ACUPUNCTURE TREATMENT
LR-3 Taichong, LR-5 Ligou, LR-14 Qimen, LI-4 Hegu,
PC-6 Neiguan, CV-17 Tanzhong and BL-18 Ganshu.
Reducing method is used on these points.
Explanations
• The Liver channel belongs to the Liver and connects to the Gall Bladder, penetrating the diaphragm and covering the hypochondriac regions and the chest. Stagnation of the Liver-Qi would cause breast pain, so the key treatment should be to smooth the Liver and circulate the Qi.
• LR-3, the Source point of the Liver, LR-14, the Front Collecting point, and BL-18, the Back Transporting point of the Liver, are used to smooth the Liver and promote the Qi circulation.
• LR-5, the Connecting point, harmonises the collateral and sedates pain in the breast.
• PC-6 and CV-17 promote the Qi circulation in the chest and sedate the breast pain.
• Ll-4 is used to promote the Qi circulation and relieve pain.
Modifications
1. If there is a feeling of fullness and oppression across the chest, add LU-7 and KI-6 to clear the blockage in the chest and sedate the chest pain.
2. If there is severe breast pain, or severe distension, add LR-6, the Accumulation point, to break up Qi stagnation of the Liver and stop the pain.
3. If there is an occasional stabbing pain in the breast, add BL-17, the Gathering point for the Blood, to promote the Blood circulation and relieve the pain.
4. If there are nodules in the breast, add ST-40, the Connecting point, to promote the Qi circulation, soften the hard lumps and relieve the pain.
5. If there are red spots on the breast, add ST-44 and LR-2, the Spring points, to clear Heat in the Blood, remove Toxin and eliminate the red spots.
6. If there is irritability, add GV-20 to clear Heat in the l iver, calm the Mind and relieve the irritability.
7. If there is a headache, add GV-20 to suppress the Liver-Yang and relieve the headache.
8. If there is a bitter taste in the mouth, add GB-40, the Source point, and GB-43, the Spring point, to clear Heat in the Liver and Gall Bladder and remove the bitter taste.
9. If there is chest pain radiating to the arm, add HT-3, the Sea point, and HT-6, the Accumulation point, to promote the Blood circulation in the Heart and relieve the pain.
10. If there is insomnia and restlessness, add HT-8, the Spring point, to clear Heat in the Heart, calm the Mind and improve the sleep.
11. If there is nausea and a poor appetite, add CV-12, the Front Collecting point of the Stomach, to harmonise the Stomach and improve the appetite.
12. If there is irregular menstruation or dysmenorrhoea, add Kl-3 and CV-6 to regulate the menstruation and relieve the dysmenorrhoea.
13. If there is constipation, add ST-25, the Front Collecting point of the Large Intestine, to promote defecation and relieve the constipation.
Case history
A 35-year-old woman had complained of breast pain for 6 months. In the previous year, her relationship with her husband had been difficult and they often had quarrels. She became depressed and was given medication. Then she developed breast pain, which was worse before menstruation and also in stressful situations. Her gynaecologist and her doctor told her the breast pain was caused by the stress and asked her to continue her antidepressive medications. Besides breast pain, she had been suffering from other symptoms such as chest pain with a sense of pressure over the chest, insomnia, headaches in the occipital region and sometimes eye pain, irritability, nervousness, tiredness and irregular menstruation for one year. Her tongue had a thin and slight yellow coating, a red tip and edges and a slight purple colour at the edges, and a deep, thready, wiry and slightly rapid pulse.
Diagnosis
Breast pain due to stagnation of the Liver-Qi with generation of Liver-Fire.
Principle of treatment
Smooth the Liver, promote the Liver-Qi circulation, harmonise the collateral, reduce the Liver-Fire and relieve the pain.
Herbal treatment XIAO YAO SAN
Free and Relaxed Powder
Chai Hu Radix Bupleuri 6 g
Dang Gui Radix Angelicae Sinensis 10 g
Bai Shao Radix Paeoniae Alba 12 g
Yan Hu Suo Rhizoma Corydalis IOg
Sheng Di Huang Radix Rehmanniae Recens 12 g
Xia Ku Cao Spica Prunella 10 g
Huang Qin Radix Scutellariae 12 g
Ju Hua Flos Chrysanthemi 5 g
Xiang Fu Rhizoma Cypcri 10 g
Gan Cao Radix Glycyrrhizae 5 g
Explanations
• Chai Hu and Bai Shao smooth the Liver, promote the Liver-Qi circulation and relieve the breast pain.
