Qin Bowei: Grasping the main disease and creating a formula for clever formulas
Qin Bowei, from 1901 to 1970, was a famous Traditional Chinese medicine practitioner, educator and clinician. He came from a family of Confucian physicians, studied under the famous doctor Ding Ganren, and graduated from the Shanghai College of Traditional Chinese Medicine. As a generation of famous doctors, Qin Bowei has rich clinical experience, is good at difficult and complicated diseases in internal medicine, and has made great achievements in wen disease, liver disease, edema disease, diarrhea, pain evidence, ulcer disease, chronic infectious hepatitis, angina and other diseases.
Grasp the main symptoms of search and symptoms of the disease machine
Qin Bo is not good at summarizing and summarizing the basic laws of diagnosis and treatment of traditional Chinese medicine, and the diagnosis pays attention to "because of people, causes, circumstances, and local conditions", and does not "cling to death to cure the living"; pro-testimony is good at analyzing the main and secondary symptoms, good at grasping the main symptoms, searching for and collecting both symptoms, taking the main symptoms as clues, taking the concurrent symptoms as evidence and identification, and analyzing them in detail and comprehensively.
For example, for coronary heart disease angina, he grasps the main symptom of paroxysmal transient precordial pain or chest stuffiness and suffocation, which is attributed to the heart, the disease mechanism is mainly unfavorable to qi and blood, and it is not clear that it is painful; at the same time, according to its disease, it is also a symptom of palpitations, self-sweating night sweats, fatigue and weakness, poor sleep, severe pain, pale face, tongue or light or tip tender redness, pulses or thin or large or weak or tight or late or number or knot or urge, and then pointed out that its disease mechanism is insufficient heart and yang, and the heart is weak. It has clinical significance.
Create a formula clever group of pro-strong
He is also good at treating both symptoms and root causes, which refer to the cause and position of the disease, and the symptoms. Although the predecessors have emphasized the treatment of causes, he summarized the composition of the prescription as "(cause + position) + symptom" from the "Yellow Emperor's Inner Classic" such as "the cold is hot, the hot one is cold", "the high one is therefore overstepped, the lower one is exhausted, and the middle is full of diarrhea in the inside", and the composition of the clinical prescription is summarized in order for the cause, disease position, and symptoms.
If the treatment of cough caused by wind chill attacking the lungs and Xuanhua dereliction of duty, the treatment method derived from the above formula is: (evacuation of wind chill + xuan lung) + phlegm cough, and the addition and subtraction of apricot susan are selected. The medicinal composition of apricot susan also coincides with the above treatment, that is, (perilla, qianhu + almond, platycodon + citrus shell + licorice) + half summer, tangerine peel, poria sativa. It can be seen that legislative prescriptions should echo each other in the three aspects of etiology, disease position and symptoms.
When using the formula, it should also be flexibly added and subtracted according to these three aspects, taking care of symptoms, and combining specimens. Prescribing medication in this way can not only quickly relieve symptoms, but also remove the root cause of the disease.
Case
A male, 60 years old, weak physique, hypertension and chronic disease, often insomnia. Cold fever in the past 5 days, once in a hospital with antipyretic agents and penicillin treatment, the heat potential is uncertain, sweating, heat rise without a certain time, several times a day, the heat rise first has a tangible cold, when the heat falls, sweating bad wind, accompanied by headache, evil, coughing sputum is not happy, eating stupid mouth bitter, dry mouth does not want to drink, constipation, small short red. Diagnosis: the veins are tight and numerous, and the tongue is thick and yellow.
Dialectics: The disease is caused by wind and evil, but the stomach and humidity are also heavy.
Treatment: According to the cold and heat exchanges, food and mouth bitterness, constipation and other symptoms, from Shaoyang, Yangming treatment.
Prescription: Chai Hu money half, qian hu two money, skullcap money half, half summer two money, artemisia annua money half, chrysanthemum money half, almond three dollars, orange stem one dollar, citrus shell money half, red ling three dollars.
After one dose, the heat does not rise, and the second dose is withdrawn. But he still sweated a lot and slept for fear of being covered by the wind. Considering that although the external evil is solved, the gastrointestinal symptoms have not been removed, and the old and weak, sweating non-stop, physical difficulty. The second diagnosis was changed to guizhi plus appendage soup.
