July 12, 2011

Two cases using Li Zhong Tang (Rectify the Centre Decoction)


Case #1

Vacuity cold diarrhea

Case of Yuan Wen-Fei; (Jiang Xi Chinese Medicine); 1964; 3:149

A 39 year old male presented on February 11, 1949 complaining of diarrhea that has lasted for over a year, with borborygmus, and quite watery-sloppy stools. He usually has around eight or nine bowel movements in the first half of the day, his appetite is poor and there are undigested food particles present in the stools. Over ten Chinese medical physicians have been consulted in the past, and very minimal effects have occurred. On consult with this patient I found his facial complexion to be very pale and lustreless. He was emotionally fatigued, his abdomen was slightly distended, but favoured pressure, his tongue had a layer of thick yellow and slimy coating, and his pulse was thin and slow.

This is a case of spleen vacuity diarrhea, and the treatment method is to supplement the centre, and boost earth. The formula used was Zhong Jing’s Li Zhong Tang.

Ren Shen 9g
Chao Bai Zhu 9g
Hei Gan Jiang 7.5g
Zhi Gan Cao 6g

He was given six packages and asked to return for a follow up consultation. He reported that his condition had improved drastically for the better, and was therefore administered another six packages of the same formula after which he made a complete recovery.


Case #2

Wheezing and Panting (Left heart failure, cardiogenic asthma)

Case of Lu Zhi-Jie (Journal of Chinese Medicine); 1998; supplementary issue: 104

On May 4, 1998 a 60 year old male presented with cardio-pulmonary disease of over 10 years duration. In the first year of the condition he would often experience difficulty breathing in the evening, which would most commonly occur roughly around midnight waking him from a deep sleep. He suffered with an oppressive sensation in his chest, and once his breathing became forced he would suddenly wake up with a fright, compelling him to sit up in bed. This was accompanied with coughing fits, a rale at the back of the throat, and spitting up of frothy phlegm. These attacks would last anywhere from ten minutes to one hour, and once they would resolve on their own, he was able to return to sleep. During the day he also experienced wheezing on exertion. His pulse was wiry and weak, and the tongue was purple and slightly dark, with a thin yellow, slimy coating. According to this man’s symptoms of weakness, coughing fits and breathing difficulties at night, he was diagnosed by western physicians with left heart failure and cardiogenic asthma.
On disease analysis, we see that this man is in his sixtieth year and his condition has persisted for an extended period, therefore we can deduce from this that there must be a vacuity and weakness of right qi, however, his symptoms seem to develop in the evening, so in addition there is a blockage in lung qi. In such a scenario we must address both the root and branch of the condition and treat both simultaneously. We treat the root with Ren Shen Tang in order to supplement the centre and assist yang to ensure that the lungs and heart are able to generate sufficient and ample original qi. The branch is addressed with Ting Li Da Zao Xie Fei Tang.

Formula:

Ren Shen 30g
Bai Zhu 30g
Gan Jiang 30g
Gan Cao 30g
Ting Li Zi 24g
Da Zao 12 pieces

The first evening after taking one package, he experienced no breathing difficulties, and after fourteen packages, his condition seemed to be stabilized. He was able to sleep peacefully in the evenings. The daytime wheezing on exertion had also obviously improved, and as long as he moved around slowly, experienced no symptoms. He continued to take the formula every other day in order to consolidate the treatment.