Myalgic Encephalomyelitis

General

Clinical Manifestations	M.E. is a chronic disease characterized by: Disabling fatigue Exhaustion Muscle pain Headaches Joint pain Confusion Poor concentration Poor memory Insomnia Light-headedness Dizziness Blurred vision Eye pain Light sensitivity Gastrointestinal disturbances Abdominal pain Depression Fever Chills Night sweats A recurrent sore throat Lymph node tenderness Skin rashes Neurological complaints It frequently follows a viral infection It can occur as a sequela to: Otitis media Hepatitis Glandular fever Acute Stage: Continuous or repeated flu-like symptoms Pharyngalgia Blocked or runny nose Chills Swollen glands Nausea Vomiting Diarrhea Cough Genera; fatigue Lack of energy Exhaustion Weariness Lack of expression Memory loss Lack of concentration Reduced capacity for work Insomnia Dizziness Nervousness General migratory soreness and pain in the: Muscles Neck Head Body Stomach Costal and hypochondriac regions Abdomen Chronic Stage: The acute symptoms may recur occasionally General exhaustion Fatigue Insomnia Drowsiness Forgetfulness Reduced or lost capacity for work Easily infected by pathogenic factors Aching or pain in the muscles (worse with Dampness)
Treatment Principle
Herb Formulas
Points	DU-14, DU-20 For the acute stage: + GB-20, LI-4, LI-11, LIV-3, SP-6, ST-44 For the chronic stage: + moxa or moxa needle DU-4, UB-13, UB-15, UB-18, UB-20, UB-23

Shao Yang Jing

Clinical Manifestations	Alternating chills and fever Restlessness Irritability Anorexia Sometimes fatigue Nausea Occasional vomiting Headaches (side of head) Hypochondriac pain and fullness Dry throat Rib pain Achiness Ear infection Hearing difficulty Red eyes Blurred vision Stiff shoulders Throat pain Hip pain T: Normal with bumps or dots on side C: Thin white or White and slippery on one side only P: Wiry
Treatment Principle	Harmonize the Liver and Gall Bladder
Herb Formulas	Xiao Chai Hu Tang With pronounced Dampness: Da Yuan Yin
Points	DU-14, SJ-5 GB-41, SJ-5 To harmonize the Liver and Gall Bladder: GB-34, LIV-3, LIV-14, SJ-5 To stop nausea and vomiting: PC-6, SP-4, ST-36 To treat headache: GB-1, GB-8, GB-14, Taiyang To treat constipation: SJ-6, ST-25 To treat fever: DU-13, DU-14 To support the San Jiao and Regulate Yin: PC-5, PC-6 To support Yin: KI-7 To support the Ying: SP-10 Head: GB-8, SJ-20, Yintang Eyes: GB-14, GB-20, ST-1, UB-1, UB-2 Ear: GB-2, SJ-5, SJ-17, SJ-21 Hypochondriac area: GB-34, GB-40 Ear: Shenmen, Gall Bladder, Point 0

Qi Stage: Lung Heat

Clinical Manifestations	High fever No chills Aversion to Heat Cough Asthma Restlessness Thirst Dark yellow urine Dyspnea Chest pain Shortness of breath Thick yellow Phlegm T: Red C: Thick and yellow, maybe dry and sticky P:  Rapid, maybe slippery, maybe forceful
Treatment Principle	Clear Heat in Lungs Strengthen when weak or elderly
Herb Formulas	Xie Bai San
Points	Dingchuan, DU-13, DU-14, LI-11, LU-5, LU-10, ST-44. UB-13

Qi Stage: Heat Obstructing The Chest

Clinical Manifestations	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 Shi Zhi Zi Chi Tang
Points	DU-14, HT-7, LI-11, PC-6, ST-44

Qi Stage: Gallbladder Heat

Clinical Manifestations	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 Gallbladder Heat Pacify the Liver and Gallbladder
Herb Formulas	Hao Qin Qing Dan Tang With pronounced Dampness: Da Yuan Yin
Points	DU-14, SJ-5 GB-34, Lanweixue, LI-11, LIV-2, LIV-3, LIV-4, LIV-13, LIV-14

