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Benign Prostatic Hyperplasia

by Giovanni Maciocia
 

The prostate and benign prostatic hyperplasia in western medicine
 
The prostate is a small organ about the size of a walnut. It is situated below the bladder and it surrounds the urethra. The prostate makes a fluid that becomes part of semen. Prostate problems are common in men aged 50 and older. The most common prostate problems are acute and chronic prostatitis and benign prostatic hyperplasia. Benign prostatic hyperplasia (BPH) is the term used to describe an enlarged prostate: BPH is common in older men.

Over time, an enlarged prostate may block the urethra, making it hard to urinate. It may cause dribbling after urination or a frequent urge to urinate, especially at night. The primary effect of benign prostatic hyperplasia is a progressive decrease in the ability to empty the bladder as the prostate enlarges and applies pressure to the urethra. Retained urine from this obstruction at first can interfere with sleep as the sufferer wakes up in the middle of the night. At other times, pressure may make it impossible to properly control urine flow (incontinence). Retained urine in the bladder can allow bacterial growth and infection. Urine may flow back up the tubules to the kidneys and cause infection there. In severe cases of retention, urine can even find its way into the blood (uraemia) with toxic consequences.

The clinical manifestations of benign prostatic hyperplasia are:

  • Sensation of not emptying bladder completely
  • Frequent urination
  • Micturition stopping and starting
  • Difficult to postpone urination
  • Weak urinary stream
  • Need to push in order to urinate
  • Nocturia

The diagnosis and treatment of benign prostatic hyperplasia raise an important question regarding the connections between Western and Chinese medicine. A benign prostatic hyperplasia is a form of abdominal mass comparable to a myoma in the uterus in women. However, in ancient times, an abdominal mass was diagnosed only on the basis of palpation, i.e it could be diagnosed only when it became palpable. The question arises then: is it legitimate to consider (and treat) an abdominal mass that is not palpable as part of the disease category Abdominal Masses (Zheng Jia or Ji Ju) in Chinese medicine? In the specific case of benign prostatic hyperplasia, such a swelling is indeed palpable but only through a rectal examination and there is no evidence that ancient Chinese doctors carried out such procedures as they never mentioned the prostate. However, using modern technology, we can now diagnose very small masses before they are palpable: can we then diagnose the Chinese disease entity of Abdominal Masses on the basis of Western medical tests? For example, are a benign prostatic hyperplasia, non-palpable ovarian cysts and a non-palpable myoma all forms of Abdominal Masses? Some of my colleagues think not, i.e. the diagnosis of Abdominal Masses should still be based only on palpation, i.e. if abdominal masses are not palpable they are then not Abdominal Masses.

My personal opinion is that non-palpable masses (diagnosed by modern tests such as MRI, CT or ultrasound scans) can and should indeed be treated as disease entities pertaining to the Chinese disease category of Abdominal Masses.

The prostate in Chinese medicine

Prostate problems were not discussed in ancient Chinese medicine because the prostate itself was not mentioned. Modern Chinese books and journals frequently discuss the treatment of prostatitis and benign prostatic hyperplasia. While Chinese medicine has a rich tradition in the diagnosis and treatment of gynaecological problems, fewer ancient or modern texts are dedicated to the diagnosis and treatment of men=s problems. For example, Chinese medicine refers to the AUterus@ in all its classic texts, but no mention is ever made of the prostate. The Governing Vessel (Du Mai), Directing Vessel (Ren Mai) and Penetrating Vessel (Chong Mai) are said to arise in the Lower Burner and flow through the uterus: but where do they flow in men? The classics do not say.

Classical texts

Chapter 65 of the Spiritual Axis says: AThe Directing and Penetrating Vessels originate from the Lower Dan Tian [literally Bao]. The actual term used by the Spiritual Axis is Bao which is often translated as Auterus. However, while the term Zi Bao refers to the Uterus, the word Bao indicates a structure that is common to both men and women: in women, it is the Uterus; in men, it is the Room of Sperm (which could also be translated as Room of Essence). Both these structures reside in the lower Dan Tian and store Essence (Jing) and, as the Extraordinary Vessels originate from here, they are closely connected to the Essence.

