The Post Exam Post

Well, it's done.

I feel pretty confident that I passed, but I guess I'm not going to find out for a couple weeks.  They could surprise us and publish the results quickly, but don't count on it.

As I suspected, a great deal of the test was based on 8 principals diagnosis, where I am perhaps the weakest.  So, I had spent most of my time studying that, and it paid off.  I was able to actually have a clue on those questions!

Also, my memorization chart was very helpful, and it confirmed the correct answer for at least 50 questions out of 155.

The worst case scenario here is that I fail, and I have to do a rewrite.  The good news out of that is that I know exactly where I need to focus my review, and that will be case studies.  Case study, diagnosis, select 5 points for treatment.

I don't regret any of this whole process, I have relearned many concepts that I should be able to apply here in clinic, and my patients will (hopefully) respond better as a result.  While I already achieve excellent results, I do NOT have a 100% cure rate!  There is always room for improvement there.

I think that I will spend some time to redesign my intake form so that it has a stronger focus on the TCM diagnosis, including simple things that Western medicine overlooks, like feelings of heat in the afternoon, thirst/appetite and food cravings.  If I organize it correctly, I'll have an excellent snapshot of the overall yin yang, hot/cold, interior/exterior, acute/chronic picture, and be able more clearly define which organ systems are out of balance, even in my simple pain relief patients.

If anyone has a good example of a TCM intake form in ENGLISH, let me know!

By this time tomorrow...

It will be over and done with, and I'll just be checking over my answers to the questions, to make sure I've answered to the best of my knowledge and abilities.

It has been a long row to hoe, and it has been a long time since I have had to study with this intensity.  During my studies, I noticed myself going through certain symptoms, mostly having to do with the excess study and worry, which of course, affects the spleen.  After meals I was becoming very sleepy, especially after a big lunch.

For a week, I had no appetite and ate very little.  That was just after my first review session, when I truly realized all the work I had ahead of me.

When I did eat, I had excessive heartburn, and a distension feeling in the chest and abdomen (stagnant liver qi).

Anyway, I'll be getting up at 5am tomorrow to head off to my exam.  The exam doesn't start until 9am, but considering it is going to be in a place that I have never been before, I want to leave myself plenty of time to get there on time and have time for some final review.

I am very pleased with my information chart.  In 15 minutes, I can reproduce a list of all of the following information:

Yuan Source Points
Luo Connecting Points
Xi-Cleft Points
Opening Points
Mother Points
Horary Points
Son Points
Jing Wells
Ying Springs
Shu Stream
Jing River
He Sea
Wood Points
Fire Points
Earth Points
Metal Points
Water Points
Mu Alarm Points
Shu Alarm Points
Extra Meridian Points (Luo, Control and Xi-Cleft points)
Zang-Fu Law
Bu-Xie Law

Whew.  That's a lot of information!  Couple all that information with just about any symptom you can throw at me and I can come up with an appropriate list of points that would be useful.

In addition to all this, add my 5 years of clinical experience and I am pretty sure that I can conquer this exam!

That's it for now, wish me luck everyone!

Special Syndromes

This isn't much of a post, it's another study guide...

Sorry guys!

Diarrhea

Western medicine – Crohn’s, IBS, GI inflammation

Spleen Damp/Cold

external pathogenic invasion impairs large intestine function, stool too wet watery and frequent with pain andborborygmi, poor appetite, aversion to cold, T- white slippery coat, P- soft or tense

P/T – expel cold, transform Damp, harmonize mid Jiao

Acupunctre – neutral, moxa, hand and foot yangming, LI 4, Ren 12, ST 25, 37 (LI low he-sea)

                - more pain – moxa Ren 8

Food stagnation

                undigested odour in the stool, T- thick dirty coat, P- slippery

                P/T – promote digestion

                Acupuncture – Shu, Mu, Ren 12, LR 13, BL 20, 21, ST 36, Ren 10, Ren 21 & Li Nei Ting (under ST 44)

