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Case 1
Name: Wang.
Sex: Female.
Age: 19 years.
Occupation: A college student.
Chief Complaint: Constipation for 3 years.
History of Present Illness: Three years ago, the patient got constipation without any obvious causes. Under her exertion, her and dry stool could be moved once a week. The stool was hard without purulency and blood in it, it looked like sheep dung. As usual, the patient had bad sleep and halitosis. But she kept her appetite normal all along. In the past 3 years, she had asked innumerable doctors for treatment, and she was treated by taking the "Bolus of Cannabis. "At the beginning of the treatment, she got better than before. But after many times of taking the drug, there was no effect on her. Then she was treated by taking another drug named " Tab. Phenolphthaleini. " During the treatment, her defecation were increased in frequency from once a week to once every 2 or 3 days. But after the treatment, her defecation became as same as before. She also got several times of treatment from a hospital, but there was no effect on her either. Then she came here for treatment on January 15,1996.
Physical Examination: The patient was spiritless and weak with shortness of breath and aversion to talk. The pulse was thready and sunken, the tongue was dark red with a thin layer of white fur. There was not other abnormal sign.
Diagnosis: Obstipation.
Differentiation: It's asthenia of qi and blood, which caused the production of intestinal fluid was reduced, then the large intestine became relatively dry and rough. So that the large intestine couldn't transport the stool smoothly. But the original doctors didn't discriminate the pathogenesis correctly and treated the
patient with dispersing drug such as Bolus of Cannabis for a quick success. But they didn' t understand too much dispersing drug would cause the exessive consumption of body fluid and blood. Under this condition, they treated the patient with purgative drug such as Tab. Phenolphthaleini, then their treatment would make the patient got more and more weak as if snow plus frost--one disaster after another.
Therapeutic Principle: It's most important to nourish blood and qi. When the qi and blood were plentiful, the large intestine would be nourished well and could transport the stool smoothly.
Treatment: Acupoint injection was used. There were 2 groups of points to be used. The 1st group included pionts of Zusanli (ST36) in both sides; the 2nd group included points of Dachangshu(BL25) in both sides. 4ml of placenta injection was injected into the chosen points of the used group, 2ml a point. Each group was alternatively used in every other day. In the same period, she was told to take the bolus of angelicae sinensis and bolus of gallus domesticus according to the interpretation. Hot food was forbidden during the treatment.
Effect Observation: After 7 days' treatment, the stool was moved once every 2 days. Then I stopped the acupoint injection and told her to take the bolus of angelicae sinensis and bolus of gallus domesticus by herself. After 1 month's treatment, the patient was cured. After half a year's follow-up, the sickness didn't recur. Then it's ending.
Case 2
Name: Li.
Sex: Male.
Age: 70 years.
Occupation: A retired worker.
Chief Complaint: Constipation for 10 years.
History of Present Illness: Ten years ago, the patient got constipation without any obvious causes. It's difficult for him to defecate smoothly. Even by exertion, the stool couldn't be moved smoothly. If the stool was moved with great difficulty, it was hard in texture and was dark brown in colour. In the past 10 years, this sickness became worse and worse. The frequency of defecation was reduced from once every 2 days to once every 3 or 4 days. In the past time, by exertion, could the stool be moved with difficulty, but now the stool couldn't be moved by exertion, even digging with his finger, it was useless too. In the past 10 years, he had been treated by using the "Bolus of Cannabis, Tab. Phenolphthaleini" and "Kaisailuo," but there was not permanent effect on him, when he was defecating, he was nervous as if he faced a formidable foe. The stool hadn' t been moved for 4 days till September 15, 1997. Then he came to our hospital for treatment.
Physical Examination: The patient was nervous. His head was soaked with sweat. The pulse was thready and uneven. The tongue was red with a dry, cracked layer of white fur. There were visible intestinal peristalsis over the abdomen. Band-like fecal mass was touched in the abdomen. There was not other abnormal sign.
Diagnosis : Obstipation.
Differentiation: It's deficiency of qi and blood, which caused deficiency of intestinal fluid. So that the large intestine became relatively dry and rough and couldn't transport the stool smoothly. In addition, as a result of a long time of illness, the blood stasis must be formed in the collaterals. On the other side, the qi-stagnation and blood stasis could aggravate the failure of transportation.
Therapeutic Principle: activating blood to resolve stasis; strengthening middle-Jiao and benefiting qi.
Recipe: Modified Decoction of Removing Blood Stasis in the Chest Formulated by Wang Qingren.
ShengDiHuang ,Rehmannia Root
DangGui,Chinese Angelica Root
ChiShao,Red Peony Root
TaoRen,Peaeh Seed
ChuanXiong,Chuanxiong Rhizome
NiuXi,Aehyranthes Root
HongHua, Safflower
BinLang,Areca Seed
JieGeng,Platycodon Root
ZhiKe,Fruit of Citron
ChaiHu,Bupleurum Root
ZhiHuangOi,Prepared Milkvetch Root
HuangLian,Coptis Root
ShengDaHuang,Raw Rhubarb fig (to be decocted later)
All the above drugs were to be decocted in water for oral administration. 5 doses were prescribed. Hot food was forbidden during the treatment.
Effect Observation: After taking the 1st dose, the stool could be moved smoothly. After taking the 2nd dose, the stool was softened and formed. After taking the 5 doses, the stool could b, moved once a day. Then he was told to take the bolus for strengthening middle warmer and benefiting qi to nurse himself. After 1 year' s follow up, the sickness didn' t recur. Then it's ending.
Case 3
Name: Liu.
Sex: Female.
Age: 40 years.
0ccupation: An accountant.
