Xu, a native of Shanghai, is a professor of pediatrics at Shanghai College of Traditional Chinese Medicine, and the chief Chinese medicine practitioner. He inherited his family studies and got a biography of his father, the famous pediatrician Xu Xiaopu. He also studied Chinese medicine from the famous doctor Zhu Weiju and won the Shanghai Scientific Research Achievement Award.

Chinese name: Xu

Nationality: China.

Place of birth: Shanghai

Date of birth: 19 1 1 year.

Date of death: 199 1 year.

Occupation: chief Chinese medicine practitioner, professor

Representative works: Clinical experience in treating children's asthma.

Character experience

Xu is from Shanghai. Professor of Pediatrics, Shanghai College of Traditional Chinese Medicine, Director of Chinese Medicine. He inherited his father's famous pediatrician, Xu Xiaopu, and studied Chinese medicine under the famous doctor Zhu Weiju. Liberation of former executive director of Chinese Medical Association. After liberation, he successively served as vice president of Shanghai 11th People's Hospital, vice president of Longhua Hospital affiliated to Shanghai College of Traditional Chinese Medicine, vice president of Shanghai Society of Traditional Chinese Medicine, chairman of Pediatric Society, member of Shanghai Branch of Chinese Medical Association, member of National Pediatric Society, vice president of Shanghai Health Workers Association and director of Shanghai Branch of National Tuberculosis Society.

Major achievements

193 1 year is responsible for participating in Zhu medical series 1 ~ 4 episodes: new meanings of typhoid fever, prescriptions for typhoid fever, pathological application and diagnostic outline. 196 1 year later, he published papers such as Brief Introduction of Xu Xiaopu's Pediatric Experience, Clinical Application of Jianpi Bushen Method in Chronic Bronchitis, Clinical Experience of Asthma in Children, and Clinical Application of Fuzi. As a consultant to the editorial board of Chinese medicine textbooks of the National College of Traditional Chinese Medicine, focusing on the editing of pediatric textbooks. 1985 personally directed the computer simulation system of cough and asthma diagnosis and treatment of Professor Xu, a famous old Chinese medicine doctor, and won the Shanghai Scientific Research Achievement Award.

Academic viewpoint

Attach importance to the role of Yang.

Xu attaches great importance to the role of yang in human body. On the basis of summarizing the experience of Xu Xiaopu and Zhu Weiju, the predecessors of traditional Chinese medicine, Xu emphasized the importance of yang in human body and quoted Neijing many times. Su Wen's On the Wrath of Heaven: "Yang is there. Without the sky and the sun, there is no life and no glory. Therefore, the sky should be bright with the sun. " I think this metaphor is very vivid. Analyze and understand. It is also pointed out that yin is the body. Yang is the driving force of life in physiological state and the main force of disease resistance in pathological state. Not only should young children's yin and yang be balanced everywhere, but long-term illness often makes yang depressed, so it is particularly important to use the principle of warming yang to strengthen the body. The so-called warming yang is firstly the yang of kidney life, and of course it also includes the yang of heart and spleen and other viscera. As a whole, the human body has always believed that the kidney contains Yuan Yin and Yuanyang. If we only infer from yang, all yang in a body is rooted in the kidney. To this end, Xu attaches great importance to the clinical application of warming yang and strengthening spleen, which has a miraculous effect every time.

