Acid Reflux, Gerd, Reflux Esophagitis

General

Clinical Manifestations
Treatment Principle
Herb Formulas	Early-Stage: Xian Fang Huo Ming Yin For Yin damage following radiotherapy: Wu Zhi An Zhong Yin + Liang Ge San modified Chinese Patent Medicines: Lan Han Guo Chong Ji With Kidney Yin Deficiency: Liu Wei Di Huang Wan With Stomach Qi and Yin Deficiency: Gu Ben Wan
Points

Tai Yang - Shao Yang

Clinical Manifestations	Joint pain with a crackling sensation Epigastric pain Fatigue Gastrointestinal weakness Headache Heaviness in the head Fever Moderately severe chills Distension beneath the Heart Periumbilical or lower abdominal pain Tenseness around the pubic bone Subcostal pain Epigastric fullness Nausea Mild vomiting Mild thoraco-costal discomfort Costal distress Tension in the rectus abdominus Chest distension Abdominal pain Abdominal distension Constipation Irritability Insomnia Repeated loss of spinal alignment due to muscular tension P: Floating and weak
Treatment Principle	Release the Exterior and muscle layer Harmonize and releases the Shao-Yang Harmonize the Liver, Spleen and Intestines
Herb Formulas	Chai Hu Gui Zhi Tang
Points

Qi Stage Obstruction Of The Chest By Heat

Clinical Manifestations	Distention of the abdomen Distention of the epigastrium Fever Fullness of the abdomen Fullness of the epigastrium Indigestion Insomnia Irritability Resurgence of Heat signs Thirst T: Red C: Greasy-dirty-yellow P: Floating, slippery and rapid especially on the right position or Floating, full and rapid
Treatment Principle	Clear Heat Remove Obstructions Disperse Stagnation
Herb Formulas	Zhi Zi Gan Cao Chi Tang With Food Stagnation: Zhi Shi Zhi Zi Chi Tang With vomiting: Zhi Zi Sheng Jiang Chi Tang
Points	DU-14, HT-7, LI-11, PC-6, REN-12, ST-44

Lung And Stomach Yin Deficiency

Clinical Manifestations	Severe, dry hacking cough No sputum expectorated Small amounts of difficult to expectorate sputum Blood tinged sputum (when Yin Deficiency Fire is present) Afternoon fever Night sweats Malar flush (especially in afternoon) Five Sole Heat Dry mouth and throat Itching in throat Hoarse voice, low voice or loss of voice Emaciation No appetite or Famished but with no desire to eat Abdominal distention after meals Dry stools Irritability with low grade fever Maybe dry retching or Hiccups T: Red C: Little and dry P: Thready and rapid
Treatment Principle	Clear and Nourish the Lungs and Stomach Generate Fluids Moisten Dryness
Herb Formulas	Wu Zhi An Zhong Yin + Sha Shen Mai Men Dong  modified Chinese Patent Medicines: Mai Wei Di Huang Wan
Points	KI-6, KI-27, LI-18, LU-7, REN-14, REN-17, REN-22, SP-6, ST-36 With Stomach Heat: + PC-8, ST-44 Ear: Stomach, Esophagus, Diaphragm, Throat, Kidney, Lung Shenmen

Cold-Damp Distresses The Spleen

Clinical Manifestations	Distention and fullness in epigastrium and abdomen Loss of taste and appetite Heavy sensation in the limbs and body Loose stools or diarrhea after eating Easily fatigued Increased desire to sleep Nausea Vomiting Belching Feeling lazy with a preference for inactivity Lethargy Acid regurgitation Cough with sputum Borborygmus Shortness of breath Fullness in the chest Persistent bitter taste in mouth T: Pale and swollen C: Thick, white and greasy P: Slippery and even or Slow or Moderate
Treatment Principle	Dry Dampness Strengthen Spleen's transporting function Promote movement of Qi Harmonize the Stomach
Herb Formulas	Ping Wei San
Points

Damp-Heat In The Spleen And Stomach

Clinical Manifestations	Recurrent acid reflux and heartburn Anorexia Epigastric and abdominal distention and discomfort A dry mouth Acne or A tendency toward boils and sores Greasy skin Strong body odor 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 or Slippery and rapid
Treatment Principle	Clear Heat Benefit Dampness
Herb Formulas	San Huang Xie Xin Tang modified
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

Spleen Qi Deficiency

Clinical Manifestations	Sallow complexion Fatigue 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, forceless and deficient
Treatment Principle	Strengthen the Spleen Benefit Qi
Herb Formulas	Si Jun Zi Tang Xiang Sha Liu Jun Zi Tang Bu Wei Fang With Damp-Turbidity clumping in the Stomach: Fu Ling Yin With Qi and Food Stagnation: Zheng Zhu Wan
Points	LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

Spleen Qi Deficiency Edema With Qi Stagnation

Clinical Manifestations	Abdominal fullness Drum-like distention Firm local distention in the epigastrium Pitting edema Ascites Scanty urination Anorexia Decreased food intake Acid regurgitation A feeling of fullness, oppression and distention in the chest Constipation
Treatment Principle	Promote urination Promote the movement of Qi Guide out Stagnation Strengthen the Spleen
Herb Formulas	Fen Xiao Tang
Points

