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1 Preeclampsia and Eclampsia Ebook Dr Qiu Xiaomei on The Prevention and Treatment of Eclampsia 2 Introduction 2 Etiology and Pathology of Threatened and Actual Eclampsia 4 Research 6 Representative Cases 11 Case 1 Threatened Eclampsia 11 Case 2 Prenatal Eclampsia 12 Case 3 Eclampsia During Labor 13 Case 4 Post Partum Eclampsia 14 Case 5 Toxemia in Pregnancy 16 Miscelaneous Eclampsia Cases 19 Case 1 Dang Gui Shao Yao San 19 Case 2 Dang Gui Shao Yao San 23 Case 3 Dang Gui Shao Yao San 26 Case 4 Da Cheng Qi Tang given as an Enema 29 Case 5 Wu Mei Wan 31 Zhu Xiaonan s Experience with Eclampsia 33 Case 1 Postpartum Eclampsia 33 Case 2 Threatened Eclampsia 38 He Zihuai s experience in Preeclampsia 41 Wind Heat liver wind Type 42 Case 1 Preeclampsia 44 Case 2 Preeclampsia 48 Phlegm Unconsciousness Type 51 Case 3 Preeclampsia 52 Another He Zihuai Case 56 Case 4 Threatened Eclampsia 56 Notes on the Finger Pulse 63 Case 1 Shen Miao Fou Shou San Miraculous Spirit of the Buddha s Palm 68 Case 2 Tuo Hua Jian Cast off the Flower Drink 70 Dr Ha Litian on Preeclampsia 73 1 Eclampsia is generally categorized as liver wind moving Yin deficiency with Yang increasing and fire rising 73 2 The principle aim is to nourish extinguish and submerge while simultaneously dispelling phlegm fire damp congealed blood and wind 75 3 Gou Teng Tang is the foundational formula It can be modified according to the pattern for great effectiveness 75 4 Don t be bigoted in your choice Vitalizing blood and transforming congealed blood has great beneficial results 78 5 Clinical Cases 83 Case 1 Preeclampsia 83 Case 2 Threatened Eclampsia 88 Translated by Sharon Weizenbaum 2021

2 Preeclampsia and Eclampsia Ebook Dr Qiu Xiaomei on The Prevention and Treatment of Eclampsia1 Introduction Threatened eclampsia and eclampsia are both subsumed under the category of toxemia in pregnancy The threat to the baby s health is significant and it is a major cause of maternal death Although the language of traditional Chinese medicine does not contain the term toxemia in pregnancy from the point of view of the disease clinical manifestations it is characteristic of the gynecological syndromes named fetal swelling fullness of pregnancy dizziness of pregnancy or epilepsy of pregnancy There is a relationship between the symptoms and etiology of this disorder and throughout the ages there has been considerable discussion of it For example the Zhu Bing Yuan Hou Lun General Treatise on the Causes and Symptoms of Diseases2 points out Water Qi in the fetal residence fetal fullness and body swelling is a consequence of pregnancy and is caused by Spleen and Stomach vacuity weakness which leads to a cutting off of the water flow which is harbored in 1 From Qiu Xiaomei s Experience in Gynecology Zhe Jiang Science and Technology Press August 1982 2 By Chao Yuanfang et al 610 AD Translated by Sharon Weizenbaum 2021

3 Preeclampsia and Eclampsia Ebook the space between the Zang Fu In Shen Shi Nu Ke Yao Jian Zhong Master Shen s Corrected Essentials oJ Gynecology with Commentary says When a pregnant body becomes swollen it is because during pregnancy the true Yin condenses in order to nourish the fetal source The Yang Qi that is housed in the Kidneys is unable to spread and disseminate and hence the water passages are inundate and overflow without restriction Treatment should spread and disseminate the Kidney Qi so that the water can move along its former course urination is disinhibited and swelling and distention can disperse The Yi Zong lin Jian The Golden Mirror oJ Medical Lineages also says When a pregnant woman suddenly falls prostrate with convulsions and is unable to recognize people and things and then after a short time regains consciousness and returns to normal as if nothing happened this is called fetal epilepsy It is clear that our predecessors were already familiar with this disorder They considered it fetal swelling fetal dizziness and fetal epilepsy In my opinion these various appellations are describing different stages of the course of this disorders entire development Fetal swelling is a relatively mild symptom but it can develop into the life threatening case of fetal epilepsy Because of this one must pay close attention to the relationship between these stages in order to prevent and treat this as early as possible This is Translated by Sharon Weizenbaum 2021

4 Preeclampsia and Eclampsia Ebook especially important Etiology and Pathology of Threatened and Actual Eclampsia 1 Yin and Blood Depletion and Vacuity with Liver Wind Moving Internally This occurs because the Liver is the Zang associated with Wind which inwardly is mutually attached to Fire The Liver depends on the rich nourishment of the Kidney water and the moisture of the Ying and Blood The Wind Fire is only tranquil with it is nourished in this way If a woman has chronic Blood vacuity after becoming pregnant the Blood goes to nourish the fetal source and the Yin and Blood become even more insufficient As a result the Liver Wood looses its moisture inner Wind violently moves and there is the appearance of dizziness twitching and other symptoms 2 Spleen and Stomach Fail to Move Leading to Water Damp Accumulation If a pregnant woman s Spleen and Stomach are habitually vacuous after becoming pregnant the central Yang doesn t disseminate and the Spleen movement and transportation becomes increasingly weak The result of this is that Damp accumulates and water floods The result is symptoms such as abdominal fullness and superficial swelling Translated by Sharon Weizenbaum 2021

5 Preeclampsia and Eclampsia Ebook The above narrated two pathogenic causes are often interrelated Yin and Blood depletion and vacuity with inner Wind moving upward is more predominant factor in the manifestation of this disorder In analyzing patients with threatened eclampsia though they may not have the critical stage symptoms of convulsion or loss of consciousness they present with superficial swelling most often with concurrent symptoms of headache and dizziness and their tongue body is crimson These patients fall into the category of Yin and Blood secretly consumed with inner Wind stirring and moving At this juncture in terms of treatment one must attend to the enrichment and nourishment of Yin and Blood in order to extinguish inner Wind It is not appropriate to merely treat swelling If you don t treat or you only treat swelling the woman could develop epilepsy For this reason whether the eclampsia is threatened or actual in terms of treatment one should without exception emphasize the enrichment of Yin and nourishment of Blood In the in patient obstetric department of my hospital I carried out a clinical survey using the prescription I formulated for the prevention and treatment of eclampsia Research This survey was carried out over several years in order to verify the Translated by Sharon Weizenbaum 2021

6 Preeclampsia and Eclampsia Ebook results Twenty four patients enrolled with threatened or actual eclampsia The clinical results are summarized below 1 Clinical Data A Patient Selection The patients were all more than twenty four weeks pregnant They all had some of the following measurable symptoms Blood pressure was either over 130 90 or 30 115 degrees higher than basal Protein in urine Superficial Swelling They also had the subjective experience of headache dizziness visual obstruction and I or chest oppression to the point of nausea All these points were observed in order to treat and tally results B Patient Age Among the twenty four cases 14 were between the ages of 21 and 25 5 were between the ages of 26 and 30 3 were between the ages of 31 and 35 and 2 were between 36 and 40 C Fetal Order Among the 24 cases 16 were prima gravid and 8 had previously given birth It was obvious that the disease incidence was higher in the prima gravid cases Translated by Sharon Weizenbaum 2021

7 Preeclampsia and Eclampsia Ebook D Symptoms and Physical Evidence Data Among the twenty four cases all have high blood pressure 5 cases diastolic pressure between 90 100 4 cases diastolic pressure between 100 110 9 cases diastolic pressure between 110 120 6 cases diastolic pressure greater than 120 15 cases had protein in their urine 1 case 3cases 11 cases There were varying degrees of superficial swelling in 18 cases 19 women had the subjective experience of headache dizziness or nausea 3 women had convulsions prior to labor in 1 case and during labor in 2 cases Among these cases of convulsion on case was a coma In the majority of cases the pulse was wiry and slippery or thin and slippery The body of the tongue s of most of the women were crimson 2 Treatment Method A Composition of principle prescription Mu Li Long Chi Tang Oyster Shell Dragon Tooth Soup Translated by Sharon Weizenbaum 2021

8 Preeclampsia and Eclampsia Ebook Mu Li 15 30 gm Du Zhong 15 30 gm Zhi Nu Zhen 9 12 gm Xia Ku Cao 9 15 gm Fu Ling 9 12 gm Long Chi 12 18gm Shi Jue Ming 15 30 gm Bai Shao 9 12 gIn Sang Ji Sheng 9 15 gm Ze Xie 9 12 gm Modification Method With extreme swelling add Che Qian Zi Chi Xiao Dou Zhu Ling With harboring of phlegm add Zhi Dan Xing Shi Chang Pu Xuan Fu Hua Translated by Sharon Weizenbaum 2021

9 Preeclampsia and Eclampsia Ebook Method Decoct in water Formula Explanation This prescription contains Mu Li and Long Chi which subdue the Liver and hide the Yang They also have a calming effect on the Spirit Du Zhong and Sang Ji Sheng supplement the Kidney and nourish the Liver and also calm the fetus Nu Zhen Zi and Bai Shao enrich Yin and supplement and nourish the Blood Xia Ku Cao and Shi Jue Ming calm the Liver and settle Wind Fu Ling and Ze Xie fortify the Spleen and disinhibit water so that the Ying and Yin may be restored and the Liver Blood nourished the Spleen movement opens up and water spontaneously leaves In this way the patient can recover from the superficial swelling dizziness and tetanic reversal Certainly because each patient body is not the same the symptoms will also be dissimilar and so will the disease characteristics Hence it is appropriate that the root prescription be fashioned with additions and subtractions according to the symptoms and flexibly modified Only then will the effect be good 3 Observation of Treatment Effectiveness A Criterion for judging treatment effectiveness Noticeably Translated by Sharon Weizenbaum 2021

10 Preeclampsia and Eclampsia Ebook effective results consisted of Short term alleviation or disappearance of the symptom of convulsion Blood pressure diastolic dropped more than 20 mm or to less than 90 mm Protein in urine and superficial swelling receded by Effective results consisted of Blood pressure diastolic dropped by 10 20 mm Protein in urine and superficial swelling receded by Ineffective results consisted of Blood pressure diastolic dropped by less than 10 mm Protein in urine and superficial swelling showed no change B Treatment Effectiveness The majority of the patient s symptoms and physical evidence were alleviated or gone In the 24 cases with high blood pressure 18 showed high effectiveness 3 cases were effective ore ineffective In the 15 cases with protein in the urine 12 cases were highly effective 1 case was effective and 1 case was ineffective 1 case was not reexamined Of the 18 cases of superficial swelling 17 were highly effective and 1 was ineffective Representative Cases Translated by Sharon Weizenbaum 2021

