感之热结可以寒下，久积之寒结亦可寒下乎？是以备急等法所由设也。然此仅可治寒实之
结，设其人禀质素虚，虽有实邪固结，敢用刚猛峻剂攻击之乎？故仲景又立附子泻心汤，
用芩、连佐大黄以法膈上之热痞，即兼附子之温以散之；大黄附子汤用细辛佐附子，以
攻胁下寒结，即兼大黄之寒以导之。寒热合用，温攻并施，此圣法昭然，不可思议者也。
越鞠汤丸 治一切湿痰食火，气血诸郁。
香附 苍术 抚芎 神曲 山栀仁
水煎服，或作丸。
【注】夫人以气为本，气和则上下不失其度，营运不停其机，病从何生？若饮食不节，
寒温不适，喜怒无常，忧思元度，使冲和之气升降失常，以致胃郁不思饮食，脾郁不消
水谷，气郁胸腹胀满，血郁胸膈刺痛，湿郁痰饮，火郁为热，及呕吐恶心，吞酸吐酸，嘈
杂嗳气，百病丛生。故用香附以开气郁，苍术以除湿郁，抚芎以行血郁，山栀以清火郁，
神曲以消食郁。此朱震亨因五郁之法，而变
通者也。五药相须，共收五郁之效。然当问何郁病甚，盒饭以何药为主？至若气虚加人
参，气痛加木香，郁甚加郁金，懒食加谷 ，胀加浓朴，痞加枳实，呕痰加姜、夏，火盛
加萸、连，则又存乎临证者之详审也。
四磨饮 治七情感伤，上气喘急，胸膈不快，妨闷不食。
人参 槟榔 沉香 天台乌药
上四味，各浓磨水取七分，煎三五沸，放温，空心服。
【集注】王又原曰∶经云∶圣人啬气如持至宝，庸人役物而反伤太和，此七情随所感
皆能为病。然壮者气行而愈，弱者气着为病。愚者不察，一遇上气喘急，满闷不食，谓是
实者宜泻，辄投破耗等药，得药非不暂快，初投之而应，投之久而不应矣。夫呼出为阳，吸
入为阴，肺阳清肃，则气下行；肾阴宁谧，则气归摄，不复散而上逆矣。若正气既衰，即
欲削坚破滞，则邪气难伏，法当用人参先补正气，沉香纳之于肾，而后以槟榔、乌药从
而导之，所谓实必顾虚，泻必先补也。四品气味俱浓，磨则取其气味俱足，煎则取其气
味纯和，气味齐到，效如桴鼓矣。
备急丸 治寒气冷食稽留胃中，心腹满痛，大便不通者。
大黄（二两） 干姜（二两） 巴豆（去皮，研如脂，一两）
先捣大黄、干姜为末，内巴豆合捣千杵，和蜜丸，如豆大，藏密器中，勿泄气，候用。
每服三四丸，暖水或酒下。
《金匮》主中恶心腹胀满，卒痛如锥刺，气急口噤如卒死者，捧头起，灌令下咽，须
臾当差，不差更与三丸，当腹中鸣，即吐利便差。若口噤者，须化开，从鼻孔用苇管吹入，自下于咽。
【集注】柯琴曰∶大便不通，当分阳结阴结。阳结有承气、更衣之剂，阴结又制备急、
白散之方。《金匮》用此治中恶，当知寒邪卒中者宜之。若用于温暑热邪，速其死矣。是
方允为阴结者立，干姜散中焦寒邪，巴豆逐肠胃冷积，大黄通地道，又能解巴豆毒，是
有制之师也。然白散治寒结在胸，故用桔梗佐巴豆，用吐下两解法。此则治寒结肠胃，故
用大黄佐姜、巴，以直攻其寒。世徒知有温补之法，而不知有温下之法，所以但讲寒虚，不议及寒实也。
【按】世人之情，惟知畏贫，不知畏祸，因其贫遗其祸。病患之情亦多如是，惟知畏
虚，不知畏病，因其虚忘其病。殊不知虚犹贫也，病犹祸也。虚而有病，犹夫贫者有祸
也，去其祸而但贫，犹可安也。实而有病，犹夫富者有祸也，不去其祸，而其富未可保也。
最可笑者，近世之医临诊病家，外饬小心，中存不决。且诿言虚不可攻，纵使病去，正气
难复。病患畏惧，自然乐从，受病浅者幸而自愈，设不愈者，另延医至。讵病者先意难
入，攻病之药尚未入口，众议咻咻，致明通之士，拂袖而去，坐而待毙，终不悟为庸工
之所误也。医者久擅其术，初心原为自全，恬不知耻，久之亦竞以为养病为能，攻病为拙，
而举世之病者，皆昧昧于治病也。尝考孙思邈以仲景麻黄、桂、杏、甘草之还魂汤，治
卒中昏冒，口噤握固；李杲以仲景巴豆、大黄、干姜之备急丸，治卒中暴死，腹痛满闭，
下咽立效。岂二人不知虚实耶？盖上工之医，未诊病时，并不先存意见，亦不生心自全，有
是病但用是药耳。柯琴曰∶备急丸治寒结肠胃，白散治寒结在胸。于此又可知还魂汤治
寒结在胸之表，以散无形之邪气也；白散治寒结在胸之里，以攻有形之痰饮也；备急丸
治寒结在肠胃，以攻不化之糟粕也。
磁朱丸 治神水宽大渐散，昏如雾露中行，渐睹空中有黑花，睹物成二体，及内障，
神水淡绿色、淡白色。又治耳鸣及聋。
磁石（二两） 辰砂（一两） 神曲（生，三两）
更以一两水和作饼，煮浮，入前药，炼蜜为丸。每服十丸，加至三十丸，空心米汤下。
【集注】王又原曰∶五脏六腑之精，皆上注于目，则目之能视者气也，目之所以能视
者精也。肾为藏精，故神水发于肾。心为离照，故神光发于心。光发阳而外映，有阴精
以为守，则不散而常明。水发阴而凝静，有阳气以为布，则洞悉而不穷。惟心肾有亏，致
神水干涸，神光短少，昏 内障诸证所由作也。磁石直入肾经，收散失之神，性能引铁，
吸肺金之气归藏肾水。朱砂体阳而性阴，能纳浮游之火而安神明。水能鉴，火能烛，水
火相济，而光华不四射欤！然目受脏腑之精，精神于谷，神曲能消化五谷，则精易成矣。盖
神水散大，缓则不收，赖镇坠之品，疾收而吸引之，故为救急之剂也。其治耳鸣、耳聋
等证，亦以镇坠之功能治虚阳之奔耳。
柯琴曰∶此丸治癫痈之圣剂。盖狂痴是心、肾、脾三脏之病，心藏神，脾藏意与智，