Chief Complaint: Constipation for 9 years.
History of Present Illness: Nine years ago, the patient go constipation without any obvious causes. The stool was moved once every 4 or 5 days. When she was defecating, she must exert herself to defecate smoothly. The stool was dry and hard so as she had gotten suffering from this sickness for a long time. In the past 9 years, she had been treated by innumerable treatment of TCM and Western medicine, she had hardly taken all the purgative drugs such as the "Bolus of Cannabis, Folium Cassiae, Radix et Rhizoma Rhei, Tab. Phenolphthaleini" and the "Oral Liquid of Cistanchis" and so on. At the beginning of the treatments, she got better than before, but some times later on, there was not permanent effect on her. In the recent 2 years, the constipation got worse and worse. Sometimes the stool must be moved by enteroclysis because she couldn't defecate by herself. Then she came to our hospital for treatment on October 12,1998.
Physical Examination: The patient was conscious with a normal general condition. The pulse was thready and uneven, the tongue was dark red with a thin layer of white fur. There was not other abnormal sign.
Diagnosis : Obstipation.
Differentiation: It's deficiency of intestinal fluid, which caused the large intestine was relatively dry and rough and couldn't transport the stool smoothly. In addition as a result of a long time of the illness, the blood stasis must be formed in the collaterals of intestine. On the other side, the blood stasis caused the large intestine couldn't be nourished well, so that it aggravated the failure of transportation.
Therapeutic Principle: activating blood to resolve stasis.
Recipe: Modified Decoction of Removing Blood Stasis in the Chest Formulated by Wang Qingren.
ShengDiHuang,Dried Rehmannia Root
MuDanPi,Tree Peony Bark
ChuanXiong,Chuanxiong Rhizome
HongHua, Safflower
ChiShao,Red Peony Root
TaoRen,Peach Seed
BinLang,Areca Seed
HuangLian,Coptis Root
All the above drugs were to be decocted in water for oral administration. She was told to take 5 doses of the above prescription.
Effect Observation: After taking the 5 doses, the stool could be moved smoothly once a day and became soft and formed. Then she was told to take 5 doses of the original prescription once more. After the above treatment, she kept normal defecation usually, the stool was moved once a day. After half a year's f011ow-up,the sickness didn't recur. Then it's ending.
The patient's father also had such sickness for several years, he couldn't get better after innumerable treatment. He took the above prescription by himself during his daughter's treatment. Then he could defecate smoothly too. He and his daughter came to me to express their thanks together.
Case 4
Name: Zhao.
Sex: Female.
Age: 21 years.
0ccupation: A college-student.
Chief Complaint: Constipation and abdominal pain for 5 years.
History of PresentⅠllness:Five years ago, the patient got an abdominal pain and constipation without any obvious causes. The pain was located in the median region of the upper abdomen, it was a dull pain and could be easily aggravated by a cold or weather changing. In addition, her stool was too dry to be moved smoothly, she defecated once every 3 or 4 days, the stool was formless. In the past 5 years, she had got innumberable treatment of TCM and Western medicine. During the treatment, the abdominal pain could be relieved, but the constipation had never been ameliorated, and abdominal pain often recurred while the treatment stopped. In the recent days, the abdominal pain got more severe because the weather was becoming cooler and cooler. After the treatment of taking "Kuaiweipian, Sanjuweitai" and the "powder for removing the qi-stagnation and relieving the stomachache, "there was no obvious curative effect on her. Then she came to our hospital for treatment on December 1,1997. After this sickness came on, the patient was weak and afraid of co1d usually. She ever got an examination of gastroscopy, by which the illness was diagnosed as " Chronic Superficial Gastritis. "Since the illness came on, her sleeping and urination had been all normal, but she got a poor appetite. There was not other complaint.
Physical Examination: The patient was conscious with a normal general condition. The pulse was thready and soggy. The tongue was pale with a thick layer of white fur. The chest was normal. The abdomen was soft and flat. There was tenderness in the upper abdomen below the xiphoid process. There was not other abnormal sign.
Diagnosis: ① Obstipation. ② Chronic Superficial Gastritis.
Differentiation: It's cold type constipation and accumulation of pathogenic cold in the stomach, which was caused by the deficiency of Yang and stagnation of qi in middle-Jiao.
Therapertic Principle: Invigorating Yangqi and promoting the functional activities of qi; warming middle Jiao and elimilating pathogenic cold.
Recipe: Modified Decoction of Aconiti for Regulating the middle-Jiao.
DangShen,Pilose Asiabell Root
BaiZhu,Bighead Atractylodes Rhizome
FuLing,Tuckahoe
ZhiFuZi,Prepared Aconite Root
GanJiang,Dried Ginger
FaBanXia,Pinellia Tuber
RouGui,Cinnamon Bark
ChenPi, Tangerine Peel
ShengHuangQi,Raw Milkvetch Root
DangGui,Chinese Angelica Root
ShuDiHuang,Prepared Rehmannia Root
RouCongRong,Desertliving Cistanche
ZhiKe,Fruit of Citron
ZhiGanCao,Prepared Liquorice Root
All the above drugs were to be decocted in water for oral taking. She was told to take 5 doses of the above prescription. Cool, cold food and radish were forbidden during the treatment, paying attention to warming herself well.
Effect Observation: After taking the 1st dose, the abdominal pain disappeared immediately. After taking the 5 doses, all uncomfortable sensation disappeared. She defecated once a day smoothly. Then she was told to take the Bolus of Anconti Praeparate for regulating the middle-Jiao continuouslly in order to keep a long curative effect.
After half a year' s follow-up, the sickness didn' t recur. Then it' s ending.