Zhang Zhongjing (張仲景), known as Ji (張仲景), was a native of Nanyang in the Eastern Han Dynasty. He was born in the first year of Huandi’s peace (150 A.D.) and died in the 24th year of Xiandi’s Jian’an (219 A.D.). He was a great medical practitioner in ancient China. Throughout his life, Zhongjing diligently sought the ancient teachings and collected various prescriptions, collecting the essence of his predecessors and ancient times, and wrote the immortal medical masterpiece “Treatise on Typhoid Miscellaneous Diseases”. This medical book integrates theory, method, prescription and medicine into one, pioneering the discriminatory treatment and forming a unique Chinese medical thought system, which has played a great role in promoting the development of medicine in later generations. Zhang Zhongjing wrote 263 prescriptions in his Treatise on Typhoid Miscellaneous Diseases, which were compiled and organized by later medical practitioners into the Treatise on Typhoid Fever and the Essentials of the Golden Horoscope. Most of the prescriptions created by Zhang were rigorously formulated and well-matched, and their efficacy was verified by the clinical practice of successive generations of medical practitioners. Therefore, exploring the characteristics of Zhang Zhongjing’s prescriptions and medicines is not only helpful to better inherit and carry forward the characteristics of Chinese medicine prescription science, but also has guiding significance for clinical use of prescriptions, creation of new prescriptions or development of new medicines. The following analysis of Zhang Zhongjing’s “Treatise on Typhoid Fever” in the prescription of drugs and the characteristics of the combination: 1, less flavor Zhang Zhongjing in the “Treatise on Typhoid Fever” recorded 113 prescriptions, the number of flavors distributed between 1 to 14, the average number of flavors per prescription is 4, 18, of which there are 2 parties composed of one flavor of medicine, 7 parties composed of two flavors of medicine, 23 parties composed of three flavors of medicine, 24 parties composed of four flavors of medicine, five flavors of medicine, 17 parties composed of five flavors of medicine. There are 17 prescriptions for 5 flavors, 11 prescriptions for 6 flavors, and 13 prescriptions for 7 flavors. It can be seen that 86% of the total number of prescriptions in the “Treatise on Typhoid” consisted of less than 7 flavors (including 7 flavors), which is far less than the number of flavors in modern clinical prescriptions. Although Zhongjing’s formulas are relatively simple in taste, they are very effective in clinical treatment, such as Si Wei Tang, which is used to treat Yang Qi weakness and Yin cold, and Li Zhong Wan, which is used to treat deficiency cold in the middle Jiao, has only 4 flavors, Ma Huang Tang, which is used to treat external wind and cold symptoms, has only 4 flavors, and Bai Hu Tang, which is used to treat heat in the Yang Ming meridian, has only 4 flavors. Because of the remarkable efficacy of Zhang Zhongjing’s prescriptions, some of them have been made into proprietary Chinese medicines and widely used in clinical practice. The specific dosage of Zhang Zhongjing’s prescriptions is not uniform over the years. Most of the dosages applied in the current textbooks are based on the conversion method of Li Shizhen’s “Compendium of Materia Medica” in the Ming Dynasty and Wang Ang’s “Tangtou Ge Zhi” in the Qing Dynasty, that is, “different systems in the present and the past, one tael in the past, and one penny in the present”. In fact, the dosage is only 1/5 of the actual amount of medicine in the “Treatise on Typhoid”. The units of measurement used in the prescriptions of the “Treatise on Typhoid” include baht, tael, jin, he, bucket, piece, and piece, etc. The Han dynasty standard of weights and measures should be used as the basis when verifying the dosage of the medicine applied. At present, the “Atlas of Ancient Chinese Weights and Measures” compiled by the General Administration of Weights and Measures of the People’s Republic of China, “Han Guanghe Dashijia Bronze Power” (in the collection of the Chinese History Museum), is considered to be the authoritative standard for calculating the Han system. It was cast on the 23rd day of the 2nd year of the leap month of the 2nd year of Guanghe (179 A.D., the same year as Zhang Zhongjing in the Eastern Han Dynasty), and the inscription on it indicates that it was the standard issued by the government at that time for the unification of weights and measures throughout the country. In the course of the examination of this right, the actual measurement of the weight of the right capacity 