Treatment

1

• Treatment
• 3) Bleeding under the skin
• A) Blood heat
• Signs Symptoms
• Main Sym. Suddenly onset, purple spots or
  plague in skin
• Concurrent sym. blood from other sites such as
  nose, intestines or bladder, mental restlessness,
  thirsty, constipation, fever at night.
• Tongue red body without coating, red
  points all over
• Pulse rapid fine
• Treatment Protocol
• Expel poison
• Clear away heat
• Cool blood to stop bleeding

2

• Formula
• Modifications
• Harmonize blood (stop bleeding, eliminate
  stasis, calm nourish blood)
• -- Qian Cao Geng, Di Yu, Gou Qi Zi
• Astringe
• -- Shan Zhu Yu
• Abdomen pain hematochezia
• -- Mai Dong, Yu Zhu , Tian hua feng
• Blood heat is very pronounced
• -- Zi Cao

Xi Jiao Di Huang Tang Xi Jiao Di Huang Tang Xi Jiao Di Huang Tang Xi Jiao Di Huang Tang Xi Jiao Di Huang Tang Xi Jiao Di Huang Tang
Shui Niu Jiao Shen Di Mu Dan Pi Chi Shao Shi Gao Zhi Mui
Zhi Zi Ce Pai Ye Gan Cao
3

• Treatment
• 3) Bleeding under the skin
• B) Yin def. type empty heat
• Signs Symptoms
• Main Sym. purple spots or plague under the skin
• Concurrent sym. blood from other sites such as
  nose, intestines or bladder, flush cheek,
  restless, hot sensation in the palms soles.
  Thirsty, lower fever, night sweating.
• Tongue red body without coating, red
  points all over
• Pulse floating-empty or slightly-rapid
• Treatment Protocol
• Nourish Yin
• Clear empty heat
• Stop bleeding

4

• Formula
• Modifications
• Yin Def.
• -- Gui Ban, Bie Jia, xuan sheng, nu zhen zi,
  han lian cao
• Kidney Yin Def.
• -- Liu Wei Di Huang Wan

Qian Gen San Qian Gen San Qian Gen San Qian Gen San Qian Gen San Qian Gen San
Qian Cao Gen Huang Qi Er Jiao Ce Bai Ye
5

• Treatment
• 3) Bleeding under the skin
• C) Qi Def. fail to govern the blood
• Signs Symptoms
• Main Sym. Chronic purple spots or plague under
  the skin opens from time to time
• Concurrent sym. dizziness, poor appetite, mental
  physical lassitude, pale or swallow complexion
• Tongue swollen light color with white
  thin fur
• Pulse thready weak
• Treatment Protocol
• Tonify Qi to govern blood

6

• Formula
• Modifications
• Stop Bleeding
• -- Xian He Cao, Zhong Lu Tan, San Qi, Pu
• Huang, Qian Geng Tan, Xue Yu Tan
• Loose stools
• -- Shan Yao, Lian Zi rou, Qian Shi
• Kid Def.
• -- Tu Si Zi, Shan Yu Rou, Xu Duan
• Kid Yang Def.
• -- Xian Mao, Rou Gui

Gui Pi Tang Gui Pi Tang Gui Pi Tang Gui Pi Tang Gui Pi Tang Gui Pi Tang
Dang Shen Huang Qi Bai Zhu Dang Gui Fu Ling Suan Zhao Ren
Long Yan Mu Xiang Yuan Zhi Sheng Jiang Da Zhao
7

• Treatment
• 4) Coughing blood
• A) Wind-Dry-Heat
• Signs Symptoms
• Main Sym. Itchy throat, cough with blood-tinged
  sputum
• Concurrent sym. dry mouth nose, light aversion
  to cold, stuff nose headache, nosebleed,
• Tongue Red on the sides and front
  part, dry
• Pulse Floating rapid
• Treatment Protocol
• Expel wind
• Clear heat
• Stop bleeding

8

• Formula
• Modifications
• Lung heat
• -- Shi Gao
• Stop bleeding
• -- Qian Cao, Ou Jie
• Wind-heat
• -- Yin Hua, Lian Qiao, Niu Pang Zi, Ju Hua
• Fluid damage
• -- Mai Dong, Xuan Shen, Tian Hua Feng

Sang Xing Tang Sang Xing Tang Sang Xing Tang Sang Xing Tang Sang Xing Tang Sang Xing Tang
Sang Ye Xing Ren Sha Shen Bei Mu Zhi Mu Huang Qin
Shan Zhi Zi Sang Bai Pi Ce Bai ye Bai Mao Gen Dan Dou chi
9

