(参汤下。如吝,龙眼汤亦好)
枸杞(一斤) 补骨脂(八两) 白术(四两) 胡椒(二两) 久蒸,晒,极纯为妙。
春阳,指木政而言。回令,回其生发之令也。夫木得水则荣,失水则枯。气满则荣,血失则枯。荣则引风,
枯则惹火。动之如雷电,发之如风雨,独出独入,无敢禁御。五脏之最难得其平者,莫肝若也。故属肝之病居多,
而治肝之法极博焉。若乃血脱、洞泄,因成阴风暴盲,此脾、肾、肝虚极,脏中阳气下陷所致。是方枸杞子味甘
质润,濡血者也。补骨脂色黑气腐,暖水者也。水以生之,血以养之,木荣弗枯
耳。胡椒之辛热以回阳,白术之辛温以补土,阳回则花叶自繁,土浓而根干始劲。用人参者,洪钓一气,无地不
周。所谓一息不运则机缄穷,一毫不续则霄壤判,使其木令回春,土、火、金、水次第而生生矣。或者不达此理,
见其血竭,而主以纯阴之四物,切恐大地否塞,万物不生。亿其精耗,而进以壮水之六味,不免怀山襄陵,水泛
木浮。故曰四物、六味,有时禁弗与者,盖此类也。余撰兹丸,敢谓救今人之失,实所以补古方所不及。高明之
士,幸教我焉。
诗曰∶杞术补骨脂,参椒回春令,会得暴盲人,诚求乐施应。
干姜 附子 葱白(去葱入甘草即四逆汤)
少阴下利,目暴盲,两手脉俱沉濡,此方主之。
少阴肾,冬令也,主天地闭藏。寒邪客之,则阴道不固而下利,利下阳气暗泄,故脉沉濡,目盲。乃用葱白
以通阳气,干姜、附子以散阴寒。寒散阳复,通者塞而塞者通矣。可即葱而名白通。
向治某甲,投此汤,利不止,渐厥逆无脉,干呕而噎呃。或据伤寒论云∶此寒盛格阳,不能下达少阴,反逆
乱于上故也。须加人尿、猪胆汁以导之。切思暴盲系肾阳虚极,方悔用葱过表,更与大寒奇苦之尿、胆,则落井
下石。所谓不死于病,死于药矣。乃以柿蒂、丁香、干姜浓煎一大杯,下咽呃逆即止。随进八物回生饮五六剂,
身温脉续,而目亦能睹。可见印板书在人活读,印板方其可死用乎哉?又太阴自利不渴,阴症脉沉身痛,与夫厥
逆不利,脉不至,用四逆
汤,煎成凉服。吴注∶太阴主水谷,内有真寒,故自利不渴。阴症举三阴而言,病在里故脉沉。里寒,则血脉凝
涩,不能宣布手足,故身痛,四肢厥逆,脉不至而下利。经曰∶寒淫于内,治以甘热。故用炙草、姜、附申发阳
气。又心凉服者,经曰治寒以热,凉而行之是也。否则戴阳者,反增上燥,口目耳鼻皆血,甚矣。药之难用如此。
按∶姜,辛温无毒,不特散寒,兼能通神明,去秽恶。故圣人日食不彻。甘草,固敦浓和平,寒热皆理,药
师目为国老。四逆汤除此,只附子一味。附性虽较姜加烈,如阴症、厥逆、自利、脉不至,再甚热品补剂,煎成
急进无害,何必凉服。鹤皋曾注内经,顾如是饶舌,市医几人明达。果见面红七窍流血,决谓此属假寒,误投姜
附而致。定改用知柏四物,或六味地黄,下咽随毙。学人讲论至此,当起立敬听。
诗曰∶少阴利后脉沉濡,两目随盲白通治。白通姜附加葱白,去葱入草四逆为。四逆不谐病或变,温经九转
可平施。
(Administered with Ginseng Decoction. If Ginseng is sparingly used, Longan Fruit Decoction is also good.)
Gouqi (Cortex Lycii Fructus, 1 jin) Bugu Zhi (Fructus Psoraleae, 8 liang) Baizhu (Rhizoma Atractylodis Macrocephalae, 4 liang) Hujiao (Piperis Fructus, 2 liang). Steam for a long time, sun-dry; extreme purity is desirable.
"Chun Yang" (Spring Sun) refers to the administration of Wood Qi (Liver Qi). "Hui Ling" means returning its generating command. Trees flourish when they receive Water and wither when they lose it. Qi being full leads to flourishing, while Blood loss leads to withering. Flourishing attracts Wind Pathogen, while withering invites Fire Pathogen. Its movement is like thunder and lightning, its eruption like wind and rain, entering and exiting alone, unpreventable. Among the Five Viscera, none is harder to balance than the Liver. Therefore, diseases belonging to the Liver are numerous, and methods for treating the Liver are extremely broad. If blood depletion and severe diarrhea occur, resulting in Yin Storm Blindness (sudden blindness), this is caused by extreme deficiency of the Spleen, Kidney, and Liver, leading to the sinking of Yang Qi within the viscera. In this formula, Gouqi is sweet in taste and moist in nature, nourishing the Blood. Bugu Zhi is black in color and has a fermented odor, warming the Kidney Water. Water generates it, Blood nourishes it, so that Wood flourishes without withering. The pungent heat of Hujiao returns Yang, while the pungent warmth of Baizhu tonifies Earth (Spleen/Stomach). When Yang returns, flowers and leaves naturally flourish; when Earth is thick, roots and trunks become strong. The use of Renshen (Ginseng) is because vital Qi is abundant and reaches everywhere. As stated, if one breath does not move, the mechanism is exhausted; if even a tiny bit is not continued, heaven and earth are separated. This allows the Wood command to return to spring, and Earth, Fire, Metal, and Water generate each other in sequence. Some who do not understand this principle, seeing blood exhaustion, may advocate using pure Yin Siwu Tang (Four Substance Decoction), fearing it will cause the earth to be blocked and all things to fail to grow. Estimating essence consumption, they may advance Liuyi Dihuang Wan (Six-Ingredient Pill with Rehmannia), inevitably causing mountains to swell and floods to rise, with water overflowing and Wood floating. Thus, it is said that Siwu Tang and Liuyi Dihuang Wan are sometimes prohibited from use, which covers such cases. I composed this pill, daring to correct the mistakes of modern people, truly supplementing what ancient formulas could not cover. Those of high wisdom, please instruct me.
