舒郁丸 治一切郁症。
香附 枳实 苍术(各三两) 沉香(一两五钱) 宿砂 山栀仁 抚芎 红曲 半夏(各
上为末水丸。每服三钱。空心白滚汤下。
气郁。加乌药。木香。槟榔。干姜。枳壳。桔梗。
湿郁。加白术。白芷。赤茯苓。木通。苍术。
痰郁。加南星。海石。栝蒌仁。枳壳。桔梗。小皂荚。
热郁。加黄连。青黛。连翘。山栀。
血郁。加桃仁。红花。丹皮。当归。韭汁。
食郁。加山楂。麦芽。神曲。伤冷食胃脘痛。加草豆蔻。干姜。如春加防风。夏加苦参
。秋冬加吴茱萸。
诸痛之症。种种不同。其患有周身骨节肩背手臂项脊腰肋。心膻小腹之殊。其致痰
之由。有风寒湿热燥火。痰血积气之异。如周身遍体。无所不痛者。此有火或饮酒之人。素有湿
痰停积于内。又为风寒邪气所侵。以至痰不能周流疏利。留蓄于经络关节之间日久凝滞不散
。郁于肩背项脊。腰肋手臂等处。不肿则痛。须令人按之摩之。则热气至而痛止。故今之背
痛者。痰滞也。必捶打千百。而后散可知矣。不然则为痰。为涎为饮三者之症。盖湿邪上浮
于肺。随气壅嗽。发动则名为痰。湿邪聚于脾。随气溢于口。气流出不禁。则名曰涎。至于
胃为湿邪所乘。而为吐。为呕。为哕。则名曰饮。此又不可不察。然大要以胜湿消痰。顺气
和血养脾为主。外此又有饮食之后。为冷气所伤。而发热身痛。此伤食身痛也。宜消导之。
六脉浮紧。鼻塞身重头痛气粗。发热身痛者。此伤寒伤风身痛也。宜解表之。如病后汗下而
身痛者。此气血虚也。宜调补之。至于头痛头风。以发散为主。心痛即胃脘痛。有旧疾有客
寒。有积痰以开郁化痰为主。其腹痛腰胁痛宜温经散寒。热湿为要。若饮食过多。内伤脾气
者。宜消导之。又如小便作痛者。须问小便利不利。小便利者是蓄血。小便不利者。是溺涩
。有卒然大痛者。是感寒时痛时止者。是火。若妇人小腹为冲任之海。一遇寒冷则血气凝
结。为之击搏而作痛。得温暖则气和通。而痛自止。又有胞络之间。阴户之中。为房事所伤
。或外寒郁遏亦能作痛。臀尖尽处。又有所谓尻骨痛有痰有血虚死血不同。学人宜详审之
舒郁丸:治疗各种郁证。
配方:香附、枳实、苍术(各三两),沉香(一两五钱),宿砂仁、山栀仁、抚芎(川芎)、红曲、半夏(各若干,原文此处似有缺漏,依常规理解为等分或适量,但严格按原文“各”后无具体剂量,结合上下文及古籍习惯,通常指前文未列出的药物或后续加味药,此处原文表述为“各”,随后直接接制法,推测原意可能为上述所有药材各取一定比例,或特指某几种。鉴于原文“各”字后紧接“上为末”,且前面列举了多味药并标注了部分重量,这里存在文本断句或传抄问题。根据常见《丹台玉案》版本,此方通常包含上述药物。为忠实于提供的文本,我们按字面意思处理:将所列药物研为细末,制成水泛丸。每次服用三钱。空腹时用白开水送服。
气郁:加乌药、木香、槟榔、干姜、枳壳、桔梗。
湿郁:加白术、白芷、赤茯苓、木通、苍术。
痰郁:加南星、海浮石、栝蒌仁、枳壳、桔梗、小皂荚。
热郁:加黄连、青黛、连翘、山栀。
血郁:加桃仁、红花、丹皮、当归、韭汁。
食郁:加山楂、麦芽、神曲。若因伤冷食导致胃脘痛,加草豆蔻、干姜;春季加防风,夏季加苦参,秋冬季节加吴茱萸。
各种疼痛的症状,各不相同。患病部位有全身骨节、肩背、手臂、项脊、腰肋、心膻、小腹等不同之处。导致痰饮产生的原因,有风寒湿热燥火的不同,以及痰、血、积气、气的差异。如果全身遍体无处不痛,这通常是有火邪,或者是饮酒之人,体内素有湿痰停积,又受到风寒邪气的侵袭,导致痰液不能周流疏利,留蓄在经络关节之间,日久凝滞不散。郁结在肩背、项脊、腰肋、手臂等处,如果不肿则痛,必须让人按摩捶打,使热气到达患处,疼痛才能停止。所以现在的背痛,多是痰滞所致,必定要经过千百次的捶打,然后才能消散,这是显而易见的。否则,就要区分是痰、是涎、还是饮这三种病症。湿邪上浮于肺,随气壅塞咳嗽,发作时称为痰;湿邪聚于脾,随气溢出到口,气流出不止,则称为涎;至于胃被湿邪所乘,出现吐、呕、哕等症状,则称为饮。这些又不可不仔细辨别。然而大原则是以胜湿、消痰、顺气、和血、养脾为主。此外,还有饮食之后,被冷气所伤,导致发热身痛,这是伤食身痛,宜用消导法。六脉浮紧,鼻塞、身重、头痛、气粗、发热、身痛的,这是伤寒伤风身痛,宜用解表法。如病后发汗或攻下后身痛的,这是气血虚弱,宜用调补法。至于头痛头风,以发散为主。心痛即胃脘痛,有旧疾和新感客寒,有积痰,以开郁化痰为主。腹痛、腰胁痛宜温经散寒,以清热祛湿为要。若饮食过多,内伤脾气者,宜消导之。又如小便作痛,须问小便通畅与否。小便通畅的是蓄血,小便不通畅的是溺涩。有突然剧烈疼痛的,是感受寒邪;时痛时止的,是火邪。若妇人小腹为冲任二脉之海,一遇寒冷则血气凝结,相互击搏而作痛,得到温暖则气和血通,疼痛自然停止。又有胞络之间、阴户之中,因房事所伤,或外寒郁遏也能引起疼痛。臀尖尽头处,有所谓的尻骨痛,有痰阻、血虚、死血等不同情况,学习者应当详细审察。
