[ Chronic Gastritis ]

Chronic gastritis is a nonspecific inflammation of gastric mucosa. It may be divided into the superficial, atrophic and hypertrophic according to its pathogenic changes. The main clinical manifestations are epigastric pain, indigestion, anorexia, etc.
The disease pertains to the category of “epigastric pain” in traditional Chinese medicine.
Differentiation and treatment in traditional Chinese medicine can be refer to
1. Deficiency- cold in the spleen and stomach:
Dull pain in the epigastrium, which may be relieved by pressing and warming, frequency in urination and defecation, regurgitation of thin fluid, chilliness and aversion to cold, anorexia, abdominal distension, Thin and white tongue coating, deep and slow pulse.
2. Attack of the stomach by the liver-qi:
Distending pain in the epigastrium, acid regurgitation, which is more severe during excitation, Thin and white tongue coating, taut pulse.
3. Stagnancy of qi and blood stasis:
Stabbing pain in the epigastrium, radiating to the back due to prolonged pain, aggravated on pressure, Tongue with ecchymoses, uneven and forceful pulse.

[ Gastrointestinal Neurosis ]

The disease is gastrointestinal dysfunction due to higher nervous activity dysfunction, characterized mainly by gastrointestinal symptoms, accompanied with insomnia, dream-disturbed sleep, amnesia, nervousness, etc.
It pertains to categories of “epigastria pain,” “vomiting”, “belching” and “diarrhea” in traditional Chinese medicine. Differentiation and treatment in traditional Chinese medicine can be refer to
1. Attack of the stomach by the liver-qi:
Fullness in the epigastrium, abdominal distension after meal, wandering pain, radiating to the hypochondriac region, frequent belching, which are more severe during emotional upset, Thin and white tongue coating, taut and slippery pulse.
2. Incoordination between the liver and the spleen: Abdominal distension, loose stools, poor appetite, sensation of fullness in the stomach after mealss, which is aggravated by anger, Pale tongue with white coating, taut pulse.

[ Hiccup ]

Hiccup is a clinical symptom referring to the adverse rise of stomach qi manifested by an involuntary short, quick sound in the throat. It may occur alone on rare occasions or accompany other conditions in continuous or paroxysmal attacks.
Hiccup is regarded as spasm of the diaphragm in modern medicine. The differentiation and treatment in this section can be referred to for hiccups related to the course of other acute or chronic diseases or that after abdominal operation
Differentiation and treatment in traditional Chinese medicine can be refer to
1. Retention of Cold in the Stomach
The hiccup is slow, deep-sounding forceful, alleviated by warmth and aggravated by cold. It is accompanied by a discomfort in the chest and epigastric region, poor appetite, profuse clear urine, loose stool, White moist tongue coating and slow pulse.

2. Ascending of Stomach Fire
The hiccup is loud and forceful in a hasty manner. It is accompanied by a foul and sour smell, fullness sensation in the epigastric region, poor appetite, straw coloured urine, constipation, Yellow tongue coating, and rapid slippery pulse.

3. Perversing of Liver Qi to the stomach
The continual hiccups are accompanied by eigastric and hypochondriac distention, restlessness, belching, fullness in the chest, Thin whi
te tongue coating, and thready pulse.

4. Yang Deficiency of the Spleen and Kidney
The low and long hiccup is released with shortness of breath, accompanied by pale complexion, poor appetite, lassitude, soreness and weakness in the lumbar region and knee joints, cold limbs, Pale tongue proper with thin white coating, and thin weak puls.

[ Dysphagia Syndrome –Esophagitis ]

Dysphagia syndrome refers to a condition characterized by a feeling of obstruction during swallowing and instant vomiting after food intake.
The obstructive feeling for swallowing is called Ye, while the difficulty in swallowing food and instant vomiting is called Ge in Chinese language. Since the former may not only appear alone in clinic, but also became the pretophase of the latter. Theses two are collectively known as the dysphagia syndrome in TCM.
The syndrome may include such diseases as pylorochesis, esophageal diverticulum, esophageal neurosis, esophagitis, esophageal carcinoma gastric cancer, cardiac cancer and cardiospasm in modern medicine.

