V. Ringworm and Scabies Types

1. Persistent Ringworm Elimination Formula: Iron Rust 50g, Tu Jin Pi Powder 50g; ground into powder and mixed with 100ml of rice vinegar, heated and boiled for 5 minutes before use. Apply externally to affected areas, changing the dressing once daily. This formula is suitable for body ringworm, tinea corporis, and various skin diseases caused by fungi.

2. Scabies Ointment: Hu Ma 15g, Bai Bu 15g, Ku Shen 15g, Wu Bei Zi 10g, Fu Fan 10g, Qing Fen 10g, Zhang Mao 3g, Mei Pian 8g; ground into fine powder and sifted through a sieve. When used, mix with rice vinegar to form a paste and apply to affected areas. This formula is suitable for various types of body ringworm and股 ringworm.

3. Scabies Ointment: Sulfur 10g, Ming Fang 10g, Mang Xiao 10g, Bor Sa 10g; ground into powder and mixed with 200g of Vaseline, applied externally as an ointment, changing the dressing once daily.

4. Scabies Wash: Chuan Jiao 20g, Chuan Lian Zi 20g, Ming Fang 3g; add 2000ml of water, simmer for 10 minutes, then use the liquid to wash affected areas, followed by application of scabies ointment.

My Views on the Treatment of Hyperthyroidism

Hyperthyroidism is short for hyperfunction of the thyroid gland, a pathological condition resulting from excessive secretion of thyroxine due to various causes. In 1956, Japanese researcher Hashimoto discovered antibodies against thyroid antigens in the serum of patients with chronic thyroiditis complicated by hyperthyroidism. Later, six types of immunoglobulins related to thyroxine were identified, establishing a close relationship between this disease and autoimmune mechanisms. While the exact cause of hyperthyroidism remains unclear, based on my long-term clinical experience, most patients with hyperthyroidism have a history of recurrent subacute thyroiditis, suggesting that subacute thyroiditis is at least one of the causes of hyperthyroidism. Given that subacute thyroiditis itself is recognized as an autoimmune disorder, the connection between hyperthyroidism and autoimmunity naturally becomes self-evident. A significant portion of patients with hyperthyroidism exhibit symptoms of hyperthyroidism alone; a small number show symptoms of hypothyroidism; and a smaller group experiences alternating episodes of both hyperthyroidism and hypothyroidism. I have observed that patients who present with hyperthyroidism symptoms are most likely to develop pure hyperthyroidism. Whether this type of hyperthyroidism is the same as that discussed by Bacedaw and Gravre remains unresolved—yet, I have not yet found definitive evidence. The clinical manifestations of hyperthyroidism in patients are largely consistent with what I have experienced in practice. Palpitations, excessive sweating, fine tremors, goiter, slight swelling in the anterior tibial region, emotional agitation, and restlessness are the six major subjective symptoms of hyperthyroidism. Elevated T3 and T4 levels, along with decreased TSH levels, are the most common indicators for diagnosis. Anemia, impotence, and amenorrhea may serve as reference points. Western medical treatments often employ methimazole and propylthiouracil to manage symptoms, but they do not offer a cure.

In recent years, iodine has shown great promise in treating this condition—but because medication must be administered under specific conditions and can easily lead to hypothyroidism, its effectiveness has not been entirely satisfactory. Total thyroidectomy remains one of the effective treatment options for hyperthyroidism, though it is particularly suitable for patients with large cold nodules or those with signs of thyroid cancer.

For these reasons, traditional Chinese medicine and herbal remedies offer a different approach to treating hyperthyroidism. Over decades, I have achieved good therapeutic results using traditional Chinese medicine for hyperthyroidism, believing that the greatest advantage of TCM in treating hyperthyroidism lies in its lack of toxic side effects and its long-term benefits.

