治经水不止鲜红项筋急脑痛脊骨强痛
炙甘草 当归身 葛根(各三分) 独活 本 升麻(各五分)柴胡(七分) 羌活 苍术
(各一钱) 红花(少许)
上锉如麻豆大都作一服水四大盏煎至一盏去渣空心稍热服取微汗立止
一妇人经候凝结黑血成块左厢有血瘕水泄不止谷有时不化后血块暴下并水俱作是前后二阴
有形
血脱竭于下既久经候犹不调水泄日见三两行食罢烦心饮食减少甚至瘦弱东垣老人曰夫圣人治
病必本四时升降浮沉之理权变之宜必先岁气无伐天和无盛无虚遗人夭殃无致邪无失正绝人长
命故仲景云阳盛阴虚下之则愈汗之则死阴盛阳虚汗之即愈下之即死大抵圣人立法且如升阳或
发
散之剂是助春夏之阳气令其上升乃泻秋冬收藏殒杀寒凉之气此病是也当用此法治之升降浮沉
之至理也天地之气以升降浮沉乃从四时如治病不可逆之故经云顺天则昌逆天则亡可不畏哉夫
人之身亦有四时天地之气不可止认在外人亦体同天地也今经漏不止是前阴之气血已脱下矣水
泄又数年是后阴之气血下陷以脱矣后阴者主有形之物也前阴者精气之户下竭是病患周身之血
气常行秋冬之令阴主杀此等收藏之病是也阳生阴长春夏是也在人之身令气升浮者谷气上行是
也既病患周身血气皆不生长谷气又不胜其肌肉消少是两仪之气俱将绝矣既下元二阴俱脱血气
将竭假令当是热证令下焦久脱化为寒矣此病久沉久降寒湿大胜当急救之泻寒以热除湿以燥大
升大举以助生长补养气血不致偏竭圣人立治之法既湿气大胜以所胜治之助甲风木上升是也故
经云风胜湿是以所胜平之也当先调和胃气次用白术之类以燥其湿而滋元气如其不止后用风药
以胜湿此便是大举大升以助春夏二湿之久陷下之至治也
治疗月经淋漓不止、颜色鲜红,伴有项部筋脉拘急、头痛、脊柱强痛。
炙甘草、当归身、葛根(各三分),独活、藁本、升麻(各五分),柴胡(七分),羌活、苍术(各一钱),红花(少许)。
以上药物切碎如麻豆大小,通常作为一剂服用。用水四盏煎煮至一盏,去渣,空腹时稍加热后服用,以微微出汗为度,出血即可立即停止。
有一位妇女,月经凝结成黑色血块,左侧少腹有血瘕(腹部结块),水样泄泻不止,谷物有时不能消化,随后血块突然大量排出,并与水样便一同从前后二阴排出。
由于长期下焦血气耗竭,月经仍然不调,水泄每日发作两三次,进食后心烦意乱,饮食减少,甚至身体瘦弱。李东垣说:圣人治病,必定依据四季升降浮沉的道理,权衡变化的适宜性。必须先考虑当年的岁气,不伤害天和;不要使实证更盛,虚证更虚,以免给人带来夭折的灾殃;不要导致邪气入侵,不要错失正气,断绝人的长寿之道。所以张仲景说:阳盛阴虚,用下法则愈,用汗法则死;阴盛阳虚,用汗法则愈,用下法则死。大抵圣人立法,例如升阳或发散的药剂,是助长春夏的阳气,使其上升,从而泻除秋冬收藏、陨杀、寒凉之气。此病正是如此,应当用此法治之,这是升降浮沉的最高道理。天地之气依靠升降浮沉来顺应四季,如治病不可违背这一规律,所以《内经》说:顺天者昌,逆天者亡,怎能不敬畏呢?
人的身体也有类似四季的变化,天地之气不能只认为存在于外部,人也体同于天地。现在月经淋漓不止,是前阴的气血已经下脱了;水泄又持续数年,是后阴的气血下陷而脱失。后阴主要主管有形之物,前阴是精气的门户。下部的枯竭,意味着病患周身的气血常行秋冬肃杀之令,阴主杀伐,这属于此类收藏的病证。阳生阴长,对应春夏。在人体中,使气机升浮的是谷气上行。既然病患周身血气都不生长,谷气又不能充养肌肉,导致肌肉消瘦,这是阴阳两仪之气都将断绝了。既然下元前后二阴都脱失,血气将要枯竭,假令原本是热证,但下焦久脱之后也会化为寒证。此病日久,沉潜下降,寒湿大胜,应当紧急救治,用热药泻寒,用燥药除湿,大力升提举陷,以助生长,补养气血,不致偏颇枯竭。圣人确立的治疗法则,既然湿气大胜,就用所胜之气来治疗,助甲木风木上升,这就是《内经》所说的“风胜湿”,是以所胜之气来平抑它。应当先调和胃气,其次用白术之类药物来燥湿并滋养元气。如果仍不止,后用风药来胜湿。这便是大力升提举陷,以助春夏之气,治疗湿气长久下陷的最高治法。
Treatment for metrorrhagia (menstrual bleeding that does not stop) with bright red blood, accompanied by stiffness and tension of the tendons in the neck, headache, and stiffness/pain in the spinal column.
