3. Wind-Extinguishing and Orifice-Opening Formulas

3. Wind-Extinguishing and Orifice-Opening Formulas

These formulas generally have the functions of clearing heat, extinguishing wind, and opening orifices, making them suitable for conditions involving yin injury, wind stirring, and heat invading the pericardium during the peak or later stages of febrile diseases. Commonly used formulas include Lingjiao Gouteng Decoction, Dadingfengzhu, Niuhuang Qingxin Pill, Zixue Dan, and Zhibao Dan.
Lingjiao Gouteng Decoction (from "Tongshu Shanghan Lun") contains antelope horn, gouteng, mulberry leaf, fritillaria, bamboo shavings, rehmannia root, chrysanthemum, white peony, poria, and licorice, primarily treating persistent high fever, confusion and delirium, and convulsions.
Dadingfengzhu (from "Wenbing Tiaobian") is composed of raw turtle shell, raw oyster, raw soft-shelled turtle shell, donkey-hide gelatin, ophiopogon, dried rehmannia root, hemp seed, raw white peony, schisandra, honey-fried licorice, and egg yolk, mainly used for symptoms such as extreme fatigue and impending collapse, tremors and numbness in the limbs; this formula is highly effective for post-acute convulsive symptoms in febrile diseases like encephalitis B.
Niuhuang Qingxin Pill (from "Wanmizhai Fang") includes coptis, scutellaria, gardenia, buffalo horn, curcuma, cinnabar, and other herbs, primarily treating confusion and delirium, trismus, stiff neck, limb twitching, and high fever with flushed face.
Zixue Dan (from "Heji Ju Fang") is made up of cold water stone, gypsum, magnetite, talc, nitrate, agarwood, sandalwood, musk, clove, rhinoceros horn, antelope horn, lespedeza, licorice, mirabilite, scrophularia, cinnabar, and other ingredients (the original formula contained a small amount of buffalo horn, which is no longer used today), mainly treating confusion and delirium, high fever and thirst, spasms and convulsions, stiff neck, and trismus.
Zhibao Dan (from "Heji Ju Fang") consists of rhinoceros horn, tortoiseshell, cinnabar, realgar, borneol, musk, buffalo horn, and benzoin (original formula included gold and silver foil, which are no longer used today), primarily treating symptoms such as confusion and muteness, excessive phlegm and coarse breathing, body heat and red tongue, yellow and greasy coating, and slippery, rapid pulse.

Section 7: Different Diseases, Same Treatment

A distinctive feature of traditional Chinese medicine is syndrome differentiation and treatment. Syndrome differentiation refers to the overall process of identifying the etiology, pathogenesis, and clinical presentation; therefore, syndrome-based treatment differs from mere symptomatic therapy. The etiology and pathogenesis in TCM are derived from logical reasoning and syndrome analysis based on clinical manifestations, whereas Western medicine's etiology and pathogenesis often result from experimental research. Consequently, the concept of "syndrome" in TCM and "disease" in Western medicine differ significantly. Clinically, it is common to encounter situations where different diseases present the same syndrome, or the same disease presents different syndromes. When TCM employs syndrome differentiation and treatment to address these scenarios, the former is termed "different diseases, same treatment," while the latter is called "same disease, different treatment." The principle of "same disease, different treatment" is an inevitable approach to managing complex and variable clinical conditions, and it exists in both TCM and Western medicine. However, "different diseases, same treatment" holds particularly significant value within the treasure trove of TCM. Over the years, TCM has accumulated an extensive body of experience and data in this area.

