The "syndrome" of "corresponding prescription and syndrome" is actually a symptom.
The Chinese Dictionary explains "symptoms" and says: "symptoms. Sometimes it also refers to diseases. Also as a "certificate". The explanations of "syndrome", "syndrome" and "syndrome" are: "syndrome, disease. Later, it is called "disease". "Certificate is the same as" certificate ". "Certificate, a simplified word for" certificate ". It can be seen from this that there is no substantial difference between syndrome and disease. Wang Ang's Collection of Medical Prescriptions said: "The patient has a syndrome. "Syndrome" is a special medical word for "syndrome", which has the same meaning and can be used universally.
The forced distinction between syndrome and syndrome originated after the spread of western learning to the east and was finalized in the 1950s. When talking about the concept of "syndrome", we should understand two premises: First, the "basic theory of traditional Chinese medicine", which is commonly used and established at present, is the product that some inherent contents of traditional Chinese medicine have been stipulated separately in modern Chinese medicine circles in order to communicate with China and the West, adapt to the trend of the times and take western medicine as the reference system under the background of "science". The concept of "certificate" is one of them. Secondly, Hui Shu thinks that the original meaning of syndrome is "the symptoms complained by patients and the signs examined by doctors", and its "original meaning and extended meaning have nothing to do with essence and generalization". As a fixed concept, it appeared after the founding of New China, "when the second edition of the textbook of College of Traditional Chinese Medicine was compiled", and it is speculated that this was done to "try to make the basic theory of traditional Chinese medicine stained with the color of dialectical materialism".
At present, the history of the concept of "certificate" does not exceed 60 years. At first, "syndrome" was put forward to emphasize the "characteristics" and "advantages" of traditional Chinese medicine, but because it is only a regulation or agreement, the obstacles caused by "syndrome" to the development of traditional Chinese medicine have become more and more obvious today. Cheng Zhaozhi thinks in the article "Treating according to Syndrome Differentiation by Judging Machine" that this "not only contradicts the inherent concepts and characteristics of traditional Chinese medicine, but also violates the laws of linguistics. 」
Discussion on "Inspection Machine" from the Application of Guizhi Decoction
When it comes to Guizhi decoction, most of them correspond to the symptoms of "sweating, bad wind and slow pulse", and then follow warm clothing, warm covering and sipping hot porridge to get slight sweat. This is the general idea of Guizhi decoction's "prescription-syndrome correspondence" But this is only one example of the use of Guizhi decoction, far from all.
Guizhi decoction can be used without sweat, which is reflected in article 276 of Treatise on Febrile Diseases. "Lunar disease, pulse floating, sweating, appropriate Guizhi decoction. "Wang Kentang explained that" this pulse is floating, and when there is no sweat, it is unnecessary to say that there is no sweat in the yin. Those who don't use cassia twig instead of ephedra are more prone to yang due to improper yin disease, and they must know that cassia twig syndrome is also useful without sweating. " If Sanyin disease sees spontaneous sweating as yang death, this article clearly States Taiyin disease, so there is no doubt that there is no sweat. Three yin is deficiency, and Guizhi decoction is used for Taiyin disease, which is called "sweating", but it is actually "nourishing yin and regulating yang" (in Ke Yunbo's language).
Guizhi decoction also has the usage of not "taking sweat" In Treatise on Febrile Diseases, Guizhi Decoction is often used (12) before use, which makes warm clothing, warm covering and sipping hot porridge become the classic methods of taking Guizhi Decoction and an indispensable part of sweating. If it is not so, even if Guizhi Jiagui Decoction is added with two ounces of cassia, it will not "sweat". That is to say, if the former method is not used, it is another method used in Guizhi decoction. Article 387 there is no "prescription before use", "those who vomit profits and suffer from endless physical pain, when the news is reconciled, it is appropriate to make a small peace with Guizhi decoction." There is also no "prescription before treatment" in Synopsis of the Golden Chamber Treating Women's Pregnancy Syndrome. "A woman's pulse is flat, and her yin pulse is weak. She is thirsty, unable to eat, and has no cold and heat, so she is pregnant, and Guizhi Decoction governs it." Cholera spits out benefits, healthy qi tends to recover, and residual evil is not abundant. "Small harmony" means to slowly recover, imperceptibly, and then heal itself; Pregnancy has a flat pulse, no cold or heat, although it is uncomfortable, it is not a disease, and it can be adjusted and allowed to recover.
The above examples show that to learn the use of Guizhi decoction, "correspondence" is far from enough, and it is necessary to "examine the machine".
"Certificate" and "Machine"
Syndrome is disease, so "prescription-syndrome correspondence" is actually "prescription-syndrome correspondence". At this point, it is not difficult to understand the propositions put forward by many Chinese medicine scholars, such as "grasping the main syndrome, using the prescription", "differentiating the prescription and syndrome is the tip of syndrome differentiation" and "Chinese medicine sometimes treats the head and foot". These are all derived from the "correspondence between prescription and syndrome", and the problem of their similarity is that they ignore the "machine".