11 Preeclampsia and Eclampsia Ebook Case 1 Threatened Eclampsia Ms Zhou was twenty years old and pregnant with her first baby On April 7 1959 she came to the hospital for an examination Her principle complaint was that she had had a headache and dizziness for two days The check up showed that her uterus had grown appropriately for her pregnancy dates and there were no contractions Her blood pressure was 180 138 superficial swelling was and protein in urine was Both pulses were wiry slippery and big Her tongue was crimson The differential diagnosis was Yin and Blood depletion and vacuity with Liver Wind moving intema1ly she took one package of Mu Li Long Chi Tang Oyster Shell Dragon Tooth Soup and her blood pressure dropped and her headache and dizziness decreased On April 10 she gave birth and her blood pressure was down to 130 90 She left the hospital after 11 days Case 2 Prenatal Eclampsia Ms Tao was 20 years old and pregnant 38 weeks On October 19 1959 she came to the hospital because of acute headache and dizziness At the time she entered the hospital the fetal position and heart rate were normal Her blood pressure was 170 124 superficial swelling was and there was trace protein in her Translated by Sharon Weizenbaum 2021

12 Preeclampsia and Eclampsia Ebook urine After entering the hospital she had one episode of convulsion Her pulse was wiry and slippery and her tongue was crimson Her differential diagnosis was Yin vacuity movement of wind Spleen vacuity and water flooding I used Mu Li Long Chi Tang Oyster Shell Dragon Tooth Soup with modifications After six packages the swelling was gone the blood pressure dropped to 130 90 and on October 28 she delivered her baby smoothly She left the hospital after eleven days Case 3 Eclampsia During Labor Ms Dong was twenty six years old and entered the hospital on November 26 1960 because early that morning she had a sudden convulsion and went into a coma Her facial complexion was purple she made snoring sounds and there was a bloody fluid coming om her oral cavity Her whole body had superficial swelling and her blood pressure was 180 120 Altogether she convulsed four times Morphine magnesium sulfate and hypertonic glucose were used for treatment but still the convulsions didn t stop At that point Chinese herbs were added Ms Dong s pulse was wiry and slippery and I was not able to observe her tongue My differential diagnosis was Yin vacuity extreme hyperactivity of Yang which generated Wind and forced Translated by Sharon Weizenbaum 2021

13 Preeclampsia and Eclampsia Ebook Phlegm to harass upward I used Mu Li Long Chi Tang Oyster SheII Dragon Tooth Soup with the following additions Huang Qin Ma Liao Dou Zhi Li Ban Xia Dan Nan Xing Shi Chang Pu This prescription was decocted in water and the liquid was poured into the throat of the unconscious patient The convulsions stopped and ten hours later she gave birth The next morning her Spirit Essence was clear again meaning she had regained consciousness Her blood pressure was 140 100 On November 30 she had recovered so she stopped the herbs and left the hospital She had been in the hospital for five days Case 4 Post Partum Eclampsia Ms Qiu was nineteen years old and pregnant with her first baby The expected birth date was October 12 1959 On October 16 1959 she entered the hospital just before delivery The obstetric check up was normal Her blood pressure was 170 130 there was a slight degree of swelling of her lower limbs and traces of protein in Translated by Sharon Weizenbaum 2021

14 Preeclampsia and Eclampsia Ebook her urine At U 20 that afternoon she gave birth Instantly her four limbs convulsed with seizure Her eyes were staring straight ahead her lips were purple and she had lock jaw This continued for one hour during which time she convulsed four times Treatments such as Magnesium sulfate Phenobarbital dolatin and acupuncture were used but were ineffective Stopping these treatments I began with Chinese herbs Her pulse was wiry and fine and with heavy pressure it lacked strength Her tongue was pale and white My differential diagnosis was post partum Blood vacuity with inner Wind coercing Phlegm I used Mu Li Long Chi Tang Oyster Shell Dragon Tooth Soup with the addition of the following herbs GouTeng DangGui ChuanXiong Zhi Li Ban Xia Dan Nan Xing Shi Chang Pu This decoction was poured gently down the unconscious patient s throat In about five to six hours the seizures finally stopped The next day her blood pressure was 130 90 and her condition continued to be stable After eight days on October 24 she left the Translated by Sharon Weizenbaum 2021

15 Preeclampsia and Eclampsia Ebook hospital Commentary The overall results of treatment of the above mentioned 24 cases was relatively effective regardless of whether the swelling was dispersed the blood pressure went down or there was control over the protein in the urine Of the 21 cases of threatened eclampsia after treatment not one case developed into eclampsia Three cases had not had Chinese herbs before entering the hospital but were given Mu Li Long Chi Tang Oyster Shell Dragon Tooth Soup after being in the hospital for a period of time after which the symptoms were under control It is clear that Chinese herbal prescriptions can treat eclampsia There were truly good results and this is worth exploring and improving Case 5 Toxemia in Pregnancy One Case Study from Section of the Treatment of Liver Pathology From Qiu Xiao Mei s Gynecology Ms Liu was a thrty one year old worker who was seven months pregnant She suffered from dizziness tinnitus lower limb swelling and dry knotted bowels Overworking lead to Qi counterflow Her Translated by Sharon Weizenbaum 2021

16 Preeclampsia and Eclampsia Ebook pulse was wiry slightly slippery and her tongue body was crimson Her blood pressure was 148 104 Her western diagnosis was toxemia in pregnancy The TCM differential diagnosis was depletion damage of Yin fluid and Liver Wind moving internally For treatment it was appropriate to enrich Yin calm and press down the Liver and extinguish Wind I gave her three packages of the following perscription Da Sheng Di 30 gm Xian Shi Hu 9 gm Zhi Nu Zhen Zi 15 gm Zhi Huang Jing 12 gm Chao Huai Mi 30 grn Duan Shi Jue Ming 30 gm Jue Ming Zi 30 gm Ling Ci Shi 30 gm Huang Qin 9 gm Sang Ji Sheng 9 gm Second Visit After the herbs Ms Liu s dizziness decreased slightly and her bowels became moist The counterflow Qi also calmed I continued with the same method and gave her five Ji the following prescription Translated by Sharon Weizenbaum 2021

17 Preeclampsia and Eclampsia Ebook Da Sheng Di 30 gm Zhi Huang Jing 12 gm Sang Ji Sheng 9 gm Huang Qin 9 gm Sheng Mu Li 30 gm Zhi Nu Zhen Zi 15 gm Chao HuaiMi 30 gm Ling Ci Shi 30 gm Duan Shi Jue Ming 30 gm Bai Shao 9 gm Miscelaneous Eclampsia Cases3 Case 1 Dang Gui Shao Yao San Ms Li was age 25 Her first consultation was January 12 1981 It was a severe winter and she worked as a hospital manager at the Yangtze river dam construction project I received her call at midnight to come visit She was 7 months pregnant and had swelling of her lower limbs and face Her whole body was twitching and her spirit was not clear Her eyes were wide open and barely blinking Then after a short while she would come to 3 Experiential Cases from Famous Doctors and Formulas of Past Generations Beijing Science and Technology Press April 2009 Translated by Sharon Weizenbaum 2021

18 Preeclampsia and Eclampsia Ebook herself again Then a moment later it would happen again Her tongue was deep red and it was enveloped by white sticky moss Her pulses were wiry thin and slippery Her blood pressure was 160 100 mmHg Her family members represented her and said that at about 6 months she began to get headaches and dizziness and a mild desire to vomit Her limbs and face had water swelling The size of her baby was checked to see if it was small for dates but it was not yet a problem That evening she had had a quarrel with a neighbor She returned home sullen and then suffered this illness She took western medicines to try to deal with this but there was no effect Taking the pulse and presentation into account this was diagnosed to be fetal epilepsy The disease was recognized as serious and the hospital recommended that she go to a different hospital Because of the limitations of time the family asked me to come I thought about the situation knowing I had to extinguish wind and stop convulsion separate out the phlegm turbidity help the Qi flow along and open the orifices I gave her modified Dang Gui Shao Yao San Dang Gui 10 gm Bai Zhu 10 gm Shi Chang Pu 10 gm Translated by Sharon Weizenbaum 2021

19 Preeclampsia and Eclampsia Ebook Dan Nan Xing 10 gm Chuan Xiong 6 gm Hu Po Wei 6 gm add powder after Bai Shao 60 gm Gou Teng 30 gm Ze Xie 15 gm Fu Ling 15 gm Dan Shen 15 gm She was given one package After taking two boils the twitching eased She vomited spittle from her mouth and her urination was frequent and abundant The evil was very strong and it would be difficult to overcome it I advised her to take another package and the situation was improving The next morning I returned and the twitching had ceased and her spirit was clear She still had a headache dry mouth fatigue and poor appetite The swelling had dispersed and her blood pressure was 130 90 I continued by nourishing blood regulating the liver fortifying the spleen and seeping dampness so as to consolidate the fetal source Dang Gui 10 gm Translated by Sharon Weizenbaum 2021

20 Bai Zhu Preeclampsia and Eclampsia Ebook 10 gm Nu Zhen Zi 15 gm Han Lian cao 15 gm Bai Shao 15 gm Huang Qin 3 gm Fu Ling Pi 15 gm Sha Ren 3 gm She was given 5 packages I received a letter after some time and there had been no repeat of the convulsions She had a son at full term and both mother and child were well Discussion This formula uses a high dosage of Bai Shao to restrain the liver Dang Gui nourishes the blood and moderates spasms Gou Teng extinguishes wind stops convulsions and clears heat from the heart Chuan Xiong smooths out the liver wood by pungently opening Bai Shao is sour and restraining Dan Shen regulates and smooths the movement of the blood in accordance with the saying that moving the blood will naturally extinguish wind Bai Zhu Fu Ling Ze Xie Chang Pu Dan Nan Xing and Hu Po return the correct and fortify the spleen disinhibit and seep phlegm turbidity open the orifices and resuscitate the consciousness In one formula Translated by Sharon Weizenbaum 2021

21 Preeclampsia and Eclampsia Ebook many demands are met Wind is put to rest phlegm is dispersed the heart and brain are clear and harmonious Disaster was headed off 1987 2 37 Case 2 Dang Gui Shao Yao San Ms Peng was 20 years old She was 8 months pregnant She was working in the fields in early spring when there was a sudden wind and she had a convulsion Her arms and legs were in spasm and her spirit was closed That night the baby died The next day I came for a consult I saw that she had swelling throughout her whole body Her mouth was dry and her urine was scanty There was slight twitching in her four limbs Her spirit alternated between being clear and darkened There were phlegm sounds from her throat like a saw Her tongue was red with white sticky moss and her pulses were wiry and thin as well as slippery This was fetal epilepsy and was a serious situation The treatment principle was to nourish the blood calm the liver fortify the spleen seep dampness clear away phlegm and open closure She was given 2 packages of the following formula Translated by Sharon Weizenbaum 2021

