I. Contagiousness

I. Contagiousness

Hepatitis B is not highly contagious. In China, approximately 70% of the population has been infected with the hepatitis B virus, yet only about 10% of those infected actually develop the disease. This means that 90% of infected individuals can easily eliminate the hepatitis B virus (HBV) that enters their bodies through their own immune mechanisms. Starting in the 1980s, China began implementing nationwide vaccination programs against hepatitis B. Three doses of the hepatitis B vaccine—administered one month and six months after the first injection—can turn the 10% of susceptible individuals into those who are no longer susceptible, rendering the hepatitis B virus unable to find a foothold. Having worked in hepatitis B clinical practice and research for over 30 years, I’ve observed that in recent years, the prevalence of hepatitis B in China has changed dramatically compared to the past. In outpatient clinics, the majority of cases were diagnosed in individuals who contracted the disease in the 1960s. Of course, the population born in the 21st century is not entirely free from hepatitis B; this is mainly due to gaps in vaccination coverage and areas with limited access to vaccines, such as rural areas and mountainous regions, as well as the presence of large numbers of migrant workers. Additionally, some parents were hepatitis B carriers, and their infants were not properly screened or treated before or after birth, allowing vertical transmission to occur. In conclusion, theoretically speaking, the contagiousness of hepatitis B can be completely contained by humanity. Today, advanced countries have already solved this problem; some countries Task output rules: Translate this markdown block from Chinese to English. Preserve markdown markers, links, and formatting. Keep headings and list structure unchanged. Return only the translated block.

Input: Home has ceased to view hepatitis B as a contagious disease; patients with chronic hepatitis B who are HBV-DNA negative should not be admitted to the infectious diseases department.

II. Refractory Cases

Hepatitis B is indeed a refractory disease. The cure rate for alpha-interferon is only 12%–15%; lamivudine has a cure rate of only 10%–12%, and the latest version of polyinosine-polycytidylic acid interferon also boasts a cure rate of just 20%–30% per year—both at a high cost that most people find difficult to afford. Recently, the United States developed adefovir, which has been successively imitated by various countries, and China is also actively conducting trials on its development. According to preliminary reports, the rate of surface antigen conversion to negative can reach as high as 50% (after one year of treatment), and the rate of E antigen conversion can reach around 70%. While complete recovery from hepatitis B is indeed quite challenging, based on more than 30 years of experience treating hepatitis B, the author believes that only about 5%–10% of all hepatitis B patients become chronically infected. This “chronicization” refers to patients who develop cirrhosis, liver cancer, or chronic active hepatitis. Among these 5%–10% of patients, most had never received systematic treatment at the onset of their illness, according to historical inquiries. However, patients who underwent systematic treatment are less likely to develop chronicity—even if their surface antigen does not turn negative, they often remain in a state of subclinical hepatitis B, with low levels of E antigen and no symptoms. Traditional Chinese medicine and herbal remedies have unique strengths in treating hepatitis B. The authors’ formulations “Hepatitis B Scan” and “Hepatitis B Health” primarily aim to strengthen the body’s vital energy and consolidate the root cause of the disease. With consistent use over 1–2 years, the surface antigen conversion rate can reach around 30%, while the E antigen conversion rate can reach approximately 60%. The cost is relatively affordable: the total cost for two years of treatment ranges from 3,000 to 4,000 yuan—much cheaper than interferon or lamivudine, costing only about 1/20th of interferon and 1/5th of lamivudine. The current challenge lies in the fact that extensive advertising campaigns often mislead patients, causing many to abandon their treatment plans prematurely, switching between different therapies, wasting time and money, ultimately leading to frustration and giving up, allowing their liver disease to progress toward chronicity.

III. Genetic Factors

In the past, there was little hope for preventing fetal infections caused by hepatitis B. Recently, foreign countries have begun implementing triple prevention measures during the perinatal period for mothers and fathers carrying hepatitis B, which can result in the birth of healthy infants in over 99% of cases where both parents are hepatitis B carriers or single-parent families. Urban hospitals in China are also gradually adopting this treatment approach. If this treatment can be widely promoted domestically, hepatitis B will become increasingly rare, and the day when hepatitis B becomes a thing of the past—when we can completely control the epidemic—is not far off. The specific method of triple prevention involves administering high-dose hepatitis B immunoglobulin to pregnant women at 28, 30, and 36 weeks, respectively, in the first three months of pregnancy. After birth, infants receive high-dose hepatitis B immunoglobulin at 24 hours and 15 days. Additionally, infants receive one dose of hepatitis B vaccine at 1 month, 3 months, and 6 months after birth. The first phase of prevention uses hepatitis B immunoglobulin for active immunity, while the second phase uses hepatitis B vaccines for passive immunity. Following these three preventive steps, 99% of infants born to mothers with hepatitis B who were positive for E antigen—those commonly referred to as “large three-positive” parents—will be born as healthy babies.

