1.清白散
当归 黄柏 ( 盐水泡 ) 白芍 ( 炒 ) 樗根皮 ( 酒炒 ) 生地
川芎 贝母各一钱 炮姜 甘草各五分
上锉, 生姜三片, 水煎服.
2.导水丸
牵牛 ( 头末 ) 滑石 ( 水飞 ) 黄芩 川大黄
上末, 蒸饼为丸, 量虚实服.
3.万安丸
牵牛 ( 头末 ) 胡椒 木香 小茴香 ( 焙 ) 各等分焙
上末, 水泛为丸, 量虚实服.
4.威喜丸
白茯苓 ( 去皮作块, 用猪苓二钱半, 同于磁器内煮二十余沸出, 晒
干,不用猪苓 ) 四两 黄蜡四两
上以茯苓为末, 炼黄蜡为丸, 如弹子大. 空心细嚼, 满口生津, 徐徐
咽服, 以小便清为度. 忌米醋, 只吃糠醋. 忌动气.
5.固精丸
牡蛎 (?? 粉 ) 菟丝子 ( 酒蒸, 焙 ) 韭子 ( 炒 ) 龙骨 五
味子 白茯苓 桑螵蛸 ( 酒炙 ) 赤石脂各等分
上为末, 酒糊丸如桐子大. 每服七十丸, 空心盐汤下.
1.五积六聚分脏腑, 七症八瘕气血凝, 症积不动有定处, 瘕聚推移
无定形. 痞闷不宣气壅塞, 未成坚块血瘀名, 蓄久不散成血蛊, 产后
经行风冷乘.
【注】五脏气积, 名曰积, 故积有五证. 六腑气聚, 名曰聚, 故聚有
六证. 难经有心, 肝, 脾, 肺, 肾五脏之积, 而无六聚. 盖以积为血
病,而聚为气病也. 故李杲有五积丸方治法. 「巢氏病源」载七症八
瘕,但有八瘕名证, 而无七症病形. 其他方书亦不概见. 大抵又以症
为气病, 而瘕为血病也. 夫病皆起于气, 也气聚而后血凝, 不必过泥
于黄, 青, 燥, 血, 脂, 狐, 蛇, 鳖等名, 但以牢固不移有定处者 ,
为症为积; 推移转动, 忽聚忽散者为瘕为聚可也. 故曰: 症者: 征也
,言有形可征也. 瘕者, 假也, 言假物成形也. 若夫痞者, 痞闷不通
,气道壅塞之谓也. 瘀血者, 血瘀腹中未成坚块也. 蓄之既久, 必成
血蛊矣. 凡此诸证, 皆有新产之后, 经行之时, 不知谨避, 以致风冷
外袭, 邪正相搏, 结于腹中而成也.
1. 清白散
当归、黄柏(用盐水浸泡)、白芍(炒制)、樗根皮(用酒炒制)、生地黄、川芎、贝母各一钱,炮姜、甘草各五分。
以上药材切碎,加生姜三片,用水煎煮后服用。
2. 导水丸
牵牛子(取头末,即最细粉末)、滑石(水飞法处理)、黄芩、川大黄。
以上药材研为细末,用蒸饼糊作为粘合剂制成丸药,根据患者虚实情况决定剂量服用。
3. 万安丸
牵牛子(取头末)、胡椒、木香、小茴香(焙干)各等分,共同焙干。
以上药材研为细末,用水泛法制成丸药,根据患者虚实情况决定剂量服用。
4. 威喜丸
白茯苓(去皮切成块,用猪苓二钱半,同置于瓷器内煮沸二十多次后取出,晒干,去掉猪苓)四两,黄蜡四两。
以上将茯苓研为细末,用炼过的黄蜡制成丸药,大小如弹子。空腹时细细咀嚼,待口中生津液后,慢慢咽下服用,以小便清澈为度。忌食米醋,只可吃糠醋。忌动气(保持情绪平稳,避免恼怒)。
5. 固精丸
牡蛎(煅粉)、菟丝子(酒蒸,焙干)、韭子(炒制)、龙骨、五味子、白茯苓、桑螵蛸(酒炙)、赤石脂各等分。
以上药材研为细末,用酒糊制成丸药,大小如梧桐子大。每次服用七十丸,空腹时用盐汤送服。
1. 五积六聚分别归属于脏腑,七症八瘕是由于气血凝滞所致;症积固定不动且有固定部位,瘕聚可以推移且形状不固定。痞闷不通是气机壅塞的表现,尚未形成坚硬肿块者称为血瘀;蓄积日久不散则成为血蛊,多因产后或经期感受风冷所致。
【注】五脏的气积,称为“积”,所以积有五种证候。六腑的气聚,称为“聚”,所以聚有六种证候。《难经》中记载了心、肝、脾、肺、肾五脏的积,而没有六聚的说法。这是因为积属于血病,而聚属于气病。所以李杲有治疗五积的丸方和方法。《诸病源候论》中记载了七症八瘕,但只有八瘕的名称和证候,而没有七症的病形。其他医书也不多见。大体上又将症视为气病,而瘕视为血病。然而疾病都起于气,气聚之后才导致血凝,不必过分拘泥于黄、青、燥、血、脂、狐、蛇、鳖等名称,只要将牢固不移、有固定部位的,称为症、称为积;将可以推移转动、忽聚忽散的,称为瘕、称为聚就可以了。所以说:症,就是征象的意思,指有形迹可以验证;瘕,就是假的意思,指假借物而成形。至于痞,是指痞闷不通,即气道壅塞的意思。瘀血,是指血液瘀滞在腹中,尚未形成坚硬肿块。蓄积既久,必然形成血蛊。凡是这些证候,都是因为新产之后,或行经之时,不知谨慎避忌,以致风冷外邪侵袭,邪气与正气相搏结,凝聚于腹中而形成的。
1. Qingbai San (Clear and White Powder)
Danggui (Radix Angelicae Sinensis), Huangbai (Cortex Phellodendri, soaked in salt water), Baishao (Radix Paeoniae Alba, stir-fried), Chugenpi (Cortex Ailanthi, fried with wine), Shengdihuang (Radix Rehmanniae Preparata), Chuanxiong (Rhizoma Chuanxiong), Beimu (Bulbus Fritillariae Cirrhosae), each 1 qian; Paojiang (Rhizoma Zingiberis Preparatum), Gancao (Radix Glycyrrhizae Uralensis), each 0.5 qian.
