Wang Qingren (王清任), courtesy name Xunchen, was a famous physician of the Qing Dynasty and the author of "Correcting Mistakes in the Medical Forest". He practiced in his body, taught the ancients instead of mud, attached great importance to human anatomy, and put forward "karmic medical diagnosis of diseases, when the internal organs are first clear" and "the key to curing diseases, in the understanding of qi and blood". His clinical contributions are nothing more than the idea of adjusting qi and invigorating blood and creating all kinds of stasis soups. His theory is "unprepared for the predecessors", and can "benefit the future learning, wing feather medical teaching".
The Suqin Sutra Commentary: "The owner of man, the ear of blood and qi." "The way of the five viscera is all born from the meridian tunnel, in order to practice qi and blood, the discord between flesh and blood, and the hundred diseases are born of change." Qi and blood are the basic substances of human life activities. The Suqin Eightfold Theory of Theophy yun: "Those who are flesh and blood, the gods of man, must not be unruly." "Qi belongs to yang, blood belongs to yin, the blood of those who carry qi is also, the blood carrier is also qi, the qi is full of blood, the blood is full of qi, the harmony of qi and blood is yin and yang, and all diseases are not born, if the qi and blood are not harmonious, the yin and yang are out of balance and the disease is born." Wang Qingren inherited and developed this theory, and in his long-term medical practice, he realized the importance of the theory of qi and blood, and proposed: "The key to curing diseases is to understand qi and blood, whether external or internal injuries... The injured person is nothing but qi and blood. ”
Influenced by the theory of "Yang Lord Yin And Yin Obedience" in the Neijing, in the midst of qi and blood, Wang Qingren emphasized Yang Qi even more, and he believed: "People are based on Yang Qi... The disease is based on qi deficiency. "The people sit and move, and the whole yuan qi is fought, if the yuan qi is sufficient, it is powerful, the yuan qi is weak, and the yuan qi is dead." "Since the yuan qi is weak, it will not reach the blood vessels, and the blood vessels will have no qi, and they will stay and stasis." "When the yuan qi is lost to 50%, it cannot be moved, and it is impossible to move half of the body." Thus the theory of qi deficiency and blood stasis was created, the method of improving qi and raising the yang and activating the blood circulation, making yang and returning five soups, and creating a precedent for the treatment of qi deficiency and blood stasis. Although this formula is designed to treat half-body failure, it is effective for all diseases caused by qi deficiency and blood stasis. In the end, its composition is quite innovative and worthy of in-depth study. Fang Zhong's use of four or two astragalus is intended to replenish the yuan qi and raise the yang and the yang, so that the qi is strong and the blood is flowing, and the blood veins around the body are through, and the stasis is correct. Angelica live blood, "Rihuazi Materia Medica" said: "break the evil blood, nourish the new blood", there is a way to dispel blood stasis without hurting the good blood. Sichuan root, red peony, peach kernel, safflower help angelica to activate blood and dispel stasis. Miao in Sichuan Qi is a qi medicine in the blood, which can "go up the leader, down the blood sea", good at dispersing, which can help astragalus to walk qi and blood to disperse stasis. The dragon cold meridian is active, and it is used with astragalus to match the cold temperature, and there are rises and falls. From the original square measurement (according to metric conversion), it can be seen: astragalus 120 grams, angelica 6 grams, red peony 4.5 grams, dilong 3 grams, Sichuan root 3 grams, peach kernel 3 grams, safflower 3 grams. It is not difficult to see that the amount of astragalus in Fangzhong is the most important, highlighting the meaning of replenishing qi and raising the sun; while the amount of blood-activating stasis is extremely light, with a ratio of about 5:1. It can be seen that Wang Qingren treats qi deficiency and blood stasis, focuses on the treatment of qi, reuses astragalus jun to replenish yuan qi, shengyang tongyang, and less with the product of activating blood stasis, which is intended to prevent stagnation of qi and blood, as he said: "If the special qi tonic medicine, the more qi is replenished and the blood is more stasis." ”
Clinically, all the evidence of qi deficiency and blood stasis, the author uses the treatment of adding and subtracting five soups of yang and yang, and the effect is satisfactory. Fangzhong astragalus is the most effective when used to 120 grams. Typical medical cases are as follows.
