治因肝气不舒、木郁克土,致脾胃之气不能升降,胸中满闷,常常短气。
于术(三钱) 生黄 (三钱) 陈皮(二钱) 川浓朴(二钱) 桂枝尖(钱半) 柴胡(钱半)
生麦冬(二钱) 生杭芍(四钱) 生姜(二钱)
脾主升清,所以运津液上达。胃主降浊,所以运糟粕下行。白术、黄 ,为补脾胃之正药,同桂枝、柴
胡,能助脾气之升,同陈皮、浓朴,能助胃气之降。清升浊降满闷自去,无事专理肝气,而肝气自理,况桂枝、
柴胡与麦芽,又皆为舒肝之妙品乎。用芍药者,恐肝气上升,胆火亦随之上升,且以解黄 、桂枝之热也。用
生姜者,取其辛散温通,能浑融肝脾之气化于无间也。
从来方书中,麦芽皆是炒熟用之,惟陈修园谓麦芽生用,能升发肝气,可谓特识。盖人之元气,根基于
肾,萌芽于肝,培养于脾,积贮于胸中为大气以斡旋全身。麦茅为谷之萌芽,与肝同气相求,故能入肝经,以
条达肝气,此自然之理,无庸试验而可信其必
然者也。然必生煮汁饮之,则气善升发,而后能遂其条达之用也。
附录∶
直隶青县张××来函∶
族侄妇,年二十余,素性谨言,情志抑郁。因气分不舒,致四肢痉挛颤动,呼吸短促,胸中胀闷,约一昼
夜。先延针科医治,云是鸡爪风,为刺囟门及十指尖,稍愈,旋即复作如故。其脉左部弦细,右部似有似无,
一分钟数至百至。其两肩抬动,气逆作喘。询知其素不健壮,廉于饮食。盖肝属木而主筋,肝郁不舒则筋挛,
肝郁恒侮其所胜,故脾土受伤而食少。遂为开培脾舒肝汤。为有逆气上干,又加生赭石细末五钱。嘱服二剂。
痉挛即愈,气息亦平。遂去赭石,照原方又服数剂,以善其后。
治疗因肝气郁结不舒、木气郁滞克制脾土,导致脾胃之气无法正常升降,出现胸部满闷、经常感觉气短的症状。
于术(三钱) 生黄芪(三钱) 陈皮(二钱) 川厚朴(二钱) 桂枝尖(一钱半) 柴胡(一钱半)
生麦冬(二钱) 生白芍(四钱) 生姜(二钱)
脾主升清阳,因此能运送津液上达全身。胃主降浊阴,因此能运送糟粕下行排出。白术、黄芪,是补益脾胃的正药,配合桂枝、柴胡,能够辅助脾气上升;配合陈皮、厚朴,能够辅助胃气下降。清气上升、浊气下降,满闷症状自然消除,无需专门调理肝气,而肝气自然得以理顺,况且桂枝、柴胡与麦芽,又都是疏理肝气的妙品。使用芍药的原因,是担心肝气上升时,胆火也随之上升,并且用芍药来缓解黄芪、桂枝的燥热之性。使用生姜的原因,是取其辛散温通的特性,能使肝脾的气化功能融合无间。
以往的方书中,麦芽都是炒熟后使用,只有陈修园认为麦芽生用,能够升发肝气,这可谓独到的见解。大概人的元气,根基在于肾,萌芽于肝,培养于脾,积聚在胸中成为大气以斡旋全身。麦芽是谷物的萌芽,与肝同气相求,所以能进入肝经,以条达肝气,这是自然的道理,无需试验即可确信其必然性。然而必须生煮汁饮用,其气才能善于升发,从而发挥其条达的作用。
附录:
直隶青县张××来信:
族侄媳妇,二十多岁,平时性格谨慎少言,情志抑郁。因气分郁结不舒,导致四肢痉挛颤动,呼吸短促,胸部胀闷,持续约一天一夜。先请针灸科医生治疗,说是鸡爪风,针刺囟门及十指尖,稍微好转,随即又复发如旧。其脉象左部弦细,右部似有似无,一分钟跳动一百次。其双肩抬动,气逆作喘。询问得知她平时身体不健壮,饮食量少。因为肝属木而主筋,肝郁不舒则筋脉挛急,肝郁常常欺侮其所胜的脾土,所以脾土受伤而食欲不振。于是为她开具培脾舒肝汤。因为有逆气上干,又加入生赭石细末五钱。嘱咐服用两剂。
痉挛即愈,气息也平稳了。于是去掉赭石,照原方又服用数剂,以善后调理。
Treats conditions caused by Liver Qi stagnation and constraint, where Wood (Liver) overacts on Earth (Spleen/Stomach), resulting in the failure of Spleen and Stomach Qi to ascend and descend properly. Symptoms include fullness and oppression in the chest, and frequent shortness of breath.
