| 1 PurposeTo identify the academic origin and development of wind-phlegm and the therapy method of calming wind and eliminating phlegm. To clarify the concept and theory of calming wind and eliminating phlegm based on the fields of TCM etiology and pathogenesis, TCM syndrome and symptoms, comprehensive therapy and analysis of herbs and prescriptions.2 Methods2.1 Method of philology(1) Ancient literatures:The "Chinese Medicine Code" (fifth edition), "The series books of TCM" and the online books from "Duxiu" system were retrieved with the searching term "phlegm", "wind-phlegm" and "calming wind and eliminating phlegm". And then the collection of books was classified into four parts according to the medical theory, herbs, prescription, medical records and notes.(2) Modern literatures from Journals:The online databases CNKI, Wangfang and VIP were searched with the searching term "wind-phlegm", "eliminating phlegm" and "calming wind". Eight hundred and fifty two literatures were retrieved, where 798 were journal articles,30 were theses and 24 were conference papers. These papers were analyzed.(3) Reference books, textbooks and modern works:Chinese medicine dictionary and other 10 reference books, "Internal medicine of traditional Chinese medicine" and other 12 textbooks, "Clinical research of TCM phlegm disease" and other 50 books were summarized.2.2 Method of historiography of Chinese MedicineIdentify the time-lined development of the theory-therapy-prescription-herbs and the medical records about "wind-phlegm", "eliminating phlegm and calming wind" from ancient literatures. Summarize the characteristics of each period on the academic origin and development of "wind-phlegm" and "eliminating phlegm and calming wind"2.3 Method of theoretical studySummarize the ancient TCM practitioners’ view on the "wind-phlegm" and "calming wind and eliminating phlegm", and then identify their theories. The rules of the treatment and therapy of the methods of "calming wind and eliminating phlegm" were concluded by extracting the clinical experience from famous TCM practitioners.3 Results3.1 Academic origin and development of "wind-phlegm"The pre-Qin and Han era:The theory of wind phlegm was established in this era. The "Huangdi Neijing" had special issue for the "wind"; the theory of "internal stirring of liver wind" was also recorded; and the some descriptions of phlegm symptoms similar to the phlegm syndrome, wind phlegm syndromes later in the next generations were mentioned in the book. And "Shennong Bencao Jin" recorded the herbs for phlegm.The era of Wei, Jin, Sui and Tang:"Zhubing Yuanhou Lun" brought out the theories of "headache and eyes diseases due to wind-phlegm, "Beiji Qianjin Yaofang" recorded that the comments from Xu Sibo about the devils of hot and phlegm contributing to wind whose foundation of phlegm-heat causing wind, "Qianjin Yifang" mentioned that the Fanshi San could treat patients with "fullness in the chest, and hot eyes" due to wind-phlegm, and "Waitai Miyao" mentioned that the Baizhu Wan could treat patients with "bump" due to the wind-phlegm.The era of Songs:This era was rich in understanding of wind-phlegm. "Xiaoer Yaozheng Zhijue" mentioned the extreme heat causing wind whose foundation of internal wind theory; "Shizai Zhifang’’showed the perspective of the relationship between wind phlegm and Qi and the treatment idea of smoothing Qi and eliminating phlegm; "Taiping Shenhui Fang" explained the causes and TCM syndrome of wind-phlegm and recorded some prescriptions for the treatment; "Taiping Huimin Heji Jufang" created many prescriptions and the herbs for calming liver wind, such as scorpion, gastrodia elata, bombyx batryticatus.The era of Jin and Yuan:Liu Wansu and Li Dongheng developed the theory of "Internal wind", and Zhu Danxi put forward the idea of "Hot-phlegm causing wind", Wang Yao, Zhang Zihe explained the TCM etiology and pathogenesis of wind-phlegm from a view external wind and exogenous etiology; Liu Wansu and Li Dongheng made a basic theory for the liver wind holding phlegm with the theories of Zangfu, Guijing and Wuxing. Luo Tianyi put forward the therapy method of eliminating phlegm and calming wind based on the view of internal wind holding phlegm. Overall, the understanding of wind phlegm in this period was still confined to the level of "external" wind phlegm rather than the "internal" wind phlegm. However, many prescriptions were created for eliminating phlegm and calming wind treatment, such as Soufeng Huatan Wan and Zhenfang Baiwan Zi.The era of Ming and Qing:This era made a large progress in the development of wind-phlegm. Qin Jingming and Sun Yikui made a deeper explanation on the TCM etiology and pathogenesis, TCM syndromes, treatment and herbs, which helped supplement the theory of external wind holding phlegm; Huang Puzhong, Li Yan made a huge progress and explanation on the TCM etiology and pathogenesis and symptoms from the theory of the internal wind-phlegm. In terms of treatment, the treatment principles of expelling wind eliminating phlegm for the TCM syndrome of external wind holding phlegm and the