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Liu, male, 54 years old. Suffering from "hepatitis B", but his body is stable and without discomfort. Recently, he suddenly experienced abdominal distension and fullness, which must occur in the afternoon and at night. During the episodes, he is restless and in extreme pain. The patient points to his abdomen and says: I have no illness to speak of, it's just the abdominal distension and fullness at night, with qi gathering in the abdomen, not belching or passing, suffocating me to death. When asked about treatment, he said he has taken countless Chinese and Western medicines, all to no avail. When asked about his stool, it is loose and shapeless, occurring two to three times a day. Whenever the stool frequency increases, the abdominal distension and fullness at night worsens. Urine is scanty, and there is pain in the right hypochondrium, extending to the shoulder and back, causing unbearable discomfort. His pulse is wiry and slow, and his tongue is pale and tender with a white, slippery coating.
Zhongjing said, " taiyin disease is characterized by abdominal distension and fullness, vomiting, inability to eat, and worsening diarrhea," so any case of diarrhea with abdominal distension and fullness without thirst belongs to taiyin . Pudendal coldness is severe at night, hence the episodes occur at night. A slow pulse belongs to taiyin , while a wiry pulse belongs to the liver and gallbladder. The gallbladder meridian runs along the sides, hence the hypochondriac pain extending to the shoulder and back. However, abdominal distension and fullness in taiyin disease is not uncommon in clinical practice, but for it to be as severe as in this case, could it not be due to the liver and gallbladder qi mechanism failing to regulate properly, leading to the dysfunction of the six fu -organs' ascending and descending? After careful examination and consideration, treating both the liver and spleen, the Bupleurum, Cinnamon Twig and Dried Ginger Decoction from the "Treatise on Cold Damage Diseases" was selected:

Bupleurum 16g, Cinnamon Twig 10g, Dried Ginger 12g, oyster shell 30g (to be decocted first), mongolian snakegourd root 10g, Skullcap Root 4g, Prepared Liquorice Root 10g
. After just one dose of this formula, the nocturnal abdominal distension and fullness was reduced by half. After three doses, the abdominal distension and fullness completely disappeared, and the diarrhea also stopped.