痰伏胞络。自肺窍嗽出。涎伏脾胃。自口角流出。饮生胃腑。从食脘吐出。饮症有六。
水停
肠胃。腹响辘辘有声。名痰饮。水流在胁。咳吐则痛。名悬饮水流四肢。身体重痛。名溢饮
。水停膈上。饱逆倚息。短气不得卧。名支饮。水停心下。背冷如手掌大。四肢历节疼痛。
缺盆咳嗽转甚。名留饮。水停膈满。呕吐喘咳。腰背痛泪出。名伏饮。六者不同。皆因饮
水。及茶酒停蓄不散。再加外邪生冷七情。相搏而成。脉多弦滑或伏。眼下皮如炭黑。治法
在皮里膜外。表分者汗之。在胸膈者吐之。在四肢经络胁肋者。分利之。在肠胃里分者下之
。病患一臂痛。不一时复移在一臂。其脉沉细非风也。必有饮在上焦矣。
挖涎卅 治一切痰饮症。或漉漉有声。或手足冷痹。
气脉不通。
大戟 白芥子 栝蒌曲(各二两) 薄桂(三钱) 全蝎(八个) 雄黄 朱砂(各一钱)
上为末。粉糊为丸。如梧子大。每服六七十丸。临卧姜汤送下。
五饮汤 治五饮神效。曰留饮。曰癖饮。曰痰饮。曰溢饮。曰流饮。
旋复花 人参 橘红 枳实 白术(各钱) 茯苓 浓朴 半夏 泽泻 猎苓(各八分)
前胡 桂心 白芍 甘草(各六分)
姜五片煎服。
降痰丸 治三焦气闭。痰饮痞满。咳嗽吐痰。肢体倦怠。不思饮食。
木香 槟榔 青皮 陈皮 三棱 枳壳(麸炒) 半夏(姜矾制) 大黄 黑牵牛(各一两)
上为末。面糊为丸。每服三钱。姜汤食前服。
痰饮潜伏在胞络之中,通过肺窍咳嗽而出。涎液潜伏在脾胃之间,从口角流出。水饮生成于胃腑,随食物从食道吐出。饮证共有六种:
水饮停滞在肠胃中,腹部发出辘辘的声响,称为痰饮。水流停留在胁肋部,咳嗽吐唾时感到疼痛,称为悬饮。水流停留在四肢,身体沉重疼痛,称为溢饮。水饮停滞在膈上,饱胀气逆,倚靠呼吸,短气不能平卧,称为支饮。水饮停滞在心下(胃脘部),背部寒冷如手掌大小,四肢关节疼痛,缺盆穴处咳嗽加剧,称为留饮。水饮停滞导致膈部满闷,呕吐喘咳,腰背疼痛流泪,称为伏饮。这六种情况各不相同,但都因为饮水以及茶、酒停蓄不散,再加上外感邪气、生冷饮食和七情内伤,相互搏结而形成。脉象多表现为弦滑或沉伏,眼下皮肤颜色如炭黑般深暗。治疗原则在于皮里膜外之处,病位在表分的用发汗法,病位在胸膈的用催吐法,病位在四肢经络及胁肋的用分利法,病位在肠胃里的用泻下法。如果病人一只手臂疼痛,过一会儿又转移到另一只手臂,其脉象沉细而非风邪所致,必定是有水饮停留在上焦。
挖涎丸:治疗各种痰饮证。症状包括喉间漉漉有声,或手足冷痹,气脉不通。
药材:大戟、白芥子、栝蒌曲(各二两)、薄桂(三钱)、全蝎(八个)、雄黄、朱砂(各一钱)。
制法与用法:将上述药物研为细末,用米粉糊制作成梧桐子大小的药丸。每次服用六七十丸,临睡前用姜汤送服。
五饮汤:治疗五种饮证效果显著。即留饮、癖饮、痰饮、溢饮、流饮。
药材:旋复花、人参、橘红、枳实、白术(各一钱)、茯苓、浓朴、半夏、泽泻、猎苓(各八分)、前胡、桂心、白芍、甘草(各六分)。
制法与用法:加生姜五片煎煮后服用。
降痰丸:治疗三焦气机闭塞,痰饮痞满,咳嗽吐痰,肢体倦怠,不思饮食。
药材:木香、槟榔、青皮、陈皮、三棱、枳壳(麸炒)、半夏(姜矾制)、大黄、黑牵牛(各一两)。
制法与用法:将上述药物研为细末,用面糊制作成药丸。每次服用三钱,饭前用姜汤送服。
Phlegm-fluid (Tan-Yin) lurking in the Bao-luo (pericardium collaterals) is coughed out through the lung orifice. Saliva (Xian) lingering in the Spleen and Stomach flows out from the corners of the mouth. Fluid (Yin) generated in the Stomach Fu organ is vomited up from the food passage. There are six types of fluid syndromes:
Water retention in the Intestines and Stomach, with a gurgling sound in the abdomen, is called Tan-Yin (Phlegm-Fluid). Water flow lodging in the hypochondrium, causing pain upon coughing and expectoration, is called Xuan-Yin (Hanging Fluid). Water flow lodging in the limbs, causing heaviness and pain in the body, is called Yi-Yin (Overflowing Fluid). Water retention above the diaphragm, causing fullness, counterflow qi, reliance on breathing for relief, shortness of breath, and inability to lie flat, is called Zhi-Yin (Supporting Fluid). Water retention below the heart (epigastrium), causing coldness in the back the size of a palm, pain in the joints of the four limbs, and aggravated cough at the Quepen (ST12) acupoint, is called Liu-Yin (Retained Fluid). Water retention causing diaphragmatic fullness, vomiting, wheezing, coughing, lower back pain, and tearing, is called Fu-Yin (Hidden Fluid). These six differ but all arise from water retention, as well as the accumulation of tea and wine that fails to dissipate, compounded by external pathogenic factors, raw/cold foods, and emotional disturbances, which interact to form the