To better understand clinical case studies, it may be beneficial                         to have read at least the Cas files and exams.

When the appetite goes well, it's
                as Chinese as Gallic!

Ms. Vachon, a bank advisor, consults for slow digestion. She
            often feels bloated, occasionally has heartburn
            and diarrhea. Her doctor gave her the usual tests,
            which reveal no physiological cause. She suffers from troubles
            functional problems that plague the quality of life of
            people, but which western medicine most often considers
            psychosomatic or related to stress. The patient then has the impression that
            everything is going on in his head when in fact everything is in the
Qi! Traditional Chinese Medicine (TCM) offers in these cases
            very precise solutions; functional disorders are also
            one of the favorite areas of TCM.

The four stages of the examination

1- Question

The acupuncturist asks his patient to describe his discomfort with the
            more precision possible. To qualify its slow digestion (what some
            call "having a slow liver"), Ms. Vachon speaks of discomfort
            in the upper abdomen and a bloated feeling in the navel area
            that she especially feels after eating. On the
            advice from her mother, she drinks hot water after meals,
            which facilitates its digestion. She also experiences burns
            occasional stomach.

Asked about her eating habits, Ms. Vachon says she is snacking
            often because she quickly feels full during meals. She eats
            a salad every noon, with his work colleagues, so as not to start again
            the weight she lost so hard. Besides, she says, she is fattening
            easily. Supper is usually taken late due to scheduling.
            work and activities of the small family.

Heartburn usually occurs in the evening or after
            have eaten spicy foods such as pizza or spaghetti.
            She then feels like a burn going up all the way through the esophagus until
            the throat. The acupuncturist pays particular attention to food cravings:
            Mrs. Vachon confesses, with guilt, to experience sweet cravings
            which she cannot resist. It can then get out of hand
            and get to the bottom of a box of cookies in one evening.

As for the stools, they are generally soft and
            normal color. Ms. Vachon mentions having occasional diarrhea,
            but don't really feel pain in your lower abdomen. On the energy side,
            Mme Vachon is often tired after lunch; she experiences
            also having trouble concentrating at work at this time
            of the day.

2- Auscultate

Using a stethoscope, the acupuncturist examines the depths
            of Ms. Vachon's abdomen. It is easy to hear the characteristic sounds
            digestion when the patient is lying on her back, since the transit
            intestinal is then stimulated. The presence of
rumbling exaggerated could signal poor digestion.
            But the complete absence of sounds could also signal a pathology.
            Ms. Vachon's abdomen reveals normal functioning: the
            bowel movement is stimulated by the pressure of the stethoscope, without
            generate pain or excessive noisy borborygmas.

3- Palpate

The pulse is fine and slightly empty in the zone corresponding to the
            Medium right hearth (see Viscères).
            The abdominal palpation of the viscera
            reveals a painful area around the navel, which corresponds to
            the area of ​​the
Spleen / Pancreas. Palpation of the four quadrants is also important
            in order to verify that there is no pain indicative of a disorder
            Body,
            like isolated constipation, for example. Abdominal percussion is added
            the tools that allow you to do this verification.

4- Observe

Ms. Vachon has a pale complexion. His tongue is pale with a light coating
            thick and white, and is indented, that is, it has
            teeth marks on the sides.

Identify the causes

There are many reasons for slow digestion. First, a
            Too cold eating is often the cause. So, digest a salad
            – mainly composed of Food
            cold of nature – requires a lot of
Qi on the part of the Spleen / Pancreas which must first warm up
            food before processing (see
Food). The Spleen / Pancreas is exhausted after
            this digestion, hence fatigue after meals and lack of concentration
            to do intellectual work. In addition, salads are often watered
            fat-free dressings, which in fact are often very sweet,
            which further overloads the Spleen / Pancreas.

