· Lung-Kidney Yang Deficiency

· Lung-Kidney Yang Deficiency

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Clinical Application in the Middle Section

Published by Hefei Book Publishing House

(3) Lung-Kidney-Liver-Spleen Type

When the lung is deficient, metal does not generate water, leading to kidney deficiency; liver and kidney share a common origin, so kidney disease can lead to liver disease, which may further result in the pathological pattern of liver wood overcoming earth. Thus, this syndrome type emerges.

· Lung-Kidney Deficiency, Liver Wood Overcoming Earth

· Lung-Kidney Deficiency, Liver Not Controlling Blood

(4) Five-Zang Disharmony Type

As seen earlier with lung-kidney yang deficiency and later with liver-spleen deficiency, the situation will inevitably affect the heart, which governs the five zang organs.

Liver deficiency means wood cannot generate fire, spleen deficiency means the child steals the mother’s qi, and kidney water deficiency prevents it from ascending to the heart, disrupting the balance of water and fire. The heart governs blood, while the lungs govern qi; when qi is deficient, blood is also hard to replenish, leading to a state of overall deficiency in the five zang organs, with heart deficiency being the most prominent.

· Five-Zang Disharmony, Cold Deficiency in the Heart

Main Symptoms | > Palpitations, shortness of breath, spontaneous sweating, fatigue and weakness, pale complexion, cold limbs, profuse sweating, poor appetite, confusion, blood counts below normal, extremely weak pulse, red tongue, no coating or thin white coating; this syndrome is commonly seen in advanced stages of leukemia. Treatment Principle | > Tonify qi and nourish the heart, strongly reinforce heart yang. Prescription | > Great Supplement to Restore Yang Decoction: Honey Roasted Licorice 30g, Smoked Ginseng 24g, Prince Ginseng 15g, Jilin Ginseng 9g, Light Aconite 6g, Atractylodes 9g, Poria 9g, Honey Roasted Licorice 6g, Angelica 9g, Cinnamon 4.5g, Cooked Rehmannia 12g, White Peony 9g, Chuanxiong 6g, Cornus 12g, Mulberry 15g, Dry Evil 3g, Deer Antler (ground finely) 2.4g, Donkey Hide Glue 9g, Difficult Blood Vine 24g, Mulberry 24g, Bone Strengthening Herb 9g, Change Winter 9g, Five Flavors 3g, Ginger 3 slices, Public 3 pieces.

Pei Zhengxue’s Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases Published by Heji Publishing House

·Five-Zang Disharmony, Yin Deficiency and Yang Collapse

Main Symptoms | > Body feels hot, profuse sweating, difficulty breathing, lack of appetite, confusion, low white blood cell count and red blood cell count (or related to chemotherapy), weak pulse, accompanied by signs of rapid heartbeat. Treatment Principle | > Nourish yin and raise yang. Prescription | > Yang-Raising and Rescue Decoction: Sand Ginseng 15g, Black Ginseng 12g, Smoked More 24g, White Ginseng 9g, Prince Ginseng 9g, Salvia 15g, Ophiopogon 9g, Schisandra 6g, Cornus 24g, Goji Berry 15g, Chinese Yam 30g, Honey Roasted Licorice 30g, Angelica 12g, White Peony 9g, Cooked Rehmannia 12g, Dragon Bone 15g, Floating Small Changes 45g, Atractylodes 9g, Qin Jiao 9g, Donkey Hide Glue 15g, White Weiyi 9g, Artemisia 6g, Complex Numbers 9g, Difficult Blood Vine 30g, Poria 9g, Honey Roasted Licorice 6g, Charred Hawthorn 9g, God Wings 9g, Chuanxiong 3g, Shengma 3g, Five Jujubes 5 pieces.

2. Treatment of Syndromes with Strong Pathogenic Factors

(1) Warm Disease Type

Leukemia (especially acute leukemia) often presents with a pattern of wind-heat and real-fire syndromes. Sometimes there is headache, fever, red tongue, and rapid pulse, indicating heat in the defensive layer; sometimes there is high fever, thirst, excessive sweating, and constipation, indicating heat in the qi layer; sometimes there is blood heat running rampant, with vomiting, nosebleeds, and bloody stools, indicating heat in the nutritive layer.

In short, for this disease with warm disease characteristics, medications should be selected that clear heat and detoxify, such as honeysuckle, forsythia, peppermint, dandelion, indigofera, purple flower ground ivy, seven-leaf one-branch flower, mulberry leaves, etc.

① If heat-toxin attacks the lungs and causes throat swelling and pain, use Huangqin, Shan Dou Gen, Burdock, Ma Bo, Raw Grass, Xuan Cao, White Snake Tongue, etc.

② If phlegm cough is not relieved, use fish mint, Fritillaria, mulberry bark, raw gypsum, or Ma Xing Shi Gan Tang.

③ If lung heat causes nosebleeds, use White Reed Root, Moutan Bark, Cooked Rehmannia, Charred Gardenia, and Safflower, etc.

④ If lung heat spreads to the large intestine and causes constipation, use Earth Rhubarb and Yuan Ming Powder; if damp-heat causes diarrhea, use Coptis, Huangqin, White Headed Elder, Qin Jiao, and Purslane, etc.

⑤ If heat-toxin attacks the kidneys and causes reddish urine and turbid urination, use Anemarrhena and Phellodendron; if kidney heat spreads to the bladder and damp-heat flows down, causing urinary difficulties (urinary tract infection), use Gardenia, Qu Mai, Plantain, Talc, Nightshade, Half Branch Lotus, etc.

⑥ If liver-gallbladder real-fire causes red eyes and bitter mouth, use Gentian and Gardenia; if liver heat spreads to the gallbladder and causes jaundice, use Yin Chen and Phellodendron, etc.

⑦ If heat-toxin attacks the heart and causes hyperactivity of heart fire and restlessness, use Coptis, Big Green Leaf, Forsythia, etc.; if heart heat spreads to the small intestine and causes reddish, astringent urine, use Cooked Rehmannia, Wood通, and Raw Licorice; if widespread skin sores and epilepsy occur, heavily use honeysuckle, forsythia, dandelion, and ground ivy; if sepsis occurs, use Coptis Detoxification Decoction with added ingredients.

⑧ If heat enters the pericardium and causes high fever, delirium, and rambling speech, accompanied by phlegm heat and a slippery, rapid pulse, because the heat is trapped inside, resulting in high fever but cold extremities, immediate cooling of the heart and relief of heat should be administered to reverse the trend, using An Gong Niu Huang Wan, Zhi Bao Dan, Zi Xue Dan, etc.

Clinical Application in the Middle Section

⑩ If evil heat remains in the yin part and cannot be eliminated, with persistent low-grade fever that fluctuates between morning and evening, heat in the palms and soles, red tongue, and rapid, fine pulse, use Qin Jiao, Turtle Shell, Cooked Rehmannia, Anemarrhena, Ground Bone, Artemisia, Stir-fried Bile of Turtle, White Weiyi, Hu Huang Lian, and Turtle Shell, etc.

① If heat-toxin attacks the spleen and causes dry mouth and lips, easy thirst and hunger, use Mountain Gardenia, Raw Gypsum, and Raw Grass, etc.; if spleen heat affects the stomach and the middle jiao becomes dry and solid, with red eyes, thirsty mouth, and abdominal fullness with constipation, use Rhubarb, Yuan Ming Powder, or Liang Ge San with added ingredients.

② On the basis of the above heat-clearing and detoxifying measures, anticancer heat-clearing and detoxifying drugs can be added as appropriate, such as White Snake Tongue Grass, Half Branch Lotus, Nightshade, Pigweed, Tree Root, Indigo, and Heavy Row, etc.; also, arsenic and toad venom, which have pungent-warm properties, can be added as detoxifying and anticancer agents. In addition to the aforementioned heat-clearing and detoxifying methods, some leukemia patients often experience generalized bone pain, obvious tenderness in the sternum, dark tongue, sticky pulse, or a combination of low-grade fever and persistent high fever; in such cases, treatment should focus on blood stasis, using Sanleng, E Zhu, Yellow Medicinal Herb, Jing Tian San Qi, Snake Six Silk, and Mountain Cimicifuga, etc.

(2) Five-Zang Interconnected Disease, Real-Fire in the Liver Type

Main Symptoms | > Chest tightness and weakness, chest pain or sternum pain, bitter taste, tinnitus, heat, insomnia, abdominal masses, hard lumps that do not dissolve, wiry and rapid pulse, red tongue, even with purple-dark spots. Treatment Principle | > Clear heat, drain the liver, and eliminate accumulation. Prescription | > Modified Dang Gui Bian Yu Tang: Dang Gui 9g, Lu Lei 9g, Gentian 9g, Coptis 6g, Huangqin 6g, Huangbo 6g, Gardenia 6g, Rhubarb 6g, Indigo (packaged) 6g, Wood Fragrance 3g, Musk 0.15g, White Snake Tongue Grass 30g, Half Branch Lotus 15g, Live Clam 24g, Live Shock 24g; for those with hepatosplenomegaly that does not resolve, add Sanleng 6g and E Zhu 6g.