22 Preeclampsia and Eclampsia Ebook Quan Dang Gui 6 gm Bai Zhu 10 gm Shi Chang Pu 6 gm Dan Nan Xing 10 gm Chuan Xiong 4 gm Hu Po Wei 3 gm add powder after Hang Bai Shao 30 gm Gou Teng Gen 12 gm Fu Ze Xie 12 gm Fu Ling 15 gm Hang Bai Ju Hua 10 gm After the two packages the wind was calmed and the closure opened Her pulse became moderate I gave her the same formula with Tao Ren Ze Lan and Jiao Shan Zha added After one package the baby came out unimpeded After two packages her appetite came back and her spirit became clear The cough was due to the closure opening and Qi rising I used herbs to stop cough and down bear Qi and all was well Discussion Fetal epilepsy is a presentation that is most violent and acute The Yi Xue Xin Wu says that if it is not treated quickly both the mother and child can die In this case the woman was 8 Translated by Sharon Weizenbaum 2021

23 Preeclampsia and Eclampsia Ebook months pregnant and her child had already perished The pulse and presentation showed that the disease cause was her frail body and over work There must have been inner wind that wanted to move about and the earth was damaged so water over flowed The was portended by dizziness in the head and eyes and swelling of the limbs As her pregnancy progressed the jing and blood congealed to nourish the fetus so the liver and kidneys were depleted The wood s water was diminished so Yang could harass and wind could spin This violated the middle earth and so the healthy movement was not controlled The fluids then could not be correctly transformed so there was overflowing phlegm turbidity Then the wind made a surprise attack and so the interior and exterior interacted with each other The wind illnesses banded together There was a fierce collision Zong Tang Rong said Fetal epilepsy comes when a pregnant woman is blood deficient and the wind evil enters the liver This can be treated with Xiao Yao San and Xiao Chai Hu Tang Dang Gui Shao Yao San with these added flavors nourishes the blood levels the liver fortifies the spleen seeps dampness clears away phlegm and opens the orifices The wind rests the closure opens the spirit clears and the appetite returns 1989 2 28 Translated by Sharon Weizenbaum 2021

24 Preeclampsia and Eclampsia Ebook Case 3 Dang Gui Shao Yao San Ms Cao was a 25 year old peasant She came in on March 5 1986 She developed fetal epilepsy 17 days after giving birth She used western medicines to stop the convulsion however her whole body was swollen and she had head pain dizziness and her eyes were unclear The medicines didn t work Her blood pressure continued to be high at 150 110 mmHg to 180 130 mmHg Her urine showed albumin red blood cells white blood cells Her retinas had become bloodshot and swollen Her complexion lacked luster and her fingernails were pale Her tongue moss was white and slightly sticky and the body was pale with red on the sides Her pulse was thin and rough This was blood stasis accumulating on the interior and lack of regulation of the Chong and Ren The treatment was to vitalize blood transform stasis and regulate the Chong and Ren She was given two packages of the following formula Dang Gui 12 gm Bai Zhu 10 gm Tao Ren 10 gm Chi Shao 10 gm Translated by Sharon Weizenbaum 2021

25 Preeclampsia and Eclampsia Ebook Chuan Xiong 15 gm Hong Hua 10 gm Yi Mu Cao 30 gm Dan Shen 15 gm Huai Niu Xi 30 gm Du Zhong 15 gm Ze Xie 30 gm Second visit 3 7 1986 The dizziness had decreased and the head pain had stopped Her blood pressure was 160 120 Her tongue was pale and her pulse was as before I gave her 3 packages of the same formula with Ze Xie increased to 20 gm and 10 gm of Yin Yang Huo Third visit 3 11 1986 Her intake of food and liquid had increased and her spirit changed for the better The edema had clearly decreased Her blood pressure was now 150 110 The sides of her tongue were pale with toothmarks I continued to use the above formula with 15 gm of Huang Qi Forth visit 3 18 1986 The water swelling had decreased and she could make out the shadows of people with her vision Her blood pressure was 130 90 Translated by Sharon Weizenbaum 2021

26 Preeclampsia and Eclampsia Ebook mmHG and her albumin in the urine was normal She was given the above formula with Ze Xie removed and Yi Mu Cao decreased to 10 gm After 9 more packages she could clearly see 5 fingers She still felt weak in her low back and knees Her tongue was pale red and her pulse was thin and moderate The illness had clearly changed for the better so she was given Qi Ju Di Huang Wan thereafter Discussion Postpartum fetal epilepsy begins in pregnancy Because the abdomen is increasing in size there is blockage and this leads to stagnation in the ascending and descending of the Qi When Qi congeals blood congeals and so the Chong and Ren lose their regulation All of the pathology arises from here Therefore the treatment principle is to vitalize blood transform stasis and regulate the Chong and Ren vessels Modified Dang Gui Shao Yao San was given so that the branch and root were both treated The effect was good 1988 4 28 Case 4 Da Cheng Qi Tang given as an Enema Ms Zhou was age 32 She was a peasant On May 30 1987 at 6 in the afternoon she had just given birth to her third child and the Translated by Sharon Weizenbaum 2021

27 Preeclampsia and Eclampsia Ebook placenta was stuck Her whole body twitched her jaw locked and she couldn t speak and then went into a coma and did not wake up She came to the gynecology clinic at my hospital During her pregnancy at about 5 months she often felt dizzy with a desire to vomit She came to seek a doctor for treatment On May 29th at dusk she began to feel abdominal pain The fetus moved and then she had head and visual dizziness Then she vomited twice Soon she fainted and her whole body twitched and convulsed Her jaw was tightly closed They sought the country doctor to treat her but it was ineffective On May 30 she gave birth to a daughter and urgently came to the hospital Her temperature was 40 7 C 105 26 F Her heart rate was 146 beats minute There were watery rales in her lungs and her blood pressure was 166 108 The convulsions did not stop Western medicine was not effective She was given Da Cheng Qi Tang modified as an enema Zhi Shi 20 gm Hou Po 15 gm Da Huang 15 gm Mang Xiao 30 gm E Jiao 50 gm Dang Gui 15 gm Fa Ban Xia 15 gm Translated by Sharon Weizenbaum 2021

28 Chen Pi Preeclampsia and Eclampsia Ebook 8 gm By June 2nd she was cured and left the hospital Discussion In this case the woman had high blood pressure and so developed eclampsia Her body type was abundant and she was pregnant These factors hindered the rising and falling of the Qi mechanism This is why there was dizziness in the head and eyes and high blood pressure Suddenly phlegm fire rose to cover the clear orifices This is why there was twitching and unconsciousness The formula wsa based on the Jin Gui Yao Lu chapter on Tetany Damp and Thirst Illness This chapter says When there is tetany illness there is chest stuffiness lockjaw inability to lie flat spasming feet and there will certainly be grinding of the teeth Da Cheng Qi Tang can be used For a newly partuent woman one must consider the Yin and blood That is why the formula contains a large amount of E Jiao This will nourish blood and enrich Yin Dang Gui will moisten the intestine to open through the bowel Fa Ban Xia and Chen Pi dry damp and dispel phlegm Because there was lockjaw the herbs were given through an enema with good effect Translated by Sharon Weizenbaum 2021

29 Preeclampsia and Eclampsia Ebook Case 5 Wu Mei Wan Ms Zhang age 20 came for her first visit on July 5 1956 She was 7 months pregnant and she suffered from abdominal pain It was especially extreme in her lower abdomen She was vomiting phlegm spittle and her four limbs were cold Her whole body was rigid and she had lost consciousness The fetal position was pressing down Her tongue moss was yellow and white her temperature was 37 4 C and her pulses were wiry and slippery Differentiation of the pattern Qi and blood without harmony diminished consciousness so that the evil toxin Qi could enter Treatment principle Supplement Qi drive out the evil harmonize blood and transform phlegm For the time being use Zhong Jing s method to treat Wu Mei 3 pieces Lu Dang Shen 15 gm Huang Bai 6 gm Gui Zhi 4 5 gm Huang Lian 4 5 gm Xi Xin 3 gm Dang Gui 9 gm Chuan Xiong 6 gm Translated by Sharon Weizenbaum 2021

30 Preeclampsia and Eclampsia Ebook Qi Jiao pepper 6 gm Wu Zhu Yu 4 5 gm Sheng Jiang 3 gm Second visit She reported that after one package the fetal position became normal and the abdominal pain also lessened She took three more packages and the illness was already cured She was afraid it would return so she made a return visit Her body temperature was 37 5 C and her pulses were slippery and fast I used the Jin Gui Yao Lue method and she was good after that Bai Zhu 9 gm Lu Dang Shen 9 gm Dang Gui 9 gm Chuan Xiong 6 gm Bai Shao 12 gm Ze Xie 6 gm Fu Ling 9 gm 617 Translated by Sharon Weizenbaum 2021

31 Preeclampsia and Eclampsia Ebook Zhu Xiaonan s Experience with Eclampsia4 Case 1 Postpartum Eclampsia Ms Fang age 30 peasant married Ms Fang had given to her third child previously and then her hands and feet began to twitch She then began to convulse and went into a coma In 1960 several days into the postpartum time after her fourth child it suddenly happened again She was unaware of her surroundings and then in an instant regained awareness She had visual dizziness and back soreness and weakness gone unconscious and then revived immediately Her family was worried it would happen again and that it could be dangerous so they accompanied her to the hospital for a consultation Her first visit was August 3 1960 It was 22 days after birth and the lochia had not stopped She experienced chest oppression dizziness A few days previously she suddenly went unconscious and then revived Her tongue was red with thin yellow moss Her pulse was thin and rapid This was eclampsia due to blood 4 From Zhu Xiaonan s Experience in Gynecology People s Hygiene Press 10 2005 Translated by Sharon Weizenbaum 2021

32 Preeclampsia and Eclampsia Ebook deficiency with flaring fire Liver wind harassing upward The treatment was directed at nourishing the blood and calming the Liver Zi Bei Chi 24 Nen Gou Teng 18 Ming Tian ma 2 4 Dan Zi Qin Huang 9 Qin Chao Zhi Qiao 4 5 Sheng Di 12 Yu Jin 9 Yuan Zhi 9 Chao Zao Ren 9 Qing Hao 9 Jiao Bai Zhu 6 Xin Hui Pi Chen 6 Pi Fu Ling Pi 9 Second visit This was mid summer time in the countryside and the weather was hot Fearing she would be exposed to wind the Translated by Sharon Weizenbaum 2021

33 Preeclampsia and Eclampsia Ebook windows were kept closed Dr Fu repeatedly warned the postpartum woman should not receive wind Nor should she be in a stuffy room The window should just be slightly open Second visit August 5 The herbs were quite effective The head and eyes were clear She did not feel dizziness again Her chest and rid side felt full and her appetite was low She had palpitations and her sleep was unsettled This was Yin deficiency with inner heat and blood failing to nourish the Heart The treatment was directed to submerge the Yang and enrich Yin level the Liver and calm the Shen Zi Bei Chi 18 Nen Gou Teng 12 Fu Shen 9 Yuan Zhi Rou 9 Chao Zao Ren 9 Qing Hao 9 Sheng Di 12 Zhi Shou Wu 9 Yu Jin 6 Bai Zhu 6 Translated by Sharon Weizenbaum 2021

