(1) Compatibility

Predecessors summarized the application of single drug and the compatibility between drugs into seven aspects, which are called "seven emotions", namely, single line, mutual need, mutual attraction, mutual fear, mutual killing, mutual evil and opposite. The breakdown is as follows:

1. Single line refers to treating a disease with a single medicine. It is mostly used for simple illness, and it can be effective to choose a targeted drug, such as "Dushen Decoction", which uses blind ginseng to replenish qi and blood.

2. The combination of drugs with similar performance and efficacy can obviously enhance the curative effect, such as rhubarb combined with mirabilite.

3. The combination of drugs with different functions can promote each other and improve the curative effect, such as Huangqi combined with Huoling.

4. Fear is the strong or toxic reaction of one medicine, which can be inhibited or alleviated by another medicine. For example, the toxicity of Pinellia ternata can be alleviated by ginger.

5. Killing each other means that one drug can reduce or eliminate the toxicity or side effects of another drug, such as windbreak and arsenic poisoning, and mung bean killing croton poison.

6. Evil is the combination of the two drugs, which can restrain each other and reduce or fail the effect, such as ginger and scutellaria baicalensis.

7. On the contrary, the combination of the two drugs can produce toxic reactions or side effects, such as Daphne genkwa against Glycyrrhiza and Radix Aconiti against Pinellia.

Prescription is the development of compatibility and a higher form of compatibility application. The prescription is combined according to the main and secondary compatibility of drugs. As early as Neijing, it has been put forward that "the main disease is called jun, the assistant jun is called minister, and the minister should be called envoy". Because the etiology and pathogenesis are complex and changeable, there are several diseases, cold and heat are mixed, and deficiency and excess are seen at the same time. Only by properly combining various drugs can we take care of everything. In terms of prescription compatibility, it is divided into main, auxiliary, auxiliary and envoy, which is called "monarch, minister, assistant and envoy" in ancient times.

Main drug (Jun): the main drug in the prescription, the drug for treating the main disease.

Auxiliary medicine (minister): the auxiliary medicine of the main medicine.

Adjuvant medicine: it has two functions, one is to restrict the main medicine, and the other is to treat concurrent diseases.

Causative drugs: refers to blending drugs, meridian-inducing drugs and secondary auxiliary drugs.

The composition of compatibility should be based on the principle of main, auxiliary, assistant and assistant. However, with the development and change of diseases and the difference of patients' physique and age, when organizing prescriptions, it is necessary to be compatible according to the principle and flexibly change with syndromes (syndrome differentiation and treatment) to meet the objective needs of various diseases. For example, the predecessors have the following points in the changes of compatibility composition:

Changes in drug tastes: the combination of four drugs, namely Codonopsis pilosula, Atractylodes macrocephala, Poria cocos and Glycyrrhiza uralensis Fisch, is named "Sijunzi Decoction", which is mainly used for treating qi deficiency, but some patients, although suffering from qi deficiency, are unable to make up for chest distress and abdominal distension after taking it, and tangerine peel is added to promote qi circulation and regulate stomach, so it is called "Wuwei Yigong Powder"; If the patient has severe phlegm and dampness, nausea and vomiting, add Pinellia ternata as Liujunzi decoction; In case of stagnation of qi in middle energizer and fullness of stomach, Radix Aucklandiae and Fructus Amomi can be added, which is named "Xiangsha Liujunzi Decoction".

Changes in dosage: "Zhizhu Decoction" consists of eight pieces of Fructus Aurantii Immaturus and four pieces of Rhizoma Atractylodis Macrocephalae, which are mainly used to treat abdominal pain and abdominal pain. The "Fructus Aurantii Pill" consists of four pieces of Fructus Aurantii Immaturus and eight pieces of Rhizoma Atractylodis Macrocephalae, and is mainly used for treating food stagnation and abdominal distension. Because of the different dosage, the two sides have different indications and different names.

Functional compatibility changes: just like blindly coptis chinensis, with the name of Evodia rutaecarpa "Zuojin Pill", it is mainly used to treat stomach disharmony, vomiting and hypochondriac pain; If Evodia rutaecarpa is removed and Radix Aucklandiae is added, it is called "Xianglian Pill", which is mainly used to treat acute diarrhea with red and white dysentery; If Radix Aucklandiae is removed, Cortex Cinnamomi is added, which is called "Jiaotai Pill" and is mainly used for treating hyperactivity of heart fire, insomnia and palpitation. The same medicine has different indications because of different addition and subtraction.

(2) Taboo

Including contraindications to medication, compatibility and pregnancy.

1. Taboos for taking medicine refer to dietary taboos (taboos) when taking medicine. As early as in ancient literature, there are sayings that Changshan is jealous of onions, Poria is jealous of vinegar, and Mume is jealous of pork. In addition, all foods that are not easy to digest, such as raw and cold, sticky, etc., should also be avoided as needed.

