1. Wei (flaccidity syndrome)
Western medicine – any disorder of the PNS that may cause weakness &/or numbness, MS, spinal & muscular disorders.
TCM – flaccidity, paralysis, hemiplagia, muscular atrophy of the limbs
Treat Yangming primarily (sea of food and water, contains the most Qi and blood) .
痿病是指肢体筋脉弛缓，软弱无力，日久不用，而致肌肉萎缩或瘫痪的一种病证。
· 痿者萎也，枯萎之义，即指肢体痿弱，肌肉萎缩。
· 《素问玄机原病式·五运主病》：“痿，谓手足痿弱，无力以运行也。”
· 因下肢痿弱较多见，故又有“痿躄”之称。
《素问·痿论》：“五脏因肺热叶焦，发为痿”。
《素问·痿论》：“肺主身之皮毛，心主身之血脉，肝主身之筋膜，脾主身之肌肉，肾主身之骨髓。故肺热叶焦，则皮毛虚弱急薄，著则生痿躄也；心气热，则下脉厥而上，上则下脉虚，虚则生脉痿，枢折挈胫而不任地也；肝气热，则胆泄口苦，筋膜干，筋膜干则筋急而挛，发为筋痿；脾气热，则胃干而渴，肌肉不仁，发为肉痿；肾气热，则腰脊不举，骨枯而髓减，发为骨痿”。
凡肢体痿软无力，弛缓不收者均属痿病范畴。西医学的感染性多发性神经根神经炎、运动神经元病、重症肌无力myasthenia gravis、肌营养不良等符合本病证候特征者可参考本节辨证论治。

2. Etiology & Pathology 1. Consumption of Fluid due to heat in the Lungs
Invasion by Dampness-Heat
Spleen & Stomach Deficiency
病因病机】
筋脉、肌肉失于濡养是痿病发病的主要病机。
其发病原因与感受温热毒邪和湿热之邪有关，或素体脾胃虚弱、肝肾亏虚，因饮食不节、劳倦内伤而致；
病位常涉及多个脏腑经络，主要与肺及脾胃肝肾有关；
病性为本虚标实，起病急者多以邪实为主。病机重点为肺热叶焦、津液不布和湿热浸淫、经脉受阻，发病缓者多虚实互见，病久则以虚证多见，病机重点在脾胃肝肾亏虚。在病程中，因正气的盛衰和邪气的消长变化，常出现病机的转变，往往由实转虚或虚实夹杂，若毒邪炽盛，正不胜邪，可迅速出现脏气虚衰之证。

3. Main Points for differentiation
Treatment protocol:
Treating the YangMing meridians:
-- Eliminating the evil Qi of Yang Ming Meridian
Eliminate evil Qi
Disperse Heat
Eliminate dampness
-- Replenishing deficient Yang Ming meridian
External
Internal
Caused by
External pathogenic warmth & heat; damp-heat
Spleen & st. def.
Onset
Acute onset & develops rapidly
Develops gradually
Curability
If treated in time, patient will be gradually recovered
Hard to cure
肢体痿软无力，肌肉萎缩为本病的主要证候特征，但有急缓与虚实的不同。虚证 ── 发病缓，病程长，多肌肉萎缩明显。实证 ── 起病急，发展快，多肌肉萎缩不明显。临床上有以手足麻木为首发症状，逐渐出现肢体力弱的，也有起病即表现为肢体无力的。急性起病者，可有呼吸道或消化道等感染病史。病情急重者，可出现呼吸困难。
　痿病应与痹病、风痱相鉴别。 病名
主要证候特征
基本病机 痿病
肢体痿软无力，肌肉萎缩
筋脉失于濡养而弛缓不收 痹病
肢体关节肌肉疼痛、屈伸不利
外邪侵袭，经络痹阻

4. Body Damaged by Lung Heat
Treatment
Body Damaged by Lung Heat
Signs & Symptoms:
Main Sym. : fever then high fever, weakness & flaccidity of the limbs ( usually lower extremities ), atrophic muscles.
Concurrent sym.: restlessness, thirst, coughing, dry throat, scandy dark or anuria, constipation, pain in the joint and limbs or numbness.
Tongue: red body with yellow scanty coating
Pulse: thready & rapid
Treatment Protocol:
Disperse heat
Moistening dryness
Nourish the lungs
Produce body fluid

