Atrophy Disorder, Wei Syndrome

General

Clinical Manifestations	Atrophy Syndrome, or Wei Syndrome, refers to a group of disorders whose symptoms range from flaccidity and weakness in the sinews and muscles to diminished muscle mass. Muscular atrophy may be localized or systemic. The lower extremities are often most affected resulting in weakness and difficulty ambulating. As the capacity for voluntary movement diminishes, unremitting Wei Syndrome progresses to a total loss of mobility of the extremities. Atrophy syndrome is often caused by injuries to the Internal organs, especially insufficient Jing and Blood, and Yin Deficiency with Excessive Fire; therefore, symptoms pertaining to Heat or Deficiency are common. Classification: 1. Muscle flaccidity syndrome (Spleen) 2. Bone flaccidity syndrome (Kidney) 3. Tendon flaccidity syndrome (Liver) 4. Vascular flaccidity syndrome (Heart) 5. Skin flaccidity syndrome (Lung)
Treatment Principle
Herb Formulas	For tongue atrophy after radiation treatment: Da Ding Feng Zhu
Points	Reducing method for heat patterns, reinforcing for deficient patterns, puncture on the affected side Upper limbs: Huatuojiaji, LI-4, LI-11, LI-15, SJ-5 Lower limbs: Huatuojiaji, GB-30, GB-34, GB-39, SP-10, ST-31 to ST-41 Needle the major points along the Du Mai and Ren Mai alternating between the two channels from treatment to treatment (DU-3, DU-4, DU-14, DU-16, DU-20, DU-26; REN-3, REN-4, REN-6, REN-12, REN-17, REN-23, REN-24) LU-7, KI-6 or KI-8 Upper limbs: LI-2, LI-3, LI-4, LI-10, LI-11, LI-14, LI-15, SJ-5 Lower limbs: 1. GB-34, GB-39, SP-3, ST-34, ST-36, ST-37, ST-38, ST-39, ST-40, ST-41 2. GB-34, LIV-3, SP-10, ST-31, ST-32, ST-36, ST-40, ST-41 Secondary points: A. Bafeng, KI-3, SP-8, SP-10 B. GB-41, SP-6, SP-9 For Heat in the Lung: LU-5, LU-6, LU-10, LU-11 For Damp-Heat: SP-6, SP-9, UB-20, UB-22 For Liver and Kidney Deficiency: KI-3, KI-7, LIV-2, LIV-5 For Qi and Blood Deficiency: UB-13, UB-15, UB-20, UB-21 For trauma: Huatuojiaji For incontinence of urine: REN-3, REN-4, REN-6, UB-23, UB-28 For fecal incontinence: DU-20, ST-25, UB-25, UB-32 Korean Sa-Am protocol - Lung tonification: Tonify LU-9, SP-3, Reduce LU-10, HT-8 Superficial threading along the Du Mai and Ren Mai with long needles, alternating between the two channels from treatment to treatment Plum Blossom: needling along the Du Mai and Ren Mai, alternating between the two channels from treatment to treatment Moxa: along the Du Mai and Ren Mai , alternating between the two channels from treatment to treatment

Yang Ming Damp-Heat

Clinical Manifestations	High fever Great thirst Anhidrosis Abdominal pain Irritability Restlessness Feverish body parts Red face No constipation No aversion to Cold Scanty urine Jaundice A greasy light colored stool A bitter taste in the mouth T:  Red C:  Greasy and yellow P:  Slippery, wiry and forceful
Treatment Principle	Clear Heat Remove Dampness Regulate Qi flow of the Liver and Gall Bladder to remove jaundice
Herb Formulas	Yin Chen Hao Tang
Points	DU-9, GB-34, LI-4, LI-11, LIV-3, SJ-6, SP-6, SP-9, ST-25, ST-37, ST-45, UB-19, UB-25 Arm: LI-4, LI-11, LI-15, SJ-5 Leg: GB-30, GB-34, GB-39, SP-9, ST-31, ST-36, ST-41, UB-20

Recurrent Wind-Cold-Damp (With Heat)

