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Deficiency of Kidney-Yin Symptoms and signs Symptoms and signs include chronic pain in the entire body with warm or hot feeling, a hot sensation in the palms and soles, lumbago with soreness, night sweating, a dry mouth, thirst, a poor appetite, sometimes hot flush, restlessness, insomnia, lassitude, tinnitus, constipation, a deep red tongue with a thin or no coating and a thready and rapid pulse. Principle of treatment Nourish the Kidney-Yin, clear the Deficient Heat and relieve the pain. HERBAL TREATMENT PRESCRIPTION Main formulas LIU WEI DI HUANG WAN Six-Flavour Rehmanniae Pill. This formula is a very basic prescription and there are many formulas are formed based upon it, such as Zhi Bai Di Huang Wan, Qi Ju Di Huang Wan, You Gui Yin, You Gui Wan, Zuo Gui Yin and Zuo Gui Wan, etc. In fact, this formula has no effect on pain relief for the entire body directly, because it can only nourish the Yin of the body slightly. ZUO GUI YIN Restore the Left (Kidney) Decoction .The effect of this formula to nourish the Yin of the Kidney is almost the same as that of LIU WEI DI HUANG WAN, but weaker than that of ZUO GUI WAN. ZUO GUI WAN

Restore the Left (Kidney) Pill. The effect of this formula to nourish the Yin of the Kidney is much stronger than that of LIU WEI DI HUANG WAN and ZUO GUI YIN. ZHI BAI DI HUANG WAN Anemarrhena, Phellodendron, and Rehmanniae Pill. This formula is good for nourishing the Yin of the Kidney and clearing the deficient Heat, especially indicated in patients with body pain and hot flushes. If one of above formulae should be used to treat the entire body pain, then some other herbs should be added to harmonise the collaterals and relieve the pain, such as Dang Gui Radix Angelicae Sinensis 10g, Chuan Xiong Radix Ligustici Wallichii 10g, Ji Xue Teng Caulis Milletiae Reticulatae 10g and Sang Zhi Ramulus Mori Albae 10g, etc. 58 generalised body pain Modifications 1. If there is severe pain, add Fang Ji Radix Stephaniae Tetrandrae 10g and Hu Zhang Rhizoma Polygoni cuspidati 10g to harmonise the collaterals and to relieve the pain 2. If there is much lower back pain, add Xu Duang Radix Dipsaci 10g and Sang Ji Sheng Ramulus Loranthi 10g to strengthen the Kidney and relieve the lower back pain 3. If there is severe insomnia, add Suan Zao Ren Semen Ziziphi Spinosae 10g to calm down the Shen and improve sleep 4. If there is severe night sweating, add Wu Wei Zi Fructus Schisandrae 10g nourish the Yin and to stop

the night sweating 5. If there is constipation, add Huo Ma Ren Semen Cannabis Sativae 10g and Xuan Shen Radix Scrophulariae 12g to tonify the Yin, lubricate the Large Intestine and to relieve the constipation. Patent remedy Liu Wei Di Huang Wan Six-Flavour Rehmanniae Pill. ACUPUNCTURE TREATMENT MAIN POINTS LR-3 Taichong, KI-3 Taixi, KI-7 Fuliu, SP-6 Sanyinjiao, CV-3 Zhongji, BL-18 Ganshu and BL-23 Shenshu. Reinforcing method is used on these points. Explanations LR-3, the Stream and Source point of the Liver channel, nourishes the Liver Yin and relieves pain KI-3, the Stream and Source point of the Kidney channel, and KI-7, the River and Metal point, nourish the Kidney-Yin and relieve the pain CV-3, the Front Collecting point of the Bladder channel and the crossing point of the Directing Vessel and the three Yin channels of the foot, is often used in the treatment for reinforcement SP-6, the crossing point of the Spleen, Kidney and Liver channels, can nourish the Yin and clear the Deficient-Fire BL-18, the Back Transporting point of the Liver, and BL-23, the Back Transporting point of the Kidney, nourish the Yin of the Kidney and Liver. Alternative points

LR-8 Ququan, KI-2 Rangu, KI-6 Zhaohai, KI-10 Yingu, HT-7 Shenmen, HT-8 Shaofu, CV-4 Guanyuan and CV-6 Qihai, etc. Modifications 1. If there is lumbago with soreness, add BL-36, BL-58 and BL-62 to strengthen the lower back and relieve the pain 2. If there is dizziness and lassitude, add SP-3, GV-20 and CV-4 to strengthen the body and relieve the dizziness 3. If there is insomnia, add HT-7 and GV-20 to tranquillise the Shen and to improve sleep 4. If there is a poor appetite, add CV-12 and SP-3 to activate the Spleen and Stomach, regulate the Qi in the Middle Burner and improve the appetite 5. If there is constipation, add BL-25, the Back Transporting point of the Large Intestine, and ST-37, the Lower Sea point of the Large Intestine, to regulate the Qi in the Large Intestine and to promote the defecation.

