3 Semi-Exterior, Semi-Interior

(3) Semi-Exterior, Semi-Interior

The disease location is between the exterior and interior, mostly due to pathogenic factors invading the Shaoyang Gallbladder Meridian. Clinical manifestations mainly include alternating chills and fever, fullness and discomfort in the chest and flanks, restlessness and nausea, reluctance to eat, bitter taste in the mouth and dry throat, and string-like pulse.

50 Pei Zhengxue’s Traditional Chinese Medicine—Discussions on TCM Theory and Clinical Cases

The identified exterior and interior syndromes are not simply exterior or interior syndromes; clinically, they often appear in many complex forms, such as exterior and interior both hot, exterior and interior both cold, exterior and interior both deficient, exterior and interior both excessive, exterior heat and interior cold, exterior cold and interior heat, exterior deficiency and interior excess, exterior excess and interior deficiency, and so on. As long as one masters the basic rules for distinguishing exterior and interior syndromes, even though the above syndromes are complex, it is not difficult to make an accurate diagnosis. In addition, if an exterior syndrome appears first and then an interior syndrome develops, it means the disease has progressed from exterior to interior; if an interior syndrome appears first and then an exterior syndrome develops, it could either mean the disease has reached the exterior from the interior, or it could mean a new exterior syndrome has emerged, with the latter being more likely.

3. Cold and Heat

Cold and heat are two categories used to distinguish the nature of a disease. Cold syndromes are usually caused by cold pathogenic factors, or arise from deficiencies in the zang-fu organs, meridians, muscles, or qi and blood; heat syndromes are usually caused by heat pathogenic factors, or arise from excesses in the zang-fu organs, meridians, muscles, or qi and blood. In TCM, the differentiation of cold and heat is often based on whether there is thirst, the characteristics of urine and stool, the temperature of the limbs, the pulse, and the tongue coating.

(1) Characteristics of Cold and Heat Syndromes

Clinical manifestations of cold syndromes include cold and non-warm hands and feet, aversion to cold, pale complexion, no thirst but preference for hot drinks, clear and long urine, loose and odorless stools, thin white coating, and slow pulse. Clinical manifestations of heat syndromes include fever and thirst, preference for cold drinks, flushed face, irritability, hard and dry stools, sticky and burning anus, short and reddish urine, red tongue with yellow coating, and rapid pulse.

(2) Locations Where Cold and Heat Occur

The occurrence of cold and heat usually has specific locations, such as the zang-fu organs, meridians, qi and blood, the triple burner, and the exterior and interior. Cold and heat in the zang-fu organs are discussed in zang-fu differentiation; cold in the meridians is discussed in six meridian differentiation; cold and heat in the triple burner are introduced in triple burner differentiation; qi and blood are shared by the five zang and six fu organs and can also be glimpsed in zang-fu differentiation.

(3) True and False Cold and Heat

There are usually two situations: true heat and false cold, and true cold and false heat. So-called "true heat and false cold" refers to cases where, along with typical heat symptoms such as hard stools, fullness and severe abdominal pain, intense thirst for cold drinks, and short, reddish urine, there are also cold symptoms such as pale complexion, cold limbs, and fine pulses. The characteristic of this syndrome is that at first glance there seem to be many cold symptoms, but upon closer inspection, heat is actually dominant. It is often referred to as "excessive yang inside, suppressing yin outside," which corresponds to what Western medicine calls "warm shock" such as acute abdominal shock or febrile shock. As for "true cold and false heat," clinical manifestations include body heat but unwillingness to remove clothes, thirst for water but unwillingness to swallow, large and powerful pulse that feels weak when pressed, flushed face but cold limbs, restless limbs but clear mind. The characteristic of this syndrome is that cold is dominant inside while deficient yang floats to the surface, often referred to as "excessive yin inside, suppressing yang outside," some people call it "daiyang" syndrome. In Western medical symptomatology, this is often associated with autonomic nervous system and endocrine disorders.

