(钱乙)
治小肠有火,便赤淋痛,面赤狂躁,口糜舌疮,切牙口渴(心与小肠相表里,心热则小
肠亦热,故便赤淋痛。心属君火,是五脏六腑火之主,故诸经之热皆应于心∶面赤烦躁,咬
牙口渴,皆为心热也;舌为心苗,若心火上炎,熏蒸于口,则口糜舌疮;轻手按皮毛之下、
肌肉之上则热,日中尤甚,是热在血脉,为心热。朱丹溪曰∶五脏各有火,五志激之,其火
随起,
生地黄 木通 甘草梢 淡竹叶,等分。煎。
此手少阴、太阳药也。生地凉心血,竹叶清心气(叶生竹上,故清上焦,)木通降心火,
入小肠(君火宜木通,相火宜泽泻,行水虽同,所用各别。君,心火也;相,肾火也,)草
梢达茎中而止痛(便赤淋痛,)以共导丙丁之火,由小水而出也(小肠为丙火,心为丁火。
心热泄小肠,釜底抽薪之义也。易老用导赤散合五苓散,治口糜神效,经曰∶膀胱移热于小
肠,膈肠不便,上为口糜。亦有用理中汤加附子者,因脾胃虚衰之火,被逼上炎,故用参术
甘草补其土,姜附散其寒,则火得所助,接引退舍矣。《纲目》曰∶心气热则上窜,宜导赤
散;肾气虚则下窜
(《局方》)
治忧思抑郁,发热烦躁∶或酒食过度,火盛克金,口苦咽干,渐成消渴,遗精淋浊,遇
劳即发,四肢倦怠,五心烦热,夜静昼甚;及女人崩带(烦躁、遗精、淋浊者,心虚而有热
也;心火妄动,则不能下交于肾,故元精失守也;遇劳则发为劳淋,劳则动其心火也;昼偏
热者,阳虚也;崩中由损伤冲任,气血俱虚,经曰∶阴虚阳搏,谓之崩。由阴虚而阳搏之,
血得热而妄行也;带者,病本于带脉而得名,赤属血,白属气,由阴虚阳竭,荣气不升,卫
气下陷
石莲肉 人参 黄 茯苓 柴胡(三钱) 黄芩(炒) 地骨皮 麦冬 车前子 甘
草(
此手足少阴、足少阳、太阴药也。参 甘草所以补阳虚而泻火(东垣曰∶参 甘草,泻
火之圣药),助气化而达州都(膀胱也,气化则能出);地骨退肝肾之虚热,柴胡散肝胆之火
邪,黄芩、麦冬清热于心肺上焦,茯苓、车前利湿于膀胱下部,中以石莲清心火而交心肾,
则诸证悉退也
(钱乙)
治疗小肠有火,小便赤涩淋痛,面色红赤、狂躁不安,口腔糜烂、舌体生疮,磨牙口渴。(心与小肠互为表里,心热则小肠也热,所以出现小便赤涩淋痛。心属于君火,是五脏六腑火热的主宰,所以各经的热邪都会应合于心:面红烦躁、咬牙口渴,都是心热的表现;舌为心之苗窍,如果心火上炎,熏蒸于口,就会导致口腔糜烂和舌疮;轻手按压皮毛之下、肌肉之上感觉发热,中午尤其严重,这是热在血脉,属于心热。朱丹溪说:五脏各有火,五志激发它,火随之而起。)
生地黄、木通、甘草梢、淡竹叶,各等分。煎服。
这是治疗手少阴心经和手太阳小肠经的药物。生地黄凉血清热以养心血,淡竹叶清心气(叶生于竹上,故能清上焦之火),木通降泄心火并引热入小肠(君火宜用木通,相火宜用泽泻,虽然都能利水,但用途各异。君指心火,相指肾火),甘草梢直达茎中而止痛(针对小便赤涩淋痛),共同引导丙丁之火(小肠为丙火,心为丁火),从小便排出。(心热通过小肠排泄,体现了“釜底抽薪”的道理。易老将导赤散与五苓散合用,治疗口腔糜烂效果显著,《内经》说:膀胱移热于小肠,膈肠不便,上为口糜。也有使用理中汤加附子的情况,是因为脾胃虚衰之火,被逼迫上炎,所以用人参、白术、甘草补益脾土,干姜、附子散其寒邪,则火得到资助,顺势退去。《本草纲目》说:心气热则火气上窜,宜用导赤散;肾气虚则火气下窜……)
(《太平惠民和剂局方》)
治疗忧思抑郁导致的发热烦躁;或者酒食过度,火盛克金,口苦咽干,逐渐形成消渴病,遗精、小便浑浊淋漓,遇劳累即发作,四肢倦怠,五心烦热,夜间安静白天加重;以及妇女崩漏、带下。(烦躁、遗精、淋浊,是心虚而有热;心火妄动,就不能下交于肾,所以元精失守;遇劳累就发作称为劳淋,劳累会扰动心火;白天特别热,是阳虚;崩中是由于损伤冲任二脉,气血俱虚,《内经》说:阴虚阳搏,谓之崩。因阴虚而阳气搏击,血受热而妄行;带下病,病名源于带脉,赤色属血,白色属气,由于阴虚阳竭,营气不升,卫气下陷……)
石莲子肉、人参、黄芪、茯苓、柴胡(三钱)、黄芩(炒)、地骨皮、麦冬、车前子、甘草(适量)。
这是治疗手少阴心经、足少阳胆经、足太阴脾经的药物。人参、甘草用来补益阳虚并泻火(李东垣说:人参、甘草是泻火的圣药),助气化而通达州都(指膀胱,气化功能正常才能排尿);地骨皮退除肝肾的虚热,柴胡疏散肝胆的火邪,黄芩、麦冬清泄心肺上焦的热,茯苓、车前子在膀胱下部利湿,中间用石莲子清心火并交通心肾,那么各种病症都会消退。
(Qian Yi)
Treats fire in the Small Intestine, presenting with red and painful dysuria (painful urinary frequency), flushed face, mania and restlessness, oral ulcers and lingual sores, teeth grinding, and thirst. (The Heart and Small Intestine are interior-exteriorly related; heat in the Heart leads to heat in the Small Intestine, hence red and painful dysuria. The Heart belongs to Ministerial Fire (Jun Huo), which is the master of fire in the five zang and six fu organs; thus, heat from all meridians responds to the Heart: a flushed face, restlessness, teeth grinding, and thirst are all manifestations of Heart Heat. The tongue is the sprout of the Heart; if Heart Fire flares upward and steams the mouth, it causes oral ulcers and lingual sores. Heat felt upon light palpation between the skin and muscle, especially severe at noon, indicates heat in the blood vessels, belonging to Heart Heat. Zhu Danxi said: Each of the five zang organs has its own fire; when stirred by the five emotions, the fire arises accordingly.)
