炙甘草 白术(各二钱) 附子(一钱五分,炮) 桂枝(四钱,炒)
风湿骨节疼烦,不欲去衣,小便不利,大便反快者,此方主之。
风湿相搏,故骨节疼烦;伤风则恶风,故不欲去衣。小便不利而大便燥者为热,今小便
不利而大便反快,则湿可知矣。附子之热,可以散寒湿;桂枝之辛,可以解风湿;甘草健脾,
则湿不生;白术燥脾,则湿有制。是方也,以桂、附之辛热而治湿,犹之潦了之地,得太阳
曝之,不终朝而湿去,亦治湿之一道也。
黄柏(乳润一宿) 苍术(泔浸七日)等分为末。空心酒服三钱。
湿热腰膝疼痛者,此方主之。
湿性润下,病则下体受之,故腰膝病。然湿未尝痛,积久而热,湿热相搏,然后痛。此
方用苍术以燥湿,黄柏以去热,又黄柏有从治之妙,苍术有健脾之功,一正一从,奇正之道
也。
白术(炒) 茯苓(去皮) 猪苓 泽泻
湿生于内,水泻,小便不利者,此方主之。
经曰∶湿胜则濡泻。故湿生于内者,令人水泻;湿并于大肠,故小便不利,白术燥而淡
,燥则能健脾,淡则能利湿;茯苓甘而淡,甘则能补中,而淡亦渗湿矣。猪苓枯而淡,泽泻
咸而淡,枯者有渗利而无补益,咸者直能润下而兼渗利。丹溪曰∶治湿不利小便,非其治也。
故
炙甘草、白术(各二钱)、附子(一钱五分,炮制)、桂枝(四钱,炒制)。
风湿之邪侵袭骨节导致疼痛烦扰,患者不愿脱去衣物,小便不通畅,大便反而稀溏的,此方主治。
风湿相互搏结,所以骨节疼痛烦扰;感受风邪则怕风,所以不愿脱去衣物。小便不通畅且大便干燥的是热证,如今小便不通畅而大便反而稀溏,那么湿邪的性质就可以知道了。附子的热性,可以驱散寒湿;桂枝的辛味,可以解除风湿;甘草健脾,湿气便不会内生;白术燥脾,湿气便有所制约。这个方子,用桂枝、附子的辛热来治疗湿邪,就像积水之地,得到太阳暴晒,不到一个早晨湿气就去了,这也是治疗湿邪的一种方法。
黄柏(用乳汁浸泡一夜)、苍术(用淘米水浸泡七天),等分研为细末。空腹时用酒送服三钱。
湿热导致的腰膝疼痛的,此方主治。
湿性滋润向下,发病时下体受病,所以腰膝患病。然而湿本身并不导致疼痛,积聚日久化热,湿热相互搏结,然后才产生疼痛。此方用苍术来燥湿,黄柏来清热,而且黄柏有“从治”的妙处,苍术有健脾的功效,一正一从,符合奇正相生的道理。
白术(炒制)、茯苓(去皮)、猪苓、泽泻。
湿气生于体内,导致水样腹泻,小便不通畅的,此方主治。
《内经》说:湿胜则导致濡泻。所以湿气生于体内,使人发生水泻;湿气并入大肠,所以小便不通畅。白术性燥而味淡,燥则能健脾,淡则能利湿;茯苓味甘而淡,甘则能补益中气,而淡也能渗泄湿气。猪苓性枯而味淡,枯者只有渗利作用而没有补益作用;泽泻味咸而淡,咸者主要能润下并兼有渗利作用。朱丹溪说:治疗湿邪如果不通利小便,就不是正确的治疗方法。所以……
Zhi Gancao (Prepared Licorice Root), Baizhu (Atractylodis Rhizoma) (each 2 qian), Fuzi (Prepared Aconite Lateralis Radix, 1.5 qian, processed by firing), Guizhi (Cinnamomi Ramulus, 4 qian, stir-fried).
For pain and vexation in the bone joints caused by Wind-Dampness, where the patient is unwilling to remove clothing, with difficult urination and loose stools, this formula is indicated.
Wind and Dampness clashing together cause pain and vexation in the bone joints; injury by Wind leads to aversion to wind, hence the unwillingness to remove clothing. When difficult urination is accompanied by dry stools, it indicates Heat; however, when difficult urination is accompanied by loose stools, the nature of Dampness can be deduced. The heat of Fuzi (Prepared Aconite Lateralis Radix) can disperse Cold-Dampness; the acridity of Guizhi (Cinnamomi Ramulus) can resolve Wind-Dampness; Gancao (Licorice Root) strengthens the Spleen, preventing the generation of Dampness; Baizhu (Atractylodis Rhizoma) dries the Spleen, thereby controlling Dampness. This formula uses the acrid-hot properties of Guizhi (Cinnamomi Ramulus) and Fuzi (Prepared Aconite Lateralis Radix) to treat Dampness, similar to how a waterlogged area, when exposed to the sun, loses its moisture in less than a morning. This is also one method for treating Dampness.
Huangbai (Phellodendri Cortex, soaked in milk overnight), Cangzhu (Atractylodis Rhizoma, soaked in rice wash water for seven days), ground into equal parts into fine powder. Take 3 qian with wine on an empty stomach.
For pain in the waist and knees caused by Damp-Heat, this formula is indicated.
The nature of Dampness is moistening and downward; thus, when diseased, the lower body is affected, leading to disorders of the waist and knees. However, Dampness itself does not cause pain; after accumulation over time, it generates Heat, and only then does Pain occur due to the clashing of Damp-Heat. This formula uses Cangzhu (Atractylodis Rhizoma) to dry Dampness and Huangbai (Phellodendri Cortex) to clear Heat. Furthermore, Huangbai (Phellodendri Cortex) possesses the subtlety of "following treatment" (Cong Zhi), while Cangzhu (Atractylodis Rhizoma) has the merit of strengthening the Spleen. One is direct, the other follows, embodying the principle of orthodox and unorthodox methods.
Baizhu (Atractylodis Rhizoma, stir-fried), Fuling (Poria, peeled), Zhuling (Polyporus), Zexie (Alismatis Rhizoma).
When Dampness arises internally, causing watery diarrhea and difficult urination, this formula is indicated.
The Classics state: "Excess Dampness leads to loose stools." Thus, Dampness arising internally causes watery diarrhea; when Dampness merges into the Large Intestine, urination becomes difficult. Baizhu (Atractylodis Rhizoma) is drying and bland; its drying property strengthens the Spleen, and its blandness promotes diuresis. Fuling (Poria) is sweet and bland; its sweetness tonifies the Middle Jiao, and its blandness also渗泄 (percolates) Dampness. Zhuling (Polyporus) is withered and bland; being withered, it has percolating and draining effects but no tonifying benefits. Zexie (Alismatis Rhizoma) is salty and bland; its salinity primarily moistens downward and also possesses percolating and draining effects. Zhu Danxi said: "To treat Dampness without promoting urination is not the correct method." Therefore...