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? You must be old before you lose your temper.
The theory of five movements and six qi reflects the overall concept of "correspondence between man and nature" and the thought of differentiation and treatment of "three factors are suitable" in traditional Chinese medicine, which has considerable guiding and application value, especially for complex clinical problems. Neijing has long had the commandment that "you must be old first, and you can't cut the sky". The following two medical records fully reflect the role of this theory.

medical record 1

Zhang, male, 5 years old, was first diagnosed on April 2, 215. Cough and asthma recurred for 5 years, and then recurred for 1 week. After anti-inflammatory and antispasmodic infusion treatment, it was ineffective. Diagnosis by engraving: after 12 o'clock at night, I have a terrible cough, a foreign body sensation in my throat, and a small amount of white sputum. When I cough, I feel hot and sweaty, and I feel nauseous, with a dark red tongue, yellow and greasy fur and a smooth pulse.

Cough onset after 12 o'clock at night is a drama, which accords with "when Jue Yin disease wants to be solved" (from ugliness to exhaustion), so it is treated with Wumei Pill. 3 grams of ebony, 3 grams of asarum, 4 grams of cinnamon, 4 grams of coptis root, 1 grams of phellodendron bark, 1 grams of angelica, 15 grams of codonopsis pilosula, 3 grams of pepper, 9 grams of dried ginger, 5 grams of prepared aconite, 1 grams of mulberry leaves, 1 grams of chrysanthemum, 1 grams of silkworm, 5 grams of platycodon grandiflorum and 5 grams of licorice. 7 doses of water decoction.

Second diagnosis (April 9, 215): After 12 o'clock at night, I still have a bad cough, and my mood is impatient, my face is burning, I can't sleep, and I feel pain in my right hypochondrium. When I cough, I feel hot, night sweats, phlegm stagnation in my throat, no nausea, and I can eat well. My tongue is dark red, my fur is yellow and greasy, and my pulse is thin and stringy. Referring to the luck characteristics of the "Second Qi" in the annual transportation, we decided to change our thinking: we should follow the principle of using Xuefu Zhuyu decoction in the annual transportation, and at the same time, we should use Wumei Pill and Huanglian Ejiao Chicken and Huangtang decoction when Jueyin wants to be relieved and when Shaoyin wants to be relieved. The original Wumei Pill prescription is added with 1 grams of Scutellaria baicalensis Georgi, 1 grams of colla Corii Asini beads, 1 grams of Radix Paeoniae Alba, 6 grams of fried Bupleurum, 1 grams of Fructus Aurantii, 1 grams of Radix Rehmanniae, 1 grams of peach kernel, 5 grams of safflower, 6 grams of platycodon grandiflorum, 6 grams of Ligusticum Chuanxiong, 1 grams of Achyranthes bidentata, 5 grams of roasted licorice, 3 grams of floating wheat, 1 grams of jujube and 1 gallus gallus domesticus brisson. 7 doses of water decoction.

Third diagnosis (April 16th, 215): Cough and asthma were obviously relieved at night, and symptoms such as insomnia, irritability and night sweats were also relieved, and foreign body sensation was still felt in the throat, with dark red tongue, thin fur and fine and slippery pulse. Add 1 grams of belamcanda chinensis to the original prescription, 7 doses.

fourth diagnosis (April 23, 215): the complaint of cough and asthma has been controlled, the sensation of foreign body in the pharynx has disappeared, the coating is thin and reddish, and the pulse is fine and quiet. Add 15 grams of goat milk to the original prescription, and 7 doses will be cured.

medical record 2

Zheng, male, aged 53, was first diagnosed on June 27th, 214. He complained of shortness of breath, asthma after exercise, stuffy nose, no runny nose, no cough, dry mouth, night sweats and fatigue. Before coming to the clinic, he was diagnosed as organic pneumonia by lung puncture pathology in a hospital in Nanjing. He has been treated with oral prednisolone for 4 months, and he still takes 3 pills a day. His tongue is dark red, his fur is thin and Huang Gan, and his pulse is thin. According to the evidence, Shengmai Powder and Danggui Liuhuang Decoction are selected from the aspects of benefiting qi and yin, resolving phlegm and blood stasis and regulating yin and yang. 1g of Codonopsis pilosula, 1g of Ophiopogon japonicus, 5g of Schisandra chinensis, 15g of raw and cooked land, 2g of Radix Astragali, 1g of fried Angelica sinensis, 3g of Rhizoma Chuanxiong, 1g of Scutellariae Radix and 1g of Folium Perillae. 7 doses of water decoction.

