2. Dispelling Pathogenic Factors

Although leukemia is fundamentally虚, with real manifestations as the outward appearance, throughout the course of the disease—especially in acute leukemia—it often presents with symptoms of wind-heat and real-fire. Sometimes there is headache, fever, red tongue, and rapid pulse, indicating heat in the wei phase; sometimes there is high fever, thirst, excessive sweating, and constipation, indicating heat in the qi phase; and at times, blood heat runs rampant, with hematemesis and hematochezia, indicating heat in the ying-blood phase. In short, this disease exhibits characteristics of warm diseases, which are commonly seen in clinical practice. Therefore, medication should focus on heat-clearing and detoxifying herbs, such as erhua, lianqiao, bohe, gongying, banlan gen, zihuadi ding, qiyeyi zhifhua, and sangye.

(1) If heat-toxins attack the lungs, causing throat swelling and pain, use huangqin, shandougen, niuzi, mabo, sheng cao, xuan shen, and bai hua she she cao, among others.

(2) If phlegm and cough are uncomfortable, use yuxingcao, beimu, sang bai pi, sheng gypsum, or ma xing shi gan tang.

Brief Table of Effective Medications in Tonifying Formulas for Improving Blood Parameters

+:----------:+:---------:+:----------------------------------------:+ Blood Parameters | Syndrome Type | Medication

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Leukopenia | Kidney Yin Deficiency | Rehmannia, Goji Berry, Mulberry Bark, Ligustrum +-----------+------------------------------------------+ | Kidney Yang Deficiency | Cornus Fruit, Psoralea, Epimedium, Morinda Root, Cnidium Seed | | | | Alpinia Oxyphylla, Deer Antler, Semen Sesamum, Cistanche, Aconite | | | | Cinnamon, Chicken Blood Vine +-----------+------------------------------------------+ | Qi Deficiency | Angelica, Ginseng, Codonopsis, Pseudostellaria, Atractylodes +-----------+------------------------------------------+ | Yin Deficiency and Fluid Loss | Glehnia, American Ginseng, Asparagus, Ophiopogon, Dendrobium | | | | Scrophularia, Turtle Shell Glue Erythrocyte Reduction | Qi and Yin Deficiency | Ginseng, Codonopsis, Pseudostellaria, Astragalus, Chinese Yam, Polygonatum | | | | Gui Pi Tang, Liu Wei Di Huang Tang Thrombocytopenia | Blood Heat | Rehmannia, Red Peony Root, Burdock, Coptis, Phellodendron, Imperata Grass | | | | Lithospermum, Large and Small Thistle, Moutan Bark, Eclipta, Lycium Bark +-----------+------------------------------------------+ | Unstoppable Bleeding | Sanguisorba Carbonized, Rubia Carbonized, Platycladus Leaf Carbonized, Donkey Hide Gelatin, Agrimonia | | | | Notoginseng, Lotus Rhizome, Charred Gardenia, Cuttlefish Bone, Dragon Bone, Oyster +-----------+------------------------------------------+ | Qi Deficiency | Astragalus, Codonopsis, Atractylodes +-----------+------------------------------------------+ | Blood Deficiency | Angelica, Rehmannia, White Peony Root, He Shou Wu, Longan Meat, Fresh Red Dates (3) For lung heat with nosebleed, use Imperata Grass, Moutan Bark, Rehmannia, Charred Gardenia, Rubia, etc.

(4) If lung heat spreads to the large intestine and causes constipation, use Rheum, Glauber's Salt. If damp-heat in the lower part of the body leads to dysentery, use Coptis, Scutellaria, Pulsatilla, Fraxinus, Purslane, etc.

(5) If heat toxin attacks the kidneys, causing red urine and turbid urination, use Anemarrhena and Phellodendron; if kidney heat spreads to the bladder and damp-heat accumulates in the lower part of the body, resulting in reduced urine output and urinary tract infection, use Gardenia, Plantain, Plantago, Talc, Solanum nigrum, and Hemiphragma, etc.

(6) If heat toxin attacks the liver, causing red eyes and bitter mouth, use Gentian and Gardenia; if liver heat spreads to the gallbladder and jaundice appears, use Artemisia and Phellodendron, etc.

(7) If heat toxin attacks the heart, causing excessive heart fire and restlessness, use Coptis, Isatis, Forsythia, etc.

If heart heat spreads to the small intestine, causing red and painful urination, use Rehmannia, Aristolochia, Licorice, and if skin sores or boils appear, use Double Flower, Forsythia, Dandelion, and Houttuynia, etc. If sepsis occurs, use Coptis Detoxifying Decoction with added ingredients.

(8) If heat evil enters the nutritive blood, depleting the nutritive blood, causing high fever at night, faint rashes, fine and rapid pulse, and a dark tongue without coating, use Rhinoceros Horn, Rehmannia, Scrophularia, Bamboo Leaves, Ophiopogon, Salvia, Coptis, Double Flower, Forsythia, etc.

(9) If heat evil invades the pericardium, causing high fever, delirium, and phlegm-heat, with a slippery and rapid pulse, since the heat evil is trapped inside, often accompanied by high fever but cold extremities, it is necessary to quickly clear the heart and reduce the heat to reverse the trend, using Angong Niuhuang Pill, Zhibao, Purple Snow, etc.

(10) If pathogenic heat remains in the yin aspect and does not dissipate, with low-grade fever that fluctuates between morning and evening, hot palms and soles, red tongue, and fine and rapid pulse, use Qin Jiao, Softshell Turtle Shell, Rehmannia, Anemarrhena, Lycium Bark, Artemisia, Stir-fried Bupleurum with Turtle Blood, White Weeping Willow, Picrorhiza, and Turtle Shell, etc.

(11) If heat toxin attacks the spleen, causing dry mouth and lips, thirst, and easy hunger, use Gardenia, Raw Gypsum, and Raw Herb, etc. If spleen heat also affects the stomach, leading to dryness and fullness in the middle jiao, red eyes, thirst, abdominal distension, and constipation, use Rheum, Glauber's Salt, or Liangge Powder with added ingredients.

(12) On the basis of the above heat-clearing and detoxifying methods, one may appropriately add heat-clearing and detoxifying herbs with anti-cancer effects, such as Hedyotis diffusa, Hemiphragma, Solanum nigrum, Galium aparine, Camptotheca acuminata, Indigo Naturalis, and Paris polyphylla, etc.; one may also add Xiong Huang and Chan Su, which have pungent-warm properties for detoxification and anti-cancer purposes.

