归脾汤 此方补养后天第一药。治食少、不眠、怔忡,吐血下血,大便或溏或秘,妄梦
健忘,七情所伤,遗精带浊,及女子不月等证。
炙 (三钱) 人参 白术(蒸) 枣仁(炒黑) 当归身 龙眼肉 茯神(各二钱) 木香(五分)
炙草(一钱) 远志(五分,去心)
水三杯,煎八分,温服。高鼓峰去木香,加白芍一钱五分,甚妙。咳嗽加麦冬二钱,
五味七分。郁气加贝母二钱。脾虚发热加丹皮、栀子。
六味地黄丸 壮水之主,以制阳光。凡一切吐血、下血、咳嗽、不眠、骨蒸、遗精、淋
浊,属于阴虚者,无不统治之。
熟地(八两) 山茱肉(四两) 怀山药(四两) 丹皮 茯苓 泽泻(各三两)
研末,炼蜜为丸,如桐子大,晒干。每服三钱,淡盐汤送下,一日两服。加五味子,名
都气丸;加麦冬,名八仙长寿丸,治咳嗽。本方减两为钱,水煎服,名六味地黄汤。
八味地黄丸 益火之源,以消阴翳。治腰膝无力,饮食不进,肿胀疝瘕,阳痿遗精带浊
,属于元阳虚者,无不统治之。
即六味丸加附子、肉桂各一两。本方去附子,名七味丸,能引火归源;本方去附子,加
五味子,名加减八味丸,治大渴不止。本方加牛膝、车前子,名《济生》肾气丸,俗名《金
匮》肾气丸,治水肿喘促;本方减两为钱,水煎服,名八味汤。
小建中汤(仲景) 此方为治虚痨第一方,今人不讲久矣!凡痨证必有蒸热,此方有姜桂
以扶心阳,犹太阳一出,则爝火无光,即退热法也。凡痨证必饮食日少,此方温脾,即进食
法也。凡痨证必咳嗽,此方补土以生金,即治嗽法也。凡痨证多属肾虚,此方补脾以输精及
肾,所谓精生于谷也。今人不能读仲景书,反敢侮谤圣法,徒知生脉、六味、八味、归脾、
补中,及款冬、贝母、玉竹、百合、苏陈酱、地黄炭之类,互服至死,诚可痛恨!
生白芍(三钱) 桂枝(一钱五分) 炙草(一钱)
加生姜一钱五分,大枣二枚,水二杯,煎八分,入饴糖三钱五分,烊服。加黄 二钱,
名黄 建中汤,治虚痨诸不足;饱闷者,去大枣加茯苓二钱;气逆者,加半夏一钱五分;此
方人参、当归、白术,俱随宜加之。
炙甘草汤(《金匮》) 肺燥、肺痿、咽痛、脉代等证。
生地(四钱) 桂枝木(一钱) 阿胶(一钱五分) 炙草(二钱) 人参(一钱) 麦冬(二钱
五分) 枣仁(原方火麻仁,一钱五分)
加生姜一钱,大枣二枚,水一杯,酒半杯,煎八分服。
清燥救肺汤(喻嘉言) 治燥气郁而成痨。
桑叶(经霜者去蒂,三钱) 人参(一钱) 石膏(二钱三分,研) 杏仁(去皮尖,一钱二分) 甘草
(一钱二分) 麦冬(一钱) 枇杷叶(去毛蜜炙,一钱三分) 黑芝麻(一钱五分,炒研)
水二杯半,煎八分,热服。痰多,加贝母三钱;或加梨汁半盏。
薯蓣丸 (《金匮》) 治虚痨诸不足,风气百疾。
薯蓣(三十分) 当归 桂枝 曲 干地黄 豆黄卷(各十分) 甘草(二十八分) 人参 阿胶(各
七分) 芎 芍药 白术 麦冬 杏仁 防风(各六分) 柴胡 桔梗 茯苓(各五分) 干姜(三分)
白蔹(二分) 大枣(百枚为膏)
上二十一味,末之,炼蜜和丸如弹子大。空腹酒服一丸,一百丸为剂。(分,去声。古以二钱半为一分。)