34 Du Zhong Preeclampsia and Eclampsia Ebook 9 Sheng Gan Cao 2 4 After this the eclampsia did not come back Discussion Birth eclampsia is a grave illness It manifests during or after birth The symptoms of birth eclampsia are the same as pregnancy eclampsia Zi Xian except that it occurs during or after birth while pregnancy eclampsia occurs during pregnancy In this case the patient had lost a lot of blood during birth and so her Yin and Ying were forced out This resulted in her Yang becoming less and less submerged and the Liver Yang then harassing upward This was during the hot days of summer The postpartum woman was in bed and it was very warm in the room These conditions induced the illness After treatment she moved to a room with ventilation In regard to the principles for applying herbs for birth eclampsia the Yi Xue Xin Wu Medical Revelations advocates Greatly boosting the Qi and blood is the principle when the fetal Qi Translated by Sharon Weizenbaum 2021

35 Preeclampsia and Eclampsia Ebook descends However this is only a reference and we cannot be rigid Dr Zhu feels it is important to nourish the blood and sink the Yang level the Liver and clear and release At the first visit He used Zi Bei Chi to submerge the Yang He used Gou Teng Tian Ma Huang Qin and Qing Hao to level the Liver and clear heat He used Sheng Di to supplement blood and Zao ren and Yuan Zhi to calm the Shen He used Chen Pi Bai Zhu and Fu Ling to fortify the Stomach and Spleen Yu Jin relaxes the chest and regulates Qi The results were striking At the second visit the dizziness had cleared and the chest had broadened This showed that the floating Yang had gradually descended When the symptoms of blood failing to nourish the heart appeared which were palpitations and insomnia the principle of treatment was to supplement Qi enrich Yin nourish blood and calm the Shen She was then given Fu Shen Zao Ren and Yuan Zhi along with Sheng Di and Shou Wu Herbs to submerge the Yang and subdue so that the Liver Yang would not be rekindled were continued though smaller amounts of these herbs were used I also increased the herbs to broaden the chest and fortify the Spleen in order to improve the appetite She was cured after this Translated by Sharon Weizenbaum 2021

36 Preeclampsia and Eclampsia Ebook Case 2 Threatened Eclampsia Ms Huang was age 28 and was a worker She came for her initial consultation on November 30 1976 She was eight months pregnant with her first child She reported having extreme vomiting in the early pregnancy Her urine acetone was positive but there was no history of bleeding On the 15th of the month she developed swelling in her feet but at that time her blood pressure was normal On the 25th her whole body was swelling She had a cough chest and rib side pain bad indigestion viscous stool headache nose bleed and itchy skin Her blood pressure was 180 120 There was proteinuria and a granular urinary cast The liver function test showed the GGT to be 88 units The lung auscultation revealed wet rales Her body temperature was 37 2 C 98 96 F Her pulses were wiry thin and rapid Her tongue body was dark with yellow sticky moss and there was hyperpigmentation on her lips and both cheeks This was liver effulgence and kidney deficiency deficiency of Yang with upward reversal and loss of regular movement of the spleen Water damp was overflowing For treatment it was appropriate to clear heat and level the liver descend reversal fortify the spleen and disinhibit damp to scatter swelling She was given five packages of the following formula Chi Xiao Dou 4 qian Translated by Sharon Weizenbaum 2021

37 Lu Dou Preeclampsia and Eclampsia Ebook 4 qian Hei Dou 4 qian Yin Hua 3 qian Sheng Gan Cao 1 5 qian Tu Fu Ling 4 qian Ze Xie 4 qian Tian Xian Teng 4 qian Dong Kui Zi 3 qian Sang Bai Pi 4 qian Discussion Toxemia in pregnancy happens easily It is mostly due to liver and kidney Yin deficiency with spleen Qi insufficiency After a woman becomes pregnant the blood gathers to nourish the fetus leaving the Yin and blood progressively diminished When the liver is unmoistened or nourished the causes Yin deficiency with overbearing Yang In this case the disease factors were complex with immanent signs of eclampsia If the liver wind moved internally there would be the critical situation of eclampsia At the time of the visit the patient s consciousness was clear but there were many symptoms Entering the gynecology ward of the hospital the doctor recommended surgery to fetch the baby Translated by Sharon Weizenbaum 2021

38 Preeclampsia and Eclampsia Ebook However the patient and family wanted to try Chinese herbs to try to avoid surgery They wanted to use a combined western and Chinese approach Hence a formula was given to level the liver descend reversal fortify the spleen benefit dampness to scatter swelling San Dou Yin was given with modifications The formula as a whole used bland seepage and slippery disinhibiting coursing and discharging the liver Qi After ten days the family reported that the swelling diminished after the herbs and that the blood pressure descended At term she gave birth to a daughter He Zihuai s experience in Preeclampsia5 The earliest mention of eclampsia appears in the the Zhu Bing Yuan Hou Lun General Treatise on the Causes and Symptoms of Diseases6 where it is considered to be convulsion in pregnancy that recurs In the Nu Ke Yi Yao Humbly Request for Gynecology says that when there is eclampsia the person does not easily know Perhaps they are dizzy or have cold numbness When it is serious they fall to the ground in a coma When you examine their eyes they are darkened They may alternate between recognizing clearing and going dark again This is generally seen in 5 6 He Zihuai s experience in Gynecology Zhe Jiang Science and Technology Press 9 1982 By Chao Yuanfang et al 610 AD Translated by Sharon Weizenbaum 2021

39 Preeclampsia and Eclampsia Ebook pregnant women or just after pregnancy Sometimes there is head and eye dizziness and when it is extreme there are convulsions and falling into a coma This is preeclampsia In Chinese medicine this pattern of eclampsia is most often one of body deficiency and receiving wind There may be heart and liver heat and the heat when extreme generates wind For example in the Yi Zong lin Jian The Golden Mirror oJ Medical Lineages eclampsia is considered to occure due to wind heat in the liver and heart channels The heart governs the vessels and the liver governs the sinews Heart belongs to fire and livers governs wind The Neijing says that wind arouses illness in the myriad things All wind swaying and dizziness belong to liver The main idea is that falling and dizziness is the shaking movement of liver wind Yin deficiency with heats up fire blood deficiency generates wind and wind and fire arouse each other The sinews and Luo are undernourished and this makes the hands and feet twitchy Alternatively phlegm can rise up and harass so that the one loses consciousness Clinically there are two types that determine treatment Wind Heat liver wind Type In general when there is effulgent fire of the heart and liver there is head and visual dizziness red face and dry mouth The emotions Translated by Sharon Weizenbaum 2021

40 Preeclampsia and Eclampsia Ebook are agitated and there is a tendency to easy anger The pulses are wiry and vigorous In pregnancy the illness can come on suddenly with head dizziness as if one might fall chest oppression vomiting high blood pressure scanty urination and edema One may see albumen in the urine Because the liver is the Zang to store the blood the pregnant woman depends on it to nourish the fetus When the liver Yin is insufficient the water will not moisten the liver and so the liver Yang is over abundant and this causes the liver wind to internally harass At this time this is most often going to threaten eclampsia One should treat as early as possible as the Yin and blood become more and more diminished as time goes on and the liver Yang grows The liver wind then rebels and this can lead to a serious condition of unconsciousness and convulsions Treatment Principle nourish and enrich the blood and Yin level the liver and extinguish wind Herbs and Formulas Ling Yang Gou Teng Tang modified Commonly used herbs are Ling Yang Jiao Sheng Di Huang Sheng Shi Jue Ming Long Chi Zi Bei Chi Gou Teng Sang Ye Shi Chang Pu Gan Ju chamomile Tian Ma Tian Chong centipede and Xie Wei scorpion Translated by Sharon Weizenbaum 2021

41 Preeclampsia and Eclampsia Ebook Case 1 Preeclampsia Ms Qian was age 36 a worker and married She had a history of hypertension and when she was pregnant four months her blood pressure went up to 160 92 The liver Yang was full and vigorous The wood fire was harassing the interior with dizziness visual dizziness dry mouth and parched tongue Her urine was dry and knotted and her pulses were wiry slippery and strong The treatment principle was to nourish the Yin level the liver and calm the fetus She was given five packages of the following formula Sheng Di 12 gm Huang Sheng Bai Shao 12 gm Gou Teng 12 gm Xuan Shen 12 gm Sang Ji Sheng 12 gm Sang Ye 12 gm Zhen Zhu Mu 30 gm Hei Han Lian 12 gm Bai Ji Li 9 gm Gan Ju 6 gm Translated by Sharon Weizenbaum 2021

42 Preeclampsia and Eclampsia Ebook Chao Zhu Ye 30 gm Return visit During her pregnancy the blood did not nourish the liver and water did not moisten wood Hence the liver Yang flowed upward so that there was dizziness numbness of the hands and feet and a lack of level of the moving power Phlegm and turbidity flowed upward with this as well It was appropriate to continue to enrich Yin and water extinguish wind transform phlegm She was given 5 packages Sheng Di 12 gm Huang Sheng Bai Shao 12 gm Gou Teng 12 gm Gou Qi Zi 12 gm Sang Ji Sheng 12 gm Xia Ku Cao 12 gm Sheng Shi Jue 24 gm Ming Chuan Bei Mu 9 gm Bai Ji Li 9 gm Gan Ju 6 gm Zhi Gan Cao 6 gm Translated by Sharon Weizenbaum 2021

43 Preeclampsia and Eclampsia Ebook Third visit There was little coughing of phlegm and the twitching decreased and leveled Again herbs from the submerge Yang category were used This was assisted with herbs to scour phlegm and open the orifices 5 packages Shi Chang Pu 6 gm Zhu Li 1 branch Tian Chong 12 gm Chuan Bei Mu 12 gm Sheng Bai Shao 12 gm Xia Ku Cao 12 gm Sheng Shi Jue 12 gm Ming Hou Wu 12 gm Bai Ji Li 12 gm Gou Teng 12 gm Pi Pa Ye 12 gm All of her symptoms calmed After stopping the herbs for more than one month the hot season arrived Internally and externally she was beset with summer heat The fetus was restless and the liver Yang was more and more external with wood and fire Translated by Sharon Weizenbaum 2021

44 Preeclampsia and Eclampsia Ebook ascending There was surging movement in the clear sky with head and eye flowery dizziness twitching of the four limbs red eyes and dry mouth It was then appropriate to clear the liver enrich Yin and regulate the interior Fresh Sheng Di 30 gm Xian Lu Gen 30 gm Xian He Ye sheet Xian Shi Hu 15 gm Gou Qi Zi 12 gm Sang Ye 12 gm Sheng Bai Shao 12 gm Gan Ju 9 gm Hei Zhi Zi 9 gm Xian Zhu Ru 9 gm Huang Qin 9 gm Case 2 Preeclampsia Ms Xu was a married peasant who as 30 years old She was five months pregnant Because of a fall she went to the public health clinic Her blood pressure 190 96 She had dizziness and flowery vision Her four limbs were numb She moved from the public Translated by Sharon Weizenbaum 2021

