Pain in the umbilical region

Pain in the region of the navel; attributed to congealing cold, spleen-kidney yáng vacuity, yáng brightness (yáng míng) heat bind, gastrointestinal qì stagnation, brewing damp-heat, food damage, or roundworm.

Patterns

Congealing cold (寒凝 hán níng) causes sudden acute pain in the umbilical region without respite that is slightly relieved by warmth, and that is accompanied by no thought of food and drink, rumbling intestines, abdominal cold diarrhea or constipation, and, in severe cases, reversal cold of the extremities. The tongue is pale or green-blue with a moist white fur, and a sunken tight slow pulse.

Medicinal therapy: Warm the center and disperse cold; rectify qì and relieve pain. Use Tiantai Lindera Powder (天台乌药散 tiān tái wū yào sǎn) plus agents such as dried ginger (Zingiberis Rhizoma, 干姜 gān jiāng) and cinnamon bark (Cinnamomi Cortex, 肉桂 ròu guì). For constipation, variations of Spleen-Warming Decoction (温脾汤 wēn pí tāng) can be used.

Acumoxatherapy: Base treatment mainly on CV, ST, SP, and LI. Main points: CV-12 (Center Stomach Duct, 中脘 zhōng wǎn), ST-25 (Celestial Pivot, 天枢 tiān shū), and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ). For congealing cold, add SP-4 (Yellow Emperor, 公孙 gōng sūn), CV-8 (Spirit Gate Tower, 神阙 shén què)^mx, and CV-4 (Pass Head, 关元 guān yuán)^mx; needle with drainage and add moxa.

Spleen-kidney yáng vacuity (脾肾阳虚 pí shèn yáng xū) causes continual intermittent pain in the umbilical region that like warmth and pressure and that is exacerbated by exposure to cold. This is accompanied by cold limbs and fear of cold, thin sloppy stool, pale tongue with a thin white fur, and a weak fine sunken pulse.

Medicinal therapy: Supplement the spleen and kidney; warm yáng and relieve pain. Use Aconite Center-Rectifying Pill (附子理中丸 fù zǐ lǐ zhōng wán) or use Yīn-Rectifying Brew (理阴煎 lǐ yīn jiān) plus cinnamon bark (Cinnamomi Cortex, 肉桂 ròu guì) and white peony (Paeoniae Radix Alba, 白芍药 bái sháo yào).

Acumoxatherapy: To the main points given above add BL-23 (Kidney Transport, 肾俞 shèn shù), BL-20 (Spleen Transport, 脾俞 pí shù), CV-4 (Pass Head, 关元 guān yuán), CV-6 (Sea of Qì, 气海 qì hǎi), and GV-4 (Life Gate, 命门 mìng mén); needle with supplementation and moxa.

yáng brightness (yáng míng) heat bind (阳明热结 yáng míng rè jié) causes pain in the umbilical region with fullness that refuses pressure. This is accompanied by tidal heat, streaming sweat at the extremities, constipation or in some cases watery diarrhea, short voidings of reddish urine, a red tongue with thick dry yellow fur, and a rapid slippery sunken pulse.

Medicinal therapy: Clear heat and induce draining-precipitation. Use Stomach-Regulating Qì-Coordinating Decoction (调胃承气汤 tiáo wèi chéng qì tāng), Major Qì-Coordinating Decoction (大承气汤 dà chéng qì tāng), and Minor Qì-Coordinating Decoction (小承气汤 xiǎo chéng qì tāng).

Acumoxatherapy: To the main points add BL-25 (Large Intestine Transport, 大肠俞 dà cháng shù), LI-4 (Union Valley, 合谷 hé gǔ), LI-11 (Pool at the Bend, 曲池 qū chí), ST-44 (Inner Court, 内庭 nèi tíng), ST-37 (Upper Great Hollow, 上巨虚 shàng jù xū), and TB-6 (Branch Ditch, 支沟 zhī gōu); needle with drainage.

Gastrointestinal qì stagnation (肠胃气滞 cháng wèi qì zhì) causes pain in the umbilical region less severe than the accompanying fullness and relieved by the passing of flatus and worsened by affect-mind ill-being. There is no desire for food and drink, a thin white tongue fur, and slippery stringlike pulse.

Medicinal therapy: Downbear qì and disperse binds; regulate the center and relieve pain. Use variations of Five Milled Ingredients Drink (五磨饮子 wǔ mò yǐn zi).

Acumoxatherapy: To the main points add CV-17 (Chest Center, 膻中 shān zhōng), PC-6 (Inner Pass, 内关 nèi guān), CV-6 (Sea of Qì, 气海 qì hǎi), and LR-3 (Supreme Surge, 太冲 tài chōng); needle with drainage.

Brewing damp-heat (湿热蕴结 shī rè yùn jié) causes pain in the umbilical region and tenesmus in dysentery. The stool is thick, sticky, and foul-smelling and contains pus and blood. In addition, there is bitter taste in the mouth, dry mouth with no desire to drink, a dark red tongue with a thick slimy yellow fur, and a slippery rapid pulse.

Medicinal therapy: Clear damp-heat and rectify qì and blood to relieve pain. Use variations of Peony Decoction (芍药汤 sháo yào tāng).

Acumoxatherapy: To the main points add LI-4 (Union Valley, 合谷 hé gǔ), LI-11 (Pool at the Bend, 曲池 qū chí), ST-44 (Inner Court, 内庭 nèi tíng), and ST-37 (Upper Great Hollow, 上巨虚 shàng jù xū); needle with drainage.

Food damage accumulation (伤食积滞 shāng shí jī zhì) can causes pain in the umbilical region relieved by the passing of flatus or by defecation. There is belching, upflow and nausea, no thought of food and drink, and sometimes diarrhea. Stool contains largely undigested food and is sour-smelling and malodorous. The tongue fur is thick and slimy at the root, and the pulse is slippery.

Medicinal therapy: Disperse accumulation and abduct stagnation. Use Aucklandia and Areca Pill (木香槟榔丸 mù xiāng bīng láng wán) or Unripe Bitter Orange Stagnation-Abducting Pill (枳实导滞丸 zhǐ shí dǎo zhì wán).

Acumoxatherapy: To the main points add Lǐ Inner Court (里内庭 lǐ nèi tíng), CV-21 (Jade Swivel, 璇玑 xuán jī), CV-10 (Lower Stomach Duct, 下脘 xià wǎn), and CV-6 (Sea of Qì, 气海 qì hǎi); needle with drainage.

Round worm (蛔虫 huí chóng) can cause intense pain with periods of complete relief. Sometimes an accumulation lump can be observed. Other signs include emaciation, periodic vomiting of clear water. In some cases, there may be grinding of the teeth in sleep, perverted appetite, passage of worms in the stool, or gray patches on the mouth and face. During attacks of pain, the pulse becomes wiry or sunken and hidden.

Medicinal therapy: Expel and kill roundworm. Use Worm-Transforming Pill (化虫丸 huà chóng wán) or variations.

Acumoxatherapy: To the main points add SP-4 (Yellow Emperor, 公孙 gōng sūn), BL-20 (Spleen Transport, 脾俞 pí shù), Hundred Worm Nest (百虫窝 bǎi chóng wō), and ST-4 (Earth Granary, 地仓 dì cāng); needle with drainage.