Discussion on the application of Ginseng efficacy from "Treatise on Spleen and Stomach"

Ling-Yuan Kong,Yue-Wu

1College of traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250300,China.

Abstract According to the original works of an ancient Chinese medicine book "Treatise on Spleen and Stomach"(Detailed Analysis of Spleen and Stomach Diseases;1249 C.E.)written by Li Dongyuan(1180-1251 C.E), and related explanations of later physicians,the efficacy and application of Ginseng(Ginseng Radix et Rhizoma)in related prescriptions were investigated from the aspects of dosage,usage and treatment methods.Ginseng appeared in 27 named prescriptions,including 20 decoctions,4 pill and 3 powder.In terms of dosage and usage,the common dosage of Ginseng is five points,mainly decoction.Most of the processing methods are "Fuju"(Bite up the medicine with your mouth so it can be taken.)and decoction with water.In terms of treatment methods,Ginseng is used in the sweet temperature and heat removing method and Nourishes Qi and Eliminates Evils Method(build your body to cure disease)in Li Dongyuan's "Treatise on Spleen and Stomach".Explaining Sweet Temperature Heat Removal Method(Use sweet and warm medicines to treat Qi-deficiency fever or Blood-deficiency fever;there are many reasons for fever,and cold and cooling medicines with heat-clearing effect are generally used for treatment.Use bitter cold medicine,so as not to consume the body's Yang.)takes Buzhong Yiqi Decoction(BYD)as an example,and explaining the Nourishes Qi and Eliminates Evils Method takes Mahuang-renshen-shaoyao decoction as an example.At the same time, "Treatise on Spleen and Stomach" matured in the Jin and Yuan Dynasties(1115-1368 C.E.).Its system of weights and measures,terminology and medical theory are quite different from those of modern Chinese medicine.Therefore,when researching the dosage,usage and treatment methods of Ginseng,we will explore the controversial points,and explain them by using modern Chinese medicine theory,so as to guide the clinical medication more accurately.

Keywords:"Treatise on Spleen and Stomach";Ginseng;Li Dongyuan;prescription;Sweet Temperature Heat Removal Method;Nourishes Qi and Eliminates Evils Method

Background

"Treatise on Spleen and Stomach"(Detailed Analysis of Spleen and Stomach Diseases;1249 C.E.)was written by Li Dongyuan(1180-1251 C.E)[1].There are 68 prescriptions recorded in"Treatise on Spleen and Stomach",of which 63 have names and dosage or ratio.Ginseng(Ginseng Radix et Rhizoma)is warm,sweet and slightly bitter,which belongs to the spleen and lung meridians[2].Among the 63 prescriptions in"Treatise on Spleen and Stomach",there are 27 prescriptions using Ginseng.They account for about 43.86% of the total prescriptions.Li Dongyuan's treatment of diseases is more focused on invigoration method.Therefore,in the prescriptions of"Treatise on Spleen and Stomach",most prescriptions have the effect of invigorating Qi(In Traditional Chinese medicine(TCM),Qi refers to the most basic elements that constitute the human body and sustain life activities,and also has the meaning of physiological function.),and Ginseng is one of the typical representatives.At the same time,Li Dongyuan thinks that the spleen and stomach are the foundation of vitality,the foundation of acquired,and the hub of the rise and fall of vital energy of human body[3],and explains in the"Treatise on Spleen and Stomach"that "all diseases are caused by internal injuries to the spleen and stomach",that is,the main cause of internal injuries is that the spleen and stomach are damaged and their functions are reduced.Based on the above two points,combined with the relevant records in"Treatise on Spleen and Stomach",it can be seen that most of the prescriptions in"Treatise on Spleen and Stomach"have the main functions of "Tonifying Soil(One of the five elements of TCM,generally refers to spleen and stomach.)" and "Tonifying spleen and stomach deficiency".

The "Gan temperature heat removal Method " and "Nourishes Qi and Eliminates Evils Method" can best reflect the academic thought of Li Dongyuan.When describing classic ancient prescription of Chinese medicine Banxia Baizhu Tianma Decoction,it also records that Ginseng has the effect of "Sweet and warm purging Fire and tonifying Qi".Therefore,when Li Dongyuan uses the "Gan temperature heat removal Method" and "Nourishes Qi and Eliminates Evils Method" to combine prescriptions,Ginseng is often used as an important component in the prescriptions.

