Treating the Stomach While Guarding Against Harming It: For Chronic Gastrointestinal Disease, the Less Medication the Better
There is a folk saying: "Nine out of ten stomachs are diseased." Stomach disorders are extremely common; almost everyone encounters stomach problems at some stage of life. The "stomach disorders" in this saying actually also include what modern medicine calls esophageal diseases and intestinal diseases — that is, the common digestive tract diseases.
Most digestive tract diseases are chronic. Treating digestive tract diseases, whether with Chinese or Western medicine, is not very effective. Some stubborn cases of reflux esophagitis, gastritis, superficial gastritis, erosive gastritis, atrophic gastritis, and chronic enteritis often grow worse the more they are treated. Part of the reason is that the medication itself has damaged the stomach.
The late veteran TCM physician Dr. Wei Changchun proposed a twenty-four-character regimen for nurturing the stomach: "Eat in moderation, keep regular hours, be active outside yet tranquil within, keep an easy mind, balance work and rest, and carefully guard against injury from medication." This mnemonic is every word a gem; it is a treasure book for self-care by patients with chronic gastrointestinal disease.
The key to recovering from stomach disease lies in nurturing, but some stomach patients cannot resolve their current suffering without medication. When medication is necessary, one must be especially careful not to let the medicine injure the stomach.
How can one avoid injuring the stomach? According to TCM theory, this kind of chronic disease should be treated slowly; pills and boluses (wan) are best for gradual regulation, and decoctions should be used as little as possible. A decoction (tang) is sweeping by nature, while a pill (wan) is gentle by nature. The medicinal force of pills is not as fierce as that of decoctions, but neither do pills damage the stomach as severely. Thus pills for stomach disease look slow, yet their therapeutic effect is ideal.
The stomach takes free flow as its tonification and downward descent as its normal course; treating stomach disease aims at unobstructing and descending. The stomach and intestines belong to the fu (bowel) organs among the zang-fu; zang organs store while fu organs should be free. Therefore the key to treating stomach disease is to keep the gastrointestinal tract unobstructed and the qi mechanism smooth.
When I myself treat stomach disease, I generally advise patients to be psychologically prepared for a long course and to take medication as lightly as possible. If one dose a day can control the symptoms, do not take two; if half the dose controls the symptoms, take only half. Moreover, when stopping medication, one should withdraw like an army retreating — gradually reducing the frequency and amount of medication.
There was once a patient whose stomach disease had progressed to an extremely severe point, such that she was allergic to every drug. Later a renowned veteran physician prescribed Zisheng Tablets for her, but not at the usual dose: he had her start from one-quarter to one-third of the dose, and when her spleen and stomach had slightly improved, increase moderately to half a dose. After half a year of this regulation, her stomach disease of many years was finally cured.
Treating stomach disease is like the ancients' saying that governing a large state is like cooking small delicacies — one must be extremely cautious. Otherwise, taking medicine to treat the illness not only fails to cure it but makes an already poor stomach even worse, which would be more loss than gain.