Gastralgia (Stomach Pain)

General

Clinical Manifestations
Treatment Principle
Herb Formulas
Points	REN-12, REN-13 ST-36, REN-12, PC-6, SP-4 SP-4, PC-6, ST-36 SP-4, REN-12, PC-6, ST-36 Acute: ST-34, UB-21 Cup: REN-12, ST-21, ST-36, KI-21, UB-18, UB-21, UB-22, PC-6 Ear: Stomach, Sympathetic, Subcortex, Duodenum

Tai Yang Shang Han With Spleen And Stomach Deficiencies

Clinical Manifestations	Chills and Fever Aversion to Cold Headache Anhidrosis Chest/gastric distension Gastric pain Nausea/vomiting Borborygmus Diarrhea (acute) Abdominal pain Thirst Dry throat T: Normal C: Greasy and white P: Floating and tight
Treatment Principle	Disperse Wind Relieve Exterior Tonify the Spleen and Stomach
Herb Formulas	Huo Xiang Zheng Qi Tang
Points	DU-16, GB-20, KI-7, LI-4, LIV-13, LU-7, REN-12, SJ-5, SP-3, ST-36, sedate UB-12, tonify UB-13, UB-20

Shao Yang Fu With Tai Yang

Clinical Manifestations	Joint pain with a crackling sensation Epigastric pain Fatigue Gastrointestinal weakness Headache Heaviness in the head Fever Moderately severe chills Distension beneath the Heart Periumbilical or lower abdominal pain Tenseness around the pubic bone Subcostal pain Epigastric fullness Nausea Mild vomiting Mild thoraco-costal discomfort Costal distress Tension in the rectus abdominus Chest distension Abdominal pain Abdominal distension Constipation Irritability Insomnia Repeated loss of spinal alignment due to muscular tension P: Floating and weak
Treatment Principle	Release the Exterior and muscle layer Harmonize and releases the Shao-Yang Harmonize the Liver, Spleen and Intestines
Herb Formulas	Chai Hu Gui Zhi Tang
Points	To treat the Shao Yang: GB-34, LIV-3, LIV-14, SJ-6 To Treat the Tai Yang: UB-12, GB-20

Spleen Deficiency Edema

Clinical Manifestations	Edema in limbs, especially lower limbs Maybe anasarca Maybe abdominal distention Loose stools Physical and mental fatigue T: Pale C: White and moist P: Soft and even
Treatment Principle	Warm Yang Strengthen the Spleen Benefit Qi Move water
Herb Formulas	Shi Pi Yin
Points	SP-6, SP-9, REN-6, REN-9, UB-20, UB-23, UB-22, ST-28, ST-36

Spleen Yang Deficiency

Clinical Manifestations	A feeling of Cold in the stomach and abdomen Maybe pain in the stomach and abdomen Sallow complexion Aversion to Cold with a preference for warmth Anorexia (maybe with vomiting) Four limbs feel tired and heavy Cold extremities Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting of clear watery fluid Loose stools or watery stools containing undigested food Maybe occasional constipation Shortness of breath Pain in the epigastrium with cold sensations (pain is relieved by warmth) Cold limbs Feeling chilled Mental fatigue Tired extremities Copious, clear urine Maybe scanty urine with edema (Spleen Deficiency Edema) Maybe clear, watery vaginal discharge T: Pale or Pale and swollen C: Thin and white P: Deep and weak or Deep, slow and thready
Treatment Principle	Warm the Center Dispel Cold
Herb Formulas	Huang Qi Jian Zhong Tang
Points	Moxa needle REN-12, UB-20, LIV-13, SP-3, SP-6, SP-5, ST-36 Moxa needle REN-10, REN-5, ST-25, ST-36, SP-4 With abdominal fullness: SP-7 With reduced food intake: REN-12 With pain in the Stomach and abdomen: SP-3 With loose stools: Moxa REN-8 With uterine prolapse: Moxa Zigong With rectal prolapse: DU-20 REN-12, REN-7, REN-6, REN-4, ST-25, ST-30, ST-36, SP-6, SP-4, KI-3, Moxa LI-11 With nausea: PC-6 With severe pain or diarrhea: Moxa REN-8 DU-20, Moxa needle REN-4, REN-6, REN-12 Moxa abdomen Ear points:  Abdomen, Large Intestine, Small Intestine, Stomach, Spleen, Shenmen, Adrenal, Sympathetic