2. Compatibility taboo means that some drugs should be avoided in compound compatibility. As for the taboo of compatibility, the ancients mentioned "eighteen opposites" and "nineteen fears" and compiled them into songs, which are listed as follows:

Eighteen anti-songs:

Materia Medica clearly states that there are eighteen opposites, and half of them attack Ukraine.

Algae and halberds are fighting against grass, and the ginseng is rebellious against Veratrum.

Notes: Aconitum (Radix Aconiti Kusnezoffii, Radix Aconiti Kusnezoffii, Radix Aconiti Lateralis, and Herba Tianxiong), Fritillaria Fritillariae Cirrhosae (Bulbus Fritillariae Cirrhosae, Bulbus Fritillariae Thunbergii), Fructus Trichosanthis (Semen Trichosanthis, Cortex Trichosanthis, pollen), Rhizoma Pinelliae (Jiang Banxia, Rhizoma Pinelliae Preparata), Radix Ampelopsis, and Rhizoma Bletillae. Glycyrrhiza anti-seaweed, Euphorbia, Kansui, Daphne genkwa. Veratrum nigrum, Radix Codonopsis, Radix Adenophorae, Radix Salviae Miltiorrhizae, Radix Scrophulariae, Radix Pseudostellariae, Radix Codonopsis, Herba Asari, Radix Paeoniae Alba and Radix Paeoniae Rubra.

Nineteen Fears Song:

Sulfur is the essence of fire, and when you see it, you will argue with each other. Mercury does not see arsenic. Stellera chamaejasme is most afraid of Tibetan monks. Croton is the strongest, and it is not suitable for Petunia. Cloves do not see Yujin, and the tooth nitrate is difficult to combine with Beijing's three ridges. Aconitum kusnezoffii is not suitable for rhinoceros. Ginseng is most afraid of trogopterus dung, and Guan Guishan can adjust air conditioning. If it meets stone fat, it will be deceitful. Generally speaking, it will be suitable for reconciliation.

Note: Sulfur is afraid of mirabilite, mercury is afraid of arsenic, poison is afraid of lithargyrum, croton is afraid of Petunia, clove is afraid of turmeric, mirabilite and mirabilite are afraid of Beijing Sparganii, Sichuan aconite and kusnezoff monkshood are afraid of rhinoceros horn, ginseng is afraid of trogopterori, and cinnamon and cinnamon are afraid of red white stone fat.

In practical application, not all the "opposite" and "fear" drugs have anti-and fear effects. For example, in the Jin and Yuan Dynasties, Li Dongyuan said, "The ancient prescription for closing the moon, adding ginseng and spirit fat to four things, is it fearful but not afraid?" Phlegm is in the chest and diaphragm, and people participate in Veratrum, but it is not against it. " In fact, the ancient prescription "Dahuoluo Dan" consists of kusnezoff monkshood, aconite and rhinoceros horn. In modern Chinese medicine, many kinds of ginseng and lingzhi are effective in treating women's diseases, but some varieties have been proved by pharmacological experiments to have toxic effects or side effects. For example, when Gansui and Glycyrrhiza uralensis are used together, when the dosage of Glycyrrhiza uralensis is greater than Gansui, guinea pigs will die of flatulence. Therefore, further pharmacological experiments should be carried out on the opposite and repulsive drugs. At present, before it is proved by experiments, it is still necessary to deal with the "eighteen evils" and "nineteen fears" put forward by the ancients.

3. Contraindications for medication in pregnancy are drugs that damage the fetus and cause miscarriage. If used improperly, it may result in abortion.

According to the degree of harm to pregnancy, it is generally divided into two categories: prohibited drugs and drugs with caution.

Most of the prohibited drugs are highly toxic or violent, such as croton, leech, Euphorbia, Daphne genkwa, Mylabris, Sparganum burmannii and musk.

Cautious use of traditional Chinese medicines, such as peach kernel, safflower, rhubarb, immature bitter orange, dried ginger, cinnamon, etc., mostly has the effects of breaking qi and blood, pungent heat and smoothing.

Any drug that is prohibited must not be used, and drugs used with caution can be used as appropriate according to the illness of pregnant women. For example, Wu You can treat the epidemic of pregnant women, and when he sees Yangming's empirical evidence, he still uses "Chengqi Decoction" to attack; "synopsis of the golden chamber" uses dried ginger, Pinellia tuber and ginseng to treat vomiting during pregnancy, all of which are aimed at diseases, that is, the meaning of "there is no reason to die, and there is no need to die" in Neijing. However, when there is no special need, it should be avoided as much as possible to prevent medication accidents.

Attachment: It is forbidden to take medicine in pregnancy. Hirudo and tabanus, aconite and aconite are matched with Tianxiong.

Pueraria lobata and croton, Achyranthes bidentata and Coix lacryma-jobi and centipede.

Daphne genkwa replaced Ochre musk deer, and Euphorbia Serpentis molted yellow male and female.

Tooth mirabilite, peony, osmanthus and morning glory are the same.

Pinellia tuber, south star, medulla tetrapanacis, dianmai dried ginger and peach kernel.

