Author: advocating classics
My family has been coughing recently. When I got home, I prescribed a small dose of Qinglong soup to a nearby drugstore. I went to a chain drugstore first. The clerk who didn't know to take the order looked at the prescription and sarcastically said, "Asarum15g?" We don't deserve it! "I went to several other pharmacies, and some asked if it was for internal use or external use. Hearing that it was an internal medicine, he immediately said, "15 grams of asarum will kill people!" Not worthy! Not worthy! "As a result, they who also dare not match.
No wonder "the amount of asarum is not more than money", which we taught when we were studying. Whether studying medicine or Chinese medicine, the training examinations for resident pharmacists in recent years have repeatedly emphasized the dosage of these "toxic" drugs. Therefore, unless all Chinese medicine practitioners have a family background or make good use of classical prescriptions or read a lot of literature about the use of asarum without toxic side effects, they should strictly follow the routine when using asarum.
A few years ago, I had an affair with an old northern Chinese doctor who was passed down from generation to generation. He often mentioned the concept of "ascending fire" (supporting yang) and often used warm drugs, such as hemp, aconite, cinnamon (cassia twig), asarum, Qiang, governor, Jing and Fang. This is the second Chinese medicine practitioner who makes good use of these drugs in my experience (the first one is my father's list). At that time, I appointed a brother of Chinese medicine as the technical director of the clinic. As soon as the brother saw the old doctor's prescription, he quietly pulled me aside and said to me with a skeptical eye, "Is this doctor okay?" You see, he uses 10 g for asarum, and asarum generally cannot exceed 3 g! "Fortunately, I have read the report in journal of traditional chinese medicine before, and the common dosage of asarum is 10 to15g, and some diseases need to use 60g, and there is no toxic side effect, and the effect is better. At that time, I was young, curious, and working in the ward. I thought I was not afraid of danger, so I said hello to my colleagues and took15g of Asari (completely rooted, unlike many herbs used as medicine now) and took it one hour later. I only feel a little tingling in my tongue, a warm feeling, and a little warm feeling in my body. Others don't feel uncomfortable at all. Since then, I often open 10 grams. At first, I was often called by the pharmacy director to verify and sign next to the medicine. At that time, I didn't know how to use classical prescriptions. In fact, the dosage of Zhongjing Yisheng's prescription is now three liang, and the dosage of one medicine is one liang (equivalent to the current15g). As for some studies, one or two in the Han Dynasty is equivalent to 3 grams now, which is absolutely wrong according to my clinical experience.
As for the dosage of asarum, according to the current data, it was first seen in the Song Dynasty. 6? 1 Chen Cheng's "Materia Medica Needless to Say", "If Asarum is used alone, it can't be used for more than half a word, it is called suffocation, and those who fail will die". A penny is equivalent to 1.5 to 2 grams, and a half penny is not more than 1 gram; Later, it was widely circulated in Li Mingshizhen's Compendium of Materia Medica, which quoted "Needless to say, Materia Medica" and said: Asarum, if used alone, can't spend too much money. If it is too much, you will suffocate. He described one and a half dollars as a dollar, which seems to be bigger than that in Don't Say (a dollar in ancient times is equivalent to about 3 grams today). However, due to the great influence of Compendium of Materia Medica, doctors in later generations passed on the wrong words, and did not specify "if it is used alone". Until now, both decoction powder and compound prescription have said "no cost".
So is Asarum poisonous, Song? 6? 1 Is Chen Cheng's statement credible? Modern pharmacological research shows that Asarum mainly contains volatile oil, and the effective components in the oil are methyl eugenol (about 50%), safrole (10%) and elemene, and the toxic component is safrole. The volatile oil of asarum has an exciting effect on frogs, mice and rabbits. At first, it was, then it was paralyzed, gradually reducing voluntary movement and respiratory movement, disappearing at the same time, and finally died of respiratory paralysis. Breathing stops before heartbeat, which has a direct inhibitory effect on myocardium and smooth muscle. The ethanol extract of rabbits can antagonize the respiratory depression caused by morphine. The LD50 of mice were 123.75 mg and 7.78 mg/10 g, respectively. The alcohol extract of asarum is more toxic than the decoction. Therefore, it is in line with "many people suffocate, and those who fail to pass die."
So why use a large dose of decoction in clinic? It turns out that after Asari was decocted at high temperature for 30 minutes, the safrole in the volatile oil was only 2% of the original medicinal material. Therefore, if the powder is effective with 1 g, the decoction is effective with 50 g after 30 minutes of decoction. If you don't spend too much money, it won't even scratch your boots. In addition, the varieties of asarum are quite different from traditional varieties. The traditional species should be China Asarum, and the similar species are North Asarum (Liaodong Asarum) and Seoul Asarum, both of which are authentic medicinal asarum recorded in China Pharmacopoeia. Now in some places, asarum (other than the genuine asarum) is used instead of the genuine asarum, and the effect is even more discounted. The results showed that the content of methyl eugenol and safrole in authentic asarum was much higher than that in non-authentic asarum. The content of methyl eugenol in three kinds of authentic asarum was: Seoul Asarum >: Asari Asarum > China Asarum, and the content of safrole was: China Asarum >: Asari Asarum > Seoul Asarum. There are also different medicinal parts. Traditional asarum is used as medicine from root, but now it is used from whole grass. The content of volatile oil is root, whole grass and leaf in turn. The harvest season is also different. Traditionally, it is harvested on the eighth day of the second day of the lunar calendar, when the active ingredients are the highest. But now driven by interests, there is no need to divide time, and its effective components are very unstable.
Therefore, the dosage of asarum depends on the specific situation. If it is correct to follow the principle of "no cost" (whether it is used alone or in combination), then it must not be used in decoction, otherwise it will be useless, so it is no wonder that Chinese medicine is ineffective and useless. But when will these fallacies stop?