Fang Yuan's Treatise on Febrile Diseases

It consists of maltose (30g), cassia twig (9g), peony (18g), ginger (9g), jujube (6 pieces) and roasted licorice (6g).

Usage: six flavors, seven liters of water, three liters of boiling, slag removal, internal pulp, and even mild fire digestion. Take one liter warm, three times a day (modern usage: decoct with water to get juice, add maltose, heat with slow fire to dissolve, and take it twice warm).

Function: warming the interior to replenish deficiency, and harmonizing the interior with urgency.

Indications: deficiency and cold in middle energizer, disharmony between liver and spleen.

Syndrome of abdominal pain, like warming and pressing, mental fatigue, weakness and lack of qi; Or heart throbbing, restless, and dull; Or accompanied by sore limbs, hot hands and feet, dry throat and dry mouth. The tongue is pale with white fur, and the pulse is thin and string.

Pathogenesis The syndrome of this prescription is caused by deficiency and cold of middle energizer, disharmony of liver and spleen, and insufficient source of transformation. Deficiency of cold in the middle energizer leads to acute pain in the abdomen and warm and pressing. Spleen and stomach are the biochemical sources of qi and blood, and the middle energizer is deficient in cold, and the source of transformation is deficient, so palpitation, dull complexion, fever, dry mouth and dry throat are seen. Although the symptoms are different, the disease is the same, which is always caused by deficiency of cold in the middle energizer. Treatment should be warming the middle energizer, tonifying deficiency and nourishing yin, and harmonizing the interior to relieve pain.

In the prescription, the sweet and moist maltose is reused as the monarch, warming and nourishing the middle jiao, and relieving pain urgently. I warm Yang qi with Xin Wen's Guizhi and dispel cold evil; Sweet and sour white peony nourishes yin, relieves liver anxiety and stops abdominal pain. With ginger to warm the stomach and dispel the cold, jujube tonifies the spleen and benefits the qi. Radix Glycyrrhizae Preparata is used for assisting and harmonizing various medicines. Among them, caramel is combined with cassia twig, which is pungent and sweet, which warms the middle energizer and tonifies spleen deficiency; Paeonia lactiflora combined with Glycyrrhiza uralensis Fisch, which is sour and sweet, turns into yin, relieves liver anxiety and stops abdominal pain. The combination of six drugs, warming the middle energizer and tonifying the deficiency, contains the meaning of softening the liver and regulating the spleen, benefiting yin and yang, which can make the middle energizer strong and the yin and yang qi and blood biochemical active, so it is named "Jianzhong".

It is not suitable for those who are forbidden to vomit or are full; It is contraindicated for patients with epigastric pain due to yin deficiency and excessive fire.

case

(1) Liu Duzhou medical record: Mrs. Li, aged 38. Excessive postpartum blood loss, coupled with the cold weather, and abdominal pain, when the pain consciously twitched inward. At this point, it must be warmed with hot things to alleviate it. It is responsible to cut the pulse string carefully, depending on its light and tender tongue and thin coating. Distinguishing from blood deficiency without nourishing the liver, the liver is anxious and punishing the spleen, and the spleen governs the abdomen, so it is urgent and painful, and it is even worse when it meets cold. For dredging: Cinnamomum cassia twig 10g, Radix Paeoniae Alba 30g, Radix Glycyrrhizae preparata 6g, Rhizoma Zingiberis Recens 9g, 7 Chinese dates, Radix Angelicae Sinensis 10g, and maltose 40g (melted). This prescription takes 3 doses, but abdominal pain does not occur. Recipe-changing can be used to supplement the work by supplementing both Qi and blood.

Pressing: This case is a typical abdominal pain due to deficiency of cold, which is caused by blood deficiency failing to nourish the liver, and the liver is urgent to punish the spleen. It is characterized by acute pain in the abdomen, warm and pressing, and thin pulse. Xiaojianzhong decoction can not only tonify the spleen and stomach, but also calm the qi of the liver and gallbladder, and relieve the tension of the tendons and veins, so it is right in this case. According to Liu Lao's experience, it is better to take Xiaojianzhong decoction first, and then use Xiaochaihu decoction to remove Scutellaria baicalensis Georgi and add Paeonia lactiflora.

