湿热痰积,流下作痛,大概因寒郁而作也;即是痰饮、食积、并死血。
戴云∶疝本属厥阴,肝之一经。余尝见俗说,小肠膀胱下部气者,皆妄言也。
子和云∶疝本肝经,宜通勿塞。只此见治之法;专主肝经,与肾绝无干,不宜下。 湿多疝气,灸大敦穴。
食积与瘀血成痛者∶
栀子 桃仁 山楂 枳实 吴茱萸
上为末,生姜汁、顺流水作汤,调服。
按之不定,必用桂枝,属虚。
桂枝 山栀(炒) 乌头(细切;炒)
上为末,姜汁为丸。每服三十丸,劫痛。
治疝方,定痛速效。湿胜者加荔枝。
枳壳(十五个) 山栀(炒) 糖球(炒) 茱萸(炒)
又方∶守丸。治 要药,不疼者。
苍术 南星 白芷 山楂 川芎 半夏 枳实 为末,神曲作丸。
治阳明受湿热,传入大肠,恶寒发热,小腹连毛际,结核闷痛不可忍。
山栀(炒) 枳壳(炒) 桃仁(炒) 山楂(等分)
上研细,砂钵内入生姜汁,用水一盏煎令沸。热服之。
治诸疝发时,用海石、香附二味为末,以生姜汁汤调服。亦能治心痛。
治疝方∶
栀子 桃仁 橘核 茱萸 川乌
上碾煎服。劫药用乌头细切,炒栀子橘核散,单止痛。
苍术(盐炒) 白术 防己 槟榔 川芎 犀角 甘草 木通 黄连 生地黄(酒炒) 黄柏 有热加
黄芩 黄连
有热加竹沥、姜汁。
大热及时令热加石膏。大便实加桃仁。小便涩加牛膝。
有食积流注。
苍术 黄柏 防己 南星 川芎 白芷 犀角 槟榔
血虚加牛膝、龟板。
如常肿者,专主乎湿热,朱先生有方。肥人加痰药。
戴云∶有香港脚冲心,宜四物加炒柏。再宜涌泉穴用附子津拌贴,以艾灸,泄引其热。
健步丸
归尾 芍药 陈皮 苍术(各一两) 生地黄(一两半) 大腹子(三个) 牛膝 茱萸(各半两)
黄芩(半两) 桂枝(二钱)
上为末,蒸饼为丸。每服百丸,白术、通草煎汤,食前下。
一妇人足肿
黄柏 苍术 南星 红花(酒洗) 草龙胆 川芎 牛膝(酒洗) 生地黄
筋动于足,大指动上来至大腿,近腰结,奉养浓因风寒作。四物汤加酒芩、红花、苍术、南星。
筋转皆属乎血热。四物汤加酒芩、红花。
大病虚脱,本是阴虚。用艾灸丹田者,所以补阳,阳生则阴生故也。不可用附子,可用参,多服。
湿热与痰浊积聚,流注于下焦引发疼痛,大都是因为寒邪郁结所致;这同时也涉及痰饮、食积以及死血(瘀血)。
戴元礼说:疝气本属于厥阴经,即肝脏的一条经脉。我常常见到世俗的说法,认为小肠和膀胱下部的胀气就是疝气,这都是错误的言论。
张子和说:疝气本源于肝经,治疗应当以通利为主,切忌闭塞。仅从这一点就能看出治法;专门针对肝经进行治疗,与肾脏完全没有关系,不宜使用攻下法。湿气重的疝气,可以艾灸大敦穴。
由食积与瘀血引起的疼痛:
栀子、桃仁、山楂、枳实、吴茱萸。
将上述药物研为细末,用生姜汁和顺流水煎汤调服。
如果按压时感觉痛处不固定,必须使用桂枝,这属于虚证。
桂枝、山栀(炒制)、乌头(细切后炒制)。
将上述药物研为细末,用姜汁制成丸剂。每次服用三十丸,用于迅速止痛。
这是治疗疝气的方子,定痛效果迅速。湿气重者加荔枝核。
枳壳(十五个)、山栀(炒制)、糖球(炒制,指金樱子或类似果实)、茱萸(炒制)。
另一个方子:守丸。用于治疗需要的重要药物,适用于不疼痛的情况。
苍术、南星、白芷、山楂、川芎、半夏、枳实,研为细末,用神曲糊制成丸剂。
治疗阳明经受湿热侵袭,湿热传入大肠,出现恶寒发热,小腹连接阴毛际处有结核状肿块,闷痛难忍。
山栀(炒制)、枳壳(炒制)、桃仁(炒制)、山楂(等分)。
将上述药物研细,在砂钵中加入生姜汁,用水一盏煎至沸腾。热服。
治疗各种疝气发作时,使用海浮石、香附两味药研为细末,用生姜汁和水调服。也能治疗心痛。
治疗疝气的方子:
栀子、桃仁、橘核、茱萸、川乌。
将上述药物碾碎煎服。作为劫痛药使用时,将乌头细切,与炒栀子、橘核散配合,单独用于止痛。
苍术(盐炒)、白术、防己、槟榔、川芎、犀角、甘草、木通、黄连、生地黄(酒炒)、黄柏。如果有热象,加黄芩、黄连。
如果有热象,加竹沥、姜汁。
大热且正值时令炎热时,加石膏。大便干结加桃仁。小便涩滞加牛膝。
如果有食积流注。
苍术、黄柏、防己、南星、川芎、白芷、犀角、槟榔。
血虚者加牛膝、龟板。
如果是通常的肿胀,专门主治湿热,朱先生有相应的方子。肥胖的人加化痰的药物。
戴元礼说:有香港脚(脚气病)冲心的症状,宜用四物汤加炒黄柏。另外适宜在涌泉穴用附子津液拌贴,并用艾灸,以泄出并引导其热邪下行。
健步丸
当归尾、芍药、陈皮、苍术(各一两)、生地黄(一两半)、大腹子(三个)、牛膝、茱萸(各半两)、黄芩(半两)、桂枝(二钱)。
将上述药物研为细末,用蒸饼制成丸剂。每次服用一百丸,用白术、通草煎汤,饭前送服。
一位妇人足部肿胀
黄柏、苍术、南星、红花(酒洗)、草龙胆、川芎、牛膝(酒洗)、生地黄。
筋脉跳动于足部,大拇指向上跳动直至大腿,靠近腰部结成肿块,这是因为生活优渥厚味导致风寒入侵所致。使用四物汤加酒炒黄芩、红花、苍术、南星。
大病导致虚脱,本质是阴虚。使用艾灸丹田的方法,是为了补阳,因为阳气生发则阴气也随之生长。不可使用附子,可以使用人参,多服用。
Damp-heat and phlegm accumulation flowing downward cause pain, generally due to cold stagnation; this also involves phlegm-fluid retention (Tan Yin), food stagnation (Shi Ji), and dead blood (stasis).
