111. DISEASES OF HEAD, TRUNK AND LUMBAR

Question 0

S/S: HA, blur vision, severe pain on the bilat sides head, irrit, hot temper, flushed face, bitter taste in the mouth
T: reddened tongue with yellow coat
P: string-taut and rapid

Answer 0

HA: b) Headache due to upsurge of liver fire:
pts:
G 20, G 5, G 43,
Du 20, Liv 2

Question 1

S/S: HA occurs on expos. to wind. The pain may extend to the nape of the neck and back regions. It is a violent, boring and fixed pain.
T: TWC
P: string-taut

Answer 1

HA: a) HA due to invasion of patho. wind into chs and collat:pts:
Occiptal HA (taiyang): G 20, B 60, SI 3
Frontal HA (yangming):  S 8, Yintang (Extra), Du 23, LI 4, S 44
Temporal HA (shaoyang):  Taiyang (Extra),GB 8, SJ 5, G 41
Parietal HA (jueyin/taiyang):  Du 20, SI 3, B 67, Liv 3

Question 2

S/S: Lingering HA, dull, dizziness, blur vision, lassitude, lustreless face, pain rel. by warmth and aggr. by cold, overstrain or mental stress
T: pale tongue with thin and white coating
P: weak and thready

Answer 2

HA: c) Headache due to deficiency of both qi and blood (migraines):
pts:
Du 20, Ren 6, S 36
B 18, B 20, B 23

Question 3

S/S: Abrupt onset, electric shock pain, cutting, boring and intol, but transient and paroxysmal. Attack lasts a few sec. or one to two minutes, may recur sev. times a day. Tender pts can be found on the supraobital foramen, infraorbital foramen, cheek foramen, lateral side of nose, angle of the mouth, and nasolabial groove, where pressure induces the attack of pain, local spasm, runny nose, lacrim, saliv.
P: string-taut and tense

Answer 3

Facial Pain: a) due to invasion by pathog. wind and cold: pts:
supraorbital region: G 14,Taiyang (Extra), B 2, SJ 5
maxillary region: S 2, SI 18, LI 20, LI 4
mandibular region: S 7, S 6, S 5, Jiachengjiang (Extra), LI 4
Specific: G 20 (wind)

Question 4

S/S: The attack of pain as described above is accomp. by irrit, hot temper, thirst, constip.
T: yellow and dry tongue coating
P: string- taut, rapid

Answer 4

Facial Pain: b) d/t exc. fire in the liver and stomach: pts:
supraorbital: G 14,Taiyang (Extra), B 2, SJ 5
maxillary: S 2, SI 18, LI 20, LI 4
mandibular: S 7, S 6, S 5, Jiachengjiang (Extra), L 14
Specific: Liv 3, S 44, (liv 2)

Question 5

S/S: Insidious pain, emaciation, malar flush, sore lumbar region, lassitude, pain aggr. by fatigue
T: red tongue with little coat
P: thready and rapid

Answer 5

Facial Pain: c) D/t deficiency of yin and excessive fire: pts:
supraorbital: G 14,Taiyang (Extra), B 2, SJ 5
maxillary: S 2, S I 18, L I 20, L I 4
mandibular: S 7, S 6, S 5, Jiachengjiang (Extra), L 14
Specific: K 6 (nt sweats, ht), Sp 6 (ton yin)

Question 6

S/S: Sudden onset, usu. after waking up, incomplete closure of the eye (affected side), drooping angle of mouth, saliv. and inability to frown, raise the eyebrow, close the eye, blow out the cheek, show the teeth or whistle, in some cases pain in the mastoid region or HA
T: TWC
P: superficial tense or superficial slow

Answer 6

Deviation of Eye and Mouth: (Bell’s. palsy): pts:
SJ 17, G 14, Taiyang (Extra), SI 18, S 7, S 4, S 6, LI 4
Suppl. pts:
HA: G 20
Diffic.frowning and raising the eyebrow: B 2, SJ 23
Incomplete closing of the eye: B 2, B I, G 1, Yuyao (Extra), SJ 23
Diffic. sniffing: LI 20, Deviation of the philtrum: Du 26
Inability to show the teeth: S 3, Tinnitus and deafness: G 2
Tender at the mastoid: G 12, SJ 5

Question 7

S/S: Dist. pain costal and hypoch, stifling sens. chest, sighing, poor appet, bitter taste in the mouth. Severity varies w/changes of emotional state
T: thin white tongue coating
P: string-taut

Answer 7

Hypoch. pain: a) Excess type, i) Stagnation of qi:
pts:
Liv 14, SJ 6, G 34
suppl pts: Liv 3, G 40

Question 8

S/S: Fixed stabbing pain in the hypoch., intensified by pressure and at night
T: dark purplish tongue proper
P: deep and hesitant

Answer 8

Hypoch. Pain: a) exc type: ii) Stagnation of blood:
pts:
B 17, 18

Question 9

S/S: Dull pain lingering in the costal and hypoch,dryness of the mouth
, irrit., dizziness, blur vision
T: red tongue with little coating
P: weak, rapid, thready

Answer 9

Hypoch. Pain: b) Deficiency type: pts:
Liv 14, Liv 3,
B 18, B 23,
S 36, Sp 6, huo tou jia ji

Question 10

S/S: LBP usu. after expos to cold and damp and aggr. on rainy days, heavy sens./stiff mm. dorsolumbar, limit. of exten./flex of back, pain radiat. down to the butt and low limbs, cold feeling of the affected area
T: white and sticky tongue coating
P: deep and weak, or deep and slow