Spleen and kidney

Give consideration to both spleen and kidney, first warm kidney and nourish yang. On the premise of strengthening the effect of yang qi on human body, Xu thought that kidney was often compared with Mingmen in past dynasties. As a matter of fact, many patients with internal injuries and miscellaneous diseases diagnosed as the failure of life-threatening fire conform to the testimony of the so-called deficiency of kidney yang, and the so-called life-nourishing gunpowder has the function of warming kidney yang. Shan Xu used drugs for warming kidney, especially blindly using aconite in clinical prescriptions. It is considered that there are as many as 20 prescriptions using Radix Aconiti Lateralis in Treatise on Febrile Diseases 1 13 written by Zhang Zhongjing in the Han Dynasty, and their effects are roughly "restoring yang to save adverse events", "warming yang to promote blood circulation", "warming middle warmer to dispel cold" and "warming meridians to relieve pain", but they can also be simply called "warming yang". For the drug aconite, if the syndrome differentiation is accurate and the compatibility is proper, not only the curative effect is remarkable, but also its side effects can be avoided. The indications for Xu's application of Radix Aconiti Lateralis are: listlessness, pale complexion, cold limbs, nocturia or frequent urination, loose stool, even diarrhea in the fifth watch, blue lips, pale and fat tongue, white and slippery fur, or dry mouth, thin or heavy pulse. In a word, aconite is an important drug to warm yang and dispel cold, especially to warm and benefit kidney, which can invigorate the functions of various organs in the whole body and increase the vitality and disease resistance of the body. Therefore, in the clinical application of aconite, we only need to grasp one or two symptoms of deficiency syndrome and cold syndrome, and not all symptoms are required.

Experience of syndrome differentiation and treatment

Infantile asthma

The occurrence and development of childhood asthma has both external and internal causes, and the internal cause (physical factor) is particularly important. In terms of internal factors, it should be emphasized that the rise and fall of kidney yang is closely related to asthma, because yang is the driving force of life in physiological state and the main force of disease resistance in pathological state, while kidney governs the yang of the whole body, and life gate is also the kidney and the foundation of life. Asthma patients often show kidney-life-fire failure syndrome, and kidney-qi is not absorbed, so the condition is aggravated.

Asthma in children is different from asthma in adults, and it is more difficult to treat. The reasons are as follows: (1) Children's yin and yang; The viscera is delicate, the five internal organs are not full, and it is easy to be empty and easy to be solid; Deep phlegm is not easy to remove; Those with congenital endowment deficiency have deficiency of kidney qi. Therefore, clinical treatment in stages.

Syndrome differentiation and treatment in attack period

Cold and asthma are the pathogenic factors of wind-cold and phlegm blocking lung collaterals in the body. At the onset, wheezing and shortness of breath, croaking in the throat, white and thin sputum, swollen chest and diaphragm, and dull complexion appeared. Not thirsty. The tongue coating is thin and white or greasy, the tongue surface is smooth, and the pulse string is smooth or tight. Commonly used methods of warming lung, resolving phlegm, relieving cough and asthma. The prescriptions of Xiaoqinglong Decoction and Sanziyangqin Decoction are as follows: ephedra 4.5 ~ 9g asarum 1.5 ~ 3g dried ginger 1.5 ~ 6g Pinellia ternata 6 ~ 12g Schisandra chinensis 1.5 ~ 3g licorice 3 ~ 6g perilla 6 ~ 9g white mustard seed 6 ~ 9g. Treating cold asthma with the above prescription can often achieve the effect of relieving asthma and resolving phlegm. For the above applications, we must also master the following points: ① Ephedra is the main drug for dispersing lung and relieving asthma. There are two kinds of raw ephedra, 4.5 ~ 9g raw ephedra and 6 ~ 9g roasted ephedra. Clinical experience shows that children's asthma condition changes rapidly and their physique is often weak. "A teacher without food is suitable for a quick victory." We should seize every opportunity to reuse and use ephedra according to the needs of the illness, so as to spread the lung and relieve asthma. For some intractable diseases. The dosage can be gradually increased on the basis of curative effect. ② This prescription takes six herbs in Xiaoqinglong Decoction, namely Herba Ephedrae, Rhizoma Zingiberis, Asari, Fructus Schisandrae, Rhizoma Pinelliae and Radix Glycyrrhizae, which have the effects of warming lung, relieving cough, relieving hangover and stopping vomiting, and regulating the middle energizer. Guizhi and Paeonia lactiflora can be used for patients with fever, while Gui Liu Shao can be used for patients with hyperhidrosis. ③ Sanzi Yangqin Decoction is a good way to treat phlegm turbidity. Perilla frutescens, Semen Sinapis Albae and Radish have the effects of reducing qi and resolving phlegm, and can enhance the antiasthmatic and expectorant effects of Xiaoqinglong Decoction. Among them, radish seeds have a slight taste, which can eliminate qi and break qi, but it is ineffective for those with obvious qi deficiency. ④ Asthma pill is often used to treat cold asthma. Asthma pill, also known as Hanchuan pill, consists of arsenic, fermented soybean, dried alum and flour. The arsenic content in each capsule is 0.00 16g ~ 0.002g, and it is generally 1 ~ 2 times, with 2 ~ 3 capsules each time. Increase or decrease according to illness and age. In the acute attack period, asthma pill and the above prescription have good curative effect. Some children don't have hair during the day, but they will gasp in the middle of the night. Such patients often take it once before going to bed. Sometimes, when climate changes or children have symptoms such as chest tightness and poor breathing, asthma pills can be swallowed immediately, and sometimes asthma attacks can be prevented or alleviated.

