即滋阴降火汤
治阴虚火动盗汗发热咳嗽吐血身热脉数肌肉消瘦少年中年酒色过伤成痨者服之极效
川芎(一钱) 当归(一钱三分) 白芍药(一钱三分) 熟地黄(一钱) 黄柏(七分蜜水浸
火炙)
知母(一钱蜜水拌炒) 生地黄(五分酒洗) 甘草(炙五分) 天门冬(一钱去心皮) 白术(炒
一钱二分) 陈皮(去白七分) 干姜(炒紫色三分)
上用生姜三片水一钟半煎八分空心服加减于后
咳嗽盛加桑白皮(蜜炒)马兜铃(各七分)五味子(十粒)痰盛加半夏(姜制)贝母栝
蒌仁
(各一钱)盗汗多加牡蛎酸枣仁(各七分)浮小麦(一钱)潮热盛加沙参桑白皮地骨皮(各
七分)梦泄遗精加龙骨牡蛎山茱萸(各七分)赤白浊加白茯苓(一钱)黄连(三分)衄血
咳血出于肺也加桑白皮(一钱)黄芩山栀(各五分炒)涎血痰血出于脾也加桑白皮贝母黄
连栝蒌仁(各七分)呕血吐血出于胃也加山栀仁(炒)黄连干葛蒲黄(炒各一钱)韭汁半盏姜汁
少许咯血唾血出于肾也加桔梗玄参侧柏叶(炒各
一钱)如先血症或吐衄盛大者宜先治血治法轻少者凉血止血盛大者先消瘀血次止之凉之盖
血来多必有瘀于胸膈者不先消化之则止之凉之不应也葛可久方宜次第捡用内惟独参汤止可施
于大吐血后昏倦脉微细气虚者气虽虚而复有火可加天门冬三四钱或如前所云阴虚火动潮热盗
汗咳嗽脉数者不可用参说见本草集要人参条下盖此病属火大便多燥然须节调饮食勿令泄泻若
胃气复坏泄泻稀溏则前项寒凉之药又难用矣急宜调理脾胃用白术茯苓陈皮半夏神曲麦芽甘草
等药俟胃气复然后用前本病药收功后可常服补阴丸及葛可久白凤膏等药
这就是滋阴降火汤。
主治阴虚火动引起的盗汗、发热、咳嗽、吐血,以及身体发热、脉搏快、肌肉消瘦等症状;适用于少年或中年因饮酒和房事过度导致成痨病(慢性消耗性疾病)的人服用,效果极佳。
药材及用量:川芎(一钱)、当归(一钱三分)、白芍药(一钱三分)、熟地黄(一钱)、黄柏(七分,用蜜水浸泡后以火炙烤)、知母(一钱,用蜜水拌炒)、生地黄(五分,用酒清洗)、甘草(炙过,五分)、天门冬(一钱,去心去皮)、白术(炒过,一钱二分)、陈皮(去白,七分)、干姜(炒至紫色,三分)。
以上药材,加生姜三片,水一碗半,煎煮至八分满,空腹服用。加减法如下:
咳嗽严重,加桑白皮(蜜炒)、马兜铃(各七分)、五味子(十粒);痰多,加半夏(姜制)、贝母、栝蒌仁(各一钱);盗汗多加牡蛎、酸枣仁(各七分)、浮小麦(一钱);潮热严重,加沙参、桑白皮、地骨皮(各七分);梦遗滑精,加龙骨、牡蛎、山茱萸(各七分);赤白浊(小便浑浊),加白茯苓(一钱)、黄连(三分);鼻出血、咳血属于肺经病变,加桑白皮(一钱)、黄芩、山栀(各五分,炒);唾血、痰血属于脾经病变,加桑白皮、贝母、黄连、栝蒌仁(各七分);呕血、吐血属于胃经病变,加山栀仁(炒)、黄连、干葛、蒲黄(炒,各一钱)、韭汁半盏、姜汁少许;咯血、唾血属于肾经病变,加桔梗、玄参、侧柏叶(炒,各一钱)。
如果是先出现血症,或者吐衄(吐血、流鼻血)严重的,应当先治疗血证。治疗方法是:轻症者凉血止血;重症者先消除瘀血,然后再止血、凉血。因为血出得多,必然在胸膈有瘀滞,如果不先化解瘀血,直接止血凉血是不会有效的。葛可久的方子适宜按次序选用。其中只有独参汤只适用于大吐血后昏倦、脉微细、气虚的人。如果气虽虚但又有火,可加天门冬三四钱。或者像前面所说的阴虚火动、潮热盗汗、咳嗽、脉搏快的人,不可用人参。详见《本草集要》人参条下。大概这个病属火,大便多干燥,然而必须节制饮食,不要令其泄泻。如果胃气再次受损,出现泄泻稀溏,那么前面的寒凉药物又难以使用了。此时急宜调理脾胃,使用白术、茯苓、陈皮、半夏、神曲、麦芽、甘草等药。等到胃气恢复后,再用前文治疗本病的药物收功。之后可以常服补阴丸及葛可久白凤膏等药。
This is Ziyin Jianghuo Tang (Nourish Yin and Descend Fire Decoction).
