Professional treatment of stomach illnesses

To treat stomach illnesses, a professional herbal doctor will apply one of the following commonly used methods : (1) tonifying, (2) eliminating, (3) warming, (4) clearing, (5) ascending, (6) descending, (7) transforming, and (8) harmonizing.

As practitioners of life cultivation, we always rely on maintenance methods that we have learned previously to take good care of our stomach and spleen. The regular maintenance of stomach and spleen will include (1) eating three meals a day regularly, (2) correcting the bad habit of overeating, (3) eating warm food and drinks, (4) balancing work and rest, (5) insisting on doing stretching exercises, (6) keeping a relaxed and peaceful emotional mind, and (7) others.

However, when regular maintenance is not sufficient to keep our stomach and spleen in good health, we may have to seek professional help. An understanding of how the professional herbal doctor treats our stomach illnesses will help us to cooperate with the doctor to carefully treat our illnesses. Do not try to do the following treatment methods without professional help. These are here merely for illustrations and reference.

01 Application of the tonifying method

Tonifying method refers to the method of nourishing the human body’s qi and blood with tonic drugs, reducing the deficiency of yin and yang, improving the weak state, and treating various deficiency syndromes.

Deficiency syndromes are divided into qi deficiency, blood deficiency, yin deficiency, and yang deficiency, and the tonic methods are correspondingly divided into four categories: (1) tonifying qi, (2) tonifying blood, (3) tonifying yin, and (4) tonifying yang.

According to the acuteness of the illness and the degree of physical weakness, it can be divided into acute tonic and slow tonic.

Clinically, tonifying methods can be used to treat various spleen and stomach illnesses with the main symptoms being spleen and stomach qi deficiency, yang deficiency and yin deficiency.

For example, chronic gastritis is characterized by dull pain or abdominal distension in the epigastric cavity, preference for warmth or massage, loss of appetite, and mental fatigue.

This is the spleen-stomach qi deficiency syndrome (including spleen-stomach deficiency-coldness syndrome) with main symptoms such as diarrhea and loose stools is treated with codonopsis pilosula 党参 and fried atractylodes macrocephala 白术 to invigorate qi and invigorate the spleen.

If the patients, at the same time, have excess dampness in the body, they will be treated with Chinese yam 山药 and white lentils 白扁豆 to invigorate the spleen and eliminate dampness. If the patients also suffer from qi stagnation, they will be treated with atractylodes macrocephala 白术 and white peony root 白芍 to regulate the liver and spleen.

In severe cases of qi deficiency, there is a syndrome of spleen deficiency and qi depression with the main symptoms of abdominal distension, chronic diarrhea and dysentery, and visceral sagging. The patients will be treated with astragalus 黄芪 and cimicifuga 升麻 to invigorate qi.

For patients with yang deficiency, they will be treated with cassia twigs 桂枝 and roasted licorice 灸甘草 to transform yang. For patients with stomach yin deficiency with burning pain in the epigastric cavity and lack of appetite, they will be treated with white peony root 白芍, roasted licorice 灸甘草, or schisandra 五味子 and heterophylla 太子参 which are sour and sweet to transform yin.

For patients with gastroesophageal reflux illness with acid reflux or vomiting of clear water and belching as the main symptoms of the spleen-deficiency and qi-reversal syndrome, they will be treated with codonopsis pilosula 党参 and fried atractylodes macrocephala 炒白芍 to invigorate qi and strengthen the spleen, and with hematite 代赭石 and fructus aurantii 枳壳 to lower qi.

For patients with constipation with symptoms of stools not dry and hard, although there is a desire to defecate, it is difficult to defecate, and sweating and shortness of breath due to exertion. the main syndrome is deficiency of the lung and spleen, and the treatment is to use radix astragalus 炙黄芪 and raw atractylodes rhizome 生白术 to invigorate the spleen.

For patients with constipation caused by deficiency of spleen and kidney yang, they can be treated with cistanche herba 肉苁蓉 and achyranthes bidentata 牛膝 to warm the kidneys and act as laxative, plus the use of cimicifuga 升麻 and fructus aurantii 枳壳 to aid in the rise and fall.

For patients with constipation with symptoms of dry and hard stool like sheep manure, it is a syndrome of insufficient body fluid (saliva) and deficient blood. They can be treated with angelica 当归 and rehmannia 生地黄 to breed blood in order to nourish the intestines, plus scrophulariaceae 玄参 and ophiopogon japonicus 麦冬 to nourish yin and clear away heat.

02 Application of the elimination method

Elimination method refers to the treatment method to dissipate the evils accumulated in qi, blood, phlegm, food, water, insects, etc. The therapeutic effect is mainly to dissipate the evils of viscera, meridians and muscles.