I believe that the primary symptoms of hyperthyroidism include excessive sweating, rapid pulse, heart palpitations, and tremors—these symptoms correspond to the “fire” syndrome in Traditional Chinese Medicine, which originates from kidney yin deficiency, leading to water failing to nourish wood, causing wood to generate fire and liver to become overly active, resulting in wind. This “fire” is called “xiang huo,” or “dragon and thunder fire”—not real fire, nor internal heat within the organs. Therefore, prescriptions like White Tiger Decoction or Cheng Qi Decoction are ineffective. The root cause of the disease lies in the depletion of kidney yin; thus, tonifying kidney and nourishing yin is the fundamental principle in treating hyperthyroidism. If this “fire” persists for a long time, it consumes qi, leading to qi deficiency—and since qi governs blood, and blood is the mother of qi, qi deficiency leads to blood deficiency as well! Therefore, strengthening qi and nourishing blood is also a key approach to treating this condition. Thyroid enlargement falls under the categories of “goiter” or “phlegm nodes,” which are also formed through the burning of “fire.” In addition to nourishing yin and clearing fire as previously mentioned, it is also necessary to transform phlegm, soften hard tissue, and resolve masses. Thus, nourishing yin and clearing fire, tonifying qi and blood, and softening hard tissue and resolving masses constitute the three main approaches to treating hyperthyroidism, with the intention of promoting qi circulation and activating blood flow. In treating hyperthyroidism, I often use the following four formulas, adjusting and modifying them based on clinical circumstances, often achieving the desired results.

1. Guishan He Ji: Turtle Placenta 15g, Yam 10g, Fragrant Herb 6g, Summer Grass 20g, Turtle Shell 15g, White Peony 15g, Polygonum cuspidatum 20g, Astragalus 30g, Sheng Di 12g, Salvia 20g, Raw Dragon and Mulberry each 15g, Purple Quartz 20g, Huang Lian 3g, Huang Qin 10g, Huang Bo 6g, Dang Gui 15g; decocted in water and taken as one dose per day. This formula is suitable for patients with obvious hyperthyroid symptoms, including rapid heart rate, palpitations, excessive sweating, tremors, and irritability. Patients often feel fatigued, lose weight, find it difficult to continue working, and their T3 and T4 levels remain elevated.

2. San Shu Tang: Three-edged Rhizome 10g, Turmeric 10g, Green and Yellow Peel each 10g, Summer Grass 20g, Sheng Di 12g, Yuan Shen 10g, Mai Dong 10g, Shan Yu 10g, Yam 10g, Dan Pi 10g, Fu Ling 12g, Ze La 10g, Fragrant Herb 6g, Su Zi 10g; decocted in water and taken as one dose per day. This formula is suitable for patients with significant thyroid enlargement, whose symptoms of toxicity are not severe but persist for a long time, and who primarily experience fatigue, weight loss, and difficulty maintaining work performance.

3. Compound Xia Mu Tang: Summer Grass 12g, Raw Dragon and Mulberry 20g, Chai Hu 10g, White Peony 15g, Huang Bo 10g, Ban Xia 6g, Dang Shen 10g, Mai Dong 10g, Wu Wei Zi 6g, Fu Shen 10g, Yuan Zhi 10g, Roasted Walnut 15g, Spicy Mustard 10g, Fragrant Herb 6g, Su Zi 10g; decocted in water and taken as one dose per day. This formula is suitable for patients with prominent mental symptoms, including frequent heartache, agitation, insomnia, and severe restlessness.

4. Exophthalmos Formula: Three-edged Rhizome 15g, Turmeric 15g, Seaweed 15g, Kelp 15g, Pangolin 10g, Soapberry Thorns 10g, Prepared Milkweed each 6g, Zhebei Mu 10g, Yuan Shen 20g, Raw Oyster 20g, Summer Grass 15g, Huang Yao Zi 10g, Shan Cigu 10g, Dang Gui 10g, Astragalus 20g, Dang Shen 10g, Bai Zhu 10g, Cinnamon 3g; decocted in water and taken as one dose per day. This formula is suitable for advanced stages of hyperthyroidism, especially when exophthalmos is pronounced.

In addition to the above four formulas, I have also used Chai Hu Jia Long Gu Mu Zhu Tang (Zhang Zhongjing), Sheng Tie Luo Yin (Cheng Zhongling), Bai Jin San (from “Surgical Complete Collection”), and Gan Mai Da Zao Tang (Zhang Zhongjing) for patients with markedly abnormal mental symptoms—each of these formulas yielded certain therapeutic results. For patients experiencing palpitations and intense heat, I have also used Tian Wang Bu Xin Dan (from “Secrets of Health Preservation”), Bai Zi Yang Xin Wan (from “Comprehensive Collection of Health Preservation”), and other formulas that provided some relief.

