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KMID : 1149220030110020001
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Korean Journal of Oriental Medical Prescription
2003 Volume.11 No. 2 p.1 ~ p.18
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Standard Principles for the Designing of Prescriptions - The Theory for Monarch, Minister, Adjuvant and Dispatcher
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Kim Do-Hoy
Seo Bu-Il
Kim Bo-Kyung
Kim Gyeong-Cheol
Shin Soon-Shik
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Abstract
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The Theory for Monarch, Minister, Adjuvant and Dispatcher (or the Theory of Principal, Assistant, Adjuvant and Guiding Korean Oriental Herbal Medicines) has served as a standard principle for newly developed prescription formulas as well as established ones. Despite its significance, however, this theory hasn’t been thoroughly studied and covered in the academic journals of Korean Oriental Herbal Medicines (KOHM) yet. This paper inquires into the origin of the theory while presenting the definitions and functions of Principal, Assistant, Adjuvant, and Guiding KOHM. In the end, the recommended doses and number of the KOHM comprising each of Principal, Assistant, Adjuvant, and Guiding KOHM are suggested. The compatibility theory of Principal, Assistant, Adjuvant, and Guiding KOHM can be traced back to the Warring States Period during which it was recorded in the treatise of the various schools of thoughts and their exponents. The theory was firmly established as a full system in Shinnong. While Shinnong focuses on the classification of the properties of KOHM, Yellow Emperor mainly deals with the principles for writing prescriptions. In this regard, it is Yellow Emperor that systemized the Theory of Principal, Assistant, Adjuvant, and Guiding KOHM in a real sense. Principal KOHM aims at the causes of diseases and treat main symptoms. The doses are greater than Assistant, Adjuvant and Guiding KOHM. With their comprehensive effects, Principal KOHM is a leading ingredient of any prescription formula. Assistant KOHM are similar to Principal KOHM in its natures and flavors. Although its natures, flavors as well as efficacies may slightly differ from those of Principal KOHM, Assistant KOHM strengthens the therapeutic effects, jointly working with Principal KOHM. They mainly treat accompanying diseases and symptoms. Adjuvant KOHM is divided into two types: facilitator and inhibitor. Facilitators with the similar properties to those of Principal and Assistant KOHM help strengthen the therapeutic effects. Since they usually treat accompanying symptoms or secondary accompanying symptoms (minor accompanying symptoms), there are two kinds of facilitators. (1) The first kind of facilitators assists Principal KOHM, targeting accompanying symptoms. (2) The second ones supporting Assistant KOHM are for accompanying or secondary accompanying symptoms (or minor accompanying symptoms). Inhibitors counteract and thereby complement Principal and Assistant KOHM. Some of them inhibit the side effects or toxicity of Principal KOHM for the sake of the safety of the whole prescription formula while the others generate induced interactions. Guiding KOHM can be used for two purposes: guiding and mediating. The Guiding KOHM for the former purpose leads the other KOHM in a prescription formula to the lesion. But, the Guiding KOHM for mediating coodinate and harmonize all the ingredients in a prescription formula. The number of KOHM for those Principal, Assistant, Adjuvant and Guiding KOHM and their doses are different, depending on the types of prescriptions: classical prescriptions, prescriptions after Treatise of Cold-Induced Diseases and prescriptions of Sasang Constitutions Medicines. In the case of the prescriptions after Treatise of Cold-Induced Diseases, it is highly recommended to follow the view of Thesaurus of Korean Oriental Medicine Doctors in Chosun Dynasty for the number of KOHM to be used. For the doses, however, Elementary Course for Medicine, is found to be more accurate. The most appropriate number of KOHM per prescription is 11-13. To be more specific, for one prescription formula, it is recommended to administer one kind of KOHM for Principal KOHM, 2-3 for Assistant KOHM, 3-4 for Adjuvant KOHM and 5 for Guiding KOHM. As for the proportion of the doses, when 10 units are to be administered for Principal KOHM in a formula, the doses for the other three should be 7-8 units for Assistant KOHM, 5-6 for Adjuvant KOHM and 3-4 for Guiding KOHM. The doses of the KOHM added to or taken out of the prescription correspond to those of Adjuvant and Guiding KOHM.
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KEYWORD
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Theory for Monarch, Minister, Adjuvant and Dispatcher, Principal KOHM, Assistant KOHM, Adjuvant KOHM, Guiding KOHM, number of KOHM, dose of KOHM
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