Morning+Sickness

Concept: Morning sickness is considered a normal physiological response to pregnancy in Chinese medicine. If there is no morning sickness there may be concern regarding low hormone levels or a possible increased risk of miscarriage. The chong is affected - all the qi is shunted into the uterus, it then moves into the connecting point ST-30 and works into the stomach meridian. With too much qi in the St channels it will begin moving upward causing nausea and vomiting.

TCM Etiology and Pathogenesis
-Spleen & Stomach Deficiency -Liver heat (liver qi stagnation turns into heat, liver overacts to spleen ) -Phlegm obstruction

Differentiation Diagnosis
- Stomach disease - Hepatitis

Pattern Identification and Treatment Principles
1) Differentiation of symptoms -Vomiting soon after eating (excess condition) -Vomiting of dilute fluids (usually deficiency condition) -Vomiting w/ retching and belching -Only slightly nauseous -Vomiting of sour fluids (Liver involvement)

2) Commonly used points Local points -Stomach meridian -Kidney meridian (Chong meridian) -Ren meridian Distal Points Dr. Li almost always uses ST-36 + PC-6

Common herbs to calm the fetus: Zi Su Ye, Sha Ren, Huang Qin, Bai Zhu, Du Zhong, Xu Duan, Sang Ji Sheng, Tu Si Zi


 * Contraindicated points in pregnancy:** LR-3, LI-4, SP-6, GB-21, BL-60, BL-67, SP-10, BL-17, points on the lumbar/sacral/abdominal region after the first trimester
 * Contraindicated Herbs:** Toxic/strong: Ba Dou, Qian Niu Zi, etc.; Invigorate blood herbs: Tao Ren, Hong Hua, Chuan Xiong, Da Huang, etc.; Break up qi/pungent hot herbs: Zhi Shi, Fu Zi, etc.

Stomach Deficiency
Early stage of pregnancy, nausea, poor appetite, vomiting clear fluids or saliva, stomach and abdominal fullness, anorexia, tastelessness, dislikes smell of food listlessness, lethargy, lassitude, sleepiness [Dang Shen (g.), Bai Zhu (g.), Fu Ling (g.), Gan Cao (g.), Ban Xia (g.), Chen Pi (g.), Mu Xiang (g.), Sha Ren(g.)] can remove ban xia (slightly toxic) and substitute with Sheng Jiang
 * Tongue:** pale tongue; thin white coat
 * Pulse:** slow, slippery, weak
 * Treatment Principles:** Strengthen spleen, regulate stomach, descend stomach qi, stop vomiting
 * Acupuncture:** //ST-36, CV-12, CV-13, PC-6, SP-4//, BL-20, BL-21
 * Herbal Treatment:** //Xiang Sha Liu Jun Zi Tang// (Six-Gentlemen Decoction with Radix Aucklandia and Amomum) - **Herbal formula generally not recommended**

Liver Heat
Early stage of pregnancy, vomiting bitter clear fluid, or sour fluid, stomach and hypochondria distention Hiccup & sighing, dizziness & head distention, vexation, easy to anger [Zi Su Ye (9g.), Huang Lian [or Huang Qin](2g.), Ban Xia (9g.), Chen Pi (6g.), Zhu Ru (9g.), Wu Mei (9g.)]
 * Tongue:** Red tongue; thin yellow coat
 * Pulse:** Wiry & slippery
 * Treatment Principles:**Suppress Liver, Regulate Stomach, Descend stomach qi, stop vomiting
 * Acupuncture:** //LR-3, PC-6, GB-34, LR-14, CV-12, ST-36//, GB-24
 * Herbal Treatment:** //Su Ye Huang Lian Tang//

Phlegm Accumulation
Early stage of pregnancy, vomiting profuse clear fluid with mucus Oppression and fullness of the chest, poor appetite, palpitations, shortness of breath, tastlessness and greasy feeling in the mouth [Ban Xia (10g.), Sheng Jiang (3 pcs.), Fu Ling (9g.)]
 * Tongue:** Thick white & greasy coat
 * Pulse:** Deep, slippery
 * Treatment Principles:** Descend stomach qi, dissolve phlegm, stop vomiting
 * Acupuncture:** //ST-40, SP-9, ST-36, CV-12, PC-6, ST-21//, KI-21, CV-11, BL-20
 * Herbal Treatment:** //Xiao Ban Xia Jia Fu Lin Tang plus Bai Zhu, Sha Ren, Chen Pi//

External Herbal Herbs:
Ding Xiang, Ban Xia, Sheng Jiang Zhi Place at CV-12 & PC-6 can also apply [|Ume] paste at CV-8