by Bob Flaws

On pages 6-7 of issue #8, 2008 of Gan Su Zhong Yi (Gansu Chinese Medicine), Li Yong-qi published an article titled “Professor Zhou Xin-you’s Clinical Experiences Treating Prostatic Hypertrophy.” In this article, Li says that Prof. Zhou identifies three basic patterns of BPH: 1) qi stagnation & blood stasis, 2) kidney qi depletion & vacuity, and 3) damp heat pouring downward. However, Prof. Zhou believes that liver-kidney depletion and vacuity with loss of duty of qi transformation is the root of this condition, while phlegm and (blood) stasis binding internally are this condition’s tips or branches. Thus, although Li describes the signs and symptoms, treatment principles, and Prof. Zhou’s guiding formulas for each of the three patterns, the representative case histories included in this article make it clear that, in actual clinical practice, these three patterns do not present in their pure, discrete form. For instance, in case #1, the patient presented a combination of liver-kidney depletion and vacuity with inhibition of qi transformation plus phlegm dampness obstructing internally and qi stagnation and blood stasis. Therefore, the formula Prof. Zhou prescribed was based on his formula for liver-kidney depletion and vacuity but heavily modified by additional ingredients for the phlegm dampness, qi stagnation, and blood stasis. Similarly, in case #2, the patient presented a pattern of damp heat brewing and accumulating in the bladder plus stasis and obstruction of the channels and vessels. Thus the formula Prof. Zhou prescribed in this case was a combination of both his qi stagnation-blood stasis and damp heat pouring downward guiding formulas. This article shows that the classroom description of treatment based on pattern discrimination of any specific disease is different from its actual clinical treatment where multi-pattern presentations are the rule rather than the exception. In that case, such multi-pattern presentations require more complex, multi-principle formulas.

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