平之气介绍

平之气介绍

马来西亚 侯颜良 (HAU, Wan Leong) 硕士

康生中医针灸内科、顺势天然医药中心

Pusat Rawatan Homeopati Chen Chin

5, Jalan Songkit 1, Lorong 3, Taman Sentosa,

80150, Johor Bahru, Johor. Malaysia.　

Tel: +6016-7834507

中医先贤在数千年的经验累积，总结出久咳难愈（慢性支气管炎）或哮喘（慢性支气管哮喘）的发病原因，多为如下数因：

（一）三脏虚损

· 脾脏：脾失健运，水谷不能运化，造成痰湿内生，阻滞气机

· 肾虚：肾虚气化无力，形成水不泛而生痰液

· 肺虚：肺虚不能健运水道，积而为痰，加上肺虚排痰无力，阻塞气道，形成气流不畅

脾为后天之本，久病必令先天肾脏失养；而肾又为肺之母，肾母虚不足供于肺子，久则子亦虚损；固三脏形成恶性循环之像。

（二）痰邪顽积

因各种因素形成的肺痰久积呼吸系统，湿痰涌盛可阻碍气机，久则随体温熬缩成顽固的粘痰，胶粘在呼吸系统里。随时间日益累积，逐渐扩展漫延，呼吸系统腔室因而造成狹窄，一旦因各种內外因素使到气流受阻，引起肺脏的宣化升降失调时，使支气管疾患产生。

创方者结合了先贤的经验，遵循了健壮肺脾肾三脏，强涤顽痰的治则；在方药上结合了古今先贤的经验，在结合本身临床所得，创立了平之气。

平之气的药方组成与药理：

虫草，淮山，灵芝	滋壮三脏，不燥不腻，调和阴阳
百合，白芨，白藕	助诸药深入肺窍，且可修补破坏组织
礞石，杏仁，淅贝，半夏，桔梗， 茯苓，远志，橘红	诸药合用涤痰散结，强化顽积
代赭石，桔壳，桔实，旋复花	降肺气
升麻，桔梗	升肺气
柴胡，麻黄，	宣化肺气，和解表里
诸药合用形成 ：滋补三脏，调和阴阳，和解表里，强涤顽积，开窍通塞之功

用药法则：

急性哮喘发作：以平之气10～20g以低温水调服，一次性吞下，即可迅速止喘。

频频咳嗽不止：以平之气3～5g或者10g， 每半小时一次（依病情而定）直至情况改善 后，才延长服药的时间成1～2小时或3小时一次，直至症状稳定后，才保持一天三次。 （平之气无毒性，故可频数和大剂量服用）

慢性支气管（长期咳嗽不愈）与 慢性支气管哮喘： 一天三餐后服3g,每三个月为一个疗程；可发觉病情迅速改善。每一个疗程结束后停1～2星期（避免产生耐药性，但期间有需要亦可按照上述方式服药）一般以四个疗程为准。 善后：经四个疗程之后，一般上病情可获稳定，受治者明显会自觉呼吸顺畅，体力增 强，精神好转。此时可一星期适量服用数次，当保健作用！本方不寒，不燥，适用于各 类型支气管疾患。

饮食禁忌：

从经验累积，支气管患者决不能单以药物做为主要治疗手段。治疗期间，除了病患

生活起居不能过度劳累外，饮食尤其非常重要。临床上，治疗期间的饮食控制与疗效成败有绝对的关系！临床的经验，发现两大类的饮食品对支气管病患者有诱发作用：

凉性
各种凉性水果	橙，龙珠果，奇异果，梨，柚子，百香果，山竹，葡萄，duku, langsat等（故尽量避免在治疗中食用此类凉性水果，以免诱发。果类所需的营养成分可从菜类加姜和辣椒片代取之。）
各种凉性蔬菜	大白菜，包菜，空心菜，甜菜，苦瓜，西洋菜等 （此类蔬菜可以在煮炒时加入姜片或辣椒片等以化解其凉性）
其他凉性饮食	燕菜，生水，汽水，乳酸菌食品，凉性保健品，鸡肉，鸭肉，牛肉，内脏，隔夜食物，某些中西药等。
刺激性 芒果，香蕉，芋头，木薯，糯米，经腌制过或经烧，烤，煎，炸过的食物。各种蜜饯，甜食，零食等。
此二类食品，支气管病患食用后发现容易产生痰湿，对支气管产生刺激。这在治疗支气管过程中成功与否往往产生了关键性的影响，因此是必须特别注意的事项。

The Clinical Report of Non Surgery Bruises Permeable Therapy for Arthritis Patients

The writer has used the bruises permeable therapy (treatment) to clinically treat arthritis patients with effective outcome, who perceived must undergo surgery in order to recover by modern medicine. The complete treatment processes are as following:


Inspection:

Applying the principle of bruises permeable therapy to relieve the muscles constriction, the practitioner has to locate the nearest and furthest occlusion area by using tendon tapper as a main examination tool. From the clinical experiences, the occlusions of bruises normally occur at internal thigh like semimembranosus, semitendinosus, adductus muscles, euadriceps and sartorius for inner arthritis. However for the external arthritis, the occlusion area normally occurs at biceps femoris, rectus femoris, external of quadriceps, tensor fasciae latae.