Clinical Manifestations	Swollen painful joints (especially lower limbs) Joints are warm to the touch (may be burning and swollen) The pain is worse at night Reduced range of motion Chills Anhidrosis Weight loss Shortness of breath Muscular atrophy Difficulty walking and moving Thirst Hemiplegia Rigidity of the limbs Headache Dizziness Vertigo Nausea Vomiting Edema Emaciation Swollen feet Numbness of the extremities Paralysis Fatigue T: Normal C: White and greasy or Thin, yellow and greasy P: Wiry and slippery or Slippery and rapid
Treatment Principle	Unblocks Yang Promotes the movement of Qi Dispels Wind Eliminates Dampness Clears Heat Unblocks the channels and collaterals Stops pain
Herb Formulas	Gui Zhi Shao Yao Zhi Mu Tang
Points

Wind-Heat Bi

Clinical Manifestations	Whole body numbness Deviation of mouth and eyes Numbness of skin Dysphagia due to stiffness of the tongue Hemiplegia Rigidity of the extremities Spasms of the extremities Aversion to Cold Fever Chills Aching joints Tingling of the skin Paralysis of the extremities Numbness and lack of sensation in the hands and feet Common cold (with above symptoms) Inability to walk Wandering joints pain T: Pink or Red C: White or Thin yellow P: Superficial or Superficial and wiry or superficial and tight or Wiry and thin
Treatment Principle	Dispel Wind Clear Heat Circulate Qi Dredge the channels Nourish and invigorates the Blood Harmonize the Ying and Wei
Herb Formulas	Da Qin Jiao Tang
Points	General points

Wind-Cold-Damp- Bi With Liver And Kidney Deficiency

Clinical Manifestations	Excruciating sharp, stabbing joint pain Pain alleviated by warmth and aggravated by Cold Pain with fixed location Few joints are involved The joints cannot be flexed or extended No local redness or Heat Painful area often feels cold to the touch Pain worse at night and better during the day Pain mostly affects low back and lower extremities Pain intense but short lived Pain changes over days or weeks Ankylosis (stiffness) of joint Aversion to Cold Maybe chills with a slight fever Anhidrosis Frequent nocturnal urination T: Pink or Pale C: Thin and white (thicker than for Wind-Bi) P: Superficial and tight or Wiry and tight - maybe slow
Treatment Principle	Warm the channels Activate Qi and Blood.
Herb Formulas	Da Fang Feng Tang With Qi and Blood Deficiency: Du Huo Ji Sheng Tang
Points	To warm and circulate channels and collaterals: LIV-3, moxa LI-4, ST-36, GB-34, GB-31, SJ-5, SJ-4, UB-23, REN-4 Or Moxa UB-23, REN-4, GB-39 Arm pain: moxa needle GB-21, LI-8, LI-9, LI-10, LI-11, LI-13, LU-9

Lung Heat With Fluid Deficiency

Clinical Manifestations	Flaccidity Atrophy Fever during the initial stage of an illness or Fever followed by weakness, rapidly developing flaccidity and immobility of the extremities with muscular atrophy, and dry skin Low grade fever and Yin impairment Usually lower extremities Dry skin Restlessness Irritability Thirst Cough A dry throat Scanty sputum Scanty, yellow urine Dry stool T: Red C: Yellow and scanty P: Thready and rapid
Treatment Principle	Clear Heat from the Lungs Moisten the Lungs Nourish the tendons and bones
Herb Formulas	Qing Zao Jiu Fei Tang  modified Sha Shen Mai Men Dong Tang Sheng Mai San In cases where fever is abated with loss of appetite and severe dry mouth and throat due to Lung and Stomach Yin Deficiency: Yi Wei Tang
Points	General points + LU-5, UB-13 KID-3, KID-6, LU-5, LU-7, REN-4, REN-6, SP-6, ST-36 Huatuojiaji, LI-11, LU-7, LU-9, ST-37 For Lung Dryness: KID-6, LU-7, UB-23 DU-14, KI-3, LU-5, SP-6, ST-34, ST-36, ST-45 Arm: LI-4, LI-11, LI-15, SJ-5 Leg: GB-30, GB-34, GB-39, LU-5, ST-31, ST-36, ST-41, UB-13

