Abdominal Pain

Abdominal pain is a frequently encountered symptom in clinic , often accompanied with many zang - fu disorders , of which dysentery , epigastric pain , appendicitis , and gynecologic diseases will be discussed in other sections . In this section only accumulation of cold , hypoactivity of the spleen yang and retention of food are related .

Etiology and Pathogenesis

Since cold is characterized by causing contraction and stagnation , accumulation of cold due to invasion of the abdomen by the pathogenic cold or injury of the stomach and spleen yang due to overeating of raw and cold food impairs the transportation and transformation function , resulting in abdominal pain .

Hypoactivity of the spleen yang or general deficiency of yang qi leads to impairment of transportation and transformation , and stagnation of cold dampness , resulting in abdominal pain .

Retention of food due to voracious eating or intake of too much fatty and hot food impedes the function of the stomach and intestines in transmission and digestion , nutrients and wastes mixing together to obstruct qi , resulting in pain .

Differentiation

Accumulation of cold :

Main manifestations : Sudden onset of violent abdominal pain which responds to warmth and gets worse by cold , loose stool , absence of thirst , clear and profuse urine , cold limbs , thin white tongue coating , deep , tense or deep , slow pulse .

Analysis : Cold is of yin nature and characterized by causing contraction and stagnation . If cold enters the body , yang qi will get obstructed , then sudden violent pain and cold limbs appear . Since cold stays inside , thirst is absent . Clear and profuse urine and loose stool are due to weakness of the stomach and spleen yang and failure in transportation and transformation . The flow of yang qi is usually obstructed by cold and facilitated by warmth , so pain responds to warmth but gets worse by cold . Deep , tense or deep , slow pulse , and thin white tongue coating are the signs of accumulation of cold .

Hypoactivity of the spleen yang :

Main manifestations : Intermittent dull pain which may be relieved by warmth or by pressure and aggravated by cold or by hunger and fatigue , lassitude , aversion to cold , thin , white tongue coating , deep , thready pulse .

Analysis : Intermittent dull pain which may be relieved by warmth or by pressure and aggravated by cold or by hunger and fatigue indicates cold of deficiency type . Hypoactivity of the spleen yang causes loose stool and aversion to cold . If the spleen qi is weak , lassitude occurs . Thin white tongue coating and deep , thready pulse also indicate cold of deficiency type .

Retention of food :

Main manifestations : Epigastric and abdominal distending pain which is aggravated by pressure , anorexia , foul belching and sour regurgitation , or abdominal pain accompanied by diarrhea and relieved after defecation , sticky tongue coating , rolling pulse .

Analysis : In case of retention of food in the intestines and stomach , epigastric and abdominal distending pain occurs . Pain is aggravated by pressure because of excess condition . Anorexia is due to retention of food , foul belching and sour regurgitation due to indigestion of food . Pain is relieved after diarrhea because the circulation of qi in the fu organs becomes smooth . Sticky tongue coating is due to retention of food and collection of dampness , while rolling pulse is the sign of indigestion .

Treatment

Accumulation of cold :

Method : Points of the Ren Meridian , Taiyin and Yangming Meridians of Foot are selected as the principal points with reducing method applied in combination with moxibustion to warm the stomach and dispel cold .

Prescription : Zhongwan ( Ren 12 ) , Shenque ( Ren 8 ) , Zusanii ( S 36 ) , Gongsun ( Sp 4 ) .

Explanation : Zhongwan ( Ren 12 ) , Zusanii ( S 36 ) and Gongsun ( Sp 4 ) are used to strengthen the function of the spleen and stomach , and to warm and promote the flow of qi in the fu organs . Indirect moxibustion with salt is applied to warm the stomach and dispel cold .

Hypoactivity of the spleen yang :

Method : The Back - Shu points and the points of the Ren Meridian are selected as the principal points with reinforcing method applied in combination with moxibustion to warm and activate the spleen and stomach yang .

Prescription : Pishu ( B 20 ) , Weishu ( B 21 ) , Zhongwan ( Ren 12 ) , Zhangmen ( Liv 13 ) , Qihai ( Ren 6 ) , Zusanii ( S 36 ) .

Explanation : Pishu ( B 20 ) and Zhangmen ( Liv 13 ) , Weishu ( B 21 ) and Zhongwan ( Ren 12 ) are selected , known as combinations of the Back - Shu and Front - Mu points . Both acupuncture and moxibustion are used to invigorate the spleen and stomach yang . Qihai ( Ren 6 ) and Zusanii ( S 36 ) are needled to strengthen the function of the spleen and stomach .

Retention of food :

Method : The points of the Ren Meridian and Yangming Meridian of Foot are selected as the principal points with reducing method applied to remove retention of food .

Prescription : Zhongwan ( Ren 12 ) , Tianshu ( S 25 ) , Qihai ( Ren 6 ) , Zusanii ( S 36 ) , Inner - Neiting ( Extra ) .

Explanation : Zhongwan ( Ren 12 ) , Zusanii ( S 36 ) , Tianshu ( S 25 ) and Qihai ( Ren 6 ) are applied to regulate the flow of the stomach qi . Inner - Neiting ( Extra ) is an empirical point to treat indigestion . The above points are used together to remove retention of food and relieve pain by promoting the flow of qi .