4. Deficiency and Excess

Deficiency of righteous qi is called deficiency, while invasion of pathogenic factors is called excess. The basic meaning of deficiency and excess is the relationship between the strength of pathogenic factors and righteous qi. Constitution varies in strength, pathogenic factors vary in intensity, and medication differs in tonifying or purging effects. The purpose of distinguishing deficiency and excess is to determine the correct treatment method. Should we attack or tonify? It all depends on whether it's deficiency or excess. "If it's excess, purge it"; "if it's deficiency, tonify it." If the distinction between deficiency and excess is wrong, even a tiny mistake can lead to a huge deviation—deficiency of deficiency and excess of excess are major taboos for physicians.

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(1) Clinical Manifestations of Deficiency and Excess

Anyone with insufficient righteous qi or deficiency in yin-yang qi and blood falls under the category of deficiency syndrome. Causes of deficiency syndrome include congenital weakness, improper post-illness care, and prolonged illness without treatment.

Congenital weakness is mostly attributed to the kidneys, while acquired deficiency of righteous qi is mostly attributed to the spleen.

From a modern medical perspective, so-called deficiency syndrome generally refers to the decline of physiological functions. Of course, apart from congenital decline in physiological functions, most cases are caused by prolonged illness or lack of rehabilitation after illness. The most common clinical manifestations of deficiency syndrome include emaciation, low voice, poor appetite, fatigue, blurred vision, hearing loss, pale and swollen tongue, and weak, thin pulse.

In deficiency syndrome, it is broadly divided into qi deficiency, blood deficiency, yin deficiency, and yang deficiency. Qi deficiency includes spleen qi deficiency, kidney qi deficiency, lung qi deficiency, etc.; blood deficiency includes heart blood deficiency, heart-spleen dual deficiency, etc.; yin deficiency includes lung yin deficiency, kidney yin deficiency, liver-kidney yin deficiency, etc.; yang deficiency includes spleen yang deficiency, kidney yang deficiency, spleen-kidney yang deficiency, heart yang deficiency, etc. In recent years, there have been many reports on spleen yin deficiency and liver yin deficiency, and specialized monographs have even been published. The above-mentioned deficiency syndromes related to the zang-fu organs are discussed in detail in zang-fu differentiation.

Anyone with excessive pathogenic factors, where pathogenic factors fiercely compete with righteous qi, falls under the category of excess syndrome. The fundamental cause of excess syndrome is the conflict between righteous qi and pathogenic factors. When the body is strong, ordinary pathogenic factors usually cannot cause disease; when the body is weak, ordinary pathogenic factors can indeed cause disease, but most of the resulting illnesses are actually deficiency syndromes. For example, if pathogenic factors are strong and righteous qi is weak, the resulting illness is also mostly a deficiency syndrome. Only when both pathogenic factors and righteous qi are strong does the conflict between them result in an excess syndrome. Clinical manifestations of excess syndrome include high fever and thirst, hard stools, short and reddish urine, coarse breathing and loud voice, abdominal pain that refuses pressure, fever and chills without sweat, excitement, and powerful pulse.

In summary, when it comes to excess syndrome, physiological functions are in a state of pathological hyperactivity, pathogenic factors are strong, and the body's ability to resist disease is also strong.

(2) True and False Deficiency and Excess

The Yizong Baidu says, "Great excess can present as deficiency, and great deficiency can present as excess," while Zhang Jingyue says, "Even in cases of extreme deficiency, signs of excess may appear, and even in cases of extreme excess, signs of deficiency may appear—this must be distinguished. For example, if a disease is triggered by emotional disturbances, hunger, overwork, alcohol or sexual indulgence, or congenital deficiency, and then manifests, it often presents with symptoms such as fever, constipation, bloating, delirium, and pseudo-rash, which at first glance seem to indicate excess, but in fact the disease is deficient. Or, if external pathogenic factors are not eliminated and remain lodged in the meridians, food stagnates and does not digest, accumulating in the zang-fu organs, or qi becomes stagnant and unresolved, or stubborn phlegm and blood stasis remain trapped, the disease eventually becomes deficient, seemingly lacking, but in reality it is an excess syndrome. In such cases, one should thoroughly analyze the situation, considering factors such as the strength of the constitution and the age of the disease, carefully examine the symptoms, and meticulously check the pulse to distinguish the true from the false and eliminate the false to keep the true."

