生地 熟地(各一两) 白芍 麦冬(各五钱) 山萸(三钱) 北五味(一钱) 炒栀子(二钱) 甘草(一钱)
水煎服。
人有不食则腹中若饥,食则若饱闷,吞酸溏泻,日以为常,遂至面色痿黄,吐痰不已,
人以为胃气之伤也,谁知是脾气之损乎。夫脾为胃土代行其传化者也。胃之气全藉脾气之运
动,胃乃得化其精微,不特脾受益,而各脏腑之气,无不受其益也。今脾气受伤,不能为胃
以代行其传化,不特胃之气无以生,而脾不得胃气之化,则脾亦受损而不受益,势必至脾胃
两损,何能分其津液,以灌注夫各脏腑之气耶,治法必大健其胃,兼补夫脾。盖胃与脾为表
里,两者宜合不宜离者也。
方用益脾汤∶
人参(一钱) 山药(五钱) 芡实(三钱) 巴戟天(三钱) 砂仁(一粒) 半夏(三分) 茯苓(二钱) 扁
豆
(一钱) 神曲(一钱) 肉果(一枚) 白术(三钱)
水煎服。服三月胃气开,再服三月脾气壮,但见有益不知有损矣。此方开胃之药多于补
脾,以脾损由于胃虚,故补胃而自益其脾也。
此症用果腹饮亦效。
白术(一两) 甘草(一钱) 破故纸(一钱) 砂仁(一粒) 茯苓(三钱) 芡实(五钱)
水煎服。
人有终朝咳嗽,吐痰微喘,少若行动则短气不足以息,人以为心火之刑肺,谁知是肺气
之自损乎。夫肺主气,五脏七腑,虽各自有气,皆仰藉肺中清肃之气,以分布之也。今肺金
自损,自卫不足,何能分给于各脏腑乎。且肾水非肺金之气不生,肺既自顾不暇,不来生肾
,肾无肺气而水涸,肺又分其气以救子而不足,自然子病而母之气亦尽矣。治法宜大补肺气
,兼补肾水。方用六味汤加麦冬、五味子,大剂与之。久服肾旺而肺亦旺也。夫六味汤补肾
之药,即加五味、麦冬之补肺,而入于六味丸汤中仍是补肾者也。补肾以治肺,此胜于治肺
者也。肾旺而肺不必顾子,况又有麦冬、五味之滋,肺受益正无尽也,何损之不愈哉。
此症用延息汤亦佳。
人参 百合(各五钱) 甘草(一钱) 熟地(一两) 山茱萸(四钱) 牛膝(二钱) 北五味(五分) 茯苓
(三钱)
水煎服。
人有贪用饮食,甚至遇难化之物而不知止,逢过寒之味而不知节,遂至胸腹胀闷,已而
作痛生疼,后至起嗳吞酸,见美味而作嗔不欲食者,人皆以为脾气之困,谁知是胃气之损乎
。夫脾胃虽为表里,然一主入,而一主出,能入而不能出者,脾气之衰,能出而不能入者,
胃气之乏也。虽脾胃交相伤损,然治法不可概治,必分别其何经之伤,使损者多获其益,则
胃易开而脾易健。盖脾胃同属一土,而补土实有两法,脾虚属肾寒,胃虚属心冷也。故补脾
者必须补肾,而补胃者必须补心,不可混也。今见美味而嗔,明是胃虚,而非脾虚矣。治法
补其心火,而胃气自开。
方用六君子汤加味治之。
人参(二钱) 白术(三钱) 炒枣仁 茯苓(各三钱) 陈皮(五分) 甘草(五分) 半夏(一钱) 干姜炒
,二钱) 附子(一片)
水煎服。连用十剂,胃中温和。再服十剂,前症顿去。
此方虽仍是统治脾胃之药,然加枣仁、干姜、附子之类,是补心者居其重,补脾者居其
轻矣。名是脾胃兼治,实偏于治胃者也。
此症用生气汤亦妙。
人参(二钱) 白术(一钱) 巴戟天(二钱) 陈皮(三分) 甘草(二分) 茯苓(二钱) 砂仁(一粒) 谷
芽
(一钱) 炮姜(五分)
水煎服。
生地黄、熟地黄(各一两),白芍、麦冬(各五钱),山茱萸(三钱),北五味子(一钱),炒栀子(二钱),甘草(一钱)。
用水煎煮后服用。
有的人不吃东西时感觉腹中饥饿,吃东西后又感觉饱胀闷堵,伴有反酸和稀便,每天都这样,以至于面色萎黄,不断吐痰。
人们认为这是胃气受损,哪里知道这其实是脾气的亏损呢?脾作为胃的土行属性,代替胃执行传化和运作的功能。胃的气机完全依赖脾气的运动,胃才能消化其中的精微物质,这不仅使脾受益,而且各个脏腑的气机,无不从中受益。现在脾气受伤,不能替胃执行传化功能,不仅胃的气机无法生成,而且脾得不到胃气的转化,那么脾也会受损而不能受益,势必导致脾胃两损,怎么能分别津液,来灌注到各个脏腑的气机中去呢?治疗方法必须大力健旺胃气,同时补益脾气。因为胃与脾互为表里,两者应该结合而不宜分离。
