January 7, 2014: Further Discussion on Liver Transplantation

This disease occurs when ectopic endometrial tissue sheds along with the menstrual cycle, causing severe dysmenorrhea. Western medicine's surgical treatment is a traditional approach, with three types of procedures: conservative (removal of lesions), semi-conservative (removal of uterus while preserving ovaries), and radical (removal of uterine and ovarian lesions). Medication treatment mainly uses danazol and gestrinone, with gonadotropin-releasing hormone analogs (GnRHa) also being commonly used. GnRHa can suppress FSH and LH, achieving pharmacological castration and inducing apoptosis of endometrial cells, thereby achieving therapeutic goals. A representative GnRHa drug is triptorelin, with a sustained-release tablet of 3.75 mg, administered once a week for a course of 3–6 months.

January 7, 2014: Further Discussion on Liver Transplantation

In the 1960s, American scholars pioneered liver transplantation surgery. Currently, this procedure has been implemented worldwide. Since China began performing this surgery in the 1980s, a total of 25,216 operations have been carried out, making China the second-largest liver transplant country after the United States.

Current problems with liver transplantation: ① Lack of donors: the supply-demand ratio is 1:4 in the United States, 1:3 in the United Kingdom, and 1:30 in China. ② Imperfect donor allocation system, resulting in excessively long waiting times. ③ Insufficient medical infrastructure for identifying liver cancer patients; for example, diagnosing liver cancer requires establishing a dedicated file. Although China has established the Model for End-Stage Liver Disease (MELD) scoring mechanism, its coverage is insufficient and its representativeness is weak. The HCC imaging score is 22 points. The Pediatric End-Stage Liver Disease model (PELD) scores 32 points. These scores are adjusted every 3 months, a process called recertification. File scores are also adjusted every 3 months to rank eligible HCC patients. After recalculating the scores, those with the highest scores are selected for transplantation, ensuring fairness and reasonableness.

January 24, 2014: Immunophenotyping of Acute Lymphoblastic Leukemia (ALL)

For a long time, ALL has been classified according to cell morphology into L1 (small cells), L2 (large cells with uneven nuclei), and L3 (large cells with uniform nuclei). Before the 1980s, a five-category classification was proposed from an immunological perspective, dividing ALL into five types based on whether HLA-DR, CD9, CD10, CD2, CD5, CD3, Smlg (surface immunoglobulin), and Cylg (cytoplasmic immunoglobulin) are expressed: pre-B cells, B cells, T cells, Common, and undifferentiated.

From 1986 to 1994, a two-category seven-type classification was proposed, dividing ALL into non-T-ALL and T-ALL. Non-T-ALL includes HLA-DR^+^, CD19^+^, CD20^+^, CD10^+^; T-ALL includes CD7^+^, CD5^+^, CD2^+^, CD3^+^, CD4^+^, CD8^+^, CDla^+^.

In the 1990s, the World Leukemia Conference held in France proposed a four-type twenty-one-category classification: ① Naked type: each series (T, B, myeloid) has a score ≤2. ② Pure type: requires one series—T, B, or myeloid—to have a score ≥2, while other series have a score of 0. ③ Variant type: requires one series to have a score ≥2, while other series have a score ≤2. ④ Multi-type: requires two or more series to have a score ≥2.

After determining the above classifications, further subdivision into 21 subtypes is carried out based on the degree of differentiation of known series and the expression of different antigens.

January 25, 2014: Reunderstanding Jingfang Baidu San

Jingfang Baidu San originates from Zhang Shiche's "Shengsheng Zhongmiaofang" from the Ming Dynasty, specifically formulated for wind-cold exterior syndrome (upper respiratory tract infection), similar to Mahuang Tang. However, this formula also has the effect of treating boils, carbuncles, and early-stage dysentery. Japanese practitioners add cinnamon twig and cherry bark to this formula, calling it "Ten-Ingredient Baidu Decoction," used to treat persistent high fever. Yatsuka Michiaki states that Jingfang Baidu San can treat boils, carbuncles, skin allergies, and other conditions. Additionally, Japanese practitioners add forsythia, scutellaria, gardenia, mint, and white angelica to Jingfang Baidu San, naming it "Qingshang Fangfeng Decoction," used to treat common acne with an effectiveness rate of 75%.

