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Learn Treatise on Febrile Diseases from Zhang Zhicong (7)
The patient is hot and wants to get clothes. Heat is in the skin and cold is in the bone marrow. Those who are too cold to get close to clothes are cold skin and hot bone marrow. ( 1 1)

This paper points out the exterior and interior of cold and heat with seven items, explains the truth and falsehood of cold and heat, embodies the dialectical method for the first time, clearly analyzes the phenomenon and essence of cold and heat, and instructs doctors not to be misled by illusions, and to distinguish the true and false essence of cold and heat.

"The patient is very hot" is a superficial phenomenon. Patients generally refer to people who are sick, not just people with typhoid fever or stroke. "Those who get clothes against their desires" is the essence of true cold, and the word "reverse" is used here to indicate abnormal syndromes. "Being hot", if it is really hot, you will be afraid of the heat and don't want to get clothes. Since "hot" and "wanting clothes" indicate that "hot" is a false phenomenon. So it is concluded that "heat is in the skin and cold is in the bone marrow". The "skin" here refers to the superficial layer, and the "bone marrow" refers to the deep layer. Cheng Wuji said: "The skin is shallow and the bone marrow is deep; The skin does not speak, and the marrow does not speak. " "Cold people who don't want to get close to clothes" is as hot as before.

Original text: the sun has a stroke, and the yang floats and the yin is weak. Yang floating, heat spontaneous; Yin is weak, sweating. Guizhi decoction is the main treatment for patients with aggravated aversion to cold, intermittent aversion to wind, fever and vomiting. ( 12)

On the basis of the third part, this paper expounds the pathogenesis of pulse condition, supplements the specific symptoms of Sun Zhongfeng, and then gives the treatment prescription.

"Sun stroke" refers to the syndrome of the sun meridian stroke, "Yang floating and Yin weak" refers to the pulse condition, Yin and Yang refers to the ups and downs, and Yang floating and Yin weak is a concrete description of the floating and slow pulse condition. "Yang floating, heat spontaneous; Spontaneous sweating due to yin deficiency is to analyze the pathogenesis of spontaneous sweating due to fever through pulse condition. "Because Weiyang suffered from common cold, Wei Qiang and Wei Qiang were' hot and spontaneous'; Yin Ying is not affected by evil, but it is unbalanced with evil Weiyang, so it cannot defend the internal affairs for Weiyang. In addition, the cold is yang evil, and its nature is sparse, so it is "spontaneous sweating". Here, the word "Zi" is used to illustrate the inevitability of fever and spontaneous sweating, and it is clear that the main symptom of solar stroke is fever and spontaneous sweating. These three adjectives describe the characteristics and degree of aversion to cold, aversion to wind, aversion to wind and aversion to wind fever. Among them, aversion to cold and wind is a mutual word, "evil wind" is a fear of cold, and "evil wind" describes the degree of evil wind, just like being caught in cold water. The original meaning of the word "Mao" is that chickens are afraid of cold and get into their mother's wings to keep warm. Here, the patient's body heat is described as heat covered by a thick cover. "Vomiting nose and retching" is the disturbance of cold, which affects lung and stomach, makes lung qi unfavorable, causes nasal congestion, cold stomach dryness, and retching due to insufficient stomach qi. Retching is silent, but vomiting caused by solar stroke is mainly vomiting, even loud, with little vomiting or silent retching; There are also people who are upset and want to vomit, so Zhongjing uses the word "retching" to summarize.

"Guizhi decoction is the main indication", and Guizhi decoction is used to relax muscles and dispel wind. In Treatise on Febrile Diseases, whoever uses the word "main" means that there is no doubt about the examination of the syndrome, and the prescription and syndrome are consistent, so it can be used boldly; Or the sheath is right, and the certificate is right.

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Guizhi Decoction

Twelve pieces of cassia twig (peeled), red peony root, licorice root (fried), ginger (cut) and jujube (broken).

Serve five flavors. Take seven liters of water, boil three liters with low heat, and take one liter at a suitable temperature. After taking it for a period of time, drinking more than one liter of hot porridge is helpful for medicine. Warm recovery for a while, the whole body, slightly like sweating, can not make the water flow, the disease will not be removed. If a dose of sweat makes you sick, stop eating and you don't have to do it all; If you don't sweat, you will abide by the previous laws; I don't sweat, I will eat less. In the meantime, I will take it for half a day and do it three times. If you are seriously ill, take it for one day and one night and observe it once a week. Take one dose, and those with symptoms will eat more. If you can't sweat, take two or three doses. No cold, sticky, meat, spicy, wine, cheese, smelly and disgusting.

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Guizhi decoction is a prescription to relieve muscle sweating by harmonizing ying and Wei. Guizhi warms the heart is king, with ginger warming stomach yang, relaxing muscles and expelling wind, sweating and clearing heat; Paeonia lactiflora is sour and cold, jujube is sweet and flat, sour and sweet turn yin, reconcile camp and health, benefit yin and stop sweating; Licorice. It's a kind of medicine that blends various drugs. After processing, it has the effects of invigorating middle energizer, invigorating qi, strengthening body resistance and eliminating pathogenic factors, and harmonizing exterior and interior. These five herbs are all condiments in life and have the function of strengthening the spleen and stomach. This recipe is cold and hot, warm and cool, giving consideration to both exterior and interior, and benefiting both yin and yang. Sweating will not cause the fear of dying, but it is impartial and harmless. So Cochin said, "This is the best in Zhongjing's group."