Professor Zhang Shengsheng believes that chronic gastritis is mainly manifested by epigastric fullness or pain and it is the syndrome of liver depression and qi stagnation. In that case, citron 香橼 and costus root 木香 are used to regulate qi and neutralize the middle-section, soothe the liver and relieve depression. With added stomach indigestion, use hawthorn 山楂, maltose 麦芽 and shenque 神曲 to aid in digestion, and use shenque 神曲 and forsythia 连翘 to reduce food accumulation.

Professor Zhang Shengsheng believes that chronic atrophic gastritis, whether it is due to dietary factors or physical factors, can lead to abnormal spleen and stomach transportation and transformation. After foods are eaten, they cannot be metabolized to produce nutrients, but instead become pathological phlegm and turn into dampness. Therefore, the treatment is to clear away heat and detoxify with five leaf akebia fruit 八月札, scutellaria barbata 半枝莲，honeycomb 蜂房, arrowhead mushroom 山慈菇, and hedyotis diffusa白花蛇舌草.

Chronic atrophic gastritis persists for a long time without healing.

“At the beginning, qi stagnates in the meridian, and after a long time, blood hurts the meridian.”

Therefore, it develops into the gastric collateral stasis syndrome which is mainly characterized by fullness in the epigastric cavity or pain with fixed location, and dark red tongue. Use puhuang 蒲黄 and wulingzhi 五灵脂 to promote blood circulation and relieve pain, and panax notoginseng powder 三七粉 and yuanhu 元胡 to nourish blood, promote blood circulation and relieve pain.

For severe abdominal pain, use scorpion 全蝎 and silkworm 僵蚕to promote blood circulation and dredge meridians to relieve pain.

For gastroesophageal reflux illness, retrosternal burning pain or tingling pain as the main symptom, blood stasis syndrome, then peach kernels 桃仁 and safflower 红花 are used to promote blood circulation and remove stasis.

Gastroesophageal reflux illness, throat discomfort such as phlegm stalks, chest discomfort as the main symptoms of qi stagnation and phlegm obstruction syndrome, treat with pinellia半夏，magnolia officinalis 厚朴 for dissipating phlegm and stagnation, reducing adverse reactions and harmonizing stomach. Use inula 旋覆花 and ocher 代赭石 for reducing phlegm and stopping vomiting.

03 Application of the warming method

The method of warming means warming and tonifying the middle section. It is mainly suitable for symptoms such as anorexia and abdominal distension due to weakness or coldness in the middle-section, loss of yang qi in the transportation, or cold pain in the abdomen, vomiting of clear water, and loose stools.

Professor Zhang Shengsheng emphasized that cold evil is an important pathogenic factor of spleen and stomach illnesses, and that out of ten stomach illnesses nine are related to coldness.

For people who have been ill for a long time, the weakness of the spleen and stomach is the root of the pathogenesis, and the invasion and attack of cold pathogens are mostly the signs of the illness. With insufficient yang-qi in the middle, the spleen is not able to move nutrients well. Now inside the body, we cannot transport and transform the dampness of water and grain, and outside the body, we are susceptible to seasonal dampness, so the cold and dampness will grow inward, and the middle-section of the body will be stagnant, and deficiency, dampness, and coldness will both appear.

Dampness is a yin-evil, and if it gets warm, it will transform. The spleen is a damp earth, and if it gets yang, it will move. The yang-warming medicine is pungent and warm in nature, which can activate the spleen yang, wake up the spleen and dry the dampness, making the yang qi of the middle rise. Thus the spleen essence will be dispersed, and the essence of water and grain will be elevated, and the water and dampness will be dispelled.

Therefore, when Professor Zhang Shengsheng treats chronic illnesses of the spleen and stomach, he often uses earth-cultivation to build the middle, warming and transporting the middle yang as the main-treatment.

For example, in the treatment of irritable bowel syndrome with diarrhea due to abdominal pain in the morning, cold pain in the abdomen, and relief of warm pain, he uses dry ginger 干姜 and fried Atractylodes macrocephala 炒白术 to warm the middle and invigorate the spleen, and he uses aconite 附子 and cinnamon 肉桂 to warm and nourish fire.

For people with kidney deficiency, add nutmeg 肉豆蔻 and chishizhi 赤石脂 to astringe the intestines to relieve diarrhea.

For people with spleen deficiency and dampness, add Poria cocos 茯苓 and yam 山药 to reduce infiltration and dampness to relieve diarrhea.

