内经曰春三月此谓发陈天地俱生万物以荣夜卧早起广步于庭披发缓形以使志生生而勿杀
予而勿
夺赏而勿罚此春气之应养生之道也逆之则伤肝夏为寒变奉长者少大法春月天气上升人气亦
上升应之故春月诸症宜吐发散升提不宜降下通利盖吐即古之宜剂今人谓宣为泻者误也春月肝
胆木气用事木旺则土亏故脾胃土气受邪宜抑肝补脾药为主清脯养心药佐之随症施治全在活法
虚则补之实则泻之寒则温之热则清之高者抑之下者举之以平为期余皆仿此今将春月诸症宜
用方法详陈于左对症施治权而用之毋胶柱而鼓瑟始可以言医矣
治春初人事劳扰饥饱失节或解衣沐浴触胃风寒致成内伤外感头疼发热
呕吐眩闷胸膈胀痛恶食或鼻流清涕咳嗽生痰鼻寒声重并宜服一二剂即愈仍忌腥晕三五日
川芎(一钱) 白芷(八分) 细辛(五分去叶) 干葛(一钱) 甘草(三分生) 紫苏叶(一
钱)
藿香(八分去土) 半夏(一钱姜制) 陈皮(八分) 苍术(麸炒一钱) 枳壳 (去穣七分)
桔梗(去芦七分) 淡豆豉(八分不用亦可)
上用姜三片葱白一根水一钟半煎八分食后热服有汗不用葱白单内伤无外感单外感无内
伤各
有本条头痛不止加 本(八分)呕吐不止加干姜(炒)砂仁(炒各七分)发热或潮热不退加
柴
胡黄芩(各一钱)胸膈胀闷加山楂枳实(各一钱)发而汗不出热不退加麻黄(一钱半)葱白(
二根)咳嗽生痰加杏仁前胡金沸花(去梗各八分)南五味子(五分)
《黄帝内经》说:春季的三个月,这叫做“发陈”(推陈出新),天地自然之气共同生发,万物因此繁荣。此时应晚睡早起,在庭院中广泛漫步,披散头发,放松形体,以使志意生机勃勃;应当顺应生发之气而不要杀戮,给予恩惠而不要剥夺,奖赏而不要惩罚。这是顺应春气、养护生机的原则。如果违背它,就会损伤肝脏,导致夏季发生寒性病变,奉养长夏之气的力量就会减少。
根据大法,春季天气上升,人气也随之上升,人体应当顺应这一规律。因此,春季的各种病症适宜使用吐法、发散法、升提法,而不宜使用降下法和通利法。因为吐法即古代所谓的“宣剂”,现在的人误将“宣”当作“泻”,这是错误的。
春季肝胆木气当令,木气旺盛则会导致脾土虚弱,所以脾胃土气容易受邪。治疗应以抑制肝气、补益脾气的药物为主,以清肺养心的药物为辅,随症状灵活施治。关键在于灵活运用:虚证用补法,实证用泻法,寒证用温法,热证用清法;病位高的予以抑制,病位低的予以提升,以恢复平衡为最终目的。其余情况都仿照此理。现将春季各种病症适宜的治疗方法详细陈述如下,请对症施治,权衡利弊后使用,不要拘泥固执,这样才能称得上懂医学了。
治疗初春时节,因人事劳碌干扰,饥饱失常,或者脱衣沐浴时触犯胃部的风寒,导致内伤兼外感。症状包括头痛发热、呕吐眩晕、胸闷、胸膈胀痛、厌食,或者鼻流清涕、咳嗽生痰、鼻塞声重等。这些情况都适宜服用一两剂药即可痊愈,但仍需忌口腥荤食物三五天。
方药组成:川芎(一钱)、白芷(八分)、细辛(五分,去叶)、干葛(一钱)、甘草(三分,生用)、紫苏叶(一钱)、藿香(八分,去土)、半夏(一钱,姜制)、陈皮(八分)、苍术(麸炒,一钱)、枳壳(去瓤,七分)、桔梗(去芦,七分)、淡豆豉(八分,不用也可)。
以上药物,用生姜三片、葱白一根、水一碗半,煎至八分满,饭后热服。如果有汗出,则不用葱白。单纯内伤无外感的,单用内伤本条方;单纯外感无内伤的,单用外感本条方。
若头痛不止,加本(八分);呕吐不止,加干姜(炒)、砂仁(炒,各七分);发热或潮热不退,加柴胡、黄芩(各一钱);胸膈胀闷,加山楂、枳实(各一钱);发热且无汗、热不退,加麻黄(一钱半)、葱白(二根);咳嗽生痰,加杏仁、前胡、金沸花(去梗,各八分)、南五味子(五分)。
The *Neijing* (Yellow Emperor's Inner Classic) states: The three months of spring are called "Fa Chen" (pushing out the old to bring forth the new). Heaven and Earth generate together, and all things flourish. One should sleep late and rise early, walk broadly in the courtyard, let down one's hair and relax the body, so as to allow the will to be vibrant and alive; one should nurture life rather than kill, give rather than take, reward rather than punish. This is the response to the Qi of Spring and the way to nourish life. To violate this will injure the Liver, leading to cold transformations in summer, and there will be less energy to support the growth phase. According to general principles, in spring, the Qi of Heaven rises, and human Qi also rises; thus, one should respond accordingly. Therefore, for various ailments in spring, methods such as emesis (吐), dispersion (发散), and elevation (升提) are suitable, while descending (降下) and purging/draining (通利) methods are not. Emesis is essentially the ancient "Xuan" (宣 - dispersing/ventilating) formula; it is a mistake for modern people to consider "Xuan" as "Xie" (泻 - purging/downward draining).
