痹者,疲也。有周痹,周身及四肢麻木或痛。盖因气血不充,兼受风湿而成,治宜补气
血,
佐散风利湿之药,须带温而行之,方有效也。有行痹,麻木与痛无定所也,其治法与周痹相
同。其胸痹乃胸中阳气窒滞,治用薤白、白酒、栝蒌皮之类,通其阳气即愈矣。
(附肺痿)
痿症多由湿热,或寒邪流注于腿膝间,或肿或不肿,或酸楚软弱,行步维艰。亦有好色
精亏
,肝血不能相济,筋失所濡,以成是症者。当戒色欲,再用滋补肝肾,兼疏通之药治之。若
因受寒,宜温通筋络,湿热须清利中加威灵仙、牛膝、木瓜等味。半由药治,半须病患留心
调养,切忌火酒,庶能速痊。其肺痿一症,名同而路别。肺痿乃心火刑金,久嗽而成者,盖
肺为燥金,有复感燥气而成者,治心火刑金,当先和心阳,加黄连亦可,继用养肺之品,如
人参、麦冬、五味、燕窝、北沙参之类。若因感燥而成痿者,宜玉女煎、清燥救肺汤之类。
肺痿之重者,眉毛脱落,皮肤干枯,肺主皮毛也,治至数月,药须百剂,方能痊可。
咳嗽有外感,有内伤,有内伤兼外感。肺主皮毛,又为娇脏。人受风寒,皮毛洒淅,肺
气不
得外泄,为喷嚏,鼻流清涕,而咳嗽者,宜用温散,如苏叶、防风、前胡、橘红、葱白、炙
草、姜皮之类。如已化火者,宜用辛凉,如薄荷、杏仁、荆芥、连翘、山栀、竹叶之类。若
受暑风,为气闷自汗而嗽者,须兼清暑之品,如滑石、茯苓、苡仁;因暑中有湿故以淡味渗
之,沙参、丝瓜叶、淡竹叶之类。受燥气,舌干口渴而咳者,须入石膏、鲜生地、桑叶之类
。若内伤,本经有形寒饮冷则伤肺,为恶寒喘促,咳吐痰血者,宜补土降气,消痰理表之药
,如六君加苏子、杏仁、桂枝木、老姜渣、大枣之类。若心火刑金,宜和心阳,养肺之药,
如茯神、枣仁、柏子仁、元参、沙参、麦冬、连翘、竹卷心、灯心,甚则黄连、黄芩亦可用
。肝火上炎,必口苦吐酸,脉弦咳嗽者,宜用和肝泄木,如生地、归身、白芍、丹皮、桑叶
、钩藤、白蒺藜之类。若肾水泛痰,而见咳嗽者,其痰必咸,耳必鸣,夜重日轻,六味汤、
都气丸俱可用。因二方有茯苓、泽泻,故能降一切虚火。更有劳倦咳嗽,其治在滋化源,方
用补中益气,去升麻、柴胡,加茯苓、麦冬、五味子;有痰再加半夏、象贝。予治此症,获
效多矣。有日晡身热,咳嗽至晓,热解,嗽亦缓者,泻白散主之。有酒客胃中湿热熏蒸,而
为咳嗽者,又当燥湿清火,如茯苓、生苡仁、茅术、半夏、神曲、黄芩、黑栀之类。以上所
采药味,原与病症相合,然并非即以此数味为方也。在观者参而用之,方为合格。更有老年
卫气不固,每当新寒束缚之时,多有咳痰者,俗称痰火病。宜于平时服补肺胃之丸,至期
不致受凉,多可免者。予治数老人。其效如神。
Bi syndrome refers to fatigue. There is Zhou Bi (General Bi Syndrome), characterized by numbness or pain throughout the body and limbs. This is generally caused by insufficiency of Qi and Blood, compounded by Wind-Damp pathogenic factors. Treatment should focus on tonifying Qi and Blood, assisted by herbs that disperse Wind and promote diuresis to resolve Dampness. The medication must be administered with warming properties to facilitate circulation for effectiveness. There is Xing Bi (Wandering Bi Syndrome), characterized by numbness and pain without fixed locations; its treatment method is the same as that for Zhou Bi. As for Xiong Bi (Chest Bi Syndrome), it results from the obstruction of Yang Qi in the chest. Treatment uses herbs such as Xi Bai (Allii Macrostemonis Bulbus), Bai Jiu (White Wine), and Gua Lou Pi (Trichosanthis Pericarpium) to unblock Yang Qi, after which recovery ensues.
(Attached: Fei Wei / Lung Atrophy)
Wei syndrome (Flaccidity Syndrome) is mostly caused by Damp-Heat, or Cold pathogenic factors flowing into the knee and leg regions. The affected area may swell or not, presenting with soreness, weakness, and difficulty walking. Some cases arise from excessive sexual activity leading to Essence depletion, where Liver Blood fails to nourish the sinews, causing them to lose moistening, thus resulting in this syndrome. One must abstain from sexual desires and use medications that tonify the Liver and Kidney while promoting unblocking. If caused by Cold exposure, warming and unblocking the sinews is appropriate; if caused by Damp-Heat, clearing and draining Damp-Heat with added Weilingxian (Clematidis Radix et Rhizoma), Niuxi (Achyranthis Bidentatae Radix), and Mugua (Chaenomelis Fructus) is required. Recovery depends half on medication and half on the patient's careful regimen management. Strong liquor must be strictly avoided to ensure rapid recovery. The syndrome named Fei Wei (Lung Atrophy) shares the name but differs in pathology. Fei Wei is formed by Heart Fire insulting Metal (the Lung) due to chronic coughing. Since the Lung belongs to Dry Metal, contracting Dryness again can cause it. To treat Heart Fire insulting Metal, one should first harmonize Heart Yang, adding Huang Lian (Coptidis Rhizoma) if necessary, followed by lung-nourishing substances such as Ren Shen (Ginseng Radix et Rhizoma), Mai Dong (Ophiopogonis Radix), Wu Wei Zi (Schisandrae Chinensis Fructus), Yan Wo (Swallow's Nest), and Bei Sha Shen (Glehniae Radix). If caused by contracting Dryness, Yu Nu Jian (Jade Woman Decoction) or Qing Zao Jiu Fei Tang (Clear Dryness and Rescue the Lung Decoction) are suitable. In severe cases of Lung Atrophy, eyebrows fall out and skin becomes dry because the Lung governs the skin and hair. Treatment takes months, requiring hundreds of doses of medicine for recovery.