大黄 虫丸(《金匮》) 治五劳虚极羸瘦,腹满不能饮食,食伤、忧伤、房室伤、饥
伤、劳伤、经络荣卫伤,内有干血,肌肉甲错,目黯黑,缓中补虚。
大黄(十分,蒸) 黄芩(二两) 甘草(三两) 桃仁(一升) 杏仁(一升) 芍药(四两) 干漆(二
两) 干地黄(十两) 虻虫(一升) 水蛭(一百个) 蛴螬(一升) 虫(半升)
上十二味,末之,炼蜜丸如小豆大。酒服五丸,日三服。愚按∶以搜血之品,为补血之
用,仿于《内经》四乌 骨一 茹丸。张路玉以此丸药料及鲍鱼入绒毛鸡腹内,黄
酒、童便煮烂,汁干,将鸡去骨取肉,同诸药悬火上烘干为末,加炼蜜为丸。每服二钱,以
黄酒送下,日三服。代 虫丸甚妥。
归脾汤:此方是补养后天之本的第一要药。用于治疗食欲不振、失眠、心悸怔忡,吐血及便血,大便或稀溏或干结,多梦健忘,七情内伤导致的遗精、白带浑浊,以及女子月经闭止等证候。
配方组成:炙黄芪(三钱)、人参、白术(蒸制)、酸枣仁(炒黑)、当归身、龙眼肉、茯神(各二钱)、木香(五分)、炙甘草(一钱)、远志(五分,去心)。
煎服法:用水三杯,煎至八分满,温服。高鼓峰建议去掉木香,加入白芍一钱五分,效果极佳。若有咳嗽,加麦冬二钱、五味子七分;若有气郁,加贝母二钱;若因脾虚导致发热,加牡丹皮、栀子。
六味地黄丸:通过滋补肾阴(壮水之主)来制约亢盛的阳热(以制阳光)。凡是属于阴虚引起的各种吐血、下血、咳嗽、失眠、骨蒸潮热、遗精、淋浊等症状,无不统摄治疗。
配方组成:熟地黄(八两)、山茱萸(四两)、怀山药(四两)、牡丹皮、茯苓、泽泻(各三两)。
制法与用法:研成细末,用炼蜜制成丸剂,大小如梧桐子大,晒干。每次服用三钱,用淡盐汤送服,每日两次。加入五味子,名为都气丸;加入麦冬,名为八仙长寿丸,用于治疗咳嗽。本方将“两”改为“钱”,用水煎服,名为六味地黄汤。
八味地黄丸:通过温补命门之火(益火之源)来消除阴寒之邪(以消阴翳)。用于治疗腰膝酸软无力、饮食不进、肿胀、疝气瘕块、阳痿、遗精、白带浑浊,凡属于元阳虚衰者,无不统摄治疗。
即六味地黄丸加上附子、肉桂各一两。本方去掉附子,名为七味丸,能引火归源;本方去掉附子,加入五味子,名为加减八味丸,用于治疗大渴不止。本方加入牛膝、车前子,名为《济生》肾气丸,俗称《金匮》肾气丸,用于治疗水肿气喘;本方将“两”改为“钱”,用水煎服,名为八味汤。
小建中汤(张仲景方):此方是治疗虚劳病的第一方,但今人已经很久不讲求了!凡是痨证必然有蒸蒸发热的症状,此方中有生姜、桂枝来扶助心阳,就像太阳出来一样,微弱的火光就失去了光彩,这就是退热的方法。凡是痨证必然饮食日渐减少,此方温补脾胃,就是增进食欲的方法。凡是痨证必然有咳嗽,此方补益脾土以生肺金,就是治疗咳嗽的方法。凡是痨证多属于肾虚,此方补脾以输送精气到肾脏,所谓“精生于谷”。如今的人不能阅读张仲景的书籍,反而敢侮辱诽谤圣人的治法,只知道生脉散、六味地黄丸、八味地黄丸、归脾汤、补中益气汤,以及款冬花、贝母、玉竹、百合、苏陈酱、地黄炭之类的药物,互相服用直到死亡,实在令人痛恨!
