The experience in the use of Chinese herbal therapy

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Edmonton AB,   Canada

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用药心得

http://www.iiyi.com/med/thread-1623976-1.html#pid6372784

绿衣 (汪庆安, 辽宁营口)

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The experience in the use of Chinese herbal therapy

By Dr. Qing-An Wang

 

Catalogue

 

1. 肝病 (Liver diseases)

2,阳痿早泄(Impotency and premature ejaculation)

3,胃病 (Gastric disease)

4,贫血 (Anemia)

5,复发性口疮 (Recurrent mouth ulcer)

6,乳腺增生 (Hyperplasia of mammary glands)

7,尿路结石 (Stone in urine tract)

8,下肢静脉曲张 (Varicose vein condition)

9,紫癜 (Purpura)

10,冠心病 (Coronary heart disease)

11,不孕 (Infertility)

12,高血压 (High blood pressure)

 

 

 13,甲亢 (Hyperthyroidism)

14,体质性低血压 (Constitutional low blood pressure)

15,腰肌劳损 (Lumber muscle degeneration)

16,耳病 (Ear disease)

17,病毒性心肌炎 (Viral myocarditis)

18,咽炎 (Pharyngitis)

19,脑血栓 (Cerebral thrombosis)

20,慢性肾炎 (Chronis nephritis)

21,慢性肾盂肾炎 (Chronic Pyelonephritis)

22,顽固性头痛 (Obstinate headache)

23,神经衰弱(失眠) Nervous exhaustion (poor sleep, insomnia)

24,慢性胆囊炎 (Chronic Cholecystitis)

 

1. 肝病

1. Liver diseases

 

(1). 旱莲草,早年治疗一慢性肝炎病人,阴虚体质,证见乏力,肢体困重,肝区隐痛,尿黄,舌苔微黄腻,给予补气,解毒,清利湿热药,效果不甚明显,10日后,又出现咽干,腰膝酸软,乏力依旧,此为利湿伤阴之象,因生地,麦冬之类对肝病属湿者实为不利,遂加旱莲草50 g一味,想不到用药第2日,症状明显减轻,第3日,症状消失,此药的用与不用差别太大。中药药理学认为,旱莲草可以保肝解毒。而此药针对阴虚湿热病人,可以有效的解决矛盾问题。既能养阴扶正,又能凉血解毒,且不助湿,成了我治疗湿热型肝炎的必用药。

(1). The use of herb Han Lian Cao in the treatment of liver diseases. Early previous years, I treated a patient with chronic hepatitis. The patient is in a Yin deficient condition. He felt chronic fatigue, heavy arms and legs, ache in the right upper belly, had urine of yellow color and his tongue covering is slight yellow and greasy. He was given treatment of Qi nourishing, toxic dispelling, Wet-Hot clearing therapy but the result was not satisfied. Ten days later, his condition became dry throat, sour in lower back and legs, with the same tiredness. This is the sign that the body Yin has been affected, since the herb Shengdi and Maidong in the formula is not so proper for the hepatitis patient with Wetness condition. So, I added herb Han Liang Cao 50 grams in each dose. To my surprise, on the second day, the condition was much approved. On the third day, all conditions went away! It is so different with the use of the herb Han Lian Cao. It is believed in the Chinese herbal pharmacology that, herb Han Lian Cao can protect liver and to detoxify. When it is used in patient with both Yin deficiency and Wetness accumulation, it can dissolve the contradiction, in which the herbs that nourish the Yin will cause more Wetness in the body. The herb Han Lian Cao can both nourish the Yin to support the defense ability of the body,  and dispel the extra Wetness from the body, as well as cooling blood and detoxify. In addition, its use does not make the Wetness worse. For this reason, it becomes a must-use herb whenever I treat hepatitis with Wet-Hot condition.

(2). 白矾,通常情况,降酶退黄治疗比较容易,但也有顽固者,对于转氨酶持续不降的,我曾试过用白矾5 g加入方药中,起解毒降酶之用,效果的确很显著,但此药需要中病即止,不宜久服,待转氨酶降至正常即可停用,一般不会反弹,这是我知道的降酶中药里,见效速度最快的药。

(2). Bai Fan[1]

Usually, it is not so difficult to reduce the blood level of aminopherase and to make disappear of jaundice in patient with hepatitis. However, it could be really difficult in some cases. For those hard cases, I have tried to add 5 grams of Bai Fan in the herbal formula to detoxify and to reduce the blood aminopherase level. The result is really good. However, it should not be continued to use once the blood level of aminopherase returns to normal. The blood aminopherase level usually does not rebound back. It is the ingredient that works fastest, among all herbs that I know to reduce aminopherase.

(3). 黄芪,慢肝病人多数都有乏力等气虚症状,所以黄芪在此处显得很重要,但我要提示的是它的剂量,我一般用100150 g4日内即可获效,如果剂量在60g以下,时有不效者,且见效缓慢,更重要的是,它还可以扶正以祛邪��对于没有气虚症状的也很有必要用。

(3). Herb Huang Qi

Patient with chronic hepatitis usually has Qi deficiency condition, such as feeling tired, etc. Therefore, the use of herb Huang Qi is very important in such patient. However, what I want to emphasize is its dose to use. I usually use 100 to 150 grams of Huang Qi. Patient can feel difference within four days. If the dose is less than 60 grams, it may not work from time to time or it works slowly. More important, it works to nourish the defense Qi to dispel disease Qi, so that it is also worthwhile to be used in those patients without apparent Qi deficiency condition.

(4). 鳖甲,众所周知,鳖甲治疗肝硬化,2年前,我曾以此一味药治愈一个肝硬化腹水病人,后来做B超提示,肝回声均匀正常,西医们很是震惊,海藻等也可以软坚,但效果远不及鳖甲,且有明显扶正效果,其含动物胶,角蛋白等,不仅能抑制或逆转纤维化,还能增加血浆蛋白水平,改善体质,缺点是仅适用于阴虚体质的病人。

(4). Bie Jia[2]

It is well known that Bie Jia can be used to treat cirrhosis. Two years ago, I have used single Bie Jia to treat a patient with cirrhosis and ascites. Later, when use B-ultra sound to check, there is no any sign of liver disease. It surprised Western medicine doctors. Another herb ingredient, Herb Hai Zao, can also be used for the treatment of cirrhosis, but it is much less effective than the Bie Jia. Bie Jia can solve cirrhosis, and it can also, due to its contents of animal gum and horn protein, work to inhibit or retard fibrosis in liver, to increase blood level of proteins, and to improve overall body condition. But the weakness is that it can only be used in patients with Yin deficiency condition.

(5). 蒲公英,对于肝炎病人,有人喜欢用芩连等苦寒之品,有人喜欢用大黄泻下排毒,我个人认为,久服苦寒之品易伤脾,久服大黄泻下易伤正,对急性病暂用可以,但对长期服药不太适宜,久服药需要无毒低毒,寒热偏度不大比较合适,蒲公英为我的首选药,用于临床效果很是满意,其优点是安全无毒,其次还有桑寄生(抑制病毒效果显著,又能补肝肾),白花蛇舌草,甘草等,对湿热明显的病人,大剂量的蒲公英还可以致泻,使邪有出路,(暂用或加白术)。

(5). Herb Pu Gong Ying

In the treatment of liver diseases, some doctors like to use Bitter-Cold herbs, some use herb Da Huang to induce diarrhea so as to dispel toxic. I myself believe that, a long term use of Bitter-Cold herbs is easy to hurt Spleen system in body and a long term use of herb Da Huang with its diarrhea effect is easy to damage health-maintaining Qi. Those herbs may be used in acute condition, but they are not good to be used for a long time in chronic condition. The herbs that need to be used for a long time should be safe, no toxic or less toxi, and their Cold or Hot herbal nature should be mild. The herb Pu Gong Ying is my first priority to chose. It works very well in clinic. Its goodness is safe and no toxic. The second choice is herb Sang Ji Sheng (its effect of inhibiting growth of virus is very apparent, and it can also nourish Liver and Kidney system in body), herb Baihuashe She Cao, and herb Gan Cao, etc. For those of patients with apparent Wet-Hot condition, herb Pu Gong Ying can stimulate diarrhea, to create an exit for Xie Qi to be dispelled out of body. (When the diarrhea happens, the Pu Gong Ying can be stop to use, or add another herb Bai Zhu in the same herbal formula) 

(6). 蜂房,有一部分病人表现为阳虚,我喜欢用蜂房,它既能助阳,用能攻毒外出,阳虚症状的多见于慢肝,毒邪深伏于肝,与湿胶结,加之正气不足,正虚邪恋而缠绵不愈,湿为阴邪,易伤阳气,故用蜂房助阳,化湿邪,攻毒外出,一药三用。

(6). Feng Fang[3]

Some patients with chronic hepatitis show Yang deficiency. For those, I like to use ingredient Feng Fang. It can work both to nourish the Yang Qi and to dispel Xie Qi out of body. Chronic hepatitis is easy to have such Yang deficiency condition, since the toxic Xie Qi hides deep in the liver, glues with Wetness, in addition of the weakness of health-maintaining Qi, the Xie Qi sticks and hard to solve. The Wet Xie Qi belongs Yin in Xie Qi nature. It tends to hurt body Yang Qi. The herb Feng Fang works to nourish the body Yang Qi, to melt the Wet Xie Qi, and to dispel Xie Qi out of body – three functions to solve hepatitis.

肝为解毒器官,所以肝病病人用药不宜太大剂量,不宜用太多毒性药,以免加重肝负担。

Liver is the organ in the body to detoxify, so for patients with liver disease, the dose of herbal or western medicine chemical drugs should be too large to increase the burden to the liver.

 

2,阳痿早泄

2. Impotency and premature ejaculation

(1). 红参,肥胖,体力差等证见气虚阳虚者,红参可以大补元气,对阳痿症状也有很明显的效果,我通常是在常规治疗效果不显时才加,起绝招之用,剂量在20g  30g.(养殖)

(1). Hong Shen (red ginseng)

For patients with over weight and weakness in energy, showing Yang deficiency or Qi deficiency, the herb Hong Shen can nourish the body Yuan Qi (Life Qi, Life energy). It also works very well for male impotency. I usually add it into herbal formula when the conventional therapy does not work well. It is my last choice for such patient. The dose is between 20 and 30 grams (if the Red ginseng is farm planted, not a wild one).

(2). 枸杞,对房劳过度引起的精血不足比较适宜,古语有离家千里,勿服枸杞,说明它有强阳道之功。虽然它的作用很平和,但却很实用,一可以补肾填精以起痿,二可以与补阳药相伍,抵制补阳药之燥烈。枸杞用量到50g以上,效果会很明显。

(2). Gou Qi Zi[4]

Herb Gou Qi Zi is proper to use in patients with deficiency in Jing and Blood due to over sexual activity. There is a old saying that, do not eat Gou Qi Zi when you leaves home for long time. It suggests that it has strong ability to nourish the sex function. Though its effect is slow, it is very practically useful. It works to nourish the Kidney and the Jing Qi to solve impotency, and can work with other Yang-nourishing herbs to solve the possible side effects of dryness by these Yang-nourishing herbs. When used for more than 50 grams, its healing effect will be very strong.

(3). 淫羊藿,对性事淡漠的病人,此药为首选,从名字中就可以看出羊食贪合,增欲望。用于临床,效果的确明显,若符合肾阳不足,其剂量一般用2050.此药是我治疗肾虚阳痿的最常用药。

(3). Yin Yang Huo

For patients with low desire for sex, the herb Yin Yang Huo is the first one to chose. From its name, it can be known that it makes sheep or goat like sexual activity. When used in clinic, it indeed works for human too. If a patient has Kidney Yang deficiency condition, use 20 to 50 grams of it. It is my mostly used herb in the treatment of impotency.

(4). 阳起石,几年前治疗一10年病史的病人,诸多治疗方法无效,我以此药为主,剂量达到70,佐以枸杞防其燥烈,病人于用药第2日获得成功房室。取效后减量巩固治疗一些时日,2年来未复发。中医之密在于量,在此处可见一斑。通常情况,它的剂量只是1530 g,随病情调节药量。此药过量会引起咽干等,但未发现其他不适。

(4). Yang Qi Shi[5]

Several years ago, I treated a patient who has impotency for ten years.  He had tried many various remedies without any improvement. I used this herb as the main ingredient, with its dose up to 70 grams, and with the herb Gou Qi Zi to prevent its sharp-drying side effect. The patient got a success sex intercourse on the second day. After that, its dose was reduced and kept in lower dose for some time for a maintenance. It was no longer a problem for him for two years.

The secret of Chinese herbal therapy is the dose. This is well dominated true in this case. In most cases, it is used for 15 to 30 grams. Its dose is adjusted according to the clinic condition. Over use of it may cause dry throat, but no any other side effects were noticed.

(5). 蜈蚣,我个人认为不用辩证分型的有效药,一,精神忧郁引起的,它可以疏通肝络以起痿,二,脉络瘀阻(动脉硬化)引起,它可以化瘀通脉以起痿,三,蜈蚣本身也有强壮之功。有一问题顺便提及一下,蜈蚣和枸杞开始时经过几例治疗发现,水煎的效果比吞服的好,原因至今未明,但为取效,一直就用水煎的方法至今。

(5). Wu Gong[6]

I believe that, the herb Wu Gong can be used in any kind of impotency without the need of a specific Traditional Chinese Medicine (TCM) diagnosis. First, for the impotency due to emotional depression, it works to lose Liver meridian to improve impotency; second, for that due to block of blood vessels (arteriosclerosis), it works to clear the block of blood clots, so to improve impotency; the third, the herb Wu Gong per se has strong effect to strengthen the sexual ability. One thing I should mention here: it was found in the early several cases that the herb Wu Gong and Gou Qi  Zi, when cooked in water to drink, work much between than they are grinded into powder to swallow. The reason is still unknown. However to keep the high healing effect, the water-cook way is continuously used up to now.

(6). 滑石,早泄遗精用,可能有的朋友感觉很奇怪,是这样,早泄和遗精都属于尿窍闭,精窍开,不兼用利水以开尿窍而仅以涩精之品固精门,很容易越涩越不利,所以在用五味子,桑螵蛸,金樱子等涩药的基础上加一味滑石,取其用涩于利之中,用补于遗之内,此为用药之密。此法还可以有效防止有轻微湿热的病人闭门留寇。

(6). Hua Shi[7]

It is used in the formula for nocturnal emission and premature ejaculation. Some one may feel stranger to use it in such clinic conditions, since both conditions belong to the close of urine tract but leakage of sperm tract. If not use diuretic medicine to open the urine tract but only use contracting medicine to close the sperm tract, it is often felt that, the more use of the closing medicine, the condition is more difficult to improve. Therefore, in the use of herbs, such as Wuweizi, Sangpiaoxiao and Jingyingzi, add the herb Hua Shi in the formula, taking the consideration of both closing and contracting for the treatment. This is a secret in using herbs for the treatment. This way is also useful to prevent sticking Xie Qi in the body in patient with Wet-Hot condition, due to the use of the closing herbs.

对于阳痿早泄病人,有一部分是因为精神压力等心理因素引起,此情况我一般以疏肝解郁为主,调补肝肾为辅。对于房劳或手淫过度引起的病人,我常用阴阳双补的方法,意在阴中求阳,阳中求阴,视病人脉证而定具体配伍。对于肥胖病人,多属于气虚阳虚,痰湿盛,所以就根据脉证多用补气补阳,化痰利湿为主。对于糖尿病病人和中老年人,其局部动脉硬化,供血不足,此为原因和过程很复杂的肾虚兼脉络瘀阻,治疗当补肾与活血通络并用,如加蜈蚣,地龙等。另外还有湿热下注等不再一一详解。

For patients with impotency and premature ejaculation, some are due to emotional stress, such psychological reason. For such patients, I usually use Liver-loosening, depression-calming therapy as main therapy, and a Liver-nourishing and Kidney-nourishing therapy as a complementary therapy. For other due to over sexual activity or stimulation, or due to too much manustupration, I commonly use the double nourish of Yin and Yang, with the consideration of getting Yang from the Yin, and getting Yin from the Yang. The use of exact herbs depends on the patient’s pulse.

For overweigh patient, they usually have Qi deficiency and Yang deficiency, and have extra Wet and phlegm[8] in the body. For those patients, it is needed to use herbs to nourish the Qi and the Yang, as well as to dissolve the phlegm and to expel the extra Wet from the body.

For patients with diabetes or for elderly patients, these problems are more due to local arteriosclerosis that reduces blood supply to the penis. In Chinese medicine, it is also due to the co-exist of Kidney deficiency and blood stagnation. The treatment should take into consideration of nourishing Kidney, activating blood circulation and smoothing meridian. The herbs should be used are such as Wu Gong, Di Long (earthworm), etc. There is also some other reasons to cause the premature ejaculation or nocturnal emission, such as Wet-Hot accumulation. It is not to be discussed further more here.

 

3,胃病

3Gastric disease

(1). 枳实,胃痛或胁痛属气滞者,单独此一味就可以获效,我感觉它是行气药里效果最明显的。本人几年前患胃痛,开始只是偶发,后来曾持续性,先以郁金,厚朴等效果不显,最后以枳实10  G,于用药第2 日后,再未发作过,从此我治疗气滞胃痛必用此药,用于临床,通常都是1日见效。如果病人脾虚腹胀作痛,需要加四君子以标本兼顾。

(1). Zhi Shi

For stomach pain due to Qi stagnation, the single herb Zhi Shi works well. I feel that it is the most effective herb among all herbs used to solve stomach pain. I myself suffered from stomach pain several years ago. From beginning, it happed occasionally, later, it became frequent. I have tried to use herb Yu Jing and Hou Po, etc. None works. Finally, ten grams of Zhi Shi worked to stop the pain. From the second of the use of Zhi Shi, the pain had never come back. From then on, it became as must-use herb when I treat stomach pain due to Qi stagnation. In clinic, it usually showed healing effect on the day to use it. If the stomach pain is due to Spleen deficiency with belly bloating feeling, it is needed to use Si Jun Zi Tang together to solve the symptoms and the cause of the stomach disease.

(2). 三七,胃痛属瘀血,痛处固定,夜重,脉涩,我首选为三七,个人感觉三七效果优于五灵脂蒲黄,其化瘀定痛之功在瘀血胃痛里也能很明显的显示出来,另外对消化性溃疡引起的出血证属瘀血的更为适宜,既能止血又能活血。

(2). San Qi

For stomach pain due to blood stagnation, in which the pain feels in fixed spot, severe at night and pulse is unsmooth, I will first choose the herb San Qi. I myself feel that it works better than herb Wu Ling Zhi and Pu Huang. Its healing effect can be well demonstrated in such stomach pain due to blood stagnation. In addition, it also works well to stop bleeding in gastric ulcer cases, if the bleeding is due to the blood stagnation condition. In this later case, it works both to stop bleeding and to improve blood circulation.   

(3). 蒲公英,此药擅长治疗痈疡,能清胃消瘀,对于糜烂性胃炎,胃溃疡伴感染,证属瘀热而胃痛的效果极佳,如能用其根更妙。辩证准确有药到病除之效。

(3). Pu Gong Ying[9]

Herb Pu Gong Ying is good at the treatment of carbuncle and ulcer. It works to clear blood stagnation syndrome in stomach. For erosive gastritis, gastric ulcer with inflammation, which belongs to stagnation-Hotness condition, it works very well to stop the gastric pain. The root works much better than other parts of the plant. If the CTM diagnosis is correct, its healing effect is very fast to cure.

(4). 穿山甲,西医检查为萎缩性胃炎肠上皮化生者,可能与癌前病变有关,中药可以使其吸收,而此功非草木所能胜任,所以我用穿山甲,配伍五灵脂,蒲黄活血化瘀,去旧生新,同时加白花蛇舌草解毒防癌。此型胃炎一般胃液分泌不足,加乌梅酸甘化阴,促进胃液分泌。

(4). Chuan Shan Jia

For atrophic gastritis with intestinal metaplasia, diagnosed by western medicine, it might be related with the development of a cancer. The TCM herbs could work to make it disappear, but it is beyond the ability of plant herbs. So, I usually use Chuan Shan Jia, plus the use of Wu Ling Zhi and Pu Huang to motivate blood circulation, to dissolve blood stagnation, to remove dead tissue and to improve new tissue growth, in addition with the use of Baihuashe She Cao to detoxify and to prevent cancer. This type of gastritis is usually with poor secretion of gastric juice. I add herb Wu Mei (plum) to develop Yin and to improve gastric juice production. 