These three aspects are the primary reasons why hepatitis B patients feel frustrated. The severity of hepatitis B’s contagiousness has largely faded from public discourse, yet people with hepatitis B still face varying degrees of discrimination. Those around them often avoid contact with hepatitis B patients, placing significant psychological pressure on those affected. In fact, over two-thirds of hepatitis B patients are actually small three-positive individuals whose virus is either non-replicating or reproduces very little; such individuals pose no risk of transmission. We often see families where both the mother and child are hepatitis B patients, while the father eats and lives alongside them without any isolation or preventive measures. Decades later, the father remains healthy. This demonstrates that hepatitis B’s contagiousness is not something to fear. The greatest source of frustration for hepatitis B patients is the difficulty in curing the disease. Although treatment for hepatitis B is challenging, advances in medical science have led to an increasing number of treatment options, each with improved efficacy. The recently introduced adefovir has achieved a surface antigen conversion rate of over 50%, and an E antigen conversion rate of over 70%. Herbal remedies offer long-lasting effects and can even help prevent hepatitis B from progressing to cirrhosis and liver cancer. All of these developments show that hepatitis B is treatable—and even curable—if approached correctly and treated consistently. The future is bright; with the right methods and consistent medication, there is no need to feel discouraged. Regarding children of hepatitis B patients, we’ve already discussed triple prevention during the perinatal period, which has effectively resolved this issue. Even if both parents are large three-positive, it is still possible to give birth to a healthy, thriving infant—there is no need to worry about having children after marriage.

Research Progress on Helicobacter pylori

In the 1970s, scientists discovered a rod-shaped, curved bacterium in the gastric contents of patients with chronic gastritis, which was initially named Helicobacter pylori. Subsequent studies revealed a close relationship between Helicobacter pylori and atrophic gastritis. Later, researchers found that this bacterium was also closely associated with ulcers. By the late 20th century, as research on Helicobacter pylori deepened, scientists discovered that this bacterium possessed broad pathogenic potential and eventually renamed it Helicobacter pylori (HP). Helicobacter pylori has been implicated in diseases across various systems of the human body.

1. Digestive System: Chronic atrophic gastritis, ulcers of the stomach and duodenum, superficial gastritis, reflux esophagitis, gastric MALT lymphoma, salivary gland MALT lymphoma, hepatic encephalopathy—all of these conditions are positively correlated with Helicobacter pylori infection.

2. Respiratory System: Recent animal experiments have shown that inflammation in the upper digestive tract may trigger chronic bronchitis through a non-adrenergic, non-cholinergic sensory nerve pathway—rather than bacterial infection as previously thought. Through evidence-based medical observation, researchers found that patients with Helicobacter pylori infection in the gastrointestinal system were several times more likely to develop chronic bronchitis compared to the general population. Some recent studies have even directly detected Helicobacter pylori in respiratory secretions.

3. Blood System: Autoimmune thrombocytopenic purpura (ATP), often referred to as primary thrombocytopenic purpura, has been linked to Helicobacter pylori infection in over 85% of cases, with gastric secretions testing positive for Helicobacter pylori in 70% of patients. How should we interpret the relationship between thrombocytopenia, gastrointestinal disease, and Helicobacter pylori? What exactly are the causal mechanisms behind this connection? Further research is needed. Recent studies have also revealed a strong link between iron deficiency anemia and Helicobacter pylori infection.

4. Cardiovascular System: Primary headaches, primary Raynaud’s phenomenon, and anemia-related heart disease—all of these conditions are associated with Helicobacter pylori infection.

5. Immune Disorders: Antigenic substances from Helicobacter pylori have been identified in the serum of patients with autoimmune thrombocytopenic purpura, suggesting a link between Helicobacter pylori infection and these disorders.

6. Recent studies have found that Helicobacter pylori is closely related to growth retardation in children, diabetes, and skin conditions such as psoriasis and alopecia areata.

