Mind, Stomach & Rebellious Energy: Acupuncture for Reflux, Pain, Heaviness & Fixated Thought
I consider the Stomach and its energetic functions most important to maintaining balance in the body. Clinically as an acupuncturist, I use the Stomach’s acupuncture channel constantly to treat a multitude of symptoms and conditions.
I’m not the only acupuncturist who considers the Stomach the most important part of the body to maintain health. One of the most famous classical Chinese medical doctors developed an entire school in the 12th century called the “School of the Stomach and Spleen.”
Digestion is arguably the most important element to health. But when we speak of the Stomach in Chinese medicine it means much more than just digestion. The Stomach possesses the 3rd longest acupuncture channel on the body, with 45 acupuncture points. It travels from the foot all the way to the top of the head. It has many functions affecting body, mind and spirit.
The most popular acupuncture point is located on the Stomach channel: ST-36 Zu San Li: the Leg 3 Miles. This is a point that is said to treat everything and anything. It is a longevity point that promotes and sustains health. It’s been acknowledged as a master point since at least the 3rd century.
My favorite point on the Stomach channel, and one of my favorites of all time is ST-40 Feng Long: “the abundant bulge,” which my first teacher calls “abundant splendor.” It is modernly considered the main point to treat phlegmatic conditions. However I use it as the master point for all “rebellious qi”: when energy is moving counter to its normal path, causing all sorts of symptoms, like nausea, vomit, cough, headaches, sensory problems, various types of pain, as well as emotional imbalances.
ST-40 is also a powerful point to work on blood circulation, especially in the head.
Rebellious qi is a big concept, which encompasses much of what I treat in my acupuncture clinic. It often begins in the Stomach, spreading to all areas of the body. It can involve heat-inflammation as well as phlegm-fluid imbalances. Rebellious qi often has a psychological aspect to it as well.
Many symptoms I see in my acupuncture clinic are psychosomatic, or have dual physical and mental-emotional manifestations. Most have a phlegmatic nature to them, or a type of blood stagnation, making ST-40 an essential point in treatment.
The most useful model for understanding rebellious qi comes from a set of acupuncture channels called the Luo Vessels. The translation of Luo is “connecting vessels,” suggesting they manage and regulate not just the workings of the organs, but the energetic connection between them.
I often notice the symptoms and problems many people struggle with are not due to an organic problem per se, but rather interaction between the organ systems. If there is a “disconnection” that needs to be rectified, the Luo Vessels are amongst the best tools to address this kind of problem.
The Luo are understood as vessels that encapsulate stressors, holding them in a static state. They are like the closets we stuff things we cannot deal with. Anything we can’t deal with, something physical or mental gets put into the Luo Vessels. This is a very fascinating ancient concept in Chinese medicine that I work with daily in my clinic.
The way the ancient Chinese view the body is as a set of energy pathways that emerge from the internal organs. These pathways utilize the power of the organs to influence and manage the various structures and functions of the body. For example, the Stomach channel has a pathway that goes into the eyes, the breasts – influencing these structures to empower their function. The Kidney system is said to control the bones, the Lung the skin, the Liver the muscles and the Stomach-Spleen the flesh.
The organs not only power physical function, but also mental and emotional. The organs are seen as “housing” aspects of the spirit. For example, the Hun (the etheric spirit or soul) is “housed” in the Liver. The “Yi” which is defined as mindfulness or attention awareness is “housed” in the Spleen (of which is the partner to the Stomach).
This is another aspect of Chinese medicine: the organ systems have partnerships: a viscera organ is matched with a bowel organ. The Spleen is the viscera, the Stomach is the bowel. The viscera “hold” while the bowels “move.” Harmony between the two partners is essential for health and balance. A disharmony between the Stomach and Spleen can lead to many problems, most of which can be classified as rebellious qi.
Any stagnation or disharmony in the body will cause functional energy to counterflow, moving in erratic ways. Heat inflammation is created, as is phlegm. The body will try to vent the pressure and heat from the body, which gives rise to more symptoms.
I’ve been working with a patient for some time. He had a particularly difficult struggle with COVID, which has left a multitude of residual symptoms. After spending much time regaining the body’s strength, we’ve had to work through recurring rebellious qi symptoms.
