Highlights of this issue

◎ What is “TCM prescription”?

◎ The history and classification of “TCM prescriptions”

◎ How is a good recipe formed?

◎ How the team solves problems systematically

What exactly is a Chinese medicine prescription?

Traditional Chinese Medicine Prescription

On the basis of dialectics, according to the needs of the disease, the seven emotions of the drug are used to determine the necessary dosage and the compatibility is organized into a prescription.

Why take medicine in prescription form

The problems that individual medicinal flavors can deal with are often relatively single. The form of prescription is to better solve complex diseases. Many medicinal flavors have certain synergistic effects with each other and can promote each other and ultimately solve a certain problem together.

The physical discomforts we encounter in life often appear in the form of syndromes, or in other words, many single symptoms often involve systemic lesions of the body. It is difficult for a single medicine to comprehensively and completely solve these problems.

When did the earliest recipe start?

It could be said that the existence and development of traditional Chinese medicine is almost as long as the existence and development of “prescriptions”. The application of prescriptions in traditional Chinese medicine probably originated during the Warring States Period, and the theoretical basis of prescriptions was basically formed during this period. During the Han Dynasty, perfect prescription dosage forms were basically developed. On this basis, the theory of prescription use became more complete, and the use of prescriptions by traditional Chinese medicine became more mature.

A brief history of the development of the recipe

Warring States Period

《Fifty-two disease prescriptions》is the earliest extant prescription book. It was probably written during the Warring States Period. The author failed to verify it and it was excavated in the Mawangdui Han Tomb in Changsha. The book contains 283 medical prescriptions from various disciplines, and describes the dosage forms such as soups, pills, and powders.

Although it contains only 13 prescriptions, the 《Nei Jing》of the Warring States Period has a more detailed discussion on the treatment principles of traditional Chinese medicine, the composition and structure of prescriptions, the compatibility rules of drugs, and the contraindications for taking medicines, etc., laying the theoretical foundation for prescriptions.

Han Dynasty

The 《Shen Nong’s Materia Medica》”Shen Nong’s Materia Medica” of the Han Dynasty already contains theories on how to choose dosage forms.

Zhang Zhongjing’s 《Treatise on Febrile Diseases》 contains 113 prescriptions, and 《The Synopsis of the Golden Chamber 》contains 262 prescriptions. Due to the legal composition of prescriptions, precise selection of medicines, accurate dosage, clever changes, and outstanding curative effects, they were respected as classic prescriptions by later generations. The dosage forms used in typhoid prescriptions include decoctions, pills, powders, suppositories, ointments, wine, vinegar, enemas, lotions, baths, fumigants, ear drops, nasal fillings, and nasal blowing agents. etc., including almost all traditional dosage forms except injections.

Jin Dynasty

Ge Hong’s 《Emergency Prescriptions》, the only remaining book from the Jin Dynasty, contains a large number of effective, convenient and inexpensive prescriptions, and for the first time proposed the concept of finished medicines, advocating that medicines should be processed into certain dosage forms and stored for emergency use.

Sui Dynasty

In the Sui Dynasty, there were as many as 2,600 volumes of 《Si Hai Lei Ju Dan Fang》 and 300 volumes of 《Si Hai Lei Ju Dan Fang》, which shows the rapid development of prescriptions.

Tang Dynasty

Sun Simiao of the Tang Dynasty wrote 《A Thousand Gold Prescriptions》, containing 5,300 prescriptions. Wang Tao’s “Secrets of Waitai” contains more than 6,000 poems.

Song Dynasty

In the Song Dynasty, 《Taiping Shenghui Prescriptions》 compiled by the government appeared, containing 16,834 prescriptions. In the Jin and Yuan Dynasties, there were four great masters: Liu, Zhang, Zhu and Li. Cheng Wuji of the Jin Dynasty wrote 《Shanghan Mingli Medicine Prescriptions》, which selected 20 prescriptions for treating colds and explained them based on the theory of 《Nei Jing》, which was the first to write a treatise on prescriptions.

