伤寒家以外感风寒为外伤。内伤饮食劳倦为内伤矣。然而曰。内非止于饮食劳倦也。凡
伤于
扑轻生。必伤于血。血之积于上。则胸膈疼。血积于中。则中脘痛。血积于下。则小腹痛。
伤重则行其血。伤不重则活其血。血既行则养其血而已矣。或忿恨冲心。暴怒顿发。争言斗
舌叫。号骂詈。必伤于气。气之积不散。则两胁胀满。胸膈塞闷。甚至发为鼓症。饮食不进
。而病斯剧矣。宜大剂伐肝化气之药治之。或自恃强壮不惜气力。纵情于女色。耗亡其真精
。则小腹并其冷如冰。其竖如石痛连阴器。小便秘而不通。切不可以精虚之故。妄加补剂。
又不可以误为霍乱。妄投盐水。要当以活血为主。而调气次之。待其痛止。养和方可。渐加带补
之剂。
补荣汤 治五脏俱虚。思虑过度。伤精损血。头眩目昏。睡卧不宁。
天门冬 人参 麦门冬 五味子 沙参 枣仁 远志(各一钱五分) 地骨皮 生地 当
归柏子仁 茯神(各一钱) 枣二枚煎服。
调元益本汤 治劳神过度。元气虚弱。四肢倦怠。
白术 人参 黄 山药 茯苓(各二钱) 紫河车(三钱) 当归 丹皮 枣仁 远志(
各一钱五分)
枣二枚。煎服。
秘授术宝真丹 治一切内伤虚损。
云苓(去皮) 白术(土炒) 人参 黄 阿胶(各四两蛤粉炒) 当归(酒浸) 生地
丹皮(各五两炒) 紫河车(二具) 海狗肾(一对酥炙) 甘草(一两炙) 杜仲(盐水炒) 山茱
萸骨碎补(各三两)
上制为末。炼蜜为丸。每服五钱空心盐汤送下。
和荣抑气汤 治跌坠所伤。心腹作痛。
当归 生地 玄胡索 木香 沉香(各二钱) 红花 乌药 郁金 山楂 苏木
水煎服。
又方 治血凝气滞。
桂枝 附子(各一钱) 乌药 五灵脂 陈皮(各三钱) 丁香(八分)
水酒各半煎服。
内伤于血。视其所伤者何处。分上下治之。如胸前痛。则用红花赤曲。降香丹皮。而以
桔梗引经。枳壳开气如两胁痛。用当归苏木。红花桃仁。而以青皮柴胡引经。以木香调气。如中
脘痛
君。佐以当归红花蓬术。而以青皮官桂引经。槟榔破气。凡血并不行。加穿山甲麝香。
内伤于气。宜伐肝破气之药治之。用青皮为君。佐以芍药香附乌药官桂木香。
内伤于精宜养血调气之药治之。用红花为君。佐以桃仁。丹皮。当归。生地。牛膝。甘
草。少
调下三钱。此其大略而言。若夫斟酌损益。则非言之所能尽述也。
伤寒家认为外感风寒属于外伤,内伤饮食劳倦属于内伤。然而又说:内伤不仅仅局限于饮食和劳倦。凡是遭受击打扑跌等轻微损伤生命的因素,必然伤及血分。血液积聚在上部,则胸膈疼痛;血液积聚在中部,则中脘疼痛;血液积聚在下部,则小腹痛。伤势重的,应当行血(促进血液运行);伤势轻的,应当活血(使血液流通)。血液既已运行,则只需养血即可。
若是因忿恨冲心,突然暴怒发作,争吵叫骂,必伤及气分。气机积聚不散,则两胁胀满,胸膈堵塞闷痛,甚至发展为鼓胀症,饮食不进,病情由此加剧。适宜用大剂量的疏肝理气药物进行治疗。
若是自恃身体强壮,不惜体力,纵情于女色,耗损真精,则小腹冰冷如冰,阴茎勃起坚硬且疼痛连及阴器,小便闭塞不通。切不可因为精液虚亏的缘故,妄加补益药剂。也不可以误认为是霍乱,妄投盐水。应当以活血为主,调理气机为辅。待其疼痛停止后,方可调养平和,逐渐加入带有补益作用的药剂。
补荣汤:治疗五脏俱虚,思虑过度,伤精损血,头晕目眩,睡眠不宁。
组成:天门冬、人参、麦门冬、五味子、沙参、枣仁、远志(各一钱五分),地骨皮、生地、当归、柏子仁、茯神(各一钱),大枣二枚。煎服。
调元益本汤:治疗劳神过度,元气虚弱,四肢倦怠。
组成:白术、人参、黄芪、山药、茯苓(各二钱),紫河车(三钱),当归、丹皮、枣仁、远志(各一钱五分),大枣二枚。煎服。
秘授术宝真丹:治疗一切内伤虚损。
组成:云苓(去皮)、白术(土炒)、人参、黄芪、阿胶(各四两,蛤粉炒)、当归(酒浸)、生地、丹皮(各五两,炒)、紫河车(二具)、海狗肾(一对,酥炙)、甘草(一两,炙)、杜仲(盐水炒)、山茱萸、骨碎补(各三两)。
制法:以上药材制成粉末,炼蜜为丸。每次服用五钱,空腹时盐汤送下。
和荣抑气汤:治疗跌坠所伤,心腹作痛。
组成:当归、生地、玄胡索、木香、沉香(各二钱),红花、乌药、郁金、山楂、苏木。水煎服。
又一方:治疗血凝气滞。
组成:桂枝、附子(各一钱),乌药、五灵脂、陈皮(各三钱),丁香(八分)。水酒各半煎服。
内伤于血,需视其所伤部位在何处,分上下进行治疗。如胸前痛,则用红花、赤曲、降香、丹皮,并以桔梗引经,枳壳开气。如两胁痛,用当归、苏木、红花、桃仁,并以青皮、柴胡引经,以木香调气。如中脘痛,以某药为君,佐以当归、红花、蓬术,并以青皮、官桂引经,槟榔破气。凡血行不畅者,加穿山甲、麝香。
内伤于气,宜用疏肝破气的药物治疗。以青皮为君药,佐以芍药、香附、乌药、官桂、木香。
内伤于精,宜用养血调气的药物治疗。以红花为君药,佐以桃仁、丹皮、当归、生地、牛膝、甘草,少量调和服用三钱。这是大概的原则。至于斟酌损益,则非言语所能详尽叙述。
Scholars of Cold Damage (Shanghan) regard external contraction of Wind-Cold as external injury, and internal damage from diet and fatigue as internal injury. However, it is also stated that internal injury is not limited to diet and fatigue. Any trauma from blows or falls that slightly endangers life inevitably injures the Blood. If Blood stagnates in the upper part, there is pain in the chest and diaphragm; if Blood accumulates in the middle, there is pain in the Zhongwan region; if Blood accumulates in the lower part, there is hypogastric pain. For severe injuries, one should promote blood circulation; for mild injuries, one should invigorate blood. Once the blood is circulating, nourishing the blood suffices.
