Ye's "Xian 'an method" based on Neijing and synopsis of golden chamber is of great clinical significance and widely used. According to the law of viscera taking advantage of the situation, safety can be "the first"; Keeping in good health according to time is "safety first"; Regulating yin and yang "putting safety first"; According to the loss of the body, "safety first"; According to the law of epidemic febrile diseases, it is "safety first". This fully shows that the essence of TCM disease prevention thought has a long history and rich content.
Ye's thought of preventing diseases in an innocent place is first influenced by the relevant theories in Neijing, such as "the disease is not cured if the sages are not treated, and the disease is cured if the disease is not treated later" and the relevant theories in synopsis of the golden chamber, such as "seeing the disease of the liver, knowing the liver to disperse the spleen and strengthening the spleen first". Secondly, Wu Youke and his Treatise on Febrile Diseases were the first to advocate prevention before illness. Wu Can also described warm pathogens as living water, which flows where the terrain is low, and where the viscera is weak, the pathogenic factors take advantage of it. For example, in The Treatise on Epidemic Febrile Diseases (Volume I), it is said that "either he is sick or even lost, and evil is transmitted from loss to loss, such as blood loss, rupture, colic and phlegm-fire, all of which are very changeable, but evil acts are like fire and spread well", which is similar to Ye's "Everything is safe in Xian 'an". Ye's prevention and treatment thought has a great influence and plays a connecting role in the treatment of epidemic febrile diseases. For example, Zhong Jiao's Treatise on Febrile Diseases said: "If Taiyin febrile disease has both qi and blood burning, the jade girl should take Achyranthes bidentata and Canadian dollar to take part in it." "Canadian dollar should take its strong water to control water, so as to prevent sore throat and blood loss. "Replenish water in advance to control the fire, and install the uninjured pharynx first to prevent blood loss in the pharynx.
Why did Ye put forward the idea of "a peaceful and innocent place"? Ye has a deep understanding of the theory of traditional Chinese medicine. He believes that "evil must take advantage of deficiency, and deficiency must suffer from evil" (exogenous warmth), and realizes that the occurrence and development of diseases are extremely complicated. Proper treatment of diseases can change from deep to shallow, from heavy to light, and from crisis to safety. If it is not treated properly, or if it is not treated or abused, the evil potential can go from shallow to deep and from light to heavy. The so-called appropriate treatment, first, eliminate all evils, strengthen the body resistance and cure the disease today, and second, nip in the bud. Ye realized that the pathogenic fire of epidemic febrile diseases changed the fastest and spread the fastest. The evil of fiery heat not only hurts body fluid, but also consumes energy, even hurts liver and kidney and endangers life. It is believed that this fiery evil will flow like running water to the deficiency of a zang-fu organ or a certain part, so this Dafa is put forward to prevent the disease from spreading in its "uninfected place". Looking at Ye's writings, there is no lack of this kind of disease prevention thought, such as "the epidemic of febrile diseases has just entered the membrane and has not returned to the gastrointestinal tract, so it is urgent to be thorough and clear, and it is not necessary to get sleepy and become a sexual disease." (Exogenous Warmth) "To fill the gap between the stomach and intestines, the wind can rest for a few days." This idea of preventing diseases is not only widely used in the treatment of fever, but also as the guiding ideology of pediatric and gynecological diseases. For example, "every prenatal disease should be protected step by step for fear of damaging good and evil" (exogenous warming). This therapeutic idea of preventing disease and transmission has great clinical guiding significance at that time, now and even in the future.
Clinical application of "safety first"
According to the law that viscera attack and insult each other, it is necessary to clear the fire of liver and gallbladder to prevent the spleen and stomach from being burned. However, it is the preventive thought of "seeing the disease of the liver, knowing that the liver spreads the spleen and strengthening the spleen first" in Synopsis of the Golden Chamber that makes the spleen and stomach bear the brunt. Ye Shi Tian is widely used in clinic, either benefiting the stomach first, benefiting the spleen first, or tonifying the spleen and stomach. For example, leaves nourish the stomach yin and prevent the invasion of liver fire: "The left side of the river is uneven, the liver wind has not been extinguished, and the stomach is exhausted, so there is nothing to support. This is the most important thing to raise Yangming. Covering the stomach belongs to the fu-organs, and the fu-organs are not invaded by wood fire, so the disease should be reduced by itself ... Ziziphus jujuba Rentang adds ginseng to Chuanxiong. Another example is: "Xu, 19 years old, is good at dieting and has diarrhea in loose stool. He has been ill for three years. What is internal injury coagulation? However, clearing the fire and moistening the lungs and relieving cough always hinders the spleen and stomach, thinking about personal illness and injury ... It is the Taiyin spleen that is cut every day, and naturally there is less yang and boldness to insult. It is the method of nourishing viscera and clearing fu-organs in Neijing. Four gentlemen add mulberry leaves to stir-fry peony bark, that is, to replenish their temper to prevent their anger. " Other viscera, such as lung diseases, can prevent lung fire from damaging the liver, which can clear the liver first, treat the lung first, and regulate liver qi first.
