Abstract, this paper emphasizes the regulation of liver Qi in the treatment of stomach disorders and discusses recipes for the eight types of stomach problems.

 

Common knowledge
According to Traditional Chinese Medical theory, the stomach is the sea of food and water. When uninhibited, there is a natural free flow and the stomach is full of Qi and blood. However, in an unhealthy state with stagnation of Qi and blood, a pathological condition may easily occur due to various pathogenic factors: heat or cold attacking the body, irregular food intake, emotional disturbances and/or disorders originating in the stomach or spleen itself. The liver function is to maintain the Qi equilibrium and to store blood. Hence, the liver has a close relationship with Qi and blood circulation and is partially responsible when stagnation of Qi and blood occurs. Furthermore, liver Qi attacking the stomach is a common cause of stomach disorders (wood overacting earth according to the theory of five elements). Thus, regulation of the liver Qi is a very important aspect in the treatment of stomach problems. It has also been proven in clinical practice that some stomach syndromes are difficult to cure if no herbs are included in the prescription to disperse and rectify the liver Qi.

 

Clinical application
Herbs with a light, clearing nature that are effective to disperse and regulate unbalanced Qi of both the liver and stomach are usually selected, like: Chai Hu, Xiang Fu, Fuo Shou, Mu Xiang, Zhi Ke, and Chen Pi, for example. The common formulas are Si Ni San, Chai Hu Shu Gan San, and Jing Ling Zi San.

 

Stomach disorders can be classified in the 8 following types with different syndromes:

 

Deficiency of stomach and spleen Qi Manifestations: chronic and dull stomach pain which is aggravated by hunger and alleviated after a meal, poor appetite, loose stool, dizziness, lassitude, a white, thin, sticky tongue coating with a wiry and slow pulse. Recipe: Dang Shen, Fu Ling, Bai Zhu(burnt), honey fried Gan Cao, Mu Xiang, Chen Pi, fried Bian Dou, Gu Ya(burnt), Mai Ya, Mei Gui Hua, Su Geng, Fuo Shou and Bai Shao.

 

Supplementation:

1. For watery regurgitation add Dai Zhe Shi and Xuan Fu Hua to reverse the adverse rising Qi of the liver and stomach.
2. Abdominal pain, borborygmus and loose stool, which are indications of liver Qi attacking the spleen, maybe treated with Tong Xie Yao Fang which is Fang Feng (roasted) combined with the above listed herbs. To improve diuretion and to dry the stool, Che Qian Cao may also be added.

Accumulation of cold pathogenic factors in the stomach and liver
Manifestations: sudden stomach pain which is relieved by warmth and pressure, no signs of thirst, preference for warm food, a thin white tongue coating and a wiry tight pulse. Recipe Wu Zhu Yu, dry-fried Jing Jiang , Dang Shen, honey-fried Gan Cao, Bai Shao prepared Xiang Fu, Suo Luo Zi,Mei Gui Hua,Mu Xiang and Fuo Shou.

 

Accumulation of heat in the stomach and liver
Manifestations: stomach distention and pain mixed with a burning sensation, thirst, a bitter taste in the mouth, rotting, swelling, or pain of the gums, mouth and/or tongue, dry stool sometimes with constipation, lassitude, a thin yellow tongue coating ,and rapid pulse. Recipe: Huang Lian, Wu Zhu Yu, Hong Teng, Pu Gong Ying, Lu Mei Hua, Chuan Lian Zi, Xiang Fu or Ba Yue Za.

 

Supplementation:

1. Hyperchlorhydria:Wu Zei Gu and Zhe Bei Mu added to control stomach acidity.
2. Hypochlorhydria: Wu Mei can be added to promote stomach acidity
3. Thirst, a red dry tongue with no coating and thready pulse can be relieved by using Bei Sha Shen,Mai Dong, Shi Hu and Tian Hua Fen to nourish the Yin and strengthen the stomach fluids.
4. Dry stool or constipation: utilization of Huo Ma Ren and honey-fried Gua Lou Ren to moisten the stool.