1. Stagnation of Phlegmatic Qi
Main manifestation
Feeling of obstruction during swallowing, fullness in the chest and epigastrium, dull pain, belching, hiccup together with vomiting of thin mucous sputum and food substance, severe constipation, dry mouth, progressive loss of weight, red tongue proper, and thready slippery pulse.
2. Retention of Phlegm in the Interior

Main manifestation
Dysphagia with pain in the chest and epigastrium, difficulty in swallowing food or water, instant vomiting, vomiting of mucous sputum and dry stools. It may also be accompanied by vomiting of reddish fluid, bloody stools, emaciation, rough dry skin, dry red tongue proper.

3. Exhaustion of Yang Qi

Main manifestation
Difficulty in swallowing food, pale complexion, cold limbs, shortness of breath, omiting of frothy sputum, edema in the face and feet, abdominal distention, flabby tongue and weak thready pulse.
[ Cholecystitis, Cholelithiasis ]
The diseases are caused mostly by inflammation of the gallbladder, obstruction of the cystic duct and cholesterol metalbolic disorder. The patient may have a history of attack of biliary colic and acute cholecystitis. The main clinical manifestations are pain of the right upper abdomen or right hypochondrium, radiating to the right shoulder and back, epigastric distension and helching after meals, aversion to greasy food, tenderness on the region of the gallbladder. Occasionally enlarged gallbladder can be felt by palpation. By cholecystography, the gallbladder gives a faint picture or none at all. Deformity or bad contractibility of the gallbladder, or the shadow of gallstones can be found.
The diseases pertain to the categories of “abdominal pain” and “hypochondriac pain” in traditional Chinese medicine.
Differentiation and treatment in traditional Chinese medicine can be refer to

1. Stagnation of the Liver-gallbladder qi;
Distending pain of the right upper abdomen and hypochdrium, chest oppression and discomfort, anorexia .
Reddish tongue with thin and white coating,, taut pulse.

2. Retention of the damp-heat in the interior: Extending pain of the right upper abdomen or right hypochondrium, nausea, vomiting, vexation, bitter mouth, Red tongue with yellow and greasy coating, taut and rapid pulse.

[ Pancreatitis ]

Pancreatitis refers to acute or chronic inflammation of the pancreas. Acute pancreatitis is caused by pancreatic secretions with overflow from the pancreatic duct resulting in inflammation of the pancreas and its peripheral tissue. Acute pancreatitis is marked by suddenly occuring, persistent stabbing pain in the left, upper abdomen with paroxysmal exacerbation and radiation to the lumbar region, back, and left shoulder usually accompanied by nausea, vomiting, fever, profuse, perspiration an even tetany or toxic shock. It occurs primarily in young people and adults and is usually induced by biliary ascariasis, roundworm, overindulgence in food or alcohol, or mental injury. Chronic pancreatitis is marked by frequently recurring severe pain in the upper abdomen radiating to the lumbar region, back, left shoulder, and usually lasting 4-5 hours. During the remission stage there may be no symptoms or minor dull pain in the upper addomen. Some cases are marked by protracted, persistant, gradually-worsening pain in the upper abdomen while others may have no pain at all. Chronic pancreatitis occurs mainly in middle-aged people and more often in males than in females. Alcoholics and those with a history of cholecystitis, cholangitis, cholelithiasis, or acute pancreatitis are at high risk for chronic pancreatitis.
Traditional Chinese medicine classifies pancreatitis as abdominal pain.

[ Diarrhea ]

Diarrhea refers to increased number of loose stools with undigested food or even watery stools. According to the clinical manifestations and duration, it is divided into acute and chronic types. The condition may occur in any of the four seasons but is more common in the summer and autumn. Similar to that described in modern medicine, it may be seen in such diseases as acute and chronic enteritis, intestinal tuberculosis, intestinal dysfunction and irritable bowel.

