【心气虚不得卧之症】二便时滑,目漫神清,气怯倦怠,心战胆寒,时时欲睡,睡中自
醒,喜热恶冷,此心气虚不得卧之症也。
【心气虚不得卧之因】真阳素乏,木不生火,心气虚则心主无威,心神失守,而夜卧不
【心气虚不得卧之脉】左寸浮散,按之无神,左关无力,木不生火。肝肾脉迟,水中无
【心气虚不得卧之治】脉散无神,人参养荣汤、归脾汤。肝肾脉迟者,八味丸。左关脉
弱者,补肝散。脉若带数,即非心气虚,乃心血不足,不得妄引此条。
人参养荣汤
人参 白芍药 陈皮 黄 桂心 当归 白术 甘草 熟地 茯苓 五味 远志
归脾汤
当归 白术 人参 甘草 白茯苓 木香 远志 黄 枣仁 龙眼肉
八味丸 即六味丸,加肉桂、附子。
补肝散 见后肝痹。
秦子曰∶痿与挛,受病相同,症形有异。挛者,拘急不能屈伸,《内经》所谓 短为
拘也。痿者,痿弱纵缓而不能起立,《内经》所谓弛长为痿也。若时伸时纵,则曰螈 ,
强直反张,则曰痉 ,皆与痿挛各自一门者也。
【风湿痿软之症】小筋弛长,手足瘫痪,痿弱不能举动,皮肤不仁,关节重痛,此风湿
【风湿痿软之因】或居处卑湿,或冒风雨,留着经络,则纵缓不收,痿软之症作矣。
【风湿痿软之脉】浮缓主风,浮濡主湿。浮缓而濡,乃是风湿。若见浮紧,乃是寒湿。
若见浮数,风热而湿。洪数而浮,风湿在表;洪数而沉,风湿在里。
【风湿痿软之治】身发热,脉浮紧,羌活胜湿汤。关节重痛,寒气胜,桂枝汤加苍术、
风、羌活、独活。热气胜,脉浮数者,荆防平胃散。脉沉数者,荆防二妙丸。皮肤不仁,
羌活胜湿汤 方见湿热肿。
家秘桂枝汤 治太阳经寒湿。
桂枝 麻黄 芍药 甘草 苍术 防风 羌活 独活
荆防平胃散 治阳明经上部风湿。
荆芥 防风 苍术 浓朴 陈皮 甘草
荆防二妙丸 治阳明经下部湿热。
荆芥 防风 苍术 黄柏
苍防五皮饮 治风湿在表之方。
生姜皮 茯苓皮 桑白皮 五茄皮 大腹皮 防风 苍术
【心气虚导致无法安卧的症状】大小便时出现滑脱不禁,眼神涣散但神志尚清,气息怯弱且身体倦怠,心中惊悸、胆寒,时常想睡觉,睡着后容易自行醒来,喜欢温暖而厌恶寒冷,这是心气虚导致无法安卧的症状。
【心气虚导致无法安卧的原因】真阳素来匮乏,肝木不能生心火,心气虚弱则心主失去威严,心神失守,因而夜间卧床时无法入睡。
【心气虚导致无法安卧的脉象】左寸脉浮散,重按无神,左关脉无力,提示木不生火。肝肾脉迟,说明水中无火(肾阳不足)。
【心气虚导致无法安卧的治疗】脉象散乱无神的,用人参养荣汤、归脾汤。肝肾脉迟的,用八味丸。左关脉弱的,用补肝散。如果脉象带数(快),这就不是心气虚,而是心血不足,不要随意引用这一条。
人参养荣汤
人参 白芍药 陈皮 黄芪 桂心 当归 白术 甘草 熟地黄 茯苓 五味子 远志
归脾汤
当归 白术 人参 甘草 白茯苓 木香 远志 黄芪 酸枣仁 龙眼肉
秦氏说:痿证与挛证,致病原因相同,症状表现不同。挛证,表现为筋脉拘急,不能屈伸,《内经》所说的“短为拘”。痿证,表现为肢体痿弱纵缓,不能起立,《内经》所说的“弛长为痿”。如果时而伸展时而纵缓,称为抽搐;强直反张,称为痉证,这些都各自属于独立的门类。
【风湿导致肢体痿软的症状】小筋弛长,手足瘫痪,肢体痿弱不能活动,皮肤麻木不仁,关节沉重疼痛,这是风湿导致的……(原文此处截断,根据语境补全为:风湿痿软之症也)
【风湿导致肢体痿软的原因】或者居住地方低洼潮湿,或者冒犯风雨,邪气留着于经络,导致筋脉纵缓不收,痿软的症状就产生了。
【风湿导致肢体痿软的脉象】浮缓脉主风,浮濡脉主湿。浮缓而兼濡,乃是风湿。如果见到浮紧脉,乃是寒湿。如果见到浮数脉,是风热夹湿。洪数而浮,风湿在表;洪数而沉,风湿在里。
【风湿导致肢体痿软的治疗】身体发热,脉浮紧,用羌活胜湿汤。关节沉重疼痛,寒气偏胜,用桂枝汤加苍术、防风、羌活、独活。热气偏胜,脉浮数的,用荆防平胃散。脉沉数的,用荆防二妙丸。皮肤麻木不仁,用羌活胜湿汤。
家秘桂枝汤 治疗太阳经寒湿。
桂枝 麻黄 芍药 甘草 苍术 防风 羌活 独活
[Symptoms of Insomnia due to Heart Qi Deficiency] Slippage during urination and defecation, eyes appearing unfocused yet consciousness remains clear, weak breath accompanied by physical fatigue, palpitations with fearfulness, frequent desire to sleep but waking spontaneously during sleep, preference for warmth and aversion to cold. These are symptoms of insomnia caused by Heart Qi Deficiency (Xin Qi Xu).
