Glaucoma

General

Clinical Manifestations	Excess eye ball pressure exceeding the normal 10-20 mmHg pressure to 50 mmHg. Can be asymptomatic in first stages but may include headache, visual disturbances, Halo Vision, Cloudy vision leading to tunnel vision, distended eye pain radiating to head areas. Simple chronic glaucoma is known as "open-angle" glaucoma (the reference is to the iridocorneal angle measured during an eye examination). It usually affects both eyes, has a genetic component (runs in families; the predisposing genetic background may yield an early age of onset), and is more common among diabetics. Chronic open-angle glaucoma is essentially asymptomatic (the person may experience headaches, but these are not necessarily attributed to the eyes), and one simply experiences deteriorating vision, which can have numerous other causes. Acute glaucoma, which can become chronic, known as "closed angle" or "angle-closure" glaucoma; this type can rapidly lead to vision loss and there may be obvious symptoms, such as severe eye pain. This is considered an emergency condition, treated by drugs (internal and topical), and sometimes by surgery. It most often occurs in one eye (though the other eye may later become affected). Symptoms: Poor vision Gradual loss of peripheral vision Severe headache Nausea/vomiting Late-stage: Loss of central vision
Treatment Principle
Herb Formulas	Jia Wei Xiao Yao San Xie Gan Jie Yu Tang Wen Dan Tang + You Gui Wan(may add Er Chen Tang) Zi Shen Ming Mu Tang For draining Fluids: Wu Ling San modified For Yin Deficiency results in dominance of Yang: Liu Wei Di Huang Tang Qi Ju Di Huang Wan For acute (closed angle) glaucoma: Wu Ling San modified For acute congestive glaucoma: Wu Zhu Yu Tang With ciliary congestion: Shi Wei San
Points	GB-1, GB-20, GB-21, GB-30, GB-37, GB-40, ST-2, ST-36, ST-41, UB-2, UB-64, UB-67, Extra Glaucoma #1 (1 cun superior to and 1 finger breadth lateral to SJ-23. In the tender spot, needle posteriorly until a strong De Qi sensation is obtained), Extra Glaucoma #2 (1/2 cun anterior to ST-5. needle posteriorly until a strong De Qi sensation is obtained). GB-1, GB-20, KI-3, LI-4, LIV-3, SP-6, UB-2, UB-48 Mild: + ST-36 Severe: + UB-62, UB-63 Moxa REN-12, ST-36, UB-19, UB-20, UB-22, UB-23 Ear: Reactive Points, Liver, eye, Depression Groove, Eye 1, Eye 2 Plum blossom: UB channel on the back

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 nose Epistaxis 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

Jue Yin Level - Cold And Heat

Clinical Manifestations	Intermittent attacks of abdominal pain Stifling sensation in the chest and epigastrium A sensation of warmth in the chest and epigastrium Irritability in the chest and epigastrium Vomiting after eating Extremely Cold extremities Vomiting of roundworms Incessant diarrhea Hunger with no desire to eat Vomiting immediately after eating Heat in the Stomach with Cold in the Intestines Bitter taste in the mouth Frequent urination Anxiety Abdominal pain (better with warmth and pressure) Pain beneath the Heart Borborygmus Unquenchable thirst Running piglet Qi Pain and Heat in the Stomach Discharge of small amounts of pus Irritability Recurrent nausea and vomiting Diarrhea Dry throat Turbid urine Polydipsia T: Red or geographic or pale C: White P: Hidden or Wiry and tight
Treatment Principle	Warm the Internal organs Warm the Middle Jiao Warms the Intestines Drains Heat Replenishes Qi Dispels parasites Calms roundworms Drains the Liver Calms the Stomach Promotes Blood circulation Relieves pain
Herb Formulas	Wu Mei Wan
Points

Wind Heat

Clinical Manifestations	Redness, pain and swelling of the eyes Dizziness Right hypochondriac pain and tension Headache Abdominal tension T: Red tip C: Thin yellow P: Floating and rapid
Treatment Principle	Dispel Wind Clear Heat Release pathogens from the Exterior Reduce swelling and pain Clear the eyes
Herb Formulas	Xi Gan Ming Mu San
Points

