| Professor Chen Tongyun was born in 1921 in Beijing in a family skilled in Traditional Chinese medicine for generations. Her father, Mr. Chen Shuren, was good at treating warm diseases. Influenced by her family, she became to be interested in medicine when she was a little girl. Chen was the only daughter of her family, so her father paid special attention to her education. He not only asked her to read The Analects of Confucius, Zuo Zhuan and schools, she started systematical ly to study the basic theory of Chinese and Western medicine. In 1966, Chen went to work at the Department of External Diseases of the Beijing Chinese Medicine Hospital. Here she learnt more from another famous dermatologist Dr. Zhao Bingnan. Since the establishment of the Department of Dermatology at the hospital, she kept working with Dr. Zhao.Integrated with what she had learnt from these distinguished doctors she developed her own academic thoughts. With her father's accomplishments in the treatment of warm diseases, Chen had a deep understanding of this category of problems, and she knew how to prescribe medicinal herbs cold in nature for patients. Treatment of skin disorders can be traced back to the 19th century, when there was no department of dermatology, but dermatology, orthopedics and traumatology could not be separated, and most practitioners of orthopedics and traumatology treated skin disorders too, so the medical skills of the three above doctors exerted great impact on Chen.Dr. Ding, Dr. Zhao's teacher studied orthopedics and traumatology intensively. Orthodox Manual of External Medicine highly this book presents detailed proofs and superb approaches in treatment of external diseases. Special attention is attached to the spleen and stomach, because external diseases are usually related to the condition of them. He gradual ly accumulated weal th of clinical experience and Effective For Orthopedics and Traumatology was famous in orthopedics and traumatology. He thought that the cause of external diseases was deficiency of qi and blood, which triggered toxin production, rather than internal production of toxic fire. Based on his experience for years, he developed the treating measure for external diseases. Innovative methods were made in the treatment of the external diseases. Dr.Zhao Bingnan, with rigorous study of dozens of medical classics since childhood was appreciated by his master instructor Dr. Ding. He really learnt all the skills in diagnosis and treatment of external diseases from his teacher. After years of clinical practice, he developed his unique treat ing methods for skin diseases, obstinate illness and mal ignant sores. Then my teacher Dr. Chen learnt tremendous knowledge of how to treat skin diseases from Dr. Ha and Dr. Zhao. With her hardworking, she had shaped her own sophisticated treating system in the treatment of skin diseases.On the other hand, Chen was also familiar with the medical classics and had a good command of the theory of traditional Chinese medicine, such as the holistic concept, pattern identification of the zang-fu organs in Huangdi's Canon of Medicine, qi she also learnt the knowledge from Liu Juanzi's Ghost-Bequeathed Prescriptions about classification of external diseases, timely treatment and prognosis. After reading the Orthodox Manual of External Medicine she knew that the importance of harmony between the spleen and stomach another book entitled Clinical Experience in the Treatment of External Diseases told her ulcers were in the range of warm diseases, seen in the upper, middle, lower parts of the body. According to the triple energizer theory the recommended formulas were Xijiaodihuang Decoction, Angongniuhuang Pill, Zixue Pill and Zhibao Pill, which acted to induce resuscitation in severe cases. The above theory is still used as guidance today. With all the medical knowledge she commanded, Chen gradually formed her own academic ideology in the treatment of skin diseases.Chen's academic thoughts can be 1. Emphasis on the holistic concept and pattern differentiation, union of man and nature, climate, environment, skin disorders and internal organs, channels, qi is the problem of the internal organs and blood condition, which reflect on the skin.2. Emphasis on "learning from the ancient medical knowledge but not confined to it, weeding through the old and bringing forth the new," She advocated integrative medicine, combining pattern differentiation with disease identification. Chen developed effective medicines for external use based on her teachers'formulas and processing methods, she overcame the shortcomings of former preparations but preserved their efficacy.3. Emphasis on the importance of zang-fu pattern differentiation, tonifying the kidney, preserving stomach qi, because it was the source of the acquired essence, qi and blood, age and constitution, tonifying the spleen when herbs cold in nature and bitter in taste were given, draining dampness, to protect the middle energizer,etc.4. Combined use of the four examinations, especially tongue diagnosis. Because the tongue was the seedling of the heart, but also the outside manifestation of the spleen, and tongue fur indicated the qi condition of the stomach.Based on the three-year clinical study with my teacher, Prof. Chen, I can summarize her special features of diagnosis and treatment of chloasma, rosacea, urticaria, itching wind, wet sores, psoriasis and other common skin diseases. In the treatment of acne Chen has her own uniqueness, her clinical experience and significant effect is universally acclaimed. Therefore, in the third part, Prof. Chen's academic thoughts, including her treating principles, methods, formulas and herbs in the treatment of acne are discussed. With the outpatient medical records, prescriptions, scientific statistical management I try to summarize, analyze the approaches she uses for acne, of its pathogenesis, pattern differentiation, characteristics of the treating principles, methods and herbs-prescribed. According to Prof. Chen heart heat toxin is the main cause as well as heat-dampness, and blood stagnation. To clear heat is the main aim, as the disorder is divided into three patterns, i.e. Lung and stomach heat, deficiency in the spleen and dampness prevailing, and qi and blood stagnation in light of the theoretical basis listed in the books--Huangdi's Canon of Medicine and lood, for which Yinchenhao Decoct ion and Huangl ian jiedu Decoction with modifications are prescribed. The two combined formulas are used to strengthen the power of clearing heat, dampness and fire. The ingredients in the formulas act on the channels of the lung, stomach, and liver, where the disorders locate.In summary, with an overall review of Chen's career in medical practice, academic thoughts dermatology, and her treatment experience of chloasma, rosacea, eczema, seborrhea, and wind itching, psoriasis, etc. I have found her special extensive clinical experience. Since Prof. Chen is good at the treatment of acne, it is taken as my research subject. By using scientific research methods, statistic management, Prof. Chen's academic characteristics about how to sep up the treating principles, methods, formulas and herbs in the diagnosis and treatment of acne have been summarized. 