: High fever, stiffness of extremities; Irritability, delirium; Possibly associated with convulsions, muscle spasms. "Extreme Heat leads to LV-Wind". Formula: Ling Yang Ge Gen Tang.

21.        Flaccid Paralysis of Extremities "Wei Syndrome", usually without pain
Body Damaged by LU-Heat: Follows febrile disease; Usually Lower extremities; Low grade fever and impaired Yin; T: Red with yellow or scanty coat. Treatment Principle: Tonify Yin and Jin Ye. Formula: Shao Shen Mail Men Dong Tang + San Miao San, Qing Zao Jie Fei Tang; AP points: Yangming points (ST for legs, LI for arms).

Qi-Xu of SP-ST: Weakness (not paralysis) of limbs, normal movement, but very weak; Bloating, indigestion, loose stool, aversion to Cold, pale complexion. T: Pale. P: Thready and weak. Prevalent during post illness recovery period. Formula: Bu Zhong Yi Qi Tang.

LV-Xu and KI-Xu: Old age, or after illness; Hyposensitivity of extremities leading to weakness leading to paralysis; Sore lower back, dysmenorrhoea, premature ejaculation; Dizziness, vertigo, fatigue. T: Pale. P: Deep, thready, weak. Jing Xu, sometimes combined with Qi or Yin-Xu. Treatment Principle: Tonify Jing and LV (for tendons). Formula: Zuo Gui Yin, You Gin Gui Yin, Da Bu Yin Wan.

Xue-Stasis: Weakness leading to numbness; Possible spasm leading to paralysis. T: Purple. P: Choppy, thready. Etiology: Post-stroke sequelae or tissue trauma; Phlegm remains in Channels after stroke. Treatment Principle: Promote Xue circulation. Formula: Tao Hong Si Wu Tang.

22.        Varicoses of the Lower Extremities
Heat-Damp-Stasis (acute Syndrome): Varicose veins are combined with red, swollen legs. Veins are Hot and burning; Fever, bitter taste in the mouth, irregular bowel movements. T: Red with yellow greasy coating. P: Wiry/rapid. Etiology: Excessive alcohol intake, Damp and Heat producing foods. Treatment Principle: Clear Heat, drain Damp. Formula: San Miao San. AP points: Local points around the varicose veins like Hua Toe Jia Jie; Points around the spine. Needles are considered more effective than herbs for this sort of varicose condition.

Cold-Damp-Stasis (chronic Syndrome): Varicose veins are combined with heavy extremities and distension; Blue or purple veins, chronic; Copious urine, loose stools. T: White Greasy coat. P: Soft. Etiology: Standing up too much, working environment. Treatment Principle: Remove Cold and Damp. Formula: Ji Ming San.

Qi-Xu and Xue-Stasis: Chronic physical weakness or Qi-Xu; Chronically carrying heavy things and/or standing for a long time; Purple veins. Not as "big" as in Damp-Cold-Stasis; Achy, but not distended; Fatigue, shortness of breath, pale complexion. T: Pale. P: Weak. Treatment Principle: Harmonize Ying, tonify Qi, Activate Xue. Formula: Bu Yang Huang Wu Tang.

23.        Feet Pain
LV-Xu and KI-Xu (old age, jing xu): Pain in heel (key symptom); No skin change; Pain worse by walking or fatigue; Tinnitus, Sore back. Formula: Hu Jian Wan (Patent formula).

Cold-Damp-Stasis: Achy joints exasperated by Cold and Damp. T: White coat. P: Soft. Formula: Dang Gui Si Ni Tang.

24.        Back Pain
Cold-Damp-Stasis (Bi Syndrome): Pain which can radiate to neck; back feels heavy, stiff; symptoms aggravated by Cold Damp weather. Formula: Qiang Huo Ji Sheng Tang.

Qi-Xue-Stasis due to recent trauma (acute): Sudden onset of pain; Limited range of motion, acute symptoms; Could develop into chronic pain. P: Tense. Formula: Yuen Lian Bai Yao, Huo Lou Xiao Ling Dan.

