2. Treatment Experience for Post-Ovarian Cancer Sequelae

Prescription: Angelica sinensis 10 g, Ligusticum chuanxiong 10 g, Red and White Paeonia lactiflora each 15 g, Rehmannia glutinosa 12 g, Peach kernel 10 g, Safflower 10 g, Bupleurum chinense 10 g, Citrus aurantium 10 g, Platycodon grandiflorus 30 g, Glycyrrhiza 6 g, Achyranthes bidentata 20 g, Scrophularia ningpoensis 10 g, Ophiopogon japonicus 10 g, Fritillaria thunbergii 10 g, Pinellia ternata 6 g, Uncaria rhynchophylla 30 g, Plantago major 10 g, Prunella vulgaris 15 g, Raw ochre 15 g, Arisaema heterophyllum 6 g, Aristolochia fangchi 6 g, Clematis armandii 6 g, Magnolia officinalis 6 g, Magnetite 20 g. One dose daily, decocted in water and taken orally.

This formula is a combination of Xuefu Zhuyu Tang, Yangyin Qingfei Tang, Banhou Heji, and Tinnitus Pill. If the headache is severe, white angelica, Asarum sieboldii, Notopterygium incisum, and Saposhnikovia divaricata can be added.

2. Treatment Experience for Post-Ovarian Cancer Sequelae

A middle-aged female patient suffered abdominal pain, dizziness, blurred vision, bilateral flank pain, epigastric discomfort, generalized joint soreness, and inability to care for herself after ovarian cancer surgery and subsequent radiotherapy and chemotherapy.

Prescription: Codonopsis pilosula 10 g, Atractylodes macrocephala 10 g, Astragalus membranaceus 20 g, Coptis chinensis 6 g, Pinellia ternata 6 g, Glycyrrhiza 6 g, Citrus reticulata 6 g, Poria cocos 12 g, Alisma plantago-aquatica 10 g, Ledebouriella seseloides 12 g, Notopterygium incisum and Saposhnikovia divaricata each 10 g, Bupleurum chinense 10 g, Paeonia lactiflora 15 g, Fresh ginger 6 g, Jujube 4 pieces, Cinnamomum cassia 10 g, Cimicifuga foetida 3 g, Angelica sinensis 10 g, Citrus aurantium 10 g, Agarwood 10 g, Amomum villosum 10 g, Scutellaria baicalensis 10 g, Rheum palmatum 10 g. One dose daily, decocted in water and taken orally.

This formula is Shengyang Yiwai Tang; adding Cinnamomum cassia turns it into Chaihu Guizhi Tang, used to treat Shaoyang deficiency syndrome; adding Xiangsha makes it Xiangsha Liujunzi Tang; adding Scutellaria baicalensis results in Banxia Xiexin Tang. Combining Xiangsha Liujunzi Tang and Banxia Xiexin Tang creates a supreme remedy for regulating the gastrointestinal tract; adding Cimicifuga foetida transforms it into Bu Zhong Yi Qi Tang.

Severely ill cancer patients often suffer from gastrointestinal dysfunction, recurrent colds, reactive joint pain, and other issues; the above formula is suitable for them.

2014.9.30 Zuogui Yin and Yougui Yin

During the Ming Dynasty, Zhang Jingyue proposed two formulas, Zuogui Yin and Yougui Yin, stating that the left kidney governs water while the right kidney governs fire. Examining the composition of these two formulas reveals they are essentially modifications of the Six-Ingredient and Eight-Ingredient Decoctions.

Zuogui Yin formula: Shu Di Huang 20 g, Shan Zhu Yu 12 g, Shan Yao 10 g, Poria cocos 10 g, Goji berries 10 g.

Yougui Yin formula: Zuogui Yin plus Cinnamomum cassia 10 g, Aconitum carmichaelii 6 g, Eucommia ulmoides 15 g.

Jingyue was a renowned scholar of his time, equally famous as Zhao Xianke for his expertise in tonifying the kidneys and particularly known for his skillful use of Rehmannia. Later generations therefore respectfully referred to him as “Zhang Di Huang.” In Zuogui Yin, four ingredients from the Six-Ingredient Decoction—Shu Di Huang, Shan Zhu Yu, Shan Yao, and Poria cocos—are retained, with Goji berries added as a complementary component. Goji berries are a powerful herb that nourishes yin and replenishes blood; when paired with the four original ingredients, their effect on nourishing yin and tonifying the kidneys surpasses that of the Six-Ingredient Decoction. Yougui Yin adds cinnamon, Aconitum, and Eucommia to Zuogui Yin, creating a potent formula for strengthening yang. This can be described as skillfully tonifying yang while simultaneously nourishing yin.