Wind-Heat Attacks The Liver Channel

Clinical Manifestations	Hot tears appear on exposure to Wind Red eyes Eyes feel gritty Dry mouth Dry nose Dizziness Vertigo Tinnitus T: Red C: Thin white P: Wiry or Thready and rapid
Treatment Principle	Mild cases: Cool the Liver Expel Wind Severe cases: Expel Wind-Heat Nourish Yin Clear Fire
Herb Formulas	Ling Yang Jiao San
Points

Deficiency Cold Of The Stomach And Liver

Clinical Manifestations	Lacrimation Vomiting immediately after eating Indeterminate gnawing hunger Acid regurgitation Belching May be epigastric pain Dry heaves or spitting of clear fluids with vertex headache Vomiting and diarrhea with cold hands and feet Restlessness Severe fidgeting Irritability So agitated, the patient wants to die Habitual headache Subcardiac distention A feeling of fullness and distention in the chest and diaphragm T: Pale C: White and slippery P: Slow and weak or Sinking or slow and thin or slow and wiry
Treatment Principle	Warm and tonify the Stomach and Liver Descends Rebellious Qi Stop Lacrimation
Herb Formulas	Wu Zhu Yu Tang
Points

Heart Fire Due To Kidney And Liver Yin Deficiency

Clinical Manifestations	Palpitations Insomnia Tinnitus Dizziness Diminished acuity of vision and hearing Seizures Headache Deafness Blurred vision
Treatment Principle	Heavily sedates and Calms the Shen Anchors Yang Improves vision and hearing
Herb Formulas	Ci Zhu Wan
Points

Liver Qi Stagnation Invades The Spleen

Clinical Manifestations	Abdominal distention and pain Gas Borborygmus Diarrhea Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Women: Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: White and greasy P: Slippery and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Xiao Yao San Hei Xiao Yao San
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

Liver Qi Stagnation Generating Fire (Open Angle)

Clinical Manifestations	Breast distention Lower abdominal pain 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 Anorexia 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	Soothe the Liver Clear Heat Cool the Blood Consolidate the Chong Mai
Herb Formulas	Jia Wei Xiao Yao San Long Dan Xie Gan Tang Xie Qing Wan Xie Gan Jie Yu Tang For draining Fluids: Wu Ling Sanmodified
Points

Liver Qi Stagnation With Blood Deficiency

Clinical Manifestations	Hypochondriac pain Headache Vertigo Bitter taste in the mouth Dizziness Frequent sighing Epigastric pain and distention Flatulence Dry mouth and throat Fatigue Anorexia Alternating chills and fever Irregular menstruation Breast distention Lassitude Insomnia Shoulder and back pain Rib pain Anxiety Tightness or fullness in the chest Cold extremities Pain in the arms and legs Heaviness of the head Night sweats Bloating and pain at the umbilicus and abdomen Diarrhea alternating with constipation Five sole heat Palpitations Malar flush Depression Irritability Increased desire to sleep T: Pink C: Thin white or yellow P: Wiry and Deficient or Wiry, tight and Deficient
Treatment Principle	Pacify the Liver Spread Liver Qi Strengthens the Spleen Nourishes the Blood Harmonizes the Liver and Spleen
Herb Formulas	Xiao Yao San
Points

Liver Fire

Clinical Manifestations	Red, swollen, painful eyes Severe, splitting headaches with dizziness Maybe one-sided headache that connects to the vertex Teeth very painful Sudden tinnitus or deafness Violent burning pain Vertigo Tinnitus Irritability Flushed face Irascibility with violent angry outbursts Suffocating feeling in the chest Thirst Dry mouth Bitter taste in mouth Thirst Nausea Vomiting sour or bitter liquid Hypochondriac pain Insomnia Restlessness Constipation or dry stools Vomiting Lumps in the upper abdomen or chest Maybe rib pain T: Red tip and edges C: Thick, yellow, dry and rough P: Wiry, Excess and rapid
	Clear Liver Purge Fire
Herb Formulas	Shi Gan Ming Mu Tang Long Dan Xie Gan Tang
Points	GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19 LIV-2, GB-34 DU-14, DU-20, GB-20, KI-7, LI-4, LU-7, ST-8, ST-44, Taiyang Yang Ming: REN-12, ST-25, ST-40, UB-20, UB-21 Shao Yang: GB-34, GB-43, UB-19 GB-3, GB-7, GB-12, GB-34, LIV-2, UB-18, UB-19 GB-20, LIV-2, LI-4, bleed Taiyang DU-20, GB-8, GB-20, GB-40, LIV-3, SJ-3, ST-8, ST-43, Taiyang DU-20, GB-43, LIV-2, Taiyang Cutaneous and cupping: L-1 to S-4, GB-20, GB-14, Taiyang Ear: Subcortex, Forehead, Occiput, Kidney, Gall Bladder

