small intestine patterns

Question 1

SI XU COLD Tx

Answer 1

Treatment Principle: expel Cold, warm the Intestines, tonify Spleen Yang
Acupuncture: reinforcing, moxa is applicable
● ST-25
● ST-36,
● ST-39
● Ren-4
Herbal Formula:
● 小建中湯 xiǎo jiàn zhōng tāng—Minor Construct the Middle Decoction
● 參苓白朮散 shēn líng bái zhú sǎn—Ginseng, Poria and White Atractylodes Powder
● 吳茱萸湯 wú zhū yú tāng—Evodiae Decoction

Herbal Formula:
小建中湯 xiǎo jiàn zhōng tāng Minor Construct the Middle Decoction
Maltosum (yi tang)
Cinnamomi Ramulus (gui zhi)
Paeoniae Radix (shao yao)
Glycyrrhizae Radix Praeparata (zhi gan cao)
Zingiberis Rhizoma recens (sheng jiang)
Jujubae Fructus (da zao)
Method: Add Maltosu (yi tang) to the strained decoction

Actions: Warms and tonifies the middle burner and moderates the spasmodic abdominal pain

Question 1

Small Intestine Deficiency Cold 小腸虛冷 xiǎo cháng xū lěng

Answer 1

Definition: Small Intestine yang deficiency failing to
warm, manifesting in hypoactivity

Clinical Manifestations: Dull pain in the lower abdomen that is relieved by pressure and warmth,
borborygmus, loose stools, frequent or clear copious urination, intolerance of cold, cold limbs,
low energy

Tongue: Pale tongue body, thin white coating
Pulse: Deep, weak and slow

Key Symptoms: Dull abdominal pain, borborygmi, loose stools, frequent or clear copious
urination, plus yang deficiency signs and symptoms

Etiology
● Improper diet
● Overconsumption of cold foods or cold drinks, which impairs yang qi
● Exopathogenic cold invasion
● Physical overstrain impairing yang qi
● Chronic illness
● Weak constitution with Spleen and Stomach deficiency can develop into this pattern

Pathology
● When Yang qi is deficient, the Small Intestine lacks the motivating force to reabsorb fluid, leading to
excess accumulation, diluting the stools in the Large Intestine, resulting in watery stools
● When excess fluids pour down the the Urinary Bladder, there is frequent, copious and clear urination
● Since Yang Qi has the function of warming the body, any insufficiency will result in a failure to warm the body, which gives rise to intolerance of cold, cold limbs and a preference for warm food and drink
● The nature of cold is to congeal, constrict and stagnate; therefore, cold may cause contraction and
obstruction that blocks qi and blood circulation, leading to pain which is aggravated by cold, and relieved by warmth and pressure
● A pale tender tongue and a slow, feeble pulse all point to yang deficiency

Question 2

Small Intestine Excess Fire Pattern, 小肠实火 xiǎo cháng shí huǒ

Answer 2

Clinical Manifestations: Frequent urination with painful, urgent, and burning sensation, scanty
dark yellow urine or bloody urine, irritability, thirst with desire to drink cold water, sore throat
canker sores, tongue ulcers. Also called Small Intestine Repletion Heat.

Tongue: A red tongue with yellow coating
Pulse: Rapid

There may also be early stage exterior symptoms; e.g., fever and chills and a superficial pulse

Key Symptoms: Frequent urination with painful, urgent, and burning sensation, bloody urine,
plus interior excess heat signs and symptoms

Etiology
● Exopathogenic invasion
● Improper diet, such as overconsumption of greasy, fatty, hot and spicy foods
● Hot natured herbs
● Alcohol
● Emotional strain, such as anxiety and excessive stress

Question 3

SI EXCESS FIRE TX

Answer 3

Treatment Principle: drain Heart Fire and Small Intestine Fire

Acupuncture: Reducing method, no moxibustion
● SI-2
● SI-5
● HT-5
● HT-8
● ST-39

Herbal Formulae:
● 倒赤傘 dào chì sǎn—Guide Out the Red Powder
● 倒赤清心汤 dào chì qīng xīn tāng—Eliminating Redness and Clearing the Heart Decoction
● 豬苓湯 zhū líng tāng—Polyporus Decoction

Question 4

Small Intestine Qi Stagnation Pattern 小腸氣滯 xiǎo cháng qì zhì

Answer 4

Clinical Manifestations: Lower abdominal twisting colicky pain, which may extend to the stomach area, abd. distention, dislike of pressure on the abdomen, borborygmus, flatulence and abdominal pain relieved by passing gas.

Tongue: Normal tongue with white coating
Pulse: Deep-Wiry

Key Symptoms: Lower abdominal twisting pain, borborygmus, pain relieved by passing gas, scrotum pain

Etiology
● Mainly caused by exopathogenic cold invasion
● Improper diet, such as overconsumption of raw or cold food
● Cold climate
● Unsuitable attire in the cold weather
● Excessive emotions, especially from anger and wailing

Question 5

SI QI STAGNATION TX

Answer 5

Treatment Principle: Move Small Intestine Qi, promote the smooth flow of Liver Qi

Acupuncture: Reducing method; moxibustion may be used if there are signs of Cold
● Ren 12, Ren 6
● ST 36
● SJ-6
● LIV-1

Herbal Formulae:
● 煖肝煎 nuǎn gān jiān—Liver Warming Brew
● 天台乌药散 tiān tái wū yào sǎn—Tiantai Lindera Powder
● 吳茱萸湯 wú zhū yú tāng + 芍藥甘草湯 sháo yào gān cǎo tāng—Evodia Decoction plus Peony and Licorice Decoction