Lung Yin Deficiency

Clinical Manifestations	Severe, dry hacking cough No sputum expectorated Small amounts of difficult to expectorate sputum Blood tinged sputum (when Yin Deficiency Fire is present) Afternoon fever Night sweats Malar flush (especially in afternoon) Five Sole Heat Dry mouth and throat Itching in throat Hoarse voice, low voice or loss of voice Exhaustion Emaciation T: Red and dry C: None P: Thready and rapid or Floating and empty
Treatment Principle	Nourish Yin Moisten the Lungs
Herb Formulas	Sha Shen Mai Men Dong Tang
Points	DU-12, LU-9, REN-12, REN-17, SP-6, ST-36, UB-13, UB-43 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

Stomach Yin Deficiency

Clinical Manifestations	No appetite or Famished but with no desire to eat Dry mouth Thirst with no desire to drink or a desire to drink in small sips Fatigue Abdominal distention after meals Dry stools Irritability with low grade fever Maybe dry retching or Hiccups Slight epigastric pain Malar flush T: Red C: Little and dry P: Thready and rapid or Floating and empty
Treatment Principle	Nourish Yin Nourish the Stomach
Herb Formulas	Yi Wei Tang modified
Points	REN-12, SP-6, ST-36, ST-44 KI-3, REN-12, SP-6, ST-36, UB-21

Kidney Yin Deficiency

Clinical Manifestations	Low back pain Exhaustion Depression Lack of drive and will power Weak knees and legs Dizziness Tinnitus Deafness Dry mouth and throat which are worse at night Night sweats Malar flush Insomnia (wakes in the middle of the night Thin body T: Red C: Little or None P:Thready and rapid or Floating and empty
Treatment Principle	Nourish Yin Tonify the Kidneys Strengthen the will power
Herb Formulas	Zuo Gui Wan
Points	KI-3, KI-6, LU-7, REN-4, SP-6, UB-23, UB-52

Yang Deficiency

Clinical Manifestations	Body cold Limbs icy Complexion white and shiny Low back, knees and abdomen feel cold and painful Sensation of Cold in the back A bright, white facial complexion 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 Impotence Premature ejaculation Lack of sexual desire Lassitude Abundant, clear urination Apathy Edema of the ankles Infertility 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	Men: You Gui Wan Women: You Gui Wan  modified
Points	Moxa or moxa needle DU-4, REN-4, KI-3, K-7, UB-23 , UB-52

Yang Deficiency With Dampness (Chronic)

Clinical Manifestations	Lack of energy Fatigue Heaviness of the whole body Edema in the lower legs Thin Leukorrhea T: Pale and fat with teethmarks C: White P: Weak and thready
Treatment Principle	Warm Yang Purge water
Herb Formulas	Zhen Wu Tang modified You Gui Wan modified
Points

Yin Deficiency With Dampness (Chronic)

Clinical Manifestations	Epigastric distress A dry mouth A dull complexion Weight loss Afternoon or evening tidal fever Irritability Insomnia T: Deep red C: Scanty and white P: Thready
Treatment Principle	Tonify Yin Eliminate Dampness
Herb Formulas	Shen Ling Bai Zhu San Liu Wei Di Huang Wan For a stronger effect: Shen Ling Bai Zhu San + Liu Wei Di Huang Wan
Points

Qi Deficiency With Dampness (Chronic)

Clinical Manifestations	A bloated sensation with pain in the Stomach Abdominal distention Borborygmus A poor appetite Loose stools Lack of energy Drowsiness Shortness of breath Disinclination to speak A pale complexion A puffy face T: Pale C: White P: Thready and slippery
Treatment Principle	Reinforce Qi Dry or drain Dampness
Herb Formulas	Xiang Sha Liu Jun Zi Tang modified
Points

Heat In The Interior

Clinical Manifestations	Muscle fatigue with no or only slight aching Thirst Insomnia Cough with scanty, yellow sputum Fatigue Breathlessness on exertion Weight lossDry throat T: Red with a redder tip C: Yellow P: Rapid and slightly wiry
Treatment Principle	Clear Interior Heat
Herb Formulas	Zhi Shi Zhi Zi Chi Tang Xie Bai San With Heat in the Heart: Dao Chi San With Heat in the Stomach: Xie Huang San
Points	DU-14, HT-8, LI-11, LU-10, SJ-5, SP-6