5. High fever, thirsty, sweating -- Zhi Mu; Lian Qiao; Jin yin Hua;
Formula:
Modifications:
High fever, thirsty, sweating
-- Zhi Mu; Lian Qiao; Jin yin Hua;
Nourish Lung Yin
-- Sang Bai Pi; Xuan Shen; Shen Di Huang;
cough with less sputum
-- Quan Gua Lou; Bei Mu;
dry mouth & throat
-- Yi Wei Tang + YiYiRen + Bai Zhu + Shan yao + Gu Ya
Qin Zao Jiu Fei Tang
Sang Ye
Shi Gao
Xin Ren
Gan Cao
Mai Dong
Ren Shen
E Jiao
Hu Ma Ren
Pi Pa Ye
High fever, thirsty, sweating
-- Zhi Mu; Lian Qiao; Jin yin Hua;
Nourish Lung Yin
-- Sang Bai Pi; Xuan Shen; Shen Di Huang;
cough with less sputum
-- Quan Gua Lou; Bei Mu;
dry mouth & throat
-- Yi Wei Tang+ YiYiRen + Bai Zhu + Shan yao + Gu Ya

6. Treatment Damp-heat invasion Signs & Symptoms:
Main Sym. : heaviness & swelling, flaccidity, weakness, numbness of the limbs, particularly the lower limbs.
Concurrent sym.: feveror dyspnes, a burning sensation on passing urine sweating, constipation and anuriesis, difficulty in swallowing.
Tongue: red body with yellow coating
Pulse: softy & rapid
Treatment Protocol:
Disperse heat
Eliminate dampness

7. -- Hou Pu; Huo Xiang; Sha Ren Damp-heat damage Yin
Formula:
Modifications:
severe dampness
-- Fu Ling; Hua Shi;
distending chest
-- Hou Pu; Huo Xiang; Sha Ren
Damp-heat damage Yin
-- Shen Di Huang; Mai Dong
Cold feeling on lower extremities
-- Gui Zhi ( reduce Huang Bai )
Blood Stasis
-- Tao Ren; Hong Hua; Chi Shao; Dan Shen
Jia Wei Er Miao San
Huang Bai
Cang Zhu
Dang Gui
Niu Xi
Fang Ji
Bi Xie
Gui Ban
severe dampness
-- Fu Ling; Hua Shi;
distending chest
-- Hou Pu; Huo Xiang; Sha Ren
Damp-heat damage Yin
-- Shen Di Huang; Mai Dong
Cold feeling on lower extremities
-- Gui Zhi ( reduce Huang Bai )
Blood Stasis
-- Tao Ren; Hong Hua; Chi Shao; Dan Shen

8. Treatment
Spleen & Stomach Def.
Signs & Symptoms:
Main Sym. : weakness & flaccidity of the limbs or muscular atrophy develops gradually
Concurrent sym.: poor appetite, loose stools, pale complexion and puffy face or accumulation & obstruction of sputum and celostomia
Tongue: thin white coating
Pulse: thready
Treatment Protocol:
Tonify Spleen
Strengthen Qi

9. Formula: Modifications: bad appetite -- Ji Nei Jing;
Cold limbs or aversion to cold
-- Fu Zi; Gan Jiang;
weakness after long time illness
-- Huang Qi, Dang Gui, Bai Shao
Shen lin Bai Zhu San
Ren Shen
Fu Ling
Bai Zhu
Jie Gen
Shan yao
Gan Cao
Bai Bian Dou
Lian Zi Rou
Sha Ren
Yi Yi Ren
bad appetite
-- Ji Nei Jing;
Cold limbs or aversion to cold
-- Fu Zi; Gan Jiang;
weakness after long time illness
-- Huang Qi, Dang Gui, Bai Shao

10. Treatment
4. Liver & Kidney def.
Signs & Symptoms:
Main Sym. : disease develops gradually, weakness, flaccidity occur in the lower, soreness & weakness of the lumbar region
Concurrent sym.: anigestations, dizziness, tinnitus, spermatorrhea or incontinence of urination and defecation, or muscular twitching and cramp
Tongue: red body with a less coating
Pulse: thready & rapid
Treatment Protocol:
Tonify kidney & liver
Nourish yin and disperse heat

