Library

Yao Shuting, in his seventies, suffered from chronic diarrhea. Various physicians treated him with mixed methods without effect. Everyone believed he would not survive. The condition dragged on until late autumn, when Meng Ying was invited to determine the timing of death, not daring to hope for a cure. Meng Ying said: "The pulse presents a wiry image (Wiry Pulse, indicating liver issues or pain) exclusively at the right Guan position (Guan Position, located proximal to the Cun position on both wrists), which is extremely weak upon deep pressure. This indicates Spleen Earth deficiency and Liver Wood encroachment (Liver overacting on Spleen). If treated correctly, longevity can still be extended; why give up so easily?" He then reviewed all previous prescriptions, which all advocated warming tonification and raising Yang. Meng Ying said: "The principle is not contrary, but the interpretation is incomplete! Herbs such as Gan Jiang (Dried Ginger), Fu Zi (Prepared Aconite Root), Rou Dou Kou (Nutmeg), and Gu Zhi (Bone Setter) are hot in nature and pungent in flavor. Although they can warm the viscera, they反而 (instead) assist Liver Yang. As Liver becomes stronger, Spleen suffers more damage. Moreover, Pungent herbs move Qi and have a draining nature, which contradicts the principle of 'astringing what is leaking.' Furthermore, Lu Rong (Deer Antler Glue) and Sheng Ma (Cimicifuga Rhizome) can treat diarrhea due to Qi sinking, but they are not agents that regulate the pivot mechanism (Qi mechanism). Shu Di (Prepared Rehmannia Root) is rich and cloying in nourishing Yin, which is unsuitable for Spleen Earth damaged by Liver Wood and failing in its transforming and transporting functions. Even if Sha Ren (Amomum Fruit) is added and stir-fried with wine, it cannot change its cloying and slippery nature. Using these formulas repeatedly, no wonder the diarrhea worsens with each dose. They merely use Jing Yue's saying 'extreme deficiency reaches the Kidney' as an excuse." Meng Ying prescribed Yi Gong San (Extra Efficacy Powder) plus Shan Yao (Chinese Yam), Bian Dou (Hyacinth Bean), Lian Zi (Lotus Seed), Wu Mei (Mume Fruit), Mu Gua (Chaenomeles Fruit), Shao Yao (Peony Root), Ji Li (Tribulus Fruit), Chi Shi Zhi (Red Halloysite), and Yu Liang Shi (Halloysite), which proved effective. Adhering strictly to this regimen for one hundred days, he recovered fully and remained healthy until he passed away three years later from another illness.

A certain person suffered from morning diarrhea for years, unresponsive to repeated treatments, especially severe in spring. Meng Ying palpated his pulse and said: "Although you suffer from diarrhea, do you feel relief in the abdomen after defecation?" The patient replied: "Indeed. Without diarrhea, I would feel bloated and have reduced appetite." However, taking Si Shen Wan (Four Spirit Pill) plus Fu Zi (Prepared Aconite Root) and Gui Zhi (Cinnamon Twig) aggravated the diarrhea. Meng Ying asked: "Why is this?" He explained: "This is not a syndrome suitable for warming, ascending, tonifying, or astringing. It is Liver excess and Spleen weakness, with Wood insulting Earth. I prescribe a formula for regular consumption; after a few doses, he will be at ease." The formula used was: Bai Zhu (Atractylodes Macrocephala Rhizome), Yi Yi Ren (Coix Seed), Huang Lian (Coptis Rhizome), Lian Shi (Chaya Fruit), Gui Zhi (Cinnamon Twig), Fu Ling (Poria), Mu Gua (Chaenomeles Fruit), Shao Yao (Peony Root), Ji Li (Tribulus Fruit), and Ju Pi (Citrus Peel).