Yang Mou, male, 78 years old, was first diagnosed on March 7, 2007. Urinary retention due to prostatic hypertrophy and hospitalization, after conservative treatment for half a month is ineffective. Doctors are concerned about their advanced age and a history of hypertension and coronary heart disease, and it is not advisable to perform prostate circumcision, and recommend cystostomy. Because the patient and his family did not agree, they referred to Chinese medicine for treatment. The first diagnosis is worried that his age is high, the kidney qi is at a loss, the kidney is not dissolved, the opening is disordered, and the rule of law of warm and yang qi and water is good, although the urine after the medicine is passed, it is still not smooth, dripping out, and the rest is inexhaustible. The second diagnosis knew that the pre-diagnosis dialectic was not accurate, and carefully examined it, and saw that the skin of his hands was purple, the capillaries were full, and the veins under the tongue were angry, so he suddenly realized that this was a bruise. To replenish the Yang also five soups and warm kidney gas products, 3 doses and urination unimpeded also.
The Great Treatise on The Yin and Yang of Su Qing says: "Fix its flesh and qi, each guard its hometown, the blood should be decided, and the qi should be introduced." The Great Treatise on the True Essence of Su Qing says: "Drain his flesh, let him be reconciled, and bring peace." Zhang Zhongjing pioneered the name of "blood stasis", and described the main symptoms, pulses and treatment principles of blood stasis in the "Treatise on Typhoid Fever" and "Outline of the Golden Shortage", and created famous formulas such as peach core gas soup, resistance soup, blood soup under stasis, and rhubarb worm pills, which initially formed the treatment framework of blood stasis. Wang Qingren gave great play to this. He saw the stasis of blood from the corpse, so he advocated invigorating the blood and dissolving the stasis, and used the "bloody descent" to treat tuberculosis. Tang Rongchuan pointed out: "Where tuberculosis is caused, most of them are harmed by blood stasis. He also praised Wang Qingrenzhi's remarks as "quite insightful" and in line with medical theory. The qi and blood of the human body are expensive in circulation, the qi line is bloody, and the stagnation of the qi is stasis, and the formation of stasis will lead to the imbalance of the body's yin and yang qi and blood, and then a hundred diseases will arise. It can be seen that blood stasis is not only a pathological product, but also a causative factor, and runs through the occurrence and development of the disease.
"Blood is suitable for decision", Wang Qingren's treatment of qi stagnation and blood stasis, focusing on the treatment of blood, the elimination of real evil, mainly to activate blood and dissolve stasis, accompanied by the product of rational qi and qi, so that the stasis is removed from the qi and the blood is smooth, and the blood house is in line with this meaning. This formula is made of peach red four things soup with raw and easy to cook, red peony easy white peony with chai hu, citrus shell, orange stem, ox knee, licorice. Fangzhong angelica, Sichuan root, red peony, peach kernel, safflower activate blood stasis. Raw land nourishes yin and blood paralysis, dispels bruises without injury, and ox knees pass through the blood veins and lead stasis downwards, which is the main medicine in Fangzhong. Shaosa Chai Hu Sparse Liver Da Yu and Rational Liver Qi, Orange Stem And Citrus Shell Open Chest Rational Qi and Lift Qi. The Fang Miao has a tong in the patchwork of abandoning the sluggishness of the ripe land and taking the raw land, abandoning the quiet harvest of white peony acid and taking the movement of red peony to scatter. Qi and blood are precious in circulation, but they are also pleasing to their liking.
