3. Discussions in “Yi Lin Gai Cuo”

The diseases treated by “Xue Fu Zhu Yu Tang” are listed below:

Headache: No exterior symptoms, no interior symptoms, no qi deficiency or phlegm-dampness, fluctuating symptoms, ineffective with all treatments—this formula cures it after one dose.

Chest pain: Sudden chest pain, previous treatments all ineffective—this formula relieves the pain immediately after one dose.

Unable to bear weight on the chest: Governor Alin of Jiangxi Province, aged 74, could sleep with his chest exposed at night, but couldn’t sleep if covered with a cloth—after using this formula, he recovered after three doses.

Unable to bear heavy objects on the chest: A 22-year-old woman had been sleeping with a maid pressing down on her chest for two years—after using this formula, she recovered after three doses.

Heart heat: Feeling cold outside but hot inside, hence the name “lamp dragon disease,” with blood stasis inside. It is believed that the more you supplement for virtual heat, the more stasis accumulates; the pulse is full and large, the colder it gets, the more it凝, so this formula clears the heat with three doses.

Dullness: Unable to handle small tasks—this is blood stasis, three doses cure it.

Irritability: Usually calm, but becomes irritable when sick—this is blood stasis, one or two doses will definitely help.

Excessive dreaming at night: This is blood stasis, one or two doses cure it.

Racing heartbeat: Using Gui Pi An Shen and other methods doesn’t work—this formula works every time.

Restless at night: Those who can’t sleep at night get up, sit down and want to sleep again, spending the whole night restless, some even rolling around in bed—this is blood stasis in the heart, taking this formula plus a few additional doses can completely eliminate it.

Occasional bursts of heat at night: Every night there is a burst of heat, sometimes accompanied by temporary skin heat—this formula cures it after one dose, two doses for severe cases.

Part Two: Passing on the Teachings

This section contains 33 articles, all written by the author’s students and clinicians from various regions based on their experiences applying the author’s teachings. All articles have been published in domestic medical journals, with two coming from Taiwanese medical magazines.

Professor Pei Zhengxue’s Experience in Treating Malignant Tumors by Strengthening the Body and Consolidating the Foundation

Xue Wenhan, Li Min, Wang Nanyao

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 and served as the deputy director of the Gansu Provincial Academy of Medical Sciences. Currently, he is a board member of the Chinese Society of Integrated Traditional Chinese and Western Medicine, an editorial board member of the “Chinese Journal of Integrated Traditional Chinese and Western Medicine,” and a member of the Gansu Provincial Committee of the Chinese People’s Political Consultative Conference. His major works include “Commentary on Blood Syndrome,” “New Compilation of Warm Disease Studies,” “Pharmacology and Clinical Application of Rhubarb,” and “Diagnosis and Treatment of Hepatitis B.” The first contemporary monumental work on integrated internal medicine authored by Professor Pei Zhengxue—“Integrated Internal Medicine”—received the “International Gold Award for Outstanding Contribution” at the Third World Congress of Traditional Medicine held in the United States in April 1996. Professor Pei Zhengxue was also honored as one of the “World’s Top 100 Stars of Ethnic Medicine,” and in 1997, the State Administration of Traditional Chinese Medicine recognized him as one of the 500 most famous senior TCM doctors nationwide.

Professor Pei Zhengxue has always emphasized the importance of strengthening the body and consolidating the foundation in cancer treatment. The author was fortunate enough to study under him and has summarized his experience as follows:

I. Deficiency of Vital Energy Is the Fundamental Cause of Malignant Tumor Occurrence and Development

Based on the principle in “Medical Essentials Read” that “accumulation arises when vital energy is insufficient, allowing pathogenic factors to take hold,” Professor Pei pointed out that deficiency of vital energy is the fundamental cause of malignant tumor occurrence and development. The essence of deficiency of vital energy lies in the dysfunction of organ qi and blood functions and the decline of the body’s own immune function. Pathogenic factors, however, not only refer to the six evils, epidemic toxins, dietary and labor injuries, but also include pathological changes arising from deficiency of vital energy, such as phlegm accumulation, dampness retention, qi obstruction, blood stasis, and heat stagnation. Cancer can only develop when the body’s yin-yang balance is disrupted and vital energy is deficient—this is the so-called “where pathogenic factors gather, vital energy must be deficient.” Conversely, cancer cells and the infections, bleeding, and obstruction they cause further affect organ qi and blood functions, making vital energy even more deficient and creating a vicious cycle. This is precisely why malignant tumors are difficult to treat and prone to recurrence. Clinically, many cancer patients present with tangible symptoms such as mass formation, fever, abdominal distension, hematemesis, and coughing, but these are merely clinical manifestations of “extreme deficiency with apparent excess.” Deficiency of vital energy remains the primary contradiction. If one blindly uses blood-breaking and mass-dispersing, bitter-cold purgatives, or heat-clearing and fire-draining methods at this stage, not only will the root problem not be solved, but vital energy will also be damaged, making the condition worse.

II. Strengthening the Body and Consolidating the Foundation Is the Basic Principle for Treating Malignant Tumors

Professor Pei believes that deficiency of vital energy encompasses both the depletion of yin-yang qi and blood, as well as organ deficiency, and that these two aspects are interconnected and inseparable. The spleen and kidneys are the dominant links in the evolution of deficiency of vital energy: the former is the postnatal foundation, the sea of food and water, capable of transforming food and water into qi and blood to nourish the organs; the latter is the innate foundation, the source of essence and blood, storing true yin and containing original yang, serving as the root of yin-yang in the organs. Therefore, strengthening the spleen and replenishing

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The kidney is the primary principle for reinforcing vital energy. In clinical practice, gastric cancer fundamentally stems from weakness of the spleen and stomach. Clinically, it is further divided into two major categories: qi deficiency and yin deficiency. The former presents with symptoms such as fullness and distension in the epigastric region, poor appetite, loose stools, and a pale tongue with thin white coating; the treatment involves modifying Xiangsha Liujunzi Decoction. The latter manifests as discomfort in the epigastric region, dry mouth and bitter taste, and a red tongue without coating; the treatment entails adapting Yeshi Yangwei Decoction. Hepatic cancer, on the other hand, typically presents with pain in the hepatic region, poor appetite and fatigue, jaundice, abdominal distension, and loose stools—indicating liver-qi stagnation and the overacting of liver wood on earth. In such cases, Xiaoyao San, Chaishao Liujunzi Decoction, or modified Xiangsha Liujunzi Decoction are employed. Esophageal cancer, however, often shows signs of emaciation, difficulty swallowing, a red tongue with scant coating, indicating liver-kidney yin deficiency; thus, Liuwei Dihuang Decoction combined with Astragalus, Angelica, and Salvia is used. Leukemia presents with dizziness, fatigue, pallor, fever, or epistaxis, reflecting qi and yin deficiency; therefore, Liuwei Dihuang Decoction combined with Shenmai Powder is prescribed.

III. "Treat the symptoms when urgent" is a necessary approach in treating malignant tumors

Malignant tumors all have underlying deficiency of vital energy as their root cause; however, in certain situations, excess pathogenic factors can also become the dominant contradiction. According to Mr. Pei, in such cases, treatment should follow the principle of "treat the symptoms when urgent, treat the root cause when less urgent." The lung belongs to metal and is easily overcome by fire; hence, most lung cancers present with excess heat. Clinically, this manifests as coughing, wheezing, phlegm production, and even hemoptysis. For the former, modified Xingsu Powder is commonly used; for the latter, cuttlefish bone, Houttuynia cordata, Panax notoginseng, hematite, Zhejiang Fritillaria, Anemarrhena asphodeloides, Adenophora stricta, Ophiopogon japonicus, and Schisandra chinensis are employed. However, "metal generates wood" and "earth generates metal," so renal water deficiency and spleen-stomach dysfunction are common complications of lung cancer. Renal water deficiency manifests as a red tongue with scant coating, lower back pain, leg fatigue, and inability of the kidneys to contain qi; spleen-stomach dysfunction presents as sallow complexion, abdominal distension, and excessive phlegm. Therefore, in treating lung cancer, methods that tonify the kidneys to contain qi or strengthen the spleen to transform phlegm are often utilized, such as Maiwei Dihuang Decoction or modified Xiangsha Liujunzi Decoction. For gastric cancer patients whose pain is a mixture of cold and heat, Wumei Pill combined with Curcuma, Salvia, White Peony, Magnolia Bark, and Coix Seed is used; for those with blood stasis obstructing the channels, Sanleng, Ezhushi, Evodia rutaecarpa, Wu Yao, Puhuang, Zhishi, Salvia, and processed Myrrh are prescribed. Once the pain subsides, Xiangsha Liujunzi Decoction is immediately switched to treat the root cause. For liver cancer patients experiencing pain in the hepatic region due to qi stagnation and blood stasis, Si Ni San combined with Sanleng, Ezhushi, Yuanhu, and Chuanlianzǐ is used; jaundice is often due to damp-heat, treated with Yinchenhao Decoction combined with Wuwei Disinfecting Drink plus Qinjiao and Banlangen; abdominal distension and ascites are caused by yang deficiency leading to water overflow, treated with Wuling San plus Dapipi and Hanfangji. Liver cancer develops rapidly and easily presents with symptoms like pain, jaundice, and abdominal distension—manifestations of excess pathogenic factors. Yet, while "treating the symptoms when urgent," one must not forget to support vital energy. Thus, regardless of the situation, Mr. Pei always uses 30 grams of Salvia and 30 grams of Astragalus in treating liver cancer.

