Whether a medical theory is scientific or not depends mainly on whether its theory can correctly guide clinical practice and whether its curative effect is exact. The scientific nature of classical prescriptions and treatise on febrile diseases is recognized by the world. It should be pointed out that prescription and syndrome are the key to determine the curative effect. Some people suspect that Chinese medicine is unscientific, and the prescriptions of classical prescriptions are only empirical and unscientific. The main reason is the lack of understanding of the history of traditional Chinese medicine, especially the development of classical prescriptions, and the lack of understanding of classical prescriptions theory. First of all, we should interpret the scientific connotation of the classics.
1. Eight Principles of Prescription and Syndrome: Prescription and Syndrome embodies eight principles of syndrome differentiation. As can be seen from the classic, Tang Ye and typhoid fever, each syndrome of the classic prescription is different from the general prescription, which not only represents the composition of the prescription, but also includes the indications of the prescription. What is more noteworthy is that the function and performance of the prescription are marked by "cold and warm in herbal stones", that is, the syndrome characteristics are marked by "shallow and deep disease detection" based on the eight classes, which is also based on the eight classes. Through repeated clinical observation, the doctors recorded the effective prescriptions and syndromes. Each prescription is a summary of experience that has been repeatedly verified by several generations and dozens of generations, and its scientific nature has been tested by history. It can be seen that the prescription is a prescription that has been tested by history, and the certificate is a certificate that has been verified by history. There are both prescriptions and drugs in the prescription, which is both reasonable and law-abiding. Therefore, Ji Yaodong said in the preface to Ji Fang: "Fu Zhongjing is the prescription and the law, and the prescription and the certificate are relative." Regarding the concept of "law", Mr. Hu Xishu explained: "The so-called law refers to the differentiation of yin and yang, the understanding of six meridians, the differentiation of syndromes and the appropriateness of sanctions." It can be seen that the correspondence between prescription and syndrome is a unique theory with profound scientific connotation. The principle of prescription and syndrome is explained here, including prescription and syndrome correspondence, prescription and syndrome correspondence, and prescription and syndrome relativity. By the way, I saw Memory Dongdong put forward the opposite certificate in Ji Fang, because Memory Dongdong first put forward the opposite certificate. It is also said that Sun Simiao put it forward first ... which is also caused by unclear understanding of the opponent's cards. We know that the origin of prescription cards is the Shennong era. Naturally, the relative prescription card began in the Shennong era. At the same time, it should be noted that some people's so-called Chinese medicine theory must cover the five elements, six qi, meridians, viscera and so on. "Typhoid fever" and Japanese prescriptions correspond to nothing, because they call it "whatever"; Or if you see that Treatise on Febrile Diseases has six classics, you think that its theory comes from Neijing ... This is mainly because you don't understand that there are different academic factions of Chinese medicine, and the classic ancestors are eight classes, while the interpretation of Treatise on Febrile Diseases by the five elements and six qi is exactly what Yang said, "It's not a yin, it's not a family, but the East also has a genealogy." The main reason for misunderstanding is the other party's card.
2. Prescription syndrome is a hint of syndrome differentiation: the main energy of studying typhoid fever is to master each prescription syndrome, which has been discussed in many classics in later generations. For example, Chen Xiuyuan pointed out in Changsha Square Width: "Generally, we should start with the prescription of treating saints. If we have this disease, we must use this prescription ... Guizhi syndrome, Mahuang syndrome, Chaihu syndrome and Chengqi syndrome. Therefore, the differentiation of prescription and syndrome is the continuation of the differentiation of six meridians and eight outlines, and it is a more specific and further differentiation. The main key to the curative effect of traditional Chinese medicine is whether the syndrome differentiation is correct. The correspondence between prescriptions and syndromes is the premise of clinical treatment, so Mr. Hu Xishu, a master of classical prescriptions, called it the highest realm and the most precise syndrome differentiation, and pointed out that the secret recipe handed down from family also belongs to syndrome differentiation, saying: "As we all know, people in rural areas often use the secret recipe at home to treat a certain disease. Although they know nothing about syndrome differentiation and treatment, they do have a good understanding of the application of the secret recipe (mastering the indications). However, readers must pay attention to the fact that any prescription, whether the user knows it or not, belongs to the details of six meridians and eight categories if the indications (prescription syndrome) are analyzed, which can be asserted. 」
The scientific and academic value of syndrome differentiation is not only confirmed by those who follow the theory of syndrome differentiation, but also falsified by those who do not follow its theory. For example, Japan's "side effects of Xiaochaihu decoction to death" shocked Japan and was intriguing. A researcher in China, Yukihiro Kurita, pointed out: "Let patients with chronic hepatitis and liver cirrhosis take Xiaochaihu decoction for a long time, interstitial pneumonia and death began with a paper published by a doctor who is chasing fame and fortune ... The root cause of the research failure is that the prescription results are determined only by the name of the disease of western medicine without learning the theory of traditional Chinese medicine, and the side effects of Xiaochaihu decoction are accused too much. It is emphasized that "letting patients without Xiaochaihu decoction take Xiaochaihu decoction for a long time" is the root cause of interstitial pneumonia. Treatise on Febrile Diseases is a syndrome differentiation and treatment system based on classic prescriptions of traditional Chinese medicine, with more emphasis on syndrome differentiation and treatment. The book is based on syndrome differentiation. Attachment 3 17: "all diseases correspond to prescriptions, but only take them." "This is the annotation of later generations, and it is the cognition of each other's syndromes. In the discussion, the usage of Xiaochaihu decoction was clearly put forward: blood deficiency, exhaustion of qi, phlegm opening, evil entering … cold and heat, sometimes stopping cooking … Xiaochaihu decoction is the main one. After taking Chaihu decoction, those who are thirsty belong to Yangming and rule by law. It has been clearly pointed out that Xiaochaihu decoction cannot be taken without its prescription. The main cause of death from side effects of Xiaochaihu decoction is that the prescription and syndrome are not divided. The lesson of blood shows the importance and scientificity of syndrome differentiation and treatment.
