Acute Pancreatitis

General

Clinical Manifestations
Treatment Principle
Herb Formulas
Points

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) or Watery diarrhea 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 Chinese Patent Medicines: Dao Chi Pian Qing Fei Yi Huo Pian
Points	LI-4, LI-11, SJ-6, ST-25, ST-37, ST-44, UB-25 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 - Yang Ming

Clinical Manifestations	Acute epigastric pain Alternating chills and fever Abdominal pain Constipation or Burning diarrhea Nausea Vomiting Hypochondriac pain Pounding temporal headaches Dizziness Chills Low-grade fever Cold hands and feet Intolerance of Cold Pain in the armpits Unilateral pain in the abdomen and hypochondrium Stiffness and spasms beside and below the umbilicus Pain in the waist and legs T: Normal C: Greasy and white or Greasy and yellow P: Deep, tight and wiry or Wiry and rapid
Treatment Principle	Harmonize and Disperse the Shao Yang Drain Internal Heat Retention
Herb Formulas	Da Chai Hu Tang Chinese Patent Medicines: Qing Fei Yi Huo Pian
Points	Ahshi points along the Stomach channel between ST-36 and ST-39, GB-39, LI-4, PC-7, PC-8, REN-12, SJ-5, ST-21, ST-25, ST-34, ST-36, ST-44 With Yin Deficiency: + UB-21 , UB-23 With vomiting or spitting Blood: + PC-4 With fever: + LI-11 Ear: Stomach, Duodenum, Abdomen, Shenmen, Sympathetic

Wei Stage: Summerheat With Damp

Clinical Manifestations	Acute epigastric pain Fever and chills, fever more pronounced or Tidal fever Fever unrelieved by sweating Abdominal distention Thirst Sweating Stifling sensation in the chest Restlessness Irritability Heaviness of the head and body Muscle aches Nausea Vomiting Severe diarrhea Scanty urine T: Red tip and edges C: Greasy yellow P: Floating, rapid and soft
Treatment Principle	Disperse Wind Clear Heat Resolve Damp
Herb Formulas	Xin Jia Xiang Ru Yin
Points	Ahshi points along the Stomach channel between ST-36 and ST-39, LI-4, PC-7, PC-8, REN-12, ST-21, ST-34, ST-36, ST-44 With Yin Deficiency: + UB-21 , UB-23 With vomiting or spitting Blood: + PC-4 With fever: + LI-11 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 Ear: Stomach, Duodenum, Abdomen, Shenmen, Sympathetic

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

Large Intestine Heat

Clinical Manifestations	Dry stools Knotted constipation Mouth parched Sensation of burning heat, swelling and pain of anus Urine short and dark T: Pink C: Yellow and dry P: Slippery and rapid
Treatment Principle	Clear Heat Purge constipation
Herb Formulas	Liang Ge San
Points	LI-4, LI-11, SJ-6, ST-25, ST-37, ST-44, UB-25

Large Intestine Excess Heat

Clinical Manifestations	Knotted constipation or Watery, thin diarrhea Burning hot sensation in the anus Abdominal distention and pain (dislikes pressure) High fever or infantile tidal fever Hands and feet dripping with perspiration Vomiting Irritating thirst Delirium T: Pink, maybe prickles or Red C: Thick, yellow and dry P: Deep and Excess
Treatment Principle	Clear Excess Heat with bitter, cold, strong purgative herbs
Herb Formulas	Tiao Wei Cheng Qi Tang Xiao Cheng Qi Tang Da Cheng Qi Tang
Points	LI-11, SJ-6, ST-25, ST-37, ST-44

Damp-Heat Injures The Spleen

Clinical Manifestations	Anorexia Abdominal distention and discomfort 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
Treatment Principle	Clear Heat Benefit Dampness
Herb Formulas	Yin Chen Wu Ling San
Points	LI-11, REN-12, SP-9, ST-36, ST-44, UB-20 With DAmp-Heat in the Liver: LIV-3, PC-6, REN-13, SP-6, SP-9, ST-19 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

