Amenorrhea

General

Clinical Manifestations	Primary amenorrhea: After 18 years old, the patient still does not have menstruation Secondary amenorrhea: Menstruation stops for more than three months before normal menopause Normal times for amenorrhea: Pregnancy During puberty when period is not yet regulated During breast-feeding
Treatment Principle
Herb Formulas	Xiao Chai Hu Tang
Points	PC-5, REN-6, SP-6, SP-10, ST-25 For digestive problems: moxa or moxa needle UB-18, UB-20, UB-21 For the Yang Wei channel: SP-10, REN-6 For restlessness: SP-6 For cough: LU-5, LU-9 For parasites: ST-4, ST-36 For Yang Qi: DU-4 For overwork: moxa or moxa needle UB-43 For Yin Qi: UB-23, KI-7 To strengthen the Middle Jiao: REN-12, UB-20, UB-21 UB-17, UB-23, SP-6, SP-8, SP-10, ST-30 Reduce SP-6, LI-13, Tonify LI-4, ST-30, ST-36, SJ-13, LIV-13, LIV-14, REN-3 For emotional causes : + PC-9 LI-4, SP-6 UB-43, ST-25, ST-36 LIV-8 REN-2, REN-3, ST-29 UB-60, REN-2, DU-1 SP-5, REN-3 KI-3, LU-7 ST-30, KI-5 DU-4, GB-26, GB-33, REN-4, SP-8, UB-26, UB-32 DU-3, KI-15, SP-6, UB-23, UB-33 LI-4, REN-3, REN-6, SP-6, UB-23 DU-3, DU-4, GB-26, KI-15, REN-3, REN-4, SP-6, SP-8, UB-23, UB-26, UB-32, UB-33 DU-1, DU-4, KI-12, KI-14, LI-4, REN-2, REN-3, REN-4, SP-6, SP-8, SP-10, ST-29, UB-23, UB-25, UB-60 LI-4, REN-3, SP-6, UB-23 LI-11, SJ-6, SP-6, ST-36 Moxa or moxa needle DU-2, KI-6 REN-6, SP-6, UB-18 PC-6, SP-4 With a yellowish complexion and vomiting: LI-11, SJ-6, SP-6, ST-36 With lower abdominal pain and stiffness: GB-26, GB-43 Ear: 1. Endocrine, Kidney, Liver, Spleen, Shenmen, Subcortex 2. Internal Secretion, Kidney, Liver, Spleen, Shenmen, Subcortex Cutaneous: Huatoujiaji from T-11 to S-4, KI-5, LIV-2, LIV-3, LIV-6, SP-3, SP-6, SP-9, ST-36, UB-18, UB-20, UB-23 For menstruation in the elderly: moxa or moxa needle REN-4, ST-36, SP-6 (if occurring more than six months after the onset of menopause, check for cancer)

Wind-Cold With Interior Qi Stagnation

Clinical Manifestations	Aversion to Cold Fever Headache Anhidrosis Anorexia Belching Aching shoulders Tinnitus Focal distention in the chest and epigastrium A stifling sensation in the chest and epigastrium Vertigo Nausea Amenorrhea T: Normal C: Thin and white P: Floating
Treatment Principle	Regulate Qi Release the Exterior
Herb Formulas	Xiang Su San
Points

Jue Yin Cold

Clinical Manifestations	Long standing cold hands and feet that are cold to the touch and feel cold to the patient Maybe lumbago and leg pain Abdominal pain and distention Midline pain Uterine pain Chills Diarrhea Menstrual abdominal pain Maybe chest pain Increased sweating, particularly of the feet Increased salivation Spasm and pain of the limbs Scanty urination Pain at the waist, hips, legs and feet Sciatica Joint pain Irregular menstruation Abdominal Cold Migraine headache Vaginal discharge T: Pale C: White P: Deep and thready (may be almost imperceptible).
Treatment Principle	Warm the channels Disperse Cold Nourish the Blood Unblock the Blood vessels
Herb Formulas	Dang Gui Si Ni Tang
Points	Moxa REN-4, REN-6, REN-8, REN-9, REN-12, ST-25

Lung And Spleen 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 Amenorrhea 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	Shen Ling Bai Zhu San
Points	LU-9, REN-17, SP-3, ST-36, UB-13, UB-20, UB-43

Lung And Kidney Yin Deficiency

Clinical Manifestations	Calcaneus pain May be bone spur Unproductive cough or Scanty, sticky phlegm or Sometimes blood-streaked sputum Dry mouth Dry throat Low back and knees sore and weak "Steaming Bone" tidal fever Night sweats Malar flush Maybe hoarse voice Maybe pain in shin, foot, and heel Spermatorrhea Irregular menses T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Lungs and Kidneys
Herb Formulas	Ba Xian Chang Shou Wan
Points	HT-6, KI-3, KI-6, LU-6, LU-9, UB-13, UB-23

Spleen And Stomach Qi Deficiency Leads To Blood Deficiency

Clinical Manifestations	Scant, light colored discharge Delayed menstruation leading to amenorrhea Pallor Cold extremities Dizziness General lassitude Palpitations Shortness of breath Anorexia Frequent abdominal distention Loose stools T: Pale C: Sticky and white P: Weak, thready and slow
Treatment Principle	Tonify the Spleen and Stomach
Herb Formulas	Bu Zhong Yi Qi Tang modified
Points	REN-6, SP-6, ST-36, UB-13, UB-20, UB-21

