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Article source: Licorice Academy
Original link:
https://www.igancao.com/aq
Author: Di Ruohong; Li Yongjian
Abstract:Xiao Pin Fang is a very influential prescription book in the history of medicine in mainland China, and it is an earlier work that compiles a special article on obstetrics and gynecology syndromes and prescriptions after Jin Kui Yaolu. This paper summarizes the academic achievements of obstetrics and gynecology in Xiaopinfang, and believes that it has played an important role in the history of academic development of obstetrics and gynecology, which is worthy of in-depth excavation.
Keywords: Xiaopinfang, Chinese medicine obstetrics and gynecology
Chen Yanzhi's "Sketch Formula" is a very influential prescription book in the history of medicine in mainland China. The book not only captures the effective scriptures handed down by the previous generations, but also collects the folk prescriptions, and dares to innovate on the basis of inheriting the predecessors, which not only has important historical value, but also has strong clinical practicability, so it is respected by doctors of all generations.
Especially in the Sui and Tang dynasties, "Treatise on Typhoid Fever and Miscellaneous Diseases" was hidden, and "Xiao Pin Fang" became a medical guideline, and was designated as a must-read book for studying medicine by the Tang Dynasty government. The book also had a profound impact on Japanese medicine. In the first year of Emperor Bunmu of Japan (701 AD), Emperor Daebo issued the Dabao Law Decree, which listed the "Xiao Pin Fang" as one of the five medical books that medical students must read. Unfortunately, the book died at the end of the Northern Song Dynasty, and there is no clear record of its writing age and historical records, resulting in its academic ideas being buried for a long time. Therefore, it is of great significance to study the collation of this book.
Chen Yanzhi attaches great importance to obstetrics and gynecology, and has a special volume on the diagnosis and treatment of obstetrics and gynecology diseases, which is divided into the following 5 articles: "Prescriptions for Treating Women's Diseases" only has 1 chalk pill, and the main treatment of women's 36 diseases: "Prescriptions for Treating Women without Children" The original text of "Prescriptions for Treating Women without Children" has yet to be verified: "Prescriptions for Treating Pregnancy" is very rich, involving 12 kinds of disease syndromes and 74 prescriptions; The article "Prescriptions for the Treatment of Postpartum Diseases" involves 6 kinds of disease syndromes and contains 20 prescriptions, and the chapter "Prescriptions for the Treatment of Women's Blood Collapse and Stagnation" involves 2 kinds of disease syndromes and contains 7 prescriptions.
The prescriptions for the treatment of obstetrics and gynecology syndromes in "Xiao Pin Fang" have been mostly cited by later generations, such as Angelica Soup, Fetal Pain Relief Soup, Jiaoai Soup for the treatment of fetal restlessness, Banxia Poria Cocos Soup and Poria Pill for the treatment of adultery and obstruction, and Soybean Purple Soup for the treatment of postpartum stroke. It can be seen that this book plays an important role in the history of the academic development of obstetrics and gynecology.
This article summarizes the academic achievements in obstetrics and gynecology.
Advocate late marriage and late childbearing, and eugenics
At the beginning of the book, the negative effects of early marriage and early menstruation on women's health care were discussed, and late marriage and childbearing were advocated. Early marriage and early childbearing are very likely to deplete the kidney qi that has not yet fully developed, which is the main cause of gynecological diseases, and has become an important factor that is not easy to treat women's diseases.
As early as the Western Jin Dynasty, Wang Shuhe's "Pulse Meridian" advocated that abortion should be carried out appropriately, but did not specify the specific prescription. In the "Sketch Formula", there are 8 prescriptions for pregnancy and 1 prescription for breaking the fetus for pregnancy and extremely weak constitution. It shows that in ancient times, more than 1,000 years ago, the mainland attached great importance to the quality of the population, advocated eugenics, and attached importance to women's health care.
Treatment of pregnancy obstruction Distinguish the urgency of specimens
Although the "Xiao Pin Fang" for the treatment of pregnancy obstruction only contains 2 prescriptions, it records in detail the etiology, pathogenesis and syndrome manifestations of the disease. It is believed that the main pathogenesis lies in "the menstrual blood is closed, the water is stained in the viscera, and the dirty qi is not declared", and the root cause is "insufficient blood qi, weak kidney qi".
