Trigeminal Neuralgia

General

Clinical Manifestations	Sudden paroxysmal burning in the facial region Sudden pain while talking Often appears after exposure to Wind Sometimes the patient wakes from sleep The pain is severe lasts from several seconds to two minutes The pain suddenly stops Pain mostly occurs in the maxillary and mandibular branches Pain in the optic branch is rare Most commonly seen in middle aged or older people Seen more in women than men Optic branch: Forehead Nose Maxillary skin Eyes Maxillary branch: Facial skin Upper lip Hard palate Maxillary sinus Mandibular branch: Mandible Oral cavity Teeth Tongue External ear
Treatment Principle
Herb Formulas	Trigeminal Neuralgia #1 San Chong Jiao Nang
Points	LI-3, LI-4 GB-1, LI-4, Taiyang, Yintang GB-20, LI-4, LI-10, SJ-17, ST-7 ST-2, ST-4, Yuyao LI-4, ST-7, Jiachengjiang Main point: ST-7 Optic branch: + Yuyao Maxillary branch: + ST-2 Mandibular branch: + Jiachengjiang Optic branch: 1. GB-14, SJ-23 through to GB-7, UB-2 2. GB-14, SJ-5, Taiyang, UB-2 3. GB-3, GB-14, Taiyang, UB-2 4. GB-14, UB-2 5. Taiyang through to ST-7 (2 cun deep along the wall of the bone)    For pain in the supraorbital region: + GB-14, SJ-23, ST-8, UB-2,     Yuyao Maxillary branch: 1. SI-18 through to ST-3, ST-7 or SJ-21 through to ST-7 2. DU-26, LI-4, ST-2, ST-3 3. ST-7, Jiachengjiang 4. GB-1, SI-18, ST-2, ST-3, ST-7 5. ST-2, ST-3, Taiyang 6. ST-7 (2 cun deep along the wall of the bone), LI-20 toward     ST-3 (1 cun deep along the bone surface), LI-19 (1.5 cun deep     along the bone surface), ST-3 towards ST-7 (3 cun deep along the bone surface) Mandibular branch: 1. ST-7 or ST-6 through to ST-5 2. REN-24, ST-6, ST-7, ST-44 3. GB-2, ST-5, ST-6 4. ST-5, ST-6 5. ST-6 toward ST-5 (transverse insertion 3 cun along the surface of the mandible), Jiachengjiang (0.5 cun into the foramen), REN-24 toward Jiachengjiang (transverse insertion 1 cun along the surface of the bone) For Wind: + LI-4, SJ-5 If the patient has Heart disease, hypotension, or anemia: + PC-6 on the affected side Ear: Forehead, Mandible, Maxilla, Sympathetic Scalp: Lower 2/3 of the sensory area

Wind-Cold

Clinical Manifestations	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 Maybe epistaxis (severe) T: Normal C: Thin and white P: Floating and tight
Treatment Principle	Relieve the Exterior Expel Cold
Herb Formulas	Chuan Xiong Cha Tiao San Ma Huang Tang With Dampness: Ma Huang Jia Zhu Tang With a stiff neck and shoulders or frozen shoulder: Ge Gen Tang
Points	General Points + GB-20, LI-4 or LI-4, SJ-5

Tai Yang Biao Fu

Clinical Manifestations	Chills and fever Achiness Stiff neck and shoulders Anhidrosis Headache Stabbing joint pain Itchy throat Cough Asthma Aversion to Cold Maybe frozen shoulder * The Tai Yang symptoms remain for 2-3 days Thirst with no desire to drink May have vomiting immediately after drinking Difficult urination May have upper body edema T: Normal C: White P: Floating and slippery
Treatment Principle	Promote urination Dispel Dampness Expel Wind
Herb Formulas	Wu Ling San
Points	Moxa or moxa needle KI-3, LI-4, LU-7, REN-3, SP-6, SP-9, UB-13, UB-28 + general points

