历节风 疼痛不可屈伸,体魁瘰肿如脱,痛掣流注骨节,自汗短气,头眩欲
吐,由风湿寒相搏而成。痛者寒多,肿者湿多,汗出历节者风多。
历节风痛走注不定;痛风有定,夜甚,鹤膝风膝大,或痹,或痛不痛,筋动难,
或仁不仁。饮痹往来如历节风;白虎飞尸痛浅按之便,附骨疽痛深按之无益。
吐衄 脉涩濡弱,细弦而涩,按之虚皆为亡血。沉弦,面无血色,无寒
热者,必衄。沉为在里,荣卫内结,胸满必吐血。
因热则淖溢妄行,有劳则血不归经,大怒则气逆血莞于上。
肾病则咳唾而有血。
衄者出于肺。
呕吐者出于胃。
鬲上伏热,寸脉洪数。
荣血妄行,左手洪大。
阳毒伤寒,脉洪数。
虚劳吐血出于肺,脉洪。
饱食大饮,屈身劳力而吐血,出月,肺洪,怒伤肝,气逆也。
传尸注病吐血,两尺弦细。
治衄凉血行血。
犀角地黄汤 加郁金、黄芩、柴胡、人参、丹参,治呕血咯血。因血上错经
火载而呕,因血虚痰盛而咳,四物汤、栀子、郁金、童便、姜汁、韭汁、山茶
花;痰加竹沥;喉中痛是气虚,加参术 柏。
咯血血虚痰盛,加青黛、栝蒌仁。嗽加诃子、海石、杏仁。
咯唾血出于肾
天门冬 麦门冬 黄柏 熟地 桔梗 知母 贝母 远志 有寒加姜桂。
呕吐血出于胃
犀角(一钱) 地黄(三钱) 牡丹皮(二钱) 芍药(三钱) 名犀角地黄汤,治胃实及有瘀血。
人参饮子 治脾胃虚弱衄血,又治吐血久不愈。
人参(三钱) 黄 (一钱) 芍药(一钱) 川归(三钱) 五味子(五个) 甘草 麦门冬(二钱)
救肺散 治咳血,六脉大,按之虚,心脉也,此气盛而亡血,以泻火补气以坠气。
四物汤 人参 黄 升麻 柴胡 牡丹皮 陈皮 甘草 多加地黄,又名三黄泻血汤。
益阴散 治阳浮阴翳,咯血衄血。
黄柏 黄芩 黄连(并以蜜水浸炒) 芍药(一两) 人参 白术 干姜(三钱) 甘草(六钱)
茶(一两) 谷(一两,香油釜炒) 米饮下五钱。
三黄丸 治衄不止,大便急燥者下之。
栀子 黄芩 黄连 地黄 大黄 朴硝
上蜜丸。
清心莲子饮 治咯痰血。
身体疼痛。这是溢饮(水饮停留于四肢肌肤)。若因虚寒与邪气搏结,导致湿邪损伤血络,也会出现这种情况。
也有因血虚而导致疼痛的情况。
历节风:关节疼痛剧烈,无法屈伸,身体消瘦且伴有瘰疬肿核,疼痛牵引并流注于骨节之间,伴有自汗、气短、头晕欲吐的症状。这是由于风湿寒三气相互搏结而形成的。疼痛明显的多为寒气偏盛,肿胀明显的多为湿气偏盛,出汗且疼痛游走于各关节的多为风气偏盛。
历节风的疼痛游走不定;痛风的疼痛部位固定,夜间加重;鹤膝风表现为膝盖肿大,或者出现麻木、疼痛或不知痛痒,筋脉拘急难以活动,或者感觉迟钝。饮痹的疼痛往来流动,类似历节风;白虎病和飞尸病的疼痛较浅,轻按即可感到;附骨疽的疼痛较深,重按也无明显益处。
吐衄:脉象涩、濡、弱,细弦而涩,重按无力,这些都是失血的表现。脉象沉弦,面色苍白无血色,没有恶寒发热症状的,必定是鼻出血。脉沉表示病位在里,营卫之气在内郁结,胸部胀满,必定会吐血。
因热邪导致血液沸腾妄行;因劳累导致血液不能归经;大怒导致气机上逆,血液郁积于上部。
肾病会导致咳嗽唾血。
鼻出血源于肺。
呕吐出血源于胃。
膈上有伏热,寸脉洪大数急。
营血妄行,左手脉象洪大。
阳毒伤寒,脉象洪大数急。
虚劳导致的吐血源于肺,脉象洪大。
饱食后大量饮水,弯腰劳作导致吐血,月经期间吐血,脉象见于肺部洪大;愤怒伤肝,导致气机上逆。
传尸注病(慢性消耗性传染病)导致的吐血,两尺脉弦细。
治疗鼻出血应凉血行血。
犀角地黄汤 加入郁金、黄芩、柴胡、人参、丹参,用于治疗呕血和咯血。因血错经上行,火邪载血而致呕;因血虚痰盛而致咳,可用四物汤,加栀子、郁金、童便、姜汁、韭汁、山茶花;若有痰,加竹沥;喉中疼痛是因气虚,加入人参、白术、柏子仁。
咯血因血虚痰盛,加入青黛、瓜蒌仁;咳嗽加入诃子、海浮石、杏仁。
唾血源于肾。
天门冬、麦门冬、黄柏、熟地黄、桔梗、知母、贝母、远志;若有寒邪,加入生姜、肉桂。
呕吐血源于胃。
犀角(一钱)、地黄(三钱)、牡丹皮(二钱)、芍药(三钱),名为犀角地黄汤,治疗胃实及有瘀血。
人参饮子,治疗脾胃虚弱导致的鼻出血,也治疗久治不愈的吐血。
人参(三钱)、黄芪(一钱)、芍药(一钱)、川当归(三钱)、五味子(五个)、甘草、麦门冬(二钱)。
救肺散,治疗咳血,六脉大而重按无力,心脉异常,这是气盛而失血,用此方泻火补气以降气。
四物汤,加入人参、黄芪、升麻、柴胡、牡丹皮、陈皮、甘草,多加地黄,又名三黄泻血汤。
益阴散,治疗阳气上浮、阴气遮蔽导致的咯血、鼻出血。
黄柏、黄芩、黄连(均用蜜水浸泡炒制)、芍药(一两)、人参、白术、干姜(三钱)、甘草(六钱)、茶(一两)、谷(一两,用香油在釜中炒)、米饮送服五钱。
三黄丸,治疗鼻出血不止,大便干燥者,用此方攻下。
栀子、黄芩、黄连、地黄、大黄、朴硝。
以上药物炼蜜为丸。
清心莲子饮,治疗咯痰带血。
Body pain. This is Yin-Yin (fluid retention in the limbs and muscles). If caused by the interaction of deficiency-cold and pathogens, leading to dampness damaging the blood collaterals, it will also present this way.
There are also cases where pain is caused by blood deficiency.
