Regulate the Stomach and Order the Qi Decoction

Pattern-based

• Interior pattern of cold damage with hard stool
• dark urine
• delirium and tidal fever
• Middle burner damage with dryness and hardness but no stuffiness or fullness

Biomedical correlates

• Constipation with fever and delirium
• Faecal impaction without distension

Donguibogam 東醫寶鑑

治傷寒裏證, 大便硬ㆍ小便赤ㆍ譫語ㆍ潮熱. 大黃 四錢, 芒硝 二錢, 甘草 一錢. 右剉, 作一貼, 先煎大黃ㆍ甘草至半, 去渣, 入芒硝, 再一沸, 溫服. 《入門》 ○三承氣須分三焦受病而用之. 若三焦傷者, 痞ㆍ滿ㆍ燥ㆍ實ㆍ堅俱全, 是用大承氣: 大黃滌熱, 枳實瀉實, 厚朴消痞, 芒硝潤燥軟堅. 若上焦傷者, 有痞ㆍ滿ㆍ實而無燥ㆍ堅, 是用小承氣: 厚朴消痞, 枳實瀉滿, 大黃滌熱. 若中焦傷者, 無痞ㆍ滿而有燥ㆍ實ㆍ堅, 是用調胃承氣: 大黃滌熱, 芒硝潤燥軟堅, 甘草和中而已. 《入門》

Translation

Treats the interior pattern of cold damage with hard stool, dark urine, delirium and tidal fever. Rhubarb, 4 don; mirabilite, 2 don; licorice, 1 don. Cut up, make one packet; first decoct the rhubarb and licorice down to half, strain off the dregs, add the mirabilite, bring to the boil once more and take warm. — Immun 入門 ○ The three Order the Qi formulas must be used according to which of the three burners has received the disease. If all three burners are damaged, stuffiness, fullness, dryness, repletion and hardness are all present together, and the Major is used: rhubarb washes out the heat, bitter orange drains the repletion, magnolia bark disperses the stuffiness, and mirabilite moistens the dryness and softens the hardness. If the upper burner is damaged, there is stuffiness, fullness and repletion but no dryness or hardness, and the Minor is used: magnolia bark disperses the stuffiness, bitter orange drains the fullness, rhubarb washes out the heat. If the middle burner is damaged, there is no stuffiness or fullness but there is dryness, repletion and hardness, and the Regulate the Stomach is used: rhubarb washes out the heat, mirabilite moistens the dryness and softens the hardness, and licorice merely harmonizes the middle. — Immun 入門 (Donguibogam · Han, upper)