treatment principles of calming wind eliminating phlegm for the TCM syndrome of internal wind holding phlegm. And the therapy method of "calming wind eliminating phlegm" was the first recorded.Modern times:Wind-phlegm and calming wind eliminating phlegm have been categorized in this period. Two categories of external wind holding phlegm and internal wind holding phlegm were clearly identified. And the calming wind eliminating phlegm was the main therapy method for the internal wind holding phlegm. Simultaneously, the combination of calming wind eliminating phlegm and promoting blood circulation to remove blood stasis extended the treatment of many diseases.3.2 Theory of calming wind eliminating phlegm therapy method3.2.1 Concept"Calming wind eliminating phlegm" means that the herbs for calming wind and eliminating phlegm were the main in the whole prescription, for treating the TCM syndrome of internal wind holding phlegm, whose therapy methods include clearing phlegm for calming wind, eliminating wind and phlegm, searching and removing wind and eliminating phlegm, and interrupting and stopping wind and eliminating phlegm. In addition, the above treatments were combined with the methods of dredging collaterals, inducing resuscitation, eliminating dampness, clearing heat, nourishing Yin and promoting blood circulation, when characteristics of diseases" pathogenesis was clear and obvious in the clinic.3.2.2 Fields of application(1) The TCM etiology and pathogenesis of internal wind hold phlegm included mood problems, unbalance between work and rest, immoderation of diet and aging problems as the the main TCM etiology; and included the liver-wind and phlegm stirring as the main TCM pathogenesis.(2) The three main TCM syndromes of internal wind hold phlegm included liver-wind holding phlegm to block the Jingluo, liver-wind holding phlegm to disturb the clear orifices, and liver-wind holding phlegm to blind the mind.3.2.3 Treatment principlesTreatment of calming wind eliminating phlegm to dredge collaterals means that the treatment principles on the TCM syndrome of wind-phlegm blocking Luo with the main symptoms like facial paralysis and hemiplegia; the main prescriptions were Baiwan Zi, Soufeng Huatan Wan, and so on.Treatment of calming wind eliminating phlegm to induce resuscitation means that the treatment principles on the TCM syndrome of wind-phlegm to disturb the clear mind with the main symptoms like sudden collapse and unconsciousness; the main prescription was Jinbo Zhenxin Wan.Treatment of calming wind eliminating phlegm and dampness means that the treatment principles on the TCM syndromes of liver-wind holding phlegm and dampness with the main symptoms like headache and dizziness; the main prescription was Banxia Baizhu Tianma Tang.Treatment of calming wind eliminating phlegm and heat means that the treatment principles on the TCM syndrome of heat-phlegm causing wind with the main symptoms like high fever with convulsion and upward staring eyes; the main prescription was Hupo Baolong Wan.Treatment of nourishing Yin to calm wind and eliminating phlegm means that the treatment principles on the TCM syndrome of wind-phlegm accompanying with Yin deficiency with the accompanying symptoms like soreness and weakness of waist and knees, flushed face and feverish palms and soles and so on; the main prescription was Liuwei Dihuang Wan and Dabu Yin Wan.Treatment of calming wind and eliminating phlegm to promote blood circulation means that the treatment principles on the TCM syndrome of wind-phlegm accompanying with blood stasis with the accompanying symptoms like numbness and pain on the limbs and dark purple tongue with ecchymosis and so on; the main prescription was the prescription for calming wind and eliminating phlegm with the herbs for promoting blood circulation, such as angelica sinensis and salviae miltiorrhizae.3.2.4 Main prescriptionsThe main prescriptions represented the therapy method of calming wind and eliminating phlegm with/without accompanying TCM therapy methods, and mainly included Banxie Baizhu Tianma Tang, Dingxian Wan, Shenxian Jieyu Dan, Zhenfang Baiwan Zi, Hupo Baolong Wan and Jinbo Zhenxin Wan.3.2.5 Main herbsThe main herbs for calming wind and eliminating phlegm were summarized, such as bile arisaema, bombyx batryticatus, arisaema consanguineum schott and calculus bovis. And the frequency of herbs in the prescriptions showed that herbs for relieving exterior syndrome, clearing heat and reinforcing qi were commonly used. The gastrodin, scorpion, bombyx batryticatus and arisaema consanguineum schott were the most used herbs. The combination of gastrodin and giant typhonium rhizome, combination of gastrodin and pinellia ternate, and the combination of bombyx batryticatus and giant typhonium rhizome were the most common in the study.3.3 Clinical application on calming wind eliminating phlegm therapy methodFive diseases stroke, epilepsy, dizziness, tremor syndrome and febrile convulsion were selected to help analyze the TCM etiology and pathogenesis, TCM syndromes and cases to interpret the therapy method of calming wind and