治肺经积热上喘, 胸膈胀满痰多, 大便涩.
人参 黄芩 栀子 栱壳 薄荷 甘草 连翘 杏仁 桑皮 大黄
桔梗水煎服.
【集注】王又原曰: 经云: 邪之所凑, 其气必虚. 又肺为娇脏, 其不
堪破耗也明矣. 自肺热伤肺之说行, 曰保肺补肺, 众共哗之; 曰清肺
泻肺, 乐与和之. 岂知古人清肺, 泻肺等汤, 而必皆以人参立名, 夫
亦可晓然于肺气之不可耗, 而人参之在所必用也. 肺体清而法天, 下
济而司降令, 一切浑浊不得上干者, 皆胸中之气健运行而不息也. 若
肺气稍弛, 则降下失令, 浑浊之气遂逆上行, 此为咳嗽为喘急, 肺叶
胀举, 胸膈紧痛, 移热大肠, 大便艰涩, 种种显有余之象, 实种种为
不足之征. 故不问内伤外感, 为热为寒, 要以人参保定肺气为主. 或
佐骨皮, 知母, 阿胶滋之, 鸟梅, 五味, 罂粟壳敛之, 半夏??, 生姜
降之, 杏仁, 桑皮, 枳壳, 桔梗利之, 栀子, 黄芩, 连翘凉之, 麻黄
,薄荷发之, 大黄下之, 总恃人参之大力, 握枢而运, 已入之邪易出
,而将来之邪无从入也. 肺邪得诸药以俱出, 而肺气不随诸药以俱出
也.然则人参亦何尝伤肺, 乃畏而不敢用耶? 又谓风寒咳嗽, 忌用五
味子; 嗽用粟壳, 止嗽如神, 切肺如刀. 然此无本之言, 不知始自何
出, 皆因不读本草, 不知药之性味功能, 以讹传讹也. 近世之医,
亦不能辨, 惟识者察之.
治疗肺经积热引起的上气喘促,胸膈胀满痰多,大便干涩难通。
人参、黄芩、栀子、枳壳、薄荷、甘草、连翘、杏仁、桑白皮、大黄。
以上药材用水煎煮后服用。
【集注】王又原说:医经云:“邪气聚集的地方,正气必然虚弱。”另外,肺是娇嫩的脏器,它不能承受过度的攻伐耗损,这是很明显的道理。自从“肺热伤肺”的说法流行以来,人们纷纷哗然反对“保肺补肺”的主张;而对于“清肺泻肺”的主张,则乐于附和。哪里知道古人使用清肺、泻肺等汤剂时,必定都以“人参”命名方名,这也可以让人清楚地明白肺气不可耗损,以及人参必须使用的道理。肺体清纯而效法天道,向下济助并主管肃降的职能,一切浑浊之气不得上犯干扰的,都是因为胸中元气健运不息所致。如果肺气稍微松弛,则肃降功能失常,浑浊之气于是逆乱上行,这就导致了咳嗽、喘急,肺叶胀大上举,胸膈紧痛,热气移入大肠,导致大便艰涩难通,种种表现看似有余(实证),实际上却是种种不足的征象。因此,不论内伤还是外感,属热还是属寒,都要以人参来固护肺气作为主要原则。或者佐以地骨皮、知母、阿胶来滋润它,乌梅、五味子、罂粟壳来收敛它,半夏、生姜来降逆它,杏仁、桑白皮、枳壳、桔梗来利气它,栀子、黄芩、连翘来凉润它,麻黄、薄荷来发汗解表它,大黄来通便下泄它,总之是依靠人参的大力,把握枢纽而运转,使已侵入的邪气容易排出,而将来欲侵入的邪气无从进入。肺部的邪气随着诸药的作用一起排出,而肺气不会随着诸药的作用一起耗散。既然这样,那么人参又何曾伤害过肺,反而让人畏惧不敢使用呢?又有人说风寒咳嗽,忌讳使用五味子;咳嗽用罂粟壳,止咳如神,但切肺(指过度收敛导致肺气闭塞)如同刀割。然而这些都是没有根据的言论,不知道起始于何处,都是因为没有研读《本草》,不了解药物的性味功能,从而以讹传讹。近世的医生,也不能辨别这些是非,只有明察的人才能看清真相。
Treats upper wheezing caused by accumulated heat in the Lung meridian, chest and diaphragm distension with abundant phlegm, and dry, difficult defecation.