January 29, 2014: Chromosome Examination for Leukemia

There are 23 pairs of 46 chromosomes in peripheral blood, of which 22 pairs are autosomes and 1 pair is sex chromosome. Chronic myelogenous leukemia (CML) often involves translocation of chromosomes 9 and 22, i.e., t(9;22); acute myeloid leukemia (AML) often involves translocation of chromosomes 8 and 21, 15 and 17; acute lymphoblastic leukemia (ALL) often involves translocation of chromosomes 8 and 14, 4 and 11, 9 and 22.

January 29, 2014: A Prescription for Treating Depression

Ms. Wang, 39 years old. She feels depressed, has a bitter taste in her mouth and dry throat, chest and flank discomfort, difficulty swallowing, restlessness, a deep and taut pulse, and a plump tongue with pale yellow coating.

Prescription: bupleurum 10 g, scutellaria 10 g, pinellia 6 g, codonopsis 10 g, licorice 6 g, hook vine 20 g, raw ochre 15 g, poria 10 g, cinnamon twig 10 g, atractylodes 10 g, coptis 6 g, tangerine peel 6 g, citron 10 g, agastache 6 g, salvia 10 g, sandalwood 6 g, cardamom 6 g, magnolia bark 6 g, rehmannia 10 g, evodia 3 g, curcuma 6 g, alum 3 g. One dose daily, decocted in water and taken orally.

After taking the above prescription for 7 doses, all symptoms disappeared, and the patient presented a banner inscribed with "The doctor's heart is like a parent's."

January 29, 2014: Ph Chromosome

Ph chromosome, also known as Philadelphia chromosome, derives its name from its discovery in Philadelphia, USA. In 1960, Nowell and Hungerford discovered an abnormal chromosome smaller than Group G chromosomes in chronic myelogenous leukemia. Chromosome banding techniques proved that it was derived from a balanced translocation between chromosomes 9 and 22, forming a derivative chromosome 22, and creating the BCR-ABL fusion gene. Specifically, chromosome 22 breaks at q11, and the resulting fragment attaches to q34 of chromosome 9, marking this chromosome as t(9;22)(q34;q11).

Extensive data show that 95% of CML patients exhibit this phenomenon.

February 7, 2014: Clinical Significance of Red Blood Cell Distribution Width (RDW)

An increase in red blood cell distribution width indicates variation in red blood cell morphology; the greater the variation, the wider the distribution, which is termed heterogeneity. Both iron deficiency anemia and thalassemia have small mean corpuscular volumes (MCV), but iron deficiency anemia is more heterogeneous, with an increased RDW.

February 7, 2014: The Wonderful Uses of Shaoyao Gancao Tang

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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: "伤寒脉浮，自汗出，小便数，心烦，微恶寒，脚挛急，反与桂枝，欲解其表，此误也。得之便厥，咽中干，烦躁，吐逆者，作甘草干姜汤与之，以复其阳；若厥愈足温者，更作芍药甘草汤与之。"此段经文说明芍药甘草汤可治疗转筋。历代医家根据此条经文将其用于治疗落枕、闪腰、岔气、痉挛性斜颈，又治疗子宫痉挛、胃痉挛、冠状动脉痉挛。总之，此方可治疗骨骼肌、平滑肌、心肌等的痉挛性疼痛。为何耶？芍药之酸，甘草之甘，酸甘化阴也。乌梅之止渴为酸甘化阴之佐证，望梅止渴为酸甘化阴之又一生活实例也。据报道，此方尚可治疗不安腿、三叉神经痛、呃逆、便秘、胃出血、肛裂、腰冷痛、偏头痛等。

2014.2.9 食管癌之效方

马钱子与甘草相配谓"神农丸"，其方组成：硇砂、朱砂、硼砂、砂仁、青黛、水蛭、牵牛子、人参、大黄、芒硝、蜈蚣、柿饼、蛤粉（口诀：四砂青水黑白人，调味蜈蛤加柿饼）。方中柿饼、马钱子乃治疗食管癌之主将尔。硇砂者，氯化铵也，乃利水祛痰之猛将也，与西医之氯化盐无异也。用此方治疗食管癌，疗效神奇。方中之马钱子油炸后无毒，向来为医者所重，除治疗风湿病、跌打损伤外，尚有明显生血之效。今人用此方治疗食管癌意在解痉也！联系前述之解痉药芍药甘草汤之解痉，加之水蛭、海藻（藻虫散）治疗食管癌，可组成下方。

