Contents
Slow digestion
To better understand the clinical case studies, it may be beneficial to have read at least the Case and Exam sheets. |
When the appetite is fine, it’s as Chinese as it is Gallic!
Mrs. Vachon, advisor in a bank, consults for slow digestion. She often feels bloated, occasionally has heartburn and diarrhea. Her doctor gave her the usual tests, which revealed no physiological cause. She suffers from functional disorders, problems that plague people’s quality of life, but which Western medicine most often considers to be psychosomatic or related to stress. The patient then has the impression that everything is happening in his head when in fact, everything is in the Qi! Traditional Chinese Medicine (TCM) offers very specific solutions in these cases; functional disorders are also one of the areas of predilection of TCM.
The four stages of the exam
1- Question
The acupuncturist asks his patient to describe her discomfort as precisely as possible. To qualify her slow digestion (what some call “having a slow liver”), Ms. Vachon speaks of discomfort in the upper abdomen and a feeling of bloating in the navel area that she feels especially after. have eaten. On her mother’s advice, she drinks hot water after meals, which helps her digestion. She also experiences occasional heartburn.
Asked about her eating habits, Ms. Vachon said she often nibbles because she quickly feels full during meals. She eats a salad every lunchtime, with her co-workers, so as not to regain the weight she has so hard to lose. Besides, she mentions, she gets fat easily. Supper is usually eaten late because of work schedules and family activities.
Heartburn tends to appear in the evening, or after eating spicy foods like pizza or spaghetti. She then feels like a burning rising all the way from the esophagus to the throat. The acupuncturist pays particular attention to food cravings: Ms. Vachon admits, with guilt, experiencing cravings for sweet that she cannot resist. She can then get out of control and get to the bottom of a box of cookies in one evening.
As for the stools, they are usually soft and normal in color. Ms. Vachon mentions having occasional diarrhea, but does not really have pain in her lower abdomen. On the energy side, Ms. Vachon is often tired after lunch; she also has difficulty concentrating at work at this time of day.
2- Auscultate
Using a stethoscope, the acupuncturist auscultates the depths of Ms. Vachon’s abdomen. It is easy to hear the characteristic sounds of digestion when the patient is lying on her back, since the intestinal transit is then stimulated. The presence of exaggerated borborygmes could signal a deficient digestion. But the complete absence of sound could also signal a pathology. Ms. Vachon’s abdomen reveals normal functioning: intestinal transit is stimulated by the pressure of the stethoscope, without generating pain or loud rumbling.
3- Palpate
The pulse is fine and slightly empty in the area corresponding to the right middle focus (see Viscera). Abdominal palpation of the viscera reveals a painful area around the navel, which corresponds to the Spleen / Pancreas area. Palpation of the four quadrants is also important in order to verify that there is no pain indicating an Organ disorder, such as isolated constipation, for example. The abdominal percussion is added to the tools that allow this verification.
4- Observer
Mme Vachon has a pale complexion. Its tongue is pale with a slightly thick, white coating, and is indented, meaning it has tooth marks on the sides.
Identify the causes
There are many reasons for slow digestion. First of all, a diet that is too cold is often to blame. Thus, digesting a salad – composed mainly of Raw Foods of Cold Nature – requires a lot of Qi from the Spleen / Pancreas which must first heat the food before processing it (see Diet). The Spleen / Pancreas is exhausted after this digestion, hence fatigue after meals and lack of concentration to perform intellectual work. Additionally, salads are often drizzled with fat-free dressings which, in fact, are often very sweet, further overloading the Spleen / Pancreas.
Mrs. Vachon’s sugar cravings mean that the Spleen / Pancreas is out of balance, as this Organ calls for its invigorating, Sweet Flavor (see Five Elements). On the other hand, the fact of succumbing to this rage maintains a vicious circle where too much Sugar unbalances the Spleen / Pancreas. In addition, the Excess Sweetness increases the heat in the stomach, hence the burns. These same burns are heightened by Acid (tomato sauce) and when meals are eaten late, it causes Stagnation of Acid in the Stomach. Indeed, this one does not have time to bring down the Foods before Mrs. Vachon goes to bed, and the horizontal position is less conducive to this operation.
