Xianhui Li

• Qi Generates Blood
– Food Qi is the basis for Blood
• Qi Moves Blood
– "When Qi moves, Blood follows". "When Qi stagnates, Blood congeals."
– When Qi is deficient or stagnant, it fails to push Blood, which also stagnates.
• Qi Holds the Blood
– If Spleen Qi is deficient, hemorrhages may occur.
• Blood Nourishes the Qi ("Blood is the mother of Qi")
– Blood provides a material basis (more Yin) which prevents Qi from "floating" away and producing signs of Empty Heat

• The menstrual function mainly depends on the two extraordinary vessels: the conception and penetrating vessels ( Ren Mai and Chong Mai)
• Both of them arise from the space between the Kidneys and then flow through the uterus in women.
• Chong mai has a deep influence on menstruation as it is the sea of blood. This vessel influences the supply and proper movement of blood in the uterus and controls menstruation.
• Ren mai is connected to Yin, Essence and fluids. It is called the ‘sea of Yin channels. Ren channels control the fetus. It has more responsibility for conception, fertility, pregnancy and menopause.

• Kidneys
• Liver
• Spleen
• Heart
• Stomach

• The kidney essence is the origin for the formation of the TIAN GUI
(heavenly gui ), the material basis of menstrual blood.
• Kidneys influence menstruation is through the connection of mutual nourishment between Blood and Essence and that between Liver and
Kidneys.
• Uterus which stores blood is also warmed by the Fire of the Gate of the
Life(Ming Men).
• The fire of the Gate of Life represents the fire within kidney.
• The fire of the Gate of Life warms the uterus and balances the yin influences. It makes conception possible and is related to sexual desire.
•
Under pathological circumstances, the Fire of the Gate of Life can become either deficient or excessive.
– When it is deficient, it fails to warm the uterus, which becomes obstructed by cold: this may lead to infertility, dysmenorrhoea and lack of sexual desire.
– When it is excessive, it heats the blood causing excessive menstrual bleeding, infertility or miscarriage.

• The liver has the function of blood storage. The liver represent the connection between the menstrual blood and the normal blood. The normal blood nourishes hair, nails, eyes, etc. The extra blood is discharged to uterus by the liver.
• The liver also has a significant influence on menstruation through Qi. Liver-Qi has the very important function of moving blood. Especially in the pre-menstrual phase, liver-Qi needs to move blood in preparation for the period. If liver Qi stagnates it may cause irregular periods, dysmenorrhoea and pre-menstrual syndrome.

• The spleen makes blood which is then stored in the liver. Any deficiency of liver-blood in women usually indicates that the spleen is also deficient and needs to be tonified.
• The spleen is the source of Qi and blood. Menstrual blood and breast milk are both produced by the spleen and stomach.
• The spleen also influences women’s physiology and pathology through Qi. Spleen Qi has an ascending movement and it keeps the uterus in place. Sinking of spleen-Qi may cause prolapse of uterus.
• Spleen Qi also gathers blood. If spleen Qi is deficient, blood may leak out causing deficient type menorrhagia.

• It governs blood and therefore has a general influence on blood.
• It is connected to the uterus via the uterus vessel (Bao Mai)
• The kidney essence forms the heavenly
Gui with the help of heart-yang.

• Stomach is the source of Qi and Blood.
• The stomach is connected to the uterus via the penetrating vessel (Chong Mai).
This channel pass through the important stomach point ST-30 Qichong.
• The stomach influences breastfeeding in nursing mothers.

• Shortened cycles:
– Menstrual cycles terminating seven or more days earlier than twenty-eight days
• Lengthened cycles:
– Menstrual cycles prolonged for seven or more days longer than twenty-eight days
• Cycles of unpredictable:
– Menstrual cycles are at times shortened and at other times lengthened by seven or more days from the normal length

• The factors harming qi and blood and injuring chong and ren:
– External heat, cold or dampness evil
– Internal disruption from emotional upset
– Improper diet and eating habits
– Overindulgent sexual activity
– Prolonged illness
– Giving birth to a large number of children
• Shortened cycles: blood heat or qi vacuty
• Lengthened cycles: blood vacuity, blood cold, or qi stagnation
• Unpredictable cycles: stagnation of the liver or depletion of the kidney

