Acute Hepatitis, Hepatitis A, Hepatitis E

General

Clinical Manifestations	Primary Stage: (This is mostly applicable to hepatitis A, in the early stage of the disease.) Fatigue Occasional jaundice (Damp-Heat Stage affecting the Blood) If the disease is cured at this stage, there will be no further manifestations. If the disease is not cured at this stage: (This stage is not seen in hepatitis C.) Fever and chills Nausea Gas
Treatment Principle
Herb Formulas
Points	For acute hepatitis: LIV-3, ST-36, UB-19 For chronic hepatitis: SP-6, ST-36, UB-18 With jaundice: + LI-4, SI-3 With abdominal distention: + REN-4 With upper abdominal distention: + REN-12 With lower abdominal distention: + ST-25 With hypochondriac pain: + Dannangxue, GB-34

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

Shao Yang Fu

Clinical Manifestations	Alternating chills and fever (not so likely) Restlessness Irritability Continuous vomiting Headache (side of head) Hypochondriac pain Epigastric pain Bitter taste in mouth Digestive disruption Anorexia Nausea Acid regurgitation Burning diarrhea or Constipation Menstrual problems Dry throat Heart pain with vomiting Throat pain Hip pain T: Red C: Thin yellow P: Wiry, forceful
Treatment Principle	Harmonize the Liver and Gall Bladder Purge Internal Heat
Herb Formulas	Da Chai Hu Tang
Points	To harmonize the Liver and Gall Bladder: GB-34, LIV-3, LIV-14, SJ-5 For nausea and vomiting: PC-6, SP-4, ST-36 For headache: GB-1, GB-8, GB-14, Taiyang For constipation: SJ-6, ST-25 For fever: DU-13, DU-14 For Stomach Heat: LI-4, LI-11, ST-44 To support the San Jiao and Regulate Yin: PC-5, PC-6 To support Yin: KI-7 To support the Ying: GB-41, SJ-5 , SP-10 To regulate menstruation: SP-6 For Shao Yang Fu with Tai Yang: For the Shao Yang: GB-34, LIV-3, LIV-14, SJ-6 For the Tai Yang: GB-20, UB-12 For Shao Yang Fu with underlying Liver Qi Stagnation: To harmonize the Shao Yang: GB-34, LIV-3, SJ-6 To clear Heat: LI-11, ST-44 To calm the Shen: HT-7, PC-6 Ear: Shenmen, Liver, Gall Bladder, bleed Heat points

Shao Yang With Fluid Accumulation

Clinical Manifestations	Alternating chills and fever (chills predominate) or Chills without fever Sensation of irritability in the chest Sweating from the head Fatigue Gastrointestinal weakness Heavy head Neuralgia Epigastric distension Lower abdominal pain Tension around pubic bone Periumbilical pain Urinary difficulty T: Moist C: White and slippery P: Superficial and wiry
Treatment Principle	Disperse Clumping Harmonize the Shao Yang Warm the Interior Dispel Cold
Herb Formulas	Chai Ling Tang
Points	GB-41, SJ-5, moxa or moxa needle REN-4, REN-6, REN-8, REN-12, SJ-6, ST-25, ST-36

Shao Yang With Phlegm Stagnation

Clinical Manifestations	Alternating chills and fever Fullness and focal distention in the chest and diaphragm Pain in the chest and diaphragm with pressure Thick, sticky, difficult-to-expectorate Phlegm Panting A bitter taste in the mouth Chest pain with coughing or on deep inhalation Anorexia T: Normal C: Yellow P: Wiry and rapid
Treatment Principle	Clear Heat Transform Phlegm Expand the chest Release the Shao Yang
Herb Formulas	Chai Hu Xian Xiong Tang
Points

Shao Yang With Phlegm-Heat

Clinical Manifestations	Alternating chills and fever Fullness and focal distention in the chest and diaphragm Pain in the chest and diaphragm with pressure Thick, sticky, difficult-to-expectorate Phlegm Panting A bitter taste in the mouth Chest pain with coughing or on deep inhalation Anorexia T: Normal C: Yellow P: Wiry and rapid
Treatment Principle	Clear Heat Transform Phlegm Expand the chest Release the Shao Yang
Herb Formulas	Chai Xian Tang
Points