The Wonderful Uses of Ganluo Disinfection Pill

This formula is derived from “Wen Re Jing Wei,” consisting of 10g of Huang Qin, 4g of Lian Qiao, 4g of Bo He, 10g of Shan Zhi, 15g of Hua Shi, 5g of Mu Tong, 11g of Yin Chen, 4g of Huo Xiang, 6g of Shi Chang Pu, 5g of Rou Dou Kou, 4g of She Gan, and 4g of She Gan; ground into powder and taken as 10g per dose, dissolved in warm boiled water. Alternatively, the formula can be made into pills using Shen Qu, sized like a small ball, and taken with hot water. According to the original prescription, this formula was intended to treat early-stage damp-heat syndromes, where dampness and heat are both prevalent, and the pathogenic factors reside in the qi layer.

I had never given much importance to this formula until the 1980s, when I encountered a patient with chronic hepatitis B. His liver function continued to deteriorate despite multiple treatments, and he was hospitalized at Beijing 302 Hospital for over two months, spending more than 40,000 yuan. His GPT and GOT levels remained high, and even mild jaundice did not improve. Seeking treatment in desperation, I examined his pulse, which was slippery, rapid, and tense, with a red tongue coated in yellow and greasy coating—a typical sign of heavy damp-heat in both pulse and tongue. I then prescribed the original Ganluo Disinfection Pill, preparing a decoction with the above dosages and taking it as one dose per day. After 10 doses, the patient felt a sudden sense of comfort throughout his body, his spirits improved significantly, and his GPT level dropped from 172 µmol/L to normal; his total bilirubin also decreased from 32 µmol/L to normal. Recognizing that this formula had produced unexpected results, I began to take it seriously and, over the following 20+ years of clinical practice, frequently used this formula to treat various types of liver diseases, discovering its unique efficacy in improving liver function.

In the 1990s, I treated a female patient with chronic urinary tract infections—40 years old—who had repeatedly experienced frequent urination, urgency, dysuria, accompanied by mild edema, lower back pain, and a feeling of fullness in the lower abdomen. Urinalysis often revealed pus cells and white blood cells, and during flare-ups, proteinuria was detected in several instances (10–20). She had tried various antibiotics, but only saw minor improvements, unable to achieve a complete cure. Through a referral, she came to me seeking treatment. Besides extensive antibiotic therapy, she had also sought treatment from various traditional Chinese medicine practitioners. I reviewed the formulas she had previously taken and found that they included formulas like Long Dan Xie Gan, Ba Zheng San, Gui Fu Ba Wei, and Zhi Bai Di Huang. She told me that over the years, she had spent over 10,000 yuan on both Chinese and Western medicines, but had never seen significant results. Thus, she turned to me for help. I thought to myself, if the previous Chinese medicine treatments had been appropriate for her condition, why hadn’t they worked? I knew I needed to explore new avenues to overcome her condition. Her pulse was tense, slippery, and rapid, with a red tongue covered in thick, greasy yellow coating—a clear sign of heavy damp-heat. I then prescribed Ganluo Disinfection Pill with modifications, and after 3 doses, she saw improvement; after 7 doses, she experienced remarkable results. Through this treatment experience, I came to respect the remarkable efficacy of Ganluo Disinfection Pill even more.

At the beginning of the 21st century, non-gonococcal urethritis became prevalent, and tests for Chlamydia and Mycoplasma were widely available in specialized and county-level hospitals. This disease is highly contagious, and standard antibiotics often prove ineffective, leading to prolonged illness and delayed recovery, causing physical and psychological suffering for patients and contributing to negative social impacts. Remembering the successful treatment of previous urinary tract infection patients, I decided to try Ganluo Disinfection Pill for non-gonococcal urethritis—and the results were quite promising. A 26-year-old male, unmarried, who had traveled to Inner Mongolia and other places for work, returned to Lanzhou for treatment due to urinary tract infections and prostatitis. Tests for Chlamydia and Mycoplasma were positive, and the Lanzhou Second People's Hospital diagnosed him with non-gonococcal urethritis. He had only seen slight improvements from medications like Azithromycin and Ceftriaxone. Through a referral, he came to me for treatment. His pulse was slippery and rapid, his tongue was red with a thick, greasy yellow coating, accompanied by urinary discomfort, pain in the lower abdomen, perineum, and the roots of his thighs. I diagnosed him as having damp-heat accumulation in the bladder and prescribed Ganluo Disinfection Pill. After 10 doses, the patient reported significant improvement and said that he had never seen such noticeable results in his previous treatments. Today, Ganluo Disinfection Pill is used as a first-line treatment for non-gonococcal urethritis in clinical practice, and it has proven effective for most patients with non-gonococcal urethritis.

