Pleurisy, Pleuritis

General

Clinical Manifestations	Pleurisy is a condition in which the pleura, a membrane consisting of a layer of tissue that lines the inner side of the chest cavity and a layer of tissue that surrounds the lungs, becomes inflamed. Also called pleuritis, pleurisy causes sharp chest pain (pleuritic pain) that worsens during breathing.
Treatment Principle
Herb Formulas
Points	Choose from: GB-34, GB-35, GB-37, HT-3, KI-23, KI-27, LI-7, LIV-3, LIV-13, SI-9, SJ-5, SP-4, SP-21, ST-40, UB-11, UB-12, UB-13, UB-17, UB-43 With a headache and fever: DU-13, GB-20, GB-34, LI-4, LU-5, SJ-5, UB-12 Dry pleurisy: Ahshi points over the ribs, DU-12, GB-34, GB-41, LU-5, LU-9, UB-12 With less fever but the chest is still painful: DU-9, DU-10, DU-13, DU-14, GB-34, LIV-13, SP-6, UB-18

Tai Yang Shang Han With Interior Heat

Clinical Manifestations	Cough Asthma Fever and chills Maybe fever only Achiness Anhidrosis Headache Aversion to Cold Edema Thirst Restlessness Irritability Fidgeting Constipation Sometimes dry achy eyes T: Normal or red C: Yellow or white P: Floating and tight or rapid
Treatment Principle	Expel Wind Disperse Cold Cool Heat
Herb Formulas	Da Qing Long Tang
Points	DU-14, DU-16, GB-20, LI-4, LI-11, LU-7, LU-9, LU-10, SJ-5, SP-1, SP-2, ST-44, UB-12, UB-13

Shao Yang Jing With Phlegm-Heat

Clinical Manifestations	Dry pleurisy (early-stage): Alternating chills and fever Hypochondriac pain and fullness Dry coughing with little or no sputum Poor appetite T: Normal C: Thin and yellow P: Wiry and rapid Exudative pleurisy: Pleural exudates Alternating chills and fever Hypochondriac pain and fullness Dry coughing with little or no sputum Poor appetite T: Normal C: Thin and yellow P: Wiry and rapid Symptoms common to both: Restlessness Irritability Sometimes fatigue Nausea Occasional vomiting Headaches (side of head) Rib pain Achiness Ear infection Hearing difficulty Red eyes Stiff shoulders Throat pain Hip pain
Treatment Principle	Dry pleurisy (early-stage): Harmonize the Shaoyang Clear Heat Resolve Phlegm Exudative pleurisy: Harmonize the Shaoyang Clear Heat Dispel Dampness
Herb Formulas	Xiao Chai Hu Tang  modified Chai Xian Tang
Points	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

Shao Yang Fu With Tai Yang

Clinical Manifestations	Chest distension Costal distress Joint pain with a crackling sensation Epigastric pain Fatigue Gastrointestinal weakness Headache Heaviness in the head Fever Moderately severe chills Distension beneath the Heart Periumbilical or lower abdominal pain Tenseness around the pubic bone Subcostal pain Epigastric fullness Nausea Mild vomiting Mild thoraco-costal discomfort Tension in the rectus abdominus Abdominal pain Abdominal distension Constipation Irritability Insomnia Repeated loss of spinal alignment due to muscular tension P: Floating and weak
Treatment Principle	Release the Exterior and muscle layer Harmonize and release the Shao-Yang Harmonize the Liver, Spleen and Intestines Dispel Water Accumulation
Herb Formulas	Chai Hu Gui Zhi Tang
Points

Jue Yin Heat

Clinical Manifestations	Cold extremities Body hot and feverish due to lack of harmony of Liver Qi Thirst Abdominal distention Fever Dark yellow urine T: Red C: Yellow P: Rapid and slippery
Treatment Principle	Clear Heat Reverse reversals
Herb Formulas	Si Ni San
Points	DU-14, LI-4, LI-11, LIV-2, LIV-3, LIV-14, PC-6, REN-12, P-6

Wind-Cold-Damp Bi With Dampness Predominant

Clinical Manifestations	A stifling sensation in chest Numbness and heaviness of the extremities Soreness and fixed pain of joints Stiffness or numbness of the muscles or skin Pain worse on cloudy or rainy days Maybe peripheral or systemic edema Pain is alleviated by pressure and warmth Pain lingers and is recalcitrant to treatment Worse during cloudy or wet weather Limited movement Edema Maybe anorexia or indigestion Maybe abdominal distention Maybe loose or semi-liquid stools T: Pink or Pale C: Greasy and white P: Slow, moderate and soft
Treatment Principle	Expel Damp Clear the channels
Herb Formulas	Yi Yi Ren Tang
Points	SP-6, SP-9 + General points

Lung Abscess With Phlegm

Clinical Manifestations	Lung abscess Coughing Wheezing Fullness and distention in the chest Profuse Phlegm and saliva Dysuria Edema Nasal congestion Clear, watery rhinorrhea Oliguria Loss of taste and smell Dyspnea Edema of the face and eyes Insomnia T: Swollen C: White and greasy P: Slippery
Treatment Principle	Drain the Lungs Move Fluids Drive out Phlegm Stop cough Calm wheezing
Herb Formulas	Ting Li Da Zao Xie Fei Tang
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 Invades The Stomach

