圣济射干丸 治呷嗽咳而胸中多痰,结于喉间,呀呷有声。
射干 半夏(各一两) 陈皮 百部 款冬花 贝母 细辛 干姜 茯苓 五味子 郁李仁
皂荚(去皮子,炙,五钱
共为末,蜜丸梧子大,空心米饮下三、四十丸,一日两服。
五淋汤 治小便淋症不出,或尿如豆汁,或成砂石,或为膏汁,或热沸便血。
赤茯苓(三钱) 白芍 生山栀(各二钱) 当归 细甘草(各一钱四分
水煎服。
此方用栀、苓治心腹,以通上焦之气,而心火清,归、芍滋肝肾,以安下焦之气,而
五脏阴复,甘草调中焦之气,而阴阳厘清,则太阳之气自化,而膀胱之水府洁矣。
补中益气汤(见疟疾) 桂附八味丸(见痰饮
白通汤(方见伤寒) 治少阴病下利者此方主之。
滋肾丸(一名通关丸) 治小便不通、口不渴者。并治肺痿声嘶,喉痹咳血,烦躁等症。
黄柏 知母(各一两) 肉桂(一钱
研末,蜜丸,每服三钱,开水送下。
此方一治小便不通,盖以小便由气化而出,气者,阳也,阳得阴则化,故用知柏以补阴
,少佐肉桂以化气。一治肺痿声嘶喉痹等症,盖以前症皆由水衰于下,火炎于上而克金,此
时以六味丸补水,水下不能遽生也,以生脉散保金,金不免犹燥也,惟节用黄柏之苦以坚肾
,则能伏龙雷之沸火,是谓浚其源而安其流。继用知母之清以凉肺,是谓沛之雨而腾之露。
然恐水火不相入而相射也,故益肉桂为反佐,兼以导龙归海,此制方之妙也。
圣济射干丸:治疗呷嗽(咳嗽时喉间有如水鸡声),症见咳嗽且胸中痰多,痰结于喉间,发出呀呷之声。
药材组成:射干、半夏(各一两)、陈皮、百部、款冬花、贝母、细辛、干姜、茯苓、五味子、郁李仁、皂荚(去皮去子,炙烤,五钱)。
制法与用法:共研为细末,用蜂蜜制成梧桐子大小的蜜丸,空腹时用米汤送服三四十丸,每日服用两次。
五淋汤:治疗小便淋证排出不畅,或尿液如豆汁样,或结成砂石,或呈膏脂状,或伴有热沸感及便血。
药材组成:赤茯苓(三钱)、白芍、生山栀(各二钱)、当归、生甘草(各一钱四分)。
制法与用法:加水煎煮后服用。
方解:此方使用栀子、茯苓来调理心腹,以疏通上焦之气,使心火得以清降;使用当归、白芍滋养肝肾,以安定下焦之气,从而使五脏之阴气恢复;使用甘草调和 middle jiao(中焦)之气,使阴阳界限清晰。如此则太阳经之气自然化行,膀胱这一水液贮藏之府也就洁净通畅了。
其他相关方剂:补中益气汤(参见疟疾章节)、桂附八味丸(参见痰饮章节)、白通汤(方剂详见伤寒章节),用于治疗少阴病出现下利的症状,以此方为主治。
滋肾丸(又名通关丸):治疗小便不通、口不渴的症状。同时治疗肺痿引起的声音嘶哑、喉痹咳血、烦躁等症状。
药材组成:黄柏、知母(各一两)、肉桂(一钱)。
制法与用法:研成细末,用蜂蜜制成蜜丸,每次服用三钱,用开水送服。
方解:此方一方面治疗小便不通,因为小便的排出依赖于气化作用,气属于阳,阳气得到阴液的资助才能化生,所以使用知母、黄柏来滋补阴液,稍加佐使肉桂以助气化。另一方面治疗肺痿、声音嘶哑、喉痹等症状,因为这些病症多是由于肾水亏虚于下,虚火上炎于上而克制肺金所致。此时若用六味地黄丸补水,水下之水不能立刻生成;若用生脉散保肺金,肺金难免依然干燥。只有节制地使用黄柏之苦寒以坚补肾阴,就能潜伏龙雷之火的沸腾,这叫作疏通源头以安顿水流。接着使用知母的清凉以冷却肺金,这叫作降下雨水并升腾露水。然而担心水火不相容而相互冲射,所以加入肉桂作为反佐药,兼以引导龙火回归大海,这是该方制剂的妙处所在。
Shengji Shegan Wan: Treats "Xiaosou" (cough with a sound like a water chicken in the throat), characterized by coughing with excessive phlegm in the chest, phlegm knotting in the throat, and producing a "yaxia" (wheezing/crackling) sound.