Qi-Xue-Stasis due to past trauma (chronic): Dull aching on & off, numbness aggravated by rest (Xu beneath). T: Purple. P: Thready and/or choppy. Treatment Principle: Tonify and activate Qi-Xue. Formula: Du Huo Ji Sheng Wan + Tao Ren and Hong Hua.

25.        Weak lower back and knees
KI-Xu and LV-Xu: Formulas: Zuo Gui Wan, Rou Gui Wan, Bao Wei Di Huang Want, Liu Wei Di Huang Wan.

Jing-Xu: Infertility, tinnitus, vertigo, sore back, premature ejaculation, amenorrhoea, grey hair, premature aging. Formulas: KI/LV formulas plus Zi He Che, Lu Rong.

Yin-Xu: Emaciation, tidal fever, Heat signs, Five Centre Heat. Formulas: KI/LV formulas plus Huang Bai, Zhi Mu.

Yang-Xu: Cold signs such as Cold hands and feet. Formula: tonic formulas for KI-LV, plus Fu Zi, Ba Ji Tian, Bu Gu Zi.

Qi-Xu: Weakness of the Lower Gates (BL/urethral sphincter, LI/anal sphincter etc.) incontinence, premature ejaculation, urination problems. Formula: tonic formulas for KI-LV, plus astringent herbs such as Sang Pian Xiao, Yi Zhi Ren, Wu Wei Zi, Fu Peng Zi.

Stone_Ac4 (1996) Symptomatic Diagnosis: Part 4.

26.        Chest Pain (often with HT disorder)
HT-Qi-Xu: Mild pain; Neurosis, HT Syndrome; dull achy chest pain on one or both sides; Chest congestion, palpitations; Spontaneous sweats, fatigue. T: Pale. P: Weak and thready. Treatment Principle: Tonify HT Qi. Formula: Bao Yuan Wan.

Cold-Stasis (Yang-Xu) Painful: CHD, chest pain, usually on the left side which could radiate to he right, back shoulder, and arm. Pale complexion, spontaneous sweats, Cold extremities. T: Pale, swollen, teeth marks. P: Deep, slow, knotty and intermittent. Treatment Principle: Tonify HT-Yang, promote circulation of Xue. Formula: Gua Luo Xie Bai Bai Jiu Tang.

HT-Xue-Stasis (still a form of Yang-Xu): Typical Angina pectoris. Intense pain that can make the patient lose consciousness due to its intensity. Spontaneous Cold sweats, fear, fatigue. T: Pale purple. P: Deep, thready, choppy, knotty, intermittent. Herb: Dan Shen for chest pain. Formula: Xue Fu Zhu Yu Tang, Ge Xian Zhu Yu Tang.

Phlegm-Stasis in LU: Cough; Excess Phlegm, pain with cough.

27.        Tumour Formation in the abdomen
Qi-Xue-Stasis: Enlargement of LV and SP; Abdominal mass begins soft, but becomes harder as time goes by. Distention, emaciation, fatigue; Dark dull facial complexion. low appetite, dry skin. T: Purple spots. P: Wiry, tense. Cancerous tumours tend to be more Xue Stasis than Qi-Stasis. Treatment Principle: Activate Xue (Yin Xu unimportant now). Formula: Ge Xian Zhu Yu Tang + Shi Xiao San.

Phlegm-Stasis: Abdominal mass, no pain yet distended and uncomfortable. Mass is movable and soft, but patient dislikes touch. T: Pale. P: soft and Slippery. Formula: Ban He Wan, Er Chan Tang.

Zhongqi-Xu (sinking, or organ prolapse): Pulling down, or bearing down sensation; Qi-Xu symptoms. Formula: Bu Zhong Yi Qi Tang.

28.        Tenesmus
Damp-Heat and toxic Heat-Stasis: Tenesmus, diarrhoea, abdominal pain, blood and mucus in stool; Pus and burning sensation in anus, possible fever; Yellow scanty urine. T: Red with yellow coat. P: Slippery and rapid. Formula: Dan Gui Xhao Yao Tang.

