1.Accurate syndrome differentiation
Only when the medicine syndrome corresponds can it take effect. If the medicine is wrong, it can only have adverse effects and even side effects on the body. It is meaningless to talk about drugs without patients. Aconitum carmichaeli is a hot product, which can only be used for internal cold syndrome or yang deficiency syndrome. If the syndrome differentiation is unclear, it will have hidden side effects on the body even if it is not poisoned. The former sages made it clear: "If you are sick, you should deal with it if you are not sick." Compared with western medicine, the side effects of traditional Chinese medicine are more terrible, many of which are recessive rather than dominant, and it is easy to misunderstand. This may be the common people's wrong understanding of "Chinese medicine has no side effects".
2. Limited application
The dosage should meet the requirements of Pharmacopoeia as much as possible to avoid unnecessary medical disputes. If you want to use a large dose, you should start with a small dose. On the basis of accumulated experience, the dosage was gradually increased. If you don't have rich clinical experience, whether it's from medical disputes or being responsible for patients, you should follow the principle of "not asking for nothing, but asking for nothing". Sounds selfish. But what if once poisoned? Besides, an old Chinese doctor once told me that it doesn't matter if you can't cure the disease, but don't cure others. -that is, don't cause drug-induced diseases. Sounds reasonable, too.
3. Compatibility and detoxification
It is clearly pointed out in the textbook that reasonable compatibility can reduce the toxicity or side effects of drugs. I think that compatibility with ginger, dried ginger, licorice, etc., the toxicity of aconite will be greatly reduced. There are the following aspects of reference:
Radix Glycyrrhizae and ginger are often used in the processing of Radix Aconiti Lateralis, which is discussed in detail in the processing of traditional Chinese medicine.
Looking through Zhongjing's works, we can see the drugs used in the four generations: Sini Decoction (one and a half roasted licorice root, one and a half dried ginger root, and one raw aconite root), which contains both licorice root and dried ginger root, and the dosage (1 2 =15g, one dried aconite root =15g) is analyzed. It is not difficult to see that Zhenwu decoction uses one processed aconite root, but three liang of ginger, which greatly exceeds the dosage of aconite root. Zhongjing was afraid of sweating too much when he used Daqinglong decoction, and there was a clear instruction after the prescription, but the prescription containing aconite did not clearly point out the rescue method of aconite poisoning. It is not difficult to understand that Zhongjing's aconite was not poisoned, and he did not see the poisoning because the compatibility was good. Like Sini decoction, it is said that a strong man can get one piece of aconite root (about 20g), and dried ginger is also added to three taels. The aconite root is not fried first, and it is raw. It seems that there is no prescription that does not match dried ginger, ginger and licorice when Zhongjing uses aconite (not carefully checked). It is bold to guess that most of the causes of aconite poisoning today lie in the lack of good compatibility.
4. Decoct for a long time to reduce toxicity
According to the requirements of the textbook, it is necessary to fry for 30-60 minutes first, and the taste is not spicy. But not all the dosage should be fried first. If it is below 15g, I don't think it is necessary to fry first. According to the relevant requirements of Chinese medicine prescription, the pharmacy must provide "prepared aconite" for those who prescribe "aconite", but never give "raw aconite". As far as I know, most pharmacies have no raw products, only processed products.
Pharmacological research shows that the toxicity of aconite can be obviously reduced by decocting it first, but its cardiotonic and analgesic effects are not affected by the length of decocting time.
5. Avoid the opposite compatibility
The ancients clearly stated "eighteen evils and nineteen fears". Although there are many medical workers who have doubts about some of the contents of the "eighteen evils and nineteen fears", they should be cautious. "Half-baked shellfish and attacking Wu" (Aconitum also includes aconite) and "Aconitum kusnezoffii is not suitable for rhinoceros", except rhinoceros horn, Pinellia ternata, Fructus Trichosanthis, Fritillariae Cirrhosae and Rhizoma Bletillae all have the opportunity to use with aconite, but it is better not to use it.