A Review on Application and Development of General Prescriptions for Treating Epidemic Diseases in Traditional Chinese Medicine

ZHAO Kai-wei (趙凱維), ZHANG Yu-hui (張玉輝), WEI Jing-jing (魏景景), LIU Li-xiang (劉理想)

1. Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences, Beijing 100700, China

2. First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China

ABSTRACT In thousands of years' struggling against epidemic diseases, traditional Chinese medicine(TCM), with its unique and advantageous theories and methods, has protected prosperity of the Chinese nation, composing a brilliant chapter. There are many famous prescriptions and medicines for prevention and treatment of epidemic diseases in TCM. In view of characteristics of epidemic diseases,application of general prescriptions in fighting against epidemic diseases has its unique effects and advantages. Through combing and studying the application of TCM general prescriptions for treating epidemic diseases in different historical periods, summarizing experience and reflecting on lessons,this paper tries to define the concept of TCM general prescriptions for treating epidemic diseases,explore elements of their efficacy guarantee, analyze their advantages and limitations, as well as reveal their enlightenment significance and application prospects, or provide ideas and reference for clinical application.

KEYWORDS Epidemic disease; General prescriptions; Reviews

History has proved that TCM has created a wonderful chapter in China's anti-epidemic history.Doctors of all dynasties accumulated extremely rich experience in prevention and treatment of epidemic diseases, and refined and sublimated them. By the end of Qing dynasty, with relatively complete theories, a system of treatment based on syndrome differentiation for treating epidemic diseases had been formed. At the same time, various prevention and treatment techniques and methods for epidemic diseases had been developed[1]. There are many famous prescriptions and medicines for prevention and treatment of epidemic diseases in TCM. In consideration of rapid spread and strong infectivity of epidemic diseases[2], for thousands of years,scholars of past dynasties paid more attention to creation, application and promotion of general prescriptions in the struggle against epidemic diseases. Many ancient medical books and historical materials record general prescriptions for treating epidemic diseases and their application. This paper sorts out the TCM general prescriptions for treating epidemic diseases and their application in different periods, and preliminarily explores their concept, characteristics, advantages, enlightenment significance, etc.

CONCEPTS OF GENERAL PRESCRIPTIONS AND GENERAL PRESCRIPTIONS FOR TREATING EPIDEMIC DISEASES

General Prescriptions

"General prescriptions" first appeared in Eastern Jin GE Hong'sPrescriptions for Saving Patients from Diseases Caused by Pathogenic Qi of Handbook of Prescriptions for Emergency(《肘后備急方》), "There is also an invaluable prescription of ZHANG Zhong-jing including 12 gHerba Ephedrae,70 pieces ofSemen Armeniacae Amarumand 3 gRadix Glycyrrhizae. It is decocted with 8 L water until only 3 L is left. The patient was given it in several doses. It can generally treat various diseases caused by pathogenic Qi (氣)."[3]The word"general", which is related to "prescriptions", can be first seen in SUN Si-miao'sPrescriptions for Treating Kidney of Essential Recipes for Emergent Use Worth A Thousand Gold(《備急千金要方 ? 腎臟方》), "Duzhong Wine (杜仲酒) can generally treat 5 kinds of lumbago", and "Sanshi Powder (三石散)is suitable for people of all ages, which should be taken in winter"[4].

At present, academic circles generally perceive "general prescriptions" from perspectives of "general prescriptions for multiple diseases"[5]and "general prescriptions for special diseases"[6].The former refers to treating various diseases by one prescription. The latter refers to an effective prescription that can be used to treat several syndromes of a certain disease in a clinical department. Predecessors also called it "the main prescription". Clinical application of the general prescriptions for special diseases has a long history. "Thirteen Prescriptions" ofInner Canon of Huangdi(《黃帝內(nèi)經(jīng)》) had already taken shape, and contents of prescriptions and treatment accumulated by later generations have become more extensive.

