 One of the most interesting aspects of Chinese medical diagnosis is using abdominal diagnosis to prescribe herbal formulas. So in this video I'm going to demonstrate really what is a several thousand year old abdominal map for prescribing herbal formulas based on Chinese medicine and a branch of Chinese medicine that actually went to Japan called Kampo. And I'm going to show you the general abdominal zones, what common findings are that we find, and what they actually indicate. Hey guys, I'm Dr. Alex Hying, doctor of acupuncture and Chinese medicine and author of the health book, Master of the Day. So going back to the abdomen here, when we talk about the abdomen overall, there was a famous 17th, 18th century, so he lived in the 1700s physician named Yoshima Soutoro, and he said that the myriad diseases all originate in the abdomen and that's why we examine it without fail to determine the basically the cause of disease. Now this is one of those lost arts in Chinese medicine that is not commonly practiced, and is very commonly practiced in Japan. One of the branches of Chinese medicine that went to Japan and is heavily used in actually some of the classical forms of Japanese acupuncture. So most acupuncturists do not actually palpate the abdomen in a diagnostic way besides, you know, poking here and does it hurt? I'm putting a needle there. But a sophisticated level of abdominal diagnosis is not that common these days, but one of my most impactful mentors, one of the herbal doctors I studied with specialized and preferred using the abdomen over the pulse diagnosis or even over the patient's own self-reported symptoms themselves. He said, you know, every skilled physician examines the abdomen and the pulse and these kinds of objective findings so that they can know and not just guess or trust what the patient says that the person is getting better. So the abdomen is one of the most objective findings that you can use with a little bit of training to know what is the quote, diseased area? Where is the problem? And what do we actually need to treat? So the first area is the epigastric area. Now typically I would do the abdominal examination from the other side, but just for the sake of lighting and the camera, I'm going to do it from the opposite side. So typically the first area that there are most commonly findings is the epigastrium. So the upper epigastric area is the area above the belly button and it's very common in this upper abdomen to find two findings. One, the primary finding is often called P syndrome and P syndrome is really a subjective and objective sometimes sensation of fullness, a blocked feeling, a queasy feeling, an indigested feeling, a nauseous feeling. So when I apply a little bit of pressure, what I look for on my side is first on the spectrum of is it more yin or yang? Is it soft or is it hard? In Julie's case, this is a soft glomus. So this soft epigastric finding means that a person often has issues with what we call the transport and transformation of food, which is really a stomach and spleen issue. So stomach and spleen often deal with issues like bloating, gas, indigestion, people who are prone to abdominal fullness, food allergies, and then we can ask, do you have any of these issues prone to them? Sometimes some bloating and whatnot. Okay, what about indigestion? Indigestion and acid reflux sometimes too. Okay, so we ask her and we can confirm. And you know on the other side of the spectrum is that there is a hard glomus here. So hardness, epigastric, this hardening, often as we go down this ren channel, right, as we get towards ren 12, which is equidistant between this really this xiphoid sternum here and the ambilicus right in the midpoint is often where you find epigastric hardening. Now this is a similar kind of epigastric finding. And it's really just a different constitutional finding sometimes for the same thing, but very often it indicates a long-term dysfunction in the stomach or even a long-term issue with the circulation in the actual stomach. So this area, the surface becomes hard here. So very common to see with people with food allergies and bloating and things like that. So we begin with the epigastric area. Most common area that I find there's issues. The second finding we look for is pulsation. I'm just applying very gentle pressure and I'm looking for the pulsation of the abdominal aorta. For Julie, very, very minor. There's not a significant pulsation here, but pulsation if you lay down and you're at rest and you can feel your heart beating in your stomach as people self-report. There's two very common findings and it's very, very commonly seen. So obviously, you know, you have the abdominal, the aorta comes down and it splits. And very commonly, this is indicative of two things that are pathological. One is just general nervous system activity. So a person who's basically has a high level of stress and there's a level of sympathetic dominance, you'll notice an elevated strength to the heartbeat and you'll notice it in the abdomen. And that just is because the heart is beating harder. Second scenario is the person is very, very thin. Now Julie's thin, but she's a healthy level of thin. And the third scenario is often when there's a lot of bloating. So