Wind-Cold-Dampness

Clinical Manifestations	High fever accompanied by severe chills and shivering Aversion to Cold Pain worse at night Difficult movement Local inflammation Migratory pain Soreness and pain of the extremities Nasal congestion with sonorous breathing Anhidrosis Pain and stiffness of the head and neck Focal distention and fullness of the chest and diaphragm A productive cough May have numbness and heaviness in the limbs Body aches Nasal obstruction Cough with sputum Stuffy nose Joint pain Pain worse with Cold and better with warmth Pain aggravated by Wind Pain aggravated by Dampness Pain is stabbing Muscle weakness Pain alleviated by movement Slight muscle edema Heaviness of the joints Cold joints Headache Dizziness T: Pale or Slightly purple or Purple spots C: White or thin, white, greasy P: Slippery or Slightly superficial or Superficial and soft or Slightly rough or Slow and Soft or Wiry and tight or Superficial and rapid that is forceless under pressure
Treatment Principle	Release the Exterior Augment Qi Remove Wind-Cold-Damp Eliminate Painful Obstruction Circulate Qi and Blood Stop pain
Herb Formulas	Ren Shen Bai Du San
Points

Wei Stage: Wind Heat With Underlying Spleen And Stomach Heat

Clinical Manifestations	Severe sore and swollen throat High fever with convulsions in infants Difficulty swallowing Carbuncles Acute localized infection Lymphangitis Furuncles Boils Abscesses T: Red C: Greasy and yellow P: Rapid
Treatment Principle	Relieve Toxic Heat Reduce swelling Alleviate pain
Herb Formulas	Liu Shen Wan
Points

Wind-Heat Toxin With Phlegm

Clinical Manifestations	Strong fever and chills Redness of the head and face Swelling and burning pain of the head and face Throat dysfunction Swelling and pain of the throat Thirst Red and swollen eyes Difficulty opening the eyes Aversion to Cold Throat Dryness Facial edema Restlessness T: Red or Dry and red C: Powdery white or Yellow P: Floating, rapid and forceful or Rapid and forceful
Treatment Principle	Clear Heat Eliminate Fire toxin Disperse Wind-Heat
Herb Formulas	Pu Ji Xiao Du Yin
Points

Wei Stage: Damp-Heat

Clinical Manifestations	Headache (wrapping) Fever and chills, fever more pronounced or Chills with afternoon fever Heavy extremities Heavy sensations in the body Stifling sensation in the chest Nausea Dizziness Gastric and abdominal distension Sticky mouth No thirst T: Normal C: Greasy, white or Greasy, yellow P: Soft and rapid or Soft and slow or Wiry thin and soft
Treatment Principle	Clear Damp-Heat
Herb Formulas	Ma Huang Lian Qiao Chi Xiao Dou Tang + Gan Lu Xiao Du Dan
Points	For fever: DU-14, bleed UB-40 For Wind-Heat: GB-20, LI-4, or SJ-5, LI-11, UB-12 For headache: DU-23, DU-24, ST-8, Taiyang For Dampness: REN-9, SP-6, SP-9, ST-28, UB-20

Wei Stage: Summerheat With Dampness

Clinical Manifestations	Fever and chills, fever more pronounced or Tidal fever Abdominal distention Thirst Sweat Stifling sensation in the chest Restlessness Gastric disturbances: Heaviness Nausea Severe diarrhea Scanty urine T: Red tip and edges C: Greasy white or yellow P: Rapid and soft
Treatment Principle	Disperse Wind Clear Heat Resolve Damp
Herb Formulas	Chai Ling Tang San Ren Tang
Points	Bleed UB-40, needle DU-14, DU-23, DU-24, GB-20, LI-4, LI-11, REN-9, SJ-5, SP-6, SP-9, ST-8, ST-28, Taiyang, UB-12, UB-20

Wen Bing: Qi Stage Damp-Heat

Clinical Manifestations	Fever (may be unremitting) Achy limbs A stifling sensation in the chest Abdominal distention Nausea and vomiting Dark, scanty, turbid or red urine Diarrhea or constipation Malaise Sore throat Jaundice Thirst with no desire to drink No perspiration Chest discomfort Swollen throat Pressure headache Anorexia Vomiting and diarrhea Unremitting fever Swelling of the lower cheeks Lumbago Heaviness Sweat Orange-yellow body Jaundice Fatigue Lethargy Low back pain Headache Oliguria Irritability Persistent low grade fever Dysentery Simultaneous bitter and sweet tastes in mouth Bowel dysfunction T: Red or normal or Pale white C: Thick greasy and white or Dry and yellow P: Soft and rapid
Treatment Principle	Resolve Dampness Transform turbidity Clear Heat Relieve toxicity
Herb Formulas	Gan Lu Xiao Du Dan
Points

