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Reference Books
The following content is selected from “Jin Kui Yao Lue Jian Shi”, Cheng Menxue’s “Jin Kui Pian Jie”, Fan Yongsheng’s “Jin Kui Yao Lue Lecture Notes”, and Liu Shaoyi’s Jin Kui Yao Lue lecture notes.
01.
Related Texts:
In Taiyang disease, if there is fever without sweating and aversion to cold, it is called “gang jìn” (rigid spasm).
In Taiyang disease, if there is fever with sweating and no aversion to cold, it is called “rou jìn” (soft spasm).
In Taiyang disease, if there is fever and the pulse is deep and thin, it is called “jìn”, which is difficult to treat.
In Taiyang disease, excessive sweating can lead to spasms.
For wind diseases, if purged, it will cause spasms; if sweating is repeated, it must be urgent.
The patient has a hot body and cold feet, a stiff neck, aversion to cold, sometimes a hot head, a red face, red eyes, and a shaking head, with sudden lockjaw and a stiff back, indicating spasms. If sweating occurs, cold and dampness will combine, and the exterior will become more deficient, leading to severe aversion to cold. After sweating, the pulse is like a snake.
If there is sudden abdominal distension, it indicates a desire to relieve, with a pulse that is still (floating and relaxed), but if it is floating and wiry, it indicates spasms.
The spasm pulse is tight like a string when pressed, moving straight up and down.
In cases of sores, although there is body pain, sweating should not be induced; if sweating occurs, it will lead to spasms.
Spasms can occur with moxibustion sores, which are difficult to treat.
In Taiyang disease, if the symptoms are complete, the body is strong, and the pulse is deep and slow, this indicates spasms, and the formula “Guo Lou Gui Zhi Tang” (Trichosanthes and Cinnamon Decoction) is indicated.
Guo Lou Gui Zhi Tang: Guo Lou Gen (Trichosanthes root) 2 liang, Gui Zhi (Cinnamon twig) 3 liang, Shao Yao (Peony) 3 liang, Gan Cao (Licorice) 2 liang, Sheng Jiang (Fresh Ginger) 3 liang, Da Zao (Jujube) 12 pieces.
In Taiyang disease, if there is no sweating but urination is scant, and qi rushes up to the chest, with lockjaw and inability to speak, it indicates a desire for “gang jìn”, and “Ge Gen Tang” (Kudzu Decoction) is indicated.
Ge Gen Tang: Ge Gen (Kudzu), Ma Huang (Ephedra), Gui Zhi (Cinnamon twig), Shao Yao (Peony), Gan Cao (Licorice), Sheng Jiang (Fresh Ginger), Da Zao (Jujube).
Spasms as a disease, with fullness in the chest and lockjaw, unable to lie down, with tight and urgent legs, must grind teeth, can be treated with “Da Cheng Qi Tang” (Major Order the Qi Decoction).
(Grinding teeth: the condition of grinding teeth, clenching the jaw, and the appearance of grinding teeth)
Da Cheng Qi Tang: Da Huang (Rhubarb), Hou Po (Magnolia Bark), Zhi Shi (Bitter Orange), Mang Xiao (Mirabilite).
In the Han Dynasty, one liang can be converted to 15g. The clinical dosage does not have to strictly follow this number.
02.
About the character “jìn”
It was anciently written as “zī”.
Qin Bowei and Cheng Menxue both believe that this section can be changed to “jìn”. Cheng Menxue believes: severe adverse conditions can all be called “zī”, which is too broad. In this section, it is definitely a case of spasms.
03.
Spasms and Pulse Patterns
The main manifestation is the stiff and tense back symptoms.
Common pulse signs: tight like a string when pressed, moving straight up and down.
In Taiyang disease, if the symptoms are complete, the body is strong, and the pulse is deep and slow, this indicates spasms, and “Guo Lou Gui Zhi Tang” is indicated.
In Taiyang disease, if there is fever and the pulse is deep and thin, it is called “jìn”, which is difficult to treat.
If there is sudden abdominal distension, it indicates a desire to relieve, with a pulse that is still (floating and relaxed), but if it is floating and wiry, it indicates spasms.
04.
Causes of Spasms
The following two points:
In Taiyang disease, if there is fever without sweating and aversion to cold, it is called “gang jìn”.
In Taiyang disease, if there is fever with sweating and no aversion to cold, it is called “rou jìn”.
