Blood stasis, like phlegm, is not only a pathological product of some reasons, but also a pathological factor leading to many diseases, and it is also widely involved in clinic. No matter any disease or a certain stage of the disease, it will always reflect the same pathological characteristics of blood stasis, or have symptoms of blood stasis, such as "blood stasis pain", cyanosis and ecchymosis, mass accumulation and so on.
In intractable diseases, although both are blood stasis syndrome, the priorities of the diseases are different; There are many pathogenic factors, and the pathogenic factors of specimens are different. Symptoms vary with the location of the viscera. Or the main syndrome, or only the syndrome, and can reflect its own particularity because of different diseases. Therefore, when applying the treatment method of promoting blood circulation and removing blood stasis, it should be analyzed in detail. If the condition is mild, it should be relieved, and the products of promoting blood circulation and removing blood stasis and resolving hard mass should be used; If the condition is serious, attack in an emergency, and use the products of breaking blood, dispersing blood and removing blood stasis. According to this standard, prescription and medication can be just right. For blood stasis caused by evil, it is necessary to eliminate evil and remove blood stasis; For blood stasis caused by insufficient positive energy, we should strengthen the body resistance and remove blood stasis. At the same time, it is emphasized that it is necessary to identify the location of visceral lesions, master the characteristics of main symptoms and the particularity of diseases, and adopt various corresponding concrete methods to remove blood stasis, so as to strengthen the pertinence of treatment and improve the curative effect of intractable diseases.
The ancients said that "seeing blood stops treating blood", and some people thought that "seeing blood stops treating blood stasis" should be achieved, and the treatment of blood stasis should be based on the cause and orientation. Clinically, we should first make clear the causes of blood stasis and treat it according to the deficiency and excess, and adopt seven methods, such as regulating qi and removing blood stasis, tonifying yang and removing blood stasis, nourishing blood and removing blood stasis, and nourishing yin and removing blood stasis. According to the location of the lesion and the characteristics of the main symptoms, the commonly used treatment methods are: dredging orifices and removing blood stasis, regulating lung and removing blood stasis, resolving food stagnation (softening hard mass), regulating stomach and removing blood stasis, dredging collaterals and removing blood stasis, regulating collaterals and removing blood stasis, eliminating carbuncle and removing blood stasis, and treating blood stasis. Although the method of promoting blood circulation and removing blood stasis is widely used in clinic and has certain unique effects, we must pay attention to the fact that human qi and blood are suitable for cutting, nourishing and unbreakable. Generally speaking, people without blood stasis should use it with caution. People with weak constitution and no blood stasis should be used with caution, and pregnant women should be prohibited in principle. When using stasis-removing drugs, blood stasis should be removed immediately, and it should not be used for a long time, so as to avoid the side effects of gas consumption and blood injury. As for the selection of drugs for promoting blood circulation and removing blood stasis, we must meet the requirements of syndrome differentiation and try our best to give full play to the specialty and meridian tropism of each drug. In particular, insect drugs for removing blood stasis are sentient beings, whose shape is better than qi, and they can be used everywhere, such as leeches, scale insects, ground beetles, pangolins, dung beetles and so on. They are all powerful drugs for removing blood stasis. Although fierce and effective, they can be used in a balanced way when necessary.
In long-term clinical practice, it is found that when acute exogenous fever and some internal injuries and miscellaneous diseases (especially difficult diseases) develop to a certain stage, many patients bear the witness of blood, blood and blood stasis at the same time, and it is often ineffective to treat them simply by clearing away heat and cooling blood or promoting blood circulation to remove blood stasis. In order to explore its internal law, we refer to relevant literature and infer pathology, which is confirmed by experimental research and clinical practice. Firstly, the common clinical syndrome of blood stasis and heat attack is defined, and it is pointed out that it is a special syndrome type formed by acute exogenous fever or internal injury developing to a certain stage, pathogenic fire or phlegm-dampness trapped in blood, blood attacking blood stasis, leading to blood stasis. Its etiology is fiery and toxic; The location of the disease is deep in blood and veins; Pathological changes are stagnation of blood stasis and heat, and damage of viscera; The treatment is to cool blood and remove blood stasis. Clinical practice has proved that applying this theory to guide prescription medication can significantly improve the clinical efficacy in treating stasis-heat syndrome of epidemic hemorrhagic fever, typhoid fever, tuberculosis, bronchiectasis, systemic lupus erythematosus, severe hepatitis, chronic hepatitis B, hyperlipidemia, diabetes, allergic purpura, polycythemia vera and other diseases. In view of this, for decades, on the basis of summarizing the knowledge of doctors in past dynasties, we have made a series of studies on five common syndromes of blood stasis from three aspects: heat stagnation, blood stagnation, blood stasis, collateral stasis, sublimated and developed the theory of blood stasis, and formed a systematic theory of blood stasis.