Liver Wind Stirring Internally: Liver Fire Generates Wind

Clinical Manifestations	Dizziness and vertigo to the point of falling over Headache with a drawing sensation Numbness and tremor of limbs Twitching and involuntary writhing of hands and feet Dysphasia Unsteady gait Sudden loss of consciousness Tongue stiffness with aphasia Facial paralysis Hemiplegia T: Red P: Thready and wiry
Treatment Principle	Nourish Yin Pacify the Liver Subdue Wind
Herb Formulas	Zhen Gan Xi Feng Tang Tian Ma Gou Teng Yin
Points	LIV-2, LIV-14, Ear Shenmen Bleed the Jing-Well points of Six Hand Channels to reduce Heat (Shixuan), DU-20, DU-26, GB-20, GB-34, KI-1, KI-3, LIV-2, LIV-3, PC-8, UB-18, UB-23 DU-24, GB-3, GB-20, KI-1, LI-1, SI-1, ST-43, UB-62 GB-1, GB-20, KI-3, LI-4, LIV-2, LIV-3, SP-6, ST-36, UB-2, UB-18, UB-62, UB-63 GB-8, GB-20, LI-11, Qiuhou, Taiyang, UB-1 GB-20, LI-4, LIV-2 GB-20, LIV-3, Qiuhou, UB-1 Plum blossom: Tap the UB channel Ear: Allergy, Liver, Eye, Low Back Pain Groove, Vision #1, Vision #2

Liver Wind Stirring Internally: Extreme Heat Generates Wind

Clinical Manifestations	Persistent high fever Irritability Restlessness Dizziness Vertigo Twitching Spasms of the extremities Insomnia Tinnitus Bitter taste in the mouth Deafness Dry throat Stiff neck with convulsions Severe headache Loss of consciousness Maybe opisthotonos Maybe expectoration of thick, yellow sputum T: Deep red, dry or burnt with prickles C: Yellow and dry P: Wiry and rapid or Wiry and smooth
Treatment Principle	Cools the Liver Extinguishes Wind Increases Fluids
Herb Formulas	Ling (Yang) Jiao Gou Teng Tang
Points	Bleed the Jing-Well points of Six Hand Channels (Shixuan), DU-14, DU-16, DU-20, DU-26, LI-11, LIV-2, LIV-3

Liver Qi And Blood Stagnation

Clinical Manifestations	Glaucoma Distended pain in the lower abdomen Hypochondriac pain Headache Vertigo Bitter taste in the mouth Dizziness Frequent sighing Epigastric pain and distention Flatulence Dry mouth and throat Fatigue Anorexia Alternating chills and fever Irregular menstruation Breast distention Lassitude Insomnia Shoulder and back pain Rib pain	Cold extremities Tightness or fullness in the chest Pain in the arms and legs Heaviness of the head Night sweats Bloating and pain at the umbilicus and abdomen Diarrhea alternating with constipation Five sole heat Palpitations Malar flush Depression Irritability Increased desire to sleep Flatulence T: Red edges C:Thin white or yellow P: Wiry and Deficient or Wiry, tight and Deficient
Treatment Principle	Regulate Liver Qi and Blood Remove Stagnation Regulate menstruation
Herb Formulas	Xiao Yao San With more severe Blood Deficiency: Hei Xiao Yao San
Points

Damp-Heat In The Liver And Gallbladder

Clinical Manifestations	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	Long Dan Xie Gan Tang
Points	Dannangxue, DU-9, GB-24, GB-34, LIV-14, SI-4, SP-9, UB-18, UB-19, UB-48

