(东垣)
治中满寒胀寒疝,二便不通,四肢厥逆,食入反出,腹中寒,心下痞,下虚阴躁,奔腾
不收(原文曰∶或多食寒凉及脾胃久虚之人,胃中寒则胀满,或脏寒生满病,此汤主之。)
川乌 干姜 毕澄茄 生姜 黄连 人参 当归 泽泻 青皮 麻黄 柴胡(二钱) 吴
茱萸 草蔻仁 浓朴 黄 黄柏(五分) 益智仁 木香 半夏 茯苓 升麻(三分。热
服。)
此足阳明、太阴药也。川乌、二姜、吴茱、澄茄、益智、草蔻除湿开郁,暖胃温肾以祛
其寒
其中
之热,又热因寒用也(李东垣曰∶中满治法,当开鬼门、洁净府。开鬼门者,发汗也;洁净
府者,利小便也。中满者,泻之于内,谓脾胃有病,令上下分消其湿,下焦如渎,气血自然
分化
治湿热内攻,心腹胀满,小便不利,大便滑泻;及水肿等证(小水并入大肠,故小便不
利
滑石(六钱) 甘草(一钱) 赤茯苓(一钱) 猪苓 泽泻 白术(土炒) 桂(五
分) 陈皮(钱半) 木香 槟榔(三分。)加姜煎。每服五钱。
此足太阳药也。赤茯、猪苓、泽泻泻火行水,白术补脾,肉桂化气,此五苓散也;滑石
清热
品,
(仲景)
治伤寒阳明病,但头汗出,腹满口渴,二便不利,湿热发黄,脉沉实者(经曰∶阳明病
发
必发
但头
内
汗
濡泄
便溏
茵陈(六两) 大黄(二两,酒浸) 栀子(十四枚,炒。)
此足阳明药也。成无己曰∶小热凉以和之,大热寒以彻之。发黄者,湿热甚也,非大寒
不能彻其热,故以茵陈为君(茵陈发汗利水,以泄太阴阳明之湿热,故为治黄主药),栀子
为臣,大黄为佐,分泄前后,则腹得利而解矣茵陈、栀子能导湿热由小便出,大黄能导湿热
由大便出
本方大黄易黄连,名茵陈三物汤∶治同。本方加浓朴、枳实、黄芩、甘草,入生姜、灯
草煎,名茵陈将军汤(节庵∶)治同。本方去栀子、大黄,加附子、干姜,治寒湿阴黄(前
证为阳黄,如身黄而色暗者为阴黄,宜此汤。大抵治以茵陈为主,各随寒热用药。诸疸,小
便黄赤不利为里实,宜利小便,或下之;无汗为表实,宜汗之,或吐之;或小便清,是无热
也,仲景云∶发黄小便自利,当与虚劳门小建中汤;自利腹满而喘,不可除热,而除之必哕,
宜小半夏汤主之。王海藏曰∶内感伤寒,劳役形体,饮食失节,中州变寒,病生黄;非外感
而得,只
(Li Dongyuan)
Treats middle jiao fullness, cold distension, cold hernia, obstruction of both urination and defecation, cold limbs (Jue Ni), regurgitation after eating, cold in the abdomen, epigastric stuffiness (Xin Xia Pi), deficiency at the lower origin with yin restlessness, and rushing qi that cannot be restrained. (The original text states: This occurs in those who consume excessive cold and cool substances or have long-standing spleen and stomach deficiency. Cold in the stomach leads to distension; cold in the zang organs leads to fullness diseases. This decoction is indicated.)
Chuanwu (Radix Aconiti Lateralis Preparata), Ganjiang (Rhizoma Zingiberis), Bichengqie (Fructus Tetradii), Shengjiang (Rhizoma Zingiberis Recens), Huanglian (Rhizoma Coptidis), Renshen (Radix Ginseng), Danggui (Radix Angelicae Sinensis), Zexie (Rhizoma Alismatis), Qingpi (Pericarpium Citri Reticulatae Viride), Mahuang (Herba Ephedrae), Chaihu (Radix Bupleuri) (each 2 qian); Wuzhuyu (Fructus Evodiae), Cao Kou Ren (Semen Karyae Arecae Condimentum), Houpo (Cortex Magnoliae Officinalis), Huangqi (Radix Astragali), Huangbai (Cortex Phellodendri) (each 5 fen); Yizhiren (Semen Alpiniae Oxyphyllae), Muxiang (Radix Aucklandiae), Banxia (Rhizoma Pinelliae), Fuling (Poria), Shengma (Rhizoma Cimicifugae) (3 fen). Take warm.
