[Abstract] Objective The importance of control of hypophrenia and the lack of effective remedies for the disease at present prompted the author to make a thorough study on this problem and developed a traditional Chinese medicinal prescription－ "Li's Prescription No.5". Very satisfactory results were obtained with clinical application of the prescription. Reported herein are the results of therapeutic observation and an approach to mechanism of action of Li's Prescription No.5. Method Xu's ten-item oral-answer test was used to test intelligence. Part of the patients were subjected to EEG, CT and chromosome examinations before and after treatment to compare therapeutic effectiveness. Only preparation of Li's Prescription No.5 was given to all the patients without any other drugs. Results Of the 1 396 patients with mental retardation, 1 253 showed marked effectiveness after 2-4 courses of treatment and 143 showed effectiveness, the effective rate being 100% and markedly effective rate being 89.8%. In no case was toxic or side effect observed. Conclusions Clinical application showed that Li's Prescription No.5 might be the ideal therapy for mental retardation at present. The author advances the theory of "adjusting point" on the development and functioning of human brain (Li's theory) and discusses the mechanism of action of Li's Prescription No.5.
[Key words] Li's Prescription No.5 Cerebral palsy Mental retardation Hypophrenia Li's theory

The prophylaxis and treatment of hypophrenia is one of the leading problems of improving population quality. The morbidity rate of child hypophrenia is about 3% abroad, 2%-3% in rural areas and 1% in cities of this country. According to a preliminary investigation, there are about 24 million people suffering from mental retardation (MR) in the 1 100 million people (1). The disease is characterized mainly by developmental retardation of intelligence, with intelligence quotient (IQ) below 70 points in most cases. Patients with the disease are unable to adapt themselves to the objective requirements in

Author's unit: Guangdong Gaoming Medical and Medicinal Institute of Encephalopathy, 2 Heping Lane, Cangjiang Road, Hecheng District, Gaoming, Guangdong 528500.
study, life and behaviors and bring about a heavy burden to the family and society. At present, no satisfactory therapy is available. For more than ten years, we have explored and studied the problem and made some progress by using traditional Chinese medicine to treat hypophrenia. This demonstrated that the intelligence of children with hypophrenia still has the possibility to improve. By using self-made capsule of Li's Prescription No.5 we have treated 1 396 MR children and achieved unexpected results. Reported herein are the results of treatment.
Clinical data
General Data
Of the 1 396 MR children, aged 3-24 years, mean 15.6 years, 833 were males and 563 were females; 92 were of mild type (dull-wittedness), 380 were of moderate type (dementia) and 924 were of severe type (idiocy). Part of the affected children had concomitant dysopia (27 cases), dyskinesia (including paralysis, stiffness and ataxia, 382 cases) and epilepsy (264 cases). The vast majority of the affected children had been treated in different places in many ways but they failed to respond to medical treatment. One thousand and thirty cases had a history of difficult labor, delivery suffocation, premature delivery, forceps delivery, 285 had a history of high fever, convulsion and diarrhea, 4 cases had chromosome abnormalities, and 77 cases had unknown causes.
Psychometric Method
The more complexity of the revised Wechsler Intelligence Scale for Children (WISC-R) prompted us to use the simple and easy Xu's oral-answer test (2), the items of which are as follows: (1) count backwards from 30 to 1 and record the state of completeness and the speed; (2) recite in order numerals, starting with five-digit number till nine-digit number, and record the digit number recited; (3) conduct continued subtraction, for children aged less than 8 years, use 30-3……, for those aged more than 8 years, use 100-7……, and record the state of completeness and the speed; (4) differentiate things, make the children differentiate a chicken from a duck, and record the state of completeness; (5) make the affected children tell the kinds of colour they know and record them; (6) describe things, let the affected children describe the contour of an elephant and record the accuracy and totality; (7) do mathematical exercises, for example, a pencil costs 13 cents, what's the money for 2 pencils? For children aged 10 years or over, they may be asked: Fifty-nine apples are distributed to 5 little friends, how many apples does everybody have? And how many apples are left over? They are asked to do sums in their head. Record the right or wrong answers; (8) explain uses, make the children explain the uses of wood and record how many kinds of uses he can tell; (9) test logic memory, let the children retell a about story and record the degree of accuracy of retelling; and (10) making test of "shooting birds", the children are asked how many birds are left over if one of the ten birds on the tree is shooted to death.
