hey there it's Clara from Acapulco beanie and today's made easy video is all about TCM diagnosis all on the inquiry method regarding the stomach and the intestine system so specifically the stomach and the large intestine mainly the digestive system because those two and TCMS are so much related right like the stomach is the beginning of digestion and the intestine is the logic test on is the end of digestion so they have a very much big relationship in TCM and so I wanted to look at diarrhea versus constipation and stomach cheeri belying and acid reflux and all that fun stuff if you want more I have tons and tons of definitely definitely awesome videos on my website a cubic atom e.com PDFs I have treatment protocols and all all on my resource page and blog there's tons of TCM courses as well so you're welcome to go on active or academy.com I am Clara and I'm your host today on this next video so without further ado let's start the stomach and intestine system by the way I did the spleen already the speed is already on my youtube channel so you're welcome to watch that because it is still part of digestion or the digestive system in Chinese medicine right it's all about the digest system which is spinning stomach or part of it but so is the I'll urgent so let's start with enquiring the right question where everything starts for the beginning of digestion which is in the mouth that's the beginning of digestion so when there is we're gonna look at the taste first right so if you look at the Five Element Biddle's tastes usually is more heart related in the five element but it's also stomach so bitter taste in the mouth carotids stomach or heart fire a sweet taste means there's deafness and usually that's affecting the spleen no taste that's the one at the bottom is also explained she deficiency so when there's no taste so we lost the sense of taste spleen Qi deficiency a salty taste salt of course related to kidney so that's usually a kidney Qi deficiency but it could also be internal access cold and a sour taste sour relates to liver so in general it's a liver hit liver heat or excess heat in the liver but it could also be stomach because again stomach is studying in the mouth so when it comes to mouth ulcers or canker sores the heart fire will have canker sores on the tongue the stomach fire will have canker sores on the oral cavity so that's the difference so when people say I have canker sores you need to ask them in your diagnosis are they in the mouth or on the tongue because that gives you a clue with its heart or stomach if the gums are sensitive usually that's a spinachy-- deficiency because spin and stomach will start at the mouth with the digestive system specifically in the five-element they open into the mouth right and reflect on the lips if there's bleeding gum that's usually stomach fire okay so those are two things you can ask question with patients and if people have teeth that are loose or loose teeth ah definitely can you cheat efficiency because tea for probably bone and bone is related to kidney so those are a few questions you can start with your method of diagnosis when it comes to stomach stomach and TCM is really much related to the screen right the very opposite but very the same in that they work together spleen transform and transform food and transported for nutrients in the body but stomach has two wipin and rock the food first so spin can transform and transport it right so everything start at the mouth with those two working together with the digestive system but today it's specifically more on the stomach so one of the most common pattern out there that I see in clinical practice is stomach fire so which really is stomach Chiri Belling it's going up the opposite way of the right way for the stomach to go down it's going back up right but it has also a lot of heat on a fire so um burn or burning sensation in the stomach and the esophagus area that is part of it right and then thirst with four cold drinks and the person is gulping gulping that's excess pattern right when this excess fire the person is thirsty and up gulping down mouth ulcers cause that stomach failure again constant hunger it's like you have a fire you need to put food on it and it keeps wanting more food and more food bleeding gums remember that heat and fire are very closely related fire means that there's bleeding feet there's no bleeding but they pretty much have the same symptom so really it could be stomach heat or stomach fire if there is bleeding then it's more stomach fire compared to stomach feet constipation because of course everything dries up acid reflux coming up for some people it could be nausea and vomiting and specifically sour regurgitation and sour vomiting and acid reflux nausea canape bad breath is also stomach heat or stomach fire like I said heartburn as well the pulse is full rapid because it's an excess the tongue is red with a thick yellow dry coat okay so that makes it a very big stomach fire specifically the coat is in the center of the top so as you can see I put a bunch of points there that we can treat that specific with clearing heat and fire like stomach 44 large intestine 11 those are really good for that when it comes to food food is really good for the stomach to balance specifically if there's on fire you wanna try to basically put some cooling food right so parsley your parsley juice is one of the best thing for stomach fire cucumbers celery juice same thing very good to bring the stomach fire down a leafy greens dandelion sea weeds they're all very cooling right minty very cooling as well you can use up apple cider vinegar for some people that works not everybody works well with apple cider vinegar as well so but I would say that specifically parsley juice and celery do so probably the best and of course avoiding spicy food and alcohol because that's going to release more heat more fire so let's look at differentiating the symptoms of the stomach when we look at stomach pattern cold invading the stomach that's usually an external pathogen cold so it's acute sudden pain in the stomach region cold the body like shivering vomiting clear fluid cannot swallow cold drinks because of course they will vomit