慢惊夹热或夹痰,身热心烦口溢涎,宜以清心涤痰治,白丸柴芍六君煎。
[注]
慢惊之证,本无热可言,但脾虚虚热内生,
故痰涎上泛,咽喉气粗,身热心烦,所谓虚夹痰热是也,
痰热相兼者,清心涤痰汤主之,
脾虚肝旺痰盛者,青州白丸子柴芍六子君汤主之。
(清心涤痰汤) 方见急惊后调理法。
(青州白丸子) 生川岛五钱去皮脐 生半夏七两 南星三两生 白附子二两生
以上为末,盛生绢袋内,用井花水摆出粉,未尽再摆,以粉尽为度,
罝磁盆内,日晒夜露,每早撇去旧水,别用新水搅,
春五日,夏三日,秋七日,冬十日,去水晒干,研为细末,
用糯米粉煎粥清丸菉豆大,每服三五丸,薄荷汤送下。
(柴芍六君子汤) 人参 白术土炒 茯苓 陈皮 半夏姜制 甘草炙
柴胡 白芍炒 □藤□ 引用姜枣水煎服。
(方歌)
脾虚木旺风痰盛,四君人参术草苓,痰盛陈半因加人,肝风更用柴芍藤。
%
惊风门
肝盛脾衰金气弱,金失承制木风生,每因吐泻伤脾胃,闭目摇头面唇青,
额汗昏睡身肢冷,舌短声哑呕澄清,温中补脾为主剂,固真理中随病情.
[注]
慢脾风一证,多缘吐泻即久,脾气大伤,以致土虚不能生金,
金弱不能制木,肝木强盛,惟脾是克,
故曰脾风,闭口摇头,面唇青黯,额汗昏陲,四肢厥冷,
舌短声哑,频呕清水,此乃纯阴无阳之证,
逐风则无风可逐,治惊则无惊可治,
惟宜大补脾上,生胃回阳为主,
吐泻亡阳者,温中补脾汤主之,
大病后成、固真汤主之,四肢厥冷者,理中汤加附子主之。
(温中补脾汤)
人参 黄耆蜜炙 白术土炒干姜 附子制 半夏姜制 陈皮 茯苓 砂仁
肉桂去粗皮研 白芍炒焦 甘草炙 丁香 引用煨姜水煎服。
(方歌)
慢脾温中补脾汤,参耆白术共干姜,陈半附苓缩砂桂,白芍甘草共丁香
(固真汤) 人参 白术土炒 肉桂去粗皮 白茯苓 山药炒 黄耆蜜炙
甘草湿纸里透 附子去皮脐汤泡浸 引用姜枣水煎服。
(方歌)
固真汤治慢脾风,人参白术桂茯苓,山药黄耆煨甘草,附子浸泡最宜精。
(理中汤) 方见不乳。
%
慢惊风夹带热邪或夹带痰浊,表现为身体发热、心中烦乱、口中溢出涎沫,适宜采用清心涤痰的方法治疗,方用青州白丸子和柴芍六君子汤。
[注]
慢惊风的证候,本来没有实热可言,但由于脾虚导致虚热内生,
因此痰涎上泛,咽喉气息粗重,身体发热、心中烦乱,这就是所谓的“虚夹痰热”。
如果是痰与热相互兼杂的,以清心涤痰汤为主治方;
如果是脾虚肝旺且痰盛的情况,以青州白丸子和柴芍六君子汤为主治方。
(清心涤痰汤)方剂内容见急惊风后的调理方法章节。
(青州白丸子)配方:生川乌五钱(去皮脐),生半夏七两,生南星三两,生白附子二两。
以上药材研为细末,装入生绢袋中,用井水反复漂洗出粉,直到粉末完全析出为止,
将药渣置于瓷盆内,白天日晒、夜间露置,每天早晨撇去旧水,换用新水搅拌,
春季五天,夏季三天,秋季七天,冬季十天,去掉水分晒干,研磨成细末,
用糯米粉煮粥取汁,制成如绿豆大小的丸药,每次服用三五丸,用薄荷汤送服。
(柴芍六君子汤)配方:人参,土炒白术,茯苓,陈皮,姜制半夏,炙甘草,柴胡,炒白芍,钩藤,引用生姜和大枣煎服。
(方歌)
脾虚木旺风痰盛,四君人参术草苓,痰盛陈半因加人,肝风更用柴芍藤。
惊风门
肝气过盛而脾气衰弱,肺金之气虚弱,失去对肝木的制约从而产生肝风,
多因呕吐腹泻损伤脾胃所致,症状包括闭目摇头、面色口唇发青,
额头出汗、昏睡、四肢冰冷,
舌体短缩、声音嘶哑、频繁呕吐清稀液体,
这是纯阴无阳的证候,
驱逐风邪则无风可逐,治疗惊厥则无惊可治,
只宜大补脾气,以生胃回阳为主要治法,
因吐泻导致亡阳的,以温中补脾汤为主治方,
大病后形成的慢脾风,以固真汤为主治方,四肢厥冷的,以理中汤加附子为主治方。
(温中补脾汤)
配方:人参,蜜炙黄芪,土炒白术,干姜,制附子,姜制半夏,陈皮,茯苓,砂仁,肉桂(去粗皮研末),炒焦白芍,炙甘草,引用煨姜煎服。
(方歌)
慢脾温中补脾汤,参耆白术共干姜,陈半附苓缩砂桂,白芍甘草共丁香
(固真汤)配方:人参,土炒白术,肉桂(去粗皮),白茯苓,炒山药,蜜炙黄芪,湿纸包裹透心的甘草,附子(去皮脐,汤泡浸),引用生姜和大枣煎服。
(方歌)
固真汤治慢脾风,人参白术桂茯苓,山药黄耆煨甘草,附子浸泡最宜精。
(理中汤)方剂内容见“不乳”章节。
