Lingshu Zhong Shi put it well, that is, "Yin and Yang are both deficient, nourishing Yang and exhausting Yin, purging Yin and eliminating Yang. If so, you can use incense to make qi ... "Sweet medicine will create everything on the earth, and Yin and Yang are active in qi and blood, so" pulse knot formation, palpitation "will have a chance to recover. It can be seen that the idea of taking licorice as a medicine in Zhigancao Decoction is different from other drugs. Other drugs belong to direct tonic, and Glycyrrhiza uralensis Fisch is used on the premise of holistic view of traditional Chinese medicine, which fully embodies the wholeness and syndrome differentiation of traditional Chinese medicine. In addition, it is recorded in ancient herbal medicine that licorice has the function of promoting blood circulation, but in Treatise on Febrile Diseases, it seems that only the decoction of roasted licorice is meaningful, and the use of roasted licorice in other prescriptions reflects the function of tonifying the middle energizer and benefiting qi, so it is not sufficient.
As a prescription for treating heart disease, Treatise on Febrile Diseases originally said: "Typhoid fever, pulse generation, palpitation, and fried licorice soup are the main ones." There are two understandings about the etiology and pathogenesis of this syndrome: one is that it belongs to sun disease, that is, sun disease mistakenly sweats and grieves yin and yang, resulting in deficiency of both heart and yin and deficiency of qi and blood, which belongs to sun disease turning into shaoyin disease; Another point of view is that it belongs to the deficiency of yin and yang of body and mind, and the cold pathogen is from the exterior yin deficiency, which leads to the disease yin deficiency. Both of these understandings are reasonable and practical.
Pulse knot formation and palpitation are the key points of syndrome differentiation. Nod pulse and substitute pulse refer to irregular pulse rhythm and intermittent pulse. Su Wen Wei Lun said that "the heart governs the blood vessels", and the operation of blood vessels depends entirely on the promotion of heart qi. This syndrome is restless because of deficiency of both yin and yang. In short, lack of heart-yang leads to lack of inspiration; Lack of heart and blood leads to insufficient pulse channels and difficulty in qi and blood operation, so the pulse is unsustainable and produces knots. Zhigancao decoction is mainly used to treat heart deficiency of both qi and blood, yin and yang deficiency, palpitation and palpitation. As far as its pathogenesis is concerned, it can be seen that the sun is closely related to the heart of shaoyin, and it also reflects the pathological changes from exterior to interior, from yang to yin. Syndrome differentiation should grasp the main pulse syndrome of pulse knot generation and palpitation, the strength of pulse, intermittent situation, and whether there is compensation after stopping, which is the key to judge the generation and substitution of ascending knot.
This side is suitable for those who are weak and less evil. If evil is restrained, only addition and subtraction can be effective. 177 discusses typhoid miscellaneous diseases, which is an example of the theory of internal and external integration. Youke Yunbo said: "Among typhoid fever, miscellaneous diseases are the most. Internal and external inclusions, virtual reality and mutual appearance, so typhoid and miscellaneous diseases are combined into one. " Therefore, this prescription is mostly used for miscellaneous diseases, heart diseases, or chronic heart diseases caused by exogenous diseases, as long as it is judged that the heart is deficient in qi and blood and the yin and yang are deficient, regardless of exogenous diseases.
This prescription is named after the main medicine of Radix Glycyrrhizae Preparata, which is heavy in dosage, warm and beneficial in nature, and is the source of qi and blood biochemistry. This Classic Bielu says it is an important medicine for pulse recovery. Ginseng, cassia twig, tonify heart qi, warm tongxinyang; Ground, wheat, glue and hemp, nourish yin and replenish blood to replenish blood. Ginseng jujube, invigorating qi and nourishing liquid. This recipe can nourish yin, but it can't turn qi without Yang Can's yin, so cassia twig, ginger and sake are used to promote yang and turn yin to help the heart to promote blood circulation and dredge veins. The whole prescription has the functions of dredging channels and activating collaterals, nourishing blood, invigorating qi and activating yang, nourishing yin and nourishing blood, harmonizing yin and yang, and supplementing qi and blood, so that qi and blood can be filled, Yang Can of yin and yang can be adjusted, pulse condition can be restored, and palpitation can be relieved. This recipe is called Fumai Decoction because it can recover pulse.
The application of Radix Glycyrrhizae Preparata in the prescription is particularly important. Radix Glycyrrhizae Preparata is the main medicine for dredging collaterals and restoring pulse, and the dosage should be heavy to enhance the function of dredging collaterals and benefiting qi. In addition, the prescription used 500g, which is the highest among Zhongjing's medicines. According to Shennong's Classic of Materia Medica, Rehmannia glutinosa "governs the injury and expels blood stasis". This classic says "promoting blood circulation and benefiting strength", so a large dose of Radix Rehmanniae can not only nourish yin and replenish blood, but also promote blood circulation. As many as 30 dates are used, which is also the best in the group. Shennong Materia Medica says that jujube "supplements less qi and body fluid", so jujube reuse can not only replenish spleen and stomach, but also replenish qi and nourish body fluid, and help it recover pulse. It can be seen that the reuse of Radix Rehmanniae and Fructus Jujubae can not only replenish true yin and nourish hard work, but also replenish spleen and qi, promote blood circulation and remove blood stasis, and help fried licorice to recover pulse.
The modern clinical use of Zhigancao Decoction is indeed a famous ancient prescription for treating heart disease and a common prescription for treating arrhythmia. Another feature of this recipe is that it is decocted with sake. This paper discusses the usage of "sake" in this recipe. The author once used this recipe to treat a person's arrhythmia. According to the provisions of Treatise on Febrile Diseases, he was told to use "sake" and decoction medicine, and "sake" was replaced by yellow wine. After the patient took dozens of doses, the effect was very good, so he changed the soup into pills to consolidate it. At this time, the patient asked Yun: Do you still use wine? Answer: why use wine when pills are not fried? A few months later, the patient came back to see a doctor and told him that the initial effect of taking water pills was not obvious. The reason must be that there was not enough wine, so he took water pills every time he drank rice wine, and the effect was good at once. He also told me that when I used to drink soup, I began to fry water and wine in half. Later, I thought that the heating of rice wine would inevitably volatilize alcohol, so I decided to take the medicine together with rice wine, or take the medicine first and then drink rice wine, saying that the effect was also good.
Of course, the patient is responsible for "not following the doctor's advice", but after careful consideration, why use alcohol? Deficiency of yin-yang and qi-blood in the heart and weak pulse are the symptoms of "pulse generation" Wine has the effect of warming meridians and relaxing pulse, whether it is fried or eaten, as long as it can play this role. However, if you take medicinal liquor, the clinic will depend on the specific patient's alcohol consumption, generally 30/50 ml of yellow wine can be used. According to the report of modern pharmacological research, adding liquor for a long time is also beneficial to the precipitation of effective components of drugs, while Rehmannia glutinosa and Ophiopogon japonicus are feminine products, which make the wine spicy and smooth, so it is said that Rehmannia glutinosa and Ophiopogon japonicus get good wine.