IV. Combining traditional Chinese medicine for reinforcing vital energy with Western radiotherapy and chemotherapy embodies the philosophy of reinforcing vital energy while eliminating pathogenic factors

Mr. Pei believes that although Western radiotherapy and chemotherapy cannot completely eradicate malignant tumors, they directly kill or inhibit cancer cells, offering advantages unmatched by traditional Chinese medicine in addressing the causes of cancer. The purpose of using traditional Chinese medicine to reinforce vital energy is to reduce the side effects of radiotherapy and chemotherapy, thereby enhancing their efficacy. Consequently, combining traditional Chinese medicine for reinforcing vital energy with Western radiotherapy and chemotherapy creates a complementary approach that has proven effective in modern internal medicine for treating malignant tumors. Typically, the dosage, efficacy, and side effects of radiotherapy and chemotherapy are positively correlated. Chemotherapy often fails because severe side effects prevent patients from receiving the maximum dose. These side effects mainly include bone marrow suppression, weakened immunity, and gastrointestinal reactions, which frequently lead to infections—a common cause of death among cancer patients. While Western medicine can temporarily alleviate these issues through blood transfusions, recent applications of immunostimulants have somewhat improved the body's immune status. Experimental studies have shown that traditional Chinese medicine for reinforcing vital energy and strengthening the spleen improves the body's hematopoietic system, immune system, autonomic nervous system, and endocrine system, fundamentally enhancing the body's overall responsiveness. Among them, tonifying the kidneys focuses on improving the specific immune system, hematopoietic system, and endocrine system, whereas strengthening the spleen emphasizes the non-specific immune system and autonomic nervous system. Clinically, Mr. Pei has formulated a traditional Chinese medicine prescription called the "Lanzhou Formula" for patients undergoing radiotherapy and chemotherapy. This formula was named the "Lanzhou Formula" at the Suzhou Conference on Hematological Diseases in 1974 after successfully curing a case of leukemia. It consists of Liuwei Dihuang Decoction combined with Shenmai Powder, supplemented with Prince Ginseng, Northern Ginseng, and Codonopsis, integrating kidney-tonifying and spleen-strengthening effects. Clinical application has indeed enabled radiotherapy and chemotherapy to achieve maximum therapeutic effect. At this point, radiotherapy and chemotherapy should be viewed as a means of eliminating pathogenic factors under the guidance of the traditional Chinese medicine philosophy of reinforcing vital energy and eliminating pathogenic factors, holding profound clinical significance.

(“Research on Traditional Chinese Medicine,” August 1999)

Professor Pei Zhengxue’s Treatment

Case Analysis of Nutritional Megaloblastic Anemia

Li Wenfu and Xue Wenhan

Pei Zhengxue, male, born in 1938. Graduated from Xi’an Medical University in 1961, professor and chief physician, a renowned expert in integrated traditional Chinese and Western medicine in China, recipient of the State Council Special Allowance. His major works include “Commentary on Blood Disorders,” “Selection of Rhubarb,” “New Compilation of Warm Disease Studies,” and “Practical Internal Medicine of Integrated Traditional Chinese and Western Medicine.” The first contemporary monumental work on integrated internal medicine he edited, “Practical Internal Medicine of Integrated Traditional Chinese and Western Medicine,” won the “International Gold Award for Outstanding Contribution” at the Third World Congress of Traditional Medicine held in the United States in April 1996 and was also honored as one of the “Top 100 Stars of National Medicine Worldwide.”

In 1997, the State Administration of Traditional Chinese Medicine recognized Professor Pei Zhengxue as one of the 500 most famous senior traditional Chinese physicians nationwide. His proposed “Sixteen-Character Guiding Principle” for integrated traditional Chinese and Western medicine has become an important school of thought in the field of modern Chinese medicine and exerts considerable influence across the national community of traditional Chinese and Western medicine. Nutritional megablastic anemia is a type of macrocytic anemia caused by deficiencies in folic acid and vitamin B12, leading to disturbances in deoxyribonucleic acid metabolism. Clinically, patients often experience dizziness, fatigue, palpitations and shortness of breath after exertion, with decreased hemoglobin and red blood cell counts; some may also exhibit hematologic manifestations such as leukopenia and thrombocytopenia, as well as digestive symptoms like abdominal distension, diarrhea, epigastric discomfort or poor appetite, constipation, bitter taste in the mouth, and oral ulcers. Western medicine often treats this condition by supplementing vitamin B12 or folic acid, but such treatments rarely achieve a complete cure.

Mr. Pei believes that this disease arises from impaired function of the spleen and stomach. He often says, “The spleen and stomach are the great source of qi and blood production and also the foundation of postnatal life.” This refers to the crucial role that the spleen and stomach play in nutrient absorption and the formation of blood components. The spleen is responsible for transformation and transportation, promoting upward movement and favoring dryness while disliking dampness; the stomach is responsible for reception and downward movement, favoring moisture while disliking dryness. Under normal physiological conditions, the spleen and stomach work in tandem—one rising, one falling, one dry, one moist—to maintain balance in the body’s digestion and absorption functions. Therefore, when the function of the spleen and stomach is disrupted and there is no source for qi and blood production, nutritional megablastic anemia is likely to occur. Consequently, Mr. Pei believes that treating nutritional megablastic anemia should begin with regulating and tonifying the spleen and stomach, which combines syndrome differentiation with disease identification and yields satisfactory results in clinical practice. There are two representative formulas: one is Xiangsha Liujunzi Decoction, and the other is Banxia Xiexin Decoction. The former strengthens the spleen and transforms dampness, treating symptoms such as fullness, poor appetite, fatigue, vomiting and diarrhea, and a pale tongue with thin white coating, along with a deep, fine pulse—equivalent to chronic gastritis in modern medicine. The latter harmonizes the stomach and descends rebellious qi, suitable for epigastric discomfort caused by disharmony between middle-jiao qi and cold-heat, resulting in a feeling of fullness and oppression in the upper abdomen, or vomiting and diarrhea, with a yellow tongue and greasy coating, and a taut, rapid pulse—equivalent to gastritis of the gastric antrum or chronic inflammatory lesions throughout the entire stomach and gastric antrum in modern medicine. In clinical practice, flexibility is required: if dry mouth and scant coating appear, Northern Ginseng, Ophiopogon, Polygonatum, and Dendrobium can be added; if nosebleeds or gum bleeding occur, carbonized Danpi, carbonized Xueyu, carbonized Mentha, and carbonized Palm can be added; for diarrhea, dried ginger and Aconitum can be added, while for constipation, rhubarb and Coptis can be increased. For low platelet counts, Polygonatum, Polygonatum, Rehmannia, and Isatis can be added.