Ms. Vachon's sugar cravings mean that the Spleen / Pancreas is out of balance,
            because this organ claims its invigorating flavor, the Sweet (see
Five Elements). However, succumbing to
            this rage maintains a vicious circle where too much Sweet imbalances
            the Spleen / Pancreas. In addition, the Sweet
Excess increases Heat
            in the stomach, hence the burns. These same burns
            are enlivened by Acid (tomato sauce) and when meals are taken late,
            this leads to Stagnation
            Acid in the Stomach.
            Indeed, he does not have time to bring down the food before Ms.
            Vachon doesn't go to bed, and the horizontal position is less conducive to this
            surgery.

The context of meals may also be involved. Eating with colleagues
            while talking about serious things like political issues, or annoying
            like conflicts at work, harms digestion. On the one hand, it solicits
            Doubly the Spleen / Pancreas which must perform digestion at the same
            time it provides the energy necessary for reflection;
            on the other hand, emotions stir the
Liver, which then negatively affects the Spleen / Pancreas.

Finally, the constitution of Mme Vachon, who says that fattening easily, testifies
            an already weak Spleen / Pancreas (she suffers from slowness
            which brings it to store fat), which adds to the factors
            precedents.

The energy balance

To lay the
energy balance, we notice that in Mme Vachon, the signs
            of a Low Spleen / Pancreas include:

• The tendency to gain weight, sign of a fragile Spleen / Pancreas, therefore
                  conducive to imbalances.
• Bloating caused by consecutive Food Stagnation
                  a Spleen / Pancreas who, due to lack of Qi, cannot do their job.
• The rages of sweetness.
• Indented language, which means that the Qi of the Spleen / Pancreas does not assume
                  not its role of retaining the flesh: the tongue becomes larger and
                  sags against the teeth.
• The pale tongue and complexion as well as the thin, empty pulse denote
                  that the Qi of the Spleen / Pancreas is not abundant enough to circulate well
                  Blood in the vessels.

We also note that hot water relieves, because it brings a little
Yang to poor Rate / Pancreas. The stool is soft because
            that the
Large intestine don't get 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 reduced concentration are the consequences
            a Rate / Pancreas that does not manage the Qi flow to
            the Brain and the muscles, which cannot provide their full performance. And it's
            worse after meals, because the little Qi available is found entirely
            mobilized for digestion, and there is little left for the functions
            annexes.

With regard to heartburn, which are signs of
            Heat,
            they result from the energetic union of the Spleen / Pancreas
            and the Stomach (see Five Elements).
            When the Spleen / Pancreas runs out, the
Yin is not well produced and the stomach does not get enough. Her
            Yang nature requires a minimum intake of Yin to keep it balanced.
            When this minimum is not present, the Yang takes up too much space, hence
            Symptoms of Heat.

The treatment plan

It will first be necessary to stimulate the Qi of the Spleen / Pancreas so that it
            regains the strength to transform Qi well and to control its circulation
            throughout the body. Consequently, the organs dependent on the spleen / pancreas,
            like the Large Intestine and the Stomach, will benefit from this improvement.
            In addition, we will facilitate the work of the Spleen / Pancreas by dispersing the Excess
            Heat present in the Stomach.

Points on the Meridian
            of the Spleen / Pancreas will therefore be chosen to tone the Qi of this Organ.
            On the Meridian of the Stomach, certain points will be used to tone
            Qi, while others will be used to disperse it so as to
            reduce the Yang. Heat, through moxibustion
            (see Moxas), will have an important role to
            play, because it increases Qi and disperses Humidity.

The positive side effects that Ms. Vachon may notice are, in addition to
            better digestion, better concentration, less burns
            and even a decrease in sweet cravings!

Advice and healthy living

It will be essential that Ms. Vachon changes her eating habits if she wishes
            achieve solid and lasting results. It should favor Food
            cooked hot and lukewarm at noon, and rather neutral at night (see
Food). Eat in a calm atmosphere, taking time
            chewing and talking about light and pleasant subjects will prove
            also beneficial; we say that to talk about cooking recipes,
            as we do in Gaul, stimulates gastric juices!

References Bibliography Faubert André. Didactic treatise on traditional acupuncture,                         Guy Trédaniel, France, 1977.