十六、便秘 Constipation

初診： 6.25.2015     某 女，33歲，身高：5fts； 體重：145lb

女兒產後憂郁後，神智失常，2015.4.5住院凱撒，19天後出院。服西藥後服奧氮平Olanzapine (Zyprexa再普樂）失眠嚴重、焦慮，老想要自殺。後改用針劑，腹部膨大，如懷孕6-7月。

刻診：室外溫度超過80度，著棉衣，戴帽子。失眠、失眠、便難、舌幹、瘦長，神可，心情尚好，開朗。話多，意識清楚，邏輯不亂，但思想強制，經常難以分辨顯示和幻覺。心悸、心慌，遇刺激聲音害怕，出汗。多飲，尤其是晚上，起夜無數。半年未來月經。

脈：六脈弱，雙尺細弱。

曾因憤怒突發狂躁，被他醫診斷為熱毒攻心

印象：陰陽俱虛。針劑殺陰，造成渴甚，身體愈發寒涼，

治則：益陰補陽、溫下焦、行腸氣、溫下

7.6號，藥後先是大便如水，後逐漸成型，但自覺腸子不動。 三診已經不帶棉帽，身著短袖夏裝。說笑較前現實，自如。仍說要自殺。

7.20號其家人說，她好很多。至7.26號，大便每天有，量不大。食少，難寐。舌仍發幹；飲多，較前好轉。月經未來。藥後無汗，後背仍發緊。拍了舌象。腹診（上次忘了）：服部柔軟，無氣無水。

這種便秘本不難治，好了，可惜該患者不再服藥，說太苦了。很遺憾，其實我很想借機將她的抑郁癥治好，而不僅是便秘。

便秘治過太多了，難以計數。問題是，便秘久了會產生腹部蘊毒，另生他證，當十分小心。



Female 33 years old, Clinic visit June 25, 2015

Developed depression after delivery. Apr 5, 2015, hospitalized for 19 days. After taking Olanzapine (Zyprexa) suffered from severe insomnia, felt like commit suicide. After getting injection, had abdominal distention, like six month's pregnancy. Thirsty and drink a lot.

Symptoms: wearing knit cap and down jacket. outside temperature: over 80 degrees.

Besides above-mentioned symptoms, palpitation, sweating, no period for six months, urinate several times at night. Unreasonable fear.

Impression: Yang deficiency with Yin

The problem of this case was the former CM diagnosed as fire attacking the heart. I could not say it was incorrect. the thing is the followed therapy must be cold which might trigger another heart problem: palpation. A weaker heart is unavoidably deepening the depression, an energy lacking illness.

July 6, 2nd visit regular summer dress and not wearing knit cap. Still no period. watery stool and later turn to shaped stool. But claimed having a sensation that large intestines would not move.

Jul 20, 3rd visit, daily bowel movement, shaped stool. Drink less. abdominal distension remained unchanged. No longer suffer from unreasonable fear and palpitation.

Regretfully the patient would not take herbs anymore because of its bad taste. I had hoped to cure her depression, not just constipation.