马钱子10个（油炸），白芍300g，甘草100g，水蛭200g，海藻200g，柿饼250g，硇砂100g，砂仁100g。除柿饼外余药共研细末，过筛，柿饼捣烂，加入1000g蜂蜜，做成蜜丸。每服8g，每日3丸，分3次饭后冲服。

2014.2.26 痤疮治疗验案

余治疗青年人痤疮，向来以石山桑柏汤、三黄栀子汤、五味消毒饮、托里透脓散为主。今有王某，女，27岁，患痤疮多年，月经少而伴腹痛。余改用荆防败毒散加连翘、黄芩、栀子、薄荷、金银花、白花蛇舌草治疗。

处方：荆芥10g，防风10g，羌活、独活各10g，柴胡10g，前胡10g，川芎6g，白芷6g，茯苓12g，甘草6g，黄芩10g，栀子10g，连翘15g，薄荷10g。每日1剂，水煎服，早晚各1次。

服药7剂，疗效明显，患者痤疮基本治愈。

2014.2.21 "胆核"之临床应用

胆核方：大黄10g，黄连6g，黄芩10g，枳实10g，柴胡10g，白芍20g，甘草6g，木香10g。

胆核方为胆胰合剂之核心也！药仅八味可代胆胰之全部功能。若加半夏、干姜，则成半夏泻心汤；若再加香砂六君子汤共十五味，则成治疗胆汁反流性胃炎之圣方；更加生龙骨、生牡蛎、海螵蛸共十八味，则治疗胃病疗效更佳。此方尚可加旋覆花、代赭石、丁香、柿蒂辈，诚治疗胆、胰、胃之效方也。

2014.2.21 原发性闭角型青光眼

王宁利等进行了原发性闭角型青光眼（简称"闭青"）发病机制与防治体系的建立及应用的研究，其通过统地研究了我国闭青患者的房角解剖结构,发现了我国闭青的发病机制,建立了新的机制分类；并对亚洲8个国家和地区的闭青患者和正常人群进行了分子遗传学研究,首次发现与闭青发生相关的4个相关基因；同时研发了闭青筛查的关键设备和筛查技术------全景超声生物显微镜。此项研究也首先提出了闭青药物、激光、手术的循序性治疗模式,改良了手术技术,构建适合中国人的慢性闭角型青光眼处理流程,提高了治疗效果。

2014.2.26 降血沉之一方

甲午正月，患者女王某，雷诺病、硬皮病，原有低热、关节痛，血沉最高80mm/h，此次就诊时血沉48mm/h。服下方，血沉降至8mm/h。

处方：党参、黄芪、桂枝、川乌、草乌、雷公藤、辽细辛、马钱子、丹参、乌梢蛇、知母、牡蛎、穿山甲、地龙、威灵仙、红花、鸡血藤、白芍、当归、制乳香、制没药、苍术、白术、巴戟天、白芷、甘草。

此方含桂枝芍药知母汤、保元汤及乌梢蛇、穿山甲、地龙等血肉有情之品，再配以活血化瘀之红花、乳香、没药、鸡血藤，以及祛风除湿之苍术、威灵仙、白芷和壮阳之巴戟天。共同组成了祛风胜湿、活血化瘀、扶正固本之方剂。患者此方后诸症减轻，血沉亦下降矣。

2014.2.26 肿瘤之相关急症

肿瘤之相关急症有：低钠血症、高钙血症、中性粒细胞减少、发热、呼吸困难、谵妄。

1.低血钠症 血钠低于135mmol/L，称为低钠血症。若血钠低于115mmol/L，患者可见厌食、恶心、呕吐、头痛、腹痛、嗜睡、注意力不集中。肿瘤导致的低钠是因大量输液，造成水中毒，产生大量腹水，因而血钠降低。