In addition, we should also pay attention to the same root and homology, the same disease and the same treatment, and the problems closely related to phlegm and blood stasis. Because of the homology between body fluid and blood, it is produced by Shui Gu subtle, blood prevails in veins, and body fluid is dispersed outside veins and between tissues. Through the gasification of zang-fu organs, they enter and exit blood vessels and transform with each other. In pathological state, not only body fluid can be condensed into phlegm, but also blood can be stagnated into blood stasis, each with its own unique signs. However, because they are all products of normalization of body fluid and blood, and they are homologous foreign bodies, they are intrinsically related under pathological conditions, and they are often mutually causal and difficult to cement. It can not only affect the normal transport of body fluid and blood under the same cause, but also lead to the coexistence of phlegm and blood stasis. For example, heat toxin can be refined into phlegm, while blood can be tortured by heat, which can form blood stasis; Cold pathogen trapping collaterals, cold coagulation and blood stasis, cold pathogen injuring Yang, and body fluid accumulating phlegm. On the other hand, it can also be manifested as phlegm and blood stasis. Phlegm and turbidity block pulse channels and hinder blood circulation, so blood stagnates into blood stasis. Blood stasis block affects the normal conduction of body fluid, or blood stasis in meridians is outside the pulse, and qi is lost in Xuantong, which stops the accumulation of body fluid and forms phlegm. Tang Rongchuan also clearly put forward in "On Blood Syndrome": "Phlegm can also be turned into blood stasis". "Blood accumulated for a long time can be turned into phlegm and water", so it can be considered that phlegm obstruction makes blood difficult to travel, and coagulation makes phlegm easy to produce; Phlegm stays in the body for a long time, which will remove blood stasis and produce phlegm for a long time. In the process of pathological changes, they can be regarded as diseases and cause and effect each other.
Because phlegm and blood stasis are the same diseases, it is necessary to distinguish the sequence and primary and secondary relationship between them in specific treatment methods, pay equal attention to phlegm and blood stasis, and determine the primary and secondary of phlegm and blood stasis or treat phlegm and blood stasis together. Although the treatment of phlegm and blood stasis is different, phlegm will promote qi and blood circulation; Removing blood stasis and dredging collaterals will help to resolve phlegm. This means "resolving phlegm and removing blood stasis, resolving phlegm and removing blood stasis". If you pay equal attention to phlegm and blood stasis, you should pay attention to both sides in treatment and eliminate its potential, so that you will not suffer from each other. At the same time, we should be careful not to overdo it, and we should "stop the disease halfway" to avoid wasting gas, blood and yin and yang and becoming a malignant disease. The selection of drugs is based on the principle of stability and effectiveness, and toxic and spicy products should be used with caution. Secondly, we should pay attention to the regulation of the five internal organs, and look for the cause from the original picture to treat it, which is the principle of "treating phlegm with phlegm and treating blood with blood". Secondly, when relaxing qi, because "qi produces phlegm" and "qi produces blood", qi-regulating drugs should be used to treat phlegm and blood stasis, so as to help the drugs for resolving phlegm and removing blood stasis play their roles. Finally, we should pay attention to finding the cause, locating and treating according to syndrome differentiation. Because phlegm and blood stasis can be caused by excess or deficiency of positive energy, the lesions involve nine orifices of viscera, limbs, joints and meridians. Therefore, the treatment of phlegm and blood stasis should be based on syndrome differentiation and etiology analysis, combined with corresponding treatment methods on the basis of phlegm and blood stasis.
