Cirrhotic ascites, especially refractory ascites, is poorly treated with western medicine alone. Our liver disease specialty, in the treatment of such diseases, give full play to the advantages of traditional Chinese medicine, learn from the ancient teachings, diligently seek the recipe, the use of Jiepao Wan disease pill for the treatment of cirrhosis of the liver and ascites, and achieved relatively satisfactory results. The author’s understanding of the formula and clinical experience is summarized below for exchange. Cirrhosis ascites, known as dropsy in Chinese medicine. The spiritual center. Water bloating chapter” cloud: “dropsy how?” “Abdominal distension body are large, large and skin distension, etc., color pale yellow, abdominal tendons, this is its Hou also.” Later medical doctors on the formation of its etiology and pathogenesis, or the main to yang deficiency or the main to yin deficiency, or gas stagnation, phlegm and silt interconnections, each expressed their views. I refer to the “Nei Jing”, read a lot of books, repeated thinking, and finally realized. Think that the root cause of dropsy lies in the liver, spleen and kidney yang qi decline, drumming powerlessness, yin qi, which leads to slow qi and blood, stagnation of blood stagnation, yin and cold and blood wrestling knot, into a symptom into accumulation into dropsy. Spleen and stomach lack of transportation, water and grain essence may not be transported, dregs may not be downstream, confusion and mingling, stagnant qi and blood operation, fluid metabolism is not normal, swelling into also. Such as the “spiritual center. Disease Begins” cloud: “the beginning of the accumulation of birth, get cold is born, syncope is into the accumulation of …… “” cold juice foam and blood wrestling, then and cohesion, not line and accumulation of carry forward.” “Suwen. Tang liquid mash sweet theory chapter” cloud: “its there is not from the hairs and raw, the five viscera Yang has been exhausted, the fluid filled Guo ……” “Su Wen. Yin and yang other theory chapter” cloud: “yin and yang knot oblique, more yin and less yang, said stone water.” “Three yin knot is called water.” “Medical Zongjiren ed.” Yun: “The liver hides blood, and less blood makes the liver leaves hard.” All of them are its arguments.” Cirrhosis ascites of Chinese medicine treatment, the author consults the ancient and modern treatment experience, came to a conclusion: if the amount of ascites is small, the treatment is based on the soup, blood circulation, warm transportation of the spleen and kidneys, through the sun and water, slow figure; if the amount of ascites is more, urinary and feces is unfavorable, abdominal distension and fullness of the intolerable, or even on the compression of the heart and lungs, it is bound to be a grim agent to expel the water (pills, bulk), and then to support the positive agent to regulate the offensive and complementary two, can be effective. Ling Shu. Disease this chapter” cloud: “size unfavorable treatment of its symptoms.” “The first disease and after the fullness of the treatment of its symptoms.” Su wen. Six micro purpose of the great theory” cloud: “in and out of the fee is God machine to destroy, lifting and resting is the gas standing alone.” Sincerely. I have been looking for a cure for dropsy. After reading “Yue Mei Chinese medicine words collection”, “Yun Tieqiao posthumous”, “Qianjin Fang Derivation”, the three books contained in the “Qianjin Fang” Jiepao Wanji Pill is quite interested in. A brief description is as follows. Yue Meizhong: Treating a woman with an unexplained abdominal distension as large as a drum, the first moxibustion and stabbing medicines were ineffective, and then, after consulting ancient books, she was inspired by Yun Tieqiao’s personal record of taking the Ten Thousand Diseases Pill and put in this medicine to remove phlegm and water for several times, and the abdominal distension gradually disappeared until it returned to normal and did not recur again. Yun Tieqiao: After middle age, he gradually felt dizziness and heaviness, weakness of the limbs, much phlegm and saliva, and less food and drink. After applying this medicine for several times, he felt refreshed, his appetite improved and his body gradually recovered as before. Zhang Luyu: This formula has been used many times in clinical practice, and the therapeutic effect is exact and wonderful. This formula is from “Thousand Golden Essentials”, Volume XII, Gallbladder and Viscera Gate. It is the second of thirteen formulas in the seventh book of Ten Thousand Diseases Pills, also known as “Niuhuang Pill” and “Jiepao Pill”. It is also known as “Niu Huang Wan” and “Jie Pu Wan”. Later, it is also contained in “Secret Essentials of Wai Tai”. This formula was introduced to China from India