Huang questioned the classic prescription of White Tiger Decoction.

Personally, I have been practicing medicine for more than 40 years and have never seen the so-called "four major cards" typical of Baihutang. The clinical fact is that it is impossible to see the fever and sweating of the "four major syndromes" at the same time. Is white tiger soup syndrome really hot? Can White Tiger Decoction Treat Body Heat? This paper proposes to re-examine Baihu Decoction. Query the so-called "four big cards" of Baihutang. So we're in the same boat.

First, about the "four big cards"

The "four major syndromes" of Baihutang are definitely not inherent in Treatise on Febrile Diseases, nor are they put forward by Treatise on Febrile Diseases. "Treatise on Febrile Diseases" said: "Taiyin febrile disease, floating pulse, yellow tongue, thirst, excessive sweating, red face, aversion to heat, pungent and heavy agent, and Baihu decoction are the main ones." In modern textbooks, the "four major certificates" are taken as the standard of Baihutang. For example, Fang Yaozhong, the textbook of China Medical College (6th Edition), pointed out: "The indications of this prescription are generally based on the typical symptoms of four major diseases (namely fever, sweating, thirst and pulse)." In the sixth edition of Treatise on Febrile Diseases, it is said that "excessive heat, excessive sweating, thirst and pulse width are the four major symptoms of Yangming fever". In fact, since Treatise on Febrile Diseases put forward the "four prohibitions", many doctors have questioned the use of Baihutang from different angles. And put forward "four cards". It seems that the basis for the use of White Tiger Decoction is "authoritative" again. It is said that the "four syndromes" were put forward by Qin Bowei (according to the Vernacular Interpretation of Epidemic Febrile Diseases compiled by Zhejiang College of Traditional Chinese Medicine), but according to the book, we don't know what the basis is at present.

Because the article "Sixteen Methods for Fever Reduction" did not mention four major syndromes, consulting Qin's "Introduction to Traditional Chinese Medicine" mentioned: "White Tiger Decoction is used for high fever, thirst, sweating and pulse." Although it has the meaning of "big four"; But I haven't seen the word "four big cards". In the article, there is no mention that Qin made such a summary of the syndrome of Baihutang. When the "four major certificates" began is unknown. However, the induction of the "four major syndromes" really has a great influence, so that the world thinks that Baihutang is designed for "high fever" (high fever). Zhongjing's original intention was diluted.

1. Dare

From Treatise on Febrile Diseases, we can know that "great fever" refers to symptoms, not pathogenesis. Clause 12: "The patient's body is very hot, but he wants to get close to the clothes. Heat is in the skin and cold is in the bone marrow. " Articles 6 1, 63, 1 10, 136, 162, 169 and 269 in Treatise on Febrile Diseases all mentioned "non-real heat". However, large heat is obviously the opposite of small heat. For example, Articles 30, 96, 242, 252, 360, 36 1, 366 and 377 of Treatise on Febrile Diseases all mentioned "slight fever". Large fever and small fever refer to the temperature, not the pathogenesis. "Great heat" evolved into "strong heat" in later generations. And such a simple symptom description, why is Zhongjing not clearly marked in the provisions of Baihutang? Instead, add a soup certificate to the white tiger to indicate "not hot"? For example, article 169 says, "For those with typhoid fever, dry mouth, thirst, upset and aversion to cold, Baihushen decoction is the main one." White Tiger Decoction has three syndromes, which are not marked as "big fever" or even fever (2 19). "Heat" exists, but it refers to the pathogenesis. If there is heat outside (176), there is heat inside (350). Therefore, it is unfounded for later generations to conclude that the "big fever" (strong fever) in the "four major syndromes" of Baihutang syndrome.

sweat

Another symptom of the so-called "Four Syndrome" is "sweating". The descriptions of "sweating" in Treatise on Febrile Diseases include spontaneous sweating, sweating, sweating (23 items), slight sweating, night sweats, sweating, hyperhidrosis (188 items), hyperhidrosis and so on. Of course, "sweating" is relative to "slight sweating" and "less sweating". But in Treatise on Febrile Diseases, "sweating" often points out the consequences of sweating. In theory, it is pointed out that there are seven rules for sweating, three of which are Sinitang syndrome and the other four are the consequences of sweating by mistake, but none of them is Baihutang syndrome. So what is the sweat of Baihutang syndrome? There is no doubt that the syndrome of Baihutang belongs to Yangming, and Yangming's sweat is sweating and spontaneous sweating. He didn't say sweating. What do you mean by sweating? A lot of sweating is continuous sweating, which can be said to be hyperhidrosis, but not necessarily sweating. For example, article 188 says: "those who have typhoid fever and Yangming syndrome are slightly sweaty."

