Vomiting - Ou Tu
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Definition
A condition of forcible expulsion of the contents from the stomach through the mouth due to rebellious uprising of the stomach qi.
Causes and Pathological Mechanisms
Four main causes: exogenous evils, improper diets, abnormal emotions and spleen and stomach deficiencies. One main mechanism: Stomach Qi Rebellion
- Wind, Cold, Summer Heat, Dampness and pestilence – cold vomit and hot vomit
- Overeating: eating spree, too much cold and raw food, too much spicy, pungent and rich food, unhygienic food, alcoholism –undigested food retained in stomach and causes stomach qi adverse movement
- Bad eating habit impairs the Spleen and Stomach: dysfunction in transport and transformation leads to Phlegm and Rheum formation and accumulation in stomach.
Abnormal Emotions
- Anger impairs the Liver: Liver Qi Stagnation invades the Stomach and causes Stomach Qi Rebellion
- Worry and pensiveness impairs the Spleen: spleen fails to transport and food fails to be digested. Stomach qi fails to descend and moves in opposite direction
Spleen and Stomach Deficiencies
- Weak stomach after major illness or Constitution weak spleen and stomach or overwork consumes middle qi. Transformation failure leads to cold and turbid blockages in the Middle Jiao.
- Protracted vomiting or febrile diseases impair stomach yin. Stomach loses nourishment and stomach qi fails to descend.
Patterns
Food Retention
- Symptoms: Vomit: rotten food serious sour and foul smell. Stuffy epigastrium and abdomen, eructation with gas, dislike food, loose feces or constipation.
- Tongue: Thick and greasy coating
- Pulse: Slippery and Solid
- Treatment strategy: Promote digestion and regulate stomach to lower adverse qi
- Formula: Bao He Wan
- Acupoints:
Obstruction of Phlegm and Rheum
- Symptoms: Vomit: phlegm, saliva and clear water. Stuffy epigastrium and no appetite, dizziness and palpitation.
- Tongue: White and greasy coating
- Pulse: Slippery
- Treatment strategy: Warm the middle to resolve phlegm and rheum, regulate stomach qi and lower rebellious qi
- Formula: Xiao Ban Xiao
- Acupoints:
- Symptoms: Vomit: vomit with acid regurgitation and frequent eructation with gas. Chest and hypochondriac distending pain.
- Tongue: Red edges with thin yellow coating
- Pulse: Wiry
- Treatment strategy: Regulate and lower rebellious qi
- Formula: Si Qi Tang
- Acupoints:
Spleen Qi Deficiency and Stomach Qi Deficiency
- Symptoms: Vomit: nausea and vomit with spitting of saliva. Poor appetite and digestion, stuffy epigastrium, defaecation without much qi.
- Tongue: White and slippery tongue
- Pulse: Empty and Wiry
- Treatment strategy: Invigorate and tonify spleen qi, regulate stomach and lower rebellious qi
- Formula: Xiang Sha Liu Jun Zi Tang
- Acupoints:
Spleen Yang Deficiency and Stomach Yang Deficiency
- Symptoms: Vomit: vomit after eating just a little, on and off, like warmth and hate cold. Very pale complexion, lassitude, no energy, cold limbs, dry mouth but no desire for drink and loose feces.
- Tongue: Pale tongue
- Pulse: Soggy and Weak
- Treatment strategy: Warm the middle and invigorate spleen, regulate stomach to lower rebellious qi
- Formula: Li Zhong Tang
- Acupoints:
- Symptoms: Vomit: repetitive vomit but sometime just retching. Seems hungry but no desire for food dry mouth and throat.
- Tongue: Red and dry tongue
- Pulse: Thready and Rapid
- Treatment strategy: Nourish stomach yin and lower rebellious qi to stop vomiting
- Formula: Mai Men Dong Tang
- Acupoints:
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