Small Intestine Pattern Differentiation in Chinese Medicine

• Excess Heat in the Small Intestine
• Small Intestine Qi Stagnation
• Small Intestine Qi Obstruction (Acute)
• Small Intestine Deficiency and Cold

Etiology of Small Intestine Patterns

The Small Intestine relies on Spleen Yang for transformation of food, and uses Kidney Yang in its transformation of fluids. Because of this, several patterns of the Small Intestine are linked to Spleen or Kidney Yang Deficiency.

Diet and Nutrition

Excess Cold and raw food can cause Cold to accumulate in the Small Intestine. Excess hot and spicy foods can cause heat to accumulate.

Emotions

The Small Intestine is indirectly affected by emotions such as anger that cause Liver Qi to stagnate.

Excess Heat in the Small Intestine (Heart Fire Transmits to Small Intestine)

Signs:

• Abdominal pain
  Small Intestine Fire
• Tongue ulcers
  Heart Fire rising to tongue
• Scanty, dark, painful, or bloody urination
  Scorched fluids
• Insomnia, mental restlessness, throat pain, thirst
  Heart Fire
• Sudden hearing loss
  Fire affecting Small Intestine Channel

Tongue

• Red with a swollen red tip and a yellow coat

Pulse

• Rapid and full pulse

Etiology/Pathology:

This is Interior Excess Heat. Heart Fire is transmitted to the Small Intestine, the Yang Organ related to the Heart. Emotional problems such as anxiety and excessive stress can predispose a person to this pattern.

Treatment Principle:

• Clear Heart and Small Intestine fire

Points:

• SI 2 (Qiangu)
  Clears Small Intestine Heat, for burning urination from Small Intestine pattern
• SI 5 (Yanggu)
  Clears Small Intestine Heat and calms Shen, Gives clarity and sense of direction
• Ht 5 (Tongli)
  Clear Heat Fire
• Ht 8 (Shaofu)
  Clear Heat Fire
• ST 39 (Xiajuxu)
  Lower Sea point of Small Intestine, Stops abdominal pain

Method

Sedate all points. No Moxa.

Small Intestine Qi Stagnation

Signs:

• Twisting pain in the lower abdomen that may radiate to the lower back, distention
  Qi Stagnation
• Pain is worse with pressure
  Excess in nature
• Borborygmus, flatulence (flatulence relieves pain)
  Intestinal Qi Stagnation
• Testicular pain
  Qi Stagnates along channel (from Liver Qi Stagnation)

Tongue

• White coating

Pulse

• Deep and wiry pulse

Etiology/Pathology

Any of the causes of Stagnation of Liver Qi may lead to this syndrome. It may be acute (Excess condition) or chronic, such as Deficiency of Spleen Qi with Liver Qi Stagnation. Excess Cold and raw food which impair the Small Intestine's transformation function.

Treatment Principle:

• Harmonize Liver, Move Qi in Lower Burner

Points

• REN-6 (Qihai)
  Move Qi in Lower Jiao
• GB 34 (Yanglingquan )
  Stop pain
• LIV-3 (Taichong)
  Moves Stagnant Liver Qi
• LIV-13 (Zhangmen)
  Harmonize Liver, tonify Spleen (esp. good in chronic patterns)
• ST-27 (Daju )
  Move Qi in lower abdomen, stop abdominal pain
• ST-29 (Guilai)
• SP 6 (SanYinjiao)
  Stop abdominal pain
• ST 39 (Xiajuxu)
  Lower Sea point of Small Intestine. Stops abdominal pain

Method

Sedate. Moxa with Cold signs.

This pattern can progress to Small Intestine Qi Obstructed which is similar to appendicitis. Lan Wei Xue (the appendix point) can be added for this situation.

When this pattern is acute, it is Excess in nature. When chronic, it is mixed Deficiency and Excess, with Liver Qi Stagnation (Excess) and Spleen Qi Deficiency (Deficiency).

Small Intestine Qi Obstruction (Acute)

Etiology:

This is similar to Small Intestine Qi Stagnation, but is always acute in nature. It is commonly caused by over-consumption of raw and cold foods which impair the Small Intestine's transformation function. While this pattern resembles appendicitis, it can occur without the presence of appendicitis.

Signs:

• Violent abdominal pain that is worse with pressure, constipation
  Stagnation and obstruction in the Small Intestine
• Vomiting, borborygmus, flatulence
  Descending function of Stomach Qi is impaired

Tongue

• Thick white coating

Pulse

• Deep and wiry pulse

Treatment Principle:

• Remove obstruction from Lower Burner, Move Qi of Small Intestine

Points

• ST 39 (Xiajuxu )
  Stop abdominal pain: move SI Qi
• Lanweixue (Extra point)
  Use if appendicitis suspected
• Ren 6 (Qihai )
  Move Qi in lower burner, stop pain
• GB 34 (Yanglingquan)
  Move Qi in lower burner, stop pain
• ST 25 (Tianshu )
  Stop abdominal pain
• SP 6 (SanYinjiao)
  Stop abdominal pain
• Liv 3 (Taichong)
  Stop abdominal pain, promote smooth flow of Liver Qi

Method

Sedate. E-Stim applicable.

Small Intestine Deficiency and Cold (Subcategory of Spleen Yang Deficiency)

Signs:

• Abdominal Pain, relieved by warm and pressure
  Cold obstructing Intestines
• Borborygmus
  Small Intestine Involvement
• Diarrhea
  Spleen Yang weak
• Pale and copious urination, desire for warm liquids
  Yang Deficiency

Tongue

• Pale with a white coat

Pulse

• Deep, slow, and weak pulse

Etiology/Pathology:

• Excess consumption of Cold and raw food

Treatment Principle:

• Warm and tonify Small Intestine and Spleen, Disperse Interior Cold

Points

• Ren 6 (Qihai)
  Moxa to tonify Yang and stop diarrhea
• ST 36 (Zusanli)
  Moxa to tonify Spleen Yang
• ST 25 (Tianshu)
  Stop diarrhea and abdominal pain
• ST 39 (Xiajuxu)
  Stops abdominal pain
• BL 20 (Pishu)
  Tonifies Spleen Qi
• BL 27 (Xiaochangshu )
  Back Shu point of Small Intestine Tonifies Small Intestine.

Method

• Tonify. Moxa applicable.