VII. Diverticula of the Stomach and Duodenum

These diverticula are pouch-like expansions or protrusions of the stomach and duodenum walls. Throughout the digestive tract, these diverticula account for approximately 10%–20% of cases (based on autopsy data). Because gastric and duodenal diverticula are prone to inflammation and subsequent symptoms, they are often given considerable attention. Most diverticula are congenital; gastric diverticula are less common, while duodenal diverticula are more frequent. Symptoms only appear when the diverticula become inflamed—typically manifesting as epigastric pain, nausea, vomiting, weight loss, and in some cases, diarrhea. Symptoms often subside at night and worsen during the day, though changing body position can sometimes alleviate the pain. If diverticulitis persists for a long time, it can lead to local bleeding, ulcers, adhesions, gangrene, abscesses, or even perforation; occasionally, it can also progress to cancer. Depending on the location of the diverticulum, jaundice may occur (in cases of ampullary diverticula), often accompanied by pancreatitis or duodenal obstruction. Given this, duodenal diverticulitis can sometimes cause severe pain, leading to a high rate of misdiagnosis.

Diagnosing the cause of this condition is often challenging; diverticula are difficult to locate during surgery, making surgical procedures complicated and causing surgeons to hesitate. Traditional Chinese medicine and herbal remedies often employ methods that focus on promoting blood circulation, resolving stasis, clearing heat and detoxifying, and regulating qi to relieve pain; common formulas include Yiren Fuzi Baisai Tang, Danyin Yin, Xiaochaihu Resolving Liver Dispersion, and Uma Combination formulas. In clinical practice, I have found these formulas to be effective. ① Uma Jin Gan Wan: 40 Ume berries (pitted), 20 Ma Qian Zi (fried), 20 Yujin, 3g Gan Qi, 20 Huo Niu, 20 Ming Fang, 100g Xian He Cao, 100g Zhi Ke, 30g Cao Kou, 30g Mu Xiang, 100g Dang Shen, 200g Sheng Yi Ren, 200g Baisai, 100g Fu Pi—ground into powder, filtered through a sieve, take 5g each time, twice daily with warm water. ② Compound Xiaochaihu Tang: 10g Chai Hu, 10g Zhi Ru, 10g Bai Shao, 6g Gan Cao, 10g San Ling, 10g E Zhu, 10g Wu Yu, 10g Wuyao, 10g Pu Huang, 10g Wu Ling Zhi, 3g Rong Gui, 10g Zhi Ru, 10g Dang Shen, 3g Mu Xiang, 3g Cao Kou, 6g Zhi Ru Mo, decocted and taken once daily.

All of these conditions can cause epigastric pain; various conditions may occur individually or in combination with two or three other conditions. Therefore, when a patient experiences epigastric pain, physicians must conduct a comprehensive analysis and weigh the appropriate medications—what should be administered first, what later, and what should be prioritized? All of these considerations affect the adjustments and additions to the treatment plan, as well as the direct therapeutic effects of the medications.

In addition to the seven diseases mentioned above, other conditions that can cause epigastric pain include gastric perforation, gastric cancer, liver disease (such as hepatitis, liver abscess, liver cysts, and liver echinococcosis), and other lower digestive tract disorders that may trigger reactive lesions in the stomach. Gastric perforation often develops as a complication of gastric ulcers or other gastric conditions; the condition is acute and severe, rapidly leading to peritoneal irritation symptoms, requiring immediate surgical intervention. Gastric cancer also benefits from early surgical treatment; during chemotherapy, the use of traditional Chinese medicine in conjunction with chemotherapy can help alleviate some of the toxic side effects of the treatment.

When treating liver disease, it is important to adopt a holistic approach—such as performing surgery for liver echinococcosis, using traditional Chinese medicine to protect the liver in cases of hepatitis, or employing antibiotics to treat liver abscesses, and, if necessary, performing surgical drainage.