(2) Hu Xishu's medical record: Zhang, male, 42 years old. 1June, 966 10. The dull pain in the epigastric cavity has recurred for 5 years and was diagnosed as "prolapse of gastric mucosa" by examination. When I am often hungry, I have stomachache, aversion to cold and fear of cold, thirst in my mouth, slight stool, walking twice a day, and limp lower limbs. First, it was ineffective to treat with Fuzi Lizhong decoction, and then it was inquired about the symptoms. According to the fact that sweating produces evil wind and the pulse is slow, it is known as the syndrome of exterior deficiency and cold in the middle. Therefore, Xiaojianzhong decoction was given: Guizhi 10g, Paeonia lactiflora 18g, Ginger 10g, 4 jujubes, 6g roasted licorice and maltose. After taking 6 doses of stomachache, I still feel uncomfortable when I am hungry, and my stool is getting better, but I still take it for 2 days, and then take it above. In July 1 day, there was no discomfort except slight stool.

Press: deficiency and cold in the middle energizer, and the stomach collaterals are warm and painful. Treatment should be warm in the middle and cold in the middle, slow in the middle and urgent. Fuzi Lizhong Decoction is effective, but it has no urgent function, so it is ineffective. However, Xiaojianzhong decoction is pungent and sweet, but warm in the interior, sour and sweet, but urgent, which is right in the middle of the pathogenesis, so it hurts.

(3) Wei Chuanyu's medical record: Li, female, 24 years old. 1June 6, 987. I felt swallowing obstruction 6 months ago and vomited after eating, sometimes light and sometimes heavy. When it is light, it is difficult to swallow dry food; When it is heavy, porridge and boiled water are difficult to swallow. With chest and hypochondriac pain, insomnia and irritability. After examination in a hospital, it was diagnosed as "achalasia of cardia". I came to see a doctor today because of swallowing obstruction and vomiting after eating. Pale face, low voice, fatigue, irritability, tender tongue, few dry fur, and weak pulse. Syndrome differentiation: middle anxiety and cold, spleen and stomach losing health. Treatment: warming the middle energizer, invigorating the spleen and strengthening the stomach. Xiaojianzhong Decoction is mainly composed of cassia twig 30g, white peony root 60g, prepared licorice root, jujube and ginger each 10g, and maltose 100g. After 8 doses, the symptoms disappeared, and esophageal barium meal examination was performed several times, and no abnormality was found.

Press: weak middle qi, achalasia of cardia, inability to swallow, and choking diaphragm. If there is evidence, it is a medicine. Xiaojianzhong Decoction can tonify the spleen and stomach, establish the middle qi, and when the middle qi is established, it can be swallowed freely, which is effective.

(4) Li Fengxiang medical record: A patient, female, 5 years old, had a low fever in the afternoon for 3 months and could not be cured for a long time. White face, thin body, poor appetite, listlessness, dry stool, saying 1 time, thready and weak pulse, pale tongue, normal coating, and the diagnosis is asthenia. Prescription: Xiaojianzhong Decoction plus Radix Codonopsis, Radix Astragali and Radix Angelicae Sinensis. After 2 doses, the fever subsided and the spirit improved. After 7 doses of follow-up, there was still low fever, and the prescription was taken 14 doses.

According to the pulse syndrome of this case, it is undoubtedly qi deficiency and fever. "Su Wen? The theory of regulating menstruation says: "There is fatigue, less decline in physical qi, insufficient grain qi, inability to burn on the upper energizer, impassability of the lower epigastric cavity, and heat in the stomach, so it is hot inside." Treatment should cultivate and replenish middle qi and reconcile yin and yang. When the qi is established and the yin and yang are balanced, the fever will retreat. This is what Wang Xugao called "thick soil and fire will converge".

