Epistaxis (Nosebleed)

General

Clinical Manifestations
Treatment Principle
Herb Formulas	Da Huang Zhi Xue Jiao Nang Cancer #3 Recurrent: Si Jun Zi Tang Shao Yao Gan Cao Tang
Points	LIV-5, SI-1, UB-18 DU-15, DU-20, DU-24, LI-19 GB-20, GB-21, SI-15, UB-10 LI-4, LI-10, LI-11, ST-44 REN-4, ST-36, UB-40 GB-39, LIV-1, LU-3, SI-2, UB-64 DU-23, GB-20, LI-4, LIV-3, SI-15, ST-36 DU-23, DU-25, LI-20 LI-20, LU-7, Yintang HT-7, KI-3, PC-7, SP-1 Moxa DU-21, DU-22, UB-13 Moxa DU-23 Severe, will not stop: SP-1, UB-40 With hemoptysis: REN-13, UB-18, UB-20

Wind-Cold

Clinical Manifestations	A small amount of Blood from the nose which is often followed by abatement of fever and which can stop spontaneously Severe chills Mild or no fever Headache Generalized discomfort Stiff neck and shoulders Body aches Joint ache Nausea Vomiting Hiccups Anhidrosis Gasping Stabbing joint pain Itchy throat Cough Asthma Aversion to Wind and Cold Maybe low back pain Maybe frozen shoulder Maybe dyspnea Blood moves wildly T: Pink C: Thick and white P:Floating and tight
Treatment Principle	Expel Wind Warm Cold Stop bleeding
Herb Formulas	Ma Huang Tang Jing Fang Bai Du San
Points	DU-14, DU-16, DU-23, GB-20, LI-4, UB-12 KI-7, LI-4, SJ-5, UB-12

Yang Ming Jing

Clinical Manifestations	High fever Profuse perspiration Great thirst with a desire to drink Epistaxis Abdominal pain Dryness Irritability Restlessness Feverish body parts Red face Dry stools No constipation No aversion to Cold T:  Red, dry C:  Dry yellow P:  Rolling and rapid (gigantic)
Treatment Principle	Clear Heat Reduce fever Moisten and replenish fluids
Herb Formulas	Bai Hu Tang With Qi and Body Fluid Deficiency: Bai Hu Jia Ren Shen Tang
Points	DU-14, LI-4, LI-11, ST-44, KI-3, KI-6, SP-6 With Qi and Body Fluid Deficiency: To nourish Yin and moisten: KI-3, KI-6, SP-6 To Tonify Qi: UB-20, REN-12, ST-36, REN-6, SP-3 To Clear Heat: DU-14, LI-11, ST-44 With diarrhea: To Expel Wind Cold: DU-16, GB-20, UB-12, LI-4, SJ-5 (Sedating technique) To Disperse the Lungs: LU-7, UB-13 To stop diarrhea:  Moxa ST-36, REN-8, REN-12, ST-25 With vomiting but no diarrhea: To Expel Wind Cold: DU-16, GB-20, UB-12, LI-4, SJ-5 (Sedating technique). To Disperse the Lungs: UB-7, UB-13 To stop vomiting: PC-6, SP-4

Yang Ming Fu

Clinical Manifestations	High fever (sometimes rises and falls) Great thirst Epistaxis 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	Tiao Wei 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

Yang Ming Xu With Constipation

Clinical Manifestations	Constipation Dry stools that cannot easily be expelled, even with purgatives Thirst Distention and fullness of the epigastrium and abdomen Dry mouth Dry lips T: Red, dry and thin C: Little or None or thin and yellow or Burnt and yellow P: Thready and slightly rapid or weak and forceless
Treatment Principle	Generate Fluids Drain Heat Unblock the bowels Enrich Yin
Herb Formulas	Zeng Ye Cheng Qi Tang
Points	General points

