心肺胃之火盛也,其火内炽,烁伤津液,以致口糜龈烂,或有时出血,以甘露饮主之。
甘露饮
生地(三钱) 熟地(三钱) 天冬(三钱) 麦冬(三钱) 石斛(三钱) 甘草(二钱)
枳壳(二钱) 枇杷叶(三钱) 水煎大半杯,温服。
大肠移热于胃,善食而瘦,谓之食亦。又胃移热于胆,亦名食亦,以甘露饮主之。
甘露饮
(方见上)
口渴不止者,为上消也。食入即饥者,为中消也。饮一溲二者,为下消也。其证虽有三,而要总属上
伤燥热,下病湿寒,燥热在肝肺之经,湿寒在脾肾之脏,宜以八味丸主之,或以六
味地黄汤加味主之。如渴欲饮水,水入即吐,小便不利者,以五苓散主之。如上渴而下淋,土湿木郁而
生风燥者,以猪苓汤主之。如饮一溲二,水寒土湿,木气疏泄者,以桂附苓乌汤主之。如脾不能为胃行其
津液,肺不能通调水道,而为消渴者,以理中丸汤,倍白术,加栝蒌根主之。如伤寒消渴,或属阳明
热证,或属厥阴火证,应以伤寒法治之,不在此例。
八味丸
(方见肺气) 酒下十五丸,日再服,不知渐加。
六味地黄加味汤
熟地黄(四钱) 山茱萸(三钱) 山药(三钱) 茯苓(三钱) 丹皮(三钱) 泽泻
(三钱) 五味子(二钱) 肉桂(二钱研) 水煎大半杯,冷服。
五苓散
(方见痰饮)
猪苓汤
(方见痰饮)
桂附苓乌汤
茯苓(三钱) 泽泻(三钱) 桂枝(三钱) 干姜(三钱) 附子(二钱) 龙骨(三钱 研)
牡蛎(三钱 研) 首乌(三钱蒸) 水煎大半杯,温服。
理中丸汤
(方见霍乱)倍白术,加栝蒌根。
消渴方
栝蒌根(三钱) 生姜(二钱) 麦冬(三钱) 芦根(三钱) 白茅根(三钱) 水煎大半杯,温
服。此方专清胃火。
心肺胃之火气亢盛,火热之邪在体内炽烈燃烧,耗伤津液,从而导致口腔黏膜溃烂、牙龈腐烂,有时伴有出血症状,治疗以甘露饮为主方。
甘露饮
生地黄(三钱) 熟地黄(三钱) 天冬(三钱) 麦冬(三钱) 石斛(三钱) 甘草(二钱)
枳壳(二钱) 枇杷叶(三钱) 加水煎煮至大半杯,温服。
大肠的热邪移注于胃,患者食欲旺盛但身体消瘦,这种病症称为“食亦”(一种多食消瘦的病证)。另外,胃的热邪移注于胆,也称为“食亦”,同样以甘露饮为主方治疗。
甘露饮
(方剂见上文)
口渴不止的,属于上消(以上焦肺热为主的消渴病)。进食后很快感到饥饿的,属于中消(以中焦胃热为主的消渴病)。饮水一份而排尿两份的,属于下消(以下焦肾虚为主的消渴病)。虽然症状分为这三种,但其根本原因总归是上部感受燥热之邪,下部病变为湿寒之邪;燥热之邪位于肝、肺经络,湿寒之邪位于脾、肾脏腑。适宜使用八味丸主治,或者使用六味地黄汤加味主治。如果口渴想喝水,但水喝进去后立即呕吐,且小便不通利的,以五苓散主治。如果出现上部口渴而下部淋沥不尽,因土湿木郁而生风燥的,以猪苓汤主治。如果是饮水一份而排尿两份,因水寒土湿、肝木之气疏泄失常的,以桂附苓乌汤主治。如果是脾脏不能为胃传输津液,肺脏不能通调水道,从而引发消渴病的,以理中丸汤为基础,加倍白术用量,并加入栝蒌根主治。如果是伤寒病引发的消渴,可能属于阳明经热证,也可能属于厥阴经火证,应当依据伤寒法治则处理,不在此处讨论的常规范围内。
八味丸
(方剂见肺气章节) 用酒送服十五丸,每日服用两次,若无效则逐渐增加剂量。
六味地黄加味汤
熟地黄(四钱) 山茱萸(三钱) 山药(三钱) 茯苓(三钱) 牡丹皮(三钱) 泽泻(三钱) 五味子(二钱) 肉桂(二钱,研末) 加水煎煮至大半杯,冷服。
五苓散
(方剂见痰饮章节)
猪苓汤
(方剂见痰饮章节)
桂附苓乌汤
茯苓(三钱) 泽泻(三钱) 桂枝(三钱) 干姜(三钱) 附子(二钱) 龙骨(三钱,研末) 牡蛎(三钱,研末) 制何首乌(三钱,蒸制) 加水煎煮至大半杯,温服。
消渴方
栝蒌根(三钱) 生姜(二钱) 麦冬(三钱) 芦根(三钱) 白茅根(三钱) 加水煎煮至大半杯,温服。此方专门用于清泻胃火。
The fire of the Heart, Lung, and Stomach is excessive. The internal blazing heat scorches and injures body fluids, leading to oral ulcers (mouth sores), gingival rotting, and occasional bleeding. Ganlu Yin (Sweet Dew Decoction) is used as the primary formula.
