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The Office: Epigastric Pain

  • ACUTE:
    • Food Retention:
      • Pulse;
        • Rt Guan pulse: can be normal or slightly high or low.
        • Right Yang Wei Pulse: too hard or stiff
      • Herbs
        • Bao He Wan 100
    • Stomach Excess Cold:
      • Pulse:
        • Very thin tight pulse in Right Guan
        • Will likely have cold hands, elbows, and abdomen.
      • Herbs:
        • Fu Zi Li Zhong Tang 40
        • Huo Xiang Zheng Qi Tang 60
    • Stomach Damp Heat:
      • Pulse:
        • Right Guan deep /pounding
      • Herbs:
        • If more Dampness than Heat, then use:
          • Gan Lu Xiao Du Dan 70
          • Huang Lian Jie Du Tang 30
        • If more Heat than Dampness, then reverse the above dosages
    • Additions:
      • For abdominal pain, especially flank pain, add:
        • Yan Hu Suo 5 to 15
        • Chuan Lian Zi 5 to 15
      • For stomach pain use
        • Gan Cao 5 to 10
        • Bai Shao 5 to 10
      • For constipation add
        • Da Huang 5 to 15
        • Mang Xiao 5 to 15
  • CHRONIC:
    • Liver Invading Stomach:
      • Pulse:
        • Wiry in both Guans.
      • Herbs: Option 1 or 2
        • Option 1
          • Chai Hu Shu Gan Tang 70
          • Yan Hu Suo 15
          • Chuan Lian Zi 15
        • Option 2:
          • Hu Zhang 15
          • Huang Shui Qie 15
          • Cha Chi Huang 15
          • Xia Ku Cao 15
          • Jia Wei Xiao Yao San 20
          • Huang Lian Jie Du Tang 20
    • Stomach Qi Deficiency with Cold:
      • Pulse:
        • Kleenex pulse in right Guan
        • Usually the patient has cold hands, cold abdomen, and a cool LI 10/11
      • Herbs:
        • Fu Zi Li Zhong Wan 70
        • Huang Qi Jian Zhong Tang 30
    • Stomach Qi Deficiency with Stagnation:
      • Pulse:
        • Right Guan is slightly weak
        • Right Yang Wei pulse is thin and tight. Right guan is wiry
      • Herbs:
        • Xiang Sha Liu Jun Zi Tang 100
    • Stomach Dampness
      • Pulse:
        • Right Guan deep and soggy
      • Herbs:
        • Xiang Sha Ping Wei San 100
    • Stomach Yin Deficiency with Fire:
      • Pulse:
        • Right Guan is thin and above the middle depth
        • Other pulse positions are Yin Deficient also (i.e. higher than they should be and thin)
      • Signs and Symptoms:
        • Signs of Yin Deficiency
        • dry mouth
        • other signs of dryness
        • possible burning sensation in epigastrium
      • Herbs:
        • Mai Men Dong 15
        • Shi Hu 15
        • Sha Shen 15
        • Zhi Zi 10
        • Bai Shao 10
        • Chuan Lian Zi 10
        • Zhi Shi 10
        • Yan Hu Suo 10
        • Gan Cao 5
    • Blood Stagnation in Stomach with Dampness:
      • Pulse:
        • Right Guan is deep and blocked
      • Herbs:
        • Xiang Sha Ping Wei San 35
        • Dan Shen 15
        • Dang Gui 10
        • Yan Hu Suo 10
        • Chi Shao 10
        • Ru Xiang 3
        • Mo Yao 3
        • Bai Shao 15
    • Stomach Excess Heat
      • Pulse:
        • Right Guan is strong and pounding possibly at all 3 depths
      • Herbs:
        • Huang Lian Jie Du Tang 30
        • Zhu Ye Shi Gao Tang 30
        • Yu Nu Jian 20
        • He Zi 5
        • Wu Bei Zi 5
        • Tian Hua Fen 5
        • Bai Wei 5
      • If there is excess stomach acid with a Proximal Right of Left Styloid Pulse, then add:
        • Wa Leng Zi 10
        • Hai Piao Xiao 10
      • If there is not enough Stomach acid add:
        • Wu Mei 4
        • Shan Zha 10 to 15
      • If there is pain add:
        • Yan Hu Suo 10
        • Chuan Lian Zi 10
      • If there is bleeding add:
        • Ce Bai Ye 10 to 15
        • San Qi 10 to 15
      • If there is constipation:
        • Dry stool:
          • Ma Zi Ren Wan 25
        • Wet stool:
          • Da Huang 5-10
          • Mang Xiao 5-10
      • If belching:
        • Ban Xia 10
        • Sha Ren 5

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