These are herbs for the Foot-Yangming and Foot-Taiyin meridians. Chuanwu, the two types of ginger (Ganjiang, Shengjiang), Wuzhuyu, Bichengqie, Yizhiren, and Cao Kou Ren dispel dampness and open stagnation, warm the stomach and kidney to eliminate cold within. The heat contained within is treated by "using heat for cold" methods. (Li Dongyuan said: The treatment for middle jiao fullness should involve opening the ghost gate (Kai Gui Men) and purifying the bladder house (Jie Jing Fu). Opening the ghost gate refers to inducing sweating; purifying the bladder house refers to promoting urination. For middle jiao fullness, one must drain from within, meaning when the spleen and stomach are diseased, dampness should be dispersed from above and below. The lower jiao is like a ditch, allowing qi and blood to differentiate naturally.)
Treats internal attack by damp-heat, abdominal distension and fullness, difficult urination, loose diarrhea; as well as edema and other syndromes (urine mixes into the large intestine, hence difficult urination and loose diarrhea).
Huashi (Talcum), Gancao (Radix Glycyrrhizae) (1 qian), Chi Fuling (Poria cum Rhizomo Polypori), Zhuling (Polyporus), Zexie (Rhizoma Alismatis), Baizhu (Rhizoma Atractylodis Macrocephalae, stir-fried with soil), Guizhi (Ramulus Cinnamomi) (5 fen), Chenpi (Pericarpium Citri Reticulatae) (1.5 qian), Muxiang (Radix Aucklandiae), Binglang (Semen Arecae) (3 fen). Decoct with fresh ginger. Each dose is 5 qian.
These are herbs for the Foot-Taiyang meridian. Chi Fuling, Zhuling, and Zexie drain fire and move water; Baizhu tonifies the spleen; Rougui (Cortex Cinnamomi) transforms qi. This constitutes Wu Ling San (Five-Ingredient Powder with Poria); Huashi is a heat-clearing agent.
(Zhang Zhongjing)
Treats Yangming disease of Shang Han (Cold Damage), characterized by sweat only on the head, abdominal fullness, thirst, obstruction of urination and defecation, jaundice due to damp-heat, and a deep, solid pulse. (The classics state: In Yangming disease with fever, there must be sweating, but if only the head sweats...)
Yinchen (Herba Artemisiae Scopariae) (6 liang), Dahuang (Radix et Rhizoma Rhei, soaked in wine) (2 liang), Zhizi (Fructus Gardeniae) (14 pieces, stir-fried).
These are herbs for the Foot-Yangming meridian. Cheng Wuji said: Mild heat is harmonized with cool herbs; severe heat is thoroughly cleared with cold herbs. Jaundice indicates severe damp-heat, which cannot be cleared without potent cold herbs; thus, Yinchen is used as the Sovereign herb (Yinchen induces sweating and promotes urination to drain damp-heat from the Taiyin and Yangming, making it the primary herb for treating jaundice); Zhizi is the Minister herb; Dahuang is the Assistant herb. By draining through the anterior and posterior orifices respectively, the abdomen benefits and the disease resolves. Yinchen and Zhizi guide damp-heat out via urination; Dahuang guides damp-heat out via defecation.
If Dahuang in this formula is replaced by Huanglian, it is named Yinchen Sanwu Tang (Three-Ingredient Decoction with Yinchen): indications are the same. If Houpo, Zhishi, Huangqin, and Gancao are added to this formula, along with fresh ginger and Dengcao (Lampwick), it is named Yinchen Jiangjun Tang (Yinchen General Decoction) (Jie'an said): indications are the same. If Zhizi and Dahuang are removed from this formula and Fuzi (Radix Aconiti Lateralis Preparata) and Ganjiang are added, it treats cold-damp Yin Jaundice (The previous syndrome is Yang Jaundice; if the body is yellow and the color is dull, it is Yin Jaundice, for which this decoction is suitable. Generally, treatment focuses on Yinchen, adjusting herbs according to cold or heat. For all types of jaundice, yellow and turbid urine with difficulty indicates interior excess, suitable for promoting urination or purgation; absence of sweating indicates exterior excess, suitable for diaphoresis or emesis; if urine is clear, there is no heat. Zhang Zhongjing stated: For jaundice with spontaneous free urination, Xiao Jianzhong Tang from the Deficiency Consumption chapter should be given; for spontaneous diarrhea with abdominal fullness and wheezing, heat-clearing is contraindicated, as it will cause hiccups; Xiao Banxia Tang is indicated. Wang Haicang said: Internal contraction of Shang Han, physical exhaustion, irregular diet leading to cold transformation in the middle jiao causes jaundice; not acquired from external pathogens, only...)