Song Yi

Chapter 335 Evidence of Asthma
Some book friends pointed out that the knowledge of Chinese medicine involved in the book is very interesting, but many of them can't understand it, so they have to skip it. They suggest that a little explanation can be added in the narration, so as to increase the interest and also increase some knowledge of Chinese medicine.

Lao Mu thought this suggestion was very good, so he decided that from now on, Lao Mu would explain the etiology and pathogenesis and the logical reasoning process of syndrome differentiation based on the relevant theories of traditional Chinese medicine, and strive to make readers understand these medical cases and treatment. The truth of the disease.

Although Chinese medicine is difficult to learn and difficult to master, it is still very interesting if you understand the principles. I hope this book by Lao Mu can help book lovers have a better understanding of Chinese medicine.

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Qian Bu Shou replied respectfully: "Returning to Master, there is a saying in the "Golden Chamber": 'My husband has a drink in his heart, and his back is cold, as big as a palm. It is also arguing that you should pay attention to drinking. It is not wrong to think carefully about Dr. Geng's prescriptions, why the medicine is not effective, and the old man does not understand, please master for advice."

What is drinking attention?This has to start with the basis of traditional Chinese medicine. Traditional Chinese medicine believes that the spleen and stomach govern digestion, and the metaplasia of subtle substances required for life activities and qi, blood, and body fluids all depend on the digestion of the spleen and stomach.The transportation and transformation function of the spleen is normal, which is called the healthy movement of the temper. The spleen absorbs the water in it on the basis of the transportation and transformation of the essence of water and grain, and produces body fluid, which is transported to the whole body.Once the spleen fails to move well, the yang qi of the spleen and stomach in the middle burner is weak, and the function of transporting and transforming the water is abnormal, it will cause the water to stagnate in the body, resulting in "phlegm retention", "edema" and other diseases. Edema and the spleen are the source of phlegm."

Don't accept money and Dr. Geng's dialectical "drinking and paying attention to it", which means that you have to drink in your heart. "Keep drinking" means that the body fluid transported is stagnant due to deficiency of spleen and stomach yang and spleen failure. The body fluid stays under the heart for a long time, just like a piece of ice.

Traditional Chinese medicine believes that the human heart produces high-temperature, damp-heat qi, which is emitted through the Xinshu point on the back of the person. Yang, so that it cannot be transmitted to the back. Therefore, when drinking mindfully, people will feel cold at the Xinshu point in the back of the heart.

Conversely, if the palm-sized area of ​​the back of the heart is cold, it means that the spleen is not functioning well, and the body fluid is stagnant under the heart, which is the so-called "drinking and paying attention to the next".The "Linggui Zhugan Decoction" advocated by Qian Bushou and Dr. Geng has the functions of warming yang and transforming drink, invigorating the spleen and promoting dampness.

After hearing this, Du Wenhao shook his head and said: "You just noticed that you should be careful. The syndrome differentiation must be comprehensive, and you can't just look at one aspect, otherwise the syndrome differentiation will be biased. This girl's asthma began when she was young, and she had short breath when she raised her shoulders. Not only the problem of drinking and paying attention, but also the problem of kidney not receiving qi, haven’t you noticed? Although Linggui Zhugan Decoction can warm the yang and transform the drink, it can’t nourish the kidney and absorb qi. With this prescription, even though the heart yang is temporary After recovering, because the kidney qi was not satisfied, her asthma remained the same, and her symptoms did not change fundamentally."

To understand Du Wenhao's meaning of "the kidney does not receive Qi", one must first understand the function of the kidney in Chinese medicine.

In the theory of Chinese medicine, the function of the kidney is not exactly the same as the anatomical function of the kidney in Western medicine. In Chinese medicine, the function of the kidney is partly attributed to the respiratory system.According to traditional Chinese medicine, the lungs belong to metal, the kidneys belong to water, and metal and water coexist.The lungs govern breathing, and the kidneys govern breathing.The air inhaled by the lungs goes down to the kidneys, and the kidney qi has a sealing effect, absorbing and hiding the air inhaled by the lungs, making the air reach the necessary depth so that it can be exchanged with the stale air produced in the body.

Once the kidney qi weakens, the inhalation is weak, and the inhaled gas cannot be fully ingested and hidden, the external performance of the person will appear shallow breathing phenomenon when exhaling more and inhaling less, and even a little activity will cause endless panting.In other words, in the final analysis, this symptom is caused by insufficient kidney qi and weak intake of "kidney not receiving qi".

Since the Linggui Zhugan Decoction used by Dr. Geng and Qian Bushou could not invigorate the kidneys and nourish Qi, the girl's root cause of the disease was not treated, so she naturally became asthmatic.