45 Preeclampsia and Eclampsia Ebook clinic to consult a doctor She was given 5 packages of herbs to build up Yin pacify the liver and calm the fetus After more than 50 days the patient suddenly went unconscious not recognizing people and things Her hands and feet were twitching and her blood pressure was 240 120 This was liver Yin deficiency with Yang increasing Liver wind was harassing the interior and manifesting eclampsia It was urgent to level the liver and extinguish wind to control convulsion Ling Yang Jiao slices 3 gm Xian Shi Chang Pu 9 gm Jian Ye Song Xie 1 5 gm Wei And another formula Sheng Shi Jue Ming 15 gm Sang Ye 15 gm Zi Bei Chi 12 gm Sheng Di 12 gm Long Chi 12 gm Sheng Bai Shao 12 gm Shou Wu 12 gm Gan Ju 9 gm Translated by Sharon Weizenbaum 2021

46 Tian Chong Preeclampsia and Eclampsia Ebook 9 gm One package A half hour after taking the first formula the patient became conscious and the twitching stopped All other symptoms also decreased She was given two more packages and she was able to provide for herself so she stopped the herbs More than ten days later the patient had a premature birth The evening before giving birth she suddenly went unconscious Her pulses were wiry and urgent Her tongue was rolled up The eclampsia had happened again She was urgently given one pill of the official prescription Zhi Bao Da7n as well as Xian Chang Pu Ye scalded and taken She regained consciousness a half hour after taking this She went into labor two days later and both mother and child were well Discussion Imitating the Nu Ke Mi Jue Secrets of Success in Gynecology in the treatment of eclampsia if it is light one should use Gou Teng Tang For example in case one it was serious and so Ling Yang Jiao San was used modified In case two there were precursor symptoms and so herbs were used to level the liver and nourish the 7 or is made up of Yin Bo silver foil 50 sheets Niu Huang 15 gm An Xi Xiang benzoin 45 gm Wu Xi Xie black rhino bits 30 gm Zhu Sha cinnabar 30 gm Xiong Huang realgar 30 gm Dai Mao Xie hawksbill turtle bits 30 gm Hu Po amber 30 gm She Xiang musk 7 5 gm Long Nao borneal 7 5 gm Translated by Sharon Weizenbaum 2021

47 Preeclampsia and Eclampsia Ebook Yin When it is serious one must use Ling Yang Jiao Li ShiZhen said that Ling Yang Jiao levels the liver and sooths the tendons stops wind and calms the Hun scatters blood and descends Qi wards off evil and resolves toxin It treats eclampsia and convulsion disease Long Chi Sheng Shi Jue Ming and Zi Bei Chi heavily sedate and clear the liver while at the same time calming the Shen Tian Ma Tian Chong and Xie Wei extinguish wind and sedate fright Shi Chang Pu fragrantly opens the orifices There is a large dose of Sheng Di because extreme heat generates wind and this disastrous burning damages the fluids It enriches Yin and moistens dryness and is not sticky It increases fluids and sooths the tendons The heat is gone and the wind extinguishes Consciousness returns and there is no damage to the fetal source If before a woman gives birth she is absent minded and twitching in a way that comes and goes both mother and child are in danger In the Tai Chan Xin Fa Heart Methods of Birth it says It is the time of evil In case two it was certainly that dangerous as she was about to give birth It was luck and the timely use of herbs to stop convulsion and open the orifices to urgently treat the outward signs This headed off disaster for the mother and child Translated by Sharon Weizenbaum 2021

48 Preeclampsia and Eclampsia Ebook Phlegm Unconsciousness Type Generally when one likes to eat foods with a thick flavor the spleen and stomach often receive damp evils as a result After pregnancy the mother s body is burdened and her digestion is not as strong This can lead to lack of flourishing of the central Yang and weak movement of the spleen The result is damp stasis When damp accumulates this can further weaken the spleen and this leads to a thickening and congealing of the Jin Ye fluids and ultimately to phlegm Chronic phlegm fire harasses the heart and stirs movement of the liver Yang so that liver wind is excited scurrying into the channels and Luo so that there is loss of consciousness and twitching At that time there is expectoration of watery white spittle and a phlegm sound The pulse is wiry and slippery as well as tight urgent and strong The tongue moss is thin and sticky and the tongue body is red and curled up There may also be edema and abdominal fullness with poor appetite Treatment Principle scour phlegm extinguish wind Herbs and Formula Zhu Li Zhen Zhu Fen swallowed Tian Zhu Huang Chuan Bei Mu Hua Ju Hong Sheng Bai Shao Gou Ten Fu Ling Ze Xie Shi Chang Pu and Ling Yang Jiao Translated by Sharon Weizenbaum 2021

49 Preeclampsia and Eclampsia Ebook Case 3 Preeclampsia Ms Qian was a married worker age 32 She was more than 7 months pregnant and her body tended to be rotund After becoming pregnant she over at thick sticky foods At times she felt dizzy and coughed up plegm This was damp phlegm stasis above and the Yin fire moved downward The damp phlegm mixed with deficiency fire surged upward Suddenly she was dizzy as if she were standing in a boat and she thought she might fall down She went unconscious and after regaining consciousness she felt short of breath with heart palpitations felt like she was floating Her tongue was red and felt curled up Her pulses were wiry slippery tight and urgent The treatment principle was to level the liver transform phlegm and extinguish wind She was given 2 packages of the following formula Zhu Li 1 Zhi Chao Pu 9 gm Chuan Bei Mu 9 gm Tian Ma 9 gm Bai Ji Li 9 gm Translated by Sharon Weizenbaum 2021

50 Gou Teng Preeclampsia and Eclampsia Ebook 9 gm Xia Ku Cao 12 gm Chao Bai Shao 12 gm Xian Di Huang 60 gm Jue Ming Zi 30 gm Return visit After clearing away phlegm and sedating convulsions extinguishing wind and opening constraint and assisting this with clearing and discharging the liver gallbladder heat There was a heavy dosage of Sheng Di to increase fluids All of her illness lessened The original formula was given with modifications Tian Ma Shi Chang Pu Tian Chong Huang Qin Chuan Bei Mu 9 gm each Sheng Bai Shao Gou Teng Shou Wu Sang Ye 12 gm each Zhen Zhu Mu 30 gm She was given 5 packages Third visit The urgency had already relaxed and her consciousness was clear and the cough had decreased Then I nourished Yin emolliated the liver as follows Sheng Di Gou Teng Shou Wu Mai Dong Qi Zi Sang Ji Sheng Xuan Shen and Sang Ye 12 gm each Bai Ji Li 9 gm Chao Zhu Ru 30 gm She was given 17 packages After the birth mother and child were well Discussion Translated by Sharon Weizenbaum 2021

51 Preeclampsia and Eclampsia Ebook The Shen Nong Ben Cao Jing says Zhu Li is greatly cold It treats sudden Zhong Feng wind Bi great heat in the chest stops vexation and stuffiness It also descends and calms the Shen and channels It lowers the blood pressure The Wai Tai Mi Yao says it treats eclampsia as follows If you are near bamboo you can grab some After making the Zhu Li make a soup with it And for all convulsions take it fresh In ancient times Zhu Li was a rescue from acute herb Clinically I have observed that it clears and discharges liver gallbladder inner heat scours phlegm settles fright and penetrates the Luo Therefore the Thousand Ducat Formulas says it For treating phlegm Qi vexation and dryness use this one flavor Zhen Zhu Fen submerges Yang settles fright transforms phlegm Chuan Bei Mu and Tian Zhu Huang cool the heart and resolve constraint transform phlegm clear heat and helps transform phlegm and makes it slippery Tian Ma and Gou Teng level the liver and extinguish wind Shi Chang Pu with Hua Ju Hong fragrantly transform phlegm and open the orifices Sheng Bai Shao enriches and nourishes Yin and blood A large amount of Xian Sheng Di nourishes Yin and increases fluid The formula as a whole transforms phlegm extinguishes wind calms the spirit and settles the will It can make the Ying Yin replenished and nourished It Translated by Sharon Weizenbaum 2021

52 Preeclampsia and Eclampsia Ebook causes the spleen to transport and spread so that the water damp naturally leaves and all of the pathology resolves The treatment method for eclampsia is to nourish the blood level the liver extinguish wind clear the heart and clear out phlegm It is relatively common to see threatened eclampsia in the clinic Because patients body types are not all the same and patterns are often complex with a variety of changing pathology the application of formula should also be given with flexibility In early and mid pregnancy it is very important that there is a clear vegetarian diet Fatty food should be eaten with care It is very important to pay attention to the blood pressure Enriching and supplementing ingredients shouldn t be given chaotically The above discussion is for the treatment of illness before birth For postpartum eclampsia is not handled the same as pregnancy eclampsia For pregnancy eclampsia on should not use the principle of greatly boost the Qi and blood returning the correct and fostering the source Another He Zihuai Case Case 4 Threatened Eclampsia Ms Li age 28 came for her first consult on May 6 1975 She had head and visual dizziness swelling in her lower limbs constipation Translated by Sharon Weizenbaum 2021

53 Preeclampsia and Eclampsia Ebook mouth thirst heart vexation difficult sleep She was already postdate by 12 days yet still had no contractions On the right her pulse was wiry and slippery and on the left it was wiry thin and slippery At the root her tongue moss was peeled and her tongue body was tender and red Her blood pressure was 150 100 This was Yin and blood insufficiency heart and liver fire effulgence and spleen damp accumulating on the interior The method was to enrich water level the liver clear the heart and seep dampness She was given one package of the following formula Sheng Di 12 gm Shan Zhu Yu 12 gm Bai Shao 9 gm Bai Ji Li 9 gm Ju Hua 9 gm Dan Pi 9 gm Gou Teng add after 12 gm Chao Shan Zhi 9 gm Ling Yang Jiao 9 gm as powdered draft Yi Yi Ren 12 gm Fu Ling 12 gm Translated by Sharon Weizenbaum 2021

54 Preeclampsia and Eclampsia Ebook Tao Ren crushed 9 gm Che Qian Zi 12 gm wrapped Second visit The head dizziness had decreased and the visual dizziness was gone The was swelling in her lower limbs had retreated There was acute pain in her knees and her stool was dry and knotted Her pulses were wiry and thin The pulse of her middle finger was showing Her tongue moss was thin and the body was tender and red Her blood pressure was 146 90 It was still important to level the liver and enrich water Sheng Di 12 gm Shan Zhu Yu 12 gm Bai Shao 9 gm Chi Shao 9 gm Dang Gui 9 gm Dan Pi 9 gm Yi Yi Ren 15 gm Tao Ren crush 12 gm Bai Ji Li 12 gm Gou Teng add after 15 gm Qu Mai 12 gm Translated by Sharon Weizenbaum 2021

