Ephedra with seeds and spicy soup from the “Treatise on Typhoid” 301: “Shao Yin disease, the beginning of the get, but fever, the pulse is sinking, Ephedra with seeds and spicy soup is the main.” Shao Yin Yang deficiency, should be vicious cold body cool, now the external cold, the positive and the evil fight then see fever. In later times, the treatment of Yang deficiency external fever is regarded as a formula for warming and sweating. In the formula ephedra sweating to relieve the Sun’s table, the sophora warm support Shao Yin Yang, the pine not only to relieve the table cold, but also to disperse Shao Yin cold evil, with ephedra, sophora can be used to treat both the table and the inside. The combination of the three drugs can help dispel the evil and warm the Yang to relieve the symptoms.
1.Analysis of disease mechanism
This formula is commonly used in clinical practice for various types of illnesses involving rash, lumbago, cough, rhinitis, bronchitis, asthma, deafness and loss of voice, and chronic renal failure. The application of this formula is based on the basic theoretical basis of the provisions described in the Treatise on Typhoid, with more emphasis on the examination of “true yang”. The kidney harbors the innate essence and the kidney yang is the root of the yang energy. Kidney Yang deficiency, the organism of the internal organs to promote the organization and warmth is weakened, the Yin cold gradually; transpiration and gasification is not enough, the water dampness is not transformed. The evil of cold and dampness is most likely to block the qi, into the blood stasis, paralysis and obstruction of the meridians, the organism organs, limbs and bones lose glory and nourishment. This is a Yang deficiency body, plus this, internal worries are not resolved, and more difficult to prevent the external disturbance of evil. Thus, Guo Shi believes that the core pathogenesis of Ephedra and Fructus Sinensis Tang is: deficiency of Yang in Shaoyin, paralysis by cold and dampness, and disturbance by external evil. It is applied to the body with Yang deficiency, in the interior, cold evil is trapped inside and cannot get out; in the exterior, cold evil invasion cannot be stopped. In this way, it helps Yang to consolidate the root, warms the meridians and channels, disperses cold and relieves the surface to find a way out for the evil, so as to achieve the effect of unblocking the surface, clearing the tunnel internally, regulating Qi and blood, and meeting Yin and Yang.
2. Recipe and decoction method
2.1 Main formula
Adults: 60g of Sliced Pill (first decocted for 2 hours), 15g of Ephedra, 15g of Hosanna, 50g of ginger.
Pediatrician: 5~12 years old: 60g of Sliced Pill (decoction for 2 hours), 10g of Ephedra, 10g of Hosanna, 50g of Ginger. >12 years old: same dosage as adult.
2.2 Addition and reduction
If the intention is to dispel the cold and promote the orifice, it is appropriate to use the original formula to go straight in, the force is specialized and the effect is grand; if the Guan and Zhu pulse is weak, the middle Yang is insufficient, the kidney Yang has no power to seal and float outside, add: 5g of roasted licorice, taking the meaning of Si Wei Tang to make up fire to generate earth, thick earth to subdue fire; if the tongue coating is thick and greasy or there is a lot of phlegm, add 20g of Fa Xian Xia, 15g of Fu Ling, 15g of Chen Pi; for cough, add 15g of almond, 15g of Aster, 15g of Dang Dong Hua, if appropriate. For cough, add 15g of almond, 15g of aster and 15g of Radix et Rhizoma, and 10g of Radix Platycodon; for itchy skin rash, add 15g of Cyperus, 15g of Radix et Rhizoma and 15g of Radix et Rhizoma.
2.3 Decoction method
Soak the tablets in water for half an hour and then rinse them three times. Put the washed tablets into a casserole, add water to boil and then turn down the heat to decoct for 2 hours. The second time for half an hour.
3.Clinical cases
The author selected one case each of dysarthria, chronic renal insufficiency and cough from Guo Shi’s many cases of using ephedra with seeds and pungent spice soup, which I would like to share with readers.
