Aetiology Pathology and Treatment of Dampness PDF

AETIOLOGY, PATHOLOGY AND TREATMENT OF DAMPNESS
馬
萬
Copyright Giovanni Maciocia
馬萬里
里
Table of Contents
1. Aetiology
2. Characteristics of Dampness
3. Diagnosis
4. Classification of Dampness
5. Pathology
6. Herbal treatment
7. Acupuncture treatment
8. Patterns and treatment
A. External dampness
1. Simple invasion of External dampness in Zang Fu
i. Invasion of External Dampness in Bladder
ii. Invasion of External Dampness in the Stomach
iii. Invasion of External Dampness in Intestines
iv. Invasion of External Dampness in Uterus
v. Invasion of External Dampness in Gall Bladder
2. Invasion of External Dampness in Channels
3. Invasion of Damp-Heat at Wei level
i. External Damp-Heat at Wei level
ii. External Summer-Heat with Dampness
B. Internal Dampness
1. Chronic internal Dampness in the Zangfu
i. Chronic Internal Dampness in Stomach and Spleen
ii. Chronic Internal Dampness in Bladder
iii. Chronic Internal Dampness in Intestines
iv. Chronic Internal Dampness in Uterus
v. Chronic Internal Dampness in Gall Bladder
2. Chronic Internal Dampness in the Channels
3. Chronic Internal Dampness in the Skin
4. Acute Internal Dampness
i. Damp Heat at the Qi level
9. Damp Heat
10. Sinusitis
11. Chronic Fatigue Syndrome and Fibromyalgia
12. Mouth Ulcers
13. Prostatitis
14. Interstitial Cystitis
15. Ulcerative Colitis
16. Bi Syndrome
17. Eczema
1. AETIOLOGY
EXTERNAL
Dampness can derive from environmental or climatic dampness:
thus, it may be due to humid weather (whether hot or cold), but
also to damp living conditions, such as living in damp houses.
Exterior Dampness can also be caught by wearing wet clothes,

wading in water, working in damp places or sitting on damp
ground.
DIET
Dampness may result from the excessive consumption of
greasy foods, dairy foods, sweets, sugar, cold-raw foods.
Damp-Heat may also arise from excessive alcohol drinking
and of greasy-fried foods.
Dampness may also arise from overeating (in the same way as
Retention of Food) or from irregular eating habits.
2. CHARACTERISTICS OF DAMPNESS
The characteristics of Dampness are:
sticky causes repeated attacks

heavy difficult to get rid of
slows things down infuses downwards
When exterior Dampness invades the body, it tends to invade

the lower part first, typically the legs. From the legs, it can
flow upwards in the leg channels to settle in any of the pelvic
cavity organs.
If it settles in the female genital system it causes vaginal

discharges, if it settles in the Intestines it will cause loose stools
and if it settles in the Bladder it will cause difficulty, frequency
and burning of urination. However, Dampness is also common
in the head.
The clinical manifestations of Dampness are extremely varied according to its
location and nature (hot or cold), but the general ones are:
• a feeling of heaviness of body or head
• no appetite
• a feeling of fullness of chest or epigastrium
• sticky taste
• urinary difficulty
• sticky vaginal discharge
• sticky tongue coating
• Slippery or Soggy pulse.
According to its location, the more specific clinical manifestations
of internal Dampness are:
Head: feeling of heaviness of the head
Eyes: red-swollen eyelids, eyes oozing a fluid, sties
Mouth: mouth ulcers on gums, swollen-red lips
Stomach and Spleen: feeling of fullness of epigastrium, feeling of

fullness after eating, sticky taste, loose stools, poor appetite,
Soggy pulse.
Lower Burner: excessive vaginal discharge, painful periods,
infertility, turbid urine, difficult and painful urination, scrotal
sweating or eczema, genital eczema, genital itching.
Skin: papules (Damp-Heat with more Heat), pustules,

vesicles (Dampness without Heat), greasy sweat, boils,
any oozing skin lesion, oozing eczema, puffy skin.
Luo Channels: numbness and loss of sensation.
Joints: swollen-painful joints (Fixed Bi or also

Wandering Bi syndrome if mixed with Wind).
The various clinical manifestations can be correlated to the main characteristics
of Dampness:
Heaviness: this causes a feeling of heaviness, tiredness, heaviness of limbs or

head, muzziness (fuzziness).
Since Dampness is heavy it causes a feeling of fullness of chest or epigastrium,

and it tends to settle in the Lower Burner.
However, Dampness often affects the head too causing the above-mentioned
symptoms. This happens because it prevents the clear Yang from ascending to
the head to brighten the sense orifices and clear the brain.
Dirtiness, turbidity: Dampness is dirty and is reflected in dirty
discharges, such as cloudy urine, vaginal discharges or skin
diseases characterized by thick and dirty fluids oozing out such
as in certain types of eczema.
Stickiness: Dampness is sticky and this is reflected in a sticky

tongue coating, sticky taste and Slippery pulse. The sticky nature
of Dampness also accounts for its being very difficult to get rid
of. It often becomes chronic, manifesting in frequent, recurrent
bouts.
Yin nature: Dampness is a Yin pathogen and it therefore tends to

injure Yang, especially of the Spleen (except, of course, if it is
Damp-Heat).
DAMPNESS IN THE MALE GENITAL SYSTEM
URINARY SYMPTOMS PATHOLOGY
• Dysuria
• Dampness obstructs the
• Stranguria
Water passages
• Turbid urine
• Dampness is sticky, dirty,
GENITAL SYMPTOMS heavy
• Pruritus of the genitals
• Urethral discharge
• Testicular swelling
• Impotence
• Anomalies of sperm
PROSTATE SYMPTOMS
• Hypertrophy
• Pain of the perineum
• Feeling of heaviness of the perineum
GENERAL SYMPTOMS
• Feeling of heaviness of the abdomen
• Feeling of heaviness
• Tongue with sticky coating on the root
• Slippery pulse
3. DIAGNOSIS
PINYIN CHINESE ENGLISH PATHOLOGY EXAMINATION
MEN 闷 Feeling of Phlegm, severe Chest and

oppression Qi stagnation epigastrium; only
subjective
MAN 满 Feeling of fullness Dampness, Food Epigastrium,

Retention abdomen;
subjective and
objective (abdomen
hard)
ZHANG 胀 Feeling of Qi stagnation, Epigastrium, chest,
distension emotional origin hypochondriumabd
omen; subjective
and objective
(abdomen
distended)
PI 痞 Feeling of ST-Qi Xu, ST- Epigastrium.
stuffiness Heat, Xu-Shi, Subjective, the
Heat-Cold patient feels
distended and full
but abdomen soft
Sticky (Ni 腻) Slippery (Hua 滑) Mouldy
• Thicker in centre • Thicker in centre • Thick and patchy
• Slippery but rougher • Oily, smooth • Crumbly like tofu

than “slippery”
• As if covered in oily • Without root
• As if covered in oily fluid which “slips”
fluid which adheres • Can be scraped off
firmly • Papillae seem to be
hidden
• Papillae can be seen
• Cannot be scraped off
• Cannot be scraped off
Sticky: Phlegm or Dampness
Slippery: definitely Dampness

Sticky
Slippery
Mouldy
Sticky Sticky Sticky
Slippery Sticky
Sticky
Slippery
4. CLASSIFICATION OF DAMPNESS
ACCORDING TO NATURE
According to its nature, Dampness may be cold or hot.
ACCORDING TO EXTERIOR/INTERIOR
Dampness can be exterior or interior.
ACCORDING TO COMBINATION WITH OTHER PATHOGENS

Dampness can combine with other pathogens to form:
Cold Dampness
Damp-Heat
Wind-Dampness
Summer Heat-Dampness
ACCORDING TO LOCATION
DAMPNESS
Bladder
CLASSIFICATION
Stomach
ZANGFU
Intestines
EXTERNAL Uterus
Gall-Bladder
CHANNELS
EXTERNAL DAMP-HEAT
WEI
LEVEL EXTERNAL SUMMER-HEAT
WITH DAMPNESS
ZANGFU Bladder Intestines

CHRONIC Stomach and Spleen Uterus
Gall-Bladder
INTERNAL
CHANNELS
SKIN
ACUTE DAMP-HEAT AT QI LEVEL

CLASSIFICATION OF DAMPNESS ACCORDING TO LOCATION
Dampness can be in:

Zangfu
Skin
Channels
In the Zangfu, it can be in:
Stomach and Spleen (epigastric pain and fullness, poor digestion,

feeling of fullness, a sticky taste, poor appetite)
Gall-Bladder (hypochondriac pain and fullness)
Liver (hypochondrial fullness, distension and pain, jaundice)

Stomach and Spleen (epigastric fullness, Gall-Bladder (hypochondrial pain,
bad digestion, sticky taste) jaundice, stones, bitter taste)
Bladder (difficult and painful Kidneys (cloudy urine, difficult

urination, cloudy urine) urination)
Uterus (infertility, excessive Intestines (loose stools with mucus,

vaginal discharge) abdominal pain and fullness)
In the channels, it can be in:
In the joints (Bi-syndrome)
In the head (feeling of heaviness of the head, dull frontal

headache)
In the skin, Dampness is the cause of a large number of skin

diseases manifesting with oozing skin lesions, papules, vesicles.
Vesicles Papules
5. PATHOLOGY
EXTERNAL DAMPNESS
There are three possible types of invasions of external Dampness:
1) A “simple” invasion of Dampness which may affect

the Bladder, Intestines, Stomach, and Uterus.
2) An invasion of Dampness in the channels causing Bi

syndrome in its acute stage.
3) An invasion of Damp-Heat of the Wen Bing type at the

Wei level, manifesting with fever.
PATHOLOGY OF INTERNAL DAMPNESS
STOMACH AND SPLEEN

A) CHRONIC
BLADDER
i. ZANGFU INTESTINES
UTERUS
ii. CHANNELS
GALLBLADDER
iii. SKIN
B) ACUTE
i. Damp Heat at the Qi level

1. EXTERNAL DAMPNESS
A) simple invasion of external Dampness in Zangfu
i. Invasion of external Dampness in Bladder
ii. Invasion of external Dampness in the Stomach
iii. Invasion of external Dampness in the Intestines
iv. Invasion of external Dampness in the Uterus
v. Invasion of external dampness in the gallbladder

B) INVASION OF EXTERNAL DAMPNESS IN THE CHANNELS
C) INVASION OF EXTERNAL DAMP-HEAT AT WEI LEVEL
i) EXTERNAL DAMP-HEAT AT WEI LEVEL
ii) EXTERNAL SUMMER-HEAT WITH DAMPNESS

6. HERBAL TREATMENT
HERBS THAT RESOLVE DAMPNESS

HERBS THAT FRAGRANTLY RESOLVE DAMPNESS
Fragrant herbs that “awaken” the Spleen to resolve Dampness, specifically
through sweating from the space between skin and muscles (Cou Li). Used for
muscle ache. Cang Zhu, Hou Po, Huo Xiang, Pei Lan, Cao Guo, Sha Ren, Bai
Dou Kou.
HERBS THAT RESOLVE DAMPNESS BY REGULATING WATER.

Diuretic herbs that resolve Dampness through urination (some bland and
neutral, some cold). Fu Ling, Zhu Ling, Yi Yi Ren, Ze Xie, Che Qian Zi, Hua
Shi, Qu Mai, etc.
HERBS THAT DRY-UP DAMPNESS AND CLEAR HEAT

Bitter-cold herbs that dry-up Dampness and clear Heat. Used for Damp-Heat.
Huang Qin, Huang Lian, Huang Bo, Long Dan Cao.
HERBS THAT RESOLVE DAMPNESS AND EXPEL WIND

Pungent herbs used to expel Dampness and Wind from muscles and joints. Used
for Bi Syndrome. Hai Feng Teng, Hai Tong Pi, Sang Zhi, Xi Xian Cao (used for
other things than just Bi)
TREATMENT METHODS IN RESOLVING DAMPNESS
NATURE HOW FROM PATTERN DISEASE HERBS FORMULAE

WHERE
BLAND, Urination Whole Dampness Lin Fu Ling, Wu Ling San,

NEUTRAL body, (hot or cold) disease, Zhu Ling, Wu Pi San, Bai
digestive or in urinary or digestive Yi Yi Ren, Zhu San, Si Ling
urinary digestive diseases Tong Cao, San, Wei Ling
system Deng Xin Tang, Yin Chen
Cao, Bian Wu Ling San,
Xu, Bi Chun Ze Tang,
Xie, Jin Shen Zhi Zhu
Qian Cao, Ling Tang
Chi Xiao
Dou, Yu
Mi Xu
WHERE
FRAGRANT Sweating Space Dampness Post-viral Huo Xiang, Ping Wei San,
PUNGENT
between in the fatigue Pei Lan, Bu Huan Jin
skin and muscles syndrome, Hou Po, Zheng Qi San,
muscles and in Wei Cang Zhu, Xiang Sha Ping
(Cou Li), digestive syndrome, Bai Dou Wei San, Chu
digestive system skin Kou, Cao Shi Wei Ling
diseases, Dou Kou, Tang, Huo Xiang
numbness, Cao Guo, Zheng Qi San
digestive Sha Ren
diseases
WHERE
BITTER-COLD Urination Digestive Damp- Epigastric Huang Qin, San Ren Tang,
system, skin, Heat pain, Lin Huang Huo Po Xia Ling
urinary system syndrome, Lian, Tang, Lian Po
Diarrhoea, Huang Bo, Yin, Huang Qin
Abdominal Long Dan Hua Shi Tang,
pain, skin Cao, Ku Gan Lu Xiao Du
diseases Shen, Qin Dan, Yin Chen
Pi Hao Tang, Zhong
Man Fen Xiao
Wan, Ba Zheng
San, Wu Lin San,
Er Miao San,
WHERE
BITTER- Sweating Urinary Cold Epigastric Hou Po, Ping Wei San,
WARM and Dampness or Cang Zhu, Xiang Sha Ping
digestive in digestive abdominal Bai Zhu Wei San, Bai
system, or urinary pain, Zhu San
muscles system or in diarrhoea,
muscles post-viral
fatigue
syndrome
WHERE
BLAND- Urination Urinary Damp-Heat Lin Ze Xie, Hua Ba Zheng San,

COOL system in urinary disease, Shi, Yi Yi Chu Shi Wei
system skin Ren, Dong Ling Tang
diseases Kua Ren, Mu
Tong, Qu
Mai, Di Fu
Zi, Shi Wei,
Che Qian Zi,
Dong Kui Zi,
Yin Chen
Hao, Han
Fang Ji
WHERE
PUNGENT Urination Urinary Cold Oedema, Gui Zhi, Zhen Wu Tang,

SWEET, and Dampness epigastric Rou Gui, Fu Zi Tang, Shi
WARM digestive and Wu Zhu Pi Yin, Bi Xie
system abdominal Yu, Gan Fen Qing Yin,
pain Jiang, Xi Ji Ming San
Xin, Fu
Zi
WHERE
PUNGENT- Urination Joints, Wind- Bi Du Huo, Qiang Huo

WARM or channel, Dampness Syndrome Qiang Sheng Shi
sweating muscles in channels Huo, Qin Tang, Juan Bi
and joints Jiao, Wei Tang, Gui Zhi
Ling Xian, Shao Yao Zhi
Hai Tong Mu Tang, Yi Yi
Pi, Mu Ren Tang,
Gua (sour), Xuan Bi Tang,
Can Sha, Du Huo Ji
Sang Zhi, Sheng Tang,
Wu Jia Pi, San Bi Tang,
Hai Feng Da Fang Feng
Teng, Tang
Kuan Jin
Teng, Song
Jie
SUMMARY OF TASTES/TEMPERATURE AND ACTIONS
Drain Dampness Resolve Dampness Dry Dampness (HUANG

through urination, through sweating QIN Hot)
diuretics (FU (CANG ZHU)
LING)
BLAND- FRAGRANT- BITTER-

NEUTRAL PUNGENT COLD
PUNGENT- BITTER-
PUNGENT- WARM
SWEET-
WARM
WARM
“Pungent to open, bitter to make descend” 辛开苦降

7. ACUPUNTURE TREATMENT
THE TRIPLE BURNER CAVITIES AND FLUID METABOLISM
IT CONTROLS THE TRANSPORTATION AND PENETRATION OF QI

The movement of Qi to carry out its various functions is called the “Qi
Mechanism” which relies on the ascending/descending and entering/exiting of Qi
in different places and different organs.
Each organ has a particular direction of flow of Qi, e.g. Spleen-Qi ascends while
Stomach-Qi descends. In each channel, Qi flows in an upward or downward
direction. Qi also enters and exits in and out of various structures and organs.
For example, Qi enters and exits the space between skin and muscles, the
Membranes, the joint capsules, and all other cavities.
The Triple Burner controls the ascending/descending and entering/exiting of Qi in the
Qi mechanism. One of the words most frequently used in Chinese books to describe
this function of the Triple Burner is tong 通 which means “free passage”, “to pass
through”, “penetrate”: this describes the function of the Triple Burner in ensuring that
Qi passes through in the Qi Mechanism, in all the cavities and in all organs.
This whole process is called “Qi Transformation by the Triple Burner”: the
result of the Qi transformation is the production of Nutritive-Qi, Defensive-Qi,
Blood and Body Fluids. That is also why the Triple Burner is said to control
“all kinds of Qi”.
The “Central Scripture Classic” (Zhong Zang Jing, Han dynasty) says:
“The Triple Burner is the three original Qi of the body, it is the Yang organ of
clear [Qi], it controls the 5 Yin and 6 Yang organs, the Nutritive- Qi and
Defensive-Qi, the channels and the Qi of the interior and exterior, left and
right, above and below. When the Qi of the Triple Burner has free passage,
Qi passes freely into interior, exterior, left, right, above and below. The Triple
Burner irrigates the body, harmonizes interior and exterior, benefits the left
and nourishes the right, it conducts upwards and descends downwards.”
Chapter 66 of the “Classic of Difficulties” confirms that the Triple
Burner controls the movement of Qi in general:
“The Triple Burner makes the Original Qi separate [into its different functions] and
it controls the movement and passage of the 3 Qi [of the Upper, Middle and Lower
Burner] through the 5 Yin and 6 Yang organs.”
The “3 Qi” are the Qi of the Upper, Middle and Lower Burner: apart from referring
generally to all the types of Qi in each Burner, this passage also refers specifically
to the Gathering Qi (Zong Qi) in the Upper, Nutritive-Qi (Ying Qi) in the Middle
and Defensive-Qi (Wei Qi) in the Lower Burner. Although the Defensive-Qi exerts
its influence primarily in the Upper Burner and the superficial layers of the body
(the space between skin and muscles), it originates in the Lower Burner from the
Gate of Life.
Chapter 18 of the “Spiritual Axis” says:
“The Nutritive Qi originates from the Middle Burner; the Defensive Qi originates
from the Lower Burner.”
Chapter 38 of the “Classic of Difficulties” confirms that the Triple
Burner exerts its influence on all types of Qi:
“The Triple Burner is the place where the Original Qi is separated: it supports all of
the Qi.”
Chapter 31 confirms the influence of the Triple Burner on the

movement of Qi in all parts of the body:
“The Qi of the Triple Burner gathers in the avenues of Qi [Qi Jie]”.
This means that the Triple Burner is responsible for the free passage of
Qi in all channels but also all structures (such as cavities) of the body; Qi
Jie is also the name for the point ST-30.
CLINICAL NOTE
T.B.-6 Zhigou is the best point to stimulate the Triple Burner's function of
transportation and penetration of Qi
POINTS
Upper Burner: Du-26 Shuigou, LU-7, LI-4, LI-6, TB-4, TB-6, Ren-
17
Middle Burner: Ren-9 Shuifen, Ren-12, ST-22, Ren-11
Lower Burner: ST-28 Shuidao, BL-22, Ren-5, BL-39, SP-9, SP-6,

KI-7.
T.B.-6 Zhigou: move Qi in the Triple Burner
T.B.-4 and BL-64: move Qi in the Triple Burner and activate

Water Passages.
Chapter 8 of the “Simple Questions” which describes the functions of
all the Internal Organs comparing them to “officials”, says:
“The Triple Burner is the official in charge of ditches”.
This means, that just like the official who is in charge of irrigation, the Triple
Burner is responsible for the transformation, transportation and excretion of fluids.
This is one of the most important functions of the Triple Burner.
The terms used in Chinese in connection with the Triple Burner influence on the
body fluids are often shu [疏 ] which means “free flow” and tong [通 ] which
means “free passage”. Therefore the Triple Burner is like a system of canals and
waterways to channel irrigation water through the proper fields and then out: this
ensures that body fluids are transformed, transported and excreted properly.
The Triple Burner function in relation to body fluids is closely dependent on
its function of controlling the transportation and penetration of Qi. The
Triple Burner influences the ascending/descending and entering/exiting of Qi
in the Qi Mechanism:
it is the coordinated and harmonized ascending/descending and

entering/exiting of Qi in all organs and structures that ensures that the body
fluids also ascend/descend and enter/exit in the proper way in all places.
Essentially, the transformation and movement of fluids depends on Qi.
The end result of the complex process of transformation, transportation and
excretion of fluids leads to the formation of various body fluids in each of the three
Burners.
The fluids of the Upper Burner are

primarily sweat which flows in the space
between skin and muscles.
The fluids of the Middle Burner are the

fluids produced by the Stomach which
moisten the body and integrate Blood
The fluids of Lower Burner are

primarily urine and the small amount
of fluids in the stools.
ACUPUNCTURE TO DRAIN DAMPNESS
Upper Burner: L.I.-4, L.I.-6, Du-26, Ren-

17, BL-13, TB-4
Middle Burner: Ren-12, Ren-9, ST-21, BL-

20
Lower Burner: SP-9, SP-6, KI-7, Ren-6, Ren-

5, Ren-3, ST-28.
8. PATTERNS AND TREATMENT
A. EXTERNAL DAMPNESS
1. “SIMPLE” INVASION OF EXTERNAL DAMPNESS IN ZANGFU

Bladder, Stomach, Intestines, Uterus and Gall-Bladder.
(i) INVASION OF EXTERNAL DAMPNESS IN BLADDER
This is a very frequent cause of acute bladder problems such as difficulty and
pain on urination. It is also often the cause of an acute recurrence of a chronic
Bladder problem.
Dampness obstructs the Water Passages of the Bladder and Lower Burner and this
causes both difficulty and pain on urination. Dampness is turbid and the urine
therefore becomes cloudy. This external Dampness may be associated with Cold or
Heat: if it is associated with Heat, there will be more burning pain and perhaps a
fever, and the tongue coating will be yellow.
Clinical manifestations
Difficulty and pain on urination, scanty but frequent
urination, cloudy urine, feeling of heaviness in the
lower abdomen, tongue with a thick-sticky coating on
the root, pulse perhaps Slippery on the left chi position.
If associated with Heat: burning pain on

urination, dark urine, thirst but no desire to
drink, yellow tongue coating and a slightly
rapid pulse.
Treatment principle
Drain Dampness, clear Heat (if there is Heat), promote
the Bladder’s function of Qi transformation, open the
Water Passages.
Acupuncture
Ren Mai in a woman (LU-7 right and KI-6 left) or Du Mai in a man (SI-3
left and BL-62 right). Or, if a woman has an underlying deficiency of
Kidney-Yang use Du Mai and Ren Mai, i.e. SI-3 right, BL-62 left, LU-7 left
and KI-6 right.
-Ren-3 and BL-28 to promote the Bladder’s function of Qi transformation.

