🌿 Folk Prescriptions

Heart failure is an emergency condition equivalent to "palpitation," "dyspnea," and "edema" in Traditional Chinese Medicine. These three cases involved patients whose conditions failed to improve despite comprehensive Western medical treatment. We applied TCM principles, following Zhang Zhongjing’s methods of combining disease and syndrome, and integrating pulse and symptom analysis, achieving excellent results.
First case: A patient with rheumatic heart disease and heart failure, complicated by cardiogenic liver cirrhosis and atrial fibrillation. After 26 days of initial treatment, symptoms persisted. Consultation with Mr. Guo Shikui revealed palpitations, insomnia, shortness of breath, reduced urination, edema, loose stools, hepatosplenomegaly, white greasy tongue coating, and intermittent pulse—diagnosed as qi-yin deficiency with spleen yang deficiency. Treatment used Qi-Nourishing and Yin-Tonifying, Spleen-Strengthening and Dampness-Removing method. Formula: Shengmai Yin combined with Yinchen Wuling San with modifications: Codonopsis 24g, Ophiopogon 15g, Schisandra 10g, Yinchen 24g, Poria 20g, Cinnamon Twig 12g, Poria 10g, Alisma 12g, Amber 3g (dissolved). Decocted and taken once daily. After five doses, symptoms improved; after 15 doses, stable condition, edema resolved, cough and dyspnea reduced, able to walk. Continued modification for over 70 days. Later, obvious stasis symptoms emerged, so treatment shifted to Qi-Nourishing and Yin-Tonifying with Blood-Activating and Stasis-Resolving method: Shengmai Yin combined with Xuefu Zhuyu Tang with modifications. Condition stabilized. Ultimately, due to severe complications like secondary infection, the patient died. This case of rheumatic heart failure, treated with TCM differentiation and modification, remained stable for over six months—possibly due to enhanced myocardial contractility, improved myocardial ischemia and hypoxia.
Second case: A patient with pulmonary heart disease complicated by coronary heart disease, uncontrolled symptoms after over two months of comprehensive Western treatment. Symptoms included dyspnea unable to lie flat, abdominal distension, constipation, dark yellow urine, yellow greasy tongue coating, wet rales bilaterally, and lower limb edema. Based on the concept that lungs and large intestine are mutually related, we used Da Chaihu Tang combined with Gan Mai Da Zao Tang with modifications to clear intestinal stagnation: Bupleurum 12g, Citrus Aurantium 12g, Rhubarb 10g, Scutellaria 12g, Pinellia 15g, Jujube 5 pieces, Floating Wheat 30g, Red Peony 20g, Magnolia Bark 12g. One dose daily, decocted. After four doses, bowel movements normalized, symptoms eased, mental clarity restored, and ambulation resumed. ECG also improved. Switched to Consolidate Breath Tablets and Coronary Heart Two Tablets for consolidation. Discharged, remained stable for three years. Pulmonary heart disease with coronary heart disease often presents with deficiency and excess mixed pattern. But whenever there is indication for purgation, it can be used. Given the complex mix of deficiency and excess, treat the urgency first (address symptoms), use purgation; treat the root later (support the body), use tonifying methods.
Third case: A patient with hypertensive heart disease complicated by coronary heart disease angina, presenting palpitations, chest pain radiating to the back, cold limbs, thin yellow coating, intermittent pulse, wet rales bilaterally, heart rate 125 beats/min, ECG showing ST-T changes, atrial fibrillation, arrhythmia. Despite comprehensive Western treatment, results were unsatisfactory. Added TCM: Qi-Nourishing and Yin-Tonifying, Blood-Activating and Stasis-Resolving method. Selected Zhi Gancao Tang combined with Guallu Xiebai Banxia Tang with modifications: Fried Licorice 10g, Codonopsis 15g, Ginger 6g, Ophiopogon 15g, Raw Rehmannia 12g, Cinnamon Twig 10g, Colla Corii Asini 10g (melted), Trichosanthes 30g, Garlic Chives 10g, Pinellia 15g, Corydalis 10g, Tangerine Peel 12g, Salvia 30g. Decocted and taken once daily. After four doses, symptoms improved; after 14 doses, only headache and dizziness remained. ECG ST-T changes returned to normal. Continued modification. One month later, blood pressure rose to 150/94 mmHg, angina recurred. Again used Qi-Nourishing and Yin-Tonifying, Blood-Activating and Stasis-Resolving method, switched to Shengmai Yin combined with Xuefu Zhuyu Tang with modifications. After seven doses, symptoms improved. This patient had previously undergone comprehensive treatment outside hospital with poor results. Using TCM differentiation and modifying formulas based on Zhang Zhongjing’s Zhi Gancao Tang and Guallu Xiebai Banxia Tang yielded excellent outcomes.
Zhang Zhongjing’s approach—using disease as the framework and syndrome as the focus, combining disease and syndrome, integrating pulse and symptoms, closely linking differentiation and treatment—is the fundamental method for treating various syndromes and the essence of inheriting and developing his medical school.