July 24, 2014: Case Study on the Treatment of Chronic Glomerulonephritis

Neonatal hemolytic anemia, also known as ABO hemolytic anemia, is caused by ABO blood type incompatibility between mother and child. It is most common when the mother is blood type O and the newborn is blood type A or B. This incompatibility is not uncommon, but only a small fraction of infants develop neonatal hemolysis, and most cases are mild, usually resolving within a week. Only a very small number of cases present with severe jaundice and anemia requiring treatment. Common laboratory tests for this condition include complete blood count, biochemical tests, Coombs test, and antibody release test. Treatment mainly involves phototherapy, intravenous immunoglobulin and albumin, and only a very small number of severe cases require exchange transfusion. Traditional Chinese Medicine treatment can use Artemisia capillaris decoction and Artemisia capillaris five-ingredient powder.

July 24, 2014: Case Study on the Treatment of Chronic Glomerulonephritis

In the summer of the Jiawu year, a patient, Ms. Wu, 18 years old, came to the clinic suffering from chronic glomerulonephritis for 5 years, with no improvement despite numerous treatments. One month ago, she sought treatment from me, with occult blood (+++) and protein (+++) in her urine.

Prescription: Angelica sinensis 10 g, White Peony 10 g, Chuanxiong 6 g, Rehmannia 12 g, Peach Kernel 10 g, Safflower 6 g, Motherwort 15 g, Salvia miltiorrhiza 15 g, Honeysuckle 15 g, Forsythia 15 g, Isatis indigotica 15 g, Euryale ferox 20 g, Rosa laevigata 20 g, Cicada Slough 6 g, Willow 15 g, Perilla 15 g, White Reed Root 15 g, Cypress Leaf 15 g, Large Thistle and Small Thistle each 15 g, Ligustrum 10 g, Gardenia 10 g, Fern 10 g, Plantain 10 g, Half Branch Lotus 15 g, White Snake Tongue Herb 15 g. Two doses every three days. Decocted in water.

After taking the above prescription for 20 doses over about a month, the patient’s occult blood and protein in urine both turned negative.

This formula is composed of Kidney-Nourishing Soup + Gold-Filled Compound + White Leaf Two-Three Women + Mountain Phoenix Two-Car Half.

July 28, 2014: Urachal Cancer and Craniopharyngioma

The urachus is a duct during pregnancy that connects the umbilical cord to the fetal bladder, serving as a pathway for the mother to excrete fetal metabolic products. After delivery, it automatically closes and transforms into fibrous tissue, known as the median umbilical ligament, which fixes the position of the bladder. Cancer originating from this tissue is called urachal cancer, usually considered a part of bladder cancer, often located on the anterior wall and posterior neck of the bladder. Hematuria and urinary tract irritation are the main symptoms of this disease, with surgery and radiotherapy/chemotherapy being the primary treatments. This disease is extremely rare, predominantly affecting males, with the peak incidence between 50 and 60 years of age. In 90–95% of cases, it is initially mistaken for bladder cancer, and 50% are considered bladder cancer before surgery, so surgical methods often result in poor prognosis.

Craniopharyngioma is commonly seen in children under 15, though it can occur at various ages. Tumor cells often originate from protrusions on the embryonic ectoderm, so they frequently appear near the pituitary gland, above the sella turcica. The main symptoms include headache, vomiting, visual impairment, endocrine changes, diabetes insipidus, and slow growth. Because this tumor is not highly malignant and grows slowly, surgical outcomes are often poor, with many sequelae, and currently there is no ideal treatment method.

July 29, 2014: Gastrointestinal Stromal Tumor and Signet Ring Cell Carcinoma

Gastrointestinal stromal tumors are mostly found in the stomach and small intestine, with tumor cells originating from mesenchymal tissue. This tumor is a potentially malignant benign tumor, including gastric leiomyoma and smooth muscle tumor, as well as other tumors derived from mesenchymal tissue. Surgery and radiotherapy/chemotherapy are standard treatments, but gastrointestinal stromal tumors are not very sensitive to radiotherapy/chemotherapy.

Signet ring cell carcinoma is an extremely malignant tumor of the gastrointestinal tract, also known as mucinous cell carcinoma, because the cancer cells are filled with mucus, pushing the nucleus to one side and forming a signet ring shape, hence the name. This cancer is highly malignant, with diffuse local infiltration, making the stomach resemble leather, and capable of rapidly metastasizing to lymph nodes around the liver. Treatment options include surgery, radiotherapy, and chemotherapy.

