I. Rapid Arrhythmias

I. Rapid Arrhythmias

Rapid arrhythmias encompass various types of premature beats, sinus tachycardia, supraventricular and ventricular tachycardia, atrioventricular flutter and fibrillation. Clinically, they often manifest as palpitations, discomfort in the precordial region, fatigue, a weak pulse, or even irregularities in the rhythm. From a TCM perspective, these conditions are often caused by qi and yin deficiency, blood stasis within the vessels, prolonged stasis leading to heat, or heat disturbing the mind; among these, qi and yin deficiency are the root cause, while blood stasis, prolonged stasis leading to heat, and heat disturbing the mind are the manifestations. Treatment primarily focuses on nourishing yin and tonifying qi, using Zhi Gan Cao Tang with modifications: 20 g of Zhi Gan Cao, 10 g of Gui Zhi, 6 g of Gan Jiang, 10 g of A Jiao (dissolved in warm water), 4 dates, 10 g of Codonopsis, 20 g of Mai Dong, 20 g of Rehmannia Root, 10 g of Sesame Seeds, 20 g of Salvia Miltiorrhiza, 20 g of Kudzu Root, 10 g of Wu Wei Zi—prepared by decocting in water, one dose per day, divided into several servings. Clinical adjustments: if there is also restlessness, insomnia, sores in the mouth and tongue, or frequent dreams, add 3 g of Coptis Chinensis and 3 g of Cinnabar (mixed and taken separately); if insomnia, frequent dreams, fatigue, lack of energy, and poor appetite are present, add 30 g of Astragalus, 6 g of Yuan Zhi, 15 g of Fried Hawthorn Seeds; if there is palpitation, excessive sweating, and general body aches after an external infection, add 20 g of White Peony to the original formula; if there is tightness and discomfort in the precordial region, a deep, slow, and slightly purple tongue with dark bruising, use the original formula combined with Guan Xin No. II (composed of Salvia Miltiorrhiza, Red Peony, Chuanxiong, Carthamus Tinctorius, and Fragrant Sandalwood), which treats coronary heart disease and angina pectoris in cases where blood stasis is identified, or use the remaining trial formula, Gui Chuan Ji, consisting of 10 g of Gui Zhi, 6 g of Chuanxiong, 10 g of Kudzu Root, 20 g of Codonopsis, 10 g of Mai Dong, 6 g of Wu Wei Zi, 15 g of Purple Quartz, 15 g of Raw Magnesium Oxide, 10 g of Ling Qi Shi, 15 g of Pearl Mother, and 6 g of Licorice; if irritability, easy anger, fear, or frequent dreams are present, add 15 g of Raw Magnesium Oxide, 3 g of Prepared Milk, 15 g of Fried Hawthorn Seeds, 15 g of Perilla Seeds, 10 g of Round Meat, 10 g of Rehmannia Root; if the condition is caused by hysteria, use the formula combined with Chai Hu Jia Longgu Mu Li Tang with modifications.

Case 1: Xu ××, male, 62 years old, cadre, with palpitations and precordial discomfort for eight years, visited the clinic on October 26, 1996. Physical examination revealed: pulse rate of 100 beats per minute, blood pressure of 16/10 kPa, cardiac examination showed clear heart sounds, heart rate of 100 beats per minute, irregular heartbeat, with 6–10 premature beats heard per minute, and no pathological murmurs in the precordial region. Electrocardiogram showed: ① myocardial ischemia, ② frequent multi-source premature beats. Combined with a weak pulse, irregular rhythms, a red tongue with a thin yellow coating and bruising points, TCM diagnosis was qi and yin deficiency, blood stasis within the vessels. Treatment focused on tonifying qi and nourishing yin, while also resolving stasis—prescription: 20 g of Zhi Gan Cao, 10 g of Gui Zhi, 6 g of Fresh Ginger, 10 g of A Jiao (dissolved in warm water), 4 dates, 10 g of Codonopsis, 20 g of Rehmannia Root, 20 g of Mai Dong, 10 g of Sesame Seeds, 20 g of Salvia Miltiorrhiza, 20 g of Kudzu Root, 10 g of Gou Tu, 10 g of Garlic, 6 g of Red Peony, 10 g of Chuanxiong—prepared by decocting in water, one dose per day, divided into several servings. After administering the formula for over 20 doses, the precordial pain had disappeared, though he still felt mild palpitations, sometimes accompanied by fatigue and discomfort in the epigastric region. Tongue was red with a thin yellow coating, pulse was fine and rapid. The above formula was adjusted to remove Chuanxiong and Red Peony, adding 6 g of Sandalwood, 6 g of Agastache, 10 g of Atractylodes, 12 g of Poria, and 30 g of Raw Magnesium Oxide; after further administration of over 20 doses, all symptoms had disappeared. Heart rate was 86 beats per minute, with only 1–2 premature beats heard per minute, and electrocardiogram showed occasional atrial premature beats.

Case 2: Zhao ××, female, 50 years old, farmer. She experienced paroxysmal palpitations for two years, accompanied by right upper quadrant pain and insomnia with frequent dreams. She visited the clinic on January 4, 1997. Physical examination revealed: pulse rate of 104 beats per minute, blood pressure of 12/8 kPa, clear heart sounds, heart rate of 110 beats per minute, regular rhythm, with a blowing murmur audible in the precordial region. Abdomen was flat and soft, with tenderness in the right upper quadrant. Electrocardiogram showed sinus tachycardia. Western medical diagnosis: ① sinus tachycardia; ② chronic cholecystitis; ③ hysteria. Combined with a red tongue with little coating and a tense, rapid pulse, TCM diagnosis was liver stagnation turning to fire, fire disturbing the mind. Treatment focused on soothing the liver, releasing stagnation, and calming the mind—prescription: Chai Hu Jia Longgu Mu Li Tang combined with Gan Mai Da Zao Tang with modifications: 10 g of Chai Hu, 10 g of Huang Qin, 10 g of Codonopsis, 6 g of Ban Xia, 6 g of Fresh Ginger, 6 g of Licorice, 4 dates, 15 g of Raw Magnesium Oxide, 15 g of Raw Magnesium Oxide, 30 g of Floating Wheat, 3 g of Coptis Chinensis, 6 g of Fang Fu, 6 g of Yuan Zhi—prepared by decocting in water, one dose per day, divided into several servings. After administering the formula for over 10 doses, her palpitations, insomnia, and frequent dreams improved, though she still experienced right upper quadrant pain. Therefore, the above formula was adjusted to remove Yuan Zhi and Fried Hawthorn Seeds, adding 10 g of Zhishi, 10 g of Wood Sage, 20 g of Qianjin Cao, and after further administration of over 20 doses, all symptoms had disappeared.

II. Slow Arrhythmias

Slow arrhythmias include sinus bradycardia, sick sinus syndrome, atrioventricular nodal rhythm, and various conduction blocks. Clinically, they often manifest as shortness of breath, dizziness, fatigue, chest tightness, and a slow pulse with irregularities. TCM diagnoses often reflect yang deficiency and phlegm-stasis; treatment focuses on warming yang, tonifying qi, and resolving phlegm—representative formulas include Mahuang Fuzi Xiexin Tang. When applied clinically, if there is also chest pain or a purple, dark tongue with bruising points, this formula is used in combination with Guan Xin No. II; if there are frequent dreams, fatigue, and a weak pulse, this formula is combined with Guipi Tang; if there is fullness in the chest and abdomen, thick white tongue coating, this formula is combined with Ling Gui Sha Gan Tang; if there is coldness, cold limbs, abdominal distension, and oliguria, this formula is combined with Zhen Wu Tang; if there is shortness of breath, excessive sweating, and dry mouth, this formula is combined with Sheng Mai San. Additionally, the roots and stems of tea trees grown in Longnan Province (also known as tea tree roots) have shown good therapeutic effects for various slow arrhythmias and can be used as appropriate.

Case 3: Xue ××, male, 61 years old. He experienced chest pain accompanied by shortness of breath and fatigue, visiting the clinic on October 7, 1997. Physical examination revealed: pulse rate of 52 beats per minute, blood pressure of 12/8 kPa. Heart sounds were clear, heart rate of 52 beats per minute, regular rhythm, no pathological murmurs in each valve, pale tongue with a thin white coating, and a slow, tense pulse. Electrocardiogram showed: ① myocardial ischemia; ② sinus bradycardia; ③ complete right bundle branch block. Western medical diagnosis: ① coronary heart disease; ② sinus bradycardia; ③ complete right bundle branch block. TCM diagnosis was heart yang deficiency and blood stasis; treatment focused on warming and opening the heart yang, promoting blood circulation to resolve stasis. Prescription: Mahuang Fuzi Xiexin Tang combined with Guan Xin No. II with modifications: 6 g of Mahuang, 6 g of Aconite, 10 g of Codonopsis, 10 g of Mai Dong, 3 g of Wu Wei Zi, 15 g of Kudzu Root, 3 g of Danshen (mixed and taken separately), 30 g of tea tree roots, 6 g of Agastache, 6 g of Sandalwood—prepared by decocting in water, one dose per day, divided into several servings. After administering the formula for over 20 doses, chest pain had completely disappeared, though he still experienced mild shortness of breath. Heart rate was 58 beats per minute, blood pressure: 13/8 kPa. The above formula was adjusted to remove Water Leech and Danshen, adding 30 g of Astragalus, 10 g of Gui Zhi, 12 g of Atractylodes, 15 g of Poria. After further administration of over 30 doses, all symptoms had disappeared; two months later, repeat electrocardiogram showed normal results. Example 4:

