As we are well into the season of late Summer, more cases are presenting at my clinic with Spleen and Stomach issues. One of my latest was a GERD client, whom I will call Bob. In his late 40s, Bob has had GERD for over 20 years and has tried everything. He currently is on two medications but still experiences terrible burning at night.
Most GERD cases I see are a combination of the patterns Cold Dampness in the Spleen and Liver Qi Stagnation. The Cold Dampness in the Spleen congests and slows digestion while the Liver Qi Stagnation attacks the Stomach, causing its contents to move upward instead of down. In this case we use Damp-dispelling and Qi-regulating herbs to clear the GERD.
Bob, however, presented with different patterns. He has Cold Dampness in the Spleen, yes, but with little Liver Qi stagnation, although he does lead a stressful life. Instead, he has many symptoms of Stomach Heat '“ a thick yellow coat in the center of his tongue, a big and fast stomach pulse, easily bleeding gums, some bad breath and of course, the acid reflux.
This pattern combination represents a different treatment approach, one of clearing Cold Dampness in the Spleen along with clearing Damp Heat from the Stomach. The formula of choice for this is Pinellia Combination. It contains pinellia to dry the Cold Damp in the Spleen and scute and coptis to dry the Damp Heat in the Stomach. Further, it includes ginseng to tonify Spleen Qi so Dampness doesn't collect and congest.
After taking this formula for two weeks with excellent results, Bob ran out of the herbs. As he was on a camping vacation, he had to do without and his symptoms returned. Thus, we knew the formula was working effectively and could separate this from the other treatments we did in session together.
This case not only demonstrates how necessary it is to first make a differential diagnosis before automatically treating a health condition, but it further represents how important it is to treat the person who has the disease and not the disease itself. As has been so wisely stated before, 'One disease, many formulas; one formula, many diseases.' Further, it shows how one may treat a combination of Heat and Cold factors by simultaneously using herbs that clear Heat and dispel Cold.
As a further note on GERD, along with taking the appropriate herbal formula, it's important for long-term correction to make dietary changes of course, but also to 're-surface' the denuded linings of the stomach and esophagus. For the latter I recommend 'Gastric Soothe' by Source Naturals (a zinc-based supplement) instead of using slippery elm or marshmallow, because these herbs are dampening, contraindicated in patterns with Dampness.
(Stomach Purging Decoction with Pinellia)
Pinellia (Rhizoma Pinelliae, Ban Xia)
Dried Ginger (Rhizoma Zingiberis, Gan Jiang)
Ginseng (Panax ginseng, Ren Shen)
Scutellaria (Radix Scutellaria, Huang Qin)
Baked Licorice (Glycyrrhizae praeparatae, Zhi Gan Cao)
Coptis (Rhizoma Coptidis, Huang Lian)
Jujube (Fructus Ziziphus, Da Zao)