Wind-Cold At The Exterior With Five Accumulations In The Interior

Clinical Manifestations	Fever and chills without sweat Headache Body aches Stiff neck and back Abdominal pain and Cold Diarrhea with borborygmus A sensation of fullness in the chest and abdomen May be Cold in the lower body with Heat in the upper body Aching at the waist Anhidrosis Loose stools Nausea Abdominal distention Borborygmus An aversion to food Vomiting Women: Cold-type epigastric and abdominal pain Menstrual irregularity Dysmenorrhea T: Normal C: White and greasy P: Deep and wiry or Superficial and slow
Treatment Principle	Release the Exterior Warm the Interior Smooth the flow of Qi Transform Phlegm Invigorate the Blood Reduce Accumulations Regulate Qi and Blood
Herb Formulas	Wu Ji San
Points	General Points + GB-20, LI-4 or LI-4, SJ-5 + moxa the abdomen

Wind-Cold With Damp-Heat

Clinical Manifestations	Generalized body aches and pains Irritability Heavy sensation in the shoulder and back Discomfort or a constricted sensation in the area of the chest and diaphragm Multiple sores, carbuncles furuncles or abscesses Redness Itching Persistent swelling Chest pain Fever Thirst Aching and painful extremities Aching and painful joints Unbearable swelling and pain of the lower extremities Shoulder stiffness T: Normal C: Greasy and slightly yellow P: Wiry and rapid or Soft and moderate or Soft, superficial and slow or Slippery and rapid or Deep and tight
Treatment Principle	Resolve Dampness Clear Heat Disperse Wind Stop pain Activate the Blood Tonify Qi and Blood
Herb Formulas	Dang Gui Nian Tong Tang
Points	General Points + GB-20, LI-4 or LI-4, SJ-5 + LI-11, SP-6, SP-9, ST-44

Wind-Cold With Phlegm Stagnation

Clinical Manifestations	Recurrent episodes of cramping Spastic pain, which, when severe is unbearable A dull white facial complexion during the pain Chills which are worse with the pain and better with warmth Simultaneous facial puffiness T: Pale or Pale and thick C: White or Thick and white :Tight or Slippery and tight
Treatment Principle	Relieve the Exterior Expel Cold Expel Phlegm Free the channels
Herb Formulas	Chuan Xiong Cha Tiao Sanmodified
Points	LI-4, LU-7 + Optic Branch: + GB-14, LI-20, Taiyang, UB-2 through to Yuyao, SJ-23 through to Yuyao use two to three points each time and alternate Maxillary Branch: + LI-20, SI-18, ST-2, ST-3, ST-7 use two to three points each time and alternate Mandibular Branch: + Jiachengjiang. REN-24, ST-4, ST-5, ST-6, ST-7 use two to three points each time and alternate For severe pain: + DU-24, Ear Shenmen For a hot sensation in the face: + ST-44 For pain on the forehead: + ST-8, Yintang For pain around the eyes: + GB-1 through to UB-2, SJ-23, Yuyao For nose pain: + Bitong, DU-25 through to LI-20 For pain in front of the ear: + GB-2, SI-19, SJ-21 For pain around the lips: + ST-4, DU-26 through to REN-24 Electro-acupuncture may be used on all points

Tai Yang With Underlying Kidney Yang Deficiency

Clinical Manifestations	Severe chills May have mild fever No sweat Aversion to Cold Cold extremities Cold sensation on back Pale face Extreme fatigue Muscle aching T: Pale with scallop C: White P: Deep, weak and thready
Treatment Principle	Warm Yang Expel Cold from the Exterior Dispel Cold from the Interior
Herb Formulas	Ma Huang Fu Zi Xi Xin Tang Zhen Wu Tang
Points	Moxa DU-4, DU-16, DU-20, UB-12, UB-15, UB-23

Tai Yang - Yang Ming

Clinical Manifestations	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
Points	General Points + GB-20, LI-4 or LI-4, SJ-5, LI-11, ST-44

Tai Yang - Shao Yang

Clinical Manifestations	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 Costal distress Tension in the rectus abdominus Chest distension 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	General Points + GB-20, LI-4 or LI-4, SJ-5

Yang Ming Fu With Blood Stagnation

Clinical Manifestations	High fever (sometimes rises and falls) Great thirst Profuse perspiration Aversion to Heat Abdominal pain (worse with pressure) Abdominal distension Foul breath Red face 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	Tao He 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

