人年四十阴气自平,从古至今,未尝不若是也。惟尊躯独异者,正气不足,湿痰素多,阳
事早痿耳。予偶阅医书,夜卧臂在被外者,每易招寒而痛。妇人露臂枕儿者,亦易受凉而
痛。此尊躯之病,虽非得于被外枕儿,而其起痛之因,本因于卧在竹榻。竹榻之性寒凉者
也,日日卧之,则寒凉之气未有不袭筋骨。较之前二条之偶伤经络者更进一层,所以阳气
不宣,屈伸不利,痛无虚日,喜热恶寒矣。仲景云∶一臂不举此为痹。载在中门风中也。实非
真中而却类中之机,岂容忽视?现下治法,首重补阳兼养阴血,寓之以驱寒,加之以化痰,
再取经络通之,则一方制度自不失君臣佐使焉。
大熟地(八两) 归身(四两) 赤芍(二两) 附子(二两) 党参(四两) 于术(四两)
茯苓(八两) 黄 (二两) 半夏(四两) 虎掌(一对) 阿胶(三两) 橘红(二两) 姜黄(一两)
桂枝(一两) 沉香(五钱) 甘草(一两) 枳壳(二两) 海桐皮(二两) 风化硝(一两) 西羌
活(一两) 为末,取竹沥一茶碗,姜汁二匙,和入淡蜜水,泛丸。
头为天谷藏神者也。面无精彩,头苦常鸣,岂非天谷内虚,神色无华乎?然头鸣右盛,
痰火必多,不得不兼顾之。
大熟地 天冬 党参(三味煮膏) 制于术 黄 龙眼肉 炙草 茯苓 远志肉 石决明 枣仁 木香
半夏 橘红 阿胶 竹茹 甘菊 为末糊丸,三钱,盐汤下。
人到了四十岁,阴气自然趋于平和,从古至今,都是如此。唯独您的身体情况与众不同,是因为正气不足,体内素来湿气痰浊较多,导致性功能过早衰退。
我偶然翻阅医书,看到记载:睡觉时手臂露在被子外面的人,容易受寒而疼痛;妇女睡觉时露着手臂枕在婴儿身上的人,也容易受凉而疼痛。您现在的病症,虽然不是因为手臂露在被子外或枕在婴儿身上引起的,但引起疼痛的原因,根本在于睡在竹榻上。竹榻的性质是寒凉的,每天睡在上面,寒凉之气没有不侵袭筋骨的道理。这比前面两种情况只是偶尔损伤经络更进一步,所以阳气不能宣通,关节屈伸不利,疼痛没有一天停止过,喜欢温暖而厌恶寒冷。
张仲景说:“一只手臂抬不起来,这是痹证。”记载在“中门风”(中风的一种类型)中。实际上虽然不是真正的外感中风,但却具有类似中风的病机,怎么可以忽视呢?现在的治疗法则,首要的是重在补阳兼养阴血,其中寓含驱散寒邪之意,加入化痰药物,再配合疏通经络的方法,那么这一方剂的配伍制度自然就不会违背君臣佐使的原则了。
大熟地黄(八两)、当归身(四两)、赤芍药(二两)、附子(二两)、党参(四两)、白术(四两)、茯苓(八两)、黄芪(二两)、半夏(四两)、虎掌(一对)、阿胶(三两)、橘红(二两)、姜黄(一两)、桂枝(一两)、沉香(五钱)、甘草(一两)、枳壳(二两)、海桐皮(二两)、风化硝(一两)、西羌活(一两)。以上药材研成细末,取竹沥汁一茶碗,姜汁两匙,调入淡蜂蜜水,泛制为丸。
头部是天谷(指脑,中医认为脑为元神之府,藏神),是藏神的地方。面色没有神采,头部经常鸣响,难道不是天谷内部空虚,神色无华吗?然而头部鸣响右侧更严重,说明痰火必然很多,不得不兼顾治疗。
大熟地黄、天冬、党参(这三味药煮成膏状)、制白术、黄芪、龙眼肉、炙甘草、茯苓、远志肉、石决明、酸枣仁、木香、半夏、橘红、阿胶、竹茹、甘菊花。以上药材研成细末,用糊剂制成丸药,每丸三钱,用盐汤送服。
When a person reaches forty years of age, the Yin Qi naturally becomes balanced; this has been the case from ancient times to the present. However, your constitution is unique: due to insufficient Zheng Qi (Upright Qi) and a pre-existing abundance of Dampness-Phlegm, you are experiencing premature impotence.
