湿病者,太阴湿旺,而感风寒也,湿气浸淫,弥漫于周身,一遇风寒感冒,闭其皮毛,通身经络之气
,壅滞不行,则疼痛热烦之病作矣。湿凌上焦,则痛在头目。湿淫下部,则痛在膝踝。湿浸肝肾,则痛在腰
腹。湿遍一身,上下表里,无处不疼,而关窍骨节尤甚。其水盛者,淫 而为湿寒。其火盛者,郁蒸而为湿
热。法当内通其膀胱,外开其汗孔,俾表里双泄,其病自除矣。如湿寒日晡烦疼者,以茵陈五苓散主之。如
风湿相
搏,身体烦痛不能自转侧,不呕不渴,脉浮虚而涩者,以桂枝附子汤主之。若其人大便硬,小便自利者,
去桂枝加白术汤主之。如风湿相搏,骨节烦疼掣痛,不得屈伸,近之则痛剧,汗出短气,小便不利,恶风不
欲去衣,或身微肿者,以甘草附子汤主之。如病者一身尽疼,发热日晡所剧者,此名风湿,以麻黄杏仁薏
苡甘草汤主之。如湿温头痛恶寒,身重疼痛,舌白或渴,午后身热,脉浮虚者,以三仁汤主之。如湿旺脾郁
肺壅,而生上热,法宜清金利水以泄热者,以元滑苓甘散主之。如腹满尿涩,木郁而生下热,法宜利水以泄
湿热者,以苓甘栀子茵陈汤主之。
茵陈五苓散
白术 桂枝 茯苓 猪苓 泽泻等分为散,每用五钱,调茵陈蒿末一两,和匀,空腹米饮
调服一汤匙,日三服。多饮热汤取汗。如发热恶寒,是表邪闭固,再加紫苏,以发其汗。
桂枝附子汤
桂枝(四钱) 甘草(二钱炙) 生姜(三钱) 附子(三钱炮) 大枣(三枚) 水煎
大半杯,温服。
去桂枝加白术汤
甘草(一钱) 大枣(三枚) 生姜(三钱) 附子(三钱炮) 白术(四钱) 水
煎大半杯,温服。
甘草附子汤
甘草(二钱炙) 附子(二钱炮) 白术(二钱) 桂枝(四钱) 水煎大半杯,温服。
麻黄杏仁薏苡甘草汤
麻黄(二钱) 杏仁(三钱) 薏仁(三钱) 甘草(一钱) 水煎大半杯,温
服。
三仁汤
杏仁(三钱) 白蔻仁(二钱) 生薏仁(三钱) 滑石(三钱) 竹叶(一钱) 桑叶(三
钱) 白通草(二钱) 半夏(二钱) 甘澜水煎大半杯,温服。方中仍有温药者,以湿属阴邪,非温行则
湿不去也。
元滑苓甘散
元明粉 滑石 茯苓 甘草等分为末,大
麦粥汁和服一汤匙,日三服,湿从大小便去,尿黄粪黑,是其候也。如湿邪在腹,肺气壅滞,以致头痛鼻
塞,声音重浊,神气郁烦,当于发汗利水之中,加橘皮、杏仁以泄肺气。
苓甘栀子茵陈汤
茵陈(三钱) 栀子(二钱) 甘草(二钱生) 茯苓(三钱) 水煎大半杯,
热服。服后小盒饭利,尿如皂角汁状,其色正赤,一宿腹减,湿从小便去矣。若湿热在脾,当加大黄、芒硝
。如湿热但在肝家,而脾肾寒湿,当加干姜、附子。若膀胱无热,但用猪苓汤利其小便可也。
湿病,是由于太阴脾土湿气旺盛,又感受了风寒之邪。湿气浸淫弥漫于全身,一旦遇到风寒感冒,闭塞皮毛,导致周身经络之气壅滞不通,于是疼痛、发热、烦躁等病症就发作了。湿气侵犯上焦,则头痛目痛;湿气淫溢于下部,则膝踝疼痛;湿气浸渍肝肾,则腰腹疼痛。湿气遍布全身,上下表里无处不疼,而关节骨缝处尤为严重。其中水湿偏盛的,转化为湿寒证;火热偏盛的,郁蒸化为湿热证。治疗法则应当内通膀胱,外开汗孔,使表里之邪同时排出,疾病自然消除。如果是湿寒证在傍晚时分烦躁疼痛的,用茵陈五苓散主治。如果是风湿相互搏结,身体烦痛不能自行转侧,不呕吐不口渴,脉象浮虚而涩的,用桂枝附子汤主治。如果病人大便干硬,小便自利的,去掉桂枝加白术汤主治。如果是风湿相互搏结,骨节烦痛牵引作痛,不能屈伸,触碰则疼痛剧烈,出汗短气,小便不利,怕风不想脱衣,或者身体轻微浮肿的,用甘草附子汤主治。如果病人全身都疼,发热在傍晚时分加剧的,这名叫风湿,用麻黄杏仁薏苡甘草汤主治。如果是湿温病,头痛恶寒,身体沉重疼痛,舌苔白或口渴,午后身热,脉象浮虚的,用三仁汤主治。如果是湿气旺盛导致脾郁肺壅,产生上焦热邪,治法宜清金利水以泄热的,用元滑苓甘散主治。如果是腹部胀满、小便涩滞,肝木郁结产生下焦热邪,治法宜利水以泄湿热的,用苓甘栀子茵陈汤主治。
茵陈五苓散
由白术、桂枝、茯苓、猪苓、泽泻等分研为散剂,每次服用五钱,调入茵陈蒿末一两,混合均匀,空腹时用米饮调服一汤匙,每日三次。多喝热汤以取汗。如果出现发热恶寒,说明表邪闭固,再加紫苏,以发散其汗。
桂枝附子汤
桂枝(四钱)、炙甘草(二钱)、生姜(三钱)、炮附子(三钱)、大枣(三枚),用水煎煮大半杯,温服。
去桂枝加白术汤
甘草(一钱)、大枣(三枚)、生姜(三钱)、炮附子(三钱)、白术(四钱),用水煎煮大半杯,温服。
甘草附子汤
炙甘草(二钱)、炮附子(二钱)、白术(二钱)、桂枝(四钱),用水煎煮大半杯,温服。
麻黄杏仁薏苡甘草汤
麻黄(二钱)、杏仁(三钱)、薏仁(三钱)、甘草(一钱),用水煎煮大半杯,温服。
三仁汤
杏仁(三钱)、白蔻仁(二钱)、生薏仁(三钱)、滑石(三钱)、竹叶(一钱)、桑叶(三钱)、白通草(二钱)、半夏(二钱),用甘澜水煎煮大半杯,温服。方中仍有温药的原因,是因为湿属于阴邪,不用温药运行则湿气不能去除。
元滑苓甘散
元明粉、滑石、茯苓、甘草等分为末,用大麦粥汁调和服用一汤匙,每日三次,湿气从大小便排出,尿液变黄粪便变黑,就是排湿的征候。如果湿邪在腹部,肺气壅滞,导致头痛鼻塞,声音重浊,神气郁结烦躁,应当在发汗利水之中,加入橘皮、杏仁以宣泄肺气。
苓甘栀子茵陈汤
茵陈(三钱)、栀子(二钱)、生甘草(二钱)、茯苓(三钱),用水煎煮大半杯,热服。服药后小便应当通利,尿色像皂角汁一样正赤色,过一夜腹部胀满减轻,湿气从小便排出了。如果湿热在脾,应当加大黄、芒硝。如果湿热仅在肝脏,而脾肾有寒湿,应当加干姜、附子。如果膀胱没有热邪,只用猪苓汤利其小便即可。