Spleen Qi Deficiency With Cold-Damp Retention

Clinical Manifestations	Sallow complexion Fatigue 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, forceless and deficient
Treatment Principle	Strengthen the Spleen Benefit Qi
Herb Formulas	Si Jun Zi Tang Xiang Sha Liu Jun Zi Tang
Points	LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

Spleen Qi Deficiency With Phlegm-Damp Retention

Clinical Manifestations	Nausea / vomiting Distention of chest and epigastrium Coughing up copious, thin, white sputum Dyspnea Sallow complexion Anorexia Rolled lips Pale lips Stiff tongue Tired limbs Heavy limbs Abdominal and epigastric distention after meals Maybe bleeding Stifling sensation in the chest and epigastrium Acid regurgitation Shortness of breath Loose stools or diarrhea Lethargy Thin muscles Fatigue Does not like to speak Weak, soft voice Maybe enuresis Maybe borborygmus Maybe cold extremities Muscle weakness in arms and legs Weak abdomen T: Pale and flabby, may have teeth marks C: White and greasy P: Soft and weak
Treatment Principle	Tonify Qi Strengthen the Spleen and Stomach Transform Phlegm Dry Dampness Stop vomiting Circulate Qi Harmonize the Middle Jiao
Herb Formulas	Xiang Sha Liu Jun Zi Tang Liu Jun Zi Tang
Points

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 Reinforce the Center Invigorate Yang Benefit Qi
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	Sallow complexion Anorexia (maybe with vomiting) 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 (pain is relieved by warmth) Cold limbs Feeling chilled Mental fatigue Maybe scanty urine with edema Maybe clear, watery vaginal discharge T: Pale C: Thin and white P: Deep and weak
Treatment Principle	Warm the Center Dispel Cold
Herb Formulas	Li Zhong Tang Fu Zi Li Zhong Wan
Points	Moxa or moxa needle LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

Spleen And Lung Qi Deficiency

Clinical Manifestations	Protracted, incessant cough Expectoration of copious, clear, watery or white Phlegm Short, weak, breathing Asthma Four limbs tired Anorexia General lassitude Distention and pain of the epigastrium and abdomen Loose stools Severe cases: Frightens easily T: Pale C: White P: Thready and weak
Treatment Principle	Reinforce the Spleen Benefit the Lungs Warm and transform Phlegm-Dampness
Herb Formulas	Wu Ji San Chinese Patent Medicines: Su Zi Jiang Qi Wan Jiu Fei Su He Wan
Points	LU-9, REN-17, SP-3, ST-36, UB-13, UB-20, UB-43 DU-12, DU-14, LU-5, LU-7, LU-9, PC-6, REN-6, ST-25, ST-36, UB-13, UB-20 Ear: Lung, Spleen, Stomach Intestines, Abdomen

Spleen And Stomach Qi Stagnation

Clinical Manifestations	Chest and abdominal distention A stifling sensation in the chest and abdomen Fixed pain in the hypochondria Belching with a fetid odor Nausea Vomiting Epigastric and abdominal fullness and pain Acid reflux Mild coughing with copious sputum Reduced appetite Indigestion T: Normal C: Thin and white or Greasy or Slippery, P: Wiry and taut or Running
Treatment Principle	Regulates Qi in the Spleen and Stomach
Herb Formulas	Yue Ju Wan  modified
Points

Spleen And Stomach Qi/Yang Deficiency

Clinical Manifestations	Intermittent or continuous abdominal distention, fullness and discomfort Distention is improved by warmth and pressure and worse when eating raw or cold foods Intermittent, chronic acid reflux and heartburn which are worse with hard to digest or raw foods, bending or any increase in abdominal pressure May wake during the night with heartburn Mild epigastric pain or discomfort which is better with warmth and pressure Hypersalivation Drooling Sour belching Poor appetite Easily satiated Fatigue Weak, tired limbs Loose stools or Diarrhea or A tendency toward sluggish bowel movements Puffiness around the eyes or in the fingers Rapid weight fluctuations A pale, sallow face and lips Shortness of breath Reluctance to speak A weak, soft voice Intolerance of Cold Cold extremities T: Pale or Pale and swollen with teeth marks C: White P:Weak and thready or Deficient or Big and weak
Treatment Principle	Tonify Qi Strengthen the Spleen Facilitate the Raising of Qi and the descent of the turbid
Herb Formulas	Bu Zhong Yi Qi Tang modified Xiang Sha Liu Jun Zi Tang  modified Chinese Patent Medicines: Bu Zhong Yi Qi Wan Xiang Sha Liu Jun Zi Wan Jian Pi Wan With Qi Stagnation: Xiang Sha Yang Wei Wan With Yang Deficiency: Li Zhong Wan With Excess acid: Wei Te Ling (combine with any of the above) For symptomatic relief: Xiang Lian Wan (combine with any of the above)
Points	LIV-13, REN-6, REN-12, SP-3, SP-6, SP-15, ST-25, ST-36, UB-20, UB-21 For severe distention: + SP-1 With Fluid retention and edema: + SP-9, ST-28 With Liver Qi Stagnation: + LIV-3, PC-6 PC-6, REN-12, REN-13, REN-17, SP-6, ST-36, UB-20, UB-21 With Phlegm-Damp: + PC-5, SP-3, ST-40 Ear: 1. Spleen, Stomach, Large Intestine, Small Intestine, Abdomen 2. Spleen, Stomach, Esophagus, Pylorus, Shenmen, Adrenal, Subcortex, Sympathetic

