叙曰∶天地以升生,而万物发陈,故气血以四布,而百体敷荣。一有拂郁,则象天地之
闭藏矣,是岂升生之道乎?此诸病之所以生也。今考名方六首,而郁之情状见矣!
香附(醋炒) 苍术(米泔浸) 抚芎 栀子(炒黑) 神曲(炒,等分)
水丸小豆大,每服百丸。
诸郁者,此方主之。
越鞠者,发越鞠郁之谓也。香附理气郁,苍术开湿郁,抚芎调血郁,栀子治火郁,神曲
疗食郁。此以理气为主,乃不易之品也。若主湿郁,加白芷、茯苓。主热郁,加青黛。主痰
郁,加南星、海石、栝蒌。主血郁,加桃仁、红花。主食郁,加山楂、砂仁。此因病而变通
也。如春加防风,夏加苦参,秋冬加吴茱萸,乃经所谓升降浮沉则顺之,寒热温凉则逆之耳!
《诗》曰∶陟彼阿丘,言采其虻。朱子曰∶虻,贝母也,采之以疗郁结之疾。故疗郁结
者每加之!
烧盐(三两) 温汤(二升)
和服探吐。
木郁,两胁大痛,脉代者,此方主之。
木,肝木也,有垂枝布叶之象,喜条达而恶抑郁。若膈间有停痰宿食,抑其肝气,不得
上达,则肝木自实,两胁大痛。脉来代者痛盛而脉止也。得吐则生,不吐则死,故主盐汤探
吐
羌活 葛根 升麻 芍药 人参(各七分) 柴胡 生甘草(各三分) 防风(五分) 葱
白
(五茎)
火郁者,内热外寒,脉沉而数,此方主之。
火,心火也,禀炎上之体,喜畅而恶郁。郁之则火无焰,故令身寒。脉沉为在里,沉而
数,为里热。是方也,羌活、防风、升麻、柴胡、干葛、葱白,皆辛温升举之药,故足以扬
无焰之火,而令炎炎。若芍药、人参、甘草者,乃所以和营卫于升发之余尔。经曰∶火郁则
发之。此之谓也。
叙曰:天地依靠气的上升而化生万物,使万物推陈出新,因此气血得以向四周布散,全身脏腑肢体得到滋养繁荣。一旦气机受到拂逆郁结,就如同天地间进入了闭藏的状态,这难道还是顺应升发生长的道理吗?这就是各种疾病产生的原因。现在考察六种名方,郁证的种种情状就显现出来了!
香附(醋炒) 苍术(米泔水浸泡) 抚芎(川芎的一种) 栀子(炒黑) 神曲(炒,以上五味药等量)
制成水丸,大小如小豆,每次服用一百丸。
各种郁证,此方为主治方剂。
“越鞠”的意思是发越、解除郁结。香附调理气郁,苍术化解湿郁,抚芎调和血郁,栀子治疗火郁,神曲疗治食郁。这个方子以调理气机为主,是根本不变的法则。如果主治湿郁,加白芷、茯苓。主治热郁,加青黛。主治痰郁,加天南星、海浮石、瓜蒌。主治血郁,加桃仁、红花。主治食郁,加山楂、砂仁。这是根据病情进行变通的方法。如春季加防风,夏季加苦参,秋冬季节加吴茱萸,这正是《内经》所说的升降浮沉要顺应四时之气,寒热温凉要逆其病势的道理!
《诗经》说:登上那高丘,去采集虻草。朱熹解释说:虻,就是贝母,采集它来治疗郁结的疾病。所以治疗郁结病症时常加入此药!
烧盐(三两) 温水(二升)
混合后服用以催吐。
木郁,表现为两胁剧烈疼痛,脉象代(间歇),此方为主治方剂。
木,指肝木,有枝条舒展、叶片分布的意象,喜欢条达舒畅而厌恶抑郁。如果胸膈间有停聚的痰饮和宿食,压抑了肝气,使其不能向上通达,那么肝木就会自身壅实,导致两胁剧烈疼痛。脉象出现代象,是因为痛盛导致脉搏时有中止。通过催吐可以获生,不催吐则致死,所以用盐汤探吐作为主治方法。
羌活 葛根 升麻 芍药 人参(各七分) 柴胡 生甘草(各三分) 防风(五分) 葱白(五茎)
火郁者,表现为内热外寒,脉象沉而数,此方为主治方剂。
火,指心火,禀受炎上之性,喜欢通畅而厌恶郁结。郁结则火无焰,所以使人身体发冷。脉沉表示病在里,沉而数,表示里有热。这个方子中,羌活、防风、升麻、柴胡、干葛、葱白,都是辛温升举的药物,所以足以扬起无焰之火,使其重新旺盛。至于芍药、人参、甘草,是为了在升发之余调和营卫。《内经》说:火郁则发之。说的就是这个意思。
Preface: Heaven and Earth generate all things through the ascending movement of Qi, allowing for the renewal of the old by the new. Thus, Qi and Blood are distributed to the four directions, and the hundred body parts flourish and thrive. If there is any obstruction or depression (Yu), it resembles the closing and storing of Heaven and Earth; how can this be in accordance with the Way of ascending and generating? This is why various diseases arise. Now, examining six famous prescriptions, the manifestations of Yu (depression/stagnation) become clear!
