Typical Case

Chai Hu 10g　　Rhubarb 10g　　Bai Jiang Cao 15g　　Zhishi 10g　　Mirabilite 10g　　Tiger Stick 10g　　White Peony Root 15g　　Scutellaria 6g　　Yuanhu 6g　　Chuanxiong 6g　　Banxia 6g　　Chuanlianzi 6g　　Xiangfu 6g　　Coptis 3g　　Mu Xiang 3g　　Licorice 6g　　Goldthread 30g

After three doses, the patient passed black-brown, watery stools, and the pain significantly decreased, though occasional mild, intermittent pain remained, along with slight abdominal bloating. The pulse was wiry and slippery, and the tongue was red with a thin yellow coating. The above formula was then adjusted by removing mirabilite and adding 12g of Poria, 6g of bamboo juice, 15g of Salvia Miltiorrhiza, and 5g of cardamom, decocted for three doses. The patient reported that after taking the adjusted formula, all symptoms markedly improved. Due to busy work schedules, she took another three doses of the same formula, and subsequently recovered completely.

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Example 2

Ms. Jiang, adult, employee in Longxi County, first visited on June 10, 1982. Pain under the right rib for several tens of days, periodically worsening. Liver function tests were normal, but recently the pain in the right upper abdomen has intensified and radiates to the right shoulder and back, with aversion to fatty foods and vomiting after eating, repeated dozens of times. There is obvious tenderness and pain upon palpation in the gallbladder area, and Murphy’s sign is positive. A gallbladder imaging examination conducted at Longxi Hospital did not reveal any stones.

Western Diagnosis: Acute exacerbation of chronic cholecystitis.

TCM Differentiation: The patient experiences bitterness in the mouth and irritability, with intermittent colicky pain under the right rib, rapid and wiry pulse, and red tongue with yellow coating. Treatment should focus on soothing the liver and resolving qi stagnation, as well as clearing damp-heat.

Prescription: Modified Chai Hu Shu Gan San, taken as a decoction.

Ultrasound: Cirrhotic ascites, splenomegaly (thickness 5.0 cm).

Upper Gastrointestinal Barium Study: Esophageal varices.

Gastroscopy Findings: Severe esophageal varices.

Laboratory Tests: Hemoglobin 8 g/dL, fecal occult blood test (++), normal liver function. Negative surface antigen, total protein 4.5 g/dL, albumin 3.2 g/dL, globulin 4.2 g/dL.

Diagnosis: Decompensated cirrhosis.

Traditional Chinese Medicine Syndrome Differentiation: Liver depression and spleen deficiency, prolonged stagnation transforming into fire, spleen deficiency generating dampness, water-dampness overflowing, qi stagnation and blood stasis. Professor Pei prescribed Danzhi Xiaoyao San as the primary formula for treatment.

Prescription:

One dose daily.

Western medicine was administered concurrently for hemostasis and albumin supplementation. After 40 days of hospitalization, abdominal distension resolved along with other symptoms. Repeat fecal occult blood test was negative. Repeat upper gastrointestinal barium study showed significant improvement in varices. Repeat ultrasound revealed resolution of ascites, improvement in liver function, and reduction in splenomegaly (thickness 4.0 cm). The patient was discharged after more than 80 days of hospitalization.

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Professor Pei Zhengxue’s Experience in Treating Arthritis

Li Min, Xue Wenhan

[Introduction to Professor Pei Zhengxue]

Professor Pei Zhengxue is a renowned expert in integrated traditional Chinese and Western medicine in China. Born in 1938 in Wushan, Gansu Province, he graduated from the Medical Department of Xi’an Medical University in 1961. He has served as the Vice President of the Gansu Provincial Academy of Medical Sciences and currently holds the position of President of the Gansu College of Traditional Chinese Medicine Guidance. He is also an editorial board member of the "Chinese Journal of Integrated Traditional Chinese and Western Medicine" and the Editor-in-Chief of the "Journal of Research on Integrated Traditional Chinese and Western Medicine." Additionally, he serves as a director of the Chinese Society of Integrated Traditional Chinese and Western Medicine, Vice Chairman and Secretary-General of the Gansu Society of Integrated Traditional Chinese and Western Medicine, a member of the Gansu Provincial Senior Evaluation Committee for Traditional Chinese Medicine and Integrated Traditional Chinese and Western Medicine, and a member of the Gansu Provincial Political Consultative Conference.

