(治痰嗽气喘)
降气汤中苏半归。橘前沉朴草姜根据。风寒咳嗽痰涎喘。暴病无妨任指挥。(苏子橘皮半
夏当归前胡浓朴各一钱。沉香炙甘草各五分。加姜煎。一方无沉香。加肉桂。○苏子前胡橘
皮半夏降气。
气行则痰行也。风寒郁于皮毛。则肺气逆而为喘。数药妙能解表。气。以血为家。喘则
流荡而忘返。
故用当归以补血。喘则气急。故用甘草以缓其急。然出气者肺也。纳气者肾也。故用沉
香之纳气入肾或肉桂之引火归元。为引导。)
陈修园曰。仲景云。喘家作桂枝汤。加浓朴杏子佳。苏子降气汤。即从此汤套出。时医
皆谓切于时用。然有若似圣人。惟曾子以为不可耳。
治心神昏乱。惊悸怔忡。寤寐不安。
安神丸剂亦寻常。归草朱连生地黄。(朱砂另研黄连各半两。生地黄三钱。当归甘草各
二钱为末。酒炮蒸饼。丸如麻子。朱砂为衣。每服三十丸。临卧时津液下。)昏乱怔忡时不
寐。操存(孟子云操则存。)须令守其乡。
陈修园曰。东垣之方。多杂乱无纪。惟此方用朱砂之重以镇怯。黄连之苦以清热。当归
之辛以嘘血。更取甘草之甘。以制黄连之大过。地黄之润。以助当归所不及。方意颇纯。亦
堪节取。
治七情感伤。上气喘急。妨闷不食。
四磨汤治七情侵。参领槟乌及黑沉。(人参天台乌药槟榔黑沉香四味等分。各磨。浓水
取十分煎二五沸。空心服。或下养正丹妙。)磨汁微煎调逆气。虚中实症此方寻。
王又原曰。七情所感。皆能为病。然愈于壮者之行。而成于弱者之着。愚者不察。一遇
上气喘急。满闷不食。谓是实者宜泻。辄投破耗等药。得药非不暂快。初投之而应。投之久
而不应矣。夫呼出为阳吸入为阴。肺阳气旺。则清肃下行。归于肾阴。是气有所收摄。不复
散而上逆。若正气既衰。邪气必盛。纵欲削坚破滞。邪气必不伏。方用人参。泻壮火以扶正
气。沉香纳之于肾。而后以槟榔乌药。从而导之。所谓实必顾虚。泻必先补也。四品气味俱
浓。磨则取其味之全。煎则取其气之达。气味齐到。效如桴鼓矣。其下养正丹者。暖肾药也。
本方补肺气。养正丹温肾气。镇摄归根喘急遄已矣。
(治疗痰嗽气喘)
降气汤由苏子、半夏、当归组成。还有橘皮、前胡、沉香、厚朴、甘草和生姜作为依据。(苏子、橘皮、半夏、当归、前胡、浓朴各一钱,沉香、炙甘草各五分。加生姜煎煮。另一版本没有沉香,加肉桂。○苏子、前胡、橘皮、半夏具有降气作用。
气行则痰随之而行。风寒郁结在皮毛,导致肺气上逆而引发气喘。这几味药妙在能解表邪。以血为根本,气喘时气血流荡而不返。
所以用当归来补血。气喘导致气急,所以用甘草来缓解急促。然而,呼气的是肺,纳气的是肾。所以用沉香纳气入肾,或者用肉桂引火归元,作为引导。)
陈修园说:张仲景曾说:“患有喘病的人服用桂枝汤,加入厚朴、杏仁效果更佳。”苏子降气汤就是从这个方剂演变而来的。当时的医生都认为它切合时宜。然而,看似像圣人之道,只有曾子认为不可取罢了。
治疗心神昏乱,惊悸怔忡,睡眠不安。
安神丸的配方也很平常。包含当归、甘草、朱砂、黄连和生地黄。(朱砂另研,黄连半两,生地黄三钱,当归、甘草各二钱,研为细末,用酒炮制蒸饼,制成如麻子大小的丸剂,朱砂为衣。每次服用三十丸,临睡前用津液送服。)昏乱怔忡时无法入睡,修养心性(孟子说:操持则存在。)必须让它守住其乡。
陈修园说:李东垣的方剂,大多杂乱无章。只有这个方子用朱砂的重镇之性来镇怯,黄连的苦寒之性来清热,当归的辛散之性来嘘血(此处指调和血液),再取甘草的甘缓之性,来制约黄连的过大苦寒;地黄的滋润之性,来辅助当归所不及之处。方意颇为纯正,也值得借鉴选取。
治疗七情内伤,上气喘急,胸闷不食。
四磨汤治疗七情侵扰。人参统领槟榔、乌药及黑沉香。(人参、天台乌药、槟榔、黑沉香四味等分,分别磨汁,浓水取十分之一,煎煮二三十沸,空腹服用。或者配合养正丹服用更妙。)磨汁微煎调理逆气,虚中夹实症寻找此方。
王又原说:七情感受,都能致病。然而,强健者通过运行而痊愈,虚弱者因滞留而成疾。愚昧之人不加考察,一遇到上气喘急、满闷不食,就认为是实证适宜泻下,往往投用破耗类药物。服药后并非不暂时痛快,初用时有效,久用则无效了。呼出为阳,吸入为阴,肺阳气旺盛,则清肃下行,归于肾阴,这样气有所收摄,不再散乱而上逆。如果正气已经衰弱,邪气必然强盛,纵然想要削坚破滞,邪气也必定不能伏藏。方中使用人参,泻壮火以扶助正气,沉香纳气于肾,然后用槟榔、乌药,从而引导它。这就是所谓的“实必顾虚,泻必先补”。这四味药气味都浓厚,磨取其味的全面,煎取其气的通达。气味齐到,疗效如桴鼓相应。至于下面的养正丹,是暖肾的药物。本方补肺气,养正丹温肾气,镇摄归根,气喘急促很快就能停止。