1. Cold-damp Type
Loose stools or even watery stools, abdominal pain, borborygmus, general cold sensation with desire for warmth, absence of thirst, Pale tongue proper with white coating and deep slow or soft pulse.
2. Damp-heat Type
Loose stools with abdominal pain, urgent bowel movement or that with difficulty, yellow stools with odour, feverish sensation in the anus, restlessness, thirst, short scanty urine, Yellow greasy tongue coating and rapid slippery or rapid soft pulse.
3. Food Retention Type
Abdominal pain, borborygmus, fetid stools, lessened pain after releasing stools, fullness and distention in the epigastric region, belching with mouth odour, poor appetite, frequent passing of wind, Sticky greasy tongue coating, and slippery pulse
4. Spleen Deficiency Type
Prolonged and reccurent loose stools with undigested food, decrease of appetite, fullness sensation in the epigastric region after food intake, apparent increase of bowel movement soon after intake of greasy or oily food, sallow complexion, White sticky tongue coating and soft slow pulse.
5. Liver and Spleen Derangement Type
Bowel movement stimulated by abdominal pain that still remains the same after bowel movement, recurrent diarrhea due to emotion disturbance or stress. The accompanying symptoms and signs include discomfort sensation in the hypochondriac region during diarrhea, belching, Thin tongue coating and wiry pulse.
6. Kidney Deficiency Type
Borborygmus and diarrhea with abdominal pain just before dawn, comfortable sensation after bowel movement, cold limbs , soreness and weakens in the knee joint and lumbar region, White tongue coating and deep thready pulse.

[ Abdominal Pain ]

Abdominal pain refers to the pain involving the area below the epigastrium and above the suprapubic hair margin. Clinically, it is a very common symptom encountered in various Zangfu disorders. It can be seen in both acute and chronic enteritis, gastrointestinal spasm, intestinal neurosis and indigestion in terms of modern medicine.
For the treatment of acute abdominal pain due to surgical and gynecological diseases refer to the contents in the related sections. Differentiation and treatment in traditional Chinese medicine can be refre to
1. Accumulation of Heat in the interior
Fullness and pain of the abdomen which cannot be pressed, constipation or dyschezia accompanied by fever, thirst, dark urine, Yellowish greasy coating of the tongue, smooth and rapid pulse or deep and forceful pulse.
2. Accumulation of Cold in the Interior
Sudden onset of sever sbdominal pain relieved by warmth and aggravated by cold, loose stools, borborygums, profuse clear urine, poor appetite, absence of thirst, cold limbs, Thin white tongue coating and deep tense or deep slow pulse.
3. Retention of Food

Main manifestation
Pain and fullness of the abdomen which cannot be pressed, anorexia, regurgitation of acid, belching, constipation or diarrhea, wind from the bowels with stinky smell, relieved pain after diarrhea, grayish greasy coating of the tongue, smooth pulse.
4. Deficiency of Spleen Yang
The lingering abdominal pain appears intermittently. It responds to pressure and warmth but is aggravated by cold, accompanied by loose stools, listlessness, weakens of the four limbs, Pale tongue with teethmarks on the edge, and a deep thready pulse.

[ Abdominal distention ]

Abdominal distention is characterized by a discomfort sensation and fullness in the abdomen. In sever cases, it also causes local pain, belching and vomiting. It is mostly the consequence of gastrointestinal dysfunction. For abdominal distention appearing as a major symptom in such diseases as gastroptosis, enteroparalysis, intestinal obstruction, gastroneurosis and acute gastrectasis, the treatment presented in the part can be taken as reference.
1. Repletion Pattern
Persistent distention and fullness in the abdomen which may also cause abdominal pain, aggravated by pressure. It is accompanied by belching, foul breath, dark yellow urine, constipation of occasional fever and vomiting, Yellow thick tongue coating, and slippery rapid and forceful pulse.
2. Vacuity Pattern
Abdominal distention relieved by pressure, borborygmus, loose stools, poor appetite, lassitude listlessness, clear urine, Pale tongue with white coating and forceless pulse.

