凡发狂骂人,不口渴,索引与水不饮者,寒症之狂也。此必气郁不舒,怒气未泄,其人平日定懦弱不振耳。
〔治之法,宜祛痰为主,而佐以补气之药,〕方用∶
人参(一两) 白术(五钱) 茯神(一两) 半夏(一钱) 南星(一钱) 附子(一两) 柴胡(一钱) 菖
蒲(三分)
水煎服。
(此方之妙,全在补气,而不十分祛痰,寒症发寒,与痫症同治,加入附子以消其寒气,菖蒲引药入心经,自
然下喉熟睡,病如失矣。方中再加柴胡,以舒其木旺之郁气,尤易奏功耳。)
〔心经之病,怔忡不寐,乃心血少也。〕方用∶
人参(三钱) 丹皮(二钱) 茯神(三钱) 麦冬(三钱) 五味子(一钱) 当归(三钱) 生枣仁(五钱)
熟枣仁(五钱) 菖蒲(一钱) 甘草(一钱)
水煎服。
此方妙在用生、熟枣仁〔各五钱〕,生使其日间不卧,熟使其夜间不醒;又以补心之药为佐,而怔忡安矣。
〔人非心不能宁静致远,非肾不能作强生育。故补心即当补肾,补肾即当补心,是二经乃一身之主宰,脏腑之
根本也。故人病心惊不安,或夜卧不睡者,人以为心病也,谁知非心病,乃肾病也。然则欲安心者先治肾,欲治
肾者当治心。〕方用∶
人参(三两) 茯苓(三两) 茯神(三两) 远志(二两) 生枣仁(一两) 熟地(三两) 山萸(三两)
当归(三两) 菖蒲(三钱) 黄连(五钱) 肉桂(五钱) 白芥子(一两) 麦冬(三两) 砂仁(五钱)
蜜丸,每日送下五钱,汤,酒俱可。
此方治心惊不安与不寐耳,用人参、茯神、当归、麦冬足矣。即为火起不寐,亦不过加黄连足矣。何以反用熟
地、山萸补肾之药,又加肉桂以助火?不知人之惊恐者,乃肾气不入于心也;不寐者,乃心气不归于肾也。今用熟
地,山萸补肾,则肾气可上通于心矣。肉桂以补命门之火,则肾气既温,相火有权,〔则心气下行〕,君火相得,
自然上下同心,君臣合德矣。
然补肾固是,而亦不可徒补其肾也。亦有肝气不上于心易成此症者,如果有之,宜再加白芍二两,以兼补肝
木,斯心泰然矣。
凡是出现发狂骂人、不觉得口渴,并且虽然索要水喝却不肯喝水的情况,这是寒证引起的狂症。这必定是因为气机郁结不畅,怒气未能宣泄,这样的人平时性格一定懦弱不振作。
〔治疗的方法,应当以祛除痰浊为主,同时辅以补气的药物,〕方剂组成如下:
人参(一两) 白术(五钱) 茯神(茯苓菌核,宁心安神)(一两) 半夏(燥湿化痰)(一钱) 南星(天南星,祛风止痉)(一钱) 附子(温肾助阳)(一两) 柴胡(疏肝解郁)(一钱) 石菖蒲(开窍豁痰)(三分)
用水煎服。
(这个方子的妙处,全在于补气,而不是过分强调祛痰。寒证引发的发狂,与痫症的治疗原则相同,加入附子来消除体内的寒气,石菖蒲引导药力进入心经,服药后自然吞咽顺畅并熟睡,病邪就像消失了一样。方中再加入柴胡,用来舒展肝木旺盛的郁结之气,更容易取得疗效。)
〔心经发生的疾病,如怔忡(心跳剧烈,心中不安)和不寐(失眠),是由于心血不足造成的。〕方剂组成如下:
人参(三钱) 牡丹皮(清热凉血)(二钱) 茯神(三两) 麦冬(养阴生津)(三钱) 五味子(收敛固涩)(一钱) 当归(补血活血)(三钱) 生酸枣仁(养心安神)(五钱) 熟酸枣仁(收敛固涩,安神)(五钱) 石菖蒲(一钱) 甘草(调和诸药)(一钱)
用水煎服。
这个方子的妙处在于使用生、熟酸枣仁各五钱,生酸枣仁使其白天不嗜睡,熟酸枣仁使其夜间不惊醒;又用补心的药物作为辅助,怔忡的症状就能安定下来。
〔人如果没有心就不能宁静致远,没有肾就不能发挥强健的作用和生育能力。所以补心就应当补肾,补肾就应当补心,这两条经脉是身体的主宰,脏腑的根本。因此,人如果生病表现为心惊不安,或者夜晚躺下睡不着,人们以为这是心病,谁知道这不是心病,而是肾病。既然如此,想要安心的人先治疗肾,想要治疗肾的人应当治疗心。〕方剂组成如下:
人参(三两) 茯苓(健脾利湿)(三两) 茯神(三两) 远志(交通心肾)(二两) 生酸枣仁(一两) 熟地黄(滋阴补血)(三两) 山茱萸(补益肝肾)(三两) 当归(三两) 石菖蒲(三钱) 黄连(清热燥湿)(五钱) 肉桂(补火助阳)(五钱) 白芥子(温肺化痰)(一两) 麦冬(三两) 砂仁(化湿开胃)(五钱)