胃病的中医分型很复杂,也与肝胆脾密切相关,所以需要辩证准确方可下药,对寒热错杂的胃痛,可用甘草泻心汤,针对寒与热的偏盛,调节姜,连的剂量,对慢性溃疡,辩证基础上加补中之黄芪,生肌之白芨可愈。等等等等。不再详述。

It is quite complex for the classification of gastric disease in Chinese medicine. The illness is also related to the function and disorder in the Liver and Spleen system in the body. For this reason, the diagnosis in TCM is very important to gain satisfied healing result. For those of gastritis with both Hot and Cold condition in the stomach, the formula of Gancao Xiexin Tang can be used. The amount of fresh ginger and herb Huang Lian in the formula should be adjusted according to the extent of the Hot and Cold. For chronic gastric ulcer, add herb Huang Qi to nourish the middle health-maintaining Qi, and add herb Bai Ji to improve new tissue growth in the stomach, under the ground of a correct diagnosis in TCM and with the use of basic herbs. This is only a example to say.

 

4,贫血

4. Anemia

(1). 黄芪,根据气与血的关系,治疗由失血,胃病等原因引起的贫血,黄芪可以补气以生血,同时,气虚气不摄血引起的出血,黄芪还能补气摄血,脾虚,气血生化乏源,黄芪可以补脾以生血。

(1). Huang Qi

When used in anemia due to lose of blood or due to gastric diseases, the herb Huang Qi works to nourish the Qi so as to stimulate the production of blood, according to the relationship between the Qi and Blood in the TCM concept. When the Qi is in deficient condition, it fails to hold blood in the blood vessels to cause bleeding. In this later case, herb Huang Qi works to support the Qi so to make more Qi to control the blood within the blood vessels. When in Spleen deficient condition, the source of Qi is not enough. The use of Huang Qi can nourish the Spleen to produce more Qi in the body, so to produce more blood.

(2). 鹿角胶,用于再障性贫血,此病病位在骨髓,肾主骨生髓,髓生精,精化血,故用鹿角胶补肾精以化血,此为精血同源原理,治疗此病必须从此处下手,我曾治疗2例,配伍龟板胶,蚕沙等取得良好效果。

(2). Lu Jiao Jiao[10]

Lu Jiao Jiao can be used for the treatment of aplastic anemia. It works on the Kidney. The Kidney dominates the bone in the body, the bone produces bone marrow, the bone marrow produces the Jing, and the Jing develops into the blood. So, the use of Lu Jiao Jiao can nourish the Kidney, so as to stimulate the production of blood. This means the Jing and the blood shares the same source. To treat aplastic anemia, we must pay attention to the Kidney. I have tried two cases with aplastic anemia, with the addition of also Gui Ban Jiao and Can Sha, and so on. The results are impressing.  

(3). 蚕沙,还是针对再障,龟鹿二仙胶是治疗再障的首选药,但很滋腻,不利于久服,而蚕沙可以补脾化湿,巧妙的解决了问题,用它的另一原因是蚕沙提取物经证实,对造血干细胞,粒单细胞,红系祖细胞,骨髓有核细胞的恢复,增值有很明显的促进作用,也能调节骨基质的修复,从而促进了骨髓造血功能的恢复。

(3). Can Sha

To treat aplastic anemia, the herbal formula of Gui Lu Er Xian Tang is the first choice. However, it is with greasy nature, and not suit for a long time intake. The herb Can Sha works to nourish Spleen and to dispel Wetness, so to solve this side effect problem. Another reason to choose the herb Can Sha is that, it is found that it has clearly strong improving effect on bone marrow to produce various stem cells for blood cells, and it can improve the repair of the base material of bone, so to improve the recovery of the bone function to produce blood cells.

(4). 磁石(代赭石),缺铁性贫血言外之意就是体内缺铁,所以我们在治疗此病时,可以适当加点原料,比从食物获取要快多了,不妨试试。

(4). Ci Shi[11] (or another herb ingredient Dai Zhe Shi[12])

For iron deficiency anemia, as its name, is due to short of iron in the body. So, in the treatment of such anemia, we can consider to add some ingredient that contains iron, to produce blood cells. It is much fast than supplying iron from diet. You may try it.

(5). 何首乌,经治疗观察,在补血药中,它的效果要比当归好的多,几乎与阿胶不差上下,我在临床经常用到50 g,它所含的卵磷脂是血细胞膜的主要原料,并且又能促进造血,在治疗贫血时,它是我的必用药。

(5). He Shou Wu[13].

It has been observed that, the herb He Shou Wu, when used for the treatment of anemia, works much better than herb Danggui[14], and its effect is similar to that of A Jiao[15].  I usually use 50 grams of it. It contains lecithin, that is the major raw material of cell membrane, and can promote blood production. It is a must-use ingredient when I treat anemia.

(6). 绿矾,钩虫病贫血的要药,治疗贫血不能只是补血那么简单的事,必须查明贫血的病因,针对病因治疗,就像钩虫病引起的贫血,单纯补血岂能行。钩虫感染导致脾虚,脾虚血失其统反生湿热,加上钩虫繁殖排泄浊气而导致萎黄,治疗需要补脾虚,泻湿热,杀虫。

(6). Lu Fan

Lu Fan is the main ingredient in the treatment of anemia due to hookworm disease. The treatment of anemia should not only pay attention to the production of more blood. The cause for the anemia must be verified and be treated. Such as for the anemia due to hookworm disease, it cannot be solved without the treatment for the hookworm disease per se. The inflammation due to the hookworm can cause Spleen deficiency, which then cause bleeding (the function of the Spleen system in TCM is to maintain blood within the blood vessels) and cause Wet-Hotness, plus the weakness due to metabolic waste material by the worms, the principle in the treatment should be to nourish Spleen, to dispel Wet-Hot and to kill the worm.

贫血可以有许多种原因,在治疗的过程中,要找到原因再对症治疗,这里需要我们辨病和辩证相结合,比如因为失血引起,我们要先治血症,慢性胃炎引起,我们要治胃病,等等,有一个方剂对贫血的症状效果很好,是人参养营汤,另外对于简单的贫血用食疗的方法也不错,比如猪肝,红枣等

Many reasons can cause anemia. In the treatment of anemia, we should find the cause before the treatment for the symptoms. Here it is needed to have both disease-diagnosis (western medicine diagnosis), as well as the TCM syndrome diagnosis. For example for the anemia due to blood loss, we need to treat the cause for the loss of blood, such as in chronic gastritis, we should treat the gastritis, etc. There is a formula that works very well for the anemia. It is the formula Rensheng Yangying Tang. In addition, for simple anemia, diet therapy works well too, such as eating pig liver and Chinese date, etc.

 

5,复发性口疮

5. Recurrent mouth ulcer

(1). 胡黄连,口疮属心脾积热,见多处溃烂,灼热而痛,口臭便干,此药为我的首选,起泻火化浊之用,临证也可以用泻心汤加减,也可以加蒲公英清热解毒,但个人感觉,此药作用十分强大。

(1). Hu Huang Lian

Mouth ulcer belongs to accumulated Fire in the Heart and Spleen system of the body. Patients may have several ulcer in the mount mucus. It feels burning and pain, with bad odor in mouth and constipation. The herb Hu Huang Lian is my first chose in the treatment of mouth ulcer. It works to dispel Fire and dirty material from the body. In clinic, we can also use herbal formula Banxia Xiexin Tang with some adjustment of its ingredients. We can also add herb Pu Gong Ying to clear Fire and to clear toxic. My own experience is that, the herb Hu Huang Lian is very strong in its healing effect. 

(2). 细辛,疮家圣药,起收湿疗疮之用,又能止痛,但不适合虚火引起的口疮。

(2). Xi Xin[16]

Herb Xi Xin is a traditionally used herb to cure ulcer. It works to clear Wet and speed up wound healing and to reduce pain. However, it is not suitable for the treatment of the mouth ulcer caused by False Fire syndrome.

(3). 肉桂,用于阴虚火旺,虚火上炎引起的口疮,可引火归元,此型口疮此愈彼起,反复发作,有阴虚体征,治疗时在养阴解毒基础上加肉桂收浮游之火是很必要的,一般我用5 g.

(3). Rou Gui[17]

The herb Rou Gui is used for the mouth ulcer due to Yin deficiency, False Fire overwhelming condition. It works to bring the Life Fire back to its storage place (Kidney). Such kind of mouth ulcer comes and goes, comes again and again. The person usually has Yin deficiency condition. In the treatment, it is very necessary to use Rou Gui to collect and to bring the floating Fire back to Kidney. I usually use 5 grams.

(4). 蜈蚣,曾治疗一例顽固口腔溃疡,局部溃烂严重,用清热敛疮等常规疗法效果不明显,后来我按毒瘀论治,在原方基础上加蜈蚣,皂角刺破瘀攻毒,很快的取得了效果,此药我也用来治疗臁疮,褥疮等。

(4). Wu Gong[18]

I treated a case with intractable mouth ulcer. The local ulcer wound is very severe. The use of Fire-clearing and wound-healing herbs do not work at all. Later, I treated it according to poison-stagnation theory, added herb ingredient Wu Gong and Zao Jiao Ci[19] in the original herbal formula, the healing became very fast. I have used this herb to solve severe wound due to other reasons, such as bed ulcer.  

(5). 黄芪,疮口久不愈合,遇劳加重,,伴脾虚之象,此类为黄芪特长,黄芪擅长托毒生肌,对虚弱而疮口不愈合的很适合,只是在剂量上要用重剂方可显效。

(5). Huang Qi.

It is the priority to use herb Huang Qi for mouth ulcer in which the wound does not heal for a long time, and it became worse when exhausted by over work. Herb Huang Qi is good at clearing toxic or poisons in the wound and at stimulating new tissue to grow. It is much more suitable for such intractable mouth ulcer. However, the dose has to be large to get healing effect.

此病新病易治,久病较难,一般急性期或新病,清热解毒剂可见效,慢性而反复发作的多属虚,根据脉证或养阴,或补气对症治疗,对没有湿热瘀毒,单纯溃疡可以加白芨促进愈合,外用药,我喜欢用儿茶粉。有烟酒嗜好,喜吃辛辣的要戒除避免之。

For mouth ulcer, it is not too difficult to treat for a newly happened ulcer, but it is really difficult for a old and chronic one. Generally speaking, for a newly occurred mouth ulcer, Fire-clearing and toxic-dispelling formula can work. The chronic mouth ulcer generally belongs to weakness condition. Based on the pulse, either Yin-nourishing, or Yi-nourishing herbal formula should be used. For those pure and single ulcer without We-Hot and toxic accumulation, herb Bai Ji can be added in the formula to stimulate healing of wound. For external used herbs, I prefer Er Cha Feng. Patients craving for cigarette smoking or alcohol, of for spicy food should avoid such things too.

 

6,乳腺增生

6. Hyperplasia of mammary glands

(1). 生麦芽,乳腺增生初期可能因情志所伤,引起肝气郁结而发病,久病也多因此加重或复发,生麦芽可以疏肝解郁,治疗肝气郁结,用它的另一原因是中药药理学证实它可以抑制催乳素释放,从而达到治疗效果,肝郁较重加柴胡,生麦芽我一般用100 g。小了无效。

(1). Uncooked MaiYa (Malt)

The hyperplasia of mammary glands might be caused from beginning by emotional disorders, which cause Liver Qi stagnation. For chronic case, it is also usually due to the same or similar reason to become worse or recurrent. The herb Mai Ya works to loose the Liver Qi, to solve the Qi stagnation to solve the this problem. Another reason to use it is that it has been evidenced in herbal pharmacology that it inhibits the secretion of hormone prolactin, so to gain additional healing effect. If the Liver Qi stagnation is severe, herb Chai Hu can be added. For the Mai Ya, I usually use 100 gram. It does not work if the dose is small.

(2). 白芥子,肝郁日久,化热生痰凝淤,形成结节,又皮里膜外,非白芥子莫能达,此结节恰恰就在皮里膜外,而白芥子又擅长消痰散结,岂能舍而不用。

(2). Bai Jie Zi

For those of node (tubercle) which is caused by long time Liver Qi Stagnation that causes Fire and Phlegm accumulation in the breast, and which is located under the skin but out of the fibro membrane that folds muscles, it is the herb Bai Jie Zi that must be used for the treatment. The node in the hyperplasia of mammary glands are just between the skin and the fibro membrane, and the herb Bai Jie Zi is good at clearing such node, certainly it should be used.

(3). 穿山甲,此病结节多属痰淤互结,祛瘀药里,功居首位的当属此药,通乳大家都知道,更何况破瘀节,我经常遇到因劳动用力过度牵拉而引起乳痛发作的,我按外伤加土鳖虫祛瘀疗伤,至今为止,未见无效者。如果有人闲穿山甲太贵,土鳖虫为最佳代替品。

(3). Chuan Shan Jia[20].

Hyperplasia of mammary glands usually belongs to the stagnation and accumulation of phlegm and dead blood. Among the herbs that work to clear the phlegm, the herb Chuan Shan Jia works the best. It is well known that it can smooth and to conduct the breast milk secretion, nor to speak of its breaking the stagnated node. Quite often, I met patients who had breast pain after over stretching the arms and chest during heavy labor work. For such pain, I treated it according to external damage to use herb Tu Bie Chong. Up to now, I did not see any case with no effects. If some one worry the herb Chuan Shan Jia too expensive, the herb Tu Bie Chong is the best alternative choice.

(4). 白僵蚕,久病结节难消,应软坚散结,白僵蚕能化顽痰,散结节,通经络,与浙贝,海藻合用,对此病乳腺结块有消散作用。

(4). Bai Jiang Can[21]

For chronic node, it is hard to make it disappear. The treatment should target the soften the hard node to make it disappear. The herb Bai Jiang Can works to soft and melt hard node, to smooth meridian. Together with other herbs, such as Zhe Bei and Hai Zao, it improve the disappear of the node in breast.

(5). 鳖甲,几年前曾治疗一个纤维化增生病人,当时考虑鳖甲可以治疗肝纤维化,对此病也该有效,于是以此一味研细末吞服2月,后经西医检查,完全治愈。

(5). Bie Jia[22]

Several years ago, I met a patient with breast fibrosis. Considering the fact that herb Bie Jia works for fibrosis in liver, it should also be effective in the breast. I asked the patient grind the Bie Jia into powder, fold in capsule to take for two months. Later after check by western medicine, the fibrosis disappeared.

(6). 二至配淫菟,这是4味药,旱莲草,女贞子,淫羊藿,菟丝子,前2药养阴,后2药助阳,合用调冲任,根据病人的阴阳偏盛偏衰,调整双方剂量,阴虚重用养阴,阳虚重用助阳,此法是我治疗阴阳失调(内分泌紊乱)的主要手段之一���因为此病也与阴阳失调(内分泌紊乱)密切相关。

(6). Herb formula Er Zhi Tang plus Yin and Tu

There are four herbs : Han Lian Cao, Nu Zhen Zi, Yin Yang Huo and Tu Si Zi. The first two herbs nourish the Yin and the later two nourish the Yang. In combination, they work to adjust the Chong and Ren meridians. Adjust their ratio according to patient’s Yin and Yang, see which is relatively more overwhelming and which is less sufficient, use more Yin-nourishing herbs or the Yang-nourishing herbs. This is my main principle to re-balance the disorder in the Yin and Yang (disorder of endocrine system) in the body. This is because this disease (the hyperplasia in mammary glands) is also related to the disorder of Yin and Yang (disorder in the endocrine system).

此病及其常见,大家在治疗上也不会陌生,可能我的方法在高手面前只是班门弄斧,不敢再妄加描述。

The hyperplasia in mammary glands is quite common. All of you are familiar with the treatment. My way of the treatment might be well known by you, so I will feel embarrassed if I continue here to talk too much.

 

7,尿路结石

7. Stone in urine tract

(1). 三金,这里的金钱草,海金沙,鸡内金是众所周知的化石排石药,提出来是为了不让大家忽视它,原理不讲了,都知道。

(1). Three Jin herbs.

The three Yin herbs refer to the herb Jin Qian Cao, Hai Jin Sha and Ji Nei Jin. They are well known herbs to stimulate and to improve stone dispelling. To mention them here is to remind the readers do not forget it. It is not needed to tell the reason to use them. Every one knows it.    

(2). 土鳖虫,结石发作时绞痛难忍,证属瘀血,土鳖虫擅长治疗瘀血腰痛,在这里当然也算符合病机,活血是排石的动力之一,我还经常用三棱,莪术,王不留行,川牛膝联用,有条件者加穿山甲更好。

(2). Tu Bie Chong[23]

It is very painful when the stone starts to move in the urine tract. In Chinese medicine, such pain belongs to blood stagnation. The herb Tu Bie Chong is good at the treatment of lower back pain due to blood stagnation. It is also suitable to be used here since it follows the same mechanism. To motivate blood circulation is one of the major ways to solve the stone syndrome in urine tract. I usually also use herb San

Len, E Zhu, and Chuan Niu Xi. It is better to use the herb Chuan Shan Jia too if it is available.

(3). 乌药,针对下焦气滞,冷痛,我喜欢用乌药行气散寒止痛,剂量比较大,要30以上方可。此病发作疼痛难忍,且有伤肾可能,所以用药最好在保证安全的前提下用大剂量速愈之。大剂量乌药可以扩张尿管,有利于排石。

(3). Wu Yao[24]

For Qi stagnation and Cold pain in the lower belly, I like to use herb Wu Yao to improve Qi movement, to dispel Cold, so as to stop the pain. However, the dose should be large. It needs more than 30 grams. The pain in the urine tract due to stone is very painful, and it may hurt the kidney, so it should be solved as soon as possible to use large dose herbal therapy, under the condition of safe. Large amount of herb Wu Yao can enlarge urine tract, so to improve the discharge the stone.  

(4). 附子,在这里用于补阳,阳主动,阳气充足才有力推动结石外出。看过很多方子都忽略了这一点。

(4). Fu Zi[25]

Here the herb Fu Zi works to nourish the Yang. The Yang in the body dominates the motivation and the movement. When the Yang Qi is sufficient, the body then has enough power to push out the stone. I found that many herbal formulae neglected this.

(5). 滑石,利尿通淋药中,此药我必用,喜欢它的名字,滑石滑石,滑出结石,有名中医说过它可以滑利尿管,对结石的排出有利。

(5). Hua Shi[26]

Among the herbs that work to smooth urination and to solve infection in the urine tract, herb Hua Shi is the one that I must use. I like its name: its name in Chinese means to slipper stone. There is a famous TCM doctor who said that Hua Shi works to smooth urine tract, and it is good for stone to discharge out.

(6). 琥珀,古方治疗石淋的,用琥珀的占一大部分,它有利尿通淋和活血化瘀的双重功效,又可以治疗尿血,为我治疗尿路结石的必用药。

(6). Hu Bo[27]

In old TCM formulae for the treatment of urine stone, the herb Hua Shi is the major part in most formulae. It works to improve urination, to solve infection, to activate blood circulation, and dissolve blood stagnation. It can also work to stop urine bleeding. It is the herb that I always use in the treatment of the urine stone.

(7). 杏仁,对于石淋有小便不利症状的,或者无尿的,我有时会考虑到肺的宣降功能,肺主通调水道,小便不利及无尿在治疗时添加杏仁桔梗宣肺以利水,是一个行之有效的思路,恰恰就是提壶揭盖的治疗方法。此法我也用于前列腺增生引起的小便不利等。

(7). Xin Ren (Apricot)

For those of urine stone syndrome with infection and difficulty in urination, or there is cessation in urination, I some times may consider to use herb Xin Ren and Jie Gen to improve the dispersing function of the Lung so as to improve the urination. This is based on the consideration that the Lung has function of dispersion and descend function in the body.  This is a useful way. It works similar to open the lid of a tea pot so to improve the running of the tea from the tea pot. I use the similar way in the treatment of the difficult urination due to hyperplasia of prostate too.