The above-mentioned 10-items test had been tested in 200 school-age children aged 7-13 years. Except the items 7 and 10 which should be evaluated according to the correct or wrong answer, the remaining items are evaluated according to the average value. If an affected child comes up to the level of average value, he (she) is said to pass the test and given 10 points. If the total score is below 40 points, the patient can be regarded as having oligophrenia by taking his (her) case history into account. The total scores of the 1 396 children in this series were all below 40 points. Follow-up study was made on several items of the test during the course of treatment to judge, with reference to the school record and the parent's report, whether there was improvement or not.
Accessory Examinations
Electroencephalography (EEG): Of the 530 patients in this series who received EEG examination, 236 showed moderate-to-severe abnormality, with asymmetrical bilateral waves. Spike and ware waves were found in patients with concomitant epilepsy.
Skull CT scanning: Two hundred and twenty-three patients were subjected to pretreatment CT scanning. Eighty-five of them showed different degrees of pathological changes, including focal low density of the brain, widened cerebral sulci, narrowed cerebral gyri, enlarged ventricles, and cystic degeneration. Patients with concomitant monoparesis and cerebral hemiplegia all showed abnormal CT findings.
Chromosome examination: Six affected children suspected of having a history of genetic diseases were subjected to chromosomal karyotype analysis. Four of them had chromosome abnormalities.
Method of Treatment and Results
Method of Treatment
All the patients were treated with Li's Prescription No.5 capsule only, without any other medicines. Three to five capsules each time, three times a day, oral administration for three successive months constitutes one course of treatment. Follow-up study was made after two courses of treatment to interpret therapeutic effectiveness. Some of the patients were given EEG and CT reexamination. For those who had some but not satisfactory results, additional one or two courses of treatment were given.
Results
Criteria for interpreting therapeutic effectiveness: (1) Notable effect: Noticeable improvement in nervous dysfunction. Affected children who had made marked progress in learning, school records, psychometry, and social adaptability based on the feedback from teachers and parents fell into this category; (2) effectiveness: showing improvement in behavior and learning capacity without resulting in a huge hike in school work; and (3) failure: showing no change in behavior and
learning capacity after treatment.
Of the 1 396 cases undergoing 2-4 courses of treatment, 1 253 had notable effectiveness and 143 had some effectiveness, the effective
rate being 100% and the notably effective rate being 89.8% (Table 1). Treatment with the drug has the following characteristics: (1) a better curative effect on congenital MR; (2) a good curative effect for patient aged less than 18 years; (3) a wonderful curative effect on MR caused by chromosome abnormalitics; (4) promoting growth and development of the organism and correcting abnormal physical signs, such as gain in body height, enlargement of head circumference, correction of strabismus and improvement in looks; (5) visual recovery of blindness due to optic atsophy; (6) recovery of limb functions in patients with cerebral palsy; and (7) correction of concomitant epilepsy and dysaudia.
Reexamination of EEG and CT made on part of the patients showed that 236 cases, especially those with concomitant epilepsy, had marked improvement in EEG, with diminution or disappearance of spike and ware wave after treatment and that 23 of the 85 cases showing abnormal CT findings had some improvement after treatment, as manifested by reduction or disappearance of focal low density of the brain, shallow cerebral sulci and widened cerebral gyri (Table 2). In none of the cases did toxic reaction occur.