制成蜜丸,每天送服五钱,可以用汤剂或酒送服均可。
这个方子治疗心惊不安和失眠,用人参、茯神、当归、麦冬就足够了。即使是因火起导致的失眠,也不过是加上黄连就够了。为什么反而使用熟地黄、山茱萸这些补肾的药物,又加入肉桂来助火呢?不知道人的惊恐,是因为肾气不能进入心中;失眠,是因为心气不能回归于肾。现在使用熟地黄、山茱萸补肾,那么肾气就可以上通于心了。肉桂用来补命门之火,那么肾气既已温暖,相火有了权柄,〔心气就会下行〕,君火与相火相得益彰,自然上下同心,君臣和谐合作了。
然而,补肾固然正确,但也不能仅仅单纯地补肾。也有因为肝气不能上达于心而容易形成这种病症的,如果有这种情况,应当再加白芍二两,以兼补肝木,这样心就能安宁了。
Whenever there is manic behavior with cursing, no thirst, and a desire for water that is not acted upon (i.e., asking for water but refusing to drink), this is mania caused by cold syndrome. This must be due to stagnant Qi failing to flow freely and unexpressed anger; such individuals are typically weak and lacking in vigor in their daily lives.
[Treatment should focus on resolving phlegm, assisted by herbs that tonify Qi.] The formula is as follows:
Ren Shen (Ginseng Radix) [1 liang], Bai Zhu (Atractylodis Macrocephalae Rhizoma) [5 qian], Fu Shen (Poria with Hostwood) [1 liang], Ban Xia (Pinelliae Tuber) [1 qian], Nan Xing (Arisaematis Tuber) [1 qian], Fu Zi (Aconiti Lateralis Radix Praeparata) [1 liang], Chai Hu (Bupleuri Radix) [1 qian], Shi Chang Pu (Acori Tatarinowii Rhizoma) [3 fen].
Decoct in water and take orally.
(The brilliance of this formula lies entirely in tonifying Qi rather than excessively resolving phlegm. Mania caused by cold syndrome is treated similarly to epilepsy; the addition of Fu Zi eliminates cold pathogens, while Shi Chang Pu guides the medicinal properties into the Heart meridian. Naturally, after swallowing, the patient will fall into a deep sleep, and the illness will vanish as if it never existed. The addition of Chai Hu in the formula soothes the stagnation of hyperactive Liver Wood, making success even more likely.)
