4. Contraindications for Medication in Blood Disorders

Tang believed that sweating and vomiting can cause qi to rise and reverse, leading to blood overflowing with qi and exacerbating the condition, so these methods are contraindicated. As for purging, it is an important method for treating blood disorders, because "in blood disorders with excessive fire and qi, eight or nine out of ten cases fall into this category. When the fire and qi surge, they cannot be contained, so it is appropriate to purge them to reduce their intensity. In the Yangming syndrome, Zhang Zhongjing advocated urgent purging to preserve yin; in the Shaoyin syndrome, he also advocated urgent purging to preserve yin. For blood disorders with excessive fire and qi, the greatest fear is losing yin, so purging is actually saving yin, and purging is no different from tonifying." He believed that purging in blood disorders can both calm the surging and reversing qi and preserve the yin that is about to be depleted, but "it must be done at the right time. If the pathogenic factors have lingered for too long and the righteous qi can no longer sustain itself, or if there is diarrhea... then it can only be slowly adjusted." As for harmonization and tonification, these are also indispensable methods for treating blood disorders. In harmonization, one can harmonize lung qi when there are exterior symptoms, and harmonize liver qi when there are interior symptoms, adjusting the middle qi. In addition, there are also tonifying yin and yang, removing stasis and blood, draining water and qi—these are all different forms of harmonization. In tonification, there are distinctions between tonifying the lung, spleen, and kidney. From the perspective of yin and yang, blood disorders are more suited to tonifying yin, accounting for about eight or nine tenths; tonifying yang is rare, only about one or two tenths. Tonification must be carried out only after the pathogenic factors have been eliminated and the stasis has been removed; otherwise, it may result in closing the door to chase away the thief.

IV. Defects and Shortcomings of "On Blood Disorders"

"On Blood Disorders" is a work of traditional Chinese medicine with innovative ideas, especially in terms of differential diagnosis and treatment of blood disorders, which has significant clinical value. However, due to the historical constraints at the time, Tang's thinking could not completely break free from metaphysical constraints. On the one hand, he believed that "the yin and yang of heaven can cause human diseases, but in fact it is not heaven that makes people sick; rather, it is the imbalance of qi and blood in the human body that leads to illness when exposed to the imbalance of heaven." This is a relatively correct explanation of the etiology that aligns with dialectical materialism; on the other hand, he also held the idealistic view that "dreams are controlled by the soul and spirit... the soul is good, the spirit is evil, so dreams involving the soul are mostly good, while those involving the spirit are mostly bad." In terms of argumentation, he was able to boldly criticize the erroneous views of predecessors and freely express his own opinions, bringing forth insights that had never been explored before; however, he also placed blind faith in ancient texts, attributing the errors of predecessors to their lack of study of the "Inner Canon" and Zhang Zhongjing's works, as well as to their superficial understanding. This shows that Tang simultaneously harbored contradictory thoughts of striving for innovation and blindly revering the ancients—materialist and idealist tendencies—which hindered further academic advancement. This is also the tragic fate of old scholars who, at the time, did not have Marxism-Leninism and Mao Zedong Thought as guiding ideologies.

In addition, in terms of argumentation, Tang excessively relied on the method of analogy and comparison. While this approach can increase the persuasiveness of arguments to a certain extent, overuse inevitably leads to forced connections. Furthermore, in the section on tuberculosis, he repeatedly emphasized the diagnostic significance of "eating beans and smelling fragrant" for this disease, lacking clinical evidence. These are all shortcomings of "On Blood Disorders."

(From "Zhejiang Journal of Traditional Chinese Medicine," June 1977)

After Reading "Selected Comments on Medical Discourse"

Yu Ying'ao and Pei Zhengxue

Pei Yizhong, a famous physician from Zhejiang in the late Ming Dynasty, wrote "Pei Zi's Medical Discourse" (abbreviated as "Medical Discourse"), consisting of four volumes, first published in the seventh year of the Chongzhen reign (1644). This book is not listed in medical bibliographies of the Ming or Qing dynasties. In 1959, the National Library of Traditional Chinese Medicine and other institutions compiled the "National Joint Catalog of Traditional Chinese Medicine Books," which included this book. Currently, the Sichuan Provincial Library holds the first edition of this book, while the Rare Books Collection of the National Library of Traditional Chinese Medicine has a Qing dynasty edition printed during the Shunzhi period.