Two case examples are provided below:

[Case 1] Patient Li, female, 60 years old. She has a history of chronic gastritis and recurrent nasal bleeding for two years, worsening over the past three days. After multiple unsuccessful treatments, she sought help from Mr. Pei in August 1999. Initial consultation: patient appeared listless and fatigued, with a sallow complexion, poor appetite, bitter and dry mouth, abdominal distension and constipation, intermittent nasal bleeding, a deep, fine pulse, and a red tongue with scant coating. Laboratory tests showed: RBC 2.01×10^12^/L, MCV 120 fl, PLT 50×10^9^/L, HGB 50 g/L, WBC 2.9×10^9^/L. Bone marrow examination revealed a significant increase in nucleated cells, predominantly megaloblasts. Western medical diagnosis: nutritional megablastic anemia. In addition to administering 500 µg of vitamin B12 intramuscularly once daily and 30 mg of folic acid orally once daily, the focus was on using traditional Chinese medicine to regulate the spleen and stomach. Medication included: Northern Ginseng 15 g, Ophiopogon 10 g, Polygonatum 6 g, Dendrobium 6 g, Salvia 10 g, Agarwood 6 g, Cardamom 3 g, carbonized Mentha 15 g, carbonized Danpi 15 g, carbonized Xueyu 15 g, rhubarb 6 g, Coptis 3 g, decocted twice and taken warm, one dose per day, for a total of 10 doses. Second consultation: after taking the above formula for 10 doses, nasal bleeding significantly decreased, bowel movements became smoother, but poor appetite and bitter taste persisted. The formula was adjusted by removing carbonized Mentha and carbonized Danpi, adding Coptis 3 g, Huangqin 10 g, and Jiaosanxian each 6 g, continuing for another 10 doses, while discontinuing vitamin B12 and folic acid, advising the patient to improve nutrition and get adequate rest. Third consultation: after another 10 doses of the original formula, symptoms improved, but mild fatigue, poor appetite, and abdominal distension still remained, with occasional nasal bleeding, a red tongue with thin yellow coating, and a taut pulse. Laboratory tests indicated: RBC 3.03×10^12^/L, MCV 92 fl, PLT 60×10^9^/L, HGB 90 g/L, WBC 3.2×10^9^/L. Treatment continued to focus on strengthening the spleen and harmonizing the stomach, supplemented by soothing the liver. Medication included: Agarwood 3 g, Cardamom 3 g, Northern Ginseng 10 g, Ophiopogon 10 g, Polygonatum 6 g, Bai Zhu 10 g, Fu Ling 12 g, Chai Hu 10 g, White Peony 10 g, Danpi 10 g, Gardenia 10 g, Angelica 10 g, Coptis 3 g, Huangqin 10 g, and decocted twice and taken warm, one dose per day, for a total of 10 doses. Fourth consultation: after another 20 doses, all symptoms disappeared, blood tests and bone marrow examination showed recovery, nasal bleeding was extremely rare, and dietary habits had markedly improved.

[Case 2] Wang, male, 50 years old. He has experienced discomfort in the stomach, postprandial bloating, dizziness, and fatigue for three years, sometimes accompanied by nausea and diarrhea, with a pale tongue and thin white coating, and a taut, fine pulse. Laboratory tests showed: RBC 2.56×10^12^/L, HGB 82 g/L, MCV 98 fl, gastroscopy revealed chronic inflammation of the gastric body. He had previously tried vitamin B12, folic acid, tinidazole, and other Western medicines for half a year without success, so he sought help from Mr. Pei. The patient appeared pale, listless, and emaciated, with a pale tongue and thin white coating, and a slippery pulse. A previous bone marrow examination at another hospital diagnosed him with nutritional megablastic anemia. Diagnosis: ① chronic gastritis; ② nutritional megablastic anemia. Traditional Chinese medicine syndrome differentiation indicated qi deficiency of the spleen and stomach. Treatment aimed to tonify qi and strengthen the spleen, using modified Xiangsha Liujunzi Decoction. Medication included: Agarwood 3 g, Cardamom 3 g, Codonopsis 10 g, Bai Zhu 10 g, Fu Ling 12 g, Licorice 6 g, Pinellia 6 g, Citrus Peel 6 g, Zhishi 10 g, White Peony 10 g, Dragon and Ox Bone 15 g each, Cuttlefish Bone 15 g, Jiaosanxian each 6 g. The formula had the effects of tonifying qi, strengthening the spleen and stomach, promoting qi circulation, transforming dampness, and eliminating phlegm. Decocted twice and taken warm, one dose per day, for a total of 10 doses. Second consultation: after taking the above formula for more than 10 doses, the patient reported significant relief from stomach discomfort and postprandial bloating, but still felt dizzy and fatigued, occasionally had trouble sleeping, with tongue and pulse remaining unchanged. Laboratory tests showed: WBC 2.9×10^9^/L, HGB 86 g/L, MCV 96 fl. Mr. Pei believed that since the spleen produces blood and the heart governs blood, although the patient’s spleen and stomach function had improved, the anemia had not yet been resolved. He therefore adopted a method of treating both the spleen and stomach simultaneously and tonifying qi and blood together, using Guipi Tang with modifications. Medication included: Huangzhi 30 g, Angelica 10 g, Codonopsis 10 g, Bai Zhu 10 g, Fu Ling 12 g, Licorice 6 g, Yuanchi 6 g, fried Ziziphus jujuba 15 g, Agarwood 3 g, Round Meat 10 g, Rehmannia 12 g, He Shou Wu 15 g, Earth Rhubarb 12 g, Ligustrum 12 g, decocted twice and taken warm, one dose per day, for a total of 10 doses. Third consultation: after taking the above formula for more than 10 doses, the symptoms of spleen and stomach qi deficiency and weak transformation function disappeared. The patient’s stomach discomfort further improved, and his diet, spirits, and sleep also improved. Follow-up blood tests showed: RBC 3.4×10^12^/L, HGB 96 g/L, MCV 92 fl. Further adjustments were made based on the above formula, and after taking a total of 40 doses of traditional Chinese medicine, blood tests returned to normal. Fourth consultation: the patient’s condition had remained stable, but five days ago, due to improper diet, he again experienced stomach discomfort, nausea, loose stools four times a day, and poor appetite, so he revisited the clinic, considering it chronic gastritis complicated by acute gastritis, with treatment primarily relying on traditional Chinese medicine. Medication included: Citrus Peel 6 g, Fu Ling 12 g, Forsythia 15 g, Pinellia 6 g, Jiaosanxian each 6 g, Atractylodes 6 g, Coptis 6 g, Agarwood 6 g, decocted twice and taken warm, one dose per day, for a total of 5 doses. Fifth consultation: the patient’s nausea and diarrhea had disappeared, but he still felt stomach discomfort and poor appetite. Follow-up blood tests showed: RBC 3.6×10^12^/L, HGB 100 g/L, MCV 94 fl, so the formula was changed to Xiangsha Liujunzi Decoction combined with Banxia Xiexin Decoction to enhance the effects of harmonizing the stomach and descending rebellious qi, opening blockages, and eliminating fullness. Decocted twice and taken warm, one dose per day, for a total of 10 doses. After another follow-up blood test and bone marrow examination, both returned to normal, and the patient has been followed up for three years without recurrence.

(“Journal of Traditional Chinese Medicine,” April 2001)

Teacher Pei Zhengxue’s Treatment

Experience in Treating Chronic Hepatitis

Li Min and Zhong Xu

Teacher Pei excels in treating liver diseases and has accumulated extensive clinical experience in this field, with unique insights that are summarized below:

I. Emphasizing Soothing the Liver and Strengthening the Spleen

The liver belongs to wood, characterized by its ability to flow freely and its preference for dispersing and releasing. Ancient texts liken the liver’s dispersing and releasing nature to the flourishing vitality of wood, describing it as the liver’s natural state. When liver qi becomes stagnant, liver disease ensues; thus, stagnation is the root cause of liver disease. Stagnant liver qi can then invade the stomach, a phenomenon known as “wood overcoming earth,” meaning liver qi stagnation leads to spleen deficiency. If stagnation persists, it can transform into heat, and spleen deficiency can generate dampness—both of which are common pathological manifestations in liver disease. In treatment, Teacher Pei focuses on the root cause of liver disease, emphasizing the need to soothe the liver and resolve stagnation, a principle that runs throughout the entire course of chronic hepatitis treatment. As stated in “Jin Gui · Visceral Organs and Meridians: Sequential Pathology and Pulse Diagnosis”: “When treating diseases before they manifest, if one sees liver disease and knows it will spread to the spleen, one should first strengthen the spleen. During the four seasons, when the spleen is strong and resistant to pathogenic factors, there is no need to supplement it.” Therefore, while soothing the liver and resolving stagnation, Teacher Pei never neglects the fundamental principle of strengthening the spleen and tonifying qi. Only by simultaneously pursuing both liver-soothing and spleen-strengthening approaches can the two complement each other and produce remarkable therapeutic effects. A commonly used representative formula is Danzhi Xiaoyao San.