Ginseng has the effects of Reinforce Vital Energy(Vigorously subsidizing vitality),Invigorating Spleen For Benefiting Lung(Refers to the treatment of Spleen-lung Deficiency syndrome with prescriptions with the functions of invigorating the spleen and nourishing the lungs),Promoting Body Fluid And Nourishing Blood(Nourishes body fluid,increases the Qi of the kidneys,people are not thirsty,and the body fluid is sufficient,Nourishing the blood is to make the viscera tissues fully nourished by blood,so that the function of the viscera tissues can return to normal).In Li Dongyuan's"Treatise on Spleen and Stomach",he quoted the ancient book of Chinese medicineHuangdi Neijing(Yellow Emperor's Canon of Internal Classic;221 B.C.E.-220 C.E.)'s explanation of drug compatibility with the method of monarch and minister's guidance[4].He thought that the drug that played the main therapeutic role in the main diseases or symptoms and used the most was Main herb of formula(A drug that plays a major therapeutic role in the treatment of the main disease or syndrome.Is indispensable in the prescription,and the drug power of the first drugs.),and proposed that the syndrome of deficiency of Ginseng in treatment was Main herb of formula.In the prescriptions in"Treatise on Spleen and Stomach",it can also be seen that Ginseng can be used as a Ministerial Drug(Adjuvant jun drug to strengthen the treatment of the main disease or the main syndrome or for the concurrent disease or concurrent syndrome of the therapeutic effect of drugs.Its medicinal power in prescription is less than that of general medicine.)to assist Main herb of formula or to treat both diseases and syndromes.

The dosage of Ginseng in the prescriptions of "Treatise on Spleen and Stomach"and the conversion of relevant weights and measures system

According to"Treatise on Spleen and Stomach",Ginseng,Fuling（Poria）and other medicinal materials in Weifeng Decoction are "equal above",that is,the dosage of each medicinal material in the prescription is the same,but the dosage is not specified.Li Dongyuan used the weight unit of Ginseng dosage in the other 26 prescriptions in"Treatise on Spleen and Stomach",including liang,qian and fen,(Table 1).

Table 1 dose of ginseng in different prescriptions

To understand the dosage of TCM in"Treatise on Spleen and Stomach",we must understand the system of weights and measures in ancient China,especially in the Song,Jin and Yuan Dynasties(960-1368 C.E.).China has a long history and a variety of measurement systems.The unification of weights and measures was completed for the first time in the Qin Dynasty(1636-1912 C.E.).After the war,it was unified again by the Han Dynasty(202-220 B.C.E.),and finally followed by later generations.By the Tang Dynasty(618-907 C.E.),the system of weights and measures has evolved into a large system stipulated by national laws and a small system inherited from ancient times in medicine,music and other aspects.The weights and measures of the Song Dynasty(960-1279 C.E.)mainly inherited the large system of Tang Dynasty,but there was a problem of using both large and small systems in the field of medical prescriptions.However,if the large system was used,the dosage units such as Jin(Large System)and liang(Large System)would be specially marked,otherwise,it would be called small system.The weights and measures system in the Jin and Yuan Dynasties mainly inherited from the Song Dynasty,so this problem also existed,even more serious than that in the Song Dynasty.

According to the law of the Song Dynasty,the size of fen,qian and liang is increased by this,and the decimal conversion is adopted,that is,1 liang(Large System)=10 qian(Large System)and 1 qian(Large System)=10 fen(Large System)[5].In the Jin and Yuan Dynasties,1 Liang(Large System)was about 40～41.3 g.Therefore,1 qian(Large System)is about 4～4.13 g,and 1 fen(Large System)is about 0.4～0.413 g.Only according to the large system conversion,the dosage of drugs in the prescription of"Treatise on Spleen and Stomach"far exceeds or is lower than that stipulated inPharmacopoeia of the People's Republic of China(National Pharmacopoeia Commission;2015.06).For example,the dosage of Ginseng in the decoction for"Invigorating spleen and stomach","Purging Yin Fire and rising Yang Qi"is seven qian,which is roughly 28～28.91 g after conversion.The dosage of ginseng in BYD is three fen,which is roughly 1.2～1.29 g.There is a large difference in the usage of 3～9 g of Ginseng as stipulated inPharmacopoeiaof the People's Republic of China.