Ming Dynasty

《Pu Ji Fang》, compiled by Zhu Ju, Teng Shuo and Liu Chun in the Ming Dynasty, contains 61,739 prescriptions, making it the most prescription book.

Wu Kun’s 《Medicine Prescription Examination》comprehensively compiles the famous prescriptions of doctors in the past dynasties, examines their prescriptions and testimonies one by one, and analyzes the meaning of the prescriptions in detail. It is the first prescription monograph.

Qing Dynasty

During this period, a large number of prescription treatises emerged, such as 《Selected Annotations of Jiangxueyuan Ancient Prescriptions》 by Wang Zijie, 《Famous Doctors’ Prescriptions》by Luo Mei, Wu Qian’s 《Abridged and Supplemented Famous Doctors’ Prescriptions》, and Wang Ang’s 《Collected Notes on Medical Prescriptions》. Wu Yiluo’s 《Cheng Prescriptions and Cut Uses》, etc., have enriched the theory of studying prescriptions.

Several types of prescriptions

From ancient times to the present, there are many famous or little-known prescriptions, numbering in the millions or even tens of millions. The prescriptions can be roughly divided into the following five categories according to their sources.

However, with the rapid development of traditional Chinese medicine today, many prescriptions do not necessarily fall into any of the above categories. There are also prescriptions based on classical famous prescriptions that have been optimized and improved by advanced scientific research methods of modern traditional Chinese medicine. Such prescriptions The formula also has the characteristics of having effects that have been clinically verified for hundreds or even thousands of years, more precise dosage ratios, higher safety, convenient use, more accurate effects, and no need for dialectics.

Where does a good recipe come from?

Although there are basic principles to follow in formulas, and there are countless high-value formulas in medical classics and medical books that can be used as reference, when it comes to solving practical problems, how to fundamentally solve various common or difficult problems according to the characteristics of modern people and not simple.

To form a good formula, at least the following basic conditions must be included:

① An in-depth understanding of a certain disease or a type of disease can form effective and feasible treatment ideas;

② Understand various existing prescriptions and be able to effectively learn from them;

③ In-depth understanding of the functions, quality and application methods of various medicinal herbs;

④ Mature grasp of formula principles.

Regarding how to form a good recipe, taking “siltation and blockage” as an example, we want to better achieve dredging and solve various siltation and blockage problems…

Understanding Stisis

First of all, you need to understand the stasis (problem):

Traditional Chinese medicine believes that all diseases arise from stasis.”Stagnation and blockage” are the root causes of many diseases. It mainly means that under the long-term stimulation of the harsh external environment or the continuous influence of bad living habits, it can lead to qi stagnation, blood stasis, accumulation of turbid evil, etc., which manifests as blocked meridians, both tangible and intangible.

Because the organs and tissues of the human body need to be nourished by qi and blood. When there is qi stagnation, blood stasis, phlegm coagulation, dampness accumulation and other blockages in the body, it will cause organ dysfunction, disharmony between qi and blood, and accumulation of turbid evils, and the body will be in trouble. You will be in systemic chronic inflammation and feel uncomfortable; if the blockage lasts for too long, it will easily evolve into various diseases, the body function will decline, and the body will be in a low immunity state for a long time, and the disease will not be easy to eliminate or will recur frequently.

The formation of stasis is a long and complicated process. The stasis itself will appear in various forms and lead to various uncomfortable symptoms. (Sexual dysfunction, chloasma, acne, cardiovascular and cerebrovascular diseases, ovarian cysts, low back pain, lower abdominal pain, pelvic effusion, hydronephrosis, joint effusion, etc.) or various diseases(Prostate diseases, gynecological diseases, gout, stones, cysts, etc.)

