妇人肾脏系于胞络。肾主于腰,若肾气虚弱,外感六邪,内伤七情,皆致腰痛。古方亦
有五种之说,如风腰痛,宜小续命汤加桃仁、杜仲煎服;脾胃气蔽及寒湿腰痛,五积散加桃仁;
如虚损及五种腰痛,青娥丸、神应丸皆可;气滞腰痛,神保丸加黑丑、茴香、橘核神效。
(总领)如神汤 治男子、妇女血滞腰痛。
当归 延胡索 桂心(等分)
上为末,温酒调下二钱,甚者不过数服。
独活寄生汤 治腰痛肾虚,卧冷湿地,当风所得。不时速治,若流入脚膝,为偏枯冷痹。
或腰痛拘挛,脚重痹,宜急服之。(方见腰痛门。)
舒筋汤 治腰痛神效,闪挫亦良。
玄胡索 杜仲 官桂 羌活 赤芍药
等分为末,酒调下。
骨碎补散 治妇人血风气攻,腰脚疼痛,腹胁拘急,肢节不利。
骨碎补(炒) 萆 川牛膝 桃仁 海桐皮 当归 桂心 槟榔(各一两) 赤芍药
附子 川芎(各三分) 枳壳(半两)
上为粗未,每服三钱,水一盏,姜三片、枣一枚,煎七分,食前热服。
妇人香港脚与丈夫不同。男子则肾脏虚弱,为风湿所乘;女子以胞络气虚,为风毒所搏。
故胞络属于肾,肾主于腰脚。又肝、脾、肾三脏,经络起于十足指。若脏腑虚损,则风邪先客
于脚,从下而上动于气,故名香港脚也。此皆由体虚或当风取凉,久坐卑湿,或产后劳损,或
恼怒伤肝,心气郁滞,致令月信不通。因其虚伤,风毒搏肌骨,则令皮肤不仁,筋骨抽痛,
五缓不遂,六急拘挛。或即冷痛,或即肿满,或两脚痹弱,或举体转筋,目眩心烦,见食则呕,
精神昏愦,肢节烦痛,小便赤,大便秘,皆其证也。妇人香港脚治法与丈夫不同者,以其气血
不调,怀胎难产,崩伤之异。故褚尚书疗寡妇、师尼与妻外家殊别,即其义也。凡妇人有香港脚之
疾者,必无生育,此可以验其异也。凡治妇人香港脚,头痛身热,肢节痛,大便秘,或呕逆而脚
屈弱者,香港脚也。轻者可与香苏散,加木瓜、槟榔、生姜煎服,然后随证治之。要知有香港脚
之人,先从脚起,或缓弱疼痹,或行起忽倒,或两胫肿满,或脚膝肿热,或心中忪悸,或小腹
不仁,皮顽不知,或举体转筋,或见食呕逆,恶闻食气,或胸满气急,或遍体酸疼,皆香港脚候。
黄帝所谓缓风湿痹是也。顽弱名缓风,疼痛为湿痹。寒中三阳,所患必
冷,小续命汤主之;暑中三阴,所患必热,小续命汤去附子,减桂一半主之。大烦躁者,
紫雪最良。
大腹皮散 治妇人风毒香港脚,肢节烦疼,心神壅闷。
大腹皮 紫苏 木通 桑白皮 羌活 荆芥 赤芍药 青皮 木瓜 独活(各五分)
枳壳(一钱)
上咀,水盏半,姜五片、葱七寸,煎七分,空心服。
牛膝散 治香港脚浮肿,心神烦闷,月信不通。
川牛膝 羚羊角 槟榔 大黄(炒) 芒硝(各一钱) 防己 桂心 牡丹皮 赤芍药
甘草(各三分) 桃仁(五大枚)
上咀,水盏半,煎七分温服。利下恶物为度,观其强弱用之。
木香散 治妇人香港脚卒发,冲心闷乱。
木香(五分,磨汁) 郁李仁 赤芍药 大腹皮 紫雪(各一钱) 桑白皮 桂心 槟榔
茯苓(各三分)
上咀,水盏半,姜三片,煎七分,温服。
木瓜煎 治妇人香港脚冲心,闷乱不知人。
木瓜 松节(各一钱) 吴茱萸 槟榔 紫苏(各钱半) 陈皮(三分)
水盏半,童便三合,煎八分温服。
紫苏散 治妇人风毒香港脚,腹内壅塞,不思饮食,虚肿脚重。
紫苏 木通 桑白皮 茴香根(各一钱) 枳壳 羌活 独活 荆芥穗 木瓜 青皮 甘草(各五分)
大腹子(一个)
上咀,每服水盏半,姜二片、葱白一茎,煎七分,温服。
妇女的肾脏与胞络相连系。肾主宰腰部,如果肾气虚弱,外感风、寒、暑、湿、燥、火六淫邪气,内伤情志七情,都会导致腰痛。古代医方中也有将腰痛分为五种的学说,例如风邪引起的腰痛,适宜服用小续命汤(Xiao Xuming Tang, Minor Continuation Life Decoction)加入桃仁、杜仲煎服;脾胃之气闭塞以及寒湿引起的腰痛,可用五积散(Wuji San, Five Accumulations Powder)加入桃仁;如果是虚损及五种腰痛,青娥丸(Qing'e Wan, Blue Young Pill)、神应丸(Shenyin Wan, Divine Response Pill)都可以使用;气滞引起的腰痛,神保丸(Shenbao Wan, Divine Protection Pill)加入黑丑、茴香、橘核效果显著。
(总领方)如神汤:治疗男性和女性因血瘀阻滞引起的腰痛。