Crush the above herbs, add three slices of fresh ginger, decoct in water, and take orally.
2. Daoshui Wan (Water-Guiding Pill)
Qianniu (Semen Pharbitidis, finest powder), Huashi (Talcum, processed by water flotation), Huangqin (Radix Scutellariae), Chuandahuang (Radix et Rhizoma Rhei).
Grind the above herbs into fine powder, use steamed wheat cake paste as a binder to form pills, and take according to the patient's deficiency or excess condition.
3. Wan'an Wan (Ten Thousand Peace Pill)
Qianniu (Semen Pharbitidis, finest powder), Hujiao (Piperis Longi Fructus), Muxiang (Radix Aucklandiae), Xiaohuixiang (Fructus Foeniculi, roasted), each in equal parts, roasted together.
Grind the above herbs into fine powder, use water to granulate and form pills, and take according to the patient's deficiency or excess condition.
4. Weixi Wan (Mighty Joy Pill)
Baifuling (Poria, peeled and cut into pieces, boiled with Erzhuling (Polyporus) 2.5 qian in a porcelain vessel for more than twenty boils, then dried and removed from Erzhuling) 4 liang, Huangla (Beeswax) 4 liang.
Grind the Poria into fine powder, melt the beeswax to form pills the size of a bullet. Chew thoroughly on an empty stomach until saliva is produced, then swallow slowly. Stop when urine becomes clear. Avoid rice vinegar; only bran vinegar is permitted. Avoid emotional agitation.
5. Gujing Wan (Essence-Securing Pill)
Muli (Concha Ostreae, calcined and powdered), Tusizi (Semen Cuscutae, steamed with wine and roasted), Jiuizi (Semen Allii Tuberosi, stir-fried), Longgu (Os Draconis), Wuweizi (Fructus Schisandrae Chinensis), Baifuling (Poria), Sangpiaoxiao (Ootheca Mantidis, fried with wine), Chishizhi (Halloysit Rubrum), each in equal parts.
Grind the above herbs into fine powder, use wine paste to form pills the size of tung tree seeds. Take 70 pills each time on an empty stomach, washed down with salt water.
1. The five accumulations (Ji) and six aggregations (Ju) are distinguished by their association with zang and fu organs respectively; the seven signs (Zheng) and eight masses (Jia) result from the stagnation of qi and blood. Zheng and Ji remain fixed in place with definite locations, whereas Jia and Ju can be moved and lack a fixed shape. Pi refers to fullness and obstruction due to qi congestion; it has not yet formed a hard mass and is named blood stasis. If retained for a long time without dispersing, it becomes Xuegu (blood gu); this often occurs after childbirth or during menstruation when exposed to wind-cold.
[Note] Qi accumulation in the five zang organs is called "Ji" (accumulation), hence there are five types of Ji. Qi aggregation in the six fu organs is called "Ju" (aggregation), hence there are six types of Ju. The Nan Jing describes accumulations in the heart, liver, spleen, lung, and kidney but does not mention six aggregations. This is because Ji pertains to blood disorders, while Ju pertains to qi disorders. Therefore, Li Gao provided formulas and methods for treating five accumulations. The Zhu Bing Yuan Hou Lun records seven zheng and eight jia, but only lists names and syndromes for the eight jia, lacking descriptions of the seven zheng. Other medical texts rarely mention them. Generally, zheng is considered a qi disorder, while jia is considered a blood disorder. However, diseases all originate from qi; after qi aggregates, blood coagulates. One need not overly adhere to specific names such as huang, qing, zao, xue, zhi, hu, she, and bie. Instead, classify those that are firm, immovable, and have fixed locations as zheng and ji; and those that are movable, rotatable, appearing and disappearing intermittently as jia and ju. Thus, it is said: "Zheng" means evidence/signs, implying tangible forms can be verified; "Jia" means false, implying shapes formed by borrowed materials. As for "Pi," it refers to stuffiness and obstruction, meaning the blockage of the qi pathway. "Blood stasis" refers to blood stagnating in the abdomen without forming a hard mass. After prolonged retention, it inevitably becomes Xuegu. All these conditions arise because, following childbirth or during menstruation, one fails to take proper precautions, allowing wind-cold external pathogens to invade. The pathogenic factors and healthy qi struggle against each other, knotting within the abdomen to form these conditions.