Keywords：专著资料, 全文在线浏览, 2. 關於衝氣
Section Index
4. Lung Disease Differentiation
| Lung Cold Cough | Headache, fever, chills, cough, thin and clear sputum, and a floating, tight pulse—all call for exterior-releasing, cold-dispelling, and cough-suppressing therapies, using Xing Su San (from the “Detailed Analysis of Warm Diseases”). This condition is a wind-cold exterior syndrome combined with cough. |
| Lung Heat Cough | Headache, fever, thirst, frequent drinking, restlessness, cough and wheezing, red tongue, and a rapid pulse—all call for clearing heat, dispersing lung qi, and suppressing cough, using Ma Xing Shi Gan Tang (by Zhang Zhongjing). This condition is a wind-heat exterior syndrome combined with cough. |
| Lung Dryness Cough | Dry mouth, dry throat, dry nose, cough with thick, sticky sputum, and a tongue with little moisture—all call for clearing dryness and rescuing the lungs, using Qing Zao Jiu Fei Tang (by Yu Jiayan). The dryness syndrome presents three dry symptoms, and this condition is formed by the combination of these three dry symptoms with cough and sticky sputum. |
| Phlegm Obstructing the Lungs | Thick, obstructive sputum, coughing and gasping to the point of being unable to lie down—all call for guiding phlegm and dispersing lung qi, using Su Zi Jiang Qi Tang (from the “Bureau Formulas”) or Ting Li Da Zao Xie Fei Tang (by Zhang Zhongjing). |
| Lung Qi Deficiency | Pale complexion, lack of energy, spontaneous sweating, cough with thick sputum, a swollen, pale tongue, and a soft, moist pulse—all call for replenishing lung qi, using Bu Fei Tang (from the “Yong Lei Qian Fang”) or Bu Fei San (an empirical formula). |
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Pei Zhengxue’s Traditional Chinese Medicine—Contemporary Discussions on TCM Theory and Clinical Cases Published by Heji Book Publishing House
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Part One: Academic Thought
“It fills the skin, fattens the flesh, and controls opening and closing.” It also says: “When wei qi is balanced, the muscles and flesh are relaxed and free-flowing, the skin is smooth and supple, and the pores are tightly closed.” This illustrates that “wei qi” is a crucial factor in clearing foreign pathogens from peripheral tissues such as muscles, skin, and mucous membranes, serving as a barrier for the skin and mucous membranes. Wei qi can vigorously resist invading pathogens, and their intense struggle gives rise to disease. The “Plain Questions·On Malaria” states: “Wherever wei qi resides, it combines with pathogenic factors to cause illness.” This phenomenon is very similar to the phagocytic action of the reticuloendothelial system. Sometimes wei qi can even surround invading “pathogenic factors,” causing localized abscesses, just as the “Plain Questions·On Wind” says: “Wind qi enters the meridians along with the sun, disperses among the muscles and flesh, interacts with wei qi, and finds it difficult to move freely, thus forming abscesses in the muscle membrane.” This demonstrates how similar the function of “wei qi” is to the phagocytic action of neutrophils in immunology. Moreover, the role of “wei qi” is not limited to the skin, muscles, and pores—it also protects internal organs. The “Spiritual Pivot·On the Path of Wei Qi” states: “It begins in the yin, often flows from the Foot-Shao Yin to the heart, then to the lungs, then to the spleen, and finally returns to the kidneys, completing a cycle.” This shows that “wei qi” can travel through the meridians of various organs, much like the dispersed reticuloendothelial system and the systemic fluid circulation throughout the body.
<!-- translated-chunk:13/39 -->The above discussion demonstrates that "Wei Qi" performs a function similar to non-specific immunity in modern immunology; however, the primary factor determining the strength or weakness of Wei Qi is the robustness of spleen and stomach functions. Traditionally, people have used Bu Zhong Yi Qi Tang to tonify spleen and stomach functions, thereby achieving the goal of preventing colds—this is precisely the clinical application of this concept. Recent domestic experimental studies have shown that Bu Zhong Yi Qi Tang can indeed improve protein metabolism in tumor-bearing organisms and enhance their non-specific immune function. The Isotope Laboratory of the Beijing Tuberculosis Research Institute conducted intravenous injections of ³I-labeled plasma protein colloidal solution into animals and measured the clearance rate in the blood as an indicator of the phagocytic function of the reticuloendothelial system. They found that spleen-tonifying and qi-enhancing herbs such as Codonopsis, Atractylodes, and Astragalus can strengthen the phagocytic function of the reticuloendothelial system, whereas control group herbs like Adenophora, Lily, Fritillaria, and Scutellaria, which nourish yin and clear heat, do not exhibit this effect.
