治一切湿痰食火, 气血诸郁.
香附 苍术 抚芎 神麴 山栀仁水煎服, 或作丸.
【注】夫人以气为本, 气和则上下不失其度, 运行不停其机, 病从何
生?若饮食不节, 寒温不适, 喜怒无常, 忧思无度, 使冲和之气升降
失常, 以致胃郁不思饮食, 脾郁不消水谷, 气郁胸腹胀满, 血郁胸膈
刺痛, 湿郁痰饮, 火郁为热, 及呕吐恶心, 吞酸吐酸, 嘈杂嗳气, 百
病丛生. 故用香附以开气郁. 苍术以除湿郁. 抚芎以行血郁. 山栀以
清火郁. 神麴以消食郁. 此朱震亨因五郁之法, 而变通者也. 五药相
须, 共收五郁之效. 然当问何郁病甚, 盒饭以何药为主? 至若气虚
加人参, 气痛加木香, 郁甚加郁金, 懒食加榖蘖, 胀加厚朴, 痞加枳
实,呕痰加姜, 夏火盛加萸, 连, 则又存乎临证者之详审也.
治七情感伤, 上气喘急, 胸膈不快, 妨闷不食.
人参 槟榔 沉香 天台乌药, 右四味, 各浓磨水取七分, 煎三五沸
,放温 , 空心服.
【集注】王又原曰: 经云: 圣人啬气如持至宝, 庸人役物而反伤太和
.此七情随所感皆能为病. 然壮者气行而愈, 弱者气着为病. 愚者不
察,一遇上气喘急, 满闷不食, 谓是实者宜泻, 辄投破耗等药, 得药
非不暂快, 初投之而应, 投之久而不应矣. 夫呼出为阳, 吸入为阴,
肺阳清肃, 则气下行; 肾阴宁谧, 则气归摄, 不复散而上逆矣. 若正
气既衰, 即欲削坚破滞, 则邪气难伏, 法当用人参先补正气, 沉香纳
之于肾, 而后以槟榔, 乌药从而导之, 所谓实必顾虚, 泻必先补也.
四品气味俱厚, 磨则取其气味俱足, 煎则取其气味纯和, 气味齐到,
效如桴鼓矣.
治疗各种湿痰、食积化火以及气、血等诸种郁滞证候。
香附、苍术、抚芎(川芎)、神曲、山栀仁,用水煎服,或者制成丸剂服用。
【注释】人是以气为根本的,气机调和则上下运行不失其常度,气血运行不停止其机能,疾病从何而生呢?如果饮食不节制,寒温不适宜,喜怒无常,忧思无限度,导致冲和之气升降失常,以致胃气郁滞不思饮食,脾气郁滞不能消化水谷,气机郁滞胸腹胀满,血行郁滞胸膈刺痛,湿气郁滞形成痰饮,火邪郁滞化为热,以及呕吐恶心,吞酸吐酸,嘈杂嗳气,百病丛生。所以用香开来解气郁,苍术来除湿郁,抚芎来行血郁,山栀来清火郁,神曲来消食郁。这是朱震亨依据五郁的方法而变通出来的方子。这五种药物相互协同,共同收得解除五郁的效果。然而应当询问是哪一种郁滞病情严重,就应当以哪种药物为主药?至于如果气虚加用人参,气痛加上木香,郁滞严重加上郁金,懒于进食加上谷芽麦芽,胀满加厚朴,痞满加枳实,呕吐痰多加生姜、半夏,火盛加上吴茱萸、黄连,这就又取决于临证医生的详细审察了。
治疗七情内伤引起的上气喘急,胸膈不快,烦闷不想吃东西。
人参、槟榔、沉香、天台乌药,以上四味药,分别浓磨取汁七分,煎煮三五沸,放温后,空腹服用。
【集注】王又原说:经书云:圣人爱惜气如同持守至宝,庸人役使外物反而损伤太和之气。这七情随所感都能成为致病因素。然而身体强壮的人气行通畅而自愈,身体虚弱的人气机阻滞而发病。愚昧的人不加考察,一遇到上气喘急、满闷不想吃东西,就认为是实证适宜泻下,往往投用破耗正气的药物,得到药物后并非不暂时痛快,初用时有效,久用后就不见效了。呼出为阳,吸入为阴,肺阳清肃,则气下行;肾阴宁静谧定,则气归摄纳,不再散乱而上逆。如果正气已经衰弱,即使想要削坚破滞,那么邪气难以平伏,治法应当用人参先补益正气,沉香纳气归于肾,然后用槟榔、乌药从而引导之,这就是所谓的实证必须顾护虚证,泻下之前必须先补益。这四味药气味都浓厚,磨制是为了取其气味充足,煎煮是为了取其气味纯和,气味齐到,疗效如击鼓应声般迅速。
Treats all types of damp-phlegm, food stagnation transforming into fire, and various depressions of Qi and Blood.