(5) Wan Guihua's medical record: Tang Moumou, female, 2 1 year old. He has been ill for more than 20 days. After the treatment of acute gastroenteritis with integrated traditional Chinese and western medicine, all the symptoms of vomiting and diarrhea were removed, but the high fever remained. I have taken bitter cold, sweet cold, pungent cold and western medicine sulfonamides 10 for more than 0 days, but they have not been effective. Symptoms: high fever, polydipsia, thirst for hot drinks rather than excessive drinking, long urine, thin stool, sallow and emaciated complexion, mental fatigue, no appetite, reddish tongue, thready and weak pulse. The syndrome belongs to qi deficiency and fever, so it is suggested that the method of "warming the liver to remove the heat" should be modified by Xiaojianzhong Decoction: Paeonia lactiflora 12g, Atractylodes macrocephala 9g, Cinnamomum cassia twig 5g, Astragalus membranaceus 24g, Zizyphus jujuba, Glycyrrhiza uralensis 6g and maltose 30g (taken orally). 2 doses.

Press: Fever due to qi deficiency is mostly caused by low fever, but there are also cases of high fever, which can also be ruled by the rule of "warming with warmth to remove high fever". In this case, the spleen is very weak, so Astragalus membranaceus and Atractylodes macrocephala are added to help strengthen the spleen.

(6) Wu Dachang's medical case: Zhang, male, 6 years old. Since March 1987, the patient began to have symptoms such as thirst and frequent urination, and then gradually worsened. By September 1987, he drank more than 4,000 ml of water every day and night and urinated about 20 times. After repeated tests of urine sugar and blood sugar, he was diagnosed as "diabetes" in a hospital and was hospitalized for two days, but his symptoms did not improve. 1April 23, 988: pale complexion, listlessness, thirst, frequent urination, anorexia, pale tongue with thin white fur, and weak pulse. Looking at the pulse syndrome, this is spleen-yang deficiency and abnormal transport.

Treatment should be warming yang and strengthening spleen, and Xiaojianzhong decoction should be given. Prescription: maltose 30g, cassia twig 5g, Radix Paeoniae Alba 10g, Fructus Jujubae 10g, Rhizoma Zingiberis Recens 5g, Radix Glycyrrhizae Preparata 5g, decocted in water (maltose is dissolved and taken orally), with 5 doses per dose per day. After taking the medicine, symptoms such as thirst and frequent urination were obviously relieved. If the effect is not correct, take 15 dose again, reduce the drinking water to about 2000mL every day and night, and urinate 3 times every night. Five times, the face began to turn rosy, and the spirit improved. After taking more than 50 doses, all the symptoms were eliminated. 1 year later, no recurrence was found.

Press: thirst, frequent urination and diabetes. However, pale tongue and heavy pulse are not caused by yin deficiency and dryness and heat, but are signs of yang deficiency and bad luck. Deficiency of benefiting spleen and yang leads to transport and transformation, and water and body fluid flow downward without being distributed, so thirst and excessive urination occur. When you are thirsty, you should drink water to save yourself. However, if the spleen is lazy and unlucky, you will drink more and urinate more frequently. Treatment should be warming the middle energizer, strengthening the spleen, supplementing the soil to make water, and when water and body fluid are distributed, thirst and frequent urination will be eliminated.

(7) Chen Daqi's medical case: Dai Moumou, female, 22 years old, unmarried. In the past three years, I have had abdominal pain. On the first and second days, I began to have less blood. On the third day, the blood gradually increased and the pain decreased slightly. The color was light and the cycle was still accurate. Usually, she likes warm and cold, is tired and weak, and can't bear fatigue. When she arrives, she must take painkillers and traditional Chinese medicine for temporary safety. Although it has been over 10, there is still continuous pain in the abdomen, sometimes swelling, pale tongue with white fur, thin and late pulse, which is characterized by weak middle qi, deficiency of qi and blood, deficiency of spleen and stomach, pain caused by cold accumulation, warming the middle warmer to dispel cold, and urgent pain relief. Xiaojianzhong decoction was given, and after continuous administration of 10 dose, the pain was greatly reduced this time. I did not take painkillers, but continued to take more than 20 doses, and I passed again, but the pain was not made.

Pressing: Dysmenorrhea has different causes, and the deficiency of cold and heat is different. If it is due to the weakness of middle qi, deficiency of spleen and stomach, imbalance of chong and ren, and pain caused by cold accumulation, this prescription can be used to warm the middle energizer, dispel cold, regulate chong and ren, and relieve pain.