• Treatment
• 4) Coughing blood
• B) Liver fire invading lung
• Signs Symptoms
• Main Sym. Cough with fresh-red blood in sputum
• Concurrent sym. Hypochondrial pain,
  irritability, easily lose temper, a bitter taste
• Tongue Red with yellow coating
• Pulse wiry rapid
• Treatment Protocol
• Clear Liver-Fire
• Clear the lungs
• Cool blood to stop bleeding

10

• Formula
• Modifications
• Lung heat
• -- Huang Qin, Zhi Mu, Shi Gao
• Stop bleeding
• -- Ce Bai Ye, Bai Mao Geng, Han Lian Cao, Da
  Ji, Xiao Ji, Qian Cao, Ou Jie
• Liver Fire
• -- Dan Pi, Zhi Zi, Huang Qin
• Abundant fresh-red color blood
• -- Xi Jiao Di Huang Tang San Qi, Da Huang
• To treat Qi Rebellion
• -- Mu Li, Niu Xi

Xie Bai San Dai Ge San Xie Bai San Dai Ge San Xie Bai San Dai Ge San Xie Bai San Dai Ge San Xie Bai San Dai Ge San Xie Bai San Dai Ge San
Sang Bai Pi Di Gu Pi Gan Cao Jin Mi Qin Dai Hai Ge Ke
11

• Treatment
• 4) Coughing blood
• C) Lung-Yin Def. with empty heat
• Signs Symptoms
• Main Sym. Cough with scanty blood-tinged sputum
• Concurrent sym. dry throat, afternoon fever or
  feeling of heat, night sweating, 5-palm heat
• Tongue Red without coating, dry
• Pulse float empty
• Treatment Protocol
• Nourish Lung Yin
• Clear empty-heat
• Stop bleeding

12

• Formula
• Modifications
• Lung heat
• -- Bai Wei, Qin Hao, Bie Jia
• Stop bleeding
• -- Ce Bai Ye
• Night sweating
• -- Ru Dao Geng, Fu xiao mai, wu wei zi, Mu li

Bai He Gu Jing Wan Bai He Gu Jing Wan Bai He Gu Jing Wan Bai He Gu Jing Wan Bai He Gu Jing Wan Bai He Gu Jing Wan
Bai He Sheng di Mai Dong Xuan Shen Bai shao Di Gu Pi
Bei Mu Ce bai ye Bai Mao gen Bai Ji Gan Cao Dang Gui
13

• Case History
• 1. Female 67 years
• Medical history She had TB of the lungs for 40
  years, had been suffering from breathlessness for
  many years.
• First visiting
• Main complain coughing of
  blood-specked sputum
• breathlessness on exertion, general
  exhaustion and coughing of blood sputum. Night
  sweating, dry throat, and fever in the afternoon,
  was very prone to cold which immediately affected
  her chest and caused bronchitis with the
  expectoration of profuse yellow-greenish sputum.
  Overweight body type,
• Tongue slightly red, swollen
  with a rootless coating in the front part
  Pulse Slippery
• TCM diagnose
• Lung Yin Def. Spleen Qi Def.
• Treatment protocol
• Nourish Lu. Yin, Clear Empty-heat, Tonify Sp
  Qi resolve Phlegm
• Formula
• Bai He Gu Jing Wan

14

• Treatment
• 5) Blood in the stools
• A) Damp-heat in the intestines
• Signs Symptoms
• Main Sym. Fresh blood in the stools
• Concurrent sym. loose and frequent stools with
  mucus, burning sensation in the anus, abdominal
  pain
• Tongue Red with yellow-sticky coating
  on root, with red spots
• Pulse slippery-rapid
• Treatment Protocol
• Resolve dampness
• Clear heat
• Stop bleeding

15

• Formula
• Modifications
• Yin Def.
• -- Bai Shao, E Jiao, Shen Di
• Stop bleeding
• -- Bai Ji

Di Yu San Di Yu San Di Yu San Di Yu San Di Yu San Di Yu San
Di Yu Qian Cao Geng Huang Qin Huang Lian Zhi Zi Fu ling
16

• Treatment
• 5) Blood in the stools
• B) Stomach Spleen Def.
• Signs Symptoms
• Main Sym. Profuse fresh blood in the stools
• Concurrent sym. slight abdominal pain, pale
  face, exhaustion, depression, loose frequent
  stools with mucus
• Tongue pale tongue
• Pulse thready weak
• Treatment Protocol
• Strength the spleen
• Warm the centre
• Stop bleeding

