Case Study: TCM Treatment for Chronic Constipation Due to Spleen Deficiency
Patient Background
Xue Heming (courtesy name He Ting), a respected censor from Lingchuan, Shanxi, was known for his integrity. While overseeing official appointments at the Ministry of Personnel, he maintained strict ethical standards. Later as an imperial censor, his forthright memorials often displeased the emperor, yet earned admiration for their fairness.
Medical History
In the summer of 1854 (Jia Yin year), his wife developed persistent constipation. Initial treatments failed:
Heat-clearing approach: Chengqi Decoction (a purgative formula) showed no effect.
Intestinal lubrication: Hemp seed (Huomaren) proved ineffective.
Digestive stagnation therapy: Pingwei San (Stomach-Calming Powder) provided temporary relief but quick relapse.
TCM Diagnosis
Pulse examination revealed:
Weak pulses across all six positions
Particularly faint right guan pulse (spleen/stomach zone)
Thin, thread-like right chi pulse (kidney yang indicator)
Pattern Identification
Spleen deficiency failing transportation – The spleen’s inability to transform and transport nutrients caused intestinal stagnation.
Treatment Principle
Treating obstruction with tonification (“Using supplementation for blockage” per Huangdi Neijing classics).
Prescription
Modified Si Jun Zi Tang (Four Gentlemen Decoction) + Pingwei San
Heavy dose: 30g Codonopsis root (Dangshen)
Patient Concerns Addressed
When questioned about using tonics for constipation:
“Constipation here stems not from excess but insufficient qi to propel stool – like a weak horse unable to pull even an empty cart. Tonifying spleen qi restores natural bowel movement.“
Outcomes
Immediate relief: Multiple bowel movements overnight
Sustained recovery: Abdominal comfort restored, appetite tripled by next morning
80-90% improvement within 24 hours
Key TCM Insights
Spleen-driven digestion: Bowel function relies on spleen qi’s ascending/descending dynamic.
Chronic constipation subtypes: Not all cases require purgation; deficiency patterns demand qi supplementation.
Pulse diagnosis validity: Right guan pulse specifically reflects spleen-stomach health.
SEO Keywords
Traditional Chinese Medicine constipation (used in traditional contexts), Spleen deficiency constipation case, Chronic constipation TCM approach, Si Jun Zi Tang clinical application, Ancient Chinese medical case studies
Note for Readers
This historical case demonstrates classical TCM pattern differentiation. Modern patients should consult licensed TCM practitioners for personalized diagnosis.
The esteemed medical text Zui Hua Chuang Medical (Original: Ming Dynasty Clinical Archives) has been translated by timtcm.com. We welcome your valuable comments and feedback in the section below.
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