犀角地黄汤(见鼻衄。) 桃仁承气汤 抵当汤(并见伤寒蓄血。)
许州陈大夫传仲景百劳丸方 治一切劳瘵积滞疾,不经药坏证者宜服。
当归(炒) 乳香 没药(各一钱) 虻虫(十四个,去翅足) 人参(二钱) 大黄(四钱) 水蛭(十四
个,炒) 桃仁(十四个,浸,去皮尖)
上为细末,炼蜜为丸,桐子大。都作一服,可百丸,五更用百劳水下,取恶物为度,
服白粥十日。(百劳水,杓扬百遍,乃仲景甘澜水也。)
抵当丸 与汤四味同,但分两减半,捣细,水调服。前之百劳丸,乃是此抵当丸内加人
参、当归、没药、乳香,蜜丸,甘澜水下。
通经丸方 乃仲景抵当丸内加穿山甲、广术、桃仁、桂,蜜丸。妇人伤寒妊娠不可
以此丸下,当以四物汤、大黄各半汤下之。
又方 卫州张推官在勘院,王公以职医宿直夜,口传此方,治人效者不可胜数,寻
常凝滞,其效尤速,任冲不调,经脉闭塞,渐
成瘕。
虻虫(麸炒,四十个) 水蛭(炒,四十个) 斑蝥(去翅足,炒) 杜牛膝(各一两) 当归 红花(各三
钱) 滑石(二钱半)
上细末,每服一钱,生桃仁七个细研,入酒调下。如血未通再服,以通为度,食前。
地黄汤(韩氏《微旨》) 治病患七八日后,两手脉沉迟细微,肤冷,脐下满,或喜或妄,或
狂或躁,大便实而色黑,小便自利者,此蓄血证具也。若年老及年少气虚弱者,宜此方主之。
生地黄(自然汁一升,如无生地黄,只用生干地黄末,一两) 生藕(自然汁半升,如无藕,以蓟刺汁
半升,如无蓟刺汁,用蓟刺末一两) 蓝叶(一握,切碎,干者末,一两) 虻虫(三十个,去足翅,炒黄)
大黄(一两,锉如骰子大) 桃仁(半两) 水蛭(十个,麸炒) 干漆(炒烟尽,半两)
上同一处,水三升半,同慢火熬及二升以来,放冷,分三服。投一服,至半日许血
未下,再投之。此地黄汤,比抵当汤丸其实甚轻也。如无地黄与藕汁,计升数添水同煎。
生漆汤(《元戎》) 病患七八日后,两手脉沉细而数,或关前脉大,脐下满,或狂走,或
喜妄,或谵语,不大便,小便自利,若病患年少气实,即血凝难下,恐抵当丸力不能及,宜此。
生地黄(汁一升,如无汁,用生干地黄三两半) 犀角(一两,镑,为末) 大黄(三两,锉碎如骰子大)
桃仁(三十个擂碎)
上作一处,用水三升,好酒一升,慢火熬,三升以来,倾出滤去滓,再入锅,投点
光生漆一两半,再熬之,至二升即住,净滤去滓,放冷,作三服,每投服,候半日许血
未下,再投一服,候血下即止。服药如无生地黄汁,更添水一升同煎。
活人大黄汤(《元戎》) 治阳毒伤寒未解,热结在内,恍惚如狂者。
桃仁(二十粒,麸炒黄) 官桂(七钱) 芒硝(二钱半) 大黄 甘草 木通 大腹皮(各一两)
上 咀,每服四钱,水一盅,煎至六分,去滓温服,无时,此方细末,蜜丸桐子大,温
酒下二三十丸,治妇人经闭或不调,若瘀血已去,以复元通气散加当归煎服亦可。又法,
筋骨损伤,用左经丸之类;或用草乌头,枣肉为丸,服之以行诸经者,以其内无瘀血,故
用之。药剂寒热温凉不一,惟智者能择之,而不可偏执也。
代抵当丸 行瘀血。(自制。)
大黄(川产如锦纹者,去皮及黑心,四两) 芒硝(一两,如欲稳,以玄明粉代) 桃仁(麸炒黄,去皮
尖,另研如泥,六十枚) 当归尾 生地黄 穿山甲(蛤粉炒。各一两) 桂(三钱或五钱)
上为极细末,炼蜜丸,如桐子大。蓄血在上焦,丸如芥子大,临卧去枕仰卧,以津
咽之,令停留喉下,搜逐膈上,中焦食远,下焦空心,俱桐子大,以百涝水煎汤下之。用
归地者,欲下血而不损血耳,且引诸药至血分也,诸药皆犷悍,而欲以和剂之也。如血