(Treating Phlegm-Cough and Asthma)
The Jiangqi Decoction (Descend Qi Decoction) consists of Fructus Viticis (Suzi), Rhizoma Pinelliae (Banxia), and Radix Angelicae Sinensis (Danggui). It also includes Pericarpium Citri Reticulatae (Chenpi), Radix Peucedani (Qianhu), Lignum Aquilariae Resinatum (Chenxiang), Cortex Magnoliae Officinalis (Houpo), Radix Glycyrrhizae Preparata (Zhigancao), and Rhizoma Zingiberis Recens (Shengjiang) as foundational ingredients. (Fructus Viticis, Pericarpium Citri Reticulatae, Rhizoma Pinelliae, Radix Angelicae Sinensis, Radix Peucedani, and Cortex Magnoliae Officinalis are each used in 1 qian; Lignum Aquilariae Resinatum and prepared Radix Glycyrrhizae are each used in 0.5 qian. Decoct with fresh ginger. In another version without Lignum Aquilariae Resinatum, add Cortex Cinnamomi.) ○ Fructus Viticis, Radix Peucedani, Pericarpium Citri Reticulatae, and Rhizoma Pinelliae have the effect of descending Qi.
When Qi moves, phlegm follows. Wind-cold stagnating in the skin and hair causes Lung Qi to rebel upward, resulting in asthma. These herbs are ingenious in their ability to release the exterior. Taking blood as the foundation, when asthma occurs, Qi and Blood flow erratically and fail to return.
Therefore, Radix Angelicae Sinensis is used to nourish Blood. Since asthma leads to rapid breathing, Radix Glycyrrhizae is used to relieve urgency. However, the Lung is responsible for exhalation, while the Kidney is responsible for inhalation. Thus, Lignum Aquilariae Resinatum is used to guide Qi into the Kidney, or Cortex Cinnamomi is used to lead Fire back to its source, serving as a guiding agent.
