Library

Wuling San (Formula see in the chapter on Convulsions)

*Xiao Fang Mai Lun* records: In pediatric polydipsia, excessive water intake leads to abdominal distension and diarrhea. This disease originates from heat in the Heart Zang; as the Heart and Small Intestine are exterior-interiorly related, the Small Intestine also receives heat. Once the Small Intestine is heated, its Qi ascends and rushes to the stomach opening, causing the child to drink excessively. When this water awaits entry into the Small Intestine, it is permeated and excreted by the heat Qi of the Small Intestine, failing to transfer to the Large Intestine in time. To treat this, one should first administer diuretic/dysuria-relieving medicines, then administer medicines to cool the Heart Zang, and finally stop thirst for efficacy.
Commentary: This also falls under the indications for Wuling San.

*Xiao Fang Mai Lun* formula for treating polydipsia by first using dysuria-relieving medicines:
Jinyu (Curcuma Aromatica Rhizome), Huashi (Talcum), Hanlianzi (Ecliptae Herba).
Grind the above ingredients into powder. Take half a qian each time, mixed with Scallion Decoction. Urgently administer three doses of cooling Heart medicines.

*Xiao Fang Mai Lun* formula for stopping thirst by subsequently cooling the Heart Zang:
Wuzeiyu Gu (Sepiae Endoconcha), Haifushi (Pumex), Puhuang (Polygoni Typhonii Pollen, stir-fried).
Grind the above into powder. Take half a qian each time, taken with Loquat Leaf Decoction.