In fact, it is impossible to have a high fever and sweat at the same time. Patients with high fever generally don't sweat. Once they sweat, the fever disappears. (including spontaneous sweating and iatrogenic sweating) Neijing says: "If the body is coke, the sweat will disperse." Yuexiu District Hospital of Traditional Chinese Medicine observed patients with high fever from July to September 103. During the peak period in summer, 89 patients had no sweat. Most people have a fever and don't sweat. According to the temperature set-point theory of modern medicine, at the extreme of fever, high fever will not coexist with sweating, and sweating is impossible when the body temperature is the highest, and sweating is the performance of fever retreat. Therefore, as mentioned above, there is no "big fever" in White Tiger Soup. What Zhong Jing may have observed during the treatment of Yangming's disease with Baihu decoction is that the duration of high fever has passed, but his body temperature is not completely normal. That is what we often say, the late stage of fever, the period when the residual heat is not exhausted.

From another point of view, the syndrome type of Baihutang or Baihujia ginseng soup is not sweating, but spontaneous sweating, or sweating, and the body temperature begins to drop gradually, that is, after the temperature set point drops, the body temperature has not dropped to normal, and the body mainly radiates heat.

thirsty

When the body temperature rises, water evaporates and even sweats, dry mouth is inevitable. Still looking back at the three articles of White Tiger Decoction Syndrome, none of them mentioned thirst. It can also be explained that Baihutang syndrome has low fever, little sweating and no serious water evaporation. There are 26, 65, 438+068, 65, 438+069, 65, 438+070, 222 cases of White Tiger plus ginseng soup Syndrome, but there is no one who does not emphasize "severe thirst" or even "people who want to drink a few liters". It can be seen that the initiator of the "four major certificates" was put forward. Baihu decoction is confused with Baihu plus ginseng soup syndrome.

4. The pulse is heavy

Take Pulse Hongda as one of the "four big cards" of the White Tiger, and what's more, add the pulse of Shentang brand to the White Tiger to get the White Tiger Tang brand. Article 176: "the pulse of typhoid fever is slippery, which means that the exterior is hot and the interior is cold, and Baihu decoction is the main one." Article 350: "White Tiger Decoction is the master of typhoid fever, slippery pulse and syncope." It can be seen that Baihutang should be regarded as a slippery pulse or a floating pulse, not a floating pulse or a big pulse. Only the syndrome of 26 white tigers plus ginseng soup is pulse flooding. It must be noted that Treatise on Febrile Diseases appeared twice. 25 items at a time: "Those who take Guizhi decoction are sweating like rain, and those with heavy pulse are not as good as Guizhi decoction;" If it looks like malaria, if it recurs during the day, it will be solved by sweating. It is appropriate to use Guizhi Erhuang Decoction. " Another time was 26: "After eating Guizhi soup, I was very thirsty and confused after sweating. Mainly white tiger and ginseng soup with heavy pulse. "The juxtaposition of the two is to identify people. Both of them ate Guizhi decoction, and after sweating, their pulse sank. When reading these two articles, we should pay attention to the word "Hou". Article 25 only says: "Sweat after taking Guizhi decoction", without the word "Hou", which has different meanings. I shouldn't have sweated after taking Guizhi decoction, but Guizhi decoction said, "If you don't make the water flow, you won't get rid of the disease. "It is impossible to stop breathing, so Guizhi Decoction cannot be removed, so it is still the same as before. Moreover, there is a word "Hou" in Article 26, which means that there are follow-up symptoms-"heavy pulse, thirst is difficult to understand". At this time, it is not Guizhi decoction syndrome, but white tiger plus ginseng soup syndrome.

