心虚盗汗睡多惊,酸枣仁汤服即宁,心火伤阴必烦热,当归六黄汤奏功。
[注]
盗汗有二,虚实两分,
心虚者阴气不敛也,睡则多惊,以酸枣仁汤主之,
心热者,火伤于阴也,身多烦热,以当归六黄汤主之。
(酸枣仁汤) 当归 白芍炒 生地 茯苓 酸枣仁炒 知母炒 黄蘖炒
五味子 人参 黄耆炒 水煎服。
(方歌)
酸枣仁汤治盗汗,阳不能藏阴本虚,归芍生地茯苓枣,知蘖五味共参耆。
(当归六黄汤)
当归 生地黄 熟地黄 黄芩 黄蘖 黄连 黄耆炙 引用浮麦水煎服。
(方歌)
当归六黄治盗汗,阳盛伤阴液自流,生熟二地芩连蘖,归耆浮麦汗能收。
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阴乘阳热血妄行,血犯气分不归经,血病及腑渗浊道,伤于藏者溢出清,
热犯阳络上吐衄,热侵阴络下失红,又有努劳成血病,血止仍嗽势多凶。
[注]
凡失血之证,阳盛乘阴,则血为热迫,不能安于脉中,
犯于气分,妄行不能归入经脉也,
若血病伤及于腑者,则血渗入肠胃之浊道上行于咽,出而为吐为衄,
下从二便而出,为便为溺也,
若血病伤及于藏者,则溢出于胸中之清道,上从喉出而兼咳嗽,
下从精窍而出,为溺血也,
失血藏于脏内,行于脉中,流于躯壳之内,
不可得而见也,非损伤不能为病,
而损之因有三,
一曰热伤阳络,腑病也,热伤阴络,藏病也,宜以清热为主,
一曰努伤,宜以破逐为主,
一曰劳伤,宜以理损为主,
若日久血止,而咳嗽不休者,主必死之证,故势多凶也。
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失血门
心气虚弱导致的盗汗,伴有睡眠中多梦易惊,服用酸枣仁汤即可安宁;心火亢盛损伤阴液必然导致心烦发热,服用当归六黄汤可奏效。
[注释]
盗汗分为虚证和实证两种情况。
心气虚弱是因为阴气不能收敛,睡眠时容易惊醒,以酸枣仁汤为主治方剂;
心热是因为火热之邪损伤了阴液,身体多有烦热感,以当归六黄汤为主治方剂。
(酸枣仁汤组成)当归、炒白芍、生地黄、茯苓、炒酸枣仁、炒知母、炒黄柏、五味子、人参、炒黄芪,用水煎服。
(方歌)
酸枣仁汤治疗盗汗,阳气不能潜藏因阴本虚,方中含归芍生地茯苓与枣仁,知母黄柏五味子共配人参黄芪。
(当归六黄汤组成)
当归、生地黄、熟地黄、黄芩、黄柏、黄连、炙黄芪,引用浮小麦水煎服。
(方歌)
当归六黄汤治疗盗汗,阳盛伤阴致津液自流,方中生熟二地配芩连柏,当归黄芪加浮小麦能止汗。
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阴气乘袭阳气,血液受热妄行,血分病变波及气分,血液不能回归经脉。若血病波及六腑,则渗入浊道(排泄糟粕的通道),若损伤五脏,则溢出清道(呼吸及生殖等清净通道)。
热邪侵犯阳络,导致上部吐血或鼻衄;热邪侵入阴络,导致下部便血或尿血。又有因过度用力劳作导致的血证,即使出血停止但仍咳嗽不止者,病情大多凶险。
[注释]
凡是失血的病症,都是阳气亢盛乘袭阴分,血液被热邪逼迫,不能安守于脉管之中,
侵犯到气分,妄行而不能回归经脉;
如果血病损伤了六腑,那么血液就会渗入肠胃等浊道,向上逆行至咽喉,表现为呕吐或鼻衄,
向下从大小便排出,表现为便血或尿血;
如果血病损伤了五脏,那么血液就会溢出胸中的清道,向上从喉咙咳出并兼有咳嗽,
向下从尿道排出,表现为尿血;
血液贮藏于脏内,运行于脉中,流动在躯壳之内,
平时是不可见的,除非受到损伤才会发病,
而造成损伤的原因有三种:
一是热邪损伤阳络,属于腑病;热邪损伤阴络,属于脏病,应当以清热为主要治疗方法;
二是努伤(因强力举重或剧烈运动导致的损伤),应当以破血逐瘀为主要治疗方法;
三是劳伤(因劳累过度导致的损伤),应当以调理虚损为主要治疗方法;
如果病程日久,出血已经停止,但咳嗽仍不停止的,主病必死之证,所以病情大多凶险。
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失血门
Sweat during sleep (Dao Han) caused by Heart Qi deficiency, accompanied by frequent startles in sleep, is calmed immediately by taking Suanzaoren Tang (Sour Jujube Decoction); if Heart Fire injures Yin and inevitably causes irritability and fever, Danggui Liu Huang Tang (Angelica Hexapartite Decoction) achieves efficacy.