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1. Spleen and Stomach Differentiation

(1) Spleen and Stomach Qi Deficiency

Pale complexion, poor appetite, fatigue, and shortness of breath are the basic symptom cluster of this syndrome. If accompanied by edema, abdominal distension, or loose stools, it is called spleen dysfunction; if accompanied by hemoptysis, hematemesis, hematochezia, or epistaxis, it is called spleen blood control failure; if accompanied by drooping eyelids, uterine prolapse, gastric prolapse, wandering spleen, or other visceral prolapses, it is called central qi collapse. The treatment for spleen and stomach qi deficiency is to strengthen the spleen and benefit qi, with Si Jun Zi Tang (from the Bureau of Regulations) as the basic formula. For spleen dysfunction, it is recommended to strengthen the spleen and benefit qi, regulate qi and dispel dampness, using Xiang Sha Liu Jun Zi Tang (from the Bureau of Regulations); for spleen blood control failure, it is recommended to strengthen the spleen and benefit qi, guide blood back to the spleen, using Gui Pi Tang (from the Jisheng Fang); for central qi collapse, it is recommended to strengthen the spleen and benefit qi, raise yang and lift the collapse, using Bu Zhong Yi Qi Tang (by Li Dongyuan). Xiang Sha Liu Jun Zi Tang, Gui Pi Tang, and Bu Zhong Yi Qi Tang are all derived from Si Jun Zi Tang, because spleen dysfunction, spleen blood control failure, and central qi collapse all stem from spleen and stomach qi deficiency.

(2) Spleen and Stomach Yang Deficiency

This syndrome develops from spleen and stomach qi deficiency, so it still retains the four symptoms of pale complexion, poor appetite, fatigue, and shortness of breath; however, yang deficiency brings additional symptoms—feeling cold and having cold limbs, spontaneous sweating. Since the spleen is the organ responsible for transformation and transportation, when its function is impaired, abdominal distension, edema, and loose stools appear. These three aspects combined form the symptom cluster of spleen and stomach yang deficiency. The treatment for spleen and stomach yang deficiency is to strengthen the spleen and warm the middle jiao, with Lizhong Tang (from the Shang Han Lun) as the basic formula. This formula is still similar to the derivation from Si Jun Zi Tang, because spleen and stomach yang deficiency also stems from spleen and stomach qi deficiency.

(3) Cold-Dampness Trapping in the Spleen

Headache and chills, fullness and distension in the upper abdomen, nausea and vomiting, intestinal rumbling and diarrhea, slippery and moist pulse—treatment involves releasing the exterior and dispersing cold, as well as aromatizing and clearing turbidity, commonly using Huoxiang Zhengqi San (from the Bureau of Regulations). The spleen is inherently weak; once exposed to wind-cold, internal dampness combines with external cold, leading to this syndrome. Therefore, this symptom cluster consists of two parts:

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(5) Excessive Stomach Fire

Dry mouth, bad breath, oral ulcers, toothache and gum swelling, bleeding gums, burning sensation in the stomach, red tongue with yellow coating, rapid pulse—treatment involves clearing stomach fire and draining excess heat, using Qingwei San (by Li Dongyuan). The characteristic of this syndrome lies in the oral cavity, because the mouth is the gateway of the spleen and stomach, located at the top, and fire tends to rise upward, directly impacting the oral cavity, thus forming this syndrome.

(6) Stomach Yin Deficiency

Burning sensation in the stomach, dry mouth with no desire to drink, red tongue with little coating, and thin, rapid pulse. At the same time, there are symptoms of bone-steaming heat, five-heart heat, and night sweats—treatment involves nourishing yin and strengthening the stomach, using Yangwei Tang (by Ye Tianshi) and Shashen Mai Men Dong Tang (by Zhang Zhongjing). This syndrome consists of two parts:

Pei Zhengxue’s Traditional Chinese Medicine—Discussions on TCM Theory and Clinical Cases

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It can descend along the meridians to the small intestine, "the small intestine is the organ responsible for receiving and transforming substances, and it expels the transformed products," and it has the function of separating clear from turbid. When the small intestine is hot, the urine becomes red and stinky. Oral ulcers are caused by the small intestine's dampness rising up due to the fiery nature of the fire. For excessive heart fire, treatment involves draining the fire and calming the spirit, using Huanglian A Jiao Tang (by Zhang Zhongjing); for heart fire transferring to the small intestine, treatment involves guiding the heat downward, using Dao Chi San (from the Pediatric Medicinal Evidence Directly Explained).

