论
《内经》曰∶饮食饱甚,汗出于胃。惊而夺精,汗出于心。持重远行,汗出于肾。疾走恐惧,汗出于肝。摇体劳苦,
汗出于脾。又曰∶久视伤血,久卧伤气,久坐伤肉,久立伤骨,久行伤筋。若夫七情五志之火飞越,男女声色之欲过淫,
是皆虚损之所由也。《机要》曰∶虚损之疾,寒热因虚而感也。感寒则损阳,阳虚则阴盛,损自上而下,一损损于肺,
皮聚而毛落,二损损于心,血脉虚少,不能荣于脏腑,妇人则月水不通,三损损于胃,饮食不为肌肤,治宜以辛甘淡,
过于胃则不可治矣。感热则损阴,阴虚则阳盛,损自下而上,一损损于肾,骨痿不能起于床,二损损于肝,筋缓不能自
收持,三损损于脾,饮食不能消克,治宜以苦酸咸,过于脾则不可治矣。又曰∶心肺损而色弊,肾肝损而形痿。《难经》
曰∶治损之法,损其肺者益其气,损其心者补其荣血,损其脾者调其饮食,适其寒温,损其肝者缓其中,损其肾者益其
精。是皆虚损病因治法之大要也,学人详之。
脉法
《脉经》曰∶脉来软者为虚。缓者为虚。微者为虚。弱者为虚。弦者为中虚。
脉来细而微者,血气俱虚。脉小者,血气俱少。
《要略》曰∶脉芤者,为血虚。脉沉小迟者,脱气。又曰∶血虚,脉大如葱管。又曰∶脉大而芤者,脱血。
方法
丹溪曰∶天为阳而运于地之外,地为阴而居乎天之中,天之大气举之。日,实也,属阳而运于月之外;月,缺也,
属阴,禀日之光以为明。人受天地之气以生,天之阳气为气,地之阴气为血,故阳常有余而阴常不足,气常有余而血常
不足也。又曰∶经曰精不足者补之以味,味阴也,补精以阴,求其本也。然味乃如谷菽果菜,出于天赋自然冲和之味,
故有食人补阴之功,非醯酱烹饪调和偏浓之味,出于人为者也。经曰阴之所生,本在五味,非天赋之味乎。曰阴之五宫,
伤在五味,非人为之味乎。善摄生者,不可谓味以补精,而遂恣于口腹,以自速其祸也。又曰∶形不足者,温之以气。
温,养也,温存以养,使气自充,气充则形完矣,曰补曰温,各有其旨。局方悉以温热药佐辅,名曰温补,岂理也哉。
又曰∶人年老或虚损,精血俱耗,阴不足以配阳,孤阳几于飞越,天生胃气尚尔留连,又借水谷之阴,故羁縻而定耳。
局方用温剂劫虚,盖脾胃得温而食进,故亦暂可。夫质有浓薄,病有浅深,设或失手,何以收救。吾宁稍迟,计出万全,
温剂补虚,决不敢用。
(以上丹溪方法凡一条)
丹溪治老人虚损,但觉小水短少,即是病进,宜以人参、白术为君,牛膝、芍药为臣,陈皮、茯苓为佐,春加川芎,
夏加黄芩、麦门冬,秋冬加当归身,倍生姜,一日或一帖或二帖,小水之长若旧乃止,此老人养生之捷法也。(此丹溪养
母之方也。)
四君子汤(局方) 治气虚。
人参(一钱五分) 白术 茯苓(各二钱) 甘草(一钱)
上细切,作一服,水煎。如自汗或小水利者,去茯苓,加黄 二钱。无汗、小水不利者,只根据本方。
四物汤(局方) 治血虚。
川归(二钱) 川芎 芍药(各一钱五分) 熟地黄(二钱)
上细切,作一服,水煎服。春倍川芎,夏倍芍药,秋倍地黄,冬倍当归。
八物汤 治气血两虚。
四君子合四物汤共为一剂,如上法加减煎服。
六君子汤 治气虚挟痰。(方见HT 逆门。)
十全大补汤(局方) 治气血俱虚而挟寒者。
人参 黄 甘草 白茯苓 当归 白术 白芍药 肉桂 熟地黄 芎 (各等分)
上细切,每服一两重,加生姜三片,大枣一枚,水二大盏,煎至─盏,温服。(加减法宜详前论。)
大补阴丸 降阴火,补肾水。
黄柏(盐酒拌,新瓦上炒褐色) 知母(去毛酒拌湿炒,各四两) 熟地黄(须用怀庆者佳。酒洗焙干用) 龟板
(酥炙黄,各六两)
上为细末,猪脊骨髓和炼蜜为丸,如梧桐子大,每服五十丸,空心姜盐汤下。
补阴丸(一名虎潜丸)(丹溪)
黄柏(半斤,如前制) 知母(去毛,酒制炒) 熟地黄(各三两) 龟板(酥炙,四两) 白芍药(煨) 陈皮 牛
膝(各二两) 虎胫骨(一两) 琐阳(酥炙) 当归(各一两五钱)
上为细末,酒煮羯羊肉为丸,盐汤下。冬,加干姜五钱。
加味虎潜丸(丹溪)
人参 黄 芍药(煨) 黄柏(盐酒炒) 当归(酒洗) 山药(各一两) 琐阳(酥炙) 枸杞子 虎胫骨(酥
炙) 菟丝子(盐酒浸三宿,细研焙干,入诸药再研) 龟板(酥炙) 破故纸(炒) 杜仲(姜汁拌炒丝断) 五味
子(各七钱五分) 牛膝(去芦,酒洗,二两) 熟地黄(四两)
上为细末,炼蜜和猪脊骨髓为丸,如梧桐子大,每服五、六十丸,温酒或姜盐汤下。
滋阴大补丸(丹溪)
川牛膝(去芦) 山药(各一两五钱) 杜仲(姜汁拌炒丝断) 巴戟(去心) 山茱萸(去核) 肉苁蓉(酒浸
洗新瓦上焙干) 五味子 白茯苓(去皮) 茴香(炒) 远志(去心,甘草同煮,各一两) 石菖蒲 枸杞子(各五
钱) 熟地黄(二两)
上为细末,红枣肉和炼蜜为丸,如梧桐子大,每服七十丸,淡盐汤或温酒空心下。与上虎潜丸相间服之,佳。所谓
补阴和阳,生血益精,润肌肤,强筋骨,性味清而不寒,温而不热,非达造化之精微者,未足以议于斯也。
补肾丸(丹溪)
黄柏 龟板(各二两) 杜仲(各根据前制) 牛膝 陈皮(各二两) 干姜(五钱,冬加) 五味子(二钱,冬用
一两)
上为细末,姜汁糊或酒糊为丸服,温酒或白汤空心下。
补天丸
紫河车(一具,即产孩胞衣也。古方不分男女。世传男用女胎、女用男胎者,俱以初胎者为胜,似为有理。若不可
得,但求肥盛无病妇人者,俱可用。初取得,长流水洗净,去筋膜,以篾笼盛之,外以纸糊,使不泄气,焙干,要用时,
以米醋浸一宿,焙干用)
上以前补肾丸药为末,同河车再研极细,酒糊为丸。或新取紫河车蒸熟,同前药末捣烂为丸亦可。
虚劳者,当以骨蒸药佐之。一云∶气虚加补气药,血虚加补血药。
一方 用侧柏叶、乌药叶,俱以酒浸,九蒸九曝,亦同紫河车为丸,名补肾丸。
六味地黄丸(局方) 治肾经虚损,久新憔悴,盗汗发热,五脏齐损,瘦弱虚烦,骨蒸痿弱,下血咯血等证。
干山药 山茱萸(去核,各四两) 泽泻(去毛) 牡丹皮 白茯苓(各三两) 熟地黄(八两)
上为细末,炼蜜为丸,如梧桐子大,每服五十丸,白汤下。
人参固本丸(局方)
天门冬(去心) 麦门冬(去心) 生地黄(各二两) 人参(去芦,一两) 熟地黄(二两)
上各焙干,同磨为末,勿犯铁器,炼蜜为丸。或只以天门冬、熟地黄二味,量酒浸捣膏,同三味末,杵千余下,丸
如梧桐子大,每服五、七十丸,空心姜盐汤下。忌萝卜。
人参膏(丹溪)
人参一味,不拘多少,去芦细切,量水于银石器内,慢火煎如稠饧,瓷器盛贮,每服一、二匙,白汤点服。
补中益气汤(东垣) 治饮食失节,劳役所伤,暴伤元气,恶寒发热,证似伤寒者。(方见内伤门。)
益胃升阳汤(东垣) 血脱益气,古圣人之法也,先补胃气,以助生发之气,故曰阳生阴长,诸甘药为之先务,
举世皆以为补,殊不知甘能生血,从阳而引阴也,故先理胃气,盖人之身谷为宝也。
柴胡 升麻(各二分五厘) 当归身(酒洗) 炙甘草 陈皮(各五分) 人参(久嗽不用) 炒神曲(各七分五
厘) 黄 (一钱,蜜炙) 白术(一钱五分) 生黄芩(二分)
上细切,作一服,水二盏,煎至一盏,温服。如腹中痛,每服加白芍药五分,中桂二分。如渴或口燥,加葛根三分。
附汤(严氏) 治阴虚气弱,虚汗大出不止,肢体倦怠。
川附子(炮) 黄 (蜜炙,各二钱)
上细切,作一服,加生姜三片,大枣二枚,水一盏半,煎至一盏,温服。
参附汤(严氏) 治真阳虚乏,上气喘息,自汗盗汗,短气,头旋眼花。
人参(五钱) 川附子(炮去皮脐,一两)
上细切,分作三服,加姜水煎,温服。
茯神汤(济生) 治六脉虚软,咳则心痛,喉仲介介,或肿或痛。
茯神 人参 远志 通草 麦冬(去心) 黄 (蜜炙) 桔梗(各六分) 甘草 五味子(各三分)
上细切,作一服,加生姜一片,水煎服。
补气汤(瑞竹堂方) 治气虚,脉浮而软,怔忡无时。
