Gingivitis, Periodontitis

General

Clinical Manifestations	Gingivitis is a common and mild form of gum disease (periodontal disease) that causes irritation, redness and swelling (inflammation) of the gingiva, the part of your gum around the base of your teeth. It's important to take gingivitis seriously and treat it promptly. Gingivitis can lead to much more serious gum disease called periodontitis and tooth loss. The most common cause of gingivitis is poor oral hygiene. Good oral health habits, such as brushing at least twice a day, flossing daily and getting regular dental checkups, can help prevent and reverse gingivitis. Healthy gums are firm and pale pink and fitted tightly around the teeth. Signs and symptoms of gingivitis include: Swollen or puffy gums Dusky red or dark red gums Gums that bleed easily when you brush or floss Bad breath Receding gums Tender gums Periodontitis is a serious gum infection that damages the soft tissue and destroys the bone that supports your teeth. Periodontitis can cause teeth to loosen or lead to tooth loss. Chronic periodontitis: is the most common type, affecting mostly adults, though children can be affected, too. This type is caused by plaque buildup and involves slow deterioration that may improve and get worse over time but causes destruction in the gums and bone and loss of teeth if not treated. Aggressive periodontitis: usually begins in childhood or early adulthood and affects only a small number of people. It tends to affect families and causes rapid progression of bone and tooth loss if untreated. Necrotizing periodontal disease: is characterized by the death of gum tissue, tooth ligaments and supporting bone caused by lack of blood supply (necrosis), resulting in severe infection. This type generally occurs in people with a suppressed immune system — such as from HIV infection, cancer treatment or other causes — and malnutrition. Signs and symptoms of periodontitis include: Swollen or puffy gums Bright red, dusky red or purplish gums Gums that feel tender when touched Gums that bleed easily Gums that pull away from your teeth (recede), making your teeth look longer than normal New spaces developing between your teeth Pus between your teeth and gums Bad breath Loose teeth Painful chewing A change in the way your teeth fit together when you bite
Treatment Principle
Herb Formulas

Tai Yang Shang Han

Clinical Manifestations	Severe chills Mild or no fever Gingivitis Headache Generalized discomfort Stiff neck and shoulders or Frozen shoulder 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 Maybe epistaxis (severe) T: Normal C: Thin and white P: Floating and tight
Treatment Principle	Relieve the Exterior Expel Cold Disperse the Lungs Stop asthma
Herb Formulas	Ge Gen Tang With Blood Stagnation: Tao He Cheng Qi Tang
Points	DU-16, GB-20, LI-4, LU-7, SJ-5, UB-12, UB-13 For a stiff neck: + GB-21, SI-3, Taiyang, UB-62

Tai Yang - Yang Ming

Clinical Manifestations	Gingivitis Fever and chills with fever increasing and chills decreasing Headache Anhidrosis Stiffness and pain of the extremities Orbital pain Eye pain Shoulder and neck tension Dry nasal passages Irritability Insomnia Thirst Epistaxis T: Normal C: Thin and yellow P: Floating and slightly flooding
Treatment Principle	Dispel Wind Release the muscle layer Clear Interior Heat
Herb Formulas	Chai Ge Jie Ji Tang Ge Gen Huang Qin Huang Lian Tang
Points

Tai Yang - Yang Ming - Shao Yin Heat

Clinical Manifestations	Early-stage gingivitis Dizziness Red, sore eyes Difficulty swallowing Nasal congestion and infection Thick, sticky nasal discharge and saliva Bitter taste in the mouth Dry mouth Focal distention in the chest and diaphragm Stifling sensation in the chest and diaphragm Manic behavior Carbuncles Heat rash Headache Acne Chills High fever Restlessness Urticaria Sore throat Swelling of the throat Coughing Reddish urine Dyspnea Vertigo Severe aversion to Cold Skin rashes Skin ruptures or ulcers Tense abdomen Shoulder stiffness Numb extremities Fatigue Constipation Dysuria with reddish urine Dark, rough urination Obesity Fullness of the abdomen Fullness of the epigastrium Heaviness in the head T: Red C: White or Yellow and greasy P: Flooding and rapid or Wiry and slippery or Floating, smooth and rapid or Floating, slippery, rapid and wiry or Floating, slippery, rapid and overflowing
Treatment Principle	Disperse Wind Release the Exterior Drain Heat Unblock the bowels
Herb Formulas	Fang Feng Tong Sheng San Shuang Jie Tong Sheng San
Points