Shengdi Huang (Rehmanniae Radix Preparata), Mutong (Akebiae Caulis), Gancao Shao (Glycyrrhizae Radix et Rhizoma - tip), and Dan Zhuye (Lophatheri Folium) in equal parts. Decoct and take.
These are herbs for the Hand Shaoyin (Heart) and Hand Taiyang (Small Intestine) meridians. Sheng Di Huang cools blood and nourishes Heart Blood; Dan Zhu Ye clears Heart Qi (since leaves grow on bamboo, it clears the Upper Jiao); Mutong descends Heart Fire and enters the Small Intestine (Ministerial Fire is suited to Mutong, while Damp-Heat Fire is suited to Zexie; although both promote urination, their applications differ. Jun refers to Heart Fire; Xiang refers to Kidney Fire); Gancao Shao reaches the urethra to relieve pain (addressing red and painful dysuria). Together, they guide Bing-Ding Fire (Small Intestine is Bing Fire, Heart is Ding Fire) out through the urine. (Clearing Heart Heat via the Small Intestine embodies the principle of "drawing firewood from under the cauldron." Yi Lao combined Dao Chi San with Wu Ling San to treat oral ulcers with excellent effect. The Classic states: When bladder heat transfers to the small intestine, causing obstruction of the diaphragm and intestines, it manifests upward as oral ulcers. There are also cases using Li Zhong Tang plus Fuzi, because fire due to Spleen-Stomach deficiency and collapse is forced upward; thus, Renshen, Baizhu, and Gancao tonify Earth, while Ganjiang and Fuzi disperse cold, allowing the fire to be assisted and retreat. Compendium of Materia Medica states: When Heart Qi is hot, fire rushes upward, suitable for Dao Chi San; when Kidney Qi is deficient, fire rushes downward...)
(The Bureau of People's Welfare Pharmacy Formulary)
Treats fever and restlessness caused by worry and depression; or excessive alcohol and food intake leading to excessive fire suppressing Metal, resulting in bitter taste in the mouth, dry throat, gradually developing into Xiao Ke (Wasting-Thirst), spermatorrhea, turbid and painful urination, recurring upon exertion, limb fatigue, five-palm heat (heat in the palms, soles, and chest), worse at night but quiet during the day; and in women, metrorrhagia and leukorrhea. (Restlessness, spermatorrhea, and dysuria indicate Heart Deficiency with Heat; when Heart Fire moves recklessly, it cannot descend to communicate with the Kidney, causing loss of Yuan Jing (Essence). Recurrence upon exertion is called Lao Lin (Exhaustion Dysuria), as exertion stirs Heart Fire. Heat predominating during the day indicates Yang Deficiency. Metrorrhagia results from damage to the Chong and Ren vessels, with both Qi and Blood deficient. The Classic states: Yin deficiency with Yang pounding is called Beng (Metrorrhagia). Due to Yin deficiency and Yang pounding, blood moves recklessly due to heat. Leukorrhea derives its name from the Dai Mai (Girdle Vessel); red indicates Blood involvement, white indicates Qi involvement, stemming from Yin deficiency and Yang exhaustion, where Ying Qi fails to ascend and Wei Qi sinks...)
Shi Lian Rou (Nelumbinis Semen), Renshen (Ginseng Radix), Huangqi (Astragali Radix), Fuling (Poria), Chaihu (Bupleuri Radix - 3 qian), Huangqin (Scutellariae Radix, stir-fried), Digupi (Lycii Cortex), Maidong (Ophiopogonis Radix), Cheqianzi (Plantaginis Semen), and Gancao (Licorice Root) in appropriate amounts.
These are herbs for the Hand Shaoyin (Heart), Foot Shaoyang (Gallbladder), and Foot Taiyin (Spleen) meridians. Renshen and Gancao tonify Yang Deficiency and drain fire (Li Dongyuan stated: Renshen and Gancao are the holy medicines for draining fire), assist Qi transformation to reach the Zhou Du (Bladder; when Qi transforms, urination occurs); Digupi retreats deficiency heat from the Liver and Kidney; Chaihu disperses fire pathogens from the Liver and Gallbladder; Huangqin and Maidong clear heat from the Heart, Lungs, and Upper Jiao; Fuling and Cheqianzi promote dampness drainage in the lower Bladder region; Shi Lian Rou in the middle clears Heart Fire and facilitates communication between the Heart and Kidney, thereby resolving all symptoms.