The evidence of fire stagnation can be seen in both external illnesses and internal injuries, and is one of the common clinical evidence. Although the evidence is “fire” evil, but because of its “fire” evil “depression” and not yet developed, so the clinical testimony is more complex, varying, sometimes instead of seeing cold signs. If not detailed diagnosis and detailed reference, to investigate the origin of the disease, often easy to misdiagnosis and mistreatment, or even the opposite, the light delayed time, serious life, so the clinical evidence must not be identified. Now I would like to discuss my understanding of fire-depression evidence and
The clinical treatment experience for reference.
First, the etiology of fire depression pathogenesis
Chinese medicine believes that: human life activities are in a state of constant movement, and the rise and fall is the basic form of human life movement. In the normal physiological state, the human body is constantly in the movement of lifting and entering, constantly from
In a normal physiological state, the human body is constantly moving in and out, constantly taking in the required substances from nature, discharging metabolic wastes, rising clear gas, falling turbid gas, exhaling the old and taking in the new, maintaining the circulation of blood and Qi, in order to make the internal organs function well and flourish. If once the lifting and lowering of the access is not normal, Qi stagnation, clear gas does not rise, turbid gas does not fall, it is a hundred diseases by the birth, or even life-threatening.
As the Suwen? Six micro purpose of the great theory of the cloud: “success or failure leaning on the volt on the move, moving and has not been, then the change is made. “Non-in and out, there is no birth, growth, strong, old, has; non-lift, there is no birth, growth, transformation, collection, hiding. Is to lift the in and out, there is no tool not to have”. “In and out of waste, then the divine machine extinguished, lift rest, then the gas stand alone dangerous”. And the formation of fire depression, is due to the evil Qi blocking the qi, lifting and entering out of order.
The term “fire depression” was first mentioned in Suwen? The Six Elements of Zhengji Da Lun. Although the manifestations of fire and heat are different, there is no essential difference between them, so later medical practitioners have also called “fire depression” as “heat depression”. There are many causes of the disease, such as the external sensation of six evil spirits; internal stagnation of Qi, blood, phlegm, drink, dampness, and food can be affected.
The pathogenesis of the disease is due to the blockage of qi, causing obstacles to the circulation of qi and blood in the body, internal depression is not pronounced, and the evil qi is not allowed to escape and is stored in the lining, thus becoming the evidence of fire and depression. The more depressed it is, the more the fire burns, and the more the fire burns, the more depressed it is. As Liu Wansu said: “Yu, Fries, also, stagnant congestion and gas is not smooth. The so-called heat is even the coup closed and depressed. As the fire refining things, the hot pole together and can not be separated from each other, so the hot depression is closed and not smooth”. (“Suwen Xuanji original disease style six qi for the disease heat class”)
Second, the diagnosis of fire depression
The clinical manifestations of fire stagnation and fire heat are very different, although they both belong to the evidence of Yang heat. Fire-heat evidence is heat burning in the inside and flared outside, the whole body surface and inside are seen a school of heat, such as: body heat and malignant heat, disturbed and agitated, red eyes, thirst and drinking cold.
The tongue coating is yellow and thick, and the pulse is strong. …… Such heat signs can be known at a glance. In contrast, fire depression is heat depression in the inside can not be open, although there is internal heat, but does not form in the outside, the surface and the inside is not the same, the symptoms are mixed, it is difficult to understand at a glance. Therefore, it is necessary to grasp
Therefore, it is necessary to grasp the key and master the essentials in order to diagnose accurately and not to make mistakes.
Generally speaking, it can be identified from the following aspects.
1, the tongue image because of the fire in the internal, fluid loss, the tongue body loss of moist, and therefore most see the tongue shape thin and thin and tongue surface less fluid, or even dry or tongue dry and cracked. If the fire is caused by dampness blocking the qi, the tongue will be red with white greasy coating.
2, pulse because of the fire-heat internal depression, qi stagnation, qi and blood circulation is not smooth, so the pulse is mostly sunken and astringent or sunken string and number. If the depression is particularly severe and the qi and blood are internally congested, the pulse may occasionally be sunken and sluggish, so it is important to make a detailed diagnosis and refer to the details, and not to treat it as cold.