尿路结石治疗如果在一周后仍未痊愈,需添加生地,防利水伤阴,发作频繁而疼痛难忍的,加全蝎粉4吞服或加重剂白芍甘草可缓解,尿血的用血余炭,小蓟利尿止血,身体壮实的加服威灵仙增排石之力,虚弱的加黄芪或补肾药增排石之力。此病引经药为牛膝,山楂。结石大于1.5,久治不愈,而又肾积水明显的,手术吧。

If the urine tract stone condition is not healed after one week, it would be needed to add herb Sheng Di, to prevent the damage of Yin due to the use of urination herbs. For the condition in which the pain is frequent and severe to tolerate, add herb Quan Xie powder 4 grams (swallow only), or add more amount of herb Bai Shao and Gan Cao. For urine bleeding, add herb Xue Yu Tang and Xiao Jin to improve urination and to stop bleeding. For stronger body condition, add herb Wei Ling Xian to increase the for force to dispel stone. For weak body condition, add herb Huang Qi or Kidney-nourishing herbs to increase the force to push down the stone. For this stone condition, the herb Niu Xie and Shan Zha are the disease-targeting herb. If the stone is bigger than 1.5 cm, or the herbal therapy does not work, and the water accumulation is too much in the kidney, the surgical operation has to be considered as the last choice.  

 

8,下肢静脉曲张

8. Varicose vein condition

(1). 黄芪,气能行血,病人久立,因气虚不能推血上行,故淤于下肢,形成瘀血,阻于脉络,脉络受损,变得曲张迂回,黄芪既可以补气让行血有力,又可以升提助血上行,故气充足推血上行全赖黄芪也。

(1). Huang Qi. 

Qi functions to pump the blood to circulate. When patient stands for a long time, his insufficient Qi would be able to push the blood moving up, so the blood becomes stagnated in the veins in the legs to block the blood vessels. The blood vessels so are damaged to become varicose like. The herb Huang Qi nourishes the Qi to increase the power to push the blood up. It can also bring the blood moving up by it self. So, it is the function of the Huang Qi to improve the blood circulation upwards.

(2). 枸杞,先天肝血不足(此病遗传,可天生血管壁薄弱)或后天郁怒伤肝而血燥,使筋脉失其濡养而薄弱,加之瘀血阻于其中,伤上加伤,故而变形扭曲。枸杞养肝血,肝血充足自可濡养受损之筋脉,使之强健回缩。

(2). Gou Qi Zi

If the liver blood is not sufficient from the birth (it can be genetic problem, in which the blood vessels are thin and weak), of if the person has emotional problem (such as anxiety or depression), which hurts the liver to cause blood dryness, which again cause the poor nutrition on the blood vessels, so as to make the vessels being weak in the walls, the blood become stagnated in the vessels, further more makes the vessels become curved and twisted. The herb Gou Qi Zi nourishes liver blood. When the liver blood is sufficient to nourish the vessels, it can repair the vessel wall to improve its flexibility.

(3). 海藻,此病中医病名为腿筋瘤,属瘤病范畴,从其外观看,曾隆起状,触之较硬,所以需要软坚散结以治之,海藻为我最常用之品。

(3). Hai Zao

In Chinese medicine, this illness is called leg tendon tumor, since it looks as a bumping mass and touches hard. So there is need to use some herbs to soft it and to disperse the bumping mass. The herb Hai Zao is one of the herbs that I used quite often.

(4). 白僵蚕,地龙,久病多痰淤,脉络受阻日久必有痰淤互结,而痰淤互结又可以加重脉络受阻,我喜欢用此2药,既能化痰淤,又能通脉络,且又为强悍之品(久病之痰淤为顽痰顽瘀,非草木所能胜任)

(4). Bai Jiang Can[28] and Di Long[29]

It tends to have Phlegm accumulation in a long term disease condition. It is also true when the blood vessels are blocked or stagnated for a time. When the Phlegm and the stagnated blood come together, they make worse the block of the blood circulation. I like to use these two herbs, for the reason that they can both disperse the Phlegm and improve the circulation, as well as they are powerful than the plant herbs in such sticky condition.

(5). 附子,久病病人下肢大多冷痛,不论是寒湿引起还是阳虚引起,附子皆适宜,况且附子走而不守,通行12经,对淤滞之处更是毫不留情,与行气活血并用,效果异常明显,上例提到的结石病用附子也是这个原理。

(5). Fu Zi

Patients with a chronic disease usually have cold pain in the legs. No matter it is due to Cold-Wet or to a Yang deficiency condition, the herb Fu Zi is a proper one to use. The Fu Zi moves in the body without stick in a specific location, it moves to all the meridians, and it works powerful in the stagnated spot as well. When it is used together with the herbs that work to improve the movement of Qi and the circulation of the Blood, the effect of the Fu Zi is much more impressive. This is the same reason to use it in the treatment of urine stone condition above.

此病的阳虚瘀血症可用阳和汤,气虚瘀血症可用补阳还五汤,在对症治疗的前提下,顾虑一下上述所言,并考虑添加之,可大大增强疗效,如果病人疼痛频繁,加蜈蚣全蝎,双腿无力,加淫羊藿,牛膝,等等等等。

If the varicose vein condition is caused due to Yang deficiency and Blood stagnation, the herbal formula Yang He Tang can be used. If it is due to Qi deficiency and blood stagnation, use formula Bu Yang Huan Wu Tang. After chose of the proper herbal formula, add some other more herbs under the consideration of above experience and explanation, the healing effect can be much more improved. If the pain is frequent, add herb Wu Gong and Quan Xie. If the leg is weak, add herb Yin Yang Huo and Niu Xi, etc.

 

9,紫癜

9. Purpura

(1). 水牛角,急性的紫癜多属于血热妄行引起,犀角地黄汤是最适合的方剂,源于犀角很难找到,一般都知道用水牛角代替,我经过多例验证,水牛角3050 g,对于过敏性紫癜,效果十分明显。

(1). Shui Niu Jiao[30]

The acute purpura is usually caused by Blood Hotness, which pushes blood run out of blood vessels. The herbal formula Xi Jiao Di Huang Tang is the most useful one in such condition. However, the herb Xi Jiao is hard to be available. It is well known that it can be replaced by buffalo horn. I have tried in many cases  and found that, using the buffalo horn 30 grams to 50 grams, the formula works very well.

(2). 桑叶,此病属虚者,一般补虚即可,如阴虚,气虚,脾肾虚等,此病属实者,一般多用清热凉血解毒或化瘀,但有时常规治疗乏效者,我多以肝论治,皮下出血属血管破裂所致,脉管为肝所主,肝又藏血,当肝弱不藏血时,脉络失和则血管破裂,血溢脉外,桑叶善清皮下之热,润肝络止血,常规用到30 g,不论是实热还是虚热都适合,再加枸杞,白芍等养肝柔肝之品,就可以解决常规治疗无效的紫癜了。

(2). Sang Ye[31]

If the purpura belongs to a weakness condition, the mostly used therapies for the weakness condition work well, such as in Yin deficiency, Qi deficiency, and Spleen deficiency and Kidney deficiency, etc. If the purpura belongs to a Shi Condition (overwhelming condition), it is usually treated with Fire-clearing, Blood-cooling, toxic-dispelling or stagnation-dispersing therapy. Some times, such routine therapy does not work. Then, I will solve it from the Liver theory. The reason is that, the bleeding under the skin is due to the broken of the blood vessels, the liver dominates the blood vessels, and the Liver functions as a blood storage place. If the Liver is weak and can not keep the blood in it, the blood vessels will broke due to poor nourishment so as to leave blood under the skin. The herb Sang Ye is good at clearing the Fire under the skin, at lubricating the liver meridians so to stop bleeding. Generally it is used up to 30 grams, no matter it is a deficient condition or a overwhelming condition. With addition of herb Gou Qi Zi and Bai Shao to nourish the liver and to moisten the liver, the purpura is usually solved without difficulty.

(3). 仙鹤草,我的恩师是中医教授,擅长治疗血液病,我见他治疗血小板减少性紫癜(ITP),从不离此药,而且剂量很大,比如一个7岁儿童,用到60 g,他告诉我,仙鹤草既能止血,又能补虚,此病多与虚有关,又是血症,所以它是一个不可多得的良药。对于脾虚失统的病人,就用归脾汤加上此药多可获效。

(3). Xian He Cao

My teacher is a professor in TCM, who is good at the treatment of disorders in blood system. I noticed that he never treated thrombocytolytic purpura without the use of the herb Xian He Cao. The dose he used is also very big. For example for a child of seven years of old, it can be used up to 60 gram. He told me that, the herb Xian He Cao can stop bleeding and can nourish the weakness condition. The purpura is usually related to a deficient condition and it is also a blood disorder condition, so the herb Xian He Cao is the most valuable choice. If the purpura is due to Spleen deficiency, use the herbal formula Gui Pi Tang, with the addition of the herb Xian He Cao. It usually works well.

(4). 生地,紫癜时发时止,迁延不愈,伴阴虚体征,生地是我的必用药,滋阴凉血众所周知,我用它的另一原因是,它有激素样作用,过敏性紫癜是变态反应,血小板减少性紫癜(ITP)与自身免疫有关,所以紫癜的治疗在西医里,主要就是靠激素控制,但激素的副作用有时也让病人得不偿失,生地的优势就是减少了那些副作用,表现的是它的治疗作用,更不违背中医的辨证论治,就效果而言,更是令人满意。

(4). Sheng Di

The purpura comes and goes and lasts for a long time. If it is in a Yin deficient condition, the herb Sheng Di is a must-use herb of mine. It is well known that it nourishes Yin and cools blood. The another reason for me to use it is that it has hormone-like effect. The allergic purpura is a immune disorder and the thrombocytolytic purpura is related to self immune disorder too. For this reason, western medicine uses mostly the hormone to treat the purpura. But the side effect of hormone products makes the life of patients very hard. The advantage of the herb Sheng Di is with much less side effects but much better healing effect.

(5). 紫草,对热毒引起的紫癜,我首选此药,其次大青叶,它们凉血解毒消斑作用很显著,个人认为比二花,连翘明显,此结论是经过几例验证所得出,所以很看好紫草。

(5). Zi Cao[32]

For the purpura due to Fire-Toxic, I choose first the herb Zi Cao, and secondly, the herb Da Qing Ye. Their effects in blood-cooling and toxic-dispelling and rash-disappearing effects are much impressive. I personally believe that these two herbs work much better than the herb Jing Yin Hua and Lian Qiao. I get this conclusion after tried for several cases so I like these two herbs very much.

(6). 甘草,儿童病毒感染后引发的ITP属于中医里的外感疫毒,甘草可以解其毒,久病脾虚,脾不统血,甘草是补脾药之一,正如上面生地里所讲,甘草也有类激素样作用,所以,甘草在此病里所对之证较多,可身兼多职,是巧合,也很难得。

(6). Gan Cao[33]

The thrombocytolytic purpura in children after virus infection belongs to the out-invading Yi disease in Chinese medicine. The herb Gan Cao works to detoxify. In addition, after a long time of disease, the Spleen system is usually in a weak condition, so that there could be bleeding in skin. The herb Gan Cao is one of the most important herbs to nourish the Spleen. More important for the Gan Cao is that it bears cortisone hormone effect, similar to the herb Sheng Di above. Therefore, there are many indications for the use of Gan Cao in this disease. It is a coincidence and it is also a very important herb to use in this disease.

(7). 鹿角胶,ITP后期,有很多表现出阳虚症状,此时血小板数值很难提升(阳主动,主生化,阳虚必然难以生化此精微,这里的精微指的是血小板),所以最有效的方法是温补肾阳,填补肾精,这样才能从根本上解决这一难题,鹿角胶就可以做到这一点,如果这样还不能获效,说明有髓寒引起了瘀血,阻碍了血小板的生成,酌加祛瘀生新即可。

(7). Lu Jiao Jiao

In the later stage of thrombocytolytic purpura, many patients have signs of Yang deficiency. At this situation, the number of blood platelet is very difficult to increase (The Yang Qi in the body functions to activate, to move, and to stimulate, and to produce and to transform. When the Yang is insufficient, the body cannot produce micro-material, which here means the platelet). Therefore, the most effective way for the treatment of this disorder is to warm and to nourish the Kidney Yang, to produce more Kidney Jing, so as to solve the disorder completely. The herb Lu Jiao Jiao can function for this. If it does not work, it will imply that the bone marrow is Cold, which causes blood stagnation in the bone marrow, which again prevent the production of platelet in the bone marrow. In this case, just add some herbs to remove the blood stagnation and to renew the production process.  

紫癜可见于过敏性紫癜,此病多与过敏有关,如是,可添加过敏煎,如情绪引起从肝论治,还有细菌感染引起等等,所以要针对病因考虑治疗方案,如果有便血等内出血症状,加血余炭,乌贼骨,三七。如果有腹痛,可考虑加芍药甘草汤,久病及肾,引起蛋白尿等症,还要针对肾病治疗,等等等等不再赘述。中医的辨证论治很重要,在此基础上,添加辨病论治,可以使治疗思路明确,治疗效果更加稳固快捷。

Purpura can be seen in allergic purpura condition, which is mostly related to immune disorder and allergy. If it is true, add herbal formula Guo Ming Jian in the treatment. If the purpura is due to emotional disorders, treat it according to the Liver theory. The purpura can also be due to bacteria infection and so on, so it is needed to consider the treatment of the cause of the disease. If there is bleeding in stool, such inner bleeding sign, add herb Xue Yu Tang, Wu Zei Gu, and San Qi. If there is stomach pain, consider to add Shao Yao Gan Cao Tang. Long term disease could hurt and affect kidney to cause protein urine and other signs. It is needed to treat the kidney disorder in such condition too. It is very important to make TCM syndrome-diagnosis. Based on this, apply the western medicine disease-diagnosis. This way, the idea for the treatment can become more clear and precise and the treatment can also be much stable and fast. 

 

10,冠心病

10. Coronary heart disease

(1). 黄芪,冠心病大多属于本虚标实,本虚包括气血不足,继而阴阳不足,但气虚是首要的,贯穿于各证之中,对于气虚病人,黄芪可以补气强心,对于实证气滞血瘀,更可以助行气血,亦可间接助化痰,散寒凝等,为我治疗此病的必用。

(1). Huang Qi

In most cases of Coronary heart disease, the disease is overwhelming for the symptoms but weakness for its real cause. The weakness condition include Qi-blood insufficiency, which further cause Yin-Yang insufficiency. However, the Qi insufficiency is the primary reason, which exist during the whole course of the disease. For the Qi insufficiency condition, the herb Huang Qi works to supply Qi and strengthen the heart. For the overwhelming condition, such as  Qi sluggish and blood stagnation, the herbs to motivate the Qi and to conduct the blood circulation can also indirectly improve the clear of phlegm and solve the Cold accumulation. I have never treated coronary heart disease without the use of the herb Guang Qi.

(2). 海藻,冠状动脉粥样硬化,管壁内脂质沉积符合痰的性质,海藻可以化痰,另外,海藻有软坚作用,可以用来软化硬化之动脉,海藻之妙用在于此。

(2). Hai Zao

In the coronary heart disease, there is accumulation of fat/lipids in the wall of the artery. Such accumulation belongs to the concept of Phlegm in the Chinese medicine. The herb Hai Zao can dissolve the Phlegm. In addition, Hai Zao can soften hard tissue. Therefore it is very suitable to use the herb Hai Zai here to dissolve the accumulated lipids in the arterial walls.

(3). 丹参,冠状动脉内的血小板集聚沉积符合瘀血的性质,丹参可以祛瘀生新,此为众医家所共识。久病多痰淤,而冠心病的病理很符合痰淤阻于脉络,所以按痰淤论治,是我的基本治疗方法。

(3). Dan Sheng

In the coronary heart disease, there is also accumulation of platelets. Such accumulation or precipitation concept follows the blood stagnation in the Chinese Medicine. The herb Dan Sheng can remove the stagnation and to stimulate new and fresh tissue grow. This is well understood by very TCM doctor. In a long term disease, there tends to have a Phlegm sluggish condition. The reason for the coronary heart disease is pretty much in accordance with the Phlegm sluggish in the artery. Therefore, treat the coronary heart disease according to the Phlegm is my basic plan.  

(4). 何首乌,对心血不足的病人,我最喜欢用何首乌,它的效果优于当归,阿胶虽然效果也好,但太滋腻,对于有痰淤阻络征象不太适合,除非血虚十分明显而痰淤又不是很重,何首乌则无需顾虑太多,另外,还有一点,它能补肝,脉管为肝所主,冠脉受损,加上痰淤阻于其中,使之受伤不轻,补肝之法可以使受损之冠脉得以濡养,从而最大程度回复原有功能,此法为治本的要诀之一。

(4). He Shou Wu

 For patient with coronary heart disease and in a heart blood insufficiency condition, I like to use herb He Shou Wu. It works better than herb Dang Gui. The healing effect of A Jiao is also pretty good, but it is also too greasy, so not proper to be used in a Phlegm accumulation condition. If the blood insufficiency is very severe and the Phlegm accumulation is not so heavy, there would be no much worry to use the herb He Shou Wu. In addition, He Shou Wu can nourish the Liver. The Liver dominate and govern the blood vessels. In the coronary heart disease, the coronary artery has been damaged by accumulation of lipids and the Phlegm seriously. To nourish the Liver can repair the artery, so to restore the function of the artery to a maximum level. This is one of the tips in the treatment of coronary heart disease.

(5). 仙鹤草,早年治疗一个崩漏病人,因出血过多出现心悸乏力症状,我以仙鹤草80五味子20治疗,第2日,症状即得以缓解,仙鹤草有强心功能,心脏病病人有很多伴有不同程度的心功能问题,以它针对之,不次于黄芪,仙鹤草味辛涩,能于止涩中寓宣通,文献《百草镜》记载它能下血活血,治疗冠心病用它也起到了其活血的功能。

(5). Xian He Cao

Previous years ago, I treated a patient with heavy bleeding from uterus. She had palpitation and fatique due to heavy loss of blood. I used the herb Xian He Cao 80 grams, Wu Wei Zi 20 grams to her. The next day, the condition had been much improved. The herb Xian He Cao has heart-strengthening effect. Patient with heart disease usually has reduction in the heart function. It is therefore good to use the Xian He Cao to improve the heart function in such patient. In this case, the function of Xian He Cao is not less than the herb Huang Qi. Herb Xian He Cao is spicy and puckery in herbal nature. The puckery functions to attract and the spicy effects to expend and to disperse, which means to activate blood circulation. In the book <<Bai Cao Jing>>, it indicated that Xian He Cao can dispel dead blood out of body from colon, uterus or urine and can also stimulate and improve blood circulation. In the treatment of coronary heart disease, its use works to activate blood circulation too.

(6). 石菖蒲,对心肌缺血发作的,芳香开窍药效果最为快速,如檀香,冰片,石菖蒲等,我最喜欢用石菖蒲,它不仅能开心窍,还能化痰浊,我多以葛根,川芎配伍起协同作用。

(6). Shi Chang Pu

To solve coma or loss of consciousness due to heart infarction, the mind-waking fragrant herbs work the fastest, such as the herb Tang Xiang, Bing Pian and Shi Chuang Pu. I like the Shi Chang Pu most, since it can not only wake up mind and consciousness, but also dissolve Phlegm. I usually use other herbs such as Ge Gen and Chuan Xiong, together with Shi Chuang Pu.