Dampness disease arises when excessive dampness in the Taiyin (Spleen/Stomach channel) combines with exogenous Wind-Cold. Dampness permeates and fills the entire body; upon encountering Wind-Cold, it closes the skin pores, causing stagnation of Qi in the meridians throughout the body, thereby triggering symptoms such as pain, fever, and restlessness. When dampness invades the Upper Jiao (Upper Burner), pain occurs in the head and eyes. When dampness overflows to the lower part, pain occurs in the knees and ankles. When dampness infiltrates the Liver and Kidneys, pain occurs in the waist and abdomen. When dampness pervades the whole body, affecting interior and exterior, upper and lower, there is no place without pain, especially severe at the joints and bone crevices. Where water-dampness predominates, it transforms into Cold-Dampness. Where Fire-heat predominates, it stagnates and steams into Damp-Heat. The treatment principle is to unblock the Bladder internally and open the sweat pores externally, allowing both exterior and interior pathogens to be discharged simultaneously, thus curing the disease. For Cold-Dampness presenting with restlessness and pain worsening in the late afternoon, Yinchen Wuling San (Artemisiae Scopariae Five-Ingredient Powder) is prescribed. For Wind-Dampness combing together, causing bodily restlessness and pain preventing self-turning, without vomiting or thirst, and with a floating, deficient, and choppy pulse, Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) is prescribed. If the patient has hard stool and free urination, Guizhi is removed and Baizhu is added (Qu Guizhi Jia Baizhu Tang). For Wind-Dampness combing together, causing joint restlessness, pulling pain, inability to flex or extend, severe pain upon touch, sweating, shortness of breath, difficult urination, aversion to wind with reluctance to remove clothes, or slight edema, Gancao Fuzi Tang (Licorice and Aconite Decoction) is prescribed. If the patient suffers from generalized body pain and fever worsening in the late afternoon, this is named Wind-Dampness, and Mahuang Xingren Yiyi Gancao Tang (Ephedra, Apricot Seed, Coix Seed, and Licorice Decoction) is prescribed. For Damp-Warmth presenting with headache, aversion to cold, heavy painful body, white tongue coating or thirst, afternoon fever, and a floating, deficient pulse, Sanren Tang (Three-Nut Decoction) is prescribed. When excessive dampness causes Spleen stagnation and Lung congestion, generating Upper Jiao Heat, the method should clear heat and promote diuresis using Yuanhua Linggan San (Mirabilite, Talcum, Poria, and Licorice Powder). For abdominal fullness and dysuria caused by Liver Wood stagnation generating Lower Jiao Heat, the method should promote diuresis to drain Damp-Heat using Linggan Zhizi Yinchen Tang (Poria, Licorice, Gardenia, and Artemisiae Scopariae Decoction).