Thus, “gang jìn” corresponds to “Ma Huang Tang” (Ephedra Decoction), and “rou jìn” corresponds to “Gui Zhi Tang” (Cinnamon Decoction), which are unrelated to spasms.
Only when the above symptoms are present, along with stiff back and urgent spasms, indicating symptoms of fluid deficiency, can it be considered spasms.
Causes of spasms:
Cheng Menxue believes there are two major causes:
Damp-heat transforming into wind; blood depletion. Moreover, all six meridians can have spasms, and all six qi can cause spasms.
Qin Bowei believes:
The six evils invading can transform into dryness and wind—this is the treatment method established in “Jin Kui”;
Other diseases causing fluid and blood dryness—this is the various bad conditions in “Jin Kui”.
The reason for spasms caused by heat diseases is that heat depletes fluids, and fluids and blood cannot nourish the tendons and meridians, thus warm diseases often prevent spasms.
Tao Hanhua believes:
“Jin Kui Yao Lue” pertains to external-induced spasms, commonly seen in children—”Guo Lou Gui Zhi Tang” (soft spasms), “Ge Gen Tang” (rigid spasms), “Da Cheng Qi Tang” (Yangming excess heat spasms);
Adults often experience internal injury spasms, namely spasms due to deficiency of yin blood, treated with “Da Ding Feng Zhu”, “Er Jiao Fu Mai Tang”, “San Jiao Fu Mai Tang”, etc.
The latter is difficult to treat, namely:
Spasms due to stroke, in the elderly, with yin failure;
Spasms in postpartum women, due to excessive blood loss, affecting Chong and Ren channels;
Spasms due to ulcers, with blood following pus, and qi and blood depletion (such as moxibustion sores);
Spasms in children, either due to wind-heat injuring yin causing acute spasms, or vomiting and diarrhea depleting yin causing chronic convulsions, although not due to mismanagement, they all belong to yin deficiency symptoms.
All of the above are individuals with inherent yin deficiency (the different levels of yin substances: fluids, nutrients, blood, essence).
In summary, the two major causes: external-induced spasms; internal injury-induced spasms. All six meridians have exterior symptoms, can all become stagnant and transform into heat and wind, and can all lead to blood dryness.
05.
Treatment Methods
Treatment methods: “Guo Lou Gui Zhi Tang”, “Ge Gen Tang”, “Da Cheng Qi Tang”, etc.
The main function of Ge Gen is to disperse wind, clear heat, and relieve muscle tension, capable of generating fluids and quenching thirst, and can disperse the exterior;
Guo Lou Gen does not have the function of dispersing the exterior, mainly generating fluids and quenching thirst, nourishing yin and moistening the tendons.
“Ge Gen Tang” is used for Taiyang disease, where fluids are injured, with no sweating, and stiffness in the neck and back, to elevate Yangming fluids to Taiyang.
In critical times, use “Da Cheng Qi Tang”: urgent purging to preserve yin.
It can be seen that the protection of yin fluids runs throughout.
Liu Shaoyi:
In Taiyang spasms, the focus is on the exterior, but yin fluids must be protected.
For acute convulsions, use “Yin Qiao San” (Silver and Qiao Powder) with added flower powder, which has better effects; if the illness is prolonged and recurrent, use “Guo Lou Gui Zhi Tang” to support Yang and nourish yin.
Question: Why can “Yin Qiao San” with flower powder also treat spasms? Why, if the illness is prolonged and recurrent, is it necessary to use “Guo Lou Gui Zhi Tang” to cure it?
If spasms have exterior symptoms, opportunities for purging should be given, first to disperse the exterior (spicy-cool or spicy-warm), and on the basis of dispersing the exterior, add sweet-cool and fluid-generating products.
Whether spasms caused by Taiyang cold damage or warm diseases, the final solution does not deviate from dispersing the exterior + generating fluids.
Therefore, soft spasms can be treated with “Yin Qiao San” with flower powder, which belongs to the initial stage of exterior symptoms of warm diseases.
If recurrent and unhealed, prolonged illness must have deficiency symptoms, still with wind evil outside, and internal fluid injury, Ge Gen has the function of dispersing the exterior, while Guo Lou Gen does not have the function of dispersing the exterior, so it is not used to assist in dispersing, but flower powder nourishes fluids, combined with “Gui Zhi Tang” to harmonize Ying and Wei, relieve muscle tension and expel evil.
