PREMENSTRUAL
SYNDROME
by Peter Deadman
The occurrence of premenstrual physical and psychologi- ing symptoms causing major disruption in all aspects of
cal changes was first mentioned in the writings of life7. As a result of these figures, PMS has been described as
Hippocrates1, whilst premenstrual syndrome itself was the worlds commonest disease. PMS has variously been
first identified in the 1930s by Frank2,3. reported to result in increased psychiatric admissions, sui-
Premenstrual syndrome (PMS) is defined as a collection cides, alcohol abuse, child abuse, accidents, accidents to
of differing signs and symptoms which occur only in the children, examination failure, varicose veins, glaucoma,
premenstruum, i.e. after ovulation, and is relieved by men- cardiac failure and hospital admissions in general. It has
struation4. Symptoms may therefore occur any time be- even served as a defence in murder cases.
tween 1 and 14 days (usually 7-10) before menstruation PMS is not usually seen in the absence of other menstrual
begins, and remit after the onset of bleeding5. The combina- symptoms. One study showed that while 15% of women
tion of symptoms seen in PMS occurs regularly, either every suffered premenstrual distress only, and 9% distress dur-
month or most months, although their severity may vary ing the menstrual flow only, 58% reported distress during
considerably from one cycle to the next. It is generally both phases8.
accepted that PMS gets worse with age (worst between the
ages of 30-40) 6, and usually does not improve after child- Aetiology
birth. The cause of PMS has resulted in much debate, contradiction
and confusion. This is in part because both physical and
Symptoms psychological factors have been found to be both
Although as many as 150 individual premenstrual symp- precipitating factors and symptoms. As a result, there is
toms have been noted, the most common symptoms can be dispute over whether PMS has a biological or a psychological
put into four main groups: cause. Reported precipitating causes of PMS include a past
Anxiety, irritability, mood swings and nervous tension. history or family history of depression, mental illness or
Depression, insomnia, lethargy and confusion. alcoholism, past history of sexual abuse, discontinuation of
Bloating, weight gain, headaches and breast tenderness. the oral contraceptive pill, bilateral tubal ligation and
Increase in appetite, cravings for sugar and/or salt and hysterectomy.
fatigue. An extraordinary number of possible aetiologies has
Other often-reported symptoms include unease, insomnia, been advanced for PMS. These include progesterone defi-
sleepiness, aggressiveness, crying spells, clumsiness, poor ciency, a fault in progesterone receptors, oestrogen-proges-
co-ordination, difficulty in concentrating, decrease or terone imbalance, fluid retention due to raised aldosterone
increase in libido, swelling, puffiness of the abdomen, face levels in the luteal phase, deficiency of vitamin B6,
or fingers, weight gain, constipation, diarrhoea, acne and hypoglycaemia, and psychosocial and personality factors.
skin rashes, muscle aches and pains, and exacerbation of None of these theories is generally accepted as having been
epilepsy, migraine, asthma, rhinitis or urticaria. substantiated.
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to restrain and lubricate the potential harshness of the Liver Also, when the Spleen is very deficient, there may be a
qi. Blood and yin deficiency can therefore lead both to a craving for food in general and sweet foods in particular
failure of the freegoing function of the Liver and to exces- which rapidly, even if temporarily, boost it. Such cravings
sive uprising of Liver yang. Because of menstruation, women are commonly encountered premenstrually30.
are prone to blood deficiency, and PMS as well as many Blood is the essence of water and grain ...generated and
other gynaecological disorders, is often characterised by transformed in the Spleen31. When the Spleen is oppressed
the combination of Liver qi stagnation and blood xu. In just and weakened by Liver encroachment, it may be unable to
the same way, the decline of Kidney yin as women ap- perform its function of generating qi and blood, and thus
proach menopause, may result in malnourishment of Liver there may be tiredness and exhaustion as well as blood
yin and a greater tendency to Liver stagnation and/or deficiency which may fail to nourish the Liver and complicate
uprising of Liver-yang. As far as treatment is concerned we its qi stagnation.
