Stomach qì ascending counterflow

Also counterflow ascent of stomach qì. The chief manifestation of impaired harmonious downbearing of the stomach that causes nausea, vomiting, belching, or hiccup and that results from a number of causes including cold, heat, phlegm, foul turbidity, food stagnation, and gastrointestinal qì stagnation. Stomach qì ascending counterflow is a pattern that can occur in any stomach disease.

• Counterflow occurring in a cold pattern is usually characterized by a pale tongue, white face, vomiting of clear fluid, or vomiting in the evening of food ingested in the morning.
• Where heat is present, signs include red tongue with yellow fur, vomiting of sour or bitter fluid, and immediate vomiting of ingested food.
• If phlegm is the cause, a slimy tongue fur, repeated ejection of phlegm-drool, and occasionally dizziness are observed. Stomach qì ascending counterflow due to foul turbidity usually occurs in hot weather, is sudden in onset and is characterized by abdominal pain, ungratified desire to vomit, and agonizing distension and oppression in the stomach duct.
• Where stomach qì ascending counterflow is a result of food stagnation, there is usually a history of food damage, and signs such as sour, putrid vomitus, with improvement brought by vomiting.
• Finally, stomach qì ascending counterflow owing to gastrointestinal qì stagnation is characterized by glomus in the chest, abdominal pain, and belching.

Medicinal therapy: Harmonize the stomach and downbear counterflow. Frequently used medicinals include: pinellia (Pinelliae Rhizoma, 半夏 bàn xià), tangerine peel (Citri Reticulatae Pericarpium, 陈皮 chén pí), evodia (Evodiae Fructus, 吴茱萸 wú zhū yú), fresh ginger (Zingiberis Rhizoma Recens, 生姜 shēng jiāng), coptis (Coptidis Rhizoma, 黄连 huáng lián), bamboo shavings (Bambusae Caulis in Taenia, 竹茹 zhú rú), inula flower (Inulae Flos, 旋覆花 xuán fù huā), and hematite (Haematitum, 代赭石 dài zhě shí). Treatment should also be directed toward eliminating the relevant cause of disease, using methods such as warming the stomach, clearing heat, transforming phlegm, repelling turbidity, abductive dispersion, and rectifying qì.

• Stomach qì ascending counterflow due to stomach cold can be treated with Evodia Decoction (吴茱萸汤 wú zhū yú tāng) or Clove and Persimmon Decoction (丁香柿蒂汤 dīng xiāng shì dì tāng) (mainly used for hiccup).
• When the cause is stomach heat, Left-Running Metal Pill (左金丸 zuǒ jīn wán) can be used.
• Minor Pinellia Decoction Plus Poria (小半夏加茯苓汤 xiǎo bàn xià jiā fú líng tāng) or Gallbladder-Warming Decoction (温胆汤 wēn dǎn tāng) can be used to treat patterns caused by phlegm, and Gallbladder-Warming Decoction supplemented with coptis (Coptidis Rhizoma, 黄连 huáng lián) can be used if an added heat complication is identified.
• Foul turbidity patterns are treated with Jade Pivot Elixir (玉枢丹 yù shū dān). Harmony-Preserving Pill (保和丸 bǎo hé wán) is appropriate for food stagnation. Inula and Hematite Decoction (旋覆花代赭石汤 xuán fù huā dài zhě shí tāng) and its variations can be used where qì stagnation is the cause.

Acumoxatherapy: Treatment varies according to the cause. The alarm and lower uniting points of ST, CV-12 (Center Stomach Duct, 中脘 zhōng wǎn) and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), and PC-6 (Inner Pass, 内关 nèi guān), can be selected as the main points to harmonize the stomach, downbear counterflow, and check vomiting.

• For cold patterns, add stomach-warming points BL-21 (Stomach Transport, 胃俞 wèi shù), CV-13 (Upper Stomach Duct, 上脘 shàng wǎn), SP-4 (Yellow Emperor, 公孙 gōng sūn), and CV-4 (Pass Head, 关元 guān yuán); needle with drainage and add moxa.
• For heat patterns, add stomach-heat-clearing points LI-4 (Union Valley, 合谷 hé gǔ), LI-11 (Pool at the Bend, 曲池 qū chí), and ST-44 (Inner Court, 内庭 nèi tíng); needle with drainage. For phlegm, add phlegm-transforming counterflow-downbearing points ST-40 (Bountiful Bulge, 丰隆 fēng lóng), CV-17 (Chest Center, 膻中 shān zhōng), SP-4 (Yellow Emperor, 公孙 gōng sūn), and BL-20 (Spleen Transport, 脾俞 pí shù); needle with drainage or with even supplementation and drainage, and add moxa.
• For food stagnation complication, add food-dispersing stagnation-abducting points CV-10 (Lower Stomach Duct, 下脘 xià wǎn), Lǐ Inner Court (里内庭 lǐ nèi tíng), and CV-21 (Jade Swivel, 璇玑 xuán jī); needle with drainage.
• For foul turbidity, add dampness-transforming turbidity-dispelling points LI-4 (Union Valley, 合谷 hé gǔ), LI-11 (Pool at the Bend, 曲池 qū chí), and SP-9 (Yīn Mound Spring, 阴陵泉 yīn líng quán); needle with drainage.
• For qì stagnation, add qì-rectifying points CV-6 (Sea of Qì, 气海 qì hǎi), BL-20 (Spleen Transport, 脾俞 pí shù), LR-3 (Supreme Surge, 太冲 tài chōng), and SP-4 (Yellow Emperor, 公孙 gōng sūn); needle with even supplementation and drainage or with drainage.