汤∶煎成清液也。补须要熟,利不嫌生。并生较定水数,煎蚀多寡之不同耳。去暴病用
之,
取其易升、易散、易行经络。故曰∶汤者,荡也。
治至高之分,加酒煎。去湿,加生姜煎。补元气,加大枣煎。发散风寒,加葱白煎。去膈病
,加蜜煎。止痛,加醋煎。凡诸补汤,渣滓两剂并合,加原水数复煎,待熟饮之,亦敌一剂
新药。其发表、攻里二者,惟煎头药取效,不必煎渣也,从缓从急之不同故尔。
膏∶熬成稠膏也。药分两须多,水煎熬宜久。渣滓复煎数次,绞聚浓汁,以熬成尔。去
久病用之,取其如饴,力大
滋补胶固,故曰∶膏者,胶也。
可服之膏,或水、或酒随熬,滓犹酒煮饮之。可摩之膏、或油、或醋随熬,滓宜捣敷患
处。此盖兼尽药力也。
散∶研成细末也。宜旋制合,不堪久留,恐走泄气味,服之无效尔。去急病用之,不循
经络,只去胃中及脏腑之积,
故曰∶散者,散也。
气味浓者,白汤调服。气味薄者,煎熟和滓服。
丸∶作成圆粒也。治下焦疾者,如梧桐子大。治中焦疾者,如绿豆大。治上焦疾者,如
米粒大。因病不能速去,取
其舒缓,逐旋成功,故曰∶丸者,缓也。
用水丸者,或蒸饼作稀糊丸者,取至易化,而治上焦也。用稠面糊丸者,或饭糊丸者,
取略迟化,能达中焦也。或
酒、或醋丸者,取其收散之意。犯半夏、南星。欲去湿痰者,以生姜自然汁作稀糊为丸,亦
取其易化也。神曲糊丸者,
取其消食。山药糊丸者,取其止涩。炼蜜丸者,取其迟化,而气循经络。蜡丸者,取其难化,
能固护药之气味,势力全
备,直过膈而作效也。
渍酒;渍煮酒药也。药须细锉,绢袋盛之,入酒罐密封。如常法煮熟,地埋日久,气烈
味浓。蚤晚频吞,经络速达。
或攻或补,并着奇功。滓漉出曝干,微捣末别渍。力虽稍缓,服
弃。补虚损证,宜少饮旋取
效;攻风湿证,宜多饮速取效。
汤剂:指煎煮后形成的清亮液体。用于补益时要求煎得熟透,用于通利时不介意煎得较生。无论是生用还是熟用,主要区别在于用水量的多少以及煎煮过程中水分蒸发损耗的不同。治疗突发急病时使用汤剂,是取其药性容易升发、容易发散、容易通行经络的特点。所以说:“汤者,荡也”,意指汤剂能涤荡病邪。
治疗位于人体上部的疾病,加酒同煎以引药上行。祛除湿邪,加生姜同煎以增强散湿之力。补益元气,加大枣同煎以助补气。发散风寒,加葱白同煎以助解表。治疗胸膈部位的疾病,加蜂蜜同煎以润燥止痛。缓解疼痛,加醋同煎以收敛止痛。凡是各种补益类的汤剂,药渣可以将两剂合并,加入原来的水量再次煎煮,待煎熟后饮用,其效果也抵得上一剂新药。至于发表(解表)和攻里(泻下)这两类方剂,只需煎煮第一遍取汁服用即可见效,不需要再煎煮药渣,这是因为病情有缓急不同所致。
膏剂:指熬制成稠厚的膏状物。用药的分量需要较多,用水煎熬的时间宜长。将药渣再次煎煮数次,过滤浓缩汁液,最终熬制成膏。治疗久病时使用膏剂,是取其质地如饴糖般粘稠,药力宏大且滋补固摄的作用,所以说:“膏者,胶也”。
可以内服的膏剂,或用水、或用酒随药熬制,剩下的药渣还可以用酒煮后饮用。可以外用的膏剂,或用油、或用醋随药熬制,剩下的药渣适宜捣碎后敷在患处。这都是为了充分利用药物的效力。
散剂:指研磨成细粉末。应当现制现用,不宜长久存放,恐怕气味挥发流失,服用后无效。治疗急病时使用散剂,药物不循行经络,只清除胃中及脏腑内的积滞,所以说:“散者,散也”,意指散剂能消散积滞。
气味浓郁的散剂,用温开水调服。气味淡薄的散剂,煎熟后连同药渣一起服用。
丸剂:指制作成圆粒状。治疗下焦疾病的丸剂,大小如梧桐子;治疗中焦疾病的丸剂,大小如绿豆;治疗上焦疾病的丸剂,大小如米粒。因为疾病不能迅速去除,取其药性舒缓,逐渐发挥作用,所以说:“丸者,缓也”。
用水泛丸的,或用蒸饼制成的稀糊做粘合剂泛丸的,取其易于化开,适合治疗上焦疾病。用稠面糊做粘合剂泛丸的,或用饭糊做粘合剂泛丸的,取其化开稍慢,能到达中焦。或用酒、或用醋泛丸的,取其收敛散漫之意。如果药物中含有半夏、南星,想要去除湿痰,就用生姜自然汁制成稀糊来泛丸,也是取其易于化开的特性。用神曲糊泛丸的,取其消食导滞的作用。用山药糊泛丸的,取其止涩收敛的作用。用炼蜜泛丸的,取其化开较慢,使药气循行经络。用蜂蜡泛丸的,取其难以化开,能牢固保护药物的气味,药力完备,直接通过膈部而在体内发挥作用。
浸酒:指浸泡或煮制药酒。药材需要切碎,用绢袋装好,放入酒罐中密封。按照通常的方法煮熟,埋在地里日久,药气猛烈,味道浓郁。早晚频繁服用,药力能迅速到达经络。
无论是攻邪还是补虚,都能取得奇效。将药渣滤出晒干,轻微捣碎后另行浸泡。虽然药力稍缓,但也不应丢弃。治疗虚损证,宜少量饮用并随时获取疗效;治疗风湿证,宜多饮以快速获取疗效。
Tang (Decoction): Refers to the clear liquid obtained after boiling. For tonification, it is required to be thoroughly cooked; for purgation or promoting fluid metabolism, a less thorough cooking is acceptable. The difference between raw and cooked usage lies mainly in the amount of water used and the degree of evaporation during boiling. It is used for acute diseases because its medicinal properties are easy to ascend, disperse, and circulate through the meridians. Hence it is said: "Tang means to sweep away," indicating that decoctions can cleanse pathogens.