August 4, 2014: Traditional Chinese Medicine Treatment of Hemolytic Jaundice

Hemolytic jaundice is essentially hemolytic anemia, representing two sides of the same issue. Hemolytic anemia can be classified according to its pathogenesis as follows: ① Red blood cell membrane defects: hereditary spherocytosis, paroxysmal nocturnal hemoglobinuria. ② Red blood cell enzyme defects: glucose-6-phosphate dehydrogenase deficiency. ③ External factors affecting red blood cells: drug poisoning.

In cases of hemolytic anemia, indirect bilirubin increases, urobilinogen is positive, urobilin is negative, hemoglobin and red blood cells decrease (anemia), reticulocyte count increases, and alkaline phosphatase rises. In autoimmune hemolytic anemia, the Coombs test is positive. In paroxysmal nocturnal hemoglobinuria, the acid hemolysis test (Ham test) is positive, and hepatosplenomegaly may be observed. Currently, Western medicine has no specific cure or effective drugs for this condition, relying only on adrenal corticosteroids, immunosuppressants, androgens, and bone marrow suppressants for treatment.

Traditional Chinese Medicine believes that jaundice is caused by "stagnant heat inside," indicating that jaundice is a combination of heat and dampness. Most cases of jaundice fall into this category, known as yang jaundice. There is also a term for yin jaundice, as stated in "Jin Gui Yao Lue · Jaundice Disease Pulse and Symptom Treatment": "When yin is overcome by cold, heat flows into the bladder, causing the whole body to turn yellow, known as 'grain jaundice'." This grain jaundice is what we now call hemolytic jaundice, with Artemisia capillaris decoction as the main formula. There is also "female labor jaundice," characterized by urgent bladder symptoms, lower abdominal fullness, whole-body yellowing, black forehead, and hot feet, with nitrate-alum powder as the main formula.

In the height of summer in the Jiawu year, I was seeing patients at the outpatient clinic of the Gansu Provincial Hospital of Traditional Chinese Medicine. A 56-year-old female patient presented with jaundice, dark red urine, indirect bilirubin accounting for 9/10 of total bilirubin, a reticulocyte percentage of 10%, and an average red blood cell volume of 125 fL. She was diagnosed with hemolytic anemia, specifically paroxysmal nocturnal hemoglobinuria.

Prescription: Rehmannia, Cornus, Ginseng, Pseudoginseng, Codonopsis, Glehnia, Cinnamon, White Peony, Licorice, Floating Wheat, Licorice, Jujube, Ginger, Mugwort, Artemisia, Sophora, Motherwort, Saltpeter, Alum, White Snake Tongue Herb, Half Branch Lotus, Solanum nigrum, Lycopus.

After taking the above prescription for 10 doses, the patient’s jaundice level dropped to 15 μmol/L, and all other indicators returned to normal.

August 13, 2014: Another Formula for Chronic Leukemia

In the height of summer in the Jiawu year, Mr. Wang, a male patient, came to the clinic with a formula, claiming: "This is a divine formula. My hemoglobin has remained at 189 g/L for 10 years without dropping, but after taking this formula for 30 doses, it fell to 151 g/L, and my liver function also returned to normal." Upon reviewing the formula, I realized it was the liver-nourishing formula I had prescribed to him three months earlier. This patient suffers from chronic hepatitis B, with ALT and AST both exceeding 100 U/L, and hemoglobin consistently above 180 g/L, never dropping. I treated him with a combination of Strong Liver Soup and a formula designed to significantly reduce enzyme levels.

Prescription: Salvia miltiorrhiza 30 g, Astragalus 30 g, White Peony 15 g, Angelica sinensis 10 g, Gentiana macrophylla 10 g, Isatis indigotica 15 g, Honeysuckle 15 g, Forsythia 15 g, Dandelion 15 g, Patrinia 10 g, White Snake Tongue Herb 15 g, Half Branch Lotus 15 g, Five-Flavor Berry Powder 3 g (to be taken in divided doses), Polygonum multiflorum 20 g, Polygonatum 20 g, Codonopsis 10 g, Alisma 10 g, Licorice 6 g, Hawthorn 10 g, Shenqu 10 g, Artemisia 10 g. Thirty doses, one dose per day, decocted in water.

August 10, 2014: A Case of Stubborn Oral Ulcers

In the summer of the Jiawu year, a 50-year-old female patient suffered from chronic, stubborn oral ulcers, which I treated with the following formula.

