↑ reinforcing ↓ reducing ⊥ even method — technique below follows standard Excess/Deficiency treatment principle for each pattern, not tied to a specific point-by-point source.
1. Painful Obstruction due to Damp-Heat in Channels
Clinical manifestations: Joints that are red, swollen, and intensely hot to the touch; severe pain worse with pressure or warmth; pain relieved by cold applications; a heavy, aching sensation in the limbs; a fever or bodily heat sensation; thirst and irritability; dark, scanty urine; brought on by hot humid weather, spicy or greasy food, alcohol, or an acute flare of a chronic condition; eased by cool compresses, cooling food and drinks, rest, or avoiding heat on the area.
Tongue: Red body, possibly slightly swollen, yellow greasy coating. Pulse: Slippery, Rapid.
Treatment principle: Clear Heat and dry Dampness, clear Damp-Heat from the Lower Burner, strengthen the Spleen and resolve Dampness.
Note: no moxa.
2. Blood Stagnation with Heat
Clinical manifestations: Fixed, stabbing pain in the joint; pain and stiffness worse at night; visible tophi or joint deformities; dark, purplish skin around the joint; irritability and an internal heat sensation; brought on by a long-standing untreated condition, chronic inflammation, or overexertion; eased by gentle movement, warmth, or gentle massage once the acute pain settles.
Tongue: Reddish-purple body with stasis spots, distended sublingual veins, thin dry yellow coating. Pulse: Choppy and Rapid, often Wiry at the left Guan position.
Treatment principle: Invigorate Blood, dispel stasis, unblock the channels, alleviate pain, move Qi.
Invigorate Blood, clear Heat
Note: no moxa.
3. Phlegm in the Channels, Joints and Muscles
Clinical manifestations: Joint swelling that feels hard or firm to the touch; subcutaneous nodules (tophi) near the joints; a heavy or numb sensation in the limbs; joint stiffness with limited range of motion; brought on by a diet heavy in greasy or sweet food, damp weather, a sedentary lifestyle, or chronic Spleen weakness feeding Phlegm production; eased by warm, plainly-cooked food, staying active, or a dry warm environment.
Tongue: Purple body with stasis spots, white greasy coating, distended sublingual veins. Pulse: Wiry and Choppy, or Wiry and Slippery if Phlegm predominates.
Treatment principle: Dry Dampness, transform Phlegm, regulate Qi, harmonize the Middle Burner.
Note: no moxa.
4. Kidney and Spleen Yang Deficiency
Clinical manifestations: A dull, aching joint pain that is not hot or red; pain worsens with fatigue and cold; cold hands and feet, especially below the knees; loose stools or early-morning diarrhoea; a sore, weak lower back and knees; brought on by ageing, chronic overwork, a long illness, or excessive strain on the Kidneys; eased by rest, warmth on the lower back, warm nourishing food, or moxibustion.
Tongue: Pale, swollen, puffy body with tooth marks, white slippery coating. Pulse: Deep, Weak, Slow, especially feeble at the Chi (Kidney) and right Guan (Spleen) positions.
Treatment principle: Tonify Qi, strengthen the Spleen, harmonize the Stomach, tonify Kidney-Yang, warm the Gate of Life (Ming Men).
Note: moxa applicable.
5. Kidney and Liver Yin Deficiency
Clinical manifestations: A dull, aching joint pain that worsens at night; soreness and weakness in the lower back and knees; dizziness and ringing in the ears; dry eyes, dry mouth, and night sweats; flushed cheekbones, especially in the afternoon; brought on by ageing, chronic overwork, excessive sexual activity, or lack of sleep; eased by rest, avoiding stimulants in the evening, or a calm quiet environment before bed.
Tongue: Red, thin body with cracks, little or no coating, dry surface. Pulse: Fine, Rapid, Wiry, weak at the left Chi position.
Treatment principle: Nourish Liver and Kidney Yin, nourish Blood, soften the Liver.
Note: no moxa (Yin deficiency).