胞痹者,《内经》云∶少腹膀胱,按之内痛,若沃以汤,涩于小便,上为清涕是也。膀
胱藏
津液而禀气化,邪气痹之,水气不行,则蓄而生热,积而成实,故按之内痛,若沃以汤而涩
于小便也。足太阳之脉,其直行者从巅入络脑,邪气不得下通于胞者,必反而上逆于脑,脑
气下灌出于鼻窍,则为清涕也。
肾沥汤 治胞痹,小腹急痛,小便赤涩。
麦冬 五加皮 犀角(镑,各一钱) 杜仲 桔便 赤芍 木通(各一钱半) 桑螵蛸(一
个)
上水盏半,入羊肾一只,去脂膜切细,竹沥少许,同煎一盏去滓,空心顿服,日再服。
一方有桑皮,无螵蛸。
按∶肠痹、胞痹,同为内痹,而胞痹为肾虚,热壅膀胱;肠痹为风寒湿着于脾胃。肾沥
汤用清凉以化热壅,吴茱萸散用辛辣以开邪痹也。
肾着汤 治胞痹,小便不通。
臂痹者,臂痛连及筋骨,上支肩胛,举动难支,由血弱而风中之也。
十味锉散
附子 黄 当归 白芍(各一钱) 川芎 防风 白术 茯苓 肉桂(各七分) 熟地(
酒浸,焙干,二钱)
上水一盅,姜三片,枣二枚,食后临卧服。
《本事方》服桑枝法。桑枝一小升,细切炒香,以水三大升,煎服二升,一日服尽无时
。《
图经》云∶桑枝平,不冷不热,可以常服,疗体中风痒,干燥香港脚,四肢拘挛,上气眼晕,
肺气嗽,消食,利小便,久服轻身,聪明耳目,令人光泽,兼疗口干。《仙经》云∶一切仙
药,不得桑枝煎不服。出《抱朴子》。政和间,予尝病二臂痛,服诸药不效,根据此作数剂,
臂痛寻愈。
治风寒湿痹,四肢麻木不仁,乌头粥法。
川乌头生末四钱,用香熟白米作粥半碗,慢火同熬,令稀薄不要稠,下姜汁一茶匙许,
蜜三
大匙,搅匀,空心啜之为佳。如若中湿,更入薏苡米二钱,增米作一中碗服。许氏云∶此粥
大治手足麻木不遂,肿痛不能举者。左氏风淫末疾,谓四肢为末也,脾主四肢,风邪客于肝
则淫脾,脾为肝克,故疾在末,此以谷气引风湿之药,径入脾经,故四肢得安。此汤剂极有
力,予尝以此方授人,服者良验。
胞痹,根据《内经》记载:少腹膀胱部位,按压时内部疼痛,感觉像被热水浇灌一样灼热,小便排尿涩滞不畅,上部表现为流清鼻涕。膀胱贮藏津液并依赖气化功能,若邪气阻滞,导致水气运行不畅,则水液停蓄而生热,积聚而成实证,所以按压时内部疼痛,感觉像被热水浇灌且小便涩滞。足太阳膀胱经的直行经脉,从头顶进入联络脑部,邪气不能向下通达于膀胱,必然反而向上逆乱至脑,脑气下灌并从鼻窍流出,就形成了清鼻涕。
肾沥汤,治疗胞痹,小腹部拘急疼痛,小便颜色红赤且涩滞。
麦冬、五加皮、犀角(镑成薄片,各一钱)、杜仲、桔梗、赤芍、木通(各一钱半)、桑螵蛸(一个)。
以上药材加水一盏半,加入一只羊肾,去除脂膜切细,加入少许竹沥,共同煎煮至一盏量,去渣,空腹一次性服下,每日服用两次。
另一配方中有桑白皮,没有桑螵蛸。
按语:肠痹和胞痹,同属于内痹,但胞痹是由于肾虚,热邪壅塞膀胱;肠痹则是风寒湿邪附着于脾胃。肾沥汤使用清凉药物以化解热邪壅塞,吴茱萸散使用辛辣药物以开通邪气阻滞。
臂痹,手臂疼痛牵连筋骨,向上支撑肩胛部,举动难以支撑,这是由于血虚而风邪侵入所致。
十味锉散
附子、黄芪、当归、白芍(各一钱)、川芎、防风、白术、茯苓、肉桂(各七分)、熟地黄(酒浸,焙干,二钱)。
以上药材用水一盅,生姜三片,大枣二枚,饭后临睡前服用。
《本事方》中记载服用桑枝的方法。桑枝一小升,切碎炒香,用水三大升,煎煮取汁二升,一天内分次服完。《图经》记载:桑枝性平,不冷不热,可以长期服用,治疗身体中风瘙痒、干燥脚气、四肢拘挛、气逆头晕、肺气咳嗽、消食、利小便,长期服用可轻身、聪耳明目、使人面色光泽,兼治口干。《仙经》记载:一切仙药,不用桑枝煎煮就不服用。出自《抱朴子》。政和年间,我曾患双臂疼痛,服用各种药物无效,依照此法制作数剂服用,臂痛随即痊愈。
治疗风寒湿痹,四肢麻木不仁,乌头粥法。
生川乌头研末四钱,用香熟的白米煮半碗粥,用慢火同熬,使粥稀薄不要太稠,加入姜汁约一茶匙,蜂蜜三大匙,搅匀,空腹饮用为佳。如果中湿邪,再加入薏苡仁二钱,增加米量煮成一碗中碗服用。许氏说:此粥大大治疗手足麻木不遂、肿痛不能举动的情况。左氏认为风淫导致末疾,谓四肢为末,脾主四肢,风邪客居于肝则侵犯脾,脾被肝克制,所以疾病在末梢,这是以谷气引导风湿药物,直接入脾经,所以四肢得以安宁。此汤剂极有力,我曾将此方授人,服用者疗效很好。
Bao Bi (Bladder Bi Syndrome), as stated in the *Neijing* (*Inner Canon*), involves pain upon pressing the lower abdomen and bladder area, a sensation of being irrigated with hot water, difficulty and涩滞 (obstruction) in urination, and clear nasal discharge from above. The Bladder stores body fluids and relies on Qi transformation. When pathogenic factors obstruct it, water Qi fails to circulate, leading to accumulation, heat generation, and excess syndrome formation; thus, there is internal pain upon pressure, a sensation like irrigation with hot water, and urinary obstruction. The straight pathway of the Foot-Taiyang Bladder Meridian enters from the vertex and connects with the brain. If pathogenic factors cannot descend to the Bladder, they must reverse and ascend to the brain. Brain Qi descends and exits through the nasal orifices, resulting in clear nasal discharge.