Ma, female, 50 years old. She has suffered from shortness of breath accompanied by dizziness, chest tightness, and throat pain for five years, and sought medical attention on December 4, 1994. Her pulse was 54 beats per minute, and her blood pressure was 14/8 kPa. The patient presented with redness and swelling in the throat, clear heart sounds, a heart rate of 56 beats per minute, and a diastolic murmur of grade II rumbling heard in the precordial region. Her tongue was pale with white coating, and her pulse was slippery and slow. An electrocardiogram revealed sinus bradycardia. Western medical diagnosis: ① Rheumatic heart disease (mitral stenosis); ② Sinus bradycardia. Traditional Chinese medicine diagnosed her as having deficiency of Heart Yang and internal accumulation of phlegm and fluid; treatment involved warming Yang and transforming phlegm, using a formula composed of Linggui Zhigan Tang combined with Mahuang Fuzi Xixin Tang with modifications: 15 g of Poria, 12 g of Cinnamon Twig, 10 g of Atractylodes Macrocephala, 8 g of Licorice, 6 g of Ephedra, 6 g of Aconite, 3 g of Asarum, 6 g of Pinellia Ternata, 15 g of Forsythia Suspensa, 15 g of Forsythia, 15 g of Houttuynia Cordata, and 15 g of Bupleurum. The herbs were decocted in water, one dose per day, divided into two doses. After taking over 20 doses, the throat pain disappeared, dizziness and fatigue eased, though she still felt chest tightness. Her tongue was pale with a thin white coating, and her pulse was sluggish; the original formula was modified to remove Forsythia Suspensa, Forsythia, Houttuynia Cordata, and Bupleurum, adding 10 g of Gou Qi, 10 g of Allium Fistulosum, and continuing treatment for over 30 doses, during which all symptoms improved. Her pulse returned to 68 beats per minute, her blood pressure was 15/10 kPa, and her electrocardiogram was normal.

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Nutritional Megaloblastic Anemia – Two Cases

Case 1: Li, female, 60 years old. She had a history of chronic gastritis and experienced recurrent nasal bleeding that worsened over three days. Despite multiple treatments, the condition remained unresponsive. In August 1999, she sought treatment from Yu. At initial consultation, she appeared listless and fatigued, with a yellowish complexion, poor appetite, bitter mouth and dry mouth, abdominal distension and constipation, intermittent nasal bleeding, a deep and fine pulse, and a red tongue with little coating. Laboratory tests showed: RBC 2.01 × 10¹²/L, MCV 120 fL, PLT 50 × 10⁹/L, HGB 50 g/L, WBC 2.9 × 10⁹/L. Bone marrow examination revealed a marked increase in nucleated cells, primarily characterized by megaloblastic erythroblasts. Western medical diagnosis: Nutritional megaloblastic anemia. In addition to administering 500 mg of vitamin B₁₂ via intramuscular injection once daily and 30 mg of folic acid orally once daily, the primary focus was on traditional Chinese medicine to regulate the spleen and stomach. The herbal formula included: 15 g of North Sand Ginseng, 10 g of Mai Dong, 6 g of Yuzhu, 6 g of Shihu, 10 g of Danshen, 6 g of Mu Xiang, 3 g of Caoduo, 15 g of Mint Charcoal, 15 g of Danpi Charcoal, 15 g of Xueyu Charcoal, 6 g of Dahuang, and 3 g of Huang Lian. The herbs were decocted in water and taken in two warm doses daily, one dose per day, for a total of 10 doses. At second consultation, after taking the above formula for 10 doses, the nasal bleeding had significantly decreased, constipation had eased, though she still had poor appetite and a bitter mouth. Mint Charcoal and Danpi Charcoal were removed from the formula, and 3 g of Huang Lian, 10 g of Huang Qin, and 6 g each of Jiao San Xian were added. After continuing treatment for another 10 doses, she stopped taking vitamin B₁₂ and folic acid, advised to improve her nutrition and rest more. At third consultation, after taking the original formula for another 10 doses, her symptoms had improved, though she still experienced mild fatigue, poor appetite, and abdominal distension, with occasional nasal bleeding. Her tongue was red with a thin yellow coating, and her pulse was wiry. Laboratory tests showed: RBC 3.03 × 10¹²/L, MCV 92 fL, PLT 60 × 10⁹/L, HGB 90 g/L, WBC 8.2 × 10⁹/L. Treatment continued focusing on strengthening the spleen and regulating the stomach, supplemented by liver-ventilation therapy. The herbal formula included: 3 g of Mu Xiang, 3 g of Caoduo, 10 g of North Sand Ginseng, 10 g of Mai Dong, 6 g of Yuzhu, 10 g of Atractylodes Macrocephala, 12 g of Poria, 10 g of Chai Hu, 10 g of Bai Shao, 10 g of Danpi, 10 g of Zhizi, 10 g of Dang Gui, 3 g of Huang Lian, and 10 g of Huang Qin. The herbs were decocted in water and taken in two warm doses daily, one dose per day. At fourth consultation, after taking another 20 doses, her symptoms had disappeared, blood counts and bone marrow examination returned to normal, and she rarely experienced nasal bleeding again, with significant improvements in her mental state and appetite.

Case 2: Wang, male, 50 years old. He experienced discomfort in the epigastric region, bloating after meals, dizziness and fatigue, and poor appetite for three years, sometimes accompanied by nausea and diarrhea. His tongue was pale with a thin white coating, and his pulse was wiry and fine. Laboratory tests showed: RBC 2.56 × 10¹²/L, HGB 82 g/L, MCV 98 fL; gastroscopy indicated chronic inflammation of the gastric body. After six months of treatment with Western medications such as vitamin B₁₂, folic acid, and tinidazole, no improvement was seen, so he sought treatment from Yu. His complexion was pale, he was listless, his body was thin, his tongue was pale with a thin white coating, and his pulse was slippery. A bone marrow examination at another hospital had previously diagnosed him with nutritional megaloblastic anemia. Western medical diagnosis: ① Chronic gastritis; ② Nutritional megaloblastic anemia. Traditional Chinese medicine diagnosed him as having deficiency of Spleen and Stomach Qi. Treatment focused on replenishing Qi and strengthening the spleen, using the Xiangsha Liu Junzi Decoction with modifications: 3 g of Mu Xiang, 3 g of Caoduo, 10 g of Dang Gui, 10 g of Atractylodes Macrocephala, 12 g of Poria, 6 g of Licorice, 6 g of Banxia, 6 g of Chen Pi, 10 g of Zhishi, 10 g of Bai Shao, 15 g each of Wu Chei Gu, and 15 g of Zhi Lu, with the aim of nourishing the middle burner, strengthening the spleen, nourishing the stomach, promoting qi circulation to resolve stagnation, drying dampness, and eliminating phlegm. The herbs were decocted in water and taken in two warm doses daily, one dose per day. At second consultation, after taking the formula for over 10 doses, the patient reported significant relief from epigastric discomfort and post-meal bloating, though he still felt dizziness and fatigue, occasionally experiencing poor sleep. His tongue and pulse were unchanged. Laboratory tests showed: WBC 2.9 × 10⁹/L, HGB 86 g/L, MCV 96 fL. Although his spleen and stomach’s digestive function had improved, his anemia had not yet resolved. The treatment was shifted to a method that treated both the spleen and stomach together, and supplemented qi and blood: the Gui Pi Decoction with modifications: 30 g of Huang Qi, 10 g of Dang Gui, 10 g of Dang Gui, 10 g of Atractylodes Macrocephala, 12 g of Poria, 6 g of Licorice, 6 g of Yuan Zhi, 15 g of Fried Hawthorn, 3 g of Mu Xiang, 10 g of Yuan Rou, 12 g of Sheng Di, 15 g of He Shou Wu, 12 g of Tu Da Huang, and 12 g of Nu Zhen Zi. The herbs were decocted in water and taken in two warm doses daily, one dose per day. At third consultation, after taking the formula for over 10 doses, his epigastric discomfort further improved, and his appetite, mental state, and sleep also improved significantly. A follow-up blood test showed: RBC 3.4 × 10¹²/L, HGB 96 g/L, MCV 92 fL; the formula was adjusted and modified, and after taking traditional Chinese medicine for over 40 doses, the blood count returned to normal.

At fourth consultation, his condition remained stable, but five days ago he experienced epigastric discomfort, nausea, loose stools four times a day, and poor appetite due to an accidental dietary mistake. He came for a follow-up consultation, considering that his condition might be a combination of chronic gastritis and acute gastritis, and treatment was primarily based on traditional Chinese medicine. The herbal formula included: 6 g of Chen Pi, 12 g of Poria, 15 g of Forsythia Suspensa, 6 g of Banxia, 6 g of Jiao San Xian, 6 g of Cang Zhu, 6 g of Huang Lian, and 6 g of Mu Xiang. The herbs were decocted in water and taken in two warm doses daily, one dose per day, for a total of 5 doses.

At fifth consultation, his nausea and diarrhea had subsided, though he still experienced epigastric discomfort and poor appetite. A follow-up blood test showed: RBC 3.6 × 10¹²/L, HGB 100 g/L, MCV 94 fL; therefore, the formula was adjusted to include Xiangsha Liu Junzi Decoction combined with Banxia Xie Xin Tang, to enhance the functions of harmonizing the stomach, descending rebellious Qi, opening blockages, and relieving fullness. The herbs were decocted in water and taken in two warm doses daily, one dose per day.

After taking 10 doses, a follow-up blood test and bone marrow examination showed normal results, and after three years of follow-up, no recurrence was observed.

