Wu Mei Pill is the main prescription of Jueyin in Treatise on Febrile Diseases. The book only says that it is used to expel constriction and promote diarrhea, but it is of great use to many diseases such as internal medicine, surgery, gynecology and pediatrics. The author of this article is Zhang Zaikang of Hebei College of Traditional Chinese Medicine, and this prescription is commonly used in clinic. To explore the mechanism and main symptoms of Wu Mei Pill's combination of cold and heat.
Common sense of pathogenesis of Wu Mei pill syndrome
Jueyin in Treatise on Febrile Diseases has profound pathology and is the most difficult to get rid of. Wu Mei Pill is the general prescription of Jueyin articles, which has been studied by doctors in past dynasties, and its understanding can be roughly summarized into three parts.
Safety theory
Ascaris has the characteristics of "acid calms down, pain decreases, and pain subsides", and Wu Mei Pill has a good effect on Ascaris, so it is regarded as a good prescription for Ascaris by later generations. However, based on this, it is not limited to using Wu Mei Pill as a special medicine for treating octopus. Chen Yuanxi said, "This is the general prescription of Jueyin. Everyone in the family said that when you are bitter, you will be calm, you will be depressed when you are bitter, and you will still despise Wu Mei Pill when you are bitter. " Ke Yunbo pointed out that "Wu Mei Pill is the main prescription of Jueyin, not just a strangulation drug. If the syndromes of Jueyin are consistent with this prescription and the benefits are unlimited, it is also consistent with the main long-term benefits". In addition, he also pointed out: "Zhongjing's prescription was originally the legislation of Jue Yin syndrome, while Shuhe was compiled under the rule of spitting, which made people suspect that Jue Yin was the main prescription." See that its medication conforms to various syndromes, not just spitting! " Both Jin Jian and Zhang Xugu emphasized that Wu Mei Pill was the main prescription of Jueyin Zheng Zhi. It can be seen that the theory of Anquan has its limitations, which is not conducive to the flexible use of Wu Mei Pills in clinic.
Theory of upper heat and lower cold
There are many doctors who hold the theory of "heating up and cooling down". For example, the Translation Interpretation of Treatise on Febrile Diseases compiled by the typhoid teaching and research group of Nanjing College of Traditional Chinese Medicine said: "Generally speaking, this syndrome is characterized by heat in the diaphragm and cold in the intestine." It is based on two aspects: first, according to the 366 categories of Jueyin disease in Treatise on Febrile Diseases, Jueyin is a disease, which can quench thirst, hit the heart with qi, grieve with heat, and if you are hungry, you don't want to eat, but you will vomit after eating, with endless benefits. The second is to test the syndrome according to the composition of Wu Mei Pill. But the theory of "heating up and cooling down" seems reasonable on the surface. In fact, there are still many questions worth pondering: what are the diagnostic indications of upper heat and lower cold syndrome? Is it judged only by the typical symptoms such as irritability, thirst, dry mouth, vomiting immediately after eating, abdominal cold, diarrhea and so on? It is difficult to meet in clinic. What are the indications of tongue pulse of "upper heat and lower cold"? If the fever is excessive, is the tongue red and the pulse strong? Is it weak tongue and weak pulse? And the hot position is in diaphragm or stomach, and the cold position is in stomach or intestine? It can be seen that the theory of "upper heat and lower cold" is the most acceptable, but it can't stand scrutiny, which is the main reason that restricts the wide application of Wu Mei Pills at present. The author thinks that it is ok to say that the pathogenesis of Wu Mei Pill is cold and heat, but it is inappropriate to say that upper heat is cold.
Theory of disharmony between yin and yang
Chen Xiuyuan said, "This prescription can cure dysentery instead of syncope. The disharmony between yin and yang, the evidence of fainting benefits, can not be abandoned. Moreover, the syndromes of Jue Yin are different. No matter whether you see insects but don't see them, you can tell whether they are vaporized or not, and you can master Wu Mei Pills. " You can't have both yin and yang. Why are you singing alone? Both Baihutang syndrome and Yangming fu-organ syndrome can cause syncope of yin and yang. This is only the general law of Jue syndrome, and it is impossible to generalize Jue Yin Wu Mei Pill syndrome.
New Understanding of Pathogenesis of Wu Mei Pill Syndrome
Jueyin meridian includes two meridians of hand and foot, but the foot meridian is long and the hand meridian is short, so Jueyin disease mainly discusses the problem of liver. The essence of Jueyin is deficiency and cold of liver meridian, which constitutes the main line of the whole article. Why is this happening? The most fundamental reason is that the liver has to cope with the spring, when the yin flourishes and the yang declines, and the yang begins to sprout but not flourish, and the liver itself is prone to yang deficiency, so exogenous six evils, internal injuries and seven emotions or parasites can easily lead to liver yang deficiency.