2.高钙血症 肿瘤导致的高钙血症常见病因有肿瘤直接破坏骨组织，释放骨钙入血；或者肿瘤释放甲状旁腺激素样物质、前列腺素E、维生素D样固醇、破骨细胞活化因子，刺激破骨细胞，使大量钙从骨骼释放入血。其临床表现为乏力、嗜睡、口渴、多尿、便秘、反射减弱、恶心呕吐。其治疗可应用降钙素，皮下或肌内注射，但其远期疗效不如二膦酸盐。

3.呼吸困难 常用药物有茶碱类、阿片类、激素类、安定类、异丙肾上腺素类、抗生素类。

4.发热、呼吸困难、谵妄 较为常见，但处理方法与常法无异。

2014.3.3 黄疸之经方治疗

《伤寒论》曰："阳明病，发热汗出者，此为热越，不能发黄也。但头汗出，身无汗，齐颈而还，小便不利，渴引水浆者，此为瘀热在里，身必发黄，茵陈蒿汤主之。""伤寒七八日，身黄如橘子色，小便不利，腹微满者，茵陈蒿汤主之。""阳明温病，不甚渴，腹不满，无汗，小便不利，心中懊憹者，必发黄。黄者，栀子柏皮汤主之。"

2014.3.6 基因分型的个体化治疗

21世纪以来，随着分子生物学和分子病理学的发展，以及流式细胞仪及电子显微镜的使用，使得利用组织标本进行基因检测成为可能，从而可以进行癌症的基因分型。此种分型充分体现了基因的多态性和疾病的个体化。中晚期肺癌患者严格来说已经失去了手术得机会，放化疗之治疗实难所宜。基因检测分型可为靶向治疗提供借鉴。组织病理检测不是所有患者都能进行，因此有研究耗时2年终于找到了检测外周血EGFR的办法。基因分型为癌症靶向治疗药物的选择带来了机遇，也为癌症的治疗开辟了新的更广阔的路径。

RAS基因之发现将转移性结直肠癌分为KRAS野生型（无突变）和突变型，其中前者占60%。有研究表明，KRAS野生型适用于西妥昔单抗和帕尼单抗。后者则不能从西妥昔单抗和帕尼单抗中获益。

2014.3.13 胃肠胰神经内分泌肿瘤医案三则

病案一

患者，男，64岁。反复发作脐周疼痛，伴腹泻、胃灼热、反酸1个月。既往曾行肠穿孔修补手术。实验室检查：血清胃泌素显著升高，肿瘤标志物正常。超声内镜检查：胃、十二指肠及空肠多发溃疡，胰尾部有占位，大小为28.5mm×38.7mm。PET/CT检查：胰尾结节及周围淋巴结肿大，肝S4、5、6、7段多发结节。诊断为胰腺神经内分泌肿瘤伴弥漫性肝转移。

胰腺神经内分泌肿瘤（pNENs）的发病率低，因有激素分泌和无激素分泌两种，故而又分别称为功能性和无功能性。

治疗：①奥美拉唑40mg，每日2次；长效奥曲肽（SSA）20mg，1次/28日；干扰素300万U/m^2^，皮下注射，隔日1次。②肝动脉化疗栓塞术（TACE）。③射频消融术（RFA）。④微波固化术治疗。

病案二

患者，女，17岁。腹痛伴间歇性黑便2个月。贫血貌，血红蛋白78g/L。胃镜检查提示十二指肠球部肿物，病理活检为神经内分泌瘤（NET）。CT检查：十二指肠球部外侧壁肿物大小38mm×35mm×30mm，肝脏S3、S4见8mm×12mm和12mm×15mm大小的结节，S1、S8见21mm×28mm×25mm大小的结节。诊断为无功能性十二指肠神经内分泌肿瘤。

本病在所有NET中所占比例较低，约为3.8%，治疗仍以生长抑素类似物（SSA）、干扰素为主。其中有2.7%的患者会出现远处转移，主要是肝转移。

病案三

患者，男，57岁。反复腹泻2年余，水样便，无腹痛，面部、胸前时有潮红，哮喘，右心纤维化，肝转移。生长抑素受体显像阳性，血清IgA升高。诊断为小肠神经内分泌肿瘤。

治疗：不可切除，予长效SSA治疗，干扰素亦可配合使用。

综上所述，胃肠胰神经内分泌肿瘤的临床特点：①发病率较低。②以腹痛、腹泻、恶心、呕吐为主要症状，以腹部肿块为主要特征；部分患者有潮红、哮喘、右心纤维化等类癌综合征的表现。③生长抑素显像阳性，血清IgA升高为主要指标。