Pei Yizhong, courtesy name Zhaogi, pseudonym Fu'an Jushi. His exact birth and death dates are unknown. According to the preface of "Medical Discourse," Pei came from a family of hereditary physicians. When he began studying medicine, he devoted seven years to reading the "Plain Questions," the "Spiritual Pivot," and the works of many great masters, believing he had gained considerable insight. Later, when he started practicing medicine, he often encountered difficult or perplexing problems. Realizing his limited knowledge, he further intensified his studies, eagerly exploring and reading extensively through hundreds of ancient and modern medical books and related works, almost to the point of neglecting sleep and food. As a result, his medical skills improved dramatically, saving countless lives, and he finally wrote this book in his later years. Pei also authored "Pei Zi's Pharmacology," "Compilation of the Essence of the Spirit," "Essentials of the Medical Forest," "Compendium of Diagnosis and Treatment," and "Refined Interpretation of the Mysteries of the Plain Questions," but unfortunately none of these works were published.

"Pei Zi's Medical Discourse" is a collection of medical essays. The book does not have a table of contents, containing a total of 148 articles (sections), including clinical experience in various specialties and related theories of clinical medicine. It was proofread by his son Pei Han and revised by his grandson Pei JinYang. When it was first published, it received sponsorship or prefaces from prominent figures of the time, such as Mao Huaimei, Jin Shengtan, Jiang Fushan, Zhang Zhenzhong, and Zhao Shengbo. In the preface written by Chen Zizun, it is stated that Pei's medical practice "saved countless lives through various methods, and young children, elderly people, officials in green robes, and students in blue robes all praised his virtue," enjoying a high reputation in the Jiangsu and Zhejiang regions.

In the 19th century, the famous physician Wang Mengying selected and commented on 50 articles (sections) from "Medical Discourse," which were later published in "Eight Volumes of the Qianzhai Medical Series" and "Fourteen Volumes of the Qianzhai Medical Series," titled "Selected Comments on Medical Discourse," without dividing into volumes. The title page reads: Original work by Pei Guangqi, reviewed by Yang Suyuan, and selected by Wang Mengying. Due to the careful selection, the comments effectively reflect Pei's academic experience and important clinical insights, and the commentary section is also highly valuable. Indeed, it is an excellent work that closely links theory with medical practice. Currently, it is difficult to find editions of "Medical Discourse," so the following mainly draws on "Selected Comments on Medical Discourse" to select and excerpt Pei's clinical and academic insights.

I. The Broad Concept of Pharmacotherapy

Taking medicine when ill reflects the most common and widely used treatment method. Pei, however, does not limit the so-called "medicine" solely to herbal remedies that can be decocted or applied externally, but rather refers to all measures that regulate or nourish the body's functions. He once vividly described it as follows: "Eating and drinking at the right times is medicine; wearing appropriate clothing in cold or warm weather is medicine; maintaining a regular routine of activity and rest is medicine... If you know how to replenish your essence but not how to restrain desire, if you know how to nurture your qi but not how to remain silent, if you know how to protect your spirit but not how to eliminate worries, then where can you find medicine? The 'Plain Questions' are the six classics of medicine. But if you follow the four seasons, have little desire, eat in moderation, and do not let pathogenic factors invade you, you don't need to talk about medicine at all. If your five emotions are the cause of illness, then your five emotions are the medicine." He equates dietary habits, daily routines, health maintenance, and emotional regulation with the therapeutic effects of medicine, believing that "you just need to know where the illness comes from and where it should go, and that is medicine." Based on this principle, he argues that avoiding hunger by not eating, avoiding thirst by not drinking, as well as everyday practices such as avoiding wind, abstaining from alcohol, escaping the summer heat, or keeping warm, are all forms of "medicine" for illness or broad pharmacotherapy, with the emphasis on adapting to the natural rhythms of the seasons, preventing illness before it occurs, and properly regulating or correcting the harmful effects that pathogenic factors may produce in the body. This view of combining diet, daily routines, and health maintenance with broad pharmacotherapy is generally misunderstood and overlooked by people, and patients often "are unaware" of it. It reflects Pei's strong preventive and therapeutic mindset.