Ganlu Yin (Sweet Dew Decoction)
Sheng Di Huang (Rehmanniae Radix Praeparata, raw Rehmannia root) [Note: Text says Shengdi, usually raw, but context implies nourishing yin. Standard WHO term for Sheng Di Huang is Rehmanniae Radix] - 3 qian
Shu Di Huang (Rehmanniae Radix Praeparata, prepared Rehmannia root) - 3 qian
Tian Dong (Asparagi Radix) - 3 qian
Mai Dong (Ophiopogonis Radix) - 3 qian
Shi Hu (Dendrobii Caulis) - 3 qian
Gan Cao (Glycyrrhizae Radix et Rhizoma) - 2 qian
Zhi Qiao (Aurantii Fructus) - 2 qian
Pi Pa Ye (Eriobotryae Folium) - 3 qian
Decoct with water until half a cup remains, take warm.
When heat from the Large Intestine transfers to the Stomach, causing voracious appetite yet emaciation, it is called Shi Yi (Insatiable Hunger). Furthermore, when heat from the Stomach transfers to the Gallbladder, it is also named Shi Yi. Ganlu Yin (Sweet Dew Decoction) is used as the primary formula.
Ganlu Yin (Sweet Dew Decoction)
(See formula above)
Unceasing thirst characterizes Shang Xiao (Upper Wasting-Thirst). Hunger shortly after eating characterizes Zhong Xiao (Middle Wasting-Thirst). Drinking one part while urinating two parts characterizes Xia Xiao (Lower Wasting-Thirst). Although these symptoms are categorized into three types, they fundamentally belong to dryness-heat injuring the upper jiao and damp-cold affecting the lower jiao. Dryness-heat resides in the meridians of the Liver and Lung, while damp-cold resides in the Zang organs of the Spleen and Kidney. Ba Wei Wan (Eight-Ingredient Pill) should be used as the primary treatment, or Liu Wei Di Huang Tang (Six-Ingredient Pill with Rehmannia) modified. If there is intense thirst with immediate vomiting upon drinking water and difficulty in urination, Wu Ling San (Five-Ingredient Powder with Poria) is indicated. If there is upper thirst accompanied by lower strangury due to earth-dampness and wood-stagnation generating wind-dryness, Zhu Ling Tang (Poria Decoction) is indicated. If drinking one part results in urinating two parts, due to cold-water and earth-dampness with hyperactive Wood Qi dispersing, Gui Fu Ling Wu Tang (Cinnamon, Aconite, Poria, and Fleeceflower Root Decoction) is indicated. If the Spleen fails to transport fluids for the Stomach, and the Lung fails to regulate water passages, resulting in wasting-thirst, Li Zhong Wan Tang (Regulate the Middle Pill Decoction) with doubled Bai Zhu (Atractylodis Macrocephalae Rhizoma) and added Gua Lou Gen (Trichosanthis Radix) is indicated. If wasting-thirst arises from Taiyang Cold Damage, it may belong to Yangming Heat Syndrome or Jueyin Fire Syndrome; these should be treated according to Taiyang Cold Damage protocols and are not covered here.
Ba Wei Wan (Eight-Ingredient Pill)
(See Lung Qi chapter) Take fifteen pills with wine, twice daily. Increase dosage gradually if ineffective.
Liu Wei Di Huang Modified Decoction
Shu Di Huang (Prepared Rehmannia Root) - 4 qian
Shan Zhu Yu (Corni Fructus) - 3 qian
Shan Yao (Dioscoreae Rhizoma) - 3 qian
Fu Ling (Poria) - 3 qian
Dan Pi (Moutan Cortex) - 3 qian
Ze Xie (Alismatis Rhizoma) - 3 qian
Wu Wei Zi (Schisandrae Fructus) - 2 qian
Rou Gui (Cinnamomi Cortex) - 2 qian (powdered)
Decoct with water until half a cup remains, take cold.
Wu Ling San (Five-Ingredient Powder with Poria)
(See Phlegm-Fluids chapter)
Zhu Ling Tang (Poria Decoction)
(See Phlegm-Fluids chapter)
Gui Fu Ling Wu Tang (Cinnamon, Aconite, Poria, and Fleeceflower Root Decoction)
Fu Ling (Poria) - 3 qian
Ze Xie (Alismatis Rhizoma) - 3 qian
Gui Zhi (Cinnamomi Ramulus) - 3 qian
Gan Jiang (Zingiberis Rhizoma) - 3 qian
Fu Zi (Aconiti Lateralis Radix Praeparata) - 2 qian
Long Gu (Fossilia Ossis Mastodi) - 3 qian (powdered)
Mu Li (Concha Ostreae) - 3 qian (powdered)
Shou Wu (Polygoni Multiflori Radix) - 3 qian (steamed)
Decoct with water until half a cup remains, take warm.
Li Zhong Wan Tang (Regulate the Middle Pill Decoction)
(See Cholera chapter) Double the dose of Bai Zhu (Atractylodis Macrocephalae Rhizoma) and add Gua Lou Gen (Trichosanthis Radix).
Xiao Ke Fang (Wasting-Thirst Formula)
Gua Lou Gen (Trichosanthis Radix) - 3 qian
Sheng Jiang (Zingiberis Rhizoma Recens) - 2 qian
Mai Dong (Ophiopogonis Radix) - 3 qian
Lu Gen (Phragmitis Rhizoma) - 3 qian
Bai Mao Gen (Imperatae Rhizoma) - 3 qian
Decoct with water until half a cup remains, take warm. This formula specifically clears Stomach Fire.