Shasha dry paint crab claw nail, gall bladder rhizome are all missed.

Notes:

Nymphs: Nymphs of the genus Agkistrodon. Spot: Mylabris. Pueraria lobata: the root of Lacqueraceae, also known as Cynanchum bungeanum and Tripterygium wilfordii. Male and female:

Orpiment and realgar. Cinnamomum cassia, Cinnamomum cassia and Cinnamomum cassia. Tong: Akebia Akebia. Crab claw: the claw of a crab. A: Shanjia. Gallbladder: an insect-like gall worm of the molting family, also known as nymph.

(3) dosage, decocting method and service method

1. dosage The dosage of the drug should be determined according to the nature of the drug, dosage form, illness and compatibility.

Generally speaking, the dosage of drugs that are toxic or violent should be small, and aromatic drugs should also be light. The amount of drugs with thick taste and greasy taste can be heavier. Dosage refers to the daily dosage of each adult who only takes medicine. Secondly, it refers to the comparative weight between traditional Chinese medicine and medicine. Generally, the dosage of non-toxic drugs can be larger when used alone, but smaller when used in combination. The main dosage in the prescription can be larger, and the auxiliary medicine can be lower than the main medicine. Children and the elderly should use less drugs than those in their prime, and women should generally use less drugs than men.

2. In the process of decoction of traditional Chinese medicine, attention should be paid to the method and temperature. If the method is improper and the temperature is out of order, the drug effect can be reduced or completely ineffective. Li Shizhen in the Ming Dynasty said: "Anyone who takes decoction medicine is expert in quality and treatment, but the decocting person is reckless, the fire and water are bad, and the temperature is out of control, so the medicine is useless." Therefore, the decocting of decoction is a key link.

It is best to use casserole or enamel pot for decocting medicine, and copper and iron vessels are not allowed. The water consumption of decoction should depend on the amount of medicine. All decoctions should be heated by direct fire, and the firepower should be adjusted according to the different properties of the drugs. Generally, it is divided into the following three types: ① light decoction: commonly used exterior-relieving drugs, which are quickly decocted with force. ② Chinese decoctions: most of them are gastrointestinal drugs and gynecological drugs, which are boiled with strong fire and then switched to medium fire.

③ Heavy decoctions: mostly tonics, first boiled with strong fire and then slowly decocted with slow fire.

Decocting quantity: generally, it is advisable to decoct each dose first to get about 250ml of liquid medicine; It is advisable to decoct twice or three times to get about 200ml of liquid medicine.

The first decoction is mixed with the second decoction and the third decoction, and taken in three times.

Decocting time: decoct the medicine first for 20 minutes before decocting the medicine in the middle. Generally, after the other drugs are boiled 10min, the same decoction is added (excluding the time of decocting the drugs first).

In order to give full play to the efficacy and achieve the maximum therapeutic effect, some Chinese medicines can be sub-contracted and decocted separately. The main ways are:

Fry first, then lower, package, fry separately, and take it.

(1) Fry first: most of them are minerals and shellfish. These drugs are hard in texture and dense in structure, and the effective components are not easy to fry for a while. Therefore, it is necessary to mash and fry first, so that the effective components can be fully fried, such as gypsum, raw keel, raw oysters and raw ochre.

(2) The lower part: Some drugs contain aromatic volatile components. If the decoction time is too long, the effective components can be volatilized, which will reduce or lose the efficacy, such as Radix Angelicae Dahuricae, Radix Aucklandiae, Herba Menthae and Aquilariae Resinatum.

(3) Decocting: In order to prevent the decocted liquid medicine from being turbid, difficult to filter out when adhering to the bottom of the pot or having bad stimulation to the digestive tract, it is necessary to wrap it with gauze and then put it into the pot for decocting, such as Plantago Seed, Lepidium Seed and Inula.

(4) decocting separately: it means decocting separately. Most of the drugs that need to be "decocted separately" are expensive and fine, so that they will not be mixed with other drugs and reduce their efficacy, such as shredded antelope horn and shredded rhinoceros horn.

(5) Dissolved and taken orally: Colloidal and salt drugs should not be decocted together with group drugs, but should be dissolved in soup and taken directly, such as donkey-hide gelatin, deer glue and mirabilite.

(6) Fine powder for oral administration: Some precious drugs and drugs that are not easily soluble in water should be fine-ground, and taken with warm water or liquid medicine according to the specified amount, such as Notoginseng Radix, Cinnabar, Thunder Pill, etc.

3. The administration method includes the administration method and administration time of different dosage forms. For example, decoction should be taken warm, but for the needs of treatment, it should also be taken cold. Chinese patent medicines must be taken according to the instructions. In the time of taking medicine, general tonics should be taken before meals, stomach tonics and drugs that are irritating to the gastrointestinal tract should be taken after meals, sleeping drugs should be taken before going to bed, anthelmintics and laxatives are mostly taken on an empty stomach, acute diseases should be taken quickly regardless of time, malaria should be taken before the onset, and chronic diseases should be taken regularly.