(4) Phlegm Blocking the Heart Orifice

Confusion of consciousness (restlessness, mania, laughter, speech), slippery pulse, and greasy tongue are the basic symptoms of this syndrome. Treatment involves guiding phlegm, opening the orifice, and calming the spirit, using Sheng Tie Luo Yin (from the Medical Insight). The heart governs the spirit, and when the heart orifice is blocked, consciousness becomes confused; slippery pulse and greasy tongue are manifestations of phlegm in the pulse and tongue, because the reason for the blockage of the heart orifice is phlegm.

(5) Blood Stasis in the Heart

Pain in the front of the heart, radiating pain to the arms, palpitations and shortness of breath, purple-dark tongue, and astringent, intermittent pulse are the basic symptoms of this syndrome. Treatment involves activating blood circulation, removing stasis, and promoting the flow of qi, using Guan Xin II (a collaborative formula from Beijing) and Gualou Xie Bai Ban Xia Tang (by Zhang Zhongjing). Astringent pulse and purple-dark tongue indicate blood stasis; pain in the front of the heart and palpitations and shortness of breath indicate that the site of blood stasis is in the heart.

3. Liver Disease Differentiation

(1) Liver Qi Stagnation

Bitter taste in the mouth, dry throat, irritability, fullness and discomfort in the chest and flanks, and string-like pulse are the basic symptoms of this syndrome. If accompanied by abdominal distension, loss of appetite, and nausea, it is called liver-stomach disharmony; if accompanied by something stuck in the throat that cannot be swallowed or spat out, it is called liver qi ascending (plum pit syndrome). For liver qi stagnation, it is recommended to soothe the liver and release the stagnation, using Chaihu Shugan San (from the Complete Works of Jing Yue); for liver-stomach disharmony, it is recommended to soothe the liver and harmonize the stomach, using Xiaoyao San (from the Bureau of Regulations); for liver qi ascending, it is recommended to soothe the liver and lower the qi, using Banxia Houpu Tang (by Zhang Zhongjing). The liver is naturally smooth and unobstructed; when it becomes stagnant, it rebels against the stomach (liver-stomach disharmony) as the first manifestation; when it rises up and attacks the throat (plum pit syndrome) as the second manifestation. Both are products of liver qi stagnation.

(2) Liver-Gallbladder Fire

Bitter taste in the mouth and dry throat, irritability, fullness and discomfort in the chest and flanks, dizziness and headache, tinnitus and red eyes, palpitations and shortness of breath, short and reddish urine, and string-like, rapid pulse—treatment involves clearing liver fire, using Longdan Xie Gan Tang (from the Golden Mirror of Medical Classics). This syndrome is mostly caused by long-term stagnation turning into fire, and its basic symptoms consist of two parts:

Liver qi stagnation: bitter taste in the mouth and dry throat, irritability, fullness and discomfort in the chest. Fire rising upward: dizziness and headache, flushed face and red eyes, short and reddish urine, rapid pulse.

(3) Liver Yin Deficiency

Dizziness and vertigo, lower back pain and tinnitus, bone-steaming heat, five-heart heat, night sweats, numbness and tremors in the limbs, red tongue with little coating, and string-like, thin pulse—treatment involves nourishing water and supporting wood, using Qiju Dihuang Wan (from the Medical Grade).

