Wang, female, 40 years old, was admitted to the hospital on January 21, 1986, with the main complaint of right hypochondriac pain accompanied by vomiting for 4 days. The patient had a 4-year history of right hypochondriac pain. She was thin and weak, with symptoms of hypochondriac pain, fever, nausea, vomiting, constipation, a pale tongue with a greasy, yellow-white coating, and a wiry and rapid pulse.
Physical examination: body temperature 38°C, obvious tenderness and muscle tension in the right upper abdomen, a 10cm×6cm round mass palpable under the right hypochondrium that moved up and down with breathing, and significant tenderness. Murphy's sign was positive. Western medical diagnosis: cholecystitis; Chinese medicine diagnosis: hypochondriac pain (liver-gallbladder dampness-heat type).
Initially, Major Bupleurum Decoction containing Rhubarb Rhizoma was used, with the prescription:
Bupleurum 45g, Rhubarb Rhizoma 18g, Peony Root 30g, Skullcap Root 12g, Immature Orange Fruit 12g, Pinellia 12g, Fresh Ginger Rhizome 18g, Chinese Date 7 pieces
decocted with water and taken. After one dose, the patient experienced diarrhea, and the fever, vomiting, and pain all decreased. Rhubarb Rhizoma was removed, and after taking 3 more doses, the fever and vomiting stopped. The patient experienced mental fatigue, lack of strength, and loose stools. The previous prescription was combined with Ginseng Decoction with modifications, and after taking 10 doses, all symptoms were resolved, and the patient recovered after further regulation.