Du Wenhao continued: "In addition to these two reasons, the patient has been wheezing for many years, and the lung qi rises upward, and a lot of phlegm must go up with the adverse qi, and the chest and lungs are empty, which is the easiest way to keep phlegm and fluid. It is deeply hidden in the lungs, and it is difficult to expel it when coughing and vomiting, so it can only be panting non-stop. This is also one of the reasons for the endless breathlessness."

When Du Wenhao dialed this, all the doctors nodded frequently and stroked their beards in admiration after hearing this.Both Qian Bushou and Dr. Geng suddenly realized, with shame on their faces.

Dr. Geng bowed and said: "Your Excellency Physician is really wise. The symptoms of asthma are mere asthma, but there are many causes such as cold drink stagnation, kidney not accepting qi, and phlegm retention in the lungs. I can't recognize the cause clearly, so naturally the diagnosis is inaccurate. Ashamed!"

The money was not accepted and he said with shame: "Master had a clear instruction in Dongda County: 'The evidence of asthma, its mark is in the lungs, and its origin is in the kidneys. It is the disciple who understands the truth of the stubborn illness. But he is still not good at using this method. Now when he encounters a similar case again, he doesn’t know how to adapt it. It’s really embarrassing.”

Although Du Wenhao has richer practical experience than No Money, Du Wenhao has 1000 years more experience in traditional Chinese medicine than No Money. The richness of knowledge and the broadening of thinking and vision are naturally not comparable to No Money.

Du Wenhao smiled and said: "Hehe, you don't have to be discouraged, you have done a good job. Now tell me, how to treat this disease?"

"Hmm..., the first is to absorb the kidney qi to suppress the water mansion; the second is to invigorate the yang qi to dispel cold and drink; Can take care of the three at the same time. Ask Master for guidance."

Du Wenhao smiled and said, "Yanghetang!"

All the doctors were shocked when they heard this.Dr. Xie stepped forward and cupped his hands and said: "My lord doctor explained the cause of this syndrome before, and we are all convinced and deeply convinced. However, this Yanghe decoction is for the treatment of yin-cold syndromes such as gangrene and gangrene. It is used for asthma..., this, huh, I really don't understand the meaning of it, so I ask the imperial doctor to give me some pointers."

Du Wenhao said: "A prescription has never been a prescription for a certain disease. As long as it can cure a disease and the prescription is verified, no matter what disease the prescription was used to treat before, it can be used for other purposes."

The doctors nodded frequently, stroking their beards and smiling without accepting the money: "Master once said: 'Prescriptions are dead, but people are alive. If you can't use the prescriptions according to the evidence, even classic prescriptions can't cure the disease. It might even make the condition worse.”

Du Wenhao laughed. This was when the two were fighting for doctors in Dongda County. Du Wenhao taught him not to accept money from his master and apprentice. Unexpectedly, he remembered it in his heart.

Du Wenhao nodded and said: "Yes, in Yanghe Decoction, the function of rehmannia glutinosa is mainly to nourish yin and blood. However, rehmannia glutinosa has another very important effect, which is to nourish kidney yin, replenish essence and marrow, and nourish kidney yin. The main medicine is just corresponding to the deficiency of kidney qi and the syndrome of inability of the kidney to receive qi. Deer antler gum, tonifies the kidney and help yang, strengthens the muscles and bones, and is used together with rehmannia glutinosa to nourish blood and help yang, so as to cure the root cause. It is a king drug. Among them, rehmannia glutinosa A heavy dose must be used, at least eight dollars."

As soon as Du Wenhao explained the dispensing of the prescription, all the doctors were stunned and even claimed it was true.

Du Wenhao continued: "Drink your heart, Linggui Zhugan Decoction can only temporarily cheer up the heart yang, and the coldness is suppressed, but it can't be eliminated. For coldness and stagnation, warming and dredging medicine is needed to resolve it. Dried ginger and cinnamon are both warming products. Dried ginger can warm the middle and dispel cold, warm the lungs and transform drink, and can break yin and unblock yang; because the cold is in the blood, cinnamon can not only cure the deficiency of yang, but also enter the camp to warm the blood. , just right for the two syndromes of staying in the heart and phlegm storing in the lungs; Flavored medicines can not only make the blood flow, but also make the rehmannia root and deer glue nourish and not stagnate. The raw licorice is used to detoxify and adjust various medicines. Everyone, isn’t this prescription just for the current disease?”

Dr. Xie was the first to applaud, and the rest of the doctors were also amazed and admired, repeatedly praising.

Dr. Geng was even more intoxicated when he heard it, and he shook his head and praised: "It's wonderful! It's really wonderful! If you can use Yin syndrome and famous prescriptions for asthma syndrome, who can do it if you don't have a deep knowledge of medical principles? Admire! Admire! !"

Du Wenhao smiled: "I'm just talking on paper, whether it's useful or not, I'll have to use it to know."

