Diagnostics

>>This material is a compilation of the editor's personal notes, lecture notes, and the following references: 1. Diagnosis in Chinese Medicine by Giovanni Maciocia 2. Formulas and Strategies by Bensky 3. Chinese Acupuncture and Moxibustion by Shanghai College of Traditional Chinese Medicine and many other texts.  Accuracy is not guaranteed.  For studying only, not intended as medical advice.<<< 

Abdominal Mass – Blood Stasis Stagnated in the interior

Symptoms
Hard, immovable and painful masses in the abdomen, dark and withered complexion, feeling cold, amenorrhoea, painful periods. Tongue: Purple. Pulse: Choppy. This is a condition of severe and chronic stasis of Blood with obvious masses. The dark and withered complexion reflects stasis of Blood and the cold feeling is due not to internal Cold, but to poor circulation of Blood. [34]
Tongue
purple
Pulse
choppy
Treatment
Eliminate blood stasis, soften hardness, dissolve masses, regulate Spleen and Stomach.
Acupunct
GB34, Ren6, SP4, PC6, SP10, BL17, ST29, LV3, SP6, LV8, ST36, BL20. (LV-8, ST-36 and BL-20 which should be reinforced.) With an underlying Qi deficiency, add Ren4, Ren8, BL23, KI3, LU7 and KI6. Moxa should be used on Ren4, Ren6 or Ren8
Herbs
FORMULAS: ➔ Ge Xia Zhu Yu Tang is specific to invigorate Blood, eliminate stasis, stop pain and dissolve masses in the lower abdomen. ➔ Gui Zhi Fu Ling Wan invigorates Blood, eliminates stasis and dissolves masses. ➔ To enhance the mass-dissolving effect, add San Leng, E Zhu and Ze Lan.
Notes
★ Blood stasis is a common cause of fixed, palpable masses in the abdomen and often represents the result of a long-term pathogenic process. It is essential to recognize that Blood stasis does not arise spontaneously but instead develops from other underlying imbalances or pathogenic factors. ★ Primary Causes of Blood Stasis: 1. Qi stagnation: When Qi becomes stagnant, it impairs the smooth flow of Blood, leading to stasis. 2. Cold in the Blood: Cold slows circulation, causing the Blood to congeal and stagnate, often resulting in fixed and painful masses. 3. Heat in the Blood: Heat can cause Blood to move erratically, leading to its thickening and eventual stagnation. ★ Secondary Causes of Blood Stasis: 1. Qi deficiency: Deficient Qi fails to circulate Blood effectively, resulting in stagnation over time. 2. Blood deficiency: Insufficient Blood can lead to poor flow and eventual stagnation, creating a condition of stasis. ★ Role of Phlegm: While Phlegm itself does not directly cause Blood stasis, it can aggravate it. The accumulation of Phlegm obstructs the channels and collaterals, further hindering the smooth movement of Qi and Blood, thereby intensifying stagnation. ★ Treatment principles of masses according to stage: 1. Beginning stages: primarily eliminate the pathogenic factor (i.e. move Qi and Blood, resolve Phlegm and dissolve masses). 2. Middle stages: eliminate the pathogenic factor and tonify the body’s Qi simultaneously. 3. Late stages: primarily tonify the body’s Qi and secondarily eliminate the pathogenic factor. ★ Treatment of Abdominal Masses from Blood Stasis: In cases of abdominal masses caused by Blood stasis, treatment requires not only the use of herbs to invigorate Blood but also stronger herbs that can “break” Blood. By incorporating softening herbs to disperse masses, complementing the action of herbs that invigorate or break Blood. [34]
Biomed
★ An abdominal mass refers to an abnormal, space-occupying growth, the nature of which requires thorough evaluation to determine its origin, composition, and clinical significance. These masses can arise from a wide range of causes, including congenital malformations, infections, benign or malignant neoplasms, hematologic disorders, vascular abnormalities such as aneurysms, and trauma. Systemic conditions like tuberculosis, lymphoma, or other inflammatory diseases may also present as abdominal masses. Such growths can displace, compress, infiltrate, or impair the function of nearby organs and structures, leading to symptoms such as pain, distention, intestinal obstruction, urinary retention, or weight loss, depending on their size and location. ★ Abdominal masses can be categorized based on their anatomical location into three primary types: 1. Intraperitoneal – arising from structures within the peritoneal cavity such as the liver, spleen, gastrointestinal tract, or reproductive organs. 2. Extraperitoneal – occurring outside the peritoneal cavity, either retroperitoneal (e.g., kidneys, adrenal glands, pancreas, lymph nodes) or pelvic (e.g., reproductive organs, bladder, rectum). 3. Abdominal wall – originating from the musculature, fascia, or subcutaneous tissues of the abdominal wall. ★ Further diagnostic evaluation relies heavily on advanced imaging techniques, which play a pivotal role in determining the mass’s location, size, composition, and relationship to adjacent structures. These techniques include: 1. Ultrasound (US): Often the initial imaging modality due to its non-invasiveness and ability to differentiate cystic from solid lesions. 2. US-guided core needle biopsy: Essential for obtaining tissue samples to confirm malignancy or infection. 3. CT scans with contrast: Provide detailed cross-sectional images, helping to identify vascular involvement, organ displacement, or metastasis. 4. MRI: Particularly useful for soft tissue characterization, assessing pelvic masses, or distinguishing benign from malignant lesions. ○ PET scans: Used for evaluating metabolic activity, staging cancers, and detecting distant metastasis. ★ In some cases, additional laboratory tests, such as tumor markers (e.g., CA-125, AFP, CEA) or blood cultures, may be warranted to aid diagnosis, especially when cancer, infection, or systemic conditions are suspected. [34]
Etiology
In the ancient text, abdominal masses are called jī jù (积聚). Ji indicates actual abdominal masses that are fixed and immovable; Ju indicates abdominal masses that come and go, do not have a fixed location and are movable. Another name for abdominal masses was zhēng jiǎ (症瘕), Zheng being equivalent to Ji (i.e. actual, fixed masses) and Jia being equivalent to Ju (i.e. non-substantial masses from stagnation of Qi). The term Zheng Jia normally referred to abdominal masses occurring only in women, but, although these masses are more frequent in women, they do occur in men as well. ★ Etiology: 1. Emotional strain: Prolonged emotional stress can disrupt the flow of Qi, leading to stagnation. 2. Irregular diet: Poor dietary habits can impair digestion, weaken the Spleen, and contribute to the formation of Phlegm or stagnation of Qi and Blood. 3. External pathogenic factors: External Cold can invade the lower abdomen, impairing the circulation of Blood and eventually leading to Blood stasis. ★ Pathology: Abdominal masses are primarily characterized by Qi stagnation or Blood stasis. In some cases, the accumulation of Phlegm may also play a role. Importantly, there is always an underlying deficiency of Qi in patients with abdominal masses, which compromises the body’s ability to resolve the condition. ★ Masses from Qi stagnation: These masses are movable upon palpation, come and go, and may shift location. Qi stagnation leads to a temporary and less defined mass due to the disrupted but dynamic flow of Qi. ★ Masses from Blood stasis:These masses are fixed in location, hard to the touch, and non-movable on palpation.Blood stasis causes a dense and stagnant mass that remains unyielding and firmly rooted. ★ Masses from Phlegm: These masses are soft to the touch, have a fixed location, and are usually painless. The accumulation of Phlegm results in a softer texture, as Phlegm is a fluid and viscous pathogenic factor.