eliminating phlegm.Stroke was treated by the therapy method of calming wind and eliminating phlegm, mainly in three TCM syndromes of attacking Jingluo, attacking Zangfu with blockage syndrome, and the wind-phlegm block syndrome on the stroke convalescence. TCM syndrome of attacking Jingluo underneath liver-wind holding phlegm was caused by Yin deficiency of liver and kidney, yang-hyperactivity stirring wind, and phlegm blocking the Jingluo, and the main prescriptions were Zhenfang Baiwan Zi and Soufeng Huatan Wan. TCM syndrome of attacking Zangfu with blockage underneath liver-wind holding phlegm was caused by liver-wind holding phlegm to interrupt and block the mind, and the main prescription was Dilun Tang. TCM syndrome of the wind-phlegm block syndrome on the stroke convalescence was caused by wind-phlegm with blood stasis to block the Jingluo. and the main prescription was Shenxian Jieyu Dan.Epilepsy was treated by the therapy method of calming wind and eliminating phlegm, mainly in the TCM syndrome of wind-phlegm blockage, and its main prescription was Dingxian Wan. If the origin TCM syndrome turned to liver-wind holding phlegm causing interruption, the herbs of clearing heat should be used, such as radix scutellariae and coptidis rhizoma. If the origin TCM syndrome turned to liver-wind holding phlegm causing blood stasis, the herbs of promoting blood circulation should be used, such as angelica sinensis and salviae miltiorrhizae.Dizziness was treated by the therapy method of calming wind and eliminating phlegm, mainly in the TCM syndrome of wind-phlegm disturbing the clear orifices, and its main prescription was Banxie Baizhu Tianma Tang.Tremor syndrome was treated by the therapy method of calming wind and eliminating phlegm, mainly in the TCM syndrome of heat-phlegm causing wind, and its main prescription was Lingjiao Gouteng Tang. If the origin TCM syndrome turned to liver-wind holding phlegm causing blood stasis due to aeipathia, the herbs of promoting blood circulation should be used.Febrile convulsion was treated by the therapy method of calming windand eliminating phlegm, mainly in the TCM syndrome of heat-phlegm causing wind, and its main prescription was Hupo Baolong Wan and Jinbo Zhenxin Wan.Other diseases was treated by the therapy method of calming wind and eliminating phlegm, such as numbness and convulsion caused by wind-phlegm blockage, headache caused by wind-phlegm interrupting the clear orifices, cold limbs, depressive psychosis and manic psychosis caused by wind-phlegm blind mind.4 Conclusions(1) "Calming wind eliminating phlegm" means that the herbs for calming wind and eliminating phlegm were the main in the whole prescription, for treating the TCM syndrome of internal wind holding phlegm, whose therapy methods include clearing phlegm for calming wind, eliminating wind and phlegm, searching and removing wind and eliminating phlegm, and interrupting and stopping wind and eliminating phlegm. In addition, the above treatments were combined with the methods of dredging collaterals, inducing resuscitation, eliminating dampness, clearing heat, nourishing Yin and promoting blood circulation, when characteristics of diseases’ pathogenesis was clear and obvious in the clinic.The TCM etiology and pathogenesis of internal wind hold phlegm included mood problems, unbalance between work and rest, immoderation of diet and aging problems as the the main TCM etiology; and included the liver-wind and phlegm stirring as the main TCM pathogenesis. The three main TCM syndromes of internal wind hold phlegm included liver-wind holding phlegm to block the Jingluo, liver-wind holding phlegm to disturb the clear orifices, and liver-wind holding phlegm to blind the mind. The main prescriptions Banxie Baizhu Tianma Tang, Dingxian Wan, Shenxian Jieyu Dan, Zhenfang Baiwan Zi, Hupo Baolong Wan and Jinbo Zhenxin Wan. The main herbs for calming wind and eliminating phlegm were summarized, such as bile arisaema, bombyx batryticatus, arisaema consanguineum schott and calculus bovis.(2) Five diseases stroke, epilepsy, dizziness, tremor syndrome and febrile convulsion were the main disease treated by the therapy method of calming wind and eliminating phlegm. Stroke was mainly treated in three TCM syndromes of attacking Jingluo, attacking Zangfu with blockage syndrome, and the wind-phlegm block syndrome on the stroke convalescence. Epilepsy was mainly treated in the TCM syndrome of wind-phlegm blockage. Dizziness was mainly treated in the TCM syndrome of wind-phlegm disturbing the clear orifices. Tremor syndrome was mainly treated in the TCM syndrome of heat-phlegm causing wind. Febrile convulsion was mainly treated in the TCM syndrome of heat-phlegm causing wind. Other diseases were numbness and convulsion caused by wind-phlegm blockage, headache caused by wind-phlegm interrupting the clear orifices, cold limbs, depressive psychosis and manic psychosis caused by wind-phlegm blind mind. Thus, when the patients were diagnosed and treated, combination of disease and syndrome should be considered, and the treatment should be reasonable. |
PDF Full Text Request