29.        Constipation
Yangming-Heat (Yangming Fu-LI): Fever, constipation, abdominal discomfort; dislikes palpation; feels mass in abdomen. P: Deep, strong and slow due to Stasis. Treatment Principle: Purge Heat and Stasis. Formula: Da Ching Qi Tang.

Qi-Stasis: Constipation; depression, easily angered, chest congestion, discomfort in hypochondrium; distention and discomfort in breast, water retention (due to digestive problems, secondary to the Stasis). Formula: Chai Hu Su Gan Tang + lubricative herbs such as Tao Ren or Huo Ma Ren.

Qi-Xu: Constipation, sometimes loose; extreme fatigue especially after a bowel movement; Weak voice; possible rectal prolapse. T: Pale with white coat. P: Weak. Formula: Bu Zhong Yi Qi Tang.

Xue-Xu and Yin-Xu: Chronic, old age patients; Constipation, emaciation, dry skin; palpitations, pale complexion. T: Pale, or Red or Narrow. P: Thready and rapid. Herbs: Dang Gui, Sheng Di Huang, Rou Cong Ren. Formula: Wu Ren Wan. Sheng Ye Cheng Qi Tang.

30.        Incontinence of Feces (all serious Syndromes)
Heat and toxin Stasis: Xue-Heat and toxin; High fever, delirium; Semi consciousness, coma, severe diarrhoea with pus and blood. T: Red with yellow coat. P: Rapid. Treatment Principle: Clear Xue-Heat. Formula: Xi Jiao Di Huang Tang.

Yang-Xu of SP-KI: Chronic Diarrhoea/dysentery; Diarrhoea with mucus, incontinence of feces; Fatigue, Cold, low back pain. T: Pale. P: Deep, thready, weak. Formula: Zheng Ren Yang Zhong Tang.

SP-Qi-Sinking (Extreme Xu Syndrome): Incontinence of feces, rectal prolapse, tired disoriented. T: Pale. P: Feeble. Formula: Shen Fu Tang.

31.        Incontinence of urine
KI-Qi-Xu (Common in old age and those recovering from serious illness): Frequent urination and incontinence, mostly in the evening; Xu symptoms of KI-Qi and/or KI-Yang. T: Pale. P: Deep, weak especially in KI positions.

LU-SP Qi-Xu: The problem begins with SP-Qi sinking and is worsened by the spasmatic action of the abdomen with coughing.

32.        Cloudy Urination (see 35 below)
Damp-Heat-Stasis (Turbid Damp-Shi, acute): Cloudy urine with white or yellow urine; Frequent, burning, urgent, painful urination; fever, thirst. T: Red with yellow coat. P: Wiry and thready. Formula: Ba Zheng San + Shi Chang Pu, Pi Xie Feng Qing Yin.

Xu of KI-Yin or KI-Yang (Xu Syndrome in which the Jing-Essence leaks out with the urine): Chronic cloudy urine (KI unable to govern the KI-Jing-Essence). Treatment Principle: Tonify KI, Astringe Jing-Essence. KI-Yin-Xu symptoms: Scanty yellow urine. T: Red. P: Thready and rapid. Formula: Zhi Bai Di Huang Wan + Pi Xia, Fu Pen Zi, Wu Wei Zi, Tu Si Zi (all astringents); or KI-Yang-Xu symptoms: Copious clear urine. T: Pale. P: Deep and weak. Formula: You Gui Yin or Wan + Pi Xia, Fu Pen Zi, Wu Wei Zi, Tu Si Zi (all astringents).

33.        Frequent Urination in Evening (often found in the elderly).
KI-Qi-Xu, or KI-Yang-Xu (see 32 above). Formula: Sang Piao Xie San + You Gui Wan; for prostate problems: Kai Kit Wan.

34.        Oliguria, or difficult urination.
Damp-Heat: Cloudy yellow urine; Frequent, burning, urgent, painful urination; incontinence. Formula: Ba Zheng San + Shi Chang Pu, Pi Xie Feng Qing Yin.

