小陷胸汤,是先以瓜萎一枚,水六升,煮取三升,去渣,再纳黄连、半夏,煮成二升,去渣,分温做三服。生姜泻心汤,甘草泻心汤,半夏泻心汤的煎法,也同小柴胡汤一个样子,是把药煎好了,去渣再煎的。
大黄黄连泻心汤,是把药用麻沸汤渍之,须臾绞去渣,分温再服的。
附子泻心汤却是大黄、黄连、黄芩用麻沸汤渍之,绞去渣,附子煎成汁,和匀。分温再服。
竹叶石膏汤的煎法,与白虎汤不同,白虎之粳米,是与诸药同煎的,竹叶石膏汤的粳米,却把药煮好,去渣后,加入米的。桂枝人参汤的桂枝,是要后入的。茵陈蒿汤的茵陈,是要先煎的。其余如凡用阿胶,总是煎好药,去渣,纳胶烊消。凡用麻黄,总是先煎去沫。
你看煎药这一件事,古人这么的郑重,可以随随便便付托任何一个人干的么。
总之,麻黄、葛根,皆须先煎去沫;柴胡泻心。皆须去滓重煎;栀豉汤则栀须先煎,豉须后入;大承气则枳实、厚朴,既须先煎,又须去滓纳大黄煎,去黄纳硝微沸。先后次序,丝毫不能通融,依此法则效,不依此法即不效,然而现在的人,知此法者,能有几人。至于芳香之药后入,金石之药先煎,粘腻之品,有毛之物,皆须包煎,此则用意甚浅,今之人无不知之矣。
论痢疾痢疾这个病,已经关及脏气,大凡一切病,关及腑气者轻,关及脏气者重,就为在腑多实,在脏多虚,虚则宜补,实则宜攻。
从前岐伯断定,肠澼便血,身热则死,寒则生。肠澼下白沫,脉沉则生,脉浮则死。肠澼下脓,脉悬绝则死,滑大则生。即使身不热,脉不悬绝,也要滑大才是生脉,悬涩依然是死脉。肾移热于脾,传为虚肠澼,此症死不可治。肾脉小搏沉为肠澼下血,血温身热者死。心肝澼亦下血,二脏同病者可治,其脉小沉涩为肠澼,其身热者死。黄帝、岐伯这两位,是我们中医的老祖师,他的一言一行,都是为万世法的,他把痢疾瞧得这么郑重。肠澼下血,就是红痢;肠澼白沫,就是白痢;肠澼下脓。就是五色痢,可知痢之生死,脉是最要紧的一件事。
张仲景是医中之圣,断定五脏气绝于内者,痢不禁下,甚者手足不仁。又言下痢脉沉弦者下重,脉大者为未止,脉微弱数者为欲自止,虽发热不死。又言下痢手足厥冷,无脉者灸之不温,若脉不还,反微喘者死。又言下痢有微热而渴,脉弱者,令自愈。又言下痢咏数有微热,汗出,令自愈,设脉紧为未解。又言下痢脉数而渴者,令自愈,设不瘥必清脓血,以有热故也。又言下痢腹胀,满身体疼痛者,先温其里,乃攻其表。
前代医圣岐伯,是黄帝时人,后代医圣仲景,是汉灵帝的人,先圣后圣,相去有二千五百年,怎么岐伯断为死症的,到了仲景手里,倒有办法,敢是仲景的本领,强过岐伯么?
原来医学的进步,愈后愈昌明,这痢疾的发源地,是在五脏的脏气;痢疾的所在地。是在大肠的部位,肠为六腑之一,五脏宜补,六腑宜通。岐伯时代治病大半仗的是针灸,《内经》上汤药方子,只有十二首。病在肠,治宜汤药。岐伯有病无方,如何不要窘急,犹之现代的西医,对于痢疾,只能知道它有痢菌,而不能辨出痢菌之属热属寒,是虚是实,与某一脏有关,某一腑相连,粗疏简陋,只一通肠一法治之,自然利弊毫无把握了。
仲景而后,巢元方论病最详,其论痢疾曰:“痢而赤白者,是热乘于血,血渗于肠内则赤也;冷气入肠,搏肠间津液凝滞,则白也;冷热相交,故赤白相杂,重者状如脓涕而血杂之,轻者白脓上有赤脉,薄血状如鱼脂脑,世谓鱼脑痢也。又言血痢者,热毒折于血,入大肠故也。又言休息痢者,胃脘有停饮,因痢积久,或冷气或热气乘之,气动于饮,则饮动而肠虚受之,故为痢也。又言痢如膏,由脏腑虚冷气入于大肠成痢,冷气积,肠又虚,滑脂凝如膏也。蛊蛀痢,毒气侵于脏腑,如病蛊蛀之象,痢血杂脓瘀黑有片如鸡肝与血俱下是也。又言杂痢谓痢色无定,或水谷或脓血。或青或黄或赤或白,变杂无常,或杂色相兼而痢也。挟热则黄赤,热甚则变脓血也。冷则白。冷甚则青黑,皆由饮食不节,冷热不调,胃气虚而故变易也。
岐伯发明痢疾之发源地,仲景认清痢疾之所在地,并定出治疗之方药,巢氏详述痢疾受病之因。吾中医不谈痢疾菌,而对于痢疾分析之细。认症之确,药治之复杂,岂彼只以通肠简单治疗,为治痢无上妙法者,所能梦见。
痢疾之方治方治根诸病源,凡病皆是如此。不仅痢疾一症也。痢疾之病源,既已千头万绪,痢疾之方治,亦当五花八门。彼西医认痢疾只有一种菌,方治自然只有一种法。考之中医治痢,古人有到三十三法,并不是自寻烦恼,欲求病之愈,不得不如此。
