慢惊本无热可言,但因脾虚而虚热内生,故痰涎上泛,咽喉气粗,身热心烦,痰热相兼者,古法主清心涤痰
汤(方见急惊后调理法)。
脾虚肝旺痰盛者,古法主柴芍六君子汤(如六君子汤加柴胡、白芍、钩藤钩,引用姜、枣)。
〔真按〕痰热之生,皆由脾虚,仍宜以治脾为主,方用卷茯
苓三钱,炒竹茹钱半,化橘红二钱,麦冬去心钱半,川尖贝钱半,金钱术钱半,炙甘草五分,引用生白芍磨汁五分。
此证多由吐泻即久,脾气大伤,以致土虚不能生金,金弱不能制木,肝木强盛,惟脾是克,故曰脾风。闭目
摇头,面唇青黯,额汗昏睡,四肢厥冷,舌短音哑,频呕清水,此乃纯阴无阳之症,吐泻亡阳者,古法主温中补
脾汤(如人参、黄 、白术、干姜、附子、半夏、陈皮、茯苓、砂仁、肉桂、白芍、甘草、丁香,引用煨姜、
大枣)。
因大病后而发者,古法主固真汤(如人参、白术、甘草、肉桂、茯苓、山药、黄 、附子,引用姜、枣)。
〔真按〕肺金不能制肝木,故肝益强,脾土不能生肺金,故脾益弱,此乃木强侮土过甚,脾阳不展,少延则
脾败,急宜大补脾土,生胃回阳,方用真吉林人参须三钱(无力者改用西党参三钱),卷茯苓三钱,淡干姜一钱,
炒天生野术三钱,广陈皮二钱,炒山药钱半,炒扁豆钱半,炙甘草八分,引用上肉桂一分。
慢惊风本来没有实热可言,但因为脾气虚弱导致虚热内生,所以痰涎向上泛溢,咽喉呼吸气粗,身体发热且心烦。如果是痰与热相互兼杂的情况,古代医法主张使用清心涤痰汤(方剂见急惊风后的调理方法章节)。
若是脾虚、肝旺且痰盛的患者,古代医法主张使用柴芍六君子汤(即在六君子汤的基础上加入柴胡、白芍、钩藤钩,煎药时引用生姜和大枣)。
〔陈守真按语〕痰热的产生,根源都在于脾虚,因此仍然应当以治疗脾脏为主。处方使用:卷茯苓三钱,炒竹茹一钱半,化橘红二钱,去心的麦冬一钱半,川贝母一钱半,金钱术一钱半,炙甘草五分,煎药时引用生白芍磨成的汁五分。
这种证候多由长期的呕吐腹泻引起,导致脾气严重受损,致使土(脾)虚弱不能生金(肺),金(肺)弱不能制约木(肝)。肝木强盛,专门克制脾土,所以称为脾风。症状表现为闭目摇头,面色和嘴唇青暗,额头出汗、昏睡,四肢冰冷,舌体短缩、声音嘶哑,频繁呕吐清水。这属于纯阴无阳的病症,是因吐泻导致阳气亡失。古代医法主张使用温中补脾汤(方中含有人参、黄芪、白术、干姜、附子、半夏、陈皮、茯苓、砂仁、肉桂、白芍、甘草,煎药时引用煨姜、大枣)。
因大病之后发作的,古代医法主张使用固真汤(方中含有人参、白术、甘草、肉桂、茯苓、山药、黄芪、附子,煎药时引用生姜、大枣)。
〔陈守真按语〕肺金不能制约肝木,所以肝更加强盛;脾土不能生养肺金,所以脾更加虚弱。这是木气过强反侮土气太过,导致脾阳无法舒展,若拖延时日则脾脏败坏。急需大补脾土,生发胃气并回阳救逆。处方使用:真吉林人参须三钱(若患者体质无力者,改用西党参三钱),卷茯苓三钱,淡干姜一钱,炒天生野白术三钱,广陈皮二钱,炒山药一钱半,炒扁豆一钱半,炙甘草八分,煎药时引用上肉桂一分。
Slow convulsion (Man Jing) fundamentally does not involve excess heat; however, due to Spleen deficiency, deficient heat arises internally. Consequently, phlegm-saliva floats upward, the breath in the throat is coarse, the body feels hot, and there is mental restlessness. In cases where phlegm and heat are combined, ancient methods primarily advocate using Qingxin Ditan Tang (Clear Heart and Wash Away Phlegm Decoction) (see formula in the regulation method section for fast convulsion).