Primary Thrombocytopenic Purpura – Two Cases

Case 1: Peng ××, female, 27 years old, cook, first consulted on September 8, 1983. One year earlier, she began experiencing nosebleeds that occurred repeatedly, with scattered hemorrhagic spots all over her body, varying in size, some forming patchy purpura. Her menstrual flow was heavy and light in color, her face gradually became yellowish, accompanied by fatigue, dizziness, palpitations, low back pain, tinnitus, fear of cold, and spontaneous sweating. She underwent a bone marrow aspiration at the First Hospital of Lan, where she was diagnosed with idiopathic thrombocytopenic purpura. Her body temperature was 36.7°C, her blood pressure was 12/8 kPa (90/60 mmHg). Her face was yellowish, and small, scattered hemorrhagic spots were visible on her neck, anterior chest, and limbs, which did not blanch when pressed. The cardiac boundary was not enlarged, and a grade II systolic blowing murmur was audible in the apex area; lungs (-), liver not palpated, spleen was palpable 1.5 cm below the ribs, with platelet counts of 27,000/L, red blood cells 3.6 million/L, hemoglobin 10 g/L, white blood cells 5,600/L, neutrophils 72%, lymphocytes 28%. Bleeding time was 8 minutes, and clot formation was poor after 24 hours. Bone marrow examination showed normal megakaryocyte morphology with an increased number of megakaryocytes, but a significant reduction in platelet-forming megakaryocytes. Diagnosis: Idiopathic thrombocytopenic purpura. Traditional Chinese medicine diagnosis: Her tongue was thick and pale, with tooth marks, a slightly yellowish and greasy coating, and her pulse was deep, fine, and rapid, especially in the double inch regions. Combined with her yellowish complexion, fatigue, dizziness, palpitations, low back pain, tinnitus, and fear of cold, this manifested as deficiency of Spleen and Kidney Qi, where Qi fails to govern blood. Long-term Qi deficiency leads to dampness, blood stasis, and even fire. The treatment should focus on strengthening the spleen and kidneys, replenishing Qi and capturing blood, while also clearing heat, drying dampness, and harmonizing blood to resolve blood stasis. The formula used was Shenqi San Huang Tang with modifications: 10 g of Dang Gui, 20 g of Huang Qi, 6 g of Atractylodes Macrocephala, 15 g of Tu Da Huang, 3 g of Huang Lian, 10 g of Huang Qin, 3 g of Zhi Lu, 20 g of Bai Ti Li, 10 g of Yuan Rou, 10 g of Shan Yu, 10 g of Po Su Zi, and other herbs were decocted in water and taken once daily. After taking 10 doses, her systemic purpura and hemorrhagic symptoms improved significantly, and her dizziness, fatigue, fear of cold, and palpitations also improved. The formula was modified to remove Po Su Zi and Tu Si Zi, and after taking 21 doses, all her symptoms had subsided, her platelet count rose to 120,000/L, bleeding time and clot formation returned to normal, and bone marrow examination also returned to normal, with red blood cells at 480,000/L and hemoglobin at 14 g/L.

Case 2: Hua ×, female, 5 years old, first consulted on February 17, 1984. Six months earlier, after a cold, she developed nosebleeds and purpura all over her body. She was diagnosed with “idiopathic thrombocytopenic purpura” at a certain hospital. After treatment with hormones and other Western medications, her platelet count temporarily increased, but the purpura and nosebleeds continued to recur. She grew increasingly thin and pale, accompanied by fatigue, thirst, spontaneous sweating, poor appetite, constipation, and heart palpitations—sometimes with rectal bleeding. Her body temperature was 38.9°C, her blood pressure was 10.7/6.7 kPa (80/50 mmHg), her face was pale, and large and small hemorrhagic spots were visible on her anterior chest, back, and limbs, which did not blanch when pressed. The cardiac boundary was not enlarged, no murmurs were heard in any valve area, lungs (-), liver was palpable 2 cm below the xiphoid process, soft in texture without tenderness, and spleen was not palpated. Her platelet count was 17,000/L, red blood cells 460,000/L, hemoglobin 12 g/L, white blood cells 5,600/L, neutrophils 78%, lymphocytes 21%, eosinophils 1%, bleeding time was 6 minutes, clot formation was poor after 24 hours, and bone marrow examination showed normal megakaryocyte morphology, but reduced platelet-forming megakaryocytes. Traditional Chinese medicine diagnosis: Her tongue was red, with scattered ecchymoses, a slightly yellowish and greasy coating, and her pulse was deep, slippery, and rapid, especially in the double inch regions. Combined with her weight loss, pallor, fatigue, spontaneous sweating, poor appetite, thirst, palpitations, fever, and constipation, the condition was characterized by deficiency of both Qi and Blood—Qi fails to capture blood; when Qi is deficient, Yang becomes deficient, leading to dampness; when Blood is deficient, blood stasis occurs, and fire arises. The treatment should address both the root and the branch, using Shenqi San Huang Tang with modifications: 10 g of Dang Gui, 20 g of Huang Qi, 10 g of Atractylodes Macrocephala, 6 g of Licorice, 19 g of Dafu Ling, 10 g of Huang Qin, 3 g of Zhi Lu, 60 g of Bai Ti Li, 30 g of Sheng Shi, and 15 g of Xian He Cao. The herbs were decocted in water and taken once daily. After taking 5 doses, her fever subsided, her thirst ceased, her spontaneous sweating and fatigue lessened, and her systemic purpura and nosebleeds improved significantly. The formula was modified to remove Sheng Shi and Xian He Cao, and after taking another 22 doses, all her symptoms had subsided, returning her to a state similar to that of a healthy person. Her platelet count was 91,000/L, red blood cells 480,000/L, hemoglobin 14.5 g/L, white blood cells 6,200/L, neutrophils 71%, lymphocytes 28%, monocytes 1%. Bleeding time and clot formation after 24 hours were both normal. Bone marrow examination showed platelet-forming megakaryocytes approaching normal levels.

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Traditional Chinese Medicine Treatments for Critical and Severe Conditions

Case 1: Wang ××, male, 51 years old, worker, sought emergency treatment on August 6, 1982. Three days earlier, he had experienced severe upper abdominal pain, like a knife cut, radiating to his left chest, waist, shoulder, and back, accompanied by nausea and vomiting. His face turned pale, his limbs grew cold, and his blood pressure dropped. He was referred for consultation with a traditional Chinese medicine practitioner. Physical examination: body temperature was 37.8°C, pulse 102 beats/min, respiration 28 breaths/min, blood pressure 8.0/5.3 kPa (60/40 mmHg), pale complexion, distressed expression, confused consciousness, soft neck, no abnormalities heard in both lungs, cardiac boundary not enlarged, a grade II systolic blowing murmur audible in the apex area. The abdomen was slightly distended, with marked tenderness and mild rebound tenderness in the upper left quadrant of the abdomen; liver and spleen were not palpated, his limbs were cold, and pathological reflexes were absent. Laboratory tests showed: white blood cells 18,000/mm³, neutrophils 84%, lymphocytes 16%, amylase levels 1260 U (Somogyi method), amylase levels in urine 445 U (Winstow method). Diagnosis: Acute pancreatitis complicated by shock. Traditional Chinese medicine diagnosis: Tongue was red with a yellowish, thick, greasy coating, pulse was deep, fine, and rapid; constipation was present, along with severe chest and abdominal pain, pale face, cold limbs—all signs of yang excess within, yin trapped outside, with a real pattern in the Yangming腑, and a yin pattern causing extremity coldness; as heat increases, coldness deepens. The treatment should focus on clearing heat and resolving excess to treat the root cause, using Da Cheng Qi Tang with modifications: 10 g of Dahuang, 10 g of Mangxiao, 10 g of Zhishi, 10 g of Chai Hu, 10 g of Bai Shao, 6 g of Yuan Hu, 6 g of Chuan Lian Zi, 6 g of Hou Pu, 6 g of Huang Qin, and other herbs were decocted in water and taken once daily, with intravenous fluids and injections of penicillin and streptomycin. The next day, upon reevaluation: his abdominal pain had greatly diminished, his consciousness had cleared, and he passed large amounts of dark black, foul-smelling, viscous stool. His blood pressure was 13.3/10.7 kPa (100/80 mmHg), though he still experienced pain in the upper left abdomen, which worsened in episodes and radiated to his left chest, waist, and shoulder, accompanied by bitter taste in his mouth, dry throat, abdominal distension, intestinal rumbling, a tense, rapid pulse, and a red tongue with a yellowish, greasy coating. The condition was characterized by residual internal heat, with pathogenic factors residing in the Shaoyang meridian; the treatment should address both the exterior and interior, using Da Chai Hu Tang with modifications: 10 g of Chai Hu, 10 g of Huang Qin, 10 g of Zhishi, 10 g of Dahuang, 15 g of Bai Shao, 6 g of Chuan Lian Zi, 6 g of Huang Qin, 3 g of Mu Xiang, and other herbs were decocted in water and taken once daily, for a total of 6 doses. At the third consultation, his mental state had improved, his blood pressure was stable, his tongue coating had thinned, his pulse was tense, and only occasional dull pain persisted in the upper left abdomen. Amylase levels dropped from 1260 U to 60 U, and amylase levels in urine dropped from 445 U to 120 U. He continued taking Shu Gan Wan (produced by Henan Yucheng Pharmaceutical Factory), one pill morning and one pill evening, to support his recovery.