in ancient times. It is said to have been created by Jiva (meaning life), who was known as the “King of Medicine” and “King of Drugs” in India. Ancient Indian Buddhist medicine believes that the human body is composed of four elements: earth, water, wind and fire, which is very similar to the five elements of Chinese medicine. In addition, the medical books named after Jaina include Jaina Pulse Classic, Jaina Sixty-four Questions, Jaina Five Viscera Theory, and Jaina Essentials Formula. The formula was widely used in the Tang Dynasty, for example, Kuan Xiu, a famous monk at the end of the Tang Dynasty who was known as the Master of the Ch’an Ri, wrote a poem entitled “Shihwanwanwanwan” (Pills for All Diseases) in which he praised the formula, which had an outstanding therapeutic effect. Guan Xiu was born at the end of the Tang Dynasty, the “Secret Essentials of Wai Tai” was compiled 150 years earlier than him. It can be seen that Wan Diao Wan has been widely used for at least a century and a half. And extract its efficacy as follows: treatment of “seven kinds of fetish block, five kinds of epilepsy, ten kinds of water disease, five kinds of jaundice …… and coughing on the gas, water chicken sound in the throat, can not sleep and lie down, food and drink do not do the skin, the five viscera stagnant qi, the accumulation of unclean, congestion closed and can not be blocked, heart and abdominal distension and fullness, and even the back of the chest, the drum qi firm knots, flowing into the four limbs …… five kinds of dysentery …… long accumulation of phlegm …… women’s cells in the blood stagnation and cold …… and children’s red and white discharges and fox odor It is also used in the treatment of deafness, nasal congestion and other diseases. This medicine to three pills for a dose, serving medicine but three doses, all diseases are removed, said poor endless, so it is called the pill of all diseases.” Serving method: weekdays on an empty stomach wine served three pills such as Wu Zi, take the micro under three liters of bad water for good. Avoid stale, cold, vinegar, slippery, sticky food, garlic, pigs, fish, chickens, dogs, horses and donkeys, white wine. One day service, two days to make up for it, get to eat new rice, leek bone (outside of Taiwan as vegetables) juice as a soup porridge, diet, three or four big good, not full. Nearly disease and new diseases are used more, cumulative disease that is less service, often take the degree of slightly loose profits. The medication for several diseases is as follows: 1. For those with phlegm, take three pills such as small beans. 2. 2. For obstruction in the abdomen, take two pills like small beans, three times a day. All of them should be eaten between meals, to the extent that they are beneficial. 3, water disease, take two pills such as small beans, not disease, the next day to take more. 4, urinary incontinence, take two pills such as small beans, do not recover, tomorrow more service. 5, fecal impassability, take three pills such as small beans, and within a pill in the lower part of the pass. 6. Fangfeng, Platycodonopsis, Radix et Rhizoma Pinelliae, Radix et Rhizoma Pinelliae, Drabanemerosa hebecarpa, Aster Herba Aster: promoting and lowering the lung qi, diarrhea of the lungs, inducing diuresis, and regulating the water channels. 1, the formula is also known as the Ox-Huang Pill, indicating that Ox-Huang is important in the formula. Niu Huang into the liver and gallbladder, pericardium meridian, can calm the liver and wind spasm, clearing heat, phlegm and opening, detoxification and avoidance of filth. Clinically seen, dropsy patients, less than the transport of water and grain, liver stagnation of excretion, urination and defecation, more unfavorable, water and poisonous dregs can not be diarrhea, gradually lead to the silt and heat into fire disturbed blood, heat and wind, entrainment of phlegm and fire upward masked the heart orifices, so see the hemorrhage, stupor, delirium, and other symptoms. Similar to the category of hepatic encephalopathy in Western medicine. So the formula to yellow, rhinoceros, sand, Xiong, musk for the king, the products of the rhinoceros, detoxification and phlegm, open the orifices to wake up the spirit, the town of the heavy liver to calm the wind, cool the blood to avoid obscenity, in order to cure this serious disease. Later generations of Angong Niuhuang Pills have these drugs. And niu huang, andrographis paniculata detoxification force strong, there are a lot of reports for the treatment of malignant tumors and leukemia, have achieved a certain degree of efficacy. Late cirrhosis is often transformed to liver cancer, and play a preventive effect. 