(7). 五味子,对气阴血虚病人证见心悸者,五味子为我的必用药,其次是酸枣仁,远志等,它不仅能养心安神,还可以收敛耗散之心气而定悸,对心动过速或心律不齐偏快者,可加牡蛎,龙骨等贝石重坠之品镇之,对心动过缓证属心阳虚见心悸者,可加附子,桂枝等,临证灵活运用。

(7). Wu Wei Zi

For patients with palpitation and in insufficient condition in Qi, Yin and Blood, I never forget the use of herb Wu Wei Zi. The other choice is the herb Suan Zao Ren and Yuan Zhi, etc. The Wu Wei Zi not only works to nourish the heart and to calm spirit/emotion, but also be able to attract back the dispersed Heart Qi so as to reduce the palpitation. For patients with over fast heart beat or irregular beat but tends to be fast, add other herbs, such as Mu Li and Long Gu, such shell-stone heavy ingredients to suppress the heart beat. For patients with too slow heart beat and in Heart Yang deficiency condition, add herb Fu Zi and Gui Zhi, etc. according to the body conditions.   

冠心病多数痰淤虚并存,针对痰淤我也经常用白僵蚕,地龙化痰淤,通脉络,针对虚证,只需辩证准确即可,此病也与肝脾肺肾等相关,不能狭隘的只针对于心本身,其基本治疗方剂一定要根据病人的脉证来下药,同时参考上述所论之药。

For coronary heart disease, in most cases, the Phlegm, the Stagnation and the insufficiency conditions exist the same time. For the Phlegm and blood stagnation, I also use Bai Jiang Can and Di Long to dissolve the Phlegm and stagnation and to conduct the circulation. For insufficient condition, use the herbs according to its kind of insufficiency (Yin or Yang, Qi or Blood). This disease is also related to the Spleen, the Liver and the Kidney. We should not pay attention only to the heart per se. The basic formula must be given based on the person’s pulse and clinic signs, and consider the introduction and explanations to the herbs above.

 

11,不孕

11. Infertility

(1). 紫河车,子宫发育不良属于中医的先天禀赋不足,紫河车为首选药,它擅长补气血阴阳,对禀赋不足的问题尤为适宜,在我治疗的14个不孕病人里,有2个就是单独靠此一味药治愈的,此2病人证见体瘦,发育较差,小手指短,西医检查为小子宫,我以此药研细末装胶囊,每日15 g,长服而愈。

(1). Zi He Che[34]

The poor development of female reproductive system (uterus and ovary) belongs to the concept in Chinese medicine the genetic weakness condition. The herb Zi He Che is the number one herbal ingredient to be used in such condition. It is good at nourishing Qi, blood, Yin and Yang. It is especially suitable for such genetic weak conditions. Among my 14 patients with infertility, two were cured with the Zi He Che alone. These two women looked thin with poor body development, and with short small fingers. They were found in western medicine smaller uterus. I grinded the herb into powder, stored in capsules and let the patients to take 15 grams every day for a long time. 

(2). 菟丝子,此药阴阳双补,偏于补阳,服之可令妇人有子,在诸多不孕方剂里多有之,它有促排卵促黄体功能的作用,对证属肾虚的,我每方必用,同样有此作用的还有枸杞,巴戟天等,辩证准确后选加。

(2). Tu Si Zi

Herb Tu Si Zi works to supply the Yin and Yang but little bit more for the Yang. It helps fertility in women. It can be found in many herbal formula for infertility. It works to improve ovulation. Whenever the patient’s body condition belongs to Kidney insufficiency, I must use it. The other herbs that bear the same function are herb Gou Qi Zi and Ba Ji Tian, etc. They are added after a correct TCM diagnosis and after set up a basic formula.  

(3). 穿山甲,有输卵管阻塞或内异症等证属瘀血的,它的功效很好,我多与皂角刺联用,通过化瘀通络来疏通输卵管,临床也可以配伍王不留行,路路通等。

(3). Chuan Shan Jia

Herb Chuan Shan Jia works very good for a condition with block in oviduct or with endometriosis. I usually use it together with Zao Jiao Ci. They open the oviduct by dissolving blood stagnation and by opening the meridian. In clinic, it can also be used together with Wang Bu Liu Xing or Lu Lu Tong, etc. 

(4). 白芥子,输卵管阻塞或盆腔炎症属于慢性的,从病理看应该属于痰淤互结,我经常以痰淤论治,化痰通络我喜欢用白芥子,白僵蚕,它们可以化痰散结通络,使之畅通,还有石菖蒲化痰开窍(这里的窍是指输卵管)此几味药为我的精选,一般不予其它药代替。

(4). Bai Jie Zi

For the oviduct block or infection in pelvic cavity for a long time, they should be regarded as the Phlegm-stagnation condition in TCM. I usually treat it as a Phlegm-stagnation condition, to solve the Phlegm and stagnation by use of herb Bai Jie Zi and Bai Jiang Can. They can work to dissolve the Phlegm and to conduct the stagnation to open the oviduct. In addition, the herb Shi Chang Pu works to clear Phlegm and to open the body various openings (here the opening means the oviduct). These herbs are what I normally used for the treatment of oviduct block.

(5). 小茴香,在我治疗的不孕症中,多半是阳虚引起,胞宫虚冷,不易受孕,此为常识,小茴香既能温补肾阳,又能暖宫散寒,而且效果很好,我经常以肉桂,艾叶,紫石英联用。

(5). Xiao Hui Xiang

The most of the patients whom I treated for infertility are with Yang insufficient condition. The uterus is Cold and in weak condition. It is hard to get fertility. This is common sense in the Chinese medicine. Xiao Hui Xiang works to warm the Kidney as well as the uterus and the effect is excellent. I usually also use Rou Gui, A ye, and Zi Shi Ying together.

(6). 香附,女科之主帅,善调经,内分泌失调病人有月经不调的一般不易怀孕,所以针对月经不调的不孕症病人,首要是调经,经期提前多为阴虚,延后多为阳虚,不定期多为肝郁,分别对症治疗,这些只是例举,总之,调经为主要治疗方法,还有一种叫免疫性不孕的,是自身免疫导致的精卵不结合,这类病人多有抑郁,善太息等肝郁症状,用疏肝之法即可解决。

(6). Xiang Fu

The herb Xiang Fu is the General herb among the herbs that are used to solve female disorders. It is good at rebalance the endocrine disorders. Usually the patients with endocrine disorder and with irregular menstruation are difficult to have pregnancy. Therefore, for those of patients with infertility and irregular menstruation, the most important thing is to correct their menstruation. A early coming menstruation usually suggests Yin insufficiency, a delayed menstruation, Yang insufficiency; and a irregular menstruation means mostly Liver Qi stagnation. They should be treated accordingly. All in all, menstruation-adjustment therapy is the major therapy in the infertility. Another kind of infertility is called immuno-infertility, that is caused by self immune disorders and affect the combination of the sperm with the egg. Patients with such problem usually have depression and tend to have long sigh, such Liver stagnation symptoms. Such condition could be solved by Liver-dredging therapy.

我治疗不孕一共14例,有12例已经怀孕生子,其他2例未知,半数是经过很多正规治疗而无效的,最长病史10年,已知者全部在半年内怀孕,有些顽固的疾病让我回头再次给予治疗的话,我恐怕也是没有信心,能够治愈不得不说是一种侥幸,但其中的治疗思路我还是比较肯定。巧合的是我的最后一位不孕症患者是我的第一个不孕症患者的孩子的老师,经孩子家长介绍而来。

I totally treated 14 cases with infertility. Among them, 12 cases have had successful pregnancy. The result for the other two cases was unknown. For those patients, half of them had had been treated with so called standard western medicine treatment but failed. The longest history for infertility was ten years. For the 12 successful cases, half of them got pregnancy within half years of the treatment. For some obstinate cases, if they would come back to me again, I may still have no confidence to success. It has to be admitted that these successes are kind of coincidence, but the healing principle should be followed. It is interesting that, my last infertility patient is the teacher of the child whose mother is my first infertility patient.

在治疗此病时,一定要在排卵期加用活血助阳药帮助排卵,抓住排卵期这几天的机会同房,受孕可能会大很多。

In the treatment of this problem, it should be emphasized to add circulation-improving and Yang-nourishing herbs during the ovulation period to help ovulation. To take the chance of the several days of ovulation to have sex, the chance for pregnancy may be increased much more.

最后还有一种不孕,是见于肥胖,月经延迟甚至闭经的,西医检查属垂体性,我只知道一般按温补脾肾,化痰祛湿治疗,但没有实践过,望有此经验的同行给予帮助解答,很想学习一下。

Finally, there is another kind of infertility, which can be seen in a overweight female. Such female has delayed menstruation, even cessation of menstruation. Western medicine may detect it as due to disorder in pituitary body. I know that it should be treated by warming up the Kidney and Spleen, as well as using Phlegm-dispelling and Wet-clearing therapy, but I myself did not practice yet. Hope that those of you whoever has experience in this aspect help me to know how to treat it.

 

12,高血压

12. High blood pressure

(1). 罗布麻,高血压早期表现为肝阳上亢,此药可以清肝热平肝潜阳,对面红目赤,易怒口苦,情绪激动加重的比较适宜,我临证多以天麻钩藤饮加此药,效果更加显著,亦可加夏枯草。

(1). Luo Bu Ma[35]

In early stage, hypertension shows as the Liver Yang Up-rushing in the Chinese medicine. The herb Luo Bu Ma can clear the Liver Fire, to calm down the Liver, and can bring the Yang Qi down to store. It is more suitable in the patients with red face and eyes, bitter mouth, easy to get upset and lose temple. In clinic, I usually use herb formula Tianma Gouteng Yin plus this herb, which makes the healing effect much better. The herb Xia Ku Cao can also be added.  

(2). 龟板,对于有明显阴虚体质的病人,养阴显得很重要,龟板不只是养阴效果极佳,它质重擅潜降,性清不浊,不易伤胃,代赭石易伤脾胃,白芍力量薄弱,唯独龟板效果全面显著,高血压阴虚阳亢多选之。

(2). Gui Ban[36]

It is important to nourish and to supply more Yin to those of patients with Yin deficiency. The herb ingredient Gui Ban is not only good at nourishing the Yin, but also good at bring the Yang down to a store stage for its heavy mass. Its nature is clear, so as not to hurt stomach, while other herbs may cause side effect, such as Dai Zhe Shi may hurt Spleen-Stomach. The herb Bai Shao is weak in its healing effect in this aspect. The herb Gui Ban here works in many aspects to help the hypertension condition. It is used in most cases with the Yin deficiency and Yang overwhelming.

(3). 白僵蚕,地龙,此病发展如果阴虚日久及阳,导致了阴阳两虚,阴虚则肝阳化风,阳虚则不能蒸化津液而凝痰,风与痰结党,阻于脉络,又易凝淤,流斥于脑,脑髓不纯,血压偏高。白僵蚕,地龙可以祛风痰,通脉络,脑髓清纯则血压降。临证以地黄饮子选加此药,意在标本兼治。

(3). Bai Jiang Can and Di Long

The hypertension develops for a long time to cause Yin deficiency. The Yin deficiency further more causes Yang deficiency. When the Yin is insufficient, the Liver Yang can turn into Wind. When the Yang is insufficient, it cannot evaporate body liquid, so the liquid could condense into Phlegm. The Wind and the Phlegm could combine to twin together to block energy meridian. When it happens in the brain, the brain is obstacle, so the blood pressure turns high. The herb Bai Jiang Can and Di Long can clear the Wind and the Phlegm, so to dredge clear the energy conduct/chanal to make the blood pressure down to normal. In clinic, the herb formula Dihuang Yin Zi is used with the addition of these herbs. The aim is to solve both the cause and the results of the increased blood pressure.

(4). 石菖蒲,痰湿盛病人多用之,劳倦内伤,或嗜肥甘厚味引起痰湿内生,引动肝风,浊阴上扰可以导致头痛如裹,血压偏高,石菖蒲可以化痰湿,开脑窍,与葛根相伍更妙,葛根擅于升清阳以降浊阴,一个化痰开窍,一个升清降浊,从而脑髓清纯,血压降。

(4). Shi Chang Pu

The herb Shi Chang Pu is most used in patients with Phlegm-Wetness condition. When a person is in over exhausted, over damaged due to physical labor or due to poor schedule or poor life style, or when a person eat too much oily foods or sweet foods, both conditions could result in the production of Phlegm and Wetness inside of the body. The inner Phlegm and Wetness trigger out the Liver Wind, and the foul Yin, when rushes up, can cause headache that feels as the head is heavily folded, and cause the increase in the blood pressure. The herb Shi Chang Pu works to clear the Phlegm and Wetness, and to open the brain openings (ears, eyes, nose, mouth), so to show its healing effects in such condition. When used together with herb Ge Gen, their healing effect is much more excellent. The herb Ge Gen is good at increasing the clear Yang Qi, so as to bring the foul Yin Qi down. So, one of them works to clear Phlegm and to open the hole in brain, and another works to bring the clear and pure Yang Qi up and foul Yin Qi down, so as to make the blood pressure down.

(5). 黄芪,对有淤血阻于脉络的,我喜欢在活血基础上用重剂黄芪,脑窍为淤血所阻滞而见头痛,血压高,黄芪可以补气助血行,淤血去,血压自降,再者黄芪也可以升清阳之气以上荣。久病高血压多因心脑肾缺血引起,活血可以改善其供血,与黄芪伍用,力量显著增强持久,且不会因为活血日久伤及正气。

(5). Huang Qi

For those with blood stagnation in blood vessels, I prefer to add large amount of Huang Qi, on the bases of circulation-activating therapy. When the brain function is affected by the block of the stagnated blood, there will be headache and increased blood pressure. The herb Huang Qi can nourish Qi to improve blood circulation, so as to remove the stagnated blood and so to reduce the high blood pressure. In addition, the Huang Qi can improve the pure and clear Yang Qi up to the brain, so to nourish the brain. A long term disease course could cause short of blood supply to the heart and the kidney, so to cause higher blood pressure. Circlation-stimulating therapy could improve the circulation and improve blood supply to the heart and the kidney. When it is used together with the Huang Qi, its healing effect is more powerful and last longer. In addition, the addition of Huang Qi could prevent the side effect by the circulation-improving therapy as hurt the body life energy (Zheng Qi, the defense energy).

(6). 海藻,高血压病人脉弦硬的,我多加海藻,高血压动脉硬化有个很可怕的并发症,就是脑出血,海藻可以软坚,使硬化的血管变软,同时它还能化痰,清除管壁内痰浊,所以有脑出血倾向的,我必用之。

(6). Hai Zao

When the patients with high blood pressure have hard blood vessels (when touch their pulse), I add herb Hai Zao. The terrible complication of the hypertensive sclerosis is brain bleeding. Hai Zao can soften the blood vessels, to make the hard vessel soft. In addition, it can clear Phlegm, clear the inner dirty Phlegm within the vessels. For this reason, for those of patients with a trend to have brain bleeding, I certainly use the herb Hai Zao.

当我们治疗高血压病时,不能一味的平肝潜阳,因为这不是高血压的唯一原因,高血压病机复杂,辨证论治在这个病里显得很重要,基本知识都了解,也不是三言两语说得清楚,就不再赘述了。

When we treat the hypertension, we should not pay attention only to the Liver-dredging and Yang-diving therapy alone, since it is not the only cause for the high blood pressure. The cause for a high blood pressure condition is complex. It is very important to exercise the syndrome-diagnosis for the treatment. The readers must have already know how to practice the TCM diagnosis. It is not easy to explain it here thoroughly, so I am not going to spend time for this more.  

 

13,甲亢

13. Hyperthyroidism

(1). 夏枯草,甲亢属肝郁化火的,夏枯草可以清肝火散郁结,颈前有结块的,它又能散结节,突眼症的,属肝旺,目为肝所主,它可清肝入目使之回窠,可见这是一个甲亢常用药。肝风手抖的要用钩藤,白芍配伍。

(1). Xia Ku Cao.

For the hyperthyroidism due to Fire syndrome developed from the Liver sluggish, herb Xia Ku Cao works to cool down and to clear the Liver Fire. If there is knob in front of the neck, it can disperse the knob. The exorbitism in the hyperthyroidism belongs to the Liver overwhelming. The eye is associated with the Liver in Chinese medicine. The herb Xia Ku Cao can clear the Liver and make the eye return back. Apparently, it is commonly used herb in hyperthyroidism. The shaking hands in the hyperthyroidism needs herb Gou Teng and Bai Shao for the treatment.

(2). 鳖甲,甲亢以阴虚火旺为主症的,鳖甲可以清虚火,滋阴潜阳,纠正阴阳失调,另外鳖甲更善于软坚散结,对甲状腺肿大有良效。

(2). Bie Jia

For hyperthyroidism with more Yin deficiency and Fire overwhelming, the herb Bie Jia can clear the weak Fire, nourish the Yin and dive the Yang, so as to correct the imbalance of the Yin and Yang. In addition, the Bie Jia is more good at soften the knob, good for the treatment of hyperthyroidism.

(3). 龟板,甲亢一般是本虚标实,本虚无不与阴虚密切相关,龟板是血肉有情之品,滋补力强,质重善潜降,亦可补心疗心悸,对阴虚诸症皆疗效显著,与鳖甲合用,其效果力压群雄,远非其他养阴药所能及。

(3). Gui Ban

Generally speaking, the hyperthyroidism is a false overwhelming syndrome but true weakness condition in Chinese medicine.  The true weakness is in most times associated with the Yin deficiency. The Gui Ban belongs to animal part, bearing strong nourishing ability. Its heavy nature enables it to dive Yang downwards, and to nourish heart to solve palpitation. It works very well in Yin deficient condition. Used together with Bie Jia, the healing effect is excellent, hard to be competed by other herbs. 

(4). 黄芪,久病气阴两虚,又每因阳旺而加重,亢奋之阳因生化,温动的作用太过,势必耗气伤阴,从而形成恶性循环,对于气虚症状,我用重剂黄芪(60以上),药理学认为,它可以改善甲状腺功能,从而降低T3T4水平,在养阴的基础上,我多用之。

(4). Huang Qi

After a long time of a disease, the Qi and the Yin both may be exhausted. When such condition meets a Yang overwhelming time (such as before noon, or in summer, or eat spicy food, or use Warm herbs, etc.), the condition becomes worse, since the overwhelming Yang consumes more Yin, so resulting a bad circle. For Qi deficiency, I use large amount of Huang Qi (60 grams more). Pharmacology shows that it can improve the function of thyroid gland, so to reduce the T3 and T4 level. I usually use it on the basis of Yin nourish therapy.

(5). 白僵蚕,肝火(亦可是虚火)灼津为痰,结于颈前,此痰为老痰顽痰,不易祛除,白僵蚕属虫类药,力大善于搜剔,故选之,也常联用海浮石化老痰,同时此药也可以软坚散结,故为首选。

(5). Bai Jiang Can

The Liver Fire could burn the body liquid into Phlegm that accumulated and  entangled in front of neck. Such Phlegm is old Phlegm (long term Phlegm) and hard to be removed off. Bai Jiang Can belongs a insect herbal ingredient that is powerful to pick up the Phlegm and other dirty things in the body. So it is usually chosen to use for the treatment of hyperthyroidism with neck knob. It is also commonly used together with herb Hai Fu Shi, which is also good at clearing old Phlegm, as well good at softening hard mass.

(6). 白芥子,颈前肿块用白芥子化痰散结无可厚非,但值得一提的是,药理学认为,它是通过抑制甲状腺功能来达到治疗效果的,正因如此,如果是缺碘引起的甲状腺肿大,用此药是不合适的,应引起注意。

(6). Bai Jie Zi

It is reasonable to use herb Bai Jie Zi to clear Phlegm and use it for the treatment of hyperthyroidism. However, as indicated in pharmacological study that it reduces the size of the thyroid knob through preventing the function of thyroid gland. So this, if the enlargement of the thyroid is due to lack of iodine, it would be not suitable to use. This should be kept in mind.

西药治疗此病副作用很大,放射性131碘治疗和手术有时后果严重,中医药在这里有很大的优势,只要辩证准确,用药恰当,可以获得良好效果。顺便提及一下,如果不是病情需要,尽量少用含碘中药,如海藻,昆布等,具体原因很复杂,篇幅关系,不作详解。

The side effect by western medicine in the treatment of hyperthyroidism is severe. Radiation therapy and surgical operation may cause serious complications. Chinese medicine has much higher advance in this aspect. If the diagnosis is correct and the herbal therapy is used in proper way, the healing effect is excellent. By the way, unless the condition is really indicated, the herbs that contain iodine should be avoided to use, such as herb Hai Zao and Kung Bu, etc.