Liver Qi stagnation

                IBS, emotions induce diarrhea, pain, borborygmi, T- red, thin coat, P- wiry

                P/T – soothe Liver

                Acupuncture – foot jueyin, yangming, BL 18, LR 14, 3, GB 34 (pain), BL 20, Ren 12, ST 25, 36

Large Intestine Damp/Heat

acute cramping then must get to toilet immediately, yellow smelly stool, burning anus, may have fever, T- red, yellow greasy coat, P- soft or slippery and rapid

P/T – clear Heat, eliminate Damp, regulate Large Intestine

Acupuncture – hand and foot yangming, LI 4 & ST 44 (clear Heat), Ren 12, ST 25, 36, 37

                - burning anus – bleed BL 40

                - fever – LI 11 & Du 14

                - Heat – Jin Jin & Yu Yue

Spleen Qi deficiency

                chronic soft stools, sensitive digestive system, fatigue, pale face, T- pale, teeth-marks, greasy coat,

                P- thin

                P/T – strengthen SP Qi, transform Damp

                Acupuncture – tonify, moxa, Ren foot taiyin, Shu, Ren 12, ST 25, BL 21, 25, Ren 9 & SP 6 (damp)

Kidney Yang deficiency

5am diarrhea, undigested food in stool, relief after bowel movements, cold pain around the umbilicus, like warmth and pressure, T- pale, swollen, teeth-marks, white coat, P- deep thin weak

P/T – astringe and warm intestines

Acupuncture – tonify, moxa, BL 23 & Ren 4, BL 20, LR 13, ST 36, Ren 12 & ST 25 (regulate intestines), Du 4 & Ren 8 (needle and moxa)

Alternative treatment methods

                auricular – SI, LI, ST, SP, LR, KI, sympathetic, shenmen, rectum

                acute – strong stimulation, chronic – mild stimulation

                7 star – T8-lower sacrum area, On lower abdomen on the SP, ST and Ren meridians

                injection – B1 & B12 combo, ST 25, 36, 37, BL 25

Chest Bi

Heart/Lung pain.

Western medicine – coronary heart disease, chronic bronchitis, etc.

TCM - Pathogen in chest Luo causing tight pain that may radiate to the back and be accompanied by dyspnea.

Blood Stasis in Heart

                intermittent stabbing fixed pain, worse at night, dark purple sublingual veins,

P- uneven deep or irregular

P/T – promote circulation, remove Blood Stasis

Acupuncture – hand jueyin and shaoyin, Ren 14, BL 15, PC 4 & HT 6 (xi-cleft pain), Ren 17 & BL 17

(Qi and blood) herbal treatment

                - Stasis – LU 11, HT 9

Cold stagnation

severe pain, cold weather triggers this pain, cold symptoms/body, dyspnea, T- white slippery, P- wiry tense or deep thin (yang deficiency)

                P/T – warm Yang Qi, expel Cold, promote Qi circulation

                Acupuncture – sedate, moxa, hand jueyin and shaoyin, Ren, BL 14, 15 (HT PC), PC 6 & HT 5

(Luo stagnation), Ren 4 & 6 (invigorate Yang Qi)

                - coldness – moxa BL 12, 13

Heart Qi deficiency

                dull pain, shortness of breath, comes and goes, palpitations, fatigue, pale face, T- pale, P- irregular

                P/T – nourish Heart Qi

                Acupuncture – Ren 17, 14, HT 6 (pain), Ren 6, ST 36 (Yuan and Spleen Qi)

                                - Yang deficient Cold – Ren 4, 8, Du 4, moxa

Heart Yin deficiency

                dull pain that comes and goes, Yin deficiency symptoms, T- red with scanty coat, P- thin rapid

                P/T – nourish Heart Yin

                Acupuncture – tonify, hand and foot shaoyin, BL 15, 23, KI 3, 6, PC 6, SP 6

Turbid Phlegm stagnation

pain with feeling of pressure from the inside (oppression), difficult to breathe, heavy limbs and body, fullness, sticky mouth, nausea, T- swollen with turbid greasy coat, P- slippery