• Blood heat
– ascendant hyperactivity of liver yang
– stagnation of liver qi
– yin vacuity
• Qi vacuity

• Clinical Manifestations
– Early periods, normal or heavy menstruation, bright-red or dark-red sticky menstrual flow, red complexion and lips, or thirst, anxiety, mental restlessness, scanty dark urine, dry stool, red tongue with yellow coating, rapid or rapid and slippery pulse.
• Treatment Principle
– Clear heat, cool blood, regulate menstruation
• Acupuncture: BL17, SP10, SP6, Ren3, LI11, DU14
– LI1,BL17 and SP10 cool the blood
– SP6 tonify the spleen and regulate menstruation
– Ren3 the intersecting point of the three yin meridians of foot, regulates chong and ren vessels and remove internal heat from the lower jiao
– DU14 clears heat and cools the blood
• Formula : qing jing san

• Clinical Manifestations
– Early Periods, heavy or scanty menstrual flow, dark red or even purplish menstrual flow, sticky or with blood clots, irritability, distension in the chest and costal region, pre-menstrual breasts distension, lower abdominal pain, bitter taste in the mouth, red tongue with thin and yellow coating, wiry and rapid pulse.
• Treatment Principle
– Clear Liver-heat, pacify the Liver-Qi and regulate menstruation.
• Acupuncture: LV2, LV3, LV14, SP10, SP6, Ren3.
– SP6 tonify the spleen and regulate menstruation
– Ren3 the intersecting point of the three yin meridians of foot, regulates chong and ren vessels and remove internal heat from the lower jiao
– SP10 cools the blood
– LV2 clears heat from the liver and soothe liver
– LV3 and LV14 soothe the liver
• Formula: dan zhi xiao yao san

• Clinical Manifestations
– Early Periods, normal or scanty quantity, red thick flow, malar flush, 5palm heat, tidal fever, night sweats, dry mouth and throat, red tongue with little coating, fine rapid pulse.
• Treatment Principle
– Nourish Yin, clear heat and regulate menstruation.
• Acupuncture: KI6, Ren4, LV3, LV8, SP6, SP10, KI3, KI2.
– SP6 tonify the spleen and regulate menstruation
– Ren4 the intersecting point of the three yin meridians of foot connects uterus and promotes qi and blood, when combined with SP6 the chong and ren vessels are regulated and then cold is removed from chong and ren
– SP10 cools the blood
– KI2 tonify kidney and clear empty heat
– KI3 tonify kidney
– LV8 he sea point of the liver, invigorates blood and regulates menstruation
• Formula: liang di tang

• Clinical Manifestations
– Early periods, dilute or scanty menstrual flow, pale red in coloration, clear in quality, sallow or bright white complexion, fatigue, lassitude, shortness of breath, dislike to speak, bearing down sensation in the hypogastrium, poor appetite, loose stool, pale tongue with thin white coating, fine and weak pulse.
• Treatment Principle
– Strengthen the spleen, tonify and raise qi, control blood and regulate menstruation
• Acupuncture Prescription: SP6, Ren12, ST36, BL20, Ren4, Ren6,
Du20
– SP6 tonify the spleen and regulate menstruation
– Ren4 the intersecting point of the three yin meridians of foot connects uterus and promotes qi and blood, also it tonify qi and blood
– Ren12, BL20 and ST36 tonify spleen and control the blood
– Ren6 tonify qi
– Du20 helps ascend qi and blood, nourishes the blood
• Formula: bu zhong yi qi tang

• Clinical Manifestations
– Early periods, profuse or scanty menstrual flow, purplish menstrual blood, clear in quality, dizziness, soreness and weakness of the loins and knees, frequent nocturnal urination, pale and tender tongue with a white and thin coating, deep and fine pulse.
• Treatment Principle
– Tonify the Kidney, supplement Qi and consolidate the Penetrating vessel.
• Acupuncture: KI6, KI3, KI7, BL23, ST36, Ren4, KI13 qi xue, Ren6
– Ren6 tonify qi, Ren4 tonify kidney and kidney yang, it assists to adjust qi and blood so that chong and ren are well regulated and mense comes on time
– KI13 can tonify chong and ren, regulate menstruation. It also a local point for uterus
– KI2 tonify kidney and clear empty heat
– KI3, KI7 and KI6 tonify kidney
– UB23 back shu point of Kidney, tonify kidney
– ST36 tonify spleen and stomach that is the source of qi and blood
• Formula: Jin gui shen qi wan