Spleen And Stomach Deficiency Cold With Blood Stagnation

Clinical Manifestations	Acid reflux A sallow facial complexion Fatigue Poor muscle tone A flabby abdomen Mild constant epigastric pain; relieved by warmth and pressure Anorexia Abdominal pain and fullness after meals Nausea Vomiting Loose, unformed stools Excessive salivation Cold limbs Lassitude Weakness Maybe edema Maybe scanty urination Maybe clear, watery, copious vaginal discharge T: Moist C: White P: Large and faint
Treatment Principle	Strengthen the Spleen Warm Yang Warm the Center Dispel Cold Regulate Qi and Blood Stop pain
Herb Formulas	An Zhong San
Points	Moxa or moxa needle LIV-13, REN-12, SP-3, SP-6, SP-10, ST-36, UB-17, UB-20, UB-21

Phlegm And Heat Stagnation In The Epigastrium

Clinical Manifestations	Focal distention in the chest and epigastrium with or without nodules which is painful when pressed Coughing up yellow, viscous sputum Constipation A bitter taste in the mouth T: Normal C: Yellow and greasy P: Slippery and floating or Slippery and rapid
Treatment Principle	Clear Heat Transform Phlegm Expand the chest Dissipate Stagnation
Herb Formulas	Xiao Xian Xiong Tang
Points

Stomach Heat

Clinical Manifestations	Scleroderma Intermittent epigastric and abdominal distention and fullness after eating followed 12 hours later by vomiting of partially digested food, which relieves the distention Vomitus may be sour and offensive Irritability Restlessness Red complexion and lips Halitosis Thirst Dry mouth and lips Tendency toward constipation and rarely, diarrhea Concentrated urine T: Red and dry C: Thick and yellow or Thick, greasy and yellow P: Slippery and rapid
Treatment Principle	Clear Heat from the Stomach Harmonize the Stomach Descend Qi
Herb Formulas	Zhu Ru Tang With damage to Qi and Yin: Da Ban Xia Tang With excessive alcohol consumption creating Damp-Heat: Ge Hua Jie Cheng San For Heat, Cold and Deficiency with a sensation of blockage, distention, fullness and discomfort in the epigastrium: Ban Xia Xie Xin Tang Chinese Patent Medicine: With Damp-Heat: Huang Lian Jie Du Wan With Phlegm-Heat: Wen Dan Wan With constipation: Niu Huang Qing Huo Wan
Points	PC-6, PC-8, REN-12, REN-14, REN-17, ST-36, ST-44 With severe Heat: + LI-4, LI-11 or SJ-2, ST-45 With constipation: + SJ-6, ST-25 With Phlegm-Heat: + PC-5, ST-40 Ear: Esophagus, Pylorus, Stomach Duodenum, Spleen, Sympathetic, Shenmen

Stomach Fire Blazing

Clinical Manifestations	Burning Heat and pain in the epigastrium Irritating thirst: drinks copious fluids and prefers cold drinks Excessive appetite: hungry again quickly after eating (as if food vanishes) Swelling, pain, ulceration and bleeding of gums Foul breath Toothache Maybe vomiting right after eating Vomiting acid or undigested food Constipation Maybe scanty, red urine T: Red C: Thick, yellow and dry P: Slippery, big, Excess and rapid
Treatment Principle	Clear and Purge Stomach Fire
Herb Formulas	Qing Wei San Mai Men Dong Tangmodified With bleeding: San Huang Xie Xin Tang Shi Hui San San Huang Xie Xin Tang  modified + Shi Hui San With Yin Deficiency: Yu Nu Jian
Points	LI-4, LI-11, PC-6, PC-8, ST-6, ST-34, ST-36, ST-43, ST-44, ST-45, UB-21 With bleeding: 1. LI-4, PC-4, PC-8, REN-12, SP-4, ST-44, ST-45 With epigastric pain: + ST-21, ST-34 With nausea: + PC-6 With constipation: + ST-25, ST-37 With Yin Deficiency: + UB-21 , UB-23 With Shao Yang Fu: + GB-39, SJ-5, ST-25 2. LIV-13, PC-6, REN-12, SP-4 For Heat: + LI-4, LI-11 For Fire: + ST-44 For bleeding: + UB-17 3. LI-4, LI-11, PC-6, PC-8, ST-6, ST-34, ST-36, ST-43, ST-44, ST-45, UB-21 Ear: Stomach, Duodenum, Liver, Large Intestine, Adrenal, Subcortex Shenmen