Cough can be caused by external contraction, internal injury, or internal injury combined with external contraction. The Lung governs the skin and hair and is a delicate organ. When humans contract Wind-Cold, the skin feels chilly, Lung Qi cannot diffuse outward, leading to sneezing, runny clear nasal discharge, and cough. Such cases should be treated with warming dispersal methods using herbs like Su Ye (Perillae Folium), Fang Feng (Saposhnikoviae Radix), Qian Hu (Peucedani Radix), Ju Hong (Citri Reticulatae Pericarpium Rubrum), Cong Bai (Allii Fistulosi Bulbus), Zhi Cao (Prepared Licorice Root), and Jiang Pi (Zingiberis Recens Pericarpium). If Heat has already transformed, acrid-cool methods are used, such as Bo He (Menthae Haplocalycis Herba), Xing Ren (Armeniacae Semen Amarum), Jing Jie (Schizonepetae Spica), Lian Qiao (Forsythiae Fructus), Shan Zhi (Gardeniae Fructus), and Zhu Ye (Bambusae Folium). If contracted Wind-Heat causes chest stuffiness, spontaneous sweating, and cough, heat-clearing summerheat-resolving agents are needed, such as Hua Shi (Talcum), Fu Ling (Poria), Yi Yi Ren (Coicis Semen); since summerheat often carries Dampness, bland flavors are used to leach out Dampness, such as Sha Shen (Glehniae Radix or Adenophorae Radix), Si Gua Ye (Luffae Folium), and Dan Zhu Ye (Lophatheri Herba). Contracting Dryness leads to dry tongue, thirst, and cough, requiring Shi Gao (Gypsum Fibrosum), Xian Sheng Di (Rehmanniae Radix Recens), and Sang Ye (Mori Folium). Regarding internal injuries, cold food and drink damage the Lung, causing aversion to cold, panting, and coughing up phlegm-blood. Treatment involves tonifying Spleen Earth, descending Qi, resolving phlegm, and regulating the exterior, using formulas like Liu Jun Zi Tang (Six Gentlemen Decoction) plus Su Zi (Perillae Fructus), Xing Ren, Gui Zhi Mu (Cinnamomi Ramulus), Lao Jiang Zha (Old Ginger Residue), and Da Zao (Jujubae Fructus). If Heart Fire insults Metal, harmonizing Heart Yang and nourishing the Lung is indicated, using Fu Shen (Poria with Hostwood), Zao Ren (Ziziphi Spinosae Semen), Bai Zi Ren (Platycladi Semen), Yuan Shen (Scrophulariae Radix), Sha Shen, Mai Dong, Lian Qiao, Zhu Juan Xin (Bambusae Caulis in Taenia), and Deng Xin Cao (Junci Medullia); in severe cases, Huang Lian and Huang Qin (Scutellariae Radix) may also be used. If Liver Fire flares upward, accompanied by bitter taste, acid regurgitation, wiry pulse, and cough, harmonizing the Liver and draining Wood is appropriate, using Sheng Di, Gui Shen (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Dan Pi (Moutan Cortex), Sang Ye, Gou Teng (Uncariae Ramulus cum Uncis), and Bai Ji Li (Tribuli Fructus). If Kidney Water overflows transforming into Phlegm causing cough, the phlegm will be salty, ears will ring, symptoms worsen at night and improve during the day; Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) and Du Qi Wan (Duqi Pill) are applicable. Because these two formulas contain Fu Ling and Ze Xie (Alismatis Rhizoma), they can descend all types of Deficient Fire. Furthermore, fatigue-induced cough requires nourishing the source of transformation, using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix) removed, adding Fu Ling, Mai Dong, and Wu Wei Zi; if phlegm is present, Ban Xia (Pinelliae Rhizoma) and Xiang Bei (Fritillariae Thunbergii Bulbus) are added. I have achieved many successes treating this syndrome. Cases with afternoon fever, coughing until dawn, with heat subsiding and cough easing, are primarily treated with Xie Bai San (Drain White Powder). For drinkers whose stomach Damp-Heat steams upward causing cough, drying Dampness and clearing Fire is necessary, using Fu Ling, Sheng Yi Yi Ren, Cang Zhu (Atractylodis Rhizoma), Ban Xia, Shen Qu (Massa Medicata Fermentata), Huang Qin, and Hei Zhi Zi (Gardeniae Fructus Preparatus). The herbs selected above originally match the syndromes, but they do not constitute a fixed prescription. Observers should reference and apply them appropriately. Additionally, elderly people with insecure Wei Qi often experience coughing and expectoration when exposed to new Cold, commonly known as Tan Huo Bing (Phlegm-Fire Disease). Taking pills to tonify Lung and Stomach regularly prevents catching cold during vulnerable periods, largely avoiding attacks. I have treated several elderly patients with miraculous effects.