• Kidney deficiency
• Blood deficiency
• Blood cold
• Full cold
• Empty cold
• Qi stagnation
• Obstruction of the phlegm

• Clinical manifestations
– Late periods, scanty or normal bleeding with dark red blood and some clots, cold pain in the lower abdomen that can be relieved by application of heat, bluish white complexion, aversion to cold, cold limbs, purple lips, dark red tongue or with ecchymosis, white tongue coating, deep tight or deep and choppy pulse.
• Treatment Principle
– Warm channels, dispel cold, invigorate blood, and regulate menstruation
• Acupuncture: Ren3 zhong ji, ST25, KI13, SP10, SP6, ST29, ST36, BL32
– SP6 and ST36 tonify the spleen and regulate menstruation, tonify qi and remove cold
– Ren3 the intersecting point of the three yin meridians of foot, regulates chong and ren vessels and regulates menstruation, moxa can remove cold from the low jiao
– SP10 invigorate the blood
– KI13 can tonify chong and ren, regulate menstruation. It also a local point for uterus
– ST29 invigorates blood in the lower abdomen
– ST25 moves qi and regulate the blood
– BL32 regulates the mestruation
• Formula: wen jing tang

• Clinical Manifestations
– Late periods, scanty bright and watery blood without clots, dull pain in the lower abdomen which can be relieved by application of heat or pressure, sore pain in the low back, profuse urine, loose stools, pale tongue with white coating, deep slow or fine and weak pulse.
• Treatment Principle
– Warm yang, dispel cold, nourish blood and regulate menstruation
• Acupuncture: Ren4, Ren6, Du4, ST29, SP6, ST36, BL32
– Ren4, Ren6 and Du4 moxa tonify yang and remove empty cold
– SP6 and ST36 tonify the spleen and regulate menstruation, tonify qi and remove cold
– ST29 invigorates blood in the lower abdomen
– BL32 regulates the menstruation
• Formula: ai fu nuan gong wan

• Clinical Manifestations
– Late periods scanty, pale red menstrual blood without clots, dull pain in the lower abdomen, white or sallow complexion, dizziness, blurred vision, palpitation, insomnia, tiredness, lusterless skin and nails, or numbness of the limbs, pale tongue with thin and white coating, fine and weak pulse.
• Treatment Principle
– Nourish blood and yin, strengthen qi, and regulate menstruation
• Acupuncture: BL17, SP10, BL20, ST36, SP6, Ren4, KI3, BL23, LV3
– ST36 and SP6 tonify spleen and stomach that are source of the qi and blood
– Ren4 nourish blood and the uterus
– BL20 strengthens the spleen and nourishes blood
– BL17 and SP10 tonify the blood
– KI3 and BL23 tonify kidney and strengthen the uterus
– LV3 regulates qi
• Formula: da bu yuan jian

• Clinical Manifestations
– Late periods, scanty, pale and dilute menstrual blood, soreness and weakness of loins and knees, dizziness, tinnitus, asexuality, white and dilute vaginal discharge, lustrouslessness complexion, pale tongue with thin and whitish coating, deep and fine pulse.
• Treatment Principle
– Nourish the kidney, tonify Yin and regulate menstruation.
• Acupuncture: BL23, Ren4, KI3, KI6, KI2, KI7, SP6.
– BL23 tonify kidney and strengthens uterus
– KI3 and SP6 nourish the kidney and liver and regulate blood
– Ren4 nourishes yin and tonify the kidneys and the uterus
– KI2 tonify kidney yin and clear empty heat
– KI6 tonify kidney yin
– KI7 tonify kidney yin
• Formula: zuo gui wan

