半夏(姜制) 陈皮 茯苓(各一钱半) 甘草(七分半,炙)
脾弱不能制湿,内生积饮者,此方主之。
水谷入胃,无非湿也。脾土旺,则能运化水谷,上归于肺,下达膀胱,无湿气可留也,
惟夫脾弱不能制湿,则积而为痰饮。半夏之辛能燥湿,茯苓之淡能渗湿,甘草之甘能健脾,
陈皮之辛能利气。脾健则足以制湿,气利则积饮能行。东南之人,多有湿饮之疾,故丹溪恒
主之。其曰加升提之剂者,亦清气升而浊气自降之谓。
苍术(泔浸七日,五斤) 陈皮(去白) 浓朴(姜汤炒,各三斤) 甘草(炙,三十
两)
湿淫于内,脾胃不能克制,有积饮痞膈中满者,此方主之。
此湿土太过之证,经曰敦阜是也。苍术味甘而燥,甘则入脾,燥则胜湿;浓朴味温而苦
,温则益脾,苦则燥湿,故二物可以平敦阜之土。陈皮能泄气,甘草能健脾,气泄则无湿郁
之患,脾强则有制湿之能,一补一泄,又用药之则也。是方也,惟湿土太过者能用之,若脾
土不足及老弱、阴虚之人,皆非所宜也。
羌活 独活(各一钱) 本 炙甘草 防风 川芎(各五分) 蔓荆子(三分)
外伤于湿,一身尽痛者,此方主之。
脾胃虚弱,湿从内生者,二陈、平胃之类主之;水停于膈,湿盛濡泻者,六一、五苓之
类主之;水渗皮肤,肢肿黄胀者,五皮、茵陈之类主之。今湿流关节,非上件所宜矣。经曰
风胜湿,故用羌、防、 、独、芎、蔓诸风药以治之。以风药而治湿,如卑湿之地,风行其
上,不终日而湿去矣。又曰无窍不入,惟风为能,故凡关节之病,非风药不可。用甘草者,
以风药悍燥,用以调之。此之谓有制之兵也。
半夏(经生姜炮制) 陈皮 茯苓(各一钱半) 甘草(七分半,蜜炙)
水谷进入胃中,没有不是湿气的。脾土功能旺盛,就能运化水谷,向上输送到肺,向下通达膀胱,就没有湿气可以停留了,
只有当脾脏虚弱不能制约湿气时,才会积聚成为痰饮。半夏的辛味能够燥湿,茯苓的淡味能够渗利湿气,甘草的甘味能够健脾,
陈皮的辛味能够理气。脾脏健运就足以制约湿气,气机通畅则停积的水饮得以运行。东南地区的人,多有湿饮为患的疾病,所以朱丹溪常常使用此方。他说加入升提的药物,也是指清气上升而浊气自然下降的意思。
苍术(用淘米水浸泡七天,五斤) 陈皮(去掉白色部分) 厚朴(用姜汤炒,各三斤) 甘草(蜜炙,三十两)
湿气在体内泛滥,脾胃不能克制,出现停积水饮、胸膈痞闷、腹部胀满的症状,此方主治。
这是湿土过盛的证候,《黄帝内经》称之为“敦阜”(土气过盛)。苍术味甘且性燥,甘味能入脾,燥性能胜湿;厚朴味温且苦,
温性能补益脾阳,苦性能燥湿,所以这两味药可以平抑过盛的湿土之气。陈皮能泄降气机,甘草能健脾,气机泄降则没有湿气郁结的祸患,脾脏强健就有制约湿气的能力,一补一泻,又是用药的法度。这个方子,只有湿土过盛的人才能使用,如果是脾土不足以及年老体弱、阴虚的人,都不适宜使用。
羌活 独活(各一钱) 藁本 炙甘草 防风 川芎(各五分) 蔓荆子(三分)
外感湿气,导致全身疼痛的,此方主治。
脾胃虚弱,湿气从体内产生的,用二陈汤、平胃散之类的方剂主治;水液停聚在胸膈,湿气盛导致大便稀溏的,用六一散、五苓散之类的方剂主治;水湿渗入皮肤,肢体浮肿、腹部胀大发黄的,用五皮散、茵陈蒿汤之类的方剂主治。现在湿气流注于关节,就不适合使用上述方剂了。《黄帝内经》说风能胜湿,所以使用羌活、防风、藁本、独活、川芎、蔓荆子等风药来治疗它。用风药来治湿,就像在低洼潮湿的地方,风吹过上面,不到一天湿气就消除了。又说风邪无孔不入,只有风能到达,所以凡是关节的疾病,非用风药不可。使用甘草,是因为风药性质猛烈燥烈,用它来调和药性。这就叫做有节制的军队。
Pinellia Rhizoma (processed with ginger juice) [Banxia]
Chenpi (Exocarpium Citri Reticulatae)
Poria [Fuling] (1.5 qian each)
Licorice Root [Gancao] (0.75 qian, honey-fried)
When the Spleen is weak and unable to control dampness, leading to the internal accumulation of fluid retention, this formula is indicated.
