Classics of Ancient and Modern Physicians on Clinical Practice·Gynecology Volume (Volume 1 and 2)

Author: Shan Shujian et al.
Editor-in-Chief: Wu Shaozhen
Publisher:
Publishing Date: 1999-08-01
Features:
Excerpt: Fluid, blood transfusion. Regarding the above two methods, whether they are effective, based on years of clinical observation, the efficacy is as follows: The first method takes effect within 3-4 days, and the second method takes effect within 1-2 days. If no improvement occurs within the specified time, it indicates that the medicine does not match the condition, and an alternative approach should be considered. After taking the medicine, patients often report a sense of overall comfort, which signifies a good match between the medicine and the condition. Further, they may feel drowsy and tired, with slight sweating. The medicine's efficacy is significant when the body becomes warm and the feet feel warm, with a slight sweat on both the upper and lower body. This indicates that the condition is improving, reflecting a harmonization of yin and yang and the circulation of qi and blood. Post-treatment adjustment should focus on the spleen. For patients with uterine bleeding, some achieve clinical recovery, and the condition is considered cured. This is the case for most. However, some experience recurrence, especially middle-aged and elderly women, who may have the condition return after half a year or a year, or even multiple times within a year. These recurrences are closely related to post-treatment adjustment. If adjusted well, the efficacy is consolidated, and recurrences are less frequent. Neglecting post-treatment can lead to recurrence. Some patients, after recovery, fear taking medicine and are busy with affairs, avoiding seeking medical attention until the condition worsens, only to regret it later. Recurrence also has a characteristic: middle-jiao qi deficiency often becomes a constitutional factor for recurrence. If qi deficiency is not addressed, the condition may reappear easily, and the previous effective method may still work. For such uterine bleeding, from the initial treatment to post-treatment, supplementing the middle-jiao and raising yang is an essential consideration. Post-treatment adjustment should focus on the spleen while also addressing the heart and kidneys. A commonly used formula is Bu Zhong Yi Qi Tang combined with Gui Pi Tang. Adjustments can be made based on the current condition, turning it into a powder for better efficacy. Although pills are convenient, their effectiveness is often inferior. Middle-aged women often suffer from liver and spleen issues, making Xiao Yao San an excellent formula, which can be combined with Bu Zhong Yi Qi. For middle-aged and elderly patients, the decline of (Chong Ren) often leads to yin deficiency, yang deficiency, or a deficiency of yin, yang, qi, and blood. In such cases, supplementing the spleen and kidneys is equally important. Bu Zhong Yi Qi can be alternated with Qi Ju Di Huang or Zhi Bai Di Huang. Additionally, I appreciate the formula of Shao Shao Dan, which "greatly supplements the heart, kidneys, and spleen," and can be adjusted according to symptoms. It is more (ingenious) than di huang pill preparations and has proven effective. Dong Yuan, when treating uterine bleeding, proposed the idea of using Huang Bai's extreme coldness as both the cause and guide, which holds deep meaning. In complex conditions, addressing both root and symptoms from multiple perspectives is a significant skill worth noting.
Example 1: A female patient named Bian, 35 years old, first diagnosed on September 1, 1984. She had been experiencing heavy bleeding for 3 days. She reported irregular menstruation for 10 months, with periods either too early or too late. Her menstrual flow was excessive, and in July, a gynecological examination revealed an improperly placed intrauterine device, which had been removed but did not restore regular menstruation. Her periods lasted 1-2 days, with little blood but many clots, and bleeding became heavy after 3-4 days, sometimes continuing for 4-5 days. She needed medication to stop the bleeding, but it still lasted for 5-7 days, sometimes even over 10 days. This was her third episode of uterine bleeding. She had no abdominal pain but felt lower back soreness and weakness, with excessive red bleeding without clots. She experienced dizziness, palpitations, pale yellow complexion, and fatigue, feeling cool in the lower body but no thirst, preferring warm clothing and drinks, and had poor appetite. Her pulse was fine but wiry, with a slightly swollen tongue and thin coating. Diagnosis: Middle-jiao qi deficiency, yang collapse uterine bleeding. Treatment: Raise yang and lift the collapse, stop bleeding. Modified Jiu Jing Tang: Fried Fang Feng 10g, Jing Jie Can 10g, Bai Zhi 15g, Gao Ben 15g, Chai Hu 5g, Fried Bai Shao 15g, Dang Gui 10g, Bao Gan Cao 5g, Cang Zhu 10g, Du Huo 10g, Fried Chuan Duan 10g, Fu Shen 10g, Sand Ren Powder (added later) 4g. Decoction as water for 2 doses.
