治打扑伤损,闪肭疼痛,风湿气痛。
当归 川芎 苍术 香白芷 赤芍药 木鳖子 大黄 草乌头(各五钱) 香油(四两) 沥青(半斤)
松香(半斤) 乳香(另研) 没药(另研,各二钱五分) 前八味同香油四两熬去渣,沥青、松香,
看熬软硬,冬软些,夏硬些,乳香、没药,摊时用之。伤损愈后,肌肤青肿,用茄子种,通黄极大者,切
片一指浓,瓦上焙干,为末,酒调二钱,临睡服,一夜消尽无痕。
肩背痛不可回顾,及脊痛项强,腰似折,项似拔者,此太阳气郁不行,经脉不运也,宜通气防风汤。
因湿热肩背沉重而痛者,当归拈痛汤。因汗出小便数而欠者,此
风热乘脾,脾气郁而肩背痛也,宜升麻柴胡汤。有痰饮流注,肩背作痛,宜导痰汤。有
肾气不循故道,气逆挟背而上,致肩背作痛,宜和气饮,加盐炒小茴香少许。有劳力
或看棋书久坐,而致脊背疼者,补中益气汤或八物汤加黄 。有醉饱后多痛欲捶者,是
脾不能运,而湿热作楚也,宜助脾胜湿,更须节饮。然背者,胸之府,故肺主气而居胸
中,肺气滞则血脉泣,肺气虚,则不能营运阳道,肺中有痰,流注肩背,皆能作胀疼。
一少年新婚且劳,胸间与肩背作痛,脉则右寸关虚大无力,投以补中益气汤,一服减,
二服全愈。
凡臂为风寒湿所搏,或痰流气滞,或提挈重物,皆致臂痛。盖饮伏于内,停滞中
脘,脾主四肢,脾滞而气不下,故上行攻臂而痛,其脉沉细者是也。若因持重劳伤,血
虚不能荣筋,而致臂痛者,其脉必洪大。然有肿者,有不肿者,因于风寒者,五积散加
羌活。因于湿者,蠲痹汤加苍术。因于痰者,导痰汤。因于气者,乌药顺气散。因提
重伤筋者,劫劳散,或和气饮,加姜黄,盖姜黄能入臂故也。若坐卧为风湿所袭,但遇
外寒即痛者,羌活散。若饮酒太过,湿痰流注者。二陈加南星、苍术、桂枝、酒芩。有
血不荣筋者,四物加姜黄、秦艽。有气血凝滞,经络不行所致者,舒筋汤。
东垣曰∶臂痛有六道,各加引经药乃验,以两手伸直垂下,大指居前,小指居后
而定之。前廉痛者,属阳明,以升麻、干葛、白芷行之。后廉痛者,属太阳,以
本、羌活行之。外廉痛者属少阳,以柴胡行之。内廉痛者,属厥阴,以柴胡、青皮行
之。内前廉痛者属太阴,升麻、白芷、葱白行之。内后廉痛者属少阳,细辛、独活行之。
治疗跌打损伤,闪挫疼痛,以及风湿气痛。
当归、川芎、苍术、香白芷、赤芍药、木鳖子、大黄、草乌头(各五钱),香油(四两),沥青(半斤),松香(半斤),乳香(单独研磨),没药(单独研磨,各二钱五分)。前八味药与四两香油一同熬制,去渣后加入沥青和松香,根据软硬程度调整,冬天稍软,夏天稍硬;乳香和没药在摊涂膏药时使用。跌打损伤痊愈后,如果肌肤出现青肿,选用通体金黄且个头极大的茄子种子,切成一指厚的片,在瓦上焙干,研成粉末,用酒调服二钱,临睡前服用,一夜之间即可消除痕迹不留疤痕。
肩背疼痛导致无法回头,以及脊痛项强,腰部像要折断,颈部像被拉扯一样,这是太阳经气郁结不通,经脉运行不畅所致,适宜使用通气防风汤。因湿热导致肩背沉重而疼痛的,使用当归拈痛汤。因出汗且小便频数并伴有哈欠的,这是风热侵袭脾脏,脾气郁结导致肩背疼痛,适宜使用升麻柴胡汤。有痰饮流注导致肩背作痛的,适宜使用导痰汤。肾气不循常道,气逆挟带背部向上,导致肩背作痛的,适宜使用和气饮,加少许盐炒小茴香。因劳累用力或下棋久坐导致脊背疼痛的,使用补中益气汤或八物汤加黄柏。醉酒后饱食后多痛欲捶打的,是脾不能运化,湿热作祟所致,应当助脾胜湿,并且必须节制饮酒。然而背部是胸部的府库,所以肺主气而居于胸部,肺气滞涩则血脉凝泣,肺气虚弱,则不能营运阳道,肺中有痰,流注于肩背,都能导致胀疼。有一个少年新婚且劳累,胸部与肩背作痛,脉象右寸关虚大无力,投以补中益气汤,一服减轻,二服全愈。
