Symptoms 9, stomach and abdomen

Below is a brief description of the major stomach and abdomen symptoms, with links to entries that provide more detail.

Appetite

Reduced eating (食少 shí shǎo): Poor appetite; eating less than normal. Similar terms include inability to get food and drink down (饮 食不下 yǐn shí bù xià), no desire to eat (不欲食 bù yù shí), and no pleasure in eating (纳谷不香 nà gǔ bù xiāng). Reduced eating is chiefly associated with spleen qì vacuity, spleen yáng vacuity, stomach qì vacuity, stomach cold, and stomach yīn vacuity. Compare the next item.

Torpid intake (纳呆 nà dāi): Absence of hunger or desire for food because of a feeling of satiety at mealtimes and fullness in the stomach duct and abdomen after one starts eating. Torpid intake usually indicates dampness, stomach cold, or food stagnating in the stomach duct.

Aversion to food (厌食 yàn shí): A feeling of revulsion at the sight or thought of food. It is a sign of food accumulation, damp-heat, or pregnancy. Aversion to greasy food (厌油 yàn yóu) may indicate gallstones.

Bitter taste in the mouth (口苦 kǒu kǔ): A bitter taste in the mouth not associated with any food. It is caused by heat in the liver and/or gallbladder; it also occurs in damp-heat brewing in the spleen and in lesser yáng (shào yáng) (shào yáng) disease patterns.

Digestion

Pain in the stomach duct (胃脘疼痛 wèi wǎn téng tòng); pain in the stomach duct and abdomen (脘腹疼痛 wǎn fù téng tòng); abdominal pain (腹痛 fù tòng): Pain usually with subjective or palpable fullness in the stomach duct (region of the stomach) and in the abdomen in general. This arises when the spleen’s yáng qì is insufficient or when evils are present. Its significance is as follows:

• Pain that likes pressure indicates vacuity (insufficiency of yáng qì).
• Pain that refuses pressure indicates repletion.
• Pain that likes warmth indicates cold.
• Pain that likes cold indicates heat.
• Periodic or continual dull pain indicates vacuity.
• Severe pain indicates repletion.
• Pain that is limited to the stomach duct tends to indicate stomach disease, while pain that is also felt in the abdomen tends to indicate a spleen problem.

Distension and fullness in the stomach duct and abdomen (脘腹胀满 wǎn fù zhàng mǎn):Fullness means a subjective feeling of bloating. Distension means severe fullness or palpable or even visible expansion. Distension and fullness in the stomach and abdomen may result from spleen-stomach yáng qì vacuity, the presence of evils (such as stagnating food or dampness), or qì stagnation. It occurs in spleen qì vacuity, spleen yáng vacuity, food stagnating in the stomach duct, cold-rheum collecting in the stomach, and liver depression invading the spleen or stomach.

Glomus (痞 pǐ); glomus and oppression (痞闷 pǐ mèn); glomus and distension (痞胀 pǐ zhàng): A sensation of blockage and fullness in the stomach duct or below the heart. It is attributed to stagnation of the qì dynamic in the center burner, usually attributable to dampness, but sometimes to stomach qì vacuity. Note that some modern textbooks avoid the term glomus altogether and replace it with distension.

Rumbling intestines (肠鸣 cháng míng): Also called borborygmus. Any sound made by food in the intestines. It occurs in food stagnating in the stomach duct, in cold strike (cold evil directly striking the interior in cold damage), center qì vacuity, and liver qì invading the spleen.

Stomach Qì Ascending Counterflow

Belching, hiccup, nausea, and vomiting reflect stomach qì ascending counterflow, which frequently occurs in stomach disease.

Nausea (恶心 ě xīn): Desire to vomit. It is a sign of stomach qì ascending counterflow. It occurs in stomach cold, stomach heat, stomach yīn vacuity, liver-stomach disharmony, and food stagnating in the stomach duct. It is sometimes described as pwelling and nausea (泛恶 fàn ě), emphasizing the upward movement of qì from the stomach.

Vomiting (呕吐 ǒu tù), retching and vomiting (呕吐 ǒu tù): Vomiting is the expulsion of the stomach contents via the mouth; retching is the same action with the expulsion of little or no matter. It is a sign of stomach qì ascending counterflow, which can occur in any stomach pattern. Vomiting (or retching) is notably observed in stomach cold, stomach heat, stomach yīn vacuity, liver-stomach disharmony, damp-heat brewing in the spleen, and in food damage (food stagnating in the stomach duct). It can also occur in external contractions such as wind-cold or summerheat.