Spleen And Stomach Qi Deficiency

Clinical Manifestations	Nausea and vomiting Emaciation Sallow complexion Anorexia with a full feeling after very little food Weak abdomen No desire for food and drink Belching Abdominal distention or pain (subtle) Borborygmus Loss of sensation of taste Rolled lips Pale lips Stiff tongue Tired limbs Heavy limbs Chest fullness Shortness of breath Acid regurgitation Epigastric distention or pain Muscle weakness in arms and legs Loose stools or diarrhea Urine clear and abundant Maybe bleeding Thin muscles. Lethargy-fatigue Does not like to speak Weak, soft voice Maybe enuresis Maybe cold extremities T: Pale and flabby - may have teeth marks C: Thin and white. P: Weak and Deficient or Even, forceless and Deficient
Treatment Principle	TonifY Qi Strengthen the Spleen Harmonize the Stomach Regulate Qi Stop pain
Herb Formulas	Xiang Sha Liu Jun Zi Tang Si Jun Zi Tang Liu Jun Zi Tang Huang Qi Jian Zhong Tang
Points	UB-20, LIV-13, SP-3, SP-6, SP-5, ST-36, REN-12

Spleen And Stomach Deficiency Causing Stomach Cold

Clinical Manifestations	Dull pain Aversion to cold Regurgitates watery fluid Lassitude Cold extremities Shallow respiration Yellow face Pain worse with movement T: Pale C: White P: Thready and soft
Treatment Principle	Warm the Middle Jiao Strengthen the Spleen and Stomach
Herb Formulas	Huang Qi Jian Zhong Tang Li Zhong Tang Fu Zi Li Zhong Tang Wu Zhu Yu Tang
Points	Moxa ST-36, REN-6, REN-12, PC-6, SP-4, UB-20 Moxa UB-20, UB-21, REN-6, REN-12, ST-21, ST-36, PC-6, SP-4 Moxa REN-4, REN-8 Moxa PC-6, ST-36, ST-40 UB-20, UB-21, REN-4, REN-14, SP-9

Spleen And Stomach Deficiency Cold With Blood Stagantion

Clinical Manifestations	Acid reflux A sallow facial complexion Fatigue Poor muscle tone A flabby abdomen Mild constant epigastric pain; relieved by warmth and pressure Anorexia Abdominal pain and fullness after meals Nausea Vomiting Loose, unformed stools Excessive salivation Cold limbs Lassitude Weakness Maybe edema Maybe scanty urination Maybe clear, watery, copious vaginal discharge T: Moist C: White P: Large and faint
Treatment Principle	Strengthen the Spleen Warm Yang Warm the Center Dispel Cold Regulate Qi and Blood Stop pain
Herb Formulas	An Zhong San
Points	Moxa or moxa needle LIV-13, REN-12, SP-3, SP-6, SP-10, ST-36, UB-17, UB-20, UB-21

Spleen And Stomach Accumulation Of Cold

Clinical Manifestations	Sudden, violent abdominal pain Pain responds to warmth Loose stools Diarrhea Nausea No thirst Clear urine T: Normal C: White P: Deep and tight
Treatment Principle	Warm the abdomen
Herb Formulas	Xiang Sha Liu Jun Zi Tang
Points	Above the umbilicus: SP-4, ST-24, REN-10 Around the umbilicus: KI-5, REN-6, ST-25 Lower abdomen: SP-6, ST-29, REN-4, moxa REN-8 Moxa UB-20, UB-21, REN-6, REN-12, ST-21, ST-36, PC-6, SP-4 PC-6, ST-36, REN-11 REN-6, REN-10, REN-12, REN-13, PC-6, ST-21, ST-25, ST-34, ST-36 If chronic: Huatoujiaji