Fang LUN

(1) Cheng Wuji's theory of typhoid fever in Jin Dynasty: the spleen should be in the center, and it should be in the middle of the four viscera, which is Zhongzhou, treating middle jiao, giving birth to Wei Rong, and passing through body fluids. If there is any disharmony, Wei Rong will lose his education and body fluid, and he will use this soup to warm and strengthen the dirty, which is known as "Jianzhong". Gum pulp tastes sweet and warm, licorice tastes sweet and flat, and the spleen wants to slow down, so it is sweet to slow down when eating urgently. Those who strengthen the spleen must give priority to sweetness, so gum pulp is the monarch and licorice is the minister. Gui Xin is hot, pungent, loose, moist, Wei Rong is insufficient, moist and scattered, Paeonia lactiflora tastes sour and slightly cold, and the body fluid is not transported, so it is collected, with Gui and Shao as assistants. Ginger tastes pungent and warm, jujube tastes sweet and warm, the stomach is the source of health, and the spleen is the source of glory. Wei is yang, and those who are insufficient will benefit from Xin; Glory is yin, and the deficiency must be supplemented by sweetness. The combination of sweetness and sweetness makes the spleen and stomach healthy and glorious. It is made of ginger and jujube.

Or, Guizhi decoction can relieve exterior symptoms but there are few peonies, while Jianzhong decoction is warm and there are many peonies. I don't know that the system of the two is far and near, and the evil of the skin is close, so it is necessary to make small clothes. Guizhi decoction is used with peony and cassia twig, not with Jianzhong. If the evil in the heart is far away, it is necessary to make a big suit. Jianzhong decoction is used with Paeonia lactiflora to strengthen the spleen, not with Guizhi.

(2) Li Gao's Spleen and Stomach Theory in Yuan Dynasty: Treatise on Febrile Diseases says that "the yang pulse is astringent, and the yin pulse is string, so the method should be acute pain in the abdomen." Taking the acid of peony in the soil to shed wood as the monarch; Caramel and roasted licorice warm and nourish spleen and stomach as ministers; Water with wood potential also comes to insult the soil, so the pulse is string and abdominal pain, cinnamon is pungent and hot, and peony is used as cold water; Ginger and jujube are sweet and warm, spreading yang, and walking in meridians and fur. The name of Jianzhong is built here.

(3) In the Ming Dynasty, Xu Hong's "Discussion on Taiwan in the Golden Mirror": Those who are under construction will build their spleen. The spleen wants to slow down, and it is sweet to eat urgently, and the taste of Jianzhong is sweet. The yang pulse is astringent, and the yin pulse is stringy, which is also deficiency in the middle and cold in the inner. Those who are nervous in the heart are qi deficiency, and those who are annoyed are blood deficiency. Therefore, the glue is the king; Glycyrrhiza uralensis Fisch and Zizyphus jujuba are ministers, and they are willing to help others. The acid of white peony can restrain the temper and benefit it, so it is used as an assistant; Cinnamon cassia twig and ginger are pungent, which can dispel the remaining evil and replenish qi.

(4) Wu Kun's Examination of Medical Prescriptions in the Ming Dynasty: those with acute pain in the abdomen of typhoid fever should be treated by this side. Acute pain in the abdomen means that the yin and yang are obedient to the middle, but the temper is not enough, so Li Jianzhong Tang is established. Cinnamon meat is different from cassia twig, but its branches are thin, so it is used to relieve muscles; Meat is thick, so it is used to build the lining. The acid of Paeonia lactiflora, collecting yin and strengthening the spleen. Ginger is pungent, dispelling cold evil and supplementing righteousness. Confucian classics: the spleen wants to slow down, and it is slow to eat urgently. Therefore, licorice, jujube and gum pulp are used to relieve the pain. Again, it is sweet to say that you can't build a home in China. If the husband has abdominal pain and vomits at the same time, it is not suitable for Jianzhong.

(5) Fang Youzhi's Treatise on Febrile Diseases in Qing Dynasty: Xiao Jianzhong, Guizhi Decoction is twice as much as Paeonia lactiflora and added with gum pulp. Guizhi decoction helps yang and strengthens Wei, and Wei is solid and harmonious. Those who are times peony are sour to receive yin, and the yin will be attached to the yang. Those who add glue are willing to moisten the soil, and if the soil is moistened, everything will be born. Build, set the law, set the law only in the middle, not biased, Wang Dao swings, what is it!