The common recurring symptoms are acid reflux, “nerve” pain in the arms and hands, neck stiffness, foggy head, heavy legs, pain in the abdomen, as well as “flares of adrenaline,” chronic fatigue, joint pain and insomnia.
When I feel his pulses, I have to constantly relate to him that he no longer has the weakness and depletion he had when I first started treating his “long COVID.” Now his pulses are tight, suggesting stagnation leading to rebellious qi. He has energy “knotting” in his body, which causes his internal (qi) energy to get stuck and/or move in the wrong direction. We no longer need to focus on building back his energy, now our focus is on untying his internal knots, and regulating qi flow. We also need to investigate and understand why knotting repeatedly occurs in his body.
The Luo Vessels and their theories of energy flow have shown me that my patient’s stagnation is rooted in the Stomach: the body’s interior energetic level. His pulses at the middle position, reflecting the energy of the Stomach, Spleen, Liver and Gallbladder are frequently tight and pulling towards the interior. This is where his “knotting” originates. But why?
Modern acupuncture would diagnose this as “Liver qi stagnation,” yet I see it as originating from the Stomach and venting into the other channels, including the Liver. Both of these organs, sharing the abdominal region have much overlap symptomatically, and often influence one another.
The Stomach and Spleen are classically seen as an “axis of qi,” which directs all energy flow in the body. It is the center of the body. The Stomach is the major force for descending energy flow in the body: everything that goes down is controlled by the Stomach’s energy. The Spleen is the major upward energy force in the body. The Liver is that which harmonizes both – it controls the smooth flow of qi in general.
The Liver as we said “houses” the etheric soul. It is also the organ that relates to anger and frustration. But the Stomach-spleen “houses” the Yi (mindfulness) and relates to pensiveness and worry.
Is the knotting due to residual, unresolved pathology from the long-COVID? Is it a response to the medications the patient has been taking? Or is there something mental-emotional that is causing it?
The aspect of the Luo Vessels I’m most interested in with this patient are called the Transverse Luo, which cause inflammatory symptoms and rebellious qi. The classic symptoms of each Luo Vessel helps to identify which channel heat and pressure are venting into.
The Transverse Luo can also be called the “internal Luo vessels.” There are another set of Luo Vessels which are more external called the Longitudinal Luo vessels. They translocate the energy of trapped physical or physiological material onto the surface of the body, whereas the Transverse Luo deal with trapped energy in the interior of the body.
The Luo can hold onto stress from unresolved infections or illness, the stress from diet or medications, as well as unresolved mental-emotional issues. They can hold onto stress, trauma, thought patterns, memories. Things we are stuck on or want to avoid. Luo is a wide-ranging and very powerful concept.
In the case of my patient, the acid reflux is a direct symptom of the Stomach. The Stomach’s Luo often expresses itself through sweating, but also through symptoms that appear above the Stomach: in the throat and head. Rebellious Qi is a classical symptom directly associated with the Luo Vessels.
Modern acupuncture often sees acid reflux as a symptom related to the Liver, yet I’m seeing it as coming from the Stomach. It is interesting to note that the most famous herbal formula “Zuo Jin Wan: the Left Metal” to treat acid reflux treats both the Stomach and the Liver. Within the thinking of this formula, the Stomach’s rebellious qi is the result of Liver fire which can be due to the emotions. The formula redirects the Stomach’s energy, while also calming the Liver (and emotions).
I suggested the use of the herbal formula “Zuo Jin Wan: the Left Metal” that uses the extremely bitter cooling herb Huang Liang (Coptis) to clear damp-heat from the Liver, Heart and Intestines. The Heart and Liver affinity to this herb shows it helps to reduce emotional distress that maybe causing inflammation. This herb is combined with the warming herb Wu Zhu Yu (Evodia) to increase circulation within the upper abdomen. It also has a particularly strong effect on regulating the Stomach’s energy, directing it downward.
I combined this classic combination with another classic combo: “Shao Yao Gan Cao Tang: the Peony and Licorice combination.” This formula is classically used to treat abdominal pain and spasm, as well as restlessness and irritability. It is more nourishing (especially to blood) than the other formula, having a very soothing effect, especially on the emotions.