Abdominal Mass – Liver Qi Stagnation

Symptoms
Movable abdominal masses which come and go, abdominal distension and pain which come and go with the masses, a feeling of discomfort in the hypochondrium, depression, moodiness, irritability, alternation of constipation and diarrhoea. Tongue: the body colour may be normal or slightly Red on the sides. Pulse: Wiry/String taut.[34]
Tongue
body color may be normal or slightly Red on the sides
Pulse
wiry
Treatment
Soothe the Liver, eliminate stagnation, move Qi and dissolve masses.
Acupunct
GB34, Ren6, LV3, SJ6, PC6, SP6, LU7, KI6. Qi and Blood stagnation: Add SP10, BL17, SP4
Herbs
FORMULAS: ➔ Xiao Yao San moves Liver-Qi, tonifies Spleen-Qi and nourishes Liver-Blood. ➔ Chai Hu Shu Gan San moves Liver-Qi in the lower abdomen and stops pain. ➔ Mu Xiang Shun Qi San moves Qi, resolves Dampness and restores the descending of Stomach-Qi. ➔ Qi and Blood stagnation: Jin Ling Zi San and Shi Xiao San together move Liver-Qi and Liver-Blood in the lower abdomen.
Notes
★ Blood stasis is a common cause of fixed, palpable masses in the abdomen and often represents the result of a long-term pathogenic process. It is essential to recognize that Blood stasis does not arise spontaneously but instead develops from other underlying imbalances or pathogenic factors. ★ Primary Causes of Blood Stasis: 1. Qi stagnation: When Qi becomes stagnant, it impairs the smooth flow of Blood, leading to stasis. 2. Cold in the Blood: Cold slows circulation, causing the Blood to congeal and stagnate, often resulting in fixed and painful masses. 3. Heat in the Blood: Heat can cause Blood to move erratically, leading to its thickening and eventual stagnation. ★ Secondary Causes of Blood Stasis: 1. Qi deficiency: Deficient Qi fails to circulate Blood effectively, resulting in stagnation over time. 2. Blood deficiency: Insufficient Blood can lead to poor flow and eventual stagnation, creating a condition of stasis. ★ Role of Phlegm: While Phlegm itself does not directly cause Blood stasis, it can aggravate it. The accumulation of Phlegm obstructs the channels and collaterals, further hindering the smooth movement of Qi and Blood, thereby intensifying stagnation. ★ Treatment principles of masses according to stage: 1. Beginning stages: primarily eliminate the pathogenic factor (i.e. move Qi and Blood, resolve Phlegm and dissolve masses). 2. Middle stages: eliminate the pathogenic factor and tonify the body’s Qi simultaneously. 3. Late stages: primarily tonify the body’s Qi and secondarily eliminate the pathogenic factor. ★ Treatment of Abdominal Masses from Blood Stasis: In cases of abdominal masses caused by Blood stasis, treatment requires not only the use of herbs to invigorate Blood but also stronger herbs that can “break” Blood. By incorporating softening herbs to disperse masses, complementing the action of herbs that invigorate or break Blood. [34]
Biomed
★ An abdominal mass refers to an abnormal, space-occupying growth, the nature of which requires thorough evaluation to determine its origin, composition, and clinical significance. These masses can arise from a wide range of causes, including congenital malformations, infections, benign or malignant neoplasms, hematologic disorders, vascular abnormalities such as aneurysms, and trauma. Systemic conditions like tuberculosis, lymphoma, or other inflammatory diseases may also present as abdominal masses. Such growths can displace, compress, infiltrate, or impair the function of nearby organs and structures, leading to symptoms such as pain, distention, intestinal obstruction, urinary retention, or weight loss, depending on their size and location. ★ Abdominal masses can be categorized based on their anatomical location into three primary types: 1. Intraperitoneal – arising from structures within the peritoneal cavity such as the liver, spleen, gastrointestinal tract, or reproductive organs. 2. Extraperitoneal – occurring outside the peritoneal cavity, either retroperitoneal (e.g., kidneys, adrenal glands, pancreas, lymph nodes) or pelvic (e.g., reproductive organs, bladder, rectum). 3. Abdominal wall – originating from the musculature, fascia, or subcutaneous tissues of the abdominal wall. ★ Further diagnostic evaluation relies heavily on advanced imaging techniques, which play a pivotal role in determining the mass’s location, size, composition, and relationship to adjacent structures. These techniques include: 1. Ultrasound (US): Often the initial imaging modality due to its non-invasiveness and ability to differentiate cystic from solid lesions. 2. US-guided core needle biopsy: Essential for obtaining tissue samples to confirm malignancy or infection. 3. CT scans with contrast: Provide detailed cross-sectional images, helping to identify vascular involvement, organ displacement, or metastasis. 4. MRI: Particularly useful for soft tissue characterization, assessing pelvic masses, or distinguishing benign from malignant lesions. ○ PET scans: Used for evaluating metabolic activity, staging cancers, and detecting distant metastasis. ★ In some cases, additional laboratory tests, such as tumor markers (e.g., CA-125, AFP, CEA) or blood cultures, may be warranted to aid diagnosis, especially when cancer, infection, or systemic conditions are suspected. [34]
Etiology
In the ancient text, abdominal masses are called jī jù (积聚). Ji indicates actual abdominal masses that are fixed and immovable; Ju indicates abdominal masses that come and go, do not have a fixed location and are movable. Another name for abdominal masses was zhēng jiǎ (症瘕), Zheng being equivalent to Ji (i.e. actual, fixed masses) and Jia being equivalent to Ju (i.e. non-substantial masses from stagnation of Qi). The term Zheng Jia normally referred to abdominal masses occurring only in women, but, although these masses are more frequent in women, they do occur in men as well. ★ Etiology: 1. Emotional strain: Prolonged emotional stress can disrupt the flow of Qi, leading to stagnation. 2. Irregular diet: Poor dietary habits can impair digestion, weaken the Spleen, and contribute to the formation of Phlegm or stagnation of Qi and Blood. 3. External pathogenic factors: External Cold can invade the lower abdomen, impairing the circulation of Blood and eventually leading to Blood stasis. ★ Pathology: Abdominal masses are primarily characterized by Qi stagnation or Blood stasis. In some cases, the accumulation of Phlegm may also play a role. Importantly, there is always an underlying deficiency of Qi in patients with abdominal masses, which compromises the body’s ability to resolve the condition. ★ Masses from Qi stagnation: These masses are movable upon palpation, come and go, and may shift location. Qi stagnation leads to a temporary and less defined mass due to the disrupted but dynamic flow of Qi. ★ Masses from Blood stasis:These masses are fixed in location, hard to the touch, and non-movable on palpation.Blood stasis causes a dense and stagnant mass that remains unyielding and firmly rooted. ★ Masses from Phlegm: These masses are soft to the touch, have a fixed location, and are usually painless. The accumulation of Phlegm results in a softer texture, as Phlegm is a fluid and viscous pathogenic factor.

Abdominal Pain Blood Stagnation

Symptoms
stabbing fixed abdominal pain, worse with pressure, purplish lips, dark rings around eyes, purplish vessels under tongue, female: irregular menses T: purple, stasis spots P: choppy, wiry [41]
Tongue
purple, stasis spots
Pulse
choppy, wiry
Treatment
Invigorate (Move) Blood, Stop Pain
Acupunct
SP8, ST29, Zi Gong, SP10, LI4, LV3, UB17 [41]
Herbs
Shao Fu Zhu Yu Tang (Dang Gui-9, Yan Hu Suo-9, Mo Yao-6, Chi Shao-9, Chuan Xiong-9, Rou Gui-6, Pu Huang-9, Wu Ling Zhi-9, Xiao Hui Xiang-6, Pao Jiang-6) [41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain [41]

Abdominal Pain Cold Deficiency

Symptoms
chronic dull abdominal pain, likes warmth, pain before eating or when hungry, pain improved with eating, fatigue, SOB, cold extremities, poor appetite, loose stool T: pale, TWC P: thin, deep, weak [41]
Tongue
pale, thin white coat
Pulse
thin, deep, weak
Treatment
Warm Interior, Benefit Spleen & Stomach, Stop Pain
Acupunct
Ren12, Ren6, Ren4, ST36, SP4, PC6 [41]
Herbs
Xiao Jian Zhong Tang (Gui Zhi-9, Zhi Gan Cao-6, Bai Shao-9, Yi Tang-6, Sheng Jiang-3) [41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain [41]

Abdominal Pain Cold Excess

Symptoms
acute abdominal pain, better with warm and pressure, chilled, cold extremities, nausea and vomiting, diarrhea, no thirst, clear urine T: white coat P: tight, wiry [41]
Tongue
white coat
Pulse
tight, wiry
Treatment
Warm Interior, Dispel Cold, Support Yang, Stop Pain
Acupunct
Moxa-Ren4/6/12, SJ5, SP4, PC6, ST34 [41]
Herbs
Si Ni Tang (Fu Zi-9, Gan Jiang-9, Zhi Gan Cao-6) [41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain [41]

Abdominal Pain Food Stagnation

Symptoms
abdominal pain, distention, worse with pressure and after eating, sour foul belching, vomiting with undigested food, acid reflux, constipation, foul smelling diarrhea T: thick greasy coat P: slippery, strong [41]
Tongue
thick greasy coat
Pulse
slippery, strong
Treatment
Relieve Food Stagnation, Stop Pain
Acupunct
Ren12, LI10, ST40, ST44, ST25[41]
Herbs
Bao He Wan (Shan Zha-9, Lai Fu Zi-6, Shen Qu-9, Lian Qiao-9, Chen Pi-6, Ban Xia-12, Fu Ling-12)[41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain [41]