The context of the meals can also be involved. Eating with coworkers while talking about serious things like politics, or annoying things like conflicts at work, hurts digestion. On the one hand, it doubly requests the Spleen / Pancreas which must carry out digestion at the same time as it provides the energy necessary for reflection; on the other hand, the emotions agitate the liver, which then negatively affects the Spleen / Pancreas.
Finally, the constitution of Mrs. Vachon, who says that she gets fat easily, testifies to an already weak Spleen / Pancreas (she suffers from a slowness which leads her to store fat), which is added to the previous factors.
The energy balance
To assess the energy balance, we notice that in Ms. Vachon, the signs of a weak Spleen / Pancreas include:
- The tendency to gain weight, a sign of a fragile Spleen / Pancreas, therefore conducive to imbalances.
- Bloating caused by Food Stagnation following a Spleen / Pancreas which, for lack of Qi, cannot perform its work.
- The cravings for sweetness.
- The indented tongue, which means that the Qi of the Spleen / Pancreas does not assume its role of retaining the flesh: the tongue becomes bigger and sags against the teeth.
- The tongue and the pale complexion as well as the thin and empty pulse indicate that the Qi of the Spleen / Pancreas is not abundant enough to circulate the Blood well in the vessels.
We also note that hot water relieves, because it brings a little Yang to the poor Spleen / Pancreas. The stools are loose because the Large Intestine does not receive enough Qi to train them well. The abdominal area of the Spleen / Pancreas is relieved by heat and painful on palpation, which confirms the Void of this Organ. Finally, fatigue and decreased concentration are the consequences of a Spleen / Pancreas which does not manage the routing of Qi to the Brain and the muscles, which cannot provide their full performance. And it is worse after meals, because the little Qi available is fully mobilized for digestion, and there is hardly any left for ancillary functions.
As for Heartburn, which is a sign of Heat, it results from the energetic union of the Spleen / Pancreas and the Stomach (see Five Elements). When the Spleen / Pancreas becomes exhausted, Yin is not produced well and the Stomach is not getting enough. Its Yang nature requires a minimum intake of Yin for it to maintain a certain balance. When this minimum is not present, the Yang takes up too much space, hence the symptoms of Heat.
Energy balance: Emptiness of the Qi of the Spleen / Pancreas with Heat in the Stomach. |
The treatment plan
It will first of all be necessary to stimulate the Qi of the Spleen / Pancreas so that it regains the strength to properly transform the Qi and to preside over its circulation throughout the organism. Consequently, Organs dependent on the Spleen / Pancreas, such as the Large Intestine and the Stomach, will benefit from this improvement. In addition, it will facilitate the work of the Spleen / Pancreas by dispersing the Excess Heat present in the Stomach.
Points on the Spleen / Pancreas Meridian will therefore be chosen to invigorate the Qi of this Organ. On the Stomach Meridian, some points will be used to tone Qi, while others will be used to disperse it so as to reduce Yang. Heat, via moxibustion (see Moxas), will have an important role to play, as it increases Qi and disperses Moisture.
The positive side effects that Ms. Vachon may notice are, in addition to better digestion, better concentration, a reduction in burns and even a reduction in cravings for sweets!
Advice and lifestyle
It will be essential for Ms. Vachon to change her eating habits if she wants to obtain solid and lasting results. It should favor food cooked hot and lukewarm at midday, and rather neutral in the evening (see Food). Eating in a calm atmosphere, taking the time to chew and talk about light and pleasant subjects will also prove to be beneficial; it is said that discussing cooking recipes, as it is done in Gaul, stimulates gastric juices!