治寒中腹胀满, 作涎作清涕; 或多溺足下痛, 不能
任身履地, 骨乏无力, 喜睡, 两丸多冷, 时作阴阴而痛, 或妄见鬼状
,梦亡人, 腰背, 胛眼, 腰脊皆痛.
白术 附子 ( 炮, 去皮脐 ) 苍术 陈皮 厚朴 ( 姜制 ) 半夏 (
汤洗 ) 茯苓 猪苓 ( 去皮 ) 半两 泽泻 肉桂四钱, 右锉如麻豆
大,每服半两, 水三盏, 姜三片, 同煎至一盏, 去滓, 食前温服. 量
虚实加减多少.
【注】李杲云: 脾胃之证, 有热中, 有寒中. 热中者, 是火乘土位之
病,则当上举清阳, 下消阴火, 故用补中益气, 泻阴火升阳等汤. 寒
中者, 水反侮土之病, 则当下伐水邪, 中燥脾湿, 故用二苓, 术, 泽
,苍, 陈, 朴, 夏, 更用桂, 附, 壮阳胜寒, 流通血脉, 寒中之病自
可愈也.
【按】李杲制此方, 施之于脾胃寒湿内盛, 胀满多溺, 涎涕外盛, 足
软,腰脊, 丸痛, 而气不虚者, 宜矣. 若其人中气已虚, 内外寒湿又
盛,水来侮土者, 总不若理中汤加附子, 苍术, 茯苓为愈也.
治酒客病.
莲花青皮 ( 去穣 ) 三分 木香五分 橘皮 ( 去白 ) 白茯苓 人
参 猪苓以上各一钱五分 神麴 ( 炒 ) 泽泻 干姜 白术以上各
二钱 白豆蔻仁 葛花 砂仁以上各五钱, , 右为细末, 和匀, 每服
三钱, 白汤调下. 但得微汗, 酒病去矣. 不可恃此过饮, 频服取汗,
损人天年.
【注】酒为水谷精液所化, 体湿性热, 少饮则能调和气血, 流畅阴阳
,内助中气, 捍御外邪. 若过饮无度, 轻则伤人脾胃, 重则损人神气
.所以酒困之人, 昏晕烦乱, 干呕恶心, 饮食即吐, 百体酸软, 身热
头疼, 嘈杂吞酸, 胸膈痞塞, 口燥舌干, 手足颤摇, 心神恍惚, 不思
饮食, 小便浑浊, 大便溏泻, 此皆湿热伤形与气也.
【按】李杲曰: 酒病者, 往往以大热, 大寒下之者, 是无形元气受病
,反下有形阴血, 乖误甚矣. 大热则伤阴, 大寒则伤胃, 元气消亡,
七神无根据, 折人寿命, 不然则虚损之病成矣. 故制此方, 君葛花, 佐
以辛香之品; 用神麴, 佐以快气之品; 用苓泽, 佐以甘温之品. 服后
取汗, 是谓外解肌肉, 内清阳明, 令上下, 内外, 分消其患, 使胃中
秽为芳变, 浊为清化, 泰然和矣.