Spleen And Stomach Damp-Heat

Clinical Manifestations	Headache Fever (maybe chills) Strong thirst with a desire to drink Vomits immediately after drinking Urinary difficulty Edema General sensation of heaviness Diarrhea Irritability Simultaneous vomiting and diarrhea Throbbing sensations below umbilicus Vomits frothy saliva Vertigo Abdominal pain and / or distention Dark urine Anxiety Jaundice Shortness of breath Cough Stomach pain Urinary retention Lower abdominal fullness Extreme thirst Palpitations Lower abdominal distention Lower abdominal palpitations Dizziness Abdominal pain Restlessness Slightly pale skin tone T: Normal C:Thick, yellow and greasy P: Soft and rapid
Treatment Principle	Promote urination Drain Dampness Strengthen the Spleen Clear Damp-Heat
Herb Formulas	Yin Chen Wu Ling San modified Xiao Feng San modified
Points	ST-36, ST-44, LI-11, SP-9, REN-12, UB-20 + Gall Bladder Damp Heat points

Stomach Qi Deficiency

Clinical Manifestations	Continuous pain in the Stomach Epigastric fullness and distention Likes pressure Reduced appetite Frequent belching Loss of sensation of taste Borborygmus Pale face Stools not solid Urine clear and abundant T: Pale C: Thin and white P: Empty, Weak an Slow or Weak and Deficiency
Treatment Principle	Warm and tonify the Spleen and Stomach Replenish Qi Harmonize the Interior Alleviate pain
Herb Formulas	Liu Jun Zi Tang Huang Qi Jian Zhong Tang Xiang Sha Liu Jun Zi Tang
Points	UB-18, UB-20, UB-21 PC-6, REN-12, ST-36

Stomach Fire

Clinical Manifestations	Burning Heat and pain in the epigastrium Irritating thirst: drinks copious fluids and prefers cold drinks Excessive appetite: hungry again quickly after eating (as if food vanishes) Swelling, pain, ulceration and bleeding of gums Foul breath Toothache Maybe vomiting right after eating Vomiting acid or undigested food Constipation Maybe scanty, red urine T: Red C: Thick, yellow and dry P: Slippery, big, Shi and rapid
Treatment Principle	Clear and Purge Stomach Fire
Herb Formulas	Qing Wei San Mai Men Dong Tang modified
Points	REN-6, REN-10, REN-13, REN-14, ST-25, ST-36, ST-44

Stomach Cold

Clinical Manifestations	Epigastrium cold with pain Constant pain Sudden bouts of sharp pain Pain is aggravated by Cold and relieved by warmth and hot drinks Cold hands and feet Nausea Diarrhea Loose stools T: Pink C: White P: Deep and tight
Treatment Principle	Warm Stomach Warm Cold
Herb Formulas	Huang Qi Jian Zhong Tang Liang Fu Wan modified Mild  Gan Jiang Ren Shen Ban Xia Wan Severe: Xiang Sha Liu Jun Zi Tang + Liang Fu Wan
Points	PC-6, SP-4, moxa or moxa needle REN-6, REN-12, ST-21, ST-36, UB-20, UB-21

Stomach And Intestinal Damp-Heat

Clinical Manifestations	Pain with diarrhea Dysentery Patient feels heavy Patient feels worse after defecation Burning anus Fever Scanty dark urine T: Normal C: Greasy and yellow P: Slippery and rapid
Treatment Principle	Clear Heat Remove Dampness And Regulate Qi
Herb Formulas	Yin Chen Hao Tang Ban Xia Xie Xin Tang
Points	DU-9, GB-34, LI-4, LI-11, LIV-3, SJ-6, SP-6, SP-9, ST-25, ST-37, ST-45, UB-19, UB-25

Stomach Cold Causing Fluid Stagnation

Clinical Manifestations	Dull pain Pain relieved by warmth Succussion sound in epigastrium on Palpations Vomiting of clear, watery fluid T: Pink C: White and sticky P: Thready or Thready and slow
Treatment Principle	Warm the Stomach Warm Cold
Herb Formulas	Liang Fu Wan modified Severe: Xiang Sha Liu Jun Zi Tang + Liang Fu Wan
Points	PC-6, ST-36, ST-40, Moxa UB-20, UB-21, REN-4, REN-14, SP-9

Food Stagnation In The Stomach

Clinical Manifestations	Distention and pain of Stomach Worse with pressure Anorexia Foul, auditory belching Bad breath better after defecation Diarrhea T: Pink C: Thick sticky white or yellow P: Slippery and rolling or Deep and Full
Treatment Principle	Remove retention
Herb Formulas	Bao He Wan
Points	ST-36, ST-44, REN-12, PC-6, SP-4, LIV-13 REN-6, REN-10, REN-12, REN-13, PC-6, ST-25, ST-36, ST-44 Above the umbilicus: SP-4, ST-24, REN-10 Around the umbilicus: KI-5, REN-6, ST-25 Lower abdomen: SP-6, ST-29, REN-4

Phlegm-Damp Stagnation In The Stomach

Clinical Manifestations	Nausea Sudden vomiting of Thin Mucus or clear Fluids Absence of thirst May feel thirsty Palpitations Dizziness Dysuria Focal distention of the epigastrium Stomach pain T: Normal C: White and Slippery P: Wiry
Treatment Principle	Harmonize the Stomach Stop vomiting Dispel Phlegm Regulate water circulation Disperse Stagnation
Herb Formulas	Xiao ban Xia Jia Fu Ling Tang
Points	REN-6, REN-10, REN-12, REN-13, PC-5 PC-6, SP-6, SP-9,  ST-25, ST-36, ST-40, ST-44

Liver Qi Stagnation

Clinical Manifestations	Lower abdominal pain Hypochondriac pain and distention Alternating fever and chills Depression Easily angered Chest fullness Bitter taste in mouth Fidgeting Breast distention and pain Irritability Dysmenorrhea Irregular menstruation Amenorrhea T: Pink C: Thin and white P: Wiry or Tight
Treatment Principle	Spread Liver Qi Promote Qi circulation Harmonize the Blood Alleviate pain
Herb Formulas	Chai Hu Shu Gan Tang
Points	LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, UB-18, SP-6, GB-40, GB-41, PC-6, SJ-6

Liver Qi Stagnation Attacks The Stomach

Clinical Manifestations	Epigastric distension Stomach or hypochondriac pain Belching Anorexia Easily angered T: Pale or Red C: Thin white P: Wiry or Deep and Rough
Treatment Principle	Regulate Qi Relieve pain
Herb Formulas	Chai Hu Shu Gan Tang Zuo Jin Wan Xiao Yao San
Points	ST-36, REN-12, SP-4, PC-6, LIV-2, LIV-14 Moxa REN-6, REN-8, ST-25 LIV-3, LIV-14, PC-6, REN-12, ST-36, ST-44 PC-6, ST-36, REN-12, LIV-3 REN-6, REN-10, REN-12, REN-13, ST-25, ST-36, UB-18, LIV-13 ST-36, ST-41, REN-12, SP-4, PC-6, LIV-2, LIV-3, LIV-14 LIV-3, LIV-13, SP-4

Liver Fire Attacks The Stomach

Clinical Manifestations	Restlessness Easily angered Regurgitation of gastric acid Stomach pain Hungers easily Dry mouth Bitter taste in mouth T: Red C: Yellow P: Wiry and Rapid
Treatment Principle	Reduce Liver Fire
Herb Formulas	Hua Gan Jian Dang Gui Long Hui Wan
Points	ST-36, REN-12, SP-4, PC-6, LIV-2, LIV-14, LI-4, LI-11 PC-6, ST-36, REN-12, LIV-2, LIV-3

San Jiao - Middle Jiao Cold-Damp

Clinical Manifestations	Fever Aversion to Cold Chest and gastric distention Gastric pain Nausea Vomiting Borborygmus Acute diarrhea Acute gastritis Abdominal pain Thirst Dry throat T: Normal C: Greasy and white P: Floating, forceful and tight
Treatment Principle	Dry Dampness Warm the body
Herb Formulas	Huo Xiang Zheng Qi Tang
Points	Moxa REN-9, SP-6, SP-9, ST-28. UB-20

Summerheat With Cold Complications

Clinical Manifestations	Fever and chills, fever more pronounced or Tidal fever Abdominal distention Thirst Sweat Stifling sensation in the chest Restlessness Gastric disturbances: Heaviness Nausea Severe diarrhea Aversion to Cold Chest and gastric distention Gastric pain Nausea Vomiting Borborygmus Acute diarrhea Scanty urine T: Red tip and edges C: Greasy and white or yellow P: Rapid and soft or Forceful and tight
Treatment Principle	Disperse Wind Clear Heat Resolve Damp Warm Cold
Herb Formulas	Huo Xiang Zheng Qi Tang
Points	DU-14, GB-20, LI-4, LI-11, REN-9, SJ-5, P-6, SP-9, ST-28. UB-12, UB-20, bleed UB-40

Blood Deficiency

Clinical Manifestations	Empty pain Dark yellow face Palpitations Insomnia
Treatment Principle	Tonify Blood
Herb Formulas	Si Wu Tang
Points	SP-6, SP-8

Blood Stagnation

Clinical Manifestations	Fixed pain Worse with pressure Hematemesis Hemafecia Black, tarry stool T: Purple or Purple spots C: White or Black
Treatment Principle	Activate Blood Remove Stagnation
Herb Formulas	Shi Xiao San
Points	REN-4, REN-12, ST-36, PC-6, SP-4, SP-6, SP-10, UB-17, LIV-2 REN-6, REN-10, REN-12, REN-13, PC-6, ST-25, ST-36, UB-17, UB-18, UB-19, UB-20, UB-21

Qi And Blood Stagnation

Clinical Manifestations	Stomach Maybe abdominal masses which are visible when lying down Piercing hypochondriac pain Irritability Indigestion Constipation Dysmenorrhea Amenorrhea Chronic diarrhea Daybreak diarrhea Palpable abdominal masses Irregular menstruation Breast distention Abdominal tumors Hypochondriac distention T: Purple with purple spots on the side P: Wiry, choppy and tight
Treatment Principle	Invigorate the Blood Dispel Blood Stasis Move Qi Alleviate pain
Herb Formulas	Ge Xia Zhu Yu Tang Dan Shen Yin Huo Luo Xiao Ling Dan With Blood Deficiency: Tiao Ying Jian Gan Ying
Points	PC-6, ST-36, REN-17, LIV-3, LIV-14 LIV-14, LIV-13, LIV-3, SP-6, UB-17

Worms

Clinical Manifestations	Pain with hunger Good appetite Bowel movements contain worms Vomiting worms White spots on lips Large belly with obvious veins Selective with food
Treatment Principle	Soothe worms Neutralize accumulations
Herb Formulas	Wu Mei Wan
Points	KI-7 (tonify before the new moon), Moxa REN-4, REN-14, ST-4

Mixed Excess And Deficiency

Clinical Manifestations	Chronic intermittent diarrhea with variable mixtures of pus and Blood Triggered or aggravated by overexertion, colds fatigue and stress or May be no obvious trigger Active phase: Diarrhea may occur many times daily Fatigue Tiredness Tenesmus Abdominal distention Mild abdominal pain which is better with warmth and maybe pressure Anorexia Loss of sense of taste Long-standing cases: Emaciation Sallow or pale complexion Listlessness Lethargy Increased desire to sleep Intolerance of Cold Cold extremities T: Normal or Pale or Red C: Greasy P: Thready and choppy or Soft and weak
Treatment Principle	Strengthen the Spleen Tonify Qi Regulate Qi Clear Damp-Heat or Clear Cold-Damp or Clear Toxic Heat
Herb Formulas	Zi Sheng Wan modified Wu Mei Wan With Liver Qi Stagnation: Jia Wei Xiao Yao San With Damp-Heat: Shao Yao Tang With Damp-Heat and abdominal distention: Zhong Man Fen Xiao Wan For treatment between episodes: With Phlegm-Damp: + Xiang Sha Liu Jun Zi Tang With anxiety, worry phobias, panic attacks and insomnia: + Gui Pi Tang With Liver Attacking the Spleen and Intestines: + Tong Xie Yao Fang + Xiao Yao San + Jia Wei Xiao Yao San + Chai Hu Shu Gan Tang With Spleen Yang Deficiency: + Wen Dan Tang Chinese patent medicines: Zi Sheng Wan Xiang Lian Wan
Points	LIV-13, REN-12, SP-6, ST-25, ST-36, ST-37, ST-39, UB-20, UB-21, UB-25 + Ahshi points + moxa if no Heat With bleeding: + LIV-1, SP-1 With mucus: + SP-3, ST-40 With Qi Stagnation: + GB-34, LIV-3 With Stagnant Heat: + LIV-2 With hypochondriac pain: + LIV-14 With tension, stress insomnia and a lateral headaches: DU-24, GB-39, SJ-5 Ear: Spleen, Large Intestine, Small Intestine, Subcortex, Sympathetic, Distal segment rectum