治肺痈喘不得卧. 及水饮攻肺喘急者.
葶苈 ( 苦 ) 一两 大枣十枚以水五钟, 先煮枣三钟, 去枣纳葶苈,
煮取一钟半, 顿服, 弱者减服. 戒盐酱.
治饮停上焦, 攻肺喘满不得卧, 面身水肿, 小便不利者.
苦葶苈子 ( 研泥 ) 南苏子 ( 研泥 ) 各等分, 合均, 用枣肉为小
丸,阴干, 磁罐盛之, 恐渗去油性, 减去药力. 每服三钱, 于夜三更
时白汤下, 以痢四, 五次为度, 痢多则减服之, 痢少则加服之. 次日
身软, 则隔一日, 或隔二日服之. 形气弱者, 先减半服之, 俟可渐加
.戒盐酱, 服之即奏奇功, 如不严戒一切咸物, 即对证用药, 万无一
生.
又名净腑丸
治水肿水胀, 形气俱实.
黑牵牛 ( 炒 ) 四两 大黄 ( 酒浸 ) 二两 甘遂 ( 面裹煨 ) 一两
大戟 ( 面裹煨 ) 一两 芫花 ( 醋炒 ) 一两 青皮 ( 炒 ) 一两
橘红一两 木香五钱 槟榔五钱 轻粉一钱, 右为末, 水丸, 每服
五分, 五更白滚水下, 大便痢三次为度. 若一二次不通痢, 次日仍服
.或六分七分 , 渐加至一钱, 若服后大便痢四, 五次, 或形气不支,
则减其服, 三分二分俱可或隔一, 二, 三日服一次, 以愈为度. 甚者
忌盐酱百日.
【注】葶苈大枣汤, 苏葶定喘丸, 舟车神佑丸, 三方皆治肿胀之剂.
然葶苈大枣汤, 治水停胸中, 肺满喘急不得卧, 皮肤浮肿, 中满不急
者,故独用葶苈之苦, 先泻肺中之水气, 佐大枣恐苦甚伤胃也. 苏葶
定喘丸, 即前方加苏子以降气, 气降则水降, 气降则输水之上源, 水
降则开水之下流也. 舟车神佑丸, 治水停诸里, 上攻喘咳难卧, 下蓄
小便不利, 外薄作肿, 中停胀急者, 故备举甘遂, 大戟, 芫花, 牵牛
,大黄, 直攻水之巢穴 , 使从大, 小二便而出, 佐青皮, 陈皮, 木
香以行气, 便气行则水行 , 肿胀两消, 其尤峻厉之处, 又在稍加轻
粉,使诸攻水行气之药, 迅烈莫当, 无微不入, 无穷不达. 用之若当
,功效神奇, 百发百中. 然非形实或邪盛者, 不可轻试, 苟徒利其有
却病之能, 消而旋肿, 用者慎之!
治疗肺痈(肺部化脓性病变)导致喘息严重、无法平卧,以及水饮邪气攻冲肺部引起呼吸急促的患者。
葶苈子(味苦)一两,大枣十枚。用水五升,先煮大枣至剩余三升,去掉枣肉,加入葶苈子,再煮取药液一升半,一次性服用,体质虚弱者减少剂量。忌食盐和酱类。
治疗饮邪停滞在上焦,攻冲肺部导致喘息胸闷、无法平卧,面部及全身水肿,小便不通利的患者。
苦葶苈子(研成泥状),紫苏子(研成泥状),各等分,混合均匀,用枣肉制成小丸,在阴凉处干燥,用磁罐盛装,以防油脂渗出导致药效降低。每次服用三钱,于夜间三更时分用白开水送服,以腹泻四到五次为限度,腹泻次数多则减少剂量,腹泻少则增加剂量。次日身体感到松软无力,则隔一日或隔两日服用一次。形体气息虚弱者,先减半服用,待适应后再逐渐增加剂量。忌食盐和酱类,服用此方即能奏奇效,如果不严格戒除所有咸味食物,即使对症用药,也万无一失(指无法治愈或危及生命)。
又名净腑丸。
治疗水肿、水胀,形体与正气均充实有力的患者。
黑牵牛子(炒制)四两,大黄(酒浸)二两,甘遂(面粉包裹煨制)一两,京大戟(面粉包裹煨制)一两,芫花(醋炒)一两,青皮(炒制)一两,橘红一两,木香五钱,槟榔五钱,轻粉一钱。以上药物共研为细末,用水泛丸,每次服用五分,于五更时分用滚开的水送服,以大便腹泻三次为限度。如果一两次后大便仍未通利腹泻,次日继续服用。或者从六分、七分开始,逐渐增加至一钱。如果服药后大便腹泻四到五次,或者出现形体气息不支的情况,则减少剂量,三分、二分均可,或者隔一、二、三日服用一次,以痊愈为限度。病情严重者,忌食盐酱一百天。
【注】葶苈大枣汤、苏葶定喘丸、舟车神佑丸,这三个方剂都是治疗肿胀的药剂。
然而,葶苈大枣汤,用于治疗水饮停聚胸中,肺部胀满喘息急促无法平卧,皮肤浮肿,腹部胀满但不紧急的情况,所以单独使用葶苈子的苦寒之性,首先泻除肺中的水气,佐以大枣是担心苦寒太过损伤胃气。
苏葶定喘丸,即在前方基础上加入紫苏子以降气,气降则水降,气降则疏通水之上源(肺),水降则开启水之下流(肾/膀胱)。
舟车神佑丸,用于治疗水饮停聚体内各处,向上攻冲导致喘息咳嗽难以平卧,向下蓄积导致小便不利,向外侵迫导致浮肿,向内停滞导致胀满急迫的情况,所以列举甘遂、京大戟、芫花、黑牵牛子、大黄,直接攻击水邪的老巢,使水邪从大便和小便排出,佐以青皮、陈皮、木香来行气,使得气行则水行,肿胀同时消除。其尤为峻猛厉害之处,又在于稍加轻粉,使得各种攻逐水饮、行气的药物,迅猛猛烈,无孔不入,无处不达。如果使用得当,功效神奇,百发百中。但是,如果不是形体实证或邪气盛实的患者,不可轻易尝试,如果只贪图它祛病的能力,导致消而复肿,使用者务必谨慎!