II. Employing Microscopic Syndrome Differentiation

Acute hepatitis or acute exacerbations of chronic hepatitis often present with elevated GPT levels, which in traditional Chinese medicine is generally classified as a pattern of damp-heat—an excess and heat manifestation. Symptoms include fever, jaundice, bitter taste, dry mouth, flank pain, hard stools, a red tongue, yellow and greasy coating, and a taut, slippery, rapid pulse. Teacher Pei states: “Elevated GPT indicates excess; according to the ‘Inner Canon’ principle of ‘eliminating excess,’ we should use purging and clearing methods.” Therefore, he often adds Wuwei Disinfecting Drink to the base of Danzhi Xiaoyao San. Specifically, 15 g of Lonicera japonica, 15 g of Forsythia suspensa, 15 g of Taraxacum mongolicum, 15 g of Patrinia scabiosaefolia, 15 g of Hedyotis diffusa, 15 g of Tripterygium wilfordii, and 15 g of Isatis indigotica are added. Chronic hepatitis often manifests as changes in flocculent tests and turbidity tests. Albumin decreases, globulin increases, the albumin-to-globulin ratio reverses, and in traditional Chinese medicine, this is generally classified as a pattern of deficiency. Symptoms include fatigue, loss of appetite, dull complexion, a pale tongue, thin coating, and a weak, fine pulse. Teacher Pei says: “Decreased albumin indicates deficiency; according to the ‘Inner Canon’ principle of ‘supplementing deficiency,’ we should use tonifying methods.” Therefore, he recommends adding 30 g of Salvia, 30 g of Hedyotis, 20 g of He Shou Wu, and 20 g of Polygonatum to the base of Danzhi Xiaoyao San. Both Salvia and He Shou Wu have substantial qi-tonifying and blood-nourishing effects, and when combined with Danzhi and Huangqi, they complement each other perfectly. Long-term illness affects the meridians. For patients with hepatosplenomegaly, drugs that promote blood circulation and dissolve stasis can also be added to the formula: Sanleng 10 g, Ezhushi 10 g, Honghua 6 g, Oyster Shell 15 g, Turtle Shell 6 g. For patients with cirrhotic ascites, treatment usually involves addressing both yang deficiency leading to water overflow and damp-heat, with the former treated using Wuling San and Zhenwu Tang, and the latter treated using Talc, Mu Tong, Plantago, Dapipi, and Hulu Pi.

III. Case Examples

[Case 1] Ma ××, male, 30 years old, hospitalization number 11595, employee of Jingtai County Agricultural Products Company, admitted to the general ward for treatment due to persistent black stools for 15 days accompanied by abdominal distension for one week. The patient reported fullness in both flanks, fatigue, loss of appetite, and a bitter taste in the mouth. Physical examination revealed listlessness, a sallow complexion, mild scleral icterus, normal heart and lungs, normal liver dullness, splenomegaly exceeding 4 cm below the ribs with moderate consistency, abdominal distension, positive shifting dullness, and no edema in the lower limbs. Ultrasound showed cirrhotic ascites and splenomegaly (thickness 5.0 cm). Barium meal radiography of the upper digestive tract revealed esophageal varices. Gastroscopy confirmed severe esophageal varices. Laboratory tests showed hemoglobin 80 g/L, fecal occult blood test (+ +), and normal liver function. Surface antigen negative, total protein 45 g/L, albumin 32 g/L, globulin 42 g/L. Diagnosis: decompensated cirrhosis. Traditional Chinese medicine syndrome differentiation indicated liver qi stagnation and spleen deficiency, with prolonged stagnation turning into heat, spleen deficiency generating dampness, dampness overflowing, and qi stagnation leading to blood stasis. Teacher Pei used Danzhi Xiaoyao San as the main formula, prescribing the following: Danpi 6 g, Shan Zhi Zi 10 g, White Peony 15 g, Angelica 10 g, Chai Hu 10 g, Fu Ling 12 g, Bai Zhu 10 g, Licorice 6 g, Salvia 30 g, Huangqi 30 g, Polygonatum 20 g, Jiaosanxian each 10 g, He Shou Wu 20 g, Ezhushi 10 g, Oyster Shell 15 g, Turtle Shell 10 g, Dapipi 15 g, Hulu Pi 15 g, Plantago 10 g, decocted once daily. Western medicine was used to stop bleeding and supplement albumin. After 40 days of hospitalization, abdominal distension disappeared along with accompanying symptoms. Follow-up fecal occult blood test was negative. Barium meal radiography showed significant improvement in esophageal varices. Ultrasound follow-up revealed disappearance of ascites and improvement in the liver. Splenomegaly reduced to 4.0 cm thick, and the patient was discharged after more than 80 days of hospitalization.

[Case 2] Zhang ××, male, 32 years old, hospitalization number 14559, acute jaundice, admitted to the general ward for treatment due to right flank fullness for five years and jaundice for three months. The patient reported fatigue, loss of appetite, aversion to oil, and nausea. Physical examination revealed poor spirits, a sallow complexion, mild scleral icterus, normal heart and lungs, no palpable liver, spleen palpable 5 cm below the ribs with moderate consistency, abdomen soft and flat, negative shifting dullness, and no edema in the lower limbs. Ultrasound showed early cirrhosis and splenomegaly (thickness 8.0 cm) with cholecystitis-related changes. No esophageal varices were found on barium meal radiography. Laboratory tests showed white blood cell count 3.0×10^9^, GPT 150 u, γ-globulin 27.2%, normal albumin-to-globulin ratio, and normal levels of both albumin and globulin. Diagnosis: early cirrhosis. Traditional Chinese medicine syndrome differentiation indicated liver qi stagnation, liver qi stagnation leading to spleen deficiency, liver qi turning into heat, and qi

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Stagnant blood and blood stasis. Teacher Pei treated this condition with a modified Danzhi Xiaoyao San formula: Dianpi 6g, Shan Zhizi 10g, Baishao 15g, Danggui 10g, Chaihu 10g, Ling 12g, Baizhu 10g, Gancao 6g, Danshen 30g, Huangqi 30g, Baihuashe Shecao 15g, Banzhilian 15g, Erhua 15g, Lianqiao 15g, Gongying 15g, Baijiang 15g, Sanlou 10g, Ezhushi 10g, Taoren 10g, Honghua 6g, Muli 15g, Biejia 6g, one dose daily. After taking 60 doses of the medication, all symptoms disappeared. A follow-up ultrasound showed diffuse changes in the liver and splenomegaly had decreased compared to before (spleen thickness reduced to 6.5 cm), γ-globulin levels dropped to 19.3%, and GPT returned to normal, demonstrating significant therapeutic efficacy.

IV. Insights

Teacher Pei’s key approach in treating chronic hepatitis is to grasp the pathogenesis of liver disease—“stagnation of liver qi, deficiency of spleen qi due to liver qi stagnation, transformation of liver qi into fire, and generation of dampness due to spleen deficiency”—while also connecting it with Western medical perspectives. His understanding of liver disease integrates both traditional Chinese and Western medical systems. Western medicine views chronic hepatitis as resulting from weakened immune function, leading to gradual degeneration of hepatocytes and progressive proliferation of fibrous tissue during viral infection. Cirrhosis, on the other hand, arises from the regeneration of pseudolobules formed by the proliferation of fibrous tissue after hepatocyte degeneration and necrosis, causing a reduction in liver volume and weight. The factors contributing to chronic hepatitis include: ① infection with hepatitis viruses; ② decreased immune function. The former calls for clearing heat and detoxifying, while the latter requires tonifying and consolidating the body. Both Chinese and Western medicine share common ground in their understanding of liver disease. In his treatment, Teacher Pei takes both perspectives into account, formulating a comprehensive strategy that includes soothing the liver to relieve qi stagnation, strengthening the spleen to benefit qi, clearing heat and detoxifying, and promoting blood circulation to remove stasis. Specifically, Western medicine addresses infection through heat-clearing and detoxification, immune deficiency through tonification, and enlarged liver and spleen through blood-activating and stasis-resolving methods, thereby bringing Chinese and Western medicine closer to a unified approach in treating liver disease. Teacher Pei’s academic thought inherits and expands upon the traditional Chinese medicine principle of syndrome differentiation. Of course, his therapeutic outcomes are more satisfactory than those achieved through conventional Chinese medicine diagnosis and treatment.

