Huangtu Decoction is an effective prescription used by Zhongjing to treat the far blood syndrome of blood after stool, blood after feces, and blood purple dark. The original prescription is composed of seven herbs: loess, licorice, shengdi, atractylodes, paofuzi, donkey-hide gelatin, and scutellaria. Loess refers to Fulong liver, which is the main medicine in the prescription. According to the "Rihua Materia Medica": "Treatment of nasal floods, intestinal wind, blood collapse, ejaculation and blood in the urine." According to the "Materia Medica Reading": "Fan Zhu It can be used for all blood diseases caused by spleen and stomach yang deficiency and unable to control it." Aconite can remove the viscera, Chen Han and Sanyin Jueni. According to "Medical Qiyuan": "Removing the viscera and cold, subsidizing insufficient Yang Qi, warming the spleen and stomach." Aconite with Baizhu, warming Yang and strengthening the spleen, can treat some diseases caused by spleen and stomach Yang deficiency. According to the "Compendium", donkey-hide gelatin contains: "Treats vomiting blood, blemishes, hematochezia, hematuria, intestinal wind and diarrhea." It can nourish yin and blood when combined with natural land. Scutellaria baicalensis is an anti-adjuvant product that slows down the pungent heat of aconite and causes blood. In short, this prescription has the obvious effect of warming yang and invigorating the spleen to stop bleeding, and warming the yang without hurting the yin, nourishing yin without hindering the spleen. Because of these characteristics, it can be used clinically to treat spleen deficiency due to yang deficiency. Various bleeding syndromes caused by the failure of the spleen to control the blood, such as vomiting blood, hematochezia, bleeding in the stool, uterine bleeding, lower blood, and purpura.
"Golden Chamber Synopsis Brief Notes": "The prescription also mainly vomits blemishes, and this is the degree of golden needles. I use this prescription to use dried ginger for easy aconite, and a catty of red stone fat instead of loess is more effective. Four taels of arborvitae and six catties of fresh bamboo."
"Blood Syndrome Theory": "This prescription is to nourish qi and blood. And the combination of Wenqing product to harmonize it is the general prescription for lower blood and metrorrhagia."
"Like Jufang General": "Cures vomiting blood and blood, prolonged periods of time, irritation under the heart, body heat and cold, youthful face and thin body, weak pulse, white tongue or abdominal pain or slight swelling. It also cures visceral poison, Hemorrhoids, unstoppable pus and blood, abdominal pain, diarrhea, trouble urination, chlorosis, and swelling and barrenness."
There are many causes of bleeding, and the pathogenesis is also more complicated. Even so, it is nothing more than two aspects. The real ones are mostly caused by fire evil and stagnation of qi, which make the blood unable to do the normal way. The weak ones are caused by insufficient viscera function, and the dysfunction of the liver and spleen due to various reasons, especially the deficiency of the spleen-yang, the deficiency of the qi and the cold. The power of dominance means that the blood can't do the usual way and go rashly and retrogradely, which results in a bleeding syndrome of deficiency and cold. The clinical characteristics are blood purple and dark, long-term treatment does not heal, or concurrent abdominal pain, hot and cold, and late pulse. This prescription is used to treat various hemorrhagic diseases caused by the deficiency of yang and the effect is very good.
1. Stomach bleeding (for those with deficiency and cold)
Irregular diet, discomfort with cold and heat, overeating and overdrinking will damage the yang of the spleen and stomach for a long time, make the spleen and stomach insufficiency and cold, and will not heal over the years, which will inevitably cause the blood collaterals of the spleen and stomach to be injured, blood stasis will be blocked, and the spleen and stomach will be weak and digestive. The ability to absorb and transfuse is getting lower and lower, and the source of biochemical qi and blood is correspondingly lacking, mutual cause and effect, and gradually forming a severe syndrome of deficiency and cold. Insufficiency of spleen yang, in addition to the dysfunction of transportation and chemistry, it is also unable to control the blood, so the gastrointestinal bleeding of the deficiency and cold type arises from this.
Clinical manifestations: epigastric pain, anorexia, delayed digestion, fixed pain, or severe pain at night, severe appetite, or pain such as knife cutting, blood in the stool or vomiting black blood, or cold hands and feet, heavy pulse Delayed weakness, like the "ulcer disease" of modern medicine. In the treatment of this disease, the symptoms and root causes should be treated at the same time. Huangtu Decoction is an ideal prescription with good therapeutic effect. If the addition and subtraction of the prescription is appropriate, combined with the patient's proper care, it will have positive significance in improving the clinical symptoms and organic quality. If the deficiency and cold stomach pain does not develop to the injury of the veins, and there is no symptoms of bleeding or occult blood in the stool, it is not the indication for this prescription.
