瘕积聚,随气血以分门。故方云,以 瘕属肝部,积聚属肺部,不亦明矣。况
七者火数,属心,盖血生于心;八者木数,属肝,盖血归于肝。虽曰强分,理似不混。夫
者,坚也,坚则难破;瘕者,假也,假物成形。然七 八瘕之名,经论亦不详出
,虽有蛟龙、鱼、鳖、肉、发、虱、米等七证,初非定名,偶因食物相感而致患耳。若妇人
七八瘕,则由内外不内外因动伤五脏气血而成。古人将妇人病为痼疾,以蛟龙等为生
瘕,然亦不必如此执泥。妇人 瘕,并属血病,龙蛇鱼鳖等,事皆出偶然,但饮食间,
误中之,留聚腹脏,假血而成,自有活性。亦犹永徽中僧病噎者,腹有一物,其状如鱼,即
生瘕也。与夫宿血停凝,结为痞块,虽内外所感之不同,治法当以类相从。所谓医者,意也
,如以败梳治虱瘕,铜屑治龙瘕,曲 治米瘕,锻石治发瘕,如此等类,方论至多,不
复繁引,学人可以理解。
治七 八瘕,聚结痞块;及妇人带下绝产,并欲服丹药,腹中有 瘕
者,当先下之。此药但去 瘕,不令人困。
硝石(六两) 大黄(八两) 人参 甘草(各三两)
上为末,以三年苦酒三升,置铜器中,以竹作准,每一升作一刻,拄器中,纳大黄,常
搅不息,使微沸,尽一刻,乃纳余药;又尽一刻,极微火熬,使可丸,则丸如鸡子中黄;若
不能服大丸,则作小丸如梧子大。米汤下三十丸,四日一服。妇人服之,或下如鸡肝,或如
米泔,正赤黑等三二升。下后忌风冷,自养如产妇。
Zheng (masses) and Ju (gatherings) are classified according to the differentiation of Qi and Blood. Therefore, medical formulas state that Zheng belongs to the Liver region, while Ju belongs to the Lung region; is this not clear? Moreover, "seven" is the number of Fire, belonging to the Heart, because Blood is generated by the Heart; "eight" is the number of Wood, belonging to the Liver, because Blood returns to the Liver. Although it is said to be a forced distinction, the principles seem not to be mixed up. The term "Zheng" means hard; being hard, it is difficult to break. The term "Jia" means false or temporary; it takes form by borrowing external substances. However, regarding the names of the Seven Jia and Eight Jia (Seven Types of Jia and Eight Types of Jia), classical treatises do not list them in detail. Although there are seven conditions named after dragon, fish, turtle, meat, hair, louse, and rice, these were not originally fixed names but rather accidental ailments caused by the interaction of food items. If women suffer from the Seven Jia and Eight Jia, it is formed due to internal causes, external causes, and non-internal/non-external causes damaging the Qi and Blood of the Five Zang Organs. Ancient people regarded women's diseases as stubborn illnesses and considered dragons etc. as the origin of generating Jia, yet one need not be so rigid in such beliefs. Women's Zheng and Jia all belong to Blood diseases. The stories of dragons, snakes, fish, and turtles are merely coincidental; they are accidentally ingested during eating, remain aggregated in the abdominal viscera, take shape by borrowing Blood, and possess their own vitality. This is similar to a monk in the Yonghui era of Emperor Gaozong who suffered from Yige (dysphagia/choking sensation); there was an object in his abdomen shaped like a fish, which constituted a Sheng Jia (living Jia). Although the internal and external factors causing it differ from those causing old Blood to stagnate and coagulate into a Pi Kuai (obstructive mass), the treatment methods should follow similar principles. It is said that a physician relies on intuition (Yi). For example, using a worn comb to treat Louse Jia, copper filings to treat Dragon Jia, Qu (fermented grain starter) to treat Rice Jia, and Duan Shi (calcined iron ore) to treat Hair Jia. There are many such examples in formula discussions, which will not be cited exhaustively here; students can understand this by analogy.
To treat the Seven Jia and Eight Jia, gathered obstructive masses; as well as women suffering from Dai Xia (leukorrhea) leading to infertility, and those who wish to take Dan Yao (alchemy pills) but have Zheng Jia in the abdomen, one should first use a purgative method to drain them. This medicine only removes Zheng Jia without causing physical exhaustion.
Xiao Shi (Natrii Nitras, Saltpeter) (6 liang) Da Huang (Rhei Radix et Rhizoma, Rhubarb) (8 liang) Ren Shen (Ginseng Radix, Ginseng Root) Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root) (each 3 liang)
Grind the above ingredients into powder. Place three sheng of aged vinegar (three years old) in a copper vessel. Use a bamboo stick with markings as a gauge: each mark represents one ke (a traditional unit of time/measure). Insert the bamboo into the vessel to measure depth. Add Da Huang, stir constantly without stopping until it boils slightly. Wait for one ke, then add the remaining medicines. Wait another ke, simmer over very low heat until the mixture can be formed into pills. The pills should be the size of a chicken egg yolk. If large pills cannot be taken, make small pills the size of wu zi (seeds of Chorisia speciosa). Take thirty pills with Mi Tang (rice soup), once every four days. After women take this medicine, they may pass excrement resembling chicken liver, rice water, or dark red-black substance, totaling two to three sheng. After defecation, avoid wind and cold. Self-care should be conducted as if one were a postpartum woman.