LU-Qi-Stasis (LU unable to descend the Water): Cough, dyspnea, chest congestion, constipation. T: Red. P: Soft and rapid. Formula: Qing Feng Wan.

Zhong Qi-Xu (SP-Qi Sinking): Urination lacking strength, sluggish stream; fatigue, bearing down sense; Urine, frequent but small amounts; Loose stool. T: Pale. P: Thready and weak. Formula: Bu Zhong Yi Qi Tang.

KI-Qi-Xu: difficult urination, sluggish stream, incontinence; frequent urination; Kidney problems in WM. Treatment Principle: Tonify KI. Formula: Ba Wei Di Huang Wan.

Stasis of Urinary Tract (esp. after abdominal surgery or trauma): Sluggish, difficult urination; Abdominal distention of pain. T: Purple, possible with raised purple bumps. P: Choppy. Formula: Chong Xian San.

35.        Seminal Fluid in Urine (see 32 above)
Damp-Heat-Stasis: This section is what WM would call a STD, or sexually transmitted disease: Frequent, cloudy, sluggish, burning urine; White sticky discharge after urination; Bitter taste in mouth; Thirst, chest congestion, sluggish BM. T: Red with Yellow greasy coat. P: Soft and rapid (if more Damp), or Slippery and rapid (if more Heat). Treatment Principle: Dry Damp, Clear Heat. Formula: Pi Xie Feng Qing Yin.

KI-Yin-Xu with Empty Heat: Frequent, cloudy, burning urine; White or red discharge after urination; Dizziness, vertigo, insomnia, restlessness; Tidal fever; Yin-Xu symptoms: T: Red with dry coat. P: Thready and rapid. Treatment Principle: Tonify Yin and Jing. Formula: Shi Bai Di Huang Wan + astringents such as Tu Si Zi, Jing Yin Zi, Wu Wei Zi.

Xu of KI-Qi or KI-Yang (very weak people, not an STD): Frequent, copious, clear urine; seminal fluid discharge after urination; Premature ejaculation, impotence, nocturnal emissions. T: Pale. P: Deep and weak. Formula: You Gui Wan and astringents.

36.        Blood in Seminal Fluid
Yin-Xu with intense Empty Heat: Blood in ejaculate; Distention & pain in testes or penis; Burning sensation in urinary tract; emaciation; thirst, irritability. T: Red with scanty coat. P: Thready and rapid. Treatment Principle: Tonify Yin, Clear Fire, harmonize Xue, stop the Bleeding. Formula: Zhi Bai Di Huang Wan or Da Bu Yin Wen + E Jiao or bleeding.

Damp-Heat-Stasis (STD): Blood in ejaculate; Frequent painful urination; Pain, burning, itching in UT; Spasms of pain in testicles; Blood in urine. T: Greasy yellow coat. P: Slippery, wiry, rapid. Formula: Bai Zhen San + Da Qing Ye, Huang Qin, Huang Bai, Zhi Zi, Bai Bu.

Stone_Ac5 (1996) Symptomatic Diagnosis: Part 5.

37.        Thin, scanty ejaculate (WM differentiation: low sperm count)
KI-Qi-Xu, or KI-Yang Xu: infertility, very chronic fatigue, pale complexion, sore or weak lower back, senility, hair loss and loose teeth, hearing loss, frequent urination-especially in the evening. T: Pale. P: weak in KI (3rd, Chi) position. Treatment Principle: Tonify KI-Qi, KI-Yang and KI-Jing-Essence. Formula: You Gui Wan.

Cold Stasis (a Yang-Xu Syndrome): Scanty semen; infertility, very chronic fatigue, pale complexion, sore or weak lower back, senility, hair loss and loose teeth, hearing loss, frequent urination-especially in the evening; Cold extremities, testicles. Formula: You Gui Wan + Fu Zi, Ba Ji Tian, Suo Yang.

