渗湿消痰饮 治湿热痰积,渗入膀胱,(曰渗入下焦则可,曰入膀胱则不可)白带不止。(总治中州之湿,盖中
焦清则无湿下流,故带自止,岂有渗入之理)
白术 苍术(炒) 半夏(姜汤泡七次) 橘红 白茯苓 白芷 香附(各一钱) 甘草(炙,五
分)
上锉。水煎服。有热,加黄芩;血虚,加芎归;气虚,加参 ;久不愈,加升麻、柴胡
升提之。
苍柏樗皮丸 治肥人白带是湿痰。(此去中焦之湿,清下部之热,亦丹溪方也)
苍术 黄柏 樗根皮 南星 半夏 海石 川芎 香附 干姜(炮,各等分) 暑月去干姜
加滑石
上为末,醋和丸,如桐子大。每服五六十丸,白汤下。
小胃丹 上可取胸膈之痰,下可利肠胃之痰,及湿痰热痰,并治妇人结痰白带。惟胃虚
少食者忌用。(是导水之猛剂,古人能用之,今则不能也)
甘遂(湿面裹,煨熟。一方面裹,长流水煮,晒干) 芫花(好醋拌经宿,瓦器内烧黑不
可焦) 大戟(长流水煮一时,再用水洗净晒干各半两) 黄柏(炒一两) 大黄(湿纸裹煨,勿
令焦,切,焙干,再以酒润,炒热焙干一两半)
上为末,以白术膏丸(白术膏为丸,乃今人所制,有独创之妙,可法),如萝卜子大。临卧津液咽下五七丸,
或白汤送下。取膈上湿痰热
积,以意消息之,欲利,空心服。一方加木香、槟榔各半两。
补药方 治痰结白带。先以小胃丹,半饥半饱,津液咽下数丸,候郁开,却服此药补之
。
白术(二两) 黄芩(五钱) 红白葵花(二钱五分) 白芍药(七钱五分)
上为末,蒸饼丸,如桐子大。每服三五十丸,煎四物汤下(此亦丹溪方,乃扶脾胃、养肝阴、清热,而葵花之
用,取其倾心向日之意,盖花性阴而用阳,一入气分,一入血分,皆使其从阳升,带自止也)。一方有苍术,无黄芩。
渗湿消痰饮:治疗湿热之痰积聚,渗入膀胱(注:说渗入下焦是可以的,但说进入膀胱则不妥),导致白带淋漓不止。(此方总治中焦之湿,因为中焦清利则无湿邪下流,所以带下自然停止,哪里有什么“渗入”的道理呢?)
药物组成:白术、苍术(炒制)、半夏(用姜汤浸泡七次)、橘红、白茯苓、白芷、香附(各一钱),甘草(炙,五分)。
制法与用法:将上述药材切碎。加水煎煮后服用。若有热象,加黄芩;若血虚,加川芎、当归;若气虚,加人参;若久治不愈,加升麻、柴胡以升提阳气。
苍柏樗皮丸:治疗形体肥胖者的白带,病机为湿痰。(此方能去除中焦之湿,清泄下部之热,也是朱丹溪的方子。)
药物组成:苍术、黄柏、樗根皮、南星、半夏、海浮石、川芎、香附、干姜(炮制,以上各等分)。夏季月份去掉干姜,加入滑石。
制法与用法:将上述药材研成细末,用醋调和制成丸药,大小如梧桐子。每次服用五六十丸,用白开水送服。
小胃丹:上方可祛除胸膈间的痰浊,下方可通利肠胃中的痰积,以及湿痰、热痰,同时治疗妇女因结痰引起的白带。只有胃气虚弱、食欲减退者忌用。(这是导水逐饮的猛剂,古人能够使用,现在人则不能使用了。)
药物组成:甘遂(用湿面粉包裹,煨熟。另一种方法是用面裹一边,用长流水煮,晒干)、芫花(用好醋拌匀过夜,在瓦器内烧至黑但不焦糊)、大戟(用长流水煮一时辰,再用水洗净晒干,各半两)、黄柏(炒,一两)、大黄(用湿纸包裹煨熟,不可焦糊,切片,焙干,再用酒润湿,炒热后焙干,一两半)。
制法与用法:将上述药材研成细末,用白术膏作为粘合剂制成丸药(用白术膏制丸,是今人所创制的方法,有独特的妙处,值得效法),大小如萝卜子。临睡前用津液咽下五到七丸,或者用白开水送服。旨在祛除膈上的湿痰和热积,需根据病情斟酌剂量。若要通便泻下,则在空腹时服用。另一版本方中加入木香、槟榔各半两。
补药方:治疗痰结引起的白带。先服用小胃丹,在半饥半饱的状态下,用津液咽下数丸,待郁结之气开通后,再服用此药进行补益。
药物组成:白术(二两)、黄芩(五钱)、红白葵花(二钱五分)、白芍药(七钱五分)。
制法与用法:将上述药材研成细末,用蒸饼作为粘合剂制成丸药,大小如梧桐子。每次服用三五十丸,用四物汤煎剂送服(这也是朱丹溪的方子,作用是扶持脾胃、滋养肝阴、清热。其中使用葵花,是取其倾心向日的意象,大概是因为花的性质属阴而作用属阳,一旦进入气分和血分,都能使其随阳气上升,带下自然停止)。另一版本方中有苍术,没有黄芩。
Shenshi Xiaotan Yin (Dampness-Percolating and Phlegm-Dissolving Decoction): Treats accumulation of damp-heat phlegm penetrating into the bladder (Note: It is acceptable to say it penetrates into the Lower Jiao, but saying it enters the bladder is incorrect), resulting in continuous leukorrhea. (This formula generally treats dampness in the Middle Jiao; since clearing the Middle Jiao prevents dampness from flowing downward, leukorrhea stops naturally, so there is no such thing as "penetration".)
