Library

Wang Zhongyang treated a man who was twenty years old and unmarried. He had suffered from chronic spermatorrhea and dribbling for a long time. Each episode was treated as deficiency-cold with collapse and leakage, but the condition worsened. Wang examined the pulse at all six positions (three on each wrist) and found them wiry and rapid; he did not record the exact rate. The patient was emaciated to the point of being skeletal and could barely support himself. Wang said, "How bitter! This is due to the dysfunction of the Sanjiao (Triple Burner), with heat accumulating in the Bladder, constituting a case of the Five Types of Strangury (Wu Lin)." The patient said, "When discharging semen, blood, sand, and filth, every urination is accompanied by unbearable pain." Therefore, Ju Fang Wu Lin San (Bureau Formula Decoction for Five Stranguries) was used, added with Gardenia Fruit (Gardeniae Fructus), Red Peony Root (Paeoniae Radix Rubra), Akebia Stem (Akebiae Caulis), Knotgrass Herb (Polygoni Avicularis Herba), fresh Plantago Seed (Plantaginis Semen), and Talcum (Talcum). It was prepared as a large dose, decocted with twenty stalks of Juncus Effusus (Junci Medullam), and administered. After five to seven days, he was completely cured. However, the relapses were frequent. One day, he suddenly came in an emergency stating that for nine days, both stool and urine had been obstructed, causing suffocation and impending death. Wang immediately ordered fine ash to be piled around the patient's navel down to the Dantian (Sea of Qi) to form a mud pond, about the size of a bowl. An instruction was given to use thick ash one finger-width high, raised around the perimeter. About one tael of Mirabilite (Natrii Sulfas) was dissolved with freshly drawn well water and slowly poured into the ash pond, preventing it from overflowing. Suddenly, both stool and urine gushed out. Blood clots like fingers appeared in the urine. If the heat had not resolved and qi had not moved freely, how could such foul matter have been discharged continuously for three or four days through the small opening of the turtle-like orifice? Thus, life was restored. He was then instructed to take Huanglian Jiedu Wan (Coptis Decoction to Resolve Toxicity Pills). Over three years, consuming approximately four jin (about 2 kg), the condition did not recur.

Zhu Danxi treated a woman who, after suffering from Bi Syndrome (Obstruction Syndrome characterized by pain), experienced obstruction of both stool and urine. This was due to phlegm obstructing the Middle Jiao and qi gathering in the Lower Jiao. Er Chen Tang (Two-Cured Decoction) with Akebia Stem was decocted and taken. After another dose, induced vomiting was performed.

Li Shizhen said: My nephew, Liu Qiao, who indulged in alcohol and sexual activity, suffered from severe distending pain in the lower extremities/genital region, with obstruction of both stool and urine. He could neither sit nor lie down, standing up crying and groaning for seven days and nights. Physicians used purgative and diuretic medicines without effect. They sent someone to ask me. I reasoned that this was damp-heat pathogenic factor in the seminal ducts, causing congestion and swelling of the passages. The disease was located between the two yin openings (urethra and anus), thus blocking urine anteriorly and stool posteriorly. The disease was not in the Large Intestine or Bladder. Therefore, I used Madrone Fruit (Chaenomelis Fructus), Fennel Fruit (Foeniculi Fructus), and Pangolin Scales (Manis Squama), adding doubled quantity of Morning Glory Seed (Pharbitidis Semen). After one dose, symptoms decreased; after three doses, they normalized. Pharbitidis Semen reaches the Mingmen (Gate of Life) of the right Kidney and travels through the seminal passages, which is unknown to most people.

Yu Zhen commented: For obstruction of both stool and urine, if the pulse is excess, Bazheng San (Eight-Herb Rectifying Powder) with doubled Rhubarb (Rhei Radix et Rhizoma), or Daohuan San (Turning Over Powder) are also excellent. If the constitution is weak, or in the elderly, or post-illness/postpartum, these cases should all be treated as deficiency constipation, focusing on moistening dryness and nourishing yin, using guiding methods below. If the physique is robust and spirit vigorous, yet experiencing constipation and difficult urination, it must be due to stagnation of Spleen and Stomach qi failing to transport, compounded by phlegm, food retention, and obstruction of turbid pathways. If the pulse is deep and excess, use Bupleurum (Bupleuri Radix), Cimicifuga (Cimicifugae Rhizoma), Er Chen Tang, and Baizhu-Atractylodes Decoction (Er Zhu Tang). The selected case of Wang Zhongyang herein is valued for its external treatment method and the peculiarity of taking Huanglian Jiedu Wan for three years. Furthermore, Li Shizhen's use of Pangolin Scales and Pharbitidis Seed to travel through seminal passages to unblock stasis is even more peculiar. It can stand alongside Dongyuan's Zishen Wan (Kidney-Nourishing Pill) forever.