ASCITES

Clinical Manifestations
  • Ascites is the abnormal buildup of fluid in the abdomen. Technically it is more than 25 ml of fluid in the peritoneal cavity. Symptoms may include increased abdominal size, increased weight, abdominal discomfort, and shortness of breath. Complications can include spontaneous bacterial peritonitis.
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Ascites
  • Itching or tickling in the throat
  • Cough with expectoration of thin, watery or frothy white sputum
  • Chills with low grade fever
  • Anhidrosis
  • No thirst
  • Headache
  • Aversion to Wind
  • Blocked and / or runny nose with clear, watery nasal discharge
  • Sneezing
  • General body aches
  • Maybe asthma
  • T: Pink
  • C: Thin, white and moist
  • P: Superficial and tight
Treatment Principle
  • Expel Wind
  • Dispel Cold
  • Ventilate the Lungs
  • Resolve Phlegm
Herb Formulas
Points
Clinical Manifestations
  • Ascites
  • Itching or tickling in the throat
  • Wheezing
  • Sneezing
  • Gasping
  • Cough with expectoration of thin, watery or frothy white sputum
  • General body aches
  • No thirst
  • Dyspnea
  • Headache
  • Body aches
  • A sensation of heaviness
  • Chills with low grade fever
  • Maybe asthma
  • Intolerance of Cold
  • Anhidrosis
  • Blocked and/or runny nose with watery nasal discharge
  • Chest discomfort
  • Neck stiffness
  • Irritability
  • T: Pink
  • C: Thin, white and moist
  • P: Superficial and tight
Treatment Principle
  • Disperse Wind-Cold
  • Induce diaphoresis
  • Dispel Dampness
Herb Formulas
Points
Clinical Manifestations
  • Severe fever and chills without sweat
  • Intolerance of Cold
  • Irritability
  • Fidgeting
  • Headache
  • Cough
  • Wheezing (asthma)
  • Muscle aches
  • General body aches
  • Thirst
  • Heaviness and aching of the entire body
  • Shortness of breath
  • Floating edema (severe)
  • Restlessness
  • Anhidrosis
  • Fidgeting
  • May be high fever
  • Edema
  • Dyspnea
  • T: Normal
  • C:Thin white or Yellow
  • P: Floating and tight or Rapid or Tight and rapid or wiry and tight
Treatment Principle
  • Promote diaphoresis
  • Release the Exterior
  • Clear Interior Heat
  • Relieve irritability
Herb Formulas
Points

Clinical Manifestations
  • Dry throat and/or mouth
  • Chronic sore throat (not acute)
  • Restlessness
  • Malar flush
  • Insomnia
  • Disturbed speech
  • Low grade fever, worse in afternoon
  • Yellow urine
  • Irritability with a sensation of Heat in the chest
  • Palpitations with anxiety
  • Sores in the mouth or on the tongue
  • More Heat than in Yin Deficiency (chronic low grade fever)
  • T: Red, deep red
  • C: None
  • P: Deep, thready and rapid
Treatment Principle
  • Nourish Yin
  • Reduce Heat
Herb Formulas
Points
Clinical Manifestations
  • Sweating
  • Aversion to Wind
  • Heavy sensation in the body
  • Superficial edema
  • Urinary difficulty
  • Knee pain
  • Abdominal bloating
  • Edema in lower legs
  • Fatigue
  • Edema in women with constitutional Deficiency
  • T: Pale
  • C: White or Swollen and moist
  • P: Floating and weak, or soft and thready
Treatment Principle
  • Augment Qi
  • Strengthen the Spleen
  • Release the Exterior
  • Promote urination
  • Reduce edema
  • Regulate water circulation
Herb Formulas
Points

Clinical Manifestations
  • Knotted constipation or
  • Watery, thin diarrhea
  • Burning hot sensation in the anus
  • Abdominal distention and pain (dislikes pressure)
  • High fever or infantile tidal fever