黄 (二分,一本作二钱) 人参 甘草(各一钱) 麦门冬(去心) 桔梗(去芦,各七分)
上细切,作一服,加生姜三片,水二盏,煎至一盏,温服。
延寿丹(千金) 治诸虚百损,怯弱欲成痨瘵,及大病后虚损不复。凡人于中年后常服,可以却疾延年。
五味子 菟丝子(煮烂,另研) 川牛膝 杜仲(姜汁拌炒丝断) 川归(酒浸) 山药 天门冬 麦门冬(去心)
生地黄 熟地黄(各一两) 肉苁蓉(二两) 人参 白茯苓 大茴香 泽泻 地骨皮 鹿茸 菖蒲(九节者) 花椒 巴
戟(去心) 远志(去心) 覆盆子(炒去汁) 枸杞子 柏子仁(各五钱)
上共磨为细末,勿犯铁器蒸捣,炼蜜为丸,如梧桐子大,每服一百丸,空心温酒或姜盐汤下。如大便溏、小便不利,
加车前子二两。如精滑或梦遗,加赤石脂、山茱萸肉各五钱。忌萝卜菜。
斑龙丸(青囊集方) 治真阴虚损,老人虚人常服,延年益寿。
鹿角胶(炒成珠子) 鹿角霜 菟丝子(酒浸研细) 柏子仁(取仁洗净) 熟地黄(各半斤) 白茯苓 补骨脂
(各四两)
上磨为细末,酒煮米糊为丸,或以鹿角胶入好酒烊化为丸,如梧桐子大,每服五十丸,空心姜盐汤下,昔蜀中有一
老人货此药于市,自云寿三百八十岁矣,每歌曰∶尾闾不禁沧海竭,九转金丹都谩说,惟有斑龙顶上珠,能补玉堂关下
阙。当时有学其道者,传得此方。
桂枝加龙骨牡蛎汤(仲景) 治六脉芤动微紧,男子失精,女人梦交,及盗汗自汗等证。
桂枝 白芍药(各三钱) 甘草(炙,二钱) 龙骨 牡蛎(各三钱)
上细切,加姜枣,水煎(愚恐此证不可用姜)。
(祖传方)
治心虚手振。
川归身(一两五钱) 川芎(一两) 粉甘草(一两五钱) 生地黄(一两五钱) 远志(去心,二两五钱) 酸
枣仁 柏子仁(各三两) 人参(一两) 辰砂(五钱另研) 金箔(二十斤) 麝香(一钱) 琥珀(三钱) 茯神
(七钱) 胆南星(五钱) 半夏(五钱) 石菖蒲(六钱)
上为极细末,蒸饼为丸,如绿豆大,辰砂为衣,每服七、八十丸,津唾咽下,或姜汤送下。
(医案)
本邑在城金儒元,国子生也,年五十余,身略瘦,十年前得内伤挟外感证,一医用发表疏利之剂,十数日后,热虽
退而虚未复,胸中痞满,气促眩运,召予治。以补中益气汤,间与东垣消痞丸、陈皮枳术丸等药调理而安,但病根未尽
除而住药,故眩运或时而举,不甚重来。延至此年,因往杭城跋涉辛苦,而兼色欲之过,还家眩运大作。历数医,皆与
防风、羌活、荆芥、南星、半夏、苍术等去风散湿消痰之剂,病愈重,一日十数次厥去,片时夏苏,凡动或转侧,即厥
不知人事。举家徨徨叫哭,召予治,诊其六脉皆浮洪而濡。予晓之曰∶此气血大虚证,幸脉不数而身无大热,不死。但
恐病愈后,而有数年不能下榻行动。病者曰∶只要有命,卧亦甘心。与大补气血之药,倍人参、黄 ,或加附子引经,
合大剂一日三帖,又煎人参膏及作紫河车丸、补阴丸之类间服,如此调理二月余,服煎药二百余帖,丸药三、五料,用
人参五六斤,其证渐不厥,饮食如故,但未能行动耳。次年闻王布政汝言往京师,道经兰溪,以舟载去彼,俟候求诊。
王公曰∶此证阴虚,风痰上壅,因误服参、 多,故病久不愈。立方以天麻、菊花、荆芥、川芎等清上之药,亦未见效,
住药。后越五、六年,方得起而步履如初。儒元不思昔日病剧而借参、 等药之功,遂以王公之语,归咎于予用药之误。
噫!彼时若非峻补,何以得一儒元见王公耶。呜呼!此诚得鱼忘筌、得兔忘蹄也,可胜叹哉。
东阳邑庠邹掌教先生一证,发大汗战,鼓栗振掉,片时许,发燥热,身如火烧,又片时许,出大汗如雨,身体若冰
冷而就发寒战如前,寒后有热,热后有汗,三病继作而昼夜不息。庠生卢明夫与作疟症治,不效。召予,诊其右手阳脉
数而浮洪无力,阴脉略沉小而亦虚,左三部比右差小而亦浮软。予曰∶此阳虚证也。用补中益气汤,倍参、 ,减升、
柴一半,加尿浸生附子一钱半,炒黄柏三分,干姜、薄桂各五分,大枣一枚,同煎服。一服而病去三分,二服而减半,
四服寒热止而身尚有微汗,减去桂、附、干姜一半,服二帖全愈。
论
《黄帝内经》说:饮食过饱,汗液从胃排出。受惊导致精气耗散,汗液从心排出。背负重物远行,汗液从肾排出。急速奔跑且恐惧,汗液从肝排出。身体摇动过度劳累,汗液从脾排出。又说:长时间用眼伤血,长时间卧床伤气,长时间坐着伤肉,长时间站立伤骨,长时间行走伤筋。至于七情(喜、怒、忧、思、悲、恐、惊)和五志(心之志为喜,肝之志为怒,肺之志为悲,肾之志为恐,脾之志为思)之火飞越妄动,男女声色欲望过度淫逸,这些都是导致虚损的原因。《医学机要》说:虚损的疾病,是因为正气虚弱而感受寒热邪气所致。感受寒邪则损伤阳气,阳气虚则阴气盛,病变自上而下发展,一损损伤于肺,表现为皮毛枯槁脱落;二损损伤于心,表现为血脉虚少,不能滋养脏腑,妇女则月经不通;三损损伤于胃,表现为饮食不能化为肌肉,治疗宜用辛、甘、淡味药,如果病势超过胃的层次,就不可治了。感受热邪则损伤阴气,阴气虚则阳气盛,病变自下而上发展,一损损伤于肾,表现为骨痿不能起床;二损损伤于肝,表现为筋缓不能自我收持;三损损伤于脾,表现为饮食不能消化,治疗宜用苦、酸、咸味药,如果病势超过脾的层次,就不可治了。又说:心肺受损则面色败坏,肾肝受损则形体痿弱。《难经》说:治疗虚损的方法,损伤肺的益其气,损伤心的补其营血,损伤脾的调理饮食,适应寒温,损伤肝的舒缓其中气,损伤肾的益其精。这些都是虚损病因和治疗方法的概要,学习的人要详细研究。
脉法
《脉经》说:脉象来势柔软的是虚证。迟缓的是虚证。微细的是虚证。微弱的是虚证。弦硬的是中气虚。
《金匮要略》说:脉象芤(中空如葱管)的,是血虚。脉象沉小迟的,是脱气。又说:血虚,脉象大如葱管。又说:脉象大而芤的,是失血。
方法
朱丹溪说:天属阳而在地的外围运转,地属阴而在天的中间居处,天的大气托举着地。日,是实体的,属阳而在月的外围运转;月,是缺损的,属阴,禀受日光才明亮。人承受天地之气而生,天的阳气成为人的气,地的阴气成为人的血,所以阳常有余而阴常不足,气常有余而血常不足。又说:经典说精气不足的用厚味来补,厚味属阴,用阴来补精,是寻求根本。然而厚味是指谷物、豆类、水果、蔬菜,出于天赋自然冲和的味道,所以有食入补阴的功效,不是醋酱烹饪调和偏浓的味道,那是人为制作的。经典说阴的生成,根本在于五味,这不是天赋的味道吗?说阴的五脏,伤害在于五味,这不是人为的味道吗?善于养生的人,不能说味道能补精,就放纵口腹之欲,加速灾祸。又说:形体不足的,用气来温养。温,就是养,温和地养护,使气自然充盈,气充盈则形体完备了,说补说温,各有深意。局方(宋代官方颁行的方书)全都用温热药辅助,名叫温补,这符合道理吗?又说:人年老或患虚损,精血都耗竭,阴不足以配阳,孤阳几乎飞越,天生的胃气尚且留恋,又借助水谷的阴气,所以羁留约束而定住。局方用温剂劫夺虚损,大概脾胃得到温暖而进食增加,所以暂时也可以。但体质有浓薄之分,病情有浅深之别,假如失误,怎么挽救。我宁愿稍慢,计出万全,温剂补虚,坚决不敢用。
(以上丹溪的方法共一条)
丹溪治疗老人虚损,只要觉得小便短少,就是病情进展,宜用人参、白术为君药,牛膝、芍药为臣药,陈皮、茯苓为佐药,春季加川芎,夏季加黄芩、麦门冬,秋冬加当归身,加倍生姜,一天服一帖或两帖,小便通畅如旧才停止,这是老人养生的捷径。(这是丹溪供养母亲的方子。)
四君子汤(出自局方) 治疗气虚。
人参(一钱五分) 白术 茯苓(各二钱) 甘草(一钱)
以上切碎,作一服,水煎。如果自汗或小便利的,去掉茯苓,加黄芪二钱。无汗、小便不利的,只依据本方。
四物汤(出自局方) 治疗血虚。
川归(二钱) 川芎 芍药(各一钱五分) 熟地黄(二钱)
以上切碎,作一服,水煎服。春季加倍川芎,夏季加倍芍药,秋季加倍地黄,冬季加倍当归。
