I am busy preparing an Ebook for the White Pine Circle‘s February resources. Our theme is Ge Gen and so I am translating material on classical formulas that include Ge Gen. One such lesser known formula is Ben Tun Tang (Running Piglet Decoction). Sometimes I run across a case that rivets my attention and I am sharing one of these today. I love that the doctor, Dr. Xióng Jìbǎi 熊继柏 is writing in a narrative style and that he is clearly using this case to teach us. I found this case in The Path of Clinical Experience with Classical Formulas for Modern Distinguished Physicians《当代经方名家临床之路》. I also love how the pharmacy was missing a key herb, Li Gen Bai Pi, which is the peel of the plum tree root, so he went out into the valley and dug some up himself! Enjoy the case!
The patient, Ms. Cheng, was age 46 and was a peasant. At the start of her illness she had dizzy spells with restlessness and palpitations. She shut herself in a room and gradually would not get out of bed. She had photophobia so she kept the room dark, with closed doors and window. She was like this for four years. She ate and went to the toilet in her dark room. Why did she shut herself into this room? In the first place, she could not bear light. Every time she saw light rays, her eyes would become distended. Secondly, she could not move about. She said that every time she moves, she feels as if there is a great flood colliding with her heart. It was a terrible feeling like a river running into a rock. Whenever she moved, this symptom would increase. It became a bit better if she lay down and did not move. Finally, she was terrified. This had gone on for more than four years. She could not open windows or even light a lamp. She had already seen many doctors. When her family members came to me, I was also trepidatious because this disease had lasted a long time and many doctors had already failed. At this time I was still young and nervous and did not want to go. But, the family wanted me to go and so I had to go.
At the time of the consult, the patient’s voice was loud and clear and she was of sound mind. She could hear, eat, sleep, urinate and move her bowels in a normal way. I wanted her to come out but she said that if she went out, she would die. I then called her and forced her out of the room. Why did I do that? First, I wanted to see her. Secondly, I wanted to observe her facial color and finally, I wanted to see her tongue moss. The moment she came to the door opening, she shouted out that she was so uncomfortable in her heart, then she shouted “I want to die!” She wailed and then abruptly made no sound and did not move. I was very anxious, but I put my hand in front of her nose and could still feel her breath. I put a needle in He Gu (LI 4) and offered a bit of ginger water. After about a minute she revived consciousness and began breathing without shouting. She said her eyes were going to explode as well as her heart organ. Her tongue body was pale red with grayish white moss. Her pulses were wiry.
This person who has been bedridden for 4 years, unexpectedly had wiry and rapid pulses. What could this mean? “great water colliding with the heart,” eyes that want to explode and terror. What disease is this? A thought suddenly occurred to me! The patient said that it was water flowing up hill and colliding. However, this may not mean that it is actually water. Also, when it came on she wanted to die. I suddenly related this to the passage in the Jingui Yaolue about Ben Tun disease; “In Ben Tun disease, there is a surging up from the lower abdomen to the throat and one wants to die. Then there is recovery and this stops. This is all due to fright.” This is what it says in the classical works that are my foundation and my tools. If I had not read the Jingui Yaolue, I would not have been familiar with this and it would have been impossible to suddenly call this to mind. The patient was not familiar with this text so she could not have described her symptoms based on it. And yet, did she not describe the symptoms as Qi surging to the heart with a fit of wanting to die? After I thought of Ben Tun, I quickly thought of Zhang Zhongjing’s treatment for it. He has three formulas: Gui Zhi Jia Gui Tang, Ling Gui Zao Gan Tang, and Ben Tun Tang. Which should I use? Gui Zhi Jia Gui Tang treats Yang deficiency Ben Tun. Ling Gui Zao Gan Tang treats water fluid pulsating below the navel that is about to Ben Tun. Ben Tun Tang is for liver Qi reversing upward Ben Tun.
What are the symptoms that indicate Ben Tun Tang? Zhang Zhongjing said “Ben Tun with Qi surging upward to the chest, abdominal pain and alternating heat and cold. This patient did not have aversion to cold or cold limbs. Also, her pulse was wiry and rapid. This showed it was not Yang deficiency. Was it water then? Her tongue was not slippery and there was no pulsating below the navel, therefore this was not water. I also went back to considering Ben Tun Tang. Why was this patient’s eyes so distended? She also had a clear aversion to light. Why was this? The light made her eyes worse. Is this not clearly liver Qi reversing upward? The liver opens into the eyes and her pulse was wiry and rapid. These three symptoms put this in the category of liver Qi reversing upward, which indicates Ben Tun Tang. Therefore, I gave her Ben Tun Tang.
The primary herb in Ben Tun Tang is Li Gen Bai Pi, which the pharmacy did not have. However, there was plenty of it in the rural valley. There were plum trees everywhere. Right then and there I dug some up and put a Lianginto each package with the rest of Ben Tun Tang. I put the Gui, Shao, Xiong, Ban, Ge, Long, Cao and Sheng Jiangin to make up Ben Tun Tang. And I added the Li Gen Bai Pi. Thought about the greyish white tongue moss as well as the fact that, even though no vomit came out, at the time I brought her out of the room she retched. I decided to add the one flavor Fu Ling to transform water. So, her first formula was the complete Ben Tun Tang with added Fu Ling. After 5 packages, I checked in because this disease was so strange, I wanted to know the results. However, after 5 packages, the patient’s family did not come. By the time they came, she had already had 8 packages and the patient had emerged from her room.
That this disease was cured was a huge surprise for me. It was completely beyond my expectations. I did not know that the results from classical formulas could be so miraculous!