Li XX, male, 55 years old. The usual diet is very irregular. I began to have pain in the gastric cavity three years ago. At first, it was only a slight pain after cold food. Later, I gradually gained weight, accompanied by loss of appetite, soreness and vomiting, and sometimes vomiting water. The diet gradually decreased, the body was weak, and fatigue. Weak, fond of heat and afraid of cold. In the past year, the condition has become more serious. Every time the stomach is full and painful after eating, it lasts about 1-2 hours each time, sometimes having black stool. Once barium meal angiography was diagnosed as gastric ulcer. Give symptomatic treatment, the effect is not good. The pulse is slow and weak, the lips are light and the mouth is light, the tongue is fat and the color is light, the stool is thin, and the hands and feet are not warm. According to the above conditions, it is considered as deficiency-cold stomachache and stomach collateral injury. Huangtu Decoction is given for treatment with one dose a day. After taking the five ingredients, the condition was relieved, the stomachache was faint, and the stool did not see black feces. After taking more than 50 doses of Ji Zongfang therapy, all the symptoms disappeared. Later, the pill was prepared with the addition and subtraction from the above, and the pills were taken for more than three months. There was no recurrence after a follow-up for three years.
Note: The syndrome of deficiency-cold stomachache in this case is mainly due to the long-term lack of diet, the formation of spleen deficiency and stomach cold, lack of Zhongyang, lack of power to transport and transform, less food, delayed digestion, loose stools and weak hands and feet. Deficiency of spleen yang cannot control the blood, and the veins are injured, so the stool is black. The principle of treatment should be to warm the stomach, strengthen the spleen and stop bleeding. Huangtu Decoction is suitable for treating this disease. Although the patient had black stools intermittently for more than a year, he did not relapse after taking only five doses of Huangtu Decoction, and his stomach pain was significantly reduced. Since then, Huangtu Decoction has been used as the main prescription, with the addition and subtraction of the card, a total of six months of treatment, and he was cured. This kind of disease is difficult to cure in a short period of time regardless of Chinese or Western medicine treatment, but as long as the doctor insists on the treatment, the patient takes the medicine patiently, closely cooperates, and a complete cure is also very promising.
2. Metrorrhagia (for those with deficiency and cold)
Metrorrhagia is a person with asthenia and cold, and its testimony is dripping bleeding, dull blood color, yellow complexion, cowardly speaking, lingering unhealed, loss of appetite, diarrhea and bowel, cold hands and feet, pale lips, and weak pulse. Delays and other symptoms of deficiency and cold are all caused by spleen yang deficiency and failure to control the blood. Zhiyi Huangtu Decoction warms yang to dispel cold, strengthens the spleen and nourishes the middle, nourishes yin and blood. Typical cases:
Li XX, female, 42 years old. Irregular vaginal bleeding lasts for half a year, and there are almost 25 to 6 days bleeding within a month. The color is purple and dark, and the dripping is constant, sometimes good and bad. Accompanied by poor appetite, cold abdomen pain, sore back and legs, a lot of leucorrhea, the color is not smelly, the lower limbs are slightly edema, the complexion (white light) is white, hot and cold. The tongue is light and thick, the fur is white, and the pulse is weak and weak. Previous doctors have repeatedly used blood-tonifying and cooling-blood agents for treatment, but the effect was not good. According to its pulse syndrome, the weakness of the spleen and yang loses its control function. The former doctors often used cold and cool medicines. Tonic blood and stop bleeding will inevitably make the yang weaker, and the yin and cold will worsen, and the disease will gradually worsen. The method of replenishment restores the Yang of Zhongjiao and gives it the right to control the blood. Give Huangtu Decoction a day. After taking five doses, the bleeding decreased and the lower abdomen was not as cold and painful as before. Since it is effective, continue to take the front. When the dose is 15 doses, the bleeding stops and all the syndromes improve. Add and subtract according to the front to make a pill, and take it for one month to consolidate the effect.
Patients with vomiting of the spleen and qi and cold cannot be controlled due to spleen deficiency and cold. Some of them are due to the syndrome of vomiting of blemishes, taking cold and cold medicine, but the yang of the spleen and stomach is injured. This treatment is often effective.
Chang XX, male, 38 years old. Suffering from nosebleeds for more than ten years, there are always several episodes every year. Each episode of bleeding continues for four or five days, and the daily outflow is about 20-30 ml. After taking cooling blood and hemostatic drugs, it will be cured. In the past two years, the disease has worsened slightly. Although the prodrug was taken again at the onset of the disease, it was either effective or ineffective. Later, it was changed to western medicine hemostatic agents, such as Anluoxue, agrimony, etc., but it was not cured and continued to relapse. .
I had a nosebleed in the autumn of 1969. The blood volume was so large that I could not stop it with various hemostatic drugs. At that time, the patient's complexion was pale, his hands and feet were rebellious, his digestion was delayed, his pulse was late and weak, and his tongue was fat and pale. Diagnosed with deficiency and cold in the Qi, and no control over. After one dose of Huangtu Decoction, the blood decreased, and all three doses stopped. After taking this prescription plus or minus a pill for two to three months, no recurrence has been seen for several years.