八物汤 治疗气血两虚。
四君子汤合四物汤共为一剂,按上述方法加减煎服。
十全大补汤(出自局方) 治疗气血俱虚而挟寒者。
人参 黄芪 甘草 白茯苓 当归 白术 白芍药 肉桂 熟地黄 川芎(各等分)
以上切碎,每服一两重,加生姜三片,大枣一枚,水两大盏,煎至一盏,温服。(加减法详见前文论述。)
大补阴丸 降阴火,补肾水。
黄柏(盐酒拌,新瓦上炒褐色) 知母(去毛酒拌湿炒,各四两) 熟地黄(须用怀庆产的为佳。酒洗焙干用) 龟板(酥炙黄,各六两)
以上研为细末,猪脊骨髓和炼蜜为丸,如梧桐子大,每服五十丸,空心姜盐汤送下。
补阴丸(一名虎潜丸)(丹溪制)
黄柏(半斤,如前法制) 知母(去毛,酒制炒) 熟地黄(各三两) 龟板(酥炙,四两) 白芍药(煨) 陈皮 牛膝(各二两) 虎胫骨(一两) 琐阳(酥炙) 当归(各一两五钱)
以上研为细末,酒煮羯羊肉为丸,盐汤送下。冬季,加干姜五钱。
加味虎潜丸(丹溪制)
人参 黄芪 芍药(煨) 黄柏(盐酒炒) 当归(酒洗) 山药(各一两) 琐阳(酥炙) 枸杞子 虎胫骨(酥炙) 菟丝子(盐酒浸三宿,细研焙干,入诸药再研) 龟板(酥炙) 破故纸(炒) 杜仲(姜汁拌炒丝断) 五味子(各七钱五分) 牛膝(去芦,酒洗,二两) 熟地黄(四两)
以上研为细末,炼蜜和猪脊骨髓为丸,如梧桐子大,每服五、六十丸,温酒或姜盐汤送下。
滋阴大补丸(丹溪制)
川牛膝(去芦) 山药(各一两五钱) 杜仲(姜汁拌炒丝断) 巴戟(去心) 山茱萸(去核) 肉苁蓉(酒浸洗新瓦上焙干) 五味子 白茯苓(去皮) 茴香(炒) 远志(去心,甘草同煮,各一两) 石菖蒲 枸杞子(各五钱) 熟地黄(二两)
以上研为细末,红枣肉和炼蜜为丸,如梧桐子大,每服七十丸,淡盐汤或温酒空心送下。与上方虎潜丸交替服用,佳。所谓补阴和阳,生血益精,润肌肤,强筋骨,性味清而不寒,温而不热,不是通达造化精微的人,不足以议论此方。
补肾丸(丹溪制)
黄柏 龟板(各二两) 杜仲(各根据前法制) 牛膝 陈皮(各二两) 干姜(五钱,冬季加) 五味子(二钱,冬季用一两)
以上研为细末,姜汁糊或酒糊为丸服,温酒或白开水空心送下。
补天丸
紫河车(一具,即产孩胞衣也。古方不分男女。世传男用女胎、女用男胎者,俱以初胎者为胜,似为有理。若不可得,但求肥盛无病妇人者,俱可用。初取得,长流水洗净,去筋膜,以篾笼盛之,外以纸糊,使不泄气,焙干,要用时,以米醋浸一宿,焙干用)
以上述补肾丸药为末,同河车再研极细,酒糊为丸。或新取紫河车蒸熟,同前药末捣烂为丸亦可。
虚劳者,当以骨蒸药佐之。一说:气虚加补气药,血虚加补血药。
一方 用侧柏叶、乌药叶,俱以酒浸,九蒸九晒,亦同紫河车为丸,名补肾丸。
六味地黄丸(出自局方) 治疗肾经虚损,久新憔悴,盗汗发热,五脏齐损,瘦弱虚烦,骨蒸痿弱,下血咯血等证。
干山药 山茱萸(去核,各四两) 泽泻(去毛) 牡丹皮 白茯苓(各三两) 熟地黄(八两)
以上研为细末,炼蜜为丸,如梧桐子大,每服五十丸,白开水送下。
人参固本丸(出自局方)
天门冬(去心) 麦门冬(去心) 生地黄(各二两) 人参(去芦,一两) 熟地黄(二两)
以上各焙干,同磨为末,勿犯铁器,炼蜜为丸。或只用天门冬、熟地黄二味,量酒浸捣膏,同三味末,杵千余下,丸如梧桐子大,每服五、七十丸,空心姜盐汤送下。忌萝卜。
人参膏(丹溪制)
人参一味,不拘多少,去芦细切,量水于银石器内,慢火煎如稠饧,瓷器盛贮,每服一、二匙,白开水点服。
补中益气汤(李东垣制) 治疗饮食失节,劳役所伤,暴伤元气,恶寒发热,证似伤寒者。(方见内伤门。)
益胃升阳汤(李东垣制) 血脱益气,是古代圣人的方法,先补胃气,以助生发之气,所以说阳生阴长,各种甘味药作为首要任务,举世都认为这是补,殊不知甘能生血,从阳而引阴,所以先理胃气,大概人身以谷气为宝。
柴胡 升麻(各二分五厘) 当归身(酒洗) 炙甘草 陈皮(各五分) 人参(久嗽不用) 炒神曲(各七分五厘) 黄芪(一钱,蜜炙) 白术(一钱五分) 生黄芩(二分)
以上切碎,作一服,水二盏,煎至一盏,温服。如果腹中痛,每服加白芍药五分,肉桂二分。如果渴或口燥,加葛根三分。
附汤(严氏制) 治疗阴虚气弱,虚汗大出不止,肢体倦怠。
川附子(炮) 黄芪(蜜炙,各二钱)
以上切碎,作一服,加生姜三片,大枣二枚,水一盏半,煎至一盏,温服。
参附汤(严氏制) 治疗真阳虚乏,上气喘息,自汗盗汗,短气,头旋眼花。
人参(五钱) 川附子(炮去皮脐,一两)
以上切碎,分作三服,加姜水煎,温服。
茯神汤(济生制) 治疗六脉虚软,咳则心痛,喉中介介,或肿或痛。
茯神 人参 远志 通草 麦冬(去心) 黄芪(蜜炙) 桔梗(各六分) 甘草 五味子(各三分)
以上切碎,作一服,加生姜一片,水煎服。
补气汤(瑞竹堂方) 治疗气虚,脉浮而软,怔忡无时。
黄芪(二分,一本作二钱) 人参 甘草(各一钱) 麦门冬(去心) 桔梗(去芦,各七分)
以上切碎,作一服,加生姜三片,水二盏,煎至一盏,温服。
延寿丹(千金方) 治疗诸虚百损,怯弱欲成痨瘵,及大病后虚损不复。凡人于中年后常服,可以却疾延年。
五味子 菟丝子(煮烂,另研) 川牛膝 杜仲(姜汁拌炒丝断) 川归(酒浸) 山药 天门冬 麦门冬(去心) 生地黄 熟地黄(各一两) 肉苁蓉(二两) 人参 白茯苓 大茴香 泽泻 地骨皮 鹿茸 菖蒲(九节者) 花椒 巴戟(去心) 远志(去心) 覆盆子(炒去汁) 枸杞子 柏子仁(各五钱)
以上共磨为细末,勿犯铁器蒸捣,炼蜜为丸,如梧桐子大,每服一百丸,空心温酒或姜盐汤送下。如果大便溏、小便不利,加车前子二两。如果精滑或梦遗,加赤石脂、山茱萸肉各五钱。忌萝卜菜。
斑龙丸(青囊集方) 治疗真阴虚损,老人虚人常服,延年益寿。
鹿角胶(炒成珠子) 鹿角霜 菟丝子(酒浸研细) 柏子仁(取仁洗净) 熟地黄(各半斤) 白茯苓 补骨脂(各四两)
以上磨为细末,酒煮米糊为丸,或以鹿角胶入好酒烊化为丸,如梧桐子大,每服五十丸,空心姜盐汤送下,昔蜀中有一老人卖此药于市,自云寿三百八十岁矣,每歌曰:尾闾不禁沧海竭,九转金丹都谩说,惟有斑龙顶上珠,能补玉堂关下阙。当时有学其道者,传得此方。
桂枝加龙骨牡蛎汤(张仲景制) 治疗六脉芤动微紧,男子失精,女人梦交,及盗汗自汗等证。
桂枝 白芍药(各三钱) 甘草(炙,二钱) 龙骨 牡蛎(各三钱)
以上切碎,加姜枣,水煎(我恐怕此证不可用姜)。
(祖传方)
治疗心虚手振。
川归身(一两五钱) 川芎(一两) 粉甘草(一两五钱) 生地黄(一两五钱) 远志(去心,二两五钱) 酸枣仁 柏子仁(各三两) 人参(一两) 辰砂(五钱另研) 金箔(二十斤) 麝香(一钱) 琥珀(三钱) 茯神(七钱) 胆南星(五钱) 半夏(五钱) 石菖蒲(六钱)
以上为极细末,蒸饼为丸,如绿豆大,辰砂为衣,每服七、八十丸,津唾咽下,或姜汤送下。
(医案)
本邑在城金儒元,是国子监学生,年五十多岁,身体略瘦,十年前患内伤挟外感证,一医生用发表疏利之剂,十数日后,热虽退而虚未复,胸中痞满,气促眩晕,召我去治。我用补中益气汤,间或用东垣消痞丸、陈皮枳术丸等药调理而安,但病根未尽除而停药,所以眩晕时而发作,不甚重来。拖延到这一年,因往杭州城跋涉辛苦,兼色欲过度,回家眩晕大作。经过多位医生,都用防风、羌活、荆芥、南星、半夏、苍术等去风散湿消痰之剂,病更重,一日十数次昏厥,片刻苏醒,凡动或转侧,即昏厥不知人事。全家惶恐叫哭,召我去治,诊其六脉皆浮洪而濡。我告诉他:这是气血大虚证,幸而脉不数而身无大热,不死。但恐病愈后,而有数年不能下榻行动。病人说:只要有命,卧亦甘心。给以大补气血之药,倍用人参、黄芪,或加附子引经,合大剂一日三帖,又煎人参膏及作紫河车丸、补阴丸之类间服,如此调理二月余,服煎药二百余帖,丸药三、五料,用人参五六斤,其证渐不厥,饮食如故,但未能行动耳。次年听说王布政汝言往京师,道经兰溪,以舟载去彼,俟候求诊。王公说:此证阴虚,风痰上壅,因误服参、芪多,故病久不愈。立方以天麻、菊花、荆芥、川芎等清上之药,亦未见效,停药。后越五、六年,方得起而步履如初。儒元不思昔日病剧而借参、芪等药之功,遂以王公之语,归咎于我用药之误。唉!那时若非峻补,何以得一儒元见王公耶。呜呼!这真是得鱼忘筌、得兔忘蹄啊,可叹哉。
