Library

Nie Jiuwu's cousin, aged thirty, initially presented with hemoptysis (coughing up blood), which resolved after taking nourishing and cooling medications. Suddenly, he experienced hematochezia (blood in stool). Since the blood was discharging from the lower orifice, this was considered a favorable pattern; thus, immediate hemostasis was not advised. Half a month later, he was cured by administering Xin Zhi Zang Lian Wan (New Formulated Intestine-Linking Pills). The preparation involves grinding Chuanlian (Corydalis Rhizome) into powder, mixing it with wine and pig large intestine, covering it with Chinese chives, steaming until soft, mashing uniformly, drying, and grinding back into powder. For every liang of Chuanlian, add two qian each of Ce Bai Ye (Biota Tops) powder and Dang Gui (Angelica Sinensis) powder, mix uniformly, bind with rice paste to form pills the size of wutong seeds. Take 2.5 qian on an empty stomach, washed down with warm wine or plain water.

Wei Yuheng stated: Zhao Zheng's wife, nearing forty years of age, suffered from hematochezia, yellow complexion, and edema of the limbs. She had tried all manner of tonifying Qi and Blood, dual-tonifying Qi and Blood, lifting and securing, cooling blood, and warming the middle agents, with Guipi Tang (Restore the Spleen Decoction) being the most frequently used, yet few showed efficacy. Medical texts state that blood appearing before stool indicates a proximal source, while blood appearing after stool indicates a distant source. In her case, both occurred. Upon pulse diagnosis, the pulse at Guan anterior was vigorous, while Guan posterior was deficient, and the pulse was wiry and rapid. I said: This is not due to the Spleen failing to control blood, but rather Liver Wood carrying fire to ascend upon the Stomach, causing blood to rebel upwards. Because the patient's Lung Qi was strong, she did not experience hematemesis (vomiting blood); instead, the blood spilled sideways into the Large Intestine, resulting in hematochezia. Thus, sometimes blood enters first and residue later, leading to blood before stool; sometimes residue enters first and blood later, leading to blood after stool; sometimes residue and blood enter simultaneously before and after, leading to blood both before and after stool. Generally, the Yangming channel is the residence of abundant Qi and Blood. Although significant blood loss occurs, the body does not become severely debilitated. One should merely strongly nourish the Liver to prevent it from carrying fire upwards, at which point bleeding will cease naturally. Prescribed were Sheng Di Huang (Rehmannia Root), Shu Di Tan (Charred Prepared Rehmannia Root), Bai Shao (White Peony Root), Zao Ren (Ziziphus Seed), and Qi Zi (Goji Berry) each at five qian, Zhi Gan Cao (Honey-fried Licorice Root) and Jiu Huang Qin (Wine-processed Scutellaria Root) each at five fen, and Chuan Liu Rou (Evodia Fruit) at one qian. After eight doses, full recovery was achieved.

A young man who had long suffered from hematochezia claimed that abdominal pain occurred after contact with filth, lasting more than a day without stopping. He sought a folk doctor who punctured the Weizhong (BL40) acupoint, causing blood to flow like a stream. Immediately thereafter, he developed severe chills and fever, headache as if being pounded, distension and pain in the abdomen and hypochondrium, inability to turn or move, and delirium resembling madness. A tutor in a school cured him using Da Chai Hu Tang (Major Bupleurum Decoction) to purge. After recovery, he intermittently experienced chills, fever, and coughing. Taking Yinzi Qingfei (Nourish Yin and Clear Lung) medications for two months worsened the cough. Recently, his food intake increased, but he suffered from diarrhea accompanied by hematochezia. The pulses at the left and right Guan and Chi positions were wiry, fine, and rapid. Zhang Feichou said: This must be due to contracting Wind-Cold during the puncture of Weizhong. Because the patient had pre-existing hematochezia, the pathogenic factor entered through the deficiency, forming Re Ru Xue Shi (Heat Entering the Blood Chamber), similar to the pattern of hematochezia and delirium in Yangming disease. The cure obtained with Da Chai Hu Tang was accidental, reflecting the principle that "pain decreases with purgation," but it was not the correct treatment. Therefore, post-recovery intermittent chills, fever, and coughing occurred because the clear Yang Qi of the Spleen and Stomach sank downward, and the Lung lost its function of regulating and distributing fluids. At this time, instead of regulating and tonifying the Spleen and Stomach, clearing the Lung was performed, which further injured Spleen Qi, causing it to fail to control blood, leading to prolapse, diarrhea, and leakage. The consumptive disease was already established; although it could persist for a long time, restoring vitality would likely be beyond power.