A Brief Discussion on Gui Zhi Shao Ya Zhi Mu Tang

This formula appears in the "Jin Kui Yao Lü," specifically in the section on "Stroke and Joint Pain." The text states: "For pain in all limbs and joints, body swelling, leg edema like a drop, dizziness, shortness of breath, a feeling of warmth and nausea, Gui Zhi Shao Ya Zhi Mu Tang is the primary remedy." Throughout history, medical practitioners have often used this formula in combination with other herbs to achieve remarkable therapeutic effects for various joint disorders. The formula aims to dispel wind, eliminate dampness, disperse cold, and relieve pain. I have found that this formula is highly effective in treating rheumatoid arthritis, osteoarthritis, spondyloarthritis, and other forms of arthritis. Based on my experience, replacing the motherwort with 15g of Sichuan's own Celastrus sinensis has dramatically enhanced its efficacy! Sichuan's Celastrus sinensis is the primary cultivated variety of Aconit in Sichuan Province; Celastrus urceolatus is an artificially cultivated variety of Aconit, but both share similar properties and effects—when combined, they complement each other and enhance their therapeutic benefits. The active ingredients in these two herbs include aconitine, including aconitine and aconitine derivatives, which are highly toxic; however, heating them to temperatures above 90°C for at least one hour can completely destroy the toxic components while preserving the beneficial ones. For this reason, when using Sichuan's Celastrus sinensis, it is essential to first decoct it for one hour. Adding 20g of Asarum sieboldii to Gui Zhi Shao Ya Zhi Mu Tang, in keeping with the principles of Ma Huang Fuzi Xie Xin Tang, can significantly enhance the effects of Sichuan's Celastrus sinensis, but since Asarum sieboldii contains a large amount of artemisinin—a toxic component that can be completely destroyed at temperatures above 90°C—Asarum sieboldii, like Sichuan's Celastrus sinensis, must also be decocted for one hour before safe use.

In addition to its effectiveness in treating the aforementioned joint disorders, considering the key symptoms described in the "Jin Kui" such as "dizziness, shortness of breath, a feeling of warmth and nausea, leg edema like a drop," I have found that this formula has been effective in treating lupus erythematosus; particularly for patients who have been taking hormones for a long time, who often become heavily dependent on hormones and find it difficult to stop taking them. After using Gui Zhi Shao Ya Zhi Mu Tang, the patients’ hormone dependence can gradually ease, allowing their pain to further improve. I believe that rheumatoid arthritis is also a connective tissue disease—now referred to as an autoimmune disorder, which is classified as type III hypersensitivity, where antigen-antibody complexes bind and deposit, triggering a series of reactions. I have expanded the application of this formula to include scleroderma, Sjögren’s syndrome, Raynaud’s disease, subacute sclerosing panencephalitis, nephrotic syndrome, and dermatomyositis, and have found that most of these conditions have shown certain therapeutic effects. In practice, I have experienced that this formula possesses a clear immune-regulatory effect. Before and after using this formula, some patients focused on monitoring various immune markers such as IgM, IgG, IgA, CD3, CD4, and CD8, discovering significant improvements—all of which indicate the formula’s immune-regulatory capabilities.

The composition of Gui Zhi Shao Ya Zhi Mu Tang is exceptionally well-balanced; although the formula is named Gui Zhi Shao Ya Zhi Mu, the motherwort is actually the primary ingredient of this formula. Motherwort (Aconit) is said to "benefit the source of fire to dispel yin obscurations"—a metaphorical expression for "clearing the vast sky of ten thousand miles." Indeed, type III hypersensitivity involves repeated battles between antigens and antibodies, ultimately leading to the accumulation of deposits—yin obscurations and dust particles. Gui Zhi promotes yang energy, allowing yang qi to flow freely both internally and externally; Bai Shao calms yin, preventing the subtle qi from dissipating as yang qi flows; Zhi Mu prevents the pungent heat of motherwort from damaging yin. Together, these three herbs work in harmony, each fulfilling its role, ensuring that motherwort clears obstructions and sweeps away dust, while also standing as the core of the formula—protecting the chief commander and enabling him to remain hidden in the depths of the battlefield, commanding victory from afar. Ma Huang opens the membranes to welcome sunlight; Bai Zhu nourishes the center, while Gan Jiang warms the center; Gan Cao and other herbs aim to strengthen the spleen and stomach, ensuring that the motherwort army can move freely without hindrance.