Food Stagnation In The Stomach

Clinical Manifestations	Epigastric fullness, distention and pain with dislike of pressure Belching with rotten food smell Acid regurgitation Detests food or Vomits after eating Distention is reduced after vomiting Unformed stools or Knotted constipation T: Pink C: Thick and greasy P: Slippery
Treatment Principle	Clear Food Conduct Stagnation
Herb Formulas	Bao He Wan Zhi Shi Dao Zhi Wan Xiang Sha Ping Wei San
Points	ST-21, ST-36, ST-44, LIV-13, LIV-14, REN-11, REN-12, PC-6, SP-4 For epigastric pain due to Food Stagnation: 1. ST-36, ST-44, REN-12, PC-6, LIV-13 2. ST-21, ST-44, LIV-13 3.PC-6, ST-36, REN-11 4. PC-6, REN-10, REN-12, ST-21, ST-36, SP-4 For vomiting due to Food Stagnation: ST-25, ST-36, PC-6, SP-4, REN-12

Disharmony Between The Stomach And Intestines With Cold And Heat

Clinical Manifestations	Indigestion Epigastric focal distention which is soft and not tender to the touch 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 Mild nausea in the morning Ascites Gurgling sounds A tendency toward diarrhea or loose stools T: Normal or with a red tip C: Thin, yellow and greasy or mixed white and yellow P:Soft, slippery, slightly wiry and rapid or 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 Chinese Patent Medicines: Chen Xiang Hua Qi Wan
Points	LI-11, LIV-13, PC-6, REN-6, REN-12, ST-25, ST-36, ST-37 For excessive Stomach Heat: + LI-4, ST-44 With Dampness: + SP-6, SP-9 With Phlegm or Plum-Pit Qi Stagnation: + PC-5, SP-3, ST-40 With fat intolerance, pale or pasty stools and right hypochondriac pain or distention: + GB-24, GB-40, Dannangxue With Shao Yang symptoms: + GB-34, GB-39, SJ-5 Ear: Spleen, Stomach, Liver, Large Intestine, Small Intestine Sympathetic

Stomach Yin Deficiency

Clinical Manifestations	No appetite or Famished but with no desire to eat Abdominal distention after meals Dry stools Irritability with low grade fever Maybe dry retching or Hiccups T: Red C: Little and dry P: Thready and rapid
Treatment Principle	Nourish Yin Nourish the Stomach
Herb Formulas	Yi Wei Tangmodified
Points	UB-21, REN-12, KI-3, SP-6, ST-36 For epigastric pain: KI-3, KI-6, REN-4, REN-12, SP-6, ST-36, UB-20, UB-21, UB-23 With deficient Heat: + KI-2, ST-43 With sharp pain: + KI-2 With nausea: + PC-6 Ear: Stomach, Spleen, Abdomen, Kidney, Shenmen, Sympathetic

Stomach Yin Deficiency With Heat

Clinical Manifestations	No appetite or Famished but with no desire to eat or Indeterminate gnawing hunger Persistent, dull, nagging epigastric pain Heartburn Morning nausea Abdominal distention after meals Black, sticky or tarry, dry stools Irritability with low grade fever Maybe dry retching or Hiccups Thirst Dry skin, hair and mucous membranes Tendency toward constipation or pellet-like stools Facial flushing Malar flush Night sweats Five-sole-Heat With Kidney Yin Deficiency: Dizziness Tinnitus Low back and knee weakness and pain T: Red or Slightly red with a peeled center or Red and dry C: Little and dry or Peeled in the center or Shiny P: Thready and rapid
Treatment Principle	Nourish Yin Clear Heat Nourish the Stomach Cool the Blood Stop bleeding
Herb Formulas	Yu Nu Jian modified
Points	KI-3, REN-12, SP-6, ST-36, UB-21 With hemafecia: KI-3, KI-6, REN-4, REN-12, SP-6, ST-25, ST-36, UB-20, UB-21, UB-23, UB-25 Ear: Stomach, Kidney, Large Intestine, Distal Segment Rectum, Shenmen, Sympathetic With hematemesis: KI-3, KI-6, REN-4, REN-12, SP-6, ST-36, UB-20, UB-21, UB-23 Ear: Stomach, Duodenum, Adrenal, Esophagus , Shenmen, Subcortex

Stomach Qi Deficiency

Clinical Manifestations	Epigastric fullness and distention No desire for food and drink Frequent belching Acid regurgitation Borborygmus Loss of sensation of taste Stools not solid Urine clear and abundant T: Pale C: Thin and white P: Weak and Deficient
Treatment Principle	Strengthen Qi Invigorate the Spleen and Stomach
Herb Formulas	Xiang Sha Liu Jun Zi Tang Liu Jun Zi Tang With turbid Phlegm: Xuan Fu Dai Zhe Tang
Points	REN-6, REN-12, SP-6, ST-21, ST-36, UB-20, UB-21

Stomach And Liver Heat

Clinical Manifestations	Recurrent or relentless acid reflux and heartburn, aggravated by coffee, chocolate and alcohol or stress The patient may wake in the middle of the night (1-2 am) with discomfort and reflux Sour or bitter belching Epigastric discomfort or burning sensation Indeterminate, gnawing hunger Foul stools Dry mouth Thirst Irritability Quick temper T: Red with red edges C: Yellow P: Wiry and/or slippery, maybe rapid
Treatment Principle	Clear Heat from the Stomach and Liver Harmonize the Stomach Descend Stomach Qi
Herb Formulas	Hua Gan Jian Jia Wei Severe cases: Zuo Jin Wan modified When Stomach Heat is primary: Qing Wei San modified Chinese Patent Medicines: Jia Wei Xiao Yao San Wen Dan Wan Wei Te Ling Xiang Lian Wan
Points	GB-34, LI-11, LIV-2, PC-8, REN-12, REN-13, REN-17, ST-36, ST-44 With severe Heat: + SJ-2, ST-45 With constipation: + SJ-6, ST-25 With Lung and Stomach Heat: + LU-5 With nausea: + PC-6 Ear: Esophagus, Pylorus, Liver, Spleen, Stomach, Shenmen, Subcortex, Sympathetic