Dampness Accumulation In The Interior (Acute)

Clinical Manifestations	Whole body soreness and stiffness Vague aches and pains Drowsiness Insomnia Poor memory Blurred vision Dizziness Loose stools Leukorrhea T: Pale red C: Greasy and white P: Slippery
Treatment Principle	Drain Dampness Regulate Qi
Herb Formulas	San Ren Tang
Points

Cold-Damp In Te Interior (Acute)

Clinical Manifestations	Blurred vision Dizziness A feeling of distention and pain in the Stomach Cold limbs Loose stools or Diarrhea A cold sensation in the lower abdomen Soreness and aching of the whole body Lack of energy Fatigue Drowsiness Insomnia A poor memory T: Pale C: White P: Slow and slippery
Treatment Principle	Warm Cold Dispel Dampness
Herb Formulas	Ling Gui Zhu Gan Tangmodified
Points

Damp-Heat In The Interior With Heat Predominant (Acute)

Clinical Manifestations	Not much Dampness Pain and heaviness in the head and body Irritability Insomnia Tinnitus Bitter taste and smell in the mouth Fullness and distention of the chest Constipation Hiccups Frequent sighing Fullness and pain in the hypochondria region, chest and back A dry, gritty sensation in the eyes T: Red C: Yellow and greasy P: Wiry and Rapid
Treatment Principle	Clear Heat Dry Dampness
Herb Formulas	Long Dan Xie Gan Tang
Points

Upper Jiao Damp-Heat (Acute)

Clinical Manifestations	A dry, sore throat Turbid nasal discharge Tinnitus Headache Pain in the: Shoulders Neck Back T: Light red C: Thin, yellow and greasy P: Soft
Treatment Principle	Clear Lung Heat Resolve Exterior Dampness
Herb Formulas	Huo Po Xia Ling Tang modified Yin Qiao Sanmodified
Points

Middle Jiao Damp-Heat (Acute)

Clinical Manifestations	A dry, sore throat Turbid nasal discharge Tinnitus Headache Pain in the: Shoulders Neck Back T: Light red C: Thin, yellow and greasy P: Soft
Treatment Principle	Clear Lung Heat Resolve Exterior Dampness
Herb Formulas	Huo Po Xia Ling Tang modified Yin Qiao Sanmodified
Points

Damp-Heat In The San Jiao (Acute)

Clinical Manifestations	A poor appetite Fullness and distention in the abdomen Loose stools or Diarrhea or Constipation Nausea Aching, heaviness and stiffness in the limbs and back A weary feeling in the whole body Lack of energy Scanty urine Leukorrhea A dull, blank complexion Dull responses T: Red C: Yellow and greasy P: Slippery
Treatment Principle	Expel Heat Drain Dampness Clear the water passages of the San Jiao
Herb Formulas	Chang Pu Yu Jin Tang Jia Wei modified
Points

Damp-Heat In The Muscles

Clinical Manifestations	Aches in the muscles Fatigue Sleepiness Heavy sensation in the body or head Muscle fatigue after even light exercise Anorexia A feeling of stuffiness in the chest or epigastrium A sticky taste in the mouth Lack of concentration A foggy sensation in the brain Poor short-term memory Dull headache T: Normal C: Sticky and yellow P: Slippery With Heat predominant: Thirst Dark urine Yellow vaginal discharge Mucus in the stools A burning sensation in the anus on defecation Possible Blood in the stools Possible night sweats With Damp-Heat entering the Liver and Gallbladder: A bitter taste in the mouth Hypochondriac pain and distention Possible jaundice T.C.: Sticky and yellow on the sides With Damp-Heat affecting the Bladder: Urinary difficulty Turbid urine Burning urination T.C.: Sticky and yellow at the root with red spots With no Heat: No thirst T.C.: Sticky and white
Treatment Principle	Clear Heat Resolve Dampness
Herb Formulas	Lian Po Yin Zhi Shi Dao Zhi Wan With dry stools and/or Food Stagnation: Huo Po Xia Ling Tang For Dampness without Heat: Hou Po Xia Ling Tang
Points	LI-4, LI-11, REN-9, REN-12, SP-3, SP-6, SP-9, ST-8