Case 2: Chen ××, male, 68 years old, retired worker, first consulted on April 7, 1983. One day earlier, he experienced chest tightness and coughing, followed suddenly by vomiting of bright red blood mixed with foam, with continuous bleeding throughout the day—total volume reaching half a bowl of sputum. He had been diagnosed with “bronchiectasis complicated by massive hemorrhage” at a certain hospital, with a history of chronic bronchitis, no history of tuberculosis, nor any history of heart disease or liver/gastric disorders. Physical examination: body temperature was 38°C, respiration 20 breaths/min, pulse 102 beats/min, blood pressure 13.3/8.7 kPa (100/65 mmHg). He was thin and pale, with clear consciousness, symmetrical chest, slightly barrel-shaped, with deformed intercostal spaces, clear percussion notes, deeper breathing on both sides, coarse respiratory sounds in both lungs, scattered dry rales, cardiac boundary not enlarged, no obvious murmurs in any valve area, A₂ > P₂, with A₂ slightly elevated. Abdomen was flat and soft, with no tenderness in the gastric region. Liver and spleen were not palpated, and ascites was absent. Chest X-ray showed markedly thickened lung markings, increased transparency, widened lung fields, indicating chronic bronchitis combined with emphysema and bronchiectasis. Laboratory tests showed: white blood cells 18,600/mm³, neutrophils 82%, lymphocytes 18%, ESR 2 mm/h. Diagnosis: Bronchiectasis, emphysema, and massive hemorrhage. Traditional Chinese medicine diagnosis: Tongue was red with a yellowish, thick, greasy coating, pulse was洪大 and rapid, constipation was present, with chest and diaphragm fullness, coughing, wheezing, and excessive phlegm, as well as foamy blood sputum. The condition was characterized by excess heat in the lung and stomach, with fire raging and forcing blood. The treatment should clear heat from the lung and stomach, cool the blood and stop the bleeding, using the Liangjie San with modifications: 10 g of Dahuang, 10 g of Mangxiao, 10 g of Forsythia Suspensa, 10 g of Huang Qin, 10 g of Shanzhi, 10 g of Baizhi, 10 g of Gou Qi, 10 g of Ju Hong, and other herbs were decocted in water and taken once daily (while administering 800,000 units of penicillin intramuscularly every 8 hours, and 0.5 g of streptomycin intramuscularly every 12 hours), for a total of 4 doses. At the second consultation, the bleeding had stopped, the tongue coating had thinned, though a yellowish, greasy coating remained, chest fullness and wheezing had lessened compared to before, and the sputum was still abundant, appearing as thick, yellow pus-like mucus, with diarrhea occurring 2–3 times a day, the stool being brownish-black, foul-smelling, and watery, with a tense, rapid pulse. The formula was modified to remove Mangxiao and Baizhi, and 5 additional doses were administered. At the third consultation, apart from chest fullness and wheezing, all symptoms had subsided, the pulse was tense and weak, and the tongue was pale with a thin, yellowish, greasy coating. He was instructed to take Mai Wei Di Huang Wan twice daily, one pill each time, to support his recovery.

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Severe Toxic Dysentery – Two Cases

Case 1: Chen ×, male, 21 years old, a middle school student. On February 16, 1969, at 14:00, he was admitted to the hospital after experiencing high fever, abdominal pain, coma, and convulsions for 2 hours. Around 7:00 a.m. that day, after getting up to wash and get ready, he felt abdominal pain and nausea, and despite taking one small bottle of Shidui Shui, which did not help, he also experienced high fever and chills. He soon fell into a coma, with occasional convulsions, and he had always been in good health. Physical examination: body temperature was 40.1°C, pulse 12 beats/min, respiration 120 breaths/min, blood pressure 14.7/10.7 kPa (110/80 mmHg), the patient was comatose, with convulsions occurring from time to time, and no jaundice, ecchymoses, rashes, or hemorrhagic spots were observed on his skin and mucous membranes. No obvious enlargement of the lymph nodes was noted, both pupils were slightly dilated, and the pupillary and nictitating reflexes were relatively sluggish. His throat was red, tonsils were I degree swollen, his neck was stiff, no murmurs were heard in either lung, the abdomen was slightly distended, with mild tenderness in the lower abdomen, liver not palpated, spleen not palpated, bowel sounds were diminished, shifting dullness was absent, knee tendon reflex was slightly heightened, and no pathological reflexes were present. Complete blood count: red blood cells 460,000/mm³, hemoglobin 89 g/L, white blood cells 12,300/mm³, neutrophils 80%, lymphocytes 18%, monocytes 1%; urinalysis (catheterization): yellow in color, acidic, no sugar, no protein, only a small amount of epithelial cells; fecal analysis (anal swab): mucus (+++), pus cells (+++), red blood cells (+), roundworm eggs 0–3/low magnification; cerebrospinal fluid: clear, transparent, Pankin’s test (-), cells (-). Diagnosis: toxic bacterial dysentery (acute form). Upon admission, routine rescue measures were taken for acute dysentery, including immediate administration of 50 mg of Diphenhydramine and 50 mg of Phenergan intramuscularly, followed by sub-hypothermia therapy. Additionally, 30 ml of 0.5% Furacilin suspension was administered via enema, 200 ml of 20% Mannitol was infused intravenously, 200 mg of Hydrocortisone, 1000 mg of Vitamin C, along with 400,000 units of penicillin every 6 hours, 0.5 g of streptomycin intramuscularly every 8 hours, and 0.5 g of chloramphenicol intramuscularly every 8 hours. After these treatments, his convulsions subsided somewhat, but his coma deepened. Around midnight, he developed tidal breathing, with unequal pupil sizes. Immediately, 1 mg of Atropine was injected into the saline solution via intravenous drip, once every 5 minutes; after more than 10 drips, respiratory failure did not improve significantly, and the family was notified that the patient was in “critical condition,” so Atropine therapy was discontinued, and traditional Chinese medicine was switched to “Xin Ding Tao Ren Cheng Qi Tang” (nasal feeding), administered in three doses via gastric tube, completed after 3 hours. After the medication was finished (around 3 a.m.), the patient expelled about 500 ml of mucus-like material through the anus, his breathing gradually became smoother, his pulse was stronger than before, though he remained in a deep coma. While continuing the aforementioned fluid therapy and antibiotic treatment, another dose of “Xin Ding Tao Ren Cheng Qi Tang” was administered via nasal feeding. During the feeding process, his consciousness gradually cleared, his breathing fully returned to normal, and later, the dosage of Dahuang and Mangxiao was reduced to 15 g, with the addition of Dang Gui 20 g, Bai Shao 15 g, and Shang Gui 4 g, one dose per day, for a total of 3 doses. The patient recovered. Example 2: Wang ××, female, 1.5 years old. She developed a fever for half a day and was admitted to the hospital after experiencing convulsions lasting 1 hour. The patient began experiencing fever that morning, crying and being restless, but her family did not notice the symptoms. One hour later, she suddenly had continuous convulsions, which terrified the family, leading them to seek emergency medical attention. Physical examination revealed a body temperature of 35.6°C, an irregular pulse, intermittent breathing, altered mental status, cyanosis of the face, clenched teeth, foaming at the mouth, intermittent convulsions that came and went, weak heart sounds with irregular rhythm, occasional pauses in breathing, and no moist or dry rales. Abdominal distension was present, bowel sounds were absent, liver and spleen were not palpated, and pathological reflexes were not elicited. A routine stool test (anal swab) showed mucus (+++) and pus cells (+++). Diagnosis: Toxic dysentery (acute type). Immediately, 500 ml of 10% glucose solution and 500 ml of 5% glucose saline were administered intravenously via scalp puncture, along with 3 mg of lobeline via intramuscular injection. Subsequently, 1 dose of “Xinzhu Tao Ren Cheng Qi Tang” was administered via nasal feeding (prescription: 15 g of rhubarb, 15 g of mirabilite, 10 g of peach kernel, 10 g of cinnamon twig, 5 g of licorice, 8 g of coptis, 5 g of wood fragrance, 10 g of scutellaria, 50 g of Portulaca oleracea, decocted in 1000 ml of water until 200 ml remained, then divided into three doses to be administered within 2 hours). After the medication was administered, the child’s convulsions stopped, and a large amount of mucous-like material was passed through the anus. Her breathing stabilized. That same day, another dose of “Xinzhu Tao Ren Cheng Qi Tang” was administered, divided into three doses. The next morning, the child’s condition improved significantly, her appetite returned somewhat, and the original formula was modified by removing rhubarb and mirabilite, adding Qinpi, Bai Shao, Dang Gui, and Shan Zha, resulting in a complete recovery and discharge.

Two Cases of Chronic Bronchitis

Case 1: Patient Gao, male, 67 years old, has suffered from wheezing for 10 years, accompanied by cough. His condition worsened after catching a cold half a month ago, with thin, clear sputum that was difficult to expectorate. Physical examination: T = 36.8°C, P = 88 beats/min, R = 30 breaths/min; BP = 18/10 kPa. The patient was alert, with cyanotic lips, a barrel-shaped chest, and hyperresonant percussion over both lungs. Auscultation revealed rapid breathing, with vesicular sounds audible at the lung bases. The tongue was thick and swollen, coated with white coating, and the pulse was floating and smooth. Laboratory tests showed WBC count of 11.2 × 10⁹/L, with neutrophils accounting for 0.78. Western medical diagnosis: ① Acute exacerbation of chronic bronchitis; ② Obstructive emphysema. Traditional Chinese Medicine diagnosis: Cold-dryness invading the lungs, with phlegm-heat obstructing the interior. Treatment should focus on warming and dispersing cold-dryness while moistening the lungs and resolving phlegm. The formula used was Xing Su San combined with Ma Xing Shi Gan Tang with modifications: 10 g of apricot kernels, 10 g of white peony root, 12 g of poria, 10 g of platycodon root, 3 g of schizandra fruit, 3 g of asarum, 6 g of dried ginger, decocted in water and taken once daily, divided into several doses. After administering this formula for more than 10 doses, the patient’s sputum production decreased, though he still experienced wheezing, which became more pronounced with physical activity. The tongue was pale with white coating, and the pulse was slippery. Asarum and raw gypsum were removed from the formula, and 6 g of sandalwood, 3 g of cinnamon, and 15 g of purple quartz were added. After continuing treatment for more than 20 doses, all symptoms disappeared.

