麻黄加术汤 《金匮》云∶湿家身烦疼,可与麻黄加术汤。发其汗为宜,慎不可
麻黄(三两,去节) 桂枝(二两,去皮) 甘草(一两,炙) 白术(四两) 杏仁(七
水九升,先煮麻黄减二升,去上沫,内诸药煮取二升半,去滓温服八合,覆取微汗。
按∶此治寒湿在表之剂也。寒固当汗,而湿在表者,亦非汗不解,故以麻黄散寒,以白
术除湿。取微汗者,汗大出,则湿反不去也。
麻黄杏仁薏苡甘草汤 治风湿一身尽疼,发热日晡所剧。此病伤于汗出当风,或
久伤取冷所致也。(方详《金匮》,兹不赘。)
羌活胜湿汤(东垣) 治湿气在表,脉浮,身重不能转侧,自汗,或额上多汗,此
羌活 独活(各一钱) 川芎 本 防风 炙草(各五分) 蔓荆子(三分)
如腰痛中冷沉沉然者,有寒湿也。加酒洗汉防己、附子各五分。
按∶此治风湿在腠理及关节之剂。吴鹤皋云∶无窍不入,惟风药为能,故凡关节之疾病
,非羌活、独活等不能致也。
五苓散 通治诸湿肿满,呕逆泄泻,痰饮湿疟,身痛身重。
猪苓 茯苓 白术 泽泻 桂
上为末,每服三钱,服后多饮热水,汗出愈。
肾着汤(《三因》) 治伤湿身重,腰冷,如坐水中。
干姜(炮) 茯苓(各四两) 甘草(炙) 白术(生用,各二两)
上每服四钱,水一盏,煎七分,空心温服。
以上温利之剂,湿兼寒者宜之。
清热渗湿汤
黄柏(盐水炒,二钱) 黄连 茯苓 泽泻(各一钱) 苍术 白术(各一钱半)
上七味,水二蛊,煎至八分服。
此清渗之剂,湿而热者宜之。
麻黄加术汤 《金匮要略》记载:患有湿病的人身体烦痛,可以使用麻黄加术汤。适宜通过发汗来治疗,但务必谨慎,不可大汗淋漓。
麻黄(三两,去节) 桂枝(二两,去皮) 甘草(一两,炙) 白术(四两) 杏仁(七枚)
用水九升,先煮麻黄,减少二升水量,撇去水面上的浮沫,加入其余药物,煎取二升半药液,滤去药渣,温服八合,服药后覆盖衣被以取得微汗。
按语:这是治疗寒湿在体表的方剂。寒邪固然应当用汗法解表,而湿邪在体表者,也不非发汗不能解除,所以用麻黄散寒,用白术除湿。要求取得微汗的原因是,如果大汗出,湿邪反而不能去除。
麻黄杏仁薏苡甘草汤 治疗风湿导致全身疼痛,发热在申时(下午3-5点)加重。这种病是由于出汗时受风,或长期贪凉所致。(方剂详情见《金匮要略》,此处不再赘述。)
羌活胜湿汤(李东垣创制) 治疗湿气在体表,脉象浮,身体沉重不能翻身转侧,自汗,或者额头多汗,这种情况……
羌活 独活(各一钱) 川芎 藁本 防风 炙甘草(各五分) 蔓荆子(三分)
如果腰痛伴有冷感,感觉沉冷,说明有寒湿。加入酒洗过的汉防己、附子各五分。
按语:这是治疗风湿在腠理及关节的方剂。吴鹤皋说:病邪无孔不入,只有风药才能到达,所以凡是关节的疾病,不用羌活、独活等药是不能治愈的。
五苓散 通治各种湿邪导致的肿胀满闷,呕吐逆气,泄泻,痰饮,湿疟,身体疼痛,身体沉重。
将上述药物研为细末,每次服用三钱,服药后多喝热水,待汗出则痊愈。
肾着汤(出自《三因极一病证方论》) 治疗因伤湿导致身体沉重,腰部寒冷,如同坐在水中一样。
干姜(炮制) 茯苓(各四两) 甘草(炙) 白术(生用,各二两)
每次服用四钱,用水一盏,煎至七分,空腹温服。
黄柏(盐水炒,二钱) 黄连 茯苓 泽泻(各一钱) 苍术 白术(各一钱半)
将以上七味药,用水二盅,煎至八分药液服用。
这是清利渗湿的方剂,适用于湿邪兼夹热邪的情况。
Mahuang Jia Zhu Tang (Ephedra Decoction Augmented with Atractylodes Macrocephala) The *Jingui Yaolue* states: For patients suffering from dampness presenting with bodily restlessness and pain, Mahuang Jia Zhu Tang may be administered. It is appropriate to induce sweating; however, one must exercise caution and absolutely avoid profuse sweating.