[ Constipation ]

Constipation is a condition manifested by prolonged intervals of dry of compacted feces from the intestines or urgent desire for immediate bowel movement but with difficulty in defecating. It commonly includes habitual constipation, constipation due to peristalsis dysfunction and constipation due to rectum or anus disorders in modern medicine.
Differentiation and treatment in traditional Chinese medicine can be refer to
1. Excess type:
Difficult defecation from every 2 to 3 days. In case of accumulation of heat, there are fever, dire thirst, foul breath, preference for cold drinks, yellow and dry tongue coating, slippery and full pulse; in case of stagnation of qi, there are fullness and distending pain in the abdomen and hypochondriac regions, frequent belching, loss of appetite, thin tongue coating and taut pulse.
2. Deficiency type:
No defecation for severe days, accompanied with pale and lusterless complexion lips and nails, dizziness and palpitation, pale tongue with thin and white coating, weak and thin pulse.
3. Cold type:
No defecation for several days, accompanied with cold sensation and pain in the abdomen, preference for warmth and aversion to cold pale tongue with white and moist coating, deep and slow pulse.

[Jaundice ]

Jaundice is a condition characterized by yellow pigmentation of the sclera and skin as well as dark yellow coloured uring. The yellow sclera is considered as the main sign in the clinic. Jaundice is mostly seen in the infantile, the young and the middle aged. The condition described here is the same as that related in modern medicine, including hepatocelular jaundice, obstructive jaundice, hemopytic jaundice, etc.
Differentiation and treatment in traditional Chinese medicine can be refer to
1. Yang Jaundice
The onset of jaundice is abrupt with very short duration. The symptoms and signs include yellow sclera and skin that is as apparent as orange skin, fever, thirst, short scanty urine, constipation, general heavy sensation, abdominal distention, fullness in the chest, nausea, Yellow greasy tongue coating and wiry pulse. Loss of consciousness, skin eruptions and hemorrhage will appear if the heat attacks the interior of the body. There will be less jaundice, milder fever, fullness in the epigastrium, moderate thirst, slightly yellow greasy tongue coating and soft rapid pulse if dampness is more severe than heat as the causative factor of the jaundice.
2. Yin Jaundice
The onset of the jaundice is slow over a long duration. The main symptoms. and signs include yellow sclera and skin which may appear gray dark as if being smoked, general lassitude, aversion to cold, anorexia, nausea, vomiting, tastelessness in the mouth, no thirst epigastric distention, unformed stools, pale tongue proper, greasy tongue coating and deep slow pulse.

[ Hypochondriac Pain ]

Hypochondriac pain refers to a painful sensation either on one side or both sides of the hypochondrium. It is included in hepatopathy, biliary disorders intercostal neuralgia, etc. in modern medicine.
1. Stagnation of Liver Qi
Distention and wanderinger pain in the hypochondriac region aggravated by emotion upset, accompanied by fullness sensation in the chest, poor appetite, frequent belching, irritability, poor sleep, Thin white coating and wiry pulse.
2. Damp-heat Retention in the liver and gallbladder
Stabbing pain with burning sensation particularly on the right hypochondriac region is accompanied by hills and fever during the acute pains, bitter taste in the mouth, irritability, nausea and vomiting, congested eyes, short scanty urine, red tongue proper with yellow coating and wiry rapid pulse.
3. blood Stasis
Localized pain with pricking sensation aggravated at night, severe pain worse by pressing, also possible hypochondriac mass, dark purplish tongue proper and deep choppy pulse.
4. Deficiency of Liver Yin
Dull pain of a lingering nature in both hypochondriac regions, dry mouth, restlessness, blurred vision, dizziness, afternoon fever, spontaneous sweating, red tongue with less coating and thin rapid pulse.

