EMPIRICAL FORMULAS

1. Qing Re Yang Yin Tang
Tx: Clear Heat, Nourish Yin, Tonify LU/KD

Shi Gao  30g
Huang Jing  30g
Huang Qi  30g
Ren Shen Ye  10g
Zhi Mu  10g
Sheng Di Huang  15g
Shu Di Huang  15g
Xuan Shen  10g
Gou Qi Zi  10g
Shan Yao  10g


2. Jiang Tang Tang
Tx: Benefit Qi, Nourish Yin, Activate Blood

Huang Qi  30g
Sheng Di Huang  30g
Cang Zhu  15g
Xuan Shen  30g
Ge Gen  15g
Dan Shen  30g
Tian Hua Fen  30g
Wu Mei  10g

High blood glucose: + Dang Shen 10g, Zhi Mu 10g, Shi Gao 30-60g
Hypertension, hunger: + Yu Zhu 10-15g, Shu Di Huang 30g
Keton urine: + Huang Qin 10g, Huang Lian 5g, Fu Ling 15g, Bai Xian Pi 15g


3. Fu Pi Xiao Ke Tang
Tx: Strengthen SP, Benefit Qi, Harmonize ST, Nourish dryness, Generate fluid, Stop thirst

Ren Shen  15g
Bai Zhu  15g
Mai Men Dong  15g
Bai He  15g
Yu Zhu  15g
Chen Pi  15g
Ji Nei Jin  15g
Gan Song  15g
Ge Gen  15g
Shan Yao  20g
Sha Shen  20g

Severe thirst, high level of sugar in urine: + Sang Shen 15g, Nu Zhen Zi 15g
Deficiency: + Huang Qi 20g, Long Yan Rou 20g
Severe Deficiency: + Gou Qi Zi 20g, Tu Si Zi 15g


4. Yu Xiao Ling
Tx: Nourish Yin, Clear Heat, Benefit Qi, Nourish Essence

Huang Qi  15g
Shan Yao  10g
Huang Jing  10g
Shi Hu  10g
Tian Hua Fen  10g
Jiang Chan  10g
Sheng Di  10g
Shu Di  10g
Zhu Ye  10g
Di Gu Pi  10g

DEFINITION AND SYMPTOMS
Diabetes Mellitus, is a disease in which the pancreas produces insufficient amount of insulin, or in which the cells fail to respond appropriately to insulin. Insulin is a hormone that helps the cells to absorb glucose (sugar), so that it can be used as a source of energy. In people with diabetes, glucose levels build up in the blood and urine, causing excessive urination, thirst, hunger, and problems with fat and protein metabolism. Diabetes mellitus differs from the less common diabetes insipidus, which is caused by lack of the hormone vasopressin (ADH), which controls the amount of urine secreted.

TYPES
Type 1:  Diabetes is classified into two types. In Type 1 diabetes, formerly called insulin-dependent diabetes mellitus (IDDM) and juvenile-onset diabetes, the body does not produce insulin or produces it only in very small quantities. Symptoms usually appear suddenly, typically in individuals under 20 years of age. Most cases occur around puberty and around age 10 to 12 in girls and age 12 to 14 in boys. In the United States Type 1 diabetes accounts for 5 to 10 percent of all diabetes cases. In Canada, Type 1 diabetes accounts for about 10 percent of all diabetes cases.
Type 2: In Type 2 diabetes, formerly known as non-insulin-dependent diabetes mellitus (NIDDM) and adult-onset diabetes, the body's delicate balance between insulin production and the ability of cells to use insulin goes wrong. The symptoms or characteristics of Type 2 diabetes include those found in Type 1 diabetes, as well as repeated infections or skin sores that heal slowly or not at all, generalized tiredness, and tingling or numbness in hands or feet.

SIGNS AND SYMPTOMS: Increased thirst, a frequent urge for urination, hunger, a flu-like feeling, including weakness and fatigue, unexplained weight loss, blurred vision, irritability, slow healing of cuts and bruises, tingling or numbness in hands or feet, red, swollen and tender gums, recurring infections of the gums, skin, vagina or bladder


COMPLICATIONS
Short-term complications: low blood sugar, high blood sugar
Long-term complications: nerve damage, kidney disease, eye disease, cardiovascular disease, increased risk of infection



DIFFERENTIAL DIAGNOSIS AND FORMULAS
In Oriental Medicine, Diabetes is categorized under "Xiao Ke". 

