黄连(一两) 吴茱萸(酒浸,逗炒) 山羊肝(一具炙干 蜜丸)
肝者,将军之官。双睛,其外阃也。自衰贼盛,皆能乱其谋虑,故肝病目亦病焉。世人至死而光不灭者,邪
未害其空窍,所谓病一不病二也。然既曰肝病,奈何用黄连苦以泻心?盖心,肝子也。子食母气,火泄木元而肝
弗实矣。且木实,金当平之,心火退则金无所畏,自足以平肝。故曰抑青。用羊肝者,羊啖百草,清净无毒,取
其同类,导引黄连之性入肝。火从寒化,热郁顿解。古人制方曲尽匠心,兹可见其大概。一法以羊胆和蜜熬膏,
且点且服,理亦同。
人参 黄芩 黄连 白僵蚕 鼠粘子 柴胡 连翘 升麻 橘红 板蓝根 元参 桔梗 甘草梢 马屁勃
薄荷
泰和二年,民多疫疠。初觉憎寒体重,次壮热头面肿盛,目不能开,喉舌干渴而喘。俗云大头伤寒。染之多
不救,亲戚不相访问。东垣曰∶身半以上,天之气也。身半以
下,地之气也。此天元气薄,客邪乘之,上攻头目而为病。乃立是方,为细末,姜汤调,时时呷之。余用蜜丸,
中夜噙化,人活甚众。盖连翘、薄荷、元参、板蓝根、鼠、马、蚕、橘,皆清喉利膈之物,虽多无碍。升麻主降
浊,甘草缓之。柴胡主升清,桔梗载之,使气味浮而不沉,自可徐徐宣力。再有人参辅主,芩连逐容,则热邪不
得复居其位,活人宜矣。倘血热便秘,加桃仁、大黄以下血。渴肉 ,加防风、芎、归而行。肿势甚者,须按穴
砭刺,此尽肿胀之治。目如蚌合,如杯覆者,皆可类推。
诗曰∶普济黄连桔薄荷,翘芩元草板蓝和,升柴马勃鼠粘橘,加入蚕参疫奈何。
【抑青丸方】
黄连(一两) 吴茱萸(用酒浸泡后,微炒) 山羊肝(一只,烤干,制成蜜丸)
肝脏,是将军之官。双眼,是其外在的门户。如果正气衰弱而邪气强盛,都能扰乱其谋虑功能,所以肝病时眼睛也会生病。世人直到死亡时眼神依然光亮不灭的,是因为邪气尚未侵害其空窍,这就是所谓的“病在一处而不波及另一处”。既然说是肝病,为什么使用黄连的苦味来泻心火呢?这是因为心是肝的子脏。子脏消耗母脏的气血,心火泄则木元(肝)得以充实而不再亢盛。况且木气过实,金应当制约它;心火退去,金就无所畏惧,自然足以平抑肝木。所以叫作“抑青”(抑制青色/肝木)。使用羊肝的原因,是因为羊吃百草,性质清净无毒,取其同类相求的道理,引导黄连的药性进入肝脏。火热之邪从寒凉转化,郁结的热毒顿时解除。古人制方极尽匠心,从这里可见大概。另一种方法是用羊胆和蜂蜜熬成膏,既滴眼又内服,道理也是相同的。
【普济消毒饮方】
人参 黄芩 黄连 白僵蚕 鼠粘子(牛蒡子) 柴胡 连翘 升麻 橘红 板蓝根 玄参 桔梗 甘草梢 马屁勃(马勃) 薄荷
泰和二年(1202年),百姓中流行瘟疫。起初感觉憎恶寒冷、身体沉重,接着出现高热、头面部肿胀严重,眼睛无法睁开,咽喉舌头干燥口渴且气喘。俗称“大头伤寒”。感染这种病的人大多无法救治,亲戚之间不敢互相探望访问。李东垣说:身半以上,是天之气所主;身半以下,是地之气所主。这是天元气薄弱,客居的邪气趁机侵犯,向上攻冲头目而致病。于是创立了这个方剂,研成细末,用姜汤调服,时时小口呷饮。我将其制成蜜丸,半夜含化服用,救活了很多病人。因为连翘、薄荷、玄参、板蓝根、鼠粘子、马勃、僵蚕、橘红,都是清利咽喉膈膜的药材,即使用量多也无妨碍。升麻主要作用是降浊,甘草缓和药性。柴胡主要作用是升清,桔梗载引药力,使气味浮扬而不沉坠,自然可以徐徐发挥宣散之力。再加入人参辅助主药,黄芩、黄连驱逐热邪,那么热邪就无法重新占据其位置,救人也就顺理成章了。如果有血热便秘的情况,加入桃仁、大黄以通下瘀血。如果有肌肉腐烂溃烂的情况,加入防风、川芎、当归以行气活血。如果肿胀严重的,必须按照穴位进行砭石刺络放血,这是治疗肿胀的全部方法。眼睛像蚌壳闭合、像杯子倒扣那样的情况,都可以类推处理。
诗曰:普济消毒方中有黄连、桔梗、薄荷,连翘、黄芩、玄参、甘草、板蓝根相配合,升麻、柴胡、马勃、鼠粘子、橘红,再加入僵蚕、人参,面对瘟疫无可奈何(意指此方能治)。
[Formula: Yi Qing Wan (Suppressing Cyan Pill)]
Coptidis Rhizoma (30 g)
Evodiae Fructus (soaked in wine, lightly stir-fried)
Caprae Hircus Hepatis Siccata (one liver, roasted dry, prepared as honeyed pills)
The Liver is the official of the General. The two eyes are its external gateways. When righteous Qi declines and pathogenic factors flourish, they can all disrupt its strategic planning; therefore, when the Liver is diseased, the eyes also become diseased. Those among the people whose gaze remains bright until death have not had their pathogenic factors invade their hollow orifices; this is referred to as "disease affecting one part but not another." Since it is stated as a Liver disease, why use Coptidis Rhizoma (Huanglian), which is bitter and drains Heart Fire? This is because the Heart is the child organ of the Liver. The child consumes the mother's Qi; draining Heart Fire allows the Wood element (Liver) to be solidified and no longer hyperactive. Furthermore, when Wood is excessive, Metal should regulate it. When Heart Fire recedes, Metal has nothing to fear and is naturally sufficient to level the Liver Wood. Hence, it is called "Yi Qing" (Suppressing Cyan/Liver). Sheep liver is used because sheep graze on various herbs, possessing a pure and non-toxic nature. By taking the principle of similar species attracting each other, it guides the properties of Coptidis Rhizoma into the Liver. Fire transforms through cold, and stagnant heat is suddenly resolved. The ingenuity of ancient physicians in formulating prescriptions can be seen generally here. Another method involves using Gallbladder of Caprae Hircus mixed with honey to make a paste, applied topically to the eyes and taken orally; the rationale is the same.