The Golden Mirror of Medicine (Yi Zong Jin Jian, 1742) says: AThe Governing Vessel arises within the lower abdomen, externally in the abdomen, internally in the Bao . . . also called Dan Tian in both men and women: in women it is the uterus, in men it is the Room of Sperm. This classic text therefore states clearly that Bao is a structure common to men and women, in the former corresponding to the 'Room of Sperm' (or 'Room of Essence') and the latter to the Uterus. The 'Room of Sperm' is in the lower abdomen but we know that the sperm is made in the testicles, seminal vesicles and prostate. I think it is therefore legitimate to assume that the prostate is a structure that is equivalent to the uterus in women and that the Governing Vessel, Directing Vessel and the Penetrating Vessel flow through the prostate.

There are indeed several connections and equivalences between the physiology of the Uterus in Chinese medicine and that of the prostate. Firstly, as the Governing, Directing and Penetrating Vessel all flow through the prostate, they are the vehicles through which the hypothalamus, pituitary and prostate interact with each other in a complex feedback mechanism in the same way as the hypothalamus, pituitary and ovaries do. Secondly, there are many correspondences between the physiology of the uterus and ovaries and those of the prostate from a Chinese perspective as follows:

Uterus/Ovaries

Prostate

Uterus muscular tissue

Controls the outflow of urine from the bladder and into the urethra. Prostate's fibromuscular tissue is about 30% of its total tissue mass. This role is closer to that of an organ than that of a gland.

Ovaries produce eggs

The seminal vesicles produce their own seminal fluid which nourishes and gives volume to the sperm. The prostate adds its own prostatic fluid to this mixture.

Ovaries mature at puberty

Almost all of the prostate=s mass develops during puberty in response to hormonal changes associated with maturation. The prostate literally doubles in size during puberty.

Ovaries peak during adolescence

Testosterone is at its peak during adolescence. It decreases thereafter and, more rapidly by about age 50.

Change in balance of Ren and Du Mai

During male menopause an increased ratio of

with menopause oestrogen to testosterone just as in women passing through menopause, the ratio of testosterone to oestrogen increases.


The main organs that affect the prostate are certainly the Kidneys and the Liver in the same way that these two organs affect the Uterus and ovaries. The prostate plays a role in the making of sperm (the Tian Gui of men) and, it is under the influence of the Kidneys which are the origin of Tian Gui. The Heart also influences the prostate in the same way as it influences the Uterus. Heart-Qi and Heart-Blood need to descend towards the Kidneys to establish the communication between these two organs. In women, the communication between the Heart and Kidneys forms the basis for a normal menstrual cycle and ovulation. In men, the communication between these two organs ensures the smooth functioning of the prostate and the regulation of the feedback mechanism among the hypothalamus, pituitary and prostate.

In terms of channels, the channels affecting the prostate are the Kidneys, Governing Vessel, Directing Vessel and the Penetrating Vessel. There is a complex feedback mechanism among the hypothalamus, pituitary and prostate which could be compared to the flow of the Governing Vessel (which flows through the brain) and the Directing Vessel. From the point of view of Chinese medicine, the clinical manifestation of benign prostatic hyperplasia closely resemble those of Urinary Retention (Long Bi): however, while benign prostatic hyperplasia often causes urinary retention, not all cases of urinary retention are due to prostatic hyperplasia.

Pathology of benign prostatic hyperplasia in Chinese medicine

The pathology of benign prostatic hyperplasia is complex and is always characterized by Emptiness and Fullness.

1. Deficiency of Kidneys, Spleen and Lungs

A Kidney deficiency is always at the root of benign prostatic hyperplasia because it affects the prostate in two ways. First, a deficient Kidney fails to transform, transport and excrete fluids in the Lower Burner resulting in accumulation of fluids and eventually Dampness and Phlegm. Secondly, the seminal fluid in the prostate is a manifestation of Tian Gui which originates from the Kidneys. In addition to a Kidney deficiency, there may also be a deficiency of the Lungs and/or Spleen. A deficient Lung fails to make fluids descend and a deficient Spleen fails to transform fluids: this leads to the formation of Dampness and Phlegm.

