In Treatise on Febrile Diseases, Zhang Zhongjing divided heart disease into chest obstruction, true heartache and palpitation, which contained rich academic thoughts on treating heart disease. This paper comprehensively and systematically summarizes Zhang Zhongjing's twelve methods of treating heart disease, such as warming heart yang, warming tongxin yang, clearing heart and calming heart, nourishing heart and calming heart, reconciling and calming heart, invigorating spleen and benefiting heart, warming heart and soothing liver and activating yang, warming kidney and calming heart, tonifying kidney and clearing heart, nourishing yin and yang, and promoting qi circulation, which fully embodies Zhang Zhongjing's academic thought of treating heart disease based on syndrome differentiation.
Heart disease belongs to the category of chest pain, true heartache and palpitation. For example, Su Wen's Theory of Dirty Qi Therapy says: "People with heart disease have pain in the chest, full ribs, pain under the hypochondrium, pain between the false back and the shoulder nail, and pain in both arms." "Lingshu Juebing" said: "It really hurts, my hands and feet are clear to the joints, and my heart is very painful; If you die, you will die. " Zhang Zhongjing inherited and developed the academic thought of treating heart disease in Huangdi Neijing, and his Treatise on Febrile Diseases contains rich academic thought of treating heart disease based on syndrome differentiation. The discussion is summarized as follows.
1 Warming and Nourishing Heart Yang Method
The beating of the heart and the smooth pulse all depend on the encouragement of the heart yang. If the heart-yang deficiency can't stimulate the heart pulse, it can be manifested as upset, palpitation and even panic. Treatment should be warming and nourishing the heart yang. Treatise on Febrile Diseases (6 1): "For those who suffer from repeated sweating, restless day, insomnia at night, no vomiting, no thirst, no exterior syndrome, and mild pulse, Ganjiang Fuzi decoction is the main prescription." This article refers to sweating after going down, excessive body fluid damage, yang falling off with body fluid, restless day and night, unable to sleep. Ganjiangfuzi decoction, that is, Sini decoction, removes licorice, and uses Ganjiangfuzi decoction to remove yin and return to yang instead of licorice, which may slow down the speed of helping yang. Article 64 of Treatise on Febrile Diseases: "Excessive sweating leads to anxiety when crossing your hands, and nervousness when you want to press them. Mainly Guizhi Gancao Decoction. " This article is that excessive sweating will damage the heart yang, and the deficiency will lead to no owner, so the heart is nervous and the deficiency will be like pressure. Guizhi Gancao Decoction uses Guizhi to warm the yang and burn licorice to replenish qi, which can slow down the warmth of Guizhi without sweating and soothe the yang. Treatise on Febrile Diseases (1 18): "Those who go against fire are mainly Guizhi Gancao Gulong Oyster Decoction, and those who burn needles." This article has been misused by fire therapy repeatedly, resulting in heart-yang deficiency and mental blindness. The prescription is Guizhi Gancao Decoction, Longgu Oyster Decoction, warming and nourishing the heart yang, calming the heart and calming the nerves. Treatise on Febrile Diseases (1 12) said: "If the pulse of typhoid fever floats, the doctor will rob it with fire. If Yang dies, you will go crazy. If you lie, Guizhi will go to Paeonia lactiflora and add Shu Qi oyster keel to save the main soup. " Typhoid pulse floating, should have been freed, this article is a mistake of fire robbery, yang scattered and yang died, crazy and uneasy. Guizhi Quyao plus Shuqi Oyster Gulong Jiuni Decoction uses Guizhi Decoction to remove Paeonia lactiflora to relieve exterior syndrome, because Paeonia lactiflora is sour and not suitable for yang deficiency. Add Shu lacquer to dispel pathogenic fire, and add oyster keel to strengthen yang and soothe the nerves.
