内经谓各脉太过则令人解 。脊脉痛而少气不欲言。夫肾为作强之官。精为身之本。所
以运动行体者也。一或受邪则肾不实而精不运。故有脊脉痛少气不欲言之证。名曰解 者。
解
方
利肾汤 治解 脉痛。气乏不欲言。此为肾气余。
泽泻 生地黄 赤茯苓(各一两) 槟榔(锉) 牛膝(酒浸各一两) 麦门冬(去心
焙) 柴
胡
通肾汤 治解 少气不能言。脊脉急痛。腰脊强直。足下热痛。小便癃闭。心烦噎
气。
菖蒲(锉) 羚羊角(镑) 生地(焙) 赤芍药(各二两) 五味子 甘草 猪苓(去
黑皮)
泽泻
匀气散 治肾气有余。足少阴脉太过。令人脊痛少气不欲言。
枳壳(麸炒) 泽泻 赤茯苓 牡丹皮 木通(锉) 槟榔 玄参(各一两) 上为粗
散。每
服三
凡骨髓虚实之应。主于肾膀胱。若其脏腑有病。从骨生热则应脏。寒则应腑。故肾主骨
髓。肾气之余。其气虚则骨弱酸疼。倦而无力。其气实则骨热苦烦。津液内燥。当随证以治
之。夫骨髓之病应肝胆。若其脏腑有病。从髓生。盖热则应脏。寒则应腑。故髓虚者脑痛不
安
方
人参饮 治骨极虚寒。面肿垢黑。腰膝疼不能久立屈伸。梦寐惊悸。上气。小腹急
痛。腰背
人参 五味子 熟地黄(焙) 赤芍药 甘草(炙) 麦门冬(去心) 白茯苓 桂(各
一两)
上
羌活丸(出圣惠方)治髓虚寒。脑痛不安。补髓。
羌活 芎 (炒各二两) 桂(一两) 当归(一两) 人参(二两) 大枣(三十个
取肉) 大
麻仁(研) 羊髓 酥 牛髓(各一两) 上捣为末。与枣肉、麻仁、酥、髓相和。入银瓷
器中。
重
补髓丸。
柴胡汤(出千金方)治髓实。勇悍热生烦。
柴胡 升麻 栀子仁(各三钱) 黄芩 细辛 枳实(各二钱) 泽泻 淡竹叶 生地
黄
(各一两) 上为 咀。每服五钱。水一盏下芒硝半钱。煎一沸去滓。分二服。早晨一服。
日
午
地骨皮汤 治髓实。使人强悍惊热。
地骨皮(二两) 胡黄连 柴胡 当归 泽泻 黄芩(各半两) 甘草(炙) 枳实(去
瓤各
一两)
苁蓉汤 治骨髓虚冷酸疼。
肉苁蓉(酒浸) 菟丝子(酒浸) 人参 黄 (锉) 木香 附子(炮去皮脐) 补
骨脂(炒
各一
秦艽汤 治骨实烦热。
秦艽(半两) 甘草(炙) 前胡 柴胡(各二两) 上为粗末。每服三钱。水一盏。
煎至七
分去
补骨脂汤 治骨虚酸疼。多倦。
补骨脂(炒) 附子(炮去皮脐) 人参 肉苁蓉(酒浸切焙) 五味子(各一两) 上
咀。
每
枳实汤 治髓实气勇悍烦热。
枳实(去瓤) 柴胡 当归 甘草(炙) 芎 (各一两) 上粗捣筛。每服三钱。水
一盏。
煎
温髓汤 治髓虚骨寒。
附子(炮去皮脐) 人参 黄 细辛 桂(各一两) 上锉如麻豆大。每服三钱。水
一盏。
煎
地骨皮汤 治骨实热烦痛。
地骨皮 柴胡 甘草(炙各一两) 胡黄连(一钱) 上粗捣筛。每服三钱。水一盏。
煎至
七分
四物方(出千金方)治骨实苦疼烦热。
葛根(取汁) 生地黄(取汁) 麦门冬(取汁) 蜜 上各半盏和匀。分三服。每服
水半盏。
同
地黄煎 治骨虚骨寒。
生地黄(五斤焙) 补骨脂 人参(各五两) 上为末。每服水二升。药末二两。猪髓
一具
去筋
地黄散(出千金方)治骨髓虚。冷痛无力。
生地黄(八斤) 豉(二升) 上同于甑上炊两次。曝干为散。每服二钱。温酒调下。