2. Dampness and phlegm

A deficiency of the Kidneys, Spleen and Lungs leads to the impairment of the transformation, transportation and excretion of fluids and therefore to Dampness and Phlegm accumulating in the prostate. The symptoms of Phlegm accumulation in the men's genital system are as follows:

  • Prostatic hypertrophy
  • Peyronie=s disease
  • Priapism
  • Impotence (only some cases of impotence)
  • Sweaty genitals

3. Stasis of essence (JING)

An important feature of benign prostatic hyperplasia is that there is a pathology not only of fluids but also of Essence (Jing). It is interesting that, although the ancient Chinese did not have a knowledge of the prostate and seminal vesicles, they were aware of the difference between urethral discharges of urine and of sperm. Urethral discharges of urine pertain to the pathology of Painful Urination Syndrome (Lin) and therefore of Body Fluids; by contrast, urethral discharges of sperm pertain to the pathology of Essence (Jing) and are generally due to a weakness of the Sperm Gate (Jing Guan). The term ‘turbidity' is often mentioned in Chinese medicine and especially in the context of diseases of the Lower Burner. In urinary diseases, turbidity indicates a pathological state of the fluids in the Lower Burner: this occurs when there is impairment in the transformation, transportation and excretion of fluids in the Lower Burner. In this context, turbidity manifests not only with turbid urine but also with urinary difficulty.

In genital diseases such as prostatitis and benign prostatic hyperplasia, turbidity refers to a pathology of Essence (Jing): in this context, it manifests with urethral discharges of sperm, prostatitis and benign prostatic hyperplasia. In both urinary and genital diseases, turbidity also refers to retention of chronic Dampness. Although we are more used to thinking of the Essence as a pure, precious fluid that is inherited from the parents, the Essence plays a role in the physiology and pathology of men's genital system in the same way that Blood does in women: as a result, Essence in men can become stagnant and be affected by turbidity.

Stasis of Essence is somewhat equivalent to Blood stasis in the Uterus in women and its clinical manifestations in men are as follows:

  • Stabbing pain lumbar region
  • Pain in perineum
  • Hypogastric pain
  • Pain in testis and/or penis
  • Impotence (only some cases)
  • Premature ejaculation (only some cases)
  • Priapism
  • Prostatic hypertrophy
  • Premature greying of hair
  • Itching or pain in pubic region
  • Abnormal sperm
  • Sperm urethral discharge
  • Peyronie's disease
  • Purple tongue
  • Choppy, Wiry or Firm pulse.

A deficiency of the Kidneys contributes to the development of stasis of Essence and the accumulation of turbidity in the prostate: this leads to Dampness and Phlegm accumulating in the prostate. Dampness and Phlegm in the prostate interact with stasis of Essence (Jing) and these two pathological conditions aggravate each other in the same way as Phlegm and Blood stasis do. In particular, when stasis of Essence interacts with Phlegm, it is men=s genital system that is affected.

4. Blood stasis

Blood stasis resulting from stagnation of Liver-Qi and Liver-Blood and from stasis of Essence is another factor in the pathology of benign prostatic hyperplasia. The clinical manifestations of Blood stasis in men's genital system are as follows:
  • Stabbing pain lumbar region
  • Pain in perineum
  • Hypogastric pain
  • Pain in testis and/or penis
  • Priapism
  • Prostatic hypertrophy
  • Abnormal sperm, blood in sperm
  • Peyronie's disease
  • Purple tongue
  • Choppy, Wiry or Firm pulse.

Blood stasis in the prostate occurs in the prostate's Blood Connecting (Luo) channels. In treatment, one therefore needs herbs that Apenetrate the Connecting channels (tong Luo) such as Lu Lu Tong Fructus Liquidambaris, Tong Cao Medulla Tetrapanacis, Ju Luo Vascular Citri reticulatae, Si Gua Luo Fructus Retinervus Luffae, Lou Lu Radix Rhapontici. Ju Luo is the pith of the red tangerine, the Apith being the white fibrous tissue surrounding the flesh and directly below the skin of a citrus fruit. It is interesting to note that the Connecting channels form a reticular network of channels and the pith of a tangerine resembles such network.

To sum up, the pathology of benign prostatic hyperplasia is as follows:

Manifestation (Biao):Dampness, Phlegm, stasis of Essence, Blood stasis.

Root (Ben): Kidney deficiency (Yang or Yin), Spleen deficiency, Lung deficiency.

Channels: Governing Vessel, Directing Vessel, Penetrating Vessel, Kidneys, Liver, Heart, Bladder.

Before discussing the treatment of benign prostatic hyperplasia, it is necessary to describe a pulse finding that is encountered frequently in practice. The prostate can be felt on the proximal end of the left-Rear position (left Kidney position): this is felt by rolling the finger proximally but only very slightly. If the prostate is enlarged, the pulse feels either Slippery (indicating Damp-Phlegm as the main cause of the swelling) or Wiry (indicating Blood stasis as the main cause of the swelling).