When the practitioner able to identify the common and regular occlusion area, the inspection time can be reduced and more specific treatment area can be located to achieve the best outcome. According to the principle of Traditional Chinese Medicine (TCM), where, “When the blood circulates smoothly, painful sensation will not occur and vise versa”, by using the tendon tapper to hit the common occlusion area with appropriate strength, normally if there is occlusion area where TCM believes that is the area of extravasated blood occludes in the blood circulation, the blood occlusion area will lead to inflammation and painful sensation as per discovery of TCM.

Therefore, in order to find out more specific occlusion area, we need to compare pain sensation of the healthy side and the disease side. This means that, if we use the same strength to hit both side (healthy side and disease side) and compare the difference of pain sensation, normally, the healthy side will not have strong pain sensation. If the healthy side have similar pain, the practitioner should pay attention to whether he had used the appropriate strength, consistency of inspecting areas, the pain sensitivity of the patient, toleration of pain and psychology effect. If the inspector can exclude the above mentioned factors, then he may suspect the healthy side has hidden symptom of inflammation or confirmed symptom of inflammation. A further enquiry of patient’s history and medical investigation is necessary.

Beside the comparison of pain sensation of contrast side technique, we can also examine the pain sensation of the muscles of disease (occlusion) side, which means that to find out the pain areas of occlusion side and apply the above mentioned methods accordingly on the pain areas and its surrounding areas. The writer discovers that, there will have a great difference of pain experienced by the patients and thus the specific pain spot can be located.


Treatment:

After identified the specific inflammation areas, together with the nearest side to the furthest side of the occlusion area, we can use the suitable techniques like scraping, pushing, pressing, tapping therapy, etc. to treat the patient. The appropriateness of the strength used depends on the individual patient’s condition and must be within the toleration of the patient. Various techniques will be applied according to the disease condition during the treatment process. Normally, there will be redness (erythema) occur in the main treatment area, and the painful sensation will gradually increase as the treatment progress. The physician can reduce the force and slow down the process accordingly at this moment. The painful sensation will gradually increase even with the same force applied in the treatment. This means that the bruise is going to permeate to the superficial skin.

As the treatment continues, the bruised area will appear in the form of spot (petechias), small patches (ecchymosis) on the superficial skin. At this point of time the patient will not only feels the natural pain at the treated area, but also feels comfortable in-depth occlusion areas.

During the progress of the treatment, some of the patients’ bruises will not permeate to the superficial skin, but only present in the form of redness. Observation of response after treatment is required, because sometime the bruises will only permeate after a few hours after the treatment. However, through clinical discovery, some of the patient condition has improved even though their bruises do not permeate to the superficial skin after the treatment.

Normally, the duration per treatment is flexible. The treatment duration and the length of treatment course are depend on the factors such as depth of the bruises, the size of bruise area, the length of illness, the patient’s body condition, age and tolerances of pain by the patient. The practitioner will recommend patients to follow up the treatment after four or five days of their last treatment. This is because the even though the bruises appeared on the skin have not completely disappeared but the bruise in-depth muscles which have not permeated might gradually gather together as a result of slower metabolism. The patients will feel the discomfort at the inflammation area after four or five days of treatment, therefore they need to follow up a new the treatment even though the permeated bruises have not completely disappeared. The permeated bruises normally will take two to three weeks to be completely disappeared, so the physician should inform the patient in advance to reduce the anxiety.

In order to enhance the effectiveness of activating the blood circulation, oral medicine and topical oilmen can be supplemented.

For some of the stubborn arthritis, besides focus the treatment on nearest side to furthest side of arthritis areas, the bruise permeable therapy can be also applied in the arthritis areas, cupping therapy, acupuncture, bloodletting (hemospasia), roasts needle, needle insertion and needle knife therapy can be used concurrently in order to achieve the excellent therapeutic outcome.


Principle:

The essential of TCM theory is to provide comprehensive and holistic care and treatment to all patients. From the past experience of the writer in treating the arthritis, we usually adopt the experience acupuncture points and certain “A Shi acupoints”[1]. The pain can be relieved in short term but the illness is not stable and unable to achieve the desirable results over long term. After consideration of the relationship with structure of human anatomy and the blood circulation, and also through the comparison of healthy and disease side, the writer discovered that the pain sensation of healthy side (whether is nearest side to furthest side) and disease side is extremely different (contrast). At that time, the writer associated some traditional folk therapies like scraping therapy, tapping therapy, whipping therapy, cupping therapy, the knife cure therapy are also achieve the treatment outcome by permeate the bruise to the superficial skin. From understanding of principle of TCM where, “when blood circulates, no pain; Pain occurs, when circulation affected.” the excellent therapeutic outcome had been achieved after the writer has combined the traditional therapy with his new findings.

From the accumulation of clinical experience, the writer had rearranged and identified the common occlusion area.

However, according to the theory of the writer’s thesis of “Brief discussion about the pathology of bruises formation and bruises permeable treatment” published in year 2001 at the fifth academic meeting which organized by Fujian Association of Research and Advancement of TCM in Fuzhou, the occlusion caused by the extravasated blood in the muscle will cause swollen of the muscle. This condition will narrow down the muscles interspaces, causing the muscles constriction and eventually result in inflammation. This had indicated that the swollen muscles, which cause by occlusion of the extravasated blood in any strand of tendon or muscle, will result in muscles constriction and causing inflammation and its complications.