-BL-63, Xi-cleft point, to stop pain and treat acute syndrome.
-BL-22 to open the Water Passages of the Lower Burner.
(ii) INVASION OF EXTERNAL DAMPNESS IN THE STOMACH
This is also very frequent occurrence: external

Dampness interferes with the ascending of Spleen-
Qi and descending of Stomach-Qi causing vomiting
and diarrhoea (not necessarily both).
It may be caused by climatic Dampness (which is more likely in the

summer and late summer) or by spoiled food (in which case it is
simply food poisoning). It may associated with Cold or Heat, but
more frequently with Cold. It may correspond to the Chinese
disease-symptom of Huo Luan (Bensky: “Sudden Turmoil
Disorder”)
Acute onset of vomiting and/or watery diarrhoea without smell,
epigastric pain, a feeling of stuffiness of the epigastrium, cold limbs, no
appetite, tongue coating white-thick-sticky, pulse Slippery or Weak-
Floating.
Treatment principle
Resolve Dampness from Middle Burner, harmonize the Stomach, subdue
rebellious Qi.
Acupuncture
-Ren-13 and ST-19 to subdue rebellious Stomach-Qi.
-Ren-12 to harmonize the Stomach
-P-6 to subdue rebellious Stomach-Qi and stop vomiting.
-ST-34, Xi-cleft point, to stop pain and treat acute syndrome.
-ST-30 and KI-21 to subdue rebellious Qi in the Chong Mai.
(iii) INVASION OF EXTERNAL DAMPNESS IN INTESTINES
External Dampness easily invades the

Intestines: this may also be due either to
climatic dampness (more common in summer
or late summer) or to spoiled food.
Dampness interferes with the ascending of

Spleen-Qi and descending of Intestines-Qi and
it causes diarrhoea.
Acute onset of watery diarrhoea, without smell,
abdominal pain, a feeling of heaviness, tongue with a
sticky-thick-white coating, pulse Slippery.
Treatment principle
Drain and resolve Dampness, stop diarrhoea, restore the ascending of
Spleen-Qi.
Acupuncture
-Ren-12 and BL-20 to tonify the Spleen to resolve Dampness.
-ST-25 to stop diarrhoea.
-Ren-6 to restore the ascending of Spleen-Qi.
-BL-22 and BL-25 to drain Dampness from the Intestines.
(iv) INVASION OF EXTERNAL DAMPNESS IN UTERUS
External Dampness may invade the Uterus causing

excessive vaginal discharge and painful periods.
Acute onset of painful period (as a one-off in periods that were not previously
painful), excessive vaginal discharge, tongue coating thick-sticky-white on the root,
pulse Slippery.
Treatment principle
Drain Dampness, regulate the Uterus.
Acupuncture
-Ren-4 to strengthen the Uterus.
-Ren-3 and ST-28 to drain Dampness.
-BL-22 to drain Dampness from the Lower Burner
-BL-53 Baohuang to drain Dampness from the Uterus.
(v) INVASION OF EXTERNAL DAMPNESS IN GALL-
BLADDER
This is usually an exacerbation of a previous chronic condition of

Dampness in the Gall-Bladder. It is usually Damp-Heat.
Acute onset of hypochondrial pain, a feeling of
heaviness, bitter taste, tongue with a sticky-yellow
coating on one side, pulse Slippery.
Treatment principle
Drain Dampness, clear the Gall-Bladder, move Qi.
Acupuncture
-G.B.-34 to regulate the Gall-Bladder and drain Dampness.
-BL-19 and BL-22 to drain Dampness from the Gall-Bladder.
-G.B.-24 to drain Dampness from the Gall-Bladder.
2. INVASION OF EXTERNAL DAMPNESS IN CHANNELS
Invasion of external Dampness in the channels is the cause of acute Bi Syndrome

characterized by retention of Dampness in the joints, channels and muscles.
Bi Syndrome is a pathology that involves many structures and channels:
Muscle channels The Cou Li space

(Jing Jin) (space between skin
and muscles)
The joints (as The Luo channels

energetic centre of (Superficial first, then
entering/exiting of proper Luo, then Blood
Qi and convergence Luo)
of Qi)
The symptoms of Damp Bi Syndrome are:
Generalized (but not moving around) or localized ache in the joints and
muscles, often starting from the lower part of the body
Swelling of joints with feeling of heaviness of limbs
Aggravation from exposure to dampness.

3. INVASIONS OF EXTERNAL DAMP-HEAT AT WEI LEVEL
The Wei level is the Exterior level within the Four Levels Differentiation
within the theory of Wen Bing diseases. Wen Bing diseases are characterized
by exterior Heat at the acute stage, there is always a fever, the pathogenic
factors enters through nose and mouth, it is infectious and is particularly
virulent (more than an “ordinary” invasion of Wind-Heat). The pathogenic
factors are the acute stage may be Wind-Heat, Wind-Dry-Heat, Summer-Heat
(which also includes Dampness) and Damp-Heat.
Thus, two of the pathogenic

factors at the Wei level include
Dampness. Wei level
(i) EXTERNAL DAMP-HEAT AT WEI LEVEL
This is common in the summer and late summer.
It consists in an invasion of external Dampness not in the Zangfu as above,

but in the Exterior of the body, i.e. the space between skin and muscles;
one can think of it as similar to an invasion of Wind-Heat which affects the
Wei portion of the Lungs, similarly, external Damp-Heat at the acute stage
affects the Wei portion of the Stomach and Spleen.
However, because it is on the Exterior, there is no vomiting or diarrhoea as in the

previous cases.
Shivers, fever, body feels hot to touch, swollen glands, fever higher
in the afternoon, headache as if wrapped, a feeling of fullness of the
chest and epigastrium, a sticky taste, no thirst
tongue with a white-sticky coating (it is white because it is

beginning stage), pulse Weak-Floating.
Treatment principle
Drain and resolve Dampness, release the Exterior, expel Wind.
Acupuncture
-L.I.-11 to expel Damp-Heat.
-T.B.-5 and L.I.-4 to release the Exterior.
-Ren-9, SP-9 and SP-6 to resolve Dampness.
YIN QIAO SAN

(ii) EXTERNAL SUMMER-HEAT WITH DAMPNESS
Summer-Heat by definition can only occur in the

summer when the weather is very hot and the person is
exposed to sunshine unprotected for a long time.
An invasion of summer-Heat actually always involves also

Dampness, the clinical manifestations of which include a
feeling of heaviness of the body, an uncomfortable
sensation of the epigastrium, a sticky tongue coating and a
Weak-Floating pulse.
Fever, shivers, no sweating, headache, a feeling of heaviness of the body, an
uncomfortable sensation of the epigastrium, a sticky tongue coating and a Weak-
Floating pulse, irritability, thirst, tongue-body red, pulse rapid. (Symptoms of
Dampness underlined).
Treatment principle
Release the Exterior, clear Heat, resolve Dampness.
Acupuncture
-L.I.-11 to clear Heat and resolve Dampness.
-T.B.-5 and L.I.-4 to release the Exterior.
-LU-11 to release the Exterior and clear Heat.
B. INTERNAL DAMPNESS
There are two possible types of internal Dampness, one chronic, the other acute.
CHRONIC Dampness derives either from acute invasion of external Dampness

or from dietary causes and may involve:
• the Zangfu
• the channels
• the skin
ACUTE, internal Dampness is Damp-Heat at the Qi level within the Four Level
Differentiation.
Qi level
1. CHRONIC INTERNAL DAMPNESS IN THE ZANGFU
(i) CHRONIC INTERNAL DAMPNESS IN STOMACH AND SPLEEN
Dampness affects both Stomach and Spleen as it settles

in the Middle Burner where it impairs the ascending of
Spleen-Qi and descending of Stomach-Qi causing
epigastric fullness, diarrhoea and vomiting.
Dampness is obstructive (it is “heavy” and “sticky”) and it impairs the proper
functioning of the “Qi mechanism” in the Middle Burner, a crucial cross-roads in
the movement of Qi on its way up and down. Dampness in the Middle Burner may
be associated with Cold or Heat.
Nausea, vomiting, loose stools, a feeling of
heaviness, a sticky taste, no thirst, poor
appetite, a feeling of fullness of the
epigastrium, a sticky tongue coating in the
centre and a Slippery pulse especially on the
guan position.
FEELING OF FULLNESS (MAN 满)
If with Heat: thirst but without desire to

drink, a feeling of heat, perhaps night-
sweating, a bitter taste, tongue coating
yellow, pulse rapid.
Treatment principle
Resolve and drain Dampness, harmonize the Stomach.
Acupuncture
-Ren-9 and BL-22 to drain Dampness.
-P-6 to harmonize the Stomach and stop nausea.
-SP-9 and SP-6 to resolve Dampness.
HUO PO XIA LING TANG, PING WEI SAN.

TT Drain Fields, Ease the Muscles
(ii). CHRONIC INTERNAL DAMPNESS IN BLADDER
Difficulty and pain on urination, scanty but
frequent urination, cloudy urine, feeling of
heaviness in the lower abdomen, tongue with a
thick-sticky coating on the root, pulse perhaps
Slippery on the left chi position.
If associated with Heat: burning pain on urination,

dark urine, thirst but no desire to drink, yellow
tongue coating with red spots on the root and a
slightly rapid and Slippery pulse (which may be
more so on the left chi position).
Treatment principle
Drain Dampness, open the Water Passages of the Lower Burner, promote the
Bladder’s function of Qi transformation.
Acupuncture
-Ren-3 and BL-28 to promote the Bladder’s function of Qi transformation.
-BL-22 and SP-9 to open the Water Passages of the Lower Burner.
-Ren Mai in a woman (LU-7 right and KI-6 left) or Du Mai in a man (S.I.-3
left and BL-62 right).
To affect urination, use the opening and coupled points of the Ren Mai (LU-7
and KI-6) together with Ren-3 Zhongji coupled with Du-20 Baihui for
sinking of Qi or with Du-26 Renzhong for Qi stagnation
BA ZHENG TANG, BI XIE FENG QING YIN, ZHI BO DI HUANG WAN

TT: Separate Clear and Turbid, and Water Passages
Du-20
For sinking of Qi (frequent
CHRONIC URINARY
urination, bearing-down sensation,
PROBLEM FROM QI
occasional, slight incontinence)
SINKING
Ren Mai (LU-7 and KI-6)

plus Du-20 for sinking of
LU-7 Qi and Ren-4.
Woman: LU-7 on right, KI-6 on

left. Reverse in a man
KI-6
CHRONIC URINARY
PROBLEM FROM QI
STAGNATION
Du-26
For stagnation of Qi
(frequent urination,
hypogastric distension,
slight pain before Ren Mai (LU-7 and KI-6)
urination, irritability) plus Du-26 for Qi
stagnation and Ren-3
LU-7
Woman: LU-7 on right, KI-6 on

left. Reverse in a man
KI-6
Du-20
For sinking of Qi (frequent
CHRONIC URINARY
urination, bearing-down sensation,
PROBLEM FROM QI
occasional, slight incontinence)
SINKING and
PRONOUNCED KI-
YANG DEFICIENCY
IN A WOMAN
Ren Mai (LU-7 and KI-6)

plus Du-20 and Ren-4
SI-3 LU-7
SI-3 right, BL-62 left,

LU-7 left, KI-6 right.
KI-6 BL-62
(iii). CHRONIC INTERNAL DAMPNESS IN INTESTINES
Loose stools, without smell, abdominal fullness and pain, a feeling of
heaviness, tongue with a sticky-thick-white coating, pulse Slippery or
Wiry on both Chi.
If associated with Heat: smelly stools, burning in the anus on defecation,

sticky-yellow coating with red spots on the root of the tongue, pulse
Slippery and Rapid, especially on both chi positions.
NOTE
In problems of the Intestines, in my experience, it is nearly always impossible to
distinguish between Small and Large Intestine pathology and, in most cases, they
are both involved. For this reason, the pulse in Dampness in the Intestines is Wiry
and/or Slippery on both Chi positions.
CUN
GUAN
BOTH CHI SLIPPERY

CHI AND/OR WIRY
Treatment principle
Drain Dampness, stop diarrhoea.
Acupuncture
-BL-22 and SP-9 to drain Dampness from the Lower Burner.
-ST-25 and BL-25 to regulate the Intestines and stop diarrhoea.
-Ren-12 and BL-20 to tonify the Spleen to resolve Dampness and to restore
the ascending of Spleen-Qi.
- ST-37 and ST-39 to drain Dampness from the Intestines and stop diarrhoea
and pain.
BAI TOU WENG TANG. TT Smooth Passage

(iv). CHRONIC INTERNAL DAMPNESS IN UTERUS
Excessive vaginal discharge, candidiasis infections, infertility, delayed
periods, painful periods, a feeling of heaviness in the lower abdomen,
sticky coating on the root of the tongue, Slippery pulse

(especially on the uterus position on the left chi
position).
Treatment principle
Regulate the Uterus, drain Dampness.
Acupuncture
-Ren Mai (LU-7 right and KI-6 left) and Ren-4 to regulate the Uterus.
-Ren-3, ST-28, BL-53 and BL-22 to drain Dampness from the Uterus.
QING RE TIAO XUE TANG (for Damp-Heat)

QI GONG WAN (for Damp-Phlegm)
DAMP-PHLEGM IN THE UTERUS
Leucorrhoea
Tongue swollen and pale with sticky coating at the root
Tendency to obesity
Fullness and heaviness of the abdomen
Pulse Slippery
Mid-cycle problems (slight pain, heaviness, bleeding)
Treatment:
During phase 3-4
Acupoints: ST-28, KI-14, Ren-5, BL-22, Zigong, ST-40, Ren-3, SP-9
FORMULA FOR DAMP-PHLEGM IN THE UTERUS
QI GONG WAN Arousing the Uterus Pill
Ban Xia Rhizoma Pinelliae ternatae 6g

Cang Zhu Rhizoma Atractylodis lanceae 6g
Chen Pi Pericarpium Citri reticulatae 3g
Fu Ling Sclerotium Poriae cocos 6g
Xiang Fu Rhizoma Cyperi rotundi 6g
Shen Qu Massa Fermentata Medicinalis 6g
Chuan Xiong Radix Ligustici Chuanxiong 4.5g
(v). CHRONIC INTERNAL DAMPNESS IN GALL-BLADDER
Hypochondrial pain, fullness and heaviness, a sticky
taste, sticky tongue coating on one side, Slippery and
Wiry pulse.
If with Heat: a bitter taste, thirst but no desire to drink, yellow tongue
coating, Slippery and Rapid pulse.
DAMPNESS IN GALL-BLADDER
Treatment principle
Drain Dampness, regulate the Gall-Bladder, move Qi.
Acupuncture
-G.B.-34 to regulate the Gall-Bladder and resolve Dampness.
-BL-19 and G.B.-24 to regulate the Gall-Bladder.
YIN CHEN HAO TANG

2. CHRONIC INTERNAL DAMPNESS IN THE CHANNELS
Chronic retention of Dampness in the channels and joints is the main cause of
chronic Damp Bi syndrome.
Bi Syndrome is a pathology that involves many structures and channels:
Muscle channels The Cou Li space (space

(Jing Jin) between skin and
muscles)
The joints (as The Luo channels (Superficial

energetic centre of first, then proper Luo, then
entering/exiting of Qi Blood Luo)
and convergence of
Qi) Write text here to point to disease at
the end
3. CHRONIC INTERNAL DAMPNESS IN THE SKIN
Chronic retention of Dampness in the skin is the main cause of

numerous skin diseases, chiefly eczema (atopic or not).
The main manifestations of skin diseases from chronic Dampness are:
• Lesions with exudate, papules,

vesicles
• Puffy skin
• Feeling of heaviness
• Localized itchiness
Papules Papules
Vesicles Pustules Papules

PRESCRIPTIONS FOR DAMP-HEAT IN THE SKIN
Prescription
BI XIE SHEN SHI TANG
Dioscorea Draining Dampness Decoction
Explanation
This formula drains Damp Heat from the Lower Burner and the skin.
Prescription
CHU SHI WEI LING TANG
Eliminating Dampness Stomach [Ling] Decoction
Explanation
This formula drains Damp Heat and clears Heat. Compared to the
previous formula, the emphasis is slightly more on Heat and on Dampness.
Prescription
QING RE SHEN SHI TANG
Clearing Heat and Draining Dampness Decoction
Explanation
This formula drains Damp Heat, clears Heat, cools Blood and expels Toxic
Heat.
BI XIE SHEN CHU SHI WEI QING RE SHEN

SHI TANG LING TANG SHI TANG
ACTION Drain Damp-Heat Drain Damp-Heat Drain Damp-Heat

via urine via urine and and resolve Toxic
relieve epigastric Heat
fullness
SKIN Moist-red skin Moist-red skin Pustular-red skin

lesions lesions, eczema lesions
more on legs
Prescription
SAN FENG CHU SHI TANG
Scattering Wind and Eliminating Dampness Decoction
Explanation
This formula is for chronic eczema from Damp Heat with dark lesions usually in a
limited area oozing fluid and with a thick-rough skin.
4. ACUTE INTERNAL DAMPNESS
(i) DAMP HEAT AT QI LEVEL
Acute, internal Dampness is Damp-Heat at the Qi

level in the context of Four Level Differentiation in
Wen Bing diseases. By definition, this must be Damp-
Heat.
Continuous fever which decreases with (but is not eliminated by) sweating then
starts again, a feeling of heaviness of the body and head, irritability, thirst but no
desire to drink, a feeling of oppression of the chest, epigastrium and abdomen,
nausea, loose stools, smelly stools,
Tongue: yellow-sticky coating on the root,

Pulse: Slippery and Rapid pulse.
Treatment principle
Drain Dampness, harmonize the Stomach, restore the ascending and descending of
Spleen-Qi and Stomach-Qi.
Acupuncture
-L.I.-11 to resolve Damp-Heat.
-BL-22, SP-9 and SP-6 to drain Damp-Heat.
-Ren-11, Ren-9 and ST-22 to resolve Dampness and harmonize the Stomach.
LIAN PO YIN – Ease the Muscles

9. DAMP-HEAT
Damp-Heat should be discussed separately because it is such a

common pathogenic factor that can be the cause of a very wide
variety of problems. However, it is also true to say that, in China and
Chinese books and journals, Damp-Heat is slightly exaggerated in its
importance.
For example, in China, every urinary problem is considered to be due

to Damp-Heat, whereas we also see a lot of urinary problems with
Dampness but without Heat, and a lot of urinary problems caused by
Qi stagnation or Qi sinking.
Similarly, any Gall-Bladder problem will always be attributed to Gall-

