血脱益气古圣人之法也先补胃气以助生发之气故曰阳生阴长诸甘药为之先务举世皆以为
补殊不知甘能生血此阳生阴长之理也故先理胃气人之身内胃气为宝
柴胡 升麻(各五分) 炙甘草 当归身(酒洗) 陈皮(各一钱) 人参(去芦有嗽去之)
炒神曲(各一钱五分)
黄 (二钱) 白术(三钱) 生黄芩(少许)
上 咀每服二钱水二大盏煎至一盏去渣稍热服如腹中痛每服加白芍药(三分) 中桂(少
许)
如渴或口干加葛根(二分) 不拘时候
治经水不止如右尺脉控之空虚是气血俱脱大寒之证轻手其脉数疾举指弦紧或涩皆阳脱之
证阴
火亦亡见热证于口鼻眼或渴此皆阴躁阳欲先去也当温之举之升之浮之燥之此法当大升浮血气
切补命门之下脱也
肉桂(去皮盛夏勿用秋冬用) 白芍药 红花(各五分) 细辛(六分) 人参(去芦) 熟地
黄
川芎(各一钱) 独活根 黑附子(炮制去皮脐) 炙甘草(各一钱五分) 羌活 本(去土)
防风(各二钱) 白术 当归 黄 柴胡(各三钱) 桃仁(十个汤浸去皮尖细研)
上 咀每服三钱若病势顺当渐加至五钱每服水三盏煎至一盏空心热服
妇人分娩及半产漏下昏冒不省瞑目无所知觉盖因血暴亡有形血去则心神无所养心与包络
者
君火相火也得血则安亡血则危火上炽故令人昏冒火胜其肺瞑目不省人事是阴血暴去不能镇抚
也
血已亏损往往用滑石甘草石膏之类乃辛甘大寒之药能泻气中之热是血亏泻气乃阴亏泻阳使二
者俱伤反为不足虚劳之病昏迷不省者上焦心肺之热也此无形之热用寒凉之药驱令下行岂不知
上焦之病悉属于表乃阴证也汗之则愈今反下之幸而不死暴亏气血生命岂能久活又不知内经有
说病气不足宜补不宜泻但瞑目之病悉属于阴宜汗不宜下又不知伤寒郁冒得汗则愈是禁用寒凉
药也分娩半产本气不病是暴去其血亡血补血又何疑焉补其血则神昌常时血下降亡今当补而升
举之心得血而养神不昏矣血若暴下是秋冬之令大旺今举而升之以助其阳则目张神不昏迷矣今
立一方补血养血生血益阳以补手足厥阴之不足也
血脱证采用益气法,这是古代圣人的治疗原则。首先补益胃气以助发生之气,所以说“阳生则阴长”,各种甘味药物是首要任务。世人皆认为甘味药只是用来补气的,却不知道甘味也能生血,这正是“阳生阴长”的道理。因此首先要调理胃气,人体内部以胃气为宝。
柴胡、升麻(各五分),炙甘草,当归身(酒洗),陈皮(各一钱),人参(去芦,若有咳嗽则去掉),炒神曲(各一钱五分),黄芪(二钱),白术(三钱),生黄芩(少许)。
以上药材切碎,每服二钱,加水两大盏,煎至一盏,去渣,稍热服用。如果腹中疼痛,每服加白芍药(三分)、肉桂(少许)。如果口渴或口干,加葛根(二分)。不拘时候服用。
治疗经水不止:如果右尺脉按之空虚,这是气血俱脱的大寒证;轻取脉搏数疾,举指感觉弦紧或涩,这都是阳气脱失的证候,阴火也随之消亡。如果在口、鼻、眼见到热象,或者口渴,这都属于阴躁,阳气欲脱的情况。应当先去除阳气脱失的问题,采用温法、举法、升法、浮法、燥法。此法应当大用升浮之药来补血气,切忌补命门之下焦的脱证。
肉桂(去皮,盛夏季节勿用,秋冬可用),白芍药,红花(各五分),细辛(六分),人参(去芦),熟地黄,川芎(各一钱),独活根,黑附子(炮制,去皮脐),炙甘草(各一钱五分),羌活,藁本(去土),防风(各二钱),白术,当归,黄芪,柴胡(各三钱),桃仁(十个,汤浸去皮尖,细细研碎)。
以上药材切碎,每服三钱。如果病势顺遂,应当逐渐加量至五钱。每服用水三盏,煎至一盏,空腹热服。
妇女分娩及半产后漏下,出现昏冒、不省人事、闭目无知觉的症状,这是因为血液突然大量亡失,有形的血液离去,心神就失去了滋养。心与心包络分别属于君火和相火,得到血液则安宁,失去血液则危险,火上炽盛,所以令人昏冒。火胜克肺,导致闭目不省人事,这是因为阴血突然大量丧失,不能镇抚阳气所致。
血液已经亏损,往往误用滑石、甘草、石膏等辛甘大寒的药物,这些药物能泻气分之热。这是在血亏的情况下又泻气,即阴亏又泻阳,使两者都受伤,反而更加不足,导致虚劳病。昏迷不省人事,是由于上焦心肺有热。这种无形的热邪,如果用寒凉药物驱令下行,难道不知道上焦的病全都属于表证,乃是阴证吗?发汗则可以痊愈,现在反而用攻下法,幸好没有死亡,但气血暴亏,生命怎能长久存活?又不知《内经》说:病气不足,宜补不宜泻。凡是闭目的病全都属于阴证,宜汗不宜下。又不知伤寒郁冒证,得汗则愈,这是禁用寒凉药的情况。分娩、半产本身元气未病,只是突然失去了血液,亡血之后补血,有什么可怀疑的呢?补充血液则神明昌盛。平时血下降,亡血时现在应当补而升举之,心得血则养神而不昏乱了。如果血液暴下,如同秋冬时令大旺之时,现在将其举而升之,以助其阳气,则眼睛张开,神志不昏迷了。现在确立一方,用于补血、养血、生血、益阳,以补手足厥阴经的不足。