肾藏精与志。心者神明之主也，主不明则十二官危，使道闭塞而不通，形乃大伤，即此
谓也。然主何以不明也？心法离而属火，真水藏其中，若天一之真水不足，地二之虚火
妄行，所谓天气者蔽塞，地气者冒明，日月明，邪害空窍，故目多妄见而作此奇疾也。
作金石之重剂以镇之，狂必不止。朱砂禀南方之赤色，入通于心，能降无根之火而安神
明。磁石禀北方之黑色，入通于肾，吸肺金之气以生精，坠炎上之火以定志。二石体重
而主降，性寒而凉阴，志同道合，奏功可立俟矣。神曲推陈至新，上交心神，下达肾志、
以生意智。且食入于阴，长气于阳，夺其食则已，此《内经》治狂法也。食消则意智明
而精神治，是用神曲之旨乎？炼蜜和丸，又甘以缓之矣。
石斛夜光丸 治神水宽大渐散，昏如雾露，空中有黑花，及睹物成二，神水淡绿、淡白色者。
天门冬（二两） 菟丝子（七钱） 人参（二两） 茯苓（二两） 甘菊花（七钱）
干山药（七钱） 麦冬（一两） 熟地（一两） 肉苁蓉（五钱） 青葙子（五钱） 生地（一
两） 枸杞（七钱） 羚羊角（镑，五钱） 草决明（八钱）
石斛（七钱） 杏仁（七钱） 蒺藜（五钱） 川芎（五钱）
甘草（炙，五钱） 黄连（五钱） 防风（五钱） 枳壳（五钱）
乌犀（镑，五钱） 牛膝（七钱五分）
上为细末，炼蜜丸，桐子大，每服三五十丸，温酒盐汤下。
【集注】罗谦甫曰∶此方为阳衰阴弱，不能升精于目而设，故目科与《千金》磁朱丸
并重，治证亦同。然磁朱为镇坠药，此为羡补药。《针经》曰∶五脏六腑精气，皆上于目
而为之精。故夫目之精明者，阴阳合传而为精明者也。若肾肝虚，则阴弱不能敛精以升
养神水于内。脾肺虚，则阳衰不能摄阴而浮散神光于外。以致神水宽大，睹物成二。此
其治法，其营在肝，其主在肾，其合在脾，能合肾脾之阴而使肝达之，则必能归精于两眸，
而继明如昼夜矣。是方先补肾肝，以二冬、二地、菟丝、枸杞、五味、牛膝、苁蓉群队滋
阴之品，以之强阴填精，敛气安神养血，此壮水之主，亦所以生水也。复以人参、炙草、
茯苓、山药培补中宫，使调合阴阳也。佐之以蒺藜、甘菊、川芎、枳壳、防风行肝达气，
青葙、决明子解结散滞，黄连、乌犀、羚角清火泻热。然必取石斛之妙合脾肾者清而行
之，要使升精归明之用，脏腑合德专精致一耳。其以为丸者，补上治下，利以缓，利以
久，不利以速也。
洗刀散 治风热上攻，火眼赤痛，骤生云翳，外障遮睛。
防风（一钱） 石膏（一钱） 滑石（一钱） 归尾（一钱） 赤芍（八分）
羌活（八分） 荆芥（五分） 黄芩（五分） 连翘（五分） 川芎（五分） 桔梗（五分） 麻黄（五分）
白术（五分） 大黄（五分） 芒硝（五分） 独活（五分）
元参（五分） 木贼（五分） 菊花（五分） 白蒺藜（五分）
蝉蜕（五分） 草决明（五分） 薄荷（四分） 栀子（四分） 蔓荆子（四分） 细辛（三分） 甘草（三分）
加清茶叶五分，水煎服。
【注】目之病内障者，昏暗不明而不肿痛，得之于内，七情动中，劳伤心肾也。外障者，
赤肿而痛，睛不昏暗，得之于六淫所袭，热蕴经络也。故内障多虚，外障多实。子和曰∶
眼无火不病，非止内障，正指外障而立言也。外障赤肿而痛者，或散外邪，或泻内热，或
并解之，可立愈也。其有风火上攻，留而不散，凝结云翳，掩其光明者，又非或散、或
下所能即愈也。洗刀散方既可以攻风热，又可以去云翳，是一方而兼擅其长也。方中用
防风通圣散全剂，是主以去风热也。倍归尾、赤芍，是治风先治血，血行风自灭也。加羌、
独活，蔓荆子，倍防风，是祛风而专在太阳表也。太阳之里少阴也，故又加细辛直走少
阴，加元参下安肾火，是治表而顾及其里也。其加木贼、蝉蜕、草决明、白蒺藜、菊花者，
是佐诸祛风清热之群药，以消风热骤壅之云翳也。
失笑散 治产后心腹绞痛欲死，或血迷心窍，不省人事。
五灵脂 蒲黄（等分）
每服三钱，酒煎服。
独圣散
南山楂肉（炒，一两）
水煎，用童便沙糖和服。
【集注】吴于宣曰∶经云∶心主血，脾统血，肝藏血。故产后瘀血停滞，三经皆受其
病，以致心腹瘀痛，恶寒发热，神迷眩运，胞膈满闷。凡兹者，由寒凝不消散，气滞不流
行，恶露停留，小腹结痛，迷闷欲绝，非纯用甘温破血行血之剂，不能攻逐荡平也。是
方用灵脂之甘温走肝，生用则行血；蒲黄辛平入肝，生用则破血。佐酒煎以行其力，庶
可直抉厥阴之滞，而有推陈致新之功。甘不伤脾，辛能散瘀，不觉诸证悉除，直可以一
笑而置之矣。至独圣散用山楂一味浓煎，与沙糖童便同服者何也？山楂不惟消食健脾，功
能破瘀止儿枕痛；更益以沙糖之甘，逐恶而不伤脾，童便之咸，人胞而不凉下。相得相
须，功力甚伟，名之曰独圣，诚不虚也。
大黄 虫丸 治五劳七伤，内有干血，肌肤甲错，两目黯黑。
大黄（酒蒸，十两） 桃仁（去皮尖，炒，四两） 杏仁（去皮尖，炒，四两） 黄芩（炒，二两）
甘草（三两） 芍药（炒，四两） 地黄（十两） 干漆（炒，一两） 虻虫（去翅足，炒，一两五钱）
水蛭（炙黄，百枚） 蛴螬（炒，一两五钱） 虫（去头足，炒，一两）
上十二味为末，蜜丸如小豆大。酒服五丸，日三服。
【集注】李中梓曰∶劳伤之证，肌肤甲错，两目黯黑，此内有瘀血者也。瘀之日久，则
