<h1 class= "pgc-h-arrow-right" > Professor Li Jianmin, Director of the Department of Nephrology: Subtle Interpretation of Doubts and Doubts</h1>
Little Master Sister Chinese Medicine World
Pay attention to the "World of Chinese Medicine"
Photo: Professor Li Jianmin, chief physician of the Department of Nephrology, Beijing Hospital of Integrated Traditional Chinese and Western Medicine
Professor Li Jianmin, Chief Physician of the Department of Nephrology, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Doctor of Medicine, Doctoral Supervisor of Beijing University of Traditional Chinese Medicine. Clinically good at using jingfang to treat kidney disease, diabetes, diabetic nephropathy and other diseases. Today, Xiao Shimei summarized and sorted out The experience of Teacher Li Jianmin's understanding and application of the yin disease for many years as follows, and shared it with the majority of Chinese medicine practitioners, in order to bring you diagnostic and treatment ideas and inspiration.
01
Outline and substantive discussion of yin disease
Successive generations of physicians have had many controversies about the outline, main prescription, pathogenesis, disease position, and pathogenesis of yin disease. Lu Yuanlei, a well-known treatise on typhoid fever during the Republic of China period, said: "The typhoid fever and yin chapter is actually a case of doubt for eternity, and it is clearly stated that there are only four articles for people with yin and yin disease, and except for the first article, which has an outline, the remaining three articles are vague and unclear, and there is no way to study it." Professor Li combined the words of various families and clinical practice to make a subtle analysis:
1 ● Outline of Yin Disease To Solve the Puzzle
Yin is sick, thirst is quenched, the heart is hit by the heart, the heart is hot, the hunger is not hungry, the food is spit out, and the benefits are not endless.
The "Medical Sect Jin Jian" believes that "this article generally speaks of the outline of yin disease." "Elder Liu Duzhou, a member of the typhoid fever, agreed to this article as an outline for yin disease. Changchun Yan Hongchen believes that the Outline of the Six Classics is a high-level summary of the characteristics of the Six Classics. However, most of the diseases are more complex, there are diseases, the root of the disease, there are also the symptoms of the disease, there are main evidence, there are also positive evidence, so the outline can only be summarized according to the characteristics of the main evidence, it is impossible to summarize all the diseases in this sutra into the outline. He gave an example that "the Yangming deficiency cold certificate is one of the contents of Yangming disease, but the Yangming disease outline only summarizes the "stomach family truth" and does not involve the stomach family cold deficiency. Therefore, he believes that "the outline of the yin disease cannot be comprehensive" The yin is yin and yang, and the mixture of cold and heat reflects this main feature of the yin, so it is reasonable to take 326 articles as the outline.
2 ● Understand the saying that "the real is less yang, and the virtual is less yin"
"Su Qing, Six Micro-Purpose Theories": "Above the yin, the wind is governed, and the middle sees the young yang." Article 379 of the "Treatise on Wounds and Sorrows": Those who vomit and have fever, xiao chai hu soup master.
In Traditional Chinese medicine, there is a saying that "in fact, there is less yang, and the virtual is yin", Ke Yunbo commented: "The main liver of the yin yin, and the bile hides in the liver, then the yin and yin heat evidence, are less yang phase fire inside the fire also." It is necessary to know that the same phase of fire, the fire of the same phase, the fire into the inside, is the yin disease; the fire out of the table, for the shaoyang disease. "
3● Discussion of the essence of yin disease
The essence of yin disease, the heat certificate represents Youcheng Wujie, Lu Jiuzhi, You Zaijing, Ke Yunbo and so on. Cold certificate representatives, rich days to wait. The mix of cold and heat represents Wu Qian, Shu Chiyuan and others. In modern times, most people represented by Mr. Liu Duzhou believe that the essence of yin disease is a false proof of cold and heat according to the "Outline theory of the Six Classics" and other theories.