Seasonal health care holds that man and nature are a unified whole, and the ups and downs of Yin and Yang in different seasons can directly affect the physiological and pathological changes of human body. Ye, according to the theory of "if you don't store semen in winter, you will have fever in spring" in Neijing, aimed at those who are deficient in semen and blood in winter, nourish semen and blood in "a place free from evil" in winter to prevent fever in spring. For example, Dr. Ye said, "Zhang, tired, is ill in summer and autumn because of shallow qi, the light snow has gone, the throat is slightly sore, and the blood is colorless, and the source is not hidden, and the yang in the yin is not hidden, so I am afraid of deep lesions in spring. Rehmannia charcoal, donkey-hide gelatin, Sichuan glutinous rice, winter and summer foam, Qiu Shi dichotomy. " According to the theory of "nourishing yang in spring and summer, nourishing yin in autumn and winter" in Neijing, Ye thinks that it is easy to hurt yang in spring and summer, and that warming yang in summer in Yichun should be "determined first" and nourishing yang in autumn and winter to prevent autumn and winter diseases. For example, there is an example of nourishing yang in spring and summer to prevent diseases: "Yin and Yang are weak, and eight flavors are added in early spring, which reduces the spicy taste of osmanthus and benefits the sour taste of peony. It is effective to absorb yin from yang and supplement its camp by returning to spleen. Therefore, if spring rises and summer rises, the deficiency in the interior will not suddenly solidify, which will inevitably aggravate fatigue. The ancients said: cold hurts the shape, and heat hurts the gas. Therefore, we should give priority to invigorating qi. The method of taking Qing capsule in early summer. Pilose antler, antler cream, Poria, Radix Rehmanniae Preparata, Cistanche deserticola, Fructus Psoraleae and Schisandra chinensis. "
Based on the theory of Neijing, combined with Ye's thought of "calming the heart first", the author often warns patients not to eat cold drinks in summer to prevent Yang injury, but to eat more ginger, pepper or vegetables, and add fennel, cinnamon, pepper and other pungent and warm products to nourish Yang. Especially for patients with chronic bronchitis, rheumatoid arthritis and other obvious winter diseases, the prevention and treatment methods of strengthening body resistance in summer and treating winter diseases in summer have been formulated, and the method of warming kidney and yang has played the role of "preventing winter diseases". In winter when the human body is closed, the internal heat is abundant, and Yin Qi is deficient, patients are often told to eat less pungent and hot products to help yang, and to eat more sweet and cold fruits and radishes to nourish yin in winter and autumn. There is a folk proverb called "eat radish in winter and ginger in summer", which is the concrete embodiment of this land of "safety first" according to the season.
Conditioning Yin and Yang "first" the human body to maintain a relatively dynamic balance of Yin and Yang, healthy and unscathed. If one side is too much or too late, it will cause pathological changes. Ye often sees cases of regulating yin and yang to promote its dynamic relative balance. For example, the method of clearing away heat and nourishing yin by calming the liver wind first is widely used, such as Ye An's case: "Cheng's disease occurs from the inside in late summer and early autumn, such as malaria-like attack and heat forcing the camp. Menstruation does not come, the tongue is as light as a mirror, the face is dull and dull, and there is a dull pain in the chest, lack of healthy qi and closed heat. Anyway, his whole body aches and his yang is out of balance. Radix Rehmanniae, Colla Corii Asini, Radix Asparagi, Radix Ophiopogonis, Fructus Cannabis, and oysters. " Another example is "on nourishing stomach yin, strengthening yang, on the contrary, you can't rule cough in a cage", "cough in winter is warm ... cough is still not over, let's talk about benefiting stomach yin and controlling dragon phase with sweetness" and so on. It is all to adjust the decline of yin and yang, so as to "protect the place from evil."
