Journal of Acpuncture and Tuina Science, Dec. 2005. Vol.3, No.6 �9 1 ~

Experience of Prof. ZHANG-Ji in Treatment of Intractable Diseases: A Report of 5 Cases

ZHANG Jun(~ ~)

Beijing University of TCM, 100700, Beijing, China

CLC number. R249

Document code: A

Prof. ZHANG Ji, male, born in Jinzhou City, Liaoning Province in May 1929, distinguished acupuncture expert in China, professor of Beijing University of TCM, doctorate supervisor, the all-China second-batch distinguished and elderly TCM expert, receives the special government allowance issued by the State Council. So far he has been doing acupuncture teaching, scientific research and clinical practice for more than 40 years. He once gave lectures in different countries including Italy, Japan, the United States, and France and got favorable comments from the international colleagues. Up to date, he has published more than 50 academic papers and 16 books including Differentiation Analysis of Neijing Disease Syndrome, Collections of Acupuncture Classics, Medical Classics of Varieties of Acupuncturists and Acupuncture g~ Moxibustion. And he has trained more than 20 students for either master degree or doctorate and obtained several scientific and technology achievements.

Trigeminai Neuralgia

The patient, female, 62 years old, a retired cadre,

came for the first visit on June 4, 1998 with 2-year

spasmodic burning pain of the right face.

Two years ago, the patient got insomnia and spasmodic burning pain of the right face because of

quarreling with her children and emotional

unhappiness and was diagnosed with "trigeminal

neuralgia" by examination. Despite the oral admi-

nistration of carbamazepine, her pain still got

worse gradually. Currently, the burning and

spasmodic pain of the right face radiated from

superior area of the ear to the area around cheeks

and zygoma, increased attack frequencies, each

attack lasted from seconds to 2 min, especially with

washing face, brushing teeth and intake of cold or

hot food. In addition, she also had the following

symptoms: bitter mouth, restlessness, insomnia,

easy anger, lusterless facial complexion, miserable

Author:ZHANG Jun (1953), female, associate professor

look, red tongue tip with thin and yellow coating,

and wiry and slippery pulse. The syndrome

differentiation was hyperactivity of fire from liver

and gallbladder attacking meridians of the face

and obstructing local qi and blood flow, and

therefore the treatment principle was to clear the

fire of liver and gallbladder and regulate

meridians of the face with both needles and herbs.

Based on the principle of treating the upper

problems with the lower points and combining both

local and distal points, points including Taichong

(LR 3), Xingjian (LR 2), Neiting (ST 44), and Hegu

(LI 4) were punctured with reducing manipulation;

points including Fengchi (GB 20), Xuanlu (GB 5),

Xuanli (GB 6), Touwei (ST 8), Xiaguan (ST 7),

Quanliao (SI 18) and Jiache (ST 6) toward Dicang

(ST 4) were punctured with even reinforcing-

reducing manipulation. The needles were remained

for 30 min and was manipulated once every 10 min.

The needling sensations of heaviness, soreness and

distension were supposed to reach the whole face.

The treatment was done once every other day and 1

course contained 10 times.

Herbal formula: 12 g of R a d i x Bupleuri ( ~ ~)~ ) , Rhizorna Cyperi ( ~r ~ ) , Fructus Gardeniae ( 4~

) , Fructus Viticis S impl ic i fo l iae ( ~ ~] -~ ) ,

R a d i x Angelicae Dahuricae ( (~ ~ ) , and R a d i x

Angelicae Sinensis ( ~ ~)~ ) , 3 g of Herba Asari ( .~

-g-), 10 g of Rhizoma Chuanxiong ( )ll • ) and

Fresh R a d i x Glycyrrhizae ( ~ ~ ~ ) , 15 g of

R a d i x Paeoniae Alba ( (~ -~ ) and 6 g of Herba

Menthae ( ~ g~ ). The herbal decoction was taken

once a day. After 1-week treatment of acupuncture

and herbs, the patient's facial pain obviously relieved

and the attack frequencies were decreased to 12

times a day. After 2 successive treatment courses,

the patient 's pain completely disappeared and no

relapse within the follow-up after 6 months.

Remark: trigeminal neuralgia belongs to the

category of "facial pa in" in TCM theory. Prof.

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ZHANG considers that the disease is mostly caused

by liver stagnation transforming into fire due to

pathogenic wind, cold, phlegm-fire, stomach-heat,

anxiety and anger, which in turn flames up to

disturb the meridians of the face and consequently

leads to qi-blood disharmony and obstruction.

