According to the cold and heat properties of diseases, as well as their deficiency and excess states, the corresponding medication methods are established, known as medication methods based on the nature of the disease.
Medication based on the nature of cold and heat
Due to the differences in the nature of cold and heat diseases, there are distinctions in medication methods as well. Although cold diseases may vary between surface cold, internal cold, excess, and deficiency, the treatment methods generally focus on expelling cold from the body surface, warming the interior, and treating excess cold. Therefore, the medications used are mostly warming and heating in nature. When taking decoctions, they should be taken warm or hot. When taking pills or powders, they should be mixed with warm wine or boiling water to enhance the dispersing and expelling effects of cold. For example, the Zhi Shi Xie Bai Gui Zhi Tang and Ren Shen Tang mentioned in the "Synopsis of the Golden Chamber" are taken warm, and the Ma Huang Tang for treating Taiyang Shanghan is also taken warm. After taking the medication, it is recommended to consume congee to assist the efficacy of the medicine. The method of taking Li Zhong Wan states, "After taking the decoction, if there is an appetite, drink about one liter of hot and thin congee." The San Wu Bai San Fang also states, "If there is discomfort, have a cup of hot congee."
Warm diseases, on the other hand, are generally expected to be taken cool, as their nature is hot. However, if we examine the various medical books throughout history, we will find that not all medications for warm diseases are taken cool. There are also instances where medications are taken warm. The principle behind this is that warm diseases, which are mostly excess in nature and have a high level of heat, are taken cool, and disperse and pill formulas are taken with cold water. For example, the An Gong Niu Huang Wan mentioned in the "Differentiation and Treatment of Warm Diseases" is taken with "cold water." The Shi Gao Wan for treating heart congestion with dry mouth and tongue is also taken with "freshly drawn water." For warm diseases that belong to surface or deficiency categories and have a low level of heat, they are generally taken warm. For example, the Qing Zao Jiu Fei Tang in the "Laws of Medicine" is taken warm two or three times. (It should be noted that due to the different eras and geographical environments in which the medical practitioners of different generations lived, as well as individual differences in medication preferences, the requirements for the temperature of the medication may not be the same. However, the mainstream approach should be considered). In cases where there is a "true cold with false heat" or "true heat with false cold," or even signs of "counteracting yin" or "counteracting yang," the temperature of the medication becomes more significant. For those with "counteracting yang," the medication should be cool, while for those with "counteracting yin," the medication should be warm. Otherwise, sudden consumption of spicy and hot or cold and chilly substances may be detrimental to the body, which is also one of the principles of the complementary approach in traditional Chinese medicine. For warm diseases, pills and powders should not be taken with alcohol, as the heat of the alcohol may contribute to the heat imbalance.
Medication based on the nature of deficiency and excess
The range of diseases involving deficiency and excess is extremely broad. Any insufficiency of qi, blood, yin, or yang, or any decline in the function of organs and viscera, can be referred to as deficiency. On the other hand, phlegm, accumulation of fluids, blood stasis, and stagnation of dampness can be referred to as excess.
Due to the differences in the deficiency and excess properties of diseases, there are different medication methods as well. Generally speaking, for those with deficiency and excess combined with heat symptoms due to yin deficiency or blood deficiency, medications that are mild and not excessively pungent, aromatic, or drying are preferred. Therefore, they are mostly taken warm or cool, with caution to prevent heat injury to yin and blood. When taking pills or powders, alcohol should not be used. For those with qi deficiency or yang deficiency, the medications should be taken warm to match the warm nature of the medicine. In terms of the timing of medication, for deficiency and excess diseases with heat symptoms, it is recommended to take the medication before meals to nourish the organs and moisten the viscera. Due to the weak nature of deficiency diseases, which mainly involve the decline of organ and viscera function, a slower progression of the disease and a longer course of illness, the location of the disease is relatively clear and limited. Therefore, the timing of medication should be determined based on the biological rhythm of the affected organ or viscera. In terms of the frequency of medication, generally speaking, there are fewer doses for excess conditions, usually only once or twice, and rarely do we see frequent administration. For example, the San Cheng Qi Tang mentioned in the "Treatise on Cold Damage" is often taken after meals, or the dosage is reduced or stopped once the condition improves. For diseases with excessive heat and stagnation, the medication for dispelling pathogenic factors can be taken in increasing doses. Sun Simiao mentioned in the "Qian Jin Yao Fang" that "when the patient's digestive function is strong, the first dose should be the largest, the second dose should be gradually smaller, and the last dose should be the smallest."