11. Formula: Modifications: pale complesion
-- Huang Qi; Dang Shen; He Shou Wu;
tonify kidney Yang
-- Ba Ji Tian; Rou Gai; Rou cong rong
Hu Qian Wan
Gui Ban
Huang Bai
Zhi Mu
Shu Di
Bai Shao
Suo Yang
Chen pi
Lian Zi Rou

12. Case History 1
1. Male 34 years
First visiting:
Main complain: muscle weakness for 6 y
symptoms started with the tiredness & weakness of four limbs, gradually developed to eyelids weakness. Western medicine diagnosis as myasthenia gravis, MG. symptoms got worse and worse.
now patient felt weakness of muscle, sore or pain muscles, especially on 2 legs, had difficulty to walk or go upstairs. Cold hands & feet; worse in cold weather
Tongue: thin white coating
Pulse: deep & fine
TCM diagnose:
Liver & kidney def.
Treatment protocol:
-- warm kidney yang
-- nourish Liver & kidney
Formula:
Zhi Fu zi 12; Gui Zhi 10; Rou Cong Rong 12; Bu Gu Zhi15; Xi Xin 3; Gao Liang Jiang 10; Wu Shao She 15; JI Xue Teng 20; Tu Si Zi 20; Gou Qi Zi 15; Zhi Gan Cao 10

13. Two of every three Americans have weight challenges
Obesity
Two of every three Americans have weight challenges
300,000 deaths per year
Unhealthy Dietary Habits
Physical Inactivity
Getting worse
15% of all Children are Overweight
关于人体产生肥胖的几种学说
高胰岛素血症学说 ( high insuline )
高胰岛素血症，能够使人们过多地增加饮食量，使肝脏及脂肪组织中的脂肪合成fat composion加快，促进血液中的脂肪沉积于脂肪组织中，同时抑制脂肪组织中的脂肪分解，增强脂肪蓄积作用是其主要原因。 大多数单纯性肥胖症患者都发现有高胰岛素血帧这一事实，这种高胰岛素血症，不仅在进食后，而且在空腹时大多数均呈升高现象。另一方面，一旦体重减至正常后，高胰岛素血症也就随之消失了。
脂肪细胞增殖学说
脂肪细胞的增殖，包括两个方面的内容：一种是指脂肪细胞内不断蓄积脂肪而使脂肪细胞体积增大性增殖；另一种是，蓄积脂肪的细胞数量增多，也就是说：不断增加新的脂肪细胞。前者称为肥大型，主要发生在成人；后者称为增殖型。多见于婴幼儿的肥胖。从婴幼儿开始肥胖者，至成人后，多表现为增殖与肥大混合型，这种情况比较容易产生重症肥胖症。
最近研究发现，有少部分脂肪细胞终生都在增殖外，大多数增殖主要发生在如下3个时期。第一是妊娠末期，第二是出生后一年左右，第三是青春发育期。脂肪细胞增殖最旺盛时期是妊娠末期和出生一年左右。
过食学说
消化机能在一般情况下被认为是吸收大部分热量（焦耳）和营养物质的手段。因此，在有关肥胖成因问题上，简单而言，就是摄取的能量与消耗的能量之差约等于贮藏的能量。也就是说，只是摄取能量过剩，哪怕身体没有发生任何代谢异常，也会增加贮藏量形成脂肪贮藏增加。事实上，动物实验表明，饮食性肥胖，一般均不存在种种与肥胖形成有关的代谢异常问题，肥胖的成因主要是由于过剩能量引起的。
错误的进食次数学说
这一学说告诉人们，在进食量相同的情况下，由于进食的次数不同，也会引起肥胖。大鼠动物实验表明，每天只给予2次饮食和自由进食的大鼠对比，前一组体重明显加重。这可能与每次进食和消化时，需要消耗饮食诱导性热产生有关。在人群中也发现少次多餐与多次少餐相比，前者更易引起肥胖。 另外，夜晚有进食习惯者，由于夜间自律神经系统中副交感神经系统处于优势，消化功能好，食物中的能量吸收比较彻底，摄入的食物也容易贮存于体内。平时要求临睡前3小时左右不进食，就是这个道理。
遗传学说
斯通卡德（Stun Kard）等在一卵双生的儿童中观察发现，肥胖的一致率比异卵双生儿童要高，强调其有遗传性。另外，一卵双生儿直到青春期，双方肥胖发生率为70%，青春期后则下降为30%。这说明遗传因素确实是引起肥胖的原因之一，而且一般情况下，这一因素也是被认为可以克服的。
运动不足学说
运动不足，不仅在于减少了能量消耗，也使机体变成了能量易在体内贮藏的代谢状态。实际上运动不足状态，胰岛素的降血糖作用也减弱，形成抗胰岛素的状态。由于拮抗胰岛素的作用，而代偿性地引起胰岛素的分泌增加，相对于降血糖作用的减弱，而脂肪合成的作用却未减弱，因此，就产生了脂肪蓄积的代谢状态。更有甚者，处于运动不足状态下，基础代谢下降，贮藏能量却增加，而且脂肪合成酶的活性也亢进。
热产生机能障碍学说
在脂肪细胞当中，有作为能量“仓库”的白色脂肪细胞和具有产热作用的褐色脂肪细胞两种。这种褐色脂肪细胞，在维持低温下的体温调节和食物诱导性热产生两方面，起着非常重要的作用。褐色脂肪细胞功能不全时，其热产生不能顺利进行，食物诱导性热产生下降，便产生了肥胖 .

