(附痼冷)
论诸虚不足 皆因肾气虚惫,下元积冷,腰背疼痛,肢体倦怠,面色无光,精神不爽,
唇口干燥,眼暗耳鸣,小便滑数,夜多异梦,盗汗失精,不思饮食,日渐羸瘦,可与菟丝子
丸、安肾丸、八味丸、无比山药丸、黄 建中汤、茴香丸。脾胃虚弱者,兼服壮胃药。虚损
甚者,可与麝香鹿茸丸、沉香鹿茸丸、法炼黑锡丹、金锁正元丸、张走马玉霜丸、正元散、
沉香鳖甲散、椒附丸、四柱散。下虚洞泄者,四柱散、正元散、丁香豆蔻散。治心气不足,
神思恍惚,言语错谬,惊悸不定,夜多异梦,可与定志丸、降气丹、镇心丸、人参黄 散、
妙香散、乌沉汤、参苓白术散。治小便白浊,梦泄遗精,可与平补镇心丹、降心丹、威喜丸
、定志丸。冷惫虚损甚,精冷滑不固者,与金锁正元丹。腰股痛者,与青娥丸。甚者,与神
应丸、黄 丸、乳香丸、活络丹、安肾丸、返风应痛丸。如耳鸣者,黄 丸立效。虚劳发热
,至午后热甚者,空心服安肾丸、八味丸、山药丸、沉香鳖甲散、参苓白术散、嘉禾散,食
后服人参当归散。若嗽涎黄或有血者,临卧服人参养肺丸。因虚劳用力太过,吐血不止者,
与秘传降气汤或小降气汤,多加人参煎服。前状发热甚者,与逍遥散。骨中热者,与人参黄
散。虚弱、老人,可与黄 建中汤常服。虚汗、盗汗,心忪气短者,可与牡蛎散、止汗散、
黄建中汤、大山药丸、人参当归散加小麦煎服。自汗不止者,术附汤、正元散。心热盗汗
,可与辰砂妙香散。
论沉寒痼冷 皆因元气虚损,下冷上盛,致水火不交,阴阳失序,手足厥冷,及伤寒阴
证,霍乱转筋,下痢久泻,脉候沉微者,与黑锡丹、来复丹、金液丹、附子理中丸、金锁正
元丹、四神丹。
(附:顽固性寒证)
论述各种虚损不足之症,多因肾气虚弱疲惫,下焦元阳积冷所致。症状包括腰背疼痛,肢体倦怠乏力,面色无光泽,精神不振,唇口干燥,视力模糊耳鸣,小便频数滑利,夜间多梦,盗汗及遗精,食欲不振,身体日渐消瘦。此类情况可服用菟丝子丸、安肾丸、八味丸、无比山药丸、黄芪建中汤、茴香丸。若脾胃虚弱者,兼服壮胃药物。若虚损严重,可服用麝香鹿茸丸、沉香鹿茸丸、法炼黑锡丹、金锁正元丸、张走马玉霜丸、正元散、沉香鳖甲散、椒附丸、四柱散。若下焦虚寒导致洞泄(水样腹泻),可用四柱散、正元散、丁香豆蔻散。治疗心气不足,神思恍惚,言语错乱,惊悸不安,夜间多梦,可服用定志丸、降气丹、镇心丸、人参黄芪散、妙香散、乌沉汤、参苓白术散。治疗小便浑浊,梦中遗精,可服用平补镇心丹、降心丹、威喜丸、定志丸。若寒邪极度虚弱且虚损严重,精气寒冷滑脱不固者,给予金锁正元丹。腰部和股部疼痛者,给予青娥丸。严重者,给予神应丸、黄芪丸、乳香丸、活络丹、安肾丸、返风应痛丸。若有耳鸣症状,黄芪丸立竿见影。虚劳发热,午后热势加重者,空腹服用安肾丸、八味丸、山药丸、沉香鳖甲散、参苓白术散、嘉禾散,饭后服用人参当归散。若咳嗽吐黄痰或带血者,临睡前服用人参养肺丸。因虚劳用力过度,吐血不止者,给予秘传降气汤或小降气汤,多加人参煎服。前述症状发热严重者,给予逍遥散。骨蒸潮热者,给人参黄芪散。体弱及老年人,可常服黄芪建中汤。虚汗、盗汗,心慌气短者,可服用牡蛎散、止汗散、黄芪建中汤、大山药丸,或将人参当归散加小麦煎服。自汗不止者,用术附汤、正元散。心热盗汗者,可服用辰砂妙香散。
论述沉寒痼冷(深重顽固的寒邪),皆因元气虚损,下焦寒冷而上焦亢盛,导致水火不交,阴阳失调。症状包括手足厥冷,以及伤寒阴证,霍乱转筋,久泻痢疾,脉象沉微者,给予黑锡丹、来复丹、金液丹、附子理中丸、金锁正元丹、四神丹。
(Attached: Stubborn Cold Syndrome)
Discussion on various deficiency and insufficiency syndromes: These are all caused by the deficiency and exhaustion of Kidney Qi, with accumulated cold in the lower Yuan (primordial source). Symptoms include pain in the waist and back, fatigue and lassitude of the limbs, lusterless complexion, lack of mental vigor, dryness of lips and mouth, dim vision and tinnitus, frequent and slippery urination, vivid dreams at night, nocturnal sweating and spermatorrhea, loss of appetite, and gradual emaciation. In such cases, Tusizi Wan (Cuscuta Pill), Anshen Wan (Kidney-Anchoring Pill), Bawei Wan (Eight-Ingredient Pill), Wubi Shanyao Wan (Incomparable Yam Pill), Huangqi Jianzhong Tang (Astragalus Decoction for Building the Middle), Huixiang Wan (Fennel Pill) may be administered. For those with Spleen and Stomach weakness, stomach-strengthening medicines should be taken concurrently. For severe deficiency damage, Shexiang Lurong Wan (Musk and Deer Antler Pill), Chenxiang Lurong Wan (Agarwood and Deer Antler Pill), Falian Heixi Dan (Refined Black Tin Elixir), Jin suo Zhengyuan Wan (Golden Lock Restoring Primordial Pill), Zhang Zouma Yushuang Wan (Zhang's Horse-Rushing Jade Frost Pill), Zhengyuan San (Primordial Powder), Chenxiang Biejia San (Agarwood and Turtle Shell Powder), Jiaofu Wan (Pepper and Aconite Pill), Sizhu San (Four Pillars Powder) may be given. For lower deficiency leading to洞泄 (profuse watery diarrhea), Sizhu San, Zhengyuan San, or Dingxiang Doukou San (Clove and Cardamom Powder) may be used. To treat Heart Qi deficiency characterized by absent-mindedness, confused speech, palpitations and restlessness, and vivid dreams at night, Zhizhi Wan (Will-Calming