Patient Background
The 4-year-old son of Pang Shouyu (a scholar who passed imperial examinations) suddenly developed symptoms including fever, vomiting at the sight of food, excessive sweating, and loss of consciousness. Due to Pang’s absence while teaching abroad and lack of decision-makers at home, (used in traditional contexts) was delayed until the condition worsened.
Initial Diagnosis
- Pulse Check: Strong, tight, and wiry pulse.
- Dietary Intake: No food for days, vomiting immediately upon seeing food.
- Excretion: Dark red urine resembling blood, no bowel movements.
- Physical Exam: Severe abdominal bloating, pain when pressing the chest.
Diagnosis & Treatment
Identified as food stagnation (impaired digestion causing food retention).
- Phase 1: Prescribed Pingwei San ( classic formula) combined with:
- Baikal skullcap (Huangqin)
- Chinese goldthread (Huanglian)
- Rhubarb (Dahuang)
- Outcome: Black stool pellets passed within an hour, followed by multiple reddish stools. Abdominal bloating subsided, and the child regained consciousness.
Follow-up & Relapse
- Phase 2: Switched to Baohe Wan ( digestion-promoting formula) with areca nut powder (Binglang).
- Mistake: The mother fed the child steamed buns (wheat-flour food) that night, causing relapse.
- Critical Advice: Strict avoidance of wheat-based foods for one month, allowing only rice porridge for recovery.
Resolution
Full recovery achieved through dietary control. During the Mid-Autumn Festival, Pang attempted to gift wine and meat as thanks, but I declined due to our scholarly friendship.
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