治肝家血虚火旺, 头痛目眩烦赤, 口苦倦怠烦渴, 抑郁
不乐, 两胁作痛, 寒热, 小腹重坠, 妇人经水不调, 脉弦大而虚.
芍药 ( 酒炒 ) 当归 白术 ( 炒 ) 茯苓 甘草 ( 炙 ) 柴胡
各二钱 引用煨姜三片, 薄荷少许, 煎服. 加味逍遥散, 即此方加丹
皮, 山栀 ( 炒 ) 各五分.
【集注】赵羽皇曰: 五脏苦欲补泻: 云肝苦急, 急食甘以缓之. 盖肝
性急善怒, 其气上行则顺, 下行则郁, 郁则火动而诸病生矣. 故发于
上,则头眩, 耳鸣而或为目赤. 发于中, 则胸满, 胁痛而或作吞酸.
发于下, 则少腹疼疝而或溲溺不利. 发于外, 则寒热往来, 似疟非疟
.凡此诸证, 何莫非肝郁之象乎? 而肝木之所以郁, 其说有二: 一为
土虚不能升木也, 一为血少不能养肝也. 盖肝为木气, 全赖土以滋培
,水以灌溉. 若中土虚, 则木不升而郁. 阴血少, 则肝不滋而枯. 方
用白术, 茯苓者, 助土德以升木也. 当归, 芍药者, 益荣血以养肝也
.薄荷解热, 甘草和中. 独柴胡一味, 一以为厥阴之报使, 一以升发
诸阳. 经云: 木郁则达之. 遂其曲直之性, 故名曰逍遥. 若内热, 外
热盛者, 加丹皮解肌热, 炒栀清内热, 此加味逍遥散之义也.
Treats conditions of Liver Blood deficiency with hyperactive Fire, manifesting as headache, dizziness (Xuanyun), redness of the eyes, bitter taste in the mouth, fatigue, irritability and thirst, depression and unhappiness, pain in the hypochondrium, alternating chills and fever, a sensation of heaviness and bearing down in the lower abdomen, irregular menstruation in women, and a wiry, large, and deficient pulse.
Prescription: Shaoyao (Paeoniae Radix Alba, stir-fried with wine), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Chaihu (Bupleuri Radix), each 2 qian. Decoct and take orally with 3 slices of ginger roasted in flour and a small amount of Bohe (Menthae Haplocalycis Herba).
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) is this formula with the addition of Danpi (Moutan Cortex) and Shanzhi (Gardeniae Fructus, stir-fried), each 5 fen.
[Collected Annotations] Zhao Yuhuang states: Regarding the "distress" (Ku) and "desire" (Yu) of the Five Viscera, and their tonification and purgation principles: It is said that "The Liver dislikes constraint; eat sweet flavors to relieve it." This is because the nature of the Liver is irritable and prone to anger; its Qi flows smoothly when ascending but becomes stagnant when descending. Stagnation generates internal Fire, giving rise to various diseases. Thus, if the pathology manifests above, there will be dizziness, tinnitus, or red eyes; if it manifests in the middle, there will be chest fullness, hypochondriac pain, or acid regurgitation; if it manifests below, there will be lower abdominal pain, hernia, or difficult urination; if it manifests externally, there will be alternating chills and fever, resembling malaria but not being malaria. Are all these syndromes not manifestations of Liver Qi stagnation? The reasons for the stagnation of Liver Wood are twofold: one is that Spleen Earth is deficient and cannot uplift Liver Wood; the other is that Blood is insufficient and cannot nourish the Liver. Since the Liver belongs to Wood Qi, it relies entirely on the nourishment of Earth and the irrigation of Water. If the Middle Jiao Earth is deficient, Wood cannot ascend and becomes stagnant. If Yin Blood is scant, the Liver lacks nourishment and becomes withered. The formula uses Baizhu and Fuling to assist the virtue of Earth to uplift Wood; Danggui and Shaoyao to enrich Ying Blood to nourish the Liver. Bohe resolves heat, and Gancao harmonizes the Middle Jiao. Only Chaihu serves as both the messenger herb for the Jueyin Liver channel and an agent to uplift Yang Qi. The Classic states: "When Wood is stagnant, it should be dispersed." By following the curving and straightening nature of Wood, it is named Xiaoyao (Free and Easy Wanderer). In cases of intense internal or external heat, add Danpi to resolve muscle-layer heat and stir-fried Shanzhi to clear internal heat; this is the rationale behind Jiawei Xiaoyao San.