方剂用益脾汤:
人参(一钱),山药(五钱),芡实(三钱),巴戟天(三钱),砂仁(一粒),半夏(三分),茯苓(二钱),扁豆(一钱),神曲(一钱),肉豆蔻(一枚),白术(三钱)。
用水煎煮后服用。服用三个月胃气开通,再服用三个月脾气强壮,只看到益处而看不到损害了。这个方剂中开胃的药多于补脾的药,因为脾的损伤是由于胃虚引起的,所以补胃自然就能益脾。
这种病症用果腹饮也有效。
白术(一两),甘草(一钱),破故纸(一钱),砂仁(一粒),茯苓(三钱),芡实(五钱)。
用水煎煮后服用。
有的人整天咳嗽,吐痰且轻微气喘,稍微活动就气短呼吸困难,人们认为是心火刑克肺金,哪里知道这是肺气自身的亏损呢?肺主气,五脏六腑虽然各自有气,都仰赖肺中清肃之气来分布。现在肺金自身亏损,卫外不足,怎么能分给各个脏腑呢?况且肾水不是由肺金之气所生,肺既然自身难保,不来生养肾,肾没有肺气则水干涸,肺又分出气来救助子脏(肾)而不足,自然子病而母的气也耗尽了。治疗方法应当大补肺气,兼补肾水。方剂用六味地黄汤加麦冬、五味子,大剂量给予。长期服用肾旺盛而肺也旺盛。六味地黄汤本是补肾的药物,即使加入五味子、麦冬这些补肺的药,进入六味地黄丸/汤中仍然是补肾的。通过补肾来治肺,这比直接治肺更好。肾旺盛而肺不必顾护子脏,况且又有麦冬、五味子的滋润,肺受益正无穷无尽,哪里有治不好的损伤呢?
这种病症用延息汤也很好。
人参、百合(各五钱),甘草(一钱),熟地黄(一两),山茱萸(四钱),牛膝(二钱),北五味子(五分),茯苓(三钱)。
用水煎煮后服用。
有的人贪吃饮食,甚至遇到难消化的食物也不知道停止,遇到过寒的食物也不知道节制,以至于胸腹胀闷,随后产生疼痛,后来出现打嗝反酸,见到美味却生气不想吃的情况,人们都认为是脾气被困,哪里知道这是胃气受损呢?脾胃虽然互为表里,然而一个主入,一个主出,能入而不能出的,是脾气的衰败;能出而不能入的,是胃气的匮乏。虽然脾胃相互损伤,但治疗方法不可一概而论,必须分辨是哪条经受伤,使受损者多获益处,那么胃容易开通而脾容易健运。因为脾胃同属土,但补土实际上有两种方法,脾虚属于肾寒,胃虚属于心冷。所以补脾必须补肾,而补胃必须补心,不可混淆。现在见到美味却生气,明显是胃虚,而不是脾虚。治疗方法补益心火,胃气自然开通。
方剂用六君子汤加味治疗。
人参(二钱),白术(三钱),炒酸枣仁、茯苓(各三钱),陈皮(五分),甘草(五分),半夏(一钱),干姜(炒,二钱),附子(一片)。
用水煎煮后服用。连续使用十剂,胃中温和。再服用十剂,前面的症状顿时去除。
这个方剂虽然仍是统管脾胃的药物,但加入了枣仁、干姜、附子之类,补心的药物占据主要地位,补脾的药物占据次要地位。名义上是脾胃兼治,实际上是偏重于治胃。
这种病症用生气汤也很奇妙。
人参(二钱),白术(一钱),巴戟天(二钱),陈皮(三分),甘草(二分),茯苓(二钱),砂仁(一粒),谷芽(一钱),炮姜(五分)。
用水煎煮后服用。
Shengdi Huang (Rehmanniae Radix) and Shudi Huang (Prepared Rehmanniae Radix) (each 1 liang), Baishao (White Peony Root), Maidong (Ophiopogonis Tuber) (each 5 qian), Shanzhuyu (Corni Fructus) (3 qian), Bei Wuweizi (Schisandrae Fructus) (1 qian), Chao Zhizi (Gardeniae Fructus, stir-fried) (2 qian), Gancao (Licorice Root) (1 qian).