Slow convulsion complicated by heat or phlegm manifests as fever, restlessness, and salivation. It is appropriate to treat with methods that clear the heart and eliminate phlegm, using Qingzhou Baiwan Zi (Qingzhou White Pill) and Chai Shao Liu Jun Zi Tang (Bupleurum and Peony Six Gentlemen Decoction).
[Note]
The syndrome of slow convulsion originally lacks excess heat; however, spleen deficiency leads to the endogenous generation of deficient heat.
Consequently, phlegm and saliva float upward, causing coarse breathing in the throat, fever, and restlessness. This is referred to as "deficiency complicated by phlegm-heat."
For cases where phlegm and heat are combined, Qingxin Ditan Tang (Clear Heart and Eliminate Phlegm Decoction) is the primary formula.
For cases involving spleen deficiency, liver hyperactivity, and abundant phlegm, Qingzhou Baiwan Zi (Qingzhou White Pill) and Chai Shao Liu Jun Zi Tang (Bupleurum and Peony Six Gentlemen Decoction) are the primary formulas.
(The formula for Qingxin Ditan Tang is found in the section on post-treatment care for fast convulsion.)
(The formula for Qingzhou Baiwan Zi consists of: Raw Chuanwu [Aconiti Radix Lateralis Preparata], 5 qian, peeled and de-navelled; Raw Banxia [Pinelliae Rhizoma], 7 liang; Raw Nanxing [Arisaematis Rhizoma], 3 liang; Raw Fuzi [Aconiti Lateralis Radix Praeparata], 2 liang.]
Grind the above ingredients into a fine powder, place them in a raw silk bag, and use well water to wash out the starch repeatedly until all powder is extracted.
Place the residue in a porcelain basin, expose it to sunlight during the day and dew at night. Each morning, discard the old water and stir with fresh water.
Process for five days in spring, three days in summer, seven days in autumn, and ten days in winter. Drain the water, dry the material, and grind it into a fine powder.
Use rice porridge liquid to bind the powder into pills the size of mung beans. Take three to five pills per dose, washed down with Bohe Tang (Mint Decoction).