Abdominal Pain Liver Qi Stagnation

Symptoms
abdominal pain related to emotions, belching, hypochondriac pain, chest pain, cold fingers and toes, depression, anxiety, irritability T: red edges P: wiry [41]
Tongue
red edges
Pulse
wiry
Treatment
Regulate Liver Qi, Smooth Liver, Stop Pain
Acupunct
LV3, PC6, SJ6, LV14, GB34 [41]
Herbs
Chai Hu Shu Gan San (Chai Hu-9, Chuan Xiong-9, Bai Shao-9, Chen Pi-6, Zhi Shi-9, Gan Cao-6, Xiang Fu-6) → this formula helps with IBS [41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain [41]

Abdominal Pain Worm Accumulation

Symptoms
Intermittent abdominal pain, usually around the umbilicus, abdominal distention, hunger or appetite loss, itchy anus/nose, grinds teeth at night, dark rings under eyes, scaly white spots on face, worms or worm eggs in stool T: pale with many red spots P: weak, wiry [41] • Roundworms (abdominal pain, vomiting worms, cold limbs), Hookworms (eat strange objects like soil, wax, uncooked rice, tea leaves), Pinworms (itchy anus, worse in the evening), Tapeworms (constant hunger).
Tongue
pale with many red spots
Pulse
weak, wiry
Treatment
Dispel Worms, Stop Pain
Acupunct
Ren 12, ST25, ST40, UB21, SP15, UB20, Bai Chong Wo [41]
Herbs
Wu Mei Wan (Wu Mei-24, Huang Lian-9, Zhi Fu Zi-6, Xi Xin-3, Huang Bai-9, Gan Jiang-6, Gui Zhi-6, Dang Gui-9, Ren Shen-9, Chuan Jiao-3)[41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain [41]

Abdominal Pain Yang Ming Heat

Symptoms
abdominal pain, fullness and distention, worse with pressure (firm palpation), fever, dry mouth, thirst, restlessness, constipation T: red, yellow sticky coat P: strong, slippery, rapid [41]
Tongue
red, yellow sticky coat
Pulse
strong, slippery, rapid
Treatment
Clear Stomach Heat, Move Bowel, Stop Pain
Acupunct
LI11, ST44, ST25, UB25, ST37 [41]
Herbs
Da Cheng Qi Tang (Da Huang-9, Hou Po-6, Mang Xiao-6, Zhi Shi-9) [41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain [41]

Acne Blood Stasis Phlegm Stagnation

Symptoms
repeated persistent eruptions on the cheeks and lower jaw, gradually enlarging to 3-5mm or larger, unevenly protruding, purplish red lumps that feel soft on palpation with pus and blood, or sticky yellow matter expelled with pressure, scars form after rupture T: pale red, greasy coat P: soggy, slippery [41]
Tongue
pale red, greasy coat
Pulse
soggy, slippery
Treatment
Promote Blood Circulation, Remove Phlegm to Soften Lumps
Acupunct
SP10, LI4, ST40, UB20, ST6 [41]
Herbs
Hai Zao Yu Hu Tang (Hai Zao-9, Zhe Bei Mu-9, Chen Pi-6, Qing Pi-6, Kun Bu-9, Ban Xai-12, Lian Qiao-9, Chuan Xiong-9, Xia Ku Cao-6, Long Gu-12, Mu Li-12, Dang Gui Wei-9)[41]
Biomed
acne is a disorder of the hair follicle sebaceous glands. It is most common during adolescence and occurs mostly on the face, chest, and back [41]
Etiology
TCM Etiology: 1) Heat in the Blood and Lung Channel - affects the face. 2)Heat Accumulation in the Spleen and Stomach - due to uncontrolled diet and eating too much spicy, heavy, fatty foods. 3)Blood heat moves to the exterior and congests the vessels - common during adolescence when the body is growing rapidly. 4)Stagnation of Qi and Blood in the channels and network vessels - due to emotional disturbances (stress, depression, worry) [41]

Acne Lung Heat

Symptoms
Lesions are distributed over the cheeks and forehead, around the nose, manifesting as discrete pinpoint to 2mm red or pale red papules. Severe cases may involve lesions on the chest and back, blackheads may be seen on some lesions, greasy or thick yellow discharge, skin appears oil and shiny, dry mouth and nose T: red, thin yellow coat P: floating, rapid [41]
Tongue
red, thin yellow coat
Pulse
floating, rapid
Treatment
Clear Lung Heat
Acupunct
LI4, LU7, Du14, LI11, SJ6 [41]
Herbs
Pi Pa Qing Fei Yin (Pi Pa Ye-9, Zhi Zi-9, Lian Qiao-9, Jin Yin Hua-9, Chi Shao-9, Sang Bai Pi-9, Huang Qin-6, Dong Gua Pi-9, Dan Pi-6, Hong Hua-9, Ling Xiao Hua-6, Dong Gua Ren-9) [41]
Biomed
acne is a disorder of the hair follicle sebaceous glands. It is most common during adolescence and occurs mostly on the face, chest, and back [41]
Etiology
TCM Etiology: 1) Heat in the Blood and Lung Channel - affects the face. 2)Heat Accumulation in the Spleen and Stomach - due to uncontrolled diet and eating too much spicy, heavy, fatty foods. 3)Blood heat moves to the exterior and congests the vessels - common during adolescence when the body is growing rapidly. 4)Stagnation of Qi and Blood in the channels and network vessels - due to emotional disturbances (stress, depression, worry) [41]

Acne Qi Blood Stagnation

Symptoms
presents as red or dark red eruptions on the face for several years. In women eruptions are usually aggravated during menstruation and are alleviated after periods. Accompanying symptoms and signs from stress and disharmony between Ren and Chong - irregular menstruation, menstrual clots, abdominal pain T: dark red, stasis marks P: deep, thin, choppy [41]
Tongue
dark red, stasis marks
Pulse
deep, thin, choppy
Treatment
Move Qi, Regulate Blood, Relieve Toxicity, Dispel Lumps
Acupunct
LI4, LV3, LI11, SP10, Du12, SP8, ST29[41]
Herbs
Liang Xue Qing Fei Yin (Sheng Di -12, Huang Qin-9, Dan Pi-6, Bai Hua She She Cao-9, Zi Hua Di Ding-9, Jin Yin Hua-15, Yin Chen Hao-15, Yi Mu Cao-12, Zhe Bei Mu-12, Pi Pa Ye-6, Chi Shao-9, Tao Ren-9, Lian Qiao-9, Zhi Mu-12). Fu Fang Zhen Zhu An Chuang Pian (Zhen Zhu Mu-18, Jin Yin Hua-9, Pu Gong Yin-9, Tian Kui Zi-9, Ling Xiao Hua-9, Lian Qiao-9, Chi Shao-12, Dan Shen-12) [41]
Biomed
acne is a disorder of the hair follicle sebaceous glands. It is most common during adolescence and occurs mostly on the face, chest, and back [41]
Etiology
TCM Etiology: 1) Heat in the Blood and Lung Channel - affects the face. 2)Heat Accumulation in the Spleen and Stomach - due to uncontrolled diet and eating too much spicy, heavy, fatty foods. 3)Blood heat moves to the exterior and congests the vessels - common during adolescence when the body is growing rapidly. 4)Stagnation of Qi and Blood in the channels and network vessels - due to emotional disturbances (stress, depression, worry) [41]

Acne Stomach Heat

Symptoms
overeating spicy, fatty, fried foods. Lesions are mainly distributed around mouth, foul breath, aversion to heat, thirst with desire for cold drinks, constipation, dark yellow urine T: red, thick yellow coat P: slippery, rapid [41]
Tongue
red, thick yellow coat
Pulse
slippery, rapid
Treatment
Clear Heat from the YangMing
Acupunct
ST44, LI11, LI4, ST25, SJ6 [41]
Herbs
Tiao Wei Cheng Qi Tang (Zhi Dan Huang-12, Zhi Gan Cao-6, Mang Xiao-12) [41]
Biomed
acne is a disorder of the hair follicle sebaceous glands. It is most common during adolescence and occurs mostly on the face, chest, and back [41]
Etiology
TCM Etiology: 1) Heat in the Blood and Lung Channel - affects the face. 2)Heat Accumulation in the Spleen and Stomach - due to uncontrolled diet and eating too much spicy, heavy, fatty foods. 3)Blood heat moves to the exterior and congests the vessels - common during adolescence when the body is growing rapidly. 4)Stagnation of Qi and Blood in the channels and network vessels - due to emotional disturbances (stress, depression, worry) [41]