can generalise to the extent of saying that in cases of Liver
qi stagnation in women, the Liver blood or yin must almost Liver fire
always be nourished. As emphasised above, the free and unobstructed spreading
of the Liver qi is closely related to the harmonious interplay
Spleen disharmony of the seven emotions. Repression of any of the emotions
The nature of the Liver is to spread and extend, and this will cause the Liver qi to stagnate, and after time to trans-
assertive and outgoing quality can easily become aggres- form to fire. The pattern of Liver fire is characterised by
sive when the Liver is shi. At the same time, the Spleen, outbursts of anger and fury as well as many signs of the qi
ceaselessly expending its qi in transportation and transfor- stagnation from which it transforms. If fire rises from the
mation, easily becomes weakened and exhausted and thus Liver to the Heart there will be restlessness and insomnia,
unable to resist encroachment by the Liver. The pattern often with vivid dreams, in which feelings of internal
known as Liver-Spleen disharmony which is almost invari- aggression are projected into violent characters or events.
ably present to some extent in PMS, may spring primarily When the fire rushes upwards to the head, there may be
from an aggressive Liver which suppresses the Spleen, or dizziness, tinnitus, headaches, neck pain etc. If heat con-
from a deficient Spleen which is unable to withstand even sumes yin fluid there will be thirst, and if it enters the blood
the normal spreading and extending of the Liver. This (the Liver stores the blood) there will be signs of reckless
important clinical relationship is recognised in the state- bleeding such as early, heavy or prolonged menstruation.
ment by Zhang Zhong Jing When encountering Liver
disharmony, it should be remembered that the Liver often Phlegm
invades the Spleen, therefore strengthen the Spleen first. In a small percentage of cases of PMS, the emotional distur-
According to the Essential Questions When the spleen is bance may extend beyond the more normal range of de-
diseased, damp is generated 26, and Damp, swelling and pression, weepiness and outbursts of anger. In these cases
fullness all pertain to the Spleen27. When Liver wood there may be more severely disturbed emotional behaviour
overacts on Spleen earth in this way, therefore, the Spleen including violence to the self and others, severe depression,
is unable to transform liquid and solid food resulting in disturbance of consciousness, exacerbation of psychiatric
such symptoms as heaviness, swelling, oppressive sensa- disorders etc. These symptoms reflect stagnant fire of the
tions, loose stools and oedema28. When Spleen deficiency is Liver and Heart with phlegm-heat obscuring the Heart
further complicated by Kidney yang deficiency, the swell- orifices. Stagnant fire (transformed from Liver qi stagna-
ing and oedema will be even more pronounced. Since tion) both affects the Liver and rises to the Heart. Phlegm is
When qi flows water also flows29, Liver qi stagnation can produced by the combination of qi stagnation and heat. The
also play a part in this oedema. relationship of qi stagnation to phlegm is an important one.
When the body is heavy with dampness, the mind clouded, Li Yong-Cui said Shock, fury, sadness and worry: phlegm
and body movement weighted and lethargic, the conse- stems therefrom32, whilst Zhu Danxi said Those who treat
quent uncoordinated movements may result in clumsiness. phlegm effectively do not treat the phlegm, but first treat
As far as the stools are concerned, when Liver and Spleen the qi. When the circulation of the qi is smooth and ordered,
suffer dual disharmony, the symptom of alternating consti- this will lead the body fluids in a smooth and ordered
pation and loose stools is frequently seen, with constipation circulation as well33. As far as Liver and Heart fire is
for several days as Liver stagnation builds, and diarrhoea or concerned, the heat will distil and condense body fluids
loose stools usually one or two days before the period when into phlegm. Finally, the disturbance of Spleen function
Spleen deficiency predominates. which commonly accompanies Liver qi stagnation, will
Spleen deficiency is traditionally associated with contribute to the formation of phlegm.
diminished appetite in Chinese medicine, although clinical
practice shows that it is often more complicated than that, Breast pain, distention and lumps
since Spleen deficiency often co-exists with some degree of According to Zhu Danxi The breasts are where the yang-
overt or hidden Stomach fire (and hence excessive appetite). ming passes, and the nipples are ascribed to the jueyin.
