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IIntroduction: The Zeng Ye Tang (增液汤) has the effect of increasing fluids and moistening dryness, primarily treating Yangming warm disease and constipation due to fluid deficiency, characterized by hard stools, thirst, and a dry red tongue. Patients with confirmed fluid deficiency constipation may choose this formula for treatment.
Zeng Ye Tang (增液汤)
Author: Li Caiyun
[Original Text] In Yangming warm disease, without upper jiao symptoms, if there is no bowel movement for several days, one should use purgative methods. However, if the patient has a deficiency of Yin, one should not use Chengqi Decoction but rather Zeng Ye Tang. After taking Zeng Ye Tang, observe for 12 hours; if there is still no bowel movement, combine it with Tiao Wei Cheng Qi Tang for a gentle effect. The formula for Zeng Ye Tang (salty, cold, bitter, sweet method): 1 liang of Yuan Shen (元参), 8 qian of Mai Dong (麦冬, including heart), and 8 qian of Sheng Di (细生地). Use 8 cups of water, boil down to 3 cups, and if thirsty, give to drink until finished. If still constipated, prepare another dose.[Explanation] In Yangming warm disease, without upper jiao symptoms, if there is no bowel movement for several days, one should use purgative methods for treatment. If the patient has a deficiency of Yin fluids, even if there is constipation, Chengqi Decoction should not be used; instead, Zeng Ye Tang should be administered. After taking Zeng Ye Tang, observe for 24 hours; if there is still no bowel movement, it can be combined with Tiao Wei Cheng Qi Tang for a gentle purgative effect to harmonize the stomach qi and facilitate bowel movements. The above conditions for Yangming warm disease can be treated with purgative methods, establishing three treatment methods: for heat accumulation in the intestines, and significant Yin fluid depletion, Da Cheng Qi Tang should be used; for heat accumulation in the intestines with less significant Yin fluid damage, Tiao Wei Cheng Qi Tang should be used; and for predominant Yin fluid deficiency with less heat accumulation, Zeng Ye Tang should be used. This emphasizes the importance of preserving Yin fluids in patients with warm disease when Yin fluids are already deficient.[Clinical Application] Zeng Ye Tang has the effect of increasing fluids and moistening dryness, primarily treating Yangming warm disease and constipation due to fluid deficiency, characterized by hard stools, thirst, dry red tongue, and a thin rapid or weak pulse. This condition is caused by pathogenic heat depleting fluids, leading to Yin deficiency and dryness, which cannot moisten the intestines. Therefore, it heavily utilizes Xuan Shen (玄参) for its salty, cold, and Yin-nourishing properties to clear heat and moisten dryness, Sheng Di (生地) for its sweet, cold, and heat-clearing properties to nourish Yin, and Mai Dong (麦冬) for its sweet, cold properties to nourish the lungs and stomach. These three herbs are salty, sweet, bitter, and cold, nourishing Yin, increasing fluids, and clearing heat, hence the “salty, cold, bitter, sweet method.” Adjustments: If the fluid deficiency and dry heat are severe, and after taking Zeng Ye Tang there is still no bowel movement, one can add Sheng Da Huang (生大黄) and Mang Xiao (芒硝) to clear heat and promote bowel movements, softening hardness and moistening dryness.[Case Studies] 1. Case of Meng Jingchun: A 25-year-old female presented with hard stools, having a bowel movement every 4-5 days, with hard texture, dry mouth, scanty menstruation, normal urination, and normal appetite. Her tongue was red with a thin coating, and her pulse was thin and slightly rapid. She had previously sought treatment from a warm disease specialist, who prescribed: Sheng Di Huang (生地黄) 30g, Xuan Shen (玄参) 50g, Mai Dong (麦冬) 30g, Sha Ren (砂仁) 3g, Rou Cong Rong (肉苁蓉) 18g, Gua Lou (瓜蒌) 60g, Ma Zi Ren (麻子仁) 25g, for 7 doses. After no effect, she consulted Professor Meng Jingchun, reporting no change in symptoms and continued constipation. Professor Meng Jingchun prescribed: Xuan Shen 15g, Sheng Di Huang 12g, Mai Dong 10g, Dang Gui (当归) 12g, Rou Cong Rong 20g, Sheng Bai Zhu (生白术) 30g, Hei Zhi Ma (黑芝麻) 30g, Zhi Wan (炙紫菀) 20g, Yu Li Ren (郁李仁) 15g, Sheng Mai Ya (生麦芽) 20g, for 7 doses. Bowel movements occurred once daily, tongue was red and slightly pale, and continued with another 7 doses for follow-up. The prescription was: Xuan Shen 12g, Sheng Di Huang 12g, Dang Gui 12g, Rou Cong Rong 20g, Sheng Bai Zhu 40g, Hei Zhi Ma 30g, Zhi Wan 12g, Yu Li Ren 15g, Chao Zhi Ke (炒枳壳) 10g, Sheng Mai Ya 20g, Lai Fu Zi (莱菔子) 10g, Xing Ren (杏仁) 10g. 2. Case of Yang Jin: Treated a patient with habitual constipation for over 10 years, aged 55, presenting with dry mouth, excessive thirst, weight loss, five hearts heat, red tongue with little coating, and bowel movements once a week or longer, requiring assistance from laxatives to defecate. Initially, due to typical Yin deficiency symptoms, Wu Ren Wan (五仁丸) and Ma Zi Ren Wan (麻子仁丸) were used, but with poor results. Later switched to Zeng Ye Tang, but the effect was still not significant, requiring the addition of Da Huang (大黄). Considering the patient’s infrequent bowel movements and the need for straining, it was determined to be a sign of intestinal qi deficiency, and given the patient’s age, kidney qi was also deficient, so Huang Qi (黄芪) 18g and Rou Cong Rong 15g were added to the formula. After treatment, good results were achieved without the need for Da Huang, and after continuous treatment for over a month, constipation was basically cured.This article is excerpted from “Essentials of Warm Disease Differentiation and Clinical Practice,” published by Shanxi Science and Technology Press. Author: Li Caiyun.
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