3. San Wu Bei Ji Wan from "Jin Gui Yao Lue"

3. San Wu Bei Ji Wan from "Jin Gui Yao Lue"

[Composition] Rheum palmatum, Croton tiglium (oil removed), and dried ginger in equal amounts.

[Administration] Grind the herbs into powder, mix with honey to form pills the size of a wutong seed, take 1–2 grams each time, washed down with warm water. If no diarrhea occurs after taking, another dose may be taken as appropriate.

[Indications] Cold accumulation and collapse.

[Symptoms] Sudden abdominal pain, inability to defecate or urinate, bluish face and rapid breathing, locked jaw and cold limbs, white tongue coating, and a deep, tight pulse.

[Functions] Drive out cold accumulation and warm yang to rescue collapse.

[Explanation] Overeating cold drinks and food, coupled with cold congealing in the intestines and blockage of qi flow, leads to sudden abdominal pain and inability to defecate or urinate; cold blocking the meridians prevents yang energy from reaching the exterior, resulting in locked jaw and cold limbs, as well as a bluish face and rapid breathing. In this formula, Croton tiglium is pungent and hot, primarily to attack cold accumulation. Dried ginger warms yang and rescues collapse, facilitating the flow of yang energy as a supplementary function. Rheum palmatum promotes bowel movements and can also mitigate the toxicity of Croton tiglium's pungency, serving as a mitigating and facilitating agent.

[Clinical Modifications] This formula can be modified by removing Rheum palmatum and dried ginger, adding Platycodon grandiflorus and Fritillaria thunbergii to form San Wu Bai San, treating cold accumulation in the chest, excessive phlegm, phlegm sounds like sawing, and a deep, tight pulse; also treating throat obstruction and phlegm in the throat.

[Reference Materials] ① Wang Ren’an said: Rheum palmatum is bitterly cold and purges heat accumulation, while Croton tiglium is pungently hot and purges cold accumulation, and adding dried ginger's pungency helps disperse both, but these are all extremely harsh substances that should only be used in emergency situations. ("Cheng Fang Bian Du") ② This formula was used to treat one case of intestinal obstruction. The patient experienced sudden abdominal pain, bloating like a drum, constipation, a white and slippery tongue coating, and a slow, deep pulse. Diagnosis revealed cold accumulation and stagnation in the intestines, classified as a cold excess syndrome requiring warm purgation. Five pills of San Wu Bei Ji Wan were administered (seven-fifths of a pill), and shortly after, bowel sounds intensified, with abdominal pain initially worsening before easing; about five minutes later, another three pills were given, leading to bowel movement and recovery. ("Journal of Traditional Chinese Medicine," September 1965)

[Commentary] This formula can be used for food poisoning and acute simple intestinal obstruction.

3. Moist Purgation

Moist purgative formulas lubricate the intestines and treat constipation, suitable for patients with dryness and real heat accumulation. Typically, such constipation occurs after a febrile illness when yin fluids are depleted; it can also occur in elderly individuals with weakened bodies and insufficient yin moisture. For the former, the treatment involves combining moisturizing and cold purgation—moistening the dryness while purging the heat. Common formulas include Maziren Wan. For the latter, the approach is to combine moisturizing with tonifying—moistening the dryness while replenishing the deficiency, with common formulas such as Jichuan Jian.