Besides that, the inflamed muscle or tendon will increase its elasticity and coupled with biological mechanism, this will cause the tendon which adheres to the bone to have inflammation. This often misdiagnosed as bone disease because of its vicinity to skeleton (certainly there might have some real bone disease). Therefore, in order to avoid subjective disturbance which affecting the treatment progress, it is very important to carry out the comprehensive and thorough inspection by contrasting the healthy and disease side.

Furthermore, based on the physiology doctrine, the occlusion of muscles will cause the blood circulation being occluded, causing insufficient of blood supply to the affected area in long term and result in deterioration of blood circulation of the small vessels. This situation will cause insufficient nutrition supply and eventually deteriorate the bone structure and causing bone damage

There are many successful cases of using the transplantation of blood vessel insertion technique to treat the necrosis of the neck of thighbone in the previous clinical research. The writer also passed his master graduation thesis though the research of the treatment of transplantation of blood vessel to treat wrist os naviculare necrosis. From that thesis the writer associates the theory of dissolving certain occlusion of extravasation blood to enhance the blood circulation and supply to regenerate the deteriorated joints. In clinical, it had successfully save the patient from surgery treatment and improved the condition and eventually recovered.


Experience:

The acupuncture and moxibustion theories emphasize on the occurrence of “Tian Ying acupoint” (which is same with “A Shi acupoint” or “painful acupoint”). If this is similar to the principle of occlusion described by the writer earlier, the abstraction of acupuncture and moxibustion theories will be cleared based on physiological anatomy relational elaboration. A better understanding of above mentioned pathogenesis can even enhance the clinical effectiveness. The key indicator is the “Tian Ying acupoint” should not only focus on patient’s main complaint area and its surrounding press pain point, but also on the far-ended area, and should treat holistically and comprehensively for best results.

Modern medicine commonly mentioned that the osteoporosis and destructive of bone should not only explained through gerontology, but further research in dissolution of blood circulation due to extravasated blood and the regeneration of ossein cell are require.

By applying the principle of dissolving and lysing the blood clot or occlusion to stimulate the blood circulation and to resume to the normal blood circulation condition, the writer had successfully treated and cures the patients without any surgical operations. However, this is limited to small samples size. In order to enhance the effectiveness of treatment, the writer need to combine and coordinate with other techniques such as moxibustion, acupuncture, bloodletting, the needle knife, etc. During the treatment process, the patients may suffer certain level of pain in body or mind. The misunderstanding of the treatment by western and Chinese medicine had caused slander and results in some of the patients giving up the treatment.
For this, if modern technology and techniques can be applied to detect and locate the accurate and specific occlusion area and coupled with advance therapy, then this might be a milestone in the modern medicine and bring well fare to human being. May this thesis shared with everybody.



[1] In TCM, the “A Shi acupoint” does not denote any particular acupoint of the body, but is the painful site reflected on the body by some disease or occlusion, we can also call it “painful point”.

透瘀疗法之膝关节炎患者免除手术的临床报告

序言:

在民间流传着许多传统医技如刀疗、拍打、鞭疗、括痧等法，皆以达到透出瘀状作为治疗手段，然而这些颇具特色的医法，常显现出令人意想不到的效果。笔者通过亲身实践与参考过许多医学文献和现代医学的观点，阐述出一些见解。并希望经过略述，能唤起现代医学对传统医学具科学性的的治疗重视与见解，更希望能结合现代医械以替代传统古老的医法和进一步治疗技术的提升和改进，并发现膝关节（半月板）软骨破坏者望以此法达到免除手术的效果。文中有提出一些新的观点与过去传统医学和现代医学的见解颇有出入，因学识有限，望同道不吝指正。

曾以透瘀疗法在临床上治疗了数位经现代医学认为非经手术方可的膝关节患者，经治疗后而获得良好的效果，特此报告如下：

具体的施治过程如下：


检查：

应用透瘀疗法而化解组织压逼的原理，故首须得先寻求出患者的远、近端阻滞所在。以检查槌为主工具，临床经验中，内膝炎症阻滞多在大腿内侧半膜样肌、半腱样肌和内收头肌、股四头肌和缝匠肌处。而外膝炎症阻滞多在股二头肌长头、股二头肌短头和股前肌群的股直肌、股四头肌外头和阔肌膜张肌! 当对一般常发阻滞区有概念后，即可缩短检查时间和更明确治疗部位以及达到最佳效果。依据中医传统理论“通则不痛，痛则不通”的原理，以检查槌用适当的力度敲打常发阻滞区，通常有阻滞处即所谓医理认为瘀血停滞而阻碍气血运行之处，气血不通畅之处依中医传统的发现都会产生炎症，有炎症自然有疼痛的感觉，所以为了更确定阻滞所在，可健患侧对比感觉：即健患侧用同一力度敲击，对比痛感的差异。一般健侧不会有太剧烈的痛感，如健侧亦有同样痛感，检查者则需注意力度是否恰当，部位是否一致，还有病人对痛感的敏感度，承受力和心理作用。如排除了以上种种因素，则可怀疑健侧或许有未发病或已发病的炎症；可进一步向患者资询！

除了健、患侧痛感对比，亦可在患肢肌群痛感检查，即在患侧找到了疼痛处，即在疼痛处周围亦用上法如法检查；一般会发现到疼痛感差异甚大，可以此定位！


施治：

明确局部的炎症痛区，和远、近端的阻滞区后，可适当用刮、推、按、拍法等，施法之力度可因人而定，须以受治者能接受为度，其间可随情调换医技。一般上未透瘀前，正施术部位处出现红潮状，患者亦会随着施术过程，感觉疼痛逐渐加剧，此时医者可适当放缓手法和力度，因病患在同样力度施治下疼痛却渐加剧。表示瘀血将透之际，随着继续施治，阻滞处会呈现瘀点，瘀斑透现出肌表外，此时受治者多可感觉除了有肌表自然瘀痛感外，深层却有另一番舒适感。