His major works include "Commentary on Blood Disorders," "New Edition of Formulas in Traditional Chinese Medicine," "Pharmacology and Clinical Applications of Rhubarb," "Diagnosis and Treatment of Hepatitis B," "Selected Cases of Dr. Pei Shen," "New Edition of Warm Disease Studies," and "Practical Internal Medicine of Integrated Traditional Chinese and Western Medicine," among others. Furthermore, he has published over 60 medical papers in national medical journals and has received five provincial-level awards for outstanding papers, two second-class awards, three third-class awards, and one provincial science and technology progress award over the years.

After the publication of his book "Commentary on Blood Disorders" in Japan, it had a significant impact. In May 1985, Professor Tan Eiichi, President of Shizuoka Medical University in Japan, traveled specifically to Lanzhou to seek Professor Pei's advice on related issues in the book. His specially formulated prescription for treating leukemia was designated as the "Lanzhou Formula" at the National Hematology Conference in 1974 and has been widely used in hospitals across China for over a decade with remarkable therapeutic effects.

His biography has been included in "Contemporary World Celebrities Biographies," "Contemporary Famous Traditional Chinese Medicine Figures," "Great Dictionary of Famous Chinese Physicians," and "Cambridge World Encyclopedia of Celebrities (Foreign Language Edition)." In February 1992, he edited and published the first comprehensive work on internal medicine integrating traditional Chinese and Western medicine—“Practical Internal Medicine of Integrated Traditional Chinese and Western Medicine.” At the Third World Congress of Traditional Medicine held in the United States in April 1996, he was awarded the “International Gold Award for Outstanding Contribution,” and he himself was honored as one of the “Top 100 Stars of Ethnic Medicine in the World.” In 1997, the State Administration of Traditional Chinese Medicine recognized Professor Pei Zhengxue as one of the 500 most famous senior traditional Chinese physicians in China, and three domestic traditional Chinese medicine institutions, including the Hong Kong University of Traditional Chinese Medicine, appointed him as a visiting professor. The “Sixteen-Character Guiding Principle” for integrated traditional Chinese and Western medicine proposed by Professor Pei has attracted attention from the entire field of integrated medicine nationwide and has become an important school of thought in the current field of traditional Chinese medicine. Professor Pei obtained the title of Chief Physician in 1987, has been a recipient of special government allowances since 1992, and was named an Advanced Worker in Integrated Traditional Chinese and Western Medicine across China in 1994.

The arthritis discussed in this article refers specifically to rheumatic arthritis and rheumatoid arthritis, which fall under the category of “Bi syndrome” in traditional Chinese medicine. According to the “Plain Questions – Discussion on Bi Syndrome”: “What is called ‘Bi’ is when one is heavily affected by wind, cold, and dampness at different times.” It further states: “When wind, cold, and dampness combine, they form ‘Bi.’” Wind, cold, and dampness are the fundamental causes of this disease; once they invade the body, they flow through the meridians and joints, obstructing the smooth circulation of qi and blood and leading to Bi syndrome. When wind combines with cold, it is called “wind-cold”; when it combines with heat, it is called “wind-heat”; when it combines with dampness, it is called “wind-damp”; and if the condition persists and enters the collaterals, it forms “blood Bi.”

<u>Pei Zhengxue’s Traditional Chinese Medicine—Discussion on Theory and Clinical Cases</u>

Published by Hepei Book Publishing House 303

Published by Hepei Book Publishing House

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Example 2

Ms. Yang, 33 years old, presented with joint redness, swelling, and pain for one week, accompanied by sore throat, fever, sweating, excessive thirst, red tongue with thin yellow coating, and wiry, rapid pulse. This case is classified as heat Bi.

Prescription: Modified Gui Zhi Shaoyao Zhimu Tang. After seven doses, the fever subsided, sweating stopped, and symptoms significantly improved. The original formula was then adjusted by removing raw gypsum, and ten additional doses were administered, resulting in complete recovery of all symptoms.

