戴云∶郁者,结聚而不得发越也。当升者不得升,当降者不得降,当变化者不得变化也。此为传化失常,
六郁之病见矣。气郁者,胸胁痛,脉沉涩;湿郁者,周身走痛,或关节痛,遇阴寒则发,脉沉细;痰郁者,动
则即喘,寸口脉沉滑;热郁者,瞀,小便赤,脉沉数;血郁者,四肢无力,能食,便红,脉沉;食郁者,嗳酸
腹饱不能食,人迎脉平和,气口脉紧盛者是也。
气血中和,万病不生,一有怫郁,诸病生焉。
气郁∶香附子、苍术、川芎。
湿郁∶苍术、川芎、白芷。
痰郁∶海石、香附、南星、栝蒌。
热郁∶青黛、香附、苍术、川芎、栀子。
血郁∶桃仁、红花、青黛、川芎、香附。
食郁∶苍术、香附、针沙(醋炒)、山楂、神曲(炒)。
春加芎,夏加苦参,秋冬加吴茱萸。
越鞠丸,解诸郁,又名芎术丸。
苍术 香附 抚芎 神曲 栀子 等分为末,水丸,如绿豆大。
凡郁皆在中焦,以苍术、抚芎、开提其气以升之。假如
食在气上,提其气则食自降。余皆仿此。
大风病,是受得天地间杀物之气,古人谓之疠风者,以其酷烈暴悍可畏耳。人得之者,须分在上、在下。
夫在上者,以醉仙散取涎血于齿缝中出;在下者,以通天散取恶物陈虫于谷道中出。取出虽有道路之异,然皆
不外乎阳明一经。治此证者,须知此意。看其疙瘩与疮,上先见者、上体多者,在上也;下先见者、下体多
者,在下也。上下同得者,在上复在下也。阳明胃经与大肠无物不受,此风之入人也。气受之,则在上多;血
受之,则在下多;血气俱受之者,上下俱多也。自非医者神手,病者铁心,罕有免此。夫从上从下以渐而来
者,皆可治。人见其病势之缓,多忽之。虽按法施治,病已痊可,若不能忌口、绝色,皆不免再发,发则终于
不能救也。余曾治五人中间,唯一妇人不再发,以其贫甚而且寡,无物可吃也。余四人,三、四年后皆再发。
孙真人云∶吾尝治四五十人,终无一人免于死。非真人不能治,盖无一人能守禁忌耳。此妇人本病药外,又服
百余帖加减四物汤,半年之上,方得经行,十分安愈。
治法∶在上者醉仙散,在下者通天再造散。后用通神散,及三棱针于委中出血。但不能忌口、绝房者,不
治之也。
醉仙散∶
胡麻仁 牛蒡子 蔓荆子 枸杞子(各半两为粗末,同炒紫色) 白蒺藜 苦参 栝蒌根 防风(各半两)
上八味为细末,每一两半入轻粉三钱,拌匀。大人一钱,空心,日午、临睡各一服,淡茶调下。五七日间,
必于齿缝中出臭涎水,浑身觉痛,昏闷如醉,利下恶臭屎为度。量大
小虚实加减与之。证候重而急者,须以再造散下之,候补养得还,复与此药吃。须断盐酱醋诸般鱼肉椒料果子
烧炙等物,止可淡粥及淡煮熟时菜食之。茄尚不可食,惟有乌稍蛇、菜花蛇可以淡酒煮熟食之,以助药力。
再造散∶郁金(半两,生用) 大黄(一两,炮) 皂角刺(一两,黑者大者) 白牵牛(头末六钱半,
炒半生用之。)
上为末,五钱临夜冷酒调下。以净桶伺候泄出虫。如虫口黑色,乃是多年虫;口如赤色,是近者。三数日
又进一服,直候无虫,即绝根也。
Dai Yuanli stated: "Yu" (Stagnation) refers to the condition where Qi mechanism is knotted and gathered but cannot be dispersed. What should ascend fails to ascend, what should descend fails to descend, and what should transform fails to transform. This constitutes a dysfunction in transmission and transformation, manifesting as the diseases of the Six Stagnations.
Qi Stagnation presents with pain in the chest and hypochondrium, and a deep, choppy pulse; Dampness Stagnation presents with wandering pain throughout the body or joint pain, which exacerbates in cold and damp weather, with a deep, fine pulse; Phlegm Stagnation presents with panting upon exertion, and a deep, slippery pulse at the Cun Kou position; Heat Stagnation presents with dizziness and blurred vision, dark red urine, and a deep, rapid pulse; Blood Stagnation presents with weakness in the four limbs, normal appetite, blood in the stool, and a deep pulse; Food Stagnation presents with belching with a sour odor, abdominal fullness, inability to eat, a peaceful Ren Ying pulse, and a tight, excessive Qi Kou pulse.
When Qi and Blood are harmonious and balanced, myriad diseases do not arise; once there is Fu Yu (Qi obstruction and stagnation), various diseases emerge.
Treatment for Qi Stagnation: Xiangfu Zi (Cyperus Rhizome), Cang Zhu (Atractylodis Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma).
Treatment for Dampness Stagnation: Cang Zhu (Atractylodis Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix).
Treatment for Phlegm Stagnation: Haishi (Pumex), Xiangfu (Cyperus Rhizome), Nanxing (Arisaematis Rhizoma Preparatum), Gualou (Trichosanthis Fructus).
Treatment for Heat Stagnation: Qingdai (Indigo Naturalis), Xiangfu (Cyperus Rhizome), Cang Zhu (Atractylodis Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhizi (Gardeniae Fructus).