Treat with Banxia Poria soup and Poria pills. The former is a decoction with a large dosage, which is used for the treatment of spleen deficiency, phlegm, dampness, vomiting and reversal. Evacuate the wind and cold, stop vomiting in the warmth, and treat the symptoms as the main thing, so after the prescription, it is particularly emphasized that "take a dose, get the news after the news, the strength is hot and cold, and the loss is more, and the adjustment is to take a dose of soup, and then urgently take Poria pills, so that you can eat, and you will be strong." "The latter is a pill with a slower dose, which is mainly used to invigorate qi and strengthen the spleen.
These two poems were reprinted by many books in later generations, and they had a great influence. But there are different opinions on whether Banxia hurts the fetus. For example, "The Good Prescription for Women" (referred to as "Good Prescription") believes that Banxia has the nature of moving the fetus, "covering the initial knot of the fetus, considering that it is easy to disperse, this must not be discouraged." ”
In order to alleviate the fierceness of the original prescription, the "Good Prescription" made appropriate adjustments in the dosage and drug composition when including this prescription, reducing the dosage of Banxia from the original five taels to one tael, and requiring soaking ten times and stir-frying yellow, thinking that "although Banxia can move the tire, it will not hurt if it has been fried". Neixue Lizhai, Chen Liangfu, Lou Quanshan and other doctors believe that Banxia is the main medicine for strengthening the spleen and dissolving phlegm stagnation.
Treatment of fetal leakage, fetal restlessness, the first priority is to strengthen the spleen and nourish blood
Fetal leakage only has a small amount of blood from time to time, and there is no backache and abdominal pain, which is less severe than fetal restlessness. For the first time, "Xiao Pin Fang" clearly pointed out that atrioventricular dissection during pregnancy can lead to fetal leakage, and used adzuki beans to disperse heat and blood, strengthen the spleen and stop bleeding, and "treat several injured fetuses".
In "Jin Kui Yaolu" (hereinafter referred to as "Jin Kui"), there is only 1 Jiao Ai Tang for the treatment of cell obstruction (fetal restlessness), and on the basis of this "Xiao Pin Fang", it has been increased to 7 prescriptions, and the symptoms of each prescription are different. For example, Jiao Ai Tang (different from the medicine of the same name as the "Jin Kui" prescription) regulates and replenishes Chong Ren, treating Chong Ren's pulse deficiency and evidence of yin and blood leakage; Angelica sinensis decoction nourishes qi and nourishes blood, treats qi and blood deficiency, and is the evidence of chongren deficiency; fetal parasitic decoction nourishes the kidney, strengthens the spleen, and strengthens the spleen, and treats fetal restlessness caused by liver and kidney deficiency; and there is also 1 nameless prescription for the treatment of anxiety deficiency and cold, and fetal restlessness.
There are 3 formulas for clearing heat and strengthening the fetus, but the effects also have their own emphasis. Ramie root soup clears heat and nourishes blood, soothes the liver and strengthens the spleen; fetal pain relief soup is good at nourishing yin and nourishing blood, communicating the heart and kidneys; and there is also a treatment for mothers with labor fever, hands and feet upset, focusing on clearing heat and removing annoyances and stabilizing the fetus.
Although the efficacy of the treatment of fetal restlessness is not the same, in view of the pathological characteristics of insufficient qi and blood and weak spleen and stomach after pregnancy, the spleen and blood nourishment and solid chong always run through it, which is one of the characteristics of the treatment of fetal restlessness in "Xiaopinfang". The above-mentioned formulas had a great influence on later generations, and the fetal drugs used in the formulas, such as ramie root, mulberry parasitism, skullcap, atractylodes, angelica, ejiao, mugwort leaves, and bamboo ru, are still used today.
The first sub-disease syndrome and special prescription treatment
"Sketch Fang" recorded: "The treatment of pregnancy is boring, the eyes do not know people, you have to wake up suddenly, wake up and relapse, and still do not wake up, it is called spasms, also known as eclampsia, also known as epilepsy, also known as Zimao, and kudzu root soup." This is the earliest surviving record of eclampsia, and its clinical manifestations are well described. Subsequently, the "Theory of the Origin and Syndrome of Diseases" clearly pointed out that its pathogenesis is "the meridian of wind hurting the sun".