I occasionally consulted medical texts, which state that those who sleep with their arms exposed outside the blanket often suffer from cold-induced pain. Similarly, women who sleep with their arms exposed while using infants as pillows are also prone to cold-induced pain. Although your condition did not arise from exposing arms outside blankets or on infants, the root cause of your pain lies in sleeping on a bamboo couch. Bamboo couches possess a cold and cool nature; daily use allows cold and cool pathogens to inevitably invade the sinews and bones. This is more severe than the previous two scenarios where only the meridians were occasionally injured. Consequently, Yang Qi fails to circulate freely, leading to difficulty in flexion and extension, persistent daily pain, and a preference for warmth while disliking cold.
Zhang Zhongjing stated: "Inability to raise one arm indicates Bi Syndrome," recorded under "Zhong Men Feng" (a type of Wind Stroke). Although it is not true external wind-stroke, it shares similar pathogenesis with stroke; how can it be ignored? The current treatment principle prioritizes tonifying Yang while nourishing Yin Blood, incorporating methods to dispel cold, adding phlegm-resolving herbs, and combining them with techniques to unblock the meridians. Thus, the formulation will naturally adhere to the principles of Jun-Chen-Zuo-Shi (Monarch-Minister-Assistant-Courier).
Da Shu Di Huang (Rehmanniae Radix Preparata, 8 liang), Gui Shen (Angelicae Sinensis Radix, 4 liang), Chi Shao (Paeoniae Radix Rubra, 2 liang), Fu Zi (Aconiti Lateralis Radix Preparata, 2 liang), Dang Shen (Codonopsis Radix, 4 liang), Yu Zhu (Atractylodis Rhizoma, 4 liang), Fu Ling (Poria, 8 liang), Huang Qi (Astragali Radix, 2 liang), Ban Xia (Pinelliae Rhizoma, 4 liang), Hu Zhang (Arisaematis Cum Bile, 1 pair), E Jiao (Colla Corii Asini, 3 liang), Ju Hong (Citri Reticulatae Pericarpium, 2 liang), Jiang Huang (Curcumae Longae Rhizoma, 1 liang), Gui Zhi (Cinnamomi Ramulus, 1 liang), Chen Xiang (Aquilariae Lignum Resinatum, 5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 liang), Zhi Qiao (Aurantii Fructus Immaturus, 2 liang), Hai Tong Pi (Saposhnikoviae Radix, 2 liang), Feng Hua Xiao (Natrii Sulfas Exsiccatus, 1 liang), Xi Qiang Huo (Saposhnikoviae Radix, 1 liang). Grind into powder. Take one tea bowl of Zhu Li (Bambusa Textilis Culmus Succus), two spoons of Jiang Zhi (Zingiberis Recens Juice), mix with light honey water, and form pills.
The head is the "Tian Gu" (Heavenly Valley, referring to the brain, where Shen [Spirit] resides). A face lacking luster and frequent tinnitus in the head indicate emptiness within the Tian Gu and a lack of vibrant spirit. However, since the tinnitus is more pronounced on the right side, there must be significant Phlegm-Fire, which requires concurrent attention.
Da Shu Di Huang (Rehmanniae Radix Preparata), Tian Dong (Asparagi Radix), Dang Shen (Codonopsis Radix) — these three decocted into paste; Zhi Yu Zhu (Prepared Atractylodis Rhizoma), Huang Qi (Astragali Radix), Long Yan Rou (Longan Arillus), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma), Fu Ling (Poria), Yuan Zhi Rou (Polygalae Radix), Shi Jue Ming (Haliotidis Concha), Zao Ren (Ziziphi Spinosae Semen), Mu Xiang (Aucklandiae Radix), Ban Xia (Pinelliae Rhizoma), Ju Hong (Citri Reticulatae Pericarpium), E Jiao (Colla Corii Asini), Zhu Ru (Bambusa Textilis Caulis Membrana), Gan Ju (Chrysanthemi Flos). Grind into powder, bind with paste to form pills. Each pill weighs 3 qian; take with salt water.