38.        Inability to ejaculate during intercourse
Yin-Xu with Empty Heat: distention in scrotum; Possible nocturnal emissions, irritability, scanty urine, constipation, thirst. T: Red. P: Thready and rapid. Treatment Principle: Tonify Yin to move Stasis. Formula: Zhi Bai Di Huang Wan + Mu Tong, Wang Bu Liu Xin.

Xue-Stasis due to chronic stress, Qi-Stasis leading to Xue Stasis. LV-Qi-Stasis (LV Channel passes through the gonads): easily angered, chest congestion; Varicoses of scrotum (varicocele). T: Purple. P: Deep and choppy. Formula: Xu Fu Zhu Yu Tang + Jiu Zi, Chi Cuang Zi.

39.        Premature ejaculation.
Xu of KI-Qi or Ki-Yang : impotence, sore back, hair loss, loose teeth, senility. T: Pale. P: weak at KI (3rd, Chi) position. Formula: You Gui Wan, Ba Wei Di Huang Wan.

Xu of HT and SP: Neurosis (if there's a psychological component); Impotence, emaciation, fatigue, pale complexion; Palpitations, insomnia, forgetfulness; indigestion. T: Pale. P: Weak. Formula: Gui Pi Tang.

40.        Nocturnal Emissions (more Heat)/Spermatorrhoea (more Cold).
Xu of HT and SP: Impotence, emaciation, fatigue, pale complexion; Palpitations, insomnia, forgetfulness; indigestion. T: Pink or red. P: Weak or thready. Treatment Principle: Clear Heat, Subdue Fire and Calm Shen-Spirit. Astringe Jing-Essence. Formula: Tian Wan Bu Xing Tang + Bai Shao, E Jiao.

LV-Fire (nocturnal emissions): Bitter taste in mouth; Dark urine; Easily angered. P: Wiry. Formula: Long Dan Xie Gan Tang.

KI-Qi-Xu (Spermatorrhoea): Tinnitus, dizziness, fatigue, sore or weak lower back. Formula: You Gui Wan + astringent herbs.

Damp-Heat-Stasis: Irritability, fever, itching; burning sensation in lower abdomen, or testicles; Scanty yellow urine. T: Yellow greasy coat. P: Wiry, slippery. Formula: Long Dan Xie Gan Tang + Ba Zhen Tang.

41.        Impotence
KI-Yang-Xu: Cold testes, soreness and weakness in the lower back and knees; Poor memory, hearing and hair loss, loose teeth, aversion to Cold and Cold extremities. Qi-Xu symptoms: T: Pale and swollen with teeth marks. P: Deep thready, weak, especially in KI (3rd, Chi) positions. Etiology: Age, too much sexual activity, constitutional weakness. Treatment Principle: Warm and stimulate KI-Yang. Formula: You Gui Yin or Wan.

HT-SP-Xu (Psychogenic, in WM): Palpitations, shortness of breath, emaciation, insomnia, restlessness, vivid dreams, fatigue, indigestion, bloating, loose stools. T: Pale. P: Thready. Etiology: Thinking or worrying too much creates SP-Qi-Xu which leads to Qi-Xue-Xu, which creates a HT-Xue-Xu, leading to various neurosis. Also, the Qi-Xue can't support the Jing-Essence, which leads to impotence. Treatment Principle: Tonify HT and SP. Formula: Gui Pi Tang + tonic herbs for KI which warm SP, such as Bu Gu Zi, Ba Ji Tian, Xian Ma.

Impotence due to fear: frustration, easily panicked, insomnia, vivid dreams and nightmares, erection up until intercourse begins. Tongue and Pulse can be normal. Treatment Principle: Calm Shen-Spirit. Formula: Ting Zhi Wan + Shi Chang Pu, Ren Shen, Yuan Zhi.

42.        Persistent Erection
LV-Damp-Heat (lasts d or even mo): Penis is dark purple, distended pain, difficult urination, scanty dark yellow urine, fear, bitter taste in mouth, thirst, constipation. T: Red with yellow coat. P: Wiry, slippery, rapid. Treatment Principle: Clear Heat, Dry Damp. Formula: Long Dan Xie Gan Tang.

