(1) four gases
Four qi, that is, four natures, refer to four different medicinal properties: cold, hot, warm and cool. According to the theory of yin and yang, cold medicine belongs to yin and warm medicine belongs to yang. Cold and cold, warm and hot, are different to some extent. Warm is not as good as hot, and cool is not as good as cold, so some drugs are often marked with words such as big heat, hot, warm and slightly warm to show the difference. The cold, heat, warmth and coolness of drugs are summarized from the reaction of drugs acting on the body, which is relative to the cold and heat of diseases. For example, in Chinese medicine clinic, gardenia, scutellaria baicalensis, gypsum and other cold drugs are used to treat febrile diseases, while aconite, dried ginger and galangal are used to treat cold diseases. Shennong's herbal classics say that "treating cold with hot drugs and treating heat with cold drugs" is the basic principle of treating diseases according to the nature and condition of drugs. If this principle is violated, it will lead to different consequences.
In addition, there are antipsychotic drugs, which refer to drugs with less obvious properties and relatively mild effects. There are also slight cold and slight temperature deviations, but they are still not beyond the scope of "four qi", so they are still customarily called "four qi".
(2) Five flavors
The five flavors are sour, bitter, sweet, spicy and salty. Some drugs are weak or astringent, so they are actually more than "five flavors", but they are still called "five flavors" because of the application habits of past dynasties. Different herbs have different functions. Similarly, it is summed up by the theory of yin and yang, so sweet returns to yang and bitter returns to yin. According to the experience of medication in past dynasties, its functions are as follows:
Pungent taste can disperse and activate qi and blood. For example, ginger and mint can dispel evil spirits, dried tangerine peel and Amomum villosum can promote qi circulation and relieve pain, and Angelica sinensis and Chuanxiong can promote blood circulation and remove blood stasis.
Sour taste has astringent effect. Such as terminalia chebula and ebony to stop diarrhea.
Sweetness has nourishing and soothing effects. For example, ginseng and astragalus can replenish qi; Rehmannia glutinosa and Ophiopogon japonicus can nourish yin; Licorice harmonizes medicinal properties and reduces toxicity.
Bitter taste has the functions of drying dampness, diarrhea and lowering. For example, rhubarb laxatives, atractylodes macrocephala dryness and dampness, and almonds reduce qi and relieve asthma.
Salty taste has the function of softening and moistening. For example, oysters can be soft and firm, and mirabilite can relieve constipation and moisten dryness.
Light taste has the function of permeating dampness and promoting diuresis. For example, Huo Ling and Cao Tong can moisten and promote urination.
The smell of drugs is both * * * and characteristic, with the same taste, the same taste and a few smells.
For example, rhubarb and coptis chinensis are bitter and cold in taste, which have the functions of clearing heat, purging fire and detoxifying, but rhubarb also has the function of relaxing bowels, and coptis chinensis has the characteristics of drying dampness, stopping vomiting and stopping dysentery. Qi is different from taste, such as ephedra and jujube. The smell is the same, for example, mint is pungent and cold, and aconite is pungent and hot. A few flavors in one breath, such as angelica, bitter and warm, peony bark, bitter and bitter. Therefore, only by mastering the properties of all drugs with similarities and differences can we use drugs accurately.
(3) ups and downs
Pathogenesis and syndromes of various diseases often show upward (such as vomiting, cough and asthma), downward (such as diarrhea, metrorrhagia), outward (such as spontaneous sweating, night sweats), inward (such as exterior evil, rash and toxic attack) and other disease trends. Choosing appropriate drugs for treatment can eliminate or improve these disease states. Therefore, as far as the role of drugs is concerned, there is also a trend to play a role. Rising and falling, floating and sinking are also relative. Rising is rising, falling is falling, floating is diverging, and sinking is draining profits. All ascending drugs are mainly ascending, which has the functions of ascending yang and dispelling cold, while all descending drugs are mainly descending, which has the functions of subduing yang, descending adverse, converging, clearing heat, eliminating dampness and purging fire.
The ups and downs are also closely related to sexual taste. Most drugs that are sweet and warm can rise and fall; Bitter, sour and salty, cold in nature, mostly precipitated. According to the nature of yin and yang, ups and downs belong to yang, and ups and downs belong to yin.
