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On the Separate Treatment of Hematochezia and Hematuria, Lumbar Pain and Headache, Spermatorrhea and Amnesia, Acid Regurgitation and Diarrhea, and Qi Collapse and Phlegm Obstruction

Chen Shiduo (courtesy name Yuangong, pseudonym Shishijushi) said: The method of "separate treatment" refers to situations where symptoms are complex and difficult, making it impossible to treat them as a single syndrome; instead, a method of separate treatment is employed. For instance, if a person presents with hematochezia (blood in stool) and also hematuria (blood in urine); lumbar pain accompanied by headache; spermatorrhea (involuntary emission of semen without sexual intercourse) accompanied by amnesia (memory impairment); acid regurgitation (sensation of sour fluid rising from the stomach to the throat) accompanied by diarrhea (loose stools). Since symptoms appear纷繁ly, medications cannot be applied uniformly, necessitating separate treatments. One may treat the upper part, or the lower part; one may treat excess pathogens, or treat deficiency of righteous qi. However, this does not imply that all cases can be treated indiscriminately. Nevertheless, if the underlying principle is grasped, unity can be achieved within separation; if the principle is not grasped, even when treating together, separation persists. For example, hematochezia and hematuria should not be conflated, yet both involve bleeding from the lower orifices. Using Shengdi Huang (Rehmanniae Radix Preparata) 1 liang and Diyú (Sanguisorbae Radix) 3 qian will naturally cure both syndromes. (Commentary: Liangdi Dan.) Although the large and small intestines have their respective meridians, their source is the same, originating from heat in the Bladder meridian. Shengdi Huang clears the fire of the Bladder, and Diyú also clears Bladder heat. Using one formula for two purposes demonstrates unity within separation.

Lumbar pain and headache differ in location (upper vs. lower). However, Kidney qi connects upward to the Brain, and Brain qi descends downward to the Kidneys. Although upper and lower are distinct, their qi mechanisms are actually interconnected. The treatment method should employ warming and tonifying herbs to greatly benefit the Yin within the Kidneys, thereby allowing the qi of the upper and lower parts to flow freely. The formula uses Shu Di Huang (Rehmanniae Radix Preparata) 1 liang, Duzhong (Eucommiae Cortex) 5 qian, Maidong (Ophiopogonis Radix) 5 qian, and Bei Wuweizi (Schisandrae Fructus) 2 qian, decocted in water and taken orally, resulting in immediate recovery. (Commentary: Shangxia Jianyang Dan.) Generally, Shu Di Huang and Duzhong are herbs for tonifying the Kidneys, and stopping lumbar pain is their specific function. Why does the headache also heal? Although Shu Di Huang is a Kidney-tonifying agent, tonifying the Kidneys nourishes the Brain upwards. The spine rises like a pulley, which is the direct path. Once Kidney qi is sufficient, qi surges upward uncontrollably. Thus, once Kidney qi is tonified, the waist ceases to hurt and the head ceases to ache. This is unity containing separation, and separation containing unity. Is this not true?

Spermatorrhea is a disease of the lower part; amnesia is a disease of the upper part. Why does separate treatment work for both? The formula uses Renshen (Ginseng Radix et Rhizoma) 3 liang, Lianxu (Nelumbinis Stamen) 2 liang, Qianshi (Euryales Semen) 2 liang, Shanyao (Dioscoreae Rhizoma) 4 liang, Maidong (Ophiopogonis Radix) 3 liang, Wuweizi (Schisandrae Fructus) 1 liang, Sheng Zao Ren (Ziziphi Spinosae Semen) 3 liang, Yuanzhi (Polygalae Radix) 1 liang, Changpu (Acori Tatarinowii Rhizoma) 1 liang, Danggui (Angelicae Sinensis Radix) 3 liang, Baiziren (Platycladi Semen) 1 liang (oil removed), Shu Di Huang (Rehmanniae Radix Preparata) 5 liang, and Shanzhuyu (Corni Fructus) 3 liang. Each is powdered, and honey is used to form pills. Take 5 qian with plain boiled water morning and evening. (Commentary: Yiwang Shuangzhi Dan.) Half a dose cures both syndromes completely. This formula is originally for treating amnesia; why is it effective for spermatorrhea? Although spermatorrhea is due to deficiency of Kidney water, its root lies in the weakness of Ministerial Fire (Heart Fire). By tonifying the Heart Monarch, the Jade Gate (referring to the essence gate) closes naturally without deliberate constriction. This is separation within unity, possessing special efficacy.

Acid regurgitation is a Fire syndrome; diarrhea is a Cold syndrome. It seems that cold and heat are different, so treatment methods should vary. However, although acid regurgitation is hot, it stems from Liver qi stagnation; although diarrhea is cold, it stems from Liver Wood overacting on Spleen Earth. If one must use one formula to treat Wood stagnation and another to tonify Spleen Earth, the Spleen Earth will collapse and Liver Wood will wither. It is better to treat both within one formula. The formula uses Chaihu (Bupleuri Radix) 1 qian, Baishao (Paeoniae Radix Alba) 5 qian, Fuling (Poria) 3 qian, Chenpi (Citri Reticulatae Pericarpium) 5 fen, Gancao (Glycyrrhizae Radix et Rhizoma) 5 fen, Cheqianzi (Plantaginis Semen) 1 qian, and Shenqu (Massa Medicata Fermentata) 5 fen, decocted in water and taken orally. (Commentary: Liangshu San.) Both syndromes are cured. The marvel of this formula lies in the exquisite action of Baishao. Baishao is an herb of the Liver meridian, best at soothing Liver Wood qi. Once Liver Wood qi is soothed, it no longer overacts on the Stomach above nor on the Spleen below. The formula also contains Fuling and Cheqianzi to dissipate dampness and turbidity. When dampness exits via urination, there is no surplus water to cause acid regurgitation, nor leftover fluids to cause diarrhea. Moreover, Banxia (Pinelliae Rhizoma) and Shenqu dissolve phlegm and digest food accumulation. This is one treatment achieving the effect of separate treatment, a fact not fully known to the world.

Master Zhang said: How can there be so many marvels? I have nothing more to say. Master Yuangong asked for further instruction. I can add one syndrome. Qi collapse (Zhongqi) and Phlegm obstruction (Zhongtan) seem different in the middle jiao, but essentially both arise from deficiency of Middle Qi. Qi deficiency naturally generates phlegm; excessive phlegm inevitably consumes Qi. Although separated, they are fundamentally united. The formula uses Renshen (Ginseng Radix et Rhizoma) 1 liang, Banxia (Pinelliae Rhizoma) 3 qian, Nanxing (Arisaematis Rhizoma) 3 qian, Fuzi (Aconiti Lateralis Radix Preparata) 1 qian, Fuling (Poria) 3 qian, and Gancao (Glycyrrhizae Radix et Rhizoma) 1 qian, decocted in water and taken orally. (Commentary: Renyong Tang.) This covers both Qi collapse and Phlegm obstruction. Renshen is originally a divine agent for tonifying Qi and also a wonderful drug for eliminating phlegm. Banxia and Nanxing are divine products for expelling phlegm and also orthodox spirits for supporting Qi. Fuzi and Gancao, one benevolent and one courageous, complement each other to form a formidable force. Used among these three ingredients, supporting righteousness necessarily expels evil, and sweeping away phlegm necessarily benefits Qi. There is separation and unity without the form of separation and unity, marvellous beyond measure and possessing spiritual transformation. This too must be understood.

Master Hua said: It is the same as mine; there is nothing more to discuss.