the composition of the first prescription is mixed with cold and heat
Chaihu Guizhi Ganjiang Decoction consists of half a catty of Chaihu, three ounces of cassia twig (peeled), two ounces of dried ginger, four ounces of Trichosanthes kirilowii root, three ounces of scutellaria baicalensis, three ounces of oyster (boiled) and two ounces of licorice (roasted). This recipe is a variant of Xiaochaihu decoction with Pinellia ternata and Trichosanthes kirilowii, that is, ginseng, jujube, Pinellia ternata and ginger are removed, and Trichosanthes kirilowii root, cassia twig, dried ginger and oyster are added. In the prescription, Bupleurum chinense is responsible for the stagnation of qi in the stomach and intestines, food accumulation, cold and heat pathogens, promoting innovation, interacting with Scutellaria baicalensis Georgi to relieve annoyance and heat, and treating chest and hypochondriac pain; When the roots of Trichosanthes kirilowii are moistened, the oysters are harvested, which can nourish the liquid and quench the thirst; Scutellaria baicalensis Georgi is bitter and cold, and the pungent warmth of dried ginger is used to manage the micro-knot; Ramulus Cinnamomi and Radix Glycyrrhizae are used to treat qi-rushing and external; Glycyrrhiza uralensis Fisch and Zingiber officinale Regulate Middle Qi to restore body fluid; The original ginseng tonic and jujube fullness are not suitable for micro-knots, so they are removed. Therefore, it is necessary to treat Xiaochaihu who goes to Pinellia and adds Trichosanthes decoction, and has micro-knots in qi or external disharmony. According to Jin Jian of Medical Zong, "shaoyang has not been solved in exterior and interior, so it is treated with a mixture of Bupleurum and Guizhi, that is, the reform of Xiaochaihu." Those who go to ginseng are not empty because of their qi; Halve the summer, because it does not vomit and help dryness; The root of Trichosanthes kirilowii can quench thirst and produce body fluid; Bupleurum chinense and cassia twig are added to control the exterior of shaoyang, and oysters are added to soften the knot of shaoyang; Dried ginger with cassia twig to disperse the cold; Scutellaria baicalensis Georgi and Bupleurum chinense DC. can be used to make dried ginger. The medicines are cold and warm, and licorice is necessary to reconcile them. "
Ke Yunbo thinks: "This recipe is all Bupleurum root addition and subtraction, so I am upset and thirsty without vomiting, so I went to the summer to add Trichosanthes kirilowii root; The chest is full and slightly knotted, so jujube and oyster are added; Although urination is unfavorable, I feel nervous, so I don't go to Scutellaria and don't add Poria; Although thirsty, the table is not solved, so you don't have to participate in the cinnamon, so dry ginger is easy to ginger, and the fullness of the chest is also scattered. " It is believed that this recipe is changed from Xiaochaihu decoction, and the views of various scholars are the same.
it is suggested in yizong jinjian that it is a mixture of Bupleurum chinense and cassia twig, suggesting that this recipe is suitable for the syndrome of half exterior and half interior, but it is considered that the loose knot is not in dried ginger but in oysters, and it is easy to treat dried ginger lightly. However, Koch noticed that dried ginger is easy to ginger, which is to disperse the fullness of chest and hypochondrium, and that cold drink is the main cause of fullness, so it is necessary to use the warmth of dried ginger instead of ginger. Therefore, dried ginger is easy to ginger, which is a big eye that distinguishes Chaihu Guizhi Ganjiang Decoction from Xiaochaihu Decoction, suggesting that Xiaochaihu Decoction focuses on reconciling the heat in half the exterior and half the interior, while Chaihu Guizhi Ganjiang Decoction tends to dispel the cold in half the exterior and half the interior (Jue Yin? )。
The disease location in the second section is half exterior and half interior
The syndrome of Xiaochaihu decoction belongs to half exterior and half interior, which is people's knowledge. Chaihu Guizhi Ganjiang Decoction was changed from Xiaochaihu Decoction. From the above explanations, it can be seen that the disease position of this prescription is still half exterior and half interior as Xiaochaihu Decoction.