For people with chronic gastritis and dyspepsia with dull pain in the epigastric cavity, preference for warmth or massage, and spleen and stomach deficiency and cold syndrome, the mild medicines of ginseng 人参, radix astragalus 黄芪, angelica 当归, and atractylodes rhizome 白术 are used to replenish qi and invigorate the spleen.

For people who also vomit, use evodia rutaecarpa 吴茱萸 and ginger 生姜 to warm the middle and lower the adverse flow to stop vomiting.

For people who are also hiccups, use cloves 丁香 and persimmons 柿蒂 to reduce the hiccups and stop the hiccups.

For people with adverse qi, use perilla stalks 紫苏梗 and longan 荜茇 to warm the middle and regulate qi.

Warming and nourishing at the same time may be compatible with each other or not. With deficiency and coldness together, then use it. If coldness exists without deficiency, then only the warming medicine is used to control it.

04 Application of the clearing method

It is also known as the heat-clearing method. It refers to the method of treating interior heat syndrome with cold and cool drugs, which has the functions of clearing away heat and purging fire, cooling blood and detoxifying.

Professor Zhang Shengsheng believes that due to overeating fat, sweet and greasy foods, lying down and moving less, or working under great pressure, people can easily suffer from stagnation of stomach qi turning into heat later.

Clinically, clearing methods are often used to treat spleen and stomach illnesses.

It is hot and sour. Professor Zhang Shengsheng regards heat-clearing as the primary treatment for gastroesophageal reflux illness. Forsythia 连翘, dandelion 蒲公英, skullcap 黄芩 coptis黄连, Scutellaria barbata 半枝莲 , and wood butterfly 木蝴蝶 are often used in clinical practice to clear away heat and detoxify fire.

If it is both damp and hot, add gentian grass 龙胆草, corn silk 玉米须, liuyisan 六一散, wax gourd peel 冬瓜皮, magnolia officinalis 厚朴, huoxiang 藿香, peilan 佩兰, etc. to clear away heat and eliminate dampness or aromatize dampness.

For example, in the treatment of erosive gastritis with stagnant heat in the liver and stomach, scutellaria baicalensis 黄芩 and gardenia 栀子 are used to clear away stomach heat, paeonol 丹皮 clears away heat and cools blood, and gentian grass 龙胆草clears away liver and gallbladder fire.

For chronic enteritis with damp-heat syndrome in the stomach and intestines, use simiao decoction 四妙汤 to clear the dampness and heat in the lower body, and use shaoyao decoction 芍药汤 flexibly.

As proposed by Liu Wansu: “promoting blood circulation will heal feces and pus, and regulating qi will improve constipation.”

05 Application of the ascending method

Ascension refers to the method of tending to rise and sinking.

Professor Zhang Shengsheng followed the treatment principles of “reinforcing the middle and replenishing Qi”, “reinforcing clearness and lowering turbidity”, “raising yang and benefiting the stomach” in regulating the spleen and stomach, and especially emphasized the importance of “rising yang.”

Professor Zhang Shengsheng believes that the root of chronic gastritis lies in the weakness of the spleen and stomach and the imbalance of ups and downs, and the illness is marked by the evil of dampness, heat and coldness.

The root cause of the illness should be treated. The treatment should be to promote yang and benefit the stomach, promote clearness and reduce turbidity. Notopterygium 羌活 and Bupleurum 柴胡 are used to promote yang qi. Coptidis 黄连 and Scutellaria 黄芩 are used to help the above medicine in promoting yang but to reduce turbidity. Use pinellia 半夏 and dried ginger 干姜 to warm the stomach, and for the effect of reducing bitterness. Use codonopsis pilosula 党参, atractylodes macrocephala 白术 , and poria cocos 茯苓 to help lung qi and nourish the spleen and stomach.

For people with obvious qi deficiency, add astragalus 黄芪. For those with fullness and pain, use white peony root 白芍.

The pathogenesis of chronic enteritis with long-term diarrhea is mainly due to spleen deficiency and excessive dampness, and imbalance of ascending and descending, causing yang-qi to sink into the ground.

Although the pathogenesis of chronic diarrhea still has factors such as liver evil, damp-heat resistance, and kidney-yang deficiency, the most common is spleen deficiency and dampness. Use bupleurum 柴胡 , Nepeta 荆芥, fangfeng 防风, notopterygium 羌活 to promote yang, dispel wind, and stop diarrhea. Coptis chinensis 黄连 and Scutellaria baicalensis 黄芩help ascending medicine to reduce turbidity and dry dampness.

06 Application of the descending method

Descending refers to the method of moistening the lower section and going against the ascent.

