Acupuncture treatment for Pi Syndrome in Shang Han Lun
Updated: Jan 12
Introduction
In Shang Hang Lun or Discussion on Cold Damage, Pi (痞) or glomus refers to the condition featured with distention or fullness, pain and other discomforts in the stomach and chest region.
There are 11 different patterns in Pi disease, which covers the common conditions of digestive system disorders with the characteristic of the spleen and stomach qi dynamic dysregulation i.e. the stomach of the rebellion qi and sunken spleen qi. According to Shang Han Lun, a patient may present pi-disease when the cold pathogen invades from Taiyang because of the wrong use of purging methods. The presence also correlates to the constitution of qi xu (deficiency) in the middle jiao. If the ascending-descending dynamic is disturbed in pi disease, water or phlegm may retain in the middle jiao and chest.
The commonly used points include Gongsun-SP4, Neiguan-PC6, Pishu-BL20, Zusanli-ST36, Yinlingquan-SP9, Zhongwan-RN12, etc. to supplement the middle qi and balance the ascending-descending dynamic of the spleen and stomach.
Nowadays, pi disease can be seen in the following conditions: (1) Digestive System Diseases: acute and chronic gastritis, bile reflux, irritable bowel syndrome, indigestion, cholecystitis, etc; (2) Cardiovascular System Diseases: hypertension, myocarditis, arrhythmia, etc; (3) Kidney Diseases: nephropathy and chronic renal failure etc; and (4) Others: pregnant vomiting and Meniere’s syndrome etc.
11 Pi Patterns of pi Disease
11 Patterns of pi Disease
1. Cold pi
Gui Zhi Ren Shen Tang (Cinnamon Twig and Ginseng Decoction) is used (O.C. 163).
Points: Zhongwan-RN12, Pishu-BL20, Neiguan-PC6, Zhubin-KI9
2. Exterior Yang Xu
Fu Zi Xie Xin Tang (Prepared Aconite Decoction to Drain the Epigastrium)
Points: Guanyuan-RN4, Qihai-RN6, Dazhui-DU14
3. Heat Pi
Da Huang Huang Lian Xie Xin Tang (Rhubarb and Scute Decoction to Drain the Epigastrium)
Points: Juque-RN14, Shaochong-HT9, Zhongchong-PC9
4. Shaoyang Pi
Ban Xia Xie Xin Tang (Pinelliae Decoction to Drain the Epigastrium)
Points: Neiguan-PC6, Gongshun-SP4, Pishu-BL20, Xiangu-ST43
5. Water Pi in Middle Jiao
Sheng Jiang Xie Xin Tan (Ginger Decoction to Drain the Epigastrium)
Points: Zhongwan-RN12, Pishu-BL20, Zusanli-ST36, Xiangu-ST43
6. Sanjiao Water Retention
Wu Ling San (Five Poria Powder)
Points: Jinggu-BL64, Taixi-KI3, Zhongzhu-SJ3, Pangguangshu-BL28
7. Water Pi in Chest
Shi Zao Tang (Ten Jujube Decoction)
Points: Zhongwan-RN12, Tianshu-ST25, Zhangmen-LR13, Yinlingquan-SP9
8. Chest Phlegm Pi
Gua Di San (Melon Pedicle Powder)
Points: Zhiyang-DU9, Tiantu-RN22, Danzhong-RN17, Fenglong-ST40
9. Rebelling Phlegm Pi
Xuan Fu Hua Dai Zhe Shi Tang (Inula and Hematite Decoction)
Points: Gongshun-SP4, Huangshu-KI16, Zhongwan-RN12, Taichong-LR3
10. Xu (Deficiency) pi
Gan Cao Xie Xin Tang (Glycyrrhizae Decoction to Drain the Epigastrium)
Points: Zusanli-ST36, Xiangu-ST43, Jianli-RN11, Neiting-ST44
11. Lower Jiao Xu Li after Pi Disease
Chi Shi Zhi Yu Yu Liang Tang (Halloysit and Limonite Decoction)
Points: Guanyuan-RN4, Zhongji-RN3, Shenshu-BL23, Tianshu-ST25
Reference
Dr Hui Zhang Use of Five-Shu points in the treatment of Six Jing disorders
Zhang H. Acupuncture Treatment of Pi Disease in the Shang Han Lun. The Journal of Chinese Medicine, 2019, Feb 119