治阳盛阴虚。血热妄行。或吐或衄者。
四生丸用叶三般。艾柏鲜荷生地斑。(生侧柏叶。生艾叶。生荷叶。生地黄各等分。)共
捣成团入水化。血随
柯韵伯曰心肾不交。则五脏齐损。阴虚而阳无所附。则火炎上焦。阳盛则阳络伤。故血
上溢于口鼻也。凡草木之性。生者凉。而熟之则温。熟者补。而生者泻。四味皆清寒之品。
尽取其生者。而捣烂为丸。所以全其水气。不经火煮。更以远于火令矣。生地多膏。清心肾
而通血脉之源。柏叶西指。清肺经而调营卫之气。艾叶芳香。入脾胃而和生血之司。荷叶法
震入肝家。而和藏血之室。五脏安堵。则水火不相射。阴平阳秘。而血归经矣。是方也。可
暂用以遏妄行之血。如多用。则伤营。盖血得寒。则瘀血不散。而新血不生也。设但知清火
凉血。而不用归脾养营等剂。以善其后。鲜有不绵连岁月而毙者。非立方之不善。妄用者之
过耳。
○热可制寒
回阳急救(节庵)。用六君。桂附干姜五味群。(附子炮干姜肉桂人参各五分。白术茯苓
各一钱。半夏陈皮各七分。甘草三分。五味九粒。姜水煎。)加麝三厘或胆汁。三阴寒厥见
奇勋。(姜桂附子。祛其阴寒。六君子汤。补助其阳气。五味人参。以生其脉。加麝香者。
以通其窍。加胆汁者。热因寒用也。)
陈修园曰。此市医得意方也。修园不释。
治疗阳气偏盛、阴液亏虚。血分有热导致血液不循常道而妄行。出现呕吐或鼻出血的症状。
四生丸由三种叶子和一味药组成:艾叶、侧柏叶、荷叶和生地黄。(生侧柏叶、生艾叶、生荷叶、生地黄各取等量。)共同捣烂成团,放入水中化开服用。
柯韵伯说:心肾不交,则五脏都会受损。阴液亏虚而阳气无所依附,则火热炎上于上焦。阳气过盛则损伤阳络(分布于体表及上部、属阳的脉络),所以血液向上溢出到口鼻。凡是草木的药性,生用的性质偏凉,煮熟后则偏温;熟用的具有补益作用,生用的具有泻实作用。这四味药都是清寒性质的药物,全部取其生用,并捣烂制成丸剂,以保全其水性,不经过火煮,更加远离了火气。生地黄多膏脂,能清心肾之火并疏通血脉之源;侧柏叶向西生长,能清肺经之热并调和营卫之气;艾叶气味芳香,入脾胃经并调和生成血液的功能;荷叶遵循震卦(东方、肝木)的法度,入肝家并调和藏血的脏腑。五脏安宁,则水火互不干扰,阴平阳秘,血液回归经脉。这个方子,可以暂时用来遏制妄行的血液。如果多用,则会损伤营血。因为血液遇到寒气,则瘀血不能消散,新血也无法生成。假如只知道清热泻火、凉血止血,而不使用归脾汤、养营汤等方剂来善后调理,很少有不在长年累月中死亡的。这不是立方的不好,而是滥用此方的过错。
○ 热证可用寒药制约
回阳急救汤(节庵创制)。使用六君子汤为基础,加上肉桂、附子、干姜、五味子等群药。(炮附子五分,干姜、肉桂、人参各五分,白术、茯苓各一钱,半夏、陈皮各七分,甘草三分,五味子九粒,生姜水煎服。)加入麝香三厘或胆汁。(姜、桂、附子,祛除体内的阴寒;六君子汤,补助体内的阳气;五味子、人参,以生津复脉。加入麝香,是为了开通窍道;加入胆汁,是运用“热因寒用”的反佐之法。)
陈修园说:这是市面上医生得意的方子。我不做解释。
Treating conditions of Excess Yang and Deficiency Yin. Heat in the Blood causing reckless bleeding. Manifesting as vomiting or epistaxis (nosebleed).
Si Sheng Wan (Four Raw Herbs Pill) utilizes three types of leaves and one herb: Ai Ye (Mugwort Leaf), Ce Bai Ye (Biota Top Leaf), He Ye (Lotus Leaf), and Sheng Di Huang (Rehmannia Root). [Raw Ce Bai Ye, Raw Ai Ye, Raw He Ye, and raw Sheng Di Huang are used in equal proportions.] They are pounded together into a paste, mixed with water, and taken orally.
Ke Yunbo stated: When Heart and Kidney fail to interact, all five Zang organs suffer damage. Due to Yin deficiency, Yang has no anchor, leading to Fire blazing upward in the Upper Jiao. Excess Yang damages the Yang collaterals (collaterals distributed on the body surface and upper parts, belonging to Yang), causing blood to overflow upwards from the mouth and nose. Generally, the nature of herbs is cool when raw and warm when cooked; cooked herbs have tonifying properties, while raw herbs have purgative properties. These four ingredients are all cold-natured substances. By using them all in their raw state and pounding them into pills, the water qi is preserved. Not being boiled by fire further distances them from heat. Sheng Di Huang is rich in mucilage, clearing Heart and Kidney heat and unblocking the source of the blood vessels. Ce Bai Ye grows westward, clearing Lung channel heat and regulating Ying and Wei Qi. Ai Ye has an aromatic scent, entering the Spleen and Stomach channels to harmonize the functions governing blood generation. He Ye follows the principles of the Zhen trigram (East, Liver Wood), entering the Liver to harmonize the residence storing blood. With the five Zang organs at peace, Water and Fire do not interfere with each other; Yin is balanced and Yang is secure, allowing blood to return to its vessels. This formula can be temporarily used to arrest reckless bleeding. However, excessive use will damage Ying blood. Since blood congeals when exposed to cold, blood stasis will not dissipate, and new blood will not generate. If one only knows to clear heat, purge fire, and cool blood without using formulas such as Gui Pi Tang (Restore the Spleen Decoction) or Yang Ying Tang (Nourish Ying Decoction) for subsequent care, death within years is inevitable. This is not due to poor formulation, but rather the fault of misuse.
○ Heat can be controlled by Cold
Hui Yang Ji Jiu Tang (Rescue Yang Emergency Decoction - created by Jie'an). It uses Liu Jun Zi Tang (Six Gentlemen Decoction) as a base, combined with Rou Gui (Cinnamon Twig), Fu Zi (Aconite Root), Gan Jiang (Dried Ginger), and Wu Wei Zi (Schisandra Fruit). [Pao Fu Zi 5 fen, Gan Jiang, Rou Gui, Ren Shen each 5 fen, Bai Zhu, Fu Ling each 1 qian, Ban Xia, Chen Pi each 7 fen, Gan Cao 3 fen, Wu Wei Zi 9 grains, decocted with ginger water.] Add She Xiang (Musk) 3 li or Dan Nong (Bile). [Jiang (Ginger), Gui (Cinnamon), and Fu Zi (Aconite) dispel internal Yin-cold; Liu Jun Zi Tang tonifies internal Yang; Wu Wei Zi and Ren Shen generate fluids and restore the pulse. Adding She Xiang opens the orifices; adding Dan Nong employs the method of "treating heat with cold" (counter-agent therapy).]
Chen Xiuyuan said: This is a favored prescription among market physicians. I shall not explain it.