Pei Zhengxue’s Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases Published by Taipei Circle Publishing House

April 6, 1975—First Visit

Physical Examination: Menstruation delayed for nearly a month, liver enlarged 3–4 cm below the rib margin, spleen enlarged about 6–8 cm, surface smooth but slightly firm.

Laboratory Tests: White blood cells 32,000/mm³.

Traditional Chinese Medicine Syndrome Differentiation: Epigastric discomfort, belching, acid regurgitation, pain in both flanks, wiry and rapid pulse, thin white coating on the tongue. According to the theory of lung-kidney deficiency and liver wood overcoming earth, treatment was prescribed.

Prescription: Use Modified Xiaoyao San to activate blood circulation, detoxify, eliminate accumulation, and grind away lumps. About 20 doses were taken.

Liver and spleen significantly shrank, symptoms improved, white blood cells dropped close to normal range, and the dosage of the Qi-Nourishing and Yin-Tonifying Decoction was increased fourfold, with honey pills added. To date, six years have passed, including two years of physical labor, with no recurrence.

Traditional Chinese Medicine Syndrome Differentiation: Red tongue, slightly thick yellow and greasy coating, floating and weak pulse, accompanied by astringent sensation; the syndrome is lung-kidney yin deficiency with internal heat burning up, treated with Qi-Nourishing and Yin-Tonifying Decoction combined with methods to dispel pathogenic factors.

August 11—Second Visit

After taking the medicine for six doses, body temperature returned to normal, consciousness clear, appetite good, tongue coating cleared, but still felt shortness of breath and excessive sweating, occasionally experienced palpitations; therefore, Qin Jiao and Turtle Shell were removed from the original formula, and 6g of Indigo and 6g of E Zhu were added.

March 29, 1977—15th Visit

Laboratory Tests: Hemoglobin 13 g, red blood cells 4.42 million/mm³, white blood cells 5,000/mm³, neutrophils 55%, eosinophils 2%, monocytes 2%.

Prescription: Add 120g of Prince Ginseng, 120g of Black Ginseng, change Human Hair Ginseng to Jilin Ginseng 60g, decoct into a concentrated paste, take one tablespoon twice daily, mixed with hot water.

Clinical Application in the Middle Section

Published by Heji Publishing House

December 1977

Sixteen months after symptom relief, sudden relapse occurred, with a large number of primitive monocytes appearing in the bone marrow, far exceeding the normal range; immediately initiated combination chemotherapy, but before completing even one course of treatment, the bone marrow was severely suppressed.

January 21, 1978—22nd Visit

Laboratory Tests: Hemoglobin 8.5 g, red blood cells 2.89 million/mm³, white blood cells 250/mm³, platelets 30,000/mm³.

Traditional Chinese Medicine Syndrome Differentiation: Excessive sweating, shortness of breath, confusion, lack of appetite, weak pulse; used Yang-Raising and Yin-Tonifying Decoction, one dose daily for five consecutive days, blood counts improved, continued with the original formula.

March 8—24th Visit

All symptoms completely alleviated, feeling normal, spirits improved, eating well.

Laboratory Tests: Hemoglobin 13.4 g, red blood cells 4.52 million/mm³, white blood cells 6,800/mm³, neutrophils 83%, eosinophils 2%, monocytes 1%, platelets 126,000/mm³.

Bone marrow picture: Within normal range. Symptom relief occurred for the second time, currently still taking the Qi-Nourishing and Yin-Tonifying Paste, having been in remission for 26 months, still under observation.

(“Guangxi Traditional Chinese Medicine,” 1981.1)

Traditional Chinese Medicine’s View on Leukemia—Pei Zhengxue

The exact causes and pathogenesis of leukemia remain unclear, but according to current research trends, viral theory and apoptosis theory have received widespread attention. The former suggests that certain viruses, through the action of reverse transcriptase, can transform into leukemia cells under specific conditions. The latter posits that abnormal regulation of the differentiation, proliferation, and maturation processes of white blood cells themselves can lead to the development of leukemia. These two theories respectively emphasize internal and external factors, and many believe that both factors may coexist in the pathogenesis of leukemia.

Therefore, some advocate boldly moving beyond the current chemotherapy-focused approach that mainly suppresses tumor cells, and instead focusing on regulating and promoting normal cellular functions, fully mobilizing the body’s own anti-pathological mechanisms. This holistic perspective is entirely consistent with the traditional Chinese medical principle of “strengthening the body to dispel pathogenic factors.”

Pei Zhengxue’s Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases Published by Heji Publishing House

(2) The Lung Has Regulatory Functions

<!-- translated-chunk:22/39 -->

《Plain Questions·Secret Canon of Linglan》: "The Lung is the official of the Minister of State, governing and regulating all functions."，《Spiritual Pivot·Discourse on the Nine Needles》: "The Lung is the canopy over the Five Zang and Six Fu organs," indicating that the Lung bears the responsibility of governing, supervising, and regulating all other organs, making it an indispensable factor for maintaining their normal functions. Since bone marrow is generated by the Kidney, its hematopoietic function must be closely related to the Lung's governing and regulating role.

(3) The Metal element of the Lung can generate the Water element of the Kidney.

The Lung belongs to the Metal element, while the Kidney belongs to the Water element; thus, Metal and Water mutually generate each other. In "Plain Questions·Great Discussion on the Correspondence of Yin and Yang," it is stated that "the Lung generates the Kidney," which conveys the same meaning. If Lung Qi is deficient, Metal and Water cannot mutually generate, potentially leading to secondary Kidney disease; consequently, the bone marrow governed by the Kidney may also become diseased.

3. The Liver and Leukemia

"Spiritual Pivot·Chapter on the True Spirit": "The Liver stores blood, and blood houses the Soul." Therefore, if the Liver's storage of blood is abnormal, the blood system is prone to illness. The Liver belongs to the Wood element, characterized by smoothness and a preference for dispersing and releasing. When Wood becomes stagnant, it easily transforms into Fire; excessive Fire then forces blood to flow erratically. Moreover, the Liver governs Wind, and when Wind stirs, it causes spasms and convulsions. These pathological conditions and syndromes share commonalities with the clinical manifestations of leukemia. Thus, when leukemia presents with symptoms similar to these syndromes, treatment should focus on the Liver.

4. The Heart and Leukemia

(1) The Heart governs blood vessels.

"Plain Questions·Six Sections on the Form and Function of the Zang-Fu Organs": "The Heart is the root of life and the transformation of the Spirit; its fullness resides in the blood vessels," indicating that only when Heart Qi is sufficient can blood fill the vessels and circulate throughout the body. The bleeding and anemia associated with leukemia can both be explained as a condition where blood does not "fill the vessels"; therefore, treatment can be approached from the perspective of the Heart.

(2) The Heart generates blood.

"Plain Questions·Great Discussion on the Correspondence of Yin and Yang": "The Heart generates blood." Wang Bing believed that "when the Heart generates blood, it means the Heart's essence and vital energy produce blood." Meanwhile, Zhang Zhicong argued that "blood is the juice of the Middle Jiao, transformed into red under the influence of the Heart's spirit; thus, blood is essentially the spirit and vital energy." This suggests that the generation of blood depends on the Heart's essence and vital energy, specifically being transformed into red under the guidance of the Heart's spirit. When suffering from leukemia, since the bone marrow's hematopoietic function is disrupted, treatment can be directed toward the Heart.

5. The Spleen and Leukemia

(1) The Spleen governs transportation and transformation.

In Traditional Chinese Medicine, the digestive functions of the stomach and intestines are collectively attributed to the Spleen. After digestion, the refined substances produced are transported throughout the body by the Spleen, part of which is transformed into red, thereby becoming blood. "Spiritual Pivot·Chapter on the Decisive Qi": "The Middle Jiao receives qi and extracts juice, which transforms into red—this is what we call blood," precisely illustrates this point. Since the Spleen participates in blood production, the treatment of leukemia should inevitably involve the Spleen.

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Pei Zhengxue's Study of Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases

Published by Heji Book Publishing House

For chronic leukemia, combining traditional Chinese medicine to tonify the righteous qi with methods to dispel pathogenic factors can achieve complete remission. Compared with Western medicines such as Myleran and chlorambucil, this approach has fewer side effects and provides long-term benefits.

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[Part Two: Clinical Applications]

Published by Heji Book Publishing House

·Lung-Kidney Yin Deficiency, Liver Yin Insufficiency

·Lung-Kidney Yin Deficiency, Liver Wind Internal Movement (Use Angong Niuhuang Pill in cases of coma.)

(3) Lung-Kidney-Liver-Spleen Type

When the Lung is weak, Metal cannot generate Water; when Water cannot nourish Wood, Wood becomes stagnant, subsequently leading to the pathology of Liver Wood overcoming Earth. This type of syndrome gradually emerges.