2014.3.16 原发性血小板增多症

近日，在众多过敏性紫癜患者中出现血小板增多，甚至超过（500～800）×10^9^/L者恒有之。余予青蔻Ⅱ号治疗多能使血小板下降，但生血颗粒必须与之伴服。盖血小板之减少为血液病中最早列入自身免疫病表现者，说明血小板对自身免疫病的反应极强，可低亦可高焉。青蔻Ⅱ号、生血颗粒有效，说明更如此也。

2014.3.16 真性红细胞增多症一例

甲午年。一患者，血红蛋白208g/L，面红目赤，胸闷气喘。余以下方20剂治疗，诸症消，血红蛋白降至140g/L。

处方：郁金6g，重楼20g，丹参20g，黄芪20g，何首乌20g，山楂10g，三棱10g，莪术10g，板蓝根15g，秦艽15g，泽泻10g，人参须15g，太子参15g，潞党参15g，北沙参10g，生地黄12g，山萸肉30g，蝉蜕3g，桑椹10g，生薏苡仁20g，桃仁10g，黄精20g，白花蛇舌草30g，半枝莲30g，红花3g，山豆根10g，茵陈20g。每日1剂，水煎服。

口诀：金车丹芪首乌山，三板秦曲泻人蝉，桑米桃黄蛇舌草，茵陈一味此中填。

2014.3.17 "兰州方"之再定位

余自1973年苏州会议确定此方之名，至今已40余年矣。全国各地的医者普遍认同此方，应用此方。结合近年的临床经验，余对此方之的用法有了新的调整。

标准方：生地黄12g，山萸肉30g，山药10g，牡丹皮6g，茯苓12g，泽泻10g，桂枝10g，白芍30g，甘草6g，浮小麦30g，生姜6g，大枣4枚，黄芪30g，丹参30g，白术10g，防风12g，生龙骨15g，生牡蛎15g，人参须15g，太子参15g，北沙参15g，潞党参15g，马钱子1个（油炸），土鳖虫6g，水蛭6g。

①肺癌，胸闷气喘，加麻杏石甘汤。

②食管癌，吞咽困难，加夏（半夏）朴（厚朴）远（远志），严重者在兰核中加夏朴远，托里透脓散。

③胃癌，加半夏泻心汤、大丹参。

④宫颈癌，加桂枝茯苓丸。

⑤白血病，土鳖虫、水蛭用至10g。慢性者加三棱、莪术、海藻、昆布。

⑥骨髓增生异常综合征，用原方。

2014.3.20 再生障碍性贫血又一方

王某，男，12岁，患再生障碍性贫血在余处诊治已3年，时好时坏。2个月前因感冒导致三系下降，血小板21×10^9^/L，白细胞1.2×10^9^/L，血红蛋白72g/L。用下方治疗后：白细胞5.7×10^9^/L，血小板120×10^9^/L，血红蛋白78g/L。

处方：荆芥10g，防风10g，羌活、独活各10g，柴胡10g，前胡10g，枳壳10g，桔梗20g，川芎6g，茯苓12g，生地黄12g，山萸肉30g，人参须15g，太子参15g，潞党参15g，北沙参15g，菟丝子15g，女贞子15g，枸杞子15g，桂枝10g，龟甲15g，补骨脂10g，皂矾2g，鸡血藤15g。每日1剂，水煎服。

按：再生障碍性贫血之用解表药由来已久，先是用麻黄一味，合鹿角胶、鹿茸辈，后有用麻黄桂枝汤者，亦有用荆防败毒散奏效者。此非偶然也。盖开腠理则见阳光也，阳气者化生之源也。"中焦受气取汁，变化而赤，是谓血。"所谓受气，即阳气也，腠理开则阳光始及矣。

