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Liver-Kidney Insufficiency Pattern

MAIN SYMPTOMS: A long, slow disease course with gradual but progressive atrophy, weakness, and loss of use of the upper or lower limbs, low back and knee soreness and limpness, emaciation, numbness and tingling of the hands and feet, dizziness, tinnitus, blurred vision, tidal heat, night sweats, a dry mouth and a parched throat, hoarse voice, a red crimson tongue with scanty fluids and teeth-marks on its edges with possible cracks and fissures, and a fine, rapid or fine, bowstring, and rapid pulse

NOTE: In actuality, this is a qi and yin vacuity pattern.

TREATMENT PRINCIPLES: Supplement and boost the liver and kidneys, foster yin and clear heat

Rx:   Hu   Qian   Wan Jia Jian (Hidden Tiger  Pills  with Additions & Subtractions)

Ingredients:  
Huang Qi (Radix Astragali) 30g
Gui Ban (Plastrum Testudinis) 30g
Shu Di (cooked Radix Rehmanniae) 30g
SangZhi (Ramulus Mori) 30g
Chuan Niu Xi (Radix Cyathulae) 15g
Dang Gui (Radix Angelicae Sinensis) 12g
processed He Shou Wu (Radix Polygoni Multifiori) 12g
Chi Shao (Radix Paeoniae Rubrae) 12g
Qiang Huo (Radix Et Rhizoma Notopterygii) 12g
Huang Bai (Cortex Phellodendri) 9g
Zhi Mu (Rhizoma Anemarrhenae) 9g
E Jiao (Gelatinum Corii Asini) 9g

ANALYSIS OF FORMULA: Gui Ban, Shu Di, He Shou Wu, Dang Gui, and E Jiao nourish liver blood and enrich kidney yin. In addition, Gui Ban strengthens the sinews and reinforces the bones. Huang Bai and Zhi Mu clear and descend vacuity heat. Huang Qi fortifies the spleen and boosts the qi. Sang Zhi and Qiang Huo dispel wind, eliminate dampness, and free the flow of impediment. Chuan Niu Xi, Dang Gui, and Chi Shao quicken the blood and free the flow of the network vessels.

ADDITIONS & SUBTRACTIONS: If yin vacuity has reached yang with chilled limbs, a pale tongue, and a deep, fine pulse, add nine grams each of Lu Jiao Jiao (Gelatinum Cornu Cervi), Bu Gu Zhi (Fructus Psoraleae), Rou Gui (Cortex Cinnamomi), and Zhi Fu Zi (Radix Lateralis Praeparatus Aconiti Carmichaeli).

Acupuncture & moxibustion: San Yin Jiao (Sp 6), TaiXi (Ki 3), Fu Liu (Ki 7), Zu San Li (St 36), Xue Hai (Sp 10), local points depending on the site of pain or discomfort

Analysis of formula: Supplementing San Yin Jiao, Tai Xi, and Fu Liu supplements the kidneys and enriches yin. Supplementing San Yin Jiao and Zu San Li supplements the spleen and boosts the qi. Zu San Li frees the flow of qi and blood in the lower extremities. Draining Xue Hai quickens the blood and dispels stasis.

Additions & subtractions: For more marked spleen qi vacuity, add Pi Shu (Bl 20) and Wei Shu (Bl 21). For marked kidney vacuity, add Shen Shu (Bl 23). If there is concomitant yang vacuity, moxa Shen Shu (Bl 23) and Ming Men (GV 4). If there is tingling or burning on the sole of the foot, add Yong Quan (Ki 1). If there is pain, tingling, or numbness of the toes, needle the Ba Feng (M-LE-8).

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