1. Indicating range
(1) shaoyang syndrome is located between the sun and Yangming, half exterior and half interior, so shaoyang syndrome is also called half exterior and half interior syndrome. Its main manifestations are cold and fever, fullness in chest and hypochondrium, hey hey, no appetite, upset and vomiting, bitter taste, dry throat and dizziness. The pathogenesis is unfavorable cardinal and stagnation of gallbladder fire. If "delirium caused by sweating" and "shock caused by vomiting", use it with caution. Xiaochaihu decoction is mainly used to treat shaoyang, eliminate pathogenic factors and strengthen the body resistance.
(2) After treatment, the syndromes of Chaihu Decoction did not stop. "If the syndrome of Chaihu decoction is not limited, it will be steamed and vibrated, and it will be solved by fever and sweat." This is because of the mistake of Chaihu syndrome, but Chaihu syndrome still exists, so it is "not contrary" to Xiaochaihu decoction. Because of mistakes, righteousness is frustrated and disease resistance is weak. After taking Xiaochaihu decoction, healthy qi can be helped and evil can be resisted, so fighting sweat is used to solve it. "Steam vibrates, and sweat fights" (Treatise on Febrile Diseases). Sweating is a good sign of healthy qi coming back, and evil is fighting hard, and it is better than evil. If the syndrome of Bupleurum ceases after wrong treatment, don't throw Xiaochaihu decoction in vain, but judge its pulse syndrome, know where it is wrong and treat it according to law.
(3) All meridians have the same disease, and the disease tends to be less yang, such as "Yangming disease, hot flashes, loose stool, spontaneous urination and Xiaochaihu decoction". "Yangming disease, hypochondriac fullness, vomiting without defecation, white tongue coating, can be matched with Xiaochaihu decoction." These two diseases are the same diseases of shaoyang and Yangming, and their syndromes focus on shaoyang, so they are treated from shaoyang. Adjust the qi of triple energizer with Xiaochaihu decoction, "make the upper energizer pass through, the body fluid flow down, the stomach qi relax due to harmony, and the body sweats." Another example is "typhoid fever for four or five days, body hot air is evil, neck is strong, chest is full, hands and feet are warm and thirsty, and Xiaochaihu decoction is the main one". This is a combination of three yang, and the treatment is from shaoyang. Make the cardinal run, communicate from top to bottom, and communicate freely inside and outside, then the evil of Sanyang will be solved. It can be seen that Xiaochaihu decoction is the main prescription of shaoyang syndrome, but it is not the special prescription of shaoyang syndrome. Chen Xiuyuan, a physician in the Qing Dynasty, had an incisive exposition on this. He said: "Xiaochaihu Decoction is the pivot of the sun disease, and it is also used by those who enter the Yin meridian of Yangming and express their spirit with the pivot. The pivot of shaoyang is called the prescription of shaoyang, and if it is called the special prescription of shaoyang disease, it will be broken. " Very profound and intriguing.
(4) Micro-stagnation of yang refers to stagnation of yang heat, which is not serious. Wu explained: "If the yang is slightly knotted, the yang evil is slightly knotted, but it is not completely dispersed." For example, "on the fifth or sixth day of typhoid fever, head sweating, slight aversion to cold, cold hands and feet, full heart, hard stool and thin pulse are mild knots of yang." There must be a table and an interior. "The Golden Mirror of Medical Zong pointed out that" this is half inside and half outside ",so" choose Bupleurum chinense and point out that its evil is inside and outside ". If after taking the soup, the exterior and interior are not harmonious, the stool can be slightly clear, so that it can be "solved by defecation."
(5) Heat entering the blood chamber is a disease syndrome that women feel cold and turn into heat invaginating the blood chamber. For example, "a woman has a stroke, fever and aversion to cold, and it will be comfortable to pass water for seven or eight days." When the heat is removed, her pulse is late, her body is cold, and her chest is full, this is the heat entering the blood room. " Xiaochaihu decoction can be used to relieve the cardinal, so that the cardinal can benefit and the heat in the blood chamber can be dissipated to treat "no stomach qi, upper middle energizer" Because of its heat entering the blood chamber, "its blood will bind", Achyranthes bidentata and peach kernel can be added to the prescription to promote blood circulation and remove blood stasis. If acupuncture is combined, the curative effect will be faster.
(6) If you have Chaihu syndrome, you don't need to know Treatise on Febrile Diseases: "Typhoid apoplexy has Chaihu syndrome, but you don't need to know if you witness it." Such as "vomiting and fever, treated with Xiaochaihu decoction", is an example. It should be pointed out that "only one syndrome is enough" does not mean that Xiaochaihu decoction can be used only by looking at one symptom of Chaihu syndrome. For example, the item 100 is Taiyin exterior syndrome, and a series of syndrome changes occurred after the mistake. At this time, although you see "hypochondriac pain", you should not underestimate Xiaochaihu Decoction. Although Bupleurum is a blending agent, Scutellaria baicalensis Georgi is inevitably bitter and cold, and the moderate cold will be aggravated after taking the medicine, so it is called "Bupleurum is not in place". The teacher's elaboration is so detailed to show flexibility, not rigidity.
