一妇人三十余岁。忧思不已。饮食失节。脾胃有伤。面色黧黑不泽。环唇尤甚。心悬如饥状。
饥不欲食。气短而促。大抵心肺在上。行荣卫而光泽于外。宜显而不藏。肾肝在下。养筋骨而强于
内。当隐而不见。脾胃在中。主传化精微以灌四脏。冲和而不息。其气一伤。则四脏失所。忧思不
已。气结而不行。饮食失节。气耗而不足。使阴气上溢于阳中。故黑色见于面。又经云。脾气通于
口。其华在唇。今水反来侮土。故黑色见于唇。此阴阳相反。病之逆也。上古天真论云。阳明脉衰
于上。面始焦。始知阳明之气不足。故用冲和顺气汤。此药助阳明生发之剂。以复其色耳。
【冲和顺气汤】
葛根(一钱半) 升麻 防风 白芷(各一钱)
黄(八分) 人参(七分) 甘草(四分) 芍药
苍术(各三分)
上 咀。作一服。水二盏。姜三片。枣两个。煎至一盏。去渣。温服。早饭后、午前。取天气
上升之时。使人之阳气易达故也。数服而愈。
内经曰。上气不足。推而扬之。以升麻苦平。葛根甘温。自地升天。通行阳明之气为君。人之
气以天地之疾风名之。气留而不行者。以辛散之。防风辛温。白芷甘辛温。以散滞气。用以为臣。
苍术苦辛。蠲除阳明经之寒湿。白芍药之酸。安太阴经之怯弱。十剂云。补可去弱。人参、羊肉之
属是也。人参黄 、甘草、甘温。益正气以为臣。至真要大论云。辛甘发散为阳。生姜辛热。大枣
甘温。和荣卫。开腠理。致津液。以复其阳气。故以为使也。
一位三十多岁的妇女。因长期忧愁思虑,饮食没有节制,导致脾胃受损。面色黧黑且无光泽,嘴唇周围尤为严重。心中空虚像饥饿的感觉,但饿了又不想吃东西。气短而急促。
大体上,心和肺位于上部,运行营卫之气并使面色光泽于外,应当显露而不隐藏;肾和肝位于下部,滋养筋骨并强健于内,应当隐伏而不显现;脾和胃位于中部,主管传导化生精微物质以灌溉其他四脏,保持冲和状态而不停息。一旦脾胃之气受伤,那么其他四脏就会失去依靠。长期忧思导致气机郁结而不能运行,饮食失节导致气耗损而不足。这使得阴气上溢于阳分之中,所以黑色出现在面部。又根据《内经》所说:“脾气通于口,其荣华表现在嘴唇。”如今水气反而来侮害土气,所以黑色出现在嘴唇。这是阴阳相反,属于病证的逆证。《上古天真论》说:“阳明脉在上部衰退,面容开始憔悴枯槁。”由此可知是阳明之气不足,所以使用冲和顺气汤。此药是辅助阳明经生发之气的方剂,用来恢复面色。
【冲和顺气汤】
葛根(一钱半) 升麻 防风 白芷(各一钱)
黄芪(八分) 人参(七分) 甘草(四分) 芍药
苍术(各三分)
以上药物捣碎。作为一服剂量,用水两盏,生姜三片,大枣两个,煎煮至一盏,去渣滓。温服。在早饭后、午前服用,是为了顺应天气上升的时机,使人的阳气容易通达。服用几剂后痊愈。
《内经》说:“上部之气不足,应当推举并扬升它。”用升麻味苦性平,葛根味甘性温,自地升天,通行阳明经之气作为君药。人的气以天地间的疾风来命名。气停留而不能运行的,用辛味药发散它。防风味辛性温,白芷味甘辛性温,用来发散滞气,作为臣药。苍术味苦辛,能清除阳明经的寒湿;白芍药的酸味,能安定太阴经的怯弱。《十剂》说:“补益可以去虚弱,如人参、羊肉之类。”人参、黄芪、甘草,味甘性温,补益正气作为臣药。《至真要大论》说:“辛甘发散为阳。”生姜味辛性热,大枣味甘性温,调和营卫,开泄腠理,促使津液生成,以恢复阳气,所以作为使药。
A woman in her thirties suffered from incessant worry and overthinking. Her diet was irregular, injuring the Spleen and Stomach (Spleen and Stomach organs responsible for digestion and transformation). Her complexion was dark and lusterless, especially around the lips. She felt a sensation of emptiness in the heart as if hungry, yet she had no desire to eat when hungry. She experienced shortness of breath and rapid breathing.