Dry retching (干呕 gān ǒu): Vomiting with little or no vomitus. It is a sign of stomach qì ascending counterflow. It is most commonly a sign of stomach yīn vacuity but can also occur in stomach cold.

Vomiting of blood (吐血 ǒu xuè): Called hematemesis in biomedicine. Expulsion from the stomach of vomitus containing fresh blood or dark-purple clots. It is a sign of stomach heat or liver fire invading the stomach, possibly with static blood in the stomach.

Water counterflow (水逆 shuǐ nì): A condition characterized by dry mouth and desire to drink with immediate vomiting of ingested fluids. It is mentioned in the Shāng Hán Lùn (On Cold Damage) in greater yáng (tài yáng) (tài yáng) water amassment patterns.

Belching (嗳气 ài/ǎi qì): Expulsion of gas from the stomach via the mouth. It occurs in spleen-stomach vacuity (spleen/stomach qì/yáng vacuity), food stagnating in the stomach duct, and liver qì invading the stomach. In food stagnating in the stomach duct, it is associated with a sour-putrid smell.

Hiccup (呃逆 è nì): Repeated production of short sharp sounds in the throat. It is a sign of stomach qì ascending counterflow. It occurs in stomach qì vacuity, stomach cold, stomach yīn vacuity, stomach heat, and spleen-kidney yáng vacuity.

Stomach Heat Signs

Several signs, especially when appearing together, are indicative of intense stomach heat.

Scorching pain in the stomach duct (胃脘灼痛 wèi wǎn zhuó tòng): A burning pain in the stomach itself. If the pain is intense, it is caused by intense stomach heat; if dull, it is caused by stomach yīn vacuity.

Clamoring stomach (嘈杂 cáo zá): A sensation described as being like hunger but not hunger and like pain but not pain. It occurs in stomach yīn vacuity, intense stomach heat, liver-stomach disharmony, and worms accumulating in the intestinal tract.

Immediate vomiting of ingested food (食入即吐 shí rù jí tù): Vomiting shortly after eating. It is observed in intense stomach heat, malign obstruction (恶阻 è zǔ), and dysphagia-occlusion (噎膈 yē gé).

Acid swallowing (吞酸 tūn suān): Upwelling of acid fluid into the mouth that is swallowed before it can be spat out. The upflow of acid is caused by stomach qì ascending counterflow. It occurs not only in intense stomach heat but also in food stagnating in the stomach duct and in depressed liver qì affecting the stomach (liver-stomach disharmony).

Swift digestion with rapid hungering (消谷善饥 xiāo gǔ shàn jī): The appearance of hunger shortly after eating. It occurs in intense stomach heat, in strong stomach and weak spleen (stomach heat with spleen cold), in dispersion-thirst, or in goiter.

Fetid mouth odor (口臭 kǒu chòu): Bad breath. If not the result of poor oral hygiene, it can be attributed to stomach heat, phlegm-heat congesting the lung with pulmonary welling-abscess, or food stagnating in the stomach duct.

Bleeding gums (牙龈出血 yá yín chū xuè): Bleeding from the juncture with the teeth. It most commonly results from stomach heat, spleen failing to control the blood, or kidney yīn vacuity.

Painful swollen ulcerating gums (牙龈肿痛溃烂 yá yín zhǒng tòng kuì làn): Mainly caused by intense stomach heat.

Liver Channel Signs

Besides the signs listed here, liver channel signs also include signs associated with the external genitals, which are listed under Two Yīn below.

Distending pain in the chest and rib-side, breasts, or lesser abdomen (胸胁、乳房、少腹胀痛 xiōng xié, rǔ fáng, shào fù zhàng tòng): This is pain and distension in the chest and rib-side, breasts, or the sides of the lower abdomen. It is a sign of depressed liver qì.

Scurrying pain in the chest and abdomen (胸腹窜痛 xiōng fù cuàn tòng): A pain that darts quickly from one place to another in the chest or abdomen. It reflects liver qì depression. Scurrying pain is a manifestation of pain of unfixed location associated with qì stagnation.

Miscellaneous

Abdominal mass (腹中有肿块 fù zhōng yǒu zhǒng kuài): Also called glomus lump (痞塊 pǐ kuài). Any palpable lump in the abdomen. Abdominal mass and glomus lump are symptom names; as diseases, abdominal masses are called concretions, conglomerations, accumulations, and gatherings.