 

14,体质性低血压

14. Constitutional low blood pressure

(1). 鹿角胶,此病多为先天禀赋不足,肾中精气亏乏,精不化气则元气不足,肝木缺乏肾水滋养则疏泄不及,升发无力,导致血压偏低,肝为阳脏,故以鹿角胶补精血,通督脉,振元阳,肾精得补则元气得生,肝木得补则疏泄升发得力,元阳得补则血压升高,为阴中求阳,需加熟地补阴。

(1). Lu Jiao Jiao

Constitutional low blood pressure is mostly related to genetic weakness, in which the Kidney Qi is insufficient, which again causes less production of Body Yuan Qi, so the Liver Wood cannot get sufficient nourishment from the Kidney Water. For this reason, the weak Liver wouldn’t be able to dredge and to improve energy Qi moving up, so that the blood pressure is low. The Liver belongs to a Yang organ. The herb Lu Jiao Jiao works to supply more Jing and Blood to the Liver, and to conduct the Dou Mai (the Mian Yang meridian in the body), and to improve Yang Qi. When the Kidney Jing is sufficient, the Yuan Qi would be sufficient, the Liver Wood is nourished properly and its Up-moving ability is therefore restored, so that the blood pressure is increased. For the treatment, herb Sheng Di is also used, for the aim to get the Yang from the Yin (Sheng Di supplies more Yin).  

(2). 枸杞,肾精不足导致的肝虚,使肝的升发疏泄功能降低,从而血不上荣,枸杞可以补肝,肝得补则升发疏泄有力,使升的气机恢复正常,从而提升血压,同时枸杞可以补肾精,养血,故多用之。注:补肝肾是治疗此病的根基所在,无此根基,任凭怎么升阳举陷也是徒劳,即使有效,也只是暂时的。

(2). Gou Qi Zi

If the weakness in the Liver is due to the insufficient Kidney Jing, which makes the Liver up-moving function is affected, the herb Gou Qi Zi could supply Liver Jing, so to improve its up-moving function, and to increase blood pressure. At the same time, Gou Qi Zi can supply more Kidney Jing and Blood, so it is also commonly used in the constitutional low blood pressure. Note: it is basic principle to nourish the Liver and Kidney for the treatment of constitutional low blood pressure. Without this, it is no use to apply any Yang-improving therapy. Even if it may works, the healing effect is also only a temporal phenomenon. 

(3). 党参,后天失养或劳倦思虑伤脾,使脾不升清,党参可以补脾益气,与黄芪等相伍有补中益气升提之功,此一条就是补中益气丸原理,不作详解。注:升麻,柴胡用小剂量取其轻浮上行之意,剂量必须在10 g以下。

(3). Dang Sheng

If the low blood pressure is due to over exhausting due to heavy labor works or to extensive mental work, which damages the Spleen, so that the Qi up-moving function is affected, the herb Dang Sheng works to nourish the middle Qi so to improve up-circle of the Qi. This is the mechanism to improve the Qi by nourish the middle Qi. Note: Sheng Ma and Chai Hu, can also be used in such herbal formula in a small doe, taking the advantage of small dose yielding a light-floating effect. Their doses must not exceed 10 grams.  

(4). 枳壳,低血压病人多数食少纳差,加上方中有滋腻成分,故用枳壳加砂仁行气宽中增食欲,疏肝理脾调气机,枳壳益气利五脏,协助肝之疏泄,从而升高血压,药理学认为它有升压之功,枳实也有,而且很强,但因为有耗气之嫌,故不作首选。

(4). Zhi Ke

Most of patients of low blood pressure have also poor appetite and eating little only. In addition, the herbal formula contains greasy ingredients that could further more affect the appetite. To prevent this side effect, the herb Zhi Ke is usually added to dredge the digestive system, so as to increase appetite. The Zhi Ke nourishes all the organs in the body, and helps the Liver to dredge the Qi circulation in the body, so as to increase the low blood pressure. This has been verified by pharmacological studies. The other herb, the Zhi Shi, which is the inner kernel of the same fruit, has also blood pressure-increasing effect, and even stronger than the Zhi Ke, but it has also affect to exhaust the Qi, so it is not used as a primary herb in the treatment of the constitutional low blood pressure. 

(5). 仙鹤草,此药多次提及,有补虚强心功能,从而升高血压,尤其对劳累过度引起的气虚症状更为适合,且效果迅速,另外它涩中寓通,能活血,可以使气血上行时一路畅通。

(5). Xian He Cao

This herb has been mentioned many times above. It works to nourish the Heart and to solve weakness condition, so as to increase the blood pressure. It is especially effective and works faster for the Qi deficiency due to over exhaustion due to heavy labor work. It has also a kind of contracting function, beside its main supplying function, e.g. it can work to improve blood circulation, so as to make the blood and Qi circulate smoothly. 

(6). 阿胶,有明显血虚症状的,阿胶可以补充血容量,从而使脉管中血气充足。

(6). A Jiao

For those with apparent Blood deficiency condition, the herb A Jiao works to supply more blood vomule, so to make the circulating blood volume is sufficient.

人的身体,元气为诸气之根本,故补肾精以化元气为此病的关键所在,肾精充足,则肝血得补,再配伍疏肝理气,气机方可升降调达,加之补中益气助升提,清阳之气则可以源源不断的上荣,血压即自然升为正常。

In the body, the Yuan Qi is the primary source of all other body Qi. To nourish the Kidney Jing is therefore the main step towards the treatment. When the Kidney Jing is sufficient, the Liver blood is supplied sufficiently. So, the Liver has sufficient energy (Qi) to dredge the conduct of the Qi movement. In addition to the nourishment of middle Spleen Qi to up-lift the Qi, the pure Qi can go to the brain continuously, so that the blood pressure is in normal.

 

15,腰肌劳损

15. Lumber muscle degeneration

(1). 土鳖虫,外伤劳损引起腰痛多于瘀血有关,举重伤腰,恶血归之,所以治疗瘀血腰痛,土鳖虫为我的首选药,与乳没,三七联用,效果极佳,2025 g,一般2日即可见效。

1. Tu Bie Chong

The lumber muscle degeneration due to external damage is usually related to blood stagnation. When the lower back is hurt by lifting heavy stuff, the dead blood will remain in the lower back, to press the muscle and  nerve and to cause the pain. Therefore to treat the lumber back pain due to the blood stagnation, the herb Tu Bie Chong is my first choice. Used together with Ru Xiang, Mo Yao and San Qi, it works very well. Using 20 grams or 25 grams a day, its healing effect is excellent. The healing effect can be shown within two days.

(2). 仙鹤草,此药擅长治疗脱力劳伤,是我的必用药,此为常识,不作详解。

2, Xian He Cao

This herb is good at the treatment of muscle damage due to over exhaust. It is my commonly used herb. This is a common sense. No need to repeat the reason for use it.

(3). 骨碎补,腰为肾之府,久病必有肾虚,在诸多补肾壮腰的中药里,我发现骨碎补的效果很明显,其次为狗脊及杜仲,续断,牛膝等,此为个人见解,不一定对,但在用药时好像每次都能明显的感觉出来它的功效。

(3). Gu Sui Bu

The lower back is the home of the kidney. A long term disease course is commonly associated with a Kidney deficient condition. Among various Kidney-nourishing herbs, I found that the herb Gu Sui Bu works very well. The second level herbs are Gou Ji and Du Zhong, Xu Duan and Niu Xi, etc. This is my own idea, which may or may not be correct. However, it seems that its healing effect can be felt every time when it is used.  

(4). 白术,脾主肌肉,此病的病位在腰肌,腰肌受损,故用白术等补脾以强壮腰肌,但凡肌肉之病,不论是劳损,还是萎缩,无力,均需从脾论治。

(4). Bai Zhu

The Spleen in the body is responsible to nourish the muscle. The problem spot is in the lumber muscle. For the hurt in the lumber muscle, the herb Bai Zhuis used to nourish the Spleen, so to make the lumber muscle stronger. Whenever a muscle is hurt and damaged, not matter it is due to over exhaust, or wither, or no strength, it should be treated from the Spleen.

(5). 枸杞,肝主筋,本病有筋腱,韧带损伤,故以枸杞补肝血,濡养受损之筋腱韧带,补肾活血为共识,补肝脾却容易被忽视,要想达到真正的治愈,补肝脾很重要。

(5). Gou Qi Zi

The Liver in the body is responsible to nourish the tendons. There is damage or hurt in the tendon and fibril membrane in this disease, so the herb Gou Qi Zi is used to nourish the sick tendon and fibril membrane. It is commonly agreed in the treatment of this disease to nourish the Kidney and to improve blood circulation, but it is commonly omitted to nourish the Liver and Spleen. It is very important to nourish the Liver and Spleen, to reach the real cure.  

(6). 黄芪,它可以补气助行气血以通络(与地龙等联用),补肝助养血养筋治筋伤,补脾以养肌肉之损伤,此药功用全面,故用大剂量。

(6). Huang Qi

Huang Qi works to nourish the Qi, so to help the circulation of the Qi and blood to dredge the meridian (used with herb Di Long); to nourish the Liver to produce more blood, to nourish the tendons, so to heal the sick tendons; and to nourish the Spleen to nourish the muscle. It bears multiple functions, so it is used with large dose.

腰痛见寒用附子,见湿用木瓜,对症下药,总体的治疗思路为补肝脾肾,化瘀通络,有时加散寒化湿,有时加祛风化痰,疼痛剧烈因痉挛明显的加白芍甘草,全蝎,因寒湿的加细辛,等等。

If there is signs for Cold in the body, use herb Fu Zi; for Wetness, use herb Mu Gua. Use specific herbs according to the clinic signs. The healing principle is to nourish the Liver, Spleen and Kidney, to dissolve the stagnated blood clots and to dredge the meridians. Some times, it is added with Cold-warming herbs, Wetness-evaporating herbs to solve the wetness, Wind-dispersing herbs to remove Wind, and the Phlegm-dissolving herbs to clear the Phlegm. If the pain is severe and is with muscle spasm, add herb Bai Shao and Gan Cao, and Quan Xie. With Cold-Wetness, add Xi Xing, etc.

骨质增生引起的腰痛容易与此病相混淆,虽然症状有些相似,治疗也有相同之处,但有一点必须注意,肾主骨,骨质增生的治疗要以补肾健骨为根本,阴虚者用龟板,阳虚者用鹿角,再配伍骨碎补,续断等,以此来制止或逆转骨质增生的进展,另外还有威灵仙,它擅长治疗腰痛痹症,大家都知道,但从其能治骨梗喉推测此药可以治疗骨刺引起的疼痛,有名医已经用于临床,并且取得了效果,所以我也多用之。其他的差不多与上述没有什么区别了,治本之法,腰肌劳损重补肝脾,骨质增生重补肾健骨。治标都是活血化瘀通络,及散寒除湿,祛风化痰等。

The lower back pain due to hyperosteogeny is easy to be confused with that due to the lumber muscle degeneration. There are some similarity in their symptoms and in the treatment. However, one point should be given attention: the Kidney is responsible for the bone. The treatment of hyperosteogeny should depend on the Kidney-nourishing and bone-strengthening. If there is Yin deficiency, use herb Gui Ban. If there is Yang deficiency, use Lu Jiao, together with herb Gu Sui Bu and Xu Duan, etc, to stop or even to reverse the process of the hyperosteogeny. In addition, the herb Wei Ling Xian is also good at the treatment of the chronic pain in the lower back. As every know, it can solve the pain in throat due bone that stick in the throat. It can also be suggested that it can also solve the pain due to hyperosteogeny in the lower back. There are some famous doctors who have tried this way with very good result. For this reason, I also use the herb Wei Ling Xian quite often. The other healing principles are similar to those for lumber muscle degeneration. The principle for the treatment of the cause of the lumber muscle degeneration is to nourish the Liver and Spleen, and for the hyperosteogeny, to nourish the Kidney and to strength the bone. For the treatment of the symptoms, both need blood circulation-stimulating, stagnation-clearing, meridian-dredging therapy, as well as Cold-warming, wetness-dispersing, Wind-dispelling, and Phlegm-dissolving therapy, etc.

 

16,耳病

16. Ear disease

(1). 苍术,美尼尔综合征证见眩晕耳鸣等,是因为各种原因引起的膜迷路积水,所以应该属于中医里的水湿上犯于耳,治疗之法一是化水湿,二是补肾,化水湿我最喜欢用苍术,诸湿肿满,皆属于脾,苍术可以补脾化湿,效果明显,且又标本兼顾,与泽泻,茯苓等同用每每可以获效。

(1). Cang Zhu

The reason for Meniere’s syndrome, which shows dizziness and tinnitus, is the water accumulation in the hydrolabyrinth in the ear due to various reasons. It should belong to the Water accumulation in the ear in the Chinese medicine too. One of the way to solve this problem is to remove the Wetness and another way is to nourish the Kidney. To clear the Wetness, I prefer to use herb Cang Zhu. It is well known that, for various swelling, water accumulation and fullness condition, consider to solve them by pay attention to the Spleen. The herb Cang Zhu is able to nourish the Spleen and to clear the Wetness. The healing effect is very good. It not only works for the symptoms but also the cause of the Meniere’s syndrome. Used together with other herbs, such as Ze Xie and Fu Ling, the healing effect is excellent.

(2). 骨碎补,耳为肾所主,故耳病多从肾治,肾虚引起的耳鸣耳聋,骨碎补可以补肾聪耳,实证引起的,它可以起引经药作用,引药入耳,链霉素等药可以引起耳鸣耳聋,它可以对抗并治疗其毒副作用,有资料说:单用此药30 g3周就可以消除中毒症状。

(2). Gu Sui Bu

The ear is developed from the Kidney (Chinese medicine concept). Therefore, the ear disease is usually treated on the aspect of the Kidney. For the tinnitus and deafness due to a Kidney deficiency, the herb Gu Sui Bu can nourish the Kidney so to improve the hearing ability of the ear. If the problem is due to a overwhelming condition, it can work can a meridian-directing herb to bring the other herbs to work on the Kidney meridian and to the ear. If it is due to the side effect by some antibiotics, such as streptomycin, the herb can confront against these antibiotics and solve there side effects. There are data suggesting that, 30 grams of the Gu Sui Bu alone can solve the symptoms within 3 weeks.

(3). 石菖蒲,湿浊蒙蔽之耳病,石菖蒲可以化湿豁痰避秽而开窍充耳,另外中老年人因内耳血循环较差而引起的耳鸣耳聋,治疗多数以补肾活血,行气开窍为思路,此时这也是石菖蒲的专长,但需要与六味,水蛭,川芎等联用。

(3). Shi Chang Pu

For the ear disease due to the block by Wetness, the herb Shi Chang Pu can clear the Wetness, Phlegm, and other dirty stuff in the ear, so as to clear the ear to improve the hearing. For elderly tinnitus and deafness due to poor blood circulation in the inner ear, it is usually considered to nourish the Kidney, to improve the circulation, improve Qi circulation and to open the openings in the head (ear). In the second condition, the herb Shi Chang Pu is also excellent to be used, but it should be used together with the herb formula Liu Wei Di Huang Wan, and with other herbs, such as Shui Zhi and Chiang Xiong, etc.

(4). 葛根,有些病人因为颈椎病,脑动脉硬化,脑梗等引起耳鸣,从病人的脉证上看,多数属于痰瘀阻络,清气不升,我多在活血化痰通络等药的基础上加葛根,取其升清之功,这与药理学认为它有改善脑供血的功能不谋而合,其实我也多用它治疗脑血栓,颈椎病等病,此类病组方时经常巧遇石菖蒲,呵呵。

(4). Ge Gen

For some patients, their tinnitus is caused by cervical spondylosis, brain arterial sclerosis, or cerebral infarction. Their pulses suggest that the condition is related to the Phlegm that blocks the brain meridians, which causes the sluggish of the Qi up-circulation in the brain. I usually use the herb Ge Gen, under the basis of the other circulation-improving, Phlegm-dissolving and meridian-dredging herbs. The function of the herb Ge Gen is to rise the pure energy Qi to the brain, coincidence with the pharmacological study showing that Ge Gen can improve the brain blood circulation. In fact, I also use Ge Gen in the treatment of brain thrombosis and cervical spondylosis. It is interested that the herbal formula used to treat such clinic conditions also contain herb Shi Chang Pu. 

(5). 蝉蜕,蔓荆子,此病有时与风有关,外感热病为外风,情志不遂引起肝风为内风,此2药均有熄内外风功能,且效果极佳,蝉蜕能安神,对神经衰弱病人耳鸣尤为适宜,蔓荆子又能升清通窍,大剂量30 g以上效果显著,而且此2药对虚证实证用之皆无妨,故多用之。

(5). Chang Tui and Man Jing Zi

Some times, the ear disease is caused by Wind invasion. The common cold related fever disease is regarded as external Wind, and the Liver Wind due to emotional problems is regarded as internal Wind. The herb Chang Tui and Man Jing Zi both are able to clear the external and the internal Wind. The effect is also very good. The Chang Tui can calm spirit and emotion. It is especially useful for those of patients with nervous exhaustion. The herb Man Jing Zi can also increase the pure energy Qi to the brain and to open the brain openings (such as ear, eye, nose). When the dose exceeds 30 grams, the effect is apparent. In addition, both herbs can be used in either weakness or overwhelming conditions. So, they can be used often.

(6). 鹿角胶,肾精亏耗,髓海空虚,发为耳鸣耳聋,补肾填精之品众多,唯血肉有情之品最效,脑以阳为荣,对重症耳鸣耳聋病人,我一定会用此药温补肾精,益髓充耳,最大程度恢复耳的功能,此药多用于老年人耳病。

(6). Lu Jiao Jiao

When the Kidney Jing is not sufficient, the brain and spine would be in a empty (hollow) condition. This can cause tinnitus and deafness. There are many herbs that can work to nourish the Kidney and fill up the Kidney Jing, but only the animal-oriented herbs works better. The brain needs Yang Qi to nourish. For those of patients with severe tinnitus and deafness, I always use such kind of herbs to warm up the Kidney and to fill up the Jing Qi. When the Jing Qi is sufficient, it could supply the ear with energy to restore the healing ability. The herb Lu Jiao Jiao is mostly used in elderly ear disease.

此病新病多属实证,与风热,肝郁,痰火等有关,久病多属虚证,与脾虚升清无力,肾虚精血不足等有关,但临证所见,多数为虚实夹杂,尤其老年人,肝肾不足,痰淤阻窍最常见,也很棘手,故疗程一般很长,如果加以针灸治疗,可望缩短疗程,提高疗效。

The newly happened ear disease in most case belongs to overwhelming condition. It is related to the Wind-Fire, Liver Qi stuggish, or Phlegm-Fire, etc. A chronic ear disease is more related to a weakness condition. It may be related to Spleen deficiency, in which the body has no sufficient energy to bring the pure energy to the brain and ear, or to a Kidney deficiency, in which there is no sufficient Jing Qi energy to supply the brain and ear. However, in clinic, most patients have both the weakness condition and the overwhelming condition. This is true especially in old persons, in whom the Liver and Kidney condition is poor, and it is easy to have Phlegm and stagnation stick in the ear. The treatment in such elderly patients is also very difficult, so that the healing period is also longer than young patients. Involvement of acupuncture treatment may shorten the healing period and to increase the healing effect.

