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From "Zang Fu Syndromes,"
by McDonald and Penner
Etiology
Qi Stagnation.
Qi Xu fails to circulate Blood vigorously which leads to Blood
Stagnation.
Chronic intractable pain leads to Stagnation.
Clinical Manifestations
| Sharp, stabbing epigastric pain with fixed location
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Pain predominates over distention or
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| Pain is severe after eating
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Pain but no distention
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| Dislike of pressure and heat on epigastrium
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Loose stools |
| Epigastric rumbling |
Vomiting purple / black blood Stools with blood like tar
(melaena) |
| May be abdominal or epigastric lumps or masses
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T: Dark purple with purple spots or dots C: White P: Wiry and choppy
Associated Western Conditions
| Gastric ulcer (hemorrhaging)
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Gastric carcinoma |
Differential Diagnosis
Blood Stagnation in ST may be identified as a Shi condition by
the dislike of pressure on the epigastrium and the adverse reaction
to eating.
Differentiation of Shi ST conditions with vomiting and epigastric
pain is as follows:
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Food Stagnation
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Blood Stagnation
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Stomach Fire Blazing
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Vomits acid and partly decomposed food
Better after vomiting Distention prominent Pain with distention
Unformed stools or Constipation T: Pink C: Thick and greasy P: Slippery |
Vomits purple / black blood
Mild or no distention Sharp, fixed pain Melaena (stools with blood like tar)
T: Dark purple with purple spots P: Wiry and choppy |
No vomiting or Vomits acid or undigested food
No distention Burning with pain Constipation T: Red C: Thick, yellow and dry
P: Slippery, big, Shi and rapid |
Treatment Principle
Adjust Qi, Transform Stagnation and Stop Pain.
Common Acupuncture Points
ST-21 / Liangmen Local point for pain.
ST-34 / Liangqiu Xi-Cleft point of the ST channel: for epigastric
pain.
To Transform Blood Stagnation and Invigorate Blood circulation:
UB-17 / Geshu Meeting point for Blood: transforms stagnant Blood.
SP-6 / Sanyinjiao Invigorates circulation of Qi and Blood.
SP-4 / Gongsun Regulates Chong Mai ("Sea of Blood")
and
ST. SP-10 / Xuehai Harmonizes Ying Qi, and regulates and clears
Blood.
Sample formula: for epigastric pain due to Blood Stagnation:
PC-6 / Neiguan
ST-36 / Zusanli
UB-17 / Geshu
SP-6 / Sanyinjiao
SP-4 / Gongsun (from "Acupuncture: a Comprehensive Text")
Common Herbal Formulae
Dan Shen Yin plus
/ Decoction of Salvia Root with additions
Shi Xiao San plus
/ Sudden Smile Powder with additions |