 

Food stagnation in stomach
Manifestation: Stomach distention and pain, lack of appetite, belching with fetid odour, sometimes vomiting of undigested food, loose stool but difficult to discharge, greasy white or yellow tongue coating and a wiry or slippery pulse.
Recipe: Mu Xiang, Bai Shao, raw Gan Cao,Hou Pu, burned Bai Zhu, Fu Ling, Chen Pi, Zhi Ke, burned Gu Ya, burned Mai Ya, and Ji Nei Jing. Supplementation: when stagnant food and the accumulated dampness rises to the head, add Huang Qin and Huang Lian to resolve the dampness and to clear the heat.

 

Disharmony between the gall bladder and stomach
Manifestation: right hyperchondriac pain radiating to the stomach or right shoulder and back ,belching ,bitter taste in the mouth, loss of appetite, a thin yellow sticky tongue coating and wiry pulse. Usually the patient has a history of cholecystitis and cholelithiasis. Recipe: Chai Hu, fried Zhi Ke, Bai Shao, raw Gan Cao, Chuan Lian Zi, JI Nei Jing, Jing Qian Cao, Yu Jing, Ren Dong Teng, Huang Qing and prepared Da Huang.

 

Disharmony between the liver and stomach caused by deficiency of liver blood
Manifestation: stomach pain, congested chest, belching, loss of appetite, dizziness, lassitude, poor sleep,palpitations, pale complexion, pale tongue, pale eyelids and nails with a thready pulse.
Recipe:Dang Gui ,Bai Shao, honey fried Gan Cao, Fu Ling, Chai Hu,Hong Zao, Huai Xiao Mai,Gou Ji Zi, Fuo Shou,Mei Gui Hua, Lu Mei Hua and Mai Ya (burnt)
Supplementation: when headache, head distention, nausea or irritability are present, they signify Yin deficiency and hyperactivity of the Yang, raw Di Huang, Mai Dong, Shi Hu, Gou Teng, Shi Jue Ming, Dai Zhe Shi and Bai Ji Li are used to support the Yin and to eliminate excess Yang.

 

Phlegm stagnation in the stomach and lung
Manifestation: sensation of fullness and/or pain in the stomach, excess sputum, congested chest, nausea ,lack of appetite, white and greasy tongue coating with a slippery pulse. Recipe: Xing Ren, Xuan Fu Hua, Zhu Ru, Dai Zhe Shi, fried Zhi Ke, Hou Pu, Su Gen and Mei Gui Hua.

 

Blood stasis causing obstruction in the stomach
Manifestation: stabbing and fixed stomach pain, purplish tongue with a wiry and choppy pulse. Recipe: Dang Gui, Chi Shao, Bai Shao, honey fried Gan Cao, Mei Gui Hua,Yan Hu Suo, Ju Luo,Yu Jing, Xuan Fu Hua,Nu Zhen Zi and Han Lian Cao.
Supplementation: when stomach pain is followed by hematemesis and bloody stool, add astringent herbs such as Han Lian Cao and Xian He Cao, Ou Jie and San Qi to stop bleeding and to avoid the side effect of blood stasis, add Dang Shen plus Huang Qi to tonify the spleen Qi in order to regulate the blood circulation.

 

Comment
Since the regulation of liver and stomach Qi is so important in the treatment of stomach disorders, attention should be paid to select those herbs whose nature is light and clear with limitation on the quantity utilized. Because Qi stagnation fluctuates easily, herbs of a slightly exciting nature and that are not heavy or sticky, are the best to promote the free-flow of Qi. Furthermore, since both the liver and stomach are strong organs while the spleen is sensitive, utilization of herbs with a dry nature can easily damage the liver and stomach, while herbs which are moist can hurt the spleen. The most important factor to be remembered in the treatment of stomach disorders is that balance restoration is the overall objective.