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HIATUS HERNIA

G ENER A L

Clinical Manifestations

Treatment Principle

Herb Formulas
For complex or confusing patterns with multiple pathology: Yue Ju
Wan + Zuo Jin Wan

Points
REN-14, REN-17, REN-22, ST-36

SP LE EN AND STOMACH Q I STAGNATION

Clinical Manifestations
Chest and abdominal distention
A stifling sensation in the chest and abdomen
Fixed pain in the hypochondria
Belching with a fetid odor
Nausea
Vomiting
Epigastric and abdominal fullness and pain
Acid reflux
Mild coughing with copious sputum
Reduced appetite
Indigestion
T: Normal
C: Thin and white or Greasy or Slippery,
P: Wiry and taut or Running

Treatment Principle
Regulates Qi in the Spleen and Stomach

Herb Formulas
Yue Ju Wan modified

Points

SP LE EN AND STOMACH Q I/YAN G DEFIC IENCY

Clinical Manifestations
Intermittent or continuous abdominal distention, fullness and
discomfort
Distention is improved by warmth and pressure and worse when
eating raw or cold foods
Intermittent, chronic acid reflux and heartburn which are worse with
hard to digest or raw foods, bending or any increase in abdominal
pressure
May wake during the night with heartburn
Mild epigastric pain or discomfort which is better with warmth and
pressure
Hypersalivation
Drooling
Sour belching
Poor appetite
Easily satiated
Fatigue
Weak, tired limbs
Loose stools or
Diarrhea or
A tendency toward sluggish bowel movements
Puffiness around the eyes or in the fingers
Rapid weight fluctuations
A pale, sallow face and lips
Shortness of breath
Reluctance to speak
A weak, soft voice

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Intolerance of Cold
Cold extremities
T: Pale or Pale and swollen with teeth marks
C: White
P:Weak and thready or Deficient or Big and Weak

Treatment Principle
Tonify Qi
Strengthen the Spleen
Facilitate the Raising of Qi and the descent of the turbid

Herb Formulas
Bu Zhong Yi Qi Tang modified
Xiang Sha Liu Jun Zi Tang modified
Chinese Patent Medicines:
Bu Zhong Yi Qi Wan
Xiang Sha Liu Jun Zi Wan
Jian Pi Wan
With Qi Stagnation: Xiang Sha Yang Wei Wan
With Yang Deficiency: Li Zhong Wan
With Excess acid: Wei Te Ling (combine with any of the above)
For symptomatic relief: Xiang Lian Wan (combine with any of the
above)

Points
LIV-13, REN-6, REN-12, SP-3, SP-6, SP-15, ST-25, ST-36, UB-20,
UB-21
For severe distention: + SP-1
With Fluid retention and edema: + SP-9, ST-28
With Liver Qi Stagnation: + LIV-3, PC-6
PC-6, REN-12, REN-13, REN-17, SP-6, ST-36, UB-20, UB-21
With Phlegm-Damp: + PC-5, SP-3, ST-40
Ear:
1. Spleen, Stomach, Large Intestine, Small Intestine, Abdomen
2. Spleen, Stomach, Esophagus, Pylorus, Shenmen, Adrenal,
Subcortex, Sympathetic

SP LE EN AND STOMACH Q I DEFICIENCY WITH PHLE GM -DAMP AND LIVER Q I

ST AG NATION

Clinical Manifestations
Focal distention and discomfort in the epigastrium and upper
abdomen
Distention worse after eating
Anorexia
Decreased sense of taste
Only able to eat a little at a time
Generalized weakness
T: Pale
C: Thick and white
P: Slippery, deep and wiry

Treatment Principle
Strengthen the Spleen
Harmonize the Stomach
Dry Dampness
Transform Phlegm
Relieve distention

Herb Formulas
Xiang Sha Liu Jun Zi Tang modified

Points
LIV-13, REN-6, REN-12, SP-3, SP-6, SP-15, ST-25, ST-36, UB-20,
UB-21
For severe distention: + SP-1
With Fluid retention and edema: + SP-9, ST-28
With Liver Qi Stagnation: + LIV-3, PC-6
Ear: Spleen, Stomach, Large Intestine, Small Intestine, Abdomen

SP LE EN AND STOMACH Q I DEFIC IENCY WITH H EAT AND CO LD

Clinical Manifestations
A sensation of blockage, distention, fullness and discomfort in the
epigastrium
When palpated, feels soft and without pain
Nausea
Vomiting or
Dry retching
Borborygmus with diarrhea
Poor appetite
T: Normal
C: Greasy and yellow
P: Soft, slippery, slightly wiry and maybe rapid

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Treatment Principle
Harmonize the Stomach
Descend Qi
Disperse Accumulation

Herb Formulas
Ban Xia Xie Xin Tang

Points
LIV-13, REN-6, REN-12, SP-3, SP-6, SP-15, ST-25, ST-36, UB-20,
UB-21
For severe distention: + SP-1
With Fluid retention and edema: + SP-9, ST-28
With Liver Qi Stagnation: + LIV-3, PC-6
Ear: Spleen, Stomach, Large Intestine, Small Intestine, Abdomen

