(济生) 治伤寒胃火热盛,吐血,衄血。
嗽血便血。蓄血如狂,漱水不欲咽,及阳毒发斑。
生地(两半) 白芍(一两) 犀角(角尖尤良。鹿取茸。犀取尖。其精气尽在是也。
作器物者,多被蒸煮,不堪入药。) 丹皮(二钱半)每服五钱。热甚如狂者,加黄芩一两。
因怒致血者,加栀子柴胡。(黄芩泻上中二焦之火,栀子泻三焦之火,柴胡平少阳厥阴之火。)
血属阴本静,因诸经火逼,遂不安其位而妄行。犀角大寒,解胃热而清心火。芍药酸寒,
和阴血而泻肝火。(肝者心之母。)丹皮苦寒,泻血中伏火。生地大寒,凉血而滋水,以共平
诸经之僭逆也。
节庵加当归红花桔梗陈皮甘草藕汁,名加味犀角地黄汤。(当归引血归经,藕汁凉血散
瘀,桔梗以利上焦,陈皮以导中焦。红花以行下焦。)
(济生) 治思虑过度,劳伤心脾,怔忡健忘,(上气不足,下气有余,肠胃实而心气
虚,故善忘。)惊悸,(有触而心动曰惊,无惊而自动曰悸,即怔忡也。)盗汗,(汗为心液,
心藏神而生血,心伤则不能生血而血少,故见前诸证。)发热,(脾主肌肉。)体倦,(脾主四
肢。)食少,(脾不健晕。)不眠,(血不归经血,脾主思而藏血,脾伤故见前诸证。)或脾虚
不能摄血,致血妄行,及妇人经带。或心脾伤痛,嗜卧,肢体作痛,大便不调,或瘰 流注
,不能消散溃敛。
黄 (蜜炙) 当归(酒洗) 龙眼肉(二钱) 枣仁(炒研) 白术(土炒钱半) 人
参茯神(一
医贯曰∶心生血,脾统血,肝藏血。凡治血证,须按三经用药。远志枣仁,补肝以生心
火,
去白术木香龙眼,加茯苓陈皮,入莲肉,姜枣煎,名酸枣仁汤,治虚烦不眠。(金匮酸
枣仁汤,亦治不眠,见和解门。)
(济生犀角地黄汤)治疗伤寒导致胃中火热炽盛,出现吐血、鼻衄。
咳嗽带血、大便下血。蓄血证表现为如狂状态,想漱口但不愿吞咽,以及阳毒引起的发斑疹。
生地黄(一两半) 白芍药(一两) 犀角(以角尖为最佳。鹿取鹿茸,犀取犀角尖,因为精气都集中在尖端。制作器物的人往往经过蒸煮处理,不堪入药。) 牡丹皮(二钱半)。每次服用五钱。如果热势极重且出现如狂症状的,加黄芩一两。
因愤怒导致出血的,加栀子、柴胡。(黄芩清泻上焦和中焦的火,栀子清泻三焦的火,柴胡平抑少阳和厥阴经的火。)
血液属于阴,本性安静,因为各条经络的火邪逼迫,所以不安于其位而妄行。犀角大寒,能解除胃热并清心火。芍药味酸性寒,能调和阴血并泻肝火。(肝是心的母脏。)牡丹皮味苦性寒,能泻血中潜伏的火邪。生地黄大寒,能凉血并滋补肾水,共同平息各条经络的僭越逆乱之气。
节庵加入当归、红花、桔梗、陈皮、甘草、藕汁,命名为加味犀角地黄汤。(当归引导血液回归经脉,藕汁凉血散瘀,桔梗以利上焦,陈皮以疏导中焦,红花以通行下焦。)
(济生归脾汤)治疗思虑过度,劳伤心脾,出现怔忡健忘,(上气不足,下气有余,肠胃充实而心气虚弱,所以容易健忘。)惊悸,(受到外界刺激而心跳加速称为惊,没有外界刺激而自动心慌称为悸,也就是怔忡。)盗汗,(汗是心的津液,心藏神并生成血液,心受伤则不能生血导致血少,所以出现前述诸症。)发热,(脾主肌肉。)身体疲倦,(脾主四肢。)食欲减退,(脾不健运头晕。)失眠,(血液不归经,脾主思虑并储藏血液,脾受伤所以出现前述诸症。)或者脾虚不能统摄血液,导致血液妄行,以及妇女月经不调、白带异常。或者心脾疼痛,嗜睡,肢体疼痛,大便不调,或者瘰疬流注,不能消散、溃破或愈合。
黄芪(蜜炙) 当归(酒洗) 龙眼肉(二钱) 酸枣仁(炒后研碎) 白术(土炒一钱半) 人参 茯神
《医贯》说:心生成血液,脾统摄血液,肝储藏血液。凡是治疗血证,必须按照这三条经络来用药。远志、酸枣仁,补肝以生心火,去掉白术、木香、龙眼肉,加入茯苓、陈皮,放入莲肉,用生姜、大枣煎服,命名为酸枣仁汤,治疗虚烦不眠。(《金匮要略》中的酸枣仁汤,也治疗失眠,见和解门。)
(Jisheng Xijiao Dihuang Tang) Treats heat fire blazing in the stomach due to Shanghan (Cold Damage), manifesting as hematemesis (vomiting blood) and epistaxis (nosebleed).
