Clinical Presentation

Discomfort or dull pain in the epigastrium, better after eating and better with pressure or massage, no appetite, preference for warm drinks and foods, vomiting of clear fluid, no thirst, cold and weak limbs, tiredness, pale complexion.

Treatment

Principle: tonify and warm Stomach- and Spleen-Qi

Combination Points (and notes)

• Pain relieved by both eating and pressure/massage is the clean differentiator from Stomach-Qi stagnation or Retention of Food, where pain is aggravated (not relieved) by these same things.
• Moxa on ginger applied to Ren-6 is the single best technique for Empty-Cold in the Stomach specifically — worth remembering as a named go-to method.

Clinical Presentation

No appetite, or slight hunger but no desire to eat, constipation (dry stools), dull or slightly burning epigastric pain, dry mouth and throat especially in the afternoon with desire to drink in small sips, slight feeling of fullness after eating. With pronounced Empty-Heat: thirst with desire to drink in small sips, feeling of hunger, night sweating, five-palm heat, bleeding gums, feeling of heat in the evening.

Treatment

Principle: nourish Stomach-Yin, nourish fluids

Combination Points (and notes)

• A strikingly compact point set — just four points, all reinforced, no moxa — reflecting how cleanly this pattern isolates to Yin/fluid nourishment alone.
• This is a common downstream development of long-standing Stomach-Qi deficiency — worth asking about a history of epigastric discomfort and tiredness even when dryness is now the leading complaint.

Clinical Presentation

Epigastric pain and distension, belching, nausea, vomiting, hiccups, irritability.

Treatment

Principle: move Stomach-Qi, eliminate stagnation, restore the descending of Stomach-Qi

Combination Points (and notes)

• Ren-12 appears here paired with G.B.-34 purely to move Qi in the Middle Burner — a useful contrast with every Deficiency pattern here where Ren-12 instead tonifies the Stomach and Spleen; the same point's role depends entirely on the pattern and its pairing.
• SP-4 + P-6 (opening the Chong Mai) recurs here for moving Qi in the Middle Burner, distinct from its more familiar Blood-stasis-moving role elsewhere — again, the same combination serving a different purpose by context.

Clinical Presentation

Burning epigastric pain, intense thirst with desire to drink cold liquids, mental restlessness, dry stools, dry mouth, mouth ulcers, sour regurgitation, nausea, vomiting soon after eating, excessive hunger, foul breath, a feeling of heat. Phlegm-Heat adds: a feeling of oppression of the chest and epigastrium, mucus in stools, expectoration of phlegm, mental derangement.

Treatment

Principle: clear Stomach-Heat, stimulate the descending of Stomach-Qi

Combination Points (and notes)

• ST-34's bleeding-gum-stopping action, alongside its usual Qi-moving role, is a good example of a single Accumulation point carrying a secondary, pattern-specific use worth teaching separately.
• Plain Stomach-Heat is distinguished from Phlegm-Heat by the sticky (vs. merely dry) tongue coating and the added mental derangement and phlegm symptoms — treat the base pattern the same way, but expect a more complex clinical picture when Phlegm is present.

Clinical Presentation

Sudden severe pain in the epigastrium, a feeling of cold, cold limbs, preference for warmth, vomiting of clear fluids (which may alleviate the pain), nausea, feeling worse after swallowing cold fluids (which are quickly vomited), preference for warm liquids.

Treatment

Principle: expel Cold, warm the Stomach, stimulate the descending of Stomach-Qi

Combination Points (and notes)

• The needling instruction is precise here: moxa can be used in conjunction with needling (never on its own), and even method replaces reducing if the condition has become subacute rather than acute — a good example of technique adapting to the stage of illness.
• Vomiting of clear fluid that actually relieves the pain is a distinctive feature of this pattern — a useful bedside clue distinguishing it from other causes of sudden epigastric pain.

Clinical Presentation

Nausea, difficulty in swallowing, belching, vomiting, hiccups.