Note: In this case, the patient with epistaxis has an early age of heat and fullness, so when the nosebleeds, the cold product is used to cast the effect. This bleeding in 1969, according to the pulse syndrome, has already developed a cold weather. It is purely due to spleen deficiency and cold that cannot be controlled. Therefore, it is necessary to warm the spleen and nourish the yang, and use Huangtu Decoction to cure it. It can be seen that clinical diagnosis must be performed accurately and nuancedly, and past experience alone cannot deal with the ever-changing diseases.
Fourth, purpura (belonging to asthenia and cold)
Purpura is mostly a syndrome of excess heat, but sometimes purpura of the deficiency-cold type may be encountered. This type of etiology and pathogenesis is mostly due to the deficiency of spleen yang and the inability to control the blood and ingest blood, break the collaterals and overflow, resulting in subcutaneous bleeding. Its spots are rather purple and dark, and are accompanied by a series of symptoms of spleen deficiency and stomach cold, such as pale complexion, fatigue, loss of appetite, pale tongue, weak pulse, weak hands and feet, etc. Zhiyi Huangtu Decoction warms the spleen and stomach yang, and the yang recovers itself.
Zhang XX, male, 4 years old. Purpura appeared for more than 20 days without fever. After pre-medical treatment, he was given eight doses of Rhizoma Dihuang Decoction. Not only did he not get better, but the bleeding spots increased day by day. The old ones have not retreated, and the new ones are born again, one after another. , All over the arms, limbs, and trunk. The color is not fresh and dark purple. His mother complained on her behalf: Recently, she has poor spirits, loss of appetite, loose stools, and is prone to abdominal distension and bowel movements, loose stools. In this way, the yang deficiency of the spleen and stomach can be known. In addition, the child's complexion is weak, his hands and feet are not warm, he is lazy to move, his pulse is weak, and his tongue is pale and no moss. Synthesizing the pulse syndrome, it is purely a sign of spleen deficiency and stomach cold. Warming tonic is not enough. He took eight doses of Xijiao Dihuang Decoction, which contused the spleen and yang more and caused the disease to develop day by day. In view of this situation, considering that non-warming and tonic methods are not enough to cure the disease, he was given two doses of Huangtu Decoction, and all the syndromes improved in different degrees after taking the four doses, and all the syndromes of the child were cured.
Note: In the first syndrome of purpura, the main cause of the disease is mostly caused by the invading of extremity heat and the invading blood. In terms of treatment, Xijiao Dihuang Decoction and Qingying Decoction are mostly used. The patient in this case had the opposite effect. It was caused by spleen-yang deficiency and failure to control the bleeding. The previous doctor did not know the syndrome differentiation, did not start from the whole, and did a comprehensive consideration, but was simply confused by some symptoms, ignoring the essence of the disease, so that he mistakenly used the eight medicines of Rhinoceros Dihuang Decoction, which made the condition worse. Then heal it with Huangtu Tang that warms the middle, nourishes the spleen and stops bleeding.
【Attached】Pus and blood in stool
Zhang xx, female, 52 years old. I have been sick for more than half a year. At first, I had pus and blood five to seven times a day. After more than ten days, there was no pus in the stool. It was pure blood. The color was the same as that of watermelon juice after decay. Severe cramps in the anterior abdomen, and after a while after going to the toilet, the abdominal pain recurred, without tenesmus, and other aspects were generally normal. The syndrome is that spleen deficiency and cold qi cannot control the blood. He was given two doses of Huangtu Decoction. After taking it, there was no bloody stool for eleven days, and the stool was normal. The next time, he took more than ten doses of this prescription. No recurrence was seen in a year.
1. Huangtu Decoction has the most reliable effect in treating blood syndrome, whether it is vomiting blood, nose bleeding caused by internal organ disease, or blood in the stool, uterine bleeding, occult blood, occult blood, or hemorrhage under the skin of the body surface muscle. All disease syndromes caused by spleen deficiency and cold qi, deficiency of Zhongyang, and no right to control the disease, have a certain effect after repeated clinical verification.
2. Dose and addition and subtraction
The general adult quantity of loess soup: 10 grams of licorice, 12 grams of raw land, 12 grams of Atractylodes macrocephala, 12 grams of cooked aconite, 15 grams of donkey-hide gelatin, 10 grams of scutellaria baicalensis Georgi, half a catty of stove heart soil, mashed, stirred with boiling water, wait for coarse soil When the bottom is clear and the fine dust is not clear, take the water for decocting, if clear water is useless.
Addition and subtraction: To treat ulcer disease, or occult blood, occult blood, you can remove the skullcap and add 10-15 grams of black gardenia as an anti-adjuvant medicine. To cure purpura, add 10 grams of Angelica sinensis and Danpi each.