Collected Medical Papers of Pei Zhengxue

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Collected Medical Papers of Pei Zhengxue Volume 2 I985 1990 Collected Medical Papers of Zhengxue (Volume 2)

Table of Contents for Collected Medical Papers of Pei Zhengxue (Volume 2) ① Pushing macroscopic syndrome differentiation toward microscopic syndrome differentiation is the urgent task of current TCM academic development ............................................................... (“Chinese Journal of Traditional Chinese Medicine” 1986 · 7)

② An initial exploration of the theoretical basis and clinical methods of the integration of TCM and Western medicine............(“Research on the Integration of TCM and Western Medicine” 1989-1)

Research progress on hepatitis B.............................................(“Research on the Integration of TCM and Western Medicine” 1989 · 1)

④. A comparative observational report on TCM syndrome differentiation and treatment in 429 cases of chronic active hepatitis B............ (“Chinese Journal of Traditional Chinese Medicine” 1989-2)

5. Observation on the therapeutic effect of TCM in treating 289 cases of chronic active hepatitis B............ (“Research on the Integration of TCM and Western Medicine” 1988 · 1)

6. Observational report on TCM syndrome differentiation and treatment of 76 cases of diabetes mellitus.....................(“Research on the Integration of TCM and Western Medicine” 1990 ·2)

Clinical analysis report on 2021 cases of hepatitis B in Lanzhou area...report..............................(“Gansu Medical Journal” 1989 ·4)

8. Clinical report on TCM syndrome differentiation and treatment of 100 cases of hepatitis B........................(“Research on the Integration of TCM and Western Medicine” 1987 · 1)

9. Flowers grow more fragrant after enduring frost (Biography and academic thoughts of renowned TCM physician Pei Sheng)............... (“Gansu TCM” 1987 · 1)

10. Combining macroscopic and microscopic syndrome differentiation to improve the level of TCM diagnosis and treatment........................(“Chinese Journal of Traditional Chinese Medicine” 1986 ·7)

11. Application of the Tongbang method in internal medicine emergencies..............................(“Journal of Integrated TCM and Western Medicine” 1986 ·6th issue)

12. Clinical insights on promoting blood circulation I number................................................(“Journal of Integrated TCM and Western Medicine” 1975 ·4)

13. Experiences in the clinical application of Yueju Wan...................................................... (“Journal of Traditional Chinese Medicine” 84 ·7)

14. Experiences in using a self-formulated Shenqi Sanhuang Tang to treat idiopathic thrombocytopenic purpura .................................................................. (“Research on the Integration of TCM and Western Medicine” 1986 · 1)

. Report on TCM treatment of 76 cases of hair loss......................................................(“Journal of Traditional Chinese Medicine” 1987 ·7)

6 A casual discussion on the format of medical records in integrated TCM and Western medicine.......................................... (“Gansu TCM” 1989 · 1)

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[Issue No. 9, 1987]{.underline}

Academic Debate: Pushing macroscopic syndrome differentiation toward microscopic syndrome differentiation is the urgent task of current TCM academic development—Pei Zhengxue, Gansu Institute of New Pharmaceutical Sciences Editor’s Note: The author is the Vice Chairman and Secretary-General of the Gansu Provincial Association for Research on the Integration of TCM and Western Medicine, as well as the Deputy Director and Head of the Department of Integrated TCM and Western Medicine at the Gansu Institute of New Pharmaceutical Sciences. He has extensive experience and has published three monographs in Beijing and Gansu over the years. In addition, he has 42 papers on the integration of TCM and Western medicine, which have been published in medical journals across the country, including 16 papers published in national-level journals. This article was originally commissioned by our journal; however, due to our delayed printing, it was subsequently published in the inaugural issue of “Chinese Journal of Traditional Chinese Medicine” (a high-level bi-monthly journal of advanced TCM scholarship based in Beijing). We hereby extend our apologies to the author and readers.

TCM academic tradition was laid down in the pre-Qin period, refined through the practical experience of Zhang Zhongjing, strengthened by the debates among scholars of the Jin and Yuan dynasties, and further innovated by the Warm Disease School, ultimately becoming an invaluable treasure that has enabled the Chinese nation to thrive, strengthen itself, and safeguard its country. Even today, in the 20th century, TCM continues to stand tall in the global medical community, shining brightly and attracting widespread attention. However, over the past century, modern science and technology have been advancing at an astonishing pace, and human understanding of disease has shifted from the macroscopic to the microscopic, from broad observations to detailed examinations. As a natural science dedicated to combating disease, TCM should naturally become part of the modern scientific network system and advance in tandem with modern science and technology. Yet, due to historical constraints, previous generations have neither been able nor could they take significant steps in this direction. Consequently, this glorious yet arduous historical mission now falls squarely on the shoulders of us TCM practitioners. Faced with this challenge, the author proposes the idea of “pushing macroscopic syndrome differentiation toward microscopic syndrome differentiation,” and invites colleagues in the TCM community to discuss this issue together. Any shortcomings or inaccuracies are welcome to be criticized and corrected.

