Ms. Cai, female, 40 years old, first consultation on July 3, 1980. Symptoms include epigastric distension and pain, chest heat, occasional vomiting of bitter green water, poor appetite, severe epigastric pain after consuming cold food, and abdominal pain with diarrhea. Western medicine diagnosis was "chronic cholecystitis," treated with penicillin and streptomycin without effect, hence referred for consultation. Examination revealed the above symptoms persisting, clear consciousness, emaciated body, bright eyes, pale tongue texture, thin white tongue coating, epigastric tension with severe pain upon pressure, no palpable masses, and a wiry and slow pulse. The syndrome was identified as upper heat and lower cold, with spleen-stomach disharmony. Treatment aimed to clear heat from the upper body, warm purgation, invigorate the spleen, and harmonize the stomach, prescribing a modified Coptis Decoction. Prescription:
Coptis Rhizome 8g, Dried Ginger 8g, Pinellia 10g, Ginseng 8g, Liquorice Root 8g, Cinnamon Twig 6g, Green Tangerine Peel 10g, Bupleurum 6g
3 doses, 1 dose daily, decocted with water and taken warm twice a day.
Second consultation: Vomiting ceased, epigastric pain reduced, appetite improved, loose stools, tongue and pulse unchanged. Continued with the above prescription for 6 doses, same administration method.
Third consultation: Symptoms alleviated, occasional epigastric stuffiness. Heat and cold balanced, liver qi constraint. Continued with liver-regulating and qi-soothing method. Prescription:
Bupleurum 10g, Curcuma Root 8g, Aucklandia Root 5g, Green Tangerine Peel 10g, Corydalis Tuber 10g, Dried Tangerine Peel 10g, Medicated Leaven 10g, Chinaberry Fruit 6g, Villous Amomum Fruit 3g, Prepared Liquorice Root 5g