Decoct in water and take orally.
Some individuals feel hungry when not eating, but feel full and distended after eating, accompanied by acid regurgitation and loose stools, occurring daily. This leads to a sallow complexion and continuous expectoration of phlegm.
People assume this is an injury to Stomach Qi (Stomach energy), but who would know it is actually a damage to Spleen Qi (Spleen energy)? The Spleen, belonging to the Earth element, acts on behalf of the Stomach to perform transportation and transformation. The Stomach's Qi relies entirely on the movement of Spleen Qi for the Stomach to digest and absorb essence and nutrients. Not only does the Spleen benefit, but the Qi of all other Zang-Fu organs also benefits from it. Now, with injured Spleen Qi unable to act on behalf of the Stomach for transportation and transformation, not only can Stomach Qi not be generated, but since the Spleen does not receive the transformation from Stomach Qi, the Spleen itself becomes damaged and fails to benefit. Consequently, both the Spleen and Stomach are damaged. How can they separate fluids and distribute them to the Qi of various organs? The treatment method must vigorously strengthen the Stomach and simultaneously tonify the Spleen. Since the Stomach and Spleen are exterior-interior paired organs, they should be combined rather than separated.
Prescribe Yipi Tang (Spleen-Benefiting Decoction):
Renshen (Ginseng Radix et Rhizoma) (1 qian), Shanyao (Dioscoreae Rhizoma) (5 qian), Qianshi (Nelumbinis Semen) (3 qian), Bajitian (Morindae Officinalis Radix) (3 qian), Sharen (Amomi Fructus Rotundus) (1 grain), Banxia (Pinelliae Rhizoma) (3 fen), Fuling (Poria) (2 qian), Biandou (Lablab Album Seed) (1 qian), Shenqu (Massa Medicata Fermentata) (1 qian), Roudoukou (Myristicae Semen) (1 piece), Baizhu (Atractylodis Macrocephalae Rhizoma) (3 qian).
Decoct in water and take orally. After three months of administration, Stomach Qi opens; after another three months, Spleen Qi strengthens. Only benefits will be seen, with no signs of damage remaining. This formula contains more herbs for opening the Stomach than for tonifying the Spleen because Spleen damage stems from Stomach deficiency; thus, tonifying the Stomach naturally benefits the Spleen.
This condition can also be effectively treated with Guofu Yin (Fruit-Belly Infusion).
Baizhu (Atractylodis Macrocephalae Rhizoma) (1 liang), Gancao (Licorice Root) (1 qian), Poguzhi (Psoraleae Fructus), Sharen (Amomi Fructus Rotundus) (1 grain), Fuling (Poria) (3 qian), Qianshi (Nelumbinis Semen) (5 qian).
Decoct in water and take orally.
Some individuals cough throughout the day, expectorate phlegm, and experience slight panting. Upon slight movement, they suffer from shortness of breath and inability to catch their breath. People attribute this to Heart Fire punishing Lung Metal, but who would know it is self-damage to Lung Qi (Lung energy)? The Lung governs Qi. Although each of the five Zang and six Fu organs has its own Qi, they all rely on the Lung's clear and descending Qi for distribution. Now, with Lung Metal self-damaged and defensive capacity insufficient, how can it distribute Qi to other organs? Moreover, Kidney Water is not generated without Lung Metal Qi. If the Lung cannot even care for itself and fails to generate Kidney, the Kidney lacks Lung Qi and its waters dry up. The Lung then divides its Qi to rescue the "child" organ (Kidney) but remains insufficient. Naturally, as the child suffers, the mother's Qi is exhausted. The treatment method should vigorously tonify Lung Qi and simultaneously tonify Kidney Water. Prescribe Liuwei Tang (Six-Ingredient Decoction, i.e., Liuwei Dihuang Wan/Tang) with added Maidong (Ophiopogonis Tuber) and Wuweizi (Schisandrae Fructus), administered in large doses. Long-term use will strengthen the Kidney, which in turn strengthens the Lung. Liuwei Tang consists of herbs that tonify the Kidney; even with the addition of Wuweizi and Maidong for tonifying the Lung, within the context of Liuwei Wan/Tang, the primary action remains tonifying the Kidney. Treating the Lung by tonifying the Kidney is superior to directly treating the Lung. When the Kidney is strong, the Lung need not worry about rescuing the child, especially with the nourishment of Maidong and Wuweizi. The Lung benefits endlessly, so how could such damage fail to heal?