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Breast disorders, therefore, are mainly ascribed to tions may be due to the kind of attack of exterior pathogens
disharmony of the Liver and Stomach, although as far as discussed under headache.
acupuncture treatment is concerned it is important to
remember that the Pericardium primary channel and the Acne
Gall Bladder muscle channel traverse the breast. Pre- If Liver fire transmits to the Stomach and/or Lung it can
menstrual breast distention, swelling, pain and lumpiness manifest as outbreaks of premenstrual facial acne. Two
involves three main patterns, in order of increasing severity: other pathological mechanisms may be involved. One is the
i. Liver qi stagnation (breast distention, hypersensitivity, tendency of heat to separate off and rise (to the face) when
pain and lumpiness), ii. Liver stagnant fire which further yin accumulates below, and the second is the resonance
transmits to the Stomach channel (more severe pain, between blood stasis in the lower jiao and in the acne lesions
hypersensitivity and heat sensation), and iii. Liver qi themselves.
stagnation complicated by phlegm and/or phlegm-fire
(more pronounced lumps). Non Liver patterns
Although Liver qi stagnation is the primary pattern seen in
Diarrhoea PMS, there is another important mechanism for dishar-
Pre-menstrual diarrhoea is commonly encountered in mony at this time. As menstruation approaches, blood
clinical practice. The most frequently seen pattern is Spleen gathers in the Ren and Chong Mai and if there is an overall
deficiency, which may be complicated by dampness. If body pattern of blood xu, it is likely to become more
Liver qi stagnation transforms to heat, however, the heat pronounced at this time. Since the most common precondi-
and dampness may combine to form damp-heat which tion for blood xu is Spleen qi deficiency, the combined
sinks to the lower jiao causing diarrhoea, often accompanied pattern of qi and blood xu may be encountered. The blood
by leucorrhoea. The qi stagnation that results from xu fails to nourish the Heart (anxiety, palpitations, insom-
obstruction by damp-heat may also give rise to pain, nia etc.) and Liver (dull lingering headaches, body aches
especially exacerbation of existing pain, in the lower back etc.), whilst the qi xu gives rise to general fatigue, lassitude
and hips. and possibly oedema. In women approaching menopause,
as well as younger women who are constitutionally Kidney
Headache xu, a similar mechanism (gathering of blood and yin prior
Pre-menstrual headache is commonly encountered clini- to menstruation) may give rise to exacerbation of symp-
cally. Once again the most likely pattern is some form of toms of yin xu and empty heat. In such cases there may be
Liver disharmony, whether qi stagnation, qi stagnation little sign of Liver stagnation.
transforming to heat, or Liver yang rising. This last pattern
is due to the gathering of yin blood in the Ren and Chong Patterns of Premenstrual Syndrome
Mai prior to menstruation which leaves a state of relative
deficiency elsewhere and results in separation of yin and Liver qi stagnation
yang. Sometimes, the Spleen deficiency aspect of Liver- Depression, weepiness
Spleen disharmony may result in phlegm which obstructs Irritability, frustration
the clear yang rising to the head, resulting in dizziness and Experienced positively as greater assertiveness, creativity
headache with a heavy and bound sensation in the skull. In and clarity, less passivity
rare cases headache may result from regular periodic attack Distention, swelling or pain in the breasts and/or nipples,
of exterior wind prior to menstruation, due to deficiency in with dislike of touch and pressure; in severe cases may
the upper body as the available blood, yin and qi gather begin around ovulation or even persist through most of
below. In such cases, there will be signs of exterior invasion the menstrual cycle
such as chills and fever, body aches etc. Breast distention may be accompanied by lumps or nodules
which disappear soon after onset of menstruation or
Hot or cold sensations enlarge and reduce according to the menstrual cycle; the
Many women will experience changes in body temperature more pronounced the swelling and lumps, the more
as part of the premenstrual pattern. The possible mecha- likely Liver qi stagnation is to be accompanied by phlegm
nisms for these changes can be complicated, but the most due to poor fluid circulation
commonly encountered clinically are: i. heat sensations due Suffocated, oppressive feeling in the chest with difficulty
to transformation of Liver qi to fire, ii. cold sensations due in taking a satisfactory breath, undue consciousness of
to stagnant qi or stagnant fire failing to warm the extremi- breathing, sighing
ties (this is an example of true heat, false cold and in some Headache, neckache, tightness and pain in the region of
cases therefore, despite the coldness, the tongue will be Jianjing GB-21
red), iii. cold sensations due to qi and blood xu, iv. heat Desire to stretch the body or yawn excessively
sensations resulting from uprising of yang and empty heat Lower abdominal distention or pain prior to menstruation,
due to blood and yin xu, v. more rarely, hot or cold sensa- which is relieved at onset of bleeding
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Irregular menstruation (either early or late) Heart and Liver fire stagnation, phlegm obscures the clear
Dream-disturbed sleep orifices
Erratic energy - lethargy or hyperactivity Extreme emotional disturbance (e.g. hopelessness, con-
Constipation fusion, suicidal depression, murderous rage etc.)