Improper clinical medication has caused many cases of liver-yang deficiency. Stagnation of liver qi, excessive use of drugs that stimulate dryness and heat and promote diffusion, is easy to damage qi and blood, and also damage kidney water and the root of liver wood. Excessive use of bitter and cold drugs in liver fire is easy to damage liver yang and cause stagnation of qi and blood. Liver-qi is excessive, running the whole body along meridians or humiliating its victory. Excessive use of liver-calming drugs is easy to damage liver-qi. If the liver yin is insufficient, the liver fire is ready to move, and excessive moistening will hinder the liver qi and the spleen and stomach. Therefore, the above methods can be used temporarily in clinic. Long-term use will damage the qi and blood of the liver, and in severe cases, it will damage the yang of the liver. What's more, the liver Yang Qi is insufficient, but the pathogenesis is not observed, which violates the virtual precepts.
Due to the deficiency of liver yang, qi can't be relaxed, so the fire hidden in the liver can't spread all over the body, leading to fire depression. Zhang Xichun once pointed out: "Because the liver governs the drainage, fire is in the zang-fu organs system (fire is born in the Ming Gate and originates in the liver and gallbladder), liver deficiency can't relieve the deflated mechanism, and fire can't flow freely in the whole body, so it stays between the meridians and qi and blood, causing heat injury, so the pain of heat drama is also dramatic ... Liu Zhongyou is from Anton, and he is 50 years old this year. His arm often feels hot and sore. The doctor repeatedly gave a cooling agent, and the high fever persisted, and the digestive function of the spleen and stomach decreased. After diagnosis, the right pulse is normal and the left pulse is weak, which is twice as bad as the right pulse. Ask him if he doesn't feel hot in his heart, knowing that his liver is weak and he can't shine smoothly, and the fire is suppressed in the meridians of his left arm, which makes him hot. Therefore, Qu Zhi decoction (one or two pieces of Cornus officinalis, six pieces of Anemarrhena asphodeloides, frankincense San Qian, myrrh San Qian, Angelica San Qian, Salvia San Qian), eight pieces of raw Astragalus, Cornus officinalis tonifying liver qi, Paeonia lactiflora San Qian, Angelica miltiorrhiza dredging meridians, take two doses, and immediately start from the left pulse, then take ten doses, and you can be cured. "
The author thinks that the mechanism of Wu Mei Pill Syndrome is that the liver yang is insufficient, and the yang can't be produced and subdued. However, there is fire in the liver, and liver yang deficiency can't be vented, and the fire can't be dispersed, resulting in stagnation of heat. In particular, Jing's sentence: "Under the product of yin, there must be supporting yang." The pathogenesis of Wu Mei Pill Syndrome includes yang deficiency, yin deficiency and cold excess, and heat stagnation in fire, so the pathogenesis of cold and heat is mixed.
Wu Mei Pill has a wide range of clinical applications.
The pathogenesis of Wu Mei Pill Syndrome is deficiency of liver yang and stagnation of fire, in which deficiency of liver yang is the main contradiction and stagnation of fire is the secondary contradiction. This repressed fire is not necessarily on the diaphragm, nor in the stomach, but can flow all over the body. Therefore, we can't confine ourselves to the theory of heating up and cooling down, and mechanically use Wu Mei Pills as planned. The liver governs the growth and catharsis, and its politics is loose and its morality is harmonious. The liver has a wide range of functions in the human body, and the basic theory textbooks of traditional Chinese medicine are highly summarized from two aspects: the liver controls the drainage and the liver controls the storage of blood. The liver governs the release of qi, flirting, transporting the spleen and stomach, promoting the movement and distribution of body fluid and blood, and regulating male and female reproduction. The liver governs blood storage in three aspects: storing blood, regulating blood volume and preventing bleeding. Once the liver-yang deficiency loses its antidiarrheal function, extensive pathological changes can occur in the five internal organs, qi, blood and body fluid. Therefore, Wu Mei Pill has a wide range of diseases and syndromes.
Experience of Wu Mei Pills Applied by Physicians in Past Dynasties
Prescription, "Shengji Zonglu" to treat cold dysentery; Zuo Jiyun's Treatise on Febrile Diseases said: "This recipe treats abdominal pain, cold drink, testicular swelling, apical pain and epigastric cough." Ye Shan used Wu Mei Pill to treat vomiting, stomachache, diarrhea, dysentery, chronic malaria, mass syndrome and fever.