Spleen And Kidney Yang Deficiency

Clinical Manifestations	Early menstruation Late menstruation Scanty menses Light-colored menses Menses may be mixed with leukorrhea Low back pain that can be severe Soft stools Distention in the lower abdomen A sense of prolapse in the lower abdomen Anorexia Fatigue Light headedness Dizziness Frequent erotic dreams Tinnitus Urinary frequency at night Weakness in the lower limbs Vertigo T: Pale C: Thin P: Deep and frail
Treatment Principle	Enrich and tonify the Kidneys Nourish the Liver Regulate the Chong and Ren channels Regulate menstruation Strengthen the Spleen
Herb Formulas	Gu Yin Jian With water flooding: Zhen Wu Tang
Points	Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23

Cold-Damp Distresses The Spleen

Clinical Manifestations	Distention and fullness of the epigastrium and abdomen Nausea and vomiting Anorexia Loose stools Reduced sensation of taste No thirst or preference for hot drinks Sticky sensation in mouth Borborygmus Lassitude Yin jaundice Heavy head Maybe edema Maybe copious white vaginal discharge Maybe cold limbs, fear of cold, feeling chilled T: Pink C: Thick, white and greasy or sticky P: Deep and slow
Treatment Principle	Warm Cold Transform Dampness Harmonize the Stomach Strengthen the Spleen
Herb Formulas	Ping Wei San
Points	Moxa or moxa needle SP-3, SP-5, SP-6, SP-9, ST-36, UB-20, REN-12 To Regulate Qi and Disperse Dampness: REN-6 For Cold-Damp Vaginal Discharge: Moxa or moxa needle GB-26, UB-30, REN-6, SP-6, REN-4, ST-36

Disharmony Between The Stomach And Intestines With Cold And Heat

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 Blood And Spleen Qi Deficiency

Clinical Manifestations	Palpitations Insomnia Much dreaming Easily startled Poor memory Four limbs tired and lethargic Loss of appetite Distention and fullness of the epigastrium and abdomen Loose stools Sallow complexion Copious, pale menses Uterine bleeding or Light menstrual flow or Amenorrhea T: Pale C: White P: Thready and weak
Treatment Principle	Reinforce and Benefit the Heart and Spleen
Herb Formulas	Gui Pi Tang
Points	UB-15, UB-20, ST-36, SP-1, SP-6, REN-4, HT-7

Heart Yin And Blood Deficiency

Clinical Manifestations	Amenorrhea after the menses has stopped suddenly in the middle of menstruation No pain No distention in the lower abdomen Heart palpitations when Scared or nervous Timidity or Nervousness Sweating on movement Insomnia Diminished memory Facial complexion pale but flushed red T: Normal C: Dry and light P: Empty and fine
Treatment Principle	Nourish Yin Nourish Blood Tonify the Heart
Herb Formulas	Tian Wang Bu Xin Dan
Points	HT-7, KI-3, PC-6, PC-7, UB-15, UB-23

Lack Of Communication Between The Heart And Kidneys

Clinical Manifestations	Amenorrhea Insomnia with much dreaming Irritability Easily startled Palpitations Poor memory Dizziness Tinnitus Low back soreness Legs weak Tidal fever Night sweats Dry mouth Red cheeks Urine short and red T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Reduce Fire Make the Hear and Kidneys communicate.
Herb Formulas	Jiao Tai Wan #1 Tian Wang Bu Xin Dan Liu Wei Di Huang Wan Ba Xian Chang Shou Wan Amenorrhea #2 With Kidney Yang Deficiency: Jiao Tai Wan
Points	HT-7, KI-3, PC-6, PC-7, UB-15, UB-23

Small Intestine Heat Attacks The Large Intestine

Clinical Manifestations	Irritability Ulceration and erosion of mouth and tongue Sore throat Dry mouth Thirst Desire for cold drinks Maybe deafness Urination short, dark, difficult and painful or Hematuria or Pain in urethra Fullness and distention of lower abdomen Constipation T: Red C: Yellow P: Slippery and rapid
Treatment Principle	Clear Excess Heat Promote diuresis Purge the Intestines
Herb Formulas	Dao Chi (Re) Sanmodified
Points	HT-8, LIV-2, REN-3, SJ-6, SP-6, SP-10, ST-25, UB-27 PC-7, REN-4, SJ-6, ST-25

Liver Qi Stagnation

Clinical Manifestations	Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Dizziness Headache Depression Irritability Inappropriate anger Irregular menses Amenorrhea Dysmenorrhea Breast distention and pain before and during menses Distention and pain in the chest and hypochondrium Low back pain Leukorrhea Anorexia T: Pink C: Thin and white or White and sticky P: Wiry or Wiry and thready
Treatment Principle	Soothe the Liver Clear Stagnation
Herb Formulas	Chai Hu Shu Gan Tang Wu Yao Tang Xiao Yao San  modified Kai Yu Er Chen Tang
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

Liver Qi Stagnation With Kidney Deficiency

Clinical Manifestations	Irregular periods Scanty bleeding Clots in the menstrual Blood Abdominal distention Breast distention Premenstrual tension Depression Sighing Irritability T: Normal or Slightly red on the sides C: Normal P: Wiry
Treatment Principle	Nourish the Blood Invigorate the Blood Regulate menstruation Tonify the Kidneys Benefit the Spleen
Herb Formulas	Ding Jing Fang
Points

