Asian Bodywork III Class 9 Timur Lokshin LMT, CPT, LAc.

Types Patterns Empty: Vacuity, Deficient, Lacking of something. Full: Excess, Replete, Obstructed or Impaired

Spleen Empty Qi: Sallow complexion, emaciation, tiredness, lassitude, reduced appetite, weakness of limbs, abdominal distention, loose stools, dislike of speaking – Toungue: Pale, thin white coating – Pulse: slow, weak or soft and thready Qi Sinking: Any of the Sx from qi vacuity, bearing down sensation in the abdominal region, visceral prolapse, frequency and urgency of urination. – Tongue: Pale, thin white coating – Pulse: Slow, weak or soft and thready

Spleen Empty Yang: Pallor, poor appetite, tiredness, abdominal distension which is worse after eating, dull pain in the abdominal region which is better with warmth and pressure, the four limbs being not warm, chilliness, cold limbs, weakness of the four limbs, loose stools, edema – Tongue: Pale and delicate, white coating – Pulse: Deep, slow

Spleen Empty Control Blood: Pale complexion, lassitude, dislike speaking, purpura, blood spot under the skin, bloody stools, excess menstrual flow, uterine bleeding in women, sallow complexion and SoB – Tongue: Pale – Pulse: Thready, weak

Spleen Full Cold Damp: Fullness and distension in the epigastrium and abdomen, loss of appetite, sweetish taste in the mouth or absence of taste, no thirst, sticky saliva, heaviness of the head and body, loose stools and diarrhea, white vaginal discharge. – Tongue: White-sticky coating – Pulse: soft, rolling, slow

Spleen Full Damp Heat: Fullness and distension in the epigastrium and abdomen, loss of appetite, nausea, vomiting, bitter taste and stickiness in the mouth, heaviness of the body and lassitude, loose stools with offensive odor, burning sensation of the anus, thirst without desire to drink or drink small sips, scanty and dark-yellow urine, low-grade fever, headache, bright yellow face, eyes and skin. – Tongue: yellow-sticky coat – Pulse: soft, rapid

Stomach Full Food Retention: Distension, fullness and pain in the epigastrium and abdomen which are relieved by vomiting, foul benching, sour regurgitation, vomiting, anorexia, hesitant bowel movement, insomnia – Tongue: thick-sticky coating – Pulse: rolling

Stomach Full Cold Fluid: Epigastrium fullness and pain, sudden pain in the epigastrium, worse with cold, better with warmth, reflux of clear fluids or vomiting after eating – Tongue: white-slippery coating – Pulse: slow

Stomach Full Fire: Burning sensation and pain in the epigastric region, empty and incomfortable feeling in the stomach, sour regurgitation, vomiting, foul breath, vomiting soon after eating, thirst with preference for cold drinks, voracious appetite and getting hungry easily, swelling and pain or ulceration and bleeding gums, constipation, scanty yellow urine. – Tongue: red, yellow coating – Pulse: rapid

Stomach Full Phlegm Fire: Stuffiness of the epigastrium, less thirst, mucus in stools, mental derangement and insomnia – Tongue: thick yellow sticky coating or yellow prickles inside midline crack – Pulse: rolling, excess, rapid

Stomach Full Blood Stasis: Stabbing pain in the epigastrium which is worse with heat and pressure, pain after eating, vomiting of dark blood, blood in stool – Tongue: N/A – Pulse: N/A

Stomach Empty Yin: Burning pain in the epigastrium region, empty and uncomfortable sensation in the stomach, hunger with no desire to eat, dry vomiting and hiccups, dryness of the mouth and throat, constipation or dry stool, thirst with no desire to drink or drinks in small sips – Tongue: red, little moisture – Pulse: rapid, thready

Large Intestine Full Damp Heat: Abdominal pain, blood and mucus in the stool, offensive odor of stools, diarrhea with yellow, watery stools, burning sensation of the anus, tenesmus(frequent bowels), scanty deep- yellow urine, possible fever, sweating, thirst without desire to drink, feeling heaviness in the body and limbs, stuffiness of the chest and epigastrium – Tongue: yellow-sticky coating – Pulse: rolling rapid or soft and rapid