General Prescriptions for Treating Epidemic Diseases

"General prescriptions for treating epidemic diseases" belong to the research category of"general prescriptions for special diseases".Combined with relevant studies[7-8], it is believed that general prescriptions for treating epidemic diseases should be effective prescriptions that can generally treat several symptoms/syndromes of epidemic diseases under the guidance of TCM theories of treatment based on disease differentiation and treatment based on syndrome differentiation. General prescriptions for treating epidemic diseases have "definiteness"and "effectiveness"[8]. That is, their objects are "epidemic diseases" and the prescriptions are effective in general treatment situations.General prescriptions for treating epidemic diseases are helpful to solve the contradiction between particularity of "epidemic diseases"and the dynamic nature of "syndromes". They are generally used in the case of rapid and wide spread of epidemic diseases.

APPLICATION OF GENERAL PRESCRIPTIONS FOR TREATING EPIDEMIC DISEASES IN DIFFERENT PERIODS

Han Dynasty

During Han dynasty, plagues were frequent due to imbalance of ecological environment, natural disasters, climate change, wars and bad funeral habits. Plague-hit areas are concentrated in Central Plains of China. According to records, there were as many as 19 epidemics in the Central Plains at that time, among which 17 outbreaks occurred in the Eastern Han dynasty, with an average of one outbreak every 17 years. During that time, the government sent officials to deliver free medicines to victims to alleviate the disasters and appease people.The Age of Emperor Xiaoling of History of the Later Han Dynasty(《后漢書(shū)孝靈帝紀(jì) ? 第八》) records, "In the spring of 179, there was severe plague. Attendants were sent to distribute medicines." The distribution of medicine here does not exclude the possibility of using general prescriptions for treating epidemic diseases.

Occurrence of major epidemic diseases also provided the possibility of innovation and perfection of TCM theory. In the late Eastern Han dynasty,epidemic diseases were prevalent, and publication ofTreatise on Cold Pathogenic and Miscellaneous Diseases(《傷寒雜病論》) was a landmark classic medical book. It creatively put forward syndrome differentiation of six channels theory, creating and retaining a large number of prescriptions with outstanding efficacy, and is called the "ancestor of prescription books". Later generations used many prescriptions for prevention and treatment of epidemic diseases, such as the Maxing Shigan Decoction (麻杏石甘湯), the Wuling Powder (五苓散), etc.. For example, the Wuling Powder is recorded inTreatise on Three Categories of Pathogenic Factors(《三因極一病證方論》)[11]to treat "damp pestilence", "In the Year of Jiwei, there was a severe plague in capital city. Patients died of diaphoresis and purgative methods. The Wuling Powder cured the patients."

Jin and Tang Dynasties

Jin dynasty doctor GE Hong'sPrescriptions forTreating Miasma,Plagues and Warm-toxin Disease of Handbook of Prescriptions for Emergency(《肘后備急方 ? 治瘴氣疫癘溫毒諸方》) mentions"Pitianxing Yili Prescription (辟天行疫癘方)". It containsRealgar,Cinnabaris,Fructus Crotonis,Alumen, Radix Aconiti Lateralis PreparataandRhizoma Zingiberis, which were made into pills.The taking method is "taking a pill at dawn while facing the sun". And it is believed that "it can be cured after 9 days of medication"[12].

Tang dynasty'sNewly Revised Materia Medica(《新修本草》) lists 25 kinds of Chinese herbs such as "Herba Ephedrae,Radix Puerariae,Semen Armeniacae Amarum,Radix Peucedani,Radix Bupleuri, etc." for epidemic diseases caused by pathogenic cold, which were listed as"general medicines for various diseases"[13]. To a large extent, it was established for epidemic diseases. According to historical records, there was an epidemic disease prevalent in the spring of 832 in most areas of the Tang dynasty. Emperor Wenzong of Tang dynasty issued an edict, "For places where the epidemic is not over, local officials need to inspect the condition, reassure the people, deliver medicines according to actual circumstances, and ask about treatment methods to save them. After that, report the results to me."[14]Under the imperial edict to fight the epidemic,administrative means and medical means were combined to make it possible to effectively promote general prescriptions. There are special discussions on "epidemic diseases" and records on general prescriptions in theEssential Recipes for Emergent Use Worth A Thousand Gold(《備急千金要方》),A Supplement to Recipes Worth A Thousand Gold(《千金翼方》) andArcane Essentials from the Imperial Library(《外臺(tái)秘要》)of this period. For example, the Essential Recipes forEmergent Use Worth A Thousand Goldrecords that Wutouchi Powder (烏頭赤散), includingRadix Aconiti,Fructus Gleditsiae,Realgar,Herba Asari,Radix PlatycodonisandRadix et Rhizoma Rhei,treats epidemic diseases; there are also others prescriptions of general treatment for epidemic diseases such as Tusu Wine (屠蘇酒), Taiyi Liujin Powder (太乙流金散), Xionghuang Pills (雄黃丸)and Biwen Prescription (辟瘟方).