17

• Formula
• Modifications
• Yang Def.
• -- Lu Jiao Shuang, Pao Jiang, Ai Ye
• Stop bleeding
• -- Bai Ji, Wu Zei Gu

Huang Tu Tang Huang Tu Tang Huang Tu Tang Huang Tu Tang Huang Tu Tang Huang Tu Tang
Zao Xing Tu Gan Cao Shen Di Huang Bai Zhu Fu Zi Er Jiao
Huang Qin
18

• Case History
• 1. male 60 years
• First visiting
• Main complain Blood in the stools for
  2 years
• No abdomen pain and his bowl movements were
  loose and very frequent. The blood was fresh-red
  and haemorrhoids were excluded as a cause of
  bleeding. He felt very tired most of the time and
  felt the cold very much. Even in summertime on a
  hot day when he came for his consultation he had
  a jumper and a jacket on.
• Tongue Pale swollen and had a
  white-sticky coating
• Pulse Generally weak, especially so on
  the right-middle position
• TCM diagnose
• Spleen Yang Def. Internal cold
• Treatment protocol
• Tonify warm Sp yang
• Formula
• Li Zhong Tang

19

• Treatment
• 6) Blood in the Urine
• A) Bladder Heat
• Signs Symptoms
• Main Sym. Scanty-dark urine with fresh blood
• Concurrent sym. Mental restlessness, thirsty,
  insomnia, red face, tongue ulcers, bitter taste
• Tongue Red with redder tip, with
  yellow spots, or red spots on the root
• Pulse Rapid, slightly overflowing
• Treatment Protocol
• Clear heat from bladder
• Stop bleeding

20

• Formula
• Modifications

Xiao Ji Ying Zi Xiao Ji Ying Zi Xiao Ji Ying Zi Xiao Ji Ying Zi Xiao Ji Ying Zi Xiao Ji Ying Zi
Sheng Di Xiao Ji Hua Shi Tong Cao Pu Huang Dan Zu Ye
Ou Jie Dang Gui Shan Zhi Zi Gan Cao
21

• Treatment
• 6) Blood in the Urine
• B) Kidney Yin def. with empty-heat
• Signs Symptoms
• Main Sym. Scanty-dark urine with blood
• Concurrent sym. dizziness, tinnitus, back-ache,
  exhaustion, feeling fever in the afternoon, night
  sweating
• Tongue Red without coating
• Pulse floating-empty
• Treatment Protocol
• Nourish kidney Yin
• Clear empty heat
• Stop bleeding

22

• Formula
• Modifications
• Empty Heat
• -- Han Lian Cao, Qing Hao

Zhi Pai Di Huang Wan Zhi Pai Di Huang Wan Zhi Pai Di Huang Wan Zhi Pai Di Huang Wan Zhi Pai Di Huang Wan Zhi Pai Di Huang Wan
Zhi Mu Huang Bai Shu di Shan yao Ze xie Fu ling
Mu Dan Pi Zhi Mu
23

• Treatment
• 6) Blood in the Urine
• C) Spleen Def. not controlling blood
• Signs Symptoms
• Main Sym. Chronic bleeding in the urine
• Concurrent sym. dizziness, tiredness, pale face,
  no appetite, depression
• Tongue Pale
• Pulse weak
• Treatment Protocol
• Tonify the spleen
• Stop bleeding

24

• Formula
• Modifications
• Stop Bleeding
• -- Xian He Cao, Zhong Lu Tan, San Qi, Pu
• Huang, Qian Geng Tan, Xue Yu Tan
• Loose stools
• -- Shan Yao, Lian Zi rou, Qian Shi
• To treat Qi
• -- Shen Ma, Cai Hu

Gui Pi Tang Gui Pi Tang Gui Pi Tang Gui Pi Tang Gui Pi Tang Gui Pi Tang
Dang Shen Huang Qi Bai Zhu Dang Gui Fu Ling Suan Zhao Ren
Long Yan Mu Xiang Dang Gui Yuan Zhi Sheng Jiang Da Zhao
25

• Treatment
• 6) Blood in the Urine
• B) Kidney Qi not firm
• Signs Symptoms
• Main Sym. Chronic bleeding in the urine with
  pale blood
• Concurrent sym. dizziness, tinnitus, sore-back,
  exhaustion
• Tongue Pale swollen
• Pulse weak
• Treatment Protocol
• Tonify kidney Yang
• Stop bleeding