必发热，热涸其液，则血干于经隧之间，愈干愈热，愈热愈干，而新血皆损。人之充养
百骸，光华润泽者，止藉此血，血伤则无以沃其肤，故甲错也。目得血而能视，血枯则
无以荣，其目故黯黑也。仲景洞见此证，补之不可，凉之无益，而立此方。经曰∶血主
濡之，故以地黄为君。坚者削之，故以大黄为臣。统血者脾也，脾欲缓急，食甘以缓之。
又酸苦涌泄为阴，故以甘、芍、桃仁为佐。咸走血，苦胜血，故以干漆之苦，四虫之咸为
使。夫浊阴不降，则清阳不升，瘀血不去，则新血不生。今人遇一劳证，便用滋阴之药，服
而不效，坐以待毙，术岂止此耶！
仙方活命饮（附∶薛己治疡通方） 治一切疮疡，未成脓者内消，已成脓者即溃，又止痛、
消毒之圣药也。
穿山甲 白芷 防风 皂角制 乳香 没药 当归尾 赤芍 花粉 贝母 陈皮
金银花 甘草
上十三味。用酒一碗。煎数沸服。
【集注】罗谦甫曰∶此疡门开手攻毒之第一方也。经云∶营气不从，逆于肉理。故痈
疽之发，未有不从营气之郁滞，因而血结痰滞蕴崇热毒为患。治之之法，妙在通经之结，
行血之滞，佐之以豁痰理气解毒。是方穿山甲以攻坚，皂刺以达毒所，白芷、防风、陈
皮通经理气而疏其滞，乳香定痛和血，没药破血散结，赤芍、归尾以驱血热而行之，以
破其结。佐以贝母、金银花、甘草，一以豁痰解郁，一以散毒和血，其为溃坚止痛宜矣。
然是方为营卫尚强，中气不亏者设。若脾胃素弱，营卫不调，则有托里消毒散之法，必
[Background Information]
Book: Shanbu Mingyi Fanglun (Supplemented and Revised Discussions on Famous Physicians' Prescriptions)
Author: Wu Qian
Dynasty: Qing
Chapter: Shanbu Mingyi Fanglun (Vol. 5) (2/3)
Category: Formulas
[Original Text Processing]
Heat accumulation from pathogenic invasion can be treated with cold purgation; can long-standing cold accumulation also be treated with cold purgation? This is why methods such as Beiji Wan (Emergency-Preparation Pill) were established. However, these methods are only applicable to cold-solid accumulations. If a person has a constitution that is inherently deficient, even if there is solid pathogenic retention, dare one use harsh and potent attacking agents? Therefore, Zhang Zhongjing further established Fuzi Xie Xin Tang (Aconite Decoction for Draining the Epigastrium), using Huangqin (Scutellariae Radix) and Lianzi (Coptidis Rhizoma) to assist Dahuang (Rhei Radix et Rhizoma) in treating heat stagnation above the diaphragm, while simultaneously utilizing the warmth of Fuzi (Aconiti Lateralis Radix Preparata) to disperse it; and Dahuang Fuzi Tang (Rhei Radix et Rhizoma and Aconite Decoction), using Xixin (Asari Radix et Rhizoma) to assist Fuzi in attacking cold accumulation under the flanks, while simultaneously utilizing the cold nature of Dahuang to guide it out. The combination of cold and hot, and the simultaneous application of warming and purging, represents a sagely method that is clear and profound, beyond ordinary comprehension.