Moreover, many people have seen the difference between the two. For example, Liu Duzhou's Clinical Guide to Typhoid Febrile Diseases records: "When Mr. Chen Shenwu, a famous classical prescription, and Mr. Liu Duzhou asked about the application of this prescription, Mr. Chen pointed out that Chaihu Guizhi Ganjiang Decoction was the most appropriate one to treat shaoyang disease with yin syndrome."
Zhang Luyu pointed out: "Xiaochaihu decoction is a prescription of stopping yin and yang, which can advance and retreat with malaria, and then add cassia twig and dried ginger to relieve yang; If you add Trichosanthes and gypsum, it will go from yin. " What is the mechanism of yin syndrome? What is from Yin to Yang? Not explained.
Hu Xishu, a master of classical prescriptions, broke through his organs in a word. In A Record of Treatise on Febrile Diseases, he explained Chaihu Guizhi Ganjiang Decoction in the chapter on shaoyang disease, and clearly pointed out when explaining the prescription syndrome of Chaihu Guizhi Ganjiang Decoction: on May 6th, typhoid fever was a period when superficial diseases often spread to shaoyang, but it was repeated because of sweating, which caused great damage to body fluids and turned the yang syndrome in half exterior and half interior into the yin syndrome in half exterior and half interior. It can be seen that Xiaochaihu decoction treats the syndrome of half exterior and half interior yang from yin, and the syndrome of half exterior and half interior yin from yang. It is also known that the pathogenesis of yin syndrome refers to the change of disease location from yang syndrome to yin syndrome in half the table and half the room. Look at Zhongjing's discussion more clearly. Article 147 of Treatise on Febrile Diseases says that "the typhoid fever has been repeated for five or six days, and the chest and hypochondrium are full of slight knots, which are unfavorable, thirsty and not vomiting, but the head sweats, cold and heat, and upset are the main causes", which means that the typhoid fever is often turned into the treatment after five or six days, although it has been sweating.
Sweat, diarrhea and pathogenic heat all hurt body fluids, and body fluids can't flow down, so urination is unfavorable; Deficiency of body fluid and heat damage to body fluid lead to dryness, so thirst does not cause vomiting. Qi rushes to the bed, so the head sweats. Between cold and heat, the evil is still in half the table and half the inside. Upset, because there is heat in the world. Here, the micro-knot is aimed at the syndrome of "Da Xian Xiong Tang", that is to say, the knot is slight, which is obviously different from the syndrome of "Da Xian Xiong Tang" with the syndrome of "Yang Ming" as hard as stone. That is, the syndrome of semi-exterior and semi-interior yang has changed to semi-exterior and semi-interior yin, showing the prescription of Chaihu Guizhi Ganjiang Decoction with upper heat and lower cold.
synopsis of the golden chamber? Supplementary prescription (3) of Malaria: "Chaihu Guizhi Ginger Decoction can treat malaria with excessive cold, slight fever, or cold but not hot, and one dose is as effective as magic". Malaria is a disease characterized by alternating cold and heat, and Chaihu Guizhi Ganjiang Decoction is suitable for malaria with excessive cold and less heat, or cold but not hot, which shows that this prescription focuses on dispelling cold at warm temperature.
There are only two articles about Zhongjing's exposition of this article, which do not directly refer to the diseases of the Six Meridians of Meiji, but we can know that the main indications of this prescription are "cold but not hot" and "cold and hot, upset". It can be seen that this prescription is similar and different from Xiaochaihu decoction syndrome: similar patients have the same disease position and are all used for semi-exterior and semi-interior syndrome; Different people have different diseases. Xiaochaihu decoction is used for yang syndrome, while Chaihu Guizhi Ganjiang decoction is used for yin syndrome.
outline of symptoms and signs of Jue yin in the third section
According to the prescriptions, the six meridians come from eight classes, that is, the diseases of the exterior, interior and half exterior of the human body are divided into yin and yang. There are yin syndrome and yang syndrome in semi-exterior and semi-interior, and Xiaochaihu decoction is known to be semi-exterior and semi-interior yang syndrome, also known as shaoyang disease; Obviously, the syndrome of Chaihu Guizhi Ganjiang Decoction belongs to semi-exterior and semi-interior yin syndrome, and it belongs to Jueyin disease. So, is it consistent to measure the prescription with the outline of Jue Yin disease?