Case 2: Patient Wang, female, 50 years old, has been suffering from cough and thick sputum for 1 month, accompanied by dry mouth and throat pain. Physical examination: T = 38°C, P = 90 beats/min, R = 28 breaths/min, BP = 16/10 kPa. The tonsils were enlarged at grade I, the chest was symmetrical, and bilateral lungs were auscultated with snoring sounds. The tongue was red with yellow coating, and the pulse was rapid and slippery. Laboratory tests showed WBC count of 16.2 × 10⁹/L, with neutrophils accounting for 0.82. Western medical diagnosis: Chronic bronchitis complicated by infection. Traditional Chinese Medicine diagnosis: Cold-dryness invading the lungs, with phlegm-heat accumulating internally. The formula used was Xing Su San combined with Ma Shi Gan Tang with modifications: 10 g of apricot kernels, 10 g of perilla leaves, 15 g of platycodon root, 10 g of citrus peel, 6 g of ephedra, 30 g of raw gypsum, 6 g of licorice, 15 g of tree bark, 15 g of mulberry bark, 15 g of honeysuckle, 15 g of forsythia, 15 g of dandelion, and 15 g of black sesame seeds. The formula was decocted in water and taken once daily, divided into several doses. After administering this formula for more than 10 doses, the patient’s sputum production significantly decreased, though he still felt dry mouth and itchy throat. The tongue was red with little coating, and the pulse was fine and rapid. Asarum, tree bark, mulberry bark, honeysuckle, and forsythia were removed from the formula, and 12 g of rehmannia, 12 g of xuan shen, 10 g of ophiopogon, 10 g of fritillaria, 20 g of pear skin were added. After continuing treatment for more than 10 doses, all symptoms disappeared.

A Case of Misdiagnosis and Correction in Tuberculous Peritonitis

In October 1982, a patient named Sun, female, 36 years old, an employee of Changfeng Factory, presented with abdominal pain and diarrhea for several months. The stools were thin and mucus-like, black in color, and occurred 6–7 times per day. Each time the abdomen hurt, the patient felt the urge to go to the bathroom, and she would have a loose stool once every morning. The abdominal pain was primarily located in the lower abdomen, with loss of appetite, good health, no feeling of coldness, but a sensation of coldness in the lower abdomen. Her pulse was deep, fine, and slippery, and her tongue was pale with a thin coating—she was diagnosed with deficiency of spleen and stomach due to cold, with dampness obstructing the middle burner. The treatment plan was to use Fuzi Lizhong Decoction combined with Pingwei Powder with modifications: 6 g of aconite, 10 g of codonopsis, 10 g of poria, 6 g of licorice, 10 g of poria, 10 g of Houpu, 6 g of tangerine peel, 10 g of bitter root, 10 g of salvia, 3 g of wood fragrance, 5 g of grass seed, 3 g of coptis, 10 g of citrus peel, 10 g each of Zhongxian and Huoxiang, 10 g of each of Huanglian and Juhua, decocted in water and taken once daily.

At the second visit, after taking the above medicine for 5 doses, the patient showed no improvement, and her symptoms remained unchanged. Upon further inquiry, it was learned that in addition to the aforementioned symptoms, she also experienced low-grade fever in the afternoon. Abdominal examination revealed significant tenderness in the right lower quadrant near the umbilicus, with referred pain in the ileocecal region. When asked about her medical history, she confirmed that the illness had lasted for six months. The erythrocyte sedimentation rate was subsequently measured: 73 mm/h, the pulse was tense and slippery, the tongue was pale red with a thin, greasy white coating. Western medical diagnosis: ① Intestinal tuberculosis, ② Tuberculous peritonitis. Traditional Chinese Medicine diagnosis: Damp-heat accumulating in the middle burner. The doctor apologized for having overlooked the examination due to busy medical duties and advised the patient to continue the treatment. The prescription was formulated as follows: 6 g of wu yao, 12 g of poria, 6 g of curcuma, 6 g of yuan hu, 10 g of abdominal skin, 6 g of dried ginger, 3 g of wood fragrance, 3 g of sandalwood, 6 g of fragrant needle, 6 g of tangerine peel, 10 g of angelica sinensis, 6 g of atractylodes, 6 g of Houpu, 10 g of poria, 10 g of citrus peel, 10 g of plantain, 6 g of aconite, 3 g of coptis, 10 g of bitter root, 15 g of white peony root. After taking this formula for 10 doses, the patient’s sputum production significantly decreased, though she still felt dry mouth and throat itching. The tongue was red with little coating, and the pulse was fine and rapid. Asarum, tree bark, mulberry bark, honeysuckle, and forsythia were removed from the formula, and 12 g of rehmannia, 12 g of xuan shen, 10 g of ophiopogon, 10 g of fritillaria, 20 g of pear skin were added. After continuing treatment for more than 10 doses, all symptoms disappeared.

Throughout this case, it became clear that doctors should maintain a down-to-earth and pragmatic approach to medical practice. Doctors should not only summarize successful cases but also learn from failures to improve their own practices.

Three Cases of Atrophic Gastritis

Case 1: Huang ××, male, 50 years old, a cadre. Chief complaint: Burning pain in the epigastric region for 10 years, worsening over the past year. Every time he consumed alcohol or ate improperly, the pain intensified, accompanied by burning in the stomach, dry mouth and a desire to drink cold beverages, a preference for cold drinks and cold foods, constipation, a red tongue with a slightly yellow coating, and a tense, rapid pulse. Physical examination: Tenderness in the left subcostal region. Gastroscopy revealed superficial gastritis, atrophic changes in the antral region, with mild intestinal metaplasia. Diagnosis: Stomach fire excess type (classified as Type B).

Prescription: Pinellia, fresh ginger, scutellaria, coptis, North Sandaishen, jujube, wood fragrance, grass seed, licorice.

After administering this formula for more than 10 doses, the symptoms eased, and after another 10 doses, the symptoms disappeared. To date, the patient has not experienced epigastric pain for 6 years.

Case 2: Wang ×, male, 50 years old, a cadre. Chief complaint: Abdominal distension and fullness for 10 years, worsening over the past 6 months. Symptoms became more pronounced in the evening, accompanied by chills and a feeling of coldness in the back, fatigue, poor appetite, loose stools, a pale tongue with a thin white coating, and a tense, fine pulse. Physical examination: Distension and fullness in the left subcostal region. Gastroscopy revealed mottled mucosa in the gastric body. Diagnosis: Atrophic gastritis with severe intestinal metaplasia. Diagnosis: Spleen and stomach qi deficiency type (classified as Type A).

Prescription: Wood fragrance, amomum villosum, codonopsis, poria, pinellia, poria, tangerine peel, galangal, fragrant needle, Chinese yam, three types of medicinal herbs, licorice.

After administering this formula for 7 doses, the symptoms improved significantly, with noticeable relief from abdominal distension and fullness, and other symptoms also improved. Subsequently, the treatment plan was further adjusted based on the patient’s condition.

Case 3: Yang ××, male, 23 years old, a worker. Chief complaint: Abdominal distension and pain for 2 years, accompanied by acid reflux. Both abdominal distension and pain persisted, making it difficult for him to eat hot or cold foods, with acid reflux and discomfort, chills and a feeling of coldness, fatigue, and stools that were either dry or loose, a pale tongue with a thin yellow coating, and a deep, fine pulse. Physical examination: Tenderness in the left subcostal region. Gastroscopy revealed mottled mucosa in the antrum and gastric body. Diagnosis: Atrophic gastritis with severe intestinal metaplasia. Diagnosis: Cold-heat conflict type (a mixture of Types A and B).

Prescription: Wood fragrance, amomum villosum, codonopsis, poria, poria, tangerine peel, citrus peel, houpo, pinellia, scutellaria, coptis, daphne, dan-shen, prepared milk, licorice.

After administering this formula for 10 doses, all reported symptoms were alleviated. Continued administration of the formula yielded satisfactory results.

Two Cases of Rheumatic Heart Disease

Case 1: Patient Zhang, female, 51 years old. She had been experiencing shortness of breath for over 10 years, worsening over the past 5 days, accompanied by palpitations, chest tightness, fatigue, and increased symptoms with physical activity, making it difficult for her to care for herself. She sought medical attention on October 10, 1996. Physical examination: The patient had a mitral face, sat upright with breathing, a pulse rate of 82 beats/min, a cardiac boundary that had expanded to the left, and auscultation revealed varying heart sounds, a heart rate of 90 beats/min, irregular rhythm, and a harsh, blowing murmur of Grade III during systole in the apex area. Mild edema was present in both lower limbs, the tongue was thick and large, with a thin white coating, and the pulse was weak and slow. Western medical diagnosis: ① Rheumatic heart disease (mitral regurgitation); ② Heart failure; ③ Atrial fibrillation. Traditional Chinese Medicine diagnosis: Phlegm-heat obstruction. The formula used was Ling Gui Shu Gan Tang combined with Zhen Wu Tang with modifications: 15 g of poria, 12 g of cinnamon twig, 10 g of poria, 6 g of licorice, 6 g of aconite, 6 g of dried ginger, 10 g of white peony root, 20 g of rehmannia, 20 g of salvia, 20 g of bitter root. After administering this formula for more than 10 doses, her shortness of breath and sitting-up breathing lessened, though she still experienced palpitations and chest tightness, with a pulse rate of 74 beats/min, a heart rate of 84 beats/min, irregular rhythm, a pale tongue with a thin white coating, and a weak pulse. Therefore, the aconite and white peony root were removed from the formula, and 10 g of egg yolk, 4 jujubes, 10 g of codonopsis, 20 g of ophiopogon, and 10 g of almond kernels were added. After administering another 15 doses, her symptoms improved. Subsequently, using Ling Gui Shu Gan Tang as the main treatment, with adjustments, all symptoms disappeared, and she was able to take care of herself completely. Her pulse rate was 72 beats/min, her heart rate was 72 beats/min, and her heart rhythm was more regular than before.