With regard to "syndrome" and "mechanism", Mr. Liu Duzhou mentioned in the article "Relativity of Prescription and Syndrome —— On Knowing Mechanism Based on Differentiation of Symptoms and Signs" that "the correspondence between prescription and syndrome" means "following the map, drawing a tiger according to the cat, and approaching copying". Although "stepping into the dialectical door of Zhongjing", it is still far from the mystery of traditional Chinese medicine. Traditional Chinese medicine "not only has the knowledge of syndrome differentiation and treatment, but also has the mystery of knowing the mechanism based on syndrome differentiation." At the two levels, there is a distinction between high and low, coarse and fine. "
There are five articles in Synopsis of the Golden Chamber: "Obstruction of the chest, fullness in the heart, stagnation of qi in the chest, threatening to shoot at the heart, the decoction of Fructus Aurantii Immaturus, Bulbus Allii Macrocephalae and Guizhi is the main one, and the ginseng decoction is also the main one"; "Obstruction in the chest, obstruction in the chest, shortness of breath, Poria cocos, almond and licorice soup is the main one, and orange and orange ginger soup is also the main one"; "When the husband is short of breath and has a slight drink, he should go away when he is young. Linggui Shugan Decoction is the main one, and Shenqi Pill is also the main one"; "Those who drink too much when they are ill should sweat, and Daqinglong decoction is the main one, and Xiaoqinglong decoction is also the main one"; "When urination is unfavorable, Puhui powder is the main one, and talc white fish powder and Fuling Rongyan decoction are the main ones." In this case, if you leave the "inspection machine", how can you "correspond the prescription and the certificate"? The difference between ginseng soup syndrome and Fructus Aurantii Immaturus Bulbus Allii and Guizhi decoction syndrome lies in deficiency and excess; The difference between Poria cocos, almond and licorice decoction syndrome and orange and orange and ginger decoction syndrome lies in whether the disease site is lung or stomach, and so on. This is the "inspection machine". Clinically, we must "know the mechanism based on syndrome differentiation".
For minor diseases and simple diseases, we can "correspond to the symptoms", and it is also convenient for popularization, entry and "hiding the prescription for the people". However, for systemic diseases and complex diseases, the "prescription-syndrome correspondence" is "seemingly agile but devious" in most cases. Adding the thinking of mechanism, even if it is unconscious, the "prescription-syndrome correspondence" will be upgraded to "observing the mechanism and using drugs" Everyone in the classic prescriptions must be "observing the opportunity" in the clinic, but we need to think twice about what to advocate and who to advocate.
There are four kinds of treatment methods: pathogen therapy, symptomatic therapy, syndrome therapy, and natural therapy (see Zhu Weiju Medical Five Books Review), all of which have their clinical value. But its core lies in "observing the machine." Only by "observing the machine" can we use the living classical prescriptions, and we can not be confused in clinical practice, and we can build a vast building of TCM in recognizing diseases and treating diseases with the help of the framework of classical prescriptions Mechanically according to the limited examples cited in Zhongjing's book to "correspond prescriptions and syndromes" can only play a role in prompting ideas, which is only applicable to the introductory stage of classics.
On the Harm of "Correspondence between Prescription and Syndrome" from Bureau Prescription
From the current point of view, there are many ingenious prescriptions in Taiping Huimin Heji Bureau, but it is such a prescription that has attracted a lot of criticism from four masters in Jin, Yuan and later generations. The fault lies not in the party, but in the use of the party's methods and people.
Zhu Danxi said, "The Prescription of Heji Bureau is also a book ... Since the Song Dynasty, the government has kept it as a law, the doctors have spread it as a profession, the patients have relied on it to make a living, and the world has become a custom in Xi Zhi." "You can prove that the prosecution can use the medicine immediately, without seeking medical treatment, without compulsory system, and the disease can be cured." The Prescription of Heji Bureau can be described as a typical "prescription-syndrome correspondence". Its popularity is far from that of traditional Chinese medicine and classical prescriptions. Popularization also means that you don't have to ask for a solution, you don't have to "know the machine." It is this lack of internal mechanism that has brought great harm to traditional Chinese medicine.
At present, when Chinese medicine is popularized, we must avoid repeating the mistakes of the Bureau Prescription. There is a lesson in Neijing that "don't pass it on unless it's someone else", and there is an ancient saying that "it's hard to know". Popularizing it is a double-edged sword, so we must not rush for success. You know, too much is too late.
To sum up, Chinese medicine practitioners should vigorously advocate "observing the mechanism and using drugs" to ensure that the mechanism of prescription and medicine is closely related to the mechanism of disease and syndrome. In this way, we can not only "get started", but also "get into the room", so that we can treat the hair first, live by the machine circle and improvise.