[总诀]肿胀原由说的端,总因水气窜皮间。无分表里和虚实,泄水扶脾病自安。
先首肿起,以下及于手足者,伤于外之湿也。宜加味五皮汤。
陈皮(二钱) 苓皮(二钱) 腹皮(二钱) 姜皮(二钱) 桑皮(二钱) 麻黄(七分) 桂
尖(二钱) 杏仁(三钱) 甘草(一钱) 大枣(二枚)
歌曰∶头肿徐徐及四肢,姜桑苓腹共陈皮。
杏仁甘草同红枣,再入麻黄及桂枝。
先脚肿起,以上及于腹股者,内之水不行也。宜原方真武汤。
白术(三钱) 白芍(三钱) 云苓(三钱) 生姜(二钱) 附子(二钱)
歌曰∶水不流行脚肿先,渐看腹股肿相连。
云苓术芍同姜附,真武原方急与煎。
(伯未按∶可兼饮冬瓜汁。)
肿胀溺赤,或兼口渴脉数者,阳郁而水壅也。宜加味五皮饮。
桑皮(三钱) 茯苓(二钱) 腹皮(二钱) 白芍(二钱) 知母(三钱) 青木香(一钱) 防
己(一钱) 滑石(三钱) 黄芩(三钱) 当归(一钱) 车前(三钱) 杏仁(三钱)
歌曰∶口干肿胀溺兼红,青木香和芩芍通。
桑腹知苓防己共,归前滑石杏仁同。
肿胀溺清,其口不渴脉沉者,阴结而水停也。宜原方真武汤。
白术(三钱) 附片(三钱) 白芍(三钱) 云苓(三钱) 生姜(三钱)
歌曰∶溺清肿胀脉兼沉,真武原方术附寻。
白芍云苓姜作引,水停阴结煮汤斟。
单腹肿大,其人四肢瘦削者,脾虚而血结也。宜加味逍遥散。
白术(三钱) 云苓(三钱) 薄荷(一钱) 煨姜(二钱) 柴胡(一钱) 蚯蚓(一钱) 香附(三
钱) 灵脂(三钱) 乳香(一钱) 腹皮(二钱) 防己(一钱) 苏梗(一钱) 当归(三钱) 白芍(
三钱)
歌曰∶胀膨多缘血结成,术苓香附许回生。
乳防苏腹荷同蚓,灵脂柴归姜芍行。
【总诀】肿胀的起因有明确的道理,总归是因为水气窜入皮肤之间。不分表证里证和虚证实证,通过泄除水湿、扶助脾土,疾病自然痊愈。
首先从头部开始肿胀,向下蔓延至手足的,是受了外来的湿气侵袭。适宜使用加味五皮汤。
陈皮(二钱) 苓皮(二钱) 大腹皮(二钱) 姜皮(二钱) 桑白皮(二钱) 麻黄(七分) 桂尖(二钱) 杏仁(三钱) 甘草(一钱) 大枣(两枚)
歌诀说:头部肿胀缓慢波及四肢,生姜皮、桑白皮、茯苓皮、大腹皮与陈皮共同使用。
杏仁、甘草同红枣一起,再加入麻黄及桂枝。
首先从脚部开始肿胀,向上蔓延至腹部的,是内部的水液运行不畅。适宜使用原方真武汤。
白术(三钱) 白芍(三钱) 云茯苓(三钱) 生姜(二钱) 附子(二钱)
歌诀说:水液不流通导致脚先肿,逐渐看到腹部和大腿根部肿胀相连。
云茯苓、白术、白芍同生姜、附子,真武汤的原方急需煎煮服用。
(伯安按语:可以同时饮用冬瓜汁。)
肿胀伴有小便赤红,或者兼有口渴、脉象数的,是阳气郁结而水湿壅滞。适宜使用加味五皮饮。
桑白皮(三钱) 茯苓(二钱) 大腹皮(二钱) 白芍(二钱) 知母(三钱) 青木香(一钱) 防己(一钱) 滑石(三钱) 黄芩(三钱) 当归(一钱) 车前子(三钱) 杏仁(三钱)
歌诀说:口干、肿胀且小便兼见红色,青木香配合黄芩和白芍以通利。
桑白皮、大腹皮、知母、茯苓、防己共同使用,当归、车前子、滑石、杏仁一同加入。
肿胀伴有小便清长,口不渴、脉象沉的,是阴寒凝结而水液停聚。适宜使用原方真武汤。
白术(三钱) 附片(三钱) 白芍(三钱) 云茯苓(三钱) 生姜(三钱)
歌诀说:小便清长、肿胀且脉象兼见沉象,寻找真武汤原方中的白术和附子。
白芍、云茯苓、生姜作为引经药,水液停聚因阴寒凝结,需煮汤斟酌服用。
仅腹部肿大,其人四肢瘦削的,是脾虚而血瘀凝结。适宜使用加味逍遥散。
白术(三钱) 云茯苓(三钱) 薄荷(一钱) 煨姜(二钱) 柴胡(一钱) 蚯蚓(一钱) 香附(三钱) 灵脂(三钱) 乳香(一钱) 大腹皮(二钱) 防己(一钱) 苏梗(一钱) 当归(三钱) 白芍(三钱)
歌诀说:胀满膨隆多因血瘀凝结而成,白术、茯苓、香附、附子许可起死回生。
乳香、防己、苏梗、大腹皮同蚯蚓,灵脂、柴胡、当归、生姜、白芍行气活血。
[General Principle] The origin of swelling and distension has a clear explanation; it is generally due to water-qi (water-dampness energy) invading the interstitial spaces of the skin. Regardless of exterior or interior patterns, or deficiency or excess conditions, draining the water and supporting the Spleen will naturally bring about recovery.