Yueju Tang/Wan (Regulating Qi Decoction/Pill) treats all types of damp-phlegm, food stagnation, fire, and qi-blood depressions.
Xiangfu (Cyperi Rhizoma), Cangzhu (Atractylodis Rhizoma), Fuxiong (Ligustici Chuanxiong Rhizoma), Shenqu (Massa Medicata Fermentata), Shanzhiren (Gardeniae Semen).
Decoct in water and take orally, or make into pills.
[Annotation]
Human beings rely on Qi as their foundation. When Qi is harmonious, the upper and lower parts do not lose their proper order, and circulation continues without interruption; how could disease arise? If dietary habits are irregular, exposure to cold and heat is inappropriate, emotions fluctuate wildly, and worry/thoughts are excessive, causing the harmonious Qi to ascend and descend abnormally, this leads to stomach depression causing loss of appetite, spleen depression failing to digest food and fluids, qi depression causing chest and abdominal distension, blood depression causing stabbing pain in the chest and diaphragm, damp depression leading to phlegm-fluid retention, fire depression generating heat, as well as vomiting, nausea, acid regurgitation, epigastric discomfort, belching, and the emergence of hundreds of diseases. Therefore, Xiangfu is used to open qi depression, Cangzhu to remove damp depression, Fuxiong to move blood depression, Shanzhi (Gardeniae Fructus) to clear fire depression, and Shenqu to resolve food depression. This is how Zhu Zhenheng adapted the method of the Five Depressions. These five herbs work synergistically to achieve the effect of resolving the five depressions. However, one must ask which depression is most severe and use the corresponding herb as the principal agent. Furthermore, if there is qi deficiency, add Renshen (Ginseng Radix et Rhizoma); if there is qi pain, add Muxiang (Aucklandiae Radix); if depression is severe, add Yujin (Curcumae Radix); if appetite is poor, add Gu Ya (Germinatus Hordei Fructus); if there is distension, add Houpo (Magnoliae Officinalis Cortex); if there is fullness, add Zhishi (Aurantii Fructus Immaturus); if there is vomiting of phlegm, add Jiang (Zingiberis Rhizoma) and Xia (Pinelliae Rhizoma); if fire is excessive, add Yuhuang (Corni Fructus) and Lian (Coptidis Rhizoma). Such adjustments depend on the detailed examination by the clinician.
Simoda Yin (Four-Ingredient Decoction for Simulating Breath) treats emotional injury, rapid upper breathing, chest/diaphragm discomfort, and inability to eat due to oppression.
Renshen (Ginseng Radix et Rhizoma), Binglang (Arecae Semen), Chenxiang (Aquilariae Lignum Resinatum), Tiantai Wuyao (Menispermi Rhizoma).
The above four ingredients are each ground thickly with water to obtain seven-tenths of the volume, boiled for three to five boils, allowed to cool to warm temperature, and taken on an empty stomach.
[Collected Annotations]
Wang Youyuan stated: The Classics say, "The sage guards Qi like a precious treasure, while the mediocre person enslaves himself to material things and thereby damages his Taihe (Great Harmony)." Thus, the Seven Emotions, depending on what triggers them, can all cause disease. However, strong individuals recover as Qi flows freely, while weak individuals suffer disease as Qi becomes stagnant. The foolish do not observe this; upon encountering rapid breathing, fullness/oppression, and inability to eat, they assume it is excess and should be purged, immediately administering breaking and耗 (consumptive) medicines. Although the medicine may provide temporary relief, it responds initially but fails after prolonged use. Exhalation is Yang, inhalation is Yin. When Lung Yang is clear and肃 (purifying), Qi descends; when Kidney Yin is tranquil, Qi is retained and does not scatter upward reversely. If Righteous Qi is already depleted, attempting to break hardness and stagnation will make it difficult to subdue pathogenic Qi. The method should be to use Renshen first to tonify Righteous Qi, Chenxiang to guide Qi into the Kidney, and then use Binglang and Wuyao to guide it subsequently. This is what is meant by "when treating excess, one must consider deficiency; when purging, one must first tonify." The four ingredients have strong flavors and odors; grinding preserves their complete flavor and odor, while decocting makes them pure and harmonious. When flavor, odor, and efficacy arrive together, the effect is immediate like a drumstick striking a drum.
Beiji Wan (Emergency-Preparation Pill) treats cold Qi and cold food lingering in the Stomach, causing abdominal fullness and pain, and constipation.
Dahuang (Rhei Radix et Rhizoma, 2 liang), Ganjiang (Zingiberis Rhizoma, 2 liang), Badou (Crotonis Fructus, peeled, ground to paste, 1 liang).
First, pound Dahuang and Ganjiang into powder, mix in Badou, and pound together for a thousand strokes. Mix with honey to form pills the size of beans, store in a sealed container to prevent leakage of Qi, and keep for use.
Take 3-4 pills at a time, washed down with warm water or wine.
Jingui Yaolue states it treats sudden onset of heart/abdominal fullness and pain, stabbing pain like a needle, shortness of breath, and jaw lock resembling sudden death. Lift the head, pour the medicine down the throat, and within a moment, improvement should occur. If not improved, give another 3 pills. There should be rumbling in the abdomen, followed by vomiting and diarrhea, after which recovery occurs. If the jaw is locked, dissolve the pill and blow it into the nostril using a reed tube so it slides down the throat.
