玄参∶色黑,味甘微苦,性凉多液。原为清补肾经之药,中心空而色白(此其本色,药局多以黑豆皮水染
之,则不见其白矣),故又能入肺以清肺家燥热,解毒消火,最宜于肺病结核、肺热咳嗽。《神农本草经》谓
其治产乳余疾,因其性凉而不寒,又善滋阴,且兼有补性(凡名参者皆含有补性),故产后血虚生热及产后寒
温诸证,热入阳明者,用之最宜。愚生平治产后外感实热,其重者用白虎加人参汤以玄参代方中知母,其轻者
用拙拟滋阴清胃汤,亦可治愈。诚以产后忌用凉药,而既有外感实热,又不得不以凉药清之,惟石膏与玄参,
《神农本草经》皆明载治产乳,故敢放胆用之。然用石膏又必加人参以辅之,又不敢与知母并用,至滋阴清胃
汤中重用玄参,亦必以四物汤中归芍辅之,此所谓小心放胆并行不悖也。《神农本草经》又谓,玄参能明目,
诚以肝开窍于目,玄参能益水以滋肝木,故能明目,且目之所以能视者,在瞳子中神水充足,神水固肾之精华
外现者也。以玄参与柏实、枸杞并用,以治肝肾虚而生热视物不了了者,恒有捷效也。又外感大热已退,其人
真阴亏损、舌干无津、胃液消耗、口苦懒食者,愚恒用玄参两许,加潞党参二三钱,连服数剂自愈。
当归∶味甘微辛,气香,液浓,性温。为生血、活血之主
药,而又能宣通气分,使气血各有所归,故名当归。其力能升(因其气浓而温)能降(因其味浓而辛),内润
脏腑(因其液浓而甘),外达肌表(因其味辛而温)。能润肺金之燥,故《神农本草经》谓其主咳逆上气;能
缓肝木之急,故《金匮》当归芍药散,治妇人腹中诸疼痛;能补益脾血,使人肌肤华泽;生新兼能化瘀,故能
治周身麻痹、肢体疼痛、疮疡肿疼;活血兼能止血,故能治吐血、衄血(须用醋炒取其能降也),二便下血
(须用酒炒取其能升也);润大便兼能利小便,举凡血虚血枯、阴分亏损之证,皆宜用之。惟虚劳多汗、大便
滑泻者,皆禁用。
当归之性虽温,而血虚有热者,亦可用之,因其能生血即能滋阴,能滋阴即能退热也。其表散之力虽微,
而颇善祛风,因风着人体恒致血痹,血活痹开,而风自去也。至于女子产后受风发搐,尤宜重用当归,因产后
之发搐,半由于受风,半由于血虚(血虚不能荣筋),当归既能活血以祛风,又能生血以补虚,是以愚治此
等证,恒重用当归一两,少加散风之品以佐之,即能随手奏效。
【附案】一少妇,身体羸弱,月信一次少于一次,浸至只来少许,询问治法。时愚初习医未敢疏方,俾每
日单用当归八钱煮汁饮之,至期所来经水遂如常,由此可知当归生血之效也。
一人年四十余,得溺血证,自用当归一两酒煮饮之而愈。后病又反复,再用原方不效,求为延医,愚俾单
用去皮鸦胆子五十粒,冰糖化水送下而愈。后其病又反复,再服鸦胆子方两次无效,仍用酒煮当归饮之而愈。
夫人犹其人,证犹其证,从前治愈之方,后用之有效有不效者,或因血证之前后凉热不同也,然即此亦可知当
归之能止下血矣。
玄参:颜色黑,味道甘甜略带苦味,性质凉润多汁。原本是清补肾经的药物,中心空且颜色白(这是它的本色,药店常用黑豆皮水染色,就看不到白色了),所以又能入肺经以清除肺部的燥热,解毒降火,最适合治疗肺病结核、肺热咳嗽。《神农本草经》说它能治疗产后余疾,因为它的性质凉而不寒,又善于滋阴,并且兼有补益作用(凡是名字带“参”的都含有补性),所以产后血虚生热以及产后感受寒温等病症,邪热传入阳明经的,用它最合适。我平生治疗产后外感实热证,重症用白虎加人参汤,用玄参代替方中的知母;轻症用我自己拟定的滋阴清胃汤,也能治愈。确实是因为产后忌讳使用凉药,但既然有外感实热,又不得不使用凉药来清热,只有石膏和玄参,《神农本草经》都明确记载能治疗产后疾病,所以我敢大胆使用。然而使用石膏时,必须加入人参来辅助它,又不敢与知母同时并用;至于在滋阴清胃汤中重用玄参,也一定要用四物汤中的当归、白芍来辅助它,这就是所谓的小心谨慎与大胆用药并行不悖。《神农本草经》又说,玄参能明目,确实因为肝开窍于目,玄参能滋补肾水以滋养肝木,所以能明目,而且眼睛之所以能视物,在于瞳孔中的神水充足,神水本来就是肾之精华外现的表现。将玄参与柏子仁、枸杞一起使用,来治疗因肝肾虚而生热导致视物模糊不清的情况,常常有显著疗效。另外,外感大热已退,患者真阴亏损、舌干无津、胃液消耗、口苦不想吃饭的,我常用玄参一两,加入潞党参二三钱,连续服用几剂就能自愈。
当归:味道甘甜略带辛味,气味芳香,汁液浓稠,性质温。是生血、活血的主要药物,而又能宣通气分,使气血各有所归,所以名叫当归。它的力量能升(因为气浓而温)能降(因为味浓而辛),内润脏腑(因为液浓而甘),外达肌表(因为味辛而温)。能润肺金的燥气,所以《神农本草经》说它主治咳逆上气;能缓解肝木的急迫,所以《金匮要略》中的当归芍药散,治疗妇人腹中各种疼痛;能补益脾血,使人肌肤光泽;既能生新血又能化瘀血,所以能治疗周身麻痹、肢体疼痛、疮疡肿痛;活血兼能止血,所以能治疗吐血、衄血(必须用醋炒以取其能降的特性),二便下血(必须用酒炒以取其能升的特性);润大便兼能利小便,凡是血虚血枯、阴分亏损的病症,都适宜使用。只有虚劳多汗、大便滑泻的人,都禁用。
当归的性质虽然温,但血虚有热的人,也可以使用它,因为它能生血即能滋阴,能滋阴即能退热。它的发散力量虽然微弱,但很善于祛风,因为风邪附着人体往往导致血痹,血液流通则痹阻开通,风邪自然去除。至于女子产后受风引起抽搐,尤其适宜重用当归,因为产后的抽搐,一半是由于受风,一半是由于血虚(血虚不能濡养筋脉),当归既能活血以祛风,又能生血以补虚,所以我治疗这类病症,常重用当归一两,少加一些散风的药物来佐助,就能随手见效。
【附案】一位少妇,身体瘦弱,月经一次比一次少,逐渐减少到只来一点点,询问治疗方法。当时我刚学医,不敢开方,让她每天单用当归八钱煮汁饮用,到了经期,流出的经血就恢复正常了,由此可知当归生血的疗效。
一个人四十多岁,得了尿血证,自己用当归一两酒煮饮用后痊愈。后来病情反复,再用原方无效,请求我为他请医生,我让他单用去皮鸦胆子五十粒,冰糖化水送服而愈。后来病情又反复,再服鸦胆子方两次无效,仍用酒煮当归饮用而痊愈。人还是那个人,病还是那个病,以前治愈的方子,后来用有效也有无效的,可能是因为血证前后寒热性质不同吧,但仅由此也可知当归能止下血了。