The strategy in combining these two herbal formulas, put together into a powder form, was to ease the emotional distress that may be causing the rebellious qi, both by cooling heat stagnation in the abdomen, directing the stomach’s energy downwards to stop the upward surging of the stomach acid, and nourishing blood and qi-energy. The Bai Shao herb (Peony) also has a balancing effect between the energy of the interior and exterior of the body.
The heaviness of the legs shows stagnation effects from the Stomach are venting into the Spleen. Heaviness of the limbs is a classic symptom of the Spleen. Also the abdominal pain is a Spleen symptom, as is the foggy head.
Venting heat and pressure into the channel of the Gallbladder causes joint pain; Into the Bladder and Small Intestine causes ear and eye symptoms, as well as other head issues.
The heat and pressure venting into the channel of the Small Intestine on the arms is causing what the patient describes as “nerve pain.” This is the body’s attempt to bring the internal stagnation pressure from the Stomach internal level of the body to the most superficial level at the Small Intestine, in an attempt to discharge and vent.
By releasing the Luo points on each of the affected channels, beginning with that of the Stomach we are able to release the pressure and restore proper Qi flow in the body. When we do so all of the symptoms cease.
The herbal formula is a base that treats many of the vectors at play here too. The Huang Lian clears the heat that is venting into the other channels; with the Wu Zhu Yu it addresses the resulting rebellious qi. The Bai Shao and Gan Cao treat the additional Spleen symptoms of abdominal pain.
Beyond merely regulating rebellious qi and releasing stagnation blocks within the Luo Vessels, we also discuss and process why rebellious qi and blocks are being created. This is a more complex and difficult process.
This is one reason why I focus so much on using the Luo Vessels with this patient, as they are the “go-to” acupuncture channels for psychosomatic and mental-emotional related symptoms, especially when manifesting rebellious qi. This is also why I selected the herbal combination to address symptoms exacerbated by the mind and emotions.
Symptoms related to the Stomach and Luo Vessels in general often have a mental and emotional component to them. Both the Stomach and Luo are highly involved in blood chemistry.
Chinese medicine believes the mind and emotions (Shen- spirit) flow through the blood. To work with blood is to work with consciousness. This is why using an herb like Bai Shao is especially applicable to working with the Luo Vessels. It nourishes the blood and also “soothes the Liver” which has a strong effect on the emotions. It also stops pain in the abdomen which can relate to obsessing of the mind: a classic symptom of the Spleen’s Luo Vessel.
It is necessary to work with the blood (mind-spirit), and not just clear inflammation or redirect rebellious qi. The root of the problem is the consciousness (mind and emotions). This must also be addressed.
The Stomach and the Luo in general are both strongly affected by our mind and emotions.
The mind and emotions often have to be worked out anytime we are addressing Stomach issues, especially those involving rebellious qi. The most popular of all acupuncture channels to treat the emotions is the Pericardium channel. Most of the acupuncture points on this channel treat digestive issues involving the Stomach, showing the close link between the mind-emotions and the Stomach. To work with the blood is to work with Pericardium, which also works on the Stomach.
Thinking more broadly on this topic, we must consider why people become “rebellious” or reactive in general. What are we rebelling against? What can we not “stomach”? What are we rejecting? What can we not process and digest? Is it something dietary, or environmental? Something experiential? This often requires investigation, which means working with the blood: the Luo.
The level of the Stomach is related to the autonomic and enteric nervous systems, which often react to that which is unconscious or instinctual. We don’t often know what we are reacting to.
I recall years ago working with a young woman who had rebellious qi and stagnation symptoms. The energy blocks would manifest as lipomas on her neck and upper back. I explained that spider veins and lipomas are often physical manifestations of the Luo Vessels, suggesting something is stuck in her body, in this case within her unconscious. Spider veins often suggest something conscious has gotten stuck, while lipomas being phlegmatic suggest an unconscious holding.
After treating the lipoma through the Luo Vessels, especially in relation to the Small Intestine channel where the lipoma was located, she had a very strong cathartic epiphany. The lipoma “burst” open, releasing stuck fluid and she immediately knew what she was holding onto.