Cheng Menxue proposed the “step back method”, referring to the process of the disease gradually moving from the exterior to the interior, from evil excess to gradually having some deficiency (yin blood), with internal deficiency worsening.
Dispersing the exterior consumes yin fluids, and blood family cannot induce sweating.
Therefore, dispersing herbs like Ma Huang and Ge Gen need to be gradually reduced to keep up with the changes in the disease.
Supplement:
The main manifestations of the eight conditions of convulsions:
Spasms, tremors, pulling, and drawing.
Spasms: elbow and arm flexing and extending
Pulling: ten fingers opening and closing
Drawing: force like wrestling
Tremors: head and limbs shaking like a bell
Pulling: body arching and head tilting back
Drawing: hands like drawing a bow
Staring: eyes wide and angry
Gazing: looking at objects without blinking
(Optional) Relate the content learned from cold damage and warm diseases, discussing the differences and similarities in the three elements of diseases when using “Chai Ge Jie Ji Tang” and “Gui Zhi Jia Ge Gen Tang” for treating spasms.
Chai Ge Jie Ji Tang: Chai Hu, Gan Ge, Bai Zhi, Jie Geng, Qiang Huo, Shi Gao, Huang Qin, Bai Shao, Gan Cao, Da Zao, Sheng Jiang
Reference dosage: Chai Hu 12g, Gan Ge 9g, Gan Cao 3g, Huang Qin 9g, Qiang Huo 6g, Bai Zhi 6g, Shao Yao 6g, Jie Geng 6g, Shi Gao 3g.
Gui Zhi Jia Ge Gen Tang: Ge Gen, Shao Yao, Gui Zhi, Sheng Jiang, Da Zao, Gan Cao
It can be seen that the common herbs in both are:
Ge Gen, Shao Yao, Sheng Jiang, Da Zao, Gan Cao.
Gui Zhi Jia Ge Gen Tang:
In Taiyang disease, if there is stiffness in the neck and back, with sweating and aversion to wind, “Gui Zhi Jia Ge Gen Tang” is indicated. 14
This is based on the foundation of Taiyang wind-cold, with aggravated symptoms of obstruction in the Taiyang meridian, stiffness in the neck and back indicating tension, with insufficient fluids, and sweating with aversion to wind, so “Gui Zhi Jia Ge Gen Tang” is used, with the pathogenesis being: evil obstructing the Taiyang meridian, Ying and Wei not harmonizing. Using Ge Gen generates fluids and assists “Gui Zhi Tang” in dispersing (elevating Yangming fluids to Taiyang).
“Chai Ge Jie Ji Tang” can be seen as “Gui Zhi Jia Ge Gen Tang” without Gui Zhi, adding Chai Hu, Bai Zhi, Jie Geng, Qiang Huo, Shi Gao, Huang Qin.
If the exterior is closed without sweating, Gui Zhi is removed.
Chai Hu and Huang Qin disperse Shaoyang stagnant heat.
Bai Zhi and Shi Gao enter the Yangming meridian, dispersing Yangming heat, using Bai Zhi to predict forehead pain, Jie Geng promotes lung qi, and Qiang Huo disperses Taiyang wind-dampness.
Named after Chai Ge, it is presumed that the main herbs are Chai Hu and Ge Gen.
It can be seen that there is still Taiyang meridian wind-cold, and additionally, there is Shaoyang and Yangming stagnant heat, and some fluid injury, so Ge Gen and Shi Gao generate fluids, and Gan Cao protects the spleen and stomach, increasing fluids.
The three elements are: Three Yang combined diseases. Taiyang exterior wind-cold not resolved, combined with dampness, stagnating and transforming into heat, gradually transmitting into Yangming and Shaoyang.
06.
Medical Cases
(Yi Silan’s Medical Case)
Wang Sun Yizhai from Ruichang, aged 52, fond of wine and pleasure. In September of the Gui You year, he suddenly fell to the ground and lost consciousness after urinating at night, resembling a stroke, with closed eyes, coarse breathing, cold hands and feet, and a stiff body, with tight jaws.
Various doctors believed it to be a stroke, while others thought it was due to phlegm obstructing the middle qi, using Wu Yao Shun Qi San and other medicines, all ineffective. Some treated it as a Yin obstruction, using Fu Zi Li Zhong Tang, which only increased phlegm sounds.
Five days later, I was called to diagnose and treat, with six pulses deep, thin, tight, and slippery, getting stronger with pressure.
His brother Hong Dao asked: What is this illness?