Discussions on Hypertension

Hypertension refers to what Western medicine calls primary hypertension. This condition is often prevalent among older adults, and most patients also suffer from varying degrees of arterial sclerosis. High cholesterol, high blood viscosity, and high uric acid are often associated with hypertension—these are known as the "four highs" of old age. Recently, the academic community has begun to consider adding high blood sugar (diabetes) to the list of the four highs; some scholars suggest calling it "metabolic syndrome of middle and old age," and the World Health Organization is currently deliberating whether to adopt this new term.

Traditional Chinese Medicine has long recognized hypertension; the "Su Wen • Adjusting the Circulation" states, "When blood and qi travel upwards together, they lead to great collapse." In the 1930s, Zhang Xichun, drawing on this passage, believed that the "great collapse" discussed in the "Su Wen" represented a critical condition of hypertensive cerebral congestion. He considered that the primary principle for treating hypertension was to draw blood downwards; among various medicinal herbs, Zhang chose Achyranthes bidentata, believing that this herb was the key to treating hypertension. 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: The "Sheng Pin" of blood circulation descending is the origin of the "Zhen Gan Xi Feng Tang," pioneering the use of traditional Chinese medicine for blood pressure reduction. Huai Niu Xi

It is the root and rhizome of a plant belonging to the family of plants, and throughout history, traditional Chinese medicine texts have consistently praised its ability to promote blood circulation and dispel stasis. During the Ming Dynasty, Zhang Jingyue

wrote that it "draws fire downward," creating the Yu Nu Jian specifically for treating toothache; in folk traditions, it is said that the stems and nodes are swollen, resembling the shape of a cow's knee, and because they share similar properties, they can be used to treat joint pain in the lower limbs. Traditional Chinese Medicine’s understanding of the pathogenesis of hypertension generally revolves around yin deficiency and yang excess, with yang excess giving rise to wind—thus, treatments often focus on nourishing water to nourish wood and calming the liver to subdue yang. Commonly used formulas include Zuo Gui Yin, Da Bu Yin Wan, Qi Ju Di Huang Wan, and others. Mr. Pu Fuzhou

