‘Constitution Theory’ in Shang Han Lun; An Examle Formula
By Jubong Kang, K.M.D.
In Sang Han Lun, there are some clauses or prescriptions related to constitution and one of them is as low:
After taking Gui Zhi Decoction and having profuse perspiration, if the great thirst of water is not relieved, and the pulse is grand and huge, then White Tiger Decoction(Bai Hu Decoction 白虎湯) plus Ren Shen reigns(『Sang Han Lun』 Line 26, p. 156, Paradigm Publication Version).
In this clause, it’s said that the reason why ‘White Tiger Decoction plus Renshen’(=’Bai Hu Decoction plus Renshen’) should be prescribed again after taking Guizhi Decoction is because of the side effects from rhe wrong prescription due to a misdiagnosed treatment with Guizhi Decoction.
The symptoms of great thirst and grand pulse were caused by the by the pungent taste and warm property of Guizhi Decoction and from this misdiagnosed treatment result, it is possible to find clause about the constitution of a patient.
The misdiagnosed treatment occurred because the external symptoms of Guizhi Decoction and White Tiger Decoction (=Bai Hu Decoction) are sometimes very similar to each other, especially in the beginning stage of greater yang disease.
Floating pulse and sweating are the sign symptoms of not only Guizhi Decoction but also White Tiger Decoction (=Bai Hu Decoction).
The former decoction, Guizhi Decoction is suitable for a person whose digestive organs are not big and food intake of meal is less than other type, i.e. they have 1/2 1 times greater digestive or middle burner function than others, which can be either autumn type or winter type person.
And the latter decoction, Bai Hu Decoction is suitable for a person whose digestive organs are a little bigger and their meal portions are more than the other type, i.e. 1~2 times greater digestive or middle burner function than others, which can be either summer type person or spring type person.
The different sign symptom betwwn the former decoction and the latter decoction is thirsty of Shigao, but sometimes sign symptom of thirsty from shiago is not strongly presented, that the traditional medicine doctor might overlook and misdiagnose the patient.
After giving Guizhi Decoction to a summer type, or spring type, profuse perspiration occurs, because of warm characteristic of their middle burner.
Guizhi Decoction was created for autumn type and winter type who has smaller spleen and stomach which cause their middle burner to become easily cold by exterior coldness, so that their middle burner could be heated by the property of Guizhi Decoction.
But if a summer type or spring type takes Guizhi Decoction in a progress of channel disease pattern then their bigger and warmer middle burner become even more hotter by the character of pungent and warmth Guizhi Decoction therefore, profuse sweating comes out and their stomachs become dry(Bigger organ means that more blood is supplied and the organ becomes warmer).
At the beginning stage, for this patient who is summer type or spring type, the suitable formula was Bai Hu Decoction; but after Guizhi Decoction had been taken by misdiagnosis, much liquid was lost by sweating, and then the pulse became weak and scattered(Scattered pulse is sanmai 散脈). If the sign symptom of hard glomus below the heart was palpated, the, rather than Bai Hu Decoction is an alternative decoction for this patient to correct the side effects.