3.1 Deafness
Wu, a 13-year-old female, first visited our clinic on August 14, 2012 for hearing loss with slurred speech for 10 years. The child had a high fever that was difficult to subside after a cold in her early childhood, and the fever was controlled after a week of infusion treatment. Later, he gradually developed hearing loss with strong tongue and blurred diction. He had low hearing and needed to wear a hearing aid, had slurred speech, was drowsy during the day, had little sweating, did not drink much, liked hot drinks, had a good sleep, and had many dreams at night. The second stool is regulated. Dr. Guo identified Yang deficiency with cold and blocked orifices.
Prescription: 60g of Siberian Pill (decocted for 2 hours), 15g of Ephedra, 15g of Radix et Rhizoma, 50g of ginger.
After taking the medicine for half a month, he returned to the clinic and complained that his hearing had improved, but he had headache, abdominal pain, regurgitation and vomiting after the medicine. Continued to use the original formula, increase the amount of sliced peppermint and ginger to 75g and 60g respectively, and add calamus 20g.
After another half month, the hearing aid was removed at the third consultation, and the family complained that he no longer needed to turn up the volume to watch TV, and his pronunciation was improved compared with that before the consultation, and his drowsiness was reduced.
The child’s high fever was difficult to subside after experiencing cold at a young age, because he was too young and weak to drive the evil out, and because the cold was so strong that it invaded the interior. Guo believes that infusion treatment can effectively reduce fever, but from the perspective of Chinese medicine, the cold evil is deeply pressed into the body, from the sun into the lesser yin, at least the yin and yang qi is suppressed, the orifice is closed and hearing loss occurs. Foot Shao Yin kidney meridian up into the lungs, along the throat to the root of the tongue on both sides, cold coagulation collection lead, then the tongue is strong, unclear pronunciation. It is also associated with drowsiness, little sweating, and a preference for hot drinks, and other symptoms of Yang deficiency and Qi weakness. The medicine used is Ephedra with Rhizoma and Radix et Rhizoma fine spice soup with ginger, which helps Yang to relieve symptoms and dispel cold to open the orifice. Although the patient had headache, abdominal pain, vomiting and other discomforts after the first consultation, it was actually a reaction of “Yang to run, Yin evil to go”. In the second consultation, the main formula was used and the dosage was adjusted, and calamus was added to strengthen the power of resolving phlegm and opening the orifice.
3.2 Cough
The child, Kong Moumou, 6 years old, was first diagnosed on June 12, 2012. His mother complained that the child had recently started to cough and sputum in the morning, which was relieved in a moment. Sweating on weekdays, easy to sneeze and runny nose after sweating, night sweating when sleeping. The tongue is pale, with a vague purple color after the middle, with a white, thin, greasy coating. Pulse: Right inch is weak, tight and thin, left ulnar is weak. Identified as Yang deficiency with cold sensation and Tai Shao with the same disease.
Prescription: 60g of P.E. Pieces (decocted for 2 hours), 10g of Ephedra, 10g of Radix et Rhizoma, 50g of ginger, 5g of roasted licorice, 10g of almonds, 20g of Radix et Rhizoma, 15g of Poria, 15g of Pericarpium Citri Reticulatae, 10g of Schisandra. 7 doses, decocted in water, twice a day.
One week later, his mother complained of a significant reduction in sneezing, occasional coughing, and night sweats like washing, but now there is a decrease.
The child’s pulse is weak and tight, the tongue is vague and purple in the middle and posterior part, and the moss is white and greasy, which indicates that the child has a deficient Yang body, insufficient Qi and blood, and internalized cold and dampness. Now the child is suffering from cold, and the Sun and Shao-Yin are both sick. If the surface is deficient, it is easy to sweat, and the positive and the evil compete with each other to produce fever. Shao-Yin is trapped in cold and dampness, at night to the deficiency of Yang can not meet in Yin and float outside, then there is night sweating. The soup is made up of hemp huang and pseudostellaria with ginger and roasted licorice to support yang and warm the lungs, to promote the lung orifices, and to intermingle yin and yang. Then add almonds and Er Chen to stop cough and resolve phlegm. Wu Wei Zi astringes the lung, nourishes the kidney and stops sweating. The combination of Radix et Rhizoma Pseudostellariae and Radix Panax notoginseng is one of the eighteen counteracts of traditional Chinese medicine, but many physicians in ancient and modern times have disagreed with this after a lot of clinical practice. Chen Shengping et al [1] reviewed many ancient and modern works and research results, and proved that the prescription combination of Radix et Rhizoma Pseudostellariae with Radix Pseudostellariae, Psidium Guajava and Phellodendron has no antagonistic effect.