I. Traditional TCM syndrome differentiation is macroscopic “Syndrome differentiation and treatment” is the hallmark of the TCM academic system and also the essence of all Chinese medicine. The foundation of “syndrome differentiation and treatment” lies in observation, auscultation and olfaction, inquiry, and palpation; the method is logical reasoning. Throughout the process of “syndrome differentiation and treatment,” only the doctor’s sensory organs and the analytical capabilities of the cerebral cortex are fully utilized. Looking back at the history of TCM development, we can easily trace the origins and evolution of this trend.

The development of TCM has always been rooted in agriculture and handicrafts, from Bian Que in the fourth century BC to modern physicians such as Xiao Longyou and Pu Fuzhou. Throughout history, TCM practitioners have never had access to the sophisticated instruments provided by large-scale industry for studying traditional medicine. Therefore, the traditional achievements in the field of TCM can only come from macroscopic observation and judgment of the external manifestations of disease. In this context, tongue color, pulse condition, patients’ subjective symptoms, and certain external physical signs become the main basis for diagnosing diseases. Previous generations have summarized four diagnostic methods, eight principles, qi-blood-phlegm-fire, five movements and six energies, and so on, thus forming a distinctive TCM syndrome differentiation system. This system has indeed played a tremendous role in humanity’s understanding and treatment of disease, and

[Qingyang TCM]{.underline}

it continues to play an important role even today. However, since human senses can only observe the external manifestations of disease, the essence of the principle “treating disease must seek its root” is actually logical reasoning to identify the cause based on syndrome differentiation, while it is impossible to gain direct insight into the intrinsic changes within the disease. Over the centuries, physicians have accumulated many vivid reasoning methods, such as analogy, similarity, and seeking commonalities, in an attempt to form an accurate mental image of the nature of the disease. Although these imaginations lack a solid experimental research foundation, they are derived from clinical practice and have practical experience as their core, so they still hold universal guiding significance for TCM clinical practice.

II. Modern medicine provides microscopic evidence

In modern times, the development of large-scale industry and natural science have complemented and promoted each other. Thanks to the new theories provided by natural science and the advanced instruments produced by large-scale industry, human understanding of disease has gradually become more microscopic. At the end of the 17th century, following the Industrial Revolution in Britain, Western medicine emerged under these circumstances. Experimental research replaced traditional logical reasoning, and microscopic understanding supplemented medieval macroscopic reasoning—this was the hallmark of that early stage. As a result, Western medicine stood out with a brand-new appearance, forming a microscopic system based on physiological and pathological changes in organs, tissues, cells, body fluids, and nerves. Every link in this system, as well as the corresponding clinical treatments and prescriptions, are closely related to the progress of modern natural science. This transformation in the field of Western medicine made it an important component of the modern scientific network system, permeating and mutually reinforcing other fields such as physics, chemistry, microbiology, meteorology, geology, and so on, advancing in sync. Examination methods and microscopic data such as liver function tests, protein electrophoresis, alpha-fetoprotein, and three-system tests for liver disease, fiber gastroscopy and tissue biopsy for stomach disease, electrocardiogram, vectorcardiogram, and echocardiography for heart disease—all are products of experimental research and results of mutual penetration among various fields of modern natural science.

III. Only by combining macroscopic and microscopic perspectives can we achieve a comprehensive understanding of disease

There is no doubt that macroscopic syndrome differentiation is an important aspect of understanding disease. However, microscopic syndrome differentiation is another equally important aspect. To make syndrome differentiation both comprehensive and precise,

