Sutra prescription for constipation with cold deficiency

  Constipation is a common clinical condition, often treated with laxatives, of which there are many who are ineffective. The author consulted Professor Feng Shilun and saw that rhubarb was rarely used, but the combination of Chai Hu Gui Zhi Gan Jiang Tang and Angelica Paeoniae San was often used, with remarkable clinical efficacy.  Cui, female, 49 years old, was first diagnosed on May 19, 2011. She has been constipated for more than 25 years, and her previous treatment with rhubarb, senna leaf, fruit guide tablets and intestinal clearing tea was ineffective. Now she has no bowel movement, 1 line of stool in 3~4 days, dry as sheep stool, relies on enema to pass stool, stomach and abdomen are distended and hard, seems to have hard lumps on palpation, dry mouth and desire to drink, phlegm, yellowish color, bad heat without sweating, bitter summer, easy to have headache and dizziness when in heat, swelling in right hand, sciatica, nasal pain, sleepy and dreamy, four reversals, last menstruation lasted 17~18 days, urine is regulated, tongue is dark, moss is white and greasy, pulse is thin. The six meridians are identified as Conjunctive Yin and Taiyin combined with Blood stasis and Blood deficiency.  The prescription belongs to the formula of Chai Hu, Gui Zhi and Gan Jiang Tang combined with Dang Gui and Shao Yao San. Prescription: Chai Hu 12g, Gui Zhi 10g, Gan Jiang 10g, Scutellaria Baicalensis 10, Tian Tian Fan 12g, Sheng Long Mu 15g, Roasted Licorice 6g, Angelica Sinensis 10g, Bai Shao 10g, Chuan Xiong 6g, Poria 12g, Rhizoma Atractylodis Macrocephalae 30g, Ze Di 18g. 7 doses with water decoction.  June 16, the second diagnosis: the above served 26 doses, now stool 1 ~ 2 days a line, dry nose, headache, dizziness, palpitations, dry mouth, thirst, eat garlic stomach tingling, fingers slightly swollen, sciatica reduction, four rebellious has been, urine regulation, white greasy moss, pulse thin string. The above formula was supplemented with 15 grams of dog’s spine to enhance the function of strengthening and laxative. 7 doses were taken with water decoction.  A total of more than 30 doses of medicine and the success.  Press: treatment of constipation must be divided into cold and heat deficiency, otherwise not only ineffective, but aggravated. The patient’s mouth is dry and wants to drink, evil heat, easy to headache and dizziness in case of heat, this is water drink heat; dry stool, stomach and abdomen bloating hard, sciatica, four rebellious, for stomach deficiency cold; headache dizziness, sleep dreamy, for heat congestion and water drink upward rebellion; phlegm, right hand has a sense of swelling, moss white root greasy, for water Sheng; with menstruation for a long time, for blood stasis water Sheng, tongue dark light pulse thin for blood deficiency should. This evidence for the stomach deficiency cold water and drink metabolism abnormal, resulting in the intestinal tract lost fluid moistening and nourishment, then fluid dry, no water to move the boat, coupled with unfavorable moistening, intestinal peristalsis slowed down, so constipation. According to Articles 147 and 148 of the Treatise on Typhoid Fever, the six meridians are identified as upper heat, lower cold, sympathetic Yin and Taiyin disease with blood stasis and blood deficiency. Treatment should be to clear the upper heat, warm the lower cold, remove blood stasis and harmonize the blood, and facilitate drinking.  Article 147 of the “Treatise on Typhoid Fever”: In five or six days of typhoid fever, the sweat has already been issued, but again down, the chest is full and slightly knotted, the urine is unfavorable, but the head sweats, thirsty but not vomiting, cold and fever, heart distress, this is not resolved, Chai Hu Gui Zhi Gan Jiang Tang is also the main. Article 148 of the “Treatise on Typhoid Fever”: Typhoid fever for five or six days, head sweating, slightly vicious cold, cold hands and feet, fullness under the heart, mouth does not want to eat, hard stool, thin pulse, this is Yang micro knot, must have a table, and then there are also. The pulse is sunken, also in the inside. Sweating, for Yang micro; if the pure Yin knot, shall not be repeated outside the evidence, all as in the lane, this is half in the lane and half outside. The pulse age sinking today, shall not be Shaoyin disease, so it is, Yin shall not have sweat, today the head sweat, so know not Shaoyin also, can be with small Chaihu Tang; set not to be able to, get shit and solve.  The two articles have unique insights from the masters Hu Xiju and Professor Feng Shilun: First, Article 148 is an explanation of Article 147. Secondly, they think that the “micro knot” in Article 147 is the “Yang micro knot” in Article 148, which is the deficiency of fluids that causes hard stools. The third is that the “can be combined with Xiao Chai Hu” in Article 148 should be “can be combined with Chai Hu Gui Zhi Gan Jiang Tang”. Professor Feng also pointed out clearly that: Chai Hu, Gui Zhi and Gan Jiang Tang is a yin symptom of upper heat, lower cold, half surface, half lining, and is a sympathetic disease of the six meridians; Xiao Chai Hu is a yang symptom of upper heat, lower cold, half surface, half lining, and is a shaoyang disease of the six meridians. The former is heavy on the lower cold and light on the upper heat; the latter is heavy on the upper heat and light on the lower cold.  The two articles are combined to recognize Chai Hu Gui Zhi Gan Jiang Tang, whose indications are: upper heat (head sweating, thirst, heart agitation), lower cold (slight coldness, cold hands and feet, subcardiac gangrene, lack of appetite in the mouth), fluid deficiency (unfavorable urination, hard stools, thin pulse), and special heat type of half-epidermal and half-liental (cold and hot exchanges). Hu Xiju and Feng Shilun often combine it with Angelica Paeoniae San in the clinical evidence, according to which the author is very effective in the clinical evidence.