I said: Cold dampness is clashing, it is “zī” disease.
“Zī” belongs to the bladder, and should be treated with “Qiang Huo Sheng Shi Tang” (Qiang Huo Decoction for Dispelling Dampness).
First, use “Xi Yan San” (Thin Saliva Powder) to induce vomiting, expelling phlegm, and he woke up immediately, then proceeded with six doses of Sheng Shi Tang, fully recovering. After a month of regulating with Ba Wei Wan, his essence and qi returned to normal.
Thus, cold dampness clashed, causing Taiyang qi to stagnate and not move, with symptoms of stiff back and neck, suddenly unable to turn back, with the waist feeling broken and the neck feeling pulled, indicating bladder meridian “zī” disease.
Hong Dao said: The “zī” disease arises from cold dampness, while Wu Yao Shun Qi and other medicines move qi and expel phlegm, and Fu Zi Li Zhong Tang dispels cold, yet all were ineffective. Why was your method so effective?
I said: The essence of recognizing the disease lies in understanding the pulse, body shape, and symptoms; the essence of using medicine lies in understanding the meridian’s movement and qi. The pulse and symptoms correspond, and the medicine has guiding properties, without disturbing the heavenly harmony, must first consider the seasonal qi, how can it not be effective?
The six pulses were all deep, thin, tight, and slippery; deep belongs to the interior, thin indicates dampness, tight indicates cold, and yet there was strength and slipperiness.
Various doctors believed it to be a stroke, but the wind pulse should be floating, yet the pulse is not floating but deep, and there are no symptoms of dizziness, how can it be a stroke? They thought it was phlegm obstructing the middle qi, but the phlegm qi pulse is not tight, yet the pulse is tight and the body is stiff, it is not phlegm obstructing the middle qi. This is indeed “zī” disease, as the poem says: strong and stiff like a bow, spirit dim like a stroke. Phlegm flows, lips and mouth move, convulsions and seizures are similar to epilepsy. Now the body is strong and stiff, the pulse is deep, tight, thin, and slippery, what else could it be but “zī”?
Previously using Wu Yao and Fu Zi Li Zhong Tang, dispelling cold could not dispel dampness, dispelling dampness could not dispel cold, and they did not use guiding medicines. Why was there no effect?
If using “Qiang Huo Sheng Shi Tang”, Gao Ben and Qiang Huo are the main herbs of Taiyang, unblocking all joints, Fang Feng and Man Jing Zi can dispel dampness from above and below, while Du Huo disperses the cold from the Shaoyin kidney channel. Once the cold dampness is dispersed, can the disease not heal?
Qiang Huo Sheng Shi Tang:
Qiang Huo, Du Huo, Gao Ben, Fang Feng, Zhi Gan Cao, Man Jing Zi, Chuan Xiong
“Zī” belongs to the bladder: the disease is located in the Taiyang meridian (the exterior).
Liu Jichen’s Medical Case
Li, female, 42 years old, consulted on October 19, 1957.
Three days prior, she felt wind-cold, with symptoms of fever, aversion to cold, and headache. After taking aspirin, sweating occurred, and the headache resolved, but she still felt unwell. Yesterday, while working in the fields, a slight breeze made her feel cold, and the headache became severe, with a sense of heat in the head and body, accompanied by stiff neck pain, sweating profusely, irritability, and thirst. Upon examination, her temperature was 37.6 degrees, tongue pale red, little coating, pulse deep and slow.
The diagnosis was external wind-cold, continuing with Taiyang disease and wind, with wind invading externally, injuring fluids internally, and disharmony of Ying and Wei, leading to soft spasms.
The treatment should clear heat, nourish fluids, and harmonize Ying and Wei, using “Guo Lou Gui Zhi Tang” with modifications.
Guo Lou Gen 20g, Gui Zhi 12g, Bai Zhi 15g, Sheng Zhi Zi 10g, Dan Dou Chi 12g, Zhi Gan Cao 10g, Sheng Jiang 3 slices, Da Zao 4 pieces. Decoction and drink hot porridge.
After taking 4 doses, all symptoms were eliminated, and the illness was cured.
Soft spasms basis:
Sweating profusely upon movement, stiff neck pain, pulse deep and slow.
In Taiyang disease, if the symptoms are complete, the body is strong, and the pulse is deep and slow, this indicates spasms, and “Guo Lou Gui Zhi Tang” is indicated.
Adding Zhi Zi and Dou Chi was due to the patient’s irritability and thirst.
