Zhang Zhongjing's synopsis of the golden chamber is a model of syndrome differentiation and treatment of miscellaneous diseases in traditional Chinese medicine. Among them, "Three Cases of Gynecological Diseases" is the earliest document of gynecological diseases, which can be said to be the first in gynecology of traditional Chinese medicine, especially the characteristics of syndrome differentiation and treatment of prescription drugs, with exquisite exposition, extraordinary curative effect and great clinical guiding value.
The prescription is based on blood, giving attention to both qi and water.
There is a cloud in Lingshu Wuyin Wuwei Pian: "A woman's life is more than qi, but less than blood, so she can divide blood by its number", which reveals the physiological and pathological characteristics of women with blood deficiency and qi excess. Based on this, the prescriptions for women in Three Chapters mainly focus on treating blood, taking into account the relationship between blood and qi, blood and water. Including medicinal Radix Paeoniae Alba, Colla Corii Asini and Radix Angelicae Sinensis. For example, Jiao Ai Tang is good at enriching blood and nourishing chong Ren, and is used to treat postpartum hemorrhage, postpartum hemorrhage and pregnancy cell block. It is a representative prescription of Zhongjing Tiaoxueji. Siwutang in Taiping Huimin Hejiju Prescription is made of Jiao Ai Tang minus Ejiao, Folium Artemisiae Argyi and Glycyrrhrizae Radix. It has always been regarded as an important medicine for enriching blood and an all-powerful and effective prescription for gynecological diseases.
Qi and blood flow from the same source, which is their foundation, coordinate with each other physiologically and influence each other pathologically. Zhongjing's theory of treating gynecological blood syndrome pays special attention to both qi and blood, or invigorating qi and nourishing blood, or promoting qi and blood circulation. In addition, based on the pathological mechanism of "blood is unfavorable, it is water", Zhongjing also established the method of promoting blood circulation and benefiting water, which has become an important principle for treating women with blood and blood stasis. For example, Danggui Shaoyao Powder, Zhishi Shaoyao Powder, Danggui Ginger Mutton Soup and Guizhi Fuling Pill all contain the idea of treating qi, blood and water at the same time.
The prescription is based on ignoring the spirit, and the medicine is specialized and strong.
"Su Wenzhi's true theory" says: "You have one minister and two ministers, and you are small; You have a minister, three assistants and five assistants, and you are also in the system; The monarch, the minister, the three assistants and the system are also big. " Zhongjing's prescription followed his will and clearly pointed out that "all diseases correspond to prescriptions and should be taken". Among the 36 prescriptions used in Women's Three Chapters, except Wenjing Decoction 12 and Zhu Ye Decoction 10, all the other medicines are no more than 9. The single prescription is rigorous, accurate and refined, which can be described as simple and effective. For example, the dried ginger and ginseng Pinellia Pills used to treat vomiting during pregnancy are used to warm the middle warmer, reduce adverse reactions and stop vomiting, and ginseng is used to strengthen the body resistance and tonify deficiency. As Chen Xiuyuan said, "Pinellia ginseng not only does not hinder the fetus, but also can prevent the fetus." Another example is the treatment of postpartum abdominal pain in women, which is full of immature bitter orange and peony powder. Fructus Aurantii Immaturus is used to break qi and disperse stagnation to benefit qi stagnation, and Radix Paeoniae Alba is used to relieve pain and benefit blood stasis. A break does not hurt yin, and nourishing yin does not hinder qi, which can be described as comprehensive. Dahuang Gansui Decoction is used to treat women's postpartum blood syndrome, with rhubarb four liang, Gansui two liang and donkey-hide gelatin two liang. Gansui is a drug for expelling water, so the dosage is halved to prevent excessive attack and injury to the right side. Combined with Ejiao to nourish blood and strengthen the body, it can eliminate evil without injury to the right side. All kinds of skills are the source of clinical reference for later generations.
Pay attention to dosage form and dosage, and pay attention to the method of administration.
According to the characteristics of diseases and syndromes, it is another therapeutic feature of Three Chapters of Gynecological Diseases, including seven dosage forms: soup, pill, powder, wine, washing, taking medicine and moistening dryness. In particular, using Langya Decoction as lotion to clean vulva, and Fructus Cnidii powder as a sitting medicine, suction yin, is the first external treatment of gynecology.
As for Zhongjing's dosage, it is even more wonderful, as big as a catty and as small as useful, such as Danggui Shaoyao Powder for treating abdominal pain during pregnancy. Peony as a monarch to a catty, astringing the liver, harmonizing the camp, and relieving pain urgently, supplemented by angelica; Danggui Kushen Fritillaria Pill is equivalent to three kinds of drugs, which shows that both promoting blood circulation and moistening dryness and clearing away dampness and heat are equally important, and various methods are the source of clinical reference for later generations.
Zhongjing is also very particular about taking medicine. Some people decoct with wine, often drink with wort or barley porridge, use vinegar as syrup, and use honey as pills, all according to the priority of their illness. The combination of Xionggui Jiaoai decoction and wine is based on the warming and dispersing power of wine, which can warm the palace and is feasible. Zhishi Shaoyao powder is taken with wheat porridge to protect stomach qi, and the preparation of pig spleen pills with "jujube meatballs" also lies in "calming the middle and benefiting qi". Zhongjing's concept of caring for the spleen and stomach can be seen. These things, we should explore their causes, inherit their essence, and continue to carry forward in gynecological clinic.