Chapter 8 Section 2 Pharmacology

Prescription is a medical leap in the use of drugs to treat diseases.It is gradually matured on the basis of the long-term accumulated pharmacological knowledge of our ancestors.Decoction is an important means of treatment in traditional Chinese medicine. The appearance of decoction is a great invention in the history of medicine in my country. According to research, decoction has been used to treat diseases in the early Shang Dynasty.In the unearthed cultural relics, it is found that the cooking utensils such as pottery kettles and pottery pots in the Xia Dynasty were more refined. In the Shang Dynasty, most eating utensils were made of copper, all of which created good conditions for decocting medicines. "Book of Rites · Qu Li" says: "If you are sick, drink medicine, and the minister tastes it first." "Historical Records · Biography of Bian Que Cang Gong" contains: "Changsang Jun gave the forbidden prescription to Bian Que." "Bian Que ruled The corpse of Crown Prince Guo...cook it with eight-reduced medicine.” In addition, the “Quick Sand Falling Slips”, a cultural relic left over from the end of the Zhou Dynasty in the 3rd century BC, contained prescriptions for treating horse injuries.It can be seen that it is credible that the decoction began in the early Shang Dynasty. "Preface to the Book of Jia and Yi" said: "Yiyin, with his sub-sage talent, chose Shennong's herbal medicine as the soup." By the Zhou Dynasty, the application of compound decoction had been very common.

With the evolution of history, ancient medical scientists have continuously developed prescriptions for treating various diseases on the basis of their own clinical practice.Different academic schools have different styles of representative prescriptions.As a result, the number of traditional Chinese medicine prescriptions is increasing day by day, and the famous prescriptions of the past dynasties have also been effectively used in clinical practice. Prescriptions are different from the use of unit medicines. According to the different diseases and syndromes, the medicines are organically combined according to certain principles, so that the efficacy of the medicines can be fully exerted, and the toxicity and severeness of the medicines can be reduced.In clinical application, there are different dosage forms such as soup, pill, powder, ointment, and liquor.Among them, decoction can add and subtract medicines most flexibly, has the characteristics of fast absorption and good curative effect, so it has been favored by doctors for thousands of years.

The content of prescription science is extremely rich. Here we will focus on the theory of prescription science and important ancient prescriptions. Prescriptions are not a simple stack of multi-flavored medicines, and their combination has certain principles. "Nei Jing" has laid a solid foundation for the theory of prescriptions.For example, "Suwen·Zhizhenyaodalun" puts forward the principles of formulating prescriptions. First, formulating prescriptions is based on disease and syndrome; second, the compatibility of specific prescriptions and medicines depends on the establishment of treatment methods; Whether it is suitable or not depends mainly on whether the compatibility of the four properties and five flavors of the medicine is appropriate.At the same time, this article first advocates the principle of formulating the prescription of monarch, minister, assistant, and envoy, that is, "the main disease is called the monarch, the assistant is called the minister, and the respondent is called the envoy." The king's medicine is the medicine that has the main therapeutic effect on the main syndrome. The ministerial drug is a drug that assists the monarch drug to strengthen its therapeutic effect; the adjuvant drug has the functions of adjuvant, anti-adjuvant, and restriction of toxicity and harshness;Only through the organic combination of monarch, minister, assistant and envoy can the best effect of the prescription be brought into play.

There are a large number of prescriptions. In order to facilitate learning and use, physicians of all dynasties have attached great importance to the research on the classification of prescriptions.The classification of prescriptions was first seen in the "Nei Jing", which proposed the "seven prescriptions" classification method of big, small, odd, even, slow, urgent, and complex. The "Ten Agents" classification method began with Xu Zhicai in the Northern Qi Dynasty.Xu Zhicai, courtesy name Shimao.Danyang (now Zhenjiang, Jiangsu) people.The Xu family is a well-known doctor of the eighth generation since Xu Xishi. His descendants are active in the south of the Yellow River and the north and south of the river. They have lived in the Liu Song Dynasty, the Southern Qi Dynasty, the Northern Wei Dynasty, and the Northern Qi Dynasty. .Xu Zhicai is the sixth generation of the Xu family. He has a deep knowledge of astronomy and medicine, and has written many books.The so-called ten doses are Xuan, Tong, Bu, Xie, light, heavy, astringent, slippery, dry, and damp. The genus is true; tonic can be removed from the weak, ginseng and mutton are genus; venting can be removed from the genus, Tingli (tingli tingli) and rhubarb are genus; lightness can be removed, ephedra and kudzu root are also genus; heavy It can remove timidity, which belongs to magnet and iron powder; slippery can remove it, such as mallow seed and elm white bark; astringent can be removed, which belongs to oyster and keel; dryness can remove dampness, and mulberry white Peel and red bean belong to it; dampness can remove dryness, and white quartz and amethyst belong to it." This is the earliest functional classification of prescriptions.Thereafter, doctors of successive dynasties developed again.