2014.3.20 重症感染患者的过度免疫反应

过度免疫反应通常是严重感染患者走向死亡的催化剂，早期给予肠内营养可能干预此种免疫反应。肠内营养（EN）是指通过胃肠道途径为人体提供代谢所需营养素的营养支持方法。柳柏斯（Lubbers）等将18名健康志愿者分成三组，每人均注射大肠埃希菌脂多糖（2ng/kg）。其中一组志愿者持续给予高脂肪、高蛋白质肠内营养液；二组志愿者给予低脂肪、低蛋白、高碳水化合物肠内营养液；三组不给予肠内营养液。分别检测三组志愿者的TNF-α、IL-6、IL-1等指标。综合各项结果得出持续给予富含脂肪、蛋白的营养液可以减轻肠道的炎症反应。

2014.3.20 脑垂体再说

在颅内两大脑半球之间，丘脑之前下方，居于蝶鞍之上，横跨视神经交叉者，脑垂体也。脑垂体横径1.5cm，高0.5cm，重量1g，其在人体中的重要性却非其他脏器可比。

垂体前叶：①嫌色细胞（占50%）：不分泌激素。②嗜酸性细胞（占35%）：分泌催乳素、生长素。③嗜碱性细胞（占15%）：分泌促甲状腺素、促肾上腺皮质激素、促性腺激素（卵泡刺激素、黄体生成素）。

垂体后叶：分泌抗利尿素、催产素。

嫌色细胞为相对幼稚的细胞，可向嗜酸和嗜碱性细胞转化，届时便有了分泌功能。

2014.3.26 《中国医学论坛报》（2014年3月20日刊）阅读小记

1.缺血性心脏病的发病率和死亡率均较前减少，但因当前社会老龄化严重，该病对社会造成的负担越来越大。

2.益生菌（乳酸杆菌、双歧杆菌、嗜热链球菌、布拉氏酵母菌）对人体的消化道有很好的作用，对消化道以外之其他疾患亦有很好的治疗作用，如肝病、心血管病、过敏性疾病、呼吸系统疾病、泌尿系疾病等。中医认为，脾胃为后天之本，又谓"有胃气则生，无胃气则死"。益生菌之健脾作用，属大补后天。前述柳柏斯(Lubbers)之三组实验均说明脾胃对健康的重要性。传统中医临床用药，通常将顾护胃气与否作为高水平与低水平之分界标。

3.阿奇霉素、左氧氟沙星并非完全安全，前者危险情况出现于用药1～5天；后者在持续服用10天后，患者的死亡率和严重心律失常风险均显著增加。

2014.4.8 血小板减少性紫癜一方

本病余前用"五虎丹丹草，白女生兰香（金银花、连翘、蒲公英、败酱草、紫花地丁、山栀子、丹皮、丹参、益母草、茜草、木通、白芍、女贞子、生地黄、泽兰、香附）"，又用参芪三黄汤（党参、黄芪、大黄、黄连、黄芩、白术、白蒺藜、制乳香、制没药），亦用犀角地黄汤；后重用白仙藕（白茅根、仙鹤草、藕节炭），出血加白虎，紫癜赤丹牛（赤芍、丹皮、牛膝），脾虚六君酬。

近日，余在荟萃堂治疗一位患者，女，42岁。血小板14×10^9^/L。

处方：人参须15g，太子参15g，潞党参15g，北沙参15g，生地黄12g，山萸肉30g，菟丝子10g，枸杞子10g，女贞子10g，桂枝10g，龟甲15g，补骨脂10g，皂矾2g，鸡血藤15g，黄芪30g，大黄10g，黄芩10g，黄连6g，白蒺藜30g，制乳香、制没药各6g。

此方服用10剂，患者血小板升至104×10^9^/L。

2014.4.9 再谈原发性血小板增多症

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This is a proliferative bone marrow disorder. Western medicine commonly uses hydroxyurea, heparin, aspirin, and other anti-aggregants, but none of these have curative effects. In recent years, given the frequent occurrence of allergic purpura and upper respiratory tract infections in children, I have pondered: platelets are the blood component with the strongest immune tendency; thrombocytopenic purpura was one of the earliest blood diseases to be classified as an autoimmune disease. By analogy, an increase in platelet count should also fall into this category. The fact that some patients respond well to hormone therapy for this condition further supports this view. A transient increase in platelet count does not necessarily indicate essential thrombocythemia; at most, it can be regarded as an early manifestation of the progression of a blood disease, and thus remains treatable. I have treated such cases with modified formulations of Mahuang Guizhi Heji, Jinche Heji (containing turmeric, purple placenta, salvia miltiorrhiza, astragalus, polygonum multiflorum, etc.), Zilong Heji (containing lithospermum, gentian, chicken blood vine, strychnos nux-vomica, halite, dryopteris crassirhizoma, etc.), and Wumu Heji (containing black plum, oyster shell, phellodendron, papaya, leech, green peel, tangerine peel, etc.), supplemented by Xiaofeng No. 2. Most patients have achieved cure.

