3 What is damp retentionAn abnormal accumulation of body fluids, which affect the physical functions of organs (most commonly spleen), tissues (muscles etc) and cells, leading to dysfunction of cellular metabolism.Damp: intercellular accumulation of body fluids?
4 Where does damp retention come from? Damp retention leading to Spleen dysfunctionSpleen has the function in transformation and transportation of food essence to produce QiExogenous Damp:Damp environment, damp weather, etc.Damp accumulating in Middle JiaoSpleenDysfunctionXu LaoEndogenous damp:Cold food/ unhealthy diet
5 What is Qi Deficiency? Qi: life force, vital energy Qi deficiency: Qi becomes weaker than normal leading to lessened energy level in the body, manifesting as fatigue/lethargy, weak muscles, poor appetite, weak voice, pale tongue and weak pulse.
6 Where does Qi Deficiency come from? Typical Qi Deficiency is Spleen Qi DeficiencyCongenital WeaknessToo little productionlong term illnesserratic dietmalnutritionSpleen Qi Deficiency - failing to transform and transport body fluids, leading to Damp retentionSpleen Deficiency- Failing to produce Qi, Qi becomes weakToo much consumptionlong term illnessoverwork
8 A. Early stage: predominantly excess patterns Damp accumulated in the interior1. Damp heat accumulated in the interiorMain symptoms:feeling slightly hot but no fever, sweating, thirst but no desire for drinking;distension/fullness in abdomen, with dull pain, poor appetite, erratic bowel movement or diarrhoea, nausea, vomiting;red tongue with yellow greasy coating, rapid soft pulse.
9 Treatment principles: Clear damp heat Herbal formulae: San Ren TangHerbal prescription: Xing Ren, Sha Ren, Yi Yi Ren, Huan Qin, Zhi Zi, Bai Zhu, Chen Pi, Gan CaoPoint selection: GB34, SP9, ST38, ST25, LI11
10 2. Damp cold accumulated in the interior Main symptoms: feeling cold, no or little sweating, no desire for drinking, distension/fullness in abdomen, poor appetite, nausea, erratic bowel movement or diarrhoea, pale tongue with white greasy coating, slow soft (soggy) pulseTreatment principles: expel cold and remove dampPoint selection: GB34, SP4, SP6, SP9, ST36, ST38, ST25, Ren 12, Ren6, or moxa
11 Treatment principles: expel cold and remove damp Herbal formulae: Ping Wei San with Huo Zhu WanHerbal prescription: Cang Zhu, Hou Po, Chen Pi, Sha Ren, Yi Yi Ren, Huo Xiang, Bai Zhu, Gan Cao, Fu Ling,Point selection: GB34, SP4, SP6, SP9, ST36, ST38, ST25, Ren 12, Ren6, or moxa
12 3. Damp /phlegm retention combined with Liver Qi stagnation Main symptoms:no feeling cold or hotdistension/fullness in abdomen, or abdominal painpoor appetite, nauseaor fullness in chest with cough and phlegmerratic bowel movement or diarrhoeairregular or painful menstruationirritability, frequent sighingpale tongue with white greasy coating, pulse soft in spleen position and wiring in liver position
13 Treatment principles: remove damp/phlegm and spread liver qi Herbal formulae: Er Chen Tang with Si Ni SanHerbal prescription: Chen Pi, Ban Xia, Fu Ling, Gan Cao; Chai Hu, Bai Shao Yao, Zhi Shi; plus Qing Pi, Yu Jin, Xing Ren.Point selection: Liv3 (or with LI4), GB34, SP4, SP6, SP9, ST36, ST40, ST25, Ren 12, Ren6, Liv13, Liv14.
14 B. Middle Stage: predominantly deficiency patterns 1. Qi deficiency mingled with dampMain symptoms: Fatigue, low energy level, poor appetite, loose stools or even diarrhoea, weight loss, pale tongue with teeth marks on the tongue edge, weak pulse.
16 2. Qi and blood deficiency Main symptoms: Fatigue, low energy level, pale complexion, poor appetite, loose stools or even diarrhoea, more obvious weight loss, abnormal menstruation in women, dizziness when feeling tired, numbness in limbs, blurred vision, pale tongue and weak pulse.
17 Treatment principles: Tonify Qi and nourish blood Herbal formulae: Ba Zhen TangHerbal prescription: Dang Sehn, Bai Zhu, Fu Ling, Gan Cao; Dang Gui, Bai Shao Yao, Shu Di Huang, Chuan Xiong; Huang Qi, Shan Yao, He Shou Wu can be added.Point selection: ST36, SP6, SP10 Ren 6, BL17, BL18, BL20.
18 3. Yin deficiencyMain symptoms: Feeling hot or hot flushes, night sweats, dry mouth and thirst, “five palm heat”, weight loss, fatigue, red tongue with little coating, weak/thin and rapid pulse.
