论曰∶饮天和,食地德,皆阴阳也。然阳为气,阴为血;气为卫,血为营。气卫血营,
通贯一身,周而复会,如环无端。岂郁闭而不流哉!夫惟动静居处,失其常,邪气乘间,曾
不知觉。此风寒湿三气,所以杂至合而为痹。浅则客于肌肤,深则留于骨髓。阳多者,行流
散徙而靡常;阴多者,凝泣滞碍而有着。虽异状殊态,然即三气以求之,则所谓痹者,可得
而察矣。且痹害于身,其为疾也,初若无足治,至其蔓而难图,则偏废弗举,四体不随,皆
自诒伊芳戚者也。可不慎哉!
论曰∶《内经》谓风寒湿三气杂至合而为痹。又曰∶以春遇此者为筋痹。又曰∶筋痹不
已,复感于邪,内舍于肝。盖五脏皆有合,病久而不去者,内舍于其合。肝之合筋也,故筋
痹不已,复感于邪,则舍于肝也。其证夜卧则惊,多饮小便数,上为引如怀者是也。
治肝痹筋脉不利,拘挛急痛,夜卧多惊,上气烦满。薏苡仁汤方。
薏苡仁 羌活(去芦头) 蔓荆实 荆芥穗各二两 白术 木瓜(去核) 防风(去叉)
牛
膝(酒浸,切,焙) 甘草(炙)各一两
上九味,锉如麻豆。每服五钱匕,水一盏半,入生姜五片,煎至一盏,去滓,稍热服。
治肝痹气逆,胸胁引痛,眠卧多惊,筋脉挛急。镇肝去邪。人参散方。
人参二两 酸枣仁(微炒) 杜仲(去皮,锉,微炒) 黄 (蜜炙,锉) 茯神(去
木)各一
两五味子 熟干地黄 芎 细辛(去苗叶) 秦艽(去苗土) 羌活(去芦头) 丹砂
(飞,
研)各半两
上一十二味,除丹砂外,同捣罗为散,入丹砂研匀。每服一钱匕,温酒调下,不拘时候
,日三。
治肝痹。缓筋脉,去邪毒,调营卫。萆 丸方。
萆 羌活(去芦头) 天麻(酒浸一宿,切,焙各一两) 附子(炮裂,去皮脐半两)
没
药(研) 乳香(研)各一分
上六味,将四味捣罗为末,入没药、乳香同研匀,炼蜜和丸,如弹丸大。每服一丸,空
心温酒化下,日再。
治肝痹两胁下满,筋急不得太息,疝瘕四逆,抢心腹痛,目不明。补肝汤方。
白茯苓(去黑皮)一两二钱 乌头四枚(炮裂,去皮脐) 薏苡仁 独活各一两 附子
二枚
(炮裂,去皮脐) 柏子仁(研) 防风(去叉) 细辛(去苗叶)各二两 山茱萸 桂(去
粗皮)各
三分 (炙,锉)半两
上一十一味,锉如麻豆,入研药拌匀。每服五钱匕,水一盏半,大枣二枚(劈开),同
煎
数沸。去滓,取一盏服,不计时候。
治肝虚气痹,两胁胀满,筋脉拘急,不得喘息,四肢少力,眼目不明。细辛汤方。
细辛(去苗叶) 防风(去叉) 白茯苓(去黑皮) 柏子仁(研) 桃仁(汤浸,去
皮尖、双
仁,麸炒微黄) 山茱萸 甘草(炙,锉各三分) 蔓荆实 枳壳(去瓤,麸炒各半两) 木
瓜(
去核) 萆 五加皮(各一两)
上一十二味,锉如麻豆。每服三钱匕,水一盏,大枣(三枚劈破),同煎数沸,去滓,
取
七分,温服,不计时候。
治肝痹头目昏塞,四肢不利,胸膈虚烦。防风汤方。
防风(去叉一两) 芎 黄 (锉) 五味子 人参 茯神(去木) 独活(去芦头)
羚羊
角(镑屑) 前胡(去芦头各三分) 细辛(去苗叶) 酸枣仁(微炒) 甘草(炙各半两)
上一十二味,粗捣筛。每服三钱匕,水一盏,大枣(三枚劈破),同煎取七分,去滓温
服
,不计时候。
治肝痹筋挛,肢体不随。牛膝汤方。
牛膝(锉,焙) 防风(去叉) 丹参 前胡(去芦头各二两) 石斛(去根二两半) 杜
仲(去
粗皮,涂酥炙,锉) 秦艽(去苗土) 续断(各一两半) 陈橘皮(汤去白,焙一两) 大
麻
仁(研一合)
上一十味,除大麻仁外,粗捣筛。每服五钱匕,水一盏半,煎五七沸,别下麻仁少许,
煎至一盏,去滓,空腹服,日二。
治肝痹多惊悸,神思不安。茯神散方。
茯神(去木) 酸枣仁(微炒) 黄 (锉) 人参各一两 熟干地黄(焙) 远志(去
心) 五
味子各半两 白茯苓(去黑皮一两) 丹砂(别研半两)
上九味,除丹砂外,捣罗为散,入丹砂末再研匀。每服一钱匕。以温酒调下,不计时候
论述说:顺应自然界的和谐之气,摄取大地所生的德泽,这都是阴阳的作用。然而,阳表现为气,阴表现为血;气具有卫外的功能,血具有营内的作用。气与卫、血与营,贯通全身,循环往复,如同圆环没有端点。难道会郁结闭塞而不流动吗!只是因为起居动静失去了常态,邪气趁虚而入,人们往往不知不觉。这就是风寒湿三种邪气混杂而至,结合而形成痹证的原因。病位浅的,邪气客居在肌肤;病位深的,邪气留滞在骨髓。阳气偏盛的人,气血运行流散迁徙而没有定处;阴气偏盛的人,气血凝涩滞碍而有固定部位。虽然症状表现各异,但根据这三种邪气来探究,那么所谓的痹证,就可以被认清了。况且痹证伤害身体,它作为疾病,起初似乎不值得治疗,等到蔓延开来难以图谋时,就会导致半身不遂无法抬起,四肢不能随意活动,这些都是自己招致的忧患啊。能不谨慎吗!
