Editor's Guide

Guizhi Decoction is a prescription that we are familiar with when we study "Treatise on Febrile Diseases". Generally speaking, it is classified as a superficial relieving agent to treat colds. However, Guizhi Decoction, as the "first prescription through the ages," will be underestimated if it is only regarded as a small prescription for treating colds. If Guizhi Decoction and its similar prescriptions are used properly, many clinical problems can be solved. Today, I will take you through a medical case to see how Guizhi decoction can solve lung infections that cannot be cured by antibiotics.

Li, female, 50 years old. He had a history of multiple ulcers in the large intestine and a history of allergies to amikacin, ada, cephalosporins, penicillins, and cyclophosphamide. In early October 2010, he developed fever after catching a cold, with a maximum body temperature of 38.5°C, accompanied by coughing, paroxysmal and continuous dry cough, sticky phlegm that was difficult to cough up, and nasal congestion and runny nose. Physical examination: There were coarse breath sounds in both lungs, a small amount of crackles could be heard in the right lower lung, the heart rate was 94 beats/min, and the rhythm was regular, and no pathological murmurs were heard in the auscultation area of ??each valve. Chest X-ray showed pulmonary infection. After being given intravenous lomefloxacin in the outpatient clinic, the patient still had fever, cough and sputum, so he was transferred to the ward on October 8. During hospitalization, intravenous infusion of azithromycin and levofloxacin and symptomatic treatment were given, but the effect was not good. Considering that the patient has allergies, it is difficult to choose antibiotics. We specially asked Dr. Huang to check the ward in the hope that traditional Chinese medicine would be effective. The patient was seen to be mentally and physically tired, with a dull complexion and emaciated body. I have fever every afternoon and evening, and my body temperature fluctuates between 37.5℃ and 38.2℃. Coughing and coughing up phlegm is difficult to come out, the phlegm is thick and white, and there is an aversion to cold.

First, take Xiaobupleurum and Maxing Shigan Decoction. The fever has not subsided for four days and the cough is still frequent.

Doctor Huang checked the ward again and found that he was sweating from time to time and had obvious aversion to cold. Although the weather was hot, he still wore thick clothes. His mouth was light and the coating was white, but he was not thirsty.

Add Guizhi plus Magnolia officinalis and apricot soup:

Guizhi 15g, white peony root 15g, ginger 15g, jujube 15g, licorice 15g, northern almond 15g, Magnolia officinalis 20g (lower back).

Take two doses that night, once every two hours, divided into 4 times. After taking the medicine, take half a bowl of hot porridge to enhance the effectiveness of the medicine, and cover yourself with a quilt to absorb sweat.

The patient followed the doctor's advice and after taking the first dose of the medicine, he felt warm all over his body and his aversion to cold suddenly subsided. The fever subsided that night. The patient stopped taking the medicine on his own, but the fever relapsed the next day. Still use Guizhi Decoction to double the amount, and add Magnolia officinalis Almond, two doses. The breathing method is as before. The fever has completely subsided and the aversion to cold and sweating have stopped.

Guizhi Decoction is the first of all prescriptions and has been a famous prescription for thousands of years. Almost no one knows its meaning. However, it is often hesitant to use it in clinical practice. It is just that there is no typhoid fever in the south and no typhoid fever in summer, which is preconceived. Therefore, clinically, even if there are Guizhi Decoction syndrome and Mahuang Decoction syndrome, they are ignored. According to the "Nei Jing": "The temperature of the disease is first on the summer solstice, and the heat of the disease is on the second summer solstice." The symptoms are not asked, but the time of onset is used to identify the symptoms. Therefore, later generations saw that people with fever, aversion to cold, and no sweat during the summer months were called Yin-shu, which means both heat and cold-dampness. There is an ephedra soup that is not used, but a new song is added to the drink, and the fragrant grass is called Xia Yue's ephedra. That is to say, if Xia Yue has ephedra syndrome and cannot use ephedra, Xiangzhi can replace ephedra.

At the beginning, I used two ounces of cinnamon twigs in Guizhi Decoction, but it had no effect; I used eight ounces of cinnamon twigs the next day, and it healed after half a treatment. Seeing that Wu was bold in using medicine and showed no mercy, it was very different from his style in "Tiao Bian of Febrile Diseases". According to Cao Yingfu's "Jingfang Experimental Record", there are six cases of Guizhi Decoction syndrome, three of which were caused by summer heat. It seems that summer is the season when Guizhi Decoction syndrome occurs most frequently. Therefore, Jiang Zuojing, a disciple of the Cao family, sighed and said: "However, Guizhi Decoction is actually the first effective prescription for those who have shown that they like cold drinks in summer. Is it just for treating typhoid fever in the north in winter?" Cao family said again: "Approximately If there is excessive sweating during the summer and the pores are wide open, if you lie down with the window open, the patient will suffer from a stroke due to external wind, so there will be symptoms of spontaneous sweating due to fever. Therefore, the Guizhi Decoction is suitable only in the summer."

