Guizhi decoction is a famous prescription when we study Treatise on Febrile Diseases. Generally speaking, treating a cold belongs to relieving exterior syndrome. However, Guizhi decoction, as the "first party in the ages", can be ignored if it is only regarded as a small prescription for treating colds. If Guizhi decoction and its similar prescriptions are used well, many clinical problems can be solved. Today, I will show you how Guizhi decoction can solve the lung infection that antibiotics can't cure from a medical case.
Li, female, 50 years old. I have a history of multiple ulcers in the large intestine in the past, and I have a history of allergies to amikacin, IDA, cephalosporin, penicillin and cyclophosphamide. 20 10, 10 At the beginning of June, I had fever after catching a cold, with the highest temperature of 38.5℃, accompanied by cough, paroxysmal dry cough, phlegm, stuffy nose and runny nose. Physical examination: the breathing sounds of both lungs are thick, and a small amount of wet rales can be seen in the right lower lung, with a heart rate of 94 beats/min and regular rhythm. No pathological murmur can be heard in the auscultation area of each valve. Chest X-ray showed lung infection. After intravenous infusion of Lomefloxacin in outpatient department, it could not be relieved, but there was still fever, cough and expectoration. He was transferred to the ward on June 8 10. Azithromycin and levofloxacin were given intravenous drip and symptomatic treatment during hospitalization, and the effect was not good. Considering the patient's allergic constitution, it is difficult to choose antibiotics. In order to cooperate with traditional Chinese medicine, Dr. Huang is invited to make rounds. See the patient tired, pale and emaciated. Fever occurs every afternoon and evening, and the body temperature fluctuates between 37.5℃ and 38.2℃. Cough, expectoration, hard sputum, thick and white sputum, aversion to cold.
First, Chaihu and Maxingshi dry soup. After four days of fever, my cough is still frequent.
Huang visited again and found that he wiped his sweat from time to time, and his fear of cold was obvious. Although the weather is very hot, he still wears thick clothes, his mouth is light, his fur is white and he is not thirsty.
That is, Guizhi Thickening Puxingzi Decoction:
Ramulus Cinnamomi 15g, Radix Paeoniae Alba 15g, Rhizoma Zingiberis Recens 15g, Fructus Jujubae 15g, Radix Glycyrrhizae Preparata 15g, Semen Armeniacae Amarum 15g, and Cortex Magnolia Officinalis 20g (below).
That night I was instructed to take two doses, once every two hours, four times in total. After taking the medicine, I took half a bowl of hot porridge to help the medicine, and I was sweating all over.
According to the doctor's advice, after taking 1 dose, the patient felt fever all over and his chills suddenly decreased. The fever dropped that night, and the patient stopped taking the medicine on his own, but the fever recurred the next day. Still use Guizhi decoction to double its amount and thicken almonds, two doses. Keep the previous interest calculation method. The fever has all gone, and the aversion to cold and sweat has also gone out.
Guizhi decoction bears the brunt and is a famous prescription throughout the ages. Few people know what it means. But it is often timid when used in clinic. It is nothing more than saying that there is no typhoid fever in the south and no typhoid fever in summer, which is preconceived. Therefore, even if there are Guizhi decoction syndrome and Mahuang decoction syndrome in clinic, we will turn a blind eye. What's more, according to Neijing: "The first summer solstice is sick temperature, and the second summer solstice is sick heat." Don't ask the symptoms, but identify the symptoms according to the onset time. Therefore, those who see Xia Yue's fever, aversion to cold and no sweat in later generations are called yin-heat, cold and wet. There is ephedra soup, and another song is added, which strongly calls Elsholtzia serrata Xia Yue ephedra. That is to say, Xia Yue has ephedra syndrome, so ephedra can't be used, and Elsholtzia can replace ephedra.