Bladder Damp-Heat, whereas in the West we see a lot of patients with
Gall-Bladder problems and Dampness but not much Heat.
Damp-Heat is particularly important as a pathogenic factor because it itself can
become a cause of disease. In fact, not only Dampness obstructs the Qi mechanism
leading to more Dampness, but Heat also dries up the fluids and condenses them into
more Dampness. Furthermore, the Heat part of Damp-Heat (especially if
predominant) may also injure Yin.
QI
DAMP Impairs
MECHANISM DAMPNESS
HEAT FLUIDS
Dries up
Injure
YIN “Hot Dampness” would be a
better name for it
INTERNAL
Diet
Excessive consumption of greasy foods, dairy foods, fats, and sweets. Greasy,
fried foods, specifically, may lead to Damp-Heat, especially when combined also
with excessive alcohol consumption.
Work
Excessive physical work (including sports, exercises, lifting, gym aerobics,
etc.) can weaken the Spleen and lead to Dampness.
Internal injury of Spleen
Weakness of the Spleen deriving from a chronic illness.
EXTERNAL
Seasonal
External Damp-Heat is more predominant in summer and late summer, and
specifically from the “Great Heat” period (of the 24 periods of a year) to the
“White Dew” period, i.e. roughly two months before the Autumn equinox.
Prevailing Qi of the place

The former is a heavenly exterior factor, this is an earthly exterior factor. This is
due to prevailing conditions of a place, i.e. a low-lying, damp place, a place prone
to fogs, damp living conditions in the house, etc.
CONSTITUTIONAL
A constitutional weakness of the Earth element predisposes the patient to Spleen

deficiency and Dampness.
On the other hand, a constitutional tendency to a Fullness of the Earth (for

example, people with a constitutional tendency to Stomach-Heat) may lead to
Heat in the Stomach and Spleen which combines with Dampness.
CHARACTERISTICS OF DAMP-HEAT
1) Seasonal character
Prevalent in summer and late summer, even in countries that are not that hot in the
summer such as England (because it is damp).
The seasonal Damp-Heat also exacerbates a pre-

existing internal condition of Damp-Heat (e.g.
urinary problems, Gall-Bladder problems, Wei
syndrome, MS, intestinal problems, etc.).
2) Lingering, long course of disease Dampness

Damp-Heat is lingering. The Heat part of Damp-Heat
also perpetuates the problem as Heat condenses the
body fluids into Dampness.
Heat
3) Gives rise to Phlegm
Damp-Heat easily gives rise to Phlegm
and Phlegm-Heat because the Heat in
Damp-Heat can condense the body fluids
into Phlegm.
4) Manifests with complex symptoms

Due to the combination of Dampness and Heat which may give rise to contradicting
symptoms and signs. For example, the patient may feel hot (from Heat) but the skin
may be cold to the touch, or he may have cold feet. Or the patient may feel cold in
general, but he may also get hot easily. There may be a feeling of heat but the pulse
is not rapid or vice versa. There may be a thirst (because of the Heat) but with no
desire to drink (because of the Dampness). The bowels may be sometimes loose
(from Dampness) and sometimes dry (from Heat).
CHARACTERISTICS OF DAMP-HEAT
5) Damp-Heat may injure Yin

The Heat part of Damp-Heat, if predominant, may injure Yin:
this leads to even more complex clinical manifestations, e.g.
the patient has obvious symptoms of Damp-Heat but the
tongue has no coating.
6) Damp-Heat is frequently toxic (Toxic Heat)

In the context of Wen Bing diseases, external Damp-Heat becomes interior (at
the Qi level) and easily gives rise to Toxic Heat (the symptoms of which are
indeed similar to Damp-Heat).
7) Damp-Heat easily damages Stomach and Spleen

Of course, Dampness by itself also damages Stomach and Spleen but Damp-Heat
even more because Dampness tends to injure the Spleen while Heat tends to injure
the Qi and Yin of the Stomach.
Low-grade fever, feeling of heat, body hot to touch, greasy skin, sticky taste,
weariness, ache in muscles, night-sweating, thirst with no desire to drink, poor
appetite, a feeling of oppression of the epigastrium, a feeling of heaviness of
body and head, scanty-dark urine, turbid urine, loose-smelly stools, nausea,
vomiting, abdominal distension, afternoon fever (rare)
Papular or pustular skin eruptions (the former
indicating predominance of Heat and the latter
predominance of Dampness)
oozing skin eruptions, swollen-

painful eyes, sties on eyelids
Damp-Heat Toxic-Heat
oozing eyes, mouth ulcers, sticky-

yellow coating, red sides of tongue,
pulse Slippery or Weak-Floating and
Rapid.
Prevalence of Dampness Prevalence of Heat
Fever, feeling of heat, greasy sweat, greasy skin More fever or feeling of heat, skin not
greasy
Face pale-yellow Face red
Feeling of heaviness of eyes and head Slightly red eyes, dizziness, headache
Sweet-sticky taste, no thirst, likes warm drinks Bitter taste, no desire to drink
Weariness, likes to lie down, feeling of oppression Irritability, insomnia

of the chest, likes to be quiet, no irritability
Poor Appetite Hungry but no desire to eat
Stools with mucus or watery, turbid urine Constipation, scanty-dark urine
Sticky-white or sticky-yellow tongue coating Red tongue-body, or red sides, sticky-

dry-yellow coating
Pulse Slow, Weak-Floating Pulse Rapid and weak-Floating or Rapid

and Wiry
TREATMENT METHODS FOR DAMP-HEAT
1) Drain and resolve Dampness primarily and clear Heat secondarily
This method is used when Dampness predominates over Heat. One can use any
of the methods outlined above in the treatment of Dampness.
2) Clear Heat primarily and resolve Dampness secondarily

This is used when Heat predominates over Dampness. Of course, there are
herbs that do both such as:
Huang Qin Huang Lian Huang Bo
3) Resolve Dampness and clear Heat

This used when Dampness and Heat are more or less equal in strength.
TREATMENT ACCORDING TO LOCATION
UPPER BURNER
Treat the Lungs. Restore the diffusing and descending of Lung-Qi with use of
fragrant herbs that resolve Dampness via sweating:
Huo Xiang Pei Lan
bitter-cold herbs to dry Dampness and clear Heat:

Huang Qin
TREATMENT ACCORDING TO LOCATION
Herbs that restore the diffusing and descending of Lung-Qi:

Xing Ren Zi Su Ye
Acupuncture
-LU-7, L.I.-4, BL-13, L.I.-6, TB-6, Du-26.
MIDDLE BURNER
Treat by stimulating the Spleen to resolve Dampness with fragrant

herbs: Cang Zhu
Huo Xiang Hou Po
Together with bitter-cold herbs to dry Dampness and clear

Heat:
Huang Lian
Damp-Heat in the Middle burner is often cleared by using the method of

“opening with pungent herbs and making descend with bitter herbs”: (in
Chinese xin kai, ku jiang 辛开苦降 )
MIDDLE BURNER
Pungent herbs “open” the Water Passages facilitating the expulsion of Dampness:
this is essential for Dampness to be expelled:
Huo Xiang Pei Lan
Bitter (and cold) herbs make Qi descend and this facilitate the transformation
of Dampness while their cold nature clears Heat. The bitter taste will also
help Stomach-Qi to descend.
Lian Po Yin (page 189) (Ease the Muscles)
San Ren Tang (page 186)
Huo Po Xia Ling Tang (page 187) (Drain Fields)
Huo Xiang Zheng Qi San (page 183)
Yi Jia Jian Zheng Qi San (page 184).
Acupuncture
Ren-12, BL-20, Ren-11, Ren-9, ST-22, Ren-10.
LOWER BURNER
For Damp-Heat in the Lower Burner combine bitter-cold herbs

that dry Dampness and clear Heat.
Huang Bo
Bland-neutral herbs that drain Dampness by promoting

diuresis, particularly the cool ones
Yi Yi Ren Ze Xie
Tong Cao Che Qian Zi

LOWER BURNER
One or two pungent-fragrant herbs to “open” the Water

passages:
Cang
Zhu
Example: Cao Guo Yin Chen Tang which has Fu Ling Pi, Zhu Ling and Ze
Xie to drain Dampness via urination, but also Chen Pi, Da Fu Pi, Hou Po and
Cao Guo, all fragrant-pungent herbs to open the Water Passages.
Acupuncture
-Ren-12 and BL-20 to strengthen the Spleen to resolve Dampness.
-BL-22 to stimulate the Lower Burner’s excretion of fluids.
-Ren-10 and Ren-9 to stimulate the descending of Stomach-Qi and promote
fluids transformation.
-L.I.-11 if the Heat within Damp-Heat is strong.
-Ren-3 to stimulate the Bladder’s function of Qi transformation.
-ST-27 and ST-28 to promote the excretion of fluids in the Lower Burner and
regulate the Intestines.
-Damp-Heat in the Uterus use Ren-3, BL-53, ST-28, SP-9.
DAMP-HEAT IN THE INTESTINES
Abdominal pain, loose stools, possibly with mucus (Dampness) and blood (Heat),
offensive odour, explosive diarrhoea, feeling of fullness and heaviness in the
abdomen. Tongue: sticky-yellow coating with red spots on root. Pulse: Slippery
and/or Wiry on both Chi positions.
BAI TOU WENG TANG Variation

SP-4 and P-6, ST-25, BL-25, BL-27, ST-37, ST-39, SP-9, Ren-9, Ren-5. BL-22.
10. SINUSITIS
The ancient disease category Bi Yuan broadly corresponds to sinusitis as

Bi Yuan manifests with purulent nasal discharge.
It is important to distinguish the Chinese disease of Bi Yuan from Bi Jiu

which is allergic rhinitis.
BI YAN 鼻炎 BI YUAN 鼻渊 “Nose Pool”

“Nose inflammation” Ancient term for purulent nasal discharge =
sinusitis
Modern term for rhinitis
Modern Chinese books mistakenly use this
term for rhinitis
3
BI JIU 鼻究 NAO LOU 脑漏 “Brain trickling”

Ancient term for profuse, Ancient term for purulent nasal discharge =
white, watery nasal discharge sinusitis
= allergic rhinitis
The main symptoms of sinusitis are a purulent, yellow nasal
discharge from the front and the back of the nose (into the throat), a
stuffed nose, a frontal headache, facial pain and a feeling of
muzziness and heaviness of the head. There may be local tenderness
over the maxillary or frontal sinuses. The area affected by sinusitis is
a Yang Ming area i.e. Stomach and Large Intestine.
STOMACH AND SPLEEN DAMP-HEAT
Sticky-yellow nasal discharge, red cheeks, thirst, dry lips, impaired sense of
smell, a feeling of heaviness and muzziness of the head, a frontal headache,
a sticky taste, a feeling of oppression of the chest and epigastrium.
Tongue: sticky-yellow coating in the centre.
Pulse: Slippery.
Treatment principle
Clear Heat, resolve Dampness, harmonize the Stomach, tonify the Spleen.
Acupuncture
Tonify the Stomach: Ren-12 Zhongwan, BL-20 Pishu, ST-36 Zusanli
Resolve Dampness: Ren-9 Shuifen, SP-9 Yinlingquan, BL-22 Sanjiaoshu
Clear Heat: L.I.-11 Quchi, L.I.-4 Hegu, ST-44 Neiting
Local point: Bitong.
Even method, except on the first two points which should be reinforced.
BIAO BEN
DAMPNESS • ST-SP XU
• LU-QI XU
• KI-YANG XU
DISTAL
• ST-36, SP-3, Ren-12, BL-20
• L.I.-4 Hegu
• LU-7, LU-9, BL-13
• L.I.-11 Quchi
• KI-3, KI-7, Ren-4, BL-23
• LU-7 Lieque
LOCAL
• Bitong
L.I.-20 Yingxiang
• Du-23 Shangxing
• ST-8 Touwei
• G.B.-13 Benshen
Herbal treatment
Prescription
CANG ER BI DOU YAN FANG
Xanthium Sinusitis Formula
Cang Er Zi Fructus Xanthii 9g

Huang Qin Radix Scutellariae baicalensis 9g
Pu Gong Ying Herba Taraxaci mongolici cum radice 6g
Ge Gen Radix Puerariae 9g
Jie Geng Radix Platycodi grandiflori 6g
Bai Zhi Radix Angelicae dahuricae 3g
Che Qian Zi Semen Plantaginis 9g
Gan Cao Radix Glycyrrhizae uralensis 3g
STOMACH AND SPLEEN TOXIC HEAT
Sticky-yellow and bloody nasal discharge, swollen cheeks, thirst, impaired
sense of smell, a feeling of heaviness and muzziness of the head, a frontal
headache, a sticky taste, a feeling of oppression of the chest and
epigastrium.
Tongue: sticky-dark yellow coating in the centre, red points.
Pulse: Slippery.
Treatment principle
Clear Heat, resolve Toxin, resolve Dampness
Acupuncture
Resolve Dampness: Ren-9 Shuifen, SP-9 Yinlingquan, BL-22 Sanjiaoshu
Clear Heat: L.I.-4 Hegu, ST-44 Neiting
Resolve Toxin: ST-40 Fenglong, L.I.-11 Quchi
Local point: Bitong.
Herbal treatment
Prescription
Empirical prescription by Dr. Hu Zhao Ming
Pu Gong Ying Herba Taraxaci mongolici cum radice

Ju Hua Flos Chrysanthemi
Huang Qin Radix Scutellariae baicalensis
Yu Xing Cao Herba cum Radice Houttuyniae Cordatae
Bai Jiang Cao Herba Patriniae
Ban Lan Geng Radix Isatidis
Bai Zhi Radix Angelicae dahuricae
Cang Er Zi Fructus Xanthii
Man Jing Zi Fructus Viticis
Chi Shao Radix Paeoniae Rubra
Chuan Xiong Rhizoma Ligustici
Jie Geng Radix Platycodi grandiflori
Can Cao Radix Glycyrrhizae uralensis
11. CHRONIC FATIGUE SYNDROME AND FIBROMYALGIA
Chronic Fatigue Syndrome and Fibromyalgia are different

diseases but they do have something in common from the
perspective of Chinese medicine. The root cause (Ben) of both
these diseases Spleen deficiency while the manifestation
(Biao) is always Dampness retained in the Cou Li space.
Because of the retention of Dampness in the Cou Li space the

main manifestations of these two diseases are a heaviness of
the limbs and a muscle ache.
COU LI 腠理
“space”, “cavity”
COU 腠 =
“texture” or “pattern”,
LI 理 = similar to the “veins” and
“grain” of wood
Jin Gui Yao Lue:
“Cou is the space of the Triple Burner where the Yuan Qi and Zhen Qi
converge, filled by Qi and Blood; Li is the pattern of the Zangfu”.
THE COU LI 腠理
ZANGFU COULI
Zhen Qi Wei Qi
TRIPLE
BURNER
Yuan Qi
Pores (“Qi holes”)
Entering
SKIN
(LU)
Sweat glands
QI
(LU)
SPACE BETWEEN
SKIN AND
MUSCLES (COU LI)
Exiting
MUSCLES
Cou Li
closed: no
invasion
Cou Li
External open:
pathogenic invasion of
factors Wind
Cou Li
“too”closed:
fever from
invasion of
Cold
A. POST-VIRAL FATIGUE SYNDROME
“TRUE” POST-VIRAL FATIGUE NOT “TRUE” POST-VIRAL FATIGUE

SYNDROME SYNDROME
• Chronic fatigue • Chronic fatigue, but following a

definite, frank, acute infection episode
• Drastic changes in brain activity
• Not so many changes in brain activity
• Pronounced muscle ache
• Muscle ache absent or mild
• Recurrent flu-like feeling, sore
throat, swollen glands • No flu-like feeling
= Persistent, chronic viral infection = Purely a residual pathogenic factor

together with a Zheng Qi deficiency but
no evidence of a viral infection
Patterns and treatment are similar but prognosis is different as “true” PVFS will
take much longer to treat
DAMPNESS IN THE MUSCLES
Lassitude, tiredness on exertion, muscle fatigue on slight exertion,

muscle ache, a feeling of heaviness of the limbs, desire to lie down.
Slippery or Soggy pulse.
Ren-12, Ren-9, ST-25, ST-36, ST-31, LI-10, LI-14, SP-9, KI-7, SP-6.
1. DAMP-HEAT IN THE MUSCLES
Key symptoms and signs: aches in the muscles, tiredness and
sleepiness, feeling of heaviness, muzzy head, sticky-yellow tongue
coat, Slippery pulse.
Prescription: Lian Po Yin
Three Treasures remedy: Ease the Muscles
2. DAMPNESS IN THE MUSCLES (WITHOUT HEAT)

Key symptoms and signs: feeling of oppression in the epigastrium,
muzziness of the head, heaviness, tiredness, loose stools, aching
muscles, tongue with a sticky-white coating, Slippery and Weak pulse.
Prescription: Huo Po Xia Ling Tang
Three Treasures remedy: Drain Fields
3. QI DEFICIENCY WITH RESIDUAL DAMP-HEAT IN THE

MUSCLES
Key symptoms and signs: exhaustion, depression, dizziness, poor
memory, slight muscle ache, Pale tongue with teethmarks and Weak
pulse.
Prescription: Bu Zhong Yi Qi Tang
Three Treasures remedy: Tonify Qi and Ease the Muscles.
FULL AND EMPTY MANIFESTATIONS OF POST-VIRAL FATIGUE
SYNDROME
FULL EMPTY
• Muscle ache intense • Muscle ache slight
• Thick tongue coating • Tongue coating thin
• Full pulse • Pulse Empty
• Remedy: Lian Po Yin (Damp- • Remedy: Bu Zhong Yi Qi Tang
Heat) or Huo Po Xia Ling
Tang (Dampness)
FREQUENTLY-USED FORMULAE
FULL PATTERNS EMPTY PATTERNS

GONG XIE 功邪 BU ZHENG 补正
• Lian Po Yin (Ease the Muscles) for • Bu Zhong Yi Qi Tang for Qi
Damp-Heat deficiency and Yin Fire
• Gan Lu Xiao Du Wan for Damp- • Liu Jun Zi Tang for Spleen-Qi
Heat deficiency
• Huo Po Xia Ling Tang (Drain • Shen Ling Bai Zhu Tang for Stomach-
Fields) for Dampness and Spleen-Qi deficiency with
Dampness
• Si Miao San for Damp-Heat
• You Gui Wan for Kidney-Yang
• Xiao Chai Hu Tang for Shao Yang
deficiency
Pattern
• Zuo Gui Wan for Kidney-Yin
• Hao Qin Qing Dan Tang for Shao
deficiency
Yang Pattern with prevalence of Heat
and some Phlegm
LIAN PO YIN
Coptis-Magnolia Decoction
Huang Lian Rhizoma Coptidis 3 g

Hou Po Cortex Magnoliae officinalis 3 g
Shan Zhi Zi Fructus Gardeniae 9 g
Dan Dou Chi Semen Sojae preparatum 9 g
Shi Chang Pu Rhizoma Acori tatarinowii 3 g
Ban Xia Rhizoma Pinelliae preparatum 3 g
Lu Gen Rhizoma Phragmitis 15 g
GAN LU XIAO DU WAN
Sweet Dew Dissolving Toxin Pill
Lian Qiao Fructus Forsythiae 6 g

Huang Qin Radix Scutellariae 6 g
Bo He Herba Menthae haplocalycis 6 g
She Gan Rhizoma Belmacandae 6 g
Chuan Bei Mu Bulbus Fritillariae cirrhosae 12 g
Hua Shi Talcum 9 g
Mu Tong Caulis Mutong 3 g
Yin Chen Hao Herba Artemisiae scopariae 6 g
Huo Xiang Herba Pogostemonis 9 g
Shi Chang Pu Rhizoma Acori tatarinowii 6 g
Bai Dou Kou Fructus Amomi rotundus 6 g
HUO PO XIA LING TANG
Pogostemon-Magnolia-Pinellia-Poria Decoction
Huo Xiang Herba Pogostemonis 6 g

Bai Dou Kou Fructus Amomi rotundus 2 g
Fu Ling Poria 9 g
Zhu Ling Polyporus 4.5 g
Yi Yi Ren Semen Coicis 12 g
Ze Xie Rhizoma Alismatis 4.5 g
Ban Xia Rhizoma Pinelliae preparatum 4.5 g
Dan Dou Chi Semen Sojae preparatum 9 g
Xing Ren Semen Armeniacae 9 g
HAO QIN QING DAN TANG
Artemisia apiacea-Scutellaria Clearing the Gall Bladder
Decoction
Qing Hao Herba Artemisiae annuae 6 g

Zhu Ru Caulis Bambusae in Taeniam 9 g
Ban Xia Rhizoma Pinelliae preparatum 5 g
Chen Pi Pericarpium Citri reticulatae 5 g
Zhi Ke Fructus Aurantii 5 g
Fu Ling Poria 9 g
Hua Shi Talcum 3 g
Gan Cao Radix Glycyrrhizae uralensis 3 g
Qing Dai Indigo naturalis 3 g
B. FIBROMYALGIA
AETIOLOGY (in Western Medicine)
Pain
Lack of
Fatigue Hormonal
Depression changes
fitness
Insomnia
Physical
Trauma Smoking
Emotional Inappropriate
trauma exercise/ poor
posture
CLINICAL MANIFESTATIONS
• Generalized muscle ache

• Muscles stiffness
• Fatigue
• Tenderness
• Sleep disturbance
• Post-exertional malaise
• Headaches
• Feeling of swelling in limbs
• Numbness and tingling
• Cognitive impairment
• Dizziness
Diagnosis of Fibromyalgia
The combination of pain and other symptoms usually leads to an extensive

course of investigations which, in cases of fibromyalgia, are nearly always
normal. There are no blood tests or x-rays which show abnormalities
diagnostic of FMS. A diagnosis is based on taking a careful history and the
finding of tender areas in specific areas of muscle. These locations (called
"tender points" or "trigger points") are tender on palpation and often feel
somewhat hardened if the muscle is stroked. Frequently, pressure over one
of these areas will cause pain in a more peripheral distribution.
To meet the diagnostic criteria, patients must have the following:

•widespread pain in all four quadrants of the body for a minimum of 6
months
•at least 11 of the 18 specified tender points (these 18 sites used for
diagnosis cluster around the neck, shoulder, chest, hip, knee and elbow
regions, see figure below).
DIAGNOSIS
Tender points in fibromyalgia (at least 11 of these 18 points

should be tender to diagnose fibromyalgia)
Large
Intestine
Muscle
channel
Gall-
Bladder Bladder
Muscle Muscle
channel channel
Trigger points/areas in black. Referred-pain areas shaded.