Treatment

Principle: subdue rebellious Qi, stimulate the descending of Stomach-Qi

Combination Points (and notes)

• A notably clean, single-mechanism pattern — every point simply restores the descending of Stomach-Qi, with no tongue changes at all, making the pulse (Tight or Wiry) the main objective sign to rely on.
• No tongue change is itself a diagnostic detail worth teaching — a normal tongue with a Wiry or Tight pulse and digestive rebellion symptoms should not be mistaken for 'nothing wrong'.

Clinical Presentation

A feeling of fullness and pain of the epigastrium, a feeling of heaviness, facial pain, blocked nose or thick sticky nasal discharge, thirst without desire to drink, nausea, a feeling of heat, dull-yellow complexion, a sticky taste.

Treatment

Principle: resolve Dampness, clear Heat, restore the descending of Stomach-Qi

Combination Points (and notes)

• Ren-12 is again the single reinforced point — the recurring Stomach/Spleen pattern of tonifying the Spleen to cut off Dampness at its source while everything else clears the Excess pathogen already present.
• The facial pain and blocked/sticky nasal discharge are worth noting as somewhat unusual additions for a digestive pattern — reflecting Damp-Heat rising along the Stomach channel's facial pathway.

Clinical Presentation

Fullness, pain and distension of the epigastrium which are relieved by vomiting, nausea, vomiting of sour fluids, foul breath, sour regurgitation, belching, insomnia, loose stools or constipation, poor appetite.

Treatment

Principle: resolve retention of Food, stimulate the descending of Stomach-Qi

Combination Points (and notes)

• Fullness and pain relieved by vomiting is the clean differentiator from Stomach Deficient and Cold, where the same epigastric discomfort is instead relieved by eating and pressure.
• ST-45 doing double duty (resolving stagnant food and calming the Mind if insomnia is present) reflects the classical link between undigested food sitting in the Stomach overnight and disturbed sleep — 'the Stomach not being at peace'.

Clinical Presentation

Severe, stabbing epigastric pain that may be worse at night, dislike of pressure, nausea, vomiting, possibly vomiting of blood, vomiting of food looking like coffee grounds.

Treatment

Principle: invigorate Blood, eliminate stasis, stimulate the descending of Stomach-Qi

Combination Points (and notes)

• Nearly identical base point set to Stomach-Qi stagnation (ST-34, ST-21, ST-19, KI-21, T.B.-6, P-6+SP-4, G.B.-34+Ren-12, ST-40) — Blood stasis adds BL-17 and SP-10 specifically to invigorate Blood, reflecting how directly this pattern develops from unresolved Qi stagnation.
• Vomiting blood that looks like coffee grounds is the clinical detail marking a genuinely advanced case — always treat this as a sign requiring careful clinical judgement about further medical investigation, not purely an acupuncture point-selection question.

Clinical Presentation

Poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, uncomfortable feeling in the epigastrium, lack of taste sensation.

Treatment

Principle: tonify Stomach- and Spleen-Qi

Combination Points (and notes)

• This is essentially Stomach-Qi deficiency and Spleen-Qi deficiency merged into a single point set — worth teaching after both individual patterns rather than before, since it's best understood as their combination.
• BL-20 and BL-21 are called out specifically for chronic conditions — a cue to add these Back-Shu points once simple digestive weakness has become longstanding rather than acute.

Clinical Presentation

Poor appetite, dry mouth, thirst with desire to drink in small sips, dry stools, dry lips, slight nausea, tiredness, uncomfortable feeling in the epigastrium, lack of taste sensation.

Treatment

Principle: tonify Stomach- and Spleen-Yin

Combination Points (and notes)

• The smallest point set in this entire deck — just three points — mirroring how tightly Stomach-Yin deficiency itself resolves down to a compact core protocol.
• This combined pattern is distinct from Liver-Qi invading the Stomach, which is discussed separately under the Liver Patterns deck's combined patterns rather than here — worth cross-referencing rather than assuming every Liver-Stomach interaction lives here.