2、白头翁汤法。白头翁黄柏秦皮3、紫参汤法。紫参甘草4、梨勒散。诃梨勒5、甘草泻心汤法。甘草黄芩干姜半夏黄连大枣6、黄芩汤法。黄芩甘草芍药大枣7、黄芩加半夏生姜汤法。即前方加半夏生姜8、干姜黄连黄芩人参汤法。
9、赤石脂禹馀粮汤法。
10、雄黄丸法。毒暑在脾,湿气连脚,不泄则痢,不痢则疟,独炼雄黄,蒸饼和药,甘草作汤,服之安乐,别作治疗,医家大错。
12、瓜蒌散法。
13、《外台》疗热毒痢、血(痢)、脐下绞刺痛方法。升麻地榆茜草黄连犀角生地栀子薤白香豉14、《外台》主赤自痢方法。黄连阿胶15、《外台》疗五疳、蒸、下痢方法。苦参青葙甘草16、《活人书》薤自汤法。豉薤白栀子17、《局方》诃梨勒丸法。肉豆蔻木香干姜砂仁诃梨勒皮川乌白矾龙骨赤石脂18、葛根汤法。
19、葛根黄芩黄连汤法。
20、当归四逆汤法。
2l、大承气汤法。
22、小承气汤法。
23、四逆散法。
24、四逆汤法。
25、白通加猪胆汁汤法。
26、白通汤法。
27、四逆加人参汤法。
28、通脉四逆汤法。
29、猪肤汤法。
30、阳毒升麻汤法。
31、生姜泻心汤法。
32、乌梅丸法。
33、威喜丸法。
有凉有热,有攻有补,有通有止,不一其症,即不一其方,不一其法,视彼西医以通肠一法,普治诸痢者,难易大别天渊矣。
论戒烟眼前新兴事业,最发达的就是戒烟,这件事,本来政令有禁,再要吸下去,真是受累不浅。
戒烟的事,我也辄闹忙,曾经在《医林》中刊布过两张戒烟验方,从古到今,个个人认直弗曲,自己总说自己好,我也当然不能例外,我刊布的两张方子,尤其是第一张红茶白盐黑膏的那方,认为万妥万当,绝无弊言,偏偏有几位多疑的仁兄,偏偏写信来问我,此方是否靠得住,我现在就在这儿答复,请你放心,此方十分可靠。
诸位也要想一想,我与诸位素不相熟,为什么好端端弄一张方子来哄诸位,问到林文忠公戒烟方,那林方又是一张方子,不能与我方相提并论,林方有林方的好处,我方有我方的好处,欢喜林方时,请向国药铺购买现成药膏就是,这林方是我们青浦前辈何书田先生撰的,君臣佐使很不错,已经有相当的成绩,大致总可以放心的了,我之方烟瘾不论大小,药味毫无加减。瞧方配服可也。
我再有一句话奉告,鸦片这东西,吸上它时,不是一天两天,三日五日吸得上瘾的,那么戒绝时光,当然不能够迅速,来既不易,去亦烦难,偏偏现在的人,要他骑牛而来,飞机而去,如何能够立刻见功,大背事理,就要弄出事来,我这方子就是不能够快。
问到身体虚弱,那是另一个问题,究竟是阳虚,还是阴虚,血虚还是气虚。那是要请医生调理的,不在戒烟范围之内。
论痰饮稠痰叫做痰,稀痰叫做饮,痰饮这一症,古人分为四种:一种叫痰饮;一种叫悬饮;一种叫溢饮;一种叫支饮。
先讲痰饮,一个人素体肥盛,忽然瘦起来,水走肠间,沥沥有声,这就叫痰饮,其实不过是痰饮之一种,以后当另题再论。
再讲悬饮,一个人饮下去的水不化,而流在胁下,必然要咳唾,那咳唾的时候,必然要引痛,这就叫悬饮。
再谈溢饮,饮入的水流行归于四肢,很该汗出而解,偏偏不汗出,那么身体疼重,这就叫做溢饮。
水饮在于心下,其人的背部寒冷如手大,心下偏又坚硬,筑筑然短气。恶水不得饮。这就是留饮在心的证状。
水饮在于肺呢,时时吐涎沫,偏又时时欲饮水,这就是留饮在肺的证状。水饮在于脾呢,是既少气又身重,这就是留饮在脾的证状。
胸中有留饮,其人短气而渴,四肢历节痛。脉必见沉,这就是留饮证的脉。
讲到伏饮的见证,与留饮有个分别,膈上病痰喘,满而咳吐,发起来就寒热,背痛、腰痛,目泣自出,其人振振,身体颤动,那就是伏饮了。
凡是饮,不管它是痰饮,是溢饮、是支饮、是悬饮、是留饮、是伏饮,它的病源总为饮水太多,水停在内,不能化。这是饮症的来源,所以一个人到大渴的时候,最忌的是牛饮(指大量饮水),古人啜茗称品,也是卫生之一法。
为了饮水太多,水停聚在两胁之间,遇着了寒气,水寒相搏,结聚成块,亘起在胁下,按之作水声,这就叫做癖饮。
为了饮酒过量,口中大渴,引饮无度。酒与饮停滞在于胁肋下,结聚成癖,时时作痛,他的病状,是胁下气急而痛,这就叫做酒癖。
本来痰水结于胸膈之上,又犯了大寒,遂致阳气不行;痰水格外的结聚不散,于是阴气上逆,上与风痰相结,上冲于头,就要头痛,有的痛到几年之久,到后来变成脑痛症,倘然头痛到手足,寒冷至骨节,那就要死了,这就是膈痰之证。