Treats lung abscess (a purulent lesion of the lung) causing severe wheezing and inability to lie flat, as well as cases where fluid retention attacks the lungs leading to acute dyspnea.
Tingli (Descurainiae Semen seu Lepidii Semen, bitter in flavor) 1 liang, Dazao (Jujubae Fructus) 10 pieces. Use 5 sheng of water, first decoct the jujubes until 3 sheng remain, remove the jujube flesh, add Tingli, and decoct again to obtain 1.5 sheng of liquid. Take in one dose; reduce the dosage for patients with weak constitution. Avoid salt and soy sauce.
Treats cases where fluid retention stagnates in the upper jiao, attacking the lungs causing wheezing, chest fullness, inability to lie flat, facial and generalized edema, and difficulty in urination.
Kutingli Zi (Descurainiae Semen seu Lepidii Semen, ground into paste), Nan Su Zi (Perillae Fructus, ground into paste), each in equal parts. Mix uniformly, use jujube flesh to form small pills, dry them in the shade, and store them in porcelain jars to prevent oil seepage which would reduce medicinal efficacy. Take 3 qian each time, administered at the third watch of the night with plain warm water. The course is defined by 4 to 5 episodes of diarrhea; if diarrhea is excessive, reduce the dose; if insufficient, increase the dose. If the patient feels physically relaxed the next day, administer every other day or every two days. For those with weak form and qi, start with half the dose and gradually increase as tolerated. Avoid salt and soy sauce. This prescription yields miraculous results if taken correctly. However, if all salty foods are not strictly avoided, even if the medication is symptomatic, there will be no hope for survival (i.e., it will fail or be fatal).
Also known as Jingfu Wan.
Treats edema and abdominal distension due to water accumulation, in patients with both robust physical form and strong qi.
Heiqianniu Zi (Pharbitidis Semen, stir-fried) 4 liang, Dahuang (Rhei Radix et Rhizoma, soaked in wine) 2 liang, Gansui (Radix Kansui, baked in flour wrapper) 1 liang, Daji (Radix Euphorbiae Pekinensis, baked in flour wrapper) 1 liang, Yuanhua (Flos Genkwa, stir-fried in vinegar) 1 liang, Qingpi (Citrini Exocarpium, stir-fried) 1 liang, Juhong (Exocarpium Citri Reticulatae Rubrum) 1 liang, Muxiang (Radix Aucklandiae) 5 qian, Binglang (Arecae Semen) 5 qian, Qingfen (Calomelas) 1 qian. Grind the above herbs into fine powder, make water pills. Take 5 fen each time, administered at the fifth watch with boiling water. The course is defined by three episodes of loose stools. If there is no bowel movement or diarrhea after one or two doses, continue taking it the next day. Alternatively, start with 6 or 7 fen and gradually increase to 1 qian. If four to five episodes of diarrhea occur after administration, or if the patient shows signs of exhaustion, reduce the dose to 3 fen or 2 fen, or take once every one to three days, continuing until cured. Patients with severe conditions must avoid salt and soy sauce for 100 days.
[Note] Tingli Dazao Tang, Suting Dingchuan Wan, and Zhouche Shenyu Wan are all formulas used to treat swelling and distension.
However, Tingli Dazao Tang treats water retention in the chest, lung fullness with wheezing and inability to lie flat, skin edema, and abdominal fullness without urgency. Therefore, it uses only the bitter nature of Tingli to first drain the water qi from the lungs, assisted by Dazao to prevent the bitterness from damaging the stomach qi.
Suting Dingchuan Wan adds Perillae Fructus to the previous formula to direct qi downward. When qi descends, water descends; when qi descends, the upper source of water (lung) is unblocked; when water descends, the lower outlet of water (bladder/kidney) is opened.
Zhouche Shenyu Wan treats water retention throughout the interior, attacking upward to cause wheezing, coughing, and inability to lie flat; accumulating downward to cause difficulty in urination; pressing outward to cause swelling; and stagnating inward to cause urgent distension. Therefore, it employs Gansui, Daji, Yuanhua, Heiqianniu Zi, and Dahuang to directly attack the nest of water pathogenic factors, expelling them through the large and small intestines. It assists with Qingpi, Chenpi, and Muxiang to promote qi circulation, ensuring that "when qi moves, water moves," thereby resolving both swelling and distension. Its particularly harsh and potent aspect lies in the addition of Calomelas, making all the water-draining and qi-moving medicines swift, fierce, penetrating everywhere, and reaching without limit. If used appropriately, its efficacy is miraculous, hitting the mark every time. However, it should not be lightly tried on patients who do not have a robust physical form or excess pathogenic factors. If one only seeks its disease-curing ability without caution, leading to swelling returning after subsiding, users must be extremely careful!