Ji Mai San 蒺麦散: Case 3

Ji Mai San Case Example 3

Ms. Qu was thirty years old when she carne for her first visit on April 5, 1977. She had been married for three years without becoming pregnant. The iodized oil roentgenograpy revealed that the fallopian tubes on both sides had inflammatory changes. The liquid went through but not smoothly. Her menstruation had been changing for several months. After using female hormones the amount of menstruate became scanty and she experienced dull pain on both sides of her lower abdomen. Her pulse was deep and thin and her tongue moss was thin and white. This appeared to be a case of Chong and Ren Mai vacuity cold and Liver Qi depressive knotting. To treat, I decided to warm her uterus and course her Liver so I used modified Gui Xian Tang, Cinnamon Immortal Soup as the prescription:

Zhi Shi Ying               Fluoritum         15gm.

Yin Yang Huo       Herba Epimidium           9gm.

Xian Mao            Rhizoma Curculingus       9gm.

Rou Cong Rong         Caulis Cistanches            12gm.

Ba Ji Tian                 Radix Morinda              12gm.

Rou Gu Mo      Cortex Cinnamon Powder     3 gm.(stir in powder)

Da Mai Ya           Massa Fermentata Hordei            15gm.

Chao Dang Gui     Stir-fried Radix Angeilca Sinensis     9gm.

Chao Chi Shao     Stir-fried Radix Peoniae Rubra     15gm.

Chao Chuan Xiong     Stir-fried Rhizoma Ligusticum        4.5 grn.

JuHe                Semen Citri                                            4.5 gm.

Ju Luo              Fructus Vascularis Citri                         4.5 gm.

Tu Hong Hua        Flos Carthami                                         4.5gm.

Pu Gong Ying        Herba Cum Radicis Taraxum                 12gm.

Bai Mao Teng      Herba Solanum Lirati                             30 gm.

There after I used the same prescription, modified in accordance with the symptoms.

She intermittently took the herbs for a period of close to one year. In April of the next year she became pregnant.

Sharon’s commentary:

As with the previous case, we see here how Dr. Qiu strings formulas together in mixed patterns.  In case one she used Ji Mai San with Wu Zi Yan Zong Wan when the presentation was a Liver Qi stasis and Kidney Qi deficiency.  In this case she has determined that the diagnosis is Liver depression and Kidney Yang deficiency because the patient’s pulse is thin and deep and her tongue moss is white.  In cases of Kidney Yang deficiency leading to infertility, Dr. Qiu uses her experiential formula Gui Xian Tang Cinnamon Immortals Soup.    In this case she combines this with Ji Mai San.  Dr. Qiu has also added the more vitalizing aspects of Si Wu Tang by including Dang Gui, Chuan Xiong and Chi Shao as well as Hong Hua to improve the quality and movement of the blood.  Generally, when a woman exhibits scanty menstruation or amenorrhea with lower abdominal pain, Dr. Qiu would consider blood stasis an aspect of the diagnosis.  Bai Mao Teng, 白毛藤 is an herb Dr. Qiu uses to treat fallopian tube and ovarian inflammation.

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