According to the records of the official compilation ofTaiping Huimin Mixture Bureau Prescription(Prescription Of Peaceful Benevolent Dispensary;1078 C.E.)in the Song Dynasty,"two and a half qian were one fen" and "four fen were one liang",that is,1 liang(Small System)=4 fen(Small System),1 fen(Small System)=2.5 qian(Small System).It can be seen that "qian" and "fen" in the small system are different from those in the large system,and "fen" are larger than "qian" in the small system.Wang Haogu once quoted Li Dongyuan's academic psychology of medication inTangye Materia Medica,explaining that 2 Liang(Small System)yuan(Large System),and after conversion,1 Liang(Small System)is about 13～13.42 g,1 fen(Small System)is about 3.25～3.36 g,and 1 qian(Small System)is about 1.3～1.34 g.According to the dosage of small system,the dosage of most medicinal materials in"Treatise on Spleen and Stomach"basically meets the requirements ofPharmacopoeia of the People's Republic of China.There is not much difference between modern drug dosage and actual dosage in clinical work.

However,according to ancient Chinese doctors' habit of recording drug doses,the larger unit is usually written before and the smaller unit is written after.According to the records in"Treatise on Spleen and Stomach",adding and subtracting Pingwei Powder's "Jupi(Citri Reticulatae Pericarpium)three liang and two qian for each of the above" and Huoxiang Anwei powder's"Ginseng for two qian and five fen for each of the above",it can be seen that when "liang" and "qian" are the same drug dosage mark,"liang" is greater than "qian";when "qian" and "fen" are marked with the same dosage of medicinal materials,"qian"is greater than"fen".

Based on the above data and literature,we can draw a conclusion:when recording the dosage of prescriptions in"Treatise on Spleen and Stomach",there is a situation that both large and small systems are used together.Therefore,when selecting prescriptions in"Treatise on Spleen and Stomach"clinically,it is necessary to distinguish whether the dosage of drugs in this prescription belongs to large or small system,and choose drugs according to the actual situation of patients and relevant notes in"Treatise on Spleen and Stomach".

Processing method of Ginseng prescription in "Treatise on Spleen and Stomach"

Of the 27 prescriptions containing Ginseng,14 were marked as "Fuju"(Bite up the medicine with your mouth so it can be taken.)and decoction with water,namely,Nourishes the spleen and stomach Purging Yin Fire Shengyang Yiwei Decoction,Tongqi Fangfeng Decoction,BYD,Huangqi Renshen Soup,Qingshuyiqi Decoction,Banxia Baizhu Tianma Decoction,Renshen Shaoyao Decoction,Mahuang Renshen Shaoyao Decoction,Qinggan Decoction,Yiwei Decoction,Shengyang Sanhuo Decoction,Shengjiang and Chinese Decoction,Qiangwei Decoction."Treatise on Spleen and Stomach" records the usage of Tongqi Fangfeng Decoction:"Fuju,two cups of water,fry until one cup,remove the residue,take it warm,and take it after eating.The original meaning of "Fuju" is "chewing the medicine with your mouth in order to take it apart for processing decoction".Later,with the development of traditional Chinese medicine appliances,drugs are generally sliced,mashed or filed with corresponding tools,but the word"Fuju"is still used to refer to this process.

"Treatise on Spleen and Stomach"has special terms when it records "File into powder".For example,it is recorded that the taking method of Dingxiang Zhuyu Soup is "File the above herbs into powder",and file the medicinal materials used to make Wenwei Decoction into a very fine powder.Therefore,it is speculated that "Fuju" in "Treatise on Spleen and Stomach"refers more to mashing or slicing drugs.Take the relevant decoction,"Treatise on Spleen and Stomach" has "Administered warm",such as Tongqi Fangfeng Decoction.

Therapeutic methods with Ginseng

Sweet temperature heat removal Method

The Sweet Temperature Heat Removal Method initiated by Li Dongyuan refers to the treatment of Deficiency-heat symptoms with a large amount of Sweet-warm and Yang-invigorating drugs,such as Ginseng and Gancao(Glycyrrhizae radix et rhizoma),combined with a small amount of Sweet-cool antipyretic drugs,such as Chaihu(Bupleuri radix)and Shengma(Cimicifugae rhizoma).According to the theoretical system of modern traditional Chinese medicine,Ganwen Chudare Method is a counter-treatment method to treat deficiency heat symptom,which belongs to the category of"Heat treated with warm".