Table 1 Therapeutical analysis of children with MD
Patient's condition No.of cases No.of cases showing No.of cases showing No.of
Notable effectiveness some effectiveness failures
Mild type (dull-wittedness) 92 92 0 0
Moderate type (dementia) 380 344 36 0
Severe type (idiocy) 924 817 107 0
Total 1 396 1 253 143 0

Table 2 Changes in EEG and CT before and after treatment
Item No.of cases No.of positive cases No.of improved cases Improvement
Examined before treatment after treatment rate (%)
EEG 530 236 151 64
CT 223 85 23 27.4


Typical cases
Case 1 Liao, a boy aged 5 years, had a history of high fever and convulsion at 3, followed by hypophrenia, abnormal behavior and dyskinesia. The patient had previously been diagnosed as having encephalopathic sequela, epilepsy, etc. and treated with pyrithioxine hydrochloride, glutamic acid and
cytidine diaphosphate choline at several
hospitals in xi'an and Lanzhou with no response. On examination, he looked dull with binocular strabismus, lockjaw and speech problem. He could only utter mono-syllabic sounds now and then. Other symptoms included: lack of response, inability to lift his head due to weak neck, upper limb spasm, tight fists, adducted thumbs, flexed wrists, inability to stand up due to weak lower limbs, intorsive feet with scissor's gait, weakened knee reflex and positive bilateral Babinski's sign. EEG showed moderate abnormality, CT scanning showed decreased white matter density in bilateral parieto-occipital regions, and magnetic resonance imaging (MRI) showed abnormal signal of bilateral lenticular nucleus, Liao was diagnosed as having demyelinating disease. He was given Li's Prescription No.5 capsule, 3 capsules each time, three times a day, for 1 successive year. Follow-up study found that he had had remarkable improvement in intelligence, his strabismus had been corrected, jaws loosened, neck muscles strengthened, upper limb spasm had disappeared, fingers had been flexible, and myodynamia of lower limbs had been recovered. Walking steadily, he could move up and down the stairs without stumble and ride a tricycle unaided for a few li's distance. Having restored his linguistic function, he was able to speak fluently and articulately and count numbers within 100. He could do simple arithmetic, eat and dress without help, and play ball games and skip rope with other children. EEG and CT reexamination showed no marked abnormalities.
Case 2 Zhang, a 7-year-old boy, born 6 weeks premature weighed only 1.4 kg at birth, had contracted neonatal jaundice and neonatal pneumonia on day 7 after birth. Ten months after birth he still had no tooth eruption and could neither creep nor raise his head because of the weak limbs and maldevelopment. When he was 3 years old, he could neither speak nor walk, and had poor comprehension. When he was 4 years and 6 months old, he could only utter such monosyllabic sounds as Pa and Ma and still could not walk alone. When first seen at the hospital, the patient made hoarse monosyllabic sounds and sometimes screamed. Though hyperactive, he could not coordinate his action well and had unstable gait. He was irritable, wilful and sialotic with his tongue often hanging outside his mouth. He could not respond to the call of nature and could not tell when he was hungry or full. Neuropsychiatric examination showed a dull appearance, microcephaly, a head circumference of 38 cm and a tower-shaped skull, depressed occiput, flat temporo-occiput, obliquely upward ocular hypertelorism, bilateral paropsis, relatively broader nose ala, and smaller, disarranged teeth. His four limbs had involuntary movement. His upper limbs were intorted, muscular tension increased, both thumbs adducted, and wrists flexed, with hyperreflexia of brachial biceps and positive Hoffmann's sign. He showed scissors gait with intorted feet. The muscle strength of the right lower limb was 2nd degree, that of the left lower limb 3rd degree. He had hyperreflexia of knee jerk, hypermyotonia, patellar and ankle clonus and positive bilateral Babinski's sign. EEG showed mild abnormality. CT showed slightly broadened cerebral sulci. Chromosome examination confirmed that the patient had 21-trisomy syndrome. He was diagnosed as having extremely severe MR complicated with cerebral palsy. After one year's treatment with Li's Prescription No.5 the affected child had marked improvement in his intelligence, awareness and understanding. He could do two-digit addition and subtraction. At ordinary times he liked singing and watching TV programs for children and could retell the central content of the story he had seen. He became enunciative and fluent. His head circumference increased to 48 cm, the morphological development of his head and facial organs became as normal as that of normal children. Involuntary movement of the extremities disappeared, and gait and posture returned to normal. He moved his hands freely, walked almost steadily. His muscular tension was reduced and his myodynamia was restored. Babinski's sign (+) was restricted only to his right side. CT reexamination showed cerebral sulci and fissures shrunk. EEG reexamination was basically normal.