Shao Yang Fu

Clinical Manifestations	Alternating chills and fever (not so likely) Restlessness Irritability Continuous vomiting Headache (side of head) Hypochondriac pain Epigastric pain Bitter taste in mouth Digestive disruption Anorexia Nausea Acid regurgitation Burning diarrhea or Constipation Menstrual problems Dry throat Heart pain with vomiting Throat pain Hip pain T: Red C: Thin yellow P: Wiry, forceful
Treatment Principle	Harmonize the Liver and Gall Bladder Purge Internal Heat
Herb Formulas	Da Chai Hu Tang
Points	To harmonize the Liver and Gall Bladder: GB-34, LIV-3, LIV-14, SJ-5 For nausea and vomiting: PC-6, SP-4, ST-36 For headache: GB-1, GB-8, GB-14, Taiyang For constipation: SJ-6, ST-25 For fever: DU-13, DU-14 For Stomach Heat: LI-4, LI-11, ST-44 To support the San Jiao and Regulate Yin: PC-5, PC-6 To support Yin: KI-7 To support the Ying: GB-41, SJ-5 , SP-10 To regulate menstruation: SP-6 For Shao Yang Fu with Tai Yang: For the Shao Yang: GB-34, LIV-3, LIV-14, SJ-6 For the Tai Yang: GB-20, UB-12 For Shao Yang Fu with underlying Liver Qi Stagnation: To harmonize the Shao Yang: GB-34, LIV-3, SJ-6 To clear Heat: LI-11, ST-44 To calm the Shen: HT-7, PC-6 Ear: Shenmen, Liver, Gall Bladder, bleed Heat points

Shao Yang - Yang Ming

Clinical Manifestations	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	Vomits clear fluid Vertex headache Migraine Nausea Dry retching Cold extremities Body cold Diarrhea Complete exhaustion of Yang T: Pale C: White or Greasy and white P: Weak or Thready, wiry and slow
Treatment Principle	Warm Yang especially in the Liver and Stomach Descend turbidity Stop vomiting
Herb Formulas	Wu Zhu Yu Tang Dang Gui Si Ni Tang
Points	Moxa REN-4, REN-6, REN-8, REN-9, REN-12, ST-25 DU-20, LIV-3, PC-6, REN-12, ST-36

Wind-Heat

Clinical Manifestations	Inflammation of throat and/or tongue Fever and chills with more fever than chills Perspiration Cough with sticky yellow sputum Aversion to Wind and Heat Yellow nasal discharge Thirst with desire for cold drinks Red bumps around mouth and lips (herpes simplex) Headache Nasal obstruction Sore, swollen throat Dyspnea Chest pain Dry mouth Rapid breathing Maybe constipation Maybe scanty urine T: Red tip C: Thin and yellow P: Floating and rapid
Treatment Principle	Disperse Wind Clear Heat
Herb Formulas	Shi Gao Tangmodified
Points	General points + DU-14, LI-11

Wind-Heat With Phlegm Obstructing The Channels

Clinical Manifestations	Sudden paroxysmal burning in the facial region Sudden pain while talking Red facial complexion Sweating during the pain Worse on exposure to Heat Better when exposed to Cold Fever Dry mouth Reddish urine T: Red C: Yellow and dry P: Wiry and rapid With Phlegm-Fire: Dizziness Chest oppression Numbness of the limbs T: Red C: Slimy and yellow P: Wiry, slippery and rapid
Treatment Principle	Disperse Wind Clear Heat Expel Phlegm Activate the channels
Herb Formulas	Xiong Zhi Shi Gao Tangmodified
Points	LI-4, SJ-5 Optic Branch: + GB-14, LI-20, Taiyang, UB-2 through to Yuyao, SJ-23 through to Yuyao use two to three points each time and alternate Maxillary Branch: + LI-20, SI-18, ST-2, ST-3, ST-7 use two to three points each time and alternate Mandibular Branch: + Jiachengjiang. REN-24, ST-4, ST-5, ST-6, ST-7 use two to three points each time and alternate For severe pain: + DU-24, Ear Shenmen For a hot sensation in the face: + ST-44 For pain on the forehead: + ST-8, Yintang For pain around the eyes: + GB-1 through to UB-2, SJ-23, Yuyao For nose pain: + Bitong, DU-25 through to LI-20 For pain in front of the ear: + GB-2, SI-19, SJ-21 For pain around the lips: + ST-4, DU-26 through to REN-24 Electro-acupuncture may be used on all points

Wind-Damp Bi

Clinical Manifestations	All types of headache Trigeminal neuralgia Facial pain Pain due to maxillary cancer T: Red, may quiver P: Superficial and may be rapid
Treatment Principle	Dispel Wind-Heat Dispel Wind-Cold Dampness Relieve pain
Herb Formulas	Qing Shang Juan Tong Tang
Points