External Heat Collecting In The Lungs And Stomach

Clinical Manifestations	Early-stage measles or rashes that do not surface evenly Fever and chills Headache Generalized body aches Sneezing Cough Red eyes Tearing Thirst Epistaxis Intolerance of Wind T: Red and dry P: Floating and rapid.
Treatment Principle	Expel Exterior Wind-Heat Release muscle layer Vent rashes
Herb Formulas	Sheng Ma Ge Gen Tang
Points	General points

Wind-Heat

Clinical Manifestations	Nosebleed with fresh, red Blood. Cough with thick sticky, yellow sputum Sore, dry, red, swollen throat Thirst, with a desire to drink cold liquids Runny or blocked nose with thick yellow discharge or Dry, painful nostrils with nasal obstruction Fever with perspiration Slight chills Aversion to Wind Headache Maybe dyspnea with flared nostrils Maybe chest pain Maybe epistaxis T: Red tip C: Thin and yellow P: Superficial and rapid
Treatment Principle	Clear the Lungs Clear Heat Expel Wind
Herb Formulas	Yin Qiao San Sheng Ma Ge Gen Tang Sang Ju Yin modified Chinese Patent Medicines: Qing Fei Yi Huo Pian Ma Xing Zhi Ke Pian Yunnan Bai Yao (can be blown into the nose)
Points	DU-14, DU-16, GB-20, LU-5, LU-10, LU-11, SJ-5 + LI-4, UB-12, UB-13 GB-20, LI-4, LI-20, LU-11, SJ-5, UB-13 With severe fever: + LI-11 With severe cough: + LU-5 DU-16, DU-23, LI-4, LI-20, LU-10

Perverse Dryness Attacks The Lungs

Clinical Manifestations	Dry cough with little or no sputum Sputum is difficult to expectorate Maybe hemoptysis Cough may cause chest pain Dry or sore throat Hoarse voice Dry lips and mouth Thirst Dryness in nose Epistaxis Chills and fever Headache Anhidrosis Dry skin and hair Constipation T: Red tip C: Thin, yellow and dry P: Superficial, maybe rapid
Treatment Principle	Cleanse the Lungs Moisten Dryness
Herb Formulas	Qing Zao Jiu Fei Tang If symptoms persist for a long time: Yang Yin Qing Fei Tang
Points	KI-3, LU-1, LU-6, SP-6, UB-13 KI-3, Jinjin-Yuye, LU-1, LU-6, SP-6, UB-13

Wei Stage: Wind-Heat Transfers To The Pericardium

Clinical Manifestations	A history of Wei Stage invasion (fever and chills for the first few days) High fever Delirium Maybe coma Maybe convulsions Maybe hemorrhage anywhere T: Dark red C: Yellow P: Rapid maybe forceful
Treatment Principle	Expel Heat from the Pericardium Resuscitate
Herb Formulas	An Gong Niu Huang Wan
Points	DU-26, KI-1, LIV-2, LIV-3, bleed the 12 Jing-Well Points

Summerheat Damaging The Lung Vessels

Clinical Manifestations	Sudden expectoration of Blood Epistaxis Cpughing Rough breathing Lack of mental clarity Lack of visual clarity Scorching Heat Vexatious thirst T: Red C: Yellow P: Wiry and rapid
Treatment Principle	Clear Heat Resolve toxins Cool the Blood Stop bleeding
Herb Formulas	Xi Jiao Di Huang Tang + Yin Qiao San  modified
Points

Summerheat And Dampness With Liver And Gallbladder Heat

Clinical Manifestations	Red eyes Sore throat Mouth, tongue and lip ulcerations Urinary difficulty Diarrhea Papules Sores Prickly Heat Ocular pain Dark urine Chest pain Hemoptysis Epistaxis Hematemesis Oliguria with dark urine Scanty urine Swelling of the throat Fever Thirst Irritability Nausea Vomiting Lassitude due to Summerheat T: Normal C: Yellow and greasy P; Soggy and rapid
Treatment Principle	Clear Heat Relieve toxicity Promote urination Eliminate Summerheat TonifY Qi Cool the Blood
Herb Formulas	Bi Yu San
Points