Case 3 Yang, a 6-year-old boy, a premature infant of 206 days, weighed 1.6 kg at birth, could smile ten months after birth, raised his head at one year of age, had closure of bregmatic fontanel at two years and six months of age, could not stand up alone. His parents were healthy and denied history of familial hereditary disease and consanguineous marriage. At the time of examination the affected child was found to be unable to take care of himself at all, hyporeactive to external stimulation, unaware of hungry or full, cold or warm, unclear in enunciation with hoarse monosyllabic sounds, unable to express a complete idea, hyperactive, irritable, sialotic with his tongue often hanging outside his mouth, and non-responsive to the call of nature, and he was often found to bite his finger nails and dirty things to eat, to be unable to stand up alone and often to imitate and repeat some simple actions. The affected child didn't cooperate with the doctor during physical examination. Neuropsychiatric examination showed no response, apathy, presence of pain, head circumference 35.5 cm, orbital hypertelorism, low and flat nose root, a protruding tongue with laceration on its surface and salivation, smaller and disarranged teeth, deformity of ear, ear margin 2.3 cm, involuntary movement of the extremities, torsion spasm of both upper limbs, showing "airplane-shaped muscle" backwards, chicken's-claw type of both hands, hypermyotonia, flexed wrists, hyperreflexia of brachial biceps and positive Hoffmann's sign. His hands were short and broad, thumbs 2.0 cm, index fingers 2.6 cm, middle fingers 2.8 cm, ring fingers 2.6 cm and little fingers 1.8 cm. His body height was 97 cm, both hands were one-line palms, both feet had plantar flexion and intorsion, with hyperreflexia of knee jerk, hypermyotonia and positive bilateral Babinski's sign. He was diagnosed as having (1) extremely severe MR and (2) 21-trisomy syndrome. After six month's treatment, the affected child grew and developed rapidly, his intelligence improved notably, he was quick in action and active in nature. Having restored his linguistic function, he was able to speak fluently and articulately. Such symptoms as protruding tongue, salivation and biting nails had disappeared. His answer kept to the point and could count numbers within 100. He could sing children's songs and do simple arithmetic. His motor function of extremities was restored to normal, involuntary movement of the extremities and torsion spasm of the upper extremities had disappeared with resultant free action. His body height was 110 cm., head circumference 48 cm, right ear margin 6.3 cm, left ear margin 6.2 cm, thumb 4.1 cm, middle finger 5.2 cm, index finger 4.7 cm and ring finger 4.6 cm, the increase of fingers being significant.
Case 4 Zhou, male, aged 18 years, had had high fever (41.2℃) due to common cold at 6 months of life, followed by frequent episodes of epilepsy one month later, which had been treated in many ways but failed to respond to medical treatment. At the time of examination, the patient showed a physiognomy of dementia with right strabismus and poor vision. He had rightward obliquity, chicken-claw type of both hands without power of gripping, hypermyotonia, torsion spasm, rightward-abduction gait of lower limbs with both heel failing to touch the ground, bilateral hyperreflexia of knee jerk, and positive Babinski's sign which was manifest on the right side. CT scanning showed broaden cerebral sulci and fissures, and EEG examination showed moderate abnormality. He was diagnosed as having severe type of MD complicated with cerebral palsy and was given Li's Prescription No.5. According to the parent's report, this medicine began to produce effect after oral administration for two successive months, and six months later intelligence and functions of extremities and speech recovered. One year later strabismus was corrected, and vision was restored to 1.5 (both eyes). He became articulate and fluent. His torsion spasm disappeared, muscular tension decreased, gait stabilized, and pathologic sign disappeared. The patient had a bright and cheerful disposition, was initiative and liked singing and dancing. He has started school and got good school record. He often initiatively helped his parents in doing housework, he could go shopping alone just as a normal person. CT scanning showed cerebral sulci and fissures shrunk, and EEG reexamination showed normal findings.