(13) In addition to the above heat-clearing and detoxifying methods, some leukemia patients often experience whole-body joint pain, obvious tenderness in the sternum, dark tongue, and sluggish pulse, or combined with low-grade fever and persistent high fever. In such cases, treatment should focus on resolving blood stasis, paying attention to blood-activating and stasis-resolving herbs, such as Sanleng, Atractylodes, Radix Curcumae, Sedum sarmentosum, Snake Six Grains, and Trichosanthes kirilowii, etc.

IV. Case Selection

[Case 1] Wei ××, male, 14 years old, student, family member of an employee at the Gansu Academy of Sciences. First visit on May 23, 1975: The parents reported that three months earlier, due to fatigue, weakness, dizziness, decreased appetite, discomfort in both flanks, and soreness in the lower back and legs, a checkup at Lanzhou ×× Hospital revealed a white blood cell count of about 165,000 per cubic millimeter, bone marrow examination showed extreme hyperplasia, with promyelocytes and early myelocytes each accounting for more than 22%, slight enlargement of the liver and spleen, ultimately diagnosed as chronic myelogenous leukemia. Upon examination: bitter taste, hearing loss, irritability, flushed face, thirst, insomnia, and hidden pain in the sternum. Based on the imbalance of organ qi and excess fire in the liver, the prescription was modified Danggui Longhui Decoction with added ingredients, plus 0.6 grams of Bezoar (taken twice by brewing), to enhance the effect of expelling pathogenic factors. Subsequent visits continued to follow this formula; on October 4 of the same year, during the seventh visit, the complexion had returned to normal, appetite improved, spirits lifted, and the white blood cell count dropped to 21,000 per cubic millimeter, then switched to Danggui Aloe Pill, 6 grams each time, once in the morning and once at night. After three months of medication, the patient was able to engage in light physical labor, the symptoms of liver fire excess greatly subsided, followed by nourishing formulas such as Xiaoyao and Gui Pi. On November 18, 1977, the white blood cell count had dropped to 18,300 per cubic millimeter, subjective symptoms disappeared, physical strength increased, appetite improved, and the patient was already working at the Academy of Sciences × Factory, still alternating between Shengmai Di Huang Pill and Danggui Aloe Pill to consolidate the therapeutic effect. The patient has been taking traditional Chinese medicine for three years since becoming ill and is still under observation.

[Case 2] Wei ××, male, 14 years old, student, resident of Lanzhou City. In April 1974, due to fever, fatigue, loss of appetite, and hidden pain in the sternum, he was hospitalized at the Gansu Provincial People’s Hospital and diagnosed with acute lymphocytic leukemia. Despite receiving combination chemotherapy, the condition did not improve. Given the continuous decline in white blood cells, a consultation with traditional Chinese medicine was requested on June 12 of the same year. At that time, the complexion was sallow, the body thin, with spontaneous sweating and fever, sternum tenderness, floating and weak pulse, especially weaker in the two cun positions. Blood test: hemoglobin 9.2 grams, red blood cells 2.32 million per cubic millimeter, white blood cells 1,550 per cubic millimeter, lymphocytes 10%, platelet count 33,000 per cubic millimeter. The diagnosis was dual deficiency of lung and kidney, so the prescription was Yiqi Yangyin Decoction. On June 26, after taking the original formula for 12 doses, the fever subsided, sweating stopped, and subjective symptoms improved. Blood test: hemoglobin 11 grams, red blood cells 4.12 million per cubic millimeter, white blood cells 5,100 per cubic millimeter, neutrophils 76%, lymphocytes 23%, immature cells (monocytes) 1%, platelet count 120,000 per cubic millimeter. Still continuing with the original formula. On July 1, sudden high fever and diarrhea occurred, and on July 7, during the third consultation, the temperature remained at 39°C, diarrhea persisted with black stools, fatigue, epigastric discomfort, lack of appetite, dry mouth, and no desire to drink, pulse deep and rapid, tongue red with thin white coating. The diagnosis was blood deficiency with yin deficiency, internal heat intertwined with warm pathogenic factors, following the principles of Xie Xin Tang and Qing Gu San, the prescription was: North Sandalwood 9 grams, White Bean 9 grams, Poria 9 grams, Coix Seed 15 grams, Cardamom 1.5 grams, Coptis 2.4 grams, Dried Ginger 2.4 grams, Silver Bupleurum 9 grams, Artemisia 9 grams, Turtle Shell 9 grams, Charred Hawthorn 9 grams, Moutan Bark 6 grams, White Weeping Willow 6 grams, Radish Seed 6 grams, Honeydew 3 grams, decocted in water and taken orally. On July 12, during the fourth consultation, after taking three doses of the above formula, the temperature dropped to 36.4°C, diarrhea stopped, slightly better appetite, pulse weak and deep, tongue red with gradually disappearing white coating, still a slightly greasy patch the size of a fingernail, tired in the morning, lighter in the afternoon, occasional spontaneous sweating, then switched to Buzhong Yiqi Tang, combining Yiqi Yangyin Decoction. After a month of adjustment, the condition and blood tests returned to the complete remission state before July 1. Since then, in terms of traditional Chinese medicine, one dose is divided into two servings, taken once daily, alternating between Yiqi Yangyin Decoction and Yiqi Yangzhen Decoction. In terms of Western medicine, apart from the initial combination chemotherapy, only traditional Chinese medicine has been used for the past year and a half, totaling two years now, still in complete remission.

Note: ①② "Comprehensive Collection of Ancient and Modern Books," Volume 91, Book 455, Page 393 (reprinted by Zhonghua Book Company in 1953) ③④ "Comprehensive Collection of Ancient and Modern Imperial Titles," Volume 23, Book 424, Page 18 (same edition as above) ⑤ "Traditional Chinese Medicine Treatment of Blood Diseases." Compiled by Lanzhou Medical College in April 1975 (internal material), 7 pages ⑥ Internal materials of Lanzhou Dasha Ping Hospital (unpublished) ⑦ Lanzhou Medical College. "Compilation of Leukemia Data." November 1973. ("Compilation of Gansu Integrated Traditional Chinese and Western Medicine Data" in 1977.1)