Cases of cold asthma complicated with yang deficiency are mostly due to yang deficiency, or the development of the disease, and yang deficiency of lung and kidney affects the absorption of kidney gas. Common in recurrent stubborn cases. Clinically, chills, cold limbs and mental weakness are common. Open your mouth, lift your shoulders, sit up and breathe. The urine is long and clear, with a pale or bluish-gray complexion, purple lips, sweaty head, light and fat tongue and thin and weak pulse. Often, 9g local prescription black tin (decocted) is added to the above-mentioned cold asthma prescription to absorb kidney qi, and 9g cooked aconite root (decocted first) is used to tonify fire and replenish energy, so as to strengthen its function of warming kidney and absorbing qi. In addition to black lead and sulfur, there are also aconite, cinnamon and fenugreek isothermal kidney drugs *** 12. According to the prescription, it can cure the critical diseases such as sudden loss of true yang, upwelling of yin fire, coma due to phlegm and asthma, and chills in limbs. However, according to the analysis, the content of aconite is extremely low, such as taking 9g of aconite every day, accounting for only 0.6g The aconite in the prescription is also an important drug for warming yang and treating asthma. It is compatible with the methods of warming lung, resolving phlegm, relieving cough and asthma, and is often effective when taken with traditional Chinese medicine. Aconitum carmichaeli has a pungent smell, warm nature, warm kidney yang and heavy cold. In the prescription, cooked aconite is used, which is first decocted 15 ~ 20 minutes. The general dose is about 9g, but it can be increased in some cases. Clinically, in order to make aconite specifically warm the kidney, keel, magnet and other yang-latent drugs are often used in combination. In recent years, through the summary of cases, it is recognized that for those with cold asthma and yang deficiency, the combination of aconite and prescription Heixidan has stronger ability to warm yang and absorb qi, and often receives obvious antiasthmatic effect.

People with cold asthma and yang deficiency generally have different degrees of sweating, and ephedra is a drug for sweating and relieving exterior syndrome. Does it cause yang to be discharged with sweat after use, making it more debilitating? In the case of sweating, ephedra is widely used because its antiasthmatic effect is more obvious than other traditional Chinese medicines. Practice has proved that there is no sweating out of yang after taking this medicine, and most patients gradually sweat out after asthma is relieved. Because sweating is the cause of asthma, asthma will stop. Ephedra is used to treat asthma here. Ephedra is not used with Ramulus Cinnamomi, but it has little sweating effect. In fact, it is used together with black tin and aconite to strengthen the functions of consolidating the essence, nourishing kidney qi and preventing collapse. This is conceived in the spirit of "treating diseases for the root" advocated by Chinese medicine.