Deficiency of Kidney-Yang Symptoms and signs A weak constitution or chronic disease, gradual occurrence of pain in the entire body, a cold sensation over the body, in the hand and feet, lassitude, an aversion to cold, a pale complexion, frequent and clear urination, especially at night, lower back pain with soreness, a pale tongue with a white coating and a deep and thready pulse are the symptoms and signs of this condition. Principle of treatment Tonify the Kidney, warm the channels, dispel the Interior Cold and relieve the pain. HERBAL TREATMENT PRESCRIPTION Main formulas BA WEI DI HUANG WAN (also called SHEN QI WAN, or JIN GUI SHEN QI WAN) Kidney Qi Pill. This formula is based on LIU WEI DI HUANG WAN by adding two more herbs to warm the Interior and tonify the Kidney-Yang; however, since the main ingredients of this formula are to nourish the Yin, the effect of this formula to tonify the KidneyYang is not very strong. YOU GUI YIN Restore the Right (Kidney) Decoction. The ability of this formula to tonify the Kidney-Yang is stronger than the ability of the one above. YOU GUI WAN Restore the Right (Kidney) Pill. This is the strongest of these three formulas. pain in the entire body 59

Although all above three formulas can tonify the Kidney-Yang, they are not sufficiently strong to relieve the entire body pain. If they are used to treat the entire body pain, some other herbs should be applied simultaneously, such as Dang Gui Radix Angelicae Sinensis 10g, Chuan Xiong Radix Ligustici Wallichii 10g, Ji Xue Teng Caulis Milletiae Reticulatae 10g and Sang Zhi Ramulus Mori Albae 10g, etc. Modifications 1. If there is pain with a cold sensation, add Wu Zhu Yu Fructus Evodiae 10g and Gui Zhi Ramulus Cinnamomi 10g to warm the Kidney-Yang, dispel the Cold and relieve the pain. 2. If there is much lower back pain with soreness, add Xu Duan Radix Dipsaci 12g and Tu Si Zi Semen Cuscutae 10g to tonify the Kidney-Yang and relieve the pain in the lower back. 3. If there is severe cold sensation in the body, add Gan Jiang Rhizoma Zingiberis 10g and Suo Yang Herba Cynomorii Songarici 10g to warm the Interior and dispel the Cold. 4. If there is oedema with scanty urination, add Chuan Niu Xi Radix Cyathulae Officinalis 10g and Che Qian Cao Herba Plantaginis 10g to promote the urination and relieve the oedema. Or Shen Qi Wan as a patent remedy could be applied. Patent remedy Jin Gui Shen Qi Wan Kidney Qi Pill ACUPUNCTURE TREATMENT MAIN POINTS

KI-3 Taixi, BL-23 Shenshu, CV-4 Guanyuan, CV-6 Qihai, ST-36 Zusanli and GV-20 Baihui. Reinforcing method is used for these points. Moxibustion is recommended. Explanations KI-3 is the Stream and Source point of the Kidney channel. BL-23 is the Back Transporting point of the Kidney. These two points are used to tonify the Kidney-Yang, to warm the channels and to relieve the pain. CV-4 and CV-6 tonify the Yang, warm the body and remove the Cold from the Interior. ST-36, the Sea point of the Stomach channel, tonifies the Qi and relieves the pain. GV-20 raises the Yang-Qi and improves the energy. Moxibustion treatment has a strong effect in warming the Yang and promotes the circulation of Qi in order to relieve the pain in the entire body. Alternative points LR-8 Ququan, KI-2 Rangu, KI-10 Yingu, HT-3 Xinshu, HT-7 Shenmen, GV-20 Baihui and BL-15 Xinshi, etc. Modifications 1. If there is pain with a cold sensation, add moxibustion on CV-8 to warm the channels, to dispel the Cold and relieve the pain 2. If there is lower back pain with soreness, add BL-25 and BL-58 to harmonise the collateral and relieve the lower back pain 3. If there is dizziness, add GB-20 and GB-39 to tonify

the Blood and relieve the dizziness 4. If there is lassitude, add SP-3 and BL-20 to tonify the Qi and strengthen the body 5. If there is a poor appetite, add CV-12 to reinforce the Stomach-Qi, regulate the Spleen-Qi and improve the appetite. Prognosis Before giving a treatment, a clear differentiation should be made to identify if the entire body pain is caused by invasion of External pathogenic factors or Internal disorders. When it is caused by the former, the treatment is rather easy and the therapeutic result is relatively good, but the treatment should be given as early as possible so as to prevent accumulation of these pathogenic factors deep in the body, which will lead to disturbance or damage of the Internal organs and cause chronic entire body pain. When it is caused by the latter, the treatment will last a bit longer. Among the entire body pain caused by Internal disorders, it is not so difficult to treat the pain when it is caused by single pathogenic factor, such as stagnation of Qi or stagnation of Blood, but when it is caused by a mixture of a few pathogenic factors at same time, such as stagnation of Qi and Blood with deficiency of Qi and Blood, for instance fibromylgia, then the treatment will become complicated, and a regular acupuncture treatment based on once per week will be necessary. During the acupuncture treatment, as few points as possible should be selected and it is suggested that these points should not be punctured deeply. In this way, Qi, Blood, Yin and Yang could gradually restore

and pathogenic factors could be eliminated slowly. It is also very important to give some good advice about lifestyle, emotions and diet to the patient, so as to avoid new invasion of External