Original case: Liu Du-Zhou
A 52 year old male came in for a diagnosis on July 18, 1994. He had diarrhea that had been going on for more than one year and had used many kinds of antibiotics with no avail. Every day he had diarrhea 3 to 6 times, and at the time of the intake it was a watery type with small amount of pus and blood. There was also tenesmus, abdominal tenderness, which was especially severe on the lower left quadrant. There was also a fear of cold and a fever (approx 37.5C / 99.5F).
Tongue: red with a white coat
Pulse: submerged and wiry
Western Exam: Microscopic examination of stool revealed leukocytes and a small amount of phagocytes. Western medicine had diagnosed “chronic bacterial dysentery.”
Differential diagnosis: qi and blood congealing in the Spleen, wood constraining the earth center.
Treatment method: regulate the yin and yang of the Spleen, free the qi and blood, while simultaneously curtailing wood, preventing it from attacking the earth center.
- guì zhī (Cinnamomi Ramulus)10g
- bái sháo (Paeoniae Radix alba)30g
- zhì gān cǎo (prepared licorice root)10g
- shēng jiāng (fresh ginger rhizome)10g
- dà zǎo (Jujubae Fructus)12 pieces
After 2 packets the frequency of the diarrhea was remarkably decreased and the abdomen was more relaxed. After 3 more packets the stool was basically formed, abdominal urgency of the lesser abdomen was gone. After 4 more packets of herbs his pattern was resolved.
Commentary: The patient suffered from chronic dysentery due to a disharmony of the Spleen and Stomach and disharmony of the qi and blood. There was diarrhea, pain, and tenesmus. If there is pain there is no free flow. These signs belong to qi stagnation and blood stasis of the Spleen. The Spleen belongs to earth and Liver belongs to wood. When the Spleen’s qi and blood is inhibited this causes the qi of Liver / wood to not outthrust. Therefore the pulse was deep and wiry. Furthermore, because of the ongoing diarrhea there was damage to the yin, qi and blood stagnation, and Spleen yin disharmony. Therefore we see a red tongue.
The treatment was to use guì zhï jiä sháo yào täng (Cinnamon Twig Decoction plus Peony) in order to regulate and harmonize the Spleen and Stomach, free the qi and blood, boost the Spleen yin, calm the Liver’s urgency (tension). This is a unique usage of this formula for diarrhea and abdominal pain in tai yin disease. It is exactly like what li dong-yuan said, “If there is abdominal pain one should use gān cǎo (Glycyrrhizae Radix) and bái sháo (Paeoniae Radix alba). Ssowing and reaping is regarded as [the flavor] sweet, and sweet is the 6th heavenly stem (earth). Bending and straightening is regarded as [the flavor] sour, and sour is 1st heavenly stem (wood). [Using the] 1st and 6th heavenly stems transforms earth, this is the marvelous (mistaken character: 炒=妙？) method of Zhong-Jing. ” *** (I am not sure how to interpret and translate this quote, does someone have any better insights?)
This formula can be used in the clinic if one sees the three issues of disharmony of the Spleen and stomach, inhibited qi and blood, and Liver / wood overwhelming earth. Then this formula can be used without danger and obtain good results.
Translated by: Jason Blalack
Original Chinese: 一、下利(慢性菌痢)