Tongue: normal colour, or purplish all over, or purple spots Thirst
along the sides Constipation
Pulse: wiry Tongue: red sides and tip, yellow or white dry or greasy
coating
Liver qi stagnation transforms to fire Pulse: wiry, slippery, rapid
Many of the qi stagnation symptoms will be the same with
the addition of: Spleen dampness due to Spleen xu and Liver suppression
Restlessness, thirst Many of the qi stagnation symptoms will be the same with
Outbursts of real anger and fury maybe alternating with the addition of:
crying and depression Oedema of the face, eyelids, feet, ankles or even swelling
Headaches, dizziness, tinnitus of the whole body
Insomnia, dream-disturbed sleep (often violent or fearful Abdominal bloating and distention
dreams) Heavy oppression of the chest and epigastrium
Early menstruation, or profuse menstruation Clumsiness
Tongue: red sides and tip Poor appetite, loose stools/diarrhoea, nausea
Pulse: wiry and rapid Craving for sweet foods
Cold extremities
Liver qi stagnation complicated by Kidney yin xu Pallor, tiredness, listlessness, sighing
Symptoms of Liver qi stagnation and heat are seen, with the If complicated by Kidney yang xu, then cold limbs and
addition of: body, weakness or aching of the lower back etc.
Soreness of the back and knees before, during or after Tongue: swollen and pale with teethmarks, maybe pale
menstruation purple or with purple spots along the sides, white sticky
Dizziness coating
Frequent urination Pulse: wiry and slippery or soggy
Hot flushes, night sweats, vaginal dryness
Insomnia, anxiety Liver (channel) damp-heat
Tongue: red and dry with scanty coating Premenstrual diarrhoea with strong and unpleasant smell
Pulse: rapid, thin, wiry Burning sensation in the anus
Lower abdominal pain and/or heaviness
Liver and Stomach stagnant fire Dark urine
Symptoms of Liver qi stagnation and heat are seen, with the Dark menstrual blood
addition of: Irritability, easily angered
Severe breast pain, maybe sharp Excessive white or yellow leucorrhoea, with unpleasant
Itchiness or hypersensitivity of the nipples smell and irritation
Heat sensation in the breasts Bitter taste in the mouth, red face
Irritability, restlessness, anger Pain of the lower back or hips
Dry mouth and thirst Tongue: red with yellow dry or greasy coating, especially at
Possibly excessive leucorrhoea the rear
Tongue: red with a yellow dry coating Pulse: wiry, slippery and rapid
Pulse: wiry and rapid
Liver Fire transmits to the Lung and Stomach
Liver-Qi stagnation accompanied by blood xu In addition to symptoms of Liver fire there may be:
Many of the qi stagnation symptoms will be the same with Facial acne
the addition of: Tongue: darkish red
Scanty or delayed menstruation Pulse: wiry
Pallor, dizziness, insomnia Key factors that determine Stomach rather than Lung
Fatigue, cold limbs and body involvement include constipation, more thirst, excessive
Pain of the neck, shoulders and upper back with tightness, appetite, digestive symptoms and a thicker tongue coating.
hardness or knotting of the muscles Key factors that determine Lung rather than Stomach
Tongue: pale, especially on the sides involvement include premenstrual facial swelling, swell-
Pulse: thin and wiry ing of the hands and feet and oppressive sensation in the
chest.
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BL-19, Wangu GB-12, Zuqiaoyin GB-44 should be used. Especially important are:
Constipation: Zhigou SJ-6, Daheng SP-15 Liangqiu ST-34: as the xi-cleft point of the Stomach
channel which passes through the breast, this point is
Liver qi stagnation transforms to fire indicated for all acute and severe breast disorders.
In addition to the points listed for Liver qi stagnation: Daling P-7: as stated above, the Pericardium jueyin chan-
Xingjian LIV-2: the Great Compendium of Acupuncture and nel has a close relationship with both the Liver jueyin and
Moxibustion says When the Liver is shi, drain Xingjian LIV- Stomach channels (the Pericardium primary channel passes
2 whilst according to the Classic of Difficulties34 ying-spring through the middle jiao). In addition to treating breast pain
points are indicated for heat in the body. Xingjian LIV-2, and abscess, this heat-clearing point is indicated for insom-
the ying-spring and fire point of the Liver channel, is nia, restlessness, anxiety with a hungry sensation, weeping,
therefore the principal acupuncture point to clear Liver fire fullness of the chest, chest and flank pain, sighing and foul
and descend Liver yang. breath.