东阳邑庠邹掌教先生一证,发大汗战,鼓栗振掉,片时许,发燥热,身如火烧,又片时许,出大汗如雨,身体若冰冷而就发寒战如前,寒后有热,热后有汗,三病继作而昼夜不息。庠生卢明夫与他按疟症治,不效。召我去,诊其右手阳脉数而浮洪无力,阴脉略沉小而亦虚,左三部比右差小而亦浮软。我说:这是阳虚证。用补中益气汤,倍人参、黄芪,减升麻、柴胡一半,加尿浸生附子一钱半,炒黄柏三分,干姜、薄桂各五分,大枣一枚,同煎服。一服而病去三分,二服而减半,四服寒热止而身尚有微汗,减去桂、附、干姜一半,服二帖全愈。
Treatise
The *Neijing* (Yellow Emperor's Inner Classic) states: When food intake is excessive, sweat originates from the Stomach. When startled and essence is depleted, sweat originates from the Heart. When carrying heavy loads and traveling far, sweat originates from the Kidney. When running fast and fearing, sweat originates from the Liver. When the body shakes with laborious toil, sweat originates from the Spleen. It also says: Prolonged viewing damages Blood; prolonged lying down damages Qi; prolonged sitting damages flesh; prolonged standing damages bones; prolonged walking damages sinews. As for the fire of the Seven Emotions (Joy, Anger, Worry, Thought, Sadness, Fear, Fright) and Five Wills (Will of Heart is Joy, Will of Liver is Anger, Will of Lung is Sadness, Will of Kidney is Fear, Will of Spleen is Thought) flying away recklessly, and the excessive lust in male-female sexual desires, these are all causes of deficiency damage. The *Jiyao* (Essentials of Medicine) states: Diseases of deficiency damage arise from feeling cold or heat due to deficiency. Feeling cold damages Yang; when Yang is deficient, Yin flourishes, and the damage proceeds from top to bottom. First damage affects the Lung, manifesting as gathered skin and falling hair; second damage affects the Heart, manifesting as deficient and scanty blood vessels unable to nourish the Zang-Fu organs, and in women, amenorrhea; third damage affects the Stomach, manifesting as food failing to transform into muscle tissue, treatment should use pungent, sweet, and bland flavors; if it exceeds the Stomach level, it becomes incurable. Feeling heat damages Yin; when Yin is deficient, Yang flourishes, and the damage proceeds from bottom to top. First damage affects the Kidney, manifesting as bone atrophy unable to rise from bed; second damage affects the Liver, manifesting as relaxed sinews unable to hold themselves; third damage affects the Spleen, manifesting as inability to digest food, treatment should use bitter, sour, and salty flavors; if it exceeds the Spleen level, it becomes incurable. It also says: Damage to Heart and Lung leads to deteriorated complexion; damage to Kidney and Liver leads to emaciated form. The *Nanjing* (Classic of Difficult Issues) states: The method for treating damage is: for damage to the Lung, benefit its Qi; for damage to the Heart, tonify its Ying-Blood; for damage to the Spleen, regulate diet and adapt to cold and warmth; for damage to the Liver, soothe its interior; for damage to the Kidney, benefit its Essence. These are the general principles of etiology and treatment for deficiency damage; students should study them in detail.