Wind-Damp-Heat With Blood Stagnation

Clinical Manifestations	Sore, achy joints The pain moves from joint to joint
Treatment Principle	Clear Heat Dry Dampness Activate the Blood Dispel Wind
Herb Formulas	Shang Zhong Xia Tang Yong Tong Feng Wan
Points	LI-3, LI-4 GB-1, LI-4, Taiyang, Yintang GB-20, LI-4, LI-10, SJ-17, ST-7 ST-2, ST-4, Yuyao LI-4, ST-7, Jiachengjiang Main point: ST-7 Optic branch: + Yuyao Maxillary branch: + ST-2 Mandibular branch: + Jiachengjiang Optic branch: 1. GB-14, SJ-23 through to GB-7, UB-2 2. GB-14, SJ-5, Taiyang, UB-2 3. GB-3, GB-14, Taiyang, UB-2 4. GB-14, UB-2 Maxillary branch: 1. SI-18 through to ST-3, ST-7 or SJ-21 through to ST-7 2. DU-26, LI-4, ST-2, ST-3 3. ST-7, Jiachengjiang 4. GB-1, SI-18, ST-2, ST-3, ST-7 5. ST-2, ST-3, Taiyang Mandibular branch: 1. ST-7 or ST-6 through to ST-5 2. REN-24, ST-6, ST-7, ST-44 3. GB-2, ST-5, ST-6 4. ST-5, ST-6 For Wind: + LI-4, SJ-5 Ear: Forehead, Mandible, Maxilla, Sympathetic Scalp: Lower 2/3 of the sensory area

Damp-Heat Injures The Spleen

Clinical Manifestations	Anorexia Abdominal distention and discomfort Suffocating sensation in the chest Epigastric mass Maybe abdominal pain on palpation Yang jaundice (sclera and skin are bright yellow) Dislike of oily foods Nausea Vomiting Lassitude Scanty, dark urine Maybe thirst or thirst with no desire to drink Diarrhea with foul smell or Constipation Fever Sweet sticky taste or bitter taste in mouth T: Pink C: Thick, yellow and greasy (maybe sticky) P: Soft and rapid
Treatment Principle	Clear Heat Benefit Dampness
Herb Formulas	Yin Chen Wu Ling San
Points	LI-11, REN-12, SP-9, ST-36, ST-44, UB-20 + general points

Spleen Qi Deficiency With Blood Stagnation

Clinical Manifestations	Enduring facial pain Continuous aching and pain for a long time Piercing pain that is difficult to bear Localized fixed pain A dark, stagnant facial complexion Tic may accompany or follow the pain Numbness may follow the pain Aversion to Wind Spontaneous perspiration Disinclination to speak A low, faint voice T: Pale with possible static Maculae C: White P: Deep, thready and weak Severe Blood Stagnation: scaly skin
Treatment Principle	Tonify Qi Invigorate the Blood Unblock the channels Stop pain
Herb Formulas	Shun Qi He Zhong Tangmodified With only Blood Stagnation symptoms: Tao Hong Si Wu Tang + Zhi Jing Sanmodified
Points	LI-4, ST-36 + general points LI-4, SP-6, ST-36 Optic Branch: + GB-14, LI-20, Taiyang, UB-2 through to Yuyao, SJ-23 through to Yuyao use two to three points each time and alternate Maxillary Branch: + LI-20, SI-18, ST-2, ST-3, ST-7 use two to three points each time and alternate Mandibular Branch: + Jiachengjiang. REN-24, ST-4, ST-5, ST-6, ST-7 use two to three points each time and alternate For severe pain: + DU-24, Ear Shenmen For a hot sensation in the face: + ST-44 For pain on the forehead: + ST-8, Yintang For pain around the eyes: + GB-1 through to UB-2, SJ-23, Yuyao For nose pain: + Bitong, DU-25 through to LI-20 For pain in front of the ear: + GB-2, SI-19, SJ-21 For pain around the lips: + ST-4, DU-26 through to REN-24 Electro-acupuncture may be used on all points