Summerheat Entering The Blood Aspect

Clinical Manifestations	High fever with agitation Purple-black rashes Hemoptysis Epistaxis Clouded Spirit Delirious raving Severe: Convulsions of the four limbs Opisthotonis Phlegm gurgling in the throat T: Crimson C: Charred P: Forceful and rapid
Treatment Principle	Cool the Blood Resolve toxicity Clear the Heart Open the Orifices
Herb Formulas	Shen Xi Dan An Gong Niu Huang Wan
Points

Qi Stage: Lung Heat

Clinical Manifestations	Nosebleed with fresh, red Blood. Cough with yellow sputum containing Blood or Cough with much bright red Blood and no sputum Fever Dry nostrils with nasal obstruction Burning pain in the nose Slight itching in the nose Dry mouth Dry throat Thirst Sore throat Chest pain Headache General malaise Restlessness Constipation Dry stools Dark-colored, scanty urine Red swelling or erosion in the nostrils T: Red C: Thin and yellow P: Wiry or Rapid or Floating and rapid
Treatment Principle	Clear Heat Disperse the Lungs Stop bleeding
Herb Formulas	Xie Bai San modified Ma Xing Shi Gan Tangmodified With congestion in the chest and epigastrium: Zhi Zi Chi Tang With vomiting: Zhi Zi Sheng Jiang Chi Tang With short, rapid breathing: Zhi Zi Gan Cao Chi Tang With Body Fluid Deficiency: Bai Hu Jia Ren Shen Tang Chinese Patent Medicines: Qing Fei Yi Huo Pian Ma Xing Zhi Ke Pian Yunnan Bai Yao (can be blown into the nose)
Points	LI-19, LI-20, LU-1, UB-13, LI-4 DU-14, LI-4, LI-11, PC-4, PC-7, PC-8 GB-20, LI-4, LI-20, LU-11, SJ-5, UB-13 With severe fever: + LI-11 With severe cough: + LU-5 With Stomach Heat: DU-23, LI-4, LI-11, ST-44 Ear: Internal Nose, Shenmen, Sympathetic

Qi Stage: Intestinal Dry Heat

Clinical Manifestations	High fever - sometimes tidal Profuse sweat Great thirst with desire to drink Epistaxis Acute constant abdominal pain Worse with pressure Distension and fullness in the Stomach and abdomen Aversion to Heat Dryness Restlessness Excess symptoms Constipation with dry knots Sweat Mental disturbance Delirium T:  Red or Dark red Severe: Gray or Black C: Thick, yellow or Dry, yellow P:  Forceful and deep or Deep and slow
Treatment Principle	Purge
Herb Formulas	Tiao Wei Cheng Qi Tang
Points	DU-14, LI-4, LI-11, REN-12, SJ-5, SJ-6, ST-25, ST-34, ST-36, ST-37, ST-39, ST-44

Qi Stage Gall Bladder Heat

Clinical Manifestations	Epistaxis Alternating chills and fever Bitter taste in mouth Thirst Dry throat Rib pain (doesn't like touch) Hypochondriac pain Nausea/vomiting Hypogastric pain and distension T:  Red C:  Yellow P:  Rapid and wiry
Treatment Principle	Relieve Gall Bladder Heat Pacify The Liver and Gall Bladder
Herb Formulas	Liang Ge San With congestion in the chest and epigastrium: Zhi Zi Chi Tang With vomiting: Zhi Zi Sheng Jiang Chi Tang With short, rapid breathing: Zhi Zi Gan Cao Chi Tang With Food Stagnation: Zhi Shi Zhi Zi Chi Tang
Points	To Pacify the Liver and Gall Bladder: LIV-3, LIV-4, LIV-13, LIV-14. To Relieve Gall Bladder Heat: Lanweixue, LI-11, LIV-2, GB-34

