Diverticulitis

General

Clinical Manifestations	Diverticulitis is a digestive disease in which pouches within the large bowel wall become inflamed. Symptoms typically include lower abdominal pain of a sudden onset. Onset however may also occur over a few days. In North America and Europe pain is usually on the left side while in Asia it is often on the right. There may also be fever, nausea, diarrhea or constipation, or blood in the stool. Repeated attacks may occur.
Treatment Principle
Herb Formulas
Points

Yang Ming Fu

Clinical Manifestations	Abdominal pain (worse with pressure) The skin over the pain may feel warmer to the touch High fever (sometimes rises and falls) Great thirst A dry mouth Profuse perspiration Aversion to Heat Abdominal fullness and distension (worse with pressure) Dryness Constipation (hard dry knots) Dislikes pressure Restlessness Irritability Concentrated urine Mental disturbances: 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 Xiao Cheng Qi Tang Tiao Wei Cheng Qi Tang With Qi and Blood Deficiency: Huang Long Tang Chinese Patent Medicines: Niu Huang Qing Huo Wan Qing Fei Yi Huo Pian
Points	DU-14, LI-4, LI-11, REN-12. ST-25, ST-34, ST-36, ST-37, ST-39, ST-44, SJ-5, SJ-6, UB-25 Ahshi points on the Bladder channel between UB-18 and UB-28, ST-25, ST-37, ST-39, ST-44, UB-25 With severe pain: + ST-34 With fever: + DU-14, LI-4, LI-11 With Shao Yang symptoms: + GB-34, GB-39, SJ-5 With constipation: +SJ-6 With diarrhea: + LI-11 Ear: Abdomen, Subcortex, Large Intestine, Small Intestine, Shenmen, Sympathetic

Wei Stage: Summerheat

Clinical Manifestations	Acute abdominal pain Fever and chills, fever more pronounced or Tidal fever Fever is unrelieved by sweating Abdominal distention Thirst Sweat Stifling sensation in the chest Restlessness Foggy headaches Irritability Heaviness Nausea Severe diarrhea Scanty urine T: Red tip and edges C: Greasy white or yellow P: Floating or Rapid and soft
Treatment Principle	Disperse Wind Clear Heat Resolve Damp
Herb Formulas	Huang Lian Xiang Ru Yin
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

Damp-Heat In The Large Intestine

Clinical Manifestations	Diarrhea with tenesmus which intensifies after defecation Dysentery Frequent stools which are small in quantity Stools are yellow or brown, thin, watery, with foul smell or sticky and pasty like jam or sticky fluid or containing pus and blood Burning hot sensation in anus Abdominal pain Severe lateral or central abdominal pain Urine short and red Sustained fever despite profuse perspiration or raging fever in the afternoon or in severe cases, high fever and coma Mouth dry but no desire to drink Body heavy Limbs tired Fullness in chest Lump in epigastrium Anorexia Vomiting T: Red C: Yellow and greasy P: Slippery and rapid
Treatment Principle	Clear Heat Eliminate toxins Transform Dampness Stop dysentery
Herb Formulas	Shao Yao Tang Bai Tou Weng Tang Chinese Patent Medicines: Huang Lian Jie Du Wan Huang Lian Su Pian Chuan Xin Lian Kang Yan Pian Long Dan Xie Gan Wan
Points	ST-25, ST-37, ST-44, UB-25, LI-4, LI-11, SP-9

