元仪救肺论超超,贝菀夏蒌力不饶(吴医以清微渣滓之品,文其短拙,不特马元仪一人,
借用还魂(汤)通气道,立看死证起崇朝。
救胃传来理本幽,三承(气汤)四顺(清凉饮)大柴(胡汤)求,阳明气顺针机转,有脚阳春自我留
。
积者,五脏所生,推之不移,属阴;聚者,六腑所成,推之则移,属阳;统以平胃散加
蓄、大麦芽、川芎各等分,木香、沉香各三分之一,大黄酒浸倍用,为末,每服三钱,
姜
汤送下,忌油腻动气之物及房事一月。服药须黄昏,勿食晚饭,大小便见恶物为度。肝积在
左胁下,名“肥气”,去苍术加柴胡、鳖甲、青皮、莪术。肺积在右胁下,名“息贲”,加
白豆蔻、桑白皮、贝母。心积起脐上至心下,大如臂,名“伏梁”,去苍术加肉桂、黄连、
石菖蒲、莪术。脾积在胃脘,腹大如盘坚如石,名“痞气”,照原方不加减。惟肾积发于小
腹,上奔冲心而痛,名“奔豚”,去苍术、大黄、陈皮、麦芽、 蓄,加茯苓为君,肉
桂、
当归、吴茱萸、附子、以楝子、李根白皮为佐,研末,炼蜜为丸,淡盐汤送下。若虚弱之人
,衰其半而止,或以补热佐之。其余热积加芩、连、寒积加姜、桂、附子,酒积加葛根,痰
积加南星、半夏,水积加海藻、猪苓、泽泻,血积加桃仁、红花,肉积加阿魏、山楂,果积
加麝香、草果。
马元仪救治肺部的论述高深莫测,贝母、菟丝子(注:此处原文“贝菀”通常指浙贝母与紫菀,或单指贝母类,结合语境及常见配伍,暂译为贝母与紫菀,但根据后文“贝母”单独出现,此处“贝菀”可能为笔误或特指,依原文直译)、半夏、瓜蒌的力量也不容小觑。吴地医家使用清轻微渣滓的药物来掩饰其短拙之处,这不仅是马元仪一人的做法。借用还魂汤来疏通气道,立刻就能看到危重证候在早晨就得到缓解。
救治胃部的道理原本幽深难测,可以寻求三承气汤、四顺清凉饮和大柴胡汤。阳明经气机顺畅,针刺的时机就会转变,如同有脚的阳春般温暖,由自我留存。
积聚之病,积是五脏所生,推之不移,属于阴;聚是六腑所成,推之则移,属于阳。统用平胃散加瞿麦、大麦芽、川芎各等分,木香、沉香各三分之一,大黄用酒浸制且加倍用量,研为细末,每次服用三钱,用姜汤送服。忌食油腻、动气之物及房事一个月。服药时间须在黄昏,不要食用晚饭,以大小便排出恶物为度。肝积位于左胁下,名为“肥气”,去掉苍术,加入柴胡、鳖甲、青皮、莪术。肺积位于右胁下,名为“息贲”,加入白豆蔻、桑白皮、贝母。心积起于脐上至心下,大如手臂,名为“伏梁”,去掉苍术,加入肉桂、黄连、石菖蒲、莪术。脾积位于胃脘部,腹部大如盘,坚硬如石,名为“痞气”,按照原方不加减。只有肾积发于小腹,向上冲撞心脏而疼痛,名为“奔豚”,去掉苍术、大黄、陈皮、麦芽、瞿麦,加入茯苓为君药,肉桂、当归、吴茱萸、附子,以楝子和李根白皮为佐使药,研为细末,炼蜜为丸,用淡盐汤送服。如果是虚弱的人,剂量减半即止,或者配合补益药物辅助治疗。其余热积加黄芩、黄连,寒积加干姜、肉桂、附子,酒积加葛根,痰积加天南星、半夏,水积加海藻、猪苓、泽泻,血积加桃仁、红花,肉积加阿魏、山楂,果积加麝香、草果。
Ma Yuanyi's treatise on saving the lungs is profound and transcendent; Beimu (Fritillariae Bulbus), Wanhu (Asteris Radix et Rhizoma), Xiaren (Pinelliae Rhizoma), and Gualou (Trichosanthis Fructus) are also potent. Physicians from Wu employ light, clear, and residue-free herbs to mask their shortcomings; this is not unique to Ma Yuanyi alone. Borrowing Huanhun Decoction (Resurrection Soul Decoction) to unblock the airway, one can immediately see critical conditions improve by morning.
