Constraint- Focal distention and clumping below the heart (YTS)

Original Case by: Ye Tian-Shi (叶天士)

Hu, 46 years of age, had been weeping due to grief. The disease arose from internally generated emotions, which led to constraint. There was a physical manifestation in the area below the heart  that was gradually getting larger with a hardness upon palpation.

Treatment principle: A bitter-acrid and downward-draining method was used. First must treat the qi clumping.

Diagnosis: (Focal distention and clumping below the heart).

Coptidis Rhizoma (huáng lián))
Zingiberis Rhizoma (gān jiäng)
Pinelliae Rhizoma preparatum (zhì bàn xià)
Zingiberis Rhizomatis Succus (jiāng zhī) (ginger juice)
Poria (fú líng))
poria with cutis (lián pí fú líng)
Trichosanthis Fructus (guā lóu)

Commentary: poria with cutis (lián pí fú líng) While it still strengthens the Spleen, its ability to leach out dampness and facilitate water is enhanced, which makes it especially suitable for water-damp edema due to weakness in the transportive function of the Spleen (Clavey and Bensky, p.270).”

Translated by: Jason Blalack

Original Chinese: 胡（四六） 悲泣。乃情怀内起之病。病生于郁。形象渐大。按之坚硬。正在心下。用苦辛泄降。先从气结治。（心下痞结）川连 干姜 半夏 姜汁 茯苓 连皮栝蒌

Source: From the Constraint Chapter of Case Records as a Guide to Clinical Practice (Lín zhèng zhî nán yï àn) 《临证指南医案》.