Case 5 Yang, a six years old girl, had been diagnosed as having (1) arachnoid cyst, (2) obstructive hydrocephlus, and (3) functional cerebral palsy at Beijing Medical University. On examination she was found to be unable to walk by changing step, to have no linguistic function, no cognitive ability and no faculty of understanding. She had a large malformed head, a head circumference of 58 cm, a markedly leftwards oblique face, strabismus and diminution of vision (left eye 0.2, right eye 0.3), and irregular features. After treatment with Li's Prescription No.5 for three successive months, functions of extremities, speech and consciousness got notable restoration, and it was unimaginable that her head circumference had reduced to 51 cm, that she had had a regular face and features and that her strabismus had been corrected with improved vision.
Discussion
Mental retardation (MR) or hypophrenia is internationally defined as the state of those whose intellectual powers fall significantly below the level of the same age on a standardized intelligence test with accompanying defect in adaptive capacity (WHO, 1985). (3) In accordance with the above-mentioned definition, the diagnostic criteria for MR should correspondingly include three aspects: (1) the fall of intellectual powers significantly below the level of the same age is that IQ is lower than the mean by 2 standard deviations, with an IQ below 70; (2) the adaptive capacity is lower than the social normal values, there are marked defects in one's own life and in practising social duties; (3) MR occurs in the stage of developmental age, namely, under 18 years of age. (4) It is evident that the diagnosis of MR should consider the following three aspects: (1) Only in the cases whose conditions conform to the three diagnostic criteria can the diagnosis of MR be mode. Simple low IQ with good adaptive capacity cannot be diagnosed as MR. Decline in intelligence after adult stage is not known as MR but as dementia. (2) The diagnosis of MR is chiefly psychological and behavioral and not simple medical evaluation. (3) MR is not a permanent intellectual disturbance in all cases, and the IQ is changeable. The vast majority of patients in this series were under 18 years of age, a small number of patients, though aged over 18 years, had their disease in childhood; therefore, their diagnosis of MR is in keeping with the criteria.
Intelligence is a multifactorial genetic trait and the result of interaction of heredity and environment. Heredity determines the attainable level of intelligence under the optimum conditions, namely, latent energy. Environment determines the extent to which the latent energy can really be developed, improvement of environment facilitates the development of intelligence. (5) There is no consistent idea on definition of intelligence. Intelligence is a power, behaviors that reflect intelligence are manifested by the following aspects: capacity of learning, capacity of acquiring knowledge and benefiting from it, capacity of thinking and reasoning, and ability to solve problems and adapt environmental changes, these belonging in the field of cognition. Adaptive capacity (behavior) is assessed on the basis of people of the same age and cultural background to interpret the extent to which one is able to attain his own life and practise social duties. Adaptive behavior does not simply take medicine as the index but takes the requirements made on oneself by social environment in which he lives as standard. Full understanding of the implications of intelligence and adaptive capacity is highly helpful to the interpretation of therapeutic effectiveness as well as to the diagnosis of disease.
MR, a symptom, has many etiologic factors including, according to the international standardized etiologic classification of MR (WHO, 1985), (1) infection and poisoning, (2) injury and physical factors, (3) metabolic and nutritional factors (including hereditary metabolic disease), (4) macroscopically detected encephalopathy (including hereditary degeneration), (5) congenital factors of unknown causes (deformity, congenital idiocy syndrome, neural tube defect), (6) chromosome disease, (7) perinatal factors, (8) concomitant mental diseases, (9) adverse environmental factors, social mental damage, social deprival, etc. , and (10) others. It can be seen from above that, other than the bio-medical factors, about 20%-35% of MR patients can be found to have medical abnormalities, which are severe type in most cases, with chromosome disease accounting for 15%-20% of the total, the most common being 21-trisome syndrome. Those without medical abnormal findings account for about 65.8% of the total, and about 50% are due to social environmental factors. In addition, part of MR patients are of unknown causes. It has also been reported (4) that in the etiological factors of MR definite genetic defect makes up about 37%, environmental factors constitute 20%, and the remaining 43% are of unknown causes. In this series of patients, 1 030 cases (73.8%) were found to have had a history of difficult labor, delivery suffocation, premature labor or forceps delivery; 285 cases (20.4%) were found to have had a history of high fever, convulsion or diarrhea; and the remaining cases (5.5%) were of unknown causes. As condition is limited, it is impossible to make chromosome analysis in all cases; in the six cases examined, however, 4 were found to have chromosome abnormalities, two of them had 21-trisome syndrome (cases 2, 3). It is obvious that chromosome abnormalities are a key factor in the pathogenesis of MR. Moreover, MR caused by prenatal and perinatal factors accounts for vast majority of the cases, indicating that prevention of MR should be focused on perinatal health care.
