健忘者。适然而忘其事。尽心力思量不来。凡所言行。往往不知首尾。病主心脾二经。盖心之官则思。脾之
官亦主思。此由思虑过多。心血耗散。而神不守舍。脾气衰惫。而意不强。二者皆令人猝然忘事也。治法必
先养其心血。理其脾气。以凝神定志之剂补之。亦当处以幽闲之地。使绝其思虑。则日渐以安也。归脾汤
主之。若心经火旺者。是火邪扰其心神。治宜清火宁心。天王补心丹治之。亦有痰沉留于心包。沃塞心窍。
以致精神恍惚。凡事多不记忆者。宜温胆汤合金箔镇心丸治之。朱砂安神丸。加龙骨远志菖蒲茯神炒
黄丹。亦治之。失血家心脾血虚。每易动痰生火。健忘之证尤多。又凡心有瘀血。亦令健忘。内经所谓血在
下如狂。血在上喜忘是也。夫人之所以不忘者。神清故也。神为何物。即心中数点血液。湛然朗润。故能照
物以为明。血在上。则浊蔽而不明矣。凡失血家猝得健忘者。每有瘀血。血府逐瘀汤。加郁金菖蒲。或朱砂
安神丸。加桃仁丹皮郁金远志。
(癫狂 见鬼)
大病伤寒之后。欲食不食。欲卧不卧。欲行不行。精神恍惚。若有鬼神附其体中者。名曰百合病。谓百脉一
宗。合致其病。肺主百脉。肺魄不宁。故病如此。诸多恍惚。未尽名状。必见溺赤脉数之证。乃肺金受克之验
也。仲景用生地百合滑石治之。此专言杂病余邪为患者也。失血家阴脉受伤。凡是恍惚不宁。皆百合病
之类。总宜清金定魄为主。清燥救肺汤。加百合茯神琥珀滑石生地金箔治之。地魄汤亦治之。或琼玉膏。
加龙骨羚羊角百合。或人参清肺汤。加百合滑石。
大凡夜梦不宁者。魂不安也。魂为阳。夜则魂藏而不用。魂不能藏。故夜梦不宁。寤时恍惚者。魄不安也。魄
为阴。寤时而阴气不足。故恍惚不定。治魂以肝为主。治魄以肺为主。二者对勘自明。然恍惚惊悸惑乱怔
忡癫狂。皆是神不清明之证。人身有魂魄。而所以主是魂魄者。则神也。故凡诸证。总以安神为主。安神丸。
金箔镇心丸治之。
语言错乱为癫。多由丧心失魄。痰迷心窍所致。统以金箔镇心丸治之。怒骂飞走为狂。由于火邪逼迫。心
神迷乱。四肢躁扰。滚痰丸治之。
见鬼者。癫狂之类也。阳明病。胃有燥屎。则目中见鬼。宜三一承气汤下之。失血家瘀血在内。亦谵语见鬼。
以其同为实邪。故俱能扰目之明也。桃仁承气汤治之。
健忘,是指突然忘记自己做过的事情,即使尽心竭力地思考也想不起来。平时所说的话、所做的事,往往不知道前因后果。这种病主要涉及心和脾两经。因为心的功能主司思维,脾的功能也主司思维。这是由于思虑过多,导致心血耗散,神志不能安守于心舍;脾气衰败疲惫,意志不够坚定。这两方面都会使人突然忘记事情。治疗方法必须先滋养心血,调理脾气,用能够凝神定志的方剂来补益。同时也应当让人居住在清静悠闲的地方,使其断绝思虑,这样病情就会日渐安稳。以归脾汤为主治方。如果心经火旺,这是火邪扰乱心神,治疗宜清热泻火、宁心安神,用天王补心丹治疗。也有痰浊沉留于心包,堵塞心窍,以致精神恍惚,凡事多不记得的情况,宜用温胆汤合金箔镇心丸治疗。朱砂安神丸,加入龙骨、远志、石菖蒲、茯神、炒黄丹,也能治疗此证。失血患者心脾血虚,容易动痰生火,健忘的症状尤为多见。另外,心中若有瘀血,也会导致健忘,这正是《内经》所说的“血在下则如狂,血在上则喜忘”。人之所以不忘事,是因为神志清明。神是什么?就是心中那几滴血液,清澈明亮润泽,所以能映照万物而显得明智。如果血在上焦,就会被浊气遮蔽而不能清明。凡是失血患者突然患上健忘的,每伴有瘀血,可用血府逐瘀汤,加入郁金、石菖蒲;或者朱砂安神丸,加入桃仁、牡丹皮、郁金、远志。
(癫狂 见鬼)
大病伤寒之后,想吃却不想吃,想睡却睡不着,想走却走不动,精神恍惚,好像有鬼神附在身体里一样,名叫百合病。说是百脉同宗,合致其病。肺主一身之百脉,肺魄不安宁,所以生病如此。许多恍惚的症状,无法完全形容清楚,必须见到小便赤、脉搏数等证候,这才是肺金受克的验证。张仲景用地黄、百合、滑石治疗它。这里专门讲的是杂病余邪为患者。失血患者阴脉受伤,凡是出现恍惚不宁的,都属于百合病之类。总宜以清润肺金、安定魂魄为主,用清燥救肺汤,加入百合、茯神、琥珀、滑石、地黄、金箔治疗。地魄汤也能治疗。或者琼玉膏,加入龙骨、羚羊角、百合;或者人参清肺汤,加入百合、滑石。
大凡夜间多梦不安的,是魂不安定。魂属阳,夜间魂应潜藏而不发挥作用,魂不能潜藏,所以夜间多梦不安。清醒时精神恍惚的,是魄不安定。魄属阴,清醒时阴气不足,所以恍惚不定。治疗魂以肝为主,治疗魄以肺为主,两者对照比较自然明白。然而恍惚、惊悸、惑乱、怔忡、癫狂,都是神志不清明的证候。人身有魂魄,而主宰这些魂魄的是神。所以凡是这些病症,总以安神为主,用安神丸、金箔镇心丸治疗。
语言错乱称为癫,多由丧失信魄、痰迷心窍所致,统用金箔镇心丸治疗。怒骂、奔跑跳跃称为狂,由于火邪逼迫,心神迷乱,四肢躁动不安,用滚痰丸治疗。
见鬼,属于癫狂一类。阳明病,胃中有燥屎,则眼中看见鬼怪,宜用三一承气汤攻下。失血患者体内有瘀血,也会说胡话、看见鬼怪,因为它们同为实邪,所以都能扰乱眼睛的清明,用桃仁承气汤治疗。