"Medical Forest Correction" contains 33 songs, of which there are 22 blood stasis prescriptions, sharing 15 kinds of blood stasis drugs, and the high frequency of use is peach kernel (14 times), safflower (13 times), and the two drugs are used for 12 times. It can be seen that Wang Qingren is good at using peach red to activate blood and dissolve stasis. "Shi Jinmo on Medicine" said: "Peach kernels have strong bruise breaking power, and safflower blood is victorious." The two drugs are used together to promote each other, activate the blood and menstruation, dispel stasis and regenerate, reduce swelling and relieve pain. My master of traditional Chinese medicine, Chao Enxiang, also likes to use peach kernels and safflower, he believes: "Peach kernels dispel stasis in the form, safflower dispels stasis in the invisible, and the two are combined to cure all stasis in the body." The predecessors said that "all flowers rise, and all sons descend." Peach kernel good rule in the lower blood stasis, safflower good cure in the upper blood stasis, peach kernel taste bitter into the heart, safflower flavor into the lungs, heart main blood vein, lung main qi and towards the hundred pulses. From the modern anatomy, the two major circulatory systems in the human body, the systemic circulation and the pulmonary circulation, are dominated by the heart and lungs, and the human body's qi and blood metabolism is completed in these two major cycles. It can be seen that the peach safflower is used together, and the blood is the fastest to dissolve stasis.
Among Wang Qingren's various blood stasis soups, the author most likes to use the blood house to chase the soup, which is designed for the blood stasis in the chest. As it was said: "The qi house stores qi, and the blood house stores blood." ”
Yang Mou, male, 46 years old. The night is hot for half a month. The patient had no obvious inducement to develop a fever at night half a month ago, and after a comprehensive examination of Western medicine, there was no abnormality, and the symptomatic treatment was not alleviated, and the treatment was sought in Traditional Chinese Medicine. Diagnosis: fever at night, especially at 9 to 11 p.m., with a body temperature of up to 39.5 to 40 ° C, accompanied by irritability, and the body temperature gradually recedes to normal after midnight. There is no fever during the day, the diet and stool are normal, and the spirit is acceptable. Its face is dark, the tongue is dark purple, the moss is white, and the veins are fine. Asked for medical history, he had a history of head trauma two months ago. Identify the blood stasis fever, give the blood house to stasis soup original formula, 3 doses and heal.
Wang Qingren said: "No matter where it is, there is qi and blood... Qi cannot be formed and cannot be clumped, and those who clumps must have tangible blood. "However, not all blood knots are due to qi, but also because of cold and heat. He believes: "When the blood is cold, it condenses into lumps, and when the blood is heated, it boils into lumps." "There are many causes of blood stasis in the aftermath of the enlightenment, and it is advisable to judge the causes and treat them."
Blood is expensive to circulate, warm is OK, cold is condensed. "Su Qing Tun Jing Lun" Yun: "Those who are flesh and blood, like warmth and cold, cold can not flow, and warmth disappears." "If the cold stays alone, the blood will coagulate, and the condensation will not work." Blood is cold coagulation, cure Yixin scattering temperature, warm yang and dissolve stasis, that is, "cold is hot" and "cold is hot". Wang Qingren's less abdomen stasis soup, first aid Huiyang soup, etc. all use warm ventilation blood products, such as the cannon ginger in the soup of the less abdomen, take the dry ginger xin scatter the warm nature, fry the black into the blood to divide the stasis; cumin is "the medicine of warm and fast qi", the warm passage is cold and relieving pain; Guan Gui is "thick and sweet, the thing in the next walk, the yang of the strong life gate... Make the yang long and the yin self-extinguishing". In addition, among the blood-activating stasis medicines used by Wang Qingren, except for the earth dragon and the red peony cold, the rest are Xin Wen, Bitter Wen or Xin Ping, Bitter Ping, and the group of ideas that cure stasis and emphasize the dispersion of the body is deeply rooted in the purpose of the "Inner Classic".