Yang Ming Jing

Clinical Manifestations	Gingivitis High fever Profuse perspiration Great thirst with a desire to drink 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 With Blood Stagnation: Tao He Cheng Qi Tang
Points	DU-27, DU-28, GB-16, LI-3, LI-19, LU-7, SI-8, SJ-9, SJ-17, ST-4, ST-5, ST-44

Yang Ming Fluid Xu

Clinical Manifestations	Previous history of Yin, Jin Ye, or Blood Deficiency Previous history of Yang Ming Fluid and Yin depleted Gingivitis Anhidrosis Numbness Weakness Dryness Constipation T: Red C: Yellow and dry P:  Weak and thready
Treatment Principle	Moisten and Lubricate Nourish Yin and Fluids
Herb Formulas	Zeng Ye Cheng Qi Tang
Points	K-6, LI-11, SJ-6, ST-25, ST-37, ST-45, UB-25

Shao Yang - Yang Ming

Clinical Manifestations	Gingivitis Abdominal pain Constipation Hypochondriac pain 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 P: Deep, tight and wiry
Treatment Principle	Warm the Interior Disperse Cold Unblock the bowels Alleviate pain
Herb Formulas	Da Huang Fu Zi Tang
Points

Jue Yin Cold

Clinical Manifestations	Gingivitis 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 Vomits clear fluid Vertex headache Body cold Diarrhea Complete exhaustion of Yang T: Pale C: White P: Weak.
Treatment Principle	Warm Yang especially in the Liver and Stomach Descend turbidity
Herb Formulas	Dang Gui Si Ni Tang
Points	Moxa REN-4, REN-6, REN-8, REN-9, REN-12, ST-25

Wind-Heat Attacks The Lungs With Underlying Spleen And Stomach Heat

Clinical Manifestations	Periodontitis 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

Toxic Wind-Heat

Clinical Manifestations	Gingival redness, swelling, Heat and pain Leakage of pus and Blood Bad breath Maybe fever Maybe aversion to Cold Thirst T: Red C: Dry and white P: Floating and rapid
Treatment Principle	Expel Wind Clear Heat Resolve toxins Disperse swelling
Herb Formulas	Wu Wei Xiao Du Yin modified Qing Shang Fang Feng Tang Niu Huang Shang Qing Wan Niu Bang Jie Ji Tang
Points	LI-4, LI-7, SI-8, SJ-20 For the upper gums: + ST-44 For a frontal headache: + ST-8 For an occipital headache: + GB-20 For severe redness, swelling, Heat and pain: + ST-6, ST-7 For a fever: + PC-9, SJ-1

Qi Stage: Obstruction Of The Chest By Heat

Clinical Manifestations	Periodontitis High fever or Fever Aversion to Heat Irritability Restlessness (neither activity nor resting brings relief) Heat sensation in the chest Thirst Has urge to vomit but cannot May have dark yellow urine T: Red C: Yellow P: Rapid or Forceful and rapid
Treatment Principle	Clear Heat Remove Obstructions
Herb Formulas	Zhi Zi Chi Tang Zhi Zi Gan Cao Chi Tang Zhi Zi Sheng Jiang Chi Tang
Points	DU-14, HT-7, LI-11, PC-6, ST-44