                P/T – invigorate Yang Qi, eliminate Phlegm, remove stagnation

                Acupuncture – sedate hand jueyin, foot yangming, Ren 14, 17, PC 4 (xi-cleft), ST 40 & LU 9 (phlegm)

                                - digestive fullness – ST 36, Ren 12

                                - Heat with Phlegm – ST 44, LI 4, SP 9

Wind Stroke (Liver)

Cerebral vascular accident, hemorrhagic, embolism, aneurysm, sudden onset of hemiplagia, loss of voice, stiff tongue.

Pre-stroke symptoms- numbing headaches, dizziness, limb numbness

Any stress on the neck through an accident or exercise may trigger stroke.

TCM – Liver, Heart, Kidney.  Wind, Phlegm, Fire, can cause a disharmony of Yin and Yang, poor regulation of Qi and Blood, and Shen can’t control the body Qi.  Either meridians get invaded, or the organs get effected.

Meridians Invasion Patterns

Liver Yang suddenly rises

                emotional stress, overwork, hemiplagia, stiff tongue, mouth deviation, dizziness, headache, red                 face & eyes, easy to anger, constipation, yellow urine, P- strong wiry, T- red (or deep red) with                 yellow and/or dry coat.

                Acupuncture – Du, hand Jueyin, foot Shaoyang, *Du 26 & *PC 6 (open orifices), *SP 6, LR 3, LI 11, SJ 5,   GB 30, 34, HT 1, Ren 23, Jin Jin/Yu Yue (bleed)

Wind-Phlegm

                hemiplagia, deviation, numbness and spasm of limbs, dizziness, cloudy mind, blurred vision, T-                 greasy coat, P- wiry slippery, generally more overweight people

                Acupuncture – Du, foot Taiyin, Shaoyang, *Du 26, *PC 6, * SP 6, ST 36, 40, SP 9, HT 1, LI 11, SJ 5,

                GB 30, 31, 34

Yangming excess with Phlegm-Heat

                same as above, with sticky mouth and constipation, T- red smoky coat

                Acupuncture – foot Yangming, *Du 26, *PC 6, * SP 6, ST 25, 37, 40, HT 1, LI 11, SJ 5, HT 1,

                GB 30, 31, 34

Qi deficiency with Blood Stasis

                hemiplagia with flaccid limbs, numbness, shortness of breath, spontaneous sweats, palpitations

                Acupuncture - *Du 26, *PC 6, * SP 6, HT 1, LI 11, SJ 5, GB 30, 31, 34, Ren 6, BL 23, ST 36, Du 14 (stop   sweat), Moxa

Liver Kidney Yin deficient Wind

                Acupuncture - *Du 26, *PC 6, *SP 6, HT 1, LI 11, SJ 5, GB 30, 31, 34, BL 23, KI 3, LR 3

Zang Fu effected

Caused by Wind and Fire attacking the organs, this is more severe than meridian invasion.

Bi Zheng (closed/tense patterns):

Wind Fire

                red face

                Acupuncture – *Du 26, Shi Xuan (bleed), *PC 6, LR 3, GB 20, all open orifices to revive patient and clear         externally caused Liver Wind

Phlegm-Fire

                red face, rough noisy breathing

                Acupuncture – *Du 26, Shi Xuan, *PC 6, ST 40, Ren 22

Phlegm-Damp

                similar to Cold Bi, limbs are more flaccid than with Heat, gurgling sound in throat, cold limbs

                Acupuncture - *Du 26, *PC 6, Shi Xuan, ST 36, SP 6, ST 40, Ren 6 (moxa)

Tou Zheng (open/flaccid patterns):

