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	<title>Chinese Medicine Doc - Boulder Acupuncture &#187; Constipation</title>
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		<title>Si ni san (constipation)</title>
		<link>http://www.chinesemedicinedoc.com/case-studies/si-ni-san-constipation/</link>
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		<pubDate>Sun, 11 Oct 2009 19:56:58 +0000</pubDate>
		<dc:creator>Jason Blalack</dc:creator>
				<category><![CDATA[All case studies]]></category>
		<category><![CDATA[Shang Han Lun]]></category>
		<category><![CDATA[Classical formulas]]></category>
		<category><![CDATA[Constipation]]></category>
		<category><![CDATA[Constraint]]></category>
		<category><![CDATA[Si ni san]]></category>

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		<description><![CDATA[On March 10, 1986, A 28 year male presented with dry stools like sheep&#8217;s feces, evacuating once every 2-3 days, which had been  going on for for nearly 1 year.  He also had abdominal distension, fullness, and pain, and cold hands. His tongue was red with a  thin and yellow coat. His pulse was wiry and rapid.  The pattern belonged to <span style="text-decoration: underline;">qi constipation</span>.   
Treatment was to regulate the qi,  unlock the yang, moisten the intestines, and unblock the bowels. Frigid Extremities Powder (sì nì&#8230;]]></description>
			<content:encoded><![CDATA[<p>On March 10, 1986, A 28 year male presented with dry stools like sheep&#8217;s feces, evacuating once every 2-3 days, which had been  going on for for nearly 1 year.  He also had abdominal distension, fullness, and pain, and cold hands. His <strong>tongue</strong> was red with a  thin and yellow coat. His <strong>pulse</strong> was wiry and rapid.  The pattern belonged to <span style="text-decoration: underline;">qi constipation</span>.  <strong> </strong></p>
<p><strong>Treatment</strong> was to regulate the qi,  unlock the yang, moisten the intestines, and unblock the bowels. Frigid Extremities Powder <em>(sì nì sân)</em> with modifications was given:<br class="spacer_" /></p>
<p>Bupleuri Radix <em>(chái hú) </em>12g<br />
Aurantii Fructus immaturus <em>(zhî shí)</em> 9g<br />
Paeoniae Radix alba <em>(bái sháo)</em> 9g<br />
Allii macrostemi Bulbus <em>(xiè bái)</em> 9g<br />
Cannabis Semen<em> (huô má rén)</em> 30g<br />
Glycyrrhizae Radix <em>(gän câo) 3g</em></p>
<p>Four packets were given whereby the stools were unblocked and normal.</p>
<p>Source: (陕西中医 1993;〈7〉 : 324 )</p>
<p><em>Translated by: Jason Blalack</em></p>
<p><strong>Jason&#8217;s Commentary:</strong><br />
Since I came across this case years ago I have used this idea and base formula multiple times with success. &#8220;Qi constipation&#8221; is an ancient disease name that comes about from yang qi constraint and clumping, qi stagnation not outthrusting, and a sluggish Large Intestine. Cold limbs and a wiry pulse are the key signs/symptoms for diagnosing this pattern. In the book, <span style="text-decoration: underline;">Book to Safeguard Life Arranged According to Pattern</span> (1108), it says, &#8220;cold extremities with constipation, urination that is reddish&#8221; is a &#8220;yang pattern resembling symptoms of yin.&#8221;  Use Frigid Extremities Powder <em>(si ni san) </em>to dredge and outthrust the constrained and trapped yang qi and free the qi dynamic.  Allii macrostemi Bulbus <em>(xie bai)</em> is added to aid in unblocking the stool whereas Cannabis Semen <em>(huo ma ren)</em> is added moisten the stool/dryness.</p>
<p><br class="spacer_" /></p>
<hr style="width: 25%; height: 1px;" size="1" />
<p>Original Chinese:</p>
<p>安少先医案 : 傅某 ,男 ,28 岁, 1986 年 3 月 10 日 就诊。大便干燥如羊矢, 2~3 日 1 行近 1年, 脘腹胀满疼痛, 两手发凉, 舌红、苔薄黄, 脉弦数。证属气秘, 治宜理气通阳, 润肠通便, 投四逆散加味 :柴胡 12g, 积实、白芍、薤白各 9g, 火麻仁 3Og, 甘草 3g。服 4 剂便通如常。</p>
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