Library

This is a syndrome of latent pathogenic qi transforming into heat. It is generally caused by contracting slight cold in winter or early spring, which does not immediately manifest as disease. The contracted cold lies hidden within the fatty membranes of the Sanjiao (Triple Burner), obstructing the ascending and descending movements of Qi transformation. After a long time, internal heat is generated. By deep spring, the latent pathogenic qi transforms further into heat along with the rising Yang energy of spring. At this point, the two heats combine, and the Zang-Fu organs cannot withstand the scorching heat. This condition originally shares the same treatment principle as exogenous pathogens penetrating deeply into the Yangming channel; therefore, it is appropriate to treat it with Baihu Tang (White Tiger Decoction).

The patient heard my words and nodded in agreement. I then prescribed Baihu Tang. In the formula, Sheng Shigao (Raw Gypsum Fibrosum) was used in an amount of 3 liang. Because the patient suffered from vomiting, 1 liang of finely powdered Sheng Zheshi (Raw Hematitum) was added. Because the patient had difficulty urinating, 6 qian of Huashi (Talcum) was added. Regarding the fact that the patient had not had a bowel movement for more than ten days, no laxatives were added because the combination of Zheshi and Shigao is particularly effective in unblocking dryness-heat accumulation in the intestines.

The decoction was prepared as one large bowl and taken slowly while warm. After ingestion, half of the medicine was vomited out. Urination became slightly freer, but the bowels remained unopened.

On the following day, the original formula was modified: Shigao was increased to 5 liang, and Zheshi to 2.5 liang. Furthermore, imitating the principle of Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng), 3 qian of Yetaishen (Wild Codonopsis Root) was added. The decoction was again prepared and taken slowly while warm. Half of the medicine was still vomited, and the bowels remained unopened.

Consequently, the dosage form was changed from decoction to powder. One liang of finely powdered Shigao and 4 qian of finely powdered Zheshi were mixed evenly to constitute one day's dose. Fresh Baimaogen (Rhizoma Imperatae) weighing 4 liang was decocted in water. The powder was administered in three divided doses using the Baimaogen decoction. After taking the medicine, there was no vomiting at all, several pieces of dry feces were passed, and urination became very smooth and profuse.

On the next day, again imitating the principle of Baihu Jia Renshen Tang, Yedangshen (Codonopsis Radix) was increased to 5 qian. The previous powder was taken with a decoction, resulting in the passage of several more pieces of dry feces. Thereafter, the medication was continued daily, with a rest day every other day when no medicine was taken. Approximately 1 jin (roughly 500g) of finely powdered Shigao was consumed in total, leading to the passage of nearly 100 pieces of dry feces. Only then did the illness completely resolve.

After recovery, the patient's appetite increased, and the Spleen and Stomach were not harmed in the slightest. Thus, the efficacy and benevolent nature of Shigao can be understood. I have used Shigao many times to treat constipation caused by dryness-heat accumulation. Sometimes Shigao powder was used alone, and sometimes a small amount of Zheshi powder was added as an adjuvant. In all cases, immediate efficacy was achieved. Since the maximum amount of Shigao powder was used in this case, I specifically recorded it.