it's very indicative of people who have bloating and issues with digestion and food allergies, food sensitivities. The reason for that is it's almost like if you have the heartbeat, the aorta is like an underwater volcano. When there's water above it, the shockwave is very, it comes up like this, right? When the abdomen is there's not excessive gas, there's not excessive fluid, then the pulsation is not quite as strong. But when the person is filled with gas or they have a lot of fluid retention, you can often see that and feel it much more popably. So epigastric finding, pulsation, and then we come under the subcostal area. So again, I'm just lightly palpating here. And what we're looking for is just a moderate amount of, there should be a healthy elasticity. The most common pathological finding you find here is it's hypertonic. So it's excessively tight. So when I press, it feels like I'm hitting a board as opposed to a pillow that has some resistance to it. So these subcostal findings are very often issues with the liver, gallbladder, or sometimes even lymphatic issues. So very common to see women develop these subcostal findings when they're on their cycle. You can find them when people have chronic digestive issues, certainly acid reflux or gallbladder issues. I mean, the anatomical gallbladder, people most often report distention, pressure, and pain in the right upper quadrant, right? It's anatomically located there. So that makes sense. But very often, we call these Cheyenne findings. So they're most often related to the gallbladder, the organ, the triple warmer, as well as the liver. So that is probably the third most common finding that I see. When we go to the low abdomen, really the areas we're looking for, we talked about the area above the umbilicus. It's very often a spleen, pancreas, stomach finding, common with GI problems, sometimes even allergies that will be hardening in this epigastric area. But then we go just lateral to the umbilicus, the belly button. And very common, even with a very light pressure to feel tension and sometimes even pain. Now in women, these are most often gynecological findings, dysmenorrhea, so painful menses that can be amenorrhea. I've seen women that have fibroids, PCOS, things like that will often show up as a hypertonic area, just lateral to the belly button here. And if it's severe, there's pain with pressure, not just a sensation of tightness, you know, as I'm talking here, my peripherals are paying attention to her face. But even via palpation, I'm not really picking up much at all from her in terms of this area anatomically around the ovaries. But very, very commonly seen. Now in men, this low abdomen finding is often an issue related to the what we call kidney deficiency. So issues with night sweats, frequent urination, issues with libido, that sort of thing. So kidney deficiency often shows up in a hypertonic low abdomen, this excessive tension in this low abdomen is cramping and tight and that kind of thing. Now, other common findings I would say, beyond those, the last one would be this area right underneath the belly button, right? So just the three inches or so below the belly button like that, this area should have a healthy sort of elasticity, just like the abdomen, it should be a healthy level of both soft and tight. So I apply pressure. There's some spring back, it doesn't cave, and it doesn't feel hard as a board. Right, even someone who works out all the time, the abdomen should not feel hard like a board, even if they work out regularly. So the low abdomen is often again, a bladder or kidney finding. So sometimes for example, you know, women who when they have UTIs will describe hardness or pressure in the low abdomen. Obviously, the bladder is right there. No surprise. But often this is a kidney deficiency finding. If what is found like a thin, hard line almost like a pencil, some people call it the pencil line. So when I push down, there's a healthy spring back and a healthy balance. And when it's pathological, either there's mush, it's just a you just sink into a cave, or you push and you can feel the separation of the rectus muscles and you can feel at the bottom of it, what feels like a little a little band of tension. And we consider that a pathological finding. So just a recap, the abdomen very, very commonly used to describe herbal formulas in my practice. Most often, we see upper epigastric areas, P syndrome, so glomus, which is usually digestive in nature or reflux, rib side findings, pulsation of the abdominal aorta findings lateral to the belly button, and then inferior to the belly button. And these are really the most common abdominal findings that I tend to see day to day. Now, a lot of people, you can even put your hands on your own abdomen and see what comes up, see what you find. Alright, guys, so that's what I have for today on the abdomen and abdominal diagnosis. Again, if you want to be a patient of mine, or learn about telemedicine with me throughout California or in Los Angeles, check out the link right below the video. And I've also put together a free guide for daily rituals that can potentially help you add years to your life with Chinese medicine. So those are all right below. And I'll catch you soon.