Damp-Heat In The Spleen And Stomach With Qi And Blood Deficiency

Clinical Manifestations	Heaviness of the limbs Weak and flaccid extremities Occasional numbness Slight swelling in the affected extremities Most often affects the lower extremities Possibly fever Stifling sensation in the chest and epigastrium Obesity Edema Skin problems Dark, scanty, painful and difficult urination A sensation of Heat that begins at the dorsum of the foot and slowly progresses up the leg to the waist T: Red C: Yellow and greasy P: Soft and rapid and possibly slippery
Treatment Principle	Clear Heat Dry Dampness Open the channels
Herb Formulas	Jia Wei Er Miao Wan modified Si Miao Wan modified Wu Wei Xiao Du Yin Yi Yi Ren Tang Dang Gui Nian Tong Tang
Points	General points + SP-9, UB-20 DU-8, DU-14, GB-34, LI-4, LI-11, SP-9 Huatuojiaji, LI-4, LI-11, SP-9, ST-31 to ST-41 With digestive problems: + REN-12, ST-44 DU-14, GB-31, LI-4, LI-11, SP-9 , ST-32, ST-36

Spleen And Stomach Qi Deficiency

Clinical Manifestations	Gradual onset of flaccidity and weakness of the extremities aggravated by exertion Gradual loss of muscle mass Sallow complexion Facial puffiness Fatigue Lassitude Anorexia No desire for food and drink Frequent belching Borborygmus Loss of sensation of taste Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath Urine clear and abundant T: Pale and flabby - may have teethmarks C: White P: Even, forceless and Deficient or Thready and forceless
Treatment Principle	Tonify and Strengthen the Spleen and Stomach Augment Qi
Herb Formulas	Shen Ling Bai Zhu San modified Shi Quan Da Bu Tang Gui Pi Tang With Blood Stasis: Bu Yang Huan Wu Tang For obesity with excessive Phlegm: Liu Jun Zi Tang For significant Qi Deficiency or Qi Sinking: Bu Zhong Yi Qi Tang Chinese patent medicine: Ba Xian Tang
Points	General points + REN-4, REN-6, SP-6, ST-36, UB-20, UB-21 REN-12, SP-6, UB-20 DU-5, DU-6, LI-10, ST-36, UB-20, UB-21 LIV-13, REN-6, REN-12, SP-3, SP-5, SP-6, ST-21, ST-36, UB-20, UB-21 Huatuojiaji, REN-6, SP-6, SP-9, ST-31 to ST-41 For vertigo: + DU-20, GB-20 DU-3, LIV-13, REN-12, SP-3, ST-31, ST-36, UB-20, UB-21

Liver And Kidney Yin Deficiency

Clinical Manifestations	Steaming bone disorder Afternoon fever Tidal fever Night sweats Spontaneous seminal emissions Irritability Heat and pain in the knees (maybe with weakness) Atrophy and weakness of the knees and legs Red face Restless fever Hematemesis Sore knees Sore lower back Maybe hemoptysis May be constant hunger Maybe constipation Hot flashes Restlessness Fidgeting Insomnia with frequent dreams Productive bloody cough Easily angered Nightmares Sore feet with flaccidity Tinnitus Burning sensation over Kidneys Dizziness or vertigo Five Sole Heat Cough T: Red C: Little or None P: Thready, Excess and rapid in the Chi position
Treatment Principle	Nourish Yin Descend Fire
Herb Formulas	Da Bu Yin Wan Hu Qian Wan  modified
Points	General points

Liver Yin Deficiency With Yang Rising Generates Wind

Clinical Manifestations	Fatigue Muscle spasms with alternating flexion and extension of the extremities Prostration Clonic convulsions Dizziness - worse with stress or anger Impaired vision Night blindness Tinnitus Irascibility Throbbing headache with distended feeling 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 Thirst Five sole Heat (palms, soles and center of chest) Night sweats Light or late menses or Amenorrhea T: Red and dry or Deep red C: Little or None or Thin or Peeled 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 Weak and faint
Treatment Principle	Nourish Yin Pacify the Liver Subdue Yang
Herb Formulas	Da Ding Feng Zhu
Points	DU-20, GB-20, GB-34, GB-43, KI-3, LIV-2, LIV-3, UB-18, UB-23