Integrated Traditional Chinese and Western Medicine Cure

Acute Monocytic Leukemia

Pei Zhengxue

I. Cases

Ma Changsheng, male, 17 years old, unmarried, Han ethnicity, native of Tianshui, soldier of Gansu Agricultural Construction Brigade No. 1. On March 15, 1967, transferred from the First Affiliated Hospital of Lanzhou Medical College, Department of Internal Medicine, with the diagnosis of "acute monocytic leukemia" to our hospital (hospitalization number 2346). The patient reported that three months earlier, he felt dizzy, fatigued, and had minor bleeding spots on his skin, but treatment at the local hospital was ineffective. As the bleeding spots increased, nasal bleeding and bloody stools appeared, and the local hospital initially suspected aplastic anemia, transferring him to the First Affiliated Hospital of Lanzhou Medical College on February 1 of the same year. During his stay in Lanzhou, the condition progressed rapidly, with worsening bleeding symptoms and deteriorating general condition day by day. Professor Zhang Aicheng from the hospital's Department of Internal Medicine confirmed the diagnosis of acute monocytic leukemia through bone marrow smear. He stayed in the hospital for over 50 days, received more than 10 blood transfusions totaling about 3,000 milliliters, and underwent various anti-leukemia treatments, but the condition continued to worsen. At the request of the family, he was transferred back to his hometown and came to our hospital.

Past medical history: Previously healthy, had suffered from colds and "typhoid," both cured promptly, no history of exposure to toxic or radioactive substances.

Physical examination: Temperature 38.5°C, pulse 112 beats per minute, blood pressure 12.0/6.7 kPa (90/50 mmHg). The patient's development was acceptable, nutrition poor, consciousness clear, cooperative during examination, pale complexion, showing signs of acute anemia. Scattered petechiae of varying sizes were visible on the skin and mucous membranes, not fading upon pressure. Two hemorrhagic patches measuring 4 cm × 6 cm and 7 cm × 4 cm were observed on the buttocks and outer side of the lower leg. No jaundice of the sclera. No congestion in the throat, tonsils not enlarged. Neck soft, no deformity. Chest symmetrical, sternum tender to palpation. Breath sounds rough in both lungs, no dry or wet rales heard. Heart border not enlarged, heart rate 112 beats per minute, rhythm regular, P2>A2, a grade III systolic murmur audible at the apex. Abdominal distension, tenderness in the mid-abdomen. Liver and spleen not palpable. No abnormalities in the limbs. Pathological reflexes negative.

Laboratory tests: Blood count: red blood cells 900,000 per cubic millimeter, hemoglobin 19.2%, platelets 10,000 per cubic millimeter, white blood cells 1,200 per cubic millimeter, neutrophils 18%, lymphocytes 72%, monocytes 10%, reticulocytes 0.1%, bleeding time 5 minutes and 20 seconds, clotting time 24 seconds. Routine urine and stool tests showed no abnormalities.

Bone marrow aspiration smear examination: Specimen number L-802, bone marrow smear quality good, bone marrow hyperplasia obvious, granulocyte:red ratio 3.1:1, white:red ratio 27.1:1, significant increase in white blood cells, mainly monocytes: primitive monocytes 5.0%, immature monocytes 69.5%, mature monocytes 6.0%, total 80.5%. All stages of erythrocytes totaled 3.5%, mature red blood cells basically normal in shape, some red blood cells with insufficient hemoglobin filling. No megakaryocytes seen (this report was made by Professor Zhang Aicheng of Lanzhou Medical College).

Diagnosis: Acute monocytic leukemia (non-leukemic type).

