Cangzhu Diyu Tang for Dysentery and Radiation Enteritis
The Suwen Bingqi Yi Baoming Ji records a formula called Cangzhu Diyu Tang (Atractylodes and Sanguisorba Decoction). Its composition is: Cangzhu (Atractylodes) 2 liang (60 g), Diyu (Sanguisorba) 1 liang (30 g). File the herbs; take 1 liang (30 g) per dose, decoct in water, strain, and take warm twice daily. This formula fortifies the spleen and dries dampness, clears heat and cools blood. It is indicated for spleen-channel damp-heat presenting diarrhea, dysentery, and bloody stools. Modifications: if there is glomus below the heart, add Zhishi (Immature Bitter Orange) 1 qian (3 g); if urination is difficult, add Fuling (Poria) 1-2 qian (3-6 g).
Today one may decoct prepared slices directly, at a dose of: Cangzhu 20 g, Diyu 10 g, decocted in 600 ml of purified water down to 300 ml, divided into two doses taken morning and evening. For abdominal distension and glomus, add Zhishi 3 g; for difficult urination, add Fuling 3-6 g.
Dysentery is a contagious disease common in summer and autumn, an intestinal infection caused by Shigella. The bacterial infection causes inflammation and ulcers of the rectum and sigmoid colon; patients present with abdominal pain, diarrhea, tenesmus, and mucopurulent-bloody stools. Traditional Chinese medicine holds that dysentery is mostly due to contraction of seasonal epidemic toxin combined with internal injury from unclean food. The disease location is the intestine; its mechanism is damp-heat, epidemic toxin, or cold-damp congealed in the intestinal fu-organs, with qi and blood stagnating and the lipid membranes and blood collaterals damaged, turning into pus and blood; the large intestine's conduction fails, giving rise to dysentery. If the patient's immunity is poor and the illness drags on, dysentery may progress to intermittent dysentery (xiuxi li), with relapsing attacks, anal heaviness, constant urge to defecate, and tenesmus.
Accordingly, TCM treats dysentery by drying dampness and clearing heat. In this formula, Cangzhu dries dampness, while Diyu clears heat, cools blood, and stops bleeding. Though simple, it provides good symptomatic treatment for dysentery. Modern pharmacological research shows that both Cangzhu and Diyu have some inhibitory effect on Shigella; Cangzhu has broad, strong antibacterial activity, and TCM commonly uses it for various epidemic diseases.
Cangzhu Diyu Tang treats not only dysentery but also bloody enteritis from other causes, such as chronic colitis, ulcerative colitis, and radiation enteritis in cancer patients after radiotherapy. For severe bloody stool in radiation enteritis with thrombocytopenia, add Xianhecao (Agrimony) 50-100 g. Chronic patients may make pills following this formula, taking 10 g three times daily (morning, noon, evening) for gradual treatment.