MYOFASCIAL PAIN
SYNDROME
DAMPNESS FIBROMYALGIA XU
POST-VIRAL FATIGUE
• pain SYNDROME • fatigue
• tension headaches or • anxiety and depression
migraines • sleep disturbances
• post-exertional malaise and •dizziness
muscle pain • restless leg syndrome
• morning stiffness
• jaw pain
• irritable bladder syndrome
• cold intolerance Others: Cold, Qi stagnation,
Blood stasis
INCIDENCE OF XU CONDITION IN MYOFASCIAL PAIN SYNDROME,
FIBROMYALGIA AND POST-VIRAL FATIGUE SYNDROME
Dampness Dampness
XU XU
XU Dampness
Myofascial Pain Syndrome Fibromyalgia Post-viral fatigue

syndrome
Note: Dampness can also obviously occur in differing degrees

DIFFERENTIATION AND TREATMENT
FULL DAMPNESS
Pronounced ache in the muscles that is worse after exposure to damp weather, feeling
of heaviness, numbness of the limbs, listlessness.
Tongue: thick-sticky coating. Pulse: Slippery
Treatment principle
Fragrantly resolve Dampness, move Qi.
DAMPNESS WITH UNDERLYING QI DEFICIENCY

Dull ache in the muscles that is aggravated by exertion, feeling of heaviness,
listlessness, tiredness, poor appetite, loose stools, weak voice, propensity to catching
colds, depression, insomnia.
Tongue: Pale with a thin-sticky coating.
Pulse: Soggy.
Treatment principle
Fragrantly resolve Dampness, tonify Qi, nourish Blood.
FORMULAE FOR PATTERNS
1) DAMPNESS: Huo Po Xia Ling Tang (Drain Fields) or Lian Po Yin (Ease the
Muscles) if there is Heat.
2) DAMPNESS WITH QI XU: above formulae plus Bai Zhu, Huang Qi
3) QI XU WITH SOME DAMPNESS: Bu Zhong Yi Qi Tang plus Sha Ren,
Cang Zhu, Pei Lan, etc. (Tonify Qi and Ease the Muscles)
4) QI STAGNATION: Chai Hu Shu Gan Tang (Break into a Smile)
5) QI STAGNATION WITH DAMPNESS: Chai Hu Shu Gan Tang with
variations (Cang Zhu, Sha Ren, etc) or plus Huo Po Xia Ling Tang
6) BLOOD STASIS with DAMPNESS: Huo Luo Xiao Ling Tang plus Sha Ren,
Cang Zhu, Pei Lan, etc.
DAMPNESS IN THE COU LI SPACE IN CHRONIC FATIGUE
SYNDROME AND FIBROMYALGIA
A major feature of both fibromyalgia and chronic fatigue syndrome is

the retention of Dampness in the Cou Li space. Although Cou refers to
ALL cavities of the Triple Burner, the space between the skin and
muscles (only ONE of the spaces) is always called the Cou Li.
This space should NOT be interpreted in a literal, Western, anatomical
sense. It is not literally the space between skin and muscles but an
ENERGETIC superficial space on the surface of the body. It is also the
space occupied by the Luo area.
There are also degrees of depth within the Cou Li. On the superficial
layers just below the skin there are smaller Connecting channels
called Minute (Sun) and Superficial (Fu) Connecting channels
Within the space between the Main channels and the skin that is occupied by
the Luo channels there are also, however degrees of depth. On the superficial
layers just below the skin there are smaller Luo channels called Minute (Sun)
and Superficial (Fu) Luo channels.
The main branches of the Luo channels are called bie, i.e. “divergent” (the
same character as that used for “Divergent” channels).
The main symptoms of Dampness in the Cou Li space are:
-Muscle ache
-Feeling of heaviness of the muscles
-Tingling and/or numbness
The herbs that resolve Dampness from the Cou Li space are the herbs that
fragrantly resolve Dampness:
CANG ZHU
HOU PO
SHA REN
BAI DOU KOU
PEI LAN
CAO GUO
HUO XIANG
More connection between
Dampness and CFS
Copy some slides from CFS and

Fibromyalgia
12. MOUTH ULCERS
Recurrent aphthous ulceration of unknown aetiology is a common oral mucosa
disorder affecting 20% of the population. Oral ulceration is seen in gastrointestinal
disorders, such as Crohn’s disease, ulcerative colitis and coeliac disease in
approximately 10-20% of cases.
Other diseases associated with oral ulceration include lupus erythematosus

(systemic and discoid), Behçet’s disease, neutropenia and immunodeficiency
disorders. In Reiter’s disease, ulceration occurs in approximately 25-30% of
patients.
Ulceration may be associated with viral infection such as the herpes simplex virus.
Primary herpes simplex (usually type I but rarely type II) presents with fever and
widespread confluent painful ulcers. After resolution, the virus remains latent and
recurs as herpes labialis (“cold sores”).
Hand, foot and mouth disease and herpangina, due to a different Coxsackie A, or
rarely B, may also cause mouth ulcers.
Other viruses may also cause mouth ulcers. Herpes zoster and cytomegalovirus are
among many viruses that can produce mouth ulceration, usually during the acute
infective phase.
Ulceration of the mouth may also be associated with bacterial infection. Syphilis
and tuberculosis can rarely cause oral ulcerations and are seen mainly in
developing countries.
Finally, when treating mouth ulcers we should ascertain whether they are caused
by drugs. Certain drugs can cause oral lichenoid eruptions. They include
antimalarials, methyldopa, tolbutamide, penicillamine, gold salts and some
chemotherapy agents used in the treatment of cancer.
Ulceration of the mouth may also be a symptom of dermatological disorders.

These include erythema multiforme major, toxic epidermal necrolysis, lichen
planus, pemphigus vulgaris, bullous pemphigoid, 'epidermolysis bullosa' and
dermatitis herpetiformis.
Minor aphthous ulcers are the most common. They are less than 10 mm in
diameter, have a grey/white centre with a thin erythematous halo and heal within
14 days without scarring. Major aphthous ulcers are larger (more than 20 mm
diameter), often persist for weeks or months and heal with scarring. Various
nutritional deficiencies of iron, folic acid or vitamin B12 (with or without
gastrointestinal disorders) are occasionally found.
MOUTH ULCERS IN CHINESE MEDICINE
PATHOLOGY
Mouth ulcers are generally due to Heat which may be of three kinds: Full Heat,
Empty Heat from Yin deficiency, and Yin Fire. Occasionally, mouth ulcers in the
elderly may be due to Yang deficiency but these are rare. The main organs involved
are the Heart, Stomach, Spleen and Kidneys.
The “Source of Difficult Diseases” (Za Bing Yuan Liu, 1773) differentiates mouth
ulcers from Full and from Empty Heat clearly when it says: “Mouth ulcers are due
to Heat and we must differentiate Empty from Full Heat. In Empty Heat, the ulcers
are pale and rather shallow, the pulse is empty, there is worry, mental restlessness
and insomnia: use Si Wu Tang plus Zhi Mu Radix Anemarrhenae and Huang Bo
Cortex Phellodendri. In Full Heat, there is burning of the mouth, swollen tongue,
thirst, Full pulse, and Heart-Fire moves restlessly: use Liang Ge San.”1
-Full Heat: large, painful ulcers with a red, raised edge
-Empty Heat: ulcers with a whitish rim and less raised edges
-Yin Fire: pale-red ulcers with a whitish edge and somewhat less raised edges;
chronic and recurrent
-Toxic Heat: ulcers that are very painful, large, red with a yellow, festering centre
and markedly raised edges.
1. Cited in Li Zheng Quan 1992 A Practical Study of the Stomach and Spleen in Chinese Medicine (Shi Yong Zhong Yi
Pi Wei Xue [ch#]), Chongqing Publishing House, Chongqing, p. 375.
_______
• Ulcers inside the cheeks: Stomach and Spleen
• Ulcers on the gums: Stomach
• Ulcers on the tongue: Heart, Spleen and Kidneys
_____
• Full Heat: large, painful ulcers with a red, raised edge
• Empty Heat: ulcers with a whitish rim and less raised edges
• Yin Fire: pale-red ulcers with a whitish edge and somewhat less raised
edges; chronic and recurrent
• Toxic Heat: ulcers that are very painful, large, red with a yellow, festering
centre and markedly raised edges
Channels involved in mouth ulcers:

• Large Intestine Main channel
• Stomach Main channel
• Spleen Main channel
• Spleen Divergent channel
• Small Intestine Main channel
• Heart Connecting channel
• Kidneys Main channel
• Kidney Divergent channel
• Triple Burner Main channel
YIN FIRE
Before discussing the patterns and treatment, it is worth describing briefly the
pathology of Yin Fire. Yin Fire was described by Li Dong Yuan in the
famous classic “Discussion on Stomach and Spleen” (Pi Wei Lun).
He said that overwork and irregular diet weaken Qi of the Stomach and
Spleen and the Original Qi (Yuan Qi) which resides in the Lower Field of
Elixir (Dan Tian): here it shares a place with the (physiological) Minister
Fire. If the Minister Fire is stirred by overwork and emotional problems, it
becomes pathological, it “displaces” the Original Qi in the Lower Field of
Elixir and it rises upwards causing a low-grade fever or a feeling of heat
Li Dong Yuan called this pathological Minister Fire a “thief” of the Original Qi:
the Heat generated by the pathological Minister Fire (and the deficiency of the
Original Qi) is called “Yin Fire”: this is neither Full nor Empty Heat, although it is
more similar to the latter as it is a Fire that arises from Qi deficiency and
deficiency of the Original Qi.
Li Dong Yuan said that this Yin-Fire is not treated by clearing it with bitter-cold
herbs but by tonifying the Original Qi with sweet-warm herbs: as the Minister Fire
and the Original Qi share the same place, tonifying the Original Qi will
automatically displace and subdue the pathological Minister Fire.
The pathology of Yin Fire is, however, often more complex than the one described
above as it is frequently aggravated by the presence of Damp Heat in the Lower
Burner. Although Yin Fire arouses from the Lower Burner, its pathology is related
to the Middle Burner as well. When there is Spleen deficiency, Dampness is
formed and this infuses down to the Lower Burner. Here it “swamps” the Original
Qi and the physiological Minister Fire, displacing the latter from the place where
it should be “concealed” (the Lower Burner).1
1. Ancient Chinese books often say that the physiological Minister Fire performs its important function of warming all
the Internal Organs but it does so without being “seen”, i.e. it is “concealed”. When it is pathological it is “seen” and it
manifests with symptoms of Heat.
When the Middle Burner is obstructed by Dampness, Spleen-Qi (or even
Spleen-Yang) is deficient and fails to rise. For this reason, Bu Zhong Yi Qi
Tang Tonifying the Centre and Benefiting Qi Decoction is used to raise Spleen-
Qi and warm Spleen-Yang so that Dampness no longer infuses downwards to
the Lower Burner (Fig. 25.2). When the Lower Burner is opened and
unblocked from Dampness, the Minister Fire will return to its place of
concealment in the Lower Burner, thus eliminating the symptoms of Yin Fire.
The symptoms of Yin Fire are a low-grade fever or feeling of heat that is
aggravated by overwork, feeling of heat of the face, red face, feeling cold, cold
feet, mouth ulcers, dizziness, tiredness, depression, mental restlessness,
insomnia, muscular weakness, spontaneous sweating, shortness of breath, loose
stools, poor appetite, weak voice, headache, thirst, Pale tongue, Weak or Empty
pulse but which may be slightly Overflowing on the Front positions.
The clinical manifestations of Yin Fire may be explained as follows:
Spleen-Qi and/or Spleen-Yang deficiency: tiredness, depression,

muscular weakness, loose stools, poor appetite, Pale tongue,
Weak or Empty pulse
Spleen-Yang deficiency: feeling cold in general, cold feet
Yin Fire rising to the Upper Burner: low-grade fever or feeling of

heat above that is aggravated by overwork, feeling of heat of the
face, red face, mouth ulcers, dizziness, headache, thirst, Pulse
slightly Overflowing on the Front positions.
Yin Fire harassing the Mind: mental restlessness, insomnia
Lung-Qi deficiency: spontaneous sweating, shortness of breath,

weak voice
This type of fever (if there is one) is caused by a severe deficiency of Qi,
usually of the Spleen, Stomach and Lungs and a deficiency of the Original
Qi.
Yin Fire with its concomitant feeling of heat deriving from Qi and Blood
deficiency is very common nowadays and is frequently seen in chronic
cases of post-viral fatigue syndrome and modern auto-immune diseases,
such as lupus or rheumatoid arthritis.
The second chapter of Book Two of the “Discussion on Stomach and Spleen” (Pi Wei
Lun) by Li Dong Yuan says:
“Irregular diet and exposure to hot and cold climate injures the Stomach and Spleen.
When the Qi of the Stomach and Spleen declines, the Original Qi [Yuan Qi] becomes
deficient and the Fire of the Heart becomes excessive by itself. This Fire of the Heart is
a Yin Fire. It arises from the Lower Burner and it flows up to the Heart. The Heart does
not govern directly, but it is deputised by the Minister Fire. The Minister Fire is the
Fire of the Bao Luo [Dan Tian] in the Lower Burner and it is a thief of the Original Qi
[Yuan Qi]. This Fire and the Original Qi cannot occupy the same space, when one is
victorious, the other declines. When the Stomach and Spleen are deficient, their Qi
descends to the Kidneys and Yin Fire overcomes the Earth...as Yin Fire rebels upwards
there is breathlessness, mental restlessness, a feeling of heat, Overflowing and Big
pulse, headache, and thirst. The skin cannot tolerate Wind and Cold and there is
alternation of feeling of heat and of cold. The Qi of Stomach and Spleen infuses
downwards so that Food-Qi [Gu Qi] cannot rise and float...How to treat this
condition? One must treat it with pungent, sweet and warm herbs to tonify the Centre
and raise Yang together with some sweet and cold herbs to drain Fire. Exhaustion and
depletion should be treated with warm herbs: warm herbs can eliminate Heat. One
must not use bitter-cold herbs that would damage the Spleen and Stomach.”1
1. Jia Cheng Wen 2002 A Vernacular Explanation of the Discussion on Stomach and Spleen (Pi Wei Lun Bai
Hua Jie [ch#]), San Qin Publishing House, Xian, pp. 110-2. The Discussion on Stomach and Spleen (Pi Wei
Lun) was written by Lin Dong Yuan and first published in 1246.
Chapter 4 of Book Two of the “Discussion on Stomach and Spleen” explains
how Yin Fire affects the Heart and the Mind and why it causes mental
restlessness:
“When the Spleen and Stomach are deficient, their Qi cannot rise and float,
this is due to Yin Fire impairing the generation and diffusing of their Qi [of the
Stomach and Spleen]. The Nutritive Qi [Ying Qi] and Blood are greatly
depleted and the former subsides into the Lower Burner [in the Liver and
Kidneys]. Yin Fire is ablaze, boiling and Blood and Qi become more depleted.
The Heart and Pericardium govern Blood and when this is depleted, the Heart
loses nourishment: this makes the Heart chaotic and leads to mental
restlessness. The Heart feels bewildered, vexed, oppressed and restless. Clear
Qi cannot rise and turbid Qi cannot descend. Clear and turbid are mutually
implicated and being in chaos in the centre of the chest, Blood is rebellious
and in chaos throughout the body. One must use pungent, sweet and warm
herbs to generate Yang. As Yang in generated, Yin grows.”1
1. Ibid., p. 158.
Chapter 8 of Book Two of the “Discussion on Stomach and Spleen” further
elucidates the influence of the Stomach and Spleen on the Heart and Mind in
an interesting passage:
“Anger, indignation, sadness, worry, fear and fright can all deplete the
Original Qi. The blazing of Yin Fire is due to the stagnation in the Heart and
to the 7 emotions being out of control. The Heart is the residence of the Mind,
when the Emperor Heart is restless, it is transformed into [pathological]
Fire. Fire is a thief of the seven Shen [Ethereal Soul (Hun), Corporeal Soul
(Po), Intellect (Yi), Will-Power (Zhi), Mind (Shen), Essence (Jing) and
Wisdom (Zhi)]. When Yin Fire is victorious, Nutritive Qi [Ying Qi] cannot
nourish the Mind [Shen]. The Mind is not nourished, the Body Fluids do not
circulate and they cannot generate the blood vessels. The Mind of the Heart
is the True Qi [encompassing Gathering (Zong), Nutritive (Ying) and
Defensive (Wei) Qi] by another name. It is generated as long as it is supplied
with Blood and when Blood is generated, the vessels thrive. The vessels are
the abode of the Mind, if there is stagnation in the vessels, the seven shen
leave the body and, in consequence, there is nothing but Fire left in the
vessels.”1
1. Ibid., p. 184.
Chapter 2 of Book 3 of the “Discussion on Stomach and Spleen” discusses the
aetiology of Yin Fire: “Irregular diet and overwork may lead to spontaneous
sweating and frequent urination [due to] Yin Fire overwhelming Earth [Stomach
and Spleen] so that clear Qi is not generated, Yang Qi does not move and Yin and
Blood harbour Fire.”1
Other authors apart from Li Dong Yuan attribute the pathology of mouth ulcers to a
deficiency of the Stomach and Spleen. The “Essential Method of Dan Xi” (Dan Xi
Xin Fa, 1347) says: “In mouth ulcers, when the administration of cold herbs
produces no results it is due to the Middle Burner Earth being deficient and to Fire
rebelling upwards without control: use Li Zhong Wan.”2 The recommendation to
use Li Zhong Wan Regulating the Centre Pill confirms the use of sweet and warm
tonic herbs to tonify the Original Qi and displace Yin Fire, as Li Dong Yuan
recommends.
Another text says: “In mouth ulcers, the Upper Burner has Full Heat, the Middle
Burner is deficient and cold and the Lower Burner has Yin Fire.”3
1. Ibid., p. 212.
2. Cited in A Practical Study of the Stomach and Spleen in Chinese Medicine, p. 375.
3. Ibid., p. 375.
Overwork and irregular diet weaken Qi of the Stomach and Spleen and the Original Qi
(Yuan Qi) which resides in the Lower Field of Elixir (Dan Tian): here it shares a place with
the (physiological) Minister Fire. If the Minister Fire is stirred by overwork and emotional
problems, it becomes pathological, it “displaces” the Original Qi in the Lower Field of
Elixir and it rises upwards causing a low-grade fever or a feeling of heat
• Pathological Minister Fire is a “thief” of the Original Qi

• Yin Fire is not treated by clearing it with bitter-cold herbs but by tonifying the
Original Qi with sweet-warm herbs
• Aggravated by the presence of Damp Heat in the Lower Burner
• Dampness infuses down to the Lower Burner where it “swamps” the Original Qi
and the physiological Minister Fire, displacing the latter from the place where it
should be “concealed” (the Lower Burner)
• The symptoms of Yin Fire are a low-grade fever or feeling of heat that is
aggravated by overwork, feeling of heat of the face, red face, feeling cold, cold
feet, mouth ulcers, dizziness, tiredness, depression, mental restlessness, insomnia,
muscular weakness, spontaneous sweating, shortness of breath, loose stools, poor
appetite, weak voice, headache, thirst, Pale tongue, Weak or Empty pulse but
which may be slightly Overflowing on the Front positions
• The representative prescription to subdue Yin-Fire is Bu Zhong Yi Qi Tang
Tonifying the Centre and Benefiting Qi Decoction within which Ren Shen Radix
Ginseng tonifies the Original Qi
Points I use for Yin Fire: Ren-4 Guanyuan (main point), ST-36 Zusanli, SP-6
Sanyinjiao, Ren-12 Zhongwan, BL-20 Pishu and BL-21 Weishu
The representative prescription to subdue Yin-Fire is Bu Zhong Yi Qi Tang
Tonifying the Centre and Benefiting Qi Decoction within which Ren Shen
Radix Ginseng tonifies the Original Qi.
To treat Yin Fire with acupuncture I use Ren-4 Guanyuan (main point),
ST-36 Zusanli, SP-6 Sanyinjiao, Ren-12 Zhongwan, BL-20 Pishu and BL-
21 Weishu.
To treat Yin Fire when it causes emotional disturbance, I use the following
treatment principles and points:
- Tonify the Original Qi: Ren-4 Guanyuan.