• Xiang Fu helps Chai Hu to promote the Liver-Qi circulation and relieve the breast pain.
• Yan Hu Suo promotes the Qi and Blood circulation and relieves the breast pain.
• Sheng Di Huang, Huang Qin, Ju Hua and Xiao Ku Cao clear Heat in the Liver, reduce Liver-Fire, sedate the headache and relieve nervousness.
• Dang Gui nourishes the Liver-Blood and smoothes the Liver.
• Gan Cao, in combination with Bai Shao, harmonises the Liver and relieves the breast pain.
Acupuncture treatment
LR-2, LR-3, LR-5, LR-14, LI-4, PC-6, CV-17, HT-8 and GB-20. Reducing method was used on these points. Treatment was given once every other day.
Explanations
• LR-3, the Source point of the Liver, and LR-14, the Front Collecting point of the Liver, are used to smooth the Liver, promote the Qi circulation and relieve breast pain.
• LR-2, the Spring point, is used to reduce Liver-Fire and calm the Liver.
• LR-5, the Connecting point, harmonises the collateral and sedates pain in the breast.
• PC-6 and CV-17 promote the Qi circulation in the chest and sedate the breast pain.
• LI-4 promotes Qi circulation, clears Heat in the Liver and relieves the pain.
• HT-8, the Spring point, clears Heat in the Heart, calms the Mind and improves the sleep.
After treatment for 3 weeks, she was much calmer, her breast pain had begun to diminish, and her sleep pattern and irritability had also improved. Treatment frequency was reduced to once every 3 days, and after another 3 weeks her breast pain had disappeared. She continued with the herbal treatment for another 6 months, during which the other symptoms also resolved.
ACCUMULATION OF DAMP-PHLEGM
Symptoms and signs
Gradual onset of breast pain with feelings of fullness, distension and heaviness, and the formation of soft nodules in the breast, accompanied by tiredness, nausea, phlegm in the throat, coughing with expectoration of white phlegm, a feeling of fullness in the stomach region, a poor appetite, loose stools, obesity, somnolence, a white and greasy tongue coating and a slippery pulse.
Principle of treatment
Resolve Damp, eliminate Phlegm, circulate the collateral and sedate the pain.
HERBAL TREATMENT
Prescription
DAO TAN TANG
Guide Out Phlegm Decoction Ban Xia Rhizoma Pinelliae 10 g
Ήβη Nan Xing Rhizoma Arisaematis 10 g
Chen Pi Pericarpium Citri Reticulatae 5 g
Fu Ling Poria IOg
Gua Lou Fructus Tricosanthis 10 g
Chang Pu Rhizoma Acori Graminei 10 g
Hou Po Cortex Magnoliae Officinalis IOg
Zhi Shi Fructus Citri Aurantii Immaturus IOg
Xie Bai Bulbus Allii 10 g
Gui Zhi Ramulus Cinnamomi 6 g
Sha Ren Fructus s eu Semen Amami 5 g
Explanations
• Ban Xia and Ήβη Nan Xing resolve Damp and eliminate Phlegm.
• Chen Pi and Sha Ren promote the Qi circulation and harmonise the Stomach so as to eliminate Damp-Phlegm.
• Fu Ling and Gua Lou resolve Damp-Phlegm.
• Hou Po and Zhi Shi break Qi stagnation and eliminate Damp. Also, Zhi Shi is a good herb for relieving the breast pain.
• Gui Zhi warms the Yang of the body and eliminates blockage of the channels by Damp-Phlegm.
• Xie Bai is a special herb that eliminates Damp-Phlegm in the breast and relaxes the chest.
• Chang Pu eliminates Damp in the chest and clarifies the Mind.
Modifications
1. If there is distension of the breast, add Zhi Qiao Fructus Aurantii 10 g and Xiang Fu Rhizoma Cyperi 10 g to promote the Qi circulation in the chest and relieve the distension.
2. If there are nodules in the breast, add Yu Jin Radix Curcumae 10 g and Zhe Bei Mu Bulbus Fritillariae Thunbergii 10 g to eliminate Damp-Phlegm in the breast and soften the nodules.
3. If there is an occasional stabbing pain in the breast, add Yan Hu Suo Rhizoma Corydalis 10 g to promote the Blood circulation and relieve the pain.
4. If there is a burning feeling in the breast, add Xia Ku Cao Spica Prunella 10 g and Huang Qin Radix Scutellariae 12 g to clear Heat in the breast and remove Toxin.