SP LE EN AND STO MACH D EFICIEN CY CO LD

Clinical Manifestations
Severe, unrelenting or intermittent abdominal distention that is
progressively worse as the day goes on which may be difficult to
bear in the evening
The abdomen may appear swollen or the patient may feel that the
clothing is tight
The distention is worse with eating, exposure to Cold and when
fatigued
Mild constant epigastric or abdominal pain which is relieved by
warmth and pressure
Cold intolerance
Anorexia
Easily satiated
Abdominal pain and fullness after meals
Nausea / vomiting
Loose, unformed stools or
Diarrhea with undigested food in the stools or
Sluggish bowel movements with no urge to defecate
Excessive salivation
Cold limbs
Fatigue
Lassitude
Weakness
Exhaustion
Sallow or pale, dull complexion
Puffiness around the eyes or in the fingers
Quick weight fluctuations
Maybe edema
Maybe scanty urination
Maybe clear, watery, copious vaginal discharge
T: Pale or Pale and swollen with teethmarks
C: White and greasy
P: Deep, thready and forceless or Deep, weak and slow

Treatment Principle
Warm Yang
Strengthen the Spleen
Warm the Center
Dispel Cold

Herb Formulas
Zhi Shi Li Zhong Wan
Chinese Patent Medicines:
Fu Zi Li Zhong Wan
Li Zhong Wan

Points
Moxa or moxa needle DU-4, REN-4, REN-6, REN-12, SP-6, SP-15,
ST-25, ST-36, UB-20, UB-21, UB-23
With severe distention: + SP-1
With fluid retention and edema: + REN-9, SP-9
With Liver Qi Stagnation: + LIV-3, PC-6
Ear: Spleen. Stomach, Large Intestine, Abdomen, Adrenal

ST OMACH QI D EFICIENC Y W ITH TURBID PHL EGM OB STRUCTION

Clinical Manifestations
Severe, constant abdominal distension
Relentless belching
Severe hiccup
Relentless acid reflux
Unremitting regurgitation
Unremitting nausea and vomiting of saliva and Phlegm
Vomiting soon after eating
Hard epigastric distention
Poor appetite
Edema
Chest and hypochondriac distension
Dizziness

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Thirst but doesn't wish to drink

Maybe no thirst
Palpitations
Shortness of breath
Frequent salivation
Frequent urination
T: Pink
C: Thick, white and slippery or White and smooth
P: Slippery and full and maybe wiry or Wiry and deficient or Wiry,
taut and feeble

Treatment Principle
Eliminate Dampness
Resolve Phlegm
Descend Qi

Herb Formulas
Xuan Fu Dai Zhe Tang

Points
ST-40, SP-6, SP-9, SJ-6, PC-6, UB-13, UB-20, UB-23

ST OM ACH AND LIVER YIN D EFICIEN CY

Clinical Manifestations
Chronic acid reflux, hyperacidity and heartburn
Symptoms may be worse in the evening and with stress
The patient may wake with symptoms during the night which may be
temporarily relieved by eating
Mild, dull epigastric or hypochondriac pain or discomfort
Anorexia or
Intermittent gnawing hunger
Dry mouth and throat
Dry stools or
Constipation
T: Red and dry
C: Little or None
P: Thready, wiry and rapid

Treatment Principle
Nourish and supplement Liver and Stomach Yin
Regulate Qi
Descend Qi
Harmonize the Stomach

Herb Formulas
Yi Guan Jian modified
Chinese Patent Medicines:
Gu Ben Wan
With Excess acid: Wei Te Ling (combine with any of the above)
For symptomatic relief: Xiang Lian Wan (combine with any of the
above)

Points
KI-9, LIV-13, PC-6, REN-12, ST-36, UB-20, UB-21
Ear: Esophagus, Pylorus, Spleen, Liver, Stomach, Shenmen,
Subcortex, Sympathetic

PHLE GM AND HEAT ACCUMULAT ION BE NEATH THE HE AR T

Clinical Manifestations
Focal distention in the chest and epigastrium with or without nodules
which is painful when pressed
Coughing up yellow, viscous sputum
Constipation
A bitter taste in the mouth
T: Normal
C: Yellow and greasy
P: Slippery and floating or Slippery and rapid

Treatment Principle
Clear Heat
Transform Phlegm
Expand the chest
Dissipate Stagnation

Herb Formulas
Xiao Xian Xiong Tang

Points

L IVE R QI STAG NATION INVADES THE ST OMACH

Clinical Manifestations
Recurrent acid reflux (worse when emotionally upset)

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Epigastric pain (worse when emotionally upset)

Frequent belching with acid regurgitation
Nausea in the morning
Vomiting
Anorexia
Hypochondriac or epigastric distention, pain, tenderness ache or
discomfort
Epigastric or abdominal bloating
Distention and pain in the sides or flanks
Suffocating sensation in the chest
Tendency to sigh
Melancholy
Depression
Irritability
Moodiness
Anxiety
Frequent worrying
Inappropriate anger
Dizziness
Tension headaches
Shoulder and neck tension
Cold fingers and toes
Irregular menses
Dysmenorrhea
Breast distention and pain before and during menses
Alternating constipation and loose stools
T: Pink or Darkish
C: Thin and white
P: Wiry