This condition can also be well-treated with Yanxi Tang (Breath-Extending Decoction).
Renshen (Ginseng Radix et Rhizoma), Baihe (Lilii Bulbus) (each 5 qian), Gancao (Licorice Root) (1 qian), Shudi Huang (Prepared Rehmanniae Radix) (1 liang), Shanzhuyu (Corni Fructus) (4 qian), Niuxi (Achyranthis Bidentatae Radix) (2 qian), Bei Wuweizi (Schisandrae Fructus) (5 fen), Fuling (Poria) (3 qian).
Decoct in water and take orally.
Some individuals indulge in eating, even consuming indigestible foods without stopping, and overeating cold foods without moderation. This leads to chest and abdominal distension and fullness, followed by pain. Later, belching and acid regurgitation occur, and they become irritable at the sight of delicious food, losing their appetite. People assume this is the Spleen Qi being trapped, but who would know it is Stomach Qi damage? Although the Spleen and Stomach are exterior-interior paired, one governs intake (entering) and the other governs output (exiting). Inability to intake but ability to output indicates Spleen Qi decline; inability to output but ability to intake indicates Stomach Qi deficiency. Although the Spleen and Stomach mutually injure each other, treatment cannot be generalized. One must distinguish which meridian is injured so that the damaged parts benefit more, allowing the Stomach to open easily and the Spleen to become robust. Since the Spleen and Stomach both belong to Earth, there are two methods for tonifying Earth: Spleen deficiency belongs to Kidney Cold, while Stomach deficiency belongs to Heart Cold. Therefore, tonifying the Spleen requires tonifying the Kidney, and tonifying the Stomach requires tonifying the Heart; these must not be confused. Irritability upon seeing delicious food clearly indicates Stomach deficiency, not Spleen deficiency. The treatment method is to tonify Heart Fire, and Stomach Qi will naturally open.
Prescribe Liujunzi Tang (Six-Gentlemen Decoction) with modifications.
Renshen (Ginseng Radix et Rhizoma) (2 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (3 qian), Chao Zaoren (Ziziphi Spinosani Semen, stir-fried), Fuling (Poria) (each 3 qian), Chenpi (Citri Reticulatae Pericarpium) (5 fen), Gancao (Licorice Root) (5 fen), Banxia (Pinelliae Rhizoma) (1 qian), Ganjiang (Zingiberis Rhizoma, stir-fried) (2 qian), Fuzi (Aconiti Lateralis Radix Praeparata) (1 slice).
Decoct in water and take orally. Use continuously for ten doses until the Stomach feels warm. Take another ten doses, and previous symptoms will disappear instantly.
Although this formula still manages both Spleen and Stomach, the addition of Zaoren (Ziziphi Spinosani Semen), Ganjiang (Zingiberis Rhizoma), and Fuzi (Aconiti Lateralis Radix Praeparata) means that Heart-tonifying herbs play the major role, while Spleen-tonifying herbs play the minor role. Named as simultaneous treatment of Spleen and Stomach, it is actually biased towards treating the Stomach.
This condition can also be wonderfully treated with Shengqi Tang (Vitality-Generating Decoction).
Renshen (Ginseng Radix et Rhizoma) (2 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (1 qian), Bajitian (Morindae Officinalis Radix) (2 qian), Chenpi (Citri Reticulatae Pericarpium) (3 fen), Gancao (Licorice Root) (2 fen), Fuling (Poria) (2 qian), Sharen (Amomi Fructus Rotundus) (1 grain), Guya (Hordei Fructus Germinatus) (1 qian), Paojiang (Zingiberis Rhizoma, roasted) (5 fen).
Decoct in water and take orally.