清白散
当归 盐黄柏 炒白芍 樗根皮 生地 川芎 贝母(各一钱) 炮姜 甘草(各五分)
上锉,生姜三片,水煎服。
导水丸
牵牛(头末) 滑石(水飞) 黄芩 川大黄
上末,蒸饼为丸,量虚实服。
万安丸
牵牛(头末) 胡椒 木香 小茴香(焙,各等分)
上末,水泛为丸,量虚实服。
威喜丸
白茯苓(去皮作块,用猪苓二钱半,同于磁器内煮二十余沸,出,晒干,不用猪苓,四两) 黄蜡(四两)
上以茯苓为末,炼黄蜡为丸,如弹子大。空心细嚼,满口生津,徐徐咽服,以小便清为度。忌米醋,只吃糠醋。
忌动气。
固精丸
牡蛎( 粉) 菟丝子(酒蒸,焙) 韭子(炒) 龙骨 五味子 白茯苓 桑螵蛸(酒炙) 白石脂(各
等分)
上为末,酒糊丸如桐子大,每服七十丸,空心盐汤下。
五积六聚分脏腑,七 八瘕气血凝。 积不动有定处,瘕聚推移无定形。痞闷不宣气雍塞,未成坚块
血瘀名。蓄久不散成血蛊,产后经行风冷乘。
【注】五脏气积名曰积,故积有五证。六腑气聚名曰聚,故聚有六证。《难经》有心、
肝、脾、肺、肾五脏之积,而无六聚。盖以积为血病,而聚为气病也。故李杲有五积丸
方治法。《巢氏病源》载七 八瘕,但有八瘕
名证,而无七 病形。其他方书亦不概见。大抵又以 为气病,而瘕为血病也。夫病皆起
于气,必气聚而后血凝,不必过泥于黄、青、燥、血、脂、狐、蛇、鳖等名,但以牢固不
移有定处者,为 为积;推移转动,忽聚忽散者,为瘕为聚可也。故曰∶ 者,征也,言
有形可征也。瘕者,假也,言假物成形也。若夫痞者,痞闷不通,气道壅塞之谓也。瘀血
者,血瘀腹中未成坚块也。蓄之既久,必成血蛊矣。凡此诸证,皆由新产之后,经行之
时,不知谨避,以致风冷外袭,邪正相搏,结于腹中而成也。
【清白散】
当归、盐炒黄柏、炒白芍、樗根皮、生地黄、川芎(各一钱),炮姜、甘草(各五分)。
以上药物切碎,加入生姜三片,用水煎煮后服用。
【导水丸】
牵牛子(取头末)、滑石(水飞法处理)、黄芩、川大黄。
以上药物研为细末,用蒸饼糊制作成丸剂,根据患者虚实情况决定剂量服用。
【万安丸】
牵牛子(取头末)、胡椒、木香、小茴香(焙干,各等分)。
以上药物研为细末,用水泛制为丸剂,根据患者虚实情况决定剂量服用。
【威喜丸】
白茯苓(去皮切成块,用猪苓二钱半,一同在磁器内煮沸二十多次,取出,晒干,去掉猪苓,取茯苓四两)、黄蜡(四两)。
以上将茯苓研为细末,用炼过的黄蜡制作成丸剂,大小如弹子。空腹时细细咀嚼,待口中生津液后,慢慢咽下服用,以小便清澈为度。忌食米醋,只可吃糠醋。
禁忌动气(保持情绪平稳,避免恼怒)。
【固精丸】
牡蛎(煅粉)、菟丝子(酒蒸,焙干)、韭子(炒)、龙骨、五味子、白茯苓、桑螵蛸(酒炙)、白石脂(各等分)。
以上药物研为细末,用酒糊制作成梧桐子大小的丸剂,每次服用七十丸,空腹时用盐汤送服。
五积六聚分别归属于不同脏腑,七瘕八瘕则是气血凝滞所致。
“积”病特点是位置固定不移,“瘕”和“聚”的特点是形态变化不定,可以推移移动。
痞证表现为胸闷不舒,气机壅塞;瘀血是指血液瘀滞在腹部,尚未形成坚硬的肿块。
瘀血蓄积日久不散,就会形成血蛊。这多发生在产后或月经期间,因感受风冷邪气所致。
【注释】
五脏之气结聚称为“积”,所以积有五种证候。六腑之气结聚称为“聚”,所以聚有六种证候。《难经》中记载了心、肝、脾、肺、肾五脏的积,而没有六腑的聚。这是因为积属于血分病变,而聚属于气分病变。因此李杲有治疗五积的丸方和方法。《诸病源候论》中记载了七瘕八瘕,但只有八瘕的名称和证候,没有七瘕的病形。其他医书也不多见。大体上认为瘕为气病,而瘕为血病(注:此处原文逻辑似有笔误,通常瘕属气,聚属气,积属血,但依原文翻译)。疾病都起于气,必须气先结聚,然后血才凝滞。不必过分拘泥于黄瘕、青瘕、燥瘕、血瘕、脂瘕、狐瘕、蛇瘕、鳖瘕等名称,只要将牢固不移、位置固定的称为瘕和积;将推移转动、忽聚忽散的称为瘕和聚就可以了。所以说:“瘕”通“征”,指有形迹可以验证;“瘕”通“假”,指假借物而成形。至于痞证,是指痞闷不通,气道壅塞的意思。瘀血,是指血液瘀滞在腹中,尚未形成坚硬肿块。蓄积久了,必然形成血蛊。所有这些证候,都是因为新产之后,或行经之时,不知谨慎回避,导致风冷外邪侵袭,邪气与正气相搏结,凝聚在腹部而形成的。
[Qingbai San (Clear and White Powder)]
Danggui (Radix Angelicae Sinensis), Yan Huangbai (Salt-processed Phellodendri Cortex), Chao Baishao (Stir-fried Radix Paeoniae Alba), Chugenpi (Cortex Bungeae), Shengdihuang (Radix Rehmanniae Preparata), Chuanxiong (Rhizoma Chuanxiong) (each 1 qian); Paojiang (Prepared Zingiberis Rhizoma), Gancao (Radix Glycyrrhizae Preparata) (each 0.5 qian).
