LI patterns

Question 1

What are the main functions of the Large intestines?

Answer 1

Controls passage and conduction
Transform stools & reabsorb fluids

Question 2

What are Large intestine channel patterns?

Answer 2

Toothache
Neck swelling
Yellow eyes
Dry mouth
Nose bleeding
Runny nose
Throat blockage
Shoulder pain
Pain and swelling along the channel down to the index finger

Question 3

What is the aetiology generally of Large intestine Patterns?

Answer 3

Cold - exposure to excessive cold / inadequate clothing
dampness - inadequate clothing in cold & damp weather/sit on damp ground
Emotional stress
- sadness
- worry -> depletes lung-qi -> fails to descend and assist LI
- anger - generally just after eating
Diet - consider high amounts of greasy can lead to dampness

Question 4

What is the treatment principles for the following
1. Large intestinal heat bind
2. Gastrointestinal qi stagnation
3. Cold stagnating in stomach and intestines
4. Intestinal heat and bowel excess
5. Large intestinal fluid deficiency pattern
6. Blood deficiency and intestinal dryness
7. Large intestinal dampness-heat
8. Worms accumulating in the intestines

Answer 4

1.Clear large intestine heat, engender fluid
2. Move qi in the large intestine
3.Warm the interior, tonify large intestine
4. Clear intestinal heat, cold purgation
5. Engender fluid, moisten the intestines
6.Tonify blood and engender fluid
7. Clear heat and resolve dampness
8.Quiet ascaris to relieve pain, kill worms

Question 5

What is the shared symptom b/w Large intestinal heat bind & gastrointestinal qi stagnation?

Answer 5

Abdo pain

Question 6

What are 6 differentiating symptoms of Large intestinal heat bind?

Answer 6

Constipation
Burning pain in anus
Feverish
Thirst
Dry lips
Strong appetite

Tongue: red with yellow dry coat
Pulse: sunken and forceful

Question 7

What are 5 differentiating symptoms of gastrointestinal qi stagnation?

thinking direct dysfunction of ST&SP

Answer 7

Epigastric pain that is distending or moving
Belching
Borborygmi alleviated by passing flatus
Nausea
Diarrhoea

Tongue:Thick coat
Pulse: String-like

Question 8

What is the shared symptom b/w Cold stagnating in stomach and intestines & intestinal heat and bowel excess?

Answer 8

abdo pain

Question 9

What are 7 differentiating symptoms of Cold stagnating in stomach and intestines?

Answer 9

Abdominal pain that is aggravated by cold and alleviated by warmth
Cold limbs
Watery diarrhoea
Nausea & Vomiting
Bland taste in mouth
No thirst

Tongue: White coat
Pulse: tight

Question 10

What are 5 differentiating symptoms of intestinal heat and bowel excess?

Answer 10

Abdominal pain and fullness that resists pressure
High fever or late afternoon fever
Constipation
Thirst
Delirium
Short voiding of urine or reddish urine

Tongue: Red with thick yellow dry coat
Pulse: Sunken rapid forceful

Question 11

What is the shared symptom b/w Large intestinal fluid deficiency pattern & blood deficiency and intestinal dryness?

Answer 11

Constipation or difficulty in defecating

Question 12

What are 4 differentiating symptoms of Large intestinal fluid deficiency pattern?

Answer 12

Dry mouth and throat
dry stools
foul breath (due to retention of food following constipation - not heat)
thin body

Tongue: pale/Red with scanty/rootless coat, dry
Pulse: Rapid and thin

Question 13

Acupuncture points to Promote fluids in LI?

Answer 13

ST36 - promotes fluids in ST & LI
SP6 & CV4 - promote fluids and tonify Yin
KI6 - particularly indicated to moisten stools
ST25 - moistens intestines
SP15 - moistens stools & treats constipation

Question 14

Aetiology of LI dry pattern?

Answer 14

Nearly always combined with stomach Yin Xu
- characterised by dryness & Xu of Jinye
- preceds full blown Yin Xu

Question 15

What are the differentiating symptoms of blood deficiency and intestinal dryness?

Answer 15

Blood in stools
Pale complexion
Tongue: pale
Pulse: Fine choppy

Question 16

What are 5 differentiating symptoms of worms accumulating in the intestines?

Answer 16

Ascariasis (presence of worms in stool)
Abdominal mass formation
Discharge of ascaris in stool
Teeth grinding during sleep
White miliary spots on the inside of lips

Question 17

What is the shared symptom between Large intestinal dampness-heat & worms accumulating in the intestines?

Answer 17

Abdo pain

Question 18

What are the 13 symptoms of Large intestinal dampness-heat?

Answer 18

• diarrhoea (retention of dampness -> interferes with LI absorbing fluids & excreting stools)
• Mucus and bloody stools (if no blood, but mucus, just damp invasion) -> blood is due to heat letting out blood
• Abdominal pain that is aggravated by pressure
• Tenesmus (the urge with no result)
• feeling of heat, strong odour to stools, burning anus, thirst, fever, Scanty dark urine, sweating that doesn’t decrease with fever ( fever only noted in severe cases) (indicative of heat)
• feeling of heaviness & fullness (indicative of dampness)

Tongue: red with Yellow, slimy coat
Pulse: Rapid and slippery

• abdo pain & diarrhoea with mucus & blood is enough to diagnose

Question 19

13 acupuncture points to clear heat, resolve dampness and stop diarrhoea?