Acute Appendicitis – Stage 1

Symptoms
acute intermittent lower abdominal pain, moving abdominal pain from upper → ST25 → lower right side, severe pain, worse with pressure, abdominal muscle spasm, tenderness, belching, appetite loss, nausea, vomiting, mild fever and chills with constipation T: thin yellow coat P: wiry or tight [41]
Tongue
thin yellow coat
Pulse
wiry, tight
Treatment
Move Qi & Blood, Clear, Heat, Open the Bowels
Acupunct
Lan Wei Xue, ST25, ST37, SP4, PC6, LI11, LI4, SP8 [41]
Herbs
Da Huang Mu Dan Pi Tang (Da Huang-12, Tao Ren-12, Mang Xiao-9, Dong Gu Ren-18, Mu Dan Pi-9) Bie Jia 6g Gui Ban 9g Ji Zi Huang (egg) Zhi Gan Cao 6g Wu Wei Zi 6g [41]
Biomed
Acute or chronic appendicitis [41]
Etiology
TCM Etiology: 1. Diet: stasis of food matter from improper diet and eating habits 2. Emotions: stress 3. External pathogenic invasion 4. Physical exercise directly after eating 4. These will result in intestinal dysfunction, stagnation of Qi, blood stasis, accumulation of heat and damp [41]

Acute Appendicitis – Stage 2

Symptoms
severe and increased abdominal pain with tenderness, patient may lie in fetal position, high fever, sweat, thirst, headache, chest and abdominal fullness and distention, constipation, nausea, vomiting T: red, yellow greasy coat P: wiry, slippery, rapid [41] Severe infection.
Tongue
red, yellow greasy coat
Pulse
wiry, slippery, rapid
Treatment
Clear Heat, Open the Bowels, Reduce Toxin
Acupunct
Lan Wei Xue, ST25, ST37, ST44, LI11 [41]
Herbs
Lan Wei Qing Hua Tang (Jin Yin Hua-12, Pu Gong Ying-9, Tao Ren-12, Mu Dan Pi-9, Zhi Da Huang-9, Gan Cao-6, Chuan Lian Zi-9, Chi Shao-9)[41] • This formula is more focused on removing toxic heat/infection. Zhi Da Huang is process with honey and moves the bowels more slowly.
Biomed
Acute or chronic appendicitis [41]
Etiology
TCM Etiology: 1. Diet: stasis of food matter from improper diet and eating habits 2. Emotions: stress 3. External pathogenic invasion 4. Physical exercise directly after eating 4. These will result in intestinal dysfunction, stagnation of Qi, blood stasis, accumulation of heat and damp [41]

Acute Appendicitis – Stage 3

Symptoms
Severe local pain, very hard and distended abdomen with rigidity and guarding (cannot be touched), constipation, concentrated urine, thirst, dry mouth lips and throat, red face and eyes, headache, nausea, vomiting, high fever, shock/coma T: deep red, dry yellow coat P: flooding, rapid [41]
Tongue
deep red, dry yellow coat
Pulse
flooding, rapid
Treatment
Clear Toxic-Heat, Invigorate Blood, Resolve Abscess
Acupunct
Shi Xuan, Du26, Du14, Jing Well Points, UB40, LI11, ST44 [41]
Herbs
Lan Wei Jie Du Tang (Hong Teng-21, Bai Jiang Cao-21, Jin Yin Hua-18, Tao Ren-9, Pu Gong Yin-18, Chi Shao-15, Da Huang-6, Chuan Lian Zi-9, Dong Gua Ren-15, Mu Xiang-6, Huang Qin-9)[41] • Expel the pus, greater at reducing the toxin. Hong Teng cools Blood Heat and controls the pain. Bai Jiang Cao for toxic heat.
Biomed
Acute or chronic appendicitis [41]
Etiology
TCM Etiology: 1. Diet: stasis of food matter from improper diet and eating habits 2. Emotions: stress 3. External pathogenic invasion 4. Physical exercise directly after eating 4. These will result in intestinal dysfunction, stagnation of Qi, blood stasis, accumulation of heat and damp [41]

Allergic Rhinitis Lung & Kidney Qi Deficiency

Symptoms
Afraid of cold, Pale complexion, weak back, propensity to catching colds, pale tongue, weak-deep pulse. [34][47]
Treatment
Treatment based on root and branches (treat root here)
Acupunct
Du4, Ren4 with moxa, BL23, KI3, BL13, Du12, Du24, Du23, GB20, Du14 with moxa, SI3 and BL62 (in women combined with LU7 and KI6) [34][47]
Herbs
Shen Qi Wan (modify): Shu Di Huang, Shan Yao, Shan Zhu Yu, Wu Wei Zi, Xin Yi Hua, Mu Dan Pi, Fu Ling, Ze Xie, Ge Jie, Xi Xin, Rou Gui[34][47]
Notes
1. For seasonal allergic rhinitis, symptoms are minimal or absent during the non-pollen season. Treatment should focus on addressing the root cause. For perennial allergic rhinitis, symptoms persist throughout the year. Treatment should focus on both the root cause and the symptoms. • 2. If the rhinitis is seasonal, begin supplementing the root six weeks to three months before the offending season. For instance, one can use modifications of Huang Qi Ren Shen Tang for the prevention of fall season rhinitis. This formula is comprised of: Huang Qi, 15g, Dang Shen, 12g, Bai Zhu, Cang Zhu, Mai Men Dong, Huang Bai, Dang Gui, Wu Wei Zi, and Chen Pi, 9g each, Zhi Gan Cao and Shen Qu, 6g each, and Sheng Ma, 4.5g. • 3. If allergic rhinitis transforms into acute sinusitis, then there can be a yellow nasal discharge. However, that then is a different disease diagnosis.[34][47]
Biomed
Allergic rhinitis refers to an atopic disease characterized by seasonal (intermittent) or perennial (chronic) sneezing, rhinorrhea, postnasal drip, nasal congestion, itching, and often conjunctivitis and pharyngitis in response to airborne allergens. • Frontal headache, irritability, anorexia, depression, and insomnia. Coughing and asthmatic wheezing may develop if the condition is more severe. • A result of the interaction between the inhaled allergen and allergen-specific immunoglobulin E (IgE) adhering to mucosal mast cells in the nasal epithelium. • Serum testing for allergen-specific IgE or allergy skin testing • Avoidance of allergen. Pharmacological options include antihistamines, intranasal steroids, leukotriene receptor antagonists (LTRAs), and immunotherapy. • Infectious rhinitis (viral or bacterial infections, most commonly seen in the pediatric population); Nasal polyposis • The prevalence of allergic rhinitis peaks in adolescence and gradually decreases with advancing age.[34][47]
Etiology
Bi Qiu: itchy nose, sneezing, profuse, white-watery nasal discharge and stuffy nose. (Allergic rhinitis) • Bi Yuan: a purulent nasal discharge with a foul smell, a stuffed nose, a runny nose, headache and sneezing. (sinusitis) • Primary mechanism: deficiency of Lung, Spleen & Kidney Wei Qi systems (root) and Wind attack with phlegm retention (Branch) • Affected Zang-fu Organs: LU, KD, SP • Spleen qi deficiency causes damp and phlegm. ○ Kidneys are responsible not only for breathing, due to their function of grasping Lung Qi, but also sneezing. • The Du Vessel emerges from between the Kidneys and flows up the spine to the top of the head and then down to the nose and lips. • Pathologic factors: wind, wind cold, wind heat, phlegm • The difference between seasonal and perennial allergic rhinitis, the latter occurs when there is a more severe Kidney deficiency.