Li Dongyuan realized that the symptoms of spleen stomach Qi Deficiency and heat are roughly the same as those of exogenous wind cold syndrome,but the etiology and pathogenesis are different.The former belongs to the fever caused by internal injuries caused by positive deficiency-disease,and the spleen and stomach should be supplemented by tonifying methods.The latter belongs to exogenous fever caused by excessive pathogenic factors,which should be eliminated by Dispelling Evil Method.According to the difference of etiology and pathogenesis between them,Li Dongyuan believes that to treat Deficiency-heat caused by spleen-stomach weakness,bitter-cold drugs should be avoided to prevent further damage to spleen and stomach,and sweet-warm drugs should be used to make up for its deficiency.

Etiology,pathogenesis and therapeutic principle of diseases treated by Ganwen Chudare Method.According to the relevant discussions in the theory of the spleen and stomach,combined with the views of modern scholars,the etiology and pathogenesis of the deficiency heat disease treated by the sweet and warm heat removal method are mainly as follows:improper diet,loss of labor,internal injury of seven emotions and other internal injury etiologies lead to the deficiency of the spleen and stomach or the loss of vitality,resulting in the inability of the spleen and stomach to transport water and valley,so it is difficult to play the role of the lifting center,the Upper Energizer(One of the three and is the upper part of the Sanjiao.Generally refers to the chest above the diaphragm,including the heart,lungs and throat.)is unable to work,the Lower Energizer(One of the three and is the lower part of the Sanjiao.Generally refers to the Large intestine and anus,etc.)is blocked,and the human body is prone to high Qi with cough and diarrhea.

According to the abnormal change law of the Five Elements(metal,wood,water,fire and earth,held by the ancients to compose the physical universe and later used in TCM to explain various physiological and pathological phenomena.),when the spleen and stomach are weak,the spleen and soil are insufficient,and the Heart Fire is out of position,which turns into endogenous Yin Fire,and the human body is prone to symptoms such as thirst,fatigue and weakness of limbs.When the Heart Fire is out of position,it rushes up from the Lower Energizer and invades the lungs,which easily leads to Lung Qi Deficiency.The human body is prone to symptoms such as Qi deficiency,polydipsia and cough.If it influences the head and face,it will easily lead to headache.At the same time,when the Heart Fire is out of position,it can't restrict the fire enveloped by the Lower Energizer,causing it to invade the whole body along the meridians of spleen and stomach,resulting in pulse conditions of Deficiency-heat syndrome,such as bounding pulse and rapid pulse.The Fire of the lower energizer envelope will damage vitality,which aggravate the spleen-stomach Qi Deficiency syndrome[6].

The pathogenesis of Sweet-warm Heat Removing Method is mainly Qi-deficiency and fever,which mainly refers to the insufficiency of Qi-deficiency and decline of spleen and stomach,and it is difficult to normally raise and Clear Qi(It refers to the refined substances produced by the transport of spleen and stomach.)and reduce Turbid Qi(It refers to the thick part of the diet essence,also refers to the human body exhaled turbid gas and exhaust vector gas,etc.),which leads to the abnormal transportation of dietary Mizutani(food and water),deposition of the middle energizer(One of the three and is the lower part of the Sanjiao),gradual transformation into pathological products,including phlegm retention,blood stasis,and food accumulation,etc.,and stagnation and stagnation become hot.According to the pathogenesis of fever due to Qi deficiency,the method of warming and removing heat mainly uses Ginseng,Huangqi(Astragali radix),Gancao(Glycyrrhizae radix et rhizoma),etc.to tonify the Qi of human body,raise Yang Qi(Qi is divided into Yang Qi and Yin Qi.Opposite to Yin Qi,Yang Qi is external,upward,hyperactive and enhanced Qi.),and use Huangqi,Gancao,etc.to reach the meridians of human body,so as to make Qi pass through normally,relieve stagnation,and dissipate heat.

Buzhong Yiqi Decoction.As a representative prescription of sweet-warm heat removing method,Li Dongyuan used Ginseng for compatibility when he created BYD.According to the notes on compatible drugs in BYD in"Treatise on Spleen and Stomach",Ginseng,Huangqi and Gancao in the prescription are "the holy drugs for eliminating damp-heat and vexing heat",which have remarkable efficacy in treating Deficiency-heat diseases of human body.At the same time,different from other prescriptions for invigorating the spleen,BYD has the efficacy of reinforcing Yang,that is,lifting the Middle Qi(the Qi in spleen and stomach),restoring or maintaining the normal physiological function of "Spleen controlling ascending the clear",and ensuring the normal transportation and dispersion of Mizutani and Subtle(nutrition).