  • Hands and feet dripping with perspiration
  • Vomiting
  • Irritating thirst
  • Delirium
  • T: Pink, maybe prickles or Red
  • C: Thick, yellow and dry
  • P: Deep and Excess
Treatment Principle
  • Clear Excess Heat with bitter, cold, strong purgative herbs
Herb Formulas
Points
Clinical Manifestations
  • Distention and fullness of epigastrium and abdomen
  • Nausea
  • Vomiting
  • Anorexia
  • Loose stools
  • Diarrhea
  • Reduced sensation of taste
  • No thirst or preference for hot drinks
  • Sticky sensation in mouth
  • Borborygmus
  • Lassitude
  • Yin jaundice
  • Heavy head
  • Maybe edema
  • Maybe copious white vaginal discharge
  • Maybe cold limbs, fear of Cold or feeling chilled
  • T: Pink
  • C: Thick, white and greasy or sticky
  • P: Deep and slow
Treatment Principle
  • Warm Cold
  • Transform Dampness
  • Harmonize the Stomach
  • Strengthen the Spleen
Herb Formulas
Points
Clinical Manifestations
  • Anorexia
  • Abdominal distention and discomfort
  • Suffocating sensation in the chest
  • Epigastric mass
  • Maybe abdominal pain on palpation
  • Yang jaundice (sclera and skin are bright yellow)
  • Dislike of oily foods
  • Nausea
  • Vomiting
  • Lassitude
  • Scanty, dark urine
  • Maybe thirst or thirst with no desire to drink
  • Diarrhea with foul smell or
  • Constipation
  • Fever
  • Sweet sticky taste or bitter taste in mouth
  • T: Pink
  • C: Thick, yellow and greasy (maybe sticky)
  • P: Soft and rapid
Treatment Principle
  • Clear Heat
  • Benefit Dampness
Herb Formulas
Points
Clinical Manifestations
  • Edema in limbs, especially lower limbs
  • Maybe anasarca
  • Maybe abdominal distention
  • Loose stools
  • Physical and mental fatigue
  • T: Pale
  • C: White and moist
  • P: Soft and even
Treatment Principle
  • Warm Yang
  • Strengthen the Spleen
  • Benefit Qi
  • Move water
Herb Formulas
Points
Clinical Manifestations
  • Abdominal distention, worse at the end of the day
  • Epigastric fullness and discomfort
  • Aversion to Cold
  • Body cold
  • Limbs icy
  • Complexion white and shiny or sallow or waxy and pale
  • Low back, knees and abdomen feel cold and painful
  • Lower abdomen feels cold and painful
  • Loose stools containing undigested food
  • “Cock-crow” diarrhea (occurs at about 5 am)
  • Edema of face and limbs
  • Poor appetite
  • Dysuria
  • Fatigue
  • Lethargy
  • Scanty urine
  • Severe:
    Abdominal ascites
  • T: Pale, moist and swollen
  • C: Thin and white or White and greasy
  • P: Deep, thready, weak and maybe slow
Treatment Principle
  • Warm and Reinforce the Spleen and Kidneys
  • Excrete Dampness
Herb Formulas
Points
Clinical Manifestations
  • Epigastric fullness, distention and pain with dislike of pressure
  • Belching with rotten food smell
  • Acid regurgitation
  • Detests food or
  • Vomits after eating
  • Distention is reduced after vomiting
  • Unformed stools or
  • Knotted constipation
  • T: Pink
  • C: Thick and greasy
  • P: Slippery
Treatment Principle
  • Clear Food
  • Conduct Stagnation
Herb Formulas
Points
Clinical Manifestations
  • Ascites
  • Sudden epigastric and abdominal pain and distention
  • The pain is so intense that it feels like an awl is piercing the abdomen
  • Rough, uneven breathing
  • Stabbing pain in the chest
  • Lockjaw
  • A cyanotic complexion
  • Asthma
  • Dyspnea
  • Oliguria
  • A pale face
  • No bowel movements
  • Rapid breathing
  • Constipation
  • Cold limbs
  • Possible loss of consciousness (severe cases)