Spleen Deficiency Edema

Clinical Manifestations	Edema in limbs, especially lower limbs Maybe anasarca Maybe abdominal distention Loose stools Physical and mental fatigue T: Pale C: White and moist P: Soft and even
Treatment Principle	Warm Yang Strengthen the Spleen Benefit Qi Move water
Herb Formulas	Si Ling San
Points	REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23

Stomach Fire Blazing

Clinical Manifestations	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) Swelling, pain, ulceration and bleeding of gums Foul breath Toothache Maybe vomiting right after eating Vomiting acid or undigested food Constipation Maybe scanty, red urine T: Red C: Thick, yellow and dry P: Slippery, big, Excess and rapid
Treatment Principle	Clear and Purge Stomach Fire
Herb Formulas	Qing Wei San San Huang Xie Xin Tang Yu Nu Jian
Points	LI-4, LI-11, PC-6, PC-8, ST-6, ST-34, ST-36, ST-43, ST-44, ST-45, UB-21 + general points

Food Stagnation In The Stomach Transforming Into Damp-Heat With Intestinal Obstruction

Clinical Manifestations	Epigastric fullness, distention and pain with dislike of pressure Abdominal and epigastric distention Belching with rotten food smell Acid regurgitation Detests food or Vomits after eating Distention is reduced after vomiting Unformed stools or Knotted constipation or Dysentery Scanty dark urine T: Red C: Yellow and greasy or slippery P: Deep and Forceful
Treatment Principle	Reduce and guide out Stagnation and Accumulation Clear Heat Dispel Dampness
Herb Formulas	Zhi Shi Dao Zhi Wan
Points	LIV-13, LIV-14, PC-6, REN-11, REN-12, SP-4, ST-21, ST-36, ST-44 + general points

Heart Fire Flaring Up

Clinical Manifestations	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	San Huang Xie Xin Tang
Points	HT-7, HT-8, PC-7, PC-8, UB-15 + general points

Heart Blood Stagnation

Clinical Manifestations	Palpitations Stabbing pain in the anterior region over the Heart Suffocating sensation in the chest Maybe drawing pain down the internal aspect of arm (especially the left arm) Pain (in chest and/or arm) tends to be severe and intermittent Severe cases: Cold limbs Cyanosis of lips and nails T: Dark red with purple spots or Purple body C: Little P: Minute (scarcely perceptible) and thready or Knotted
Treatment Principle	Clear Yang Invigorate the Blood Transform Stagnation
Herb Formulas	Xue Fu Zhu Yu Tang
Points	HT-5, HT-6, HT-7, PC-3, PC-4, PC-5, PC-6, PC-7, REN-14, REN-17, UB-15, UB-17 + general points

Liver Qi Stagnation

Clinical Manifestations	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 Clear Stagnation
Herb Formulas	Chai Hu Shu Gan Tang
Points	GB-40, GB-41, LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, PC-6, SJ-6, SP-6, UB-18 + general points With Heat: General points + LIV-3, ST-44

Liver Qi Stagnation Invading 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	Dang Gui Shao Yao San
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

Liver Qi Stagnation Invading The Stomach

Clinical Manifestations	Trigeminal neuralgia Epigastric pain Belching with acid regurgitation Recurrent or chronic nausea Vomiting Vomiting immediately after meals Sour belching Acid reflux Heartburn Indigestion All symptoms are worse when emotionally upset Fullness of the chest Hypochondriac pain Continual belching Anorexia Epigastric distention Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Bitter taste in the mouth Dry mouth Irritability Inappropriate anger Frustration Anxiety Moodiness Irregular menses Dysmenorrhea Breast distention and pain before and during menses Head and nape painful or swollen T: Pink or Dark with slightly red edges C: Thin and white or Thin and sticky yellow P: Wiry or Thready and wiry or Wiry and slippery
Treatment Principle	Soothe the Liver Harmonize the Stomach Descend Stomach Qi
Herb Formulas	Si Ni San
Points

