4 Psychogenic anorexia: currently quite common; use Chaihu Longgu Muli Tang. In this formula, lead丹can be replaced with raw iron filings.

<!-- translated-chunk:5/22 -->

(3) Exogenous Shaoyang syndrome with anorexia: symptoms include bitter taste in the mouth and dry throat after exposure to external pathogens, along with loss of appetite. Use Xiaochaihu Tang. (4) Psychogenic anorexia: currently quite common; use Chaihu Longgu Muli Tang. In this formula, lead丹can be replaced with raw iron filings. (5) Yangming organ-fulfillment syndrome with anorexia: symptoms include fever, restlessness, dry and hard stools, and loss of appetite. Use Dachengqi Tang. Meanwhile, based on many years of clinical experience, Professor Pei Zhengxue has formulated a “Great Three Combination Decoction” for treating anorexia (mnemonic: “Great Three Fragrances, Dry and Charred Three Herbs”), which consists of Dafupi, Muxiang, Xiangfu, Chenxiang, Ganjiang, Chao Maiya, Shenqu, and Laizi. Among these, Dafupi promotes diuresis, Muxiang and Xiangfu regulate qi flow, Ganjiang warms the middle jiao, while Chao Maiya, Shenqu, and Laizi aid digestion. 4. Agitation refers to a condition where the stomach feels neither truly hungry nor truly full, and eating alleviates the discomfort. Professor Pei Zhengxue commonly uses four formulas to treat agitation. For cold-type stomach, agitation is relieved by warmth; use Xiangsha Liujunzi Tang with added Ganjiang and Shengjiang. For heat-type stomach, agitation is accompanied by a burning sensation; use Yueju Wan combined with Zuojin Wan. For food-stagnation-related agitation, use Baohe Wan combined with Zuojin Wan. For liver-stomach disharmony-related agitation, which is triggered by emotional factors, use Chaihu Shugan San combined with Zuojin Wan. It can thus be seen that Zuojin Wan plays an important role in treating agitation. This formula originates from “Danxi Xinfa” and consists of Huanglian and Wuzhuyu, originally in a ratio of 6:1. Professor Pei Zhengxue often uses a ratio of 4:1, i.e., 12g of Huanglian and 3g of Wuzhuyu. 5. Black stool and bleeding: If the bleeding is bright red, with yellow tongue coating and a wiry, rapid pulse, it indicates stagnation of heat forcing blood to flow abnormally; one may use Sanhuang Xiexin Tang with added Chao Puhuang, Ajiao, Diyu Tan, Bai, Shenglonggu, Shengmuli, Wuzi Gu, and Han Sanqi to clear heat and stop bleeding. If the bleeding is dark purple, with a sallow complexion, cold limbs, pale tongue, and weak pulse, it indicates deficiency-cold of the spleen and stomach, resulting from the spleen’s failure to control the blood; one may use Huangtu Tang with modifications to warm and invigorate spleen yang, tonify qi, and consolidate blood. If the bleeding is profuse, sometimes accompanied by hematemesis and black stools, close monitoring of blood pressure is required. If signs of critical condition appear, such as pallor, cold extremities, cold sweat, and a barely perceptible pulse, active integrated Chinese-Western rescue measures should be taken, including intravenous blood transfusion, fluid replacement, and the use of traditional Chinese medicines such as Shenfu Tang, Dushen Tang, and Guipi Tang. At the same time, regarding such diseases, Professor Pei Zhengxue repeatedly emphasizes the importance of promoting blood circulation and removing blood stasis. Common representative formulas include Danshen Yin, Sanshu Wuwu Puhuang Rou, Shidai Lingdan, Wudi Huangliang Xiang, Shixiao San, Jinlingzi San, Wuma Jin Gangan Huo Niaoniao, Baihe Feifei Guocaoqiao (see “Pei Zhengxue Medical Notes”), and Gexia Zhuyu Tang, among others. Six. Clinical