Generally, the Heart and Lung are located superiorly; they circulate Ying-Wei (Nutritive and Defensive Qi) and manifest luster externally, thus should be revealed rather than concealed. The Kidney and Liver are located inferiorly; they nourish sinews and bones and strengthen internally, thus should be hidden rather than visible. The Spleen and Stomach are located centrally; they govern the transportation and transformation of refined essences to irrigate the other four Zang organs, maintaining a harmonious state without ceasing. Once the Qi of the Spleen and Stomach is injured, the other four Zang organs lose their support. Incessant worry causes Qi stagnation and obstruction; irregular diet causes Qi consumption and deficiency. This allows Yin Qi to overflow into the Yang aspect, hence black color appears on the face. Furthermore, the *Neijing* states: "The Qi of the Spleen connects with the mouth, and its brilliance manifests in the lips." Now, Water Qi counteracts and insults Earth Qi, hence black color appears on the lips. This represents an inversion of Yin and Yang, a contrary pathological state. The *Shanggu Tianzhen Lun* chapter says: "When the Maiyang (Stomach) meridian declines superiorly, the face begins to wither." From this, it is known that there is a deficiency of Maiyang Qi. Therefore, Chonghe Shunqi Tang (Harmonizing and Qi-Smooth Decoction) is used. This formula assists the generating and ascending power of the Maiyang meridian to restore the complexion.
[Chonghe Shunqi Tang]
Puerariae Radix (Ge Gen, 葛根) (1.5 qian)
Cimicifugae Rhizoma (Sheng Ma, 升麻)
Saposhnikoviae Radix (Fang Feng, 防风)
Angelicae Dahuricae Radix (Bai Zhi, 白芷) (each 1 qian)
Astragali Radix (Huang Qi, 黄芪) (0.8 qian)
Ginseng Radix (Ren Shen, 人参) (0.7 qian)
Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草) (0.4 qian)
Paeoniae Radix Alba (Bai Shao, 芍药)
Atractylodis Rhizoma (Cang Zhu, 苍术) (each 0.3 qian)
Crush the above herbs. Prepare as one dose. Add two cups of water, three slices of Zingiberis Rhizoma Recens (Fresh Ginger, 生姜), and two Jujubae Fructus (Jujube, 大枣). Decoct until one cup remains. Remove dregs. Take warm. Administer after breakfast and before noon, taking advantage of the time when heavenly Qi ascends, so that human Yang Qi can easily reach its destination. After several doses, the condition healed.
The *Neijing* states: "When Qi at the upper part is insufficient, push and elevate it." Cimicifugae Rhizoma is bitter and neutral; Puerariae Radix is sweet and warm. They ascend from earth to heaven, unblocking the Qi of the Maiyang meridian, serving as the Sovereign drug. Human Qi is likened to the swift wind of heaven and earth. When Qi stays and fails to circulate, disperse it with acrid substances. Saposhnikoviae Radix is acrid and warm; Angelicae Dahuricae Radix is sweet, acrid, and warm. They disperse stagnant Qi, serving as the Minister drugs. Atractylodis Rhizoma is bitter and acrid, eliminating cold-dampness from the Maiyang meridian. The sour nature of Paeoniae Radix Alba stabilizes the weakness of the Taiyin meridian. The *Shi Ji* (Ten Categories) states: "Tonification can remove weakness, such as Ginseng and mutton." Ginseng Radix, Astragali Radix, and Glycyrrhizae Radix et Rhizoma are sweet and warm, tonifying righteous Qi, serving as Minister drugs. The *Zhi Zhen Yao Da Lun* chapter states: "Acrid and sweet disperse and belong to Yang." Zingiberis Rhizoma Recens is acrid and hot; Jujubae Fructus is sweet and warm. They harmonize Ying-Wei Qi, open the Couli (pores/skin texture), promote the generation of Jin-Ye (Body Fluids), and restore Yang Qi, thus serving as the Envoy drug.