Wen Bing: Ying Stage Heat Attacks The Pericardium

Clinical Manifestations	High fever worse at night Thirst Insomnia Major mental problems Dramatic change of personality Delirium Speech difficulty Aphasia Poor memory Dizziness Maybe fainting Maybe coma Feverish extremities T: Deep red P: Thready and rapid
Treatment Principle	Clear Heat in Pericardium
Herb Formulas	An Gong Niu Huang Wan
Points	To Clear Heat from the Heart: HT-3, PC-8, Sifeng, bleed Shixuan For delirium: PC-7 To detoxify: LI-11 To Pacify Heart and calm the Shen: HT-5, HT-6, HT-7 To Nourish Yin: KI-3, SP-6

Wen Bing: Xue Stage Heat

Clinical Manifestations	High fever Confusion of mind Delirium Mania Dark yellow urine Excessive skin rashes all over body Hemorrhage: Hematemesis Hemoptysis Epistaxis Hemafecia Hematuria T: Deep red, dry or Purple red C: None P: Rapid or Thready and rapid or Thready and feeble
Treatment Principle	Cool the Blood Dispel Heat and Toxins from the Xue Stage Promote Blood Circulation
Herb Formulas	Xi Jiao Di Huang Tang
Points	To clear Heat and Toxins: Bleed the Jing Well points, DU-14, LI-11, ST-44 To promote Blood circulation: SP-10, UB-17 To treat hemafecia: SP-1, ST-25, ST-37 To restore consciousness: DU-26, K-1 To nourish Yin: KI-3, SP-6 To calm the Shen: HT-7

Lung Qi And Yin Deficiency

Clinical Manifestations	Chronic cough or Dry cough Insomnia Night sweats Spontaneous perspiration Weakness Palpitations Shortness of breath Fever Irritability T: Red and dry or Red and swollen C: Little or None P: Thready and weak
Treatment Principle	Replenish Qi and Yin Generate Body Fluids
Herb Formulas	Sheng Mai Yin Wan
Points

Spleen Deficiency Edema

Clinical Manifestations	Edema in limbs, especially lower limbs Maybe anasarca Maybe abdominal distention Loose stools Physical and mental fatigue T: Pale C: White and moist P: Soft and even
Treatment Principle	Warm Yang Strengthen the Spleen Benefit Qi Move water
Herb Formulas	Si Ling San
Points	REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23

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 Gua Di San
Points	LIV-13, LIV-14, PC-6, REN-11, REN-12, SP-4, ST-21, ST-36, ST-44 Epigastric pain due to Food Stagnation in the Stomach: 1. LIV-13, PC-6, REN-12, ST-36, ST-44 2. LIV-13, ST-21, ST-44 3. PC-6, REN-11, ST-36 4. PC-6, REN-10, REN-12, SP-4, ST-21, ST-36 Vomiting due to Food Stagnation in the Stomach: PC-6, REN-12, SP-4, ST-25, ST-36

Liver Qi Stagnation Invading The Spleen

Clinical Manifestations	Abdominal distention and pain Gas Borborygmus Diarrhea Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Emotional tension Irritability Inappropriate anger Fatigue Weakness Cold hands and feet Maybe anorexia A bland taste in the mouth Loose stools Women: Irregular menses Dysmenorrhea Breast distention and pain before and during menses Premenstrual syndrome T: Pale or Dark, fat and swollen C: Thin and white or White and slippery P: Slippery and wiry or Thready and wiry
Treatment Principle	Soothe the Liver Strengthen the Spleen Tonify Qi
Herb Formulas	Chai Hu Gui Zhi Tang With diarrhea: Tong Xie Yao Fang
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37 GB-34, LIV-3, ST-36, UB-18 For more pronounced Qi Stagnation: + PC-6 For more pronounced Spleen Deficiency with fatigue: + UB-20, UB-21 For Phlegm-Dampness: + ST-40 For Liver Qi Stagnation Transforming into Heat: - LIV-3 + LIV-2 With Blood Deficiency: + SP-6, UB-17 With Blood Stasis: + SP-6, UB-17 For abdominal distention and pain: + REN-12 For abdominal distention and pain at the level of the waist: + ST-25 For Liver Qi Invading the Stomach with nausea, vomiting and/or belching: + PC-6, REN-13 For a lack of appetite due to Food stagnation: + ST-21

