On August 26, 2013, a 26-year-old male patient presented with a rapid and tight pulse, thick white coating on the tongue, multiple ecchymoses on the tongue root, painful and difficult urination, slight abdominal pain, normal bowel movements, blue veins on finger joints, slightly sunken eye sockets, frequent sexual activity, and a previous diagnosis of prostate and urethral calcification at the county hospital, which did not respond to treatment.
Diagnosis: The rapid and tight pulse, thick white coating on the tongue, blue veins on finger joints indicate cold and dampness; multiple ecchymoses on the tongue root, painful and difficult urination, slight abdominal pain, and urethral calcification suggest blood stasis and obstruction of the channels. The prescription is Zhen Wu Tang decoction for treatment.
Prescription: Prepared Aconite 30g, Fresh Ginger 15g, Stir-fried White Atractylodes 30g, Poria 30g, White Peony 30g, Codonopsis 30g, Prepared Licorice 30g, Bupleurum 20g, one dose. Due to the slightly sunken eye sockets indicating damaged essence, Codonopsis and Prepared Licorice were added to the prescription. Bupleurum was added to warm the lower Jiao, disperse cold, relieve obstruction, and promote smooth urination, which corresponds to the intention of combining Zhen Wu Tang and Si Ni San. However, due to the patient's weakened essence, Fructus Aurantii was reduced. Concerned about the cold nature of White Peony, which may not be suitable for the patient's constitution, Codonopsis was added instead.
On August 27, 2013, the patient returned for a follow-up visit with no improvement in symptoms. The original prescription was continued for one more dose.
On August 28, 2013, the patient reported that urination was smoother and less painful, abdominal pain was relieved, and his spirits were improved. The dosage of Bupleurum was reduced from 20g to 15g in the original prescription. Two more doses were given, and the patient later reported by phone that he had recovered.
Gradually, I realized that according to the Compendium of Materia Medica, White Peony can break up stubborn accumulations and promote smooth urination. When the urination is not smooth, it is due to blood stasis obstruction. Therefore, White Peony is used to treat urinary obstruction caused by blood stasis.