The correspondence between prescription and card is not right.
The correspondence between prescription and syndrome is not simply a matter of sitting in the right position. Some people say that "the correspondence between prescription and syndrome is the right place", that is, it is only based on the original text of Treatise on Febrile Diseases, which is caused by not reading or understanding the essence of Treatise on Febrile Diseases. In fact, 398 prescriptions in Treatise on Febrile Diseases, 1 12 prescriptions and about 260 prescriptions in Synopsis of the Golden Chamber are all talking about the corresponding ways of prescriptions and syndromes. It includes not only the correspondence between prescription and syndrome, but also the correspondence between dosage and condition, and also the correspondence between decoction and condition.
Correspondence between medicine and syndrome: Zhongjing's book is characterized by prescription and syndrome. For example, there are 36 prescriptions based on Guizhi decoction and 40 prescriptions based on Guizhi decoction. There is no need to add or subtract Guizhi decoction in the book, but each prescription has its own name, which shows that the prescription and syndrome are corresponding.
Dose corresponds to disease and syndrome: to understand the correspondence between prescription and syndrome, we should also realize that not only the drug taste corresponds to symptoms, but also the dose corresponds to disease and syndrome strictly. A recently cured arthralgia is worth pondering: patient Liu, male, 65 years old, 201013. First diagnosis: joint pain in both knees, heavy left knee, no four adverse reactions, neutral mouth, no sweat, tinnitus for many years, two stools every day, greasy pulse with fur. The syndrome differentiation of the six meridians is the combination of shaoyin and Taiyin, and the syndrome differentiation is Guizhi plus Lingshu plus decoction. The first visit to Sichuan and Wu 10g, and the second visit to Sichuan and Wu 15g, but they remained unchanged for one week. The third diagnosis of Radix Aconiti 18g and the fourth diagnosis of Radix Aconiti-25g showed no obvious change. When 30g of Radix Aconiti was used for the fifth diagnosis, the joint pain completely disappeared.
Similar treatment methods are common in clinic, and all previous generations have profound experience, which is also elaborated in Treatise on Febrile Diseases. For example, Sini Decoction and Tongmai Sini Decoction have the same ingredients, but they are called two different prescriptions, because their indications are different (see Article 225: "The pulse floats late, the exterior is hot and cold, which is beneficial to clearing the valley, and Sini Decoction is the main one". Medicine: licorice. (Baked), two halves of dried ginger, and aconite (raw, peeled, and broken) Article 3 17: "Shaoyin disease, clearing the bottom of the valley, cold inside and heat outside, limb paralysis, slightly heartbroken pulse, body does not hate cold, and people's face is red; Or abdominal pain, retching, sore throat, or inability to stop the pulse, Tongmai Sini Decoction is the main indication. " Medication: Glycyrrhiza uralensis Fisch (fried), 22 liang, dried ginger, 32 liang, strong man can be 42 liang, aconite (raw, peeled and broken into eight pieces), the largest one). Sini decoction and Tongmai Sini decoction have the same composition, but Tongmai Sini decoction is more serious than Sini decoction, that is, it is more deficient in cold, so the dosage of aconite and dried ginger is large.