1. ObjectiveAfter collection of the three years' study based on the medical records, prescriptions, diagnosis and treatment of acne by Prof. Chen Tongyun, including the treating principles, laws, formulas and herbs used I try to analyze Chen' s understanding of the etiology and pathogenesis, pattern characteristics of acne.Treating principles, laws, formulas and herbs are practical presentative of the theory of traditional Chinese medicine. All of these are interrelated and cannot be separated from one another. In the treatment of acne Chen's formulas and herbs prescribed are analyzed.2. Research MethodsAll clinical materials are based on the data collected from October 2008 to June 2010 when I was her student. The cases selected are in line with Western diagnostic criteria of acne and Chinese medicine diagnostic criteria. At least the data of three times visit of each patient are valid together with the detai led formulas and herbs and dose prescribed. All the valid cases were classified according to pattern differentiation and then the formulas and herbs used were analyzed. The occurrence frequency of each herb was under statistical management, and finally the most effect formula was confirmed. Secondly, modifications of formulas were under statistical management too when complications were found. This part did not affect pattern differentiation.In terms of statistics of the herbs used, a database using Access 2003, was set up. The data were statistically analyzed. According the herbal occurrence frequency and ratio, a basic formula for acne and a formula for comlications were developed.3. ResultBase on medical records finishing, herbal medicines in a prescription data statistics and analysis. To come up with a basic recipe:the Yin Chen, Hypericum perforatum, wild chrysanthemum, Salvia miltiorrhiza, and cortex phellodendri and rhizoma coptidis, knotweed, pubic phthiriasis.4. Conclusion4.1 Treating PrinciplesProf. Chen believes that acne is caused by toxic heat, dampness-heat, and qi stagnation. "All skin disorders are due to disturbance of the heart," says in Huangdi's Canon of Medicine. Golden Mirror of Medicine points out that "ulcers and boils are caused by toxic fire. " In modern times, global warmth and improper diet bring more heat to the body. The quick tempo of life and work pressure triggers stress, anxiety and depression. Emotional problems may cause production of internal fire according to TCM theory. Prof. Chen believes that toxic heat is the main cause, combined by other factors like physical condition, innate gifts and heat constitution.4.2 MethodBased on the understanding of the disease cause and pathogenesis, Prof. Chen' adheres to the concept "treating a heat pattern with herbs cold in nature". To detoxify, clear heat and purge fire are the main method. The disease is divided into the following patterns, ie. Dampness-heat in the lung and stomach, deficiency and excessive dampness in the spleen, and congestion of phlegm-dampness. This classification is in consistent with the pathological basis. Under her father's influence she attaches importance to qi and blood differentiation, believing that the occurrence is related to excessive heat in blood and disorders of the lung, stomach and liver.4.3 FormulaThrough collection and screen of the formulas used by Prof. Chen, the basic formulas are selected. They are the Yinchenhao Decoction and Huanglianjiedu Decoction with modifications. The chief herbs are Yinchen, Lianqiao, Yejuhua, Danshen, Danggui, Huanglian, Huangbai, Huzhang. The first formula originates from Zhang Zhongjing's Treatise on Cold-induced Diseases, acting to clear heat and dampness indicated for internal heat, and pouring of dampness-heat. The second formula as originates from the Handbook of Prescriptions for Emergencies, acting to clear toxic fire from the triple energizers. Two formulas used together strengthen the power to clear toxic heat, which further proves Chen's understanding about the cause of the disease.4.4 Herbs givenThe herbs given to clear toxic heat, dampness-heat and purge fire. They are of the bitter sweet and pungent taste and cold in nature Herbs bitter in taste are given to clear heat, dampness and make bowel movement. Herbs sweet in taste are given to detoxify. Herbs cold in nature are given to remove heat, and herbs of pungent taste are given to move qi and blood. The herbs act on the Lung, Liver and Stomach Channels, which is consitent with the fact that the disease locates on them.5. DiscussionAcne is a common skin disease. With the progress of society, the rich life materials, the incidence rate has increased year by year and more and more young patients are found. People have paid attention to improvement of. life quality, so that people suffering from the disease hurry to see doctor. Traditional Chinese medicine is effective to this disease so it has its own advantage in its treatment.Prof. Chen pays much attention to pattern differentiation, and also to the external treatment. She has developed some effective hospital remedies. In addition she says that it is important to care about diet; however, there are some limitations in evaluation of the efficacy and not enough valid laboratory data in TCM, which impedes standardization. It is essential to stipulate unified criteria of pattern differentiation and efficacy research on the related herbs in laboratory. |
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