• Clinical Manifestations
– Late periods, scanty, dark red menstrual blood and some clots, distending pain in the chest, costal region, breast and lower abdomen which is more severe before menstruation, emotional depression or irritability, vexation, preference for sign, pale red tongue with thin white coating, wiry pulse.
• Treatment Principle
– Move Qi, invigorate blood, and regulate menstruation
• Acupuncture: LV3, LIV14, SP6, PC6, TB6, Ren3
– LV3 and LV14 move qi and blood and stop pain
– SP6 helps to move blood and stop pain
– Ren3, the meeting point of the three foot yin meridians and the chong and ren, is used to adjust the qi of the chong ren vessels
– PC6 removes fullness from the chest and adjust qi
– TB6 regulate Qi
• Formula: wu yao san

• Clinical Manifestations
– Late periods, scanty, light red menstrual blood, sticky in quality, overweight, profuse leukorrhea, fullness in the chest and epigastrium, dizziness, palpitations, nausea, profuse phlegm, poor appetite, loose stools, swollen tongue with white and greasy coating, slippery pulse.
• Treatment Principle
– Remove dampness, dissolve phlegm, invigorate blood, and regulate menstruation
• Acupuncture: SP6, SP9, ST36, Ren3, ST40, ST28 shui dao
– ST36, SP9 and SP6 tonify spleen and resolve the dampness
– Ren3 and ST28 resolve dampness from the lower burner and uterus
– ST40 transform the phlegm
• Herbal treatment: cang fu dao tan tang

• Successive occurrence of irregularity of menstrual periods, either more than 7 days ahead of or more than 7 days later than normal, and in more than consecutive
3 cycles, known as irregular periods.

• Disharmony between qi and blood
• Dysfunction of the penetrating and directing vessels
• Disturbance of the uterus in blood-filling and blood discharging
• The liver, the spleen and the kidney functional disturbance.
– Kidney qi deficiency
– Liver qi stagnation

• The normal menstrual cycle is 28 days. If the menstrual cycle is sometimes less than 21 days and sometimes more than 35 days and this condition presents successively in more than 3 months, this disease can be diagnosed.

• Clinical Manifestations
– Irregular period, heavy or scanty, purplish menstrual flow with blood clots which is difficulty to be discharged, distending pain in the chest, hypochondrium and breast which can be relieved after menstruation, irritability, emotional depression, fullness and oppression in the chest, frequent sighing, thin white or yellow tongue coating, wiry pulse.
• Treatment Principle
– Soothe the liver, move qi, nourish blood and regulate menstruation
• Acupuncture: LIV3, LIV14, Ren3, PC6, BL18, GB34.
– LV14 soothe the liver and relieve the distending pain in the hypochondriac region and breast
– LV3 soothe the liver
– Ren3, the meeting point of the three foot yin meridians and the chong and ren, is used to adjust the qi of the chong ren vessels
– PC6 removes fullness from the chest and adjust qi
– BL18 soothe the liver
– GB34 soothe the liver
• Formula: xiao yao san

• Clinical Manifestations
– Irregular period, scanty, light red and thin menstrual flow, profuse thin leukorrhea, dizziness, tinnitus, soreness and pain in the lumbar and sacral regions, frequent clear urine, pale tongue with thin white coating, deep and weak pulse especially in the rear position of the pulse.
• Treatment Principle
– Tonify Kidney-Qi, regulate the menstruation
• Acupuncture: BL23, Ren4, KI7, KI6, SP6, KI13, DU4
– BL23, Ren4, KI13, KI7 and KI6 tonify kidney and stabilize chong and ren vessels
– DU4 moxa can warm kidney yang
– SP6 tonify kidney yin
• Formula: gu yin jian

• Dysmenorrhea indicates the menstrual pain in the lower abdomen, lumbar and sacral region before, during or after the menstrual periods. In severe case, there may be nausea and vomiting or even fainting.