A large pulse and dry mouth are probably the early or early manifestations of septic shock. Therefore, high output and low resistance, vasodilation and insufficient effective blood volume. Hu Lianxi, a close friend, also made a similar statement in Treatise on Febrile Diseases: "The extensive pulse is the further expansion of blood vessels, but the tension is slightly reduced, and the cardiac output is still sufficient, so the pulse is extensive and prosperous. Another feature of flood pulse is descent, which means that it advances at a very fast speed and then drops suddenly. This phenomenon is mostly caused by peripheral vasodilation and low peripheral resistance. This high power cycle with high output and low vascular resistance is the earliest sign of shock. Due to the rapid infiltration of blood into the dilated peripheral blood vessels, visceral perfusion is insufficient, and body fluids cannot be applied to the whole body, so it is difficult to understand polydipsia at first glance. Repeated emphasis on thirst in White Tiger plus ginseng soup Syndrome is the essence of Zhongjing's syndrome differentiation. Compared with slippery pulse, extensive pulse has changed in nature. Therefore, I think that Mai Hongda has always been a white tiger plus ginseng soup card. " It can be seen that the syndrome of Baihu plus ginseng soup is similar to the shock with high output and low resistance, that is, septic shock.

To sum up, the formulation of "four major syndromes" of Baihu decoction is not in line with clinical practice, nor is it Zhongjing's original intention. Heat and sweat will not meet at the same time; Great thirst is white tiger plus ginseng soup syndrome. The pulse is not the pulse of Baihutang. Although the "Four Certificates" were put forward by later generations, Wu Jutong has an unshirkable responsibility. Wu Jutong's "four prohibitions" seem to standardize the use of Baihu decoction, but it makes the world mistakenly think that Baihu decoction is a heavy agent for clearing heat. Dare not cross the line, which narrows the scope of application of White Tiger Soup, and also leads to the joke that "if it is someone else's mother, you must use White Tiger Soup".

It can be considered that there are two trends in the development of fever in its extreme stage; First, after sweating, fever, thirst, and slippery pulse. Residual heat is not a benign trend, so white tiger soup can be used. Second, the body fluid is exhausted after heat, the pulse slips and the limb syncope, and the effective blood volume is insufficient. Baihu decoction can also clear away heat and protect body fluid. At this moment, we should be alert to the occurrence of shock. If it develops further, although the fever has gone down, it will continue to sweat, thirst, severe dehydration, heavy pulse and aversion to cold. It's a vicious trend. It's pre-shock. This is by no means beyond the White Tiger Hall. Save Tianjin with white tiger ginseng soup and ginseng. Otherwise, the syndrome of Sini decoction will appear soon, and it is necessary to return to Yang for first aid.

Two, about the use of Baihu Decoction and similar prescriptions

Although Baihu decoction is mainly based on body heat and sweating, it is not hot and is not necessarily designed for the extreme period of fever. In the prescription, only gypsum is used to clear away heat blindly, and it is matched with Yin-nourishing products such as Anemarrhena asphodeloides. So it is actually a kind of medicine for clearing away heat and protecting body fluid.

1. The function of gypsum

White tiger soup and white tiger soup are mainly gypsum. From the prescription of gypsum in Treatise on Febrile Diseases, we can see the function of gypsum from another side. There is gypsum in Shennong's Classic of Materia Medica: "The main stroke is cold and heat, the heart goes against qi, the shock leads to asthma, and the thirst leads to thirst ..." It is not pointed out that gypsum can reduce calories. Let's look at the explanation of other drugs in Shennong Herbal Classic. For example, Scutellaria baicalensis Georgi refers to "main heat"; Pueraria lobata: "the main thirst, body heat"; Cortex Phellodendri: "Heat accumulates in the five internal organs and governs the stomach"; Jiyi Dongdong's "Medicine Sign" plaster said: "The famous doctor Bielu said that plaster was very cold, and doctors were afraid of it from now on. So there's no need to put it aside. Citing the evidence of Baihu decoction, Zhong Jing said: If there is no heat, the evidence of Yuemai decoction is also turbid, and both sides mainly use plasters. However, Zhongjing's medication is not based on its cold and heat ... If he is thirsty and goes home without heating, he will be plastered and the disease will not be seen. In the hot summer, some people are very thirsty, but thirsty people will be given gypsum powder, their thirst will stop, and they will never see their harm again. " It can be seen that Dongdong Weng also takes this product as the starting point to treat polydipsia. Not direct heat.

