Hello, I am glad to answer your question. Zhang Zhongjing's "Treatise on Typhoid Fever" everywhere embodies the idea of identification, each prescription is from the patient's individual point of view, through the comprehensive analysis of the characteristics of the disease through the look and smell, focusing on telling us to pay attention to the individual complexity of the evidence, palpitations and chest pain to get rid of paeoniflora is a strict condition, not all palpitations and chest pain can not be used paeoniflora, the specific principles and application of the condition is summarized as follows:

★ Remove Paeonia lactiflora when there is deficiency in the middle.

• The "Treatise on Typhoid Fever" on palpitations and chest pain recorded as "Sun disease, after the next, the pulse is rapid chest fullness, Gui Zhi to go to the peony soup," I will restore the patient's situation.
• Sun disease is caused by external wind evil fever, headache, fear of the wind such diseases, due to the wind evil for the positive evil, will not block the pores, generally does not cause high fever, the patient is only a low fever or self-awareness of the fever but the temperature is not high, under the next after the prompting of the two cases, one is the doctor mistakenly used a laxative medication, and the second is the patient is usually weak in the spleen and stomach, the external wind evil flu diarrhea after the manifestation of the fact that the second possibility of We all know that the weak human body if diarrhea occurs, the body will be more weak, weak physical state in the activity will appear obvious palpitations, chest tightness, then, the pulse is urging the pulse, rapid means fast, fast pulse rate is easy to palpitation symptoms, in line with the weakness of the stomach weak physical state.

• The purpose of removing Paeonia lactiflora is that Paeonia lactiflora is sour and cold, and cold medicines are very likely to cause diarrhea, aggravating the problem of weakness of the spleen and stomach in the middle jiao. Retaining Gui Zhi Gan Cao can disperse wind and evils, and at the same time warm up the spleen and stomach.

★ Remove the peony in case of yang deficiency

• In the Treatise on Typhoid Fever, there is a sentence that reads, "After sweating, if the person's hands are crossed and the heart is cold, and the heart is palpitating underneath, and the person wants to be pressed, Gui Zhi Gan Cao Tang is the mainstay of the treatment." Note that in this case, the patient had palpitations, but did not use Paeoniae alba.
• The principle of not using paeoniae is not that paeoniae can cause palpitations, but that this patient only had a transient impairment of the heart's yang qi, which could be solved simply by using gui gan tang. The Nei Jing says that "pungency and sweetness disperses yang", and that pungency of gui and sweetness of herbs, when combined, will generate heat and elevate the yang qi, and that dispersal is upward movement, and the target of action is the heart. After sweating means excessive sweating, this person presses the heart with his hand, and the palpitation performance can be relieved by pressing is that the yang of the heart is damaged, if only Gui Gan is used to see, such a patient usually has a good physique, and the function of the internal organs is relatively strong, and the heart's yang is damaged for a short period of time after excessive sweating, and the yang of the heart can be restored by giving this formula, and, in fact, can be restored without medication and more water and more rest.

• Transient insufficiency of heart yang does not use peony because the pathogenesis is not complex enough to warrant the use of sour and cold peony, and because peony is slightly cold in nature, which is not conducive to the recovery of heart yang. If the patient's insufficiency of heart yang involves kidney yang, and blood stasis and stagnation of water and fluid after yang qi insufficiency, then consider that paeoniae can dissolve blood stasis and promote diuresis, together with warming yang and tonifying the kidneys, to solve the complicated pathological situation, such as the treatment of palpitation under the heart and dizziness of the head with the Zhenwu Tang, which uses paeoniae.

★Summary

Zhongjing emphasized the importance of observing the pulse and evidence and treating with the evidence, meaning that he warned the descendants to always keep track of the patient's physical condition, focusing on simple problems, such as Gui Zhi going to Paeoniae Lactiflorae, which is the weakness of the middle jiao, lest Paeoniae Lactiflorae injure the spleen and stomach. Complicated cases focus on combinations, such as Zhen Wu, which is a coexistence of Yang deficiency and Blood stasis. Although Paeonia lactiflora is not conducive to Yang deficiency, it focuses on solving the problem of Blood stasis and water stagnation on the basis of warming Yang. In fact, palpitations can also occur when Liver Fire is exuberant or when Liver Yin and Blood are deficient, in which case Paeonia lactiflora needs to be reapplied, or else Liver Blood cannot be restored, and the Heart will inevitably palpitate without blood to nourish it.

Gui Zhi Tang removing peony for palpitations and chest tightness is from the Treatise on Typhoid Fever.

Article 22 of the Treatise on Typhoid Fever reads as follows: "In solar diseases, when the pulse is rapid and the chest is full after the downward movement, Gui Zhi and Paeoniae Lactiflorae Soup is the mainstay of the disease". What about removing the peony if the pulse is rapid and the chest is full?

