【肺热痿软之症】皮毛干揭,上则喘咳,下则挛拳,此《内经》肺热成痿之症也。
【肺热痿软之因】有志不遂,所求不得,郁而生火,火来克金,肺热叶焦,清化不行,
金不生水,则肺热痿 之症作矣。
【肺热痿软之脉】寸脉浮数,浮则主肺,数则主热,浮数相兼,主乎肺热。
【肺热痿软之治】肾火上炎,知柏天地煎,玄武胶为丸。肺中伏火,二丹二冬汤,合家
知柏天地煎
知母(二两) 黄柏(二两) 天冬(八两) 地黄(八两)
玄武胶为丸。
二母二冬汤
川贝母 知母 天门冬 麦门冬
家秘泻白散
桑白皮 地骨皮 甘草 桔梗 石膏 川黄连 黄芩
【心热痿软之症】四肢关节不能活动,足胫纵缓,不能收持,如枢纽之折,而不能提挈
,面颊常赤,意乱心烦,此《内经》心热痿软之症也。
【心热痿软之因】内而欲心妄动,外而起居如惊,则心火上炎,三阴在下之脉,亦厥逆
而上,火盛水衰,则阴血日损,而心热脉痿作矣。
【心热痿软之脉】脉多洪数,左寸尤甚。肝脉上朝,木火通明。两尺躁疾,水衰火旺。
【心热痿软之治】左寸洪数者,导赤各半汤。左关上朝者,泻青丸,合龙胆泻肝汤。尺
脉躁疾,水中火发,六味丸,合丹溪大补丸。
导赤各半汤
生地 木通 川连 甘草 黄芩 山栀 犀角磨冲。
泻青丸 见后肝痹。
龙胆泻肝汤 见前肝火胀。
六味丸合大补丸 即六味地黄丸加黄柏四两。
【肺热导致肢体痿软无力的症状】皮肤和毫毛干燥起屑,上部出现气喘咳嗽,下部出现筋脉拘挛、手指蜷曲,这是《黄帝内经》中所述因肺热引起的痿证。
【肺热导致肢体痿软无力的病因】志向不能实现,所求不得满足,情志抑郁而生内火,火热之邪克制肺金(五行中金被火克),导致肺叶焦枯,肺的宣发肃降功能失常,肺金不能滋养肾水(金生水),于是肺热痿证的病症就发作了。
【肺热导致肢体痿软无力的脉象】寸口脉浮而数,浮脉主肺病,数脉主热证,浮脉与数脉相兼见,主病为肺热。
【肺热导致肢体痿软无力的治法】若是肾中虚火上炎,用知柏天地煎,以玄武胶(龟板胶)制成丸剂。若是肺中潜伏之火,用二丹二冬汤,合上方知柏天地煎。
知母(二两) 黄柏(二两) 天冬(八两) 地黄(八两)
用玄武胶(龟板胶)制成丸剂。
二母二冬汤
川贝母 知母 天门冬 麦门冬
家秘泻白散
桑白皮 地骨皮 甘草 桔梗 石膏 川黄连 黄芩
【心热导致肢体痿软无力的症状】四肢关节不能活动,足胫部松弛无力,不能支撑身体,就像枢纽折断一样,无法提举,面颊经常发红,神志混乱且心烦,这是《黄帝内经》中所述因心热引起的痿软证。
【心热导致肢体痿软无力的病因】内部欲望妄动,外部起居受到惊吓,导致心火上炎,三阴经在下部的脉气也厥逆上行,火势旺盛而肾水衰少,导致阴血日益损耗,于是心热脉痿证就发作了。
【心热导致肢体痿软无力的脉象】脉象多呈洪大且数,左寸脉尤为明显。肝脉上朝于心,形成木火通明之象。两尺脉躁动疾速,表明肾水衰少而心火旺盛。
【心热导致肢体痿软无力的治法】左寸脉洪数的,用导赤各半汤。左关脉上朝的,用泻青丸,合方龙胆泻肝汤。尺脉躁动的,属水中火发,用六味丸,合方丹溪大补丸。
导赤各半汤
生地 木通 川连 甘草 黄芩 山栀 犀角磨汁冲服。
泻青丸 参见后文肝痹篇。
龙胆泻肝汤 参见前文肝火胀篇。
六味丸合大补丸 即六味地黄丸加黄柏四两。
[Symptoms of Flaccidity Caused by Lung Heat] The skin and lanugo hair are dry and scaly. Upper symptoms include panting and coughing, while lower symptoms involve tendon contraction and curled fingers. This corresponds to the flaccidity syndrome caused by lung heat as described in the *Neijing* (Inner Canon).