配方组成:生白芍(三钱)、桂枝(一钱五分)、炙甘草(一钱)。
煎服法:加入生姜一钱五分、大枣二枚,用水二杯,煎至八分满,加入饴糖三钱五分,烊化后服用。加入黄芪二钱,名为黄芪建中汤,治疗虚劳诸不足;若感到饱闷,去掉大枣,加入茯苓二钱;若有气逆,加入半夏一钱五分;此方中的人参、当归、白术,均可根据情况适当加入。
炙甘草汤(出自《金匮要略》):治疗肺燥、肺痿、咽痛、脉代等证候。
配方组成:生地黄(四钱)、桂枝木(一钱)、阿胶(一钱五分)、炙甘草(二钱)、人参(一钱)、麦冬(二钱五分)、酸枣仁(原方用火麻仁,一钱五分)。
煎服法:加入生姜一钱、大枣二枚,用水一杯、酒半杯,煎至八分满服用。
配方组成:桑叶(经霜后去蒂,三钱)、人参(一钱)、石膏(二钱三分,研碎)、杏仁(去皮尖,一钱二分)、甘草(一钱二分)、麦冬(一钱)、枇杷叶(去毛蜜炙,一钱三分)、黑芝麻(一钱五分,炒后研碎)。
煎服法:用水二杯半,煎至八分满,热服。痰多者,加贝母三钱;或者加梨汁半盏。
薯蓣丸(出自《金匮要略》):治疗虚劳诸不足,以及风气引起的各种疾病。
配方组成:薯蓣(三十分)、当归、桂枝、神曲、干地黄、豆黄卷(各十分)、甘草(二十八分)、人参、阿胶(各七分)、川芎、芍药、白术、麦冬、杏仁、防风(各六分)、柴胡、桔梗、茯苓(各五分)、干姜(三分)、白蔹(二分)、大枣(一百枚,熬膏)。
制法与用法:以上二十一味药,研成细末,用炼蜜调和制成如弹子大小的丸剂。空腹时用酒送服一丸,一百丸为一剂。(注:“分”读去声。古代以二钱半为一分。)
大黄䗪虫丸(出自《金匮要略》):治疗五劳虚极导致的身体消瘦,腹部胀满不能饮食,由食伤、忧伤、房室伤、饥伤、劳伤、经络营卫受伤,体内有干血停滞,皮肤粗糙如鳞甲,眼睛暗黑,具有缓中补虚的功效。
配方组成:大黄(十分,蒸制)、黄芩(二两)、甘草(三两)、桃仁(一升)、杏仁(一升)、芍药(四两)、干漆(二两)、干地黄(十两)、虻虫(一升)、水蛭(一百个)、蛴螬(一升)、䗪虫(半升)。
制法与用法:以上十二味药,研成细末,用炼蜜制成如小豆大小的丸剂。用酒送服五丸,每日三次。我按语认为:以搜逐瘀血的药物,作为补血之用,效法于《内经》中的四乌鲗骨一藘茹丸。张路玉将此丸药的药料及鲍鱼放入绒毛鸡腹内,用黄酒、童便煮烂,汁液收干后,将鸡去骨取肉,同诸药悬挂在火上烘干研为细末,加炼蜜制成丸剂。每次服用二钱,用黄酒送下,每日三次。用䗪虫丸替代非常妥当。
Gui Pi Tang (Obligate Heart Decoction): This formula is the primary remedy for nourishing the Post-Heaven Root (Spleen and Stomach). It treats symptoms such as poor appetite, insomnia, palpitations (Zhen Tong), hematemesis (vomiting blood) and hematochezia (blood in stool), loose or constipated stools, vivid dreams with forgetfulness, damage caused by the Seven Emotions, seminal emission, turbid leukorrhea, and amenorrhea in women.
Ingredients: Zhi Huang Qi (Baked Astragali Radix, 3 qian), Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma, steamed), Zao Ren (Ziziphi Spinosae Semen, stir-fried until black), Dang Gui Shen (Angelicae Sinensis Radix body), Long Yan Rou (Longan Aril), Fu Shen (Poria with Hostwood, each 2 qian), Mu Xiang (Aucklandiae Radix, 0.5 qian), Zhi Cao (Baked Glycyrrhizae Radix et Rhizoma, 1 qian), Yuan Zhi (Polygalae Radix, 0.5 qian, heart removed).
Preparation and Administration: Use three cups of water, decoct until reduced to 0.8 cup, and take warm. Gao Gufeng suggested removing Mu Xiang and adding Bai Shao (Paeoniae Radix Alba, 1.5 qian), which is excellent. For cough, add Mai Dong (Ophiopogonis Tuber, 2 qian) and Wu Wei Zi (Schisandrae Fructus, 0.7 fen); for Qi stagnation, add Bei Mu (Fritillariae Bulbus, 2 qian); for fever due to Spleen deficiency, add Dan Pi (Moutan Cortex) and Zhi Zi (Gardeniae Fructus).
Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill): Strengthens the source of Water (Kidney Yin) to control excessive Yang (Fire). It universally treats all conditions belonging to Yin Deficiency, including hematemesis, hematochezia, cough, insomnia, bone-steaming tidal fever, seminal emission, and stranguria/turbid urine.
Ingredients: Shu Di Huang (Prepared Rehmanniae Radix, 8 liang), Shan Zhu Yu (Corni Fructus, 4 liang), Huai Shan Yao (Dioscoreae Hypoglaucae Rhizoma, 4 liang), Dan Pi (Moutan Cortex), Fu Ling (Poria), Ze Xie (Alismatis Rhizoma, each 3 liang).
