妇人有饮食少思,胸膈满闷,终日倦怠思睡,一经房事,呻吟不已。人以为脾胃之气虚也,谁知是肾气不足乎?
夫肾宜升腾,不宜消降。升腾于上焦则脾胃易于分运,降陷于下焦则脾胃难于运化。人乏水谷之养,则精神自尔倦
怠,脾胃之气,可升而不可降也,明甚。然则,脾胃之气,虽充于脾胃之中,实生于两肾之内。无肾中之水气,则胃
之气不能腾;无肾中之火气,则脾之气不能化。惟有肾之水火二气,而脾胃之气始能升腾而不降也。然则补脾胃之
气,可不急补肾中水火之气乎!治法必以补肾气为主,但补肾而不兼补脾胃之品,则肾之水火二气,不能提于至阳
之上也。
方用并提汤。
大熟地(一两,九蒸) 巴戟(一两,盐水浸) 白术(一两,土炒) 人参(五钱) 黄 (五钱,生用) 山
萸肉(三钱,蒸) 枸杞(二钱) 柴胡(五分)
水煎服。三月而肾气大旺,再服一月,未有不能受孕者。此方补气之药,多于补精,似乎以补脾胃为主矣。孰
知脾胃健而生精自易,是补脾胃之气与血,正所以补肾之精与水也。又益以补精之味,则阴气自足,阳气易升,自
尔升腾于上焦矣。阳气不下临,则无非大地阳春,随遇皆是化生之机,安有不受孕之理与?
眉批∶胸满不孕,人每以为脾胃虚寒,不能克食,用扶脾消导之药,胃气愈虚,何能受孕?妙在立方不峻补
肾火,所以不用桂、附等药,但专补肾气,便脾胃之气不复下陷,则带脉气充,胞胎气暖,自然受孕无难矣。
歌括∶胸满膈闷食不思,倦怠欲卧力难支。
肾中水火二气弱,脾胃失运不妊子。
并提汤中用熟地,巴戟白术人参 。
山萸柴胡枸杞子,精旺自有化生机。
妇女中有饮食减少、没有食欲,胸膈部胀满闷堵,整天疲倦想睡觉,一旦进行房事,就呻吟不止。人们以为是脾胃之气虚弱,谁知道其实是肾气不足呢?
肾脏的气机适宜上升升腾,不适宜消沉下降。气机在上方焦升腾,则脾胃容易分别运化;气机在下焦降陷,则脾胃难以运化。人缺乏水谷精微的滋养,精神自然就会疲倦懈怠,脾胃之气,只能上升而不能下降,这是很明显的道理。既然这样,脾胃之气,虽然充盈在脾胃之中,实际上却产生于两肾之内。如果没有肾中的水气,胃的气机就不能升腾;如果没有肾中的火气,脾的气机就不能运化。只有具备肾中水火二气,脾胃之气才能升腾而不下降。既然如此,补益脾胃之气,难道不是应该急切地补肾中水火之气吗!治疗方法必须以补肾气为主,但是补肾如果不兼用补脾胃的药物,那么肾的水火二气,就不能提升到至阳的高度。
方剂用并提汤。
大熟地黄(一两,九次蒸制) 巴戟天(一两,盐水浸泡) 白术(一两,土炒) 人参(五钱) 黄芪(五钱,生用) 山茱萸肉(三钱,蒸) 枸杞子(二钱) 柴胡(五分)
用水煎服。三个月后肾气大旺,再服用一个月,没有不能受孕的。这个方子补气药多于补精药,似乎是以补脾胃为主。谁知道脾胃健运则生成精血自然容易,这补益脾胃的气与血,正是为了补肾的精与水。又加上补精味的药物,阴气自然充足,阳气容易升发,自然就在上焦升腾了。阳气不向下压迫,那就无非是大地上的阳春之气,随处都是化生之机,哪有不受孕的道理呢?
