论曰肾气不化,则二阴不通,故小便不利,胃气不足,则肌肉开疏,故皮肤浮肿,脾者
土也,脾虚既不能制水,肾者胃之关也,关闭不利,是以水气流溢于皮肤为 肿也。
治虚劳四肢发肿,饮食不进,百节无力,多卧少起,人参汤方
人参 赤茯苓(去黑皮) 桑根白皮(锉炒) 芍药 秦艽(去苗土) 半夏(汤洗去
滑七遍
三棱(醋浸炮
上一十三味,粗捣筛,每服三钱匕,水一盏,入生姜三片,枣二枚,同煎至五分,去滓
温服,不拘时候。
治虚劳四肢浮肿气急,大小便不利,坐卧不安,五味子汤方
五味子(炒) 黄 (锉) 枳壳(去瓤麸炒) 大腹皮(微煨锉) 桑根白皮(炙锉)
白术 桂(去粗皮) 槟榔(煨) 陈橘皮(汤浸去白炒各一两) 浓朴(去粗皮生姜汁炙
熟) 防己(各一两半)
上一十一味,粗捣筛,每服三钱匕,水一盏半,煎至七分,去滓空心温服,日晚再服,
微利即止。
治虚劳脾肾不足,身面浮肿,卧即胀满,喘急痰嗽,胸膈痞闷,大小便不利,渐成水气,
防己丸方
防己(二两半) 杏仁(去皮尖双仁麸炒三分) 苦葶苈(炒香三两一分) 陈橘皮(汤
浸去
上七味,捣罗为末,炼蜜和丸,如梧桐子大,空心食前,温酒下三十丸。
治虚劳身体浮肿,上气喘促,小便不利,大腹皮汤方
大腹皮(锉) 槟榔(煨锉) 前胡(去芦头) 赤茯苓(去黑皮) 防己 陈橘皮(汤
浸去白
上一十味,粗捣筛,每服三钱匕,水一盏,煎至五分,去滓温服、日二。
治虚劳遍身浮肿,心腹气胀,大小便涩,赤茯苓汤方
赤茯苓(去黑皮) 防己 槟榔(煨锉) 甜葶苈(隔纸炒令紫色) 桑根白皮(锉) 木
通(
上八味,粗捣筛,每服三钱匕,水一盏半,煎至七分,去滓食前温服,以大小便利为度
治虚劳香港脚,脐腹及面目浮肿,人参饮方
人参(一两) 鳖甲(醋浸去裙 炙黄二两) 柴胡(去苗) 当归(切焙) 枳壳(去
瓤麸炒)
上八味,粗捣筛,每服三钱匕,童子小便一盏,浸一宿,平旦煎至七分,去滓空心温服,
若女人病,加牛膝一两。
治虚劳脾肾气弱,水液妄行,四肢浮肿,小便不利,桑白皮汤方
桑根白皮(炙锉) 猪苓(去黑皮) 滑石(碎) 木通(锉) 郁李仁(汤浸去皮尖
炒) 赤茯
(三分)
上九味,粗捣筛,每服五钱匕,水一盏半,煎至一盏,去滓温服。
论述说:肾气不能气化,则前后二阴不通畅,所以小便不利;胃气不足,则肌肉腠理疏松,所以皮肤浮肿。脾属土,脾虚既不能制约水湿;肾是胃的关隘,关门开合不利,因此水气流溢于皮肤而形成水肿。
治疗虚劳导致四肢发肿,饮食不进,全身关节无力,嗜睡少起,人参汤方:
人参、赤茯苓(去掉黑色外皮)、桑根白皮(切碎炒制)、芍药、秦艽(去掉苗和泥土)、半夏(用热水洗去滑腻七遍)、三棱(醋浸后炮制)。
以上十三味药,粗捣筛碎,每次服用三钱匕,加水一盏,放入生姜三片、大枣两枚,共同煎煮至剩余五分液量,滤去药渣,温服,不限定具体时间。
治疗虚劳导致四肢浮肿、气急,大小便不利,坐卧不安,五味子汤方:
五味子(炒制)、黄芪(切碎)、枳壳(去掉瓤麸炒)、大腹皮(微火煨后切碎)、桑根白皮(炙后切碎)、白术、桂枝(去掉粗皮)、槟榔(煨制)、陈橘皮(热水浸泡去掉白色内层炒制,各一两)、厚朴(去掉粗皮用生姜汁炙熟)、防己(各一两半)。
以上十一味药,粗捣筛碎,每次服用三钱匕,加水一盏半,煎煮至剩余七分液量,滤去药渣,空腹时温服,傍晚再服一次,若有轻微腹泻即停止服药。
治疗虚劳脾肾不足,身体面部浮肿,躺下即感胀满,喘急痰嗽,胸膈痞闷,大小便不利,逐渐形成水气病,防己丸方:
防己(二两半)、杏仁(去皮尖双仁麸炒三分)、苦葶苈(炒香三两一分)、陈橘皮(热水浸泡去掉白色内层……[原文此处有缺漏])。
以上七味药,捣碎过罗成粉末,炼蜜调和做成丸药,如梧桐子大小,空腹饭前,用温酒送服三十丸。
治疗虚劳身体浮肿,上气喘促,小便不利,大腹皮汤方:
大腹皮(切碎)、槟榔(煨后切碎)、前胡(去掉芦头)、赤茯苓(去掉黑色外皮)、防己、陈橘皮(热水浸泡去掉白色内层……[原文此处有缺漏])。
以上十味药,粗捣筛碎,每次服用三钱匕,加水一盏,煎煮至剩余五分液量,滤去药渣温服,每日两次。
治疗虚劳遍身浮肿,心腹部气胀,大小便涩滞,赤茯苓汤方:
赤茯苓(去掉黑色外皮)、防己、槟榔(煨后切碎)、甜葶苈(隔纸炒至紫色)、桑根白皮(切碎)、木通(……[原文此处有缺漏])。
以上八味药,粗捣筛碎,每次服用三钱匕,加水一盏半,煎煮至剩余七分液量,滤去药渣饭前温服,以大小便利为度。
治疗虚劳香港脚(脚气病),脐腹部及面目浮肿,人参饮方:
人参(一两)、鳖甲(醋浸去掉裙边炙黄二两)、柴胡(去掉苗)、当归(切片焙干)、枳壳(去掉瓤麸炒)……[原文此处有缺漏]。
以上八味药,粗捣筛碎,每次服用三钱匕,用童子小便一盏,浸泡一夜,清晨煎煮至剩余七分液量,滤去药渣空腹温服。如果是女性患病,加牛膝一两。
治疗虚劳脾肾气弱,水液妄行,四肢浮肿,小便不利,桑白皮汤方:
桑根白皮(炙后切碎)、猪苓(去掉黑色外皮)、滑石(打碎)、木通(切碎)、郁李仁(热水浸泡去皮尖炒制)、赤茯苓(……[原文此处有缺漏])。
以上九味药,粗捣筛碎,每次服用五钱匕,加水一盏半,煎煮至剩余一盏液量,滤去药渣温服。