Liver Qi And Blood Stagnation

Clinical Manifestations	Facial color dark and dull Emaciation Sides and ribs distended on both sides (maybe with sharp pain) Enlargement of the Liver and Spleen Suffocating sensation in chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Dark purple (maybe purple spots on edge of tongue) P: Wiry, choppy and slow
Treatment Principle	Regulate Liver Qi Invigorate the Blood
Herb Formulas	Hepatitis B #1 Ge Xia Zhu Yu Tang
Points

Liver Fire

Clinical Manifestations	Severe, splitting headaches with dizziness Sudden tinnitus or Sudden 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 In severe cases: Mania Hemoptysis Hematemesis Epistaxis Liver Fire Attacks the Lungs: Hemoptysis Rib pain which is severe when coughing Liver Fire Attacks the Stomach: Hematemesis T: Red tip and edges C: Thick, yellow, dry and rough P: Wiry, Excess and rapid
Treatment Principle	Clear the Liver Purge Fire
Herb Formulas	Dang Gui Long Hui Wan Long Dan Xie Gan Tang modified With Qi and Blood Deficiency: Si Wu Tang  modified Chinese Patent Medicines: Long Dan Xie Gan Wan
Points	GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19

Liver And Gallbladder Heat With Stomach Cold

Clinical Manifestations	Alternating chills and fever Pronounced chills with light fever or Chills without fever Cold extremities Aversion to Wind Headache Thirst Sweating on the head Irritability Insomnia Dry cough Tuberculosis Diarrhea Palpitations Loose stools Hypochondriac pain A feeling of fullness and clumping in the chest and hypochondrium Rapid Heart palpitations Dysuria Night sweats Gastric distention T: Moist C: White and slippery P: Wiry and tight on the left or Wiry and slow on the right or Thin and rapid or Irregular
Treatment Principle	Harmonize and release the Shao Yang Disperse clumping Warm the Interior Dispel Cold Dispel water accumulation Clear Heat
Herb Formulas	Chai Hu Gui Zhi Gan Jiang Tang
Points

Liver And Gallbladder Damp-Heat

Clinical Manifestations	Yang jaundice (sclera and skin bright yellow) Fatigue Fever and chills Nausea Gas Pain and fullness in ribs on both sides Maybe pain in the right hypochondrium Bitter taste in mouth Vomiting sour and bitter fluids Anorexia Maybe alternating chills and fever Concentrated, dark urine Abdominal distention Women: Yellow vaginal discharge with foul smell Pruritis vulvae Men: Pain, swelling and burning sensations of testicles T: Pink C: Yellow and greasy or sticky P: Wiry and rapid or Slippery and rapid
Treatment Principle	Clear Dampness Purge Heat from Liver and Gall Bladder
Herb Formulas	Long Dan Xie Gan Tang Hao Qin Qing Dan Tang Xiao Cheng Qi Tang With Heat greater than Dampness: Yin Chen Hao Tang modified With Dampness greater than Heat: Yin Chen Wu Ling San Yin Chen Wu Ling San + Ping Wei San With equal Heat and Dampness: Zhi Zi Bai Pi Tang + Wu Ling San For severe nausea: sip every few minutes. After four hours, the urine will be dark and the abdomen will gurgle. The next day the fever will be reduced or gone. Treat for one to four weeks. Reduce the dosage as you go. Chinese Patent Medicines: Ji Gu Gan Cao Wan Ji Gu Cao Chong Ji Li Dan Pian Long Dan Xie Gan Wan
Points	Dannangxue, DU-9, GB-24, GB-34, LIV-14, SI-4, SP-9, UB-18, UB-19, UB-48 GB-24, GB-34, GB-43, LIV-3, LIV-14, SJ-6, UB-18, UB-19 With severe fever: + DU-14, LI-11 With alternating chills and fever: + GB-39, SJ-5 With nausea: + PC-6 With jaundice: + DU-9 DU-9, GB-34, LIV-3, REN-12, SP-9, ST-36, UB-19, UB-39 With nausea: + PC-6 With hypochondriac pain: + LIV-13, LIV-14, SJ-6 Ear: Liver, Heart, Shenmen, Adrenal, Spleen