Decocting method corresponds to illness: There are many explanations of decocting method in Treatise on Febrile Diseases, which embodies the rich scientific connotation of prescription and syndrome. For example, the decoction method of Guizhi decoction is: "Take seven liters of water, boil three liters with low heat, and take one liter at the appropriate temperature. After taking it for a while, I have heated more than one liter of porridge to help the medicine. It's better to heat up for a while and feel sweaty all over. Don't let it flow like water, and the disease won't go away. If you get sick after eating, you don't have to do it all. If you don't sweat, bring more clothes, according to the former method; I didn't sweat anymore, but took a small dose of promotion and made three copies in half a day. If you are seriously ill, eat one day and one night, observe once a week, and take one dose. If you are still sick, you should eat more. If you can't sweat, take two or three doses. " What does such a detailed decocting method tell us? Obviously, the prescriptions and syndromes of Guizhi decoction are differentiated according to symptoms in clinic, but the appropriate dosage must be just right, and it cannot be cured by eating more or less. There are many expositions in Treatise on Febrile Diseases, such as 20 articles: "Sun disease, sweating and leakage" and 25 articles: "Sweating after taking Guizhi decoction"; Article 26: "After taking Guizhi decoction, you will be thirsty after sweating." . What is more noteworthy is that the prescriptions under discussion, such as Guizhi Jia Gui Decoction, Guizhi Qushaoyao Decoction, Guizhi Jiashaoyao Decoction, Guizhi Mahuang, all correspond to the prescriptions and syndromes. The correspondence between prescription and syndrome not only refers to the composition of prescription, but also emphasizes the correspondence between dose and condition.
Because the prescriptions and syndromes of classic prescriptions come from clinical practice, both classic prescriptions and contemporary prescriptions pay attention to the application and research of classic prescriptions, and their understanding is deepening, and they gradually realize the scientific nature of prescriptions and syndromes. For example, Shen Ziyin thinks: "In a broad sense, decoction syndrome differentiation also belongs to the category of syndrome differentiation, so it is called prescription and drug syndrome differentiation ... It is the meaning of prescription syndrome differentiation to adjust the syndrome of pathological system and seek the integration of prescription efficacy value ... in a certain sense, it can summarize all the contents of syndrome differentiation and treatment. It is clearly pointed out here that the treatment based on syndrome differentiation is not simply to sit in the right place, but to carry out more detailed, specific and comprehensive treatment on the basis of syndrome differentiation. Many people have realized the importance of syndrome differentiation and treatment. The treatment of traditional Chinese medicine depends not on taste and dosage, but on the adaptation and correspondence of prescription and syndrome. He Tianlin said: "In clinical prescriptions, it is generally believed that the treatment of" syndrome "is more effective, but it is not always the case. The author is a girl from Ceng Zhi, suffering from a cold, fever, asthma, cough, floating pulse and white fur. After adding two doses of almonds to Xiaoqinglong decoction for the first time, the fever was flat and the cough was relieved, but asthma was still working and urine was less. The second diagnosis showed that the original prescription was effective, but after adding poria cocos to promote diuresis, the condition did not decrease after taking it, but the urine was still less. Third diagnosis, go to the front and continue to take ephedra, relieve asthma and cough, and urinate smoothly; Yue Meizhong treated women with chronic nephritis, hematuria, frequent micturition and low back pain with three doses of Zhu Ling decoction. A few months later, the disease recurred. Because of its deficiency, Zhu Ling Tangyuan recipe was reused, because yam was blindly added, and the condition was seriously reversed. After the disease recurred, it increased the blindness of Lygodium japonicum, but it had no effect, so it was treated with the original prescription of Zhu Ling Decoction. Get more inspiration here, as the preface of Shen Kuo's Good Prescription says: The single use of drugs is easy to know, but the reuse is difficult to know. In the world, people who use one medicine to treat prescriptions can't do it, but also benefit from many medicines. I don't know that drugs have messengers and opposites, but also have the same and changeable nature. It is known that there are common customs and impermanence laws. On the basis of syndrome differentiation and treatment, it is better to stick to one method than to keep one. "That is to say, the syndrome differentiation of prescription and syndrome must be accurate, and the addition and subtraction of drugs should also be based on syndrome, instead of treating diseases with symptoms like Guizhi Jia Gui Decoction.
Our country has always attached importance to the study of prescriptions and their indications. Later prescriptions, such as Qian Jin Fang Yao, He Ji Fang and Tai Ping Sheng Hui Fang, are all syndromes, and their contents are mainly about prescriptions and syndromes. Typhoid fever is widely spread at home and abroad, especially in Japanese traditional Chinese medicine, because it not only has the experience of prescription, but also has a complete theoretical system. During the Meiji Restoration in Japan, the decision-makers wanted to abolish Chinese medicine. At that time, Mr. Akihito, a friend of western medicine, was deeply saddened to see his daughter die because western medicine failed to treat diarrhea. He dared to take the world by storm and turned to study the classic prescriptions (reading "Iron Vertebra in the Medical Field" for the first time), and his clinical application was like a drum. Combined with my own clinical experience, I wrote Huang Hanfang, and some people discussed the corresponding relationship between prescription and syndrome from clinical and laboratory aspects. For example, through the study of Wuling powder syndrome, Ito Kaji thinks that the pathological state of Wuling powder syndrome is the decrease of osmotic pressure adjustment point, and its diuretic effect is to restore normal water-liquid metabolism by adjusting the adjustment point. Normal people and animals take Wuling powder, but there is no diuretic effect. If people and animals sweat a lot, which leads to the syndrome of Wuling powder after body fluid injury and superficial deficiency, taking Wuling powder again will see obvious diuretic effect. Therefore, it is considered that Wuling powder and Wuling powder prescription syndrome have their particularity.