the outline of Jue yin disease is: quenching thirst, qi hitting the heart, heart burning with pain, hunger without eating, vomiting when eating, and the benefits will not stop. Its main characteristics are: half exterior and half interior cold, upper heat and lower cold, and obvious thrust. The indications of Chaihu Guizhi Ganjiang Decoction have been as mentioned above: treating malaria with excessive cold, slight fever, or cold without heat, alternating cold with heat, upset, etc. What is more noteworthy is that this prescription has Guizhi, such as Trichosanthes Radix, raw oysters for nourishing body fluid, astringing body fluid, and quenching thirst. It is a typical prescription to treat Jueyin disease with dried ginger to warm the cold and Scutellaria baicalensis to clear the heat, and it is often effective to treat Jueyin disease in clinic.
The fourth section is proved to belong to Jueyin
Example 1: Li, female, 88 years old. Initial diagnosis on October 6th, 22: Paroxysmal atrial fibrillation occurred in the past 3 years, which was uncontrollable after long-term hospitalization. Recent symptoms: tightness in the precordial region, chest tightness, palpitation, cold hands and feet, dry mouth, backache, fatigue, dizziness, tinnitus, poor sleep, easy sweating, thin and white tongue coating, pale tongue, bilateral pulse inversion, and sometimes knot. Electrocardiogram showed that V3, V5 and ST decreased, and T wave was low. The syndrome belongs to Jue Yin disease with upper heat and lower cold, and blood deficiency and excess water. Indications of Chaihu Guizhi Ganjiang Decoction combined with Danggui Shaoyao Powder are: Chaihu 12g, Scutellaria baicalensis 1g, Trichosanthes root 12g, raw oyster 15g, raw keel 15g, Guizhi 15g, dried ginger 6g, roasted licorice 6g, Angelica 1g, Chuanxiong 6g, Paeonia lactiflora 1g, Alisma orientale 15g, Rhizoma Atractylodis 15g and Poria 12g. < P > Treatment results: After taking 7 doses, the dizziness, fatigue and palpitation improved, and atrial fibrillation attacks decreased. After taking the medicine for 2 months, no atrial fibrillation occurred again, and the condition was stable after 2 years of follow-up.
case 2: Wang, first diagnosed on August 19th, 1955: he was ill for six days, but failed to take western medicine. His symptoms were: cold and fever, bitter taste in the mouth, dry throat, upset, full chest and hypochondriac pain, underwater sound when rubbing his upper abdomen, dysuria, reddish tongue, white and slippery fur, and thready pulse. The syndrome belongs to shaoyang disease, and it is also a syndrome of internal stagnation of water and drink. It is advisable to reconcile shaoyang and control water and drink. The prescription is Chaihu Guizhi Ganjiang Decoction: Chaihu 9g, Scutellaria 9g, Guizhi 6g, Ganjiang 4.5g, Poria 9g, Chenpi 6g, Alisma orientalis 6g and powdered licorice 3g.
treatment results: after taking 2 doses, the cold and heat were relieved, the symptoms of fullness in chest and hypochondrium and stopping drinking disappeared, and the urine was smooth. (Meng Yongli, Modern Research and Clinical Application of Treatise on Febrile Diseases. Beijing: Academy Press, 1998)
Example 3: Female, 23 years old. First diagnosis: January 2, 1961. Menopause for 5 months, more leucorrhea, no pregnancy. In recent 7 days, I have felt bitter mouth, full of chest and hypochondriac pain, and I don't think about eating and drinking. The day before yesterday, I felt pain all over my body, low back pain, and then my menstruation, with bright red color, fishy breath, little urine, painful urethra when I urinate, dry lips, thirsty mouth, like hot drinks, upset, sweating in my head at night, backache and abdominal pain, and thin tongue and thin pulse. This element has little body blood, and shaoyang is affected by evil recently. It is proposed to use Chaihu Guizhi Ganjiang Decoction to balance shaoyang, and add Siwu Decoction to nourish blood: Beichai 15g, Guizhi 1g, Ganjiang 6g, Trichosanthes 12g, Scutellaria baicalensis 1g, Radix Glycyrrhizae preparata 6g, Oyster 12g, Rehmannia glutinosa 1g, Radix Paeoniae Rubra 1g, Chuanxiong 3g and Angelica 1g.
