Appreciation of He Xiuchuan's Medical Case of Hepatitis B
He Xiuchuan, male, born 1939, chief TCM physician, graduated from the Tianjin College of Traditional Chinese Medicine in 1962. He once served as executive vice president of the Cangzhou (Hebei) Chinese Medicine Hospital and was a supervising teacher for the second national cohort of inheritors of renowned older TCM experts' academic experience. He specialized in liver diseases and served as director of the Cangzhou Institute of TCM Hepatology. He often treated hepatitis B with his empirical formula "Ganning Tang" (Liver-Calming Decoction), with some success. Below I reprint one of his hepatitis B cases for readers' reference.
The patient, Li, male, 44, first presented on July 28, 1995. He was a worker on the Cangzhou local railway and had been a hepatitis B virus carrier for many years. Over the previous 10-plus days, after work-related fatigue, he developed weakness and limpness of the limbs, poor appetite, epigastric and abdominal distension, and hypochondriac pain. Liver function was abnormal; in the hepatitis B five-item panel, HBsAg, HBeAg, and anti-HBc were all positive (the so-called "big three positives"). The pulse was deep and wiry; the tongue was dark with a thin white coating.
Old Master He differentiated the patient as having liver depression with spleen deficiency and interior accumulation of stasis-toxin. The treatment principle was to nourish the liver and fortify the spleen, soothe the liver and resolve stasis, and detoxify and lower enzyme levels, using his self-formulated "Ganning Tang" with modifications.
First-visit prescription: Baihua She She Cao (Hedyotidis Diffusae Herba) 30 g, Pugongying (Taraxaci Herba, dandelion) 15 g, Danshen (Salviae Miltiorrhizae Radix) 20 g, Chaihu (Bupleuri Radix) 15 g, Zelan (Lycopi Herba) 15 g, Huzhang (Polygoni Cuspidati Rhizoma) 15 g, Sheng Huangqi (raw Astragalus) 20 g, Wuweizi (Schisandrae Chinensis Fructus) 8 g, Sharen (Amomi Fructus) 8 g, Baizhu (Atractylodis Macrocephalae Rhizoma) 12 g, Mudanpi (Moutan Cortex) 12 g, Tufuling (Smilacis Glabrae Rhizoma) 20 g, Zhiqiao (Aurantii Fructus) 12 g, Gancao (Glycyrrhizae Radix) 6 g. Decocted in water, divided into two doses morning and evening, one dose daily.
On August 16 the patient returned; liver function tests had improved, and in keeping with the principle that an effective formula should not be changed, he was told to continue. When liver function was rechecked on September 13, both the tests and symptoms had improved further, and he continued the same formula. On October 4, a repeat check showed all indices normal; in the hepatitis B panel, HBeAg had also seroconverted to negative. He was told to keep the formula unchanged but take one dose every other day, continuing for a month to consolidate. Follow-up for one year showed no relapse.
Old Master He's formula combines pattern-based and disease-based treatment. It uses Chaihu-series formulas to soothe the liver and resolve stasis together with the Four Gentlemen to fortify the spleen and drain dampness—that is pattern-based treatment; at the same time it includes Baihua She She Cao, Pugongying, and Tufuling, herbs regarded as having antiviral effects. Such a formula, for hepatitis B patients with active virus, both treats the branch (relieving symptoms) and the root (controlling the virus). Treating both branch and root allowed the patient's condition to be controlled to a degree.