Cover the essence and blood to nourish the fetus, yin and blood deficiency, the heart and liver are prosperous, the wind and fire are fanning each other, burning into phlegm, and the phlegm and fire disturb the clear body, so the disease occurs. In the soup of kudzu root, fritillary, pueraria, danpi and gypsum, clear away heat and dissolve phlegm, prevent wind, live alone, dispel wind and stop spasmosms, defend oneself, zexiao, poria cocos, strengthen the spleen and water, ginseng, angelica, cinnamon, Chuanxiong, scorched grass and other qi and blood.
Because fritillary is easy to give birth, Fang Hou pointed out, "If the moon is at the end, cimicifuga will replace it." "Xiao Pin Fang" also mentions the simple method of treating this disease with bamboo drainage, "If there is a bamboo close to the fast, you should make the drain first, and then make the soup; This two rules will get one of them. "
Subsequently, the method of preparing the fresh bamboo drain is described in detail. Bamboo drain is sweet and cold, and it is good at treating phlegm, heat, and epilepsy. "Materia Medica" calls it "the holy medicine of the phlegm family". The use of bamboo juice in the treatment of eclampsia fully reflects the characteristics of "Xiaopin Fang" that is simple to use and suitable for clinical use.
There are various treatments for the symptoms of labor
Nearly half of the "Prescriptions for Pregnancy Treatment" discusses labor disorders, transverse births, reverse labor, non-delivery of cells, and fetal death, which shows the importance attached to obstetric diseases at that time. In addition to the internal decoction, there are also external treatments and witch remedies used to treat them.
External treatment, such as treatment, fetal death does not come out. Use three liters of soil in the ant room, boil it, put it in a cloth bag, and warm it to the heart. In ancient times, when medical conditions were relatively backward, it was more common to use witch prescriptions to treat dystocia. For example, if the treatment of labor difficulties is desperate for several days, "the book is played as two lines of words, where there are two crosses, Wen Ri: Emperor Yi gives birth to a son, and the order does not stop, that is, out of his cell and his son, and his mother is not sick." Seal the center of it, seal it, and let the mother hold it. ”
Pay attention to postpartum care and discuss postpartum stroke in detail
In "Governing Postpartum Prescriptions", the concept of "full moon" is first emphasized. It is pointed out that "those who are full of the moon do not count thirty days, but also cross the moon." "For example, the first month of production, across February into March is the cross-month. It is believed that when a woman gives birth, the bones are dissolved, and it takes 100 days to completely recover, if the recuperation is not careful. If yin and yang converge too early, it is easy to move and injure all kinds of pulses, which will then cause five labors and seven injuries. For postpartum dietary therapy, pig liver is the first choice to nourish yin and blood.
The content of postpartum diseases discussed in "Xiao Pin Fang" is very rich, including postpartum milk deficiency, postpartum false win, lochia, urinary incontinence, postpartum vaginal prolapse and postpartum stroke. Among them, the discussion of postpartum stroke is particularly detailed, containing a total of 9 prescriptions.
For example, soybean purple soup is mainly used to treat "women who have a postpartum stroke, due to a strong mouth on the back, or a strong mouth on the back, or heat irritability, bitter thirst, or heavy head and body, or itchy body, and the dramatist vomits and looks directly", which is caused by postpartum blood and injury, physical weakness, and feeling the evil of wind, cold and dampness. Only one flavor of soybeans is used in the recipe, and after stir-frying, it is soaked in sake, and the wine turns purple, so it is called soybean purple soup.