Treatment strategies

Herbal strategies

Before discussing the treatment according to patterns, it is useful to review the general guidelines governing the strategies of treatment of benign prostatic hyperplasia. The following are the treatment strategies commonly adopted:

Invigorate Blood: Lu Lu Tong Fructus Liquidambaris, Wang Bu Liu Xing Semen Vaccariae, Mu Dan Pi Cortex Moutan.

Resolve Dampness: Yi Yi Ren Semen Coicis, Bi Xie Rhizoma Dioscoreae hypoglauca, Shi Wei Folium Pyrrosiae, Hai Jin Sha Spora Lygodii, Tian Kui Zi Radix Semiaquiligiae.

Resolve Phlegm: Zhe Bei Mu Bulbus Fritillariae thunbergii, Ban Xia Rhizoma Pinelliae preparatum, Xia Ku Cao Spica Prunellae, Dan Nan Xing Rhizoma Arisaematis preparatum, Si Gua Luo Fructus Retinervus Luffae.

Soften hardness: Yi Yi Ren Semen Coicis, Zhe Bei Mu Bulbus Fritillariae thunbergii, Kun Bu Thallus Eckloniae, Hai Zao Herba Sargassi.

Resolve Toxic Heat: Bai Hua She She Cao Herba Hedyotidis diffusae, Shan Dou Gen Radix Sophorae tonkinensis, Tian Kui Zi Radix Semiaquiligiae.

Penetrate the Connecting (Luo) channels: Lu Lu Tong Fructus Liquidambaris, Tong Cao Medulla Tetrapanacis, Ju Luo Vascular Citri reticulatae, Si Gua Luo Fructus Retinervus Luffae, Lou Lu Radix Rhapontici.

Open the orifices: Shi Chang Pu Rhizoma Acori tatarinowii.

The method of softening hardness is used for abdominal masses, especially those from Blood stasis.

Acupuncture

When treating prostate problems, it is important to treat one of the three extraordinary vessels that flow through it, i.e. the Governing Vessel, Directing Vessel or Penetrating Vessel. The Governing Vessel is selected when there is a pronounced deficiency of Kidney-Yang; the Directing Vessel if there is a pronounced deficiency of Kidney-Yin; and the Penetrating Vessel if there is a pronounced Blood stasis. In all cases, I use the opening and coupled points of the relevant extraordinary vessel. In men, I use the opening point on the left side and the coupled point on the right, e.g. for the Governing Vessel, S.I.-3 Houxi on the left and BL-62 Shenmai on the right. The main points used according to channel and patterns are as follows:

  • Governing Vessel: SI-3 Houxi on the left and BL-62 Shemai on the right, Du-20 Baihui, Du-26 Renzhong.
  • Directing Vessel: LU-7 Lieque on the left and KI-6 Zhaohai on the right, Ren-2 Qugu, Ren-3 Zhongji.
  • Penetrating Vessel: SP-4 Gongsun on the left and P-6 Neiguan on the right, KI-14 Siman.
  • Liver channel: LIV-5 Ligou, LIV-1 Dadun, LIV-3 Taichong.
  • Back-Transporting points: BL-32 Ciliao, BL-34 Xialiao.
  • Damp-Phlegm: ST-40 Fenglong, SP-9 Yinlingquan, SP-6 Sanyinjiao, BL-22 Sanjiaoshu, ST-28 Shuidao, Ren-3 Zhongji, Ren-5 Shimen.
  • Blood stasis: LIV-3 Taichong, SP-10 Xuehai, BL-17 Geshu, KI-14 Siman.
  • Stasis of Essence: KI-14 Siman, Ren-5 Shimen.

Blood stasis

Clinical manifestations

Decreased urinary flow, nocturia, hypogastric pain, pain in the perineum, the prostate feels hard on rectal examination. Tongue: Purple. Pulse: Wiry, Choppy or Firm. Prostate pulse Wiry.

Treatment principle

Invigorate Blood and eliminate stasis, soften hardness.

Acupuncture

Points

LIV-3 Taichong, SP-10 Xuehai, BL-17 Geshu, KI-14 Siman, SP-4 Gongsun on the left and P-6 Neiguan on the right (Penetrating Vessel), Ren-2 Qugu, BL-32 Ciliao, BL-34 Xialiao. Even method.