 

17,病毒性心肌炎

17. Viral myocarditis

(1). 苦参,此病多因体虚复感温毒之邪,内舍于心,邪毒损心,继而虚实夹杂,心损与邪留共存,此起彼伏,又每因劳累或复感外邪而反复发作,治疗的时候扶正与祛邪兼顾,但急性期,应以清解热毒为主,我首选苦参,它归心经,善泻火解毒,疗惊悸怔忡,有明显的抗心律失常作用,在诸多抗病毒中药里,它的作用可以与蚤休相媲美,这么多优势注定做心肌炎的首选药。

(1). Ku Shen shen

Viral myocarditis usually occurs in a person who is in a weak condition and attacked by a Warm-Toxic Xie Qi. The Xie Qi sticks in the heart and causes damage to the heart. Later, the weakness and the overwhelming condition mix and entangled. The symptoms come and go, and trigged by labor exhaust or by a new common cold. In the treatment, it has to pay attention to the treatment of both energy-improving and disease-dispelling. In acute stage, the main healing principle is to clear the Fire Toxic (virus). I first of all chose the herb Ku Shen. It goes mostly to the Heart meridian, good at dispelling Fire and the Toxic (poison), to calm emotion and nerves. It has also very apparent effect on the heart arrhythmia. Among so many herbs that bear anti-virus ability, its healing effect can be compared with another herb Zao Xiu. For so many advantages, it is the first line herb in the treatment of viral myhocarditis.

(2). 西洋参,温毒为阳邪,最易耗气伤阴,此病必有乏力心悸等气阴虚症状,心主血脉,运血全靠阳气鼓动,心气不足,力不任重,故气短心悸,另外,心属火脏,赖水济既,阴水足则火变为阳气,阴水虚不济火则心动虚亢,如灯烛之油耗尽,虚焰焚心,故补气阴势在必行,西洋参善于补气阴,对此病最为适合,另外配伍仙鹤草,仙鹤草可以补气强心,再配伍甘草补益心气,安魂定魄,注意一点,扶正之品要以不助邪为好。

(2). North America Shen (Ginshen)

The Warm-Toxic Xue Qi belongs to a Yang Xie Qi, which is ready to exhaust Qi and to damage the Yin. This disease must have the Qi and Yin deficient symptoms, such as fatigue and palpitation. The Heart is responsible to the blood circulation. The blood circulation depends the pushing by Yang Qi. If the Heart Qi is no sufficient, the heart would have no energy to push the blood to circulate, so that the person feels palpitation and short of breath. In addition, the Heart belongs to a Fire organ, which depends a water to calm. If the Yin Water (in Kidney) is sufficient, the Heart Fire becomes a Yang Qi, while if it is not sufficient, the heart Fire would be a floating pure Fire which is unable to push the circulation. Therefore, the Qi and the Yin must be supplied to a sufficient level. The herb America Ginshen works to nourish the Qi and the Yin, so it is the most suitable herb in the treatment of this disease. It can be used together with other herbs, such as Xian He Cao. Xian He Cao works to nourish Qi and strengthen the heart. The herb Gan Cao works to nourish the heart Qi and to calm spirit and emotion. Both are recommended to be used in addition to the Xian He Cao. It should be appointed out that, the energy-improving hers should not bear some effect to help the Xie Qi staying in the body.   

(3). 丹参,温毒之邪客留于心,势必炼液为痰,灼血成瘀,痰瘀滞留,故有胸闷,胸痛,心悸等症,丹参可以祛瘀生新,凉血安神,与化痰药伍用,共消痰祛瘀以愈病。

(3). Dan Shen

When the Fire-poison Xie Qi sticks in the heart, it definitely will burn the heart liquid into Phlegm and to burn blood into stagnated clot. Since the Phlegm and the Stagnated clot entangled in the chest, the patient feels fullness and pain in the chest, and feels palpitation too. The herb Dan Shen works to dissolve the stagnated clot and to improve renew the heart tissue, to cool the heart and to calm the emotion. Used together with Phlegm-clearing herbs, the herbs work together to clear Phlegm and the stagnated clot, so to cure the problem.

(4). 栝楼,化痰之品,首推栝楼,因为它善化热痰,又能宽胸理气,对于有胸闷症状的尤为适宜。(此病痰瘀互结尽量不选虫药搜剔,因体虚难耐其攻逐)

(4). Gua Lu

The herb Gua Lu is the number one herb that works to clear the Phlegm in the body. Since it is good at clearing Hot Phlegm, and at loosening the chest, it is more suitable to be used in patient with chest fullness feeling. (Since the patients with this disease is usually in a body weakness condition, the herb of a insect kind should be avoided, for the reason that such herb may damage the body energy Qi).

(5). 酸枣仁,心主藏神运血,体阴而用阳,在心阴充足的情况下才能发挥它的藏神运血功能,心肌炎病人因为温毒之邪耗伤心之气阴,心气不足,心阴受损,故神不守舍,如鱼失水而跃,曾现虚性亢奋,心慌心悸乃作,所以在补心之气阴的同时,还要安心神,心性喜静,静则藏神,我多选酸枣仁,柏子仁等,以安养同治,如果安神不效,镇摄胜于安神,用琥珀,龙骨等。

(5). Suan Zao Ren

The heart is responsible to hold the spirit and to induce blood circulation. It belongs to the Yin in structure, but to a Yang in function. Only when the heart Yin is sufficient, it can then exercise its circulation function. The patients with the myocarditis has their heart Qi and Yin damaged by the invading Fire-Poison Xie Qi. The heart Qi is not sufficient, and the heart Yin is damaged, so that the spirit is hard to stay in the heart. This is similar to the fish jumping due to less water in a pound. The body shows as a weak anxiety and the person feels anxiety and palpitation. For this reason, it is needed to use herbs to calm down the heart spirit, at the time to nourish the heart Qi and Yin. The nature of the heart is to prefer calm. When the heart is calm, the spirit is kept in the heart. I commonly choose the herb Suan Zao Ren and Bo Zi Ren, and so on, with the aim to nourish and to calm the same time. If the calm therapy does not work to a desired level, use stronger herbs to suppress the spirit/emotion, such as herb Hu Bo and Long Gu, etc.   

(6). 附子,久病阴损及阳,或(肾)阳虚体质,体现明显阳虚症状时,附子可以温助心肾之阳,心阳得补则搏动有力,可以鼓动心血运行,肾阳得补,则一身之元阳旺,心阳自得其温煦。

(6). Fu Zi

After a long term disease, the body Yin will be exhausted, which again cause the Yang in a insufficient condition too. If the body is originally in a (Kidney) Yang deficient condition, and the body shows the Yang deficient signs, use the herb Fu Zi. Fu Zi can warm up the heart Yang Qi and the Kidney Yang Qi. When the heart Yang Qi is sufficient after supply, the heart can beat stronger to push the blood in circulation. When the Kidney Yang Qi become sufficient, the whole body Yuan Yang is in sufficient condition and the heart Yang will also be warm up.

此病多为心损与邪留共存,心损多数是心气阴(血)虚,但也有阳虚者,邪留多数是温毒,痰瘀等,虽病损为心,但也与肺(肺邪传心)肝(肝木化火扰心)肾(肾失温化心阳不振)等有关,故需整体宏观调治,还有,此病急性期重在祛邪,但不能不补虚,缓解期重在补虚,但也不能忘了祛邪,扶正祛邪贯穿于治疗的始终,只是在不同的时期,侧重点不同而已。

For the myocarditis, the damage to the heart and the stick of the Xie Qi are in the body the same time. The heart damage shows mostly as heart Qi-Yin double deficiency, though there could also be a Yang deficiency. The stuck Xie Qi is mostly a Fire-poison Xie Qi, and Phlegm and stagnated clot, etc. Though the damage is in the heart, the lung (Lung Xie Qi passed to the heart), and the liver (the liver wood turns into Fire to bother the heart), and the kidney (the kidney cannot sufficiently warmed up the heart) are all involved. For this reason, the treatment should be pay attention to the whole body, not only stick to the heart alone. More over, when in an acute stage, the treatment principle should be to clear and to dispel the Xie Qi, but should not forget to nourish the heart Qi. Similarly, when in a chronic stage, the most attention should be paid on the nourishing the heart Qi, but similarly not forget to continue to dispel the Xie Qi either. To nourish the normal body Qi and to dispel the disease-causing Xie Qi should be done at the same time during the whole course of the healing process. The point is that, in each stage, one should be paid relatively more attention than another.

 

18,咽炎

18. Pharyngitis

(1). 山豆根,解咽喉肿痛第一要药,对风热或热毒蕴结于咽的,它可以直折上炎之火,与牛蒡子,甘草联用,效果很好。但经常听说此药的中毒事件发生,说明此药不宜大量用,我一般只用10 g,效果也不错。

(1). Shan Dou Gen

This herb is the number one herb most important in the treatment of throat pain and swelling. For the throat pain due to Wind-Hotness or Fire-poison stick in the throat, it can cool down the Fire thoroughly. The healing effect is even better with the use of other herbs together, such as Gan Cao and Niu Bang Zi. However, it is heard the side effect for its use, suggesting that the dose should not be too large. I usually use only 10grams. The healing effect is reasonably good as well.

(2). 青果,对风热及热毒咽炎常规治疗效果不显时,加青果及百部往往可以获取意想不到的效果,对热毒引起的慢性单纯性咽炎,此药为我的首选药。

(2). Qing Guo

When the healing effect for the Wind-Hotness or Fire-poison is not satisfied, add herb Qing Guo and Bai Bu can get surprising good effect again. For the chronic sour throat due to Fire-poison Xie Qi, the Qing Guo is my first choice.

(3). 玄参,慢性咽炎中,阴虚火旺引起的不在少数,此药可以滋阴降火,解毒利咽,热毒性也可以用,加牛蒡子,连翘即可,阴虚火旺者加生地,麦冬等,对阴虚见咽干有明显虚热症状的,此药为我的首选药,如果没有明显的热象,仅仅是咽干,则首选麦冬,因为我感觉生津利咽麦冬效果好,清虚热则玄参效果好,此为不同之处。

(3).  Xuan Shen

Among the chronic sour throat, that due to Yin deficiency-Fire overwhelming is not less in number. The herb Xuan Shen works to nourish the Yin and to cool down the Fire, to detoxify so as to clear the throat. It can also be used in sour throat caused by Fire-poison. It is enough to add other herbs, such as Niu Bang Zi and Liang Qiao. For those caused by Yin deficiency-Fire overwhelming, add herb Sheng Di and Mai Dong, etc. For the sour throat caused by Yin deficiency with dry throat with apparent false Fire syndromes, the herb Xuan Shen is my first choice. If there is clear sign for the Fire or Hotness, the symptom is only the dry throat, I chose the Mai Dong first, since I feel that the herb Mai Dong works better for lubricate the throat, while the Xuan Shen is better for false Hotness. This is their difference.

(4). 白僵蚕,蝉衣,此2药气味俱薄,浮而升,阳也,擅于散风热,消肿毒,拔邪外出,白僵蚕又可以化顽痰,蝉衣又可以亮音治喑哑,如果再配伍全蝎一味,则可以通瘀化痰,散结解毒,用于久病顽疾,可以很显著的获效,久病咽炎,常因热毒(虚火)灼伤津血而成痰瘀,痰瘀毒互结于咽,缠绵难去,此3药均属虫类,善搜剔,用于此证,恰为合拍。

(4). Bai Jiang Can and Chan Yi

These two herbs are with light smell. The light smell herbs bear a capacity to lift, to rise, and such capacity belongs to a Yang, which is good at disperse the Wind and Hotness, to make disappear the swelling and poisoning, and to pull the poison/toxic out of the body. The herb Bai Jiang Can also work to dissolve the obstinate Phlegm and the herb Chan Yi is good at clear the throat and to improve sound. If they are used together with herb Quan Xie, they all can work to clear the stagnation, to clear the Phlegm, to disperse the swelling and to detoxify. When used in long term sour throat, the healing effect can be excellent. The chronic sour throat is commonly with the Phlegm, stagnation and toxic entangled severely in the throat, which are caused by the burning of Jing and blood by the Fire-Poison Xie Qi. These three herbs all belong to herbs of a insect kind, good at searching and picking up. They are suitable to be used in the condition here.

(5). 黄芪,临床所见,脾阳虚咽炎也不少,脾虚气血精微生化乏源,不能上承濡养咽喉,以至咽壁溃烂久久不愈,黄芪可以补脾升阳,增益气血,托毒生肌,促进痊愈,另外有名医认为咽喉类似肌肉,应为脾所主,咽喉也是胃之入口,所以从脾论治可取,所以针对脾阳虚咽炎者,会加白术,党参,肉桂等,验之的确有效。

(5). Huang Qi

In clinic, it was found that it is not rare the sour throat caused by Spleen Yang deficiency. A deficient Spleen Yang fails to produce more Qi, blood and Jing to supply to the body, so there is not enough Jing liquid to nourish and to lubricate the throat, so that the throat become ulcer in shape that is hard to cure. The herb Huang Qi can nourish the Spleen and to raise the Yang Qi to the throat. It can dispel the toxic stuff and stimulate renew of the tissue in a wound to speed up the healing. A famous TCM doctor said that he believes the throat is similar to muscle, so it should be associated to the Spleen. Also, the throat is the starting point of the stomach, so it is reasonable to solve the sour throat from the Spleen point of view. For this reason, when treat the chronic sour throat, some herbs that nourish the Spleen are involved, such as herb Bai Zhu, Dang Shen and Rou Gui, etc.

(6). 桔梗,此药可以开宣肺气,化痰利咽,在治疗咽炎时,起到了很好的效果,但我用它的主要目的是引经,引诸药入咽喉,无此向导,药力难以集中。

(6). Jie Gen

The herb Jie Gen works to disperse the Lung Qi, to dissolve the Phlegm and to clear the throat. In the treatment of sour throat, its effect is pretty good. I use it however is to use its capacity to bring other herbs to the throat. Without it, the healing effect of other herbs might be dispersed and scattered.

此病看似小病,实则复杂,急性咽炎多数外感风热,或热毒犯咽,治疗较易,慢性则多因阴虚火旺,虚火上扰导致,滋阴降火基础上一定要加少量肉桂引火归元,滋阴要根据脉证考虑是滋补肺胃肾中的哪个,脾虚,气血不足从脾论治,用大剂量黄芪可以获显效,取其升阳,濡养,托毒,生肌之用,萎缩性咽炎要加阿胶,结合黄芪大补气血,养阴血以滋养萎缩之咽喉,肥厚性咽炎要加浙贝,牡蛎,穿山甲以增强化痰散结之效,使之回缩,等等等等。

The treatment of sour throat is complex, though it seems a simple clinic condition. Acute pharyngitis is normally caused by external Wind and Hotness, or by Fire-Poisoning stuff, the healing is relatively easy. Chronic sour throat is commonly caused by Yin deficiency-Fire overwhelming. The false Fire rushes up to burn the throat. In the treatment of the chronic sour throat, little bit Rou Gui should be added to bring the false Fire back to the Kidney, under the ground of using Yin-nourishing and Fire-clearing therapy. In terms of the Yin-nourishing therapy, it is again needed to verify to nourish the Spleen and Stomach Yin or Kidney Yin. For Spleen deficiency, large amount of herb Huang Qi can work well. For withered pharyngitis, add herb A Jiao, together with the Huang Qi, to nourish the Qi and blood the same time, to nourish and lubricate the throat. For hypertrophic pharyngitis, add herb Zhe Bei Mu, Mu Li and Chuan Shan Jia to increase the ability of the formula in Phlegm-clearing and mass-dispersing capacity, and so on.

 

19,脑血栓

19. Cerebral thrombosis

(1). 龟板,巴戟天,年过四十而阴气自半,肾阴不足,虚火炼液为痰,灼血成瘀,或因恼怒引动肝风,痰瘀风火互结,阻于脑脉,故而发病,龟板滋阴力胜,为治本之法;肾阳不足,气化无权,温动无力,血流滞缓成瘀,津液凝聚成痰,痰瘀阻于脑脉,巴戟天补肾阳,温而不燥,亦为治本之法,我通常2药合用,取其阴阳互根原理,阴虚者重用龟板,阳虚者重用巴戟天,此2 药不腻,不助痰湿,故用之。

(1). Gui Ban and Ba Ji Tian

After age 40, the Yin in a body is exhausted half, according to Chinese medicine. When the Kidney Yin is not sufficient, the false Fire burns the liquid part of the body into Phlegm and burns the blood into stagnated clot, or a Liver Wind that is caused by upset or angry feeling is created in the body. The Phlegm, the stagnated clot and the Liver Wind entangled together to block the brain meridians to cause the cerebral thrombosis. The herb Gui Ban is good at supply Yin liquid, which is the main principle in the treatment of this disease. When the Kidney Yang is not sufficient, there would have no enough Yang Qi to run the body function or to warm up the body, the blood circulation becomes sluggish to form stagnated clot, the body liquid part forms Phlegm, and the Phlegm and clots can also entangled in the brain to cause this disease. The herb Ba Ji Tian works to nourish the Kidney Yang Qi. It is warm but not so dry. It is also another major way to treat this disease. I normally use both of the herbs, to make the use of the Yin-Yang transformation each other. If the Yin deficiency is more, use more Gui Ban, and if the Yang deficiency is more, use more Ba Ji Tian. These two herbs are not greasy, so they do not cause more Phlegm or wetness accumulation in the body. For this reason, they are used often.

(2). 胆南星,半夏,阴虚之痰为热痰,我喜用胆南星清化之,阳虚之痰为寒痰,我喜用半夏温化之,也经常用白僵蚕,石菖蒲,白僵蚕善于祛风通络,石菖蒲善于开窍醒神,另外有的病人喜食肥甘厚味或饮食饥饱无常,使脾生痰,此痰的治疗还是健脾为好,总之,化痰药要根据病人的需求而定。

(2). Dan Nan Xing and Ban Xia

The Phlegm caused by Yin deficiency is a hot Phlegm. I like to use herb Dan Nan Xing to dissolve it. The Phlegm caused by  Yang deficiency is a cold Phlegm. I normally use herb Ban Xia to warm up and to evaporate it. I also often use herb Bai Jiang Can and Shi Chang Pu. The herb Bai Jing Can is good at dispersing Wind and to dredge the meridians. The herb Shi Chang Pu is good at opening the openings in the head (eye, ear, nose). Some patients like to eat oily or greasy food, or have irregular diet habit, so that there is Phlegm formed in the body. In this case, herbs should be used to nourish the Spleen so as to clear the Phlegm. All in all, the kind of the Phlegm-clearing herbs should be decided according to the patient condition and the cause for the Phlegm.

(3). 水蛭,地龙,活血药中的竣烈之品,擅治顽疾,用于重病,为防止后遗症的发生,故多选之,待大势已去,再去之,以当归,川芎,三七等善其后。

(3). Shui Zhi and Di Long

These two herbs belong to the strong herbs among the herbs that work to stimulate blood circulation. They are good at the cure of obstacle diseases. When used in severe disease conditions, they can prevent complications to happen. For this reason, they are commonly used in the treatment of the cerebral thrombosis condition. Once the clinic condition become stable, they can be omitted from the herbal formula, replaced with other herbs, such as Dang Gui, Chuang Xiong and San Qi, etc.

(4). 蜈蚣,全蝎,无论是急性期,还是后遗症期,此2药都可以治疗口眼歪斜,半身不遂,口强语蹇等,此为常识,不作详解。

(4). Wu Gong and Quan Xie

No matter it is in an acute stage or in complication stage, these two herbs can work to solve facial paralysis, body paralysis, hard to speak. This is common sense in the TCM community, so no need to talk too much more. 

(5). 黄芪,久病多虚,脉络淤滞日久不愈多因气虚不运,所以在治疗中风后遗症时,我很重视补气以活血的理论,黄芪不仅能扩张血管,改善血液循环,还能兴奋中枢神经系统,对此病益处多多。

(5). Huang Qi

A long term disease course would cause a weakness condition of the body. The block and stagnation of blood vessels and meridians is due to the Qi deficiency. In the treatment of the post stroke syndrome, I therefore pay much attention to the Qi-nourishing and Blood-activating therapy. The herb Huang Qi can not only relax the blood vessel walls to improve blood circulation, but also activate the central nerve system. It is good for the treatment of the post stroke syndrome in many aspects.

