TCM Surgery


Specific Application of Internal Therapy 1
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1. Exterior-Relieving Method
When the obvious exterior symptoms are accompanied in the initial stage of the external diseases, the herbal drugs that can relieve the exterior symptoms are used to expel the pathogenic factors from perspiration, in order to obtain the goal to disperse the external diseases invisibly. The exterior-relieving method can be divided into two categories: pungent and cool exterior-relieving method and pungent and warm exterior-relieving method. 

The representative formulas are respectively "Niubang Jieji Decoction" or "Yinqiao Powder", "Jingfang Baidu Powder" or"Wan Ling Pills", and the commonly used herbal drugs are Bohe (Herba Menthae), Sangye (Folium Mori), Gegen (Radix Puerariae), Chantui (Periostracum Ci- cadae), Niubangzi ( Fructus Arctii ) , Lianqiao (Fmectus Forsythiae) (pungent and cool exterior-relieving herbs); Jingjie (Herba Schizonepetae), Fangfeng (Radix Labourieliae), Qianghuo ( Rhizoma  seu Radix Notopterygii ), Mahuang (Herba Ephedrae), Guizhi ( Ramulus Cinnarnomi) , Shengjiang (Rhizoma Zingiberis Recens ) (pungent and warm exterior-relieving herbs), etc. 

In the application of the exterior-relieving method, even if the exterior symptoms caused by exogenous factors exist in those patients with weak constitution and whose wound does not heal for a long time after ulceration breaks, it is not advisable to promote diaphoresis rashly in order to prevent over perspiration, because it can lead to syncope, yin exhaustion and yang depletion.

2. Interior-Dredging Method 
This method is supposed to use the purgative herbs to discharge the toxins accumulated inside the body, in order to obtain the goal to eliminate food retention, disperse stagnation and accumulation, clear away heat, stop pain, eliminate pathogenic factors and expel toxins. This method is mainly suitable for acute abdomen. The interiordredg-ing method can also be divided into two categories of the harsh purgative method and moist purgative method. 

The representative formulas are respectively "Da Cheng Qi Decoction" or "Nei Shu Huanglian Decoction" and "Run Chang Decoction". The commonly used herbal drugs are Dahuang (Radix et Rhizoma Rhei), Zhishi (Fructus Aurantii Immaturus), Binglang (Semen Arecae),Mangxiao (Natrii Sulfas) (harsh purgative), and Gua-louren (Fructus Trichosanthis), Huomaren (Fructus Cannabis), Yuliren (Semen Pruni), Fengmi ( Mel )(moist purgative), etc. 

In the application of the harsh purgative method, it is necessary to master the indications strictly and stop using it immediately after illness is cured for avoiding over dose. This method must be carefully used for the patients in high age, weak constitution, pregnancy or women in period and children.

3. Heat-Clearing Method
This is one of the main therapeutic methods for the surgical diseases to use cool herbal drugs for clearing away and dissolving the accumulated heat and toxins, in order to obtain the goal to eliminate tumefaction and alleviate pain. In accordance with the different therapeutic purpose, the heat-clearing method commonly used in the surgical diseases can be further divided into the heat-clearing and detoxifying method, ying-system-clearing and blood-cooling method, yin-nourishing and heat-clearing method, etc. 

In the heat-clearing and detoxifying formulas, based upon the therapeutic functions, there are respectively "Qing Wen Bai Du Drink", "Huanglian Jie Du Decoction" and "wu wei xiao du drink ". In the ying-system-clearing and blood-cooling formuals, there aer "xiao dihuang"Decoction" and "Qing Ying Decoction.In the yin-nourishing and heat-clearing formulas, there is "Qing Gu Powde", etc.