According to Fan Ji, Shanghai famous doctor Fan used Baihu Guizhi decoction, Guizhi to dispel pathogenic factors and reduce fever, and Baihu decoction to clear heat and protect body fluid to treat Yangming fever. Look at Zhang Xichun again. He used gypsum with aspirin, that is, "gypsum aspirin soup": "Take two ounces of gypsum and one watt of aspirin, first take it with white sucrose, then take aspirin, and then fry a big bowl of gypsum soup. When you are sweating all over, drink two-thirds of gypsum soup while it is hot and help aspirin. After sweating, after two or three o'clock, if you still feel that there is residual heat, you can drink the remaining gypsum soup. " It can be seen that Zhang thinks that Baihu decoction is not effective in reducing fever, so it is used with aspirin.

2. The prescription containing gypsum in Treatise on Febrile Diseases is not designed for reducing fever.

Judging from Zhongjing's other prescriptions for gypsum, gypsum is not used to reduce fever. Try the following prescription containing gypsum:

(1) All parties who use half a catty of gypsum. Maxingshi dry soup and Yuemai soup both contain half a catty of gypsum, but they are "not hot". For example, Article 63 says, "After sweating, Guizhi decoction should not be used. If you have sweating but no fever, you can take it with Ephedra Almond and Glycyrrhiza Extract. " "synopsis of the golden chamber: water vapor disease": "pathogenic wind and water, edema all over the body, no thirst in the pulse, but continuous sweating, no heat, so it is treated by crossing the pulse hall."

(2) the parties who use less than half a catty of gypsum. Such as Daqinglong Soup, Xiaoqinglong plus Gypsum Soup, Xu Ming Soup and Yin Feng Soup. Large and small dragons and plasters are not used for "great heat", but because of irritability. Xu Ming decoction has no "heat" syndrome, but only makes patients more tolerant to warm drugs.

(3) use a prescription of more than one catty of gypsum. For example, the prescription comes from the article "Synopsis of the Golden Chamber: Phlegm Drink": "When a person drinks between the diaphragmatic parts, his breath is full, his heart is swollen and firm, his face is dull, and his pulse is heavy and tight, which can last for dozens of days. If the doctor spits it, it will not heal. " The prescription uses four ingredients: Radix Stephaniae Tetrandrae, Ramulus Cinnamomi, Ginseng Radix and Gypsum Fibrosum. One 12 piece of gypsum is as big as an egg. This prescription was originally used to treat alcoholism, and it is also used by people around you to treat congestive heart failure. It really works wonders, so I won't go into details here. However, Zhongjing Fang uses gypsum the most. An egg is about 45 grams bigger than a piece of gypsum and not less than 30 grams smaller than it. If there are twelve pieces, it is about 360 to 540 grams. According to one or two calculations, that is, 15.6 grams, a catty of white tiger soup is only 250 grams. And our side is by no means designed for the Heat.

3. White Tiger Soup

White tiger soup, such as white tiger plus Guizhi soup, bamboo leaf gypsum soup. We know that the small white tiger soup in Fu Xing Jue Zangfu Fang is the white tiger soup in Treatise on Febrile Diseases. Xiaochaihu decoction syndrome is "treating hot weather, sweating, dry mouth, drinking several liters of water and heavy pulse." That is, White Tiger Plus ginseng soup Syndrome in Treatise on Febrile Diseases. For example, Article 26 says: "After taking Guizhi decoction, you will feel thirsty after sweating, and the pulse will be heavy, and Baihushen decoction will come first." . Article 168: "If typhoid fever occurs, if it is vomited, if it falls down, it will not be solved for seven or eight days. The heat will accumulate in the stomach, and both the exterior and the interior will be hot, and there will always be bad wind, great thirst and dry tongue. You have to drink a few liters of water, and the white tiger ginseng soup is the master. " Both Fu and Treatise on Febrile Diseases originated in the Tang Dynasty.

