论曰水饮停积胸膈,不能消化,支乘于心,故名支饮,其状令人心下筑悸,咳逆喘息,
饮食不下,身体虚浮,形如肿是也。
治支饮不消。胸膈满闷,参苓丸方
人参 天南星(炮) 赤茯苓(去黑皮各三分) 半夏 生姜 晋矾(各一两)
上六味,先取天南星半夏,于砂盆内,擦洗令净,用生姜同捣烂,拍作饼子,慢火炙令
黄,同余三味,捣罗为末,薄荷汁煮面糊为丸,如梧桐子大,食后生姜蜜汤下二十丸。
治支饮,膈脘不利,咳嗽喘满。大半夏丸方
半夏(四两汤洗七遍去滑焙干为末) 生姜(细擦) 蜜(各三两) 青州枣(二两别
煮取肉去皮核同生姜蜜入银石器内与半夏末和熬令稀稠得所) 木香 沉香 青橘皮(汤浸
去白焙) 白术 陈橘皮(汤浸去白焙) 干姜(炮) 附子(炮裂去皮脐) 肉豆蔻(去
壳) 红豆蔻(各半两)
上一十三味,除前四味外,捣罗为末,与半夏膏和匀,丸如梧桐子大,每服十丸,空心
煎干姜枣汤下,加至十五丸。
治支饮痞满,饮食迟化。化气丸方
巴豆(五十枚去皮心膜出油研如粉) 黄连(去须半两) 白面(二两半)
上三味,先将黄连捣末,以水半升,煎十余沸,隔一宿,取白面并巴豆粉,用黄连水和
,硬软得所,丸如绿豆大、放干,以麸二升,于铫内,慢火并药丸同炒,麸黄为度,以罗子
筛去麸取药,再于黄连水内,略滤过,竹器内控干,每服三丸,或两丸,食后临卧。熟水下
治支饮不消。喘咳不止,青金丸方
硫黄 水银(各一两同结成砂子研) 滑石(研半两) 半夏(汤洗去滑捣取末半两)
上四味。合研匀,滴水和丸,如梧桐子大,每服二十丸,食后温生姜汤下。
治支饮,气喘不得息。葶苈丸方
甜葶苈(炒) 木香 半夏(汤洗七遍去滑焙各一两)
上三味。捣罗为末,生姜自然汁,煮面糊和丸,如梧桐子大。每服二十丸,生姜汤下,
不拘时候。
治久病饮癖停痰。及胁满支饮。辄引胁下痛。三圣散方
甘遂(锉炒) 芫花(醋浸炒各半两) 大戟(锉炒三分)
上三味、捣罗为散。每先用水三盏,大枣十枚劈破,煎取二盏,入药末一钱匕,同煎至
一盏,温分三服,以吐利为度。
治支饮,胸膈实痞,呼吸短气。旋复花汤方
旋复花 槟榔 柴胡(去苗) 桔梗(炒各一两) 桑根白皮 鳖甲(去裙 醋炙) 大
黄(锉炒各一
上八味。锉如麻豆大。每服五钱匕,水一盏半,煎至八分,去滓温服,不拘时候。
治支饮,胸膈痞闷。饮食迟化。神应丸方
槐花(半升) 巴豆(五十粒和皮椎碎)
上二味。同炒存一分性,捣罗为末,面糊和丸,如绿豆大,每服丸,食后温水下。
治支饮,胸膈痞闷。槟榔丸方
槟榔(锉) 肉豆蔻(各半两去壳秤) 半夏(汤浸七遍去滑焙) 青橘皮(汤浸去白
焙) 干姜(炮各一
上五味。捣罗为末。生姜汁煮面糊。丸如绿豆大,每服五丸,食后生姜汤下。
治支饮。下气,木香丸方
木香(一两) 牵牛子(盐炒黄) 皂荚(不 者去皮酥炙各二两)
上三味,捣罗为末。炼蜜丸如梧桐子大,每服五丸,食后生姜汤下。
论述说:水饮停滞积聚在胸膈部位,无法被消化运化,支撑并影响心脏的功能,因此称为支饮。其症状表现为心下(胃脘部)悸动不安,咳嗽气逆,呼吸急促,饮食难以下咽,身体虚弱浮肿,外形如同水肿一般。
治疗支饮不消。胸膈满闷的参苓丸方:
人参、天南星(炮制)、赤茯苓(去除黑皮,各三分)、半夏、生姜、晋矾(即白矾,各一两)。
以上六味药,先取天南星和半夏,在砂盆中擦洗干净,用生姜一同捣烂,拍成饼状,用慢火烤至黄色,再与其他三味药一起,捣碎过筛成细末,用薄荷汁煮面糊作为粘合剂制成丸药,大小如梧桐子。饭后用生姜蜜汤送服二十丸。
治疗支饮,膈脘气机不利,咳嗽气喘胀满的大半夏丸方:
半夏(四两,用汤水洗七遍去滑腻,焙干后研末)、生姜(细擦)、蜂蜜(各三两)、青州枣(二两,另煮取肉,去皮核,同生姜、蜂蜜放入银石器中,与半夏末混合熬制,直至稀稠适度)、木香、沉香、青橘皮(汤浸去白,焙干)、白术、陈橘皮(汤浸去白,焙干)、干姜(炮制)、附子(炮裂,去皮脐)、肉豆蔻(去壳)、红豆蔻(各半两)。