2 Warming Meridians, Clearing Heart and Nourishing Heart Method
Qi can promote blood circulation, and yang in the chest is weak, so the heart and pulse are blocked, resulting in chest obstruction. Treatment of chest obstruction, heartache and shortness of breath in synopsis of the golden chamber: "The symptoms of chest obstruction, such as wheezing, expectoration, chest and back pain, shortness of breath, delayed pulse, and closed minority, are mainly white wine soup." This article refers to chest and back pain caused by chest yang deficiency, phlegm obstruction and heart pulse obstruction. Tong Yang San Jie Zhi Bi with Gualou Bulbus Allii Macrostemon White Liquor Decoction. Syndrome and Treatment of Chest Obstruction, Heartache and Shortness of Breath: "If chest obstruction can't lie flat, and heartache passes through the back, the decoction of' Head Leakage, Bulbus Allii Macrostemon and Pinellia ternata' is the main indication." This article is the worsening syndrome of chest obstruction. Therefore, Gualou Congbai Banxia Decoction is used to increase the effect of eliminating phlegm and relieving pain. "Syndrome and Treatment of Chest Obstruction, Heartache and Shortness of Breath": "Chest obstruction is suffocating in the heart, and the chest is full, and the heart is robbed under the threat. Zhi Zhi Garlic Guizhi Decoction is the main one; Ginseng chicken soup is also the Lord. " Chest arthralgia mentioned in this article can be divided into deficiency of positive energy and excess of evil energy. What is biased towards reality is caused by poor yang deficiency and hyperactivity of yin, cold and phlegm. Fructus Aurantii Immaturus, Bulbus Allii Macrostemi, and Guizhi Decoction are used for activating yang and dispersing stagnation, eliminating mass-qi, and reducing adverse events. Those who suffer from deficiency should use ginseng chicken soup to invigorate qi and help yang, and warm yang to dissipate stagnation. Belongs to "purse seine". Synopsis of the Golden Chamber Syndrome and Treatment of Chest Obstruction, Heartache and Shortness of Breath: "In case of chest obstruction, barley and aconite powder are the main ones." Chest arthralgia in this article is caused by stagnation of yin and cold and obstruction of yang. Coix seed aconite powder warms yang, relieves arthralgia and relieves pain. "Syndrome and Treatment of Chest Obstruction, Heartache and Shortness of Breath": "Heartache cuts the back, waist soreness cuts the heart, and Aconitum Chishi Pill treats it." This article is the heartache caused by stagnation of yin and cold. Aconitum carmichaeli Pills contain a lot of pungent and hot products, such as aconite, Sichuan aconite, Sichuan pepper and dried ginger, which have the functions of activating yang, dispelling cold and relieving pain.
3 clear the heart and soothe the nerves
The heart belongs to fire, and the evil of fire is easy to disturb the mind. Article 76 of Treatise on Febrile Diseases: "After sweating and vomiting, I can't sleep because of fatigue. If you play, you will be turned upside down repeatedly and feel depressed. " Article 77 of Treatise on Febrile Diseases: "Gardenia black bean soup is mainly used for those who feel sweaty, irritated with heat and have chest tightness." Article 78 of Treatise on Febrile Diseases says: "Those who have fever for five or six days and have pain in their hearts do not want to get rid of it. Gardenia black bean soup is the main one. " The above three points are that after sweating, the residual heat is not exhausted, which disturbs the thorax and diaphragm, so there is fatigue, insomnia, frustration, annoyance and pain in the heart. Gardenia black bean soup uses gardenia and fragrant black beans to clear away heat and trouble. Article 79 of Treatise on Febrile Diseases: "After typhoid fever, people who are upset and full of stomach should be treated with Zhi Zi Houpu Decoction." This syndrome is that after typhoid fever, the residual heat disturbs the chest and diaphragm, causing upset and abdominal distension, so Zhi Zi Houpu decoction is used. Gardenia clears away heat and annoys, while Magnolia officinalis and Fructus Aurantii Immaturus reduce swelling. Article 80 of Treatise on Febrile Diseases: "Pills are the main medicine for typhoid fever, and the body heat can't be removed. If you are slightly annoyed, use Gardenia dry ginger soup." This syndrome is that after typhoid fever, the upper focus is hot and upset, and the middle focus is cold. Treatment should be clear and warm, gardenia and dried ginger soup should be clear and burnt with gardenia, and dried ginger should be warm and burnt.
4 nourish the heart and soothe the nerves
The liver stores blood, and the heart circulates blood. The liver does not hide blood, and the heart has no owner. Synopsis of the Golden Chamber Syndrome of Blood Stasis and Fatigue: "Insomnia and fatigue can't sleep, and Suanzaoren Decoction is the main indication." This article is about liver blood deficiency, who is upset due to mental dystrophy. Therefore, Ziziphus jujuba seed soup uses Ziziphus jujuba seed, Anemarrhena asphodeloides and Poria cocos to nourish yin, nourish blood and soothe the nerves.
5 Adjustment and sedation methods
Treatise on Febrile Diseases (107): "On the eighth or ninth day of typhoid fever, the next day, my chest is full of boredom, my urine is unfavorable, my speech is heavy, and I can't turn sideways. Mainly based on Chaihu Jialong oyster soup. " This article refers to typhoid fever without excess. After the onset, pathogenic factors take advantage of it, and the mind is weak and upset. This syndrome is a mixture of excess and deficiency caused by abuse. Chaihu plus Gulong Oyster Decoction is used for eliminating pathogenic factors, while Gulong and Oyster are used for calming the heart and calming the nerves.
6 Spleen-invigorating and Heart-benefiting Method
Heart and spleen are the viscera of mother and child, spleen deficiency leads to passive qi and blood biochemistry, and palpitation is caused by mother and child diseases. Treatise on Febrile Diseases (102): "On the second or third day of typhoid fever, Xiaojianzhong decoction is the main one, and those who are worried are also." Treatment of blood stasis deficiency syndrome in synopsis of the golden chamber: "internal fatigue, palpitation, cyanosis, abdominal pain, dreaminess, limb pain, fidgety hands and feet, dry throat, Xiaojianzhong decoction as the main indication." Both of the above are due to deficiency of spleen-qi and cold, deficiency of essence, loss of qi and blood, and dystrophy of heart branch. Therefore, Xiaojianzhong decoction should be used to warm the middle warmer, strengthen the spleen and benefit the heart.