Zhong Jing did not treat this syndrome with Baihu Decoction in Lun Guang and Tang. But ginseng was used. And the white tiger ginseng soup shows its ingenuity. As mentioned earlier, neither Bai Hu nor ginseng soup in Zhongjing can cure the fever, but they are sweating after sweating, and the body fluid is exhausted, resulting in thirst and heavy pulse. More obviously, the key point of this syndrome should not be to reduce fever, but to save qi and promote fluid production. Another big white tiger soup of Fu is the bamboo leaf gypsum soup from Treatise on Febrile Diseases. "Assisted Travel Tactics" takes it as: "Cure hot weather, get upset, dry mouth when sweating, sharbat. When coughing, I can't understand it for a long time. " Obviously, the prescription of "Fuxing Jue" is still related to the prescription of Xiaobaihutang. Zhongjing has another cubic certificate; Article 397: "After typhoid fever is relieved, it causes deficiency and qi deficiency, and the gas turns to vomit, mainly with bamboo leaf gypsum soup." After the typhoid fever is relieved, it should be gone, and both qi and body fluid are hurt. Baihushen decoction still uses Anemarrhena asphodeloides, bamboo leaves, Pinellia ternata and Ophiopogon japonicus. Eliminate residual heat, nourish yin and produce body fluid. It should be said; White Tiger Soup, White Tiger plus ginseng soup, Bamboo Leaf Gypsum Soup. Zhongjing is used in the middle and late stage of fever, mainly to nourish yin and protect body fluid, supplemented by clearing heat.

This paper focuses on the corresponding provisions of Zhongjing, and puts forward bold speculation on the application of Baihutang. Doubt the antipyretic effect of Baihu decoction. Where there are mistakes and fallacies, I hope colleagues will correct me.

Cold and temperature are unified, and disputes are useless.

For hundreds of years, there have been many controversies about exogenous fever. The academic debate between typhoid fever school and epidemic febrile disease school has never stopped. Doctors are completely different from Zong Zhongjing or living in Shi Tian.

Cao, the classic master of Zhang Cigong, was originally a classic school. He is especially diligent in Treatise on Febrile Diseases, Thousand Golden Formulas and so on. , and cure Lu Jiuzhi's Book of Tonifying Heaven and Wide Temperature Theory. However, in clinical practice, he found that some diseases could not be cured by prescriptions, but the worse they got, so he had to try to use the Prescription for Treatise on Febrile Diseases in Qing Dynasty, but the effect was often remarkable.

He said with deep feelings: "We were influenced by it in our early years, thinking that except for two symptoms of fever, they were all caused by mistreatment. Later, some relatives and friends invited them to see a doctor immediately after the onset of a cold and fever, and the more they were treated, the more serious they became. Magway, Qinglong, Zhichi, Qinlian and Baihu all tasted it, but it was ineffective after all. At first, Ye Shi created a light and delicate agent, which he had to do. It is not different from Zhongjing, nor is it a traitor of Zhongjing. " "If Zhongjing must be regarded as an eternal saint, then our country will treat typhoid fever."

Zhang Ci recognized that cold and heat are a complete system, and febrile diseases are the extension and development of Treatise on Febrile Diseases, and there is no insurmountable gap between them. He hit the nail on the head and pointed out: "The theory of febrile diseases takes Wei Qi Xue Ying as the key link, and its method of inducing syndrome is based on objective facts, which divides solid and Zhongjing into six meridians with the same result."

No matter whether it is cold or warm, the person who has been ill for a long time, the heart of care.

Treatise on Febrile Diseases treats exogenous diseases based on differentiation of six meridians. Shaoyin disease is one of the six channels of typhoid fever, the last level and the most critical stage of the six channels. It is characterized by deficiency of both heart and kidney, and weakness is the main clinical manifestation of Shaoyin disease. Most patients are in a coma state of extreme mental exhaustion, unable to sleep, as if they were sleeping instead of sleeping.