Liver Qi And Blood Stagnation

Etiology	Cold invasion and stress lead to Qi and Blood stagnation
Clinical Manifestations	No period Chronic stabbing pain in the chest Pain in the hypochondrium Chronic, stubborn headache with a fixed, piercing quality Palpitations Chronic incessant hiccups Five sole Heat Choking sensation when drinking Dry heaves Depression or low spirits with a sensation of warmth in the chest Chest distention Dry, scaly skin Dark rings under the eyes Spider naevi on the cheeks, nose, trunk, inner knee and ankle Dizziness Chronic tinnitus Chronic gum disease with dark, purplish, patchy or dark, red atrophic gums Loose teeth Painful receding gums Lower abdominal pain with guarding Frequently bleeding gums	Vomiting after intake of water Chest and subcostal distending pain Persistent daytime drowsiness Insomnia (persistent with much dreaming) Restless sleep Forgetfulness Irritability Fidgeting Agitation Irascibility A bad temper Extreme mood swings Evening tidal fever Dark or purplish lips, conjunctiva or nail beds Dark complexion Dark sclera Hair loss on the head and body T: Dark-red with purple spots on the edges or Cyanotic or speckled with purpuric spots P: Choppy or Wiry and tight or Wiry and choppy or Thready or Deep and choppy or Wiry
Treatment Principle	Invigorate the Blood Dispel Blood Stasis Spread Liver Qi Unblock the channels Stop pain Promote menstruation
Herb Formulas	Xue Fu Zhu Yu Tang Jia Wei Xiao Yao San Wen Jing Tang Wu Yao San Ge Xia Zhu Yu Tang Dang Gui Bu Xue Tang Shi Xiao San Due to Heat Congestion: Tao Hong Si Wu Tang
Points	REN-3, REN-4, Zigong For Heat Congestion:REN-3, REN-4, Zigong, SP-6, SP-10, GB-34, LIV-5, LIV-3

Liver Fire Attacks The Stomach

Clinical Manifestations	Restlessness Easily angered Regurgitation of gastric acid Stomach pain Hungers easily Dry mouth Bitter taste in mouth T: Red C: Yellow P: Wiry and Rapid
Treatment Principle	Reduce Liver Fire
Herb Formulas	Hua Gan Jian
Points	ST-36, REN-12, SP-4, PC-6, LIV-2, LIV-14, LI-4, LI-11 PC-6, ST-36, REN-12, LIV-2, LIV-3

Liver Fire Generates Heart Fire

Clinical Manifestations	No period Heart vexation Easily angered Constipation Hot, red urination Insomnia Restlessness T: Red or Crimson C: Little P: Thin, Wiry and rapid
Treatment Principle	Calm the Liver Drain Fire Clear the Heart Clear the channels or menses
Herb Formulas	San Huang Xie Xin Tang modified Amenorrhea #4
Points

Liver Yin Deficiency

Clinical Manifestations	Dizziness Blurred vision Impaired vision Dry eyes Night blindness Tinnitus Headache Nervousness Insomnia with much dreaming Dry throat Thirst Five sole heat (palms, soles and center of chest) Night sweats Light or late menses or Amenorrhea T: Red C: Little P: Thready, wiry and rapid
Treatment Principle	Nourish Yin Nourish the Liver
Herb Formulas	Yi Guan Jian With Liver Yang Rising: Jian Ling Tang
Points	KI-3, LIV-3, UB-18, UB-23

Liver Blood Deficiency

Clinical Manifestations	Pale complexion Pale lips Blurred or failing vision Spots before eyes Dizziness Dry eyes Pale nail beds Irritability Frightens easily Insomnia with much dreaming Tinnitus Numbness of limbs Light menses or amenorrhea Late menses T: Pale C: Little P: Thready
Treatment Principle	Nourish Liver Blood
Herb Formulas	Si Wu Tang Hei Xiao Yao San Bu Gan Tang Hei Xiao Yao San Si Wu Tang Jia Wei With Kidney Yin Deficiency: Yi Shen Tong Jing Tang
Points	Moxa or moxa needle  REN-4, ST-36, UB-17, UB-18, UB-20tonify LIV-3, SP-6 GB-37, LIV-3, ST-36, UB-18, UB-20

Liver Blood Deficiency Generates Wind

Clinical Manifestations	Pale complexion Pale lips Blurred or failing vision Spots before eyes Dizziness Dry eyes Pale nail beds Irritability Frightens easily Insomnia with much dreaming Tinnitus Numbness of limbs Tremor, spasms or involuntary movements (chorea) Involuntary shaking of head Light menses or amenorrhea Late menses Tic or tremor of hands and feet Maybe trismus T: Pale C: Little P: Thready and wiry
Treatment Principle	Nourish Liver Blood Extinguish Wind
Herb Formulas	Si Wu Tang
Points	DU-16, DU-20, GB-20, LIV-3, REN-4, SP-6, ST-36, UB-17, UB-18, UB-20

