Pathogenesis of Hypertension
Through extensive clinical practice with classical formulas and reflective thinking, I believe that the human body operates primarily through the movement of Qi, Blood, and Water. The mechanism behind elevated blood pressure can be attributed to three pathological mechanisms: Qi stagnation, Blood stasis, and Water retention.
(1) Blood stasis is fundamental: The pathological basis for elevated blood pressure in patients lies in increased blood flow resistance, leading to sluggish blood circulation and stasis. Once stasis occurs, blood flow is further obstructed, which exacerbates Qi stagnation and causes water retention; thus, blood stasis is fundamental.
(2) Qi stagnation is key: Traditional Chinese Medicine (TCM) posits that Qi is the commander of Blood, and Blood is the mother of Qi. Disorders of Qi and Blood often influence each other; Blood stasis leads to Qi stagnation, and Qi stagnation further aggravates Blood stasis. Clinically, prolonged Qi stagnation can transform into fire, leading to symptoms of Liver fire rising and hyperactive Liver Yang in hypertension.
(3) Water retention is common: The movement of Water in the body relies on the propulsion of Qi. Qi stagnation easily leads to water retention, and Blood stasis can also cause water retention. Once water retention occurs, it further exacerbates Qi stagnation and Blood stasis; hence, patients with hypertension often suffer from water retention. Based on this analysis, I propose using Gui Zhi Fu Ling Wan (Cinnamon Twig and Poria Pill), Dang Gui Shao Yao San (Angelica and Peony Powder) combined with Da Chai Hu Tang (Major Bupleurum Decoction) or Xiao Chai Hu Tang (Minor Bupleurum Decoction) as foundational formulas for treating hypertension, which has yielded good results.
The characteristics of the combined formulas are as follows.
(1) Blood stasis must be resolved: Blood flows when warmed and coagulates when cold; therefore, resolving stasis should primarily focus on warming. The formula selected is Gui Zhi Fu Ling Wan. The Jin Gui Yao Lue states:
“If a woman has a history of masses and has not menstruated for less than three months, and experiences continuous bleeding with fetal movement above the navel, it indicates a mass causing harm. If fetal movement occurs in the sixth month, it is due to timely menstruation in the first three months. If there is bleeding, it is due to the cessation of menstruation for three months. Therefore, if bleeding does not stop, it is because the mass has not been removed; Gui Zhi Fu Ling Wan is indicated.”
From this, it is clear that Gui Zhi Fu Ling Wan is a remedy for resolving stasis and generating new blood, harmonizing Qi and Blood. The formula contains Tao Ren (Peach Kernel) and Mu Dan Pi (Moutan Root) to invigorate blood and resolve stasis; combined with equal amounts of Bai Shao (White Peony) to break stasis and nourish blood, allowing stasis to be eliminated and new blood to be generated; adding Gui Zhi (Cinnamon Twig) not only warms and unblocks the blood vessels to assist the action of Tao Ren but also harmonizes Qi and Blood, while also having the effect of descending Qi; Fu Ling (Poria) helps to drain dampness and resolve water retention associated with blood stasis.
(2) Water retention must be resolved: The water retention associated with hypertension is fundamentally based on Blood stasis; therefore, while draining water, one must not forget to invigorate blood. The selected formula is Dang Gui Shao Yao San, and for those with Yang deficiency, Fu Zi (Aconite) is often added (drawing from the meaning of Zhen Wu Tang).
The Jin Gui Yao Lue states: “For women who are pregnant and experience abdominal pain, Dang Gui Shao Yao San is indicated.” The Jin Gui Yao Lue also states: “For women with various abdominal diseases and pain, Dang Gui Shao Yao San is indicated.”
From this, it is clear that Dang Gui Shao Yao San is a formula for nourishing and invigorating blood. The formula includes Dang Gui (Angelica) to nourish and invigorate blood; Bai Shao (White Peony) to alleviate pain; Fu Ling, Bai Zhu (Atractylodes), and Ze Xie (Alisma) to drain water; Chuan Xiong (Szechuan Lovage) to promote circulation and relieve stagnation.
(3) Qi stagnation must be resolved: In the pathogenesis of hypertension, Qi stagnation is key, and Qi stagnation often leads to excessive Shao Yang fire and internal accumulation in Yang Ming. Therefore, the selected formula should be Da Chai Hu Tang. In this formula, Chai Hu (Bupleurum) is used to soothe the Liver and regulate Qi, Huang Qin (Scutellaria) clears Shao Yang fire, while Da Huang (Rhubarb), Zhi Shi (Bitter Orange), and Bai Shao eliminate internal accumulation in Yang Ming. Ban Xia (Pinellia) and Sheng Jiang (Fresh Ginger) transform phlegm.
Case Studies Analysis
Case 1:
Mr. Zhang, male, 43 years old, first diagnosed on December 26, 2017. Chief complaint: diagnosed with hypertension for 1 year.
Medical history: The patient discovered elevated blood pressure during a physical examination one year ago, with a reading of 156/99 mmHg. He was subsequently diagnosed with hypertension at a local general hospital and was treated with antihypertensive medication. During medication, his blood pressure remained normal, but he experienced significant increases in blood pressure when he occasionally stopped taking the medication, even exceeding his highest pre-treatment reading. The patient was distressed about the need for lifelong medication and sought traditional Chinese medicine for a complete cure.
Current symptoms: The patient feels fatigued, with dark-colored lips, drowsy during the day, difficulty sleeping at night, frequent dizziness, cold hands and feet, particularly sensitive to cold, dry mouth with no desire to drink, normal appetite, frequent urination at night, and slightly dry stools, once a day. The tongue is pale and swollen with tooth marks on the edges, white greasy coating, and the pulse is floating and wiry at the cun position, while the guan and chi positions are deep. Blood pressure at the time of consultation: 154/101 mmHg. (Patient height: 174 cm, weight: 54 kg, slightly thin)
Diagnosis:Combination of Shao Yin and Tai Yin syndromes with stasis.Treatment principle:Warm Yang, invigorate blood, and drain water.Formula:Zhen Wu Tang, Gui Zhi Fu Ling Wan, and Dang Gui Shao Yao San combined with modifications. Ingredients: Fu Zi 15g, Fu Ling 15g, Cang Zhu 15g, Bai Shao 15g, Dang Gui 15g, Chuan Xiong 20g, Ze Xie 15g, Gui Zhi 10g, Tao Ren 15g, Mu Dan Pi 30g, Huai Niu Xi 30g. 7 doses, one dose per day, decocted in water, to be consumed slowly as tea within one day. The patient was advised to measure blood pressure three times in the morning while lying down, with intervals of more than 5 minutes between measurements, and to record the average value. He was also advised to walk more after meals, eat less meat, consume more vegetables, and go to bed early at night.
Second diagnosis:After treatment, the patient’s average blood pressure dropped to 140/92 mmHg, and his spirit improved significantly. During medication, he no longer felt drowsy during the day, and he was able to sleep normally at night. Symptoms of dizziness, cold hands and feet, sensitivity to cold, dry mouth, and frequent urination at night all improved significantly, and his bowel movements returned to normal. He continued with the same formula for 7 more doses.
Third diagnosis:The patient’s average blood pressure dropped to 128/84 mmHg, and all symptoms disappeared, except for slightly dark lips. The patient expressed deep gratitude. He was advised to continue with the decoction for 3 months. Six months later, during follow-up, the patient’s blood pressure had not rebounded, and he reported that due to stable blood pressure and improved sleep, his weight had increased by about 6 kg compared to six months ago. Note: The patient felt fatigued, drowsy during the day, frequently dizzy, with cold hands and feet, particularly sensitive to cold, dry mouth with no desire to drink, frequent urination at night, pale and swollen tongue with tooth marks on the edges, white greasy coating, and deep pulse at the guan and chi positions, indicating a combination of Shao Yin and Tai Yin syndromes according to the Zhen Wu Tang pattern; the dark color of the lips indicates stasis in the body, while the pale and swollen tongue with tooth marks and white greasy coating indicates water retention. Therefore, Gui Zhi Fu Ling Wan combined with Dang Gui Shao Yao San was prescribed. The addition of Gui Zhi was to treat the upward disturbance of Qi and water, and Huai Niu Xi was to guide blood downward. The patient was advised to complete the formula during the day, as Fu Zi can stimulate Yang Qi, leading to increased energy during the day and a natural calming effect at night, which is the beauty of TCM.
Case 2:
Mr. Du, male, 45 years old, first diagnosed on September 12, 2017. Chief complaint: diagnosed with hypertension for over 3 years.
Medical history: The patient is overweight (92 kg) and often drinks alcohol due to work commitments, frequently staying up late. Three years ago, he experienced sudden dizziness and was diagnosed with elevated blood pressure at the hospital, with a reading of 168/106 mmHg. He began taking antihypertensive medication, initially one type, but after developing resistance, he was prescribed three types of antihypertensive drugs, yet his blood pressure remained poorly controlled. The patient was very distressed and sought treatment from various doctors, taking a large amount of traditional Chinese medicine with no significant effect. He came for consultation upon a friend’s recommendation.
Current symptoms: The patient feels fatigued, with dark complexion and lips, abdominal obesity, irritability, dry mouth, bitter taste, and bad breath, normal appetite, poor sleep, and slightly dry stools, every 2-3 days. The tongue is pale with tooth marks on the edges, yellow greasy coating, and the pulse is floating and wiry at the cun position, while the guan and chi positions are deep. Blood pressure at the time of consultation: 170/108 mmHg.
Diagnosis:Combination of Shao Yang and Yang Ming syndromes with stasis.Treatment principle:Clear Shao Yang, drain Yang Ming, invigorate blood and resolve stasis.Formula:Da Chai Hu Tang, Gui Zhi Fu Ling Wan, and Dang Gui Shao Yao San combined with modifications.
Ingredients: Chai Hu 30g, Fu Ling 15g, Gui Zhi 15g, Mu Dan Pi 30g, Tao Ren 15g, Huang Qin 30g, Ban Xia 20g, Zhi Shi 20g, Sheng Da Huang 5g, Bai Shao 15g, Sheng Shi Gao 30g, Dang Gui 15g, Chuan Xiong 15g, Ze Xie 15g, Bai Zhu 20g.
7 doses, one dose per day, decocted in water, to be consumed slowly as tea within one day. The patient was advised to measure blood pressure three times in the morning while lying down, with intervals of more than 5 minutes between measurements, and to record the average value. He was also advised to reduce alcohol consumption, walk more after meals, eat less meat, consume more vegetables, and go to bed early at night.
Second diagnosis:After treatment, the patient reported that on the third day of taking the formula, his average blood pressure was 160/102 mmHg. After completing 7 doses, his average blood pressure was 154/98 mmHg, and symptoms of irritability, dry mouth, bitter taste, and bad breath were alleviated, with bowel movements returning to normal. The formula was adjusted as follows.
Ingredients: Chai Hu 30g, Fu Ling 15g, Gui Zhi 15g, Mu Dan Pi 30g, Tao Ren 15g, Huang Qin 30g, Ban Xia 20g, Zhi Shi 15g, Sheng Da Huang 5g, Bai Shao 15g, Sheng Shi Gao 30g, Dang Gui 15g, Chuan Xiong 15g, Ze Xie 15g, Bai Zhu 20g.
7 doses, one dose per day, decocted in water, to be consumed slowly as tea within one day. The patient was advised to continue measuring blood pressure three times in the morning while lying down, with intervals of more than 5 minutes between measurements, and to record the average value.
Third diagnosis:After taking the formula for the fourth day, the patient’s average blood pressure was 148/94 mmHg. After completing 7 doses, his average blood pressure was 140/89 mmHg, with significant reduction in irritability, and no dry mouth, bitter taste, or bad breath. Bowel movements were normal, but complexion and lip color remained dark. He continued with the same formula for 7 more doses.
Fourth diagnosis:The patient’s average blood pressure was 132/82 mmHg, and all symptoms disappeared, except for the dark complexion and lips. He was advised to continue with the decoction for 3 months. One year later, during follow-up, the patient’s blood pressure had not rebounded, and he reported a weight loss of over 20 kg in the past year.
Note: The patient felt fatigued, irritable, dry mouth, bitter taste, bad breath, and slightly dry stools every 2-3 days, with a wiry pulse at the cun position, indicating a combination of Shao Yang and Yang Ming syndromes according to the Da Chai Hu Tang pattern; the dark complexion and lips indicate stasis, while the pale tongue with tooth marks and yellow greasy coating indicate phlegm-dampness. Therefore, Gui Zhi Fu Ling Wan combined with Dang Gui Shao Yao San was prescribed. The combination of formulas effectively controlled blood pressure.
[Personal Insights]1. Obesity does not necessarily indicate Yang deficiency, and thin individuals are not always fiery. I remember when I first studied TCM, textbooks stated that overweight individuals often have Yang deficiency and cold-dampness, while thin individuals often have Yin deficiency and excess fire. However, in my clinical practice, I found that many overweight patients present with Yang heat symptoms due to excessive consumption of rich foods and alcohol, without showing signs of cold sensitivity; conversely, thin individuals often have poor appetite, malabsorption, and frequent diarrhea, without obvious signs of Yin deficiency and excess fire, but rather more often present with Yang deficiency and cold-dampness. Therefore, I repeatedly emphasize in clinical teaching that the only standard for verifying the correctness of any theory is clinical practice; clinical diagnosis should not be rigidly adhered to classical texts but should be pragmatic and based on differential diagnosis and treatment.
2. Qi and water rising can lead to high blood pressure, and the effect of guiding blood downward is good. Clinically, elevated blood pressure is often caused by Qi and water rising, and the best herbs for descending Qi and water are Gui Zhi, while Huai Niu Xi is used to guide blood downward. However, it should be noted that Huai Niu Xi is commonly used for Yang deficiency with cold-dampness and floating Yang, and should not be used in cases of excess heat in the upper jiao, which is why it was not used in the second case.
3. Dietary considerations for hypertension. As the saying goes, “Three parts treatment, seven parts nourishment.” This is especially true for hypertension, where daily dietary management is crucial. Therefore, patients with hypertension should have a reasonable diet, eating small, frequent meals that are light, low in salt and oil, and avoiding overeating. Foods to be reduced include: high-calorie foods such as chocolate, sugar, and syrup; meats that can lead to high blood lipids; salt, which should be limited; strong tea, which can cause brain excitement, anxiety, insomnia, and palpitations; spicy foods such as chili and garlic; and alcohol, which can increase heart rate, constrict blood vessels, and raise blood pressure. Excessive and long-term alcohol consumption can also induce arteriosclerosis and worsen hypertension. Therefore, patients with hypertension should abstain from alcohol.
—1—
Mr. Zhang Dachang: Effective Methods for Treating Hypertension
Effective Method 1:
Prescription
Xia Ku Cao 15g Sheng Bai Shao 10g
Sheng Du Zhong 15g Sheng Huang Qin 6g
First, decoct the first three ingredients in three tea cups of water for 30 minutes, then add Huang Qin and decoct for another 5 minutes. Take twice daily.
This formula is recorded in Shanxi Chinese Herbal Medicine as each ingredient being 5 qian (approximately 15g). It is effective for hypertension, and I have clinically tested it with good results.
Effective Method 2: Da Xie Gan Tang (from Fa Yao)
Prescription
Zhi Shi (processed) 30g Bai Shao 30g
Gan Cao (honey-fried) 30g Huang Qin 10g
Sheng Jiang (sliced) 10g Da Huang 10g
Combine the six ingredients with five liters of water, boil down to two liters, and take warm in divided doses.
Treatment: headache, red eyes, irritability, fullness and pain under the ribs, and urgent discomfort.
For those with high blood pressure, diastolic pressure can drop by twenty millimeters of mercury after taking this. Continue with Jin Gui Feng Yin Tang for consolidation of effects. I have clinically verified this.
Effective Method 3:
Alternatively, use 30g of Bai Fan, mix with water, and then use mung bean powder to form pills (from Inner Mongolia’s Selected Compilation of New Medical Methods of Chinese Herbal Medicine). Take four to five pills each time. The effect is as cold as ice and snow.
I once used a small formula of mung beans and Bai Fan boiled together, and the resulting water was as green as jade, which is the meaning of refreshing on a hot day.
Effective Method 4:
Alternatively, use 30g of vinegar, boil it, and add the white of one egg to take at once. This formula is a variation of the bitter wine decoction from Shang Han Lun.
Effective Method 5:
Alternatively, use seven pieces of Bai Ding Xiang and seven pieces of Ku Ding Xiang, roast them into powder, and add a little Yin Chen to decoct and take.
I remember during the New Year in 1986, I visited my hometown and an elderly neighbor, Mr. Sun, suffered from hypertension and suddenly had a nosebleed that wouldn’t stop. Despite trying many remedies, it was ineffective. A relative mentioned that they had a secret recipe that could cure it, and indeed it worked, stopping the bleeding and normalizing blood pressure. This formula is said to treat jaundice, but I have not seen it cure such an urgent condition.
Effective Method 6:
Prescription
Cao Jue Ming 15g
Wang Bu Liu Xing 15g
Sheng Di Huang Gao 15g
Chong Wei Zi (lightly fried) 30g
Form into pills, each weighing 10g, take one pill three times a day. I have found this formula effective for those with internal wind rising, headache, dizziness, and elevated blood pressure.
——Zhang Dachang’s Medical Theory and Case Studies
Mr. Zhu Liangchun: Yi Mu Jiang Ya Tang for Treating Hypertension
Prescription
Yi Mu Cao 60g Du Zhong 12g
Sang Ji Sheng 20g Gan Cao 5g
For high blood pressure, Yi Mu Cao is very effective.
This herb clears the Liver and calms the rising Yang, especially effective for postpartum hypertension.
If there is severe headache, add Xia Ku Cao 12g, Gou Teng 20g, Sheng Bai Shao 25g, Sheng Mu Li 30g;
If there is severe Yin deficiency, add Nu Zhen Zi 12g, Chuan Shi Hu 15g, Da Sheng Di 15g.
——Famous TCM Doctors’ Secret Methods for Treating Diseases
Mr. Zhang Zhiyuan: Gui Zhi and Yi Mu Cao for Lowering Blood Pressure and Promoting Diuresis
In clinical practice for diuresis and lowering blood pressure, two herbs are often overlooked. Most believe that Gui Zhi opens the blood vessels and assists Ma Huang in releasing the exterior; Yi Mu Cao resolves stasis and contracts the uterus, being a gynecological specialty.
However, this is not the case. Clinical observations show that the combination of these two herbs has a common point: they lower blood pressure and open the water pathways. For primary hypertension and edema, adding these herbs to the appropriate formula can yield effective results.
In Shang Han Lun, Wu Ling San plus Gui Zhi not only warms and transforms Qi but also promotes drainage; for body edema, adding Yi Mu Cao does not merely invigorate blood but also facilitates urination.
For treating hypertension, there is an effective formula composed of Shan Zha 40g, Gui Zhi 15g, and Yi Mu Cao 20g, decocted in water and taken in three doses daily for seven days, showing significant efficacy. Even without Shan Zha, it still works effectively.
——Zhang Zhiyuan’s Seventy Years of Clinical Essence
Mr. Chen Cunren: Four Types of Health Pillows for Hypertension
For patients with hypertension, an important consideration is the pillow used during sleep.
1. Mung Bean Shell Pillow
The best option is to use mung bean shells as the pillow filling. Avoid using cotton pillows, and especially avoid the wild duck down pillows used by Westerners, which should be absolutely prohibited.
Because when sleeping, the back of the head rests on the pillow, which is closest to the central nervous system in the brain and the medulla oblongata. Using a warm cotton pillow can have the greatest impact on the patient’s nerves, so it must be replaced with another type of filling to be effective.
The nature of wild duck down is even warmer. Some people have experienced nosebleeds or gum bleeding after using wild duck down pillows in foreign hotels, so they are absolutely unsuitable for patients with high blood pressure.
Patients with hypertension can use mung bean shells as pillow filling. Mung bean shells can be purchased from vendors selling sprouted seeds at a very low price. However, finding small vendors may not always be possible.
One can buy ten kilograms of mung beans, boil them in a large pot with water, and after boiling, use a knife to crush the mung beans, stirring continuously until the shells float to the top, while the mung bean paste settles at the bottom, which can be used as food. After removing the mung bean shells and drying them, the shells from ten kilograms of beans can make a very large pillow.
Because mung bean shells are cool, making a pillow from them is breathable and very helpful for patients with high blood pressure, making it easy to sleep comfortably.
2. Wild Chrysanthemum Pillow
The second option is to use dried wild chrysanthemum flowers as pillow filling. Wild chrysanthemum clears the Liver and eliminates heat, which can treat dizziness. This can be purchased at herbal medicine shops. White chrysanthemum flowers are very expensive, while wild chrysanthemum is inexpensive, especially if purchased from herbal shops.
Each pillow requires at least five kilograms of wild chrysanthemum, removing the hard stems and flower bases, using only the petals to fill the pillow, which is very suitable for patients with hypertension who experience dizziness, restlessness at night, and anxiety.
3. Tong Cao Silk Pillow
The third option is to use Tong Cao silk as pillow filling. Tong Cao can be obtained from herbal medicine shops. One type is square and white, known as Chuan Tong Cao. The other type is round and branch-like, very light, which can be cut into thin slices. Both types of Tong Cao can be used. It is best to ask the pharmacy to cut the Tong Cao into fine silk, and a large quantity of about 250g is sufficient to make one pillow. However, Chuan Tong Cao is too expensive, while the branch Tong Cao is cheap but too hard, making it uncomfortable to sleep on.
One can also purchase a small amount of Tian Ma and cut it into fine silk to mix with the Tong Cao silk, which is very suitable for patients with hypertension.
4. Oil Olive Leaf Pillow
The fourth option is to use oil olive leaves as pillow filling, which requires attention to purchase from vendors. When making the pillow, be sure to remove the hard seeds and thick stems. This pillow has the effect of clearing heat and calming the spirit.
Zhu Liangchun: Yi Mu Jiang Ya Tang for Treating Hypertension
Yi Mu Cao 60g, Sang Ji Sheng 20g, Du Zhong 12g, Gan Cao 5g.
For high blood pressure, Yi Mu Cao is very effective.
This herb clears the Liver and calms the rising Yang, especially effective for postpartum hypertension.
If there is severe headache, add Xia Ku Cao 12g, Gou Teng 20g, Sheng Bai Shao 25g, Sheng Mu Li 30g;
If there is severe Yin deficiency, add Nu Zhen Zi 12g, Chuan Shi Hu 15g, Da Sheng Di 15g.
Application of Yi Mu Cao
The blood pressure-lowering effect of Yi Mu Cao has been confirmed by modern pharmacological experiments, but it should not be used indiscriminately. It is mainly suitable for hypertension with excessive Liver Yang.
The New Interpretation of Miscellaneous Diseases states that Tian Ma Gou Teng Yin (Tian Ma, Gardenia, Huang Qin, Chuan Niu Xi, Du Zhong, Yi Mu Cao, Sang Ji Sheng, Ye Jiao Teng, Zhu Fu Shen) has the effect of calming Liver Yang and lowering blood pressure. Analyzing this formula, in addition to using herbs that subdue Yang, drain fire, and calm the Liver, it is particularly clever to use Niu Xi and Yi Mu Cao for invigorating blood and guiding it downward, allowing the Liver wood to be gentle and the errant wind and Yang to be restrained, which is the essence of this “new interpretation.”
Mr. Zhu pointed out: “Yi Mu Cao has a significant effect of clearing the Liver and lowering the Yang, especially effective for postpartum hypertension, but the dosage must be increased to 60g for the effect to be substantial.” When Liver Yang is rampant, causing wind to rise, leading to elevated blood pressure, dizziness, and limb numbness, or in cases of prolonged illness with phlegm-dampness and blood stasis, accompanied by facial swelling, limb edema, and body pain, it can be applied.
Mr. Zhu once formulated Yi Mu Jiang Ya Tang, using Yi Mu Cao 60g, Du Zhong 12g, Sang Ji Sheng 20g, Gan Cao 5g. For severe headache, add Xia Ku Cao and Sheng Bai Shao each 12g, Gou Teng 20g, Sheng Mu Li 30g; for significant Yin deficiency, add Nu Zhen Zi 12g, Chuan Shi Hu and Da Sheng Di each 15g.
[Case Example]
A 93-year-old woman with a long history of hypertension, regularly taking antihypertensive tablets.
Today, her blood pressure is measured at 178/106 mmHg, frequently experiencing dizziness and swelling, with numbness and pain in her limbs.
In the past half month, she has also developed abdominal pain and diarrhea three to four times a day, feeling increasingly fatigued. The tongue coating is thin, and the pulse is wiry.
Due to excessive Yang rising, the Spleen is constrained. The treatment is to subdue Yang, extinguish wind, and calm the center.