Experiments conducted by the Tumor Group at the Beijing Institute of Traditional Chinese Medicine show that Codonopsis can increase the number of white blood cells in peripheral blood counts; Jiang Tingliang injected rabbit extracts of this herb, resulting in an increased proportion of neutrophils in the peripheral blood. These experiments indicate that the spleen-tonifying herb Codonopsis can enhance the defensive function of white blood cells and boost the body's non-specific immunity. The Guang'anmen Hospital of the Chinese Academy of Traditional Chinese Medicine measured the phagocytic function of macrophages in 89 patients with malignant tumors, finding that their phagocytic rates were significantly lower than those of healthy individuals. Among them, five cervical cancer patients showed a marked improvement in macrophage phagocytic function after receiving spleen-tonifying and vital energy-supporting treatment. The above data demonstrate that spleen-tonifying methods can indeed enhance the defensive efficacy of macrophages, neutrophils, and the reticuloendothelial system, thus providing experimental evidence for the view that spleen-tonifying therapy can regulate the body's non-specific immunity.
The kidneys are the foundation of innate vitality and the source of life force. The Su Wen states in the chapter "On the Flow of Vital Energy to Heaven": "When yin is balanced and yang is concealed, spirit is well-regulated," and further says: "When yin and yang are separated, vital essence is extinguished," indicating that the balance of yin and yang is a prerequisite for maintaining normal ecological balance. Since the root of both yin and yang lies in the kidneys, they are referred to as the original yin and original yang. Disruption of kidney qi is often the key factor leading to overall imbalance of yin and yang. Modern immunology holds that the functions of T cells dependent on the thymus and B cells independent of the thymus are the main components of specific immunity, and the precursors of these two types of cells are stem cells located in the bone marrow. The Su Wen states in the chapter "On the Great Principles of Yin and Yang": "The kidneys generate bone marrow," from which it can be inferred that the transformation of bone marrow stem cells into T cells and B cells is closely related to the kidneys. Therefore, by regulating kidney yin and kidney yang, it is hoped that the body's specific immune response can be improved.
Pei Zhengxue’s Discussion on Traditional Chinese Medicine Theory and Clinical Cases
The Shanghai Cancer Research Institute in China used fetal alpha-fetoprotein (AFP) as an antigen to induce an immune response in rabbits, then divided them into groups and administered kidney-yin-tonifying drugs and kidney-yang-tonifying drugs for antibody measurement. The results showed that yang-tonifying drugs could accelerate the formation of antibodies, while yin-tonifying drugs could prolong the survival time of antibodies, demonstrating that kidney-tonifying therapy can improve specific humoral immune function.
The Department of Traditional Chinese Medicine at the Affiliated Hospital of Guangzhou Medical College conducted rose flower tests on patients with chronic bronchitis due to kidney deficiency to measure their specific cellular immunity. They found that the ratio of T cells in these patients was generally low, but after receiving kidney-tonifying treatment, the T cell ratio gradually increased, and clinical symptoms also improved accordingly. According to a report from the Henan Provincial Health Bureau’s Bronchitis Office, from the perspective of specific humoral immunity, measuring the IgA content in the sputum of chronic bronchitis patients revealed that after treatment with kidney-tonifying drugs such as rabbit placenta extract, the IgA content in the patients’ sputum tended to increase. The First Outpatient Clinic of the Chengdu Military Region Command conducted serum IgG and IgA measurements on more than 50 cases of chronic bronchitis patients with kidney deficiency, and all values were below normal. After applying warming and tonifying kidney-yang medicines via navel patches, the aforementioned indicators all increased to varying degrees. The above data show that kidney-tonifying therapy can enhance the conversion of T cells into lymphoblasts and promote the release of lymphokines, while also strengthening the function of immunoglobulins in body fluids, thereby providing experimental evidence for the argument that "kidney qi" has specific immune functions.