case examples by Professor Pei Zhengxue Case 1: Ms. Yang, 38 years old. Chief complaint: Stomach discomfort accompanied by nausea and vomiting twice. During the height of summer, she was enjoying the cool evening air at a beer square, drank alcohol, caught a chill, felt body aches and heaviness, headache, vomited stomach contents, and had two episodes of loose, watery stools. Physical examination: Body temperature 38°C, mild tenderness in the upper abdomen and around the umbilicus. Tongue body red, greasy yellow coating, slippery rapid pulse. [Western diagnosis] Acute gastroenteritis. [TCM differentiation] External pathogen invasion due to summer dampness, internal injury from diet. [Treatment principle] Dispel summer heat and release exterior pathogens, transform dampness and harmonize the middle jiao. [Prescription] Huoxiang Zhengqi San with modifications: Huoxiang 10g, Zisu Ye 10g, Houpu 10g, Chenpi 6g, Fuling 10g, Dafupi 10g, Muxiang 6g, Cangzhu 10g, Jineijin 10g, Chao Maiya 10g, Chao ShanZha 10g, Chao Shenqu 10g, Chao Baizhu 10g, Chao Biandou 30g. Decoct in water and take one dose daily for a total of five doses orally. Second visit: The next day after taking the medicine, nausea and vomiting eased, abdominal pain and diarrhea improved, followed by treatment with Huoxiang Zhengqi Water combined with Baohe Wan for post-treatment conditioning. Case 2: Mr. Li, 35 years old. Chief complaint: Upper abdominal distension and pain accompanied by nausea for one week. Poor appetite, constipation, short and reddish urine, bitter and sticky mouth. The patient had not undergone any examinations but bought Domperidone and Huoxiang Zhengqi Pills from a pharmacy and took them for two days, after which symptoms alleviated. However, after eating leftover food from the refrigerator, he again experienced upper abdominal distension, nausea, and vomiting of stomach contents, so he came to the emergency room. Physical examination: Tenderness below the xiphoid process, Murphy's sign positive, soft abdomen, no abdominal muscle tension. Tongue body red, greasy yellow coating, tight wiry pulse. Ultrasound showed rough gallbladder wall, acute cholecystitis. Complete blood count: White blood cells 12.5 × 10^9/L, neutrophils 78%, lymphocytes 22%. [Western diagnosis] Acute gastritis, acute cholecystitis. [TCM differentiation] Damp-heat stagnation in the gastrointestinal tract, combined with food accumulation inside. [Treatment principle] Clear heat and transform dampness, aid digestion and remove stagnation. [Prescription] Pingwei San and Dachengqi Tang with modifications: Cangzhu 10g, Houpu 10g, Chenpi 6g, Gancao 6g, Dahuang 15g (added later), Mangxiao 10g (dissolved in water), Zhishi 10g, Baodoukou 10g, Yiren 30g, Xingren 10g, Banxia 6g, Shengjiang 6g, Zhuru 10g. Decoct in water and take one dose daily for a total of seven doses orally. Second visit: After taking the medicine, abdominal pain, nausea, and vomiting improved, but poor appetite and fatigue persisted, tongue body red, white coating, wiry slippery pulse. The above formula was adjusted by removing Mangxiao, reducing Dahuang to 6g, and adding Chao Maiya and Jineijin each 10g. After taking 14 doses, the condition was cured. Case 3: Ms. Li, 50 years old. Chief complaint: Stomach pain accompanied by diarrhea for one week. One week ago, she developed vague stomach pain after eating cold and raw food, with decreased appetite, vomiting sour and rotten food, loose stools, lack of appetite, fatigue, pale red tongue, swollen tongue with tooth marks, greasy yellow coating, and a wiry rapid pulse. She usually has stomach discomfort and feels