2014.10.3 Cataracts and Guizhi Fuling Wan

In the summer of the Jiawu year, a patient came to the clinic with a prescription, claiming, “This formula is a divine remedy that cured my uterine fibroids and also my cataracts.” Upon examination, it turned out to be a modified version of Guizhi Fuling Wan, originally prescribed a year earlier for her uterine fibroids.

Prescription: Cinnamomum cassia 10 g, Paeonia lactiflora 15 g, Poria cocos 15 g, Moutan cortex 6 g, Peach kernel 10 g, Sanleng 10 g, Ezhushi 10 g, Seaweed 10 g, Kelp 10 g, Panax notoginseng 3 g, Water leech 10 g (to be taken by brewing), Angelica sinensis 10 g, Ligusticum chuanxiong 6 g, Rehmannia glutinosa 12 g, Safflower 6 g, Atractylodes macrocephala 10 g, Bupleurum chinense 10 g, Moutan cortex 6 g, Gardenia jasminoides 10 g. One dose daily, decocted in water and taken orally.

2014.10.15 Erxian Tang for Hypothyroidism

In mid-autumn of the Jiawu year, Ms. Liu, 40 years old, suffered from hypothyroidism, presenting with edema, hair loss, and a TSH level of 19.6 mU/L. After taking Erxian Tang combined with Yuebi Tang, her TSH dropped to 0.04 mU/L, and all symptoms disappeared.

Prescription: Epimedium 10 g, Horny goat weed 10 g, Morinda citrifolia 10 g, Anemarrhena asphodeloides 10 g, Phellodendron amurense 10 g, Angelica sinensis 10 g, Ephedra 10 g, Gypsum 30 g, Glycyrrhiza 6 g, Cinnamomum cassia 10 g, Atractylodes macrocephala 10 g, Poria cocos 12 g, Alisma plantago-aquatica 10 g, Polyporus umbellatus 12 g. One dose daily, decocted in water and taken orally.

After taking this prescription for 10 doses, the patient’s TSH returned to normal.

2014.10.17 Case Study of Primary Thrombocytosis

In mid-autumn of the Jiawu year, Ms. Li, 50 years old, had suffered from primary thrombocytosis for 7 years, with persistently high platelet counts. Western medicine had tried hydroxyurea, heparin, and other treatments without significant effect. At the clinic, her platelet count was found to be 1120 × 10^9^/L, with slightly higher white blood cell levels than usual.

Prescription: Rehmannia glutinosa 12 g, Cornus officinalis 30 g, Ginseng root 15 g, Prince ginseng 15 g, Northern ginseng 15 g, Codonopsis pilosula 15 g, Salvia miltiorrhiza 30 g, Astragalus membranaceus 30 g, Angelica sinensis 10 g, Paeonia lactiflora 15 g, Gentiana scabra 10 g, Isatis indigotica 15 g, Strychnos nux-vomica 1 piece (deep-fried), Rhubarb 10 g, Water leech 10 g (to be taken by brewing), Taxus chinensis 10 g, Camptotheca acuminata 10 g, Indigofera tinctoria 3 g, August flower 10 g, Stonecrop 10 g, Amomum villosum 10 g. Two doses every three days, decocted in water and taken orally.

After taking this prescription for 20 doses, the patient’s platelet count dropped to 405 × 10^9^/L, and she reported feeling much better than before, with significant reductions in bleeding and thrombosis symptoms.

This formula combines the core liver-tonifying ingredients with the core kidney-tonifying ingredients from the Lanzhou formula, adding Strychnos nux-vomica, Rhubarb, Water leech, along with Taxus chinensis, Camptotheca acuminata, August flower, and Stonecrop. The liver-tonifying core greatly nourishes qi and blood while clearing heat from the liver; the kidney-tonifying core strongly nourishes qi and blood while tonifying yin. When the liver and kidneys are balanced, qi flows smoothly and blood circulates freely, revitalizing qi and blood, thus eliminating stagnation and promoting renewal. Primary thrombocytosis is characterized by “excess”; the task of the Lanzhou core and the strong core is to “supplement what is lacking,” while the eight stones and red flowers are responsible for “reducing what is excessive”—this is one of the standard practices in traditional Chinese medicine. I believe that chronic leukemia, including chronic myelogenous leukemia, chronic lymphocytic leukemia, multiple myeloma, myelodysplastic syndrome, and polycythemia vera, can all be treated using this formula with appropriate modifications.

