For the treatment of chronic cholecystitis, HengXi combines specialized prescriptions and medicines (ChaiHu 10g, Gentiana 10g, raw oyster 30g) with evidence-based treatment. Why should we use specific prescriptions and medicines? Firstly, to make up for the shortage of evidence-based treatment, and secondly, there is really an objective basis for using specific prescriptions and medicines. The clinical symptoms of chronic cholecystitis are complex, but the overall pathological mechanism is mostly due to liver and gallbladder heat, the spleen and stomach gasification disorder and congestion (constant evidence so, variant evidence is not listed here). Therefore, Chai Hu is used to promote liver qi (liver likes to ascend) and to clear liver depression (wood depression); Bile Cao is bitter and cold, sinking yin and descending, to relieve the actual fire of liver and gallbladder (phase fire is in the liver and gallbladder, there is diarrhea but no tonic, it should descend but not ascend); raw oyster is cold, salty and soft, dispersing the agglomeration of qi and fire, removing the hardness of the hypochondrium, and can melt the qi of liver, gallbladder and spleen and stomach in one. The combination of the three flavors, a rise and a fall and a and, specifically for the treatment of liver and gallbladder heat, so it can improve the clinical efficacy. Here are some test cases to prove this. Case 1: Chen, female, 41 years old, first diagnosed on May 11, 1977. The patient suffered from acute cholecystitis in June 1974, which was relieved by conservative treatment with Chinese and Western medicines, but the right upper abdomen kept swelling and pain radiating to the right scapular region. He said he had taken 43 doses of Chinese herbal medicine and the pain did not stop, accompanied by chest tightness and refusal to press, coughing up sputum in lumps, bitterness in the mouth like containing fish bile, yellowish greasy moss, and slippery pulse. This is due to heat depression in the liver and gallbladder, decoction of fluid into phlegm, which runs through the shoulders and back, blocking the chest and diaphragm. The treatment is to elevate the liver and lower the gallbladder, clear heat and resolve phlegm. I gave a special formula of special medicine combined with warm gallbladder soup, small trapped chest soup plus pollen: Chai Hu 10g, gentian grass 10g, raw oyster 30g, Fa Xia, Yun Ling, Citrus aurantium, fried Gua Pou Ren 12g each, bamboo rhizome 10g, Chen Pi, licorice 6g each, Chuan Lian 3g, pollen 30g. Take 4 doses of pain, all symptoms greatly reduced, but the right scapular area stagnant uncomfortable, the above plus Di Long 10g, stiff silkworm 15g, and take 4 doses, clinical symptoms disappeared. After one year follow-up visit did not recur. Case 2: Li, female, 38 years old, first diagnosed on February 27, 1974. She has been suffering from chronic cholecystitis (diagnosed by cholecystography) for 4 years without interruption of Chinese and Western medicine, although it has not led to acute attack, but the right upper abdomen has always been painful, accompanied by greasy mouth, dullness, loose stools, excessive sweating, leucorrhea, with left-stringed and right-moistened pulse and white greasy and slightly yellow coating. This is due to heat stagnation in the liver and gallbladder and damp-heat in the middle jiao. The treatment is to elevate the liver and lower the gallbladder, and to promote the circulation and smooth the middle. I gave a special formula and medicine combined with San Ren Tang: Chai Hu 10g, Gentian Cao 10g, Sheng Oyster 30g, Almond and Fuxia 15g each, Coix Seed and Slippery Rock 18g each, Cardamom, Tong Cao, Light Bamboo Leaf and Hou Pu 6g each, taking 4 doses to relieve the pain and all the symptoms. In the future, whenever the right upper abdomen starts to be painful, this formula can be used to relieve the pain, and the recent efficacy is good. Case 3: Zheng, male, 56 years old, first diagnosed on December 8, 1977, suffered from acute cholecystitis in May 1976, which became chronic after being relieved by conservative therapy. The right upper abdomen was distended and painful, sometimes running to the shoulder and back, and the hands and feet were slightly cold when the pain was present. The pain could be reduced with frequent yagging, but increased with worry and irritation. The pain can be relieved but not stopped by repeated use of liver-regulating drugs. The tongue is red, the moss is thin and yellow and dry, and the pulse is string-like and weak. This is due to heat in the liver and gallbladder and Qi stagnation in the chest, with signs of injury to Yin. The treatment is to elevate the liver and lower the gallbladder, regulate qi and open depression, and protect liver yin. I gave a special formula with Chai Hu and Liver Dispersion to remove Chuanxiong, and reused Bai Shao: 10g of Chai Hu, 10g of Gentiana, 30g of raw oyster, 30g of Bai Shao, 10g each of Xiang