55 Tu Niu Xi8 Preeclampsia and Eclampsia Ebook 30 gm Zhi Da Huang 9 gm Gui Jiu9 9 gm Hong Hua 4 5 gm Ling Yang Jiao 3 as draft powder Third visit The dizziness was gone and the bowel moved through The day before she had abdominal pain that was increasing On the day of this visit she had cramping abdominal pain and pain in her knees and limbs Her pulse was small slippery and fast Her middle finger pulse moved to her finger tip The tongue moss was thin and the tongue body was paler Her blood pressure was 120 80 Her Yin fluids had begun to return and her liver Yang had leveled However she was two weeks past her due date She continued with the same method and was given one package of the following formula Sheng Di 12 gm Zhi Xiang Fu 15 gm Tai Wu Yao 12 gm Chi Shao 12 gm 8 9 Achyranthes aspera Linn var india Linn Or Achyranthes bidentata Rhizoma Dysosmae Versipellis Common Dysosma Rhizome Translated by Sharon Weizenbaum 2021

56 Dang Gui Preeclampsia and Eclampsia Ebook 9 gm Tao Ren 12 gm Hong Hua 9 gm Chuan Xiong 9 gm Qu Mai 15 gm Gui Jiu 9 gm Bai Ji Li 12 gm Gou Teng add after Forth visit There was no longer dizziness and the floating red on her face had gone In the middle of the night she had abdominal pain and uterine contractions but they calmed in the morning She had back soreness frequent and inhibited urination There was pulsing on the left middle finger and the right one was resounding Her pulses were soft and slippery and her tongue moss was thin and white Her blood pressure was 136 90 She was again given herbs to regulate Qi vitalize blood and guide the fetus to move downward The previous formula was used with added herbs 15 gm Dang Shen 9 gm E Zhu and 12 gm Ji Xing Zi10 She was instructed to take 2 packages each day one package every 6 hours 10 Semen Impatientis Translated by Sharon Weizenbaum 2021

57 Preeclampsia and Eclampsia Ebook Fifth visit After taking the herbs to move the baby downward at three in the morning she began to have severe abdominal pain and at 5 am it relaxed and resolved She was given electrical acupuncture on San Yin Jiao Sp 6 She felt her abdomen distend and her left middle finger had a pulse but her right finger pulse was not felt Her tongue moss was thin white Her blood pressure was 120 80 She still needed help to guide the fetus She was given 2 packages and instructed to take one every 6 hours Dang Shen 9 gm Dang Gui Wei 9 gm Chuan Xiong 9 gm Hong Hua 6 gm Qu Mai 15 gm Tu Niu Xi 30 gm Gui Jiu 12 gm Gou Teng add after 12 gm E Zhu 9 gm Ji Xing Zi 12 gm Sheng Da Huang add 9 gm after Yi Mu Cao 15 gm Tao Ren 12 gm Translated by Sharon Weizenbaum 2021

58 Preeclampsia and Eclampsia Ebook Zhi Xiang Fu 15 gm Tai Wu Yao 12 gm Bai Ji Li 12 gm Sixth visit After taking these herbs the gynecology exam showed that the cervix was completely open She had slight back soreness and her pulses were soft and rapid Her tongue moss was thin and white She was given herbs to level the liver and guide the fetus Dang Gui 9 gm Chi Shao 9 gm Hong Hua 6 gm Tao Ren 12 gm Zhi Xiang Fu 15 gm Bai Ji Li 12 gm Tu Niu Xi 30 gm Gui Jiu 12 gm Tian Xian Teng 30 gm Ji Xing Zi 9 gm Sheng Da Huang add 9 gm after Sheng Shi Jue 15 gm Translated by Sharon Weizenbaum 2021

59 Preeclampsia and Eclampsia Ebook She took on package every 6 hours At 6pm that day she gave birth to a son with forceps Discussion The pulsing on the middle finger of both hands can be a clear indicator of the progress of labor Along with the dates that move toward birth the finger pulse moves up the finger from the first joint to the fingertip From the start of uterine contractions to after the birthing process the finger pulses appear strong and forceful with a surging out feeling along with the birthing process The surging out quality of the pulsing is from the root of the finger section toward the fingertip At the time of birth it reaches the fingertip Master Pang did extensive study among the people on the basis of finger pulse during birth of a child This will be used as a reference for the primiparous woman and is truly valuable Notes on the Finger Pulse Dr Qiu Xiao mei s introduced me to the use of the finger pulse as a diagnostic tool during labor It can give the doctor a reading on the woman s readiness to give birth the dilation of the cervix and the strength behind the contractions I have translated and read case studies in which the finger pulse is used but I had never read anything in particular about its meaning or how to do it I decided Translated by Sharon Weizenbaum 2021

60 Preeclampsia and Eclampsia Ebook to do a bit of a query to some knowledgeable friends of mine I got a lengthy reply from Steven Clavey He sent me a descriptive passage in Chinese that I translated this morning as well as a diagram and a few words of his own I ve included all this here and have also added a couple of cases of Dr Qiu Xiao mei to illustrate her use of the finger pulse In the first case the finger pulse was weak and this indicated to Dr Qiu that a strong tonification method was necessary In the second case the finger pulse was strong but did not extend to the fingertip This indicated a case of stagnation and so strong abducting herbs were given It is interesting to note the use of Quinine as an agent to induce labor Because quinine has this effect it cannot be used to treat malaria in pregnant women There are many writings about how to treat women who contract malaria during pregnancy with Chinese herbs because quinine is contraindicated So here it is About the finger pulse The middle finger has three joints This can be divided into 7 sections The first finger joint has 1 section The Translated by Sharon Weizenbaum 2021

61 Preeclampsia and Eclampsia Ebook second finger joint has the 2nd and 3rd sections The third finger joint has the 4th 5th 6th and 7thsections When checking the woman should be supine with the hand stretched out flat The doctor uses her thumb and two eating fingers curved to form a hoop and grasps the middle finger To do the exam at the beginning of each contraction move from the first finger joint toward the fingertip When the finger vessel pulsing feels strong and forceful in a throbbing manner this is normal The arm of the woman in labor should be laying stretched out comfortably with the palm up There should be nothing to obstruct the circulation of blood The finger pressure should not have too much tension If there is too much tension you may get confused by your own finger pulse If you don t feel this sufficiently on either side of the middle finger you can seek it more toward the back of the hand or toward the palm side Generally it is easiest to feel on the middle finger The pulsing is most clear from the time a contraction begins to the time it ends so this is the standard time during which it should be checked When labor first begins the contractions are relatively light and the time between contractions is relatively long The pulse beats at the first and second section During the first stage of birth in which labor is progressing and the cervix gradually opens the finger pulse Translated by Sharon Weizenbaum 2021

62 Preeclampsia and Eclampsia Ebook also moves toward the fingertip From the time that the cervix is open 6 7 centimeters until it is completely open the finger pulse progressively reaches section 5 6 and 7 and the finger pulse shows clear strength During the second stage of labor in which the baby is ready to come out the woman begins to hold her breath to increase abdominal pressure and the finger pulse comes with even more force This force continues until the placenta is discharged Steve Clavey wrote First mention I know of for the finger pulse is in Zhang Jing Yue s Fu Ren Gui Standards for Gynecology I have not used it myself but I might start trying it Basically you feel along the side of the middle finger with your thumb and forefinger applying even pressure not too tight and see if you can feel a pulse It isn t always right in the middle of the side of the finger it might be more toward the palm or the back of the hand The pulse moves higher up the finger the as the end of pregnancy progresses Closer to the top it starts to show the degree Translated by Sharon Weizenbaum 2021

63 Preeclampsia and Eclampsia Ebook of cervix opening when the pulse reaches the tip she is ready to go The pulse will be most obvious during contractions so that s a good time to use this to check cervical opening If these pulses exist clearly but suddenly stop the baby may have died although I d be cautious of suddenly announcing this out of the blue Case 1 Shen Miao Fou Shou San Miraculous Spirit of the Buddha s Palm Ms Xie entered the hospital on November 24 1960 She was pregnant with her first child and her expected date of delivery of October 26 She was post term and this is why she was hospitalized On the second day of her hospitalization she was given quinine to induce labor but after two days she had not manifested any clear signs of labor so in addition I gave her Chinese herbs to hasten labor Her pulse was thin soggy and slippery The throbbing of her finger pulse lacked strength and wasn t extending beyond the fingertip The body of her tongue was pale red I used the prescription Shen Miao Fo Shou San Miraculous Spirit of the Buddha s Palm Powder With the addition of the following herbs Dang Shen 10 gm Translated by Sharon Weizenbaum 2021

64 Huang Qi Preeclampsia and Eclampsia Ebook 12 gm Yi Mu Cao 9 gm After these herbs that evening the contractions began The sequence of the delivery went smoothly she gave birth naturally Discussion Shen Miao Fo Shou San Miraculous Spirit of the Buddha s Palm Powder is also called Xiong Gui Tang Ligusticum and Angelica Soup with the two ingredients Chuan Xiong Radix Ligustici Chuanxiong and Dang Gui Radlix Angelica Sinensis Chuan Xiong and Dang Gui are both principle herbs for treating the Blood level Dang Gui is sweet and so it supplements It is pungent and so it dissipates Its bitterness drains and its warmth penetrates It is both able to supplement Blood and quicken Blood Chuan Xiong is pungent warm fragrant and piercing It moves but doesn t stay and it treats the Qi within the Blood It has the function of quickening the Blood and moving the Qi It supplements while penetrating through opens while closing In regard to hastening birth it is the most reliable having a fast acting and victorious effect In addition Dang Shen Radix Codonopsitis Pilosulae and Huang Qi Radix Astragali Membranacei are added to supplement Qi Yi Translated by Sharon Weizenbaum 2021

65 Preeclampsia and Eclampsia Ebook Mu Cao Herba Leonuri Heterophylli is given to activate uterine contractions boost the mother and calm the child Case 2 Tuo Hua Jian Cast off the Flower Drink Ms Zheng was age 40 when she entered the outpatient ward for a consultation She was admitted into the hospital pregnant nine months with her ninth child She had been passing water for eight hours and had developed abdominal pain characteristic of labor for a period of four hours The checkup showed her blood pressure to be 130 80 mm mercury Her heart and lung were normal The fundus of her uterus was four finger below her xiphoid The baby presented cephalic and left anterior occipital The fetal heart rate was 140 minute Contractions were irregular An anal exam revealed that the amniotic sack had been broken Her cervix was dilated two fingers The western diagnosis was full term pregnancy with premature rupture of membranes Because of this they gave her antibiotics to prevent an infection She was simultaneously gave her quinine and pituitrin in an intravenous drip to hasten labor All of these Translated by Sharon Weizenbaum 2021

66 Preeclampsia and Eclampsia Ebook methods were ineffectual The membrane had been ruptured already for ten days and her temperature was over 38 degrees centigrade Her blood chemistry exam showed that the total leukocyte count was 2400 cubic mm Neutrophils were 85 Ms Zheng s amniotic fluid was murky and her facial color was dull white and clear She experienced chest oppression and distention In spite of the abdominal pain the fetus did not descend Her pulse was deep wiry and slippery Her finger was throbbing distinctly and with strength but only to between the first and second finger joint The body of her tongue was dark red I gave her two packages of Tuo Hua Jian Cast Off the Flower Drink Dang Gui 9gm Chuan Xiong 6gm Rou Gui Wei 3gm Niu Xi 12gm Che Qian Zi 9gm Hong Hua 9gm Yi Mu Cao 9gm Gui Ban 12gm Huang Qin 6gm Translated by Sharon Weizenbaum 2021