In summary, the discovery of Helicobacter pylori represents another major breakthrough since the establishment of microbial pathology by American physician George G. in the 19th century. As research progresses, we anticipate that this discovery will provide new opportunities to address many longstanding medical challenges that were previously unresolved. Traditional Chinese medicine posits that “the spleen and stomach are the foundation of postnatal life,” and that “where there is stomach qi, life exists; without stomach qi, death follows”—indicating that the spleen and stomach are the source of human health. Since Helicobacter pylori, originating in the gastrointestinal tract, can cause so many systemic diseases, it is clear that the theories developed in traditional Chinese medicine through practice possess scientific merit and should be continuously explored, adapted for modern use, and further developed to enhance their value. The concepts of “cultivating the earth to generate gold,” “water fears earth,” and “liver wood overcomes earth” all reflect the pathogenic mechanisms and therapeutic principles centered on the gastrointestinal system.

A Brief Discussion on Evidence-Based Medicine

In the 1970s, Dr. Cochrane first proposed the concept and mindset of evidence-based medicine, sparking widespread interest among renowned scholars worldwide. In the 1980s, international medical conferences held in Canada officially recognized the term “evidence-based medicine.” Evidence-based medicine (EBM) refers to the careful, accurate, and informed application of the best available evidence from current research to formulate treatment plans for patients. Today, EBM has become a key focus in medical research globally. In 1999, 13 countries established the Cochrane Collaboration Network.

The implementation of EBM involves five key steps: identifying problems, collecting evidence, determining the best evidence, making decisions, and evaluating outcomes. These five steps can also be summarized in a single phrase: “Use the best evidence to create the best treatment plan.” Achieving these goals requires a systematic effort—not a quick fix. The critical step is “collecting evidence,” which demands large-scale, comprehensive, multi-faceted, and multi-level data collection. Only today, with computer networks and fully modernized information infrastructure, is this process feasible. Throughout this process, clinicians must play a leading role—but as the primary actors in disease occurrence, patients’ subjective experiences are equally important. Therefore, starting with basic patient history taking and medical record-keeping, a standardized protocol aligned with EBM should be established as a fundamental standard for clinical practice in hospitals. High-quality scientific evidence is the most basic requirement of EBM; in addition to evidence derived from hospital medical records, clinical research reports from various regions, personal experiences, insights, and reflections should also be incorporated. The reliability and strength of these diverse sources of evidence often vary, but they can generally be categorized into five levels.

① Summary reports from research centers across the country, with a sample size exceeding 500 (randomized, double-blind, controlled studies). ② Research reports from medical institutions, with a sample size of 100–200 (randomized, double-blind, controlled studies). ③ Reports from departments or collaborative studies involving multiple researchers, with well-designed studies lacking randomization but focusing solely on pre- and post-treatment comparisons without a control group. ④ Personal summaries, well-designed but lacking randomized studies. ⑤ Expert opinions, insights, and experiences lacking reliable evidence.

Among these five levels, levels 1–2 represent the gold standard, while levels 3–5 are considered lower standards. China’s 21 medical journals have been adopted by the World Health Organization, ranking 8–10th in international rankings—but the number of papers cited by EBM is far below this level. This indicates that while Chinese medical journals are working to increase the quantity of published papers, they must also focus on improving the quality of those papers, beginning with large-scale, multi-center, randomized, double-blind, controlled studies.

Systematic evaluation and meta-analysis of collected literature and data are also crucial components of EBM. It is essential to accurately integrate small samples from various regions and levels into larger datasets, ensuring fairness, objectivity, and comprehensiveness. Once these datasets are assembled, systematic reviews (SR) and meta-analyses (MA) are conducted. SR involves rigorously evaluating literature and data using modern methodologies; MA then performs statistical analysis on the results of SR. Globally, biological journals publish over 25,000 articles annually, with 2 million research papers published each year. To stay abreast of global biological trends, reading all of these publications would be nearly impossible for a biological researcher—but after SR and MA processing, the key points and core ideas of these 2 million papers become clearly visible, enabling researchers to grasp the overall picture in a short amount of time. The ultimate goal of EBM is to draw conclusions about treatment efficacy—whether through endpoint indicators or surrogate endpoints. Endpoint indicators include cure rates, mortality rates, disability rates, and other relevant metrics. To meet the needs of international EBM, domestic journals now require adherence to basic principles such as randomized, double-blind, controlled studies. Medical centers, institutions, and individual researchers must strictly follow SR and MA guidelines when handling data; only then can the fruits of our labor truly be included within the scope of EBM. While China’s medical journals and paper volumes currently rank among the highest in the world, the number of papers cited by foreign research institutions remains relatively low. This highlights that although Chinese medical research is aligning with international standards, it still lags behind. Over the past decade, traditional Chinese medicine and herbal medicine have made significant strides; major research centers across the country have already demonstrated strong capabilities in randomized, double-blind, controlled studies, and have gradually aligned their research practices with Western medicine’s SR and MA frameworks. However, traditional Chinese medicine’s purely empirical data still occupies the majority of Chinese medical literature, significantly hindering the integration of traditional Chinese medicine into EBM and impeding the advancement of traditional Chinese medicine research. Addressing this issue will not be easy—it requires starting with three key areas: standardizing traditional Chinese medicine evidence, establishing standardized disease classifications, and defining clear efficacy criteria. To achieve these three standards, we must organically combine macroscopic dialectics with microscopic dialectics. This requires generations of effort to accomplish.