·Lung-Kidney Deficiency, Liver Wood Overcoming Earth

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Pei Zhengxue's Study of Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases

Published by Heji Book Publishing House

·Lung-Kidney-Liver Deficiency, Spleen Unable to Control Blood

Part Two: Clinical Applications

Published by Heji Book Publishing House

·Five Zang Organs Out of Balance, Yin Deficiency and Yang Overflow

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Table 1: Brief Summary of Effective Medications Used in Tonifying Formulas to Restore Blood Parameters

2. Dispelling Pathogenic Factors

Although leukemia is fundamentally characterized by deficiency and superficially by excess, throughout the course of the disease—especially in acute leukemia—it frequently manifests as patterns of wind-heat and real-fire syndromes. Sometimes there is headache, fever, red tongue, and rapid pulse, indicating heat in the defensive layer; sometimes there is high fever, thirst, profuse sweating, and constipation, indicating heat in the qi layer; sometimes there is uncontrolled blood heat, with hematemesis and hematochezia, indicating heat in the nutritive layer. In short, this disease exhibits characteristics of warm diseases, which are commonly seen in clinical practice; therefore, medications should focus on clearing heat and detoxifying, such as Forsythia, Lonicera, peppermint, dandelion, Isatis indigotica, Viola philippica, seven-leaf one-flower, mulberry leaves, and others.

①For example, when heat-toxin attacks the lungs and causes throat swelling and pain, use Huangqin, Shan Dou Gen, Niuzi, Mabo, raw herbs, Xuan Shen, and White Snake Tongue Herb.

②For phlegm-related coughs that are not relieved, use Houttuynia cordata, Fritillaria cirrhosa, Mulberry bark, raw gypsum, or Ma Xing Shi Gan Tang.

③For lung heat causing nosebleeds, use white pampas grass, Moutan bark, Rehmannia, roasted hawthorn, and Eclipta prostrata.

④For cases where lung heat spreads to the large intestine and causes constipation, use Rhubarb and Glauber's salt. For damp-heat diarrhea, use Coptis, Scutellaria, White Headed Herbs, Qinpi, and Portulaca oleracea.

Pei Zhengxue's Study of Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases

Published by Hefei National Fragrance Publishing House

⑤For heat-toxin attacking the kidneys and causing reddish urine with turbidity, use Zhimu and Huangbo; when kidney heat spreads to the bladder and damp-heat descends, resulting in reduced urination and urinary tract infections, use Gardenia, Qu Mai, Plantago, Talc, Solanum nigrum, and Half Branch Lotus.

⑥For heat-toxin attacking the liver and causing red eyes and bitter taste, use Long Grass and Gardenia; when liver heat spreads to the gallbladder and causes jaundice, use Yin Chen and Huangbo.

⑦For heat-toxin attacking the heart and causing excessive heart fire and restlessness, use Coptis, Da Qing Ye, and Lonicera. When heart heat spreads to the small intestine and causes reddish, stinging urine, use Rehmannia, Mu Tong, and raw licorice. For skin eruptions and eczema, heavily use Forsythia, Lonicera, dandelion, and Isatis indigotica. If sepsis occurs, use Coptis Detoxification Soup with additional ingredients.

⑧For heat entering the nutritive layer and depleting the nutritive blood, causing high fever at night, faint rashes, thin and rapid pulse, and dark red tongue without coating, use Rhinoceros Horn, Rehmannia, Xuan Shen, bamboo leaves rolled up, Mai Dong, Salvia miltiorrhiza, Coptis, Forsythia, Lonicera, and others.

⑨For heat entering the pericardium and causing high fever, delirium, and rambling speech, accompanied by phlegm heat and slippery, rapid pulse, because the heat is trapped inside, often resulting in high fever while the extremities feel cold, immediate cooling of the heart and relief of heat are necessary to reverse the trend. Use Angong Niuhuang Pill, Zhibao, and Zixue, among others.

⑩For pathogenic heat remaining in the yin layer and not dissipating, with low-grade fever persisting, lighter in the morning and heavier in the evening, hot palms and soles, red tongue, and thin, rapid pulse, use Qin Jiao, turtle shell, Rehmannia, Zhimu, ground bones, Artemisia annua, fried Bupleurum with turtle blood, Bai Wei, Hu Huanglian, and turtle shell, among others.

⑪For heat-toxin attacking the spleen and causing dry mouth and lips, easy thirst and hunger, use gardenia, raw gypsum, and raw herbs. When the spleen and stomach are hot, the middle jiao is dry and solid, with red face and thirsty mouth, abdominal distension and constipation, use Rhubarb, Glauber's salt, or Liangge San with added ingredients.

On the basis of the above-mentioned methods of clearing heat and detoxifying, anti-cancer herbal remedies can be added as appropriate, such as White Snake Tongue Herb, Half Branch Lotus, Solanum nigrum, Pigweed, Tree-of-Heaven root, Indigo, and Chonglou; additionally, arsenic and toad venom—herbs with pungent-warm properties—can also be used for detoxification and anti-cancer purposes. Besides the aforementioned methods of clearing heat and detoxifying, some leukemia patients frequently experience widespread joint pain, obvious tenderness in the sternum, dark tongue, sticky pulse, or combined low-grade and high-grade fever that does not subside. In such cases, treatment should focus on promoting blood circulation and removing blood stasis, using herbs like Sanleng, E Zhu, Huang Yao Zi, Jing Tian Sanqi, She Liu Gu, and Shan Ci Gu, among others.

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Example 1

Wei, male, 14 years old, student, son of a worker at the Gansu Provincial Academy of Sciences.

First Visit on May 23, 1975

Parents reported: Three months ago, he began experiencing fatigue, dizziness, decreased appetite, discomfort on both sides, and soreness in the lower back and legs. He was examined at ×× Hospital in Lanzhou.

Laboratory results: White blood cell count 165,000/mm³.

Bone Marrow Examination: Bone marrow showed extreme hyperplasia, with blast cells and promyelocytes accounting for over 22%; liver and spleen were slightly enlarged. Diagnosed as chronic myelogenous leukemia.

Clinical Application in Part Two

Upon examination: bitter taste in the mouth, hearing loss, irritability, flushed face, thirst and insomnia, hidden pain in the sternum. Based on the imbalance of organ qi and the presence of real-fire in the liver, the treatment plan was modified to include a flavored version of Dang Gui Long Hui Tang, along with 0.6g of ox bile (taken twice daily) to enhance the effect of expelling pathogenic factors. Subsequent follow-up visits continued to focus on this prescription.

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Visit on October 4, 1975

Seventh visit on October 4 of the same year: complexion returned to normal, appetite improved, spirits lifted, white blood cell count dropped to 21,000/mm³. Switched to Dang Gui Aloe Pill, taking 6g twice daily—one in the morning and one at night. After three months of medication, he was able to engage in light physical labor, and the symptoms of real-fire in the liver significantly diminished. Continued treatment with Xiaoyao and Guipi formulas followed.

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Visit on November 18, 1977

Laboratory results: White blood cell count reduced to 18,300/mm³, subjective symptoms disappeared, physical strength increased, appetite good. Now working at a factory under the Academy of Sciences, still alternating between Shengmai Dihuang Tang and Dang Gui Aloe Pill to consolidate the therapeutic effect. The patient has been taking traditional Chinese medicine for three years since onset and remains under continuous observation.

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Platelet count 33,000/mm³, indicating dual deficiency of Lung and Kidney. Treatment plan: Tonify qi and nourish yin.

Second Visit on June 26

Still taking the previous prescription for 12 doses, fever subsided and sweating stopped, with noticeable improvement in subjective symptoms.

Laboratory results: Hemoglobin 11g, red blood cells 4.12 million/mm³, white blood cells 5,100/mm³, neutrophils 76%, lymphocytes 23%, monoblasts 1%, platelets 120,000/mm³. Continuing to take the original prescription.

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Pei Zhengxue's Study of Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases

Published by Hefei National Fragrance Publishing House

---

Fourth Consultation on July 12

After taking three doses of the previous prescription, body temperature dropped to 36.4°C, loose stools stopped, slight improvement in eating, pulse became deep and weak, tongue turned red with white coating gradually fading, though a small patch about the size of a fingernail remained slightly greasy. Feeling tired in the morning but more energetic in the afternoon, occasional spontaneous sweating, switched to Bu Zhong Yi Qi Tang and the combination of Tonify Qi and Nourish Yin prescriptions. After about a month of adjustment, both the condition and blood parameters returned to the state of complete remission prior to July 1.

Since then, in terms of traditional Chinese medicine, each dose is divided into two portions and taken once daily, alternating between Tonify Qi and Nourish Yin formulas and Tonify Qi and Boost Yang formulas. Regarding Western medicine, apart from the initial period of combined chemotherapy, for the past year and a half only traditional Chinese medicine has been used for treatment. To date, for a full two years, the patient remains in a state of complete remission.

(From "Compilation of Gansu Materials on Integrated Chinese and Western Medicine," 1977.1)

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①② "Comprehensive Collection of Ancient and Modern Books," Volume 91, Book 455, Page 393 (reprinted by the China Book Publishing House in 1953).

③④ "Comprehensive Collection of Ancient and Modern Books," Volume 23, Book 424, Page 18 (same edition as above).

⑤ "Traditional Chinese Medicine Treatment of Blood Diseases," April 1975, compiled by Lanzhou Medical College (internal material), 7 pages.