Qi Stage: Lung And Stomach Heat Injures The Qi And Fluids

Clinical Manifestations	Lingering fever from a febrile disease Vomiting Irritability Thirst with a desire to drink Parched mouth, lips and throat Choking cough Restlessness Insomnia Nausea Anorexia Profuse perspiration A dry mouth Indigestion Toothache Listlessness Chest oppression Ulcerations of the mouth Coarse skin Cough Night sweats Stifling sensation in the chest or epigastrium T: Red C: Little or None P: Rapid and Deficient or Thready and rapid
Treatment Principle	Clear Heat Generate fluids Tonify Qi Harmonize the Stomach
Herb Formulas	Zhu Ye Shi Gao Tang Zhi Shi Zhi Zi Chi Tang
Points

Qi Stage: Gallbladder Heat

Clinical Manifestations	Gingivitis 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
Points	GB-34, Lanweixue, LI-11, LIV-2, LIV-3, LIV-4, LIV-13, LIV-14

Xue Stage: Excess Heat Causes Bleeding

Clinical Manifestations	Gingivitis 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	Si Sheng Wan
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

Large Intestine Heat

Clinical Manifestations	Gingivitis 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	Gingivitis 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 Qing Wei San + Tiao Wei Cheng Qi Tang
Points	REN-3, REN-12, SJ-6, SP-6, ST-44 For constipation: + ST-25, ST-37 For burning pain in the Stomach: + bleed ST-45 For acid regurgitation with a clamoring Stomach: + ST-36 LI-11, SJ-6, ST-25, ST-37, ST-44

Damp-Heat In The Spleen And Stomach

Clinical Manifestations	Swelling and inflammation of the gums with or without pus Mouth ulcers Bad breath Sore throat Toothache Dry mouth Constipation Dysuria Bleeding from the gums T: Red and dry C: Yellow-green P: Thready and rapid
Treatment Principle	Nourish Yin Generate Fluids Clear Heat Detoxify the Blood Stop inflammation Disseminate Lung Qi Resolve Dampness
Herb Formulas	Gan Lu Yin
Points

Spleen Not Governing Blood

Clinical Manifestations	Bleeding gums on slight stimulation Bleeding possibly profuse Bleeding worse with fatigue Pale gums Bruises easily Sallow or pale complexion Anorexia Four limbs feel tired and heavy Physical and mental exhaustion Fatigue Lassitude Weakness Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose or unformed stools Shortness of breath Disinclination to speak A weak voice Insomnia Dizziness Palpitations Functional Uterine Bleeding Purpura Epistaxis Hemafecia Hematuria Menorrhagia Metrorrhagia T: Pale and flabby - may have teethmarks C: White P: Thready and weak
Treatment Principle	Benefit Qi Conserve Blood
Herb Formulas	Gui Pi Tang  modified For atrophic, pale gums: Ba Zhen Tang modified For painful, swollen gums and fissuring with occasional discharges of pus wit Qi and Blood deficiency: Tuo Li Xiao Du Yin modified
Points	SP-1, SP-3, ST-6, ST-7, ST-36 With Blood Deficiency: + SP-6, UB-17 With lassitude, weakness, shortness of breath, disinclination to speak and a weak voice: + UB-20, UB-21 With palpitations and insomnia: + HT-7 With Dampness: + SP-9

Spleen And Stomach Qi Deficiency With Damp-Heat Flowing Into The Lower Jiao

Clinical Manifestations	Periodontal disease Loss of taste Anorexia Abdominal fullness and distention Irregular bowel movements Fatigue Lethargy A sensation of heaviness in the body Joint pain Chills Aversion to Wind A stuffy nose with mucus Sweating Sore limbs Dizziness Tinnitus Scanty, dark urination Frequent urination Leukorrhea Borborygmus A shiny, pale complexion A dry mouth and tongue A bitter taste in the mouth T: Pale C: Thin and white P: Floating, large and slow or Slippery and empty
Treatment Principle	Strengthens the Spleen Tonifies Qi Raises Yang Leaches out Dampness Dispels Wind and Dampness
Herb Formulas	Sheng Yang Yi Wei Tang
Points