Hospital treatment course: The patient was admitted on March 15, 1967, immediately given penicillin 400,000 units intramuscularly every 8 hours, streptomycin 0.5 grams intramuscularly twice daily, vitamin B1 10 mg orally three times daily, vitamin C 100 mg orally three times daily, prednisone 30 mg orally three times daily. At the same time, emphasis was placed on treating according to TCM syndrome differentiation. The patient presented with high fever, thirst, sweat from bones, widespread petechiae, vomiting, nosebleeds, bloody stools, little coating on the tongue, and a fine and rapid pulse. Clearly a case of dual deficiency of qi and yin, with rampant blood heat. The treatment should be to tonify qi and yin, clear heat and reduce fire, consolidate the exterior and stop sweating, cool the blood and stop bleeding. Thus, prescription No. 1① was prepared as a decoction and taken once daily. After 8 doses, the patient's general condition slightly improved, fever, sweating, and thirst all lessened compared to before, and bleeding symptoms also improved somewhat (during this period, two blood transfusions totaling 600 milliliters were given). On April 5, TCM examination showed that nighttime heat and morning coolness, bone-steaming spontaneous sweating, vomiting, nosebleeds, and black stools—overall bleeding symptoms slightly alleviated compared to before, tongue red with little coating, pulse still fine and rapid. The remaining heat has not been cleared, and there is still dual deficiency of qi and yin. Qi deficiency cannot control the blood, yin deficiency cannot restrain the fire. The treatment should be to greatly tonify qi and yin, clear heat and remove steaming; supplemented by cooling the blood and stopping bleeding, consolidating the exterior and stopping sweating. So prescription No. 2② was changed to a decoction and taken once daily. After a total of 10 doses, the patient's temperature dropped to normal, nosebleeds stopped, widespread petechiae and bleeding spots gradually dried up and showed no tendency to develop further. The patient's general condition further improved, able to do light activities in bed, appetite increased compared to before (during this period, two blood transfusions totaling 600 milliliters were also given). On April 20, TCM examination showed that the complexion was pale, qi deficient and fatigued, palpitations and shortness of breath, restless sleep at night, dizziness and vertigo, bone-steaming spontaneous sweating, tongue red with thin coating, pulse fine and rapid. This is a case of qi and yin deficiency, with both interior and exterior being weak and unstable, yang floating outward. The treatment should be to greatly tonify qi and yin, calm the mind and stabilize emotions, supplemented by consolidating the exterior and stopping sweating. Prescription No. 3③ was used as a decoction and taken once daily. After taking more than 40 doses, the patient's general condition improved markedly, bleeding stopped, rashes disappeared, complexion slightly reddened, and symptoms such as fatigue, spontaneous sweating, palpitations, shortness of breath, and restless sleep at night all eased to some extent (during this period, three blood transfusions totaling 800 milliliters were given). On June 25, 1967, with the intention of continuing to greatly tonify qi and yin, prescription No. 4④ was changed to a concentrated decoction, taken twice daily, 5 qian each time, diluted with boiled water, a total of 3 batches were taken. Over five months, until November 1967, the patient's physical strength increased, complexion became rosy, appetite improved, spirits were good, symptoms such as fever, bone-steaming, thirst, and excessive sweating were basically controlled, only occasional dizziness, vertigo, palpitations, and shortness of breath, and the patient was able to do some light work (during this period, five blood transfusions totaling 1,200 milliliters were given, Western medicine only included vitamins and daily prednisone 10 mg divided into two doses). Hemoglobin remained above 5%. To accurately determine the degree of cure, considering the limited diagnostic level of our hospital, on November 10, a bone marrow smear was performed, advising the patient to take the smear to Professor Zhang Aicheng in Lanzhou for re-examination, and instructing him to continue taking prescription No. 3 once daily, decocted in water, without interruption, while in Lanzhou. After going to Lanzhou, the patient continued to take prescription No. 3 in the Department of Internal Medicine of the First Affiliated Hospital of Lanzhou Medical College, and on January 17, 1968, received a letter from Professor Zhang Aicheng saying: "The patient's bone marrow picture shows changes in the remission phase of acute monocytic leukemia; except for the remaining small amount of incomplete monocytes at various stages, all other cell systems have returned to normal." He was very satisfied with the efficacy of the traditional Chinese medicine and said: "The patient continued to take the herbal prescriptions you formulated during his stay in Lanzhou." On January 18, 1968, due to inconvenience in taking traditional Chinese medicine in Lanzhou, the patient returned home to Tianshui and continued to take traditional Chinese medicine. On January 20, the author was invited to visit the patient's home and found that the complexion was pale, fatigued and sweaty, palpitations and shortness of breath, occasional gum bleeding and nosebleeds, pulse deep and fine, tongue swollen and pale, prescribed prescription No. 4④, concentrated decoction, 1 batch, diluted with boiled water (same method as before). On March 9, 1968, the patient complained of a two-day cold and chest tightness with cough, and the next day was admitted to our hospital (hospitalization number 3102). At that time, the patient had a fever (temperature 39.2°C), chest tightness with cough, a small amount of blood in the sputum, a few bleeding spots on the front and back of the chest, slightly red throat, tonsils not enlarged, rough breath sounds in both lungs, no dry or wet rales heard, sternum tender to palpation, liver and spleen not palpable, limbs not abnormal, pathological reflexes negative. Blood count: red blood cells 3.45 million per cubic millimeter, hemoglobin 5.2%, white blood cells 3,400 per cubic millimeter, neutrophils 56%, lymphocytes 40%, monocytes 4%. Diagnosis: ① acute monocytic leukemia (remission phase), ② upper respiratory infection. Immediately after admission, given penicillin 400,000 units intramuscularly every 8 hours, streptomycin 0.5 grams intramuscularly twice daily, vitamin B1 20 mg three times daily, vitamin C 100 mg three times daily, prednisone 20 mg three times daily, Kebiqing 50 mg three times daily. TCM examination showed: high fever without sweating, restless breathing, headache and chills, tongue red with little coating, pulse moist and fine. This is a case of wind-cold invading the exterior, heat trapped in the lung metal, and dual deficiency of qi and yin. The treatment should be to release the exterior and clear the interior, tonify qi and yin, and prescribe prescription No. 5⑤, decocted in water, taken once daily. After taking four doses, the general condition improved, temperature dropped to 37.5°C, cough stopped, sputum foamy with no blood. From March 15, switched to prescription No. 3, took more than 40 doses, and except for occasional dizziness and palpitations, all other symptoms completely disappeared, discharged on May 18, 1968.

After discharge, the patient continued to take prescription No. 3 at home for over 60 doses, recovered health, and returned to work in July 1968.

In mid-April 1973, the author traveled over a thousand miles to visit the patient at the Jinta Farm in Jiuquan. The patient was in good health, energetic, promoted to squad leader (Third Company, Seventh Regiment, First Brigade of Agricultural Construction), leading all the farm workers in labor and production, and praised multiple times by the regiment for outstanding performance.

Recent blood count (March 24, 1973): red blood cells 4.2 million per cubic millimeter, hemoglobin 8.2%, platelets 200,000 per cubic millimeter, white blood cells 5,600 per cubic millimeter, neutrophils 65%, lymphocytes 33%, monocytes 2%.

Recent bone marrow picture (March 26, 1973, report from the Hematology Department of Lanzhou Medical College): bone marrow hyperplasia active, granulocyte:red ratio 1.96:1, among granulocyte system, the proportion of immature granulocytes to band-shaped nuclei is slightly lower,

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The immature monocytes and monocytes are relatively elevated (total 17.8%, of which immature monocytes account for 3.8%), lymphocytes are basically normal, the erythroid system is basically normal, three mature megakaryocytes are seen in the whole smear, with no evidence of platelet formation, mature red blood cells have normal morphology, and hemoglobin filling is good.

Table of changes in blood counts during two hospitalizations (see Table 1 and Table 2).

II. Discussion

Leukemia is a disease characterized by malignant disorders of bone marrow hematopoiesis, for which there is currently no specialized treatise in traditional Chinese medicine. 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 complementing the traditional Chinese medicine therapy. Regarding the role of traditional Chinese medicine, the author has the following insights:

This patient consistently exhibited obvious symptoms of qi deficiency throughout the course of the illness, such as pale complexion, spontaneous sweating, lack of energy, shortness of breath, dizziness, and blurred vision. "Qi is the commander of blood," so qi deficiency inevitably leads to blood deficiency, resulting in symptoms of blood deficiency such as palpitations, shortness of breath, and disturbed sleep in the mid-stage of the disease. The "Inner Canon" states: "Qi is yang, blood is yin." Therefore, qi deficiency and blood deficiency mutually reinforce each other, causing the disease to progress rapidly, eventually leading to yin deficiency with internal heat and blood heat running rampant; qi deficiency also impairs the ability to control bleeding. In the formation of this series of pathogenic mechanisms, qi deficiency, which appears earliest, is an extremely important factor. Traditional Chinese medicine focuses on tonifying qi to address the root cause. The five prescriptions formulated all primarily aim to tonify qi, using large doses of ginseng roots, American ginseng, Prince's ginseng, astragalus, and other qi-tonifying herbs to achieve this goal. What exactly is qi? From the perspective of modern medicine, it can be regarded as the general concept encompassing all normal physiological functions and disease-resistance capabilities of the body. The "Inner Canon" says: "Where evil gathers, qi must be deficient," and "When righteous qi resides within, evil cannot invade." It can thus be considered that by fully tonifying qi, the body's own disease-resistance mechanisms are thoroughly mobilized, and the hematopoietic system is improved—this is the main factor in curing this disease. In addition, while tonifying qi, it is also necessary to nourish yin. In traditional Chinese medicine, nourishing yin involves increasing blood moisture and nutrients, which are prerequisites for maintaining normal bodily functions. Only by combining qi-tonifying with yin-nourishing can the effects be maximized and remarkable results achieved.

