[Chinese Medicine] learning experience (33) Bupleurum and Longgu Oyster Soup

The notes I compiled are based on the textbook "Prescriptions" of the University of Traditional Chinese Medicine, and some prescriptions that I think are good. The prescriptions written are all my personal experience, and the analysis methods are mainly based on the six meridians and the viscera. I am not a medical professional, studying medicine is purely a hobby. It is normal if there are mistakes in the text.

[Source] "Treatise on Febrile Diseases"

【Category】Double antidote (controversial)

[Composition] Bupleurum four liang (12g), keel, boiled oyster, ginger cut, ginseng, cinnamon sticks peeled, Poria cocos one or two halves each (4.5g each), pinellia washed, two in half (9g), skullcap one two (3g), lead red one and two halves (1g), rhubarb two two (6g), jujube six pieces (2 pieces)

[Usage] For the first twelve flavors, take eight liters of water, boil four liters, add rhubarb in it, cut it like a chess piece, boil it once or twice, remove the water, and serve warm for one liter.

[Function] Reconcile Shaoyang, unblock yang and relieve heat, calm the nerves (controversial).

[Indications] Syndrome of typhoid fever and Shaoyang combined with phlegm heat disturbing the heart. Chest full of irritability and fright, trouble urinating, delirium, heavy body, unable to turn sideways.

After understanding the previous three prescriptions (Xiaochaihu Decoction, Bupleurum Guizhi Decoction, Bupleurum Guizhi Dry Ginger Decoction), it is not difficult to understand this prescription.

Bupleurum, Scutellaria, Pinellia, Ginseng, Ginger, Jujube, these six medicines are Xiaochaihu Decoction without licorice, why go to licorice, I will talk about it later. The combination of Poria cocos and cassia twig is used to control water and drink internally, such as Linggui Zhugan Decoction, Linggui Zaogan Decoction, and Wuling Powder are all Linggui medicines. Moreover, Poria and Pinellia are half of Erchen Decoction, which are used to treat phlegm and drink.

So does it mean that this soup syndrome is to treat cold phlegm? Not necessarily, because there is rhubarb, which clears away heat. Poria cocos, cinnamon twigs, and pinellia combined with rhubarb can not only cure cold phlegm, but also hot phlegm. This idea is a bit like Wendan soup. Therefore, the dosage of rhubarb is a valve that can flexibly adjust the cold and heat.

After the stagnation of phlegm and drink, it will definitely generate heat. When heat and evil disturb the heart, mental illnesses will occur, such as insanity, mania, etc. At this time, keel, oysters, and lead pills are used to calm the nerves. Keel bones and oysters themselves are water-suppressing medicines, so they can also cure water-adverse symptoms. If the water vapor rushes up and causes heart discomfort, keel oysters can suppress water evils. In addition, rhubarb can also play a role in washing away evil spirits.

Why not use licorice? First, licorice will affect the power and speed of rhubarb to attack real evil. Second, licorice has the function of gathering water, which will hinder the metabolism of water. Western medicine also recognizes this point of view. Western medicine has proved through experiments that licorice can induce edema (for details, please refer to relevant information on western medicine). Many water diuretics in traditional Chinese medicine also bypass licorice, such as Zhenwu Decoction and Wuling Powder.

Finally, let's talk about lead. With the commercial and medical exchanges between ancient China and countries in the Western Regions, especially ancient Persia (now Iran), more and more medicinal materials entered China and entered clinical practice. No one has used lead pill for a long time.

Lead red, acrid in the mouth, slightly cold in nature, poisonous. The substance is heavy and submerged, can enter the liver and kidney, and the red color enters the heart. It is the medicine of the Shaoyin meridian. Red lead is not pure lead, but trilead tetroxide. It can soothe the nerves, reduce phlegm, promote granulation, suppress sores, and has miraculous effects on treating athlete's foot. Appropriate amount for external use, more prone to poisoning. Soothe the nerves can be replaced by sharpening water, and I am used to using magnets instead.

There is another thing called lead powder, which is white powder in color, and sometimes it gathers into lumps, and it disperses when you twist it with your hands. It is not pure lead, but basic lead carbonate. Its taste is pungent and sweet, its nature is cold, poisonous, and it is good at killing three insects. It is used in the licorice powder and honey soup in "Synopsis of the Golden Chamber".

In addition, there is no lead in the pencil, and the lead is made of a mixture of graphite and clay.

Bupleurum plus Longgu Oyster Decoction only involves Article 107 of "Treatise on Febrile Diseases": "Treatise on Febrile Diseases for eight or nine days, treat with chest fullness, irritability, difficulty urinating, delirium, heavy body, and cannot turn the side, Bupleurum plus Longgu Oyster Decoction is the main treatment."

Exogenous pathogenic factors attack and cause evil spirits to sink in. Chest fullness, weight all over the body, inability to turn on one side, difficulty in urinating, are all symptoms of internal stagnation of water evil. Anxiety, fright, and delirium are all signs of disturbing the mind and spirit on the fire. The disease is in Shaoyang, both water and fire are reversed. Therefore, Xiao Chaihu Decoction is used to reconcile Shaoyang. Guizhi, Poria, keel, oyster, lead pill to dispel water, calm down and soothe the nerves. Rhubarb is evil all over the body, not only for defecation, but also for defecation. This prescription syndrome can be seen only in Shaoyang disease, and can also be seen in Shaoyang Yangming combined disease.

Some people think that this card has unresolved evil, which is absurd. Whether analyzing the pathogenesis from the text or analyzing the overall trend from the composition of the drug, it has no effect on the table. You can't tell the truth as soon as you see Guizhi, is it true that Guizhi Fuling Pills are also the medicine?

Bupleurum plus Longgu Muli Decoction is mainly used to treat insomnia in clinical practice. In fact, its main effect is to treat Shaoyang disease and reverse water and fire. Calming the nerves and helping sleep is only a small part of the effect. If the patient's insomnia is caused by qi and blood deficiency, excess fire disturbing the heart, deficiency fire disturbing the heart, and kidney essence deficiency, then the doctor's use of Bupleurum and Longgu Muli Decoction will not cure insomnia, but may cause serious side effects.

Bupleurum plus Longgu Muli Decoction can also be used to treat high blood pressure, cerebral infarction, uterine bleeding, uterine prolapse, dizziness, mania, depression, epilepsy, cervical spondylosis, abdominal distension, etc. It also needs syndrome differentiation and treatment.

I once saw a piece of news: a woman was often subjected to domestic violence by her husband, and suffered from severe insomnia. The doctor treated it with "Bupleurum plus keel oyster soup", and asked him to replace lead red with sharpening water. From then on, the woman sharpened the knife once a day in the morning and evening, and took water for medicine. Her husband did not commit domestic violence again, and his illness recovered.