Qian Yi discussed similar jaundice conditions saying: When the body skin and eyes are yellow, it is called Huang Bing (Jaundice Disease). Body pain, stiffness in the arms and back, difficulty in urination and defecation, full-body yellowing, yellowing of the face, eyes, and nails, urine colored like house dust, objects appearing yellow, accompanied by thirst which is difficult to treat, is Huang Dan (Jaundice). These two syndromes often occur after severe illnesses. There is another syndrome, not caused by post-illness condition, with slight body yellowing, which is Stomach Heat, also applicable to adults. There is also facial yellowing, abdominal distension, geophagia (eating soil), and thirst, which is Pi Gan (Spleen Malnutrition). There is also congenital body yellowing, known as Tai Dan (Fetal Jaundice). Ancient texts state: All types of jaundice are heat syndromes; deep yellow indicates this. If pale yellow with white tones, it indicates weak Stomach Qi and disharmony. *Nan Zhi* states: Color resembling smoked yellow indicates Dampness disease, with full-body pain. Color resembling orange yellow indicates Huang Bing, without body pain. Dry, hot, and dry yellow, with spontaneous urination, non-heavy limbs, thirst, and desire to drink, indicates Zhizi Bopi Tang (Gardenia and Phellodendron Bark Decoction). Wet yellow belongs to the Spleen, with difficulty in urination, heavy limbs, apparent thirst but no desire to drink, indicates Da Yincheng Tang (Large Coptis and Artemisia Capillaris Decoction). Spontaneous loose stools with yellow color indicates Yincheng Zhizi Huanglian Sanwu Tang (Coix Seed, Gardenia, and Coptis Three-Ingredient Decoction). Alternating chills and fever with full-body yellowing indicates Xiaochaihu Jia Zhizi Tang (Minor Bupleurum Decoction plus Gardenia). Jiegu states: Yang Huang presents with red, obstructed urination and defecation, and body heat; this is Earth of the Spleen clashing with Fire of the Heart, constituting a Yang disease. The method requires first promoting urination, then promoting defecation. Yin Huang presents with normal urination and defecation, yellowing of the face, eyes, and body, and cold limbs; this is Spleen deficiency failing to control Kidney Water. One should use Yihuang San (Yellow-Safeguarding Powder) and Shi Junzi Wan (Quisqualis Pill) (Yihuang San formula see in Spleen chapter, Shi Junzi Wan formula see in Gan chapter). For treating Huang Bing with abdominal distension, Yincheng Hao Tang (Artemisia Capillaris and Coix Seed Decoction) should be used to mix with Wuling San. If the goal is to promote urination, remove Dahuang. If the goal is to promote defecation, add Dahuang or similar herbs. Yang syndromes can take this, referring to those with red face and desire to drink water. Tang Shi states: Body pain, arm and back pain, obstructed urination and defecation, yellowing of skin, face, teeth, and nails, urine like house dust; if unobstructed, easy to treat; if obstructed, difficult to treat. It is suitable to take Wuling San added with Yincheng, decocted and mixed. It is also suitable to take Daochi San (Guide Out Redness Powder) added with Yincheng and decocted. Or if there is body heat, take Xiaochaihu Tang (Minor Bupleurum Decoction); if severe, take Chengqi Tang (Chengqi Decoction). [Zeng] All jaundice patients cannot be treated uniformly; the root and branch differ, so diagnosis and treatment vary. It is due to Spleen and Stomach Qi deficiency, contracting Damp-Heat, stagnating in the Cou Li (interstices), flooding the skin, accumulating to form yellow, steaming outward, thus causing this syndrome. Or due to Spleen and Stomach weakness, internal accumulation of masses, resulting from aggressive treatment. However, Gan Xie (Malnutrition Diarrhea) also manifests as yellow skin, erect hair, large abdomen with visible veins, emaciation, lack luster externally, and inevitable body yellowing; this arises from Gan disease, leading to this syndrome. Treatment method: If contracted from Damp-Heat, with body yellow like smoke-stained color, use coarse-cut Wuling San added with Mahuang and Shengjiang, decocted and administered; sweating will lead to recovery. Using Yincheng Hao Tang mixed with Wuling San is also good. If obtained from Gan Pi (Malnutrition Masses), the shape resembles yellow earth, use Xingpi San (Slow Convulsion) and Hua Pi Wan (Accumulation) to awaken the Spleen and speed up the Stomach, grind accumulations and regulate Gan, harmonize Stomach Qi, increase food intake significantly, transform essence and micro-nutrients, nourish all bones, irrigate Zang-Fu organs, let the five colors appear in their respective parts, let the essence manifest in the face, and the yellow will naturally disappear. [Xue] The Classics state: Central yellow connects to the Spleen; thus, Huang Dan is the color of the Spleen. The spirit of the human body values concealment and silence; if manifested externally, the interior is deficient. These syndromes are all due to Spleen Qi deficiency, failure of transformation and transportation, Damp-Heat remaining in the skin and muscles, erupting as Dan. As Qian Zhongyang said: body pain, back stiffness, obstructed urination and defecation, full-body, face, and nail yellowing; brown urine is difficult to treat. Therapy should prioritize securing the Spleen. If exclusively using attacking, widening the middle, and draining/diuretic medicines, few will avoid critical danger. If newborns or within 100 days to half a year, not due to illness but body yellow, it is Stomach Heat Tai Huang. Abdominal distension and eating soil indicate Pi Gan; combined with thirst and drinking cold, use Xiehuang San (Spleen). Difficulty in urination indicates Yincheng Tang. Post-illness yellowing with limb edema indicates Baizhu San (Thirst). Normal urination/defecation, cold limbs, and drowsiness indicate Yihuang San (Spleen). Pale yellow-white body indicates Tiaozhong Wan (Abdominal Pain) and Buzhong Yiqi Tang (Deficiency Heat) added with Yincheng. Body heat, chest fullness, and yellowing of skin, muscles, face, and eyes indicate Ji Jian Xiehuang San (Modified Draining Yellow Powder). Differentiate the cause: if eyes closed, high fever, incessant crying, red and obstructed urination/defecation, and hot breath in the mouth, these are signs of fetal toxin from rich flavors during pregnancy. Mother and child should both take Shengdihuang Tang (Fetal Jaundice), still avoiding alcohol, wheat, five pungent spices, and hot foods. If not cautious, mistakenly injuring Spleen Earth, urgently it transforms into Convulsion with vomiting and diarrhea; slowly it becomes limb edema, difficulty in urination, eye obstruction, mostly becoming Gan diseases. There are also cases of Spleen deficiency causing yellowing, which should be sought within the Spleen and Stomach.