Thanks to the development of EBM, international collaborations have yielded remarkable results in many areas, including the confirmation of statin drugs’ role in reducing coronary heart disease mortality, the reevaluation of existing hypertension standards, and a deeper understanding of heart failure treatment protocols. One notable example of EBM’s success is the determination of the normal blood pressure range for hypertension, which involved participation from 26 countries and 18,000 hypertensive patients over a five-year period. The study found that lowering systolic blood pressure from 14.0 kPa (105 mmHg) to 11.1 kPa (83 mmHg) could reduce cardiovascular deaths by 4 cases among 1,000 hypertensive patients—equivalent to a 30% reduction in deaths—and also lowered diastolic blood pressure to 11.1 kPa (83 mmHg), thereby minimizing cardiovascular risk. Given WHO’s revisions to previous hypertension standards, the new normal blood pressure threshold is <17.3/11.3 kPa (130/85 mmHg); values above this threshold are considered pre-hypertension or early-stage hypertension.

In the field of heart failure, EBM has also yielded substantial results. Historically, heart failure was understood primarily through cardiovascular dynamics—such as ventricular enlargement and reduced cardiac output—and treatments focused mainly on enhancing positive myocardial function and regulating negative cardiac rhythms. However, large-scale EBM observations revealed that such treatments did not extend the lifespan of heart failure patients. Furthermore, researchers discovered that the sympathetic neurotransmitter catecholamine plays a crucial role in quantifying heart failure severity. Consequently, beta-blockers—long considered contraindicated in heart failure—were successfully used to treat heart failure, yielding excellent therapeutic outcomes. It turned out that beta-blockers (such as bisoprolol and carvedilol) could significantly reduce the mortality rate from heart failure.

Zhi Gan Cao Tang for Coronary Heart Disease

The “Shanghan Lun” states, “When the pulse is irregular and the heartbeat is rapid, Zhi Gan Cao Tang is prescribed.” This indicates that irregular pulses and rapid heartbeat are the primary symptoms of Zhi Gan Cao Tang; “jie” refers to a slow, regular pulse, while “dai” denotes a pulse with a fixed rhythm. These patterns encompass modern medical conditions like premature beats, dual-beat rhythms, and triple-beat rhythms. Based on 40 years of clinical experience, the author believes that patients exhibiting these pulse patterns often experience chest tightness and pain, followed by palpitations and shortness of breath. In an era where coronary heart disease is becoming increasingly prevalent, the author has observed that arrhythmias in adult patients are often accompanied by coronary heart disease. Some patients initially do not meet the diagnostic criteria for coronary heart disease, but after six months, they are ultimately diagnosed with coronary heart disease. When encountering similar patients, the author typically finds that Zhi Gan Cao Tang combined with Guan Xin No. II provides effective relief.

Case 1: Qi, a 58-year-old woman, had been diagnosed with coronary heart disease for many years. She frequently experienced chest discomfort, primarily in the left chest, radiating to her left back. She also suffered from palpitations and shortness of breath. An electrocardiogram showed complete atrioventricular block, myocardial ischemia, frequent ventricular premature beats, irregular pulses, a red, darkened tongue with ecchymoses. Her heart qi was deficient, blood stagnated, and the pattern called for replenishing qi, nourishing the heart, activating blood circulation, and resolving stasis. The author prescribed Zhi Gan Cao Tang combined with Guan Xin No. II, modified:

Gui Zhi 10g, Dang Shen 10g, A Jiao 10g (dissolved in warm water), Mai Dong 10g, Dang Gui 10g, Sheng Di 12g, Chi Shu 10g, Hong Hua 6g, Jiang Xiang 10g (dissolved in warm water), Dan Shen 10g, Chuan Xiong 6g, Huo Ma Ren 10g, Sheng Jiang 6g, Da Zao 4 pieces, Shui Zhi 10g (divided and taken separately), Han San Qi 3g (divided and taken separately). The herbs were decocted in water and taken once daily.