Dr. Geng said: "It must be useful. If this method is useless, then only gods can help."

Dr. Xie also said cheerfully: "Yes, then we don't need to study medicine anymore, we will go to seek immortals and visit Taoism, and go to learn the art of ghosts and gods, hehehe"

All the doctors looked up to the sky and laughed.

At that moment, Dr. Geng wrote the prescription with a pen, handed it to Du Wenhao for review and confirmation, and handed it to the girl's parents to follow the prescription.

The old couple couldn't understand what Du Wenhao and the others said, but they could also see that the doctors admired Du Wenhao, and knowing that their daughter's illness had hope, they were very excited and hurriedly thanked him.

After one dose of this girl's medicine, her asthma was greatly reduced. After three doses, not only her asthma was cured, but she was able to work in the fields, but she was a little dizzy and sweaty. He took three qian of Schisandra chinensis and took ten doses in a row, and there has been no recurrence since then.

Du Wenhao went on to see a second patient with intractable diseases.Coincidentally, this was also an asthmatic, only much worse than the previous one.

This patient is also a woman, an old lady in her 60s with gray hair, lying on her side on the bed and suffering from constant asthma.Her son stood aside, looking at Du Wenhao anxiously.

Du Wenhao sat down on the chair beside her bed and asked, "Old man, are you watching asthma?"

"Yes!" The old woman nodded, panting like a bellows, and coughing hard from time to time: "Old illness, wheezing... It's been almost 30 years, and coughing and wheezing have become more severe in recent years, cough cough..., especially It's just recently..., it's even more powerful... wheezing..."

Du Wenhao glanced at the middle-aged man next to him, and asked the old woman: "Old man, is this your child? You are struggling to speak, why don't you let him speak for you, and if you say something wrong, you can correct it. How about you?" ?”

The old woman nodded gratefully.

Du Wenhao asked the middle-aged man: "Does your mother cough with phlegm? What kind of phlegm is it?"

"There is phlegm, the sputum is white, frothy, and thick."

"Is it easy to cough up phlegm?"

"Hmm..." The middle-aged man hesitated for a moment, seemingly not noticing, and said casually, "It's okay."

The old woman shook her head again and again: "No! Cough cough..., the phlegm is not easy to cough, wheezing..., I just want to cough it up, cough cough..., the chest feels better when I cough it out, cough cough..., no It's so stuffy, and it's better to breathe, wheezing..."

"Any other symptoms?"

The middle-aged man said: "Well, my mother often said that she has a headache, swells when it hurts, and often sweats, afraid of the wind, flustered, and short of breath."

"Do you have a fever?"

"No fever."

Du Wenhao also asked about diet, sleep, stool and past medical history, nothing special.Looking at the tongue for pulse diagnosis, it is found that the tongue is dark and fat, the fur is thin and white, and the pulse is slippery.

Du Wenhao asked whose patient it was, and a fat doctor came over and bowed to salute: "My lord doctor, this is my patient, my surname is Li, this old woman has asthma, and my syndrome is that the lungs are invaded by external evils. Going into the interior to dissipate heat, the phlegm heat is obstructed in the interior, and the descending is abnormal, resulting in persistent coughing and dyspnea."

Exogenous evils invading the lungs include wind-cold, wind-heat, dryness and other external causes. Different external causes have different syndromes. They are all exogenous evils attacking the surface. The function of Weiyang is ineffective or due to exogenous evils invading the lungs, resulting in loss of lung qi. announced.However, the wind-cold exterior syndrome caused by external evils attacking the exterior will often invade the inside of the body and turn into interior syndrome if it cannot be cured within a few days.

In TCM theory, besides the breathing function in anatomy, the lung also mainly conducts water. On the one hand, through the function of promoting lung qi, the temper is transported to the relatively light and clear part of the water liquid and the essence of water and grain in the lung, and upwards. Scatter to the orifices on the head and face, and spread to the fur to form sweat.On the other hand, through the descending effect of lung qi, the relatively thick part is transported inward and downward to the viscera, and finally forms urine.

Once exogenous evils attack the lungs, the function of lung qi and water flow is abnormal, which will cause the water transported from the spleen to the lungs to not be distributed normally, and thus gather in the lungs to form phlegm and water-dampness.And the accumulation of water in the lungs will block the airway, so there will be wheezing and coughing.

If the exopathogen is dryness, it will burn the body fluid, resulting in less and thick phlegm, making it difficult to spit out.

Dr. Li continued: "I use Maxing Shigan Decoction to treat this syndrome. Among them, moxibustion ephedra and almonds are [-] qian each, Tinglizi, perilla, mulberry and earthworm are [-] qian each, scutellaria baicalensis, angelica, and white Paeoniae officinalis and licorice are three qian each, Gualou Ren and Citrus aurantium are each four qian, and gypsum and Houttuynia cordata are each ten qian. After taking the medicine, the wheezing and coughing became worse, and the number of shortness of breath increased. I think carefully about the syndrome, there is no mistake, why not only It doesn’t work but the condition worsens, it’s really inexplicable, so I’m here to ask the imperial physician for advice.”