Case 2: Patient Lei, male, 30 years old. He had been experiencing shortness of breath for 5 years, often worsening after catching a cold or after exertion, accompanied by intermittent coughing and pink frothy sputum, fatigue, and pain in both knee joints. He visited the clinic in October 1995, where wheezing was audible in both lungs, the cardiac boundary had expanded to the left, and auscultation revealed clear heart sounds, a heart rate of 80 beats/min, regular rhythm, and a booming murmur of Grade III during diastole in the apex area. The tongue was pale with a thin yellow coating, the pulse was floating and rapid, and a chest X-ray showed enlargement of the left atrium. Western medical diagnosis: Rheumatic heart disease (mitral stenosis). Traditional Chinese Medicine diagnosis: Phlegm-fluid obstruction, with lung dysfunction. Treatment focused on warming yang, promoting water metabolism, and opening the lungs to relieve asthma. The formula used was Ling Gui Shu Gan Tang combined with Ma Xing Shi Gan Tang with modifications: 15 g of poria, 12 g of cinnamon twig, 10 g of poria, 6 g of licorice, 15 g of lespedeza, 4 jujubes, 15 g of honeysuckle, 15 g of forsythia, 6 g of ephedra, 10 g of apricot kernels, 30 g of raw gypsum. After administering this formula for more than 20 doses, his shortness of breath lessened, and the coughing and sputum production disappeared; however, he still experienced joint pain and a low-grade fever. Therefore, the formula was changed to Ling Gui Shu Gan Tang combined with Gui Zhi Shaoyao Zhi Mu Tang with modifications: 12 g of cinnamon twig, 12 g of white peony root, 10 g of Zhi Mu, 10 g of poria, 10 g of Chuan Cao Wu each (first decocted for 60 minutes), 12 g of Fang Feng, 6 g of ephedra, 6 g of licorice, 4 jujubes, 15 g of poria, 15 g of tree bark. After administering these formulas for more than 20 doses, his joint pain disappeared, and his erythrocyte sedimentation rate returned to normal. He continued treatment with Ling Gui Shu Gan Tang with modifications for one month, and all symptoms resolved. A follow-up chest X-ray showed that the left atrium had decreased in size compared to the previous scan.

Three Cases of Hair Loss

Case 1: Li ××, male, 21 years old, from Hebei Province, a worker, first seen in early September 1983. Four years earlier, he had experienced hair loss, initially affecting the corners of both forehead areas, gradually extending toward the crown. Two years ago, aside from a small amount of sparse hair remaining on the occipital region, most of his hair had fallen out; his scalp had an oily sheen, he felt itchy, and occasional small flakes of dandruff fell off. He had a history of duodenal bulb ulcer, and recently he still experienced stomach pain. Physical examination: Moderate nutrition, good development, no abnormalities found in the heart or lungs; abdomen was flat, neither the spleen nor the liver were palpated; most of his hair had fallen out, his scalp was shiny and oily, with few wrinkles. Western medical diagnosis: Seborrheic alopecia. Traditional Chinese Medicine diagnosis: Deep, fine pulse, pale tongue with a thin white coating, self-reported fatigue and poor appetite, discomfort in the epigastric region. The condition was characterized by spleen and stomach deficiency, insufficient mid-level qi, and imbalance in the source of blood nourishment; early baldness was observed. The treatment should focus on strengthening the spleen and stomach, nourishing the spleen and stomach, and replenishing nutrients and blood. The formula used was Formula No. 1, one dose daily, and side-bark leaves were decocted in water and used to wash his hair once a day.

After 20 doses of medication, new hair resembling soft fuzz began to grow across his entire head; after another 20 doses, the hairs turned dark and thicker. Three months later, his head was fully covered in dark hair, indistinguishable from others.

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Case 2: Xu ×, female, 16 years old, from Gansu Province, a middle school student, first seen in early March 1978. One year earlier, she had experienced hair loss, initially affecting the occipital region and the entire crown of her head. Physical examination: Nutrition was adequate, development was good, no abnormalities were found in the heart or lungs, abdomen was flat, neither the liver nor the spleen were palpated. The forehead and crown were completely bald, with a smooth scalp without wrinkles. Western medical diagnosis: Alopecia areata. Traditional Chinese Medicine diagnosis: Tense, fine pulse, slightly weak in the second finger, red tongue with a thin white coating. She reported occasional bitterness in her mouth and discomfort in her ribs, dizziness and lower back discomfort, and dark menstrual flow with abdominal pain. The condition was characterized by liver stagnation and kidney deficiency, with blood deficiency, leading to hair loss. The treatment should focus on soothing the liver, benefiting the kidneys, and nourishing qi and blood. The formula used was Formula No. 2, one dose daily, paired with 1 dose of Formula No. 3, two pills daily, dissolved in warm water and taken twice. After 3 months, after 20 doses of the formula and 1 dose of the pill, the areas of hair loss had begun to grow dark hair, indistinguishable from others, and after 3 years of follow-up, there were no recurrences.

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Case 3: Ning ××, male, 38 years old, from Gansu Province, first seen in early April 1983. Half a month earlier, due to marital discord at home and a heavy emotional state, he noticed a patch of hair loss on the occipital region, which gradually expanded over the course of a week. Within half a month, he lost all hair on his scalp and eyebrows, leaving his scalp shiny and feeling slightly itchy. Physical examination: Face was pale, nutrition was poor, no abnormalities were found in the heart or lungs, abdomen was flat, neither the liver nor the spleen were palpated. Western medical diagnosis: Alopecia areata. Traditional Chinese Medicine diagnosis: Deep, fine pulse, red tongue with a light white coating, self-reported fatigue, dry mouth, deficiency, with qi and yin both damaged, and blood deficiency, leading to hair loss. The treatment should focus on nourishing qi and yin, greatly replenishing nutrients, and using Formula No. 3, 1 dose daily, paired with 2 pills daily, dissolved in warm water; additionally, side-bark leaves were decocted in water with 3 g of fresh ginger, and 1 dose was washed once a day. On a certain day in December 1983, the patient’s head was covered in dark hair, with both eyebrows and beard fully grown, indistinguishable from others. He said he had taken the herbal formula for 45 doses, the pill for 2 doses, and also used the herbal wash for 2 months. In April 1985, he was contacted for a follow-up visit, and no recurrence was observed.

Five Cases of Internal Injury Headaches

Case 1: Patient Zhao, male, 70 years old. He had a history of hypertension for over 10 years, and had been experiencing headaches for 3 years, accompanied by trembling in both hands, blurred vision, and numbness in his limbs. His blood pressure was 21/16 kPa, his tongue was red with little coating, and his pulse was tense and rapid. Treatment should focus on calming the liver, lowering yang, and reversing the upward movement of qi; the formula used was Qiju Di Huang Tang with modifications: 10 g of goji berries, 10 g of chrysanthemum, 12 g of rehmannia, 10 g of Chinese yam, 6 g of cornelian cherry, 12 g of poria, 10 g of alisma, 10 g of paeonia, 20 g of bitter tea, 10 g of dried lotus leaf, 15 g of raw oyster shell, 15 g of raw turtle shell, 15 g of raw turtle shell, 10 g of ophiopogon, 10 g of egg yolk, 10 g of hemp seeds, 6 g of ligusticum, 6 g of angelica, 3 g of asarum, after administering this formula for 20 doses, his headaches, tremors in both hands, and blurred vision all subsided. His blood pressure was 20/14 kPa; the formula was modified by removing ligusticum, angelica, and asarum, and adding 15 g of raw ochre, 15 g of raw white peony root, and 20 g of melilot. After continuing treatment for more than 20 doses, his symptoms disappeared, and his blood pressure was 20/12 kPa.

Case 2: Patient Zhang, female, 68 years old. She had been experiencing headaches for 3 years, accompanied by dizziness, tinnitus, chest tightness, and memory impairment; she had tried medications like Weinaoluotong without improvement. Her tongue was pale with a thin white coating, her pulse was tense and sluggish, her blood pressure was 18/13 kPa, and laboratory tests showed elevated blood viscosity. Brain CT showed atrophy, and ECG indicated myocardial ischemia. Western medical diagnosis: ① Cerebral arterial sclerosis-related headache; ② Coronary heart disease. Traditional Chinese Medicine diagnosis: Blood stasis headache. Treatment should focus on activating blood circulation and resolving stasis. The formula used was Xue Fu Zhu Yu Tang with modifications: 10 g of peach kernel, 6 g of safflower, 10 g of angelica, 10 g of rehmannia, 6 g of ligusticum, 10 g of red peony, 10 g of bupleurum, 20 g of platycodon root, 15 g of achillea, 10 g of citrus peel, 6 g of angelica, 3 g of asarum, 10 g of frankincense, 10 g of salvia, 6 g of angelica, 6 g of plantain, 20 g of knotweed, and 10 g of cistanche. After administering this formula for more than 10 doses, her headaches and chest tightness significantly reduced, though she still felt dizziness and tinnitus. Therefore, the formula was modified by removing frankincense and salvia, and adding 15 g of goji berries, 10 g of chrysanthemum, and 15 g of Acorus calamus, and continuing treatment for more than 30 doses. Follow-up blood viscosity and ECG both returned to normal. Her blood pressure dropped to 16/12 kPa.

