阿胶(一两半,蛤粉炒) 鼠粘子(二钱半,炒香) 马兜铃(半两,焙) 炙甘草(五
钱)
杏仁(去皮尖,七个) 粳米(一两)
肺虚有火,嗽无津液,咳而哽气者,此方主之。
燥者润之,今肺虚自燥,故润以阿胶、杏仁;金郁则泄之,今肺中郁火,故泄以兜铃、
粘子;土者金之母,虚者补其母,故入甘草、粳米以补脾益胃。
黄柏(一斤,炮褐色,为末,水丸 气虚者四君子汤下,血虚者四物汤下)
肾火从脐下起者,肾水衰也,此方主之。
肾非独阴也,命门之火寄焉。肾水一亏,则命门之火无所畏而自炽矣,故龙雷之火从脐
下动也。经曰∶水郁则折之。水郁者,肾部有郁火也。折之者,制其冲逆也。柏皮味苦而浓,
为
此之谓也。气虚下以四君子汤,恐其寒凉而坏脾也;血虚下以四物汤,助其滋阴而制火也。
黄柏(十两,酒浸) 知母(六两,酒浸) 肉桂(五钱)
肾火起于涌泉之下者,此方主之。
热自足心直冲股内而入腹者,谓之肾火起于涌泉之下。知、柏苦寒,水之类也,故能滋
益肾水;肉桂辛热,火之属也,故能假之反佐,此《易》所谓水流湿、火就燥也。
黄芩 黄连 黄柏(俱酒润,等分)
三焦有火,嗌喉干燥,小便赤涩,大便秘结,此方主之。
少火之火,无物不生;壮火之火,无物不耗,《内经》曰壮火食气是也。故少火宜升,
壮火宜降。今以三物降其三焦之壮火,则气得其生,血得其养,而三焦皆受益矣,故曰三补。
黄芩苦而枯,故清热于上;黄连苦而实,故泻火于中;黄柏苦而润,故泻火于下。虽然火有
虚实,是方但可以治实火,若虚者用之,则火反盛,谓降多亡阴也。丹溪曰∶虚火可补,人
参、黄 之类。则虚实之辨,若天渊矣,明者幸求之证焉。
阿胶(一两半,用蛤粉炒制) 鼠粘子(二钱半,炒至香气溢出) 马兜铃(半两,焙干) 炙甘草(五钱)
杏仁(去皮和尖,七个) 粳米(一两)
肺虚且有内火,咳嗽时缺乏津液,咳嗽伴有气逆哽塞感的,此方主治。
燥邪当用滋润之法,现因肺虚导致自身干燥,故用阿胶、杏仁来滋润;金气郁结则需疏泄,现因肺中郁积之火,故用马兜铃、鼠粘子来清泄;土是金的母脏,虚证应当补益其母脏,故加入甘草、粳米以补益脾胃。
黄柏(一斤,炮制至褐色,研为粉末,用水泛丸。气虚者用四君子汤送服,血虚者用四物汤送服)
肾火从脐下发起的,是因肾水衰少所致,此方主治。
肾并非只有阴,命门之火寄寓其中。肾水一旦亏损,则命门之火无所畏惧而自行炽盛,因此龙雷之火从脐下发动。经书说:水郁结则需折损其势。所谓水郁,是指肾部有郁积之火。所谓折之,是指制约其冲逆之势。黄柏皮味苦且浓厚,正是为此目的而设。气虚时用四君子汤送服,是担心其寒凉性质损伤脾胃;血虚时用四物汤送服,是为了助其滋阴并制约火势。
肾火从涌泉穴之下发起的,此方主治。
热气从足心直冲大腿内侧并进入腹部,称为肾火起于涌泉之下。知母、黄柏味苦性寒,属于水类,因此能滋补肾水;肉桂味辛性热,属于火类,因此能起到反佐的作用,这正是《易经》所说的“水流湿、火就燥”的道理。
三焦有火,咽喉干燥,小便赤红涩痛,大便秘结,此方主治。
少火(生理之火)能使万物生长;壮火(病理之火)会消耗一切,《内经》说“壮火食气”就是这个道理。因此,少火宜升发,壮火宜降泄。现在用这三味药来降低三焦的壮火,那么气就能得到生发,血就能得到滋养,从而三焦都受益,所以叫作“三补”。
黄芩味苦而枯,故在上焦清热;黄连味苦而实,故在中焦泻火;黄柏味苦而润,故在下焦泻火。虽然火有虚实之分,但此方只能治疗实火,如果是虚火使用它,火势反而会旺盛,这是因为降火过度会导致亡阴。丹溪说:虚火可以用补法,如人参、黄芪之类。因此虚实之间的辨别,如同天壤之别,明智的人希望仔细审察证候。
Ejiao (Donkey-hide Gelatin, 1.5 liang, stir-fried with clam powder) Arctii Fructus (Niu Bang Zi, 2.5 qian, stir-fried until fragrant) Aristolochiae Fructus (Ma Dou Ling, 0.5 liang, baked) Zhi Gancao (Prepared Licorice Root, 5 qian)
Xingren (Apricot Seed, skin and tip removed, 7 seeds) Jingmi (Oryza sativa var. glutinosa, 1 liang)
For deficiency of the Lung with internal heat, coughing without fluid secretion, and cough accompanied by qi rebellion and choking sensation, this formula is indicated.
