(此中间有错字,因无副本可勘,暂仍其旧。)
麋茸丸(麋茸一两,鹿茸亦可。)着许学士,(《普济本事方》)羊肾(二对,用酒浸,煮
烂去
(少
阴
所谓正治之良图。)小便失禁菟丝(子)丸,(严用和《济生方》)苁蓉麋茸并五味(子),鸡
(内
)金附子桑螵蛸,升举督脉护阳气。失禁诸方多用涩,惟此独得寻源计。然必佐以芳香品,
入阴升阳乃克济。入阴芳香是何类?杜仲茴香破故辈。(古方惟用固涩,或兼通太阳,究非
寻
源探本之法。盖小便癃秘,则用附子等独折太阳之气化;若夫不约,则三焦俱澈矣,独折太
阳亦无益也,当举督脉之阳,以保护诸阳之气,故麋茸为必需之药,然必佐以芳香入阴之品
,乃能抵下焦而升阳,如茴香、杜仲、破故纸之类。)柴胡四物(汤 地、芎、归、芍各一
钱
半。)参(人参) (黄 )草(甘草),(各三钱。疏通少阳。一方有半夏三钱。)和卫调营
达少
阳
最
用
原
物
清
一,加
入
腑
可
越脾汤越脾中气,发汗生津凉散委,(越脾者,发脾之津气而为汗,乃渐发汗于不发之
中,
肿脉洪
浮
篇》
云∶“风水恶风,一身悉肿,脉浮不渴,续自汗出,无大热,越脾汤主之。”按∶此条原文
,颇有舛错,从来注者,多胡芦提过。风水者,风中肌肤,津气不行,一身暴肿,有似于水
,故曰“风水”,其实非因于水也。故又云∶“风水脉浮,里水脉沉”,便可见矣。盖风为
阳邪,肺、脾、胃三经受风热之阳邪,闭郁其汗液而为病,必兼烦渴无汗易喘见象,与此汤
清火而发汗之旨合符。《金匮》风水一门,证多错杂,读者自会之可耳。)又有越脾加术汤
,里水亡津渴者饵。(《金匮要略·水气篇》云∶“里水者,一身面目黄肿,其脉沉,小便
不利,故令病水。假令小便自利,此亡津液,故令渴。越脾加术汤主之。”按∶风水脉浮当
发汗,里水脉沉当分利,此正法也。而里水亦用发汗者,盖小便自利,亡津口渴,里已无水
,而水在皮中,既不能下利,惟有发汗一法,使从外解,故用此汤。但加白术实脾胜水止渴
,此权变之法也。)温邪挟饮填肺中,为胀为喘加半(夏)治。(名越脾加半夏汤,《金匮》
治
肺胀,咳而上气,其人喘,目如脱状,脉浮大者,即越脾汤原方加半夏也。)浮而且大大为
阳,散邪蠲饮辛寒利。(越脾散邪之力多,蠲饮之力少,故用半夏,辅其未逮。不用小青龙
汤者,以脉且大,病属阳邪,利辛寒不利辛热也。)若夫桂枝(二)越脾(一汤)法,脉弱
无阳
勿轻试。(《伤寒论太阳篇》云∶“太阳病,发热恶寒,热多寒少,脉微弱者,此无阳也,
不可发汗,宜桂枝二越脾一汤。”柯韵伯《伤寒来苏集》云∶“仲景言不可发汗,则必不用
麻黄;言无阳,是无胃脘之阳,亦不用石膏。古方多有名同而药不同者,安可循名而不审
其实也。此等脉证最多,宜用柴胡桂枝汤为恰当。”)无阳是亡阳分津,喻王二子说亦是。(
“无阳”二字,仲景言之不一,后人置为阙疑,嘉言谓即亡津之通称。王晋三曰∶“无阳乃
阳分亡津之谓,故用桂枝汤二分行阳,一分行阴。”其说亦是。)然必烦渴脉不微,热多寒
少乃克恃。(柯韵伯《伤寒来苏集》云∶“此汤可以治太阳阳明合病,热多寒少而无汗者”
,“然必兼见烦渴之证,脉虽不长大浮缓,而不微弱者宜之。”)甘草麻黄(汤)治里水,水
从汗解斯方美,(《金匮要略·水气病篇》云∶“水病发其汗即已。”)麻(黄)得甘草入中焦
,散水和脾厥有旨。(麻黄得甘草,引经入中焦,能散水和脾,取水谷之津为汗,深得厥旨
。)脉沉小者属少阴,温固必须加附子,(名麻黄附子汤。《金匮要略·水气病篇》云∶“水
之为病,其脉沉小属少阴,宜此汤。”)不使麻黄入肾经,汗不伤阴水自已。(熟附温肾固液
,不使麻黄深入肾经,劫液为汗,则水去而汗不伤阴。)《水气门》中三十五条,证多错杂
难
法
肿
水
)恶风无汗汗之宜,小便不利利之是。(此要诀也)脉沉虽寒必温经,(水气脉沉,当利小便;
若兼恶风无汗之表证,亦当发汗,然必佐以固里温经之药,如麻黄、附子是也。)脉浮而下
须兼使。(水气脉浮,在表,当发其汗,使水气从毛窍而出;若兼小便不利,法当利小便,
使水气从上而下,然必兼解其表,五苓散之属是也。)三拗汤(《太平惠民和剂局方》)中用
法拗,杏仁不去皮尖捣,麻黄留节甘草生,(麻黄留节,发中有收。杏仁留尖,取其发;连
皮取其涩。甘草生用,补中有发也。)风寒喘嗽服之好。(治感冒风邪,鼻塞咳嗽痰多,胸满
气短。)仓廪散治噤口痢,(下痢不欲食,名曰“噤口”,此乃胃中湿热蕴蒸清道所致。)人
参败毒(散)加陈(仓)米。(人参败毒散发湿热之邪,升清化浊,加陈米充脾胃之气。)或
用人
参与石莲,煎汤灌呷亦能济。(名人参石莲汤)痢后大渴脾气虚,单煎陈米汤(王肯堂《证
治
准绳》)可已。
(There are typos in the original text here; as there is no copy to verify, we retain the original.)
