泻白甘桑地骨皮。再加粳米四般宜。(桑白皮地骨皮各一钱。甘草五分。粳米百粒。○
KT云桑皮泻肺火。地骨退虚热。甘草补土生金。粳米和中清肺。李时珍曰。此泻肺诸方
之准
纯也。)
秋伤燥令成痰嗽。火气乘金此法奇。
季楚重曰。火热伤气。救肺之治有三。伤寒邪热侮肺。用白虎汤除烦。此治其标。内症
虚火烁金。用生脉散益阴。此治其本。若夫正气不伤。郁火又甚。则泻白散之清肺调中。标
本兼治。又补二方之不及也。
治胃中湿热。包黄溺赤。口疮吐血衄血。
甘露二冬二地均。(天冬。麦冬。生地。熟地。)枇杷芩枳(黄芩。枳壳。枇杷叶。)斛
茵伦。(石斛。茵陈。)合和甘草平虚热。(等分煎温服。)口烂龈糜吐衄珍。
陈修园曰。足阳明胃为燥土。喜润而恶燥。喜降而恶升。故以二冬二地石斛甘草之润以
补之。枇杷枳壳之降以顺之。若用连柏之苦。则增其燥。若用 术之补。则虑其升。即有湿
热。用一味黄芩以折之。一味茵陈以渗之。足矣。盖以阳明之治。最重在养津液二字。此方
二地二冬等药。即猪苓汤用阿胶以育阴意也。茵陈汤芩之折热而去湿。即猪苓汤中之用滑泽
以除垢意也。
治赤下痢。
茱连六一左金丸。肝郁胁疼吞吐酸。(黄连六两。吴茱萸一两盐汤泡。名茱连丸。)更有
痢门通用剂。香连丸子服之安。(黄连二十两以吴茱萸十两水拌浸一宿同炒。去吴茱萸。木
香四两八钱五分二味共研末。醋糊丸桐子大。每服二三钱。空心米汤下。○薛立斋治虚痢。
以四君子汤四物汤补中益气汤。随宜送下。)
陈修园曰。肝实作痛。惟肺金能平之。故用黄连泻心火。不使克金。且心为肝子。实则
泻其子也吴茱萸入肝。苦辛大热。苦能引热下行。同气相求之义也。辛能开郁散结。通则不
痛之义也。何以谓之左金。木从左而制从金也。至于香连丸。取黄连之苦以除湿。寒以除热。
且藉其苦以坚大便之滑。况又得木香之行气止痛。温脾和胃。以为佐乎。故久痢之偏热者。
可以统治也。
泻白散由桑白皮、地骨皮、甘草和粳米四味药组成,这四样药材配合适宜。(其中桑白皮和地骨皮各一钱,甘草五分,粳米一百粒。○柯琴说:桑白皮能清泻肺火,地骨皮能退除虚热,甘草能补益脾土以生肺金,粳米能调和胃气并清润肺脏。李时珍说:这是治疗肺脏疾病方剂的准则和纯正代表。)
秋季感受燥邪导致痰嗽,火热之气侵犯肺金,此法颇为奇妙。
季楚重说:火热之邪损伤正气,救治肺脏的方法有三种。如果是伤寒邪热侮犯肺脏,使用白虎汤来除烦,这是治其标;如果是内伤虚火灼烧肺金,使用生脉散来滋养阴液,这是治其本;如果是正气未受损伤,但郁结之火非常严重,那么泻白散清肺调中,标本兼治,又弥补了前两个方剂的不足。
治疗胃中湿热,表现为大便黄赤,口舌生疮,吐血或鼻出血。
甘露饮由天冬、麦冬、生地、熟地四味药等分组成。(天冬、麦冬、生地、熟地。)枇杷叶、黄芩、枳壳与石斛、茵陈相配。(黄芩、枳壳、枇杷叶;石斛、茵陈。)混合甘草煎服可平复虚热。(等分煎煮,温服。)对于口烂牙龈溃烂、吐血流鼻血尤为珍贵。
陈修园说:足阳明胃经属于燥土,喜欢滋润而厌恶干燥,喜欢通降而厌恶上逆。所以用天冬、麦冬、生地、熟地、石斛、甘草的滋润之性来补益它,用枇杷叶、枳壳的通降之性来顺应它。如果使用黄连、黄柏的苦寒之性,则会增加其干燥;如果使用白术、附子的温补之性,则担心其升提。即使有湿热,只用一味黄芩来折伏火热,一味茵陈来渗利湿气,就足够了。大概因为治疗阳明胃经,最重要的是“养津液”这二字。这个方子中的生地、熟地、天冬、麦冬等药,就是猪苓汤中使用阿胶来育阴的意思。茵陈蒿汤和黄芩的折热去湿,就是猪苓汤中使用滑石、泽泻来除垢的意思。
治疗赤色痢疾(便下脓血)。
茱连丸即左金丸,由吴茱萸和黄连按一比六的比例组成,用于肝郁引起的胁痛、吞酸吐酸。(黄连六两,吴茱萸一两,用盐水浸泡后炒制,名为茱连丸。)还有痢疾门通用的方剂,服用香连丸即可安宁。(黄连二十两,用吴茱萸十两拌水浸泡一夜后同炒,去掉吴茱萸,加入木香四两八钱五分,两味药共研为末,用醋糊制成梧桐子大小的丸药。每次服用二三钱,空腹时用米汤送服。○薛立斋治疗虚证痢疾,用四君子汤、四物汤、补中益气汤,根据情况选择送服。)