Therefore the treatment principle is to clear the fire

of liver and gallbladder, dredge the meridians of

the face, and regulate qi and blood. Based on the

principle of treating the upper problems with the

lower points, points including Taichong (LR 3),

Xingjian (LR 2), Neiting (ST 44), and Hegu (LI 4)

were punctured with reducing manipulation to

clear the fire of Liver, Gallbladder and yang-ming

Meridians and regulate meridians; points including

Fengchi (GB 20), Xuanlu (GB 5), Xuanli (GB 6),

Touwei (ST 8), Xiaguan (ST 7), Quanliao (SI 18)

and Jiache (ST 6) toward Dicang (ST 4) were

punctured to regulate the qi and blood of the facial

meridians, remove stasis, clear collaterals and stop

pain. In addition, the herbal formula can soothe

liver, remove wind, stop pain and regulate the

whole body.

External Ophtha lmopleg ia

The patient, female, 42 years old, company clerk,

came for first visit on December 27, 1999 with more

than 2-month internal strabismus and double

vision of the two eyes.

In the past 2 months, the patient got internal

strabismus and double vision of the two eyes and

failure to external abduction of the two eyeballs

whenever she felt fatigue from work. Then she was diagnosed with internal strabismus of external ophthalmoplegia by Tongren Hospital. She didn't get significant effect the symptom-targeted treat-

ment. Physical examination showed flexible upward

and downward movement of the two eyes, limited

external abduction, red tongue with yellow coating

and wiry and slippery pulse. The TCM syndrome

differentiation was deviated eyesight due to

deficiency of both liver and kidney and obstruction

of pathogenic wind. And therefore the treatment

principle was to remove wind, clear collaterals, and

tonify liver and kidney. Points including Fengchi

(GB 20), Taiyang (Ex-HN 5), Jingming (BL 1),

Qiuhou (Ex-HN 7), Hegu (LI 4), Sanyinjiao (SP 6),

Taichong (LR 3) and Zhaohai (KI 6) were

punctured with even reinforcing-reducing mani-

pulation. The needles were remained for 30 min

and manipulated once every 10 rain with the

needling sensation radiating to the eyes. After

treatment of 3 times, the patient's symptom of internal

strabismus alleviated and after treatment of 20

times, the patient's symptoms of both internal strabismus

and double vision disappeared. And no relapse

showed in the follow-up up to date.

Remark: This disease belongs to the TCM scope

of "deviated eyesight". Prof. ZHANG considers that

it is mostly caused by liver-kidney deficiency and

insufficiency of essence-blood due to long-term

working stress and over-fatigue plus attack by

pathogenic wind obstructing the meridians around

the eyes, which in turn leads to local qi and blood

obstruction failing to nourish the eye muscle.

Therefore the treatment principle should be to

remove wind, clear collaterals, tonify liver and

kidney and regulate the function of eye muscles. As

wind is one of the yang-pathogenic factors which

always flares up to reach head and face, so Fengchi

(GB 20) plus Taiyang (Ex-HN 5) were selected to

remove wind; Jingming (BL 1) was added to

regulate the meridians around the eyes; Qiuhou

(Ex-HN 7) was a key point for internal strabismus,

double vision and pathological changes of optical

fundus, for beneath this point is the optical nerve;

distal points including Hegu (LI 4), Sanyinjiao (SP

6) and Taichong (LR 3) were selected to regulate

the meridians of the head and face to tonify liver

and kidney and nourish eyes; Zhaohai (KI 6) was

selected to nourish kidney-water and inhibit liver-

yang. The combination of all above points can treat

both the superficial symptoms and root cause and

consequently obtain good results.

Facial Muscle Spasm

The patient, female, 43 years old, an accountant, came for first visit with muscle spasm of the left

face for more than one year.

One year ago, because of emotional unhappiness and working stress, the patient always felt tense of

the facial muscle and spasmodic muscle spasm of

the left face, which gradually worsened for lacking

immediate treatment and didn't get good result from

western medication. With time went on, her left face

continued to get tense and rigid, and the spasm

frequencies increased from 2 or 3 times to more

than 10 times a day, each time lasting around 15

min with complication of restlessness and easy anger. Physical examination showed lusterless

complexion, smaller palpebral fissure of left eye

than that of the right eye, spasmodic and

involuntary twitching of the left-side facial muscle,

sometimes slight and sometimes severe, especially

Journal of Acpuncture and Tuina Science, Dec. 2005. Vol.3, No.6 �9 3 ~

occurred to the area around left eyelid and the

corner of the mouth, facial pain, reduced sensation

of the left face, dark red tongue with thin coating,

and wiry and slippery pulse. The TCM syndrome

differentiation was insufficiency of liver-yin and qi

and blood stagnation obslr, ucting the meridians of

the face, and therefore the treatment principle was

to relieve stagnation, nourish yin-btood, remove

wind and stop the spasm. Based on the principle of

combining both local and distal points, points

including Taichong (LR 3), Hegu (LI 4), Houxi (SI

3), and Yanglingquan (GB 34) were punctured with

reducing manipulation by twisting, points

including Sanyinjiao (SP 6), Ganshu (BL 18),

Fengchi (GB 20), Tongziliao (GB 1), Sibai (ST 2),

Quanliao (SI 18), Dicang (ST 4) and Jiache (ST 6)

were punctured with even reinforcing reducing

manipu-lation. The needles were remained for 30

min and manipulated once every 10 min with the

heat sensation radiating to the face. The treatment

was done once every other day and 1 course

contained 10 treatments. The patient's facial spasm

was basically under control after 1 course and then

recovered after another course for consolidation.