Treatment Principle
Soothe the Liver
Harmonize the Stomach
Descend Stomach Qi

Herb Formulas
Si Ni San modified
Chai Hu Shu Gan Tang modified
For women: Xiao Yao San + Zuo Jin Wan
Chinese Patent Medicines:
Chai Hu Shu Gan Wan
Xiao Yao Wan
With epigastric pain: Shu Gan Wan
With stagnant Heat: Jia Wei Xiao Yao Wan
For symptomatic relief of heartburn: Wei Te Ling (combine with other
appropriate formulas)

Points
LIV-13, LIV-14, PC-6, REN-12, ST-36, ST-44
GB-34, LIV-3, LIV-5, LIV-13, PC-6, REN-6, REN-12, ST-25
For calming the Shen: + DU-19, DU-24, Yintang
For Blood or Yin Deficiency: + SP-6, ST-36, UB-18, UB-23
For Phlegm or plum pit Qi Stagnation: + PC-5, SP-3, ST-40
For fat intolerance, pale or pasty stools, and right side hypochondriac
pain and distention: + Dannangxue, GB-24, GB-40
PC-6, REN-12, ST-36
LIV-13, LIV-14, PC-6, REN-12
LI-10, LIV-3, PC-6, REN-12, REN-13, REN-17, ST-36, UB-18, UB-19,
UB-21
With lateral headaches and neck tension: + GB-34
With hypochondriac pain: + LIV-14
With Gall Bladder involvement: + Dannangxue, GB-24, GB-40
With Heat in the Liver: + LIV-2
With Spleen Deficiency: + UB-20
With Phlegm or Plum-Pit Qi Stagnation: + PC-5, SP-3, ST-40
With dizziness: + GB-20
With Shen disturbance: + one or two of the following: DU-19,
DU-24, HT-7, Yintang
GB-34, LI-10, LIV-3, LIV-13, PC-6, REN-12, ST-36, UB-18, UB-19,
UB-21
With lateral headaches and neck tension: + GB-21
With hypochondriac pain: + LIV-14
With Gall Bladder involvement: + Dannangxue, GB-24, GB-40
With Heat in the Liver: + LIV-2
With Spleen Deficiency: + UB-20
With Phlegm or Plum-Pit Qi Stagnation: + PC-5, SP-3, ST-40
With dizziness: + GB-20
With Shen disturbance: + one or two of the following: DU-19,
DU-24, HT-7, Yintang
Ear:
1. Esophagus, Pylorus, Liver, Spleen, Stomach, Shenmen,
Subcortex, Sympathetic
2. Liver, Stomach, Subcortex, Sympathetic, Shenmen

L I VE R QI STAG NATION INVADES THE ST OMACH WITH H EAT

Clinical
Hypochondriac pain and distention
Manifestations

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Indeterminate gnawing hunger

Epigastric distention and pain
Vomiting
Acid regurgitation
Belching
Bitter taste
Dry mouth
Nausea
Dry lips
Hiccups
T: Red
C: Yellow
P: Wiry and rapid

Treatment Principle
Clear Liver Heat (Fire)
Descend Rebellious Qi
Stop vomiting

Herb Formulas
Zuo Jin Wan
Jia Wei Xiao Yao San modified

Points

L I VE R QI STAG NA TI ON: P HLEG M A ND Q I STAGNANT AND B LOCK ED

Clinical
Feeling of obstruction in throat as if a slice of roast meat were stuck
Manifestations
there which cannot be coughed up nor swallowed down. This sensation
becomes more prominent during emotional upset and subsides when
relaxed
Recurrent acid reflux, heartburn or regurgitation
Distention and pain in the sides or flanks
Suffocating sensation in the chest and epigastrium
Belching
Nausea
Vomiting
Dry mouth and throat
Tendency to sigh
Melancholy
Depression
Irritability
Inappropriate anger
Irregular menses
Dysmenorrhea
Breast distention and pain before and during menses
T: Pink
C: Thin and white or Greasy and white
P: Slippery and wiry (slippery due to Phlegm)

Treatment Principle
Spread Qi
Resolve Phlegm

Herb Formulas
Qi Ge San modified

Points
LI-18, LIV-3, PC-5, SI-17, SJ-6
LI-10, LIV-3, PC-6, REN-12, REN-13, REN-17, ST-36, UB-18, UB-19,
UB-21
With lateral headaches and neck tension: +GB-34
With hypochondriac pain: + LIV-14
With Gall Bladder involvement: + Dannangxue, GB-24, GB-40
With Heat in the Liver: + LIV-2
With Spleen Deficiency: + UB-20
With Phlegm or Plum-Pit Qi Stagnation: + PC-5, SP-3, ST-40
With dizziness: + GB-20
With Shen disturbance: + one or two of the following: DU-19, DU-24,
HT-7, Yintang
Ear: Esophagus, Pylorus, Liver, Spleen, Stomach, Shenmen, Subcortex,
Sympathetic

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