Among the five prescriptions formulated, all include ingredients similar to Liuwei Dihuang Tang. According to historical records, Liuwei Dihuang Tang was specifically designed by Qian Yi during the Five Dynasties period to tonify yin, with the effect of "strengthening the master of water to treat excess yang." The so-called "master of water" mainly refers to tonifying kidney yin. Since "the kidneys govern bones, and bones store marrow," whether Liuwei Dihuang Tang, by tonifying kidney yin, can also benefit bone marrow hematopoiesis is a question worthy of further study. The five prescriptions also contain ingredients such as ophiopogon, wheat winter, and schisandra, which were originally part of Shengmai San formulated by Sun Simiao during the Tang Dynasty to tonify qi. For this disease, these ingredients can help ginseng-based formulas tonify qi and also assist Liuwei Dihuang Tang in nourishing yin, thereby making the combined effects of qi-tonifying and yin-nourishing even more focused. Prescription No. 1 adds "white tiger" to clear heat and rhino horn to cool blood; Prescription No. 2 adds artemisia and turtle shell to eliminate residual heat and bone-steaming; and Prescription No. 5 uses ma huang and guizhi to release exterior pathogens and dispel cold. These are all appropriate symptomatic treatments.

Prescriptions: ① Prescription No. 1: Gypsum 30g, Anemarrhena 12g, Japonica rice 9g, Licorice 9g, Ginseng roots 15g, Charcoal 15g, North sand ginseng 30g, Lu ginseng 30g, Rhinoceros horn 9g, Radix rehmanniae 15g, Rehmannia 30g, Moutan bark 9g, Chinese yam 15g, Cornus fruit 30g, Dragon bone 15g, Oyster shell 15g, Schisandra 3g, Floating wheat 30g.

② Prescription No. 2: Artemisia 15g, Turtle shell 15g, Anemarrhena 15g, Stir-fried Bupleurum with turtle blood 15g, Ginseng roots 15g, Charcoal 15g, North sand ginseng 30g, Lu ginseng 30g, Rhinoceros horn 9g, Rehmannia 30g, White peony 30g, Moutan bark 9g, Chinese yam 15g, Cornus fruit 30g, Dragon bone 15g, Oyster shell 15g, Schisandra 3g, Floating wheat 30g.

③ Prescription No. 3: Ginseng roots 15g, North sand ginseng 30g, Lu ginseng 30g, Chinese yam 15g, White peony 15g, Grass 9g, Ophiopogon 9g, Rehmannia 30g, Dragon bone 9g, Oyster shell 30g, Schisandra 3g, Sour jujube seed 9g, Cornus fruit 30g, Floating wheat 30g, Ten dates.

④ Prescription No. 4: Tai ginseng 90g, Prince's ginseng 90g, North sand ginseng 90g, Radix rehmanniae 90g, Raw and cooked Rehmannia each 15g, Winter melon 90g, White peony 90g, Goji berries 90g, Polygonum multiflorum 90g, Chinese yam 90g, Cornus fruit 90g, Polygonatum 90g, Lily 90g, Angelica sinensis 90g, Heart-removed white lotus seeds 120g, White weeping willow 45g, Atractylodes 90g, Honeyed licorice 90g, Oyster shell 90g, Sour jujube seed 90g, Cypress seed 90g, Red dates 90g, Schisandra 15g, Stir-fried Moutan bark 45g, Roasted yellow angelica 150g. All these herbs are decocted four times to obtain a concentrated broth, to which 15g of donkey-hide gelatin, 15g of turtle shell gelatin, and 15g of soft-shelled turtle gelatin are added, along with 2000g of brown sugar. After dissolving everything, the mixture is taken with plain warm water, 5 qian per dose.

⑤ Prescription No. 5: Ephedra 9g, Cinnamon twig 9g, Apricot kernel 9g, Licorice 6g, Scutellaria 9g, Lycium cortex 9g, Mulberry bark 9g, Ginseng roots 15g, North sand ginseng 15g, Lu ginseng 15g, Chinese yam 15g, White peony 15g, Honeyed licorice 9g, Rehmannia 30g, Cornus fruit 30g, Rhinoceros horn 9g, Moutan bark 15g.

Note: The diagnosis of this patient was made with the assistance of Professor Zhang Aicheng from Lanzhou Medical College, and three bone marrow smears were all reported by the college. We hereby express our gratitude. Regarding the differential diagnosis of this patient, the hospital’s hematology department has previously published a special report (see “Compilation of Leukemia Data” compiled by the First Affiliated Hospital of Lanzhou Medical College, internal materials, pp. 11–19).

Explanation: According to a letter sent in July 1978, the patient is still healthy and working as a technician at the Jiuquan Agricultural and Pastoral Bureau.

Editor’s note: This patient was interviewed again in 2002 and is still alive and well, now over sixty years old with many grandchildren.

(“Shaanxi New Journal of Medicine,” September 1979)

Clinical Experience in Treating Chronic Pancreatitis

Pei Zhengxue

I. Case Examples

[Case 1] Patient Wang ××, female, 48 years old, cadre. In August 1978, she suddenly experienced severe upper abdominal pain, described as knife-like, tossing and turning in bed, screaming in agony. Intramuscular injection of atropine at the local health center was ineffective. A hospital examination revealed a blood amylase level of 1250 units (Somogyi method) and a urine amylase level of 645 units (Winslow method), confirming acute pancreatitis. After more than a month of hospitalization and treatment with anti-inflammatory, antispasmodic, and supportive therapies, the pain subsided and she was discharged. Over the past two years, the patient has frequently experienced vague distending pain in the left upper abdomen, radiating to the left chest, left shoulder, and lower back, with fluctuating intensity and recurrent episodes. She has been losing weight day by day, with generalized abdominal distension and loose stools, 3–4 times daily. Despite extensive treatment with both traditional Chinese and Western medicines, no significant improvement has been observed. Body temperature is 36.7°C, pulse rate is 72 beats per minute, blood pressure is 16.0/10.7 kPa (120/80 mmHg). Facial complexion is sallow, sclera shows no jaundice, upper abdomen is distended, tender to palpation, with mild tenderness in the left upper quadrant. The liver is 1 cm below the xiphoid process, soft in texture, and Murphy's sign is negative. Skin, facial features, heart, and lungs are all normal. White blood cell count is 7600/mm³, with neutrophils accounting for 72% and lymphocytes 28%; blood amylase is 32 units, urine amylase is 64 units. Fecal fat droplets are present (+), blood glucose is 125 mg%, urine glucose is negative, and the glucose tolerance curve is elevated. Western medical diagnosis: chronic pancreatitis.