The method of tonifying Qi in cases of Blood depletion is the principle of ancient sages. First, tonify Stomach Qi to assist the generating Qi; thus it is said that "when Yang generates, Yin grows." Various sweet-flavored herbs are the primary task. The world generally believes that sweet flavors only tonify Qi, not realizing that sweet flavors can also generate Blood, which is precisely the principle of "Yang generating Yin." Therefore, one must first regulate Stomach Qi, as Stomach Qi is the treasure within the human body.
Chai Hu (Bupleuri Radix) and Sheng Ma (Cimicifugae Rhizoma), each 5 fen; Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma); Dang Gui Shen (Angelicae Sinensis Radix, washed with wine), each 1 qian; Ren Shen (Ginseng Radix, remove the芦 head; if there is cough, remove it); Chao Shen Qu (Stir-fried Massa Medicata Fermentata), each 1.5 qian; Huang Qi (Astragali Radix), 2 qian; Bai Zhu (Atractylodis Macrocephalae Rhizoma), 3 qian; Sheng Huang Qin (Scutellariae Radix, raw), a small amount.
Crush the above herbs. Take 2 qian per dose, add two large bowls of water, decoct until one bowl remains, strain, and take slightly warm. If there is abdominal pain, add Bai Shao Yao (Paeoniae Radix Alba), 3 fen, and Rou Gui (Cinnamomi Cortex), a small amount, per dose. If there is thirst or dry mouth, add Ge Gen (Puerariae Lobatae Radix), 2 fen. Take at any time.
To treat persistent menstruation: If the pulse at the right Chi position feels empty upon pressing, this is a severe cold syndrome of simultaneous depletion of Qi and Blood. If the pulse is rapid and hurried upon light pressure, or feels wiry, tight, or choppy upon lifting, these are all signs of Yang depletion, with Yin fire also extinguished. If heat symptoms appear in the mouth, nose, or eyes, or if there is thirst, these belong to Yin restlessness with impending Yang collapse. One should first address the Yang collapse by employing warming, lifting, ascending, floating, and drying methods. This approach requires heavily using floating and ascending agents to tonify Qi and Blood, while strictly avoiding tonification of the lower Jiao Ming Men (Gate of Life) in cases of collapse.