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Example 3

Ms. Wang, 52 years old, presented with pain and deformity in both hand and wrist joints, as well as pain in other major joints. The condition had persisted for over ten years, leading to loss of work capacity. Her tongue was dark with thin coating, and her pulse was fine and涩, indicating long-standing illness resulting in blood Bi. Professor Pei prescribed the following formula:

After fourteen doses, pain in all joints eased somewhat; after thirty doses, various symptoms markedly improved, and joint mobility shifted from stiffness to flexibility.

(“Modern Traditional Chinese Medicine” 1998.3)

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Professor Pei Zhengxue’s Clinical Impressions on Using Ling Gui Zhu Gan Tang to Treat Rheumatic Heart Disease

Liang Yujie, Xue Wenhan, Li Min, Wang Nanyao, Xue Wenjun

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Example 1

Patient Zhang, female, 51 years old. She had experienced shortness of breath for over ten years, which worsened in the past five days, accompanied by palpitations, chest tightness, fatigue, especially upon exertion, rendering her unable to care for herself. She sought medical attention on October 10, 1996.

Physical Examination: The patient exhibited mitral valve face, orthopnea, pulse rate of 82 beats per minute, enlarged cardiac border on percussion, irregular heart sounds with varying intensity, heart rate of 90 beats per minute, arrhythmic rhythm, a grade II harsh blowing murmur heard at the apex during systole, mild edema in both lower extremities, swollen tongue with thin white coating, and intermittent pulse.

<u>Pei Zhengxue’s Traditional Chinese Medicine—Discussion on Theory and Clinical Cases</u>

Published by Hepei Book Publishing House

Western Diagnosis: ① Rheumatic heart disease (mitral valve insufficiency); ② Heart failure; ③ Atrial fibrillation.

Traditional Chinese Medicine Syndrome Differentiation: Phlegm turbidity obstructing the interior.

Prescription: Modified Ling Gui Zhu Gan Tang combined with Zhen Wu Tang:

After more than ten doses, shortness of breath and orthopnea alleviated, but palpitations and chest tightness persisted, with pulse rate at 74 beats per minute and heart rate at 84 beats per minute, still irregular rhythm, pale tongue with thin white coating and intermittent pulse. Therefore, the above formula was modified by removing Fuzi and White Peony Root, adding 10g of donkey-hide gelatin, four jujubes, 10g of Codonopsis pilosula, 20g of Ophiopogon japonicus, and 10g of sesame seeds. After another fifteen doses, the patient’s symptoms improved. Subsequently, using Ling Gui Zhu Gan Tang as the main formula with adjustments, she took over twenty doses until all symptoms disappeared and she regained full self-care ability. Pulse rate was 72 beats per minute, heart rate 73 beats per minute, and rhythm became more regular than before.

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Example 2

Mr. Lei, male, 30 years old. He had experienced shortness of breath for five years, often worsening after colds or physical exhaustion, accompanied by intermittent coughing, producing pink frothy sputum, fatigue, and pain in both knee joints. He sought medical attention in October 1995, with wheezing audible in both lungs and an enlarged cardiac border on percussion.

Western Diagnosis: Rheumatic heart disease (mitral stenosis).

Traditional Chinese Medicine Syndrome Differentiation: Phlegm-fluid obstruction, lung failing to disperse and descend. Treatment focuses on warming yang and promoting diuresis, while dispersing the lung and relieving asthma.

Prescription: Modified Ling Gui Gan Tang combined with Ma Xing Shi Gan Tang:

Poria 15g　　Honeysuckle 15g　　Cinnamon Twig 12g　　Forsythia 15g　　Atractylodes 10g　　Ephedra 6g　　Licorice 6g　　Apricot Kernel 10g　　Semen Trichosanthes 15g　　Four Jujubes 4 pieces　　Raw Gypsum 30g

After taking the above formula for over twenty doses, shortness of breath lessened, coughing and sputum production ceased, but joint pain persisted, along with low-grade fever and elevated ESR. Therefore, the formula was changed to Ling Gui Zhu Gan Tang combined with Gui Zhi Shaoyao Zhimu Tang:

Cinnamon Twig 12g　　White Peony Root 12g　　Anemarrhena 10g　　Atractylodes 10g　　Aconite 10g (decocted for 60 minutes)　　Ledebouriella 12g　　Ephedra 6g　　Licorice 6g　　Four Jujubes 4 pieces　　Poria 15g　　Dioscorea 15g　　Cortex Moutan 15g

After taking the above formula for over twenty doses, the patient’s joint pain disappeared, and ESR returned to normal. Subsequently, Ling Gui Zhu Gan Tang was used with modifications for another month, completely eliminating all symptoms. A follow-up chest X-ray showed that the left atrium had shrunk compared to before.