2996 grams, about equal to 3000 grams, it is determined that this right 12 jin right, according to which it is known that 1 jin in the Eastern Han Dynasty is equivalent to 250 grams now, and 1 liang is equivalent to 15, 625 grams in modern times [1] [2]. Based on the above conversion method to calculate, then the dosage of each medicine of Gui Zhi Tang in the Treatise on Typhoid should be 45 grams of Gui Zhi, 45 grams of peony, 30 grams of roasted licorice, 45 grams of ginger, and 12 jujubes (about 35 grams), and the total amount of this prescription should be about 200 grams. Instead of about 43 grams as in the textbook. The most distinctive feature of the prescriptions in Typhoid is that the medicine is specialized and powerful. Because of the small number of flavors in the prescription, only the appropriate reuse of the drugs in the formula can really play its function of eliminating evil and healing the disease. As Zhang Zhongjing advocated less flavor but more dosage in his prescriptions. Therefore, he was very particular about the usage of his prescriptions (decoction and administration methods), especially the usage of prescriptions containing more potent drugs. For example, the usage of Xiao Chai Hu Tang is: “Take the original formula with seven flavors, boil six liters of water in a bucket of two liters, then decoct, take three liters, take one liter of warm water, three times a day”. The use of Xiao Qing Long Tang is: “The original formula is eight flavors, take one bucket of water, boil ephedra first, reduce two liters, remove the froth, boil three liters of all the medicines inside, remove the dregs, take one liter of warm water”. The usage of Gui Zhi Tang is: “Take seven liters of water, boil three liters on a light fire, and take one liter to suit the cold and dampness. After taking a short time, sip hot thin porridge for more than one liter to help the medicine. Warm cover so that a moment, tie up all over the body slightly seems to have sweat is good, do not make such as water flowing dripping, the disease will not be removed. If a sweat out of the disease disease, stop after the service, do not have to exhaust the dose; if not sweat, and then serve as before; and not sweat, after serving a small promotion of its interval, half a day, so that the three services are complete. From the above tripartite medicine method can be seen, Zhongjing advocates a formula with a large amount of water decoction, boiled, and then divided into multiple doses a day. This ensures that each dose is not too large and that the medicine continues to work in the body. 4, unique combination 4, 1 must be combined with the same flavor, efficacy or similar drugs with each other, the drugs stimulate each other to obtain synergistic effect, to achieve the purpose of “accumulation of medicinal power”, in order to enhance the original effect. For example, in Ephedra Tang, Ephedra is combined with Gui Zhi, both of which are pungent and warm, and have the effect of pungent warmth to relieve symptoms. The combination of Radix et Rhizoma Pseudostellariae and Radix et Rhizoma Ginger in Si Wei Tang is very pungent and hot, which can warm the spleen and kidneys, and is characterized by “going but not keeping”. The combination of the two drugs, “both go and keep”, can enhance the efficacy of warming the spleen and dispersing cold, returning Yang to save the rebellion, but also make the effect strong and long-lasting (Article 387). The combination of rhubarb and mangosteen in Da Cheng Qi Tang, rhubarb is bitter and cold, which can clear heat and pass stools and cleanse the stomach; mangosteen is salty and cold, which can soften and moisten dry stools; when the two herbs are combined, mangosteen first softens dry stools, and rhubarb then passes through the ground, which not only enhances the power of relieving heat and passing stools, but also makes the therapeutic effect fast and achieves the purpose of urgently lowering and preserving yin (Article 213). 