Ephedrae Herba (Mahuang, 麻黄), three liang, nodes removed; Cinnamomi Ramulus (Guizhi, 桂枝), two liang, bark removed; Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), one liang, honey-fried; Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), four liang; Armeniacae Semen Amarum (Xingren, 杏仁), seven seeds.
Add nine sheng of water, first boil Ephedrae Herba until the volume reduces by two sheng, skim off the foam on the surface, then add the remaining herbs. Boil to obtain two and a half sheng of decoction, strain, and take eight he of the warm liquid. After ingestion, cover with blankets to induce slight perspiration.
Commentary: This is a formula for treating cold-dampness located in the exterior. While cold pathogens should indeed be resolved through diaphoresis, dampness residing in the exterior also requires sweating to resolve. Therefore, Ephedrae Herba is used to disperse cold, and Atractylodis Macrocephalae Rhizoma is used to eliminate dampness. The requirement for slight perspiration arises because profuse sweating causes the dampness to remain rather than being expelled.
Mahuang Xingren Yiyi Ren Gancao Tang (Ephedra, Apricot Seed, Coix Seed, and Licorice Decoction) Treats wind-dampness causing generalized body pain, with fever exacerbating during the Shen hour (15:00–17:00). This condition results from exposure to wind while sweating or from chronic overexposure to cold. (The detailed prescription is found in the *Jingui Yaolue*; it is not repeated here.)
Qianghuo Shengshi Tang (Notopterygium Decoction to Overcome Dampness, created by Li Dongyuan) Treats dampness in the exterior, characterized by a floating pulse, heaviness of the body preventing turning or side-positioning, spontaneous sweating, or excessive sweating on the forehead...
Notopterygii Rhizoma et Radix (Qianghuo, 羌活); Angelicae Pubescentis Radix (Duhuo, 独活), each one qian; Chuanxiong Rhizoma (Chuanxiong, 川芎); Ligustici Rhizoma et Radix (Gaoben, 藁本); Saposhnikoviae Radix (Fangfeng, 防风); Honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao, 炙甘草), each five fen; Viticis Fructus (Manjingzi, 蔓荆子), three fen.
If lower back pain is accompanied by a sensation of cold and heaviness, indicating cold-dampness, add Han Fangji (Stephaniae Tetrandrae Radix, 汉防己) washed with wine and Aconiti Lateralis Radix Praeparata (Fuzi, 附子), each five fen.
Commentary: This is a formula for treating wind-dampness in the couli (interstices) and joints. Wu Hegao stated: Pathogenic factors penetrate everywhere, only wind-dispelling herbs can reach them; therefore, for diseases of the joints, without Notopterygii Rhizoma et Radix and Angelicae Pubescentis Radix, cure is unattainable.
Wuling San (Five-Ingredient Powder with Poria) Universally treats various conditions caused by dampness such as edema and distension, vomiting and regurgitation, diarrhea, phlegm-fluid retention, damp-malaria, body pain, and bodily heaviness.
Polyporus (Zuling, 猪苓); Poria (Fuling, 茯苓); Atractylodis Macrocephalae Rhizoma (Baizhu, 白术); Alismatis Rhizoma (Zexie, 泽泻); Cinnamomi Ramulus (Guizhi, 桂枝).
Grind the above ingredients into powder. Take three qian per dose. After ingestion, drink plenty of hot water; recovery occurs when sweat appears.
Shenzhe Tang (Kidney Attire Decoction, from *Sanyin Fang*) Treats injury from dampness resulting in bodily heaviness, coldness of the waist, and a sensation as if sitting in water.
Zingiberis Rhizoma Recens (Paojiang, 干姜), processed; Poria (Fuling, 茯苓), each four liang; Glycyrrhizae Radix et Rhizoma (Zhigancao, 炙甘草), honey-fried; Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), raw, each two liang.
Take four qian per dose. Add one zhan of water, decoct to seven-tenths volume, and take warm on an empty stomach.
The aforementioned warming and draining formulas are suitable for cases where dampness is combined with cold.
Qingre Shen Shi Tang (Clear Heat and Drain Dampness Decoction)
Phellodendri Cortex (Huangbai, 黄柏), stir-fried with salt water, two qian; Coptidis Rhizoma (Huanglian, 黄连); Poria (Fuling, 茯苓); Alismatis Rhizoma (Zexie, 泽泻), each one qian; Atractylodis Rhizoma (Cangzhu, 苍术); Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), each one and a half qian.
Decoct the above seven ingredients in two zhong of water until eight-tenths remains, then take.
This is a clearing and draining formula, suitable for cases where dampness is combined with heat.