Soybean sweet and warm is non-toxic, good at treating postpartum diseases, can dispel wind and dissipate blood stasis, especially for postpartum stroke sleepy. Just as Sun Sixiang said in "Prepare for the Rush of the Golden Prescription, Volume 3, Stroke": "All postpartum horn reversal and wind diseases should not use poison, but it is advisable to do one or two flavors alone, and not to sweat profusely. Soybean purple soup, great goodness after childbirth. ”
"Good Recipe" is improved on the basis of this recipe, first soak it in wine, fry it for one or two boils, so as to enhance the effect of dispelling wind and dehumidifying, and then put the fried soybeans into the wine and seal them, and wait for them to be cold to remove the beans. "Sketch Fang" also has a medical case attached to the party, Yun · Zhou Decheng became a wife and let the fetus die, touched the urn and died in the womb for three days. There is no bad treatment after that. "
In the later "Famous Doctors' Cases, Volume 11", there is also a case of using soybean purple soup to treat postpartum stroke and spasms. It can be seen that the efficacy of this prescription in the treatment of postpartum stroke is conclusive, so it has been reprinted in many prescription books such as "Jingxiao Zhuangbao", "Qianjin Yao Fang", "Waitai Secret", "Compendium of Materia Medica", "Jiyin Compendium" and so on
In the treatment of collapse, leakage, make good use of unilateral prescriptions
"Sketch Formula" not only refines the formula, but also makes good use of single herbs. Five of the seven prescriptions used to treat collapse were unilateral. For example, the use of wine to boil Sichuan camp to treat blood stasis and leakage: the treatment of blood heat leakage with Shengqin root juice or Shengdihuang juice, and the treatment of leakage with Huai ear ash and so on.
In addition to stopping bleeding and treating the symptoms, there is also 1 jujube soup that treats both the symptoms and the root causes, "treating the five collapses of the woman, red, white, green, yellow, and black". In the formula, 100 jujubes, three taels of yellow and yellow, eight taels of ejiao, and one foot of licorice nourish qi and blood to stop bleeding, so as to strengthen the scriptures.
Leakage is a difficult gynecological problem. "Jin Kui" has an account of "leakage" and "blood in the collapse", and it has been pointed out that there are different causes such as leakage, continuous bleeding after half-birth, and blood in pregnancy. The "Sketch Formula" does not identify the cause of collapse and leakage in detail, and takes hemostasis as the main treatment method, and the medication is specialized, which fully reflects the characteristics of "Sketch Formula" that is simple, convenient, inexpensive and testable.
epilogue
"Xiao Pin Fang" is an earlier work after "Jin Kui" that compiled a special article on obstetrics and gynecology syndromes and prescriptions. Before the "Xiao Pin Fang" was written, volumes 8 and 9 of Wang Shuhe's "Pulse Meridian" of the Western Jin Dynasty preserved part of the content of "Jinkui", of which volume 9 "is mainly about obstetrics and gynecology."
The content of obstetrics and gynecology discussed in the "Pulse Meridian" mainly includes pregnancy physiology and pathology, menstrual diseases and miscellaneous diseases. The discussion is detailed in the diagnosis and differential diagnosis of disease syndromes, and is omitted in prescription medication. The prescriptions contained are all based on Zhongjing's prescriptions.
In terms of the types of disease symptoms and the number of prescriptions contained, the "Sketch Formula, Volume 7" is richer than the "Three Articles" of Women's Diseases and the "Pulse Meridian, Volume 9" of "Jinkui", and the reasoning is clear, concise and concise, the treatment method is simple, and the medication is precise and practical. Many of the obstetrics and gynecology prescriptions in the book have been reproduced in later prescriptions. It has played an important role in the history of the academic development of obstetrics and gynecology.
In the Tang Dynasty, "Xiao Pin Fang" and "Treatise on Typhoid Fever and Miscellaneous Diseases" were listed as required books for doctors stipulated by the government, which proved its high academic value. However, the original book of "Xiao Pin Fang" died in the Song Dynasty, and its contents were scattered in many medical books in later generations.
Therefore, his academic ideas have not been systematically sorted out for a long time, and many valuable prescriptions contained in the book have not received enough attention. This article only starts with the treatment of obstetrics and gynecology syndromes in "Xiao Pin Fang", which is superficial and meaningful, throwing bricks and stones, and giving a few examples, which can be seen. "Jing Fang Sketches", won the trust of the ancients, and the effect is in the present, which is worthy of being the sub-of "Typhoid Fever", which is worthy of in-depth study and excavation.
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