treatment results: after taking one dose of the medicine, the symptoms such as bitter taste and backache are greatly reduced, and the leucorrhea is also less. The symptoms such as chest tightness, upset and thirst are all removed, and the menstruation is still not clean. Continue to take two doses, and then recover after cleaning the leucorrhea. (Li Peisheng, et al. Teaching Reference Series of Chinese Medicine Colleges. Treatise on Febrile Diseases. Beijing: People's Medical Publishing House, 1987)
Press: These three cases were diagnosed by different doctors, but all of them were treated with Chaihu Guizhi Ganjiang Decoction for common acute and chronic diseases. All 3 cases had chest and hypochondriac pain, bitter mouth, dry throat, upset, palpitation, dysuria, or four adverse reactions, which showed the syndrome of upper heat and lower cold. Scholars think that the disease location of this prescription is the same in half exterior and half interior, but it has always been influenced by the interpretation of Shanghan in Neijing. They always think that half exterior and half interior are shaoyang, Xiaochaihu decoction is the representative of shaoyang disease, and Chaihu Guizhi Ganjiang decoction is modified from Xiaochaihu decoction, so it is still regarded as shaoyang, because the essence of the six meridians is unknown.
We should know that the six meridians in Treatise on Febrile Diseases are not the zang-fu organs and meridians in Neijing, but the six meridians formed by the idea of adding eight classes into the semi-exterior and semi-interior. In the semi-exterior and semi-interior, there are yang syndrome and yin syndrome, and the yang syndrome is shaoyang disease and the yin syndrome is Jueyin disease. In case 2, the author thinks that "the syndrome belongs to shaoyang meridian disease with internal stagnation of water and drink", that is, "shaoyang disease with internal stagnation of water and drink", that is, the syndrome of cold and heat in the upper part and cold and drink in the lower part, that is, the syndrome of half exterior and half interior yin.
Xiaochaihu decoction is used to treat semi-exterior and semi-interior yang syndrome, while Chaihu Guizhi Ganjiang decoction is used to treat semi-exterior and semi-interior yin syndrome. There are obvious differences between them. This is what Mr. Chen Shenwu refers to as "yin syndrome turns to mechanism" and what Zhang Luyu refers to as "from yang", that is, from semi-exterior and semi-interior yang syndrome to semi-exterior and semi-interior yin syndrome, and the six meridians belong to Jueyin disease.
here's a comparison of the prescriptions and syndromes of Wumei Pill. The concept of Jueyin disease has always been unclear in later generations, and the prescription for Jueyin disease is even more vague. However, the view that Wumei Pill is the prescription for Jueyin disease is the same, and its prescription is characterized by both cold and heat, and its main indications are mixed cold and heat.
The prescription composition of Chaihu Guizhi Ganjiang Decoction is the combination of cold and heat, and its main indications are mixed cold and heat. The prescriptions and indications of the two sides are similar, so Chaihu Guizhi Ganjiang Decoction is the same as Wumei Pill in treating Jueyin disease.
In a word, from the composition of the prescription, Chaihu Guizhi Ganjiang Decoction belongs to the syndrome of upper heat and lower cold in half exterior and half interior; From the analysis of the location of the disease, this prescription belongs to the syndrome of half exterior and half interior yin; According to the outline of six meridians and clinical treatment, this prescription belongs to Jueyin disease, so Chaihu Guizhi Ganjiang decoction belongs to Jueyin disease.
In the past, people can use this prescription according to the symptoms mentioned in the provisions, and it has been widely used to treat colds, malaria, hepatitis, coronary heart disease, endocrine disorders, gynecological diseases, chronic nephritis, prostatitis and other diseases. When the prescription belongs to Jue Yin, its meaning will be further understood, which will be more widely and accurately used in clinic, and the essence of Jue Yin disease will be further understood by further analyzing other prescriptions of Jue Yin disease.