2, Huang Lian, Scutellaria baicalensis clearing heat and diarrhea and detoxification, not only can strengthen the power of the upper medicine, but also can prevent the formula of warm medicine to hurt the yin, can be used as adjuvant. 3, glycyrrhiza glabra, halberd, guanhua, bazhou, a collection of traditional Chinese medicine to attack and expel the water drink the most violent power of the products, one of the water poison is fierce, non-heavy drugs do not think that the work; the second is the division of the grain should not be a long battle, so a drum, hit and go. For the ministerial medicine. 4, Guanqing, also known as the green lady, insects, pungent, toxic. Functions: to attack poison and expel silt, eliminate phlegm and disperse knots. Lizard, salty cold with small poison, function: eliminating galls, attacking poison and dispersing knots, detoxifying and tonifying yin. Together with centipede, it can attack toxins and disperse lumps, break the obstruction in the abdomen, enter the channels to search for evils, and supplemented with yu yu gan, pohuang and chuanxiong, it has certain curative effects on dispersing the bad blood in the liver, promoting the improvement of blood circulation in the liver, repairing hepatic fibrosis, and reversing the structure of cirrhosis of the liver. And the three animal medicines can also prevent liver cancer. Lizards can break their tails to save themselves, and their strong regenerative ability can be known. Modern research has proved that lizards can effectively inhibit phlegm secretion (good effect on cold phlegm), and also promote fracture healing. The author speculates whether this drug can similarly promote liver cell regeneration, which can be further studied. In the Ben Jing, Yu Yu Liang is said to be able to break up blood closure and obstruction of the masses. Yu Yu Liang Pill is used for this purpose. This group of herbs is also used as ministerial herbs. 5. There are eight flavors in this group of medicines, namely, Radix Angelicae Sinensis (参归) to nourish qi and blood, Radix Paeoniae Alba (桂芍) to harmonize the camping and defending forces, and Ginger, Capsicum, Cynanchum, and LING, which together warm the liver and spleen, and complement the positive qi. Yang qi is restored, qi and blood are filled, the middle jiao healthy transport force line, water and grain essence can be absorbed, the medicine can be carried out, fluid, qi and blood back to its normal, and the patient’s have? For the adjuvant. 6, this group of drugs into the lung meridian, declaring down the lung qi, diarrhea lung water. The lung is the highest, the source of water. The scripture says: “Spleen qi disperses the essence, which goes up to the lungs, regulates the water channels and transports the bladder downwards”. The declaring and descending of the lung qi contributes to the normal metabolism of water and liquids. Lung qi to facilitate urination and defecation, the previous use of a lot, I will not repeat. It can be used as an enzyme. This is probably the case for the analysis of the meaning of the formula. In addition, the method of administration of this formula is also worth studying. There are the following characteristics: 1, “on an empty stomach on the first day of the week, wine”, the first to take “yin qi has not yet moved, yang qi has not yet dispersed, qi and blood is not yet chaotic”, is conducive to the expulsion of evil spirits. Secondly, the drug will be diarrhea, taking in the morning to facilitate the observation of the doctor. The third is to send wine to serve, wine for the valley of the humongous gas, can help the medicine to reach the depths of the people. The author intends to use rice wine is good. 2, each time the dosage is small, “two pills or three pills,” as far as possible, to avoid the evil of the harsh agent drive injuries to the right side of the problem. 3, attack in the complement, “one day service, two days to make up for the”, “get to eat new rice, leek juice for porridge, diet, three or four big good, but also not full.” Reflecting the idea of taking into account the positive qi at all times. New rice is the most nutritious stomach gas, and leek juice, appetizing blood, eat small meals, do not make full, stomach gas is weak, full is easy to eat again. 