  • T: Bluish-purple
  • C: White or White and slippery
  • P: Deep and tight or Deep and slow
Treatment Principle
  • Harshly Purge Cold Accumulation
  • Alleviate pain
Herb Formulas
Points
Clinical Manifestations
  • Epigastric focal distention
  • Fullness and tightness with very slight or no pain
  • Dry heaves
  • Vomiting
  • Borborygmus
  • Diarrhea
  • Anorexia
  • Stomach pain
  • Abdominal pain
  • Subcardiac distention
  • Heartburn
  • Resistance below the Heart
  • Soft epigastrium
  • Nausea
  • Ascites
  • Gurgling sounds
  • T: Normal or with a red tip
  • C: Thin, yellow and greasy
  • P: Wiry and rapid or Wiry, tight and rapid
Treatment Principle
  • Harmonize the Stomach
  • Descend Rebellious Qi
  • Disperse clumping
  • Eliminate focal distention due to Cold and Heat factors
Herb Formulas
Points
Clinical Manifestations
  • Palpitations
  • Stabbing pain in the anterior region over the Heart
  • Suffocating sensation in the chest
  • Maybe drawing pain down the internal aspect of arm (especially the left arm)
  • Pain (in chest and/or arm) tends to be severe and intermittent
  • Severe cases:
    Cold limbs
    Cyanosis of lips and nails
  • T: Dark red with purple spots or Purple body
  • C: Little
  • P: Minute (scarcely perceptible) and thready or Knotted
Treatment Principle
  • Clear Yang
  • Invigorate the Blood
  • Transform Stagnation
Herb Formulas
Points
Clinical Manifestations
  • Feeling of obstruction in throat as if a slice of roast meat were stuck there which cannot be coughed up nor swallowed down. This sensation becomes more prominent during emotional upset and subsides when relaxed
  • Distention and pain in the sides or flanks
  • Suffocating sensation in the chest
  • 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
  • P: Slippery and wiry (slippery due to Phlegm)
Treatment Principle
  • Spread Qi
  • Resolve Phlegm
Herb Formulas
Points
Clinical Manifestations
  • Abdominal distention, swelling and hardness
  • Obvious distended blue-green veins radiating out from the umbilicus
  • Emaciation
  • Dry mouth
  • Facial complexion pale and sallow or dark
  • Red-purple lips
  • Both cheeks slightly red
  • Restlessness
  • Irritability
  • Dizziness
  • Dry eyes
  • Blurred vision
  • Spots before the eyes
  • Numbness of limbs
  • Flaccid paralysis (Wei syndrome), weakness
  • Tinnitus
  • Deafness
  • Forgetfulness
  • Low back and knees sore and painful
  • Throat dry and painful
  • Five Sole Heat
  • Low-grade fever
  • Night sweats
  • Irritability
  • Insomnia
  • Dry stools
  • Stools difficult to pass
  • Constipation
  • Scanty urination
  • Men:
    Spermatorrhea
  • Women:
    Irregular menses or
    Scanty menses or
    Amenorrhea
    Vaginal discharge
  • T: Red or Scarlet or Crimson
  • C: Little or None
  • P: Thready and rapid or Thready, wiry and rapid
Treatment Principle
  • Nourish and Reinforce the Liver and Kidneys
Herb Formulas
Points
Clinical Manifestations
  • Edema of whole body particularly at and below the waist
  • Pitting edema
  • Low back pain, aching and heaviness
  • Abdominal distention with full sensations
  • Oliguria
  • Cold limbs
  • Face gray and congested or pale
  • Feeling nervous and cold with mental weariness
  • In severe cases:
    Ascites
    Edema of scrotum
  • T: Pale and swollen
  • C: Thin, white or Thick, white and sticky
  • P: Deep and thready
  • With Water Flooding the Lungs:
    Cough with copious, thin watery phlegm
    Asthma with phlegmy sound (wheezing)
