Vomiting Flashcards
Definition of vomiting. Ou vs Tu?
Expulsion of stomach contents through mouth
Ou - there is sound
Tu - no sound
What are some examples of Western diseases associated with vomiting?
- Appendicitis
- Pancreatitis
- Peptic ulcer
- Poison substances
What TCM factor is vomiting most associated with?
Rebellious Stomach Qi
Organ locations related to vomiting?
Stomach (likes moist, hates dry)
Spleen (likes dry, hates moist and cold)
Liver
Pathogeny and Pathogenesis for vomiting?
- Fear or fright disturbs the Stomach
- Food stagnation
- Cold stagnation
- Heat stagnation
Four main patterns for vomiting?
- Food (Milk) Stagnation
- Heat Accumulating in Stomach
- Spleen/Stomach Deficient Cold
- Liver Qi Affecting the Stomach
Note about leaking syndromes. Must be very careful as it can damage the yin! What are the main leaking syndromes?
- Bleeding (nose, menstruation)
- Cough, phlegm, nasal secretion excessive
- Diarrhea
- Drooling (Sp Xu sign)
- Ejaculation
- Sweating
- Urination profuse (esp. at night)
- Vomiting
Main effects of Rebellious Qi?
- Stomach Qi goes up
- Lung Qi function is affected, too much coughing
- Liver Heat, Liver overacts on Stomach
What formula for heat in the Stomach caused by Liver Heat?
Bai Hu Tang
Etiology (Pathogenesis) for vomiting?
- Fear or fright causes Qi to disperse and scatter, distorts Qi mechanism. (Remember the Shen is not stable in children because the heart is always in excess.)
- Food, cold or heat stagnation: Dampness. Heat. Malfunction of Stomach which does not like dry. Cold damages spleen which cannot moisten the stomach. Heat caused by Liver Qi Stagnation.
Differential diagnosis for vomiting.
- Abdominal pain
- Brain diseases
- Excessive breast milk
- Food stagnation
- Poisoning, dirty food
Helpful tips for syndrome differentiation for vomiting. Vomit characteristics of four patterns?
- Food stagnation: Smelly
- Stomach heat: Smelly and hot
- SP and ST Xu Cold: Clear
- LR Qi invades St: Yellow and bitter
Main treatment principle for vomiting?
Direct the Stomach Qi downward
Food/Milk Stagnation Sx, Tx, Formula
Sx:
- vomiting sour smelly (curdled milk)
- acid reflux
- bad breath
- colic
- constipation or diarrhea
- gas
- nausea
- no appetite
- tongue: thick sticky coat, yellow greasy
- pulse: slippery
Tx: Dissipate food stagnation
Formula: Bao He Wan
Bao He Wan (Citrus and Craetagus formula) ingredients and actions
- Shan Zha (Crataegi) - meat, fat, protein stagnation
- Shen Qu (Massa) - bread, starch stagnation
- Lai Fu Zi (Radish seed) - Descend Qi, reduce phlegm accumulation from stagnant grains
- Chen Pi (ripe Tangerine peel) - Regulate Qi, adjust MJ, dry damp, descend qi, transform phlegm
- Ban Xia (Pinellia) - Descend qi, transform phlegm, harmonize stomach
- Fu Ling (Poria) - Strengthen SP, drain damp, MJ
- Lian Qiao (Forsythia) - Clear heat due to stagnation (like a bomb!)
Overall action:
- Disperse food stagnation
- Harmonize Stomach
Stomach Heat Sx, Tx, Formula
Sx:
- Vomit frequent after eating, sour and foul smelling
- strong vomiting
- agitation
- constipation or foul stool
- dry lips
- heat vexation
- insomnia
- irritability
- thirst with desire to drink
- yellow urine
- tongue: yellow coat
- pulse: rapid
Tx: clear stomach heat
Formula: Huang Lian Wen Dan Tang
Huang Lian Wen Dan Tang
ingredients
functions
- Zhu Ru (Bamboo shavings) Transform phlegm heat
- Zhi Shi (immature bitter orange) Regulate Qi
- Ban Xia (Pinellia) Transform phlegm, stop vomit, descend Qi
- Chen Pi (Tangerine peel) Regulate Qi, Tonify Spleen
- Fu Ling (Poria) Drain damp, Tonify Spleen, Harmonize MJ
- Gan Cao
- Da Zao
- Sheng Jiang (fresh Ginger) Regulate GB and Stomach relationship
- Huang Lian (Coptis rhizome) Clear Heart heat, Dry damp, Calm shen
Overall functions:
* Regulate Qi
* Transform phlegm
* Clear GB
* Clear heat
* Harmonize Stomach
What other patterns can Huang Lian Wen Dan Tang be used for?
- Disharmony between GB and ST w/ phlegm-heat
- GB Damp-Heat Qi Stage
- GB Xu Heat
- Phlegm Fire Disturbs the Heart
Spleen and Stomach Empty Cold Sx, Tx, Formula
Sx:
* Clear vomit or vomit food with no smell
* Abdominal pain better with warmth
* Cold hands and feet
* Loose stool
* Nausea
* Prolonged development
* White complexion
* Tongue: pale
* Coat: thin, white, slippery
* Pulse: forceless or deep, thready
Tx: Warm MJ, Dissipate Cold
Formula: Ding Yu Li Zhong Tang
Ding Yu Li Zhong Tang
Clove and Evodia Decoction to Regulate Middle
ingredients and fx
- Gan Jiang (dried Ginger) Warm SP/ST, Eliminate cold
- Ren Shen (Ginseng) Reinforce Yang, Tonify Yuan Qi, harmonize MJ
- Bai Zhu (white atractylode) Strengthen SP, Dry damp
- Gan Cao
- Ding Xiang (Clove) Warm MJ, Expel cold, Descend Qi, Warm Kidney
- Wu Zhu Yu (Evodia) Warm MJ, Disperse cold, Descend Qi, Move Qi, Relieve stagnation
Overall fx:
- Warm MJ
- Dispel Cold
- Strengthen SP/ST
- Tonify Qi
Liver Qi Invading Stomach Sx, Tx, Formula
Sx:
- Vomit sour fluid
- Belching
- Emotional
- Restless sleep
- Rib and chest aching
- Tongue: red with slimy fur
- Pulse: wiry
Tx: Smooth Liver Qi
Formula: Jie Gan Jian
Jie Gan Jian ingredients and functions
- Chen Pi (Tangerine peel) Regulate Qi, Dry damp, Transform phlegm
- Ban Xia (Pinellia) Dry damp, transform phlegm, descend rebellious Qi
- Hou Po (Magnolia bark) Dispel damp, Movement of Qi MJ, Resolve stagnation
- Fu Ling (Poria) Drain damp, Promote urination, Harmonize MJ
- Zi Su Ye (Perilla leaf) Movement of SP/ST Qi
- Bai Shao (White Peony Root) Nourish blood, Calm Liver Yang and wind
- Sha Ren (Cardomom) Movement of Qi, aromatically transform damp, strengthen spleen, stop vomiting
- Sheng Jiang (raw ginger) Warm middle, Stop vomit
Overal fx:
- Smooth movement of Qi
- Harmonize MJ
- Transform damp
- Calm fetus
9 acupuncture points for vomiting
- CV10
- CV12
- CV13
- GV14
- ST36
- PC6
- LI4
- LR3
- GB34