Chen Xiuyuan stated: Zhang Zhongjing said, "For patients with a history of asthma who contract a cold, Guizhi Tang (Cinnamon Twig Decoction) with added Cortex Magnoliae Officinalis and Semen Pruni Armeniacae is optimal." The Suzi Jiangqi Tang was derived from this formula. Contemporary physicians consider it highly applicable to current conditions. However, although it appears to resemble the Way of the Sages, only Zengzi deemed it unacceptable.
(Treating Mental Confusion, Palpitations, and Insomnia)
The Anshen Wan (Calming the Spirit Pill) formula is quite common. It contains Radix Angelicae Sinensis, Radix Glycyrrhizae, Cinnabaris (Zhusha), Rhizoma Coptidis (Huanglian), and Radix Rehmanniae Preparata (Shengdihuang). (Cinnabaris is ground separately; Rhizoma Coptidis is used in 0.5 liang; Radix Rehmanniae Preparata in 3 qian; Radix Angelicae Sinensis and Radix Glycyrrhizae in 2 qian each. These are powdered, processed with wine and steamed buns, formed into pills the size of hemp seeds, coated with Cinnabaris. Take 30 pills each time, swallowed with saliva before bed.) During episodes of confusion and palpitations when sleep is impossible, one must cultivate the mind (as Mencius said: "If you grasp it, it exists") and ensure it remains in its proper place.
Chen Xiuyuan stated: Li Dongyuan's formulas are often chaotic and disorganized. Only this formula uses the heavy nature of Cinnabaris to suppress fear, the bitter nature of Rhizoma Coptidis to clear heat, the acrid nature of Radix Angelicae Sinensis to regulate Blood, and further employs the sweet nature of Radix Glycyrrhizae to moderate the excessive bitterness of Rhizoma Coptidis. The moistening nature of Radix Rehmanniae Preparata assists where Radix Angelicae Sinensis falls short. The intent of the formula is pure and worthy of selection.
(Treating Emotional Injury, Upper Asthma, and Chest Fullness)
Simoge Tang (Four-Ingredient Decoction) treats injuries caused by the Seven Emotions. Ren Shen (Ginseng Root) leads Bing Lang (Areca Seed), Wu Yao (Lindera Root), and Hei Chen Xiang (Black Agarwood). (Ren Shen, Tiantai Wu Yao, Bing Lang, and Hei Chen Xiang are used in equal parts. Each is ground separately. Take one-tenth part of the concentrated liquid, boil for 20-30 times, and take on an empty stomach. Alternatively, combine with Yangzheng Dan for better results.) The ground juice, slightly boiled, regulates rebellious Qi; this formula is sought for deficiency-patterns complicated by excess.
Wang Youyuan stated: The Seven Emotions can all cause disease. However, they heal through movement in the robust, but become entrenched due to stagnation in the weak. Ignorant people fail to investigate; upon encountering upper asthma, chest fullness, and loss of appetite, they assume it is an excess pattern suitable for purging, and immediately administer dispersing and consuming drugs. Although there may be temporary relief after taking the medicine, it works initially but fails with prolonged use. Exhalation is Yang, inhalation is Yin. When Lung Yang Qi is vigorous, it descends clearly and returns to Kidney Yin, allowing Qi to be retained and preventing it from scattering and rebelling upward. If Righteous Qi is already depleted, Pathogenic Qi will inevitably be strong. Even if one attempts to break hardness and stagnation, the Pathogenic Qi will not subside. Therefore, Ren Shen is used to drain hyperactive Fire and support Righteous Qi; Hei Chen Xiang guides Qi into the Kidney; then Bing Lang and Wu Yao follow to guide it. This is what is meant by "when treating excess, one must consider deficiency; when purging, one must first tonify." These four substances have dense flavors and aromas. Grinding extracts their complete flavor; decocting extracts their aromatic energy. When both flavor and energy arrive together, the efficacy is immediate like a drumstick striking a drum. As for Yangzheng Dan mentioned below, it is a kidney-warming drug. This formula tonifies Lung Qi, while Yangzheng Dan warms Kidney Qi, anchoring and returning to the root, causing urgent asthma to cease quickly.