Answer 19

SP9 & SP6 - resolve damp in lower burner
CV3 (front Mu of bladder) & BL22 (back shu of SJ) - resolve dampness from lower burner
ST25 - front mu point of LI and stops diarrhoea
ST27 - stops abdo pain
CV6
BL25 - clears heat from LI
LI11
CV12 & BL20 - tonify spleen to resolve dampness
ST37 - lower he sea point of LI
SP10 - stops bleeding (sea of blood)

Question 20

What are frequent western medical diagnoses with damp heat in large intestine?

Answer 20

Ulcerative colitis
Crohn’s

Question 21

2 Key symptoms of heat in large intestine?

Precursors and developments?

Answer 21

Dry stools
Burning sensation in anus

Thick yellow dry tongue coat (may be brown/black)
Pulse: full-rapid

Stomach heat often leads to heat in LI which may developed into stomach yin Xu

Question 22

Acupuncture points to clear heat from LI and stomach, and promote body fluids?

Answer 22

ST25 & BL25 -front and back shu point of LI
LI11
ST37 - lower he sea point of LI
ST44 - clears stomach heat
LI2 - clear LI heat
SP6, KI6 & CV12 - promote body fluids

Question 23

3 Key symptoms and aetiology of heat obstructing LI?

Answer 23

Constipation, abdo pain, fever/tidal fever
tongue: thick dry yellow (or brown/black) coating with red body
Pulse: deep-full

Aetiology
Acute pattern - often Middle stage of febrile disease caused by wind cold/heat
- > occurs when exterior wind becomes interior heat
Frequent in children

Question 24

9 Acupuncture points to clear heat in yang Ming and promote bowel movement?

Answer 24

LI11
LI4 - clear LI heat and promotes bowel movements
SP15 - promotes bowel movement
SJ6 - clear heat intestines and promotes bowel movement
SP6 - nourishes yin and stops abdo pain
LI2
ST44
ST25 & BL25

Question 25

3 Key symptoms of cold invading intestines and aetiology? What patterns may predispose?

Answer 25

Sudden abdo pain, diarrhoea, feeling cold Tongue: thick white coat Pulse: deep tight Due to invasion of exterior cold 🥶 Eg. Sit on cold surfaces or exposed to cold weather with uncovered abdo Xu of stomach & spleen yang may predispose

Question 26

6 acupuncture points to expel cold from LI and warm lower burner?

Answer 26

ST37 lower he sea point and stops diarrhoea & pain ST25 also stops diarrhoea and pain ST36 moxa on needle to expel cold from LI SP6 calms abdo pain LIV3 - moves qi in lower jiao & calms spasms ST27 - expels cold from LI

Question 27

What are 3 signs and symptoms of Qi stagnation in Large intestines? think due to liver stagnation

Answer 27

Key: Abdo distension & pain with bitty stools constipation, irritability Tongue: normal/slightly red on sides Pulse: wiry on both rear positions

Question 28

7 acupuncture points to move Qi in Large intestines?

Answer 28

CV6 & GB34 - move Qi in lower abdo ST25 - moves Qi in LI SP15 - moves Qi in LI and promotes bowel movement ST37 - particularly indicated in chronic conditions SP6 - stops abdo pain BL25

Question 29

What are 4 S&S of LI cold and aetology?

Answer 29

Loose stools (like duck droppings) dull abdo pain cold limbs pale urine Tongue: pale Pulse: deep-weak Aetiology - due to excessive consumption of cold & raw foods or chronic exposure to cold weather on abdo Basically the same as spleen-yang Xu

Question 30

6 acupuncture points to tonify & warm LI and SP?

Answer 30

ST25 - stops diarrhoea & pain CV6 - tonifes qi & stops chronic diarrhoea ST36 - tonifies spleen qi ST37 - stops chronic diarrhoea BL25 BL20

Question 30

7 S&S of collapse of LI and aetiology?

Answer 30

Chronic diarrhoea & prolapsed ani haemorrhoids tiredness after bowel movement cold limbs no appetite mental exhaustion desire for warm fluids/abdo massage Tongue: pale pulse: deep-fine-weak Aetiology - caused by any of the causes of st/sp Xu - excessive physical work - sunken spleen-qi is always a precursor

Question 31

7 Acupuncture points to tonify stomach and spleen, raise qi?

Answer 31

CV6 - tonifies & raises Qi ST25 ST36 SP3 BL21 & BL20 DU20

Question 32

How does one differentiate b/w cold invading LI and LI cold (empty-cold)? Key Symptoms Tongue Pulse Differentiating Features / Notes

Answer 32

Cold invading LI Key Symptoms: Sudden abdominal pain, watery diarrhea, aversion to cold, chills Tongue: Pale or normal, thin white coat Pulse: Tight, slow Differentiating Features / Notes: Acute attack from external Cold; usually short duration LI cold (empty-cold) Key Symptoms: Watery diarrhea, abdominal pain relieved by warmth, pale complexion, nausea, fatigue Tongue: Pale, wet, white coat Pulse: Deep, weak, slow Differentiating Features / Notes: Chronic or post-illness; interior deficiency; pain relieved by warmth distinguishes from acute Cold invasion