Yin and Yang collapse

                Acupuncture – Ren 4, 8 *heavy Moxa), *Du 26, *PC 6, ST 36, Du 20, Si Shen Cong

Eczema

Accumulation of Damp/Heat

                acute onset, covers the body sparsely from head to toe, may be painful, swollen, buring, red, may                 have vesicles

                P/T – clear Heat, eliminate Damp, relieve itch

                Acupuncture – foot Taiyang, hand Yangming, foot Taiyin, BL 13, LI 11, BL 40 (bleed for Damp/Heat),

                SP 9, HT 7

Spleen deficiency with Damp

                slow onset, red itchy, Spleen deficiency symptoms (fatigue, loose stool, poor digestion), T- pale,                 tender fat looking, white coat, P- soft

                Acupuncture – foot Taiyin, and Yangming, BL 20, SP 9, ST 36, SP 2, LI 11, Ren 12, ST 25

Blood deficiency with internal or external Wind-dryness

                area gets thick, dry, itchy, and flakes away, patient scratches, P- wiry thin

                Acupuncture – BL 17 & SP 10, SP 6 & ST 36, PC 4 & HT 7, LI 11

 Facial Paralysis (Bell’s Palsy)

 Mostly affects young adults, acute, usually one side of the face is effected, can’t close eye, or mouth, causes tearing and drooling. May be accompanied by pain before attack (around GB 12 SJ 17 +/-), front 2/3 of tongue loses taste sensation, hearing may become sensitive.

Wind/Cold or Wind/Heat

When body is weak the meridians are empty, the pathogen gets inside and blocks the flow of Qi, this results in a lack of nourishment to the tendons and muscles.  Can become chronic, this causes an eventual Yin deficiency with Heat and/or deficiency Wind.  This condition may cause the deviation to move to the other side of the face.

P/T – promote blood circulation, open meridians to expel Wind

Acupuncture – hand and foot Yangming and Shaoyang, *SJ 17, ST 4-6, LI 4, LR 3, GB 20, LI 20, 19,

Du 26, Jia Cheng Jiang

                - eye not closing- Yin Qiao KI 6, Yang Qiao BL 62, BL 2, GB 14, Yu Yao

                - technique is to push drooping skin back towards normal position

                - patient should come as soon after attack as possible, and return every other day

                - only puncture effected side

                - be sure to wear head and neck scarves

Headache – Tou Feng

Certain area or whole head pain that can correspond to many characteristics, lasting minutes to months.  Caused by both internal and external pathogenic factors.

Western Medicine- neurovascular, high blood pressure

External Pathogenic invasion

                P/T – treat the same as common cold except factor in location differences.

                Acupuncture – vertex: Du 20, LR 2, BL 7,  frontal: Du 23, ST 8, 43,  occipital: BL 10, 60, Du 19, 

temporal: GB 20, 43, taiyang

Liver Yang rising

Throbbing and/or stabbing, feeling of heat on the face, red eyes, tinnitus with headache, thirst, irritable, T- red with thin yellow coat, P- wiry

P/T – descend Liver Yang, extinguish Wind

Acupuncture – foot Jueyin and Shaoyang, GB 4-5, 20, *40, LR 3, ashi points

                - dizziness- Si Shen Cong

Turbid Phlegm

Throbbing heavy headache, blurred vision, dizziness, nausea, chest fullness, tendency to be overweight, T- greasy, P- wiry slippery

                P/T – transform Phlegm, descend turbid, open cavities

                Acupuncture – foot yangming, local, ashi points, Ren 12 & ST 40, Du 20, Yintang, ST 25

                                - nausea- PC 6

Blood Stasis

                Chronic fixed stabbing headaches, caused by injury, or long term illness

                P/T – promote circulation, move Stasis, and meridian Qi

                Acupuncture – ashi, LI 4, SP 6, BL 17, 40

Qi and Blood deficiency

Lack of nourishment, mild dull headache that is worse in the afternoon, photophobia, tired eyes, poor sleep, palpitations, fatigue, pale complexion and tongue, P- weak