The onset of this case coincided with the Mid-Autumn Festival, and the Guangzhou area was still like hot summer. However, the fever persisted for a long time, the aversion to cold was obvious, and he sweated spontaneously. During the ward rounds, Dr. Huang saw that he kept wiping his sweat with a towel, his tongue was pale and the coating was white, and his mouth was neutral. There is no doubt that the syndrome of cinnamon twig is there, and there is cough and qi inversion, so Pu Xingzi Decoction is thickened with cinnamon twig.

Treating Taiyang Disease with Guizhi Decoction is not just for Taiyang Disease. In fact, there is Guizhi Decoction in both Yangming Chapter and Taiyin Chapter, which is designed to treat fever, sweating and bad wind.

After receiving the prescription on the same day, Master Huang noticed that he was sweating frequently and had bad wind, so he ordered to add aconite the next day. Cover Article 21 of "Treatise on Febrile Diseases": "If the person suffers from Taiyang disease and sweats, and then leaks, and the person is averse to wind, has difficulty urinating, has a slight urgency in the limbs, and has difficulty bending and extending, Guizhi plus Fuzi Decoction can treat this." The next day, I asked again, Although there is a lot of sweating, there is no sweating during fever, and the sweating is more obvious during fever. If the leakage does not stop, and the sweating has decreased at this time, there is no need to use Fuyang Fuzi and Guizhi Decoction. That’s it.

After the prescription of Guizhi Decoction in "Treatise on Febrile Diseases", it says: "Take one liter. After taking it for a while, sip the hot gruel for one liter. Warm it up for a while and spread it all over the body. There may be slight sweating. It will be beneficial. Do not let it flow like water, and the disease will not be cured. If you sweat after taking it for a while, do not take it all. If you don't sweat, take it again as before and take it for a short period of time. After half a day, take three doses. If the patient is seriously ill, take one dose a day and one night. If the symptoms persist, take two or three more doses. "This section of taking Guizhi Decoction to stop breathing should not be taken lightly, but sometimes it is the key to the curative effect.

There are two issues to note with this provision. The first is the problem of sweating: Guizhi Decoction is already sweating, so why does it cause sweating more? Is Guizhi Decoction a remedy for sweating? Recipe to suppress sweating? "Jingfang Experimental Record" Jiang classified "sweat" into "disease sweat" and "medicine sweat". That is, the "sweating" syndrome of Guizhi Decoction is "sick sweat", and the "slightly like sweating" after the decoction is said to be "medicinal sweat". After sweating, the "sick sweat" is eliminated and the sweating is stopped. The second is the issue of taking medication. Most of the classic prescriptions require one dose of medicine to be taken in three doses. Guizhi decoction can be taken "a day and a night...or even two or three doses" according to the condition. Three doses is nine times of taking the medicine! Looking at today's doctors, they always use convenience to solve problems and never pay attention to the method of taking medicine. Even if the evidence is correct, it may not be able to cure the disease. Take it three times a day. Zhongjing knew at that time that the effect of the medicine must last. This case was originally ordered to be taken four times, but the patient took it twice on his own, so the effect could not be achieved in one dose.

Mr. Huang Shipei’s ancestors have been practicing medicine for five generations. His father, Huang Jizu, is a famous old Chinese medicine doctor in Guangzhou and specializes in febrile diseases. Mr. Huang Shipei specializes in classic prescriptions in clinical practice and is famous for his large doses. This book "Huang Shipei's step-by-step recording of classic prescriptions - Medical records of relative prescriptions and syndromes and questioning of classic prescriptions" contains Mr. Huang Shipei's medical records of relative prescriptions, syndromes and classic prescriptions, as well as his clinical insights——

This book is divided into four parts, namely, the relative medical records of prescriptions and syndromes, dialogues between teachers, Huang Shipei's "Clinical Insights" and the appendix: "Huashan Sword Theory" based on prescriptions. The theory and clinical characteristics of classic prescriptions by Mr. Huang Shipei, a classic prescription clinician, are demonstrated through different aspects.

Part of the content of this article is selected from "Huang Shipei's step-by-step recording of Jingfang Prescriptions - Comparative Medical Records with Prescriptions and Syndrome and Comparison of Jingfang Prescriptions" (published by China Traditional Chinese Medicine Press, edited by He Lina, Pan Linping and Yang Senrong). The final right of interpretation belongs to It is owned by the original author and published by Yuedu Traditional Chinese Medicine. Please do not reprint without authorization!