【白术附子汤】治疗寒邪直中脾胃导致的腹部胀满,分泌过多涎液和清稀鼻涕;或者小便频多、足底疼痛,身体沉重无法承受站立行走,骨骼酸软无力,嗜睡,阴囊寒冷,时常出现隐隐作痛,或者幻觉看见鬼怪形状,梦见已故之人,腰部、背部、肩胛部、眼睛以及腰脊部位都感到疼痛。
白术、附子(炮制,去皮和脐)、苍术、陈皮、厚朴(姜汁炒制)、半夏(沸水清洗)、茯苓、猪苓(去皮),以上各半两;泽泻、肉桂各四钱。将上述药材切碎如麻豆大小,每次服用半两,加水三盏,生姜三片,共同煎煮至一盏,滤去药渣,饭前温服。根据患者虚实情况加减用量。
【注释】李杲说:脾胃的病证,有热中和寒中之分。热中,是火邪侵犯土位(脾胃)的病,应当提升清阳之气,消除下焦的阴火,所以使用补中益气汤、泻阴火升阳汤等方剂。寒中,是水邪反侮脾土的病,应当向下祛除水湿邪气,燥化脾脏湿气,所以使用茯苓、猪苓、白术、泽泻、苍术、陈皮、厚朴、半夏,再加上肉桂、附子,以壮阳驱寒,流通血脉,寒中的病自然可以痊愈。
【按语】李杲制定此方,适用于脾胃寒湿内盛,表现为腹胀满、小便多、涎涕外溢、足部软弱、腰脊及睾丸疼痛,且正气未虚的患者,是适宜的。如果患者中气已经虚弱,内外寒湿又很盛,导致水来侮土的情况,总不如使用理中汤加入附子、苍术、茯苓疗效更好。
【葛花解酲汤】治疗饮酒过度引起的疾病。
莲花青皮(去除瓤)、木香各五分;橘皮(去除白色部分)、白茯苓、人参、猪苓,以上各一钱五分;神曲(炒制)、泽泻、干姜、白术,以上各二钱;白豆蔻仁、葛花、砂仁,以上各五钱。将上述药材研成细末,混合均匀,每次服用三钱,用白开水调服。只要微微出汗,酒病即可去除。不可依赖此方而过度饮酒,频繁服药取汗,会损害人的寿命。
【注释】酒是由水谷的精微液体转化而成的,其体质湿润而性质温热,少量饮用能调和气血,流畅阴阳,内部辅助中气,抵御外邪。如果过量饮酒没有节制,轻则伤害脾胃,重则损伤人的精神元气。所以醉酒的人,会出现昏晕烦乱、干呕恶心、饮食即吐、全身酸软、身体发热头痛、胃脘嘈杂吞酸、胸膈痞塞、口燥舌干、手足颤抖摇晃、心神恍惚、不想饮食、小便浑浊、大便溏泻等症状,这些都是湿热损伤形体与元气的表现。
【按语】李杲说:患酒病的人,往往被误用大热或大寒的药物攻下,这是无形元气受病,反而攻下有形的阴血,错误非常严重。大热的药物会伤阴,大寒的药物会伤胃,导致元气消亡,七神无所依托,折损人的寿命,否则就会形成虚损的疾病。所以制定此方,以葛花为君药,辅以辛香之品;使用神曲,辅以行气之品;使用茯苓、泽泻,辅以甘温之品。服药后出汗,这叫作从外部解除肌肉层面的邪气,从内部清除阳明经的热邪,使上下、内外分消病患,让胃中的秽浊变为芳香,浊气化为清气,身体就能安然平和了。
[Baizhu Fuzi Decoction] Treats abdominal distension and fullness caused by cold pathogen directly invading the middle jiao (Spleen and Stomach), excessive production of saliva and clear nasal discharge; or frequent urination, pain in the soles of the feet, heaviness of the body making it difficult to stand or walk, bone soreness and weakness, somnolence, coldness of the scrotum, occasional dull pain, visual hallucinations of ghosts, dreaming of deceased persons, and pain in the waist, back, shoulder blades, eyes, and spinal column.
Baizhu Rhizoma (Atractylodis Macrocephalae Rhizoma), Fuzii Radix Preparata (Prepared Aconiti Lateralis Radix) [processed, skin and umbilicus removed], Cangzhu Rhizoma (Atractylodis Rhizoma), Chenpi Pericarpium Citri Reticulatae (Pericarpium Citri Reticulatae), Houpo Cortex Magnoliae Officinalis (Cortex Magnoliae Officinalis) [prepared with ginger juice], Banxia Rhizoma Pinelliae Ternatae (Pinelliae Rhizoma) [washed with boiling water], Fuling Sclerotium Poriae (Sclerotium Poriae), Zhuling Sclerotium Polypori Umbellati (Sclerotium Polypori Umbellati) [skin removed], each 1.5 liang (approx. 45g); Zexie Rhizoma Alismatis Orientales (Rhizoma Alismatis), Rouguai Cortex Cinnamomi Cassiae (Cortex Cinnamomi Cassiae), each 4 qian (approx. 12g). The above herbs are chopped into pieces the size of hemp seeds. Each dose is 0.5 liang (approx. 15g), boiled with 3 cups of water and 3 slices of fresh ginger until reduced to 1 cup. Strain and take warm before meals. Adjust dosage according to the patient's deficiency or excess condition.