Allergic Rhinitis Lung & Spleen Qi Deficiency

Symptoms
Fatigue, lack of strength, reluctant to speak and spontaneous sweating, tongue with teeth-marks, soft pulse [34][47]
Treatment
Treatment based on root and branches (treat root here)
Acupunct
BL13, BL20, Du23, GB20, ST36, ST40, SP6, REN6, KD3 [34][47]
Herbs
Yu Ping Feng San + Er Chen Tang (modify): Huang Qi, Bai Zhu, Dang Shen, Fang Feng, Fu Ling, Ban Xia, Chen Pi, Dang Gui, Zhi Gan Cao, Chai Hu, Sheng Jiang[34][47]
Notes
1. For seasonal allergic rhinitis, symptoms are minimal or absent during the non-pollen season. Treatment should focus on addressing the root cause. For perennial allergic rhinitis, symptoms persist throughout the year. Treatment should focus on both the root cause and the symptoms. • 2. If the rhinitis is seasonal, begin supplementing the root six weeks to three months before the offending season. For instance, one can use modifications of Huang Qi Ren Shen Tang for the prevention of fall season rhinitis. This formula is comprised of: Huang Qi, 15g, Dang Shen, 12g, Bai Zhu, Cang Zhu, Mai Men Dong, Huang Bai, Dang Gui, Wu Wei Zi, and Chen Pi, 9g each, Zhi Gan Cao and Shen Qu, 6g each, and Sheng Ma, 4.5g. • 3. If allergic rhinitis transforms into acute sinusitis, then there can be a yellow nasal discharge. However, that then is a different disease diagnosis.[34][47]
Biomed
Allergic rhinitis refers to an atopic disease characterized by seasonal (intermittent) or perennial (chronic) sneezing, rhinorrhea, postnasal drip, nasal congestion, itching, and often conjunctivitis and pharyngitis in response to airborne allergens. • Frontal headache, irritability, anorexia, depression, and insomnia. Coughing and asthmatic wheezing may develop if the condition is more severe. • A result of the interaction between the inhaled allergen and allergen-specific immunoglobulin E (IgE) adhering to mucosal mast cells in the nasal epithelium. • Serum testing for allergen-specific IgE or allergy skin testing • Avoidance of allergen. Pharmacological options include antihistamines, intranasal steroids, leukotriene receptor antagonists (LTRAs), and immunotherapy. • Infectious rhinitis (viral or bacterial infections, most commonly seen in the pediatric population); Nasal polyposis • The prevalence of allergic rhinitis peaks in adolescence and gradually decreases with advancing age.[34][47]
Etiology
Bi Qiu: itchy nose, sneezing, profuse, white-watery nasal discharge and stuffy nose. (Allergic rhinitis) • Bi Yuan: a purulent nasal discharge with a foul smell, a stuffed nose, a runny nose, headache and sneezing. (sinusitis) • Primary mechanism: deficiency of Lung, Spleen & Kidney Wei Qi systems (root) and Wind attack with phlegm retention (Branch) • Affected Zang-fu Organs: LU, KD, SP • Spleen qi deficiency causes damp and phlegm. ○ Kidneys are responsible not only for breathing, due to their function of grasping Lung Qi, but also sneezing. • The Du Vessel emerges from between the Kidneys and flows up the spine to the top of the head and then down to the nose and lips. • Pathologic factors: wind, wind cold, wind heat, phlegm • The difference between seasonal and perennial allergic rhinitis, the latter occurs when there is a more severe Kidney deficiency.

Allergic Rhinitis Wind Cold

Symptoms
Sneezing, profuse runny nose with white-watery discharge, pale complexion, stuffy nose, slight headache, no thirst. [34][47]
Treatment
Treatment based on root and branches (treat branches here)
Acupunct
BL12, BL13, LU7, LI20, Bitong, Du23, GB20, Yintang [34][47]
Herbs
Cang Er Zi San. For runny nose, add Huo Xiang (Herba Pogostemonis), Bai Zhi (Radix Angelicae Dahuricae) 9g each. For itchy eyes, add Chan Tui (Periostracum Cicadae), Jing Jie (Herba Schizonepetae) 9g each. [34][47]
Notes
1. For seasonal allergic rhinitis, symptoms are minimal or absent during the non-pollen season. Treatment should focus on addressing the root cause. For perennial allergic rhinitis, symptoms persist throughout the year. Treatment should focus on both the root cause and the symptoms. • 2. If the rhinitis is seasonal, begin supplementing the root six weeks to three months before the offending season. For instance, one can use modifications of Huang Qi Ren Shen Tang for the prevention of fall season rhinitis. This formula is comprised of: Huang Qi, 15g, Dang Shen, 12g, Bai Zhu, Cang Zhu, Mai Men Dong, Huang Bai, Dang Gui, Wu Wei Zi, and Chen Pi, 9g each, Zhi Gan Cao and Shen Qu, 6g each, and Sheng Ma, 4.5g. • 3. If allergic rhinitis transforms into acute sinusitis, then there can be a yellow nasal discharge. However, that then is a different disease diagnosis.[34][47]
Biomed
Allergic rhinitis refers to an atopic disease characterized by seasonal (intermittent) or perennial (chronic) sneezing, rhinorrhea, postnasal drip, nasal congestion, itching, and often conjunctivitis and pharyngitis in response to airborne allergens. • Frontal headache, irritability, anorexia, depression, and insomnia. Coughing and asthmatic wheezing may develop if the condition is more severe. • A result of the interaction between the inhaled allergen and allergen-specific immunoglobulin E (IgE) adhering to mucosal mast cells in the nasal epithelium. • Serum testing for allergen-specific IgE or allergy skin testing • Avoidance of allergen. Pharmacological options include antihistamines, intranasal steroids, leukotriene receptor antagonists (LTRAs), and immunotherapy. • Infectious rhinitis (viral or bacterial infections, most commonly seen in the pediatric population); Nasal polyposis • The prevalence of allergic rhinitis peaks in adolescence and gradually decreases with advancing age.[34][47]
Etiology
Bi Qiu: itchy nose, sneezing, profuse, white-watery nasal discharge and stuffy nose. (Allergic rhinitis) • Bi Yuan: a purulent nasal discharge with a foul smell, a stuffed nose, a runny nose, headache and sneezing. (sinusitis) • Primary mechanism: deficiency of Lung, Spleen & Kidney Wei Qi systems (root) and Wind attack with phlegm retention (Branch) • Affected Zang-fu Organs: LU, KD, SP • Spleen qi deficiency causes damp and phlegm. ○ Kidneys are responsible not only for breathing, due to their function of grasping Lung Qi, but also sneezing. • The Du Vessel emerges from between the Kidneys and flows up the spine to the top of the head and then down to the nose and lips. • Pathologic factors: wind, wind cold, wind heat, phlegm • The difference between seasonal and perennial allergic rhinitis, the latter occurs when there is a more severe Kidney deficiency.

Allergic Rhinitis Wind Heat

Symptoms
Sneezing, runny nose with white and watery discharge, itchy throat, itchy-red eyes, slight thirst. [34][47] Itchy, skin hypersensitivity; eyes feel itchy, inflamed or stinging [42]
Treatment
Treatment based on root and branches (treat branches here)
Acupunct
BL12, BL13, LI4, LI11, LI20, Bitong, Yintang, GB20 [34][47]
Herbs
Sang Ju Yin (modify): For more sneezing: add Cang Er Zi, Xin Yi Hua and Bai Zhi [34][47] • Cang Er Zi and Xin Yi Huan are mostly for sneezing. Bai Zhi will dry up the runny nose. [42]
Notes
1. For seasonal allergic rhinitis, symptoms are minimal or absent during the non-pollen season. Treatment should focus on addressing the root cause. For perennial allergic rhinitis, symptoms persist throughout the year. Treatment should focus on both the root cause and the symptoms. • 2. If the rhinitis is seasonal, begin supplementing the root six weeks to three months before the offending season. For instance, one can use modifications of Huang Qi Ren Shen Tang for the prevention of fall season rhinitis. This formula is comprised of: Huang Qi, 15g, Dang Shen, 12g, Bai Zhu, Cang Zhu, Mai Men Dong, Huang Bai, Dang Gui, Wu Wei Zi, and Chen Pi, 9g each, Zhi Gan Cao and Shen Qu, 6g each, and Sheng Ma, 4.5g. • 3. If allergic rhinitis transforms into acute sinusitis, then there can be a yellow nasal discharge. However, that then is a different disease diagnosis.[34][47]
Biomed
Allergic rhinitis refers to an atopic disease characterized by seasonal (intermittent) or perennial (chronic) sneezing, rhinorrhea, postnasal drip, nasal congestion, itching, and often conjunctivitis and pharyngitis in response to airborne allergens. • Frontal headache, irritability, anorexia, depression, and insomnia. Coughing and asthmatic wheezing may develop if the condition is more severe. • A result of the interaction between the inhaled allergen and allergen-specific immunoglobulin E (IgE) adhering to mucosal mast cells in the nasal epithelium. • Serum testing for allergen-specific IgE or allergy skin testing • Avoidance of allergen. Pharmacological options include antihistamines, intranasal steroids, leukotriene receptor antagonists (LTRAs), and immunotherapy. • Infectious rhinitis (viral or bacterial infections, most commonly seen in the pediatric population); Nasal polyposis • The prevalence of allergic rhinitis peaks in adolescence and gradually decreases with advancing age.[34][47]
Etiology
Bi Qiu: itchy nose, sneezing, profuse, white-watery nasal discharge and stuffy nose. (Allergic rhinitis) • Bi Yuan: a purulent nasal discharge with a foul smell, a stuffed nose, a runny nose, headache and sneezing. (sinusitis) • Primary mechanism: deficiency of Lung, Spleen & Kidney Wei Qi systems (root) and Wind attack with phlegm retention (Branch) • Affected Zang-fu Organs: LU, KD, SP • Spleen qi deficiency causes damp and phlegm. ○ Kidneys are responsible not only for breathing, due to their function of grasping Lung Qi, but also sneezing. • The Du Vessel emerges from between the Kidneys and flows up the spine to the top of the head and then down to the nose and lips. • Pathologic factors: wind, wind cold, wind heat, phlegm • The difference between seasonal and perennial allergic rhinitis, the latter occurs when there is a more severe Kidney deficiency.

