《内经》云。脾恶湿。湿宜淡渗。二苓、苡、滑、是其主药。湿重者脾阳必虚。香砂、理中、是其主方。湿着者肾
阳亦亏。真武汤是正本清源之要药。他如风湿宜温散以微汗之。通用羌、防、白芷。重则二术、麻、桂。所
谓风能胜湿也。寒湿宜辛热
以干燥之。轻则二蔻、砂、朴。重则姜、附、丁、桂。所谓湿者燥之也。湿热宜芳淡以宣化之。通用如蔻、藿、佩兰、滑通、二苓、
茵泽之类。重则五苓、三石。亦可暂用以通泄之。所谓辛香疏气。甘淡渗湿也。惟湿火盘踞肝络。胆火内
炽。血瘀而热。与湿热但在肺脾胃气分者迥异。宜用苦寒泻火为君。佐辛香以通里窍。如栀、芩、连、柏、
龙荟、清麟丸等。略参冰、麝、归须、泽兰。仿当归龙荟丸法。始能奏效。
《内经》云、燥热在上。故秋燥一症。先伤肺津。次伤胃液。终伤肝血肾阴。故《内经》云。燥者润之。首必
辨其凉
燥、温燥。凉燥温润。宜用紫菀、杏仁、桔梗、蜜炙橘红等。开达气机为君。恶风怕冷者。加葱白、生姜、辛润以解表。
咳嗽胸满者。加蜜炙苏子、百部通润以利肺。挟湿者。加蔻仁四分拌研滑石。辛滑淡渗以祛湿。痰多者。加栝蒌仁、半夏、
姜汁、荆沥等。辛滑流利以豁痰。里气抑郁。大便不爽。或竟不通而腹痛者。加春砂仁三分拌捣郁李净仁、松仁、
光桃仁、柏子
仁、蒌皮、酒捣薤白等。辛滑以流利气机。气机一通。大便自解。后如胃液不足。肝逆干呕者。用甜酱油、蔗浆、
姜汁等。甘咸辛润。以滋液而止呕。阳损及阴。肝血肾阴两亏者。用当归、苁蓉、熟地、杞子、鹿胶、菟丝子等。甘
温滋润以补阴。且无阴凝阳滞之弊。温燥凉润宜用鲜桑叶、甜杏仁、栝蒌皮、川贝等。清润轻宣为君。热盛者。如花
粉、知母、芦根、菰根、银花、池菊、梨皮、蔗皮等。酌加三四味以泄热。热泄则肺气自清。肺清则气机流利。
每多化津微汗而解。如咳痰不爽。甚则带血者。酌加竹沥、梨汁、藕汁、芽根汁、童便等。甘润咸降。以活痰
而止血。若痰活而仍带血者。加犀角汁
鲜地汁等。重剂清营以止血。胃阴虚燥者。酌加鲜石斛、鲜生地、蔗浆、麦冬等。以养胃阴。便艰或秘者。酌加海
蜇、荸
荠、白蜜和姜汁一二滴。甘咸辛润。滋液润肠以通便。总之上燥则咳。嘉言清燥救肺汤为主药。中燥则渴。仲景人
参白虎汤为主药。下燥则结。景岳济川煎为主药。肠燥则隔食。五仁橘皮汤为主药。筋燥则痉挛。阿胶鸡子黄汤
为主药。阴竭阳厥。坎气潜龙汤为主药、阴虚火旺。阿胶黄连汤为主药。生津液以西参、燕窝、银耳、柿霜为主药。养
血则归身、生地、阿胶、鸡血藤胶。益精则熟地、杞子、龟胶、鱼鳔、猪羊脊髓。在用者广求之。此总论凉燥温
燥实燥虚燥用药之要略也。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The Spleen dislikes dampness. Dampness is best treated with bland and leaching agents; Fu Ling (Poria), Zhu Ling (Polyporus), Yi Yi Ren (Coix Seed), and Hua Shi (Talcum) are the primary herbs for this purpose. When dampness is severe, Spleen Yang must be deficient; Sha Ren (Amomum Fruit), Mu Xiang (Aucklandia Root), and Lizhong Tang (Regulate the Middle Decoction) are the primary formulas. When dampness lingers, Kidney Yang is also depleted; Zhen Wu Tang (True Warrior Decoction) is a crucial formula to address the root cause. Regarding wind-dampness, it is appropriate to use warm-dispersing methods to induce slight sweating; Qiang Huo (Notopterygium Rhizome), Fang Feng (Saposhnikovia Root), and Bai Zhi (Angelica Dahurica Root) are commonly used. For severe cases, Cang Zhu (Atractylodes Rhizome), Bai Zhu (Atractylodes Macrocephala Rhizome), Ma Huang (Ephedra Herb), and Gui Zhi (Cinnamon Twig) are used. This is what is meant by "wind can overcome dampness." For cold-dampness, acrid-hot substances should be used to dry dampness; for mild cases, Bai Dou Kou (Cardamom Fruit), Rou Dou Kou (Nutmeg), Sha Ren (Amomum Fruit), and Hou Po (Magnolia Bark) are used; for severe cases, Gan Jiang (Dried Ginger), Fu Zi (Aconite Lateral Root), Ding Xiang (Clove), and Rou Gui (Cinnamon Bark) are used. This is what is meant by "dampness is dried by dryness." For damp-heat, aromatic and bland substances should be used to diffuse and transform; common choices include Bai Dou Kou (Cardamom Fruit), Huo Xiang (Patchouli Herb), Pei Lan (Agastache Herb), Hua Shi (Talcum), Tong Cao (Rice Paper Pith), Fu Ling (Poria), Zhu Ling (Polyporus), Yin Chen (Artemisia Capillaris Herb), and Ze Xie (Alisma Rhizome). For severe cases, Wu Ling San (Five-Ingredient Powder with Poria) or San Shi Tang (Three-Stone Decoction) may be used. They can also be temporarily employed to unblock and drain damp-heat. This illustrates the principle of "acrid-aromatics to disperse qi, bland-sweet substances to leach dampness." However, when damp-fire lodges in the