Second diagnosis (September 1th, 214): Asthma improved after exercise, but I was consciously afraid of the cold, with cold feet, night sweats, bitter dry mouth, diarrhea due to cold, acceptable stool, red tongue, yellow fur peeling and fine and slippery pulse. According to the characteristics of luck at this time, Fuzi Shanyu Decoction and Zhengyang Decoction were given. 6 grams of prepared Radix Aconiti Lateralis Preparata, 1 grams of Cornus officinalis, 1 grams of stewed nutmeg, 15 grams of dark plum, 1 grams of papaya, 1 grams of radix aucklandiae, 3 grams of clove, 5 grams of fried licorice, 1 grams of jujube, 3 slices of ginger, 1 grams of cortex Phellodendri, 5 grams of Amomum villosum, 1 grams of Chinese angelica, 12 grams of white peony root, 6 grams of Ligusticum chuanxiong, 15 grams of mulberry bark and Scrophularia. 7 doses of water decoction.

Third diagnosis (September 17th, 214): fear of cold has disappeared, dry mouth and bitter taste have disappeared, no diarrhea, poor sleep, easy to wake up at 2 o'clock in the night, night sweats, acceptable stomach, dark red tongue, thin fur and smooth pulse. According to the certificate, Huanglian Ejiao Chicken Egg Yellow Decoction and Danggui Liuhuang Decoction were given. 3 grams of Coptidis Rhizoma, 1 grams of Scutellariae Radix, 1 grams of colla Corii Asini beads, 12 grams of Radix Paeoniae Alba, 2 grams of Radix Astragali preparata, 1 grams of Radix Angelicae Sinensis preparata, 15 grams of Radix Rehmanniae, 1 grams of Cortex Phellodendri preparata, 5 grams of Fructus Schisandrae Chinensis, 15 grams of Bulbus Lilii, and 1 tablet of gallus gallus domesticus brisson. 14 doses of water decoction.

Fourth diagnosis (September 3th, 214): Night sweats disappeared after taking medicine, and the night sleep was peaceful. After treatment, the condition was stable in March and the hormone stopped taking.

according to the above two medical records, both of them have achieved good results after using routine diagnosis and treatment and referring to the theory of luck.

When the first case was diagnosed, Wumei Pill was ineffective according to "Jue Yin disease is about to be solved", because the current year's luck is "two qi". At this time, "controlling qi and being polite" are all about reducing yin and controlling fire, and following the training of "you must be old first, and you can't cut the sky", so Xuefu Zhuyu decoction can solve the problem of less yin fire, because patients still have the luck of "reducing yin and trying to solve it" At the same time, the success of compound prescription combining Jue Yin and Shao Yin fully embodies the academic thought of "those who seek it, when it comes to qi, just wait for it, qi can keep pace with the time, and when it is lost, the five treatments are indistinguishable, evil is isolated and endogenous, and work cannot be banned" (Su Wen Six Sections on Tibetan Images).

in case 2, the response after the treatment of Shengmai Powder combined with Danggui Liuhuang Decoction according to the conventional syndrome differentiation at the initial diagnosis was mediocre. In the second diagnosis, it was considered that 214 was the year of Jiawu, when the soil was too transported, and in September, the main qi was polite to cross the soil that was too damp and Yangming was dry and golden, and the yang was less than yang, which showed both cold and dampness and internal heat due to yin deficiency. The symptoms reflected in patients were both cold and heat, including "fear of cold, cold feet and easy to catch cold." The fur is yellow, the quality is reddish, and so on, so we use Fuzi Shanyu decoction, which is mainly over-aged, and Zhengyang decoction, which shows that the gas of fire, water, cold and heat is in contact with gas, to make the symptoms of cold and heat all disappear. The later symptoms are "poor sleep, easy to wake up at 2 o'clock in the night, night sweats", which is in line with "when the yin is lacking" (from the child to the yin), so we choose Huanglian Ejiao Chicken and Yellow Decoction combined with Liuhuang Decoction.

Through the analysis of the above-mentioned cases, I deeply realize that the five movements and six qi are "the great discipline of heaven and earth, and the harmony between man and god". If we can "examine the pathogenesis without losing qi" and "adjust it at the right time" in clinical practice, we can achieve "not going against the weather, which is called supreme happiness". When applying the theory of luck in clinical practice, we must not stick to it, but change it at random, so that we can get the unspoken message of the ancients and do our best.