Laogong P-8: the ying-spring and fire point of the Pericar-
dium channel is a powerful point to clear heat from the Liver qi stagnation accompanied by blood xu
Heart. Due to the close relationship of the Pericardium and In addition to the points listed for Liver qi stagnation:
Liver jueyin channels, Laogong P-8 is particularly indicated Geshu BL-17: as the hui-meeting point for blood, this is an
when stagnant Liver fire transmits to the Heart giving rise important point to treat all blood disharmony, including
to various manifestations such as susceptibility to anger, blood deficiency.
sadness, apprehension, restless zang disorder35, mania-de- Zusanli ST-36: The Stomach is the sea of qi and blood
pression disorder, and burning sensation and pain in the and "He-sea points treat the internal fu37". As the he-sea
region of the Heart in women. point of the Stomach channel, this is the most important
Tianfu LU-3: this point, which is rarely used nowadays, point on the channel to tonify both blood and qi.
was traditionally indicated for Liver fire which attacks the Pishu BL-20: As the back-shu point of the Spleen zang,
Lungs (sudden and severe thirst, internal rebellion, Liver where the qi of the Spleen emanates from the interior to the
and Lung struggle against each other36) as well as for a body surface, this point has a strong action on regulating
variety of psycho-emotional disorders such as somnolence, and tonifying the Spleen, and thus promoting blood forma-
insomnia, sadness, weeping, disorientation and forgetful- tion.
ness.
Yongquan KID-1: this is an important point to root Heart and Liver fire stagnation, phlegm obscures the clear
excessive yang and fire which rushes upwards giving rise orifices
to such symptoms as dizziness, vertex headache, agitation, In addition to the points listed for Liver qi stagnation and
insomnia, poor memory, rage with desire to kill people, Liver fire:
depression with disordered speech, and constipation. Fenglong ST-40: The Spleen is the origin of phlegm38.
Xiaxi GB-43: as the ying-spring and water point of the Gall According to the theory of the luo-connecting points,
Bladder channel which is externally-internally paired with Fenglong ST-40 is able to treat disorders of the Spleen and
the Liver channel, this point is indicated for Liver and Gall is the primary acupuncture point to treat phlegm disorders.
Bladder heat which ascends along the channel to the head It is indicated for copious phlegm, fullness, oppression and
and gives rise to such symptoms as headache, dizziness, pain of the chest, plumstone throat, wind-phlegm head-
deafness and tinnitus. ache, mania-depression disorder, mad laughter, likes to
ascend to high places and sing, likes to undress and walk
Liver qi stagnation complicated by Kidney yin xu around, restlessness, sees ghosts, indolence and epilepsy.
In addition to the points listed for Liver qi stagnation: Jianshi P-5: along with Fenglong ST-40, this is the most
Taixi KID-3 and Shenshu BL-23: as the shu-stream and important point to treat phlegm disorders and is indicated
back-shu points of the Kidneys respectively, these are the for such symptoms as sudden palpitations, oppression of
two principal points to tonify all deficiency patterns of the the chest, apprehension, susceptibility to fright, epilepsy,
Kidneys. sudden mania, manic raving, agitation and restlessness,
Guanyuan REN-4: as a meeting point of the three leg yin absent mindedness, poor memory and plumstone throat.
channels with the Ren Mai, this is one of the principle Laogong P-8: see above.
acupuncture points to benefit jing-essence and nourish Renzhong DU-26: the Du Mai both enters the brain and
Kidney yin. connects (via its anterior pathway) with the Heart. Renzhong
In case of hot flushes and night sweats, add Rangu KID- DU-26 is one of the thirteen ghost or devil points of Sun
2, Fuliu KID-7 and Yinxi HE-6. Si Miao for the treatment of mania disorder and epilepsy.
According to The Ode to Xihong the ability of Renzhong
Liver and Stomach stagnant fire DU-26 to treat mania disorder is supreme; the thirteen devil
In addition to the general points listed for Liver qi stagna- points must not be overlooked.
tion, the points given above for breast distention and pain
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JOURNAL OF CHINESE MEDICINE NUMBER 48 MAY 1995
Spleen dampness due to Spleen xu and Liver suppression back-shu points of the Heart, these sre the two major points
In addition to the points listed for Liver qi stagnation: to nourish Heart blood and stabilise the shen.