After more than 40 doses, all symptoms were alleviated, and the electrocardiogram returned to normal.

Case 2: Wang, a 54-year-old woman, was diagnosed with coronary heart disease three years ago. For the past three years, she had experienced chest discomfort, palpitations, and shortness of breath, though she did not exhibit arrhythmias. Her electrocardiogram only showed myocardial ischemia, elevated blood lipids, and increased plasma viscosity and whole blood viscosity compared to normal levels. Her pulse was tense and forceful, her tongue was red with little coating, and she had ecchymoses. Her blood pressure was 21.3/12 kPa (160/90 mmHg), indicating yin deficiency and yang excess, with blood stagnation due to insufficient blood flow. The author prescribed Zhi Gan Cao Tang combined with Guan Xin No. II, modified:

Dang Shen 10g, Gui Zhi 10g, A Jiao 10g (dissolved in warm water), Mai Dong 10g, Sheng Di 12g, Huo Ma Ren 20g, Sheng Jiang 6g, Da Zao 4 pieces, Gan Cao 30g, Chi Shu 10g, Chuan Xiong 10g, Hong Hua 6g, Jiang Xiang 6g, Dan Shen 20g, Huai Niu Xi 30g, Sheng Bai Shou 15g, Sheng Bai Shou 15g, Sheng Gui Ban 15g, Sheng He Shi 15g, Shan Yao 10g. The herbs were decocted in water and taken once daily.

After 10 doses, her chest discomfort, palpitations, and shortness of breath were all alleviated, and her blood pressure dropped back to normal. She still felt some discomfort in her chest, particularly when walking or climbing stairs, though this sensation became less pronounced. She removed Huo Ma Ren, Sheng Jiang, and Da Zao, adding 12g of Fu Ling, 10g of Xing Ren, 10g of Gua Lou, and 10g of Xie Bai. The herbs were decocted in water and taken once daily. After 15 doses, all symptoms were gone, and tests showed that her blood pressure, blood lipids, and blood viscosity were all within normal limits. She increased the dosage by tenfold, adding Han San Qi 30g and Shui Zhi 100g, ground into powder, sifted through a sieve, and made pills weighing 6g. Each pill was taken once daily, three times a day, mixed with warm water after meals. Three months later, she reported that she had not experienced chest discomfort or shortness of breath since starting the medication. Her blood pressure occasionally rose, but she was now taking Xin Tong Ding sustained-release tablets, 20mg daily.

Both cases utilized Zhi Gan Cao Tang, a remedy often known for treating arrhythmias—but its use in treating coronary heart disease has been less frequently reported. Based on the author’s experience, this formula is absolutely reliable for treating coronary heart disease, offering unique benefits compared to the Gua Lou Xie Bai Ban Xia Tang. Combined with the blood-activating formulas Tao Hong Si Wu and Guan Xin No. II, its efficacy is even more pronounced. The heavy use of licorice in Zhi Gan Cao Tang is a hallmark of this formula; the “Shanghan Lun” states, “When there is pain in the heart and fullness in the abdomen, and the heart feels restless… Gan Cao Xie Xin Tang is prescribed.” This suggests that licorice helps alleviate restlessness and discomfort in the heart. Modern experimental research has proven that glycyrrhizic acid in licorice has a powerful sedative effect on the central nervous system; glycyrrhizin and glycyrrhizic acid can rapidly reduce elevated triglyceride levels in experimental atherosclerosis and even significantly slow down arterial hardening. Licorice is effective for treating gastric ulcers, liver diseases, cardiovascular ailments, endocrine disorders, prostatitis, and neurasthenia—and it can harmonize the effects of other herbs, which is why it appears in most traditional Chinese medicine prescriptions. Chinese medical practitioners often refer to licorice as “national elder,” a fitting metaphor for its qualities.