2. Endocrine Aspects
In recent years, materials combining organ differentiation diagnosis with endocrine aspects are still frequently seen in relation to the spleen and kidneys.
The kidneys are the foundation of innate vitality and the source of life force, making them crucial organs in the human body. The Su Wen states in the chapter "On the Ancient Heavenly Truth": "At the age of seven, a girl's kidney qi is strong, her teeth change, and her hair grows longer; at fourteen, Tian Gui arrives, the Ren meridian becomes unblocked, the Tai Chong meridian flourishes, menstruation occurs regularly, and she can bear children; at forty-nine, the Ren meridian becomes weak, the Tai Chong meridian declines, Tian Gui is exhausted, the path of conception is blocked, and the body deteriorates without children." Shen Kuo also said: "For women, if there is no power of the kidneys (kidney qi), there will be no beard." He even extracted sex hormone crystals of a certain purity from human urine, called Qiu Shi, to treat diseases involving abnormal growth, development, and sexual characteristics (endocrine disorders). It is evident that Chinese medicine has long attributed endocrine dysfunction to the kidneys. After the Ming Dynasty, the warm-tonifying school rose, and discussions about the kidneys and the Ming Men became more frequent. Zhang Jingyue said: "The Ming Men is the root of primordial qi, the abode of water and fire, the yin qi of the five zang organs cannot be nourished without it, the yang qi of the five zang organs cannot be activated without it, the Ming Men has a fiery quality, which is the primordial yang, the fire of life itself." All these discussions show that the kidneys and the Ming Men are closely linked to the body's energy metabolism.
In the early 1960s, Shen Ziyin and others at the Shanghai First Medical College began experimental research aimed at elucidating the relationship between the kidneys and adrenal gland endocrine functions. They first noticed that six different systems of diseases—functional uterine bleeding, bronchial asthma, pregnancy toxemia, systemic lupus erythematosus, coronary heart disease, and neurasthenia—all exhibited clinical manifestations of kidney yang deficiency at a certain stage of their development. At this point, if the same kidney-tonifying therapy was administered, all six diseases would show some degree of improvement. From this, they inferred that there might be a common metabolic dysfunction in the pathological processes of these six diseases, and that this metabolic dysfunction was the internal factor, while the external manifestation was kidney yang deficiency syndrome. Kidney-tonifying therapy could not only alleviate and eliminate kidney yang deficiency syndrome, but also undoubtedly regulate the underlying metabolic dysfunction.
Later, through a series of experimental studies, they finally discovered that the 24-hour urinary excretion of 17-hydroxyprogesterone in patients with kidney yang deficiency was significantly lower than normal, and after kidney-tonifying treatment, it returned to normal levels, while the kidney yang deficiency syndrome also improved accordingly. The level of 17-hydroxyprogesterone in urine reflects the synthesis, secretion, and catabolic metabolism of adrenal cortical hormones within the body; any disruption in one of these three processes will lead to changes in the urinary 17-hydroxyprogesterone level. Such disruptions are usually closely related to the hypothalamus-pituitary-adrenal cortex system. Based on this, they concluded that the kidneys in traditional Chinese medicine, to a certain extent, possess the functions of the hypothalamus-pituitary-adrenal cortex system; the kidney deficiency syndrome in traditional Chinese medicine, to a certain extent, is the external manifestation of insufficient hypothalamus-pituitary-adrenal cortex function; and kidney-tonifying therapy, to a certain extent, can improve the functions of the hypothalamus-pituitary-adrenal cortex system.
Based on this conclusion, it becomes obvious why traditional Chinese medicine can use kidney-tonifying therapy to treat various diseases. In addition to the aforementioned six diseases, the author has also frequently used kidney-tonifying therapy to treat aplastic anemia, leukemia, tumors, hypertension, chronic nephritis, prostatitis, lumbar muscle strain, rheumatoid arthritis, and other conditions, all of which have achieved varying degrees of clinical efficacy. With a clear understanding of the above mechanism, this provides an important avenue for exploring the reasons behind its therapeutic effects.