Pulse Diagnosis
The *Maijing* (Classic of Pulses) states: A pulse that comes soft indicates deficiency. A slow pulse indicates deficiency. A fine pulse indicates deficiency. A weak pulse indicates deficiency. A string-like pulse indicates middle Qi deficiency.
A pulse that comes fine and minute indicates both Blood and Qi are deficient. A small pulse indicates both Blood and Qi are scarce.
The *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) states: A knotted pulse (hollow like a scallion stem) indicates Blood deficiency. A deep, small, and slow pulse indicates loss of Qi. It also says: In Blood deficiency, the pulse is large like a scallion stem. It also says: A large and knotted pulse indicates loss of Blood.
Methods
Zhu Danxi said: Heaven is Yang and moves outside the Earth; Earth is Yin and resides within Heaven, held up by the great Qi of Heaven. The Sun is solid, belongs to Yang, and moves outside the Moon; the Moon is deficient, belongs to Yin, and derives its brightness from the Sun. Humans receive the Qi of Heaven and Earth to generate life; the Yang Qi of Heaven becomes human Qi, and the Yin Qi of Earth becomes human Blood. Therefore, Yang is often in excess while Yin is often insufficient; Qi is often in excess while Blood is often insufficient. He also said: The Classics state that for insufficiency of Essence, one should tonify with flavor. Flavor is Yin; tonifying Essence with Yin seeks the root. However, flavor refers to grains, beans, fruits, and vegetables, which come from the natural, harmonious flavors endowed by Heaven, thus having the power to tonify Yin when eaten. This is not the strong, concentrated flavors produced by vinegar, sauces, cooking, and blending, which are man-made. The Classics state that the generation of Yin is based on the Five Flavors; are these not flavors endowed by Heaven? It also states that the five palaces of Yin are damaged by the Five Flavors; are these not man-made flavors? Those skilled in self-care should not say that flavor can tonify Essence and thus indulge their mouths and bellies, thereby hastening disaster. He also said: For insufficiency of form, one should warm with Qi. "Warm" means to nourish; gently nourishing allows Qi to fill itself; when Qi fills, form is complete. There is a distinction between "tonify" and "warm," each having its specific meaning. The *Ju Fang* (Prescriptions of the Bureau) entirely uses warm and hot medicines as assistants, naming it "warm tonification." How can this be reasonable? He also said: When people are old or suffer from deficiency damage, both Essence and Blood are exhausted. Yin is insufficient to match Yang, and lone Yang is about to fly away. The innate Stomach Qi still lingers, borrowing the Yin of water and grain, thus restraining and stabilizing it. The *Ju Fang* uses warm agents to rob deficiency; perhaps because the Spleen and Stomach get warm and food intake increases, it is temporarily acceptable. But constitutions vary in thickness, and diseases vary in depth. If a mistake is made, how can it be rescued? I prefer to be slightly slower but ensure absolute safety; I dare not use warm agents to tonify deficiency.