[Etiology of Insomnia due to Heart Qi Deficiency] The True Yang (Zhen Yang) is inherently deficient; Liver Wood fails to generate Heart Fire. When Heart Qi is deficient, the Heart Master loses its authority, and the Spirit (Shen) loses its residence, resulting in the inability to fall asleep at night.
[Pulse Signs of Insomnia due to Heart Qi Deficiency] The left Cun pulse is floating and scattered, lacking spirit upon deep pressure; the left Guan pulse is forceless, indicating that Wood does not generate Fire. The Kidney and Liver pulses are slow, indicating a lack of fire within Water (Kidney Yang deficiency).
[Treatment of Insomnia due to Heart Qi Deficiency] For a scattered and spiritless pulse, use Renshen Yangrong Tang (Ginseng Decoction for Nourishing Ying) or Guipi Tang (Spleen-Restoring Decoction). For slow Kidney and Liver pulses, use Bawei Wan (Eight-Ingredient Pill). For a weak left Guan pulse, use Bugan San (Liver-Nourishing Powder). If the pulse is rapid, it is not Heart Qi Deficiency but rather Heart Blood Deficiency; this clause should not be applied arbitrarily.
Renshen Yangrong Tang (Ginseng Decoction for Nourishing Ying)
Ren Shen (Panax Ginseng Radix et Rhizoma), Bai Shao Yao (Paeoniae Radix Alba), Chen Pi (Citri Reticulatae Pericarpium), Huang Qi (Astragali Radix), Gui Xin (Cinnamomi Ramulus), Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Shu Di Huang (Rehmanniae Radix Praeparata), Fu Ling (Poria), Wu Wei Zi (Schisandrae Chinensis Fructus), Yuan Zhi (Polygalae Radix).
Guipi Tang (Spleen-Restoring Decoction)
Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Ren Shen (Panax Ginseng Radix et Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Bai Fu Ling (Poria cum Ligno), Mu Xiang (Aucklandiae Radix), Yuan Zhi (Polygalae Radix), Huang Qi (Astragali Radix), Suan Zao Ren (Ziziphi Spinosae Semen), Long Yan Rou (Longan Arillus).
Bawei Wan (Eight-Ingredient Pill)
Consists of Liuwei Wan (Six-Ingredient Pill) plus Rou Gui (Cinnamomi Cortex) and Fu Zi (Aconiti Lateralis Radix Praeparata).
Bugan San (Liver-Nourishing Powder)
See the section on Liver Bi (Liver Obstruction) later.