Shuyu Wan (Soothe Depression Pill): Treats various types of Yu Syndrome (Depression Syndrome).
Ingredients: Xiangfu (Cyperi Rhizoma), Zhishi (Aurantii Fructus Immaturus), Cangzhu (Atractylodis Rhizoma) (each 3 liang); Chenxiang (Aquilariae Lignum Resinatum) (1.5 liang); Susharen (Amomi Fructus Rotundus), Shanzhiren (Gardeniae Semen), Fuxiong (Ligusticum Chuanxiong Radix), Hongqu (Monascus Purpureus Rice), Banxia (Pinelliae Rhizoma Preparatum) (each [amount unspecified in text, implied equal parts or as needed]).
Preparation and Administration: Grind the above ingredients into fine powder and make water pills. Take 3 qian per dose. Swallow with plain boiled water on an empty stomach.
For Qi Depression (Qi Stagnation): Add Wuyao (Linderae Radix), Muxiang (Aucklandiae Radix), Binglang (Arecae Semen), Ganjiang (Zingiberis Rhizoma), Zhike (Aurantii Fructus), Jiegeng (Platycodonis Radix).
For Dampness Depression (Damp Stagnation): Add Baizhu (Atractylodis Macrocephalae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Chifuling (Poria cum Ramis et Ligno Rubra), Mutong (Akebiae Caulis), Cangzhu (Atractylodis Rhizoma).
For Phlegm Depression (Phlegm Stagnation): Add Nanting (Arisaematis Rhizoma Preparatum), Haishi (Fossilia Arthropodi), Gualouren (Trichosanthis Semen), Zhike (Aurantii Fructus), Jiegeng (Platycodonis Radix), Xiaozaojia (Gleditsiae Sinensis Spina).
For Heat Depression (Heat Stagnation): Add Huanglian (Coptidis Rhizoma), Qingdai (Indigo Naturalis), Lianqiao (Forsythiae Fructus), Shanzhi (Gardeniae Fructus).
