In the Ming Dynasty, Xue Ji wrote in the Digest of Internal Medicine: Xiaochaihu Decoction: to treat hepatobiliary diseases, cold and heat, or fever in the morning, or hot flashes to warm the body, silently unwilling to eat; Or anger, bitter taste, deafness, cough, fever, hypochondriac pain, and even inconvenience to roll over, both sides are full; Or diarrhea and cough; Or spit acid and suffer hardships; Or suffer from malaria and dysentery because of anger.
From this passage in Xue Ji, we know that Xiaochaihu decoction is widely used, with cold and heat coming one after another, and fever coming day by day, which refers to internal injuries. When we talk about sun fever in trauma, it is often Yangming fever. Or hot flashes, often Yangming fever is more common. Internal injury and fever can be treated with Xiaochaihu decoction for cold and heat, sun fever and hot flashes.
We only use exogenous fever to cover internal injuries, and fever often goes wrong. Or it is often wrong to cover up the performance of external feelings with the performance of internal injuries.
What is the difference between exogenous diseases and internal injuries in Xiaochaihu decoction?
Xiaochaihu decoction is used for exogenous diseases, and its main function is to reconcile exterior and interior and eliminate evil. Xiaochaihu decoction is used for internal injuries, and is often used to regulate liver and spleen, relieve depression and clear heat.
Xiaochaihu decoction is used for exogenous diseases, and we use six meridians to differentiate syndromes. Xiaochaihu decoction is used for internal injuries, and we use zang-fu organs to differentiate syndromes.
Let's take a look at a medical case in Xueji Internal Medicine Digest: Zhu Yangshan, the prefect, was out of his mind because of anger and abdominal pain, or fullness in both sides, or chest and breast pain, or cold and heat, or bad urination, improper diet, vomiting and spitting. This liver tree is treated by using spleen soil, adding Bupleurum, Gardenia, ginger, Poria and dried tangerine peel to make Rhizoma Coptidis.
The cause of this disease is anger, and the symptoms are abdominal pain and diarrhea, abdominal distension on both sides, chest and breast pain, cold and heat, unfavorable urination, improper diet, vomiting and spitting, and unclear thinking. This group of diseases appears repeatedly or alternately, and this group of diseases is divided into upper and lower, internal and external.
Just prescribe a dose of the disease, and the effect will be quick. Look at his symptoms. It's really serious. If this disease is a syndrome, how should it be distinguished from the six meridians? Will it be dialectical to shaoyang? If shaoyang is identified, how should it be treated?
The Yukime used here is syndrome differentiation of zang-fu organs, disharmony between liver and spleen, liver and wood taking advantage of spleen soil, Xiaochaihu decoction plus Gardenia, soaked ginger, Poria, dried tangerine peel, and prepared Coptidis Rhizoma. The production method of Coptidis Rhizoma is to divide Coptidis Rhizoma and Evodia rutaecarpa equally, mix them with hot water for two or three days, and fry Coptidis Rhizoma for later use. Actually, it's Zuojinwan. That is to say, Xiaochaihu decoction and Zuojin pill are made of soaked ginger, poria cocos and dried tangerine peel. Xiaochaihu decoction contains ginseng and licorice, plus soaked ginger, which is half a Lizhong decoction.
Xiaochaihu decoction combined with Lizhong decoction combined with Zuojin pill, Xiaochaihu decoction contains Pinellia ternata, with Poria, Chenpi and Erchen decoction. Pinellia, soaked ginger, coptis, ginseng, fried licorice, this is similar to Pinellia soup. This is Xiaochaihu decoction, Banxia Xiexin decoction, Lizhong decoction and Erchen decoction. Four prescriptions together, there are not many herbs. And the prescription of syndrome differentiation of zang-fu organs is often used in this way. But this style is completely different from the prescription of six meridians syndrome differentiation. Here, Xiaochaihu decoction is actually a prescription for treating internal injuries by transforming liver and spleen into the same tone.
According to the analysis of the prescriptions in this case, Xiaochaihu Decoction, Banxia Xiexin Decoction and Erchen Decoction are three combined prescriptions (if "making Rhizoma Coptidis" is regarded as Zuojin Pill method, it is cut on all sides). If it is used to treat exogenous diseases, Xiaochaihu decoction should not be used in this way if it is used according to the differentiation of six meridians. If the prescription based on six meridians is used, Xiaochaihu decoction will not be combined with Banxia Xiexin decoction, Erchen decoction and Zuojin pill casually. This combination is chaotic, so there is no way to treat Shaoyang disease.
The treatment of internal injuries is based on syndrome differentiation of zang-fu organs. The usage of Xiaochaihu decoction in this case seems very natural and reasonable. This should be the natural development and natural expansion of the clinical application of Zhang Zhongjing's classic prescription after the development of later generations.