五苓、胃苓、六和、正气,见论吐下泻痧、霍乱痧、水腹痛痧。
五苓散加减∶去桂即四苓,白术换苍术,加末二味。
猪苓、茯苓、泽泻、苍术(泔浸)、车前、木通。
胃苓汤∶去白术、桂、草。即前上四味,加制浓朴、陈皮去白。
六和汤∶浓朴钱五分,赤苓、藿香、扁豆、木瓜、苍术各钱,砂仁、半夏、人参、杏仁
、甘草各五分,暑加香薷、冷加紫苏,一方无苍术,一方有白术。
藿香正气散∶藿香、紫苏、白芷、茯苓、腹皮各二钱,桔梗、紫朴、陈皮、白术(土炒)
、半夏曲各二钱,甘草钱,每五钱,水煎(此与六和、姜、枣引勿轻用),或加木瓜,伤食
重
一客匠,年十六,发热,久之胸胁痛,脉细弱,或作劳怯治。呕哕便秘,小腹胀急。或
参用左金,便溺通而痛愈紧,夜尤甚,小便赤色,投痧症药亦未效。儒医孙敬承云∶脉无变
,而胸前不可手近,其痛在络,用金铃子肉一个,元胡钱,蒌皮钱,生香附钱半,陈大麦仁
三钱,煎饮,一服而愈。金铃入络,佐以元胡,气血俱通。似与痧宜,而书中未收,附记于
此。
又,海浮石治痰甚妙,并附后。金铃子(即川楝子),苦寒,能导小肠、膀胱之热,因
引
寒润
原叙言康熙庚戍有涤痧丸引刻于毗陵,此书症案中屡言涤痧散,而方竟失载,续当访补
五苓散、胃苓汤、六和汤、正气散(藿香正气散),参见关于呕吐、腹泻、痧症,霍乱痧,水腹痛痧的论述。
五苓散的加减法:去掉桂枝即为四苓散,将白术换成苍术,再加上另外两味药。
猪苓、茯苓、泽泻、苍术(用米泔水浸泡)、车前子、木通。
胃苓汤:去掉白术、桂枝、甘草。即由上述前四味药,加上制厚朴、去白的陈皮组成。
六和汤:厚朴五分,赤茯苓、藿香、扁豆、木瓜、苍术各一钱,砂仁、半夏、人参、杏仁、甘草各五分,暑天加香薷,受冷加紫苏,有的方子没有苍术,有的方子有白术。
藿香正气散:藿香、紫苏、白芷、茯苓、大腹皮各二钱,桔梗、紫厚朴、陈皮、白术(土炒)、半夏曲各二钱,甘草一钱,每服五钱,水煎服(此方与六和汤,以生姜、大枣为引,不可轻易使用),或者加木瓜,如果是伤食重症则加重用量。
有一位工匠,十六岁,发热,时间久了出现胸胁疼痛,脉象细弱,有人当作劳损虚怯病治疗。出现呕吐呃逆、便秘,小腹胀满急迫。有人参考使用左金丸,大小便通畅后疼痛反而加剧,夜间尤其严重,小便颜色红赤,投用治痧症的药也没有效果。儒医孙敬承说:脉象没有变化,但胸前部位不能用手触碰,疼痛在络脉,用金铃子肉一个,延胡索一钱,瓜蒌皮一钱,生香附半钱,陈大麦仁三钱,煎汤饮用,服用一次就痊愈了。金铃子入络,配合延胡索,气血都通畅了。这似乎适合治痧症,但书中未收录,特此附记于此。
Wuling San (Five-Ingredient Powder with Poria), Weiling Tang (Stomach and Five-Ingredient Decoction), Liuhe Tang (Six-Harmony Decoction), Zhengqi San (Righteous Qi Powder) [referring to Huoxiang Zhengqi San], are discussed in the sections on vomiting, diarrhea, Sha syndrome, Huoluan Sha (Cholera-like Sha), and abdominal pain due to water retention Sha.
Modifications of Wuling San: Removing Guizhi (Cinnamon Twig) results in Siling San (Four-Ingredient Powder with Poria); replacing Baizhu (Atractylodis Rhizoma) with Cangzhu (Atractylodis Rhizoma) and adding two other ingredients.
Zhu Ling (Polyporus), Fuling (Poria), Zexie (Alisma), Cangzhu (Atractylodis Rhizoma, soaked in rice wash water), Cheqian (Plantaginis Semen), Mutong (Akebiae Caulis).
Weiling Tang: Remove Baizhu, Guizhi, and Gancao. It consists of the aforementioned four ingredients, plus Zhizhoupo (Prepared Magnolia Bark) and Chenpi (Citri Reticulatae Pericarpium, pith removed).
Liuhe Tang: Houpo (Magnolia Bark) 0.5 qian, Chifuling (Red Poria), Huoxiang (Agastaches Herba), Bian Dou (Dolichos Lablab Seed), Mugua (Chaenomelis Fructus), Cangzhu each 1 qian; Sharen (Amomi Fructus), Banxia (Pinelliae Rhizoma), Renshen (Ginseng Radix), Xingren (Armeniacae Semen Amarum), Gancao (Licorice Root) each 0.5 qian. Add Xiangru (Elsholtziae Herba) for summer heat, add Zisu (Perillae Folium) for cold. Some versions lack Cangzhu, while others include Baizhu.
Huoxiang Zhengqi San: Huoxiang, Zisu, Baizhi (Angelicae Dahuricae Radix), Fuling, Fupi (Mature Citrus Fruit Peel) each 2 qian; Jiegeng (Platycodonis Radix), Zipu (Purple Magnolia Bark), Chenpi, Baizhu (soil-fried), Banxiaqu (Pinellia Fermented Paste) each 2 qian; Gancao 1 qian. Take 5 qian per dose, decoct in water. (Use this formula cautiously alongside Liuhe Tang, with Shengjiang [Fresh Ginger] and Dazao [Jujube] as guides). For severe food stagnation, Mugua may be added and dosage increased.
A craftsman, aged sixteen, suffered from fever. After a long duration, he experienced chest and hypochondriac pain with a fine and weak pulse. He was treated for consumption deficiency. Symptoms included vomiting, hiccups, constipation, and distending urgency in the lower abdomen. Someone attempted using Zuojin Wan (Left Metal Pill); after urination and defecation became unobstructed, the pain intensified, especially at night, with red urine. Sha-syndrome remedies were ineffective. Scholar physician Sun Jingcheng stated: "The pulse has not changed, but the chest area is tender to touch; the pain resides in the collaterals." Prescription: Jinlingzi (Toosendan Fructus) 1 piece, Yuanhu (Corydalis Rhizome) 1 qian, Loupi (Trichosanthis Pericarpium) 1 qian, Sheng Xiangfu (Cyperi Rhizoma) 0.5 qian, Chen Damairen (Aged Barley Grain) 3 qian. Decoct and drink. One dose resulted in cure. Jinlingzi enters the collaterals, assisted by Yuanhu, thereby regulating both qi and blood. This seems suitable for Sha syndrome, but was not recorded in the book; thus, it is appended here.
Furthermore, Haifushi (Pumex) is excellent for treating phlegm; it is appended below. Jinlingzi (i.e., Chuanlianzi), bitter and cold, can guide heat from the Small Intestine and Bladder downward, hence referencing cold-moistening methods.
The original preface mentions that Dishasha Wan (Sha-Clearing Pill) was printed in Piling during the Gengxu year of the Kangxi reign. Although this book's case studies frequently mention Dishasha San (Sha-Clearing Powder), the prescription is missing. It should be sought out and supplemented later.