14. Obesity Definition of obesity
Western Medicine term: Obesity is a condition describing increase or enlargement of fat cells, excessive accumulation of fat (especially triglyceride) and the body weight exceeding the normal body weight by more than 20%.
How Does TCM View Obesity and Its Causes?
As early as in the Han dynasty, TCM practitioners recorded the symptoms, mechanism and risk factors of obesity. The Suwen (The Book of Plain Questions) states in chapter 28: "If obesity occurs in the nobleman and rich people, they must be over consuming heavy and greasy foods." Similar to the modern understanding of obesity, associated risk factors include (1)undesirable eating habits, (2)under exercising, (3)body constitution and (4)mental state.
Classification of obesity: more than 95% of obesity have no obvious reasons and therefore are called simple obesity, while some obesity results from certain diseases and therefore is called secondary obesity.
Most people believe that obesity results from eating too much, which is certainly true in most cases. But it fails to explain why some people gain weight even though they eat little and drink lots of water while others keep slim though they eat a big dinner every day.
It is not simply the case that the more you eat, the more weight you gain, Whether your stomach and spleen work well plays a much more important role.

15. Etiology & Pathology
Dyspepsia causes stomach heat and poor spleen functioning
Exogenous evils giving rise to obesity
Qi (vital energy) stagnation causes turbid phlegm accumulation
Kidney essence exhaustion leads to disharmony
Dyspepsia causes stomach heat and poor spleen functioning
Over consumption of heavy, greasy and spicy foods or alcohol facilitate production of heat evils in the stomach. Meanwhile, inadequate exercise after eating these types of foods damages the spleen function. The over-heated stomach will ripen an excessive amount of food.Therefore, the stomach will digest food easier and make an individual feel hungry, but the spleen cannot handle an excessive food load causing it to under function and be unable to carry out its transformation and transportation functions properly. As a result, the spare metabolic products turn into turbid fluid and phlegm which intermix with blood and qi (vital energy) filling up the bones and muscles.
Exogenous evils giving rise to obesity
Invasion of exogenous evils or over consumption of greasy foods leads to poor transformation and transportation functions of the spleen. Dampness evils then begin to accumulate in the middle burner, which is part of the triple burner (the passage through which water, food and fluid are transported). When dampness and turbid fat enter these passages, they are further distributed by the lungs, allowing penetration into all the organs internally. Additionally, exogenous evils can also penetrate the skin, subcutaneous tissue and muscles through the body's surface giving rise to obesity.
3. Qi (vital energy) stagnation causes turbid phlegm accumulation
For those who are emotionally disturbed, experience trauma, have menstruation problems or are elderly, the liver can fail to regulate qi (vital energy) flow which in turn affects digestion and blood flow. The resulting sluggish qi (vital energy) and blood flow tend to block the meridians. Therefore, in these people, dampness is likely to endure in the body. Over time, this will congeal into phlegm and result in obesity.
4. Kidney essence exhaustion leads to disharmony
Lifestyles, which consume kidney essence, such as being sexually over active can lead to the excitation of the internal ministerial fire. The excessive ministerial fire is a kind of evil fire; which makes the body produce an over abundance of heat. This evil fire affects the middle burner, leading to a malfunction of the stomach and spleen. When this persists over a long period, the vaporization processes in the bladder and triple burner are impaired causing more evils to accumulate and worsen the obesity condition.
From TCM experience, the clinical status of a person with obesity can change leading to a complex diagnosis during consultation. The above causes of obesity can appear together or separately. In short, the fundamental causes of obesity are spleen and kidney deficiencies, which manifest as an overflow of body fluids, accumulation of dampness and phlegm evils and stagnation in blood flow. Sometimes stomach heat and qi (vital energy) stagnation are associated. Moreover, improper vaporization of body fluids by the triple burner may also appear. All of these factors play an important role in the development of obesity.