Second consultation on September 3: She reported excellent results after taking the medicine, feeling comfortable all over, tired, and sleepy, with significantly reduced menstrual flow, though still experiencing lower back soreness and heaviness. The same formula was continued for 3 more doses.
Postscript: I once studied under the renowned elderly Chinese medicine practitioner Hong Zheming in Jilin Province, benefiting greatly from his teachings. With more reading, I realized that the experience of elderly Chinese medicine practitioners is the essence of Chinese medicine, and without it, one cannot truly master the art. Since 1979, I have been engaged in editing and have dedicated myself to studying and organizing the experience of elderly Chinese medicine practitioners. I have devoted nearly 20 years to this pursuit, enduring hardships and visiting practitioners for guidance, often gaining new insights. Corresponding with them and reading their works has been like receiving personal instruction, a truly delightful experience! Compiling and revising the series "Contemporary Famous Practitioners' Clinical Essentials," I was honored by domestic experts, who generously contributed their works. Reading the works of these masters, one finds that "a single flower is a world, a thousand leaves are ten thousand Buddhas," with profound insights that enlighten and inspire. Their ingenious ideas open new perspectives. Indeed, their works contain hidden treasures, and I have been delighted by them. Hu Guo Chen, President and Chief Editor of China, instructed me to compile the clinical experiences of ancient and modern famous practitioners and named it "Golden Mirror of Contemporary and Ancient Famous Practitioners' Clinical Experiences," a high-minded goal that resonates with me. Based on the revised "Contemporary Famous Practitioners' Clinical Essentials," I selected ancient literature to compile this work. The selection of ancient literature was rushed and lacks refinement. Moreover, with my limited knowledge and experience, I cannot fully meet expectations. I sincerely hope the esteemed readers will offer guidance to make this work perfect. Fu Fang and Zhang Nianshun, deputy editors of China, provided guidance on the compilation of this series. The editorial team has also devoted significant effort, and my dear friend Wu Shaozhen has contributed especially greatly. I hereby express my gratitude. This series has been supported by many elderly practitioners, especially Zhu Liangchun, a renowned Chinese medicine master, who took time out of his busy schedule to write the preface, encouraging the revitalization of Chinese medicine with great passion. His sincerity and dedication are deeply felt and will never be forgotten. Chen Zihua, winner of the first China Outstanding Young Chinese Medicine Ten Gold Medals, and Shi Zhichao, professor, assisted me in some work. I am also very grateful for their support. Du Fu, while staying in Chengdu, wrote "Six Quatrain Poems" in which the sixth stanza goes: "Do not doubt the predecessors, passing on their legacy, who can surpass them? Discard false styles, embrace elegance, learn from many masters, you are their teacher." Although Du Fu spoke of "not surpassing the predecessors," he advocated against hastily suppressing one in favor of the other, blindly valuing the ancient over the modern. The key is to discern false styles and learn from multiple masters. The poet sage's words are equally applicable to the study of Chinese medicine.
The art of writing is eternal, but success and failure are known only to the heart. If "Contemporary Famous Practitioners' Clinical Essentials" has been cherished by many elderly Chinese medicine practitioners and loved by clinical colleagues, I believe "Golden Mirror of Contemporary and Ancient Famous Practitioners' Clinical Experiences" will further benefit clinical practice and gain recognition from friends, not fading away with time.
Shan Shujian
Spring Festival, 1999
At Bu Hui Study House