当归(Danggui, Angelicae Sinensis Radix)、延胡索(Yanhusuo, Corydalis Rhizoma)、桂心(Guixin, Cinnamomi Cortex)各等分。
以上药物研为细末,用温酒调服二钱,病情严重者不过数服即可见效。
独活寄生汤(Duhuo Jisheng Tang, Notopterygium and Sangjisheng Decoction):治疗腰痛肾虚,因睡在冷湿地或当风受邪所致。若不及时迅速治疗,病邪流入脚膝,会导致偏枯冷痹(hemiplegia with cold bi-syndrome)。如果出现腰痛拘挛,脚部沉重麻木,应当立即服用。(此方详见腰痛门。)
舒筋汤(Shujin Tang, Relax Tendons Decoction):治疗腰痛效果显著,闪挫损伤也有效。
玄胡索(Xuanhushuo, Corydalisis Rhizoma)、杜仲(Duzhong, Eucommiae Cortex)、官桂(Guan Gui, Cinnamomi Ramulus)、羌活(Qianghuo, Notopterygii Rhizoma et Radix)、赤芍药(Chishaoyao, Paeoniae Radix Rubra)
各等分研为细末,用酒调服。
骨碎补散(Gusuibu San, Drynaria Powder):治疗妇人血风气攻,腰脚疼痛,腹胁拘急,肢节活动不利。
骨碎补(炒)(Gusuibu, Drynariae Rhizoma)、萆薢(Bixie, Dioscoreae Hypoglaucae Rhizoma)、川牛膝(Chuanniuxi, Cyathulae Radix)、桃仁(Taoren, Persicae Semen)、海桐皮(Haitongpi, Sapindus Cortex)、当归(Danggui, Angelicae Sinensis Radix)、桂心(Guixin, Cinnamomi Cortex)、槟榔(Binglang, Arecae Semen)各一两;赤芍药(Chishaoyao, Paeoniae Radix Rubra)、附子(Fuzi, Aconiti Lateralis Radix Praeparata)、川芎(Chuanxiong, Chuanxiong Rhizoma)各三分;枳壳(Zhiqiao, Aurantii Fructus)半两。
以上药物捣成粗末,每次服用三钱,加水一盏,生姜三片、大枣一枚,煎至七分,饭前热服。
妇女的香港脚(Hongxiangjiao, Hongxiangjiao disease, a traditional term for gout or beriberi-like symptoms in the lower limbs)与男子不同。男子是因为肾脏虚弱,被风湿邪气侵袭;女子因为胞络气虚,被风毒邪气搏结。所以胞络归属于肾,肾主宰腰脚。另外肝、脾、肾三脏的经络起始于足十趾。如果脏腑虚损,风邪先客居于脚部,从下向上扰动气机,所以称为香港脚。这都是由于体质虚弱或当风取凉,久坐卑湿之地,或产后劳损,或恼怒伤肝,心气郁滞,导致月经不通。因为虚损受伤,风毒搏结于肌肉骨骼,就会导致皮肤麻木不仁,筋骨抽痛,五缓(five slacknesses)不能随意运动,六急(six tensions)拘挛。或者立刻感到冷痛,或者立刻肿满,或者两脚麻木软弱,或者全身转筋,头晕眼花心烦,看见食物就呕吐,精神昏沉困倦,肢节烦痛,小便色赤,大便秘结,这些都是证候。妇女香港脚的治疗方法之所以与男子不同,是因为她们有气血不调、怀胎难产、崩漏外伤等差异。所以褚尚书(Chu Shangshu, Minister Chu)治疗寡妇、尼姑与普通妻子的方法有所不同,就是基于这个道理。凡是患有香港脚疾病的妇女,必定没有生育能力,这可以用来验证其特殊性。凡是治疗妇女香港脚,如果有头痛身热、肢节痛、大便秘结,或者呕吐逆乱而脚屈弱无力的,就是香港脚。轻症可以给予香苏散(Xiangsu San, Fragrant Perilla Powder),加入木瓜、槟榔、生姜煎服,然后随证治疗。要知道患有香港脚的人,病邪先从脚部发起,或者缓慢软弱疼痛麻木,或者行走时突然跌倒,或者两小腿肿满,或者脚膝肿胀发热,或者心中悸动不安,或者小腹麻木不知痛痒,或者全身转筋,或者看见食物呕吐逆乱,厌恶闻食物的气味,或者胸满气急,或者遍体酸痛,都是香港脚的征候。这就是黄帝所说的“缓风湿痹”(slow wind-damp bi-syndrome)。皮肤麻木软弱称为缓风,疼痛称为湿痹。寒邪侵入三阳经,所患疾病必定寒冷,用小续命汤主治;暑邪侵入三阴经,所患疾病必定发热,用小续命汤去掉附子,减少一半桂枝主治。大烦躁者,紫雪(Zixue, Purple Snow)最为良效。