老成积,此药攻之不动,宜去归、地,加广术,醋浸透焙干,一两,肉桂七钱。
通真丸 妇人通经,男子破血。
大黄(去皮,米醋同煮烂) 桃仁(各四两,去皮尖,另研) 天水末(四两,天水一名益元散) 干漆
(二两,用瓦上焙烟尽) 杜牛膝(二两,生)
上为末,醋糊丸,如桐子大。每服六七十丸。
大内伤丸 治血瘀。
白术(黄土炒) 枳壳(麸炒) 黄芩(酒炒。各六钱) 浓朴(姜汁炒) 香附(童便炒) 苍术(米泔水洗,
葱汁炒) 草果(炒) 木瓜 赤曲(炒) 三棱(蜜炙,各五钱) 蓬术(蜜水炒,七钱) 青皮(麸炒) 川芎
白芍药(酒炒) 神曲(炒) 枳实(麸炒) 石菖蒲(各一两) 小茴香(炒) 肉桂 甘草(炙) 乳香(出汗。
各一两) 前药二十一味,共为细末,神曲糊丸,如弹子大,朱砂一两为衣。汤、酒任下,
多不过二丸。
上部内伤方
牡丹皮(一钱) 江西红曲(八分) 香附(八分,童便制) 麦芽(一钱) 桔梗(五分,中部不用) 川通
草(一钱) 穿山甲(一钱,麸炒,有孕不用) 降香(一钱,为末) 红花(七分) 山楂(八分) 苏木(一钱,捶碎)
上酒、水各一盅,煎八分。甚者加童便一盅。如痰盛加姜制半夏七分半,有孕者油
炒。如痛甚加真乳香、没药各七分半。中部加枳壳,胁痛加柴胡。
犀角地黄汤(参见鼻衄章节)。桃仁承气汤。抵当汤(均见于伤寒蓄血章节)。
许州陈大夫传授的仲景百劳丸方,用于治疗各种虚劳积滞疾病,且未经药物误治坏证的病人适宜服用。
当归(炒制)一钱,乳香一钱,没药一钱,虻虫十四个(去除翅膀和足),人参二钱,大黄四钱,水蛭十四个(炒制),桃仁十四个(浸泡后去皮尖)。
以上药材研成细末,用炼蜜制成梧桐子大小的丸剂。总量作为一次服用的量,约一百丸。在五更天用百劳水送服,以排出恶物为度,服药后连续十天喝白粥。(百劳水,即舀起倒下一百遍的水,也就是张仲景所说的甘澜水。)
抵当丸与抵当汤的四味药相同,只是剂量减半,捣碎后用水调服。前面的百劳丸,就是在抵当丸的基础上加入人参、当归、没药、乳香,用蜜制成丸剂,用甘澜水送服。
通经丸方,是在仲景抵当丸中加入穿山甲、广术(莪术)、桃仁、桂枝,用蜜制成丸剂。妇女在伤寒妊娠期间不可用此丸攻下,应当用四物汤和大黄各半煎成的汤剂来攻下。
又一方:卫州张推官在勘院时,王公担任职医值夜班,口传此方,治疗有效者不可胜数。对于寻常的气血凝滞,其疗效尤其迅速;对于任脉、冲脉不调,经脉闭塞,逐渐形成瘕块的情况也适用。
虻虫(麸炒)四十个,水蛭(炒)四十个,斑蝥(去翅足,炒),杜牛膝一两,当归三钱,红花三钱,滑石二钱半。
以上研成细末,每次服用一钱,将七个生桃仁细细研磨,用酒调服。如果血未通畅可再服,以血通为度,饭前服用。
地黄汤(出自韩氏《微旨》):治疗病患七八日后,两手脉象沉迟细微,皮肤发冷,脐下胀满,或喜笑无常,或胡言乱语,或狂躁,大便干结色黑,小便自利的症状,这是蓄血证具备的表现。如果是老年人及年轻人中气血虚弱者,宜用此方主治。
生地黄(取自然汁一升,若无生地黄,只用生干地黄末一两),生藕(取自然汁半升,若无藕,用蓟刺汁半升,若无蓟刺汁,用蓟刺末一两),蓝叶(一把,切碎,干者研末一两),虻虫三十个(去足翅,炒黄),大黄一两(锉如骰子大小),桃仁半两,水蛭十个(麸炒)。
以上放在一起,加水三升半,用慢火熬至二升左右,放凉,分三次服用。投服一剂,若半天左右血未下行,再投服一剂。此地黄汤,比起抵当汤丸药力其实很轻。如果没有地黄和藕汁,按升数加水同煎即可。
