益元艾附与干姜。麦味知连参草将。(附子炮艾叶干姜麦冬五味知母黄连人参炙甘草。
○艾叶辛热。能回阳。)葱白童便为引导。内寒外热是慈航。
此阴盛格阳之症。面赤口渴欲卧于泥水之中。为外热内寒。此汤姜附艾叶加知连等药。
与白通加人尿猪胆汁同意。乃热因寒药为引用也。内热曰烦。为有根之火。外热不宁曰躁。
为无根之火。故但躁不烦。及先躁后烦者。皆不治。
肾气丸名别济生。车前牛膝合之成。(熟地四两茯苓三两。山药山茱丹皮泽泻肉桂车前
子牛膝各一两。附子五钱。蜜丸。空心米汤送下。)肤膨腹肿痰如壅。气化 水自行。
张景岳曰。地黄山药丹皮。以养阴中之真水。山茱桂附。以化阴中之阳气。茯苓泽泻车
前牛膝。以利阴中之滞。能使气化于精。即所以治肺也。补火生土。即所以治脾也。壮水利
窍。即所以治肾也。水肿。乃肺脾肾三脏之病。此方所以治其本。
治卒中昏不知人。口眼 斜。半身不遂。并痰厥阴厥。
三生饮用附乌星。香入些微是引经。(生南星一两。生川乌生附子各去皮各五钱。木香
二钱。)参汁对调宗薛氏。(每服一两。加参一两。)风痰卒倒效神灵。
柯韵伯曰。风为阳邪。风中无寒。不甚伤人。惟风中挟寒。害始剧矣。寒轻而在表者。
宜发汗以逐邪。寒重而入里者。非温中补虚。终不可救。此取三物之大辛大热者。且不炮不
制。更佐以木香。乘其至刚至锐之气而用之。非以治风。实以治寒也。然邪之所凑。其气必
虚。但知勇于攻邪。若正气虚而不支。能无倒戈之患乎。必用人参两许。以驾驭其邪。此立
斋先生真知确见。立于不败之地。而获万全之效者也。若在庸手。必谓补住邪气而不敢用。
此谨熟阴阳。毋与众论。岐伯所以叮咛致告耳。观其每服五钱。必四服而邪气始出。今之畏
事者。用乌附数分。必制热而后敢用。更以芩连滥制之焉。能挽回如此危症哉。古今人不相
及如此。
益元汤由艾附、干姜组成,配以麦冬、五味子、知母、黄连、人参和炙甘草。(其中包含炮制过的附子、艾叶、干姜、麦冬、五味子、知母、黄连、人参和炙甘草。)
○艾叶性味辛热,能够回阳救逆。
以葱白和童便作为药引。此方主治内寒外热的证候,如同慈航普渡。
这是阴盛格阳的病症,表现为面部发红、口渴,甚至想卧在泥水中,属于外热内寒。此汤剂中干姜、附子、艾叶配合知母、黄连等药物,与白通加人尿猪胆汁汤的意义相同,都是采用“热因寒用”的方法,以寒凉药为引导。内部发热称为“烦”,是有根之火;外部躁动不安称为“躁”,是无根之火。因此,只有躁动而没有心烦,或者先躁动后出现心烦的,都属于不治之症。
济生肾气丸是肾气丸的别名,由车前子和牛膝合入而成。(配方为:熟地黄四两,茯苓三两,山药、山茱萸、牡丹皮、泽泻、肉桂、车前子、牛膝各一两,附子五钱。制成蜜丸,空腹时用米汤送服。)身体浮肿、腹部肿胀、痰多壅滞,通过恢复气化功能,水液自然运行。
张景岳说:熟地黄、山药、牡丹皮,用来滋养阴中之真水;山茱萸、肉桂、附子,用来化生阴中之阳气;茯苓、泽泻、车前子、牛膝,用来疏通阴中之滞涩。能够使精气发生气化作用,这就是治疗肺脏的方法;补火以生土,这就是治疗脾脏的方法;壮水利窍,这就是治疗肾脏的方法。水肿,是肺、脾、肾三脏的疾病,此方所以能治其根本。
治疗中风突然昏倒不省人事,口眼歪斜,半身不遂,以及痰厥、阴厥。
三生饮由生南星、生川乌、生附子组成,加入少量木香作为引经药。(配方为:生南星一两,生川乌、生附子各去皮五钱,木香二钱。)服用时用人参汁调匀,效法薛己(薛氏)的方法。(每次服用一两,加入人参一两。)治疗风痰突然昏倒是神效灵验的。
柯韵伯说:风是阳邪,风中无寒,对人体的伤害不深。只有风中挟带寒气,危害才剧烈。寒气轻而在表者,适宜发汗以驱除邪气;寒气重而入里者,如果不温中补虚,最终无法挽救。此方选取三味大辛大热的药物,且不经过炮制加工,再佐以木香,凭借它们至刚至锐的气机来使用,并非用于治疗风邪,实际上是用于治疗寒邪。然而,邪气聚集之处,正气必然虚弱。如果只知道勇于攻伐邪气,而正气虚弱不能支撑,难道不会导致正气崩溃吗?必须使用大量人参,来驾驭邪气。这是李中梓(立斋先生)真正深刻的见解,立于不败之地,从而获得万全的效果。如果在庸医手中,必定认为补益会留住邪气而不敢使用。这正是岐伯反复叮咛告诫的:“谨熟阴阳,毋与众论”。观察此方每服五钱,必须服用四次,邪气才能排出。现在那些畏事的人,只用几分乌头、附子,一定要经过制热处理后才敢使用,再加上黄芩、黄连胡乱制约,怎么能挽回如此危急的病症呢?古今人的水平相差如此之大。
Yi Yuan Decoction consists of Ai Ye (Artemisia argyi), Fu Zi (Aconite), and Gan Jiang (Dried Ginger), combined with Mai Dong (Ophiopogon), Wu Wei Zi (Schisandra), Zhi Mu (Anemarrhena), Huang Lian (Coptis), Ren Shen (Ginseng), and Zhi Gan Cao (Honey-fried Licorice). (Ingredients include Pao Fu Zi, Ai Ye, Gan Jiang, Mai Dong, Wu Wei Zi, Zhi Mu, Huang Lian, Ren Shen, and Zhi Gan Cao.)