                P/T – nourish Qi and Blood, promote circulation

                Acupuncture – tonify, foot Taiyin and Yangming, Du 20, 23, ST 36, SP 6, 10

                                - when in remission add Shu points, Ren 4 & 6, and Moxa

Liver Kidney Yin deficiency

Dizziness and blurred vision, Liver and Kidney deficiency symptoms, may be mild or severe, T- red with scanty coat, P- thin wiry

                P/T – nourish Liver and Kidney

                Acupuncture – foot Shaoyin, Shu, Du 20, BL 18, 23, LR 3-KI 1, SP 6

                                - heat signs- PC 8

Indigestion

Food stagnation, either with strong digestion (just eat too much), or with Spleen deficiency and eat too much.

Excess Food stagnation

                P/T – invigorate Spleen and Stomach digestive functions

                Acupuncture – foot Yangming, Ren 6, 12, ST 21, 25, 36, Si Feng, Li Nei Ting

Food stagnation with Spleen deficiency

                P/T – Tonify and invigorate Spleen and Stomach

                Acupuncture – same as above, add BL 20, 21, SP 3 (yuan)

Acupuncture and Reproductive Health

Researchers from New York's Weill Cornell Medical Center reviewed existing studies and found that acupuncture helps...

1. Reduce stress hormones that interfere with ovulation

2. Normalize hormones that regulate ovulation so an egg is released

3. Increase blood flow to the uterus, improving the chances of a fertilized egg implanting

4. Improve ovulation cycles in women with polycystic ovary syndrome (PCOS), which makes getting pregnant difficult

5. Improve pregnancy rates in women undergoing in vitro fertilization (IVF)

If you want to avoid taking fertility drugs, have PCOS, are not eligible for IVF, or want to improve the success rate of IVF, consider acupuncture, says study author Raymond Chang, MD, an acupuncturist and clinical assistant professor of medicine at Cornell. 

Leukorrhea (vaginal discharge)

Accumulation of Damp with Spleen deficiency

                Acupuncture – Ren 6, BL 30, GB 26, BL 20 & SP 6

                                - poor digestion- Ren 12, ST 25

                                - low limb edema- SP 9, ST 36

Kidney Yin deficiency

                Acupuncture – BL 23 & KI 3, SP 6, BL 32 & GB 26 (stop discharge)

                                - dizziness, palpitation, insomnia- LR 3, HT 7

Kidney Yang deficiency

                Acupuncture – BL 23, Du 4, Ren 4, GB 26 & BL 32, ST 36

                                - abdominal cold pain- moxa Zi Gong, Ren 3

Damp/Heat in low Jiao

                Acupuncture – Ren 3, BL 32 & GB 26, SP 9

                                - itch, burning vagina- LR 5, GB 43

Lin Zheng (urinary syndromes, Urinary tract infections)

Classically there are five Lin Zheng, although six are now recognized: Stone, Qi, Chyluria, Chronic Lao, Re (Heat), Xue (blood).

Re (Heat)

                P/T – induce diuresis, clear heat

                Acupuncture – sedate, foot Taiyang & Jueyin, Mu, Shu, *BL 28 & *Ren 3 (for all Lin), SP 9 (primary points         to induce diuresis), LR 2 (pain and Heat)

                                - acute onset symptoms- LI 4, SJ 6

Stone

                P/T – clear Heat, induce diuresis

                Acupuncture – neutral, foot Taiyang and Shaoyin, BL 28 & Ren 3, BL 54 toward ST 28 (3 cun lateral to Du             mai, 3^rd sacral vertebrae), BL 39, KI 10

                                - acute attack of pain- Du 26

                                - Kidney Yin deficiency- BL 23, KI 3

                                - Qi deficiency- ST 36, Ren 6

Liver Qi stagnation

                P/T – sooth and regulate Liver Qi

                Acupuncture – neutral, tonify Shu, sedate Mu, BL 28 & Ren 3, BL 54 toward ST 28, BL 18, LR 14, PC 5        (ghost)