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The liver and kidneys share the same origin; liver yin draws nourishment from kidney yin, so the manifestations of liver yin deficiency consist of three parts:

(4) Internal Movement of Liver Wind

Clinically, it usually manifests in three situations:

Extreme heat generating wind | > Symptoms include high fever, accompanied by palpitations, convulsions, syncope, and string-like, rapid pulse; treatment involves draining the fire and calming the spirit, using Lingyang Gouteng Tang (wind and fire stirring each other) | > (from the Popular Treatise on Cold Damage). | > | > Main manifestations include headache and tinnitus, hemiplegia and aphasia, facial and eye distortion (distortion: skewing), convulsions and coma; treatment involves | > soothing the liver and extinguishing the wind, using Zhen Gan Xi Feng Tang (from the Medical Records of the Heart and Middle) | > | > Main clinical manifestations are tremors, numbness, convulsions, muscle twitching, etc.; treatment involves nourishing blood and extinguishing the wind, using Da | > Ding Feng Zhu (from the Warm Disease Classified Discussion). +----------------------+ Excessive yang generating wind | | (All sudden rigidity belongs to wind) | +----------------------+ Blood deficiency generating wind | (Blood does not nourish the sinews) | (5) Cold stagnation in the Liver Meridian

Lower abdominal pain, shrinking of the scrotum, heavy descent of the testicles—treatment involves warming the liver and dispelling cold, using Nuangan Jian (from the Complete Works of Jing Yue). The lower abdomen, scrotum, and testicles are all areas through which the Foot-Jueyin Liver Meridian runs.

4. Lung Disease Differentiation

Lung cold cough | > Symptoms include headache, fever and chills, coughing and wheezing with copious sputum, thin and clear sputum, floating and tight pulse; treatment involves releasing the exterior and dispersing cold, stopping cough and eliminating phlegm, using | > Ma Huang Tang (from the Shang Han Lun), this syndrome is a wind-cold exterior syndrome combined with cough. | > | > Symptoms include headache, fever and chills (more heat than cold), thirst, frequent drinking, irritability, coughing and wheezing, red tongue, and rapid pulse; treatment involves clearing | > heat, opening the lungs, and stopping cough, using Ma Xing Shi Gan Tang (from the Shang Han Lun), this syndrome is a wind-heat exterior syndrome combined with cough. | > | > Dry mouth, dry throat, dry nose, coughing and spitting, sticky and difficult-to-clear phlegm, red tongue with little moisture—treatment involves clearing dryness and saving the lungs, using Qingzao Jiu Fei Tang | > (from the Medical Gate Law). In TCM, "any dry syndrome must have three drynesses"—dry mouth, dry throat, and dry nose—and this syndrome is composed of these three drynesses | > together with sticky and difficult-to-clear phlegm. | > | > Phlegm obstructing the airways, coughing and gasping to the point of being unable to lie down—treatment involves guiding phlegm and opening the lungs, using Su Zi Jiang Qi (from the Bureau of Regulations) and Ting Lian Da | > Zao Xie Fei Tang (by Zhang Zhongjing). | > | > Pale complexion, shortness of breath, spontaneous sweating, coughing and phlegm, fat and pale tongue, and moist, thin pulse—treatment involves benefiting qi and supplementing the lungs, using | > Bu Zhong Yi Qi Tang (by Li Dongyuan), which is the main formula for nurturing earth to produce gold. +------------+ Lung heat cough | +------------+ Lung dry cough | +------------+ Phlegm blocking the lungs | +------------+ Lung qi deficiency | (Continued on next page)

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Kidney does not store essence |

Kidney does not take in qi | For those with basic symptoms of kidney yang deficiency accompanied by shortness of breath and panting, it is recommended to warm the kidney and take in qi, using Du Qi Wan (from the Medical Duty Assignment Compilation). Life gate fire declines | > For those with basic symptoms of kidney yang deficiency accompanied by five o'clock diarrhea, it is recommended to warm the kidney and stop diarrhea, using Si Shen Wan (from the Internal Medicine Abstract). Yang deficiency causing water to overflow | For those with basic symptoms of kidney yang deficiency accompanied by generalized or localized edema, it is recommended to warm the yang and transform the water, using Zhen Wu Tang (by Zhang Zhongjing).