Ren Shen (Ginseng Radix), Huang Qin (Scutellariae Radix), Zhi Zi (Gardeniae Fructus), Zhi Ke (Aurantii Fructus), Bo He (Menthae Haplocalycis Herba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Lian Qiao (Forsythiae Fructus), Xing Ren (Armeniacae Semen Amarum), Sang Bai Pi (Mori Cortex), Da Huang (Rhei Radix et Rhizoma).
Decoct these herbs in water and take orally.
[Collected Annotations] Wang Youyuan stated: The Classics say: "Where pathogenic factors gather, the healthy Qi must be deficient." Furthermore, the Lung is a delicate organ, and it is evident that it cannot withstand excessive depletion or attack. Since the theory of "Lung heat injuring the Lung" became prevalent, people have loudly opposed the idea of "preserving and tonifying the Lung," while readily agreeing with "clearing and purging the Lung." How could they know that ancient formulas for clearing and purging the Lung invariably featured Ren Shen (Ginseng Radix) in their names? This should make it clear that Lung Qi must not be depleted, and thus Ren Shen (Ginseng Radix) is indispensable. The Lung's substance is pure and follows the Heavenly Dao; it descends to assist and governs the descending function. The reason turbid pathogens do not ascend to interfere is due to the vigorous and ceaseless movement of Qi in the chest. If Lung Qi becomes slightly lax, the descending function fails, and turbid Qi rebels upward. This leads to cough, wheezing, distension and elevation of the lung lobes, tight pain in the chest and diaphragm, heat transferring to the Large Intestine, and difficult defecation. These various manifestations appear as excess (Shi patterns), but are actually signs of deficiency (Xu patterns). Therefore, regardless of whether the cause is internal injury or external contraction, heat or cold, the primary principle must be to use Ren Shen (Ginseng Radix) to stabilize Lung Qi. One may add Gu Pi (Phellodendri Cortex), Zhi Mu (Anemarrhenae Rhizoma), and E Jiao (Colla Corii Asini) to moisten it; Wu Mei (Mume Fructus), Wu Wei Zi (Schisandrae Fructus), and Ying Su Qiao (Papaveris Pericarpium) to astringe it; Ban Xia (Pinelliae Rhizoma) and Sheng Jiang (Zingiberis Rhizoma Recens) to direct rebellious Qi downward; Xing Ren (Armeniacae Semen Amarum), Sang Bai Pi (Mori Cortex), Zhi Ke (Aurantii Fructus), and Jie Geng (Platycodonis Radix) to benefit Qi flow; Zhi Zi (Gardeniae Fructus), Huang Qin (Scutellariae Radix), and Lian Qiao (Forsythiae Fructus) to cool it; Ma Huang (Ephedrae Herba) and Bo He (Menthae Haplocalycis Herba) to induce sweating and release the exterior; Da Huang (Rhei Radix et Rhizoma) to purge downwards. All rely on the powerful force of Ren Shen (Ginseng Radix) to grasp the pivot and regulate, allowing existing pathogens to exit easily and preventing future pathogens from entering. The Lung pathogens exit together with the action of the various herbs, while Lung Qi does not dissipate along with them. In this case, how has Ren Shen (Ginseng Radix) ever injured the Lung, yet people fear it and dare not use it? Others claim that for wind-cold cough, Wu Wei Zi (Schisandrae Fructus) is contraindicated; and that using Ying Su Qiao (Papaveris Pericarpium) for cough stops it miraculously, but constricting the Lung like a knife cut. However, these are baseless statements of unknown origin, resulting from not studying Materia Medica and not understanding the properties, flavors, and functions of drugs, thereby spreading errors. Physicians of recent times also fail to distinguish right from wrong; only those with insight can perceive the truth.