Song and Jin Dynasties

There is a record of Song dynasty that Imperial Medical Service prescribed and prepared medicines for preventing epidemic diseases,and they were paid by Bureau of People's Welfare Pharmacy of National Medical Products Administration at that time to distribute them to the army. According toThe Classic of Opening the Tiger-shaped Lock(《虎鈐經(jīng)》)[16]that general prescriptions like Shiqiyi Prescription (時(shí)氣疫方), Huoluan Tuxie Prescription (霍亂吐瀉方), Shanzhangnue Prescription (山瘴瘧方) and Wennue Prescription (瘟瘧方) were used to treat epidemic diseases at that time. Sanxia Prescription(散夏藥) was used to prevent epidemic diseases during seasons of high incidences, which was "not only given to government officials, but also to the army and people".

Formulas of the Administration of People's Welfare Pharmacy(《太平惠民合劑局方》) is a medicinal standard compiled and published by the Imperial Medical Service of the Song dynasty. It contains general prescriptions such as Shengsanzi Prescription (圣散子方) and Shishen Decoction (十神湯)[17]. The Shengsanzi Prescription can "treat cold pathogenic disease, epidemic diseases, wind-warm disease and damp-warm disease, without differentiating Yin (陰) and Yang(陽(yáng)), superficies and interior, as well as external heat and internal cold... spontaneous sweating sometimes, and dysuria, it is suitable to take for all these conditions". Its range of treatment is very wide, and it can be use as a general prescription for preventing epidemic diseases. Its usage and dosage are recorded in detail. The recorded Shishen Decoction is actually powder, consisting of 10 medicines such asRhizoma Ligustici Chuanxiong, etc.. "It can be taken regardless of Yin and Yang, as well as diseases caused by wind, cold or dampness" for treating various epidemic diseases. It can be applied without distinguishing people and it is believed that "even parturients, infants and the elderly can take it". Its administration method is also detailed that it can be modified according to syndrome differentiation when applying. For instance, "If there are fever and headache, three pieces ofBulbus Allii Fistulosiwith roots are added. If there is flatulence caused by excessive Qi, several pieces ofFructus Aurantiiare added to be decocted and taken together".

During this period, there were also incidents on abuse and misuse of general prescriptions endangering people's health. In 1155, an epidemic was prevalent, and there was a fatal incident on misuse of prescriptions in the treatment of the epidemic. The government issued a special edict on giving suitable prescriptions according to the pathogenesis, region and population characteristics to stop the harm. The edict said, "I know that there is an epidemic disease this year, and people are suffering from abuse and misuse of prescriptions.Herbs warm in property for diaphoresis are misused.People who have never learned medicine and know nothing about pulses and syndromes prescribe decoctions arbitrarily. They have killed a lot of people, and I feel really sorry for these. According to medical books, anyone who suffers from headache, fever, aversion to wind and arthrodynia of extremities at the beginning of this disease must be given diaphoresis. Based on changes in regions and climatic characteristics, it is appropriate to take prescriptions such as Xiaochaihu Decoction (小柴胡湯) to clear pathogenic toxin. When defecation is smooth, the disease will be cured at once. Lin'an prefecture can publish a notification to people."[18]Therefore, it can be seen that efficacy of general prescriptions takes into account symptomatic application such as pathogenic characteristics and regional changes.