Preparation and Administration: Grind into fine powder, mix with refined honey to form pills the size of tung tree seeds, and dry in the sun. Take 3 qian per dose, washed down with light salt soup, twice daily. Adding Wu Wei Zi makes it Du Qi Wan; adding Mai Dong makes it Ba Xian Chang Shou Wan, used for cough. If this formula uses "qian" instead of "liang" and is decocted in water, it is called Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Decoction).
Ba Wei Di Huang Wan (Eight-Ingredient Rehmannia Pill): Benefits the source of Fire (Kidney Yang) to dissipate Yin shadows (Cold/Dampness). It treats weakness in the lower back and knees, loss of appetite, swelling, hernia and masses, impotence, seminal emission, and turbid leukorrhea, universally treating conditions belonging to Yuan Yang (Primordial Yang) Deficiency.
It is Liu Wei Di Huang Wan plus Fu Zi (Aconiti Lateralis Radix Praeparata) and Rou Gui (Cinnamomi Cortex), each 1 liang. Removing Fu Zi from this formula yields Qi Wei Wan, which guides fire back to its source; removing Fu Zi and adding Wu Wei Zi yields Jia Jian Ba Wei Wan, used for unquenchable thirst. Adding Niu Xi (Achyranthis Bidentatae Radix) and Che Qian Zi (Plantaginis Semen) yields Ji Sheng Shen Qi Wan, commonly known as Jin Gui Shen Qi Wan, used for edema and panting; using "qian" instead of "liang" and decocting in water yields Ba Wei Tang.
Xiao Jian Zhong Tang (Minor Construct the Middle Decoction - Zhang Zhongjing): This is the premier formula for treating Xu Lao (Deficiency Consumption), yet it has been neglected by modern practitioners for a long time! All consumption cases must have steaming heat; this formula contains Sheng Jiang (Zingiberis Rhizoma Recens) and Gui Zhi (Cinnamomi Ramulus) to support Heart Yang, just as the rising sun renders weak fires insignificant—this is the method of reducing heat. All consumption cases involve decreasing appetite; this formula warms the Spleen, which is the method of promoting food intake. All consumption cases involve cough; this formula tonifies Earth to generate Metal (Lung), which is the method of treating cough. Most consumption cases belong to Kidney Deficiency; this formula tonifies the Spleen to transport essence to the Kidney, meaning "essence is born from grain." Modern people who cannot read Zhang Zhongjing’s books dare to insult sacred methods, only knowing how to interchangeably use Sheng Mai San, Liu Wei Di Huang Wan, Ba Wei Di Huang Wan, Gui Pi Tang, Bu Zhong Yi Qi Tang, and herbs like Kuan Dong Hua, Bei Mu, Yu Zhu, Bai He, Su Chen Jiang, and Di Huang Tan, taking them until death—this is truly lamentable!
Ingredients: Sheng Bai Shao (Raw Paeoniae Radix Alba, 3 qian), Gui Zhi (Cinnamomi Ramulus, 1.5 qian), Zhi Cao (Baked Glycyrrhizae Radix et Rhizoma, 1 qian).
Preparation and Administration: Add Sheng Jiang (1.5 qian) and Da Zao (Jujubae Fructus, 2 pieces), use two cups of water, decoct to 0.8 cup, add Yi Tang (Maltose, 3.5 qian), melt, and take. Adding Huang Qi (Astragali Radix, 2 qian) makes Huang Qi Jian Zhong Tang, treating various deficiencies in Xu Lao; for fullness/stuffiness, remove Da Zao and add Fu Ling (2 qian); for rebellious Qi, add Ban Xia (Pinelliae Rhizoma, 1.5 qian); Ren Shen, Dang Gui, and Bai Zhu in this formula can be added as appropriate.
Zhi Gan Cao Tang (Baked Licorice Decoction - *Jin Gui Yao Lue*): Treats Lung Dryness, Fei Wei (Flaccidity of the Lung), sore throat, and Dai Mai (Intermittent Pulse).
Ingredients: Sheng Di Huang (Rehmanniae Radix, 4 qian), Gui Zhi Mu (Cinnamomi Ramulus pith, 1 qian), E Jiao (Colla Corii Asini, 1.5 qian), Zhi Cao (Baked Glycyrrhizae Radix et Rhizoma, 2 qian), Ren Shen (Ginseng Radix, 1 qian), Mai Dong (Ophiopogonis Tuber, 2.5 qian), Zao Ren (Ziziphi Spinosae Semen, originally Huo Ma Ren/Semen Cannabis in the original formula, 1.5 qian).
Preparation and Administration: Add Sheng Jiang (1 qian) and Da Zao (2 pieces), use one cup of water and half a cup of wine, decoct to 0.8 cup, and take.
