"Xiao Wang, let's talk about Ganmai jujube soup today." Teacher Xie turned around and said to Xiao Wang.
Xiao Wang hurriedly opened the notebook and prepared the pen, "Okay, Mr. Xie." I heard that Ganmai jujube soup is from "Jin Kui Yao"? ”
Teacher Xie nodded and began to speak: "Yes, there is a cloud in "Jin Kui Yaolu • Women's Miscellaneous Diseases and Pulse Syndrome and Treatment Twenty-two": 'Women are dirty and irritable, happy and sad and want to cry, as if they were made by the gods, the number is not stretched, and the sweet wheat and jujube soup are the masters. This is the classic origin of sweet wheat jujube soup. The recipe is composed of licorice, wheat, and jujube. ”
Xiao Wang listened and recorded quickly, the pen in his hand swiped across the paper, making a rustling sound. He looked up and asked, "Teacher, what is the specific dosage and decoction method of these three flavor medicines?" ”
Teacher Xie smiled and explained, "Licorice, wheat, big. On the three flavors, boiled in water, temperature. It also tonifies the temper. ”
Xiao Wang nodded as he remembered, "I understand." Teacher, what are the specific effects of Ganmai jujube soup? ”
Teacher Xie explained with a smile: "This recipe has the effects of nourishing and nourishing, nourishing the heart and soothing the nerves, relieving the middle and urgency, and tonifying the spleen and invigorating qi. It is suitable for people with dirty mania disorder, with mental trance, frequent sadness and crying, unrealistic sleep, abnormal words and deeds, frequent yawning, and less red tongue. ”
Xiao Wang frowned and thought for a while, then asked, "Then can this prescription be used for other symptoms?" ”
Teacher Xie nodded and added, "Yes, Ganmai jujube soup can also be used as an auxiliary diet for vaginismus patients. Its sweet and nourishing properties have a certain auxiliary effect on relieving the symptoms of vaginismus. ”
After Xiao Wang finished recording, he looked up at Teacher Xie, "Teacher Xie, can you specifically talk about the role of each medicinal herb in Ganmai jujube soup?" ”
Teacher Xie nodded and began to explain in detail: "Irritability is mostly caused by heart deficiency and liver depression, which is manifested as various symptoms of delirium, such as mental confusion and sleeplessness. The wheat in the recipe is the king's medicine, the valley of the ditch liver, its qi is cold, and the water qi enters the kidney; Its taste is sweet, with earthy flavor and returns to the spleen and stomach, and it is good at nourishing the heart qi, can be with the heat of the liver and yin, and benefit the heart fluid, and has the function of eliminating annoyance and stopping sweating. ”
Xiao Wang carefully wrote down this information.
Teacher Xie explained: "Wheat can not only nourish the heart qi, but also promote the heat of liver yin, benefit the heart fluid, eliminate annoyance and stop sweating. And licorice pours the heart and stomach, which is a subordinate medicine. Jujube regulates the stomach, dispels the irritability of the upper pressure, and is used as an adjuvant. Licorice and jujube are combined, sweet and moisturizing, so they can nourish the dirty qi and stop its irritability. ”
Xiao Wang nodded, "I see, the combination of licorice and jujube still has such a wonderful use." ”
Teacher Xie continued: "Yes, the licorice and jujube in this recipe are used together, which can moisturize the dirty qi and calm the restlessness. The root of the disease is the blood, it will be the master of the blood, the liver is the son, the heart is hot and the earth is peaceful, and the stomach is down. The lungs are moist, the liver is regulated, and the disease is eliminated by dryness. ”
Xiao Wang asked thoughtfully: "Then what is the role of tonifying the temper here?" ”
Teacher Xie explained: "For those who replenish their temper, fire is the mother of the earth, and if they are nourished by the heart, fire can give birth to the earth." This recipe is mainly based on the sweet agent to tonify the spleen and stomach, and the spleen and stomach are the source of secondary biochemical qi and blood, and the blood congestion will stop drying, and the disease will be eliminated by itself. ”
Xiao Wang recorded carefully, and his understanding of traditional Chinese medicine deepened again, "I see, this combination is really ingenious." ”
Teacher Xie smiled and nodded, "Modern Chinese medicine clinics often add or subtract Ganmai jujube soup to treat intractable neurasthenia, hysteria, headache, vertigo, chronic fatigue syndrome and menopausal syndrome. ”
Medical case analysis
"Mr. Xie, I have a related medical case that I would like to discuss with you." Xiao Wang said.
Teacher Xie raised his head and looked at Xiao Wang with a smile, "Oh, is it? Let's talk about it. ”
Xiao Wang cleared his throat and began to narrate: "Patient Xu Li, female, 25 years old, graduate student, unmarried. When she came to the clinic in April, she reported that her menstruation had been mostly normal since menarche. However, due to study tension, unpleasant mood, menstruation has been in the future for 3 months, mental depression, irritability, vague pain in the breasts and both flanks, and less abdomen, dreams at night, and boring eating. The tongue is pale red, thin and white, and the pulse is astringent and short. ”
Teacher Xie nodded, a hint of interest flashed in his eyes, "Well, go on." ”
Xiao Wang continued: "Yes, teacher. In the medical case, the master prescribed a prescription for her, and the prescription was as follows: boiled licorice, floating wheat, jujube, tulip, zeeland leaf, and incense. After Xu Li took 2 doses, menstruation came on, blood was red, the amount was medium, and irritability and other symptoms disappeared. ”
Teacher Xie nodded with satisfaction, "Yes, this recipe is very targeted." ”
Xiao Wang continued: "In the second month, her menstrual period was delayed for half a month, and irritability and other symptoms reappeared, but it was milder than before. She took the above 2 doses, menstruation, and all symptoms were subsided. After that, it became normal and did not take any more medications. After half a year, menstruation came down from time to time. ”
Teacher Xie smiled approvingly, "Very good." ”
Xiao Wang said again, please Mr. Xie help me analyze and analyze.
