Danshen siwu decoction is siwu decoction plus salvia miltiorrhiza. Siwutang is the time prescription. Chen Xiuyuan's "Song of the Times" has the following articles:

Chen Xiuyuan said: Siwutang is a purely stagnant product, which cannot cure the source of blood [refers to qi]; That is, Bazhen Decoction can supplement both qi and blood, but it is also ineffective. Those who must be good at adding and subtracting will be effective. "

Siwutang, Radix Angelicae Sinensis, Radix Rehmanniae Preparata, Radix Paeoniae Alba and Rhizoma Chuanxiong, and Siwu Buxue, however, are all pure and stagnant products, which cannot promote qi circulation. Chen Xiuyuan said that even with the addition of the four drugs of Sijunzi Decoction, Ginseng, Atractylodes Macrocephala, Poria and Glycyrrhiza uralensis Fisch, it has become Bazhen Decoction, which can supplement both qi and blood, but it is ineffective. Therefore, adding Danshen to Siwu Decoction, if its effect is as wonderful as Pixar said, is also the reason for adding Danshen. That is to say, Chen Xiuyuan said, "Only those who are good at adding and subtracting can be effective.

Shengyu decoction

About the addition and subtraction of Siwutang, besides Bazhen Decoction, Shiquan Dabu Decoction and Ginseng Yangrong Decoction, there is also Shengyu Decoction.

Chen Xiuyuan's "Song of the Times" volume:

Ke Yunbo said: This prescription takes Shenqi with four ingredients to treat yin deficiency and blood loss. Yin and yang are the roots of each other, and yin deficiency means that yang has no attachment, so it is annoying to be hot and thirsty, and yang also dies; Qi and blood are both exterior and interior, and when the blood is removed, the qi has no return, so it is restless to sleep and the qi is also removed. However, there is no method of sudden supplement for yin deficiency, which is based on storing yang; If the blood takes off the opportunity of generating blood, it must first replenish qi. This is also the reason why yang generates yin and blood moves with qi. Therefore, yin deficiency means no qi, and no qi means death. The predecessors treated yin deficiency with eight treasures and ten perfection, but those who died were not rescued, because of the sweetness of licorice, they could not reach the lower energizer; The dryness of Atractylodes macrocephala is not conducive to kidney yin; Poria cocos leaks, which hinders the growth; Cinnamon is pungent and hot, so move its virtual fire. These six flavors are mellow, peaceful and moist, and when taken, the qi and blood are dredged, and the inside and outside are reconciled, which is in line with the sanctity.

Chen Xiuyuan said: This prescription is a good medicine for all blood loss, and it can treat both vexation and fever, restless sleep and thirst after blood. Its hemostasis lies in Chuanxiong blindly; The beauty of sleeping to quench thirst lies in ginseng blindly. Ke Yunbo's use of Shenqi as a medicine for qi-dispersing and yang-dispersing, and his use of four kinds of words, etc., is also somewhat hampered by popular saying. According to the cloud, the middle energizer receives qi and takes juice, while the change is red, which means blood. The prevalence of blood, half with chong ren, runs in the meridian, half scattered outside the pulse and filled in the hair of the muscle abscess. All blood loss can not run in the meridian, but scattered outside the hair of the muscle abscess, so it gushes from the orifices. The warmth of Chuanxiong is wonderful, and Angelica sinensis moistens it, so that blood still flows in the meridians; Chuanxiong's pungent powder is obtained, and Astragalus membranaceus is used to drum it, so that the blood is still scattered in the skin of the muscle; The origins are clear, but there are more than blood! As for the dryness and heat after blood, if Astragalus membranaceus is slightly sweaty, the qi will be harmonious and the heat will subside, that is, Danggui Buxue Decoction also means. Sleeping restless, caused by yin deficiency after blood. The five internal organs belong to yin, and only ginseng can supplement them; If the yin of the five internal organs is long, the troubles of the five hearts will be removed by themselves; When the annoyance and heat are removed, the body fluid will be self-generated, and the symptoms will gradually recede. Since the Song and Yuan Dynasties, no one has been able to read the Classic of Materia Medica. It is suspected that this side has the help of God, and it is beyond the reach of others. Ke Yunbo is outstanding, but it is a pity that he did not read the Classic of Materia Medica.