Each Luo Vessel has associated mental and emotional states, detailed in the ancient medical textbooks. I often see these as psychosomatic expressions of issues as they get stuck in the channels. Chinese medicine sees each of the internal organs as giving capacity (qi) to allow us to experience the emotions and mental states. For example, the Kidney allows us to feel fear, but also to develop willpower. The Liver allows us to feel anger, but also to develop benevolence and vision. When issues are stuck in the Luo Vessels, the Kidney Luo can manifest obsessive-compulsive tendencies and paranoia; the Liver can cause shifting personality and hyper-sexuality.
The organs provide the energy (Qi) for emotional experience. This is normal physiology. Yet when something becomes stuck, either in a fixated state, or that of avoidance, the Luo Vessels become active. The terms used for the Luo Vessels are “full” and “empty.” When the Luo Vessels become “full” they can cause a fixated or obsessive state. When the Luo Vessels empty, this can lead to avoidance states, or cause something to become habitual or unconscious.
The Luo of the Stomach when it is full can give rise to manic states that alternate with depression. The classic term for this is Dian Kuang: mania and withdrawal – a type of bipolar state, or manic-depression: highs and lows. When the Stomach is empty there can be a state of “weak legs,” which is both a physical symptom as well as a metaphor for a lack of mental direction.
The Spleen when it is full can cause obsessiveness; when it is empty it leads to unconscious habituated behavior and thought. The physical symptoms of the Spleen Luo involve pain in the abdomen and bloating: drum-like distention. Another manifestation of emptiness, when issues being held in the Luo Vessels drain into the main channel of the Spleen is weakness or heaviness of the limbs, including the head.
Assessing the acupuncture channels requires determining where the problem is located. In terms of the Luo Vessels, there are many branches. The problem can be located in the superficial (Longitudinal) Luo Vessels. These are the vessels that we can see on the surface of the body, usually as spider veins, discoloration or swellings. However when the problem goes internal, into the Transverse Luo Vessels the problems manifest heat (inflammatory) symptoms and rebellious qi. The problem can progress further to afflict the main acupuncture channels or the organs, which usually cause more serious symptoms.
The Luo Vessels translocate issues. They are an energy-exchange mechanism. In classic Chinese medical theory, the Yang aspect of the body, which usually refers to the channels or organs associated with the bowels are always moving and translocating problems. The Yin or viscera organs (and channels) store problems, keeping them hidden. Part of diagnosis and treatment of disease involves determining where issues are being moved from and to, as well as where they might be stored.
That which is stored must be brought to the surface. That which is moving must be cleared and purged. Treating the rebellious qi is usually just the first step in addressing a condition. The holding area must also be uncovered. We must continually ask: what is the fixation or aversion?
The Luo Vessels give us clues. The psychosomatic symptoms associated with each Luo Vessel direct us in certain directions for exploration. Since the Luo deal with blood, the symptoms can often be associated with traumas. The blood (and the Luo) hold onto traumas. This is known as a form of “blood stagnation.”
Through our explorations, my patient and I are starting to discover a post traumatic stress disorder underlying the rebellious qi symptoms. His experience with COVID rattled his sense of security and safety. He became very worried about getting sick again, developing a type of hyper-vigilance and hyper-sensitivity, especially related to change.
I related to him a concept called “running piglet qi,” which is experienced like a panic attack. This is a form of rebellious qi that comes from the lower abdomen and surges into the chest. It originates from cold stagnation in the lower abdomen.
I explained that what he is going through, his form of rebellious qi, was originating from the middle abdomen. It’s not as extreme as running piglet qi, which can feel like a heart attack. His form of rebellious qi was milder yet still due to a blockage in the center that we needed to figure out.
I often like to use herbal formulas alongside acupuncture treatments. There is a famous herbalist from the 19th century called Wang Qing Ren who specialized in treating blood stasis. He has several famous formulas that target specific areas in the body. His most famous is called “Drive Out Blood Stasis in The Blood Mansion,” targeting the chest.
Wang Qing Ren has another formula that targets the lower abdomen, used often for uterine and menstrual problems.
I considered using either the Blood Mansion formula with my patient or the progression formula called “Drive Out Blood Stasis Below the Diaphragm.”
The Blood Mansion formula is better suited for situations that are in a state of “fullness,” causing fixation. There is more of a tendency to be able to see the problems manifest on the surface of the body, classically in the form of spider veins or discoloration with “fullness.” “Emptiness” of the Luo manifests itself more in swellings.