had a unique insight and, contrary to common practice, adopted a method of warming yang and transforming water to treat hypertension. His primary formula was Zhen Wu Tang, with added ingredients, which yielded unexpected therapeutic effects in clinical practice. Mr. Wang Qingren, meanwhile, employed a method of promoting blood circulation and resolving stasis, developing the Xue Fu Zhu Yu Tang to treat such conditions—a truly innovative approach. The significance of this method lies in the fact that Wang’s approach not only effectively treated hypertension but also addressed many other conditions, including hypertension combined with cerebral arterial sclerosis and coronary artery sclerosis. In the 20th century, a collaborative group in Beijing, while studying coronary heart disease, developed “Coronary Heart No. II” (Chi You, Chuan Xiong, Hong Hua, Jiang Xiang, Dan Shen), which achieved remarkable therapeutic results and caused a sensation nationwide. Later, this formula was refined into Fufang Dan Shen Pian, becoming a widely used remedy both domestically and internationally. Subsequently, it was further refined into “Fufang Dan Shen Dripping Pills,” which were among the first traditional Chinese medicines approved by the U.S. FDA and are now distributed worldwide. Not only did these formulations make significant contributions to the treatment of hypertension and arteriosclerosis, but they also brought substantial foreign exchange earnings to China, opening up new avenues for traditional Chinese medicine and Chinese herbal medicine to reach the global stage. My own treatment of hypertension drew upon the insights of these various approaches, building on over 40 years of experience, and I proposed the following principles: ① Promoting Blood Circulation and Resolving Stasis: This is a fundamental principle in treating hypertension—it can be described as “to treat wind, first promote blood circulation; when blood is flowing, wind naturally dissipates.” The development of hypertension often occurs in tandem with the hardening of arterial vessels, progressing in parallel. When observing the pulse of hypertensive patients, I often found that a strong, tight, and firm pulse was characteristic, and the degree of tension, tightness, and hardness could serve as a reference point for assessing the severity of hypertension. The origins of these characteristics—tension, tightness, and hardness—are rooted in vascular hardening. Although these indicators may not be as precise as modern medical techniques like blood lipids, blood viscosity, Doppler ultrasound, or blood flow imaging, they still offer valuable insights as a development and extension of traditional Chinese pulse diagnosis. Hardened vessels indicate blood stasis, so promoting blood circulation and resolving stasis is considered the correct approach. I believe that Taohong Siwu Tang is the preferred formula for promoting blood circulation and resolving stasis; adding 60g of Gou Teng to this formula, along with Huang Lian Jie Du Tang, yields the following composition: Dang Gui 10g, Chuan Xiong 6g, Chi Shao 10g, Sheng Di 12g, Tao Ren 10g, Hong Hua 6g, Gou Teng 60g, Huang Lian 3g, Huang Qin 6g, Huang Bo, Shan Zhi 10g—this decoction is taken orally, one dose per day. This formula is highly effective for early-stage hypertension, and for patients with poor gastrointestinal function, 3g of Mu Xiang and 3g of Cao Kou may be added as appropriate. ② Nourishing Yin and Tonifying Kidneys: The symptoms of dizziness, tinnitus, low back pain, leg fatigue, bone heat, five internal heat sensations, and night sweats in hypertensive patients are often manifestations of kidney yin deficiency. While most hypertensive patients exhibit a strong, long pulse, their radial pulse is relatively weak and deep, a result of kidney deficiency. For early-stage hypertension, adopting a method of nourishing yin and tonifying kidneys can often achieve satisfactory results. I believe that while the “kidney” in traditional Chinese medicine differs significantly from the “kidney” in Western medicine, there are some parallels in the pathogenesis of hypertension. Western medicine suggests that under certain conditions, renal tissue releases renin, which then acts on angiotensin I, converting it into angiotensin II. This substance directly causes contraction of small arteries throughout the body, leading to increased blood pressure. Can nourishing yin and tonifying kidneys in traditional Chinese medicine influence the process of renin-angiotensin II conversion? While experimental studies are still needed to confirm this, nourishing yin and tonifying kidneys in traditional Chinese medicine has indeed helped reduce blood pressure in early-stage hypertensive patients and alleviate systemic symptoms—this is a fact I have experienced in clinical practice. I consider Liu Wei Di Huang Tang to be the preferred formula for nourishing yin and tonifying kidneys; adding Goji Berries, Chrysanthemum Flowers, Zhimu, Huang Bo, and other herbs to this formula yields: Sheng Di 12g, Shan Yu 10g, Shan Yao 10g, Dan Pi 6g, Fu Ling 12g, Ze Xie 10g, Goji Berries 10g, Chrysanthemum Flowers 10g, Zhimu 10g, Huang Bo 10g, Xian Mao 10g, Yin Yang Huo 10g, Ba Ji Tian 10g, Dang Gui 10g—this decoction is taken orally, one dose per day. Like the previously mentioned formulas for promoting blood circulation and resolving stasis, this formula is suitable for patients with obvious kidney deficiency; whereas the earlier-mentioned formulas are more appropriate for patients with less pronounced kidney deficiency. For lower back pain, add 15g of Du Zhong, 30g of Huai Niu Xi, Chuan Du Shi, and Sang Ji Sheng 15g; for headaches, add 10g of Gan He Ye, 20g of Gou Teng, 10g of Tian Ma, 6g of Bai Zhi, 3g of Xi Xin, 15g each of Qiang Du Huo and Qiang Du Hua; for half-body paralysis, add 6g of Shui Zhi, 3g of Han San Qi, and 10g of Wu Xing. ③ Calming the Liver and Subduing Wind: In mid-to-late stage hypertension, blood pressure remains high, not only reflecting kidney yin deficiency but also causing yang excess due to yin deficiency, and when yang becomes excessive, wind arises. At this stage, patients may experience headaches, restlessness, numbness in the hands and feet, and in some cases, facial asymmetry or even hemiplegia. From a Western medical perspective, this type of hypertension is often associated with cerebral arterial sclerosis, cerebral infarction, and cerebral atrophy, yet blood pressure continues to remain elevated. Zhang Xichun’s Zhen Gan Xi Feng Tang and Jian Che Tang were originally designed as the preferred formulas for this type of hypertension. Given the prominent neurological symptoms associated with this condition, the formula can be supplemented with blood-circulating herbs such as Chi Shao, Chuan Xiong, Hong Hua, Jiang Xiang, and Dan Shen—such as the following composition: Huai Niu Xi 60g, Sheng Gui Ban 15g, Sheng He Shi 15g, Sheng Bai Shao 15g, Sheng Long Mu 15g, Yuan Shen 15g, Tian Dong 15g, Chuan Lian Zi 20g, Sheng Mai Ya 10g, Yin Chen 10g, Gan Cao 6g, Chi Shao 10g, Chuan Xiong 10g, Hong Hua 6g, Jiang Xiang 6g, Dan Shen 20g—this decoction is taken orally, one dose per day. For severe headaches, add 6g of Bai Zhi, 3g of Xi Xin, 15g each of Qiang Du Hua and Qiang Du Hua; for facial asymmetry, add 6g of Jiang Chong, 6g of Quan Xie, and 10g of Wugong; for half-body paralysis, add 6g of Shui Zhi (taken orally) and 3g of Han San Qi (taken orally). ④ Clearing Heat and Discharging Fire: Hypertensive patients, whether in the early, middle, or late stages, may experience fever and intense heat, as yin deficiency leads to yang excess, and when yang becomes excessive, wind and fire fuel each other, causing heat to overwhelm fire. Patients often present with red eyes, flushed face, dry throat and mouth, yellowish, greasy tongue coating, and constipation. Herbs such as Huang Lian, Huang Qin, Huang Bo, and Shan Zhi can all be used. Other commonly prescribed formulas include Ban Xia Xie Xin, Huang Lian Jie Du Tang, Gan Lu Xiao Dan, Bai Hu Tang, Zhu Ye Shi Gao Tang—and through clinical adjustments and modifications, good results are often achieved. Here is a list of formulas: Sheng Shi Gao 30g, Mai Dong 10g, Fang Feng 12g, Chrysanthemum Flowers 15g, Huang Lian 3g, Huang Qin 10g, Huang Bo 6g, Shan Mei 10g, Zhimu 10g, Ban Xia 6g, Chen Pi 6g, Fu Ling 12g, Dan Shen 20g, Gou Ding 30g—this decoction is taken orally, one dose per day. This formula combines Huang Lian Jie Du Tang with Bai Hu Tang; the Er Chen Tang aims to strengthen the spleen and stomach to prevent cold and bitter herbs from harming the stomach; it is supplemented with Mai Dong to nourish yin, Fang Feng and Gou Ding to dispel wind, and Dan Shen to promote blood circulation. When treating patients with hypertension experiencing heat and fire, this formula often proves highly effective. From a Western medical perspective, patients with this type of hypertension often suffer from significant autonomic nervous system disorders, with sympathetic nerve excitation dominating; or they may also experience chronic pharyngitis, chronic prostatitis, chronic gastritis, chronic cholecystitis, or chronic oral inflammation—chronic inflammatory diseases. Throughout my career as a physician, I have come to understand that patients with hypertension are particularly prone to these conditions, as the coexistence of hypertension, high blood viscosity, high blood lipids, high uric acid, and high blood sugar—all five “highs”—lowers the immune system compared to healthy individuals. Therefore, clearing heat and discharging fire is an essential part of treatment.