For Blood Depression (Blood Stagnation): Add Taoren (Persicae Semen), Honghua (Carthami Flos), Danpi (Moutan Cortex), Danggui (Angelicae Sinensis Radix), Jiuji (Allii Tuberosi Juice).
For Food Depression (Food Stagnation): Add Shanzha (Crataegi Fructus), Maiya (Hordei Fructus Germinatus), Shenqu (Massa Medicata Fermentata). If stomach pain is caused by cold food injury, add Caodoukou (Cardamomi Fructus), Ganjiang (Zingiberis Rhizoma); in spring, add Fangfeng (Saposhnikoviae Radix); in summer, add Kushen (Sophorae Flavescentis Radix); in autumn and winter, add Wuzhuyu (Evodiae Fructus).
The symptoms of various pains are diverse. The affected areas vary among the whole body's bones and joints, shoulders, back, arms, neck, spine, waist, ribs, chest (Xinshan), and lower abdomen. The causes for generating phlegm differ due to wind-cold, damp-heat, dryness, fire, as well as differences between phlegm, blood stasis, accumulated qi, and qi stagnation. If pain is widespread throughout the entire body, it usually indicates the presence of Fire pathogen, or that the patient is a drinker who has had damp-phlegm accumulation internally for a long time, and is now invaded by wind-cold pathogens. This prevents the phlegm from circulating freely, causing it to accumulate in the meridians and joints. Over time, it condenses and stagnates without dispersing. It becomes depressed in the shoulders, back, neck, spine, waist, ribs, and arms. If there is no swelling, there is pain. One must massage and beat the area so that heat reaches the site, and the pain will stop. Therefore, current cases of back pain are mostly due to phlegm stagnation; it is evident that they require hundreds or thousands of beats before the stagnation can disperse. Otherwise, one must distinguish between three conditions: Phlegm (Tan), Saliva (Xian), and Fluid Retention (Yin). When Dampness pathogen floats up to the Lung, obstructing Qi and causing cough, when it manifests, it is called Phlegm. When Dampness gathers in the Spleen, overflows to the mouth with Qi, and flows out uncontrollably, it is called Saliva. When the Stomach is attacked by Dampness, resulting in vomiting, retching, or hiccups, it is called Fluid Retention. These distinctions must not be overlooked. However, the general principle is to overcome dampness, eliminate phlegm, regulate Qi, harmonize Blood, and nourish the Spleen.
Furthermore, after eating, if injured by cold Qi leading to fever and body pain, this is Body Pain due to Food Injury, and should be treated with digestion-promoting methods. If the six pulses are floating and tight, accompanied by nasal congestion, heavy body, headache, coarse breathing, fever, and body pain, this is Body Pain due to Cold Damage (Shanghan) or Wind Strike (Shangfeng), and should be treated with exterior-releasing methods. If body pain occurs after sweating or purging during illness, this is due to Qi and Blood deficiency, and should be treated with regulation and tonification. For headache and Head Wind (Toufeng), the primary method is dispersion. Heart pain is equivalent to Epigastric Pain; whether due to old diseases, new external cold invasion, or accumulated phlegm, the primary method is to open depression and resolve phlegm. Abdominal pain and waist/rib pain should be treated with warming meridians and dispelling cold, focusing on clearing heat and removing dampness. If excessive diet injures the Spleen Qi internally, use digestion-promoting methods. Regarding painful urination, one must ask if urination is smooth or difficult. Smooth urination indicates Blood Stasis (Xuexu); difficult urination indicates Urinary Difficulty (Niao Se). Sudden severe pain indicates Cold pathogen invasion; intermittent pain indicates Fire pathogen. In women, the lower abdomen is the Sea of Chong and Ren meridians. Upon exposure to cold, Qi and Blood coagulate and strike each other, causing pain. With warmth, Qi harmonizes and flows, and pain stops naturally. Additionally, injuries from sexual intercourse in the Bao Luo (uterine network) and Yin Hu (vaginal opening), or external cold suppression, can also cause pain. At the very end of the buttocks, there is what is called Kaogu Pain (coccygeal pain), which differs based on phlegm obstruction, Blood deficiency, or Dead Blood (severe stasis). Students should examine these details carefully.