人参 麦冬 五味 当归 黄 甘草 乌梅 白芍 枣皮
煎成,用葛、梨、蔗、藕、茅根、地黄、西瓜,自然汁一杯,入汤服。如非时无有,得人乳、牛乳、石蜜、
枣膏亦可。
此治燥之通剂。
燥乃阳明秋金之化。经曰∶逆秋气,则太阴不收,肺气焦满。肺为寒水生源,源止流绝,不能灌溉周身。且
或汗,下亡津,或房劳竭髓,或过饵金石,或贪哺酒食,皆能助狂火而损真阴,故化为燥。在外则皮肤皱揭,在
内则喘咳烦渴,上则咽焦鼻干,下则肠枯便秘。治宜生津存液,其燥自退。故用参、 、麦冬、甘草补气以生津,
归、芍、梅、枣,五味辛酸而致液。且津生于自然,当用自然之瓜、梨等汁以为助。液存于温润,更须温润之乳、
蜜、枣膏以为养。
诗曰∶自然汁,一二好,花样兼并何处有,有的生脉如归 ,和着枣梅芍药草。
黄连 干姜 桂枝 甘草 人参 半夏 大枣
胸中有热欲呕,胃中有寒作痛,与此汤而愈者,黄连之苦佐以半夏之辛,则苦从辛化,寒者不滞,可以泄上
热;姜、桂之温和以参、草之甘,则温从甘缓,热者不燥,可以散中寒。寒热之相用,犹兵法奇正之相倚也。况
大枣益胃,又所以热中而靖招摇矣。若早下误下,胸满不痛,渐成痞气,去桂枝,换黄芩,盖病在表,早下误下
皆逆矣。下而虚其中,表邪乘之,则阴阳不通如痞象,故曰痞。邪正相搏,抑郁心肺,必烦躁肠鸣、干呕或泄利、
谷不化。论因固属虚,见症如斯,虚亦成实尔。故须出桂入芩,从其部而泻之。假无热,只自虚而痞,当塞因塞
用,补阵热阵选方,芩连俱用不着。
诗曰∶黄连癖干姜,甘草爱肉桂,偏是枣强人,半夏为知契。
人参、麦冬、五味子、当归、黄芪、甘草、乌梅、白芍、山茱萸。
煎煮成药汤后,取葛根汁、梨汁、甘蔗汁、藕汁、白茅根汁、生地黄汁、西瓜汁中的一种自然汁一杯,混入药汤中服用。如果不在这些药材生长的季节或无法获取,用人乳、牛乳、石蜜(冰糖)、枣膏也可以。
这是治疗燥证的通用方剂。
燥证是阳明秋金之气转化的结果。《内经》说:违背秋季收敛之气,太阴脾肺之气就不能正常收敛,导致肺气焦枯胀满。肺为寒水之源,源头停止流动则水流断绝,不能灌溉全身。况且或因发汗、攻下导致津液亡失,或因房劳过度耗竭骨髓,或因过量服用金石类药物,或因贪恋饮酒进食辛辣厚味,都能助长狂火而损伤真阴,从而化生为燥邪。在体表表现为皮肤皱裂脱屑,在体内表现为气喘咳嗽、心烦口渴,向上表现为咽喉干燥、鼻腔干涩,向下表现为肠道干枯、大便秘结。治疗应当生津存液,燥邪自然消退。所以用人参、黄芪、麦冬、甘草补气以生津液,用当归、白芍、乌梅、山茱萸、五味子,利用其酸辛之味来化生津液。而且津液生于自然之物,应当使用自然的瓜、梨等汁液作为辅助。津液存于温润之中,更须用温润的人乳、蜂蜜、枣膏来滋养。
诗曰:自然汁,一二好,花样兼并何处有,有的生脉如归芪,和着枣梅芍药草。
黄连、干姜、桂枝、甘草、人参、半夏、大枣。
胸中有热欲呕吐,胃中有寒冷作痛,服用此汤可愈。黄连的苦味佐以半夏的辛味,则苦从辛化,寒邪不致凝滞,可以清泄上部的热邪;干姜、桂枝的温和佐以人参、甘草的甘味,则温从甘缓,热邪不致燥烈,可以疏散中部的寒邪。寒热药的相互配伍,就像兵法中奇正相互倚靠一样。况且大枣能益胃,又是用来安定中焦而平息躁动的。如果过早使用泻下法或误用泻下法,出现胸满但不痛,逐渐形成痞证,应去掉桂枝,换成黄芩。因为病在表,过早或误用泻下法都是逆治。泻下导致中焦空虚,表邪乘虚而入,导致阴阳不通,呈现痞塞之象,所以称为“痞”。邪气与正气相搏结,郁阻在心肺,必然出现烦躁、肠鸣、干呕或腹泻、完谷不化等症状。论述病因固然属于虚证,但见症如此,虚证也可转化为实证。所以必须去掉桂枝加入黄芩,顺应病位而泻除邪气。假若没有热象,只是因自身虚弱而导致痞证,应当采用“塞因塞用”的方法,补益为主。此时阵发性发热时选方用药,黄芩、黄连都不需要使用。
诗曰:黄连癖干姜,甘草爱肉桂,偏是枣强人,半夏为知契。
Ren Shen (Ginseng Radix), Mai Dong (Ophiopogonis Tuber), Wu Wei Zi (Schisandrae Fructus), Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix), Gan Cao (Licorice Radix), Wu Mei (Mume Fructus), Bai Shao (Paeoniae Radix Alba), Shan Zhu Yu (Corni Fructus).