Pill), Jiangqi Dan (Qi-Descending Elixir), Zhenxin Wan (Heart-Sedating Pill), Renshen Huangqi San (Ginseng and Astragalus Powder), Miaoxiang San (Wonderful Incense Powder), Wuchen Tang (Black Sedative Decoction), Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) may be administered. To treat cloudy urine, nocturnal emission due to dreams, and spermatorrhea, Pingbu Zhenxin Dan (Balancing and Calming Heart Elixir), Jiangxin Dan (Heart-Descending Elixir), Weixi Wan (Vigorous Joy Pill), or Zhizhi Wan may be used. For extreme cold-induced exhaustion and severe deficiency, where essence is cold and sliding/uncontrolled, Jin suo Zhengyuan Dan (Golden Lock Restoring Primordial Elixir) is given. For pain in the waist and thighs, Qing'e Wan (Blue Quiver Pill) is prescribed. For severe cases, Shenyin Wan (Divine Response Pill), Huangqi Wan (Astragalus Pill), Ruxiang Wan (Frankincense Pill), Huoluo Dan (Meridian-Activating Elixir), Anshen Wan, or Fanfeng Yingtong Wan (Wind-Returning Pain-Relieving Pill) may be used. For tinnitus, Huangqi Wan provides immediate effect. For deficiency-labor fever that worsens in the afternoon, Anshen Wan, Bawei Wan, Shanyao Wan, Chenxiang Biejia San, Shenling Baizhu San, Jiahe San (Harmonious Grain Powder) should be taken on an empty stomach, followed by Renshen Danggui San (Ginseng and Angelica Sinensis Powder) after meals. If coughing up yellow phlegm or blood occurs, Renshen Yangfei Wan (Ginseng Lung-Nourishing Pill) should be taken before sleep. For continuous hematemesis due to excessive exertion from deficiency-labor, Michuan Jiangqi Tang (Secret Formula Qi-Descending Decoction) or Xiao Jiangqi Tang (Minor Qi-Descending Decoction) with added Ginseng should be decocted and taken. For severe fever as described above, Xiaoyao San (Free and Easy Wanderer Powder) is given. For heat steaming from the bones, Renshen Huangqi San is administered. The weak and elderly may take Huangqi Jianzhong Tang regularly. For spontaneous sweating, nocturnal sweating, palpitations, and shortness of breath, Muli San (Oyster Shell Powder), Zhihan San (Sweat-Stopping Powder), Huangqi Jianzhong Tang, Dashanyao Wan (Great Yam Pill), or Renshen Danggui San decocted with Wheat may be used. For unceasing spontaneous sweating, Shufu Tang (Atractylodes and Aconite Decoction) or Zhengyuan San is used. For Heart-heat causing nocturnal sweating, Chensha Miaoxiang San (Cinnabar Wonderful Incense Powder) may be given.
Discussion on Chenhan Guling (Deep-seated Stubborn Cold): This is all caused by the deficiency and damage of Primordial Qi, with cold in the lower part and excess in the upper part, leading to the failure of Water and Fire to interact, and the disorder of Yin and Yang. Symptoms include cold extremities, as well as Yin syndromes of Shanghan (Cold Damage), Huoluan (Cholera-like syndrome) with muscle cramps, chronic dysentery and diarrhea, and a deep and faint pulse. Heixi Dan (Black Tin Elixir), Laifu Dan (Returning Life Elixir), Jin Ye Dan (Golden Fluid Elixir), Fuzi Lizhong Wan (Aconite Decoction for Regulating the Middle), Jin suo Zhengyuan Dan, or Sishen Dan (Four Spirits Elixir) may be administered.