- Tonify and raise Spleen-Qi: Ren-12 Zhongwan, Ren-6 Qihai, ST-36 Zusanli,
BL-20 Pishu.
- Calm the Mind: Du-24 Shenting, Du-19 Houding, Ren-15 Jiuwei, HE-5
Tongli.
- Clear Heat upwards: P-8 Laogong, P-7 Daling.
- Regulate the Triple Burner: T.B.-6 Zhigou, T.B.-5 Waiguan.
Damp Heat in Stomach and Spleen with Yin Fire
Sheng Di Huang Radix Rehmanniae 15g

Xuan Shen Radix Scrophulariae 12g
Mai Men Dong Radix Ophiopogonis 10g
Tian Hua Fen Radix Trichosanthis 12g
Zhi Mu Radix Anemarrhenae 10g
Jiang Can Bombyx batryticatus 10g
Huang Bo Cortex Phellodendri 10g
He Zi Rou Fructus Terminaliae chebulae 5g
Bai Can Hua Flos Rosae multiflorae 6g
13. PROSTATITIS
Damp Heat in Lower Burner
Damp Heat with Toxic Heat in Lower Burner
Damp Heat and turbidity in the Lower Burner, deficiency of Kidney-

Essence
CHRONIC PROSTATITIS IN WESTERN MEDICINE
Prostatitis is an inflammation of the prostate which may involve considerable
pain; in contrast, benign prostatic hyperplasia (BPH) may not involve any pain
at all. Prostatitis is fairly common in adult males and has been classified into
four types:
1. Acute bacterial prostatitis

2. Chronic bacterial prostatitis
3. Non-bacterial prostatitis
4. Prostatodynia (prostatic pain in the absence of active infection)
At most only 5% of all cases consist of either acute or chronic bacterial

prostatitis. Nonbacterial prostatitis comprises 64 % of cases and
prostatodynia makes up another 31 %.
Bacterial prostatitis is a relapsing infection which is difficult to treat. It

presents with perineal pain, recurrent epididymo-orchitis and prostatic
tenderness, with pus in expressed prostatic secretion. Treatment is given
for 4-6 weeks with drugs that penetrate the prostate, such as
trimethoprim or ciprofloxacin. Long-term low-dose treatment may be
required.
Acute bacterial prostatitis is the result of bacterial infection, usually E. coli, and
typically begins with the fever, chills and other symptoms which bacterial
infections bring on. Pain in the lower back and in the area between the scrotum
and the anus are typical. There is difficult and/or painful urination and increased
frequency of urination.
Acute prostatitis is most commonly found in young sexually active men, and this
may be the source of infection, especially if there are many different sexual
partners. Treatment includes antibiotics and is usually effective.
Chronic bacterial prostatitis can be related to failed treatment of acute prostatitis

or it may develop on its own. It involves frequently recurrent low-level infections
of the prostate which usually involve the same strain of bacteria. Symptoms
include frequent and painful urination and nocturia. Stones or calculi made up of
urinary components are often found in the prostatic ducts, which implies a reflux
of urine into these areas. Antibiotics fail as a treatment in cases of chronic
prostatitis because they cannot eliminate the bacteria which are found in these
stones, hence there is a constant source for reinfection present.
Another factor often found is a lack of zinc in prostatic fluid. Prostatic fluid is
continuously released and contains a potent antibacterial factor which includes
free zinc as the most active ingredient. Men with low levels of zinc in their
prostatic fluid seem especially prone to chronic prostatitis.
Non-bacterial prostatitis is the most common of the prostatic conditions. It is

characterized by an unusually high number and activity of inflammatory cells in
the prostate. The resulting inflammation resembles that found in chronic bacterial
prostatitis, but there is neither a history of infection and bacterial cultures do not
prove positive. Along with the symptoms found in bacterial infections, post-
ejaculatory pain and discomfort are typical of this form of prostatitis.
Conventional medical treatments do not yield good results.
The clinical manifestations of chronic non-bacterial prostatitis may be very

varied. Some men report frequent urination and others do not. Some report
sexual dysfunction and erectile difficulties, others do not.
Generally, when cultures are negative, chronic non-bacterial prostatitis can be described
as persistent relapsing pain or discomfort in any of the following areas:
Urethra
Perineum
Tip of the penis (not related to urination)
Hypogastrium
Testicles
Some of the functional symptoms are:
Pain or burning during urination
Pain or discomfort during or after ejaculation
Pain in the lower back and upper legs
Pain in the groin and above the bladder
Burning high up in the urethra
A sensation of not emptying the bladder completely after finishing urinating
Lowering of libido
Other symptoms are:
Fatigue
Discoloured semen (yellowish - from dead white blood cells - a sign of
inflammation)
Pain after ejaculation, lasting from hours to days
Impaired memory, difficulty in concentration
Painful lymph nodes
Chronic prostatitis may be defined as follows:
• The principal symptom is pain or discomfort in the pelvic region lasting

3 months or more
• It affects younger men than benign prostatic hyperplasia, median age 43
years
• Pain is the most severe symptom and most commonly reported
symptom
• Symptoms are episodic, and wax and wane with variable periodicity
• Most common site of pain is the perineum but a wide variation in places
throughout the pelvic region are reported as uncomfortable
• Voiding symptoms, irritative symptoms contribute more than
obstructive symptoms
• Sexual function impairment although most men potent
• Pain after ejaculation is a very specific complaint that distinguishes
prostatitis from benign prostatic hyperplasia
CHRONIC PROSTATITIS IN CHINESE MEDICINE
From the perspective of Chinese medicine, prostatitis may fall under the heading
of several different conditions:
• “Spermatorrhoea” (Bai Yin)

• “Essence Turbidity” (Jing Zhuo)
• “White Turbidity” (Bai Zhuo)
• “Red Turbidity” (Chi Zhuo)
• “Urinary Syndrome” (Lin and specifically “Sticky Urinary Syndrome”
and “Fatigue Urinary Syndrome”)
• Lower Backache (from Kidney deficiency)
“Spermatorrhoea” is characterized primarily by an involuntary discharge of
sperm (even though in prostatitis there may not be a spermatic discharge);
“Essence Turbidity”(Jing Zhuo) is characterized by a turbid-sticky urethral
discharge, itching and pain of the penis that may feel like a burning blade, and
dark-yellow urine; “White Turbidity” is characterized by turbid urine, a turbid-
white urethral discharge and dysuria.
The essential aspect of the pathology of prostatitis is that there is a pathology

not only of fluids but also of Essence (Jing).
It is interesting that, although the ancient Chinese did not have a knowledge of
the prostate and seminal vesicles, they were aware of the difference between
urethral discharges of urine and of sperm. Urethral discharges of urine pertain
to the pathology of Urinary Syndrome (Lin) and therefore to Body Fluids; by
contrast, urethral discharges of sperm pertain to the pathology of Essence
(Jing) and are generally due to a weakness of the “Sperm Gate” (Jing Guan).
Dr Lin Pei Qin of the late Qing dynasty says that the Kidneys have two
orifices, one urinary, the other spermatic. According to him, Urinary Syndrome
(Lin) pertains to the urinary orifices and it involves the Liver and Spleen;
Turbidity Syndrome (Zhuo) pertains to the spermatic orifice and it involves the
Heart and Kidneys.1 Ye Tian Shi said: “Urinary turbidity and spermatic
turbidity are different.”2 He also confirms that spermatic turbidity involves the
Heart and Kidneys.
The modern doctor Xu Fu Song confirms that, although the urine and sperm go
through the same passage (urethra), the former pertains to the urinary system
and the latter to the genital system. Diseases of the genital system and sperm
pertain to what the ancient Chinese called the Room of Sperm (Jing Shi) or also
the “Palace of Sperm” (Jing Gong). Please note that, in this context, Jing
could be translated either as “sperm” or “Essence” (as sperm is a direct
manifestation of the Kidney-Essence).
1. Xu Fu Song “The Treatment of Chronic Prostatitis in Chinese Medicine” in Journal of Chinese Medicine
(Zhong Yi Za Zhi [ch#]), Vol. 27, No. 4, 1986, pp. 60-1.
2. 2. Cited in Xu Fu Song “The Treatment of Chronic Prostatitis in Chinese Medicine” in Journal of Chinese
Medicine, pp. 60-1.
The term “turbidity” is often mentioned in Chinese medicine, especially in the
context of diseases of the Lower Burner. In urinary diseases, “turbidity” indicates
a pathological state of fluids in the Lower Burner: this occurs when there is an
impairment in the transformation, transportation and excretion of urine in the
Lower Burner. In this context, “turbidity” manifests not only with turbid urine but
also with urinary difficulty.
In genital diseases such as prostatitis, “turbidity” refers to a pathology of Essence

(Jing): in this context, it manifests with urethral discharges of sperm and
discolouration of sperm (as seen in prostatitis). Although we are more used to
thinking of the Essence as a pure, precious fluid that is inherited from the parents,
the Essence plays a role in the physiology and pathology of men’s genital system
in the same way that Blood does in women: as a result, Essence in men can
become stagnant and be affected by “turbidity”.
Dr Zhou An Fang thinks that the two main aetiological factors of prostatitis are
poor genital hygiene leading to Damp Heat and to excessive sexual activity
leading to stasis of Essence. Damp Heat, on the other hand, frequently leads to the
formation of Toxic Heat.
Therefore, according to Dr Zhou, the main treatment principles for prostatitis are
as follows:
Clear Heat
Resolve Dampness
Resolve Toxic Heat
Invigorate Blood and Essence and eliminate stasis
According to Dr. Zhu Yong Jian, the pathology of chronic prostatitis is

accumulation of Damp Heat in the Lower Burner and a deficiency of Kidney-
Essence; the Kidney-Essence is “unstable” and this causes urethral discharge.
According to him, the three main treatment principles are:
Consolidate the Kidney-Essence

Resolve Dampness and clear Heat
Eliminate turbidity.
Dr Xu Fu Song thinks that the main aetiological factors of prostatitis in
Chinese men are “retention of sperm”, excessive masturbation, dirty
underwear, long prepuce, irregular diet and excessive consumption of
greasy and hot foods.1 These aetiological factors result in the formation of
Damp Heat.
Dr Xu therefore thinks that there are three main pathological conditions in

chronic prostatitis:
Damp Heat
Kidney deficiency
Stasis of Essence.
Damp Heat causes urethral discharges; a Kidney deficiency will cause lower
backache, dizziness and tinnitus; and stasis of Essence will cause pain in the
perineum, scrotum, penis or hypogastrium.
1. Ibid., pp. 60-1

Dr Mai Guo Jian considers the three main patterns appearing in prostatitis to be:
Stasis of Blood and Essence

Damp Heat
Heart and Kidney deficiency.1
Dr Liu You Fang considers Blood stasis to be the central pathology of chronic
prostatitis. He says that Blood stasis in the prostate causes pain and that stagnant
Blood often rises to harass the Heart and cause palpitations and insomnia. On the
other hand, stagnant Blood in the Lower Burner may prevent clear Yang from
rising leading to headaches and dizziness.
Dr Liu therefore uses a formula that invigorates Blood and eliminates stasis as the
basis for modifications according to symptoms. The basic formula that
invigorates Blood by Dr Liu You Fang is listed in the Prescriptions
1. Mai Guo Jian “Patterns and Treatment of Prostatitis” in Journal of Chinese Medicine,
Vol. 28, No. 6, 1987, pp. 19-20.
He modifies this formula according to symptoms as follows:
- If stagnant Blood generates Heat, add: Mu Dan Pi Cortex Moutan and Bai
Jiang Cao Herba Patriniae.
- If Blood stasis gives rise to Deficiency, add: Huang Qi Radix Astragali and
Dang Gui Radix Angelicae sinensis.
- If there is Damp Heat, add: Ze Xie Rhizoma Alismatis and Yi Yi Ren Semen
Coicis.
- If there is a Kidney deficiency, add: Tu Si Zi Semen Cuscutae.
In conclusion, Dr Liu You Fang considers invigorating Blood and eliminating

stasis to be the main treatment principles in prostatitis; the secondary treatment
principles are to move Qi, resolve Damp Heat and resolve Toxic Heat.
Dr Wang Bing Jun differs from other modern Chinese doctors in that he
places more emphasis on Yin deficiency as an underlying condition in
chronic prostatitis. Dr Wang considers Damp Heat and Blood stasis to be the
two main pathological conditions in chronic prostatitis.
He says that Damp Heat often affects the Liver channel against a background
of Liver- and Kidney-Yin deficiency. Interestingly, Dr Wang says that when
there is Liver- and Kidney-Yin deficiency, the prostate feels small on rectal
examination.
Dr Lin Jun Yu recommends tonifying the Kidneys and resolving Dampness

as the main treatment principle in chronic prostatitis. He modifies his basic
formula in cases of Damp Heat or Blood stasis.
Dr Zhou An Fang has slightly different ideas on the pathology of chronic
prostatitis. He concurs with the general view that the main pathological
conditions are Damp Heat, Blood stasis and Kidney deficiency. However, he also
considers deficiency and sinking of Spleen-Qi as an important underlying
pathology of chronic prostatitis.
Dr Zhou also differs from the general view because he recommends the use of
small quantities of warm herbs that warm the Spleen and Kidneys, such as Rou
Gui Cortex Cinnamomi. As in chronic prostatitis there is nearly always Damp
Heat, the general view is that warm herbs should not be used. However, Dr Zhou
thinks that small amounts of warm herbs are necessary to promote the
transformation of fluids. I personally tend to concur with this view and often use
small quantities of Gui Zhi Ramulus Cinnamomi cassiae or Rou Gui Cortex
Cinnamomi in prescriptions for chronic prostatitis even if there is Damp Heat.1
Finally, it should be noted that most modern Chinese journals list sexual
dysfunction symptoms (impotence, premature ejaculation, nocturnal emission,
spermatorrhoea) among the symptoms of chronic prostatitis, while such
symptoms are not common in Western patients with chronic prostatitis.
1. Zhou An Fang “Why Does One Use Warm Herbs in the Treatment of Prostatitis?” in Journal of Chinese
Medicine, Vol. 36, No. 5, 1995, p. 306.
EXTERNAL TREATMENTS
Dr Wang Bing Jun recommends an external application for chronic prostatitis. The patient
should boil the herbs in a large quantity of water for half an hour, strain them, and pour the
decoction into a shallow bath where he should sit for 10-15 minutes twice a day. The main
purpose of this treatment it to apply the herbs to the point Ren-1 Huiyin which is the meeting
point of the Governing, Directing and Penetrating Vessels (Du, Ren and Chong Mai). The herbs
that Dr Wang uses for external application are Huang Bo Cortex Phellodendri, Ming Fan
Alumen and Dan Shen Radix Salviae milthiorrizae.
Dr Zhou also recommends three external treatments for chronic prostatitis:
Enema with Pu Gong Ying Herba Taraxaci, Ye Ju Hua Flos Chrysanthemi indici, Bai
Jiang Cao Herba Patriniae, Ku Shen Radix Sophorae flavescentis, Hu Zhang Rhizoma
Polygoni cuspidati, Da Huang Radix et Rhizoma Rhei, Hong Teng Caulis Sargentodoxae,
Yan Hu Suo Rhizoma Corydalis, Chuan Shan Jia Squama Manitis Pentadactylae.
External application of decoction to the perineum with Pu Gong Ying Herba Taraxaci, Hu
Zhang Rhizoma Polygoni cuspidati, Bai Jiang Cao Herba Patriniae, Sheng Jiang Rhizoma
Zingiberis recens, San Leng Rhizoma Sparganii stoloniferi, E Zhu Rhizoma Curcumae,
Chuan Shan Jia Squama Manitis Pentadactylae, Wei Ling Xian Radix Clematidis.
Application of a paste to the umbilicus (paste of Hu Zhang Rhizoma Polygoni cuspidati,

Da Huang Radix et Rhizoma Rhei, Sheng Jiang Rhizoma Zingiberis recens).
ACUPUNCTURE TREATMENT
When treating prostate problems, it is important to treat one of the three
extraordinary vessels that flow through it, i.e. the Governing Vessel (Du Mai),
Directing Vessel (Ren Mai) or Penetrating Vessel (Chong Mai) (see Figure 35.8 in
chapter 35).
The Governing Vessel is selected when there is a pronounced deficiency of Kidney-

Yang; the Directing Vessel if there is a pronounced deficiency of Kidney-Yin; and
the Penetrating Vessel if there is a pronounced Blood stasis. In all cases, I use the
opening and coupled points of the relevant extraordinary vessel. In men, I use the
opening point on the left side and the coupled point on the right, e.g. for the
Governing Vessel, S.I.-3 Houxi on the left and BL-62 Shenmai on the right.
The main points used according to channel and patterns are as follows:
• Governing Vessel: S.I.-3 Houxi on the left and BL-62 Shemai on the
right, Du-3 Yaoyangguan.
• Directing Vessel: LU-7 Lieque on the left and KI-6 Zhaohai on the
right, Ren-1 Huiyin, Ren-2 Qugu, Ren-3 Zhongji, Ren-8 Shenque.
• Penetrating Vessel: SP-4 Gongsun on the left and P-6 Neiguan on the
right, KI-14 Siman.
• Liver channel: LIV-5 Ligou, LIV-1 Dadun, LIV-3 Taichong.
• Back-Transporting points: BL-32 Ciliao, BL-34 Xialiao.
• Damp Heat: Ren-3 Zhongji, ST-28 Shuidao, SP-9 Yinlingquan, BL-
22 Sanjiaoshu.
• Blood stasis: LIV-3 Taichong, SP-10 Xuehai, BL-17 Geshu, KI-14
Siman.
• Stasis of Essence: KI-14 Siman, Ren-5 Shimen.
The point Ren-1 is particularly important for chronic prostatitis because it
is a meeting point of the Governing, Directing and Penetrating Vessels as
they all emerge at this point.
DAMP HEAT IN LOWER BURNER
Acute pain on urination, frequency, urgency, urinary difficulty, pain in the
genitalia radiating
to the groin, sticky-yellow urethral discharge.
Tongue: Red with sticky-yellow coating on root.

Pulse: Slippery-Rapid.
Treatment principle
Clear Heat and resolve Dampness.
i. Acupuncture
Points
BL-22 Sanjiaoshu, ST-28 Shuidao, Ren-3 Zhongji, SP-9 Yinlingquan, SP-6
Sanyinjiao, Ren-1 Huiyin, BL-32 Ciliao, BL-34 Xialiao, L.I.-11 Quchi. Even
method.
Explanation
- BL-22, ST-28, Ren-3, SP-9 and SP-6 resolve Dampness.
- Ren-1, BL-32 and BL-34 are used as local points to affect the prostate.
- L.I.-11 clears Heat.
Herbal therapy
Prescription
EMPIRICAL PRESCRIPTION
Explanation
This formula resolves Damp Heat and Toxic Heat.
Prescription
QIAN LIE XIAN YAN PIAN
Prostatitis Tablet
Explanation
This formula strongly resolves Dampness and clears Heat. Please note that it
contains many bitter and cold herbs which, in the long run, may damage the
Spleen.
Prescription
LONG DAN XIE GAN TANG Variation by Dr Wang Bing Jun
Gentiana Draining the Liver Decoction Variation by Dr Wang Bing Jun
Explanation
This formula resolves Damp Heat in the Liver channel in the Lower Burner. It
has been modified by Dr Wang with the addition of herbs that resolve Toxic
Heat. Please note that it contains Mu Tong Caulis Akebiae trifoliatae the use of
which is illegal in most countries. It can be replaced by Tong Cao Medulla
Tetrapanacis.
Three Treasures remedy

Clear the Root.
Clear the Root resolves Damp Heat and Toxic Heat.

DAMP HEAT WITH TOXIC HEAT IN LOWER BURNER
Dysuria, sticky-yellow urethral discharge, dribbling of urine during effort of
defecation, dribbling of urine, pain in the perineum, penis or hypogastrium,
frequency of urination, pain on micturition.
Tongue: Red, Swollen, sticky-dark-yellow coating on the root with red spots.
Pulse: Slippery-Rapid.
Treatment principle
Resolve Damp Heat and Toxic Heat, invigorate Blood, eliminate stasis.
i. Acupuncture
Points
SP-4 Gongsun on left with P-6 Neiguan on the right, Ren-1 Huiyin, BL-32
Ciliao, BL-34 Xialiao, Ren-3 Zhongji, BL-22 Sanjiaoshu, ST-28 Shuidao, SP-9
Yinlingquan, SP-6 Sanyinjiao. Even method.
Explanation
- SP-4 and P-6 regulate the Penetrating Vessel (Chong Mai) and invigorate
Blood.
- Ren-1, BL-32 and BL-34 are local points to affect the prostate.
- Ren-3, BL-22, ST-28, SP-9 and SP-6 resolve Dampness from the Lower
Burner.
Herbal therapy
Prescription
EMPIRICAL PRESCRIPTION by Dr Liu Chun Ying
Explanation
This formula resolves Damp Heat and Toxic Heat and invigorates Blood.
Please note that it contains Mu Tong Caulis Akebiae trifoliatae the use of
which is illegal in most countries. It can be replaced by Tong Cao Medulla
Tetrapanacis.