Li-Jie Feng (Joint Bi): Severe joint pain with inability to flex or extend, emaciation accompanied by scrofula-like swellings, pain radiating and flowing into the joints, spontaneous sweating, shortness of breath, dizziness, and a sensation of vomiting. This is formed by the binding of wind-dampness and cold. Prominent pain indicates excess cold; prominent swelling indicates excess dampness; sweating with pain wandering through various joints indicates excess wind.
The pain of Li-Jie Feng wanders without fixed location; the pain of Tong-Feng (Gout) is fixed and worsens at night; He-Xi Feng (Crane's Knee) presents with swollen knees, numbness, pain or insensitivity, tendon stiffness making movement difficult, or reduced sensation. The pain of Yin-Bi flows back and forth, similar to Li-Jie Feng; the pain of Bai-Hu Bing (White Tiger Disease) and Fei-Shi Bing (Flying Corpse Disease) is superficial and felt upon light palpation; the pain of Fu-Gu Ju (Bone-Attached Abscess) is deep and unaffected by heavy palpation.
Tu-Nv (Hematemesis and Epistaxis): Pulse is choppy, soggy, weak, thready, wiry, and choppy; pressure reveals emptiness, all indicating blood loss. A sunken and wiry pulse, pale complexion without aversion to cold or fever, indicates epistaxis. A sunken pulse indicates an interior condition; internal knotting of Ying and Wei (Nutritive and Defensive Qi) causes chest fullness and必然 hematemesis.
Heat causes blood to boil and flow recklessly; labor causes blood to fail to return to its vessels; extreme anger causes qi to rebel upward, causing blood to stagnate in the upper body.
Kidney disease leads to coughing up blood in sputum.
Epistaxis originates from the Lung.
Vomiting blood originates from the Stomach.
Stagnant heat above the diaphragm presents with a surging and rapid Cun pulse.
Reckless flow of Ying blood presents with a surging and large Left hand pulse.
Yang-Du Shang-Han (Yang-Toxin Cold Damage) presents with a surging and rapid pulse.
Deficiency-Lao (Consumption) hematemesis originates from the Lung, presenting with a surging pulse.
After overeating and drinking heavily, bending and labor cause hematemesis; menstruation-related hematemesis presents with a surging Lung pulse; anger injuring the Liver causes qi rebellion.
