Shao Yao Gan Cao Tang combined with Wu Ling San to treat Kidney colic pain and hydronephrosis
Shanghai Zhongyiyao Zazhi (Shanghai Chinese Medicine Journal) 1992-2 Page 25
Translated by Mary Muth 2004
The patient is a twenty-four year old male who sought medical attention for colicky pain on the left side of his low back accompanied by nausea and urinary obstruction. The symptoms are severe and continuous, worse with pressure and tapping on the low back. The left lower abdomen is also tender and the urine dribbles out. The urinary flow is obstructed. He also has nausea, vomiting, dry mouth with desire to drink but vomits as soon as he drinks. There is no cold or heat but he sweats. Bowel movements are normal. The tongue fur is yellow, greasy and the tongue body is pale red. The pulse is deep, fine and moderate. Ultrasound shows both kidney capsules are smooth and measure 10x4 cm. The left kidney lower pole shows a 0.8x0.5 cm bright, round density. The renal pelvis has a separation measuring 1.2 cm. The right kidney shows no density present and no separation of the renal pelvis. The diagnosis is a left kidney stone with mild hydronephrosis. Differentiation of the pattern is water evil accumulation with inhibition of Qi transformation. Treat in order to relieve pain, transform Qi and disinhibit water.
The formula used is Shao Yao Gan Cao Tang combined with Wu Ling San. The herbs used are: Bai Shao 30 gm, Zhi Gan Cao 10 gm, Fu Ling 10 gm, Zhu Ling 10 gm, Ze Xie 10 gm, Bai Zhu 10 gm, Gui Zhi 10 gm. He took two packets and the back pain clearly lightened, urinary flow was unobstructed, vomiting and nausea were better compared to before. He was sleeping well but food did not taste good. His pulse was moderate, tongue fur thin white and the body pale red. He continued to take two more packets and the low back pain and other symptoms vanished. Repeat exam by ultrasound showed both kidney capsules to be smooth measuring 10x4 cm, no separation of the renal pelvis but the left kidney stone was still visible. The formula was changed to Zhu Ling Tang boosted by the use of Jin Qian Cao, Dong Kui Zi, Di Long, Niu Xi, Mu Xiang. He was treated for over 20 days and expelled one small stone measuring 0.8x0.4 cm in his urine. Ultrasound examination showed both kidney capsules to be smooth without separation of the renal pelvis, and the kidney stone was gone.
The low back is the house of the Kidney, which governs Qi transformation and is exteriorly/interiorly paired with the Urinary Bladder. When a stone blocks the Kidney the transformation of Qi and the movement of water through the downward transportation of the Urinary Bladder is influenced. Water and fluids are depressed and bound and are not able to descend and discharge. Qi and Blood are stagnant, rough and then there is pain. Therefore, use Shao Yao Gan Cao Tang to relax tension urgently and to coarse, disinhibit and stop pain. Wu Ling San assists Qi transformation in order to disinhibit water. The next step in the process is to use Zhu Ling Tang adding Jin Qian Cao and Dong Kui Zi in order to open stranguary and expel the stone. In this way Qi transformation will recover. The water evil is able to go out and then the stone gets expelled.