Excess Heat In The Spleen And Stomach

Clinical Manifestations	Severe constipation (dry knots) Flatulence Focal distention Abdominal fullness Abdominal pain - worse with pressure Tense firm abdomen Tidal fevers Delirious speech Profuse perspiration from the palms and soles Trembling extremities Aversion to Heat Mania Convulsions Abdominal masses Dry mouth Thirst Cracked lips Periumbilical pain Irritability Heavy body Hemorrhoids Fever Cold extremities Perspiration from the head A hot sensation in the sternum and epigastrium Scanty, dark urination Green, watery and foul-smelling diarrhea Abdominal spasms T: Pink with prickles or Red C: Yellow and dry or Black and dry P: Deep, Excess and rapid or Slippery and rapid
Treatment Principle	Strongly purge Heat Accumulation
Herb Formulas	Da Cheng Qi Tang
Points

Stomach Fire

Clinical Manifestations	Burning Heat and pain in the epigastrium The pain is worse with pressure and or spicy hot foods Irritating thirst: drinks copious fluids and prefers cold drinks Epigastric distention Excessive appetite: hungry again quickly after eating (as if food vanishes) Thirst with a desire for cold drinks Swelling, pain, ulceration and bleeding of gums Foul breath Toothache Maybe vomiting right after eating Vomiting acid or undigested food Heartburn Constipation or maybe diarrhea Restlessness Irritability Maybe scanty, red urine T: Red C: Thick, yellow and dry or Peeled or A wide, shallow crack P: Slippery, big, Excess and rapid
Treatment Principle	Clear and Purge Stomach Fire
Herb Formulas	Qing Wei San modified With Damp-Heat: Huang Lian Jie Du Tang With Yin Deficiency: Yu Nu Jian Chinese Patent Medicines: With mouth ulcers: Niu Huang Jie Du Pian With constipation: Niu Huang Qing Huo Wan
Points	Ahshi points along the Stomach channel between ST-36 and ST-39, LI-4, PC-7, PC-8, REN-12, ST-21, ST-34, ST-36, ST-44 With Yin Deficiency: + UB-21 , UB-23 With vomiting or spitting Blood: + PC-4 With fever: + LI-11 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, Abdomen, Shenmen, Sympathetic

Blood Stagnation In The Stomach

Clinical Manifestations	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: Dark purple with purple spots or dots P: Wiry and choppy
Treatment Principle	Invigorate the Blood Adjust Qi Transform Stagnation Stop pain
Herb Formulas	Dan Shen Yin modified Xue Fu Zhu Yu Tang
Points	SP-4, SP-6, SP-10, ST-21, ST-34, UB-17 PC-6, SP-4, SP-6, ST-36, UB-17

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
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

Clinical Manifestations	Distention and pain in the sides or flanks Insidious pain that comes and goes The pain may radiate to the chest, shoulder, upper back and arm Suffocating sensation in the chest Belching Maybe dry heaves Anorexia 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 or Thready and wiry or Deep and thready
Treatment Principle	Soothe the Liver Clear Stagnation
Herb Formulas	Xiao Chai Hu Tang modified
Points	LIV-13, LIV-14, PC-6, SJ-6 For Heat: - PC-6 + GB-34, LIV-2 For nausea and vomiting: + REN-12 For marked Spleen Deficiency: + ST-36 With Blood Stagnation: + SP-6, UB-17 With Food Stagnation: + ST-21 With constipation: + KI-6 With Stomach and abdominal fullness: + REN-12 GB-40, GB-41, LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, PC-6, SJ-6, SP-6, UB-18 LIV-2, PC-6, REN-12 , ST-36, UB-18, UB-21

Liver Qi Stagnation Transforming Into Heat With Food Stagnation

Clinical Manifestations	Stabbing, diffuse pain in the epigastrium that extends to the back Anorexia Alternating chills and fever Abdominal pain Constipation T: Normal or Darkish C: Yellow or Greasy and Yellow P: Wiry and rapid
Treatment Principle	Clear and drain Excess Heat Spread Liver Qi Promote the movement of Qi Alleviate pain
Herb Formulas	Qing Yi Tang modified
Points