For conditions characterized by Spleen deficiency, Liver hyperactivity, and abundant phlegm, ancient methods primarily advocate using Chaishao Liujunzi Tang (Bupleurum and White Peony Six Gentlemen Decoction) (i.e., Liujunzi Tang [Six Gentlemen Decoction] added with Chaihu [Bupleuri Radix], Baishao [Paeoniae Radix Alba], and Goutenggou [Uncariae Ramulus cum Uncis], with Shengjiang [Zingiberis Rhizoma Recens] and Dazao [Jujubae Fructus] as guides).
[Commentary by Chen Shouzhen] The generation of phlegm-heat stems from Spleen deficiency; therefore, treatment should still focus on the Spleen. The prescription consists of: Juan Fuling [Poria] 3 qian, Chao Zhuru [Bambusae Caulis in Taeniam] 1.5 qian, Huajuhong [Aurantii Perfructus Immaturus Exsiccatum] 2 qian, Maidong Qu Xin [Ophiopogonis Radix] 1.5 qian, Chuanbei [Fritillariae Cirrhosae Bulbus] 1.5 qian, Jinqinshu [Atractylodis Macrocephalae Rhizoma] 1.5 qian, Zhi Gancao [Glycyrrhizae Radix et Rhizoma Preparata] 0.5 fen, with Sheng Baishao [Paeoniae Radix Alba] juice (made by grinding 0.5 fen) used as a guide.
This syndrome often results from prolonged vomiting and diarrhea, causing severe injury to Spleen Qi. This leads to Earth (Spleen) being too weak to generate Metal (Lung), and Metal (Lung) being too weak to control Wood (Liver). Consequently, Liver Wood becomes hyperactive and exclusively overacts upon Spleen Earth, hence it is called Pi Feng (Spleen Wind). Symptoms include closing eyes and shaking head, dark cyan complexion and lips, sweating on the forehead, lethargy/sleepiness, cold limbs, short tongue, hoarse voice, and frequent vomiting of clear water. This is a syndrome of pure Yin without Yang, resulting from Yang loss due to vomiting and diarrhea. Ancient methods primarily advocate using Wenzhong Bupi Tang (Warm the Middle and Tonify Spleen Decoction) (containing Renshen [Ginseng Radix et Rhizoma], Huangqi [Astragali Radix], Baizhu [Atractylodis Macrocephalae Rhizoma], Ganjiang [Zingiberis Rhizoma], Fuzi [Aconiti Lateralis Radix Preparata], Banxia [Pinelliae Rhizoma], Chenpi [Citri Reticulatae Pericarpium], Fuling [Poria], Sharen [Amomi Fructus], Rougui [Cinnamomi Cortex], Baishao [Paeoniae Radix Alba], Gancao [Glycyrrhizae Radix et Rhizoma], with Weijiang [Zingiberis Rhizoma Praeparatum] and Dazao [Jujubae Fructus] as guides).
When occurring after a major illness, ancient methods primarily advocate using Guzhen Tang (Solidify the True Decoction) (containing Renshen [Ginseng Radix et Rhizoma], Baizhu [Atractylodis Macrocephalae Rhizoma], Gancao [Glycyrrhizae Radix et Rhizoma], Rougui [Cinnamomi Cortex], Fuling [Poria], Shanyao [Dioscoreae Rhizoma], Huangqi [Astragali Radix], Fuzi [Aconiti Lateralis Radix Preparata], with Jiang [Zingiberis Rhizoma] and Zao [Jujubae Fructus] as guides).
[Commentary by Chen Shouzhen] Since Lung Metal cannot control Liver Wood, Liver becomes stronger; since Spleen Earth cannot generate Lung Metal, Spleen becomes weaker. This represents excessive counter-restriction (Wu) of Wood over Earth, leading to the failure of Spleen Yang to unfold. If delayed, Spleen function will collapse. Urgent treatment requires greatly tonifying Spleen Earth, generating Stomach Qi, and restoring Yang. The prescription uses: Zhen Jilin Renshen Xu [Ginseng Radix et Rhizoma Rootlets] 3 qian (if vitality is insufficient, substitute with Xi Dangshen [Codonopsis Radix] 3 qian), Juan Fuling [Poria] 3 qian, Dan Ganjiang [Zingiberis Rhizoma] 1 qian, Chao Tiansheng Ye Baizhu [Atractylodis Macrocephalae Rhizoma] 3 qian, Guang Chenpi [Citri Reticulatae Pericarpium] 2 qian, Chao Shanyao [Dioscoreae Rhizoma] 1.5 qian, Chao Biandou [Dolichoris Semen] 1.5 qian, Zhi Gancao [Glycyrrhizae Radix et Rhizoma Preparata] 0.8 fen, with Shang Rougui [Cinnamomi Cortex] 0.1 fen used as a guide.