If swelling begins first in the head and spreads downwards to the hands and feet, it is caused by external dampness invasion. Jia Wei Wu Pi Tang (Modified Five Peel Decoction) is appropriate.
Chenpi (Citri Reticulatae Pericarpium, 2 qian), Lingpi (Poriae Cutis, 2 qian), Fupi (Tugong's Citrullus Vulgaris Fruit Peel, 2 qian), Jiangpi (Zingiberis Recensis Pericarpium, 2 qian), Sangpi (Mori Cortex, 2 qian), Mahuang (Ephedrae Herba, 7 fen), Guizhi (Cinnamomi Ramulus, specifically the tip, 2 qian), Xingren (Armeniacae Semen Amarum, 3 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian), Dazao (Jujubae Fructus, 2 pieces).
The verse states: Swelling starts slowly from the head and reaches the four limbs; Ginger peel, Mulberry bark, Poria peel, Tangerine peel are used together.
Apricot kernel, Licorice root, and red dates are combined, followed by Ephedra stem and Cinnamon twig.
If swelling begins first in the feet and spreads upwards to the abdomen and groin, it is due to the failure of internal water metabolism. Zhen Wu Tang (True Warrior Decoction) in its original formula is appropriate.
Baizhu (Atractylodis Macrocephalae Rhizoma, 3 qian), Baishao (Paeoniae Radix Alba, 3 qian), Yunling (Poria, 3 qian), Shengjiang (Zingiberis Rhizoma Recens, 2 qian), Fuzi (Aconiti Lateralis Radix Praeparata, 2 qian).
The verse states: When water fails to circulate, foot swelling appears first; gradually, abdominal and inguinal swelling connects.
Poria, Atractylodes macrocephala, White Peony root, along with Ginger and Prepared Aconite root; the original Zhen Wu Tang should be decocted urgently.
(Note by Bo'an: Drinking winter melon juice can be taken concurrently.)
If swelling is accompanied by dark/red urine, or thirst and a rapid pulse, it indicates Yang constraint with water accumulation. Jia Wei Wu Pi Yin (Modified Five Peel Drink) is appropriate.
Sangpi (Mori Cortex, 3 qian), Fuling (Poria, 2 qian), Fupi (Tugong's Citrullus Vulgaris Fruit Peel, 2 qian), Baishao (Paeoniae Radix Alba, 2 qian), Zhimu (Anemarrhenae Rhizoma, 3 qian), Qingmuxiang (Illicii Armati Radix, 1 qian), Fangji (Stephaniae Tetrandrae Radix, 1 qian), Huashi (Talcum, 3 qian), Huangqin (Scutellariae Radix, 3 qian), Danggui (Angelicae Sinensis Radix, 1 qian), Cheqian (Plantaginis Semen, 3 qian), Xingren (Armeniacae Semen Amarum, 3 qian).
The verse states: Dry mouth, swelling, and red urine; Illicium armati radix harmonizes with Scutellaria root and White Peony root to promote flow.
Mulberry bark, Tangerine peel, Anemarrhena rhizome, Poria, Stephania tetrandra root are combined; Angelica sinensis root, Plantago seed, Talcum, and Apricot kernel are added together.
If swelling is accompanied by clear urine, no thirst, and a deep pulse, it indicates Yin binding with water retention. Zhen Wu Tang (True Warrior Decoction) in its original formula is appropriate.
Baizhu (Atractylodis Macrocephalae Rhizoma, 3 qian), Fupian (Prepared Aconite Root Slice, 3 qian), Baishao (Paeoniae Radix Alba, 3 qian), Yunling (Poria, 3 qian), Shengjiang (Zingiberis Rhizoma Recens, 3 qian).
The verse states: Clear urine, swelling, and a deep pulse; seek the original Zhen Wu Tang for Atractylodes macrocephala and Aconite.
White Peony root, Poria, and Ginger serve as guides; for water retention due to Yin binding, decoct the soup carefully.
Abdominal distension alone with emaciated limbs indicates Spleen deficiency with blood stasis. Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) is appropriate.
Baizhu (Atractylodis Macrocephalae Rhizoma, 3 qian), Yunling (Poria, 3 qian), Bohe (Menthae Haplocalycis Herba, 1 qian), Weijiang (Roasted Ginger, 2 qian), Chaihu (Bupleuri Radix, 1 qian), Qiuyin (Lumbricus, 1 qian), Xiangfu (Cyperi Rhizoma, 3 qian), Lingzhi (Datiscae Rhizoma, 3 qian), Ruxiang (Olibanum, 1 qian), Fupi (Tugong's Citrullus Vulgaris Fruit Peel, 2 qian), Fangji (Stephaniae Tetrandrae Radix, 1 qian), Sugeng (Perillae Caulis, 1 qian), Danggui (Angelicae Sinensis Radix, 3 qian), Baishao (Paeoniae Radix Alba, 3 qian).
The verse states: Distension and bloating often arise from blood stasis formation; Atractylodes macrocephala, Poria, Cyperi rhizome, and Aconite may restore life.
Olibanum, Stephania tetrandra root, Perilla stem, Tangerine peel, and Lumbricus are combined; Datiscae rhizome, Bupleurum root, Angelica sinensis root, Ginger, and White Peony root promote circulation.