⑥ Internal materials from Lanzhou Dashaping Hospital (unpublished).

⑦ Lanzhou Medical College's "Compilation of Leukemia Materials," November 1973.

Integrated Chinese and Western Medicine Treatment of Acute Myelogenous Leukemia

Pei Zhengxue's Study of Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases

=3.1:1, white:red=27.1:1, white blood cells significantly proliferate, with monocytes being the main cell type: 5.0% primitive monocytes, 69.5% monoblasts, 6.0% mature monocytes, totaling 80.5%. Early-stage erythrocytes account for 3.5%, while mature red blood cells are mostly normal in shape, though some lack adequate hemoglobin filling. No megakaryocytes were observed (according to a report by Professor Zhang Aicheng of Lanzhou Medical College).

Western Medical Diagnosis: Acute myelogenous leukemia (non-leukemic type).

Hospitalization treatment process: On March 15, 1967, the patient was admitted and immediately given 400,000 units of penicillin intramuscularly every 8 hours, 0.5g of streptomycin intramuscularly twice daily, 10mg of Vitamin B₁ orally three times daily, 100mg of Vitamin C orally three times daily, and 30mg of corticosteroids orally three times daily. At the same time, emphasis was placed on applying TCM diagnosis and treatment.

TCM Diagnosis: The patient presented with high fever and thirst, tidal sweating, widespread petechiae, vomiting, hematochezia, and black stools, with a dark red tongue and a thin, rapid pulse. Clearly a case of dual deficiency of qi and yin, coupled with uncontrolled blood heat. The treatment plan was to tonify qi and nourish yin, clear heat and reduce fire, reinforce the exterior to stop sweating, and cool the blood to stop bleeding. Accordingly, [Prescription No. 1, see page 215] was decocted and administered daily, one dose per day. After eight doses, the patient's general condition slightly improved, with reduced fever, sweating, and thirst, as well as some improvement in bleeding symptoms (during this period, two blood transfusions totaling 600ml were performed).

April 5

TCM Diagnosis: The patient exhibited night fever and morning coolness, tidal sweating, and reduced bleeding symptoms such as vomiting, hematochezia, and black stools compared to before. Tongue was red with little coating, and pulse remained thin and rapid. The condition indicated residual heat that had not yet cleared, along with dual deficiency of qi and yin. Qi deficiency prevented proper blood control, while yin deficiency failed to restrain the fire. The treatment plan was to greatly tonify qi and yin, clear heat and remove dampness, supplemented by cooling the blood to stop bleeding and reinforcing the exterior to stop sweating.

Prescription: Switched to [Prescription No. 2, see page 216], decocted and administered daily, one dose per day.

After a total of ten doses, the patient's body temperature dropped to normal, nosebleeds stopped, and widespread petechiae and bleeding spots gradually dried up, showing no tendency to worsen. The patient's overall condition further improved, allowing him to perform light activities in bed and increasing his appetite (during this period, two blood transfusions totaling 600ml were also performed).

April 20

TCM Diagnosis: The patient presented with pale complexion, lack of energy, palpitations and shortness of breath, restless sleep, dizziness and vertigo, tidal sweating, red tongue with thin coating, and a thin, rapid pulse. This was a case of qi and yin deficiency, with the spirit weakened and unable to stabilize the blood, and yang floating outward. The treatment plan was to greatly tonify qi and yin, calm the spirit, and supplement with reinforcing the exterior to stop sweating.

Prescription: [Prescription No. 3, see page 216], decocted and administered daily, one dose per day.

After more than forty doses, the patient's overall condition markedly improved, bleeding stopped, petechiae disappeared, complexion slightly reddened, and symptoms such as fatigue, sweating, palpitations, shortness of breath, and restless sleep all eased to varying degrees (during this period, three blood transfusions totaling

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Hemoglobin levels have consistently remained above 5 g/dL. To accurately assess the patient's recovery, given our hospital's limited diagnostic capabilities, a bone marrow biopsy was performed on November 10. The patient was advised to take the biopsy slides to Professor Zhang Aicheng in Lanzhou for re-examination and was instructed to take one dose of Prescription No. 3 daily during their stay in Lanzhou, prepared by decocting in water, without interruption. After arriving in Lanzhou, the patient diligently continued taking Prescription No. 3 in the Department of Internal Medicine at the First Affiliated Hospital of Lanzhou Medical College. On January 17, 1968, a letter was received from Professor Zhang Aicheng stating: "The patient's bone marrow morphology shows changes characteristic of the remission phase of acute myeloid leukemia; with the exception of a small number of monocytes at various stages that are not fully mature, all other cell lines have returned to normal." He also expressed great satisfaction with the efficacy of the traditional Chinese medicine treatment, adding: "During their stay in Lanzhou, the patient continued to adhere to the herbal prescription you formulated."

January 18, 1968

Due to the inconvenience of obtaining traditional Chinese medicine in Lanzhou, the patient returned home to Tianshui to continue the herbal treatment. On January 20, the author was invited to visit the patient at home and observed pale complexion, fatigue with excessive sweating, palpitations and shortness of breath, occasional gum bleeding and nosebleeds, a deep and fine pulse, and a swollen, pale tongue. A formula [Prescription No. 4, see page 216] was prescribed as a paste, to be taken with plain boiled water (dosage as before).

March 9, 1968

Physical Examination: The patient presented with a two-day history of cold, chest tightness, and cough. The next day, they were admitted to our hospital (admission number 3102). At the time, the patient had a fever (temperature 39.2°C), chest tightness and cough, with a small amount of blood streaks in the sputum. A few petechiae were visible on the anterior and posterior chest, the pharynx was slightly red, the tonsils were not enlarged, breath sounds in both lungs were coarse, with no dry or moist rales heard, there was tenderness over the sternum, the liver and spleen were not palpable, no abnormalities were noted in the extremities, and pathological reflexes were negative.

Laboratory Tests: Red blood cells 3.45 million/mm³, hemoglobin 5.2 g/dL, white blood cells 3,400/mm³, neutrophils 56%, lymphocytes 40%, monocytes 4%.

Western Medical Diagnosis: ① Acute myeloid leukemia (remission phase), ② Common cold.

Upon admission, penicillin 400,000 units was administered intramuscularly every 8 hours, streptomycin 0.5 g intramuscularly twice daily, vitamin B₁₂ 20 mg three times daily, vitamin C 100 mg three times daily, corticosteroids 20 mg three times daily, and cough suppressant 50 mg three times daily.

Traditional Chinese Medicine Differentiation: High fever without sweating, restless breathing, headache and aversion to cold, red tongue with little coating, and a slippery, fine pulse. This is a pattern of wind-cold invading the exterior, heat stagnating in the lung metal, and deficiency of both qi and yin. The therapeutic principle is to release the exterior and clear the spirit, while tonifying qi and nourishing yin.

Prescription: [Prescription No. 5, see page 216], to be decocted in water and taken once daily.

214 Pei Zhengxue’s Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases Published by Hepei Book Publishing House

After four doses, the general condition improved, body temperature dropped to 37.5°C, coughing stopped, and sputum became frothy without blood streaks. Starting March 15, [Prescription No. 3, see page 216] was used instead, and after more than 40 doses, except for occasional dizziness and palpitations, all other symptoms completely disappeared. The patient was discharged on May 18, 1968.

After discharge, the patient continued taking [Prescription No. 3, see page 216] at home for over 60 doses, gradually recovering health and returning to work on July 1968. In mid-April 1973, the author traveled over a thousand miles to visit the patient at Jinta Farm in Jiuquan. The patient was in robust health and full of energy, having been promoted to team leader and repeatedly commended by the regimental headquarters for outstanding performance in leadership duties.

March 24, 1973

Laboratory Tests: Red blood cells 4.2 million/mm³, hemoglobin 8.2 g/dL, platelets 200,000/mm³, white blood cells 5,600/mm³, neutrophils 65%, lymphocytes 33%, monocytes 2%.

March 26, 1973

Bone Marrow Morphology: According to the report from the Department of Hematology at Lanzhou Medical College, bone marrow proliferation is active, with a granulocyte-to-erythrocyte ratio of 1.96:1. Among the granulocytic series, the proportion of promyelocytes to band forms is slightly low, while the proportion of blast and immature monocytes is relatively high (totaling 17.8%, including 3.8% blast forms). Lymphocytes are basically normal, erythrocyte system is basically normal, and three mature megakaryocytes are seen throughout the smear, with no evidence of platelet formation. Mature red blood cells are normally shaped, with good hemoglobin filling.

Table of blood count changes during the two hospitalizations (see Table 1 and Table 2).