[Collected Annotations]
Ke Qin stated: Constipation should be differentiated into Yang-Jie (Yang knot) and Yin-Jie (Yin knot). Yang-Jie has Chengqi (Harmonizing Powder) and Gengyi (Changing Garment) formulas; Yin-Jie has Beiji Wan and Baisan (White Powder) formulas. Jingui Yaolue uses this formula to treat Zhong'e (Sudden Evil Attack); one should know it is suitable for sudden attack by Cold Pathogen. If used for Warmth/Summerheat/Hot Pathogens, it would hasten death. This formula is indeed established for Yin-Jie. Ganjiang disperses Cold Pathogen in the Middle Jiao, Badou expels cold accumulation in the intestines and stomach, and Dahuang opens the Earthly Path (intestines) and can also detoxify Badou. It is a disciplined army. However, Baisan treats cold knot in the Chest, thus using Jiegeng (Platycodonis Radix) to assist Badou, employing both vomiting and purging methods to resolve it. This formula treats cold knot in the intestines and stomach, thus using Dahuang to assist Jiang and Ba, directly attacking the cold. The world only knows the method of Warming and Tonifying, but does not know the method of Warming and Purging; therefore, they only discuss Cold Deficiency and do not discuss Cold Excess.
[Commentary]
People's nature is to fear poverty but not disaster, leaving disaster behind because of poverty. Patients' nature is often similar; they fear deficiency but not disease, forgetting the disease because of the perceived deficiency. They do not realize that deficiency is like poverty, and disease is like disaster. Having disease while deficient is like having disaster while poor; removing the disaster but remaining poor is still manageable. Having disease while excess is like having disaster while rich; if the disaster is not removed, the wealth cannot be guaranteed. Most laughable are modern physicians visiting patients' homes; outwardly appearing careful, inwardly undecided. They claim deficiency cannot be attacked, and even if the disease leaves, Righteous Qi is hard to restore. Patients, fearing this, naturally agree. Those with shallow disease may luckily recover spontaneously; if not, another doctor is summoned. But if the patient's intent is difficult to enter, and the attacking medicine has not yet entered the mouth, amidst noisy discussions, enlightened practitioners leave in frustration, sitting and waiting for death, never realizing they were misled by incompetent doctors. Physicians who have long practiced their art originally intended self-preservation, shamelessly unaware. Over time, they compete to regard nurturing illness as skill and attacking disease as clumsy, causing all patients in the world to be ignorant of treating disease. I once examined Sun Simiao using Zhongjing's Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), Xingren (Armeniacae Semen Amarum), Gancao (Glycyrrhizae Radix et Rhizoma) in Huanhun Tang (Soul-Returning Decoction) to treat stroke coma, jaw lock, and clenched fists; and Li Gao using Zhongjing's Badou, Dahuang, Ganjiang in Beiji Wan to treat sudden death from stroke, abdominal pain and fullness/blockage, with immediate effect upon swallowing. Did these two men not know deficiency and excess? Superior physicians, before diagnosing, do not pre-conceive opinions nor think of self-preservation; if there is the disease, they simply use the corresponding medicine. Ke Qin stated: Beiji Wan treats cold knot in intestines/stomach; Baisan treats cold knot in the chest. From this, we can also know that Huanhun Tang treats cold knot in the exterior of the chest, dispersing formless pathogenic Qi; Baisan treats cold knot in the interior of the chest, attacking有形 (form-shaped) phlegm-fluid; Beiji Wan treats cold knot in intestines/stomach, attacking undigested waste.
Cizhu Wan (Magnetite and Cinnabar Pill) treats widening and gradual dispersion of Shen Shui (Divine Water - aqueous humor), vision obscured like walking in fog/mist, gradually seeing black flowers in the air, diplopia (seeing objects as double), and internal cataracts, where Shen Shui is pale green or pale white. Also treats tinnitus and deafness.
Cishi (Magnetitum, 2 liang), Chensha (Cinnabaris, 1 liang), Shenqu (Massa Medicata Fermentata, raw, 3 liang).
Take 1 liang of water, make into a cake, boil until floating, add the previous medicines, refine honey to form pills. Take 10 pills per dose, increasing to 30 pills, taken on an empty stomach with rice soup.
[Collected Annotations]
Wang Youyuan stated: The essence of the Five Zang and Six Fu organs all ascends to the eyes; thus, the ability of the eyes to see is Qi, and the substance enabling sight is Essence. The Kidney stores Essence, hence Shen Shui originates from the Kidney. The Heart is like the sun shining, hence Shen Guang (Divine Light) originates from the Heart. Light emanates from Yang and reflects outward; with Yin Essence guarding it, it does not scatter and remains bright. Water emanates from Yin and condenses quietly; with Yang Qi distributing it, it sees clearly without limit. Only when Heart and Kidney are deficient does Shen Shui dry up and Shen Guang become short, giving rise to blindness and internal cataracts. Cishi enters the Kidney Meridian directly, gathering scattered Shen (Spirit); its nature attracts iron, absorbing Lung Metal Qi to store in Kidney Water. Zhusha (Cinnabar) is Yang in body but Yin in nature, able to absorb floating Fire and calm the Spirit/Mind. Water can reflect, Fire can illuminate; when Water and Fire assist each other, does not brilliance radiate? However, the eyes receive the essence of the Zang-Fu, and spirit comes from grain. Shenqu can digest the five grains, making Essence easy to form. Since Shen Shui scatters and enlarges, if slow, it cannot be gathered; relying on heavy/sinking substances, it rapidly gathers and attracts it, thus serving as an emergency remedy. Its treatment of tinnitus and deafness also uses the sinking function to treat running-away of Deficient Yang to the ears.