Spleen Qi deficiency

                P/T – tonify mid Jiao Qi

                Acupuncture - neutral, tonify Shu, sedate Mu, BL 28 & Ren 3, BL 54 toward ST 28, Ren 4, ST 36, BL 20

Xue (blood)

                excess Damp/Heat, or, Qi or Yin deficiency

                P/T – stop bleeding

                Acupuncture – neutral, BL 28 & Ren 3, SP 6, 10

                                - purge Heart Fire- PC 8, HT 8

                                - Kidney Qi deficiency- KI 6, 7

                                - Spleen Qi deficiency- ST 36, Ren 6

Chyluria (cloudy)

                greasy cloudy urine caused by excess Damp/Heat, or, Kidney Spleen deficiency

                Acupuncture -  foot Taiyang & Taiyin, BL 28 & Ren 3, Du 4 (Kidney Qi, astringe Essence), SP 6 & 9              (ascend clear Qi, descend turbid Qi)

Lao chronic

                disorder recurs when patient is feeling low or fatigued

                Acupuncture – foot Yangming, Taiyin, Shu, BL 28 & Ren 3, BL 20, 21, 23, Du 4, Ren 4, ST 36

Palpitations

Western medicine – this accompanies heart disorders, chronic fatigue, anxiety, etc.

Heart Gallbladder deficiency

anxiety attack, neurosis, depression, chronic fatigue, whole body not balanced, induced by shock or wake in the middle of the night, poor sleep

                P/T – nourish Heat and Gallbladder Qi, calm spirit

                Acupuncture – BL 15, Ren 14, BL 19, PC 5 (ghost), HT 7

                                - timid, edgy, easily scared – PC 7

                                - spontaneous sweat, shortness of breath – ST 36, KI 7

Heart Spleen deficiency

similar to the above Heart symptoms but with the addition of Blood deficiency and Spleen deficiency symptoms

                P/T – nourish Heart Spleen Qi and blood

                Acupuncture – tonify BL 15 & Ren 14, BL 20, ST 36, BL 17 (blood)

                                - loose stool – ST 25, 37

Heart Yin deficiency

                blood deficiency and Heat symptoms

                P/T – nourish Yin, clear deficient Fire

                Acupuncture – BL 23, KI 3, HT 7, 6

                                - 5 centre heat – KI 1, PC 8

Heart Blood Stasis

                palpitations and fixed pain

                P/T – promote circulation, remove Stasis

                Acupuncture – neutral, PC 6, Ren 17, BL 15, moxa Ren 6, BL 17, SP 10

                                - insomnia – HT 7

Fluids attack Heart

palpitations and water retention, frothy watery phlegm with cough, chest fullness, dyspnea, difficult to lay flat, facial and/or ankle edema, scanty urine, dizziness, P- slippery wiry

P/T – invigorate Yang Qi, transform water

Acupuncture – hand shaoyin, Ren, Ren 4 & BL 23 (KI Yang), SP 9 (diuresis), PC 6 & HT 7 (palpitations),

Ren 17 (regulate chest Qi)

Heart Yang deficiency

                palpitations and cold symptoms

                P/T – warm and invigorate Yang

                Acupuncture – BL 14, 15 (Heart Yang), Ren 4, 6 (moxa), PC 6 & HT 7 (palpitations)

Polio

TCM- toxic Damp/Heat.

Mostly happens to children between the ages of 6 moths to 2 years.  It is worst in summer and fall.  Polio starts with fever (with a sore neck) coming before the paralysis or flaccidity, strange mental symptoms, sweat, nausea, headache.  Fever goes up, then comes down again.  When it rises after this remission it will be accompanied by the paralysis or flaccidity (one sided). 