Chuan-Shi Zhu Bing (Transmitted Corpse Disease) hematemesis presents with wiry and thin Chi pulses.
Treatment for epistaxis involves cooling blood and promoting blood circulation.
Xi-Jiao Di-Huang Tang (Rhino Horn and Rehmannia Decoction) added with Yu-Jin (Curcuma aromatica), Huang-Qin (Scutellaria baicalensis), Chai-Hu (Bupleurum chinense), Ren-Shen (Panax ginseng), Dan-Shen (Salvia miltiorrhiza), treats hematemesis and hemoptysis. Caused by blood taking the wrong pathway and fire carrying blood upward causing vomiting; or due to blood deficiency and abundant phlegm causing cough, use Si-Wu Tang (Four Substances Decoction) with Zhi-Zi (Gardenia jasminoides), Yu-Jin, Tong-Bian (Child's Urine), Jiang-Zhi (Ginger Juice), Jiu-Zhi (Chinese Chive Juice), Shan-Cha Hua (Camellia sinensis flower); add Zhu-Li (Bamboo Sap) for phlegm; throat pain indicates qi deficiency, add Ren-Shen, Bai-Zhu (Atractylodes macrocephala), Bo-Ren (Biota seed).
Hemoptysis due to blood deficiency and abundant phlegm: add Qing-Dai (Indigo Naturalis), Gua-Lou Ren (Trichosanthes seed); cough: add He-Zi (Terminalia chebula), Hai-Shi (Fossilia Osseum), Xing-Ren (Prunus armeniaca).
Sputum blood originates from the Kidney.
Tian-Men Dong (Asparagus cochinchinensis), Mai-Men Dong (Ophiopogon japonicus), Huang-Bo (Phellodendron amurense), Shu-Di (Prepared Rehmannia glutinosa), Jie-Geng (Platycodon grandiflorus), Zhi-Mu (Anemarrhena asphodeloides), Bei-Mu (Fritillaria cirrhosa), Yuan-Zhi (Polygala tenuifolia); if cold is present, add Sheng-Jiang (Zingiber officinale) and Rou-Gui (Cinnamomum cassia).
Hematemesis originates from the Stomach.
Xi-Jiao (1 qian), Di-Huang (3 qian), Mu-Dan-Pi (Moutan Cortex, 2 qian), Shao-Yao (Paeonia lactiflora, 3 qian), named Xi-Jiao Di-Huang Tang, treats Stomach excess and blood stasis.
Ren-Shen Yin-Zi (Ginseng Drink), treats epistaxis due to Spleen-Stomach deficiency, and chronic hematemesis unresponsive to treatment.
Ren-Shen (3 qian), Huang-Qi (Astragalus membranaceus, 1 qian), Shao-Yao (1 qian), Chuan-Gui (Angelica sinensis, 3 qian), Wu-Wei-Zi (Schisandra chinensis, 5 berries), Gan-Cao (Licorice root), Mai-Men Dong (2 qian).
Jiu-Fei San (Lung-Saving Powder), treats hemoptysis with six pulses being large but empty upon pressure, Heart pulse abnormality, indicating excess qi and blood loss; this formula clears fire, tonifies qi, and descends qi.
Si-Wu Tang added with Ren-Shen, Huang-Qi, Sheng-Ma (Cimicifuga foetida), Chai-Hu, Mu-Dan-Pi, Chen-Pi (Citrus reticulata), Gan-Cao, with increased Di-Huang, also known as San-Huang Xie-Xue Tang (Three Yellows Blood-Draining Decoction).
Yi-Yin San (Yin-Nourishing Powder), treats floating yang and obscured yin causing hemoptysis and epistaxis.
Huang-Bo, Huang-Qin, Huang-Lian (all soaked and stir-fried with honey water), Shao-Yao (1 liang), Ren-Shen, Bai-Zhu, Gan-Jiang (Dried Ginger, 3 qian), Gan-Cao (6 qian), Cha (Tea, 1 liang), Gu (Grain, 1 liang, stir-fried in sesame oil in a cauldron); taken with rice decoction, 5 qian per dose.
San-Huang Wan (Three Yellows Pill), treats persistent epistaxis with dry stool, using purgation.
Zhi-Zi, Huang-Qin, Huang-Lian, Di-Huang, Da-Huang (Rhubarb radix et rhizoma), Pu-Xiao (Mirabilite).
Made into pills with honey.
Qing-Xin Lian-Zi Yin (Heart-Clearing Lotus Seed Drink), treats hemoptysis with phlegm.