so this is an invasion of cold there could be a stomach flu it could be you know clear diarrhea as well as vomiting but it's basically an acute issue so the pulse is still floating and it's tense because it's cold and we have a thick white coat on the tongue because again it's an excess and it's acute right so it's external it's not quite internal yet stomach fire we just did so I'm not gonna repeat that very much we understood from the perspective of the slide before us food with tension in the stomach that is really in digestion it's basically someone that over eats so it could be acute or chronic it could be a cute if it's a Christmas dinner or a birthday dinner and someone overweight and they're like oh my gosh I'm so bloated I don't feel good I feel like nauseated like I could vomit and you know lots of sour good station and really belching and not being able to sleep because our stomach doesn't feel right and we feel over over over full right so almost to the point where it's just so uncomfortable in the stomach region but for some people that could also be chronic some people overeat chronically every day and that becomes a slippery pulse that's constantly slippery full large big because that's excess food retention in the stomach and a thick coat on the tongue now the color of the coat depends if there's heat or cold or not so usually it's just a thick I quote on the tongue and most of time probably greasy coat on the tongue for those people so again that can be acute or chronic stomach blood stasis so stomach PlayStation's is not fun it's really really painful remember blood stasis is purple and pain so pain in that region of the stomach is dabbing pain that would be worse on pressure because that's an excess condition when it's better on pressure or massage that's a deficiency condition when it's better on pressure or worse on pressure it's an excess condition so or if the person put cold on it it makes it worse because cold congeals and creates more stagnation so pain is worse after meal the person may be vomiting dark blood and there may be blood in the stool as you can see this is not a good condition I could be bleeding ulcers it could be a lot of issue but it's usually not a great condition it's quite advanced the pulse is wiry choppy and of course purple in pain so the tongue is purple with purple dots in the center stomach Qi deficiency is very very similar to splint XI deficiency they're very much related usually if the stomach Qi deficiency there is an underlying screen XI deficiency so they both have no appetite they both have a lack of taste in the mouth no craving very fatigue especially in the morning loose stools feeling weak and the only thing with stomach 2 deficiency is that the stomach region doesn't feel right it's not painful but it just feel it's uncomfortable it's not like people will say that very much often the pulse is weak because it's a deficiency and the tongue is pale and it could be pink if it's not too much of a deficiency because there's always degrees right stomach yin deficiency systemic um deficiency is quite a common pattern I see in clinical practice so the person has no appetite but they do eat they just don't feel hungry they have to eat because you have to they usually like to sip on cold drinks all day long so thirst but for sipping cold drinks they bloated easily they have constipation with dry pebbles tools like little pebble you know marbles tools dry mouth and kind of a an achy stomach like a dull stomach pain it's not really painful but it's just uncomfortable as well the pulse is a yin deficiency pulse which would mean it's thin and rapid this person also may be tossing and turning night and not sleeping well because your heart at night they have a tongue that's red of course I can be peeled in the center because of systemic area and no quote so as you can see were going into the the deficiency mode right the first four patterns were XS and the last we are deficiency stomach Yong deficiency again very closely closely sorry related to spleen Yong deficiency if there's some icky um deficiency you can definitely be sure that there is spin Yong deficiency underneath it or with it so the pain in the stomach region is worse after bowel movement and better after eating or with massage so that's a deficiency right so when someone is deficient when we eat or we have a massage or rub it feels so much better right specifically if the person prefers warm food and they avoid cold food because it's gonna make them worse right and they have tendency to vomit clear fluid they feel cold specifically in the limbs no thirst and very fatigue because no fire no heat right so the post is very deep weak and slow specifically at the spleen and stomach region which is on the right middle position and a pale swollen tongue swollen can rotate the young deficiency and the paleness because there's no fire so those are all the pattern of the stomach I went super fast I know that but it's just to kind of give you an idea as you can see a lot of similar symptoms but some are very excess and some are more deficiency with the chiyan weakness right so we could see the difference now let's look at more of a large intestine picture the large intestine is the organ that lets go and sometimes we have chronic constipation and the organ is not letting go and it could be due to diet it could be due to no movement it could be due to emotional stress I could be to a lot of different causes but let's look at bowel movement itself and what it shows in diagnosis so if someone is gas a lot of gas they're bloated specifically bloated worse by the end of the day you know at the beginning of the day they feel really flat stomach and then as the day goes they're sitting at the desk and sonido pants are getting too tight and too tight and too tight by the end of the day the pants are bursting there's gas but there's also tendency to straining so when they go to the bathroom they have to strain and they have to sit there for a while that is all liver Qi stagnation okay you can have food stagnation when there's lots of blow to the gas but mostly it's a liver Qi stagnation in general if there's liver we'll go act on spleen that