Vomiting – Ou Tu

Vomiting of food, fluids, (bitter/sour/acidic) or phlegm (sputum) due to stomach Qi up surging.  

Western Medicine and Vomiting: gastritis, Stomach sphincters spasm, hepatitis, pancreatitus, febrile disease, meningitis

Etiology (causes) of Vomiting:

1. Exterior Pathogen Invasion - acute vomiting due to (wind, fire, cold, heat, summer heat) which impairs St. Qi function causing it to up surge and cause vomiting. Most common in summer

2. Diet - irregular Diet - cold/hot foods , no scheduled meal times - causes spleen dysfunction – phlegm goes upward with stomach Qi

3. Emotion - liver Qi stagnation attacks stomach causing disharmony, which causes St. Qi to upsurge - Spleen Qi stagnates due to over thinking, causes food stagnation in middle jiao and St. Qi to up surge

4. Middle Jiao Def. - Sp/St deficiency – can’t transform/transport food and water -cold- stomach yang Qi deficient -hot- stomach yin deficient

5. POISONING

6. ULCER

7. INTESTINAL PARASITES

Differentiate Vomiting From:

Dysphagia (ye gu)– vomiting with swallowing difficulty, slow progression

Upset Stomach (fan wei)-eat in morning and vomit at night or eat in evening and vomit in morning.

Cholera - diarrhea and vomit together, acute with severe abdominal pain. Excess (acute onset) Deficient (slow onset)

**do not purge unless there is constipation complicating the vomiting.**

Chinese Medicine Differentiation and Treatment of Vomiting  

Exterior Pathogens Invade Stomach Wind cold / Wind heat / Summer heat / Dampness -acute sudden vomiting Tongue - (hot - red) (cold – pale) P - superficial

Principle of Treatment: Expel exterior pathogens, harmonize Stomach Qi to relieve vomit.  

Acupuncture points – Ren, foot yangming, hand jueyin, Ren 12 and Stomach 36 (regulate and descend Stomach Qi), Pericardium 6 (regulate 3 Jiao Qi), Large Intestine 4 and Gall bladder 20 (expel Wind-Cold) - dry heaves – Moxa Pericardium 5 - vomit bile water – Gall bladder 40

Herbal Medicine Formula: Wind-cold - Hou Xiang Zheng Qi San Wind-heat - Yin Qiao San Summer heat damp - Xin Jia Xiang Ru Yin

Diet - Retention of Food retention of food causes vomit of old food, patient has history of irregular diet, belching, poor appetite, abdominal pain, irregular bowel movements. Tongue - thick, greasy coat Pulse - slippery

Principle of Treatment: promote digestion, remove food retention to harmonize St. Qi  

Acupuncture points – Ren, foot yangming, Ren 10 and 21 (10 meets Spleen meridian, 21 regulates stomach Qi), Stomach 36 and Pericardium 6 (descend Stomach Qi), Spleen 14 (stagnation), Stomach 44 (clear HeaTongue - purge)

Herbal Medicine Formula: Bao Hu Wan

Accumulation of Phlegm slow onset, vomiting of phlegm or fluids, general phlegm symptoms, dizziness, fullness / distension of chest, rumbling in stomach/intestines Tongue - white, greasy coat Pulse - slippery u>

Principle of Treatment: eliminate phlegm and fluids, harmonize stomach Qi

Acupuncture points – foot taiyin, Liver 13 and Spleen 14 (strengthen Spleen to eliminate fluids), Ren 12 and Stomach 40 (Phlegm), Pericardium 6 (nausea/vomiting) - borborygmi – Bladder 20, 25 - palpitations – Heart 7

Herbal Medicine Formula: Er Chen Tang (phlegm) + Ling Gui Zhu Gan Tang (fluids)

Liver Qi Stagnation vomiting with acid regurgitation, frequent belching, chest/hypochondriac distension and pain, aggravated by emotion Tongue - thin greasy coat (red on sides + heat) P - wiry

Principle of Treatment: sooth liver to harmonize stomach Qi

Acupuncture points – Ren, foot jueyin, Ren 13 and Stomach 34 (regulate chest and diaphragm and Stomach Qi), Liver 3 and Gall bladder 34 (soothe Liver), Heart 7 (calm emotions) - acid reflux – Pericardium 6, Spleen 4  

Herbal Medicine Formula: Ban Xia Hou Po Tang (no heat) Si Ni San + Zou Jin Wan (heat)

Spleen and Stomach Deficient Cold chronic illness, vomit after eating bad(different) foods, spleen and stomach deficient cold symptoms, poor appetite, cold St, dry mouth, no desire to drink, soft stools, cold limbs. Tongue - pale, white coat Pulse - weak

Principle of Treatment: Warm middle Jiao, strengthen spleen/stomach, stop vomit

Acupuncture points – Ren foot yangming, Moxa, warm and tonify, Ren 12, Pericardium 6, Stomach 36, Bladder 20, 21, Liver 13, Ren 4

Herbal Medicine Formula: Li Zhong Tang

Stomach Yin Deficiency chronic vomit, small amounts with dry heaves, nausea, dry mouth, thirsty, no appetite, heart burn. Tongue - red, dry (scanty) coat Pulse - thin, rapid

Principle of Treatment: Nourish St. yin, moisten St. to descend St. Qi to relieve vomit  

Acupuncture points – Shu, foot yangming, Bladder 20, 21, Spleen 10, 6, Stomach 36, Pericardium 6 - burning stomach – Kidney 3 or 6 - dry heaves – Spleen 4

Alternative Treatment Methods for vomiting  

Ear Acupuncture – ST, LR, sympathetic, subcortex, shenmen, leave for 30 minutes

Injection Therapy– Pericardium 6, Stomach 36, vitamin B6, B12