Over the summer and well into the fall months, I tend to see more patients presenting with gastrointestinal issues. Symptoms such as gas, bloating, heartburn, loose stool, and constipation are typically the main complaints, and these often combine together in symptom constellations. This is commonly due to changes in the diet related to events such as outdoor grilling and traveling, during which patients tend to eat heavier, fatty foods and/or more “junk foods.”
While there are a wide range of TCM remedies for such issues, in this installment I will focus on how to differentiate between the spleen points of Sp 3 and Sp 4, in combination with stomach points, in patients suffering from such seasonal digestive disorders.
Points along the spleen and stomach meridians are primary for helping resolve such gastrointestinal symptoms and are ideally used in combination to maximize therapeutic outcomes. Clinicians and students are often confused on how to choose or differentiate between using Sp 3 vs. Sp 4 when creating point prescriptions.
Both points are highly effective for digestive issues related to spleen / stomach issues; however, there are unique characteristics within each point which can be used to help decide which to use in clinical scenarios.
Spleen 3 (Taibai / “Supreme White”)
Sp 3 is the shu stream, yuan source, and Earth point of the spleen channel. Its main actions include tonifying the spleen, resolving dampness and damp heat, harmonizing the spleen and stomach, regulating the qi, and stopping joint pain.
Being a yuan source point, Sp 3 is ideally suited for clearing deficiency syndromes; and being a shu stream point, it is ideally suited for heaviness of the body and pain of the joints caused by damp or damp heat.
For patients suffering from digestive issues such as bloating, loose stools, burning stools, reduced appetite, fatigue, and sensations of heaviness and joint pain, Sp 3 is an ideal point. For patients suffering from patterns rooted in spleen deficiency and stomach excess / stomach heat (a common pattern presentation in the summer and fall months), I frequently use the following point prescription. Tongue presentations in such patterns can range from pale with teeth marks to red body with sticky yellow coat; pulses can range from slippery to wiry.
Sp 3 + St 25 + LI 11
This three-point formula is an excellent foundation to build upon with patterns of spleen deficiency / stomach excess with potential heat complications. As mentioned, Sp 3 tonifies the qi, resolves dampness, and harmonizes the spleen and stomach.
ST 25, the front mu point of the large intestine, regulates the intestines, regulates the spleen / stomach, resolves dampness and damp heat, regulates the qi and blood, and eliminates stagnation. LI 11 clears heat from the yang ming meridian (as well as the entire body), drains damp, regulates the qi and blood, and relieves pain.
This three-point prescription can be used to build upon when targeting patterns rooted in spleen deficiency / stomach excess with heat complications.
Spleen 4 (Gongsun / “Yellow Emperor”)
Sp 4 is the luo connecting point on the spleen meridian and chong mai master point (coupled with PC 6). Its main actions include tonifying the spleen and harmonizing the middle Jiao, regulating the qi and resolving dampness, benefiting the heart and chest, and regulating the penetrating vessel.
Being a luo connecting point and particularly targeting the chest and heart, Sp 4 is an effective point for gastrointestinal disorders that have both upper and lower GI symptoms, such as heartburn with bloating and loose stools, heartburn with anxiety, and loose stools due to stress.
Sp 4 has more of a qi-regulating effect than Sp 3, which can be important in patterns showing more stagnation such as food stagnation or liver qi stagnation. These two patterns are extremely common underlying factors in complex and recalcitrant, multi-layered patterns of gastrointestinal disorders.
Sp 4 + St 25 + Ren 12
This three-point prescription can also be used as a foundation to build upon while creating point prescriptions for patients experiencing gastrointestinal issues with more symptoms of stagnation with deficiency, as well as upper-GI involvement such as heartburn and “plum pit qi” expressions.
As mentioned, Sp 4 tonifies the spleen, regulates the qi, resolves dampness, and benefits the chest / heart area. ST 25, the front mu of the large intestine, regulates the intestines, regulates the spleen / stomach, resolves dampness / damp heat, and eliminates stagnation.
Ren 12, the front mu point of the stomach and meeting point of the conception vessel with the small intestine, san jiao, and stomach channels, harmonizes the middle jiao, descends rebellious qi, tonifies the spleen, regulates the qi and relieves pain. It is also important to note that Ren 12 is particularly unique in that it is equally applicable to both excess and deficiency presentations.
Clinical Pearls
Hopefully this short discussion helps you create acupuncture point prescriptions targeting the unique pattern presentations of patients suffering from both acute and chronic gastrointestinal disorders. Both Sp 3 and Sp 4 are highly effective acupuncture points for patients suffering from digestive issues, and the not-so-small nuances between the two points are often the key to clinical success.
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