Spleen And Kidney Yang Deficiency

Clinical Manifestations	Bleeding gums Pale, puffy gums Loose teeth A thin secretion from the cracks in the gums Somber white colored gums Listlessness Weakness Body cold Limbs icy Aversion to Cold Poor appetite Complexion white and shiny Low back, knees and abdomen feel cold and painful Lower abdomen feels cold and painful Loose stools containing undigested food “Cock-crow” diarrhea (occurs at about 5 am) Edema of face and limbs Dysuria Severe: Abdominal ascites T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep, thready, weak and maybe slow
Treatment Principle	Warm and Reinforce the Spleen and Kidneys
Herb Formulas	Jin Gui Shen Qi Wan  modified You Gui Wan  modified Chinese Patent Medicines: Jin Gui Shen Qi Wan
Points	REN-4, REN-6, SP-1, SP-3, ST-6, ST-7 With severe Spleen Deficiency: + ST-36 With severe Yang Deficiency: + DU-4 With a poor appetite and loose stools: + REN-12, SP-9

Stomach Fire

Clinical Manifestations	Redness, swelling, pain, ulceration and bleeding of gums Bleeding gums with fresh, red Blood Maybe discharge of pussy, bloody secretions Dry mouth Burning Heat and pain in the epigastrium Irritating thirst: drinks copious fluids and prefers cold drinks Excessive appetite: hungry again quickly after eating (as if food vanishes) Foul breath Toothache Red, flushed face Red lips Frontal headache Maybe vomiting right after eating Vomiting acid or undigested food Constipation or Sluggish stools Maybe scanty, red urine T: Red and possibly dry C: Thick, yellow and dry P: Slippery, big, Excess and rapid
Treatment Principle	Clear and Purge Stomach Fire
Herb Formulas	Qing Wei San modified Hua Ban Tang Zhu Ye Shi Gao Tang With Yin Deficiency: Yu Nu Jian Topical: 1. Boil 15g Rx. Scutellariae Huang Qin  in 1 cup of water for 20 minutes and hold the liquid in the mouth for as long as possible. 2. Bing Peng San 3. With dental caries and relatively severe pain: Gargle a decoction of 12g Nidus Vespae Lu Feng Fang and 12g Cx. Erythrinae Hai Tong Pi Chinese Patent Medicines: For Stomach Heat and Damp-Heat: Huang Lian Jie Du Wan For constipation: Niu Huang Qing Huo Wan For Heat in the upper body: Bei Jing Niu Huang Jie Du Pian Huang Lian Shang Qing Pian For Liver Fire: Long Dan Xie Gan Wan For massaging into the affected area to relieve pain and swelling: Shuang Lian Hou Feng San Topically to relieve pain and swelling: Xi Gua Shuang
Points	LI-4, LI-11, PC-8, REN-12, SJ-2, ST-6, ST-7, ST-44 With swelling: + SI-8, SJ-20 With severe pain: + LI-2, SI-5 With severe Heat: + bleed ST-45 With constipation: + SJ-6, ST-25 LI-4, LI-11, ST-6, ST-7, ST-44 For persistent bad breath: + PC-7, PC-8 For constipation: + ST-25, ST-37 For a bitter taste in the mouth: + GB-34 LI-4, LI-11, PC-6, PC-8, ST-6, ST-34, ST-36, ST-43, ST-44, ST-45, UB-21 DU-16, KI-3, LI-4, LI-10, REN-24, ST-6, ST-44 Acute: + Jinjin-Yuye Chronic: + moxa REN-24, ST-6 LI-4, LI-11, LIV-3, PC-6, PC-8, ST-6, ST-34, ST-43, ST-44, ST-45 Ear: Stomach, Mouth, Tragus Apex, Upper Jaw, Lower Jaw, Shenmen

