Professor Gu Zhishan thinks that the theory of "six meridians to be solved" put forward by Zhong Jing is actually based on the concept of space-time orientation of orderly and dynamic changes of "three Yin San yang" and "opening and closing pivot" in Huangdi Neijing, which is the expression of six states of human body's gasification. "Three Yang" of the Six Classics has its own dominant qi in heaven and earth, and the three Yang is solved by its dominant qi.
"When Six Classics Want to Solve" comes from Zhang Zhongjing's Treatise on Febrile Diseases. Through the study and practice of Professor Gu Zhishan, the representative inheritor of Shilongsha Medical College, the author deeply feels its application value. Here, I use a case to talk about my experience.
Case 1: Bronchial Asthma (treated from "Jueyin to relieve exterior syndrome" and "Yangming to relieve exterior syndrome")
Gong, female, 30 years old, was first diagnosed on February 2, 20 14. I have been suffering from asthma since I was a child. Asthma began to attack frequently from June 20 14, but it didn't get better after taking traditional Chinese medicine for 2 months. Diagnosis: At 2 o'clock at night, wheezing, expectoration, chest tightness, dyspnea, nocturnal dyspnea with thirst, heat upset, white sputum, clear nose, unsmooth cough, fair stomach, normal stool, thin yellow tongue coating, red tongue and thready pulse. Considering that the onset of syndrome ugliness (2: 00 pm) accords with "the moment when Jue Yin wants to be relieved", the prescription of Wu Mei Pill is added and subtracted: ebony 30g, asarum 3g, Cinnamomum cassia 4g, Chuanlian 6g, Cortex Phellodendri 10g, Angelica sinensis 10g, Codonopsis pilosula 15g and Zanthoxylum bungeanum 4g. 7 doses, decocted in water, before going to bed after meals 1 time, each time 150 ml.
Second diagnosis (20 14 12.24): the chief complaint was that after taking the above two doses, the asthma at night was relieved, because the back was afraid of cold, the tongue was thin and dry, the tongue was dark red and the pulse was rapid. It is also suggested to add cornu Cervi10g, Radix Rehmanniae Preparata10g, Herba Ephedrae 5g and Ramulus Cinnamomi10g to the original prescription. 7 doses, decocted in water, instead of 1 time in the morning and evening.
The third diagnosis (2015 65438+127 October): The condition was controlled after taking the medicine. Due to the change of weather, I accidentally caught a cold, which led to the recurrence of asthma, wheezing, wheezing, suffocation, cold back and fear of cold. I used Xiaoqinglong decoction and Yanghe decoction in the local area, and later I came to see a doctor. I told you when the attack got worse at 5-6 pm and 3-6 am. The attack was obvious, with wheezing throat. When coughing, I feel smooth, vomit a small amount of transparent foam-like sputum, sneeze with runny nose, slightly swollen upper abdominal cavity, and loose stool. According to the onset time at 5-6 pm, which is in line with "when Yangming wants to be relieved" and at 3-6 am, which is in line with "when Jueyin wants to be relieved", the prescription of Wu Mei Pill plus Xiaochengqi Decoction is selected. The prescription is: Wu Mei 30g, Asarum 3g, Cinnamomum cassia 4g (bottom), Chuanlian 4g, Cortex Phellodendri 6g and Angelica sinensis 10g. Magnolia officinalis 15g, rhubarb 5g, roasted licorice 9g, lepidium 15g, ephedra 5g, almond 10g, jujube 10g. 14 dose, decocted in water, after lunch 1 time, 40 minutes after dinner, each time 150 ml.
The fourth diagnosis (2065438+February 2005 12): The chief complaint was that after taking 1 time (half dose), I felt relaxed and my asthma was relieved. After taking 3 doses, my chest tightness disappeared. After taking 7 doses, I took 1 Zhou Gonggu again. I caught a cold yesterday and coughed a little, so I didn't have asthma this time. The patient is very happy, with little sputum, no nasal congestion, thin and dark red fur and a thin pulse. 9 g of dried ginger, 0/0 g of fried Rhizoma Atractylodis, and 0/0 g of Liuqu/kloc were added to the original prescription to strengthen the spleen and stomach, stimulate appetite and increase food intake. 14 dose, asthma is completely controlled after taking the medicine, and then decocted more than twice to consolidate the sequelae.