In spring, the Wood Qi of the Gallbladder and Liver is active. When Wood is excessive, Earth becomes deficient. Thus, the Earth Qi of the Spleen and Stomach is prone to pathogenic invasion. Treatment should primarily focus on suppressing Liver Qi and tonifying Spleen Qi, assisted by formulas that clearing Lung heat and nourishing the Heart. Treatment must be adapted flexibly according to symptoms. The key lies in adaptability: tonify deficiency, drain excess, warm cold, clear heat; suppress what is high, elevate what is low, aiming for balance. All other cases follow this pattern. The following details the appropriate methods for various spring ailments; apply them according to symptoms, weigh the situation, and do not play the zither with fixed pegs (be inflexible), only then can one speak of medicine.
For treating early spring conditions caused by mental or physical overexertion, irregular eating habits, or catching wind-cold in the Stomach after undressing or bathing, resulting in internal injury combined with external contraction: symptoms include headache and fever, vomiting, dizziness and chest oppression, distending pain in the chest and diaphragm, aversion to food, runny clear nasal discharge, cough with phlegm, nasal congestion, and heavy voice. These conditions generally resolve after taking one or two doses. However, avoid raw, cold, and fishy foods for three to five days.
Formula Composition: Chuanxiong Rhizome (Chuanxiong, 1 qian), Baizhi Root (Baizhi, 8 fen), Asarum Root (Xixin, 5 fen, remove leaves), Kudzu Root (Gegen, 1 qian), Licorice Root (Gancao, 3 fen, raw), Perilla Leaf (Zisuye, 1 qian), Agastache Herb (Huoxiang, 8 fen, remove soil), Pinellia Tuber (Banxia, 1 qian, processed with ginger), Tangerine Peel (Chenpi, 8 fen), Atractylodes Rhizome (Cangzhu, 1 qian, bran-fried), Bitter Orange Fruit (Zhike, 7 fen, remove pith), Platycodon Root (Jiegeng, 7 fen, remove root tip), Fermented Soybean (Dandouchi, 8 fen, optional).
Take the above herbs, add three slices of fresh ginger, one stalk of scallion white, and one and a half cups of water. Decoct until reduced to eight-tenths. Take hot after meals. If sweating is present, omit the scallion white. For pure internal injury without external contraction, use the specific internal injury clause alone; for pure external contraction without internal injury, use the specific external contraction clause alone.
If headache persists, add Bencao (Ben, 8 fen); if vomiting persists, add Fried Ginger (Ganjiang, fried) and Amomum Fruit (Sharen, fried, 7 fen each); if fever or tidal fever persists, add Bupleurum Root (Chaihu) and Scutellaria Root (Huangqin, 1 qian each); if chest/diaphragm distension and oppression occur, add Hawthorn Fruit (Shanzha) and Immature Bitter Orange (Zhishi, 1 qian each); if fever occurs with no sweat and heat does not recede, add Ephedra Stem (Mahuang, 1.5 qian) and Scallion White (Congbai, 2 stalks); if cough with phlegm occurs, add Apricot Seed (Xingren), Peucedanum Root (Qianhu), and Farfara Flower (Jinflorescence/Jinfeihua, stems removed, 8 fen each), and Schisandra Berry (Nanwuweizi, 5 fen).