In Zhi Gan Cao Tang, Mai Dong, Gui Zhi, and Sheng Di are the primary herbs used to treat coronary heart disease. Modern experimental research has shown that Sheng Di and Mai Dong have the ability to lower blood pressure, reduce lipid levels, and regulate heart rhythm—making them the most potent ingredients in Zhi Gan Cao Tang. Gui Zhi has been shown in experimental studies to help raise blood pressure, thus promoting warmth and unblocking heart yang, as traditional Chinese medicine describes. Thanks to these findings, Zhi Gan Cao Tang has laid the groundwork for treating coronary heart disease. When combined with Guan Xin No. II (Chi Shu, Chuan Xiong, Hong Hua, Jiang Xiang, Dan Shen), the formula addresses both qi and blood, complementing each other perfectly. The use of Shui Zhi and Han San Qi—two herbs that break up blood stasis and promote blood circulation—enhances the medicinal power of the formula, allowing stagnant blood to be cleared away, providing a truly pivotal moment in the treatment.

Traditional Chinese Medicine Treatment of Epilepsy Task output rules: Translate this markdown block from Chinese to English. Preserve markdown markers, links, and formatting. Keep headings and list structure unchanged. Return only the translated block.

Input: Epilepsy is a common clinical condition, often beginning in children or young adults under the age of 18. It is typically categorized into three types: congenital epilepsy, traumatic brain injury-related epilepsy, and primary epilepsy. Congenital epilepsy refers to epilepsy caused by genetic chromosomal abnormalities, brain malformations, hydrocephalus, and other conditions; traumatic brain injury-related epilepsy is associated with sequelae following cranial-brain injuries. Primary epilepsy accounts for the majority of epilepsy cases and serves as the primary target for traditional Chinese medicine (TCM) treatment of epilepsy, which is the focus of this paper.

The primary clinical manifestations of primary epilepsy include brief episodes of loss of consciousness, followed by convulsions, dizziness, numbness in the limbs, tingling sensations, and other sensory abnormalities. These episodes can last for several seconds or minutes, though in severe cases they may persist for hours. A small number of patients exhibit isolated localized seizures, characterized by localized motor and sensory disturbances, as well as autonomic and psychiatric symptoms such as facial twitching, abnormal sensations in the eyelids, fingers, toes, and brief mental confusion. In infants and young children, common symptoms include one-sided eye deviation, repetitive sucking and lip-smacking movements, and recurrent movements on one side of the body—these are all considered part of epileptic syndromes. Electroencephalogram (EEG) testing plays a significant role in diagnosing primary epilepsy, but a single or double negative EEG result does not fully rule out the possibility of epilepsy. Brain CT and MRI scans are crucial for ruling out traumatic brain injury, brain tumors, and congenital brain disorders. When diagnosing epilepsy, it is important to differentiate it from hysteria, syncope, migraine, hypoglycemia, and other conditions. These conditions share the characteristic of lacking conscious loss of awareness, whereas most cases of epilepsy are accompanied by loss of consciousness, making them distinct from these conditions. However, a small number of patients without conscious loss of awareness are particularly prone to misdiagnosis. Western medicine treats epilepsy using phenobarbital, phenytoin sodium, carbamazepine, ethosuximide, and diazepam, but these treatments are only symptomatic and do not offer a cure. TCM offers a rich array of therapeutic approaches for epilepsy; although these methods cannot be said to have fundamentally resolved the problem of treating epilepsy, consistent medication can lead to recovery in some patients, while many others experience relief. This discussion focuses on primary epilepsy, though cases of congenital brain disease or epilepsy resulting from traumatic brain injury are treated separately.