Rou Gui (Cinnamomi Cortex, remove bark; do not use in midsummer, use in autumn and winter); Bai Shao Yao (Paeoniae Radix Alba); Hong Hua (Carthami Flos), each 5 fen; Xi Xin (Asari Radix et Rhizoma), 6 fen; Ren Shen (Ginseng Radix, remove the 芦 head); Shu Di Huang (Rehmanniae Radix Praeparata); Chuan Xiong (Ligustici Chuanxiong Rhizoma), each 1 qian; Du Huo Gen (Angelicae Pubescentis Radix); Hei Fu Zi (Aconiti Lateralis Radix Praeparata, processed, remove skin and umbilicus); Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma), each 1.5 qian; Qiang Huo (Notopterygii Rhizoma et Radix); Ben Cao (Ligustici Wallichii Rhizoma et Radix, remove soil); Fang Feng (Saposhnikoviae Radix), each 2 qian; Bai Zhu (Atractylodis Macrocephalae Rhizoma); Dang Gui (Angelicae Sinensis Radix); Huang Qi (Astragali Radix); Chai Hu (Bupleuri Radix), each 3 qian; Tao Ren (Persicae Semen), ten kernels, soaked in hot water, remove skin and tips, finely ground.
Crush the above herbs. Take 3 qian per dose. If the disease condition is favorable, gradually increase the dose to 5 qian. Add three bowls of water per dose, decoct until one bowl remains, and take on an empty stomach while hot.
Women experiencing postpartum hemorrhage or miscarriage with continuous bleeding may suffer from fainting, loss of consciousness, closed eyes, and lack of perception. This is due to the sudden massive loss of Blood. When有形 (substantial) Blood leaves, the Heart Spirit loses its nourishment. The Heart and Pericardium correspond to Ministerial Fire and Sovereign Fire, respectively; they are peaceful when nourished by Blood but endangered when Blood is lost. With Fire blazing upward, one becomes faint and unconscious. Excessive Fire overacts on the Lung, causing closed eyes and loss of consciousness, because the sudden massive loss of Yin Blood fails to anchor and calm the Yang.
When Blood is already deficient, practitioners often mistakenly use herbs like Shi Hui (Talcum), Gan Cao (Glycyrrhizae Radix et Rhizoma), and Shi Gao (Gypsum Fibrosum), which are acrid-sweet and severely cold. These herbs drain Heat from the Qi level. Draining Qi when Blood is deficient means draining Yang when Yin is deficient, injuring both and exacerbating insufficiency, leading to deficiency exhaustion. Fainting and loss of consciousness are caused by Heat in the Upper Jiao (Heart and Lungs). This formless Heat, if treated with cold herbs to drive it downward, ignores the fact that diseases of the Upper Jiao all belong to the Exterior and are Yin syndromes. Sweating would cure them; instead, purging is used. Fortunately, death does not occur immediately, but with sudden depletion of Qi and Blood, how can life be sustained? Furthermore, the *Neijing* states that for deficiency of pathogenic Qi, tonification is preferred over purgation. All conditions involving closed eyes belong to Yin syndromes and should be treated with sweating, not purgation. It is also unknown that in Taiyang disorders with depression and fullness, sweating leads to recovery; thus, cold herbs are contraindicated. Childbirth and miscarriage do not inherently damage the Original Qi; they merely cause sudden Blood loss. After losing Blood, one should tonify Blood—what is there to doubt? Tonifying Blood restores the Spirit. Normally, Blood descends; in cases of Blood loss, one should now tonify and lift/ascend. When the Heart receives Blood, it nourishes the Spirit, preventing confusion. If Blood flows down violently, resembling the excessive Yang of Autumn and Winter, lifting and ascending it now assists Yang, opening the eyes and preventing mental confusion. Herein, a formula is established to tonify, nourish, generate Blood, and benefit Yang, addressing the insufficiency of the Hand and Foot Jueyin meridians.