眉批:胸满不孕,人们常认为是脾胃虚寒,不能消化食物,使用扶脾消导的药物,胃气更加虚弱,怎么能受孕?妙在立方时不峻烈地补肾火,所以不用桂枝、附子等药,只是专门补肾气,便使脾胃之气不再下陷,那么带脉之气充盛,胞胎之气温暖,自然受孕就不难了。
歌括:胸满膈闷不想吃东西,疲倦想躺下力气难以支撑。
肾中水火二气虚弱,脾胃失去运化功能导致不孕。
并提汤中使用熟地黄,巴戟天、白术、人参。
山茱萸、柴胡、枸杞子,精气旺盛自然有化生之机。
Women who have little desire to eat, fullness and oppression in the chest and diaphragm, fatigue and drowsiness all day long, and groaning incessantly after sexual intercourse. People consider this to be deficiency of Spleen-Stomach Qi, but who would know that it is actually deficiency of Kidney Qi?
The Qi of the Kidney should ascend and rise, not descend and sink. When it ascends to the Upper Jiao (Upper Burner), the Spleen and Stomach find it easy to distribute and transport; when it sinks to the Lower Jiao (Lower Burner), the Spleen and Stomach find it difficult to transform and transport. Lacking nourishment from food and water, the spirit naturally becomes fatigued and lethargic. It is evident that the Qi of the Spleen and Stomach can only ascend and must not descend. Therefore, although the Qi of the Spleen and Stomach is abundant within the Spleen and Stomach itself, it is truly generated within the two Kidneys. Without the Water Qi of the Kidney, the Qi of the Stomach cannot rise; without the Fire Qi of the Kidney, the Qi of the Spleen cannot transform. Only with the Water and Fire Qi of the Kidney can the Qi of the Spleen and Stomach ascend and not descend. Thus, when tonifying the Qi of the Spleen and Stomach, is it not urgent to tonify the Water and Fire Qi of the Kidney? The treatment method must focus on tonifying Kidney Qi, but if one tonifies the Kidney without simultaneously using herbs that tonify the Spleen and Stomach, the Water and Fire Qi of the Kidney cannot be lifted to the highest Yang level.
Prescribe Bingti Tang (Simultaneous Uplifting Decoction).
Shu Di Huang (Rehmanniae Radix Praeparata, 1 liang, steamed nine times)
Ba Ji Tian (Morindae Officinalis Radix, 1 liang, soaked in salt water)
Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 liang, stir-fried with soil)
Ren Shen (Ginseng Radix, 5 qian)
Huang Qi (Astragali Membranacei Radix, 5 qian, used raw)
Shan Yu Rou (Corni Fructus, 3 qian, steamed)
Gou Qi Zi (Lycii Fructus, 2 qian)
Chai Hu (Bupleuri Radix, 5 fen)
Decoct with water and take orally. After three months, Kidney Qi will be greatly vigorous; taking it for another month, there is no case where pregnancy cannot be achieved. This formula contains more Qi-tonifying herbs than essence-tonifying ones, seemingly focusing mainly on tonifying the Spleen and Stomach. However, who knows that when the Spleen and Stomach are healthy, generating essence becomes easy? Tonifying the Qi and Blood of the Spleen and Stomach is precisely how one tonifies the Essence and Water of the Kidney. By adding essence-tonifying ingredients, Yin Qi becomes sufficient, and Yang Qi rises easily, naturally ascending to the Upper Jiao. If Yang Qi does not descend oppressively, it is like the spring warmth of the earth, everywhere providing the mechanism of transformation and generation. How could there be any reason for failing to conceive?
Commentary: Chest fullness and infertility are often attributed to Cold-Deficiency of the Spleen and Stomach, unable to digest food, leading to the use of Spleen-supporting and digestion-promoting herbs, which further deplete Stomach Qi, making conception impossible. The brilliance lies in the prescription not aggressively tonifying Kidney Fire, thus avoiding herbs like Gui Zhi (Cinnamomi Ramulus) and Fu Zi (Aconiti Lateralis Radix Praeparata). Instead, it specifically tonifies Kidney Qi, preventing the sinking of Spleen and Stomach Qi. Consequently, the Qi of the Dai Mai (Girdle Vessel) becomes abundant, and the Bao Tuo (Uterus) becomes warm, making conception naturally effortless.
Verse:
Chest fullness and diaphragmatic oppression, no desire to eat;
Fatigue and desire to lie down, strength hard to support.
Weakness of Water and Fire Qi in the Kidney,
Spleen and Stomach lose their transporting function, leading to barrenness.
Bingti Tang uses Shu Di Huang, Ba Ji Tian, Bai Zhu, and Ren Shen.
Shan Yu Rou, Chai Hu, and Gou Qi Zi; when Essence is vigorous, the mechanism of transformation arises naturally.