Explanation

  • LIV-3, SP-10, BL-17 and KI-14 invigorate Blood and eliminate stasis.
  • SP-4 and P-6 regulate the Penetrating Vessel and invigorate Blood.
  • Ren-2, BL-32 and BL-34 are used as adjacent points for the prostate.

Herbal therapy

Prescription

Hu Po Si Wu Tang (Succinum Four Substances Decoction)

Explanation

This formula invigorates Blood, eliminates stasis and soften hardness.

Prescription

Dai Di Dang Wan (Surrogate Keeping out Decoction)

Note: Chuan Shan Jia in this formula can be replaced by Wang Bu Liu Xing Semen Vaccariae.

Explanation

This formula invigorates Blood and soften hardness. It is especially suitable if there is Heat in the Stomach and Intestines with dry stools.

Damp phlegm

Clinical manifestations

Urinary difficulty, turbid urine, painful urination, micturition stopping and starting, hypogastric heaviness, feeling of heaviness at the perineum. Tongue: Swollen with sticky coating. Pulse: Slippery. Prostate pulse Slippery.

Treatment principle

Resolve Dampness and Phlegm, tonify the Spleen.

Acupuncture

Points

LU-7 Lieque on the left and KI-6 Zhaohai on the right, ST-28 Shuidao, BL-22 Sanjiaoshu, Ren-3 Zhongji, Ren-5 Shimen, Ren-9 Shuifen, Ren-12 Zhongwan, BL-20 Pishu. Even method, except the last two points that should be needled with reinforcing method.

Explanation

  • LU-7 and KI-6 regulate the Directing Vessel. The Directing Vessel is used in this case because it helps to regulate the Triple Burner=s transformation and excretion of fluids.
  • ST-28 is an important point to resolve Damp-Phlegm in the Lower Burner.
  • BL-22, Ren-3 and Ren-5 resolve Dampness and Phlegm from the Lower Burner.
  • Ren-9 is a general point to resolve Dampness and Phlegm.
  • Ren-12 and BL-20 tonify the Spleen.

Herbal therapy

Prescription

Cang Fu Dao Tan Wan(Atractylodes Resolving Phlegm Pill)

Explanation

This formula resolves Damp-Phlegm from the Lower Burner. It is primarily for Damp-Phlegm associated with Cold. The formula contains Fu Zi Radix Aconiti lateralis preparata which may be illegal in some countries and can be replaced by Rou Gui Cortex Cinnamomi.

Prescription

Tong Fu Zhi Long Tang(Penetrating the Yang Organs and Treating Urinary Retention Decoction)

Explanation

This formula is applicable when Damp-Phlegm is combined with Heat and there is Full Heat in the Stomach and Intestines with dry stools and a thick-dry-yellow coating.

Kidney and Spleen Yang deficiency

Clinical manifestations

Urinary frequency, slight incontinence, dribbling, urgency, cold legs and knees, lower backache, dizziness, tinnitus, tiredness, depression, loose stools. Tongue: Pale tongue. Pulse: Deep-Weak.

Treatment principle

Tonify and warm the Spleen and Kidneys, resolve Dampness from the Lower Burner.

Acupuncture

Points

BL-20 Pishu, Ren-12 Zhongwan, BL-23 Shenshu, KI-13 Qimen, Ren-4 Guanyuan, SI-3 Houxi with BL-62 Shenmai, Ren-3 Zhongji, SP-9 Yinlingquan, KI-12 Dahe, BL-32 Ciliao, BL-34 Xialiao. Reinforcing method. Moxa is applicable.

Explanation

  • BL-20 and Ren-12 tonify the Spleen.
  • BL-23, KI-13 and Ren-4 tonify the Kidneys.
  • S.I.-3 and BL-62 regulate the Governing Vessel.
  • Ren-3, SP-9 and KI-12 resolve Dampness from the Lower Burner.
  • BL-32 and BL-34 are adjacent points to affect the prostate.

Herbal therapy

Prescription

Empirical Prescription

Explanation

This formula tonifies Spleen- and Kidney-Yang and resolves Dampness from the Lower Burner.

Prescription

Lao Ren Long Bi Tang(Urinary Retention Decoction for the Elderly)

Explanation

This formula tonifies primarily Spleen-Yang and resolves Dampness from the Lower Burner.