[Note]
Sweat during sleep (Dao Han) is divided into deficiency and excess patterns.
Heart deficiency implies that Yin Qi fails to consolidate; with frequent startles during sleep, Suanzaoren Tang (Sour Jujube Decoction) is the primary formula.
Heart heat implies that Fire injures Yin; with bodily irritability and heat, Danggui Liu Huang Tang (Angelica Hexapartite Decoction) is the primary formula.
(Composition of Suanzaoren Tang [Sour Jujube Decoction]): Danggui (Angelicae Sinensis Radix), Chao Baishao (Fried White Peony Root), Shengdihuang (Rehmanniae Radix), Fuling (Poria), Chao Suanzaoren (Fried Semen Ziziphi Spinosae), Chao Zhimu (Fried Rhizoma Anemarrhenae), Chao Huangbo (Fried Cortex Phellodendri), Wuweizi (Schisandrae Fructus), Renshen (Ginseng Radix), Chao Huangqi (Fried Astragali Membranacei Radix). Decoct in water and take orally.
(Verse for Formula)
Suanzaoren Tang (Sour Jujube Decoction) treats sweat during sleep; Yang fails to store due to fundamental Yin deficiency. It contains Danggui, Baishao, Shengdihuang, Fuling, and Suanzaoren; Zhimu, Huangbo, Wuweizi, Renshen, and Huangqi are combined.
(Composition of Danggui Liu Huang Tang [Angelica Hexapartite Decoction])
Danggui (Angelicae Sinensis Radix), Shengdihuang (Rehmanniae Radix), Shudihuang (Prepared Rehmanniae Radix), Huangqin (Scutellariae Radix), Huangbo (Phellodendri Cortex), Huanglian (Coptidis Rhizoma), Zhi Huangqi (Honey-fried Astragali Membranacei Radix). Decoct with Fu Mai (Tritici Levigati Fructus) in water and take orally.
(Verse for Formula)
Danggui Liu Huang Tang (Angelica Hexapartite Decoction) treats sweat during sleep; Excess Yang injures Yin causing fluids to flow freely. Shengdihuang, Shudihuang, Huangqin, Huanglian, and Huangbo are used; Danggui, Huangqi, and Fu Mai can stop sweating.
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Yin encroaching on Yang leads to reckless movement of hot blood; when Blood pathology invades the Qi level, it fails to return to the meridians. If Blood pathology affects the Fu organs, it seeps into the turbid pathways (excretory channels); if it injures the Zang organs, it overflows from the clear pathways (respiratory and reproductive channels).
Heat invading the Yang collaterals causes upper hematemesis or epistaxis; Heat invading the Yin collaterals causes lower hematochezia or hematuria. There is also blood disease resulting from strenuous labor; even if bleeding stops, persistent coughing indicates a generally ominous prognosis.
[Note]
In all cases of blood loss, Excess Yang encroaches on Yin, forcing blood with heat so that it cannot remain safely within the vessels.
It invades the Qi level, moving recklessly and failing to return to the meridians.
If blood pathology injures the Fu organs, blood seeps into the turbid pathways of the intestines and stomach, ascending to the pharynx, manifesting as vomiting or epistaxis.
Descending through the two excretions, it manifests as hematochezia or hematuria.
If blood pathology injures the Zang organs, it overflows from the clear pathways in the chest, ascending through the throat accompanied by coughing,
and descending through the essence orifice, manifesting as hematuria.
Blood is stored within the Zang, circulates within the vessels, and flows within the body shell;
it is invisible under normal conditions and only becomes pathological upon injury.
There are three causes of such injury:
First, Heat injuring the Yang collaterals constitutes a Fu organ disease; Heat injuring the Yin collaterals constitutes a Zang organ disease. The treatment should primarily focus on clearing heat.
Second, Injury from strain (Nu Shang) requires treatment primarily focused on breaking stasis and expelling blood.
Third, Injury from fatigue (Lao Shang) requires treatment primarily focused on regulating deficiency and damage.
If, after a long duration, bleeding has stopped but coughing persists without relief, it indicates a fatal condition, hence the prognosis is generally ominous.
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Section on Blood Loss