Clear the Root.
Clear the Root resolves Damp Heat and Toxic Heat.

KIDNEY-QI DEFICIENCY WITH DAMPNESS
Chronic urinary difficulty, turbid urine, frequency, urgency and pain, whitish
discharge at the end of urination, dull ache in the genitals radiating to the groin.
Tongue: Pale with a sticky coating.
Pulse: Soggy.
Treatment principle
Tonify and warm the Kidneys and Spleen and resolve Dampness.
i. Acupuncture
Points
S.I.-3 Houxi on the left with BL-62 Shenmai on the right, Ren-4 Guanyuan, BL-23
Shenshu, KI-7 Fuliu, Ren-12 Zhongwan, ST-36 Zusanli, BL-20 Pishu, Ren-3
Zhongji, ST-28 Shuidao, SP-9 Yinlingquan, SP-6 Sanyinjiao, BL-22 Sanjiaoshu,
Ren-1 Huiyin, BL-32 Ciliao, BL-34 Xialiao. Reinforcing method on Ren-4, BL-23,
KI-7, Ren-12, ST-36, BL-20 and Ren-3; even method on all the other points. Moxa
is applicable.
Explanation
- S.I.-3 and BL-62 regulate the Governing Vessel (Du Mai) and tonify Kidney-Yang.
- Ren-4, BL-23 and KI-7 tonify Kidney-Yang.
- Ren-3, ST-28, SP-9, SP-6 and BL-22 resolve Dampness.
- Ren-12, ST-36 and BL-20 tonify the Spleen.
Herbal therapy
Prescription
EMPIRICAL PRESCRIPTION by Dr. Liu Chun Ying
Explanation
This formula tonifies Spleen- and Kidney-Yang and resolves Dampness.
Modifications
Dr Lin modifies his basic formula in cases of Damp Heat or Blood stasis.
- In the case of Damp Heat, remove Sha Yuan Zi Semen Astragali

complanati and add Mu Dan Pi Cortex Moutan, Yi Yi Ren Semen Coicis
and Dong Gua Ren Semen Benincasae.
- In the case of Blood stasis, remove Sha Yuan Zi Semen Astragali complanati
and Qian Shi Semen Euryales and add Chi Shao Radix Paeoniae rubra,
Tao Ren Semen Persicae, Dan Shen Radix Salviae milthiorrizae and
Chuan Shan Jia Squama Manitis Pentadactylae.
Prescription
EMPIRICAL PRESCRIPTION
Explanation
This formula tonifies Kidney-Yang and resolves Dampness. However, the
emphasis is on resolving Dampness as it contains only one Kidney tonic.
Prescription
TU SI ZI WAN plus BI XIE FEN QING YIN
Cuscuta Pill plus Dioscoreae Separating the Clear Decoction
Explanation
These two formulae together tonify Kidney-Yang, resolve Dampness and eliminate
turbidity.
Prescription
EMPIRICAL PRESCRIPTION by Dr Lin Jun Yu
Explanation
This formula tonifies Kidney-Yang and resolves Dampness.

Separate Clear and Turbid plus Strengthen the Root.
Separate Clear and Turbid resolves Dampness from the genito-urinary

passages while Strengthen the Root tonifies Kidney-Yang.
KIDNEY-YIN DEFICIENCY
Dull ache and feeling of heaviness in the perineum, white-stringy urethral
discharge, scanty-dark urine, lower backache, insomnia, 5-palm heat, night-
sweating, dizziness, tinnitus.
Tongue: without coating; Red if there is Empty Heat.
Pulse: Floating-Empty; Rapid if there is Empty Heat.
Treatment principle
Nourish Kidney-Yin, resolve Dampness.
i. Acupuncture
Points
LU-7 Lieque on the left with KI-6 Zhaohai on the right, Ren-4 Guanyuan,
KI-3 Taixi, BL-23 Shenshu, Ren-3 Zhongji, ST-28 Shuidao, SP-9
Yinlingquan, SP-6 Sanyinjiao, BL-22 Sanjiaoshu, Ren-1 Huiyin, BL-32
Ciliao, BL-34 Xialiao. Reinforcing method.
Explanation
- LU-7 and KI-6 regulate the Directing Vessel (Ren Mai) and nourish Yin.
- Ren-4, KI-3 and BL-23 tonify the Kidneys.
- Ren-3, ST-28, SP-9, SP-6 and BL-22 resolve Dampness.
Herbal therapy
Prescription
EMPIRICAL PRESCRIPTION by Dr Liu Chun Ying
Explanation
This formula nourishes Liver- and Kidney-Yin, resolves Dampness
and mildly invigorates Blood.
Prescription
EMPIRICAL PRESCRIPTION by Dr Wang Bing Jun
Explanation
This formula nourishes Liver- and Kidney-Yin and resolves
Dampness. Compared to the previous formula, its Yin-nourishing
effect is stronger.

Clear the Root and Nourish the Root
Clear the Root resolves Damp Heat and Nourish the Root
nourishes Liver- and Kidney-Yin.
DAMP HEAT AND TURBIDITY IN THE LOWER BURNER, DEFICIENCY
OF KIDNEY-ESSENCE
Turbid-white urethral discharge, dysuria, dribbling after micturition, lower
backache, pain in the hypogastrium, perineum, penis, painful urination, impotence,
premature ejaculation, nocturnal emissions, dizziness, tinnitus, decreased memory.
Tongue: Pale.
Pulse: Weak, Choppy.
Treatment principle
Consolidate the Kidney-Essence, resolve Dampness, eliminate turbidity.
i. Acupuncture
Points
BL-23 Shenshu, Ren-4 Guanyuan, KI-13 Qixue, Ren-3 Zhongji, Ren-9 Shuifen,
BL-22 Sanjiaoshu, SP-9 Yinlingquan, SP-6 Sanyinjiao, Ren-5 Shimen.
Reinforcing method on BL-23, Ren-4, KI-3 and Ren-3; even method on all other
points.
Explanation
- BL-23, Ren-4 and KI-13 tonify the Kidneys and consolidate the Essence.
- Ren-3, Ren-9, BL-22, SP-9, SP-6 and Ren-5 resolve Dampness and eliminate
turbidity.
Herbal therapy
Prescription
EMPIRICAL PRESCRIPTION by Dr Zhu Yong Jian
Explanation
This formula tonifies the Kidneys, consolidates the Essence, resolves
Dampness and resolves turbidity
MODERN CHINESE LITERATURE
a) Meng Yu “Experience of Dr Xu Fu Song
in the Treatment of Prostatic Diseases with
the Method of Transforming Yin with Sour
and Sweet Herbs” Journal of Chinese
Medicine (Zhong Yi Za Zhi), Vol. 41, No. 9,
2000.
Dr Meng Yu reports experiences of Dr Xu Fu
Song treating disease of the prostate by
nourishing Yin and transforming fluids. This
treatment especially applies to the elderly.
For chronic prostatitis of the elderly
with Kidney-Yin deficiency and Dampness in
the Lower Burner, Dr Xu Fu Song uses the
following formula:
Wu Wei Zi Fructus Schisandrae 10g
Lian Zi Semen Nelumbinis 10g
Wu Mei Fructus Mume 10g
Bai Shao Radix Paeoniae alba 10g
Wu Bei Zi Galla Chinensis 10g
He Zi Fructus Chebulae 10g
Bai Lian Radix Ampelopsis 10g
Long Gu Mastodi Ossis fossilia 15g
Mu Li Concha Ostreae 20g
Zhi Gan Cao Radix Glycyrrhizae uralensis
preparata 5g
b) Zhou An Fang “Observation on the Treatment of 147 Cases of Chronic
Prostatitis with ‘Prostatitis Formulae’ no. I and no, II”, Journal of Chinese
Medicine (Zhong Yi Za Zhi), Vol. 34, No. 3, 1993, p. 165.
Dr Zhou An Fang treated 147 cases of chronic prostatitis in the following age
groups:
Between 19 and 30 years old: 74 cases

Between 31 and 40: 49 cases
Between 41 and 50: 19 cases
Over 50: 5 cases.
The main clinical manifestations were: white-sticky urethral discharge, dripping of

urine after micturition, dripping of urine as a result of the effort of defecation,
frequent urination, urgency and pain on urination, pain in the perineum, penis,
testis, anus, hypogastrium or sacrum, decreased sexual desire, premature
ejaculation, nocturnal emissions, impotence.
Two formulae were used according to the patterns: “Prostatitis Formula No. I” for
Damp Heat and “Prostatitis Formula No. II” for Damp Heat with stasis of Essence
and Blood. These two formulae are listed in the Prescriptions Appendix.
The results were that 102 patients achieved a complete cure (69.4%), 34 a good
improvement (23.1%), 9 a moderate improvement (6.1%) and 2 no results (1.4%).
c) Ji Hui Yi “Clinical Observations on the Treatment of Chronic Prostatitis
by Clearing Heat, Transforming Fluids, Eliminating Stasis and Tonifying the
Kidneys”, Journal of Chinese Medicine (Zhong Yi Za Zhi), Vol. 35, No. 11,
1994, p. 679.
312 patients suffering from chronic prostatitis were treated. The main presenting
symptom in each group was as follows:
Decreased sexual function: 112

Spermatorrhoea: 86
Impotence: 74
Premature ejaculation: 37
Blood in sperm: 3
The main patterns found were Damp Heat, Blood stasis and Kidney deficiency
and the treatment principles adopted were to clear Heat, resolve Dampness,
invigorate Blood, eliminate stasis, tonify the Kidneys and to simultaneously
support the Upright Qi and eliminate pathogenic factors
The basic formula used was:

Huang Bo Cortex Phellodendri 10g
Ye Ju Hua Flos Chrysanthemi indici 10g
Sheng Di Huang Radix Rehmanniae 10g
Shu Di Huang Radix Rehmanniae preparata 10g
Yi Zhi Ren Fructus Alpiniae oxypyllae 10g
Dan Shen Radix Salviae milthiorrizae 10g
Da Huang Radix et Rhizoma Rhei 10g
This formula was modified as follows:
- In the case of Damp Heat, add Long Dan Cao Radix Gentianae, Yi Yi
Ren Semen Coicis and Zi Hua Di Ding Herba Violae.
- In the case of pronounced Kidney deficiency, add Tu Si Zi Semen
Cuscutae and Gou Qi Zi Fructus Lycii chinensis.
- In the case of Blood stasis, add Ze Lan Herba Lycopi, Dan Shen Radix
Salviae milthiorrizae and Wang Bu Liu Xing Semen Vaccariae.
The results were as follows:
Cured: 162 (51.9%)
Improved: 94 (30.1%)
Moderate improvement: 27 (8.7%)
No results: 29 (9.3%)
d) Xu Fu Song et al “The Treatment of 218 Cases of Chronic Prostatitis
with Protecting the Essence Pill”, Journal of the Nanjing University of
Chinese Medicine (Nanjing Zhong Yi Da Xue Za Zhi), Vol. 12, No. 3,
1996, 17.
218 cases of chronic prostatitis were treated with the formula Bao Jing Pian
Protecting the Essence Tablet. The clinical manifestations were as follows:
Urinary manifestations: frequent urination, dysuria, burning on

urination, dribbling after urination
General manifestations: tiredness, lower backache, insomnia,

discomfort in the perineum
Sexual manifestations: impotence, premature ejaculation,

spermatorrhoea.
The formula used was as follows:
Tu Si Zi Semen Cuscutae
Yi Zhi Ren Fructus Alpiniae oxypyllae
Fu Ling Poria
Dan Shen Radix Salviae milthiorrizae
Che Qian Zi Semen Plantaginis
Bi Xie Rhizoma Dioscoreae hypoglauca
Xiao Hui Xiang Fructus Foeniculi
Bi Yu San (Hua Shi, Gan Cao, Qing Dai)
Xu Duan Radix Dipsaci
The results were as follows:
Cured: 43 (19.72%)
Clear improvement: 125 (57.34%)
Improvement: 31 (14.22%)
No results: 19 (8.72%)
e) Zhang Ping et al “The Treatment of 100 Cases of Chronic Prostatitis with
Herbal Poultice”, Journal of the Nanjing University of Chinese Medicine
(Nanjing Zhong Yi Da Xue Za Zhi), Vol. 12, No. 4, 1996, p. 43.
100 cases of chronic prostatitis were treated with the external application of a
herbal poultice on acupuncture points.
The points used were Ren-8 Shenque, Ren-6 Qihai, Ren-4 Guanyuan, Ren-3
Zhongji and BL-23 Shenshu. The herbal decoction was placed in a muslin bag
and then fastened onto the acupuncture points and kept in place for 7 days. The
treatment was repeated three times.
The treatment principles adopted were to tonify and warm Kidney-Yang, move Qi
with pungent-warm-dispersing herbs, invigorate Blood and benefit urination.
The formula used was:

Ding Xiang Flos Caryophilli
Jiu Cai Zi Semen Allii tuberosi
She Chuang Zi Fructus Cnidii
Dang Gui Radix Angelicae sinensis
Xi Xin Herba Asari
Feng Fang Nidus V espae
Please note that the use of Feng Fang is illegal and it should therefore be
eliminated from the formula.
f) Zhou An Fang “External Methods of Treatment for Chronic
Prostatitis”, Journal of Chinese Medicine (Zhong Yi Za Zhi), Vol. 36,
No. 5, 1995, p. 306.
Dr Zhou discusses three external methods of treatment for chronic

prostatitis. The first is by way of enema. Dr Zhou says that this method
of treatment is particularly suitable for Damp Heat, Toxic Heat and Blood
stasis. The herbs used in the decoction for the enema are:
Pu Gong Ying Herba Taraxaci

Ye Ju Hua Flos Chrysanthemi indici
Ku Shen Radix Sophorae flavescentis
Hu Zhang Rhizoma Polygoni cuspidati
Da Huang Radix et Rhizoma Rhei
Hong Teng Caulis Sargentodoxae
Yan Hu Suo Rhizoma Corydalis
Chuan Shan Jia Squama Manitis Pentadactylae
The second external method of treatment is a wash (from a decoction) to
be applied to the perineum. Dr Zhou has an interesting explanation for the
rationale behind applying the wash to the perineum. He says that Ren-1
Huiyin (on the perineum) is the point where the Governing, Directing and
Penetrating Vessels (Du, Ren and Chong Mai) emerge from the Interior.
Therefore, applying a wash to this point treats all three of these

extraordinary vessels It will be remembered that the old classics say that
these three extraordinary vessels flow through the uterus: I think it is
feasible to assume that, in men, they flow through the prostate.
The herbs used in the wash are:

Hu Zhang Rhizoma Polygoni cuspidati
Jiang Huang Rhizoma Curcumae longae
San Leng Rhizoma Sparganii stoloniferi
E Zhu Rhizoma Curcumae
Chuan Shan Jia Squama Manitis Pentadactylae
The third external method of treatment is a poultice applied to the
umbilicus. The rationale behind this is to treat the Directing Vessel
(which flows to the prostate) through the umbilicus (where the point
Ren-8 Shenque is situated). The herbs used are Da Huang Radix et
Rhizoma Rhei, Lu Hui Aloe and Jiang Huang Rhizoma Curcumae
longae.
g) Xu Fu Song and Zhu Yong Jian “Present Status of Treatment of

Chronic Prostatitis in Chinese Medicine”, Journal of Chinese
I have already reported some of Dr Xu Fu Song’s ideas above.
However, it is worth reporting this article here as it provides some
interesting ideas on the nature of the prostate and prostatitis in Chinese
medicine.
The authors start by saying that there is no category of disease called
“prostatitis” in ancient Chinese medicine. The modern disease of
prostatitis may correspond to various ancient diseases, among them
Urinary Syndrome (Lin), Turbidity (Zhuo), Impotence (Yang Wei),
Spermatorrhoea (Bai Yin) or Seminal Emissions (Yi Jing).
The authors say that prostatitis pertains particularly to the two ancient
diseases called “White Turbidity” (Bai Yin) and “Essence Turbidity”
(Jing Zhuo). This term could also be translated as “Turbid Sperm”. The
“Complete Book of Jing Yue” (Jing Yue Quan Shu, 1624) describes
“White Turbidity” as follows: “In Turbidity, there is a white-sticky
discharge like sperm coming out of the penis without pain: it stains the
underwear.” It describes “Essence Turbidity” as follows: “In Essence
Turbidity, there is a pain in the penis which feels like a cutting knife: it
is due to rotting and stagnating sperm.”
The authors then quote Lin Pei Qin, a doctor from the Qing dynasty, who
clearly distinguishes urinary from sperm problems. This is interesting as
both problems manifest through the urethra and the ancient Chinese
doctors, although they did not have a knowledge of the prostate, they
obviously realized the difference between urinary and prostatic problems.
Lin Pei Qin says:
“The Kidneys have two orifices: one is the orifices for [the expulsion of]
turbidity; the other is an Essence [sperm] orifice. Urinary Syndrome [Lin]
manifests through the turbidity orifice and it is due to a disharmony of
Spleen and Liver. Turbidity manifests through the Essence orifice and it is
due to a disharmony of Kidneys and Heart. These two conditions manifest
through the same ‘door’ but separate ‘roads’.”
Ye Tian Shi expresses the same idea when he says : “Urinary turbidity and
sperm turbidity have different ‘roads’ [outlets].” The authors concur that
Essence Turbidity is due to a disharmony of Kidneys and Heart. The say
that both urinary turbidity and sperm turbidity manifest through the urethra
but the former is a urinary problem while the latter a genital one. In sperm
turbidity, the problems therefore lies not in the urinary passages but in
what the ancient Chinese doctors called “Room of Essence” [or Sperm] or
“Palace of Essence” [or Sperm].
1) Damp Heat and Toxic Heat
Qian Lie Quan Pian Prostate Tablet
Yu Xing Cao Herba Houttuniae
Feng Wei Cao Herba Pteridis multifoetidae
Tu Fu Ling Rhizoma Smilacis glabrae
Di Ding Cao Herba Violae
Ban Zhi Lian Herba Lobeliae chinensis
Bai Hua She She Cao Herba Hedyotidis diffusae
Long Dan Cao Radix Gentianae
Ma Chi Xian Herba Portulacae
If there swelling of the scrotum, use a variation of Bi Xie Fen
Qing Yin Dioscorea Separating the Clear Decoction:
Bi Xie Rhizoma Dioscoreae hypoglaucae

Yi Zhi Ren Fructus Alpiniae oxyphyllae
Wu Yao Radix Linderae
Shi Chang Pu Rhizoma Acori tatarinowii
Hua Shi Talcum
Shi Wei Folium Pyrrosiae
Bian Xu Herba Polygoni avicularis
Qu Mai Herba Dianthi
Fu Ling Poria
Ze Xie Rhizoma Alismatis
2) Stasis of Essence
The authors recommend any of the following prescriptions:
- Huo Luo Xiao Ling Dan Miraculously Effective Invigorating the
Connecting Channels Pill
- Di Dang Tang Washing Away Phlegm Decoction
- Wang Bu Liu Xing Tang Vaccaria Decoction
- Prostatitis Formula No. 1.
3) Kidney deficiency with Damp Heat

Zhi Bo Di Huang Wan Anemarrhena-Phellodendron-Rehmannia
Pill.
h) Zhu Yong Jian “Report on the Treatment of 133 Cases of

Chronic Prostatitis with the Method of Consolidating the
Essence and Eliminating Turbidity”, Journal of Chinese
Dr Zhu treated 133 men suffering from chronic prostatitis ranging in
age from 17 to 68. The treatment principle adopted was to
consolidate the Essence and eliminate turbidity with the following
formula.
Bi Xie Rhizoma Dioscoreae hypoglauca
Tu Si Zi Semen Cuscutae
Sha Yuan Zi Semen Astragali complanati
Yi Zhi Ren Fructus Alpiniae oxypyllae
Shan Yao Rhizoma Dioscoreae
Huai Niu Xi Radix Achyranthis bidentatae
Fu Ling Poria
Ze Xie Rhizoma Alismatis
Wu Yao Radix Linderiae
Shi Chang Pu Rhizoma Acori tatarinowii
Gan Cao Radix Glycyrrhizae uralensis
The results reported by the author were as follows:

- Cured 50 (37.6%).
- Marked improvement: 42 (31.5%).
- Some improvement: 36 (27.1%).
- No results: 5 (3.8%).
14. INTERSTITIAL CYSTITIS
Cystitis indicates a bladder infection which is generally due to infection with

bacteria. Bacteria that are normally found in the gastrointestinal tract, such as
Escherichia coli, cause most urinary tract infections. Other bacteria that can cause
urinary tract infections include Staphylococcus saprophyticus, proteus, klebsiella
and enterococcus. In recent years, an increasing number of bladder infections in
both men and women have been linked to two sexually transmitted organisms:
Chlamydia trachomatis and mycoplasma.
Women are more prone to urinary tract infections because the urethra is much
shorter than in men. Because the urethral opening is relatively close to the anus in
women, bacteria that are normally present in the colon, can easily contaminate the
female urethra. A urinary tract infection in young women is often associated with
increased sexual activity.
In men, a bladder infection is almost always a symptom of an underlying
disorder rather than a “simple” bacterial infection. Often the infection has
migrated from the prostate or some other part of the body, signalling
problems in those locations. Or it may indicate a tumour or other
obstruction is interfering with the urinary tract.
Interstitial cystitis (IC) is a condition that results in recurring discomfort or

pain in the bladder and the surrounding pelvic region. The symptoms vary
from case to case and even in the same individual. There is usually a mild
discomfort, feeling of pressure, tenderness, or intense pain in the bladder
and pelvic area. Symptoms may include urgency, frequency, or a
combination of these symptoms. Pain may change in intensity as the
bladder fills with urine or as it empties. Women's symptoms often get
worse during menstruation. They may sometimes experience pain with
vaginal intercourse.
Because IC varies so much in symptoms and severity, most researchers believe
that it is not one, but several diseases. In recent years, doctors have started to
use the term painful bladder syndrome (PBS) to describe cases with painful
urinary symptoms that may not meet the strictest definition of IC. The term IC /
PBS includes all cases of urinary pain that cannot be attributed to other causes,
such as infection or urinary stones.
Some of the symptoms of IC / PBS resemble those of bacterial infection, but
medical tests reveal no organisms in the urine of patients with IC / PBS.
Furthermore, patients with IC / PBS do not respond to antibiotic therapy.
IC / PBS is far more common in women than in men. Of the estimated 1 million
Americans with IC, up to 90% are women.
The diagnosis of IC / PBS in the general population is based on the presence of

pain related to the bladder. This is usually accompanied by frequency and
urgency in the absence of other diseases that could cause the symptoms.
White and red blood cells and bacteria in the urine may indicate an infection of
the urinary tract, which can be treated with an antibiotic. If urine is sterile for
weeks or months while symptoms persist, then a diagnosis of IC / PBS is
considered.
In IC / PBS, the bladder wall may be irritated and become scarred or stiff.
Glomerulations (pinpoint bleeding caused by recurrent irritation) often appear
on the bladder wall. Hunner’s ulcers are present in 10% of patients with IC.
Some people with IC / PBS find that their bladders cannot hold much urine,
which increases the frequency of urination. People with severe cases of IC /
PBS may urinate as many as 60 times a day, including frequent night-time
urination (nocturia).
There is no cure for IC / PBS in Western medicine. Symptoms may disappear

without explanation or coincide with an event such as a change in diet or
treatment. Even when symptoms disappear, they may return after days, weeks,
months, or years.
Pentosan polysulfate sodium (Elmiron) is the first oral drug developed for IC
and approved by the FDA in 1996. In clinical trials, the drug improved
symptoms in 30% of patients treated. Elmiron may affect liver function,
which should therefore be monitored.
INTERSTITIAL CYSTITIS IN CHINESE MEDICINE
Acute cystitis from a bacterial infection clearly corresponds to Heat Urinary
Syndrome in Chinese medicine. Chronic bacterial cystitis corresponds to a
mixture of patterns and chiefly from three conditions, i.e. Heat Urinary
Syndrome, Fatigue Urinary Syndrome and Turbid Urinary Syndrome.
The main difference in approach is that, in bacterial cystitis, one must

always add some herbs that have an antibacterial effect. Very many
Chinese herbs have an antibacterial effect and the main ones with an effect
on the bladder are:
• Bian Xu Herba Polygoni avicularis

• Chi Xiao Dou Semen Phaseoli
• Da Ji Radix Euphorbiae seu Knoxiae
• Hua Shi Talcum
• Huang Bo Cortex Phellodendri
• Qu Mai Herba Dianthi
• Shi Wei Folium Pyrrosiae
• Xiao Ji Herba Cirisii
• Zhi Mu Radix Anemarrhenae
• Zhu Ling Polyporus
Judging by the clinical manifestations outlined above, interstitial cystitis is
clearly a condition characterized by Fullness and Emptiness from the point of
view of Chinese medicine. Let us review and interpret the clinical
manifestations of interstitial cystitis. These are:
• mild discomfort in the bladder: Qi stagnation or Heat

• feeling of pressure: Dampness
• tenderness: Dampness or Qi deficiency
• intense pain: Dampness and/or Qi stagnation with Blood stasis
• urgency: Qi sinking
• frequency: Qi sinking
• irritated bladder wall: Heat (Full, Empty or Yin Fire)
• glomerulations (pinpoint bleeding caused by recurrent irritation) on the
badder wall: Heat (Full, Empty or Yin Fire)
• Hunner’s ulcers: Heat (Full, Empty or Yin Fire)
• nocturia: Kidney-Yang deficiency.
An analysis and summary of the above clinical manifestations leads us to
identify the main patterns involved in interstitial cystitis as being the
following:
• Spleen-Qi and/or Kidney-Yang deficiency

• Sinking of Spleen- and/or Kidney-Qi
• Heat (Full, Empty or Yin Fire)
• Dampness
• Qi stagnation
• Blood stasis
Therefore, it is obvious that the pathology of interstitial cystitis always

involves a combination of Fullness (Dampness, Heat, Qi stagnation, Blood
stasis) and Emptiness (Spleen-Qi and/or Kidney-Yang deficiency, sinking
of Qi).
The Heat condition in interstitial cystitis is more often due to Empty Heat
or Yin Fire than to Full Heat. Please note that it is not at all unusual to
have some Heat or Yin Fire in combination with Kidney-Yang deficiency
while Empty Heat obviously always derives from Yin deficiency.
Please note also that, especially in women over 40, it is not at all
unusual to have both Kidney-Yin and Kidney-Yang deficiency
(albeit in different degrees) so that she may have Empty Heat from
Kidney-Yin deficiency but also frequency and slight incontinence
from Kidney-Yang deficiency.
For a discussion of Yin Fire, see chapter 25 on Mouth

Ulcers.
YIN FIRE
Before discussing the patterns and treatment, it is worth describing

briefly the pathology of Yin Fire. Yin Fire was described by Li
Dong Yuan in the famous classic “Discussion on Stomach and
Spleen” (Pi Wei Lun). He said that overwork and irregular diet
weaken Qi of the Stomach and Spleen and the Original Qi (Yuan
Qi) which resides in the Lower Field of Elixir (Dan Tian): here it
shares a place with the (physiological) Minister Fire. If the
Minister Fire is stirred by overwork and emotional problems, it
becomes pathological, it “displaces” the Original Qi in the Lower
Field of Elixir and it rises upwards causing a low-grade fever or a
feeling of heat.
Li Dong Yuan called this pathological Minister Fire a “thief” of the
Original Qi: the Heat generated by the pathological Minister Fire (and the
deficiency of the Original Qi) is called “Yin Fire”: this is neither Full nor
Empty Heat, although it is more similar to the latter as it is a Fire that arises
from Qi deficiency and deficiency of the Original Qi.
Li Dong Yuan said that this Yin-Fire is not treated by clearing it with bitter-
cold herbs but by tonifying the Original Qi with sweet-warm herbs: as the
Minister Fire and the Original Qi share the same place, tonifying the
Original Qi will automatically displace and subdue the pathological
Minister Fire.
The pathology of Yin Fire is, however, often more complex than the one
described above as it is frequently aggravated by the presence of Damp
Heat in the Lower Burner. Although Yin Fire arouses from the Lower
Burner, its pathology is related to the Middle Burner as well. When there is
Spleen deficiency, Dampness is formed and this infuses down to the Lower
Burner. Here it “swamps” the Original Qi and the physiological Minister
Fire, displacing the latter from the place where it should be “concealed”
(the Lower Burner).1
1. Ancient Chinese books often say that the physiological Minister Fire performs its important function of warming all the
Internal Organs but it does so without being “seen”, i.e. it is “concealed”. When it is pathological it is “seen” and it manifests
with symptoms of Heat.
When the Middle Burner is obstructed by Dampness, Spleen-Qi (or
even Spleen-Yang) is deficient and fails to rise. For this reason, Bu
Zhong Yi Qi Tang Tonifying the Centre and Benefiting Qi Decoction is
used to raise Spleen-Qi and warm Spleen-Yang so that Dampness no
longer infuses downwards to the Lower Burner. When the Lower
Burner is opened and unblocked from Dampness, the Minister Fire will
return to its place of concealment in the Lower Burner, thus eliminating
the symptoms of Yin Fire.
The symptoms of Yin Fire are a low-grade fever or feeling of heat that
is aggravated by overwork, feeling of heat of the face, red face, feeling
cold, cold feet, mouth ulcers, dizziness, tiredness, depression, mental
restlessness, insomnia, muscular weakness, spontaneous sweating,
shortness of breath, loose stools, poor appetite, weak voice, headache,
thirst, Pale tongue, Weak or Empty pulse but which may be slightly
Overflowing on the Front positions.
The clinical manifestations of Yin Fire may be explained as follows:
Spleen-Qi and/or Spleen-Yang deficiency: tiredness, depression,

muscular weakness, loose stools, poor appetite, Pale tongue,
Weak or Empty pulse
Spleen-Yang deficiency: feeling cold in general, cold feet
Yin Fire rising to the Upper Burner: low-grade fever or feeling

of heat above that is aggravated by overwork, feeling of heat of
the face, red face, mouth ulcers, dizziness, headache, thirst, Pulse
slightly Overflowing on the Front positions.
Yin Fire harassing the Mind: mental restlessness, insomnia
Lung-Qi deficiency: spontaneous sweating, shortness of breath,

weak voice
IDENTIFICATION OF PATTERNS AND TREATMENT
The main patterns appearing in interstitial cystitis are therefore as

follows:
• Spleen-Qi and Kidney-Yang deficiency with Yin Fire

• Spleen-Qi and Kidney-Yang deficiency with Dampness
• Spleen-Qi and Kidney-Yang deficiency with Qi stagnation
• Spleen-Qi and Kidney-Yang deficiency with Blood stasis
• Kidney-Yin deficiency with Empty Heat
SPLEEN-QI AND KIDNEY-YANG DEFICIENCY WITH DAMPNESS
Frequency of urination, urgency, slight burning pain or no pain, feeling of fullness in
the hypogastrium, dysuria, irritation of the bladder wall, glomerulation or Hunner’s
ulcers on bladder wall, loose stools, tiredness, abdominal fullness, lower backache,
dizziness, tinnitus.
Tongue: Pale with a thick-sticky coating.
Pulse: Soggy.
Treatment principle
Tonify Spleen-Qi and Kidney-Yang, resolve Dampness.
i. Acupuncture
Points
Ren-12 Zhongwan, ST-36 Zusanli, SP-6 Sanyinjiao, BL-20 Pishu, BL-23 Shenshu, KI-
3 Taixi, Ren-4 Guanyuan, BL-63 Jinmen, Ren-3 Zhongji, SP-9 Yinlingquan, ST-28
Shuidao. All with reinforcing method except for the last four which should be needled
with even method.
Explanation
- Ren-12, ST-36, SP-6 and BL-20 tonify the Spleen.
- BL-23, KI-3 and Ren-4 tonify the Kidneys.
- BL-63 Jinmen regulates the Bladder and stops urinary pain.
- Ren-3, SP-9 and ST-28 resolve Dampness in the urinary passages.
Herbal therapy
Prescription
JIN GUI SHEN QI WAN Variation
Golden Chest Kidney-Qi Pill Variation
Explanation
This variation of Jin Gui Shen Qi Wan tonifies the Kidneys and the
Spleen and resolves Dampness.
PROGNOSIS AND PREVENTION
Acupuncture and herbs in combination can be effective to treat interstitial
cystitis but it does take time. As the Root of the condition is always a
deficiency of the Kidneys and/or Spleen, the condition is always chronic
and will require at the very least 9 months of treatment.
The most difficult pattern to treat is that from Kidney-Yin deficiency with
Empty Heat. As for prevention, it is important to avoid eating hot-spicy
foods which would aggravate symptoms of Heat. Women should also avoid
the excessive consumption of greasy-fried foods which lead to Dampness.
It would also help the treatment if women reduced the frequency of sexual
intercourse for the duration of the treatment.
15. ULCERATIVE COLITIS
Ulcerative colitis is a type of inflammatory bowel disease (IBD) that

affects the lining of the large intestine (colon) and rectum. Crohn's
disease is a related condition.
The cause of ulcerative colitis is unknown. People with this condition

have an autoimmune disease, but it is not clear whether immune problems
cause this illness.
Ulcerative colitis may affect any age group, although there are peaks at
ages 15 - 30 and then again at ages 50 - 70.
The disease can begin the rectal area, and may involve the entire large
intestine over time. It may also start in the rectum and other parts of the
large intestine at the same time.
Risk factors include a family history of ulcerative colitis, or Jewish

ancestry.
Symptoms
The symptoms vary in severity and may start slowly or suddenly. About half the
patients only have mild symptoms. Others have more severe attacks that occur
more often. Many factors can lead to attacks, including respiratory infections or
physical stress.
Symptoms include:
Abdominal pain and cramping

Abdominal sounds (gurgling or splashing)
Blood and mucus in the stools
Diarrhea, from only a few episodes to very often
Fever
Tenesmus (rectal pain)
Weight loss
Children's growth may slow.
Other symptoms that may occur with ulcerative colitis include the following:
Gastrointestinal bleeding
Joint pain and swelling
Mouth ulcers
Nausea and vomiting
Skin lumps or ulcers
Signs and tests
Colonoscopy with biopsy is generally used to diagnose ulcerative colitis.
Colonoscopy is also used to screen people with ulcerative colitis for colon
cancer. Ulcerative colitis increases the risk of colon cancer. Anyone with this
condition, should be screened with colonoscopy about 8 - 12 years after being
diagnosed and then have follow-up colonoscopies every 1 - 2 years.
Other tests that may be done to help diagnose this
condition include:
Barium enema
Complete blood count (CBC)
C-reactive protein (CRP)
Sedimentation rate (ESR)
Colonoscopy
Treatment
The goals of treatment are to:
Control the acute attacks
Prevent repeated attacks
Help the colon heal

MEDICATIONS
Medicines that may be used to decrease the number of attacks

include:
• 5-aminosalicylates such as mesalamine or sulfazine

(Azulfidine), which can help control moderate symptoms
• Immunomodulators such as azathioprine (Imuran ) and 6-

mercaptopurine
• Corticosteroids (prednisone and methylprednisolone) taken

by mouth during a flare-up or as a rectal suppository, foam,
or enema
• Adalimubab (Humira ) (anti TNF medication), Infliximab

(Remicade ).
SURGERY
Surgery to remove the colon will cure ulcerative colitis (!!) and removes the
threat of colon cancer. Surgery is usually recommended in:
Colitis that does not respond to complete medical therapy
Changes in the lining of the colon that are thought to be precancerous
Serious complications such as rupture perforation of the colon, severe

bleeding, or toxic megacolon
Most of the time, the entire colon, including the rectum, is removed (total
proctocolectomy with ileostomy). Afterwards, one needs an ileostomy.
ULCERATIVE COLITIS IN CHINESE MEDICINE
Obviously, there is no category of “ulcerative colitis” in the original texts. In

Chinese medicine, ulcerative colitis might correspond to various categories
of disease:
Dysentery 痢疾
Diarrhoea 泄泻
Blood in the stools 便血
Intestinal Wind 肠风
Intestinal Pi masses 肠癖
AETIOLOGY
External pathogenic factors
Cold easily invades the intestines but the two most likely external
pathogenic factors are Heat and Dampness.
Irregular diet
Excessive consumption of greasy foods, sugars and dairy foods. Also
excessive consumption of spicy foods and alcohol.
Emotional stress
Emotions that lead to Qi stagnation may affect the Intestines. It is not only
Liver-Qi stagnation that affects the Intestines but also Spleen-Qi stagnation
and Stomach-Qi stagnation.
Qi stagnation may lead to Blood stasis which often plays a role in ulcerative
colitis. Also, Qi stagnation contributes to the formation of Phlegm which
may also play a role in UC.
Stomach and Spleen deficiency

A deficiency of Stomach and Spleen deriving from a chronic illness or
overwork is very often at the root of the development of UC.
Latent Damp-Heat
Latent Damp-Heat forms after an invasion of external pathogenic factors that
does not cause immediate symptoms. The formation of Latent Damp-Heat is
more common at the end of summer. This is often the Chinese
correspondent to the autoimmune aspect of UC.
PATHOLOGY
Deficiency of Stomach and Spleen
A deficiency of Stomach and Spleen is practically always a factor in the
development of UC. Spleen deficiency itself may be a cause of the diarrhoea.
Spleen deficiency may also cause bleeding.
Dampness (Damp-Heat)
In my experience, in UC there is always Dampness and especially Damp-Heat.
Dampness obstructs the Intestines and may also cause diarrhoea by itself.
Qi stagnation
Qi stagnation is also nearly always present in UC. It causes borborygmi and
distension.
Blood stasis
Blood stasis may develop from Qi stagnation and it causes intense pain.
Toxic Heat
Toxic Heat may develop from Damp-Heat and it is present in acute cases or in
flare-ups of chronic cases.
Blood Heat
Blood Heat may also develop from Damp-Heat and it causes bleeding.
PATHOLOGY OF “INTESTINES”
Three things to clarify. Firstly, Qi stagnation can affect almost any organ,
not just the Liver. For example, it affects Lungs, Heart, Stomach, Spleen,
Gall-Bladder and the “Intestines”.
Secondly, in many pathological conditions of the digestive system, in my

experience, one cannot really differentiate the Small from the Large
Intestine: this is due to the close anatomical connection between ileum and
colon. Please note that I am referring to digestive-system conditions as the
Small Intestine may be involved in other symptoms such as urinary
conditions.
Thus, when a digestive-system pathology is in in the Intestines, the patterns

involved (Qi stagnation, Blood stasis, Damp-Heat, Toxic Heat) usually
affect both Small and Large Intestine.
Thirdly, a pathology of the Stomach is very often associated with the same pathology i
the Large Intestine. This happens especially with Yin Xu and Dampness. This is
because the Stomach and Large Intestine are connected through the Yang Ming
Ileum
STOMACH
YANG
MING
LARGE
INTESTINE
This is reflected also on the pulse if you put the Large Intestine on the right Chi position (as I do).
Damp-Heat in ST and LI Yin Xu of ST and LI

DEFICIENCY OF YIN OF STOMACH AND INTESTINES
Yang Ming = Stomach and Large Intestine.
A Yin deficiency of the Stomach often affects the Large Intestine

too, although we do not have a syndrome called “Yin deficiency
of Stomach and Large Intestine”.
The association between a pathology of the Small Intestine with that of
the Large Intestine is reflected in pulse diagnosis with a pulse that is
abnormal in both Chi positions.
Wiry on both Chi positions = Qi stagnation (or Blood stasis) in Intestines

Slippery on both Chi positions = Dampness in Intestines
It follows that the treatment outlined for ulcerative colitis may apply also
to Crohn’s disease, even though this is different from the biomedical point
of view (Crohn’s disease may affect the whole digestive system from
mouth to anus).
NOTE: if both Chi are weak and deep, it is a KI deficiency

Yao Cheng Wen, A Vernacular Explanation of the Discussion on Stomach and Spleen Pi Wei Lun
Bai Hua Jie, Three Qin Publishing House, Xian, 2002, p. 206.
Citing Acupuncture Channels of the Yellow Emperor Huang Di Zhen Jing 黄帝针经.
“The Large Intestine and the Small Intestine pertain to the Stomach Yang
Ming. The point of the Small Intestine is ST-39 Xiajuxu and that of the
Large Intestine is ST-37 Shangjuxu, both below ST-36 of the Stomach Yang
Ming. The Large Intestine controls the Jin fluids and the Small Intestine the
Ye fluids. The Small and Large Intestine receive Ying Qi from the Stomach
and send the Jin-Ye fluids to the Upper Burner where they irrigate the skin
and hair and fill the Cou Li space.”
Practically the same quote is in chapter 2 of the Ling Shu.
What this quote is saying is that the Small and Large Intestine, in the field
of digestive disease, come under the sphere of influence of the Stomach. It
also confirms the importance of ST-39 and ST-37 for intestinal diseases.
Note the location of ST-37 and ST-39 in relation to ST-40: the former is
above it and the latter below. ST-40 is the Luo point and the Great Luo of
the Stomach is called Xu Li 虚里. The names of ST-37 and ST-39 could
be related to this: “above the great emptiness” and “below the great
emptiness” (or “void”).
XU LI
...ST-37 Shangjuxu- Upper Great Void

ST-40
ST-39 Xiajuxu- Lower Great Void
The Small and Large Intestine are different than other organs in so far
as the their channels have a physiology and pathology that is quite
distinct from that of their organs (the Triple Burner is also like this).
DAMP HEAT
Chronic condition, abdominal pain, foul-smelling diarrhoea with mucus and
blood, pain alleviated by defecation, tenesmus, borborygmi, rectal pain and
burning in anus, possibly fever, thirst, irritability, scanty-dark urine.
Tongue: red with thick-sticky-yellow coating.
Pulse: Rapid-Slippery.
Treatment principle
Clear Heat, resolve Dampness, cool Blood, stop diarrhoea.
Prescription
Ge Gen Qin Lian Tang Pueraria-Scutellaria-Coptis Decoction
Ge Gen Radix Puerariae

Huang Lian Radix Coptis
Huang Qin Radix Scutellariae
Gan Cao Radix Glycyrrhizae
1) Treat Root
QING RE ZHI BENG TANG Clear Heat, Cool Blood
Clearing Heat and Arresting Flooding Decoction
Shan Zhi Zi Fructus Gardeniae
Huang Qin Radix Scutellariae 2) Harmonize Blood
Huang Bo Cortex Phellodendri a) Stop bleeding
Sheng Di Huang Radix Rehmanniae b) Nourish Blood
Mu Dan Pi Cortex Moutan radicis c) Calm Blood
Di Yu Radix Sanguisorbae d) Invigorate Blood
Ce Bai Ye Cacumen Biotae
Chun Gen Bai Pi Cortex
Gui Ban Plastrum Testudinis 3) Astringe
Bai Shao Radix Paeoniae alba
4) Treat Qi
FORMULAE
Bai Tou Weng Tang Pulsatilla Decoction (Damp-Heat)
Bai Tou Weng Radix Pulsatillae

Huang Bo Cortex Phellodendri
Qin Pi Cortex Fraxini
Tong Xie Yao Fang Important Formula for Painful Diarrhoea (Liver-Qi
invading the Spleen, Dampness)
Bai Zhu Radix Atractylodis

Bai Shao Radix paeoniae alba
Chen Pi Pericarpium Citri reticulatae
Fang Feng Radix Saposhnikoviae
Note: I use this formula also if there is no pain.