Case 3: Patient Guo, male, 51 years old. He had suffered from Meniere’s syndrome and chronic gastritis for 3 years; now he experienced headaches that worsened with movement, accompanied by nausea, poor appetite, abdominal distension and fullness, and frequent insomnia and vivid dreams. His tongue was thick and large, with a pale white coating, and his pulse was slippery. His blood pressure was 16/10 kPa. Treatment should focus on warming the middle burner, resolving phlegm, and reversing the upward movement of qi. The formula used was: 10 g of wu yu, 10 g of codonopsis, 6 g of dried ginger, 6 g of licorice, 30 g of alisma, 3 g of schizandra, 10 g of Chinese yam, 10 g of angelica, 10 g of round flesh, 15 g of rotundiflorum, 20 g of raw oyster shell, 6 g of pinellia, 6 g of angelica, 3 g of asarum, and 6 g of plantain. After administering this formula for more than 10 doses, his headaches lessened, his sleep improved, though he still felt nauseous, had poor appetite, and experienced abdominal distension and fullness; his tongue was pale with a thick white coating, and his pulse was slippery. Therefore, treatment should focus on nourishing qi and strengthening the spleen, resolving phlegm and reversing the upward movement of qi. The formula used was Xiang Sha Liu Jun Zi Tang with modifications: 3 g of wood fragrance, 3 g of amomum villosum, 10 g of codonopsis, 10 g of poria, 12 g of licorice, 6 g of pinellia, 6 g of tangerine peel, 6 g of plantain, 30 g of alisma, 10 g of rotundiflorum, 20 g of raw oyster shell, 6 g of ligusticum, 6 g of angelica, 3 g of asarum, 6 g of plantain, 6 g of plantain, 6 g of knotweed, and 20 g of cistanche. After continuing treatment for more than 20 doses, all symptoms were alleviated.

Case 4: Patient Wang, female, 32 years old. Her headaches worsened after exertion, accompanied by insomnia, vivid dreams, forgetfulness, fatigue, soreness in the lower back and knees, and excessive vaginal discharge. Her blood pressure was 12/8 kPa, her tongue was pale with little coating, and her pulse was deep and fine. Western medical diagnosis: ① Hypotension; ② Menstrual irregularities. Treatment should focus on nourishing qi and blood. The prescription was: 30 g of astragalus, 10 g of angelica, 10 g of codonopsis, 10 g of poria, 12 g of licorice, 3 g of wood fragrance, 10 g of round flesh, 6 g of farmland, 12 g of longan, 15 g of raw oyster shell, 15 g of cuttlefish bone, 10 g of eucommia, 30 g of raw barley, 15 g of epimedium, after administering this formula for more than 10 doses, her vaginal discharge decreased, the soreness in the lower back and knees disappeared, and her headaches eased. Therefore, eucommia, raw barley, and epimedium were removed from the formula, and 6 g of ligusticum, 6 g of angelica, 3 g of asarum were added; after continuing treatment for 7 doses, all symptoms were alleviated.

Case 5: Patient Qiu, male, 38 years old, had headaches of unknown cause for 2 years, which worsened recently after exposure to external factors, accompanied by chills, general body aches, and a dry throat. His blood pressure was 16/10 kPa, his tongue was pale with a thin white coating, and his pulse was floating. Western medical diagnosis: ① Vascular-neural headache; ② Common cold. Treatment should focus on dispersing wind and releasing exterior pathogens, while clearing heat inside; the formula used was: 10 g of qianghuo, 12 g of fangfeng, 6 g of cangzhu, 6 g of ligusticum, 6 g of angelica, 3 g of asarum, 12 g of rehmannia, 10 g of cinnabar, 6 g of licorice, 6 g of jingjie, 6 g of ephedra. After taking the medicine for 3 doses, his chills and general body aches disappeared, and his headaches lessened. The formula was modified by removing rehmannia, jingjie, and ephedra, and adding 10 g of angelica, 10 g of rotundiflorum, 12 g of chrysanthemum, and 10 g of ophiopogon; after administering another 10 doses, all symptoms were alleviated.

Three Cases of Diabetes

Example 1: Li ××, female, 52 years old, housewife. She was first seen in early June 1983. Since 1972, the patient had been diagnosed with positive urine glucose, often experiencing dry mouth and frequent urination. She was treated at a local hospital for diabetes and took medications such as Jiangtangling and D₈60; her condition fluctuated over time. In recent years, her condition has worsened compared to previous years, with fasting blood glucose often ranging between ±~+++. One month ago, she visited the clinic due to an upper respiratory tract infection that exacerbated her condition. Her symptoms included excessive thirst, frequent drinking, spontaneous sweating, fatigue, palpitations, and hunger. She also experienced frequent urination and large volumes of urine. Physical examination revealed a body temperature of 37°C, a flushed face, no jaundice of the sclera, no ulcers or purulent lesions on the skin or mucous membranes throughout the body. Lung sounds were rough, with no dry or moist rales heard. The heart was normal in size, with no murmurs auscultated in the valve areas. Abdomen was flat, liver and spleen were not palpated, and there were no abnormalities in the limbs or spine. Laboratory tests showed hemoglobin levels of 14.5 g/L, red blood cell count of 5.2 million/L, platelet count of 96,000/L, white blood cell count of 9,000/L, with neutrophils accounting for 76%, lymphocytes 23%, and mononuclear cells 1%. Urine glucose was (+++), ketone bodies were negative, fasting blood glucose was 450 mg, blood ketone bodies were 5 mg, and postprandial blood glucose 2 hours later was 620 mg. CO₂-CP was 58, urea nitrogen was 16 mg. Western medical diagnosis: diabetes. Traditional Chinese medicine diagnosis: pulse was strong and rapid, tongue was red with a yellowish greasy coating, accompanied by excessive thirst and frequent urination, spontaneous sweating, and fatigue. The diagnosis was characterized by excess Yang fire in the Yangming meridian; the treatment should focus on clearing heat, reducing fire, and nourishing qi and yin. The formula used was Ren Shen Bai Hu Tang with additions: 30 g of raw gypsum, 6 g of Zhi Mu, 10 g of Shan Yao, 10 g of Gan Cao, 10 g of Dang Shen, 10 g of Mai Dong, 10 g of Wu Wei Zi, 6 g of Huang Lian, and 10 g of Hua Fen. The herbs were decocted in water and taken once daily. After taking 10 doses, all symptoms disappeared, the patient’s mental state returned to normal, the pulse became firm and the tongue color less red, urine glucose was negative, fasting blood glucose was 140 mg, and postprandial blood glucose was 260 mg. The formula was adjusted to remove Huang Lian and Hua Fen, adding 10 g of Sheng Di, and reducing the amount of raw gypsum to 20 g. After continuing to take the formula for 30 doses, the patient’s urine glucose began to fluctuate again between + and ++ due to a cold, with occasional symptoms of thirst and frequent urination. Therefore, the formula was modified by adding 6 g of Huang Lian and 10 g of Hua Fen, and increasing the amount of raw gypsum to 30 g. After taking another 10 doses, the patient’s thirst and frequent urination subsided, urine glucose was negative, fasting blood glucose was 120 mg, and postprandial blood glucose was 190 mg. The patient was advised to regularly take Gui Fu Ba Wei Wan. Two years later, during follow-up visits, the patient was back to normal—urine glucose was negative, fasting blood glucose and postprandial blood glucose were both within the normal range.

Example 2: Zhao ×, male, 29 years old, teacher. He was first seen in early March 1986. Five years earlier, he developed diabetes and had undergone various treatments with unsatisfactory results. He had taken Yu Quan Wan, Jiangtangling, You Jia Tang, and had even been hospitalized for insulin injections; his urine glucose remained consistently between + and ++++. He came to our outpatient clinic through a friend’s recommendation. His symptoms included frequent and abundant urination, fatigue, spontaneous sweating, dizziness, tinnitus, lower back pain, leg discomfort, and feeling cold. Physical examination revealed a body temperature of 36°C, a yellowish complexion, no ulcers or purulent infections on the skin or mucous membranes throughout the body; no abnormalities were found in the heart or lungs, and neither the liver nor the spleen were palpated. Laboratory tests showed a blood cell count of 11,000/L, with neutrophils accounting for 72% and lymphocytes 28%; urine glucose was (+++), ketone bodies were negative, fasting blood glucose was 360 mg, blood ketone bodies were 3 mg, postprandial blood glucose was 520 mg, and urea nitrogen was 16 mg. Western medical diagnosis: diabetes. Traditional Chinese medicine diagnosis: pulse was deep, tense, and fine, with a weak radial pulse, a thickened tongue with tooth marks, a thin white coating, accompanied by dizziness, lower back pain, spontaneous sweating, and chills. The diagnosis was characterized by kidney yang deficiency; the treatment should focus on warming and tonifying kidney yang. The formula used was Gui Fu Ba Wei Wan with additions: 10 g of Sheng Di, 6 g of Shan Yu, 10 g of Shan Yao, 6 g of Dan Pi, 12 g of Fuling, 10 g of Ze Xie, 10 g of Rou Gui, 6 g of Fu Pian, 10 g of Wu Wei Zi, 3 g of Huang Lian, and 10 g of Hua Fen. The herbs were decocted in water and taken once daily. After taking 10 doses, the patient’s symptoms improved significantly; urine glucose dropped to (+), fasting blood glucose was 140 mg. To this formula, 30 g of Huang Qi were added; after continuing to take the formula for 30 doses, all symptoms were completely resolved, urine glucose was negative, fasting blood glucose was 100 mg, and postprandial blood glucose was 180 mg. By the autumn of 1989, the patient’s condition was stable, and no further recurrences occurred.