Xi Liang Cheng’s Clinical Record
Postpartum spasms: Qin, female, 20 years old, consulted in the autumn of 1948.
Seven or eight days postpartum, she experienced dizziness and could not sit up. During the examination, the patient suddenly showed finger spasms, followed by yawning, opening her mouth wide, increasingly wide, until the corners of her mouth cracked and bled, urgently needing someone to press her mouth closed, yet it did not stop. She also exhibited pale complexion, wide eyes, drooling, cold sweat, and faint consciousness, with a pulse that was wiry, slow, and weak.
Diagnosis: Postpartum blood loss injuring yin, excessive sweating injuring yang, and then receiving external invasion, with wind entering the meridian and causing spasms, showing signs of yin depletion and yang collapse. The treatment should restore yang and stabilize collapse, expel wind and calm spasms.
Urgently decoct 15g of Korean ginseng and administer, after half an hour there was slight improvement, then continue with “Guo Lou Gui Zhi Tang” with modifications.
Korean ginseng 9g, Zhi Huang Qi 30g, Gui Zhi 6g, Hang Shao 9g, Fu Pian 4.5g, Guo Lou Gen 12g, Zhi Gan Cao 9g, Sheng Jiang 9g, Da Zao 5 pieces. Two doses, decoct and take.
Second diagnosis: After taking one dose, sweating gradually decreased, and spasms also improved, but she felt dizzy and fatigued, indicating that the exterior had stabilized and yang had returned, but yin blood was still deficient. The plan was to nourish blood and calm spasms, supplementing both qi and blood.
“Guo Lou Gui Zhi Tang” combined with “Si Wu Tang” with modifications.
Zhi Huang Qi 30g, Dang Gui 9g, Gui Zhi 4.5g, Hang Shao 9g, Guo Lou Gen 9g, Sheng Di Huang 15g, Chuan Xiong 4.5g, Gou Teng 9g, Zhi Gan Cao 6g, Korean ginseng 9g. Continued for 2 doses, dizziness decreased, and spirit gradually recovered.
This case was due to postpartum yin deficiency, with external invasion leading to yin depletion and yang collapse, urgently needing Korean ginseng to greatly tonify the original qi and restore yang. Afterward, treat the spasms (while supplementing original qi and restoring yang).
Mu Yongchang’s case of “gang jìn”
Lin, male, 48 years old, worker, consulted on March 6, 1964.
After catching a cold for 5 days, he took “Yin Qiao Jie Du Wan” in the factory clinic, showing slight improvement, but still had persistent fever, body aches, headache, cold limbs, fullness in the chest, nausea, and scant urination, with thin greasy tongue coating and tight pulse.
The diagnosis was that evil invaded the Taiyang and Yangming meridians, causing “gang jìn”. Therefore, the treatment should disperse the exterior, induce sweating, harmonize Ying and Wei, relieve muscle tension, and thus “Ge Gen Tang” was applied.
Prescription: Ge Gen 30g, Ma Huang 10g, Gui Zhi Tang 12g, Hang Bai Shao 12g, Chen Pi 10g, Zhu Ru 10g, Zhi Gan Cao 10g, Sheng Jiang 3 slices, Da Zao 4 pieces. First boil Ma Huang and Ge Gen, remove the foam, then add the other herbs, strain and take warm, inducing slight sweating, no need to drink porridge.
After taking 3 doses, he recovered.
This case raises doubts: Since it is said to be “gang jìn”, with headache, cold limbs, scant urination, there should also be no sweating and aversion to cold, with a floating pulse.
After taking “Yin Qiao Jie Du Wan”, there was slight improvement, which raises some questions. Why?
Is there evidence for Yangming meridian? If nausea and fullness in the chest, Shaoyang can also have nausea and fullness in the chest. The evidence for Yangming is insufficient.
Zhu Ru: clears and transforms heat phlegm, can clear heat from the lungs, as well as heat phlegm from the heart and liver, clear the stomach and stop vomiting. What is the evidence for using it here with Chen Pi (Chen Pi Zhu Ru Tang)? Fullness in the chest and nausea? Because the diagnosis is Yangming, Chen Pi Zhu Ru Tang was added to clear the stomach and descend the counterflow?
