论曰内经谓冬脉太过,则令人解 ,脊脉痛而少气不欲言,夫肾为作强之官,精为一身
之本,所以运动形体者也,一或受邪,则肾实而精不运,故有脊脉痛,少气不欲言之证,名
曰解 者,解有解缓之义, 则疑于寒亦疑于热,疑于壮亦疑于弱。不可必之辞,诊其尺脉
缓而涩者,解 也。
治解 脊脉痛,气乏不欲言,此为肾气有余。利肾汤方
泽泻 生干地黄(焙) 赤茯苓(去黑皮各一两半) 槟榔(锉) 麦门冬(去心焙) 柴
胡(
去苗) 枳壳(去瓤麸炒) 黄芩(去黑心) 牛膝(酒浸切焙各一两)
上九味,粗捣筛,每服三钱匕,水一盏,煎七分,去滓温服。
治肾气有余,足少阴脉太过,令人脊脉痛,少气不欲言,病名解 。匀气汤方
枳壳(去瓤麸炒) 泽泻 赤茯苓(去黑皮) 牡丹皮 木通(锉) 槟榔(锉) 玄
参(各一
两)
上七味,粗捣筛,每服三钱匕,水一盏,煎七分,去滓温服。
治解 少气不欲言,脊脉急痛,腰背强直,足下热疼,小便癃闭,心烦嗌干,通肾汤
菖蒲(锉) 羚羊角(镑) 生干地黄(焙) 赤芍药(各二两) 五加皮(锉) 甘
草(炙锉)
猪苓(去黑皮) 泽泻(各一两)
上八味,粗捣筛,每服三钱匕,水一盏,煎七分,去滓温服。
论述说:《内经》提到,冬季的脉象如果过于强盛(太过),就会使人出现懈怠无力、脊背经脉疼痛以及气短懒言的症状。肾是主管强力动作的脏腑,精气是身体的根本,用来运动形体。一旦受到邪气侵袭,就会导致肾气实盛而精气不能正常运行,因此会出现脊背经脉疼痛、气短不想说话的症状。这种病名叫“解㑊”,“解”有松懈迟缓的意思,“㑊”则表现为似寒非寒、似热非热、似壮实非壮实、似虚弱非虚弱的状态,症状难以确定。诊察时,如果尺部脉象缓而涩,就是解㑊病。
治疗解㑊引起的脊背经脉疼痛、气乏不想说话,这是肾气有余(实证)。利肾汤方:
泽泻、生干地黄(焙干)、赤茯苓(去掉黑皮,各一两半)、槟榔(捣碎)、麦门冬(去心焙干)、柴胡(去苗)、枳壳(去瓤麸炒)、黄芩(去掉黑心)、牛膝(酒浸后切片焙干,各一两)。
以上九味药,粗捣筛过,每次服用三钱匕,用水一盏,煎至七分,去渣温服。
治疗肾气有余、足少阴脉太过引起的脊背经脉疼痛、气短不想说话,病名解㑊。匀气汤方:
枳壳(去瓤麸炒)、泽泻、赤茯苓(去黑皮)、牡丹皮、木通(捣碎)、槟榔(捣碎)、玄参(各一两)。
以上七味药,粗捣筛过,每次服用三钱匕,用水一盏,煎至七分,去渣温服。
治疗解㑊引起的气短不想说话、脊背经脉拘急疼痛、腰背强直、足底发热疼痛、小便癃闭不通、心烦咽干。通肾汤:
菖蒲(捣碎)、羚羊角(镑片)、生干地黄(焙干)、赤芍药(各二两)、五加皮(捣碎)、甘草(炙后捣碎)、猪苓(去黑皮)、泽泻(各一两)。
以上八味药,粗捣筛过,每次服用三钱匕,用水一盏,煎至七分,去渣温服。
Commentary states: The *Neijing* (Classic of Internal Medicine) mentions that if the winter pulse is excessive, it causes the person to suffer from Xieji (a condition characterized by flaccidity and weakness), pain in the spinal meridians, shortness of breath, and a reluctance to speak. The Kidney is the official responsible for strength and vigor; Jing (Essence) is the root of the entire body and is used to move the form. If once affected by pathogenic factors, the Kidney becomes full/excess, and Jing fails to circulate, thus resulting in symptoms such as pain in the spinal meridians, shortness of breath, and reluctance to speak. This condition is named Xieji. "Xie" implies relaxation and slowness, while "Ji" presents as resembling cold but not being cold, resembling heat but not being heat, resembling robustness but not being robust, and resembling weakness but not being weakness. These are indeterminate descriptions. Upon diagnosis, if the Chi (Cun Kou) pulse is slow and choppy, it indicates Xieji.
To treat Xieji with pain in the spinal meridians, lack of Qi, and reluctance to speak, which indicates excess Qi in the Kidney. Formula for Draining the Kidney (Li Shen Tang):
Alisma Rhizoma (Zexie), Prepared Rehmanniae Radix (Sheng Gan Di Huang - baked), Red Poria (Chi Fu Ling - black skin removed, each 1 liang 5 qian), Areca Seed (Bing Lang - crushed), Ophiopogonis Radix (Mai Men Dong - heart removed, baked), Bupleuri Radix (Chai Hu - roots removed), Aurantii Fructus Immaturus (Zhi Ke - albedo removed, stir-fried with bran), Scutellariae Radix (Huang Qin - black heart removed), Achyranthis Bidentatae Radix (Niu Xi - soaked in wine, sliced, baked, each 1 liang).
The above nine herbs are coarsely pounded and sieved. Each dose consists of 3 Qianbi, decocted with one Zhan of water until reduced to seven-tenths. Strain and take warm.
To treat excess Qi in the Kidney and excessive pulse of the Foot-Shaoyin meridian causing pain in the spinal meridians, shortness of breath, and reluctance to speak, a condition named Xieji. Formula for Harmonizing Qi (Yun Qi Tang):
Aurantii Fructus Immaturus (Zhi Ke - albedo removed, stir-fried with bran), Alisma Rhizoma (Zexie), Red Poria (Chi Fu Ling - black skin removed), Moutan Cortex (Mu Dan Pi), Akebia Caulis (Mu Tong - crushed), Areca Seed (Bing Lang - crushed), Scrophulariae Radix (Xuan Shen, each 1 liang).
The above seven herbs are coarsely pounded and sieved. Each dose consists of 3 Qianbi, decocted with one Zhan of water until reduced to seven-tenths. Strain and take warm.
To treat Xieji with shortness of breath, reluctance to speak, spasmodic pain in the spinal meridians, stiffness and rigidity of the waist and back, hot and painful soles, retention of urine (Long Bi), irritability, and dry throat. Formula for Unblocking the Kidney (Tong Shen Tang):
Acori Tatarinowii Rhizoma (Chang Pu - crushed), Cornu Saigae Tataricae (Ling Yang Jiao - shaved), Prepared Rehmanniae Radix (Sheng Gan Di Huang - baked), Rubia Cordifoliae Radix et Rhizoma (Chi Shao Yao, each 2 liang), Acanthopanacis Cortex (Wu Jia Pi - crushed), Glycyrrhizae Radix et Rhizoma (Gan Cao - roasted, crushed), Polyporus (Zhu Ling - black skin removed), Alisma Rhizoma (Zexie, each 1 liang).
The above eight herbs are coarsely pounded and sieved. Each dose consists of 3 Qianbi, decocted with one Zhan of water until reduced to seven-tenths. Strain and take warm.