To treat diseases located in the upper part of the body, add wine for boiling to guide the medicine upward. To dispel dampness, add fresh ginger for boiling to enhance the dispersion of dampness. To tonify Yuan Qi (Original Qi), add Jujube (Ziziphus jujuba) for boiling to assist in replenishing Qi. To disseminate wind-cold, add scallion white (Allium fistulosum) for boiling to aid in releasing the exterior. To treat diseases in the chest and diaphragm, add honey for boiling to moisten dryness and relieve pain. To relieve pain, add vinegar for boiling to astringe and alleviate pain. For all kinds of tonifying decoctions, the dregs from two doses can be combined, added with the original amount of water, and boiled again. Drinking this after it is cooked is also equivalent to the effect of one dose of new medicine. As for formulas for releasing the exterior (Releasing the Exterior) and attacking the interior (Attacking the Interior), only the first decoction needs to be taken for efficacy; there is no need to boil the dregs again, due to the differences in the urgency of the conditions.
Gao (Paste/Electuary): Refers to the thick paste formed by prolonged simmering. The dosage of herbs must be large, and the boiling time in water should be long. The dregs are boiled several more times, filtered to concentrate the juice, and finally simmered into a paste. It is used for chronic diseases because of its sticky texture like maltose, its powerful medicinal force, and its solidifying and nourishing effects. Hence it is said: "Gao means glue/adhesion."
Pastes for internal use may be prepared with water or wine according to the prescription. The remaining dregs can still be boiled in wine and drunk. Pastes for external application may be prepared with oil or vinegar according to the prescription. The remaining dregs should be pounded and applied to the affected area. This is done to fully utilize the medicinal power.
San (Powder): Refers to fine powder ground from herbs. It should be prepared freshly and not stored for long periods, lest the aroma and flavor volatilize, rendering it ineffective when taken. It is used for acute diseases because the powder does not strictly follow the meridian pathways but instead clears accumulations in the stomach and viscera. Hence it is said: "San means to scatter/disperse," indicating that powders can dissipate accumulations.
Herbs with strong flavors and aromas are taken mixed with warm water. Herbs with weak flavors and aromas are boiled until cooked and taken together with the dregs.
Wan (Pill): Refers to round granules made from herbs. For diseases of the Lower Jiao (Lower Burner), they are sized like Sophora japonica seeds (Wutongzi). For diseases of the Middle Jiao (Middle Burner), they are sized like mung beans. For diseases of the Upper Jiao (Upper Burner), they are sized like rice grains. Because diseases cannot be eliminated quickly, pills are used for their slow-acting nature, achieving gradual success. Hence it is said: "Wan means slow/gentle."
Pills made with water, or using thin paste from steamed dough as a binder, are chosen for their ease of dissolution, suitable for treating Upper Jiao diseases. Pills made with thick wheat flour paste or rice paste are chosen for their slower dissolution, capable of reaching the Middle Jiao. Pills made with wine or vinegar are chosen for their intention to gather and restrain scattered Qi. If the formula contains Pinellia Rhizome (Banxia) or Aconitum carmichaelii lateral root processed with ginger and alum (Nanxing), and the goal is to remove phlegm-dampness, fresh ginger juice is used to make a thin paste for pill formation, also taking advantage of its ease of dissolution. Pills made with Medicated Leaven (Shenqu) paste are chosen for their ability to digest food. Pills made with Chinese Yam (Shanyao) paste are chosen for their astringent and stopping effects. Pills made with refined honey are chosen for their slow dissolution, allowing the medicinal qi to circulate through the meridians. Pills made with beeswax are chosen for their difficulty in dissolving, which firmly protects the medicinal aroma and flavor, ensuring complete potency, passing directly through the diaphragm to take effect.
Jiu (Medicated Wine): Refers to soaking or boiling medicinal ingredients in wine. The herbs must be finely chopped, placed in a silk bag, and sealed in a wine jar. Cooked according to standard methods and buried in the ground for a long time, the medicinal qi becomes potent and the flavor rich. Taken frequently morning and night, the medicinal force reaches the meridians rapidly.
Whether for attacking pathogens or tonifying deficiency, remarkable results can be achieved. The dregs are filtered out, dried in the sun, slightly pounded into powder, and soaked separately. Although the medicinal force is slightly weaker, they should not be discarded. For treating deficiency and damage syndromes, small amounts should be drunk to obtain effects promptly; for treating wind-dampness syndromes, larger amounts should be drunk to obtain effects quickly.