Table 1 First Hospitalization (1967)

Table 2 Second Hospitalization (1968)

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Middle Section: Discussion on Clinical Application

Leukemia is a disease characterized by malignant disruption of bone marrow hematopoiesis, and Chinese medicine currently lacks specialized literature on this condition. The cure of this patient is the result of integrating traditional Chinese and Western medicine. Repeated blood transfusions enabled the patient to gradually recover through oral administration of traditional Chinese medicine; the use of antibiotics and hormones helped control infection and enhance resistance, thereby supporting the traditional Chinese medicine treatment. Regarding the role of traditional Chinese medicine, the author has the following observations:

From beginning to end, this patient exhibited obvious signs of qi deficiency, such as a dull complexion, spontaneous sweating and fatigue, lack of energy and reluctance to speak, dizziness and blurred vision. “Qi governs blood,” so qi deficiency inevitably leads to blood deficiency, which is why, in the middle stage of the illness, symptoms like palpitations, shortness of breath, and disturbed sleep appeared—symptoms associated with blood deficiency. The Inner Canon states: “Qi is yang, blood is yin,” and “solitary yin cannot arise, solitary yang cannot grow.” Qi deficiency and blood deficiency mutually reinforce each other, causing the disease to progress rapidly and eventually develop into yin deficiency with internal heat and blood heat running rampant; qi deficiency can no longer control the blood.

In the formation of this series of pathologies, the earliest manifestation of qi deficiency is an extremely important factor. Traditional Chinese medicine focuses tightly on tonifying qi as the root cause of the problem. The five prescriptions formulated all primarily aim to tonify qi, using large doses of ginseng, codonopsis, prince ginseng, astragalus, and other qi-tonifying herbs to achieve this goal. What exactly is qi? From a modern medical perspective, it can be regarded as the overarching concept encompassing all normal physiological functions and disease-resistance mechanisms of the body. The Inner Canon says: “Where evil gathers, qi must be deficient,” and “When righteous qi resides within, evil cannot invade.” Therefore, by making all-out efforts to tonify qi, the body’s own anti-pathological defenses can be fully mobilized, and the hematopoietic system can be improved—this is the main factor behind curing this disease. In addition, while tonifying qi, it is also essential to nourish yin. In Chinese medicine, nourishing yin involves increasing blood moisture and providing nutrients—these substances are prerequisites for maintaining normal bodily functions. Only by combining qi-tonifying with yin-nourishing can the two complement each other and produce remarkable effects.

Among the five prescriptions formulated, all include ingredients similar to Liu Wei Di Huang Tang. According to historical records, Liu Wei Di Huang Tang was specifically designed by Qian Yi during the Five Dynasties period to tonify yin, with the therapeutic effect of “strengthening the master of water to treat yang light.” The term “strengthening the master of water” mainly refers to tonifying kidney yin. Since “the kidneys govern bones, and bones store marrow,” whether Liu Wei Di Huang Tang can also benefit bone marrow hematopoiesis is a question worthy of further research. The five prescriptions also contain shashen, mai dong, wu wei zi, and other herbs—ingredients from Sun Simiao’s Sheng Mai San during the Tang Dynasty, formulated to benefit qi. For this disease, these herbs can help ginseng tonify qi and also assist Liu Wei Di Huang Tang in nourishing yin, thus enhancing the combined effect of qi-tonifying and yin-nourishing.

Prescription No. 1 includes “white tiger” to clear heat and rhino horn to cool blood; Prescription No. 2 adds artemisia and turtle shell to eliminate residual heat and dispel bone-steaming; Prescription No. 5 uses ma huang and gui zhi to release the exterior and dispel cold—all of these are appropriate symptomatic treatments.

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Prescriptions

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

216 Published by Hepei Book Publishing House

(Continued)

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Treatment Experience for Chronic Pancreatitis

Pei Zhengxue’s Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases Published by Hepei Book Publishing House

After taking the medication for 20 doses, the patient’s general condition improved: chest and epigastric distension decreased, stools became formed, appetite increased, and the tongue coating became lighter. The original formula was adjusted by removing yuanhu, chuanlianzi, fupian, ganjiang, yi ren, hong teng, and bai jiang cao, and adding dang shen 10g, ban xia 6g, chen pi 6g, jiao san xian 6g, ji nei jin 6g, and lai fu zi 10g. After taking 10 doses, all symptoms subsided, and stool microscopy showed normal results.

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Case 2

Mr. Xu, male, 40 years old. Nine years ago, he experienced severe right flank pain and was diagnosed at a certain hospital with acute cholecystitis complicated by gallstones. After undergoing cholecystectomy, the pain subsided and he was discharged.

One year ago, he again developed severe upper abdominal pain and was admitted to a hospital where he was diagnosed with acute pancreatitis. At that time, his serum amylase level was 1,250 units, and urinary amylase was 560 units. Following anti-inflammatory, spasmolytic, and supportive treatments, his condition improved and he was discharged. Over the past six months, the patient has experienced persistent left upper abdominal pain that recurs and worsens, especially after heavy meals or consumption of greasy foods. The pain radiates to the left chest, left flank, and lower abdomen, accompanied by severe abdominal distension. His bowel movements alternate between constipation and diarrhea, and despite extensive treatment with Western medicine, there has been no improvement, so he came to our hospital for treatment.

Physical Examination: Body temperature 36.7°C, pulse 80 beats per minute, blood pressure 13.3/8.0 kPa (100/60 mmHg). Pale complexion, mild jaundice of the sclera, distended upper abdomen, palpation reveals a 10 cm × 3 cm transverse mass with significant tenderness, and abnormalities are noted in the liver, spleen, heart, and lungs. White blood cells 5,600/mm³, neutrophils 76%, lymphocytes 24%; serum amylase 16 units, urinary amylase 32 units. Fatty droplets in stool (++), blood glucose 100 mg/dL, urine glucose (-).

Western Medical Diagnosis: Chronic pancreatitis.

Traditional Chinese Medicine Differentiation: String-like, slippery, and rapid pulse; red tongue with thick, greasy yellow coating; persistent pain in the left upper abdomen and flank; mass in the upper abdomen; jaundice; abdominal distension; constipation. The pattern is liver qi stagnation turning into fire, with damp-heat combining, and qi and blood being blocked. The therapeutic principle is to soothe the liver and regulate qi, clear fire and remove dampness, and activate blood circulation to disperse stasis.

Prescription: To be decocted in water and taken once daily.

+:-------+---------+:------+--------+-------------+------+--------+------+

Chai Hu | > 10 g | > 10g | > Bai | > Gan Cao 6g | > 6 | > Xiang Fu | > 6g Yuan Hu | > Zhi Yun | > 6g | > Shao 1 | > Chuan Xiong | > g | > Mang Xiao | > San Ling | > | > 6g | > 5 g | > | > | | > 10 | > 6 g | | > Pu Huang | > Wu Ling Zhi | > 10 | | > g | > Chuan Liang | | > 6g | > 6 g Da Huang | > g | | | > Zi 6g | | > Yi Ren | > 15g | > | | | > E Zhu | | > Ren | > Bai Jiao Cao 15g | > 30 | | | | | | > Hong Teng | > g | |

After taking five doses, a large amount of dark, sauce-like material was passed in the stool, and pain in the upper abdomen and flank, as well as abdominal distension, markedly decreased. Jaundice subsided, and the yellow coating on the tongue became thinner. The previous formula was adjusted by removing mang xiao and adding huang lian and mu xiang, followed by eight more doses. Pain in the upper abdomen and flank disappeared, abdominal distension eased, bowel movements normalized, microscopic examination showed no abnormalities, and the tongue coating turned thin, pale yellow, and slightly white. The pulse became deep, fine, and string-like, and the transverse mass in the upper abdomen was no longer palpable. The original formula was adjusted by removing yuanhu, chuanlianzi, pu huang, wu ling zhi, bai jiao cao, hong teng, and da huang, and adding dang shen and bai zhu, each 10g, along with fu ling 12g, ban xia 6g, chen pi 6g, and cao kou 3g, to improve the subsequent treatment. After taking ten doses, all symptoms completely subsided.

Middle section, clinical application of Yue Ju Wan according to Pei Zhengxue’s experience—published by Heji Four Snow Publishing House

Yue Ju Wan originates from “Danxi Xin Fa” and consists of xiang fu, chuan xiong, shan zhi, cang shu, and shen mian, effectively treating chest and diaphragm fullness, acid regurgitation, vomiting, and indigestion. In recent years, the author has used this formula to treat various diseases with good results.

Xiang fu 6g, Chuan xiong 10g, Cang shu 6g, Shan zhi 10g, Shen wei 10g, Chi shao 10g, Dan shen 20g

Follow-up visit: Chest tightness greatly reduced, no angina attacks, tongue coating thinned. The original formula was adjusted by removing chi shao and adding jiang xiang 3g, followed by another 30 doses. All symptoms completely subsided.

Pei Zhengxue’s Traditional Chinese Medicine—Clinical Case Studies and Practical Applications Published by Heji Four Snow Publishing House

Traditional Chinese Medicine differentiation: Liver qi stagnation, which turns into fire, leading to disharmony between the liver and stomach, and prolonged dampness accumulation, resulting in flank pain and fullness. The therapeutic principle is to regulate qi and activate blood circulation, remove dampness and clear heat, and harmonize the stomach and reverse the upward flow of qi.

Prescription: Yue Ju Wan with added ingredients, taken for nine doses.