Dai Yun stated: Shan (Hernia) originally belongs to the Jueyin channel, specifically the Liver channel. I often see vulgar sayings claiming that Qi in the lower part of the small intestine and bladder constitutes Shan; these are all false statements.
Hezi said: Shan originates from the Liver channel; treatment should focus on unblocking rather than obstructing. This alone reveals the method of treatment; it focuses exclusively on the Liver channel and has absolutely nothing to do with the Kidney; purgative methods should not be used. For Shan caused by excessive dampness, moxibustion at Dazhun (LR1) acupoint is indicated.
For pain caused by food stagnation and blood stasis:
Gardeniae Fructus (Zhizi), Persicae Semen (Taoren), Crataegi Fructus (Shanzha), Aurantii Fructus Immaturus (Zhishi), Evodiae Fructus (Wuzhuyu).
Grind the above into powder, decoct with ginger juice and smooth-flowing water, and take with the liquid.
If the painful area is indeterminate upon palpation, Guizhi (Cinnamon Twig) must be used, indicating a deficiency pattern.
Guizhi (Cinnamon Twig), Gardeniae Fructus (Zhizi, stir-fried), Aconiti Lateralis Radix Preparata (Wutou, finely sliced and stir-fried).
Grind the above into powder, make pills with ginger juice. Take 30 pills per dose to rapidly relieve pain.
This is a formula for treating Shan, offering rapid pain relief. Add Litchi Seed (Lizhihe) if dampness is predominant.
Aurantii Fructus (Zhike, 15 pieces), Gardeniae Fructus (Zhizi, stir-fried), Rosa Laevigata Fructus (Tangqiu, stir-fried), Evodiae Fructus (Zhuoyu, stir-fried).
Another formula: Shou Wan. Used as an important remedy for cases where there is no pain.
Atractylodis Rhizoma (Cangzhu), Pinelliae Tuber (Nanxing), Angelicae Dahuricae Radix (Baizhi), Crataegi Fructus (Shanzha), Chuanxiong Rhizoma (Chuanxiong), Pinelliae Tuber (Banxia), Aurantii Fructus Immaturus (Zhishi), grind into powder, make pills with Massae Fermentatae Medicamentosa (Shenqu).
Treating Yangming channel affected by damp-heat, transmitting to the Large Intestine, presenting with aversion to cold and fever, tubercles in the lower abdomen extending to the pubic region, causing unbearable stifling pain.