means those liver Qi stagnation creating spleen XI deficiency right liver overact on screen is a five element pattern and liver Qi stagnation creating screen Qi deficiency is a junk-food Oregon pattern of diagnosis and TCM so IBS or irritable bowel syndrome sometimes nowadays it's called irritable bowel disease or disorder is literally stress which creates liberty stagnation and it's creating alternating constipation diarrhea so it depletes the spleen so stress making the digestive system being weak that's what it means sticky stools is phlegm so when there is constipation there is usually no dampness it can happen sometimes with young deficiency constipation that's pretty rare so in general with constipation you know the difference if you have a stool that is formed but very sticky where the person needs a lot of toilet paper to clean after that means this phlegm okay it's sticky so that's a phlegm issue large intestine seat um basically this is a bowel movement that is large formed the person has to push in and makes them sweat and hot but they feel better after the bowel movement and it is very smelly so no roses in there you come back in the bathroom and you're like oh right big bad smell that's the Internet should know I did that sign sheet and the last two we haven't talked about the blood or yin deficiency so blood is kind of part of body fluids so when there's blood deficiency there's less body fluid and Yin is more body fluid as well so in general when is small hard dry little pebbles or sheep pebbles or marbles that's either a blood or a yin deficiency okay and how would you know well through the blood deficiency person would be pale pale tone right but if it was a hidden deficiency they would have a red tongue and they would have feeling hot at night and red cheeks right that's how you differentiate and the last one is pain that is stabbing pain usually that's blood stagnation so blood stasis with internal cold so that could be acute or that could be chronic so it's really fun to differentiate those different kind of when we ask questions to people you know and I usually am in clinic and I go how's your bowel movement you have one every day right so constipation is the person doesn't have one every day or it is that they have issue like straining they go but it they don't finish an unfinished feeling of bowel movement is also a liberty stagnation so liberty stagnation is gas bloating straining and unfinish bowel movement so there's a lot for people that don't move let's start moving then we can ask question on the opposite hand where it's more diarrhea right so when it comes to diarrhea as you can see we have lots of different kinds so again we need to differentiate if someone says oh I have diarrhea or chronic diarrhea right so I'm going to start with the top one on the fluid accumulation in the large intestine on the left hand side so usually if there's excess fluid I'm accumulation or excess body fluid or deafness in the large intestine the bowel movements going to be watery but with foams like frothy almost full me right that usually is excess deafness in the large intestine or body fluid accumulation spleen she deficiency is going to be having mucus so different from the frothy this one is more mucus like when you have diarrhea and it's very much loose stools as well we screen shield efficiency you right often but with diarrhea itself or hot mucus so that can happen in people with colitis or Crohn's disease for example food stagnation usually it's people that have that you know over eating and then eventually when they have diarrhea it's very smelly because it creates heat the food stagnation because it basically you know faster in there for a long time then it comes out and it's diarrhea that is very smelly with food in these tools so pieces of food in the stool so it went right through the person and it didn't wasn't digested liver overact on spin is the same as the one from constipation is liberty stagnation creating spin sheet efficiency or stress creating some urgency into going to the bathroom and in this instance it's diarrhea sometimes I can turn into constipation back and forth and that could be IBS but this one will be painful urgent diarrhea which is usually due to stress blood stasis is usually very painful the diarrhea is very painful when the person is having about movement so the cramping very badly in the lower abdominal region urgent and smelly is usually damp eat okay so urgent and smelly is really a smelly is the heat and urgent is the excess damn heat of course there's damp in every diarrhea cause diarrhea is damp in itself right live overact on speed is urgent but it's not smelly unless ters feet coming from another place right so from the stomach or deliver cold damp is usually urgent again this is more acute sometimes but it's better with warmth right so and it's very watery so it would be definitely watery urging diarrhea no smell when it's cold there's no smell heater smell cold there's no smell and the person prefers warmth and the last one is spleen and kidney Yong deficiency for early-morning diarrhea so we call this often in TCM the 5:00 a.m. diarrhea or when the person wakes up they go to the bathroom first Vernon first thing in the morning and they have watery diarrhea and if you're really cold in general and very weak and fatigued after the bowel movement you're exhausted and that usually happened once a day and they're good for the rest of the time most of the time so that's a spinning Keeney Yong deficiency not able to digest the food so there will be also undigested food in the stools in that spin and can a young deficiency pattern lots of information on this video right but this is how we differentiate the inquiry method of diagnosis when we look at diarrhea no diarrhea is created equal no constipation is created equal so let's look at the pattern of the large intestine there are a few not as many as the stomach but there still are a few so as I said the heat in the large intestine is going to be more constipation with a burning sensation in the mouth because it's related to the stomach those usually stomach heat when does large intestine heat dry mouth dry Tom a burning and swollen