Xiang fu 6g, Chuan xiong 6g, Shan zhi 10g, Cang shu 6g, Shen wei 10g, Chai hu 10g, Mu xiang 3g, Sheng bian 6g

Follow-up visit: Flank pain, abdominal fullness, and nausea all reduced, appetite increased, and the original formula was adjusted by removing sheng jiang, shen wei, and cang shu, adding bai shao 15g, followed by another nine doses.

Subsequent follow-up: Except for slight pain in the right flank, all symptoms have completely subsided. The original formula was increased tenfold, ground into fine powder, taken twice daily, five grams each time, mixed with warm boiled water. After completing one course, all symptoms disappeared and the patient recovered.

Case 1

Ms. Lu, female, 28 years old, first visit on August 4, 1976. Over the past three years, the patient has experienced menstrual cramps, scanty and dark-colored periods with blood clots, accompanied by lower back pain, bitter taste in the mouth and dry throat, irritability, hot palms and soles, and a red tongue with slightly yellow, greasy coating. The pulse is string-like, slippery, and rapid.

Traditional Chinese Medicine Differentiation: Emotional depression, imbalance of the Chong and Ren channels, stagnation of qi and blood, which over time turns into heat and dampness, leading to dysmenorrhea. The therapeutic principle is to regulate qi and activate blood circulation, clear heat and remove dampness.

Middle section: Clinical application

Prescription: Yue Ju Wan with added ingredients, taken for five doses.

Xiang fu 6g, Chuan xiong 6g, Shan zhi 10g, Cang shu 6g, Shen tong E 6g, Dan pi 6g, Tao ren 10g

Follow-up visit: Menstruation came on time, menstrual cramps significantly reduced, menstrual flow increased compared to before. The original formula was adjusted by adding pen mo cao 20g, followed by another 20 doses.

Third follow-up: Menstrual flow increased, color turned redder, menstrual cramps disappeared, only slight discomfort remained in the lower abdomen. The patient was instructed to take the original formula for another five doses each week before menstruation, one dose daily, for a total of three months, until all symptoms completely subsided.

Clinical application of Activated Blood II—according to Pei Zhengxue’s experience

Activated Blood II is a specialized prescription for treating coronary heart disease formulated by a collaborative group in Beijing, composed of chi shao, chuan xiong, hong hua, jiang xiang, dan shen, and other herbs. In recent years, the author has used this formula not only to treat coronary heart disease and cerebrovascular diseases but also atrophic gastritis and scleroderma, achieving satisfactory results.

Case 1

Mr. Zhang, male, 47 years old, supervisor, first visit on April 20, 1979. The patient has experienced burning pain in the epigastric region for two years, radiating to the back, accompanied by chest tightness and abdominal distension. He has previously sought treatment at county hospitals and provincial hospitals, where he was diagnosed with atrophic gastritis. Despite Western medical treatment, there has been no significant improvement.

Physical examination: Body temperature 36°C, pulse 70 beats per minute, blood pressure 16.0/9.3 kPa (120/70 mmHg). The patient is of medium build, with poor nutrition, pale face, and a small cardiac border on percussion. A grade II systolic murmur can be heard at the apex, with significant tenderness in the upper abdomen. The liver and spleen are not palpable, and no abnormalities are noted in the extremities.

Laboratory tests: Hemoglobin 9.8 g/dL, red blood cells 3.6 million/mm³, white blood cells 11,000/mm³, gastroscopy confirms the diagnosis of atrophic gastritis.

Traditional Chinese Medicine differentiation: The patient experiences burning pain in the epigastric region, which intensifies upon palpation, with a fixed location. The tongue is pale red with scattered ecchymoses, the coating is yellow and greasy, and the pulse is string-like. The pattern is qi stagnation and blood stasis, which over time turns into heat. The prescription is Activated Blood II with added ingredients.

Prescription:

Chi shao 15g, Chuan xiong 6g, Hong hua 3g, Jiang xiang 6g, Dan shen 10g, Cao kou 3g, Huang lian 3g

After taking five doses, the stomach pain greatly subsided, and appetite increased. The original formula was adjusted by removing chi shao and adding bai shao 15g and gan cao 6g, followed by another 20 doses. All symptoms completely subsided.

In June 1982, due to poor diet, the previous symptoms recurred. Activated Blood II with added ingredients was used again, and after taking more than 40 doses, the condition improved. In March 1983, a follow-up visit revealed that, apart from occasional minor pain, the stomach no longer experienced major flare-ups as before. In March 1984, gastroscopy showed no obvious lesions.

226 Pei Zhengxue’s Traditional Chinese Medicine—Clinical Case Studies and Practical Applications Published by Hefei Painting Good Publishing House

Introduction to Two Winter Clinical Formulas—according to Pei Zhengxue

Tian men dong and mai men dong are both commonly used clinical herbs. Tian men dong is sweet and cold, non-toxic, and enters the lung and kidney meridians. Its main functions are to nourish kidney yin and moisten lung dryness. It can be used for conditions such as lung and kidney deficiency with heat, insufficient essence, pulmonary tuberculosis, pulmonary paralysis, asthma, lung exhaustion, yin deficiency with phlegm-heat, diabetes, and other ailments. Mai men dong is sweet and slightly cold, entering the heart, lung, and stomach meridians. Its functions include nourishing yin and clearing heat, moistening the lungs and clearing phlegm, calming the mind and relieving restlessness. It is mainly used for lung heat or warm diseases with fluid loss, yin deficiency with thirst, labor-induced cough, thick phlegm, sore throat, blood disorders, night sweats, and diabetes. Clinically, many formulas either use Tian men dong or Mai men dong as the main ingredient, or incorporate both as key components. Here, we will introduce Tian men dong formulas, Mai men dong formulas, and combinations of the two.

| 228 | | | > Pei Zhengxue | | | | | > Traditional Chinese Medicine—Practical Knowledge | | | | | > Clinical Case Studies | | | | | > Discussion 2. Tian men dong compound (with less than five ingredients) |

| > Indications | > Preparation method

Formula for treating small intestine prolapse | > Formula for treating small intestine prolapse | > Three qian of Tian men dong, five qian of Wu mei. Decoct in water and take. | > | > | > (from “Living Heart Mirror”) | > Tian men dong (remove the core), two liang of Sheng di, one liang of Ren shen. Take Tian men dong and Sheng di and | > | > | > For those with deficiency of yin blood and lower yuan | Add alcohol, steam nine times, let it dry, then grind together with Ren shen into powder, mix with steamed jujube pulp to form pills, | > Weakness; also treats labor-induced weakness | | > Cough. | > Pills are about the size of a paulownia seed, take 30–50 pills each time, swallow with warm wine before meals, three times a day. | > | > | > For those with long-term summer heat and insomnia, confused consciousness, | > Three qian of Ren shen, two qian of Tian men dong, five qian of Sheng di. Boil five cups of water down to two cups, | > Unable to sleep peacefully, unclear mental state, | > Drink twice. | > Both yin fluids and vital energy are damaged. | > | > | > Ten jin of Huang jing (remove the core, steam until soft), three jin of white honey, three jin of Tian men dong (remove the | > Longevity benefits, cures myriad diseases | > Core, steam until soft). Mix the first three ingredients thoroughly, put them in a stone mortar and pound until very soft, | > | > Divide into four portions, pound again until extremely soft, make pills about the size of a paulownia seed, take 30 pills each time, warm | > | > Wine, no specific time, three times a day. +----------------+ | | Three Talents Pill | | | | | | “Rituals of the Confucian Family” | | | +----------------+ | | Three Talents Soup | | | | | | “Differentiation of Warm Diseases” | | |

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+----------------+ | |

Huangjing Pill | | | | | | "Shengji Zonglu" | | |

Mai Men Dong Formula

Single-ingredient formulas using Mai Men Dong are relatively rare. The "Lan Shi Jin Jian" records that a decoction of Mai Men Dong can be used as a mouthwash to treat bleeding from the gaps between teeth.

The "Taiping Huifang" includes a formula called "Mai Men Dong Decoction," which is said to "treat qi stagnation, overeating causing abdominal discomfort, rupture of the stomach meridians, emaciation with shortness of breath, heaviness and yellowing of the eyes, fullness and distension in the epigastric region, deficiency-induced internal heat, dry mouth and thirst, heart palpitations and vomiting; it also cures paralysis, strengthens yin and nourishes essence, aids digestion and regulates the middle jiao, calms the spirit and stabilizes qi, harmonizes the five zang organs, makes one plump and healthy, enhances complexion, and ensures having children..." The formula calls for five jin of fresh Mai Men Dong (with the core removed), pounded until soft, then squeezed to extract the juice. Add half a jin of white honey, boil in a silver pot over low heat while stirring continuously until it reaches a consistency similar to honey, then store in porcelain containers for use. Take half a spoonful mixed with warm wine, two to three times daily.

As a compound formula, the "Jin Yao Lue" by Zhang Zhongjing already contains the Mai Men Dong Tang, primarily used to treat reversed fire ascending qi and throat obstruction. The formula consists of Mai Men Dong, Ban Xia, Ren Shen, Gan Cao, Jing Mi, and Da Zao. In the Qing dynasty, Wang Zi Jie's "Thirteen Categories of Ancient Formulas Selected and Commented" describes this formula as "a remedy that generates body fluids from the stomach to relieve dryness, treating conditions of deficient fire and ascending qi."