Ingredients: Baizhu (Atractylodis Rhizoma), Cangzhu (Atractylodis Rhizoma, stir-fried), Banxia (Pinelliae Rhizoma, soaked seven times in ginger juice), Juhong (Citri Reticulatae Pericarpium Rubrum), Bai Fuling (Poria), Baizhi (Angelicae Dahuricae Radix), Xiangfu (Cyperi Rhizoma) (each 1 qian); Gancao (Licorice Root, honey-fried, 0.5 qian).
Preparation and Administration: Coarsely crush the ingredients. Decoct with water and take orally. If heat signs are present, add Huangqin (Scutellariae Radix); if blood deficiency exists, add Chuanxiong (Ligustici Chuanxiong Rhizoma) and Danggui (Angelicae Sinensis Radix); if qi deficiency exists, add Renshen (Ginseng Radix et Rhizoma); if chronic and unhealed, add Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) to raise yang qi.
Cangbai Chupi Wan (Coptis and Toona Pill): Treats leukorrhea in obese individuals due to damp-phlegm. (This formula removes dampness from the Middle Jiao and clears heat from the lower part; it is also a formula by Zhu Danxi.)
Ingredients: Cangzhu (Atractylodis Rhizoma), Huangbai (Phellodendri Cortex), Chugenpi (Toonae Cortex), Nanxing (Arisaematis Rhizoma), Banxia (Pinelliae Rhizoma), Haishi (Pumex), Chuanxiong (Ligustici Chuanxiong Rhizoma), Xiangfu (Cyperi Rhizoma), Ganjiang (Zingiberis Rhizoma, processed) (all in equal proportions). In summer months, remove Ganjiang and add Huashi (Talcum).
Preparation and Administration: Grind into fine powder, mix with vinegar to form pills, size similar to paulownia seeds. Take 50–60 pills per dose, washed down with plain warm water.
Xiao Wei Dan (Small Stomach Pill): The upper action extracts phlegm from the chest and diaphragm, while the lower action promotes the discharge of phlegm from the intestines and stomach, including damp-phlegm and hot-phlegm. It also treats leukorrhea caused by congealed phlegm in women. Contraindicated for those with weak stomach qi and poor appetite. (This is a potent purgative for guiding out water; ancients could use it, but modern practitioners cannot.)
Ingredients: Gansui (Kansui Radix, wrapped in wet flour and roasted until cooked; alternatively, wrap one side and boil in running water, then dry), Yuanhua (Genkwa Flos, mixed with good vinegar overnight, burned in a clay vessel until black but not charred), Daji (Euphorbiae Pekinensis Radix, boiled in running water for one shichen [2 hours], rinsed with water, dried, each half liang), Huangbai (Phellodendri Cortex, stir-fried, 1 liang), Dahuang (Rhei Radix et Rhizoma, wrapped in wet paper and roasted until not charred, sliced, dried, moistened with wine, stir-fried until hot, then dried again, 1.5 liang).
Preparation and Administration: Grind into fine powder, use Baizhu paste (a modern innovation with unique efficacy worth emulating) as a binder to form pills, size similar to radish seeds. Swallow 5–7 pills with saliva before bedtime, or take with plain warm water. Aim to eliminate damp-phlegm and heat accumulation above the diaphragm; adjust dosage according to condition. For purgative effect, take on an empty stomach. Another variant adds Muxiang (Aucklandiae Radix) and Binglang (Arecae Semen), each half liang.
Bu Yao Fang (Tonifying Formula): Treats leukorrhea caused by phlegm concretion. First, take Xiao Wei Dan when half-hungry and half-full, swallowing several pills with saliva. After the stagnation opens, take this tonifying formula.
Ingredients: Baizhu (Atractylodis Rhizoma, 2 liang), Huangqin (Scutellariae Radix, 5 qian), Hongbai Kuihua (Hibisci Rosa-Sinensis Flos, red and white, 2.5 qian), Baishaoyao (Paeoniae Radix Alba, 7.5 qian).
Preparation and Administration: Grind into fine powder, use steamed biscuit dough as a binder to form pills, size similar to paulownia seeds. Take 30–50 pills per dose, washed down with Siwu Tang (Four Substances Decoction). (This is also a formula by Zhu Danxi, functioning to support spleen and stomach, nourish liver yin, and clear heat. The use of hibiscus flowers relies on their imagery of turning towards the sun; generally, flower nature is yin but function is yang. Once entering the qi and blood levels, they facilitate ascending via yang, thus stopping leukorrhea.) Another variant contains Cangzhu instead of Huangqin.