Liver Fire

Clinical Manifestations	One-sided burning head and facial pain The pain is worse with Heat and emotional disturbance Severe, splitting headaches with dizziness Sudden tinnitus or Sudden deafness Flushed face Red, swollen, painful eyes Impatience Irascibility with violent angry outbursts Dry mouth Bitter taste in mouth Thirst Vomiting sour or bitter liquid Insomnia Restlessness Restless sleep Constipation or dry stools Maybe rib pain Chest oppression Sighing There may be alternating periods of attack and remission Reddish yellow urine In severe cases: Tics and spasms Mania Hemoptysis Hematemesis Epistaxis Liver Fire Attacks the Lungs: Hemoptysis Rib pain which is severe when coughing Liver Fire Attacks the Stomach: Hematemesis T: Red or Red tip and edges C: Thick, yellow, dry and rough P: Wiry, Excess and rapid
Treatment Principle	Clear the Liver Purge Fire Clear the channels
Herb Formulas	Zhi Zi Qing Gan Tangmodified Long Dan Xie Gan Tang With Spleen Qi Deficiency: Jia Wei Xiao Yao Sanmodified
Points	GB-41, LI-4, LIV-2 Optic Branch: + GB-14, LI-20, Taiyang, UB-2 through to Yuyao, SJ-23 through to Yuyao use two to three points each time and alternate Maxillary Branch: + LI-20, SI-18, ST-2, ST-3, ST-7 use two to three points each time and alternate Mandibular Branch: + Jiachengjiang. REN-24, ST-4, ST-5, ST-6, ST-7 use two to three points each time and alternate For severe pain: + DU-24, Ear Shenmen For a hot sensation in the face: + ST-44 For pain on the forehead: + ST-8, Yintang For pain around the eyes: + GB-1 through to UB-2, SJ-23, Yuyao For nose pain: + Bitong, DU-25 through to LI-20 For pain in front of the ear: + GB-2, SI-19, SJ-21 For pain around the lips: + ST-4, DU-26 through to REN-24 GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19 Electro-acupuncture may be used on all points

Liver Wind Stirring Internally: Extreme Heat Generates Wind

Clinical Manifestations	High fever Contractures Spasms Neck stiffness Convulsions Oculogyric crises Opisthotonos Coma Possibly death T: Red or Deep red P: Wiry and rapid
Treatment Principle	Clear Heat Cool the Liver Subdue Wind
Herb Formulas	Zhi Jing San
Points	Bleed the Jing-Well points of Six Hand Channels, needle DU-14, DU-16, DU-20, DU-26, LI-11, LIV-2, LIV-3 + general points

Liver Wind Stirring Internally: Liver Yang (Fire) Generates Wind

Clinical Manifestations	Sudden paroxysmal stabbing or burning in the facial region Sudden pain while talking The pain may continue for several seconds It may occur several times during one minute or Only several times during the day Even a light touch may induce an occurrence Muscular twitching Congested eyes Lacrimation Saliva flowing from the angle of the mouth Vexation Easily angered Constipation Fever Contractures Spasms Neck stiffness Deep colored urine Constipation 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 Dysphagia Unsteady gait With Wind-Stroke: Sudden loss of consciousness Tongue stiffness with aphasia Facial paralysis Hemiplegia T: Red or Deep red C: Thin and yellow P: Wiry and rapid or Taut and rapid
Treatment Principle	Nourish Yin Pacify the Liver Subdue Wind
Herb Formulas	Tian Ma Gou Teng Yin Xiong Zhi Shi Gao Tang modified Grind equal portions of Scorpio Quan Xie, Scolopendra Wu Gong and Bombyx Batryticatus Jiang Can into a fine powder and take 6g three times per day. Chinese patent medicines: Long Dan Xie Gan Wan + Yuan Hu Zhi Tang
Points	Bleed the Jing-Well points of Six Hand Channels, needle DU-20, DU-26, GB-20, GB-34, KI-1, KI-3, LIV-2, LIV-3, PC-8, UB-18, UB-23  + general points GB-14, GB-29, LI-4, REN-24, SJ-5, ST-6, ST-44, Taiyang, UB-2, UB-67, Yuyao

