Xuan Guowei Master of Traditional Chinese Medicine (1937.11-)
Xuan Guowei, the second master of traditional Chinese medicine, chief physician of Guangdong Provincial Hospital of Traditional Chinese Medicine. Chief Professor of Guangzhou University of Chinese Medicine, Doctoral Supervisor. He specializes in the treatment of alopecia diseases, acne, urticaria, lupus erythematosus and other connective tissue skin diseases and other difficult skin diseases. The experience of the elderly in the treatment of skin diseases is summarized as follows to feed colleagues.
• "Poisonous evil" refers to the evil qi that has a strong pathogenic effect and is deeply poisonous to the human body, which is a special cause different from the six obscenities, which is often formed because of the accumulation of evil qi such as six obscenities, seven emotions, phlegm drinking, and blood stasis, and it is long and stubborn, and the thick accumulation exceeds the normal.
• In the identification and treatment of difficult skin diseases, in addition to removing common pathogenic factors, attaching importance to the pathogenesis of poison and evil from the pathogenesis mechanism, and attaching importance to detoxification and detoxification in treatment, which is the key to carrying forward the traditional theory of etiology in Chinese medicine, and it is also the key to improving the efficacy.
• "Skin Detoxification Soup" is composed of Wumei, Curcuma, Soil Poria, Comfrey, Su Ye, Windproof, Xu Changqing and Licorice, the whole key is to remove the poison of external offenders and the poison of the inner, according to the severity of various poisons and evils can be added or subtracted according to the severity of various poisons.
"Poison" release
The original meaning of "poison" refers to "poisonous weed", and the "Explanation of Words" Cloud: "Poison, thick also, harmful grass, often born." ”
The meaning of "poison" in Chinese medicine is extremely broad, and can be summarized in four aspects: First, it refers to drugs or medicinal properties, such as "Zhou Li Tianguan": "The government decree of the physician in charge of the doctor, the gathering of poison to work together." "Second, it refers to the diagnosis, which is mostly seen in surgical diseases, such as erysipelas, boils, poisoning, etc. Third, it refers to treatment, such as extraction, detoxification, detoxification and other methods. Fourth, it refers to the cause of the disease, such as the "Su Qing Qi Tong Tian": "Although there is a strong wind and harsh poison, the Buddha can harm." It puts forward the possibility of "external poison" causing disease; another example is the "Su Qing Wu Chang Zheng Da Theory": "The young sun is in the spring, and the cold poison does not grow... Yang Ming is in the spring, wet poison is not born... The sun is in the spring, the heat poison is not born... Yin is in the spring, detoxification is not born... Less yin in the spring, cold poison is not born... Too yin in the spring, dry poison is not born. He pointed out the method of generating and restraining the "endogenous poison"; and then wang Bing's note in the "Su Qing And Five Permanent Political Treatise": "Those who are poisonous are also the acts of the five elements of the standard of violent qi." It shows that no matter whether the evil qi is excessive or the accumulation is long-lasting, it can turn into "poison."
It can be seen from the above that the concept of "poison and evil" in the Neijing is based on its original meaning, which refers to the evil qi that has a strong pathogenic effect and is deeply poisonous to the human body, which is a special cause different from the six fornications. In the "Treatise on Typhoid Fever and Miscellaneous Diseases", there are records of "yin poison" and "yang poison" as diseases, such as the "Golden Treasure Key, Lily Fox Confusion Disease Evidence": "Yang poison is a disease, the face is red spots like brocade, sore throat, saliva pus blood." "Yin poison is a disease, the face is blue, the body pain is like a cane, and the throat is sore." As for the "Theory of the Origin of Diseases", there are also records about "poisoning", "medicinal poisoning", "diet poisoning", "snake and beast venom" and "miscellaneous poisonous diseases", which not only enriches the connotation of causing viral evil, but also further develops the relevant etiological theories. In theology of thermophilia, the theory of the pathogenesis of thermophilia has dominated. In modern times, many Traditional Chinese medicine practitioners have also continuously enriched and exerted the theory of poison and evil, and it is generally believed that "poison" is mostly formed due to the accumulation of evil qi (including six adultery, seven emotions, phlegm drinking, blood stasis, etc.) and cannot be evacuated, and it is stubborn for a long time and the accumulation exceeds the normal.