Zhi Gancao (Prepared Licorice Root), Danggui Shen (Body of Angelica Sinensis), Gegen (Kudzu Root) (each 3 fen); Duhuo (Angelica Pubescens), Gaoben (Ligusticum Wallichii), Shengma (Cimicifuga Rhizome) (each 5 fen); Chaihu (Bupleurum Root) (7 fen); Qianghuo (Notopterygium Rhizome), Cangzhu (Atractylodes Rhizome) (each 1 qian); Honghua (Carthamus Flower) (a small amount).
Crush the above herbs to the size of hemp seeds. Generally, prepare as one dose. Decoct in four cups of water until reduced to one cup. Strain the dregs. Take warm on an empty stomach. Induce a slight sweating; the bleeding will stop immediately.
A female patient had menstrual blood coagulating into black clots, with a blood mass (Xue Jia) in the left hypochondrium/abdomen, incessant watery diarrhea, and occasional indigestion of food grains. Subsequently, the blood clots were discharged violently along with the watery stool from both the anterior and posterior orifices.
Due to prolonged depletion of blood and Qi in the lower jiao, menstruation remained irregular. Watery diarrhea occurred two to three times daily. After eating, she experienced vexation and irritability, reduced appetite, and eventually emaciation. Dongyuan stated: The sage treats diseases based on the principles of ascending, descending, floating, and sinking according to the four seasons, adapting to changes appropriately. One must first consider the annual climate (Sui Qi) without violating the Heavenly Harmony; do not exacerbate excess conditions or deplete deficiency conditions, thereby avoiding premature death; do not allow pathogenic factors to invade nor lose the righteous Qi, thus preserving longevity. Therefore, Zhang Zhongjing said: In cases of Yang excess and Yin deficiency, purgation leads to recovery while diaphoresis leads to death; in cases of Yin excess and Yang deficiency, diaphoresis leads to recovery while purgation leads to death. Broadly speaking, the laws established by sages, such as using agents to raise Yang or induce dispersion, assist the Yang Qi of Spring and Summer to ascend, thereby draining the cold and storing energy of Autumn and Winter. This disease is exactly of this nature and should be treated accordingly, embodying the ultimate principle of ascending, descending, floating, and sinking. The Qi of Heaven and Earth relies on ascending, descending, floating, and sinking to follow the four seasons. Treating disease must not go against this rule. Hence, the Classic states: Those who follow Heaven prosper; those who oppose Heaven perish. Can one not revere this?
The human body also mirrors the four seasons. The Qi of Heaven and Earth cannot be regarded solely as external; humans are congruent with Heaven and Earth. Now, metrorrhagia indicates that the Qi and Blood of the anterior orifice have already sunk and depleted. Watery diarrhea persisting for years indicates that the Qi and Blood of the posterior orifice have sunk and depleted. The posterior orifice primarily governs tangible substances, while the anterior orifice is the gateway of essence and Qi. Depletion at the lower end means the patient's systemic Qi and Blood operate under the killing/minuting influence of Autumn and Winter, where Yin dominates destruction. Such storage-related diseases involve the generation of Yang and growth of Yin, corresponding to Spring and Summer. In the human body, it is the Grain Qi (Gu Qi) ascending that causes Qi to float and rise. Since the patient's systemic Qi and Blood fail to grow, and Grain Qi fails to nourish the muscles, leading to muscle wasting, the Qi of the Two Poles (Yin and Yang) are on the verge of extinction. With the depletion of the lower Yuan and both orifices, and Qi and Blood nearing exhaustion, even if the original condition was Heat, long-term depletion in the Lower Jiao would transform into Cold. This disease has been deep and sinking for a long time, with excessive Cold-Dampness. Urgent rescue is required: use hot herbs to drain Cold and drying herbs to remove Dampness. Greatly raise and lift to assist growth, tonify and nourish Qi and Blood to prevent partial depletion. The therapeutic method established by sages, given the overwhelming Dampness, uses the overcoming element to treat it, assisting the Wind-Wood (Jia Wood) to ascend. This aligns with the Classic stating "Wind overcomes Dampness," using the overcoming element to pacify it. First, harmonize the Stomach Qi. Second, use herbs like Baizhu (Atractylodes Macrocephala Rhizome) to dry Dampness and nourish Original Qi. If it persists, subsequently use wind-dispelling herbs to overcome Dampness. This constitutes the supreme treatment of greatly raising and lifting to assist the Qi of Spring and Summer, addressing the long-term sinking of Dampness.