67 Preeclampsia and Eclampsia Ebook Ren Dong Teng Lian Qiao 12 gm 9 gm After two packages Ms Zheng s contractions increased and became regular and stronger On the afternoon of July 2 she smoothly completed childbirth After the birth her condition was good Discussion This example of Blood vacuity relates to many deliveries The Qi mechanism has become stagnant and depressed The amniotic sack broke early and the amniotic fluid was dry and obstructed and hence unable to move the fetus downward Since this problem came with an infectious fever she was no longer a candidate for a cesarean section Her only possible course was to conclude the birth process right away in order to save her life In this situation I imitated Zhang Jing Yue by using the method exemplified by his prescription Cui Sheng Tuo Jian Hastening Life Cast Off the Flower Drink This prescription contains Dang Gui Radix Angelica Sinensis Chuan Xiong Radix ligustici Chuanxiong and Hong Hua FIos Carthami Tinctorrii to nourish the Blood quicken the Blood and dispel stasis Translated by Sharon Weizenbaum 2021

68 Preeclampsia and Eclampsia Ebook Niu Xi Radix Cyathulae moves the Blood and induces all the herbs to move downward Che Qian Zi Semen Plantaginis is slippery and penetrates through stasis Rou Gui Cortex Cinnamomi Cassiae is pungent and warm and penetrates through to guide the Qi into the Blood There is also Yi Mu Cao Herba Leonuni Heterophylli and Gui Ban Plastrum Testudinis which hasten birth and open the joining bone Huang Qin Radix Scutellariae Baicalensis Ren Dong Teng Ramus Lonicerae and Lian Qiao Fructus Forsythiae are important for clearing hear and resolving toxin In this way the herbs mutually support and reinforce each other By increasing Qi and Blood there could be disinhibited which is why the fetus moved down The mother and child were safe and childbirth was smooth Dr Ha Litian on Preeclampsia11 1 Eclampsia is generally categorized as liver wind moving Yin deficiency with Yang increasing and fire rising Based on the symptoms of quivering body twitching convulsion and neck rigidity that arise when this disease is present and the sayings that Wind s nature is to move and All wind moves about 11 Ha Litian Clinical Experience Series of 100 Chinese medicine doctors over 100 years China s Chinese Herbal Medicine Publisher May 1 2003 pg 154 Translated by Sharon Weizenbaum 2021

69 Preeclampsia and Eclampsia Ebook and changes rapidly Master Ha considers it to be wind He especially bases this on the clinical manifestations There is also the theory that all wind falling down dizziness belongs to the liver along with the fact that the basic illness is most often seen in pregnant women with a liver and kidney Yin deficiency body and liver Yang tending to be effulgent disease conditions He considers it to be due to liver wind internally moving and not to external wind Before or during the birth eclampsia is generally due to the woman s body being depleted of liver and kidney Yin with liver Yang tending to effulgence During the final stages of pregnancy or during the birth the Yin and blood are gathered downward leaving the essence and blood more depleted so the Yang has nothing to keep it submerged As soon as there is stimulation such as emotions being stirred bright lights or a loud noise the liver Yang suddenly exceeds its bounds the Qi and blood reverse chaotically the sinews and vessels are without nourishment and the Shen is not guarded This is when there is convulsions and rigidity with coma Postpartum eclampsia is due to Yin going down and Yang floating upward This disease is a root deficiency and branch excess Translated by Sharon Weizenbaum 2021

70 Preeclampsia and Eclampsia Ebook 2 The principle aim is to nourish extinguish and submerge while simultaneously dispelling phlegm fire damp congealed blood and wind Based on the etiology and patho mechanisms of this disease the primary method should rely heavily on nourishing blood extinguishing wind enriching Yin and submerging Yang At the same time because there are mixed causes one might clear away phlegm and open the orifices or assist with clearing heat and discharging fire or seep open and benefit urination Perhaps one will vitalize blood and transform the congealed or use pungent to scatter and dispel wind 3 Gou Teng Tang is the foundational formula It can be modified according to the pattern for great effectiveness Master Ha found that the formula Gou Teng Tang from the The Complete Compendium of Fine Formulas for Women could be modified to match the clinical pattern It has herbs such as Gou Teng Ju Hua Bai Ji Li Sheng Mu Li Zhu Ru Dang Gui Sheng Di Mai Dong Sha Shen Dan Shen Hu Po and Sang Ji Sheng It functions to gather and nourish the blood grow the Yin submerge Yang and press down reversal It is often used for eclampsia manifesting with head pain flowery vision chest oppression vomiting heart palpitations vexation swelling of the limbs and face sudden falling twitching of the four limbs rigidity of the Translated by Sharon Weizenbaum 2021

71 Preeclampsia and Eclampsia Ebook whole body foaming of the mouth red tongue and wiry rapid pulses If the flaring liver fire is relatively extreme the face will flush red with red eyes vexation with darkened eyes and strong twitching In this case add clear the liver discharge heat enrich Yin and submerge Yang ingredients such as Long Dan Cao Huang Qin Chao Shan Zhi Xiong Dan Hang Bai Shao Sheng Gui Ban Ling Yang Jiao Sheng Shi Jue Zi Bei Chi and Da Wu Gong Dr Ha often used Xiong Dan ground up and taken with Zhu Li water to calm the strength of the illness After that he would give herbal decoction to help the person recuperate If there is flourishing heart fire with vexation rash speech bitter mouth red urine and a red tongue tip you can add herbs to clear the heart and disinhibit urination such as Xi Jiao Huang Lian Zhu Ye and Yun Fu Ling If there is Qi fire combined with phlegm covering the clear orifices above with coma rough breath with phlegm sounds it is appropriate to add herbs to wash away phlegm and open the orifices such as An Gong Niu Huang Wan Zhu Li Shui Tian Zhu Huang Yu Jin Shi Chang Pu and Yuan Zhi If this is accompanied by receiving a wind evil with exterior manifestations such as fever and chills body pain it is appropriate Translated by Sharon Weizenbaum 2021

72 Preeclampsia and Eclampsia Ebook to add pungent scattering herbs to dispel wind such as Fang Feng Qiang Huo and Bai Jiang Can If there is spleen deficiency with water stoppage there may be floating edema of the face and limbs that leave an indentation when pressed chest stuffiness shortness of breath and short urination For this it is appropriate to fortify the spleen boost the Qi seep dampness and benefit the urination Herbs can be used such as Tai Zi Shen Yun Fu Ling Yi Yi Ren Dong Kui Zi and Dong Gua Ren If there is accompanying congealed blood such as in postpartum eclampsia it may be that the lochia is not flowing smoothly out so that there is lower abdominal distention and pain In this case add herbs to vitalize blood and transform congealed blood such as Niu Xi Liu Ji Nu Yuan Hu Suo and Ze Lan Ye 4 Don t be bigoted in your choice Vitalizing blood and transforming congealed blood has great beneficial results The ancients of the past had the theory that if one gives a formula to move and scatter blood the fetus will drop out and there will be looming disaster There is the idea that using a lot of herbs to vitalize blood and transform the congealed in pregnant women is contraindicated Master Ha thought that these details were a crystallization of the ancient s investigations to attain knowledge Translated by Sharon Weizenbaum 2021

73 Preeclampsia and Eclampsia Ebook He feared they had some clinical setbacks that were not examined in detail and hence these herbs were considered prohibited Modern doctors also put out a good many clinical reports about herbs contraindicated in pregnancy which also supports this idea Consequently one must read the ancient books without muddying their theories Vitalizing blood and transforming the congealed method is an essential method in the treatment of eclampsia for Master Ha Su Wen Discourse on Regulating the Channels says When the blood and Qi move upwards together this is a great reversal In Su Wen Discourse on Generating Qi to Communicate with Heaven says When blood is contained it causes the person to become weak and faint Wang Qingren thought that convulsions are not wind Rather they are Qi deficiency with congealed blood In Master Shen s Summary of Gynecology it says When contrarily the postpartum woman s back area is distended this is convulsion and it is nothing other than Qi and blood fleeing upward stopping in the cranial nerves Stimulated by these words master Ha thought that congealed blood must be a causative factor for this disease This is not only supported by clinical evidence there are also the following points Translated by Sharon Weizenbaum 2021

74 Preeclampsia and Eclampsia Ebook 1 This disease consists of liver yang transforming into wind which reverses and flees upward The Yang Qi then cannot nourish the sinews and vessels which makes them twitch and spasm This causes the movement of the Qi and blood to certainly become rough static and unsmooth 2 The Yin and blood are already depleted so that the blood vessels lose their liquid and become rough and static Congealed blood is unavoidable It is appropriate to use herbs to vitalize blood and transform stasis so that the sinews and vessels are soft and relaxed The smooth flow of blood is attained There is the saying that to treat wind first treat the blood When the blood moves the wind will be spontaneously extinguished On the other hand when the liver Qi spins upward it coerces the Qi and blood to scurry up into the head causing the Qi and blood to reverse chaotically The Chong and Ren lose their synchronicity and the uterine blood supply will be insufficient The fetus will certainly be unable to obtain nourishment At this time if one merely extinguishes wind and submerges Yang it will be difficult for the reversed Qi and blood to return quickly Not only will the pregnancy suddenly descend the Qi and blood will scatter so that it will be difficult to protect the mother If you combine herbs to Translated by Sharon Weizenbaum 2021

75 Preeclampsia and Eclampsia Ebook course and disinhibit the blood vessels and compel the blood downward this will assist the down bearing of liver wind and make the mother s Qi and blood quickly descend harmonize Yin Yang and regulate the Chong and Ren so that the uterus is nourished This will naturally nourish the fetus As a result Mother and child will both be safe For master Ha the goal of using herbs to vitalize blood and transform congelation is only to open the channels and vitalize the luo and smooth the flow of blood Hence one should not use harsh attacking and cracking herbs and one should avoid damaging the fetus Vitalizing blood and transform congelation herbs are not all the same in terms of their strength when applied Some divide them into the following categories 1 Harmonizing blood Dang Gui Chi Shao Dan Shen etc 2 Vitalizing blood Pu Huang Wu Ling Zhi Ru Xiang Mo Yao Hong Hua Niu Xi Ze Lan Su Mu and Liu Ji Nu etc 3 Cracking blood Shui Zhi Meng Chong San Leng E Zhu and Tao Ren etc Because the herbs in the cracking stasis category can easily damage the fetal source except for Tao Ren none of the others are used in pregnancy Tao Ren does not merit being considered fierce and attacking like the other cracking blood herbs Its body is moist and Translated by Sharon Weizenbaum 2021

