(山药打糊为丸,芡实,大朱砂飞净作衣,封固听用)
人参 附片 肉桂 小茴 韭子(各一两) 地黄 当归 黄 龟胶 枸杞 羊肾(炙,各三两) 五味 故纸
胡巴 巴戟 益智仁 鹿茸(各二两)
病患火症泄利太过,小水不禁,目暗,此方主之。
溲溺惟宣,形气治也。不禁,则病矣。因药过利且目暗,其形气大虚可知。故宜鹿茸、当归、龟胶、羊肾、
地黄、枸杞味浓之属以补形,附子、肉桂、故纸、小茴、葫芦巴、巴戟天、人参、黄 、家韭子、益智仁辛温之
品以补气。曰巩堤者,欲水藏巩固如堤。故复以山药、朱砂为糊为衣,益以滋培水土,百川东障,此丸其近之。
诗曰∶戟天参 巴地桂,龟羊鹿并杞茴味,附 补骨韭归阳,不但巩堤还益智。
黄 人参 苁蓉 山茱萸 白术 当归 肉桂 五味子 甘草 芎 防风 茯苓 地黄
大病后,目昏自汗,此方主之。
有因而汗,虽汗无伤。无因而汗,则阳虚矣。曰∶大病后自汗且目昏,此克伐太过,阴阳俱虚。乃用十全大补加
肉苁蓉、五味、枣皮,生津液而收耗气,不用白芍用防风者,脏腑无恙,但皮毛之间微有病,而欲平也。间虚不
受补,宜牡蛎、黄 、麻黄根、浮小麦煎服。陈来章曰∶汗乃心之液,心有火则出不止,宜牡蛎、浮小麦之咸凉,
以去烦热。阳为阴之卫,阳气虚则卫不固,宜黄 、麻黄根之甘温,而实肌表。
诗曰∶大补黄 汤,元本十全意,蓉味枣皮加,致精销阴翳。出芍入防风,相畏特相使。
(山药捣烂成糊制作丸药,芡实,大朱砂飞研洁净作为包衣,密封保存备用)
人参、附片、肉桂、小茴香、韭菜子(各一两)、地黄、当归、黄芪、龟板胶、枸杞子、羊肾(炙烤,各三两)、五味子、补骨脂、胡芦巴、巴戟天、益智仁、鹿茸(各二两)。
若患者因火邪病症导致泄泻痢疾过度,小便失禁,视物昏暗,此方主治。
小便通畅宣利,说明形体与正气得到调理。若出现失禁,则是疾病的表现。因为药物过于通利且伴有视物昏暗,可知其形气已经极度虚弱。因此适宜使用鹿茸、当归、龟板胶、羊肾、地黄、枸杞子等味厚滋腻的药物来补益形体;使用附子、肉桂、补骨脂、小茴香、葫芦巴、巴戟天、人参、黄芪、家韭子、益智仁等辛温的药物来补益正气。名为“巩堤”,是希望水液封藏巩固如同堤坝一般。所以再用山药、朱砂制成糊状和包衣,以增强滋养培补脾土的作用,使百川之水向东汇聚受阻(比喻固摄水液),这个丸药的功效接近于此。
诗云:巴戟天、人参、巴戟、地黄、肉桂,龟板、羊肉、鹿茸并配伍枸杞、小茴香、五味子,附子、补骨脂、韭菜、当归、阳起石(注:诗中“阳”可能指代某药或泛指助阳药,结合前文药材列表,此处保留原意或指代鹿茸/附子等助阳之品,但根据上下文主要指代前述补阳药群,诗中“阳”字单独列出,疑为衍文或特指,此处依原文直译),不仅能巩固堤防还能益智。
黄芪、人参、肉苁蓉、山茱萸、白术、当归、肉桂、五味子、甘草、川芎、防风、茯苓、地黄。
大病之后,出现视物昏花、自汗出,此方主治。
有病因导致的出汗,虽然出汗但无大碍。若无明显原因而出汗,则是阳气虚弱的表现。所谓:大病后出现自汗且视物昏花,这是因为攻伐太过,导致阴阳俱虚。于是使用十全大补汤加入肉苁蓉、五味子、枣皮(山茱萸),以生津液并收敛耗散之气。不用白芍而用防风的原因在于,脏腑没有病变,只是皮毛之间微有不适,想要使其平和。如果间歇性虚弱不能耐受滋补,适宜用牡蛎、黄芪、麻黄根、浮小麦煎服。陈来章说:汗是心液的体现,心有火则汗出不止,适宜用牡蛎、浮小麦的咸凉性质,以去除烦热。阳气是阴气的卫护,阳气虚弱则卫外不固,适宜用黄芪、麻黄根的甘温性质,以充实肌表。
诗云:大补黄芪汤,蕴含十全大补汤的本意,加入肉苁蓉、五味子、枣皮,旨在消除精血亏损导致的阴翳(视力障碍)。去掉白芍加入防风,二者相畏又相互促进功效。
(Shan Yao (Dioscoreae Rhizoma) is pounded into a paste to form pills; Qian Shi (Euryales Semen) and Da Zhu Sha (Cinnabar, purified by flying) are used as coating. Seal and store for use.)
