Library

Whenever abdominal pain is caused by food stagnation, whether due to stagnant matter or cold substances, all can accumulate in the Zhongwan (Middle Jiao/Epigastrium) area. It is necessary to use the previously mentioned methods for treating food stagnation with modifications; this is the standard orthodox treatment. However, there are cases where food stops in the lower abdomen. I once treated a Shanshe (an official title), who was around thirty years old. Because he ate boiled dough dumplings at noon, by the time of Chugeng (early evening), the food had moved down to the lower abdomen, specifically stopping between the right corner and below. It accumulated and could not move, becoming hard and protruding like a fist, as large as a goose egg. The pain was severe and indescribable. Upon examination, it was clearly evident that this was caused by wheat flour accumulation (mianji). Considering the food had entered the Large Intestine, this presented a pattern of "obstruction causing pain" (tong ze bu tong - though here implying obstruction needs clearing). Therefore, I administered Muxiang Binglang Wan (Pinellia and Areca Pill). After taking it two or three times consecutively, the pain remained unchanged. Suspecting the medication's action was too slow and had not yet reached the disease site, I switched to Shenyou Wan (Divine Protection Pill) to purge, but it was also ineffective. I reasoned that since the properties of these medicines were likely cold, they failed to resolve the stagnation. Consequently, I administered Beiji Wan (Emergency Aid Pill). Although it induced significant diarrhea, the hardness and pain did not diminish at all. At this point, my strategies were exhausted. I secretly analyzed the cause: it was merely due to wheat flour. Was there no way to counteract it? Since direct purgation had failed, unless we utilized Qi movement to propel it, success would be impossible. Moreover, garlic is needed to neutralize wheat toxicity, and Muxiang (Aucklandiae Radix) is needed to move Qi stagnation. Given the deep location and long distance of the stagnation, only a potent guide drug could reach it. Thus, I prepared Muxiang ground in Huojiu (Fire Wine), instructed him to chew one clove of raw garlic, and washed it down with the fragrant wine mixture. After one dose, the pain slightly decreased. After three or four doses, the pain gradually ceased, appetite returned, and full recovery was achieved. However, although the pain stopped and appetite improved, the mass in the lower abdomen persisted until it completely dissipated after about half a year. From this, we learn that even powerful drugs like Dahuang (Rhei Radix et Rhizoma) and Badou (Crotonis Fructus) may fail to eliminate food stagnation; thus, promoting Qi movement should be prioritized. Furthermore, this case reveals that the pathway for dietary descent must pass through the lower right corner of the lower abdomen before exiting via the Changchang (Large Intestine/Rectum). This anatomical insight has never been mentioned before, so I record it here to broaden knowledge.

Previously, a fellow townsman of mine, aged forty, was affected by Yin-cold and sandy toxic qi following heavy rains at the end of August when the weather turned cold. Suddenly, during Ergu (late night), he experienced vomiting and nausea upwards, and twisting abdominal pain downwards, with an unstoppable momentum. As it was night and medicine was unavailable, I used salt water to induce vomiting. The pain did not subside; instead, repeated vomiting caused the Qi to rise further, exacerbating the pain until it blocked the throat, rendering him unable to speak or swallow water or medicine. He was in critical condition, facing imminent death. I suddenly recalled a secret method of Kuosha (Scraping Therapy) I had learned years ago. I selected a smooth, narrow-mouthed porcelain bowl, poured a cup of hot water, added one or two spoons of sesame oil, dipped the rim of the bowl into the warm oily water to make it slippery, and held the bowl with both hands. I gently scraped downwards along the patient's back, gradually increasing pressure. When the bowl became dry and cold, I re-dipped and continued scraping. After a while, he felt the chest distension and stagnation beginning to descend, feeling somewhat relieved, and was able to produce sounds. Soon after, loud rumbling occurred in the abdomen, followed by profuse watery diarrhea, and the pain subsided. He fortunately survived. After sleeping post-diarrhea, roughly the time it takes to eat one meal, his entire body became extremely itchy, and numerous wheals resembling coins erupted, which receded by Sigeng (midnight). Upon careful reflection after recovery, the principle is that the connections of the Five Zang Organs attach to the back; thus, downward scraping causes the pathogenic factors to descend. Generally, if toxic vapors ascend, they become rebellious; if they descend, they become compliant. Changing rebellion to compliance leads to healing. Although there is a recent method of scraping the arms to treat dysentery and relieve pain, for cases with deep toxicity and acute illness, treating the back is essential. Regarding the origin of the wheals, it is precisely because cold-toxic qi filled the exterior and interior, closing the meridians and organs, leading to critical severity. Now that the organ toxicity was resolved, the Meridian Qi could flow, dispersing both exterior and interior pathogens. This demonstrates that for external cold-toxic invasion, if the Zang Qi is unharmonized, the exterior will not release; if exterior pathogens are not scattered, the Zang organs will inevitably be disharmonious. This illustrates the interrelationship between exterior and interior. Treatment priorities depend on the urgency, relying on the physician's judgment. A few days later, a man surnamed Wei suffered from this same condition at Ergu. Due to improper treatment, he died from extreme pain by Wugu (early morning). Whether one encounters effective treatment or not determines fate.