(Above, one item of Danxi's methods)
Danxi treated deficiency damage in the elderly: whenever there is a sensation of short and scanty urination, it indicates disease progression. One should use Ren Shen (Ginseng Root) and Bai Zhu (Atractylodes Rhizome) as sovereign drugs, Niu Xi (Achyranthes Root) and Shao Yao (Peony Root) as minister drugs, Chen Pi (Tangerine Peel) and Fu Ling (Poria) as assistant drugs. Add Chuan Xiong (Ligusticum Rhizome) in spring; add Huang Qin (Scutellaria Root) and Mai Men Dong (Ophiopogon Tuber) in summer; add Dang Gui Shen (Angelica Sinensis Root Body) in autumn and winter; double the amount of Sheng Jiang (Fresh Ginger). Take one or two doses per day. Stop when urination returns to normal. This is a quick method for the elderly to maintain health. (This is the formula Danxi used to nourish his mother.)
Si Jun Zi Tang (Four Gentlemen Decoction) (from *Ju Fang*) Treats Qi deficiency.
Ren Shen (1.5 qian) Bai Zhu Fu Ling (each 2 qian) Gan Cao (1 qian)
Finely chop, make one dose, decoct in water. If spontaneous sweating or frequent urination occurs, remove Fu Ling and add Huang Qi (Astragalus Root) 2 qian. If no sweating and difficult urination, follow the base formula only.
Si Wu Tang (Four Substances Decoction) (from *Ju Fang*) Treats Blood deficiency.
Chuan Gui (2 qian) Chuan Xiong Shao Yao (each 1.5 qian) Shu Di Huang (Rehmannia Root, Prepared) (2 qian)
Finely chop, make one dose, decoct in water and take. Double Chuan Xiong in spring; double Shao Yao in summer; double Di Huang in autumn; double Dang Gui in winter.
Ba Wu Tang (Eight Substances Decoction) Treats dual deficiency of Qi and Blood.
Combine Si Jun Zi Tang and Si Wu Tang into one dose, decoct and take with modifications as above.
Liu Jun Zi Tang (Six Gentlemen Decoction) Treats Qi deficiency with phlegm retention. (Formula see in Ni Men section.)
Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) (from *Ju Fang*) Treats dual deficiency of Qi and Blood with cold retention.
Ren Shen Huang Qi (Astragalus Root) Gan Cao Bai Fu Ling (Poria) Dang Gui Bai Zhu Bai Shao Yao Rou Gui (Cinnamon Bark) Shu Di Huang Chuan Xiong (equal parts)
Finely chop, each dose weighs 1 liang. Add 3 slices of Sheng Jiang, 1 Da Zao (Jujube Fruit), 2 large bowls of water, decoct to 1 bowl, take warm. (For modification methods, see previous treatise.)
Da Bu Yin Wan (Great Tonifying Yin Pill) Descends Yin fire, tonifies Kidney water.
Huang Bo (Phellodendron Bark, mixed with salt wine, stir-fried on new tile until brown) Zhi Mu (Anemarrhena Rhizome, de-haired, moistened with wine, stir-fried, each 4 liang) Shu Di Huang (use Huaiqing origin if possible best. Washed with wine, dried by baking) Gui Ban (Tortoise Shell, fried in butter until yellow, each 6 liang)
Grind into fine powder, mix with pig spinal marrow and refined honey to make pills, size of wutong seeds. Each dose 50 pills, taken on an empty stomach with ginger-salt water.
Bu Yin Wan (Tonifying Yin Pill) (also known as Hu Qian Wan / Tiger Crouching Pill) (by Danxi)
Huang Bo (8 liang, prepared as above) Zhi Mu (de-haired, wine-processed and stir-fried) Shu Di Huang (each 3 liang) Gui Ban (butter-fried, 4 liang) Bai Shao Yao (roasted) Chen Pi (Tangerine Peel) Niu Xi (each 2 liang) Hu Jing Gu (Tiger Tibia Bone, 1 liang) Suo Yang (Cynomorium Herb, butter-fried) Dang Gui (each 1.5 qian)
Grind into fine powder, boil castrated ram meat in wine to make pills, take with salt water. In winter, add Gan Jiang (Dried Ginger) 5 qian.
Jia Wei Hu Qian Wan (Modified Tiger Crouching Pill) (by Danxi)
Ren Shen Huang Qi Shao Yao (roasted) Huang Bo (salt-wine stir-fried) Dang Gui (wine-washed) Shan Yao (Dioscorea Rhizome) (each 1 liang) Suo Yang (butter-fried) Gou Qi Zi (Goji Berry) Hu Jing Gu (butter-fried) Tu Si Zi (Cuscuta Seed) (soaked in salt-wine for three nights, finely ground and baked, then added to other herbs and re-ground) Gui Ban (butter-fried) Po Gu Zhi (Cibotium Rhizome) (stir-fried) Du Zhong (Eucommia Bark) (mixed with ginger juice, stir-fried until fibers break) Wu Wei Zi (Schisandra Fruit) (each 7.5 qian) Niu Xi (de-rhizome, wine-washed, 2 liang) Shu Di Huang (4 liang)
Grind into fine powder, mix with refined honey and pig spinal marrow to make pills, size of wutong seeds. Each dose 50-60 pills, take with warm wine or ginger-salt water.
Zi Yin Da Bu Wan (Nourishing Yin Great Tonifying Pill) (by Danxi)
Chuan Niu Xi (de-rhizome) Shan Yao (each 1.5 liang) Du Zhong (mixed with ginger juice, stir-fried until fibers break) Ba Ji (Morinda Root) (de-heart) Shan Zhu Yu (Cornus Fruit) (de-pit) Rou Cong Rong (Cistanche Stem) (soaked in wine, washed, dried on new tile) Wu Wei Zi Bai Fu Ling (de-skin) Hui Xiang (Fennel Fruit) (stir-fried) Yuan Zhi (Polygala Root) (de-heart, boiled with Gan Cao, each 1 liang) Shi Chang Pu (Acorus Rhizome) Gou Qi Zi (each 5 qian) Shu Di Huang (2 liang)
Grind into fine powder, mix with red date flesh and refined honey to make pills, size of wutong seeds. Each dose 70 pills, take on an empty stomach with light salt water or warm wine. Alternate taking with the aforementioned Hu Qian Pill for best results. This is called tonifying Yin to harmonize Yang, generating Blood and benefiting Essence, moistening skin and muscles, strengthening bones and sinews. Its nature and flavor are clear but not cold, warm but not hot. Only those who understand the subtleties of creation can discuss this.
Bu Shen Wan (Tonify Kidney Pill) (by Danxi)
Huang Bo Gui Ban (each 2 liang) Du Zhong (prepared as above) Niu Xi Chen Pi (each 2 liang) Gan Jiang (5 qian, add in winter) Wu Wei Zi (2 qian, use 1 liang in winter)
Grind into fine powder, make pills with ginger juice paste or wine paste. Take with warm wine or plain water on an empty stomach.
