Digestion & Elimination

Case Study: TCM & Constipation

By Gory ⋅ March 12, 2009 ⋅  Print This Post ⋅ Post a comment

Just to demonstrate the use of formulas in combination to treat constipation, I shall recount today’s episode at Yangjin’s clinic. Yangjin is Nanjing’s Warm Disease specialist and of course has authored many books on this subject, including the textbook used by all undergraduate students in China. That said, he is still an across-all-discipines doctor (全科医生) treating patients that come in with all manner of malady.

Today, this old lady came in. Often constipated, this time round she hadn’t shat for ten days. After asking her more about it, feeling her pulse and looking at her tongue, Yangjin told her that her constipation was one of weakness, and also a deficiency of fluids. His prescription was a combination of Zhenye Tang (增液汤), Maziren Wan (麻子人丸) and Jichuan Jian (济川煎).

This lady is weak and deficient, so the classic Chenqi Tang (承气汤) protocol is not suitable – it’s taken out from Maziren Wan. I remember some students here voicing concern that Maziren Wan is not just Hemp Seed (麻子人); it’s the entire formula, they say. But yet other teacher would emphasize the spirit of the prescription. In this vein, our revered teacher Yangjin added other seeds to the decoction: 郁李仁, 砂仁，瓜蒌仁 (he used 全瓜蒌).

For her deficiency of Yin fluids, teacher Yangjin added Shengdi (生地) Xuanshen (玄参) and Maidong (麦冬).

Two herbs used to represent the spirit of Jichuan Jian (济川煎) were Rou Congrong (肉苁蓉) and He Shouwu (何首乌). He Shouwu aka Polygonum Multiflorum is an excellent Yin tonic with one side effect – it may cause diarrhea. That said, this herb is perfect for the old lady. Rou Congrong is a Yang tonic that is not overly heaty. It’s nature is lubricating and moisturizing. Again, very suitable.

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