Liver Blood And Kidney Yin Deficiency

Clinical Manifestations	A young woman has reached 18 years of age and her menses Have not come or At the beginning of the tide it is comparatively slow or tardy, or The menses has come but eventually becomes later and scantier and evolves into amenorrhea A dark, gloomy facial complexion Dizziness Tinnitus Soreness and weakness of the low back and knees Possibly a dry mouth and throat Tidal fever Night sweats Both cheeks tidally red Five sole Heat Dry skin Dry, astringent eyelids Constipation Scanty, reddish urination Heart palpitations T: Red or Pale C: Scanty P: Deep and wiry or Deep and thready or Possibly floating at the inch and/or cubit positions if Yin fails to control Yang or Rapid if there is Heat
Treatment Principle	Tonify the Kidneys Nourish the Liver Regulate menstruation With Deficiency Heat: Nourish Yin Clear Heat
Herb Formulas	Liu Wei Di Huang Wan modified Gui Shen Wan modified Zi Lu Xian Zong Tang Jia Wei
Points

Liver And Spleen Deficiency With Blood Stagnation Due To Dampness

Clinical Manifestations	Continuous cramping pain in the abdomen Pain is not severe Pain is relieved by pressure Edema of the feet Urinary difficulty Slight edema (primarily of the lower limbs) Symptoms generally occur during pregnancy Pale face Fatigue Heaviness of head Lassitude Lower abdominal pain Dizziness Tinnitus Lumbago Edema Abdominal pain with edema during pregnancy due to Blood Deficiency and abnormal water circulation Oliguria	Palpitations Cold feet Extreme coldness of the hands and feet Vertigo Weakness and numbness of lower back and legs during pregnancy or postpartum Mal position of the fetus Dysmenorrhea Irregular menstruation Right upper quadrant pain Hepatomegaly Anemia Lack of energy Sore back Thirst with no desire to drink T: Pale or pink maybe petechiae on margin C: Thin or Greasy white P: Deep and weak or Soft, floating, small and slow or Wiry and small or Wiry and rough
Treatment Principle	Nourish Liver Blood Soften the Liver Spread Liver Qi Strengthen the Spleen Resolve Dampness
Herb Formulas	Dang Gui Shao Yao San
Points

Liver And Kidney Yin Deficiency

Etiology	Body constitution tends to be weak, with aching weakness in the waist and knees, dizziness and tinnitus. The tongue is pale red, with slight coating, and the pulse is deep and feeble or threadlike
Clinical Manifestations	Low back, knees and legs painful and weak Foot pain Light-headedness Vertigo Tinnitus Diminished hearing Five sole Heat Chronic dry, sore throat Toothache Wasting and thirsting disorder (Xiao Ke) Dizziness Muscular weakness Dry skin Deafness Steaming bones Tidal fevers Loose teeth Dripping urine Thirst Dry tongue Numbness and weakness at the waist and knees Heel pain Dry mouth Blurred vision Hemoptysis Asthma Hot flashes Nocturnal emissions Urinary incontinence Spontaneous and nocturnal emissions Night sweats T: Red C: Little or None P: Thready and rapid
Treatment Principle	Enrich Yin Astringe and Nourish the Essence of the Liver and Kidneys
Herb Formulas	Tiao Gan Tang Mai Wei Di Huang Wan Yi Guan Jian modified Dang Gui Yu Zhu Tang Qi Ju Di Huang Wan With Dry Blood: Yi Yin Jian modified Liu Wei Di Huang Wan With Empty Fire Rising: Zhi Bai Di Huang Wan Zuo Gui Wan Severe: Gui Shen Wan
Points	UB-18, UB-23, SP-6, LIV-3, KI-3

Kidney Yang Deficiency

Etiology	Young age: The essence can’t transform the Blood and the Liver has no Blood to store so the Chong and Ren meridians never receive any blood Poor diet Over sexual activity The Ming Men Fire is deficient creating deficient Cold blocking the meridians.
Clinical Manifestations	No period The cycle slowly gets slower and slower until it gradually stops Weak body symptoms Facial complexion dull and dark Dizziness Frequent urination, especially at night Profuse urine Tinnitus Pain in the lower back Weakness of lower back Weakness of the knees Weary limbs A feeling of chilly pain in the lower abdomen which desires warmth and pressure Clear, thin vaginal discharge T: Pale and moist C: Thin and white P: Weak and deep or Weak, deep and tight or Deep, fine and forceless
Treatment Principle	Tonify the Kidneys Promote menstruation
Herb Formulas	Gui Shen Wan modified Jin Gui Shen Qi Wan Amenorrhea #2 You Gui Wan
Points	REN-3, REN-4, ST-36, SP-6, KI-3, Zigong, UB-17, UB-18, UB-20, UB-23 With hot flashes: + UB-43

Kidney Yin Deficiency With Fire Flaring

Clinical Manifestations	Night sweats Dry mouth and tongue Lower back and knee pain Urinary difficulty Weakness of the lower back, knees and extremities Steaming bones Light-headedness Vertigo Tinnitus Diminished hearing Five sole heat Chronic dry, sore throat Toothache Wasting and thirsting disorder (Xiao Ke) Dizziness Muscular weakness Irritability Dry skin Deafness Spontaneous and nocturnal emissions Tidal fevers Loose teeth Dripping urine Thirst Swollen gums, painful and light red in color Numbness and weakness at the waist and knees Heel pain Urinary incontinence Pain at midline and in lower back Sore throat T: Red C: Little or None P: Thready and rapid (large at the Kidney positions)
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zhi Bai Di Huang Wan
Points	KI-1, KI-2, KI-3, KI-6, REN-4, SP-6, UB-23