• Excess
– qi stagnation and blood stasis
– accumulation of cold in the uterus
– flow downwards of damp-heat
• Deficiency
– qi and blood deficiency
– liver and kidney deficiency

• Clinical Manifestations
– Distending pain or colicky pain with tenderness in the lower abdomen before 1~2 days or during the menstrual period, scanty or sluggish discharge of menstrual blood which is also dark purplish with blood clots, irritability or emotional depression, distending pain in the chest, costal region and breasts. The pain is usually relieved after passing of blood clots. The tongue is dark purplish with ecchymosis, and the pulse is wiry or wiry slippery.
• Treatment Principle
– Regulate move of Qi, activate blood, remove blood stasis and relieve pain.
•
Acupuncture: LI4, PC6, SP6, LIV3, REN3, BL17, SP8, SP10
– LV3, BL17 and SP10 regulate liver qi and relieve stagnation and stasis
– LI4 and SP6 can get qi and blood down to restore the normal menstruation
– Ren3, the meeting point of the three foot yin meridians and the chong and ren, is used to adjust the qi of the chong ren vessels
– PC6 removes fullness from the chest and adjust qi
– SP8, Xi cleft point of the spleen, may invigorate blood flow and menstruation
• Herbal treatment: xue fu zhu yu tang

• Clinical Manifestations
– Persistent cold pain in the lower abdomen which can be relieved by palpation or by the application of heat, scanty, pale red menses, pale tongue with white and moist tongue coating, and a deep, fine and slow pulse.
• Treatment Principle
– Warm vessel and the uterus, stop pain.
• Acupuncture: KI6, Ren4, Ren6, SP6, DU4, BL32, ST29, ST36, Zigong,
BL23
– Ren4, with moxa, warms the uterus.
– Ren6 with moxa, moves qi and expels cold form the lower abdomen
– Du with moxa, warm the kidney yang
– BL23 KI6 tonify kidney
– BL32 regulates the mestruation
– ST29 moves blood
– ST36 tonify qi and remove cold
– SP6 move blood and stop pain
– Zigong regulates qi and menstruation
• Herbal treatment: wen jing tang

• Clinical Manifestations
– Cold or colicky pain with tenderness in the lower abdomen before or during menstrual period, which can be relieved by application of heat, but aggravated by exposure to Cold, dark purplish menstrual Blood with blood clots, aversion to cold, liability to lie flat with the limbs huddled up, cold limbs, blue purplish lips, white and greasy tongue coating, and a deep tense pulse.
• Treatment Principle
– Warm Uterus, expel cold, and stop pain.
• Acupuncture: Ren3, ST28, SP8, SP6, BL20, Zigong
– Ren3 is the front mu point of the bladder, combined with ST28 resolve dampness from the lower jiao
– SP8, Xi cleft point of the spleen, may invigorate blood flow and menstruation
– SP6 move blood and stop pain
– BL20 strengthens the spleen and nourishes blood
– ST28 promotes flow of fluids in the lower burner and resolves dampness in the lower jiao
– Zigong regulates qi and menstruation
• Herbal treatment: cang fu dao tan tang

• Clinical Manifestations
– Pain with a burning sensation in the lower abdomen before menstrual period, dark purplish and viscid menstrual Blood, or dull pain in the lower abdomen in the ordinary days which is aggravated during menstrual period, yellow, viscid and foul leukorrhea, sticky mouth, bitter taste in the mouth, poor appetite, scanty and difficult urine, difficult defecation, red tongue with yellow greasy tongue coating and a slippery rapid pulse.
• Treatment Principle
– Clear heat, remove dampness, eliminate Blood stasis and stop pain.
•
Acupuncture: SP6, Ren3, ST28, ST40, BL22, Ren9, SP10, BL32, LI11,
ST25
– BL22 promotes the transformation of fluids and resolves dampness from the lower burner
– BL32 resolves dampness in the uterus
– Ren3 and ST28 resolve dampness from the lower burner and uterus
– Ren9 SP6 resolve dampness in the lower burner
– LI11 clear heat
– SP10 quicken the blood
– ST25 resolve dampness and clear heat. Move qi and invigorate the blood
• Herbal treatment: qi re tiao xue tang