Hemoptysis (coughing up blood) and hematochezia (blood in stool). Blood stasis syndrome presenting with manic-like behavior, a desire to rinse the mouth without swallowing, and macules caused by Yang toxin.
Shengdi Huang (Rehmanniae Radix Preparata, 1.5 liang) Baishao Yao (Paeoniae Radix Alba, 1 liang) Xijiao (Rhinoceros Horn; the tip is best. For deer, the horn core is used; for rhinoceros, the tip is used, as the essence resides there. Those processed into artifacts are often steamed or boiled and are unsuitable for medicinal use.) Mudan Pi (Moutan Cortex, 2.5 qian). Take 5 qian per dose. If the heat is severe and manic symptoms occur, add Huangqin (Scutellariae Radix, 1 liang).
If bleeding is caused by anger, add Zhizi (Gardeniae Fructus) and Chaihu (Bupleuri Radix). (Huangqin clears fire from the Upper and Middle Jiao; Zhizi clears fire from the Triple Burner; Chaihu pacifies fire in the Shaoyang and Jueyin meridians.)
Blood belongs to Yin and is inherently quiet. Due to the coercion of fire from various meridians, it becomes restless and moves recklessly. Xijiao is extremely cold; it resolves stomach heat and clears Heart fire. Shaoyao is sour and cold; it harmonizes Yin-blood and drains Liver fire. (The Liver is the mother of the Heart.) Mudan Pi is bitter and cold; it drains latent fire within the blood. Shengdi Huang is extremely cold; it cools blood and nourishes Kidney water, jointly pacifying the rebellious qi of various meridians.
Jie'an added Danggui (Angelicae Sinensis Radix), Honghua (Carthami Flos), Jiegeng (Platycodonis Radix), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), and Ouji (Nelumbinis Stomach Juice), naming it Jiawei Xijiao Dihuang Tang. (Danggui guides blood back to the vessels; Ouji cools blood and disperses stasis; Jiegeng benefits the Upper Jiao; Chenpi directs the Middle Jiao; Honghua promotes circulation in the Lower Jiao.)
(Jisheng Guipi Tang) Treats excessive overthinking that injures the Heart and Spleen, manifesting as palpitations and forgetfulness. (Insufficiency of Upper Qi and excess of Lower Qi, fullness in the intestines and stomach but deficiency of Heart Qi, leads to easy forgetfulness.) Jingji (startle palpitations); (Heart beating rapidly upon external stimulation is called Jing; spontaneous heart palpitation without stimulation is called Ji, which is equivalent to Zhengchong.) Night sweats. (Sweat is the fluid of the Heart; the Heart stores Shen and generates blood. Injury to the Heart impairs blood generation, leading to blood deficiency and the aforementioned symptoms.) Fever. (The Spleen governs the muscles.) Fatigue. (The Spleen governs the four limbs.) Poor appetite. (Spleen failing to transform and transport causes dizziness.) Insomnia. (Blood fails to return to its vessels; the Spleen governs thought and stores blood; injury to the Spleen leads to the aforementioned symptoms.) Or, Spleen deficiency failing to control blood, causing reckless bleeding, and menstrual irregularities or leukorrhea in women. Or Heart-Spleen pain, lethargy, limb pain, irregular bowel movements, scrofula (Luo Li) or flowing abscesses (Liuzhu) that cannot dissipate, suppurate, or heal.
Huangqi (Astragali Radix, honey-fried) Danggui (Angelicae Sinensis Radix, wine-washed) Longyan Rou (Longan Aril, 2 qian) Zaoren (Ziziphi Spinosomi Semen, stir-fried and crushed) Baizhu (Atractylodis Macrocephalae Rhizoma, soil-fried, 1.5 qian) Renshen (Ginseng Radix) Fushen (Poria with Hostwood)
Yi Guan states: The Heart generates blood, the Spleen controls blood, and the Liver stores blood. In treating blood disorders, one must medicate according to these three organs. Yuanzhi (Polygalae Radix) and Zaoren nourish the Liver to generate Heart Fire. Remove Baizhu, Muxiang (Aucklandiae Radix), and Longyan Rou; add Fuling (Poria), Chenpi, and Lianrou (Nelumbinis Semen); decoct with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus), named Suanzaoren Tang, treating vexation-insomnia due to deficiency. (The Suanzaoren Tang in Jin Gui Yao Lue also treats insomnia, see Harmonizing Section.)