Mu Yongchang’s case—Epidemic Encephalitis B
Wang, admitted on July 26, 1965, with epidemic encephalitis B, treated with Western medicine without effect, still high fever and convulsions. Master Mu Yongchang was invited for consultation. The patient showed restlessness, confusion, limb convulsions, abdominal distension, no sweating, body temperature reaching 40 degrees, persisting without resolution, scant red urine, and no bowel movement for three days, with yellow greasy tongue coating and rapid pulse.
Diagnosis: Summer heat and warm evil transmitted into Yangming, resulting in Yangming organ excess syndrome. The treatment should be severe purging of heat accumulation, moistening dryness, and preserving yin. Modified “Da Cheng Qi Tang” was used.
Sheng Da Huang 10g (added later), Hou Po 10g, Zhi Shi 10g, Mang Xiao 6g (taken with water), Shi Gao 30g, Zhi Mu 10g, Jin Yin Hua 15g, Lian Qiao 10g, Zhi Gan Cao 10g.
Assistant medication: Zi Xue Dan (for heat disease with confusion) 3g, divided into two doses, taken with water.
The next day, fever subsided and consciousness cleared. Continued with 3 doses, all symptoms resolved.
Afterward, continued with three doses, with Da Huang and Mang Xiao still present, indicating that after one dose, bowel movements had not yet normalized.
Here, the absence of sweating, high fever, and rapid pulse.
The absence of sweating suggests the presence of exterior symptoms (summer heat). Either the heat is strong and obstructing yin externally, or the fluids are damaged, leading to insufficient sweat production. The formula included Jin Yin Hua and Lian Qiao.
Jin Yin Hua and Lian Qiao are suitable at all stages of warm diseases, can disperse the exterior in the Wei level, clear and resolve in the Qi level, disperse and transform in the Ying level, and clear and resolve heat toxins in the blood level.
Liu Shaoyi’s case—Gallbladder Stones
Yan, female, 38 years old, first consultation on June 14, 1981. Previous history of gallstones. Cured with Chinese medicine.
Three days prior, the patient suddenly experienced pain in the right upper abdomen, radiating to the right shoulder and back, followed by severe pain, accompanied by nausea and vomiting, fever and chills, and jaundice. Internal medicine diagnosed acute cholecystitis, and she was transferred to the TCM department for treatment. Symptoms included thirst, desire to drink, constipation, and scant red urine. Tongue coating was yellow and greasy, pulse was rapid.
Diagnosis: Gallbladder meridian accumulating heat, qi stagnation, and obstruction of the bowel qi.
The treatment should drain heat, unblock the bowel, benefit the gallbladder, and reduce jaundice. Modified “Da Cheng Qi Tang” was used.
Sheng Da Huang 10g (added later), Mang Xiao 10g (taken with water), Zhi Shi 10g, Hou Po 10g, Zhi Zi 10g, Yin Chen 20g, Yu Jin 12g.
After one dose, bowel movements improved and pain decreased, continued with 5 doses, fever and skin jaundice subsided, and continued with 5 doses, all symptoms resolved. Advised to take Yin Chen 30g and Da Zao 10 pieces decocted as a drink.
Why do patients with yellow greasy tongue coating still experience thirst and desire to drink? Why is there fever and chills without using dispersing formulas?
Constipation indicates Yangming has heat, and the heat qi rises, causing thirst and desire to drink.
Although there is fever and chills, it is not due to exterior symptoms causing fever and chills. Constipation indicates internal excess evil obstruction, leading to qi stagnation and inability to distribute Yang qi to the exterior. Since it is not an exterior symptom, naturally, dispersing formulas are not used.
Acute Pancreatitis Case
Zheng, female, 23 years old, first consultation on March 9, 1973.
The day before consultation, she ate oily food, and at night experienced severe upper abdominal pain that resisted pressure, radiating to the back, nausea and vomiting, dry mouth, and constipation. Today, she has a fever of 38 degrees, white blood cell count of 17.1*10^9/L, neutrophils 0.82; blood amylase 1600U, pulse small and wiry, tongue coating thin and yellow greasy.
Diagnosis: Damp-heat mutually obstructing the middle burner, affecting the pancreas, causing pain due to obstruction. Modified “Da Cheng Qi Tang” was used.
Sheng Da Huang 9g (added later), Xuan Ming Fen 9g (taken with water), Zhi Shi 12g, Sheng Shan Zha 15g, Da Xue Teng 30g, Bai Jiang Cao 30g, decocted for 2 doses.
After one dose, abdominal pain decreased, and after two doses, abdominal pain resolved, fever subsided, and blood tests returned to normal.