Stomach Heat With Yin Deficiency

Clinical Manifestations	Bleeding gums Atrophy and retraction of the gums The roots of the teeth are revealed Maybe ulceration of the gums with slightly red margins Maybe occasional suppuration Toothache Loose, chipped or broken teeth Maybe pain when chewing Frontal headache Irritability Fever Thirst with a desire to drink cold beverages Epistaxis Dysphoria Excess hunger Hemoptysis Dry throat Dry skin Dry mucus membranes Blurred vision Poor memory Malar flush Night sweats Five-Sole-Heat Low back pain Hematemesis Restlessness Night sweats Warm sensations T: Red and dry C: Little or None or White or Yellow and dry P: Superficial, full, slippery, deficient and large or Gigantic and rapid or Rapid
Treatment Principle	Drain Heat from the Stomach Replenish Yin
Herb Formulas	Yu Nu Jian modified With Kidney Yin Deficiency: Liu Wei Di HUang Wan  modified Topical: Rinse the mouth with a decoction of 60-120g Hb. Ecliptae Mo Han Lian Chinese Patent Medicines: With Kidney Yin Deficiency: Liu Wei Di Huang Wan With Stomach Qi and Yin Deficiency: Gu Ben Wan With Deficient Heat: Zhi Bai Di Huang Wan With ulcerations and/or Heart and Kidney Yin Deficiency: Tian Wang Bu Xin Dan Topical to remove pain and swelling: Xi Gua Shuang
Points	KI-3, KI-6, LI-4, LU-7, REN-4, REN-12, SP-6, ST-36, UB-20, UB-21 To reinforce local circulation of Qi and Yin around the mouth: + Ahshi, DU-26, REN-24, ST-4 KI-6, LI-4, SP-6, ST-6, ST-7, ST-44 With bad breath: + PC-7 With dizziness: + DU-20, GB-20 With tinnitus: + GB-2 With low back pain: + KI-7, SP-4 With a clamoring Stomach and abdominal distention after meals: + REN-12, ST-36 For marked Deficiency Heat with nights sweats and Five-Sole- Heat: + DU-14, HT-6 Ear: Stomach, Kidney, Mouth, Upper Jaw, Lower Jaw, Shenmen

Heart Fire

Clinical Manifestations	Gingivitis Ulceration, erosion, and pain of mouth and tongue Thirst with a desire for cold drinks Irritability Irascibility Feeling of Heat and disturbance in the Heart Insomnia Flushed face Bitter taste in the mouth T: Red tip with ulcers especially on the tip P: Excess and rapid
Treatment Principle	Clear Heat Purge Fire Calm the Shen
Herb Formulas	Liang Ge San Xiao Ji Yin Zi
Points	HT-7, HT-8, PC-7, PC-8, UB-15

Heart Blood And Spleen Qi Deficiency

Clinical Manifestations	Gingivitis or periodontitis Palpitations Insomnia Anxiety 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 P: Thready and weak
Treatment Principle	Reinforce and Benefit the Heart and Spleen
Herb Formulas	Gui Pi Tang  modified Chinese Patent Medicines: Ba Zhen Wan Gui Pi Wan With Cold: Shi Quan Da Bu Wan With Kidney Yang Deficiency: Jin Gui Shen Qi Wan
Points	HT-7, REN-4, SP-1, SP-6, ST-36, UB-15, UB-20

Liver Qi Stagnation Turning To Heat With Qi And Blood Deficiency

Clinical Manifestations	Gingivitis Irritability Short temper Restlessness Fever or tidal fever Red eyes Dry mouth and throat Palpitations Lower abdominal pain Difficult urination Painful urination Increased menstrual flow Uterine bleeding Early menstruation Aching in limbs Dizziness Mental instability Red face Thirst Turbid urine Alternating chills and fever Red cheeks Wheezing Nervousness Headache Red eyes Dry mouth Anorexia Infertility Abdominal pain Spontaneous sweating or night sweats with fever Anxiety Dry eyes Hypochondriac pain Somnolence Insomnia Aching shoulders Five Sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude Depression Restlessness Constipation with flushing up Pale complexion Bitter taste in mouth Vertigo Abdominal distention near the umbilicus Epistaxis Irregular menstruation Heaviness in the lower abdomen T:Red or Red edges C: Thin and yellow P: Thready, rapid and wiry or Wiry and tight and rapid
Treatment Principle	Pacify the Liver Spread Liver Qi Strengthen the Spleen Nourish the Blood and Yin Regulate menstruation Sedate the Heart Clear Heat
Herb Formulas	Jia Wei Xiao Yao San
Points