In addition, with the development of modern social science and technology and the changes in the living environment of human beings, there have been many new diseases and toxic factors that were not known in the past, such as industrial exhaust gases, automobile exhaust, pesticides, fertilizers and other toxic gases, compounds released from construction or decoration materials, toxic side effects of drugs, pollution of water sources by industrial wastewater discharge, auxins in meat, poultry, eggs, food, fattening agents, preservatives, various additives, etc., as well as noise, communications, telephones, electromagnetic waves of computers, televisions, ultra-high frequencies interference with the human body , all belong to the category of "poison".
"Poison" and skin diseases
In the theoretical system of Chinese medicine, "poison" and evil are divided into internal and external. Among them, "external poison" refers to a type of disease and evil that comes from the outside, invades the body and causes poisoning; "internal poison" refers to the poison that arises from the inside, which is due to the dysfunction of the internal organs and the abnormal operation of qi and blood, so that the physiological products or pathological products in the body cannot be discharged in time, and the metamorphosis is accumulated in the body, such as fecal poison, urine poison, phlegm poison, stasis, etc. Internal toxicity is mostly produced in the course of the disease, which can not only aggravate the original disease, but also produce new medical evidence, marking the disease into a more complex stage.
As an independent etiology, "poison" has its own special pathogenic characteristics, such as fulminant, severe, critical, infectious, refractory, stubborn, etc. The unhealthy qi of the four times is often a prerequisite for the emergence of poison and evil, so it cannot be separated from the six adulteress, and the poisonous evil also has properties similar to the six obscenities, and is often mixed with the six obscenities to cause diseases, so it can be clinically called "wind poison", "wet poison", "warm poison" and so on.
Wind, humidity, heat evil is the most common cause of skin diseases, these evil qi invade the human body, if not dissolved in time, and the yang hot physique is in harmony, it is very easy to turn into fire and contain poison. If the evil qi does not occur in the body, and the warm qi of spring and summer is felt, then the poison comes out from the inside, the surface is hot, and the fumigation of the body skin becomes a disease. If the internal injury of the seven emotions, the five ambitions of the fire, can not be vented, contain poison and heat, can also be a skin disease.
There are 929 literature related to the "poison" of traditional Chinese medicine in recent years, involving 189 kinds of diseases related to "poison", most of which are found in complex and refractory diseases, of which the literature related to the "poison" of skin diseases is second only to the diseases of the internal medicine system.
There are two main aspects to all diseases caused by "poison": one is to feel from the outside, such as being directly invaded by warm poison and evil, or indirectly transformed by wind, cold, wet, dry and other evils; the other is that the body is yang or yin, and the seven emotions are out of order, and the excess of qi is fire, and fire is born from within, and it becomes poisonous.
In addition to the causes and mechanisms of six obscenities, seven emotions, trauma, endowments, etc., Elder Xuan believes that the incidence and extension of many difficult skin diseases are often closely related to the "poisonous evil".
In the etiology of difficult skin diseases, often due to the repeated incurable diseases, resulting in wind, humidity, heat and evil glue is difficult to solve, can be poisoned over time, can not be understood, internal injuries to the internal organs, hindering qi and blood, consuming fluid. The longer the course of the disease, the deeper the poison, and the more attention needs to be paid to the opportunity of "poison" evil to cause disease.
For example, systemic lupus erythematosus, many diseases are changeable, the disease mechanism is complex, but in the virtual reality, the kidney yin deficiency and stasis connotation is the main line through the course of the disease, from the most common clinical signs of the disease "red spots on the face, body heat undulating, hair loss, reddening of the face, waist and knee soreness, labor is aggravated, dizziness, women's menstrual irregularities, menstrual purple and dark, or abdominal pain, even amenorrhea, repeated mouth and tongue sores, skin petechiae, ecchymosis, tongue redness or petechiae, moss yellow, fine pulses" and other symptoms, kidney yin, detoxification, detoxification, Treating both the symptoms and the root causes is a good strategy for the opportunity of the disease.