论述说:《内经》中说风寒湿三种邪气混杂而至,结合而形成痹证。又说:在春季遇到这种邪气的,称为筋痹。又说:筋痹如果不愈,再次感受邪气,就会内传并归属于肝。大概五脏都有相应的相合组织,病情长久不愈的,就会内传归属于其相合的脏腑。肝相合于筋,所以筋痹不愈,再次感受邪气,就会归属于肝。其症状是夜间睡眠则惊骇,多饮且小便频数,上部出现牵引感如同怀孕状,就是这种情况。
治疗肝痹导致的筋脉不利,拘挛急痛,夜间睡眠多惊骇,上气烦闷胀满。薏苡仁汤方。
薏苡仁 羌活(去除芦头) 蔓荆实 荆芥穗各二两 白术 木瓜(去除果核) 防风(去除枝叉)
牛膝(用酒浸泡,切片,焙干) 甘草(炙烤)各一两
以上九味药,切碎如麻豆大小。每次服用五钱匕,用水一盏半,加入生姜五片,煎煮至一盏量,去渣滓,稍热时服用。
治疗肝痹导致的气逆,胸胁部牵引疼痛,睡眠中多惊骇,筋脉挛缩紧急。镇肝去邪。人参散方。
人参二两 酸枣仁(微炒) 杜仲(去除外皮,切碎,微炒) 黄芪(用蜜炙烤,切碎) 茯神(去除木质心)各一两 五味子 熟干地黄 川芎 细辛(去除苗叶) 秦艽(去除苗土) 羌活(去除芦头) 朱砂(水飞,研细)各半两
以上十二味药,除朱砂外,一同捣碎过筛成为散剂,加入朱砂研匀。每次服用一钱匕,用温酒调服,不限时候,每日三次。
治疗肝痹。舒缓筋脉,祛除邪毒,调和营卫。萆薢丸方。
萆薢 羌活(去除芦头) 天麻(用酒浸泡一夜,切片,焙干各一两) 附子(炮制裂开,去除皮脐半两)
没药(研细) 乳香(研细)各一分
以上六味药,将前四味捣碎过筛成为粉末,加入没药、乳香一同研匀,用炼蜜和丸,如弹丸大小。每次服用一丸,空腹时用温酒化开服用,每日两次。
治疗肝痹导致的两胁下胀满,筋脉紧急不能深呼吸,疝气瘕积四肢厥冷,冲撞心胸腹痛,视力不明。补肝汤方。
白茯苓(去除黑皮)一两二钱 乌头四枚(炮制裂开,去除皮脐) 薏苡仁 独活各一两 附子
二枚
(炮制裂开,去除皮脐) 柏子仁(研细) 防风(去除枝叉) 细辛(去除苗叶)各二两 山茱萸 桂枝(去除粗皮)各
三分 (炙烤,切碎)半两
以上十一味药,切碎如麻豆大小,加入已研细的药物拌匀。每次服用五钱匕,用水一盏半,大枣二枚(掰开),一同煎煮数沸。去渣滓,取一盏量服用,不限时候。
治疗肝虚气痹,两胁胀满,筋脉拘急,不能喘息,四肢无力,眼目视力不明。细辛汤方。
细辛(去除苗叶) 防风(去除枝叉) 白茯苓(去除黑皮) 柏子仁(研细) 桃仁(热水浸泡,去除皮尖、双仁,麸炒微黄) 山茱萸 甘草(炙烤,切碎各三分) 蔓荆实 枳壳(去除瓤,麸炒各半两) 木瓜
(去除果核) 萆薢 五加皮(各一两)
以上十二味药,切碎如麻豆大小。每次服用三钱匕,用水一盏,大枣(三枚掰破),一同煎煮数沸,去渣滓,取七分量,温服,不限时候。
治疗肝痹导致头目昏塞,四肢不利,胸膈虚烦。防风汤方。
防风(去除枝叉一两) 川芎 黄芪 (切碎) 五味子 人参 茯神(去除木质心) 独活(去除芦头)
羚羊角(镑成屑) 前胡(去除芦头各三分) 细辛(去除苗叶) 酸枣仁(微炒) 甘草(炙烤各半两)
以上十二味药,粗捣后筛选。每次服用三钱匕,用水一盏,大枣(三枚掰破),一同煎煮取七分量,去渣滓温服,不限时候。
治疗肝痹导致的筋挛,肢体不能随意活动。牛膝汤方。
牛膝(切碎,焙干) 防风(去除枝叉) 丹参 前胡(去除芦头各二两) 石斛(去除根二两半) 杜仲(去除
粗皮,涂酥炙烤,切碎) 秦艽(去除苗土) 续断(各一两半) 陈皮(热水去除白色内皮,焙干一两) 大
麻
仁(研细一合)
以上十味药,除大麻仁外,粗捣后筛选。每次服用五钱匕,用水一盏半,煎煮五七沸,另外放入少许麻仁,煎煮至一盏量,去渣滓,空腹服用,每日两次。
治疗肝痹导致的多惊悸,神思不安。茯神散方。
茯神(去除木质心) 酸枣仁(微炒) 黄芪 (切碎) 人参各一两 熟干地黄(焙干) 远志(去除
心) 五
味子各半两 白茯苓(去除黑皮一两) 朱砂(单独研细半两)
以上九味药,除朱砂外,捣碎过筛成为散剂,加入朱砂末再研匀。每次服用一钱匕。用温酒调服,不限时候。