Alzheimer’s Disease Damp and Phlegm Misting the Orifices

Symptoms
Heavy-headedness, a yellow, stagnant facial complexion, superficial edema, fatigue, lack of strength, sleepiness, phlegmy sounding respiration, slow reaction, lack of speech or confused speech, alternating sorrow and joy for no particular reason, no discrimination between good and bad, profuse mouth drool, abdominal distention, if severe, lack of sensitivity, inability to manage one’s activities by oneself.[34], [47]
Tongue
pale, swollen tongue with wet/sticky, white coating
Pulse
soft, rolling
Treatment
tonify Spleen, resolve dampness and phlegm, clear orifices and mind
Acupunct
DU20, Si Shen Cong, GB20, ST36, SP9, ST40, REN12, HT5, HT7 [34], [47]
Herbs
Xi Xin Tang: Ren Shen, Suan Zao Ren, Fu Shen, Ban Xia, Shi Chang Pu, Chen Pi, Shen Qu, Zhi Gan Cao, Zhi Fu Zi. If there is abdominal distention and scanty intake, remove Ren Shen, Zhi Fu Zi, and Suan Zao Ren and add Huo Xiang, Pei Lan, Hou Po, Lai Fu Zi, Zhi Ke, Mu Xiang, 9g each. ★ Extract of Huperzia serrata (Qian Ceng Ta) contains HupA, which is a potent, reversible, and selective inhibitor of cholinesterase, which helps increase acetylcholine levels in the brain, enhancing cognitive function. It reduces glutamate-induced toxicity in neurons by modulating glutamate-NMDA receptor interaction and Ca2+ ion channel passage. It has antioxidant properties too. ★ Ginkgo biloba: treats age related physical and cognitive disorders. It contains EGb 761 Extract which shows favorable effects on cerebral circulation, neuronal cell metabolism, the muscarinic cholinergic system, and exhibits antioxidant activity. It protects agains beta-amyloid and nitric oxide induced toxicity in vitro and reduces apoptosis both in vitro and in vivo. It also maintains calcium homeostasis by blocking abeta1-42. ★ Salidroside (Hong Jing Tian), traditionally used as a tonic and anti-aging agent in East Asia. It has neuroprotective activity and antioxidative effects. ★ Salvia miltiorrhiza (Labiatae), Dan Shen, official indications for the root include treatment of blood circulation disorders. It is neuronal protective by inhibiting neuronal cell death by preventing presynaptic glutamate release or nitric oxide formation. It potentially modifies ischemic cell changes by modulating somatostatin. It has antioxidant properties and cholinesterase inhibitory activity. [34], [47]
Notes
1. Qi Fu Yin (七福饮), a formula designed for dementia treatment, includes Ren Sheng, Shu Di Huang, Dang Gui, Da Zao, Zhi Gan Cao, and Yuan Zhi. This formula is considered the earliest known herbal therapeutic strategy for dementia globally and continues to be utilized for AD treatment. 2. According to the CDC's National Center for Health Statistics in 2023, Alzheimer's disease (AD) ranks as the 6th leading cause of death, accounting for nearly 120,000 deaths annually. AD predominantly affects individuals over 65 years old, increasing their susceptibility to complications that significantly impact their health and well-being. These complications encompass mental/behavioral challenges as well as physical difficulties. 3. Rehabilitation and physical activity play pivotal roles in the treatment and prevention of dementia. They can enhance cognitive function, particularly executive functioning, thereby reducing the risk of falls and improving the ability to perform daily activities. 4. Caregivers and healthcare teams are essential in ensuring continuous care and providing necessary support to dementia patients. 5. Certain traditional Chinese medicines show promise as potential anti-AD treatments. Herbs are relatively less toxic, can penetrate the blood-brain barrier effectively, and exhibit bioavailability, thus exerting multiple synergistic effects. 6. Research indicates that Qigong exercise significantly enhances neurocognitive function in aging individuals. It contributes to increased hippocampal volume and reduced peripheral IL-6 levels.[34], [47]
Biomed
★ Alzheimer's Disease (AD) is a neurodegenerative condition with an insidious onset and progressive impairment of cognitive and behavioral functions, including memory, comprehension, language, attention, reasoning, and judgment. AD is classified into different stages based on the level of cognitive impairment: preclinical or presymptomatic stage, mild cognitive impairment, and dementia stage, which is further divided into mild, moderate, and severe stages. ★ The neurodegenerative process in AD typically begins in the entorhinal cortex within the hippocampus and is characterized pathologically by the accumulation of abnormal neuritic plaques and neurofibrillary tangles in the brain. These pathological changes are accompanied by the loss of neurons, particularly cholinergic neurons in the basal forebrain and the neocortex. ★ Factors contributing to AD include genetic factors, age, cardiovascular diseases, obesity, and diabetes. On average, individuals aged 65 or older diagnosed with AD may have a life expectancy of about 4 to 8 years. ★ Treatment options for AD include Cholinesterase Inhibitors (donepezil, rivastigmine, and galantamine), partial N-Methyl D-Aspartate (NMDA) antagonist (Memantine), and disease-modifying therapies. [NIH-StatPearls]
Etiology
★ In Chinese Medicine, Alzheimer's Disease (AD) is referred to as Chi Dai, Jian Wang, or Dai Zheng. Ancient Chinese medical literature has discussed memory and cognitive deficits associated with AD. ★ Pathologic mechanism: The gradual insufficiencies in yin blood and aging process can lead to a lack of essence transformation and insufficient nourishment for the sea of marrow (Brain). Moreover, yang qi deficiency may result in a loss of Shen. An unhealthy diet may contribute to the generation of damp phlegm, which can mist the orifices of the heart (mind) and brain, leading to mental confusion and aphasia. ○ In instances of liver depression qi stagnation, which is expected due to the frustration caused by this condition, blood stasis can occur. Additionally, faulty or impaired memory and difficulty with abstract thinking may be attributed to heart and /or Spleen blood deficiency. ★ Early-stage AD often presents as Kidney Essence Deficiency and Spleen Qi Weakness, resulting in mild memory impairment and brain fatigue. ★ Mid-stage AD frequently involves Heart Blood Deficiency, Liver Qi Stagnation, and Phlegm Obstruction, leading to agitation, confusion, speech difficulties, and emotional instability. ★ Late-stage AD is typically complicated by Blood Stasis and Phlegm Misting the Mind, causing severe cognitive dysfunction, apathy, and loss of communication abilities.[34],[47]