Qi And Blood Stagnation

Clinical Manifestations	Acute, intermittent, spasmodic lower abdominal pain The pain is usually in the left or right iliac fossa The pain may be quite severe and is worse with pressure There may be rebound pain The abdominal muscles over the site of pain may be tight The pain may have begun over the navel Qi Stagnation predominant: The pain may move around Blood Stagnation predominant: The pain is fixed Abdominal distention Belching Loss of appetite Nausea Maybe vomiting Maybe constipation Maybe a mild fever Maybe chills and fever T: Normal C: Thin and white or Thin and yellow P: Wiry or Tight
Treatment Principle	Open the bowels Move Qi Invigorate the Blood Eliminate Blood Stasis Clear Heat
Herb Formulas	Da Huang Mu Dan Tang For Liver Qi and Blood Stagnation: Chai Hu Shu Gan Tang modified During pregnancy: Qing Chang Yin Chinese Patent Medicines: Niu Huang Qing Huo Wan Huang Lian Jie Du Wan Chuan Xin Lian Kang Yan Pian
Points	Ahshi points on the Stomach channel between ST-36 and ST-37 (strong electro-acupuncture), SP-8, ST-25, ST-37 With appendix affected: + Lanweixue With fever: + LI-4, LI-11, ST-44 With severe pain: + SP-4, ST-34, ST-43 With nausea and vomiting: + PC-6, REN-13 With abdominal distention: + GB-34, SJ-6, SP-14 With constipation: + LIV-3, LIV-5 With a history of loss or grief: + LU-3, LU-7, UB-43 Ear: Appendix, Large Intestine, Abdomen, Sympathetic, Shenmen

Qi Deficiency With Damp-Heat

Clinical Manifestations	Fatigue Lack of strength Lassitude Shortness of breath A weak voice Disinclination to speak Fixed, burning pain on one side of the lower abdomen Dark colored, bound stools Maybe frequent, scanty dark colored urine A dry mouth and throat T: Red or Pale or fat and tender C: Slimy and yellow at the root P: Deep, wiry, slippery and rapid
Treatment Principle	Tonify the Spleen Tonify Qi Clear Heat Eliminate Dampness Move Qi Invigorate the Blood
Herb Formulas	Bu Zhong Yi Qi Tang modified
Points	KI-6, PC-6, SJ-6, ST-25, ST-36 With severe Kidney Yin Deficiency: + SP-6 With severe Kidney Yang Deficiency: + moxa or moxa needle REN-4 With severe abdominal distention and flatulence: + LI-4 With severe Damp-Heat: + SP-9, ST-44 With night sweats: + HT-6 With low back pain and abdominal distention: + SP-4 With undigested food in the stools or reduced food intake: + REN-21, ST-21 With severe Qi Deficiency: + SP-3

Qi Deficiency With Toxic-Heat

Clinical Manifestations	Fatigue Lack of strength Lassitude Shortness of breath Fever Nausea and vomiting Lower abdominal pain Constipation T: Swollen and red or Red and tender C: Slimy and yellow at the root P: Deep, wiry slippery and rapid
Treatment Principle	Tonify the Spleen Tonify Qi Expel Toxins from the Interior Clear Heat Stop pain
Herb Formulas	Tuo Li Xiao Du San  modified
Points	KI-6, PC-6, SJ-6, ST-25, ST-44 With severe Kidney Yin Deficiency: + SP-6 With severe Kidney Yang Deficiency: + moxa or moxa needle REN-4 With severe abdominal distention and flatulence: + LI-4 With severe Damp-Heat: + SP-9, With night sweats: + HT-6 With low back pain and abdominal distention: + SP-4 With undigested food in the stools or reduced food intake: + REN-21, ST-21 With severe Qi Deficiency: + SP-3 With tenderness at the following points: + needle Lanweixue, ST-37, ST-39

Qi And Yin Deficiency With Qi And Blood Stagnation

Clinical Manifestations	Fatigue Lack of strength Lassitude Shortness of breath Insomnia Palpitations Poor appetite Reduced food intake A bland taste in the mouth No taste for food Slow digestion Constipation Dry skin Dry eyes Dry lips and mouth A pale face Maybe malar flush Cold hands an feet Maybe Five Sole Heat Tinnitus Deafness Dizziness Hair loss Decreased visual acuity Poor memory Loose teeth Loss of teeth Low back and knee pain and weakness Lower abdominal distention and pain T: Pale, maybe a red tip or Red and fat C: Scanty P: Soft and weak or Empty
Treatment Principle	Strengthen the Spleen Tonify Qi Strengthen the Kidneys Nourish Yin Unblock the stool Stop pain
Herb Formulas	With Spleen Qi Deficiency most prominent: Bu Zhong Yi Qi Tang  modified With Yin Deficiency most prominent: Liu Wei Di Huang Wan modified
Points	REN-6, SJ-6, SP-6, ST-25, ST-36 With severe constipation: + KI-6 With Yang Deficiency: + moxa or moxa needle REN-6 With severe abdominal distention and flatulence: + PC-6 With Night sweats: + HT-6 With low back pain and abdominal distention: + SP-4 With undigested food in the stools or reduced food intake: + REN-21, ST-21 With severe Qi Deficiency: + SP-3

