悲属肺。经云∶在脏为肺,在志为悲。又云∶精气并于肺则悲是也。
〔仲〕妇人脏躁,喜悲伤欲哭,象如神灵所作,数欠伸,甘麦大枣汤主之。
甘草(三两) 小麦(一升) 大枣(十枚)
上三味,水六升,煮三升,温分三服。亦补脾气。
〔《本》〕乡里有一妇人,数次无故,悲泣不止,或谓之有祟,祈禳请祷备至,终不应。予忽忆《金匮》
有一证。云∶妇人脏躁悲伤欲哭,象如神灵,数欠伸者,宜甘麦大枣汤。予急令治药,尽剂而愈。古人识病制
方,种种绝妙如此。
运气 悲皆属寒水攻心。经云∶火不及曰伏明,伏明之纪,其病昏惑悲忘,从水化也。又云∶太阳司天,
寒气下临,心气上从,喜悲数欠。又云∶太阳司天,寒淫所胜,喜悲时眩仆。又云∶太阳之复,甚则入心,善
忘善悲,治以诸热是也。
针灸 悲有二∶
其一取心。经云∶邪在心,则病心痛善悲,时眩仆,视有余不足而调其输也。
其二取厥阴。经云∶厥阴根于大敦,结于玉英,络于 中。厥阴为阖,阖折即气绝而喜悲,悲者取之厥阴,
视有余不足虚实寒热陷下而取之也。
〔《大》〕论管先生治一妊娠四五个月,脏躁悲伤,遇昼则惨感泪下,数欠象若神灵,如有所凭,医与
巫皆无益,与仲景大枣汤,一投而愈。
悲伤在五行中归属于肺。《内经》记载:在五脏中对应肺,在五志中对应悲。又说:精气偏并于肺时就会表现为悲伤。
〔张仲景〕妇女患脏躁病,喜欢悲伤想哭,症状像被神灵附体一样,频繁打哈欠、伸懒腰,用甘麦大枣汤主治。
甘草(三两) 小麦(一升) 大枣(十枚)
以上三味药,用水六升,煮取三升,分三次温服。此方也能补益脾气。
〔《本草衍义》/注:此处“本”可能指代某本草或笔记,结合语境为医案记录〕乡里有一位妇人,多次无缘无故地悲伤哭泣不止,有人说是中了邪祟,祈祷驱鬼的方法都用尽了,最终没有效果。我突然想起《金匮要略》中有一个证候,说:妇女患脏躁病,悲伤想哭,症状像被神灵附体,频繁打哈欠伸懒腰的,适宜用甘麦大枣汤。我急忙让人抓药,服完一剂后痊愈。古人识别病症、创制方剂,竟然精妙到如此地步。
运气学说方面:悲伤都归属于寒水之气攻心。《内经》记载:火气不及称为伏明,伏明之纪,其病症表现为昏乱迷惑、悲伤健忘,这是从水气变化所致。又说:太阳司天之年,寒气下临,心气上从,表现为容易悲伤、频繁打哈欠。又说:太阳司天之年,寒气过胜,表现为容易悲伤、时常眩晕跌倒。又说:太阳之复气发作,严重时侵入心脏,表现为善忘、易悲,治疗应用各种热性药物。
针灸疗法方面:悲伤有两种情况:
其一取用心经。《内经》记载:邪气在心,则出现心痛、易悲、时常眩晕跌倒的症状,需根据有余或不足的情况来调节其腧穴。
其二取用厥阴经。《内经》记载:厥阴经根于大敦穴,结于玉英穴,络于膻中穴。厥阴主阖,阖折则气绝而容易悲伤,对于悲伤者应取厥阴经,根据有余不足、虚实寒热及陷下的情况进行针刺治疗。
〔《丹溪心法》/注:“大”可能指代丹溪或其他医家著作〕论管先生治疗一位怀孕四五个月的孕妇,患脏躁病导致悲伤,白天感到凄惨流泪,频繁打哈欠,症状像被神灵附体,好像有所依附,医生和巫术都无济于事,给予张仲景的大枣汤(即甘麦大枣汤),服用一次后痊愈。
Sorrow is associated with the Lung. The Classics state: "In the Zang organs, it corresponds to the Lung; in the emotions, it corresponds to sorrow." It also states: "When essence and Qi congregate in the Lung, sorrow occurs."
[Zhang Zhongjing] Women suffering from Zang Jiao (Visceral Agitation) often feel like crying and are prone to sadness. Their symptoms resemble those possessed by spirits, accompanied by frequent yawning and stretching. Ganmai Dazao Tang (Sweet Wheat and Jujube Decoction) is the primary treatment.
Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*) - 3 liang
Xiaomai (Wheat, *Tritici aestivi Fructus*) - 1 sheng
Dazao (Jujube, *Ziziphi Jujubae Fructus*) - 10 pieces
Take the above three ingredients, add six sheng of water, boil down to three sheng, and take warm in three divided doses. This formula also tonifies Spleen Qi.
[Recorded in Ben Cao / Local Notes] A woman in my hometown repeatedly wept uncontrollably without cause. Some said she was afflicted by evil spirits, and various prayers and exorcisms were performed, but to no avail. I suddenly recalled a syndrome in the *Jin Gui Yao Lue*: "Women with Zang Jiao who are sad, want to cry, appear as if possessed by spirits, and frequently yawn and stretch should be treated with Ganmai Dazao Tang." I urgently ordered the medicine to be prepared. After completing one dose, she recovered. The ancients' ability to identify diseases and formulate prescriptions was truly exquisite.
Regarding Yunqi (Five Movements and Six Qi): Sorrow is generally attributed to Cold Water attacking the Heart. The Classics state: "When Fire is deficient, it is called Fu Ming (Hidden Brightness). In the Fu Ming pattern, the disease manifests as confusion, disorientation, sorrow, and forgetfulness, transforming according to Water." It also states: "When Taiyang governs the year, Cold Qi descends, and Heart Qi responds upward, leading to a propensity for sorrow and frequent yawning." Furthermore: "When Taiyang governs, and Cold excess prevails, there is a propensity for sorrow and occasional vertigo with collapse." Additionally: "When the counter-acting Qi of Taiyang acts severely, it enters the Heart, causing forgetfulness and sorrow; treat with various Hot methods."
Regarding Acupuncture: There are two types of sorrow:
First, treat the Heart. The Classics state: "Pathogens in the Heart cause heart pain, propensity for sorrow, and occasional vertigo with collapse. Regulate their Shu points based on excess or deficiency."
Second, treat the Jueyin Meridian. The Classics state: "The Jueyin meridian originates at Dadun (LR1), terminates at Yuying, and connects with Danzhong (CV17). Jueyin governs closure; if closure fails, Qi perishes, leading to a propensity for sorrow. For sorrow, select the Jueyin meridian, and needle based on excess or deficiency, emptiness or fullness, cold or heat, and sinking conditions."
[Recorded in Da Yi / Dan Xi] Discusses Mr. Guan treating a pregnant woman of four to five months gestation who suffered from Zang Jiao and sorrow. During the day, she felt miserable and wept, frequently yawning, appearing as if possessed by spirits or attached to something. Neither physicians nor shamans could help. Administering Zhang Zhongjing's Dazao Tang (Ganmai Dazao Tang), she recovered after one dose.