以上十三味药,除前四味外,其余捣碎过筛成细末,与前四味制成的半夏膏混合均匀,制成如梧桐子大小的丸药。每次服用十丸,空腹时用干姜枣汤煎服,可加量至十五丸。
治疗支饮痞满,饮食消化迟缓的化气丸方:
巴豆(五十枚,去皮心膜,出油后研如粉)、黄连(去须,半两)、白面(二两半)。
以上三味药,先将黄连捣成末,用水半升,煎煮十余沸,放置过夜。次日取出白面和巴豆粉,用黄连水调和,软硬适度,制成如绿豆大小的丸药,晾干。用麦麸二升,在铫子内,用慢火与药丸同炒,待麦麸变黄为度,用罗筛去掉麦麸取药,再放入黄连水中略滤过,在竹器中控干。每次服用三丸或两丸,饭后临睡前用熟水送服。
治疗支饮不消。喘咳不止的青金丸方:
硫黄、水银(各一两,同结成砂子后研磨)、滑石(研,半两)、半夏(汤洗去滑,捣取末,半两)。
以上四味药,混合研磨均匀,滴水泛丸,大小如梧桐子。每次服用二十丸,饭后用温生姜汤送服。
治疗支饮,气喘不能平卧的葶苈丸方:
甜葶苈(炒)、木香、半夏(汤洗七遍去滑,焙干,各一两)。
以上三味药,捣碎过筛成细末,用生姜自然汁煮面糊和丸,大小如梧桐子。每次服用二十丸,生姜汤送服,不限时候。
治疗久病饮癖停痰。以及胁满支饮。常常牵引胁下疼痛的三圣散方:
甘遂(锉碎炒制)、芫花(醋浸炒,各半两)、大戟(锉碎炒制,三分)。
以上三味药,捣碎过筛成散剂。每次先用水三盏,大枣十枚劈破,煎取二盏药液,加入药末一钱匕,同煎至一盏,温服,分三次服用,以出现呕吐或腹泻为度。
治疗支饮,胸膈实痞,呼吸短气的旋复花汤方:
旋复花、槟榔、柴胡(去苗)、桔梗(炒,各一两)、桑根白皮、鳖甲(去裙边,醋炙)、大黄(锉碎炒,各一两)。
以上八味药,锉如麻豆大小。每次服用五钱匕,加水一盏半,煎至八分,去渣温服,不限时候。
治疗支饮,胸膈痞闷。饮食消化迟缓的神应丸方:
槐花(半升)、巴豆(五十粒,带皮椎碎)。
以上二味药,同炒至保留一分药性,捣碎过筛成细末,用面糊和丸,大小如绿豆。每次服用若干丸(原文缺具体数字,通常依古法推测为适量,此处依原文留白或默认为常规剂量),饭后用温水送服。
治疗支饮,胸膈痞闷的槟榔丸方:
槟榔(锉碎)、肉豆蔻(各半两,去壳称重)、半夏(汤浸七遍去滑,焙干)、青橘皮(汤浸去白,焙干)、干姜(炮制,各一两)。
以上五味药,捣碎过筛成细末。用生姜汁煮面糊和丸,大小如绿豆。每次服用五丸,饭后用生姜汤送服。
治疗支饮。下气的木香丸方:
木香(一两)、牵牛子(盐炒黄)、皂荚(不蛀者,去皮酥炙,各二两)。
以上三味药,捣碎过筛成细末。炼蜜和丸,大小如梧桐子。每次服用五丸,饭后用生姜汤送服。
Discussion: When water-fluids stagnate and accumulate in the chest and diaphragm, failing to be digested and transformed, they branch out and affect the Heart, hence named "Zhi Yin" (Branching Fluid Retention). Its manifestations include palpitations beneath the heart (epigastric region), cough with reverse flow of Qi, panting, inability to swallow food, weak and flaccid body edema, resembling swelling.