Ingredients: Shegan (Belamcandae Rhizoma), Banxia (Pinelliae Rhizoma Praeparatum) (each 1 liang), Chenpi (Citri Reticulatae Pericarpium), Baibu (Stemonae Radix), Kuandonghua (Farfarae Flos), Beimu (Fritillariae Cirrhosae Bulbus), Xixin (Asari Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma Conspectum), Fuling (Poria), Wuweizi (Schisandrae Chinensis Fructus), Yuliren (Prunus japonica seed), Zaojiao (Gleditsiae Sinensis Spina) (skin and seeds removed, roasted, 5 qian).
Preparation and Administration: Grind all ingredients into fine powder, mix with honey to form pills the size of wutong seeds. Take 30-40 pills on an empty stomach with rice decoction, twice daily.
Wulin Tang: Treats Lin syndrome (dysuria) where urine is difficult to pass, or urine resembles bean curd dregs, or forms sand/stones, or appears as paste-like fluid, or is accompanied by heat sensation and hematochezia/hematuria.
Ingredients: Chifuling (Poria with Red Hosta Root) (3 qian), Baishao (Paeoniae Radix Alba), Sheng Shanzhi (Gardeniae Fructus raw) (each 2 qian), Danggui (Angelicae Sinensis Radix), Sheng Gancao (Glycyrrhizae Radix et Rhizoma raw) (each 1.4 qian).
Preparation and Administration: Decoct in water and take orally.
Formula Analysis: This formula uses Zhizi (Gardeniae Fructus) and Fuling (Poria) to regulate the heart and abdomen, thereby unblocking Qi in the Upper Jiao (Upper Burner) and clearing Heart Fire; Danggui (Angelicae Sinensis Radix) and Baishao (Paeoniae Radix Alba) nourish the Liver and Kidney to stabilize Qi in the Lower Jiao (Lower Burner), thus restoring Yin of the Five Zang organs; Gancao (Glycyrrhizae Radix et Rhizoma) harmonizes Qi in the Middle Jiao (Middle Burner), clarifying Yin and Yang. Consequently, Taiyang (Bladder/Small Intestine channel) Qi transforms naturally, and the Bladder (the reservoir of water) becomes clean and unobstructed.
Related Formulas: Buzhong Yiqi Tang (See Malaria chapter), Guifu Bawei Wan (See Phlegm-Fluid Retention chapter), Baitong Tang (Formula seen in Shanghan Lun chapter): Treats Shaoyin disease presenting with diarrhea; this formula is the primary treatment.
Zishen Wan (also known as Tongguan Wan): Treats urinary retention without thirst. Also treats symptoms such as hoarseness due to Feiwei (Lung Atrophy), Houbi (Sore Throat) with hemoptysis, and irritability.
Ingredients: Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma) (each 1 liang), Rougui (Cinnamomi Cortex) (1 qian).
Preparation and Administration: Grind into powder, make into honey pills. Take 3 qian per dose, washed down with boiled water.
Formula Analysis: This formula addresses two conditions. First, for urinary retention: urination depends on Qi transformation. Qi belongs to Yang, and Yang requires Yin to transform. Thus, Zhi Mu (Anemarrhenae Rhizoma) and Huang Bai (Phellodendri Cortex) are used to tonify Yin, with a small amount of Rou Gui (Cinnamomi Cortex) added to facilitate Qi transformation. Second, for Feiwei (Lung Atrophy), hoarseness, and Houbi (Sore Throat): these conditions arise from Water deficiency in the Lower Jiao and Fire flaring upward to attack Metal (Lung). Using Liuwei Dihuang Wan to tonify water cannot instantly generate water; using Shengmai San to protect Metal does not prevent dryness. Only by judiciously using the bitter cold of Huang Bai to strengthen the Kidney can one subdue the boiling fire of Dragon and Thunder (mineral fires), which is described as dredging the source to calm the flow. Subsequently, using the cooling property of Zhi Mu to cool the Lung is likened to pouring rain and rising dew. However, fearing that Water and Fire may not integrate and instead clash, Rou Gui is added as a counter-agent (fan zuo) to guide the Dragon Fire back to the sea. This illustrates the ingenuity of the formula's composition.