Medication for Stomach Diseases Should Be Mild
There is a folk saying: nine out of ten stomachs are diseased. Stomach disease is an extremely common condition; almost everyone encounters it at some stage of life. The "stomach disease" of folk saying actually also includes what modern medicine calls esophageal diseases and intestinal diseases—that is, common gastrointestinal disorders.
Most gastrointestinal diseases are chronic. Treatment of gastrointestinal diseases, whether with Chinese medicine or Western medicine, is not very satisfactory. Some refractory cases—reflux esophagitis, gastritis, superficial gastritis, erosive gastritis, atrophic gastritis, and chronic enteritis—often worsen the more they are treated. Part of the reason is that the medicines themselves have injured the patient.
The late veteran TCM physician Wei Changchun proposed a twenty-four-character regimen for stomach health: "Eat and drink with moderation; rise and rest on a regular schedule; external activity with internal stillness; a cheerful mood; balanced work and rest; and guard against drug-induced injury." This maxim is every word a gem; it is a treasured guide for self-care in patients with chronic gastrointestinal disease.
The key to recovering from stomach disease relies on nourishment, but some patients cannot resolve their current suffering without medication. When using medicine, one must take special care not to injure the stomach with drugs.
How can one avoid injuring the stomach? According to TCM theory, such chronic diseases should be treated slowly; it is best to use pills for gradual regulation and to minimize the use of decoctions. A decoction is swift and aggressive; a pill is gradual. The medicinal force of a pill is not as drastic as that of a decoction, but its damage to the stomach is also not as severe. Thus, treating stomach disease with pills appears slow, yet the therapeutic result is ideal.
The stomach governs free flow as its tonification, and downward descent as its normal course. Treating stomach disease should aim at free flow and downward descent. Among the zang-fu organs, the stomach and intestines belong to the fu organs; zang organs should store, while fu organs should free-flow. Therefore, the key to treating stomach disease is to ensure the patient's gastrointestinal tract is unobstructed and the qi mechanism flows smoothly.
When I myself treat stomach disease, I generally advise patients to psychologically prepare for a long course and to keep medication as light as possible. If taking medicine once a day can control symptoms, do not take it twice; if half the dose controls symptoms, take only half. Moreover, when stopping medication, do so like a retreating army—gradually reducing the frequency and dosage.
There was once a patient whose stomach disease had progressed to an extremely severe stage, such that she was allergic to any medicine. Later, a renowned veteran physician prescribed Zisheng Pian for her, but not at the usual dose; instead, he had her start at one-quarter to one-third of the dose, and when her spleen and stomach had improved slightly, increase moderately to half the dose. After half a year of this regulation, the patient's years-long stomach disease finally resolved.
Treating stomach disease is like the ancients said, governing a large state is like cooking small fish—one must be meticulous and cautious. Otherwise, taking medicine to treat the disease not only fails to cure it but makes the already-poor stomach even worse, which would be more loss than gain.