Liver collaterals, Gallbladder fire blazes internally, causing blood stasis and heat, this differs significantly from damp-heat confined to the Qi level of the Lung, Stomach, and Spleen. In such cases, bitter-cold herbs that purge fire should be used as the sovereign drug, assisted by acrid-aromatics to open the interior orifices, such as Zhi Zi (Gardenia Fruit), Huang Qin (Scutellaria Root), Lian Lian (Coptis Rhizome), Huang Bo (Phellodendron Bark), Lu Hui (Aloe), and Qing Lin Wan (Clear Forest Pill). Small amounts of Bing Pian (Borneol), She Xiang (Musk), Dang Gui Xu (Angelica Sinensis Root Tip), and Ze Lan (Lygodium Spore) may be added, imitating the method of Dang Gui Long Hui Wan (Angelica Aloe Pill), to achieve efficacy.
The *Huangdi Neijing* states: Dryness-heat resides in the upper jiao. Therefore, in autumn dryness syndrome, Lung Jin (Lung Fluids) are injured first, followed by Stomach fluids, and finally Liver Blood and Kidney Yin. Thus, the *Neijing* says: "Dryness is moistened." One must first distinguish between cool-dryness and warm-dryness. For cool-dryness, warm-moistening is appropriate; Zi Wan (Aster Root), Xing Ren (Apricot Seed), Jie Geng (Platycodon Root), and Mi Zhi Ju Hong (Honey-fried Tangerine Peel) can be used, with agents that open and diffuse Qi mechanism as the sovereign drugs. If accompanied by aversion to wind and cold, Cong Bai (Scallion White) and Sheng Jiang (Fresh Ginger) are added to resolve the exterior with acrid-moistening methods. For cough and chest fullness, Mi Zhi Su Zi (Honey-fried Perilla Fruit) and Bai Bu (Stemona Root) are added to benefit the Lung with moistening properties. If complicated by dampness, Kou Ren (Cardamom Seed) mixed with Hua Shi (Talcum) is added to dispel dampness with acrid-slippery bland-leaching methods. For profuse phlegm, Gua Lou Ren (Trichosanthes Seed), Ban Xia (Pinellia Tuber), Jiang Zhi (Ginger Juice), and Jing Li (Bletilla Juice) are added to resolve phlegm with acrid-slippery slippery methods. If internal Qi is depressed, stool is difficult to pass, or completely blocked with abdominal pain, Chun Sha Ren (Spring Amomum Fruit) mixed with Yu Li Ren (Prunus Seed), Song Ren (Pine Nut), Guang Tao Ren (Peach Kernel), Bai Zi Ren (Biota Seed), Lou Pi (Trichosanthes Peel), and Jiu Dao Xie Bai (Wine-crushed Allium Macrostemon Bulb) are added to smooth the Qi mechanism with acrid-slippery methods. Once the Qi mechanism flows freely, stool will naturally pass. Subsequently, if Stomach fluids are insufficient and Liver Qi rebels causing dry heaving, Tian Jiang You (Sweet Soy Sauce), Zhe Jiang (Sugarcane Juice), and Jiang Zhi (Ginger Juice) are used to nourish fluids and stop vomiting with sweet-salty-acrid-moistening methods. If Yang damage extends to Yin, resulting in dual deficiency of Liver Blood and Kidney Yin, Dang Gui (Angelica Sinensis Root), Rong Rong (Cistanche Stem), Shu Di Huang (Rehmannia Root), Qi Zi (Goji Berry), Lu Jiao Jiao (Deer Antler Glue), and Tu Si Zi (Cuscuta Seed) are used to tonify Yin with sweet-warm moistening methods, avoiding the drawback of Yin stagnation blocking Yang. For warm-dryness, cool-moistening is