Xuan Shen (Scrophulariae Radix): Black in color, sweet with a slight bitter taste, cool in nature and rich in fluid. It is originally a herb that clears and tonifies the Kidney Meridian. Its center is hollow and white in color (this is its natural color; pharmacies often dye it with black soybean peel water, obscuring the whiteness), thus it can also enter the Lung to clear dryness-heat in the Lung, detoxify and reduce fire, making it most suitable for lung tuberculosis and cough due to lung heat. The *Shennong Bencao Jing* states it treats residual diseases after childbirth. This is because its nature is cool but not cold, it excels at nourishing yin, and possesses tonifying properties (any herb named "Shen" contains tonifying qualities). Therefore, it is most appropriate for postpartum blood deficiency generating heat, as well as various postpartum conditions involving cold or warm pathogens, where heat has entered the Yangming stage. Throughout my career, in treating severe cases of postpartum exogenous excess heat, I use Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction) replacing Zhimu (Anemarrhenae Rhizoma) with Xuan Shen; for mild cases, I use my own formulated Ziyin Qingwei Tang (Nourish Yin Clear Stomach Decoction), which can also achieve cure. Indeed, while cooling herbs are contraindicated postpartum, if exogenous excess heat exists, cooling herbs must be used to clear heat. Only Shigao (Gypsum Fibrosum) and Xuan Shen are explicitly recorded in the *Shennong Bencao Jing* to treat postpartum conditions, so I dare to use them boldly. However, when using Shigao, one must add Renshen (Ginseng Radix et Rhizoma) to support it, and dare not combine it with Zhimu. In Ziyin Qingwei Tang, where Xuan Shen is heavily used, it must be assisted by Danggui (Angelicae Sinensis Radix) and Shaoyao (Paeoniae Radix Alba) from Siwu Tang (Four Substances Decoction). This is what is meant by combining caution with boldness without contradiction. The *Shennong Bencao Jing* further states that Xuan Shen can brighten the eyes. This is indeed because the Liver opens into the eyes, and Xuan Shen can benefit Kidney Water to nourish Liver Wood, thereby brightening the eyes. Moreover, vision depends on sufficient "Shen Shui" (Spirit Water) in the pupil; Shen Shui is essentially the essence of the Kidney manifesting externally. Combining Xuan Shen with Baishi (Platycladi Semen) and Gouqi (Lycii Fructus) to treat blurred vision caused by heat generated from Liver-Kidney deficiency often yields rapid effects. Additionally, when high fever from exogenous pathogens has subsided, but the patient suffers from true yin depletion, dry tongue without saliva, consumption of stomach fluids, bitter taste in the mouth, and loss of appetite, I frequently use Xuan Shen (30g), adding Ludangshen (Codonopsis Radix) 6-9g, taken continuously for several doses until self-healing occurs.