Ren Shen (Ginseng Radix), Fu Pian (Aconiti Lateralis Radix Praeparata), Rou Gui (Cinnamomi Cortex), Xiao Hui Xiang (Foeniculi Fructus), Jiu Zi (Tragostematis Semen) (each 1 liang); Di Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix), Gui Jiao (Colla Corii Asini), Gou Qi Zi (Lycii Fructus), Yang Shen (Ovis Testis, roasted) (each 3 liang); Wu Wei Zi (Schisandrae Fructus), Gu Zhi (Psoraleae Fructus), Hu Ba (Hibisci Tritilobati Semen), Ba Ji Tian (Morindae Officinalis Radix), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), Lu Rong (Cervi Cornu Pantotrichum) (each 2 liang).
If a patient suffers from excessive diarrhea or dysentery due to fire-pathogen syndromes, accompanied by urinary incontinence and dim vision, this formula is indicated.
Smooth urination indicates that the body structure and vital qi are regulated. Incontinence, however, signifies disease. Given the excessive use of draining herbs and the presence of dim vision, it can be deduced that both body structure and vital qi are severely deficient. Therefore, it is appropriate to use thick-flavored substances such as Lu Rong (Deer Antler Velvet), Dang Gui (Dong Quai), Gui Jiao (Donkey-hide Gelatin), Yang Shen (Sheep Kidney), Di Huang (Rehmannia Root), and Gou Qi Zi (Goji Berry) to tonify the body structure; and acrid-warm substances such as Fu Zi (Prepared Aconite Root), Rou Gui (Cinnamon Bark), Gu Zhi (Psoralea Fruit), Xiao Hui Xiang (Fennel Fruit), Hu Ba (Abutilon Seed), Ba Ji Tian (Morinda Root), Ren Shen (Ginseng Root), Huang Qi (Astragalus Root), Jia Jiu Zi (Leek Seed), and Yi Zhi Ren (Alpinia Fruit) to tonify vital qi. The name "Gong Di" (Consolidating Embankment) implies consolidating the storage of fluids like an embankment. Thus, Shan Yao (Dioscorea Rhizome) and Zhu Sha (Cinnabar) are used as paste and coating to further nourish and cultivate the earth element, obstructing the flow of waters to the east (metaphor for retaining fluids). This pill approximates this effect.
The poem states: Ba Ji Tian, Ren Shen, Ba Ji, Di Huang, Rou Gui; Gui Jiao, Yang Shen, Lu Rong combined with Gou Qi, Hui Xiang, and Wu Wei Zi; Fu Zi, Bu Gu Zhi, Jiu Zi, Dang Gui, Yang [herbs]; not only does it consolidate the embankment but also benefits intelligence.
Huang Qi (Astragali Radix), Ren Shen (Ginseng Radix), Cong Rong (Cynomorii Herba), Shan Zhu Yu (Corni Fructus), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Rou Gui (Cinnamomi Cortex), Wu Wei Zi (Schisandrae Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma), Xiong (Chuan Xiong Rhizoma), Fang Feng (Saposhnikoviae Radix), Fu Ling (Poria), Di Huang (Rehmanniae Radix).
After a severe illness, if there is blurred vision and spontaneous sweating, this formula is indicated.
Sweating caused by a specific factor, even if present, causes no harm. Spontaneous sweating without a clear cause indicates yang deficiency. It is stated: Spontaneous sweating and blurred vision after a severe illness result from excessive purgation or attack, leading to deficiency of both yin and yang. Therefore, Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction) is used, added with Cong Rong (Cynomorium Herb), Wu Wei Zi (Schisandra Fruit), and Zao Pi (Cornus Fruit/Shan Zhu Yu), to generate body fluids and conserve depleted qi. Bai Shao (White Peony Root) is omitted and Fang Feng (Saposhnikovia Root) is used instead because the internal organs are intact, but there is a slight disorder in the skin and hair layer, which needs to be harmonized. If intermittent deficiency cannot tolerate heavy tonification, Mu Li (Oyster Shell), Huang Qi (Astragali Radix), Ma Huang Gen (Ephedrae Radix et Rhizoma), and Fu Xiao Mai (Tritici Levis Fructus) should be decocted and taken. Chen Laizhang said: Sweat is the fluid of the heart; if there is fire in the heart, sweat flows incessantly. It is appropriate to use the salty-cool properties of Mu Li (Oyster Shell) and Fu Xiao Mai (Light Wheat) to remove irritability and heat. Yang serves as the guard of yin; when yang qi is deficient, the defensive function is not solid. It is appropriate to use the sweet-warm properties of Huang Qi (Astragali Radix) and Ma Huang Gen (Ephedra Root and Rhizome) to strengthen the muscular exterior.
The poem states: Da Bu Huang Qi Tang (Great Tonifying Astragalus Decoction) embodies the essence of Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction); adding Cong Rong (Cynomorium Herb), Wu Wei Zi (Schisandra Fruit), and Zao Pi (Cornus Fruit) aims to eliminate yin obscurity caused by essence depletion. Removing Bai Shao (White Peony Root) and entering Fang Feng (Saposhnikovia Root), they exhibit mutual inhibition yet mutual enhancement.