In addition to these four methods, for patients whose blood pressure remains persistently high despite multiple treatments, I often use Mr. Pu Fuzhou’s Zhen Wu Tang, modified with additional ingredients. Although this formula primarily uses the Yang-tonifying herb Aconite as its main component, it focuses on warming yang and promoting water metabolism—when yin deficiency reaches extreme levels, solitary yang cannot arise, and even a small amount of Yang-tonifying herbs can help restore yin fluids. Modern diuretics are also used to lower blood pressure, as this is a common treatment option.

Further Reflections on Anemia

Anemia, often referred to as aplastic anemia, is a condition characterized by impaired hematopoietic function in the bone marrow, resulting in a decrease in three types of blood cells. Currently, the cause of aplastic anemia remains unclear, though it is widely believed to be related to autoimmune mechanisms. Western medicine has studied aplastic anemia for over 100 years; although significant progress has been made in treatment, research and applications related to hematopoietic growth factors—such as interleukins, macrophage colonies, and erythropoietin—have provided theoretical foundations for the study and treatment of aplastic anemia, ultimately paving the way for the development of effective therapies. Traditional Chinese Medicine has also demonstrated remarkable efficacy in treating aplastic anemia. Over decades of clinical practice, I have treated more than 100 patients with aplastic anemia, and my overall experience shows that traditional Chinese medicine not only extends the survival time of patients with aplastic anemia but also enables complete recovery in some cases. Among the patients I have treated, approximately 12 have been fully cured after follow-up and analysis. These findings were compiled and published by my students in the “Traditional Chinese Medicine Correspondence Newsletter ×2000.4.” Here, I will briefly describe two patients who were cured in the past two years.

