熟地黄(八两) 山茱萸肉 山药(各四两) 白茯苓 牡丹皮 泽泻(各三两) 肉
桂(炮)
附子(炮,去皮脐,各一两)
渴而未消者,此方主之。
此即前方六味地黄丸加附子、肉桂也。渴而未消,谓其人多渴,喜得茶饮,不若消渴之
求饮无厌也。此为心肾不交,水不足以济火,故令亡液口干。乃是阴无阳而不升,阳无阴而
不降,水下火上,不相既济耳。故用肉桂、附子之辛热壮其少火,用六味地黄丸益其真阴。
真阴益则阳可降。少火壮则阴自生。故灶底加薪,枯笼蒸溽,槁禾得雨,生意维新,惟明者
知之,昧者鲜不以为迂也。昔汉武帝病渴,张仲景为处此方,至圣玄关,今犹可想。
取朽木方寸者三十枚,煎汤饮之。得水土中者良。
此消渴之良方也。
经曰∶热中、消中富贵人。盖以消渴之病,责之肥甘炮炙、嗜酒耽辛之所致也,非富贵
人何以得之?朽木年深而质腐,腐者水之气,水足以制火,故腐足以胜焦。热中、消中皆焦
证也,故此物主之。
伤酒消渴,宜主葛花,以其善解酒毒故耳。或用葛根,其功不相上下也。
熟地黄(八两) 山茱萸肉 山药(各四两) 白茯苓 牡丹皮 泽泻(各三两) 肉桂(炮制) 附子(炮制,去皮和脐,各一两)
口渴但尚未发展为严重消渴症状的,此方主治。
这就是前方六味地黄丸(Liuwei Dihuang Wan, Six-Ingredient Rehmannia Pill)加上附子和肉桂。所谓“渴而未消”,是指病人多感口渴,喜欢喝茶饮水,但不像消渴病那样饮水无度、仍觉不足。这是因为心肾不交(Heart and Kidney Non-interaction),肾水不足以制约心火,导致津液亏损、口干舌燥。这是由于阴气没有阳气的推动就不能上升,阳气没有阴气的依附就不能下降,导致水在下而火在上,两者不能相互既济(Mutual interaction of Water and Fire)。因此使用肉桂、附子的辛热之性来壮旺少火(Shao Huo, Mild Fire/Physiological Fire),使用六味地黄丸来补益真阴(Zhen Yin, True Yin/Essential Yin)。真阴得到补益则阳气可以下降;少火得到壮旺则阴液自然滋生。这就好比在灶底添加柴薪,枯笼中便会充满蒸汽,干枯的禾苗得到雨水,生机得以更新。只有明智的人才能理解其中道理,愚昧的人很少不认为这是迂腐之谈。从前汉武帝患渴病,张仲景为他开具此方,这真是圣人的关键法门,如今犹可想象。
取腐朽木头一方寸大小者三十枚,煎汤饮用。生长在水土环境中的朽木品质较好。
这是治疗消渴(Xiao Ke, Wasting-Thirst Syndrome)的良好方剂。
《内经》说:“热中(Re Zhong, Heat in the Middle)、消中(Xiao Zhong, Wasting in the Middle)多见于富贵之人。”大概因为消渴病,归咎于食用肥甘厚味、油炸烧烤食物以及嗜酒贪吃辛辣所致,如果不是富贵之人,怎么会得这种病呢?朽木年代久远而质地腐烂,腐烂体现了水的特性,水足以制约火,所以腐烂的性质足以战胜焦枯。热中和消中都属于焦枯证候,所以用朽木来主治。
因饮酒过度导致的消渴,适宜主要使用葛花(Puerariae Flos),因为它善于解除酒毒的缘故。或者使用葛根(Puerariae Radix),其功效不相上下。
喜欢吃肥甘厚味及焦炙食物,从而引起消渴的,适宜使用豆豉(Fermented Soybean Paste)。因为豆豉是由大豆发酵制成,味道苦且气味腐熟,苦味能胜热,腐性能胜焦的缘故。
Prepared Rehmanniae Radix (8 liang), Fructus Corni, Rhizoma Dioscoreae (each 4 liang), Poria, Cortex Moutan, Rhizoma Alismatis (each 3 liang), Cinnamomi Ramulus (processed), Aconiti Lateralis Radix Praeparata (processed, skin and umbilicus removed, each 1 liang).
For cases of thirst without full-blown wasting-thirst, this formula is indicated.
This is the aforementioned Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) plus Aconiti Lateralis Radix Praeparata and Cinnamomi Ramulus. "Thirst without wasting" refers to a person who feels thirsty and desires tea or water, but unlike wasting-thirst syndrome, does not drink insatiably. This condition arises from Heart-Kidney non-interaction, where Kidney Water fails to control Heart Fire, leading to fluid depletion and dry mouth. It occurs because Yin cannot ascend without Yang's promotion, and Yang cannot descend without Yin's anchoring; thus, Water remains below and Fire above, failing to achieve mutual interaction (Ji Ji). Therefore, the acrid-hot properties of Cinnamomi Ramulus and Aconiti Lateralis Radix Praeparata are used to strengthen Shao Huo (Mild Fire/Physiological Fire), while Liuwei Dihuang Wan is used to nourish Zhen Yin (True Yin). When Zhen Yin is nourished, Yang can descend; when Shao Huo is strengthened, Yin naturally generates. This is akin to adding firewood to the stove base, causing steam to fill a withered cage, or giving rain to withered crops so that vitality is renewed. Only the wise understand this; the ignorant rarely fail to consider it pedantic. In the past, Emperor Wu of Han suffered from thirst, and Zhang Zhongjing prescribed this formula for him. This represents the profound secret of the Sages, which can still be imagined today.
Take thirty pieces of rotten wood, each one square cun in size, decoct in water, and drink the soup. Rotten wood obtained from environments rich in water and soil is superior.
This is an excellent formula for treating Xiao Ke (Wasting-Thirst Syndrome).
The Classics state: "Re Zhong (Heat in the Middle) and Xiao Zhong (Wasting in the Middle) are common among the wealthy." Generally, wasting-thirst disease is attributed to the consumption of rich, sweet, fried, and roasted foods, as well as excessive alcohol and spicy flavors. How else could the wealthy acquire such conditions? Rotten wood, aged and decomposed, embodies the Qi of Water. Water controls Fire, so decomposition overcomes scorching/dryness. Both Re Zhong and Xiao Zhong are scorching syndromes; therefore, this substance treats them.
For wasting-thirst caused by alcohol injury, Ge Hua (Puerariae Flos) should be primarily used because it effectively resolves alcohol toxicity. Alternatively, Ge Gen (Puerariae Radix) may be used, as its efficacy is comparable.
For wasting-thirst induced by a preference for rich, sweet, fried, and roasted foods, Dou Chi (Fermented Soybean Paste) is appropriate. Since Dou Chi is made from fermented soybeans, it has a bitter taste and a decomposed aroma. Bitterness overcomes heat, and decomposition overcomes scorching.
Seeing plum trees or thinking of plums stimulates saliva production; therefore, for sudden severe thirst due to dry stomach, this is suitable. This illustrates the principle that "sour flavor promotes fluid generation."