目赤肿痛,人知降火,而不知活血,所以多不得力,只用四物汤,内地黄用生,芍药用
赤,
加酒蒸大黄、赤茯苓、薄荷叶,治之甚妙,此戴复庵法。余谓目赤肿痛,人知活血,而不知
治痰。脾胃壅滞,积热生痰,积痰生热,辗转相因,气冲头目,昏痛不已者,须用半夏、石
菖蒲、黄芩、枳实、茯苓、陈皮,微兼菊花、白蒺藜之属治之。
王肯堂治许少薇口糜,谓非干姜不愈,卒如其言。又从子懋 ,亦患此,势甚危急,欲
饮冷
水,与人参、白术、干姜各二钱,茯苓、甘草各一钱,煎成冷冻饮料,日数服,乃已。盖土温则
火敛,人多不能知。此所以然者,胃虚食少,肾水之气逆而乘之,则为寒中,脾胃虚衰之火
被迫上炎,作为口疮。其症饮食少思,大便不实,或手足逆冷,肚腹作痛是也。
虚劳之人,气血枯耗,生气不荣,则内生寒冷,张鸡峰所谓冷劳者是也。宜建中、复脉
、八
味肾气之属,甘温辛润,具生阳化阴之能者治之。亦有邪气淹滞,经络瘀郁者,元珠所谓体
虚之人,最易感于邪气,当先和解,微利微下之,次则调之。医不知而遽行补剂,邪气不解
,往往致死。是故虚劳之治,固不必专以补阴降火为事也。
热风,热化为风也。患人头目昏眩痛,口鼻燥,热气出,微恶风,时时有热者是也。是
虽辛
凉,不能解之。孟诜云∶患热风人,宜食牛乳,谓其气味甘寒,而性濡润,能使肌热除而风
自熄。求之草木,芦根、蔗浆、梨汁之属,性味相似,亦《内经》风淫于内,治以甘寒之旨
也。
目赤肿痛,人们只知道降火,却不知道活血,所以治疗效果往往不得力。如果只用四物汤,其中地黄用生品,芍药用赤芍,再加酒蒸大黄、赤茯苓、薄荷叶来治疗,效果非常奇妙,这是戴复庵的方法。我认为目赤肿痛,人们只知道活血,却不知道治痰。脾胃壅滞,积热生痰,积痰又生热,两者互为因果,气冲头目,导致昏痛不止,这种情况下,必须使用半夏、石菖蒲、黄芩、枳实、茯苓、陈皮,并微加菊花、白蒺藜等药物来治疗。
王肯堂治疗许少薇的口糜(口腔黏膜溃烂),说非干姜不能治愈,最终果然如他所言。他的侄子王懋也患此病,病情十分危急,想喝冷水,王肯堂用人参、白术、干姜各二钱,茯苓、甘草各一钱,煎煮后做成冷冻饮料,每天服用数次,病才痊愈。这是因为脾土温暖则虚火收敛,人们大多不知道这个道理。之所以这样,是因为胃虚食少,肾水之气上逆乘犯脾胃,导致寒中;脾胃虚衰产生的火被迫上炎,形成口疮。其症状表现为饮食减少、大便不成形,或者手足逆冷、肚腹作痛。
虚劳之人,气血枯耗,生气不能荣养身体,则体内产生寒冷,这就是张鸡峰所说的“冷劳”。适宜使用建中汤、复脉汤、八味肾气丸之类的方剂,这些方药具有甘温辛润的特性,具备生阳化阴的功能来进行治疗。也有因邪气滞留,经络瘀郁的情况,正如元珠所说,体质虚弱的人最容易感受邪气,应当先和解,轻微通利或攻下,然后再调理。医生如果不了解这一点而急于使用补剂,邪气不解,往往会导致死亡。因此,治疗虚劳,固然不必专门以补阴降火为事。
热风,是指热转化为风。患者出现头目昏眩疼痛、口鼻干燥、热气外发、轻微恶风、时常发热等症状。这种情况虽然用辛凉药物,也不能解除。孟诜说:患热风的人,适宜食用牛乳,因为牛乳气味甘寒,性质濡润,能够消除肌肤之热,使风邪自然平息。寻求与牛乳性味相似的草木药物,芦根、蔗浆、梨汁等属于此类,这也符合《内经》中“风淫于内,治以甘寒”的宗旨。
Redness and swelling of the eyes: People know to reduce fire (clear heat), but do not know to invigorate blood, so treatments are often ineffective. If only Siwu Tang (Four Substances Decoction) is used, with raw Rehmanniae Radix (Sheng Dihuang) and red Paeoniae Radix (Chi Shaoyao), added with wine-processed Rhei Radix et Rhizoma (Jiu Da Huang), Polyporus (Chi Fuling), and Menthae Haplocalycis Herba (Bohe Ye), the treatment is very effective; this is the method of Dai Fu'an. I believe that for redness and swelling of the eyes, people know to invigorate blood, but do not know to treat phlegm. When the spleen and stomach are obstructed, accumulated heat generates phlegm, and accumulated phlegm generates heat, revolving around each other as causes and effects, qi rushes to the head and eyes, causing persistent dizziness and pain. In such cases, one must use Pinelliae Rhizoma Preparatum (Banxia), Acori Tatarinowii Rhizoma (Shichangpu), Scutellariae Radix (Huangqin), Aurantii Fructus Immaturus (Zhishi), Poria (Fuling), and Chenpi, slightly adding Chrysanthemi Flos (Juhua) and Tribuli Fructus (Bajili) to treat it.