• Clinical Manifestations
– Dull pain in the lower abdomen in the end of or just after the menstrual period, which is relieved by pressing or massage, or a dragging sensation in the lower abdomen and vulva, scanty, light red , pale complex, palpitation, shortness of breath, tiredness, insomnia, poor appetite, loose stools, pale tongue with thin coating, and a feeble and fine pulse.
• Treatment Principle
– Supplement Qi, nourish Blood, and regulate menstruation to stop pain.
• Acupuncture: REN4, REN6, ST36, SP6, BL20, BL17
– ST36, SP6 and BL20 strengthen the function of the spleen and stomach
– Ren4 and Ren6 tonify qi
– BL17 tonify the blood
• Herbal treatment: ren shen yang rong tang or sheng yu tang

• Clinical Manifestations
– Dull pain in the lower abdomen after menstrual period, soreness in the lumbar and sacral regions, or dizziness, tinnitus, amnesia, insomnia, scanty bleeding with a dark color, thin whitish or thin yellowish coating, and a deep fine pulse.
• Treatment Principle
– Nourish the Kidney and the Liver, regulate the menstruation and stop pain
• Acupuncture: BL23, BL18, LV3, KI3, Ren4, SP6, ST36
– BL23 and KI3 tonify kidney
– BL18 and LV3 tonify liver
– BL20 strengthens the spleen and nourishes blood
– Ren4 tonify qi and blood
– ST36 and SP6 tonify spleen and stomach
• Herbal treatment: gui shen wan or tiao gan tang

• The menstruation is never presented in a female over 18 years old, or the menstruation is not presented in three successive months in a female who has experienced the menarche, it will be the no periods.

• Deficiency of both kidney and liver
• Deficiency of both qi and blood
• Qi stagnation and blood stasis
• Obstruction of phlegm and dampness

• Deficiency of Both Liver and Kidney
• Deficiency of Both Qi and Blood
• Qi Stagnation and Blood Stasis
• Accumulation of Phlegm

• Clinical Manifestations
– Menses stops after becoming scanty, tiredness, lower backache, weak knees, frequent urination, depression, feeling cold, pale tongue, deep weak pulse
– Dizziness, dry eyes, blurred vision, insomnia, lower backache, night-sweating, tinnitus. Red tongue without coating, with cracks. fine-rapid pulse.
• Treatment Principle
– Tonify kidney, nourish liver blood and regulate menstruation
• Acupuncture Treatment: BL18, BL23, BL17, Ren4, Ren6, KI6, LV3, KI3,
ST29
– BL23, KI6 and KI3 tonify the kidney
– BL18 promotes the blood in the liver
– Ren4 and Ren6 tonify qi and blood
– ST29 regulates the blood in the uterus
– BL17 tonify the blood
– LV3 soothe the liver
• Herbal treatment: gui shen wan

• Clinical Manifestations
– Menstruation stops after several months of decreasing periods, dizziness, blurred vision, numbness and tingling, poor memory, insomnia, palpitation, dull-pale complexion, dry skin, dry hair, falling hair, dry eye, tiredness, Pale tongue. Thin pulse.
• Treatment Principle
– Nourish blood, tonify qi, strengthen the liver and regulate menstruation
• Acupuncture: LV3, SP6, ST36, Ren4, Ren6, Ren12, BL17, BL18,
ZiGong, BL20, ST29
– ST36, SP6 and BL20 strengthen the function of the spleen and stomach
– BL18 promotes the blood in the liver
– Ren4 and Ren6 tonify qi
– Zigong regulates qi and menstruation
– ST29 regulates the blood in the uterus
– BL17 tonify the blood
• Herbal treatment: ren shen yang rong tang

• Clinical Manifestations
– Amenorrhea, irritability, abdominal distension and pain, depression, dark complexion, purple tongue and wiry pulse
• Treatment Principle
– Soothe the liver, move qi and blood
• Acupuncture Treatment: PC6, ST29, LV3, SP6, GB34, LIV13, LIV14,
REN3, SP10, BL17
– LV3 moves qi and blood
– LV13, GB34 and LV14 soothe the liver
– PC6 regulate qi and moves the blood
– ST29 regulates the blood in the uterus
– SP6 moves blood
– SP10 and BL17 quicken the blood and move blood stasis
– Ren3, the meeting point of the three foot yin meridians and the chong and ren, is used to adjust the qi of the chong ren vessels
• Herbal treatment: xue fu zhu yu tang

• Clinical Manifestations
– Amenorrhea, obesity, vaginal, discharge, lassitude, feeling of heaviness, feeling of oppression in the chest, nausea. Swollen tongue, sticky coating, which is thicker on the root. Slippery pulse
• Treatment Principle
– Resolve dampness, move qi, benefit the uterus
• Acupuncture Treatment: SP9, SP6, BL22, ST28, REN12, REN9,
ST40, Ren3, ST29
– Ren3 is the front mu point of the bladder, combined with ST28 resolve dampness from the lower jiao
– Ren12, SP9 and SP6 tonify the spleen and resolve dampness and phlegm. SP6 also moves blood
– BL22 promotes the transformation of the fluids and resolves dampness from the lower burner
– ST29 regulates the blood in the uterus
– ST40 resolves phlegm
• Herbal treatment: cang fu dao tan tang

• This refers to sudden and massive uterine hemorrhage or persist dribbling of blood from the Uterus out of the menstrual period.

• Deficiency of kidney
• Deficiency of spleen
• Blood heat
• Blood stasis

• Clinical Manifestations
– Irregular uterine bleeding with dribbling of blood from the uterus or sudden massive hemorrhage which is bright red and viscid, vexation, tidal fever, insomnia, or dark and scanty urine, dry stools, red tongue with little coating, and a fine rapid pulse.
• Treatment Principle
– Nourish Yin, clear away heat, stop bleeding and regulate menstruation.
• Acupuncture: LI11, SP10, LIV2, SP6, SP1, KID1, KID2, Ren4
– SP1 stops bleeding and checks for metrorrhagia
– SP10 removes blood heat and stop bleeding
– SP6 tonifies the spleen and foster the restriction of qi on blood
– Ren4 tonify yin
– LI11 clears heat
– KI2 and KI1 tonify kidney yin and clear empty heat
– LV2 can clear heat from the liver
• Herbal treatment: zhi bai di huang wan

• Clinical Manifestations
– Sudden massive uterine hemorrhage or persistent dribbling of blood from the uterus, dark red in color and viscid in quality, accompanied with red face, thirst, restlessness, scanty and dark urine, dry stools, red tongue with yellow coating, and a full and rapid pulse.
• Treatment Principle
– Clear away heat, cool blood, arrest bleeding and regulate menstruation
• Acupuncture LI11, SP10, LIV2, SP6, SP1, Ren3
– Ren3, the meeting point of the three foot yin meridians and chong and ren vessels, is used to adjust the qi of chong and ren mai so as to check the escape of blood
– SP1 stops bleeding and checks for metrorrhagia
– SP10 removes blood heat and stop bleeding
– SP6 tonifies the spleen and foster the restriction of qi on blood
– LI11 clears heat
– LV2 can clear heat from the liver
• Herbal treatment: qing re tiao xue tang

• Kidney Yang Deficiency:
• Clinical Manifestations
– Irregular uterine bleeding, which may attack suddenly with massive loss of blood or may be persistent dribbling of blood from the uterus, light in color and thin in quality, accompanied with aversion to cold, cold limbs, severe soreness of loins as if being broken, clear and profuse urine, pale tongue with thin and whitish coating and a deep, fine pulse.
• Kidney Yin Deficiency:
• Clinical Manifestations
– Irregular menstrual period with massive hemorrhage or persistent dribbling of blood from the uterus, bright red in color, accompanied with dizziness, tinnitus, soreness and weakness of the loins and knees, feverish sensation over the palms, the soles and the chest, red tongue with little coating, and a fine and rapid pulse.
• Treatment Principle
– Tonify the kidney, consolidate the Chong Channel, arrest bleeding and regulate menstruation.
• Acupuncture: Ren4, Ren 6, KID3, BL23, SP1, DU4
• Herbal treatment: you gui wan or qing re tiao xue tang