生漆汤(出自《元戎》):病患七八日后,两手脉象沉细而数,或者关前脉大,脐下胀满,或狂跑,或喜笑妄语,或谵语,不大便,小便自利。如果病患年少气实,则血凝难下,恐怕抵当丸药力不能达到,宜用此方。
生地黄(汁一升,若无汁,用生干地黄三两半),犀角一两(镑片,研末),大黄三两(锉碎如骰子大小),桃仁三十个(擂碎)。
以上放在一起,用水三升,好酒一升,慢火熬至三升左右,倾倒出来滤去渣滓,再放入锅中,投入光生漆一两半,再熬,至二升时停止,净滤去渣滓,放凉,分三次服用。每次投服,若候半天左右血未下行,再投服一剂,待血下行后即止。服药时若无生地黄汁,可再加水一升同煎。
活人大黄汤(出自《元戎》):治疗阳毒伤寒未解,热结在内,神志恍惚如狂的症状。
桃仁二十粒(麸炒黄),官桂七钱,芒硝二钱半,大黄一两,甘草一两,木通一两,大腹皮一两。
以上锉碎,每次服用四钱,加水一盅,煎至六分,去渣温服,不拘时候。此方也可研成细末,炼蜜制成梧桐子大小的丸剂,温酒送服二三十丸,治疗妇人经闭或月经不调。若瘀血已去,可用复元通气散加当归煎服亦可。又一种方法,筋骨损伤,用左经丸之类;或用草乌头,枣肉为丸,服用以通行诸经,因为体内无瘀血,所以这样用。药剂有寒热温凉不同,只有智者能选择,不可偏执。
代抵当丸:行瘀血。(自制方。)
大黄(四川产如锦纹者,去皮及黑心,四两),芒硝一两(若想稳妥,可用玄明粉代替),桃仁(麸炒黄,去皮尖,另研如泥,六十枚),当归尾一两,生地黄一两,穿山甲(蛤粉炒,一两),桂三钱或五钱。
以上研成极细末,炼蜜制成梧桐子大小的丸剂。蓄血在上焦,丸剂如芥子大,临睡前去掉枕头仰卧,用唾液吞咽,令其停留在喉下,搜逐膈上;中焦食远时服用,下焦空腹时服用,均为梧桐子大,用百劳水煎汤送服。使用归、地,是为了下血而不伤血,并且引导诸药至血分。诸药皆猛烈,欲用平和之剂调和它们。如果血老成积,此药攻不动,应去掉归、地,加广术一两(醋浸透焙干),肉桂七钱。
通真丸:妇人通经,男子破血。
大黄(去皮,米醋同煮烂),桃仁(各四两,去皮尖,另研),天水末(四两,天水一名益元散),干漆(二两,用瓦上焙至烟尽),杜牛膝(二两,生用)。
以上研成末,醋糊制成梧桐子大小的丸剂。每次服用六七十丸。
大内伤丸:治疗血瘀。
白术(黄土炒),枳壳(麸炒),黄芩(酒炒,各六钱),浓朴(姜汁炒),香附(童便炒),苍术(米泔水洗,葱汁炒),草果(炒),木瓜,赤曲(炒),三棱(蜜炙,各五钱),蓬术(蜜水炒,七钱),青皮,川芎,白芍药(酒炒),神曲(炒),枳实(麸炒),石菖蒲(各一两),小茴香(炒),肉桂,甘草(炙),乳香(出汗处理,各一两)。以上二十一味药,共研细末,神曲糊制成弹子大小的丸剂,朱砂一两为衣。汤剂或酒送服均可,多不超过二丸。
上部内伤方:
牡丹皮一钱,江西红曲八分,香附八分(童便制),麦芽一钱,桔梗五分(中部不用),川通草一钱,穿山甲一钱(麸炒,有孕不用),降香一钱(研末),红花七分,山楂八分,苏木一钱(捶碎)。
以上用酒、水各一盅,煎至八分。重症加童便一盅。如痰盛加姜制半夏七分半,有孕者油炒。如痛甚加真乳香、没药各七分半。中部加枳壳,胁痛加柴胡。
Xijiao Dihuang Tang (See section on Epistaxis). Taoren Chengqi Tang. Didang Tang (Both seen in the section on Shaoyin Blood Stasis).
