🌿 Folk Prescriptions

Gallstone disease refers collectively to stones in the biliary system, most commonly occurring with cholecystitis. It predominantly affects middle-aged women. Includes gallbladder stones, common bile duct stones, and intrahepatic bile duct stones. Bile duct stones are far more common than gallbladder stones, and rates of residual or recurrent stones after surgery are relatively high. Classified by composition: cholesterol stones, bilirubin stones, and mixed stones. By location: gallbladder stones, common bile duct stones, and intrahepatic bile duct stones. Clinical manifestations depend on degree of obstruction and presence of infection, with symptoms varying slightly based on stone location. When stones obstruct the common bile duct and cause acute cholangitis, symptoms include upper abdominal pain, chills and high fever, jaundice; severe cases may present with hypotension, toxic shock, high fever, delirium, altered consciousness, or even coma. Intrahepatic bile duct stones show atypical symptoms: persistent dull distension and discomfort in the right upper quadrant, intermittent dull pain, irregular chills and fever, asymmetric hepatomegaly, and tenderness on percussion over the liver area. Patients often have a history of recurrent episodes; late stages may feature hepatic atrophy due to inflammatory fibrosis or portal hypertension secondary to cholestatic cirrhosis. Patients should maintain proper diet, eat light foods, avoid fatty, sweet, and rich foods, avoid emotional stress and overwork, and actively prevent intestinal parasitic diseases. Surgical intervention may be necessary. This condition corresponds to Traditional Chinese Medicine categories such as “costal pain,” “jaundice,” “gastric pain,” and “epigastric pain.” The underlying cause is heat accumulation leading to stagnation of bile, dietary injury to the spleen and stomach, damp-heat blocking the middle burner, emotional depression impairing liver Qi flow, resulting in Qi stagnation and blood stasis, and impaired liver and gallbladder regulation. Common clinical patterns include: 1. Liver-Gallbladder Heat Stagnation: Symptoms include chills and high fever, pain in the right costal region and epigastrium that resists pressure, worsening jaundice, reduced urine output with dark color, constipation, yellow-dry or black-yellow tongue coating, red-purple tongue, fine weak pulse, possibly accompanied by mental confusion or delirium. 2. Liver-Gallbladder Damp-Heat: Onset is sudden, severe pain in the right upper abdomen, nausea and vomiting, loss of appetite, bitter mouth, dry throat, thirst, chills and high fever. Jaundice appears within 2–3 days post-onset, short and red urine, constipation, red tongue with yellow greasy coating, wiry slippery or rapid pulse. 3. Qi Stagnation Type: Intermittent dull or mild pain in the right upper abdomen, sometimes sharp pain, intervals resembling normal health. Often accompanied by bitter taste, poor appetite, postprandial epigastric fullness, mild scleral icterus, clear or yellow urine, pale red tongue with white or slightly yellow coating, wiry pulse. I. Western Medications for Cholelithiasis: Besides medication, extracorporeal shock wave lithotripsy may be used. Surgery remains the most effective curative method. Suitable drugs include: 1. Drugs promoting bile secretion: (1) 50% magnesium sulfate: Oral dose of 50 ml, three times daily. (2) Cholagogic acid: 0.2 g orally, three to four times daily. (3) Dehydrocholic acid: Oral dose 0.25–0.5 g, three times daily. Intravenous injection: 0.5 g per dose, gradually increase up to 2 g daily depending on condition. (4) Lian’anfen (Cholagogic Phenol): 0.25–0.5 g orally, three times daily, before meals. (5) Oxy-methoxyamide (Cholagogue素): 1–2 tablets orally, three times daily, after meals. (6) Triethylbutinone (Triethoxyphenylpropionic acid): 40 mg orally, three times daily.