If the fire burns the yin, it may cause sleeplessness or nightmares, and there are shrieks in the dream; if the fire disturbs the clear orifices, the head and eyes will be dizzy; if the fire is hot and depressed in the warm disease, it may even be delirious; the face may look dark and dull, or even sallow; or the head may sweat, but the body does not sweat; the limbs are not warm, or even cold. The deeper the depression, the deeper the syncope; urine is short and red, the stool is constipated, in the warm disease, each can see the stool does not pass for several days, or see the side flow of heat knots, there are also depressed fire within the forced and made fire discharge; or spotted rash hair but does not penetrate, or out and back, or dark and stagnant, or thick and tight bundle. The above testimonies are all due to the internal depression of fire and heat that cannot be reached externally, and the complexity of the evidence can be understood.
Third, the treatment of fire depression
The evidence of fire depression, the Qi is closed, no door to drain. If the pure use of cold products, it is easy to stagnate the qi, so that there is no way out of the evil, but into a cool deterrent potential, is to clear but stagnant, the more clear the more depressed, not only the disease is not healed, anti-terrorism incur other problems.
The “Su Wen Liu Yuan Zheng Ji Da Lun” proposes “Fire Yu Fa Zhi”, which opens the doorway to treating fire depression, and is actually the fundamental rule for treating fire depression. The so-called “fa zhi” means to declare and vent. The clinical evidence of fire-depression, must first use the method of relieving depression, sparing, venting, and lightening, etc., to open and disperse the depression, promote its stagnation, and smooth the flow of Qi and blood, so that the Ying and Wei can reach, and then the fire will have the opportunity to escape.
Although there are many causes of fire depression, if you can examine the evidence to find the cause, remove the cause of depression, you can make the depression open qi and fire discharge, without cold and the fire will disappear. For example, if the fire is caused by the six sexes, get rid of the external evil, then the fire can be developed; if it is due to qi stagnation, unclog the qi, then the fire can be declared; if it is due to blood stasis, move the stagnation, then the fire will be relieved; if it is due to phlegm and dampness, dissolve the phlegm and dampness, then the qi will be unclogged and the fire will be released; if it is due to food stagnation, eliminate the stagnation, then the fire will not exist, ……
All sorts of things, always to smooth the qi as its key meaning.
The Qing dynasty doctor Yang Lishan made a formula called “elevation san”, which is contained in his book “Typhoid Fever and Warm Epidemic” and has been passed down to the world to enlighten future generations. Although this formula was developed for warming diseases, it is also very effective in treating many fire-depression symptoms of external influenza and miscellaneous diseases. I have been able to use it by adding, subtracting, and tailoring it for the treatment of fire-depression, and it has been very effective.
The composition of the formula is: white silkworm (wine fried) two money, whole cicada shed one money, wide ginger yellow (peeled) three money, raw rhubarb four money. (The original formula is a bulking agent, served with yellow wine and honey).
Yang’s analysis of the drugs in the formula cloud: silkworm for the ruler, cicada molting for the minister, turmeric for the adjuvant, rhubarb for the make. The stiff silkworm taste hard, thin, light and floating, so it can win the wind and remove dampness, clearing heat and relieving depression, …… disperse the inverse turbid stagnation of phlegm also, can be able to ward off all the fries of the evil gas. The cicada molasses is cold, non-toxic, salty and sweet, and can dispel wind and win dampness, clean heat and detoxify. Turmeric moves qi and disperses depression, building up the strength to ward off epidemics. Rhubarb is bitter and cold, and it passes up and down, so that the hyperactive Yang is not suppressed.
There are only four herbs in this formula, but they are well formulated and are indeed a model agent for “fire depression. The combination of the four herbs, cold and warm, up and down due to each other, to promote the three jiao, strip the qi and blood, so that the surrounding qi and blood flow, then the fire depression of the evil can be drained and evacuated.
I use this formula to treat the evidence of fire and depression, and add and subtract flexibly for the cause of fire and depression, such as.
If the fire is caused by external evil attacking the surface, add silver flower, forsythia, peppermint, burdock, bupleurum, bupleurum and sage.
If the fire is caused by qi stagnation, add Chai Hu, Neem, Radix et Rhizoma, Pericarpium Citri Reticulatae, and Radix Aromaticus.
In cases of fire stagnation due to blood stasis, add Dan Pi, Red Peony, Radix et Rhizoma, Comfrey, and Radix et Rhizoma.
For fire-depression due to phlegm-dampness, add Radix Panax, Psidium Guajava, Acorus Calamus, Poria, Melon Peel, Fried Fangfeng, etc.
If the fire is caused by food stagnation, add hen’s nest, jiao hawthorn, jiao shengqu, jiao malt, lycopodium and so on.