Prescription: Sandalwood, Ophiopogon, Polygonatum, Dendrobium, Gypsum, Gardenia, Coptis, Scutellaria, Agastache, Ledebouriella, Rehmannia, Anemarrhena, Achillea. One dose per day, decocted in water.

After taking the above prescription for 10 doses, the patient’s oral ulcers healed completely.

August 21, 2014: Alteplase

Alteplase, also known as Ataprase or Ataplu, is the latest thrombolytic agent, a fibrinolytic drug, best used in the early stages of ischemic stroke, and the earlier the better. Each vial contains 50 mg, to be diluted in 5% glucose or 0.9% sodium chloride injection solution for intravenous drip.

August 27, 2014: On Neuropathic Invasion (PNI)

PNI is an important pathological factor affecting cancer prognosis. As early as 1835, Cruveilheir first proposed that head and neck malignancies are most likely to invade the intracranial space along nerve pathways. Later, through numerous studies, people gradually recognized that cancers of the skin, pancreas, colon, gallbladder, prostate, bladder, and other organs also exhibit PNI, and long-term clinical observations have proven that PNI is a reliable indicator for assessing cancer prognosis.

September 2, 2014: Wuji Baifeng Wan

Wuji Baifeng Wan formula: black chicken (de-feathered, de-clawed, gutted, and cleaned of impurities), ginseng, astragalus, deer antler glue, turtle shell, oyster, cuttlefish, angelica, white peony, xiangfu, asparagus, licorice, Rehmannia, cooked Rehmannia, chuanxiong, silver bupleurum, salvia, euryale, and others. All ingredients were ground into powder and made into water pills, 10 pills per dose (0.2 g).

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This formula was first recorded in Gong Tingxian's "Shoushi Baoyuan," and later modified and formulated by the imperial physicians of the Qing court, becoming known as "Wuji Baifeng Wan," used to treat leukorrhea, dysmenorrhea, and menstrual irregularities among concubines and palace maids. The formula is based on the Siwu Tang composed of Rehmannia glutinosa, Ligusticum chuanxiong, Paeonia lactiflora, and Angelica sinensis; supplemented with Tian Dong, Shu Di Huang, and Ren Shen for tonifying the three treasures; and employs turtle shell, oyster shell, Euryale ferox seeds, and Sepia officinalis to astringe and stop leukorrhea while strengthening yang and suppressing yin; additionally, Xiang Fu and Salvia miltiorrhiza are added to invigorate blood circulation, and Bupleurum chinense to clear heat and resolve stagnation.

Among these ingredients, Siwu Tang, Salvia miltiorrhiza, and Xiang Fu primarily invigorate blood and regulate menstruation, while the three treasures serve as supplementary support; turtle shell, oyster shell, Sepia officinalis, and Euryale ferox seeds act as adjuncts to astringe and stop leukorrhea; two deer antlers suppress yin, and Bupleurum chinense clears heat and resolves stagnation—these components work together to harmonize blood circulation, regulate menstruation, stop leukorrhea, and suppress yin. However, this formula lacks herbs that clear heat and detoxify, because women in the imperial harem generally have no history of promiscuity, and their ailments are mainly caused by endocrine disorders.

2014.9.4 Gynecological Rejuvenation Pill

Gynecological Rejuvenation Pill formula: Angelica sinensis, Ligusticum chuanxiong, Rehmannia glutinosa, Paeonia lactiflora, Ren Shen, Atractylodes macrocephala, Poria cocos, Glycyrrhiza uralensis, Cornus officinalis, Dioscorea opposita, Moutan cortex, Alisma plantago-aquatica, Eucommia ulmoides, Achyranthes bidentata, Dipsacus asper, Xiang Fu, Leonurus cardiaca, Corydalis yanhusuo, Panax notoginseng, Artemisia argyi, Salvia miltiorrhiza, Lycium barbarum, Phellodendron amurense, Toona sinensis, Cimicifuga foetida, Amber, Turtle shell, Raw dragon bone, Raw oyster shell, Sepia officinalis, Astragalus membranaceus, Cistanche deserticola, Sanguisorba officinalis, Ligustrum lucidum, Citrus reticulata, Polygala tenuifolia, Stir-fried Ziziphus jujuba seed, Rubus idaeus, Deer antler frost, Scutellaria baicalensis, Nelumbo nucifera leaf, Alpinia oxyphylla.

