Book Title: Selected Medical Cases from Famous Doctors in the Shang Hun Traditions

Editors: Chen Ming and Zhang Yin Sheng

Class: Medical Chinese, Spring/Summer 2004

Translation by: Gina Hedahl

Herbal Formula: ban xia, huang qin, dang shen, gan cao, huang liang, da zao

Cooking Method: Put the above herbs in 1 dou of water and cook until the water is reduced to 6 sheng. Remove dregs and cook until the water is reduced to 3 sheng.  Warm decoction and take 1 sheng 3 times daily. (Modern method: Decoct in water 2 times and take)

Source Text:

When there is cold damage for 5 to 6 days with vomiting and feverishness and xiao chai hu tang sign are present, if other medicinals were used to purge and xiao chai hu tang signs are still present, xiao chai hu tang can still be used.  If purging has already been used and was not an adverse treatment, there will be steaming and quivering, then feverishness and sweating, this indicates the disease will be resolved.  If there is distention and hardness below the heart, this is chest bind and da xian xiong tang governs. If there is only distention and no pain, this is a glomus and xiao chai hu tang should not be given but ban xia xie xin tang is appropriate to use. (149)

Narration:

This syndrome is phlegm qi glomus and the basis of the disease is spleen, stomach weakness and deficiency with a dysfunctional qi uplifting and down bearing mechanism. When the stomach qi does not go down, heat is developed.  When the spleen qi des not go up, cold is developed.  Because of this, there is a mixing of cold and heat in the middle jiao and therefore the glomus below the heart belongs to the “cold heat mixed glomus” type.  Phlegm qi glomus characteristics: in the middle one would see a glomus below the heart with an uncomfortable distended feeling, above there is vomiting or spitting up of sticky saliva, and below there is diarrhea. The tongue fur is white and greasy and the pulse is usually slippery.  The formula is xiao chai hu tang without chai hu, sheng jiang and the addition of huang lian and gan jiang.  Ban xia is the main herb which transforms phlegm, harmonizes the stomach and stops vomiting.  Huang qin and huang lian are bitter, cold and clear heat.  Gan jiang is acrid, hot and scatters cold. Dang shen, gan cao and da zao tonify and benefit the spleen and stomach.  Ban xia xie xin tang is the number one formula for spleen, stomach disharmony with a mix of cold and heat because it has the composition of acridness to open and bitterness to go downward and heat and cold herbs that go to the same place.  This formula with modifications can treat spleen, stomach weakness and deficiency, the mixing of heat and cold, the dysfunction of the upward and downward mechanism, the murkiness of the clear and turbid inside the intestines and stomach that’s not harmonized, stomach duct and abdomen pain and distention, and vomiting and diarrhea.

Usages:

Vomiting and Diarrhea

Male, alcoholic, disease started in 1969 with vomiting, oppression and glomus below the heart with unformed bowel movements 2-3 times per day.  The patient was treated with many formulas without any effect.  Pulse was wiry and slippery and the tongue coat was white.  Differential diagnosis is alcohol dampness injuring the stomach, and depression creating phlegm.  Phlegm turbidity is the evil and the stomach qi is deficient therefore this effects the upward and down bearing mechanism resulting in vomiting, glomus and distention in the middle and diarrhea. Treatment is to harmonize the stomach, down bear counter flow, drain damp, and remove the glomus. Formula: ban xia -12, gan jiang – 6, huang qin- 6, huang lian – 6, dang shen – 9, zhi gan cao – 9, da zao – 7 pieces. After taking 1 bag of herbs, the bowel movements contained a lot of white colored glue like substance, and the vomiting was reduced by 70%.  After taking another bag, the glomus and diarrhea were reduced and after 4 bags, the patient was cured.

Jaundice

Female 41 y/o, June 6, 1980: first visit.  Three days prior, the patient had a high fever and jaundice of the sclera and skin appeared with yellow urination, bilirubin levels of 26u, and bowel movements were white.  This was suspected to be an obstruction type disease. The patient was hospitalized for 80 days and left the hospital because she was scared to have surgery.  Patient had dizziness, bitter taste in the mouth, nausea and vomiting, chest oppression, poor appetite, stomach duct pain with a glomus type feeling, right rib pain, unable to lay on the right side, white colored bowel movements 1 time per day, tongue body was red with a yellow coat, and the pulse was slow and weak.  Appropriate treatment would be to use acridness to open, bitterness to down bear and to also course the liver and release depression.  Formula: Ban Xia Xie Xin Tang modified:  dang shen- 15, fa ban xia – 9, gan jiang- 6, huang qin- 9, chai hu- 9, hang shao- 9, zhi shi- 10, chao san xian- 9, ji nei jin – 9, yu jin- 9, gan cao- 6.  Patient took herbs for about ½ year and eventually the formula was modified (added xiang fu, shan zha, dan shen to disinhibit the gallbladder and remove stasis). The bowel movements gradually turned from white to yellow, bilirubin levels decreased to 6u and the patient was cured.