Milu Rong Wan (Deer Antler Velvet Decoction) [Note: Milu refers to sika deer, but the text notes Lu Rong (Cervum Nippon Pantotrichum) can be used]. It originates from Xu Shuwu's *Puji Ben Shi Fang* (General Essential Prescriptions for Emergencies). Use Sheep Kidney (two pairs, soaked in wine, boiled until soft, and the membrane removed), treating what is referred to as the proper treatment for Shaoyin disease. For urinary incontinence, Tusi Zi Wan (Cuscuta Seed Pill) can be used, originating from Yan Yonghe's *Jisheng Fang*. The formula contains Congrong (Cistanche Deserticola), Milu Rong (Sika Deer Antler), Wuwei Zi (Schisandra Chinensis Fruit), Jineijin (Gallus Gallus Domesticus Gizzard Lining), Fuzi (Aconitum Carmichaelii Lateralis Radix Praeparata), and Sangpiaoxiao (Mantis Egg Case), to lift the Du Meridian Yang Qi to protect the Yang Qi of all meridians. Formulas for incontinence mostly use astringent herbs, but this one alone seeks the root cause. However, it must be assisted by aromatic herbs that enter the Yin aspect to raise Yang, which is effective. What kind of aromatic herbs enter the Yin? These include Duzhong (Eucommia Ulmoides Bark), Huixiang (Foeniculum Vulgare Fruit), and Poguzhi (Psoralea Corylifolia Fruit). (Ancient formulas only used astringents, or occasionally ones that also unblock the Taiyang Meridian, which ultimately is not a method of seeking the root. Generally, for urinary retention (Longmi), herbs like Fuzi are used to suppress the Qi transformation of the Taiyang Meridian alone; if it is incontinence without restraint, the Sanjiao is already clear, so suppressing the Taiyang alone is of no benefit. One should raise the Yang of the Du Meridian to protect the Yang Qi of all meridians, thus Milu Rong is a necessary herb, but it must be assisted by aromatic herbs entering the Yin to reach the Lower Jiao and raise Yang, such as Huixiang, Duzhong, and Poguzhi.)
Chaihu Siwu Tang (Original Formula: Dihuang (Rehmanniae Radix), Chuanxiong (Ligusticum Chuanxiong Rhizome), Danggui (Angelica Sinensis Radix), Shaoyao (Paeoniae Radix Alba) each 1 qian). Add Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Membranacei Radix), and Gancao (Glycyrrhizae Radix et Rhizoma) (each 3 qian) to unblock the Shaoyang Meridian. Another version adds Banxia (Pinelliae Rhizoma) 3 qian. Harmonizing Wei (Defensive) Qi and Ying (Nutritive) Qi to reach the Shaoyang Meridian is most crucial. The original substance is clear and unified... (The text here seems fragmented or has layout errors, implying harmonization of Ying and Wei).
