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7 Treatment

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• 1.其高者因而越之• An illness located above the diaphragm an

d chest can be treated with emeics to induce vomiting

• --5 MANIFESTATION OF YIN AND YANG

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• Case 1• Male Adult 1228 A.D• Mania• Sudden onset, can’t recognize his folks, cr

easy and can’t be controlled by 3 people• Niu Huang, Bing Pian, She Xiang were us

eless for him.• Zhang Zihe gives D.D: phlegm fire glued o

n heart.

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• Promote vomiting

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• 2.其下者引而竭之• An illness…below the diaphragm and in th

e intestines can be purged.• --5 MANIFESTATION OF YIN AND YANG

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• Case 2• Female 71 • The patient suffers from headache for several

years. She takes 1~2 tablets anodyne several times every day.

• Poor appetite, bad sleep, fatigue, dry stools with difficult defecation, once bowl movement in couple of days.

• P-deep strong• T-red with thin yellow coating

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• DD: Yangming Fu excess, disturb clear heaven

• Xiao Cheng QI Tang modi– Sheng Da Huang (later), Mang Xiao (infusion)– Gan Cao 6, Chao Zhi Zi 10, Hou Po 8– Xuan Shen 12

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• Case 3• Female 26• The patient has epigastric fullness and dist

ention for many years. Belching a lot, with loud sound which leads her headache. She eats little, bad sleep, dry stools, once defecation in 2~3 days. Red complexion

• T-red tongue body with thin yellow coating• P-wiry strong

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• DD: ST qi up flowing

• San Huang Xie Xin Tang modi– Sheng Da Huang (later), Huang Qin 12, Huang Lian 8– Chao Zhi Zi, Chao Zhi Shi, Gan Cao– He Geng10, Chuan Lian Zi 8

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• 3 中满者泻之于内• If it is in the middle, involving the somach,

then digestive and carminative herbs will be used.

• --5 MANIFESTATION OF YIN AND YANG

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• Case 4• Male 45• The patient has epigastric distention and fullness, slight

pain several years . Sometime acid regurgitation, bad sleep.Middle jiao. Xie Xing method – use acrid to open, bitter to descend. Works for all things in the middle, scattering stuff away from middle. .

• P-wiry rapid• T-dark tongue body with thin yellow coating

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• DD: middle Jiao qi obstruction with heat cold mix

• Xie Xin method– Huang Lian 6 Wu Zhu Yu 5,

bitter acrid – Yan Hu Suo 10 Chuan Lian Zi 8– Zhe Bei Mu 10 He Ye (lotus leaf)8– Bai Shao 10 Zhi Gan Cao 6

Ban xia, wu zhu yu, ding xiang, xiang fu, and gan jiang are acrid and opening. Could use da huang, huang qin or huang lian as bitter herbs to descend. Could add anything like this to a formula to open/descend.

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• The idea of Xie Xin Tang– Epigastric fullness-Zhe Bei Mu, He Ye– Gastric pain, wiry pulse- Shao Yao Gan Cao Tang– Cold type, worsen with cold food-Liang Fu Wan– Heat type, thirst, rapid pulse-Jing Ling Zi San– Blood stagnation, stabbing pain-Shi Xiao San– Acid regurgitation-Zuo Jin Wan

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• Wu Zhu Yu, Gao Liang Jiang, Xiang Fu, Sha Ren---pungent to open

• Huang Lian, Chuan Lian Zi, Zhi Zi--- Bitter to descend

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• 塞因塞用，通因通用• treating obstructive syndrome with tonifyin

g method, while treating incontinent syndrome with dredging method

• --74 ESSENTIALS OF DISEASE AND THERAPY

“Block the blocked, unblock the unblocked.”

Counter intuitive? The sx is blocked, but the root is unblocked. Example: constipation can be a sx of Qi xu. Instead of purging which would further deplete, tonify the Qi in order to help push the stool out. So basically you are tonifying/blocking for a blockage.

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• Case 7• Female 41• The patient has pain in joints and skin all over the body• She tried steroids treatment, not satisfied• Constipation, using Enema glycerin • T- thin white coating• P-wiry thin

Also has weakness in the lumbar region

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• DD: essence and blood deficiency, insufficient water fail to push boat

• Ji Chuan Jian modi– Dang Gui 15, Ze Xie10, Niu Xi 12– Rou Cong Rong 15, Sheng Ma 6, Chao Zhi Ke 10– Chao Du Zhong 12, Tu Si Zi 10, Mai Men Dong 12– Zhi Gan Cao 6, Dan Shen 15

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• 3 bags, 30 min separated from wester medicine

• After 3 bags, she has defecation with out Enema glycerin. Several days later, she has defecation once every 2 days.

• Prescribed the original formula as pills for long term usage

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• Case 8

• Male 3y

• The baby has fever for 4 days,

• Sometimes restlessly cry, abdominal distention, refuse to eating, turbid loose stools, several times of defecation in a day.

• T- red tongue body with thin yellow coating

• P- blood vessel pass through Qi Guan/Gate/Bar

This is on the test! Loose stools, sounds like diarrhea. Do you use an astringing formula/tonifying the spleen? No. abdominal distention here indicates there’s an obstruction already. Remember your diagnostics for kids – the vein on the finger.

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• DD: food stagnation transformed to heat

• Sheng Da Huang 2(later) Chao Lai Fu Zi 6• Hou Po 4 Bin Lang 6• Chao Zhi Zi 4Lian Qiao 6, Chen Pi 4

Purge the food stagnation. Juicy foods and body fluids will flow through, hence the diarrhea, but the solids stagnation remains. You need to purge the stagnation.

Another example: heavy menses. . . You don’t always stop bleeding – they might have stagnation causing bleeding because the blood has to flow out of the vessels in order to keep flowing at all. Like a big rock in a creek – the rock will block the flow, but water will flow around the rock and out of banks.

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• The patient has large amount of turbid stools coming out at midnight after he took the formula. The boy sleep soundly after defecation. Fever vanished next morning

Turbidity has been pushed away. Problem is resolving. Happens a lot with kids who don’t have that developed “I’m full” sensor and will keep eating. Happens a lot in China due to the 1 child policy (2 parents + 4 grandparents = 1 spoiled child)