Qi And Ying Stage Heat

Clinical Manifestations	Epistaxis High fever Thirst Headache Agitation Papules Hematemesis T: Crimson C: Yellow P: Rapid
Treatment Principle	Clear Heat from the Qi and Ying
Herb Formulas	Yu Nu Jian modified Severe: Qing Wen Bai Du Yin
Points

Xue Stage: Excess Heat Causes Bleeding

Clinical Manifestations	Epistaxis High fever Confusion of mind Delirium (mania) Dark yellow urine Excessive skin rashes all over body Hemorrhage Hematemesis Hemoptysis 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 Qing Wen Bai Du Yin Si Sheng Wan With Shen disturbance: Qing Ying Tang  modified With delirium: An Gong Niu Huang Wan Zhi Bao Dan Zi Xue Dan
Points	Bleed the Jing Well points, DU-14, DU-26, HT-7, KI-1, KI-3, SP-1, LI-11, SP-6, SP-10, ST-25, ST-37, ST-44, UB-17 HT-8, KI-1, LI-11, PC-8, UB-40

Xue Stage: Blood Heat Causes Wind

Clinical Manifestations	High fever Confusion of mind Delirium Mania Dark yellow urine Excessive skin rashes all over body Hemorrhage: Hematemesis Hemoptysis Epistaxis Hemafecia Hematuria Stiffness Convulsions:   Clenched jaws Clenched fists Shaking Opisthotonis Stiff neck Semi-consciousness T: Deep red and dry C: Yellow P: Wiry and rapid
Treatment Principle	Subdue Wind Clear Heat Nourish Yin Stop convulsions
Herb Formulas	Ling Jiao Gou Teng 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 Yin Deficiency

Clinical Manifestations	Development of a white curd-like membrane in the throat that is difficult to scrape off Dry mouth and throat worse at night Soft or hoarse voice Low back and legs sore and weak Night sweats Malar flush Afternoon fever Sterility Spermatorrhea Sore and swollen throat Asthma Dry nose and lips Low grade fever Raspy breathing resembling wheezing Cough with dry or little Phlegm Five sole heat May be fever Blood flecked Phlegm Irritability Insomnia Steaming bones White complexion Maybe a red face Skinniness Shortness of breath (maybe exertional) Urgent panting Allergies Seminal emission with dreams Diminished urination Feeling miserable and agitated with fever T: Red and dry C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Clear the Lungs Improve the condition of the throat Relieve toxicity Cool the Blood
Herb Formulas	Yang Yin Qing Fei Tang Bai He Gu Jin Tang
Points	KI-3, KI-6, LU-1, LU-5, LU-6, LU-7, LU-9, LU-10, ST-36, UB-13, UB-17, UB-23, UB-43

Lung And Kidney Yin Deficiency

Clinical Manifestations	Development of a white curd-like membrane in the throat that is difficult to scrape off Dry mouth and throat worse at night Soft or hoarse voice Low back and legs sore and weak Night sweats Malar flush Afternoon fever Sterility Spermatorrhea Sore and swollen throat Asthma Dry nose and lips Low grade fever Raspy breathing resembling wheezing Cough with dry or little Phlegm Five sole heat May be fever Blood flecked Phlegm Irritability Insomnia Steaming bones White complexion Maybe a red face Skinniness Shortness of breath (maybe exertional) Urgent panting Allergies Seminal emission with dreams Diminished urination Feeling miserable and agitated with fever T: Red and dry C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Clear the Lungs Improve the condition of the throat Relieve toxicity Cool the Blood
Herb Formulas	Yang Yin Qing Fei Tang Bai He Gu Jin Tang Shun Jing Tang
Points	KI-3, KI-6, LU-1, LU-5, LU-6, LU-7, LU-9, LU-10, ST-36, UB-13, UB-17, UB-23, UB-43