2014.10.20 Atopic Dermatitis May Be a Lifelong Condition

Atopic dermatitis (AD) is a common and frequently occurring disease, traditionally thought to begin in infancy and continue into adulthood or even longer. Recent research by American scholars has found that AD eczema can accompany the condition throughout life. (April 3, 2014, China Medical Forum Daily)

2014.10.20 Bian Que’s Six No-Treats

① Those who do not believe should not be treated. ② Those who trust in witchcraft rather than medicine should not be treated. ③ Those whose clothing does not fit properly or whose diet is unbalanced should not be treated. ④ Those who value life lightly and money heavily should not be treated. ⑤ Those who change doctors frequently should not be treated. ⑥ Those who only know a few kinds of medicine should not be treated.

2014.10.28 Fanconi Syndrome

China Medical Forum Daily published a case report about a hepatitis B patient who had been taking adefovir dipivoxil for a long time and subsequently developed Fanconi syndrome. The characteristics of this disease include decreased blood phosphorus and uric acid levels, increased urinary NAG, microalbumin, glucose, and protein levels, as well as hypokalemia (muscle weakness, flaccid paralysis, periodic paralysis, etc.) and hypocalcemia (tetany, etc.).

2014.10.27 Sentinel Lymph Node Biopsy (SLNB) and Sentinel Lymph Node Dissection (SLND)

1. For early-stage breast cancer (EBC) with negative SLNB results, deep lymph node dissection (ALND) is not necessary.
2. For EBC with 1–2 positive sentinel lymph nodes, ALND is also not required.
3. For ductal carcinoma in situ of the breast, patients undergoing adjuvant chemotherapy with positive SLNB results must undergo ALND.
4. SLNB is not suitable for stage T3 or T4 breast cancer or for large breast cancers.

2014.10.29 Herbal Treatment for Thrombocytosis

The number of patients with thrombocytosis has been increasing year by year. For example, children with allergic purpura and severe colds or infections may also develop thrombocytosis. Typically, platelet counts range from 350 to 700 × 10^9^/L; if they exceed this range, primary thrombocytosis should be considered. In recent years, I have often encountered such children, and instead of using anticoagulants like hydroxyurea, heparin, warfarin, or gabapentin, I have achieved ideal therapeutic effects by applying herbal diagnosis and treatment based on syndrome differentiation.

Prescription: Ginseng root 15 g, Prince ginseng 15 g, Lu Dangshen 15 g, Northern ginseng 15 g, Rehmannia glutinosa 12 g, Cornus officinalis 30 g, Salvia miltiorrhiza 30 g, Astragalus membranaceus 30 g, Angelica sinensis 10 g, Paeonia lactiflora 15 g, Gentiana scabra 10 g, Isatis indigotica 10 g, Strychnos nux-vomica 1 piece (deep-fried), Earthworm 10 g, Water leech 10 g (to be taken by brewing), Camptotheca acuminata 10 g, Taxus chinensis 10 g.

The above prescription is adjusted according to the specific condition of the patient.

2014.10.29 Acute Pulmonary Embolism

Acute pulmonary embolism is a common and frequently occurring disease, often seen after major surgery, as well as in patients with heart disease or chronic illnesses requiring prolonged bed rest. Tumor patients with deep vein thrombosis in the lower limbs or severe varicose veins in the legs may also develop pulmonary embolism. Additionally, lipid droplets from amniotic fluid or comminuted fractures can potentially cause pulmonary embolism. The onset of this disease is sudden, with clinical manifestations such as shortness of breath, hemoptysis, chest pain, and orthopnea, which are indistinguishable from pulmonary edema caused by acute left heart failure. Previously, diagnosis was often based on the appearance of a triangular shadow on chest X-rays, with its apex pointing toward the hilum of the lung; nowadays, however, pulmonary angiography (CTPA) is the primary diagnostic tool. Western medicine mainly uses urokinase and streptokinase for thrombolysis, while TCM focuses on activating blood circulation and removing stasis with ingredients such as Red Paeonia, Ligusticum chuanxiong, Safflower, Agarwood, Salvia miltiorrhiza, Panax notoginseng, Water leech, Ephedra, Apricot kernel, Gypsum, Glycyrrhiza, dried ginger, Asarum sieboldii, Schisandra, Pinellia ternata, and others, adjusting the dosage according to the patient’s condition.

