Intense stomach heat

Also:

• Stomach repletion heat (胃实热 wèi shí rè)
• Stomach heat (胃热 wèi rè)
• Intense stomach fire (胃火炽盛 wèi huǒ chì shèng)
• Stomach fire (胃火 wèi huǒ)
• Stomach fire bearing upward (胃火上升 wèi huǒ shàng shēng), which denotes intense stomach fire affecting the gums.
• Stomach fire flaming upward (胃火上炎 wèi huǒ shàng shēng), which denotes intense stomach fire affecting the gums.

A disease pattern chiefly characterized by scorching pain in the stomach duct; swift digestion with rapid hungering; acid upwelling; interior repletion heat signs.

Description: Scorching pain in the stomach duct that rejects pressure; thirst with desire for cold drinks; swift digestion and rapid hungering; acid upwelling or acid swallowing; in some cases, fetid mouth odor, bleeding gums; constipation; short voidings of yellow urine; red tongue with yellow fur; a pulse that is slippery and rapid.

Diseases: Stomach duct pain; dispersion-thirst; clamoring stomach; painful swollen gums; vomiting.

Pathogenesis: Fire-heat congesting the stomach and impairing the harmony and downbearing of the stomach. Contributory factors include:

• predilection for hot, spicy, acrid, sweet, or fatty foods or liquor, all of which foster heat (the most common cause);
• affect-mind frustration causing liver depression transforming into fire, which in turn invades the stomach;
• invasion of evil heat.

Analysis of signs

• Impaired harmony and downbearing attributable to heat in the stomach: Burning heat in the stomach duct that refuses pressure, acid upwelling or acid swallowing, and in some cases immediate vomiting of ingested food.
• Digestion accelerated by fire-heat: Swift digestion and rapid hungering; clamoring stomach.
• Heat scorching liquid: Thirst with intake of cold drinks.
• Fire flaming up through the channels: Fetid mouth odor (bad breath), bleeding gums, and sore swollen ulcerating gums are all signs of stomach heat ascending to the upper body.
• Frenetic movement of hot blood: Bleeding gums.
• Generalized signs of intense fire-heat: Constipation, reddish urine, red tongue with yellow fur, and a rapid pulse.

Comparison: See table.

Treatment

Medicinal therapy: Treatment involves clearing the stomach and draining fire. Commonly used medicinals include coptis (黄连 huáng lián), gypsum (Gypsum Fibrosum, 石膏 shí gāo), phragmites (Phragmitis Rhizoma, 芦根 lú gēn), gardenia (Gardeniae Fructus, 山栀子 shān zhī zǐ), scutellaria (Scutellariae Radix, 黄芩 huáng qín), and rhubarb (Rhei Radix et Rhizoma, 大黄 dà huáng).

Representative formulas: Stomach-Clearing Powder (清胃散 qīng wèi sǎn) and Jade Lady Brew (玉女煎 yù nǚ jiān). Intense (i.e., severe) invariably causes damage to yīn fluids of the stomach so that the judicious admixture of medicinals that nourish yīn and engender liquid is indicated. These include dried/fresh rehmannia (Rehmanniae Radix, 生地黄 shēng dì huáng), ophiopogon (Ophiopogonis Radix, 麦门冬 mài mén dōng), and scrophularia (Scrophulariae Radix, 玄参 xuán shēn).

Acumoxatherapy: Base treatment mainly on ST points. Main points: ST-44 (Inner Court, 内庭 nèi tíng), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), and LI-4 (Union Valley, 合谷 hé gǔ). For stomach repletion heat, add ST-45 (Severe Mouth, 厉兑 lì duì); needle with drainage. For vacuity heat, add BL-21 (Stomach Transport, 胃俞 wèi shù), KI-6 (Shining Sea, 照海 zhào hǎi), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo); needle with even supplementation and drainage.