Large Intestine Full Heat: Constipation, burning in the anus, abdominal distension and pain which is worse with pressure, high fever or tidal fever, sweating especially on the limbs, vomiting, thirst, delirium – Tongue: red body, thick dry yellow or brown black coating – Pulse: thready

Large Intestine Empty Dry: Dry stools, constipation, dryness of the mouth and throat – Tongue: red, little moisture, or dry yellow coating – Pulse: thready

Small Intestine Full Qi Pain: Acute twisting of the lower abdomen which may extend to back, abdominal distension, dislike of pressure in the abdomen, borborygmus, flatulence, abdominal pain relieved by emission of wind, bearing down pain in the testes referring to the lumbar region – Tongue: White coating – Pulse: deep, string-taught

Small Intestine Full Qi Tied: Sudden violent abdominal pain, dislike of pressure, abdominal distension, constipation, borboygmus, flatulence vomiting – Tongue: thick white coating – Pulse: deep, string taut

Small Intestines Full Worms: abdominal pain and distension, bad taste in mouth, sallow complexion Roundworms: abdominal pain, vomiting of roundworms, cold limbs Hookworms: eat strange objects (soil, wax) Pinworms: itchy anus, worse in the evening Tapeworms: constant hunger

Abdominal Pain Abdominal pain refers to pain in the region around the umbilicus to the pubic bone, and is distinguished from epigastric pain. This symptom is frequently encountered clinically and is presented in a wide variety of illnesses.

Biomed Conditions Treated Acute and Chronic gastroenteritis Enterospasm Psychosomatic Gastrointestinal Conditions Dyspepsia  Not for treatment of abdominal pain due to gynecological disorders.

Etiology Patterns of abdominal pain are caused by external evils of cold, dampness or heat, or by internal disruptions because of improper diet and poor eating habits, emotional stress or constitutional yang vacuity. These factors cause stagnation and obstruction of Qi flow, leading to blockage of the connecting vessels, or to reduced nourishment of channels, resulting in abdominal pain.

Pathogenesis The pathogenesis of abdominal pain include cold, heat, repletion and vacuity. Clinically, one may give rise to another, one may transform into another, or two or more may manifest.

TCM Conditions Obstruction by Cold Evil Obstruction by Damp-Heat Vacuity of Spleen Yang Obstruction by Food Stagnation Qi Stagnation and Blood Stasis – Predominant Qi Stagnation – Predominant Blood Stasis

Obstruction by Cold Evil Sx: Acute and sudden abdominal pain that is decreased by external application of heat and increased by cold, no apparent thirst, copious clear urine, loose stools. – Tongue: White slimy coating – Pulse: Deep, tight Tx: ST36, Ren 12, Heat to Ren4-6 area

Obstruction by Damp-Heat Sx: Abdominal pain that is increased by external pressure, abdominal fullness and distention, constipation or difficult elimination of loose stools, irritability, thirst, scanty dark urine. – Tongue: Yellow slimy coating – Pulse: Slippery, rapid Tx: St25, LI11, GB34

Vacuity of Spleen Yang Sx: Dull periodic abdominal pain relieved by heat or external pressure that increases when hungry or fatigued, loose stools, tiredness, physical cold. – Tongue: Pale with white coating – Pulse: Deep, thready Tx: ST36, Heat to Ren4-Ren6 area.

Obstruction by Food Stasis Sx: Abdominal fullness, distention and pain increased by external pressure, refusal of food, belching of foul gas, acid regurgitation, sometimes constipation or in some cases abdominal pain that occurs just prior to a bout of diarrhea and that disappear with the emptying of the bowels. – Tongue: Slimy coating – Pulse: Replete, slippery Tx:ST36, ST25, Ren12 Li Nei Ting (Opposite of ST44)

Qi Stag and Blood Stasis (Predominant Qi Stagnation) Sx: Distention, fullness and pain in the epigastrium and abdomen increasing with anger, indeterminate moving location of pain, relief following belching or expulsion of gas. – Tongue: Thin coating – Pulse: Wiry Tx: ST36, LI4, LV3, PC6

Qi Stag and Blood Stasis (Predominant Blood Stasis) Sx: Predominance of blood stasis, pain is sever and the location of the pain is defined and stationary. – Tongue: Purplish – Pulse: Wiry or rough Tx: Ren17, LV3, SP6