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Yibian
 Shen Yaozi 
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titleLiu Du-Zhou Medical Case Records
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Article 230 of the "Treatise on Cold Damage Diseases" mentions the use of Minor Bupleurum Decoction to treat yangming disease with constipation. I have always had doubts about this. In the summer of 1984, while supervising graduate students during their clinical practice, I treated a 52-year-old woman surnamed Han. She had been suffering from dry and hard stools for over a year, with bowel movements occurring only once every three to four days. Each time, she had to strain so hard that her clothes would become soaked with sweat, leaving her exhausted and hoarse. Although the stool would eventually pass, she would be left utterly fatigued. In addition to constipation, she also experienced fullness in the chest and hypochondrium, a bitter taste in the mouth, and irritability. Her pulse was wiry and straight, and her tongue coating was white and slippery. Upon analyzing her symptoms, I concluded that her constipation was related to yangming, while the fullness in the chest and hypochondrium, bitter taste in the mouth, and wiry pulse were related to shaoyang. Observing that her tongue coating was white rather than yellow, it aligned with the description in Article 230. Therefore, instead of using Chengqi Decoction, I prescribed Minor Bupleurum Decoction to test the statement in the text that "body fluids will descend." After taking three doses, not only did the fullness in her chest and hypochondrium disappear, but her bowel movements also became smooth, occurring once daily and returning to normal. This exemplifies the principle that "when the upper jiao is unblocked, body fluids will descend." How remarkable!

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