Alzheimer’s Disease Heart and Spleen Deficiency

Symptoms
Confused, chaotic thinking, a predilection to sorrow and a desire to cry, excessive stillness, scanty speech, slow movement, lack of involvement in the outside world, lassitude, spontaneous sweat, lack of strength, emaciation, palpitations, susceptibility to fright, shortness of breath on slight exertion, lower food intake, lack of taste.[47]
Tongue
pale, swollen tongue with thin white coating
Pulse
weak, thready
Treatment
tonify and nourish Heart and Spleen Qi and blood, Calm and stabilize the Shen and Mind
Acupunct
BL15, BL17, BL20, BL52, DU20, Si Shen Cong, HT7, PC7, SP6. [47]
Herbs
Yang Xin Tang: Ren Shen, Mai Men Dong, Suan Zao Ren, Dang Gui, Sheng Di Huang, Shu Di Huang, Fu Ling, Bai Zi Ren, Wu Wei Zi, Zhi Gan Cao. If there is chaotic speech, add Shi Chang Pu, Long Chi, and Yu Jin, 9g each. If there is blood stasis, add Dan Shen 9g, and Hu Po 3g. [47] • ★ Extract of Huperzia serrata (Qian Ceng Ta) contains HupA, which is a potent, reversible, and selective inhibitor of cholinesterase, which helps increase acetylcholine levels in the brain, enhancing cognitive function. It reduces glutamate-induced toxicity in neurons by modulating glutamate-NMDA receptor interaction and Ca2+ ion channel passage. It has antioxidant properties too. ★ Ginkgo biloba: treats age related physical and cognitive disorders. It contains EGb 761 Extract which shows favorable effects on cerebral circulation, neuronal cell metabolism, the muscarinic cholinergic system, and exhibits antioxidant activity. It protects agains beta-amyloid and nitric oxide induced toxicity in vitro and reduces apoptosis both in vitro and in vivo. It also maintains calcium homeostasis by blocking abeta1-42. ★ Salidroside (Hong Jing Tian), traditionally used as a tonic and anti-aging agent in East Asia. It has neuroprotective activity and antioxidative effects. ★ Salvia miltiorrhiza (Labiatae), Dan Shen, official indications for the root include treatment of blood circulation disorders. It is neuronal protective by inhibiting neuronal cell death by preventing presynaptic glutamate release or nitric oxide formation. It potentially modifies ischemic cell changes by modulating somatostatin. It has antioxidant properties and cholinesterase inhibitory activity. [34], [47]
Notes
1. Qi Fu Yin (七福饮), a formula designed for dementia treatment, includes Ren Sheng, Shu Di Huang, Dang Gui, Da Zao, Zhi Gan Cao, and Yuan Zhi. This formula is considered the earliest known herbal therapeutic strategy for dementia globally and continues to be utilized for AD treatment. 2. According to the CDC's National Center for Health Statistics in 2023, Alzheimer's disease (AD) ranks as the 6th leading cause of death, accounting for nearly 120,000 deaths annually. AD predominantly affects individuals over 65 years old, increasing their susceptibility to complications that significantly impact their health and well-being. These complications encompass mental/behavioral challenges as well as physical difficulties. 3. Rehabilitation and physical activity play pivotal roles in the treatment and prevention of dementia. They can enhance cognitive function, particularly executive functioning, thereby reducing the risk of falls and improving the ability to perform daily activities. 4. Caregivers and healthcare teams are essential in ensuring continuous care and providing necessary support to dementia patients. 5. Certain traditional Chinese medicines show promise as potential anti-AD treatments. Herbs are relatively less toxic, can penetrate the blood-brain barrier effectively, and exhibit bioavailability, thus exerting multiple synergistic effects. 6. Research indicates that Qigong exercise significantly enhances neurocognitive function in aging individuals. It contributes to increased hippocampal volume and reduced peripheral IL-6 levels.[34], [47]
Biomed
★ Alzheimer's Disease (AD) is a neurodegenerative condition with an insidious onset and progressive impairment of cognitive and behavioral functions, including memory, comprehension, language, attention, reasoning, and judgment. AD is classified into different stages based on the level of cognitive impairment: preclinical or presymptomatic stage, mild cognitive impairment, and dementia stage, which is further divided into mild, moderate, and severe stages. ★ The neurodegenerative process in AD typically begins in the entorhinal cortex within the hippocampus and is characterized pathologically by the accumulation of abnormal neuritic plaques and neurofibrillary tangles in the brain. These pathological changes are accompanied by the loss of neurons, particularly cholinergic neurons in the basal forebrain and the neocortex. ★ Factors contributing to AD include genetic factors, age, cardiovascular diseases, obesity, and diabetes. On average, individuals aged 65 or older diagnosed with AD may have a life expectancy of about 4 to 8 years. ★ Treatment options for AD include Cholinesterase Inhibitors (donepezil, rivastigmine, and galantamine), partial N-Methyl D-Aspartate (NMDA) antagonist (Memantine), and disease-modifying therapies. [NIH-StatPearls]
Etiology
★ In Chinese Medicine, Alzheimer's Disease (AD) is referred to as Chi Dai, Jian Wang, or Dai Zheng. Ancient Chinese medical literature has discussed memory and cognitive deficits associated with AD. ★ Pathologic mechanism: The gradual insufficiencies in yin blood and aging process can lead to a lack of essence transformation and insufficient nourishment for the sea of marrow (Brain). Moreover, yang qi deficiency may result in a loss of Shen. An unhealthy diet may contribute to the generation of damp phlegm, which can mist the orifices of the heart (mind) and brain, leading to mental confusion and aphasia. ○ In instances of liver depression qi stagnation, which is expected due to the frustration caused by this condition, blood stasis can occur. Additionally, faulty or impaired memory and difficulty with abstract thinking may be attributed to heart and /or Spleen blood deficiency. ★ Early-stage AD often presents as Kidney Essence Deficiency and Spleen Qi Weakness, resulting in mild memory impairment and brain fatigue. ★ Mid-stage AD frequently involves Heart Blood Deficiency, Liver Qi Stagnation, and Phlegm Obstruction, leading to agitation, confusion, speech difficulties, and emotional instability. ★ Late-stage AD is typically complicated by Blood Stasis and Phlegm Misting the Mind, causing severe cognitive dysfunction, apathy, and loss of communication abilities.[34],[47]

Alzheimer’s Disease Liver & Kidney Yin Deficiency with Phlegm Stasis

Symptoms
A relatively long disease course, dizziness, vertigo, numbness, tingling of the hands and feet, loss of intelligence and coordination, decreased memory power, lack of Shen in both eyes, a stagnant, shallow facial expression, malar flushing, night sweats, possible emaciation, dry, scaly skin, a predilection for abnormal anger, trembling or spasms and contractions, if severe, difficult, encumbered movement, possible hemilateral paralysis and aphasia. [47]
Tongue
dark red tongue with possible static macules and scanty coating
Pulse
string-taut, thready, rapid
Treatment
Nourish Liver and Kidney Yin, invigorate blood, resolve phlegm
Acupunct
BL18, BL23, BL52, DU20, Si Shen Cong, SP6, ST40, KD1, HT5 [47]
Herbs
Liu Wei Di Huang Wan (modify): Shu Di Huang, Fu Ling, Shan Zhu Yu, Mu Dan Pi, Ze Xie, Chi Shao, Chuan Xiong, Hong Hua, Tao Ren, Yuan Zhi, Shi Chang Pu. If there is dizziness, add Ci Shi 12g, Tian Ma, Gou Teng, and Nu Zhen Zi, 9g each. If there is hemiplegia or numbness of the hands and feet, add Ji Xue Teng and Dan Shen, 15g each, Dang Gui and E Jiao 9g each. [47] • ★ Extract of Huperzia serrata (Qian Ceng Ta) contains HupA, which is a potent, reversible, and selective inhibitor of cholinesterase, which helps increase acetylcholine levels in the brain, enhancing cognitive function. It reduces glutamate-induced toxicity in neurons by modulating glutamate-NMDA receptor interaction and Ca2+ ion channel passage. It has antioxidant properties too. ★ Ginkgo biloba: treats age related physical and cognitive disorders. It contains EGb 761 Extract which shows favorable effects on cerebral circulation, neuronal cell metabolism, the muscarinic cholinergic system, and exhibits antioxidant activity. It protects agains beta-amyloid and nitric oxide induced toxicity in vitro and reduces apoptosis both in vitro and in vivo. It also maintains calcium homeostasis by blocking abeta1-42. ★ Salidroside (Hong Jing Tian), traditionally used as a tonic and anti-aging agent in East Asia. It has neuroprotective activity and antioxidative effects. ★ Salvia miltiorrhiza (Labiatae), Dan Shen, official indications for the root include treatment of blood circulation disorders. It is neuronal protective by inhibiting neuronal cell death by preventing presynaptic glutamate release or nitric oxide formation. It potentially modifies ischemic cell changes by modulating somatostatin. It has antioxidant properties and cholinesterase inhibitory activity. [34], [47]
Notes
1. Qi Fu Yin (七福饮), a formula designed for dementia treatment, includes Ren Sheng, Shu Di Huang, Dang Gui, Da Zao, Zhi Gan Cao, and Yuan Zhi. This formula is considered the earliest known herbal therapeutic strategy for dementia globally and continues to be utilized for AD treatment. 2. According to the CDC's National Center for Health Statistics in 2023, Alzheimer's disease (AD) ranks as the 6th leading cause of death, accounting for nearly 120,000 deaths annually. AD predominantly affects individuals over 65 years old, increasing their susceptibility to complications that significantly impact their health and well-being. These complications encompass mental/behavioral challenges as well as physical difficulties. 3. Rehabilitation and physical activity play pivotal roles in the treatment and prevention of dementia. They can enhance cognitive function, particularly executive functioning, thereby reducing the risk of falls and improving the ability to perform daily activities. 4. Caregivers and healthcare teams are essential in ensuring continuous care and providing necessary support to dementia patients. 5. Certain traditional Chinese medicines show promise as potential anti-AD treatments. Herbs are relatively less toxic, can penetrate the blood-brain barrier effectively, and exhibit bioavailability, thus exerting multiple synergistic effects. 6. Research indicates that Qigong exercise significantly enhances neurocognitive function in aging individuals. It contributes to increased hippocampal volume and reduced peripheral IL-6 levels.[34], [47]
Biomed
★ Alzheimer's Disease (AD) is a neurodegenerative condition with an insidious onset and progressive impairment of cognitive and behavioral functions, including memory, comprehension, language, attention, reasoning, and judgment. AD is classified into different stages based on the level of cognitive impairment: preclinical or presymptomatic stage, mild cognitive impairment, and dementia stage, which is further divided into mild, moderate, and severe stages. ★ The neurodegenerative process in AD typically begins in the entorhinal cortex within the hippocampus and is characterized pathologically by the accumulation of abnormal neuritic plaques and neurofibrillary tangles in the brain. These pathological changes are accompanied by the loss of neurons, particularly cholinergic neurons in the basal forebrain and the neocortex. ★ Factors contributing to AD include genetic factors, age, cardiovascular diseases, obesity, and diabetes. On average, individuals aged 65 or older diagnosed with AD may have a life expectancy of about 4 to 8 years. ★ Treatment options for AD include Cholinesterase Inhibitors (donepezil, rivastigmine, and galantamine), partial N-Methyl D-Aspartate (NMDA) antagonist (Memantine), and disease-modifying therapies. [NIH-StatPearls]
Etiology
★ In Chinese Medicine, Alzheimer's Disease (AD) is referred to as Chi Dai, Jian Wang, or Dai Zheng. Ancient Chinese medical literature has discussed memory and cognitive deficits associated with AD. ★ Pathologic mechanism: The gradual insufficiencies in yin blood and aging process can lead to a lack of essence transformation and insufficient nourishment for the sea of marrow (Brain). Moreover, yang qi deficiency may result in a loss of Shen. An unhealthy diet may contribute to the generation of damp phlegm, which can mist the orifices of the heart (mind) and brain, leading to mental confusion and aphasia. ○ In instances of liver depression qi stagnation, which is expected due to the frustration caused by this condition, blood stasis can occur. Additionally, faulty or impaired memory and difficulty with abstract thinking may be attributed to heart and /or Spleen blood deficiency. ★ Early-stage AD often presents as Kidney Essence Deficiency and Spleen Qi Weakness, resulting in mild memory impairment and brain fatigue. ★ Mid-stage AD frequently involves Heart Blood Deficiency, Liver Qi Stagnation, and Phlegm Obstruction, leading to agitation, confusion, speech difficulties, and emotional instability. ★ Late-stage AD is typically complicated by Blood Stasis and Phlegm Misting the Mind, causing severe cognitive dysfunction, apathy, and loss of communication abilities.[34],[47]