appropriate; Xian Sang Ye (Fresh Mulberry Leaf), Tian Xing Ren (Sweet Apricot Seed), Gua Lou Pi (Trichosanthes Peel), and Chuan Bei Mu (Fritillaria Bulb) are used, with clear-moistening light-dispersing agents as the sovereign drugs. If heat is excessive, Hua Fen (Trichosanthes Root), Zhi Mu (Anemarrhena Rhizome), Lu Gen (Reed Rhizome), Gu Gen (Zizania Root), Yin Hua (Chrysanthemum Flower), Chi Ju (Chrysanthemum), Li Pi (Pear Peel), and Zhe Pi (Sugarcane Peel) are added, selecting three or four ingredients to clear heat. Once heat is cleared, Lung Qi becomes clear, Qi mechanism flows smoothly, and resolution often occurs through slight sweating after generating fluids. If coughing up phlegm is difficult or even bloody, Zhu Li (Bamboo Sap), Li Zhi (Pear Juice), Ou Zhi (Lotus Root Juice), Ya Gen Zhi (Sprout Root Juice), and Tong Bian (Child's Urine) are added to resolve phlegm and stop bleeding with sweet-moistening salty-descending methods. If blood persists despite resolved phlegm, Xi Jiao Zhi (Rhinoceros Horn Juice - note: substitute with water buffalo horn in modern practice) and Xian Di Huang Zhi (Fresh Rehmannia Juice) are added as heavy agents to clear the Ying (Nutritive) level and stop bleeding. For Stomach Yin deficiency with dryness, Xian Shi Hu (Fresh Dendrobium), Xian Sheng Di (Fresh Rehmannia), Zhe Jiang (Sugarcane Juice), and Mai Dong (Ophiopogon Tuber) are added to nourish Stomach Yin. For difficult or constipated stool, Hai Zhe (Sea Cucumber), Bi Qi (Water Chestnut), Bai Mi (White Honey), and one or two drops of Jiang Zhi (Ginger Juice) are added to moisten intestines and relieve constipation with sweet-salty-acrid-moistening methods. In summary, upper jiao dryness causes cough, primarily treated with Jia Yan's Qing Zao Jiu Fei Tang (Clear Dryness Rescue Lung Decoction); middle jiao dryness causes thirst, primarily treated with Zhong Jing's Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction); lower jiao dryness causes constipation, primarily treated by Jing Yue's Ji Chuan Jian (Benefit River Decoction); intestinal dryness causes food blockage, primarily treated with Wu Ren Ju Pi Tang (Five-Seeds Orange Peel Decoction); tendon dryness causes spasms, primarily treated with E Jiao Ji Zi Huang Tang (Donkey-hide Gel Egg Yolk Decoction); Yin exhaustion with Yang collapse, primarily treated with Kan Qi Qian Long Tang (Kan Qi Hidden Dragon Decoction); Yin deficiency with hyperactive fire, primarily treated with E Jiao Huang Lian Tang (Donkey-hide Gel Coptis Decoction); generating fluids primarily uses Xi Shen (American Ginseng), Yan Wo (Swallow's Nest), Yin Er (Tremella Fuciformis), and Shi Shuang (Persimmon Frost); nourishing Blood uses Gui Shen (Angelica Sinensis Root Head), Sheng Di (Rehmannia Root), E Jiao (Donkey-hide Gel), and Ji Xue Teng Jiao (Spatholobus Glue); benefiting Essence uses Shu Di (Rehmannia Root), Qi Zi (Goji Berry), Gui Jiao (Turtle Shell Glue), Yu Biao (Fish Swim Bladder), and Pig/Sheep Spinal Cord. Practitioners should seek applications widely. This summarizes the essential principles of medication for cool-dryness, warm-dryness, excess-dryness, and deficiency-dryness.