function. These have already been discussed in detail in the chapter on epigastric pain (Chapter
14 ). First of all, simply eating too much leads to retention of food in the Stomach and Intestines
and thus to abdominal pain. Eating irregularly, eating in a hurry, skipping meals, eating while
discussing business, may all influence the function of the Intestines and lead to stagnation of Qi
which causes abdominal pain.

In abdominal pain, a distinction is often made between substantial and non-substantial pain.
Substantial abdominal pain (literally called "with form") is caused by stasis of Blood or retention
of food. Any other type is non-substantial (literally called "without form"). A substantial
abdominal pain improves after bowel movements, whilst a non-substantial one does not.

Diagnosis

There are some aspects of diagnosis which particularly apply to abdominal pain. These will be
discussed under the following headings:

• nature of pain


• reaction to pressure


• reaction to food or drink


• reaction to bowel movement


• reaction to activity/rest


• reaction to heat


• tongue signs


• pulse signs.

Nature of Pain

A dull pain is due to an Empty condition, whilst a severe pain is due to a Full condition.

A distending pain indicates stagnation of Qi. Patients often describe this as a "bloated" sensation.

A stabbing, fixed and intense pain indicates stasis of Blood, especially if it is associated with a
fixed abdominal mass.

A feeling of fullness (which is more intense than "distension"), in Chinese called man, indicates
retention of food or simply a more severe stagnation of Qi.

Both a feeling of distension (zhang) and of fullness (man) may be observed objectively as the
abdomen will be distended or hard on pressure.