Kidney Yin Deficiency Leads To Blood Deficiency

Clinical Manifestations	Night sweats Backache Lower back pain Five sole heat Dizziness Tidal fevers Palpitations Occasional cough Shortness of breath Emaciation Pallor T: Pale or Slightly bright C: Little or None P: Deep, weak, rapid and feeble
Treatment Principle	Nourish the Kidneys Nourish the Blood
Herb Formulas	Ren Shen Yang Rong Tang With over-secretion of milk: Shi Quan Da Bu Tang With Excess sexual strain: Liu Wei Di Huang Wan With cardiac and pulmonary complications: Yi Guan Jian For Blood deficiency with Excess Heat: Bai Zi Ren Wan
Points	KI-3, KI-7, REN-4, SP-6, UB-17, UB-23

Kidney Yin And Yang Deficiency

Clinical Manifestations	Amenorrhea or Infrequent periods or Delayed menstruation Emaciation Hirsuitism or Pilosity Lumbar soreness Dizziness Aversion to Cold Loose stools Lassitude T: Pale or Reddish C: Little or None P: Deep and thready
Treatment Principle	Warm and supplement Kidney Yang Regulate and rectify the Chong and Ren
Herb Formulas	Zuo Gui Yin modified With Fire Rising: Er Xian Tang
Points	To regulate conception vessels and dissipate masses: LU-7, KI-6 To transform Damp from genital system: REN-3, ST-28, UB-32 To resolve Dampness and Phlegm: SP-9, ST-40 To tonify kidney Yang: moxa KI-3, REN-4, KI-7, UB-23 To tonify the Spleen and resolve Dampness and Phlegm: UB-20, ST-36 To invigorate the Blood: UB-17, SP-10, ST-29 To tonify Spleen and Kidney: SP-6 To stimulate ovulation: Zigong

Kidney Qi Deficiency

Clinical Manifestations	Amenorrhea Frequent urination Copious amounts of clear urine Incontinence of urine Enuresis Abortion or miscarriage Either a tendency towards being too hot of too cold Shortness of breath Asthma Cold limbs Weak back and knees T: Pale C: White P: Deep, weak possibly tight
Treatment Principle	Tonify Kidney Qi Consolidate the Chong and Ren channels
Herb Formulas	Gu Yin Jian modified Amenorrhea #3
Points

Kidney, Spleen And Heart Deficiency

Clinical Manifestations	Irregular periods Scanty bleeding Clots in the menstrual Blood Abdominal distention Breast distention Premenstrual tension Depression Sighing Irritability T: Normal or Slightly red on the sides C: Normal P: Wiry
Treatment Principle	Nourish the Blood Invigorate the Blood Regulate menstruation Tonify the Kidneys Benefit the Spleen
Herb Formulas	Ding Jing Tang Generates Jing Deficiency: Huan Shao Dan
Points

Yin And Yang Deficiency

Clinical Manifestations	Coughing and wheezing which is worse on exertion Expectoration of frothy or dark-streaked mucus A mild tidal fever A cold body Aversion to Cold Spontaneous sweating Night sweats Superficial and facial edema Mouth and tongue ulcers Emaciation Anxiety Nervousness Dark lips Anorexia Loose stools or "Cockcrow diarrhea" Amenorrhea Impotence T: Red, dry and peeled or Pale, purplish and swollen with teethmarks C: White or none P: Minute, thready and rapid or Deficient and large
Treatment Principle	Nourish Yin Tonify Yang Support Yuan Qi Consolidate the root Kill the pathogen
Herb Formulas	Bu Tian Da Zao Wan Chinese Patent Medicines: Chuan Lu Wan Ge Jie Bu Shen Wan
Points	REN-6, UB-13, UB-15, UB-17, UB-19, UB-43 With Bone-Steaming fever: + DU-14, KI-3, LU-10, PC-8 With night sweats: + HT-6, KI-7 With hemoptysis: + LU-6, UB-17 With a hoarse voice: + LI-18, LU-9

Yin And Blood Deficiency

Etiology	There is no source of Blood, so the Sea of Blood is dry.
Clinical Manifestations	Scanty menstruation which slowly becomes smaller and disappears Soreness of the lower back Abdominal pain Emaciation Achy and uncomfortable flesh and bones of the hands and feet Five sole Heat Anxiety Dizziness Light headedness Tidal fever Fever with exhaustion Recurrent fever with night sweats or hemoptysis General disquietude Gradually worsening afternoon fevers T: Red C: Scanty P: Thready and rapid
Treatment Principle	Nourish Yin and Blood Clear Deficient Heat Regulate menstruation
Herb Formulas	Nu Ke Bai Zi Ren Wan Yi Yin Jian Gua Shi Tang Yi Guan Jian Yi Guan Jian #2 Liu Wei Di Huang Wan Bai He Gu Jin Tang
Points	HT-6, HT-7, KI-3, KI-6, KI-7, LU-7, LU-9, REN-3, REN-4, REN-6, SP-6, UB-13, UB-15, UB-17, UB-18, UB-20, UB-23, UB-32