Liver Yin Deficiency With Liver Yang Rising

Clinical Manifestations	Paroxysmal distended solitary, limited attacks of unilateral headache that does not shift sides (Sjaastad syndrome) Throbbing headache with distended feeling Contracture of the cranial angle with referred pain to the teeth Facial twitching Dizziness Dysphoria Insomnia Impaired vision Night blindness Tinnitus Irascibility Flushed face Blurred vision Red, dry eyes with feeling of grit in eye Dry mouth and throat with bitter taste in mouth Palpitations Headache Nervousness Insomnia with much dreaming Dry throat Irritability Thirst Five sole Heat (palms, soles and center of chest) Night sweats Light or late menses or Amenorrhea Scanty, yellow urine With Stomach Fire: Constipation T: Red and dry C: Little or None or Dry and yellow P: Thready and wiry or Wiry and rapid (when Yang is Rising and Excess, pulse is forceful) or Thready and rapid when Yang is not prominent or Taut, thready and rapid
Treatment Principle	Nourish Yin Pacify the Liver Subdue Yang Stop pain
Herb Formulas	Zhen Gan Xi Feng Tang Jian Ling Tang Trigeminal Neuralgia #2 Chinese patent medicine: Qi Ju Di Huang Wan + 3g powdered Magnetitum Ci Shi and 1g powdered Cinnabaris Zhu Sha
Points	General points + LIV-3, ST- 36, ST-44 Tonify SI-3, ST- 36, ST-44, UB-18, UB-23, reduce GB-14, REN-24, ST-6, UB-2, Taiyang, Yuyao Ear: Kidney, Gall Bladder, Liver, Sympathetic

Disharmony Between The Liver And Spleen

Clinical Manifestations	Abdominal pain Irritability Slight chills Spasms of the calf muscles Cramps in the hands Weak legs Hypertonicity of the extremities characterized by difficult flexion and extension Wheezing Coughing Hiccup Vomiting Diarrhea Sciatic pain Severe and painful muscle spasms in the Stomach, bronchi, Gallbladder and uterus. Intestines Shoulder pain Pain in the head, body or limbs due to arterial spasms characterized by a severe pulling pain T: Normal or Reddish C: None or Yellowish P: Wiry and rapid or Thready and rapid
Treatment Principle	Soften the Liver Nourish the Blood Nourish Yin Moderate painful spasms Relieve pain Harmonize the Middle Jiao Replenish Body Fluids
Herb Formulas	Shao Yao Gan Cao Tang
Points	General points

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

Clinical Manifestations	Recurrent episodes of severe, fixed, burning, one-sided face and head pain Fatigue Emaciation Malar flush Afternoon fever Dizziness Tinnitus Low back and knee soreness and weakness Anxiety Agitation Red eyes T: Red C: Scanty yellow, or Dry or None P: Thready, wiry and rapid
Treatment Principle	Nourish the Kidneys Enrich Yin Clear Heat Unblock the channels
Herb Formulas	Di Xuan Shi Gao Tang With Liver Wind: Tian Ma Gou Teng Yin modified
Points	KI-7, LI-4, SP-6 Optic Branch: + GB-14, LI-20, Taiyang, UB-2 through to Yuyao, SJ-23 through to Yuyao use two to three points each time and alternate Maxillary Branch: + LI-20, SI-18, ST-2, ST-3, ST-7 use two to three points each time and alternate Mandibular Branch: + Jiachengjiang. REN-24, ST-4, ST-5, ST-6, ST-7 use two to three points each time and alternate For severe pain: + DU-24, Ear Shenmen For a hot sensation in the face: + ST-44 For pain on the forehead: + ST-8, Yintang For pain around the eyes: + GB-1 through to UB-2, SJ-23, Yuyao For nose pain: + Bitong, DU-25 through to LI-20 For pain in front of the ear: + GB-2, SI-19, SJ-21 For pain around the lips: + ST-4, DU-26 through to REN-24 For Yin Deficiency with Fire Rising: GB-20, KI-3 + general points Electro-acupuncture may be used on all points

Yang Deficiency With Internal Cold-Damp

Clinical Manifestations	Lower abdominal pain and Cold Abdomen feels chilled Aching bones and joints Muscle ache Whole body pain Aversion to Cold, especially at the back Cold limbs No Thirst Lower abdominal pain and Cold Abdomen feels chilled Maybe fever No thirst T: Normal C: White and slippery P: Deep and faint or Forceless or Choppy and slow or Wiry
Treatment Principle	Dispel Cold Warm the channels Assist Yang Dispel Dampness Relieve pain
Herb Formulas	Fu Zi Tang
Points

Qi And Blood Stagnation In The Channels

Clinical Manifestations	Pain that is fixed, stabbing and /or severe or Pains that move around Distention Depression Irritability Pan is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas, Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Activate the Blood Break up Stagnation
Herb Formulas	Tao Hong Si Wu Tang
Points	GB-40, GB-41, LIV-3, LIV-14, PC-6, SJ-6, ,SP-6, SP-10, ST-36, UB-17, UB-18, UB-40 + general points

