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Precipitating gastrointestinal heat bind
下胃肠热结 〔下胃腸熱結〕 xià wèi cháng rè jié
To eliminate yáng brightness (yáng míng) bowel repletion through precipitation. yáng brightness (yáng míng) bowel repletion is characterized by tidal heat, abdominal distension that refuses pressure, constipation, old yellow or burnt-yellow tongue fur, or a dry fissured tongue with parched black fur and prickles at the tip and margins, and a forceful slippery sunken pulse. These signs are classically summarized with the words glomus, fullness, dryness, and repletion. In severe cases, there may be delirious speech and manic agitation, or diarrhea characterized by foul-smelling stool and burning sensation on defecation, together with fecal impaction (classically referred to as heat bind with circumfluence).
Medicinal therapy: The principal medicinal used in precipitating gastrointestinal heat bind is rhubarb (Rhei Radix et Rhizoma, 大黄 dà huáng), which frees the stool, drains fire, resolves toxin, and flushes the heat bind. It is often used with mirabilite (Natrii Sulfas, 芒硝 máng xiāo), which is salty and cold, and which softens hardness and drains heat. Patients with pronounced abdominal pain and distension should be prescribed formulas that also contain unripe bitter orange (Aurantii Fructus Immaturus, 枳实 zhǐ shí) and officinal magnolia bark (Magnoliae Officinalis Cortex, 厚朴 hòu pò), which loosen the center and break qì, thereby eliminating glomus and fullness. These three medicinals enhance the precipitant effect of rhubarb (Rhei Radix et Rhizoma, 大黄 dà huáng). Commonly used Formulas include