Prescription: eight cents of guizhi, three dollars of white peony, three dollars of cooked tablets, half of raw astragalus, half of summer two dollars, three dollars of poria, half of tangerine peel, six points of hot licorice.
After taking one dose of medicine, sweating is less, and there is no bad wind after two doses. The third diagnosis continued to dissolve the sputum wet, and it healed soon.
This disease is mainly physical weakness and internal and external causes of mixed disease, Qin Bo did not respond to the situation, the initial prescription uses typhoid fever method combined with septic dispersion, with chai, front, citrus, orange lifting and discharging evil, not a simple small chai hu soup, this is where the prescription medication changes.
Another example is a man, 67 years old, often cold, often for one or two months, symptoms of nasal congestion, cough and phlegm, head and face sweating. Once served the jade screen scattered for half a month invalid. After Qin Bo did not receive treatment, he switched to Guizhi tang and astragalus. After taking the patient, the patient's conscious mental and physical strength increased, the symptoms gradually resolved, and the cold did not occur.
He said that the effect of using astragalus before and after the disease was different, because the guizhi soup and the camp guard were mixed, and the astragalus was added to strengthen the righteous qi to ward off evil. The jade screen scattered to cure the virtual people from evil, and the evil love was incomprehensible. It is generally believed that astragalus and windproof are afraid of each other, astragalus is windproof, do not worry about its solidity, windproof astragalus, do not worry about its scattered table, in fact, it is scattered in the supplement, supplement in the dispersion, is not equal to the correction of the fixed table. If you do not show evil and take the windproof evacuation, it will give the opportunity for external evil to invade.
Fine formulas to identify and treat special drugs
Qin Bo was not good at using chengfang. He said that the chengfang is the experience party left behind after the practice of the predecessors is effective, and can be divided into the general treatment party (which also treats several diseases) and the main treatment party (exclusive treatment of one disease). He believes that even if the general treatment formula is used, the main treatment and the main drug should be analyzed, and after recognizing the main cause, main organ and main disease of the disease being treated, and then adding or subtracting it according to the specific condition, that is, "if the cause and therapy are closely combined with the symptoms, the general treatment party can be transformed into the main treatment party", "Only by mastering these routines can we enter and exit the changes, and get the ring beyond the image.".
As for the choice of a specific treatment, the key is not that the main symptoms are the same, but that the cause and the position of the disease are consistent, only in this way can there be a basis for addition and subtraction changes. Therefore, he successfully used astragalus Jianzhong soup to treat cold stomach pain, guizhi plus astragalus and angelica to treat weak colds and the pain paralysis caused by them, and replaced Xiaoqinglong soup with yang and soup to treat stubborn phlegm drinking cough asthma caused by wind chills.
Wang Mou, male, 26 years old, saw paroxysmal palpitations and chest tightness 5 years ago, and gradually saw puffiness in the lower limbs. Diagnosis: swelling from the waist down to the back of the foot is very severe, the abdomen is full, vomiting, palpitations, shortness of breath, can not lie flat, there is very little urine, the stool is thin; the lips are cyanotic, the hands are red and purple, the cheeks are red like makeup; the tip of the tongue is red, the moss is white and creamy, and the veins are fine and stringed.
Dialectics: It is yang deficiency and water flood, qi and blood stasis.
Treatment: Flavor with real martial soup.
Prescription: two dollars for cooked tablets, two dollars for ginger, three dollars for fried white art, three dollars for white peony, five dollars for poria, five points for spring sand kernels, five points for wood fragrance.
Taking four doses in a row, the amount of urine increased, the edema of the lower limbs basically disappeared, only the back of the foot did not retreat, the bloating and vomiting improved, but the cheeks were red, the gusts were anxious, there was coughing, the sputum was bloody, and the pulse was still fine and not still. Long-term illness and anxiety, floating yang is not contained, liver fire rushed to the lungs, so see hemoptysis.
Still use the front to remove the wood fragrance, add 5 grams of clam powder, after two doses of blood to stop coughping, the condition gradually stabilized.