亦有一部份受治者在施术过程，未有瘀状外现而只有红潮状，可暂且观察治后反应，有时瘀状可在数小时后出现，但临床上亦有发现虽未有瘀状外现而施治后病患处获得改善者。

一般上，一次施治时间不定，阻滞的深浅度，部位大小，病程长短，体质壮弱，年龄长幼和患者的耐受力等因素都和施治时间，疗程长、短有关，而每次最好在四至五日复治；因外现的瘀状虽未消散，但深层未外透的阻滞可因代谢放缓而逐渐重聚阻滞，故大多患者在四，五日后觉炎症部开始不适。这时虽之前外透之瘀状未散，但必须加紧治疗，而已透之瘀状同常需二至三个星期才大体消散，故需预先叮咛受治者免令其引起恐慌！为了加强活血化瘀效果，可配合应用外搽活血类配剂和随症内服强筋壮骨，活血化瘀类药物。

对于一些特别顽固的膝关节炎，除了注重在远、近端的施治外，亦可应用透瘀疗法于炎症处，和酌情应用针刺，针炙，火针，拔罐，放血和针刀疗法以求达到更佳疗效!


原理：

中医学的理论精髓在于整体治疗和全面兼顾，笔者在过去膝关节炎中，多采用经验穴位和局部阿是穴治疗；近期都可达到舒缓的效果，但观察远期的效果不理想，病势不稳定，后来经一番考虑肢体解剖学的结构之相联关系和血运关系；再从健患侧对比，发现患肢远，近端和健肢的远，近端对比有异常的疼痛感，当时联想到民间有一些传统疗法如刮痧，拔罐，拍打，鞭疗，刀疗等法都以治疗出有瘀状外现方达医效！循从中医“通则不痛，痛则不通”的原理了解，于是从传统疗法又加上新的观点，经施治后效果非常显著。

随着经验累积，亦整理出一些阻滞常见区，尽管如此，如从笔者于二零零一年在福建省中医药研究促进会第五次学术交流会内发表《浅谈透瘀疗法对机体的影响》；文章中提到肌腱因阻滞而引起肿胀，而逼使肌腔狭窄而相互压逼导致引起炎症产生的原理，表明了任何一条肌腱的阻滞造成的组织肿胀都可引起整体压逼造成炎症产生的综合反应。

另外，发炎的肌腱可形成本身张力增加，加上生物力学的关系，使附著于骨的远端肌腱发生炎症。由于刚好于骨骼处，所以一般多误认为骨骼疾患（当然亦有真正骨疾患者），所以要求检查中全面进行健患侧的对比是非常重要的，以避免受主观的干扰而影响治疗的进度！

再以解剖生理学而言，有阻滞的肌群，会造成血运受阻，而使许多微小血管因长期血运不利而造成局部供血不足，长期会使滋养骨骼的养份缺乏而形成了骨质破坏！

过去许多临床研究，运用血管移植注入术进行治疗股骨颈坏死的成功例数颇多，而笔者亦以通过血管移植治疗腕舟骨坏死的研究通过硕士论文之毕业；故而联想到以通过化解局部阻滞，加强血运和供血充足使破坏的软骨再生的原理；临床上成功的使接受治疗者成功脱离手术治疗而仍获得改善甚至痊愈者。


体会：

i. 针灸学内很重视的天应穴的产生，如从笔者所掸述的阻滞原理相契，那从生理解剖学的关系论述，那就可脱离了针灸学许多令人感觉抽象感，而更好病机理解上更加发挥了临床效用。在此亦必须重点注明：天应穴不应只注意患者主诉痛区附近的压痛点；更应注意远区的压痛点，应在一并治疗下产生最佳疗效！

ii. 现代医学常言骨质疏松，破坏，不可只从老化论理解，还应加强对化解阻滞造成的血运问题和骨质细胞再生进行深一层的研究和探讨！
笔者再临床上应用化解组织的阻滞而促进血运以使血供正常的原理， 成功使在接受治疗者在无手术治疗下得到康复，但毕竟例数太少，且其间一些患者为加强疗效亦必须加用针刺，灸治，针灸，放血，针刀等疗法配合。在治疗过程中，患者都必须承受一定的身心痛苦，而且多受到中、西同业的误解而面对种种毁谤致使部份患者放弃治疗。由此，如能研究通过先进科技能准确探测出阻滞所在处和应用更先进疗法施治，这将对医学必有一番创举和突破，造福人群；愿以众方共勉之!

Brief Discussion about the Pathology of Bruises Formation and Bruises Permeable Treatment

Bruises permeable treatment has no fixed terminology in the past. It was originated from China as a folk treatment through tapping on the skin until local congestion (erythema) is visible, subsequently it will appear as bruises (hematoma) on the skin in order to relieve and reduce the pain and illness. Therefore, it is also known as “tapping treatment”. However, within the past few years, the writer discovered that this treatment is unable to achieve the excellent therapeutic outcome in certain area. Hence, we need to strengthen it by using the cupping glass treatment, cutaneous scraping therapy (“Gua Sha”) or hemospasia[1]. The bruises require these combined treatments to permeate to the superficial skin in order to achieve the excellent outcome. Therefore, the writer suggests naming the combined treatment as “Bruises Permeable Treatment (BPT)”.