Case 2: Asthma with chest tightness variability (treated from "Jue Yin as Shu" and "Shao Yang as Shu")
Zhang, female, aged 36, was first diagnosed on 2065438+20041October 20th. Respiratory cough, especially 1~ 3 am, nausea, irregular stool, thin yellow tongue coating, dark red tongue and thready pulse. The airway provocation test was positive. Because the onset time is at 1~ 3: 00 am, which is in line with "when Jue Yin wants to be relieved", the prescription of Wu Mei Pill is revised as follows: ebony 35g, asarum 3g, cinnamon 4g, Chuanlian 3g, Cortex Phellodendri 10g, Angelica sinensis 10g and Codonopsis pilosula 15g. 7 doses, decocted in water, before going to bed after meals 1 time, each time 150ml.
Second diagnosis (2065438+ 200465438+128 October): After taking the prescription, 65438+wheezing disappeared at 0~3 a.m., but at 5~6 a.m. and 7~9 a.m., it was still easy to catch a cold and cough, expectoration with yellow phlegm, dry mouth and bitter taste, nausea, dry throat and face. Because the onset time is 5-9 am, and the time span is between Jueyin and Shaoyang (from Yin to Shao Yang), the original recipe is added to Xiaochaihu Decoction, including 6 grams of Bupleurum, 65,438+05 grams of Codonopsis pilosula, 65,438+00 grams of Scutellaria baicalensis Georgi, 65,438+00 grams of processed Pinellia ternata, 5 grams of roasted licorice and 65,438 pieces of jujube. 7 doses, decocted in water, morning and evening 1 time, each time 150 ml.
The third diagnosis (20 14 1 1.5): The upper cough was completely eliminated after the chief complaint.
Case 3: hypochondriac pain (treated from "Jue Yin should be solved")
Lu, female, 56 years old, was first diagnosed on June 6, 20 14. The patient suffered from pain and discomfort in the right hypochondrium for more than 10 years. Medical history: The patient 10 years ago had no obvious cause of right rib pain, and took drugs to soothe the liver and regulate qi successively, but there was no obvious relief. When seeing a doctor, the patient has pain in his right hypochondrium, preferring to lie in the right position and wander in pain. At 2~3 o'clock in the evening, I have severe pain, accompanied by belching and watery acidity. After catching cold, it is easy to cough, sore throat, dry mouth, good appetite, dry stool, drowsiness at night, thin yellow tongue coating, dark texture and astringent pulse. No hepatobiliary abnormalities were found by B-ultrasound. For the first time, the traditional methods of soothing the liver, regulating qi and dredging collaterals were ineffective, such as Xiangfu Inula Decoction, Sini Powder, Jinlingzi Powder and Shixiao Powder. Considering that the onset time is 2-3 pm, it is in line with "when Jue Yin wants to relieve". Wu Mei pill prescription: Kiichigo 30g, Asarum 3g, Ramulus Cinnamomi 10g, Radix Aconiti Preparata 5g, Rhizoma Coptidis 4g. 7 doses, daily 1 dose, 300ml thick soup, twice a day.
The second diagnosis (2065438+June 2004 13): The patient complained that the pain in his right flank was greatly relieved, his mouth was dry, his hunger was relieved, and now he had a burning sensation in his right flank, with a thin yellow tongue coating and dark and thin pulse. The effect is not correct. The original formula of ebony is increased to 50g, and Fructus Trichosanthis 10g, Flos Carthami 5g and Radix Glycyrrhizae preparata 5g are added. 7 doses, generally decocted.
The third diagnosis (2065438+June 20th, 2004): The patient complained of hypochondriac pain, slightly dry throat, obvious burning sensation in the right hypochondriac region, thin and white tongue coating, dark substance and thready pulse. If the effect is not correct, the original prescription will continue to take 7 doses.