Gardeniae Fructus (Zhizi, stir-fried), Aurantii Fructus (Zhike, stir-fried), Persicae Semen (Taoren, stir-fried), Crataegi Fructus (Shanzha, equal parts).
Grind the above finely, add ginger juice in a mortar, decoct with one cup of water until boiling. Take hot.
When various Shans occur, use Hai Shi (Calcitrum) and Xiang Fu (Cyperi Rhizoma) ground into powder, taken with ginger juice and water. This can also treat Heart Pain.
Formula for treating Shan:
Gardeniae Fructus (Zhizi), Persicae Semen (Taoren), Juglandis Fructus Septum (Juhe), Evodiae Fructus (Zhuoyu), Aconiti Radix (Chuanwu).
Grind and decoct for oral administration. When used as a potent analgesic, finely slice Wutou, mix with stir-fried Zhizi and Juhe powder, used alone for pain relief.
Atractylodis Rhizoma (Cangzhu, salt-stir-fried), Atractylodis Macrocephalae Rhizoma (Baizhu), Stephaniae Tetrandrae Radix (Fangji), Arecae Semen (Binglang), Chuanxiong Rhizoma (Chuanxiong), Rhinocerotis Cornu (Xijiao), Glycyrrhizae Radix et Rhizoma (Gancao), Akebiae Caulis (Mutong), Coptidis Rhizoma (Huanglian), Rehmanniae Radix (Shengdihuang, wine-stir-fried), Phellodendri Cortex (Huangbai). If heat signs are present, add Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian).
If heat signs are present, add Bamboo Sap (Zhuli) and Ginger Juice (Jiangzhi).
In cases of high fever during hot seasons, add Gypsum Fibrosum (Shigao). For solid stool, add Persicae Semen (Taoren). For difficult urination, add Achyranthis Bidentatae Radix (Niuxi).
If there is food stagnation flowing through channels:
Atractylodis Rhizoma (Cangzhu), Phellodendri Cortex (Huangbai), Stephaniae Tetrandrae Radix (Fangji), Pinelliae Tuber (Nanxing), Chuanxiong Rhizoma (Chuanxiong), Angelicae Dahuricae Radix (Baizhi), Rhinocerotis Cornu (Xijiao), Arecae Semen (Binglang).
For blood deficiency, add Achyranthis Bidentatae Radix (Niuxi) and Testudinis Carapax et Plastrum (Guiban).
For general swelling, the primary treatment targets damp-heat; Master Zhu has a specific formula. For obese individuals, add phlegm-resolving herbs.
Dai Yun stated: In cases of Hongxiangjiao (Gouty/Feet Qi) rushing to the heart, use Siwu Tang plus stir-fried Huangbai. Additionally, apply Fuzi paste mixed with ginger juice to Yongquan (KI1) acupoint and perform moxibustion to vent and guide the heat downward.
Jianbu Wan (Walking-Strong Pill)
Angelicae Sinensis Radix (Guiwei), Paeoniae Radix (Shaoyao), Citri Reticulatae Pericarpium (Chenpi), Atractylodis Rhizoma (Cangzhu, each 1 liang), Rehmanniae Radix (Shengdihuang, 1.5 liang), Arecae Semen (Dafuzi, 3 pieces), Achyranthis Bidentatae Radix (Niuxi), Evodiae Fructus (Zhuoyu, each 0.5 liang), Scutellariae Radix (Huangqin, 0.5 liang), Guizhi (Cinnamon Twig, 2 qian).
Grind into powder, make pills with steamed bread dough. Take 100 pills per dose, washed down with decoction of Baizhu and Tongcao before meals.
A woman with swollen feet:
Phellodendri Cortex (Huangbai), Atractylodis Rhizoma (Cangzhu), Pinelliae Tuber (Nanxing), Carthami Flos (Honghua, wine-rinsed), Gentiana Scabra Radix et Rhizoma (Caolongdan), Chuanxiong Rhizoma (Chuanxiong), Achyranthis Bidentatae Radix (Niuxi, wine-rinsed), Rehmanniae Radix (Shengdihuang).
Sinews moving in the foot, twitching from the big toe up to the thigh, knotting near the waist, caused by rich nourishment leading to wind-cold invasion. Use Siwu Tang plus wine-stir-fried Huangqin, Honghua, Cangzhu, and Nanxing.
Sinew twisting belongs to blood heat. Use Siwu Tang plus wine-stir-fried Huangqin and Honghua.
Severe illness leading to collapse is fundamentally Yin deficiency. Using moxibustion on Dantian is to tonify Yang; when Yang generates, Yin is produced. Do not use Fuzi; instead, use Renshen (Ginseng), administered in large doses.