Remark: Facial spasm belongs to TCM scope of "twitching" and "convulsion". Prof. ZHANG

considers that the disease is mostly caused by liver

stagnation transforming into fire (due to internal

emotional injury) consuming too much liver-yin. As

liver stores blood and controls tendons, liver-yin

insufficiency fails to nourish tendons and leads to

internal stirring of liver wind, which in turn goes

up to affect the meridians of the face and results in

facial muscle spasm. Therefore the therapeutic

approach should be to relieve stagnation, nourish

yin-blood, remove wind and stop spasm. Taichong (LR 3), the Yuan primary point of the Liver

Meridian, is the first choice to soothe liver

stagnation; Hegu (LI 4), the Yuan-primary point of

the Large Intestine Meridian, was combined to

remove wind and regulate qi and blood flow; Houxi

(SI 3), one of the eight confluent points connecting

Governor Vessel, was added to regulate yang

meridians; Yanglingquan (GB 34), the influential

point of tendon, and Fengchi (GB 20) were added

to relax tendons, clear collaterals, remove wind

and stop spasm; Sanyinjiao (SP 6) and Ganshu

(BL 18) were added to nourish liver yin, blood and

tendons; points of the face were combined to

regulate the local qi and blood circulation. The combined local and distal points target both the

superficial symptoms and the root cause and thus

get good results.

Bronchial Asthma

The patient, male, 54 years old, government

official, came for first visit on July 5, 1997 with

recurrent attack of chest stuffiness and shortness

of breath for 14 years.

In the past 14 years, his asthma attacked

frequently whenever he got common cold, which got

alleviation with both Chinese and western medicine

targeting on the symptoms. Recently his asthma

recurred because of common cold with the

symptoms of chest stuffiness, panting and excessive

sputum. Physical examination showed dark-purple

complexion, difficult respiration, rale in the throat,

wheezing full of the lungs, a little audible wet rale

in the left base of the lung, yellow tongue coating

and slippery pulse. The TCM syndrome

differentiation was phlegm-heat accumulating in

the lung and lung failing to purify and descend,

and therefore the treatment principle was to

disperse lung, clear heat, resolve phlegm and stop

asthma by both needles and herbs. Points including

Dazhui (GV 14), Dingchuan (Ex-B 1), Zusanli (ST

36) and Taixi (KI 3) were punctured with even

reinforcing-reducing manipulation. The needles

were remained for 30 rain, the treatment was done

once every other day and 1 course contained 10

treatments. As for the herbal formula, modified Ma

Xing Shi Gan Tang was adopted including 10 g of

Herba Ephedrae(ff~g/s ), 6 g of Apricot Kernel ( k~

4= ), 30 g of Fresh Gypsum Fibrosum ( ~ Z , ~ ) , 10

g of Radi~ Platycodi ( ~ ~ ) , 12 g of Radi:r

Peucedani (-~ ~1~ ) , 20 g of Fructus Trichosanthis

( @ ~ ) , 12 g of Rhizome P i n e l l i a e ( ~ j . ) , 15 g of

Fresh Semen Coicis ( ~ ~ "f= ), 15 g of Radix"

Scutellariae ( ~. ~ ) , 12 g of Pericarpium Citri

Reticulatae ( ~ /s , 12 g of Poria ( 4~ y~z ) , 12 g of

Semen Lepidi i seu Descurainia ( ~- ffj ~ ) , 12 g of

Semen Ra phani ( ~ ff~-Sr- ) and 10 g of Fresh Radi:c

Glycyrrhizae( ~ - ~ ~ ). The herbal formula was

orally administered once a day. After 1-week

treatment of needles and herbs, the patient felt

alleviated stuffy chest and auscultation showed

obviously reduced wheezing in the lungs. After 1

treatment course, the patient felt energetic with

good appetite and normal urine and stool, and the

asthma symptoms basically disappeared. Another

2-month treatment was continued for consolidation,

the patient's symptoms totally disappeared and he restored to normal work. No relapse was found in the

two-year follow-up.