II. Key Points of Tonifying Deficiency and Timing of Tonification

"Tonify deficiency" is a corresponding treatment method, and in clinical practice, tonifying qi and blood as well as tonifying the zang-fu organs are particularly commonly used. Pei analyzes that most formulas for tonifying qi and blood have the drawback of being sweet, greasy, and causing blockage in the chest. If used on patients with weak stomach qi, not only is it difficult to achieve the expected therapeutic effect, but it may even cause digestive symptoms such as bloating, diarrhea, vomiting, and inability to eat. Therefore, he believes that "the most important thing in tonifying deficiency is to strengthen stomach qi. When stomach qi is strong, food intake increases, and when food intake increases, qi and blood are produced..." He also offers a relatively objective analysis of the clinical application of certain traditional tonifying formulas. For example, Li Gao's Buzhong Yiqi Tang is often used by later doctors without carefully considering its meaning. Whenever there is a spleen deficiency, they simply prescribe the original formula. Pei Yizhong emphasizes that this formula "is designed for cases of spleen deficiency with sinking middle qi." Therefore, when Wang Shixiong selects this section of Pei's work, he believes that "this formula by Dongyuan should be called Buzhong Shengqi Tang. If there is no need to lift the sinking qi, but only to boost qi, why add ingredients like Sheng and Chai? Later generations do not understand this meaning, resulting in many misdiagnoses." This is consistent with practical clinical experience.

For some common internal medicine conditions in clinical practice, such as diarrhea, dysentery, parasitic infections, childhood malnutrition, jaundice, and edema, Pei's experience is that when these diseases are just recovering, one should not immediately take tonifying medicines, because most of these illnesses are caused by damp-heat. "Tonifying medicines only exacerbate damp-heat, so taking them suddenly is likely to cause harm." Wang Shixiong adds a bit to this, pointing out that "there are also cases where tonifying is appropriate for diarrhea, but it must be accompanied by ingredients that strengthen yin and clear heat, not just sweet and greasy tonics." This provides valuable guidance for clinicians on how to determine the timing of tonification and the specific tonifying methods for certain diseases.

Pei opposes the exclusive use of tonifying medicines, believing that "when using tonifying medicines, one must also drain pathogenic factors. Only when the pathogenic factors are gone can the tonifying medicines truly work... If you only focus on tonifying without knowing when to drain pathogenic factors, the tonifying will only cause harm." This is an important trick in using tonifying methods. For example, if the signs of "pathogenic factors" are not obvious in the diagnosis, one should still add some qi-moving, blood-circulating, and appetite-stimulating ingredients to avoid dull, greasy tonification that prevents the tonifying medicines from functioning properly.