Blood Stagnation

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 Dry skin Blue, dark or purplish discoloration of skin in small or large areas, Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the Blood Break up Stagnation
Herb Formulas	Tong Qiao Huo Xue Tang Tao Hong Si Wu Tang + Zhi Jing Sanmodified
Points	SP-6, SP-10, ST-36, UB-17, UB-40 + general points

Phlegm Stagnation

Clinical Manifestations	Piercing one-sided face and head pain Heavy head Numbness and insensitivity Maybe frequent vomiting at the time of pain A possible slimy feeling in the mouth T: Pale and cyanotic C: Glossy and slippery P: Thready and soggy
Treatment Principle	Dispel Phlegm Clear the channels
Herb Formulas	Er Chen Tang + Tong Qiao Huo Xue Tangmodified
Points	LI-4, SP-6, ST-40 Optic Branch: + GB-14, LI-20, Taiyang, UB-2 through to Yuyao, SJ-23 through to Yuyao use two to three points each time and alternate Maxillary Branch: + LI-20, SI-18, ST-2, ST-3, ST-7 use two to three points each time and alternate Mandibular Branch: + Jiachengjiang. REN-24, ST-4, ST-5, ST-6, ST-7 use two to three points each time and alternate For severe pain: + DU-24, Ear Shenmen For a hot sensation in the face: + ST-44 For pain on the forehead: + ST-8, Yintang For pain around the eyes: + GB-1 through to UB-2, SJ-23, Yuyao For nose pain: + Bitong, DU-25 through to LI-20 For pain in front of the ear: + GB-2, SI-19, SJ-21 For pain around the lips: + ST-4, DU-26 through to REN-24 Electro-acupuncture may be used on all points

Phlegm-Fire

Clinical Manifestations	Oppression and pain of short duration or Burning sensation Pain often provoked by eating A desire for something cold to be put on the area Dry mouth with no desire to drink Heavy headedness Chest and abdominal oppression and distention Occasional vomiting of Phlegm, drool, sour fluid or bitter bile A bitter taste in the mouth Irritability Impatience T: Red C: Slimy and yellow P: Wiry, slippery and rapid
Treatment Principle	Transform Phlegm Clear Heat Free the channels Stop pain
Herb Formulas	Huang Lian Wen Dan Tangmodified
Points	LI-4, , ST-40, ST-44 For Heat due to Liver Fire: LI-4, LIV-2, ST-40 Optic Branch: + GB-14, LI-20, Taiyang, UB-2 through to Yuyao, SJ-23 through to Yuyao use two to three points each time and alternate Maxillary Branch: + LI-20, SI-18, ST-2, ST-3, ST-7 use two to three points each time and alternate Mandibular Branch: + Jiachengjiang. REN-24, ST-4, ST-5, ST-6, ST-7 use two to three points each time and alternate For severe pain: + DU-24, Ear Shenmen For a hot sensation in the face: + ST-44 For pain on the forehead: + ST-8, Yintang For pain around the eyes: + GB-1 through to UB-2, SJ-23, Yuyao For nose pain: + Bitong, DU-25 through to LI-20 For pain in front of the ear: + GB-2, SI-19, SJ-21 For pain around the lips: + ST-4, DU-26 through to REN-24 Electro-acupuncture may be used on all points

Wind-Stroke

Clinical Manifestations	Headache due to Wind attack Headache in any part of the head Fever and chills Dizziness Nasal congestion Stuffy nose Clear or white nasal discharge Sneezing Body aches Nasal obstruction Vertigo Aversion to Cold Copious sputum T: Normal C: Thin and white P: Superficial
Treatment Principle	Dispel Wind Alleviate pain
Herb Formulas	Chuan Xiong Cha Tiao San Wu Yao Shun Qi San With Qi and Blood Deficiency: Xu Ming Tang:
Points	General points

Feng Tan (Wind Phlegm)

Clinical Manifestations	Paralysis Numbness Slurred speech Deviated eyes Deviated mouth (wry mouth) Dizziness Tinnitus Sputum in the throat Chest fullness and distention Epigastric fullness and distention Hypertension Stroke T: Deviated and trembling C: Thick P: Slippery and maybe wiry
Treatment Principle	Resolve Phlegm Subdue Wind
Herb Formulas	Dao Tan Tang modified Qian Zheng San
Points	General points + ST-40, UB-40