Yinchen Wuling San (Artemisiae Scopariae Five-Ingredient Powder)
Composed of Baizhu (Atractylodis Rhizoma), Guizhi (Cinnamomi Ramulus), Fuling (Poria), Zhuling (Polyporus), and Zexie (Alismatis Rhizoma) in equal parts, ground into powder. Take 5 qian per dose, mix with 1 liang of Yinchenhao (Artemisiae Scopariae Herba) powder, blend evenly, and take one tablespoon mixed with rice water on an empty stomach, three times daily. Drink more hot soup to induce sweating. If fever and aversion to cold occur, indicating exterior pathogen closure, add Zisu (Perillae Folium) to release the exterior.
Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction)
Guizhi (Cinnamomi Ramulus, 4 qian), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma, 2 qian), Shengjiang (Zingiberis Rhizoma Recens, 3 qian), Pao Fuzi (Prepared Aconiti Lateralis Radix, 3 qian), Dazao (Jujubae Fructus, 3 pieces). Decoct in water to obtain half a cup, take warm.
Qu Guizhi Jia Baizhu Tang (Decoction with Guizhi Removed and Baizhu Added)
Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian), Dazao (Jujubae Fructus, 3 pieces), Shengjiang (Zingiberis Rhizoma Recens, 3 qian), Pao Fuzi (Prepared Aconiti Lateralis Radix, 3 qian), Baizhu (Atractylodis Rhizoma, 4 qian). Decoct in water to obtain half a cup, take warm.
Gancao Fuzi Tang (Licorice and Aconite Decoction)
Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma, 2 qian), Pao Fuzi (Prepared Aconiti Lateralis Radix, 2 qian), Baizhu (Atractylodis Rhizoma, 2 qian), Guizhi (Cinnamomi Ramulus, 4 qian). Decoct in water to obtain half a cup, take warm.
Mahuang Xingren Yiyi Gancao Tang (Ephedra, Apricot Seed, Coix Seed, and Licorice Decoction)
Mahuang (Ephedrae Herba, 2 qian), Xingren (Armeniacae Semen Amarum, 3 qian), Yiren (Coicis Semen, 3 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian). Decoct in water to obtain half a cup, take warm.
Sanren Tang (Three-Nut Decoction)
Xingren (Armeniacae Semen Amarum, 3 qian), Baokouren (Amomi Fructus Rotundus, 2 qian), Sheng Yiren (Raw Coicis Semen, 3 qian), Huashi (Talcum, 3 qian), Zhuye (Bambusae Folium, 1 qian), Sangye (Mori Folium, 3 qian), Baigengtong (Akebiae Caulis, 2 qian), Banxia (Pinelliae Rhizoma, 2 qian). Decoct in Ganlan Water (water boiled up and down repeatedly) to obtain half a cup, take warm. The formula still contains warming herbs because Dampness is a Yin pathogen; without warming agents to move Qi, Dampness cannot be eliminated.
Yuanhua Linggan San (Mirabilite, Talcum, Poria, and Licorice Powder)
Yuanmingfen (Natrii Sulfas), Huashi (Talcum), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma) in equal parts, ground into powder. Mix with Barley Porridge Juice and take one tablespoon, three times daily. Dampness exits via urine and stool; yellow urine and black stool are signs of this process. If dampness is in the abdomen causing Lung Qi stagnation, leading to headache, nasal congestion, hoarseness, and mental restlessness, add Chenpi (Citri Reticulatae Pericarpium) and Xingren (Armeniacae Semen Amarum) to vent Lung Qi alongside sweating and diuresis.
Linggan Zhizi Yinchen Tang (Poria, Licorice, Gardenia, and Artemisiae Scopariae Decoction)
Yinchen (Artemisiae Scopariae Herba, 3 qian), Zhizi (Gardeniae Fructus, 2 qian), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma, 2 qian), Fuling (Poria, 3 qian). Decoct in water to obtain half a cup, take hot. After ingestion, urination should become profuse, resembling soapberry juice in color and bright red. Abdominal distension reduces overnight as dampness exits via urine. If Damp-Heat is in the Spleen, add Dahuang (Rhei Radix et Rhizoma) and Mangxiao (Natrii Sulfas). If Damp-Heat is solely in the Liver while the Spleen and Kidneys have Cold-Dampness, add Ganjiang (Zingiberis Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata). If the Bladder lacks Heat, simply use Zhuling Tang (Polyporus Decoction) to promote diuresis.