Later generations have developed numerous compound formulas involving Mai Men Dong. Below we introduce some Mai Men Dong-based compound formulas containing two to five herbs, for clinical reference.

1. Single-ingredient Tian Men Dong formula

| > Indications | > Preparation

Formula to Stop Thirst | > Relieve thirst | > Use one liang of Mai Men Dong and three qian of Huang Lian. Decoct in water and take orally. | | > Cui Yuanliang | | > Mai Men Dong paired with Huang Lian; the "Pu Ji Fang" uses this combination to treat "sores in the throat and deficiency heat in the spleen and lungs," and recommends taking Mai Men Dong decoction as a supplementary treatment. Additionally, the "Ben Shi Fang" suggests grinding one liang of Mai Men Dong (core removed) together with five qian of Huang Lian into a fine powder, then mixing with honey to form pills about the size of paulownia seeds. Take 20–30 pills each time with warm boiled water, two to three times daily. This formula is known as "Mai Men Wan."

(Continued on next page)

Middle Section: Clinical Applications—Combined with National Book Publishing House’s “Jing Xing” Series, No. 229

(Continued)

Sheng Di Mai Men Yin | > Nosebleeds and earbleeds. | > Use five qian each of Sheng Di and Mai Men Dong, add two cups of water, decoct until eight-tenths remain, and take after meals. Its function is to cool the blood and clear lung heat. This formula originally appeared in the "Su Wen Pathology and Qi Regulation Collection for Preserving Life," where it was used to treat nosebleeds that did not stop. 《Lu Zong Jin Duan》 | | | | Blood-clearing and lung-cleansing effects. This formula was originally recorded in the "Su Wen Pathology and Qi Regulation Collection for Preserving Life," used to treat nosebleeds that did not stop. | | | | > It also appears in other formula collections such as "Liang Peng Zui Ji," but none of them specify the name of the formula. | | > | | > Furthermore, the "Zheng Zhi Jun Sheng" adds Huang Qi and roasted Gan Cao (with particular emphasis on Ren Shen and Huang Qi) to the Sheng Mai San, using frequent water decoctions to treat conditions of kidney-yin deficiency and dry mouth and tongue. | | > | | > Another version of this formula, found in the "Zheng Zhi Jun Sheng," involves adding Shu Di and Zhi Gan Cao (with heavy use of Ren Shen and Huang Qi), and employs frequent water decoctions to treat symptoms of depleted kidney-yin and dry mouth and tongue. | | > | | > Use one liang of Mai Men Dong (core removed), five qian of ginger (juiced), and two liang each of almond kernels (peeled and pointed) and honey. First, decoct Mai Men Dong and almond kernels in one cup of water until reduced to four-tenths, then squeeze out the juice in a sand basin, pour it into a silver vessel, add the ginger juice, and simmer over low heat until it becomes a thick paste. Store in porcelain containers, take half a teaspoon each time, mixed with plain porridge, twice during the day and once at night, adjusting the dosage according to the child’s age. | | > | | > One liang of Ren Shen, eight qian of Mai Men Dong, and eight qian of Sheng Di. Boil eight cups of water down to three cups, and if the child still feels thirsty, give more water along with food; if there is no bowel movement, administer another dose. +--------------------+--------------------+ Sheng Mai San | > ① Summer heat injury leading to qi deficiency and fluid loss, excessive sweating and fatigue, | > Shortness of breath, thirst, and weak pulse; | > | | > ② Chronic cough due to lung deficiency, with little phlegm, spontaneous sweating, dry mouth, | > Dry tongue, and weak pulse; | > | | > ③ Heart qi deficiency, resulting in various related symptoms. Mai Men Dong Tang | > Lung consumption (i.e., upper consumption). | > Use two qian each of Mai Men Dong (core removed), Huang Lian, and dried winter melon, add two cups of water, decoct until eight-tenths remain, 《Yi Lin Ji Yao》 | | > Drink warm. If dried winter melon is unavailable, use one fresh winter melon weighing three jin, peel and remove the pulp, cut it into twelve pieces, and take one piece each time when decocting mulberry leaves, three times a day. | | > | | > Also: There are other versions of the Mai Men Dong Tang formula besides those mentioned in the "Jin Gui Yao Lue" and "Yi Lin Ji Yao." For example, combining Mai Men Dong with Di Gu Pi treats bone-steaming and lung-wasting conditions. Mai Men Dong paired with Wu Mei treats extreme thirst, unbearable dry throat, incessant drinking, and acute abdominal distension. Mai Men Dong combined with Ju Geng and Gan Cao treats pulmonary paralysis with copious sputum and pus-like discharge (all three of these formulas appear in the "Sheng Ji Zong Lu"). | | > | | > Use one liang of Mai Men Dong (core removed), five qian of ginger (juiced), and two liang each of almond kernels (peeled and pointed) and honey. First, decoct Mai Men Dong and almond kernels in one cup of water until reduced to four-tenths, then squeeze out the juice in a sand basin, pour it into a silver vessel, add the ginger juice, and simmer over low heat until it becomes a thick paste. Store in porcelain containers, take half a teaspoon each time, mixed with plain porridge, twice during the day and once at night, adjusting the dosage according to the child’s age. | | > | | > One liang of Ren Shen, eight qian of Mai Men Dong, and eight qian of Sheng Di. Boil eight cups of water down to three cups, and if the child still feels thirsty, give more water along with food; if there is no bowel movement, administer another dose. +--------------------+--------------------+ Mai Men Dong Decoction | > Children with severe cough and high fever, chest 《Zheng Zhi Jun Sheng》 | > Diaphragmatic congestion. | +--------------------+--------------------+ Zeng Ye Tang | > Yangming warm disease, no upper-jiao symptoms, | > Several days without bowel movements, 《Wen Bing Tiao Bian》 | > | | > 通，体虚不堪用承 | | > 気湯者。 | Mai Men Dong San | > Women with cold and heat blockage, lactation | > Use equal parts of Mai Men Dong, Tong Cao, Shi Zhong Ru, and gypsum, grind them into a fine powder, and take after meals with alcohol 《Qian Jin Yao Fang》 | > Juice does not flow. | > One qian, three times daily; if there is heat, remove Shi Zhong Ru and add Lou Lu. Mai Men Dong Yinzi | Hemoptysis and persistent nosebleeds. | > Mix five he of raw Mai Men Dong juice, raw Ci Jian juice, and raw Sheng Di Huang juice together in a pot and gently warm them up 《Tai Ping Sheng Hui Fang》 | | > Over, take a small cup each time, mix with one qian of Fulong Gan Mo, and drink all at once. Yu Zhu Mai Men Dong Tang | > Stomach yin deficiency due to dryness. | > Use three qian each of Yu Zhu and Mai Men Dong, two qian of Sha Shen, one qian of Sheng Gan Cao, and five cups of water, decoct until two cups remain, 《Wen Bing Tiao Bian》 | | > Two cups, divided into two doses. | | > | | > Use one liang of Mai Men Dong, three qian of roasted Gan Cao, fifteen fresh bamboo leaves, and two pieces of northern meat. | | > | | > All ground into a fine powder, mixed thoroughly, take five qian each time, accompanied by one and a half cups of rice porridge, decoct until one cup remains, and drink warm; those who cannot take it may apply it directly to the mouth. Adding Ren Shen will enhance the effect. +--------------------+--------------------+ Mai Men Dong Tang | > After sexual exhaustion and impending qi depletion
| > Those who are exhausted. | 《Wen Re Jing Wei》 | | Di Xian San | > Bone-steaming muscle heat, all kinds of heat | > Use two qian of Di Gu Pi, one qian of Fang Feng (with the outer layer removed), and one qian of Mai Men Dong, plus half a qian of roasted Gan Cao. | > Labor-related restlessness. | > These medicines are made into a powder, take three qian each time, add four slices of ginger, and decoct. 《Fu Ren Liang Fang》 | | (Continued on next page) Pei Zhengxue’s Middle Theory—Integration of Traditional Chinese Medicine Theory and Clinical Case Studies, Illustrated Edition by He Xiang Publishing House (Continued)