Fullness also has more of a conscious fixated nature to it; whereas emptiness is more unconscious and habitual in terms of behavior.
While the patient doesn’t show swellings, which would be most associated with “emptiness,” his presentation was more associated with the Transverse Luo Vessels which are more internal than the more superficial longitudinal Luo vessels. There was also more of an unconscious nature to the symptoms. I decided to start with the formula associated with the region “below the diaphragm” and then move backwards to the “blood mansion.”
The strategy when working with “emptiness” of the Luo Vessels is to bring blood into the area. This is done through using Moxabustion to warm and stimulate blood movement as well as creation of new blood. It also helps “transform phlegm.”
Bringing blood into the area promotes conscious awareness. Transforming phlegm helps dissipate confusion. New blood brings new awareness; moving old blood helps eliminate trauma stasis.
The key ingredients to both of these blood stasis formulas are Peach pit (Tao Ren) and Safflower (Hong Hua) which is a classic combination to move blood stasis. The formula to treat below the diaphragm contains even stronger blood stasis moving herbs that target pain, such as Corydalis (Yan Hu Suo), Lindera (Wu Yao) and a strong Qi moving herb that is popular for treating depression: Cyperus (Xiang Fu).
The formula that treats the “blood mansion” is more nourishing for blood, containing one of the strongest blood and Yin nourishing herbs: Rehmannia (Sheng Di). It also contains a special herb that is also used for depression: Bupleurum (Chai Hu). However Chai Hu is also used to treat a stuck condition that is located 1/2 interior and 1/2 exterior: something lingering that the body is unable to release.
The third formula called “Drive Out Blood Stasis from the Lower Abdomen” contains many warming herbs such as Fennel (Xiao Hui Xiang), Cinnamon Bark (Rou Gui) and Dried Ginger (Gan Jiang) to address cold stagnation in the lower abdomen, which is the cause of Running Piglet Qi, the form of rebellious qi that brings about panic attack experiences. There is also contained within the formula the classic painful menstruation combination (called the Sudden Smile combination), targeting stagnation that may be causing significant pain in the lower abdomen.
The core of the acupuncture treatment to address rebellious qi via the Luo Vessels addresses also the blood stagnation root. We move blood to rid the body of trauma, but also to change consciousness. Many holding patterns causing psychosomatic symptoms must be treated through moving the blood.
ST-40 is usually my choice for the chief point in the treatment. If there is also joint pain, GB-37 is added. SP-4 and SP-3 are added if there is heaviness of the legs and abdominal pain. SI-7 and BL-58 are added if there are sensory issues affecting the head, ears and eyes. When there are palpitations or significant anxiety or chest tightness either HT-5 or PC-6 is added. LU-7 is also added to promote greater release.
Tears are often shed, as is a frequent release of heat. Sometimes also cold in the form of chills comes out. Whatever is stuck as a blockage in the body releases itself during our treatments.
A drop of blood is often released from the point SP-4 on the foot after the acupuncture needle is removed. Luo points are likely to expel a small amount of blood, as they are points that regulate blood and clear heat (agitation) in the blood. It is significant which point releases the blood, as this gives clue as to which aspect of the psyche the condition might be rooted: where the fixation is located.
SP-4 once again manifests symptoms associated with both the abdomen and chest. Obsessiveness and habituation are they key psychological symptoms associated with this point. By name this point has an association with the family. It is called “Gong Sun: Grandfather Grandson.” The Spleen is associated with the Earth element which manages our social self. Our reactivity and viewpoint of the world: our social self is created in the family. Many of our habitual thinking patterns root from our family, which can be worked out through SP-4.
The emotional state associated with the Earth Element which includes the Stomach and Spleen is pensiveness or worry. This is said to “bind the qi” creating a knotting in the center of the abdomen. Meditation can be the most powerful process to come to witness and understand our thoughts and thinking patterns. The acupuncture sessions I give to my patient are set up to be guided meditations. The acupuncture points put us into a receptive, reflective, relaxed state where we can observe our thoughts. As a teacher of mine used to say: “the meditation part of the session is just as important as putting in the needles and talking.”
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