Library

Jiao Chang (Intestinal Exchange) disease is characterized by the exchange of excretion sites for urine and feces. Its etiology may stem from drunkenness and overeating, or from severe anger, leading to chaotic Qi of the Zang-Fu organs that no longer follows its normal pathway. The treatment principle should employ inducing vomiting to raise and lift the Qi. Wuling San (Five-Ingredient Poria Decoction) with added Muxiang (Aucklandiae Radix) is suitable for this purpose. For patients who are obese and have abundant phlegm, Erchen Tang (Two-Aged Decoction) with Zhishi (Aurantii Fructus Immaturus) and Muxiang (Aucklandiae Radix) should be used to induce vomiting. This clears and benefits the Lanmen (Gate between Small and Large Intestine), restoring its function of separating the clear from the turbid, thereby curing the disease.

Shi Wan stated: Although Jiao Chang syndrome is recorded in medical texts, it is rarely seen in the world. For instance, the wife of a stone mason named Zhan from Shishan, five or six days postpartum, had retained lochia, abdominal distension, and wheezing fullness, with feces discharging from the anterior yin. Upon investigating the cause, it was found that she had previously had a strong craving for tobacco and alcohol, and her newborn child was soft-bodied without bones, causing great fright, which led to this syndrome. I prescribed Xiong Gui Tang (Angelica and Ligusticum Decoction) with Ezhu (Curcumae Rhizoma), Rougui (Cinnamomi Cortex), and charred Shan Zha (Crataegi Fructus). After one dose, the lochia flowed freely, and urination and defecation returned to normal. Another case involved the daughter of Lu Shengxiang, aged four, who suffered from bloody dysentery in early autumn, with loose stools discharging from the anterior yin. Treated as cold-heat imbalance with food stagnation, she was given Wuling San (Five-Ingredient Poria Decoction) combined with Xianglian Wan (Costus and Coptis Pill). She recovered after two doses. Additionally, the daughter of Qian Jifu, aged thirteen, was obese with excessive phlegm. Due to a robbery at a neighbor's house, she experienced fright, fever, headache, vomiting, cyanotic face, and wiry-rapid pulses throughout all six positions, along with exchanged excretion sites. This was caused by chaotic Qi from fright and phlegm invading the ends of the orifices. Siqi Tang (Four-Seven Decoction) was administered with Mengshi Guntan Wan (Calamine Rolling Phlegm Pill) to open the phlegm-Qi obstruction, resulting in stabilization.

The Nei Jing (Inner Canon) describes five types of intestinal borborygmus. First, Spleen deficiency: The classic states, "Spleen deficiency leads to abdominal fullness, intestinal borborygmus, undigested stool diarrhea, and failure to digest food." Use Zhishi Lizhong Tang (Immature Bitter Orange and Atractylodes Macrocephala Decoction) with added Muxiang (Aucklandiae Radix). Second, insufficiency of Middle Qi: The classic states, "Insufficiency of Middle Qi causes painful borborygmus in the intestines." Use Liujunzi Tang (Six-Gentlemen Decoction) with added Muxiang (Aucklandiae Radix). Third, pathogenic factors in the Large Intestine: The classic states, "Borborygmus like thunder in the intestines, with Qi rushing up to the chest; this indicates pathogenic factors in the Large Intestine." Use Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium). Fourth, Earth depression: The classic states, "When Earth depression occurs, there is borborygmus accompanied by frequent tenesmus." Use Pingwei San (Powder to Level the Stomach) with added Banxia (Pinelliae Rhizoma), Muxiang (Aucklandiae Radix), and Fuling (Poria). Fifth, excess Heat: The classic states, "When Shaoyin rules the interior and Heat dominates excessively, symptoms include abdominal borborygmus and Qi rushing up to the chest." use Tingli Muxiang San (Descurainia and Aucklandia Powder). The Jin Gui Yao Lue (Essential Prescriptions from the Golden Cabinet) states: "Cold Qi in the abdomen causes borborygmus-like cutting pain, reverse fullness of the chest and abdomen, and vomiting." Use Fuzi Jiangmi Tang (Aconite and Rice Decoction). Li Dongyuan stated: "For diarrhea and borborygmus due to Stomach cold, add Yizhi (Alpiniae Oxyphyllae Fructus) and Banxia (Pinelliae Rhizoma), each 0.5 fen, to Shengyang Chushi Tang (Raise Yang and Expel Dampness Decoction), decocted with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus)." Zhu Danxi stated: "Borborygmus in the abdomen originates from the Stomach; it is Fire agitating Water." Use Erchen Tang (Two-Aged Decoction) with Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Shanzhi (Gardeniae Fructus). If ineffective, use Weiling Tang (Stomach and Five-Ingredient Poria Decoction) with modifications. When Lung transfers Cold to the Kidney, it is called Yong Shui (Surging Water). In Yong Shui, pressing the abdomen reveals no hardness; Water Qi resides in the Large Intestine, producing a sloshing sound when walking quickly, resembling a bag containing liquid. This is a water pathology. Use Tingli Wan (Descurainia Pill) with added Muxiang (Aucklandiae Radix).