Professor Zhang Shengsheng often treats spleen and stomach illness by lowering qi and harmonizing the stomach to treat spleen and stomach illnesses with stomach qi upside down syndrome. Commonly used medicines include inula 旋覆花, ocher 代赭石, pinellia 半夏, ginger 生姜, bamboo 竹茹, berberine黄连, clove 丁香, persimmon 柿蒂. Among them, inula 旋覆花 and ocher 代赭石 can calm the liver, ginger 生姜 and pinellia 半夏 tend to reduce phlegm, bamboo 竹茹 and berberine 黄连 can also clear away heat, and clove 丁香 and persimmon 柿蒂 are often used to stop hiccups.

Stomach-qi upward reversal syndrome is further classified into coldness and heat, and into deficiency and excess.

For cold syndrome, it is suitable to warm the middle and dispel coldness, then dried ginger 干姜 and cinnamon 肉桂 can be added. For heat syndrome, it is suitable to clear heat and harmonize the stomach, with reed rhizome 芦根 and coriander root 茅根. Deficiency syndrome should invigorate the spleen and qi, and combine with Codonopsis pilosula 党参 and Poria cocos 茯苓. Excess syndrome should improve flow of qi and open up stagnation, and Magnolia officinalis 厚朴 and Amomum japonicus 砂仁 are commonly used.

The method of descending qi and harmonizing the stomach is sometimes combined with medicines for suppressing and descending the lung qi. Because the lungs govern the qi of the whole body, if the lung qi are not suppressed and descended, the stomach qi will not be harmonious.

Commonly used medicines include perilla leaves 苏叶 and loquat leaves 枇杷叶. Perilla leaves warms the exterior, dispels coldness, relieves vomiting, and enters the lung and stomach meridian.

If patients suffer from wind-cold from outside and damp stagnation inside, perilla leaves are compatible with Huoxiang 藿香, Angelica dahurica 白芷 and tangerine peel, and the formula is known as Huoxiangzhengqi Powder 藿香正气散.

For symptoms such as damp and hot vomiting, yellow and greasy tongue coating, slippery and rapid pulse, Xue Shengbai’s prescription for Damp-Heat Diseases is very effective. It uses small doses of perilla leaves 苏叶 and Coptis chinensis 黄连 together, and good results are obtained every time. Loquat leaves 枇杷叶 are bitter and slightly cold and it soothes the lungs and resolves phlegm, clears the lungs and harmonizes the stomach.

If the stomach qi is reversed and belongs to heat, the above prescription is combined with reed rhizome 芦根 and courgette root 茅根. One may also use the orange peel bamboo soup 橘皮竹茹汤 recorded in the Golden Chamber. Reed rhizome 芦根 and courgette root 茅根 can clear the heat in the lungs and stomach, and can also produce body fluid and quench thirst. It is used for deficiency heat syndrome caused by prolonged illness, vomiting, and hiccups.

Elderly people with habitual constipation often use Jichuan decoction 济川煎.

The usual drugs are cistanche 肉苁蓉, angelica 当归, alisma 泽泻, achyranthes 牛膝, aurantium 枳壳 which are moisturizer and helping with descending.

Add cimicifuga 升麻 to it, then cimicifuga is combined with achyranthes bidentata 牛膝, one up and one down, so that the clear yang can be raised, and the turbid yin will be lowered automatically.

07 Application of the removing method

The removing method includes removing dampness, removing phlegm, and removing blood stasis.

Professor Zhang Shengsheng believes that many recurrent spleen and stomach illnesses are all related to phlegm dampness, and the generation of phlegm dampness is most closely related to the spleen. In the formation of phlegm dampness, the strength of spleen-earth plays an extremely important role, as the saying goes, “the spleen is the source of phlegm.”

Professor Zhang Shengsheng believes that the spleen and stomach are located in the middle-section, and they are the hub for the movement of qi. At the same time, the stomach is the big brother of the twelve meridians. It is an organ with a lot of qi and blood.

The initial illness of the spleen and stomach can affect the ups and downs of the spleen and stomach qi movement. If the qi stagnation is bad enough, the qi flow will stagnate, resulting in phlegm and blood stasis. The state of an illness is lingering with the passing of time, and pathogenic energy is restrained for a long time, and both qi and blood are injured, which can lead to blood stasis and phlegm, and block the meridians.

Professor Zhang Shengsheng paid special attention to removing blood stasis and expelling phlegm when treating chronic refractory spleen and stomach illnesses.

The clinical method of removing blood stasis and promoting blood circulation mostly uses the following methods:

01 Nourishing and activating blood method: choose to use angelica 当归, paeonol 丹皮, salvia 丹参, rehmannia root 生地黄, red peony root 赤芍, millet root 鸡血藤, etc., which have the effect of nourishing blood and blood vessels.