Case 1: Ms. Wang, female, 60 years old, with a decrease in three types of blood cells—hemoglobin had dropped to 20 g/L, platelets to 16×10^9/L, and white blood cells to 1.2×10^9/L. Bone marrow biopsy confirmed aplastic anemia. Western medical treatment had shown little effect; for the past year since onset, she had relied solely on blood transfusions to sustain her life. Upon seeing her, I observed that her face was pale, her appetite was poor, she felt fatigued and weak, she had shortness of breath and labored breathing, her heart rate was 100 beats per minute, and she was short of breath. Her six pulses were tense and rapid, her tongue was pale with a white coating. Prescription: Dang Gui 10g, Chi Shao 10g, Sheng Di 12g, Xian He Cao 15g, Tu Da Huang 15g, He Shou Wu 15g, Han Lian Cao 10g, Jie Xue Teng 20g, Hong Hua 6g, Black Soybeans 20g, Shan Yu 6g, Yuan Rou 10g, Ma Qian Zi 1 piece (fried), Tu Si Zi 10g, Nu Zhen Zi 10g, Goji Berries 10g, Da Yun 10g, Lu Rong 3g (split in half), Shui Zhi 10g (split in half)—this decoction is taken orally, one dose per day. After seven doses, she reported feeling slightly calmer in her heart and more comfortable throughout her body, and she continued to take another 30 doses on her own. Two months later, her spirits had improved significantly, and her face had begun to turn pink. Her hemoglobin level had risen to 68 g/L, her white blood cell count was 2.4×10^9/L, with 24% neutrophils, 66% lymphocytes, 10% monocytes, and her platelet count had reached 45×10^9/L. As her condition had clearly improved, I increased the amounts of Shan Yu and Yuan Rou to 15g each, instructing her to continue taking 30 doses. Forty days later, she returned for a follow-up visit, looking much better and with a rosy complexion. Her hemoglobin level had risen to 84 g/L, her white blood cell count was 2.41×10^9/L, with 24% neutrophils, 68% lymphocytes, and 10% monocytes. Her six pulses were tense and fine, her tongue was pale but thick with tooth marks, her tongue coating was thin but greasy—she was suffering from both qi and blood deficiency, with qi failing to govern blood. I prescribed Guipi Tang with additions: Dang Gui 10g, Bai Zhu 10g, Huang Qi 20g, Fu Shen 10g, Yuan Zhi 6g, Chao Zao Ren 15g, Mu Xiang 3g, Yuan Rou 10g, Dang Gui 10g, Shan Yu 10g, Tu Si Zi 15g, Nu Zhen Zi 15g, Jie Xue Teng 20g, Po Guo Zhi 10g, He Shou Wu 10g—this decoction is taken orally, one dose per day. After 20 doses, her nasal congestion had subsided, the bruises on her body had faded, and no new bruises appeared. Her hemoglobin level had risen to 84 g/L. I removed Yuan Zhi, Zao Ren, and Mu Xiang from the formula, adding Dan Shen 20g, Hong Hua 3g, Lu Rong 3g (taken separately), and Shui Zhi 10g (taken separately). I instructed her to continue taking 30 doses, and she never came back for follow-up visits. Three years later, a healthy adult came to the clinic, holding a prescription in his hand, folded like a piece of cardboard. When I looked at it, I realized it was the same formula I had prescribed three years earlier. He told me that he had taken over 200 doses of this formula, and the more he took, the better he felt. Now, his physical strength was normal, his spirits were good, and his appetite was also good. Looking at him, I saw that his face was rosy, his energy was abundant. A quick blood test showed a hemoglobin level of 150 g/L, a red blood cell count of 5.70×10^9/L, and a white blood cell count of 4.28×10^9/L. His platelet count was 160×10^9/L. He had recovered and was advised to continue taking Liang Wei Di Huang and Guipi Wan regularly to support his health.

