SI patterns

Question 1

What are the main functions of the Small intestine?

Answer 1

Controls receiving and transforming
Separates fluids

Question 2

What are small intestine channel symptoms?

Answer 2

Pain and swelling in throat
Unable to turn head side to side
Shoulder pain with a pulling sensation
Hearing loss
Yellow eyes
Swollen cheeks
Pain along the channel pathway

Question 3

What is the course of the SI primary channel?

What pathology is related to its pathway?

Answer 3

Originates at the ulnar tip of the little finger, runs along the posterior ulnar aspect of the arm, goes up to the shoulder, then ascends to the cheek, passes anterior to the ear, and ends at the SI 19 area near the ear.
Internal branch enters the heart, stomach, and small intestine.

Functions & Pathologies:
The SI channel primarily affects urination, digestion, and emotional processing.
Conditions related to this channel:
Small Intestine Qi Pain/Heat: Lower abdominal pain, urinary difficulty, sometimes mental restlessness.
Shoulder & Neck Pain: Posterior shoulder pain, restricted movement along the posterior arm.
Ear Disorders: Tinnitus, deafness, otalgia, due to the channel reaching the ear.
Eye & Face Disorders: Redness, swelling, or pain along cheek and lateral face.
Emotional/Heart Connection: Anxiety, mental restlessness, insomnia (via internal branch connecting to heart).

Question 4

What is the pathway of the Luo-connecting channel of SI?

Answer 4

Starts at SI 7 on the forearm.
Connects to the Heart channel, travels to the axilla, and links the shoulder/upper back.

Question 5

What organs the small intestine subordinate to in its role?

Answer 5

Kidney-yang (and bladder) - transforms fluid in coordination with these 2
Spleen yang - transforms food in coordination with spleen
therefore - most SI patterns are different manifestations of spleen/kidney yang patterns

Question 6

What is the general aetiology of Small intestine patterns?

Answer 6

diet - overconsumption of hot/cold/raw foods
emotions - effected by the same emotional stress as spleen & liver
- sadness - destroys mental clarity & capacity of sound judgement
- worry/anger/frustration/resentment - causes qi stagnation

Question 7

What is the treatment principles for:
1.Excess heat in the small intestine
2. Deficiency cold in the small intestine
3. Small intestine qi stagnation

Answer 7

1. Clear heart and small intestine fire
2. Warm the interior to dissipate cold, invigorate yang
3. Move qi to relieve pain, soothe the liver

Question 8

What are the symptoms of Excess heat in the small intestine?

Answer 8

• mental restlessness, pain in throat, tongue and/or mouth ulcers & thirst with desire to drink cold liquids (fire in heart)
• insomnia
• deafness (fire in SI channel - which enters the ear)
• uncomfortable feeling & heat sensation in chest
• abdo pain
• scanty & dark urine, burning pain on urination, blood in urine (SI function of separating fluids in lower jiao is disturbed by heart-fire, burning fluids)

Tongue: red with redder & swollen tip with yellow coat
Pulse: Rapid/overflowing - particularly in front position - if there are urinary symptoms, pulse would be wiry on left-rear position

Abdo pain, tongue ulcers with scanty, dark painful urination is enough to diagnose

Question 9

What pattern is full-heat in small intestine closely related to?

Answer 9

Heart-fire blazing

Question 10

5 acupuncture points to drain heat & SI fire?

Answer 10

SI2 - clears SI heat
SI5 - Jing river point - clears heat and calms the mind. Also affects the tongue. Helps to gain clarity & discriminate b/w choices
HE5 & HE8 - drain heart-fire
ST39 - lower He sea point of SI & stops abdo pain

Question 11

What are the symptoms of deficiency cold in the small intestine?

Answer 11

Dull abdominal pain alleviated by pressure (due to cold obstruction)
Desire for warm drinks
Cold limbs
Borborygmi
Diarrhoea (separation of food & fluids is impaired by empty-cold)
Pale and abundant urination
Difficulty Taking in (absorbing) Information

Tongue: Pale with white coat
Pulse: Deep weak and slow

• dull abdo pain, borborygmi & diarrhoea are enough to diagnose

Question 12

What pattern is SI Xu & cold usually associated with?

And how does one pinpot SI involvement generally?

Answer 12

Spleen Yang Xu

• difficult to distinguish from spleen-yang Xu, with borborygmi being the main symptom to signal SI involvement

Question 13

6 acupuncture points to expel cold, warm intestines and tonify spleen-yang?

Answer 13

CV6 - moxa cones with ginger for empty-cold in intestines
ST25 - stops diarrhoea
ST39
ST36 - with moxa tonifies Yang and expels cold
BL20 - back shu point of spleen
BL27 - back shu point of SI & expels cold

Question 14

What are the shared symptoms b/w Small intestine qi stagnation & deficiency cold in the small intestine?

Answer 14

Abdominal pain
Borborygmi

Question 15

What is the difference between SI-Qi tied and pain?

Answer 15

Qi tied is generally more acute pain, characterised by obstruction and severe stagnation -> sudden, severe pain and constipation

Question 16

7 acupuncture points to remove obstruction from the lower burner and move QI of SI?

Answer 16

ST39 - stops abdo pain & moves SI -Qi
Lanweixue (appendix point) - b/w ST36 & ST37 -> used if tender & appendicitis is suspected
CV6 & GB34
ST25 - front mu point of LI - stops abdo pain
SP6 - stops abdo pain
LIV3 - stops abdo pain & spasms & promotes smooth flow of Liver-qi

Question 17

What are the symptoms of SI Qi tied?

similar S&S to acute appendicitis (however can occur without appendicitis)

Answer 17

severe abdo pain
dislike of pressure
abdo distension
constipation & vomiting
borborygmi & flatulence

Tongue: thick white coat
Pulse: deep, wiry

Question 18

What are the differentiating symptoms and aetiology of Small intestine qi stagnation?

usually associated with Liver-Qi stagnation invading the spleen

Answer 18

(caused by excess cold/raw food or Liver qi stagnation)
*Lower Abdominal Twisting pain which may extend to back, worse with pressure, relieved by passing wind
*Abdominal Distension
*Borborygmi
*Flatulence

Pulse: Wiry (deep if cold/raw food)
Tongue: Thick White Coat (if cold/raw food)

Question 19

8 acupuncture points to move SI-Qi and promote the smooth flow of Liver-Qi?

Answer 19

CV6 (sea of Qi) - in combination with GB34 -> moves qi in lower burner & relieves pain
LIV13 - front mu point of spleen -> harmonises liver & spleen (particularly applicable in chronic patterns)
ST27 & ST29 - move Qi in lower abdo, stimulate SI functions and stop abdo pain
SP6 - stops abdo pain
LIV3 - relieves Liver-qi stagnation (heavenly star point)
ST39 - lower he sea point of SI

Question 20

What factors allow worms to thrive according to TCM?

Answer 20

cold of spleen and intestines

Question 21

What are the S&S of infestation of worms in SI?

Answer 21

*Abdominal Pain & Distension
*Bad Taste in Mouth
*Sallow (sickly yellow) Complexion

Pulse: knotted (from the cold), slow, deep Tongue: White Coat