2014.11.2 On Myxomas

Myxomas are rare benign tumors in clinical practice. Three-quarters of patients present with cardiac myxomas, while the remaining quarter have myxomas in the peritoneum, appendix, or ovaries, often accompanied by elevated levels of CEA, CA125, and CA199. Myxomas are encased in a relatively thick capsule, contain mucinous material inside, and their shape is highly variable. Cardiac myxomas are usually located in the left atrium, often with pedunculated structures that sway within the left atrial cavity with blood flow, sometimes getting stuck at the mitral valve or pulmonary vein opening, leading to sudden death. The primary treatment for this disease is surgery, ensuring complete removal of the myxoma; otherwise, recurrence is very likely, often requiring second or third surgeries, and the disease is insensitive to radiotherapy and chemotherapy.

In 2002, a patient experienced persistent high fever for three months, with an erythrocyte sedimentation rate of 120 mm/h and widespread joint pain, eventually being diagnosed with adult-onset Still’s disease. After treatment, the patient’s ESR and body temperature returned to normal, and the joint pain also eased. Half a year later, the patient suddenly developed heart problems, experiencing chest pain and shortness of breath, and was admitted to a hospital in Shanghai, where she was diagnosed with a ruptured cardiac myxoma and died during surgery. The surgeon explained that the patient’s death was due to delayed treatment. Following this incident, the patient’s husband filed a complaint in Lanzhou, but after deliberation by the Gansu Provincial Medical Accident Appraisal Committee, it was determined that the Lanzhou doctor’s treatment was not problematic. This case involved adult-onset Still’s disease, which is inherently difficult to treat, and cardiac myxomas are a secondary manifestation.

2014.11.3 Pseudomyxoma Peritonei

Pseudomyxoma peritonei is caused by advanced metastases of colorectal cancer, ovarian cancer, and a small number of gastric and mucinous cancers (such as appendiceal cancer). Recently, the Peritoneal Surface Tumor International Collaborative Group (PSOGI) held a special conference in Amsterdam, Netherlands, where Professor Sugarbaker proposed cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) as the standard treatment for pseudomyxoma peritonei.

2014.11.11 Electrolytes in Chronic Kidney Disease

Hyperphosphatemia is a common clinical manifestation of chronic kidney disease (CKD). Among patients undergoing dialysis, hyperphosphatemia becomes even more prevalent, often occurring in conjunction with hyperkalemia. Hyperphosphatemia accounts for 57.4% of all dialysis patients, while hyperkalemia accounts for about 84.2%. Hyperphosphatemia stimulates the parathyroid glands, causing them to over-secrete parathyroid hormone, which in turn raises blood calcium levels, but blood phosphorus does not necessarily decrease. Consequently, high blood potassium, high blood calcium, and high blood phosphorus coexist, severely damaging the heart, brain, and kidneys, leading to rapid deterioration of the condition.

To address hyperphosphatemia, one can take calcium acetate, calcium phosphate, or calcium citrate orally, which bind with phosphorus in the intestines to form calcium-phosphorus complexes, thereby increasing phosphorus excretion through the intestines. Calcium and phosphorus metabolism are closely linked, and the function of the parathyroid glands plays a crucial role in this process. Normally, when parathyroid function is overactive, calcium levels rise while phosphorus levels fall. However, in chronic kidney disease, high blood calcium, high blood potassium, and high blood phosphorus can coexist, making the condition difficult to treat.

2014.11.18 Edema Due to Endocrine Disorders

In the depths of winter during the Jiawu year, a non-renal, non-cardiac, and non-hypoalbuminemic patient came to the provincial hospital’s outpatient clinic with edema. The patient was a 40-year-old woman who had suffered from edema for over ten years, with no obvious abnormalities found in heart, lung, or kidney examinations, only experiencing scanty periods that occurred every other month. There was no basis for diagnosing Cushing’s syndrome or Sheehan’s syndrome. After treatment with the following prescription, the edema completely subsided, and the patient reported that a five-year-long ailment had suddenly vanished.

Prescription: Verbena officinalis 15 g, Vitex negundo 10 g, Clematis armandii 10 g, Coix lacryma-jobi 15 g, Achyranthes bidentata 15 g, Earthworm 15 g, Humulus lupulus 15 g, White Vetch 15 g, White Reed Root 15 g, Ramie Root 15 g. One dose daily, decocted in water and taken orally.

After taking this prescription for 10 doses, the edema completely disappeared, and the patient felt that a stubborn illness lasting five years had suddenly vanished.

2014.11.23 Bile Reflux Gastritis and Esophagitis

During the Jiawu year, I treated nearly a hundred cases of this disease. Since I encountered patients in the outpatient clinic, detailed medical records were not kept, so I’m now compiling my treatment experience based on memory.