1. LU Heat with Fluid Deficiency
S/S: thirst with desire to drink even after drinking, dry and heat sensation in the throat, polyuria, red tongue, lack of saliva, thin yellow coating, rapid pulse

Modified Xiao Ke Fang (Dan Xi Xin Fa, 1481)
Huang Lian
Tian Hua Fen
Ou Jie
Sheng Di
Sheng Jiang
+
Mai Men Dong
Xuan Shen
Ge Gen

2. ST Heat
S/S: thirst with drinking lots of water, hungry easily even after big meal, thin body, dry stool, frequent urination, red tongue, yellow coating, slippery and rapid pulse

Modified Yu Nu Jian (Jing Yue Quan Shu, 1624)
Shi Gao  9-15g
Shu Di Huang  9-30g
Mai Men Dong  6g
Zhi Mu  4.5g
Niu Xi  4.5g
+
Xuan Shen
Jue Ming Zi

3. Qi and Yin Both Deficiency
S/S: mental fatigue, tiredness, shortness of breath worse with exertion, weakness of lower limbs, dryness of mouth and throat, five palms heat, drinking lots of water, polyuria, slight pale tongue with teeth mark, thin white coating, lack of saliva, thready pulse

Modified Ren Shen Bai Hu Tang (Za Bing Yuan Liu Xi Zhu, 1773)
Ren Shen  6g
Zhi Mu  10g
Shi Gao  15g
Tian Hua Fen  10g
Ge Gen  10g
Mai Men Dong  8g
Dan Zhu Ye  8g
Geng Mi  20g
+
Huang Qi
Sheng Di Huang
Xuan Shen

4. Yin and Yang Both Deficiency
S/S: Pain on the lower bak and knee, aversion to cold, cold limbs, spermatorrhea, impotence, frequent urination during night time, dizziness, tinnitus, dark face, slight pale and swollen tongue, white coating, deep and week pulse.

Modified Jin Gui Shen Qi Wan (Jin Gui Yao Lao, 3rd century)
Sheng Di Huang  24g
Shan Yao  12g
Shan Zhu Yu  12g
Fu Ling  9g
Ze Xie  9g
Mu Dan Pi  9g
Gui Zhi  3g
Fu Zi  3g
+
Gou Qi Zi
Tu Si Zi
Huang Qi
Ba Ji Tian

  Modern Chinese Acupuncture

1. The general treatment strategy in using acupuncture for weight loss: is to strengthen the Spleen, harmonize the Stomach, transform phlegm and drain dampness, warm and unblock the channels and collaterals, as well as raise the clear and descend the turbid

2. Select points: along the Foot Taiyin Spleen channel, Foot Yangming Stomach channel, the Ren channel and Foot Taiyang Bladder channel. Use tonifying or draining methods according to pattern diagnosis

3. Locations
● On the abdomen: choose ST25, RN6, and RN9. Insert the needles perpendicularly to a depth of approximately 1 cun
● On the upper limbs: use LI4 and SJ6. Insert the needles perpendicularly to a depth of approximately 1.5 cun
● On the lower limbs: select ST36, ST37 and ST39, use perpendicular insertion to a depth of approximately 2 cun. For all these points, needling should result in the area feeling achy and distended

4. Technique
● Select 4-6 points at a 1 or 2 cun from RN8. Needle all points obliquely towards the navel. Insert to about 1 cun, or until the area is achy and distended

5. Differentiation
● Spleen deficiency: add UB20, RN12, and RN4, using a tonification technique
● Stomach Heat: add UB21 and UB17. Use a draining technique, and strong stimulation.
● Liver and Gallbaldder damp-heat: add UB18, UB17, and LV3; use a draining technique
● Liver and Kidney Yin deficiency: add UB18, UB23, KD3, and SP6. Apply a tonifying technique
● Qi stagnation and Blood stasis: add UB18, UB17, LV3, and SP10. Use a draining technique on LV3 and tonifying on all other points.

6. Electro Acupuncture
After the arrival of Qi, an electrical acupuncture stimulation device may be applied to the needle handles. Use continuous waveform, with a frequency of 3-4 cycles/second, and an intensity as strong as the patient can tolerate. Treat for 30 minutes. Treatment should be given every other day; a treatment course consists of one month of treatment.

7. Key aspect
The key aspect of acupuncture treatment for weight-loss is to select points on the basis of pattern differentiation; and to use tonifying or draining manipulations suitable to the body's Yin and Yang, Zang Fu, Qi and Blood, and Channels. In this way, it can achieve similar treatment results for different patients.

8. Auricular Acupuncture
● Primary Point: Appetite Control, Mouth, Stomach, Small Intestine, Shen Men
● Supplementary Point: Point Zero, Thalamus Point, Master Sensorial, Master Cerebral, Endocrine Point, Anti-Depressant Point, Occiput

CLASSIC FORMULAS FOR OBESITY

1. FANG FENG TONG SHENG SAN
● EXCESS + HEAT
● CENTRAL OBESITY
● DETOX: CIRCULATION, INTEGMENTARY, DIGESTIVE SYSTEM
   Dang Gui  4.8g
   Bai Shao  4.8g
   Chuan Xiong  4.8g
   Zhi Zi  4.8g
   Lian Qiao  4.8g
   Bo He  4.8g
   Sheng Jiang  4.8g
   Jing Jie  4.8g
   Fang Feng  4.8g
   Ma Huang  4.8g 
   Da Huang  3g
   Mang Xiao  3g
   Jie Geng  4g
   Bai Zhu  4g
   Gan Cao  4g
   Huang Qin  4g
   Shi Gao  4g
   Hua Shi  6g

2. FANG JI HUANG QI TANG
● EDEMA + DEFICIENCY
● KNEE PAIN
● EDEMA/SWOLLEW ON FEET AFTER PROLONG STANDING
   Fang Ji  8g
   Gan Cao  4g
   Bai Zhu  6g
   Huang Qi  9g
   Sheng Jiang  6g
   Da Zao  6g

3. DA CHAI HU TANG
● UPPER BODY OBESITY
● CONSTIPATION, STRESS
● YELLOW COATING
   Chai Hu  12g
   Ban Xia  12g
   Huang Qin  6g
   Bai Shao  6g
   Zhi Shi  6g
   Da Zao  6g
   Sheng Jiang  8g
   Da Huang  4g

4. TONG DAO SAN
● LOWER ABDOMEN OBESITY
● BLOOD STASIS
● ESP. FOR WOMEN
   Dang Gui  6g
   Da Huang  6g
   Mang Xiao  6g
   Hong Hua  6g
   Zhi Shi  4g
   Su Mu  4g
   Mu Tong  4g
   Hou Po  4g
   Chen Pi  4g
   Gan Cao  4g

5. YUE BI JIA ZHU TANG
● EDEMA + EXCESS
● ACUTE JOINT PAIN INCLUDING KNEES
● DIAPHORESIS AND THIRST
   Ma Huang  12g
   Shi Gao  16g
   Sheng Jiang  6g
   Da Zao  8g
   Gan Cao  4g
   Bai Zhu  8g

KOREAN FORMULAS FOR OBESITY
 
K.F. (1) Obesity Basic Formula
Yi Yi Ren  10g
Shu Di Huang  10g
Tian Hua Fen  4g
Fang Ji  4g
Gan Cao  3g
Ze Xie  3g
Zhu Ling  2g
Dang Gui  2g
Hong Hua  1g
Su Mu  1g

K.F. (2) Obesity + Drinker, Thick fat deposit under skin, Heat
Yi Yi Ren  20g
Tian Hua Fen  10g
Ge Gen  8g
Mu Tong  6g
Ze Xie  6g
Zhu Ling  6g
Huang Qi  6g
Shan Yao  6g
Shu Di Huang  6g
Hong Hua  4g
Su Mu  4g
Gou Qi Zi  4g
Shan Zhu Yu  4g
Fang Ji  4g
Yin Chen  4g
Dang Gui  4g
Ma Huang  4g
Su Ye  4g
Qiang Huo  4g

K.F. (3) Hypertension, Atherosclerosis, Stroke, Constipation, Heat
Yi Yi Ren  20g
Shu Di Huang  20g
Gan Cao  6g
Huang Lian  6g
Shi Gao  6g
Huang Qin  6g
Jie Geng  6g
Dang Gui  6g
Mu Tong  6g
Ze Xie  6g
Chuan Xiong  4g
Chi Shao  4g
Hong Hua  4g
Su Mu  4g
Da Huang  2g
Ma Huang  2g
Bo He  2g
Jing Jie  2g
Bai Zhu  2g
Zhi Zi  2g

K.F. (4) Obesity + Healthy in general, Good appetite, Desire to sleep, Don't want to exercise
Yi Yi Ren  20g
Shu Di Huang  40-60g
Fang Ji  8g
Gan Cao  6g
Mu Tong  6g
Ze Xie  6g
Zhu Ling  6g
Hou Po  6g
Lai Fu Zi  6g
Sang Bai Pi  6g
Dang Gui  4g
Gou Qi Zi  4g
Shan Zhu Yu  4g
Chuan Xiong  3g
Hong Hua  3g
Su Mu  3g
Deng Xin Cao  2g

K.F. (5) Obesity + Gain weight easily even with drinking water
Yi Yi Ren  20g
Cang Zhu  10g
Hou Po  10g
Lai Fu Zi  10g
Shu Di Huang  10g
Mu Tong  10g
Ze Xie  10g
Zhu Ling  10g
Fang Ji  6g
Dang Gui  6g
Gan Cao  6g
Sang Bai Pi  6g
Hong Hua  3g
Su Mu  3g
Ban Xia  3g
Zhi Shi  3g

K.F. (6) Obesity + Weakness, Neurosis, Stress, Eating late at night
Shu Di Huang  20g
Yi Yi Ren  20g
Shan Yao  10g
Bai Fu Ling  10g
Long Yan Rou  10g
Dang Gui  8g
Bai Zhu  8g
Mai Men Dong  8g
Bai Zi Ren  8g
Suan Zao Ren  8g
Ze Xie  6g
Zhu Ling  6g
Huang Qin  6g
Hong Hua  4g
Su Mu  4g
Mu Tong  4g
Yuan Zhi  2g
Wu Wei Zi  2g

CHA YE (tea leaf) FORMULAS

(1) Obesity + Food retention: Relieve food stagnation, Transform Damp
Shan Zha  7g
Ze Xie  7g
Lai Fu Zi  7g
Mai Ya  7g
Shen Qu  7g
Xia Ku Cao  7g
Chen Pi  7g
Bai Qian Niu Zi (fried) 7g  (Semen Pharbitidis - white)
Hei Qian Niu Zi (fried)  7g  (Semen Pharbitidis - black)
Jue Ming Zi  7g
Fu Ling  7g
Chi Shao Dou  7g
Huo Xiang  7g
Cha Ye  7g

(2) Obesity + Hypertension: Extinguish Liver Wind, Move Qi, Transform Damp
He Shou Wu  10g
Xia Ku Cao  10g
Shan Zha  10g
Ze Xie  10g
Shi Jue Ming  10g
Lai Fu Zi  10g
Cha Ye  10g

(3) Obesity + Edema: Strengthen SP, Dry Damp, Drain Damp
Cang Zhu  10g
Bai Zhu  10g
Ze Xie  10g
Fu Ling  10g
Che Qian Zi  10g
Zhu Ling  10g
Fang Ji  10g
Cha Ye  10g

(4)  Obesity + Excess Heat in Yangming: Relieve stagnation, Move Stool
Da Huang  20g
Zhi Shi  20g
Bai Zhu  20g
Gan Cao  20g
Cha Ye  50g

(5) Obesity + Spleen deficiency with Damp: Strengthen SP, Expel Damp
Ban Xia  5g
Fu Ling  5g
Chen Pi  5g
Chuan Xiong  5g
Zhi Ke  5g
Da Fu Pi  5g
Dong Gua Pi  5g
Xiang Fu Zi (fried)  5g
Ze Xie  5g
Che Qian Zi  5g
Cang Zhu (fried)  5g
Bai Zhu (fried)  5g
Yin Chen  5g
Cha Ye  5g

(6) Obesity + Food retention and Blood stasis: Relieve food retention, Move Blood stasis
Shan Zha  40g
Ze Xie  7g
Lai Fu Zi  7g
Mai Ya  7g
Shen Qu  7g
Xia Ku Cao  7g
Chen Pi  7g
Bai Qian Niu Zi (fried) 7g  (Semen Pharbitidis - white)
Hei Qian Niu Zi (fried)  7g  (Semen Pharbitidis - black)
Jue Ming Zi  7g
Fu Ling  7g
Chi Shao Dou  7g
Huo Xiang  7g
Cha Ye  7g

EMPIRICAL FORMULAS FOR OBESITY

FORMULA 1: Clear Stomach heat, Drain Damp, Strengthen SP
Fan Xie Ye  1.5g  (Folium Sennae)
Ze Xie  12g
Shan Zha  12g
Jue Ming Zi  12g

FORMULA 2: Benefit Qi, Nourish Yin, Clear Damp-Heat
Jue Ming Zi  6g
Ze Xie  6g
He Ye  6g
Fang Ji  6g
Lu Hui  6g
Sheng Di  12g
He Dou  12g 
Shui Niu Jiao  12g
Yi Yi Ren  12g
Ren Shen  12g

FORMULA 3: Strengthen SP, Expel Phlegm and Damp
Ban Xia  9-12g
Fu Ling  9-12g
Cang Zhu  9-12g
Yi Yi Ren  9-12g
Da Fu Pi  9-12g
Chen Pi  5-9g

FORMULA 4: Strengthen SP, Dry Damp and Phlegm
Ban Xia  10g
Chen Pi  10g
Fu Ling  10g
Yi Yi Ren  10g
Da Fu Pi  10g
Che Qian Zi  10g
Ze Xie  10g
Xiang Fu  10g
Dong Gua Pi  10g
Cang Zhu  15g
Bai Zhu  15g
Bai Zi Ren  15g

Indications are listed according to the following aspects of L.I. channel
Organ: Large Intestine
Channel: LI channel
Five Element: Metal
Six Energy: Yangming (Dry Metal)

Points
Tonify ST36, LI11
Sedate SI5, LI5

Indications
1. Headache: headache on rainy day or damp weather
2. Ear: Middle ear infection, Parotitis (below the ear)
3. Eye: red eyes, sty
4. Nose: nasal blockage, nasal discharge, rhinitis, sinusitis
5. Tooth: toothache
6. DU14: if DU14 area is much more protrude than other person
7. Back: lordosis, lower back pain due to LI deficiency (can't stand long time)
8. Abdomen: abdominal distention, pain around the umbilicus
9. L.I. organ: Irregular bowel movement, constipation or diarrhea, rectal prolapse, chronic dysentery, bloody stool
10. Dampness: Excess Dampness pattern (b/c LI belongs to Yangming Dry Metal)
11. Skin: itchy, weepy, oozing skin
12. Channel: shoulder pain due to dislocation of shoulder joint, joint squishing sound, hernia, knee pain

HB's Tip: Korean four needle technique should be understood by comprehensive aspects; organ, channel, five element, and six energies.

VAGINITIS & HERBAL FORMULAS

DEFINITION AND SYMPTOMS
Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. The cause is usually due to the change in the normal balance of vaginal bacteria or an infection. Vaginitis can also result from reduced estrogen levels after menopause.