不拘
时候
地黄酒 治骨髓虚冷痛。
用生地黄一石洗切。木臼中捣取自然汁。绞去滓。用酒二斗和匀。同于瓷石器中煎熟为
度。
天门冬散 治骨热疼痛。
用天门冬为散。酒服方寸匕。日三服。一百日取瘥。
虎骨酒 治骨虚酸痛不安。好倦。主膀胱寒。
用虎骨一具。通炙取黄焦。汁尽。碎如雀头大。酿米三石。曲四斗。水三石。如常酿酒
法。
芍药散 治骨虚冷痛。倦怠。\x(方见芍药汤)
《黄帝内经》中说,各经脉气太过就会使人出现懈惰的症状。表现为脊背经脉疼痛,气短懒言。肾是负责强健身体的官职,精液是生命的根本,所以用来运动肢体。一旦受到邪气侵袭,肾脏就不充实,精气就不能运行。因此会出现脊背经脉疼痛、气短、不想说话的症状。这种病名叫“解㑊”。
利肾汤:治疗解㑊引起的脉痛,气乏无力不想说话。这是肾气有余(实)的表现。
药材:泽泻、生地黄、赤茯苓(各一两)、槟榔(锉碎)、牛膝(酒浸,各一两)、麦门冬(去心焙干)。
通肾汤:治疗解㑊导致的气少不能说话,脊背经脉拘急疼痛,腰脊强直,脚底发热疼痛,小便不通畅,心烦闷气。
药材:石菖蒲(锉碎)、羚羊角(镑片)、生地黄(焙干)、赤芍药(各二两)、五味子、甘草、猪苓(去黑皮)、泽泻。
匀气散:治疗肾气有余,足少阴脉太过,使人脊背疼痛、气短、不想说话。
药材:枳壳(麸炒)、泽泻、赤茯苓、牡丹皮、木通(锉碎)、槟榔、玄参(各一两)。上药研为粗散。每次服用三钱。
凡是骨髓虚实的变化,主要归属于肾和膀胱。如果脏腑有病,从骨产生热象则对应脏,寒象则对应腑。所以肾主骨骼骨髓。肾气有余时,若气虚则骨头软弱酸痛,疲倦无力;若气实则骨头发热且痛苦烦闷,体内津液干燥。应当根据证候进行治疗。骨髓的疾病应归属于肝胆。如果脏腑有病,从髓产生变化。一般来说,热则对应脏,寒则对应腑。所以髓虚的人会出现脑痛不安。
人参饮:治疗骨极虚寒,面部浮肿污秽发黑,腰膝疼痛不能久立或屈伸,睡梦中惊悸,气逆上冲,小腹急痛,腰背疼痛。
药材:人参、五味子、熟地黄(焙干)、赤芍药、甘草(炙)、麦门冬(去心)、白茯苓、桂枝(各一两)。
羌活丸(出自《太平圣惠方》):治疗髓虚寒,脑痛不安,补益精髓。
药材:羌活、川芎(炒,各二两)、桂枝(一两)、当归(一两)、人参(二两)、大枣(三十个取肉)、大麻仁(研碎)、羊髓、酥油、牛髓(各一两)。上药捣成末,与枣肉、麻仁、酥油、髓混合,放入银瓷器中。
补髓丸。
柴胡汤(出自《千金方》):治疗髓实,使人勇悍、热生烦闷。
药材:柴胡、升麻、栀子仁(各三钱)、黄芩、细辛、枳实(各二钱)、泽泻、淡竹叶、生地黄(各一两)。上药为粗末。每次服用五钱,用水一盏,加入芒硝半钱,煎煮一沸后去渣,分两次服用。早晨服一次,日午服一次。
地骨皮汤:治疗髓实,使人强悍、惊热。
药材:地骨皮(二两)、胡黄连、柴胡、当归、泽泻、黄芩(各半两)、甘草(炙)、枳实(去瓤,各一两)。
苁蓉汤:治疗骨髓虚冷酸痛。
药材:肉苁蓉(酒浸)、菟丝子(酒浸)、人参、黄芪(锉碎)、木香、附子(炮制去皮脐)、补骨脂(炒,各一两)。
秦艽汤:治疗骨实烦热。
药材:秦艽(半两)、甘草(炙)、前胡、柴胡(各二两)。上药为粗末。每次服用三钱,用水一盏,煎至七分去渣。