In addition to abnormalities of intelligence and social adaptive capacity, MR has some concomitant somatic diseases, the most important are the three kinds of diseases: (1) Sensory disturbance In this series of patients, 251 (18%) had dysopia with optic atrophy. (2) Dyskinesia In addition to the common clumsiness in movement, MR has rigidity, ataxia and other disturbances. In this series of MR patients, cerebral palsy was seen in 382 (27.4%) cases. (3) Epilepsy Epileptic attack is very common in the disease, especially in severe cases. It is reported that about one third of patients have epileptic attack. It is more frequently encountered in MR due to brain injury. In our series of patients, there were 264 cases (18.9%) of concomitant epilepsy, slightly lower than the figure reported in literature, and among the factors inducing epilepsy, the most common is the high fever caused by "common cold", "pneumonia" and "toxic dysentery". No sufficient attention was devoted to the morphology and electrophysiology of the brain of the affected children. The author made CT and EEG observation on part of the cases and found that no marked abnormalities were detected in the vast majority of the affected children but that in extremely severe MR children, especially in those with concomitant cerebral palsy, shallowed cerebral gyri, deepened cerebral sulci and fissures, local cerebromalacia and hydrocepalus were observed in CT scanning and in the affected children with concomitant epilepsy pathological spike and ware wave were detected in EEG examination.
The diagnosis of MR should be carried out at the same time of treatment or intervention, this being the process of comprehensive multidiscipline diagnosis and treatment. The purpose of treatment is to make, as far as possible, the affected child take care of himself, to improve his intelligence to the maximum limit, and to learn the skills of communicating with people and of adapting social life. Method of treatment includes pharmacotherapy and psychological education. Because MR patients are, for the most part, of unknown causes and even if the cause of disease is known, the symptoms that have developed cannot usually be treated by the method of removing etiologic factors. Therefore, no specific therapy is available at present. In Western medicine, drugs with action of promoting cerebral metabolism such as vitamin B6, pyrithioxine hydrochloride, glutamic acid and cytidine diphosphate choline are commonly used but they have no notable therapeutic effectiveness. For some accompanying symptoms of MR, the Western medicine can only give expectant treatment, for examples, behavior abnormalities, restless leg syndrome and hypoprosexia are treated with nervous stimulants, epilepsy with antiepileptics and mental symptoms with tranquilizers. Treatment of MR with traditional Chinese medicine seems to have its distinctive qualities. In this aspect, scholars at home have done large quantities of research work and obtained encouraging results. It must be, however, noted that treatment of the disease remains in the stage of clinical observation at present. The use of decoction in the form of prepared drugs is inconvenient for long-term use. Other forms of prepared drugs convenient for administration, carry and storage such as granule preparation, syrut, tablet, pill, etc. must be used for the affected child's persistent administration. Methods of treatment include (6) a special prescription for a particular disease, treatment with syndrome differentiation, acupuncture and moxibustion, point-injection therapy, ear needling and auricular-plaster therapy. A special prescription for a particular disease refers to a special prescription or fixed form of prepared drugs composed of effective drugs screened according to experience through the ages and clinical data and from different angles for treatment of disease, this being the method more frequently used at present. According to various reports in literature, (6,7,8) treatment starts mainly with (1) tonifying the kidney, replenishing vital essence and marrow, (2) tonifying the heart, invigorating the spleen and inducing resuscitation, (3) tonifying the viscera with viscera and (4) promoting blood circulation by removing blood stasis, restoring consciousness and dispelling phlegm. Treatment with syndrome differentiation, though it can be directed against the patient's condition and can be individualized in treatment, is difficult to systematize, scientize and popularize. In view of this restriction of treating MR with traditional Chinese medicine at the moment, the author has, based on many years' research with great concentration and repeated practices, successfully developed "Li's Prescription No.5" capsule which is easy to be administered for treating MR. This drug, absorbing the quintessence of traditional Chinese medicine and using the achievements of modern medical scientific researches, has yielded unexpected results in clinical application. It has broken a fresh path for treating MR with traditional Chinese