III. Unique Experience and Insightful Views

According to the specific content of "Medical Discourse," Pei excels in treating various internal medicine conditions as well as gynecological and pediatric diseases. Although the number of cases recorded in the book is not large, they reflect his rich clinical experience. The book records a case of a female patient: "She suffered from dizziness and tinnitus, her skin was moist and her muscles twitched, she felt confused and couldn't sleep, and the symptoms came and went for half a year. Later, her menstruation was blocked for four months, and her abdomen felt like she was pregnant, so doctors suspected pregnancy and reassured her. One day, however, she passed a small amount of dark purple blood, realizing that her menstruation was blocked. She then tried several menstrual-regulating medicines, but her abdomen didn't get any smaller, instead she felt increasingly nauseous and vomited, food and drinks would come back up as soon as she swallowed them, her throat felt burning, her tongue was black and dry, and no doctor could figure out what was wrong. I (that is, Pei) found that her six pulses were tense and slippery, especially the two cun pulses. I said: This is stubborn phlegm blocking the Blood Sea, causing stagnation. Her menstruation is blocked... We must first treat the phlegm. So I prescribed eight pills of Mengshi Gun Tan Wan, followed by seven more pills, and her abdomen slightly hurt. The next day, she took the same dosage again, and the abdominal pain became unbearable. Around midnight, she passed four or five pieces of blood like pig liver, each piece measuring several feet, and then more like shredded fat membrane, countless pieces, like pomegranate seeds, red and white clustered together and falling down, totaling two or three dou. Her abdomen immediately flattened, and the pain disappeared. What was most unusual was that she spat out a bowlful of phlegm, all green like grass juice, and her mouth suddenly became as hard as a violin string." Pei realized that Zhu Danxi's so-called "strange disease—phlegm syndrome—accounts for eight or nine out of ten cases" makes sense. Later, he switched to using tangerine peel, scutellaria, coptis, citrus aurantium, pinellia ternata, bamboo sap, ginger juice, and finally used Liu Junzi Tang and Runxia Wan to adjust the dosage, achieving success. He also treated another case of menstrual disorder: "She took too much blood-tonifying medicine, so the blood didn't flow and her appetite decreased, and she also developed chills, fever, and vomiting. Doctors still thought it was blood stasis and kept intensifying the treatment, but the patient suddenly fell into a coma, her teeth clenched, saliva flowing from her mouth, looking like a stroke. Her pulse was faint and weak, and pressing on her heart felt full and urgent, with a sound. I said: This is phlegm-related. After asking around, I found out that it was caused by the medicine, not by the bleeding. Only by using oil goose feather to flush it out could it be resolved, and four or five liters of acidic water came out at once, and she woke up. First, I used herbs to dry dampness and expand the middle, then supplemented with tonifying the spleen and strengthening the stomach, waiting until her eating and living returned to normal before giving her menstrual-regulating pills, and then the blood flowed again." These two cases of amenorrhea—one solved by treating phlegm, the other determined to be caused by drug-induced damage to the blood—were treated step by step, demonstrating Pei's meticulous diagnosis and bold prescription skills.

Clinicians use medicines to treat diseases, and there are so-called "kingly" and "tyrannical" methods. Generally, medicines with mild properties or leaning toward tonification are considered "kingly," while those with strong flavors or harsh properties are considered "tyrannical." Regarding "kingly" and "tyrannical" medicines, Pei believes that "medicines themselves are neither king nor tyrant; the way they are used is also neither king nor tyrant... If the user is skilled, licorice, ginseng, and astragalus are king; aconite, nitrate, and rhubarb are also king... So whether a medicine is king or tyrant depends not on the medicine itself, but on how it is used; and it also depends not on the medicine, but on whether it is used skillfully or not..." This view is based on actual effectiveness and proper diagnosis, rather than judging a medicine's strength or weakness based on its taste or tonifying effect.

Regarding the treatment of some internal medicine conditions, Pei places great importance on moxibustion in addition to pharmacotherapy, even believing that some conditions are more suitable for moxibustion first and then medicine. He says: "Whenever there is phlegm, fluid, accumulation, or distension in the chest or abdomen, or pain, acid, or vomiting, if these symptoms come and go intermittently and persist for years without healing, it is urgent to take decisive action to cure them, so that other diseases won't compound the problem and make it harder to deal with. However, the method of treatment should be moxibustion first, followed by medicinal stones." This is because taking medicine first for these conditions can easily damage the spleen and stomach, depleting vital energy; whereas moxibustion first does not affect the spleen and stomach or eating habits, thus avoiding damage to vital energy. Wang Shixiong believes that especially for conditions caused by cold-damp stagnation, it is even more appropriate to use moxibustion first to warm and promote circulation, which is a good method for targeted treatment and can serve as a reference for clinicians when considering treatment options.