Liver Yin Deficiency With Liver Yang Rising

Clinical Manifestations	Throbbing headache with distended feeling Dizziness Vertigo Tinnitus Blurred vision Sensation of Heat rushing to the head Insomnia Dream disturbed sleep Numbness Irascibility Dizziness Flushed face Blurred vision Red, dry eyes with feeling of grit in eye Tinnitus Dry mouth and throat with bitter taste in mouth Insomnia Palpitations T: Red and dry C: Little or None P: Thready and wiry or Wiry and rapid (when Yang is Rising and Excess, the pulse is forceful) P: Thready and rapid when Yang is not prominent
Treatment Principle	Nourish Yin Pacify the Liver. Subdue Yang
Herb Formulas	Shi Gan Ming Mu Tang
Points	DU-20, GB-20, GB-34, GB-43  KI-3, LIV-2, LIV-3, UB-18, UB-23

Liver And Kidney Yin Deficiency

Clinical Manifestations	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
Herb Formulas	Ming Mu Di Huang Wan #2 Qi Ju Di Huang Wan
Points	KI-3, LIV-3, SP-6, UB-18, UB-23

Liver And Kidney Yin Deficiency With Blood Deficiency Leading To Empty Fire Rising With Blood Stagnation And Liver Wind

Clinical Manifestations	Enlarged pupils Blurred vision Photophobia Excessive tearing Light-headedness Vertigo Dry eyes Irritation of the eyes Photophobia Poor vision Red eyes Dizziness Glare Insomnia Night sweating Pain in the lower back Weakness of lower back T: Red-tipped (may be trembling) C: Little or None P: Rapid and Empty
Treatment Principle	Nourish Yin Descend Liver Yang Dispel Internal Wind Brighten the eyes
Herb Formulas	Shi Hu Ye Guang Wan
Points

Kidney Yang Deficiency

Clinical Manifestations	Lumbago: low back feels cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Pale face Urinary frequency with abundant, clear urine or Oliguria with edema Maybe nocturia Lassitude Withdrawn, subdued behavior Knees feel cold and aching Dizziness Tinnitus Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow
Treatment Principle	Warm and Reinforce Kidney Yang
Herb Formulas	Jing Gui Shen Qi Wan With Water Flooding: Wu Ling San
Points	Moxa or moxa needle DU-4, KI-3, REN-4, UB-23

Yin Deficiency Generating Empty Fire (Open Angle)

Clinical Manifestations	Palpitations Tinnitus Diminished acuity of vision and hearing Blurred vision Insomnia with much dreaming Spermatorrhea with erotic dreams Premature ejaculation Irritability Easily startled Poor memory Dizziness 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 Heart and Kidney Yin
Herb Formulas	Liu Wei Di Huang Tang Qi Ju Di Huang Tang modified Ci Zhu Wan Nei Zhang Ming Yan Wan
Points	UB-15, UB-23, HT-7, PC-6, PC-7

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
Points

Blood Stagnation Generating Fire (Closed Angle)

Clinical Manifestations	High fever Bleeding Hematemesis Epistaxis Hemoptysis Hemafecia Hematuria Purplish skin rashes (maculae) Black, tarry stools Abdominal distension and fullness Thirst with an inability to swallow Menorrhagia Mania T: Scarlet with prickles or Deep purplish P: Thin and rapid
Treatment Principle	Clear Heat Relieve Fire toxicity Cool the Blood Nourishes the Yin Dispel Blood Stasis Stop bleeding
Herb Formulas	Xi Jiao Di Huang Tang
Points

Phlegm-Fluid Accumulation Generating Fire (Open Angle)

Clinical Manifestations	Nausea Vomiting Hiccups Coughs with clear, profuse Phlegm or Coughs with thick yellow Phlegm Loose and watery stools Facial edema, Palpitations Shortness of breath
Treatment Principle	Dry Dampness Transform Phlegm Clear Heat Invigorate the Blood Dispel Blood Stasis Nourish Yin Disperse Wind Calm the Liver Clear the eyes
Herb Formulas	Jia Wei Xiao Yao San Er Chen Tang For draining Fluids: Wu Ling San modified Si Ling San For Phlegm Rushing Upward: Ling Yang Jiao San #1 For gradual upward movement of phlegm: Dao Tan Tang
Points

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
Points