(“Gansu Science and Technology,” April 1998)

Professor Pei Zhengxue’s Experience in Treating Arthritis

Li Min and Xue Wenhan

[Profile of Professor Pei Zhengxue] Professor Pei Zhengxue is a renowned expert in integrated 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 previously 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. He is also a member of the editorial board of the “Chinese Journal of Integrated Chinese and Western Medicine” and the chief editor of the “Journal of Research on Integrated Chinese and Western Medicine.” Additionally, he serves as a director of the Chinese Society of Integrated Chinese and Western Medicine, Vice Chairman and Secretary-General of the Gansu Society of Integrated Chinese and Western Medicine, a member of the Gansu Provincial Senior Evaluation Committee for Traditional Chinese Medicine and Integrated Chinese and Western Medicine, and a member of the Gansu Provincial Committee of the Chinese People’s Political Consultative Conference. His major publications include “Commentary on Blood Syndrome,” “New Compilation of Chinese Herbal Formulas,” “Pharmacology and Clinical Applications of Rhubarb,” “Diagnosis and Treatment of Hepatitis B,” “Selected Cases of Pei Shen’s Medical Practice,” “New Compilation of Warm Disease Studies,” and “Practical Internal Medicine of Integrated Chinese and Western Medicine,” among others. Furthermore, he has published over 60 medical papers in journals across the country and has received five provincial-level awards for outstanding papers, including two second-class awards and three third-class awards, as well as one provincial science and technology progress award.

After Professor Pei’s book “Commentary on Blood Syndrome” was published 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 consult with Professor Pei on issues related to the book. The specialized prescription he formulated for treating leukemia was designated as the “Lanzhou Formula” at the National Hematology Conference in 1974. For over ten years, this formula has been widely used in hospitals across the country with remarkable therapeutic effects. His biography has been included in “Contemporary World Celebrities,” “Contemporary Chinese Medicine Celebrities,” “Great Dictionary of Famous Chinese Doctors,” and the foreign-language edition of “Cambridge World Who’s Who.” In February 1995, he edited and published the first comprehensive work on internal medicine integrating Chinese and Western medicine in contemporary times—“Practical Internal Medicine of Integrated Chinese and Western Medicine.” At the Third World Congress of Traditional Medicine held in the United States in April 1996, the book won the “International Gold Award for Outstanding Contribution,” and Professor Pei himself was honored as one of the “Top 100 Stars of Ethnic Medicine Worldwide.” In 1997, the State Administration of Traditional Chinese Medicine recognized Professor Pei Zhengxue as one of the 500 most famous senior TCM doctors nationwide, and three domestic TCM colleges, including the Hong Kong College of Traditional Chinese Medicine, appointed him as a visiting professor. The “Sixteen-Character Guiding Principle” for integrated Chinese and Western medicine proposed by Professor Pei has attracted attention from the entire field of Chinese and Western medicine and has become an important school of thought in the current TCM community. Professor Pei obtained the title of Chief Physician in 1987, became a recipient of a special government allowance starting in 1992, and was named a National Advanced Worker in Integrated Chinese and Western Medicine in 1994.

The arthritis discussed in this article refers specifically to rheumatoid arthritis and rheumatic arthritis, which fall under the category of “Bi syndrome” in traditional Chinese medicine. According to the “Bi Lun” chapter of the “Suwen”: “What is called ‘Bi’ is when each person 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 human body, they flow through the meridians and joints, obstructing the smooth flow of qi and blood and thus causing 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 disease persists and affects the meridians, it can lead to blood Bi.

I. Prescription and Medication

According to the “Zhongfeng Lijie Bing Pian” section of the “Jin Gui Yao Lue”: “For pain in all limbs and joints, emaciation, swelling of the feet as if they were detached, dizziness, shortness of breath, and nausea, the Gui Zhi Shaoyao Zhimu Tang is the primary prescription.” Professor Pei believes this formula is the main prescription for treating all types of Bi syndrome, and through clinical adjustments and modifications, it can be adapted to various situations. The Fuzi in the formula can be replaced with Chuanwu or Caowu, with dosages ranging from 10 to 15 grams, but these herbs must be decocted for one hour beforehand. As everyone knows, Chuanwu and Caowu are highly toxic, with aconitine as their main component; the usual dosage is 6 grams. However, Professor Pei has exceeded the conventional dosage by more than twice without any toxic reactions, thanks to the method of pre-decocting for one hour, which removes the toxicity before combining with other ingredients, resulting in remarkable clinical efficacy. The formula also includes one fried Ma Qianzi, paired with Chuanwu and Caowu to enhance its ability to dispel cold and wind, making the effect stronger and doubling the therapeutic effect. Additionally, apricot kernels and coix seeds are added, following the principle of the “Jin Gui” Ma Xing Yi Gan Tang, which is effective for “whole-body pain caused by wind-damp, accompanied by fever that worsens in the afternoon.” Therefore, the basic formula is as follows: Gui Zhi 10g, Bai Shao 15g, Zhi Mu 6g, Gan Jiang 6g, Fang Feng 12g, Ma Huang 10g, Bai Zhu 10g, Chuanwu and Caowu each 10g (pre-decocted for one hour), Ma Qianzi 1 fried, apricot kernels 10g, raw coix seeds 20g, Gan Cao 6g. Adjustments: If the disease is widespread and wind is dominant, add 10g each of Qiang Du Huo and Du Huo; if the pain is severe and cold is prominent, increase the dosage of Chuanwu and Caowu to 15g each; if there is fever and thirst, indicating wind-heat, add raw Shigao and Ren Dong Teng; if the pain is heavy and accompanied by sourness and numbness, indicating excessive dampness, increase the amount of coix seeds to 30–40g; if the disease has persisted and affected the joints, adding Tao Hong Si Wu Tang can help.

II. Case Examples

[Case 1] Wang XX, female, 26 years old, one month postpartum, experiencing severe pain in all large and small joints throughout the body, exacerbated by cold. Difficulty walking and pain during flexion and extension. Pain migrates and sweating is profuse. Pale tongue with white coating, pulse is deep, fine, and slippery. Diagnosis: Wind-damp Bi syndrome. Prescribed Gui Shao Zhi Mu Tang with additions: Gui Zhi 10g, Bai Shao 15g, Zhi Mu 6g, Gan Jiang 6g, Fang Feng 12g, Ma Huang 10g, Bai Zhu 10g, Chuanwu and Caowu each 10g (pre-decocted for one hour), Ma Qianzi 1 fried, apricot kernels 10g, raw coix seeds 20g, Gan Cao 6g, Dang Gui 10g, Huang Qi 30g, Sheng Di and Shu Di each 12g, Huang Qin 10g, Huang Bo 6g. After seven doses, joint pain significantly improved and sweating decreased. Continued taking another seven doses, and all symptoms disappeared.

[Case 2] Yang X., female, 33 years old. Joint redness, swelling, and pain for one week, accompanied by sore throat and fever with profuse sweating. Thirsty and drinks a lot. Red tongue with thin yellow coating, pulse is wiry and rapid. This case is considered wind-heat Bi syndrome. Prescribed Gui Zhi Shaoyao Zhi Mu Tang with additions: Gui Zhi 10g, Bai Shao 15g, Zhi Mu 6g, Gan Jiang 6g, Fang Feng 12g, Ma Huang 10g, Bai Zhu 10g, Chuanwu and Caowu each 10g (pre-decocted for one hour), Ma Qianzi 1 fried, raw coix seeds 20g, apricot kernels 10g, raw Shigao 30g, Ren Dong Teng 20g, Sang Zhi 30g. After seven doses, the fever subsided, sweating stopped, and symptoms greatly improved. The original formula was adjusted by removing raw Shigao. Continued taking ten more doses, and all symptoms were cured.

