Evolution and Medicine-using Analysis of Eighteen Incompatible Medicaments in TCM
中药十八反配伍禁忌的历史沿革与用药分析

Clinical Chinese medical practitioners at all times considered eighteen incompatible medicaments as incompatibility, which would lead to toxicity. However, the tradition to utilize eighteen incompatible medicaments for remedying human disease has been passed down from one generation to another. In this paper, based on the historical development of eighteen incompatible medicaments and analysis of its application in formulae, we found that the formulae in Veratrum group reached the heap in Song and Yuan Dynasties, while, the formulae in Glycyrrhiza and Aconitum group were at most in Ming and Qing Dynasties, but they all gradually disappeared since the 20th century. It is also informed that the formulae containing eighteen incompatible medicaments for external use are more than others, and the number of medicines used in these formulae was higher, usually 8 to 9. Therefore, the eighteen incompatible medicaments which are closely related to toxic medicines is a conditional incompatibility such as different pathophysiologic conditions, variation in ratio and dose, different administration routes and application with other medicines. The clarification of the toxicity mechanism for the eighteen incompatible medicaments would offer scientific support for safe medicine utilization in clinical practice, help to promote the development of TCM property theories and TCM formulae compatibility rules, and provide reference for the research about other incompatibility theory.