Wind/Heat/Damp invades the Lungs

                initial fever is quite high, sore throat, nausea, diarrhea, cold symptoms

                P/T – promote Lung function, expel pathogens

                Acupuncture – hand Taiyin and Yangming, LI 4, 11, LU 7, Du 14, Ren 12, ST 25, 36, GB 20

Damp/Heat in Jing Luo (Yangming)

                Mid stage, fever rises again, whole body is painful and heavy, may vomit, diarrhea, irritability

                P/T – clear Heat, transform Damp

                Acupuncture – hand and Foot Taiyin and Yangming, LI 4, 11, ST 36, SP 9, GB 34

                                - limb paralysis- LI 10, 11, 14, GB 30

Liver Kidney deficiency

                chronic paralysis/flaccidity, muscular atrophy, weakness, cold

                P/T – nourish Liver and Kidney, strengthen bones and tendons

                Acupuncture – Shu, foot Shaoyang, hand Yangming, BL 18, 23, Du 2, 3, KI 3, GB 34, 39, ST 36

                                - local points for paralysis, i.e. Hua Tou Jia Ji western correspondence to the nerves that                                                control the particular area that is paralysed. 

Stomach ache

Western medicine – GI complaints, acute or chronic

Liver attack Stomach

                Liver Qi stagnation causes wandering distending chest/abdominal/hypochondriac pain

                P/T – soothe Liver, harmonize Stomach

                Acupuncture – foot jueyin, ST 36 & Ren 12, LR 3 & 14

                                - belching – PC 6, Ren 17

Cold invades Stomach

                acute severe cold pain, cold symptoms, T- white coat, P- wiry tense

                P/T – warm Stomach, expel Cold, harmonize Stomach Qi

                Acupuncture – sedate, moxa, Ren, foot yangming, Ren 12 & ST 36 (Stomach pain), SP 4 & PC 6 (abdomen)

                                - severe pain – ST 34

Accumulation of Stomach Heat

acute attack feels like painful fullness is pressing from the inside outwards, chronic attacks feel like fullness and distension, difficult for patient to describe (just say feels irritable or heart burn), acid reflux, bitter taste or sticky, T- red with yellow coat, P- rapid

                P/T – purge Heat, relieve pain

Acupuncture – sedate, foot yangming, Ren 13 (cardia sphincter, meeting of Stomach and Ren),

ST 34 (Xi-cleft), ST 44, LI 4 & LR 2 (purge Stomach Fire)

                                - more Heat – HT 8

Food stagnation

distended pain, belching, poor diet, acid reflux, nausea, bloating, vomiting, dislike pressure,

bowel movement helps pain, T- thick dirty fur, P- strong

P/T – promote digestion, regulate Stomach Qi

Acupuncture – foot yangming, ST 36 (lower he-sae), ST 25, PC 6, Ren 10 (pyloric sphincter, digestion), Li Nei Ting (digestion, under ST 44)

Blood Stasis

                ulcer, severe stabbing fixed pain, black tar-like stools, dislike pressure

                P/T – promote blood circulation, move Stasis

                Acupuncture – neutral, Ren, foot yangming, Ren 12, ST 36, PC 6, SP 4, BL 17 & LR 14, SP 6

                                - black tar-like stools – SP 10

Stomach Yin deficiency

dull pain, heart burn, difficult to describe pain, dry mouth and stools, T- red cracked, scanty coat, P- thin rapid

P/T – nourish Yin, harmonize Stomach

Acupuncture – Shen, Mu, BL 20, 21, LR 13, Ren 12, ST 36, PC 6, SP 6, 10

                - black tar-like stool – SP 1, BL 17

Spleen Stomach deficient Cold

dull mild ache, worse on empty stomach- better after eating, like warmth and pressure, cold body, soft stool, nausea, vomiting clear fluids, T- pale, P- deep thin

P/T – warm mid Jiao, strengthen Spleen Stomach

Acupuncture – tonify, moxa, Shu, Mu, BL 20, 21, LR 13, Ren 12, PC 6 & SP 4 (confluent, abdomen), Ren 4