Traditional Chinese Medicine has a long history of understanding epilepsy. The "Suwen" states that "when the two yin energies become tense, epilepsy occurs," attributing epilepsy to the two yin energies—specifically the kidney yin in the feet and the heart yin in the hands. The "Qianjin Fang" provides more detailed descriptions of epilepsy, noting that "during an attack, the eyes and gaze are drawn together, the body becomes stiff and tense, there is a bellowing sound like a sheep's cry, and the symptoms subside only after a few moments." It also describes that "during an attack, the patient appears to be dead, experiences urinary incontinence, and then recovers when the situation stabilizes," vividly capturing the clinical symptoms of epilepsy. The "Shishi Mulu" offers detailed discussions on the symptoms and treatment of epilepsy, stating: "The signs of epilepsy often arise from qi deficiency and phlegm accumulation—like a sudden storm, where the patient collapses suddenly, foams at the mouth, and emits sounds resembling those of cattle, sheep, or horses. If treatment is not appropriate, many patients die. I now present a prescription: 'Qu Sha Ding Xian Tang.' It contains ginseng 3 qian, pinellia 3 qian, lotus seed 3 qian, white atractylodes 5 qian, licorice 1 qian, aconite 1 qian, tangerine peel 1 qian, and delphinium 1 qian. Brew the herbs in water and take the decoction." In this formula, ginseng, atractylodes, poria, and peony are powerful herbs for strengthening the spleen and calming the liver; tangerine peel, pinellia, and licorice help eliminate phlegm and harmonize the middle burner. Remarkably, aconite and delphinium help awaken the heart’s energy, guiding all the herbs directly into the mind and spirit. According to the "Shishi Mulu," "There are also cases of 'yang-ting' epilepsy—suddenly the patient falls down, makes sounds like a sheep or horse, and spits up phlegm as if it were surging. Phlegm obstructs the heart and spirit, arising from cold; it is triggered by exposure to cold." This prescription includes ginseng, pinellia, and Chinese yam each 3 qian, white atractylodes 1 liang, lotus seed and coptis root each 5 qian, cinnamon and aconite each 1 qian, all brewed in water and taken as a decoction. Chen Shi, the author of the "Shishi Mulu," once treated a patient who had only taken one dose of this formula and never experienced another episode. He even remarked that he “cherished this formula.” Chen Shi also developed another formula for treating this condition, which was equally effective: ginseng 3 liang, white atractylodes 5 liang, tangerine peel 3 qian, raw pinellia, pinellia, and licorice each 1 liang, along with aconite 1 qian, ground into powder, mixed with honey to form pills. Take the pills before an attack, and the patient would never experience another episode. These examples demonstrate that ancient practitioners developed a comprehensive system for understanding epilepsy—from its causes and pathogenic mechanisms to its treatment principles, formulas, and therapies. Chen Shi’s approach focused on “deficiency” and “phlegm,” leading to the saying “no deficiency is without epilepsy” and “no phlegm is without epilepsy.” His treatment methods included ginseng, atractylodes, licorice, and poria (the Four Gentlemen Decoction) to tonify the spleen and stomach; pinellia, tangerine peel, poria, and licorice (the Two-Chen Decoction) to strengthen the spleen and eliminate phlegm; cinnamon, aconite, and other herbs to tonify the kidneys and warm yang—also aimed at replenishing deficiency. Coptis root and bitter melon complemented the other herbs, embodying the true essence of tonifying deficiency and eliminating phlegm. “Phlegm” is the fundamental pathogenic mechanism of epilepsy; where does it originate? From the spleen and the kidneys. The lungs store phlegm, while the spleen is the source of phlegm formation. Phlegm is dampness, water—and ultimately rooted in the kidneys, which is why it is said that “the kidneys are the origin of phlegm.”

I once used Chen Shi’s formula to treat epilepsy, which proved effective for mild cases—but not for severe cases. After more than 40 years of clinical practice, I have been tirelessly seeking effective treatments for epilepsy. I now share my incomplete experiences below, hoping that readers will try these remedies in their own clinical settings. Should there be any shortcomings, I welcome criticism and suggestions from fellow practitioners.

1. Pei’s Anti-Epilepsy Granules: 6g of pinellia, 6g of pinellia, 3g of agarwood, 10g each of black and white atractylodes, 20g of stone, 10g of floating stone, 50g of iron oxide, 20g of Sheng Longmu, brewed in water three times, collecting the liquid, then concentrated. Add 40g of roasted Chinese yam powder and an appropriate amount of sugar to the concentrate, form four packets of granules—each packet containing 2 days’ worth of dosage, taken twice daily, 1 packet each time, diluted with warm water. This formula is suitable for minor daily seizures in patients with mild epilepsy, where symptoms are not severe and resolve within a few seconds. Regularly taking this formula over time can yield positive results. For those with a naturally weak stomach, the dosage can be halved as needed.

2. Pei’s Anti-Epilepsy Pills: 10g of angelica sinensis, 6g of fritillary bulb, 10g of red peony, 100g of rehmannia root, 100g of peach kernel, 60g of saffron, 60g of ginger worm, 60g of whole scorpion, 10 centipedes, 100g of gastrodia, 300g of climbing vine, 100g of delphinium, 100g of white pepper—all ground into powder, mixed with honey to form pills, 6g per pill, taken twice daily, 1–2 pills each time, diluted with warm water. This formula is ideal for more severe attacks, especially for patients with weak constitutions; for those who frequently experience symptoms like chest discomfort or fatigue, drinking a decoction made with jujubes and then taking this formula can provide lasting relief.