Yuan Zunshan, a close friend, used Wu Mei Pill, Sichuan pepper, centipede and silkworm to treat spasms caused by tetanus, sequelae of toxic encephalopathy and Japanese encephalitis. Gaoti Powder uses Wu Mei Pill to treat ascaris lumbricoides, abdominal pain due to menstrual cold, abdominal pain due to deficiency cold, chronic adnexitis, leucorrhea due to deficiency cold, chronic colitis, chronic enteritis, chronic dysentery, stomach pain due to deficiency cold, chronic prostatitis, impotence, enuresis, sciatica, chronic trigeminal neuralgia, proctoptosis and uterine prolapse. Gong Zhixian introduced the experience of Wu Mei Pill in treating Wu Mei Pill invagination (chronic keratitis and corneal ulcer).
Clinical application of Wu Mei Pill
Clinically, the author used Wu Mei Pill to treat cold and heat, headache, fainting, convulsion, hypochondriac swelling and pain, anorexia, vomiting, belching, chest pain, thirst quenching, slacking, paralysis, mental fatigue, dysmenorrhea, vaginal contraction pain, eye pain and even irritability, or loss of breath and wheezing, purulent blood, sore throat and sores on the tongue.
According to the author's experience, the main indications for applying Wu Mei Pill are: ① weak pulse string. The string is the pulse of the liver, and those with liver yang deficiency have a rapid pulse due to insufficient temperature. Its chords can be slow, slippery, rich and moist, but they must be reduced; ② Tongue picture: the tongue is pale with white or yellow coating, and there may be red spots on the tip or root of the tongue; ③ Symptoms of liver meridian: slackness, depression, timidity, dizziness, numbness of limbs, chills and cold limbs, hypochondriac swelling and pain, convulsions and muscle convulsions, yin pain and cystic contraction, cold and heat mixed, etc. If several symptoms can be seen at the same time, or only one symptom can be seen on the tongue pulse, Wu Mei Pill can be used for treatment.
Prescription characteristics of Wu Mei Pills
Zhang Zhongjing's synopsis of the golden chamber said: "The disease of husband's liver should be supplemented with acid and adjusted with bitterness ... This method is used for patients with liver deficiency, but not used." Neijing says: "The liver is bitter and anxious, which should be dispersed with pungent food, supplemented with pungent food, and diarrhea with sour food". Qin Bowei's Notes on Qianzhai Medicine: "Warming the liver: cold pathogen damages the liver. When warming herbs are used to dissipate heat, the yang of the liver itself is insufficient, so it is advisable to warm and tonify it to promote the rise of qi activity, which is generally called warming and tonifying, with different meanings. The method of nourishing liver yang must be supplemented with warm drugs in nourishing blood, not just warm. "
The prescription characteristics of Wu Mei Pill fully reflect the therapeutic characteristics of warming liver-yang and purging depressed fire. There are 300 pieces of ebony in ebony pills, and about 570 grams are measured. After removing the core, the remaining ebony meat is measured to be about192g, which is the only weight. In the prescription, the sour-gathered dark plum is reused, soaked in vinegar to make it taste the same, enhance its sour taste, and be compatible with Angelica sinensis to nourish the liver and yin, forming the meaning of yin generating yang.
In addition, the sour taste of ebony can converge and disperse yue qi and solidify essence. There is a saying in the Western Medical Records: "Anyone who falls off is in the liver", so it is exactly the same as Wu Mei Maruko's rescue with Kiichigo. Radix Aconiti Lateralis Preparata, Ramulus Cinnamomi, Rhizoma Zingiberis, Fructus Zanthoxyli, and Asari; Zanthoxylum bungeanum and asarum are pungent, which can regulate qi, strengthen yang and soothe the liver; Coptidis Rhizoma and Cortex Phellodendri are bitter cold to relieve summer heat. They are used together with Asari and Zanthoxylum bungeanum to relieve depression and heat. Ginseng, rice and white honey strengthen the spleen and nourish the stomach, and cultivate the soil to control the liver. It means "seeing the disease of the liver, knowing the liver and dispersing the spleen, and strengthening the spleen first".
This is the recipe used by the author. If there is no sign of qi escaping, Wumei often uses it sparingly. For those with severe fever, increase the dosage of cold medicine or add a little gentian; When the cold is serious, increase the dosage of aconite or add Evodia rutaecarpa; For patients with severe qi deficiency, raw Astragalus membranaceus is added; Radix Paeoniae Alba is added for patients with yin deficiency and blood deficiency; Radix Morindae Officinalis and Herba Epimedii are added for patients with deficiency of kidney qi; Bupleurum, Cimicifuga, Platycodon grandiflorum, etc. All added to Qingyang; Peach kernel, safflower, salvia miltiorrhiza, turmeric, etc.
