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Traditional Chinese Medicine Remedies
IIntroduction:Zengye Decoction has the effect of increasing fluids and moistening dryness, primarily treating Yangming warm disease and fluid deficiency constipation syndrome, characterized by constipation, thirst, and a dry red tongue. Patients with confirmed fluid deficiency constipation can choose this formula for treatment. (Editor/Zhuo Qun)
Zengye Decoction
Author/Li Caiyun
[Original Text]Yangming warm disease, without upper jiao symptoms, has not had a bowel movement for several days; if the person has a deficiency of Yin, it is not appropriate to use purgatives. Zengye Decoction is indicated. After taking Zengye Decoction, observe for 24 hours; if there is still no bowel movement, it is advisable to combine it with Tiaogui Chengqi Decoction for a mild effect. Zengye Decoction formula (salty, cold, bitter, sweet method): 1 liang of Yuan Shen (Scrophularia), 8 qian of Mai Dong (Ophiopogon, with heart), 8 qian of Xie Sheng Di (Rehmannia). Use 8 cups of water, boil down to 3 cups, and if thirsty, drink it all. If still constipated, prepare another dose.[Explanation]Yangming warm disease, without upper jiao symptoms, should be treated with purgation methods if there has been no bowel movement for several days. If the patient has a deficiency of Yin fluids, even if there is constipation, purgatives should not be used; Zengye Decoction is recommended 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 mild purgative effect to harmonize the stomach qi and facilitate bowel movements.The above discusses the conditions for which purgation methods can be used in Yangming warm disease, establishing three treatment methods: for heat accumulation in the intestines and significant Yin fluid depletion, Da Chengqi Decoction should be used; for heat accumulation in the intestines with less obvious Yin fluid damage, Tiaogui Chengqi Decoction should be used; for predominant Yin fluid deficiency with less heat accumulation, Zengye Decoction should be used. This emphasizes the importance of preserving Yin fluids in patients with warm disease when Yin fluids are already deficient.[Clinical Application]Zengye Decoction has the effect of increasing fluids and moistening dryness, primarily treating Yangming warm disease and fluid deficiency constipation syndrome, characterized by constipation, thirst, dry red tongue, and a fine, rapid or weak pulse. This syndrome is caused by pathogenic heat depleting fluids, leading to Yin deficiency and dryness, which cannot moisten the intestines. Therefore, it heavily uses Xuan Shen (Scrophularia) to nourish Yin and moisten dryness while clearing heat, Sheng Di (Rehmannia) to nourish Yin and clear heat, and Mai Dong (Ophiopogon) to nourish the lungs and stomach. The three herbs are salty, sweet, bitter, and cold, nourishing Yin, increasing fluids, and clearing heat, hence the “salty, cold, bitter, sweet method.” Adjustments: If fluid deficiency and dryness-heat are severe, and after taking Zengye Decoction there is still no bowel movement, Da Huang (Rhubarb) and Mang Xiao (Mirabilite) can be added to clear heat and promote bowel movements, softening hardness and moistening dryness.[Case Studies]1. Meng Jingchun’s case: A 25-year-old woman presented with dry and hard stools, having a bowel movement every 4-5 days, with hard texture, thirst, scant menstruation, normal urination, and normal appetite. Her tongue was red with thin coating, and her pulse was fine and slightly rapid. She had previously sought treatment from a warm disease specialist, who prescribed: Sheng Di (Rehmannia) 30g, Xuan Shen (Scrophularia) 50g, Mai Dong (Ophiopogon) 30g, Sha Ren (Amomum) 3g, Rou Cong Rong (Cistanche) 18g, Gua Lou (Trichosanthes) 60g, Ma Zi Ren (Hemp Seed) 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 12g, Mai Dong 10g, Dang Gui (Angelica) 12g, Rou Cong Rong 20g, Bai Zhu (Atractylodes) 30g, Hei Zhi Ma (Black Sesame) 30g, Zhi Wan (Aster) 20g, Yu Li Ren (Bush Cherry Seed) 15g, Sheng Mai Ya (Barley Sprout) 20g, for 7 doses. Bowel movements occurred once a day, tongue was red and slightly pale, and continued with another 7 doses for follow-up. The prescription was: Xuan Shen 12g, Sheng Di 12g, Dang Gui 12g, Rou Cong Rong 20g, Bai Zhu 40g, Hei Zhi Ma 30g, Zhi Wan 12g, Yu Li Ren 15g, Chao Zhi Ke (Bitter Orange) 10g, Sheng Mai Ya 20g, Lai Fu Zi (Radish Seed) 10g, Xing Ren (Apricot Kernel) 10g.2. Yang Jin’s case: 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 every week or longer, requiring the use of laxatives to facilitate bowel movements. Initially, due to typical signs of Yin deficiency, Wuren Wan (Five Nut Pill) and Ma Zi Ren Wan were used, but with poor results. Later, Zengye Decoction was used, but the effect was still not significant, and it was necessary to add Da Huang. Considering that the patient rarely had the urge to defecate and had to strain significantly, it was determined to be a sign of intestinal qi deficiency. Additionally, considering the patient’s age, kidney qi was also deficient, so 18g of Huang Qi (Astragalus) and 15g of Rou Cong Rong were added to the formula, resulting in good outcomes without the need for Da Huang to facilitate bowel movements. After continuous treatment for over a month, constipation was essentially cured.
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