Heat asthma is mostly caused by phlegm-heat accumulating in the lungs. However, many cases have evolved from cold asthma, and the cold pathogen has been stagnant for a long time and turned into heat or partially turned into heat, thus showing a mixture of cold and heat. Heat asthma can be accompanied by internal heat due to yin deficiency and yang deficiency. The clinical manifestations of dyspnea due to heat include chest tightness, sudden cough, thick and yellow phlegm, difficult discharge, dry mouth and bitter taste, preference for drinking water or cold water, excessive sweating due to body heat, red and greasy tongue coating, general coating and slippery pulse. Maxingshi dry soup is commonly used, and drugs such as Danxing, Fructus Trichosanthis, Scutellariae Radix and Houttuynia Cordata can be added. The dosage of gypsum is not less than 30g, so it should be wrapped in cloth and fried first, otherwise the soup will be greasy and unpalatable. If the fever is mild, you can also use Dingchuan decoction. The prescription consists of Herba Ephedrae, Semen Armeniacae Amarum, Flos Farfarae, Jiang Banxia, Perillae, Cortex Mori, Scutellariae Radix, Glycyrrhrizae Radix, Ginkgo biloba, etc. In fact, the compatibility of this prescription is both warm and cold, and it is also suitable for asthma, fever or mixed cold and heat, so it is widely used in clinic. The above-mentioned symptoms of heat asthma include upset, hot hands and feet, red tongue with little body fluid, thin fur, falling flowers and thready pulse. Phlegm heat accumulates in the lungs, and Yin points are also injured. Scutellaria baicalensis Georgi, Fructus Trichosanthis and Bulbus Fritillariae Cirrhosae can be added to Maxingshi dry soup, and then ginseng, Ophiopogon japonicus and Polygonatum odoratum can be added to benefit yin and promote fluid production. Some people think that ephedra is pungent and warm, and it is not used for fear of hurting yin. But I think ephedra is an important antiasthmatic drug in Chinese medicine. As long as the compatibility is proper, there is no harm in using it. Again, the symptoms of heat asthma are pallor, weakness of limbs and tepid hands and feet. If the pulse is thready, the syndrome differentiation is phlegm-heat accumulating in the lung, kidney-yang deficiency in the lower part, and kidney-qi deficiency. In this case, it is not necessary to stick to the prescription, and the method of clearing lung and lowering kidney can be adopted. For example, Ma Xing Shi Gan Tang is used to disperse lung and clear heat, and Radix Aconiti Lateralis Preparata and local prescription Heixidan are added to warm the kidney and absorb qi, giving consideration to both upper and lower levels, so as to achieve the effect of warming and cooling.

Because asthma attacks at night, during the day, day and night or in the early hours of the morning, the medication time should also be determined according to the specific circumstances of the attack. Continue to send the author all day, you can fry two stickers together, and take it 4-5 times a night; Sent at midnight, half taken during the day and the other half taken before going to bed; If it happens during the day, you can use 1 ointment to decoct the juice for the first two times. If it is delivered in the morning, fry it overnight, eat the first juice at 3 ~ 4 in the morning and eat the second juice during the day.

prejudice

Traditional Chinese medicine believes that yellow color is mostly related to heat, such as "Huang Chi is heat" in Ling Shu, "Spleen heat is yellow" in Su Wen Wei Lun, and "Spleen color must be yellow, and blood stasis heat is abundant" in Synopsis of Golden Chamber. The yellow color seen in clinical treatment often belongs to yang syndrome and heat syndrome. Xu believes that "yellow" is related to "heat" to a certain extent, and its clinical guiding significance is beyond reproach. However, if you see "yellow" in some diseases, you must distinguish it according to the specific situation, and you can't treat it as "heat syndrome" simply by "yellow".

Jaundice invades the blood because bile does not follow the normal route and overflows the body surface. The patient's stool is gray, and his eyes, skin, tongue coating and urine are yellow. Clinical treatment is generally dominated by damp heat. I realized that patients with jaundice have yellow eyes and bodies, and their yellowing is only a symptom. The clinical manifestations of most patients with jaundice are fatigue, loss of appetite, general aversion, thirst, heavy or thin pulse, and a few patients have fever. Its pathogenesis is closely related to dampness, which is not uncommon in clinic. For these diseases, I emphasize the treatment with the agent of warming dryness and removing dampness, and the effect is faster. Grasping the symptoms of cold and dampness, such as mental fatigue, weakness, thirst, thin or heavy pulse, we can apply warm dryness to remove dampness. If we stick to the theory of "yellow is a hot image" and "jaundice is damp heat" in general syndrome differentiation, we should treat heat-clearing exclusively and avoid using warm and dry products, which will often prolong the pathogenesis and will not heal every time.