补骨脂汤:治疗骨虚酸痛,多疲倦。
药材:补骨脂(炒)、附子(炮制去皮脐)、人参、肉苁蓉(酒浸切焙)、五味子(各一两)。上药为粗末。每次服用...
枳实汤:治疗髓实气勇悍烦热。
药材:枳实(去瓤)、柴胡、当归、甘草(炙)、川芎(各一两)。上药粗捣筛。每次服用三钱,用水一盏,煎...
温髓汤:治疗髓虚骨寒。
药材:附子(炮制去皮脐)、人参、黄芪、细辛、桂枝(各一两)。上药锉如麻豆大。每次服用三钱,用水一盏,煎...
地骨皮汤:治疗骨实热烦痛。
药材:地骨皮、柴胡、甘草(炙,各一两)、胡黄连(一钱)。上药粗捣筛。每次服用三钱,用水一盏,煎至七分。
四物方(出自《千金方》):治疗骨实苦疼烦热。
药材:葛根(取汁)、生地黄(取汁)、麦门冬(取汁)、蜂蜜。以上各取半盏混合均匀,分三次服用。每次服用用水半盏同服。
地黄煎:治疗骨虚骨寒。
药材:生地黄(五斤焙干)、补骨脂、人参(各五两)。上药为末。每次服用用水二升,药末二两,猪髓一副(去筋)。
地黄散(出自《千金方》):治疗骨髓虚,冷痛无力。
药材:生地黄(八斤)、豆豉(二升)。以上一同在甑上蒸两次,晒干后研为散。每次服用二钱,用温酒调下。不拘时候。
地黄酒:治疗骨髓虚冷痛。
用法:用生地黄一石洗净切碎,在木臼中捣取自然汁,绞去渣滓。用酒二斗混合均匀,同在瓷石器中煎熟即可。
天门冬散:治疗骨热疼痛。
用法:用天门冬研为散,用酒送服方寸匕,每日三次,一百天可痊愈。
虎骨酒:治疗骨虚酸痛不安,好疲倦,主治膀胱寒。
用法:用虎骨一副,通体炙烤至黄色焦枯,汁液尽出,碎成雀头大小。用米三石,曲四斗,水三石,按常规酿酒法酿造。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states that excessive Qi in the various meridians causes a condition of "Xie Jie" (exhaustion and flaccidity). The manifestations include pain in the spinal meridian, shortness of breath, and reluctance to speak. The Kidney is the official responsible for strength and vigor; Essence (Jing) is the root of the body, used to move and support the limbs. Once invaded by pathogenic factors, the Kidney becomes deficient and Essence fails to circulate. Consequently, symptoms such as spinal meridian pain, shortness of breath, and reluctance to speech occur. This condition is named "Xie Jie".