我们中国人病痰饮的特别多,那病痰饮的人,必然有咳嗽,必然多痰,可怜西医先生不认识痰饮本来面目,一见痰饮咳嗽,就要吓得屁滚尿流,说是肺病第二期,肺病第三期。
赶快入医院疗养,那病人的病,休谈到治愈。倒吓重了二三分呢。
我作此篇文字,有两个意思,一个安慰病家,患了咳嗽,不一定是痨病,不要自己吓自己;一个是教乖西医先生,知道咳嗽中还有一个痰饮咳嗽,治疗的法子,与痨病咳嗽,是大大不同的。
痰饮之治法痰饮症的病源病状,我已经讲过,痰饮症的咳嗽,与肺病咳嗽,大不相同,大大的有别,请咳嗽病家,休要误会,休要听信胡言。自己吓自己。
我现在把古人痰饮症治法,详详细细讲给诸位听,且请静坐。听我道来。
却说痰饮一症,有病在心下的,证见胸胁支满,目眩短气,有微饮,这是很该使病从小便去的,主用苓桂术甘汤。
还有病者脉伏,其人欲自利,利过后倒反爽快,虽然自利,心下还是坚满,此乃是留饮欲去之故,主用甘遂半夏汤,由它从大便而去。
有脉沉而弦的,悬饮内痛,有数家脉弦的水症,还有欬烦、胸中痛的支饮症,都是用十枣汤泻去其水的。
有心下有水气症,那外证是干呕发热,或咳或利,少腹满而喘者,主治小青龙汤的。
有膈间支饮症,其人喘满,心下偏又痞坚,面色偏又黧黑,脉来偏又沉紧,此病得之已有数十日,医家用过吐法、下法都不效,就可用木防己汤去治疗。倘然病势不结实,可以好了。倘然病势结实,好过三日要复发的,那么就要用木防已汤去石膏加茯苓、芒硝汤治疗了。
有心下有支饮,证见苦冒眩的,主治用泽泻汤,呕而不渴,也是心下有支饮,主治用小半夏汤。倘使猝然呕吐,心下有痞,膈间有水,既眩且悸,主治用小半夏加茯苓汤,支饮不得息呢,主治用葶苈大枣泻肺汤。
还有效逆倚息不得卧,服过小青龙汤,还是多唾口燥,寸脉沉,尺脉微,手足厥逆,气从小腹上冲胸咽,手足痹,其面翕热如醉状,因复下流阴股,小便难。时复冒者,与桂苓五味甘草汤,治它的气冲,倘然服药之后,冲气即低,那就好了,倘使冲气虽低,反倒胸满而咳,那就要用桂苓五味甘草汤去桂加姜辛以治其咳满,病情千变万他。倘使欬满止后,又口渴起来,冲气重又发作,那是为了细辛、千姜是热药,服下去很该就渴,现在颠倒,渴反止了,那就为了支饮之故。支饮的症,在法当冒,冒的人必然呕,倘然见呕,再与苓甘五味加姜辛半夏汤;倘然水去呕止,其人形肿者,当加杏仁,即与苓甘五味加姜辛半夏杏仁汤;倘使面热如醉,这就是胃热上冲熏其面,当加大黄除其热,即是苓甘五味加姜辛半夏杏仁大黄汤;更有支饮胸满症,是用厚朴大黄汤主治的。
我们中医治痰饮有这许多法子,岂是惯用老辞来吓人,对于病变一筹奠展者可比。
Xiao Xianxiong Tang (Minor Intractable Phlegm Decoction) is prepared by first taking one Gualou (Trichosanthes Fruit), adding six sheng of water, boiling it down to three sheng, straining out the dregs, then adding Huanglian (Coptis Rhizome) and Banxia (Pinellia Tuber), boiling until two sheng remain, straining out the dregs, and dividing into three warm doses. The decoction methods for Shengjiang Xiexin Tang (Ginger Heart-Draining Decoction), Gancao Xiexin Tang (Licorice Heart-Draining Decoction), and Banxia Xiexin Tang (Pinellia Heart-Draining Decoction) are similar to Xiaochaihu Tang (Minor Bupleurum Decoction): the herbs are boiled, strained, and then boiled again.