Prescription:
Yi Mu Cao and Sheng Mu Li (first decocted) each 30g, Sang Ji Sheng and Gou Teng (added later) each 20g, Bai Shao 12g, Wu Mei 6g, Mu Guo 10g, Gan Cao 5g.
After taking 8 doses, blood pressure dropped to 150/88 mmHg, and diarrhea stopped. The original formula was adjusted and continued for a month, resulting in the disappearance of dizziness and edema, with stable blood pressure.
Single Herb Yi Mu Cao Decoction for Treating Hypertension
In my clinical work over the past ten years, whenever I encounter patients with acute hypertension, I often prescribe a concentrated decoction of Yi Mu Cao, which has shown good results without significant toxic side effects, and I present it here.
[Example 1]
A female patient, 70 years old, with primary hypertension for over ten years, accompanied by ischemic heart disease and a history of acute myocardial infarction, requiring regular medication such as “Diao Xin Xue Kang” and “Mercaptoacetylpropranolol” to maintain normal blood pressure.
On October 7, 1991, after exertion, she experienced headache, facial flushing, palpitations, and anxiety, with a yellow tongue coating and wiry pulse.
Blood pressure measured at 28/17 kPa (editor’s note: approximately 210/127.5 mmHg), so I prescribed Yi Mu Cao (whole herb) 60g for concentrated decoction to be taken frequently.
Three hours later, her symptoms significantly alleviated.
Blood pressure measured at 18.7/12.7 kPa (editor’s note: approximately 140.25/95.25 mmHg).
I advised her to regularly drink Yi Mu Cao as tea, and follow-up for two years showed no recurrence.
[Example 2]
A female patient, 62 years old, with primary hypertension for 7 years, accompanied by cataracts. She regularly took “Compound Antihypertensive” and “Compound Luo Bu Ma Tablets” to maintain blood pressure, but during exertion or emotional agitation, her blood pressure often rose to 23-27/14-17 kPa (editor’s note: approximately 172.25-202.25/105-127.5 mmHg).
On April 3, 1992, due to emotional agitation, she experienced headache, dizziness, nausea, vomiting, limb numbness, with a yellow tongue coating and wiry pulse.
Blood pressure measured at 27.5/16 kPa (editor’s note: approximately 202.5/120 mmHg).
I prescribed Yi Mu Cao (fresh herb) 90g for concentrated decoction to be taken orally, and four hours later, her symptoms disappeared, with blood pressure dropping to 18/12 kPa (editor’s note: approximately 135/90 mmHg).
Experience: Yi Mu Cao has a pungent and bitter taste, slightly cold nature, and enters the Liver, Heart, and Kidney meridians, possessing the functions of invigorating blood, regulating menstruation, promoting diuresis, and clearing heat and detoxifying. It is commonly used for gynecological diseases and nephritis-related edema. I learned from Chinese Herbal Medicine (Shandong Science and Technology Press, 1981) that this herb is effective for primary hypertension, and clinical trials have shown it to be particularly effective for hypertension of the Liver Yang rising type.
In rural areas, Yi Mu Cao is widely available and is an effective and inexpensive herbal medicine that colleagues may wish to try.
Huang Jing Si Cao Tang for Treating Hypertension
[Ingredients]
Huang Jing 20g, Xia Ku Cao, Yi Mu Cao, Che Qian Cao, and Xi Xian Cao each 15g.
[Indications]
Hypertension.
[Preparation]
First soak the above herbs in water for 30 minutes, then decoct for 30 minutes, combining the two decoctions.
[Dosage]
One dose daily, taken in two portions in the morning and evening.
[Case Example]
Mr. Pan, male, 48 years old.
History of hypertension for over ten years.
Recently experiencing headache and dizziness, with mild edema in the lower limbs, limited mobility, accompanied by back pain, palpitations, irritability, insomnia with vivid dreams, chest tightness, poor appetite, and difficulty urinating.
Blood pressure measured at 170/100 mmHg. Previously diagnosed with hypertension and gout at a certain hospital.
I prescribed Huang Jing Si Cao Tang with modifications.
After taking seven doses, dizziness decreased, and lower limb edema gradually subsided. Continuing with the original formula for a month resulted in the disappearance of dizziness and edema, with stable blood pressure.