4, the new disease into the disease are used more, cumulative disease that is less service “also reflects the view that the maintenance of positive qi everywhere. The newest disease is more real, long illness is the decline of positive qi, the use of medicine should be measured. The author in the clinical use of the formula, several of the medicine for the adjustment, so that it is safer, more economical, more practical. Specific artificial oxalis instead of natural oxalis, gecko easy lizard, buffalo horn easy rhinoceros horn, dried toad skin easy Guanqing, plus a flavor of Zihechuan, tonic essence and blood. The whole prescription dose in addition to ginseng, purple river car with 6 grams each, musk 1 grams, the remaining drugs are taken 3 grams, powdered, honey to do pills, soybean size, the morning first with jujube soup on an empty stomach to send down more than 10 pills, and then eat a bowl of thin rice. After taking the medicine, it usually takes two to four hours for the medicine to kick in. At the beginning of the attack, the patient first manifested different degrees of nausea, regurgitation, light mouth saliva secretion increased, heavy mouth can spit out clear thin saliva bowl, followed by abdominal pain, yagi, stools then down. Stools before the dry and then dilute, first can be discharged in the intestines of more than 100 kilograms, after the diarrhea are dilute water, the number of times five or six times to more than ten times ranging from the amount of diarrhea less than a thousand milliliters, more than three or four thousand milliliters, urine is less, generally only a few hundred to a thousand milliliters of Xu. After the diarrhea, the vast majority of patients will feel lighter. Thereafter, the formula of activating blood circulation and warming the spleen and kidneys will be used to treat the root cause of the disease. Sage Pills should be used once every other day. For those with good appetite, it can be taken more than ten times intermittently. For those with poor appetite, five or six times is sufficient, and should not be used more than once. One will hurt the positive qi, and the other is afraid of causing gastrointestinal bleeding. Attach two cases in the following: Zheng Mou, female, 52 years old, cirrhosis decompensation, hospitalized patients. Abdominal distension, abdominal wall tension, but no pressure pain and rebound pain, abdominal wall varicose veins, umbilical convexity, wheezing, limbs lean, still eat, urinate less, only 200-300 ml per day, stool dryness for two or three days a line, the tongue is pale and tender, the moss is thin white greasy, the pulse is thin and stringy. Abdominal circumference is 103 centimeters. Has with tachycardia injection, mannitol and other Western medicine IV diuretic, ineffective, Chinese medicine soup used Gan Sui, rhubarb, black clowns, etc., the first small effect, and then ineffective. The patient was distended and intolerable, but insisted on not pumping ascites. I think, the patient’s ascites is too large, is not a soup can its role. Fortunately, his stomach qi is still alive, so he took the Jiepao Wan disease pill more than ten pills. Three hours later, the patient first felt nausea, spit out two bowls of dilute saliva, followed by abdominal cramps, non-stop vector gas, and then unloaded before the dry after the soft molding of stools in the basin. And then diarrhea light yellow dilute water 1500 milliliters. Although the whole process of the patient has been abdominal discomfort, but after the diarrhea felt a lot of body lightness. And then to activate blood circulation, warming the spleen and kidneys, diuresis and Yang’s prescription and service. Sage pills are taken on alternate days, during which albumin and plasma are supplemented. After the above treatment, the patient was able to diarrhea about 2000 to 3000 ml of diluted water each time, and the urine gradually increased to 800-1000 ml. After more than 20 days of treatment, abdominal distension gradually disappeared, and the abdominal circumference was reduced to 85 centimeters, so the patient stopped using Jiepao Wan Disease Pill, and took it orally with tachycardia tablets and spironolactone together with traditional Chinese medicinal soup, and was able to urinate 1200-1800 milliliters of urine per day. Yang, male, 46 years old, cirrhosis complicated with slow plus acute liver failure, spontaneous peritonitis, hospitalized patient. Generalized yellow stain, abdominal distension and fullness, whole abdominal pressure and rebound pain obvious, two unfavorable bowel movements, tender red tongue, thin white moss, pulse sinking and smooth. Despite intravenous cephalosporins, levofloxacin and other antibiotics, supplementation of plasma, albumin, and intravenous tachycardia, the stools were still inaccessible, and the abdomen was still distended and painful. He took five pills of Jaina Wan Disease Pills. Two hours later, more than 1,000 grams of stools and more than 1,000 milliliters of diluted water were ejected, and the abdominal distension and pain were significantly reduced. Afterward, the patient was treated with qi nourishing and yin nourishing tonics, which he drank to maintain his positive qi. In short, Jiepao Wan disease pill is unique in its efficacy, the treatment of cirrhosis ascites is only one aspect of its many functions, it is worthwhile for us to further inheritance and discovery in the clinical use of it.