(6) Zhang Lu's Treatise on Febrile Diseases in Qing Dynasty: In Guizhi Decoction, Paeonia lactiflora and Ramulus Cinnamomi were equally divided, and Paeonia lactiflora was used to assist Ramulus Cinnamomi to treat Wei Qi; In Xiaojian, the Chinese side doubled the peony, and Guizhi was used to assist the peony to treat the qi, and it was even more sticky to relieve its spleen, hence the name Jianzhong. Its function is very different.

(7) Luo Mei's Treatise on Ancient and Modern Doctors' Prescriptions in Qing Dynasty: Guizhi Decoction is designed to treat exterior symptoms, and those who are assisted by peony will sweat their ears. Spontaneous sweating is the exterior syndrome, so the spontaneous sweating is caused by annoyance, and the annoyance is also caused by internal heat. This soup is twice as good as Paeonia lactiflora with gum pulp, and it is called Jianzhong, so it is solid as a liniment. However, although typhoid fever occurred inside, but the external cold was not removed, it was impossible to go to Guangxi and Ginger, so it was urgent to build a hospital, so it was nicknamed. Its agent is neither cold nor hot, neither tonic nor diarrhea, but it is willing to slow down the heat and slightly sour to collect it, so it is called "Jian" ear.

There are two so-called "neutral" people: one is troubled by anxiety, while the anxiety is hot, and the anxiety is empty. It is the deficiency of Fang Xin's willingness to disperse the sun and the bitterness to nourish the yin, which is the Miyagi under construction; Acute pain in one's stomach, which is hot when it is urgent, and empty when it is painful, is the way to dispel the evil of Jue Yin, to ease the anxiety of the liver, to relieve the fire of shaoyang when it is bitter, and to make the liquid of Taiyin sour, which is the capital of Zhongzhou. If the husband is injured by insufficient qi and fatigue, and it is not caused by wind and cold, Astragalus membranaceus should be added to the Golden Chamber to protect the fur by consolidating the acupoints, so that the symptoms of blood death and spermatorrhea will be cured. This Yang Mi is a solid principle.

(8) Qing Dynasty You Yi's "Synopsis of the Golden Chamber": this is also the method of regulating the camp and health of Yin and Yang. The way for a lady to live is to say Yin is Yang, and Yin and Yang are at peace, and all diseases are not born. If yang disease can't be reconciled with yin, the yin will walk alone because of its cold, which is urgent in the interior and painful in the abdomen, but it is not the fullness of yin; If Yin diseases cannot be reconciled with Yang, Yang will be alone with its heat, vexed with heat for hands and feet, and dry throat and mouth, but it is not the blazing of Yang.

Ignorant people attack heat with cold, attack cold with heat, and cold and heat are thieves, which is very beneficial. Only acridine and synthetic agent are used. If the harmony is achieved, the yang will be in yin and the cold will be warm, and the yin will be in yang and the heat will be in harmony, which is why doctors are so important. Is it true that cloud cold can cure heat, and heat can cure cold?

Or ask, it's a good idea to adjust the camp and guard with yin and yang, but what about those who will build it? As the saying goes, the middle-energizer, the spleen and stomach, and the camp guard were born in Shui Gu, while Shui Gu lost to the spleen and stomach, so the middle-energizer stood on its own feet, and the camp guard became popular without losing its harmony. Moreover, the middle is the axis of the four movements, and the machine of yin and yang is also there. Therefore, the neutral gas is followed by yin and yang, such as endless, but not extreme. It is the combination of Fang gan and Xin that gives birth to yang, and the sweetness of acid gives birth to yin, yin and yang give birth to each other, and neutral qi stands. Therefore, those who seek the sum of yin and yang must be in the middle; Those who seek to stand in the middle of the gas must also build a middle school.