In treating aplastic anemia, traditional Chinese medicine emphasizes the spleen and kidney as key organs in treatment. The spleen is the source of qi and blood; as the “Nan Jing” states, “In the middle burner, qi is received and transformed into juice, and when it turns red, it becomes blood.” It is clear that blood is a product of the spleen and stomach after receiving nutrients from food. The kidney governs bones; bones store marrow, and marrow and blood share a common origin, indicating that bone marrow also plays a role in blood production. Later physicians further proposed ideas such as “bone generates blood,” “the liver stores blood,” and “the spleen controls blood.” Based on these concepts, I believe that the key to treating aplastic anemia in traditional Chinese medicine lies in strengthening the spleen and nourishing the kidney, followed by regulating the liver and promoting blood circulation—by focusing on these two aspects, the treatment of aplastic anemia begins to take shape. Commonly used formulas include Guipi Tang, Si Jun Zi, Bao Yuan Tang, and other formulas; Liang Wei Di Huang and Gui Fu Ba Wei are preferred formulas for nourishing the kidneys. To regulate the liver and promote blood circulation, formulas like Xiao Yaoshan, Si Wu Tang, Taohong Si Wu, Xiao Chai Hu, and Chai Hu Shu Gan are often employed. I believe that while nourishing the kidneys and strengthening the spleen, it is crucial to also use qi-regulating and blood-promoting herbs—Chai Hu, Mu Xiang, Chu Shan Jia, Jie Xue Teng, Hong Hua, Ma Qian Zi, Chi Shao, Dang Gui, and other herbs are essential components. By regulating qi and promoting blood circulation, the medicinal forces can reach the affected areas; nourishing the kidneys and strengthening the spleen ensures that qi and blood are generated and abundantly replenished. These two processes complement each other and enhance one another. In recent years, I have often used herbs like He Shou Wu, Po Guo Zhi, Nu Zhen Zi, Han Lian Cao, Tu Si Zi, Goji Berries, Xian He Cao, Tu Da Huang, and others—some to nourish the kidneys, some to enrich essence, and some to generate blood—often offering beneficial results for patients with aplastic anemia. In particular, I would like to emphasize the special significance of Lu Rong and Shui Zhi in treating aplastic anemia. Lu Rong refers to the young horns of male deer, such as sika or maral, covered in dense antlers, which have not yet ossified. Modern pharmacological research has shown that Lu Rong has a clear blood-producing effect, exerting significant impacts on the three blood cell lines: white blood cells, platelets, and red blood cells.

Shui Zhi, on the other hand, is the whole body of aquatic insects such as leeches and willow-leaved leeches. Traditional Chinese medicine regards breaking up blood stasis and eliminating blood as its primary purpose; modern research has discovered that leeches contain components like hirudin, heparin, and antithrombin, all of which possess anti-coagulant and thrombolytic properties—making them useful for treating coronary heart disease, thrombophlebitis, and obliterating vasculitis. Based on Tang Rongchuan’s saying, “If blood stasis is not cleared, new blood will never be produced,” I added a small amount of Shui Zhi to the formula for aplastic anemia, finding that this herb could accelerate patient recovery and promote healing. Both Shui Zhi and Lu Rong are sensitive to high temperatures; when boiled at around 100°C, their active ingredients can be destroyed. Since both herbs are best consumed as capsules, I finely ground them into 0.25g capsules and named them Sheng Bao Dan, specifically for treating aplastic anemia—achieving remarkable therapeutic results in clinical practice.