medicine, enriched the theories of traditional Chinese medicine, and demonstrated the huge potentiality contained in treatment of disease with traditional Chinese medicine. In our series of patients, the notably effective rate was 89.8% and the effective rate was 100%, with all the patients highly improved in intelligence, speech and physical development. Moreover, dyskinesia of extremities and hypoacusis were markedly improved, strabismus was corrected, blindness due to optic atrophy regained its vision. The medication was particularly effective for those patients with concomitant epilepsy, with a consolidation rate of 100%. What is more, the marked effectiveness of the medication is also reflected in the morphology and electrophysiology of the brain, with EEG improvement rate reaching 64%, CT improvement rate reaching 27.4%. The author also found that a better therapeutic effectiveness was obtained in MR caused by congenital factors than by acquired factors. It is worth mentioning that this drug was highly effective in treating MR due to chromosome abnormalities as well (case 2 and case 3) and promoted physical development, as seen in case 3 in which after treatment the affected child not only regained his motor function of extremities and linguistie function and improved his intelligence but also had great changes in physical signs, as was observed in follow-up study in which the head circumference was found to be 48 cm, an increase by 12.5 cm; ear margin 6.3 cm in length, an increase by 2.7 cm; body height 118 cm, an increase by 22 cm; and fingers were found to have an average increase of 2.3 cm. In addition, those aged under 18 years had a significant therapeutic effectiveness. This breaks through the age limit in MR treatment, differing from the reports of many domestic scholars. Wang et al. (7) reported that of the 70 children with atelencephalia treated by differentiation of symptoms and signs, 23 were notably effective and 37 were effective, the total effective rate being 85.8% and that the smaller the age and the earlier the treatment, the more notable the effect in treating MR due to congenital factors and with dyskinesia as the dominant manifestation. Zhou et al. (8) also reported similar findings. The author is of the opinion that the present medication has blazed new trails in three aspects: (1) The therapeutic effectiveness is unexpected, the effective rate being 100%; (2) it breaks through the age limit in MR treatment, those aged under 18 years all had a better therapeutic effectiveness; and (3) in addition to the redevelopment of the central nervous system, it promotes the redevelopment of the whole organism.
The miraculous effectiveness of Li's Prescription No.5 defies any explanation using existing theories. In an attempt to explain the encephalic and body development as well as their normal functioning, the author boldly puts forward a new hypothesis (called Li's theory for short), the main point of which is that there might exist in the brain an "adjusting point" which controls the normal development and functioning of the central nervous system, just as the central nervous system governs the development and functioning of the whole organism. The hypofunction of the "adjusting point" will make an impact on the development and functioning of the central nervous system, followed by the occurrence of disturbances of perception and thinking of human brain, manifested as feeblemindedness and affective disorder and loss of control of cerebral domain governing somatic movement, resulting in extremity dyskinesia, hypoacusis and blindness. The hyperfunction of the "adjusting point" will lead to the occurrence of over-excitation of central nervous system, thus developing different types of psychonosema such as affective disorder and epilepsy. It is, therefore, reasonable to regard the "adjusting point" as the center of the central nervous system. The definition of the "adjusting point" is functional and not anatomical, it may be a high-energy magnetic field in the brain which interferes with all the activities of the brain in the form of electromagnetic wave and maintains electric potential gradient on both sides of neurolemma. Advancing the hypothesis is based on the following facts: Firstly, the activities of human brain, whether those of higher thinking or those of controlling the body, are based on bioelectric activity, the production and transmission of which necessarily forms electro-magnetic field in the ambient space and thus makes an impact on the function and metabolism of adjacent neurons(9) ; secondly, despite the deep thorough studies on the formation and metabolism of the brain in modern science, the structural complexity of human brain and the limitations of research methods impose restrictions on the understanding of the cerebral functions, or rather, the cerebral latent energy, such as the extraordinary powers and the phenomenon of deep breathing exercises of man; and despite the fact that the one-position sign governing somatic movement can easily