The commonly used herabal drugs that can clear away heat and dissolve toxins are Pugongying (Herba Taraxaci), Zihuadiding (Herba Violae), Jinyinhua (Fols Loniceerae), Yejuhua (FlosChrysanthemi Indici), Huanglian (Rhizoma Coptidis), Huangqin (Radix Scutellariae), Huangbai (Cortex Phellodendri), Shanzhizi (Fructus Gardeniae), etc. The ying-system-clearing and blood-cooling herbs are Shuiniujiao(Cornu Bubali), raw Dihuang (Radix Rehmanniae), Mudanpi rubra ), Zicao (Radix Arnebiae seu Lithospermi), Qiancao (Radix Rubiae ),etc. The yin-nourishing and heat-clearing herbs are Zhimu (Rhizoma Anemarrhenae ), Yinchaihu (Radix Stellariae) Digupi (Cortex Lycii Radicis ), Qinghao (HERba Artemisiae Chinghao), Guiban (plastrum Testudinis ),Biejia (CarapaxTriomycis), Maimendong (Radix Ophiopogonis),xuanshen (radix Scrophulariae),etc. 

In application of the heatclearing method, it is necessary not to overuse the dose , in order to avoid damaging the stomach qi and influencing the healing the wound. 

specific application of internal therapy 1


4. Warm-Dredging Method
This method is supposed to use the herbs that can warm up the meridians and dredge the collaterals, and disperse cold and resolve phlegm for expelling accumulated pathogenic cold, in order to obtain the goal to break the tumefaction and heal the wound, and is a main therapeutic method for syndromes of yin cold. The warm dredging method is also divided into two categories of the yang-warming and phlegm-resolving method and meridian-warming and cold-dispersing method. 

The representative formulas are respectively "Yang He Decoction" and "Danggui Si Ni Decoction". The commonly used herbal drugs are Fuzi (Radix Aconiti Praeparata), Rougui ( Cortex Cinnamomi), Ganjiang (Rhizoma Zingiberis), Guizhi (Ramulus Cinnamomi), Mahaung (Herba Ephedrae), Baijiezi (Semen Sinapis Albae) (warm yang and resolve phlegm) ; Xixin (Herba Asari), Guizhi ( Ramulus Cinnamomi ), Shengjiang ( Rhizoma Zingiberis Recens) (warm the meridians and disperse cold), etc. In application of the warm-dredging method, it is necessary not to use it for a long time, in order to avoid consuming and damaging yin fluid and leading to other complications.

5. Phlegm-Expelling Method
This is a therapeutic method to disperse tumefaction created by accumulation of pathogenic phlegm by using salty and cold herbs to resolve phlegm. Because phlegm or other problems caused by phlegm in predominance with other pathogenic factors are mainly manifested by mass and can also be manifested by discharged pus as tenacious as sputum, it is advisable to treat these diseases selecting the wind-expelling and phlegm-resolving method, stagnation-relieving and phlegm-resolving method, and ying-sys-tern-nourishing and phlegm-resolving method respectively in accordance with the different syndromes. The representative formulas are respectively "Niubang Jieji Decoction" plus "Er Chen Decoction", "Xiao Yao Powder" plus " Er Chen Decoction", and "Xiang Bei Yang Rong Decoction", etc.

The commonly used phlegm-resolving herbs are Niubangzi (Fructus Arctii), Jiangcan (Barnbyx Batryticatus), Xiakucao (Spica Prunellae), Banxia (Rhizoma Pinelliae), Xingren (Semen Armeniacae Amarum), Chenpi (Pericarpium Cirri Reticulatae), Yujin (Radix Curcumae),  Haizao (Sargassum),  Kunbu (Thallus Laminariae seu Eckloniae), Beimu (Bulbus Fritillariae Thunbergii), Xiangfu (Rhizoma Cyperi), Baijiezi (Semen Sinapis Albae ) , Gualou ( Fructus Trichosanthis), etc. 

Because the surgical diseases are often complicated with qi stagnation and pathogenic fire and heat, it is very seldom to combine the warm phlegm-resolving method, in order to avoid supporting heat to produce fire.
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