Stomach yīn vacuity

A disease pattern chiefly characterized by dull scorching pain; clamoring stomach; hunger without desire to eat; vacuity heat signs.

Description: Clamoring stomach; hunger with no desire to heat; in some cases, glomus and distension and dull pain in the stomach duct; dry retching; belching; dry mouth and pharynx; dry bound stool; short voidings of scant urine; tidal reddening of the cheeks; red tongue with little fur and liquid; a pulse that is fine and rapid.

Diseases: Stomach duct pain; clamoring stomach; dispersion-thirst; dysphagia-occlusion (噎膈 yē gé).

Pathogenesis: Insufficiency of yīn humor depriving the stomach of moisture and impairing its functions of intake, of ripening and rotting, and of harmony and downbearing. Stomach yīn vacuity can be caused by several factors, related to a superabundance of yáng (heat and dryness) or insufficiency of yīn:

• damage to stomach in advanced-stage warm-heat disease;
• damage to liquid through vomiting and diarrhea;
• predilection for deep-fried and aromatically spiced foods, which are drying;
• excessive consumption of warm dry medicinals.

Analysis of signs

• Insufficiency of yīn humor in the stomach: Dull scorching pain, discomfort, and glomus in the stomach duct. Dull pain reflects the yīn vacuity, while scorching pain reflects the vacuity heat.
• Impaired harmony and downbearing of stomach qì: Clamoring stomach, dry retching, and hiccup.
• Food intake and digestion: Hunger with no desire to eat arising when vacuity heat increases the speed of digestion, and lack of stomach yīn causes stagnation of stomach intake.
• Yīn liquid failing to bear upward: Dry mouth and pharynx.
• Intestines deprived of moisture: Dry bound stool.
• Depletion of fluids: Short voidings of scant urine; dry mouth and pharynx.
• Tongue: Red with scant liquid.
• Pulse: Fine and rapid.

Treatment

Medicinal therapy: Treat by nourishing stomach yīn, combined where necessary with clearing heat and harmonizing the stomach. Commonly used medicinals include ophiopogon (Ophiopogonis Radix, 麦门冬 mài mén dōng), Solomon’s seal (Polygonati Odorati Rhizoma, 玉竹 yù zhú), adenophora/glehnia (Adenophorae seu Glehniae Radix, 沙参 shā shēn), dendrobium (Dendrobii Herba, 石斛 shí hú), dried/fresh rehmannia (Rehmanniae Radix, 生地黄 shēng dì huáng), and trichosanthes root (Trichosanthis Radix, 天花粉 tiān huā fěn).

Formulas include Ophiopogon Decoction (麦门冬汤 mài mén dōng tāng) and Stomach-Nourishing Decoction (养胃汤 yǎng wèi tāng). The former clears qì and fire ascending counterflow, whereas the latter restores stomach yīn with cool sweet moistening medicinals.

Acumoxatherapy: Base treatment mainly on ST, CV, KI, and back transport points. Select ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), CV-12 (Center Stomach Duct, 中脘 zhōng wǎn), ST-25 (Celestial Pivot, 天枢 tiān shū), BL-21 (Stomach Transport, 胃俞 wèi shù), BL-20 (Spleen Transport, 脾俞 pí shù), KI-6 (Shining Sea, 照海 zhào hǎi), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), and ST-44 (Inner Court, 内庭 nèi tíng); needle with supplementation.