Case 002: Afternoon fever (Astragalus Jianzhong Soup)

Second afternoon fever (Astragalus jianzhong soup) Ma, female, 74 years old.First diagnosis: 21 July 1993.Afternoon fever, body temperature of about 38℃, diet attenuation, abdominal burning, and back and thigh spread.Palms hotter than backs, short of breath.However, his mouth was not thirsty, and his belly was not swollen.The tongue is red crimson with thin white moss.The pulse is very weak.Summarized the description of the medical case, the patient’s main symptoms are: (1) fever: afternoon fever, temperature of about 38℃, not thirsty.(2) Discomfort in the abdomen: the diet is attenuated, there is a burning feeling in the abdomen, and it is released to the back and thighs, and the abdomen is not distension.Palm heat: palm heat more than the back of the hand.④ Lack of energy: short of breath and exhausted.⑤ The pulse is weak.Looking at the symptoms of fever in the afternoon, there are hot flashes in the afternoon, some like white tiger soup syndrome, but its mouth is not thirsty, so exclude white tiger soup syndrome.If the afternoon fever, not thirsty and also have the symptoms of aversion to cold, it should use cassia twig soup or ephedra soup.However, chills are not described in this medical record, indicating that the patient did not suffer from typhoid fever or stroke.Look at the patient’s symptoms such as hot palms, shortness of breath, weakness of pulse, all accord with the characteristics of typhoid exhaustion.”Synopsis of the golden chamber · blood bi deficiency Lao disease pulse syndrome and treatment” cloud: “Lao is a disease, its pulse float big, hand and foot trouble, spring and summer drama, autumn and winter 瘥, Yin and cold essence from the, acid cutting can not go.This paragraph is about the characteristics of asthenia: pulse floating big weakness, hands and feet hot, more serious in spring and summer, autumn and winter, men prone to spermatorrhea, limbs ache, emaciation, unable to walk.Combined with the fact that the onset of the patient happened to be in summer, these were enough to indicate that the patient was suffering from asthenia and fever.The book synopsis of the Golden Chamber has a special chapter on the treatment of exhaustion, of course, there are many prescriptions for the treatment of exhaustion and abdominal discomfort, but there are few prescriptions for the treatment of exhaustion.Let’s have a look at the provisions of “The Golden chamber synopsis · Blood bi deficiency of labor disease pulse syndrome and treatment” involving deficiency of labor and abdominal discomfort: 1. “deficiency of labor is urgent, palpitation, epistaxis, abdominal pain, dream loss of semen, pain in limbs, hot hands and feet, dry throat and dry mouth, the Lord of small building soup.2. “Empty Laurie is urgent, all deficiencies, Astragalus Jianzhong soup Lord.Add astragalus membranaceus in xiaojian Medium soup, more than according to the above method.For shortness of breath and full chest, add ginger, for full abdomen, go to jujube and half of Tuckahoe, and treat deficiency of lung deficiency, replenish qi and pinellia pinellia.”3. “For those with low back pain, less abdomen and urgent urination, eight flavor Kidney qi pill is the Lord.”According to the above provisions to analyze the patient in this medical case, it is obvious that the eight wei Shenqi pill syndrome does not meet the patient’s symptoms, because the patient has no symptoms of low back pain and adverse urination.The patient’s abdominal discomfort (a burning sensation in the abdomen that radiates to the back and thighs) is an acute category.In this way, consistent with the patient’s symptoms for xiaojianzhong Decoction syndrome and Astragalus jianzhong decoction syndrome.It should be noted that the medical case describes the patient as “not thirsty”, but it does not mean that the patient does not necessarily have the symptoms of dry throat and dry mouth.Then how to identify xiaojianzhong Decoction syndrome and Astragalus jianzhong Decoction syndrome?Very simple, astragalus jianzhong soup is in the small construction of the soup on the basis of a lot of astragalus just, as long as we figure out why astragalus can be added.As we all know, Astragalus rongwei gas, cassia branch also rongwei gas, and the difference between astragalus and cassia branch is: Cassia branch rongwei to drive rongwei in the evil;Astragalus tong rongwei is to fill the shortage of rongwei gas.That is to say, the qi of rongwei is not because of disease, but the gas of Rongwei itself caused by the lack of impropriation, this time to use astragalus.In fact, the root of Astragalus rongwei qi is that it can benefit the gas of three coke, enhance temper and promote the gasification of coke, in order to angry blood.Again, the patient had symptoms of dietary decay, indicating that coke’s ability to vaporize angry blood has been inadequate.In this way, the patient’s exhaustion and fever is due to the fact that the coke gas is not enough to produce qi and blood, which is insufficient in the table (Rongwei’s qi) (in the coke gas), which is the “deficiency” of Huangqi Jianzhong Decoction syndrome, so the patient should be treated with Huangqi Jianzhong Decoction.Qi deficiency and fever.Its pathogenesis is spleen deficiency qingyang subsidence, rise and fall disorder, Li Dongyuan so-called “Yin fire superior soil position” caused by.For this internal injury fever, when the east wall “warm in addition to heat” method.Shubuzhong Yiqi soup with raw licorice.Astragalus membranaceus 20 grams, Dangshen 15 grams, prepared glycyrrhiza glycyrrhiza 5 grams, raw glycyrrhiza 5 grams, Atractylodes atractylodes 12 grams, Angelica 12 grams, tangerine peel 8 grams, hohoma 3 grams, Buaihu 6 grams, ginger 3 pieces, jujube 12.Take five doses, appetite increases, physical strength increases, no fever in the afternoon, abdominal burn greatly reduced.After 5 doses, afternoon fever and abdominal burn were cured.The doctor prescribed buzhong Yiqi decoction, and the treatment was based on “buzhong”, while our analysis concluded that “jianzhong” should be the main treatment.So what is the difference between building and filling?”Jianzhong” focuses on building the gas of coke to promote its energy and blood, so there are only seven flavors: Astragalus, cassia twig, paeonia root, processed licorice, ginger, jujube and caramel;”Buzhong” focuses on strengthening the spleen and improving temper, so it uses 12 herbs.In comparison, the symptoms of diseases treated by Buzhong Yiqi Decoction seem to be more severe.This patient’s erechuan is still ok, no other discomfort, so the choice of Astragalus Jianzhong decoction should be more accurate.Minor remedies do not always produce satisfactory results, and often backfire.It should be noted that if the patient has a burning sensation in the abdomen, which spreads to the back and thighs, and is accompanied by a feeling of falling, loose stools, thirst and other symptoms, it is necessary to choose buzhong Yiqi soup.The above original medical case is selected from Liu Duzhou’s Examination Case.

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