Xiangfu (Cyperi Rhizoma, vinegar-fried), Cangzhu (Atractylodis Rhizoma, soaked in rice wash water), Fuxiong (Ligusticum Chuanxiong Rhizoma), Zhizi (Gardeniae Fructus, charred black), Shenqu (Medicated Leaven, fried), equal parts.
Made into water pills, size of small beans. Take 100 pills per dose.
For various types of Yu (stagnation), this prescription is the primary treatment.
"Yueju" means to disperse and resolve stagnation. Xiangfu regulates Qi stagnation, Cangzhu resolves Dampness stagnation, Fuxiong harmonizes Blood stagnation, Zhizi treats Fire stagnation, and Shenqu cures Food stagnation. This formula focuses on regulating Qi, which is an unchangeable principle. If treating Dampness stagnation, add Baizhi (Angelicae Dahuricae Radix) and Fuling (Poria). If treating Heat stagnation, add Qingdai (Indigo Naturalis). If treating Phlegm stagnation, add Nanting (Arisaematis Rhizoma Preparatum) and Haishi (Fossilia Arctolithus), and Gualou (Trichosanthis Fructus). If treating Blood stagnation, add Taoren (Persicae Semen) and Honghua (Carthami Flos). If treating Food stagnation, add Shanzha (Crataegi Fructus) and Sharen (Amomi Fructus). This represents modification according to the disease. For example, add Fangfeng (Saposhnikoviae Radix) in spring, Kushen (Sophorae Flavescentis Radix) in summer, and Wuzhuyu (Evodiae Fructus) in autumn and winter. This follows the classic saying: "Ascending, descending, floating, and sinking should follow the seasons; cold, heat, warm, and cool should oppose the pathogenic factors."
The Book of Songs says: "Climb that high hill, go gather the Meng grass." Zhu Xi explained: "Meng refers to Beimu (Fritillariae Bulbus); gathering it is used to treat diseases of stagnation and knotting." Therefore, it is often added when treating stagnation and knotting disorders!
Burned Salt (3 liang), Warm Water (2 sheng).
Mix and take to induce vomiting.
Wood Yu (Liver Wood Stagnation): characterized by severe pain in both hypochondriac regions and a choppy pulse (Dai Mai). This prescription is the primary treatment.
Wood refers to Liver Wood, which has the imagery of hanging branches and spreading leaves; it prefers free flow and detests depression. If there is retained Phlegm and leftover food in the diaphragm, it suppresses Liver Qi, preventing it from ascending. Consequently, Liver Wood becomes excess internally, causing severe pain in both hypochondriac regions. A Dai pulse indicates that the pain is severe enough to cause pauses in the pulse. Inducing vomiting leads to survival; failing to do so leads to death. Therefore, salt water emesis is the primary treatment.
Qianghuo (Notopterygii Rhizoma et Radix), Gegen (Puerariae Lobatae Radix), Shengma (Cimicifugae Rhizoma), Shaoyao (Paeoniae Radix), Renshen (Ginseng Radix) (each 7 fen), Chaihu (Bupleuri Radix), Sheng Gancao (Glycyrrhizae Radix et Rhizoma Preparata) (each 3 fen), Fangfeng (Saposhnikoviae Radix) (5 fen), Congbai (Allii Fistulosi Bulbus) (5 stalks).
Fire Yu (Heart Fire Stagnation): characterized by internal heat with external cold, and a deep and rapid pulse. This prescription is the primary treatment.
Fire refers to Heart Fire, which possesses the nature of flaming upward; it prefers smooth flow and detests stagnation. When stagnant, the fire lacks flame, thus causing the body to feel cold. A deep pulse indicates the disease is interior; deep and rapid indicates interior heat. In this formula, Qianghuo, Fangfeng, Shengma, Chaihu, Gegen, and Congbai are all acrid-warm herbs that ascend and raise. They are sufficient to stir up the flameless fire, making it blaze again. Shaoyao, Renshen, and Gancao serve to harmonize Ying and Wei after the ascending and dispersing action. The Classic states: "When Fire is stagnant, disperse it." This is what is meant.