[Formula: Pu Ji Xiao Du Yin (Universal Benefit Decoction for Eliminating Toxins)]
Ginseng Radix et Rhizoma
Scutellariae Radix
Coptidis Rhizoma
Bombyx Batryticatus
Arctii Fructus
Bupleuri Radix
Forsythiae Fructum
Bupleuri Radix (Note: Text lists Chai Hu and Sheng Ma separately, usually Bupleuri is Chai Hu) -> Correction: Shengma Rhizoma
Citri Reticulatae Pericarpium
Isatidis Radix
Scrophulariae Radix
Platycodonis Radix
Glycyrrhizae Radix et Rhizoma (tip portion)
Lasiosphaeria (Ma Bo)
Menthae Haplocalycis Herba
In the second year of Taihe (1202 AD), an epidemic plagued the populace. Initially, patients felt aversion to cold and heaviness of the body, followed by high fever, severe swelling of the head and face, inability to open the eyes, dryness and thirst of the throat and tongue, and wheezing. Colloquially known as "Big Head Cold Syndrome" (Da Tou Shang Han). Most infected individuals could not be saved, and relatives dared not visit each other. Li Dongyuan said: The upper half of the body is governed by Heaven's Qi; the lower half is governed by Earth's Qi. Here, the primordial Qi of Heaven was weak, allowing exogenous pathogens to take advantage and attack upwards, causing disease in the head and eyes. Thus, he established this formula, ground into fine powder, adjusted with ginger decoction, and sipped frequently. I prepared it as honeyed pills, held in the mouth to dissolve at midnight, saving many lives. Forsythiae Fructum, Menthae Haplocalycis Herba, Scrophulariae Radix, Isatidis Radix, Arctii Fructus, Lasiosphaeria, Bombyx Batryticatus, and Citri Reticulatae Pericarpium are all substances that clear the throat and benefit the diaphragm; even in large doses, they cause no harm. Shengma Rhizoma primarily descends turbidity, while Glycyrrhizae Radix et Rhizoma moderates the action. Bupleuri Radix primarily ascends clarity, and Platycodonis Radix carries the medicinal qi, ensuring the flavors float rather than sink, thus gradually exerting their dispersing power. Additionally, Ginseng Radix et Rhizoma assists the principal agents, while Scutellariae Radix and Coptidis Rhizoma drive out residual heat, so that pathogenic heat cannot reoccupy its position, making recovery likely. If there is blood-heat with constipation, add Persicae Semen and Rhei Radix et Rhizoma to purge blood stasis. If there is muscle rot/ulceration, add Saposhnikoviae Radix, Ligustici Chuanxiong Rhizoma, and Angelicae Sinensis Radix to promote circulation. If swelling is severe, needle-pricking according to acupoints is required; this covers the treatment of swelling. Conditions where the eyes are closed like a clam shell or covered like an inverted cup can be inferred analogously.
Poem states: Pu Ji Xiao Du Yin contains Huanglian, Jiegeng, Bohe, Qiaoxin, Yuancao, Banlangen harmonized together; Shengchai, Mabo, Niuzao, Ju, plus Can and Renshen, addressing epidemics helplessly (implying efficacy against such dire conditions).