Huo Xiang San | > Mai Men Dong (core removed and cultivated), Ban Xia Wei, and roasted Gan Cao, each half a qian, plus one qian of Huo Xiang leaves. | > Children with spleen-stomach deficiency heat, grind everything coarsely, take three qian each time, decoct in water and take orally. 《Xiao Er Yao Zheng Zhi Que》 | | Red, vomiting, and drooling. Note: In the "Collected Edition" of "Xiao Er Yao Zheng Zhi Que," there is another version of this formula that includes one and a half qian of Shi Dou, which is | | > is. | | Children vomit, and the pulse shows Mai Men Dong, Ban Xia, Ren Shen, Fu Ling, each two qian, and one qian of Gan Cao. Grind everything into a fine powder, take | | Two qian each time, add one cup of water, add three slices of ginger, decoct until five-tenths remain, strain out the residue, and drink warm, twice | | > every day, two to three times. | > | > Postpartum shortness of breath, pulse is weak, and five qian of Wu Wei Zi (crushed and fried), Ren Shen (removed from the husk), Mai Men Dong (core removed), and almond kernels | > are all present. (Peel off the pointed ends), and two qian each of orange-red and tangerine, decoct in water and take orally. +----------------------+ Mai Men Dong San | | 《Lei Zheng Pu Ji Ben Shi Fang》 | +----------------------+ Wu Wei Zi Tang | 《Zheng Zhi Jun Sheng》 | Three Two Winter Combinations (for formulas with five or fewer ingredients) · Single-ingredient Tian Men Dong formula | > Indications | > Preparation Two Winter Paste | > Lung and stomach dry heat, phlegm-damp cough | > Use one jin each of Tian Men Dong (core removed) and Mai Men Dong (core removed). Decoct in water to extract the juice, then add white honey 《Zhang Shi Jiang Tong》 | > Cough. | > Make a paste, take two to three spoons each time, take on an empty stomach with warm water. | | > | | > This formula clears the heart and moistens the lungs, reducing fire and eliminating phlegm. Zhang Lu said: "Mai Men Dong derives its essence from water and ascends to the Yangming, while Tian Men Dong derives its essence from water and ascends to the Taiyang. Winter represents closure, while door represents opening; thus, the 'door' of Mai Men Dong can open and close, allowing energy to flow upward. Combining the two creates a paste that eliminates phlegm, moisturizes the lungs, and clears the heart. Long-term use strengthens the kidneys and balances qi, making the body lighter and healthier, preventing aging and hunger—truly beneficial." From this, we can see that this formula can also serve as a good first-line remedy. | | > | | > Ten liang of Tian Men Dong (core removed), eight liang of Mai Men Dong (core removed), and three jin of Sheng Di Huang | | > | | > (Extract the juice and make a paste). Grind the two into a fine powder, and make Sheng Di Huang paste and pills about the size of paulownia seeds, | | > Take 50 pills each time, twice a day, taken with warm water. | | > | | > Tian Men Dong (core removed), Mai Men Dong (core removed), Ren Shen, etc., ground into a fine powder, and made into pill-like pellets about the size of marbles, each containing one pellet, taken twice a day with warm water. | | > | | > Ren Shen (removed from the husk) two liang, Tian Men Dong and Mai Men Dong (both core removed, pounded thin, dried or baked), and Sheng Di (avoid iron, pound into a paste) each four liang. | | > | | > All these medicines are ground into a fine powder, and made into honey-coated pills about the size of paulownia seeds, take three qian each time, taken with plain hot water on an empty stomach. | | > | | > Tian Men Dong eight liang, Mai Men Dong, Dang Gui, Ma Ren, and Sheng Di each four liang. Make a paste and coat with honey, | | > Take 8–10 teaspoons each time, morning and evening, with plain hot water. +----------------------+----------------------+ Tian Men Dong Pills | > Women with shortness of breath and hand-foot discomfort
| > Heat, bone-steaming sweat, and dry mouth | 《Su Wen Pathology and Qi Regulation Collection for Preserving Life》 | > Drinking, facial swelling, and edema. | | | > Kidney deficiency and lung heat, causing shortness of breath and other symptoms. | +----------------------+ | Formula to Treat Mouth Ulcers | | 《Wai Ke Jing Yi》 | | +----------------------+ | Ren Shen Foundation Pills | | 《She Sheng Mi Pao》 | | +----------------------+ | Formula to Treat Elderly People’s Intestinal Dryness and Constipation | | 《Fang Shi Jia Zhen》 | | Middle Section: Clinical Applications In summary, we can see that the two winters have a wide range of clinical applications. Since both herbs are non-toxic and have nourishing effects, they are also prone to misuse by physicians. At the end of the Ming dynasty, Li Zhongzi wrote in his "Ben Cao Zheng Yao": "Tian Men Dong is cold and slippery; if one has spleen deficiency and diarrhea, or poor appetite, it is not suitable." He also pointed out that Mai Men Dong "is slightly less cold, but still should be avoided if one has cold deficiency and diarrhea." In addition, both winters are often used by doctors to treat coughs and dry thirst, but if the lungs do not have deficient fire but instead have cold phlegm or phlegm-dampness, Tian Men Dong should not be used; if the stomach and lungs have internal heat, Mai Men Dong should not be used. People with inherently cold stomachs should also use the two winters with caution. (From "Guangxi Zhong Ji Ye" 1981.2)

Pei Zhengxue’s Instrumental Study—Integration of Traditional Chinese Medicine Theory and Clinical Case Studies, Illustrated Edition by He Xiang Publishing House

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Joint Record ■ Four Outlets Society Borderline | On September 2nd, due to a severe cold with high fever, I immediately began experiencing persistent nosebleeds. My hemoglobin level dropped to 5.4 g/dl, red blood cell count was 2.2 million/mm³, white blood cell count was 1,850/mm³, platelet count was 24,000/mm³, and my body temperature reached 38.6℃. I exhibited signs of intense internal heat, with high fever, thirst, profuse sweating, a rapid and forceful pulse, a red tongue, and a greasy yellow coating. This indicates real fire raging internally, with excessive heat driving the blood. Following the principle of urgent treatment to clear heat and cool the blood:

| Rhubarb | 10g | Northern Sand Ginseng | 10g | Mai Men Dong | 10g | Yu Zhu | 10g | Stone Orchid | 10g |

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|------|-----|--------|--------|------|--------|------|-----|------|-----| | 牛膝 | 10g | 棕炭 | 10g | 黄芩 | 6g | 黄連 | 6g | 犀角 | 6g | | 丹皮 | 6g | 白茅根 | 30 g | 大小勳 | 15g | | | | |

After four doses, the fever subsided and the nosebleed stopped (during medication, 300 ml of blood was transfused), but the face remained pale, with spontaneous sweating and fatigue, chest discomfort and heat, poor sleep at night, weakness and shortness of breath, a desire to vomit due to qi rebellion, a red tongue with thin, greasy yellow coating, and a rapid pulse. This indicated residual heat not yet cleared and damage to both qi and yin. The treatment principle was to clear heat and cool the blood while tonifying qi and nourishing yin. The original formula was modified by removing rhinoceros horn, achyranthes root, white pampas grass root, large and small thistles, and brown charcoal, and adding 3 g of schisandra, 15 g each of ginseng roots, prince ginseng, and ligustrum fruit, 20 g of cornelian cherry, 10 g each of dodder seed and cuscuta seed, and 6 g of bamboo leaves. After eight doses, the fever had subsided, the tongue coating was thin and yellow, the pulse was deep, fine, and rapid, hemoglobin was 7.4 g/dL, red blood cells were 2.6 million/mm³, white blood cells were 2,100/mm³, and platelets were 46,000/mm³. A further regimen of strengthening the spleen and kidney was then adopted, with over 100 doses in total. By February 28, 1977, follow-up showed a rosy complexion and abundant energy, with blood counts as follows: hemoglobin 11.2 g/dL, red blood cells 4.1 million/mm³, white blood cells 4,120/mm³, and platelets 64,000/mm³. The patient has now returned to work.

Pei Zhengxue’s Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases Published by Hefei Book Publishing House

Reflections on the TCM Treatment of Chronic Nephritis by Pei Zhengxue

Chronic nephritis is a common kidney disease that arises from an allergic reaction related to streptococcal infection; however, its precise pathogenesis remains unclear, resulting in often unsatisfactory clinical outcomes. In recent years, TCM treatment for this condition has become increasingly sophisticated, with steadily improving efficacy. Based on my limited clinical experience, I would like to share some thoughts on TCM treatment for chronic nephritis. Any shortcomings are welcome to be criticized and corrected.

Pei Zhengxue’s Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases Published by Hefei Book Publishing House

“As the master water regulator, the kidney is the ‘Zhi Yin’; the Zhi Yin is where water accumulates.” This clearly demonstrates the close relationship between the “kidney” and the onset of chronic nephritis. When kidney yang is deficient, water qi overflows, which is the fundamental cause of edema in chronic nephritis. In fact, patients with chronic nephritis, in the absence of secondary infections or other complications, often exhibit symptoms of kidney yang deficiency, such as sensitivity to cold, spontaneous sweating, lower back pain, leg fatigue, dizziness, and tinnitus. Therefore, warming the kidney yang and tonifying the kidney can be regarded as the fundamental therapeutic approach for this condition, with Jisheng Shenqi Tang being a representative formula. This formula uses cinnamon and processed aconite to warm the kidney yang and tonify the kidney, while also using achyranthes root and plantain seeds to unblock the meridians and promote diuresis, making it an excellent prescription that addresses both the root and the branches. For generally stable cases of chronic nephritis, this formula can be taken long-term, consistently, and often yields good results. The dosage of cinnamon and processed aconite should not be too low, as these two herbs are the main agents for warming the kidney yang and tonifying the kidney; if used in insufficient amounts, the effect will be suboptimal! Typically, about 10 g of each can be used. Other formulas such as Zhenwu Tang, Yougui Yin, Pogu Zi, Epimedium, and Morinda can also be considered as appropriate.