After decocting into a liquid, take one cup of natural juice from Ge Gen (Puerariae Lobatae Radix), Li (Pyrus Fruit), Zhe Gao (Saccharum Japonicum), Ou (Nelumbinis Rhizoma), Mao Gen (Imperatae Rhizoma), Di Huang (Rehmanniae Radix), or Xi Gua (Citrullus Lanatus) and mix it with the herbal decoction for administration. If these are unavailable due to seasonality, Ren Ru (Human Milk), Niu Nai (Cow's Milk), Shi Mi (Rock Sugar), or Zao Gao (Date Paste) may be used instead.
This is a general formula for treating Dryness Syndrome (Zao Zheng).
Dryness arises from the transformation of Yangming Autumn Metal Qi. The Classics state: "Violating the Qi of Autumn causes Taiyin [Spleen/Lung] to fail in receiving/consolidating, resulting in Lung Qi becoming scorched and distended." The Lung is the source of Cold Water; if the source stops, the flow ceases, and it cannot irrigate the whole body. Furthermore, excessive sweating or purging can deplete Body Fluids (Jin Ye); sexual exhaustion can deplete Marrow; overconsumption of mineral drugs can damage Yin; and indulgence in alcohol and rich foods can fuel raging Fire and injure True Yin, thereby transforming into Dryness. Externally, it manifests as wrinkled and peeling skin; internally, as panting, coughing, restlessness, and thirst; upwards, as scorched throat and dry nose; downwards, as dry intestines and constipation. Treatment should focus on generating fluids and preserving moisture, so that Dryness naturally recedes. Therefore, Ren Shen, Huang Qi, Mai Dong, and Gan Cao are used to tonify Qi to generate fluids; Dang Gui, Bai Shao, Wu Mei, and Zao Pi (Shan Zhu Yu), along with Wu Wei Zi, utilize their Sour and Acrid flavors to produce fluids. Moreover, since fluids originate from natural sources, natural juices of melons, pears, etc., are used as assistance. Since fluids reside in moistening and warming substances, moistening and warming agents like milk, honey, and date paste are required for nourishment.
Poem: Natural juices, two or three are good, where can such variety be found? With Sheng Mai San-like Dang Gui and Huang Qi, mixed with dates, plums, white peony root, and licorice grass.
Huang Lian (Coptidis Rhizome), Gan Jiang (Zingiberis Rhizoma), Gui Zhi (Cinnamomi Ramulus), Gan Cao (Licorice Radix), Ren Shen (Ginseng Radix), Ban Xia (Pinelliae Tuber), Da Zao (Jujubae Fructus).
For heat in the chest causing nausea/vomiting, and cold in the stomach causing pain, this formula brings cure. The Bitterness of Huang Lian assisted by the Pungency of Ban Xia transforms Bitterness into Pungency, preventing stagnation of Cold, thus draining Upper Heat; the Warmth of Gan Jiang and Gui Zhi moderated by the Sweetness of Ren Shen and Gan Cao transforms Warmth into Gentleness, preventing Dryness of Heat, thus dispersing Middle Cold. The combination of Cold and Hot herbs is like the interdependence of Unorthodox and Orthodox tactics in military strategy. Furthermore, Da Zao benefits the Stomach, serving to calm the Middle Jiao and quell agitation. If purgatives are used too early or erroneously, chest fullness without pain may gradually develop into Pi Syndrome (Glomus/Pi Mass). In this case, remove Gui Zhi and substitute with Huang Qin (Scutellariae Radix). Because the pathogen is in the Exterior, premature or erroneous purging is contrary to treatment principles. Purging empties the Interior, allowing Exterior pathogens to invade, leading to obstruction of Yin and Yang, presenting as Pi (stagnation/glomus). When Evil and Righteous Qi struggle, depressing the Heart and Lung, symptoms must include restlessness, borborygmus, dry retching, diarrhea, or undigested food in stool. Although the etiology is indeed Deficiency, the manifestations suggest that Deficiency has transformed into Excess. Thus, removing Gui Zhi and adding Huang Qin is necessary to drain the pathogen according to its location. If there is no Heat, and Pi arises solely from internal Deficiency, one should employ "Tonifying Obstruction with Tonification" (Se Yuan Se Yong). During episodes of fever, select formulas accordingly; Huang Qin and Huang Lian are not needed.
Poem: Huang Lian favors Gan Jiang, Gan Cao loves Rou Gui, Dates particularly strengthen the person, Ban Xia acts as a confidant.