3.3 Chronic renal insufficiency
Zhang, a 54-year-old female, was first diagnosed on November 4, 2011. Chief complaint: abnormal renal function was found for more than 8 years. Her kidneys were reduced in size, and her renal function showed: Scr271.4umol/L, BUN29.9mg/dl, UA442umol/L. Her blood count showed: Hb118g/L. Her face was yellowish, she was afraid of cold, had little sweat, her hands and feet were cold, her calves had frequent cramps, and she had vague pain in her lower back bilaterally, which worsened every rainy day. He has a dry mouth, does not drink much water and prefers hot drinks. Sleeps peacefully. Mental health. Small amount of urine, yellowish in color, not much froth, urinates once at night, normal bowel movements. The tongue is pale purple with tooth marks on the side, and the coating is white, thin and slippery. The sixth pulse is stringent, the stomach Qi has been lost, and the ulnar pulse is deficient and floating. The treatment is based on the main formula of Ephedra with sesame seeds and fine spice soup, which is used to warm Yang and disperse cold.
Prescription: 105g of Pieces of Radix Aconiti (decocted for 2 hours), 15g of Ephedra, 15g of Hosanna, 105g of ginger and 30g of Cinnamomum.
On December 16, he returned to the clinic, complaining that after taking the above 7 doses, he began to sweat freely and urine output gradually increased. Fear of cold, cold limbs, dry mouth relief, urine color gradually clear, the rest of the symptoms as before. The patient is still being followed up, the general condition is good, more than a year after the consultation, the renal function index is stable and decreasing.
The patient is still in good general condition and has been seen for more than one year. In this patient, Yang deficiency is incompetent to warm the body, resulting in fear of cold, little sweating, cold hands and feet, and lumbar pain; transpiration is weak, and dampness and turbidity are strong, which is evident in low urine and yellow color, dry mouth, accumulation of metabolites such as serum creatinine, urea nitrogen and uric acid in the body, teeth marks on the edge of the tongue, and white, greasy and smooth coating; blood stasis and ligament obstruction are associated with calf cramps, pale purple tongue, and tight pulse. There are many symptoms, but the root of the problem is “true yang deficiency”. To treat the root of the disease, Master Guo used Ephedra and Fructus Sinensis Tang to warm and support true yang, disperse cold and dampness, and promote the circulation of the three jiao. The addition of cinnamon can not only help Yang to drive out the evil, warm the Qi and blood, but also prevent excessive sweating from the hemp, with fine products.
4.Conclusion
The skin is the largest organ of the body, is the body’s first line of defense against external evil, in the perception of the outside world, energy exchange and excretion of metabolites have an extremely important role. The surface area of the adult body is 1.5 to 2 square meters, and through the sweat pores, the body is exchanging gases with the outside world all the time, and the amount of information circulated is immeasurable. Based on this, we can understand from the perspective of Chinese medicine that the skin is the best shortcut for all the evil to enter and leave the body. Since it is a shortcut, we can follow its treatment and take advantage of the situation. If the muscular surface is unclogged, the lung qi will be harmonized, the breathing will be facilitated, and the whole body qi will be unobstructed. If we then add the power to support the righteousness, then the internal and external evil can be dispelled. The power of Ma Huang and Fructus Schisandrae Tang can unblock the surface, open the orifices, and promote the lung, so that the surface can be unblocked and the internal Qi can be unblocked.
In recent years, under the influence of academic thought, clinical attention has been paid to the protection of human Yang Qi. His proposed core pathogenesis for the use of Ephedra with seeds and fine spices Tang and the above cases all fully embody the therapeutic principle of supporting and warming Yang Qi. Guo believes that the application of this formula has considerable breadth and flexibility, and as long as the key pathogenic mechanism is accurately grasped, many clinical diseases can be tried and observed.