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Remark: The disease belongs to the TCM scope of "wheezing syndrome" and "dyspnea syndrome". Prof. ZHANG considers that asthma is mostly caused by deficiency of lung, spleen and kidney, plus internal phlegm and attack by wind-cold. Therefore he adopted the therapeutic principle of purifying and descending lung-qi, and resolving

phlegm to stop asthma. He usually selected points including Dazhui (GV 14), Quchi (LI 11), Hegu (LI 4) and Feishu (BL 13) with reducing manipulation to clear lung-heat and disperse lung-qi; points including Dingchuan (Ex-B 1) and Fenglong (ST 40) were combined to descend the adverse flow of qi, resolve phlegm and stop asthma; in the case of excessive phlegm due to spleen and kidney deficiency, the treatment should be mainly target at strengthening spleen, tonifying kidney, resolving phlegm and stopping asthma by such points as Feishu (BL 13), Pishu (BL 20), Shenshu (BL 23), Zusanli ( S T 36) and Taixi (KI 3). The comprehensive therapy of needles, cupping and Chinese herbs work together to regulate the organism immune function, strengthen anti- pathogenic resistance, remove pathogenic factors and stop the asthma.

G o u t y Arthr i t i s

The patient, male, 56 years old, government

official, came for first visit on September 12, 1998 with red, swollen and burning pain of the right- foot great toe for more than one month.

One month ago, the patient went to Qingdao for a meeting and got red, swollen and pain of the right-foot great toe after seafood and alcohol drinking. Hospital examination showed faster blood sedi-mentation and higher index of blood uric acid than the normal index and the patient was diagnosed with gout. Then the patient was hospitalized for intravenous dripping of penicillin. After one-month treatment, his symptoms didn ' t improve obviously and therefore he came to visit us. Physical examination showed swollen right-foot great toe, foot dorsum and medial malleolus, local tenderness, dark red skin, claudication, red tongue tip and edges, thin and yellow coating and wiry and slippery pulse. So the patient was diagnosed with gouty arthritis. The TCM syndrome differentiation was downward flowing of damp- heat and qi-blood stagnation and the therapeutic principle was to clear heat, remove dampness, promote blood flows, and resolve swollen and stop pain by needles and herbs. Points including Xingjian (LR 2), Taibai (SP 3), Qiuxu (GB 40), Jiexi

(ST 41), Sanyinjiao (SP 6), Yinlingquan (SP 9) and Dazhui (GV 14) were punctured with reducing manipulation. The needles were remained for 30 rain and manipulated once every 10 min. The treatment was done once every other day and 1 course contained 10 treatments.

Herbal formula: 12 g of Forsythia ( .~. ~ ~'~ ) , Lonicera ( L~: ?f~ ), Fructus Gardeniae ( ~ ~ ), Radix Stephyaniae Tetrandrae ( ~Y~ ~2; ~ ), Radix Sanguisorbae ( ~ ~ ), Radix Clernatidis ( flf~ Yx ,[d~ ), Cortex Phellodendri ( 7~ ~ ), Radix

Paeoniae Rubra ( ~ ~ ~ ) and Radix Paeoniae Alba ( ~ ~ ~ ), 15 g of Radix Salviae Miltiorrhizae( ~- ~ ) and Ramulus Mori ( ~ ~.) , 20 g of Poria (4~ ~ ) and 10 g of Radix Glycyrrhizae ( N - ~ ) . After 1-week treatment of

acupuncture and herbs, the patient's swollen and pain of the right-foot great toe alleviated and the swollen in foot dorsum and medial malleolus reduced. And after one-course successive treatment, the patient 's swollen and pain of the right-foot great toe and swollen in foot dorsum and medial malleolus all disappeared totally. Then the patient could walk freely and was advised to avoid seafood and alcohol drinking. The test results were all within the normal range in the six-month follow-up.

Remark: Gouty arthritis belongs to the TCM scope of "Bi-syndrome". Prof. ZHANG considers

that it is mostly caused by damp-heat affecting

spleen and stomach due to long-term intake of greasy food and alcohol, which in turn leads to spleen failing to transport and transform and generating damp-heat to obstruct qi and blood of the joints and tendons, and then mixture of dampness, heat and stagnant blood resulted in pain. Therefore the therapeutic principle was to clear heat, remove dampness, activate blood flows, and resolve swollen and stop pain. Points including Xingjian (LR 2), Dazhui (GV 14), Jiexi (ST 41) and combination of Taibai (SP 3) and Qiuxu (GB 40) were punctured to clear damp-heat, regulate meri-dians and stop pain; points including Sanyinjiao (SP 6) and Yinlingquan (SP 9) were punctured to activate blood flows, remove stasis, clear dampness and remove swollen; in addition, Chinese herbal formula was added to clear heat-toxin, remove dampness, resolve stasis and stop pain. The combination of needles and herbs worked together to drive the pathogenic factors out, resolve swollen and stop pain.

Translator: XIAO Yuan-chun ( ~i ~L~) Received date: Aug. 20, 2005