Fu, Citrus aurantium and Qing Pi, and 3g of licorice, and took 4 doses to relieve the pain. Half a year later, because of things whisked, the right upper abdomen and distension pain, still cast above, plus Xuan Hu 6g (rolled subdivision four times swallowed), 2 doses of pain. Case 4: Wang, female, 42 years old, first diagnosed on October 12, 1976. Stabbing pain in the right upper abdomen for more than a year, the pain seems to decrease with light rubbing, but increases with heavy pressing. She moaned at night and felt a fishy taste when drinking water. He said he had been touched by a cow’s horn before the onset of the pain in the right upper abdomen. After several medical consultations, all the symptoms were reduced with the use of prescriptions for activating blood circulation and eliminating blood stasis, except for the pain in the right upper abdomen, which remained the same. The tongue is purple-blue and the two guan veins are stringent and astringent, which is indeed a sign of blood stasis. However, there are still signs of chronic cholecystitis such as bitterness in the mouth and worsening of pain and bitterness in the right upper abdomen after eating fatty food. We considered the symptoms of liver and gallbladder stagnation and heat, and blood stasis in the chest, and tried to promote the liver and lower the gallbladder, dispel blood stasis and open the ligaments, and gave special prescriptions and medicines to combine with Dan Shen Drink and Active Ligaments: Chai Hu 10g, Gentiana 10g, Sheng Oyster 30g, Angelica and Dan Shen 15g each, Frankincense and Myrrh 10g each, Sha Ren 6g, Sandalwood 3g, and even into 8 doses, the pain gradually stopped. Not and half a year, the right upper abdomen and began to stabbing pain, diagnosed by cholangiography for chronic cholecystitis, to the above 10 doses, pain and gradually stop. Still feel slight pain in the chest and hypochondrium, abdominal distension, change to take Chai Shao Liu Jun Zi Tang 8 doses, all symptoms disappeared, has not recurred for more than three years. I have not tried to use specific prescriptions and medicines for the treatment of chronic cholecystitis in my early years, but only according to the principles of evidence-based treatment, using a variety of treatment methods, such as dredging the liver and Qi, clearing the gallbladder and stomach, promoting dampness and heat, activating blood circulation. If there is no discrepancy in the certification, it is indeed effective. However, because the condition is variable and recurrent, it is difficult to master and control. However, once the special prescriptions and the identification of evidence are combined, it is possible to manage the complexity, and improve the effectiveness of treatment. This shows that while the identification of evidence is important, the identification of disease should not be neglected. The combination of theoretical identification of disease and identification of evidence, and the combination of specific prescriptions and medicine and identification of evidence in practice is an important way to improve the level of Chinese medicine treatment. 2, chronic cholecystitis is mostly complicated by gallstone disease, while non-stone chronic cholecystitis is not uncommon in clinical practice. The specific prescriptions and medicines introduced in this article are in principle applicable to both non-stone chronic cholecystitis and cholelithiasis cholecystitis. However, the latter is mostly biliary heat and gastric realities, so it is advisable to treat the latter with special prescriptions and drugs to remove heat and clear the internal organs. This special formula has been used to treat “post-biliary surgery syndrome”, which can be used to clear bile and relieve pain. 3, clinically there are biliary roundworm with infection, this special formula and medicine combined with Wu Mei Wan can improve the effect of roundworm and lower roundworm, clear bile and relieve pain. For those who are suffering from chronic cholecystitis and have a deficient kidney yin constitution, this formula can be used together with Gao Gu Feng Zhi Shui Liver Clearance Drink, which is also effective. 4, the combination of special prescriptions and treatment of chronic cholecystitis, because the prescriptions are on the bitter-cold side, such as a long time to take, after the pain is stopped, some patients can appear some spleen deficiency and weakness of Qi symptoms, at this time do not delusion to warm tonic. “I am afraid that although the smoke of the furnace is extinguished, there is fire in the ash.” It is advisable to use Chai Shao Liu Jun Zi Tang to dredge the liver and support the spleen, and slowly figure out the treatment. The patient should also be advised to abstain from oily and spicy, warm and dry food, and should regulate the mood, optimism and cheerfulness. Otherwise, it is feared that the work will be accomplished but abandoned, and the chronic illness will return.