[Etiology of Flaccidity Caused by Lung Heat] Unfulfilled ambitions and unmet desires lead to emotional depression generating internal fire. Fire overacts on Metal (Lung), causing the lung leaves to become scorched and dry. The clear descending function fails, and Lung Metal fails to nourish Kidney Water, resulting in the onset of flaccidity due to lung heat.
[Pulse of Flaccidity Caused by Lung Heat] The Cun position pulse is Floating and Rapid. Floating indicates Lung pathology; Rapid indicates Heat. The combination of Floating and Rapid pulses indicates Lung Heat.
[Therapeutic Methods for Flaccidity Caused by Lung Heat] If Kidney fire flares upward, use Zhibai Tiandi Decoction (Anemarrhenae and Phellodendri Heaven-Earth Decoction), formed into pills with Xuanwu Jiao (Testudinis Carapax et Plastrum Glue). If latent fire resides in the Lung, use Erdan Erdong Decoction (Moutan and Anemarrhenae, Asparagus and Ophiopogon Decoction), combined with the aforementioned Zhibai Tiandi Decoction.
Zhimu (2 liang) Huangbai (2 liang) Tiandong (8 liang) Dihuang (8 liang)
Form into pills using Xuanwu Jiao (Testudinis Carapax et Plastrum Glue).
Ermu Erdong Decoction
Chuanbeimu Zhimu Tianmendong Maidong
Jiami Xiebai San (Secret Formula for Draining White)
Sangbaipi Digupi Gancao Jiegeng Shigao Chuanhuilian Huangqin
[Symptoms of Flaccidity Caused by Heart Heat] The joints of the four limbs cannot move; the calves and shins are flaccid and weak, unable to support the body, resembling a broken hinge that cannot lift or hold. The cheeks are often red, accompanied by mental confusion and irritability. This corresponds to the flaccidity syndrome caused by heart heat as described in the *Neijing*.
[Etiology of Flaccidity Caused by Heart Heat] Internal excessive desire and external fright during daily activities cause Heart fire to flare upward. The pulses of the Three Yin meridians below also reverse and ascend. Excessive fire and deficient water lead to daily depletion of Yin blood, resulting in the onset of Mai Fei (Vessel Flaccidity) due to heart heat.
[Pulse of Flaccidity Caused by Heart Heat] The pulse is generally Hong (Surging) and Rapid, especially at the Left Cun position. The Liver pulse rises to meet the Heart, indicating Wood and Fire illuminating each other. The two Chi positions are restless and rapid, indicating deficient Water and flourishing Fire.
[Therapeutic Methods for Flaccidity Caused by Heart Heat] For a Hong and Rapid pulse at the Left Cun, use Daochi Geban Decoction (Half-Combined Decoction for Guiding Out Redness). For an ascending pulse at the Left Guan, use Xieqing Wan (Drain Green Pill), combined with Longdan Xiegan Tang (Gentian Decoction to Drain the Liver). For a restless Chi pulse, indicating fire arising from water, use Liuwei Wan (Six-Ingredient Pill), combined with Danxi Dabu Wan (Danxi's Great Tonifying Pill).
Daochi Geban Decoction
Shengdi Mutong Chuanlian Gancao Huangqin Shanzhi Xijiao (ground and mixed in)
Xieqing Wan See the section on Liver Bi later.
Longdan Xiegan Tang See the section on Liver Fire Distension earlier.
Liuwei Wan Combined with Dabu Wan This refers to Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) plus 4 liang of Huangbai.