Its treatment principle is mainly to support yang and nourish yin. Cold will help yang, and warmth will be appropriate; Heat must nourish yin, and heat-clearing method must be combined. Cold syndrome is common, and it is urgent to restore yang to save the adverse, so Sini decoction should be used. The main medicine is aconite, which is very hot. The drugs used to treat fever are cool and cold, and usually no hot drugs are used; Moreover, both typhoid fever and febrile diseases attach importance to the disease period, typhoid fever is treated according to the six meridians, and febrile diseases are treated according to the principle of defending qi and nourishing blood. Zhang Cigong pioneered the idea of paying attention to the length of the course of disease: people in the same illness period may have the same or different course of disease. If the illness time is not long, it may conform to the general treatment law; If the patient is ill for a long time, and his vital qi declines, he may make mistakes if he is still treated according to the general rules. At this time, priority should be given to the treatment of patients' healthy qi. He believes that when the epidemic febrile disease develops to a certain extent and the patient's mind is extremely exhausted, the treatment of Shaoyin disease should be introduced to restore yang and save the adverse, because the treatment of disease first saves life.

When treating exogenous fever, Zhang Cigong paid attention to strengthening the body resistance and protecting yang. Because the heart is the master of the five internal organs and the hub to maintain human life; The maintenance of heart function lies in the abundance of yang, and the heart can beat around the clock to promote the flow of qi and blood to the whole body. If the heart is weak, the qi does not run and the blood circulation is blocked, many diseases will occur. Nourishing heart qi is the primary factor to ensure heart function.

draw

Through a lot of clinical practice, Zhang Cigong deeply realized the importance of fever to protect the heart. If a patient has been ill for a long time, or is seriously ill, exhausted in vital energy and extremely weak, at this critical juncture, the decisive factor of whether the condition can be improved is no longer heat. "Only supporting healthy qi is the most important thing", "Healthy qi is vigorous, and qi will die when exhausted", so we must pay attention to strengthening the healthy qi and consolidating the foundation, protecting yang and consolidating yin.

Zhang Cigong's theory of melting cold and warming a furnace said that the theory of typhoid fever with insufficient heart and yang made up for the deficiency of warming evil and damaging yin. We can understand the essence of Shaoyin disease in Treatise on Febrile Diseases with reference to modern medical theory: "The main symptoms of Shaoyin disease are: although the pulse is fine, the patient wants to sleep, the physiological function has declined, the patient has lacked normal resistance and circulatory dysfunction", and pointed out that Shaoyin disease must save the dying heart; At the same time, "warm people also have shortcomings, that is, they obviously don't pay enough attention to the maintenance of mental health, mistakenly regard typhoid fever as a fever, and are too obsessed with cold damage, so they feel in a dilemma when the syndrome of fever is less yin and too yin."

It can be said that his academic views on maintaining the heart of epidemic febrile diseases are unique and have contributed to the development of epidemic febrile diseases.

draw

Analysis of subtle "heart failure"

Zhang Cigong has unique views on some signs of heart failure caused by epidemic febrile disease, and his analysis is meticulous. In particular, it is very incisive in pulse diagnosis, manifestation of divine knowledge and explanation of chest distension.

In his view, tongue diagnosis is not enough to examine whether there is heart failure, and the key to syndrome differentiation lies in looking at the face and examining the pulse condition. Such as mental weakness, thick pulse, or thin pulse without bulging, or two pulse stops, or the pulse is slightly heartbroken. All these indicate that the patient is weak in vital qi and must focus on strengthening the body resistance and strengthening the heart, protecting yang and consolidating yin; If you hesitate, you will lose both sides; If the temperature is clear and the patient is discharged, the life of the patient will not be guaranteed.

It is difficult to distinguish the symptoms of fever because of the lingering pathogenic heat and the mixture of excess and deficiency. Zhang Cigong is particularly good at distinguishing: "Although the heat is not high, his eyes are blurred", "When asking questions, half of them are conscious and the other half don't know what they are talking about", "If you talk nonsense all day, your mind will be restless", ".

In addition, fever with chest distension syndrome has both ends of deficiency and excess. Zhang Cigong said: "There are two major differences in the boredom of damp-heat syndrome: when the heat is strong, the heart is not strong and the pulse is weak; Those who are not hot or stuffy are mostly undernourished, and Zhongjing is called deficiency. "In a few words, I learned to distinguish the true meaning of the machine with chest tightness.

