Emergency Case of Hemorrhage and Severe Pain

Here is a Case we had last month of severe rectum pain reduced in 24 hours and under control wihtin 2 days.


Patient 54 yrs Female


August 18, 2016 patient underwent a colorectal surgery which was followed by a severe hemorrhage five days later (23/8) for which she received 3 x blood transfusions. Two days later (25/8) there was again another hemorrhage for which she received 2 more blood transfusions.


She was medicated with analgesics: Dihydrocodamol, Ibuprofen, Paracetamol, Morphine.
Purgatives: Laxido, Senna, Docusate Sodium.
Blood clotting meds: Transaxmic Acid IV every four hours.


Main complaint: Searing intense constant severe stabbing pain in rectum using ice pack to reduce swelling and pain. She was also catheterized 3 times during the experience due to pain blocked urine.


Accompanying Symptoms:
Aversion to heat, likes a fan on, Hot sensation during urination, Constant black exudate oozing slowly from rectum but unable to pass stool, Good sleep if medicated – otherwise disturbed by pain,
Emotions: irritable and easily angered, good appetite, dry feet, Temp: Normal to warm, hot at night
Energy: exhaustion, cannot walk far. Sleeps immediately after exertion. Muscles very weak
Dizziness, Huge distended belly, constipated, Occasional nausea


Pulse: wiry but not a lot of depth, Tongue: red with very thick greasy yellow coat
Swollen body peeled right side pale


Analysis: The nausea, exhaustion and dizziness showed a Shao yang syndrome and the constipation, distended abdomen, aversion to heat, heat sensation at night and hot sensation in the urination was the Yang ming syndrome. The severe constant stabbing pain in the rectum was a blood stasis confirmed by the haemorrhage.


Formula given was: Da Chai Hu Tang plus Gui Zhi Fu ling Wan plus Yi Yi Cang Zhu Bai Jiang Cao plus Ze Xie.


Composition: Chai Hu 12g, Huang Qin 10g, Zhi Shi 10g, Bai Shao 18g, Jiang Ban Xia 15g, Sheng Jiang 15g, Da Zao 20g, Sheng Da Huang 6g, Gui zhi 10g, Fu ling 12g, Dan Pi 10g, Tao Ren 10g, Sheng Yi Ren 30g, Cang Zhu 10g, Bai Jiang Cao 30g, Ze Xie 15g.


I told her to take the formula for 3 to 5 days and report back.


Results: Immediate reduction in pain and swelling within 6 hours of herbs. She passed one huge BM followed by a lot of bleeding which ceased after an hour. Slept a good night’s sleep. On waking had 6-7 consecutive BM as belly reduced and became a normal size. The pain and swelling continued to reduce to nil pain and was completely off all pain medications within 2 days.


The patient continued taking the formula 2 more days and symptoms changed. The patient had nightmares waking through the night suddenly recalling the traumatic events. Contacted me again for a follow up formula.


Symptoms: Main Complaint: Fatigue weakness.


Accompanied symptoms: Mild pain with occasional bearing down sensation in anus, moving around can still be mild sore, BM can be sore but not painful, Thirst: normal through the day, dry mouth at night, night wakes to drink 4-5 times, watery diarrhea- easy to pass, occasional abdominal discomfort, slight cramping prior to BM, Hot feet and hands at night, slight sweating, worse at night, sleeping with minimal covers, normal to warm temp during the day, sweating after eating hot at night, energy very low, easily tires, weak muscles, difficulty falling asleep, waking to drink, mild anxiety with recalled thoughts of hospital, pain, surgery, loss of blood etc., appetite normal but gets full easily, slight acid reflux at night, skin normal not dry, eyes dry at night, not dizzy, no headache, urine: still catheterized but plenty, not dark. looks normal volume, Aversion to heat but no aversion to cold, wind or damp, no ribside pain, nausea, tinnitus, blocked nose, ENT all fine. No muscle cramps, twitching or tremor.


With these new set of symptoms we can see that the lack of nausea, ribside pain and tinnitus shows a lack of Shao yang. However, the Yang ming symptoms are very present seen in the night sweating, aversion to heat, dry mouth, thirst at night. However in this case we can see the Tai yin syndrome is more obvious seen in the sinking sensation in the anus confirming the internal rheums, severe fatigue, getting full easily after eating, sl. acid reflux. We also have the nightmares and anxiety here confirming a Ben Tun of unresolved exterior with internal rheum.


So the diagnosis was Tai yang Tai yin Yang ming with internal rheum and blood depletion.
This is a Wu Ling San plus Dang Gui Shao Yao San plus Sheng Yi Ren and Chi Xiao Dou pattern. The dosage are really important to correctly address the syndrome. Ze xie was doubled to continue to address the Yang ming and purge the BM and urine. Bai Shao was also doubled to nourish the blood depletion and nourish the muscles while relieving the abdominal cramps. Chi Xiao Dou Dang Gui San was added to prevent pain upon removal of catheter.


Composition: Gui Zhi 10g, Cang Zhu 15g, Fu Ling 12g, Zhu Ling 10g, Ze Xie 20g, Dang Gui 10g, Bai Shao 20g, Chuan Xiong 6g, Chi Xiao Dou 15g, Sheng Yi Ren 30g.


After one day’s dose of the formula the mind settled, she have had no recurring worries or thoughts about past events, BM continues to improve, No infection with catheter due to this formula and had more energy feeling much better.