Traditional Chinese medicine diagnosis: pulse is wiry, fine, and rapid; tongue is pale, with thin, yellow, greasy coating; chest and epigastric region are distended and painful; appetite is poor, stools are loose; facial complexion is sallow; mouth is bitter and throat is dry. The pattern is liver qi stagnation, with liver wood overcoming earth, so the treatment principle should be to soothe the liver and regulate qi, strengthen the spleen and tonify qi. Prescription: Bupleurum 10g, White peony 10g, Citrus aurantium 10g, Licorice 6g, Chuanxiong 6g, Cyperus rotundus 6g, Atractylodes macrocephala 10g, Poria cocos 12g, Salvia miltiorrhiza 10g, Agarwood 3g, Cardamom 3g, Amomum villosum 15g, Red vine 30g, Houttuynia cordata 20g, Aconite 6g, Dried ginger 6g, Corydalis yanhusuo 6g, Platycodon grandiflorus 6g, all decocted in water, one dose per day.

After taking 20 doses of the above prescription, the patient’s general condition improved, chest and epigastric pain lessened, stools became formed, appetite increased, and the tongue coating turned paler. The original formula was then adjusted by removing Corydalis yanhusuo, Platycodon grandiflorus, Aconite, Dried ginger, Amomum villosum, and Red vine, adding Party ginseng 10g, Pinellia ternata 6g, Citrus peel 6g, roasted Sanxian 6g each, Chicken gizzard 6g, Radish seed 10g, and another 10 doses were taken. All symptoms completely resolved, and stool microscopy showed normal results.

[Case 2] Xu ××, male, 40 years old. Nine years ago, he was diagnosed with acute cholecystitis complicated by gallstones due to severe right flank pain at a certain hospital. After surgical removal of the gallbladder, the pain subsided and he was discharged. One year ago, he again experienced severe upper abdominal pain, and was admitted to ×× Hospital with a diagnosis of acute pancreatitis. At that time, blood amylase was 1250 units, and urine amylase was 560 units. After treatment with anti-inflammatory, antispasmodic, and supportive therapies, his condition improved and he was discharged. In the past six months, the patient has developed persistent pain in the left upper abdomen, recurring and worsening, especially after heavy meals or consumption of greasy foods. The pain radiates to the left chest, left waist, and lower abdomen, accompanied by severe abdominal distension. Stools alternate between dry and loose, and despite extensive treatment with Western medicines, no improvement has been seen, so he came to our hospital for treatment. Body temperature is 36.7°C, pulse rate is 80 beats per minute, blood pressure is 13.3/8.0 kPa (100/60 mmHg). Facial complexion is sallow, sclera shows mild jaundice, upper abdomen is distended, and palpation reveals a 10 cm × 3 cm transverse mass with obvious tenderness. Liver, spleen, heart, and lungs all show abnormalities. White blood cell count is 5600/mm³, with neutrophils accounting for 76% and lymphocytes 24%; blood amylase is 16 units, urine amylase is 32 units. Fecal fat droplets are (++), blood glucose is 100 mg%, urine glucose is negative. Western medical diagnosis: chronic pancreatitis.

Traditional Chinese medicine diagnosis: pulse is wiry, slippery, and rapid; tongue is red, with thick, yellow, greasy coating; persistent pain in the left upper quadrant and abdomen; jaundice; abdominal distension; constipation. The pattern is liver qi stagnation turning into fire, with damp-heat combining, leading to blockage of qi and blood circulation, resulting in symptoms such as abdominal distension, constipation, and palpable masses. The treatment principle should be to soothe the liver and regulate qi, clear heat and remove dampness, and activate blood circulation to disperse masses. Prescription: Bupleurum 10g, Citrus aurantium 10g, White peony 15g, Licorice 6g, Chuanxiong 6g, Cyperus rotundus 6g, Corydalis yanhusuo 6g, Pu Huang 6g, Five spirit resin 6g, Rheum palmatum 10g, Glauber's salt 10g, Sanleng 6g, Ezhushi 6g, Amomum villosum 15g, Houttuynia cordata 15g, Red vine 30g, all decocted in water, one dose per day.

After taking five doses, a large amount of dark black stool was passed, and pain in the left upper quadrant and abdominal distension significantly eased. Jaundice disappeared, and the yellow coating on the tongue became thinner. The original formula was then adjusted by removing Glauber's salt and adding Coptis chinensis and Agarwood, followed by another eight doses. After these adjustments, pain in the left upper quadrant disappeared, abdominal distension slightly decreased, stools normalized, and microscopic examination showed no abnormalities. The tongue coating turned thin and slightly yellow, and the pulse became deep, fine, and wiry. The transverse mass in the upper abdomen was no longer palpable. The original formula was then adjusted again by removing Corydalis yanhusuo, Platycodon grandiflorus, Pu Huang, Five spirit resin, Houttuynia cordata, Red vine, and Rheum palmatum, adding Party ginseng and Atractylodes macrocephala each 10g, Poria cocos 12g, Pinellia ternata and Citrus peel each 6g, Cardamom 3g, to improve the overall effect. After taking ten doses, all symptoms completely resolved.

II. Reflections

In both of the above cases, the abdominal pain is located in the left upper quadrant and radiates to the left chest, left flank, and lower back. Combined with abdominal distension and loose stools, the traditional Chinese medicine diagnosis points to liver qi stagnation and spleen deficiency. The author used Bupleurum to soothe the liver and Xiangfu to resolve qi stagnation, while Atractylodes macrocephala and Poria cocos were used to strengthen the spleen and tonify qi, forming the basic prescription. When liver qi stagnates, it turns into fire; when the spleen is deficient, it generates dampness. Dampness and heat combine, resulting in yellow, greasy tongue coating, slippery and rapid pulse, jaundice, and other symptoms. To clear heat and remove dampness, the author used ingredients such as Amomum villosum, Houttuynia cordata, Houttuynia cordata, and Red vine. When damp-heat persists for a long time, it obstructs the flow of qi and blood, either causing obstruction of organ qi or leading to accumulation of masses. To unblock organ qi, the author used Rheum palmatum and Glauber's salt; to break up masses, the author used Sanleng, Ezhushi, Shixiaosan, and milk resin.