Mr. Qin stated: Wei Syndrome (Flaccidity Syndrome) and Luan Syndrome (Tetany/Contracture) share the same pathogenic origin but present with different symptoms. Luan Syndrome involves tendon contraction preventing flexion and extension, described in the *Neijing* as "shortness leads to contracture." Wei Syndrome involves flaccid weakness and relaxation preventing standing, described in the *Neijing* as "slackness leads to flaccidity." If there is intermittent extension and relaxation, it is called convulsion (Chou Chu); if there is rigidity and opisthotonos, it is called Jing Syndrome (Spasm). These belong to distinct categories from Wei and Luan.
[Symptoms of Flaccidity due to Wind-Dampness] Relaxation of small tendons, paralysis of hands and feet, limb flaccidity preventing movement, skin numbness, and heavy pain in joints. This constitutes [Wind-Damp Flaccidity].
[Etiology of Flaccidity due to Wind-Dampness] Dwelling in damp, low-lying areas, or exposure to wind and rain, allows pathogens to lodge in the meridians, causing relaxation and loss of tension, thereby producing flaccidity symptoms.
[Pulse Signs of Flaccidity due to Wind-Dampness] Floating and moderate pulses indicate Wind; floating and soggy pulses indicate Dampness. A combination of floating, moderate, and soggy indicates Wind-Dampness. A floating-tight pulse indicates Cold-Dampness. A floating-rapid pulse indicates Wind-Heat with Dampness. A full-rapid and floating pulse indicates Wind-Dampness in the Exterior; a full-rapid and deep pulse indicates Wind-Dampness in the Interior.
[Treatment of Flaccidity due to Wind-Dampness] For body fever with a floating-tight pulse, use Qianghuo Shengshi Tang (Notopterygium Decoction for Overcoming Dampness). For heavy joint pain indicating predominant Cold, use Guizhi Tang (Cinnamon Twig Decoction) modified with Cang Zhu (Atractylodis Rhizoma), Fang Feng (Saposhnikoviae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), and Du Huo (Angelicae Pubescentis Radix). For predominant Heat with a floating-rapid pulse, use Jingfang Pingwei San (Schizonepeta and Saposhnikovia Powder for Calming the Stomach). For a deep-rapid pulse, use Jingfang Ermiao Wan (Schizonepeta and Saposhnikovia Pill for Two Marvels). For skin numbness, use Qianghuo Shengshi Tang.
Qianghuo Shengshi Tang (Notopterygium Decoction for Overcoming Dampness)
See the section on Damp-Heat Swelling.
Jiamigui Zhi Tang (Secret Family Cinnamon Twig Decoction)
Treats Cold-Dampness in the Taiyang Channel.
Gui Zhi (Cinnamomi Ramulus), Ma Huang (Ephedrae Herba), Shao Yao (Paeoniae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Cang Zhu (Atractylodis Rhizoma), Fang Feng (Saposhnikoviae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix).
Jingfang Pingwei San (Schizonepeta and Saposhnikovia Powder for Calming the Stomach)
Treats Wind-Dampness in the upper part of the Yangming Channel.
Jing Jie (Schizonepetae Spica), Fang Feng (Saposhnikoviae Radix), Cang Zhu (Atractylodis Rhizoma), Hou Po (Magnoliae Officinalis Cortex), Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Jingfang Ermiao Wan (Schizonepeta and Saposhnikovia Pill for Two Marvels)
Treats Damp-Heat in the lower part of the Yangming Channel.
Jing Jie (Schizonepetae Spica), Fang Feng (Saposhnikoviae Radix), Cang Zhu (Atractylodis Rhizoma), Huang Bo (Phellodendri Cortex).
Cangfang Wupi Yin (Atractylodia and Saposhnikovia Five-Skin Decoction)
A formula for Wind-Dampness in the Exterior.
Sheng Jiang Pi (Zingiberis Rhizoma Recens Pericarpium), Fu Ling Pi (Poria Pericarpium), Sang Bai Pi (Mori Cortex), Wu Jia Pi (Acanthopanacis Cortex), Da Fu Pi (Arecae Pericarpium), Fang Feng (Saposhnikoviae Radix), Cang Zhu (Atractylodis Rhizoma).