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 Epistaxis 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
Points	LI-11, SJ-6, ST-25, ST-37, ST-44

Spleen Not Governing Blood

Clinical Manifestations	Occasional dripping epistaxis with pale, pink blood The Blood is small in quantity, but may be copious It is easy to stop but tends to recur easily Bruises easily Sallow or pale complexion Anorexia Four limbs feel tired and heavy Physical and mental exhaustion Disinclination to speak Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose or unformed stools Fatigue Shortness of breath Postural dizziness Palpitations Functional Uterine Bleeding Purpura Hemafecia Hematuria Menorrhagia Metrorrhagia Light red blood T: Pale and flabby - may have teethmarks C: White P: Thready and weak or Hollow and weak
Treatment Principle	Benefit Qi Conserve Blood
Herb Formulas	Gui Pi Tang  modified Bu Zhong Yi Qi Tangmodified Gui Pi Tang + Jiao Ai Tang Bu Wei Fang Shou Pi Jian Chinese Patent Medicines: Gui Pi Wan Jin Kuei Shen Qi Wan Yun Nan Bai Yao
Points	SP-1, SP-3, SP-10, ST-36, UB-17, UB-20 DU-20, REN-4, REN-11, SJ-4, SP-1, SP-3, SP-10, UB-17, UB-20 DU-23, REN-13, SP-1, ST-36, UB-17, UB-20 DU-20, REN-6, SP-1, SP-6, ST-36, UB-20 DU-23, LU-9, REN-6, ST-36, UB-20 For severe bleeding: + moxa LIV-1

Spleen Yang Deficiency

Clinical Manifestations	Hematochezia Hematemesis Hemoptysis Epistaxis Metrorrhagia Cold extremities A wan or sallow complexion Dark red or pale Blood General fatigue A lack of taste No thirst Pale face T: Pale or Dull red C: White P: Deep, thready and weak
Treatment Principle	Warm Yang Strengthen the Spleen Nourish the Blood Stop bleeding
Herb Formulas	Huang Tu Tang You Gui Wan  modified Jin Gui Shen Qi Wan modified Gan Cao Gan Jiang Tang
Points	Moxa LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

Latent Fire In The Spleen And Stomach

Clinical Manifestations	Mouth ulcers Bad breath Thirst Frequent hunger Dry mouth and lips Epistaxis Tongue thrusting in children Irritability T: Red C: Normal or Yellow P: Rapid
Treatment Principle	Drain Latent Fire from the Spleen and Stomach
Herb Formulas	Xie Huang San
Points

Stomach Fire

Clinical Manifestations	Epistaxis with copious, fresh Blood A dry, painful nose Toothache Loose teeth Bleeding gums Swollen, ulcerated gums Frontal headache A red, swollen face and nose Bags under the eyes Irritability Fever Thirst with a desire to drink cold beverages Dysphoria Hungers easily Acid reflux Bad breath Hemoptysis Dry throat Hematemesis Restlessness Warm sensations Concentrated urine Constipation T: Red and dry C: White or Yellow and dry P: Superficial, full, slippery, Deficient and large or Gigantic and rapid or Rapid or Slippery and rapid or Flooding
Treatment Principle	Drain Heat from the Stomach and Heart Replenish Yin Cool the Blood Stop bleeding
Herb Formulas	Yu Nu Jian  modified Qing Wei San Chinese Patent Medicines: Qing Fei Yi Huo Pian Niu Huang Jie Du Pian Yun Nan Bai Yao
Points	DU-23, LI-2, LI-4, LI-11, ST-3, ST-44, ST-45 ST-6, ST-34, ST-36, ST-43, ST-44, ST-45, LI-4, LI-11, PC-6, PC-8, UB-21 DU-23, LI-2, REN-12, SP-1, ST-44