The pathogenic hypochondriasis of yin disease is conjugated, which breeds a correlation between standard and real. Yin disease is the final stage of the disease: "Yin Ping Yang Secret Deviation, Yin and Yang Supply Deficiency". Yin disease is virtual: true yang is weak, yang does not give birth to yin, yin does not contain yang, yin and yang are weak. Yin disease standard real: or hypochondriatic endogenous, or hypothermia endogenous, intermingled with "original hypocrisy". Sick position: foot yin meridian, internal evidence, or in the meridian, or in the intestine, or through the intestine. Pathogenesis: Foot yin through the yin, yang, qi, blood have different partial decay, foot yin through the intestine cold, hot, virtual, real have different partial births.
02
Prescription analysis and clinical application
1 ● Ume maru
Article 338: Typhoid fever, the pulse is weak and faint, until the seventh or eighth day, the skin is cold, its people are restless, and there is no temporary peace, this is a Tibetan, not a roundworm. Roundworms should be spit on. To make the sick quiet, and to be annoyed again, this is to hide the cold. Roundworms are put into the diaphragm, so they are annoyed, they must be revived, they have to eat and vomit, and those who are annoyed, smell the smell of food, and their people should spit out their own clams. Roundworm, Lord of Umemaru. And the Lord Of Good.
The provisions of Wumei Pill combined with the outline evidence can be used as an outline for the mild evidence of yin disease, and are clinically used to treat the symptoms of upper fever (hypothermia is the weather of floating yang), lower cold (liver and kidney yang deficiency, cold endogenous) stomach pain, or accompanied by evidence of long-term profits. For the floating yang, it is clear that there is stomach pain with swollen gum pain, mouth and tongue sores (aphthous sores), or candidate Wumei pills with a long period of time. With stomach pain as the mainstay, you can choose Ye Tianshi pepper plum soup. Clinical significance: Wumei pill as liver and kidney yang deficiency, liver and kidney yin deficiency are present, accompanied by floating yang on the Yue, phase fire endogenous disease as a disease mechanism. Wumei, angelica acid glycan yin, nourish the liver and kidneys, huanglian, yellow cedar qing floating yang, phase fire of the "virtual heat".
2● Four reverse soups, four reverse soups
Article 353 of the "Treatise on Typhoid Fever": Sweating heavily, not going hot, being anxious inside, hurting in the limbs, and profiting, those who are rebellious and cold, and the four reverse soup masters. Article 354 of the Treatise on Typhoid Fever: "Great Khan, if the great one is cold, the four rebels are the masters of the soup." Article 370 of the "Treatise on Typhoid Fever": "The lower Li Qinggu, the cold inside and the heat outside, the sweaty and the squeamish, the four reverse soup masters of the veins." Article 390 of the "Treatise on Typhoid Fever": "Those who vomit have been broken, sweating and squealing, limbs are anxious and incomprehensible, and their pulses are weak and desperate, and the four reverses of the pulse are added to the main body of pig bile soup."
Comprehensive thinking: The yin disease chapter appears "sweating, the heat does not go, if the big profit and the cold person", this is the phenomenon of the yin disease liver and kidney yang deficiency, yang qi outflow, and false yang outflow. Borrow the four reverse soups of the Shaoyin Disease chapter or the four reverse soups of the Tongmai Four Reverses to return to the Yang to save the rebellion. And cholera chapter of the "Treatise on Typhoid Fever" Article 390 vomiting under the profit of the long, the choke, through the pulse of the four reverse plus pig bile soup master. "The article suggests: Kidney Yang is the root of a body of Yuan Yang, liver Yang is weak, and it can play the therapeutic goal of warming liver Yang through the prescription of large supplements to kidney yang. The simple hint of the classic thinking routine of traditional Chinese medicine for the treatment of liver and kidney yang deficiency and liver and yang deficiency is simple.
3● Ephedra cohosh soup
Article 357 of the Treatise on Typhoid Fever: After the sixth or seventh day of typhoid fever, after the great fall, the pulse is deep and late, the hands and feet are rebellious, the lower pulse is not reached, the larynx is unfavorable, the spitpus and blood are not exhausted, and the person who is difficult to treat, ephedra cohosh soup is the master.