Kong Guangyu, a Sima (official title), suffered from loose stools for a long time, with a black tongue coating and shortness of breath. From spring to winter, treatment failed. Meng Ying examined him and said: "Excessive mental labor has scorched Yin with Yang. Observers see loose stools and immediately apply warming middle-jiao methods, unaware that Lung Fire insults the Lung, causing loss of clear descending function and shortness of breath above. This prevents the generation of Water source, naturally leading to scant urine and loose stools." He employed methods to soothe Lung, clear Heart, cool Liver, and nourish Kidney, resulting in gradual recovery.

Madam Yang, widowed and suffering from diarrhea, had not healed after prolonged treatment. Meng Ying said: "Wind Wood is punishing the Stomach." She did not believe this and hired another physician, Zhang, who aggressively administered warming tonics. This led to abdominal distension, anorexia, night fever, insomnia, acid regurgitation, amenorrhea, and splitting headache. She sought Meng Ying again. Initially, he used bitter-draining combined with pungent-unblocking to counteract the medicinal error, followed by sour-bitter methods to extinguish Wind and calm the Stomach. After a month, she recovered, and subsequent tonification restored her menstruation and health.

Miss Fang suffered from chronic diarrhea with epigastric pain, occasional toothache, irregular menstruation, and extreme aversion to heat, unresponsive to treatment. In early summer last year, her relative Cui Yingxi invited Meng Ying to diagnose her. She was plump, with a pulse not very apparent but subtly wiry and slippery. Meng Ying said: "This is Liver excess and Phlegm abundance. However, the disease root is deeply entrenched; reckless tonification must not be performed." Her mother said: "Loose stools for over ten years indicate extreme deficiency of original Qi. Extensive tonification has yielded no result; attacking the disease now is dangerous." Meng Ying replied: "Not so. Current physicians often use the vague term 'deficiency' to categorize all diseases. They always tonify, driving the nation mad. Witnessing this causes heartbreak. Deficiency refers only to Yin or Yang. Now, her muscles are not emaciated, and she does not fear cold in winter; is this Yin deficiency or Yang deficiency? Because of chronic diarrhea, they ignore pulse and symptoms, suspecting Cold-Deficiency. One must know that Phlegm diseases are stubborn and illusory; combined with Wind-Yang, their nature is highly variable. Treatment must first eliminate the pathogen, then tonify deficiency; it is not too late. Otherwise, nurturing the carbuncle leads to disaster, rendering Ginseng useless." The mother did not believe him, seeking various doctors who all prescribed tonics. By autumn, a phlegm nodule appeared below her neck, flattened by Dr. Huang's application, followed by massive warming tonics for one hundred days. Suddenly, she vomited and purged over a dou of sticky phlegm and died. My commentary: This was Phlegm-Fluid spreading, Wood and Earth conflicting. Over time, the body could not withstand the pathogen, leading to collapse. Had she listened to Meng Ying earlier, she would not have died suddenly.

Madam, wife of Kang Kanghou Sima, suffered from chronic diarrhea, poor appetite, and sore throat upon using drying-hot herbs. Many physicians failed to cure her. Meng Ying diagnosed: "Spleen deficiency with Fluid retention, Liver excess generating Wind." He prescribed: Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Ju Pi (Citrus Peel), Ban Xia (Pinellia Tuber), Gui Zhi (Cinnamon Twig), Fu Ling (Poria), Lian Shi (Chaya Fruit), Bai Shao (White Peony Root), Mu Gua (Chaenomeles Fruit), and Ji Li (Tribulus Fruit). She gradually improved.

In winter, she suffered from vertigo, sweating on the head, facial heat, cold limbs, and cardiac twisting pain, groaning as if dying. Meng Ying prescribed: Shi Ying (Hematite), Cong Rong (Cistanche Stem), Mu Li (Oyster Shell), Lv E Mei (Green Calyx Plum), Fu Ling (Poria), Ji Li (Tribulus Fruit), Lian Shi (Chaya Fruit), Bai Shao (White Peony Root), and Xuan Fu Hua (Inula Flower). She recovered after one dose.

