bubble_chart Concept

Epigastric stuffiness refers to a symptom of discomfort and fullness in the epigastric region. The "Treatise on Cold Damage Diseases" states, "If there is only fullness without pain, this is stuffiness." It also says, "When pressed, it feels soft, indicating only qi fullness." This indicates that epigastric stuffiness is a blockage syndrome caused by the dysfunction of spleen and stomach qi.

bubble_chart Pattern Analysis

1. Heat Pattern︰Epigastric stuffiness, soft upon palpation, accompanied by restlessness and thirst, or possible hematemesis and epistaxis, dark urine, thin yellow tongue coating, and a floating pulse at the guan position. The stuffiness syndrome is often caused by repeated erroneous purgation in Taiyang disease, which damages the spleen and stomach, leading to the upward rebellion of guest qi and obstruction in the epigastrium. Heat fullness is characterized by restlessness, thirst, dark urine, and a yellow tongue coating, indicative of a heat pattern. Treatment should focus on discharging heat and dispersing stuffiness, with the prescription selection being Rhubarb and Coptis Heart-Draining Decoction.
2. Cold-heat Pattern︰Epigastric stuffiness, soft upon pressure, accompanied by aversion to cold, sweating, thin white tongue coating, and a floating weak or rapid pulse. The stuffiness symptom is often caused by repeated erroneous purgation in Taiyang disease, which damages the spleen and stomach, leading to the upward rebellion of guest qi and obstruction at the heart region. In addition to the stuffiness symptom caused by heat disturbing the heart region, cold-heat fullness must also be accompanied by aversion to cold and sweating, indicating a yang deficiency pattern. Treatment should focus on clearing heat, supporting yang, and resolving stuffiness. The recommended formula is Aconite Heart-Draining Decoction.
3. Phlegm-Qi︰Epigastric stuffiness, nausea, vomiting, dizziness, blurred vision, difficulty with bowel movements, white and greasy tongue coating, slippery pulse. With nausea, vomiting, and greasy tongue coating; Pinellia Heart-Draining Decoction can be used to resolve phlegm and alleviate stuffiness.
4. Drinking Qi︰Epigastric stuffiness, poor appetite, dry retching with foul breath, borborygmus, loose stools, thin white tongue coating, and deep weak pulse. There is borborygmus with a thin white coating. Option: Fresh Ginger Heart-Draining Decoction to dissipate fluid retention and relieve stuffiness.
5. Rebellious Qi︰Epigastric stuffiness, restlessness and unease, retching, reduced food intake, or accompanied by diarrhea, thin white tongue coating, slightly wiry pulse. In cold-damage disease or apoplexy, when the exterior syndrome is unresolved and purgative methods are mistakenly used, the stomach becomes empty, allowing guest qi to ascend counterflow, leading to epigastric stuffiness and hardness. If this epigastric stuffiness and hardness are mistakenly attributed to incomplete purgation and further purgation is applied, the stuffiness will worsen. The characteristic symptoms are restlessness and unease, with inability to sit or lie peacefully. Treatment should aim to alleviate urgency and dissipate stuffiness, Licorice Heart-Draining Decoction is the primary remedy.

The symptom of epigastric stuffiness is generally caused by the disharmony in the ascending and descending of spleen and stomach qi. It is commonly seen in cases of cold-damage disease due to incorrect treatment, or internal damage to the spleen and stomach. The treatment focuses on regulating the spleen and stomach, promoting the ascent of clarity and descent of turbidity, and facilitating the pivot of middle qi, thereby naturally resolving the symptom of stuffiness.

bubble_chart Documentation

1. Jingyue Quanshu．Stuffiness and Fullness: "Stuffiness refers to a blocked and unopened state, while fullness refers to a distended and immobile state. Generally, fullness is close to distension, but stuffiness does not necessarily involve distension. Therefore, the syndrome of stuffiness and fullness is highly ambiguous, and the key to differentiation lies in the terms 'deficiency' and 'excess.' Stuffiness caused by pathogenic factors and stagnation is a fullness syndrome of excess type; stuffiness without any substance or stagnation is a fullness syndrome of deficiency type. Fullness accompanied by distension and pain is excess fullness; fullness without distension or pain is deficiency fullness. For fullness syndrome of excess type and excess fullness, it can be dispersed or eliminated; for fullness syndrome of deficiency type and deficiency fullness, it is essential to apply significant warming and tonifying. Misuse in this regard often leads to errors in treatment."