[Case 3] Wang XX, female, 52 years old, with pain and deformation in the finger and wrist joints of both hands, as well as pain in other major joints. The disease has lasted for over ten years, resulting in loss of working capacity. Dark tongue with thin coating, pulse is fine and sluggish, diagnosed as blood Bi caused by long-term involvement of the meridians. Professor Pei prescribed: Gui Zhi 10g, Bai Shao 15g, Zhi Mu 6g, Gan Jiang 6g, Fang Feng 12g, Ma Huang 10g, Bai Zhu 10g, Chuanwu and Caowu each 10g (pre-decocted for one hour), Ma Qianzi 1 fried, apricot kernels 10g, raw coix seeds 20g, Dang Gui 10g, Chi Shao 10g, Chuan Xiong 10g, Sheng Di 12g. After fourteen doses, joint pain eased somewhat; after thirty doses, various symptoms improved markedly, and joint mobility changed from stiff to flexible.

(Modern Chinese Medicine, March 1998)

Pei Zhengxue’s Application of Ling Gui Shu Gan Tang

Clinical Insights on Rheumatic Heart Disease

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

I. Professor Pei’s Understanding of Rheumatic Heart Disease

Rheumatic heart disease typically presents clinically as shortness of breath, chest tightness, and palpitations. Professor Pei Zhengxue (hereinafter referred to as Professor Pei) believes this disease mostly falls under the categories of “phlegm-fluid accumulation,” “chest obstruction,” and “palpitations” in traditional Chinese medicine. The failure of the spleen to transport qi leads to the inability of chest yang to disperse, subsequently causing qi stagnation and blood stasis—the main pathogenic mechanisms of this disease. The lungs govern qi, while the heart governs blood; when qi stagnates in the heart, the meridians become blocked, resulting in chest tightness and palpitations. Over time, metal and water cannot generate each other, and the balance between fire and water is disrupted, leading to kidney yang deficiency and excessive fluid retention. In summary, although the location of this disease is in the heart and lungs, and it involves the inability of chest yang to disperse, the root cause is actually the failure of earth to produce metal. Therefore, the primary treatment strategy is to strengthen the spleen to transform dampness, warm yang, and promote diuresis—this is the correct approach.

II. Syndrome Differentiation and Treatment

Professor Pei believes that Ling Gui Shu Gan Tang is the foundational formula for treating rheumatic heart disease, with the dosage of Fu Ling greater than Gui Zhi, Gui Zhi greater than Bai Zhu, and Bai Zhu greater than Gan Cao. In clinical practice, however, Professor Pei adjusts the formula flexibly based on the specific syndrome. For patients with cough, phlegm, and chest pain, it is combined with Ma Xing Shi Gan Tang; for those with chest pain radiating to the back, bruising on the tongue, and a wiry, sluggish pulse, it is combined with Gu Lou Xie Bai Ban Xia Tang and Guan Xin Yi Hao; for those with dizziness, palpitations, a red tongue with little coating, and a fine, rapid, and irregular pulse, it is combined with Zhi Gan Cao Tang, where the dosage of Zhi Gan Cao, Sheng Di, Mai Dong, and Ku Shen is appropriately set at 20–30 grams; for patients with distended jugular veins, lower limb edema, chest tightness, cough, and dyspnea, especially when sitting upright, with a swollen tongue and thick white coating, and a slippery pulse, it is considered yang deficiency with excessive fluid, and Ling Gui Shu Gan Tang is combined with Zhen Wu Tang and Sheng Mai San; for those who only experience “shortness of breath upon exertion,” indicating kidney yang deficiency, it can be combined with Mai Wei Di Huang Tang; for those with fatigue, poor appetite, insomnia, and frequent dreams, indicating heart-spleen deficiency, it is combined with Gui Pi Tang.

III. Case Examples

[Case 1] Patient Zhang, female, 51 years old. Shortness of breath for over ten years, worsening in the past five days, accompanied by palpitations and chest tightness. Fatigue. Symptoms worsen with activity. Unable to care for herself. Presented on October 10, 1996. Physical examination: patient exhibits mitral valve face. Sitting upright, breathing laboredly. Pulse rate 82 beats per minute, cardiac percussion shows leftward enlargement of the cardiac border, auscultation reveals uneven heart sounds, heart rate 90 beats per minute, irregular rhythm, and a harsh systolic murmur of grade 3 heard at the apex. Mild edema in both lower limbs. Swollen tongue with thin white coating, pulse is irregular and weak. Western medical diagnosis: 1. Rheumatic heart disease (mitral valve insufficiency); 2. Heart failure; 3. Atrial fibrillation. Traditional Chinese medicine diagnosis: phlegm-turbidity obstructing the interior. Prescribed Ling Gui Shu Gan Tang combined with Zhen Wu Tang with additions: Fu Ling 15g, Gui Zhi 12g, Bai Zhu 10g, Gan Cao 30g, Fu Zi 6g, Gan Jiang 6g, Bai Shao 10g, Sheng Di 20g, Danshen 20g, Ku Shen 20g. After more than ten doses, shortness of breath and labored breathing eased, but palpitations and chest tightness persisted. Pulse rate 74 beats per minute, heart rate 84 beats per minute, irregular rhythm, pale tongue with thin white coating and irregular pulse. Therefore, the above formula was adjusted by removing Fu Zi and Bai Shao, adding 10g of Ajiao, four jujubes, 10g of Dang Shen, 20g of Mai Dong, and 10g of Ma Zi Ren. Continued taking another fifteen doses. Patient’s symptoms improved. Subsequently, continued using Ling Gui Shu Gan Tang as the main formula with adjustments, taking over twenty doses until all symptoms disappeared and she regained full self-care ability. Pulse rate 72 beats per minute, heart rate 73 beats per minute, rhythm more regular than before.

[Case 2] Patient Lei, male, 30 years old. Shortness of breath for five years, often worsening after a cold or fatigue, accompanied by intermittent coughing, pink frothy sputum, fatigue, and pain in both knee joints. Presented in October 1995. Auscultation revealed wheezing in both lungs, and cardiac percussion showed leftward enlargement of the cardiac border. Western medical diagnosis: rheumatic heart disease (mitral valve stenosis). Traditional Chinese medicine diagnosis: phlegm-fluid accumulation, lung failing to disperse and descend. Treatment focused on warming yang and promoting diuresis, as well as dispersing lung qi and relieving asthma. Prescribed Ling Gui Shu Gan Tang combined with Ma Xing Shi Gan Tang with additions: Fu Ling 15g, Gui Zhi 12g, Bai Zhu 10g, Gan Cao 6g, Ting Li Zi 15g, four jujubes, Yin Hua 15g, Lian Qiao 15g, Ma Huang 6g, apricot kernels 10g, raw Shigao 30g. After more than twenty doses, shortness of breath eased, coughing and sputum disappeared, but joint pain persisted, along with low-grade fever and elevated erythrocyte sedimentation rate. Therefore, the formula was adjusted to Ling Gui Shu Gan Tang combined with Gui Zhi Shaoyao Zhi Mu Tang with additions: Gui Zhi 12g, Bai Shao 12g, Zhi Mu 10g, Bai Zhu 10g, Chuan Wu and Caowu each 10g (pre-decocted for one hour), Fang Feng 12g, Ma Huang 6g, Gan Cao 6g, four jujubes, Fu Ling 15g, Di Gu Pi 15g, Dan Pi 15g. After more than twenty doses, joint pain disappeared, and erythrocyte sedimentation rate returned to normal. Continued taking Ling Gui Shu Gan Tang with adjustments for another month, and all symptoms were eliminated. Follow-up chest X-ray showed that the left atrium had shrunk compared to before.

IV. Insights

Rheumatic heart disease is a common illness in China; mild cases can lead to loss of working capacity, while severe cases pose a threat to life. Apart from valve replacement surgery, Western medicine generally relies on symptomatic treatment, but the long-term efficacy is not ideal. Professor Pei adopts a treatment strategy of strengthening the spleen to transform dampness and warming yang to promote diuresis, with Ling Gui Shu Gan Tang as the main formula. Ling Gui Shu Gan Tang originates from the “Jin Gui Yao Lue,” where it is stated that “there is phlegm-fluid accumulation in the heart, chest and flank discomfort, dizziness,” and “shortness of breath with slight fluid accumulation.” The formula primarily focuses on strengthening the spleen to transform dampness; Gui Zhi warms yang and transforms qi as a supplementary measure; Bai Zhu strengthens the spleen and benefits qi as a complementary treatment; and Gan Cao harmonizes the other ingredients as a guiding force. Its clinical function aligns with what the “Medical Gate Law” says: “Phlegm-fluid accumulation represents yin, inhibiting yang; using yang-tonifying herbs 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 of rheumatic heart disease, significantly improving patients’ quality of life, and even leading to noticeable improvements in cardiac imaging and echocardiography for some patients after treatment.