Chen Mou occasionally suffered from loose stools. His relative Bao Jizhong said: "I suffered diarrhea last year, treated improperly, lasting half a year. This autumn, I took Meng Ying's prescription and recovered quickly. Medication must be chosen carefully. Why not invite Meng Ying?" Chen, having two relatives who were physicians, consulted them instead for convenience. They prescribed warming-tonifying Spleen herbs. Diarrhea decreased initially, but fever, coma, convulsions, and black necrosis of the throat developed. The host, Qu Yingshan, fearing rapid deterioration, advised seeking Meng Ying. Meng Ying said: "Too late. The disease started with diarrhea; why assume Cold? This is latent pathogen seeking exit, blocked by warming tonics. It has sunk into Jueyin, incurable." He died shortly after.

Yu Sheng, younger brother of Gao Xiao Liao Jing, developed diarrhea after eating crabs. Dr. Huang used large doses of warming tonics, stopping the diarrhea but causing neck tendon soreness, crimson tongue, vomiting, thirst, and foul breath. Meng Ying palpated a deep, rapid pulse. He said: "Diarrhea after eating crab was coincidental. Given the pulse and symptoms, clearing and moistening is indicated. However, fearing cold herbs, he consulted Wu Mou, who also advocated warming tonics. After ten days, he died with coma, convulsions, and black tongue."

Dui Guan, grandson of Wu Yunxiang Xiao Liao Jing, suffered from fever, profuse diarrhea, extreme thirst, scant urine, and absence of tears and nasal discharge. Meng Ying said: "Summerheat and Wind affecting Spleen and Stomach." He prescribed: Sha Shen (Glehnia Root), Sheng Yi Yi Ren (Raw Coix Seed), Sheng Bian Dou (Raw Hyacinth Bean), Yin Hua (Honeysuckle Flower), Shi Hu (Dendrobium Stem), Hua Shi (Talcum), Gan Cao (Licorice Root), Zhu Ye (Bamboo Leaf), and Dong Gua Pi (Winter Melon Peel), decocted in clarified earth water. He recovered in several days. Commentary: Such cases are often misdiagnosed as Infantile Convulsion by pediatricians, leading to many deaths.

Shen Xinfu, proficient in Traditional Chinese Medicine, had a wife constitutionally weak but diligent. Over forty, she had excessive menstruation, loose stools, cold sweat, and rebellious Qi. Repeated use of Ren Shen (Ginseng) and Huang Qi (Astragalus Root) worsened her condition. Meng Ying diagnosed: "Roots remain in Heart and Spleen pulses; recovery is possible." He prescribed: Long Gu (Fossilized Bone), Mu Li (Oyster Shell), Gui Ban (Tortoise Plastron), Bie Jia (Turtle Carapace), Hai Piao Xiao (Cuttlefish Bone), Shi Ying (Hematite), Yu Liang Shi (Halloysite), Shu Di (Prepared Rehmannia Root), and Fu Ling (Poria). One dose brought a turning point, and she gradually recovered.

A certain person suddenly suffered from profuse watery diarrhea in early autumn, with profuse sweating, lethargy, and faint breathing. Meng Ying found a deep, fine pulse, no fever, resembling Cold-Deficiency. However, the tongue coating was yellow and greasy, and there was no urine. This was Damp-Heat disease. He prescribed Gui Ling Gan Lu Yin (Guiling Sweet Dew Decoction) plus Hou Po (Magnolia Bark), curing him instantly.

Madam Shen suffered from abdominal distension and diarrhea postpartum, with facial and foot edema. Physicians used damp-draining and warming tonics for a month without effect, suspecting postpartum injury. Meng Ying observed: Tongue normal, urination smooth, resembling Qi deficiency. However, the pulse was rough and choppy, lacking weakness. He prescribed: Dan Shen (Salvia Root), Hua Shi (Talcum), Ze Lan (Lycopus Herb), Fu Ling (Poria), Chong Wei Zi (Leonurus Fruit), Ge Qiao (Clam Shell), Tao Ren (Peach Seed), Hai Jin Sha (Lygodium Spore), Wu Ling Zhi (Trogopterus Feces), and Dou Juan (Soybean Sprout). She recovered in months.