Step 2 add and subtract
(1) complicated with solar diseases, such as "typhoid fever for six or seven days, slight aversion to cold, vexation and pain in side-joints, slight vomiting, side-joints in the heart, with symptoms and signs not removed, Chaihu Guizhi Decoction as the main indication". This is "although the exterior syndrome of the sun has not gone, the pathogenesis has seen shaoyang" ("Golden Mirror of Medical Zong"). As can be seen from Will, the diseases of Sun and Shaoyang are relatively mild, so we take half of Bupleurum and half of Guizhi to double the evil of the two meridians. "If you are not thirsty and slightly hot outside, go and find someone to participate in the three cool cassia twigs, warm and slightly sweaty." This is the manifestation of evil, so the tonic of ginseng is removed, and cassia twig is added to relieve it, making it slightly sweaty and eliminating evil with sweat.
(2) Yangming disease, such as Dachaihu decoction and Chaihu plus mirabilite decoction, can cure shaoyang and interior excess. The former is mainly used to treat "stomach fever" rather than the injured; Although the latter is mainly used to treat dry stool, "treating it with pills" damages the healthy qi. Therefore, all the treatments are to reconcile shaoyang, and at the same time, to dredge the interior and use Xiaochaihu decoction to increase the damage. Remove the ginseng and grass in front, and add yellow and immature bitter orange to attack the heat knot; After that, ginseng grass was left to tonify deficiency and strengthen body resistance, and mirabilite was added to soften and strengthen diarrhea. Their instructions are similar, but their emphasis is different.
(3) When drinking water at the same time, it stops as follows: "Typhoid fever has been sweating for five or six days, and then it comes down, and the chest and hypochondrium are full of slight knots, which is unfavorable for urination, but the thirst is not vomiting, but the head is sweating, cold and heat are coming and going, and people are upset and still unsolved. Chaihu Guizhi Ganjiang Decoction is the main treatment." This is the syndrome of shaoyang disease complicated with internal stagnation of water and drink. Because it doesn't drink water, it goes to ginseng to make up; Because I don't vomit, I get rid of the bitterness of Pinellia ternata. Radix Bupleuri, Scutellariae Radix and Shaoyang in the prescription; The roots of Trichosanthes kirilowii and oysters are soft and firm; Ramulus Cinnamomi, Zingiberis Rhizoma, and Radix Glycyrrhizae Preparata tonify zhongyang and warm cold drinks. "If you have palpitations and difficulty urinating, go to Scutellaria baicalensis Georgi and add poria cocos." This is not for drinking water, because the water stops when it is cold, and benefits when it is weak. Therefore, the cold condensation of Scutellaria baicalensis Georgi is removed, and the osmotic benefits of Poria cocos are increased.
(4) People with anxiety and shock at the same time, such as "typhoid fever on August 9, chest full of anxiety and shock the next day, unfavorable urination, delirious speech, and severe rollover, mainly Bupleurum and keel oyster soup". This is typhoid fever caused by accidental injury, and pathogenic heat invades the whole body, resulting in both exterior and interior diseases. It is a disease syndrome centered on restlessness. "Is a witness, is the evil of Yin and Yang; It's also a prescription, and it's also used to attack and tonify miscellaneous drugs (The Golden Mirror of Medical Zong). The prescription uses Xiaochaihu decoction to strengthen the body resistance and eliminate pathogens, and turn shaoyang into the pivot. Ramulus Cinnamomi is added to regulate yang exterior, rhubarb is used to clear away heat and relieve exterior, keel, oyster and plumbum preparatium are used to calm the nerves, and Poria is used to soothe the nerves. "Si treats miscellaneous diseases with miscellaneous drugs" ("Medical Zong Jin Jian").
(5) Chest tightness "Chest tightness does not vomit, go to Pinellia to participate in a piece of Fructus Trichosanthis". Boredom in the chest is caused by phlegm-heat accumulating in the chest, and Fructus Trichosanthis is added to clear heat and resolve phlegm. Hot gathering can't make up for sweetness, and if it doesn't go against it, it doesn't need pungent powder, so it will go to the summer genus.
(6) At the same time, you are thirsty. "If you are thirsty, go to Pinellia ternata, and add four or two pieces of Fructus Trichosanthis." Thirst is the cause of heat damaging qi and body fluid. Pinellia died of warm dryness, and ginseng and Trichosanthes kirilowii root were reused to replenish qi and promote fluid production.
(7) Threatening and indulging "Threatening and indulging, adding four ounces of oysters to jujube". Under coercion, it is hard, and it is firm and tangible that evil gathers shaoyang. Jujube tastes sweet, so go away. Add the salty taste of oysters to make them soft and firm. Wang said: "Bupleurum can lure oysters, and Bupleurum can scare off splashing." .
(8) Abdominal pain "If there is abdominal pain, go to Scutellaria baicalensis Georgi and add Radix Paeoniae Alba". Abdominal pain caused by liver-wood multiplying spleen. Removing the bitter cold of Scutellaria baicalensis Georgi and consolidating the soil, and adding the sweetness and softness of Paeonia lactiflora make it urgent.
(9) Cough "If you cough, remove ginseng, jujube and ginger, and add half a liter of Schisandra chinensis and two ounces of dried ginger". Cough is caused by lung cold, so ginseng and jujube are supplemented, and Schisandra chinensis is added to astringe the lung and relieve cough. Dried ginger warms the lungs and dispels cold easily. "Although lung cold does not reduce Scutellaria baicalensis Georgi, I am afraid that dried ginger will help heat" ("Medical Zong Jin Jian").