Discussion: When the Qi of the Kidney fails to transform, the two yin orifices (anterior and posterior) become obstructed, resulting in difficult urination. When the Qi of the Stomach is insufficient, the muscle tissue becomes loose and porous, leading to edema of the skin. The Spleen belongs to Earth; when the Spleen is deficient, it cannot control water dampness. The Kidney serves as the gate of the Stomach; if the opening and closing of this gate are impaired, water qi overflows into the skin, causing swelling.
For treating deficiency-wasting (Xu Lao) with swelling of the four limbs, poor appetite, weakness in all joints, excessive sleeping with little rising, use Ginseng Decoction (Renshen Tang):
Ren Shen (Ginseng Radix), Chi Fu Ling (Red Poria with Cortex), Sang Gen Bai Pi (Morus Alba Root Bark, chopped and stir-fried), Shao Yao (Paeonia Lactiflora Radix), Qin Jiao (Gentiana Macrophylla Radix, removed seedlings and soil), Ban Xia (Pinellia Tuber, washed seven times in hot water to remove slipperiness), San Leng (Curcuma Zedoaria Rhizome, soaked in vinegar and processed).
The above thirteen ingredients are coarsely crushed and sifted. Each dose consists of three qian bi (approx. 9g), boiled with one sheng (approx. 200ml) of water, adding three slices of Sheng Jiang (Fresh Ginger) and two dates. Simmer until five fen (approx. 100ml) remains, strain, and take warm at any time.
For treating deficiency-wasting with edema of the four limbs, shortness of breath, difficulty in urination and defecation, and restlessness in sitting or lying, use Schisandra Decoction (Wuweizi Tang):
Wu Wei Zi (Schisandra Fruit, stir-fried), Huang Qi (Astragalus Root, chopped), Zhi Ke (Bitter Orange Pericarp, pulp removed and bran-stir-fried), Da Fu Pi (Areca Peel, lightly roasted and chopped), Sang Gen Bai Pi (Morus Alba Root Bark, roasted and chopped), Bai Zhu (Atractylodes Macrocephala Rhizome), Gui Zhi (Cinnamon Twig, coarse bark removed), Bing Lang (Areca Seed, roasted), Chen Ju Pi (Tangerine Peel, soaked in hot water, white pith removed and stir-fried, each 1 liang), Hou Po (Magnolia Bark, coarse bark removed, roasted with ginger juice until cooked), Fang Ji (Stephania Tetrandra Root, each 1.5 liang).