As for "Wu Jutong Medical Records", Jutong's medical records show that at the age of 40, on June 13th, the summer first followed the wind, sweating like rain, and the aversion to cold remained unsolved. At first, it was bright with Guizhi decoction and Guizhi, which had no effect; The next day, I had eight taels of smallpox, and it took me half a post to recover. Seeing that Wu used drugs boldly and mercilessly, his style was quite different from Treatise on Febrile Diseases. However, there are 6 cases of Guizhi decoction syndrome in Cao's classic prescription experimental records, of which 3 cases come from summer and summer. It seems that summer is the frequent season of Guizhi decoction syndrome. Therefore, Cao Shi disciple Jiang sighed: "However, Guizhi Decoction is really the first effective prescription for people who drink cold drinks in summer, not only for treating typhoid fever in the north in winter?" Cao Shi also said: "About summer, you sweat heavily and your pores are wide open. You lie down with the window open and your pores are in the outside wind, which is a stroke, so you have fever and spontaneous sweating. Therefore, Guizhi Decoction should be independent of summer in recent days. "
The onset of this case coincides with the Mid-Autumn Festival, and Guangzhou is still in the hot summer. However, the fever lasts for a long time, and the fear of cold is obvious. When Huang made rounds, he saw that he was constantly wiping his sweat with a towel, and his tongue was pale, thin and white, and his speech was neutral. There is no doubt that this kind of cassia twig syndrome has the gas of coughing, so cassia twig is used to thicken Puxingzi decoction.
Guizhi decoction is not only designed for treating solar diseases. In fact, there are Guizhi Tang in Yangming and Taiyin articles, which are designed for fever and sweating.
After Huang prescribed medicine that day, he frequently wiped his sweat and the wind was not good. He told him to add aconite the next day. Cover article 2 1 of Treatise on Febrile Diseases: "Sun disease is sweating, so it is constantly discharged. If the wind is bad, it is difficult to urinate, the limbs are slightly anxious, and it is difficult to bend and stretch. The treatment is mainly Guizhi plus Fuzi Decoction. " I asked again the next day. Although I sweated a lot, I didn't sweat when I had a fever, especially when I had a fever. Originally, it was not like this. At this time, there is less sweat, so you don't need to help Yang Fuzi. You can reuse Guizhi Decoction.
"Treatise on Febrile Diseases" Guizhi Tang later said: "After taking a liter, it will be fine in a moment. After drinking more than a liter of hot porridge, it will be warm in a moment. It seems that people who are sweating all over will be better. If you sweat, you won't get rid of the disease. If you get sick after taking it, you don't need to take it after stopping taking it. Don't sweat, just take it as before. I don't sweat, and I will take a short promotion period. Half a day, make three copies If you are seriously ill, take it for one day and one night and observe it once a week. Take one dose, and those with symptoms will eat more. Take two or three doses without sweating. " This period of taking Guizhi decoction should not be taken lightly, but sometimes it is the key to curative effect.
We should pay attention to two problems in this paragraph. First, the problem of sweating: Guizhi decoction has already sweated, why do you still sweat? Guizhi decoction is a recipe for sweating? The secret of stopping sweating? Jiang divided "sweat" into "disease sweat" and "medicine sweat" in Classic Prescription Experiment Record. That is, the "sweating out" of Guizhi decoction syndrome is "sweating out of illness" and the "slightly sweating out" after decoction is "sweating out of medicine". After sweating, the "sick sweat" is removed and sweating stops. The second is the problem of taking medicine. The prescription is divided into three doses, and Guizhi decoction is taken "one day and one night" ... but two or three times according to the condition. Three doses is nine times! Looking at the current medicine, as long as it is convenient, we never pay attention to the method of taking medicine. Even if the certificate is correct, it may not be able to cure the disease. Take it three times a day. Zhongjing knew at that time that the efficacy must last. This case was originally given four times, but the patient took it twice, so he failed to receive a dose of work.
Mr. Huang has been a doctor for five generations, and his father, Huang Jizu, is a famous old Chinese medicine practitioner in Guangzhou, who is good at febrile diseases. Mr. Huang Lao is a famous clinical doctor. The book "Huang Jing Fang Step by Step-Jing Fang-Syndrome-related Medical Records and Methods of Asking Classic Prescriptions" contains Mr. Huang's related medical records, methods of asking classic prescriptions and clinical experience.
This book is divided into four parts, namely, the relative medical records of prescriptions and syndromes, the dialogue between teachers and students, Teacher Huang's Experience of Clinical Evidence and the appendix: Huashan Lun Jian based on classical prescriptions. The classic prescription theory and clinical characteristics of Mr. Huang, a classic prescription clinician, were displayed from different aspects.
Part of this article is selected from Huang's Classic Prescription-Prescription-Syndrome Relative Medical Records and Classic Prescriptions (published by China Traditional Chinese Medicine Publishing House, edited by He Lina, Pan Linping and Yang Senrong). The final interpretation right belongs to the original author and is recommended by Du Yue TCM. Please do not reprint without authorization!