"Hot people cold", because of heat and stasis, stasis and heat interconnection is to cure heat to cold, when the heat is mainly detoxified, supplemented by blood circulation and stasis. However, Wang Qingren believes that "yin blood is of the same origin", and yin wounds are blood withered and cannot flow, and coagulation is stasis. Taking the tongjing stasis soup as an example, the pangolin, the earth dragon, and the red peony in the square are matched with salty cold and yin, soft and firm loose knots, and dissolve the stasis through the scriptures; and also with a large dose of peach kernels and double safflowers, there is a run in the tong without hurting the yin blood, which has the meaning of Ye Tianshi's "first peace and no evil place"; with forsythia to clear the heat and relieve the fire; shao zuo chai hu, take its cool and scattered nature to achieve the effect of "fire and depression", which can be described as the finishing touch. In its detoxification and blood soup, a large dose of peach kernels is used to breed the ground, nourish the cool blood, activate the blood and dispel stasis, and its method is the same as Ye Tianshi's "cool blood and blood dispersion".
In addition, people with blood deficiency can also cause bruising due to deficiency. For those who have not been stasis for a long time, in the treatment of this evidence, Zhang Zhongjing used rhubarb insect pills to slow down the deficiency, while Wang Qingren activated the blood on the basis of nourishing blood. He said: "Illness caused by weakness can be cured when it is weak." "Looking at Wang Qingren's living blood, peach kernels, safflower, angelica, red peony, and Sichuan root are used most frequently, and it is intended to be reduced and cut from the peach red four things soup, which is to revitalize the blood on the basis of nourishing blood and camping, and to make up for it, so that the stasis is removed and not hurt. As Tang Rongchuan said: "Without blood replenishment and dispelling stasis, can the bruises be exhausted?" Tonic diarrhea at the same time, stasis is gone without injury. ”
It is worth mentioning that the soup of less abdomen and stasis, this party is Wang Qingren for the cold coagulation of the lower abdomen and blood stasis, which is widely used in the treatment of gynecological transocial diseases. Wang Qingren said that the seeds of this party are like gods, and they must have the age of men and women and the month of the yang number to give birth to children. Yu zeng used this formula to treat 7 cases of primary infertility caused by blood deficiency and cold coagulation uterus and secondary infertility after miscarriage, all of which were successfully pregnant (no month was chosen), of which 6 were born male babies and 1 female baby.
Han Mou, female, 25 years old. Date of initial consultation: November 2, 2006. The patient was married at the age of 21, had a spontaneous abortion two and a half months after marriage, and has not been pregnant ever since. Diagnosis: late menstruation, dysmenorrhea, dark color, there are blocks, cold pain in the waist and abdomen during menstruation, cold fear of cold, cold hands and feet. The tongue is dark, the moss is white, and the veins are deep. The dialectic is blood deficiency and cold coagulation palace, the treatment of warm passage to disperse cold and relieve pain, with less abdomen and stasis soup combined with angelica four reverse soup plus and minus. After 10 doses of menstruation, the blood is red, there are a few blood clots, the pain is significantly reduced compared with before, and the hands and feet are gradually warmer. The above addition and subtraction are followed by 1 month, menstruation arrives at the right time, all symptoms are flat, and the drug is stopped. At the end of 2007, a baby boy was born at full term.