    Dyspnea
    Facial edema
    Edema of limbs
    Dysuria
    T: Pale and swollen
    C: White and moist or White and greasy
    P: Superficial and tight
Treatment Principle
  • Warm Kidneys
  • Promote diuresis
Herb Formulas
Points
Clinical Manifestations
  • Ascites
  • Aching bones and joints
  • Muscle ache
  • Whole body pain
  • Aversion to Cold, especially at the back
  • Cold limbs
  • Lower abdominal pain and Cold
  • Abdomen feels chilled
  • Maybe fever
  • No thirst
  • T: Normal
  • C: White and slippery
  • P: Deep and faint or Forceless or Choppy and slow or Wiry
Treatment Principle
  • Dispel Cold
  • Warm the channels
  • Assist Yang
  • Dispel Dampness
  • Relieve pain
Herb Formulas
Points
Clinical Manifestations
  • Varicosities of the abdominal veins
  • Red streaks on the skin
  • Abdominal fullness and distention
  • Thirst
  • T: Purplish
  • C: White
  • P: Wiry and choppy
Treatment Principle
  • Regulate Qi
  • Invigorate the Blood
  • Remove Stagnation
Herb Formulas
  • Xue Fu Zhu Yu Tang
Points
  • LIV-3, LIV-14, REN-9, UB-17, UB-22
Clinical Manifestations
  • Abdominal distention and pain, worse after meals
  • White face
  • Poor appetite
  • Belching
  • Scanty urine
  • T: Pale pink
  • C: Sticky and white
  • P: Deep and wiry
Treatment Principle
  • Regulate the Qi of the Liver and Spleen
  • Expel Dampness
  • Remove Stasis
Herb Formulas
Points
Clinical Manifestations
  • A swollen, distended, hard abdomen
  • Obvious dilated, blue-green veins radiating out from the umbilicus
  • Hypochondriac and abdominal pain
  • Pain that is fixed, stabbing and /or severe
  • Pan is worse with pressure
  • Dark, ashen, sallow or purplish complexion
  • Fixed, palpable masses
  • Bleeding with clots
  • Purple lips and conjunctiva
  • Dark rings under the eyes
  • Purple nails
  • Palmar erythema
  • Dry, scaly skin
  • Blue, dark or purplish discoloration of skin in small or large areas
  • Varicose and spider veins
  • Cold hands and feet
  • Tendency to hemorrhage dark blood or clots
  • Black, tarry stools
  • T: Purple, possible purple or red spots
    Red purple if there is Heat
    Blue purple if there is Cold
  • C: White
  • P: Choppy or Wiry and choppy
Treatment Principle
  • Invigorate the Blood
  • Break up Stagnation
  • Move Qi
  • Drain Fluids
Herb Formulas
Points
Clinical Manifestations
  • Ascites
  • Heaviness in the body and head
  • Aversion to Cold
  • Warming the abdomen makes it better
  • Edema of the extremities (usually not pitting)
  • Scanty urination
  • Loose stools or
  • Diarrhea
  • T: Normal
  • C: Greasy and white
  • P: Soft and moderate or Wiry and slow
Treatment Principle
  • Transform Dampness
  • Drain Fluids
  • Warm Yang
  • Disperse Cold
Herb Formulas
  • Shi Pi Yin modified
  • Chinese Patent Medicines: Fu Zi Li Zhong Wan
Points
Clinical Manifestations
  • A swollen, distended, firm abdomen
  • Epigastric and abdominal pain and distention that is worse with pressure
  • Flushing
  • Smothering fever
  • Restlessness
  • A bitter taste in the mouth
  • Bad breath
  • Scanty urination
  • Dry stools
  • Thirst or a dry mouth with with little desire to drink
  • Scanty, concentrated urine
  • Constipation and/or
  • Diarrhea
  • Maybe jaundice
  • T:Red tip and edges
  • C: Sticky and yellow or Grayish black
  • P: Wiry and rapid
Treatment Principle
  • Disperse Heat
  • Excrete Dampness
  • Promote diuresis
Herb Formulas
Points
Clinical Manifestations