[ Peptic Ulcer ]

Peptic Ulcer refers to circular or oval lesions on the wall of the stomach or duodenum occurring primarily on the gastric pylorus or the duodenal bulb. Peptic ulcer is marked by regularly occurring pain in the epigastric region accompanied by belching, acid regurgitation, nausea, vomiting and poor appetite. Onset of pain is generally related to intake of food. In cases of gastric ulcer, pain is usually occurring 30 minutes to two hours after eating and disappearing sometime before the next meal. In cases of duodenal ulcer, the pain usually starts three to four hours after eating and is relieved after eating the next meal.
It belongs to the category of “epigastric pain”; in traditional Chinese medicine.

[ Chronic Nonspecific ulcerative Colitis ]

This disease is also termed ulcerative colitis. Its etiology is still unknown but in recent years has been associated with autoimmunity. The pathological change attacks the rectum, sigmoid colon and descending colon. It is a kind of nonspecific inflammation which primarily involves the mucosal layer. Precipitating factors include emotional tonus, psychic trauma and allergy to certain foods. It occurs more frequently in males than in females.
In traditional Chinese medicine the disease is categorized as “diarrhea”, “dysentery”, etc.

[ Prolapse of Rectum ]

Prolapse of rectum refers to the condition in which the lower portion of the rectum is prolapsed out of the anus, mainly seen in aged patients, children or those with poor body constitution due to certain lingering diseases. The condition described here is similar to rectum prolapse in modern medicine.
Differentiation and treatment in traditional Chinese medicine can be refer to
1. Prolapse Due to Deficiency of the Spleen
Long history of diarrhea, prolapse of rectum mucosa, accompanied by sallow complexion, palpitation and shortness of breath, mental weakens and fatigue, pale tongue with thin white coating, thready and feeble pulse.
2. Intense Fire Due to Yin Deficiency
Prolapse of rectal mucosa, pain in the anus, accompanied by dry mouth and thirst, constipation, dark urine, red tongue with thin coating, rapid pulse.
3. Damp-heat Attacking the Lower~Jiao
Prolapse of the rectum involved with swelling and burning pain in the anus. It is accompanied by flushed face, fever, dry mouth with foul breath, chest and epigastric fullness, abdominal distention, scanty yellow urine, red tongue proper with yellow greasy coating, and soft rapid pulse.

[ Stomach Reflux ]

Stomach reflux is characterized by epigastric distension with undigested food and fullness in the abdomen hours after food intake. It is seen pylorospasm, prolorochesis and gastroneurosis in terms of modem medicine.

[ Vomiting ]

Vomiting is a condition referring to the casting up of food substance or gastric fluid from the stomach through the mouth.
Differentiation and treatment in traditional Chinese medicine can be refer to
1. Exogenous pathogenic invasion into the stomach
Vomiting characterized by sudden casting up of food, discomfort in the chest accompanied by aversion to cold, fever, headache and general pain, white tongue coating and superficial pulse.
2.Food retention in the stomach
Vomiting characterized by casting up of sour fluid or food substance, epigastric distension and fullness, frequent belching, abdominal pain lessened by vomiting , dry or loose stools, greasy tongue coating, and slippery full pulse.
3.Liver Qi attacking the stomach
Vomiting characterized by casting up of sour fluid or food substance, frequent belching, pain and distention in the hypochondriac region, suffocating sensation often aggravated by emotional disturbances, thin greasy tongue coating and wiry pulse.
4.Deficiency of the spleen and stomach
Pallor complexion, instant vomiting with repeated attack, lassitude, weakness, poor appetite, loose stools, pale tongue proper, and weak soft pulse.
4. Yin deficiency of the stomach
The vomiting appears in repeated attacks. It is accompanied by dryness in the mouth and throat, anorexia despite hunger, red tongue proper, lacking fluid distribution, and red rapid thready pulse.

[ Acute Gastroenteritis ]

Acute gastroenteritis refers to acute inflammation of gastrointestinal mucosa due to various pathogenic factors. The clinical manifestations are sudden onset, nausea, vomiting, abdominal pain, diarrhea, etc.
It pertains to the categories of ‘diarrhea’, ‘vomiting’, and “cholera morbus” in traditional Chinese medicine.