Following the "Ten Doses", Kou Zongshi in the Song Dynasty added two doses of cold and heat to form the "Twelve Doses".In the Ming Dynasty, Miao Zhongchun added two doses of ascending and descending to make it "fourteen doses".Zhang Jingyue believed that "prescription should be kept simple", and proposed the "eight formations" classification method of supplement, harmony, attack, loose, cold, heat, solid, and cause. In the Qing Dynasty, Cheng Zhongling put forward the classification method of sweating, vomiting, lowering, harmonizing, clearing, warming, eliminating and tonifying.In Wang Ang's "Medical Prescription Collection", he uses nourishing, publishing, vomiting, attacking the inside, inside and outside, reconciliation, regulating qi, regulating blood, expelling wind, dispelling cold, clearing heat, promoting dampness, moistening dryness, purging fire, "Twenty-one doses" for eliminating diseases, eliminating cataracts, reducing astringency, killing insects, improving eyesight, carbuncles, and menstrual cramps are combined into multiple prescriptions.In modern times, there is a slight discrepancy from it.

There are also prescriptions classified by disease. The earliest is "Fifty-two Disease Prescriptions", followed by "Taiping Shenghui Prescription" in Song Dynasty, and "Puji Prescription" in Ming Dynasty. They are all representative works of prescriptions classified by disease. The above classification methods have their own strengths, but through clinical practice, Wang Ang's classification method of "twenty-one doses" is more comprehensive and suitable for clinical practice, and is highly praised by later generations. "Hanshu Yiwenzhi Fang Jilue" contains 11 classic prescriptions, 274 volumes.According to the whole story of "Han Shu·Yiwenzhi", it can be inferred that most of these prescriptions are posthumous works of the pre-Qin period, but unfortunately they have all been lost long ago.The earliest prescription script that can be seen so far is the silk script unearthed from Han Tomb No. 3 Mawangdui, Changsha, Hunan Province in 1973——"Fifty-two Disease Prescriptions" (originally without title, author unknown), according to research about the Spring and Autumn Period and the Warring States Period work.The book contains more than 15,000 words and describes the treatment methods of 52 diseases. There are more than 280 medical prescriptions that can be identified. There are various kinds of soups, powders, and ointments, and most of the prescriptions consist of more than two herbs.In addition to internal administration, external treatment methods are also very rich, including surgery, medicinal dressing, medicinal bath, fumigation, ironing, Bianstone, moxibustion, massage, horn method, etc.

The most influential prescription book in history should be "Treatise on Febrile Diseases and Miscellaneous Diseases" written by Zhang Zhongjing, a famous doctor in the Eastern Han Dynasty.Zhang Zhongjing, on the basis of inheriting the theory of "Internal Classics", combined with his own clinical experience, established the principle of syndrome differentiation and treatment integrating theory, law, prescription and medicine.Due to the rigorous formulation of prescriptions, precise and appropriate medication, and reliable curative effect, the book is honored as "the ancestor of medical prescriptions" by later generations of doctors. The prescriptions in it are called "jingfang", and Zhang Zhongjing is also known as "medical sage". "Treatise on Febrile and Miscellaneous Diseases" contains a total of 375 prescriptions, except for duplication (the same prescription with different syndromes), 269 prescriptions are actually received, and 214 medicines are used.After the completion of the book, it was quickly lost due to the war. After being collected and sorted by Wang Shuhe, a native of the Western Jin Dynasty, it was reorganized into two books, "Treatise on Febrile Diseases" and "Synopsis of the Golden Chamber".Wang Shuhe, whose name is Xi, was born in Gaoping of the Western Jin Dynasty. He was once a doctor of the Jin Dynasty and wrote 10 volumes of "Mai Jing", which is the earliest surviving monograph on pulse in my country.He sorted out Zhang Zhongjing's works and passed them on to later generations, and his contribution is most praised by later generations. Lin Yi and others in the Song Dynasty corrected "Treatise on Febrile Diseases" and said: "Since Zhongjing has been around for eight hundred years, only Shuhe can learn from it."