Ye Xingjiang Zhong Lang suffered from fever and diarrhea for seventeen days without effect, becoming emaciated, hoarse, and short of breath. Relative Xu Zhiqing recommended Meng Ying. Pulse was rapid, with extreme thirst, profuse sweating, and yellow coating. He prescribed modified Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction). After over ten doses, she improved, but stool became hard and dry. Subsequent nourishment restored her health.

Yao Outing suffered from severe diarrhea in early summer, followed by Spleen constraint (constipation due to Spleen deficiency). Initially once every ten days, then monthly, with difficulty, hard stool preceding loose stool, sweating, and exhaustion. Over sixty, walking was difficult. Human milk and lubricating laxatives failed. Occasionally, food felt stuck, with acid regurgitation. Six pulses were slow and soft, tongue white and moist, no thirst, clear copious urine, no abdominal pain. This is Middle Qi deficiency, "urination and defecation become abnormal." Can intestinal dryness be cured by moistening? Since moistening is contraindicated, purging is forbidden. Middle deficiency lacks opening/closing control; opening without closing is dangerous. Ascending is also contraindicated because acid regurgitation indicates downward blockage and upward rebellion. Having smoked opium, closing without opening is risky. He prescribed: Ren Shen (Ginseng Root), Ju Hua (Chrysanthemum Flower), Ban Xia (Pinellia Tuber), Xuan Fu Hua (Inula Flower), Bai Shao (White Peony Root), Ji Jin (Chicken Gizzard Lining), Mu Gua (Chaenomeles Fruit), and Pi Pa Ye (Loquat Leaf). After six doses, two bowel movements occurred, passing four pellets. Three more doses passed fifteen-six pellets. Another three doses passed nine pellets, finally relieving obstruction. Stool was neither hard nor loose, strength returned. Prescription matched syndrome. He left conditioning advice.

If acid regurgitation occurs, temporarily use: Ren Shen (Ginseng Root), Huang Lian (Coptis Rhizome), Ju Pi (Citrus Peel), Ban Xia (Pinellia Tuber), Xuan Fu Hua (Inula Flower), Zhu Ru (Bamboo Sap), Su Ye (Perilla Leaf), Pi Pa Ye (Loquat Leaf), and Zi Shi Ying (Hematite) to clear, descend, and calm.

Meng Ying's second daughter, on August 23rd, suddenly suffered from painful diarrhea, cold limbs, and hidden pulse. Cui Mou prescribed modified Fuzi Lizhong Tang (Aconite and Ginger Decoction), but diarrhea persisted, tongue turned black, lips dried, showing Heat signs. Modified to Xi Jiao (Rhinoceros Horn - *Note: Modern substitute usually Shui Niu Jiao/Ox Horn*), Shi Hu (Dendrobium), and Sheng Mai San (Generate Pulse Powder). Condition deteriorated. Then Gui Fu Ba Wei Wan (Cinnamon and Aconite Eight-Ingredient Pill) was used. On August 29th, her tongue became charred black, and she died.

Alas! Based on this case, it was Latent Summerheat. For Sha Zheng (Plague-like diseases) and Huoluan (Cholera-like disorders) complicated by food stagnation, food must be removed first. Same for Shang Han (Cold Damage). Qin's theories explain this well. However, some patients develop disease after full meals, not necessarily due to food. Ban Chi (Meng Ying's pseudonym) once said: "Since one does not wait for disease with an empty stomach, how can treatment focus solely on attacking and digesting? Therefore, clinical practice requires careful inquiry, reflection, and clear discrimination to avoid negligent errors."