The bruises which permeate to the superficial skin can be seen in the forms of spots (petechias), small patches (ecchymosis) or big patches. Some of them appear in groups and some of them are scattered. An experienced practitioner is able to determine the progression of illness through the appearance of the bruises. Through the treatment, the bruises can be gradually lysed and eventually eliminated, so the illness can be gradually improved and eventually recovered. Therefore, the writer believes that it is essential to focus and research the bruise formation and its mechanism of mutual influence with the illness.

The Traditional Chinese Medicine (TCM) believes that we are able to remain healthy and resist to disease whenever our blood circulation is functioning well in a normal, smooth condition. This concept can be explained as “when the blood flows smoothly in the blood vessels, painful sensation will not occur. However, when there is a partially occlusion in the blood circulation, we will have various kinds of diseases”. This concept is similar to the statement of which “when the blood flow is partially occluded, painful sensation will occur”.

Clinically, the writer has discovered that patients who had taken long term medication, meat consumers, having long term emotional stress, previously neglected trauma, weak and entering aging process, their bruises normally appeared more obvious on their skin after undergoing their treatment. This represents their level of disease are not only more serious, but also more chronic. The reasons are those patients who were taking long term medicines, the residual of medicines have been deposited in their body, while patients who are meat consumers has higher blood acidity than normal individual.

Modern medicine has confirmed that mentally stressed patients not only have faster accumulation of free radical in their body than normal people, but they also contain certain toxins secreted from their blood stream as well. Furthermore, the weaker and aging body that result in slower metabolism of blood circulation will easily cause hypoxemia. The above mentioned phenomenon leads to increased blood viscosity resulting in blood flowing slowly, causing the formation of blood clot (thrombosis). This type of dead and damaged materials partially occludes the blood vessels, which lead to poor blood circulation over a long period of time, subsequently deteriorating the medical condition.

Using drainage system as an illustration example, if there is a small amount of sedimentation accumulated in drainage system, it will not cause the occlusion. However, with the sediments in the drainage system will gradually increase, distend and expend after a period of time, this results the water unable to flow smoothly. Eventually, the drainage system becomes totally occluded. This example has the same mechanism as the phenomenon that is caused by the deposition and retention of dead and damaged materials in the body.

Japan traditional Chinese physician Dr. Kyushin Yumoyo ever stated that blood clots are unphysiological dirty blood that can be the medium for bacteria growth, which cause the formation of thromboembolism. In 1941, Dr. Yoshio Manaka had used the Modern medical terms of hypohepatia or hepato splenopathy to describe blood clots (Hematoma). Besides, after the World War II, the Japan traditional Chinese physician had had mentioned that “blood clot”, “hydropoisoning” and “food poisoning” are the three major causes for disease formation. In addition to that, America Air Force Hospital had emphasized that blood in normal condition should contain high concentration of oxygen, and it should appear in bright red colour. In contrast, oxygen depleted blood (hypoxemia) would appear in dark red colour. This type of oxygen depleted blood will cause harmful effect to human body if it cannot be eliminated through normal metabolism. This statement is similar to the TCM statement of “bruises”.

From the aspect of the muscles anatomy, there are spaces in between each strand of muscle in the muscle groups in order to maintain the mobilization between muscles. If there is one strand of oxygen depleted muscle lead to bruises due to the mentioned reasons, it will easily inflamed and swollen. This condition would narrow the muscles interspaces causing the muscles constriction that would lose its original elasticity. In this circumstance, based on the special point of view of anatomy and theory of biomechanic, the capillaries in the muscle can be damaged by certain movement, causing the blood seeps into the surrounding tissue (extravasation blood), this blood always hypoxic due to slow metabolism and result in occlusion of bruises (extravasated blood). This type of occlusion is still unable to be detected by modern medical technology and results in medical maltreatment due to clinical negligence. The burden of muscle group will gradually increase as a result of the viscous cycle, which leads to deterioration of inflammation and pains. In addition, patients with more severe medical condition will transform to other or similar internal medical illness.

For instances,

a) The inequality of the muscles at the both sides of the vertebral column will lead to the vertebral column slowly being pulled till curvature/distortion and subsequently compress the vertebral nerve.

b) Peptic nerve compression will lead to chronic gastritis

c) Patients with lumbar nerve compression can have chronic lower back pain.

d) The cervical spondylosis will develop symptoms of vertigo, headache and abnormal blood pressure as a result of the compression of cervical nerve and blood vessels.

e) Occlusion of the bruises (extravasated blood) in the posterior trunk can lead to symptoms which are similar to angina pectoris.

If the doctor neglects the above mentioned factors and effects by adopting the treatment of internal medicine, the treatment outcomes are normally not effective and result in slow recovery or even deterioration of the illness.

The healthiness of epithelium can be changed as a result of the occlusion which caused by the oxygen depleted blood (lack of oxygen supply in the blood). Therefore, an experienced doctor able to palpate the lump from the skin around the patient’s main complains area. Through the bruises permeable treatment, the lump and its surrounding area will appear as bruises (represent oxygen depleted blood) on the skin. All those bruises will gradually fade to yellowish colour and disappear during healing process via the metabolism of the capillaries, and the pain or ache at the affected area will be reduced or even completely recovered. Besides these, the writer has noticed that the patches and the size of the bruises appear bigger on serious illness or chronic illness patients and vice versa.