"Elbow Reserve Emergency Prescription", referred to as "Elbow Backside", was written by Ge Hong in the Jin Dynasty.The characteristics of the prescriptions contained in this book are simplicity, convenience, cheapness, and authenticity, which have a profound influence on later generations. "Behind the Elbow" preserves many precious materials on the history of infectious diseases in ancient times.For example, "Lushang" recorded in the book is the earliest record of smallpox in the world.Another example is the description of sand lice, which is also the earliest record of scrub typhus in the world. "The Back of the Elbow" was later supplemented by Tao Hongjing from the Liang Dynasty and Yang Yongdao from the Jin Dynasty.

From the Jin Dynasty to the Tang Dynasty, there were many prescription books with high academic achievements, among which "Small Prescriptions", "Qianjin Prescriptions" and "Waitai Secret Yao" had the greatest influence on later generations. Xiaopin Fang, also known as Jingfang Xiaopin, was compiled by Chen Yanzhi at the end of the Eastern Jin Dynasty.At that time, it became a fashion that "all noble families wrote their own collections and took prescriptions". In the Tang Dynasty, the imperial court ordered that "all doctors should study Zhang Zhongjing's "Treatise on Febrile Diseases" and Chen Yanzhi's "Small Pieces", which shows the high academic value of "Small Prescriptions".But it was also lost in the Song Dynasty. Fortunately, "Thousand Gold Prescriptions", "Waitai Secret Essentials", "Yi Xin Fang" by Tanba Yasunai of Japan, and "Yi Fang Lei Ju" by Kim Ri-moong of North Korea have excerpted many "Xiao Pin Fang" precious information. In 1958, the first volume of the fragmented volume of "Xiao Pin Fang" was discovered in Japan. It is a manuscript handed down in the Tang Dynasty, including the preface, general catalog, and formulas for prohibiting drug use, etc. It is an important material for researching and compiling the book.

"Thousand Gold Prescriptions" includes "Thousand Gold Prescriptions" and "Thousand Gold Wing Prescriptions", which were written by Sun Simiao in the Tang Dynasty.Only "Thousand Gold Prescriptions" contains more than 5,300 prescriptions. This book systematically summarizes and reflects the medical achievements before the Tang Dynasty, and preserves a large number of ancient prescriptions and proven prescriptions that were popular at that time.The book also contains two monographs on medical ethics, "Great Physician Practice" and "Great Physician Sincerity", which are still of practical significance today.