Kidney Yin Deficiency With Blood Stagnation

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 A hard, palpable lump in the epigastrium Facial color dark and dull or pale Emaciation Sides and ribs distended on both sides (maybe with sharp pain) Enlargement of the Liver and Spleen Suffocating sensation in chest Tendency to sigh Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid
Treatment Principle	Break up Blood Stasis, Activate the Blood Moisten the Intestines Unblock the bowels Nourish Yin Reduce swelling
Herb Formulas	Huo Xue Hua Yu Run Chang Tang
Points	General points

Kidney Qi And Yang Deficiency

Clinical Manifestations	Weak and Cold lower back Difficulty rising T: Pale and swollen P: Very deep and weak
Treatment Principle	Tonify the Kidneys Warm Yang
Herb Formulas	You Gui Wan You Gui Yin
Points	DU-3, DU-4, KI-7, UB-23

Kidney And Liver Yin Deficiency With Empty Fire Rising

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 in the afternoon Night sweats Irritability Stools difficult to pass Constipation Aching, soreness or weakness of low back Aching in bones Aching in leg and heel Dry mouth Thirst Men: Spermatorrhea Premature ejaculation Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge Dry throat, maybe recurrent sore throat Dry stools and / or constipation Urine short and red Heightened libido If Liver Yang also Rises: Dizziness Blurred vision T: Red C: None P: Thready and rapid
Treatment Principle	Anchor Liver Yang Calm the Spirit Benefit Yin Nourish the Kidneys Augment the Liver Activate and tonifies the Blood Clear Heat Cool the Blood Drain Kidney Fire
Herb Formulas	Huo Xue Tong Luo Tang
Points	General points

Kidney And Liver Yin And Blood Deficiency

Clinical Manifestations	Slow and gradual onset Weak and flaccid lower limbs Muscle twitching Soreness and weakness of the lower back and spine Inability to stand for a long time Total loss of mobility and severe loss of muscle mass can result with exacerbation Dizziness Vertigo Hair loss Dry throat Tinnitus Fatigue Nocturnal emissions Enuresis Fecal and urinary incontinence Irregular menstruation Dysmenorrhea T: Red C: Little or None P: Thready and rapid
Treatment Principle	Tonify the Liver and Kidneys Nourish Yin Clear Heat
Herb Formulas	Hu Qian Wan modified Zi Shui Qing Gan Yin He Che Da Zao Wan Da Bu Yin Wan Liu Wei Di Huang Wan Zuo Gui Wan Zuo Gui Yin Yi Sui Tang With Yang Deficiency: Ba Wei Di Huang Wan
Points	General points + KI-3, LIV-3, REN-4, SP-6, UB-18, UB-23 Huatuojiaji, KI-3, LIV-3, LIV-8, REN-4, SP-6, ST-31 to ST-41, UB-23 DU-4, GB-34, KI-3, REN-4, UB-18, UB-23 For tinnitus: + GB-2 For dizziness and vertigo: + GB-20, UB-2

Qi Deficiency With Blood Stagnation

Clinical Manifestations	Hemiplegia Paralysis Atrophy of the lower limbs Facial paralysis Slurred speech Drooling Dry stools Frequent urination Urinary incontinence Deviation of the eyes and mouth Excess salivation Cold extremities Asthenia T: Normal C: White P: Moderate
Treatment Principle	Tonify Qi Activate the Blood Unblock the channels Promote movement in the limbs
Herb Formulas	Bu Yang Huan Wu Tang
Points	General points