凡是手臂为风寒湿邪所搏结,或者痰流气滞,或者提挈重物,都会导致臂痛。大概是因为饮食停滞于内,阻滞在中脘,脾主四肢,脾滞则气不下行,反而上行攻冲手臂导致疼痛,其脉象沉细的就是这种情况。如果是因持重劳伤,血虚不能濡养筋脉,而导致臂痛的,其脉象必定洪大。然而有的肿胀,有的不肿胀,因风寒引起的,用五积散加羌活。因湿气引起的,用蠲痹汤加苍术。因痰湿引起的,用导痰汤。因气滞引起的,用乌药顺气散。因提举重物严重伤筋的,用劫劳散,或者和气饮加姜黄,因为姜黄能入臂的缘故。如果坐卧时被风湿所侵袭,只要遇到外寒就疼痛的,用羌活散。如果饮酒太过,湿痰流注的,用二陈汤加南星、苍术、桂枝、酒黄连。有血不荣养筋脉的,用四物汤加姜黄、秦艽。有气血凝滞,经络不行所致的,用舒筋汤。
李东垣说:臂痛有六道,各加引经药才有效,方法是两手伸直垂下,大拇指在前,小指在后来确定。前缘疼痛的,属于阳明经,用升麻、干葛、白芷作为引经药。后缘疼痛的,属于太阳经,用藁本、羌活作为引经药。外侧缘疼痛的,属于少阳经,用柴胡作为引经药。内侧缘疼痛的,属于厥阴经,用柴胡、青皮作为引经药。内侧前缘疼痛的,属于太阴经,用升麻、白芷、葱白作为引经药。内侧后缘疼痛的,属于少阳经(注:此处原文有误,通常内侧后缘属太阳或少阳争议,但依原文翻译),用细辛、独活作为引经药。
Treats contusions and sprains, sudden strain pain, and wind-dampness qi pain.
Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Cangzhu (Atractylodis Rhizoma), Xiangbaizhi (Angelicae Dahuricae Radix), Chishao (Paeoniae Radix Rubra), Mubiezi (Strychni Semen), Dahuang (Rhei Radix et Rhizoma), Caowutou (Aconiti Kusnezoffii Radix) (each 5 qian), Xiangyou (Sesame Oil), Qingshui (Asphaltum), Songxiang (Rosin), Ruxiang (Olibanum, ground separately), Moyao (Myrrha, ground separately, each 2.5 qian). The first eight herbs are boiled together with 4 liang of sesame oil until the dregs are removed. Then add Qingshui and Songxiang, adjusting the consistency according to temperature: softer in winter, harder in summer. Ruxiang and Moyao are added when applying the plaster. After contusions heal, if the skin shows bruising and swelling, select large, entirely yellow eggplant seeds, slice them to the thickness of a finger, bake them on tiles until dry, grind into powder, mix with wine, take 2 qian before sleep, and it will disappear overnight without a trace.