A Case Study on Gastric Cancer Treatment

In the early 1980s, I traveled to Guangzhou with Professor Xu Zicheng from Lanzhou Medical College for a conference. On our way to Wuhan, we stayed at the guesthouse of Hubei University of Traditional Chinese Medicine. Professor Hong Ziyun of that institution was a renowned veteran TCM practitioner nationwide; in the 1950s, he had taught in the Central China Integrated Chinese and Western Medicine Research Class, where Xu Zicheng studied at the time, so we developed a teacher-student relationship with Professor Hong. That evening, Xu invited me to interview Professor Hong Ziyun. By then, Professor Hong was already advanced in age, yet his mind was still sharp and alert. When discussing his clinical experience, he spoke freely and casually about the case of a gastric cancer patient who was cured through traditional Chinese medicine. Under repeated requests from me and Xu, he shared a formula: 6 branches of Ume, 6g of Sichuan Pepper, 6g of Huang Lian, 6g of Dried Ginger, 3g of Asarum, 6g of Ban Xia, 6g of Curcuma, 10g of Salvia, 15g of White Peony, 10g of Red Peony, 6g of Hou Pu, 20g of Fresh Radix Polygona, 10g of Wuling Xian, 20g of Buddha’s Hand, 20g of Bitter Wormwood, and 10g of Half-Branch Lotus; decocted in water and taken as one dose per day. I copied the formula and kept it safe. After returning to Lanzhou from Guangzhou, several years passed, and one day I opened the bookshelf and saw the formula, which I quickly wrote down in my notebook. In October 2000 (the Year of the Monkey), a patient named Wang, a 58-year-old woman, was diagnosed with middle-grade differentiated adenocarcinoma of the stomach. Because she firmly refused surgery and chemotherapy, she came to me for treatment. She was thin, pale, with persistent severe pain in the stomach area, worsening in episodes, accompanied by a noticeable burning sensation. Her pulse was tense, large, and slippery, with a red tongue covered in yellow and greasy coating. The pulse pattern matched the formula proposed by Professor Hong—no additions or subtractions were made to the original formula, and I recorded it accordingly. After 10 doses, the patient came to see me again, saying that the pain had greatly reduced, and the burning sensation was noticeably lighter than before. Her pulse had become calmer, and the yellow, greasy coating on her tongue had begun to fade slightly. I realized how truly valuable Professor Hong’s formula was, and I deeply admired his rigorous academic approach, his down-to-earth nature, and his sincere teaching style. I asked her about her condition and learned that she sometimes experienced nausea and vomiting, and her stools were dry and constipated. To address these issues, I increased the dosage of Rhubarb by 6g and Ginger by 6g, decocted in water and taken as one dose per day. After another 10 doses, the patient came to see me again, saying that she could now eat a bowl of noodles, and her symptoms had improved significantly compared to before, with her energy returning. I added 3g of Agarwood and 3g of Cardamom to the formula, recommending that she take them regularly. One year later, the patient came to see me again, saying that the more she took the formula, the better she felt, and she had persisted with the treatment for over 200 doses. Now, her stomach no longer felt abnormal, her complexion was rosy, and her demeanor and spirit were just like those of a healthy person. Barium meal radiography showed no lesions, and gastroscopy also revealed no lesions—only congestion of the gastric mucosa. The diagnosis was chronic superficial gastritis. The recovery of this patient was truly inspiring, leaving us amazed by Professor Hong Ziyun’s exquisite medical skills and his genuine quality of teaching others. In subsequent clinical practice, I often used this formula. Ultimately, I concluded that this formula has varying degrees of efficacy for most cases of gastric cancer, especially for patients with pain-related symptoms of gastric cancer. The ingredients in this formula—Ume, Sichuan Pepper, Dried Ginger, Huang Lian, Ban Xia, and Asarum—are also found in the Ume Pill, a formula specifically designed for Jueyin diseases in the “Shanghan Lun” by Zhang Zhongjing, and used in the “Jin Gui Yao Lü” to treat intestinal worms. Both books clearly state that this formula has the effect of relieving gastric pain. Hou Pu, Yi Ren, Buddha’s Hand, and Fu Ling possess properties to eliminate dampness, regulate qi, and descend rebellious qi; Salvia, Red Peony, and Curcuma promote blood circulation and dissolve blood stasis, focusing on treating chronic conditions that have entered the meridians; Bitter Wormwood and Half-Branch Lotus clear heat and detoxify, reducing inflammation in the stomach. Precisely because of these properties, this formula has demonstrated significant efficacy. I created a mnemonic to help remember: “Ume Pill, Jin Dan, Shao, Ban Xia, Hou Pu, Half-Branch Lotus, Bitter Wormwood—this combination is especially effective for relieving pain in gastric cancer.”