Check the box
Hot and cold exchange box
Ji, female, 5 1 year old.
During the day, my body is like ice water, and my heart can't help but feel cold. Although I don't know how to wear thick clothes; At night, the body is as hot as fire, even in the middle of winter, I will lie naked, with night sweats, headache and left back pain. If you feel a little frustrated, you will have a ball-like bag in your heart, stuck in your chest. Diet, two stools are acceptable, and at the beginning of the year, absolutely not. The pulse is heavy and slippery. Has been hospitalized 1 1 times, or menopausal syndrome, or endocrine disorder, or autonomic nerve dysfunction.
Prescription: dark plum 6g, prepared aconite 15g, asarum 4g, dried ginger 5g, cassia twig 10g, angelica sinensis 12g, codonopsis pilosula 12g, coptis chinensis 10g, phellodendron amurense 6g and pepper 5g. Two doses can dispel cold and heat, stop sweating, and greatly reduce the mass under the heart. Four doses can cure it. It's been five years, life is normal, and there is no recurrence.
Dolphin case
Male, aged 63.
After being ill for more than 30 years, I feel angry and attack from my lower abdomen. I feel abdominal pain when I attack my abdomen. When I attack my chest, I feel suffocation and pain in my chest, and I have difficulty breathing. I want to die, even my head, neck and back are suffocating and painful, and my whole body is weak. Then there are frequent burps, and the gas spews like a landslide. When exhaling, all symptoms are slightly relieved and can be recovered in an instant. The pulse string is greatly reduced and weighs two feet. Western medicine diagnosed coronary heart disease, gastric neurosis, swallowing, etc. Traditional Chinese medicine diagnosed it as running dolphin, which was caused by deficiency of liver and kidney yang and qi syncope.
Prescription: dark plum 6g, prepared aconite 15g, dried ginger 5g, cassia twig 12g, poria cocos 15g, atractylodes macrocephala 10g, Sichuan pepper 5g, asarum 4g, coptis 8g, phellodendron 4g, codonopsis pilosula 12g, angelica 650. This recipe is modified to take 24 doses. The symptoms gradually eased and improved, and there was no recurrence for two years.
Syncope case
Su Mou, female, 37 years old.
Every time I pass by, I feel dizzy and vomiting, my eyes are sore, I can't open my eyes, and I often faint, ranging from three to five degrees a day. Cold and heat alternate, abdominal cold pain is less, and menstrual blood is less dark. After about five days, the pure prescription gradually recovered and has been treated for seven or eight years. The pulse is heavy, the string is thin and astringent, and the tongue is pale and dark. It's liver-yang deficiency, liver blood deficiency.
Prescription: 5g of ebony, 0g of cassia twig10g, 0g of aconite root10g, 4g of dried ginger, 4g of pepper, 4g of asarum herb, 0g of angelica12g, 2g of codonopsis pilosula12g, 7g of Ligusticum wallichii and 0g of trogopterori12g. Start taking it when you want to go until your period is clean. I take six to seven doses a month and take Ginseng Yang Rong Pills every day. It will be fine after eating for three months, and the menstruation is normal.
Threatening pain cases
Zhang, female, 38 years old.
Recently, I have a dull pain and discomfort in my right flank, poor appetite, aching all over, and lazy. I hope he looks gloomy and depressed. The tip of the tongue is slightly red, the coating is slightly white and thick, and the pulse is weak. It was diagnosed as deficiency of liver yang and dampness in fire.
Prescription: Mume 10g, Ramulus Cinnamomi 10g, Radix Aconiti Lateralis 6g, Rhizoma Zingiberis, Fructus Zanthoxyli 4g, Asari 4g, Radix Angelicae Sinensis 10g, Radix Codonopsis 10g, Rhizoma Coptidis 6g, Radix Scutellariae 6g and Radix Bupleuri 6g. I was ill for four doses and didn't relapse for four years.
Most drugs come from plants, animals and minerals in nature. The medicinal part contains certain medicinal components, but there are often some non-medicinal parts, which affect the curative effect, and the efficacy of different medicinal parts is also different. While the original medicinal materials play a therapeutic role, some adverse reactions may occur, which need to be processed and adjusted to increase the advantages and eliminate the disadvantages to meet the requirements of clinical treatment. The book I brought to you today can be called the "museum" for moving Chinese herbal pieces. This book is-
Illustration of Chinese herbal pieces
This article is selected from the official account of WeChat of China Traditional Chinese Medicine News, and the final interpretation right belongs to the original author. Please do not reprint without authorization!