The weight of drug texture is another basis for inducing ups and downs. Generally, flowers and leaves and light medicines can rise and fall, such as chrysanthemum, Flos Magnoliae and Cimicifuga. Most drugs with heavy seeds can settle, such as perilla, immature bitter orange and magnet. However, the law of material application is not absolute, such as "a hundred flowers blossom, and Inula alone falls"; Perilla frutescens is pungent and warm, which should go up, but because of its heavy weight, it has the function of reducing qi, so it goes down, indicating that drugs are different. Moreover, the ascending and descending drugs can also be reduced, and the descending drugs can also be increased, which also shows that the ups and downs of drugs can be transformed with each other under certain conditions, and they are not static. Modern pharmacological analysis believes that the difference of drug odor is related to its chemical composition, and different components often show different effects. Because of the complex components of traditional Chinese medicine, its smell is composed of many components.
At present, the new medical books discuss pharmacology and effective components, and we can't simply stay on the understanding of "four qi", "five flavors", "ascending and descending" and "meridian tropism". We should continue to carry out physiological, pathological and pharmacological research, gradually explore areas that people have not yet known, and further explore the essence of traditional Chinese medicine.
(4) Meridian tropism
It means that through long-term clinical practice, Chinese medicine recognizes that certain drugs have special selectivity for certain diseases of viscera and meridians. As a cold medicine, although they all have the effect of clearing heat, the scope of action is either clearing lung heat or clearing liver heat, each with its own specialty; Both of them are tonics, and there are differences between tonifying lung, spleen and kidney. Meridian tropism is based on the theory of zang-fu organs and meridians. Meridian can communicate the inside and outside of human body, diseases on body surface can affect internal organs, and pathological changes of internal organs can also be reflected on body surface, so we can systematically understand the symptoms of pathological changes in various parts of human body through meridian. Like headache, the pain is in the forehead, which belongs to Yangming stomach meridian disease, so it is advisable to use gypsum, angelica dahurica and other drugs; Pain is in the back of the head and neck, which is a pathological change of the bladder meridian of the sun. It is advisable to use drugs such as Ligusticum and Fangfeng. If the pain is on both sides or one side, it is a gallbladder meridian lesion of Shaoyang, and drugs such as Chuanxiong and Bupleurum should be used. Therefore, the same headache, because of different parts, the choice of drugs is also different, so if you do not master the medication of different meridians, it will inevitably affect the therapeutic effect. For example, every time a lung meridian disease sees cough and asthma, it is treated by platycodon grandiflorum and almond, so these two drugs are classified as lung meridian. Heart meridian diseases are mostly caused by palpitation. After cinnabar is cured, it is classified as the Heart Meridian. Wait, it shows that the theory of meridian tropism is summarized from the observation of curative effect.
But the theory of meridian tropism is not an absolute and mechanically unchangeable formula. Homologous drugs have different effects of warming, clearing away heat, tonifying and purging. For example, Scutellaria baicalensis Georgi, Lilium and Lepidium can all enter the lung meridian, but functionally, Scutellaria baicalensis Georgi can clear lung heat, Lilium can tonify lung deficiency, and Lepidium can purge lung excess. The pathological changes of zang-fu organs and meridians also affect each other. For example, lung disease with spleen deficiency, lung and spleen should be treated. Therefore, when using drugs, we should not only be familiar with the meridian tropism of drugs, but also master the relationship between zang-fu organs and meridians, so as to achieve the expected effect of dialectical medication.
(5) Toxicity and adverse reactions
The so-called toxicity generally refers to the adverse effects and damages of drugs on the body, including acute toxicity, subacute toxicity, subchronic toxicity, chronic toxicity and special toxicity such as carcinogenesis, mutagenesis, teratogenesis and addiction. Chinese medicine is no exception. In herbal books of past dynasties, drugs are often labeled as "toxic" and "non-toxic" under their taste. Toxicity and non-toxicity are also one of the important signs of drug performance, and it is a problem that must be paid attention to when mastering the properties of drugs. The side effect of traditional Chinese medicine refers to the uncomfortable reaction that has nothing to do with the treatment needs when the dosage is commonly used, which is generally light and does little harm to the body. It can disappear automatically after stopping the drug, but the side effects should be minimized in clinical application.
As a doctor, in addition to understanding the toxicity and adverse reactions of traditional Chinese medicine from the classics of traditional Chinese medicine, we should also pay attention to relevant clinical reports. We must correctly understand and treat the toxicity of traditional Chinese medicine in order to ensure the safety of medication.
At present, the toxic Chinese medicines are arsenic, mercury, raw nux vomica, raw aconite, raw kusnezoff monkshood, raw Typhonium, raw aconite, raw Pinellia ternata, raw Arisaema, asarum, raw croton, raw kansui, toad venom, scorpion, Datura flower, cinnabar, realgar, Akebia stem, betel nut, croton and morning glory.