**Lishen Tang (Benefit Kidney Decoction)**: Treats Xie Jie characterized by meridian pain, lack of Qi, and reluctance to speak. This indicates an excess of Kidney Qi.
Ingredients: Alisma Rhizoma (Zexie), Rehmanniae Radix Recens (Shengdihuang), Poria Cocos with Red Bark (Chifuling) (each 1 liang); Areca Seed (Binglang) (crushed); Achyranthes Bidentatae Radix (Niuxi) (soaked in wine, each 1 liang); Ophiopogonis Radix (Maidong) (heart removed, dried over fire).
**Tongshen Tang (Unblocking Kidney Decoction)**: Treats Xie Jie causing shortness of breath and inability to speak, spasm and pain in the spinal meridian, stiffness of the waist and spine, heat and pain in the soles of the feet, difficulty in urination (Longbi), mental restlessness, and stifling sensation in the chest.
Ingredients: Acori Tatarinowii Rhizoma (Changpu) (crushed); Cornu Saigae Tataricae (Lingyangjiao) (sliced); Rehmanniae Radix (Shengdi) (dried over fire); Paeoniae Radix Rubra (Chishaoyao) (each 2 liang); Schisandrae Fructus (Wuweizi); Glycyrrhizae Radix et Rhizoma (Gancao); Polyporus (Zhuling) (black skin removed); Alisma Rhizoma (Zexie).
**Yunqi San (Harmonizing Qi Powder)**: Treats excess Kidney Qi and excessive pulse of the Foot Shaoyin meridian, causing spinal pain, shortness of breath, and reluctance to speak.
Ingredients: Aurantii Fructus Pericarpium (Zhike) (bran-fried); Alisma Rhizoma (Zexie); Poria Cocos with Red Bark (Chifuling); Moutan Cortex (Mudanpi); Akebiae Caulis (Mutong) (crushed); Areca Seed (Binglang); Scrophulariae Radix (Xuanshen) (each 1 liang). Grind the above into a coarse powder. Take 3 qian per dose.
The variations of deficiency and excess in bone marrow are primarily governed by the Kidney and Bladder. If there is disease in these zang-fu organs, heat arising from the bones corresponds to the Zang organs, while cold corresponds to the Fu organs. Thus, the Kidney governs bones and bone marrow. When Kidney Qi is in excess: if it manifests as deficiency, the bones become weak, sore, and painful, accompanied by fatigue and weakness; if it manifests as excess, the bones feel hot and painful with vexation, and internal body fluids dry up. Treatment should follow the specific syndrome. Diseases of the bone marrow correspond to the Liver and Gallbladder. If zang-fu diseases arise from the marrow, generally heat corresponds to the Zang organs and cold to the Fu organs. Therefore, those with deficient marrow experience headache and restlessness.
**Renshen Yin (Ginseng Drink)**: Treats extreme deficiency-cold of the bones, presenting with facial edema, dirty/dark complexion, pain in the waist and knees preventing prolonged standing or flexion/extension, dream-disturbed sleep with palpitations, rebellious Qi ascending, acute pain in the lower abdomen, and pain in the waist and back.
Ingredients: Ginseng Radix et Rhizoma (Renshen); Schisandrae Fructus (Wuweizi); Rehmanniae Radix Praeparata (Shudihuang); Paeoniae Radix Rubra (Chishaoyao); Glycyrrhizae Radix et Rhizoma (Gancao) (honey-fried); Ophiopogonis Radix (Maidong) (heart removed); Poria Cocos (Baifuling); Cinnamomi Ramulus (Gui) (each 1 liang).
**Qianghuo Wan (Notopterygium Pill)** (from *Taiping Shenghui Fang*): Treats deficient-marrow cold, headache, and restlessness; tonifies marrow.