Anger

Symptoms
Red face and eyes, emotional depression, easily angered, dizziness, headache, chest oppression and frequent sighing, distension and pain in the hypochondria and breast area, and plum-pit syndrome. In severe cases, vomiting or cough with blood, or sudden fainting can be seen. Wiry pulse [Qiao]
Pulse
wiry

Asthma Kidney Yang Deficiency

Symptoms
SOB upon exertion, low back soreness, frequent urination, easy sweats, aversion to cold, cold body, pale face T: enlarged, teethmarks, TWC P: deep [41]
Tongue
enlarged, teethmarks, thin white coat
Pulse
deep
Treatment
Tonify Kidney Yang, Grasp Lung Qi
Acupunct
Ren4, UB23, GB39, Du4, KD3, UB13, Ren17
Herbs
Jin Gui Sheng Qi Wan (Shu Di Huang-12, Shan Yao-12, Shan Zhu Yu-12, Fu Ling-12, Mu Dan Pi-6, Zi Xie-12, Rou Gui-9, Fu Zi-9)[41]
Biomed
Allergies, abnormal weather, emotional changes, seafood, illness, excess exercise (KD deficiency), drugs. Clinical signs: wheezing, mucus, cough, chest fullness. [41]
Etiology
Etiology: 1) Evil Qi - pollution, weather changes 2) Wei Qi Def, Zhong Qi Def, Lung Qi Def. 3) Diet - seafood allergies. [41]

Asthma Liver Qi Stagnation

Symptoms
Wheezing combined with acute emotions, sudden onset, chest and hypochondriac pain, plum-pit qi, insomnia, palpitations T: purple, TWC P: wiry [41]
Tongue
purple, thin white coat
Pulse
wiry
Treatment
Smooth Liver Qi, Stop Wheezing
Acupunct
LV3, Ren17, LV14, SP4, PC6
Herbs
Wu Mo Yin Zi (Wu Yao-9, Mu Xiang-6, Zhi Shi-9, Chen Xiang-6, Bing Lang-9) [41]
Biomed
Allergies, abnormal weather, emotional changes, seafood, illness, excess exercise (KD def), drugs[. Clinical signs: wheezing, mucus, cough, chest fullness41]
Etiology
Etiology: 1) Evil Qi - pollution, weather changes 2) Wei Qi Def, Zhong Qi Def, Lung Qi Def. 3) Diet - seafood allergies. [41]

Asthma Lung Qi Deficiency

Symptoms
Intermittent wheezing, chronic asthma, sweats easily, catches colds easily, cough with white mucus, low voice, sneezing, runny nose, pale face T: pale, teethmarks, white moist coat [41]
Tongue
pale, teethmarks, white moist coat
Pulse
soft, weak
Treatment
Tonify Lung Qi, Protect Wei Qi
Acupunct
LU9, ST36, SP3, UB13, Ren6
Herbs
Yu Ping Feng San +/- (Huang Qi-15, Bai Zhu-12, Fang Feng-9, Su Zi-9, Lai Fu Zi-9, Bai Jie Zi-9) [41]
Biomed
Allergies, abnormal weather, emotional changes, seafood, illness, excess exercise (KD deficiency), drugs. Clinical signs: wheezing, mucus, cough, chest fullness. [41]
Etiology
Etiology: 1) Evil Qi - pollution, weather changes 2) Wei Qi Def, Zhong Qi Def, Lung Qi Def. 3) Diet - seafood allergies. [41]

Asthma Phlegm Heat

Symptoms
Wheezing, chest fullness and tightness, sticky yellow mucus, bitter taste, dry mouth, red face, fever, nausea, poor appetite, sore throat, mild sweating, constipation T: red, yellow sticky coat P: rapid, slippery. Phlegm-Heat originates in the middle jiao, so there will be digestive symptoms (compared to Wind Internal Heat, which enters the Lungs from exterior and does not have explicit middle jiao component) [41]
Tongue
red, yellow sticky coat
Pulse
slippery, rapid
Treatment
Clear Heat, Dispel Lung Qi, Transform Phlegm, Stop Wheezing
Acupunct
Ding Chuan, Ren17, ST40, ST44, UB13
Herbs
Ma Xing Shi Gan Tang +/- (Zhi Ma Huang-9, Xing Ren-12, Shi Gao-30, Gan Cao-6, Dong Gua Ren-12, Yi Yi Ren-12) [41]
Biomed
Allergies, abnormal weather, emotional changes, seafood, illness, excess exercise (KD def), drugs[. Clinical signs: wheezing, mucus, cough, chest fullness41]
Etiology
Etiology: 1) Evil Qi - pollution, weather changes 2) Wei Qi Def, Zhong Qi Def, Lung Qi Def. 3) Diet - seafood allergies. [41]

Asthma Spleen Qi Deficiency

Symptoms
Wheezing that comes and goes, fatigue, poor digestion, low voice, loose stool, diarrhea T: pale, teethmarks, white greasy coat P: thin, weak [41]
Tongue
pale, teethmarks, white greasy coat
Pulse
thin, weak
Treatment
Tonify Spleen Qi, Transform Phlegm
Acupunct
ST36, SP6, Ren12, SP4/PC6, Ren17
Herbs
Liu Jun Zi Tang +/- (Ren Shen-9, Bai Zhu-9, Fu Ling-12, Ban Xia-12, Chen Pi-6, Gan Cao-6, Zi Su Zi-9, Cang Zhu-9) [41]
Biomed
Allergies, abnormal weather, emotional changes, seafood, illness, excess exercise (KD deficiency), drugs. Clinical signs: wheezing, mucus, cough, chest fullness. [41]
Etiology
Etiology: 1) Evil Qi - pollution, weather changes 2) Wei Qi Def, Zhong Qi Def, Lung Qi Def. 3) Diet - seafood allergies. [41]

Asthma Wind Cold Phlegm Fluids

Symptoms
wheezing, chills > fever, onset with seasonal and weather changes, chest fullness, excess watery mucus, thirsty but prefers hot drinks, cough T: pale, thin white moist coat P: floating, tight, slippery [41]
Tongue
pale, thin, white moist coat
Pulse
floating, tight, slippery
Treatment
Dispel Cold, Warm Lungs, Transform Phlegm, Stop Wheezing
Acupunct
LI4, UB12, LU9, UB13, Du14, PC6 [41]
Herbs
Xiao Qing Long Tang (Ma Huang-9, Ban Xia-12, Zhi Gan Cao-6, Gui Zhi-9, Xi Xin-3, Wu Wei Zi-9, Gan Jiang-3) OR Da Qing Long Tang [41]
Biomed
Allergies, abnormal weather, emotional changes, seafood, illness, excess exercise (KD def), drugs[. Clinical signs: wheezing, mucus, cough, chest fullness41]
Etiology
Etiology: 1) Evil Qi - pollution, weather changes 2) Wei Qi Def, Zhong Qi Def, Lung Qi Def. 3) Diet - seafood allergies. [41]
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