Introduction: Some difficult diseases, such as systemic lupus erythematosus and Behçet’s syndrome, can initially manifest as skin lesions. How can we utilize the concept of Yin and Yang to treat these diseases? Let’s explore the clinical experience of Dr. Zhao Bingnan!
Skin diseases encompass a wide range and are closely related to various clinical specialties. Traditional Chinese Medicine (TCM) emphasizes the integrity and unity of the human body, with the theory of Yin and Yang being one of the foundational theories of Chinese medicine.Here, I will share my personal insights on the application of harmonizing Yin and Yang in dermatology.1. Symptoms of Yin-Yang Imbalance and Their Manifestations in DermatologyThe imbalance of Yin and Yang primarily manifests as an excess or deficiency of either Yin or Yang.According to the general principles of Yin-Yang imbalance, an excess of Yin leads to Yang diseases, while an excess of Yang leads to Yin diseases; an excess of Yang results in heat, while an excess of Yin results in cold.In dermatological practice, based on my years of experience, many conditions are related to Yin-Yang imbalance. These cases often share common characteristics: intermittent headaches, dizziness, cold hands and feet with warm palms; feelings of coldness, along with five hearts heat, lower back pain;occasional symptoms of heart-kidney disharmony and water-fire imbalance, such as palpitations, irritability, insomnia, forgetfulness, dizziness, tinnitus, fatigue, night sweats, or symptoms of upper heat and lower cold, such as mouth sores, thirst, and chapped lips, often accompanied by abdominal distension, diarrhea, and abdominal pain;female patients often experience irregular menstruation, excessive vaginal discharge, or young girls may have white discharge even before menstruation begins; male patients may experience nocturnal emissions, premature ejaculation, impotence, and coldness in the scrotum due to kidney deficiency or cold; and even symptoms such as insomnia with vivid dreams, irritability, forgetfulness, confusion, and unclear vision may occur. The pulse is often characterized by a wiry and slippery pulse at the cun position, a deep and thin pulse at the chi position, or a hollow pulse with a firm pulse at the sides, or a rough pulse with irregularities. The skin manifestations are diverse, including butterfly-shaped erythema or butterfly-shaped hyperpigmentation on the face, erythema nodosum, pruritus, and alopecia. The most common conditions are fox disease (similar to Behçet’s syndrome) and red butterfly (similar to lupus erythematosus), especially after high-dose corticosteroid treatment. Additionally, pruritus, alopecia areata, dermatomyositis, and scleroderma are also not uncommon.In summary, if the above symptoms appear in skin diseases, Yin-Yang imbalance should be considered first.2. Treatment of Yin-Yang ImbalanceThe principle of treating Yin-Yang imbalance is to harmonize Yin and Yang.Based on clinical experience, commonly used herbs include: Tianxian Teng (Clematis), Jixueteng (Spatholobus), Shouwu Teng (Polygonum multiflorum), and Gouteng (Uncaria). Tianxian Teng is bitter and warm, entering the liver, spleen, and kidney meridians; its bitterness promotes the flow of Qi and blood, thus activating blood circulation and unblocking meridians, ensuring that water flows smoothly, blood is activated, and wind is eliminated, achieving balance throughout the body; Jixueteng is warm, slightly bitter and sweet, entering the heart and spleen meridians, functions to invigorate blood and relax tendons, can dispel stasis and generate new blood, serving as a tonic in blood-invigorating herbs, treating symptoms like lower back and knee weakness, numbness, and irregular menstruation; Shouwu Teng is neutral, slightly sweet and bitter, entering the heart, liver, spleen, and kidney meridians, functions to nourish blood and calm the spirit, dispel wind and unblock meridians, can tonify middle Qi, promote circulation, and unblock blood vessels, guiding Yang into Yin; Gouteng is cool and sweet, entering the liver and pericardium meridians, its lightness can disperse, and its cooling nature can clear heat, thus calming the liver, extinguishing wind, and relieving dizziness. The combination of these four herbs can circulate through the twelve meridians, invigorate Qi and blood, regulate blood vessels, relax tendons, and achieve the function of harmonizing Yin and Yang.In clinical applications, if the patient shows signs of kidney deficiency, herbs like Tu Si Zi (Cuscuta) and Gou Qi Zi (Goji berry) can be added to tonify kidney Qi and nourish Yang; Nu Zhen Zi (Ligustrum) nourishes the kidney and benefits the liver, while Che Qian Zi (Plantago) promotes urination without harming Yin, and does not disturb the fire.The combination of these four herbs can generate essence and Qi, nourish the liver and kidneys, strengthen tendons and bones, and promote urination, achieving the effect of balancing water and fire, harmonizing Yin and Yang.If there are symptoms of heart-kidney disharmony and water-fire imbalance, Zishi Qing (Amethyst) can be used to calm the heart and nourish the liver, its nature is gentle and tonifying, treating anxiety, insufficient liver blood, paired with Lvying Mei (Green Plum) to alleviate dizziness and anxiety. If the heart rate is slow and blood pressure is low, Long Yan Rou (Longan), Li Zhi (Lychee), He Huan Hua (Mimosa flower), He Huan Pi (Mimosa bark), and Shi Lian Zi (Lotus seed) can be added to nourish blood, strengthen the spleen, benefit the liver, and calm the heart, ensuring the five organs are harmonious and the spirit is relaxed. If oral ulcers persist for many years, with Yin deficiency and Yang fire in excess, a small amount of Zi You Rou Gui (or Shang Rou Gui) can be added to guide fire back to its source, and can be combined with symptomatic herbs like Jin Lian Hua (Lotus flower), Ma Lin Zi (Euphorbia), and Jin Deng Long (Campsis) for comprehensive treatment. For those with both spleen and stomach deficiency, herbs like Shan Yao (Chinese yam), Shan Zhu Yu (Cornus), Sheng Di (Rehmannia), Shu Di (Rehmannia), and Ze Xie (Alisma) can be used to strengthen the spleen and benefit the kidneys.3. Case ExamplesLet me illustrate with some cases:Case 1: Zhang XX, male, 54 years old, case number: 458909. The patient presented with intermittent high fever and joint pain for over two years. He had received long-term treatment at a certain hospital with no significant effect, ultimately diagnosed with systemic lupus erythematosus, and was prescribed a large dose of hormones, with slight relief of symptoms. Upon arrival, he was still taking 60 mg of prednisone daily, but persistent low-grade fever, palpitations, weakness, dizziness, night sweats, irritability, vivid dreams, and poor sleep were reported.The tongue was slightly dark, and the pulse was deep and wiry at the cun position, with a deep and thin pulse at the chi position.Diagnosis: Yin-Yang imbalance, heart-kidney disharmony. Treatment: Harmonize Yin and Yang, connect heart and kidney. Prescription: Tianxian Teng 15g, Jixueteng 15g, Shouwu Teng 15g, Gouteng 10g, Zishi Qing 15g, He Huan Hua 10g, He Huan Pi 10g, Lian Zi Rou 12g, Li Zhi 10g. This prescription was taken daily for thirty-five doses, and the prednisone was reduced to 40 mg daily, with significant improvement in symptoms and stabilization of the condition. Case 2: Li XX, female, 40 years old, case number: 609591. The patient had recurrent oral ulcers for seven years, previously diagnosed with Behçet’s syndrome at a certain hospital, taking 20 mg of prednisone daily, along with Chinese medicine, with symptoms fluctuating in severity and never stabilizing. Upon arrival, she reported cold hands and feet, leg pain, occasional dizziness, headaches, and continuous oral ulcers, along with frequent loose stools, diarrhea, and lower back pain. The tongue was enlarged, with a white coating, and the pulse was wiry at the cun position, with a deep and thin pulse at the chi position. Diagnosis: Yin-Yang imbalance, upper heat and lower cold. Treatment: Harmonize Yin and Yang, nourish Yin and reduce fire. Prescription: Tianxian Teng 15g, Jixueteng 15g, Gouteng 10g, Sha Shen 30g, Tu Si Zi 12g, Nu Zhen Zi 15g, Che Qian Zi 15g, Ma Lin Zi 10g, Jin Lian Hua 15g. This prescription was taken daily for forty-nine doses, stabilizing the condition, with oral ulcers occurring only occasionally, and the duration of the disease significantly shortened. Both cases of systemic lupus erythematosus and Behçet’s syndrome are serious systemic diseases that are difficult to treat, and currently, there are no specific therapies. Western medicine uses corticosteroids (hereinafter referred to as hormones), which can temporarily relieve symptoms in some patients, but for others, even high doses may not control the condition; some patients find it difficult to reduce the dosage after long-term use, and during the reduction process, symptoms often recur and worsen, while long-term use of hormones can lead to a series of side effects and complications, often becoming a major cause of patient mortality.For example, in the first case, the patient was taking 60 mg of prednisone daily, yet the condition remained uncontrolled, with persistent low fever, palpitations, weakness, dizziness, and night sweats. According to general principles, the hormone dosage should be increased, but we not only did not increase the hormone dosage but also gradually reduced it, leading to gradual improvement in the condition, which certainly reflects the effect of treating according to syndrome differentiation and harmonizing Yin and Yang.In the second case, the patient was taking 20 mg of prednisone daily, with recurrent symptoms. After using the method of harmonizing Yin and Yang, the condition stabilized after just nineteen doses, and the hormone was discontinued, which also demonstrates the effectiveness of harmonizing Yin and Yang.4. PrecautionsIn summary, Yin-Yang imbalance presents very complex manifestations in clinical practice, and can be encountered in various diseases, with diverse expressions in skin diseases.Additionally, during clinical treatment, the following situations should be noted: First, for the treatment of skin diseases, it is essential to carefully analyze the symptoms. If the skin manifestations are caused by Yin-Yang imbalance, a comprehensive treatment approach should be adopted, addressing both the root and the symptoms, to achieve faster results.Second, Yin-Yang imbalance is the internal factor causing pathological changes in skin diseases, while the pathological changes in the skin are the external manifestations of internal Yin-Yang imbalance.The transition from Yin-Yang imbalance to skin pathological changes requires a certain process. Therefore, after medication treatment, the internal harmonization of Yin and Yang and the improvement and healing of skin diseases also require a certain process. Both the physician and the patient must have sufficient understanding, close cooperation, and maintain patience in treatment. Physicians should avoid changing prescriptions too frequently; patients should not seek treatment from multiple sources without adhering to the treatment plan. Only through a course of treatment over time can the internal Yin-Yang imbalance gradually improve, leading to the gradual improvement of skin disease symptoms and achieving therapeutic effects.Recommended for You:Support the author by purchasing a copy of “New Scientific Chinese Medicine”!It is difficult for folk practitioners to obtain certification, a challenge akin to climbing to the sky! The plight of traditional Chinese medicine practitioners in the assessment process!Chinese medicine should completely abolish the “Physician Qualification Certificate” and switch to clinical examinations!Rather than regulating “illegal medical practice,” it is better to fully open up!To achieve free healthcare in China, traditional Chinese medicine is essential!Using Western medicine to treat cancer is often fatal; this is how traditional Chinese medicine should treat it!