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Next Part: Sharing Experiences

307

Published by Heji Book Publishing House

Warming yang and promoting diuresis are the main therapeutic principles, with Ling Gui Zhu Gan Tang as the primary formula. Ling Gui Zhu Gan Tang originates from “Jin Gui Yao Lue” and addresses symptoms such as “phlegm-fluid accumulation in the epigastrium, chest fullness, dizziness,” and “shortness of breath with slight fluid accumulation.” In this formula, Poria primarily strengthens the spleen and transforms dampness; Cinnamon Twig warms yang and transforms qi; Atractylodes strengthens the spleen and benefits qi, serving as a complementary treatment; and Licorice harmonizes all herbs, acting as a guiding agent. As stated in “Medical Gate Laws”: “Phlegm-fluid is yin in nature and suppresses yang; using this yang-tonifying herb to transform qi and expand yang is the correct approach.” Based on the cases treated by Professor Pei, this formula indeed effectively eliminates various clinical symptoms in patients with rheumatic heart disease, significantly improving their quality of life, and even leading to noticeable improvements in cardiac X-rays and echocardiograms for some patients after treatment.

(“Hunan Journal of Traditional Chinese Medicine” 1999.3)

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Professor Pei Zhengxue’s Experience in Using Chai Hu Shu Gan San to Treat Gallbladder Diseases—Ha Lüzhong

From 1982 to 1983, I accompanied Chief Physician Pei Zhengxue for over a year, observing how he used a combination of symptom-based diagnosis and treatment to achieve remarkable results in managing various clinical conditions, which greatly benefited me. Now, I would like to share my personal, superficial impressions regarding his use of Chai Hu Shu Gan San in treating gallbladder diseases.

My teacher believes that Chai Hu Shu Gan San has obvious spasmolytic, choleretic, and analgesic effects. Therefore, when treating gallbladder diseases, he always uses this formula as the main treatment, making appropriate adjustments based on individual cases. Although traditional Chinese medicine does not have specific terms for cholecystitis or gallstones, descriptions such as “when the gallbladder is distended, there is pain under the ribs, bitterness in the mouth, and frequent sighing” (“Spiritual Pivot—Discussion on Distention”) and “for all types of jaundice accompanied by abdominal pain and vomiting, Chai Hu Tang is recommended” (“Golden Cabinet—Jaundice”) provide valuable references for diagnosing and treating this condition. My teacher believes that the main symptoms of gallbladder diseases include pain under the ribs, bitterness in the mouth, jaundice, vomiting, and abdominal distension, all of which reflect the underlying pathologies of liver qi stagnation, liver wood overcoming earth, and internal accumulation of damp-heat. Among these symptoms, liver qi stagnation is the root cause that triggers the other manifestations, so treatment must focus on the key principle of soothing the liver and promoting qi circulation. Therefore, Chai Hu Shu Gan San is used as the base formula, with adjustments made according to the specific situation. The six腑 organs function best when they are unobstructed, especially during acute episodes of this disease, where, in addition to soothing the liver, agents that promote bowel movements and clear blockages are consistently added. Combining Chai Hu Shu Gan San with San Huang and Cheng Qi formulas often yields excellent results.

Chai Hu Shu Gan San relieves liver qi stagnation; adding ingredients such as rhubarb, scutellaria, coptis, and mirabilite not only resolves Shaoyang qi stagnation but also clears Yangming organ blockages, achieving a dual effect of clearing both Shaoyang and Yangming. Among them, zhishi promotes qi circulation and disperses knots, chuanxiong activates blood circulation and promotes qi flow, peony softens the liver and calms yin to relieve urgency, and xiangfu regulates qi and relieves pain. Rhubarb and mirabilite clear Yangming organ blockages, contributing to the overall effect of unblocking the organs; scutellaria clears Shaoyang qi heat, and banxia harmonizes the stomach. On top of these basic adjustments, if there is severe heat, add goldthread, summer dry grass, hedyotis, and tiger stick; if there is severe pain, add chuanlianzi, yuanhu, and processed milkweed.

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