(The formula for Chai Shao Liu Jun Zi Tang consists of: Renshen [Ginseng Radix et Rhizoma], earth-fried Baizhu [Atractylodis Macrocephalae Rhizoma], Fuling [Poria], Chenpi [Citri Reticulatae Pericarpium], Jiangzhi Banxia [Pinelliae Rhizoma Preparatum cum Zingibere], Zhigancao [Glycyrrhizae Radix et Rhizoma Preparatum cum Melle], Chaihu [Bupleuri Radix], Chao Baishao [Paeoniae Radix Alba Preparata], Gouteng [Uncariae Ramulus cum Uncis]. Use Shengjiang [Zingiberis Rhizoma Recens] and Dazao [Jujubae Fructus] as guides, decocted in water.)
(Verse Formula)
Spleen deficiency with wood hyperactivity generates wind and phlegm;
Si Jun Zi Tang (Four Gentlemen Decoction) contains Renshen, Baizhu, Gancao, and Fuling.
For abundant phlegm, add Chenpi and Banxia;
For liver wind, further add Chaihu, Baishao, and Gouteng.
Door of Convulsion
When liver qi is excessive and spleen qi is weak, lung metal qi is insufficient, losing its ability to control liver wind, which arises.
This often results from vomiting and diarrhea damaging the spleen and stomach. Symptoms include closed eyes, head shaking, cyanosis of the face and lips,
forehead sweating, lethargy, cold limbs,
short tongue, hoarse voice, and frequent vomiting of clear fluid.
This is a syndrome of pure yin without yang.
Eliminating wind is futile as there is no wind to eliminate; treating convulsion is ineffective as there is no convulsion to treat.
One should only greatly tonify spleen qi, focusing on generating stomach qi and restoring yang.
For collapse of yang due to vomiting and diarrhea, Wenzhong Bupi Tang (Warm the Middle and Tonify the Spleen Decoction) is indicated.
For slow spleen wind resulting from severe illness, Guzhen Tang (Solidify the Truth Decoction) is indicated.
For cold extremities, Lizhong Tang (Regulate the Middle Decoction) with added Fuzi [Aconiti Lateralis Radix Preparata] is indicated.
(The formula for Wenzhong Bupi Tang consists of: Renshen [Ginseng Radix et Rhizoma], Mi Zhi Huangqi [Astragali Radix Preparatum cum Melle], Tu Chao Baizhu [Atractylodis Macrocephalae Rhizoma Preparatum cum Terra], Ganjiang [Zingiberis Rhizoma], Zhi Fuzi [Aconiti Lateralis Radix Preparata], Jiangzhi Banxia [Pinelliae Rhizoma Preparatum cum Zingibere], Chenpi [Citri Reticulatae Pericarpium], Fuling [Poria], Sharen [Amomi Fructus], Rougui [Cinnamomi Cortex], Chao Jiao Baishao [Paeoniae Radix Alba Preparata et Usta], Zhigancao [Glycyrrhizae Radix et Rhizoma Preparatum cum Melle]. Use Wei Jiang [Zingiberis Rhizoma Preparatum] as a guide, decocted in water.)
(Verse Formula)
Wenzhong Bupi Tang for slow spleen wind,
Renshen, Huangqi, Baizhu, and Ganjiang together;
Chenpi, Banxia, Fuzi, Fuling, Sharen, and Rougui,
Baishao, Gancao, and Dingxiang [Caryophylli Flos] combined.
(The formula for Guzhen Tang consists of: Renshen [Ginseng Radix et Rhizoma], Tu Chao Baizhu [Atractylodis Macrocephalae Rhizoma Preparatum cum Terra], Rougui [Cinnamomi Cortex], Bai Fuling [Poria], Chao Shanyao [Dioscoreae Rhizoma Preparatum], Mi Zhi Huangqi [Astragali Radix Preparatum cum Melle], Gancao [Glycyrrhizae Radix et Rhizoma] wrapped in wet paper and steamed through, Fuzi [Aconiti Lateralis Radix Preparata] peeled, navels removed, soaked in decoction. Use Shengjiang [Zingiberis Rhizoma Recens] and Dazao [Jujubae Fructus] as guides, decocted in water.)
(Verse Formula)
Guzhen Tang treats slow spleen wind,
Renshen, Baizhu, Rougui, and Fuling;
Shanyao, Huangqi, roasted Gancao,
and soaked Fuzi are most suitable when refined.
(The formula for Lizhong Tang is found in the section on refusal to suckle.)