Appendix: ① Lower Yuan deficiency and cold: bedwetting, frequent urination, nocturnal urination, cold lower abdomen—recommended to warm and tonify the lower yuan, using Suo Quan Wan (from the Women’s Good Prescription). ② Bladder damp-heat: frequent urination, urgent urination, painful urination, cold lower abdomen—recommended to clear heat and drain dampness, using Ba Zheng San (from the Bureau of Regulations).

The above-mentioned zang-fu differentiation clinical symptoms can appear individually, but in most cases, several zang-fu syndromes appear together. For example, heart-spleen dual deficiency syndrome, spleen-kidney yang deficiency syndrome, liver-kidney yin deficiency syndrome, etc. Heart-spleen dual deficiency syndrome is formed by the combination of heart blood deficiency and spleen qi deficiency, meaning that it includes both the pale complexion, poor appetite, fatigue, and shortness of breath associated with spleen qi deficiency, as well as palpitations, forgetfulness, insomnia, and frequent dreaming associated with heart blood deficiency. The representative formula for treating this syndrome is Gui Pi Tang, which contains ingredients such as dangshen, baizhu, fuling, and huangqi to strengthen the spleen and benefit qi, as well as yuanzhi, yuanshi, and fried zao ren to nourish the heart blood. As long as one understands the individual zang-fu syndromes, it is easy to analyze, understand, and recognize their combined clinical manifestations.

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(1) Sun Syndrome

Headache, fever and chills, and floating pulse are the basic symptom cluster of Sun Syndrome. If accompanied by no sweat and tight pulse, it is classified as cold damage.

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In recent years, various regions have adopted the therapeutic approach of strengthening the spleen and tonifying the kidneys to treat this disease, with an increasing number of successful cases. Gu et al. combined the spleen-strengthening formula Buzhong Yiqi Tang with the kidney-tonifying formula Jianbu Hujian Wan to treat a case of subacute myeloid leukemia, achieving favorable results②. The Wujin County People’s Hospital used a method of tonifying the kidneys and nourishing the blood, supplemented by cinnamon to guide fire back to its source, to treat a case of acute myeloid leukemia, resulting in basic improvement in both blood and bone marrow findings. In 1967, the author admitted a case of acute monocytic leukemia and, after employing the spleen-strengthening and kidney-tonifying approach—emphasizing qi-tonifying herbs such as ginseng and yuzu for yin-nourishing—administered over 400 doses of medication, ultimately achieving complete remission. To date, the patient has remained healthy for 12 years. The Department of Pediatrics at Chaoyang People’s Hospital in Liaoning Province conducted integrated Chinese–Western medicine treatment on 18 cases of acute leukemia and concluded that the disease is generally a deficiency syndrome, with the primary therapeutic focus being “supporting the body’s righteous qi” while simultaneously “eliminating pathogenic factors.” Traditional Chinese medicine for supporting righteous qi can ensure the continued use of chemotherapy and enhance the body’s resistance⑤.

The Hematology Group of the Internal Medicine Department at Xiyuan Hospital of the Chinese Academy of Traditional Chinese Medicine treated two cases of erythroleukemia, consistently prioritizing the support of righteous qi and achieving positive outcomes. During treatment, they fully recognized the importance of strengthening the spleen and tonifying the kidneys, believing that this approach has three key effects: ① alleviating the condition; ② prolonging the course of the disease; and ③ reducing the side effects of chemotherapy. From the above information, it is evident that the spleen-strengthening and kidney-tonifying method is indeed an effective therapeutic principle for treating this disease. Leukemia has been proven to be caused by a tumor virus. This virus invades the body, where its RNA, through reverse transcriptase activity, replicates into DNA and inserts itself into host cells, inducing cancerous mutations. Normally, the human body possesses an immune surveillance system primarily composed of T cells, which can reduce or prevent such mutations. This represents an abnormal immune response characterized by specific cellular immunity. Kidney-tonifying therapy aims to improve this abnormal immune response, while spleen-strengthening therapy works by regulating non-specific immunity, thereby promoting the enhancement of specific immunity.

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Specific immunity appears to share certain similarities.

3. Specific immunity and non-specific immunity mutually promote each other to jointly accomplish the body’s immune functions; similarly, middle qi and kidney qi also mutually reinforce each other to form the body’s righteous qi.