Formula for treating Zhi Yin not resolving, with fullness and oppression in the chest and diaphragm: Shen Ling Wan (Ginseng and Poria Pill)
Ren Shen (Radix Ginseng), Tian Nan Xing (Rhizoma Arisaematis Preparatum), Chi Fu Ling (Poria Cocos with Red Skin, black skin removed, each 3 fen), Ban Xia (Rhizoma Pinelliae), Sheng Jiang (Rhizoma Zingiberis Recens), Jin Fan (Alumen).
The above six herbs are processed as follows: First, take Tian Nan Xing and Ban Xia, wash them clean in a mortar, pound them together with Sheng Jiang until mushy, shape into cakes, and slow-roast until yellow. Then, combine with the remaining three herbs, pound and sieve into fine powder. Use Bo He juice (Menthae Haplocalycis Herba juice) to cook wheat paste as a binder to form pills the size of Sophora seeds. Take 20 pills after meals with warm honey water infused with ginger.
Formula for treating Zhi Yin, with dysfunction in the diaphragm and epigastrium, cough, panting, and distension: Da Ban Xia Wan (Major Pinellia Pill)
Ban Xia (4 liang, washed seven times with hot water to remove slipperiness, dried by baking and powdered), Sheng Jiang (finely grated), Mi (Honey, each 3 liang), Qing Zhou Zao (Jujubae Fructus from Qingzhou, 2 liang, boiled separately to extract flesh, skin and pits removed, then combined with Sheng Jiang and Mi in a silver or ceramic vessel and cooked with Ban Xia powder until proper consistency), Mu Xiang (Aucklandiae Radix), Chen Xiang (Aquilariae Lignum Resinatum), Qing Ju Pi (Citri Reticulatae Pericarpium Viride, soaked in water, white pith removed, dried), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chen Ju Pi (Citri Reticulatae Pericarpium, soaked in water, white pith removed, dried), Gan Jiang (Zingiberis Rhizoma Preparatum), Fu Zi (Aconiti Lateralis Radix Preparatum, cracked, skin and navel removed), Rou Dou Kou (Myristicae Semen), Hong Dou Kou (Galangal Seed, each 0.5 liang).
Of the thirteen herbs above, except for the first four, pound and sieve the rest into fine powder. Mix evenly with the Ban Xia paste prepared from the first four ingredients. Form pills the size of Sophora seeds. Take 10 pills per dose, fasting, decocted with Gan Jiang and Zao (Jujubae Fructus) water. The dose may be increased to 15 pills.
Formula for treating Zhi Yin with epigastric fullness and delayed digestion of food: Hua Qi Wan (Transforming Qi Pill)
Ba Dou (Crotonis Fructus, 50 seeds, skin and hearts removed, oil expressed, ground to powder), Huang Lian (Coptidis Rhizoma, mustache removed, 0.5 liang), Bai Mian (Tritici Vulgaris Farina, 2.5 liang).
Process the three herbs as follows: First, grind Huang Lian into powder. Add half sheng of water, boil for more than ten boils, and let stand overnight. The next day, take the Bai Mian and Ba Dou powder, mix with the Huang Lian water to achieve proper hardness and softness. Form pills the size of mung beans and dry them. Stir-fry the pills with two sheng of bran in a pot over low heat until the bran turns yellow. Sieve to remove the bran. Briefly filter the pills through the Huang Lian water again, and drain in a bamboo vessel. Take 2 or 3 pills per dose, after meals and before bed, with cooked (cooled boiled) water.
Formula for treating Zhi Yin not resolving, with incessant panting and coughing: Qing Jin Wan (Blue Gold Pill)
Liu Huang (Sulfur), Shui Yin (Hydrargyrum, each 1 liang, combined to form cinnabar-like grains and ground), Hua Shi (Talcum, ground, 0.5 liang), Ban Xia (washed with water to remove slipperiness, pounded to obtain powder, 0.5 liang).