When warm pathogens invade, the fire is the fastest and spreads most urgently. Ye Shi Tian often washes uninfected viscera directly or indirectly to prevent transmission. For example, to treat stagnation in the warm interior and prevent heart injury, we must first clear the excess fire in the stomach and intestines: "Warm pathogen comes from the interior, sore throat, dry mouth, tongue and heart stagnation, upper energizer is hot and hazy, most afraid of colic and convulsion, bitter cold and falling straight, so that the stomach and intestines have nothing to do with warm pathogen. Fructus Forsythiae, Fructus Gardeniae, Fructus Arctii, Semen Armeniacae Amarum, Pollen, puffball, Trichosanthes kirilowii bark, Prunellae Spica, Golden Juice and Honeysuckle Dew.
According to the theory of body deficiency, the purpose of "safety first" can also be achieved by supplementing the deficiency of viscera first. Only by distinguishing between the patients' physical weakness and physical weakness can we apply the methods and drugs of "calming the heart and calming the nerves" in a targeted way, such as nourishing yin fluid at the beginning of epidemic febrile diseases, nourishing yin fluid at the beginning of epidemic febrile diseases, and invigorating qi at the beginning of epidemic febrile diseases. For example, Ye Bupi heatstroke prevention: "Shen, 23, white pulse, qi deficiency, weak stomach, less food, scraping when the smell is turbid, feminine medicine, often taking pig belly pills to nourish the stomach, which is even more harmful in summer. Every time you eat a dose of Shengmai Sijunzi Decoction, you can observe your daily clothes, so that you can avoid the invasion of summer heat ... "
According to the spreading law of epidemic febrile diseases, Xian 'an is defined as an innocent place in Xian 'an. According to the spreading law of epidemic febrile diseases, if you see Wei syndrome, you should "Xian 'an" qi or blood. If you see Qi syndrome, you should "Xian 'an" camp or blood. Specifically, you can clear the qi in advance. If you see Qi syndrome, you can clear the camp in advance and cut off the passage of pathogenic factors. If the vegetarian body has stagnation in the gastrointestinal tract and pathogenic heat is in the Wei-fen syndrome, it can treat Wei-fen syndrome, and at the same time guide gastrointestinal diarrhea to prevent heat accumulation.
In recent years, many scholars have put forward the truncation method of epidemic febrile diseases, which is actually the "first aid" method of Ye. For example, Ye treated the pericardium case of "evil is not in the first place" before the epidemic poison raged and wanted to invade the pericardium: "Zhu, the epidemic evil is sucked from the nose and mouth, and the triple energizer is sent ... When clearing the blood collaterals and preventing the knot from closing, it is necessary to use detoxification to drive away its filth, so that it will not heal for nine days and the evil will gradually dry up the pericardium.
Problems needing attention in the application of "first aid method"
Proper application of "evil does not oppress the right place" is of great significance to the prevention and spread of diseases. If it is not properly applied, it will be counterproductive, promote its spread and aggravate the condition. So first of all, we should distinguish symptoms from symptoms in detail. On the one hand, it is necessary to distinguish the nature of pathogenic factors and the ways of their transmission, on the other hand, it is necessary to distinguish the different situations of viscera deficiency and excess, so that diarrhea can not be excessive and harmful, and tonic can not be excessive and stagnant. We must know ourselves and make appropriate choices. For example, the general constitution of febrile diseases is divided into Wei syndrome. As long as the method of pungent and cool relieving exterior syndrome is reasonably applied, the disease can be cured, and it is not necessary to relieve Wei and clear qi at the same time. Only when Yang Can fills the whole body can stomach qi be treated. Another example is that if the syndrome of epidemic febrile diseases is complicated with gastrointestinal stagnation, the application of "Xian 'an" to guide stagnation and clear the stomach is too heavy, so as to hurt the spleen and stomach, which will lead to the disadvantages of opening the door and being foolish. Ye has the description that "in the middle of Qing dynasty, it was sparse as an epidemic place, and its epidemic-free land was cut down" In addition, the body yang is insufficient. If the heat sensitive person is treated according to the "safety first" theory, it should be warmed up first, and then it can be warmed up again. When they are in clinic, they should pay attention to both yang and evil spirits, or eliminate evil spirits first and then warm them up, so there is no need to spend money on fire fighting. For example, those who have yin deficiency and feel cold pathogens should first eliminate cold pathogens and then replenish yin, or apply them at the same time. In a word, only by comprehensively grasping the specific situation of pathogenic factors and healthy qi can we achieve the goal of preventing diseases from spreading and changing.
Wang Yusheng Wang Cui Shandong Dezhou True Love Hospital Dong Xiuwen Shandong University of Traditional Chinese Medicine