Zhangmen LIV-13: as the front-mu point of the Spleen, Pishu BL-20: see above.
located on the Liver channel, this is an essential point to
harmonise Liver-Spleen disharmony, especially when it Management of PMS
affects the middle and lower jiao. A full discussion of the management of PMS is beyond the
Yinlingquan SP-9: Yinlingquan SP-9 opens and moves scope of this article. There are many PMS self-help groups
the water passages39. Yinlingquan SP-9 is the foremost which advocate dietary changes, nutritional supplements,
point on the Spleen channel for transforming and draining exercise etc., and these all have their committed supporters.
shi dampness. A brief discussion of exercise and diet, however, follows:
Zusanli ST-36: see above. Exercise
Pishu BL-20: see above. Physical movement and exercise is one of the most effective
Fenglong ST-40: see above. ways to counter stagnation of Liver qi since it vigorously
In case of complication by Kidney yang xu: promotes qi circulation throughout the whole body. When
Fuliu KID-7: this is an important point in the treatment of stagnant qi is unavailable for use, there may be subjective
any kind of oedema, especially when due to Kidney defi- sensations that mimic qi deficiency, and the resultant leth-
ciency. argy may mean that there is a great reluctance to exercise.
Jingmen GB-25: the front-mu point of the Kidneys and If exercise is taken, however, and the qi begins to flow, there
indicated for both chronic oedema and diarrhoea due to will be much greater energy afterwards, a greater feeling of
deficiency of the Spleen and Kidneys. well-being, and an improvement in many of the PMS symp-
toms40. Generally speaking, aerobic exercise is more effec-
Liver channel damp heat tive than exercise such as qigong, and Chinese research has
In addition to points for Liver qi stagnation and Liver fire: indicated that in the absence of more vigorous exercise,
Ququan LIV-8: as the he-sea and water point of the Liver some kinds of qigong may fail to relieve, or even exacerbate,
channel, Ququan LIV-8 has a strong action on draining depression. Physical movement that combines playfulness
damp-heat from the lower jiao. may be even more helpful than overly serious exercise, and
Zhongji REN-3: as the front-mu point of the Bladder and so dancing and sport should be considered. It is important
a meeting point of the Ren Mai with the Spleen, Liver and to remember that exercise can help to manage Liver qi
Kidney channels, Zhongji REN-3 is able to drain damp-heat stagnation but will not generally resolve it. As a result, if
from the whole lower jiao, especially in the treatment of underlying problems are not addressed, the tendency to
leucorrhoea and urinary disorders. obsessiveness that can accompany Liver stagnation may
Tianshu ST-25: the front-mu point of the Large Intestine lead to an ever-increasing dependency on exercise, which
both treats diarrhoea due to dampness or damp-heat and has to be continually increased to deliver the same feeling
regulates the uterus. of well-being that accompanies free-flow of qi. Two possi-
Daimai GB-26: this point , located on the Dai Mai girdle ble results of this are i. an even greater build-up of Liver
channel which binds the Ren, Chong, Kidney, Liver and stagnation when a person cannot exercise, and ii. consump-
Spleen channels, plays an important role in controlling tion of qi, blood and yin through excessive exertion.
leucorrhoea, especially when due to damp-heat. Singing, shouting and breathing
Singing, shouting and deep breathing can all be helpful,
Liver fire transmits to the Lung and Stomach especially to move qi stagnation in the chest.
In addition to points to clear Liver fire: Diet
Neiting ST-44: as the ying-spring and water point of the Many self-help PMS groups stress that great benefit can be
Stomach channel, Neiting ST-44 has a strong action on obtained by reducing sugar and junk foods, salt intake,
clearing heat from the upper portion of the Stomach chan- tea, coffee, nicotine and alcohol, and dairy foods, and
nel in the face. emphasising the use of green vegetables, salads, good
Quchi L.I.-11 and Weizhong BL-40: these are two of the quality vegetable oils and wholefoods. Others advocate
few acupuncture points traditionally indicated for skin taking small, high carbohydrate meals every three hours.
disorders. As far as this latter suggestion is concerned, appropriate
Yuji LU-10: the ying-spring and fire point of the Lung eating boosts the Stomach and Spleen and helps resist Liver
channel, to clear heat from both the Lung zang and channel. encroachment41.
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