(Hunan Journal of Traditional Chinese Medicine, March 1999)

Professor Pei Zhengxue’s Application of Chaihu Shu Gan San

Experience in Treating Gallbladder Diseases

Ha Lüzong

From 1982 to 1983, I accompanied Chief Physician Pei Zhengxue for over a year, observing his clinical practice. His method of combining disease patterns with syndrome differentiation proved highly effective in treating various clinical conditions, and I gained considerable insight from it. Here, I would like to share my humble personal experience regarding his use of Chaihu Shu Gan San in treating gallbladder diseases.

My teacher believes that Chaihu Shu Gan San has obvious antispasmodic, choleretic, and analgesic effects. Therefore, when treating gallbladder diseases, he mainly uses this formula, making adjustments as needed. Although traditional Chinese medicine does not have specific terms for gallbladder inflammation or gallstones, descriptions such as “when the gallbladder is distended, there is distension and pain in the hypochondrium, a bitter taste in the mouth, and a tendency to sigh frequently” (“Ling Shu · Zhang Lun”) and “for those with abdominal pain and vomiting due to jaundice, Chaihu Tang is appropriate” (“Jin Gui · Huang Dan”) provide valuable references for diagnosing and treating this condition. My teacher believes that the main symptoms of gallbladder disease include pain in the hypochondrium, bitterness in the mouth, jaundice, vomiting, and abdominal distension—conditions that fall under the category of liver qi stagnation, liver wood overcoming earth, and internal accumulation of damp-heat in traditional Chinese medicine. Among these symptoms, liver qi stagnation is the root cause that triggers the others, so treatment must focus on the overarching goal of soothing the liver and promoting qi circulation. Therefore, Chaihu Shu Gan San is used as the base formula, with adjustments made according to the specific situation. The six腑 should be kept open and unobstructed, especially during acute episodes of this disease; in addition to soothing the liver, agents that promote bowel movement and clear heat should always be added. Combining Chaihu Shu Gan San with San Huang and Cheng Qi formulas often yields excellent results. Chaihu Shu Gan San relieves liver qi stagnation; adding ingredients such as Da Huang, Huang Qin, Huang Lian, and Mang Xiao not only resolves Shaoyang qi stagnation but also clears Yangming腑实, achieving a dual effect of resolving Shaoyang and Yangming. Among them, Zhi Shi promotes qi circulation and disperses knots, Chuan Xiong activates blood circulation and promotes qi, Bai Shao softens the liver and calms yin to relieve urgency, and Xiang Fu regulates qi and relieves pain. Da Huang and Mang Xiao clear Yangming腑实, working together to promote bowel movement; Huang Qin clears Shaoyang interior heat, while Ban Xia harmonizes the stomach. Based on these adjustments, if the heat is severe, add Jin Qian, Xia Ku, Xi Xian Cao, and Hu Zhang; if the pain is severe, add Chuan Xiong, Yuan Hu, and Zhi Ru Mei.

Typical Cases:

[Case 1] Wang ×, female, adult, cadre of the Lanzhou Housing Management Bureau, first visit on May 24, 1982. On the night of May 23, she experienced severe right upper quadrant pain and vomiting, and was taken to the institute’s outpatient clinic the next morning for treatment by Teacher Pei.

Right upper quadrant tender to palpation, constant moaning, unable to sit or lie down comfortably, pain in the right shoulder and back, vomiting, sweating. Pulse is wiry and rapid, tongue is red with thick yellow coating. Murphy’s sign (+), blood count: white blood cells 26,000/mm³, neutrophils 89%. Ultrasound: cholecystitis complicated by gallstones, diagnosis: gallstone disease complicated by cholecystitis. Treatment: soothe the liver and promote bile flow, clear the bowels and dissipate heat. Prescribed Chaihu Shu Gan San with additions: Chaihu 10g, Zhi Shi 10g, Bai Shao 15g, Chuan Xiong 6g, Xiang Fu 6g, Gan Cao 6g, Da Huang 10g, Mang Xiao 10g, Huang Qin 6g, Ban Xia 6g, Huang Lian 3g, Jin Qian 30g, Bai Jiang 15g, Hu Zhang 10g, Yuan Hu 6g, Chuan Lian 6g, Mu Xiang 3g. Decocted in water and taken for three doses, after which the patient passed black-brown, watery stools, and the pain greatly subsided, though occasional mild, intermittent pain remained, along with slight abdominal bloating. Pulse was wiry and slippery, tongue was slightly red with thin yellow coating. The above formula was adjusted by removing Mang Xiao, adding Fu Ling 12g, Zhu Ru 6g, Danshen 15g, and Cao Kou 5g, then decocted again for three doses. Upon receiving feedback, it was reported that after taking the above formula, all symptoms improved significantly. Due to work commitments, another three doses were taken, and the patient eventually recovered.

[Case 2] Jiang ×, female, adult, employee of Factory 113 in Longxi, first visit on June 10, 1982. Right hypochondrial pain for several days, worsening intermittently. Liver function tests were normal, but recently the right upper quadrant pain has intensified, radiating to the right shoulder and back, aversion to fatty foods, vomiting after eating, repeated several times. A cholecystography performed at Longxi Hospital did not reveal any stones. Diagnosis: acute exacerbation of chronic cholecystitis. Patient experiences bitterness in the mouth and irritability. Right hypochondrium feels intermittent cramping pain, pulse is wiry and rapid, tongue is red with thin yellow coating. Examination: obvious tenderness and pressure in the gallbladder area, Murphy’s sign (+). Diagnosis: acute attack of chronic cholecystitis. Treatment: soothe the liver and resolve qi stagnation, clear damp-heat. Prescribed Chaihu Shu Gan San with additions: Chaihu 10g, Zhi Shi 10g, Bai Shao 15g, Gan Cao 6g, Chuan Xiong 6g, Xiang Fu 6g, Yuan Hu 6g, Chuan Lian 6g, Yu Jin 6g, Yin Chen 16g, Jin Qian 30g, Da Huang 10g, Huang Qin 6g, Huang Lian 3g, Mu Xiang 10g, Cao Kou 3g, Zhi Ru Mei 3g, Ban Xia 6g, Dang Gui 10g, Huang Qi 20g, Danshen 10g. After taking the above formula, multiple episodes of loose stools occurred, and the pain dramatically decreased, with mental state and diet returning to normal. Pulse was wiry, tongue was slightly red with thin yellow coating. After five doses, the above formula was adjusted by removing Chuan Lian, Huang Qi, and Danshen, then decocted again for five doses. On August 12, family members came to the institute to report that all symptoms had completely subsided and the patient had returned to work in Longxi.

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[Example 3] Ma ×, female, adult, resident of Xigu District, first visit on October 7, 1982. The patient

was escorted by her daughter to the outpatient clinic due to severe pain in the right hypochondrium and epigastrium. A few days earlier, she had experienced liver region pain and scleral jaundice; after undergoing liver function tests at Xigu District Hospital (I), she sought treatment from our teacher without improvement at the Provincial Traditional Chinese Medicine Hospital. She reported bitter taste in the mouth, vomiting, nausea, dry stools with black color, colicky pain under the right rib cage radiating to the shoulder and back, and incessant moaning.

Examination: Yellowish complexion with slight sweating, moderate scleral jaundice. Abdomen is flat and soft, liver and spleen are not palpable, but there is obvious tenderness and rebound tenderness in the gallbladder area, Murphy's sign (+). Pulse is wiry, slippery, and rapid; tongue is red with thick, greasy yellow coating. Diagnosis: Acute cholecystitis. Treatment principle: Soothe the liver and harmonize the stomach, clear heat and drain dampness. Prescription: Modified Chaihu Shugan San: Chaihu 10 g, Zhishi 10 g, Baishao 15 g, Gancao 6 g, Chuanxiong 6 g, Xiangfu 6 g, Yuanhu 6 g, Chuanlian 6 g, Mangxiao 10 g, Huangqin 10 g, Huanglian 3 g, Muxiang 3 g, Jinqian 30 g, Baijiang 15 g, Huzhang 10 g, Daizhe Shi 15 g, Banxia 6 g, Fulonggan 30 g (decocted first), Shengjiang 5 g. Decoct in water and take orally. After 5 doses, loose dark brown stools were passed in large quantities, pain subsided accordingly, and nausea and vomiting also ceased. Diet and mental state were both normal, except for mild aching in the back. Scleral jaundice markedly faded, bowel movements became regular, and most of the damp-heat pathogenic factors had been eliminated. Pulse was wiry and slippery, tongue pale with slightly yellow coating. Following the previous method, Mangxiao and Fulonggan were omitted, and another 5 doses were taken to clear residual pathogenic factors. On October 16, re-examination: All pain and scleral jaundice had disappeared, bowel movements were regular, pulse was slippery, tongue pale with thin coating. Chaihu Shugan San combined with Xiangsha Liujunzi Tang was used for post-treatment conditioning, leading to complete recovery.

