Main Formula for Treating Deficiency of Body Fluids and Constipation

IIntroduction:The Zengye Decoction (增液汤) has the effect of increasing body fluids and moistening dryness, primarily treating Yangming warm disease and deficiency of body fluids leading to constipation, characterized by dry and hard stools, thirst, and a dry red tongue. Patients with deficiency of body fluids and constipation can choose this formula for treatment.

Zengye Decoction (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, it should be treated immediately. If the patient has a deficiency of Yin, the use of purgatives is not appropriate; Zengye Decoction is the main treatment. After taking Zengye Decoction, observe for 24 hours. If there is still no bowel movement, combine it with Tiaogui Chengqi Decoction (调胃承气汤) for a gentle effect. The formula for Zengye Decoction (salty, cold, bitter, sweet method): 30g of Yuan Shen (元参), 24g of Mai Dong (麦冬, Ophiopogon), and 24g of Xuan Shen (玄参). Boil with 8 cups of water to obtain 3 cups. If thirsty, drink it all; if still constipated, prepare another dose.[Explanation]In Yangming warm disease, without upper jiao symptoms, if there is no bowel movement for several days, a purgative method should be used. If the patient has a deficiency of Yin fluids, even if there is constipation, do not use Chengqi Decoction; instead, use Zengye Decoction for treatment. After taking Zengye Decoction, observe for 24 hours. If there is still no bowel movement, it can be combined with Tiaogui Chengqi Decoction for a gentle effect to harmonize the stomach qi and facilitate bowel movements.The above discusses the conditions under which purgative methods can be used for Yangming warm disease, establishing three treatment methods: for heat accumulation in the intestines and significant Yin fluid depletion, Da Chengqi Decoction (大承气汤) should be used; for heat accumulation in the intestines with less obvious Yin fluid damage, Tiaogui Chengqi Decoction should be used; and for cases with significant Yin fluid depletion and less heat accumulation, Zengye Decoction should be used. This emphasizes the importance of preserving body fluids in patients with warm disease when Yin fluids are already deficient.[Clinical Application]Zengye Decoction has the effect of increasing body fluids and moistening dryness, primarily treating Yangming warm disease and deficiency of body fluids leading to constipation, characterized by dry and hard stools, thirst, dry red tongue, and a thin rapid or weak pulse. This condition is caused by pathogenic heat depleting body fluids, leading to Yin deficiency and dryness, which cannot moisten the intestines. Therefore, it heavily uses Xuan Shen (玄参) for its salty, cold, and Yin-nourishing properties, Sheng Di Huang (生地黄) for its sweet, cold, and heat-clearing properties, and Mai Dong (麦冬) for its sweet, cold, and lung-stomach nourishing properties. These three herbs are salty, sweet, bitter, and cold, nourishing Yin, increasing body fluids, and clearing heat, hence the “salty, cold, bitter, sweet method.” Adjustments: If the deficiency of body fluids and dryness-heat is severe, and after taking Zengye Decoction there is still no bowel movement, add Da Huang (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 patient presented with dry and hard stools, having a bowel movement every 4-5 days, with hard texture, thirst, scant menstrual flow, normal urination, and normal appetite. Her tongue was red with a thin coating, and her pulse was thin and slightly rapid. After consulting a teacher of warm disease, she was 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, and Ma Zi Ren (麻子仁) 25g for 7 doses. After no improvement, she consulted Professor Meng Jingchun, who noted no change in symptoms and continued constipation. Professor Meng prescribed: Xuan Shen 15g, Sheng Di Huang 12g, Mai Dong 10g, Dang Gui (当归) 12g, Rou Cong Rong 20g, Bai Zhu (白术) 30g, Hei Zhi Ma (黑芝麻) 30g, Zhi Zi (紫菀) 20g, Yu Li Ren (郁李仁) 15g, Sheng Mai Ya (生麦芽) 20g for 7 doses. Bowel movements improved to once daily, with a slightly pale red tongue, and continued with another 7 doses for follow-up: Xuan Shen 12g, Sheng Di Huang 12g, Dang Gui 12g, Rou Cong Rong 20g, Bai Zhu 40g, Hei Zhi Ma 30g, Zhi Zi 12g, Yu Li Ren 15g, Chao Zhi Ke (炒枳壳) 10g, Sheng Mai Ya 20g, and Lai Fu Zi (莱菔子) 10g, and Xing Ren (杏仁) 10g.2. Case of Yang Jin: Treated a patient with habitual constipation for over 10 years, aged 55, presenting with thirst, weight loss, five hearts heat, red tongue with little coating, and bowel movements once a week or longer, requiring assistance from laxatives. Initially, due to typical signs of Yin deficiency, he was given Wu Ren Wan (五仁丸) and Ma Zi Ren Wan (麻子仁丸) with poor results. Later, Zengye Decoction was used, but the effect was still not significant without adding Da Huang. Considering the patient had little urge to defecate and had to strain, it was determined to be a sign of Qi deficiency in the intestines. Given the patient’s age and kidney Qi deficiency, 18g of Huang Qi (黄芪) and 15g of Rou Cong Rong were added to the formula, resulting in good outcomes without the need for Da Huang, achieving regular bowel movements. After continuous treatment for over a month, the constipation was essentially cured.This article is excerpted from “Essentials of Warm Disease Differentiation and Clinical Application,” published by Shanxi Science and Technology Press. Author: Li Caiyun. Please cite the source when reprinting.

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