[Note] Li Gao stated: Disorders of the Spleen and Stomach include Heat-Zhong and Cold-Zhong. Heat-Zhong refers to a disease where Fire pathogen invades the Earth position (Spleen/Stomach); treatment should raise clear Yang and drain Yin-Fire, thus utilizing formulas such as Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Xieyin Huoyang Tang (Drain Yin Fire and Raise Yang Decoction). Cold-Zhong refers to a disease where Water pathogen counter-insults Earth; treatment should downwardly eliminate Water dampness and dry Spleen dampness, thus utilizing Zhuling, Baizhu, Zexie, Cangzhu, Chenpi, Houpo, Banxia, along with Rougui and Fuzi to strengthen Yang, overcome cold, and promote blood circulation, thereby curing Cold-Zhong.
[Commentary] Li Gao formulated this decoction for cases of internal abundance of Cold-Dampness in the Spleen and Stomach, manifesting as abdominal distension, polyuria, external overflow of saliva and mucus, weak legs, pain in the waist/spine and testicles, provided that the Righteous Qi (Zhengqi) is not yet deficient. However, if the Middle Qi is already deficient, and both internal and external Cold-Dampness are abundant, leading to Water insulting Earth, it is superior to use Lizhong Tang (Regulate the Middle Decoction) added with Fuzi, Cangzhu, and Fuling.
[Gehua Jiecheng Tang] Treats diseases caused by excessive alcohol consumption.
Lianhua Qingpi (Green Peel of Lotus Flower) [pulp removed], Muxiang Radix Aucklandiae (Radix Aucklandiae), each 5 fen (approx. 1.5g); Juqi Pericarpium Citri Reticulatae (Pericarpium Citri Reticulatae) [white pith removed], BaiFuling Sclerotium Poriae (Sclerotium Poriae), Renshen Radix Ginseng (Radix Ginseng), Zhuling Sclerotium Polypori Umbellati (Sclerotium Polypori Umbellati), each 1.5 qian (approx. 4.5g); Shenqu Massamedicated Saccharomyces (Massa Medicata Fermentata), Zexie Rhizoma Alismatis Orientales (Rhizoma Alismatis), Ganjiang Rhizoma Zingiberis Recens (Rhizoma Zingiberis Recens), Baizhu Rhizoma Atractylodis Macrocephalae (Rhizoma Atractylodis Macrocephalae), each 2 qian (approx. 6g); Baidoukou Ren Semen Amomi Rotundae (Semen Amomi Rotundae), Gehua Flos Speranskiae Tuberculatae (Flos Speranskiae Tuberculatae), Sharen Fructus Amomi Rotundae (Fructus Amomi Rotundae), each 5 qian (approx. 15g). Grind all ingredients into a fine powder and mix evenly. Take 3 qian (approx. 9g) per dose, mixed with warm water. If a slight sweat is induced, the alcohol-induced illness will be resolved. Do not rely on this formula to consume excessive alcohol; frequent administration to induce sweating damages natural lifespan.
[Note] Wine is transformed from the essence of food and fluids; its nature is damp and hot. Moderate consumption harmonizes Qi and Blood, smooths Yin and Yang, assists Middle Qi internally, and defends against external pathogens. Excessive and unregulated drinking lightly injures the Spleen and Stomach, and heavily damages Spirit and Yuan Qi. Therefore, intoxicated individuals may experience dizziness, irritability, dry retching, nausea, vomiting immediately after eating, general body soreness and weakness, fever, headache, gastric discomfort with acid regurgitation, chest and diaphragm oppression, dry mouth and tongue, trembling of hands and feet, mental confusion, loss of appetite, turbid urine, and loose stools. These are all manifestations of Damp-Heat injuring form and Qi.
[Commentary] Li Gao stated: Patients with alcohol-induced illness are often mistakenly treated with drastic Hot or Cold purgatives. This harms the formless Yuan Qi while unnecessarily attacking the formed Yin Blood, which is a grave error. Drastic heat injures Yin, and drastic cold injures the Stomach, leading to the depletion of Yuan Qi, leaving the Seven Spirits without foundation, shortening life, or resulting in chronic deficiency disorders. Therefore, this formula was created: Gehua is used as the Sovereign herb, assisted by acrid-aromatic substances; Shenqu is used, assisted by Qi-moving substances; Fuling and Zexie are used, assisted by sweet-warm substances. Inducing sweat after ingestion resolves pathogens externally in the muscles and clears Heat internally in the Yangming channel, dispersing the affliction through upper/lower and internal/external pathways, transforming foulness into fragrance and turbidity into clarity, restoring harmony.