4. Existing domestic literature reports that astragalus can improve specific immune indicators. Further research is needed to determine whether this effect is due to direct action on the specific immune mechanism or indirect promotion through modulation of the non-specific immune pathway. This remains a matter for further discussion.

(“Compilation of Integrated Chinese–Western Medicine Materials from Gansu,” March 1978)

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① Shen Ziyin · “Shanghai Journal of Traditional Chinese Medicine.” 1962, (11):19

② Liu Yaguang · “Tianjin Pharmaceutical Journal.” 1978, (2):80

③ Tumor Research Group of the Institute of Traditional Chinese Medicine · “Selected Works on Tumor Prevention and Treatment Research.” 1977, (6):6

④ Isotope Laboratory of the Beijing Tuberculosis Research Institute · “New Medical Journal.” 1974, (8):15

⑤ Tumor Research Group of the Institute of Traditional Chinese Medicine · “Selected Works on Tumor Prevention and Treatment Research.” 1977, (6):7

⑥ Jiang Tingliang · “Journal of Laiyang New Medical University.” 1977, (8):78

⑦ Basic Experimental Laboratory of the Guang’anmen Hospital of the Chinese Academy of Traditional Chinese Medicine · “Selected Works on Tumor Prevention and Treatment Research.” 1977, (6):17

⑧ Wu Jianguang · “Guandong Pharmaceutical Journal.” 1976, (3):41

⑨ Wu Jianguang · “Guandong Pharmaceutical Journal.” 1976, (3):44

⑩ New Medical Department of the Affiliated Hospital of Guangzhou Medical College · “New Medical Journal.” 1974, (12):12

⑪ Office of Chronic Bronchitis of the Henan Provincial Health Bureau · “Discussion on Integrated Chinese–Western Medicine Treatment of Chronic Bronchitis.” Internal document from 1975

⑫ Liu Zhengcai · “Zhejiang Journal of Traditional Chinese Medicine.” 1977, (4):14

⑬ Teaching and Research Group of Normal Human Anatomy at Shanghai College of Traditional Chinese Medicine · “New Medical Journal.” 1977, (9):36

⑭ “Special Issue on New Medical Oncology Research.” 1975, 16

⑮ Lu Shouyan · “Journal of Traditional Chinese Medicine.” 1962, (3):1

⑯ Respiratory Group of the Internal Medicine Department at Xiyuan Hospital · “Reference Materials for Traditional Chinese Medicine Research.” 1977, (1):2

⑰ Prevention and Treatment Group for Senile Chronic Bronchitis at the Shaanxi Provincial Institute of Traditional Chinese Medicine · “Shaanxi New Medical Journal.” 1972, (1):6

⑱ Bronchitis Group of the Institute of Traditional Chinese Medicine · “Reference Materials for Traditional Chinese Medicine Research.” 1973, (6):9

⑲ Organ Imaging Research Group at Shanghai First Medical College · “New Medical Journal.” 1976, (4):24

⑳ “Complete Works of Jing Yue (Volume One)” · Shanghai: Shanghai Science and Technology Press, 1959, p. 397

㉑ “Journal of Traditional Chinese Medicine.” 1965, (10):48

㉒ Li Chunyue · “Shanghai Journal of Traditional Chinese Medicine.” 1965, (12):17

㉓ Internal Medicine Department of the PLA’s 285th Hospital · “Tianjin Pharmaceutical Journal.” 1975, (4):192

㉔ Internal Medicine Department of the PLA’s 51st Army Hospital · “New Medical Journal.” 1974, (8):36

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㉕ Longhua Hospital affiliated with Shanghai College of Traditional Chinese Medicine · “Journal of Traditional Chinese Medicine.” 1974, (11):14

㉖ Beijing Traditional Chinese Medicine Hospital · “New Medical Journal.” 1974, (11):22

㉗ Chinese Academy of Traditional Chinese Medicine · “New Medical Journal.” 1977, (10):25

㉘ Longhua Hospital affiliated with Shanghai College of Traditional Chinese Medicine · “New Medical Journal.” 1977, (10):19

