According to the location and inside/outside differentiation of the disease, as well as the differences between the organs, the corresponding medication method is established, which is called medication method based on disease location.
For diseases located above, the medication is usually taken after meals. For decoctions, small and frequent doses are often taken, while for pills, they are often taken with chewing, with the aim of prolonging the time the medication stays in the upper part of the body and allowing the full effect of the medication to be exerted. For example, the Jiu Jiu Wine Decoction for treating sore throat and the formation of ulcers, as recorded in the "Treatise on Cold Damage," is "taken in small amounts and swallowed." The Pu Ji Disinfectant Drink for treating "head disease" recorded in "Weisheng Baojian" is taken "half as a decoction, taken frequently, and half as honey pills, chewed in the mouth."
For diseases located below, the medication is usually taken before meals, either as a single dose or twice or thrice a day, rarely with frequent doses or chewing. The aim is to directly target the affected area and exert the power of the medication to combat the disease and dispel evil, reducing the loss of medication efficacy in the upper part of the body. For example, the Gan Jiang Fu Zi Tang for treating kidney yang deficiency is taken as a single dose, and the Da Cheng Qi Tang and Xiao Cheng Qi Tang are taken twice a day. The Long Gu Pill for treating bladder and kidney cold with the symptom of feeling like falling when sitting up is recommended to be taken "on an empty stomach, with 30 pills swallowed with wine." The Ba Wei Kidney Qi Pill for treating kidney deficiency is also taken on an empty stomach, with 20 pills swallowed with wine.
In terms of establishing medication methods based on disease location, Sun Simiao succinctly summarized in the "Essential Prescriptions Worth a Thousand Gold" that "diseases located in the chest and upper abdomen should be taken after meals, while diseases located in the lower abdomen should be taken before meals." This method based on disease location and the sequence of medication and meals contains profound principles. The "Plain Questions - Great Treatise on the Ultimate Truth" mentioned, "Supplement the upper to treat the upper with mildness, supplement the lower to treat the lower with urgency." It is generally believed that this refers to the principle of prescribing formulas, but it also implies guidance for medication methods. The words "mildness" and "urgency" do not only refer to the efficacy of the formulas, but also imply the urgency or slowness in medication methods.
Li Dongyuan also said, "In ancient times, the method of medication was flexible. For diseases located above, frequent and small doses were used, while for diseases located below, infrequent and large doses were used. A small dose nourishes the upper part of the body, while a large dose replenishes the lower part. Generally, three doses are taken twice, and for those who take three doses, they should be taken according to the person's strength and the severity of the disease, without sticking rigidly to a fixed method." From this, it can be seen that medication methods are not only related to disease location but also to the individual's constitution and the severity of the disease.
The correct medication method is established based on various factors, but one thing to note is that the concentration of the medication in the blood must be maintained. Li Dongyuan also said, "The power of the medication should be coordinated."
We know that the efficacy of medication depends on the function of the spleen and stomach, and there is a sequential process in the digestion and absorption of food and medication in the spleen and stomach. Generally, the spleen and stomach first digest and absorb the easily digested food, and then the harder-to-digest ones. For diseases located above, taking medication after meals can delay the time the medication stays in the upper part of the body. At the same time, the power of the medication can be transported to the upper part of the body through the ascending and dispersing function of the spleen. Taking medication before meals allows the power of the medication to directly reach the lower part of the body. Modern pharmacology has also found that the amount of contents in the gastrointestinal tract can affect the absorption of medication. More contents in the stomach result in slower absorption, while less contents result in faster absorption. However, it should be noted that the absorption and utilization of medication are not only through the gastrointestinal tract but also through direct local absorption.
According to the theory of disease location, "if it is on the skin, it should be sweated out," as mentioned in the "Plain Questions - Great Treatise on Yin and Yang Correspondence." This is a major method for treating superficial diseases. Therefore, when taking medication, the characteristics of the disease location on the surface should be considered to establish the corresponding medication method. Since the aim for diseases located on the surface is to induce sweating, regardless of whether it is deficiency or excess, cold or heat, the medication should be taken warm or hot, preferably after meals, so that the medication floats on top and can reach the skin and hair through the dispersing function of the lungs. The number of medication doses is often 2 or 3 times.
If the sweating effect is slow but sweating is desired, congee or soup can be sipped or taken after medication to enhance the effect of the medication. For example, the Gui Zhi Tang for treating Taiyang Wind as recorded in the "Treatise on Cold Damage" states, "Taken for a moment, sipping more than a liter of hot congee to enhance the effect of the medication." For medications with strong sweating effects (such as Ma Huang Tang and Da Qing Long Tang), sipping congee is not necessary to prevent excessive sweating and damage to yin. However, for diseases located on the surface, the amount of sweating and the difference between urgency and slowness can also determine whether congee is sipped or not. The Jiawei Qiang Huo Tang formula in "This Matter is Difficult to Know" states, "If it is urgently sweating and hot, it should be taken with congee. If it is slowly sweating and warm, the medication can be taken without congee."
For diseases located internally, they can also be classified as cold or heat, deficiency or excess, and based on the organs involved. Therefore, it is difficult to establish an accurate medication method based solely on the internal location of the disease and requires consideration of the nature of the disease, the severity of the condition, and other factors.
Based on the location in the organs, the medication method should also be differentiated. The "Ru Men Shi Qin - Seven Formulas and Ten Medications" records, "For treating liver diseases located lower and farther away, large formulas should be taken in a single dose... Therefore, for liver diseases, three doses can be combined with the seven doses for the heart, and two doses for the kidneys can be combined with the seven doses for the lungs... For treating heart and lung diseases located above and nearer, small formulas should be taken in small doses and frequently, sipping slowly." It further explains that for two doses of kidneys, they can be divided into nine doses for the lungs, and for three doses of the liver, they can be combined with seven doses for the heart. This mainly discusses the difference in medication doses and intervals based on the location in the organs (as different medication doses require different intervals).
In fact, the establishment of medication methods based on the location in the organs is not limited to this. It is also evident in the choice of "water" for medication. The "Sheng Hui Fang" records that the Teng Li Wan for treating lung qi excess is taken with mulberry root and white skin decoction. The "Sheng Ji Zong Lu" mentions the Ding Chen Wan for treating fatigue, aversion to lying down, and laziness in the limbs, which is taken with Chen rice. The intention behind these prescriptions is to use the specific "water" to control the medication and target the affected organs.