Commentary states: Harmonizing with the natural harmony of Heaven and consuming the virtue generated by Earth are both manifestations of Yin and Yang. However, Yang manifests as Qi (vital energy), while Yin manifests as Blood; Qi functions as Wei (defensive energy), and Blood functions as Ying (nutritive energy). Qi and Wei, Blood and Ying, penetrate the entire body, circulating repeatedly like a ring without beginning or end. How could they be stagnant and blocked without flowing! It is merely because daily activities and rest lose their regularity, allowing pathogenic factors to take advantage of the gap, often without people realizing it. This is why the three pathogenic factors of Wind, Cold, and Dampness mix together to form Bi syndrome (obstruction syndrome). If shallow, the pathogens lodge in the skin and muscles; if deep, they remain in the bone marrow. Those with abundant Yang have Qi and Blood that flow and scatter without constancy; those with abundant Yin have Qi and Blood that coagulate, stagnate, and adhere to fixed locations. Although the symptoms vary greatly, by investigating these three pathogenic factors, the so-called Bi syndrome can be understood. Moreover, Bi syndrome harms the body. As a disease, it may initially seem unworthy of treatment, but once it spreads and becomes difficult to manage, it leads to hemiplegia where one side cannot be lifted, and limbs become unresponsive. These are all troubles brought upon oneself. Can one not be cautious!
Commentary states: The *Neijing* (Inner Canon) states that the mixing of Wind, Cold, and Dampness forms Bi syndrome. It also says: encountering these factors in spring results in Jin Bi (Sinew Bi). Furthermore: if Jin Bi does not resolve and is exposed to pathogens again, it internally resides in the Liver. Generally, each Zang organ has a corresponding external association; when a disease persists for a long time, it internally resides in its associated organ. The Liver associates with Sinews; therefore, if Jin Bi does not resolve and is exposed to pathogens again, it resides in the Liver. Its symptoms include waking with fright during sleep, excessive thirst with frequent urination, and upper body pulling sensations resembling pregnancy.