Stomach And Lung Yin Deficiency

Clinical Manifestations	Cough with little yellow sputum Spitting saliva Wheezing Shortness of breath Dry, uncomfortable sensation in throat Hiccups Dry mouth Coughing up difficult-to-expectorate Phlegm Nausea Hoarseness Thirst Asthma Flushed face Five sole Heat Vomiting T: Red and dry C: Little or None P: Thready and rapid or Deficient and rapid
Treatment Principle	Benefit the Stomach Generate Fluids Descend Qi Harmonize the Middle Jiao
Herb Formulas	Mai Men Dong Tang
Points

Stomach And Liver Yin Deficiency

Clinical Manifestations	Chronic acid reflux, hyperacidity and heartburn Symptoms may be worse in the evening and with stress The patient may wake with symptoms during the night which may be temporarily relieved by eating Mild, dull epigastric or hypochondriac pain or discomfort Anorexia or Intermittent gnawing hunger Dry mouth and throat Dry stools or Constipation T: Red and dry C: Little or None P: Thready, wiry and rapid
Treatment Principle	Nourish and supplement Liver and Stomach Yin Regulate Qi Descend Qi Harmonize the Stomach
Herb Formulas	Yi Guan Jian  modified Chinese Patent Medicines: Gu Ben Wan With Excess acid: Wei Te Ling (combine with any of the above) For symptomatic relief: Xiang Lian Wan (combine with any of the above)
Points	KI-9, LIV-13, PC-6, REN-12, ST-36, UB-20, UB-21 Ear: Esophagus, Pylorus, Spleen, Liver, Stomach, Shenmen, Subcortex, Sympathetic

Deficiency Cold Of The Stomach And Liver

Clinical Manifestations	Epigastric pain (worse when emotionally upset) Belching with acid regurgitation Nausea / vomiting Anorexia Epigastric distention 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: Wiry
Treatment Principle	Soothe the Liver Harmonize the Stomach
Herb Formulas	Chai Hu Shu Gan Tang Zuo Jin Wan Xiao Yao San Shu Gan Wan Hei Xiao Yao San
Points	LIV-13, LIV-14, PC-6, REN-12, ST-36, ST-44 PC-6, REN-12, ST-36 LIV-13, LIV-14, PC-6, REN-12

Disharmony Between The Stomach And Intestines

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

Heart Yang Not Vigorous: Water Qi Insults The Heart With Lung And Spleen Qi Deficiency

Clinical Manifestations	Palpitations Shortness of breath Dizziness Epigastric fullness and contravection (reflux vomiting) Sensation of Qi rushing upward to the chest (Running Piglet) Suffocating sensation in chest Weak cough Expectorating watery white Phlegm T: Pale C: White P: Deep and wiry
Treatment Principle	Clear Yang Transform Harmful Fluid (Yin)
Herb Formulas	Ling Gui Zhu Gan Tang Si Jun Zi Tang
Points	DU-25, moxa or moxa needle HT-5, HT-7, HT-8, LU-9, PC-3, PC-4, PC-5, PC-6, PC-7, REN-1, REN-12, REN-14, REN-17, SP-6, ST-36, ST-40, UB-13, UB-15, UB-20, UB-43

Liver Qi Stagnation

Clinical Manifestations	Chronic epigastric and abdominal distention, fullness and discomfort which is worse with emotional upset. Distention and pain in the sides or flanks, which is generally worse at night Suffocating sensation in the chest Tendency to sigh Belching Flatulence Borborygmus Anorexia Melancholy Depression Irritability Moodiness Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses Alternating constipation and diarrhea T: Pink C: Thin and white P: Wiry
Treatment Principle	Soothe the Liver Clear Stagnation
Herb Formulas	Yue Ju Wan With chronic sluggish stools or constipation: Liu Mo Tang With Food Stagnation and sluggish bowels: Mu Xiang Shun Qi Wan Chinese Patent medicines: Chai Hu Shu Gan Wan 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
Points	GB-40, GB-41, LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, PC-6, SJ-6, SP-6, UB-18 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 Ear: Liver, Spleen, Stomach, Large Intestine, Small Intestine, Abdomen