Preservation of wet and warm hematocrit by aconite and rehmannia glutinosa

In view of the characteristics that fever is easy to damage yin, Zhang Cigong often applies both sweet and cold (such as Radix Rehmanniae and Radix Ophiopogonis) and both sweet and warm (such as Radix Astragali and Radix Codonopsis). In heart failure, Zhang Cigong decisively took measures such as warming yang and strengthening the heart, and even added aconite to protect the heart. Aconitum carmichaeli was highly praised by doctors in past dynasties because of its ability to save lives by drowning. Zhang Zhongjing was the best doctor who used aconite in ancient times. In order to understand the medicinal properties of aconite, Zhang Cigong tasted raw aconite and became a master of using aconite.

A patient named Li, with a high fever, flushed face and bright red stool, was delirious all day, talking nonsense and dying. Zhang Cigong diagnosed that this is the most serious complication of wet temperature: intestinal bleeding.

draw

In the first diagnosis, cortex phellodendri, honeysuckle charcoal, purslane, talc and so on. Used for clearing away heat and regulating intestine. Fortunately, clearing the intestines is effective, and patients no longer have bloody stools. However, the high fever persists and I am uneasy. Sometimes, the patient is unconscious, pale and has a thin pulse, indicating that the patient is in a state of vital qi failure and dangerous condition. At this time, the medicine of bitter cold incense has no effect, so we must focus on strengthening the body resistance, protecting yang and protecting yin fluid.

So Zhang Cigong played a risky chess game: "The truth is all in one soup", and he resolutely gave up his illness to save people, just in case. Quanzhen Yiqi decoction is Feng's secret recipe, which is composed of six herbs: Radix Rehmanniae Preparata, Radix Ophiopogonis, Atractylodis Macrocephalae, Achyranthes bidentata, Radix Aconiti Lateralis Preparata and Ginseng. It has the effects of strengthening the body resistance, nourishing yin and absorbing qi.

He changed cultivated land into fresh land with a little addition and subtraction. Because at this time, the patient's body fluid is dry and his heart is weak, if only aconite is used to strengthen his heart, the body fluid will be drier; If you specialize in nourishing body fluids, it will have no therapeutic effect on guilty conscience. Fuzi and Radix Rehmanniae are used together to maintain the heart, and the body fluid is not dry, which is really a satisfactory solution.

After four consultations, the patient's fever dropped and his consciousness gradually became clear. By the sixth diagnosis, the body temperature returned to normal. After seven consultations, she basically recovered.

"Quanzhen Yiqi decoction", namely Shenfu decoction and Shengmai powder, has the disadvantage of warming yang without rising and floating, and nourishing yin has the function of transforming qi. In the treatment of severe damp-heat syndrome, as long as there are signs of heart failure, Zhang Cigong often uses "Quanzhen Yiqi Decoction" to treat it. High fever is not taboo, and it can indeed receive the curative effect of gradually decreasing fever and gradually recovering heart function. If you are delirious and raving, you can add Arisaema cum bile, Bulbus Fritillariae Cirrhosae, Radix Polygalae, Rhizoma Acori Graminei, etc., and even add Zixuedan, which has saved many dying patients.

Zixuedan is composed of gypsum, mirabilite, talc and rhinoceros horn (now replaced). The use of aconite together can be said to be the ultimate compatibility of aconite and antipyretic drugs. Zhang Ci has the courage to treat such a critical illness, and his courage to use drugs in this way shows his courage.

But aconite is not a routine treatment for fever, but an emergency method. Treating a fever with hot medicine is like carrying firewood to put out a fire. It is inevitable to be criticized, but as long as it is beneficial to patients, Zhang Cigong is innocent. However, some patients were afraid to use aconite because it was hot, so Zhang Cigong carefully screened other drugs. He analyzed the compatibility of Liushen Pill, a throat medicine, and thought that Niuhuang not only has the functions of clearing away heat and toxic materials, inducing resuscitation with fragrance, resolving phlegm and relieving spasm, but also has the function of strengthening the heart. Venenum Bufonis not only attacks poison and detumescence, but also has the functions of strengthening heart, boosting blood pressure and exciting breathing. Musk also has the strength to return to the Soviet Union. Therefore, it is pointed out that "Liushen Pill can excite myocardium and cranial nerves", "Treating heart failure and fever will make people fear it. Using Liushen Pill can not only strengthen the heart, but also avoid being slandered." Used for fever, heart failure or toxic shock, it has a good effect every time.

Huang questioned the classic prescription of White Tiger Decoction.