Heat In The Liver And Gall Bladder Channels

Clinical Manifestations	Fever Chills Severe headache Flushed cheeks Bad breath Tinnitus Hearing loss Irritability Insomnia Coughing up viscous, thick sputum Dark urine Swollen lymph nodes Abdominal tension and itching Darkened skin Epistaxis Itching Formation of cellulitis T: Red C: Normal or Yellow P: Wiry and rapid
Treatment Principle	Drain Fire Relieve toxicity Spread the Liver Qi Strengthen the Spleen Disperse Wind-Heat
Herb Formulas	Chai Hu Qing Gan Tang
Points

Blood Stagnation In The Lower Jiao Due To Blood Heat

Clinical Manifestations	Firmness and distention in the lower abdomen which is painful and gives resistance on pressure Smooth urination Manic behavior Forgetfulness Black stools that are easy to expel Delayed menstruation Amenorrhea Irregular menstruation Coagulated blood Thirst Dry mouth Polyuria Liver spots indicating stagnant blood found on the face, lips, tongue, limbs and finger nails T: Purplish C: Normal P: Deep, slow and irregular
Treatment Principle	Break up and dispel Blood Stasis Clear Heat
Herb Formulas	Di Dang Tang
Points

Damp-Heat With Unexpelled Wind-Heat And Jaundice

Clinical Manifestations	Generalized yellowing Aversion to Cold Fever Anhidrosis Body aches Aversion to Wind Thirst Nasal congestion Sore throat Edema Constipation Sneezing with clear watery nasal discharge Itchy throat Irritability A stifling sensation in the chest Heat in the joints with pain and swelling Itching Dysuria Expectoration of yellow Phlegm Dark, scanty urination or bloody urination T: Red C: Yellow P: Floating or Slippery and rapid
Treatment Principle	Resolve the Exterior Dissipate Toxins Clear Heat Eliminate Dampness
Herb Formulas	Ma Huang Lian Qiao Chi Xiao Dou Tang
Points

Toxic-Heat

Clinical Manifestations	High fever Fidgeting Thirst with desire for drinks Skin eruptions Jaundice is acute and worsens quickly Dark yellow or gold colored skin Hot feeling of the skin Irritability Insomnia Mania Unconsciousness Hematemesis Epistaxis Hemafecia Delirium Bleeding from the mouth Bruises easily T: Deep purplish or Deep red C: White, greasy and thick, obvious in the middle part or Thin and white, with scanty fluids or Dry yellow P: Wiry and rapid or Thready and rapid
Treatment Principle	Clear Heat Purge Fire Relieve toxicity Cool the Blood
Herb Formulas	Wu Wei Xiao Du Yin Xi Jiao Tang   Huang Lian Jie Du Tang + Yin Chen Hao Tang + Wu Wei Xiao Du Yin modified Xi Jiao San modified With roundworms in the bile duct (sudden jaundice, intermittent boring upper right quadrant pain vomiting of worms): Dan Dao Qu Hui Tang For delirium, loss of consciousness and confusion: An Gong Niu Huang Wan Zhi Bao Dan * If the patient is unconscious, the powder is blown into the nose or given via a nasogastric tube. For constipation, muscular spasms or convulsions: Zi Xue Dan For severe abdominal distention and constipation: Zhi Zi Jin Hua Tang Chinese patent medicines: An Gong Niu Huang Wan Zi Xue Dan Wan Shi Niu Huang Qing Xin Wan
Points	DU-20, DU-26, GB-34, GB-40, LI-11, LIV-3, UB-19, UB-40 With impaired consciousness: bleed Shixuan GB-34, LI-4, PC-6, SP-6, SP-10, UB-19 For verbal delirium, loss of consciousness and obsession: + DU-26 For severe abdominal distention and constipation: + REN-12, SJ-6, ST-25, ST-36

Damp-Heat In The Middle Jiao

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
Points