26

• Formula
• Modifications
• Stop Bleeding
• -- Xian He Cao, Zhong Lu Tan, San Qi, Pu Huang,
  Qian Geng Tan, Xue Yu Tan

Wu Bi Shang Yao Wan Wu Bi Shang Yao Wan Wu Bi Shang Yao Wan Wu Bi Shang Yao Wan Wu Bi Shang Yao Wan Wu Bi Shang Yao Wan
Shao Yao Rou Cong Rong Tu Si Zi Ba Ji Tian Du Zhong Shu Di
Niu Xi Shan Zhu Yu Ze Xie Wu Wei Zi Chi Shi Zhi Fu Shen
27

• Case History
• 1. Male 75 years
• First visiting
• Main complain bleeding in the urine
  for 3 months
• no pain on urination and the blood was dark,
  sometimes with tiny clots. He felt generally hot
  and his mouth felt very dry and hot
• Tongue Red dry and nearly completely
  peeled Pulse Floating-empty
• TCM diagnose
• Kid. Yin def. empty fire
• Treatment protocol
• Nourish Kidney yin, clear empty fire, stop
  bleeding
• Formula
• Sheng di 6, Shan Zhu Yu 3, Shan Yao 6, Ze Xie
  4, Fu Ling 6, Mu Dan Pi 6, Zhi Mu 4, Huang Bo4,
  Xiao Ji 6, Pu Huang 4, Dang Gui 6, Mu Li 12

28

• Palpitation
• TCM Diagnoses and Treatments
• Palpitation involves pavor and severe
  palpitation which denote the subjective symptoms
  of the patients pulsation, terror unease
• Etiology Pathology
• Main pathogenesis of bleeding
• The focus of the disease is at Heart (Sp.
  Kid. Liv. Lu.)
• 1) Lacking of self-confidence timid
• 2) Heart blood insufficient
• 3) Hyperactivity of fire due to Yin def.
• 4) Heart Yang Def.
• 5) Excessive fluid invades the heart
• 6) Blood stasis blocked channels

29

• Treatment
• 1) Timid
• Signs Symptoms
• Main Sym. Palpitation, usually frightened and
  liable to anger
• Concurrent sym. feel restless, sleeplessness,
  dreaminess
• Tongue thin and whitish fur or normal
• Pulse weakly rapid, knotted or
  intermittent or string-like
• Treatment Protocol
• Calming the mind
• Nourish the heart

30

• Formula
• Modifications
• Calm the mind
• -- Ci Shi, Hu Po,
• Heart Qi Def.
• -- Dang Shen, Zhi Gan Cao
• Heart Yin Def.
• -- Bo Zi Ren, Wu Wei Zi, Suan Zhao Ren

An Shen ding Zhi Wan An Shen ding Zhi Wan An Shen ding Zhi Wan An Shen ding Zhi Wan An Shen ding Zhi Wan An Shen ding Zhi Wan
Fu Ling Fu Shen Yuan Zhi Ren Sheng Shi Chang Pu Long Chi
31

• Treatment
• 2) Heart blood insufficient
• Signs Symptoms
• Main Sym. Palpitation, dizziness weakness
• Concurrent sym. pale complexion, tiredness,
  fatigue
• Tongue light red
• Pulse thin weak
• Treatment Protocol
• Nourish heart blood
• Calm down mind

32

• Formula
• Modifications
• Tonify heart Qi
• -- Zhi Gan Cao

Gui Pi Tang Gui Pi Tang Gui Pi Tang Gui Pi Tang Gui Pi Tang Gui Pi Tang
Dang Shen Huang Qi Bai Zhu Dang Gui Fu Ling Suan Zhao Ren
Long Yan Mu Xiang Dang Gui Yuan Zhi Sheng Jiang Da Zhao
33

• Treatment
• 3) Hyperactivity of fire due to Yin def.
• Signs Symptoms
• Main Sym. Palpitation, unease, vexation,
  sleeplessness
• Concurrent sym. feverish sensation in the palms
  and soles, soreness of waist, tinnitus,
  dizziness,
• Tongue red tongue, without coating
• Pulse thin rapid
• Treatment Protocol
• Nourish yin purging fire
• Calm down mind

34

• Formula
• Modifications
• Empty fire of heart sym. ( dry mouth, throat,
  restless)
• -- Huang Lian, or Zhi Bai Di Huang Wan
• Heart Qi Def.
• -- Dang Shen, Zhi Gan Cao
• Heart Yin Def.
• -- Bo Zi Ren, Wu Wei Zi, Suan Zhao Ren