3. Pei’s Anti-Epilepsy Capsules: 10g of owl brain marrow, 20g of alum, 60g of curcuma, 60g of ginger slices, 60g of golden scorpion, 10 centipedes—all ground into powder, packaged in capsules (0.5g), taken 1–3 times daily, 1–3 capsules each time, diluted with warm water. This formula is suitable for patients experiencing severe seizures, with mental confusion or unstable mental states.

4. Fuzhong Anti-Epilepsy Soup: 10g of codonopsis, 10g of white atractylodes, 10g of lotus seed, 6g of pinellia, 6g of tangerine peel, 6g of licorice, 20g of processed coptis root, 3g of cinnamon, 6g of aconite, 3g of wood fragrance, 6g of grass cardamom, 100g of raw ironwort (previously boiled), brewed in water and taken daily. This soup is suitable for patients with weakness and excessive phlegm, and can be combined with the aforementioned granules, pills, or capsules.

5. Raw Ironwort Drink: 15g of wintergreen, 15g of wheatgrass, 15g of codonopsis, 15g of salvia miltiorrhiza, 15g of northern sandwort, 15g of yuan shen, 6g of curcuma, 6g of fritillary bulb, 15g of raw ochre, 6g of pinellia, 15g of delphinium, 6g of farfara, 15g of raw ironwort (previously boiled), brewed in water and taken daily. This formula is ideal for patients experiencing mental seizures or epilepsy accompanied by psychological symptoms—such as irritability, insomnia, palpitations, or restlessness. This formula is based on a formula from Chen Zhongling, originally published in "Medical Heart Wisdom."

6. Compound Chaihu Wending Decoction: 10g of chaihu, 10g of scutellaria baicalensis, 6g of pinellia, 6g of licorice, 10g of cinnabar, 10g of white peony, 6g of curcuma, 10g of citrus aurantium, 6g of bamboo shoots, 6g of tangerine peel, 10g of lotus seed, 6g of delphinium, 5g of roasted jujube seeds, 6g of aconite, 6g of dried ginger—brewed in water and taken daily. This formula is suitable for patients with weakness and frequent colds, who experience epilepsy outbreaks whenever they catch a cold.

7. Compound Zishen Tablets: 10g of mountain zishen, 10g of five-flavor berry, 10g of cyclocarya, 6g of large ephedra, 3g of yellow bark, 3g of cinnabar, 1g of musk, 30g of bitter root—ground into powder, made into tablets, 0.3g per tablet, taken 3 times daily, 2 tablets each time, diluted with warm water. Originally named "Zijin Ding," this formula was popular in TCM as a first-aid remedy, commonly used to treat sores, swelling, boils, and lymphadenitis; it could also be used for food poisoning, acute dysentery, or acute gastric spasms. I found that this formula was effective in treating severe epilepsy attacks.

In summary, traditional Chinese medicine’s treatment of epilepsy primarily focuses on primary epilepsy—a condition that TCM can handle effectively on its own. For cases of brain disease or epilepsy caused by traumatic brain injury, a combination of TCM and Western medicine is essential. Among the above formulas, four preparations can be chosen based on the patient’s condition for regular use. Three decoctions can be taken intermittently depending on the severity of the condition. TCM treatment of epilepsy is a long-term, systematic process requiring cooperation between doctors and patients through continuous medication. The fundamental principle of TCM treatment is to strengthen the body’s vital energy and consolidate its foundation, while simultaneously dispelling wind and calming the spirit. The former helps regulate the autonomic nervous system and endocrine system, promoting greater harmony and alleviating the physiological basis of epilepsy attacks; the latter focuses on symptom management, alleviating clinical manifestations of epilepsy. Together, these approaches aim to treat the root cause of epilepsy while providing supportive care.

Clinical Cases

This study includes 30 cases, totaling 87 cases, all of which involved difficult-to-treat or rare diseases. The research adhered to the clinical sixteen-character principle proposed by the author early in his career: “Western diagnosis, TCM syndrome differentiation, TCM as the mainstay, Western medicine as a supplement.” The study sought to be realistic and reliable in its outcomes.