Pei attaches great importance to preserving stomach qi, especially for elderly patients, believing that one should not focus solely on medicine at the expense of eating. "It is better to give up medicine because of food than to give up food because of medicine." He also has views on dietary restrictions and recommendations for patients during and after illness that are consistent with diagnosis and scientific principles. He believes that "during illness, it is indeed advisable to restrict food, especially drink. Everyone knows that food can harm you, but few realize that drink can also harm you—not only tea, soup, juice, wine, and ice, spring water, melons, and fruits, which are all considered drink-related harm—but even taking too much medicine is considered drink-related harm."

<!-- translated-chunk:23/57 -->

Drink. Its manifestation ranges from mild abdominal distension and intestinal rumbling, leading to vomiting and regurgitation, to severe cases where the abdomen becomes as rigid as a drum, resulting in shortness of breath and hiccups.

In even more severe cases, the patient may clench their teeth tightly, drool from the corners of their mouth, fall into a state of unconsciousness, resembling a stroke. When encountering such conditions, it is all too common... "Such cases of injury due to excessive drinking are not uncommon in clinical practice today, yet they are easily overlooked by physicians, making it difficult for the public to recognize this condition. Furthermore, after falling ill, patients should appropriately moderate their diet based on their specific condition. However, Pei opposed overly restrictive dietary restrictions, believing that such practices would hinder post-illness recovery.

Another example is the clinical presentation of coma. Physicians often emphasize the theory that "the heart houses the spirit," attributing the root cause of the disease to the heart. Pei, however, proposed the idea that "the root cause of coma lies in the stomach; only when the stomach is clear can the spirit be clear." Although "it is said that the heart stores the spirit, but it is qi that controls the spirit. Qi originates from the stomach; if the stomach qi is not clear, it cannot control the spirit to return to its proper place, inevitably leading to confusion and dullness of the heart and spirit." He illustrated this with examples such as drunkenness, overeating, phlegm obstructing the middle jiao, and internal excess of yangming qi, providing both theoretical elaboration and practical clinical application—qualities that make his work worthy of our close study.

In summary, Pei Yizhong was never satisfied with the medical achievements of his predecessors. His book "Yan Yi" presents unique scholarly insights while remaining firmly grounded in orthodox principles. He was also adept at observing and summarizing patterns and regularities. For instance, pediatricians generally hold the view that children from wealthy families tend to have delicate constitutions and are prone to illness, whereas children from poor families are often robust and less likely to get sick. Pei analyzed five factors contributing to childhood illnesses: first, overheating; second, excessive drinking; third, emotional instability and frequent anger (resulting from parents' overindulgence and children's willfulness); fourth, "suppressing crying" (where parents discourage children from crying, mistakenly believing it harms their health); and fifth, medication-related harm (such as taking too many drugs for minor or no ailments). These are all common issues among children raised in affluent families, while the opposite is true for children from poorer households. Therefore, Pei believed that "poor families actually follow a more natural approach to raising children," because limited family finances generally prevent them from overfeeding, overwarming, or overmedicating, and also avoid spoiling and wilfulness. Moreover, children from poor families tend to have abundant yang energy, making them more susceptible to heat-related illnesses; crying, on the other hand, helps release excess heat, which is beneficial for child health—points that pediatricians should pay attention to.

The preface to this book by Zhao Shengbo states: "...Pei has mastered both ancient and modern knowledge, comprehends the relationship between heaven and humanity, possesses an almost divine talent, and has a compassionate heart... Reading his words feels like hearing what Xuanyuan and Qibo wished they could say but regretted not having expressed, as well as what many great masters wanted to convey but were unable to articulate..." Considering that there are few published editions of "Yan Yi," making it difficult for readers to access, we have provided a brief introduction to selected excerpts from "Selected Comments on Yan Yi" above. Any inaccuracies are welcome to be pointed out.