A Brief Discussion on Itching Skin Conditions

Itching skin conditions are among the most common dermatological disorders in clinical practice. Traditional Chinese Medicine’s understanding of these conditions is limited to discussions about causes and pathogenic mechanisms such as “wind,” “fire,” “phlegm,” and “blood.” They are also known as urticarial lesions, prurigo, wind rash, ringworm, scabies, and other conditions—but often lack specific diagnostic criteria, and are typically treated using a broad, general approach. The guiding principle for diagnosing and treating these conditions should still be based on Western medical diagnosis, traditional Chinese medicine differentiation, traditional Chinese medicine prescriptions, and Western medicine as a complementary approach—this has been the guiding principle for decades of clinical practice, yielding satisfying results. First, it is important to possess a basic understanding of Western medical diagnostics; generally speaking, these conditions fall into five categories: ① Urticaria: Though there are different types such as acute, chronic, and papular, they share a common characteristic: sudden onset and spontaneous resolution, worsening with wind. ② Eczema: Although there are different types such as infant eczema, localized eczema, and generalized eczema, they share a common feature: the presence of vesicles, erosion, oozing, crusting, thickening, and scaling. ③ Dermatitis: Though there are types such as neurodermatitis, contact dermatitis, allergic dermatitis, and exfoliative dermatitis, their common characteristic is redness, papules, lichenification, and crevices—without erosion or exudation. Exfoliative dermatitis often presents with large patches of crusts falling off; contact dermatitis frequently involves a clear history of allergen exposure. ④ Prurigo: Typically, skin itching precedes scratching, which can lead to various skin manifestations such as papules, blood scabs, scratch marks, nodules, and more—appearing all over the body, in the anus, genital area, and lower limbs. ⑤ Ringworm and Scabies: There are types such as scalp ringworm, body ringworm, nail ringworm, pityriasis versicolor, tinea corporis, psoriasis, and scabies. Except for psoriasis (silver lingua), all of these conditions are caused by fungi and are contagious. A common feature of ringworm is the presence of a layer of white or yellow scales covering the lesion. Psoriasis, in addition to white scales, often presents with red bases and bleeding dots on the surface. Scabies is caused by the parasitic mite Sarcoptes scabiei, commonly occurring in the armpits, groin, and between the fingers and toes—characterized by blisters, pustules, oozing, and crusting.

All five categories of skin conditions share itching as a distinctive symptom. In traditional Chinese medicine, itching is considered to be caused by wind; wind is the root of all diseases, moving swiftly and changing frequently. Wind can combine with dampness, heat, cold, or dryness. When combined with dampness, chronic conditions may linger, as dampness tends to be sticky and difficult to eliminate quickly. If a condition persists for a long time, it often damages the blood vessels, so “to treat wind, first promote blood circulation; when blood is flowing, wind naturally dissipates.” After more than 40 years of clinical practice, I have learned that the fundamental principles of treating these conditions always revolve around dispelling wind, overcoming dampness, clearing heat, detoxifying, promoting moisture, harmonizing blood, removing stasis, and dispersing cold. The key lies in combining Western medical diagnosis with a practical, concrete approach to understanding the condition—this is the most fundamental aspect of treating these conditions. Below, I will briefly outline commonly used traditional Chinese medicines, which can serve as a reference for clinical formulation. ① Wind-dispelling herbs: Jing Jie, Fang Feng, Fu Ping, Jiang Chan, Quan Xie, Wugong, Wu She, Chuan Teng, Chai Hu, Bai Xian Pi, Bai Zhi, Ma Huang, Gui Zhi, Cang Rui Zi; ② Dampness-overcoming herbs: Qiang Huo, Du Huo, Lei Gong Teng, Sang Zhi, Xi Xian Cao, Wei Ling Xian, Wu Jia Pi; ③ Heat-clearing herbs: Sheng Shi Gao, Shan Wei Zi, Da Huang, Huang Bo, Huang Lian; ④ Detoxifying herbs: Jin Yin Hua, Lian Qiao, Gong Ying, Baishang, Xia Ku Cao, Zi Cao, Long Dan Cao; ⑤ Moisture-removing herbs: Sheng Yi Ren, Fu Ling, Ze Xie, Di Fu Zi, Che Qian Zi; ⑥ Blood-promoting herbs: Dang Gui, Chuan Xiong, Chi Shao, Tao Ren, Hong Hua, Ru Xiang, Mo Yao, Yi Mu Cao; ⑦ Stasis-removing herbs: Shui Zhi, San Ling, E Zhu; ⑧ Cold-dispersing herbs: Chuan Jiao, Chuan Wu, Cao Wu, She Chong Zi, Fu Zi, Xi Xin. Below, I will list the formulas I have used clinically, categorized by type. Please feel free to offer criticism and suggestions for improvement if any points are incorrect.