Yin-Xu with intense Empty Heat: emaciation, high sex drive, distention and pain, though slight compared to Damp-Heat in LV; Sometimes scanty urine; Malar flush, nervousness, hyperactive, easily anxious. T: Red and narrow, scanty coat. P: Thready and rapid. Treatment Principle: Tonify Yin, Clear Heat. Formula: Zhi Bai Di Huang Wan.

43.        Cold in the external genitalia (both men and women)
KI-Yang-Xu with Internal Cold or Mingmen-Xu: KI-Yang-Xu Symptoms: Impotence, premature ejaculation (male); Low sexual desire (female). T: Pale with teeth marks. P: Deep, slow and weak. Formula: Ba Hui Di Huang Wan + Lu Rong and Wu Zhu Yu.

44.        Flaccid retraction of the penis
Cold-Stasis: Cold extremities and body, purple lips, severe muscle aches and abdominal cramping, maybe diarrhoea. T: Normal. P: Deep, slow and weak, or deep, slow and tense. Etiology: Constitutional Yang-Xu + pathogenic Cold or just pathogenic LV-Cold leading to Cold-Stasis which blocks Qi-Xue in the Channels that pass through the genital area. Treatment Principle: Warm and remove Cold Stasis. Formula: Wu Zhu Yu Tang or Dang Gui Si Ni Tang.

Yang-Collapse (a critical Syndrome: LV is dying): Spontaneous Cold sweats; Semiconsciousness or unconsciousness. Treatment Principle: Obviously the penile retraction will be secondary to the more immediate need to rescue and restore the Yang before the patient expires. Formula: Gui Yang Tang.

45.        Itching and Burning in the genitalia
LV-Damp-Heat: Burning, difficult, dark, painful and frequent urination; cloudy urine, fever thirst. T: Yellow greasy. P: Slippery, wiry, rapid. Treatment Principle: Clear Damp, clear Heat. Formula: Long Dan Xie Gan Tang.

Heat-Fire-Stasis: Burning and Heat in genitals, fever, mouth ulcers, thirst, more Heat symptoms. T: Red, especially the tip. P: Rapid. Treatment Principle: Clear Heat, Clear Fire. Formula: Da Chi San.

Xue-Stasis: Severe, excruciating pain, burning in urinary tract; KI, or urinary tract stones, bloody urine, cloudy urine; Pain referred to the abdomen or lower back. T: Purple spots. P: Deep and choppy. Formula: Tao Hong Si Wu Tang + Ba Zhen San.

46.        Light menstrual flow
Qi-Xue-Xu: Light flow, delayed cycle; abdominal aching, fatigue, dizziness. T: Pale. P: Thready. Anaemia. Heavy flow possible in Qi-Xu with no Xue-Xu. Formula: Ba Zhen Tang.

Phlegm-Damp-Stasis: Light flow, obese patient, irregular cycles; heavy sensation in body. T: Swollen tongue body with greasy coat. P: Soft and slippery. Formula: Chuang Gui Er Chen Tang.

47.        Dark Purple Flow or Thick Flow.
Qi-Xue-Stasis: Dark purple flow with clots, sever abdominal pain, sever PMS symptoms. T: Purple. P: Choppy. Formula: Tao He Cheng Qi Tang.

Heat-Stasis and Xue-Stasis: Thick dark clotted flow; Severe abdominal pain, fever, mental symptoms. Formula: Tao He Si Wu Tang.

Cold-Stasis leading to Xue-Stasis: Thick dark clotted flow; Severe abdominal pain, fever, mental symptoms; Lower back Cold, patient prefers warmth. T: White coat. P: Deep and tense. Formula: Wen Jing Tang.

Stone_Ac6 (1996) Symptomatic Diagnosis: Part 6.48.        Thick Menstrual Flow
Qi-Xue-Stasis: Dark purple flow with clots, severe abdominal pain, severe PMS symptoms. T: Purple. P: Choppy. Formula: Tao He Cheng Qi Tang.

