Shanghan clinical cases

study

In the 1980’s, People Republic of China

Dr. Zahn Dechao‘s

clinical case张德超医案

Food-denying dysenteryMain complains:

A 7 year-old boy suffering from severe diarrhea with passage of mucus and blood for five days.

ManifestationMain signs: more than 10 times of major bloody stools a dayOther symptoms and signs:

Abdominal pain, poor appetite, relief of fever after resolving the exterior.

Initial treatments:1)Since fever with severe diarrhea ，use the method of ”hauling the boat upstream”(exterior

syndrome)

Maybe food accumulation ?

2)Since poor appetite may be caused by food accumulation, use the method of precipitation

to discharge accumulated food.

Evaluation First treatment is somewhat right, fever relieved, but no effect on diarrhea.Second treatment is completely wrong,

more severe diarrhea, vomit and food-denying appears.

Dr. Zahn Dechao’ s initial impression

Pulse: soggy and weak pulse, especially right Guan Pulse. Tongue: red tongue body with white coating .

What information those signs

give us?

Pulse LocationLeft right Hand cun hand

guan Chi

Heart

Liver

kidney

Lung

Spleen&Stomach

Vital gate

Soggy and weak pulse means

Just like Air chair is leaking air.

Tongue Red tongue ＝

Since body fluid loses due to diarrhea, it is a kind of physical

response.White coating ＝

Evil locates in Qi aspect

Mechanism Spleen & Stomach

extremely deficiencyand Qi dynamic disorder

no exteriorno repletion

机制：脾胃虚极，气机失调（非表非实）

伤寒中风，医反下之，其人下利日数十行，谷不化，腹中雷鸣，心下痞硬而满，干呕，心烦不得安。（ 158 ）With wind stroke of Cold damage, treated by precipitation, the patient showed diarrhea,

tens of times a day, indigested food, thunder-like bowel rumbling, glomus Qi with hardness and fullness located in stomach, dry retching, restless vexation. （ 158 ）

伤寒论 In Shang-Han-Lun

东汉 Donghan(25-220)

Licorice Heart-Draining Decoction

Syndrome(LHDDS) 甘草泻心汤证

医见心下痞，谓病不尽，复下之，其痞益甚。此非结热，但以胃中虚，客气上逆，故使硬也。甘草泻心汤主之。（ 158 ）Since glomus Qi located in stomach remained, which represented not to recover, and then treated by precipitation again, it became more severe. It is not heat bind, however, hardness is caused by stomach stomach deficiency and Guest Qi upwarddeficiency and Guest Qi upward. Licorice Heart-Draining Decoction takes charge of this syndrom. （ 158 ）

The same Main complainsSecond inapropriate treatmentMain mechanism of this syndrome

惊奇的一致：主证，误治，主病机

Dr. Zahn Dechao’ s diagnosis

Before second treatment, Spleen and stomach deficiency and Guest

Qi (evil) located in Mid Jiao. Therefore it appeared diarrhea due to abnormal upbearing and downbearing.

But now Guest Qi goes Upward and leads to food denying.

Herbs and preparation of LHDD

Licorice 12g, Pinellia 12g, Scutellaria 9g, Coptis 3g, dried ginger 9g, Jujube 4 pieces, Ginseng 9g. 炙甘草 12 克，半夏 9 克，黄芩 9 克，黄连3 克，干姜 9 克，大枣 4 枚，人参 9 克。2 L——1.5 L---0.6 L——— 》 0.2 L

7 herbs put into water Taking

herbs outDrink one

third

Dr. Zahn Dechao’ s treatment

Main principle:Supplement the center and harmonize the

stomach, and clear Damp heat as well.治则：补中和胃，清化湿热。Licorice 12g, Pinellia 9g, Scutellaria 6g,

Coptis 3g, Fresh ginger 9g, Jujube 3 pieces, Codonopsis 9g. 2 formula.

甘草 6 克，黄芩 6 克，黄连 3 克，制半夏 9 克，党参 9 克，生姜 6 克，红枣 3 枚。

2 剂

Curative effect2 formula, vomit and diarrhea got relieved. After 3 more formula with original decoction variant, the patient was cured .

2 剂，呕痢均减，更服原方加减，续服 3 剂而安。

The modern medical describing

Concept: Dysentery is defined as a disease characterized by severe diarrhea with passage of mucus and blood and usually caused by infection.Some symptoms include, intestinal ulceration, diarrhea, painful spasms and the inflammation of the lining of the large intestines. The disease is spread through the feces of carriers who have the bacteria in their intestines.It is transmitted by eating or drinking from anything contaminated with the bacteria from the feces of these carriers. Even touching something contaminated and then touching the mouth can cause infection. Flies also spread the disease.

Q1:Do the foreigners know what I am talking about ?

Q2:Have Shang Han Lun been translated?

Shang Han Lun in foreign countary

Q3: We do know about Shang Han Lun outside China, but no Chinese herb permits to prescription legally in our

nation.However, acupuncture is OK, can we use needle to get the same good curative effect ?

The answer is yes of course.

Acupuncture under guide of Shang Han Lun:

Licorice Heart-Draining Decoction Syndrome(LHDDS)

甘草泻心汤证

Using Mechanism of Shang Han Lun to pick

acupoints运用伤寒论病机选穴

Main Mechanism :Stomach Main Mechanism :Stomach deficiency and Guest Qi upwarddeficiency and Guest Qi upward

主病机：胃中虚，客气上逆

Herbs and acupoints

Licorice stomach deficiency and Guest Qi upwardstomach deficiency and Guest Qi upward －－ ST-36ST-36

GinsengScutellaria －－－ food accumulation and food accumulation and

vacuity fire generatevacuity fire generate －－－ ST-44Coptis －－－ clear heart fire and relieve vacuity vexationclear heart fire and relieve vacuity vexation －HT-7Pinelli －－ spleen deficiency and engender phlegmspleen deficiency and engender phlegm － ST-37dried ginger －－－ warm interiorwarm interior －－－ SI-3

Jujube －－－ supplement bloodsupplement blood －－－ SP-6

药物及对应穴位甘草 人参－胃中虚，客气上逆－足三里黄芩－－－食积虚火－－内庭黄连－－－清心火，止虚烦－－神门半夏－－－脾虚生痰－－丰隆干姜－－－温里－－－后溪大枣－－－补血－－－三阴交

Thank you