The method of activating blood circulation and removing blood stasis is commonly used to treat traumatic blood stasis, but this case advocates that blood stasis can turn into phlegm and generate heat. Bombyx Batryticatus, Arisaema cum bile, Alisma orientalis, Eupatorium adenophorum, Trichosanthis Radix, Cynanchum atratum, Radix et Rhizoma Rhei preparata, and Semen Persicae can be used to resolve phlegm, clear blood stasis and clear heat. Choose insects with strong blood stasis removing ability, such as leech, ground beetle, pangolin, etc. Improve efficiency; Adding Rhizoma Acori Graminei, Moschus, and Suhexiang Pills, and dispersing the stagnation with fragrance to help the medicine dredge orifices and remove blood stasis, and reach the affected area directly; Because of the lack of healthy qi after a long illness, ginseng, astragalus, angelica and radix rehmanniae are used to replenish qi, nourish blood and nourish yin, so that qi can transport blood, blood can fill the pulse, and qi stagnation is conducive to the dissipation of blood stasis and phlegm and water. The prescription and prescription complement each other and the disease is reported. It breaks through the judgment that surgery is necessary and proves that the method of resolving phlegm and removing blood stasis has a good effect on traumatic brain hematoma.
It is also the formulation of ancient doctors, and we extend it to the diagnosis and treatment of difficult diseases, mainly because the clinical symptoms of difficult diseases are peculiar, which are manifested as "phlegm" syndrome (including intangible phlegm) mentioned by Chinese medicine. When treated with the method of resolving phlegm in traditional Chinese medicine, unexpected results can often be achieved, as the source of miscellaneous diseases, rhinoceros candle phlegm drink said: "People have phlegm from birth to death. ..... and it is a thing, the flow is unpredictable, so it is harmful, from the top to the bottom of the spring, rising and falling with the gas, all over the body, inside and outside, and the internal organs. Try to make a rare analogy, just like a cloud in the sky, with no root and no destination, coming and going for no reason, gathering and scattering. Fire is born, qi stagnation is flourishing, wind drums are surging, and it becomes strange, so phlegm is the source of all diseases, and strange diseases are all caused by phlegm. "
The strange diseases referred to by ancient doctors are all diseases such as mental nerves and body fluids today. Although similar to hypochondria, it mainly focuses on mental symptoms, but its clinical manifestations are complex and diverse, strange and inexplicable. One is invisible, mainly functional diseases, and the other is visible, mainly substantive diseases. Objective: in clinic, that disease caused by phlegm far exceed this range, and modern medicine involves inflammatory diseases of respiratory system and excessive secretion of bronchial glands. Excessive and abnormal secretion of mucus in digestive tract, or hyperplasia of pathological tissue; Coronary insufficiency of cardiovascular system, myocardial ischemia and hypoxia; Central nervous system dysfunction, increased or decreased excitability, brain hypoxia and brain edema; Chronic proliferative inflammation in the body, or hyperplasia of some special pathological tissues. Regardless of any pathological changes in any system and those with specific syndromes of "phlegm", they can be treated from phlegm according to the spirit of treating different diseases at the same time.
The formation of phlegm involves all aspects of exogenous and internal injuries, and is the pathological product of various pathogenic factors. On the other hand, when the disease is caused by phlegm, phlegm becomes the direct cause of the disease, and it is always combined with the original cause or other pathological products at the same time to cause the disease. Therefore, in the syndrome differentiation and treatment of intractable diseases, we must consider the dual factors of phlegm in turn as the basis for syndrome differentiation and treatment. Because phlegm can move up and down with qi, it can be seen everywhere, so it can be blocked in the lung, covered in the heart, accumulated in the spleen, depressed in the liver, moved in the kidney, and can also flow out of joints and meridians, showing different symptoms of viscera and meridians. According to the nature of phlegm, it can be further divided into wind phlegm, cold phlegm, wet phlegm, hot phlegm, dry phlegm and depressed phlegm. We found from long-term clinical practice that anyone with phlegm must have black soot on his eyelids and eyes. Among them, the complexion is dark and earthy, which is deficiency-cold phlegm, and the cheeks are red and shiny, which is hot phlegm, Yuk Wong's wet phlegm and green stagnation wind phlegm. The patient has a fat neck and a short neck, and the swollen shape is phlegm. Those with dull expression and poor eye movement are turbid phlegm blocking orifices. Judging from the color and smell of sputum, those with short course of disease and mild illness have innocent sputum color and light smell; After a long time, it is heavy, yellow, turbid, thick and sticky, and it is difficult to cough, and it is getting worse, smelly and salty. If you spit on the ground, it is like saliva foam when a snail walks after drying, or it has five colors in the sun. It is easy to turn into water after spitting, which belongs to deficiency cold. Sweet phlegm is mostly spleen heat, bitter taste is gallbladder heat, foul smell is lung heat and salty taste is kidney deficiency. If phlegm and turbidity persist for a long time, it will be stubborn and prone to strange diseases, especially in the diagnosis and treatment of intractable diseases.
The treatment of phlegm should be divided into viscera deficiency and excess, followed by the severity of the disease. Anyone who has phlegm due to illness should be treated first, and the phlegm will clear itself after illness. If some diseases persist due to phlegm, the treatment of phlegm should be the first, and the symptoms will heal themselves after phlegm removal. Secondly, spleen dampness is the basis of phlegm dampness, and regulating spleen dampness is very important for treating phlegm dampness. Moreover, the treatment of phlegm must also regulate qi, and the qi is smooth, so the body fluid is smooth, and there is no danger of phlegm accumulation. At the same time, phlegm should be treated by fire, and those who burn phlegm in body fluid with excessive qi and fire should be treated by clearing away the pathogenic wind; Those with deficiency of both qi and fire, and body fluid condensed into phlegm, should be warmed up. As for the principle of treating phlegm, it is to eliminate phlegm and resolve phlegm. Resolving phlegm can normalize sputum, dissipate it invisibly, or dilute and excrete it. It has the widest scope of application, and can be used for those who are not too sick or have insufficient dirty qi and produce phlegm due to deficiency. Eliminating phlegm can clean and remove accumulated phlegm, including eliminating phlegm, eliminating phlegm, expelling phlegm and other methods. It is suitable for patients with excessive pathogenic factors, sudden illness, chronic illness and excessive phlegm.
Refractory virus refers to the meaning that most severe diseases are related to toxic pathogens, and refers to some infectious and pathogenic exogenous pathogens in epidemic febrile diseases; The second refers to extreme heat. The so-called "fire is poisonous", "warm is poisonous, and poison is evil"; Third, it refers to the pathological factors produced in the process of disease, such as heat toxin, water toxin and blood stasis toxin. Poison is the further development of many diseases and evils. When evil prevails and poison is produced, poison will be evil at the same time. Regardless of its nature, it can be called "poisonous evil". There is a saying in Oriental that "all diseases are poisonous", and there is also a saying in Su Wen's "Anger to Heaven" that "the meat is closed when it is quiet, and the wind is harsh and poisonous, which can harm people"
Poison and evil can be felt from the outside or produced from the inside. Exogenous viruses are mostly related to six evils and furuncle. "Poison resides in evil" and "Poison enters with evil" have the characteristics of sudden onset, fierce strength, rapid spread and easy invagination, which makes the condition critical, difficult to treat and changeable. Endogenous toxins are produced by pathological factors such as visceral dysfunction, wind, fire, phlegm and blood stasis during the development and evolution of diseases. Common toxins, such as wind, heat, fire, cold, dampness, water, phlegm, blood stasis, etc., are diverse in nature and can be intertwined with each other, causing substantial damage to multiple organs and serious dysfunction, which has become a decisive factor affecting the smooth and reversible return of diseases. Such as heat toxin of severe hepatitis, wet (turbid) toxin of late nephritis, wind toxin of facial paralysis, cancer toxin of malignant tumor and blood stasis toxin of systemic lupus erythematosus.
Toxic pathogens have the following syndrome characteristics: ① fierce: acute and violent illness, such as SARS, avian influenza and so on. ② Stubborn: The disease is stubborn and easy to repeat, such as refractory nephropathy and chronic hepatitis. ③ Difficulties: Routine diagnosis and treatment is ineffective, such as systemic lupus erythematosus and cancer. ④ Epilepsy: The course of disease is long and the location of the disease is deep, such as uremia and epilepsy. ⑤ Miscellaneous: Due to the toxic and pathogenic factors mixed with wind, fire, phlegm, blood stasis and other pathogenic factors, there are many clinical symptoms, and the condition is complex and difficult to distinguish. Because of this, we should pay special attention to the particularity of toxic pathogens when treating refractory diseases.
There are methods to treat toxic pathogens, such as detoxification, detoxification and attack, but detoxification should be the cause. First of all, we should distinguish the nature of toxic pathogens, and then pay attention to the viscera where toxic pathogens are located and other diseases and pathogens they carry. If the heat toxin focuses on clearing away heat and detoxifying, but the heat toxin is in the lung, Houttuynia cordata, Fagopyrum cymosum and Scutellaria baicalensis Georgi are selected to clear away the lung and detoxify; Heat poison, Euphorbia helioscopia, Paris polyphylla, Solidago, Achyranthes bidentata for relieving sore throat and detoxifying; When heat poison enters the stomach, gypsum, dandelion and Ganzhonghuang are selected to clear the stomach and purge fire and detoxify; Bezoar, cinnabar and coptis root are used to clear the heart, soothe the nerves and detoxify when heat toxin attacks the heart; Antelope horn, gentian and gardenia are used to cool the liver and detoxify the liver; Heat toxin accumulated in bladder was treated with Cortex Phellodendri, Radix Sophorae Flavescentis and Herba Lysimachiae. The toxic heat enters the blood with rhinoceros horn (buffalo horn), Radix Rehmanniae, Cortex Moutan, Radix Arnebiae, Folium Isatidis, etc. Scorpion, centipede, Zaocys and Bombyx Batryticatus are commonly used to search for wind and detoxify. For cold toxin, Radix Aconiti, Radix Aconiti Kusnezoffii, Radix Aconiti Lateralis Preparata and Rhizoma Zingiberis are used to dispel cold and detoxify; Wet poison commonly used Smilax glabra, Polygonum aviculare, Sabina vulgaris and Lobelia chinensis to remove dampness and detoxify; Stir-fried Rhizoma Arisaematis, Rhizoma Typhonii, Rhizoma Pinelliae Preparata, Nidus Vespae, and Prunellae Spica are commonly used to eliminate phlegm and detoxify. Pangolin, leech, Eupolyphaga Seu Steleophaga, Lumbricus, Eupolyphaga Seu Steleophaga and Camptotheca acuminata are commonly used to remove blood stasis and detoxify.
In addition, we should pay attention to the specificity of different diseases. For measles and smallpox, we should use the method of revealing the virus; For advanced nephropathy, attention should be paid to removing turbidity and detoxifying; For patients with multiple organ failure and abnormal rise and fall of Yangming qi, it is appropriate to detoxify the fu organs; For patients with long-term surgical ulcer and those who are addicted to drugs, Astragalus membranaceus should be reused to strengthen the body resistance and entrust drugs; Shā rotto Katakuri, baked toad skin, nux vomica, red bean fir, and Hedyotis diffusa are commonly used anticancer drugs.
In 1980s, according to the pathological characteristics of acute renal failure caused by epidemic hemorrhagic fever, I put forward the theory of "three poisons" (heat poison, blood poison and water poison) for acute renal failure caused by epidemic hemorrhagic fever, and treated 27 cases of hemorrhagic fever11by purgation and removing blood stasis. Especially the acute renal failure in oliguria with the highest mortality rate, the mortality rate is only 4%, which is obviously better than that in the western medicine control group (22%). In the past, a female patient who was diagnosed as huge osteoblastoma by pathological section was treated. After amputation of the middle part of the right leg, extensive metastasis, joint pain all over the body, neck masses on both sides, big as pigeon eggs, small as broad beans, high fever, sweating, fever, recovery in the afternoon, lasting for 2 months, and severe anemia. After taking the drugs of clearing away heat and toxic materials, resolving phlegm and removing blood stasis (Biexue Decoction Bupleurum, Biejia Decoction, Gentiana macrophylla, Artemisia annua, Radix Rehmanniae, Squama Manis, Rhizoma Smilacis Glabrae, Lumbricus, Nidus Vespae, Bombyx Batryticatus, Ranunculus ternatus, Shā rotto Katakuri, etc.), the body temperature gradually dropped to normal, and the tumor basically disappeared after 3 months. Follow-up has exceeded 10 years.