The spleen is the foundation of acquired vitality, and like the kidneys, it is another extremely important organ in the human body.
Based on the principles that "the spleen governs transportation and transformation" and "it can transform waste and produce the five flavors," people generally believe that the spleen in traditional Chinese medicine has the absorption and digestion functions of the small intestine in modern medicine. In recent years, the similarities between the spleen and the pancreas in modern medicine have gradually attracted attention, leading to a preliminary explanation of the relationship between the spleen and the endocrine system. The Su Wen states in the chapter "On the Taiyin and Yangming Meridians": "The spleen and stomach are connected by a membrane, yet they can circulate their body fluids." This shows that the anatomical position of the spleen is similar to that of the pancreas. The Su Wen also says: "Patients with spleen diseases experience heaviness, excessive hunger, and muscle wasting." This is very similar to the symptoms of diabetes. During the Ming Dynasty, Zhang Jingyue developed the above viewpoint, pointing out: "Zhongxiao refers to diseases of the middle jiao, characterized by overeating and excessive hunger, leading to gradual weight loss without muscle gain. The disease lies in the spleen and stomach, hence the name 'zhongxiao'." (From the Complete Works of Jingyue) He explicitly stated that diabetes caused by pancreatic endocrine dysfunction is one of the diseases of the spleen.
Modern medicine has discovered the gastrointestinal and pancreatic endocrine systems in the past ten years. First, in 1964, someone abroad injected glucose solution into the duodenum, causing a rapid rise in blood insulin levels—far exceeding the effect of injecting glucose directly into the bloodstream. Subsequently, special endocrine cells were discovered in the upper intestinal mucosa, which secrete several peptide hormones (such as gastrin, glucagon, secretin, cholecystokinin, and enterogastrone) into the bloodstream, regulating digestion, absorption, storage, and breakdown. This regulatory function often operates under the participation of the vagus nerve, and this endocrine system including the vagus nerve is called the "gastrointestinal and pancreatic endocrine system."
The spleen in traditional Chinese medicine has functions very similar to this endocrine system. Hou Can from Sun Yat-sen Medical College, starting from analyzing symptoms of spleen deficiency such as excessive salivation, dampness, abdominal distension, loose stools, acid regurgitation, and nausea, believes that when the spleen yang is deficient, vagal tension increases. Some have measured the acetylcholinesterase activity in patients with spleen yang deficiency and found it higher than in the normal control group, supporting this view. Hou Can also participated in measuring the autonomic nervous function of 53 patients with chronic dysentery due to spleen deficiency, discovering that 53% had parasympathetic dominance, while only 5% had sympathetic dominance. Jiangsu New Medical College conducted experiments using isolated rabbit intestinal tubes and found that spleen-tonifying formulas such as Bu Zhong Yi Qi Tang could inhibit excessive intestinal peristalsis, further supporting the above view.
In the aforementioned gastrointestinal and pancreatic endocrine systems, the role of the parasympathetic nervous system is merely to transmit information and regulate the increase or decrease of secretions. For example, hypoglycemic drugs promote increased insulin secretion, leading to hypoglycemia; when insulin secretion increases, it reflexively causes increased gastrin secretion (promoting gastric acid and pepsin secretion), increased secretin secretion (promoting pancreatic enzyme release), and increased cholecystokinin secretion (promoting bile secretion), thereby fully activating the "gastrointestinal and pancreatic endocrine system" and preparing it for upcoming digestive and absorptive activities.
This shows that the spleen in traditional Chinese medicine, in terms of digestion, absorption, and metabolism, basically performs the same functions as the "gastrointestinal and pancreatic endocrine system" in modern medicine, with pancreatic endocrine function playing the dominant role. The traditional Chinese medical belief that diabetes is caused by spleen deficiency and the fact that spleen-tonifying therapy is effective in treating this disease provide a preliminary answer to this question.