16. TCM does not treat "excess weight" per se; rather it deals with the underlying body condition that may have led to the excess weight. Once the body's balance is restored, the metabolism will process food properly and excess weight should no longer be a problem provided correct foods are eaten in moderate quantities. Specifically, TCM holds that fat or adipose tissue is mostly due to phlegm and dampness evils. The is said to be at the root of all phlegm production and is involved in the transportation and transformation of body fluids and foods. If the spleen becomes damaged by eating too many sweet foods and getting too little exercise, it will fail in its duty to move and transform waste fluids and foods. Instead these metabolic wastes will gather, collect and transform into dampness evils. If dampness evils endure over time, they will congeal into phlegm, and become fat tissue.

17. Treatment Principle:
Transform Phlegm; Strengthen Spleen; Move Blood

18. Android Type
The Android body type has broad shoulders and strong muscular limbs. The trunk is somewhat straight up and down and there is not much of a waist. The pelvis is narrow and the hips do not flare. Android types have an anabolic metabolism, which means that they tend to be “body- building” and will gain weight in the upper part of their body so that they may become apple-shaped. Most of their weight gain occurs on the front of the abdomen. They build muscle mass easily and make good athletes. They tend to produce more male hormones than do the other body types. Android types tend to crave foods that are high in cholesterol and salt. The body turns cholesterol into steroid hormones, which will have a body building effect. This may lead to some cellulite in the abdominal area, trunk and upper buttocks, but not below the hips.
Gynaeoid Body type
The Gynaeoid body type is the curvy shape with small to medium shoulders tapering to a small waist and then flaring below to wide curvaceous hips. Weight gain occurs only on the thighs and lower buttocks and gives a very feminine and curvy shape. Many gynaeoid types will have a big problem with cellulite accumulating around the upper thighs and buttocks. If they try to lose weight with just any old low-fat low-calorie diet, it can be quite frustrating because weight will tend to come off easily from areas where there is not a problem, while the thighs and buttocks retain their fatty deposits and cellulite. They often have a hormonal imbalance called “oestrogen dominance” which means that there is too much oestrogen compared to progesterone. They often crave foods combining high amounts of fat and sugar, which will increase their sensitivity to oestrogen, leading to more cellulite in the buttocks and thighs. They do well with plant hormones (phytoestrogens), which have a balancing effect and help them to reduce their oestrogen dependent weight gain.
Thyroid Type
The Thyroid body type is characterised by a fine narrow bone structure and long limbs. This body type often has a “race-horse” or “grey hound” appearance. Many dancers and models belong to this body type. Thyroid types often crave stimulants such as caffeine, nicotine and artificial sweeteners, and may miss meals. They often have problems with unstable blood sugar levels, which can cause fatigue and cravings for sugar and stimulants. Generally speaking, thyroid types do not gain weight easily and have a very high metabolic rate. Of all the body types they are least likely to develop cellulite and if it does occur, it is on the buttocks and back of the thighs.
Lymphatic Types
Lymphatic body types gain weight all over the body, and have a “cuddly baby doll” appearance. Weight gain occurs very easily because lymphatic types have a very low metabolic rate. They also have a dysfunctional lymphatic system resulting in generalised fluid retention, which makes them look fatter than they are. They are prone to deposits of fat swollen with lymphatic fluid, which can cause severe cellulite. This type of cellulite gives them thick puffy limbs so that it is hard to see their bone structure. They often avoid exercise and crave dairy products, both of which will exacerbate their cellulite

