虚痨统治(小)建中(汤加黄) ,火炽二加龙骨(汤)医,吐血理中(汤)姜草(甘草干姜汤)妙,喘生肾
气(丸)桂甘(苓桂甘术汤)奇(小青)龙能导水寒痰治(小)柴胡最疏肝热嗽施,千古滋阴都误解(金元诸
医,以血为阴,立斋、景岳以肾为阴,所用如地黄、当归、白芍、黄柏、枸杞、龟板之类毕
其能事。时医叶天士增入海参胶、淡菜、燕窝胶,更为离经,如此滋阴,久服无不归阴,)太
阴脾土要扶持(血虽为阴,取汁必在中焦,肾虽为阴,而精生于谷,故圣人名为太阴为诸阴之母
。
怔忡者,心下跳动不安,即惊(有触而动曰惊)悸(不触而动曰悸)之类也。健忘之治法亦同。
皆肾水虚而不能上升,以致心火不能下降之病。宜大剂归脾汤去木香,加麦冬、五味子、枸
杞,吞都气丸,如挟心包一种有余之火兼痰者,加贝母、黄连、生地以清之。又有水气凌心
,轻则用小半夏汤,倍加茯苓以泄之;重则用桂枝、茯苓、大枣、甘草汤以安之;再重则用
真武汤以镇之。若奔豚以桂枝汤加桂主之。《金匮》有奔豚汤甚妙,若小麦、生龙骨、生牡
蛎皆可加入(此条多引高鼓峰。
心肾不交病怔忡,归脾(汤)都气(丸)两方通,有余痰火加连贝,水气奔豚另法攻。
痿者,两足痿弱不能行也(痿而不痛),宜独取阳明。阳明为五脏六腑之海,主润宗筋。宗
筋主束骨而利机关。若阳明虚,不能受水谷之气而布化,则五脏无所禀,宗筋无所养,而痿
作矣。宜虎潜丸主之,或以淫羊藿剪去刺一两,天门冬五钱,紫菀三钱,苍术二钱,黄
柏一钱,水煎服。本方意义非熟于《神农本草经》者,不可与语也。此证为胃虚不足,故列于
虚劳病统用(小)建中汤加黄芪,火旺炽盛用二加龙骨汤治疗。吐血之症,理中汤或干姜甘草汤疗效奇妙;气喘发作,肾气丸、苓桂甘术汤效果奇特;小青龙汤能引导水寒之痰得以治愈;小柴胡汤最适宜疏解肝热引起的咳嗽。自古以来对滋阴法的理解多有误解(金元时期的各位医生,将血液视为阴,李东垣、张景岳将肾脏视为阴,他们所用的药物如地黄、当归、白芍、黄柏、枸杞、龟板等,已尽其能事。当时的名医叶天士又加入了海参胶、淡菜、燕窝胶,更是背离了经典医理。如此滋阴,长期服用没有不导致身体衰败归于阴寒的),关键在于扶持太阴脾土(血液虽然属于阴,但津液的提取必依赖于中焦脾胃;肾脏虽然属阴,但精液生于水谷精气,所以圣人称太阴脾为诸阴之母。
怔忡,是指心下跳动不安,即惊(受到触动而发作为惊)悸(未受触动而自发悸动为悸)之类的病症。健忘的治疗法则也与此相同。这都是因为肾水虚弱不能上升,导致心火不能下降所引发的疾病。适宜使用大剂量的归脾汤去掉木香,加入麦冬、五味子、枸杞,同时吞服都气丸;如果兼夹心包络有余之火且伴有痰浊者,加入贝母、黄连、生地以清泻之。又有水气凌犯心脏的情况,轻症用小半夏汤,加倍加入茯苓以泄除水气;重症用桂枝、茯苓、大枣、甘草汤以安定心神;再重的则用真武汤来镇摄。若是奔豚病,以桂枝汤加桂为主治方。《金匮要略》中有奔豚汤非常妙用,若小麦、生龙骨、生牡蛎都可以加入其中(此条内容多引用高鼓峰的观点。
心肾不交导致的怔忡,归脾汤和都气丸两方皆通治,若有剩余的痰火则加入黄连、贝母,若是水气或奔豚则用另外的方法攻治。痿证,是指双足痿弱无力无法行走(痿证而不疼痛),应当专门选取阳明经进行治疗。阳明经是五脏六腑气血的海源,主要滋润宗筋。宗筋主要约束骨骼并利于关节运动。如果阳明经虚弱,不能接受水谷的精气并进行布化输布,那么五脏就无所禀受,宗筋就得不到滋养,从而产生痿证。适宜用虎潜丸主治,或者用淫羊藿剪去刺一两,天门冬五钱,紫菀三钱,苍术二钱,黄柏一钱,加水煎服。这个方子的深意,如果不是熟读《神农本草经》的人,是无法与之谈论的。此证属于胃气虚弱不足,所以将其列在……
Xu Lao (Consumptive Disease) is generally treated with Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) plus Huang Qi (Astragali Radix); when fire is blazing, Er Jia Long Gu Tang (Two-Added Dragon Bone Decoction) is used for treatment. For hemoptysis (coughing up blood), Li Zhong Tang (Regulate the Middle Decoction) or Gan Cao Gan Jiang Tang (Licorice and Dried Ginger Decoction) yields miraculous results. For asthma onset, Shen Qi Wan (Kidney Qi Pill) or Ling Gui Gan Zhu Tang (Poria, Cinnamon Twig, Licorice, and Atractylodes Macrocephala Decoction) works wonders; Xiao Qing Long Tang (Minor Blue Green Dragon Decoction) can guide out cold-phlegm caused by water-cold; Xiao Chai Hu Tang (Minor Bupleurum Decoction) is best for dispersing liver-heat coughs. For millennia, the understanding of Yin-nourishing methods has been largely misunderstood (The physicians of the Jin and Yuan dynasties regarded blood as Yin; Li Dongyuan and Zhang Jingyue regarded the Kidney as Yin. The herbs they used, such as Di Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Huang Bo (Phellodendri Cortex), Gou Qi Zi (Lycii Fructus), and Gui Ban (Testudinis Carapax et Plastrum), exhausted their efficacy. Later physicians like Ye Tianshi added Hai Shen Jiao (Sea Cucumber Gel), Dan Cai (Mussel Meat), and Yan Wo Jiao (Swallow's Nest Gel), which deviated even further from the correct path. Such Yin-nourishing practices, if taken long-term, inevitably lead to a state of excessive Yin). One must support the Spleen Earth of Taiyin (Although blood belongs to Yin, its extraction relies on the Middle Jiao; although the Kidney belongs to Yin, essence is generated from grain and water. Thus, the Sage named Taiyin the Mother of all Yins.)