大腹皮散(Dafupi San, Betel Nut Peel Powder):治疗妇人风毒香港脚,肢节烦疼,心神壅闷。
大腹皮(Dafupi, Arecae Pericarpium)、紫苏(Zisu, Perillae Folium)、木通(Mutong, Akebiae Caulis)、桑白皮(Sangbaipi, Mori Cortex)、羌活(Qianghuo, Notopterygii Rhizoma et Radix)、荆芥(Jingjie, Schizonepetae Spica)、赤芍药(Chishaoyao, Paeoniae Radix Rubra)、青皮(Qingpi, Citri Reticulatae Pericarpium)、木瓜(Mugua, Chaenomelis Fructus)、独活(Duhuo, Angelicae Pubescentis Radix)各五分;枳壳(Zhiqiao, Aurantii Fructus)一钱。
以上药物切碎,加水一盏半,生姜五片、葱七寸,煎至七分,空腹服用。
牛膝散(Niuxi San, Cyathula Powder):治疗香港脚浮肿,心神烦闷,月经不通。
川牛膝(Chuanniuxi, Cyathulae Radix)、羚羊角(Lingyangjiao, Saiga Tataricae Cornu)、槟榔(Binglang, Arecae Semen)、大黄(Dahuang, Rheum Palmati Radix et Rhizoma 炒)、芒硝(Mangxiao, Natrii Sulfas)各一钱;防己(Fangji, Stephaniae Tetrandrae Radix)、桂心(Guixin, Cinnamomi Cortex)、牡丹皮(Mudanpi, Moutan Cortex)、赤芍药(Chishaoyao, Paeoniae Radix Rubra)、甘草(Gancao, Glycyrrhizae Radix et Rhizoma)各三分;桃仁(Taoren, Persicae Semen)五大枚。
以上药物切碎,加水一盏半,煎至七分温服。以排出恶物为度,根据患者强弱酌情使用。
木香散(Muxiang San, Aucklandia Powder):治疗妇人香港脚突然发作,冲心闷乱。
木香(Muxiang, Aucklandiae Radix 五分,磨汁)、郁李仁(Yuliren, Prunus japonica Seed)、赤芍药(Chishaoyao, Paeoniae Radix Rubra)、大腹皮(Dafupi, Arecae Pericarpium)、紫雪(Zixue, Purple Snow)各一钱;桑白皮(Sangbaipi, Mori Cortex)、桂心(Guixin, Cinnamomi Cortex)、槟榔(Binglang, Arecae Semen)、茯苓(Fuling, Poria)各三分。
以上药物切碎,加水一盏半,生姜三片,煎至七分,温服。
木瓜煎(Mugua Jian, Chaenomeles Decoction):治疗妇人香港脚冲心,闷乱不知人事。
木瓜(Mugua, Chaenomelis Fructus)、松节(Songjie, Pinus Node)各一钱;吴茱萸(Wuzhuyu, Evodiae Fructus)、槟榔(Binglang, Arecae Semen)、紫苏(Zisu, Perillae Folium)各钱半;陈皮(Chenpi, Citri Reticulatae Pericarpium)三分。
加水一盏半,童子尿三合,煎至八分温服。
紫苏散(Zisu San, Perilla Powder):治疗妇人风毒香港脚,腹内壅塞,不思饮食,虚肿脚重。