Shen Li Tang (Kidney Drip Decoction) treats Bao Bi, characterized by urgent and painful lower abdomen, and red, obstructed urine.
Mai Dong (Ophiopogonis Radix), Wu Jia Pi (Acanthopanacis Cortex), Xi Jiao (Rhinocerotis Cornu, sliced into thin pieces, 1 qian each), Du Zhong (Eucommiae Cortex), Jie Geng (Platycodonis Radix), Chi Shao (Paeoniae Radix Rubra), Mu Tong (Akebiae Caulis, 1.5 qian each), Sang Piao Xiao (Mantis Egg Case, 1 piece).
Add one and a half cups of water, one sheep kidney (remove fat membrane and cut finely), and a little Zhu Li (Bambusae Succus). Simmer together until one cup remains, strain, and take on an empty stomach in one dose. Take twice daily.
Another prescription includes Sang Bai Pi (Morus Alba Bark) instead of Sang Piao Xiao.
Note: Chang Bi (Intestinal Bi Syndrome) and Bao Bi are both internal Bi syndromes. However, Bao Bi is due to Kidney deficiency with heat stagnation in the Bladder, whereas Chang Bi is caused by wind-cold-dampness adhering to the Spleen and Stomach. Shen Li Tang uses cooling herbs to resolve heat stagnation, while Wu Zhu Yu San (Evodia Powder) uses pungent-warm herbs to open pathogenic obstruction.
Shen Zhuo Tang (Kidney Fixation Decoction) treats Bao Bi with urinary retention.
Bi of the Arm involves arm pain radiating to the sinews and bones, extending upward to support the scapula, making movement difficult to sustain. This arises from blood deficiency allowing wind invasion.
Shi Wei Cuo San (Ten-Ingredient Coarse Powder)
Fu Zi (Aconiti Lateralis Radix Praeparata), Huang Qi (Astragali Radix), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba, 1 qian each), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Fang Feng (Saposhnikoviae Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Rou Gui (Cinnamomi Cortex, 7 fen each), Shu Di Huang (Rehmanniae Radix Praeparata, soaked in wine, dried, 2 qian).
Add one cup of water, three slices of fresh ginger, and two jujubes. Take after meals and before bedtime.
The *Ben Shi Fang* (*Prescriptions Worth a Thousand Gold*) records the method of consuming Mulberry Twig. One small sheng of mulberry twig, finely chopped and stir-fried until fragrant, is boiled in three large shengs of water to yield two shengs of decoction, consumed throughout the day at any time. The *Tu Jing* (*Illustrated Classic*) states: Mulberry twig is neutral, neither cold nor hot, suitable for long-term consumption. It treats wind-stroke itching, dry gangrene, limb contracture, rising qi causing dizziness, lung qi cough, aids digestion, promotes urination, lightens the body with long-term use, sharpens hearing and vision, enhances complexion, and relieves dry mouth. The *Xian Jing* (*Immortal Classic*) states: All immortal medicines should not be taken without being decocted with mulberry twig, citing *Baopuzi*. During the Zhenghe era, I suffered from bilateral arm pain; various medications were ineffective. Following this method for several doses, my arm pain quickly resolved.
For wind-cold-damp Bi causing numbness and insensitivity of the four limbs, Wutou Zhou (Aconite Porridge) method:
Four qian of raw Chuan Wu Tou (Aconiti Radix) powder, cooked with fragrant white rice into half a bowl of porridge. Simmer slowly over low heat until thin and not thick. Add about one teaspoon of fresh ginger juice and three large spoons of honey, mix well. Best taken on an empty stomach. If dampness is involved, add two qian of Yi Yi Ren (Coicis Semen) and increase the rice amount to fill a medium bowl. Xu Shi says: This porridge greatly treats numbness and paralysis of hands and feet, swelling, pain, and inability to lift. Zuo Shi posits that wind excess leads to diseases of the extremities ("mo"), where "extremities" refer to the four limbs. The Spleen governs the four limbs. Wind pathogen lodging in the Liver invades the Spleen; since the Spleen is controlled by the Liver, disease manifests in the extremities. This method uses grain Qi to guide wind-damp resolving herbs directly into the Spleen Meridian, thereby calming the four limbs. This decoction is extremely potent. I once shared this formula with others, and it proved highly effective.