Signs and symptoms: irritation and/or itching of the genital area, inflammation, vaginal discharge, foul vaginal odor, discomfort or burning when urinating, pain/irritation with sexual intercourse

Most common types:
Bacterial vaginosis: Vaginitis caused by Gardnerella (a bacterium). This type of vaginitis results from overgrowth of one of several organisms normally present in your vagina, upsetting the natural balance of vaginal bacteria. More than one in six pregnant women in the United States has bacterial vaginosis, though many aren't aware of it. (Key: fish odor, pH>4.5)
Yeast infections: Vaginitis caused by Candida albicans (a yeast). An estimated three out of four women will have a yeast infection in their lifetime. (Key: no smell, pH<4.5)
Trichomoniasis: Vaginitis caused by Trichomonas vaginalis (a protozoan). This type is caused by a parasite and is commonly transmitted by sexual intercourse. (Key: possible smell, pH>5.0)
Atrophic vaginitis: This type is resulted from reduced estrogen levels after menopause. The vaginal tissues become thinner and drier, which may lead to itching, burning or pain. (Key: Yin deficiency symptoms)


DIFFERENTIAL DIAGNOSIS
In Oriental Medicine, Vaginitis is categorized under "Leukorrhea" or "Vaginal itching".  There are two main differential diagnoses.
1. Damp-Heat pouring downward: itching, a thick, white or yellow, cottage cheese-like vaginal discharge, bitter taste, yellow coating, wiry-rapid pulse
2. Yin Deficiency with Heat: dry vagina, burning sensation, itching, yellow leukorrhea, five-palm heat, dry mouth, dry throat, red tongue, no coating, thready-rapid pulse


HERBAL FORMULAS
1. Damp-Heat pouring downward: Long Dan Xie Gan Tang
Long Dan Cao  6g
Huang Qin  9g
Zhi Zi  9g
Chai Hu  6g
Mu Tong  4.5g
Che Qian Zi  12g
Ze Xie  9g
Sheng Di  12g
Dang Gui  9g
Gan Cao  4.5g

2. Yin Deficiency with Heat: Zhi Bai Di Huang Wan
Zhi Mu  6g
Huang Bai  6g
Shu Di  24g
Shan Zhu Yu  12g
Mu Dan Pi  9g
Shan Yao  12g
Fu Ling  7g
Ze Xie  7g


EMPIRICAL FORMULAS
Formula 1: Yeast infection or Trichomoniasis (External)
Actions: Clear Heat, Expel Wind, Stop itching, Stop leurkorrhea
Huang Bai  100g
Gan Cao  50g
Hua Jiao  50g
Bai Zhi  50g

Formula 2: Atrophic vaginitis or Elderly vaginitis (Internal)
Actions: Nourish Yin, Clear Heat, Relive stagnation, Transform Damp
Ban Xia  10g
Di Gu Pi  10g
Zhi Ke (fried)  10g
Gua Lou Pi  15g
Bei Mu  15g
Tu Fu Ling  25g
Niu Xi  15g
Zhi Gan Cao  15g
Bai Shao  30g
Chen Xiang  9g

Formula 3: Various Kinds (External)
Actions: Dry Damp, Clear Heat, Kill parasties, Stop itching
She Chuang Zi  30g
Bai Bu  15g
He Shi  12g
Ku Shen  12g
Xiong Huang  12g

Q:  Hello!  I'm looking for help in putting together a raw herbal formula for a patient who recently was involved in a motorcycle accident.  He suffered six fractures total-collarbone, 3 ribs and 3 hairlines in the pelvis (ASIS, acetabulum and sacral area).  Any suggestions?  He is 29 y.o., tongue is enlarged (particularly at the sides and tip) with normal color and thin white fur, pulses are bowstring, slippery and long.  Previous history of alcohol abuse, depression, migraines and bouts of anger.  Had been working with him based on a diagnosis of damp heat in the Liver and had good success with a modified version of Xiao Chai Hu Tang.  Any suggestions would be greatly appreciated!


A:  FORMULA
For collarbone fracture, try the following formula.

6.0g   Pu Huang
6.0g   Mu Dan Pi
6.0g   Wu Ling Zhi
8.0g   Tao Ren
8.0g   Chi Shao
8.0g   Dang Gui Wei
8.0g   Niu Xi
8.0g   Xu Duan
8.0g   Bai Shao
6.0g   Jing Jie
3.2g   Gan Cao