Electrolyte Imbalance in Decompensated Liver Cirrhosis

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Due to massive ascites in the decompensated stage of cirrhosis, the entire body is in a state of sodium and water retention. This condition naturally leads to hypokalemia, as sodium ions and potassium ions both belong to the same group of monovalent cations and compete with each other. Furthermore, the use of large amounts of diuretics results in potassium loss; therefore, electrolyte imbalances in patients with cirrhotic ascites often begin with hypokalemia. Some argue that hypokalemia is a fundamental characteristic of cirrhotic ascites, and potassium supplementation is a basic treatment for such cases—this view has some merit. Given that calcium and magnesium are also monovalent cations and, like potassium, they exhibit a similar antagonistic relationship with sodium ions, when hypokalemia occurs, the levels of calcium and magnesium are also low. Although ascites and edema lead to overall sodium and water retention in the body, since sodium ions are abundantly present in the interstitial space, the serum sodium level remains below the normal range. Thus, in the early stages of cirrhotic ascites, the overall serum electrolyte levels are generally described as "low." However, as cirrhosis progresses and renal impairment develops, this "low" electrolyte profile quickly begins to shift. Cirrhosis can lead to secondary renal dysfunction, known as hepatorenal syndrome.

At this point, the kidneys' clearance function is compromised, leading to elevated blood urea nitrogen levels, increased creatinine levels, and decreased carbon dioxide partial pressure. The body subsequently experiences acidosis. Initially, due to oliguria and impaired excretory function, serum potassium levels begin to rise. Because phosphate excretion is hindered, hyperphosphatemia develops. The antagonistic relationship between calcium and phosphorus causes calcium levels to drop, further lowering calcium levels and exacerbating acidosis. As acidosis sets in, positive ions such as sodium and calcium are absorbed by negative ions, making hypokalemia and hypocalcemia even more pronounced. Only a small number of patients are exceptions—those with hyperparathyroidism, where serum calcium levels rise while serum phosphorus levels immediately decline. In summary, after hepatorenal syndrome develops, as serum potassium and phosphorus levels increase, serum calcium levels fall. As acidosis progresses, the adsorption of positive ions by negative ions intensifies, causing serum calcium and sodium levels to continue declining. Only in cases of cirrhosis complicated by hyperparathyroidism does serum calcium levels sometimes reverse their usual pattern, rising, while serum phosphorus levels may decrease accordingly. In fact, when cirrhosis is combined with ascites, the changes in electrolytes may seem complex, but they are actually quite simple—if you grasp the key points outlined above, you only need to understand three essential concepts: ① In cirrhotic ascites, the levels of potassium, calcium, sodium, phosphorus, magnesium, and other major electrolytes are all low or reduced; ② When renal failure occurs—when hepatorenal syndrome develops—as urine output decreases, serum potassium levels rise rapidly; as acidosis sets in, serum phosphorus levels begin to rise, and hypocalcemia becomes even more pronounced. ③ Only in cases of hyperparathyroidism do serum calcium levels rise, while serum phosphorus levels may even decline. The key characteristics of decompensated cirrhosis include the appearance of ascites; the important indicator of hepatorenal syndrome is the elevation of blood urea nitrogen levels; and hyperparathyroidism leads to changes in calcium and phosphorus levels.

Case Reports on Four Patients

Following the Spring Festival of 2000 (Gengchen year), four consultations were conducted at external hospitals, involving the diagnosis and treatment of four patients. These reports are faithfully recorded, and they may be helpful for young medical professionals.