Dahuang Huanglian Xiexin Tang (Rhubarb and Coptis Heart-Draining Decoction) is prepared by soaking the herbs in boiling water (Mafei Tang) for a short while, wringing out the juice, straining out the dregs, and dividing into two warm doses.
Fuzi Xiexin Tang (Aconite Heart-Draining Decoction) involves soaking Dahuang (Rhubarb Root and Rhizome), Huanglian (Coptis Rhizome), and Huangqin (Scutellaria Root) in boiling water, wringing out the juice, and straining out the dregs; separately, Fuzi (Prepared Aconite Lateral Root) is boiled into a liquid, and the two juices are mixed evenly and divided into two warm doses.
The decoction method for Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) differs from Baihu Tang (White Tiger Decoction): in Baihu Tang, Jingmi (Rice Grain) is boiled together with the other herbs, whereas in Zhuye Shigao Tang, Jingmi is added after the other herbs have been boiled and strained. In Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction), Guizhi (Cinnamon Twig) should be added later in the process. In Yinchen Hao Tang (Artemisiae Scopariae Decoction), Yinchen (Artemisiae Scopariae Herba) should be boiled first. Generally, when using Ejiao (Donkey-Hide Gelatin), the other herbs are boiled and strained first, then the gelatin is added and melted. When using Mahuang (Ephedra Herb), it is always boiled first to remove the foam.
You see how seriously the ancients treated the preparation of herbal decoctions; how can such a task be casually entrusted to just anyone?
In summary, Mahuang (Ephedra Herb) and Gegen (Pueraria Root) must both be boiled first to remove the foam; Chaihu (Bupleuri Radix) and various Xiexin Tangs (Heart-Draining Decoctions) must be strained and then re-boiled; in Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), Zhizi (Gardenia Fruit) must be boiled first, and Chidou (Fermented Soybean) added later; in Dachengqi Tang (Major Order the Qi Decoction), Zhishi (Immature Bitter Orange Fruit) and Houpo (Magnolia Bark) must be boiled first, then strained before adding Dahuang (Rhubarb Root and Rhizome) to boil again, and finally adding Moxiao (Mirabilite) and brought to a slight boil. The sequence is strict and cannot be compromised; following this rule yields efficacy, while ignoring it leads to failure. Yet, how many people today know this method? As for aromatic herbs being added later, mineral and metallic herbs being boiled first, sticky substances or those with hairs being wrapped during decoction—these principles are relatively shallow and known to everyone today.
On Dysentery: This disease involves the Zang organs. Generally, diseases involving the Fu organs are lighter, while those involving the Zang organs are heavier, because conditions in the Fu organs are mostly Excess, while those in the Zang organs are mostly Deficiency. Deficiency requires tonification, and Excess requires purging.
Previously, Qibo stated that in Changpi (Intestinal Dysentery) with blood in the stool, fever indicates death, while coldness indicates survival. If there is white mucus, a deep pulse indicates survival, while a floating pulse indicates death. If there is pus and blood, a suspended and severed pulse indicates death, while a slippery and large pulse indicates survival. Even without fever or a suspended pulse, a slippery and large pulse is auspicious, while a suspended and choppy pulse is ominous. If Kidney heat transfers to the Spleen, transforming into deficiency-type Changpi, this condition is incurable and fatal. A small, pounding, and deep Kidney pulse indicates dysentery with blood; if the blood is warm and the body is hot, death ensues. Heart and Liver dysentery also present with blood; if both organs are diseased simultaneously, it is treatable. A small, deep, and choppy pulse indicates Changpi; if accompanied by fever, death ensues. Huangdi (Yellow Emperor) and Qibo are the ancestral masters of our Traditional Chinese Medicine; their words and deeds serve as eternal models. They regarded dysentery with such seriousness. Changpi with blood is Red Dysentery; Changpi with white mucus is White Dysentery; Changpi with pus and blood is Five-Color Dysentery. Thus, the pulse is the most critical factor in determining the prognosis of dysentery.
Zhang Zhongjing, the Sage of Medicine, determined that if the Qi of the Five Zang organs is exhausted internally, dysentery cannot tolerate purgatives; in severe cases, the hands and feet become insensible. He also stated that a deep and wiry pulse in dysentery indicates tenesmus; a large pulse indicates the disease has not stopped; a weak, thready, and rapid pulse indicates spontaneous cessation, and even with fever, death will not occur. He further stated that if dysentery presents with cold hands and feet and no pulse, moxibustion that fails to warm the limbs, combined with a return of no pulse and slight panting, indicates death. He said that mild fever with thirst and a weak pulse in dysentery allows for self-healing. He also stated that a rapid pulse with mild fever and sweating allows for self-healing, but a tight pulse indicates unresolved disease. He said that a rapid pulse with thirst allows for self-healing; if it does not resolve, pus and blood will appear due to heat. He stated that dysentery with abdominal fullness and body pain requires warming the interior first, then attacking the exterior.