In 1202, "swollen-head epidemic" was prevalent. Li Dong-yuan created and prepared Puji Xiaodu Decoction (普濟(jì)消毒飲) for treatment.Volume 9 of Dong-yuan's Effective Prescriptions(《東垣試效方 ? 九卷》) records, "It is April now,and people are suffering from the epidemic disease.At first they feel aversion to cold with a heavy sensation of the body. Then the head and face swell up so severely that the eyes fail to open. There are dyspnea, sticking sensation in throat, thirst and a dry tongue. It is called swollen-head epidemic. Relatives stop visiting each other. If people get infected,they will die." LI Dong-yuan applied Puji Xiaodu Decoction to save the patients, and people said that"this prescription was made by an immortal". "One who has gone can not to be saved, but one who is still alive is to be treated. As long as there is a patient, I prescribe and treat him, and the decoction have saved many people."

Ming and Qing Dynasties

Epidemic Diseases of Prescriptions for Universal Relief(《普濟(jì)方 ? 時(shí)氣門(mén)》) of Ming dynasty records Shuangjie Powder (雙解散),Hejie Powder (和解散), Congzhu Powder (蔥術(shù)散) and other general prescriptions[20]. They are all powder, and anyone can take them, with a wide range of indications. Such as "Shuangjie Powder"can "relieves cold pathogenic disease, epidemic diseases, wind-warm disease and damp-warm disease". When using it, "there is no need to think about Yin and Yang, superficies and interior,aversion to cold with fever, headache, rigidity of nape, lumbodorsal spasm, arthralgia, vomiting,dyspneic cough, nasal obstruction, deep voice,painful eyes, dizziness, dysthesia, thirst, alternate attacks of chill and fever, having been performed diaphoresis and the purgative method, severer fever, misuse of prescriptions, bad syndrome,non-acclimatization, malignant malaria, or fever due to blood deficiency in women". "Anyone can take it."

During 1522 to 1620, there were epidemic diseases. In view of vast territory with few doctors,and based on similar symptoms during outbreaks of epidemic diseases, the authority promoted,explored and created general prescriptions for treating patients with epidemic diseases, which played an effective role. For example, in May of 1541, the epidemic disease prevailed in the capital. Emperor Shizong of Ming dynasty once made a prescription called "Jiyi Decoction (濟(jì)疫小飲子)", required subordinates to follow the prescription when preparing, and "also ordered Ministry of Rites to publish it"[21]. Another example is promulgation of Renshen Baidu Powder (人參敗毒散), Jiuwei Qianghuo Decoction (九味羌活湯), "Xiangsu Powder (香蘇散)" and other general prescriptions for treating epidemic diseases during 1573-1620. "Twelve Discussions on Relief of Famine(《救荒十二議》)"[22]records, "Epidemics refer to diseases with the same syndrome. No matter during the early or late stage, Renshen Baidu Powder is extremely effective. Jiuwei Qianghuo Decoction or Xiangsu Powder can also be used, but they must be taken more before they can be effective. It is supported by the government to let doctors act quickly. Dozens of preperations are distributed to help the poor.In summer, if there are infeccted people with warm disease, Baidu Powder (敗毒散) with Guiling Ganlu Decoction (桂苓甘露飲) is effective.

Radix Ginsengis removed from Baidu Powder,while it is better to addGypsum Fibrosum. And let the specialist to determine the medication,the diseases will not be delayed." The general prescriptions for treating epidemic diseases issued in this period were different according to seasonal characteristics, and "the specialist to determine"was more significant in syndrome differentiation.

In Qing dynasty, with plenty of outbreaks of epidemic diseases, the TCM theory and practice in preventing and treating epidemic diseases were continuously enriched and perfected. Many medical books set a special chapter for "epidemic diseases", with many general prescriptions collected and sorted out. For example, there is a special chapter called "General Prescriptions for Treating Epidemic Diseases" inEpidemic Diseases of Medical Complete Book,Ancient and Modern(《古今醫(yī)統(tǒng)大全 ? 瘟疫門(mén)》)[23], recording 16 general prescriptions such as Baidu Powder and Huoxiang Zhengqi Powder (藿香正氣散). It is believed that Baidu Powder "treats epidemic diseases of the four seasons". Shengma Gegen Decoction (升麻葛根湯) "treats epidemic diseases in both adults and children with fever and headache". Huoxiang Zhengqi Powder and Jiuwei Qianghuo Decoction can be used in the early stage of epidemic diseases.In this period, ancient books had clearly pointed out "general prescriptions". For example,General Prescriptions of Standard from the Imperial Library(《蘭臺(tái)軌范 ? 通治方》) lists Zixue Pills (紫雪丹) and Jiedu Wanbing Pills (解毒萬(wàn)病丹), which is also known as Zijin Pills (紫金錠), as general prescriptions for preventing and treating epidemic diseases[24].Prescriptions for Preventing Epidemic Diseases of Songfeng's Discussion on EpidemicDiseases(《松峰說(shuō)疫 ? 避瘟方》) records "general prescriptions for treating epidemic diseases", "Peach twigs that grow to the east are often decocted for bathing, so as to prevent and treat diseases." "Ligan Decoction (梨甘飲) can generally treats epidemic diseases[25]."