[Pathologies of the Heart meridian, such as palpitations (Zhen Tong - severe anxiety and heart palpitations) and insomnia (Bu Mei), are due to a deficiency of Heart Blood.] The formula is as follows:
Ren Shen (Ginseng Radix) [3 qian], Mu Dan Pi (Moutan Cortex) [2 qian], Fu Shen (Poria with Hostwood) [3 qian], Mai Dong (Ophiopogonis Tuber) [3 qian], Wu Wei Zi (Schisandrae Fructus) [1 qian], Dang Gui (Angelicae Sinensis Radix) [3 qian], Sheng Zao Ren (Semen Ziziphi Spinosae - raw) [5 qian], Shu Zao Ren (Semen Ziziphi Spinosae - processed) [5 qian], Shi Chang Pu (Acori Tatarinowii Rhizoma) [1 qian], Gan Cao (Glycyrrhizae Radix et Rhizoma) [1 qian].
Decoct in water and take orally.
(The efficacy of this formula lies in using both raw and processed Semen Ziziphi Spinosae, each at 5 qian; the raw form prevents daytime drowsiness, while the processed form prevents nighttime awakening. By assisting with Heart-tonifying herbs, the palpitations are stabilized.)
[Man cannot achieve tranquility and far-reaching vision without the Heart, nor can he perform strenuous tasks or reproduce without the Kidney. Therefore, tonifying the Heart requires tonifying the Kidney, and tonifying the Kidney requires tonifying the Heart. These two meridians are the masters of the body and the roots of the Zang-Fu organs. Thus, when a person suffers from heart palpitations and unease, or inability to sleep at night, people assume it is a Heart disease. Who would know that it is not a Heart disease, but a Kidney disease? Consequently, those who wish to calm the Heart must first treat the Kidney, and those who wish to treat the Kidney must treat the Heart.] The formula is as follows:
Ren Shen (Ginseng Radix) [3 liang], Fu Ling (Poria) [3 liang], Fu Shen (Poria with Hostwood) [3 liang], Yuan Zhi (Polygalae Radix) [2 liang], Sheng Zao Ren (Semen Ziziphi Spinosae - raw) [1 liang], Shu Di Huang (Rehmanniae Radix Praeparata) [3 liang], Shan Yu Rou (Corni Fructus) [3 liang], Dang Gui (Angelicae Sinensis Radix) [3 liang], Shi Chang Pu (Acori Tatarinowii Rhizoma) [3 qian], Huang Lian (Coptidis Rhizoma) [5 qian], Rou Gui (Cinnamomi Cortex) [5 qian], Bai Jie Zi (Sinapis Semen) [1 liang], Mai Dong (Ophiopogonis Tuber) [3 liang], Sha Ren (Amomi Fructus Rotundus) [5 qian].
Make into honey pills, taking 5 qian daily, which can be taken with decoction or wine.
This formula treats heart palpitations and insomnia; using Ren Shen, Fu Shen, Dang Gui, and Mai Dong would suffice. Even if insomnia is caused by fire, adding Huang Lian would be enough. Why use Shu Di Huang and Shan Yu Rou to tonify the Kidney, and add Rou Gui to assist fire? It is unknown that fright in humans results from Kidney Qi failing to enter the Heart; insomnia results from Heart Qi failing to return to the Kidney. Now, by using Shu Di Huang and Shan Yu Rou to tonify the Kidney, Kidney Qi can ascend to connect with the Heart. Rou Gui tonifies the Fire of the Ming Men (Gate of Life); once the Kidney Qi is warmed and the Minister Fire has authority, [Heart Qi descends], allowing the Sovereign Fire and Minister Fire to harmonize. Naturally, the upper and lower parts become united in heart, and the ruler and minister act in virtue together.
However, while tonifying the Kidney is correct, one must not merely tonify the Kidney alone. There are also cases where this syndrome arises because Liver Qi fails to ascend to the Heart. If this is the case, one should additionally add 2 liang of Bai Shao (Paeoniae Radix Alba) to simultaneously tonify Liver Wood, thereby bringing peace to the Heart.