anus maybe some hemorrhoids in their scanty dark urine the person is also gonna have a smelly bowel movement and when it comes out it's formed it's full and it's a large amount but it's smelly the pulse is full and rapid because it's an excess pattern and of course it's a thick yellow coat because that's excess heat at the root of the tongue because the large intestine is at the back of the tongue so that's the opposite damp eating large intestine is still heat but this time is not conservationist diarrhea right so it's watery diarrhea with abdominal pain they may be blood in the stool or mucus burning anus again because there's heat strong order so the stool is still smelly because there's heat if it's acute like a stomach flu or something there be fever and sweating if it's not a chewed you still can have heavy limbs thirst with no desire to drink so no desire to doing but feel thirsty if you've never had that people have a hard time understanding this concept what it is is your mouth is dry but you just don't feel like drinking it just doesn't make you feel like you want to drink right so that's what thirst without desire to drink means and then scanty dark urine because again there's heat right so the pulse is still operate as the dampness and rapid which is the heat and of course it's a red tone there's excess heat with a yellow sticky or greasy coat the greasy sticky is dampness and the yellow is heat and again at the root of the tongue or the back of the tongue large intestine blood stasis this is a big bad one too so this is usually constipation with stabbing pain the person is really distended abdomen and the pain is so bad and it's worse with pressure so they don't want to be touched they feel like this burning sensation in the ill in all the area they may have tidal fever vomiting and delirium this could be a blockage like this could be a physical blockage of the large intestine and that's why the person maybe vomit so this is a serious condition usually and the person may have had no bowel movement for like seven days I've had patients coming to the clinic and they're like oh I go to the bathroom like every once in a once a week I had a person saying oh I go about two to three times a month and I was like oh my two to three times a month okay we need to talk because that cannot be right you understand that this is now good but some people are so used to it they don't know the difference right so this would be a full deep big pulse because again this is a serious condition and the tongue is gonna be red purple because there's massive inflammation there because nothing is moving which means the body is gonna start reabsorbing all the toxins instead of evacuating them so that's not good I wanted to share with you on my website on the resource page of my website um I do if you go on it have different kind of treatment protocol and one of them is all on constipation and it's my personal story with constipation due to emotional trauma and so that kind of you know you can look at it and I share that story with you go check it out my resource page like I said and you look at treatment protocols go under constipation and you'll see I tell my personal story on this and hopefully you can kind of see how emotional trauma can create chronic constipation for people and because they can't let go of the emotional stress called in the large intestine that's usually going to connote ate some diarrhea with sudden this is again an acute like cold in the stomach we talked about before cold in the large intestine is diarrhea with sudden abdominal pain so this is more of a acute problem ah it's cold feeling in the abdominal region the person puts the worm or heating pad on it and it feels a bit better it is urgency in the diarrhea and it's sudden and crampy so this is the pulse is gonna be why we slow because it's tighten and maybe deep if there's a lot so again this is acute most of time and half the person will have a thick white coat specifically at the root or the back of it dryness in the large intestine so that's quite you can see all those patterns we've seen so far it's all excess right all the first five balance excess excess excess excess to Iast Ness and the large intestine is basically dry stool difficulty in passing this tool because they're so dry right and they were coming out and really really dry so it can be painful and it could create some hemorrhoids or bleeding our fishes dry mouth dry skin thin body the person is a thin pulse and AD right on cracked with no coat so that needs a lot of lubrication and hydration right and the only one that I look at that's deficiency is large intestine Yan deficiency so that's not a common common one but the main symptom is loose stools as duck dropping so it looks like I'm sorry to say this to you if you like that bath it looks like yogurt yogurt consistency I'm sorry to use yogurt but yogurt consistency stools and it is really yellowish in color so very soft very yellowish but not diarrhea like right and with a dull achy abdominal pain the person has Babur with me which means they have sound in the abdominal region like blue like that watery sound baba yaga me feel you in the long street no urine cold limbs cold body fatigue because they have no fire exhausting and after the bowel movement they're usually feeling fatigued as well so they have a deep thin probably slow pulse it depends on how much young deficiency there is and a pale swollen tongue so again that's a young deficiency so as you can see we have a lot of question we can ask when it comes to large intestine and stomach pattern even though in TCM perspective they don't have a lot of function as much as the spleen - they have a lot of symptoms associated with different pattern and treatment so I hope that really really resonated with you I have tons more on my website please please please if you want more go there sign up to my newsletter you get tons of free stuff all the time so I have three courses TCM courses on on my website as well and check me out on Facebook I'm there all the time every night 6 p.m. Pacific Standard Time I put new post every single night I create graphics 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