Liver Qi Stagnation Invades The Stomach

Clinical Manifestations	Recurrent acid reflux (worse when emotionally upset) Epigastric pain (worse when emotionally upset) Frequent belching with acid regurgitation Nausea in the morning Vomiting Anorexia Hypochondriac or epigastric distention, pain, tenderness ache or discomfort Epigastric or abdominal bloating Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Moodiness Anxiety Frequent worrying Inappropriate anger Dizziness Tension headaches Shoulder and neck tension Cold fingers and toes Irregular menses Dysmenorrhea Breast distention and pain before and during menses Alternating constipation and loose stools T: Pink or Darkish C: Thin and white P: Wiry
Treatment Principle	Soothe the Liver Harmonize the Stomach Descend Stomach Qi
Herb Formulas	Chai Hu Shu Gan Tang Xiao Yao San Shu Gan Wan Hei Xiao Yao San Xiao Chai Hu Tang Yue Ju Wan Si Ni San  modified With Heat: Zuo Jin Wan Jia Wei Xiao Yao San  modified For chronic sluggish bowels or constipation: Liu Mo Tang For Qi and Food Stagnation: Mu Xiang Shun Qi Wan Chinese Patent medicines: Chai Hu Shu Gan Wan Xiao Yao Wan For symptomatic relief: Wei Te Ling Xiang Lian Wan With epigastric pain: Shu Gan Wan With Stagnant Heat: Jia Wei Xiao Yao Wan For chronic sluggish bowels or constipation: Mu Xiang Cheng Qi Wan For constipation: Chen Xiang Hua Qi Wan For Spleen Deficiency and Dampness: Xiang Sha Yang Wei Wan
Points	LIV-13, LIV-14, PC-6, REN-12, ST-36, ST-44 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 PC-6, REN-12, ST-36 LIV-13, LIV-14, PC-6, REN-12 LI-10, LIV-3, PC-6, REN-12, REN-13, REN-17, ST-36, UB-18, UB-19, UB-21 With lateral headaches and neck tension: + GB-34 With hypochondriac pain: + LIV-14 With Gall Bladder involvement: + Dannangxue, GB-24, GB-40   With Heat in the Liver: + LIV-2 With Spleen Deficiency: + UB-20 With Phlegm or Plum-Pit Qi Stagnation: + PC-5, SP-3, ST-40 With dizziness: + GB-20 With Shen disturbance: + one or two of the following: DU-19, DU-24, HT-7, Yintang Ear: Esophagus, Pylorus, Liver, Spleen, Stomach, Shenmen, Subcortex, Sympathetic

Liver Qi Stagnation Invades The Stomach With Cold-Dampness Stagnation

Clinical Manifestations	Stomach duct distention and fullness Borborygmus Watery, loose stools Dull pain in the Stomach, relieved by warmth and pressure Moderate pain when eating Occasional vomiting of bitter water A dry mouth with no desire to drink T: Pale C: White P: Deep, thready and wiry
Treatment Principle	Dredge and regulate the Liver Unblock Qi
Herb Formulas	Chai Hu Shu Gan Tang  modified
Points

Liver Qi Stagnation Invades The Stomach With Stagnant Heat

Clinical Manifestations	Burning pain A clamoring Stomach Bitter tasting vomit Acid regurgitation Vexation Agitation Irritability A bitter taste in the mouth A dry mouth Thirst with a desire for cold drinks T: Red C: Yellow P:Wiry and rapid
Treatment Principle	Dredge the Liver Clear Heat Regulate Qi Harmonize upbearing and downbearing
Herb Formulas	Chai Hu Shun Gan Tang + Er Chen Tang  modified
Points	GB-24, GB-34, PC-6, REN-12, REN-13, SP-4, ST-44 With Spleen Qi Deficiency: + ST-36 With constipation or irregular defecation: + SJ-6 With severe Liver Qi Stagnation: + LIV-3 With flank and Stomach pain: + LIV-14 With an acid Stomach: + ST-34 With hiccups or belching: + UB-17

Liver Qi Stagnation Invades The Stomach With Qi Deficiency

Clinical Manifestations	Stomach duct pain which is tolerable and lessens with eating Poor appetite Abdominal distention after meals Reduced food intake Fatigue Lassitude Weakness Clear, watery vomit T: Pale and fat with teethmarks C: White P: Thready and wiry or Soft and wiry
Treatment Principle	Dredge the Liver Tonify the Spleen Regulate Qi Harmonize upbearing and downbearing
Herb Formulas	Chai Hu Shun Gan Tang + Er Chen Tang  modified
Points	GB-24, PC-6, REN-13, SP-3, SP-4, ST-36 With severe vomiting: + REN-12 With Cold symptoms: + moxa or moxa needle REN-13, SP-3, ST-36 With Heat symptoms: + ST-44 With Food Stagnation: + ST-21 With severe Liver Qi Stagnation: + LIV-3 With flank and Stomach pain: + LIV-14 With hiccups or belching: + UB-17

Liver Qi Stagnation Invades The Stomach With Yang Excess

Clinical Manifestations	Stomach duct distention and fullness Severe pain Retching Bitter, flooding vomiting worsened by rating A bitter taste in the mouth Bad breath Dry, bound stools T: Red C: Yellow P: Wiry, rapid, slippery and forceful
Treatment Principle	Clear Heat Eliminate Stagnation Regulate Qi Harmonize upbearing and downbearing
Herb Formulas	Chai Hu Shun Gan Tang + Er Chen Tang  modified
Points