After hearing this, Du Wenhao's smile became a little awkward, he lowered his head and pondered for a moment, then looked up at the money.

Qian Bu accepted and quickly bowed and replied: "My disciple's identification is the same as Dr. Li's. It is not wrong to examine his prescription. I don't know why it doesn't work."

Du Wenhao frowned, pondered for a moment, and said to the old woman: "I'll feel your pulse again!"

Taking the old woman's hand, Du Wenhao closed his eyes to observe the pulse carefully, and after a while, he slowly let go, speechless for a while.

All the doctors were looking at Du Wenhao eagerly, waiting for him to give advice, but Du Wenhao, like an old monk in meditation, half-closed his eyes, motionless, not knowing what he was thinking.

Yingzi couldn't understand the medical case they were discussing. She only cared about how Du Wenhao was doing. Seeing that he looked extremely tired, she couldn't help but feel distressed. She leaned into his ear and whispered: "Master, let's rest for a while, let Doctor Qian They will take over for a while, continue to take care of the patient first, and then..."

Hearing Yingzi's words, Du Wenhao's eyes lit up, he couldn't help turning his head, grabbed Yingzi's plain hand, and kissed him, the sound was so loud that everyone in the venue heard it, and Yingzi buried his head in embarrassment I really want to find a crack in the ground and get in, but my heart is sweet.

When the doctors were stunned, Du Wenhao laughed loudly: "My Yingzi is smart! Do you think there are any girls in the world who are smarter than my Yingzi? There must be none! Hahahaha"

All the doctors looked at each other in blank dismay, not knowing what the imperial doctor meant, they all laughed along with them.

Du Wenhao said to the old woman's son, "Is the medicine Dr. Li prescribed earlier available?"

"Yes, after taking it, the condition worsened, so I didn't take it anymore."

"Bring it to me right now!"

The middle-aged man hastily agreed, ran to the door, and called the family members who were waiting outside to hurry back and bring the old lady's untaken medicine to the imperial physician.Several relatives agreed and left in a hurry.

The doctors were puzzled, Dr. Xie cupped his hands and said, "My lord doctor, could it be... there is something wrong with this medicine?"

Du Wenhao nodded: "To be honest, my syndrome differentiation and medication are exactly the same as Dr. Li and the villain, but I don't know why there is no effect. Just now I re-examined the pulse and reexamined it for a long time. I didn't find anything wrong. , and studied the four diagnoses carefully, and there were no mistakes. I really don’t understand why it didn’t work. It was what my pretty girl said just now that reminded me! I suddenly found the reason for the problem—a very likely reason !"

Yingzi was ashamed and embarrassed, and said in a low voice: "Master, what did I say, you are just making fun of him!"

"It's true this time!" Du Wenhao said cheerfully, "If you ask them to replace me for a while, let me think about whether some medicine in the prescription has been replaced by others, and fake or inferior medicines have been used. That's why it didn't work!"

Everyone immediately understood, Dr. Li blushed, hesitated for a moment, and finally stepped forward to cup his fists and said: "My lord doctor, this old woman was diagnosed at the humble medicine shop, and she also picked up the medicine at the humble medicine shop. Guaranteed with my life, there will be no fake or inferior medicines in the cheap medicine shop, and all the medicines used are high-quality and authentic medicines!"

Du Wenhao smiled and said: "I absolutely believe this. Let's wait and see. You must know that the problem of medicinal materials is not just a problem of fake and inferior medicinal materials."

The imperial physicians all made it clear that they believed it, Dr. Li naturally had nothing to say, so they all waited quietly.

Yan Miao stood behind and listened with a folding fan in her hand, some couldn't understand, seeing that Du Wenhao was closing his eyes and resting his mind, and the rest of the doctors were silent, waiting for the medicine to arrive. Wen Wen was confused, put away the folding fan, squeezed forward and clasped his fists, "Master, disciple and grandson are puzzled about this medical case, I wonder if Master can give some pointers."

Du Wenhao didn't open his eyes, and said lazily: "Speak."

"Yes, master, the ephedra in Ma Xing Shi Gan Decoction is full of ephedra, pungent, bitter, and violent. This old woman is old and weak. She has been wheezing and coughing for more than [-] years. Her lung qi must be weak. I'm afraid I can't bear it. Why don’t you give up ephedra and change it to another medicine?”

Du Wenhao opened his eyes slightly, gave him a strange sideways glance, closed his eyes again, and said slowly: "Well... then tell me, why is the medicine ephedra used in Maxing Shigan Decoction? "

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(End of this chapter)