If anger rushes to the heart, sudden rage erupts, accompanied by arguing, shouting, cursing, and scolding, the Qi is inevitably injured. If Qi stagnates and does not disperse, there will be distension and fullness in both hypochondria, stuffiness and oppression in the chest and diaphragm, and even development into Drum Distension (Guzheng), with loss of appetite, causing the disease to worsen. It is appropriate to treat with large doses of herbs that subdue the Liver and transform Qi.
If one relies on physical strength, disregards effort, and indulges in sexual activity, depleting the True Essence (Jing), the hypogastrium becomes cold as ice, the penis becomes erect like stone and painful, radiating to the genitalia, with urinary retention and inability to urinate. One must not rashly add tonifying prescriptions due to essence deficiency. Nor should one mistakenly diagnose this as Cholera (Huoluan) and administer salt water. Treatment should focus primarily on invigorating blood, with regulating Qi as secondary. Only after the pain subsides can one begin to harmonize and gradually introduce mildly tonifying formulas.
Bu Rong Tang (Nourish Glory Decoction): Treats deficiency of all five Zang organs, excessive overthinking, injury to Essence and Blood, dizziness, blurred vision, and restless sleep.
Ingredients: Tianshuodong (Asparagi Radix), Renshen (Ginseng Radix et Rhizoma), Maimendong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), Shashen (Glehniae Radix), Zaoren (Ziziphi Spinosae Semen), Yuanzhi (Polygalae Radix) (each 1.5 qian); Digupi (Lycii Cortex), Shengdi (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), Baiziren (Platycladi Semen), Fushen (Poria cum Risus) (each 1 qian); Jujubae Fructus (2 pieces). Decoct and take orally.
Tiao Yuan Yi Ben Tang (Regulate Origin and Benefit Root Decoction): Treats excessive mental labor, deficiency of Original Qi, and limb fatigue.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma), Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Shanyao (Dioscoreae Rhizoma), Fuling (Poria) (each 2 qian); Ziheche (Placenta Hominis) (3 qian); Danggui (Angelicae Sinensis Radix), Danpi (Moutan Cortex), Zaoren (Ziziphi Spinosae Semen), Yuanzhi (Polygalae Radix) (each 1.5 qian); Jujubae Fructus (2 pieces). Decoct and take orally.
