Stomach vacuity cold

Also:

• Stomach qì vacuity cold (胃气虚寒 wèi qì xū hán)
• Stomach yáng vacuity (胃阳虚 wèi yáng xū)

A disease pattern chiefly characterized by continual cold pain in the stomach duct relieved by warmth and pressure; vacuity cold signs.

Description: Periodic continual cold pain in the stomach that likes warmth and pressure and that is relieved after eating; upwelling or vomiting of clear water sometimes containing undigested food (grain failing to transform); reduced eating; stomach duct glomus; bland taste in the mouth; absence of thirst; fatigue and lack of strength; fear of cold and cold limbs; bright-white facial complexion; pale tongue that is tender-soft and possibly enlarged; a pulse that is sunken, slow, and forceless.

Diseases: Stomach duct pain; belching.

Biomedical correspondence: Stomach qì vacuity cold is often seen in diseases described by Western medicine as ulcers and gastric neurosis.

Pathogenesis: Insufficiency of yáng qì in the stomach affecting its ripening and rotting function and its warming action. This results from any of the following factors:

• dietary irregularities, excessive consumption of raw and cold foods, or excessive use of bitter and cold medicinals;
• spleen vacuity affecting the stomach;
• enduring illness weakening the stomach.

Analysis of signs

• Congealing cold: Continual periodic cold pain in the stomach that likes warmth and pressure and is relieved by eating results from insufficiency of yáng qì giving rise to congealing cold that hampers the qì dynamic. Relief by warmth and pressure reflects vacuity cold.
• Impaired harmony and downbearing: Reduced eating and glomus in the stomach duct.
• Stomach qì ascending counterflow: Upwelling of clear water, sometimes containing undigested food; belching.
• General yáng vacuity: Fear of cold and cold limbs; fatigue and lack of strength.
• Tongue: Pale and tender-soft and possibly enlarged, reflecting yáng qì vacuity.
• Pulse: Sunken, slow, and forceless, reflecting yáng qì vacuity.

Treatment

Medicinal therapy: Fortify the center and warm the stomach. Center-fortifying medicinals include malt sugar (Maltosum, 饴糖 yí táng), white peony (Paeoniae Radix Alba, 白芍药 bái sháo yào), licorice (Glycyrrhizae Radix, 甘草 gān cǎo), and jujube (Jujubae Fructus, 大枣 dà zǎo). Stomach-warming medicinals include cinnamon twig (Cinnamomi Ramulus, 桂枝 guì zhī), fresh ginger (Zingiberis Rhizoma Recens, 生姜 shēng jiāng), lesser galangal (Alpiniae Officinarum Rhizoma, 高良姜 gāo liáng jiāng), and evodia (Evodiae Fructus, 吴茱萸 wú zhū yú).

A basic formula is Minor Center-Fortifying Decoction (小建中汤 xiǎo jiàn zhōng tāng), which fortifies the center and warms the stomach, as well harmonizing provisioning and relieving pain.

• For pronounced qì vacuity, astragalus (Astragali Radix, 黄芪 huáng qí) can be added to form Astragalus Center-Fortifying Decoction (黄芪建中汤 huáng qí jiàn zhōng tāng).
• For pronounced qì stagnation and pain, add cyperus (Cyperi Rhizoma, 香附子 xiāng fù zǐ), toosendan (Toosendan Fructus, 川楝子 chuān liàn zǐ), corydalis (Corydalis Rhizoma, 延胡索 yán hú suǒ), costusroot (Aucklandiae Radix, 木香 mù xiāng), and tangerine peel (Citri Reticulatae Pericarpium, 陈皮 chén pí).
• For pronounced acid upflow, add cuttlefish bone (Sepiae Endoconcha, 海螵蛸 hǎi piāo xiāo) and ark shell (Arcae Concha, 瓦楞子 wǎ léng zǐ), which have an antacid effect.

Acumoxatherapy: Base treatment mainly on ST points. Select BL-20 (Spleen Transport, 脾俞 pí shù), BL-21 (Stomach Transport, 胃俞 wèi shù), CV-12 (Center Stomach Duct, 中脘 zhōng wǎn), LR-13 (Camphorwood Gate, 章门 zhāng mén), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), ST-44 (Inner Court, 内庭 nèi tíng), ST-21 (Beam Gate, 梁门 liáng mén), and ST-37 (Upper Great Hollow, 上巨虚 shàng jù xū). Needle with supplementation and large amounts of moxa.

Point selection according to signs: For pronounced qì vacuity, add CV-6 (Sea of Qì, 气海 qì hǎi). For pronounced qì stagnation, add CV-17 (Chest Center, 膻中 shān zhōng), PC-6 (Inner Pass, 内关 nèi guān), and LR-3 (Supreme Surge, 太冲 tài chōng).

See also spleen-stomach vacuity cold.