Case 4: hypochondriac pain (treated from Yang Ming Yu Jie)
Chen Mou, male, 65 years old, was hospitalized with acute exacerbation of chronic obstructive pulmonary disease, and his cough and asthma were relieved after treatment. On the third day of ward round, the patient complained of left hypochondriac pain, sometimes swelling pain, severe pain at 3~4 pm, dry mouth and bitter taste, no special discomfort, thin yellow tongue coating. Because of hypochondriac pain after 3pm, it accords with "Yangming wants to relieve" (from spirit to business), that is, adding and subtracting Xiaochengqi decoction: raw rhubarb 10g (waist and back), bitter orange 10g, magnolia officinalis 10g, and roasted licorice 5g. 2 doses, taking 1 dose, the hypochondriac pain will be relieved immediately.
According to "When Six Meridians Want to Solve", it first appeared in Zhongjing's Treatise on Febrile Diseases, and "Six Meridians Disease" has its own solution time, such as "When Taiyang disease wants to solve, from fourth to last", "When Yangming disease wants to solve, from application to last", "When Shaoyang disease wants to solve, from yin to morning" and "Taiyin disease wants to solve". Professor Gu Zhishan thinks that the theory of "six meridians to be solved" put forward by Zhong Jing is actually based on the concept of space-time orientation of orderly and dynamic changes of "three Yin San yang" and "opening and closing pivot" in Huangdi Neijing, which is the expression of six states of human body's gasification. "Three Yang" of the Six Classics has its own dominant qi in heaven and earth, and the three Yang is solved by its dominant qi. Of course, "trying to solve" doesn't necessarily mean getting well, but with the help of the weather in their respective time areas, the Six Meridians may have overcome the evil spirits and made the disease well solved, and there may also be people who struggle fiercely between good and evil and have aggravated symptoms.
Case 1, wheezing occurred at ugly time (2 o'clock at night) at the first diagnosis, which is consistent with "when Jue Yin wants to relax". Therefore, Wu Mei Pill, a representative prescription of Jueyin disease, was used to regulate yin and yang, cold and heat, eliminate yin and close yang, and make qi flow smooth, so two doses of medicine were taken to relieve wheezing. When I was diagnosed for the third time, due to the ineffectiveness of conventional therapy, I chose Wu Mei Pill and Xiaochengqi Decoction (which is beneficial to activating Yangming and storing yang) according to the aggravation time of the attack at 5-6 pm, "when Yangming wants to relieve" and "when Jueyin wants to relieve" at 3-6 am, but I felt relaxed after taking 65,438+0 times (half dose). Case 2: wheezing cough occurred at 1~ 3 am at the first diagnosis, and the onset time coincided with "when Jueyin was about to relieve". After being treated with Wu Mei Pill, the symptoms were controlled at this time, but at the second visit, I was told that it was easy to catch a cold and cough at 5-6 am and 7-9 am, so the onset time was changed to 5-9 am, crossing the "Jueyin". Cases 3 and 4 are hypochondriac pain, but the routine method of soothing the liver, regulating qi and activating collaterals in case 3 is ineffective, because the hypochondriac pain time is aggravated at 2~3 pm, which accords with "when Jue Yin wants to relieve", so Wu Mei Pill is effective. In case 4, the patient's left hypochondriac pain was very severe at 3~4 pm, which was in line with "Yangming's desire to relieve". Give Xiaochengqi decoction to open Yangming, so that Yiyang gas reservoir is closed and the gas flow is smooth. After taking 1 dose, hypochondriac pain was relieved.
Therefore, "when should the six meridians be interpreted" is the starting point of Zhongjing's six meridians syndrome differentiation, which conforms to the purpose of "observing the pathogenesis without losing qi" (Su Wen Zhi Zhen Da Lun). If we can attach importance to the application of clinical evidence and make it "improvise and adapt to the times", we can adjust the yin and yang of the sick body with the help of the inherent changes of yin and yang in nature and human body, so as to give full play to our strength and make it used by the ancients. (stone) according to