更衣丸用荟砂研。滴酒为丸服二钱。(朱砂五钱。研如飞面芦荟七钱研细。滴酒和丸。
每服一钱。好酒送下。)阴病津枯肠秘结。交通水火妙通玄。
柯韵伯曰。胃为后天之本。不及固病。太过亦病。然太过复有阳盛阴虚之别焉。两阳合
明而胃家实。仲景制三承气下之。水火不交而津液亡。前贤又制更衣丸以润之古人入厕必更
衣。故为此丸立名用药之义。以重坠下达而奏功。朱砂色赤为火。体重象金。味甘归土。性
寒类水。为丹祖永母。能输坎以填离。生水以济火。是肾家之心药也。配以芦荟黑色通肾。
苦味入心。滋润之质。可转濡胃燥。大寒之性。能下开胃关。此阴中之阴。询为肾家主剂矣。
合以为丸。有水火既济之理。水土合和之义。两者相须。得效甚宏。奏功甚捷。真匪夷所思
矣。
治实热老痰之峻剂。虚寒者不宜用。
隐君遗下滚痰方。礞石黄连及大黄。少佐沉香为引导。顽痰怪症力能匡。(青礞石三两。
用焰硝一两。同入瓦KT 。盐泥固济。 至石色如金为度。水飞过。大黄酒蒸。黄芩酒洗。
各八两。沉香一两。为末水丸。姜汤下。量虚实服。服过咽即便仰卧。令药徐徐而下。半日
不可饮食行动。待药气自胃口渐下二肠然后动作饮食。服后喉间稠粘壅塞。乃药病相拒故也。
少顷药力到自愈)
柯韵伯曰脾为生痰之原。肺为贮痰之器此无稽之谈也。夫脾为胃行其津液。以灌四旁。
而水津又上输于肺。焉能凝结而为痰。惟肾为胃关。关门不利。故水聚而泛为痰也。则当曰
肾为生痰之原。经云。受谷者浊。受气者清。清阳走五脏。浊阴归六腑。肺为手太阴。独受
诸气之清。而不受有形之浊。则何可贮瘦。惟胃为水谷之海。万物所归。稍失转输之职。则
湿热凝结为痰。根据附胃中而不降。当日胃为贮痰之器。斯义也。惟王隐公知之。故治老痰之
方。不涉脾肺。而。责。之。胃。肾。二黄礞石。禀中央之黄色。入通中宫者也。黄芩能清
理胃中无形之气。大黄能荡涤胃中有形之质。然痰之为质。虽滑而粘。善栖泊于肠胃曲折之
处而为巢穴。不肯顺流而下。仍得绿涯而升。故称老痰。二黄以滋润之品。只能直行而泄。
欲使委曲而导之。非其所长也。故选金石以佐之。礞石之燥。可以除其湿之本。而其性之悍。
可以迅扫其曲折根据伏之处。使浊秽不得脏滞而少留。此滚痰之所由名乎。又虑夫关门不开。
仍得为老痰之巢臼。沉香为扎
方之色。能纳气归肾。又能疏通肠胃之滞。肾气流通。则水垢不留。而痰不再作。且使礞石
不粘着于肠。二黄不伤及于胃。一举而三善备。所以功效若神也。
更衣丸由芦荟和朱砂研磨制成。滴入酒调和成丸,每次服用二钱。(朱砂五钱,研得像飞面一样细;芦荟七钱,研细。滴酒和药粉制成丸剂。每服一钱,用优质黄酒送服。)此方适用于阴病导致津液枯竭、肠道便秘的情况。它能交通心肾水火,其妙用通晓玄理。
柯韵伯说:胃是后天之本,功能不足固然致病,功能太过也会致病。然而“太过”又有阳盛阴虚的区别。两阳合明而形成的“胃家实”,张仲景制定了三承气汤来攻下。若水火不交导致津液亡失,前贤又制作了更衣丸来滋润。古人上厕所前必须更换衣服,因此以此命名此丸。用药的道理在于利用重坠之性下达以奏效。朱砂颜色赤红属火,体重象金,味甘归土,性寒类水,被称为丹中之祖、永中之母,能输送坎水以填补离火,生水以济助心火,这是肾脏中的心脏药物。配合芦荟,其色黑通肾,苦味入心,具有滋润的质地,可以转化并濡润胃部的燥热;其大寒的性质,能下行开通胃关。这属于阴中之阴,确实是主治肾脏的方剂。两者合为丸剂,蕴含了水火既济的原理和水土合和的意义。两者相辅相成,疗效非常宏大,见效迅速,真是令人难以置信。
王隐君遗留下来的滚痰方,包含青礞石、黄连和大黄。稍加沉香作为引导,对于顽固怪异的痰症有力挽狂澜之功。(青礞石三两,用焰硝一两,一同放入瓦罐中,用盐泥密封加固,直到石头颜色变成金色为止,然后用水飞过(水飞法);大黄用酒蒸制;黄芩用酒洗制,各八两;沉香一两,研为细末,用水泛丸,姜汤送服。根据虚实情况调整剂量。服药后吞咽下去便立即仰卧,让药力徐徐下行,半日内不可饮食或行动,等待药气从胃口逐渐下行至大肠和小肠后,再行动和饮食。服药后喉间出现稠粘壅塞感,这是药力与病邪相互抗拒的缘故。过了一会儿,药力到达病灶,症状自然消除。)
柯韵伯说:“脾为生痰之源,肺为贮痰之器”这种说法是无稽之谈。脾为胃运行津液,灌溉四肢百骸,而水津又向上输注于肺,怎么能凝结成为痰呢?只有肾是胃的关口,如果关门不利,所以水液积聚而泛滥成为痰。那么应该说“肾为生痰之源”。《内经》说:受纳谷物产生浊气,受纳清气产生清气。清阳之气走散于五脏,浊阴之气归于六腑。肺是手太阴经,独自接受诸气的清轻部分,而不接受有形的浊物,那怎么能贮存痰呢?只有胃是水谷之海,万物所归,稍微失去转输的功能,湿热就会凝结成为痰,依附在胃中而不下降。应当说“胃为贮痰之器”,这个义理只有王隐君知道了。所以治疗老痰的方子,不涉及脾肺,而是责之于胃、肾。大黄、黄芩、礞石禀受中央土的黄色,进入并通达中宫(脾胃)。黄芩能清理胃中无形的气分郁热,大黄能荡涤胃中有形的实质积滞。然而痰这种物质,虽然滑腻粘稠,善于栖息在肠胃曲折之处并形成巢穴,不肯顺流而下,仍然得到绿涯(此处疑为原文传抄错误,结合语境应指某种特性或借代,暂按原文保留或理解为痰之特性)而上升,所以称为老痰。大黄和黄芩作为滋润之品,只能直行泄降,想要使其迂回曲折地引导排出,不是它们的长处。所以选择金石类药物来辅助它。礞石的燥性,可以去除湿的根本;而其性悍烈,可以迅速清扫那些曲折潜伏的地方,使浊秽之物不能脏滞而稍有停留。这就是“滚痰”名字的由来。又担心关门不开,仍然成为老痰的巢穴,沉香作为引经药,能纳气归肾,又能疏通肠胃的滞涩。肾气流通,则水垢不留,痰不再产生。并且使礞石不粘着于肠道,大黄不伤及胃部,一举而三善具备,所以功效如神一般。
