“Right” and “Wrong”: Insights After Testing 1985.6.22

“Right” and “Wrong”: Insights After Testing 1985.6.22

The "Jufang Fahu" states that using overly complex prescriptions is like "scattering nets across the fields in hopes of catching a rabbit," essentially mobilizing troops without a clear target. Formulas in the "Beiji Qianjin Yaofang" and "Taiping Huimin Heji Jufang" sometimes contain thirty to forty ingredients, even fifty or sixty, which could be compared to "scattering nets across the fields." However, in my clinical practice, I have found the special efficacy of "adding more medicinal ingredients." Particularly for some difficult and complicated cases, large formulas often prove effective.

Take migraine as an example: Aconite, dried ginger, cinnamon twig, Asarum, gypsum, gentian, Scutellaria, rhubarb, Codonopsis, Astragalus, Atractylodes, Chinese yam, Angelica, Rehmannia, Notopterygium, Saposhnikovia, Bupleurum, Cornus, Schisandra, Arisaema, Pinellia, Chuanxiong, Angelica dahurica, Magnolia bark, Oyster shell, Magnetite, whole scorpion, Weilingxian, centipede, earthworm, peach kernel, Poria, Ziziphus jujuba seeds, and so on. Although the formula is complex, its therapeutic effect is definite—this is what we call "the principle is unclear, but the prescription works first."

Take chronic nephritis as another example: This disease involves antigen-antibody complex reactions and can manifest as proliferative, membranous, or degenerative changes. Clinically, it is broadly classified into latent type, nephrotic type, hypertensive type, renal insufficiency type, and mixed type.

Western medical classification is as above, but in treating chronic nephritis, I believe it is crucial to pay attention to one very important factor: unresolved heat-toxin accumulation in the lower burner. The practical basis for this view is: ① this disease is often caused by pharyngitis and systemic suppurative inflammation; ② patients frequently present with lower burner damp-heat symptoms such as frequent urination, urgency, and dysuria; ③ when warming-kidney methods fail, switching to clearing-heat and detoxifying methods often proves effective. Therefore, the main principles of TCM treatment for nephritis should involve adjusting and combining methods such as clearing heat and detoxifying, warming the kidneys and promoting yang, strengthening the spleen and benefiting qi, dispelling wind and eliminating dampness, consolidating and astringing, promoting diuresis and relieving urinary obstruction, nourishing yin and cooling blood, etc., creating a wide range of possible combinations. Although the formulas may appear complex and hard to grasp at a glance, their therapeutic effects are indeed reliable.

In applying heat-clearing and detoxifying medicines, I commonly use five herbs: Hedyotis diffusa, Ampelopsis grossedentata, Scutellaria, Phellodendron, and Lysimachia christinae.

Mnemonic: Yellow-white-leak, nephritis wins.