Ingredients: Notopterygii Rhizoma et Radix (Qianghuo); Ligustici Chuanxiong Rhizoma (Xiong) (fried, each 2 liang); Cinnamomi Ramulus (Gui) (1 liang); Angelicae Sinensis Radix (Danggui) (1 liang); Ginseng Radix et Rhizoma (Renshen) (2 liang); Jujubae Fructus (Dazao) (30 pieces, flesh only); Cannabis Fructus (Damaoren) (ground); Sheep Marrow (Yangsui); Butter (Su); Cow Marrow (Niushi) (each 1 liang). Grind the above into powder, mix with jujube flesh, hemp seed, butter, and marrow. Place in a silver or porcelain vessel.
**Busui Wan (Tonify Marrow Pill)**.
**Chaihu Tang (Bupleurum Decoction)** (from *Qianjin Fang*): Treats excess marrow, causing boldness/aggressiveness, heat generation, and vexation.
Ingredients: Bupleuri Radix (Chaihu); Cimicifugae Rhizoma (Shengma); Gardeniae Fructus (Zhizi Ren) (each 3 qian); Scutellariae Radix (Huangqin); Asari Radix et Rhizoma (Xixin); Immature Tangerine Peel (Zhishi) (each 2 qian); Alisma Rhizoma (Zexie); Lophatheri Herba (Danzhuye); Rehmanniae Radix Recens (Shengdihuang) (each 1 liang). Grind the above into coarse particles. Take 5 qian per dose, decocted in one sheng of water with half a qian of Mirabilite (Mangxiao). Boil once, remove dregs, and divide into two doses. Take one dose in the morning and one at noon.
**Digupi Tang (Cortex Lycii Decoction)**: Treats excess marrow, causing boldness, fright, and heat.
Ingredients: Cortex Lycii (Digupi) (2 liang); Picrorhizae Rhizoma (Huhuanglian); Bupleuri Radix (Chaihu); Angelicae Sinensis Radix (Danggui); Alisma Rhizoma (Zexie); Scutellariae Radix (Huangqin) (each ban liang); Glycyrrhizae Radix et Rhizoma (Gancao) (honey-fried); Immature Tangerine Peel (Zhishi) (pith removed, each 1 liang).
**Congrong Tang (Cistanche Decoction)**: Treats deficiency-cold of bone marrow causing soreness and pain.
Ingredients: Cistanches Herba (Rongcongrong) (wine-soaked); Cuscutae Semen (Tusizi) (wine-soaked); Ginseng Radix et Rhizoma (Renshen); Astragali Radix (Huangqi) (crushed); Costi Radix (Muxiang); Aconiti Lateralis Radix Praeparata (Fuzi) (processed, skin and bud removed); Psoraleae Fructus (Buguzhi) (fried, each 1 liang).
**Qinjiao Tang (Gentian Decoction)**: Treats excess bones with vexation and heat.
Ingredients: Gentianae Macrophyllae Radix (Qinjiao) (ban liang); Glycyrrhizae Radix et Rhizoma (Gancao) (honey-fried); Peucedani Radix (Qianhu); Bupleuri Radix (Chaihu) (each 2 liang). Grind the above into coarse powder. Take 3 qian per dose, decocted in one sheng of water until reduced to seven-tenths, then strain.
**Buguzhi Tang (Psoralea Decoction)**: Treats deficiency of bones causing soreness/pain and frequent fatigue.
Ingredients: Psoraleae Fructus (Buguzhi) (fried); Aconiti Lateralis Radix Praeparata (Fuzi) (processed, skin and bud removed); Ginseng Radix et Rhizoma (Renshen); Cistanches Herba (Rongcongrong) (wine-soaked, sliced, dried); Schisandrae Fructus (Wuweizi) (each 1 liang). Grind the above into coarse particles. Take...
**Zhishi Tang (Immature Tangerine Peel Decoction)**: Treats excess marrow with bold Qi, aggressiveness, and vexation/heat.