If there is an occlusion in the thin internal lining where human cortical neurons are lesser, the patients would only feel occasionally muscle constriction and mild discomfort at the affected area. As there is no obvious pain, so the patients would usually neglect those symptoms which would leads to maltreatment. However, when occlusion gradually increase, permeate from the internal lining to external lining and stimulates cortical neuron, the patients will develop obvious discomfort like numbness and painful sensation. In fact, most of the occlusion of bruises (extravasated blood) are appear in bigger muscles group, for examples, muscles group of buttocks, thigh and so on. All these occlusion will lead to patient’s mobility status being affected.

From the clinical experiences, the writer discovered that, if the treatment focus on the patients’ main complaint area, the symptoms will normally improved immediately, but the disease condition is not stable, and the pain will recurrent and relapse during long observation period. However, if we provide integrated treatment to the main complaint area and its surrounding area, the patients’ disease condition not only can be improved effectively immediately, but also can achieve excellent outcome in a long period of time. This concludes that the integrated treatment should not be overlooked. Now, the writer is going to report his findings which obtained from his clinical experiences pertaining to the occlusion that are caused by the oxygen depleted blood in parts of the tissues and its related consequences.

1) Occlusion of the bruises (extravasated blood) in the shoulder joint muscular tissue can cause limitation in the mobility of shoulder joint, soreness and painful sensation at the shoulder joint. The stiffness of the supraspinatus would lead to shoulder pain and the patients will easily feel tired. If these conditions remain untreated, it can lead to neck pain and discomfort. Moreover, the unequal constrict level of muscles at both sides of the neck can force the cervical vertebrae curved towards the more constrict side, and results in formation of lateral flexion of cervical vertebrae which will lead to cervical syndrome.

2) Extravasated blood in the muscles of the anterior and posterior shoulders, muscles of the upper arm, muscles of the forearm or muscles of the back (the posterior trunk) can lead to spasm, numbness and painful sensation at the arm and fingers.

3) Extravasated blood in the triceps, brachialis and radio carpus could easily cause tennis elbow (radiohumeral bursitis).

4) Extravasated blood in the brachioradialis and short supinator easily lead to stenosing tendovaginitis of radial styloid.

5) Extravagated blood in the supraspinatus, infraspinatus and levator scapulae can cause the neck pain or unequal constriction level for both sides of the neck muscles. It forces the cervical vertebrae curved towards the more constricted side which compress the cervical nerves and blood vessels, end up as cervical syndrome.

6) Extravagated blood in the muscles of the posterior trunk, rhomboideus major and trapezius can lead to dorsal vertebrae distortion and causing compression to the nerves and blood vessels, which will have the symptoms of internal medical disease as it is caused by the vertebrae pressing on the spinal nerve. Modern treatments for the vertebrae realignment are mostly focus on the vertebrae column realignment but overlooked the primary leading cause of the vertebrae distortion. So this is the reason why the outcomes of the modern treatment are always unstable. At here, the writer emphasizes to dissolve the extravasated bloods in the muscles of the posterior trunk before proceed to the treatments for the vertebrae realignment in order to achieve better outcome.

7) Extravasated blood in the buttocks muscles can cause topical pain and compression of nerve.

8) Extravasated blood in the thigh muscles can cause pain and weakness at the knee joint, especially extravasated blood in the tensor fasciaelatae. It can cause patients significantly experiencing fatigue in thigh during the flexion-extension movement, and she will feel weak and lack of strength at the knee joint area when climbing up the staircases. While extravasated blood in the muscles of the posterior thigh such as the extravasated blood in the biceps femouis, semimembranosus and semitendinosus can lead to spasm and painful sensation at her posterior thigh muscles. The above mentioned extravasated blood in the distal portion of the muscle of posterior trunk, muscles of the knee joint and ligament can lead to painful sensation at the posterior knee joint, which cause patients unable to perform squatting activity.

9) Many patients with sprained ankle would experience relapse in the future after undergoing the topical treatment, this probably due to the leg muscles was injured as well. Usually the writer would treat to dissolve the extravasated blood at the tibialis anterior, the muscles of the long flexion at toes and posterior peroneus muscles for the injury of the internal malleolus. While, the writer would provide treatment to dissolve the extravasated blood in the peroneus longus for the patients with injured external malleolus. All of his patients have achieved rapid improvement and recovered.

10) Extravasated blood in the muscles of the posterior leg such as gastrocremius, soleus, achillis tendon can leads to posterior leg or gastrorcemius spasm, inflammation at the surrounding of the calcaneal tendon, foot pain and so on.
Conclusion

In conclusion, the writer noted that many patients with generalized body aches are unable to detect significant abnormality by modern medical appliance. Therefore, we believe that modern medical appliance still unable to detect these generalized body aches that are caused by partially occlusion in the blood vessels or the extravasated blood in the muscle. These palpable lumps that have undergone certain treatment would appear on the superficial skin as bruises that are similar to the contusion that are caused by trauma.

By adopting the treatments of activating extravasated blood and lysing blood clots via oral medicine and topical oilment, the bruises can be diffused rapidly. While the physician is treating the bruises, those patients’ condition is also improved and eventually recovered.