According to records of BYD in"Treatise on Spleen and Stomach",the unit of drug dosage is "fen",and combined with the prescribed amount of related drugs inPharmacopoeia of the People's Republic of China,it is inferred that the drug weighing system of BYD adopts a small system.So the dosage of Huangqi is roughly 16.25～16.8 g and that of Ginseng is 9.75～10.08 g.(Table 2).

Table 2 composition and dosage of Buzhong Yiqi Decoction

Qi deficiency caused by internal injury to the spleen and stomach will make Wei Qi(In the body surface of the Qi,mainly refers to the defense of the immune system and the elimination of foreign body endogenous function.)unable to gather normally,float on the surface of the human body,show the symptoms of spontaneous sweating,further consume vitality,play a warm role on the surface,and finally lead to fever on the surface of the human body,resulting in the symptoms of external heat and internal cold.

BYD takes Huangqi as the monarch drug,which focuses on tonifying Lung Qi,Secure the exterior(strengthen the protective function of the body),keeping Positive Qi and relieving spontaneous sweating symptoms.Ginseng has the effect of invigorating Qi[7].In this prescription,as a ministerial drug,it focuses on invigorating Yuan Qi and Middle Qi.On the one hand,Ginseng can restore the normal physiological activities of viscera,and orifices,and on the other hand,it can restore the spleen and stomach Qi to rise and clear and lower turbidity normally,thus fundamentally treating deficiency-heat caused by Qi deficiency.

Yiqi Quxie Method

Yiqi Quxie Method follows the therapeutic principle of "Surport Healthy Energy(build bodies)and liminating Evil(cure disease)",which is a method used by Li Dongyuan to treat diseases caused by insufficient internal injuries and invasion of human body by external evils."Yi Qi" in the method of invigorating Qi and eliminating pathogenic factors can not only be used to tonify the deficiency of human body,but also be understood as helping the Positive Qi of human body,that is,enhancing the body's ability to resist and prevent diseases.It can be seen that,Yiqi Quxie Method refers to a therapeutic method that can eliminate exogenous pathogens,restore human health and normal physiological activities by supplementing deficient Qi of human body,such as Yuan Qi,Qi of organs and meridians,or enhancing the ability of preventing diseases.

Li Dongyuan is good at using the Tonifying Method,which not only helps the human body to be deficient,but also helps the human body to be healthy and get rid of diseases and pathogens.At the same time,he is good at using tonics[1].Ginseng,Huangqi,Baizhu(Atractylodis macrocephalae rhizoma),Gancao,etc.are often used in the prescriptions recorded inT"Treatise on Spleen and Stomach"to tonify the spleen and lung.Therefore,as the most commonly used treatment method in Li Dongyuan,Yiqi Quxie Method is widely used in the prescriptions of"Treatise on Spleen and Stomach".

Etiology,pathogenesis and therapeutic principle of diseases treated by Yiqi Quxie Method.The causes of diseases treated by Yiqi Quxie Method arenot limited to internal and external causes,but are caused by internal injuries,external causes and even secondary causes.The etiology and pathogenesis of this kind of diseases are:emotional disorder,loss of work and rest,improper diet and other internal injuries,which lead to the damage of viscera,shape,quality,organs and orifices and the loss of Jing （Constitut e the basic substance of the human body,also one of the material basis of functional activities),Qi,blood and body fluid.Or pathological products such as blood stasis,Shuishi(wet),Tanyin(phlegm retention),Jieshi(calculi),etc.,which originally existed in the human body,blocked the movement of Qi,blood and body fluid,interfered with the normal physiological functions of viscera,led to the deficiency of Zheng Qi(General term for human body function,and usually as opposed to pathogenic,refers to the body's ability to resist disease.),decreased disease resistance and disease prevention ability,and made it difficult to resist external evil,which caused external causes such as wind,cold,heat,dampness,dryness,Fire(heat)Six Evils(abnormal wind,cold,heat,humidity,dryness,fire)or furuncle to invade the human body and eventually led to diseases.Therefore,the occurrence of this kind of diseases belongs to"excess resulted from deficiency"pathogenesis.