(Journal of Zhejiang University of Traditional Chinese Medicine, June 1981)

My Journey in Integrative Medicine

Pei Zhengxue

I was born in February 1938 in Wushan County, Gansu Province. In 1961, I graduated from Xi'an Medical University with a bachelor's degree. I have served as chief physician and researcher at the Gansu Provincial Academy of Medical Sciences, as well as department head and vice president, focusing on integrative medicine in gastroenterology, hematology, and cardiovascular diseases. I once led the provincial science and technology commission's key research project on hepatitis B. I have edited or authored 14 monographs on integrative medicine, including "Practical Internal Medicine of Integrative Medicine," "Chinese Herbal Formulas," "Commentary on Blood Disorders," "Diagnosis and Treatment of Hepatitis B," "New Compilation of Warm Disease Theory," "Selected Cases of Pei Shen's Medical Practice," and "Pharmacological and Clinical Applications of Rhubarb," among others. I have published over 70 papers, won two provincial awards for scientific and technological progress, seven awards for outstanding publications, and one international gold award for traditional medicine. I have also lectured in the United States and Japan. Currently, I serve as a member of the Gansu Provincial Committee of the Chinese People's Political Consultative Conference, a director of the Chinese Society of Integrative Medicine, and an editorial board member of the "Chinese Journal of Integrative Medicine."