4, 2, opposite pairing of drugs with opposite taste or efficacy, in order to mutually restrain their bias, or stimulate each other to produce a “phase into” effect, mainly in the following aspects: 4, 2, 1, dispersal and collection of the combination. The combination of drugs with dispersing effect and drugs with astringent effect, dispersing to get rid of the evil outside the surface, astringent to protect the body’s vital energy and fluids, so as to get rid of evil without harming the right, help the right without leaving evil. For example, in Gui Zhi Tang, Gui Zhi is paired with Bai Shao, which is pungent, sweet and warm, and can dissolve the surface of the muscles to disperse the evil of wind and cold outside; Bai Shao is bitter, sour and slightly cold, and can nourish Yin and astringent, and consolidate the external drainage of Ying Yin; the two medicines together, one disperses and the other astringent, and harmonize Ying and Wei, so that the formula disperses wind and cold without hurting Yin, and nourishes Yin without retaining evil (Article 12). In Xiao Qing Long Tang, Ephedra, Hosi and Wu Wei Zi are combined to disperse wind-cold with Ephedra and Hosi, while Wu Wei Zi is sour to astringent lung qi and stop cough, so that the formula disperses cold and stops cough without hurting the righteousness and astringent lung qi without retaining evil. Others, such as sour jujube in Sour Jujube Soup with Chuanxiong, Ling Gan Wu Wei Jiang Xin Tang with Gan Jiang and Xiao Xin with Wu Wei Zi, and Wu Mei Pill with Shu Pepper and Xiao Xin, are also in the relationship of dispersing and collecting each other. 4, 2, 2, cold and heat with. To the cold nature of the drug and warm nature of the drug used in combination, cold drugs to clear heat, hot drugs to dispel cold, for the cold and hot mixed evidence; or cold and hot drugs together can play a “compulsory retention with” or “into” the role. For example, in Peach Kernel Cheng Qi Tang, rhubarb is paired with Gui Zhi, rhubarb is bitter and cold to remove blood stasis, while Gui Zhi is pungent and warm to disperse, which can warm the meridians and open the blood vessels, although the two drugs are opposite in nature, they both have the effect of invigorating the blood. (Article 109). In Ma Heng Shi Gan Tang, ephedra and gypsum are combined, with ephedra pungent and warm to induce sweating, and gypsum sweet and cold to clear heat. The formula uses a large amount of gypsum with a small amount of ephedra, aiming to expel heat from the lung, with ephedra pungent and dispersing to open the way to expel heat; gypsum bitter and cold to clear heat from the lung to eliminate its source; the two drugs are combined to play the effect of expelling heat from the lung, and are used to treat asthma and cough caused by heat congestion in the lung (Article 63). In Huanglian Tang, Huanglian is paired with Ganjiang, which is bitter-cold and diaphoretic to clear the heat in the chest, diaphragm and stomach; Ganjiang is pungent and disperses cold to dispel cold in the spleen and intestines; the two are used to treat abdominal pain and vomiting caused by heat in the upper part of the body and cold in the lower part (Article 178). In Han Xia Di Xuan Xin Tang, dry ginger is used to warm the middle and disperse cold, while Huang Lian and Scutellaria are used to drain heat with bitter cold. The combination of cold and hot herbs is used to regulate cold and heat, eliminate lumpiness and disperse knots, and treat subcardiac fullness and vomiting and dysentery caused by cold and heat (Article 154). In Wu Mei Wan, Huang Lian and Huang Bai are used to clear heat with bitter cold, while Shu Jiao, Gan Jiang, Radix et Rhizoma Pseudostellariae, and Hsio Xin are used to dispel cold with warmth, treating the mixed cold and heat of ascariasis (Article 338). 4, 2, 3, both attack and supplementation. Zhang Zhongjing made good use of the combination of attacking and tonifying drugs in his prescriptions, attacking to dispel evil and tonifying to support righteousness, in order to treat the evidence of positive deficiency and evil solidity. For example, in Chai Hu plus Dragon Bone and Oyster Soup, Rhubarb is bitter and cold to relieve the heat of the stomach and intestines, while Ginseng, Jujube and Poria nourish the qi and strengthen the spleen to support the positive qi, so that both attacking the evil and supporting the positive are used together with Dragon Bone, Oyster and Chai Hu to treat delirium due to the injury of positive qi and diffusion of evil qi caused by the misuse of typhoid fever (Article 110). In Xiao Chai Hu Tang, Chai Hu, Scutellaria Baicalensis and Shao Yang are used to relieve the evil of half of the surface and half of the interior, while Ginseng, Jujube and Radix et Rhizoma Glycyrrhizae are used to benefit the Qi and strengthen the spleen, both to support the righteousness to dispel the evil and to benefit the Qi to prevent internal transmission of evil. In Han Xia Di Xuan Xin Tang, Han Xia, Gan Jiang, Huang Lian and Scutellaria are used to calm the cold and heat to eliminate the rebellion; Ginseng, Jujube and Roasted Glycyrrhiza are also used to nourish the middle and benefit the Qi to promote transportation and digestion to help eliminate the rebellion (Article 154). In Pig Ling Tang, pig ling, poria, zedoary, and slippery stone are used to facilitate water and permeate dampness, and aconite is used to nourish yin and moisten dryness, so that the formula can facilitate water without harming yin and nourish yin without astringing evil (Article 226). 