There is blood in the five zang-organs and no blood in the six fu-organs. It is a mistake of the past doctors to vomit stomach blood by observing the abdomen, heart, spine and envelope, liver, heart, spleen, lung and kidney, and six fu-organs. Every five zang-organs blood spits out a trace and dies. If hematemesis, epistaxis, bleeding and women's bleeding collapse occur, they are all blood flowing in meridians and scattered in muscles. Overflow on the upper part is vomiting, and seepage on the lower part is collapse. "

There is an excellent passage in Ke Yunbo's explanation: "Yin deficiency has no method of sudden supplement, and the plan is to save Yang; If the blood takes off the opportunity of generating blood, it must first replenish qi. This is also the reason why yang generates yin and blood moves with qi. Therefore, yin deficiency means no qi, and no qi means death. " In Hao Wanshan's Treatise on Febrile Diseases, Mr. Hao once mentioned that "tangible yin can't be produced quickly, but intangible yang should be solidified urgently" and "tangible blood can't be produced quickly, but intangible qi should be solidified urgently".

Danshen siwu decoction is based on siwu decoction, which promotes blood circulation and tonifies blood, and adds salvia miltiorrhiza to invigorate qi and promote qi circulation. After all, it is slow to replenish blood. So pizza also said that it would take four cycles in a row, that is, 120 days to see the effect.

Of course, Chen Xiuyuan's explanation can also be used for reference, which is not meaningful.

Pain, stagnation of qi or lack of blood?

Danshen Siwu Decoction is mainly used for regulating menstruation and relieving pain, nourishing blood and relaxing tendons. Dysmenorrhea, pain, is it because of congestion, or is it because of insufficient blood supply and lack of nutrition?

I also remembered another article, from the first 13 of Hao Wanshan's Treatise on Febrile Diseases about the application of Guizhi Decoction (2):

The modified recipe of Guizhi decoction, the last example here, is the new decoction syndrome. Article 62 of the original text, "For those with body pain and delayed pulse after sweating, cassia twig and peony ginger should be added one or two each, and ginseng should be added three or two, and the new soup should be added to treat them."

This is the prescription with the longest Chinese name in Treatise on Febrile Diseases. Do you have the comma in the middle of the prescription in my textbook, your textbook? You said that you can put a comma in the middle of a square name, so remove that comma. Because the name of the prescription is too long, we simply call it Guizhi Xinjiatang, or simply Xinjiatang.

In Treatise on Febrile Diseases, there is a new prescription of adding soup, which shows that most other prescriptions, Zhang Zhongjing, are an inheritance of ancient literature. In front of me, I once quoted a passage from Huangfu Mi's Preface to Acupuncture and Moxibustion A and B, saying, "Yi Yin wrote Shennong Materia Medica with the talent of Yasheng, thinking that the soup .... On Zhongjing, Yi Yin's "Tang Ye" has dozens of volumes, which are used for many tests. " Tang Ye Jing is an ancient classic, so Zhang Zhongjing's Treatise on Exogenous Febrile Diseases inherited a lot of achievements of the compound prescription in Tang Ye Jing, and this prescription called it a new soup, so our teacher Liu Duzhou said it was a prescription added by Zhang Zhongjing himself. On the basis of Guizhi decoction in the ancient Tang Ye Jing, he added one or two pieces of Paeonia lactiflora and ginger respectively, and now he added ginseng. Because it is his own newly-created prescription, it is called a new soup. After sweating, there is still body pain. Is this because the exterior evil has not been solved, or the condition has changed? At this time, Zhang Zhongjing should differentiate the symptoms according to the pulse. If the pulse is floating, it definitely means that the exterior pathogen has not been solved, and now it is a heavy pulse, which suggests that this is not a physical pain with the exterior pathogen unsolved, but a disease in the body. What does the pulse delay master? Today, our pulse study is mainly about yang deficiency due to delayed pulse, but Zhongjing's pulse delay here is mainly about blood deficiency.

How do you know that the main blood is insufficient? Let's open page 32 of the handout and look at article 50 of the original text. "If the pulse is tight, the method should be used to relieve the body pain, and it should be solved by sweating. If the ruler is late, he should not sweat. How can he know it? Because of insufficient qi and less blood." Therefore, Zhong Jing's late pulse is mainly due to insufficient qi and less blood, which is his own words. We will explain Zhong Jingyi with Zhong Jing's words and explain Zhang Zhongjing's meaning with Zhang Zhongjing's words. Therefore, the deep pulse here is mainly due to the disease in the stomach, and the delayed pulse is mainly due to the deficiency of qi and the lack of blood, so the pain of this skin is the lack of blood, and the skin is not nourished, and it hurts if it is disgraced. Of course, some books say that "deficiency hurts" and others say that "lack of nutrition hurts", which means the same thing.

With regard to the pathogenesis of pain, we are all very familiar with the saying that "it hurts if it doesn't work, and it doesn't hurt if it doesn't work". Here, we have introduced deficiency and pain, loss of nutrition and dishonor.