○ Ai Ye is acrid and hot in nature. It can restore Yang Qi.
Scallion white (Cong Bai) and child's urine (Tong Bian) are used as guides for the medicinal action. This decoction treats the syndrome of internal cold and external heat, acting like a compassionate ferryboat.
This is a syndrome of Yin excess repelling Yang. Symptoms include facial redness, thirst, and a desire to lie in mud or water, representing external heat and internal cold. In this decoction, Gan Jiang, Fu Zi, and Ai Ye are combined with Zhi Mu, Huang Lian, and other herbs. Its principle is consistent with Bai Tong Tang plus human urine and pig bile, employing the method of "using heat due to cold," where cold herbs serve as guides. Internal heat is termed "Fan" (restlessness/agitation), which is fire with roots; external restlessness is termed "Zao" (fidgeting/irritability), which is fire without roots. Therefore, cases presenting only with Zao without Fan, or Zao followed by Fan, are considered untreatable.
Ji Sheng Shen Qi Wan is an alternative name for Shen Qi Wan, formed by adding Che Qian Zi (Plantago seed) and Niu Xi (Achyranthes root). (Formula: Shu Di Huang 4 liang, Fu Ling 3 liang, Shan Yao, Shan Zhu Yu, Mu Dan Pi, Ze Xie, Rou Gui, Che Qian Zi, and Niu Xi each 1 liang, Fu Zi 5 qian. Made into honey pills, taken on an empty stomach with rice soup.) It treats body edema, abdominal swelling, and phlegm obstruction by restoring Qi transformation, allowing water metabolism to proceed naturally.
Zhang Jingyue stated: Shu Di Huang, Shan Yao, and Mu Dan Pi nourish the true Yin water within Yin; Shan Zhu Yu, Rou Gui, and Fu Zi transform the Yang Qi within Yin; Fu Ling, Ze Xie, Che Qian Zi, and Niu Xi promote the unblocking of stagnation within Yin. This enables Qi transformation from essence, which constitutes treating the Lung; tonifying Fire to generate Earth constitutes treating the Spleen; strengthening water and opening orifices constitutes treating the Kidney. Edema is a disease of the Lung, Spleen, and Kidney. This formula treats the root cause.
It treats sudden stroke with unconsciousness, deviation of the mouth and eyes, hemiplegia, as well as Phlegm Jue (syncope) and Yin Jue (cold extremities/syncope).
San Sheng Yin consists of Sheng Nan Xing (Arisaema cum Bile), Sheng Chuan Wu (Sichuan Aconite Root), and Sheng Fu Zi (Prepared Aconite Mother Root), with a small amount of Mu Xiang (Aucklandia) added as a meridian-guiding herb. (Formula: Sheng Nan Xing 1 liang, Sheng Chuan Wu and Sheng Fu Zi each peeled 5 qian, Mu Xiang 2 qian.) It is mixed with Ren Shen juice for administration, following the method of Xue Ji. (Each dose is 1 liang, added with 1 liang of Ren Shen.) It is miraculously effective for sudden collapse due to Wind-Phlegm.
Ke Yunbo stated: Wind is a Yang pathogen. Wind without Cold does not severely harm the body. Harm becomes severe only when Wind carries Cold. If Cold is mild and in the exterior, sweating should be induced to expel the pathogen. If Cold is heavy and has entered the interior, without warming the middle and tonifying deficiency, rescue is impossible. This prescription selects three substances that are extremely acrid and hot, without processing or preparation, assisted by Mu Xiang, utilizing their extreme rigidity and sharpness. It is not used to treat Wind, but actually to treat Cold. However, where pathogens gather, Qi must be deficient. If one only knows how to aggressively attack pathogens, while deficient Qi cannot sustain itself, will there not be a risk of collapse? One must use a large amount of Ren Shen to control the pathogen. This represents the profound insight of Mr. Li Zhongzi (Li Lai), establishing invincibility and achieving perfect results. If used by mediocre practitioners, they would fear that tonification retains the pathogen and dare not use it. This is precisely what Qibo earnestly admonished: "Carefully master Yin and Yang, do not discuss with the masses." Observing that each dose is 5 qian, and four doses are required for the pathogen to exit. Nowadays, those who fear trouble use only a few fen of Wu Tou and Fu Zi, daring to use them only after heat-reducing processing, and further restricting them with Huang Qin and Huang Lian. How could such critical conditions be reversed? The gap between ancient and modern practitioners is so vast.