Heat In The Heart Channel Transferring To The Small Intestine

Clinical Manifestations	Dark, turbid, scanty, difficult, frequent, urgent and painful urination Urination may be red Maybe fever Sores in mouth, on tongue or throat Dry mouth and throat Maybe urinary retention (severe) Maybe lower abdominal distention and pain (severe) Thirst Maybe total obstruction Parched throat Severe sore throat Maybe anuria (severe) Dribbling urination May be profuse whitish, yellow vaginal discharge Maybe be urinary calculi Constipation Eye redness and pain Epistaxis Distending lower back pain Irritability Scorched lips T: Red C: Thick, yellow and greasy P: Slippery and rapid or Smooth and rapid
Treatment Principle	Clear Heat Purge Fire Promote urination Unblock painful urinary dysfunction
Herb Formulas	Ba Zheng San
Points	General points

Heart And Stomach Fire

Clinical Manifestations	Toothache Ulceration, erosion, and pain of mouth and tongue Loose teeth Bleeding gums Frontal headache Irritability Irascibility Feeling of Heat and disturbance in the Heart Fever Thirst with a desire to drink cold beverages Epistaxis Dysphoria Insomnia Flushed face Excess hunger Hemoptysis Dry throat Bitter taste in mouth Hematemesis Restlessness Warm sensations T: Red and dry or A red tip with ulcers especially on tip C: White or Yellow and dry P: Superficial, full, slippery, deficient and large or Gigantic and rapid or Rapid or Excess and rapid
Treatment Principle	Drain Heat from the Stomach Replenish Yin
Herb Formulas	San Huang Xie Xin Tang
Points	HT-7, HT-8, LI-4, LI-11, PC-6, PC-7, PC-8, ST-6, ST-34, ST-36, ST-43, ST-44, ST-45, UB-15, UB-21

Liver Fire

Clinical Manifestations	Epistaxis with copious, fresh Blood which is initiated by emotional turmoil Severe: Scleral hemorrhage Alternating fever and chills Dizziness Vertigo Irritability Insomnia Easily angered Fullness in the chest and hypochondrium (with or without pain) Bitter taste in mouth Dry mouth Nausea Continuous vomiting Hard focal distension in the epigastrium Fullness and pain in the epigastrium Burning diarrhea or no bowel movement Despondency Slight fidgeting Slight irritability Temporal headache Constipation or discharge of fluids rectally Tinnitus Diminished hearing Diminished vision Red, sore eyes Manic behavior Asthma Mental instability Chronic: A swollen, red nose with orange-peel-like skin and spider naevi on the cheeks T: Normal or red C: Yellow or Thick and yellow P: Wiry and forceful or Wiry tight and forceful
Treatment Principle	Harmonizes and Disperses the Shao Yang Drains Internal Heat Retention Clear Liver Fire Cool the Blood Stop bleeding
Herb Formulas	Long Dan Xie Gan Tang  modified Chai Hu Qing Gan Tang With Qi and Blood Deficiency: Jia Wei Xiao Yao San Premenstrual: Si Wu Tang  modified Chinese Patent Medicines: Long Dan Xie Gan Wan Yun Nan Bai Yao
Points	GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19 GB-18, GB-20, GB-34, LI-11, LIV-2, LIV-3, LU-5, UB-13, UB-18

Liver Fire Invades The Lungs

Clinical Manifestations	Bright red or crimson profuse nose-bleeding which often follows emotional upsets The bleeding may occur repeatedly Painful distention of the head Coughing fits with hemoptysis Burning pain in chest and sides Dizziness Face and eyes red Bitter taste in mouth Dry lips Dry throat Vexation Short-tempered Irascibility Restlessness Maybe dark urine Maybe constipation T: Red C: Thin, yellow and dry P: Wiry and rapid
Treatment Principle	Clear Liver Fire Purge the Lungs
Herb Formulas	Xie Bai San Dai Ge San Long Dan Xie Gan Tang  modified
Points	LIV-2, LU-5, LU-6, LU-10, PC-6, UB-13, UB-18 LI-7, LI-20, LIV-1, LIV-2, LU-10, LU-11