The main prescription used is Fei's Yichunhe Decoction (Herba Artemisiae Scopariae, Rhizoma Corydalis, Atractylodis Macrocephalae, Cortex Magnolia Officinalis, Fructus Amomi, Pericarpium Citri Tangerinae, Radix Aucklandiae, Fructus Gardeniae, Poria, Semen Plantaginis, Rhizoma Dioscoreae Septemlobae, Radix Angelicae Sinensis, and raw and cooked semen oryzae). Atractylodes macrocephala and Magnolia Officinalis are commonly used for eliminating dampness and strengthening the spleen, Amomum villosum, Pericarpium Citri Tangerinae, Radix Aucklandiae and rice buds are commonly used for regulating qi and regulating middle energizer, Herba Artemisiae Scopariae, Poria, Semen Plantaginis, Rhizoma Dioscoreae Septemlobae and Fructus Beizi are commonly used for diuresis and dampness, Gardenia is commonly used for clearing away heat and toxic materials, and Angelica sinensis enters liver blood. For those with obvious signs of cold and dampness, the effect is more obvious by adding aconite to warm and disperse cold and dampness; For patients with constipation, it can increase the laxative effect. This recipe has the effects of eliminating dampness, promoting diuresis and regulating qi. Generally, jaundice can be eliminated after taking 10. It must be pointed out that after the application of this prescription, patients often change from not loving drinking water to drinking more water, which is not a bad thing, and there is no need to worry about their yin injury, because patients' drinking water can also increase their urine volume, which is conducive to the regression of jaundice.

Empirical prescription

Xinjia Pulsatilla decoction

Consists of Pulsatilla root 9g, Coptidis Rhizoma 3g, Cortex Phellodendri 6g, Cortex Fraxini 12g, Radix et Rhizoma Rhei 4.5g (below), Portulaca oleracea 18g and Glycyrrhrizae Radix 3g.

Indications Acute bacillary dysentery.

Add and subtract 1. Fever: Radix Puerariae 9g and Radix Scutellariae 9g are added. 2. Severe abdominal pain: add 9g of Radix Aucklandiae and 9g of Radix Paeoniae Alba. 3. Red and white stool: add 9g of Angelica sinensis and 9g of Paeonia lactiflora. 4. Pan-evil: Add 3g to 6g of dried ginger. 5. White and greasy tongue coating: add 9g of Rhizoma Atractylodis and 9g of Magnolia officinalis. 6. Thick and greasy tongue coating: add 9 grams of hawthorn, 9 grams of betel nut and 9 grams of bitter orange. 7. Shenwei, limbs are not warm: add 9g of aconite and 4.5g of cassia twig. 8. Shock: First, use 4.5-9g of ginseng (first fried), 5-9g of cooked aconite (first fried), 3-6g of dried ginger and 6g of licorice. Use the basic prescription after Hugh's remission.

Asthma prescription

It consists of 9 grams of ephedra, 3 grams of asarum, 4.5 grams of dried ginger, 4.5 grams of licorice, 4.5 grams of Schisandra chinensis and 9 grams of Pinellia ternata.

Indications: bronchial asthma (cold asthma)

Add and subtract 1. Apparent symptoms or fever: add 9g of Ramulus Cinnamomi and 9g of Radix Paeoniae Alba. 2. The exterior syndrome is not obvious and sweating is excessive: add 9g of Radix Paeoniae Alba or 9g of Radix Astragali. 3. Too much phlegm: add 9g of white mustard seed and 9g of perilla. 4. Symptoms of yang deficiency, such as chills, cold limbs, long urine, pale face, etc. Add 9 ~ 15g cooked aconite (fry for half an hour first). If it can't be relieved by using the upper part, 6 ~ 9g of local prescription black tin can be added (swallowed or decocted twice). 5. sore throat: dried ginger, 9g of platycodon grandiflorum, 6 g.6. Cold and heat inclusions such as yellow phlegm, dry mouth and drinking: dried ginger, Pinellia ternata, gypsum (fried first) 30g, Scutellaria baicalensis 9g. 7. Patients with insufficient vaginal fluid such as less red tongue and fur: 9g of Radix Rehmanniae and 9g of Radix Glehniae. 8. Persistent case: 9g pepper. 9. Nasal congestion and runny nose: add 9g of Xanthium sibiricum. According to the child's dose.