Gengyi Wan (Changing Clothes Pill) is made by grinding Huizhe (Aloe, *Aloe*) and Zhusha (Cinnabar, *Cinnabaris*). It is mixed with wine into pills, taken in doses of 2 qian. (Zhusha [Cinnabar] 5 qian, ground as fine as flying flour; Huizhe [Aloe] 7 qian, ground finely. Mixed with wine to form pills. Take 1 qian per dose, delivered with good red wine.) This formula applies to Yin diseases where fluid depletion leads to intestinal constipation. It facilitates the communication between Heart Fire and Kidney Water, its profound efficacy connecting to metaphysical principles.
Ke Yunbo stated: The Stomach is the foundation of the post-heaven (acquired) constitution. Insufficiency causes disease, but excess also causes disease. However, "excess" differs between Yang excess and Yin deficiency. When two Yangs combine to brighten, resulting in "Stomach House Excess" (*Weijia Shi*), Zhang Zhongjing formulated the three Chengqi Decoctions for purgation. When Water and Fire do not communicate, leading to the loss of body fluids, earlier sages created Gengyi Wan to moisten. Ancients had to change clothes before using the toilet, hence the name of this pill. The rationale of the herbs lies in their heavy, descending nature to achieve effect. Zhusha (Cinnabar) is red like Fire, heavy like Metal, sweet entering Earth, and cold like Water. It is the ancestor of Dan (elixirs) and mother of Yong, capable of conveying Kan (Water/Kidney) to fill Li (Fire/Heart), generating Water to assist Fire. It is the heart medicine of the Kidney organ system. Paired with Huizhe (Aloe), which is black connecting to the Kidney, bitter entering the Heart, with a moistening quality that can transform and nourish Stomach dryness, and a great cold nature that descends to open the Stomach gate. This is Yin within Yin, truly the main agent for the Kidney. Combined into pills, it embodies the principle of Water and Fire having achieved balance (*Shuihuo Jiji*) and the meaning of Water and Earth harmonizing. These two mutually assist each other, yielding significant efficacy and rapid results, truly beyond imagination.