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 Recurrent acid reflux, heartburn or regurgitation Distention and pain in the sides or flanks Suffocating sensation in the chest and epigastrium Belching Nausea Vomiting Dry mouth and throat 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 or Greasy and white P: Slippery and wiry (slippery due to Phlegm)
Treatment Principle	Spread Qi Resolve Phlegm
Herb Formulas	Qi Ge San  modified
Points	LI-18, LIV-3, PC-5, SI-17, SJ-6 LI-10, LIV-3, PC-6, REN-12, REN-13, REN-17, ST-36, UB-18, UB-19, UB-21 With lateral headaches and neck tension: +GB-34 With hypochondriac pain: + LIV-14 With Gall Bladder involvement: + Dannangxue, GB-24, GB-40   With Heat in the Liver: + LIV-2 With Spleen Deficiency: + UB-20 With Phlegm or Plum-Pit Qi Stagnation: + PC-5, SP-3, ST-40 With dizziness: + GB-20 With Shen disturbance: + one or two of the following: DU-19, DU-24, HT-7, Yintang Ear: Esophagus, Pylorus, Liver, Spleen, Stomach, Shenmen, Subcortex, Sympathetic

Liver And Kidney Yin Deficiency With Liver Qi Stagnation

Clinical Manifestations	Hypochondriac and chest pain Dry, parched mouth and throat Bitter taste in mouth Acid regurgitation Epigastric and abdominal distention T: Red and dry P: Thready and weak or Wiry and Deficient
Treatment Principle	Enriches Kidney and Liver Yin Spreads Liver Qi
Herb Formulas	Yi Guan Jian
Points	GB-40, GB-41, KI-3, LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14,  PC-6, SJ-6, SP-6, UB-18, UB-23

Gall Bladder Damp-Heat

Clinical Manifestations	Alternating chills and fever with fever more prominent A bitter taste in the mouth Nausea Dry heaves Hiccups A stifling sensation in the chest Chest and hypochondriac pain and distention Distending pain in the upper abdomen Vomiting bitter or sour fluids that are yellow and sticky Acid regurgitation Thirst T: Red C: Yellowish or White and greasy or Yellow and greasy P: Left: Wiry and rapid, Right: Slippery and rapid
Treatment Principle	Clear Gall Bladder Heat Dispel Dampness Harmonize the Stomach Resolve Phlegm
Herb Formulas	Hao Qin Qing Dan Tang
Points

Disharmony Between The Gallbladder And Stomach With Phlegm-Heat

Clinical Manifestations	Acid reflux or Heartburn Nausea Vomiting Indeterminate gnawing hunger Insomnia Anxiety T: Normal C: Yellow and greasy P: Slippery and rapid
Treatment Principle	Resolve Phlegm-Heat Descend Qi Stop reflux
Herb Formulas	Wen Dan Tang modified
Points

Yin And Fluid Deficiency Of The Throat And Esophagus Due To Heat

Clinical Manifestations	Difficulty swallowing maybe with a burning of painful sensation Food is difficult to swallow but Fluids are easy After eating, the bulk of the ingested food may be vomited up, possibly mixed with mucus Gradual weight loss Dryness oft the mouth and throat Dry skin Thirst Pain in the chest and upper back An uncomfortable burning sensation in the epigastrium A hoarse or croaky voice Five-Sole-Heat Low-grade afternoon fever Night sweats Facial flushing A tendency toward constipation T: Red and dry with multiple surface cracks C: Maybe yellow P: Wiry, thready and rapid
Treatment Principle	Nourish and moisten Yin and Fluids Clear Heat Disperse accumulations
Herb Formulas	Wu Zhi An Zhong Yin With severe Dryness, constipation and lack of saliva: + Zeng Ye Tang  modified Chinese Patent Medicines: Lan Han Guo Chong Ji With Kidney Yin Deficiency: Liu Wei Di Huang Wan With Stomach Qi and Yin Deficiency: Gu Ben Wan
Points	KI-6, KI-27, LI-18, LU-7, REN-14, REN-17, REN-22, SP-6, ST-36 With Stomach Heat: + PC-8, ST-44 Ear: Stomach, Esophagus, Diaphragm, Throat, Kidney, Lung Shenmen

Qi , Food And Phlegm Stagnation

Clinical Manifestations	Epigastric fullness, distention and pain with dislike of pressure Abdominal distension Belching with rotten food smell Acid regurgitation Detests food or Vomits after eating Distention is reduced after vomiting Unformed stools or Knotted constipation Heaviness Anorexia Feverish Chest discomfort Coughing up Phlegm Uncomfortable bowel movements Nausea and /vomiting Lower abdominal distension Excruciating abdominal pain Mania Delirious speech from extreme pain Afternoon fever Amenorrhea Dysmenorrhea Irregular menstruation Chills and fever Headache Hard stool Sharp, stabbing epigastric pain with fixed location Pain is severe after eating Dislike of pressure and heat on epigastrium Pain predominates over distention or Pain but no distention Epigastric rumbling Vomiting purple / black blood Stools with blood like tar (melaena) May be abdominal or epigastric lumps or masses T: Pink or Dark purple with purple spots or dots C: Thick and greasy white or yellow P: Slippery, maybe rapid or Wiry and choppy
Treatment Principle	Tonify the Spleen Augment Qi Dry Dampness Regulate Qi Adjust the Middle Transform Phlegm Descend Qi Dissipate accumulations Reduce Food Stagnation Activate the Blood Stop pain
Herb Formulas	Kai Yu Zheng Yuan San
Points

