治积热
地黄汁(四升三合) 茯神 知母 葳蕤(四两) 栝蒌根 生姜汁 鲜地骨皮 生麦
冬汁 白
上 咀,以水一斗零二升,先煮诸药,取汁三升,去渣。下竹沥地黄麦冬汁,缓火煎四
五沸
之。
(又名茱连丸)
治肝胆郁火,左胁作痛,或胸胁痛不可忍,吞酸吐酸,筋疝痞结,酒湿发黄。(肝火盛
则胁
筋疝
但得
黄连(六两姜汁炒) 吴茱萸(一两盐水泡) 水丸。
肝实则作痛,心者肝之子,实则泻其子,故用黄连泻心清火为君,使火不克金,金能制
木,
一热
肝居于
皆属
能相
何也?丹溪曰∶吐酸与吞酸不同。吐酸,吐出酸水如醋。平时津液,随上升之气,郁而成积
,湿中生热,故随木化,遂作酸味,非热而何。其有郁之久,伏于肠胃之间,咯不得上,咽
不得下。肌表得风寒,则内热愈郁,而酸味刺心。肌表温暖,腠理开发,或得香热汤丸,汁
液得行,亦可暂解,非寒而何。素问言热,言其体位。东垣言寒,言其末也。予当治吞酸,
用黄连吴茱制炒,随时令迭为佐使。苍术茯苓为辅,蒸饼为丸吞之。仍教糖食蔬果自养,则
病易安(丹溪之论,亦未畅尽。总之此证有热有寒,不可执一。)戴氏曰∶房劳肾虚之人,
胸
未
加炒芩苍术陈皮,亦名茱连丸,治同。加芍药等分为丸,名戊己丸,治热痢热泻。(热
泻者
子一
青丸
【地黄煎】
治疗积热证。
取地黄汁四升三合,茯神、知母、葳蕤(玉竹)、栝蒌根、生姜汁、鲜地骨皮、生麦冬汁各四两。
将上述药材切碎,用水一斗零二升,先煎煮各种药物,取药汁三升,滤去药渣。
加入竹沥、地黄汁、麦冬汁,用小火煎煮四五次沸腾即可。
【左金丸】
(又名茱连丸)
治疗肝胆郁火,左侧胁肋疼痛,或胸胁部剧烈疼痛难以忍受,吞酸吐酸,筋疝及痞块结聚,因酒湿导致的发黄。(肝火旺盛则导致胁痛和筋疝)。
肝气实则产生疼痛,心是肝的“子”脏,根据“实则泻其子”的原则,所以使用黄连来清泻心火作为君药,使火不克制肺金,肺金就能制约肝木。
这是什么原因呢?朱丹溪说:吐酸与吞酸不同。吐酸,是指吐出像醋一样的酸水。平时的津液,随着上升的气机,郁结而成积聚,湿气中生热,因此随肝木之气化,遂产生酸味,这难道不是热证吗?那些郁结时间久远的,潜伏在肠胃之间,咳不出来,咽不下去。如果肌表受到风寒侵袭,则内部的热邪更加郁结,酸味刺痛心脏。如果肌表温暖,腠理开泄,或者服用香热的汤剂或丸药,津液得以运行,也可以暂时缓解,这难道不是寒证吗?《素问》所说的“热”,是指疾病的本质属性;李东垣所说的“寒”,是指疾病的外在表现。我治疗吞酸证,使用黄连和吴茱萸制炒,根据时令变化交替作为佐使药。苍术、茯苓作为辅药,用蒸饼做丸剂吞服。并教导患者食用糖、蔬菜和水果以调养身体,这样病就容易痊愈。(朱丹溪的论述,也没有完全详尽。总之这个病症有热证也有寒证,不可固执一端。)戴氏说:房劳过度导致肾虚的人……(此处原文残缺,推测为加味用法)……加上炒黄芩、苍术、陈皮,也叫做茱连丸,主治相同。加上芍药等量制成丸剂,叫做戊己丸,治疗热痢和热泻。(热泻者……此处原文残缺)……青丸……
[Di Huang Jian (Rehmannia Decoction)]
Treats accumulated heat.
Take Di Huang Zhi (Fresh Juice of Rehmanniae Radix) 4 sheng and 3 he; Fu Shen (Poria with Hostwood), Zhi Mu (Anemarrhenae Rhizoma), Wei Rui (Polygonati Odorati Rhizoma, also known as Yuzhu), Gua Lou Gen (Trichosanthis Radix), Sheng Jiang Zhi (Fresh Ginger Juice), Xian Di Gu Pi (Fresh Cortex Lycii), and Sheng Mai Dong Zhi (Fresh Juice of Ophiopogonis Radix), each 4 liang.
Chop the aforementioned herbs. Add 1 dou and 2 sheng of water. First decoct the various herbs, obtain 3 sheng of liquid, and filter out the dregs.
Add Zhu Li (Bamboo Sap), Di Huang Zhi, and Mai Dong Zhi. Simmer over a slow fire for four or five boils.
[Zuo Jin Wan (Left Metal Pill)]
(Also known as Zhu Lian Wan)
Treats liver-gallbladder stagnant fire, pain in the left hypochondrium, or unbearable chest and hypochondriac pain, acid regurgitation, tendon hernia, and palpitations/masses, jaundice caused by damp-heat from alcohol consumption. (When liver fire is excessive, it causes hypochondriac pain and tendon hernia).
When liver qi is excess, pain occurs. The Heart is the "son" organ of the Liver. According to the principle of "tonifying deficiency by treating the mother and purging excess by treating the son," Huang Lian (Coptidis Rhizoma) is used to purge heart fire and clear heat as the sovereign drug. This prevents fire from overcoming metal, allowing metal to control wood.
Why is this? Danxi stated: Regurgitating acid differs from swallowing acid. Regurgitating acid involves spitting out sour fluid like vinegar. Normally, body fluids, following ascending qi, become stagnant and accumulate. Heat generated within dampness transforms according to Wood Qi, thus producing an acidic taste. Is this not a heat condition? Those that have been stagnant for a long time lie hidden between the stomach and intestines, unable to be coughed up or swallowed down. If the skin and muscles are exposed to wind-cold, internal heat becomes more stagnant, and the acidic taste pierces the heart. If the skin and muscles are warm, pores open, or if aromatic hot soups or pills are taken, body fluids can flow, providing temporary relief. Is this not a cold condition? *Su Wen* speaks of "heat" referring to the nature of the disease. Dongyuan speaks of "cold" referring to the manifestation. I treat swallowing acid using Huang Lian and Wu Zhu Yu processed together, alternating them as minister and guide drugs according to the seasons. Cang Zhu (Atractylodis Rhizoma) and Fu Ling (Poria) serve as assistant drugs. Pills are made with steamed dough and swallowed. Patients are instructed to nourish themselves with sugar, vegetables, and fruits, so the illness will easily resolve. (Danxi's discussion was not exhaustive. In summary, this syndrome has both heat and cold aspects; one must not adhere rigidly to one view.) Dai stated: For those with kidney deficiency due to sexual exhaustion... [text fragment] ...add fried Huang Qin (Scutellariae Radix), Cang Zhu, and Chen Pi (Citri Reticulatae Pericarpium); this is also called Zhu Lian Wan, with the same indications. Add Bai Shao (Paeoniae Radix Alba) in equal amounts to make pills; this is called Wu Ji Wan, treating dysentery and diarrhea due to heat. (For heat diarrhea... [text fragment] ...Qing Wan...)