If the fire stagnation is particularly severe, add Huang Lian, Scutellaria, Gardenia and other bitter-cold and clearing products to the formula.
If the fire is burning the fluid and the fluid is depleted, add rehmannia, foxglove, sage, maitake, etc.
Personal experience, the treatment of fire depression and the need to add discretionary wind medicine, such as: wind, mustard spike, Su leaves, etc., to wind medicine to move the qi open depression, smooth the qi mechanism, access to the couples and send its depression fire.
Four, fire depression case analysis
A. Qi stagnation and fire depression
Sun X, male, 47 years old, was seen on May 21, 1974.
Emotional and mental disorders, dullness and pain in the ribs, chest tightness, bouts of cold, cold extremities, disturbed dreams, dry stools, urine red heat, red tongue and dry mouth, two veins sunken and slightly numbered, the disease has been two months there she. The evidence belongs to wood stagnation turning into fire, the treatment should be to regulate the qi and open the stagnation, smooth the three jiao to drain the fire.
Prescription: Cicada molasses 6g, Silkworm 10g, Radix Bupleurum 6g, Aromatic Herb 10g, Turmeric 6g, Edamame 10g, Gardenia 6g.
After two doses, all the symptoms were reduced and cured with two more doses.
The analysis of the disease is due to emotional disorders and the pain of the hypochondrium, chest congestion, all belong to the image of liver depression and qi stagnation. The disease has been in progress for two months, the depression has turned into fire and disturbed the heart and mind, so the heart is troubled with many dreams. The heat burns and injures the fluid, then the stool is dry and red, the tongue is red and the mouth is dry. Fire stagnation and qi stagnation, deregulation of the Ying and Wei, and loss of the division of the Wei outside, so the bouts of cold, Yang Qi does not reach the four extremities, which leads to rebellious cold extremities. The two veins are sunken and stringent, the main qi stagnation, and the number is a sign of internal pushing of depressed fire.
In summary, although the evidence is mixed with cold and heat, but all from the qi depression, so the treatment starts with regulating the qi flow of the Sanjiao, the depression of the qi flow, the fire will be released. The prescription is composed of Shengqi San with the addition of Da Huang. Cicada molasses, Silkworm, and turmeric are used to regulate the Qi flow and vent the fire. Add Chai Hu and Xiang Shen to enhance the function of soothing the liver and relieving depression, and to regulate the qi flow. It also adds Gardenia and Black Bean Soup, with black bean curd to expel heat and expand qi, and Gardenia to relieve fire by relieving the three jiao. The combination of all medicines, so that the gas to fire discharge, evil has a way out, so four doses and healed.
Second, the warm disease fire depression, rash out of not smooth
Xu XX, male, 7 years old, presented to the clinic on March 10, 1978.
He has been suffering from warmth for three days, with high fever that does not subside, a red rash outside, a two-day rash that is vague all over the body and does not come out smoothly, chest tightness, wheezing and coughing, swollen and painful throat, sleeplessness, restlessness, and restlessness, a four-day absence of stool, a dry and vivid tongue with thorns, and a thin and counted pulse. The rash is impermeable due to heat stagnation in the battalion and injury to yin fluid.
Prescription: 3 grams of cicada moth, 6 grams of silkworm, 15 grams of silver flower, 15 grams of forsythia, 15 grams of hooked vine, 30 grams of raw earth, 10 grams of comfrey, 30 grams of ginseng, 20 grams of rhizome and thatch, 3 grams of raw rhubarb powder (punch), 0.5 grams of Angong Niuhuang San (divided into two punches).
One dose of rash penetrated heat and reduced Shenqing, the original formula was removed from Angong Niuhuang San and 15 grams of Bei Sha Shen, 10 grams each of Jiao Shanzha, Jiao Shenqu and Jiao Ma Ma Ye were added, which was cured in three doses.
The patient felt warm-heat evil qi, which entered the Ying division and forced the blood to travel outward, causing the rash to develop on the skin surface and blood channels. Because of the internal depression of fire and heat, the rash does not come out smoothly, and although it has been out for two days, it is still vague and not completely transparent. If the fire is internalized in the lung, the lung Qi is not declared and the rash is seen as chest tightness and coughing. The fire of depression attacks the throat, so the throat is swollen and painful. Depression fire disturbs the heart, which leads to sleeplessness and restlessness, and if the fire is not released, there is a risk of heat trapping in the pericardium. Fire and fluid injury, so the tongue is dry and vivid
Prickly. The large intestine is deficient in fluid and dry stools are knotted inside, resulting in stools that do not pass for four days. The pulse is thin and counted, which is also a sign of fire and yin injury. Fire-heat internal depression burns Ying-Yin, so the treatment is not to cool Ying-Yin and promote the flow of Qi.