I. Theoretical Basis of "Different Diseases, Same Treatment"

Although the causes of disease are diverse, the affected organism is always human, which means that different diseases must share some common factors in their pathogenic mechanisms. In the intricate web of pathogenic factors, TCM has identified one primary determinant—the internal factor—which is a unique aspect of TCM's fundamental theory and serves as the main basis for "different diseases, same treatment." The "Suwen·Yipian Cifa Lun" states: "When righteous qi resides within, evil cannot invade." It also says: "Where evil gathers, qi must be deficient." The "Suwen·Shengqi Tongtian Lun" further explains: "When yin is balanced and yang is concealed, spirit is well-regulated." These teachings emphasize that the body's inherent righteous qi and yin-yang balance are the primary defenses against external pathogenic factors. Materialist dialectics posits that "external factors are the conditions for change, while internal factors are the basis for change." TCM's emphasis on internal factors is entirely consistent with this principle. Given the pathogenic significance of internal deficiencies in righteous qi and imbalances in yin-yang, TCM history has seen the emergence of the Soil-Replenishing School represented by Li Dongyuan and the Mingmen School represented by Zhao Xianke, Zhang Jingyue, and others. By emphasizing the body's deficiency in righteous qi, they developed the theory of righteous qi deficiency as a pathogenic mechanism and advanced the Great Method of Reinforcing Righteous Qi and Consolidating the Root, thereby opening up vast new horizons for the theory and practice of "different diseases, same treatment" in TCM. The "Suwen·Siqu Diaoshen Dalun" states: "Do not treat existing illness, but prevent it; do not treat existing disorder, but prevent it." The "Jinkui Yaolue·Zangfu Jingluo Pian" adds: "Why does the superior physician treat pre-disease? Because when treating pre-disease, if one sees liver disease, knows it will spread to the spleen, one should first strengthen the spleen. During the four seasons, a strong spleen resists evil, so there is no need to supplement it." From these statements, it is clear that, as a further development of the theoretical foundation of "different diseases, same treatment," TCM has long taken the correct step in disease prevention. This demonstrates that the Great Method of Reinforcing Righteous Qi and Consolidating the Root can both treat many diseases after they occur and prevent many diseases before they arise. As the main principle underlying "different diseases, same treatment," this method has played an extremely important role in disease prevention and treatment over the years. The theory of righteous qi deficiency upon which it is based has always served as the primary theoretical foundation for "different diseases, same treatment."

Additionally, there are cases where two or more diseases with completely different etiologies and pathologies present identical clinical syndromes from a TCM perspective—for example, uterine fibroids and ovarian cysts. For these two conditions, TCM applies the same syndrome-based treatment centered on activating blood circulation and removing stasis, often achieving good therapeutic results. This represents another facet of "different diseases, same treatment."

Regarding the pathogenesis of mass lesions, TCM still considers them to be products of righteous qi deficiency. The "Yizong Bidu" states: "Masses form when righteous qi is insufficient, allowing pathogenic qi to take hold." Thus, in the relationship between the manifestation and root of mass lesions, blood stasis is only the manifestation, while the root remains righteous qi deficiency. Therefore, when treating mass lesions, in addition to using blood activation and stasis removal as one method of "different diseases, same treatment," reinforcing righteous qi and consolidating the root remains an indispensable fundamental principle. The former addresses the manifestation, while the latter addresses the root.

Beyond "different diseases, same treatment" based on reinforcing righteous qi and consolidating the root, there is also widespread application of "different diseases, same treatment" within the scope of eliminating pathogenic factors. The "Suwen·Tongping Xushi Lun" states: "When pathogenic qi is abundant, it is real; when righteous qi is depleted, it is虚." The "Suwen·Sanbu Jiuhou Lun" further explains: "For real conditions, drain them; for虚 conditions, replenish them." It is evident that among the various factors contributing to disease, besides righteous qi deficiency as the fundamental factor, the abundance of pathogenic qi is also very important. For conditions dominated by pathogenic qi (typically real patterns), treatment should focus on eliminating pathogenic qi. The "Leijing" states: "If there is no deficiency, the urgent priority is pathogenic qi—remove it quickly, otherwise complications will arise." The "Lingshu·Genjie Pian" adds: "When pathogenic qi is excessive, it overwhelms righteous qi, so it must be drained urgently." TCM's methods for eliminating pathogenic qi are diverse; among the Eight Methods, all except the tonifying method contain elements of pathogen elimination. TCM's Six Meridians differentiation, Wei-Qi-Ying-Xue differentiation, and organ differentiation are all theoretical systems formed through horizontal classification of syndromes and logical reasoning. They likewise lay the foundation for "different diseases, same treatment," enabling TCM theory to simplify complexity and successfully solve infinitely variable clinical problems with limited principles and formulas. Take the Six Meridians of Shanghan as an example: although it only represents six syndromes in the progression of febrile diseases, the clinical practices guided by it extend far beyond those six! Baihu Tang, as the principal formula for Yangming meridian syndrome, can be used for any condition with high fever, thirst, profuse sweating, and a large, powerful pulse, thus being applied not only in influenza, typhoid fever, pneumonia, meningitis, encephalitis B, typhus, relapsing fever, rheumatic fever, tuberculosis, and other febrile diseases, but also in diabetes, diabetes insipidus, heatstroke, and autonomic dysfunction. Xiaochaihu Tang, as the principal formula for Shaoyang syndrome, can be used for any condition with bitter taste in the mouth, dry throat, dizziness, chest and flank discomfort, irritability and nausea, and alternating chills and fever, thus commonly being adjusted and used in cases of cholecystitis, hepatitis, pelvic inflammatory disease, urinary tract infections, influenza, autonomic dysfunction, pleurisy, pancreatitis, and other conditions. It is thus apparent that the number of diseases suitable for adjustment and use of these two formulas is roughly estimated at dozens each. This fully demonstrates the importance of "different diseases, same treatment" in TCM scholarship.