Qi And Blood Deficiency

Etiology	Spleen and Stomach deficiency do not produce Blood so there are no stores of blood. There is no Qi to push and move Blood out of uterus.
Clinical Manifestations	No period Menstruation gradually disappears The menses is light-colored and thin A constant ache in the lower abdomen that occurs during or just after menstruation The pain responds favorably to pressure Pale or sallow complexion Dizziness with blurred vision Vertigo Palpitations Shortness of breath, Thirst Listlessness Lethargy Anorexia Weak limbs Withdrawn behavior Restlessness Insomnia Sensation of Heat Lusterless hair and skin Loose stools T: Pale C: Thin white P: Thin and frail or Empty or Deep and even or Deep and retarded Due to severe postpartum hemorrhage: Lack of interest Vaginal dryness Vulvar and axillary hair loss Reduced libido Genital atrophy
Treatment Principle	Tonify Qi and Blood Promote menstruation
Herb Formulas	Sheng Yu Tang Ren Shen Yang Rong Tang modified Ba Zhen Tang modified Nu Ke Ba Zhen Wan modified Shi Quan Da Bu Tang With hemorrhage: Ren Shen Yang Rong Tang With Cold: Fu Ke Zhong Zi Wan
Points	REN-4, REN-6, SP-6, ST-36, KI-3, UB-13, UB-15, UB-17, UB-18, UB-20, UB-23, PC-6, HT-7 Ear Points: Ovary, Kidney, Zigong

Qi And Blood Stagnation

Clinical Manifestations	Delayed menstruation Scanty periods with clots Abdominal pain during menstruation Amenorrhea for several months Infertility Mental depression Distending fullness in the chest and hypochondria Dizziness Heart vexation Easily angered Breast distention and pain Hiccups Twitching and spasm of the sinew vessels A sore feeling in the extremities and body The facial complexion is dusky and stagnant Bitter taste in the mouth Dry throat Constipation Reddish urine T: Red edge and tip or Purplish and may have Maculae or spots of static blood on its border C: Normal or Slightly yellowish P: Deep and wiry or Small and wiry or Wiry and forceful or Thready and choppy or Deep and choppy
Treatment Principle	Activate Qi Invigorate the Blood Break up Stasis
Herb Formulas	Ge Xia Zhu Yu Tang Wu Yao San Si Ni San modified + Gui Zhi Fu Ling Wan modified Dysmenorrhea #2 Tong Yue Jian Xue Fu Zhu Yu Tang  modified
Points	DU-20, ST-25, ST-29, REN-3, Moxa REN-4, REN-6, REN-8, Electro-acupuncture UB-23, UB-32. UB-52 For strengthening Spleen Qi: ST-36, SP-10, ST-40, SP-9, SP-6, UB-20 For warming Kidney Yang: UB-23, UB-25, DU-4, DU-3, KI-7, KI-6 For nourishing Kidney Yin: UB-23, KI-3, SP-6, PC-6 For soothing Liver Qi and resolving Blood Stasis: UB-17, UB-18, SJ-5, LI-4, SP-6, LIV-3, GB-41

Qi , Blood And Phlegm Stagnation

Clinical Manifestations	Immobile masses below the hypochondrium or in the abdomen Abdominal pain Emaciation Poor appetite Alternating chills and fever Amenorrhea Hard abdominal masses that produce pain Aggravated by pressure Hypochondriac distention T: Purple with echymoses P: Choppy
Treatment Principle	Invigorate the Blood Remove Stasis Circulate Qi Resolve Phlegm Eliminate accumulations Soften and resolve hard masses
Herb Formulas	Bie Jia Jian Wan
Points

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 Transforms Phlegm Descend Qi Dissipate accumulations Reduce Food Stagnation Invigorate the Blood Stop pain
Herb Formulas	Kai Yu Zheng Yuan San
Points

Blood Deficiency

Clinical Manifestations	Delayed menstruation leading to amenorrhea Fatigue Anorexia Restless fetus General weakness Light red Blood Constant lower abdominal pain Insomnia A pale or sallow complexion Lassitude Palpitations Incessant coughing Malar flush Ptosis of the viscera Dizziness Dry skin Emaciation Gaunt appearance Lethargy Low grade fever May be night sweats Loose stools T: Pale C: Slippery or Thin and white P: Slippery and forceless or Deep and weak or Forceless or Weak and floating
Treatment Principle	Nourish the Blood Nourish the Liver, Spleen and Kidneys
Herb Formulas	Tai Shan Pan Shi San Bai Zi Ren Wan Si Wu Tang
Points	REN-4, REN-6, SP-6, ST-36, KI-3, UB-13, UB-15, UB-17, UB-18, UB-20, UB-23, PC-6, HT-7 REN-4, SP-6, ST-25, ST-36, UB-18, UB-20, UB-23 REN-7, SP-6, SP-10, UB-17, UB-23 UB-42, UB-43, REN-4, ST-36 With Yang Deficiency: 1. Moxa REN-4, REN-6, REN-12, SP-6, ST-36, UB-18, UB-20, UB-21, UB-43 2. Moxa or reinforce REN-4, ST-36, UB-20, UB-21, UB-23, UB-43