Clinical Manifestations	Epigastric pain (worse when emotionally upset) Belching with acid regurgitation Nausea Vomiting Anorexia Epigastric distention Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: Thin and white P: Wiry
Treatment Principle	Soothe the Liver Harmonize the Stomach
Herb Formulas	Xiao Yao San Hei Xiao Yao San
Points	LIV-3, LIV-14, PC-6, REN-12

Liver Fire Scorches The Lungs

Clinical Manifestations	Coughing fits with hemoptysis Burning pain in chest and sides Dizziness Face and eyes red Bitter taste in mouth Dry lips 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 Xiao Yao San + Ban Xia Hou Po Tang With Phlegm-Heat: Dai Ge San + Qing Jin Hua Tan Wan For mild cases: Sang Dan Xie Bai Tang Chinese Patent Medicines: Qing Qi Hua Tan Wan Long Dan Xie Gan Wan Qing Fei Yi Huo Pian With hemoptysis: Yunnan Bai Yao
Points	LIV-2, LU-5, LU-6, LU-10, PC-6, UB-13, UB-18 GB-34, LIV-2, LIV-3, LIV-14, LU-5, PC-6, UB-13, UB-18 With hemoptysis: LU-6

Kidney Yang Deficiency With Water Flooding

Clinical Manifestations	Edema of whole body particularly at and below the waist Pitting edema Low back pain, aching and heaviness Abdominal distention with full sensations Oliguria Cold limbs Face gray and congested or pale Feeling nervous and cold with mental weariness In severe cases: Ascites Edema of scrotum T: Pale and swollen C: Thin, white or Thick, white and sticky P: Deep and thready With Water Flooding the Lungs: Cough with copious, thin watery phlegm Asthma with phlegmy sound (wheezing) Dyspnea Facial edema Edema of limbs Dysuria T: Pale and swollen C: White and moist or White and greasy P: Superficial and tight
Treatment Principle	Warm Kidneys Promote diuresis
Herb Formulas	Zhen Wu Tang
Points	KI-7, REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23, UB-39

Phlegm And Heat Accumulation In The Chest And Yang Ming

Clinical Manifestations	Focal distention in the chest and epigastrium with or without nodules which is painful when pressed Fullness and pain which is worse with pressure A red facial complexion A Heat sensation to the touch Coughing up yellow, viscous sputum Thirst Constipation A bitter taste in the mouth Nausea T: Normal C: Yellow and greasy P: Slippery and floating or Slippery and rapid
Treatment Principle	Clear Heat Transform Phlegm Expand the chest Dissipate Stagnation
Herb Formulas	Xiao Xian Xiong Tang Chinese Patent Medicines: Qing Qi Hua Tan Wan Qing Fei Yi Hao Pian
Points	LI-4, LI-11, LU-5, ST-25, ST-37, ST-40, ST-44, UB-25

Toxic Heat In The Liver And Gall Bladder Channels

Clinical Manifestations	Fever Chills Severe headache Flushed cheeks Bad breath Tinnitus Hearing loss Irritability Insomnia Coughing up viscous, thick sputum Dark urine Swollen lymph nodes Abdominal tension and itching Darkened skin Epistaxis Itching Formation of cellulitis T: Red C: Normal or Yellow P: Wiry and rapid
Treatment Principle	Drain Fire Relieve toxicity Spread the Liver Qi Strengthen the Spleen Disperse Wind-Heat
Herb Formulas	Chai Hu Qing Gan Tang
Points	DU-14, DU-16, GB-20, LI-4 + LU-7 or LI-4 + SJ-5, LU-5, LU-10, LU-11, UB-12, UB-13

Xuan Yin

Clinical Manifestations	Cough with sharp pain in the chest and hypochondrium Hypochondriac distention and pain Hard focal distention in the epigastrium Dry heaves Shortness of breath Headache Abdominal distention Wheezing Fullness in the chest Dyspnea caused by extreme chest and back pain Dizziness Vertigo Asthma Rapid breathing Generalized edema which is worse in the lower body Difficult urination and defecation T: Normal or Dark C: Thick, greasy and white P: Deep and wiry
Treatment Principle	Attack and Dispel water
Herb Formulas	Shi Zao Tang
Points	KI-3, LI-4, LI-11, PC-6, REN-11, REN-12, ST-36, UB-13, UB-20, UB-23

Chest Bi

Clinical Manifestations	Fullness and pain in the chest or Stabbing pain that radiates from the chest to the back Wheezing Coughing with sputum Drooling Shortness of breath Focal distention in the chest that feels like a flow of Qi proceeding from the flanks to the area around the Heart T: Normal C: White and greasy P: Deep and wiry or Deep and tight
Treatment Principle	Unblock Yang Dissipate clumps Expel Phlegm Descend Qi
Herb Formulas	Zhi Shi Xie Bai Gui Zhi Tang
Points