Prescription

Bao Yuan Tong Bi Tang (Protecting the Origin and Penetrating Urinary Retention Decoction)

Explanation

This formula, based on only three herbs, tonifies Spleen-Yang (with Huang Qi Radix Astragali 100g), resolves Dampness from the urinary passages (with Hua Shi Talcum 30g), invigorates Blood and opens the orifices of the urinary passages (with Hu Po Succinum 30g). Although the original formula calls for a dose of 100g daily for Huang Qi, I would reduce that to 30g and the other two herbs to 10g.

Liver and Kidney Yin Deficiency

Clinical manifestations

Urinary difficulty, dark urine, frequent but scanty urination, night-sweating, 5-palm heat, lower backache, dizziness, tinnitus, dry eyes. Tongue: without coating. Pulse: Floating-Empty.

Treatment principle

Nourish Liver- and Kidney-Yin, resolve Dampness from the Lower Burner.

Acupuncture

Points

Ren-4 Guanyuan, KI-13 Qimen, SP-6 Sanyinjiao, LIV-8 Ququan, LU-7 Lieque on the left with KI-6 Zhaohai on the right, Ren-7 Yinjiao, Ren-3 Zhongji, SP-9 Yinlingquan, BL-32 Ciliao, BL-34 Xialiao. Reinforcing method.

Explanation

  • Ren-4, KI-13, SP-6 and LIV-8 nourish Liver- and Kidney-Yin.
  • LU-7 and KI-6 regulate the Directing Vessel and nourish Yin.
  • Ren-7 nourishes Yin.
  • Ren-3 and SP-9 resolve Dampness from the Lower Burner.
  • BL-32 and BL-34 are adjacent points to affect the prostate.

Herbal therapy

Prescription

Zhi Bo Di Huang Wan Variation (Anemarrhena-Phellodendron-Rehmannia Pill) Variation

Explanation

This formula nourishes Liver- and Kidney-Yin and drains Damp Heat from the Lower Burner.

Stasis of Essence (JING)

Clinical manifestations

Urinary difficulty, decreased urinary flow, nocturia, hypogastric pain, pain in the perineum, seminal emissions, urethral discharge. Tongue: Purple. Pulse: Wiry, Choppy or Firm. Prostate pulse Wiry.

Treatment principle

Invigorate Blood, eliminate stasis, soften hardness, eliminate turbidity.

Acupuncture

Points

SP-4 Gongsun on the left with P-6 Neiguan on the right , LIV-3 Taichong, LIV-1 Dadun, Ren-3 Zhongji, KI-14 Siman, Zigong, BL-32 Ciliao, BL-34 Xialiao. Even method.

Explanation

  • SP-4 and P-6 regulate the Penetrating Vessel, invigorate Blood and eliminate stasis of Blood and Essence.
  • LIV-3 invigorates Blood.
  • LIV-1 affects the prostate.
  • Ren-3, KI-14 and Zigong invigorate Blood and eliminate stasis from the prostate.
  • BL-32 and BL-34 are adjacent points for the prostate.

Herbal therapy

Prescription

Huo Xue Tong Jing Tang Variation (Invigorate Blood and Penetrate the Essence Decoction) Variation

Explanation

This formula invigorates Blood and resolves turbidity and Dampness in the Lower Burner,

Liver Qi Stagnation with damp phlegm

Clinical manifestations

Urinary difficulty, retention of urine when under stress, hypogastric distension, irritability, turbid urine, hypogastric heaviness, feeling of heaviness at the perineum. Tongue: Red on the side, Swollen with sticky coating. Pulse: Slippery-Wiry. Prostate pulse Wiry.

Treatment principle

Soothe the Liver, move Qi, resolve Dampness and Phlegm.

Acupuncture

Points

SP-4 Gongsun on the left with P-6 Neiguan on the right, LIV-3 Taichong, LIV-5 Ligou, KI-14 Siman, Ren-3 Zhongji, SP-9 Yinlingquan, ST-40 Fenglong, ST-28 Shuidao. Even method.

Explanation

  • SP-4 and P-6 regulate the Penetrating Vessel.
  • LIV-3 and LIV-5 move Liver-Qi.
  • KI-14 and Ren-3 move Qi in the Lower Burner.
  • SP-9, ST-40 and ST-28 resolve Damp-Phlegm from the Lower Burner.

Herbal therapy

Prescription

Shu Gan San Jie Fang (Soothe the Liver Disperse Stagnation Formula)

Explanation

This formula moves Liver-Qi, invigorates Blood, resolves Damp-Phlegm and softens hardness.

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