(“Journal of Traditional Chinese Medicine,” February 1983)

Clinical Application of Yueju Wan: A Successful Experience

Pei Zhengxue

Yueju Wan originates from “Danxi Xinfa” and consists of Xiangfu, Chuanxiong, Shan Zhi, Cangzhu, and Shenqu, 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.

I. Chest Distress Case

Li ××, male, 56 years old, first visit on June 20, 1982. For the past three years, the patient has experienced chest tightness and occasional angina pectoris, accompanied by palpitations, shortness of breath, cough, and back pain. Pulse is wiry and rapid, tongue is plump and pale, with scattered ecchymoses and yellow, greasy coating. ECG shows insufficient coronary artery blood supply, and Western medical diagnosis is coronary heart disease. Diagnosis: qi and blood are blocked in the chest, preventing the chest yang from being released; over time, this leads to dampness and heat, resulting in chest distress. Treatment principle: promote qi circulation, activate blood, remove dampness, and clear heat. Prescription: Yueju Wan with the following ingredients: Xiangfu 6g, Chuanxiong 10g, Cangzhu 6g, Shan Zhi 10g, Shenqu 10g, Red peony 10g, Salvia miltiorrhiza 20g, take 10 doses. Follow-up visit: chest tightness greatly reduced, no angina attacks, tongue coating thinned. The original formula was then adjusted by removing Red peony and adding 3g of fragrant incense, followed by another 30 doses, and all symptoms completely resolved.

II. Flank Pain Case

Zhao ××, female, 42 years old, first visit on April 2, 1983. The patient is obese and has experienced intermittent, worsening pain in the right flank for the past two years, radiating to the right chest, shoulder, and back. Accompanied by bitter taste in the mouth, dry throat, nausea, vomiting, abdominal distension, increased flatulence, loss of appetite, aversion to fatty foods, left pulse is wiry and slippery, especially at Guan position; right pulse is deep, wiry, and thin, tongue is red with yellow, slightly greasy coating. Body temperature is 37°C, sclera shows no jaundice, gallbladder imaging shows poor gallbladder contractility, and B-mode ultrasound indicates chronic cholecystitis. Diagnosis: liver qi stagnation, which turns into fire, leading to disharmony between liver and stomach; over time, dampness accumulates, resulting in flank pain and fullness. Treatment principle: promote qi circulation, activate blood, remove dampness, clear heat, harmonize stomach and reverse reflux. Prescription: Yueju Wan with additional ingredients: Xiangfu 6g, Chuanxiong 6g, Shan Zhi 10g, Cangzhu 6g, Shenqu 10g, Bupleurum 10g, Agarwood 3g, Ginger 6g, take 9 doses.

Follow-up visit: flank pain, abdominal distension, and nausea/vomiting all alleviated, appetite increased. The original formula was then adjusted by removing Ginger, Shenqu, and Cangzhu, adding White peony 15g, followed by another 9 doses. Subsequent follow-up: except for occasional mild pain in the right flank, all symptoms have completely resolved. The original formula was then increased tenfold, ground into fine powder, taken twice daily, 5g each time, mixed with warm water. After finishing one batch, all symptoms disappeared and the patient recovered.

III. Headache Case

Ju ××, female, 19 years old, first visit on October 21, 1979. The patient has experienced episodic right-sided headaches for over a year, accompanied by palpitations, irritability, nausea, vomiting, restlessness, dry stools, yellow urine, scanty and dark menstrual flow, and absence of abdominal pain. Pulse is wiry, rapid, and slippery, tongue is thick, yellow, and greasy. Western medical diagnosis is vascular neural headache. Diagnosis: qi and blood have been stagnant for a long time, turning into heat; heat combined with dampness causes headache. Treatment principle: promote qi circulation, activate blood, clear heat, and remove dampness. Prescription: Yueju Wan with additional ingredients: Xiangfu 6g, Chuanxiong 6g, Shan Zhi 12g, Cangzhu 6g, Shenqu 10g, Coptis chinensis 3g, Rheum palmatum 10g, White peony 3g, Asarum 3g, take 6 doses. Follow-up

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Diagnosis: Headache alleviated, tongue coating thinned, loose stools three times daily. The dosage of rhubarb in the previous formula was reduced to 6 grams, and the treatment continued.

Ten doses were administered, and all symptoms completely resolved.

IV. Case of Dysmenorrhea

Lu XX, female, 28 years old, first visit on August 4, 1976. Over the past three years, the patient has experienced abdominal pain during menstruation, with scanty dark-colored flow containing blood clots, accompanied by low back pain, bitter taste in the mouth, dry throat, irritability, heat in the palms and soles, red tongue with slightly yellow greasy coating, and wiry, slippery, rapid pulse. Syndrome differentiation: emotional stagnation, disharmony of Chong and Ren channels, blood stasis, prolonged stasis transforming into heat and dampness, leading to dysmenorrhea. Treatment principle: regulate qi and activate blood, clear heat and eliminate dampness. Prescription: Yueju Pill with modifications: Xiangfu 6 g, Chuanxiong 6 g, Shan Zhi 10 g, Cangzhu 6 g, Shenqu 6 g, Danpi 6 g, Taoren 10 g. Five doses were taken. Follow-up visit: Menstruation was approaching, dysmenorrhea significantly alleviated, menstrual flow increased compared with before. The original formula was supplemented with Yimucao 20 g, and another 20 doses were taken. Subsequent visit: Menstrual flow increased, color turned red, dysmenorrhea disappeared, only mild discomfort in the lower abdomen remained. It was advised to take five doses of the original formula once daily for one week before each menstruation, for a total of three months, after which all symptoms completely resolved.

V. Reflections

This formula primarily treats the "Six Stagnations": when stagnation occurs, circulation is blocked; when circulation is blocked, pain arises. All the above clinical cases have pain as the main symptom. Prolonged stagnation transforms into heat, and prolonged stasis generates dampness. The presence of both heat and dampness is an important diagnostic indicator for this formula. For stagnation leaning toward qi, emphasize regulating qi; for stagnation leaning toward blood, emphasize activating blood; for excessive heat, strengthen purging fire; for excessive dampness, add herbs to dispel dampness. In all cases of pain, this formula can be adjusted and modified accordingly.