In addition, a variety of difficult skin diseases are particularly closely related to intolerance. Air, water, daylight, animals, food, drugs, metals, etc. are environmental, biological and chemical substances closely related to humans, and the average person who is exposed to the above substances usually does not produce a pathogenic reaction, but many skin disease patients can often produce pathogenic effects or aggravate the disease after contact. This kind of high sensitivity reaction to difficult skin diseases due to inlerance is very consistent with the "Ciyuan" that "the ability of things to harm others is known as poison", especially highlighting the important position of "poison" in the etiology of difficult skin diseases.
Based on this, Elder Xuan believes that in the identification and treatment of difficult skin diseases, in addition to removing common causative factors, attaching importance to the pathogenesis of poison and evil from the pathogenesis, and attaching importance to detoxification and detoxification in treatment, which is not only the key to carrying forward the traditional theory of etiology in Chinese medicine, but also the key to improving the efficacy.
Skin detoxification prescription
The treatment of "poisonous" evil diseases is to directly relieve them with drugs aimed at poisonous evils, including using methods such as clearing, eliminating, sweating, lowering, and vomiting, so that poisonous evils are excreted from the body from sweat, urine, and digestive tract; the second is to enhance and regulate the body's own anti-poison ability to resist the damage of poisons and evils to the human body, that is, to help correct and dispel evils. In the detoxification method, there are clear, clear, clear, clear, clear, cool, clear and open and other treatment methods.
Successive generations of physicians have accumulated rich experience in the use of "poisonous evil" disease evidence and antidotes. "Golden Essentials" to cure yin and yang poison, with cohosh turtle soup, of which cohosh, male yellow for detoxification, poison attack with poison. "Outer Terrace Secret Essentials" contains Huanglian detoxification soup, "Epidemic Chapter" contains Qing plague and poison drink, "Medical Sect Golden Book" contains five-flavor disinfectant drink, etc., all of which are commonly used detoxification recipes in ancient and modern times, and Chinese medicine dermatology is also often selected, which can be used properly to treat serious diseases and turn the tide.
However, the above prescriptions are either cold and heavy or contain toxic drugs, generally only for short-term emergency use, long-term use may be risk of stomach failure or poisoning. Therefore, for chronic and difficult skin diseases that require a longer course of treatment, there is still a need for another remedy.
Zedoary turmeric
After clinical practice, Xuan Lao found that there are various problems of "poisonous evil" in refractory skin diseases. Such as psoriasis, refractory eczema, chronic urticaria, etc., often with blood fever poison, cold and wet poison, fish and shrimp poison, food poison to wine poison, medicinal poison, wind poison, etc., on the basis of dialectical construction of a basic formula, making it more widely applicable to the treatment of refractory skin diseases.
In repeated practice, Xuan Lao named the recipe "skin detoxification soup": it is composed of wumei, curcuma, soil poria, comfrey, su leaves, windproof, Xu Changqing and licorice. Fang took Wumei Zi Yin detoxification, Curcumin removal and detoxification, soil poria li wet detoxification, comfrey cool blood dialysis detoxification, Su ye detoxification of fish and shrimp poison, wind and wind detoxification, Xu Changqing tongluo detoxification, licorice good antidote poison. The key to the whole party is detoxification, to remove the poison of external offenders and the poison of the inner. According to the evidence, drugs can be added or subtracted according to the severity of various poisons and evils, such as Zhimu with Wumei can strengthen the power of nourishing yin and detoxification; Shi Shangbai and Jiujie tea with curcuma can strengthen the power of blood activation and detoxification; Sichuan ginseng, white fresh skin, Mianyin Chen with soil poria can strengthen the power of dampness and detoxification; raw land, flea, half lotus, houttuynia cordata with comfrey can strengthen the power of detoxification of hot and cool blood; dandelion, kudzu flowers and su leaves can strengthen the power of detoxification of accumulated wine and fish and shrimp poison; bitter ginseng, ground skin, white tribulus terrestris with windproof can strengthen the power of wind and detoxification; angelica, Sichuan, and dilonggan, Whole worm with Xu Changqing and other can strengthen the power of blood circulation and detoxification, and the clinic can be added or subtracted with the symptoms according to the changes in the patient's condition.