Xiangfu (Cyperi Rhizoma), Cangzhu (Atractylodis Rhizoma), Fuxiong (Chuanxiong Rhizoma), Shenqu (Massa Medicata Fermentata), Shanzhiren (Gardeniae Semen), decocted in water and taken orally, or made into pills.
[Annotation] Human beings are based on Qi; when Qi is harmonious, the ascending and descending functions do not lose their proper measure, and circulation does not cease its mechanism, so how can diseases arise? If diet is irregular, cold and heat are inappropriate, emotions of joy and anger are uncontrolled, and worry and thought are excessive, causing the harmonious Qi to ascend and descend abnormally, leading to Stomach Qi depression with loss of appetite, Spleen Qi depression with inability to digest food and water, Qi depression with chest and abdominal fullness, Blood depression with stabbing pain in the chest and diaphragm, Dampness depression with phlegm-fluid retention, Fire depression manifesting as heat, as well as vomiting, nausea, acid regurgitation, epigastric discomfort, and belching, resulting in the emergence of myriad diseases. Therefore, Xiangfu (Cyperi Rhizoma) is used to open Qi depression; Cangzhu (Atractylodis Rhizoma) to remove Dampness depression; Fuxiong (Chuanxiong Rhizoma) to promote Blood depression; Shanzhi (Gardeniae Fructus) to clear Fire depression; and Shenqu (Massa Medicata Fermentata) to resolve Food depression. This is a modification by Zhu Zhenheng based on the method of treating the Five Depressions. These five herbs work synergistically to achieve the effect of resolving the Five Depressions. However, one must inquire which type of depression is most severe and make that corresponding herb the principal agent. Furthermore, if there is Qi deficiency, add Renshen (Ginseng Radix et Rhizoma); if there is Qi pain, add Muxiang (Aucklandiae Radix); if depression is severe, add Yujin (Curcumae Radix); if there is reluctance to eat, add Guniang (Hordei Fructus Germinatus); if there is distension, add Houpo (Magnoliae Officinalis Cortex); if there is stuffiness, add Zhishi (Aurantii Fructus Immaturus); if there is vomiting with phlegm, add Jiang (Zingiberis Rhizoma Recens) and Xia (Pinelliae Tuber); if Fire is excessive, add Yuzhu (Evodiae Fructus) and Lian (Coptidis Rhizoma). This depends entirely on the careful examination by the clinician.
Treats upper asthma and rapid breathing, chest and diaphragmatic discomfort, and stifling sensation with anorexia caused by emotional injury (Seven Emotions).
Renshen (Ginseng Radix et Rhizoma), Binglang (Arecae Semen), Chenxiang (Aquilaria Lignum Resinatum), Tiantai Wuyao (Linderae Radix). The above four ingredients are each ground thickly to extract juice (7 fen), boiled for three to five boils, allowed to cool to warm temperature, and taken on an empty stomach.
[Collected Annotations] Wang Youyuan stated: The Classics say: "The sage cherishes Qi as if holding a supreme treasure, while the mediocre person enslaves himself to material things and thereby damages the Great Harmony." These Seven Emotions, depending on what triggers them, can all become pathogenic factors. However, those who are robust recover as Qi circulates freely, while those who are weak develop disease due to Qi stagnation. The ignorant fail to observe this; upon encountering upper asthma, rapid breathing, fullness, stifling sensation, and anorexia, they assume it is an Excess pattern suitable for purgation, and thus administer drugs that break and deplete. Although these drugs may provide temporary relief and respond initially, they cease to be effective after prolonged use. Exhalation is Yang, inhalation is Yin; when Lung Yang is clear and肃 (descending), Qi moves downward; when Kidney Yin is tranquil and still, Qi is grasped and retained, preventing it from scattering and reversing upward. If Righteous Qi has already declined, even if one attempts to break hardness and stagnation, Pathogenic Qi will be difficult to subdue. The method should be to first use Renshen (Ginseng Radix et Rhizoma) to tonify Righteous Qi, then use Chenxiang (Aquilaria Lignum Resinatum) to guide Qi into the Kidney, and subsequently use Binglang (Arecae Semen) and Wuyao (Linderae Radix) to guide it further. This is what is meant by "when treating Excess, one must consider Deficiency," and "before purging, one must first tonify." These four substances have strong flavors and properties; grinding preserves their full aromatic potency, while boiling ensures their properties are mild and harmonious. When flavor and property arrive together, the efficacy is as immediate as a drumbeat.