Blood Deficiency With Heat

Clinical Manifestations	Amenorrhea Heartburn Nervous agitation Afternoon fever Bitter taste in the mouth Thirst Emaciation Dry stools Scant, reddish urine Early menstruation leading to amenorrhea T: Scarlet C: Dry, thin and yellow or Peeled P: Thready, wiry and rapid
Treatment Principle	Clear Heat Nourish Yin
Herb Formulas	Yi Guan Jian
Points	KI-3, LIV-3, LIV-8, REN-4, SP-6

Blood Stagnation

Clinical Manifestations	Amenorrhea Sudden onset Irregular menstruation Palpable masses that may or may not be painful Lower abdominal pain without palpable masses Pain worse with pressure Lower abdominal distention and hardness Lower back pain Lower abdominal distention during menstruation Frequent menstruation (3-5 timer per month) Spotting Dark purple menstrual Blood (usually with clots) Abnormal uterine bleeding with abdominal soreness and pain Aversion to Cold Chest congestion Flank pain Depression Cold extremities Dry, flaky skin White vaginal discharge T: Pale or With purple spots C: White P: Choppy or Deep and wiry or Deep, tight and choppy With Heart Heat: Constipation Black rings around the eyes Thirst T: Red C: Yellow P: Thready and rapid
Treatment Principle	Invigorate the Blood Dispel Stasis Regulate menstruation
Herb Formulas	Shao Fu Zhu Yu Tang Xue Fu Zhu Yu Tang Tao Hong Si Wu Tang Gui Zhi Fu Ling Wan Da Huang Zhe Chong Wan Si Wu Tang modified Di Dang Tang Dai Di Dang Wan modified Shi Xiao San Aloe and Scirpus Formula Citrus and Cyperus Combination Codonopsis and Coix Combination Hysteromyoma #2 Leech and Sargassum Combination Zedoaria and Dang Gui Combination With Kidney Deficiency: Ding Jing Tang With Heat: Xia Yu Xue Tang With Heat, hard accumulations and constipation: Da Huang Zhe Chong Wan With Damp-Heat: Da Huang Xiao Shi Tang With Toxic-Heat: Gong Nei Sheng Zhang Chi Huan Wan With Phlegm Stagnation: Gui Ling Xiao Liu Wan Postpartum: Qing Hun San
Points	REN-3, REN-4, Zigong, SP-10, UB-17 LI-4, LIV-2, REN-3, SP-6, SP-10, ST-29, UB-32 LI-4, LI-11, LIV-2, REN-4, SP-6, SP-10, UB-25 LI-4, LIV-2, LIV-8, SP-6, SP-8, ST-30 With abdominal pain: + ST-29 REN-3, REN-4, SP-6, UB-23 LIV-8, REN-7, SP-6, SP-8, ST-30, UB-23

Blood Stagnation Due To External Cold Invasion

Clinical Manifestations	No period Abdominal pain and distention which is worse with pressure Leukorrhea Lumbar soreness Dark or pale green complexion Headache Stiff neck Aversion to Cold T: Dark red with purple spots C: Normal P: Deep and choppy or Deep, slow and tight
Treatment Principle	Invigorate the Blood Dispel Cold Warm the channels
Herb Formulas	He Xue Tong Jing Tang Amenorrhea #1 Wu Yao San Jia Wei Wen Jing Tang For obvious Phlegm or unaccountable abdominal masses: Da Huang Zhi Chong Wan Di Dang Tang Ban Xia Hou Po San
Points	Moxa or moxa needle REN-4, REN-8, SP-6, ST-28, ST-36

Blood Stagnation Due To Qi Stagnation

Clinical Manifestations	Amenorrhea Melancholy Dizziness Headache Distention and pain in the chest and hypochondrium Anorexia Lumbar soreness Leukorrhea Menstrual irregularity T: Normal C: Sticky and white P: Thready and wiry
Treatment Principle	Disperse Stagnation Soothe the Liver
Herb Formulas	Xiao Yao San modified
Points	LIV-2. LIV-13, REN-6, SP-6

Blood Stagnation Due To Blood Deficiency

Clinical Manifestations	Abdominal pain in women Dizziness Blurred vision Pale, lusterless complexion Pale nails Pale lips Generalized muscle tension Irregular menstruation with little flow Amenorrhea Periumbilical pain Lower abdominal pain Vertigo Tinnitus Blurred vision Insomnia Spotting of pale Blood Postpartum uterine bleeding Maybe five sole Heat Delayed menstruation Palpitations Dizziness Dry skin Maybe leukorrhea Maybe fever Firm, painful abdomen Sporadic fever and chills Dysmenorrhea Breast distention and pain before and during menses Menorrhagia Hard abdominal masses with recurrent pain Unstable fetus with bleeding Chills and fever T: Pale C: Normal P: Thready and wiry or Thready and choppy
Treatment Principle	Nourish the Blood Invigorate the Blood Dispel Stasis
Herb Formulas	Tao Hong Si Wu Tang Si Wu Tang modified Shi Xiao Si Wu Tang
Points

Blood Stagnation Due To Cold Blood

Clinical Manifestations	No period Cold lower abdominal pain with guarding The abdominal pain is alleviated by warmth The body and limbs are cold Pallid complexion T: Pale or Cyanotic C: White P: Deep and tight
Treatment Principle	Warm the channel Disperse Cold Invigorate the Blood Promote menstruation
Herb Formulas	Wen Jing Tang
Points	Moxa REN-3, REN-4, Zigong, SP-10, UB-17

