舒郁丸 治一切郁症。
香附 枳实 苍术(各三两) 沉香(一两五钱) 宿砂 山栀仁 抚芎 红曲 半夏(各
上为末水丸。每服三钱。空心白滚汤下。
气郁。加乌药。木香。槟榔。干姜。枳壳。桔梗。
湿郁。加白术。白芷。赤茯苓。木通。苍术。
痰郁。加南星。海石。栝蒌仁。枳壳。桔梗。小皂荚。
热郁。加黄连。青黛。连翘。山栀。
血郁。加桃仁。红花。丹皮。当归。韭汁。
食郁。加山楂。麦芽。神曲。伤冷食胃脘痛。加草豆蔻。干姜。如春加防风。夏加苦参
。秋冬加吴茱萸。
诸痛之症。种种不同。其患有周身骨节肩背手臂项脊腰肋。心膻小腹之殊。其致痰
之由。有风寒湿热燥火。痰血积气之异。如周身遍体。无所不痛者。此有火或饮酒之人。素有湿
痰停积于内。又为风寒邪气所侵。以至痰不能周流疏利。留蓄于经络关节之间日久凝滞不散
。郁于肩背项脊。腰肋手臂等处。不肿则痛。须令人按之摩之。则热气至而痛止。故今之背
痛者。痰滞也。必捶打千百。而后散可知矣。不然则为痰。为涎为饮三者之症。盖湿邪上浮
于肺。随气壅嗽。发动则名为痰。湿邪聚于脾。随气溢于口。气流出不禁。则名曰涎。至于
胃为湿邪所乘。而为吐。为呕。为哕。则名曰饮。此又不可不察。然大要以胜湿消痰。顺气
和血养脾为主。外此又有饮食之后。为冷气所伤。而发热身痛。此伤食身痛也。宜消导之。
六脉浮紧。鼻塞身重头痛气粗。发热身痛者。此伤寒伤风身痛也。宜解表之。如病后汗下而
身痛者。此气血虚也。宜调补之。至于头痛头风。以发散为主。心痛即胃脘痛。有旧疾有客
寒。有积痰以开郁化痰为主。其腹痛腰胁痛宜温经散寒。热湿为要。若饮食过多。内伤脾气
者。宜消导之。又如小便作痛者。须问小便利不利。小便利者是蓄血。小便不利者。是溺涩
。有卒然大痛者。是感寒时痛时止者。是火。若妇人小腹为冲任之海。一遇寒冷则血气凝
结。为之击搏而作痛。得温暖则气和通。而痛自止。又有胞络之间。阴户之中。为房事所伤
。或外寒郁遏亦能作痛。臀尖尽处。又有所谓尻骨痛有痰有血虚死血不同。学人宜详审之
Shuyu Wan (Soothe Depression Pill): Treats various types of Yu Syndrome (Depression Syndrome).
Ingredients: Xiangfu (Cyperi Rhizoma), Zhishi (Aurantii Fructus Immaturus), Cangzhu (Atractylodis Rhizoma) (each 3 liang); Chenxiang (Aquilariae Lignum Resinatum) (1.5 liang); Susharen (Amomi Fructus Rotundus), Shanzhiren (Gardeniae Semen), Fuxiong (Ligusticum Chuanxiong Radix), Hongqu (Monascus Purpureus Rice), Banxia (Pinelliae Rhizoma Preparatum) (each [amount unspecified in text, implied equal parts or as needed]).
Preparation and Administration: Grind the above ingredients into fine powder and make water pills. Take 3 qian per dose. Swallow with plain boiled water on an empty stomach.
For Qi Depression (Qi Stagnation): Add Wuyao (Linderae Radix), Muxiang (Aucklandiae Radix), Binglang (Arecae Semen), Ganjiang (Zingiberis Rhizoma), Zhike (Aurantii Fructus), Jiegeng (Platycodonis Radix).
For Dampness Depression (Damp Stagnation): Add Baizhu (Atractylodis Macrocephalae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Chifuling (Poria cum Ramis et Ligno Rubra), Mutong (Akebiae Caulis), Cangzhu (Atractylodis Rhizoma).
For Phlegm Depression (Phlegm Stagnation): Add Nanting (Arisaematis Rhizoma Preparatum), Haishi (Fossilia Arthropodi), Gualouren (Trichosanthis Semen), Zhike (Aurantii Fructus), Jiegeng (Platycodonis Radix), Xiaozaojia (Gleditsiae Sinensis Spina).