Gen Gen Huang Qin Huang Lian Tang Pueraria-Scutellaria-Coptis Decoction
(Damp-Heat)
Ge Gen Radix Puerariae

Zhi Gan Cao Radix Glycyrrhizae
Shao Yao Tang Paeonia Decoction (Damp-Heat)

Dang Gui Radix Angelicae sinensis
Bai Shao Radix Paeoniae alba
Gan Cao Radix Glycyrrhizae
Mu Xiang Radix Aucklandiae
Bing Lang Semen Arecae
Rou Gui Cortex Cinnamomi
EXAMPLE OF FORMULA FOR UC FROM DAMP-HEAT WITH BLEEDING
1) Treat Root
Bai Tou Weng Tang Pulsatilla Decoction Clear Heat, drain
Dampness. cool Blood
Bai Tou Weng Radix Pulsatillae
Huang Bo Cortex Phellodendri 2) Harmonize Blood
Qin Pi Cortex Fraxini a) Stop bleeding
Dang Gui Radix Angelicae sinensis b) Nourish Blood
Bai Shao Radix Paeoniae alba c) Calm Blood
Di Yu Radix Sanguisorbae d) Invigorate Blood
Mu Dan Pi Cortex Moutan
Huang Qi Radix Astragali
3) Astringe
4) Treat Qi
EXAMPLE OF FORMULA FOR UC FROM DAMP-HEAT WITH
BLEEDING
Li Zheng Quan, Practical Study of Stomach and Spleen in Chinese Medicine Shi Yong Zhong Yi Pi Wei
Xue, Chongqing Publishing House, Chongqing, 1992, p. 582.
1) Treat Root
Huang Bo Cortex Phellodendri Clear Heat, drain
Huang Lian Radix Coptis Dampness. cool Blood
Di Yu Radix Sanguisorbae
Huai Hua Flos Sophorae
Bai Tou Weng Radix Pulsatillae 2) Harmonize Blood
Bai Shao Radix Paeoniae alba a) Stop bleeding
Mu Dan Pi Cortex Moutan b) Nourish Blood
Mu Xiang Radix Aucklandiae c) Calm Blood
Xian He Cao Herba Agrimoniae d) Invigorate Blood
Gan Cao Radix Glyryrrhizae
3) Astringe
4) Treat Qi
PATIENTS
Western disease Chinese disease Patterns Pulse Tongue Formula
Damp-Heat Intestines, Bai Tou Weng

Ulcerative colitis Diarrhoea SP-Qi Xu Weak Red tip, sticky-yellow coating Tang ah
Bai Tou Weng
Ulcerative colitis Diarrhoea Damp-Heat Intestines Slippery Red Tang ah
Diarrhoea, Damp-Heat Intestines, Right Weak, left Red, Swollen, sticky-yellow Bai Tou Weng
Ulcerative colitis Abdominal Pain SP-Qi Xu Slippery coating Tang h
Damp-Heat, stasis of Slippery, Firm, left Purple, rootless-yellow Bai Tou Weng
Ulcerative colitis Diarrhoea Blood Guan and Chi Weak coating Tang ah
Ulcerative colitis Diarrhoea Damp-Heat, Ki Xu Deep, Weak Pale, Swollen, teethmarks a

Wiry both Chi, Weak Bai Tou Weng
Ulcerative colitis Diarrhoea Damp-Heat L.I., SP-Qi Xu on right Pale, sticky coating Tang ah
Rapid, Wiry, Slippery, Red, slightly Purple, sticky Bai Tou Weng
Ulcerative colitis Diarrhoea Damp-Heat both Chi Wiry coating, swollen sides Tang h
Red sides, yellow-sticky

Ulcerative colitis Diarrhoea Damp-Heat, Blood Heat Slippery, Weak coating Si Miao San h
Damp-Heat L.I., LIV-Blood Bai Tou Weng
Ulcerative colitis Diarrhoea Xu, SP-Qi Xu Wiry, left Wiry-Empty Red, sticky coating Tang h
Ulcerative colitis, Diarrhoea, Bai Tou Weng

psoriasis, arthritis psoriasis Damp-Heat L.I., LU-Yin Xu Rapid, Floating-Empty Red, Peeled, cracks Tang ah
Damp-Heat Large Bai Tou Weng

Ulcerative colitis Diarrhoea Intestine Wiry-Slippery Red, red sides, Swollen Tang h
Journal of Autoimmunity 33 (2009) 197–207
16. BI SYNDROME
The symptoms of Damp Bi Syndrome are:
Generalized (but not moving around) or localized ache in the joints and
muscles, often starting from the lower part of the body
Swelling of joints with feeling of heaviness of limbs
Aggravation from exposure to dampness.

DAMP BI SYNDROME OR (FIXED BI SYNDROME)
This is caused by Dampness and is characterized by pain, soreness and
swelling in muscles and joints with a feeling of heaviness and numbness of the
limbs, the pain being fixed in one place and aggravated by damp weather. In
acute cases the pulse would be Slow and slightly Slippery.
Damp Bi Syndrome: SP-9 Yinlingquan, SP-6 Sanyinjiao, G.B.-34

Yanglingquan, ST-36 Zusanli, BL-20 Pishu. Use the reducing method in acute
cases and even method in chronic ones. BL-20 should be reinforced in either
case. Moxa is also applicable. If the joints are swollen (as they usually are in
Damp Bi Syndrome), one can lightly tap the affected joint with the plum-
blossom needle until very tiny droplets of blood appear and then direct the
smoke of burning moxa onto it.
The "Compendium of Acupuncture" suggests using BL-17 Geshu for Damp Bi

Syndrome.
DAMP PAINFUL OBSTRUCTION SYNDROME
Treatment principle
Drain Dampness, remove obstruction from the channels, expel Wind, scatter
Cold.
Prescription
YI YI REN TANG
Coix Decoction
Explanation
This formula resolves Dampness, expels Wind, warms the channels, scatters
Cold and invigorates Blood.
Prescription
MA HUANG LIAN QIAO CHI XIAO DOU TANG Variation
Ephedra-Forsythia-Phaseolus Decoction Variation
Explanation
This formula is used if Dampness combines with Heat and is not too severe,
causing red-swollen-hot joints fever, thirst and a Floating-Rapid pulse, at the
acute stage. It expels Wind-Heat, resolves Dampness and clears Heat.
Prescription
CHUAN BI TANG
Eliminating Painful Obstruction Syndrome Decoction
Explanation
This formula (suitable also for Wind Painful Obstruction Syndrome) expels
Wind, resolves Dampness, scatters Cold, invigorates Blood, removes
obstructions from the channels and stops pain.
Prescription
SAN MIAO SAN
Three Wonderful Powder
Explanation
This is for Damp Heat affecting the legs (or one leg) and causing the knee joint to
be hot, red painful and swollen. It resolves Dampness and clears Heat from the
Lower Burner and legs.
Prescription
GUI SHAO XI CAO TANG
Angelica-Paeonia-Siegesbeckia Decoction
Explanation
This prescription is used if the joints are still swollen after an acute attack and all
the acute symptoms and signs have gone. It expel Wind, resolves Dampness and
removes obstructions from the channels.
Prescription
BU TU ZAO SHI TANG
Tonifying the Earth and Drying Dampness Decoction
Explanation
This formula tonifies Spleen-Qi, dries Dampness, resolves Dampness and
expels Wind from the channels. Compared to the other formulae, its Qi-
tonifying action is pronounced.
Prescription
SHU JIN TANG
Relaxing the Sinews Decoction
Explanation
This formula resolves Dampness, expels Wind, invigorates Blood and tonifies
the Spleen.
THREE TREASURES REMEDIES FOR DAMPNESS IN JOINTS
CLEAR CHANNELS: for chronic or acute exacerbation of chronic Bi

syndrome with Damp-Heat in the channels.
BENEFIT THE SINEWS: for chronic Bi with Dampness in channels,

Phlegm in joints and Blood stasis.
INVIGORATE THE ROOT: for chronic Bi with Dampness in the joints

and underlying Kidney-Yang deficiency.
NOURISH THE ROOT AND CLEAR WIND: for chronic Bi with Dampness in
the channels with an underlying Kidney-Yin deficiency.
BROCADE SINEWS : for Chronic Wind-Damp Painful Obstruction (Bi)

Syndrome with Liver-Blood/ Liver-Yin deficiency.
TONGUES FOR THREE TREASURES REMEDIES FOR DAMPNESS IN JOINTS
CLEAR CHANNELS: for chronic or acute

exacerbation of chronic Bi syndrome with
Damp-Heat in the channels.
BENEFIT THE SINEWS: for chronic Bi with Dampness

in channels, Phlegm in joints and Blood stasis.
INVIGORATE THE ROOT: for chronic Bi with

Dampness in the joints and underlying Kidney-Yang
deficiency.
NOURISH THE ROOT AND CLEAR WIND:

for chronic Bi with Dampness in the channels
with an underlying Kidney-Yin deficiency.
Journal of Autoimmunity 33 (2009) 197–207
17. ECZEMA
Eczema manifests with many patterns such as Wind-Heat, Wind-Damp-

Heat, Damp-Heat, Blood deficiency ect.
The eczema from Damp-Heat manifest with red papules or pustules and
it is often exudative, i.e. the skin oozes a fluid after scratching.
Papule Pustule
Heat or Damp-Heat at Qi level Toxic Heat
Vesicle Bulla
Dampness or Damp-Heat External Wind 261
Atopic eczema is the most common type of eczema
It is a chronic, inflammatory skin disease which usually starts in early

childhood, with 85% of children improving by the start of puberty.
There are three distinct age groups, with different characteristics:
1) Infantile Phase (1 month – 2 years)
scalp cheeks, forehead Spreads to the trunk and

limbs in a few cases
262
2) Childhood Phase (3-12 years)
antecubital fossae
popliteal fossae
wrists, neck
ankles
263
3) Adolescent and Adult Phase (12-20s)
antecubital fossae popliteal fossae anterior and lateral

aspects of the neck
Well-demarcated dry lesions, Hands may develop lesions after

with subsequent pigmentation contact with irritants.
264
Exudative vs Dry Type
Lesions cause severe itching
Exudative-type: erythema with many

papules, papulo-vesicles and vesicles
with exudate. “Weeping”.
Dry-type: dry, dark-red patches with

many small papules and greyish scales.
265
Babies
There are two basic types of eczema in babies, one characterized
by Wind-Heat (called “dry foetus”) and the other characterized
by Damp Heat (called “damp foetus”).
They are both due to a deficiency of Lung and Kidney's Wei Qi

systems but with varying degrees of involvement of the Lungs or
Kidneys.
The Wind-Heat type is more due to the Lungs
Damp Heat type is more related to the Kidneys.
As for the treatment, the aim depends on whether the asthma or the eczema
is the predominant problem.
If asthma is the predominant problem, one would simply use one of the
asthma formulae and add some herbs to treat the eczema according to type:
266
Wind-Heat Damp Heat
Jing Jie Herba Schizonepetae Fang Feng Radix Saposhnikoviae

Chan Tui Periostracum Cicadae Bai Xian Pi Cortex Dictamni
Bo He Herba Menthae haplocalycis Ge Gen Radix Puerariae
Bai Xian Pi Cortex Dictamni Bai Zhi Radix Angelicae dahuricae
Niu Bang Zi Fructus Arctii
Sheng Ma Rhizoma Cimicifugae
Acute eczema Chronic eczema
Wind Heat Damp Heat Wind-Heat Damp Heat

(with Blood deficiency)
267
All these herbs are suitable for babies or young children.
Eczema from Wind-Heat is characterized by skin lesions which

are very dry, red and itchy, with the itchiness being spread all
over the body and moving from place to place.
Eczema from Damp Heat is characterized by skin lesions which

are moist, oozing fluid, red and itchy, with the itchiness being
more confined to specific parts of the body, often the forearm
and lower leg.
268
However, please remember that in eczema there is always
Dampness, even in the “dry” type: in fact, the typical skin
puffiness seen in eczema is a manifestation of Dampness.
Comparison between Wind-Heat and Damp-Heat types of eczema
WIND-HEAT DAMP HEAT

“Dry foetus” “Damp foetus”
ORGAN Lungs Kidneys
Dry skin lesion, red, itchy, Moist skin lesions, oozing a

CLINICAL itchiness all over and moving fluid, itchy, itchiness
MANIFESTATIONS from place to place confined to specific parts
(usually limbs)
HERBS Jing Jie, Chan Tui, Bo He, Fang Feng, Bai Xian Pi, Ge
Bai Xian Pi Gen, Bai Zhi, Niu Bang Zi,
Sheng Ma
269
In babies and young children I often use a variation of Chu Shi Wei
Ling Tang Eliminating Dampness Stomach “Ling” Decoction which
is aimed primarily at eliminating Dampness.
I modify it with the addition of herbs with the following aims:
- To expel Wind: Jing Jie Herba Schizonepetae or Chan Tui

Periostracum Cicadae.
- To tonify the Lung’s Wei-Qi system: Bei Sha Shen Radix Glehniae
and Mai Men Dong Radix Ophiopogonis.
- Anti-allergy herbs: Dan Shen Radix Salviae miltiorrhizae, Wu Wei Zi

Fructus Schisandrae, Wu Mei Fructus Mume.
- To tonify the Kidneys’ Wei-Qi system: Tu Si Zi Semen Cuscutae.
270
Adolescents and adults
Prescriptions for Damp-Heat eczema

Chu Shi Wei Ling Tang Eliminating Dampness Stomach “Ling”
Decoction
Bi Xie Shen Shi Tang Dioscorea Draining Dampness Decoction
Chu Shi Wei Ling Tang

Eliminating Dampness Stomach Ling Decoction
Qing Re Shen Shi Tang

San Feng Chu Shi Tang

Scattering Wind and Eliminating Dampness Decoction
271
ii. Damp Heat
Acupuncture
L.I.-11 Quchi, SP-9 Yinlingquan, SP-6 Sanyinjiao, Du-14 Dazhui, SP-10
Xuehai, Ren-12 Zhongwan, BL-20 Pishu, LU-7 Lieque and KI-6 Zhaohai
(Ren Mai), KI-3 Taixi, Sifeng. Reducing method except on Ren-12, BL-20,
LU-7, KI-6, LU-9 and KI-3 which should be reinforced. No moxa.
Prescription
Explanation
This formula drains Damp Heat from the Lower Burner and the skin.
Prescription
Eliminating Dampness Stomach Ling Decoction
Explanation
This formula drains Damp Heat and clears Heat. Compared to the previous
formula, the emphasis is slightly more on Heat and on Dampness. 272
Bi Xie Rhizoma Dioscoreae hypoglaucae 6 g

Huang Bo Cortex Phellodendri 6 g
Fu Ling Poria 6 g
Mu Dan Pi Cortex Moutan 6 g
Ze Xie Rhizoma Alismatis 6 g
Hua Shi Talcum 12 g
Mu Tong Caulis Akebiae 3 g
NOTE: we cannot use Mu Tong
273
Eliminating Dampness Stomach “Ling” Decoction
Cang Zhu Rhizoma Atractylodis 6 g

Mu Tong Caulis Akebiae 2 g
Zhu Ling Polyporus 6 g
Ze Xie Rhizoma Alismatis 6 g
Hua Shi Talcum 6 g
Shan Zhi Zi Fructus Gardeniae 4 g
274
Prescription
Explanation
This formula drains Damp Heat, clears Heat, cools Blood and expels Toxic Heat.
These three formulae for acute eczema may be differentiated in the table below.
BI XIE SHEN SHI CHU SHI WEI QING RE SHEN

TANG LING TANG SHI TANG
ACTION Drain Damp-Heat Drain Damp-Heat Drain Damp-Heat

via urine via urine and relieve and resolve Toxic
epigastric fullness Heat
SKIN Moist-red skin Moist-red skin Pustular-red skin

lesions lesions, eczema lesions
more on legs 275

Huang Bo Cortex Phellodendri 3 g
Ku Shen Radix Sophorae flavescentis 3 g
Bai Xian Pi Cortex Dictamni 3 g
Ban Lan Gen Radix Isatidis seu Baphicacanthis 5 g
Sheng Di Huang Radix Rehmanniae 5 g
Fu Ling Poria 3 g
Hua Shi Talcum 5 g
Zhu Ye Folium Phyllostachys nigrae 3 g
276

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AETIOLOGY, PATHOLOGY AND TREATMENT OF DAMPNESS

Exterior Dampness can also be caught by wearing wet clothes,

The characteristics of Dampness are:

sticky causes repeated attacks

When exterior Dampness invades the body, it tends to invade

If it settles in the female genital system it causes vaginal

• a feeling of heaviness of body or head

Head: feeling of heaviness of the head

Eyes: red-swollen eyelids, eyes oozing a fluid, sties

Mouth: mouth ulcers on gums, swollen-red lips

Stomach and Spleen: feeling of fullness of epigastrium, feeling of

Skin: papules (Damp-Heat with more Heat), pustules,

Luo Channels: numbness and loss of sensation.

Joints: swollen-painful joints (Fixed Bi or also

Heaviness: this causes a feeling of heaviness, tiredness, heaviness of limbs or

Since Dampness is heavy it causes a feeling of fullness of chest or epigastrium,

Stickiness: Dampness is sticky and this is reflected in a sticky

Yin nature: Dampness is a Yin pathogen and it therefore tends to

PINYIN CHINESE ENGLISH PATHOLOGY EXAMINATION

MEN 闷 Feeling of Phlegm, severe Chest and

MAN 满 Feeling of fullness Dampness, Food Epigastrium,

• Thicker in centre • Thicker in centre • Thick and patchy

• Slippery but rougher • Oily, smooth • Crumbly like tofu

Sticky: Phlegm or Dampness

Slippery: definitely Dampness

Slippery: definitely Dampness

Sticky Sticky Sticky

Slippery: definitely Dampness

ACCORDING TO COMBINATION WITH OTHER PATHOGENS

ZANGFU Bladder Intestines

ACUTE DAMP-HEAT AT QI LEVEL

Dampness can be in:

In the Zangfu, it can be in:

Stomach and Spleen (epigastric pain and fullness, poor digestion,

Gall-Bladder (hypochondriac pain and fullness)

Liver (hypochondrial fullness, distension and pain, jaundice)

Bladder (difficult and painful Kidneys (cloudy urine, difficult

Uterus (infertility, excessive Intestines (loose stools with mucus,

In the joints (Bi-syndrome)

In the head (feeling of heaviness of the head, dull frontal

In the skin, Dampness is the cause of a large number of skin

There are three possible types of invasions of external Dampness:

1) A “simple” invasion of Dampness which may affect

2) An invasion of Dampness in the channels causing Bi

3) An invasion of Damp-Heat of the Wen Bing type at the

STOMACH AND SPLEEN

i. Damp Heat at the Qi level

A) simple invasion of external Dampness in Zangfu

i. Invasion of external Dampness in Bladder

ii. Invasion of external Dampness in the Stomach

iii. Invasion of external Dampness in the Intestines

iv. Invasion of external Dampness in the Uterus

v. Invasion of external dampness in the gallbladder

C) INVASION OF EXTERNAL DAMP-HEAT AT WEI LEVEL

i) EXTERNAL DAMP-HEAT AT WEI LEVEL

ii) EXTERNAL SUMMER-HEAT WITH DAMPNESS

HERBS THAT RESOLVE DAMPNESS

HERBS THAT RESOLVE DAMPNESS BY REGULATING WATER.

HERBS THAT DRY-UP DAMPNESS AND CLEAR HEAT

HERBS THAT RESOLVE DAMPNESS AND EXPEL WIND

NATURE HOW FROM PATTERN DISEASE HERBS FORMULAE

BLAND, Urination Whole Dampness Lin Fu Ling, Wu Ling San,

BLAND- Urination Urinary Damp-Heat Lin Ze Xie, Hua Ba Zheng San,

“Pungent to open, bitter to make descend” 辛开苦降