For treating Liver Bi causing sinew and vessel dysfunction, spasms, acute pain, night terrors, and upper Qi stagnation with irritability and fullness. Yiyiren Tang (Coix Seed Decoction) formula:
Ephedrae Herba (Mahuang, Mahuang) [Note: Text says Yiyiren Tang but lists Qianghuo etc., likely a specific variation or typo in source, translating strictly based on ingredients listed] -> Actually, the text lists Yi Yi Ren (Coix Semen) first.
Coix Semen (Yi Yi Ren) Qianghuo (Notopterygii Rhizoma et Radix, removed rhizome head) Manjingzi (Viticis Fructus) Jingjiesui (Schizonepetae Spica) each 2 liang Baizhu (Atractylodis Macrocephalae Rhizoma) Mugua (Chaenomelis Fructus, removed core) Fangfeng (Saposhnikoviae Radix, removed branches)
Niuxi (Achyranthis Bidentatae Radix, soaked in wine, sliced, dried) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) each 1 liang
The above nine herbs are chopped like hemp seeds. Each dose takes 5 qian bi (approx. 15-20g depending on era measurement, literally "spoonful"), 1.5 zhan of water, add 5 slices of Shengjiang (Zingiberis Rhizoma Recens), decoct until 1 zhan remains, remove dregs, and take slightly warm.
For treating Liver Bi causing counterflow of Qi, pulling pain in chest and hypochondrium, night terrors, and sinew spasm/tightness. To calm the Liver and expel evil. Renshen San (Ginseng Powder) formula:
Renshen (Panacis Ginseng Radix) 2 liang Szaoren (Zizyphi Fructus, lightly fried) Duzhong (Eucommiae Cortex, peeled, chopped, lightly fried) Huangqi (Astragali Radix, honey-fried, chopped) Fushen (Poria cum Radice, removed wood core) each 1 liang Wuweizi (Schisandrae Fructus) Shudihuang (Rehmanniae Radix Preparata) Xiongqiong (Ligustici Chuanxiong Rhizoma) Xixin (Asari Radix et Rhizoma, removed seedlings and leaves) Qinjiao (Gentianae Macrophyllae Radix, removed seedlings and soil) Qianghuo (Notopterygii Rhizoma et Radix, removed rhizome head) Zhusha (Cinnabaris, water-floating, ground) each 0.5 liang
The above twelve herbs, except Zhusha, are pounded and sifted into powder. Add Zhusha and grind evenly. Each dose takes 1 qian bi, taken with warm wine, at any time, three times a day.
For treating Liver Bi. Relaxes sinews and vessels, expels evil toxins, regulates Ying and Wei. Bibie Wan (Dioscoreae Hypoglaucae Pill) formula:
Bibie (Dioscoreae Hypoglaucae Rhizoma) Qianghuo (Notopterygii Rhizoma et Radix, removed rhizome head) Tianma (Gastrodiae Rhizoma, soaked in wine overnight, sliced, dried each 1 liang) Fuzi (Aconiti Lateralis Radix Preparata, cracked by frying, removed peel and navel 0.5 liang) Moyao (Myrrha) Rushi (Olibanum, ground) each 1 fen
The above six herbs: pound the first four into powder, add Moyao and Rushi, grind evenly. Mix with refined honey to make pills the size of bird eggs. Each dose takes 1 pill, dissolved in warm wine on an empty stomach, twice a day.
For treating Liver Bi causing fullness under both hypochondria, tight sinews preventing deep breathing, hernia masses with cold extremities, rushing heart/abdominal pain, and blurred vision. Bugan Tang (Tonify Liver Decoction) formula:
Baifuling (Poria, removed black skin) 1 liang 2 qian Wutou (Aconiti Radix, cracked by frying, removed peel and navel) 4 pieces Yiyiren (Coix Semen) Duhuo (Angelicae Pubescentis Radix) each 1 liang Fuzi (Aconiti Lateralis Radix Preparata) 2 pieces
(cracked by frying, removed peel and navel) Baiziren (Platycladi Semen, ground) Fangfeng (Saposhnikoviae Radix, removed branches) Xixin (Asari Radix et Rhizoma, removed seedlings and leaves) each 2 liang Shanzhuyu (Corni Fructus) Guizhi (Cinnamomi Ramulus, removed rough bark) each 3 fen (Fried, chopped) 0.5 liang
The above eleven herbs are chopped like hemp seeds, mixed with ground herbs. Each dose takes 5 qian bi, 1.5 zhan of water, 2 Dazao (Zizyphi Fructus, split), decoct for several boils. Remove dregs, take 1 zhan, at any time.