76 Preeclampsia and Eclampsia Ebook it contains generating Qi so master Ha likes to use it When using it he pounds it into mush and the effect is even better Vitalizing blood and transforming congelation herbs should be used for the following two circumstances 1 When the indications for blood stasis are relatively clear for example with depressive emotions dark purple lips or tongue or stasis areas or spots on the tongue superficial swelling of the face limbs or spider veins on the body This may go along with abdominal pain body pain heart palpitations agitation dry mouth without a desire to drink In the postpartum time this may be accompanied by lack of smooth or any flow of the lochia The frequently used herbs are Liu Ji Nu Su Mu Tao Ren Hong Hua Hu Po Ru Xiang Mo Yao Chuan qian Cao Chi Shao and Dan Shen etc Generally one or two flavors are combined and used For postpartum eclampsia one can add Niu Xi Shi Chang Pu and Wu Ling Zhi type herbs These are usually combined with herbs to enrich Yin and moisten the intestines such as Hei Zhi Ma Yu Li Ren Huo Ma Ren and Sang Shen These can make the fire discharge through the bowel so that the Qi mechanism is smoothly moving which improves the effectiveness Translated by Sharon Weizenbaum 2021

77 Preeclampsia and Eclampsia Ebook 2 When the congealed blood indications are not clear one should use herbs such as Dang Gui and Ze Lan that harmonize and nourish the blood This will often have a good effect Regardless of whether or not there are congealed blood indications for this disease the method to vitalize blood and transform the congealed must be used The important point is to use one s discretion in using the appropriate type of herbs in order to properly treat the disease mechanism 5 Clinical Cases Case 1 Preeclampsia The patient was the wife of a Tianjin factory worker She was 24 and married In 1952 in mid autumn she came for a consultation She was almost 7 months pregnant when she developed water swelling of her face and limbs She also felt dizzy and had a headache nausea and a desire to vomit Because the financial situation of her family was not good she worked ceaselessly day and night One day she suddenly began to twitch and her spirit became dim Her eyes were withdrawn and she had lock jaw She then began to convulse which came and went Her whole family was anxious and at a loss They urgently sent someone to fetch Translated by Sharon Weizenbaum 2021

78 Preeclampsia and Eclampsia Ebook master Ha to come check At the moment he arrived she convulsed so he could see the state of affairs He could see that the convulsing of her limbs was strong Her face was dark and her lips were bluish Soon the convulsing stopped Her pulses were wiry and slippery Her tongue was dark red with stasis spots on the sides She also had heart palpitations head and eye pain as well as a feeling of oppressive heat Master Ha sat back and then said to the husband This is eclampsia which is related to blood deficiency During pregnancy the blood gathers to nourish the fetus so that the Yin and blood are even more depleted The Yin deficiency leads to effulgent Yang and then there is transformation to brutally oppressive wind The blood cannot nourish the sinews and so there are these symptoms At the start there was headache eye pain and nausea with a desire to vomit This showed that the inner wind was wanting to stir Yet you did not know to let the mother have peace This is the result If these convulsions keep happening the mother and child will be harmed The husband firmly requested but try to save the adult and do not tend to the child Master Ha saw the correctness of these words Xiong Dan 6 gm ground to powder Zhu Li Shui 15 gm Translated by Sharon Weizenbaum 2021

79 Preeclampsia and Eclampsia Ebook If there is no Xiong Dan one can use Ji Dan as a substitute Stir the powder in the Zhu Li water and drink After that she was to take one package of the following herbs Dang Gui 12 gm Hang Shao 24 gm Liu Ji Nu 12 gm Tao Ren 9 gm Hong Hua 9 gm Mai Men Dong 9 gm Hei Zhi Ma 12 gm Gou Teng 12 gm Ze Bei Chi 15 gm Jiang Can 9 gm Di Long 9 gm Tiao Huang Qin 9 gm Ci Ya Lian12 9 gm Decocted Second visit 8 16 After taking the first boiling of these herbs the twitching gradually calmed After taking the second boil her headache also decreased 12 I am pretty sure this is a name for Huang Lian Translated by Sharon Weizenbaum 2021

80 Preeclampsia and Eclampsia Ebook Altogether the disease was slightly better This was the considered to be the start of recovery One more package of the original formula was given in hopes to achieve the unexpected Third visit 8 17 The sick woman s pulse relaxed and her spirit cleared She had no more twitching She only had dry mouth and poor appetite and her swelling was still there She was then given herbs to build Yin clear heat nourish and vitalize blood soothing the sinews and transforming damp She was given 2 packages of the following formula Qin Dang Gui 12 gm Bai Shao 9 gm Chi Shao 9 gm Tian Xian Teng 12 gm Nan Hong Hua 9 gm Xuan Mu Gua 9 gm Yu Ling Pi 15 gm Xiang Fu Mi 6 gm Mai Men Dong 9 gm Fei Yu Zhu 9 gm Nu Zhen Zi 12 gm Translated by Sharon Weizenbaum 2021

81 Preeclampsia and Eclampsia Ebook Sang Ji Sheng 12 gm Huang Qin 6 gm Huang Lian 6 gm Bai Jiang Can 9 gm Liu Shen Qu 12 gm Several years later master Ha ran into Mr Wang who was hand in hand with a small child The talked about the past events He told him that after taking the herbs from the second visit all of the symptoms retreated The twitching did not happen again At term she gave birth to a child who was right there with him Discussion This is a case of liver and kidney Yin deficiency After a woman becomes pregnant the Yin and blood descend to nourish the fetus If the Yin and blood are deficient the solitary Yang does not submerge Add to this excessive labor and exhaustion and the Yang Qi floats outward Ultimately this disease of eclampsia manifested as the liver Yang becoming more and more violent with Qi and blood reversing chaotically When the liver wind stirred inwardly it was the lack of nourishment of the sinews and vessel that lead to the twitching of the limbs and whole body convulsions with dazed look and lock jaw When the Qi and blood reversed chaotically heat Translated by Sharon Weizenbaum 2021

82 Preeclampsia and Eclampsia Ebook harassed the heart Shen causing loss of spirit vexatious heat and heart palpitations This disease was one of root deficiency with branch excess However the branch pattern was forceful and acute so the treatment began with Xiong Dan and Zhu Li to clear heat resolves spasming and dispel phlegm spittle The treatment continued with Gou Teng Zhe Bei Jiang Can and Di Long to press down the liver and extinguish wind Dang Gui Chi Shao Tao Ren Ji Nu and Hong Hua were used to vitalize blood and transform congelation Tiao Qin Ci Yao Lian were used to clear the heart and discharge the liver This was assisted lightly with Mai Men Dong to increase the nourishment of Yin and consolidate the strength of the root In the end the liver wind was extinguished the Qi and blood obtained smooth flow the inner heat was cleared and the root deficiency was restored She fully recovered from the disease Case 2 Threatened Eclampsia At seven months of pregnancy the patients limbs and face developed water swelling and her blood pressure was tending to be high She also had dizziness and headache One evening she became angry and the dizzy vision and headache became worse She also had abdominal pain and back soreness and weakness She then came to the hospital for an emergency visit She underwent Translated by Sharon Weizenbaum 2021

83 Preeclampsia and Eclampsia Ebook and examination She had superficial edema albumen in urine and her blood pressure was 180 110 She also had headache dizziness dry mouth with a desire to drink The diagnosis was threatened eclampsia She planned to stay in the hospital but because she was an ethnic minority her families food and drink were different and she decided to return home As predicted that night she suddenly developed a splitting headache a tight jaw and she became unconscious Her four limbs were twitching her whole body convulsed her eyes were fixed her lips were purple After a short time she became conscious and then it happened again In half a day she had five episodes each one lasting 1 2 minutes Her blood pressure was 170 190 110 120 She took anti convulsants and anti hypertensives and went to sleep In a panic Mr Li drove his vehicle and pleaded with Dr Ha to come see her When he arrived her spirit was clear She had head pain heart vexation nausea with a desire to vomit dry mouth and throat knotted stool and red urine Her tongue was red with yellow moss and her pulses were wiry slippery and rapid The diagnosis was liver and kidney Yin deficiency with liver fire blazing on the interior increasingly violent wind and lack of harmonious descent of the stomach The disease was strong and acute Luckily the family knew to get help so she did not perish Translated by Sharon Weizenbaum 2021

84 Preeclampsia and Eclampsia Ebook She was given the following formula Xiong Dan 6 gm ground to powder Hu Po 1 5 gm ground to powder Zhu Li Shui 15 gm Stir the powder in the Zhu Li water and drink After that she was to take one package of the following herbs Gou Ten 15 gm Tiao Huang Qin 9 gm Chuan Ya Lian 9 gm Hang Bai Shao 24 gm Qin Dang Gui 9 gm Liu Ji Nu 9 gm Tao Ren paste 9 gm Cao Hong Hua 6 gm Tian Zhu Huang 9 gm Bai Jiang Can 9 gm Su Di Long 9 gm Sang Ji Sheng 12 gm Mai Men Dong 9 gm Qing Ban Xia 9 gm Translated by Sharon Weizenbaum 2021

85 Preeclampsia and Eclampsia Ebook After one package the twitching stopped and her body and spirit were tired Her symptoms were poor appetite dry stool poor sleep slight body heat red tongue with scanty moisture and a wiry rapid pulse with slight thinness Her Qi and fluids were both diminished and she had deficiency heat floating outward I gave her the same formula with the bitter cold Qin and Lian as well as the pungent drying clearing summer her that was opening through and scattering taken out 12 gm Tai Zi Shen and 15 gm Dong Bai Wei were added to boost Qi and generate fluids while penetrating through the heat to dispel vexation 12 gm Hei Zhi Ma and 9 gm Yu Li Ren were added to enrich Yin nourish blood moisten the intestine and open through the stool She was given two packages After these herbs there was no more twitching It was observed that she was out of danger While taking the Chinese herbs she also took a mild sedative but no other western drugs Several months later Mr Li carried his granddaughter in for a visit Mother and child were both healthy Discussion This case is also one of liver and kidney deficiency of Yin with ministerial fire blazing within It was due to unsatisfied emotions This lead to the movement of wind Yang which increased to the point of this illness The kidneys are the stomach s gate If the gate is inhibited the gathering water will Translated by Sharon Weizenbaum 2021

86 Preeclampsia and Eclampsia Ebook come from this place 13 When there is kidney deficiency the kidneys are unable to transform Qi and move water and this causes superficial edema of the limbs and face When Yin is deficient and Yang is high the Qi and blood reverse upwards which leads to dizziness and head pain Wind Yang increases more and more so the blood does not soften the sinews and this causes the four limbs to twitch and convulse until the whole body convulses When liver fire is blazing in the interior this harasses the heart and damages the fluids so heart vexation is seen with dry mouth knotted stool yellow urine red tongue with yellow moss and a wiry slippery and rapid pulse When this is acute one must treat the branch and then continue by treating the root In the beginning he cleared heat resolved convulsions transformed phlegm and extinguished wind At the return visit he shifted to boosting Qi and fluids At the end the Yin balanced and Yang was hidden The Qi flowed and the blood was harmonized 13 From Su Wen Chapter 61 Translated by Sharon Weizenbaum 2021