Heat-Stasis and Xue-Stasis: Thick dark clotted flow; Severe abdominal pain, fever, mental symptoms. Formula: Tao He Si Wu Tang.

Cold-Stasis leading to Xue-Stasis: Thick dark clotted flow; Severe abdominal pain, fever, mental symptoms; Lower back Cold, patient prefers warmth. T: White coat. P: Deep and tense. Formula: Wen Jing Tang.

Damp-Heat-Stasis: Dark thick flow, strange odour, vaginal burning and itching; Phlegm-Stasis; Thick, though not dark flow; Congestion, dizziness, leucorrhea. T: Greasy coat. P: Slippery.

49.        Thin flow (the quality of the blood, see "light" flow)

50.        Early menstruation (early in the month, not early in life)
Xue-Heat: Bright red, copious flow. Could lead eventually to very dark red if the Heat goes untreated.

Yin-Xu, Xue-Heat: scanty quality, red.

Xue-Stasis leading to Xue-Heat: Clots, abdominal pain. Early or late period, heavy or light amount, spotting.

Qi-Xu: Light and thin flow; Abdominal pulling or bearing down sensation, fatigue. P: Weak.

51.         Late menstruation (In the month, not in life)
Cold-Stasis and Xue-Stasis: Abdominal pain, patient desires warmth, flow with clots. T: Purple. P: Deep, slow, possibly choppy.

Phlegm-Damp-Stasis: Delayed, or lack of menses; Pale red thick flow; Obesity, indigestion. T: Greasy coat. P: Soft.

Qi-Xue-Xu

52.        Amenorrhoea (Lack of period)
KI-Qi-Xu: Congenital KI-Qi-Xu (Primary amenorrhoea); No period as of the 15th birthday; Emaciation, Lower back pain, fatigue; slow development. P: Weak. T: Pale. Treatment Principle: Tonify KI.

Qi-Xue-Xu: Usually found after an illness or postpartum; No pain, no period; Palpitations; Fatigue, weakness. P: Weak. Treatment Principle: Tonify Qi-Xue. Formula: Ba Zhen Tang.

Qi-Xue-Stasis: Amenorrhoea after traumatic injury or stress; Lots of distention and pain; fatigue, depression, anger. T: Varies. P: Deep and wiry.

Damp-Phlegm-Stasis: Menopausal symptoms; Delayed cycle, quantity of flow is light; Amenorrhoea, weight gain, water retention. T: Pale with white greasy coat. P: Soft and slippery.

53.         Metrorrhagia (heavy flow)
Qi-Xue-Xu: Heavy quantity, thin quality and light colour.

Xue-Heat: Dark Red flow.

Xue-Stasis: Irregular flow, spotting, dark purple colour clots, pain in abdomen, which gets better after the onset of the flow. T: Purple. P: Deep and choppy, or wiry and slippery.

54. Irregular Menstrual cycle
LV-Qi-Stasis (95% of cases): Formula: Xiao Yao San.

KI-Qi-Xu

55.        Fever during menstruation
LV-Qi-Stasis with LV-Fire (most common): Fever alternating with chills, more often before period, sometimes during; Early or irregular cycle, irritation, dizziness; Thirst, dry mouth. T: Red with yellow coat. P: Wiry and Rapid.

Yin-Xu Fever: Fever after illness postpartum; this fever tends to happen before or during the period; Emaciation, irritability, dry mouth, thirst. T: Red and thin. P: Thready and rapid.

Wind-Cold: The Chong Mai and CV are weak just before menses. Taiyang Syndrome. Formula: Gui Pi Tang even if there's no sweating. Xiao Chai Hu Tang if fever is also associated with chills.

Xue-Stasis before or during period: Abdominal pain, dark complexion; Flow is purple with clots. Formula: Xue Fu Zhu Yu Tang.

Qi-Xu or Qi-Xue-Xu Fever: Fever before or during the period. Light colour and thin quality, scanty quantity. T: Pale. P: Weak. Formula: Bu Zhong Yi Qi Tang

CONTINUE