Ke Qin stated: This pill is a sacred remedy for mania/epilepsy. Mania and insanity are diseases of the Heart, Kidney, and Spleen. The Heart stores Shen (Spirit), the Spleen stores Yi (Intellect) and Zhi (Will), and the Kidney stores Jing (Essence) and Zhi (Will). The Heart is the master of Spirit/Mind; if the master is unclear, the Twelve Officials are endangered, the pathways become blocked, and the形体 (Form) is severely damaged; this is what is meant. But why is the master unclear? The Heart corresponds to Li (Fire), containing True Water within. If Tianyi's True Water is insufficient, Erdi's Deficient Fire wanders recklessly. What is called Heaven Qi is blocked, Earth Qi obscures clarity, the sun and moon are dim, pathogens harm the empty orifices, thus the eyes often see hallucinations and develop this strange disease. Using heavy metallic/mineral agents to settle it, mania must cease. Zhusha inherits the red color of the South, connects to the Heart, can descend rootless Fire and calm Spirit/Mind. Cishi inherits the black color of the North, connects to the Kidney, absorbs Lung Metal Qi to generate Essence, and sinks flaming-upward Fire to stabilize Will. Both stones are heavy and primarily descending, cold in nature and cooling Yin; sharing the same aspiration, their efficacy can be expected immediately. Shenqu pushes out the old and brings forth the new, communicating upward with Heart Shen and downward with Kidney Zhi, generating Intellect/Will. Moreover, "Food enters Yin, nourishes Yang; depriving food stops it." This is the method for treating mania in Neijing. When food is digested, Intellect/Will becomes clear and Spirit is regulated; is this the purpose of using Shenqu? Refining honey to form pills adds sweetness to moderate the action.
Shihu Yeguang Wan (Dendrobium Night-Luminous Pill) treats widening and gradual dispersion of Shen Shui, vision obscured like fog/mist, black flowers in the air, diplopia, and pale green/pale white Shen Shui.
Tianmendong (Asparagi Radix, 2 liang), Tusizi (Cuscutae Semen, 7 qian), Renshen (Ginseng Radix et Rhizoma, 2 liang), Fuling (Poria, 2 liang), Gan Juhua (Chrysanthemi Flos, 7 qian).
Gan Shanyao (Dioscoreae Rhizoma, 7 qian), Maidong (Ophiopogonis Radix, 1 liang), Shudi (Rehmanniae Radix Praeparata, 1 liang), Roucongrong (Cynomorii Herba, 5 qian), Qingxiangzi (Celosiae Semen, 5 qian), Shengdi (Rehmanniae Radix, 1 liang), Gouqi (Lycii Fructus, 7 qian), Lingyangjiao (Saigae Tataricae Cornu, sliced, 5 qian), Cao Jueming (Cassiae Semen, 8 qian).
Shihu (Dendrobii Caulis, 7 qian), Xingren (Armeniacae Semen Amarum, 7 qian), Jili (Tribuli Fructus, 5 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma, 5 qian).
Gancao (Glycyrrhizae Radix et Rhizoma, roasted, 5 qian), Huanglian (Coptidis Rhizoma, 5 qian), Fangfeng (Saposhnikoviae Radix, 5 qian), Zhike (Aurantii Fructus, 5 qian).
Wuxi (Rhinocerotis Cornu, sliced, 5 qian), Niuxi (Achyranthis Bidentatae Radix, 7.5 qian).
Grind into fine powder, refine honey to form pills the size of tung tree seeds. Take 30-50 pills per dose, washed down with warm wine and salt water.
[Collected Annotations]
Luo Qianfu stated: This formula was established for Yang deficiency and Yin weakness, unable to ascend Essence to the eyes. Thus, in Ophthalmology, it is valued equally with Qianjin's Cizhu Wan, and the indications are the same. However, Cishi and Zhusha are settling/sinking agents, whereas this is a tonifying formula. Zhenjing states: "The essence and Qi of the Five Zang and Six Fu organs all ascend to the eyes to form their essence." Thus, the clarity of the eyes is the transmission of Yin and Yang combining to form brightness. If Kidney/Liver are deficient, Yin is weak and cannot gather Essence to ascend and nourish Shen Shui internally. If Spleen/Lung are deficient, Yang is weak and cannot control Yin, causing Shen Guang to float and scatter externally. This leads to widening of Shen Shui and diplopia. In treatment, Ying (Nutritive) relates to Liver, Zhu (Master) relates to Kidney, He (Harmony) relates to Spleen. If one can harmonize Kidney/Spleen Yin and allow Liver to reach it, Essence will surely return to the eyes, and brightness will continue day and night. This formula first tonifies Liver/Kidney with Er Dong (Tianmendong, Maidong), Er Di (Shudi, Shengdi), Tusizi, Gouqi, Wuweizi (Schisandrae Fructus), Niuxi, Rongrong (Cynomorii Herba) – a group of Yin-nourishing substances – to strengthen Yin, fill Essence, gather Qi, calm Spirit, and nourish Blood. This strengthens the Master of Water, thereby generating Water. Then, using Renshen, Zhi Gancao (Roasted Licorice), Fuling, Shanyao to cultivate and tonify the Central Palace, harmonizing Yin and Yang. Assisted by Jili, Ganju, Chuanxiong, Zhike, Fangfeng to move Liver and reach Qi; Qingxiangzi, Juemingzi to resolve knots and dissipate stagnation; Huanglian, Wuxi, Lingyangjiao to clear Fire and drain Heat. However, one must select Shihu, which wonderfully harmonizes Spleen/Kidney, clearing and moving it, to ensure the function of ascending Essence and returning brightness, so that Zang-Fu virtues combine and focus on unity. The reason for making pills is that tonifying upper and treating lower benefits from slowness, longevity, not speed.
