🌿 Folk Prescriptions

Rheumatic heart disease falls under the category of "chest obstruction" in TCM. Having practiced clinically for many years, I have achieved notable results in treating rheumatic heart disease. To stimulate discussion, I offer a brief perspective.
1. Pathogenesis of Rheumatic Heart Disease Should Be Treated Based on Spleen Function
As stated in classics: "Kidneys are innate, spleen is acquired." The body’s vitality, fluid regulation, and distribution of dietary essence all depend on spleen function. Once spleen function is impaired, one organ’s disease can affect multiple organs. In the five-element theory, there are pathological transmissions through generation, inhibition, overacting, and counteracting. Therefore, treatment principles include "tonify the mother when deficient, purge the child when excessive." The established rule of treating liver disease by first regulating spleen applies here. Thus, comprehensive chronic diseases should be treated holistically through syndrome differentiation.
2. Case Example: Mr. Chen, male, 46 years old, visited in August. Main complaint: hospitalized for over two years, treated with both Chinese and Western medicine, yet condition worsened. Examination revealed: EEG showing cerebral vascular sclerosis, ECG showing left atrial hypertrophy, X-ray showing lumbar vertebrae osteophyte formation, and impotence for over a year. Pulse examination: irregular, alternating between large and small, rough and knotted. Tongue diagnosis: enlarged tongue, dark and pale color, thick white coating, dark face and lips, alternating hard and loose stools, clear and long urination, obese physique. TCM diagnosis: complex rheumatic heart disease, attributed to heart-spleen yang deficiency, liver wind rising, dampness and qi stagnation with blood stasis. Treatment should aim to warm yang, resolve dampness, activate blood, break stasis, unblock meridians, promote diuresis, tonify kidney, calm liver, elevate clear, and descend turbid. Prescription: self-formulated formula: codonopsis, astragalus, salvia, processed aconite (pre-boiled for one hour), poria, atractylodes each 30g, garlic chives, dry ginger, peach kernel, safflower, safflower each 10g, winter melon seed 12g, cinnamon twig, hematite, cornus, schisandra each 20g, pinellia, tangerine peel, red peony, angelica, ligusticum, achyranthes, areca nut each 15g, alisma, kudzu root 30g, jujube 5 pieces, total 5 doses, one dose daily, decocted twice, divided into two servings. Second visit: patient reported feeling comfortable. Gradually increase aconite by 5g every five days up to 50g. After one month, added Shen Qi San (equal parts red ginseng and notoginseng, ground into fine powder), taken twice daily, 5g each time. Follow-up every five days. After four months of treatment, fully recovered. One-year follow-up showed no recurrence.
3. Experience: Among the formula, codonopsis, astragalus, atractylodes, tangerine peel, pinellia, safflower are the main components of Liu Junzi Tang for warming and strengthening the spleen; salvia, garlic chives, winter melon seed, pinellia are primary drugs for treating chest obstruction; ligusticum, angelica, red peony, peach kernel, safflower are main drugs for activating blood and breaking stasis; aconite, cinnamon twig, poria, alisma, hematite, achyranthes, eight-ingredient kidney qi pill are main drugs for calming liver and stabilizing yang. The entire formula integrates Liu Junzi Tang, kidney qi pill, tranquilizing liver and extinguishing wind, Tao Hong Si Wu Tang, and gua lou-xie bai, synthesized and modified from six formulas. Heavy use of aconite aims to revive heart yang; heavy use of atractylodes best strengthens spleen yang and dries dampness; kudzu root elevates stomach qi and prevents overheating from other herbs; areca nut enhances blood stasis elimination, diuresis, and downward regulation; dry ginger warms the center and prevents toxicity from aconite; schisandra’s sour taste gathers primordial qi and moderates the drying effect of atractylodes. Combined use precisely targets the disease mechanism.