The "Su Qing Six Micro Purpose Theory" says: "When entering and leaving the waste, the gods are destroyed; when the breath rises and falls, the qi is immediately isolated and dangerous." ...... Lifting and descending, no instruments. "Man and heaven and earth are in harmony with each other, and they echo with the qi of heaven and earth. Lifting and descending is the movement form of the human body's qi machine, the opening of the qi must have its pivot, the spleen rises and the stomach descends to the center of the human body, the liver rises left and the lungs descend to the left and right pivot of the human body, the rise and fall in and out of the order is the harmony of qi and blood, and all diseases are not born; the imbalance of lifting and falling in and out of the body is reversed, and the diseases are transformed. Wang Qingren said: "If there is no breath of qi, then there is no breath of blood." "The qi adjustment machine is an important method of chinese medicine to treat diseases, aiming to conform to the rise and fall of the internal organs, so that the qi and blood can be harmonized, the yin and yang are secret, and the physiological functions of the organs are restored." For example, the "Su Qing Zhi Zhi Zhi Da" said: "The tone of the loose breath is also its way." Zhu Danxi has: "Qi and blood rush into harmony, all diseases do not arise, once there is depression, all diseases are born." The Qing Dynasty Huang Yuanyu's "Four Sacred Heart Sources" said: "Liver wood left depressed and blood disease, lung gold right stagnation and qi disease." Dong Chee-hwa, a famous modern Chinese medicine scientist, believes that under physiological conditions, the qi machine rises and falls, and the spleen and stomach are the pivot; under pathological conditions, the qi machine is depressed, headed by liver qi. The liver is just dirty, the body yin and yang, blood-based, the main blood, the storage and regulation of the blood; the liver is mainly drained, the qi is used, the sex is happy, the body qi machine is transferred smoothly, if the liver is lost and leaked, the qi is stagnant and the blood is stasis. Wang Qingren's active blood treatment in the regulation of the qi machine, the main to adjust the liver, supplemented by the adjustment of the lungs, such as the blood house stasis soup, with peony medicine into the liver to nourish the liver yin so that the liver "body" can be nourished; Chai Hu thin liver qi to make the liver "use" normal; platycodon to open the stagnation of lung qi to adjust; citrus shell to fast diaphragm to smooth the middle; ox knee into the liver to activate the blood through the menstruation, sexual good downward to cure, in order to achieve the effect of "blood downward".
When Wang Qingren activates blood, he will also match different qi adjusting products according to the location of the blood stasis. Blood stasis on the head and face is scattered with musk, wine, and onion spices, and goes straight to the top, such as tongzhi live blood soup; blood stasis in the chest, then with chai hu, citrus shell, orange stem wide chest diaphragm, through the chest threat of the qi, such as blood house stasis soup; stasis blood under the diaphragm is with black medicine, incense, citrus shell to regulate the liver and spleen, such as the soup under the diaphragm; in the small abdomen, it is directly to the bottom with cumin and guangui, such as the soup of stasis under the abdomen, such as the soup of stasis under the abdomen.
Clinically, the author inherits the method of Wang Qingren, for the evidence of blood stasis, pay attention to the adjustment of the qi machine, and apply more methods to adjust the liver and lower the lungs, so as to achieve the purpose of qi and blood vitality.
Sun Mou, female, 60 years old. Initial consultation on March 2, 2009. History of diabetes for 3 years. Oral hypoglycemic drugs have been taken to maintain blood glucose stability. Two months ago, due to the stimulation of emotion, a cough gradually appeared, mainly dry cough, coughing a little white phlegm, light day and night, difficult to sleep. Transpulmonary CT suggests that there is a high-density shadow in the upper right lung, and it is recommended to repeat it after anti-inflammatory. After half a month of antibiotic treatment, there was no significant improvement, and he was transferred to Chinese medicine for treatment. Immediate diagnosis: dry cough and less phlegm, light day and night, restless night, irritability and irritability, dry mouth but want to rinse the mouth without swallowing, chest flank suffocation is not comfortable, dry stool is not smooth, dry tongue is red and less moss, and the pulse strings are fine. The dialectic is qi stagnation, blood stasis, yin wound lung dryness. Cure to activate blood stasis, nourish yin and moisten the lungs, and punish the blood house with stasis soup and lily solid gold soup plus or minus. After 5 doses, the cough is reduced, and the night can sleep peacefully. And the above plus and minus treatment for half a month, all diseases are flat. Re-examination of lung ct shows that the hyper-density shadow of the right upper lung disappears and everything is normal.
In summary, Wang Qingren is indeed a person who diagnoses and treats blood stasis. Tang Rongchuan praised him: "The evidence of blood stasis is the most detailed" and "only the treatment of blood stasis is the longest.". Its idea of adjusting qi and invigorating blood originated from the "Inner Classic" and inherited from Zhang Zhongjing, on the basis of which there was great development and innovation. His formula idea of adjusting qi and activating blood provides theoretical basis and clinical ideas for the treatment and research of blood stasis. (Source: China Traditional Chinese Medicine News, Author: Liu Jianjun, Dashiqiao Central Hospital, Liaoning Province)