The former medical sage Qibo lived during the time of the Yellow Emperor; the latter medical sage Zhongjing lived during the reign of Emperor Ling of Han. Separated by 2,500 years, why did Qibo declare certain dysentery cases fatal, while Zhongjing had remedies? Is Zhongjing’s skill superior to Qibo’s?
Actually, medicine progresses and becomes more enlightened over time. The origin of dysentery lies in the Qi of the Five Zang organs; its location is in the Large Intestine. The intestine is one of the Six Fu organs; the Five Zang organs benefit from tonification, while the Six Fu organs benefit from unblocking. In Qibo’s era, treatment relied largely on acupuncture and moxibustion; the *Neijing* contains only twelve herbal formulas. Since the disease is in the intestine, herbal decoctions are appropriate. Qibo had diagnoses but no formulas, which was indeed distressing. Similarly, modern Western medicine knows only of the dysentery bacillus but cannot distinguish whether the pathogen is Heat or Cold, Deficiency or Excess, nor which Zang or Fu organ is involved. Their approach is crude and simplistic, relying solely on intestinal purgation, leaving them uncertain of benefits and risks.
After Zhongjing, Chao Yuanfang discussed diseases in great detail. Regarding dysentery, he said: "Dysentery with red and white discharge indicates Heat affecting the Blood, which seeps into the intestines causing redness; Cold Qi entering the intestines condenses intestinal fluids, causing whiteness; when Cold and Heat interact, red and white mix. Severe cases resemble pus and mucus mixed with blood; mild cases show red streaks on white pus, resembling fish fat or brain matter, known as Fish Brain Dysentery." He also stated that bloody dysentery results from Heat-Toxicity damaging the Blood and entering the Large Intestine. He described Resting Dysentery as caused by retained fluid in the Stomach cavity, lingering from chronic dysentery, where Cold or Heat Qi agitates the fluid, moving it into the empty intestines, causing dysentery. He described dysentery resembling paste as resulting from internal Cold and Deficiency in the Zang-Fu, where Cold Qi enters the Large Intestine, accumulates, and causes slippery fat to congeal like paste. Gu Zhu Dysentery involves Toxic Qi invading the Zang-Fu, resembling parasitic decay, with bloody dysentery mixed with dark pus and clots resembling chicken liver. Mixed Dysentery has variable colors—water, food, pus, blood, green, yellow, red, or white—changing unpredictably due to irregular diet, imbalance of Cold and Heat, and Stomach Qi Deficiency.
Qibo identified the origin of dysentery; Zhongjing clarified its location and established treatments; Chao detailed its etiology. Our Traditional Chinese Medicine does not discuss dysentery bacteria, yet our analysis of dysentery is meticulous, diagnosis accurate, and treatment complex. How could Western medicine, relying solely on simple intestinal purgation, ever dream of achieving such mastery?
Treatment of Dysentery: Treatments stem from the sources of disease, applicable to all illnesses, not just dysentery. Given the myriad origins of dysentery, its treatments must be diverse. Western medicine, believing dysentery is caused by a single bacterium, naturally adopts a single treatment method. Examining Chinese medicine, the ancients developed up to thirty-three methods for treating dysentery. This is not seeking trouble unnecessarily; to cure the disease, such complexity is necessary.
1. Taohua Tang (Peach Blossom Decoction) method: Chishizhi (Halloysitum Rubrum), Ganjiang (Dried Ginger), Jingmi (Rice).
2. Baitouweng Tang (Pulsatilla Decoction) method: Baitouweng (Anemones Radix), Huangbai (Phellodendri Cortex), Qinpi (Ash Bark).
3. Zishen Tang method: Zishen (Stemonae Radix), Gancao (Licorice Root).
4. Helile San (Persimmon Seed Powder) method: Helile (Chebulae Fructus).
5. Gancao Xiexin Tang (Licorice Heart-Draining Decoction) method: Gancao (Licorice Root), Huangqin (Scutellaria Root), Ganjiang (Dried Ginger), Banxia (Pinellia Tuber), Huanglian (Coptis Rhizome), Dazao (Jujube Fruit).
6. Huangqin Tang (Scutellaria Decoction) method: Huangqin (Scutellaria Root), Gancao (Licorice Root), Shaoyao (Peony Root), Dazao (Jujube Fruit).
7. Huangqin Jia Banxia Shengjiang Tang (Scutellaria Decoction with Added Pinellia and Fresh Ginger) method: Add Banxia (Pinellia Tuber) and Shengjiang (Fresh Ginger) to the previous formula.
8. Ganjiang Huanglian Huangqin Renshen Tang (Dried Ginger, Coptis, Scutellaria, and Ginseng Decoction) method.
9. Chishizhi Yuyuliang Tang (Halloysite and Hematitum Decoction) method.
10. Xionghuang Wan (Realgar Pill) method: Toxic summer heat in the Spleen, dampness connecting to the feet; if not diarrhea, then dysentery; if not dysentery, then malaria. Refine Realgar alone, mix with steamed bread dough, take with Licorice decoction for comfort. Other treatments would be major errors by physicians.