Poem says: Gouqi, Baizhu, and Bugu Zhi, Renshen and Hujiao restore the Spring Command. Understand sudden blindness, sincerely seek and generously apply the response.
Ganjiang (Dried Ginger Rhizome) Fuzi (Prepared Aconite Root) Congbai (Scallion White) (Remove Congbai and add Gancao to form Sini Tang).
Shaoyin disease presents with diarrhea and sudden blindness; both hands have deep and soggy pulses. This formula governs.
The Shaoyin Kidney corresponds to the Winter command, governing the closure and storage of Heaven and Earth. When Cold Pathogen invades, the Yin channels are not secure, leading to diarrhea. Diarrhea causes Yang Qi to leak secretly, hence the pulse is deep and soggy, and blindness occurs. Therefore, Congbai is used to unblock Yang Qi, while Ganjiang and Fuzi disperse Yin Cold. When Cold disperses and Yang recovers, the blocked becomes unblocked, and the unblocked remains open. It can be named Baotong (White Connecting) based on the scallion.
I once treated a certain Mr. Jia. After administering this decoction, diarrhea did not stop, gradually leading to cold limbs, absence of pulse, dry retching, and hiccups. Someone cited the *Shanghan Lun* saying: This is Cold excess repelling Yang (Cold Pathogen is too severe, rejecting Yang Qi outward), unable to descend to Shaoyin, instead reversing chaotically upwards. One must add Human Urine and Pig Bile to guide it. Upon careful thought, sudden blindness is due to extreme Kidney Yang deficiency. Regretting the use of too much Congbai (which is too dispersing for the exterior), adding the extremely cold and bitter urine and bile would be kicking someone when they are down. So-called not dying from the disease, but dying from the medicine. Instead, I used Persimmon Calyx, Clove, and Dried Ginger, decocted strongly into a large cup. After swallowing, hiccups stopped immediately. Then administered Bawu Huisheng Yin (Eight-Ingredient Revival Decoction) for five or six doses. The body warmed, pulse resumed, and vision was restored. This shows that printed books require living reading by humans; how can printed formulas be used rigidly? Furthermore, Taiyin spontaneous diarrhea without thirst, Yin syndrome with deep pulse and body pain, as well as cold limbs with no diarrhea and absent pulse, use Sini Tang, taken cool after decoction. Wu Qian's commentary states: Taiyin governs water and grain, containing true Cold, hence spontaneous diarrhea without thirst. Yin syndrome refers to the Three Yin channels; since the disease is interior, the pulse is deep. Interior Cold causes blood vessels to coagulate and stagnate, unable to distribute to the hands and feet, hence body pain, cold limbs, absent pulse, and diarrhea. The Classic says: Cold rampant inside, treat with Sweet and Hot. Hence, use Roasted Licorice, Ginger, and Aconite to promote Yang Qi. Also, taking it cool: the Classic says treat Cold with Heat, administer hot remedies in a cool manner. Otherwise, for Daiyang syndrome (Floating Yang), it would increase upper dryness, causing bleeding from mouth, eyes, ears, and nose, which is severe. The difficulty of using medicines is thus.
Note: Ginger is pungent, warm, and non-toxic. Not only does it dispel Cold, but it also connects the Spirit and removes filth. Hence, sages do not eat food left overnight. Licorice is indeed thick, honest, peaceful, and harmonious, regulating both Cold and Heat; pharmacists call it the "Old Man of the State." Besides Licorice, Sini Tang contains only Aconite. Although Aconite's nature is more intense than Ginger, for Yin syndrome, cold limbs, spontaneous diarrhea, and absent pulse, using another intensely hot tonic, decocted and rapidly administered, is harmless. Why take it cool? Hegao annotated the *Neijing*, yet speaks so much. How many city physicians are truly enlightened? If one actually sees red face and bleeding from seven orifices, one would surely claim this is false Cold, caused by mistakenly investing Ginger and Aconite. One would definitely switch to Zhibai Siwu Tang or Liuyi Dihuang Wan, leading to death upon swallowing. Students discussing this should stand up and listen respectfully.
Poem says: After Shaoyin diarrhea, the pulse is deep and soggy; both eyes follow blindness, treated with Baotong. Baotong adds Ginger and Aconite to Scallion White; remove Scallion, add Licorice to form Sini. If Sini does not harmonize and the disease changes, warming the meridians nine times can be applied peacefully.