both aspects must be considered together. For example, in liver disease, based on macroscopic patterns such as Qi stagnation, Liver Wood overcoming Earth, Liver-Gallbladder damp-heat, and Liver-Kidney Yin deficiency, if we also comprehensively consider microscopic changes in liver function, plasma proteins, “alpha-globulin,” and so on from the perspective of TCM syndrome differentiation and treatment, we will undoubtedly deepen our understanding and improve therapeutic efficacy. Through long-term clinical practice, the author has discovered some patterns that may be useful for colleagues to refer to. To lower SGPT levels, it is effective to use heat-clearing and detoxifying herbs such as Forsythia, Lonicera, Dandelion, Houttuynia, Prunella, Isatis root, Gentian, and Sedum; to turn turbidity test results negative, it is effective to use tonifying and consolidating herbs such as Astragalus, Codonopsis, Polygonum multiflorum, and Angelica sinensis. By testing with medication, we can determine that the former indicates excess pathogenic factors, while the latter indicates deficiency—SGPT elevation reflects elevated transaminases, which is “excess”; increased turbidity indicates decreased albumin, which is “deficiency.” As the “Inner Canon” says, “eliminate excess” and “supplement deficiency,” so the former requires heat-clearing and detoxifying methods, while the latter requires tonifying and consolidating methods. In regulating the three systems of hepatitis B, the author often uses heat-clearing and detoxifying methods to lower surface antigen ratios, and tonifying and consolidating methods to turn core antibody results negative. Modern immunological views hold that the relationship between antigens and antibodies is complementary, so the essence of TCM syndrome differentiation for the three systems of hepatitis B should be a combination of deficiency and excess, and treatment should emphasize both heat-clearing and detoxification as well as tonifying and consolidating, so that the medication truly addresses the root cause. In chronic nephritis, macroscopic syndrome differentiation often manifests as Yang deficiency with water overflow, spleen-stomach qi deficiency, lung failing to descend, Liver-Gallbladder fire, and bladder damp-heat; microscopic syndrome differentiation should pay attention to casts, red blood cells, white blood cells, protein, non-protein nitrogen, carbon dioxide binding capacity, and other indicators in routine urine tests. When treating this disease, the author first determines a basic formula based on macroscopic syndrome differentiation, such as Zhenwu, Jisheng, Liu Jun, and Longdan Xiegan, then prescribes tonifying and astringent medicines for proteinuria, hemostatic medicines for hematuria, and heat-clearing and detoxifying medicines for white blood cells in urine; if non-protein nitrogen rises or carbon dioxide binding capacity declines, it is advisable to use methods that lift the clear and sink the turbid. Gastric pain ( Continued on page 21)

Syndrome differentiation and treatment, oh, Sichuan meat small and, stomach fire raging, spleen-stomach damp-heat, lung-stomach yin deficiency, and so on; microscopically, it involves fiber gastroscopy, pathological biopsy changes, gastric juice analysis, and so on. The author usually determines a basic formula based on macroscopic syndrome differentiation, such as Liu Jun, Xiaoyao, Qingwei, Xiexin, and Yiguan Jian, and if microscopic examination reveals superficial gastritis, adds Coptis and Scutellaria; if atrophic gastritis, adds Salvia miltiorrhiza, Corydalis yanhusuo, Coptis, and Scutellaria; if gastric or duodenal ulcer, adds White Peony, Raw Dragon Bone, and Cuttlefish Bone; if gastric prolapse, adds Astragalus, Citrus aurantium, and Atractylodes; if gastric mucosal prolapse, adds Agarwood, Sandalwood, Amomum, and Cardamom, and so on. IV. Conclusion The combination of macroscopic and microscopic syndrome differentiation is an important trend in the current development of TCM. It is not merely a matter of improving the therapeutic efficacy of TCM, but rather the urgent task facing TCM today in the 1980s. Only by boldly extending TCM academic research into the microscopic world can TCM both preserve its unique characteristics and integrate into the modern scientific and technological network system characterized by mutual interweaving and penetration. Only in this way can TCM advance in step with modern science and technology. The era when “the older TCM is, the better” should be a thing of the past, and the time when “every word in the “Treatise on Cold Damage” is golden and unchangeable” should also be gone. We hope that in the near future, TCM monographs surpassing the “Treatise on Cold Damage” and “Discussions on Warm Diseases” will appear in the Chinese medical community, featuring the combination of macroscopic and microscopic perspectives. 21

Please feel free to offer criticism and corrections. I. Theoretical Basis of TCM-Western Medicine Integration TCM and Western medicine originated and developed on different social foundations. As Engels stated in “Dialectics of Nature,” “When the economic base changes, the entire superstructure undergoes change, sooner or later”①. The differences between TCM and Western medicine are precisely the result of such changes in the superstructure. TCM became an academic discipline around the fourth century BC, during a period of transition from slave society to feudal society in China. In line with the reform of the ownership of the means of production, TCM broke free from the shackles of divine authority and the concept of destiny, finally separating itself from witchcraft. The famous TCM physician Bian Que was a representative figure of this transformative period, and the “Yellow Emperor’s Classic of Internal Medicine” was the representative work of that era. Over the subsequent two thousand-plus years, China remained in a long feudal society (after the Opium War in 1940, it became a semi-feudal, semi-colonial society), with an economic base primarily composed of individual farming and scattered handicrafts. Such an economic foundation could not provide modern instruments and equipment for the development of medicine, let alone microscopic data on physiology, anatomy, biochemistry, pathology, and other areas. Therefore, what people engaged in TCM clinical practice and theoretical exploration could rely on were only patients’ complaints and the external manifestations of disease. Beyond that, if there was anything else to rely on, it was the TCM practitioners’ own thinking and