Current blockage analgesic (restricted) treatment or local treatment has covered the actual signs and symptoms of the disease which has lead to the effect of deterioration in disease condition. In Previous clinical experiences, the writer ever adopted the single treatment of medicine. Acupuncture or massage which has brought certain therapeutic effects on lysing occlusion. However, the writer found that this combined treatment, also called the bruises permeable treatment has created more effective therapeutic outcome as it is using a more direct method to activate the extravasated blood and lyse blood clot which able to accelerate blood metabolism to lyse occlusion, so the affected blood can resume its oxygenation.

Through Eastern clinical experience, the doctors are more afraid to the internal pain that is hidden in the body but has no significant clinical signs and symptoms of medical disease. It is because they knew that this kind of invisible killer is difficult to excrete from human body, which has great harmful effect that will lead to serious illness in the future.

However, this bruises permeable treatment is mainly to permeate the internal injury to the superficial skin whereby the extravasated blood and blood clots are able to be metabolized by the capillaries that are lying in the epidermis layer of the skin. Through this treatment, recovery is attainable.


[1] Hemospasia refers to using a fine sterile needle to pick on the superficial skin in order to drain out a very small amount of extravasated blood from patient’s body.

略论人体组织血液缺氧和透瘀疗法的作用

“透瘀疗法”以前并没有一个固定的名称，其前身是流传在中国的一种民间疗法，以拍打致皮肤产生充血后呈现瘀青而达到减轻病痛的目的，故又称拍打疗法。然而几年来笔者发现在此治疗中，又多须借用走罐、刮痧或放血的方式来补充拍打所不能达到的效果。由于这些瘀青，是用各种综合疗法令其透出肌表，以达到治疗的目的，故笔者建议以“透瘀疗法”作为统一名称！

透现肌表的瘀青可呈现点、斑、片和块状，有局部型的，亦有散布型的，有经验的施术者可从瘀青呈现的状况来判断病痛的程度。而随着治疗，瘀青逐渐消散、减少直至消失，病情也随着好转和康复。因此笔者认为有必要重视和探讨这些瘀青的产生及其与病痛的相互影响的机理！




祖国医学认识到人体的气血循环正常通畅则百疾不生，所谓“通则不痛”；而一旦气血循环出现障碍时则百病丛生，又谓“不通则痛”。

临床上，笔者发现多数患者，如长期服用西药、嗜肉食、长期精神压力太大、曾经创伤而失治、体质衰弱和进入老化期的，他们经过治疗后的瘀青多较严重，也表示病痛程度较剧，病时亦久。原因是服用西药者的西药晶素沉淀于体内和嗜肉食者其血液酸性偏高。现代医学也证实了精神压力患者的自由氧化基的沉淀和累积亦较常人快，并且血中会分泌出某种毒素，而人体在衰弱时和老化期间气血循环代谢缓慢也易引起血中缺氧。上述现象均可造成血浆黏稠不利，易于停滞而形成瘀血。此类坏死无机物质阻塞于体内，日以月积造成气血循环失常，使得病痛逐渐加重。以水道作为例子，当小部分的沉淀物堆积时可能产生不了阻塞现象。但水道的沉积物必然随着时间逐渐沉积、扩容并散布，使得水流逐渐不畅发展到成完全阻塞。各种坏死无机物沉淀停滞于体内所产生的现象，亦同样机理。

日本汉方医家古方派大师汤本求真有“瘀血是污秽的非生理性血液，可成为细菌的培养基，在体内招致血栓血塞之形成”之说。1941年间中喜雄以现代医学所称的“肝脏低格症”或“肝脾性疾患”来说明瘀血。二次大战后，日本汉方医者甚至把“瘀血”与“水毒”、“食毒”并列，认为是病理上三大致病因素。美国空军军医院曾强调正常的血液应具多氧量，而多氧量的血液应呈鲜红色，一旦血液缺氧时就变成暗红色了，这种缺氧的血液如不能正常代谢即对人体产生危害，这理论与东方医学中的“瘀血”理论不谋而合！

从肌肉的解剖角度而言，肌群中的肌肉与肌肉之间的肌间隙应存在一定的空间以保持肌肉群的相互运动需要。如其中一束肌肉如前述某因造成肌肉组织缺氧而形成瘀血，就易肿胀发炎，必迫使这空隙变窄，形成肌群呈绷紧状态而失去了原有的自然弹韧性。这种情况下，在某些解剖学的特有角度和生物力学的作用下，即可因某些动作引起一些微细血管破裂，产生脱离正常轨道的血液，这种血液往往不易代谢而缺氧形成阻滞（瘀血）。这类阻滞物至今仍未被现代医械所透视察觉，造成临床上的忽略而误治，产生恶性循环。在这种情况下肌群的负荷不断增加，炎症与疼痛亦随之加重，病情也逐渐加深，严重者某些组织可继发成内科疾患或类似内科疾患。如脊柱两旁肌肉不协调时引起脊柱慢性牵拉而侧弯压迫脊间神经，如压迫胃神经可产生慢性肠胃炎，如压迫腰肌神经患者可长期腰痛不愈，颈椎病因压迫颈部的神经和血管产生眩晕、头疼和血压异常等现象，如背肌有瘀血阻滞，可产生类似心痛的症状。如在临床上忽略了上述的影响而以内科方式误治，往往疗效不佳，反而使患者病情长期难愈甚至恶化。