In addition, during 1875-1908, there were also records on general prescriptions for treating epidemic diseases issued by the government. For instance, in 1887, a pestilence was raging in Lin'an prefecture in Yunnan province. Doctor XIE Benlun made an empirical prescription for treaing the pestilence, which was approved by the authority as a general prescription for treating epidemic diseases,and promoted for application.

Modern Times and Present

In modern times, infectious diseases such as cholera, bacillary dysentery, typhoid fever and smallpox seriously endangered people's lives and health. As prevention and treatment of infectious diseases continues to play a role in establishment of a new health care system, the prevention and treatment of infectious diseases has achieved certain results. General prescriptions for treating epidemic diseases were also applied during this period. During the epidemic period of cholera in the Republic of China, ZHANG Xi-chun created Jijiu Huisheng Pills (急救回生丹), Weisheng Fangyi Pills (衛(wèi)生防疫寶丹), etc., with good efficacy.

Since establishment of The People's Republic of China, the Communist Party of China and the state have attached great importance to people's lives and health. On the basis of summing up experience and lessons on prevention and treatment of epidemic diseases at home and abroad, a series of major measures have been taken to prevent and control infectious diseases.With attention of the Communist Party of China and the government, a policy of giving priority to prevention has been implemented, and significant progress has been made in the prevention and control of infectious diseases. Since the 1950s, the main prescriptions used in TCM fighting against epidemic diseases have shown characteristics of combining syndrome differentiation with disease differentiation, and treatment due to regions, time and individuals.

In the 1950s, epidemic encephalitis type B was prevalent in Shijiazhuang and Beijing, and was mainly treated with Baihu Decoction (白虎湯) and Cangzhu Baihu Decoction (蒼術(shù)白虎湯)[28-29], with remarkable efficacy. From 1957 to 2005, TCM treatment for scarlet fever included not only clinical trial studies on application ofRhizoma Coptidis, but also clinical observation on treatment with Scarlet Fever Prescription 1(猩紅熱1方) and Scarlet Fever Prescription 2 (猩紅熱2方) as the main prescriptions, as well as introductions on treatment with TCM Shigao Mixture (石膏合劑) and Xiere Jiedu Decoction(泄熱解毒湯)[30]. In 1956 GAO Yi-cheng et al.[31]reported treating 40 cases of diphtheria with Yangyin Qingfei Decoction (養(yǎng)陰清肺湯) in Hefei Infectious Disease Hospital, which achieved good efficacy. In 1958,Radix et Rhizoma Achyranthestherapy was used to treat diphtheria in Foshan, and experience and existing problems of this method in preventing and treating diphtheria were studied[32].Moreover, treatment for measles, typhoid fever,influenza, typhus fever, epidemic hemorrhagic fever, dengue fever, epidemic cerebrospinal meningitis and the like by TCM or integration of traditional and western medicine has achieved good efficacy[30]. The above includes exploration on differentiation of seasons, syndromes, origins and their characteristics, favorable syndromes and syndromes with unfavorable prognosis in measles, differentiation rules of its secondary symptoms, as well as its treatment of integration of traditional and western medicine; application of"Liugan Xietong Prescription (流感協(xié)同處方)" for influenza in Shanghai, an experience summary on applying Modified Ganlu Xiaodu Pills (甘露消毒丹加減), Chaige Jieji Decoction (柴葛解肌湯) and personal empirical prescriptions in Guangzhou, as well as research, development and application of Jinhua Qinggan Granules (金花清感顆粒) for H1N1 influenza[33], etc.. Exploration on TCM treatment based on syndrome differentiation for typhoid fever, and a report on treatment experience in individual cases with self-made Shanghan Jiedu Decoction (傷寒解毒飲), etc.. Clinical reports on application of Dayuan Decoction (達(dá)原飲),Ganlu Sanshi Decoction (甘露三石湯) and Baihu Sanren Decoction (白虎三仁湯) for typhus fever,discussions, clinical studies and experimental studies on treatment for epidemic hemorrhagic fever with Zhuye Shigao Decoction (竹葉石膏湯)as the main prescription, as well as exploration on its treatment with integration of traditional and western medicine; observation on treatment with Qingwen Baidu Decoction (清瘟敗毒飲) and Qingqi Liangying Decoction (清氣涼營(yíng)湯) for dengue fever.Exploration on TCM syndrome differentiation,treatment with integration of traditional and western medicine, etc. for epidemic cerebrospinal meningitis. At the same time, TCM treatment for acquired immune deficiency syndrome (AIDS) also shows advantages and prospects.