Bai Zhu (Atractylodis Rhizoma, 3 qian)
Sheng Huang Qi (Astragali Radix, raw, 3 qian)
Chen Pi (Citri Reticulatae Pericarpium, 2 qian)
Chuan Hou Po (Magnoliae Officinalis Cortex, 2 qian)
Gui Zhi Jian (Cinnamomi Ramulus apical part, 1.5 qian)
Chai Hu (Bupleuri Radix, 1.5 qian)
Sheng Mai Dong (Ophiopogonis Radix, raw, 2 qian)
Sheng Bai Shao (Paeoniae Radix Alba, raw, 4 qian)
Sheng Jiang (Zingiberis Rhizoma Recens, 2 qian)
The Spleen governs the ascending of clear Yang, thereby transporting body fluids upward. The Stomach governs the descending of turbid Yin, thereby transporting waste downward. Bai Zhu and Huang Qi are the primary herbs for tonifying the Spleen and Stomach. Combined with Gui Zhi and Chai Hu, they assist the ascending of Spleen Qi; combined with Chen Pi and Hou Po, they assist the descending of Stomach Qi. When clear Qi ascends and turbid Qi descends, the fullness and oppression naturally resolve. There is no need to specifically regulate Liver Qi, yet Liver Qi will regulate itself. Moreover, Gui Zhi, Chai Hu, and Mai Ya are all excellent herbs for soothing the Liver. Shaoyao (Bai Shao) is used because one fears that if Liver Qi rises, Gallbladder Fire may rise with it; additionally, Shaoyao helps to mitigate the heat-drying nature of Huang Qi and Gui Zhi. Sheng Jiang is used for its pungent, dispersing, and warming-unblocking properties, which allow the Qi transformation of the Liver and Spleen to blend seamlessly without obstruction.
In traditional prescription books, Mai Ya (Hordei Fructus Germinatus) is typically used after being stir-fried until cooked. Only Chen Xiuyuan stated that raw Mai Ya can stimulate the ascending of Liver Qi, which demonstrates unique insight. Generally, Yuan Qi (Primal Qi) is rooted in the Kidney, sprouts in the Liver, is cultivated by the Spleen, and accumulates in the chest as Da Qi (Great Qi) to pivot the whole body. Mai Ya is the sprout of grain; sharing the same Qi resonance with the Liver, it enters the Liver Meridian to smooth and unblock Liver Qi. This is a natural principle, credible without needing empirical verification. However, it must be boiled raw and drunk as a decoction so that its Qi ascends effectively, thereby fulfilling its function of smoothing and unblocking.
Appendix:
Letter from Zhang XX of Qing County, Zhili:
My clan-nephew's wife, in her early twenties, has always been cautious in speech and prone to emotional depression. Due to stagnation of Qi, she experienced spasms and tremors of the four limbs, shortness of breath, and chest distension and oppression, lasting approximately one day and night. Initially, an acupuncture specialist was consulted, who diagnosed it as "Chicken Claw Wind" (Ji Zhao Feng). Needles were applied to the fontanelle and the tips of the ten fingers. She improved slightly but soon relapsed to the original state. Her pulse was wiry and thin on the left side, and faint/indistinct on the right side, beating up to 100 times per minute. Her shoulders lifted involuntarily, and she panted due to rebellious Qi. Inquiry revealed she was constitutionally weak and had poor appetite. Since the Liver belongs to Wood and governs the sinews, Liver stagnation leads to sinew spasms. Liver stagnation often overacts upon its controlled element (Earth/Spleen), thus injuring the Spleen and causing reduced food intake. Therefore, Pei Pi Shu Gan Tang (Spleen-Nourishing and Liver-Soothing Decoction) was prescribed. Because there was rebellious Qi attacking upward, 5 qian of finely powdered Sheng Zhe Shi (Oolithum, raw) was added. She was instructed to take two doses.
The spasms ceased immediately, and her breathing normalized. The Zhe Shi was then removed, and she continued taking the original formula for several more doses to consolidate the recovery.