Tian Wang Bu Xing Dan Tian Wang Bu Xing Dan Tian Wang Bu Xing Dan Tian Wang Bu Xing Dan Tian Wang Bu Xing Dan Tian Wang Bu Xing Dan
Ren Sheng Dan Sheng Fu Ling Wu Wei Zi Yuan Zhi Jie Geng
Dang gui Tian Dong Mai Dong Bo Zi Ren Suan Zhao Ren Shen Di
35

• Treatment
• 4) Heart Yang Def.
• Signs Symptoms
• Main Sym. Palpitation, restlessness, oppressed
  feeling in chest, shortness of breath
• Concurrent sym. pale complexion, cold limbs
• Tongue light whitish tongue,
• Pulse weak or deep thin or infrequent,
  knotted or intermittent
• Treatment Protocol
• Warm heart yang
• Calm down mind

36

• Formula
• Modifications
• Warm Yang
• -- Fu Zhi, Gan Jiang
• Tonify Heart Qi
• -- Huang Qi, Huang Jing

Gui Zhi Gan Cao Long Gu Mu Li Tang Gui Zhi Gan Cao Long Gu Mu Li Tang Gui Zhi Gan Cao Long Gu Mu Li Tang Gui Zhi Gan Cao Long Gu Mu Li Tang Gui Zhi Gan Cao Long Gu Mu Li Tang Gui Zhi Gan Cao Long Gu Mu Li Tang
Gui Zhi Long Gu Mu Li Gan Cao
37

• Treatment
• 5) Excessive fluid invades heart.
• Signs Symptoms
• Main Sym. Palpitation, restlessness, oppressed
  feeling in chest, dyspnea, edema
• Concurrent sym. dizziness, cold limbs, feeling
  of stuffiness and fullness in the chest, thirst,
  nausea and vomiting of water fluid
• Tongue whitish slippery coating,
• Pulse taut slippery pulse
• Treatment Protocol
• Activating the heart yang
• Promoting the circulation of qi to induce diuresis

38

• Formula
• Modifications
• Nausea vomiting
• -- Ban Xia, Chen Pi, Sheng Jiang
• Kidney Yang def.
• -- Zhen Wu Tang

Lin Gui Zhu Gan Tang Lin Gui Zhu Gan Tang Lin Gui Zhu Gan Tang Lin Gui Zhu Gan Tang Lin Gui Zhu Gan Tang Lin Gui Zhu Gan Tang
Gui Zhi Fu Ling Bai Zhu Gan Cao
39

• Treatment
• 6) Heart blood stasis
• Signs Symptoms
• Main Sym. Palpitation, restlessness, chest pain
• Concurrent sym. oppressed feeling in chest,
  unease, dark purple lips and nails
• Tongue dark purple ,
• Pulse knotted, intermittent or uneven
• Treatment Protocol
• Remove blood stasis

40

• Formula
• Modifications
• Warm heart Yang
• -- Gui Zhi, Gan Cao
• Calm mind
• -- Long Gu, Mu Li
• Phlegm block the channel
• -- Gua Lou xie bai Ban Xia Tang

Tao Ren Hong Hua Tang Tao Ren Hong Hua Tang Tao Ren Hong Hua Tang Tao Ren Hong Hua Tang Tao Ren Hong Hua Tang Tao Ren Hong Hua Tang
Tao Ren Hong Hua Dan shen Chi Shao Chuan Xiong Yuan Hu
Xiang Fu Qing Pi Shen Di Dang Gui
41

• Case History
• 1. Female 54 years
• Medical History Patient had a fever 2 month
  ago, after the fever was gone, patient started
  feeling palpitation. She had looked for several
  doctors, but no one can help her, which caused
  her feel depressed. She could sit whole day
  quietly without talking to anyone
• First visiting
• Main complain Palpitation for 2 month
• Insomnia, lower fever sometimes, small
  quantity of menstrual flow with light color blood
• Tongue Pale body with thin white
  coating Pulse Floating-empty
• TCM diagnose
• Depression damage Sp. Function
• Sp Qi Heart Blood Def.
• Treatment protocol
• Tonify Sp Qi heart blood
• Formula
• Ren Shen 5, Bai Zhu 10, Huang Qi 10, Zhi Gan
  Cao 10, Dang Gui 10, Fu Shen 10, Yuan Zhi 10,
  Suan zhao ren 30, Mu Xiang 3, Ye Jiao Teng 15,
  Bai shao 15, Sheng Jiang 5 p, Da Zhao 3 p