Amnesia refers to suddenly forgetting one's own actions, being unable to recall them even after exerting utmost mental effort. One often does not know the beginning or end of what was said or done. This disease primarily involves the Heart and Spleen meridians. The function of the Heart governs thinking (Si), and the function of the Spleen also governs thinking. This is caused by excessive worrying, which depletes Heart Blood, causing the Shen (Spirit) to fail to reside in its dwelling; the Spleen Qi becomes weak and exhausted, leading to a lack of firm Yi (Intellect). Both conditions cause sudden forgetfulness. The treatment method must first nourish Heart Blood and regulate Spleen Qi, supplementing with formulas that stabilize the Shen and fix the will. It is also appropriate to place the patient in a quiet and leisurely environment to cut off sources of worry, so that the condition will gradually stabilize. Gui Pi Tang (Restore the Spleen Decoction) is the primary formula. If there is excess fire in the Heart meridian, it is due to Fire Evil disturbing the Heart Shen; treatment should focus on clearing fire and calming the Heart, using Tian Wang Bu Xin Dan (Emperor of Heaven’s Pill to Tonify the Heart). In cases where phlegm turbidity lingers in the Pericardium, blocking the heart orifices, resulting in mental恍惚 (fluctuation/unsteadiness) and poor memory, Wen Dan Tang (Warm the Gallbladder Decoction) combined with Jin Bo Zhen Xin Wan (Gold Foil Pill to Calm the Heart) should be used. Zhu Sha An Shen Wan (Cinnabar Pill to Calm the Spirit), added with Long Gu (Fossilized Bones), Yuan Zhi (Polygala Root), Shi Chang Pu (Acorus Rhizome), Fu Shen (Poria with Hostwood), and Chao Huang Dan (Stir-fried Yellow Lead Oxide), can also treat this condition. Patients who have suffered blood loss often have deficiency of Heart and Spleen Blood, making them prone to generating phlegm and fire, with amnesia being particularly common. Furthermore, stasis of blood in the Heart also causes amnesia, as stated in the *Nei Jing*: "Blood stagnating below leads to manic behavior; blood stagnating above leads to forgetfulness." The reason humans do not forget is that their Shen is clear. What is Shen? It is the small amount of blood in the Heart, clear, bright, and moist, enabling it to reflect objects clearly. If blood stagnates in the Upper Jiao, it becomes obscured by turbidity and loses clarity. Whenever patients with blood loss suddenly develop amnesia, it is often accompanied by blood stasis; Xue Fu Zhu Yu Tang (Drive Out Stasis in the Mansion of Blood Decoction) added with Yu Jin (Turmeric Tuber) and Shi Chang Pu can be used, or Zhu Sha An Shen Wan added with Tao Ren (Apricot Seed), Mu Dan Pi (Moutan Bark), Yu Jin, and Yuan Zhi.