7 Warming the nerves.
Spleen governs body fluid. Article 356 of Treatise on Febrile Diseases: "For typhoid fever, syncope and palpitation, water should be controlled first, and Poria and Glycyrrhiza Decoction should be taken." This article refers to the stagnation of spleen, internal stagnation of water and drink, and palpitation caused by water vapor. The prescription is poria cocos and licorice soup. Cinnamomum cassia twig, ginger warm the yang, Poria cocos and Glycyrrhiza uralensis Fisch are soaked in the middle warmer, which plays the role of warming the middle warmer and calming the nerves.
8 Shugan Myrica rubra method
Heart governs blood vessels, and liver governs catharsis. Treatise on febrile diseases (article 3 18): "shaoyin disease, four adverse reactions, cough, palpitation, dysuria, abdominal pain, or relieving stress, four adverse reactions disperse the main body." This article refers to palpitation caused by stagnation of liver qi, inhibition of Yang Qi and obstruction of heart yang. The prescription uses Sinisan to soothe the liver and regulate qi, and to warm Tongxinyang.
9 Warming kidney and calming heart method
Kidney water is dirty, governing body fluid. Article 82 of Treatise on Febrile Diseases: "If the sun is sick and sweating inexplicably, this person still has fever, palpitations, dizziness, body tremors and tremors, and Zhenwu Decoction is the main one." This article refers to palpitation caused by deficiency of kidney yang, failure of kidney to absorb water, and water vapor permeating the heart. Zhenwu decoction uses aconite and ginger to warm kidney and help yang, while ginseng, Atractylodes macrocephala and Poria strengthen spleen and promote diuresis. * * * Play the role of warming kidney, promoting diuresis and calming nerves.
10 Bushen Xiexin method
Heart and kidney intersect, fire and water ji ji, in order to maintain the coordination and balance of physiological functions between heart and kidney. Article 303 of Treatise on Febrile Diseases says: "The disease of shaoyin lasts for two or three days, but you can't lie down if you are bored. The treatment is mainly Huanglian Ejiao Decoction. " This article refers to the deficiency of water in shaoyin and kidney, excessive fire in shaoyin's heart, water not rising, fire not falling, and heart and kidney not lying down. The prescription is Huanglian Ejiao decoction for tonifying kidney and stopping diarrhea. Colla Corii Asini and Radix Paeoniae Alba nourish kidney yin, while Coptidis Rhizoma and Scutellariae Radix purge heart fire, so that heart and kidney are in intercourse, and water rises and fire falls.
1 1 Yin-Yang complement method
The pulse is the blood house, and the heart governs the blood. Treatise on Febrile Diseases (177): "Typhoid fever, pulse, palpitation, Zhigancao decoction is the main indication." This article refers to deficiency of both yin and yang, deficiency of both qi and blood, loss of nourishing pulse and palpitation. Treatment should nourish yin and blood, and benefit the temperature and yang. Zhigancao Decoction uses Radix Glycyrrhizae Preparata and Ginseng to replenish qi and nourish heart, Ramulus Cinnamomi to warm Tongxinyang, Radix Rehmanniae, Radix Ophiopogonis, Colla Corii Asini, Fructus Cannabis and Fructus Jujubae to nourish yin and blood. * * * plays the role of yin and yang and qi and blood.
12 method of changing drinking and promoting qi circulation
Qi can regulate body fluid, and body fluid can carry gas. If you don't drink body fluid, you will be depressed, and if you don't drink body fluid, you will drink it. All of them can block chest yang and become chest obstruction. "synopsis of the golden chamber: chest obstruction, heartache and shortness of breath": "chest obstruction, chest obstruction and shortness of breath, with Fuling almond licorice soup as the main indication; Orange ginger soup is also the main one. " This paper discusses mild chest obstruction. Its condition is different from drinking pathogenic factors and qi stagnation, and its treatment should also follow the principle of "treating the same disease differently". Poria cocos and licorice formula. It can only be used when the evil drink is biased towards the winner. For people with high pressure due to qi stagnation, the treatment is to promote qi circulation and dissipate stagnation, using orange orange ginger soup. Synopsis of the Golden Chamber Syndrome and Treatment of Chest Obstruction, Heartache and Shortness of Breath: "Heart distension is suspended in the heart, and Guizhi Ginger Zhishi Decoction is the main one." In this paper, the prescription for cold drink heartache is Guizhi Ginger Fructus Aurantii Tangwenyanghua Decoction, which can reduce qi and reduce swelling.