㉙ Qin Bowei et al. · “Chinese Journal of Internal Medicine.” 1960, (8):5

㉚ Dexin et al. · “Shanghai Journal of Traditional Chinese Medicine.” 1963, (7):13

㉛ Gu Zaishi et al. · “Shanghai Journal of Traditional Chinese Medicine.” 1965, (9):21

㉜ Wujin County People’s Hospital · “Jiangsu Journal of Traditional Chinese Medicine.” 1962, (12):25

㉝ Pei Zhengxue · “Report on the Cure of a Case of Acute Monocytic Leukemia”—Unpublished

㉞ Pediatric Department of Chaoyang People’s Hospital in Liaoning Province · “Reflections on Integrated Chinese–Western Medicine Treatment of Acute Leukemia”—Internal Document

㉟ Hematology Group of the Internal Medicine Department at Xiyuan Hospital of the Chinese Academy of Traditional Chinese Medicine · “Reference Materials for Traditional Chinese Medicine Research.” 1973, (9):11

㊱ Huashan Hospital affiliated with Shanghai First Medical College · “Tumor Prevention and Treatment Newsletter.” 1975, (3):16

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Theory and Application of Activating Blood Circulation and Removing Stasis

Pei Zhengxue

Activating blood circulation and removing stasis is an extremely important component of the Chinese medical treatment system. The clinical application of this therapeutic method is not only effective for common ailments but often yields remarkable results even in difficult cases that modern medicine has yet to resolve. Consequently, research and exploration of this issue have garnered widespread attention within the modern medical community. This article begins by discussing the traditional understanding of “activating blood circulation and removing stasis” in Chinese medicine, then combines this with findings from modern experimental research to provide a concise overview of the topic. Any shortcomings are welcome to be criticized and corrected by readers.

Pei Zhengxue’s Traditional Chinese Medicine—Discussion on Theory and Clinical Cases, published in collaboration with a book publishing house

Ren Tang Zonghai authored “On Blood Disorders,” a work that, although focused on “blood disorders,” offers insightful discussions on blood stasis and the therapeutic principles of activating blood circulation and removing stasis—for example, “Therefore, in all cases of blood disorders, eliminating stasis is paramount” and “If old blood is not removed, new blood cannot develop properly.” These statements hold significant guiding value in clinical practice.

In recent years, with the vigorous development of integrated Chinese–Western medicine, experimental research on activating blood circulation and removing stasis has been widely carried out across China. Beijing, Shanghai, Chengdu, Xi’an, and other cities have successively established specialized research institutions dedicated to this field, while Guangzhou and Shanghai have also organized specialized training courses on activating blood circulation and removing stasis. Between 1978 and 1979, Guangzhou hosted two three-month-long specialized training programs on this topic, cultivating a new generation of researchers in this area. Currently, research on activating blood circulation and removing stasis is advancing to new depths and broader scopes, representing an important aspect of contemporary integrated Chinese–Western medicine research.

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Within the category of “stasis,” the Shanxi Institute of Traditional Chinese Medicine, based on this perspective, formulated a kidney-tonifying decoction centered on activating blood circulation and removing stasis (containing angelica, red peony root, chuanxiong, peach kernel, safflower, motherwort, salvia, honeysuckle, dandelion, radix bupleuri, indigofera, and white grass root), using it to treat 181 cases of various types of nephritis, including 37 cases of acute nephritis, 125 cases of chronic nephritis, and 19 cases of azotemia and uremia. Treatment outcomes: the cure rate for acute nephritis was 64.86%, with an excellent response rate of 86.48%; the complete remission rate for chronic nephritis was 45.6%, with a basic remission rate of 24.8% and an excellent response rate of 70.4%; however, the efficacy for uremia was less pronounced. The author believes that treating various types of nephritis primarily through activating blood circulation and removing stasis yields good results in eliminating proteinuria and restoring renal function. The First Affiliated Hospital of Beijing Medical College used a nephritis-decongestion decoction (angelica, red peony root, chuanxiong, peach kernel, safflower, and motherwort) to treat 33 cases of refractory chronic nephritis (patients who had previously received Western medical treatment without success), achieving favorable results after 2–12 months of medication.