Treatment for Blood Stagnation: Taoren (Persicae Semen), Honghua (Carthami Flos), Qingdai (Indigo Naturalis), Chuanxiong (Ligustici Chuanxiong Rhizoma), Xiangfu (Cyperus Rhizome).
Treatment for Food Stagnation: Cang Zhu (Atractylodis Rhizoma), Xiangfu (Cyperus Rhizome), Zhensha (Magnetitum, stir-fried with vinegar), Shanzha (Crataegi Fructus), Shenqu (Massa Medicata Fermentata, stir-fried).
In spring, add Chuanxiong; in summer, add Kushen (Sophorae Flavescentis Radix); in autumn and winter, add Wuzhuyu (Evodiae Fructus).
Yueju Wan (Regulating Depression Pill), which resolves various stagnations, is also known as Xiongshu Wan.
Formula: Cang Zhu (Atractylodis Rhizoma), Xiangfu (Cyperus Rhizome), Fuxiong (Ligustici Chuanxiong Rhizoma from Fuzhou), Shenqu (Massa Medicata Fermentata), Zhizi (Gardeniae Fructus), in equal parts, ground into fine powder, made into water pills the size of mung beans.
All stagnations reside in the Middle Jiao (Middle Burner). Use Cang Zhu and Fuxiong to lift and raise the Qi. For instance, if food is stagnant above the Qi level, lifting the Qi will cause the food to descend naturally. The other types of stagnation follow this principle.
The Great Wind Disease (Leprosy/Mal Feng) is contracted from the killing qi of heaven and earth. Ancients called it Lifeng (Plague Wind) because its nature is fierce, violent, and terrifying. Upon contracting this disease, one must distinguish whether the pathogen is located in the upper or lower part of the body.
For pathogens in the upper part, use Zuixian San (Intoxicating Immortal Powder) to draw out phlegm and blood from the gum crevices; for pathogens in the lower part, use Tongtian San (Heaven-Penetrating Powder) to expel foul matter and old worms via the anus (Gu Dao). Although the routes of expulsion differ, they all pertain to the Yangming Meridian. Those treating this condition must understand this principle. Observe the nodules and sores: if they appear first on the head and are more numerous on the upper body, the pathogen is in the upper part; if they appear first on the feet and are more numerous on the lower body, the pathogen is in the lower part. If both upper and lower are affected, it involves both. The Yangming Stomach Meridian and Large Intestine Meridian accept everything; this is how the wind pathogen enters the human body. If Qi is affected, the disease manifests mostly in the upper part; if Blood is affected, it manifests mostly in the lower part; if both Qi and Blood are affected, it manifests in both. Unless the physician has divine skill and the patient has an iron will, few escape death. Cases developing gradually from top to bottom or bottom to top are treatable. People often neglect the disease due to its slow progression. Even if treated according to method and the illness appears cured, if the patient does not observe dietary restrictions and abstains from sexual activity, relapse is inevitable. Once relapsed, it becomes incurable. I once treated five patients; only one woman did not relapse because she was extremely poor and widowed, having nothing substantial to eat. The other four relapsed after three or four years. Sun Simiao stated: "I have treated forty or fifty people, yet not one escaped death." It is not that Sun could not cure them, but that no one could keep the taboos. This woman, in addition to the medicine for her primary disease, took over a hundred doses of modified Siwu Tang (Four Substances Decoction). After more than half a year, her menstruation resumed, and she achieved complete recovery.
Treatment Method: For pathogens in the upper part, use Zuixian San; for those in the lower part, use Tongtian Zaizao San (Heaven-Penetrating Regeneration Powder). Subsequently, use Tongshen San (Spirit-Opening Powder) and apply three-edged needle bleeding at Weizhong (BL40). However, those who cannot observe dietary restrictions and abstain from sex are considered incurable.
Zuixian San Formula:
Huma Ren (Sesamum Indicum Seed), Niubangzi (Arctii Fructus), Manjingzi (Viticis Semen), Gouqizi (Lycii Fructus) (each 1.5 taels, coarsely powdered and stir-fried together until purple), Bajieli (Tribuli Fructus), Kushen (Sophorae Flavescentis Radix), Gualougen (Trichosanthis Radix), Fangfeng (Saposhnikoviae Radix) (each 1.5 taels).
Grind the above eight herbs into fine powder. For every 1.5 taels of powder, mix in 3 qian of Qinfen (Calomelas). Adults take 1 qian per dose, on an empty stomach, once at noon and once before sleep, taken with light tea. Within five to seven days, foul saliva will necessarily flow from the gum crevices, the whole body will feel painful, and the patient will feel dizzy and intoxicated, ending when foul-smelling stool is passed. Adjust the dosage according to the patient's constitution, severity, and deficiency/excess. For severe and acute cases, administer Zaizao San first to purge, then after recuperation and nourishment, administer this medicine. Strictly avoid salt, soy sauce, vinegar, meat, fish, spices, fruits, and roasted foods. Only consume plain congee and bland, boiled vegetables. Eggplant is also forbidden. Only Vipera aspis (Wushao She) and Elaphe carinata (Caihua She) may be consumed, boiled in plain wine, to assist the medicinal power.
Zaizao San Formula:
Yujin (Curcumae Longae Rhizoma) (1.5 taels, raw), Dahuang (Rhei Radix et Rhizoma) (3 taels, processed), Zaojiaoci (Gleditsiae Spina) (3 taels, large and black ones), Baiqianniu (Pharbitidis Semen) (2.8 taels of the first harvest powder, half stir-fried, half raw).
Grind into powder. Take 5 qian at night, mixed with cold wine. Prepare a clean bucket to receive the expelled worms. If the worm mouth is black, it is an old worm; if red, it is a recent infection. Administer another dose after three or four days, continuing until no worms are expelled, thereby eradicating the root.