Shoulder and back pain so severe that one cannot turn the head, along with spinal pain and neck stiffness, where the waist feels like breaking and the neck feels like being pulled, is caused by stagnation of Taiyang Qi and failure of meridians to circulate. Tongqi Fangfeng Tang is appropriate. For shoulder and back heaviness and pain due to damp-heat, Danggui Jiantong Tang is indicated. For sweating, frequent urination, and yawning, this is wind-heat attacking the Spleen, causing Spleen Qi stagnation leading to shoulder and back pain; Shengma Chaihu Tang is suitable. For shoulder and back pain caused by phlegm-fluid retention flowing into the area, Daotan Tang is appropriate. When Kidney Qi does not follow its normal path, and rebellious Qi carries upward along the back causing shoulder and back pain, Heqi Yin is used, with a small amount of salt-fried Huixiang (Foeniculi Fructus). For spinal and back pain caused by physical labor or prolonged sitting while reading chess books, Buzhong Yiqi Tang or Bawu Tang plus Huangbo (Phellodendri Cortex) is prescribed. For excessive pain after drunkenness and overeating, wanting to be beaten, this is Spleen failing to transform and damp-heat causing discomfort; one should strengthen the Spleen to overcome dampness and must moderate alcohol intake. However, the back is the mansion of the chest; thus, the Lung governs Qi and resides in the chest. Lung Qi stagnation causes blood vessels to congeal; Lung Qi deficiency fails to circulate Yang pathways; phlegm in the Lung flowing to the shoulder and back can all cause distension and pain. A young man who was newly married and fatigued suffered from chest and shoulder/back pain; his pulse at the Right Cun and Guan positions was deficient, large, and powerless. He was given Buzhong Yiqi Tang; symptoms reduced after one dose and resolved completely after two doses.
Whenever arms are attacked by wind-cold-dampness, or due to phlegm flow and Qi stagnation, or lifting heavy objects, arm pain results. Generally, food stagnates internally, blocking the Zhongwan area. The Spleen governs the four limbs; Spleen stagnation prevents Qi from descending, so it attacks the arms upwards causing pain, characterized by a deep and fine pulse. If arm pain is due to heavy lifting and injury, with Blood deficiency failing to nourish tendons, the pulse must be flooding and large. Some cases present with swelling, others without. For those caused by wind-cold, Wuji San plus Qianghuo is used. For those caused by dampness, Juanbi Tang plus Cangzhu is used. For those caused by phlegm, Daotan Tang is used. For those caused by Qi stagnation, Wuyao Shunqi San is used. For severe tendon injuries from lifting, Ji Lao San or Heqi Yin plus Jianghuang (Curcumae Longae Rhizoma) is used, because Jianghuang enters the arm channels. If sitting or lying down exposes one to wind-dampness, causing pain only upon exposure to external cold, Qianghuo San is indicated. If excessive drinking leads to damp-phlegm retention, Erchen Tang plus Nanxing (Arisaematis Rhizoma Preparatum), Cangzhu, Guizhi (Cinnamomi Ramulus), and Jiu Huangqin (Scutellariae Radix prepared with wine) is prescribed. For cases where Blood fails to nourish tendons, Siwu Tang plus Jianghuang and Qinjiao (Gentianae Macrophyllae Radix) is used. For cases caused by Qi and Blood stagnation and meridian obstruction, Shujin Tang is indicated.
Li Dongyuan stated: There are six pathways for arm pain, and adding guiding herbs to each yields verification. Extend both hands downwards, with the thumb forward and little finger backward to determine the location. Pain on the anterior margin belongs to the Yangming channel; use Shengma (Cimicifugae Rhizoma), Gange (Puerariae Lobatae Radix), and Baizhi (Angelicae Dahuricae Radix) as guides. Pain on the posterior margin belongs to the Taiyang channel; use Gaoben (Ligustici Jingweii Rhizoma) and Qianghuo (Notopterygii Rhizoma et Radix) as guides. Pain on the lateral margin belongs to the Shaoyang channel; use Chaihu (Bupleuri Radix) as a guide. Pain on the medial margin belongs to the Jueyin channel; use Chaihu and Qingpi (Citri Reticulatae Pericarpium Viride) as guides. Pain on the anterior-medial margin belongs to the Taiyin channel; use Shengma, Baizhi, and Congbai (Allii Fistulosi Bulbus) as guides. Pain on the posterior-medial margin belongs to the Shaoyang channel [Note: Text says Shaoyang, typically associated with Taiyang or Shaoyin in other contexts, but translating strictly]; use Xixin (Asari Radix et Rhizoma) and Duhuo (Angelicae Pubescentis Radix) as guides.