What the main functions of the Stomach?
Controls receiving
Controls ‘rotting and ripening’
Transport food essence
Controls descending of qi
Origin of fluids
What are common Stomach channel symptoms?
Frequent yawning
Borborygmi
Epigastric pain and swelling
Madness
Malaria
Sweating
Nose bleeds
Runny nose
Neck swelling
Throat pain
Pain and swelling along the channel pathway to the middle toe
How is a rootless coating formed?
It is formed when the stomach is weak & ceases to send its “dirty dampness” up to the tongue - meaning that the old coat loses its root -> making it look as though it’s sprinkled on top of the tongue & easily scraped away
What is the treatment principles for the following:
1.Stomach qi deficiency
2. Blood stasis in the stomach collateral
3. Stomach yang deficiency
4. Stomach yin deficiency
5. Stomach excess cold
6. Stomach heat
- Tonify the stomach qi
- Activate blood and resolve stasis, free the collateral vessels
3.Tonify the stomach yang
4.Nourish the stomach yin
5.Warm the stomach, dissipate cold
6.Clear the stomach heat
What are the shared symptoms b/w Stomach qi deficiency & Blood stasis in the stomach collateral?
Epigastric pain
What are the differentiating symptoms of Stomach qi deficiency?
- Epigastric pain is dull and relieved by pressure (caused by a failure of stomach qi descending)
- Anorexia, Loss of appetite, loose stools (as spleen-qi is often Xu)
- lack of taste sensation
- weak limbs (food essence isn’t being transported to limbs)
Tongue: Pale
Pulse: Weak - empty particularly in stomach position
- tiredness in the morning & a weak stomach pulse is enough to diagnose
What are the consequences of stomach-qi xu?
spleen-yin Xu
stomach-qi stagnation -> stasis of blood in stomach
phlegm
4 acupuncture points to tonify stomach-qi?
ST36 - moxa is particularly effective
CV12
BL21 - important in the case of extreme tiredness, moxa is applicable
CV6 - indicated for chronic cases of spleen-qi Xu - esp with loose stools
What are the differentiating symptoms of Blood stasis in the stomach collateral?
Epigastric pain is stabbing that is aggravated by pressure
Palpable mass in epigastric region
Vomiting dark blood with clots
coffee ground vomits
nausea
Tongue: Purple spots
Pulse: String-like choppy
What are the shared symptoms b/w Stomach yang deficiency & Stomach yin deficiency?
Loss of appetite
What are 4 differentiating symptoms of Stomach yang deficiency?
Epigastric pain that is relieved by warmth and pressure
Full sensation in the stomach
Sensitive to cold
Cold limbs
Tongue: pale with white coat
Pulse: Sunken slow weak
What are the differentiating symptoms of Stomach yin deficiency?
Dry mouth & throat
no appetite/slight hunger but no desire to eat
Thirst but desire to drink in small sips
Constipation (dry stools)
Retching
Tongue: without coating in the centre, or with rootless coating, normal body colour
Pulse: Floating and empty
What if the Stomach Yin Xu has empty-heat? What additional S&S would you see?
night sweating
five-palm heat
bleeding gums
feeling of heat in evening
Tongue: red & without coating in centre
Pulse: floating-empty on stomach position and slightly rapid
4 acupuncture points to nourish stomach-yin and fluids?
CV12 - tonifies stomach-yin
ST36, SP6
SP3 - nourishes fluids
What are the symptoms of Stomach excess cold?
Acute epigastric pain that is cold in nature
Vomiting watery fluid
Aversion to cold
Cold limbs
Tongue: White coat
Pulse: Deep, tight, slow
What are the symptoms of stomach heat?
- Intense thirst, constipation & dry tongue (heat in ST has burnt fluids)
- painful gums (due to heat rising in ST channel)
- sour regurgitation, N&V (full-heat obstructs the descending of ST Qi, fluid is sour b/c heat ferments the St fluids)
- excessive hunger
- Foul breath
- Mouth ulcers
- mental restlessness
Tongue: red in the centre with dry yellow coat or dark yellow coat
Pulse: Rapid, slightly overflowing in stomach position
What are the additional S&S to Stomach heat that makes it phlegm heat?
feeling of oppression in epigastrium & chest, mucus in stools, expectoration of phlegm, mental derangement
Tongue: red with sticky yellow coating
Pulse: rapid-slippery-overflowing
What makes stomach-heat more stomach-fire?
symptoms will be more severe
eg. gums will be bleeding
tongue redder with a darker and drier coat
8 acupuncture points to clear stomach-heat, stimulate the descending of Stomach Qi?
ST44
ST34
ST21
CV13 - subdues rebellious ST Qi
LI11
LI4 - clears stomach-heat
CV11 - clears stomach heat
SP15
What are 8 symptoms of Stomach Xu & cold?
normally associated with Spleen yang Xu
Key symptoms - discomfort in the epigastrium (esp. if better after eating/pressure/massage) tiredness & cold limbs are enough to diagnose
- no appetite/thirst
- vomiting of clear fluids
- preference for warm drinks/foods
- weak limbs
- bowel movement aggravates feeling of discomfort in epigastrium
Tongue: pale & wet
Pulse: deep-weak-slow, esp in stomach position
5 acupuncture points to tonify & warm stomach & spleen-qi?
ST36, CV12, BL20, BL21,
CV6 - good for moxa on ginger on empty-cold pattern
What are S&S of Stomach-Qi stagnation?
- Epigastric pain (cardinal sign)
- distension
- belching, N&V, hiccups (ST Qi is ascending)
- irritability
Tongue: N/A - except in extreme cases it may be red on the sides in central section
Pulse: wiry on the stomach position
11 acupuncture points to move Stomach-qi, eliminate stagnation & restore the descending of Stomach-Qi?
ST34 - Xi cleft point, moves ST-qi & is used in full conditions
ST21 & ST19 - restore the descending of St Qi
KI21 - point of the penetrating vessel - restores the descending of St-qi and removes stagnation from middle burner
GB34 + CV12, TE6 - moves Qi & eliminates stagnation in middle jiao
PC6 - restores descending of St Qi
SP4 (with PC6) opens the penetrating vessel
ST40 - moves ST Qi, restores the descending of ST Qi
What are S&S of cold invading the Stomach?
- sudden severe epigastric pain (exterior cold blocks stomach qi from descending)
- a feeling of cold & cold limbs (yang of stomach is impaired)
- preference for warmth
- vomiting of clear fluids (which may alleviate pain)
- nausea
- feeling worse after cold fluids & then quickly vomiting them
Tongue: thick white coating
Pulse; deep-tight-slow
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Tongue diagnosis51
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Random CMPR122 nuggets20
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Inspection99
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Body movements9
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Listening and smelling22
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Interrogation104
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Palpation31
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Ba Gang & vital substances35
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Lung Pattern39
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Spleen Patterns26
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Stomach Patterns32
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Heart and Pericardium Patterns53
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LI patterns33
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SI patterns21
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Liver & GB patterns69
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Kidney patterns31
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Bladder patterns12
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Identifcation of Patterns according to the 12 channels16
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Identification of patterns according to the 3 Jiao28
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Wu Xing pattern Differentiation15
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External Pattern Differentiation58
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Six divisions + Wk 1163
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Four Level Pattern Differentiation62
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Case studies from lectures33