For treating Liver deficiency with Qi Bi, distension in both hypochondria, sinew spasms, inability to breathe deeply, weakness in four limbs, and blurred vision. Xixin Tang (Asari Decoction) formula:
Xixin (Asari Radix et Rhizoma, removed seedlings and leaves) Fangfeng (Saposhnikoviae Radix, removed branches) Baifuling (Poria, removed black skin) Baiziren (Platycladi Semen, ground) Taoren (Persicae Semen, soaked in hot water, removed skin and tip, double kernels removed, bran-fried light yellow) Shanzhuyu (Corni Fructus) Gancao (Glycyrrhizae Radix et Rhizoma, fried, chopped each 3 fen) Manjingzi (Viticis Fructus) Zhike (Aurantii Fructus Immaturus, removed pulp, bran-fried each 0.5 liang) Mugua (Chaenomelis Fructus, removed core) Bibie (Dioscoreae Hypoglaucae Rhizoma) Wujiaopi (Acanthopanacis Cortex) each 1 liang
The above twelve herbs are chopped like hemp seeds. Each dose takes 3 qian bi, 1 zhan of water, 3 Dazao (split), decoct for several boils. Remove dregs, take 7/10 parts, take warm, at any time.
For treating Liver Bi causing dizziness and blockage of head and eyes, limb dysfunction, and empty irritability in chest and diaphragm. Fangfeng Tang (Saposhnikoviae Decoction) formula:
Fangfeng (Saposhnikoviae Radix, removed branches 1 liang) Xiongqiong (Ligustici Chuanxiong Rhizoma) Huangqi (Astragali Radix, chopped) Wuweizi (Schisandrae Fructus) Renshen (Panacis Ginseng Radix) Fushen (Poria cum Radice, removed wood core) Duhuo (Angelicae Pubescentis Radix, removed rhizome head) Lingyangjiao (Saigae Tataricae Cornu, shaved into flakes) Qianhu (Peucedani Radix, removed rhizome head each 3 fen) Xixin (Asari Radix et Rhizoma, removed seedlings and leaves) Szaoren (Zizyphi Fructus, lightly fried) Gancao (Glycyrrhizae Radix et Rhizoma, fried each 0.5 liang)
The above twelve herbs are coarsely pounded and sifted. Each dose takes 3 qian bi, 1 zhan of water, 3 Dazao (split), decoct to 7/10 parts. Remove dregs, take warm, at any time.
For treating Liver Bi causing sinew spasms and limbs unable to move freely. Niuxi Tang (Achyranthes Decoction) formula:
Niuxi (Achyranthis Bidentatae Radix, chopped, dried) Fangfeng (Saposhnikoviae Radix, removed branches) Danshen (Salviae Miltiorrhizae Radix) Qianhu (Peucedani Radix, removed rhizome head each 2 liang) Shihu (Dendrobii Caulis, removed roots 2.5 liang) Duzhong (Eucommiae Cortex, removed rough bark, coated with butter, fried, chopped) Qinjiao (Gentianae Macrophyllae Radix, removed seedlings and soil) Xuduan (Dipsaci Radix) each 1.5 liang Chenpi (Citri Reticulatae Pericarpium, washed with hot water to remove white pith, dried 1 liang) Damaoren (Cannabis Fructus, ground 1 he)
The above ten herbs, except Damaoren, are coarsely pounded and sifted. Each dose takes 5 qian bi, 1.5 zhan of water, decoct for 5-7 boils. Add a little Damaoren separately, decoct until 1 zhan remains. Remove dregs, take on empty stomach, twice a day.
For treating Liver Bi causing frequent palpitations and unsettled spirit. Fushen San (Poria Powder) formula:
Fushen (Poria cum Radice, removed wood core) Szaoren (Zizyphi Fructus, lightly fried) Huangqi (Astragali Radix, chopped) Renshen (Panacis Ginseng Radix) each 1 liang Shudihuang (Rehmanniae Radix Preparata, dried) Yuanzhi (Polygalae Radix, removed heart) Wuweizi (Schisandrae Fructus) each 0.5 liang Baifuling (Poria, removed black skin 1 liang) Zhusha (Cinnabaris, ground separately 0.5 liang)
The above nine herbs, except Zhusha, are pounded and sifted into powder. Add Zhusha powder and grind evenly. Each dose takes 1 qian bi. Take with warm wine, at any time.