It treats symptoms caused by Yin deficiency with hyperactive fire, including night sweats, fever, cough, hematemesis (vomiting blood), generalized body heat, rapid pulse, and emaciation. It is highly effective for adolescents or middle-aged individuals who have developed consumptive diseases (Lao disease) due to excessive indulgence in alcohol and sexual activity.
Ingredients and dosages: Chuanxiong Rhizoma (1 qian), Danggui Radix (1.3 qian), Baishao Radix (1.3 qian), Shudihuang Rehmanniae Radix Praeparata (1 qian), Huangbai Phellodendri Cortex (0.7 qian, soaked in honey water and stir-fried over fire), Zhimu Anemarrhenae Rhizoma (1 qian, stir-fried with honey water), Shengdihuang Rehmanniae Radix (0.5 qian, washed with wine), Gancao Glycyrrhizae Radix et Rhizoma (roasted, 0.5 qian), Tiandong Asparagi Radix (1 qian, heart and skin removed), Baizhu Atractylodis Macrocephalae Rhizoma (stir-fried, 1.2 qian), Chenpi Citri Reticulatae Pericarpium (peel removed, 0.7 qian), Ganjiang Zingiberis Rhizoma (stir-fried until purple, 0.3 qian).
Take the above ingredients, add three slices of fresh ginger, and one and a half zhong of water. Decoct until eight-tenths remains. Take on an empty stomach. Modifications are as follows:
For severe cough, add Sangbaipi Mori Cortex (honey-roasted) and Madouling Aristolochiae Fructus (each 0.7 qian), Wuweizi Schisandrae Fructus (10 grains); for profuse phlegm, add Banxia Pinelliae Tuber (processed with ginger), Beimu Fritillariae Bulbus, and Gualouren Benincas Semen (each 1 qian); for increased night sweats, add Muli Ostreae Concha, Suanzaoren Ziziphi Spinosae Semen (each 0.7 qian), and Xiaomai Tritici Levis Fructus (1 qian); for severe tidal fever, add Shashen Glehniae Radix, Sangbaipi Mori Cortex, and Digupi Lycii Cortex (each 0.7 qian); for nocturnal emission and spermatorrhea, add Longgu Fossilia Ossis Mastodi et Ostei Femoris, Muli Ostreae Concha, and Shanzhuyu Corni Fructus (each 0.7 qian); for turbid urine (red or white), add Baifuling Poria (1 qian) and Huanglian Coptidis Rhizoma (0.3 qian); for epistaxis and hemoptysis originating from the Lung, add Sangbaipi Mori Cortex (1 qian), Huangqin Scutellariae Radix, and Zhizi Gardeniae Fructus (each 0.5 qian, roasted); for salivary blood and phlegm-blood originating from the Spleen, add Sangbaipi Mori Cortex, Beimu Fritillariae Bulbus, Huanglian Coptidis Rhizoma, and Gualouren Benincas Semen (each 0.7 qian); for hematemesis and vomiting blood originating from the Stomach, add Zhiren Gardeniae Fructus (roasted), Huanglian Coptidis Rhizoma, Gange Puerariae Lobatae Radix, Puhuang Typhae Pollen (roasted, each 1 qian), Jiuzjuice Allii Tuberosi Juice (half zhan), and Jiangzjuice Zingiberis Recens Juice (a small amount); for spitting blood and saliva-blood originating from the Kidney, add Jiegeng Platycodonis Radix, Xuanshen Scrophulariae Radix, and Cebaiye Biotae Cacumen (roasted, each 1 qian).
If hemorrhagic symptoms appear first, or if hematemesis and epistaxis are severe, treat the blood disorder first. The treatment principle is: for mild cases, cool the blood and stop bleeding; for severe cases, first resolve blood stasis, then stop bleeding and cool the blood. This is because excessive bleeding inevitably leads to stasis in the chest and diaphragm; if the stasis is not resolved first, attempts to stop bleeding and cool the blood will be ineffective. Ge Kejiu’s formulas should be used sequentially. Among them, Dushen Tang (Single Ginseng Decoction) is only applicable to patients who are faint, fatigued, have a minute and fine pulse, and suffer from Qi deficiency after massive hematemesis. If Qi is deficient but accompanied by fire, add Tiandong Asparagi Radix (3-4 qian). However, for conditions described earlier such as Yin deficiency with hyperactive fire, tidal fever, night sweats, cough, and rapid pulse, Ren Shen Panax Ginseng Root must not be used. See "Bencao Jiyao" under the entry for Ren Shen. Generally, this disease belongs to fire, and constipation is common; however, diet must be regulated to prevent diarrhea. If Spleen-Stomach Qi is further damaged leading to loose stools, the preceding cold-natured herbs become difficult to use. In such cases, prioritize regulating the Spleen and Stomach using Baizhu Atractylodis Macrocephalae Rhizoma, Fuling Poria, Chenpi Citri Reticulatae Pericarpium, Banxia Pinelliae Tuber, Shenqu Massae Fermentatae Medicamentosa, Maiya Hordei Fructus Germinatus, Gancao Glycyrrhizae Radix et Rhizoma, etc. Once Spleen-Stomach Qi recovers, resume the original disease-specific medications to conclude treatment. Subsequently, Buyin Wan (Nourish Yin Pill) and Ge Kejiu’s Baifeng Gao (White Phoenix Paste) can be taken regularly.