紫苏(Zisu, Perillae Folium)、木通(Mutong, Akebiae Caulis)、桑白皮(Sangbaipi, Mori Cortex)、茴香根(Huixianggen, Foeniculi Radix)各一钱;枳壳(Zhiqiao, Aurantii Fructus)、羌活(Qianghuo, Notopterygii Rhizoma et Radix)、独活(Duhuo, Angelicae Pubescentis Radix)、荆芥穗(Jingjisui, Schizonepetae Spica)、木瓜(Mugua, Chaenomelis Fructus)、青皮(Qingpi, Citri Reticulatae Pericarpium)、甘草(Gancao, Glycyrrhizae Radix et Rhizoma)各五分;大腹子(Dafuzi, Arecae Semen)一个。
以上药物切碎,每次用水一盏半,生姜二片、葱白一茎,煎至七分,温服。
The Kidney meridian of Foot-Shaoyin is connected to the Bao Luo (uterine collateral). The Kidney governs the waist. If Kidney Qi is deficient, external invasion by the Six Excesses (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) and internal injury by the Seven Emotions will all lead to lower back pain. Ancient prescriptions also propose a classification into five types. For example, Wind-induced lower back pain is suitable for Xiao Xuming Tang (Minor Continuation Life Decoction) added with Taoren (Persicae Semen) and Duzhong (Eucommiae Cortex); Pi Wei Qi obstruction and Cold-Damp induced lower back pain can be treated with Wuji San (Five Accumulations Powder) added with Taoren; for deficiency injuries and the five types of lower back pain, Qing'e Wan (Blue Young Pill) and Shenyin Wan (Divine Response Pill) are both applicable; for Qi stagnation induced lower back pain, Shenbao Wan (Divine Protection Pill) added with Heiqiu (Cassiae Semen), Huixiang (Foeniculi Fructus), and Juhe (Aurantii Fructus Pericarpium) yields miraculous effects.
(General Formula) Rushen Tang: Treats blood stasis-induced lower back pain in men and women.
Danggui (Angelicae Sinensis Radix), Yanhusuo (Corydalisis Rhizoma), Guixin (Cinnamomi Cortex) in equal parts.
Grind the above into powder, take two qian mixed with warm wine. In severe cases, a few doses suffice.