I come from a family of three generations of traditional Chinese medicine practitioners. My grandfather was a scholar during the Qing Dynasty who practiced medicine in his hometown and enjoyed great prestige throughout southern Gansu Province. My father graduated from the liberal arts program at Central University but later switched to medicine, gaining widespread recognition across Shaanxi and Gansu provinces. After graduating from the medical department of Xi'an Medical University in 1961, although I spent many years working in Western medicine, my early exposure to traditional Chinese medicine through family teachings and constant immersion sparked a deep interest in TCM. In clinical practice, when faced with patients whose conditions proved resistant to Western medicine, I often combined Western medications with traditional Chinese herbal formulas, achieving notable therapeutic effects in cases such as aplastic anemia, leukemia, systemic lupus erythematosus, and rheumatoid arthritis. I recall January 1967, when I was in charge of the internal medicine department at a hospital in Tianshui. A 16-year-old male patient named Ma XX from Lanzhou had been treated unsuccessfully at another hospital, showing no improvement after chemotherapy, with hemoglobin levels as low as 3 g/dL and in critical condition. After applying a traditional Chinese medicine therapy aimed at "strengthening vital energy and consolidating the body," his condition gradually improved significantly, and subsequent chemotherapy revealed partial remission in bone marrow morphology. Thereafter, traditional Chinese medicine continued to be used in conjunction with chemotherapy. Over the course of a year, his condition fully recovered, with bone marrow morphology indicating complete healing. This case was presented at the Suzhou Hematology Conference in 1973 and received widespread attention from attendees, leading to the designation of the treatment protocol as the "Lanzhou Protocol," which was subsequently promoted nationwide. The patient is still alive today, having survived for over 30 years. This case profoundly inspired me and strengthened my commitment to studying and advancing traditional Chinese medicine. Thus, starting in the 1960s, I began self-studying classic texts such as "Shanghan Lun," "Jin Gui Yao Lue," "Wen Bing Tiao Bian," and "Neijing Zhi Yao," while also carefully reading representative works by modern integrative medicine pioneers like Tang Rongchuan, Zhang Xichun, Shi Jinmo, Yu Wuyan, and Shi Yiren. Their theories and practices provided new insights, revealing that earlier scholars, constrained by historical circumstances, had not yet achieved a thorough understanding of modern Western medicine. Although their clinical applications yielded good results, they failed to develop a systematic theory of integrative medicine, limiting their impact on future developments in the field. Shi Jinmo left behind very few writings, though several case studies compiled by his disciples demonstrated excellent efficacy, with formulas incorporating integrative medicine principles. Zhang Xichun's "Zhong Zhong Can Xi Lu" likewise leaned more toward practice than theory. Yu Wuyan and Shi Yiren both showed a spirit of exploring the integration of theory and practice, but their haste sometimes led to forced interpretations. Only Tang Rongchuan, in his "Blood Disorder Treatise," subtly hinted at genuine insights into integrative medicine. Taking advantage of the two years I was sent to the countryside during the Cultural Revolution, I wrote "Commentary on Blood Disorders," which was published by the People's Health Publishing House in 1978. In 1973, I was transferred to the Gansu Provincial Institute of New Medicine, where I taught courses such as "Shanghan Lun," "Jin Gui Yao Lue," "Chinese Herbal Formulas," and "History of Chinese Medicine," engaging in mutual learning through teaching and research. As a result, my foundation in traditional Chinese medicine improved significantly, reaching a new level. I came to believe that "formulas" are the core of traditional Chinese medicine, connecting theory and method above with medicinal ingredients below, serving as the frontline of clinical practice. No wonder there is the saying, "Memorize the formulae and you can go anywhere." I focused my research on formulas, eventually writing "New Compilation of Chinese Herbal Formulas," which was officially published in 1980. This book boldly attempted to integrate theory, method, and herbs, aiming to standardize diagnosis and treatment based on syndrome differentiation in traditional Chinese medicine. Through teaching, writing, and clinical practice, I realized that traditional Chinese medicine's formulas are effective, but they are based solely on "syndromes," completely disconnected from modern medicine's concept of "diseases." If we could combine "syndromes" with "diseases," that would be the most basic and crucial task in integrating Chinese and Western medicine. To achieve this goal, I proposed the "Sixteen-Character Principle" in the 1980s—namely, "Western diagnosis, Chinese syndrome differentiation, Chinese medicine as the mainstay, Western medicine as the auxiliary"—and subsequently wrote over ten papers elaborating on this principle from various angles. I was also invited to give lectures on this principle in more than ten cities across China. The Gansu Provincial Department of Health even commissioned the Provincial Society of Integrative Medicine to organize four training sessions for attending physicians at traditional Chinese hospitals, focusing on the theory and clinical application of the "Sixteen-Character Principle," which was widely regarded as the "Sixteen-Character Policy" for developing modern Chinese medicine. Over the past decade and more, guided by this policy, I have published over 70 papers and written twelve monographs on integrative medicine, including "Diagnosis and Treatment of Hepatitis B," "New Compilation of Warm Disease Theory," "Selected Cases of Pei Shen's Medical Practice," "Pharmacological and Clinical Applications of Rhubarb," and "Integrated Treatment of Common Diseases," bringing the total to 12 official publications. Recognizing the need to summarize the entire field of integrative medicine for internal diseases under the guidance of the "Sixteen-Character Policy," in February 1992 I organized 21 renowned experts in integrative medicine from the five northwestern provinces to compile a monumental work on integrative internal medicine—"Practical Internal Medicine of Integrative Medicine." This book was officially published in 1995, totaling 1.5 million characters in a single hardcover volume. In 1996, it won the Third World Traditional Medicine International Gold Award for Outstanding Contribution, and I was invited to the United States to receive the award and give lectures. On February 23, 1998, coinciding with my 60th birthday, my workplace, the Gansu Provincial Academy of Medical Sciences, held a large-scale symposium to commemorate my 40 years of contributions to integrative medicine, education, and research, attended by numerous leaders and colleagues from across the province. I felt deeply encouraged and motivated by the Party and government's recognition of my efforts. Although I am now in my sixties, I remain committed to redoubling my efforts to repay the Party and the people's high expectations, continuing to shine and generate warmth for the cause of integrative medicine, and making new contributions—just as the old ox knows its sunset is near, yet still strives forward without being urged.

(The Expert Collection of the Chinese Society of Integrative Medicine, 1998)

Part Two: Clinical Practice

This section comprises 25 articles, primarily clinical studies and reports published in domestic journals between 1980 and 2000, with particular emphasis on liver diseases, blood disorders, kidney diseases, and pancreatic conditions.