Examples of medical cases
Liu Mou, male, 40 years old at the time, was first diagnosed on June 5, 2003 for "whole body scaly erythema with itching for 5 years, aggravated l week". 5 years ago, there was no obvious cause of erythema on the scalp, covered with greasy thick debris, followed by multiple infiltrative erythema on the extensor side of the trunk and limbs, covered with scaly, itchy, deformed and sunken fingers and toenails. In the outer hospital, he was diagnosed with seborrheic dermatitis and psoriasis successively, and was given corticosteroid topical and symptomatic treatment, which was ineffective and still recurrent.
Immediate diagnosis: multiple infiltrative erythemas and plaques throughout the body, dripping scaly papules, partially fused into pieces, with scalp hairline, back and extensor of limbs are obvious, scraping scales can see film phenomenon and punctate bleeding, finger and toenail deformation, partial thimble-like changes, bundled hair, no arthralgia and pustules, upset, irritability, dry mouth, stool knots, yellow urine, red tongue, less moss, fine pulses.
Dialectics: psoriasis vulgaris, which is evidenced to be blood fever poison and injury to the yin.
Treatment: Detoxify cool blood and activate blood, accompanied by nourishing yin.
Red peony
Prescription: Skin detoxification decoction plus or minus. Raw ground yellow, red peony, comfrey, golden millet orchid, soil poria and ume are each 15 grams, angelica, Sichuan root, curcuma 10 grams each, licorice 6 grams. 7 doses of decoction, 1 dose a day.
Second diagnosis (June 12, 2003): after the drug, the erythema color fades, the scales thin, some skin lesions subside, the tongue is dark red, the moss is thin and white, and the pulses are fine. The poisonous force fell, the jin liquid was restored, the effect was not more square, and the original party went to Umega danshen 30 grams to strengthen the power of blood nourishment.
Third consultation (June 19, 2003): A total of 15 doses were taken above, and the erythema scales of the trunk and limbs basically subsided, leaving only the hairline lesions of the scalp, the tongue was dark red, the moss was thin and white, and the pulses were fine. The defender adds 30 grams of chicken blood vine to nourish the blood and activate the blood.
Fourth consultation (July 4, 2003): 14 more doses were taken above, and the condition was stable and did not recur. Six-flavor dihuang pills and salvia tablets are given orally for later treatment.
Press: Psoriasis, also known as psoriasis, white cloth, is a common difficult disease of dermatology, due to the disease evil guest in the heart, the accumulation is not dispersed, depressed and heat into poison, blocking the meridians, unfavorable veins, resulting in toxic heat and blood stasis interlocking, skin qi and blood operation is not smooth, the inside can not be drained, the outside can not be penetrated, into dry nail errors of erythema, papules, flakes stacked. The blood loss of the camp for a long time, the weathering and dryness, the meridians are blocked, and the qi and blood are stagnant.
Based on the disease mechanism of stasis and hot knot, when treated from stasis blood fever, the treatment is detoxified by the method of cool blood activation, and the skin detoxification soup is added and subtracted. Because the blood fever is very poisonous, su ye, parsnip, Xu Changqing and other herbs are removed, and the work of adding raw land, red peony, golden millet orchid, angelica, Sichuan root, and chicken blood vine is used to strengthen the cool blood and blood, and to reconcile the qi and blood. At this time, if the treatment is only with the method of clearing heat and cool blood detoxification, the cold coagulation of the blood veins, the meridians are even more unsmooth, the stasis is long-lasting, and the poisonous heat is even worse; if a large dose of blood circulation is thrown to dissolve the stasis, the blood veins are open, and the poison and evil are scattered all over the body, and their symptoms will be serious. Therefore, when the disease is treated by evidence, it should be treated from poison and stasis, mainly to clear heat and detoxification, detoxification does not forget to activate blood, and active blood is to detoxify first. ■
Zheng reiterated that:
Since each person's constitution and condition are different, the prescription drugs and dosages in this case are only applicable to the patient's condition at that time. The prescriptions and dosages in this case may not be copied without the dialectical diagnosis and treatment of Chinese medicine practitioners. If necessary, the majority of readers should go to a regular hospital for diagnosis and treatment to avoid delaying the disease.
[Source: China Traditional Chinese Medicine News, content compiled from: China Traditional Chinese Medicine News, July 13, 2015, fourth edition, author: Chinese medicine master Xuan Guowei Guangdong Provincial Hospital of Traditional Chinese Medicine]