Food and drink entering the Stomach are all sources of dampness. When Spleen Earth is vigorous, it can transform and transport food and drink, sending them upward to the Lung and downward to the Bladder, leaving no dampness to remain.
However, when the Spleen is weak and cannot control dampness, it accumulates into phlegm-fluid. The pungency of Pinellia Rhizoma [Banxia] can dry dampness, the blandness of Poria [Fuling] can leach out dampness, the sweetness of Licorice Root [Gancao] can tonify the Spleen,
and the pungency of Chenpi [Exocarpium Citri Reticulatae] can promote the movement of Qi. A healthy Spleen is sufficient to control dampness, and smooth Qi flow allows accumulated fluids to move. People in the Southeast often suffer from diseases of damp-fluid retention, so Zhu Danxi frequently used this formula. He stated that adding lifting agents refers to the principle that when clear Qi rises, turbid Qi naturally descends.
Atractylodis Rhizoma [Cangzhu] (soaked in rice water for seven days, five jin)
Chenpi [Exocarpium Citri Reticulatae] (white pith removed)
Magnolia Bark [Houpo] (stir-fried with ginger decoction, three jin each)
Licorice Root [Gancao] (honey-fried, thirty liang)
When dampness overflows internally and the Spleen and Stomach cannot restrain it, resulting in fluid retention, chest and diaphragm stuffiness, and abdominal fullness, this formula is indicated.
This is a syndrome of excessive damp-Earth, referred to as "Dunfu" (protruding earth) in the classics. Atractylodis Rhizoma [Cangzhu] has a sweet taste and drying nature; sweetness enters the Spleen, and drying nature overcomes dampness. Magnolia Bark [Houpo] has a warm and bitter taste; warmth benefits Spleen Yang, and bitterness dries dampness. Therefore, these two herbs can level the excessive damp-Earth. Chenpi [Exocarpium Citri Reticulatae] can drain Qi, and Licorice Root [Gancao] can tonify the Spleen. Draining Qi prevents the hazard of dampness stagnation, and a strong Spleen gains the ability to control dampness. One tonifying and one draining constitute the principle of medication. This formula is only suitable for those with excessive damp-Earth; it is not appropriate for those with insufficient Spleen Earth, the elderly, the weak, or those with Yin deficiency.
Notopterygii Rhizoma et Radix [Qianghuo]
Angelicae Pubescentis Radix [Duhuo] (one qian each)
Ligustici Rhizoma [Gaoben]
Licorice Root [Gancao] (honey-fried)
Saposhnikoviae Radix [Fangfeng]
Ligusticum Chuanxiong Rhizoma [Chuanxiong] (five fen each)
Viticis Fructus [Manjingzi] (three fen)
When externally affected by dampness, causing pain throughout the entire body, this formula is indicated.
For dampness generated internally due to Spleen and Stomach weakness, formulas such as Erchen Tang (Two-Aged Decoction) or Pingwei San (Stomach-Pacifying Powder) are indicated; for water retention in the diaphragm and dampness-induced loose stools, formulas such as Liuyi San (Six-to-One Powder) or Wuling San (Five-Ling Powder) are indicated; for water-dampness infiltrating the skin, causing limb edema and yellowish abdominal distension, formulas such as Wupi San (Five-Bark Powder) or Yinchenshao Tang (Artemisia Capillaris Decoction) are indicated. Now, since dampness flows into the joints, the aforementioned formulas are not suitable. The classics state that wind overcomes dampness; therefore, wind herbs such as Notopterygii Rhizoma et Radix [Qianghuo], Saposhnikoviae Radix [Fangfeng], Ligustici Rhizoma [Gaoben], Angelicae Pubescentis Radix [Duhuo], Ligusticum Chuanxiong Rhizoma [Chuanxiong], and Viticis Fructus [Manjingzi] are used to treat it. Using wind herbs to treat dampness is like wind blowing over low, wet land; within a day, the dampness disappears. It is also said that wind penetrates every orifice, and only wind can do so; thus, for any joint disease, wind herbs are indispensable. Licorice Root [Gancao] is used because wind herbs are harsh and drying, and it serves to moderate their properties. This is what is meant by a disciplined army.