11. Chaihu Jia Mangxiao Tang (Bupleurum Decoction with Added Mirabilite) method: Add Mangxiao (Mirabilite) to the Chaihu Tang formula.
12. Gualou San (Trichosanthes Powder) method.
13. *Waitai* method for treating Heat-Toxic Dysentery, Bloody Dysentery, and stabbing pain below the umbilicus: Shengma (Cimicifugae Rhizoma), Diyü (Sanguisorbae Radix), Qiancao (Rubiae Radix), Huanglian (Coptis Rhizome), Xijiao (Rhinocerotis Cornu - note: substitute legally), Shengdi (Rehmanniae Radix), Zhizi (Gardenia Fruit), Xiebai (Allii Macrostemonis Bulbus), Jiangchi (Fermented Soybean).
14. *Waitai* method for Red and White Dysentery: Huanglian (Coptis Rhizome), Ejiao (Donkey-Hide Gelatin).
15. *Waitai* method for treating Five Wasting-Tndrinking Disorders, Steaming, and Dysentery: Kushen (Sophorae Flavescentis Radix), Qingxiang (Celosiae Semen), Gancao (Licorice Root).
16. *Heren Shu* Xiebai Tang (Welsh Onion Decoction) method: Jiangchi (Fermented Soybean), Xiebai (Allii Macrostemonis Bulbus), Zhizi (Gardenia Fruit).
17. *Ju Fang* Helile Wan (Persimmon Seed Pill) method: Roudoukou (Myristica Seed), Muxiang (Aucklandiae Radix), Ganjiang (Dried Ginger), Sharen (Amomi Fructus), Helile Pi (Chebulae Pericarpium), Chuanwu (Aconiti Radix Praeparata), Baifan (Alumen), Longgu (Fossilia Ossis Mastodi), Chishizhi (Halloysitum Rubrum).
18. Gegen Tang (Pueraria Decoction) method.
19. Gegen Huangqin Huanglian Tang (Pueraria, Scutellaria, and Coptis Decoction) method.
20. Danggui Sini Tang (Angelica Decoction for Cold Extremities) method.
21. Dachengqi Tang (Major Order the Qi Decoction) method.
22. Xiaochengqi Tang (Minor Order the Qi Decoction) method.
23. Sini San (Cold-Reversal Powder) method.
24. Sini Tang (Cold-Reversal Decoction) method.
25. Bitong Jia Zhu Danjiang Tang (Bitong Decoction with Added Pig Gallbladder Juice) method.
26. Bitong Tang (Bitong Decoction) method.
27. Sini Jia Renshen Tang (Cold-Reversal Decoction with Added Ginseng) method.
28. Tongmai Sini Tang (Pulse-Unblocking Cold-Reversal Decoction) method.
29. Zhufu Tang (Pig Skin Decoction) method.
30. Yangdu Shengma Tang (Yang-Disease Cimicifuga Decoction) method.
31. Shengjiang Xiexin Tang (Ginger Heart-Draining Decoction) method.
32. Wumei Wan (Mume Pill) method.
33. Weixi Wan (Weixi Pill) method.
There are cooling and heating methods, purging and tonifying methods, unblocking and astringing methods. Different symptoms require different formulas and methods. Compared to Western medicine’s universal use of intestinal purgation for all dysenteries, the difference in difficulty is vast, like heaven and earth.
On Quitting Smoking: Among emerging endeavors today, quitting smoking is the most developed. This matter is already prohibited by government decree; continuing to smoke brings considerable hardship.
I have also busied myself with quitting smoking. I previously published two effective prescriptions for quitting smoking in *Yilin*. From ancient times to the present, everyone insists they are right and others wrong, claiming their own methods are best. Naturally, I am no exception. Of the two prescriptions I published, especially the first one involving Black Tea, White Salt, and Black Paste, I considered it perfectly sound and free of flaws. Yet, several suspicious gentlemen wrote to ask if this prescription is reliable. I reply here: rest assured, this prescription is highly reliable.
Consider this: I am unfamiliar with you all; why would I fabricate a prescription to deceive you? Regarding Lord Lin Wen-zhong’s (Lin Zexu) prescription for quitting smoking, that is another formula and cannot be compared with mine. His formula has its merits, and mine has mine. If you prefer his formula, purchase the ready-made paste from a Chinese medicine shop. This formula was authored by Mr. He Shutian, a senior from Qingpu. Its Jun-Chen-Zuo-Shi (Emperor-Minister-Assistant-Courier) structure is excellent, and it has achieved considerable results. You can generally trust it. My formula applies regardless of the severity of nicotine addiction, with no additions or subtractions to the ingredients. Follow the prescription and take it accordingly.