Mi Shou Shu Bao Zhen Dan (Secretly Transmitted Precious True Pill): Treats all types of internal injury and deficiency consumptive diseases.
Ingredients: Yunling (Poria, peeled), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil), Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Ejiao (Colla Corii Asini) (each 4 liang, stir-fried with clam powder); Danggui (Angelicae Sinensis Radix, soaked in wine), Shengdi (Rehmanniae Radix), Danpi (Moutan Cortex) (each 5 liang, stir-fried); Ziheche (Placenta Hominis) (2 units); Haigoushen (Testis Canis Maritimi) (1 pair, roasted with butter); Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) (1 liang); Duzhong (Eucommiae Cortex, stir-fried with salt water); Shanzhuyu (Corni Fructus), Gusuibu (Drynariae Rhizoma) (each 3 liang).
Preparation: Grind the above into powder, mix with refined honey to make pills. Take 5 qian per dose, administered with salted water on an empty stomach.
He Rong Yi Qi Tang (Harmonize Blood and Suppress Qi Decoction): Treats injuries from falls and strikes, causing pain in the heart and abdomen.
Ingredients: Danggui (Angelicae Sinensis Radix), Shengdi (Rehmanniae Radix), Yanhusuo (Corydalis Rhizoma), Muxiang (Aucklandiae Radix), Chenxiang (Aquilariae Lignum Resinatum) (each 2 qian); Honghua (Carthami Flos), Wuyao (Linderae Radix), Yujin (Curcumae Longae Radix), Shanzha (Crataegi Fructus), Sumu (Sappan Lignum). Decoct in water and take orally.
Another Prescription: Treats blood coagulation and Qi stagnation.
Ingredients: Guizhi (Cinnamomi Ramulus), Fuzi (Aconiti Lateralis Radix Praeparata) (each 1 qian); Wuyao (Linderae Radix), Wulingzhi (Trogopterori Faeces), Chenpi (Citri Reticulatae Pericarpium) (each 3 qian); Dingxiang (Eugeniae Flos) (8 fen). Decoct in half water and half wine and take orally.
For internal injury to Blood, treat according to the location of the injury, distinguishing between upper and lower. If there is pain in the chest, use Honghua (Carthami Flos), Chiqu (Red Fermented Rice Curd), Jiangxiang (Daemonorops Draco), and Danpi (Moutan Cortex), guiding with Jiegeng (Platycodonis Radix) and opening Qi with Zhike (Aurantii Fructus Immaturus). If there is pain in both hypochondria, use Danggui (Angelicae Sinensis Radix), Sumu (Sappan Lignum), Honghua (Carthami Flos), and Taoren (Persicae Semen), guiding with Qingpi (Citri Reticulatae Pericarpium Viride) and Chaihu (Bupleuri Radix), and regulating Qi with Muxiang (Aucklandiae Radix). If there is pain in the Zhongwan region, use a primary herb, assisted by Danggui (Angelicae Sinensis Radix), Honghua (Carthami Flos), and Pengzhu (Curcumae Rhizoma), guiding with Qingpi (Citri Reticulatae Pericarpium Viride) and Guigui (Cinnamomi Cortex), and breaking Qi with Binglang (Arecae Semen). If blood flow is completely obstructed, add Shanjiajia (Manis Squama) and Shexiang (Moschus).
For internal injury to Qi, treat with herbs that subdue the Liver and break Qi stagnation. Use Qingpi (Citri Reticulatae Pericarpium Viride) as the sovereign herb, assisted by Shaoyao (Paeoniae Radix), Xiangfu (Cyperi Rhizoma), Wuyao (Linderae Radix), Guigui (Cinnamomi Cortex), and Muxiang (Aucklandiae Radix).
For internal injury to Essence, treat with herbs that nourish Blood and regulate Qi. Use Honghua (Carthami Flos) as the sovereign herb, assisted by Taoren (Persicae Semen), Danpi (Moutan Cortex), Danggui (Angelicae Sinensis Radix), Shengdi (Rehmanniae Radix), Niuxi (Achyranthis Bidentatae Radix), and Gancao (Glycyrrhizae Radix et Rhizoma), taken in small adjusted doses of 3 qian. This is a general overview. Regarding specific adjustments and modifications, words cannot fully describe them.