Fluid And Heat Stagnation

Clinical Manifestations	Food stagnation Firm epigastric focal distention Dry heaves with a foul odor The sound of Fluids in the hypochondria Diarrhea Very loud borborygmus Nausea Vomiting Fullness and oppression in the chest and abdomen Heartburn Acid regurgitation Ascites T: Normal C: Thin, yellow and greasy P: Wiry, taut and rapid
Treatment Principle	Harmonize the Stomach Reduce focal distention Disperse clumping Expel water Descend Qi
Herb Formulas	Sheng Jiang Xie Xin Tang
Points

Phlegm-Fire

Clinical Manifestations	Simultaneous vomiting and diarrhea Focal distention in the chest and epigastrium A stifling sensation in the chest and epigastrium Irritability Acid regurgitation Anorexia Restlessness Fatigue Abdominal pain A bitter taste in the mouth Dark, scanty, possibly reddish urine T: Normal C: Yellow and greasy P: Slippery and rapid or Smooth and wiry
Treatment Principle	Clear Heat Transform Dampness Regulate Qi Harmonize the Middle Jiao
Herb Formulas	Lian Po Yin Xiao Xian Xiong Tang Qing Huo Di Tan Tang Shi Yi Wei Wen Dan Tang
Points	LI-11, LU-5, ST-40, UB-13

Phlegm And Qi Obstruction

Clinical Manifestations	Difficult to swallow food (often with an emotional component) Swallowing with a choking sensation Swallowing eventually becomes impossible Dull or burning pain Distention with indistinct pain that is relieved by belching, dry retching or spitting up of Phlegm or mucus A feeling of esophageal constriction Dry mouth and throat Focal distention of the chest and diaphragm or Dull chest pain Hiccups Acid reflux Vomiting of a mucus-like material of food streaked with mucus Dry mouth and throat Difficult bowel movements Severe weight loss Gradual emaciation Sometimes acute pain Maybe severe coughing Maybe aspiration of fluids Maybe fever Maybe aortic erosion T: Normal or Red or Red with red edges C: White or Greasy and white or Greasy and yellow P: Thready and wiry or Wiry and slippery or Thready and rapid
Treatment Principle	Regulate Qi Soothe and soften the Liver Moisten Dryness Clear Heat
Herb Formulas	Qi Ge San Ban Xia Hou Po Tang Ping Chen Tang With Liver Qi Stagnation dominant: Xiao Yao San  modified With rebellious Stomach Qi: Xuan Fu Dai Zhe Tang  modified Chinese Patent Medicines: Xiao Yao Wan Jia Wei Xiao Yao Wan For Phlegm masses: + Hai Zao Wan For Phlegm and blood Stagnation masses: + Nei Xiao Lan Li Wan
Points	KI-4, KI-27, LI-18, PC-5, PC-6, REN-14, REN-17, REN-22, ST-40 With Lung involvement associated with long-term sadness or grief: + LU-3, LU-7 PC-6, REN-12, REN-17, REN-21, REN-22, ST-36 Ear: Liver, Stomach Esophagus, Throat, Shenmen

Phlegm Accumulation Above The Diaphragm And Below The Heart

Clinical Manifestations	Violent nausea and vomiting Severe vomiting of Phlegm and/or thin fluids Severe pain Migrating and shooting pain throughout the upper and lower back Chest pain Precordial pain T: Pale C: Greasy and white P: Deep and wiry
Treatment Principle	Dry Dampness Dissolve Phlegm Regulate Qi Subdue Rebellious Qi Relieve pain
Herb Formulas	Zhi Suo Er Chen Tang
Points

Middle Jiao Damp Stagnation With Wind-Cold Attacking The Exterior

Clinical Manifestations	Vomiting Abdominal distention and fullness Fever and chills Diarrhea and vomiting T: Pink C: Thick, white and greasy P: Soft or Floating tight and soft
Treatment Principle	Activate Qi Dry Dampness Transform turbidity Descend Qi Harmonize the Stomach Stop vomiting
Herb Formulas	Bu Huan Jin Zheng Qi San
Points

Xuan Yin (Hanging Damp)

Clinical Manifestations	Cough with sharp pain in the chest and hypochondrium Hypochondriac distention and pain Hard focal distention in the epigastrium Dry heaves Shortness of breath Headache Abdominal distention Wheezing Fullness in the chest Dyspnea caused by extreme chest and back pain Dizziness Vertigo Asthma Rapid breathing Generalized edema which is worse in the lower body Difficult urination and defecation T: Normal or Dark C: Thick, greasy and white P: Deep and wiry
Treatment Principle	Attack and Dispel water
Herb Formulas	Shi Zao Tang
Points	KI-3, LI-4, LI-11, PC-6, REN-11, REN-12, ST-36, UB-13, UB-20, UB-23

Toxic Heat

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 Relieve inflammation
Herb Formulas	Zhen Ren Huo Ming Yin
Points

Heat Above And Cold Below

Clinical Manifestations	Stifling sensation and irritability in the chest Nausea with an urge to vomit Abdominal pain Fever with slight chills Diarrhea Vexation Borborygmus Thirst T: Pink C: White and greasy P: Wiry
Treatment Principle	Regulate Cold and Heat Harmonize the Stomach Descend Rebellious Qi
Herb Formulas	Huang Lian Tang
Points