Let me add one more word of advice: Opium addiction does not develop in one or two days, or three or five days. Therefore, quitting cannot be rapid. Coming is difficult; going is also arduous. Yet, people today want to quit overnight, like switching from riding a cow to flying in an airplane. How can immediate results be expected? This goes against reason and may cause harm. My prescription is simply not fast-acting.
Regarding physical weakness, that is a separate issue. Whether it is Yang Deficiency, Yin Deficiency, Blood Deficiency, or Qi Deficiency requires adjustment by a physician and is outside the scope of quitting smoking.
On Phlegm-Fluid Retention: Thick phlegm is called Tan (Phlegm); thin phlegm is called Yin (Fluid). The ancients categorized Phlegm-Fluid Retention into four types: Tan Yin (Phlegm-Fluid), Xuan Yin (Suspended Fluid), Yi Yin (Overflowing Fluid), and Zhi Yin (Supporting Fluid).
First, Tan Yin: A person who was formerly obese suddenly becomes thin, with water moving through the intestines making gurgling sounds, is called Tan Yin. This is merely one type of Phlegm-Fluid Retention, to be discussed separately later.
Next, Xuan Yin: Water ingested is not transformed and flows into the hypochondrium, inevitably causing coughing and spitting. During coughing and spitting, pain is elicited. This is called Xuan Yin.
Then, Yi Yin: Ingested water flows to the limbs. Sweating should resolve the condition, but if sweating does not occur, the body feels heavy and painful. This is called Yi Yin.
Furthermore, cough with rebellious Qi, leaning to breathe, shortness of breath, inability to lie flat, and swelling-like appearance is called Zhi Yin.
Beyond these four types, there are Liu Yin (Retained Fluid) and Fu Yin (Hidden Fluid). Liu Yin is differentiated by the Five Zang organs.
When Fluid is in the Heart region (below the diaphragm), the back feels cold in an area the size of a hand, the epigastrium is hard, there is palpitations, shortness of breath, aversion to water, and inability to drink. These are signs of Liu Yin in the Heart.
When Fluid is in the Lung, there is frequent spitting of saliva and frequent desire to drink water. These are signs of Liu Yin in the Lung.
When Fluid is in the Spleen, there is shortness of breath and heaviness of the body. These are signs of Liu Yin in the Spleen.
When Fluid is in the Liver, there is fullness and distension in the hypochondrium, and pain upon sneezing. These are signs of Liu Yin in the Liver.
When Fluid is in the Kidney, there is palpitations in the epigastrium. These are signs of Liu Yin in the Kidney.
Generally, pain in the hypochondrium radiating to the clavicular fossa, accompanied by cough, indicates Liu Yin.
If there is Retained Fluid in the chest, the person experiences shortness of breath and thirst, and pain in all joints. The pulse must be deep. This is the pulse sign of Retained Fluid syndrome.
Regarding the manifestations of Hidden Fluid, they differ from Retained Fluid. Phlegm-Wheezing above the diaphragm, fullness with coughing and spitting, onset with chills and fever, back pain, lower back pain, tearing eyes, trembling, and bodily shaking indicate Hidden Fluid.
For all Fluid disorders, whether Tan Yin, Yi Yin, Zhi Yin, Xuan Yin, Liu Yin, or Fu Yin, the root cause is excessive water intake, leading to water stagnation internally that cannot transform. This is the source of Fluid syndromes. Therefore, when extremely thirsty, one must avoid guzzling large amounts of water (Niu Yin). Ancient sages savoring tea was also a health-preserving method.
Additionally, there are three conditions: Pi Yin (Accumulated Fluid), Jiu Pi (Alcohol Accumulation), and Ge Tan (Diaphragmatic Phlegm). Formed Fluid disorders are called Fake Pi.
Due to excessive water intake, water stagnates between the hypochondria. Encountering Cold Qi, Cold and Water clash, forming a mass that rises in the hypochondrium, producing a splashing sound upon pressure. This is called Pi Yin.
Due to excessive alcohol consumption, extreme thirst follows, leading to uncontrolled drinking. Alcohol and Fluid stagnate in the hypochondrium, forming an accumulation that causes periodic pain. The symptom is urgency and pain in the hypochondrium. This is called Jiu Pi.
Originally, Phlegm and Water accumulate above the diaphragm. Contracting severe Cold causes Yang Qi to fail to circulate; Phlegm and Water accumulate excessively. Consequently, Yin Qi rebels upward, combining with Wind-Phlegm, rushing to the head, causing headache. Some headaches last for years, eventually becoming Brain Pain Syndrome. If the headache extends to the hands and feet, and cold reaches the bone joints, death ensues. This is Ge Tan syndrome.
Chinese people suffer frequently from Phlegm-Fluid retention. Those with this condition inevitably have coughing and excessive phlegm. Poor Western doctors, unaware of the true nature of Phlegm-Fluid, panic at the sight of Phlegm-Fluid coughing, labeling it Stage II or Stage III Pulmonary Disease. Urging hospitalization for recuperation, the patient’s condition worsens rather than heals, frightened into greater illness.