The Fang of Zhongjing Bailao Wan, transmitted by Dr. Chen from Xuzhou, is used to treat various types of consumptive diseases with accumulation and stagnation, suitable for patients whose conditions have not been worsened by improper medication.
Danggui (Fried) 1 qian, Ruxiang 1 qian, Moyao 1 qian, Mengchong 14 pieces (remove wings and feet), Renshen 2 qian, Dahuang 4 qian, Shuizhi 14 pieces (fried), Taoren 14 pieces (soaked, remove skin and tips).
Grind the above into a fine powder, make pills with refined honey, size of paulownia seeds. The total amount constitutes one dose, approximately 100 pills. Take at dawn (5-7 AM) with Bailao water, until foul matter is expelled. Follow with white rice porridge for ten days. (Bailao water is water scooped and poured back 100 times, also known as Ganlan water by Zhang Zhongjing.)
Didang Wan contains the same four ingredients as Didang Tang, but with halved dosages. Grind finely and take mixed with water. The aforementioned Bailao Wan is essentially Didang Wan with added Renshen, Danggui, Moyao, and Ruxiang, made into honey pills and taken with Ganlan water.
Tongjing Wan Fang is made by adding Chanshanjia, Guangzhu (Ezhur), Taoren, and Guizhi to Zhongjing's Didang Wan, formed into honey pills. Women suffering from Cold Damage during pregnancy should not use this pill for purging; instead, they should use a decoction of Siwu Tang and Dahuang in equal parts.
Another Prescription: When Wang Gong served as an official physician on night duty at the Kan Yuan in Weizhou, he orally transmitted this prescription. It has cured countless cases. It is particularly effective for ordinary qi and blood stagnation, and for irregularities in the Ren and Chong meridians, obstruction of menstrual channels, and gradual formation of masses (Jia).
Mengchong (bran-fried) 40 pieces, Shuizhi (fried) 40 pieces, Banmao (remove wings and feet, fried), Dunnium 1 liang, Danggui 3 qian, Honghua 3 qian, Huashi 2.5 qian.
Grind into a fine powder. Take 1 qian per dose, grinding 7 raw Taoren finely, mixing with wine to swallow. If blood flow does not resume, take again until flow resumes. Take before meals.
Dihuang Tang (from Han Shi's "Weizhi"): Treats patients after 7-8 days of illness, presenting with deep, slow, fine, and weak pulses in both hands, cold skin, fullness below the umbilicus, or manic laughter, delirious speech, mania, or restlessness, solid black stools, and free urination. These are complete signs of Blood Stasis Syndrome. For elderly patients or young patients with deficient qi and blood, this formula is indicated.
Shengdihuang (Natural juice 1 sheng; if unavailable, use dried Shengdihuang powder 1 liang), Shengou (Natural juice 0.5 sheng; if unavailable, use Jici juice 0.5 sheng; if unavailable, use Jici powder 1 liang), Lanye (One handful, chopped; dried powder 1 liang), Mengchong 30 pieces (remove feet and wings, fried yellow), Dahuang 1 liang (cut into dice-sized pieces), Taoren 0.5 liang, Shuizhi 10 pieces (bran-fried).
Place all together with 3.5 sheng of water, simmer slowly until reduced to about 2 sheng. Cool, divide into three doses. Administer one dose; if half a day passes without blood expulsion, administer another. This Dihuang Tang is significantly milder than Didang Tang/Wan. If Dihuang and Oujie juice are unavailable, add water according to volume and decoct together.
Shengqi Tang (from "Yuanrong"): Treats patients after 7-8 days of illness, presenting with deep, fine, and rapid pulses in both hands, or a large pulse at the Guan position, fullness below the umbilicus, running wildly, manic laughter, delirious speech, constipation, and free urination. If the patient is young and robust, blood coagulation may be difficult to resolve, and the force of Didang Wan may be insufficient; this formula is appropriate.
Shengdihuang (Juice 1 sheng; if unavailable, use dried Shengdihuang 3.5 liang), Xijiao 1 liang (shaved, powdered), Dahuang 3 liang (cut into dice-sized pieces), Taoren 30 pieces (pounded).
Place all together with 3 sheng of water and 1 sheng of good wine. Simmer slowly until reduced to 3 sheng. Strain and remove dregs. Return to the pot, add 1.5 liang of raw Qi (lacquer), simmer until reduced to 2 sheng. Stop heating. Filter cleanly to remove dregs. Cool, divide into three doses. After each administration, if half a day passes without blood expulsion, administer another dose. Stop when blood is expelled. If raw Shengdihuang juice is unavailable, add 1 sheng of water and decoct together.