Answer 10

LBP: a) Cold damp:
pts:
B 23, Du 3, B 40
suppl pts: B 25, 26

Question 11

S/S: Insidious onset of protracted pain/sore, accomp. by lassitude and weak loins and knees, aggr. by fatig, allev. by bed rest. In (kidney yang xu) cramp-like sens. in the low abd., pallor, normal taste in the mouth, cold limbs, (pale tongue, deep thready or deep slow). In (kidney yin xu) irritability, insom, dry mouth and throat, flushed face, feverish sens. in the chest, palms and soles
T: red tongue proper with scant coat
P: thready weak or thready rapid

Answer 11

LBP: b) Kidney deficiency: pts:
B 23, Du 3, B 40
suppl pts:
kidney yang xu: Du 4, Yaoyan (Extra).
kidney yin xu: B 52, K 3

Question 12

S/S: Hx lumbar strain, rigidity/pain lower back which is generally fixed in a certain area, and is aggr. by pressure and by turning the body
T: pink or dark purplish tongue proper
P: string-taut hesitant

Answer 12

LBP: c) Trauma: pts:
B 23, Du 3, B 40
suppl pts:
Du 26 lbp pt, Yaotongxue (Extra)lbp specific, Ahshi points

Question 13

S/S: Wandering pain (wind) joints, esp. the wrists, elbows, knees and ankles; limitation of movement, chills and fever
T: thin and sticky tongue coat
P: superficial and tight or superficial and slow

Answer 13

Bi Synd: Wandering Bi: pts: shoulder: LI 15, SJ l4, SJ 19, SI 10, scapula: SI 1I, SI 12, SI 14,B 43, elbow: LI 1I, L 5, SJ 10, SJ 5, LI 4, wrist: SJ 4, LI 5, SI 5, SJ 5, Stiff fingers: Sl 5, Ll 4, SI 3, Numb/pain fingers: SI 3, LI 3, Baxie (Extra), lumbar pain: Du 26, Du 12, Du 3,
hip joint: G 30, G 29, G 39, thigh: B 54, B36,G34,
knee: Heding (Extra), S 35, Xiyan (Extra), G 34, Sp 9, numb/pain leg: B 57, B 58, ankle: S 41, Sp 5, G 40, B 60, K 3
Numb/pain toes: Sp 4, B 65, Bafeng (Extra),back: Du 26,Du 12, Du 3
General pain: SI 3, B 62, Sp 21, B 17, LI I5, LI 11, LI 4, SJ 4, G 30, G 34, G 39, S 41
**Suppl pts: B 17, Sp 10

Question 14

S/S: Severe stabbing joint pain, alleviat. by warmth and aggr. by cold, with fixed localization but no local redness and hotness
T: thin and white tongue coating
P: string-taut and tense

Answer 14

Bi Syndrome: Painful Bi: pts:
same as Wandering Bi, plus…
**suppl pts: B 23, Ren 4

Question 15

S/S: Numbness and heavy sensation of the limbs, soreness and fixed pain of the joints, aggr. on cloudy and rainy days
T: white and sticky tongue coating
P: soft

Answer 15

Bi Syndrome: c) Fixed Bi: (damp), pts:
same as Wandering Bi, plus…
suppl pts: S 36, Sp 5

Question 16

S/S: Arthralgia involving one or sev. joints, local redness, swell. and excruciating pain, limitation of mvt, accomp. by fever and thirst
T: yellow tongue coating
P: rolling and rapid

Answer 16

Bi Syndrome: d) Heat bi: pts:
same as Wandering Bi, plus…
**suppl pts: Du 14, LI 11
Tendon bi: G 34, Bone bi: B1I, G 39

Question 17

S/S: Muscular flaccidity of the lower limbs with motor impair, accomp. by fever, cough, irritability, thirst, scanty and brownish urine
T: red tongue with yellow coating
P: thready and rapid or rolling and rapid

Answer 17

Wei syndromes: a) Heat in the lung: pts:
Upper limb: LI 15, L 11, LI 4, SJ 5
Lower limb: S 31, G 30, Sp l0, S 34, S 36, G 34, S 41
**suppl pts: L 5, B 13

Question 18

S/S: Flaccid or slight swollen legs, a little hot sensation on touch, gen. heav., sens. of fullness chest/epig., painful urin., hot brownish urine
T: yellow sticky tongue coating
P: soft and rapid

Answer 18

Wei Syndromes: b) Damp heat: pts:
Upper limb: LI 15, LI 11, LI 4, SJ 5
Lower limb: S 31, G 30, Sp l0, S 34, S 36, G 34, S 41
**suppl pts: B 20, Sp 9

Question 19

S/S: Muscular flaccidity of the lower limbs with motor impair., comb. with sore. and wk. of lumbar, seminal emiss, prospermia, leuko. dizziness, blurring of vision
T: reddened tongue
P: thready and rapid

Answer 19

Wei Syndromes: c) Liv/Kid Yin Xu: pts:
Upper limb: LI 15, LI 11, LI 4, SJ 5
Lower limb: S 31, G 30, Sp l0, S 34, S 36, G 34, S 41
**suppl pts: B 18, B 23

Question 20

S/S: History of trauma, flaccid paralytic limbs, may be accomp. with incont. of urine and feces
T: pink or dark purplish tongue with TWC
P: relaxed or hesitant

Answer 20

Wei Syndromes: d ) Trauma: (bld stasis), pts:
Upper limb: LI 15LI 11, LI 4, SJ 5
Lower limb: S 31, G 30, Sp l0, S 34, S 36, G 34, S 41
**suppl pts: Huatuojiaji pts at level of injury
Incont.of urine: Ren 3, Sp 6, Incont.of feces: B 25, B 32