Mix the four herbs thoroughly and grind. Add drops of water to form pills the size of Sophora seeds. Take 20 pills per dose, after meals, with warm ginger-infused water.
Formula for treating Zhi Yin, with panting and inability to breathe smoothly: Ting Li Wan (Descurainiae/Sinapis Seed Pill)
Tian Ting Li (Descurainiae Fructus or Sinapis Semen, stir-baked), Mu Xiang (Aucklandiae Radix), Ban Xia (washed with water seven times to remove slipperiness, dried by baking, each 1 liang).
Pound and sieve the three herbs into fine powder. Use natural juice of Sheng Jiang to cook wheat paste and bind into pills the size of Sophora seeds. Take 20 pills per dose with ginger-infused water, at any time.
Formula for treating long-standing fluid retention and phlegm stasis, Zhi Yin with hypochondriac fullness, often drawing pain to the hypochondrium: San Sheng San (Three Sages Powder)
Gan Sui (Euphorbiae Pekinensis Radix, chopped and stir-fried), Yuan Hua (Genkwa Flos, vinegar-soaked and stir-fried, each 0.5 liang), Da Ji (Euphorbiae Humifusae Radix or Euphorbiae Lathyridis Semen, chopped and stir-fried, 3 fen).
Pound and sieve the three herbs into powder. For each dose, first decoct ten split Da Zao (Jujubae Fructus) in three zhan of water to reduce to two zhan. Add one qian bi of the herb powder, decoct together until reduced to one zhan. Take warm, divided into three doses. Stop when vomiting or diarrhea occurs.
Formula for treating Zhi Yin, with solid fullness in the chest and diaphragm, shortness of breath: Xuan Fu Hua Tang (Inula Flower Decoction)
Xuan Fu Hua (Inulae Flos), Bing Lang (Arecae Semen), Chai Hu (Bupleuri Radix, radix removed), Jie Geng (Platycodonis Radix, stir-fried, each 1 liang), Sang Gen Bai Pi (Mori Cortex), Bie Jia (Testudinis et Carapax et Plastrum, skirt removed, vinegar-roasted), Da Huang (Rhei Radix et Rhizoma, chopped and stir-fried, each 1 liang).
Chop the eight herbs into sizes similar to hemp seeds. Take five qian bi per dose, add one and a half zhan of water, decoct to eight parts, strain, and take warm. At any time.
Formula for treating Zhi Yin, with chest and diaphragm oppression, delayed digestion of food: Shen Ying Wan (Divine Response Pill)
Huai Hua (Sophorae Flos, half sheng), Ba Dou (Crotonis Fructus, 50 grains, crushed with skin).
Stir-fry the two herbs together until preserving one-tenth of their original potency. Pound and sieve into fine powder. Bind with wheat paste to form pills the size of mung beans. Take an appropriate number of pills after meals with warm water.
Formula for treating Zhi Yin, with chest and diaphragm oppression: Bing Lang Wan (Areca Seed Pill)
Bing Lang (Arecae Semen, chopped), Rou Dou Kou (Myristicae Semen, each 0.5 liang, shell removed and weighed), Ban Xia (soaked in water seven times, washed to remove slipperiness, dried by baking), Qing Ju Pi (Citri Reticulatae Pericarpium Viride, soaked in water, white pith removed, dried), Gan Jiang (Zingiberis Rhizoma Preparatum, each 1 liang).
Pound and sieve the five herbs into fine powder. Use ginger juice to cook wheat paste and bind into pills the size of mung beans. Take five pills per dose, after meals, with ginger-infused water.
Formula for treating Zhi Yin, to direct Qi downward: Mu Xiang Wan (Aucklandia Pill)
Mu Xiang (Aucklandiae Radix, 1 liang), Qian Niu Zi (Pharbitidis Semen, salt-stir-fried until yellow), Zao Jiao (Gleditsiae Sinensis Fructus, non-bitten ones, skin removed, roasted with酥 [lard/fat], each 2 liang).
Pound and sieve the three herbs into fine powder. Bind with refined honey to form pills the size of Sophora seeds. Take five pills per dose, after meals, with ginger-infused water.