Mahuang Renshen Shaoyao Decoction.Prescriptions in"Treatise on Spleen and Stomach",such as Huangqi Renshen Decoction,Qingshu Yiqi Decoction and Tiaozhong Yiqi Decoction,all use Yiqi Quxie Method,among which Mahuang Renshen Shaoyao Decoction is representative.Mahuang Renshen Shaoyao Decoction selects qi-tonifying drugs such as Ginseng and Gancao.

"Treatise on Spleen and Stomach"records Mahuang-renshen-shaoyao Decoction,using "qian" and "fen" at the same time.Ginseng and Maidong(Ophiopogonis radix)are measured by "fen" and Rougui(Cinnamomi cortex)and Danggui(Angelicae sinensis radix)are measured by "qian".According to the calculation of the drug dosage of the prescription according to the large-scale system,the dosage of Ginseng and Maidong is 1.2～1.239 g,and the dosage of Guizhi(Cinnamomi ramulus)and Danggui is 2～2.065 g,which is significantly lower than the specified amount of relevant drugs inPharmacopoeia of the people's Republic of China;According to the calculation of the drug dosage of the formula according to the small-scale system,the dosage of Mahuang(Ephedrae herba),Zhigancao(Glycyrrhizae radix et rhizoma praeparata cum melle),Baishao(Paeoniae radix alba)and Huangqi is 1.32～1.34 g,which is also lower than the specified amount.

Therefore,it is inferred that when recording Mahuang Renshen Shaoyao Decoction in"Treatise on Spleen and Stomach",large-scale "qian" and small-scale "fen" were used.And the dosage of Ginseng and Maidong was 9.75～10.08 g,the dosage of Guizhi and Danggui is 16.25～16.80 g,and the dosage of Mahuang,Zhigancao,Baishao and Huangqi is 4.0～4.13 g,which basically meets the corresponding drug requirements.

"Treatise on Spleen and Stomach"discusses the efficacy and application of Mahuang-renshen-shaoyao Decoction through medical record.According to the records,the etiology and pathogenesis of the disease treated by this prescription are as follows:Yang-deficiency(The pathological phenomenon of Yang Qi deficiency and decline.Yang Qi has the function of warming limbs and viscera.Yang deficiency mostly has Qi deficiency symptoms and cold symptoms.The symptoms include fear of cold and cold limbs,liking to eat hot drinks,low body temperature,pale complexion,thin stools,clear and long urination,heavy and weak pulse,etc)in human body,decline of vitality deficiency,causing cold evil to accumulate on the body surface,invading human body,interfering with the normal operation of human Qi and Blood,so that the heat is endogenous,leading to symptoms of external cold and internal heat.

According to the dosage of drugs and the treatment of diseases,Mahuang Renshen Shaoyao decoction takes Mahuang as the monarch drug,which is used for sweating,relieving exterior syndrome and dispelling external cold.However,"Treatise on Spleen and Stomach",when annotating the drug action in this prescription,said that Ginseng "benefits the deficiency of vitality in the Triple Energizers(A unique term in the theory of Traditional Chinese medicine,one of the six fu organs,located between the body and the viscera cavity,including the chest and abdominal cavity,the other organs of the human body are in it.)and deficiency of body surface".The triple energizers have vital energy,and the vital energy can maintain the normal physiological activities of viscera,meridians,body and organs.Therefore,Li Dongyuan can make use of the effect of Ginseng to replenish vitality,so as to replenish the body surface deficiency,enhance the body's ability to resist pathogenic factors,and prevent the recurrence of diseases on the basis of eliminating pathogenic factors.

Conclusion

Ginseng is a herb with a long history in China[7].Up to now,there are still many pharmacological studies on Ginseng to expand its application range.As an ancient medical book,"Treatise on Spleen and Stomach"has many unique features in the application of Ginseng.But because of the age,the system of weights and measures,terminology and theoretical system in"Treatise on Spleen and Stomach"are quite different from modern traditional chinese medicine's theoretical system.Therefore,in the process of discussing the application of Ginseng efficacy,some controversial issues in"Treatise on Spleen and Stomach"are also analyzed,hoping to provide experience for clinical application of Ginseng and research on"Treatise on Spleen and Stomach".