4.3.Treating both the surface and the lining of the body with the same medicine to achieve the purpose of treating both the surface and the lining of the body. For example, in Da Chai Hu Tang, Chai Hu is combined with Scutellaria baicalensis to reconcile Shao Yang and clear the evil heat of Shao Yang; it is also combined with Rhubarb and Citrus aurantium to relieve heat and relax the bowels and remove the evil of Yang Ming; the medicines are used together to treat the combined disease of Shao Yang and Yang Ming (Article 106). In Ge Gen Scutellaria Tang, Ge Gen is used to remove heat from the surface, and Huang Lian and Scutellaria are used to dry dampness and stop dysentery, treating heat dysentery when the external surface is not relieved and the heat enters the interior (Article 34). In Xiao Qing Long Tang, Ephedra and Gui Zhi dispel cold, and dry ginger, Hsiang Xin and Wu Wei Zi warm the lungs and dissolve drinks, treating wheezing and coughing caused by external wind and cold and internal watery drinks (Article 40). Other examples include Xiao Chai Hu Tang in which Chai Hu penetrates the surface and Baicalin clears the lining (Article 98). In Wu Ling San, Gui Zhi disperses the wind and cold outside and relieves the surface, while Zelig, Poria, and Fu Ling are used to promote water and drainage, which also reflects the rule of treating both the surface and the inside (Article 29). 4.4.Qi and Blood are harmonized. “Qi is the handsome of Blood, and Blood is the mother of Qi”, so Qi and Blood are closely related. In roasted licorice soup, roasted licorice and ginseng benefit heart qi, while jujube and aconite nourish heart blood, so that the qi is strong and the blood is sufficient to restore the pulse (Article 182). In Si-wei-san, Citrus aurantium moves Qi and directs stagnation, while Bai Shao softens the Liver and nourishes Yin and Blood, which are used together to harmonize Qi and Blood and help to clear the Liver and drain the Spleen (Article 318). The treatment principle of “when we see the disease of the liver, we know that the liver transmits the spleen, so we should first strengthen the spleen” by Zhongjing reflects this theory and is used as the basis for formulas. For example, Huang Lian and Ah Gao Tang is used to treat Shao-Yin disease, in which the heart is troubled and cannot sleep, using Huang Lian and Huang Qin to clear the fire in the heart and remove the troubling heat; using Ah Gao, Paeonia lactiflora and Rooibos to nourish the kidney yin and nourish the yin blood and calm the mind. In Zhen Wu Tang, Radix et Rhizoma Atractylodis Macrocephalae is used together, one to strengthen the spleen to control water, the other to warm the kidneys to main water, and the combination of the herbs to treat the deficiency of Yang water-dampness within the stopping evidence, also implies the meaning of internal organs (Article 84). 4, 6, yin and yang mutual root because “lonely yang is not born, only yang does not grow, yang to yin for the body, yin to yang for use”. Therefore, often with nourishing Yin medicine to help strengthen Yang, in order to “seek Yang in Yin”; or with warming Yang medicine to help nourish the power of the Yin blood medicine. For example, in the treatment of pulse knot generation and palpitation, roasted licorice soup is used to benefit the heart qi to restore the pulse and fix the palpitation, combined with jujube and ginger to nourish the stomach qi to replenish the source of yin and blood, supplemented with raw earth, aconite, maitong and hemp seed to nourish yin and nourish blood, and ginseng and cinnamon branch to replenish yang qi, and clear wine to open up the meridians and to promote the power of all medicines, implying the mutual root of yin and yang (Article 182) [3] [4]. References: [1] Feng Lei, Mu Lancheng. Chinese medicine drug dosage should return to the basics-Professor Tong Xiaolin interpreted the “Treatise on Typhoid” drug dosage, China Chinese Medicine News, May 16, 2008, edition 4 [2] Yu Zhongjing, focus on the proportion of the scripture formula and the amount of medicine, contemporary medical doctors on the scripture formula, China Chinese Medicine Press, 1993, first edition [3] Hubei College of Traditional Chinese Medicine, “Selected readings from the Treatise on Typhoid”, Shanghai Science and Technology Press, Shanghai [4] Shi Xuguang, Exploring the characteristics of drug combination in the prescriptions of the Treatise on Typhoid Fever, Henan Chinese Medicine, 1998, 18(10):1