Damp-Heat In The Liver And Gall Bladder

Clinical Manifestations	Acute attacks accompanied by chest oppression Pain and fullness in ribs on both sides Persistent hypochondriac and/or epigastric pain which is worse with pressure A dry mouth with a bitter taste Nausea Vomiting sour and bitter fluids Anorexia Aversion to fatty, oily foods Maybe alternating chills and fever Maybe fever or afternoon fever A yellowish body and eyes Concentrated, dark urine Abdominal distention and pain Bound stools or Diarrhea which is yellow or brown and foul smelling or Constipation Maybe jaundice 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 or Wiry, slippery and rapid
Treatment Principle	Clear Dampness Purge Heat from Liver and Gall Bladder
Herb Formulas	Da Chai Hu Tang Long Dan Xie Gan Tang Yin Chen Hao Tang Qing Dan Xie Huo Tang  modified For Heat greater than Dampness: Yin Chen Hao Tang modified Chinese Patent Medicines: Ji Gu Gan Cao Wan Ji Gu Cao Chong Ji Li Dan Pian Long Dan Xie Gan Wan
Points	GB-34, LIV-13, LIV-14, SJ-6, SP-9 With jaundice: + DU-9, UB-18 With Blood Stagnation: + SP-6, UB-17 For Qi Stagnation Transforming into Heat: + LIV-2 With nausea and vomiting: +REN-12 With Spleen Deficiency: + ST-36 With Food Stagnation: + ST-21 With constipation: + KI-6, ST-25 With Stomach and abdominal fullness: + REN-12 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 Dannangxue, DU-9, GB-24, GB-34, LIV-14, SI-4, SP-9, UB-18, UB-19, UB-48 For Heat greater than Dampness: DU-9, GB-34, LIV-3, SI-4, SP-9, UB-19 With severe fever: + DU-14, LI-11 With nausea: + PC-6 With hypochondriac pain: + LIV-13, LIV-14, SJ-6

Heat And Water Accumulation In The Chest And Epigastrium

Clinical Manifestations	Fullness and hardness of the epigastrium and/or abdomen Lower abdominal pain Severe pain that becomes unbearable with the slightest pressure Tidal fever at dusk Shortness of breath Severe constipation Thirst Irritability Restlessness T: Normal C: Very dry P: Deep, tight and forceful
Treatment Principle	Drains Heat Purge Water Accumulation
Herb Formulas	Da Xian Xiong Tang
Points

Phlegm-Heat

Clinical Manifestations	Prolonged, nagging epigastric pain and distention Patient tends to be overweight Cough with sticky, yellow, difficult to expectorate sputum Rapid breathing with a harsh voice Restless fever Sore throat Constipation Thirst with no desire to drink Dry stools Alternating constipation and diarrhea Variable appetite Mania Shortness of breath Dyspnea Nausea Vomiting Chest and/or epigastric fullness A heavy sensation in the body Lethargy Pain in the ribs T: Scarlet C: Yellow or Yellow and greasy or Yellow and smooth P: Rapid and smooth or Slippery and rapid
Treatment Principle	Clear Heat Resolve Phlegm Soothe the Liver Harmonize the Stomach
Herb Formulas	Xiao Xian Xiong Tang  modified Chinese Patent Medicines: Qing Qi Hua Tan Wan Wen Dan Wan
Points	Ahshi points along the Stomach channel between ST-36 and ST-39, LI-4, PC-7, PC-8, REN-12, ST-21, ST-34, ST-36, ST-40, ST-44 With Yin Deficiency: + UB-21 , UB-23 With vomiting or spitting Blood: + PC-4 With fever: + LI-11 LI-11, LU-5, ST-40, UB-13 Ear: Stomach, Duodenum, Abdomen, Shenmen, Sympathetic

Roundworms

Clinical Manifestations	Paroxysmal, severe pain in the upper abdomen Pain worse with pressure No fever at first Fever when severe Occasional vomiting of roundworms T: Pink C: Thin and white or Thin and yellow P: Deep and tight or Wiry and rapid
Treatment Principle	Promote Liver functions Eliminate Heat Clear roundworms
Herb Formulas
Points	Dannangxue, GB-24, REN-12, ST-19