• The Journal of Korean Medical History
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• v.23 no.1
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• pp.23-41
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• 2010

Greater yang disease(太陽病) is a syndrome induced by peripheral obstruction. One of them is "wind stroke(中風)" with the obstruction in lymphatic system. The other obstruction appearing on circulatory system is called "cold damage(傷寒)." Kyejitang(桂枝湯) is the formula prescribed for greater yang wind stroke pattern(太陽中風證) which is caused by peripheral lymphatic duct obstruction. Ramulus Cinamoni acts as a vasodilator and Radix Paeoniae relieves the abdominal tension. They make blood move to the internal organ and this can remove the retention of peripheral lymphatic system. Covering the patient with a blanket and getting him/her to have hot and thin rice gruel causes slight Diaphoresis, contributing to relieving the retention of lymphatic system. Disharmony between nutrient and defense(營衛不和) means that pressure becomes different between lymphatic system and vascular system. Kyejitang(桂枝湯) is called releasing muscles formula(解肌劑) because it can resolve such pressure difference. Diaphoresis is not a means to eliminate pathogenic qi(邪氣) from the body. That is the syndrome proving that the body fluid has moved around when disordered fluid distribution is corrected. Therefore, diaphoresis should be induced weakly all the time. If diaphoresis is induced excessively, body fluid will move more than desired and then illness cannot be cured. In Sanghanlun(傷寒論), dispersing drugs aim at addressing the retention in the exterior field, but it actually applies to the entire exterior and interior to make body fluid move. Therefore, diaphoresis does not just act on exterior field, and freeing the stool does not only apply to interior field. Distribution of body fluid changed by pathogenic qi(邪氣) influences the whole body because the human body has a closed circulatory system. Sanghanlun(傷寒論) has included treatments for pathogenic disease. However, its value should not be limited to pathogenic disease. It is because controlling blood flow by sending body fluid to the place a doctor wants is certainly worth using for treatment of non-exogenous disease or chronic illnesses.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.6
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• pp.594-600
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• 2019

With improving survival of children with complex congenital heart disease (CCHD), postoperative complications, like protein-losing enteropathy (PLE) are increasingly encountered. A 3-year-old girl with surgically corrected CCHD (ventricular inversion/L-transposition of the great arteries, ventricular septal defect, pulmonary atresia, postdouble switch procedure [Rastelli and Glenn]) developed chylothoraces. She was treated with pleurodesis, thoracic duct ligation and subsequently developed chylous ascites and PLE (serum albumin ${\leq}0.9g/dL$) and was malnourished, despite nutritional rehabilitation. Lymphangioscintigraphy/single-photon emission computed tomography showed lymphatic obstruction at the cisterna chyli level. A segmental chyle leak and chylous lymphangiectasia were confirmed by gastrointestinal endoscopy, magnetic resonance (MR) enterography, and MR lymphangiography. Selective glue embolization of leaking intestinal lymphatic trunks led to prompt reversal of PLE. Serum albumin level and weight gain markedly improved and have been maintained for over 3 years. Selective interventional embolization reversed this devastating lymphatic complication of surgically corrected CCHD.