condition. The pulse is often wiry and slippery or deep/hidden; the skin under the eyes appears dark black like charcoal. The treatment principle targets the area between the skin and fascia. For manifestations in the exterior layer, induce sweating. For those in the chest and diaphragm, induce vomiting. For those in the four limbs, meridians, and hypochondrium, promote differentiation and urination. For those in the interior of the intestines and stomach, purge downward. If a patient experiences pain in one arm that shifts to the other arm after a short time, and the pulse is deep and thin rather than indicating Wind, it must be due to fluid retention in the Upper Jiao.
Wa-Xian Wan (Saliva-Digging Pill): Treats all phlegm-fluid syndromes, characterized by gurgling sounds in the throat, cold numbness in the hands and feet, and obstruction of Qi and pulses.
Ingredients: Da Ji (Kansui Radix), Bai Jie Zi (White Mustard Seed), Gua Lou Qu (Prepared Trichosanthes Fruit), Bo Gui (Thin Cinnamon Twig) (each 2 liang); Bo Gui (3 qian); Quan Xie (Whole Scorpion) (8 units); Xiong Huang (Realgar), Zhu Sha (Cinnabar) (each 1 qian).
Preparation and Administration: Grind the above ingredients into fine powder. Form pills using rice flour paste, sized like wu zi (wu-tzu seeds). Take 60–70 pills per dose, administered with ginger decoction before sleep.
Wu Yin Tang (Five Fluid Decoction): Highly effective for treating five types of fluid syndromes: Liu-Yin (Retained Fluid), Pi-Yin (Mass Fluid), Tan-Yin (Phlegm-Fluid), Yi-Yin (Overflowing Fluid), and Liu-Yin (Flowing Fluid).
Ingredients: Xuan Fu Hua (Inula Flower), Ren Shen (Ginseng Root), Ju Hong (Tangerine Peel), Zhi Shi (Immature Bitter Orange), Bai Zhu (Atractylodes Macrocephala Rhizome) (each 1 qian); Fu Ling (Poria), Nong Po (Magnolia Bark), Ban Xia (Pinellia Tuber), Ze Xie (Alisma Rhizome), Lie Ling (Polyporus) (each 8 fen); Qian Hu (Peucedani Radix), Gui Xin (Cinnamon Heart), Bai Shao (White Peony Root), Gan Cao (Licorice Root) (each 6 fen).
Preparation and Administration: Decoct with 5 slices of fresh ginger and take orally.
Jiang Tan Wan (Phlegm-Descending Pill): Treats closure of Qi in the Three Jiao, phlegm-fluid distension and fullness, coughing with expectoration, limb fatigue, and loss of appetite.
Ingredients: Mu Xiang (Aucklandiae Radix), Bing Lang (Areca Seed), Qing Pi (Green Tangerine Peel), Chen Pi (Aged Tangerine Peel), San Leng (Curcuma Zedoaria Rhizome), Zhi Ke (Bitter Orange Fruit, stir-fried with bran), Ban Xia (Pinellia Tuber, processed with ginger and alum), Da Huang (Rhubarb Rhizome), Hei Qian Niu (Black Morning Glory Seed) (each 1 liang).
Preparation and Administration: Grind the above ingredients into fine powder. Form pills using wheat flour paste. Take 3 qian per dose, administered with ginger decoction before meals.