Dang Gui: Sweet with a slight pungent taste, fragrant odor, thick fluid, warm in nature. It is the primary herb for generating and invigorating blood, and can also disseminate Qi, ensuring that Qi and Blood each return to their proper places, hence the name "Dang Gui" (Returning to the Proper Place). Its power can ascend (due to its dense and warm Qi) and descend (due to its dense and pungent taste); it moistens internal Zang-Fu organs internally (due to its dense and sweet fluid) and reaches the exterior muscle layer (due to its pungent and warm taste). It can moisten the dryness of Lung Metal, so the *Shennong Bencao Jing* states it treats rebellious Qi and upward cough; it can relieve the urgency of Liver Wood, so the Danggui Shaoyao San (Dang Gui and White Peony Powder) in the *Jingui Yaolue* treats various abdominal pains in women; it can tonify Spleen Blood, giving luster to skin and flesh; it generates new blood while resolving stasis, thus treating generalized numbness, limb pain, and painful swelling of sores; it invigorates blood while stopping bleeding, thus treating hematemesis and epistaxis (must be stir-fried with vinegar to utilize its descending property), and bleeding from both bowels and urine (must be stir-fried with wine to utilize its ascending property); it moistens the large intestine while promoting urination. All conditions of blood deficiency, blood exhaustion, and yin deficiency are suitable for its use. However, it is strictly contraindicated in cases of consumptive disease with profuse sweating and loose stools.
Although Dang Gui is warm in nature, it can be used for blood deficiency with heat, because generating blood implies nourishing yin, and nourishing yin implies reducing heat. Although its dispersing power is weak, it is quite good at expelling wind, because wind pathogens attaching to the body often cause blood bi-obstruction; when blood flows freely, the obstruction opens, and wind naturally departs. Regarding women experiencing convulsions postpartum due to wind invasion, heavy use of Dang Gui is particularly suitable. Postpartum convulsions are half due to wind invasion and half due to blood deficiency (blood deficiency failing to nourish sinews). Dang Gui can both invigorate blood to expel wind and generate blood to tonify deficiency. Thus, in treating such conditions, I frequently use a heavy dose of Dang Gui (30g), adding a small amount of wind-expelling herbs as assistants, achieving immediate results.
[Attached Case] A young woman, physically frail, experienced menstruation becoming progressively lighter, eventually reducing to only a scanty flow. She asked for treatment methods. At that time, I had just begun studying medicine and dared not prescribe formulas. I advised her to boil and drink 24g of Dang Gui alone daily. By the next cycle, her menstrual flow returned to normal, demonstrating the blood-generating efficacy of Dang Gui.
A man in his forties suffered from hematuria. He cured himself by drinking decoction made from 30g of Dang Gui boiled in wine. Later, the illness recurred. Using the original formula again was ineffective. He sought medical help. I prescribed him to take fifty peeled Yadanzi (Brucea Fructus) pills delivered with rock sugar dissolved in water, which cured him. Later, the illness recurred again. Taking the Brucea formula twice more was ineffective. He then resumed drinking the wine-boiled Dang Gui decoction and was cured. The person remained the same, the condition remained the same. The formula that cured him previously became effective or ineffective later on. This may be due to differences in cold and heat patterns before and after the blood disorder. Nevertheless, this case also demonstrates that Dang Gui can stop lower jiao bleeding.