(“Chinese Medicine Journal,” July 1984)

Clinical Experience with “Blood-Activating No. II” by Pei Zhengxue

“Blood-Activating No. II” is a specialized prescription for treating coronary heart disease formulated by the Beijing Collaborative Group, composed of ingredients such as Red Peony Root, Chuanxiong, Safflower, Agarwood, and Salvia Miltiorrhiza. In recent years, in addition to using this formula to treat coronary heart disease and cerebrovascular diseases, the author has also used it to treat atrophic gastritis and scleroderma, achieving satisfactory results.

I. Atrophic Gastritis

Zhang XX, male, 47 years old, cadre, first visit on April 20, 1979. The patient had experienced burning pain in the epigastric region for two years, radiating to the back, accompanied by chest tightness and abdominal distension. He was hospitalized successively at the county hospital and provincial hospital, where he was diagnosed with atrophic gastritis. Despite Western medical treatment, no significant improvement was observed. Physical examination: body temperature 36°C, pulse 70 beats/min, blood pressure 16.0/9.3 kPa (120/70 mmHg). The patient’s development was moderate, with poor nutrition, sallow complexion, normal cardiac border on percussion, grade II systolic murmur heard at the apex, obvious tenderness in the upper abdomen, no palpable liver or spleen, and no abnormalities in the limbs. Hemoglobin 9.8 g%, red blood cells 3.6 million/mm³, white blood cells 11,000/mm³. Gastroscopy confirmed the diagnosis of atrophic gastritis. Traditional Chinese medicine syndrome differentiation: the patient had burning pain in the stomach, worsening upon palpation, localized and fixed, pale red tongue with scattered ecchymoses, yellow greasy coating, wiry pulse—indicating qi stagnation and blood stasis, with prolonged stagnation transforming into heat. The prescription was “Blood-Activating No. II” with modifications. Prescription: Red Peony Root 15 g, Chuanxiong 6 g, Safflower 3 g, Agarwood 6 g, Salvia Miltiorrhiza 10 g, Amomum 3 g, Coptis 3 g. After five doses, the stomach pain greatly subsided, and appetite improved. The original formula was then adjusted by removing Red Peony Root and adding White Peony Root 15 g and Licorice 6 g, followed by another 20 doses, after which all symptoms completely resolved. In June 1982, due to poor diet, the previous symptoms recurred, but were again treated with “Blood-Activating No. II” with modifications. After taking more than 40 doses, the condition improved again. In March 1983, a follow-up visit revealed that apart from occasional minor pain, the patient’s stomach no longer experienced severe attacks as before. A gastroscopic examination in March 1984 showed no obvious lesions.

II. Scleroderma

Wang X, female, 52 years old, first visit on May 20, 1980. Six months earlier, the patient began experiencing itching and mild pain in the skin of the face, anterior chest, and back, followed by local coldness, loss of wrinkles, waxy sheen on the skin surface, and gradually hardening of the skin. She was diagnosed at a certain hospital with diffuse scleroderma and underwent ultraviolet irradiation, novocaine intravenous blockade, and hormone therapy, but none of these treatments were effective. Physical examination: body temperature 36.8°C, pulse 72 beats/min, blood pressure 16.0/10.0 kPa (120/75 mmHg). The patient’s development was moderate, with poor nutrition. The skin of the face, anterior chest, back, and dorsal side of the upper limbs appeared pale, with lost wrinkles and waxy sheen; palpation revealed a bone-like hardness. Breathing movements of both lungs were symmetrical and uniform, breath sounds rough, with no rales heard. Cardiac border on percussion was small, and a grade II systolic blowing murmur was audible at the apex. Abdominal wall reflexes were present, and knee-jerk reflex could be elicited. Hemoglobin 14 g%, red blood cells 4.8 million/mm³, white blood cells 6,600/mm³, neutrophils 79%, lymphocytes 18%, eosinophils 2%, monocytes 1%, erythrocyte sedimentation rate 11 mm/h. Western medical diagnosis: scleroderma. Traditional Chinese medicine syndrome differentiation: red tongue with patchy ecchymoses, wiry pulse. Considering the hardening of the skin, this case should be classified as blood stasis. Treatment principle: activate blood and resolve stasis. Prescription: Red Peony Root 10 g, Chuanxiong 6 g, Safflower 6 g, Agarwood 10 g, Salvia Miltiorrhiza 10 g, Curculigo 6 g, Epimedium 6 g, Astragalus 30 g. After 21 doses, the skin color turned red, local touch became softer, and the patient felt less discomfort in the affected areas. The original formula was then supplemented with Guizhi 10 g for long-term use. On June 4, 1982, the patient reported that after taking over 100 doses of the above medication, her symptoms gradually improved. Examination of the face, anterior chest, etc., showed that the skin’s color, texture, and elasticity were no longer significantly different from those of ordinary people. It was recommended to continue taking “Blood-Activating No. II” with modifications (same dosage as before) in powder form, twice daily, 3 g each time, for long-term maintenance. In March 1984, a follow-up visit revealed that the skin had returned to normal.

(“Journal of Integrated Chinese and Western Medicine,” April 1985)

Selected Clinical Formulas Using Winter Medicines

Yu Ying’ao and Pei Zhengxue

Both Asparagus cochinchinensis and Ophiopogon japonicus are commonly used in clinical practice. Asparagus cochinchinensis is sweet and cool, non-toxic, and enters the Lung and Kidney meridians. Its main functions are to nourish kidney yin and moisten lung dryness. It is suitable for conditions such as lung and kidney deficiency with internal heat, essence deficiency, pulmonary fistula, pulmonary abscess, asthma, tuberculosis, yin deficiency with phlegm-heat, and diabetes. Ophiopogon japonicus is sweet and slightly cool, entering the Heart, Lung, and Stomach meridians. Its functions include nourishing yin and clearing heat, moistening and clearing the lungs, eliminating phlegm and relieving cough, restoring pulse and generating fluids, as well as clearing heart and relieving vexation. It is mainly used for lung heat or warm diseases with fluid deficiency, yin deficiency with thirst, weakness-related cough, thick phlegm, throat discomfort, blood disorders, night sweats, and diabetes. Clinically, there are many formulas that either use Asparagus cochinchinensis or Ophiopogon japonicus as the main ingredient, or incorporate both winter medicines as key components. Below, we will introduce formulas featuring Asparagus cochinchinensis, Ophiopogon japonicus, and combinations of the two.

I. Formulas Featuring Asparagus Cochinchinensis