人参 甘草(炙,各一钱) 升麻(五分) 黄 (一钱五分,炙) 当归 白术(炒)
陈皮
(去白) 柴胡(各五分)
劳倦伤脾,中气不足,懒于言语,恶食溏泄,日渐瘦弱者,此方主之。
脾主四肢,故四肢勤动不息,又遇饥馁,无谷气以养,则伤脾。伤脾故令中气不足,懒
于言语。脾气不足以胜谷气,故恶食。脾弱不足以克制中宫之湿,故溏泄。脾主肌肉,故瘦
弱。五味入口,甘先入脾,是方也,参、 、归、术、甘草,皆甘物也,故可以入脾而补中
气。中气者,脾胃之气也。人生与天地相似,天地之气一升,则万物皆生,天地之气一降,
则万物皆死。故用升麻、柴胡为佐,以升清阳之气,所以法象乎天地之升生也。用陈皮者,
一能疏通脾胃,一能行甘温之滞也。是证黄 建中汤亦可主用,见伤寒门。
枸杞子(一斗) 酒(二斗,同煎)
肝劳,面目青,口苦,精神不守,恐畏不能独卧,目视不明者,此方主之。
肝者,将军之官,谋虑出焉,故谋而不决,拂而数怒,久久则劳其肝。肝,东方之色也
,病则色征于面目,故令面目色青;口苦者,肝移热于腑而胆汁上溢也;肝藏魂,肝劳则邪
居魂室,故令精神不守,且恐畏不能独卧也;肝气通于目,肝和则能辨五色矣,今肝为劳伤,
故令目视不明。经曰∶味为阴,味浓为阴中之阴,枸杞味浓,故足以养厥阴之阴;煮以纯酒
,取其浃洽气血而已。他如六味地黄丸,亦可主用。古谓肝肾之病同一治,又谓虚则补其母
,肾是肝之母,故地黄丸亦宜。
人参、甘草(炙,各一钱)、升麻(五分)、黄芪(一钱五分,炙)、当归、白术(炒)、陈皮(去白)、柴胡(各五分)。
因劳累损伤脾脏,导致中气不足,表现为懒得说话、厌恶进食、大便稀溏、身体日渐消瘦者,此方主治。
脾主四肢,因此四肢频繁活动不停息,又遇到饥饿匮乏,没有水谷精气来滋养,就会损伤脾脏。损伤脾脏所以导致中气不足,懒得说话。脾气虚弱不足以消化水谷之气,所以厌恶进食。脾脏虚弱不足以制约中焦的湿气,所以导致大便稀溏。脾主肌肉,所以身体消瘦。五味入口,甘味首先入脾,这个方剂中,人参、黄芪、当归、白术、甘草,都是甘味的药物,所以能够入脾而补益中气。中气,就是脾胃之气。人与天地相似,天地的阳气上升,万物就生长;天地的阳气下降,万物就死亡。所以用升麻、柴胡作为佐药,以升发清阳之气,这是效法天地阳气升发生长的道理。使用陈皮的原因,一是能疏通脾胃,二是能行散甘温药物的滞涩。这种证候,黄芪建中汤也可以主治,详见伤寒门。
枸杞子(一斗)、酒(二斗,同煎)。
肝劳,表现为面目青色、口苦、精神不能守舍、恐惧害怕不能独自卧床、视物不明者,此方主治。
肝是将军之官,谋虑由此产生,所以谋划而不能决断,受挫而经常发怒,时间久了就会劳伤肝脏。肝对应东方,其色为青,生病时颜色反映在面目上,所以导致面目呈青色;口苦,是肝将热邪转移给腑,胆汁上溢所致;肝藏魂,肝劳则邪气占据魂室,所以导致精神不能守舍,并且恐惧害怕不能独自卧床;肝气通于目,肝气调和就能辨别五色了,现在肝被劳伤,所以导致视物不明。经文说:味属阴,味浓重属于阴中之阴,枸杞味道浓重,所以足以滋养厥阴之阴;用纯酒煮制,是为了取其通达气血的作用。其他的如六味地黄丸,也可以主治。古人说肝肾的疾病治疗原则相同,又说“虚则补其母”,肾是肝之母,所以地黄丸也适宜使用。
Ren Shen (Ginseng Radix), Gan Cao (Licorice Root, honey-fried, 1 qian each), Sheng Ma (Cimicifugae Rhizoma, 5 fen), Huang Qi (Astragali Radix, 1.5 qian, honey-fried), Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried), Chen Pi (Citri Reticulatae Pericarpium, pith removed), Chai Hu (Bupleuri Radix, 5 fen each).
For cases where fatigue and overwork injure the Spleen, resulting in deficiency of Middle Qi, manifesting as reluctance to speak, anorexia, loose stools, and gradual emaciation, this formula is indicated.
The Spleen governs the four limbs; thus, if the limbs are active incessantly, and one encounters hunger or famine without grain qi to nourish them, the Spleen will be injured. Injury to the Spleen leads to deficiency of Middle Qi and reluctance to speak. When Spleen Qi is insufficient to overcome the qi of food, anorexia occurs. When the Spleen is weak and insufficient to control dampness in the Central Palace (Middle Jiao), loose stools result. The Spleen governs muscles, hence emaciation. Among the five flavors, sweet flavor enters the Spleen first. In this formula, Ren Shen, Huang Qi, Dang Gui, Bai Zhu, and Gan Cao are all sweet substances, thus they can enter the Spleen and tonify Middle Qi. Middle Qi refers to the Qi of the Stomach and Spleen. Humans resemble Heaven and Earth: when the Qi of Heaven and Earth ascends, all things grow; when it descends, all things die. Therefore, Sheng Ma and Chai Hu are used as assistants to ascend the clear Yang Qi, imitating the ascending and generating nature of Heaven and Earth. Chen Pi is used for two reasons: first, to unblock the Stomach and Spleen; second, to move the stagnation caused by sweet and warm herbs. For this syndrome, Huang Qi Jian Zhong Tang (Astragalus Decoction to Establish the Middle) may also be used, as seen in the Shaoyang Disease section.
Gou Qi Zi (Lycii Fructus, 1 dou), Jiu (Wine, 2 dou, decocted together).
For Liver Labor, manifesting as bluish complexion around the eyes and face, bitter taste in the mouth, inability to guard the Spirit, fearfulness preventing solitary sleeping, and blurred vision, this formula is indicated.
The Liver is the official of the General, from whom strategies arise. Thus, if one plans but cannot decide, or is frustrated and frequently angered, over time the Liver becomes labored. The Liver corresponds to the East and its color is green; when diseased, this color manifests on the face and eyes, causing a bluish hue. A bitter taste results from Liver heat transferring to the Fu organs, causing bile to overflow upwards. The Liver stores the Hun (Ethereal Soul); Liver labor allows evil to occupy the chamber of the Hun, leading to an inability to guard the Spirit and fearfulness preventing solitary sleep. Liver Qi connects to the Eyes; when Liver Qi is harmonious, the five colors can be distinguished. Now, since the Liver is injured by labor, vision becomes unclear. The Classics state: "Flavor is Yin; strong flavor is Yin within Yin." Gou Qi Zi has a strong flavor, thus it is sufficient to nourish the Yin of Jueyin (Liver). It is boiled in pure wine to facilitate the circulation of Qi and Blood. Other formulas such as Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) may also be used. Ancient texts state that diseases of the Liver and Kidney share the same treatment principle, and further state that "when deficient, tonify the Mother." Since the Kidney is the Mother of the Liver, Di Huang Wan is also appropriate.