陈修园说:肝脏实证作痛,只有肺金能制约它。所以使用黄连清泻心火,防止心火过旺克制肺金,而且心是肝的子脏,实则泻其子。吴茱萸入肝经,味苦辛性大热,苦味能引导热气下行,符合“同气相求”的道理;辛味能开郁散结,符合“通则不痛”的道理。为什么叫左金丸?因为肝木从左升,需用金来制约它。至于香连丸,取黄连的苦味以除湿,寒性以除热,并且借助其苦味使大便坚实以防滑泄,再加上木香的行气止痛、温脾和胃作用作为佐助。所以对于偏于热证的久痢,可以统一治疗。
Xiebai San (Lung-Clearing Powder) consists of Sangbaipi (Morus Cortex), Digupi (Lycii Cortex), Gancao (Licorice Root), and Jingmi (Rice Grain); these four ingredients are suitable when combined. (Sangbaipi and Digupi are each used in amounts of one qian, Gancao is used in an amount of five fen, and Jingmi is used in an amount of one hundred grains. ○ Ke Qin stated: Sangbaipi clears and drains Lung fire; Digupi dissipates deficiency heat; Gancao tonifies Spleen Earth to generate Lung Metal; Jingmi harmonizes the Stomach and moistens the Lung. Li Shizhen stated: This is the standard and purest representative among formulas for treating the Lung.)
Autumn injury by dryness leads to phlegm-cough; this method is ingenious for addressing Fire Qi invading Metal (Lung).
Ji Chuzhong stated: There are three treatments for rescuing the Lung when injured by Fire-Heat damaging Qi. If it is pathogenic Heat from Cold damage insulting the Lung, Baihu Tang (White Tiger Decoction) is used to relieve irritability, which treats the branch (symptoms). If it is internal deficiency Fire scorching Lung Metal, Shengmai San (Generate Pulse Powder) is used to nourish Yin, which treats the root (cause). However, if the healthy Qi is not damaged but stagnant Fire is severe, then Xiebai San clears the Lung and regulates the Middle Jiao, treating both branch and root, thereby supplementing the deficiencies of the previous two formulas.
Treating Damp-Heat in the Stomach, manifesting as yellow urine, mouth ulcers, hematemesis (vomiting blood), or epistaxis (nosebleed).