Bu Tian Wan (Tonify Heaven Pill)
Zi He Che (1 placenta, i.e., afterbirth of newborn. Ancient formulas did not distinguish gender. Worldly tradition says men use female fetus, women use male fetus, considering first birth superior, which seems reasonable. If unavailable, seek any fat, healthy woman, all are usable. Upon initial acquisition, wash clean with flowing water, remove fascia, place in bamboo basket, cover outside with paper to prevent qi leakage, bake dry. When needed, soak in rice vinegar overnight, bake dry again)
Grind the aforementioned Bu Shen Wan medicine into powder, mix with He Che and grind extremely fine. Make pills with wine paste. Or steam fresh Zi He Che until cooked, mix with the aforementioned medicine powder, pound into paste to make pills.
For Xu Lao (Deficiency Consumption), assist with Gu Zheng (Bone Steaming) medicines. One view adds Bu Qi (Tonify Qi) medicines for Qi deficiency, and Bu Xue (Tonify Blood) medicines for Blood deficiency.
One prescription: Use Ce Bai Ye (Biota Top) and Wu Yao Ye (Lindera Leaf), both soaked in wine, steamed nine times and sun-dried nine times. Also make pills with Zi He Che, named Bu Shen Wan.
Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) (from *Ju Fang*) Treats Kidmer channel deficiency damage, chronic or acute emaciation, night sweats and fever, simultaneous damage to five Zang organs, thinness and weakness with deficiency vexation, bone steaming and atrophy, lower bleeding and hemoptysis.
Gan Shan Yao Dried Yam Shan Zhu Yu (de-pit, each 4 liang) Ze Xie (Alisma Rhizome) (de-hair) Mu Dan Pi (Moutan Cortex) Bai Fu Ling (each 3 liang) Shu Di Huang (8 liang)
Grind into fine powder, mix with refined honey to make pills, size of wutong seeds. Each dose 50 pills, take with plain water.
Ren Shen Gu Ben Wan (Ginseng Solidifying Root Pill) (from *Ju Fang*)
Tian Men Dong (Asparagus Tuber) (de-heart) Mai Men Dong (Ophiopogon Tuber) (de-heart) Sheng Di Huang (Rehmannia Root, Raw) (each 2 liang) Ren Shen (de-rhizome, 1 liang) Shu Di Huang (2 liang)
Bake each until dry, grind together into powder, avoid iron vessels. Mix with refined honey to make pills. Or use only Tian Men Dong and Shu Di Huang, soak in appropriate amount of wine, pound into paste, mix with the three powders, pound over a thousand times, make pills size of wutong seeds. Each dose 50-70 pills, take on an empty stomach with ginger-salt water. Avoid radish.
Ren Shen Gao (Ginseng Paste) (by Danxi)
Use only Ren Shen, any amount. Remove rhizome, cut finely. Measure water into silver or earthenware vessel, simmer slowly over low fire until thick syrup. Store in porcelain jar. Each dose 1-2 spoons, take with plain water.
Bu Zhong Yi Qi Tang (Tonify Middle and Benefit Qi Decoction) (by Li Dongyuan) Treats irregular diet, injury from labor, sudden damage to Yuan Qi, aversion to cold and fever, symptoms resembling Shang Han (Cold Damage). (Formula see in Nei Shang section.)
Yi Wei Sheng Yang Tang (Benefit Stomach and Ascend Yang Decoction) (by Li Dongyuan) For blood loss, benefit Qi; this is the method of ancient sages. First tonify Stomach Qi to aid generating and ascending Qi. Thus it is said "Yang generates, Yin grows." All sweet medicines are prioritized. The world thinks this is tonification, not knowing that sweet can generate Blood, drawing Yin from Yang. Thus, first regulate Stomach Qi, for grain is the treasure of the human body.
Chai Hu Bupleurum Root Sheng Ma Cimicifuga Rhizome (each 2.5 li) Dang Gui Shen (wine-washed) Zhi Gan Cao (Honey-fried Licorice Root) Chen Pi (each 5 fen) Ren Shen (do not use for chronic cough) Chao Shen Qu (Stir-fried Medicated Leaven) (each 7.5 li) Huang Qi (1 qian, honey-fried) Bai Zhu (1.5 qian) Sheng Huang Qin (Raw Scutellaria Root) (2 fen)
Finely chop, make one dose. 2 bowls of water, decoct to 1 bowl, take warm. If abdominal pain, add Bai Shao Yao 5 fen per dose, Rou Gui (Cinnamon Bark) 2 fen. If thirsty or dry mouth, add Ge Gen (Kudzu Root) 3 fen.
Fu Tang (Aconite Decoction) (by Yan Shi) Treats Yin deficiency with weak Qi, profuse continuous sweating from deficiency, limb fatigue.
Chuan Fu Zi (Prepared Aconite Lateral Root) Huang Qi (honey-fried, each 2 qian)
Finely chop, make one dose. Add 3 slices of Sheng Jiang, 2 Da Zao, 1.5 bowls of water, decoct to 1 bowl, take warm.
Shen Fu Tang (Ginseng and Aconite Decoction) (by Yan Shi) Treats true Yang deficiency and exhaustion, upward Qi and wheezing, spontaneous and night sweats, shortness of breath, dizziness and blurred vision.
Ren Shen (5 qian) Chuan Fu Zi (prepared, de-skin and de-navel, 1 liang)
Finely chop, divide into three doses. Add ginger water, decoct, take warm.
Fu Shen Tang (Poria Spirit Decoction) (by Jisheng) Treats six pulses soft and weak, heart pain upon coughing, sensation of obstruction in throat, or swelling or pain.
Fu Shen (Poria with Hostwood) Ren Shen Yuan Zhi Tong Cao (Tetrapanax Pith) Mai Dong (de-heart) Huang Qi (honey-fried) Jie Geng (Platycodon Root) (each 6 fen) Gan Cao Wu Wei Zi (each 3 fen)
Finely chop, make one dose. Add 1 slice of Sheng Jiang, decoct in water and take.
Bu Qi Tang (Tonify Qi Decoction) (from Ruizhutang Fang) Treats Qi deficiency, floating and soft pulse, palpitations without fixed time.
Huang Qi (2 fen, some texts say 2 qian) Ren Shen Gan Cao (each 1 qian) Mai Men Dong (de-heart) Jie Geng (de-rhizome, each 7 fen)
Finely chop, make one dose. Add 3 slices of Sheng Jiang, 2 bowls of water, decoct to 1 bowl, take warm.
Yan Shou Dan (Longevity Elixir) (from Qianjin Fang) Treats various deficiencies and hundred damages, timidity and weakness tending towards Lao Zhai (Consumption Disease), and deficiency damage not recovering after severe illness. Anyone taking it regularly after middle age can ward off disease and prolong life.
Wu Wei Zi Tu Si Zi (boiled until soft, ground separately) Chuan Niu Xi Du Zhong (mixed with ginger juice, stir-fried until fibers break) Chuan Gui (wine-soaked) Shan Yao Tian Men Dong Mai Men Dong (de-heart) Sheng Di Huang Shu Di Huang (each 1 liang) Rou Cong Rong (2 liang) Ren Shen Bai Fu Ling Da Hui Xiang (Star Anise) Ze Xie Di Gu Pi (Lycium Bark) Lu Rong (Deer Antler) Chang Pu (nine-joint type) Hua Jiao (Sichuan Pepper) Ba Ji (de-heart) Yuan Zhi (de-heart) Fu Pen Zi (Stawberry Tree Fruit) (stir-fried to remove juice) Gou Qi Zi Bai Zi Ren (each 5 qian)
Grind all together into fine powder, avoid iron vessels, steam and pound. Mix with refined honey to make pills, size of wutong seeds. Each dose 100 pills, take on an empty stomach with warm wine or ginger-salt water. If loose stool or difficult urination, add Che Qian Zi (Plantago Seed) 2 liang. If seminal emission or nocturnal emission, add Chi Shi Zhi (Red Halloysite) and Shan Zhu Yu Rou (Cornus Flesh) each 5 qian. Avoid radish and vegetables.