Wang Kentang treated Xu Shaowei's aphthous stomatitis (koumi), stating that only dried ginger could cure it, and it turned out exactly as he said. His nephew, Wang Mao, also suffered from this condition, which was critical; he desired to drink cold water. Wang Kentang administered Ginseng Radix (Renshen), Atractodis Macrocephalae Rhizoma (Baizhu), and Zingiberis Rhizoma Recens (Ganjiang), each 2 qian, along with Poria (Fuling) and Glycyrrhizae Radix et Rhizoma (Gancao), each 1 qian. The decoction was prepared as a chilled beverage, taken several times a day, until the illness subsided. This is because when the earth (spleen/stomach) is warm, the fire (heat) converges; most people do not understand this. The reason is that due to stomach deficiency and poor appetite, the qi of kidney water rebels and overacts upon the spleen and stomach, resulting in interior cold. The fire generated by the deficiency and decline of the spleen and stomach is forced to flare upward, forming mouth ulcers. Symptoms include lack of desire for food, loose stools, or cold extremities and abdominal pain.
In patients with consumptive disease (xulao), qi and blood are depleted, and the vital qi fails to nourish, leading to internal cold. This is what Zhang Jifeng referred to as "cold consumption" (leng lao). It is appropriate to use formulas such as Jianzhong Tang (Middle-Building Decoction), Maigui Fumai Tang (Reviving Pulse Decoction), or Bawei Shenqi Wan (Eight-Ingredient Kidney Qi Pill). These sweet-warm and pungent-moist preparations possess the ability to generate yang and transform yin. There are also cases where pathogenic factors linger, causing stasis and depression in the collaterals. As Yuanyuan stated, those with weak constitutions are most susceptible to pathogenic factors; one should first harmonize, using mild purgation or drainage, followed by regulation. If physicians do not understand this and hastily administer tonics, the pathogenic factors will not resolve, often leading to death. Therefore, the treatment of consumptive disease does not necessarily focus solely on nourishing yin and reducing fire.
Refractory wind (refeng) refers to heat transforming into wind. Patients experience dizziness and pain in the head and eyes, dryness in the mouth and nose, emission of hot air, slight aversion to wind, and intermittent fever. Although acrid-cool herbs may be used, they cannot resolve this condition. Meng Shen said: Patients with refractory wind should consume cow's milk, as its flavor is sweet and cold, and its nature is moistening, which can eliminate heat in the muscles and extinguish wind naturally. Among herbal plants, reed rhizome (Lugen), sugarcane juice (Zhe Jiang), and pear juice (Lizhi) have similar properties and flavors, which also aligns with the principle in the *Neijing*: "When wind dominates internally, treat with sweet and cold substances."