Develop ideas for clearing stasis

On the basis of understanding the siltation and blockage, the basic desilting ideas are formed: Since stasis and the problems it causes are often systemic problems, to solve it and the symptoms and diseases it causes, we need to treat people as a whole and start from the relationship between the normal physiological functioning of the human body, the immune mechanism and the occurrence and development of diseases. Focusing on the common characteristics and patterns of diseases, starting from the root factors of various diseases caused by blockage, multi-component and multi-target, combined with Promotes blood circulation, reduces swelling, drains pus, relieves stranguria and diuresis, reduces inflammation, clears away heat, and diuresisetc., using a systematic approach, focuses on clearing stasis, combined with dispersing stagnation and replenishing, to fundamentally solve the problem.

Related raw materials

According to the basic treatment ideas, Chinese medicinal materials can be found that are conducive to achieving clear stasis, dissipate stagnation, and replenish common medicinal flavors/raw materials:

Promoting blood circulation and dispersing blood stasis	Ephedra, peach kernel, costus, chuanxiong, myrrh, safflower, motherwort, etc.
Disperse knots	White mustard seed, honey locust, dandelion, yellowtail seed, notoginseng, trichosanthes, etc.
Reduce swelling	Ephedra, Alisma, purslane, dandelion, saffron, poria, salvia, frankincense, etc.
Tonglin diuretic	Dandelion, plantain, Houttuynia cordata, Akebia, bee pollen, dandelion, Difuzi, talc, etc.
Detoxification	Forsythia, dandelion, Houttuynia cordata, Andrographis paniculata, purslane, bittersweet, etc.
Anti-inflammatory	Isatis root, dandelion, Bupleurum, Houttuynia cordata, Purslane, Purslane, Sijiqing, etc.
Dampness	Poria, dandelion, cardamom, purslane, Platycladus orientalis leaves, Sophora flavescens, Perrin, etc.
Benefit	Dendrobium, bee pollen, Polygonatum, Eucommia ulmoides, Cuscuta, Polygonum multiflorum, white peony root, etc.
Protect liver and kidneys	Ganoderma lucidum, bee pollen, Poria cocos, Rehmannia glutinosa, Polygonum multiflorum, Ligustrum lucidum, Atractylodes, etc.
Regulate endocrine	Bee pollen, pearl powder, astragalus, white chrysanthemum, white peony root, raw licorice, etc.
Enhance immunity	Bee pollen, Schisandra chinensis, ginseng, Codonopsis pilosula, astragalus, American ginseng, etc.
Among them, bee pollen is a recognized health food and is included in the 《List of Items Both Food and Drugs》 in Annex 1 of the 《Notice on Further Standardizing the Management of Health Food Raw Materials》published by the Ministry of Health food and medicine come from the same source the items include: bee pollen, dandelion, Houttuynia cordata, purslane, poria, platycodon, and peach kernels.

Scientific proportion

The basic principles to be followed in the formulation ratio: However, the formulation of traditional Chinese medicine is not simply a random stack of medicines, but a formula based on the guidance of a certain ratio principle. Just like fighting a war, the key to winning a war is not simply to pursue a large number of soldiers or weapons (medicinal materials), but more importantly, to follow a certain strategy (selection of materials) based on the terrain environment (basic physical condition of the patient) and the characteristics of the enemy (disease). Only by arranging troops and formations can the true strength of the team be unleashed.

The basic principles of Chinese medicine formula are divided into four parts: “Jun, Chen, Assistant and Envoy”. This principle of formulating was first seen in the 《Nei Jing》.

“Jun” medicine: That is, the main drug or treating drug is a drug that plays a main therapeutic role in targeting the main disease or cause;

“Chen” medicine: That is, auxiliary drugs or auxiliary drugs are drugs that help the main drug to work better;

“Adjuvant” medicine: Also called concurrent medicine, it refers to drugs that assist the main drug in treating concurrent diseases, or supervise the preparation of the main drug to eliminate the toxicity and potency of certain drugs, or have a counter-adjuvant effect;

“Make” medicine: It refers to the medicine that guides various medicines and plays a harmonious role.