Crush the above herbs, add three slices of fresh ginger, decoct in water, and take orally.
[Daoshui Wan (Water-Guiding Pill)]
Qianniu (Semen Pharbitidis) (first extraction powder), Huashi (Talcum) (processed by water flotation), Huangqin (Radix Scutellariae), Chuan Dahuang (Radix et Rhizoma Rhei Preparata).
Grind the above herbs into fine powder, make pills using steamed bread paste, and administer according to the patient's deficiency or excess condition.
[Wan'an Wan (Ten-Thousand-Safety Pill)]
Qianniu (Semen Pharbitidis) (first extraction powder), Hujiao (Piperis Longi Fructus), Muxiang (Radix Aucklandiae), Xiaohuixiang (Fructus Foeniculi) (roasted, equal parts).
Grind the above herbs into fine powder, make pills using water as a binder, and administer according to the patient's deficiency or excess condition.
[Weixi Wan (Mighty-Promise Pill)]
Baifuling (Poria) (skin removed, cut into blocks, boiled with 2.5 qian of Zhuling [Polyporus] in a porcelain vessel for more than twenty boils, taken out, dried, discard Zhuling, use 4 liang of Poria); Huangla (Beeswax) (4 liang).
Grind the Poria into fine powder, melt the beeswax, and make pills the size of quail eggs. Chew thoroughly on an empty stomach until saliva is abundant, then swallow slowly. Stop when urine becomes clear. Avoid rice vinegar; only bran vinegar is permitted.
Avoid emotional agitation (maintain calmness, avoid anger).
[Gujing Wan (Essence-Fixing Pill)]
Muli (Concha Ostreae) (calcined powder), Tusizi (Semen Cuscutae) (steamed with wine, roasted), Jiuizi (Semen Allii Tuberosi) (stir-fried), Longgu (Os Draconis), Wuweizi (Fructus Schisandrae Chinensis), Baifuling (Poria), Sangpiaoxiao (Ootheca Mantidis) (stir-fried with wine), Baishizhi (Kaolinite) (equal parts).
Grind the above herbs into fine powder, make pills the size of paulownia seeds using wine paste as a binder. Take 70 pills each time, on an empty stomach, washed down with salted water.
Five types of Ji (masses) and six types of Ju (gatherings) correspond to different zang-fu organs; Qi Ba Xia Jia (seven jias and eight jias) result from qi and blood stagnation.
Ji (masses) are characterized by fixed locations without movement; Jia (intermittent masses) and Ju (gatherings) are characterized by shifting forms that can be moved.
Pi (fullness) manifests as chest stuffiness and obstruction due to qi stagnation; Yuxue (blood stasis) refers to blood stagnating in the abdomen without forming hard masses.
If blood stasis accumulates and does not dissipate over time, it becomes Xuegu (blood gu disorder). This often occurs postpartum or during menstruation, caused by invasion of wind-cold pathogens.
[Annotation]
Qi accumulation in the five zang organs is called "Ji" (mass), hence there are five types of Ji. Qi gathering in the six fu organs is called "Ju" (gathering), hence there are six types of Ju. The *Nan Jing* (Classic of Difficult Issues) records the five accumulations of the heart, liver, spleen, lung, and kidney, but does not record six gatherings. This is because Ji belongs to blood pathology, while Ju belongs to qi pathology. Therefore, Li Gao provided formulas and methods for treating five accumulations. *Zhubing Yuanhou Lun* (Source Book of Pathogenesis and Symptoms of All Diseases) records Qi Ba Xia Jia, but only lists the names and symptoms of the eight jias, lacking the pathological forms of the seven jias. Other medical texts rarely mention them. Generally, it is considered that Jia is a qi disease, while Jia is a blood disease (Note: The original text contains a logical ambiguity here, typically Jia is associated with qi and mass with blood, but translated literally). Diseases originate from qi; only after qi gathers does blood coagulate. One need not overly adhere to names such as Huang Jia, Qing Jia, Zao Jia, Xue Jia, Zhi Jia, Hu Jia, She Jia, and Die Jia. Instead, classify firm, immobile masses with fixed locations as Jia and Ji; and shifting, rotating masses that appear and disappear intermittently as Jia and Ju. Thus, "Jia" implies "Zheng" (signs), meaning it has tangible signs. "Jia" also implies "Jia" (false/assumed), meaning it takes shape falsely. As for Pi (fullness), it refers to stuffiness and blockage of the qi pathway. Yuxue (blood stasis) refers to blood stagnating in the abdomen without forming hard masses. If accumulated for a long time, it inevitably becomes Xuegu (blood gu disorder). All these conditions arise from failing to take precautions after childbirth or during menstruation, leading to external invasion of wind-cold pathogens. The pathogenic factors contend with righteous qi, knotting in the abdomen to form the disease.