Huorendahuang Tang (from "Yuanrong"): Treats Yang-toxin Cold Damage that has not resolved, with heat binding internally, causing mental confusion resembling mania.
Taoren 20 grains (bran-fried yellow), Guangui 7 qian, Mangxiao 2.5 qian, Dahuang 1 liang, Gancao 1 liang, Mutong 1 liang, Dafupi 1 liang.
Cut into small pieces. Take 4 qian per dose, decoct with 1 zhong of water until reduced to 60%. Strain and take warm, at any time. This formula can also be ground into fine powder, made into honey pills size of paulownia seeds, taken with warm wine (20-30 pills) to treat amenorrhea or irregular menstruation in women. If blood stasis has been cleared, Fuyuan Tongqi San with added Danggui can be decocted and taken. Another method: for bone and tendon injuries, use Zuo Jing Wan or similar; or use Caowutou made into pills with jujube meat to promote circulation through the meridians, as there is no internal blood stasis. Medicinal properties vary in cold, heat, warmth, and coolness; only the wise can choose appropriately, avoiding bias.
Dai Didang Wan: Promotes blood circulation. (Self-made formula.)
Dahuang (Sichuan origin with brocade patterns, remove skin and black heart, 4 liang), Mangxiao 1 liang (use Xuanmingfen for stability), Taoren (bran-fried yellow, remove skin and tips, pounded separately into paste, 60 pieces), Dangguwei 1 liang, Shengdihuang 1 liang, Chanshanjia (fried with clam powder, 1 liang), Guizhi 3-5 qian.
Grind into extremely fine powder, make pills with refined honey, size of paulownia seeds. For blood stasis in the Upper Jiao, make pills size of mustard seeds. Lie supine without pillow before sleep, swallow with saliva to retain under the throat, searching out stasis above the diaphragm. For Middle Jiao, take far from meals; for Lower Jiao, take on an empty stomach. All are paulownia seed size, taken with Bailao water decoction. Danggui and Dihuang are used to purge blood without damaging it, and to guide other herbs to the blood level. Other herbs are harsh, so harmonizing agents are added. If old, hardened blood stasis resists attack, remove Danggui and Dihuang, add Guangzhu 1 liang (soaked in vinegar, dried), Rougui 7 qian.
Tongzhen Wan: Unblocks menstruation in women, breaks blood stasis in men.
Dahuang (remove skin, boiled rotten with rice vinegar), Taoren (each 4 liang, remove skin and tips, pound separately), Tian Shui Mo (4 liang, Tian Shui is also known as Yiyuan San), Ganqi (2 liang, baked on tile until smoke ceases), Dunnium 2 liang (raw).
Grind into powder, make pills with vinegar paste, size of paulownia seeds. Take 60-70 pills per dose.
Da Neishang Wan: Treats blood stasis.
Baizhu (fried with yellow earth), Zhike (bran-fried), Huangqin (wine-fried, each 6 qian), Houpo (ginger juice-fried), Xiangfu (child's urine-fried), Cangzhu (rice wash-water washed, scallion juice-fried), Caoguo (fried), Mugua, Chiqu (fried), Sanleng (honey-roasted, each 5 qian), Pengzhu (honey-water fried, 7 qian), Qingpi, Chuanxiong, Baishao (wine-fried), Shenqu (fried), Zhishi (bran-fried), Shichangpu (each 1 liang), Xiaohuixiang (fried), Rougui, Gancao (roasted), Ruxiang (sweated, each 1 liang). The above 21 herbs are ground into fine powder, made into pill size of quail eggs with Shenqu paste, coated with 1 liang of Zhusha. Take with decoction or wine, no more than 2 pills.
Upper Internal Injury Formula:
Mudanpi 1 qian, Jiangxi Hongqu 8 fen, Xiangfu 8 fen (prepared with child's urine), Maiya 1 qian, Jiegeng 5 fen (not used for middle section), Chuantongcao 1 qian, Chanshanjia 1 qian (bran-fried, contraindicated in pregnancy), Jiangxiang 1 qian (powdered), Honghua 7 fen, Shanzha 8 fen, Sumu 1 qian (crushed).
Decoct with 1 zhong of wine and 1 zhong of water until reduced to 80%. For severe cases, add 1 zhong of child's urine. If phlegm is abundant, add Jiangbanxia 7.5 fen (oil-fried if pregnant). If pain is severe, add real Ruxiang and Moyao 7.5 fen each. Add Zhike for middle section pain, add Chaihu for hypochondriac pain.