Qing Zao Jiu Fei Tang (Clear Dryness Rescue the Lung Decoction - Yu Jiayan): Treats consumption formed by the stagnation of Dryness Qi.
Ingredients: Sang Ye (Mori Folium, frosted and de-stemmed, 3 qian), Ren Shen (Ginseng Radix, 1 qian), Shi Gao (Gypsum Fibrosum, 2.3 qian, ground), Xing Ren (Armeniacae Semen Amarum, peeled and de-seeded, 1.2 qian), Gan Cao (Licorice Radix et Rhizoma, 1.2 qian), Mai Dong (Ophiopogonis Tuber, 1 qian), Pi Pa Ye (Loquat Leaf, de-hairy and honey-fried, 1.3 qian), Hei Zhi Ma (Sesami Fructus Niger, stir-fried and ground, 1.5 qian).
Preparation and Administration: Use two and a half cups of water, decoct to 0.8 cup, and take hot. For excessive phlegm, add Bei Mu (3 qian); or add Li Zhi (Pear Juice, half zhan).
Shu Yu Wan (Dioscorea Pill - *Jin Gui Yao Lue*): Treats various deficiencies in Xu Lao and hundred diseases caused by Wind Qi.
Ingredients: Shu Yu (Dioscoreae Hypoglaucae Rhizoma, 30 fen), Dang Gui (Angelicae Sinensis Radix), Gui Zhi (Cinnamomi Ramulus), Qu (Medicated Leaven), Gan Di Huang (Rehmanniae Radix), Dou Huang Juan (Sojae Semen Preparatum, each 10 fen), Gan Cao (Licorice Radix et Rhizoma, 28 fen), Ren Shen (Ginseng Radix), E Jiao (Colla Corii Asini, each 7 fen), Xiong (Chuanxiong Rhizoma), Shao Yao (Paeoniae Radix), Bai Zhu (Atractylodis Rhizoma), Mai Dong (Ophiopogonis Tuber), Xing Ren (Armeniacae Semen Amarum), Fang Feng (Saposhnikoviae Radix, each 6 fen), Chai Hu (Bupleuri Radix), Jie Geng (Platycodonis Radix), Fu Ling (Poria, each 5 fen), Gan Jiang (Zingiberis Rhizoma, 3 fen), Bai Lian (Akebiae Caulis, 2 fen), Da Zao (Jujubae Fructus, 100 pieces made into paste).
Preparation and Administration: The above twenty-one ingredients are ground into powder, mixed with refined honey to form pills the size of a bullet. Take one pill with wine on an empty stomach; one hundred pills constitute one course. (Note: "Fen" is pronounced with the departing tone. In ancient times, 2.5 qian equaled one fen.)
Da Huang Zhe Chong Wan (Rhubarb and Ground Beetle Pill - *Jin Gui Yao Lue*): Treats extreme emaciation due to the five labors (Wu Lao), abdominal fullness preventing eating, injuries from diet, emotion, sexual activity, hunger, overwork, and damage to meridians, Ying, and Wei. It addresses internal dry blood, rough skin resembling scales, dark eyes, and provides gentle central tonification and deficiency replenishment.
Ingredients: Da Huang (Rhei Radix et Rhizoma, 10 fen, steamed), Huang Qin (Scutellariae Radix, 2 liang), Gan Cao (Licorice Radix et Rhizoma, 3 liang), Tao Ren (Persicae Semen, 1 sheng), Xing Ren (Armeniacae Semen Amarum, 1 sheng), Shao Yao (Paeoniae Radix, 4 liang), Gan Qi (Dry Lacca, 2 liang), Gan Di Huang (Rehmanniae Radix, 10 liang), Meng Chong (Blatta Orientalis), Shui Zhi (Hirudo, 100 pieces), Qi Cao (Otiorhynchus Larva, 1 sheng), Zhe Chong (Eupolyphaga Seu Steleophaga, 0.5 sheng).
Preparation and Administration: The above twelve ingredients are ground into powder, mixed with refined honey to form pills the size of small beans. Take five pills with wine, three times daily. My commentary: Using blood-searching herbs for blood-tonifying purposes follows the principle of Si Wu Ju Gu Yi Lu Ru Wan from *Nei Jing*. Zhang Luyu suggests placing these herbs and Abalone inside the belly of a downy chicken, boiling with yellow wine and child's urine until dry, removing bones and meat, drying the mixture over fire, grinding to powder, and mixing with refined honey. Take 2 qian with yellow wine, three times daily. Replacing Zhe Chong with other insects is also appropriate.