In the formula, raw earth, elemental ginseng, thatch root and comfrey can cool the Ying and nurture Yin and move the blood. Cicada molasses, stiff silkworm, silver flower, forsythia, hooked vine, light clear and transparent, smooth the qi flow, have the function of transmutation of heat and turn the qi, can make the camp fire outside. Raw rhubarb cools the blood and moves stagnation, tapping the lower
The intestine, so that the dry stool down and Qi flow, then the fire can be developed. The reed root clears heat and generates fluid. Add Angong Niuhuang San to clear heat and open the body and awaken the mind. The combination of all the medicines, internal clearing and external permeation, so that the fire is ventilated, so a dose of the rash is transparent heat reduction. Because the agitation had been
As the agitation was removed, we removed Angong Niuhuang San and took three more doses to remove the remaining evil and restore the fluids. The addition of Bei Sha Shen Shen, Jiao Shen Qu, and Jiao Ma Ye to awaken the stomach with jiao fragrance and promote the recovery of the spleen and stomach functions.
Third, warm disease mismanagement, fire depression and mental faintness
Huang XX, male, 43 years old, was seen on March 18, 1976.
He had been injected with penicillin and streptomycin, and took large doses of cold drugs, such as raw gypsum, Huang Lian, wide rhinoceros horn, Zixue San, Angong Niuhuang Pill, etc., but even the injection was ineffective, and the disease reverberated day by day, so he asked for consultation.
The evidence: high fever does not subside, head slightly sweating, no sweating all over the body, the extremities convulsions, chest and abdomen burning, delirium, short urine red, stool for three days, tongue red, coating yellow and thick, pulse sunken and strong. The evidence of warm evil is in the qi, too much use of cold products, Yang Qi is suppressed, no power to lift, fire depression is not issued, the evil heat is forced into the camp, the most fear of spasms and convulsions of change. It is urgent to clear the air circulation to regulate the lift and lower, and pass the internal organs to declare the fire to wake up the spirit.
Prescription: 6 grams of cicada moth, 6 grams of silkworm, 6 grams of turmeric, 3 grams of raw rhubarb powder (punch), 3 grams of peppermint, 6 grams of almonds, 20 grams of silver flower, 15 grams of forsythia, 30 grams of rhizome, 10 grams of nine-jointed calamus.
Two doses of small sweat all over the body, the fever subsided and the body cooled, the pulse was quiet and clear, and healed.
The analysis of this patient warm evil in the first qi, it is appropriate to pungent cold to clear the qi, to reach the heat out of the table. But the wrong use of Huang Lian, wide rhinoceros horn, purple Xue San, Angong Niuhuang Wan and other drugs, but into the cool containment of the momentum, the evil heat outside to reach no way, is forced into the camp. The fire is depressed in the inside.
Therefore, high fever does not subside, chest and abdomen burning. Depression fire upward, fumigating the head and face, but the head sweat. Qi blockage, Yang Qi does not reach the end of the four, and cause the extremities convulsions, heat deep convulsions deep is also. When the heart is closed by heat, it is seen as delirium. Stagnant fire burns fluid, thus
Short, red urine and inability to pass stool. The red tongue with yellow and thick coating, and the sunken and strong pulse are all signs of fire and depression in the qi division. Although there is delirium, not from the camping treatment, if you still mistakenly put Angong Niuhuang Pills and so on, the more cool and more suppressed, the depression of the fire out of no time, but the disease is not solved, is bound to move the wind spasms. Urgent to promote its qi, the development of its fire depression, the camp heat is removed.
In the formula, cicada moth, stiff silkworm, peppermint, silver flower and forsythia are all lightly propagated products, which are lightly cleared and propagated to lead the evil out. Add almond to open the lung Qi, turmeric to move Qi and blood, rhubarb to ventilate the internal Qi, calamus pungent to awaken the spirit, reed root to clear heat and generate fluid. The combination of all the drugs, promote the smooth flow of Qi and make the fire outside, so the second dose is a small sweat all over the body, the fever subsides body cool, the pulse is quiet and clear, the danger is turned into a bargain, the disease is healed.