Let's make a simple explanation of the original text. After taking Guizhi decoction or diarrhea, the patient still has headache, acute but not soft neck pain, like moss covering the body, fever and no sweat, fullness in the upper abdomen, slight pain and poor urination. Guizhi decoction is used to treat Jia Gui Fuling Baizhu decoction.
If the patient takes laxatives after drinking Guizhi decoction or under constipation, he still has a strong headache, dysuria, fever and fullness under his heart. Below his heart is his stomach, that is to say, his stomach is very sad, uncomfortable, full and slightly painful. This is Guizhi Qugui plus Fuling Baizhu Decoction.
Zhang Zhongjing said that the fullness under the heart is different from the fullness in the chest, which means that the whole chest pulse flows back to the heart too fast. Therefore, Guizhi decoction goes to peony, so it is necessary to go to peony when the chest is full. When the heart is full, Zhang Zhongjing is talking about the bottom of my heart, which is the stomach. My stomach is very sad, I feel uncomfortable and my stomach is full.
Before we learn this recipe, we must first understand the effects of Atractylodes macrocephala and Atractylodes macrocephala, mainly to eliminate dampness and promote diuresis. Of course, it also has the functions of strengthening the spleen, benefiting qi and stopping sweating. Clinically, it is generally used to treat spleen and stomach weakness, mental fatigue, abdominal distension, phlegm and edema, dampness, dizziness, spontaneous sweating and fetal movement discomfort. But this cassia twig goes to Guijia Fuling Baizhu decoction, mainly to eliminate dampness, and we are in clinical practice.
Therefore, this Guizhi Qugui Jiawei Baizhu Decoction means that this patient is moderately wet, that is, a person with a relatively wet middle energizer, and his spleen likes dryness and hates dampness. If the spleen is too wet, the spleen will swell, and the stomach will creep to the top of the spleen, resulting in fullness under the heart. How do we know that this person is wet? The person with a big belly is wet, and it depends on his tongue coating. If the coating is thick, it is wet.
Medium coke is wet, so it can only be dehumidified with water. Atractylodes macrocephala is specially used for dehumidification. Although Atractylodes macrocephala also promotes diuresis, its diuresis intensity is not enough. So this recipe adds poria cocos. The purpose of using Poria cocos is to facilitate urination, Atractylodes macrocephala to promote diuresis, and Poria cocos to promote diuresis. When these two drugs are used together, the patient's dampness can come from urine.
If this prescription is to remove peony and leave cassia twig, if the dosage of cassia twig is still relatively heavy, then moisture will not be discharged from urine, but will be emitted from sweat. The end result is that the moisture burns up from the middle and the face turns red. So this prescription is to remove cassia twig, not peony. Why do you want to remove cassia twig? Because the dampness is in the middle jiao, Guizhi has certain stimulation to the stomach, which will cause slight pain under the heart. Paeonia lactiflora has a good analgesic effect on abdominal pain, which can just relieve the pain. Atractylodes macrocephala, Poria cocos and diuresis, together, can facilitate diuresis from childhood.
In this recipe, Atractylodes macrocephala and Poria cocos must be equivalent. Atractylodes macrocephala is too dry if it is opened too much. Poria cocos is more open, which is also beneficial to normal body fluids. Poria cocos, especially the water with medium coke removed, is very good. Some people have a bad appetite, maybe the coke is too wet. Therefore, Atractylodes macrocephala and Poria cocos are often used together to remove moderate coke in the same amount.
Some people eat Guizhi decoction, but the disease is not completely cured. They still feel a little stomachache and urine is still dripping, that is, they are moderately wet. We should consider changing the prescription, removing Guizhi and adding Baizhu Poria.
All doses of this prescription can be prescribed in equal amounts, namely, Radix Paeoniae Alba III, Radix Glycyrrhizae Preparata III, Rhizoma Zingiberis Recens III, Poria III, Atractylodis Rhizoma III, and twelve Chinese dates. Generally, three bowls of water and nine bowls of water are boiled, and one bowl is wet, which is convenient for getting sick.
Then we learned from this prescription before that when we should go to Paeonia lactiflora, when we should go to Guizhi, when we have flatulence, and when our breasts are full, we will go to Paeonia lactiflora. This is the addition and subtraction of Guizhi and Paeonia lactiflora. Therefore, we should be good at summing up when learning prescriptions.