Blood Stagnation

Clinical Manifestations	Pain that is fixed, stabbing and /or severe Pan is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas, Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the Blood Dispel Blood Stasis Spread Liver Qi Unblock the channels Stop pain
Herb Formulas	Shao Fu Zhu Yu Tang With Heat: Shao Yao Tang Chinese Patent Medicines: Xue Fu Zhu Yu Wan Fu Ke Wu Jin Wan With bleeding: add Sheng Tian Qi Pian to either of the above formulas
Points	SP-6, SP-10, ST-36, UB-17, UB-40 Ahshi points over the abdomen, Ahshi points along the Stomach channel between ST-36 to ST-39, LI-4, LIV-3, REN-6, SP-6, SP-8, SP-10, ST-25, UB-17, UB-25 With Bleeding: + Ahshi points over the Ba Liao on the sacrum With Cold: + Moxa Ear: Large Intestine, Distal Segment Rectum, Abdomen, Sanjiao, Shenmen, Adrenal

Toxic Heat

Clinical Manifestations	Severe localized pain or Pain that is spreading to involve the whole abdomen Abdominal rigidity Abdominal guarding Epigastric and abdominal hardness and distention Constipation No passing of gas Rapidly developing jaundice with a gold color High fever or Chills and fever Thirst Dry mouth, throat and lips A red complexion Red eyes Malaise A headache Restlessness Irritability Thirst Foul breath Nausea/Vomiting Halitosis Concentrated urine Abdominal pain Constipation Scanty urine Skin rashes Epistaxis Bleeding gums Muscular spasms or Convulsions Hypochondriac and Stomach fullness and pain Unclear thinking Delirium Epistaxis Hematochezia Bleeding from the mouth Bruises easily T: Deep red or Scarlet C: Greasy and yellow or Dry and yellow P: Flooding and rapid
Treatment Principle	Clear Toxic Heat Invigorate the Blood Break up Blood Stasis Cool the Blood Dissipate accumulation Resolve the abscess Stop pain
Herb Formulas	Lan Wei Jie Du Tang Xi Jiao San With Heat in the Ying or Xue Stage: Qing Ying Tang  modified With chronic Damp-Heat and Blood Stagnation: Qing Re Jie Du Hua Yu Tang For Spleen and Stomach Deficiency in recovery Stage: Xiang Sha Liu Jun Zi Tang Shen Ling Bai Zhu San Li Zhong Wan Ba Zhen Tang For damaged Qi and Yin in recovery Stage: Yi Wei Tang Sheng Mai San Sha Shen Mai Men Dong Tang Zeng Ye Tang Chinese Patent Medicines: Niu Huang Qing Huo Wan Da Bai Du Jian Nang Wu Wei Xiao Du Yin Recovery Stage: Spleen Deficiency with Damp: Xiang Sha Liu Jun Zi Wan Qi and Yin Deficiency: Shen Ling Bai Zhu Wan Spleen Yang Deficiency: Li Zhong Wan Qi and Blood Deficiency with Cold: Shi Quan Da Bu Wan Qi and Blood Deficiency: Ba Zhen Wan Lung and Stomach Qi and Yin Deficiency: Sheng Mai San Wan Spleen and Stomach Qi and Yin Deficiency: Gu Ben Wan
Points	DU-14, DU-26, LI-11, PC-3, PC-9, UB-40 With unrelenting fever: + bleed Shixuan With spasms or convulsions: + DU-12, LI-4, LIV-3 With severe nausea: + PC-6 With severe pain: + ST-34 Ear: Appendix, Large Intestine, Abdomen, Sympathetic, Shenmen