治面肿,小便涩,心腹胀满。
茯苓 苏子 杏仁(去皮尖,各二两) 橘皮 防己 葶苈(纸炒,各一两一分)
上为末,蜜丸,如小豆大。以桑白皮汤下三十丸,食后服。
夫洪肿,门类极多,自正水之余,有风水、皮水、石水、黄汗等,分入水门,如脾气横
泄,香港脚支满,肤胀鼓胀,肠覃石瘕,与夫造作干犯土气,皆作浮肿,属血属气,理自不同
。奈外证相类,未易甄别,若不预学,临病必迷,错乱汗下,皆医杀之。更有气分血分,亦
入肿门类,治法颖别,其可不学?古方类例虽明,多见不学人抄写数方,一道施治,倘非其
病,妄投其药,盛者致困,困者必死,况有饮食禁忌,种种不同,学人勉HT 。不可轻玩,以
病试药,甚为不仁,戒之戒之。(血分方见妇人门,气分方论附于后)
气分与胸痹、中满皆相类,但胸痹属气实,中满为气虚,气分则挟涎饮。气为涎饮所隔
,荣卫不利,腹满胁鸣,相逐气转,膀胱荣卫俱劳,阳气不通则身冷,阴气不通则骨疼,阳
前通则恶寒,阴前通则痹不仁,阴阳相得,其气乃行,大气转,其气乃散,实则失气,虚
则遗溺,乃知气挟涎饮之所为也。其脉寸口迟而涩,迟则为气不足,涩则为血不足;趺阳脉
微而迟,微则为气,迟则寒,斯证也,名曰气分。
治疗面部浮肿,小便涩滞不畅,心胸及腹部胀满。
茯苓、苏子、杏仁(去皮尖,各二两)、橘皮、防己、葶苈(用纸炒,各一两一分)。
以上药物研为细末,用蜂蜜制成丸剂,大小如小豆。服用时以桑白皮汤送服三十丸,饭后服用。
大凡严重的浮肿,门类极多,除了正水之外,还有风水、皮水、石水、黄汗等,分别归入水气病门类;以及像脾气横逆泄泻、脚气病导致的胸腹胀满、肤胀、鼓胀、肠覃、石瘕,以及因人为造作或外邪侵犯土气(脾胃)引起的各种浮肿,这些都属于血分或气分病变,其机理自然不同。无奈外在症状相似,不易辨别,如果不预先学习,面对疾病必然迷惑,错误地采用发汗或攻下法,都会导致患者死亡。更有气分和血分病变,也归入浮肿门类,治疗方法截然不同,怎能不学习呢?古方分类虽然明确,但常见不学之人只抄写几个方子,对所有病症都使用同一方法治疗,如果不对症,妄加用药,实证者会导致困顿,虚证者必死无疑,况且还有饮食禁忌,种种不同,学习者务必努力。不可轻视,拿病人的生命去试验药方,非常不仁义,切记切记。(血分的方剂见妇人门,气分的方论附在后面)
气分病与胸痹、中满(脘腹胀满)症状相似,但胸痹属于气实,中满属于气虚,而气分病则夹杂痰饮。气被痰饮阻隔,营卫运行不利,出现腹部胀满、胁肋鸣响,随着气的转动而疼痛,膀胱的营卫都受损,阳气不通则身体寒冷,阴气不通则骨骼疼痛,阳气前通则怕冷,阴气前通则麻木不仁,阴阳之气相合,气机才能运行,大气运转,郁结之气才能消散,实证则失气(放屁),虚证则遗尿,由此可知这是气挟带痰饮所致的病症。其脉象寸口部迟而涩,迟表示气不足,涩表示血不足;趺阳脉微而迟,微表示气虚,迟表示寒,这种证候,称为气分。
Treats facial edema, astringent and difficult urination, and fullness and distension in the heart and abdomen.
Poria (Fuling), Perilla Seed (Suzi), Apricot Kernel (Xingren) [removed skin and tip, each 2 liang], Tangerine Peel (Chenpi), Podophyllin Root (Fangji), Lepidium Seed (Tingli) [stir-fried on paper, each 1 liang 1 fen].
Grind the above into powder, make pills with honey, size of small beans. Take thirty pills with Mulberry Root Bark Decoction (Sangbaipi Tang), after meals.
Severe edema belongs to many categories. Besides Zhengshui (True Water Edema), there are Fengshui (Wind Edema), Pishui (Skin Edema), Shishui (Stone Edema), Huanghan (Yellow Sweat), etc., which are classified under Water Pathology. Also included are conditions like Spleen Qi rebellion with diarrhea, Jiaoxie (Beriberi/Edema) causing chest and abdominal fullness, Fuzhang (Skin Distension), Guzhang (Drum-like Distension), Changtan (Intestinal Polyp/Tumor), Shijia (Uterine Tumor), and various swellings caused by artificial factors or external pathogens invading Earth Qi (Spleen/Stomach). These all belong to Blood or Qi pathologies, and their mechanisms differ naturally. Unfortunately, external symptoms are similar and hard to distinguish. Without prior study, one will be confused when facing diseases; erroneous use of sweating or purging methods can kill patients. Furthermore, Qifen (Qi Pattern) and Xuefen (Blood Pattern) also fall under edema categories, with distinct treatment methods; how can they not be studied? Although ancient formulas are clearly categorized, it is common for unlearned practitioners to copy only a few prescriptions and apply them uniformly to all cases. If the disease does not match the prescription, reckless medication will cause distress to those who are strong and death to those who are weak. Moreover, dietary restrictions vary greatly. Practitioners must strive to learn. Do not treat lightly or test medicines on patients' lives; this is extremely inhumane. Beware, beware. (Formulas for Blood Pattern are found in the Women's Section; the discussion on Qi Pattern formulas is attached below.)
Qifen (Qi Pattern) resembles Xiongbi (Chest Bi/Pain) and Zhongman (Middle Fullness/Distension), but Xiongbi is due to Excess Qi, Zhongman is due to Deficient Qi, while Qifen involves Phlegm-Fluid retention. When Qi is obstructed by Phlegm-Fluid, Ying and Wei (Nutritive and Defensive Qi) fail to circulate smoothly, leading to abdominal fullness, borborygmus in the hypochondrium, and pain following the movement of Qi. The Ying and Wei of the Bladder are both exhausted; if Yang Qi fails to penetrate, the body feels cold; if Yin Qi fails to penetrate, bones ache. If Yang Qi penetrates anteriorly, there is aversion to cold; if Yin Qi penetrates anteriorly, there is numbness and insensitivity. When Yin and Yang Qi harmonize, Qi circulation resumes; when the Great Qi rotates, stagnation dissipates. In excess patterns, flatus occurs; in deficiency patterns, urinary incontinence occurs. Thus, it is known that this condition is caused by Qi carrying Phlegm-Fluid. The pulse at Cun Kou (Radial Artery at wrist crease) is slow and choppy; slow indicates Qi deficiency, choppy indicates Blood deficiency. The pulse at Fu Yang (Dorsalis Pedis Artery) is faint and slow; faint indicates Qi deficiency, slow indicates Cold. This syndrome is named Qifen (Qi Pattern).