19 Treatment principles: Nourish Yin Herbal formulae: Liu Wei Di Huang Wan plusHerbal prescription: Shu Di Huang, Shan Yao, Shan Zhu Yu, Mu Dan Pi, Ze Xie, Fu Ling; Mai Men Dong, Nu Zhen Zi, Gou Qi Zi, Tai Zi Shen can be addedPoint selection: SP6, BL18, BL23, Ren4; KI2, 6 or 7
20 4. Yang deficiencyMain symptoms: Feeling cold with cold hands and feet, lack of sweats, weight loss, very tired with low energy, obvious general weakness, loose stools or diarrhoea, frequent urination, pale or purple tongue, deep weak pulse.
21 Treatment principles: tonify Yang Herbal formulae: modified Jing Gui Shen Qi WanHerbal prescription: Xian Mao (as substitute of Fu Zi), Rou Gui, Shu Di Huang, Shao Yao, Shan Zhu Yu, Mu Dang Pi, Ze Xie, Fu Ling; Tu Si Zi, Ba Ji Tian can be added.Point selection: KI3, 6, 7; BL20, 23; Ren4, 6; DU4, ST36
22 C. Later Stage: predominantly multiple deficiency patterns 1. Qi and Yin dual deficiencyMain symptoms: Extreme weakness, feeling hot or hot flushes, night sweats, dry mouth and thirst, “five palm heat”, weight loss, fatigue, poor appetite, erratic bowel movement, red tongue with teeth marks, little tongue coating, weak, thin and rapid pulse.
23 Treatment principles: Tonify Qi and nourish Yin Herbal formulae: Bao Yuan Jian with Liu Wei Di Huang WanHerbal prescription: Dang Shen, Bai Zhu, Huang Qi, Fu Ling, Chen Pi, Gan Cao; Shu Di Huang, Shan Yao, Shan Zhu Yu, Mu Dan Pi, Ze Xie; or Sheng Mai Yin (Ren Shen, Mai Men Dong, Wu Wei Zi) can be added.Point selection: ST36, SP6, BL18, BL20, BL23, Ren 4 Ren 6; KI 2, 3, 6 or 7
24 2. Yin and Yang dual deficiency Main symptoms: Extreme weakness, no hot or cold feeling, or feeling warm/hot in the afternoon but cold at night or in the morning, night sweats and spontaneous sweats, severe weight loss, very poor appetite, deep and very thin/weak pulse.
25 Treatment principles: tonify Yang and nourish Yin Herbal formulae: Liu Wei Di Huang Wan with Zhen Wu TangHerbal prescription: Shu Di Huang, Shan Yao, Shan Zhu Yu, Mu Dan Pi, Ze Xie, Fu Ling; Fu Zi (substituted by Xiao Mao), Gan Jiang, Bai Zhu, Bai Shao Yao; Rou Gui, Ba Ji Tian can be added.Point selection: SP6, ST36, BL18, BL20, BL23, Ren4; KI2, 3, 6 or 7; Ren4, 6; DU4
26 Lifestyle Modification Balance DietAdequate RestGentle exercise: Tai Ji, Yoga, etc.Spiritual relaxation: Meditation, enjoy life, have a good relationshipFamily supportSocial activity
27 Balanced Diet High protein food: red meat, fish Vegetarian: may not be good for ME sufferersEating hot or cold food?
28 Hot/Cold Property of Common Food 常用食物的寒热属性 Warm or Hot Food 温热性食物(more suitable to people with cold constitution or cold pattern of illness)Neutral Food中性食物(suitable to all)Cool or Cold Food 寒凉性食物(more suitable to people with heat constitution or heat pattern of illness)MeatLamb, chicken, goose, prawn,羊肉, 鸡肉, 鹅肉, 海虾Pork, beef猪肉, 牛肉Crab, most sea food, rabbit, duck, pig liver, donkey螃蟹, 多数水产品, 兔肉, 鸭, 猪肝, 驴肉VegetableEggplant, onion, chive, garlic, pepper,茄子, 洋葱, 韭菜, 大蒜, 辣椒, 姜, 茴香Potato, Chinese Yam土豆, 山药Seaweed, Chinese leaf, cabbage, spinach, carrots, celery, cucumber, wax gourd, gourd, lotus root, tomatoes, green bean海带, 白菜, 菠菜, 萝卜, 芹菜, 黄瓜, 冬瓜, 葫芦, 莲藕, 西红柿, 绿豆FruitsLongan, litchi chinensis, chestnut, walnut, citrus,龙眼, 荔枝, 栗子, 胡桃, 橘类Peach, apricot, grape桃, 杏, 葡萄Pears, watermelon, melon, persimmon, banana, pineapple梨, 西瓜, 甜瓜, 柿, 香蕉, 菠萝OthersBrown sugar, syrup, wine, coffee, curry红糖，饴糖，酒，咖啡，咖喱Chicken egg鸡蛋Sugar, ice sugar, tofu, duck egg白糖, 冰糖, 豆腐, 鸭蛋
29 Qi Tonic herbs Ginseng (Ren Shen) Other Qi tonic herbs: Chinese ginsengKorean ginsengSiberian ginsengAmerican ginsengOther Qi tonic herbs:Huang QiDang ShenBai ZhuShan Yao