  • Ascites
  • General edema of the body and extremities
  • Dysuria
  • Oliguria
  • Orthopnea
  • Pitting edema
  • Dyspnea
  • Gasping
  • Anorexia
  • Abdominal fullness and pain
  • T: Thick
  • C: White and thick
  • P: Slow or Wiry
Treatment Principle
  • Dispel Stagnant Water
  • Dry Dampness
  • Harmonize the Spleen
  • Relieve edema
  • Move Qi
Herb Formulas
Points
Clinical Manifestations
  • Clear, watery, frothy diarrhea
  • More water than diarrhea
  • Borborygmus with the sound of water sloshing in the abdomen on palpation
  • Emaciation
  • Nausea and/or
  • Vomiting of clear fluids
  • Abdominal distention
  • Scanty urination
  • A dry mouth
  • Dizziness
  • T: Pale
  • C: Greasy and white
  • P: Slippery or Soggy
Treatment Principle
  • Warm and strengthen the Spleen
  • Warm and strengthen Fluid metabolism
  • Drain Dampness through the urine or bowel
Herb Formulas
Points
Clinical Manifestations
  • Ascites in a robust person
  • Thirst
  • Labored breathing
  • A hard, distended abdomen
  • Anuria
  • Dysuria
  • Constipation
  • Edema
  • Scanty urine
  • T: Red
  • C: Slippery
  • P: Deep, rapid and forceful
Treatment Principle
  • Move Qi
  • Drive out water and Heat Accumulation
Herb Formulas
Points
Clinical Manifestations
  • Anorexia
  • Edema
  • Ascites
  • Abdominal distention
  • Chest and hypochondriac distention
  • Dizziness
  • Nausea
  • Vomiting
  • Vertigo
  • Thirst with no desire to drink
  • Maybe no thirst
  • Palpitations
  • Shortness of Breath
  • T: Normal
  • C: Thick and slippery
  • P: Slippery, full and maybe wiry
Treatment Principle
  • Warm and Dissolve Tan Yin
Herb Formulas
Points
Clinical Manifestations
  • Ascites
  • Rapidly developing jaundice that quickly deepens in color to orange or gold both in the body and conjunctiva
  • High fever
  • Irritability
  • Agitation
  • Restlessness
  • Thirst
  • Dry mouth
  • Dry throat
  • Foul breath
  • Chest oppression with a feeling of suffocation and Heat
  • Frequent vomiting
  • Abdominal distention and pain that is worse with pressure
  • Flank pain
  • Insomnia
  • Dark urine
  • Palpitations
  • Tinnitus
  • Purpura
  • Red face
  • Rashes
  • Deep-rooted boils
  • Red eyes
  • Itchy skin
  • Dry lips
  • Dysentery with fever
  • Scanty urine or
  • Anuria
  • Dark urine
  • Constipation or
  • Diarrhea
  • Drowsiness
  • Severe:
    Epistaxis
    Maculae
    Melaena
    Carbuncles
    Hematemesis
    Hemoptysis
    Hematuria
    Cloudy mind
    Delirium
    Obsession
    Furuncles
    Incoherent speech
    Bleeding gums
    Muscle spasms
    Convulsions
    Loss of consciousness
  • T: Dark red
  • C: Dark yellow
  • P: Wiry and rapid or Rapid and forceful or Thready and rapid
Treatment Principle
  • Clear Heat
  • Resolve toxicity
  • Resolve Dampness
  • Cool the Blood
  • Purge accumulations
Herb Formulas
Points
Clinical Manifestations
  • Ascites
  • Cough with sharp pain in the chest and hypochondrium
  • Hypochondriac distention and pain
  • Hard focal distention in the epigastrium
  • Dry heaves
  • Shortness of breath
  • Headache
  • Abdominal distention
  • Wheezing
  • Fullness in the chest
  • Dyspnea caused by extreme chest and back pain
  • Dizziness
  • Vertigo
  • Asthma
  • Rapid breathing
  • Generalized edema which is worse in the lower body
  • Difficult urination and defecation
  • T: Normal or Dark
  • C: Thick, greasy and white
  • P: Deep and wiry
Treatment Principle
  • Attack and Dispel water
Herb Formulas
Points