Case of Diarrhea due to Deficiency of Spleen and Kidney Yang

Case Study:   

Medical Record Number: 72690046

Mr. Bao, 50 years old

Chief Complaint: loose stools for over 3 years

Medical History:Patient has loose stool for 3 years, 2-3 times a day, some time it become more often when ate improper food, meanwhile he has profuse sweating, aversion to wind or cold, profuse phlegm in the throat, dizziness and numbness. The patient had a long history of alcohol addiction, hypertension for over 10 years, asthma, and was easily brought up when exposed to cold. Sleep is normal.

Tongue and pulse:Tongue is pale and enlarged with tooth marks and white thick greasy coating, thin and week pulse.

Diagnosis:Intestinal dysfunction

Pattern Differentiation:Yang Deficiency of spleen and kidney, cold-dampness block middlejiao

Treatment Strategy:Warm and resolve cold-phlegm, subdue yang and tonify kidney

Prescription:

Rou dou kou 10g

Wu wei zi 6g

xiao hui xiang 10g

Wu yao 10g

Gan jiang 10g

Gui zhi 10g

jiang ban xia 9g

fu ling 15g

Lu jiao shuang 15g

Zhi gan cao 6g

duan long gu 30g

duan mu li 30g

mi ma huang 9g

Qian shi 20g

Zhi wu zhu yu 6g

yin yang huo 15g

Zao jiao ci15g

zhu ling 10g

xi xin 3g

 

7 doses, one doses a day and decoct in water twice a day, take the decoction when it is warm. Keep the same treatment principle in second visit. He was completely recovered after two weeks medication.

“Man at the age of 40, half of Yin Qi has already been consumed.” Due to insufficiency of kidney Qi , kidney yang is unable to warm spleen yang, causes failure in transportation and transformation, so it become frequent defecation, especially when taking improper food.

Due to spleen dysfunction in T& T, Qi fails to moving water, causes water-damp retention that aggravates spleen function fatherly, water-dampness mix with undigested food goes directly down to the large intestine result in diarrhea.

Qi is deficiency, it fails to secure and contain defensive Yang, causes interstices insecure, so patient has profuse sweating, aversion to wind or cold, which easily brought up asthma when attached by cold wind. However the pathogenic cause is congruent, which is yang deficiency of lung and kidney, the vexing yang is unable to heat the body and subdue Yang.

In Chinese Medicine, liver and kidney originated from same source, essence and blood mutual transforms. Therefore, if kidney essence deficiency for a long time, the true essence becomes insufficient and liver blood also becomes insufficient. Chinese slogan says shallow water could not raise dragons. So if yin deficiency with effulgent fire over a long time, dragon fire soaring upward, hyperactivity of liver yang makes hypertension, dizziness and numbness. Yang deficiency engenders dampness and phlegm, and disturbs Qi movement.

In this formulae, Rou dou kou, lu jiao shuangandqian shiis to warm and tonify spleen and stomach;wu  yao,wu zhu yuandxiao hui xiangis to warm middlejiaoand eliminate cold;fu ling is toinvigorate spleen and promote urination;yin yang huotonify yang and supplement essence;gan jiang, xi xin,andban xiawarms lung, transforms and dispels phlegm;duan long guandduan mu lisubdues yang and guides it to its root, astringes and stops sweating, withqian shi to normalizes bowel movement;gui zhiis to open and dispel external evils and harmonize the nutrient; small dose ofma huangpromotes sweating, to dispelling evils and harmonize the nutrient and defense;zhi gan caoeliminates fire and harmonize middle Jiao. In summary, the combination of formulae warm and tonify lung, spleen and kidney Yang, dissipate cold and dispel phlegm.