"Secrets of Outer Taiwan" was written by Wang Tao.Wang Tao loves medicine very much. He worked in Hongwen Library (National Library) for more than 20 years.The book contains more than 6,000 prescriptions, and what is valuable is that the content quoted from other books is marked with the source, which has become an important reference material for the study of medical achievements before the Tang Dynasty.The content of many prescription books before the Tang Dynasty that were lost later, many of which can be handed down to this day thanks to "Qianjin Fang" and "Waitai Secret Yao". "Taiping Shenghui Prescription" is a large prescription book published by the Song Dynasty government, which was edited by Wang Huaiyin and others under orders.Wang Huaiyin was born in Sui [sui] Yang (now Shangqiu, Henan) in Songzhou.He was a Taoist priest at the beginning, proficient in medicine, returned to vulgarity under the imperial edict, and served as an emperor for advocating medicine. Later, he was promoted to a medical officer in the Imperial Academy.The book contains 100 volumes, containing 16,834 prescriptions, and the classification is based on the Sui Dynasty's "General Discussion on the Origin and Symptoms of Various Diseases".The book was completed, with a preface written by Emperor Taizong of the Song Dynasty, promulgated to all states, and placed in the hands of doctors.This is the first prescription book compiled by the government in my country. Later, during the reign of Emperor Renzong, He Xipeng selected the essence of it as "Sheng Hui Xuan Fang", which was used as a standard medical book as a teaching material and has been used for hundreds of years. "Taiping Huimin Heji Bureau Prescriptions", formerly known as "Heji Bureau Prescriptions", is a standardized summary of prescriptions used by Heji Bureau to manufacture and sell finished medicines.It was corrected by medical officials such as Chen Shiwen and Pei Zongyuan by the imperial edict of the Song Dynasty.It is the first patent book and formula manual issued by the government in my country.There are 788 prescriptions, and there are as many as 13 dosage forms, which have made important contributions to the development of patent medicines, and some famous prescriptions have been used to this day.After the book became popular, folk medical practitioners all studied it, resulting in the current disadvantage of copying its prescriptions without further studying medical theory. Physicians in the Jin and Yuan Dynasties criticized this disadvantage many times, which also reflected the "Hejijufang" in the middle and late Northern Song Dynasty. The impact is huge. "Shengji Zonglu", also known as "Zhenghe Shengji Zonglu", is another huge prescription compiled by the government in the late Northern Song Dynasty.Later, it was republished twice during the Dading period of the Jin Dynasty and the Dade period of the Yuan Dynasty.There are nearly 20,000 prescriptions, and the collection of prescriptions of past dynasties and folk prescriptions is very rich in content. "Puji Prescriptions" was edited by Zhu Huan and Teng Hong in the early Ming Dynasty, and collected 61,739 prescriptions. The book is extensive, rich in materials, and detailed in compilation. It is the largest prescription book in my country.This book is not only of great value in prescription science, but also makes great contributions to the preservation of ancient medical literature.For example, when Li Shizhen was compiling, many ancient medical books had been lost or were rare. It is really thanks to "Puji Fang" that the content of the lost medical books can be glimpsed and quoted in them. In the Qing Dynasty, there was also a distinctive Fang Shu, which was "Chuan Ya" compiled and edited by Zhao Xuemin.This is a collection of medical experience of folk prescription medicine (bell medicine).The preface says: Zongfang doctors have always been despised by people, and they do have a cunning side. It often works very well.Its medicine has the characteristics of being cheap, safe, and convenient, and the medical theory it is based on does not violate ancient teachings.Because of its secretive techniques and little-known prescriptions and treatments, he edited the book with Zhao Baiyun, a well-known old Ling doctor at that time. The works explaining Fang Yi began with "Treatise on Febrile Diseases and Prescriptions" written by Cheng Wuji in the Jin Dynasty.Its content is an interpretation of 20 commonly used prescriptions in "Treatise on Febrile Diseases". "Medical Prescription Kao" written by Wu Kun in the Ming Dynasty is another monograph on prescriptions.Wu Kun, also known as Wu Kun, with the word Shanfu and alias Hegao, was born in She County (now She County, Anhui).In terms of medical theory, "Nei Jing" is highly praised; the treatment advocates the combination of acupuncture and medicine.He has written "Wu Annotated Yellow Emperor's Canon of Internal Medicine, Plain Questions", "Six Collections of Acupuncture and Prescriptions", "Pulse Language", "Testing Medical Prescriptions", etc. More than 700 prescriptions are selected in "Medical Prescription Kao", "Test its prescriptions, test its testimony, test its name, test its flexibility, and test its gains and losses" ("Medical Prescription Kao Preface"), which makes the meaning of the prescription clear and easy to understand It has become an important reference book for later generations of doctors to learn prescriptions. "Yifang Jijie" is a book on prescriptions written by Wang Ang in the Qing Dynasty.Wang Ang, word cut [renken] nunnery, was born in Xiuning, Anhui.In his early years, he practiced Confucianism and was a student of the city, and later devoted himself to medicine.He had a relatively open attitude towards Western medicine introduced into my country in the late Ming Dynasty. He once had a different term for "the heart governs the gods", and believed that "the brain is the home of the primordial spirit" and "the memory of the brain is in the brain".He has written a lot, involving medical classics, herbal medicine, and prescriptions.Because his works are concise, concise and easy to understand, they are deeply loved by doctors, widely circulated, and have contributed to the popularization of medicine.In view of the fact that "Yifangkao" is only the opinion of one family, Wang Ang selected more than 300 prescriptions and compiled the opinions of each school, so it was called "Yifang Jijie". Comprehensive and more practical, it has a great influence on future generations. "Chengfang Qiyong" was written by Wu Yiluo in the Qing Dynasty.Wu Yiluo, styled Zuncheng, was born in Haiyan, Zhejiang.On the basis of Wang Ang's "Compendium of Materia Medica", he once wrote "Materia Medica Cong Xin", which is concise and practical.He thought that there were not many prescriptions in "Yifang Jijie", so he selected more than 1,100 prescriptions, which were compiled by Wu Kun and Wang Ang, and added and modified. It is "Chengfangqieyong".