After completing my studies in 1983 and returning home, whenever I encountered this disease in clinical practice, I often achieved good results using my teacher’s treatment methods.

(“Research on Integrated Traditional Chinese and Western Medicine,” January 1991)

Application of Teacher Pei Zhengxue’s Treatment

Reflections on Experience in Treating Atrophic Gastritis

Li Min

Atrophic gastritis is a type of chronic gastritis and a common gastric disorder. Its onset may be related to the following factors: 1. Prolonged acute gastritis. 2. Reflux of duodenal fluid. 3. Immune factors. 4. Helicobacter pylori infection. Single Western medicine treatment is not very effective; traditional TCM syndrome differentiation can only be based on subjective symptoms for medication. Therefore, it is easy to confuse with other epigastric diseases, leading to misdiagnosis and improper treatment.

Chief Physician Pei Zhengxue has conducted extensive clinical observations on patients with atrophic gastritis over many years of clinical practice, accumulating rich clinical experience. Based on this, he classifies atrophic gastritis into two types according to the site of lesion and performs TCM syndrome differentiation. Different formulas are prescribed for different types and syndromes, achieving good clinical results and opening up a new avenue for integrated TCM-Western medicine treatment of atrophic gastritis.

“The sixteen-character guideline of ‘Western diagnosis, TCM syndrome differentiation, TCM as the mainstay, Western medicine as an adjunct’ was pioneered by Chief Physician Pei Zhengxue for integrated TCM-Western medicine diagnosis and treatment. The classification and syndrome differentiation of atrophic gastritis are carried out under the guidance of this sixteen-character guideline. First, on the premise of a clear Western diagnosis, for atrophic gastritis occurring in the gastric body (Type A, positive B-cell antibodies, with plasma cell infiltration), since the clinical symptoms are mostly distension and fullness, often accompanied by fatigue, poor appetite, dizziness, and a pale, plump tongue, treatment is based on spleen-stomach qi deficiency syndrome differentiation. For atrophic gastritis occurring in the gastric antrum (Type B, negative B-cell antibodies, with neutrophil infiltration), since the clinical symptoms are mainly gastric pain, often accompanied by burning sensation in the stomach, dry mouth, constipation, and greasy yellow tongue coating, treatment is based on stomach-fire excess syndrome differentiation. Type A is mostly treated with Xiangsha Liujunzi Tang, while Type B is mostly treated with Banxia Xiexin Tang. From 1986 to the present, hundreds of cases have been treated, with an overall effective rate of about 95% and a cure rate estimated at over 80% (detailed data are being compiled), achieving remarkable efficacy. Typical case reports are as follows:

[Case 1] Huang ××, male, 50 years old, cadre, chief complaint: burning pain in the epigastrium for 10 years, worsening for 1 year. Each time triggered by drinking or irregular diet, the pain is severe, accompanied by burning sensation in the stomach, dry mouth and desire to drink, preference for cold drinks and foods, dry stools, red tongue with slightly yellow coating, and wiry, rapid pulse.

Physical examination: Tenderness in the left subxiphoid area.

Gastroscopy: Superficial gastritis. Antral atrophy with mild intestinal metaplasia.

Syndrome differentiation: Stomach-fire excess type (classified as Type B).

Prescription: Banxia, Shengjiang, Huangqin, Huanglian, Beishashen, Dazao, Muxiang, Caokou, Gancao.

After taking the above prescription for more than 10 doses, symptoms alleviated; after another 10 doses, symptoms disappeared, and there has been no epigastric pain for 6 years.

[Case 2] Wang ×, male, 50 years old, cadre, chief complaint: upper abdominal distension for 10 years, worsening for half a year. Most pronounced in the evening, accompanied by fear of cold, chill in the back, fatigue, loss of appetite, loose stools, pale tongue with thin white coating, and wiry, fine pulse.

Physical examination: Distension upon palpation of the subxiphoid area.

Gastroscopy: Mottled mucosa of the gastric body, suggesting atrophic gastritis with severe intestinal metaplasia.

Syndrome differentiation: Spleen-stomach qi deficiency type (classified as Type A).

Prescription: Muxiang, Sharen, Dangshen, Baizhu, Lingzhi, Chenpi, Liangjiang, Xiangfu, Shan Yao, Jiaosanxian, Gancao.

After taking the above prescription for 7 doses, noticeable improvement occurred, with significant relief of upper abdominal distension and other symptoms. Subsequent adjustments to the formula yielded remarkable results.

[Case 3] Yang ××, male, 23 years old, worker, chief complaint: upper abdominal distension and pain for 2 years, accompanied by acid regurgitation. Both distension and pain coexist in the stomach, unable to eat overly hot or cold food, acid regurgitation and discomfort, fear of cold, fatigue, stools either dry or loose, pale tongue with thin yellow coating, and deep, fine pulse.

Physical examination: Tenderness in the left subxiphoid area.

Gastroscopy: Mottled mucosa of the gastric antrum and body, suggesting atrophic gastritis with severe intestinal metaplasia.

Syndrome differentiation: Mixed type of cold and heat (AB type).

Prescription: Muxiang, Sharen, Dangshen, Baizhu, Lingzhi, Chenpi, Zhishi, Houpu, Banxia, Huangqin, Huanglian, Danggui, Danshen, Zhi Rumei, Gancao.

After taking the above prescription for 10 doses, all reported symptoms were alleviated. Continued adjustment of the formula resulted in satisfactory therapeutic effects.

Over several years of clinical work, I have benefited greatly from the meticulous guidance of Chief Physician Pei Zhengxue, applying the aforementioned syndrome differentiation diagnostic method to treat numerous cases of atrophic gastritis, each time achieving excellent results and gaining profound insights.

(“Research on Integrated Traditional Chinese and Western Medicine,” January 1992)

Pei’s Shenqi Sanhuang Tang Treatment

Reflections on Idiopathic Thrombocytopenic Purpura

Pei Xinyan

Over the past 10 years, we have used the Shenqi Sanhuang Tang formula devised by Teacher Pei Zhengxue to treat idiopathic thrombocytopenic purpura, achieving satisfactory results. Here are the reports of 40 cases.

I. Case Overview

All 40 patients had platelet counts below 100 × 10^9^/L, prolonged bleeding time, and bone marrow findings consistent with the diagnosis of this disease. Among them, 14 were male and 26 were female. Twenty-two were under 20 years old, 11 were between 20 and 30, and 7 were over 30. Twelve were first diagnosed within six months, 20 were diagnosed between six months and one year, and 8 were diagnosed more than one year ago.

All 40 patients exhibited varying degrees of bleeding symptoms, with skin purpura in every case. Fifteen had nosebleeds, 8 had increased menstrual flow. Among them, 38 had pallor, 36 had dizziness, 33 had palpitations, 28 had poor appetite, 26 had spontaneous sweating, 18 had lower back pain, 16 had aversion to cold, 13 had tinnitus, 12 had irritability, 8 had fever, 21 had deep, fine pulse, 10 had fine pulse, and 20 had weak chi pulse. Four had platelet counts between (60–100) × 10^9^/L, 11 had (40–60) × 10^9^/L, 16 had (20–40) × 10^9^/L, and 9 had less than 20 × 10^9^/L. Coagulation tests were performed on 25 cases, with 23 showing prolonged clotting times. Bone marrow examinations all showed: normal granulocyte proliferation, normal or mild erythroid proliferation, megakaryocyte system proliferation with maturation disorders, increased proplatelets and decreased platelets, consistent with the diagnosis of idiopathic thrombocytopenic purpura.

II. Treatment Methods and Prescription Composition