Kidney And Liver Yin Deficiency With Empty Fire Rising

Clinical Manifestations	Intermittent nosebleeds, usually with only small amounts of Blood The Blood is bright red Fever Night sweats Red face Dry mouth Loose teeth Atrophy of the gums Dizziness Vertigo Tinnitus Blurred vision Poor memory Constipation Dark, scanty urine Irritability Fidgeting Insomnia Five Sole Heat Night sweats Malar flush Low back pain A thin physique Nocturnal emissions Parched lips Irritability Dry stools T: Red and dry C: None P: Thready and rapid
Treatment Principle	Nourish Yin Clear Heat Cool the Blood Stop bleeding
Herb Formulas	Zhi Bai Di Huang Wan  modified With Yang Rising predominant: Zhen Gan Xi Feng Tang For chronic cases with Blood Deficiency: Jiao Ai Tang Chinese Patent Medicines: Zhi Bai Di Huang Wan Qi Ju Di Huang Wan He Che Da Zao Wan To stop bleeding: Yun Nan Bai Yao
Points	DU-23, KI-3, LI-4, LI-11, ST-44 KI-1, KI-3, LIV-3, SP-1, SP-6, UB-7, UB-23 GB-20, KI-2, KI-3, LI-20 With night sweats: + KI-7 Ear: Internal Nose, Sympathetic, Shenmen

Kidney And Liver Yin Deficiency With Empty Fire Rising And Blood Deficiency

Clinical Manifestations	Fever Night sweats Red face Dry mouth Leukorrhagia with yellow, thick, foul discharge Constipation Dark, scanty urine Irritation Fidgeting Insomnia Five sole Heat Irregular menstruation A thin physique Nocturnal emissions Parched lips Irritability Dry stools T: Dark red and dry C: Dry and yellow or None P: Flooding and rapid or Thin and rapid
Treatment Principle	Nourish Yin Clear Heat Nourish the Blood
Herb Formulas	Dang Gui Liu Huang Wan
Points	General points

Collapse Of Yin And Yang

Clinical Manifestations	Epistaxis with incessant, profuse bleeding Severe: bleeding of the mouth, teeth, ears and skin Profuse perspiration A drained, whiter facial complexion An open mouth with closed eyes Counterflow frigidity of the limbs Open hands Enuresis Clouded Shen Dyspnea T: Pale C: Little or None P: Faint, on the verge of expiring
Treatment Principle	Return Yang Stem counterflow Tonify Qi Stop bleeding
Herb Formulas	Shen Fu Tang  modified + Sheng Mai San
Points	Strong moxibustion on: LIV-1, REN-4, REN-8

Qi Rebellion Damaging The Channels

Clinical Manifestations	Bleeding gums Spasmatic cough Radiating chest and lateral-costal pain Red tinged Phlegm A dry mouth Irritating Heat Epistaxis Abdominal glomus and pain Black colored stools Dizziness Tidal fever Short, red urination T: Red C: Yellow P: Wiry and rapid
Treatment Principle	Calm the Shen Open the Channels Descend Qi Transform Stasis Clear Heat Cool the Blood Stop bleeding
Herb Formulas	Qi Rebellion #1
Points

Blood Stagnation With Heat Accumu;Ation

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 Blue, dark or purplish discoloration of skin in small or large areas Dry skin Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots Sporadic Intestinal bleeding with fresh Blood T: Red purple with possible purple or red spots if there is Heat C: Yellow P: Wiry and rapid
Treatment Principle	Clear Heat Invigorate the Blood Cool the Blood Stop bleeding
Herb Formulas	Da Huang Huang Qin Xie Xin Tang Xia Yu Xue Tang
Points