Duhuo Jisheng Tang (Notopterygium and Sangjisheng Decoction): Treats lower back pain due to Kidney deficiency, caused by lying on cold/damp ground or exposure to wind. If not treated promptly, the pathogen may flow into the legs and knees, resulting in hemiplegia with cold Bi-syndrome. If accompanied by spasmodic lower back pain and heavy, numb feet, it should be taken immediately. (See the Lower Back Pain section for the formula.)
Shujin Tang (Relax Tendons Decoction): Highly effective for lower back pain, and also good for sprains and strains.
Xuanhushuo (Corydalisis Rhizoma), Duzhong (Eucommiae Cortex), Guan Gui (Cinnamomi Ramulus), Qianghuo (Notopterygii Rhizoma et Radix), Chishaoyao (Paeoniae Radix Rubra) in equal parts.
Grind into powder, take mixed with wine.
Gusuibu San (Drynaria Powder): Treats women suffering from Blood-Wind attacking the body, causing pain in the lower back and legs, spasm in the abdomen and hypochondrium, and stiffness in the joints.
Gusuibu (Drynariae Rhizoma, stir-fried), Bixie (Dioscoreae Hypoglaucae Rhizoma), Chuanniuxi (Cyathulae Radix), Taoren (Persicae Semen), Haitongpi (Sapindus Cortex), Danggui (Angelicae Sinensis Radix), Guixin (Cinnamomi Cortex), Binglang (Arecae Semen) each 1 liang; Chishaoyao (Paeoniae Radix Rubra), Fuzi (Aconiti Lateralis Radix Praeparata), Chuanxiong (Chuanxiong Rhizoma) each 3 fen; Zhiqiao (Aurantii Fructus) 0.5 liang.
Coarsely crush the above. Take 3 qian per dose with one cup of water, three slices of ginger, and one jujube. Decoct to 70% volume, and take hot before meals.
Women's Hongxiangjiao (a traditional term for gout or beriberi-like symptoms in the lower limbs) differs from that in men. In men, it is caused by Kidney deficiency allowing Wind-Damp to invade; in women, it is caused by Bao Luo Qi deficiency allowing Wind-Toxin to bind. Since the Bao Luo belongs to the Kidney, and the Kidney governs the waist and legs, and the meridians of the Liver, Spleen, and Kidney originate at the ten toes, when the Zang-Fu organs are deficient, Wind pathogen first lodges in the feet, moving upward affecting Qi, hence the name Hongxiangjiao. This results from physical weakness, exposure to wind while cooling off, prolonged sitting in damp places, postpartum overexertion, or anger injuring the Liver and stagnating Heart Qi, leading to amenorrhea. Due to this deficiency and injury, Wind-Toxin binds to muscles and bones, causing skin anesthesia, muscle and bone cramping, "Five Slacknesses" (wu huan - inability to move freely), and "Six Tensions" (liu ji - spasms). Symptoms may include sudden cold pain, swelling, numbness and weakness in both legs, generalized tetany, dizziness, irritability, nausea upon seeing food, mental confusion, joint pain, dark urine, and constipation. The treatment for women's Hongxiangjiao differs from men's due to differences in Qi and Blood regulation, pregnancy difficulties, and metrorrhagia or trauma. Thus, Minister Chu's treatments for widows, nuns, and ordinary wives differ, illustrating this principle. Any woman suffering from Hongxiangjiao is likely infertile, which serves as a diagnostic indicator. When treating women's Hongxiangjiao, if there is headache, fever, joint pain, constipation, or vomiting with weak, flexed feet, it is Hongxiangjiao. Mild cases can be treated with Xiangsu San (Fragrant Perilla Powder) added with Mugua (Chaenomelis Fructus), Binglang (Arecae Semen), and ginger, decocted and taken. Then treat according to specific symptoms. It is important to know that Hongxiangjiao always starts in the feet: it may present as slow weakness and painful numbness, sudden collapse while walking, swelling of both calves, swollen and hot ankles/knees, palpitations, anesthesia of the lower abdomen, generalized tetany, vomiting upon seeing food, aversion to food odors, chest fullness and shortness of breath, or generalized soreness. These are all signs of Hongxiangjiao. As stated by the Yellow Emperor, this is "Slow Wind-Damp Bi-syndrome." Skin numbness and weakness are called Slow Wind; pain is called Damp Bi. If Cold invades the Three Yang meridians, the condition will definitely be cold-type, treated primarily with Xiao Xuming Tang. If Summer-heat invades the Three Yin meridians, the condition will definitely be heat-type, treated primarily with Xiao Xuming Tang minus Fuzi and with half the dosage of Gui. For severe restlessness, Zixue (Purple Snow) is most effective.