I wrote this text with two purposes: first, to reassure patients that coughing is not necessarily Tuberculosis (Lao Bing), so do not frighten yourselves; second, to instruct Western doctors that there is a type of cough caused by Phlegm-Fluid Retention, the treatment of which is vastly different from Tuberculous coughing.
Treatment of Phlegm-Fluid Retention: I have already discussed the etiology and symptoms of Phlegm-Fluid Retention. The coughing associated with Phlegm-Fluid Retention is significantly different from Pulmonary Disease coughing. Patients with coughing should not misunderstand or listen to false claims, frightening themselves unnecessarily.
Now, I will explain in detail the ancient treatments for Phlegm-Fluid Retention. Please sit quietly and listen.
Regarding Phlegm-Fluid Retention, some cases involve the Heart region, presenting with fullness and distension in the chest and hypochondrium, vertigo, shortness of breath, and slight Fluid retention. It is appropriate to promote urination to eliminate the pathogen, primarily using Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction).
In cases where the pulse is hidden, the patient desires spontaneous diarrhea, feeling relieved after defecation, yet the epigastrium remains hard and full, this is due to Retained Fluid attempting to exit. The primary treatment is Gansui Banxia Tang (Kansui and Pinellia Decoction), allowing it to exit via the bowels.
With a deep and wiry pulse, indicating internal pain from Suspended Fluid, or various Water Syndromes with wiry pulses, or Zhi Yin syndromes with coughing, irritability, and chest pain, Shizao Tang (Ten Jujube Decoction) is used to purge the Water.
For Water-Qi in the epigastrium, with external signs of dry retching, fever, cough or diarrhea, lower abdominal fullness, and wheezing, Xiao Qinglong Tang (Minor Green Dragon Decoction) is indicated.
For Zhi Yin in the diaphragm, presenting with wheezing and fullness, hardness in the epigastrium, dark complexion, and a deep, tight pulse, persisting for dozens of days despite failed emetic and purgative treatments, Mufangji Tang (Stephania Decoction) is used. If the condition is not solid, it may resolve. If it is solid and recurs after three days, Mufangji Tang minus Gypsum plus Poria and Mirabilite is used.
For Zhi Yin in the epigastrium presenting with severe dizziness and vertigo, Zexie Tang (Alisma Decoction) is used. Vomiting without thirst also indicates Zhi Yin in the epigastrium, treated with Xiaobanxia Tang (Minor Pinellia Decoction). Sudden vomiting with epigastric fullness, Fluid in the diaphragm, dizziness, and palpitations are treated with Xiaobanxia Jia Fuling Tang (Minor Pinellia Decoction with Added Poria). For Zhi Yin causing breathing difficulty, Tingli Dazao Fei Tang (Descurainia Seed and Jujube Lung-Draining Decoction) is used.
For rebellious Qi preventing lying flat, after taking Xiao Qinglong Tang, if there is still excessive salivation, dry mouth, deep radial pulse, faint ulnar pulse, cold extremities, Qi rushing from the lower abdomen to the chest and throat, numbness in hands and feet, facial flushing like drunkenness, radiation to the inner thighs, difficult urination, and intermittent dizziness, Guiling Wuweigancao Tang (Poria, Cinnamon Twig, Schisandra, and Licorice Decoction) is used to treat the Qi rush. If the Qi rush subsides after medication, the condition improves. If the Qi rush subsides but chest fullness and cough appear, Guiling Wuweigancao Tang minus Cinnamon Twig plus Dried Ginger and Asarum is used to treat the cough and fullness. Conditions change infinitely. If cough and fullness cease but thirst appears and the Qi rush recurs, it is because Xixin (Asarum) and Ganjiang (Dried Ginger) are hot herbs; thirst should normally follow, but if thirst ceases instead, it is due to Zhi Yin. According to protocol, Zhi Yin causes dizziness, and dizzy patients vomit. If vomiting occurs, Linggan Wuweijia Jiangxin Banxia Tang (Poria, Licorice, Schisandra, Dried Ginger, Asarum, and Pinellia Decoction) is administered. If Water leaves and vomiting stops, but edema appears, Apricot Kernel is added, i.e., Linggan Wuweijia Jiangxin Banxia Xingren Tang (Poria, Licorice, Schisandra, Dried Ginger, Asarum, Pinellia, and Apricot Kernel Decoction). If the face is hot like drunkenness, it indicates Stomach Heat rushing upward; Rhubarb is added to clear the heat, i.e., Linggan Wuweijia Jiangxin Banxia Xingren Dahuang Tang (Poria, Licorice, Schisandra, Dried Ginger, Asarum, Pinellia, Apricot Kernel, and Rhubarb Decoction). For Zhi Yin with chest fullness, Houpo Dahuang Tang (Magnolia Bark and Rhubarb Decoction) is used.
Our Traditional Chinese Medicine has so many methods for treating Phlegm-Fluid Retention. Is this merely using old terms to scare people, comparable to those helpless against pathological changes?
Gentlemen, what I have described are methods from before the Han Dynasty, merely a portion of the techniques for treating Phlegm-Fluid Retention. There are many novel methods from post-Han periods, but I find them too cumbersome and will conclude here for now.