Liver Fire Attacks The Stomach

Clinical Manifestations	Gingivitis or periodontitis Redness, swelling and bleeding of the gums Symptoms worse with emotional stress Hematemesis 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 Epistaxis 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	Long Dan Xie Gan Tang  modified Chinese Patent Medicines: Long Dan Xie Gan Wan For massaging into the affected area to relieve pain and swelling: Shuang Lian Hou Feng San Topically to relieve pain and swelling: Xi Gua Shuang
Points	LI-4, LI-11, LIV-2, PC-8, REN-12, SJ-2, ST-6, ST-7, ST-44 With swelling: + SI-8, SJ-20 With severe pain: + LI-2, SI-5 With severe Heat: + bleed ST-45 With constipation: + SJ-6, ST-25 GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19

Liver And Gallbladder Damp-Heat

Clinical Manifestations	Gingivitis Yang jaundice (sclera and skin bright yellow) Pain and fullness in ribs on both sides Maybe pain in the right hypochondrium Bitter taste in mouth Nausea 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	Yin Chen Hao Tang
Points	Dannangxue, DU-9, GB-24, GB-34, LIV-14, SI-4, SP-9, UB-18, UB-19, UB-48

Liver And Stomach Fire

Clinical Manifestations	Gingivitis Headache Dizziness Red eyes Tinnitus Oral ulcers Bleeding gums Constipation
Treatment Principle	Purge Fire Detoxify Draw out pus
Herb Formulas	Niu Huang Jie Di Pian
Points

Liver And Kidney Yin Deficiency

Clinical Manifestations	Loose teeth Receding, atrophic gums Possible gum swelling with slight pain Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome), weakness Tinnitus Deafness Forgetfulness Low back and knees sore and painful Throat dry and painful Five Sole Heat Low-grade fever Night sweats Irritability Insomnia Stools difficult to pass Constipation Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Liver and Kidneys Strengthen the bones Harden the teeth
Herb Formulas	Liu Wei Di Huang Wan  modified
Points	KI-3, SP-6, ST-5, ST-6, ST-7 For seminal emissions: + UB-52 For a sore throat: + KI-6, SJ-6 For marked deficiency Heat: + HT-6, KI-7 KI-3, LIV-3, SP-6, UB-18, UB-23

Kidney Yin Deficiency With Fire Flaring

Clinical Manifestations	Gingivitis Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of the low back Spermatorrhea or Premature ejaculation Aching in the bones Aching in the leg and heel Dry mouth Thirst Night sweats Five Sole Heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Urine short and red Heightened libido If Heart Fire also Flares: Insomnia Frequent dreams Palpitations If Liver Yang also Rises: Dizziness Blurred vision T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zhi Bai Di Huang Wan
Points	KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23 If Heart Fire also Flares: HT-7, PC-7, UB-15 If Liver Yang also Rises: LIV-3, UB-18