This formula incorporates eight precious herbs such as Siwu Tang, Liuwei Dihuang Tang, Wuji Baifeng Wan, Gui Pi Tang, Xiang Fu, Corydalis yanhusuo, Salvia miltiorrhiza, Panax notoginseng, and Leonurus cardiaca—all of which invigorate blood circulation—and also contains turtle shell, Rubus idaeus, Sanguisorba officinalis, Dragon bone, Oyster shell, Sepia officinalis, and Amber—ingredients that astringe and stabilize the body—as well as Bai Wei, Scutellaria baicalensis, Nelumbo nucifera leaf, and Alpinia oxyphylla—herbs that clear heat and calm the spirit. The single ingredient of Deer antler frost is intended to suppress yin and stop bleeding. Therefore, this formula has the effects of invigorating blood circulation, resolving stasis, stabilizing and astringing leukorrhea, clearing heat and calming the spirit, while also nourishing both qi and blood and strengthening the spleen and kidneys, making it suitable for treating all syndromes in perimenopausal women.

2014.9.15 Neurofibroma

This disease is an autosomal dominant genetic disorder, with most patients developing symptoms during childhood. It can affect the skin and subcutaneous tissues, occurring either singly or in multiple lesions, with various forms such as grape-like, bead-like, or hilly patterns. Milk coffee-colored macules are commonly seen in the early stages of the disease, accounting for about 50% of cases. This condition is often accompanied by incomplete brain development.

Although neurofibromas are benign tumors, they have a tendency to become malignant, making radiotherapy and chemotherapy unsuitable, and surgery is also not recommended. Surgery may be considered only in the following situations: ① when the tumor compresses blood vessels, leading to complete functional impairment; ② when the tumor ruptures, causing massive hemorrhage and endangering life.

2014.9.17 Safety Issues of Nucleoside Drugs

Nucleoside drugs such as entecavir, adefovir dipivoxil, and lamivudine have opened a new chapter in the antiviral treatment of hepatitis B, but their safety still warrants attention.

Common adverse reactions to these drugs include: ① dizziness, headache, gastrointestinal symptoms, and rash; ② elevated creatine kinase and serum amylase levels; ③ long-term use may lead to lactic acidosis, hepatic steatosis, redistribution of body fat, and impaired renal function, resulting in increased creatinine levels.

2014.9.20 Summary of Traditional Chinese Medicine Treatment for Cancer

Firstly, for lung cancer, gastric cancer, and colorectal cancer, radiotherapy and chemotherapy should be combined with traditional Chinese medicine. The focus of TCM is to strengthen the body’s vital energy and consolidate its foundation, while Western medicine aims to target the pathogenic factors of the disease. Lung, stomach, and colon cancers are currently common cancers affecting both men and women. Adopting a treatment plan that combines surgery with radiotherapy and chemotherapy has proven highly effective in extending survival and improving quality of life. However, why hasn’t the ultimate goal of conquering cancer been achieved yet? The reasons are: ① Both surgery and radiotherapy/chemotherapy focus on the local aspects of the cancer, neglecting the overall regulatory role of the whole body on the local area; ② Surgery itself is a double-edged sword—it removes cancerous tissue but also damages the body’s immune, metabolic, endocrine, and autonomic nervous systems, and the same applies to radiotherapy and chemotherapy, allowing the cancer to make a comeback; ③ Clinically, people have focused solely on improving surgical techniques, developing radiotherapy equipment, and inventing chemotherapy and targeted drugs, while paying little attention to enhancing the body’s immunity and improving its stress response capabilities.

Given these three shortcomings, perhaps shifting our perspective to traditional Chinese medicine could offer a breakthrough. TCM’s methods of strengthening vital energy and consolidating the body’s foundation precisely complement the deficiencies of Western medicine. Therefore, the formulas and medicines used in TCM for cancer treatment, passed down through thousands of years from top to bottom, can all be regarded as treasures. If we take these as a starting point and launch related research projects, it will be like using a fishing net to catch fish—after several generations of dedicated effort, TCM may soon board the fast track of modern science and technology, becoming a key contributor to the advancement of Western medicine and the conquest of cancer.

2014.9.24 Some Reflections

1. Treatment Experience for Tinnitus

A middle-aged female patient presented with dizziness, headache, fatigue, tinnitus, and blood pressure of 140/90 mmHg. She was treated with the following prescription, which proved effective: