A true story told and written by a TCM doctor (Ms. Wang, Xuehua) in China:
Original Chinese article （June 2023）: 疑问求解 – 王雪华老师<麦门冬汤+加消瘰丸>治疗结节病
(Translated)
A 31-year-old female patient was going to study and work in Japan with her husband. When she left, she might have been busy preparing for work and had emotional fluctuations. She was always coughing without sputum or phlegm. After arriving in Japan, the symptoms became more and more serious. Japan’s diagnostic conditions are also very good, and she was immediately diagnosed as “sarcoidosis” (nodules in lung).
Doctors in Tokyo, Japan suggested hormone therapy, using a large amount of prednisone. Because her sister is a pathologist in our western medicine hospital (she knows it’s not good), her sister asked the patient to return immediately in the phone call, and told her DO NOT use hormone therapy in Japan.
After returning to China, this patient first went to Harbin Medical University. The teachers at Harbin Medical University happened to use her case (diagnosis with X ray and other methods) to teach, because Sarcoidosis is relatively rare. Later, her sister also copied the contents of “Western Medicine Internal Medicine” and sarcoidosis, and got the X-ray film and test results. Of course, the patient didn’t come to see me.
It was a summer vacation. However I didn’t know what “sarcoidosis” is, because in our current “Internal Medicine” of undergraduate TCM courses, the “sarcoidosis” is shown in the part of Western medicine. Because it is not common in clinical practice, I have never seen it in practice, and I have no impression.
When she came, she first showed me the materials/documents of her examination, especially the contents of the copybook given by the medical university. I also learned about “sarcoidosis” from it. Her chest X-ray was very, very clear, that is, in the swelling and swelling.
Her clinical symptoms:
The first one is a dry cough without phlegm.
Second, she can’t lie on her back, she can only sleep on her side, or in a semi-recumbent position, and she is very nervous.
Why did the Medical University use her case as a teaching sample? Because the symptoms for this disease is very typical, and she’s about 30 years old, and there is a possibility of self-healing.
The teacher at the medical university also said that there is no other way to treat it without prednisone (from the perspective of Western Medicine).
I invited a TCM expert who is an expert in blood diseases for the treatment. He said “let’s differentiate her symptoms based on yin deficiency, because what the tongue and pulse tell you is equivalent to a dry cough due to yin deficiency”. But he didn’t use MaiMendDong (a herb) soup as a base, as the rule has already suggested, and he used some anti-tumor herbs, including ZhuLing (a herb). At that time, he was studying ZhuLing to have anti-tumor effect. He wrote a herbal formulation including ZhuLing, Hedyotis diffusa, etc. He prescribed them for one week and seven doses of herbal medicines. After taking them, there was no effect/improvement.
The patient said: “You can do more study on my case”. Her time is very tight because she only asked for a month off. She told me that even if I can’t find out a herbal formula as solution, I can find someone to recommend, or point her a way that how to treat it with TCM.
Then I thought of some contents in a TCM classic book, “throat is bad, stop the flow of breath”, so if you memorize the texts, you may be able to think of it once in a while,
First, I also think she is a manifestation of yin deficiency. It is not clear whether the yin deficiency is in the lungs or somewhere. Anyway, it is a manifestation of yin deficiency and dry cough, “bad throat”. Now, we already know that her lymph nodes are swollen, and when I think about it, I use MaiMengDong soup, plus XiaoLuoWan,
Can you understand what my idea is? I thought, she has such a cough and dryness, at least in terms of her condition. The main treatment is nourishing yin and clearing heat, nourishing the yin of the lung and stomach. “Cultivating the soil to generate gold”. (Note: special term in TCM theory to describe the relationship between digestive system and lung system to get the body re-balanced.) At least I will not let her dry cough, which will cure the root cause. “XiaoLuoWan”, I think, may help to reduce her lymph nodes, being it so swollen. I prescribed seven doses of herbal medicine (seven days), to see if she can improve.
When she came again in a week, I still have other things to deal with, so I asked her to sit down to wait. But she didn’t sit down. She just stood and looked at me and smiled. When I finished things and looked at her, I said, “How’s everything going?” She said, “Didn’t you notice? I don’t cough much anymore.” I said, “Really?”.
She said, “What is my most obvious change? I have not been able to lie on my back for a long time. When I woke up this morning, I saw that I was not lying on my side.” Then she asked me if I can prescribe more doses of herbal medicine so she can bring them to Japan when she returns.
I happened to have a graduate student who was in front of me, and the student asked me if we will give her more doses of herbal medicine. I said, “No.” The graduate student said that her symptoms had improved. I still said “no”. And I said, “You take her to our hospital and take an X-ray to see if her lymph nodes are still big or not. Isn’t this sarcoidosis mainly based on lymph nodes? Her hilar lymph nodes are enlarged. Our X-ray staff immediately took a water X-ray. Because of anxiety and it is in a rush, it is not very clear.
However, you can see that the hilar lymph nodes are blurred and a little smaller. Compared with the original lesion, this lymph node can obviously be reduced by half, just this week.
I think it has to have the effect of the previous prescription. Our prescription is actually included two formula added together. My prescription has the effect of XiaoLuoWan. XiaoLuoWan contains Zhebei, XiaKuCao, and raw oysters, all of which have the function of loosen the hardened tissue.
When I saw the results, my graduate student also said, “Ms. Wang, you can prescribe it to her.” I said, “Then you can discuss it with the preparation room. It is better to make a granule, which is convenient.” But they said that it is impossible to make a granule in such a short time, because the drug content of the granule is small, and it must be half of the drug and half of the excipient. In addition, the drug has to be dried and processed, and it is too late. Later, the patient asked: “What should I do?”, I said: “Then I still prescribe the raw herbs, you can take them!”, I said: “You pack it, take a cardboard box and put more Chinese herbal medicine, go back and boil it!”
After she went home, her sister thought a clever method, but none of us thought about her trick. What did they do? I prescribed 30 doses of medicines for a month. They unpacked all the boxes, and boiled out all herbal medicine according to our traditional method, and then one by one, they were packed into 500ml empty glucose bottles, sterilized at high temperature and high pressure, and then packed in cartons and transported to Japan by plane.
I insisted on taking the herbal medicine like this for three months. Suddenly, one day in the middle of the night, a phone call came. Who is that? It is she called from Tokyo. She said slowly, “Now I have a reexamination in Japan, and basically healed. The lymph system has returned to normal, and the nodules are gone.” The doctor in Tokyo hospital wanted to ask what medicine to take. She told the doctor, “Take Traditional Chinese Medicine, but I don’t know what the content is.”
“He asked me to tell more about it.” I said it’s better not to say it, it’s fine. Because, I think we can’t tell the doctor casually. Besides, in this process of understanding, I also treat it based on syndrome differentiation (Note: a method of personalized diagnosis and personalized treatment, instead of based on a “disease name” that is categorized by modern medical science.) For her sarcoidosis, I just use MaiMenDong Decoction and added XiaoLuoWan.
But what did we learn from it?
First, I ask everyone to familiarize themselves with the old scriptures and understand their original meaning. In the process of identifying diseases and syndromes, we must grasp the main symptoms. First of all, I think that the teacher who treated her before inspired me, she should at least treat it according to the yin deficiency and dryness cough, whether the main prescription has been determined.
Second, regarding her sarcoidosis, even though I don’t know this disease (Note: it is categorized and named by Modern Medical Science), her film told me that the lymph nodes are blocked here, so I gave her “XiaoLuoWan”. XiaoLuoWan actually treat the liver meridian, because scrofula follows the liver meridian. So, the patient’s recovery is very good.
Later, in order to consolidate the curative effect, she still used it like this, which is just such a stupid way: according to the decoction, used high-temperature for sterilization, and then transported to Tokyo. Now, the patient has returned to Dalian (a city in China) to settle down, and we are still in touch, which is very good.
Third, I think Western medicine is also the same, that we have to find a treatment for diseases even with unclear etiology. This disease is also unclear etiology, and the treatment method in Western Medicine is hormone therapy, with obviously has side effects,. And patients cannot persist. For TCM, we also have to develop a unique method (personalized solution). Zhang Zhongjing (Note: a very famous ancient Herbal Master who wrote the classic TCM treatment book) did not tell us how to treat sarcoidosis. However, you have learned the deficiency-heat lung impotence, so don’t insist on it. Deficiency-heat lung impotence is caused by insufficient stomach yin or lung yin. The combination of disease and syndrome differentiation is based on syndrome differentiation.
Fouth, MaiMenDong Soup, also mentioned in its notes, not only treats asthenic heat and lung impotence. It also talks about treating cough and asthma mainly due to asthenic fire, and article 10 (Note: refer to classic book “ShanghanLun”) is placed in the content of coughing and upper qi, which belongs to cough and asthma caused by asthenic fire, so it can be used for cough and asthma caused by asthenia fire, labor cough, including stomach yin injury, hiccups, bloating, and loss of appetite.
Fifth, If we say that the stomach yin is injured, what should it have? “Hungry and not wanting to eat” is a typical symptom of stomach yin injury. MaiMengDong Soup can also be used as a basic prescription, and you can add some other herbs for nourishing stomach yin to promote appetite. Therefore, it is a good prescription for stomach problems.
Now let’s talk about it treating deficiency-heat lung impotence, what effect does it take? It is already very clear that it is “cultivating the soil to produce gold”, and of course it can also nourish the stomach yin.
Take-away:
1- In the face of complex diseases, classic TCM also need syndrome differentiation
2-Western medicine examination can also be used to a certain extent. But to reach the curative effect of TCM, of course, syndrome differentiation should be the main method and standard.
3- I have heard that herbal medicine (from TCM) has developed very well in Japan? This example does not seem to prove the case. .
4- Still have to memorize. . . Familiarity with the classic provisions of Shanghan / Jinkui (Note: very classic and old TCM book 1800 years ago and still use for practice) is still necessary. .
*The information presented on this site is for educational purposes only and is not intended to replace advice from your physician or other health care professional or any information found on any product label or packaging. You should always consult with a qualified health care professional before starting any exercise, diet or supplement regimen.