When Mr. Ren Yingqiu was alive, I discussed it with him once. There was a hospital that treated coronary heart disease, and almost all of them used drugs for promoting blood circulation and removing blood stasis. After some patients ate the drugs for promoting blood circulation and removing blood stasis, the curative effect was really good, and the frequency of angina pectoris was less, and the degree of attack was lighter. However, some patients did not relieve angina pectoris after eating it, and even the more they ate it, the less energetic they were. These patients went to our University of Traditional Chinese Medicine to see any teacher. Teacher Ren disagrees with the view that coronary heart disease is caused by blood stasis. He thinks that it hurts if there is no nourishment, and it hurts if there is deficiency, so he uses qi-invigorating and blood-nourishing drugs to treat it. After using qi-invigorating and blood-nourishing drugs, these patients are strong, the frequency of angina pectoris attacks is reduced, and the degree of attacks is reduced, so these patients are very happy. However, some patients, when they were first diagnosed, went to see any teacher. When the teacher used tonic method, the more they made up the chest tightness, they went to the hospital for treatment and used drugs to promote blood circulation and remove blood stasis, which gradually eased. Teacher Ren believes that angina pectoris is caused by insufficient blood supply to the heart muscle, and it hurts if you lose nutrition, and it hurts if you are not honored. Some hospitals use drugs to promote blood circulation and remove blood stasis because they think that the blood supply caused by coronary arteriosclerosis is insufficient. According to this clinical phenomenon, I once had a special discussion with teacher Ren. I said angina pectoris, ren Lao, do you think it hurts if you lose your nutrition or if you don't get it? He said it was true that lack of oxygen was caused by lack of nutrition. I said that the blood vessel was blocked, so it wouldn't work. Did he say it was the place where the blood vessel was blocked that hurt or the myocardial pain? This makes me don't know how to answer well. As a matter of fact, the pain caused by impassability and the pain caused by dystrophy occur at the same time, which are two sides of the same problem. Take coronary heart disease as an example. This patient is mainly impassability, so you should promote blood circulation and remove blood stasis. This patient is mainly myocardial dystrophy, so you should replenish qi and nourish blood. For us doctors, we should master these two technologies and these two ideas, and we should learn them.

Just like dysmenorrhea, some people treat it with drugs for promoting blood circulation and removing blood stasis, while others treat dysmenorrhea with drugs for invigorating qi and nourishing blood. Those who use promoting blood circulation to remove blood stasis are based on her qi stagnation and blood stasis, while those who use qi to nourish blood are based on her blood deficiency and uterine dystrophy. Clinically, let's see how we can differentiate syndromes.

Therefore, the body pain we are talking about now is a syndrome of insufficient blood supply and skin dystrophy, which belongs to deficiency and pain, and dystrophy and pain. Therefore, in Guizhi decoction, the amount of Paeonia lactiflora is increased to nourish blood and soften tendons, relieve spasm and relieve pain, and the amount of ginger is added to attract drugs to the surface, and ginseng is added to replenish qi and nourish blood. This prescription has a good effect on the body pain caused by insufficient blood and skin dystrophy. We say that deficiency of qi and blood, deficiency of nourishing blood and visceral dystrophy, we can use Bazhen Decoction and Ginseng Nourishing Decoction. Skin dystrophy leads to body pain. We often use Bazhen Decoction and Ginseng Nourishing Decoction, but the effect is not ideal, and the newly added soup is a good prescription.

I have cited this case before, remember? I said that I got the final feeling line on the paper, and I never knew that I had to do it. When I treated postpartum body pain, I used ginseng to nourish my skin, but the effect was not good when I used Bazhen. Teacher Liu reminded me to use Xinjia soup, but as a result, I used less ginger, and its curative effect was still not good, which increased the amount of ginger and made it effective. Therefore, when we use this prescription to treat the body pain caused by insufficient blood and skin dystrophy, we must use the medicine according to the proportion of the dosage in the prescription.

The above is an excerpt from Hao Wanshan's Treatise on Febrile Diseases.

Is it qi stagnation or lack of blood? Is it painful if it doesn't work, or is it painful because of insufficient blood and lack of nutrition? Qi and blood are often intertwined. There is little simple qi stagnation and little simple blood loss. Therefore, it is still necessary to differentiate.

Then Danshen Siwu Decoction, Siwu Decoction, Bazhen Decoction, Shiquan Dabu Decoction and Shengyu Decoction should be differentiated clearly, and the clinical symptoms should be added and subtracted.