Section 3: Differentiation and Prescription Based on Syndrome in Traditional Chinese Medicine

(1) Excessive worry, anger, and emotional distress lead to stagnation of qi and blood, which eventually turns into fire, causing liver qi and liver yang to surge upward and disturb the body, with blood following the qi and causing blood pressure to rise. The "Inner Canon" records: "Great anger causes qi to be exhausted and blood to stagnate at the top, leading to fainting." "When blood and qi move upward together, it results in severe fainting; if qi returns, life continues, otherwise death ensues." (2) Long-term overwork and exhaustion lead to depletion of yin in the kidneys and hyperactivity of yang in the liver, or aging leads to deficiency of yin, with yin unable to restrain yang, resulting in virtual yang transforming into wind, which then disturbs the body and raises blood pressure. The "Inner Canon" records: "Yang qi expands when one is overworked, causing heatstroke." (3) Irregular diet, indulgence in rich, sweet, and heavy foods, excessive consumption of strong alcohol, day after day, leads to spleen deficiency and impaired transportation, accumulation of dampness and phlegm, obesity, phlegm turning into heat, stirring up liver wind, and combined with blood stasis disturbing the body, ultimately raising blood pressure. The "Inner Canon" records: "When diet doubles, the stomach and intestines are injured." Physicians say: "No phlegm, no dizziness." "Obese people have a lot of damp phlegm." "Dampness generates phlegm, phlegm generates heat." (4) Yin damage leading to yang deficiency, dual deficiency of yin and yang, blockage of meridians, stagnation of qi, and elevated blood pressure. Physicians say: "No deficiency, no dizziness." (5) Pregnancy in women leads to lack of convergence of essence and blood, resulting in liver being deprived of nourishment and virtual yang surging upward; menopause in women leads to imbalance of Chong and Ren channels, loss of essence and blood, and virtual yang disturbance, causing blood pressure to rise. This disease is fundamentally deficient with superficial excess. In the early stage, it leans toward hyperactivity of liver yang and inflammation of liver fire, with excess being the main feature; in the middle stage, it involves both yin deficiency and yang excess, with mixed deficiency and excess; in the late stage, it is characterized by damage to both yin and yang, with dual deficiency. Hyperactivity of liver yang, inflammation of liver fire, internal movement of liver wind, phlegm disturbing the clear space, and blood stasis blocking the meridians are all superficial manifestations. However, the root cause lies in deficiency of kidney yin and dual deficiency of yin and yang. The root is in the kidneys, the manifestation is in the liver, and the heart and spleen are also involved. Section 3: Differentiation and Prescription Based on Syndrome in Traditional Chinese Medicine There is no complete consensus across the national TCM community; various regions have conducted extensive research, with some categorizing based on yin-yang, others based on zang-fu organs, and still others based on deficiency-excess, among others. Among these, classification based on zang-fu organs is the most widely adopted. (1) Syndrome-Based Treatment

1. Liver Fire Disturbance Type: Headache and dizziness, flushed face and red ears, irritability and quick temper, bitter taste in mouth and dry throat, constipation, dark yellow urine, red tongue with yellow coating and string-like rapid pulse. Treatment should clear liver fire. Prescription: Modified Longdan Xiegan Tang: 10 g of Longdan Cao, 10 g of Huangqin, 10 g of Zhizi, 10 g of Dilong, 6 g of Dandpi, 10 g of Xiakucao, 20 g of Gouteng, 6 g of Juhong, 10 g of Chaihu, 20 g of Caoguoming, 12 g of Shengdi, decocted in water and taken once daily. For severe constipation, add Dahuang; for very dark yellow urine, add Mutong; for bitter taste and dry throat, add Yuanshen and Maidong.
2. Liver Yang Hyperactivity Type: Headache and dizziness, feeling of heaviness in head and lightness in feet, rosy complexion, restlessness and insomnia, five hearts feeling hot, worsening with anger, red tongue with white coating and string-like large pulse. Treatment should calm the liver and subdue yang. Prescription: Modified Tianma Gouteng Yin: 10 g of Tianma, 20 g of Zili, 30 g of Gouteng, 12 g of Shengdi, 10 g of Yuanshen, 10 g of Maidong, 20 g of Shijue Ming, 20 g of Sheng Muli, 6 g of Huangqin, 15 g of Sangjisheng, 15 g of Duzhong, 20 g of Xiakucao, decocted in water and taken once daily. For numbness and twitching of limbs, add Dilong and Danshen; for dry stools, add Dahuang and Fanshaieye; for dark yellow urine, add Mutong and Huashi.
3. Liver-Kidney Yin Deficiency Type: Dizziness and headache, tinnitus and blurred vision, restlessness and insomnia, hot flashes and dry throat, soreness in waist and legs, numbness in limbs, red tongue with little coating and fine string-like pulse. Treatment should nourish yin and subdue yang, enrich water and nourish wood. Prescription: Modified Qiju Dihuang Tang: 15 g of Ju Hua, 10 g of Gou Qi Zi, 10 g of Sheng and Shu Di each, 10 g of Shanyao, 6 g of Shanyou Rou, 6 g of Dandpi, 10 g of Shouwu, 15 g of Huangjing, 15 g of Maidong, 15 g of Sangjisheng, decocted in water and taken once daily. For poor sleep, add Sangshenzi and Yejiaoteng; for poor appetite, add Neijin and ShanZha; for frequent urination, add Fubenzǐ and Tusi Zi; for severe palpitations, add Sheng Muli and Sheng Longgu.