In recent years, with the help of modern medical research methods, it has been discovered that pharmacological research on the various herbs in traditional Chinese medicine compounds shows that the compatibility of Chinese medicines plays an important role in improving efficacy and reducing/eliminating toxicity.

Raw material quality

The formulation involves quality control of raw materials: 

When it comes to the application stage of prescriptions, how to select the raw materials involved in the prescriptions is also a particularly critical link, because raw materials with the same name and the same shape may have different effects due to differences in origin, picking time, processing methods, storage methods, etc. The difference between mud.

Among them, the place of origin has a particularly obvious impact on the quality of medicinal materials. For example, Ailao Mountain is an important production area of traditional Chinese medicinal materials in Yunnan. Due to its special geographical location, its soil, temperature, light and other natural conditions have more natural advantages. The medicinal materials grown here are generally of higher quality and more authentic than similar medicinal materials on the market. The authenticity of the medicinal materials affects the effect of the medicinal materials themselves and plays a key role in the final effectiveness of the formula.

Of course, the above example of “removing stasis” only lists a few keyaspects that can be covered by forming an effective team. The actual formulation process will involve more complex details and be more rigorous, requiring the assistance of a large amount of clinical experience and the support of scientific research methods.

Moreover, after a prescription is formed, it may undergo continuous optimization and adjustment, and some prescriptions formed under the ideas and methods of modern Chinese medicine already have the characteristics of not requiring dialectics.

Kind tips

Here, Dianhetang needs to remind readers that the so-called “the secret of traditional Chinese medicine lies in the quantity.” This is because most people have difficulty grasping the ratio of medicinal ingredients, do not have an in-depth understanding of pharmacology, and it is difficult to distinguish the quality of medicinal materials. Therefore, do not make your own formula. After all, the effects of medicinal materials are not purely additive. It is also difficult for ordinary people to know whether different raw materials will produce certain toxicity when combined together. The formula and usage still require professional help.

How to solve problems systematically

Because Chinese medicine takes a holistic view and starts from the root, it simultaneously solves the lesions and their symptoms (that is, the various symptoms that appear), and restores the internal balance destroyed by the disease through conditioning and supplementation, and finally achieves:

① Eliminate disease symptoms;

② Remove the root cause of symptoms;

③ Regulate the internal environment and improve body functions.

Only in this way can a certain type of disease be completely solved and the human body restored to a healthy and energetic state, so that the disease is less likely to relapse. This is why Chinese medicine often uses prescriptions to systematically solve certain problems/types, which inevitably requires a process. Western medicine mostly starts from the symptoms. Although it can often achieve the effect of quickly eliminating a certain symptom, it is difficult to fundamentally solve a certain disease and make it less likely to relapse.

Still taking “siltation” as an example，at “Mainly desilting, combined with dispersing stagnation and replenishing, to fundamentally solve the problem”under this treatment principle, in the process of using the formula to solve the congestion problem, you will often experience the following three phases:

Stage one: This stage focuses on clearing stasis in organs and tissues to eliminate most of the symptoms caused by stasis. It mainly improves microcirculation by clearing stasis and dispersing stagnation. Remove stagnant metabolites, secretions and other toxins from organ tissues. This relieves the stimulation and compression of nerves and tissues and relieves various main symptoms of blockage problems.

Stage two：By continuously clearing stasis, dispersing stagnation and tonifying, the body’s functions are continuously improved, the body’s strong disease resistance is restored, some remaining minor symptoms are completely eliminated, and systemic chronic inflammation is improved.

Stage three: Regular/daily desilting at this stage can avoid the generation of new stasis, thereby achieving the purpose of preventing the occurrence of diseases and keeping the body in a smooth, energetic and healthy state.

When solving problems, traditional Chinese medicine never just pursues the elimination of diseases, but takes “health” as the ultimate goal. After all, no disease equals health. There is a big gray area between the two – sub-health. This is also a major manifestation of the wisdom of traditional Chinese medicine: look at the present and prepare for the future; avoid disease and enjoy life.