19. （1）Excessive Internal phlegm and dampness Signs & Symptoms:
Treatment
（1）Excessive Internal phlegm and dampness
Signs & Symptoms:
Main Sym. : excess weight ( generally due to an eating disorder, or secondarily by some other illness )
Concurrent sym.: tiredness, body heaviness, chest and/or stomach distension, and in some cases poor appetite. Dry mouth, thirsty, constipation
Tongue: red body with yellow coating
Pulse: slippery & rapid pulse
Treatment Protocol:
Removing phlegm & stagnation
Clear phlegm-heat

20. Ban Xia Bai Zhu Tian Ma Tang + Er Chen Tang
Formula:
Ban Xia Bai Zhu Tian Ma Tang + Er Chen Tang
Ban Xia 10
Bai Zhu 10
Tian Ma 10
Ling Yang Jiao 6
Gan Jiang 6
Su Ye 10
Chen Pi 10
Xia Ku Cao 10
Di Long 6
Bai Jie Zi 12
Zao Jia 6
Dan Shen 10
: Zhi Shi; Hou Po; Dang Shen; Bai Zhu; Fu Ling; Gan Cao; Bai Jie Zi; Lai Fu Zi; Ze Xie; Shan Zha; Shou Wu; Da Huang;
He Zhu Tang: He Ye; Cang Zhu; Bai Zhu; Huang Bai; Niu Xi; Yi Ni Ren; Huang Qi; Gui Zhi; Mu Gua; Fu Ling; Ze Xie; Shan Zha; Che Qian Cao; Hu Zhang; Xia Ku Cao; Gan Cao
　以决明子二两，炒山楂三钱，陈皮二钱及甘草三片煮茶喝。决明子和山楂是中医常用来降胆固醇的药材，服用有此两种中药的中医处方，可在一星期内减掉6磅。常觉便秘、口干舌燥的的实热体质人士服食后可帮助排便，达到减肥效果。
与减肥西药的病因治疗不同，减肥中药的配方原则是根据八纲辨证的结果。从前文中可见，存在多种分型结果，所得方剂就更多了，加上近年来又不断配出不少新方剂，据不完全统计，已不下数十种。主要有4种剂型：方剂(煎剂)，中成丸药，冲剂(药荼)，粉剂(散剂)。      传统的配方，
如来自《宣明论》的“防风通圣散”，有攻下、解表、清热、健脾和胃的功用，对阴虚内热、胃热湿阻型等实胖患者有效。
来自《金匮要略》的“防己 黄芪汤”、“泽泻汤”，有利水消肿的功用，适用于脾虚湿阻型患者。
来自《伤寒论》的“大柴胡汤”、“大承气汤”，有攻泻肝，、肠实热的功用，可用于肝郁气 滞型患者。
还有“荟桂术甘汤”、“核桃承气场”、“九味半夏汤”、“桂枝茯苓丸”、“麻子仁丸”“荷叶散”等等。      名中医江幼李曾按减肥治疗的8条原则，提出
化湿可用
“二术四苓汤”、“泽泻汤”、“防已黄芪汤”；
法痰可用
“二陈汤”、“平陈汤”、“三子养亲汤”；
利 水，
轻者用“五皮饮”、“导水泻苓汤”，重者用“再车丸”、“十枣汤”，
通腑用
“小承气汤”、“一味大黄汤”；
消导用
“三消饮”、“保和丸”；
舒肝利胆用
“温胆汤”、“疏肝饮”、“消肠散”；
健脾用
“五味异功散”、“参苓白术散”、“积术丸”、“五苓散”；
温阳用
“苓桂术甘汤”、“济生肾气丸”、“甘草附 子汤”。      近年来新出的中西医减肥方剂有：“三花减肥茶”、“轻身一号”、“轻身降脂乐”、“消肥美”、“春风减肥茶”、“减肥降脂灵”、“唐龙轻身酒”、“天燕减肥茶”、“仙药茶”、“瑶山减肥茶”、“还童荼”、“脉安冲剂”、“七消丸”、“消肥健身荼”等等，种类繁多。