Yu Jiayan said: "The inch pulse is late, the ming is the reason why the yang goes into the yin, and the non-yang qi is weak and can be simulated, so although it is reversed in the foot, the lower pulse is not reached, and the profit is not excessive, it must not be pure yin and no yang." In the case of unfavorable throat, spitpus and blood, and the signs of yang and evil fighting yin and yin, so Zhongjing specially proposed his yang in the yin, and he had to sweat out and solve the evil of the intricacies." Ephedra cohosh soup master. Key points of dialectics: Typhoid fever is incomprehensible, hot and cold, and the symptoms are unfavorable to the throat, abdominal leakage, cold hands and feet, and slow pulse. Key diseases: lung fever and spleen cold, poor qi machine. (Lung infection with diarrhea may be the most minimal case) Solution: ephedra, gypsum, licorice to thin the table, more Yuyang Guizhi, white peony to reconcile the camp guard cohosh taste spicy cold, functional shengyang, clear heat detoxification Zhimu, skullcap to Qingshang lung heat white surgery, dried ginger, poria to rationalize the soup to warm the spleen and yang, and warm the intestines under the cold day winter, jade bamboo flavor ganping, to nourish the yin and clear heat Angelica to nourish the blood, and to prevent the drawbacks of the yue.
4 ● Evodia soup
Article 243 of the Treatise on Typhoid Fever and the Simultaneous Treatment of Yang Ming's Disease: "The appetite for grain is vomited, and it belongs to Yang Mingye, and the master of Wu Zhu Yu Soup." The anti-drama of the soup belongs to Shangjiaoya. Article 309 of the Treatise on Typhoid Fever and the Identification and Treatment of The Pulse Evidence of Shaoyin Disease: "Shaoyin disease, Tuli, cold hands and feet, irritable and eager to die, Wu Zhu Yu Tang Lord." Article 378 of the Treatise on Typhoid Fever and the Simultaneous Treatment of Yin Disease: "Those who vomit leaf saliva and have a headache, Wu Rongyu soup master." "
"Golden Mirror Inner Taiwan Fang Discussion" on Wu Zhu Yu Soup: dry vomiting, spitting, headache, and the cold of yin attacking also. Tu li, the hand and foot against the cold, the cold inside sheng also. Irritable and dead, yang qi infighting also. Those who are hungry for grain and vomit, the stomach is cold and not also. This is the disease of the three, and those who share this side take the reverse qi of the three yins as the king, the ginger can dissipate the qi as the subject, the ginseng and the jujube are gentle, and the one who can reconcile the qi is also used, so it is used as an envoy, to be safe. Pro-evodia with dried ginger, dosage 15-30 grams, not equal, treatment of refractory diarrhea, thin stools, frequent.
Analysis of the elements of wu zhu yu soup for the treatment of three yin deficiency cold evidence
How to identify evodia soup in the clinic? Evodia soup treatment of three yin deficiency cold evidence: all accompanied by fat and thick tongue, tooth marks, white and greasy water slippery mainly. Gluten-eating vomiting: vomiting is the mainstay, stomach pain or illness is full of discomfort, accompanied by eating discomfort. Tuli, hand and foot cold, irritability and death: vomiting can not digest food, the next profit is thin with indigestible food residue, or morning abdominal stains, several times a day, hands and feet are cold, upset to death. Dry vomiting, spitting, headache: peak headache, spitting (saliva), dry vomiting, or vomiting towards food. Although the above three certificates are divided into three yin deficiency and cold, in fact, the essence is the liver, spleen, kidney, and intestines are cold and cold, and the liver, spleen, and kidneys are different in viscera, and the clinical manifestations are different. What you see is seen, but what you see is what you see, and you don't have to know it.
Professor Li Jianmin believes that Zhongjing's Treatise on Typhoid Fever is based on the four major evidences of the lesions of foot yin disease, vomiting, beeping, and profit, which are the changes in the cold, heat, void, and real of the evidence and the changes in the yin, yang, qi, and blood of the internal organs, and the shift of cold and heat is mixed is biased towards the middle school medical identification as the main line, which runs through the entire process of dialectical treatment of the foot yin. It is our basic responsibility to respect the original ideas of Zhongjing, learn the classic thinking of traditional Chinese medicine, and implement the clinical practical application of integrated medical theory. After reading Professor Li's experience, what did you gain? Feel free to leave a message at the end of the article.