II. Clinical Applications of "Different Diseases, Same Treatment"

Through analyzing and classifying the external manifestations of diseases, TCM identifies the common characteristics shared by a group of illnesses and establishes the principle of "different diseases, same treatment." Take Buzhong Yiqi Tang, a formula for strengthening the spleen and replenishing qi, as an example: when used for qi deficiency leading to inability to control blood due to weak middle qi, it can achieve the effect of tonifying qi and stopping bleeding. This includes aplastic anemia, purpura, leukemia, and gynecological bleeding; when used for qi deficiency causing downward sinking of qi, it can lift yang and elevate the fallen, applicable to hypotension, uterine prolapse, gastric prolapse, and myasthenia gravis; when used for qi deficiency causing qi deficiency-related fever, it can warm and dispel heat. Similarly, Shenqi Wan, a formula for warming and tonifying kidney yang, can be used for yang deficiency with water overflowing, warming yang and transforming water, applicable to chronic nephritis, heart failure, and malnutrition-related edema; when used for kidney not containing qi, it can warm the kidneys and gather qi, applicable to chronic bronchitis, emphysema, and bronchial asthma. In addition, this formula can also treat prostatitis, vaginal discharge, diabetes, and systemic lupus erythematosus. The "Jinkui" Gui Zhi Fuling Wan was originally formulated specifically for women's mass lesions, but through practical application by medical experts, it can now treat uterine fibroids, ovarian cysts, acute and chronic pelvic inflammatory disease, dysmenorrhea, menopausal hypertension, incomplete abortion, retained placenta, old ectopic pregnancy, functional uterine bleeding, retinitis, and prostatitis. The "Ju Fang" Xiaoyao San was originally designed for liver depression and spleen deficiency, but through clinical practice, it can now treat retinitis, optic neuritis, optic nerve atrophy, infectious hepatitis, chronic cholecystitis, chronic pancreatitis, menstrual irregularities in women, autonomic dysfunction, gastric and duodenal ulcers, and chronic gastritis. During the Qing Dynasty, the renowned physician Wang Qingren formulated blood-stasis-dispersing formulas such as Xuefu Zhuyu Tang, Gexia Zhuyu Tang, and Shaofu Zhuyu Tang, each capable of treating numerous different ailments. Take Xuefu Zhuyu Tang as an example: it can treat up to 20 different conditions. In modern times, the famous physician Zhang Xichun formulated Huoluo Xiaoling Dan, commonly used to treat injuries from falls, rheumatoid arthritis, osteoarthritis, pelvic inflammatory disease, old ectopic pregnancy, and chronic osteomyelitis. Pei Zhengxue frequently uses Chaihu Shugan San with added ingredients to treat acute and chronic hepatitis, acute and chronic pancreatitis, gastric and duodenal ulcers, chronic gastritis, intercostal neuralgia, and breast diseases in women, all achieving certain therapeutic effects. He also uses Taohong Siwu Tang with added ingredients to treat coronary heart disease, cerebral arteriosclerosis, menstrual irregularities in women, pelvic diseases, and various injuries from falls. In recent years, the widely recognized Tongfu method—using modified Chengqi Tang—has been employed to treat various acute abdominal conditions, including acute cholecystitis, gallstones, acute pancreatitis, acute intestinal obstruction, and acute jaundice-type infectious hepatitis, all yielding remarkable clinical results.

III. Conclusion

As an important principle, "different diseases, same treatment" permeates every aspect of TCM theory and clinical practice, thereby forming a key characteristic of the TCM academic system. Whether in terms of reinforcing righteous qi or eliminating pathogenic factors, because it embodies the academic thought of "different diseases, same treatment," TCM is able to adapt to infinitely variable clinical needs with limited principles and formulas. This objectively reveals to people that, by looking beyond the complex and variable external manifestations of diseases to explore their inner essence, any pair of diseases subject to "same treatment" must necessarily share several common internal connections in terms of etiology and pathogenesis. With the advancement of integrated Chinese-Western medicine and the gradual deepening of experimental research on TCM theory, some substantial breakthroughs have already emerged in this area. For example, Shen Ziyin and others at Shanghai Second Medical College, through experiments on renal parenchyma, revealed that TCM's kidney qi corresponds to the modern medical hypothalamus-pituitary-adrenal cortex system. Research conducted by Beijing Normal University and others on the nature of spleen deficiency has shown that TCM's spleen deficiency is closely related to the body's autonomic nervous system, metabolic system, endocrine system, and immune system.

These studies have provided an intrinsic material basis for TCM's "different diseases, same treatment" approach to tonifying the kidneys and strengthening the spleen, thereby illuminating the profound significance of this traditional TCM theory.

Section 8: Reinforcing Righteous Qi and Consolidating the Root vs. Immunity