This is a harsh formula for treating solid heat and old phlegm; it is not suitable for those with deficiency-cold.
Wang Yinjun left behind the Gun Tan Fang (Rolling Phlegm Formula), containing Mengshi (Lapis Micae Aureus, *Lapis Micae Aureus*), Huanglian (Coptidis Rhizoma, *Coptidis Rhizoma*), and Dahuang (Rhei Radix et Rhizoma, *Rhei Radix et Rhizoma*). A small amount of Chenxiang (Aquilariae Lignum Resinatum, *Aquilariae Lignum Resinatum*) serves as a guide. It has the power to correct stubborn and strange phlegm syndromes. (Qingmengshi [Green Lapis Micae Aureus] 3 liang, mixed with Yanxiao [Saltpeter, *Natrii Nitras*] 1 liang, placed together in a clay pot, sealed tightly with salt mud, until the stone turns golden in color, then processed by water flotation (water-flying method). Dahuang [Rhubarb] is steamed with wine. Huangqin (Scutellariae Radix, *Scutellariae Radix*) is washed with wine, each 8 liang. Chenxiang [Agarwood] 1 liang. Ground into powder, formed into water pills, taken with ginger decoction. Dosage adjusted according to deficiency or excess. After swallowing, lie supine immediately to allow the medicine to descend slowly. Do not eat or move for half a day. Wait until the medicinal qi gradually descends from the stomach pit to the large and small intestines before moving or eating. After taking the medicine, if there is a feeling of thick, sticky obstruction in the throat, this is due to the resistance between the medicine and the pathogen. After a short while, when the medicinal force reaches the target, it will heal itself.)
Ke Yunbo said: The saying "The Spleen is the source of phlegm production, the Lung is the vessel storing phlegm" is nonsense. The Spleen transports fluids for the Stomach to irrigate the four sides, and water fluids are transported upward to the Lung. How can they congeal into phlegm? Only the Kidney acts as the gate of the Stomach. If the gate is not functioning properly, water accumulates and overflows to become phlegm. Thus, it should be said that "the Kidney is the source of phlegm production." The Classics state: Grain produces turbidity, Qi produces clarity. Clear Yang travels to the five Zang organs, turbid Yin returns to the six Fu organs. The Lung is Hand-Taiyin, receiving only the clear aspect of all Qi, not the有形 (form/solid) turbidity. How can it store phlegm? Only the Stomach is the sea of water and grain, the destination of all things. If its transport function is slightly lost, damp-heat condenses into phlegm, adhering to the Stomach without descending. One should say "the Stomach is the vessel storing phlegm." This principle was known only by Wang Yinjun. Therefore, formulas for treating old phlegm do not involve the Spleen or Lung, but focus on the Stomach and Kidney. Dahuang [Rhubarb], Huangqin [Scutellaria], and Mengshi [Lapis Micae Aureus] possess the yellow color of Central Earth, entering and communicating with the Middle Palace (Spleen/Stomach). Huangqin [Scutellaria] clears formless Qi stagnation in the Stomach, while Dahuang [Rhubarb] sweeps away有形 (solid) accumulation in the Stomach. However, phlegm as a substance, though slippery and sticky, tends to lodge in the folds of the intestines and stomach forming nests, refusing to flow down smoothly. It still rises, hence called "old phlegm." Dahuang [Rhubarb] and Huangqin [Scutellaria], being moistening agents, can only purge directly downward and are not good at guiding through twists and turns. Therefore, mineral stones are selected to assist. The drying nature of Mengshi [Lapis Micae Aureus] removes the root of dampness, and its fierce nature rapidly sweeps through convoluted areas where pathogens hide, preventing turbid filth from stagnating. This is the origin of the name "Rolling Phlegm." Fearing that the gate remains closed, becoming a nest for old phlegm again, Chenxiang [Agarwood] guides the Qi, directing it back to the Kidney, and also unblocks stagnation in the intestines and stomach. When Kidney Qi flows freely, water deposits are not retained, and phlegm does not reoccur. Furthermore, it prevents Mengshi [Lapis Micae Aureus] from sticking to the intestines and Dahuang [Rhubarb] from damaging the Stomach. One action achieves three benefits, hence its miraculous efficacy.