26/05/2024
Nogangyangwitang (2-074) Double Dosage: Chronic Indigestion, Food Stagnation after Beer, Cold-Damp Vomiting
Female, 54 years old, Soyangin, 158 cm, 48 kg
Main Symptoms
Chronic Indigestion
Feels more comfortable being hungry than feeling full due to chronic indigestion.
Has difficulty swallowing Gamisachiltang pills with water when indigestion is severe.
Recently started feeling discomfort after eating a hamburger for lunch, which she usually skips.
Experienced a choking sensation after drinking a can of beer in the evening and felt relieved after vomiting.
Additional Symptoms
Sensitive to cold but not to heat.
Three years ago, received herbal acupuncture on the shoulder every other day for three weeks at an oriental medicine clinic, resulting in a cold sensation in the shoulder, requiring her to wear a scarf even in summer.
Since then, has felt cold and achy in the shoulder all year round, becoming more sensitive to cold than before.
Sleeps with a thermal mat under her upper body year-round, even in summer, due to the cold shoulder.
Only the lower abdomen feels slightly cold.
Prefers hot foods and drinks about two glasses of water only in the evening.
Drinks 1-2 cups of coffee daily.
Experiences constipation, having a bowel movement once every three days.
Eats 1-2 meals a day; feels uncomfortable all day if eating rice for lunch, so usually eats bread. Feels more comfortable eating less or skipping meals, hence skips lunch.
Diagnosis
Initially suspected that the chronic indigestion might be due to food stagnation. Experiencing indigestion even after drinking beer, which is essentially liquid, indicates that it is indeed food stagnation with dampness. Given the patient's usual cold constitution, drinking cold (han:寒) beer exacerbated the issue, leading to vomiting and indigestion due to a cold-damp state in the digestive tract.
Treatment Approach
The vomiting after drinking beer is due to the cold nature of the beer affecting someone with a cold or cold-deficient constitution, leading to a cold-damp state in the digestive tract. Therefore, the treatment aimed to improve the cold-damp state. Given the patient's chronic indigestion, cold sensitivity, and use of a thermal mat even in summer, a treatment involving warming and removing dampness was chosen.
Prescription Selection
For treating vomiting and indigestion due to a cold-damp state in the digestive tract, prescriptions including warming agents were considered, such as Seungsuptang, Nogangum, Nogangyangwitang, Gyegangyangwitang, Jinmutang, and Bokwon-dan. Considering the patient's chronic indigestion as a Soyangin, Insaengyangwitang was selected, combined with Nogangum to address both cold deficiency and dampness, resulting in Nogangyangwitang, deemed most appropriate.
Medication
For a Soyangin with chronic indigestion and vomiting after drinking beer, Nogangyangwitang was used to warm the digestive tract and restore its function. To enhance effectiveness, a double dosage was prepared: 5 doses, boiled down to 15 packets, to be taken twice daily for 5 days.
Progress
After taking the double dosage of Nogangyangwitang (5 doses, 15 packets):
Other digestive medications caused temporary relief but led to repeated indigestion from overeating.
With Nogangyangwitang, the digestive system normalized, preventing overeating.
The patient felt her digestive function had naturally improved.
Normally ate 2 meals, but now could eat 3 meals without discomfort.
Used to eat snacks 1-2 times a year, but now eats snacks without issues.
No longer feels compelled to eat more after digestion, unlike before taking the herbal medicine.
No bloating or indigestion, feels comfortable in the stomach and body.
Conclusion
Nogangyangwitang, originally prescribed for lingering malaria, was effectively used here for chronic indigestion and cold-damp vomiting. It not only aids digestion but also appears to regulate the autonomic nervous system, improving overall digestive function. The patient can now eat three meals comfortably without previous symptoms.
Prescription Details:
Bangyak Hapyeon Jungtong 74 Nogangyangwitang (Insamyangwitang + fresh ginger 4 liang) double dosage, 5 doses, 15 packets, 5 days.
Note: "Nohak" refers to lingering malaria, treated with prescriptions like Gunggwi Byeolgyapsan, Sangsanum, Orowon, Yukwutang, Odachiljotang, Nogangyangwitang, Sipjanggunhwan, Ilboilbaldan, Jinsawon, and Yangwidan.