Western Perspectives on the Clinical Application of Classic Formulas

Pei Zhengxue

The so-called "classic formulas" refer to the prescriptions found in "Shanghan Lun" and "Jin Gui Yao Lue." Originally, these two books were part of a single work titled "Shanghan Zabing Lun," authored by Zhang Zhongjing, a great clinical physician of the late Eastern Han Dynasty. Zhang experienced the massive epidemic that swept across Asia in the third century, accumulating extensive clinical experience through his frequent medical practice. He then wrote "Shanghan Zabing Lun," and shortly after its completion, due to frequent wars, the bamboo slips were scattered. Wang Shuhe, the Imperial Physician of the Western Jin Dynasty, later compiled the external pathogenic factors section into a separate book, naming it "Shanghan Lun." More than 500 years later, Wang Zhu, a scholar at the Northern Song Dynasty's Imperial Academy, discovered fragments of "Shanghan Zabing Lun" and reorganized the sections dealing with miscellaneous diseases into a separate volume, calling it "Jin Gui Yao Lue." The classic formulas recorded in "Shanghan Lun" number 112, while those in "Jin Gui Yao Lue" total 262, excluding duplicates. Altogether, there are approximately 300 classic formulas. Over more than a thousand years of clinical practice, successive generations of physicians have highly praised the remarkable efficacy of these formulas, giving rise to numerous doctors specializing in treating diseases with classic formulas and many researchers dedicated to studying them, collectively known as the "Classic Formula School." Drawing on my own more than 40 years of clinical experience, I believe that "classic formulas" truly represent the treasure of traditional Chinese medicine: concise formulation, precise clinical effects, and the profound theories derived from them, which form the core of traditional Chinese medicine's syndrome differentiation and treatment. However, in today's era of highly advanced diagnostic technology, how can "classic formulas" be integrated with modern science and technology? How can they benefit humanity worldwide? Through long-term clinical practice, I have accumulated some experience, which I will now share. I welcome criticism and suggestions from my colleagues regarding any inaccuracies.

1. Mahuang Tang and Guizhi Tang

"The symptom of Taiyang disease is floating pulse, stiff neck and headache, accompanied by aversion to cold"; "Whether feverish or not, one must feel cold, have body pain, hiccups, and have both yin and yang pulses tight—this is called Shanghan"; "Fever, sweating, aversion to wind, and slow pulse—this is called Zhongfeng"; "Fever and thirst, without aversion to cold—this is called Wenbing." These passages indicate that external pathogenic factors can be categorized into three types: Shanghan, Zhongfeng, and Wenbing. Shanghan involves headache, fever, aversion to cold, no sweat, and floating, tight pulse; Zhongfeng includes headache, fever, aversion to cold, sweating, and floating, slow pulse; Wenbing is characterized by headache, fever, thirst, and no aversion to cold. According to recent research, the epidemic at the end of the Eastern Han Dynasty was likely caused by a viral influenza. In the preface to "Shanghan Zabing Lun," Zhang Zhongjing wrote: "My clan has always been large, numbering about 200 members. Since the Jian'an era, more than two-thirds of us have died, with Shanghan accounting for 70% of the deaths." Clearly, this epidemic was extremely severe. Given the rudimentary medical conditions at the time, the complications and sequelae caused by severe influenza alone could be fatal—this is easy to imagine. In essence, "Shanghan," "Zhongfeng," and "Wenbing" are simply three different types of external pathogenic fevers. "Shanghan" is referred to as "biaoshi" in traditional Chinese medicine, representing a severe form of external pathogenic invasion; "Zhongfeng" is called "biaoxu," a milder form; and "Wenbing" is termed "biaore," referring to infections involving the upper respiratory tract and throat. Mahuang Tang is the preferred prescription for treating biaoshi. Guizhi Tang is the preferred prescription for treating biaoxu. As for "biaore" (Wenbing), "Shanghan Lun" does not provide a specific formula; later, Wu Jutong, a master of Wenbing theory, created Sangju Yin and Yinqiao San, which proved highly effective, thus filling the gap left by "Shanghan Lun."