localize the functional position of human brain, the domain of the higher thinking activities of human brain cannot be accurately localized because of the involvement of extensive synergism of the brain, this bringing about some difficulties and remaining to be explored further; thirdly, the fact that central nervous system has some plasticity, (10) namely, power of regeneration, suggests that regulation of the function and development of neurons by "adjusting point" has some material base; and fourthly, lack of marked abnormality in cerebral morphology in many patients with mental retardation, especially in those having chromosome abnormalities, indicates that there may be neuronal hypometabolism and hypofunction only and that there exists possibility of further improving such hypometabolism and hypofunction. According to this hypothesis, the author is of the opinion that MR, whether congenital or acquired, all leads to anion-cation imbalance in the brain, thus interferes with the function of the "adjusting point", with development of abnormalities of neuronal function and metabolism (such as microcirculatory disturbance, pathological enhancement of free radical reaction, and reduction of cytotrophic supply). Those with accompanying somatic symptoms (such as cerebral palsy, strabismus, blindness, etc) have particular nerve mass and the organic lesion of fiber yet. It is, therefore, the key to treating MR to correct the anion-cation imbalance in the brain, the wonderful therapeutic effectiveness of Li's Prescription No.5 in treating MR in turn confirms this. This elevation of anion-cation index by Li's Prescription No.5 leads to enhancement of potential gradient, functional improvement of the "adjusting point", and acceleration of transformation and transmission of electromagnetic field, thus directly promoting the regeneration and functioning of the central nervous system. The routes by which Li's Prescription No.5 takes effect are: (1) opening the blood-brain barrier and increasing quantity of entry of such nutrients as amino acids, peptides and phospholipids to make the residual neurons regenerate and function; (2) regulating microcirculation of the brain, raising the energy metabolism of the brain, increasing oxygen supply, and enhancing the activity of nerve cells and their sensitivity to external stimulation to make the nerve cells in dormant state and the damaged nerve cells revive and to mobilize the latent energy of the brain; (3) promoting synthesis of neurotrophic factors to strengthen regeneration of nerve cells; (4) regulating ions (such as Ca, Na, K, etc.) transport in the brain and restoring the bioelectric activity of nerve cells and its transmission: (5) eliminating noxious substances such as free radicals in the brain and restoring the function of nerve cell membrance; and (6) mobilizing the pituitary function to increase the synthesis and release of growth hormone and facilitate physical development. This hypothesis might explain the patients' post-treatment rise of intelligence, enhancement of social adaptive ability, restoration of extremity and speech function, correction of strabismus, improvement of hearing, regaining vision in those with optic atrophy, surpassing normal level in intelligence in individual patients, physical development, and the return to normal of physical signs. This drug has a dual-directional regulation: skull exceeding normal size shrinks (case 5) and that smaller than normal size enlarges (case 2), this being a strong evidence.
To sum up, the author used "Li's Prescription No.5" to treat MR and obtained wonderful therapeutic effectiveness, the notably effective rate being 89.8% and the effective rate being 100%. Patients aged less than 18 years all had therapeutic effectiveness. The medication was highly effective for those with concomitant blindness and epilepsy. More notably, the medication was able to promote redevelopment of the organism of affected children with microsoma due to chromosome abnormalities. In addition, the notable therapeutic effectiveness was also reflected in the anatomy and electrophysiology of the affected children's brain, with CT improvement rate reaching 27.4% and EEG improvement rate reaching 64%. The author advances the theory of "adjusting point" on the development and functioning of human brain (Li's theory). The occurrence of MR is related to the hypofunction of the "adjusting point". Li's Prescription No.5 makes intelligence of child with fe4eblemindedness recover or even exceed the normal level, it certainly makes normal persons more clever by developing the latent function of the brain. This fully suggests a vast range of prospects for developing "Li's Prescription No.5" to serve the whole society. In addition, Li's theory might be used as theoretical guidance or for reference in the diagnosis and treatment of other diseases of the central nervous system and somatic diseases, and this remains to be jointly explored by people of the same profession.
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