02 Promoting blood circulation and removing blood stasis method: choose to use chuanxiong 川弓, puhuang 蒲黄, safflower 红花, wulingzhi 五灵脂, turmeric 郁金, notoginseng 三七, motherwort 益母草, eupatorium 泽兰, sumac 苏木, corydalis 延胡索, frankincense 乳香, myrrh 没药, etc. Function: once blood stasis is gone, new blood will be born spontaneously.

03 Searching and dredging meridians method: mostly use insect medicines such as silkworm 僵蚕, scorpion 全蝎, earthworm 地龙, white snake 白花蛇, etc., go deep into the tunnel, search and eliminate evil, and attack and remove phlegm and blood stasis in chronic knots, so as to dredge the meridian, reach the collaterals and clear the qi and blood.

However most insect medicines are toxic to a certain extent, and they are suspected of destroying qi, consuming blood and hurting yin. The dosage should be light, and it should not be taken for a long time.

For resolving phlegm and turbidity, pinellia 半夏 , aracea 天南星, chuan fritillaria 川贝母, zhe fritillaria 浙贝母, gualou 瓜蒌 and other medicines are often used. These medicines have the effects of drying dampness, clearing away heat and resolving phlegm.

Blood stasis and phlegm coagulation are all related to qi stagnation. Professor Zhang Shengsheng attaches great importance to regulating qi while eliminating phlegm and blood stasis. When qi moves, gold distributes, and when qi moves, blood flows.

Smoothing qi not only includes nourishing qi to strengthen the foundation, strengthening the body to eliminate phlegm and blood stasis, but also regulates qi to help fluid and blood circulation. First of all, it is necessary to distinguish the deficiency and excess of qi. People with qi deficiency can add qi-invigorating medicines such as astragalus root 生黄芪 , codonopsis pilosula党参 , and atractylodes macrocephala 白术, which can not only promote the circulation of body fluid and blood, activate phlegm and blood stasis, but also achieve the purpose of eliminating phlegm and blood stasis without harming the body.

At the same time, it can be supplemented with cyperus cyperi 香附 , woody fragrance 木香, amomum amomum 砂仁, sugeng 苏梗, and bergamot 佛手 for promoting qi, so that the qi movement can be smooth and the body fluid and blood can run smoothly. In this way, blood stasis is dispelled and collaterals are dredged, and qi and blood are harmonized.

08 Application of the harmonizing method

Harmonizing is a method of treatment aimed at getting rid of pathogenic factors through reconciliation. The method of harmonizing is suitable for illnesses with disharmony of qi and blood in viscera, or mixed cold and heat, or mixed deficiency and excess. Therefore, all evils that cause illnesses lurking in shaoyang or muyuan, or liver-spleen disharmony, intestinal cold and stomach-heat, qi-blood disorders, and ying-qi and wei-qi disharmony can all be cured by this method.

Regardless of exogenous pathogenic factors or internal injuries, whether the spleen and stomach are naturally affected or affected by other viscera, they can lead to abnormal physiological functions of the spleen and stomach, and the common pathological manifestations include weakness of the spleen and stomach, stagnation of spleen and stomach qi, disharmony between the spleen and the stomach, heat in the stomach and cold in the spleen, damp heat in the spleen and stomach, and gallbladder illness, stomach stagnation and heat, ans illnesses such as liver-qi violating the stomach.

Due to its special physiological characteristics and pathogenic characteristics, the treatment of spleen and stomach is based on the principle of harmonizing the spleen and stomach.

Professor Zhang Shengsheng’s commonly used methods for treating spleen and stomach illnesses include

harmonize the spleen and stomach using zhizhu decoction 枳术汤
harmonize the liver and stomach using sini powder 四逆散
harmonize the liver and spleen using danggui shaoyao powder 当归芍药散
harmonize gallbladder and stomach using dachaihu soup 大柴胡汤
harmonize stomach and intestines using Banxia Xiexin Decoction 半夏泻心汤
harmonize shaoyang meridian using xiaochaihu soup 小柴胡汤

Its application rules are: combined use of coldness and heat; combined use of lifting and lowering; combined use of strengthening the body and eliminating pathogenic factors; solving both the inside and outside evil factors.

We repeat our warnings here. Do not try to use the above-mentioned methods to treat your stomach and spleen illnesses. You must seek professional help. You can see that the appropriate herbal medicines are limited, but the ways the professional doctors use the herbs vary from syndromes to syndromes. In addition, the patients have different body constitution, so the variations are more varied than presented here.

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