(6). 葛根,本品善升清以降浊,以前有一网友认为此药能升血压,其实不然,此药升的是清阳,清阳之气不会令人头疼头晕,令人头疼头晕的多数是痰瘀浊阴之邪,此药可以引清阳之气上行,从而消散浊阴之邪,所以高血压,脑血栓病人因痰浊湿瘀阻于脑窍的大可放心而用,唯独肝火上炎者慎之罢了,此药可以改善脑血液循环,降低血压,而且安全无毒,治疗此病我几乎每方必用。

(6). Ge Gen

The herb Ge Gen is good at rising pure energy (Qi) to the brain, so as to drain the wasted, foul Qi down the body. Previously, there is a friend on the internet believes that the herb Ge Gen can increase the blood pressure. This is not true. What it raised is clear and pure energy Qi, which will not cause headache or dizziness. That causes headache and dizziness is the foul Qi, such as Phlegm and stagnated Qi. Ge Gen raises the pure and clear Qi up to the brain, so to disperse the foul Qi off the brain. So, when deal with the patients with high blood pressure, and with cerebral thrombosis caused by the Phlegm and foul stagnation, it can be used without too much worry. Only when deal with the Liver Fire-up rushing condition, it should be used with care. It can improve the cerebral blood circulation so to reduce the increased blood pressure. It is also with less toxic effect. I use it in almost every formula.

脑血栓为常见病,也是极其复杂的疾病,区区几条用药根本不能把所有内容都概括在内,比如几年前治疗一个肝火挟痰瘀上扰的病人,发病症状主要是血压高,不能走路,在医院住院7天,无效出院,我以益母草90 g为君,在用药第4天开始见效,7天可以走路,半月后生活自理不成问题,益母草可以清肝,活血,祛风,降压;再比如有一个嗜酒病人,脉证为阳明腑实证,一侧肢体不灵活,我以大黄为君,将其彻底治愈,毫无后遗症,有认为动脉硬化因巨细胞病毒引起的,加解毒药治疗,等等。只要辩证准确,用药精当,一般无效者是很少的。

Cerebral thrombosis is a commonly seen disease, and also a very complex disease. Only several comments can not explain every aspect for the treatment. For example, several years ago, I treated a patient with Liver Fire Up-raising with Phlegm. His most symptom is high blood pressure and hard to walk. He was kept in hospital for seven days without any improvement. I used Yi Mu Cao 90 gram as the main ingredient. The healing effect shows up after four days. On the 7 days of the treatment, he could walk. After half month, he could handle his daily life. The Yi Mu Cao works to clear the Liver, to activate blood circulation, to dispel the Wind, and to reduce the blood pressure. Another example is a patient who craving for alcohol. His pulse suggests that he is in a Yang-Ming overwhelming condition. The arm and leg on one side can not move by will. I used herb Da Huang as main ingredient and get him cured without any complication. There is a comment that the artery sclerosis is caused by megavirus infection and it should be added an anti-virus herb, etc. If the TCM diagnosis is correct and precise, and the herb is used in a proper way, it is rare to have a case without healing effect.   

在中风先兆时,我多以补肾为主,活血化痰为辅,急性期多以化痰为主,补肾活血为辅,后遗症时主要以补气补肾活血为主,化痰为辅,此为一思路;肢体不遂见证者,用引经药,上肢用桑枝,防风,下肢用牛膝,地龙,左侧用川芎,黄芪,右侧用赤芍,当归;中风后见肢体疼痛者(丘脑性疼痛)从补气活血通络治疗无效时,加附子温阳多数可以获效,肢体拘挛者,用木瓜,白芍等,肢体痿软者用桂枝,马钱子,口眼歪斜用牵正等等等等

If there is a sign suggesting stroke, I would apply Kidney-nourishing therapy as a main therapy, and a blood-activating and Phlegm-clearing therapy as a complementary. In acute stage, the main therapy is to clear the Phlegm and Kidney-nourishing and circulation-activating therapy as a complementary. In the post stroke complication stage, the herbs should be used mostly to nourish the Qi and Kidney and to activate the circulation but the Phlegm-clearing is a complementary means. This is one way to figure out the healing principle. For the difficulty to move arm or leg, use meridian-directing herbs. If the problem is in the arm, use herb Sang Zhi and Fang Feng; in the leg, use Niu Xi and Di Long; in the left side, use Chuang Xiong and Huang Qi; and in the right side, use Chi Shao and Dang Gui. If the patient has pain (pituitary-inducing pain), and if the Qi-nourishing, circulation-stimulating and meridian-dredging therapy does not work, add herb Fu Zi to warm the meridian can get healing effect in most cases. If there is arm and leg spasm, use Mu Gua and Bai Shao, etc. If the arm and leg feels weak, use herb Gui Zhi and Ma Qian Zi. If there is facial paralysis, use herbal formula Qian Zhen Sang, etc.   

 

20,慢性肾炎

20. Chronis nephritis

(1). 何首乌,淫羊藿,肾为水火并居之脏,肾病见阴虚者,多因热毒之邪久留不去,伤及肾阴,加之肾失封藏,精微下注流失而至,或先天阴虚体质患病者,何首乌善于滋补肾阴,填精补血,可与女贞子,旱莲草伍用,无恋湿之弊;临床所见阳虚比较多见,此证多因肾阴亏损,无以化气而至,肾体阴而用阳,只助其阳,不滋其阴,可能会伤其阴,故治疗当阴阳双补,肾阴充足,肾阳蒸动,阴精自能化气而阳出有根,命门之火可以久燃,肾之功能从而改善,补阳我喜用淫羊藿,因其还可以益精,若阳虚明显,伴水肿,方可加附子等大热之品,补阴补阳要根据病情而定,调节双方的剂量及配伍即可。

(1). He Shou Wu and Yin Yang Huo

The Kidney is a organ in which both the Fire and Water are stored in. If there is sign for Yin deficiency in the kidney disease, the most common reason is the sticking of Fire-poison Xie Qi in the kidney, which damages the kidney Yin, in addition to the failure of the kidney’s function to keep and to restore the fine Jing stuff in the body. The fine Jing stuff leaks from the urine to lose the Yin stuff. It can also be due to genetic Yin deficient body of the patient. The herb He Shou Wu is good at nourishing the kidney Yin, to fill up the Jing stuff and blood in the kidney. It can be used together with other herbs, such as Nu Zhen Zi and Han Lian Cao. Work together, it would have no side effect to keep the Wetness Xie Qi in the body. In clinic, it is more common to see a Yang deficiency. It is caused by the first Yin deficiency, which makes there is no enough fine Jing to produce more Yang Qi. The Kidney belongs to Yin in constitution but works as Yang in the body. If only supply more Yang without nourishing the Yin, the Yin might be exhausted. Therefore, the Yin and the Yang should be nourished the same time. When the Kidney Yin is sufficient, the Kidney Yang is produced in sufficient and works for longer time too. The kidney function is possible to restore to normal. To supply Kidney Yang, I like to use herb Yin Yang Huo, since it has also a function to nourish Jing Qi. If the Yang deficiency is very apparent with swelling, add stronger Warming herbs, such as Fu Zi. It is really depending on the person’s condition to decide to nourish the Yin or the Yang relatively more.

(2). 黄芪,慢性肾炎之水肿,脾阳不足者不少,黄芪甘温益气,补中有升,气升则水降,与补脾药相伍,可健脾以燥湿治水肿,助脾统血治血尿,同时黄芪补肺,可助肺通调水道以利水,此病多因外感而发作,黄芪补肺固表,以抵抗外邪入侵,黄芪与补肾药相伍可以固精气,治蛋白尿,久病毒邪根深蒂固,黄芪可以鼓邪外出,久病入络,必有瘀血,瘀血伤肾,可加重肾病,黄芪与活血药相伍,可助血行,等等,综上所述,若没有此药,我宁可不治此病。

(2). Huang Qi

The swelling in chronic nephritis could be due to the Spleen Yang deficiency. The herb Huang Qi warmly nourish the Spleen Qi and there is also a raising function among its nourishing capacity. The rise of the Qi is followed by the descending of water. Used with Spleen-nourishing herbs, the nourished Spleen functions to dry the Wetness so to solve the swelling, to control the blood circulation within the blood vessels so to control the bleeding in urine. At the same time, the Huang Qi also nourish the Lung, to help the lung to dredge the water (urine) conduct, so to improve the secretion of extra water out of the body. The chronic nephritis is usually triggered by common cold (the external stimulation). The Huang Qi nourish the Lund and to strength the skin defense system to prevent against the external attacks (by Wind, Cold or Hotness). When used together with Kidney-nourishing herbs, it works to seal the Jing Qi within the kidney, so to stop the protein urine. In a long term disease course, the Xie Qi stick deep in the body. Huang Qi could push the Xie Qi to the surface layer of the body. In a long term disease, there could also be blood stagnation, that could hurt the kidney to make the nephritis worse. The Huang Qi works with circulation-activating herbs to improve blood circulation, etc. All in all, if there is no the herb Huang Qi, I would rather not treat the nephritis.

(3). 蝉蜕,连翘,此病的首发多与外感有关,外邪入里,深伏于肾,最后导致湿热毒瘀胶结难去,正气不足,又每因复感而发作,从而进一步加重,扶正很重要,但祛邪也很重要,我喜欢用此二药清解毒邪,蝉蜕善于散风热,抗过敏,对控制病情进展意义很大,连翘善于解温毒,又能散结消肿,故多用之。

(3). Chang Tui and Liang Qiao

The nephritis is commonly triggered by a common cold. The external Xie Qi invades in the body, hidden in the kidney, and eventually causes the entangled Wetness, Hotness, Toxic and poison, and Phlegm in the kidney that is obstacle to be dispelled. If the body is in a weakness condition (Qi deficiency), the person is easy to get the common cold, e.g. to be attacked by the external Xie Qi. The repeated attacks by the external Xie Qi make the body condition worse and worse. It is important to dispel Xie Qi for the treatment, but it is similarly important to help the body defense system (the Zheng Qi). I prefer the use of herb Chang Tui and Liang Qiao to clear the Xie Qi, the toxic stuff. The Chang Tui is good at dispersing Wind-Hotness, to combat against allergy. It is very useful to control the development of the disease. The herb Liang Qiao is also good at detoxify, and at disperse mass and solve the swelling. For these reasons, these two herbs are used quite often.

(4). 益母草,有些疾病见水肿,以利水治疗无效时,用活血方法多可以见效,所谓血不利,则为水,此病有肾损伤,肾络瘀血明显,可发生水肿,益母草可以活血以利水。对有高血压者,它可以使上冒之水湿下行,从而降血压,即使是阴虚阳亢高血压,益母草也能使其降压,活血一般多与地龙为伍,还能改善肾病的血液高凝状态。我一般以大剂量用之,效果极好。

(4). Yi Mu Cao

Some times, some diseases show swelling. If the water-dispelling (urination therapy) does not work, the circulation-improving therapy might still be able to work. The explanation for this phenomenon is that, if the blood is not circulated smoothly, the water will be accumulated to form swelling. In the nephritis, the kidney is damaged somehow, there would be blood stagnation in the kidney micro-circulation network, which could cause the swelling. The herb Yi Mu Cao can improve blood circulation so to reduce swelling. For the patients with hypertension, it makes the water that raising up to the brain descends, so to reduce blood pressure. Even if it is high blood pressure caused by Yin deficiency and Yang overwhelming, the herb can also reduce the blood pressure. The circulation-improving therapy is commonly used together with herb Di Long. The herb Yi Mu Cao can also improve the high clotting situation of the body. I usually use it in a large dose. The effect is excellent.

(5). 血余炭,脾虚不统血,可见尿血,肾络受损亦可见尿血,对止血药的选择,我喜欢用血余炭,此药活血止血,有止血不留瘀的优点,又能养阴利尿,故用之,临证也多与三七等药相伍。

(5). Xue Yu Tan

If the Spleen is in deficient condition, it is unable to control the blood circulate within the blood vessels, so that there could be blood in the urine during nephritis. If the kidney micro-circulation network (meridian) is damaged, there could also be blood in urine. To choose bleeding-stopping herbs, I like to use Xue Yu Tan, for the reason that it can improve blood circulation and stop bleeding the same time, as well as the bleeding is stopped without formation of blood clots in the kidney. It again has ability to nourish the Yin and to improve urination. For these reasons, I use it more often. In clinic, I also use other herbs, such as San Qi, together with the Xue Yu Tan.  

(6). 五味子,肾虚失封藏,精微下注,见蛋白尿,我多用五味子补肾固摄,同时用金樱子,桑螵蛸,与补脾肾药联用,多可以解决这一难题,因为有利湿药,故不会闭门流寇。

(6). Wu Wei Zi

When the Kidney is in deficient, it fails to keep Jing stuff in the kidney, so there would be proteins in the urine. In clinic, I like to use herb Wu Wei Zi to improve the retaining property of the kidney. At the same time, I use herb Jing Ying Zi and Sang Piao Xiao, together with other herbs that nourish the Spleen and Kidney. The protein urine can be solved by this way in most cases. Such therapy would not crease a side effect to create Wetness in the body, since there is other herbs that work to clear Wetness in the body.

此病的治疗一般是标本兼顾,在稳定期,以补脾肾为主,在发作期,此时湿热毒瘀邪甚,或兼外感,当祛邪为主,利湿药一般以茯苓,白茅根,玉米须为好,尽量不用木通等。

For the treatment of nephritis, the cause and the symptoms of the disease should be treated the same time. In a stable stage, the therapy should focus on the nourish of Spleen and Kidney. In onset stage, in which the Wetness-Poison stuff is overwhelming, or in which there is external Xie Qi invasion, the therapy should focus on the dispelling of the Xie Qi. The Wetness clearance herbs used are usually Fu Ling, Bai Mao Gen, Yu Mi Xu, and so on. Try not to use herb Mu Tong.

吕,    40    腰痛乏力半年,浮肿一周。病人素体肢冷畏寒,半年前感冒后出现腰痛,乏力症状,病人以为病后体虚,未注意,一月后,症状加重,经医院化验检查,尿血 ,尿蛋白 ,血压160100.被诊断肾小球肾炎。输液青霉素一周无效,一周前出现面部浮肿,下肢也浮肿,来 我门诊求治。刻诊,面白,浮肿,病人自述乏力腰酸痛,食少,舌淡苔滑,脉沉。来诊前化验尿常规,尿蛋白 ,余无异常。

诊断:慢性肾炎(脾肾阳虚,湿毒内留)

方药:黄芪80白术20茯苓25甘草15淫羊藿25杜仲20肉桂15何首乌20连翘20蝉蜕15地龙20土鳖虫20益母草60五味子20牛膝20

3剂后症状大减,7剂后所有症状消失,化验尿蛋白(—),此病人脾肾阳虚,复感外邪,外邪久留不去,深伏于肾,致使正虚邪恋。邪毒伤肾,化瘀化热,肾络受损,导致肾之固摄失职,精微遗漏,故见蛋白尿,脾肾阳虚,运化水湿蒸腾气化功能失职故水湿内停,水湿上冒,故血压偏高,所以治疗当攻补兼施,方中连翘,蝉蜕,甘草祛风清热解毒,地龙,土鳖虫,益母草通络祛瘀,祛旧生新,血不利,则为水,故用大剂量益母草活血利水,使上冒水湿下行,降血压,黄芪甘温补气,又主升,气升则水降,与白术,茯苓健脾以渗湿,诸湿肿满,皆属于脾,脾主运化水湿,所以补脾为治肿之要,淫羊藿,杜仲,肉桂补肾阳,因肾阳不足,不能蒸腾气化水湿,而水肿,所以补肾阳也是治肿之要,何首乌补精,五味子敛精,避免肾中精微流失,牛膝引药入肾,众药合用,故效果显著。

 

21,慢性肾盂肾炎

21. Chronic Pyelonephritis

(1). 土茯苓,湿热温毒寝及于肾,此为首要病因,又因正气不足,导致正虚邪恋,祛邪我首选土茯苓,此药擅长化湿毒,对淋症疗效较好,又可利尿,由于肾盂生理结构,导致病菌容易潜伏,利尿可以冲洗局部,有利于痊愈。

(1). Tu Fu Ling

The main cause for the chronic pyelonephritis is the stick and the entangle of Wetness-Hotness Toxic-poison stuff in the kidney. Together due to the body in a weakness condition, the Xie Qi is kept in the body for a long time. To dispel the Xie Qi, I choose first the herb Tu Fu Ling. This herb is good at dissolve the Wetness-poison stuff. It works very good for infection in urine system. It can also improve urination. For the structure of the pelvis within the kidney, it is easy to keep the toxic Xie Qi there for a long time. The improvement in urination helps to clear the kidney with rush force, so it is helpful to improve healing.

(2). 琥珀,湿热蕴结于肾,气机不畅,气滞水停血瘀,又因正气不足,运血无力,从而加重瘀血形成,瘀血又可以加重病情,导致病情反复不愈,肾盂局部充血,变形,肾实质纤维化,都应属于瘀血范畴,琥珀善于活血通淋,与丹参,土鳖虫为伍,可以化瘀,改善肾血流量,促进炎症吸收,软化瘢痕组织,修复变形的肾盂。

(2). Hu Bo[37]

 When the Wetness-Hotness stick in the kidney, the Qi circulation is damaged, which causes the stagnation in the water and blood circulation. Also due to the weakness condition of the body, there is no sufficient energy to guide the blood circulation, which make the stagnation of the blood circulation worse. The blood stagnation makes the whole disease worse, resulting in a chronic disease condition. The pelvis becomes blood stagnated, disformed in shape, fibril tissue formed. All of such pathological changes belong to the Phlegm in the Chinese medicine. The herb Hu Bo is good at improving blood circulation and at clearing the inflammation in urine system. Used together with herb Dan Shen and Tu Bie Chong, all help to clear the stagnated blood clots, to improve local blood circulation within the kidney, to speed up the absorption of the inflammation, to soften the scar tissue and to repair the deformed pelvic.

(3). 黄芪,湿热毒瘀胶结于肾,与正气不足关系很密切,黄芪可以托毒外出,与蜂房,皂角刺相伍,对深伏之邪仇有独钟(自创成语,呵呵),另外黄芪可以间接化湿祛瘀(多次提及),所以对此病的根治起着重要作用。

(3). Huang Qi

The stick of Wetness-Hotness and Toxic-poisoning stuff in the kidney is closely related to the weakness of body life energy (the body Zheng Qi). The herb Huang Qi can push the toxic floating to the surface of the body. When used together with herb Feng Fang and Zao Jiao Ci, it is more powerful to pick up the deeply stuck Xie Qi. In addition, Huang Qi can indirectly clear the Wetness and Phlegm (this has been mentioned again and again above). Therefore, the herb Huang Qi is very important in the treatment of this disease.

(4). 黄柏,清肾经湿热,乃黄柏之专职,另外,热邪易伤阴,利湿药亦能伤阴,黄柏可以坚阴,如果阴虚明显,需要加旱莲草,女贞子养阴,此亦为扶正之法。

(4). Huang Bo[38]

The herb Huang Bo is good at clearing the Wetness-Hotness in the kidney. This is the main function of this herb. In addition, the Hotness Xie Qi is easy to hurt the Yin in the body. The Wetness-clearing herb also has a trend to damage the Yin. Huang Bo works to strength the Yin. If the Yin deficiency is apparent, it is need to add other herb, Hang Lian Cao, and Nu Zhen Zi to nourish the Yin. This is the Qi-supporting therapy.

(5). 肉桂,湿为阴邪,易伤阳气,尤以脾肾之阳为甚,阳虚不化水,则湿浊之邪积留肾与膀胱,从而病情顽固不愈,温阳我喜用肉桂,温阳化湿功专力雄,另外补阳之法,我通常都是阴阳双补,补阴可以使阴精充足,从而可以蒸化阳气,使阳出有根,此为阴阳互根也。

(5). Rou Gui

The Wetness Xie Qi belongs to a Yin Xie Qi, which tends to hurt the Yang Qi in the body, especially to hurt the Spleen and Kidney Yang Qi. When the Yang Qi is not sufficient, it fails to evaporate water, so that the Wetness accumulates and sticks in the kidney and in urine bladder, which further more makes the disease into obstinate stage. To warm the Yang Qi, I like to use Rou Gui, which is powerful to clear the Wetness. I usually nourish the Yin and Yang the same time. When nourishing the Yin, the sufficient Yin would be able to evaporate into the Yang Qi, makes the Yang Qi have a source to be created. This is the theory that the Yin can produce the Yang, and the Yang can create more Yin. 