Qi And Yin Deficiency

Clinical Manifestations	Emaciation Weak low back Dry skin T: Pale or Red and dry C: White or Little or None P: Weak and thin
Treatment Principle	Tonify Qi Nourish Yin
Herb Formulas	Shen Ling Bai Zhu San modified + Da Bu Yin Wan
Points	DU-3, LU-9, REN-4, SP-3, UB-23 Arm: LI-4, LI-11, LI-15, SJ-5 Leg: GB-30, GB-34, GB-39, SP-9, ST-31, ST-36, ST-41, UB-18, UB-23

Qi , Blood And Yang Deficiency

Clinical Manifestations	Uterine bleeding Cold extremities Pale or sallow face Dizziness General fatigue Coarse skin Nocturnal emissions Weak knees Fatigue Dyspnea Night sweats Irregular menstruation Insomnia Intolerance of Cold Decreased eyesight after a prolonged illness Anxiety Intermittent fever Jaundice Deficient cough Shortness of breath Palpitations Anorexia Listlessness Lassitude Spontaneous sweating Spermatorrhea Continuous spotting Leukorrhea Weak legs and knees T: Pale C: Thin and white P: Thready and weak
Treatment Principle	Replenish Yang Warm and tonify Qi and Blood
Herb Formulas	Shi Quan Da Bu Tang
Points

Deficient Qi , Blood And Kidney Jing Bi With Damp-Heat

Clinical Manifestations	Weakness of the knees Soreness of the lower back Lumbago Atrophy of the leg muscles Lower back weakness Knee pain Difficulty walking Emaciation Impotence Poor memory Dizziness Night sweats Five-sole Heat Aggravation of the pain by Damp weather Pale complexion Profuse urination at night Tinnitus Hair loss Sensation of warmth Thirst Dry skin T: Red or Pale and flabby with teethmarks C: Little or Thin and white P: Thready and weak, especially in the Kidney positions
Treatment Principle	Tonify the Liver and Kidneys Strengthen the tendons and bones Eliminate Damp-Heat Tonify Kidney Jing Relieve rheumatic pain
Herb Formulas	Deficient Bi #3
Points	ST-25, Xiyan, Heding, SP-6, SP-9, GB-34, KI-3 + General points

Blood Stagnation

Clinical Manifestations	Chronic flaccidity and weakness of the limbs Muscular atrophy Weakness and numbness of the limbs Dark-colored skin or Dry, scaled, fish-like skin Possible muscular pain Possible spasm leading to paralysis Blood vessels may be visible on the skin surface T: /purple tongue P: Choppy/uneven, thready T: Dusky, purple C: Thin and white P: Choppy or Choppy and thready
Treatment Principle	Circulate Qi Activate the Blood Eliminate Stasis Open the channels and collaterals
Herb Formulas	Sheng Yu Tang modified Tao Hong Si Wu Tang With Qi Stagnation: Juan Bi Tang
Points	General points + REN-6, SP-6, SP-10, UB-40 Huatuojiaji, REN-6, SP-6, SP-10, UB-17, bleed UB-40

Damp-Heat

Clinical Manifestations	Heat and pain in the joints and muscles Severe limitation of movement Fever and shaking chills Lusterless yellow complexion Scanty, dark urine Pain worse on cloudy or rainy days Arthralgia involving one or several joints Local redness and Heat of the extremities Swelling with excruciating pain Pain better during the day and worse at night Numbness of the muscles Thirst Dryness of the mouth Irritability Muscular atrophy Restlessness Anorexia Desire for Cold drinks Loose stools Aversion to Heat Fullness of the chest Pain improved with Cold and worse with Heat Muscular swelling Muscle redness General heaviness T:Red, maybe flabby C: Yellow and greasy P: Slippery and rapid
Treatment Principle	Clear Heat Eliminate Dampness Activate the collaterals Stop pain
Herb Formulas	Jia Wei Xuan Bi Tang Wu Wei Xiao Du Yin
Points	General points

Trauma

Clinical Manifestations	A history of trauma   Flaccidity or paralysis of the limbs  Incontinence of urination and defecation T: Dark and purplish  C: Thin and white  P: Astringent
Treatment Principle	Tonify Qi Invigorate s the Blood Unblock the channels Promote movement in the limbs
Herb Formulas	Bu Yang Huan Wu Tang  modified
Points