4. Dual Yin-Yang Deficiency Type: Dizziness and blurred vision, tinnitus and deafness, palpitations and shortness of breath, swelling of face or lower limbs, weakness in waist and knees, frequent nocturnal urination, pale red tongue with thin white coating and deep fine string-like or slippery pulse. Treatment should nourish yin and replenish yang. Prescription: Modified Jisheng Shenqi Tang: 15 g of Sangjisheng, 10 g of Cheqian Cao, 20 g of Sheng and Shu Di each, 10 g of Shanyao, 6 g of Shanyou Rou, 6 g of Dandpi, 12 g of Yunling, 10 g of Zexie, 3 g of Rou Gui, 6 g of Fuzi, 15 g of Niuxi, 10 g of Duzhong, decocted in water and taken once daily. For those leaning toward yang deficiency, add Fupian and Bajitian; for those leaning toward yin deficiency, add Shouwu and Guiban; for poor appetite, add Neijin; for bloating, add Laibuzi.
5. Phlegm-Dampness Obstruction Type: Head feels foggy and stuffy, poor appetite, chest tightness and fullness, nausea and vomiting, white greasy coating, plump and tender tongue, string-like or smooth pulse. Treatment should strengthen the spleen and transform phlegm. Prescription: Modified Banxia Baizhu Tianma Tang: 10 g of Tianma, 10 g of processed Banxia, 10 g of fried Baizhu, 12 g of Yunling, 6 g of Chenpi, 6 g of Zhuru, 10 g of Zhike, 20 g of fried Yimi, 2 g of Muxiang, 20 g of Gouteng, 3 g of Bai Zili, decocted in water and taken once daily. For severe phlegm heat, add Tianzhu Huang and Huangqin; for numbness in limbs, stiffness in neck and slurred speech, add Dan Nanxing, Danshen or Zhuli; for severe vomiting, add Huoxiang and Peilan; for difficult bowel movements, add Dahuang and Laibuzi; for dark yellow urine, add Biyu San; for poor appetite, add Shenqu and Maiya.
6. Chong-Ren Imbalance Type: Commonly seen in menopausal women, often with headache and dizziness, occasional spontaneous sweating, flushed face, restlessness and insomnia, irritable temperament, red tongue with little coating and string-like rapid pulse. Treatment should regulate Chong and Ren channels. Prescription: Modified Erxian Tang: 10 g of Xianmao, 10 g of Xianlingpi, 10 g of Bajitian, 6 g of Huangbo, 6 g of Zhimu, 10 g of Danggui, 12 g of Shengdi, 10 g of Chishao, 10 g of Chuangxiong, 10 g of Yimu Cao, decocted in water and taken once daily. For excessive spontaneous sweating, add Sheng Longmu; for palpitations, add Chifushen and Hehuan Pi; for five hearts feeling hot, add Digupi and Baiwei.
7. Adjustments Based on Syndrome: For obvious liver heat, choose Longdan Cao 10–20 g, Huanglian 10 g, Huangqin 10–15 g, Zhizi 10–12 g, Huangbo 10–15 g, Xiakucao 10–15 g, Dahuang 6–12 g, Caoguoming 10–15 g, Baiwei 10–15 g; for obvious yin deficiency, choose Shengdi 10–15 g, Yuzhu 10–15 g, Baihe 10–15 g, Zhimu 10–12 g, Shashen 10–15 g, Huafen 10–15 g, Tiandong 10–12 g, Maidong 10–15 g, Shihu 10–15 g; for obvious liver wind, choose Gouteng 10–20 g, Tianma 10–12 g, Ju Hua 10–15 g, Chan Tui 6–10 g, Shijue Ming 15–30 g, Lingci Shi 20–30 g, Jiangcan 10–12 g, Quanxie 3–10 g, Wucheng 6–10 g; for obvious liver-kidney yin deficiency, choose He Shou Wu 10–15 g, Gou Qi Zi 10–15 g, Tu Si Zi 10–20 g, Nüzhen Zi 10–15 g, Black Sesame 10–15 g, Bajitian 10–15 g, Han Lian Cao 10–15 g, Chuan Duan 10–15 g; for obvious phlegm-dampness, choose Dan Nanxing 10–12 g, Zhuru 6–10 g, Beimu 10–12 g, Fa Banxia 10–12 g, Quan Gua Wei 10–20 g; for limb numbness, choose Dilong 10–15 g, Luoshi Teng 15–20 g, Chuan Niuxi 15–20 g, Du Huo 10–12 g, Hai Feng Teng 10–15 g, Lu Lu Tong 10–15 g, Mu Gua 10–15 g. (2) Single and Verified Prescriptions (1) 50 g of castor seeds, 20 g of Wu Zhu Yu, 20 g of Fuzi. Usage: Grind all ingredients into fine powder, add 150 g of fresh ginger, pound everything into a paste, then add 10 g of Bingpian, mix well, form into a paste, apply two patches to the soles of the feet (Yongquan acupoint) every night, 7 days constitute one course, continue for 3–4 courses. (2) 12 g of peach kernels, 12 g of apricot kernels, 3 g of Zhizi, 7 grains of pepper, 14 grains of glutinous rice. Usage: The ingredients are thoroughly pounded together, then mixed with one egg white to form a paste. Apply the paste in three separate applications: at night before going to bed, place it on the Yongquan acupoint at the sole of the foot; remove it during the day; apply once daily, alternating between the two feet. A total of six applications constitute one treatment course. The skin at the application site may turn bluish-purple.