5. If there is a yellow and greasy tongue coating and a slippery and rapid pulse due to the accumulation of Damp-Heat, remove Ήβη Nan Xing, Gui Zhi and Xie Bai from the prescription and add Huang Lian Rhizoma Coptidis 5 g, Cang Zhu Rhizoma Atractylodis 10 g and Zhu Ru Caulis Bambusae in Taeniam 10 g to clear the Heat and resolve the Damp.
6. If there is depression, irritability and headache, add Gou Teng Ramulus Uncariae cum Uncis 10 g to calm the Liver and relieve the headache.
7. If there is a bitter taste in the mouth, add Zhi Zi Fructus Gardeniae 9 g to clear Heat in the Liver and Gall Bladder and remove the bitter taste.
8. If there is diarrhoea or loose stools, add Bai Zhu Rhizoma Atractylodis Macrocephalae 10 g and Ge Gen Radix Puerariae 10 g to activate the Spleen, eliminate Damp and relieve the diarrhoea.
9. If there is nausea and a poor appetite, add Sha Ren Radix Aenophorae 5 g to harmonise the Stomach and improve the appetite.
10. If there is insomnia and restlessness, add Duan Long Gu Os Draconis 15 g and Huang Lian Rhizoma Coptidis 5 g to clear Heat in the Heart, calm the Mind and improve the sleep.
11. If there is irregular menstruation, add Dang Gui Radix Angelicae Sinensis 10 g and Yi Mu Cao Herba Leonuri 10 g to relieve blockage in the Penetrating and Directing Vessels and regulate the menstruation.
12. If there is amenorrhoea, add Chuan Xiong Rhizoma Ligustici Chuanxiong 6 g and Chuan Niu Xi Radix Cyathulae 10 g to eliminate Blood stagnation and regulate the menstruation.
Patent remedy
Xiao Luo Wan Reduce Scrofula Pill
ACUPUNCTURE TREATMENT
LI-4 Hegu, SP-6 Sanyinjiao, SP-9 Yinlingquan, ST-36
Zusanli, ST-40 Fenglong, CV-12 Zhongwan, LR-3
Taichong, LR-14 Qimen and PC-6 Neiguan. Reducing method is used on these points.
Explanations
• Formation of Damp-Phlegm is usually caused by bad diet or weakness of the Spleen and Stomach, or of Kidney, leading to disorder of Water metabolism in the body. Weakness of Spleen and Stomach together with a bad diet is often seen.
• LI-4 and LR-3, the Source points, promote the Qi and Blood circulation and relieve breast pain.
• SP-6 and ST-36, the crossing points of the three Yin channels of the foot and the Sea point of the Stomach channel respectively, activate the Spleen and Stomach and eliminate Damp.
• SP-9, the Sea point, and ST-40, the Connecting point, resolve Damp and eliminate Phlegm. ST-40
also harmonises the collateral in the breast and sedates the pain.
• CV-12, the Gathering point for the Fu organs and the Front Collecting point of the Stomach, activates the Stomach and resolves Damp in the body.
• Accumulation of Damp-Phlegm in the body and breast blocks the Qi circulation and causes Qi stagnation. PC-6 and LR-14 promote the Qi circulation and relieves the blockage in the breast caused by the Damp-Phlegm.
Modifications
1. If there is severe pain in the breast, add PC-4 and ST-34, the Accumulation points of the Pericardium and Stomach channels respectively, to harmonise the collateral and sedate the pain.
2. If there is distension of the breast, add PC-3, the Sea point, to promote the Qi circulation in the chest and relieve the distension.
3. If there are nodules in the breast, add Ah Shi points around the nodules to eliminate Damp-Phlegm in the breast and soften the nodules.
4. If there is an occasional stabbing pain in the breast, add SP-6 and BL-17 to promote the Blood circulation and relieve the pain.
5. If there is a burning feeling in the breast, add PC-8 and LR-2, the Spring points, to clear Heat in the breast and remove Toxin.
6. If there is depression, irritability and a headache, add GB-20 and LR-8 to calm the Liver and relieve the headache.
7. If there is a bitter taste in the mouth, add GB-40 and GB-43 to clear Heat in the Liver and Gall Bladder and remove the bitter taste.
8. If there is a poor appetite and loose stools, add SP-3, the Source point, to activate the Spleen and Stomach, eliminate Damp and improve the appetite.
9. If there is nausea, add SP-4 in combination with PC-6 to cause the Stomach-Qi to descend and relieve the nausea.
10. If there is insomnia and restlessness, add HT-3, the Sea point, and HT-8, the Spring point, to clear Heat in the Heart, calm the Mind and improve the sleep.