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

Qi And Blood Deficiency

Clinical Manifestations	Gingivitis Atrophy of the gums revealing the roots of the teeth Pale gums Loose teeth The gums bleed easily with brushing and chewing May bruise easily Maybe epistaxis Maybe uterine bleeding Maybe heavy menstrual bleeding A waxy, pale complexion Pale lips Pale conjunctiva Postural dizziness Blurred vision Anorexia Abdominal distention Loose stools Fatigue Weakness Shortness of breath Low voice Insomnia Frequent vivid dreaming Restless sleep Palpitations T: Pale C: Thin and white P: Thready and weak or Hollow (with significant Blood loss)
Treatment Principle	Tonify Qi and Blood Aid discharge of pus Promote healing
Herb Formulas	Ba Zhen Tang Chinese Patent Medicines: Ba Zhen Wan Gui Pi Wan With Cold: Shi Quan Da Bu Wan With Kidney Yang Deficiency: Jin Gui Shen Qi Wan
Points	LI-4, LI-11, REN-4, REN-12, SP-6, ST-36, UB-20, UB-21 With Kidney Yang Deficiency: + KI-3, moxa or moxa needle DU-4, UB-23 With frequent bleeding: moxa or moxa needle SP-1 To reinforce local circulation of Qi and Blood: + DU-26, REN-24, ST-4 Ear: Stomach, Spleen Mouth Upper Jaw, Lower Jaw, Shenmen

Blood Stagnation

Clinical Manifestations	Chronic gum disease Discolored, purplish, patchy or dark red atrophic gums Loose teeth Painful receding gums Persistent insomnia with much dreaming and restlessness Low grade fever at night Irritability A short temper Depression Mood swings Frequently bleeding gums Dizziness Forgetfulness Dry, scaly skin Hair loss Broken vessels or spider naevi on the face, trunk, inner knee and ankle Purplish lips, sclera, conjunctiva and nails Dark rings around the eyes Pain that is fixed, stabbing and /or severe Pain 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 Varicose veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the Blood Break up Stagnation
Herb Formulas	Xue Fu Zhu Yu Tang  modified Topical: Zhi Teng Jiu Chinese Patent Medicines: Xue Fu Zhu Yu Wan + Tong Jing Wan Jian Kang Wan Sheng Tian Qi Pian To stop bleedings: + Yun Nan Bai Yao
Points	Ahshi Points, LI-4, SP-6, SP-10, ST-36, UB-17, UB-18, UB-21 With depression: + LIV-3 SP-6, SP-10, ST-36, UB-17, UB-40 Ear: Liver, Mouth, Sympathetic, Stomach, Shenmen

Toxic Heat

Clinical Manifestations	Gingivitis Suppurative, bleeding gums with copious, fresh, red Blood Maybe epistaxis Maybe bleeding sclera Maybe bleeding skin eruptions Fever and chills or High fever Malaise Irritability Restlessness Severe thirst Bad breath Muscle and bone aches Constipation or Diarrhea Concentrated urine T: Red C: Yellow P: Forceful and rapid or Hollow
Treatment Principle	Clear Toxic Heat from the Stomach Cool the Blood
Herb Formulas	Huang Lian Jie Du Tang modified Huang Lian Shang Qing Wan Xi Jiao San Chinese Patent Medicines: For Stomach Heat and Damp-Heat: Huang Lian Jie Du Wan For constipation: Niu Huang Qing Huo Wan For Heat in the upper body: Bei Jing Niu Huang Jie Du Pian Huang Lian Shang Qing Pian For massaging into the affected area to relieve pain and swelling: Shuang Lian Hou Feng San Topically to relieve pain and swelling: Xi Gua Shuang
Points	LI-4, LI-11, LIV-2, PC-3, PC-8, REN-12, SJ-2, ST-6, ST-7, ST-44, ST-45, UB-40 With swelling: + SI-8, SJ-20 With severe pain: + LI-2, SI-5 With severe Heat: + bleed ST-45 With constipation: + SJ-6, ST-25 With Liver Fire: + LIV-2

Longitudinal Luo Of The Large Intestine

Clinical Manifestations	Yang: Gingivitis Dental caries Painful gums Deafness Yin: Gingivitis Cold gums Cold teeth Chest pain Headaches Dizziness Blurred vision
Treatment Principle
Herb Formulas
Points	LI-6, LI-15 LI-6, LU-9 LI-6, LU-11