Ganlu Yin (Sweet Dew Decoction) equally comprises Tiandong (Asparagi Radix), Maidong (Ophiopogonis Radix), Shengdi (Rehmanniae Radix), and Shudi (Prepared Rehmanniae Radix). (Tiandong, Maidong, Shengdi, Shudi.) Pipa Ye (Loquat Leaf), Huangqin (Scutellariae Radix), Zhike (Aurantii Fructus) are matched with Shihu (Dendrobii Caulis) and Ychen (Artemisiae Scopariae Herba). (Huangqin, Zhike, Pipa Ye; Shihu, Ychen.) Mixed with Gancao and decocted, they calm deficiency heat. (Equal parts decocted, taken warm.) It is precious for treating oral ulcers, gingival erosion, vomiting blood, and nosebleeds.
Chen Xiuyuan stated: The Foot-Yangming Stomach channel belongs to Dry Earth; it prefers moisture and dislikes dryness, prefers descending and dislikes ascending. Therefore, the moistening properties of Tiandong, Maidong, Shengdi, Shudi, Shihu, and Gancao are used to tonify it, while the descending properties of Pipa Ye and Zhike are used to facilitate its function. If bitter-cold herbs like Lianru (Coptidis Rhizoma) and Bohu (Phellodendri Cortex) were used, they would increase dryness; if tonifying herbs like Baizhu (Atractylodis Macrocephalae Rhizoma) were used, there would be concern about causing ascending. Even with Damp-Heat, using one portion of Huangqin to restrain heat and one portion of Ychen to leach out dampness is sufficient. Generally, treating the Yangming Stomach focuses most on "nourishing Body Fluids." The Shengdi, Shudi, Tiandong, and Maidong in this formula reflect the intention of using Ejiao (Donkey-Hide Glue) in Zuling Tang (Polyporus Decoction) to nourish Yin. The heat-restraining and damp-draining action of Ychen Hao Tang (Artemisiae Scopariae Decoction) and Huangqin reflects the intention of using Huashi (Talcum) and Zexie (Alismatis Rhizoma) in Zuling Tang to remove turbidity.
Treating Excess Fire in the Liver, manifesting as pain under the left hypochondrium, or regurgitation of sour fluid.
Treating bloody dysentery.
Zulian Wan (Evodia and Coptis Pill), also known as Zuojin Wan (Left Metal Pill), composed of Wu Zhu Yu (Evodiae Fructus) and Huanglian (Coptidis Rhizoma) in a 1:6 ratio, is used for Liver stagnation causing hypochondriac pain, acid regurgitation, and belching. (Huanglian six liang, Wu Zhu Yu one liang, soaked in salt water and stir-fried together, named Zulian Wan.) There is also a general formula for the Dysentery category; taking Xianglian Wan (Costus and Coptis Pill) brings relief. (Huanglian twenty liang, soaked overnight with ten liang of Wu Zhu Yu mixed with water, then stir-fried together; discard the Wu Zhu Yu. Add Muxiang (Aucklandiae Radix) four liang eight qian five fen. Grind both into powder, make pills with vinegar paste the size of tung tree seeds. Take two to three qian per dose, on an empty stomach with rice soup. ○ Xue Lizhai treated deficiency-type dysentery by sending down the pills with Sizijunzi Tang (Four Gentlemen Decoction), Siwu Tang (Four Substances Decoction), or Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) according to suitability.)
Chen Xiuyuan stated: Pain caused by Liver Excess can only be pacified by Lung Metal. Therefore, Huanglian is used to drain Heart Fire so that it does not overly control Metal. Moreover, the Heart is the Son of the Liver; when there is excess, we drain the Son. Wu Zhu Yu enters the Liver channel; it is bitter, acrid, and greatly hot. Its bitterness guides heat downward, following the principle of "seeking what is similar in nature"; its acridity opens stagnation and disperses nodules, following the principle that "free flow results in no pain." Why is it called Zuojin (Left Metal)? Because Liver Wood ascends from the left and must be controlled by Metal. As for Xianglian Wan, it takes the bitterness of Huanglian to drain dampness and its cold nature to clear heat, and further relies on its bitterness to firm loose stools. Additionally, it benefits from the Qi-moving and pain-relieving properties of Muxiang, which warms the Spleen and harmonizes the Stomach as an assistant herb. Thus, it can uniformly treat chronic dysentery that leans towards heat.