21. (2) Stagnation of Qi (vital evergy ) and Blood
Treatment
(2) Stagnation of Qi (vital evergy ) and Blood
Signs & Symptoms:
Main Sym. : excess weight
Concurrent sym.: irrtability or low motivation, chest or breast fullness, insomnia, a dreamy state, menstrual disorder or amenorrhea ( absence of menstruation), and infertility. Some patients may complain of headaches. There may be dizziness and numbness of the four extremities.
Tongue: dark red with a white thin coating or a thin and greasy coating
Pulse: thready & slippery
Treatment Protocol:
Promote the blood & Qi circulation
Remove stagnation

22. Yue Ju Wan + Tao Hong Si Wu Tang
Formula:
Yue Ju Wan + Tao Hong Si Wu Tang
Chuan Xiong 10
Cang Zhu 12
Shen Qu 15
Zhi Zi 10
Chai Hu 10
Shi Di 6
Ban Xia 10
Dang Gui 12
Shen Di 12
Chi Shao 10
Hong Hua 6
Ze Lan 10
Ze Xie 10
He ye 10
Pu Huang 10

23. Si Jun Zi Tang + Shen Qi Wan
Treatment
(3) Yang deficiency of spleen & kidney
Signs & Symptoms:
Main Sym. : over weight
Concurrent sym.: often feel exhausted or fatigued. May experience lower back and knee weakness, shortness of breath, impotence or low libido.
Tongue: pale
Pulse: deep & fine
Treatment Protocol:
Tonify Spleen & Kidney yang
Si Jun Zi Tang + Shen Qi Wan
Dang Shen 10
Bai Zhu 10
Fu Ling 12
Rou Gui 5
Fu Zi 6
Shen Di 15
Ze Xie 10
Dan Pi 10
Yin Yang Huo 10
Che Qian Cao 10
Niu Xi 10

24. Treatment (4) Liver Stagnation Signs & Symptoms:
Main Sym. : excessive fatty material deposited in the abdomen;
Concurrent sym.: feel drained of energy. Individuals may also experience excess sputum secretion, dizziness, vertigo, retching, a dry mouth, lack of desire of food or drink and discomfort in chest and abdomen.
Tongue: greasy coating
Pulse: wiry
Treatment Protocol:
Improving liver qi circulation
Unblocking the GB. & liver stag.

25. (5) Big belly type ( Stomach excess heat )
Treatment
(5) Big belly type ( Stomach excess heat )
Signs & Symptoms:
Main Sym. : Too good Appetite; Strong muscle; easily feel thirsty & drink lots water; constipation; high blood pressure;
Concurrent sym.: This type of people gains weight mostly around the abdomen. We call them Big Belly Type overweight. Due to eating too many greasy or bad foods, there are lots wastes, pathogens and plaque in the gastrointestinal tract, colon, arteries, blood, etc. This leads to a metabolism problem, which caused overweight.
Formula:
Fang Feng; Jing Jie; Bo He; Lian Qiao; Jie Geng; Chuan Xong; Dang Gui; Bai Shao; Bai Zhu; Shan Zi Zi; Da Huang; Mang Xiao; Shi Gao; Huang Qin; Hua Shi; Gan Cao

26. Treatment
(6) Lymphatic Types ( Spleen Qi deficiency)
Main Sym. : easily get tired all the time; weak tissue & muscle; swollen four limbs; bad appetite; Post-partum female;
Concurrent sym.:
Tongue: swollen with teeth mark
Pulse: fine
Treatment Protocol:
Tonify Spleen Qi
Formula:
Zhi Shi; Bai Jie Zi; Fang Ji; Xing Ren; Bai Zhu; Fu Ling; Da Fu Pi; Dong Gua Pi; Ze Xie; Chi Xiao Dou; Fa Ban Xia; Chen Pi;
HuangQi XianLing Pi