For Heat Depression (Heat Stagnation): Add Huanglian (Coptidis Rhizoma), Qingdai (Indigo Naturalis), Lianqiao (Forsythiae Fructus), Shanzhi (Gardeniae Fructus).
For Blood Depression (Blood Stagnation): Add Taoren (Persicae Semen), Honghua (Carthami Flos), Danpi (Moutan Cortex), Danggui (Angelicae Sinensis Radix), Jiuji (Allii Tuberosi Juice).
For Food Depression (Food Stagnation): Add Shanzha (Crataegi Fructus), Maiya (Hordei Fructus Germinatus), Shenqu (Massa Medicata Fermentata). If stomach pain is caused by cold food injury, add Caodoukou (Cardamomi Fructus), Ganjiang (Zingiberis Rhizoma); in spring, add Fangfeng (Saposhnikoviae Radix); in summer, add Kushen (Sophorae Flavescentis Radix); in autumn and winter, add Wuzhuyu (Evodiae Fructus).
The symptoms of various pains are diverse. The affected areas vary among the whole body's bones and joints, shoulders, back, arms, neck, spine, waist, ribs, chest (Xinshan), and lower abdomen. The causes for generating phlegm differ due to wind-cold, damp-heat, dryness, fire, as well as differences between phlegm, blood stasis, accumulated qi, and qi stagnation. If pain is widespread throughout the entire body, it usually indicates the presence of Fire pathogen, or that the patient is a drinker who has had damp-phlegm accumulation internally for a long time, and is now invaded by wind-cold pathogens. This prevents the phlegm from circulating freely, causing it to accumulate in the meridians and joints. Over time, it condenses and stagnates without dispersing. It becomes depressed in the shoulders, back, neck, spine, waist, ribs, and arms. If there is no swelling, there is pain. One must massage and beat the area so that heat reaches the site, and the pain will stop. Therefore, current cases of back pain are mostly due to phlegm stagnation; it is evident that they require hundreds or thousands of beats before the stagnation can disperse. Otherwise, one must distinguish between three conditions: Phlegm (Tan), Saliva (Xian), and Fluid Retention (Yin). When Dampness pathogen floats up to the Lung, obstructing Qi and causing cough, when it manifests, it is called Phlegm. When Dampness gathers in the Spleen, overflows to the mouth with Qi, and flows out uncontrollably, it is called Saliva. When the Stomach is attacked by Dampness, resulting in vomiting, retching, or hiccups, it is called Fluid Retention. These distinctions must not be overlooked. However, the general principle is to overcome dampness, eliminate phlegm, regulate Qi, harmonize Blood, and nourish the Spleen.
Furthermore, after eating, if injured by cold Qi leading to fever and body pain, this is Body Pain due to Food Injury, and should be treated with digestion-promoting methods. If the six pulses are floating and tight, accompanied by nasal congestion, heavy body, headache, coarse breathing, fever, and body pain, this is Body Pain due to Cold Damage (Shanghan) or Wind Strike (Shangfeng), and should be treated with exterior-releasing methods. If body pain occurs after sweating or purging during illness, this is due to Qi and Blood deficiency, and should be treated with regulation and tonification. For headache and Head Wind (Toufeng), the primary method is dispersion. Heart pain is equivalent to Epigastric Pain; whether due to old diseases, new external cold invasion, or accumulated phlegm, the primary method is to open depression and resolve phlegm. Abdominal pain and waist/rib pain should be treated with warming meridians and dispelling cold, focusing on clearing heat and removing dampness. If excessive diet injures the Spleen Qi internally, use digestion-promoting methods. Regarding painful urination, one must ask if urination is smooth or difficult. Smooth urination indicates Blood Stasis (Xuexu); difficult urination indicates Urinary Difficulty (Niao Se). Sudden severe pain indicates Cold pathogen invasion; intermittent pain indicates Fire pathogen. In women, the lower abdomen is the Sea of Chong and Ren meridians. Upon exposure to cold, Qi and Blood coagulate and strike each other, causing pain. With warmth, Qi harmonizes and flows, and pain stops naturally. Additionally, injuries from sexual intercourse in the Bao Luo (uterine network) and Yin Hu (vaginal opening), or external cold suppression, can also cause pain. At the very end of the buttocks, there is what is called Kaogu Pain (coccygeal pain), which differs based on phlegm obstruction, Blood deficiency, or Dead Blood (severe stasis). Students should examine these details carefully.