Ingredients: Immature Tangerine Peel (Zhishi) (pith removed); Bupleuri Radix (Chaihu); Angelicae Sinensis Radix (Danggui); Glycyrrhizae Radix et Rhizoma (Gancao) (honey-fried); Ligustici Chuanxiong Rhizoma (Xiong) (each 1 liang). Coarsely crush and sieve the above. Take 3 qian per dose, decocted in one sheng of water...
**Wensui Tang (Warming Marrow Decoction)**: Treats deficient marrow and cold bones.
Ingredients: Aconiti Lateralis Radix Praeparata (Fuzi) (processed, skin and bud removed); Ginseng Radix et Rhizoma (Renshen); Astragali Radix (Huangqi); Asari Radix et Rhizoma (Xixin); Cinnamomi Ramulus (Gui) (each 1 liang). Cut into sizes similar to hemp seeds. Take 3 qian per dose, decocted in one sheng of water...
**Digupi Tang (Cortex Lycii Decoction)**: Treats excess bones with heat, vexation, and pain.
Ingredients: Cortex Lycii (Digupi); Bupleuri Radix (Chaihu); Glycyrrhizae Radix et Rhizoma (Gancao) (honey-fried, each 1 liang); Picrorhizae Rhizoma (Huhuanglian) (1 qian). Coarsely crush and sieve the above. Take 3 qian per dose, decocted in one sheng of water until reduced to seven-tenths.
**Siwu Fang (Four Substances Formula)** (from *Qianjin Fang*): Treats excess bones with bitter pain, vexation, and heat.
Ingredients: Puerariae Lobatae Radix (Getgen) (extract juice); Rehmanniae Radix Recens (Shengdihuang) (extract juice); Ophiopogonis Radix (Maidong) (extract juice); Honey (Mi). Mix equal parts (half sheng each) evenly. Divide into three doses. For each dose, take half a sheng of water mixed with the preparation.
**Dihuang Jian (Rehmannia Decoction/Jelly)**: Treats deficiency of bones and bone cold.
Ingredients: Rehmanniae Radix Recens (Shengdihuang) (5 jin, dried over fire); Psoraleae Fructus (Buguzhi); Ginseng Radix et Rhizoma (Renshen) (each 5 liang). Grind into powder. Take 2 liang of powder with 2 sheng of water and one set of Pig Marrow (Zhushui) (tendons removed).
**Dihuang San (Rehmannia Powder)** (from *Qianjin Fang*): Treats deficiency of bone marrow, cold pain, and weakness.
Ingredients: Rehmanniae Radix Recens (Shengdihuang) (8 jin); Sojae Semen Preparatum (Chi) (2 sheng). Steam together twice in a steamer, dry in the sun, and grind into powder. Take 2 qian per dose, taken down with warm wine. No specific time restrictions.
**Dihuang Jiu (Rehmannia Wine)**: Treats deficiency-cold pain of bone marrow.
Preparation: Use 1 shi of fresh Rehmannia root, wash and cut. Pound in a wooden mortar to extract natural juice, strain off the dregs. Mix with 2 dou of wine. Decoct in a porcelain or stone vessel until cooked.
**Tianmendong San (Asparagus Powder)**: Treats bone heat and pain.
Preparation: Grind Tianmendong (Asparagi Radix) into powder. Take with wine using a "fangcun bi" measure, three times daily. Cure expected within 100 days.
**Hugu Jiu (Tiger Bone Wine)**: Treats deficiency of bones causing soreness/pain and restlessness, frequent fatigue; mainly treats Bladder cold.
Preparation: Use one Tiger Bone (Hugu). Roast thoroughly until yellow and charred, juices exhausted. Crush into sizes like sparrow heads. Brew with 3 shi of rice, 4 dou of yeast/qu, and 3 shi of water, following standard brewing methods.
**Shaoyao San (Paeonia Powder)**: Treats deficiency-cold pain of bones and fatigue. (Formula see Shaoyao Tang)