The principle of saving the stomach is inherently obscure; one may seek recourse in Chengqi Tang (Three Inheriting Qi Decoctions), Sishun Qingliang Yin (Four Smooth Cooling Drink), and Chaihu Daizhe Tang (Bupleurum Major Combination). When the Qi of the Yangming channel becomes smooth, the timing for acupuncture shifts; like a spring with feet, it remains within oneself.
Ji (accumulations) are generated by the five Zang organs; they are fixed and immovable, belonging to Yin. Ju (gatherings) are formed by the six Fu organs; they move when pushed, belonging to Yang. Generally, use Pingwei San (Calm the Stomach Powder) plus Qumai (Dianthi Herba), Dayamaita (Hordei Fructus Germinatus), and Chuanxiong (Ligustici Chuanxiong Rhizoma) in equal parts; Muxiang (Aucklandiae Radix) and Chenxiang (Aquilariae Lignum Resinatum) in one-third parts each; Dahuang (Rhei Radix et Rhizoma) soaked in wine and doubled in dose. Grind into powder, take 3 qian per dose, delivered with ginger decoction. Avoid greasy, Qi-moving foods and sexual intercourse for one month. Take medicine at dusk, do not eat dinner, and continue until foul matter is expelled in stool or urine. Liver Ji located under the left hypochondrium is named "Feiqi" (Fat Qi); remove Cangzhu (Atractylodis Rhizoma), add Chaihu (Bupleuri Radix), Biejia (Testudinis Carapax et Plastrum), Qingpi (Citri Reticulatae Pericarpium Viride), and Ezhu (Curcumae Rhizoma). Lung Ji located under the right hypochondrium is named "Xiben" (Breath Burden); add Baiddoukou (Amomi Fructus Rotundus), Sangbaipi (Mori Cortex), and Beimu (Fritillariae Bulbus). Heart Ji starts above the umbilicus up to the epigastrium, large as an arm, named "Fuliang" (Hidden Beam); remove Cangzhu, add Rougui (Cinnamomi Cortex), Huanglian (Coptidis Rhizoma), Shichangpu (Acori Tatarinowii Rhizoma), and Ezhu. Spleen Ji is in the epigastrium, abdomen large as a plate, hard as stone, named "Piqi" (Stagnant Qi); follow the original formula without modification. Only Kidney Ji arises in the lower abdomen, rushing upward to strike the heart causing pain, named "Ben Tun" (Running Piglet); remove Cangzhu, Dahuang, Chenpi (Citri Reticulatae Pericarpium), Dayamaita, and Qumai; add Fuling (Poria) as the sovereign herb, Rougui, Danggui (Angelicae Sinensis Radix), Wuzhuyu (Evodiae Fructus), Fuzi (Aconiti Lateralis Radix Praeparata), with Lianzi (Meliae Semen) and Ligengbaipi (Pruni Radicis Cortex) as assistants. Grind into powder, make pills with refined honey, deliver with light salt water. For weak persons, stop when half the dose has been taken, or assist with tonifying heat methods. For remaining Heat Ji, add Huangqin (Scutellariae Radix) and Huanglian; for Cold Ji, add Jiang (Zingiberis Rhizoma), Rougui, and Fuzi; for Wine Ji, add Gegen (Puerariae Lobatae Radix); for Phlegm Ji, add Nanting (Arisaematis Rhizoma Preparatum) and Banxia (Pinelliae Rhizoma); for Water Ji, add Haizao (Sargassum) and Zhuling (Polyporus); for Blood Ji, add Taoren (Persicae Semen) and Honghua (Carthami Flos); for Meat Ji, addawei (Ferulae Resina) and Shanzha (Crataegi Fructus); for Fruit Ji, add Shexiang (Moschus) and Caoguo (Tsaoko Fructus).