Example 3: Bai ××, male, 61 years old, worker. He was first seen in early February 1981, having suffered from diabetes for 13 years. Recently, he had experienced weight loss, bone heat, and hot flashes in the five internal organs, along with thirst, frequent drinking, dark red and bitter urine, constipation, and joint pain throughout his body. He had been hospitalized multiple times, taking Yu Quan Wan, Jiangtangling, and D₈60 for long periods, and had even received multiple insulin injections during hospitalization, with the highest dose reaching 80 units per day (regular insulin). Three months ago, he underwent an ophthalmological examination due to blurred vision, which revealed bilateral senile cataracts. Physical examination revealed a body temperature of 36.8°C, a pulse rate of 92 beats per minute, blood pressure of 24/13.3 kPa (180/100 mmHg), a dark complexion, weight loss, bad breath, and no ulcers or infected foci on the skin or mucous membranes throughout the body. Lung sounds were rough, with no dry or moist rales heard; the heart was slightly enlarged to the left, with P₂ > A₂, A₂ being enhanced, and a grade II systolic blowing murmur audible in the apex area. Abdomen was flat, liver and spleen were not palpated, and there were no deformities in the limbs or spine. Laboratory tests showed hemoglobin levels of 10.2 g/L, red blood cell count of 352,000/L, platelet count of 120,000/L, white blood cell count of 1,000/L, with neutrophils accounting for 79% and lymphocytes 21%. Urine glucose was (+++), ketone bodies were weakly positive, fasting blood glucose was 190 mg, blood ketone bodies were 8 mg, postprandial blood glucose was 580 mg, urea nitrogen was 20 mg, CO₂-CP was 65, blood cholesterol was 270 mg, lipoproteins were 1,100 mg, triglycerides were 200 mg, and fundus arteriosclerosis was grade II. Western medical diagnosis: ① diabetes, ② hypertension with arteriosclerosis, ③ bilateral cataracts. Traditional Chinese medicine diagnosis: tongue was red with little fluid and some bruising, coated with a thick yellowish greasy coating, pulse was tense and rapid, combined with previous symptoms. The diagnosis was characterized by chronic illness leading to blockages in the channels, generating heat and burning fluids; the treatment should focus on activating blood circulation, resolving stasis, clearing heat, and eliminating dampness. The formula used was Zeng Ye Tang with additions: 12 g of Sheng Di, 10 g of Yuan Shen, 10 g of Mai Dong, 10 g of Chi Shu, 6 g of Chuan Xiong, 3 g of Hong Hua, 10 g of Jiang Xiang, 20 g of Dan Shen, 6 g of Dan Pi, 10 g of Ge Gen, 6 g of Zhi Mu, 6 g of Huang Bo, 6 g of Cang Zhu, 6 g of Huang Lian, 10 g of Hua Fen, and 3 g of Ren Shen. The herbs were decocted in water and taken once daily. When the patient retired and returned to his hometown to continue the formula, in September 1983, he visited the clinic, saying that he had continued to take the formula regularly due to its effectiveness, having taken more than 200 doses. All of his previous symptoms had disappeared, his physical strength had recovered, and he was able to participate in ordinary work. Urine glucose was negative, fasting blood glucose was 100 mg, postprandial blood glucose was 170 mg, triglycerides were within the normal range, blood pressure was 20/12 kPa (150/90 mmHg). He was advised to continue taking the formula, adding one pill of Gui Fu Ba Wei Wan daily. In March 1985, when he was visited again, all symptoms had completely resolved, and both urine glucose and blood glucose were normal.

Case Study: Chronic Pancreatitis with Gallstone Disease

A 26-year-old male patient was admitted to the hospital on August 26, 1963, due to severe upper abdominal pain. About 15 minutes before admission, he experienced sharp, continuous pain in the upper abdomen, radiating to the waist, back, left chest, and left shoulder, accompanied by nausea and vomiting. Multiple injections of atropine were ineffective. He had a history of right upper quadrant pain, and in 1960, a cholecystography revealed gallstones.

Physical examination: body temperature was 38°C, blood pressure was 10.7/8.0 kPa (80/60 mmHg), facial skin was pale, the patient was in a passive position, the upper abdomen was distended, soft to the touch, with significant tenderness, particularly in the left upper quadrant, accompanied by rebound tenderness. Bowel sounds were diminished, and no gas or stool had passed in the past 24 hours. The liver, spleen, and gallbladder were not palpated; Moley’s sign was negative, and there were no abnormalities in the skin, ears, heart, or lungs. Laboratory tests showed a white blood cell count of 13,600/mm³, with neutrophils accounting for 85%, acidophiles 2%, alkalophiles 1%, lymphocytes 11%, and mononuclear cells 1%; serum amylase was 524 U (Somogyi method), urinary amylase (Wina-LOW method) was 256 U, blood glucose was 120 mg, blood calcium was 8 mg, and urine glucose was negative. Diagnosis: acute pancreatitis. The patient was treated with sedatives, anti-inflammatory drugs, antispasmodics, and fluid resuscitation, but the upper abdominal pain persisted and radiated to the lower back, intensifying after meals and when hungry. More than two months after onset, the patient developed chronic diarrhea, with 7–8 bowel movements per day, resulting in foul-smelling, watery stools. Laboratory tests showed fat droplets in the stool (+++), urinary amylase 64 U, blood amylase 226 U, blood glucose 125 mg, urine glucose was negative, and the glucose tolerance test curve was elevated. The duodenal drainage contained small amounts of cholesterol crystals in the bile. Cholecystography revealed a negative stone shadow measuring 2 cm × 3 cm. Diagnosis: chronic pancreatitis with gallstones.

On November 2, 1963, the patient began treatment based on traditional Chinese medicine diagnosis. Examination revealed a tense, rapid pulse, a white, greasy tongue coating, persistent dull pain in the chest and epigastrium, radiating to both flanks, dizziness, fatigue, and shortness of breath. The diagnosis was characterized by stagnation of liver and gallbladder qi, with wood overactive and earth deficient; the treatment should focus on soothing the liver and promoting bile flow, strengthening the spleen to eliminate dampness, and regulating qi to relieve pain. The proposed formula was as follows:

Chai Hu 18 g, Dang Gui 9 g, Hang Shu 6 g, Bai Zhu 9 g, Fu Ling 9 g, Zhi Ke 4.5 g, Yu Jin 4.5 g, Xiang Fu 4.5 g, Qing Pi 3 g, Fo Shou 6 g, Dan Shen 9 g, Tan Xiang 3 g, Sha Ren 13 g, Jin Ling Zi 6 g, Qian Yin Cao 30 g, Gan Cao 6 g. The herbs were decocted in water and taken once daily. After taking 2 doses, the pain in both flanks gradually subsided, the bitter taste in the mouth and dry throat were relieved, and the chest and epigastrium still felt distended, radiating to the left shoulder. The patient preferred to be massaged and warmed, and the diarrhea decreased to 3–4 bowel movements per day, with yellow, watery stools. The tongue coating was white and greasy, the pulse was tense and fine; the condition still indicated liver-spleen disharmony and insufficient middle qi. The treatment should focus on soothing the liver and stomach, and replenishing qi and benefiting blood. The following formula was proposed:

Dang Shen 10 g, Huang Qi 12 g, Gui Shen 9 g, Sheng Ma 3 g, Chai Hu 6 g, Gan Cao 6 g, Yu Jin 6 g, Nei Jin 6 g, Huang Qin 6 g, Zhi Ke 6 g, Bai Zhu 9 g, Bai Shu 12 g, Qian Yin Cao 30 g. The herbs were decocted in water and taken once daily. After using the formula for 73 doses, the patient’s symptoms greatly improved. On March 25, 1964, cholecystography revealed that the stone shadows had disappeared. Further examination showed a weak, fine pulse, combined with dull pain in the chest and epigastrium, and loose, watery stools—this indicated qi and blood deficiency, liver stagnation, and spleen deficiency. To address these conditions, the treatment focused on strengthening the spleen and stomach while regulating qi and soothing the liver. The following formula was proposed:

Dang Shen 12 g, Bai Zhu 9 g, Huang Qi 20 g, Dang Gui 10 g, Bai Shu 9 g, Fu Ling 12 g, Qing Pi 6 g, Yu Jin 6 g, Mu Xiang 6 g, Jiang Xiang 3 g, Fo Shou 3 g, Dan Shen 15 g, Sha Ren 3 g, Nei Hu 6 g, Bai Ti Li 10 g, Pei Lan 10 g. The herbs were decocted in water and taken once daily. After taking 95 doses, the abdominal pain and chest tightness disappeared, the diarrhea stopped, appetite increased, energy levels rose, and the patient was discharged in good health. Follow-up visits over the next 14 years showed no recurrence.

Note: During the acute phase of this disease, comprehensive Western medical treatment was effective; however, as the condition progressed to chronic stage, traditional Chinese medicine treatment was employed. Although the treatment course was relatively long, it ultimately led to the expulsion of gallstones and the recovery from chronic pancreatitis. Although traditional Chinese medicine does not have a specific term for this condition, based on the diagnosis, it is considered a case of liver qi stagnation and spleen-gastric qi deficiency. Therefore, both the first and second formulas were based on the general formula Xiaoyao San, which focuses on soothing the liver and strengthening the spleen. As the condition was also associated with damp-heat, the herb Qian Yin Cao was added to clear heat and eliminate dampness. After nearly a hundred doses, the patient’s condition improved, demonstrating that proper diagnosis and appropriate herbal formulations were key. The third formula, on the other hand, emphasized strengthening the spleen and stomach, while also incorporating herbs that regulate qi and soothe the liver—this approach focused on supporting the body’s vital forces while eliminating pathogenic factors.

Three Cases of Chronic Nephritis