bloated and vaguely painful whenever she eats carelessly. Gastroscopy: Gastric mucosa shows alternating red and white areas, thin and abundant mucus, chronic superficial gastritis. [Western diagnosis] Chronic superficial gastritis. [TCM differentiation] Spleen and stomach deficiency, food stagnation. [Treatment principle] Tonify qi and strengthen the spleen, aid digestion and resolve food accumulation. [Prescription] Xiangsha Liujunzi Tang and Banxia Xiexin Tang with modifications: Muxiang 6g, Sharen 3g, Fuling 10g, Banxia 6g, Chenpi 6g, Gancao 6g, Dazao 4 pieces, Chao Baizhu 10g, Dangshen 15g, Huangqin 10g, Huanglian 6g, Ganjiang 6g, Quanshi 10g, Jiaosanxian each 10g, Danshen 10g, Caodoukou 6g, Fuzi 6g (decocted first). Decoct in water and take one dose daily for a total of seven doses orally. Second visit: After taking the medicine, stomach pain lessened, diarrhea and nausea improved, tongue body red, thin yellow coating, wiry rapid pulse. The above formula was adjusted by adding Cangzhu and Houpu each 10g to dry dampness and strengthen the spleen, and after taking 14 doses, the condition was cured, followed by post-treatment conditioning with Jianpi Wan. Case 4: Ms. Liang, 41 years old. Chief complaint: Stomach pain with radiating pain to both sides for half a year. The patient is irritable and easily angered, with a bitter mouth and dry stools, acid reflux, heartburn, nausea, vomiting, red tongue with yellow coating, and a wiry rapid pulse. Gastroscopy: Gastric mucosa shows congestion and edema, with bile reflux. Ultrasound: Chronic cholecystitis. [Western diagnosis] Chronic gastritis with bile reflux, chronic cholecystitis. [TCM differentiation] Liver qi stagnation, rebellious qi attacking the stomach. [Treatment principle] Soothe the liver and relieve qi stagnation, regulate qi and relieve pain. [Prescription] Danpan Hezheng Fang with modifications: Chaihu 10g, Zhishi 10g (crushed), Baishao 10g, Gancao 6g, Chuanxiong 6g, Xiangfu 6g, Danshen 10g, Muxiang 6g, Caodoukou 6g, Dahuang 6g, Huangqin 10g, Huanglian 6g, Yanhushuo 10g (with vinegar), Chuanlianzǐ 20g, Zhi Ruxiang 10g, Zhi Meiyao 6g, Ganjiang 6g, Pugongying 15g, Baijiangcao 15g, Shenglonggu 15g, Shengmuli 15g, Wuzigu 15g, Walingzi 15g (calcined), Baifan 2g. Decoct in water and take one dose daily for a total of 14 doses orally. Second visit: After taking the medicine, stomach pain, acid reflux, and bitter mouth with dry stools all improved, but still experiencing dry heaving, poor appetite, fatigue, red tongue, thin yellow coating, and wiry slippery pulse. The above formula was adjusted by removing Walingzi and Baifan, adding Banxia 6g, Chenpi 6g, and Dangshen 15g to regulate qi and harmonize the middle jiao, strengthen the spleen and stomach. After continuous use for over two months, the condition was cured, followed by post-treatment conditioning with Jianpi Wan. Case 5: Mr. Xia, 38 years old. Chief complaint: Stomach pain for half a year, worsening with nausea for three days. Six months ago, he experienced nausea and vomiting after excessive drinking, with stomach pain. He intermittently took Cimetidine and Sanjiu Weitai Granules for treatment, and his condition improved. Later, due to work requirements, he often ate out, drank, smoked, and had irregular eating habits, leading to intermittent stomach pain, chest tightness, nausea, dry and bitter mouth, sticky and unpleasant feeling in the mouth, sticky sweating, red tongue with yellow coating, swollen tongue with tooth marks, and a slippery rapid pulse. Gastroscopy: Acute active inflammation of the gastric mucosa, with congestion and erosion. Blood pressure 140/90 mmHg.