Mr. Tim 47yr
Chief Complaint : Gastric dull pain for 4 months
The patient works as a package worker in an ice cream factory ,four months ago , he started to have persistent dull pain in the epigastrium , the pain becomes worse during this period which is relieved by warmth and pressure , he also has poor appetite , fullness in epigastrium ,vomiting of watery fluid , cold body and limbs , lassitude , pale complexion , loose stools or diarrhoea, with undigested food in the stools
He has a pale and tender tongue body with white or watery smooth coating  , slow pulse

TCM disease : Gastric  pain
TCM type/pattern : Stomach / Spleen yang deficiency

Classify patient’s condition
(         )  Patients condition is classified according to the Fundamental substances
(    v   )  Patients condition is classified according to the Zang Fu
(         )  Patients condition is classified according to Jing Luo
(    v   )  Patients condition is classified according to aetiology

Cold - damp invading the middle Jiao   /       yin,  interior, cold, deficiency
Shanghan                                  Taiyin syndrome

Explanation

Def. cold - dull pain for 4 months which is relieved by warmth and pressure

Exterior Cold damp - ice cream factory environmental

Yang def. of ST/SP - poor appetite, fullness in epigastrium, cold body and limbs, lassitude, pale complexion, loose stools or diarrhoea

Taiyin syndrome (inner damp) - it fail to transform/transport foodstuff due to yang def. of middle jiao

Interior def. cold - pale and tender tongue body with white or watery smooth coating, slow pulse

Treatment Principle:   warm yang of ST/SP, eliminate damp dispel cold to relieve pain

TCM principles: Cold damp evil from exterior/interior - eliminate damp dispel cold can relieve pain.

Warm yang of ST/SP - improve transform/ transport function of middle jiao

Each point relevant to the treatment principle 
Point number & name                                              Function & Indication

Qihai (RN6)                                           Strengthen qi to warm yang, dispel cold 

Pishu (BL20)                                           B/shu   warm yang, Gastric pain poor appetite, fullness   

Weishu (BL21)                                       B/shu   warm yang, Gastric dull pain, poor appetite, fullness 

Zhongwan (RN12)                                 Mu point of stomach, tonify ST / SP function

Zusanli (ST36)                                        Lower He sea point to treat Fu organ, tonify ST, and promote ST Qi descending

Neiguan (PC6) +Gong sun (SP4)            Luo point / 8 confluent point fullness, distention, gastric pain

Conclusion

Gastric pain due to exterior cold damp impairing ST/SP function, accompany with inner def. cold ,damp as well apply with mix point of channel of RN,ST,SP, BL, PC to strengthen qi to warm yang ,dispel cold can relieve pain

All points forcus to strengthen qi to warm yang ,dispel cold ,regulate ST/SP function improve the patient’s condition

(a) Treatment technique intended

Reinforcing methods to warm yang expel cold, damp + Moxa or TDP

(b) Function of channels involved

Taiyin Spleen Channel, disperse cold damp

Yangming Stomach channel, to treat disorder of stomach, intestines

Backshu point (BL channel), to warm yang can regulate inner zang-fu organ

REN Mai - to warm yang to treat disorder of spleen /stomach

PC channel - disorder of chest, heart, stomach