Tympanites - Gu Zhang

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Contents 1 Definition 2 Causes 3 Pathological Mechanisms 4 Patterns 5 References 6 Articles 7 Books

Definition

A condition marked by distending and enlarged abdomen like a drum, wilted complexion and exposed blood vessels.

Causes

• Emotions Damage: Liver and Spleen
• Alcohol and Rich Food: Damp Heat and Spleen
• Weak Spleen with Food Retention: food and Dampness
• Masses and Gatherings: Liver and Spleen
• Protracted illnesses: Jaundice - Huang Dan, Diarrhea - Xie Xie, Dysentery - Li Ji and Malaria - Nue Ji.
• Water Toxin (Shui Du): schistosomiasis (caused by schistosome).
• Wind Cold Envelops Internal Heat: Neijing – disorders characterised by abdominal fullness and distension are related to heat
• Trauma

Pathological Mechanisms

The main Zang Fu organs are the Liver, the Spleen and the Kidney.

The main pathological products are Qi Stagnation, Blood Stasis, Dampness and water accumulation.

The main courses for pathological changes are:

From the Liver to the Spleen

• Emotional damage – Liver Qi Stagnation – Spleen invaded – Water and Dampness accumulation – Gu Zhang

From the Spleen to the Liver

• Improper Diet alcohol and rich food) – Spleen injured by Damp Heat – Liver
• Cold evil or cold and retained food – Spleen Yang injured by Cold Damp – Liver

From the Liver to the Kidney

• Liver Qi Stagnation – Heat – Yin Deficiency – Kidney Yin Deficiency
• Liver Blood Deficiency – kidney essence deficiency – Kidney Yin Deficiency

From Spleen to Kidney

• Spleen Qi Deficiency – Post Heaven Qi fails to replenish Pre Heaven Qi – Kidney Yang Deficiency
• Spleen Qi Deficiency – Liver Blood Deficiency – kidney essence deficiency – Kidney Yin Deficiency

Patterns

Qi Stagnation and Dampness

• Symptoms: Abdomen: distending and enlarged, not too hard when palpated. Distending and painful hypochondria, eat little, bloated easily, eructation not smoothly and scanty urine.
• Tongue: White and greasy coating
• Pulse: Wiry
• Treatment strategy: Soothe the liver and regulate qi, drain the dampness and dissipate ascites
• Formula: Chai Hu Shu Gan San and We Ling Tang
• Acupoints:

Cold Damp suppresses the Spleen

• Symptoms: Abdomen: distending and enlarged, when palpated it feels like water in a sac. Distending feeling in epigastrium and abdomen, eased by warmth and heat, face and leg oedema, tiredness and lassitude, aversion to cold, scanty urine and loose feces.
• Tongue:
• Pulse:
• Treatment strategy: Warm the middle and invigorate spleen, activate qi and drain the water
• Formula: Shi Pi Yin
• Acupoints:

Damp Heat Accumulation

• Symptoms: Abdomen: distending and enlarged, when palpated it feels hard and hot and the skin is extremely stretched. Vexation, bitter mouth, thirsty but drink little, with or without jaundice, dark and scanty urine, constipation or loose and sticky feces.
• Tongue: Red tongue with yellow and greasy or grey and black coating
• Pulse: Wiry and Rapid
• Treatment strategy: Clear the heat, drain the dampness and purge the turbid fluid
• Formula: Zhong Man Fen Xiao Wan
• Acupoints:

Liver and Spleen Blood Stasis

• Symptoms: Abdomen: distending and enlarged, with exposed blood vessels. Stabbing pain in hypochondria and abdomen, spider naevi on face, neck, chest or upper arm, palmar erythema, brown and purple lips, thirsty but even unable to swallow water and black feces.
• Tongue: Purple and ecchymosed tongue
• Pulse: Thready and Uneven or Empty
• Treatment strategy: Promote blood movement to remove stasis, activate qi and drain the water
• Formula: Tiao Ying Yin
• Acupoints:

Spleen Yang Deficiency and Kidney Yang Deficiency

• Symptoms: Abdomen: distending and enlarged, better in morning and worse in evening. Wilted complexion, poor appetite, stuffy epigastrium, lack of shen, aversion to cold, cold limbs, oedema in legs, short and scanty urine and palpitations.
• Tongue: Pale purple and swelling tongue
• Pulse: Deep, Wiry and Weak
• Treatment strategy: Warm to tonify spleen and kidney, activate qi and drain the water
• Formula: Fu Zi Li Zhong Tang and Wu Ling San
• Acupoints:

Liver Yin Deficiency and Kidney Yin Deficiency

• Symptoms: Abdomen: distending and enlarged, hard and full or even with exposed blood vessels. Black-ish complexion as if smoked, severe weight loss, cachectic, purple lips, dry mouth, vexation, nose and gum bleeding, dark and scanty urine.
• Tongue: Red, crimson and dry tongue
• Pulse: Thready, Wiry and Rapid
• Treatment strategy: Nourish liver and kidney, cool blood and remove stasis
• Formula: Yi Guan Jian and Ge Xia Zhu Yu Tang
• Acupoints:

References

Articles

Books