Ban Long Wan (Spotted Dragon Pill) (from Qingnang Ji Fang) Treats true Yin deficiency damage. Regular use by elderly and deficient persons prolongs life and benefits longevity.
Lu Jiao Jiao (Deer Horn Glue) (fried into beads) Lu Jiao Shuang (Deer Horn Ash) Tu Si Zi (soaked in wine, finely ground) Bai Zi Ren (extract kernel, wash clean) Shu Di Huang (each half jin) Bai Fu Ling Gu Bo Zhi (Psoralea Fruit) (each 4 liang)
Grind into fine powder. Make pills with rice paste boiled in wine, or dissolve Lu Jiao Jiao in good wine to make pills, size of wutong seeds. Each dose 50 pills, take on an empty stomach with ginger-salt water. Once, an old man in Shu sold this medicine in the market, claiming to be 380 years old. He often sang: "The tailgate cannot stop the ocean from drying up, the nine-turn golden elixir is all talk. Only the pearl on top of the spotted dragon can supplement the jade hall and close the lower gate." At that time, someone learned his way and transmitted this formula.
Gui Zhi Jia Long Gu Mu Li Tang (Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell) (by Zhang Zhongjing) Treats six pulses knotted, moving, fine, and tight; seminal emission in men; dream intercourse in women; and night sweats and spontaneous sweating.
Gui Zhi (Cinnamon Twig) Bai Shao Yao (each 3 qian) Gan Cao (honey-fried, 2 qian) Long Gu (Dragon Bone) Mu Li (Oyster Shell) (each 3 qian)
Finely chop, add Sheng Jiang and Da Zao, decoct in water. (I fear ginger should not be used for this condition.)
(Ancestral Formula)
Treats Heart deficiency causing hand tremors.
Chuan Gui Shen (Angelica Sinensis Root Body) (1.5 liang) Chuan Xiong (1 liang) Fen Gan Cao (Licorice Root) (1.5 liang) Sheng Di Huang (1.5 liang) Yuan Zhi (de-heart, 2.5 liang) Suan Zao Ren (Ziziphus Seed) Bai Zi Ren (each 3 liang) Ren Shen (1 liang) Chen Sha (Cinnabar) (5 qian, ground separately) Jin Bo (Gold Foil) (20 jin) She Xiang (Musk) (1 qian) Hu Po (Amber) (3 qian) Fu Shen (7 qian) Dan Nan Xing (Arisaema with Bile) (5 qian) Ban Xia (Pinellia Tuber) (5 qian) Shi Chang Pu (6 qian)
Grind into extremely fine powder. Make pills with steamed cake dough, size of mung beans. Coat with Chen Sha. Each dose 70-80 pills, swallow with saliva or send down with ginger water.
(Medical Case)
Jin Ruyuan, a resident of the city in our county, was a student at the Imperial Academy. Over fifty years old, slightly thin. Ten years ago, he suffered from internal injury complicated by external contraction. A physician used releasing and purging agents. After more than ten days, fever subsided but deficiency did not recover. Chest fullness and oppression, shortness of breath and dizziness. He summoned me to treat. I used Bu Zhong Yi Qi Tang, occasionally using Dongyuan Xiao Pi Wan and Chen Pi Zhi Zhu Wan to regulate, and he recovered. But because the root cause was not fully eliminated and medication stopped, dizziness recurred occasionally, not severely. Delayed to this year, due to arduous travel to Hangzhou city and excessive sexual desire, upon returning home, dizziness became severe. Passed through several physicians, all used Fang Feng (Saposhnikovia Root), Qiang Huo (Notopterygium Rhizome), Jing Jie (Schizonepeta Spike), Nan Xing (Arisaema with Bile), Ban Xia, Cang Zhu (Atractylodes Rhizome) etc. to dispel wind, scatter dampness, and eliminate phlegm. Condition worsened. Dozens of times a day, he fainted, regaining consciousness briefly. Any movement or turning caused fainting and loss of consciousness. Family panicked and cried, summoned me. Pulse diagnosis: six pulses were floating, surging, and soft. I told him: This is a major deficiency of Qi and Blood. Fortunately, pulse is not rapid and body has no high fever, so death is avoided. But fear that after recovery, he may be unable to get out of bed and walk for years. Patient said: As long as life remains, I am willing to lie down. Prescribed major Qi and Blood tonifying medicine, doubled Ren Shen and Huang Qi, or added Fu Zi (Aconite) to guide meridians. Combined large doses, three doses per day. Also decocted Ren Shen Gao and made Zi He Che Wan, Bu Yin Wan etc. to take alternately. Regulated for over two months, took over 200 doses of decoction, 3-5 batches of pills, used 5-6 jin of Ren Shen. Condition gradually ceased fainting, diet returned to normal, but still unable to walk. Next year, heard Governor Wang Ruyan going to the capital, passing through Lanxi, transported by boat to wait for consultation. Governor Wang said: This condition is Yin deficiency, wind-phlegm obstructing upwards, due to mistaken overuse of Ren Shen and Huang Qi, hence chronic non-recovery. Prescribed Tian Ma (Gastrodia Rhizome), Ju Hua (Chrysanthemum Flower), Jing Jie, Chuan Xiong etc. to clear upper jiao, but ineffective. Stopped medication. After five or six years, finally able to stand and walk as before. Ruyuan did not think of the past severe illness relying on the merit of Ren Shen and Huang Qi, but attributed the delay to my medication error based on Governor Wang's words. Alas! If not for drastic tonification then, how could Ruyuan have seen Governor Wang? Alas! This is truly forgetting the trap after catching the fish, forgetting the snare after catching the rabbit. How can one not sigh!
Mr. Zou Zhangjiao, a school official in Dongyang County, had a case: profuse sweating and shivering, trembling and shaking, for a short while, then dry heat, body burning like fire, for another short while, then profuse sweating like rain, body cold as ice then shivering as before. Cold followed by heat, heat followed by sweat. Three illnesses succeeded each other ceaselessly day and night. School student Lu Mingfu treated him as malaria, ineffective. Summoned me. Pulse diagnosis: right hand Yang pulse rapid, floating, surging, and powerless; Yin pulse slightly deep, small, and also deficient. Left three positions smaller than right, also floating and soft. I said: This is Yang deficiency. Used Bu Zhong Yi Qi Tang, doubled Ren Shen and Huang Qi, halved Sheng Ma and Chai Hu, added Niu Jin Sheng Fu Zi (Urine-soaked raw Aconite) 1.5 qian, Chao Huang Bo (Stir-fried Phellodendron) 3 fen, Gan Jiang, Hou Gui (Thin Cinnamon) each 5 fen, 1 Da Zao. Decoct and take together. One dose removed one-third of disease, two doses halved it, four doses stopped chills and fever, body still had slight sweat. Halved Gui, Fu, Gan Jiang, took two doses and fully recovered.