In Treatise on Febrile Diseases, Guizhi Decoction is not used to treat the syndrome of solar apoplexy alone, but can be used to treat all cases of disharmony between camp and health, with symptoms of fever, sweating, aversion to wind and slow pulse. Another example is Guizhi Gancao Decoction, Shaoyao Gancao Decoction and Xiaojianzhong Decoction, all of which are modified prescriptions of Guizhi Decoction. These prescriptions are also modified, such as Guizhi Gancao Gulong Oyster Decoction and Shaoyao Gancao Fuzi Decoction. It shows that Guizhi decoction is the first in this group, which has the functions of calming internal factors and promoting external factors, and has a unique role in harmonizing qi and blood, ying and Wei, yin and yang, and exterior and interior.

Zhong Jing made a detailed and thorough introduction to the adjustment of prescription, decocting method and contraindications after taking medicine. Of the five herbs in the prescription, cassia twig, Paeonia lactiflora and Radix Glycyrrhizae Preparata are filed into powder, then boiled for three liters with seven liters of water, then taken out, and aired until the cold temperature is moderate, and one liter is taken. Drink a liter of hot porridge after taking the herbs. This is to use hot porridge to help drugs work. Then cover the quilt for about an hour and sweat slightly all over. Sweat as much as possible. Don't let the patient sweat like rain, that is, don't sweat. If you sweat too much, you will get sick. If you sweat once, don't take the rest of the medicine. There's no need to take it all. If you don't sweat once, take the second liter according to the previous method; Don't sweat, stay for a while, about half a day, and then drink for the third time, that is, drink all three liters in one dose. If the condition is serious, take it all day and night and observe the patient for 24 hours. After taking one dose, that is, three times * * * three liters, the symptoms are still there, and then take it according to the previous method; If you don't sweat all the time, take two or three doses. Cold, sticky (greasy), meaty noodles, five spices, wine, cheese, smelly and disgusting are prohibited.

Sun sickness, headache and fever, excessive sweating and bad wind are the main symptoms of Guizhi decoction. ( 13)

This article is not repeated with 12, but it expands the application scope of Guizhi decoction. Solar disease is a superficial disease, not limited to solar stroke. As long as miscellaneous diseases include headache, fever, sweating and bad wind, they can all be treated with Guizhi decoction. Moreover, headache, fever, sweating and bad wind have the sum of 1, 2 and 12. Sweating is the key to syndrome differentiation. Unspoken pulse is to save words, and the pulse should be slow.

Original: Taiyang disease, strong point, antiperspirant and evil wind, Guizhi plus Gegen decoction as the indications. ( 14)

This article is a combination of Guizhi Decoction and Xiangbei Qiangtu Certificate.

Strong, read Jiang or Qiang. Pictographs are pictographs, pronounced as shū, which means that chicks are not feathered and can't fly, just guiding the way and can't look around; Another example is the sound that chickens are afraid of the cold and their heads are bent and stretched out. This is a vivid description of the symptoms, which shows the pathological mechanism that the sun has a serious stroke, the cold hurts the sun's meridians, makes the sun's meridians unobstructed, and the sun's body fluid is hurt by wind evil. Pueraria lobata can cooperate with Guizhi decoction to relieve exterior syndrome and dispel wind, nourish body fluid and dredge collaterals, relax tendons and relieve exterior syndrome, and relax meridians and activate collaterals.

In this article, the word "anti" is used to create a new face. Because the obstruction of meridians is generally caused by stagnation of cold pathogen, this paper is caused by the dryness of cold hurting body fluids and failing to moisten meridians, so the word "anti" is used to indicate the abnormal pathogenesis.

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Guizhi Jiagegen Decoction

Radix Puerariae, Ramulus Cinnamomi (peeled), Radix Paeoniae, Radix Glycyrrhizae (parched), Rhizoma Zingiberis Recens (sliced), Fructus Jujubae (chopped), and Herba Ephedrae.

Seven flavors, a bucket of water, first boil ephedra and kudzuvine root, reduce two liters, remove the foam, put all the medicines in, boil three liters, remove me, take a heat, cover it with sweat, don't sip porridge, and the rest is like Guizhi method.

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The word "Jiang" was ignored by the ancients. Professor Liu Duzhou found Yamada's Treatise on Febrile Diseases: "The word' Jiang' is a deed; The word' interest' ends here. In the way of taking medicine, if you are ill, don't stop taking medicine, and if you are not cured, take two or three doses. This is the so-called breathing. "

This prescription should be the original prescription of Guizhi Decoction with Radix Puerariae and without Herba Ephedrae. Treatise on Febrile Diseases is a book with remnants of war, and there are inevitably mistakes. The following is a note taken by Lin Yi and others when proofreading the book to illustrate this problem. Chen Yi and others want to press: "On Zhongjing's theory, cassia twig is used for spontaneous sweating due to solar stroke, and ephedra is used for typhoid fever without sweating. Today, it is proved that there is no sweat and evil wind in the clouds. Just like this side, ephedra is also used. This cloud cassia twig and pueraria root soup can be added with cassia twig. " Yu believes that it is more accurate to say that there is no ephedra in this prescription, and you should not use ephedra to sweat when you have a bad wind. Ephedra sinica may be an extension of replication. Furthermore, Guizhi plus Pueraria Decoction and Pueraria Decoction are two on one side, which is unreasonable and definitely wrong.