11. If there is amenorrhoea, add ST-28 and ST-29 to promote the Qi and Blood circulation and regulate menstruation.
12. If there is abdominal distension, add ST-30 to regulate the Qi circulation in the abdomen and relieve the distension.
13. If there is profuse leucorrhoea, add BL-22 and BL-32 to eliminate Damp in the Lower Burner and relieve the leucorrhoea.
STAGNATION OF BLOOD
Symptoms and signs
Prolonged persistence of stabbing breast pain with a fixed location, and aggravation at night, accompanied by scar formation after operation or trauma, amenorrhoea, dysmenorrhoea or discharge of purplish blood during menstruation, restlessness, insomnia, a purplish tongue, with a thin coating or ecchymoses and a wiry and choppy pulse.
Principle of treatment
Promote Blood circulation, eliminate stagnant Blood and sedate the pain.
HERBAL TREATMENT
Prescription
XUE FU ZHU YU TANG
Drive Out Stasis in the Manswn of Blood Decoction
Chi Shao Radix Paeoniae Rubra 6 g
Chuan Xiong Rhizoma Ligustici Chuanxiong 9 g
Dang Gui Radix Angelicae Sinensis 9 g
Hong Hua Flos Carthami 9 g
Yan Hu Suo Rhizoma Corydalis 6 g
Yu Jin Radix Curcumae 10 g
Xiang Fu Rhizoma Cyperi 10 g
Zhi Qiao Fructus Aurantii 10 g
Gan Cao Radix Glycyrrhizae 6 g
Explanations
• Xiang Fu, Zhi Qiao and Yu Jin regulate the Liver-Qi and relieve the breast pain.
• Chuan Xiong, Hong Hua and Yan Hu Suo promote the Blood circulation, eliminate Blood stasis and relieve breast pain.
• Dang Gui tonifies the Liver-Blood and harmonises the Liver.
• Chi Shao promotes the Blood circulation and clears Heat in the Blood.
• Gan Cao harmonises the herbs in the prescription and relieves the pain.
Modifications
1. If there is depression, add Chai Hu Radix Bupleuri 6 g to regulate the Liver-Qi and relieve the depression.
2. If there is severe breast pain with cramp, add Bai Shao Radix Paeoniae Alba 12 g to smooth the muscles and tendons so as to stop the breast pain and relieve the cramp.
3. If there are palpable and immobile nodules, add Mu Li Concha Ostreae 18 g and Wang Bu Liu Xing Semen Vaccariae 10 g to promote the Blood circulation and remove the nodules.
4. If there is breast cancer, add Bai Hua She Shi Cao Herba Oldenlandiae 20 g and Zi Hua Di Ding Herba Violae 20 g to clear Heat, remove Toxin and reduce the swelling.
5. If there is night sweating and hot flushes due to deficiency of Liver-Yin, add Huang Bai Cortex Phellodendri 12 g and Sheng Di Huang Radix Rehmanniae Recens 12 g to nourish the Liver-Yin and clear Deficient-Heat.
6. If there are Heart palpitations, add Dan Shen Radix Salviae Miltiorrhizae 20 g to clear Heat in the Heart and calm the palpitations.
7. If there is insomnia, add Huang Lian Rhizoma Coptidis 5 g to clear Heat in the Heart and improve the sleep.
8. If there is lower abdominal pain, add Wu Yao Radix Linderae 6 g to promote the Qi circulation and relieve the pain.
9. If there is amenorrhoea, add E Zhu Rhizoma Zedoariae 10 g and Pu Huang Pollen Typhoo 12 g to eliminate Blood stagnation and promote menstruation.
10. If there is irregular menstruation or dysmenorrhoea, add Shu Di Radix Rehmanniae Praeparata 10 g and Yi Mu Cao Herba Leonuri IOg to regulate the menstruation and relieve the dysmenorrhoea.
11. If there is scar formation on the breast or poor wound healing after a breast operation, add Mo Yao, Resina Myrrhae 6 g and San Qi Radix Notoginseng 10 g to reduce the scar and promote healing of the wound.
12. If there is generalised tiredness, add Huang Qi Radix Astragali seu Hedysari 10 g and Dang Shen Radix Codonopsis Pilosulae 10 g to tonify the Qi and relieve the tiredness.
13. If there is constipation, add Da Huang Radix en Rhizoma Rhei 10 g to promote defecation and relieve the constipation.
Patent remedy
Yan Hu Suo Zhi Tong Pian Corydalis Stop Pain Tablet