The above eleven ingredients are coarsely crushed and sifted. Each dose consists of three qian bi, boiled with one and a half sheng of water until seven fen remains. Strain and take warm on an empty stomach, and again in the evening. Stop if mild diarrhea occurs.
For treating deficiency-wasting due to Spleen and Kidney insufficiency, with whole-body and facial edema, abdominal distension upon lying down, panting, phlegm-cough, chest and diaphragm stuffiness, difficulty in urination and defecation, gradually developing into water qi disease, use Stephania Pill (Fang Ji Wan):
Fang Ji (Stephania Tetrandra Root, 2.5 liang), Xing Ren (Apricot Seed, skin and pointed ends removed, double-kernel bran-stir-fried, 3 fen), Ku Ting Li (Descurainia Seed, roasted until fragrant, 3 liang 1 fen), Chen Ju Pi (Tangerine Peel, soaked in hot water, white pith removed... [text missing]).
The above seven ingredients are pounded and sieved into powder. Mix with refined honey to form pills the size of Sophora seeds. Take thirty pills with warm wine before meals on an empty stomach.
For treating deficiency-wasting with whole-body edema, upper body panting, and difficult urination, use Areca Peel Decoction (Da Fu Pi Tang):
Da Fu Pi (Areca Peel, chopped), Bing Lang (Areca Seed, roasted and chopped), Qian Hu (Peucedanum Root, rhizome removed), Chi Fu Ling (Red Poria with Cortex, black skin removed), Fang Ji (Stephania Tetrandra Root), Chen Ju Pi (Tangerine Peel, soaked in hot water, white pith removed... [text missing]).
The above ten ingredients are coarsely crushed and sifted. Each dose consists of three qian bi, boiled with one sheng of water until five fen remains. Strain and take warm, twice daily.
For treating deficiency-wasting with generalized edema, abdominal qi distension, and sluggish urination and defecation, use Red Poria Decoction (Chi Fu Ling Tang):
Chi Fu Ling (Red Poria with Cortex, black skin removed), Fang Ji (Stephania Tetrandra Root), Bing Lang (Areca Seed, roasted and chopped), Tian Ting Li (Descurainia Seed, roasted between papers until purple), Sang Gen Bai Pi (Morus Alba Root Bark, chopped), Mu Tong (Akebia Stem, ... [text missing]).
The above eight ingredients are coarsely crushed and sifted. Each dose consists of three qian bi, boiled with one and a half sheng of water until seven fen remains. Strain and take warm before meals. Discontinue when urination and defecation normalize.
For treating deficiency-wasting with Hong Jiao (Foot Qi/Jamjiao), edema of the umbilical/abdominal region and face, use Ginseng Drink (Renshen Yin):
Ren Shen (Ginseng Radix, 1 liang), Bie Jia (Turtle Shell, soaked in vinegar, skirt removed, roasted yellow, 2 liang), Chai Hu (Bupleurum Root, seedlings removed), Dang Gui (Angelica Sinensis Radix, sliced and baked), Zhi Ke (Bitter Orange Pericarp, pulp removed and bran-stir-fried)... [text missing].
The above eight ingredients are coarsely crushed and sifted. Each dose consists of three qian bi, soaked overnight in one sheng of urine from a young boy. Boil in the morning until seven fen remains, strain, and take warm on an empty stomach. If the patient is female, add Niu Xi (Achyranthes Root, 1 liang).
For treating deficiency-wasting with weak Spleen and Kidney Qi, erratic flow of fluids, edema of the four limbs, and difficult urination, use Mulberry Root Bark Decoction (Sang Bai Pi Tang):
Sang Gen Bai Pi (Morus Alba Root Bark, roasted and chopped), Zhu Ling (Polyporus Umbellatus), Hua Shi (Talcum), Mu Tong (Akebia Stem, chopped), Yu Li Ren (Prunus Japonica Seed, soaked in hot water, skin and pointed ends removed, stir-fried), Chi Fu Ling (Red Poria... [text missing]).
The above nine ingredients are coarsely crushed and sifted. Each dose consists of five qian bi, boiled with one and a half sheng of water until one sheng remains. Strain and take warm.