During the SARS epidemic in 2003, people actively performed TCM treatment and achieved good clinical efficacy, showing its advantages.At that time, Beijing Administration of Traditional Chinese Medicine organized experts to draw up and recommendTraditional Chinese Medicine Treatment for SARS in Beijing《北京地區(qū)非典型肺炎中醫(yī)治療方案》[34], which suggests that clinicians should combine TCM treatment methods according to prevention and treatment situations.For SARS cases or suspected cases, according to the TCM principle of treatment based on syndrome differentiation, adjust the method and principle of treatment to local conditions, stages,syndromes and disease conditions, and modify prescriptions based on syndromes. According to observation on more than 100 patients admitted to Guangdong Hospital of Chinese Medicine,DENG Tie-tao put forward a major treatment method of "strengthening vital Qi to eliminate pathogenic factor". Guangdong Hospital of Chinese Medicine then formulated relevant TCM schemes of treatment based on syndrome differentiation, which was treatment based on syndrome differentiation and early, middle, critical and convalescent stages[35]. China Association of Chinese Medicine also issuedA Guide to TCM Diagnosis and Treatment for Severe Acute Respiratory Syndrome(SARS)《傳染性非典型肺炎 (SARS) 中醫(yī)診療指南》[36], which points out that active application of TCM in early prevention and early treatment, focusing on elimination of pathogenic factors, strengthening vital Qi in the early stage and prevention of transmission can achieve good efficacy. The guide elaborates on diagnosis, differential diagnosis, stages, etiology,pathogenesis, treatment based on syndrome differentiation, etc..

DISCUSSION

Distribution Characteristics of General Prescriptions for Treating Epidemic Diseases in Different Periods

Through combing and studying general prescriptions for treating epidemic diseases in different periods, it shows that TCM has strong vitality in prevention and treatment for epidemic diseases. In this paper, nearly 70 prescriptions are sorted out, of which nearly 20 were officially promoted. Especially records on application in the Song and Qing dynasties are relatively more.Many classic medical books in the Qing dynasty list a special chapter of "Epidemic Diseases" or"General Prescriptions for Treating Epidemic Diseases", which may be related to the large number of epidemic diseases at that time and the continuous development and improvement of TCM theory and practice on fighting against epidemic diseases.

With the continuous development of the times and the TCM theory and practice on prevention and treatment of epidemic diseases,the connotation of general prescriptions for treating epidemic diseases in different periods has changed continuously, from the initial one that a prescription generally treating symptoms of epidemic diseases to flexible application due to changes of individuals, local conditions and seasonal climates. It embodies the characteristics of combining treatment based on disease differentiation and treatment based on syndrome differentiation. Especially for nowadays, the combination of individualized treatment based on syndrome differentiation and general treatment provides a more optimized choice for clinical treatment of new and sudden infectious diseases.

