The Characteristics And Compatibility Of Internal Medicine And Gynecology Prescription In "Insights Of Medicine "

Guopeng Cheng, also known as Zhong Ling, or Shan Ling or Heng Yang Zi or Pu Ming Zi, lived between1662and1735in Tian Du (now She Xian in Anhui Province). He published a book based on his30-year experience in medicine entitled "Insights of Medicine" as a textbook for his students. This book had six volumes, covering a wide range of topics such as theories of medicine, research on "Treatise on Exogenous Febrile Disease' diagnosis and treatment in internal medicine, otolaryngology, surgical medicine, and common disease in gynecology. This book was rich in both theory and clinical practice and written in a comprehensive and objective way. The language in the book was easy to understand and the treatment documented in the book had great practical value.The current study focused on205prescriptions in internal medicine and gynecology in Volume3-5. Using data mining software Clemetine, this study examined the characteristics, drug group, drug type, and main medical treatment card of the most frequently used ingredients in these sections of the book. Based on the combination of comparison of Chinese medicine theories, statistical analysis and data mining results, this current study aims to explore the characteristics of the prescription. The total205prescriptions can be divided into18categories, including heat agent, the qi agent, tranquilizers, relieving agent and etc, and were used443times. There were209ingredients belonging to21categories including the antipyretic, qi drugs, sedative drugs, relieving drugs and etc, and were used1663times. The average number of ingredients per prescription was81. Tonic drug was most frequently used and was used for454times, accounting for27.30%of total time used of all ingredients. Tonic prescription was used169times, accounting for38.15%of all prescriptions. Among the ingredients used for more than4times (the top109most frequently used ingredients, the total time used were1371times, accounting for82.39%of total time used of all ingredients), ingredients of the Rupi Sutra category accounted for the most, which had48different ingredients used773times, accounting for56.38%. Among the treatment for90symptoms, tonic prescription was used for73of them, accounting for81.11%. There were199pairs of ingredients that were used for more than4times,242groups that consisted of3ingredients,163groups that consisted of4ingredients, and41groups that consisted of5ingredients.Theoretical analysis was then conducted on29representative ingredients such as atractylodes macrocephala and dried tangerine peel, Fritillaria and Campanulaceae, tangerine peel and Pinellia, ginseng and Angelica to investigate the underlying principles of how ingredients were used in combination.①The prescriptions to increase Qi included ingredients that assist in the flow of Qi. Patients who lacked Qi often had weak spleen and stomach, who might suffer from blocked Qi when using drugs to increase Qi. The use of ingredients which were able to help the flow of Qi in the prescriptions to increase Qi could avoid the blockage of Qi.②The prescription to increase Qi included ingredients that decrease dampness. There were two reasons:first, spleen is the soil for Yin which functions better in a dry environment than a damp one. A malfunction spleen cannot clear dampness hence may result in a harmful dampness and trap the Qi of spleen. Second, the inclusion of these ingredients can avoid the blockage of Qi in the process of increasing Qi, so that the prescription had a good combination of tonic ingredients and purgative ingredients to be tonic but not obstructing.③The prescription to increase blood included ingredients that increases Qi. The production of bleed depends on the flow of Qi from the spleen, the circulation of blood depends on the pushing force of Qi from the heart and control force of the Qi from the lung.④The prescription to increase blood included ingredients that promote blood circulation. The lack of blood is often caused by the malfunction of circulation which is prone to result in blockage.⑤The prescription to increase blood included ingredients that adjust Qi. With a small amount of ingredients that adjust Qi and harmonize environment in stomach and spleen, the prescription which aims to promote Yin and increase blood can yield good adjustment of Qi, being tonic without blockage or too much.⑥The prescription to increase Feng included ingredients that increases Qi and blood. These ingredients can help hence cure Fengxie.⑦The prescription to increase Feng included ingredients that promote blood circulation. These ingredients are often mild and can help remove the blockage in the blood and meridians, stop the pain, achieve a better blood circulation, and hence cure Fengxie.⑧The prescription to help digestion included ingredients that assist the flow of Qi. These ingredients can help with the symptoms such as bloating that caused by the undigested food in the stomach because the good flow of Qi is good for digestion.⑨The prescription to help digestion included ingredients to improve the function of spleen. The undigested food cannot be removed if the spleen is too weak to carry water. On the other hand, poor digestion can weaken the spleen in the long run.⑩The prescription to remove sputum included ingredients that assist the flow of Qi. The sputum is caused by the blocked fluid. The good flow of fluid depends on a good flow of Qi. On the other hand, sputum will hinder the flow the Qi, which becomes a vicious circle and results in a worse flow of Qi. Therefore, the ingredients that enable a good flow of Qi will help removing sputum.(11) The prescription to remove sputum included ingredients that improve the spleen and decrease dampness. The main function of the spleen is to carry fluid and dampness. A weak spleen cannot fulfill this function and dampness will accumulate to form sputum. To improve the function of the spleen to carry the dampness is to cure the underlying cause for sputum as well as provide an outlet for sputum.(12) The prescription to remove sputum included ingredients that decrease heat. The sputum is a result from too much dampness with heat.(13) The prescription to increase Yin included ingredients that increase Yang. By doing so, it has the effect of inducing Yin from Yang.(14) The prescription to adjust blood circulation included ingredients that help the flow of Qi. As a master of blood, Qi provides the force for blood circulation. A good flow of Qi can help dredge the blockage of blood.(15) The prescription to decrease dampness included ingredients that improve the function of spleen and the flow of Qi. The metabolic of body fluid depends on the function of the lung, spleen and kidney, especially the carrying force from the spleen. The spleen is central in the metabolic of body fluid. It is circulation of the Qi from the spleen and the harmonization by the Qi from the stomach that promotes the circulation of body fluid. The waste is then urinated by the bladder. Therefore, the prescription to increase the excretion of body fluid to decrease the dampness often included ingredients that can improve the function of spleen and the flow of Qi. The author emphasized on tonic. It is difficult to remove Xie and cure the disease when there is a lack of Zheng Qi. He suggested that all the organs can benefit from the improvement of the spleen and stomach which produce Qi and blood. A healthy spleen and stomach can help in removing Xie. The spleen and stomach should not be injured when removing Xie. It is also important to improve the function of the spleen and stomach in the recovery stage. In conclusion, the author seldom used aggressive ingredients. Instead, he had an inclination to use ingredients that were mild and tonic to produce a good curing effect.