Zhen Tong (Palpitations) refers to a sensation of trembling and unease in the epigastrium, belonging to the category of Jing (Fright, triggered by external stimuli) and Ji (Trepidation, occurring spontaneously without external triggers). The treatment method for forgetfulness is also the same. These are diseases caused by Kidney Water deficiency failing to ascend, resulting in Heart Fire failing to descend. It is appropriate to use a large dose of Gui Pi Tang (Restore the Spleen Decoction) minus Mu Xiang (Aucklandiae Radix), plus Mai Dong (Ophiopogonis Radix), Wu Wei Zi (Schisandrae Fructus), and Gou Qi Zi (Lycii Fructus), swallowed with Du Qi Wan (Nine-Ingredient Pill with Cornus). If accompanied by an excess fire in the Pericardium combined with phlegm, add Bei Mu (Fritillariae Bulbus), Huang Lian (Coptidis Rhizoma), and Sheng Di Huang (Rehmanniae Radix Preparata) to clear it. In cases where Water-Qi assaults the Heart, mild cases are treated with Xiao Ban Xia Tang (Minor Pinellia Decoction) with doubled Fu Ling (Poria) to drain it; severe cases use Gui Zhi (Cinnamomi Ramulus), Fu Ling (Poria), Da Zao (Ziziphi Jujubae Fructus), and Gan Cao (Glycyrrhizae Radix et Rhizoma) Decoction to calm it; even more severe cases use Zhen Wu Tang (True Warrior Decoction) to suppress it. If it is Ben Tun (Running Piglet disease), Gui Zhi Tang (Cinnamon Twig Decoction) plus Gui Zhi (Cinnamomi Ramulus) is the primary formula. The *Jin Gui Yao Lue* contains Ben Tun Tang (Running Piglet Decoction), which is excellent; Xiao Mai (Tritici Semen), Sheng Long Gu (Dragon Osis Preparatum), and Sheng Mu Li (Ostreae Concha) can all be added (This section draws heavily on Gao Gufeng's views.)
Heart-Kidney non-interaction leads to Zhen Tong; Gui Pi Tang and Du Qi Wan are both effective. Add Lian (Huang Lian) and Bei (Bei Mu) for excess phlegm-fire; treat Water-Qi and Ben Tun with different methods.
Wei Zheng (Flaccidity Syndrome) refers to weakness and inability to walk in both legs (flaccidity without pain). Treatment should focus primarily on the Yangming channel. Yangming is the sea of the five zang and six fu organs, primarily moistening the Zong Jin (Major Tendons). The Zong Jin binds the bones and facilitates joint movement. If Yangming is deficient and cannot receive the Qi of grain and water to distribute and transform it, the five zang organs will have no source, the Zong Jin will lack nourishment, and Wei Zheng will arise. Hu Qian Wan (Tiger Hidden Pill) should be used as the main treatment. Alternatively, one may use Yin Yang Huo (Epimedii Folium) trimmed of thorns, 1 liang; Tian Men Dong (Asparagi Radix), 5 qian; Zi Wan (Adenophorae Radix), 3 qian; Cang Zhu (Atractylodis Rhizoma), 2 qian; Huang Bo (Phellodendri Cortex), 1 qian; decocted in water and taken orally. The profound meaning of this formula cannot be discussed with those not well-versed in the *Shennong Bencao Jing*. This syndrome is due to Stomach deficiency and insufficiency, hence it is listed under...