Yuebi Tang can disperse the Middle Qi of the Spleen, generating sweat and body fluids through sweating, cooling, and dispersing to treat edema. ("Yuebi" means dispersing the Spleen's Jin-Ye (body fluids/Qi) to produce sweat, gradually inducing sweat within non-sweating conditions. The *Jinkui Yaolue · Water Qi Chapter* states: "Wind-water causes aversion to wind, whole-body swelling, floating pulse, no thirst, continuous spontaneous sweating, no high fever; Yuebi Tang governs it." Commentary: This original passage has many errors, and commentators have often glossed over it. Wind-water refers to wind pathogenic factors invading the skin and muscles, causing Jin-Qi (fluids and Qi) stagnation, leading to sudden whole-body swelling resembling water retention, hence called "Wind-water," but it is actually not caused by water pathogens. Thus it says: "Wind-water has a floating pulse, interior water has a sinking pulse," which makes this clear. Wind is a Yang pathogen; when the Lung, Spleen, and Stomach meridians are affected by Wind-Heat Yang pathogens, closing and stagnating sweat glands leads to disease, necessarily accompanied by irritability, thirst, anhidrosis, and susceptibility to wheezing, which matches the purging heat and inducing sweat purpose of this decoction. The *Jinkui Yaolue* chapter on Wind-water has complex and mixed syndromes; readers should comprehend them themselves.) There is also Yuebi Jia Zhu Tang (Yuebi Tang plus Atractylodis Macrocephalae Rhizoma), taken for interior water with fluid depletion and thirst. (*Jinkui Yaolue · Water Qi Chapter* says: "Interior water presents with yellowish swelling of the whole body and face, sinking pulse, and difficult urination, thus causing water disease. If urination is spontaneous, this indicates fluid depletion, thus causing thirst. Yuebi Jia Zhu Tang governs it." Commentary: Wind-water with a floating pulse should be treated with sweating; interior water with a sinking pulse should be treated with promoting diuresis; this is the standard method. Why is sweating used for interior water? Because spontaneous urination depletes fluids and causes thirst, meaning there is no water inside, but water remains in the skin. Since it cannot be drained downward via urine, sweating is the only method to resolve it externally, hence this decoction is used. Adding Baizhu (Atractylodis Macrocephalae Rhizoma) strengthens the Spleen, overcomes dampness/water, and stops thirst; this is a flexible method.) Warm pathogens combined with phlegm-fluid filling the lungs cause distension and wheezing, treated by adding Banxia (Pinelliae Rhizoma). (Named Yuebi Jia Banxia Tang. *Jinkui Yaolue* treats lung distension, cough with upward rushing Qi, wheezing, eyes protruding like popping out, and floating-large pulse, using the original Yuebi Tang formula plus Banxia.) Floating and large pulses indicate excessive Yang; dispersing pathogens and eliminating phlegm-fluid requires acrid-cold properties. (Yuebi Tang has more power to disperse pathogens than to eliminate phlegm-fluid, hence Banxia is added to supplement its deficiency. Xiao Qinglong Tang is not used because the pulse is large, indicating a Yang pathogen; acrid-cold is suitable, while acrid-hot is not.) If following the method of Guizhi Er Yuebi Yi Tang (Two parts Cinnamon Twig Decoction to one part Yuebi Decoction), do not lightly try it if the pulse is weak and there is "No Yang." (*Shanghan Lun · Taiyang Chapter* states: "Taiyang disease, fever and aversion to cold, more heat than cold, weak pulse—this is 'No Yang,' sweating is contraindicated; Guizhi Er Yuebi Yi Tang is appropriate." Ke Yunbo in *Shanghan Laishu Ji* says: "When Zhongjing says sweating is contraindicated, he definitely does not use Mahuang; saying 'No Yang' means deficiency of Stomach-Middle Yang, so Shigao (Gypsum Fibrosum) is also not used. Many ancient formulas have the same name but different ingredients; how can one follow the name without examining the reality? There are many such pulse-syndrome combinations; Chaihu Guizhi Tang is more appropriate.") "No Yang" refers to loss of body fluids; the theories of Yu Jiayan and Wang Jinshan are also correct. (Zhongjing uses the term "No Yang" inconsistently, leaving later generations in doubt. Jiayan stated it is synonymous with fluid loss. Wang Jinshan said: "'No Yang' refers to fluid loss in the Yang aspect, hence Guizhi Tang is used two parts to move Yang and one part to move Yin." His theory is also correct.) However, it must be accompanied by irritability and thirst, and the pulse must not be weak; only when there is more heat than cold can one rely on it. (Ke Yunbo in *Shanghan Laishu Ji* says: "This decoction can treat Taiyang-Yangming combined disease with more heat than cold and no sweat," "However, it must present with irritability and thirst; even if the pulse is not typically large-long-floating-slow, it is suitable if not weak.")