(Epilepsy, Mania, and Hallucinations)
After a severe illness such as Shang Han (Cold Damage), the patient may desire food but not eat, desire to sleep but not sleep, desire to walk but not move, experiencing mental fluctuation (Huang Hu), as if possessed by spirits or ghosts. This is named Bai He Bing (Lily Disease), meaning that all vessels belong to one source, combining to cause the disease. The Lung governs all vessels in the body; when the Po (Corporeal Soul) of the Lung is unsettled, the disease manifests thus. Many symptoms of fluctuation cannot be fully described, but one must observe signs such as dark urine and rapid pulse, which are evidence of Metal (Lung) being overcome. Zhang Zhongjing treated this with Sheng Di Huang (Rehmannia Root), Bai He (Lily Bulb), and Hua Shi (Talcum). This specifically addresses residual pathogens from miscellaneous diseases. For patients with blood loss who have injured Yin vessels, any case of fluctuation and restlessness belongs to the category of Bai He Bing. The general principle is to clear Lung Metal and settle the Po, using Qing Zao Jiu Fei Tang (Clear Dryness and Rescue the Lung Decoction) added with Bai He, Fu Shen, Hu Po (Amber), Hua Shi, Sheng Di Huang, and Jin Bo (Gold Foil). Di Po Tang (Earth Po Decoction) can also treat this. Alternatively, Qiong Yu Gao (Jade Elixir Paste) added with Long Gu, Ling Yang Jiao (Antelope Horn), and Bai He; or Ren Shen Qing Fei Tang (Ginseng Clear Lung Decoction) added with Bai He and Hua Shi.
Generally, restless dreams at night indicate an unsettled Hun (Ethereal Soul). Hun is Yang; at night, the Hun should hide and remain inactive. If the Hun cannot hide, restless dreams occur. Fluctuation during wakefulness indicates an unsettled Po (Corporeal Soul). Po is Yin; during wakefulness, if Yin Qi is insufficient, fluctuation occurs. Treating the Hun focuses on the Liver, while treating the Po focuses on the Lung; comparing the two makes the distinction clear. However, fluctuation, palpitations, confusion, Zheng Chong (palpitations/panic), epilepsy, and mania are all signs of unclear Shen. Although the human body possesses Hun and Po, the entity that governs them is the Shen. Therefore, for all these conditions, the primary treatment is to calm the Shen, using An Shen Wan (Calming Spirit Pill) and Jin Bo Zhen Xin Wan.
Disordered speech is termed Dian (Epilepsy/Melancholia), mostly caused by loss of Xin Po (Heart Po) and phlegm confusing the Heart orifices; it is generally treated with Jin Bo Zhen Xin Wan. Cursing, shouting, and running about is termed Kuang (Mania), caused by Fire Evil forcing the Heart Shen into confusion, with restlessness of the four limbs; Gun Tan Wan (Rolling Phlegm Pill) is used.
Seeing ghosts belongs to the category of Dian and Kuang. In Yang Ming disease, dry feces in the Stomach cause visual hallucinations of ghosts; San Yi Cheng Qi Tang (Three-One Bowel-Relieving Decoction) should be used to purge. In patients with blood loss, internal blood stasis also causes delirium and hallucinations, because both are excess pathogens that disturb the clarity of the eyes; Tao Ren Cheng Qi Tang (Apricot Kernel Bowel-Relieving Decoction) is used.