由于缺氧的血液形成阻滞，使健康的表层组织产生变化，所以有经验的治疗者，可从患者的主诉病区的周围触摸到异状物。经过治疗后，异状物或其周围都会出现瘀青（表示缺氧的血液）透现皮表，再经过丰富的毛细血管代谢后，瘀青色泽亦逐渐转淡、消失、此时患处即可减轻痛苦或痊愈。医者亦察觉到病程越久或病情较重的患者所呈现的瘀青部位较广，块体亦较大。相反的，病程较短或病情较轻者其瘀青部位亦较狭小，瘀块亦呈散布型。但如人体皮质神经较稀散、浅薄的深层组织内有瘀血阻滞，患者多只长期感觉时有时无的肌肉绷紧感或轻微酸楚不适感，而无明显的剧烈疼痛反应，造成患者忽视而失治。一旦阻滞日以累积逐渐由少积多、由里透表而刺激皮质神经时，则患者开始产生明显的酸麻、疼痛等不适感。这些部位多在肌肉较丰厚的地方，如：臀部的肌群，大腿的肌群等等，往往造成日后的行动异常障碍。

临床上笔者发现如只在主诉点进行治疗，一般上患者也即可改善症状，但长期观察病情不稳定，疼痛反复发作。而如着重于其周围进行整体施治时即可达到及时改善病情而长期效果观察良好，说明整体组织的治疗是不可忽视的。现在笔者报告临床上所发现的组织部位因血液缺氧产生的阻滞（瘀血）与其所产生的连带关系：

一、肩关节肌群的组织可产生肩关节活动障碍、肩关节处酸楚疼痛不适和冈上提肌僵硬而引起肩膀酸疼和患者容易疲劳。如长期发展可使颈项酸疼不适，如双侧肌肉绷紧的程度不一，可迫使颈椎歪向较紧张的一侧造成颈椎弯引起颈椎综合症！

二、肩部的前后肌群、上臂肌群、前臂肌群或背部肌群的阻滞可引起手臂或十指痉挛、麻木、疼痛！

三、手臂肱三头肌、肱肌和桡侧腕屈肌的阻滞易引起网球肘！

四、肱桡肌和短旋后肌的阻滞易引起桡骨茎突狭窄性腱鞘炎！

五、背部冈上肌、冈下肌和提肩胛肌的阻滞可引起颈项疼痛或因双侧肌肉紧张力不等，迫使颈椎歪向较紧张的一侧而压迫颈部神经，血管形成颈椎病。

六、背部的肌群如大菱形肌和斜方肌有阻滞易引起胸椎歪曲不正和造成压迫神经和血管而产生类似内科疾病的症状，这缘起于向椎体压迫椎间神经有关。现代流行的整脊疗法多着重于整复脊椎，而忽略了引起椎体歪曲之首因，故患者疗效多不稳定。故笔者强调以化解背肌阻滞再进行整脊以取得良好的效果。

七、臀部肌群的阻滞，引起局部酸疼和压迫神经反应。

八、大腿肌群的阻滞可引起膝关节疼痛和无力，尤其股四头肌外头和腱内髂的阻滞，可使患者明显的感觉大腿伸屈动作疲劳，这可使患者上楼时觉膝关节疲痿无力。而大腿后肌群的阻滞如股二头肌长头、半膜样肌和半腱肌的阻滞，可引起大腿背面抽搐、疼痛。如以上背肌远端的阻滞或膝关节的背部肌肉、韧带的阻滞可致膝关节背部疼痛，患者不能屈曲下蹲。

九、许多踝关节扭伤的患者经局部治疗后，日久仍觉踝关节不适，这多因在扭伤时并伤小腿肌群所致，一般笔者以内踝损伤以化解前胫骨肌、长屈趾肌和后胫骨肌，而外踝损伤以化解腓骨长肌的阻滞为主，患者即觉改善和恢复！

十、小腿背部肌肉如腓肠肌，比目鱼肌和脚跟腱的阻滞可造成小腿背部或腓肠肌痉挛，脚跟腱周围炎和足痛症等！


结论

临床上，我们发现许多疼痛病的患者在进行现代医械诊察时，并无重大发现，故相信现代医械并未有透视这类由瘀血阻滞所产生病痛的能力。这类经触诊后再经施治的阻滞体，在肌表透现时似呈现外伤造成的瘀肿现象，而采用活血化瘀的内服、外敷法，瘀肿即迅速消散，而病情亦随着治疗瘀肿消散即可逐渐减轻直至痊愈。现代医学的封闭止痛疗法或只进行局部治疗，反而使病情失真而掩饰了症状，引起病程日后加重、恶化等副作用。临床上笔者亦采取单用药物疗法，针灸和推拿来进行治疗，对于化解阻滞亦有一定的疗效，但却没透瘀疗法的效果来得快速。这取决于透瘀疗法采用比较直接活血化瘀的方法，以加速血液代谢而化解瘀血阻滞，使病灶的血液恢复充氧的原因。

东方医学通过临床经验，都对潜伏于体内的伤痛而外表无特别征兆的“内伤”较畏忌，因为他们发现了这类外表观察不到的无形杀手的伤害力和其难以在人体内代谢是造成日后的顽疾。

而透瘀疗法主要以令伏邪外现的作用，令内伤外透，借助体表丰富的微细血管代谢作用，令其消散，以取得康复！

此篇论文于2001年8月受邀发表于中国福建省中医药研究促进会第五次海内外学术交流会上。