此病急性发作,祛邪为主,缓解期以扶正为主,即使尿路刺激证完全缓解,仍需巩固治疗一月之久,同时辅以扶正方可有望根治,如果有血尿,高血压等,根据病性症候治其兼证即可,但总体思路���变,热毒之邪一般二花,鱼腥草,白花蛇舌草即可,若为顽毒,用苦参,蚤休,全蝎攻逐之,利湿有滑石,车前子等,需防利湿伤阴,苦寒药容易伤及脾胃,选加陈皮,白术预防,引经药牛膝不要忘了,此病复杂多变,后果较为严重,需要长期治疗,故用药不宜太重太偏,勿犯顾此失彼之忌,等等等等。

In acute stage, it should pay attention more to dispel the Xie Qi. In a stable stage, pay more attention to support the body life energy and the defense system. Even if the urine tract stimulating symptoms disappears completely, the treatment needs to be continued for one month. At the same time, use the life energy supporting therapy. By this way, the disease is hopeful to cure. If there is blood in the urine, and high blood pressure, treat them accordingly. But the main healing principle should be kept. To dispel Hotness-Toxic, the herb Jing Yin Hua, Bai Hua She She Cao are used. If the toxic stuff is obstinate to remove, use herb Ku Shen, Zao Xiu, and Quan Xie to clear it. To clear the Wetness, use herb Hua Shi, and Che Qian Zi, etc. It should be careful not to damage the Yin during the Wetness clearing therapy. Bitter-Cold herbs tends to hurt the Spleen-stomach. Add Chen Pi and Bai Zhu to prevent the side effect. No not forget the herb Niu Xi, which works as guide to direct other herbs working in the kidney. This disease is complex and easy to come back and the clinic progression is severe. It needs a long time to cure, so the herbs should not be used for a large dose and not to extreme. Do not catch the mistake to solve one problem but create another problem.  

 

22,顽固性头痛

22. Obstinate headache

(1). 川芎,本品辛温,能上行头目,祛风止痛,无论外感还是内伤均适宜,对实证顽固病,剂量需要较大(20--30),但对虚证,小剂量调和气血即可,此为常识,但很重要,故提及一下。

(1). Chuan Xiong

The herb Chuan Xiong is spicy and warm in herbal nature. It can travel up to the brain, to dispel the Wind and to stop the pain. It can be used to solve the headache that is caused by either external or internal Xie Qi. For overwhelming and obstinate headache, the dose should be large (20 to 30 grams). For weakness condition, use smaller dose. This is common sense but it is very important, so it has to be mentioned here. 

(2). 白芍,偏头痛以女性多见,与情绪波动密切,多为肝阳头痛,白芍可以平肝缓急;在病机复杂的血管神经性头痛里,有以肝虚为主的(如头痛有遗传者),脉管为肝所主,肝血不足,则血不容络,继而内生痰瘀,加之外风或肝风引动,头痛即发作,白芍可以养阴补血,从而濡养络脉;脉管舒缩失调引起头痛,与柴胡伍用,可以调肝,使肝所主的脉管舒缩功能恢复正常;瘀血头痛病人,瘀血多为死血,枯血,因为它的产生与络脉枯滞有关,白芍可以润其络脉,使瘀血容易化祛;此药的运用更可以减轻川芎等药的燥烈之性。

(2). Bai Shao

Migraine is more seen in female. It is more related to the emotional stress. It is in most cases caused by Liver Yang overwhelming. The herb Bai Shao helps to calm down Liver and to relax the spasm. In complex angioneurotic headache, some cases are caused by Liver deficiency (such as the headache is with family history). The blood vessels are dominated by the Liver. If the liver blood is not sufficient, there would have no sufficient blood to nourish the vessels. The blood stagnation and Phlegm would be produced. In addition of the triggering by external Wind or internal Wind, the headache comes. The herb Bai Shao helps to nourish the Yin and to supply blood, so to nourish the micro-blood network. If the pain is due to the disorder in the blood vessel contract and relaxation, use the Bai Shao together with herb Chai Hu, which could recover the blood vessel function of contract and relax. For headache caused by blood stagnation, the stagnated blood is “died’ blood or a withered blood, since its exist is related with the wither of the micro-circulation network. The herb Bai Shao helps to lubricate the micro-circulation network, making the withered blood clot easier to be removed. Its use helps to reduce the strong dryness nature of the herb Chuan Xiong.

(3). 蜈蚣,其走窜之力最速,内而脏腑,外而经络,凡气血凝聚之处皆能开之,此药可以搜风通络,对顽固性头痛属瘀血的,我多用之,如无此药,全蝎亦可代替之。此2药治疗头痛,鲜有不效者。

(3). Wu Gong

The herb Wu Gong is the fastest to move and to travel in the tissues and organs, everywhere in the body where there is blood stagnation or clots. It works to pick up Wind and to conduct the micro-circulation network. For obstinate headache caused by blood stagnation, I use it very often. If it is not available, use Quan Xie as a replace. These two herbs, when used for the treatment of headache, are rarely without effect.

(4). 葛根,紧张性头痛,多因紧张,劳累引起头项肌肉持久收缩而头痛,葛根善于升清,解肌,对头项背肌肉收缩有缓解之功,所以此病我必用葛根,另外颈椎病病人的相关症状,我也多用之。

(4). Ge Gen

The nervous headache comes mostly after a nervous condition or a labor work (such as computer work, or lift heavy stuff), which cause the neck muscle contracting for a long time so to cause the pain. The herb Ge Gen works to raise the pure energy to the head and to relax muscle on the neck so to solve the headache. For this kind of headache, I use the Ge Gen very often. In addition, I also use it often in the treatment of  cervical spondylosis with headache and tight shoulders.  

(5). 柴胡,瘀血头痛,除了活血外,我也比较重视疏肝,肝主疏泄,可调畅气机,疏泄营血;此病瘀血的形成也多与情志引起的肝郁有关,故欲想化瘀,先当疏肝。

(5). Chai Hu

For headache caused by blood stagnation, beside using circulation-improving therapy, I also pay much attention to Liver-dredging therapy. The function of the Liver is to dredge the pathways or conducts of the energy flow and blood flow. The formation of the stagnated blood is also related to the Liver stagnation. So, to dissolve the stagnated blood, it should first dredge the stagnated liver.

(6). 白僵蚕,脾湿生痰中阻,可引发肝风,肝风挟痰上犯高巅,阻于清窍,脉络不通,头痛乃作,脑为清阳之府,岂容痰浊上犯,故以白僵蚕化痰,同时取其祛风,通络,止痛之功。为治其本,应该加白术,茯苓等补脾,以杜绝痰源。

(6). Bai Jiang Can

Spleen deficiency would produce Phlegm, which can trigger Liver Wind, and the Liver Wind rushes up to the head, to block the head, stagnate the blood circulation network, so to cause the headache. The herb Bai Jiang Can works to dissolve Phlegm, as well as to dispel Wind, dredge the circulation network, so to stop the pain. To have a radical cure, it should be added the herb Bai Zhu and Fu Ling to nourish the Spleen, to stop the source of the Phlegm.

顽固性的头痛多与肝脾肾不足,痰瘀风互结等相关,也就是虚实夹杂者居多,个人认为,草木之品,可以以量取胜,用虫药搜剔则效果更专。也有纯虚性头痛病人,治疗则补气血,补肝肾等,补气血我喜用补中升阳之法,使气血上荣,补肝肾我喜用温髓养血之法,使脑髓得充。对疼痛难忍的,可以选加细辛,蜂房,元胡等缓解症状,因思虑过度引起头痛的,我一般多加酸枣仁,合欢花养神治痛。头痛的部位各有引经药,这一点众所周知,不说了。

Obstinate headache is usually related to the weakness in the Liver, Spleen and Kidney, to the accumulation and entangle of Phlegm, Wind and blood stagnation, etc. In another words, it means it is a condition in which the weakness and the overwhelming condition stay together. I myself believe that the herbs of plants may work by using large dose, the herbs of animal/insects origin could work better to search and pick the disease-causing stuff out. Of course there are some patients with headache of weakness condition alone. For the treatment, it should be sued to nourish the Qi and blood, to nourish the Liver and Kidney etc. To nourish the Qi an blood, I prefer to nourish the middle Spleen Qi, so as to supply more Qi and blood to the head. To support the Liver and Kidney, I like to use the bone marrow-warming and blood-nourishing therapy to fill the brain and spine. If the pain is very severe to tolerate, add herb Xi Xin, Feng Fang and Yuan Hu, etc. to solve symptoms. If the headache is due to too much brain work, I usually add herb Suan Zao Ren and He Huan Hua to nourish the spirit, so as to reduce pain. For the herbs that could guide other herbs to focus on a specific meridians on the head, it is well known, no need for me to mention them here gain.

 

23,神经衰弱(失眠)

23. Nervous exhaustion (poor sleep, insomnia)

(1). 黄连,临床所见,阴虚阳亢,心肾不交失眠最为常见,治疗自当滋阴潜阳,交通心肾,黄连可以清心火,再配伍生地等滋肾阴,此法也叫泻南补北,待阴平阳秘,阴阳相济,自能安然入睡。

(1). Huang Lian

In clinic, it is common to see a nervous exhaustion caused by Yin deficiency and Yang overwhelming, as well the disharmony between the Heart and the Kidney. Fore the treatment, the therapy should be used to nourish the Yin and dive the Yang, as well as to harmony the Heart and the Kidney. The herb Huang Lian can clear Heart Fire. With additional use of herb Sheng Di to nourish the Kidney Yin, the poor sleep can be solved. This therapy is also called To release the South but to nourish the North. After the Yin is supplied and the Yang is dived down, the Yin and the Yang is in a harmony situation, of course the one can fall into sleep easily.  

(2). 龙骨,牡蛎,龙骨入肝以安神,牡蛎入肺以定魄,魂魄者,心神之左辅右弼也。此二药善潜阳,能使阳入阴��对阴阳失衡效果较为快速。

(2). Long Gu and Muli

The herb Long Gu goes into the Liver to calm spirit, and the Mu Li into the Lung to calm spirit. The Liver spirit and the Lung spirit are the assistants of the Heart spirit. These two herbs are good at diving the Yang, making the Yang moving and staying in the Yin. This couple works better for nervous exhaustion caused by imbalance between the Yin and the Yang.

(3). 半夏,胃不和则卧不安,有胃脘不适而不易入睡者,半夏可以和胃助眠。半夏能和阴阳通表里,使阳入阴而令安眠。《医学秘旨》中记载用此药与夏枯草合用,交通阴阳,半夏得至阴之气而生,夏枯草得至阳之气而长,二药伍用,平衡阴阳,交通季节,引阳入阴而治失眠。另外对痰热扰心引起的失眠需加黄连为妥。

(3). Ban Xia

If the stomach is in an irritated condition, the sleep will be also in an irritated condition as poor sleep. In such condition, use herb Ban Xia which can calm down the stomach so to improve sleep. It can also conduct the Yin and Yang together, to make the Yang moving into the Yin to calm. It has been indicated in a TCM book that, when used with herb Xia Ku Cao to conduct the Yin and Yang, the Ban Xi obtains the extreme Yin Qi to grow and the Xia Ku Cao gains the extreme Yang Qi to develop. There combined effect is to conduct the Yin and the Yang together in a harmony condition, to transfer one season to another season, from one time zone into another time zone, so to solve the poor sleep. However, if the poor sleep is caused by the stirring of Heart by Hot Phlegm, it is needed to add herb Huang Lian. 

(4). 酸枣仁,心主血,肝藏血,心藏神,肝藏魄,酸枣仁能养心阴,补肝血,故心肝血虚引起的不眠,此药为必用。

(4). Suan Zao Ren

The Heart is responsible to blood circulation, the Liver, to the blood storage. The Heart is also responsible to hide and keep the spirit and the Liver, the emotion. The herb Suan Zao Ren works to nourish the Heart spirit and supply blood to the liver. So it is good to solve sleep caused by Liver blood insufficiency.

(5). 合欢花,有的病人因七情所伤,忿怒烦躁,忧郁不眠,此药可以解郁安神,对虚烦不眠最为合适。酸枣仁与合欢花经验证,有很好的助眠作用,很多时候,即使没有辩证,用此2药也会获取很好的效果,比如有人治疗其他疾病,想顺便把失眠也治一下,我此2药各取30 g,加入方药中,无效者很少。等剂量的此2药,合欢花要比酸枣仁效果明显。

(5). He Huang Hua

Some patients have nervous exhaustion caused by emotional disorders, upset, irritate, depression, and poor sleep. The herb He Huang Hua works to solve depression and to calm spirit. It is especially good for poor sleep with irritate and annoyed feeling. It has been tested and found that, the combination of He Hua Hua and Suan Zao Ren have very good sleep improvement effect. Many times, they can be used without TCM diagnosis. For example, when treat a patient with other disease, and with the idea to solve the poor sleep at the same time, I added these two herbs 30 grams each into that main formula, it is rare that the sleep was not improved. With the same amount, the He Huan Hua works better than Suan Zao Ren.

(6). 何首乌,发现有些失眠病人存在很明显肾精亏虚的症状,如头痛,健忘,腿软等,长期失眠最易耗伤心血,精血同源,故肾精受累,也正因精血同源,补精的方法也能很好的补养心血,何首乌是我治疗肾精不足的常用药,药理学认为它能强壮神经,对神经衰弱病人来说,我倒比较喜欢选此药治疗,同样能强壮神经的药还有五味子,人参等,建议辩证准确后优先选加之。

(6). He Shou Wu

Some patients with poor sleep are with clear Kidney deficiency condition, such as headache, poor memory, weak legs, etc. A long time poor sleep is easy to exhaust Heart blood. The blood and the fine nutrition stuff shares the same source. So the fine nutrition material is also in short. For this reason, to supply more fine nutritional material would also be good to create more Heart blood. The herb He Shou Wu is my commonly used herb to nourish the Kidney micro-nutritional material. Pharmacologic study suggests that it could strength nerves. For nervous exhaustion condition, I would rather like to use it for this reason. Other herbs that could also work to strength the nerve system is Wu Wei Zi and Ren Shen, etc. It is better to use them based on correct TCM diagnosis.

思虑劳倦伤及心脾,忿怒忧郁引发肝火等等很多原因都可以引发失眠,脏腑功能紊乱,气血阴阳平衡失调,是发生失眠的基本病机,如果能掌握失眠的关键原因所在,治疗并不是困难的事。

Many causes could results in poor sleep and nervous exhaustion, such as over mind work or heavy and exhausting labor work, which exhaust the Heart and Spleen; and long term of upset or angry feeling, which hurt the Liver. The basic mechanism for the poor sleep is the disorder in the organ functions, that cause imbalance between the Yin and the Yang Qi. If the core mechanism for the poor sleep can be verified out, the treatment is not so difficult.

 

24,慢性胆囊炎

24.  Chronic Cholecystitis


(1). 柴胡,湿热痰瘀等邪阻滞于胆,或情志不遂,使肝郁气滞,柴胡重剂可疏胆利胆,亦可引药入胆,不论新病久病,皆为必选。

(1). Chai Hu

When the Wetness, Phlegm and stagnation stick in the gall bladder, or emotional disorders, all can stagnate the Liver Qi, to reduce the ability of Liver in dredging the movement and the circulation pathway of the Qi. Large amount of herb Chai Hu works to dredge the Liver and the gall bladder. It can also guide other herbs focusing on the gall bladder. No matter the disease is in acute or chronic phase, it should be the first choice.


(2). 枳实,胆主通降,一旦阻塞,不通则痛,通降破气之品,我首选枳实,它破气除痞,化痰消积,其药力强大,利胆作用十分显著,可谓立竿见影,如是虚性体质,需加黄芪防其耗气。

(2). Zhi Shi

The function of gall bladder is descending in Chinese medicine. Once the bladder is blocked, there would be pain. For the herbs that work to improve the descending function, I chose the herb Zhi Shi. It break the sluggish Qi and to solve fullness and bloating, to dissolve Phlegm and shrink mass in the body. Its function is pretty powerful to conduct the gall juice flow. Its effect comes also very fast. When used in weak body, it should be used together with herb Huang Qi to support the basic body condition.


3,栀子,刚刚参加工作那年,我有一同事慢性胆囊炎急性发作,疼痛难忍,输液无缓解,大黄煎剂效果不明显,我的恩师嘱其以栀子30g捣碎泡水代茶饮,结果效果很明显。胆囊炎久病胆郁化火,栀子可以宣火热,受早年此病例的影响,此药成了我治疗胆囊炎属郁热的必用药。

(3). Zhi Zi

On the year when I just started to work as TCM doctor, I had a co-worker who got acute onset of chronic chelocystitis with severe pain. In vein infusion did not work. Herb Da Huang extinct did not work either. My dear teacher told me to rinse the herb Zhi Zi 30 gram in water, to drink it as a tea. The healing effect is very excellent. For chronic cholecystitis, the long term of stagnation of gall bladder creates Fire. The herb Zhi Zi works to clear the Fire. Due to this early year experience, this herb is very commonly used in my formula to treat this disease.


(4). 蒲公英,此药清热解毒,消痈散结,肝胆乳胃属实热者皆为我必用,它虽非竣烈之品,但在剂量上做些手脚,效果实在让人满意,治疗此病,早年用过茵陈,金钱草,如今是蒲公英,以后应该不会再换了,我通常用30--80g

(4). Pu Gong Ying

This herb works to clear Fire and to neutralize toxic stuff, to cure carbuncle and to dissolve mass. I use this herbs very often for the diseases in the liver, gall blander, breast, and stomach. It is though not a very strong herb, but it still works very good if we use a proper dose. To treat the chronic cholecystitis in earlier year, I have tried Yin Chen and Jing Qian Cao. Nowadays, I use the herb Pu Gong Ying. It may not be changed in future anymore. For this herb, I usually use 30 – 80 grams.


(5). 水蛭,白僵蚕,胆热淤积日久,必有痰瘀互结,也正因痰瘀互结,导致病情久治不愈,B超示胆壁增厚,及结石,息肉,我均以痰瘀论治,由于是顽痰顽瘀,故以虫药破之,否则实难见效,此2药可以修复胆壁,是远期疗效的保障,我治疗的慢性胆囊炎,凡按疗程服药的,很少有复发。

(5). Shui Zhi and Bai Jiang Can

If the Fire accumulated in the gall bladder for a longer time, there must be Phlegm and stagnated clot entangled in the bladder. Since their entangle, the disease becomes obstinate to cure. If the B ultrasound detect shows the gall bladder wall thicker, the stone, and polypus, I would treat the disease as Phlegm and stagnated clot. Since the Phlegm is a obstinate Phlegm, the herb of insect origin is needed to break it. Otherwise it is hard to work. These two herbs work to repair the wall of the bladder, ensuring a long time healing effect. For those of patients with this disease, who I treated, and whom followed my healing plan well, their disease is rarely recurred.



[1] Bai Fan: alum.

[2] Bie Jia: turtle shell.

[3] Feng Fang: Honey comb. Feng: bee; Fang: net, house.

[4] The fruit of Chinese wolfberry

[5] actinolite

[6] Centipede.

[7] Talc.

[8] The concept of phlegm in Chinese medicine is a very broad concept, not only means the “phlegm” out of body through cough.

[9] Dandelion.

[10] Deer-horn glue.

[11] Magnet.

[12] Reddle.

[14] Chienese angelica.

[15] Donkey-hide gelatin.

[16] Herba Asari.

[17] Cinnamon.

[18] Centipede.

[19] Spina gleditsiae

[20] Pangolin.

[21] Silkworm larva.

[22] Turtle Shell.

[23] Ground beetle.

[24] The root of three-nerved spicebush.

[25] Monkshood.

[26] Talc.

[27] Amber.

[28] Silkworm larva

[29] Earth worm.

[30] buffalo horn.

[31] Mulberry leaves.

[32] Chinese gromwell.

[33] Licorice.

[34] Placebta.

[35] bluish dogbane.

[36] Turtle shell.

[37] Amber.

[38] Golden cypress.