(9) In the Qing Dynasty, the prince received "Selected Notes on the Ancient Formulas of Jiangxue Garden": those who are under construction are also under construction. Those who are called "small" can only build coke and nourish qi. Qian Guizhi decoction is peony with cassia twig, and Jin Jianzhong decoction is cassia twig with peony, which emphasizes on sweetness and sourness, and is specialized in harmonizing the yin of blood. Paeonia lactiflora and Glycyrrhiza uralensis Fisch. have a wonderful relationship with each other. Gum paste is the sweetness of crops, and cassia twig is the poplar, which means that Jia has turned into soil. Those who use ginger and jujube to help the spleen and stomach to promote body fluid, the soft yang in the blood comes from the stomach.

(10) in the Qing dynasty, Wu Qian's "golden mirror of medical cases? The theory of deleting and supplementing famous doctors' prescriptions: it is a prescription, that is, Guizhi decoction is twice as much as Paeonia lactiflora and gum pulp is added. It is called "Xiaojianzhong", which means that a small amount of gas is established. Although the gas is empty, the table has not yet been reconciled, and it dare not make up for it. Therefore, Guizhi decoction is used to reconcile camp and health, and Paeonia lactiflora and gum pulp are used to build Zhongzhou, instead of sipping gruel to warm up and make you sweat, which means that the emphasis is on deficiency in the middle, not on the surface of typhoid fever. The deficiency in the middle is established, the camp and the guard are self-harmonious, the body fluid can be produced, the sweating is the solution, and the annoyance can be removed. Typhoid fever floating pulse astringent, lack of camp and health; When the pulse is heavy, when the wood is buried in the ground, it is empty, and when the wood is buried in the ground, it is urgent, and the surface is empty and urgent, so this soup is also used to treat it. Nausea is not available at home, which means that anyone who is sick and vomiting is not available, and it is afraid that sweetness will help vomiting.

(1 1) On Medical Prescriptions by Fei Boxiong in Qing Dynasty: If the liver wood is too strong, the spleen and soil will be restrained, while the spleen and yang will not be far away, and the deficiency will lead to cold, and the yin will be self-coagulated, and the yang will be reduced day by day, so the symptoms such as bowel sounds, diarrhea and abdominal pain will be seen. The meaning of Xiaojianzhong decoction is to suppress wood and help soil. According to Wu's theory, cinnamon should be used instead of cassia twig. Cinnamon is warm, cassia twig is exterior-relieving, and each has its own function. And cinnamon can kill wood and combine peony to make liver. With the warmth of ginger, jujube, licorice and maltose to replenish the spleen, the yang in Sizhongzhou is relaxed and the yin is cold.

(12) Zhang Bingcheng's "Reading Conveniently" in Qing Dynasty: If we look at the three articles together, we can know the disease of the virtual wooden thief in this side's treatment. However, if the first two articles are labeled as typhoid fever, it is known that although the liver and spleen are ill in the interior, the external cold remains in the exterior; The latter one is purely the liver and spleen, and the liver has fire, so all kinds of syndromes appear.

Ginger from Guizhi can disperse exterior, and Paeonia lactiflora from Guizhi can calm the liver. Zhongjing Guizhi Decoction is used to disperse common cold outside to save exterior, and internal cutting of liver wood to prevent spleen. It serves to show that Zhongjing's prescription is not limited to usage. However, this prescription is based on the deficiency of soil and wood, so the treatment must be based on tonifying the spleen first. The spleen wants to slow down, so it is sweet to slow down when eating urgently. Therefore, the sweetness of maltose, jujube and licorice is used to slow down, and the dirty parts are built up a little. Then Guizhi, Ginger and Paeonia lactiflora come out of the surface and enter the interior, and each plays its own role according to the disease situation. Besides, ginger and jujube have the wonderful effect of harmonizing health, while Paeonia lactiflora and Glycyrrhiza uralensis have the spirit of calming spleen and relieving pain. The meaning of cube is really deified.

Fang ge Xiao Jian zhong Tang has many peonies, cinnamon, licorice, jujube and. More caramel supplements the dirty, and the abdomen is cold and cold.

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1, Wenyuan: This article is taken from Practical Classics of Traditional Chinese Medicine 100 Fang, published by Henan Science and Technology Publishing House/edited by Yao Jianping Li Qingya/Xiao Zhuru.

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