Gancao Mahuang Tang (Licorice and Ephedra Decoction) treats interior water; resolving water through sweat makes this formula excellent. (*Jinkui Yaolue · Water Qi Chapter* says: "Water disease, once sweat is induced, it resolves.") When Mahuang (Ephedrae Herba) meets Gancao (Glycyrrhizae Radix et Rhizoma), it enters the Middle Jiao, dispersing water and harmonizing the Spleen; its intent lies in taking fluids from food and grain to produce sweat, deeply grasping the profound principles. (Mahuang combined with Gancao guides the meridian into the Middle Jiao, able to disperse water and harmonize the Spleen, extracting Jin-Ye from digested food to create sweat, deeply understanding the essence of the *Neijing*.) Pulses that are sinking and small belong to the Shaoyin Meridian; warming and securing requires adding Fuzi (Aconiti Lateralis Radix Praeparata). (Named Mahuang Fuzi Tang. *Jinkui Yaolue · Water Qi Chapter* says: "For water disease, if the pulse is sinking and small, it belongs to Shaoyin; this decoction is appropriate.") By preventing Mahuang from entering the Kidney Meridian, sweat will not injure Yin, and water will resolve itself. (Shu Fuzi (Prepared Aconite Root) warms the Kidney and secures fluids, preventing Mahuang from penetrating deep into the Kidney Meridian to rob fluids for sweat; thus water leaves without injuring Yin.) In the "Water Qi Chapter" Article 35, syndromes are complex and hard to distinguish... (Text fragment implies diagnostic key points.) Aversion to wind and no sweat indicate suitability for sweating; difficult urination indicates suitability for promoting diuresis. (This is the essential principle.) Although a sinking pulse indicates Cold, warming the meridians is mandatory. (Water Qi with a sinking pulse should be treated by promoting diuresis; if accompanied by exterior symptoms of aversion to wind and no sweat, sweating is also indicated, but must be assisted by herbs that secure the interior and warm the meridians, such as Mahuang and Fuzi.) For a floating pulse, lower symptoms must be addressed concurrently. (Water Qi with a floating pulse is at the exterior; sweating should be induced to expel water Qi through hair follicles; if accompanied by difficult urination, promoting diuresis is the method to drain water Qi downward, but exterior release must be concurrent, as in Wuling San.)
San'ao Tang (Three Unyielding Decoction) from *Taiping Huimin Heji Jufang* uses specific methods: Xingren (Prunus Armeniaca Seed) is not peeled or destalked before crushing; Mahuang (Ephedrae Herba) retains its nodes; Gancao (Glycyrrhizae Radix et Rhizoma) is used raw. (Retaining Mahuang nodes allows for releasing while retaining; retaining Xingren tips utilizes their dispersing power; keeping the skin utilizes their astringent nature. Raw Gancao provides tonification with dispersing action.) It is good for wheezing and cough caused by Wind-Cold. (Treats colds with wind pathogens, nasal congestion, cough with profuse phlegm, chest fullness, and shortness of breath.)
Canglin San treats Jin Kou Li (Anorexic Dysentery). (Dysentery with loss of appetite is named "Jin Kou" [Lock-mouth], caused by damp-heat accumulating in the Stomach steaming the clear pathways.) Ren Shen Bai Du San (Ginseng and Imperceptible Pathogens Powder) plus Chen Cang Mi (Aged Rice Grain) is used. (Ren Shen Bai Du San disperses damp-heat pathogens and raises the clear to transform turbidity; adding aged rice nourishes Stomach-Spleen Qi.) Alternatively, Ren Shen (Ginseng Radix et Rhizoma) and Shilian (Nelumbinis Nucillus) can be decocted in water and administered orally, which also helps. (Named Ren Shen Shilian Tang.) After dysentery, if there is extreme thirst due to Spleen Qi deficiency, decocting Chen Mi Tang (Aged Rice Decoction) alone (from Wang Kentang's *Zhengzhi Zhunsheng*) can cure it.