Heat

Clinical Manifestations	Heartburn Nervous agitation Afternoon fever A bitter taste in the mouth Thirst Emaciation Dry feces Scanty, reddish urine A gradual evolution from irregular menstruation to amenorrhea T: Scarlet C: Thin, dry and yellowish or Peeled P: Wiry, thready and rapid
Treatment Principle	Clear Heat
Herb Formulas	Yi Guan Jian Decoct 250g of the juice from Rx. Rehmanniae Sheng Di Huang reduced to 120g. Add powdered Rx. et Rz. Rhei Da Huang Make into pills and take 9g per day.
Points

Heat Consuming Blood

Clinical Manifestations	No period Tidal fever Greenish complexion Dizziness Blurred vision Palpitations Insomnia Irritability T: Red C: Yellow P: Rapid or Thready, forceful and rapid
Treatment Principle	Tonify the Blood Drain Heat
Herb Formulas	Qin Lian Si Wu Tang Da Huang Mu Dan Pi Tang
Points

Cold Stagnation

Clinical Manifestations	Pain and distention of the abdomen which is worse with pressure Leukorrhea Low back pain A dark or pale and greenish complexion Headache Stiff neck Aversion to Cold T: Dark red or Purplish maculae C: White P: Deep and Choppy or Deep, retarder and tight
Treatment Principle	Expel Cold Warm the channels Invigorate the Blood
Herb Formulas	He Xue Tong Jing Tang Wu Zhu Yu Tang With an unaccountable abdominal mass: Hu Po San Da Huang Zhe Chong Wan Di Dang Tang
Points

Cold-Damp Accumulation Obstructing The Chong And Ren

Clinical Manifestations	Amenorrhea Cold pain in the lower abdomen A heavy, dragging, or bearing down, distended feeling Desire for warmth Resistance to pressure Continuous white vaginal discharge Lack of warmth in the four extremities Chest oppression Hiccups A greenish-bluish white facial complexion If due to External Contraction of Wind-Cold: Aversion to Cold Headache Soreness and distention of the lower and upper back T: Greenish blue and dark tongue C: White and glossy P: Deep, relaxed (retarded), and forceful or Deep and slow pulse
Treatment Principle	Warm the channels Warm the menses Scatter Cold Dry Dampness Transform Stasis
Herb Formulas	Wen Jing Tang modified Shao Fu Zhu Yu Tan He Xue Tong Jing Tang Wu Zhu Yu Tang For menstrual pain after the menses arrives: Chinese Patent Medicine: Dang Gui Wan
Points

Phlegm-Damp Obstruction

Etiology	Spleen Qi and/or Yang Deficiency blocks the Chong and Ren meridians. The patient will usually be over weight.
Clinical Manifestations	Light colored discharge leading to no period Palpitations of the Heart Shortness of breath A fat, plump body Profuse sputum Epigastric fullness Upper abdominal distention Chest and epigastric tightness Nausea Vomiting with profuse phlegm Increased vaginal discharge that is white and viscid In general, the patient also is obese or has generalized edema Lassitude Lack of strength Fatigue Dizziness Blurred vision Puffy, yellowish complexion Anorexia Lumbar soreness Edema and swelling Profuse white colored vaginal discharge T: Pale and plump C: White and greasy P: Slippery or Wiry and slippery or Deep, and/or small pulse
Treatment Principle	Eliminate Phlegm and Dampness Invigorate the Blood Promote menstruation
Herb Formulas	Cang Fu Dao Tan Tang modified Dao Tan Tang Er Chen Tang modified Hou Po Er Chen Tang Xiao Zhi Mo Dao Tan Tang With Spleen Deficiency: Liu Jun Zi Tangmodified Bu Zhong Yi Qi Tang With Blood Stagnation: Jia Wei Si Wu Er Chen Tang
Points	REN-3, REN-4, Zigong DU-20, KI-13, REN-3, REN-12, SP-6, ST-30, ST-40

Lower Jiao Blood Stagnation With Heat

Clinical Manifestations	Acute lower abdominal pain Incontinence of urine Night fevers Delirious speech Irritability Restlessness Thirst May be mania (severe) Dysmenorrhea Amenorrhea Hard stool Dark red complexion Headache Vertigo Tinnitus Insomnia Palpitations Constipation Frequent urination Emotional instability Chills in the waist and feet Tremors Excruciating abdominal pain with cold Black stool May be chills and fever Hemoptysis Hematuria Red eyes Pain and distention of the head Toothache Irregular menstruation Lochioschesis Severe wheezing Distention of the chest T: Red and dry C: Yellow P: Deep and forceful or Choppy
Treatment Principle	Drain Heat Break up Blood Stasis
Herb Formulas	Tao He Cheng Qi Tang Dai Di Dang Wan Zhe Chong Yin
Points

Disharmony Between The Chong And Ren

Clinical Manifestations	Breast distention and pain before and during menses Pain in the breast and nipple Dislike of having them covered Small nodules 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 Scanty menstruation Dysmenorrhea Maybe amenorrhea Maybe infertility T: Pink C: Thin and white P: Wiry and thready
Treatment Principle	Harmonize the Chong and Ren Soften hardness Resolve lumps
Herb Formulas	Tian Chong Hua Jian Tang
Points