As more and more people study the classic formulas, dig into that current of thought and begin to gain some comfort with using not small doses of zhì fù zî (Aconiti Radix lateralis preparata); the Fire Spirit current which focuses exclusively on the preservation and restoration of yang has become a topic of interest for many practitioners.

Today’s post is a case study from the Lectures on Supporting Yang (fu yang jiang ji, 扶陽講記), written by Liu Li Hong (劉力紅) and his teacher, Lu Chong Han (盧崇漢). It concerns the use of True Warrior Decoction (zhën wû täng) in the treatment of benign prostatic hyperplasia.
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In August of 1988 I had a 58 year-old male patient from Japan who served as a representative to one of the educational committees of the United Nations. He suffered over the past six years from Benign Prostatic Hyperplasia (BPH), which lead to difficulty with expelling urine, and had become increasingly worse within the space of the last three years. He reports that in the afternoon the condition worsens to the point that he frequently is in need of using the washroom. Furthermore, in the course of a single night he would need to get up to urinate 15-16 times, basically there was just no way he could get a normal night’s sleep. His lower abdomen was distended and when he urinated the stream was extremely thin and without force. Because of this difficulty, whenever he needed to urinate, the process would require spending 3-5 minutes. In Beijing, Japan and America he took medications as prescribed by Western doctors, and finally was advised to have a surgical procedure. However, he was uninterested in that option as he was afraid of how it might interfere with his ability to have sex, so he switched to trying Chinese medicine.

For a long period of time he saw Chinese medicine doctors in Japan, Beijing and Shanghai who frequently prescribed formulas with fú líng (Poria), zé xiè (Alismatis Rhizoma), chë qián zî (Plantaginis Semen) and mù töng (Akebiae Caulis), but none of these prescriptions brought about a lasting improvement in his situation. Overall he had taken over 100 packets of Chinese herbs. Usually when he first started a particular prescription it would help a little for a short time, then after taking for a while his condition would deteriorate. It was a real source of suffering for him.

A representative from the Chengdu American Consulate suggested that he come to see me for treatment. At the time he came to me I only used external methods to diagnose him (1), so I could not see how severe the illness actually was. However from the tongue, tongue coating and pulse I could see that the tongue body was flabby, pale in color with tooth-marks on the edges and a white slippery, greasy coating; the pulse was deep, unhurried and forceless. This led me to believe that he suffered from an insufficiency of Kidney yang, leading to retention and stagnation of fluids, and dampness. In this case the treatment method should be to warm the yang, move fluids and promote urination using a modification of True Warrior Decoction (zhën wû täng).

At that time I wrote the following prescription:
zhì fù zî (Aconiti Radix lateralis preparata) 75g
shëng bái zhú (Fresh Atractylodis macrocephalae Rhizoma) 15g
fú ling (Poria) 25g
yín yáng huò (Epimedii Herba) 20g
shëng jiäng (Zingiberis Rhizoma recens) 60g

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The patient was compliant in taking these herbs on a consistent basis. After the first serving he felt like he was expelling more urine every time he went to the bathroom, furthermore he did not need to go as frequently and it was a bit easier to void his bladder. After taking three packets of herbs the whole process of urination was much smoother and more open. And while his nocturia was reduced to just twice a night, he still felt that the strength of the stream still needed improvement.

When he came for his second consultation 25 grams of guì zhï (Cinnamomi Ramulus) was added to the original formulation. After using the second prescription his ability to expel urine was strengthened. In the third visit 15 grams of shä rén (Amomi Fructus) was added with the goal being that the flavor of this medicinal would connect the qi of the five zang to the Kidney. (2)

In all, his treatment consisted of less than 30 packets of herbs, which completely changed his entire situation. His energy increased, the ability to expel urine normalized, and he arose only once at night to urinate. The patient asked me if it was possible to eliminate that one instance of nocturia. I replied that it would probably be a bit difficult to do so, as he was already almost 60 years old. Of course, if he continued with treatment perhaps even that single instance of nocturia might be resolved.

After that I don’t know about this patient’s condition, as he did not return. However, two years later he brought his son to me for treatment when they were in Chengdu. At that time he reported that for the past year he had none of the symptoms for which he previously sought treatment, he was completely fine. Unfortunately, I was not able to obtain a complete western physiological examination. I asked him to come for such, but he ignored my request. So I do not know if the treatment actually affected the size of his prostate.

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1) Doctors in China often send patients for x-rays, ultrasounds and other western imaging and blood work types of testing.
2) Heiner Fruehauf gave a lecture at the recent ICEAM conference in Portland on the use of Qian Yang Dan (Sink the Yang Pill). In this prescription shä rén (Amomi Fructus) is used to open up the middle jiao and help descend the floating yang. He has an excellent article concerning this prescription on his website.