Traditional Chinese medicine has always attached great importance to the relationship between the spleen and the kidneys. Zhang Jingyue said: "At birth, humans originate from the source of essence and blood; after birth, they are nourished by food and water. Without essence and blood, there is no basis for forming the body; without food and water, the body cannot grow strong. Essence and blood are governed by the Ming Men, while food and water are governed by the spleen and stomach. Thus, the Ming Men receives innate qi, while the spleen and stomach receive acquired qi. Therefore, the sea of food and water relies primarily on innate qi, while the sea of essence and blood must rely on acquired qi for support. Consequently, from birth to old age, anyone whose innate foundation is insufficient can compensate for it through acquired nurturing, which can make up half of their strength." After clarifying the endocrine relationship between the spleen and the kidneys, understanding Zhang Jingyue's view seems even more precise.
The kidneys have the function of the hypothalamus-pituitary-adrenal cortex system, while the spleen has the function of the gastrointestinal and pancreatic endocrine system. The former uses energy substances to carry out life activities, while the latter absorbs and produces energy substances to supply the former. The two mutually promote and restrain each other, existing in a dynamic equilibrium of unity of opposites.
(“New Pharmaceutical Journal,” March 1977)
① Shen Ziyin et al. Preliminary Exploration of the Rules for Combined Western and Traditional Chinese Medicine Diagnosis and Treatment Based on Kidney Yin and Kidney Yang. “Shanghai Journal of Traditional Chinese Medicine,” 1962, Vol. 1, p. 19
② Gu Tianjue et al. Observation of Changes in the Urinary Excretion of 17-Hydroxyprogesterone in Patients with Kidney Deficiency. “Chinese Journal of Internal Medicine,” 1964, Vol. 1, p. 307
③ Zhang Zehao. Exploration of the Principles of Strengthening and Nurturing in Traditional Chinese Medicine. “Chongqing Pharmaceutical,” 1977, Vol. 3, p. 67
④ Li En. The Relationship Between Biochemistry and Traditional Chinese Medicine. “New Pharmaceutical Research,” 1977, Vol. 1, p. 42
⑤ Hou Can. Preliminary Exploration of the Nature of the Spleen in Traditional Chinese Medicine. “New Pharmaceutical Journal,” 1977, Vol. 10, p. 5
⑥ Pei Zhengxue. Strengthening and Nurturing and Immunity. “Compilation of Materials on the Combination of Chinese and Western Medicine,” 1978, Vol. 2, p. 15
Application of Bowel-Regulating Therapy in Internal Medicine Emergencies – Pei Zhengxue
Bowel-regulating therapy, specifically bowel-clearing and heat-dispelling therapy, is a method of clearing internal heat by promoting bowel movements. The author has used this method to rescue patients with internal medicine emergencies, achieving good therapeutic effects.
Next-day follow-up visit: The patient's abdominal pain has greatly subsided, consciousness has cleared, and a large amount of dark, muddy, watery stool has been passed, with blood pressure at 13.3/10.7 kPa (100/80 mmHg). However, the patient still experiences intermittent, radiating pain in the left upper abdomen, extending to the left chest, waist, and shoulder, accompanied by bitter taste in the mouth and dry throat, along with abdominal distension and intestinal rumbling. The pulse is wiry and rapid, and the tongue is red with a thick, greasy yellow coating. The pattern indicates residual internal heat, with pathogenic factors residing in the Shaoyang channel, requiring simultaneous treatment of both exterior and interior.
Prescription: Modified Da Chai Hu Tang. Decocted in water, one dose per day, for a total of six doses.
| Chai Hu | 10g | Huang Qin | 10g | Zhi Shi | 10g | Da Huang | 10g |
|---|---|---|---|---|---|---|---|
| Bai Shao | 15g | Chuan Xiong | 6g | Xiang Fu | 6g | Yuan Hu | 6g |
| Chuan Lian Zi | 6g | Huang Lian | 3g | Yi Ren | 20g | Hong Teng | 20g |
Follow-up visit: The patient's mental state has improved, blood pressure is stable, the tongue coating has become thinner, the pulse is wiry, and there is only mild pain in the left upper abdomen. Amylase levels have dropped from 1260 U to 60 U, and amylase in urine has decreased from 224 U to 120 U. The patient continues to take Shu Gan Wan pills (produced by the Yu County Pharmaceutical Factory in Henan Province), one pill twice daily, to consolidate the effects.
This chapter is prepared for online research and reading; for external materials, please align with original publications and the review process.