Xidao San (Washing Knife Powder) treats Wind-Heat attacking upward, fiery red/painful eyes, sudden formation of nebula (cloudy opacity), external obstruction covering the pupil.
Fangfeng (Saposhnikoviae Radix, 1 qian), Shigao (Gypsum Fibrosum, 1 qian), Huashi (Talcum, 1 qian), Guiwei (Angelicae Sinensis Radix tail, 1 qian), Chishao (Paeoniae Radix Rubra, 8 fen).
Qianghuo (Notopterygii Rhizoma et Radix, 8 fen), Jingjie (Schizonepetae Spica, 5 fen), Huangqin (Scutellariae Radix, 5 fen), Lianqiao (Forsythiae Fructus, 5 fen), Chuanxiong (Ligustici Chuanxiong Rhizoma, 5 fen), Jiegeng (Platycodonis Radix, 5 fen), Mahuang (Ephedrae Herba, 5 fen).
Baizhu (Atractylodis Macrocephalae Rhizoma, 5 fen), Dahuang (Rhei Radix et Rhizoma, 5 fen), Mangxiao (Natrii Sulfas, 5 fen), Duohuo (Angelicae Pubescentis Radix, 5 fen).
Yuanshen (Scrophulariae Radix, 5 fen), Muzei (Equiseti Herba, 5 fen), Juhua (Chrysanthemi Flos, 5 fen), Bai Jili (Tribuli Fructus, 5 fen).
Chantui (Bombyx Batryticatus, 5 fen), Cao Jueming (Cassiae Semen, 5 fen), Bohe (Menthae Haplocalycis Herba, 4 fen), Zhizi (Gardeniae Fructus, 4 fen), Manjingzi (Vittariae Fructus, 4 fen), Xixin (Asari Radix et Rhizoma, 3 fen), Gancao (Glycyrrhizae Radix et Rhizoma, 3 fen).
Add Qing Cha Ye (Clear Tea Leaves, 5 fen), decoct in water and take orally.
[Annotation]
Internal cataract disease involves dimness and lack of clarity without swelling/pain, originating internally from Seven Emotions disturbing the center, exhausting Heart and Kidney. External obstruction involves redness/swelling and pain, with clear vision, originating externally from Six Evils invading, with Heat accumulating in meridians. Thus, internal cataracts are mostly deficiency, external obstructions are mostly excess. Hezi stated: "The eye does not get diseased without Fire"; this refers not only to internal cataracts but specifically to external obstructions. For external obstructions with redness/swelling/pain, dispersing external pathogens, draining internal Heat, or doing both can lead to immediate cure. However, if Wind-Fire attacks upward, lingers without dispersing, condensing into nebula covering brightness, it cannot be cured immediately by merely dispersing or purging. Xidao San can both attack Wind-Heat and remove nebula, excelling in both aspects. The formula uses the complete Fangfeng Tongsheng San (Wind-Dispersing and Supreme-Protecting Powder) as the main component to remove Wind-Heat. Doubling Guiwei and Chishao follows the principle "to treat Wind, first treat Blood; when Blood moves, Wind extinguishes itself." Adding Qianghuo, Duohuo, Manjingzi, and doubling Fangfeng targets Wind-dispersion specifically in the Taiyang Exterior. The interior of Taiyang is Shaoyin; thus, adding Xixin goes directly to Shaoyin, and Yuanshen descends to calm Kidney Fire, treating the exterior while considering the interior. Adding Muzei, Chantui, Cao Jueming, Bai Jili, Juhua assists the group of Wind-dispersing and Heat-clearing herbs to eliminate nebula suddenly congested by Wind-Heat.
Shixiao San (Laughing-Over Powder) treats postpartum heart/abdominal colic causing near-death agony, or Blood confusing the Heart Orifice, resulting in unconsciousness.
Wulingzhi (Trogopterori Faeces), Puhuang (Typhae Pollen) in equal parts.
Take 3 qian per dose, decoct in wine and take orally.
Dusheng San (Single-Saint Powder)
Nan Shan Zha Rou (Crataegi Fructus flesh, roasted, 1 liang).
Decoct in water, mix with Tongbian (Child Urine) and Shatang (Brown Sugar) and take.
[Collected Annotations]
Wu Yuxuan stated: The Classics say: "Heart governs Blood, Spleen controls Blood, Liver stores Blood." Thus, postpartum Blood Stasis stagnation affects these three meridians, leading to heart/abdominal stasis pain, aversion to cold/fever, confusion/dizziness, and uterine/diaphragm fullness/oppression. All these result from Cold coagulation not dispersing, Qi stagnation not flowing, lochia remaining, lower abdominal knotty pain, confusion/near-death state. Purely using Sweet-Warm Blood-breaking and Blood-moving agents is necessary to attack, purge, and level. This formula uses Wulingzhi's Sweet-Warm nature entering Liver; raw use moves Blood. Puhuang is Pungent-Ping, enters Liver; raw use breaks Blood. Assisted by wine decoction to enhance its power, it can directly resolve Jueyin stagnation and achieve the function of pushing out the old and bringing forth the new. Sweet does not damage Spleen, Pungent disperses Stasis; unconsciously all symptoms are eliminated, allowing one to laugh and dismiss them. As for Dusheng San using concentrated decoction of Shan Zha alone, mixed with Shatang and Tongbian, why? Shan Zha not only aids digestion and strengthens Spleen, but also breaks Stasis and stops "child pillow" (postpartum abdominal mass) pain. Added to the sweetness of Shatang, it drives out evil without damaging Spleen; the saltiness of Tongbian enters the Uterus without cooling downward. Mutual assistance yields great power; named Single-Saint, truly not in vain.