Figure 1. Brief Diagram on the Number of Prescriptions and Dynasty Distribution Mentioned Above

Advantages and Limitations of General Prescriptions for Treating Epidemic Diseases

"Patients get sick with similar pulses and symptoms, then they infect others, involving more people, as if waves coming over and over again,or fire burning and spreading. It is hard to stop immediately, just like huge battles, in which no one can survive. Therefore, it is called an epidemic disease."[37]In the process of prevention and control on epidemic diseases, it is found that some fulminating epidemic diseases are characterized by rapid onset, strong infectivity, fast transmission,severe disease condition, etc..[38]Once they are pandemic, there will be many patients with similar symptoms in a short period of time. It is difficult to perform individualized treatment due to one by one syndrome differentiation. At this time,promotion and application of general prescriptions or general methods for treating epidemic diseases is particularly significant in a large range to control or block development of the diseases, and shows its irreplaceable advantages.

However, although "general prescriptions can be applied in most cases, disease condition should also be carefully differentiated, and they should not be used ambiguously." The process of clinical understanding on diseases is gradually deepened. Usually, there is treatment based on disease differentiation first, and then syndrome differentiation. Before the syndrome differentiation,general prescriptions are mainly aimed at diseases,which may involve all their syndromes. General treatment is a common and programmed treatment method for a type of diseases. In the process of its application, there are inevitably limitations such as inability to fully consider specific conditions of a disease and adopting flexible countermeasures for many syndromes.

Reflection and Enlightment on Application of General Prescriptions for Treating Epidemic Diseases

Since ancient times, in the history of TCM fighting against epidemic diseases, the effective application of general prescriptions for treating epidemic diseases has provided us with valuable medical experience. However,there are also lessons that make people think deeply. For example, Shengsanzi Prescription(圣散子方) is a prescription for treating colddamp epidemic diseases. SU Shi used it to treat epidemic diseases, and "saved many people".Later, he wrote a book to promote it widely. The prescription was once very popular. However,the same prescription used in later generations gave a lesson on "killing countless people".Although these lessons are not unrelated to blind belief in "celebrity advertisements", it is a mistake of "improper application" to probe into the causes, which are actually due to the doctors[39].In preventing and treating epidemic diseases,only one prescription (a general prescription for treating epidemic diseases) was usually used in medication. They were often distributed in large quantities. If the prescription did not suit the symptoms, they would do harm to people. There were many such lessons in history. Therefore,symptomatic treatment is very important, and ensuring its efficacy is the key.

Facing epidemic diseases, doctors of all dynasties actively searched for treatment methods, which promoted exploration, creation, application and development of general prescriptions for treating epidemic diseases. Faced with treatment for new outbreaks of infectious diseases and difficulties like an absence of specific drugs and "vaccines",TCM is not trapped in the thinking of "vaccines",and it can be used to intervene as soon as possible in the first place, mastering the common laws of diseases, finding out the core pathogenesis, and drawing up general prescriptions. The first-place intervention can set aside a large buffer zone for treating infectious diseases, which is of great significance from the perspective of prevention and control. However, general treatment is the basis for preventing and treating a type of diseases,and provides a range of options for individualized treatment based on syndrome differentiation.The individualized treatment based on syndrome differentiation is to give full play to advantages of TCM individualized syndrome differentiation under the premise of general treatment. In order to ensure its efficacy, the core pathogenesis should be grasped, taking complex factors such as regions,seasonal climates and individual differences into consideration.

CONCLUSION

Since ancient times, TCM has been the backbone of our people's struggle against epidemic diseases. It has escorted prosperity of the Chinese nation for thousands of years. It has been proved that the history of TCM fighting epidemic diseases is brilliant. Regarding the prevention, diagnosis and treatment of epidemic diseases, the TCM theory is perfect, with rich treatment methods and recognized efficacy.Among them, the general prescriptions for treating epidemic diseases are important for the TCM prevention and treatment for epidemic diseases,which play a remarkable role in the history of TCM fighting against epidemic diseases. Reviewing the application of general prescriptions for treating epidemic diseases in different times, as well as summarizing and reflecting them will help us have a clearer understanding on the characteristics and advantages of TCM general prescriptions for treating epidemic diseases. "Inheriting essence and keeping innovation." There is still much room for in-depth exploration on the studies of TCM general prescriptions for treating epidemic diseases.