April 10, 2014: Gout Treatment Case

In the year of Jia Wu, a gout patient had a uric acid level of 607 μmol/L. After taking the following prescription for 10 doses, the uric acid level dropped to 214 μmol/L.

Prescription: Angelica sinensis 10g, Ligusticum chuanxiong 10g, Rehmannia glutinosa 12g, Peach kernel 10g, Safflower 6g, Honeysuckle 20g, Forsythia 20g, Dandelion 20g, Patrinia 20g, Leonurus cardiaca 20g, Salvia miltiorrhiza 10g, Isatis indigotica 10g, Perilla frond 10g, Areca nut 10g, Papaya 20g, Tangerine peel 6g, Licorice 6g, Cinnamon twig 10g, Aconite slice 6g, Pinellia ternata 6g, Evodia rutaecarpa 6g, Polygonum multiflorum 10g. One dose daily, decocted in water and taken orally.

April 16, 2014: Further Discussion on Oral Ulcers

Oral ulcers are common and frequently recurring conditions that are difficult to cure. When accompanied by inflammation around the anus or conjunctiva, they are referred to as Behçet's disease; when associated with joint pain, they are called Reiter's syndrome. This shows that oral ulcers are sometimes more than just simple ulcers. This condition has an immune component, and such patients are most commonly seen in outpatient clinics. In treating this condition, I have traditionally used formulas such as Xiehuang San, Zhibai Maiwei Chaidan Yuan, Yipian Huangtu Dongshengcao, Yunü Jian, and Yangyin Qingfei Wan, with modifications, and most cases show improvement. Recently, I found in the "Clinical Handbook of Traditional Chinese Medicine" that the "Shihu Qingwei Tang" from "Zhang Shiyitong" can treat this condition.

Shihu Qingwei Tang formula: Dendrobium 10g, Tangerine peel 6g, Poria 12g, Licorice 6g, White hyacinth bean 10g, Agastache rugosa 10g, Citrus aurantium 10g, Moutan cortex 10g, White peony 30g. One dose daily, decocted in water and taken orally.

Mnemonic: Hyacinth bean fragrance, two stones (citrus), peony and licorice—oral inflammation.

Another formula is Ganlu Yin, which has similar effects to the above and is recorded in the "Taiping Huimin Heji Ju Fang."

Ganlu Yin formula: Dendrobium 10g, Asparagus cochinchinensis 15g, Ophiopogon japonicus 15g, Rehmannia glutinosa 12g, Rehmannia preparata 12g, Baked loquat leaf 10g, Artemisia capillaris 10g, Citrus aurantium 10g, Scutellaria baicalensis 10g, Licorice 6g. One dose daily, decocted in water and taken orally.

Mnemonic: Winter earth, loquat, artemisia, citrus, dendrobium, scutellaria, and licorice.

Another formula: Ganlu Yin with added Bupleurum and rhinoceros horn, specifically for treating halitosis.

Mnemonic: Winter earth, loquat, artemisia, citrus, bupleurum, scutellaria, and rhinoceros horn.

There is also Pei's Qingwei Tang formula: Dendrobium 10g, White peony 20g, Licorice 6g, Scutellaria baicalensis 10g, Artemisia capillaris 10g, Gardenia jasminoides 10g, Gypsum 30g, Coptis chinensis 6g, Agastache rugosa 10g, Ledebouria 12g, Forsythia 15g, Mint 6g, Schizonepeta 10g. It has the effect of clearing heat and cooling blood, and is mainly used to treat halitosis, toothache, oral ulcers, and gum bleeding.

April 26, 2014: My Views on Elevated Hemoglobin