The root cause of this case is the weakness of the heart and yang, which cannot be scorched and wet in warm transportation, but from the accompanying cheeks, the redness is like makeup, indicating that the water vapor is flooded, the void yang is floating, not only the stomach qi is down, but there is a danger of the heart and kidney yang failure at any time. Therefore, the treatment adopts zhenwu soup with flavor, Fuyang warming is the mainstay, accompanied by yin and spleen, and after 4 doses, it will receive a manifest effect. If the liver is on fire, it should be a blood prevention certificate. In this case, the liver fire is complicated by hemoptysis of the lungs, and the original formula goes to the dry and cleans the liver and relieves cough, so it can quickly reverse the disease mechanism.
Good classification of the drug to treat liver disease
Qin Bo is not good at using the right medicine, and often uses angelica and white peony, Cangshu and Magnolia, Banxia and Tangerine Peel on prescriptions, etc., which he believes are all the accumulation of previous experience, and there is also a theoretical basis, which is worthy of attention.
He divided the pair into three types:
The first is to combine two drugs with opposite properties or smells and different effects, such as qi and blood, cold and heat, tonic and diarrhea, dispersion and harvest, rise and fall, hard and bitter, etc., to change their original efficacy or achieve a new effect in the opposite phase, such as guizhi and white peony, Sichuan neem and Yanhusuo, Huanglian and Wu Zhu, Huang Cedar and Cangshu, Astragalus and Windproof, Red Dates and Ginger, Dried Ginger and Schisandra, Platycodon and Citrus Aurantium, Half Summer and Huanglian and so on.
The second is to complement each other with two drugs, play their own strengths, so as to enhance their role, such as tempeh and onion white, astragalus and self-defense, people involved in appendages, etc.
The third is to use two drugs of similar nature and efficacy to enhance the efficacy or take into account the relevant organs, such as the party's participation in astragalus, keel and oysters, green skin and orange peel, perilla stem and weed stem and so on. In view of the ingenious compatibility of the drug, which can strengthen the efficacy of the drug and expand the scope of treatment, it is not liked by Qin Bo and strongly recommended it.
In the 1950s, when liver disease was prevalent in China, Qin Bo did not propose to distinguish between several important concepts such as "liver qi and liver depression", "liver fire and liver fever", "liver wind and liver yang".
He believes that "liver qi" refers to the liver's role is too strong and its diseases are reversed; "liver depression" refers to the disease in which the liver qi and blood cannot reach a comfortable line, and its sexual depression. The former is too much, the latter is too leaky, and there are discrepancies in the treatment of medication.
The clinical manifestations of hepatitis are complex, and from the perspective of traditional Chinese medicine, Qin Bo is not classified into two categories:
First, it belongs to the liver: the symptoms are faintly swollen and painful in the right flank, aggravated by pain when encountering exertion, or headache and dizziness, hot flashes or palm fever on the head and face, or consciously baking heat and low body temperature, insomnia, easy sweating, yellow urine, occasional itching or dandruff on the skin, menstrual irregularities, etc.
The second is that it belongs to the spleen and stomach (including the intestine): the symptoms are dull, averse to greasy, aversion to oiliness, pantheism, belching, bloating and bowel sounds, constipation or loose stools, wasting, fatigue and weakness, lack of energy, jaundice, etc.
From the perspective of etiological mechanism, the symptoms of the liver are divided into falsehood and blood, including qi deficiency and blood deficiency, qi stagnation and blood stasis, and due to the discord between qi and blood, there is a phenomenon of cold and heat; the symptoms of the spleen and stomach are mostly caused by liver disease, among which the spleen and stomach are weak due to the wood Wangke soil, and there are also gastrointestinal stagnation due to the lack of soil, and the symptoms of the liver are aggravated when the spleen and stomach are not harmonious.
To this end, hepatitis diagnosed by Western medicine and traditional Chinese medicine are mainly based on liver disease, but the treatment cannot treat the liver alone, and it cannot be treated with a single treatment. Because the liver and spleen and stomach are closely related, and hepatitis is often accompanied by complicated symptoms of liver and spleen and stomach, it is necessary to take care of them separately and comprehensively.
Article source: China Traditional Chinese Medicine Network