The standard interpretation now is that, according to the description of the article, combined with Zhongjing's use of medicines, it can be deduced that the pathogenesis suggested by this article is that, after diarrhea, it injures Yang Qi in the chest of the human body, which is not invigorated, leading to cold stagnation in the chest, hence the chest tightness. Therefore, Gui Zhi, Glycyrrhiza glabra, Ginger and Jujube were used to invigorate Yang Qi in the chest, while Paeonia lactiflora was acidic, astringent and yin-soft, which was not conducive to the transmission and dissemination of Yang Qi, and was therefore removed.

The article deals with the definite deficiency of yang qi and heart yang. Paeonia lactiflora is a medicine that can replenish fluids, so in the treatment of muscle spasms Paeonia lactiflora is often paired with Glycyrrhiza glabra to replenish fluids and alleviate the pain of spasms. The patient's pulse beats very fast and the heart dissipates a lot of energy, if some water is added, it is feared that the heart cannot withstand it, but only Gui Zhi and Gan Cao can invigorate the heart to make it beat out powerfully, so as to reduce this metabolic quickening of the heart and bring the heart rate back to a normal state.

Clinically, many patients with kidney yang deficiency, kidney water without warming, the body of water and dampness into phlegm and drink, further injury to the body's yang. The human heart is the main fire, and the water can restrain the fire, when the drink evil on the offender disturbing the heart, there will be heart fire weak, heart yang is not vibrant, the patient can be manifested as chest tightness, pain, arrhythmia, aggravated by cold, Western medicine diagnosis of coronary artery disease, traditional Chinese medicine is known as thoracic paralysis, the pulse manifests itself as "yangwei yinxin," i.e., the inch of the left hand pulse is weak, Guanzuo pulse strings Tight. This is a typical chest paralysis syndrome, cold phlegm and cold drinks, congestion in the chest, the heart yang is weakened, revitalize the heart yang as a priority. However, the formation of cold phlegm and cold drinks originates from the kidney. When kidney yang is weak, the water and drink cannot be warmed, and the essence of food is not transformed and utilized, but turns into phlegm and dampness, which is congested in the interior. Therefore, warming is the main method for treating this kind of disease, which mainly includes invigorating the heart yang and warming and tonifying the kidney yang. White peony is bitter, sour and slightly cold in nature, and belongs to the liver and spleen meridians. Chinese medicine says that its main effect is to nourish yin and nourish blood, soften the liver and relieve pain, so it is natural that peony should be removed in cases of palpitations and chest pain as seen in the Treatise on Typhoid Fever.

In the "Treatise on Typhoid Fever", it is written about palpitation and chest pain, "In solar disease, after going down, the pulse is rapid and the chest is full, Gui Zhi goes to Paeonia lactiflora soup to be the main one". In my opinion, there are two ways to use Paeonia lactiflora. One is to use fried white peony, white peony after frying the acidic and cold nature is greatly reduced, to take its blood nourishing and blood function. The second is to use red peony, which can activate blood circulation and remove blood stasis. When combined with gui zhi, its coldness is also reduced. The above two cases: fried white peony, red peony and gui zhi with, the key in the dose ratio. Personal opinion, in order to attract jade!

Peony flavor: bitter, sour, slightly cold, non-toxic. Attributed to the meridian, Zhongjing book "palpitation" "Yang deficiency" for the cold evidence to remove the medicine to remove its bitter cold ......

The Dharma Change of the Masters.

First: Paeonia lactiflora astringes Yin and protects the Liver, regulating the fluids of Ying and Wei.

Yingwei is the qi and blood qi of the muscles, couplings, and sinews. ...

"In the case of solar disease, after descending, with a rapid pulse and fullness in the chest, Gui Zhi Go Shao Yao Tang is the mainstay.

Lower Back, Prompted Pulse, Fullness in the Chest... Symptoms: Deficiency in the lower part of the body and solidity in the upper part of the body. Real: the realities of the Heart and Liver, and those who are real should not be astringent and should be sparing. ...thus removing the properties of Paeonia lactiflora.

The following points are for reference. ...

Real Sun disease, injuring true Yin and fluid in the first place.... Protecting the fluid and yin in exogenous diseases is a major method.

But Gui Zhi Tang is streamlined and far-reaching.... It is not necessary to remove the white peony, but of course it needs to be dialectical and methodological.......not to be stuck in the ancient formula.

Chinese medicine is based on the person and the use of medication, never memorize a recipe and the medical law can be mechanically and blindly unified medicine war disease, flexible application is the essence of Chinese medicine, for peony should be used, when to use? Should we use peony, when to use? So there is no such thing as removing a certain flavor of medicine, this is the Western medicine theory thinking, Chinese medicine and Western medicine point of view is very different.

I don't know enough about the specialty to comment on it.

The preface to the Treatise on Typhoid Fever, written with the use of Su Wen Yun Yun, were all added by the Nei Jing school, who wanted to find a theoretical basis for the Treatise on Typhoid Fever.

They felt that typhoid without theory this was not possible, so they found a theoretical source for him.

Because there's no point in adding it.