Blood Heat

Clinical Manifestations	High fever Hypertension Dizziness Headache 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: Yellow and dry P:  Rapid or thready and rapid or thready and feeble or Tight
Treatment Principle	Dispel Wind Disperse Stagnation Clear Heat Remove Toxins Stop bleeding
Herb Formulas	Jing Jie Lian Qiao Tang Shi Hui San Da Huang Zhi Xue Nao Nang San Huang Si Wu Tang Qing Gan Yin Jing Tang
Points	DU-14, LI-11, ST-44, SP-10, UB-17

Heat Stagnation

Clinical Manifestations	Sudden Bleeding from the nose with great force The Blood is purple Sensation of Heat and irritability in the chest, diaphragm and abdomen Delirious speech (severe) Hemoptysis Thirst Flushed face Red or scorched lips Tongue sores Sore throat Swollen tongue Red eyes Epistaxis Constipation Toothache Hematemesis Fever Bitter taste in mouth Red urine Dry, chapped lips Dark, scanty urine Restlessness Vomiting Red mouth or ulcers on the mouth Rashes Insomnia Mania T: Red body or Red edges C: Yellow and dry or White and dry P: Slippery (maybe) and rapid or Overflowing and slippery
Treatment Principle	Drain Fire Unblock the bowels by Clearing Upper Jiao and Draining the Middle and Lower Jiaos
Herb Formulas	San Huang Shi Gao Tang Liang Ge San
Points	DU-16, DU-23, GB-39, LI-4, LI-11, LI-20, LIV-13, SI-15, SP-1, ST-36 DU-22, DU-23, LI-11, LI-4, LI-20, ST-44 Tonify LI-3, LI-4, Sedate SI-1, SI-3 Moxa DU-23, Needle DU-14, DU-15, DU-20, KI-1, LI-4, LI-11, SI-3, UB-12, UB-13, UB-20, UB-40, UB-60 DU-14, DU-16, DU-23, DU-26, LI-4, LI-20, UB-64, Yintang

Toxic Heat

Clinical Manifestations	Epistaxis usually profuse High fever Irritability Fidgeting Restlessness Malaise 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 Hematuria Cloudy mind Diarrhea T: Red C: Yellow P: Rapid and forceful
Treatment Principle	Clear Heat Drain Fire Relieve toxicity Relieve inflammation Stop bleeding
Herb Formulas	Huang Lian Jie Du Tang
Points	General points

Middle Jiao Yang Deficiency

Clinical Manifestations	Diarrhea with watery stools Nausea and vomiting No thirst Anorexia Abdominal and/or epigastric fullness (likes pressure) Abdominal pain Gastrointestinal weakness Pale face Frequent urination Tends toward fatigue May have cold limbs May have headache with fever Body aches Epistaxis Hematemesis Shortness of breath Lassitude Epigastric pain All Blood from bleeding is pale Edema Insomnia Hemoptysis Intestinal bleeding Chronic bleeding Hemafecia Uterine bleeding Rectal bleeding Profuse menstrual flow Chest fullness and pain Hypochondriac pain that shoots toward the Heart Intolerance of Cold Rigid focal distention in the Heart region Excessive production or drooling of foamy saliva Emaciation T: Pale, may be moist C: White or None P: Deep, weak and slow or Deep and thready or Big and weak
Treatment Principle	Warms the Middle Jiao Dispels Cold Strengthens the Spleen and Stomach Tonifies Qi Stop bleeding
Herb Formulas	Li Zhong Tang Xiao Jian Zhong Tang
Points	General points

Interior Empty And Cold With False Heat In The Upper Body

Clinical Manifestations	Nose bleeding all day Not stopped by cool medicinals Dry mouth No desire to drink T: Pale C:Thin and white P: Hollow and slow or Empty and thready
Treatment Principle	Warm Cold Cool false Heat Stop bleeding
Herb Formulas
Points	DU-14, moxa REN-4, ST-36, UB-20

Longitudinal Luo Of The Urinary Bladder

Clinical Manifestations	Epistaxis Rhinorrhea
Treatment Principle
Herb Formulas
Points	KI-1, UB-58 KI-3, UB-58