Library

Vomiting, diarrhea, and purgation are three treatment categories appended to the Shaoyin disease chapter. These conditions originally belong to Taiyin disease, but since they occur more frequently in Shaoyin disease, they are appended there.

The hallmark of Taiyin disease is abdominal fullness with vomiting, inability to eat, worsening spontaneous diarrhea, and occasional spontaneous abdominal pain. If purgation is mistakenly applied, it will inevitably lead to hardness and binding below the chest. In Taiyin disease, if the pulse is floating, sweating therapy may be employed, and Guizhi Tang (Cinnamon Twig Decoction) is appropriate.

If a patient initially had Taiyang disease, but the physician mistakenly applied purgation, resulting in lower abdominal fullness and intermittent pain, this belongs to the category of Taiyin disease; Guizhi Jia Shaoyao Tang (Cinnamon Twig and Peony Decoction) should be used. If stool is hard and painful, Guizhi Jia Dahuang Tang (Cinnamon Twig and Rhubarb Decoction) should be used.

Guizhi Jia Shaoyao Tang (Cinnamon Twig and Peony Decoction)
Ingredients: Guizhi (Cinnamomi Ramulus, 1.5 liang), Shengjiang (Zingiberis Rhizoma Recens, 1.5 liang each), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang), Shaoyao (Paeoniae Radix Alba, 3 liang), Dazao (Jujubae Fructus, 6 pieces).
Preparation and Administration: Crush the herbs. Take 5 qian per dose, decoct in water, and take warm.

Guizhi Jia Dahuang Tang (Cinnamon Twig and Rhubarb Decoction)
Ingredients: Guizhi (Cinnamomi Ramulus, 1 liang), Shaoyao (Paeoniae Radix Alba, 1.5 liang), Gancao (Glycyrrhizae Radix et Rhizoma, roasted, 0.5 liang), Dahuang (Rhei Radix et Rhizoma, 0.5 liang; increase by 1 liang if stool is hard and painful; reduce by 5 qian if deficiency prevails).
Preparation and Administration: Crush the herbs. Add 3 Dazao (Jujubae Fructus) and 4 slices of Shengjiang (Zingiberis Rhizoma Recens). Decoct in water and take warm.

In Taiyin disease, if the pulse is weak and the patient continues to have spontaneous bowel movements, even if Dahuang (Rhei Radix et Rhizoma) or Shaoyao (Paeoniae Radix Alba) are indicated, their dosages should be reduced. This is because the patient's Stomach Qi is weak and easily disturbed. In Taiyin wind-stroke, with irritability and pain in the four limbs, if the pulse is micro, choppy, and long, recovery is imminent. The time when Taiyin disease tends to resolve is from Hai hour to Chou hour. Abdominal fullness, intermittent pain, vomiting, and diarrhea indicate Taiyin disease. (See Taiyin section above.)

For Huoluan (Huo-loan) with vomiting and diarrhea, accompanied by headache, fever, body pain, absence of thirst, and abdominal fullness, Lizhong Wan (Regulate the Middle Pill) with Fuzi (Aconiti Lateralis Radix Praeparata) is indicated. (See Huoluan section.) For diarrhea with abdominal distension and whole-body pain, use Sini Tang (Four Reversal Decoction) to warm the interior first, followed by Guizhi Tang (Cinnamon Twig Decoction) to release the exterior. (See Diarrhea section.)

For hiccups accompanied by abdominal fullness, observe the anterior and posterior orifices for obstruction; relieving the obstruction will cure the condition. (See Hiccups section.) In Shaoyin disease, abdominal fullness and bloating with constipation indicate Da Chengqi Tang (Major Order the Qi Decoction). (See Constipation section.)

Abdominal fullness with difficulty in urination and jaundice indicates Yinchen Hao Tang (Artemisiae Scopariae Decoction). (See Jaundice section.) If accompanied by hypochondriac pain and a string-taut, floating, and large pulse, Xiao Chaihu Tang (Minor Order the Qi Decoction) is appropriate. (See Dry Nose section.)

If abdominal fullness persists without relief, or even slight reduction is negligible, purgation is required, and Da Chengqi Tang (Major Order the Qi Decoction) is suitable. If abdominal fullness comes and goes, returning to normal afterwards, this is due to deficiency-cold rising from below; warming herbs should be used to harmonize.