Teacher Xie smiled approvingly, "Xiao Wang, Ganmai jujube soup was originally a special prescription for treating irritability. Although this case is not really dirty, due to the influence of the fire of the five wills, the symptoms involve the heart of the five organs, causing amenorrhea. The pathogenesis is similar to that of irritability and can be seen as premenstrual tension. Therefore, the use of sweet wheat jujube soup, with its sweet, peaceful and heart-nourishing effect, supplemented by tulip to soothe the liver, zeeland and incense to promote qi and blood, can make the meridian water smooth. ”
Xiao Wang nodded excitedly, "Thank you, teacher, for your guidance." Through this case, I have come to appreciate the importance of dialectical treatment and the characteristics of the use of prescriptions. So what exactly is dirty? ”
Teacher Xie said, "I'll give you two days, you sort out the medical case, and then you can report it to me." ”
So what exactly is dirty?
Two days later, Xiao Wang came to Mr. Xie and said, "Mr. Xie, this is the medical case I have sorted out. Discussion on the treatment of irritability with Ganmai jujube soup and the views of later generations of doctors. ”
Teacher Xie took the medical case, glanced at it slightly, and nodded in understanding. He looked at the contents of the medical case and thought about the direction of the next discussion.
Xiao Wang continued to explain: "Ganmai jujube soup was originally prepared by Zhang Zhongjing to treat irritability. As for the term 'dirty irritability', Zhang Zhongjing's original book does not discuss it much, mainly mentioning the name, symptoms and prescription of the disease, but does not elaborate on the pathogenesis. ”
"Later generations of physicians have different views on the interpretation of 'dirty irritability', and there are several representative ones." Xiao Wang began to quote information from medical cases, "The first is the 'heart' theory, which Wu Qian and others hold. It is pointed out in the "Medical Sect Jinjian" that if the heart is quiet, the mind is hidden, but if it is hurt by the seven emotions, the heart is not quiet, and the mind is restless, resulting in symptoms such as joy, sadness, and crying. This state of affairs seems to be based on the gods, but in fact the mind is incapable of gods, as in modern times it is called madness. ”
Teacher Xie nodded slightly and motioned for Xiao Wang to continue.
"The second view is the 'lung' theory, which is held by doctors such as Liu Wansu, Chen Shiduo, and Cao Yingfu. "Jin Kui Fa Wei" mentions that the lung master is sad and good at crying, and lung qi deficiency will lead to the symptoms of joy, sadness and crying. According to this theory, the weakness of lung qi will directly affect emotions and trigger emotional fluctuations. ”
Xiao Wang continued: "The third view is the 'heart and lungs' theory, which is held by the Qing Dynasty physician Gao Xueshan. He pointed out in "Gao Zhu Jin Kui Yao" that "dirty" refers to the heart and lungs, and dirty and irritable means that the yang fluid in the viscera is dried up, and the real dirty qi is involuntary, which leads to the appearance of irritability symptoms. He believes that the mind and lungs have lost their original support, resulting in symptoms such as sadness and crying. Moreover, he quoted the record in the Neijing that the lungs are crying when they are crying and they are worried about their aspirations, emphasizing the connection between cardiopulmonary dysfunction and emotional changes. However, I have found that there are other points of view, and I have only compiled three for now. ”
Xiao Wang paused and looked at Teacher Xie, waiting for his reaction and further guidance.
Teacher Xie thought for a while, and then slowly spoke: "These points of view have their own truth, and they all explain the pathogenesis of 'dirty' from different angles. In fact, although doctors in the past generations have different understandings of the pathogenesis of dryness, they all agree that dryness is an emotional disease, and its occurrence is closely related to the five organs of the heart, liver, spleen, lungs and kidneys. Among these viscera, the mind is the god who is the great master of the five viscera and the six viscera, managing the spiritual activities and ensuring the normal residence of the gods. The liver is regarded as the general's officer, responsible for the balance of yin and yang in the body, leading the function of draining the channel, and at the same time taking on the abode of the soul. "
He went on to explain: "If the patient thinks and works for a long time, it will lead to the depletion of the heart yin, the lack of yin blood, and the spirit will not be relentless; or the liver qi is stagnant, depressed and turns into fire; Or the constitution itself is weak, such as the deficiency of yin and blood after illness, or excessive blood loss after childbirth, the viscera cannot be adequately nourished, and the dryness and fire rise, there will be a loss of visceral yin, malnutrition of the heart and liver, and the disturbance of deficiency and heat, resulting in the symptoms of uneasiness. Therefore, clinically, we can see that patients may present with typical symptoms such as mental trance, frequent sadness and crying, inability to be autonomous, restlessness, decreased sleep quality, and even abnormal speech and behavior, red tongue and little lichen, and thin pulse. "
"Therefore, for the evidence of dryness, especially the clinical mechanism that is closely related to the relationship between the heart and liver, we should follow the theory of 'insufficient heart yin, liver loss of nourishment, and disharmony of liver qi' in the textbook "Formulary" compiled by the state. This theory not only helps us to understand the pathogenesis, but also guides us to choose the appropriate treatment and prescription in practice. "
Xiao Wang listened carefully and nodded in understanding, "Thank you for the teacher's guidance, I will continue to study in depth and strengthen my theoretical mastery and practical ability." ”
Teacher Xie smiled and encouraged: "Very good, continue to work hard and pass on the wisdom of Chinese medicine." ”