• Clinical Manifestations
– Massive uterine bleeding out of the menstrual period, or persistent dribbling of blood from the uterus, light in color, thin in quality without blood clots, accompanied with pale and puffy face, edema of face and limbs, palpitation, shortness of breath which is more severe on exertion, listlessness, lassitude, cold limbs, poor appetite, loose stools, pale tongue with thin and whitish coating, and a deep and feeble pulse.
• Treatment Principle
– Tonify qi to control blood flow, and regulate menstruation.
• Acupuncture: Ren 6, BL20, SP1, DU1, ST36, SP6
• Herbal treatment: gu ben zhi beng tang

• Clinical Manifestations
– Persistent dribbling of blood from the uterus or recurrent uterine bleeding, or sudden massive hemorrhage followed by persistent dribbling of blood from the uterus, dark purplish in color and mixed with blood clots, pain in the lower abdomen which is relieved after the clots are discharged, dark red tongue with ecchymosis in the margin, deep and uneven pulse.
• Treatment Principle
– Activate blood flow, remove blood stasis, arrest bleeding and regulate menstruation.
• Acupuncture: Ren 3, BL17, SP1, SP10, SP6, Zigong
• Herbal treatment: si wu tang and shi xiao san

• Gynecological disorders involving increased volume of vaginal discharge, with changes in color, texture and odor
• Includes:
– Vaginitis
– Cervicitis
– Pelvic inflammation

• Pathological mechanism: dysfunction of the ren and dai
– Vacuity: spleen and kidney
• Spleen qi vacuity
• Kidney vacuity
– Repletion: dampness heat

• Spleen qi vacuity
• Kidney vacuity
• Downpour of damp-heat

• Clinical Manifestations
– Profuse leukorrhea, yellow in color and viscid in quality with a foul odor, accompanied by pruritus, chest fullness, poor appetite, sticky feeling in the mouth, scanty and dark urine, loose stools which is difficult to discharge, yellow and greasy tongue coating and a moderate rapid pulse.
• Treatment Principle
– Clear away heat and remove dampness.
• Acupuncture Ren 3, SP6, SP9, ST40, GB41 zu lin qi, LIV5, LIV2, ST28,
LI11
– Ren3 is the front mu point of the bladder, it can clear damp heat from the lower jiao
– SP6 removes damp and reduces the liver fire
– SP9 and ST40 drain dampness
– GB41 resolves damp heat in the genital region and regulates Daimai
– ST28 resolves dampness and promotes transformation and transportation of fluids in the lower burner
– LV5 cures the itching by removing damp and heat away from the liver meridian
– LV2 clears heat from the liver meridian
– LI11 clears heat
• Herbal treatment: long dan xie gan tang

• Clinical Manifestations
– Profuse leukorrhea, white or slight yellow vaginal discharge without smell, pale or sallow complexion, lassitude, poor appetite and loose stools, edema in the lower limbs, pale tongue with white sticky coating, slow weak pulse.
• Treatment Principle
– Tonifty the spleen, remove dampness and regulate chongmai and daimai.
• Acupuncture GB26 dai mai, Ren6, BL30 baihuanshu, SP9 , ST36
– GB26, an intersecting point of the belt vessel and foot shaoyang meridians, stabilizes the dai mai and is a cure for leukorrhagia
– Ren6 regulates qi, resolves damp, adjusts the chong mai and stabilizes the dai mai
– BL30 is an adjacent point to check leukorrhagia
– ST36 and SP9 tonify the spleen and resolve the dampness
• Herbal treatment: wan dai tang

• Clinical Manifestations
– Profuse and continuous leukorrhea, thin and transparent or white vaginal discharge, severe soreness of the low back, cold sensation in the lower abdomen, frequent and excessive urine, loose stools, pale tongue with thin coating and deep pulse.
• Treatment Principle
– Tonifty the kidney and regulate chongmai and daimai.
• Acupuncture GB26 dai mai, Ren4, BL23, KI12, KI7
– GB26, an intersecting point of the belt vessel and foot shaoyang meridians, stabilizes the dai mai and is a cure for leukorrhagia
– Ren4 BL23, KI12 and GB26 , a combination of adjacent and distal points, are applied together to promote yang qi and tonify the kidney sa as to restore its storing function, and stabilize the chong mai and leukorrhagia
– KI7 tonify the kidney promotes the transformation of the fluids in the lower burner
• Herbal treatment: nei bu wan or zhi bai di huang wan