In Taiyin disease, with abdominal fullness, intermittent pain, and a floating pulse, Guizhi Tang (Cinnamon Twig Decoction) is appropriate. (See Taiyin section above.) In Yangming disease, with a string-taut, floating, and large pulse, hypochondriac pain, jaundice, and abdominal fullness, Xiao Chaihu Tang (Minor Order the Qi Decoction) is indicated. (See Dry Nose section.) In Shanghan (Cold Damage) with abdominal fullness and delirium, if the Cun position pulse is floating and tight, this is Liver Qi invading the Spleen, termed "Zong" (Vertical); acupuncture at Qimen (LR14) is appropriate. (See Stomach House Excess section. Note: Harmonization is indicated.)

In Yangming disease, with abdominal fullness and a slow pulse, suffering from vertigo and difficult urination, purgation is contraindicated; however, if tidal fever, sweating, and absence of aversion to cold are present, Da Chengqi Tang (Major Order the Qi Decoction) is indicated. (See Stomach Excess section.)

In combined disease of the Three Yang, with abdominal fullness, heavy body difficult to turn, delirium, enuresis, and spontaneous sweating, Baihu Tang (White Tiger Decoction) is appropriate. (See Combined Disease section.) In Shanghan with fever, choppy pulse, aversion to cold, extreme thirst for water, and inevitable abdominal fullness, if spontaneous sweating and free urination occur, the disease is resolving; this is Liver Qi invading Lung Metal, termed "Heng" (Horizontal); acupuncture at Qimen (LR14) is appropriate. With abdominal fullness, sweating, absence of aversion to cold, and wheezing, if the pulse is slow with tidal fever, Da Chengqi Tang (Major Order the Qi Decoction) is used. If the pulse is floating and tight with bitter taste and dry throat, sweating, moxibustion/cauterization, and purgation are all contraindicated. (See Abdominal Fullness with Floating and Slow Pulse section.)

After sweating therapy, if abdominal distension occurs, Nongpu Shengren Renshen Gancao Banxia Tang (Magnolia Bark, Ginger, Ginseng, Licorice and Pinellia Decoction) is indicated.

Nongpu Shengren Renshen Gancao Banxia Tang (Magnolia Bark, Ginger, Ginseng, Licorice and Pinellia Decoction)
Ingredients: Houpo (Magnoliae Officinalis Cortex, 2 liang), Shengjiang (Zingiberis Rhizoma Recens, 2 liang), Banxia (Pinelliae Rhizoma, 6 qian), Renshen (Ginseng Radix et Rhizoma, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 5 qian).
Preparation and Administration: Crush the herbs. Take 5 qian per dose, decoct in water, and take warm.

In diarrhea with undigested food, if sweating therapy is mistakenly applied, abdominal distension will inevitably result. (See Diarrhea section.) After Shanghan vomiting leads to abdominal fullness, Tiaowei Chengqi Tang (Harmonize the Stomach Major Order the Qi Decoction) is given. After purgation, if restlessness, abdominal fullness, and inability to lie or sit comfortably occur, Zhizi Nongpu Tang (Gardenia and Magnolia Bark Decoction) is indicated. (See Restlessness section.) After severe vomiting and purgation, if there is nausea, chest pain, loose stools, abdominal fullness, and irritability, Tiaowei Chengqi Tang (Harmonize the Stomach Major Order the Qi Decoction) is used. (See Vomiting section.)

If there is no bowel movement for six or seven days, administer a small amount of Xiao Chengqi Tang (Minor Order the Qi Decoction); if flatus does not pass, do not attack with purgatives, as this will cause abdominal fullness and anorexia. (See Constipation section.) Abdominal fullness with vomiting and diarrhea contraindicates purgation.

(About Taiyin.) Abdominal fullness with a floating-tight pulse and bitter taste/dry throat contraindicates sweating, purgation, and needling. (See Spontaneous Sweating section.) Abdominal fullness with a slow pulse contraindicates purgation. (See Slow Pulse section above.) Abdominal fullness with a weak pulse and spontaneous diarrhea: if Dahuang (Rhei Radix et Rhizoma) or Shaoyao (Paeoniae Radix Alba) are needed, reduce the dosage. (See Taiyin section.)