Dafupi San (Betel Nut Peel Powder): Treats women's Wind-Toxin Hongxiangjiao, causing joint pain and mental oppression.
Dafupi (Arecae Pericarpium), Zisu (Perillae Folium), Mutong (Akebiae Caulis), Sangbaipi (Mori Cortex), Qianghuo (Notopterygii Rhizoma et Radix), Jingjie (Schizonepetae Spica), Chishaoyao (Paeoniae Radix Rubra), Qingpi (Citri Reticulatae Pericarpium), Mugua (Chaenomelis Fructus), Duhuo (Angelicae Pubescentis Radix) each 5 fen; Zhiqiao (Aurantii Fructus) 1 qian.
Cut into pieces. Decoct with 1.5 cups of water, five slices of ginger, and seven cun of scallion until 70% remains. Take on an empty stomach.
Niuxi San (Cyathula Powder): Treats Hongxiangjiao edema, mental restlessness, and amenorrhea.
Chuanniuxi (Cyathulae Radix), Lingyangjiao (Saiga Tataricae Cornu), Binglang (Arecae Semen), Dahuang (Rheum Palmati Radix et Rhizoma, stir-fried), Mangxiao (Natrii Sulfas) each 1 qian; Fangji (Stephaniae Tetrandrae Radix), Guixin (Cinnamomi Cortex), Mudanpi (Moutan Cortex), Chishaoyao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix et Rhizoma) each 3 fen; Taoren (Persicae Semen) five large kernels.
Cut into pieces. Decoct with 1.5 cups of water until 70% remains. Take warm. Continue until foul matter is discharged, adjusting based on the patient's strength.
Muxiang San (Aucklandia Powder): Treats sudden onset of women's Hongxiangjiao rushing to the heart, causing mental chaos.
Muxiang (Aucklandiae Radix, 5 fen, prepared as juice), Yuliren (Prunus japonica Seed), Chishaoyao (Paeoniae Radix Rubra), Dafupi (Arecae Pericarpium), Zixue (Purple Snow) each 1 qian; Sangbaipi (Mori Cortex), Guixin (Cinnamomi Cortex), Binglang (Arecae Semen), Fuling (Poria) each 3 fen.
Cut into pieces. Decoct with 1.5 cups of water and three slices of ginger until 70% remains. Take warm.
Mugua Jian (Chaenomeles Decoction): Treats women's Hongxiangjiao rushing to the heart, causing unconsciousness and chaos.
Mugua (Chaenomelis Fructus), Songjie (Pinus Node) each 1 qian; Wuzhuyu (Evodiae Fructus), Binglang (Arecae Semen), Zisu (Perillae Folium) each 1.5 qian; Chenpi (Citri Reticulatae Pericarpium) 3 fen.
Decoct with 1.5 cups of water and 3 he of child's urine until 80% remains. Take warm.
Zisu San (Perilla Powder): Treats women's Wind-Toxin Hongxiangjiao, causing abdominal blockage, loss of appetite, and puffy, heavy legs.
Zisu (Perillae Folium), Mutong (Akebiae Caulis), Sangbaipi (Mori Cortex), Huixianggen (Foeniculi Radix) each 1 qian; Zhiqiao (Aurantii Fructus), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Jingjisui (Schizonepetae Spica), Mugua (Chaenomelis Fructus), Qingpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma) each 5 fen; Dafuzi (Arecae Semen) one piece.
Cut into pieces. Take 1.5 cups of water per dose, add two slices of ginger and one stalk of white scallion. Decoct until 70% remains. Take warm.