Dahuang Zhechong Wan (Rhei Radix et Rhizoma and Beetle Pill) treats Five Labors and Seven Injuries, with Dry Blood inside, skin resembling scales (xerosis), and dark eyes.
Dahuang (Rhei Radix et Rhizoma, wine-steamed, 10 liang), Taoren (Pruni Persicae Semen, peeled/cut tips, roasted, 4 liang), Xingren (Armeniacae Semen Amarum, peeled/cut tips, roasted, 4 liang), Huangqin (Scutellariae Radix, roasted, 2 liang).
Gancao (Glycyrrhizae Radix et Rhizoma, 3 liang), Shaoyao (Paeoniae Radix, roasted, 4 liang), Dihuang (Rehmanniae Radix, 10 liang), Ganqi (Dryobalanops aromatica resin, roasted, 1 liang), Mengchong (Blatta orientalis, wings/legs removed, roasted, 1.5 liang).
Shuizhi (Hirudo, roasted yellow, 100 pieces), Qicao (Silphiodaphne larva, roasted, 1.5 liang), Chengchong (Onychophagus larva, head/legs removed, roasted, 1 liang).
Grind the above twelve ingredients into powder, mix with honey to form pills the size of small beans. Take 5 pills with wine, three times daily.
[Collected Annotations]
Li Zhongzi stated: In Labor-Injury syndromes, skin resembling scales and dark eyes indicate internal Blood Stasis. Long-standing Stasis must generate Heat; Heat dries fluids, causing Blood to dry in the meridians. The drier it gets, the hotter it becomes; the hotter it gets, the drier it becomes, damaging new Blood. The nourishment of the hundred bones and the luster/gloss of the body rely solely on this Blood. When Blood is damaged, there is nothing to moisten the skin, hence xerosis. Eyes see due to Blood; when Blood is枯竭 (exhausted), there is nothing to nourish, hence dark eyes. Zhongjing saw this syndrome clearly; tonification is impossible, cooling is useless, thus establishing this formula. The Classics say: "Blood primarily moistens," hence Dihuang is the Sovereign. "Hardness is削 (reduced)," hence Dahuang is the Minister. The Spleen controls Blood; Spleen desires relaxation from urgency, sweet food relaxes it. Sour-Bitter rising/draining is Yin, hence Gancao, Shaoyao, Taoren are Assistants. Salty enters Blood, Bitter overcomes Blood, hence Ganqi's Bitter and the Four Insects' Salty are Envoys. If Turbid Yin does not descend, Clear Yang cannot ascend; if Stasis Blood does not leave, New Blood cannot be born. Nowadays, people encountering any Labor Syndrome immediately use Yin-tonifying medicines; taking them without effect, they sit and wait for death. Is this the extent of medical art!
Xianfang Huoming Yin (Immortal Method Life-Saving Decoction) (Appendix: Xue Ji's General Formula for Ulcers) treats all sores/ulcers; those not yet suppurated are resolved internally, those suppurated are drained immediately, and it is also a sacred medicine for pain relief and detoxification.
Chuanshanjia (Manis Squama), Baizhi (Angelicae Dahuricae Radix), Fangfeng (Saposhnikoviae Radix), Zaojiao Zhi (Gleditsiae Sinensis Fructus processed), Ruxiang (Olibanum), Moyao (Myrrhae Resina), Dangguiwei (Angelicae Sinensis Radix tail), Chishao (Paeoniae Radix Rubra), Huafen (Trichosanthis Radix), Beimu (Fritillariae Cirrhosae Bulbus), Chenpi (Citri Reticulatae Pericarpium).
Jinyinhua (Lonicerae Japonicae Flos), Gancao (Glycyrrhizae Radix et Rhizoma).
The above thirteen ingredients. Use one bowl of wine. Decoct for a few boils and take.
[Collected Annotations]
Luo Qianfu stated: This is the first formula in the Ulcer Department for attacking toxins. The Classics say: "Ying Qi does not follow, reversing in the muscle tissue." Thus, the onset of carbuncles/furuncles always stems from Ying Qi stagnation, leading to Blood knotting, Phlegm stagnation, accumulating Heat-Toxin as pathology. The treatment method lies in unblocking meridian knots, moving Blood stagnation, assisted by resolving Phlegm, regulating Qi, and detoxifying. In this formula, Chuanshanjia attacks hardness, Zaoci (Gleditsiae Spina) reaches the toxin site, Baizhi, Fangfeng, Chenpi unblock meridians, regulate Qi, and disperse stagnation; Ruxiang stabilizes pain and harmonizes Blood, Moyao breaks Blood and dissipates nodules; Chishao, Dangguiwei drive out Blood Heat and move it, breaking knots. Assisted by Beimu, Jinyinhua, Gancao; one resolves Phlegm and relieves depression, the other disperses toxin and harmonizes Blood; thus, it is suitable for softening hardness and relieving pain. However, this formula is established for those with strong Ying/Wei and intact Middle Qi. If Spleen/Stomach are inherently weak, Ying/Wei disharmonious, then Tuoli Xiaodu San (Support Interior and Detoxify Powder) method should be used, necessarily...