Dryness requires moistening; since the Lung is deficient and inherently dry, Ejiao and Xingren are used to moisten it. When Metal (Lung) is constrained, it must be dispersed; since there is constrained fire in the Lung, Aristolochiae Fructus and Arctii Fructus are used to clear and disperse it. Earth is the mother of Metal; for deficiency, one should tonify the mother. Therefore, Gancao and Jingmi are added to tonify the Spleen and benefit the Stomach.
Huangbai (Phellodendri Cortex, 1 jin, processed until brown, powdered, formed into pills with water. For Qi deficiency, take with Sigongzi Decoction; for Blood deficiency, take with Siwu Decoction)
When Kidney Fire originates from below the umbilicus, it is due to the decline of Kidney Water; this formula is indicated.
The Kidney is not solely Yin; the Fire of the Gate of Vitality (Mingmen) resides within it. Once Kidney Water is depleted, the Fire of the Gate of Vitality has nothing to fear and becomes self-igniting, causing the Dragon and Thunder Fire to move from below the umbilicus. The Classics state: "When Water is constrained, it must be broken." By "Water constraint," it refers to constrained fire in the Kidney region. By "breaking it," it means restraining its rebellious surge. Phellodendri Cortex is bitter and dense, which serves this purpose. Taking it with Sigongzi Decoction for Qi deficiency prevents the cold-natured herb from damaging the Spleen; taking it with Siwu Decoction for Blood deficiency aids in nourishing Yin and restraining Fire.
Huangbai (Phellodendri Cortex, 10 liang, soaked in wine) Zhimu (Anemarrhenae Rhizoma, 6 liang, soaked in wine) Rougui (Cinnamomi Cortex, 5 qian)
When Kidney Fire originates from below the Yongquan acupoint, this formula is indicated.
Heat rising directly from the sole of the foot into the inner thigh and abdomen is called Kidney Fire originating from below Yongquan. Zhimu and Huangbai are bitter and cold, belonging to the Water category, thus they can nourish and supplement Kidney Water; Rougui is pungent and hot, belonging to the Fire category, thus it can act as a counter-agent. This is what the I Ching refers to as "water flows to wetness, fire moves to dryness."
Huangqin (Scutellariae Radix) Huanglian (Coptidis Rhizoma) Huangbai (Phellodendri Cortex) (all moistened with wine, equal parts)
When there is fire in the San Jiao (Triple Burner), causing dryness of the throat, red and scanty urine, and constipation, this formula is indicated.
Shao Huo (Lesser Fire/Physiological Fire) generates all things; Zhuang Huo (Excessive Fire/Pathological Fire) consumes all things. The Neijing states that "Zhuang Huo eats Qi." Therefore, Shao Huo should be ascending, while Zhuang Huo should be descending. Now, using these three herbs to descend the excessive fire of the San Jiao allows Qi to be generated and Blood to be nourished, benefiting the entire San Jiao; hence it is called "San Bu" (Three Tonifications).
Scutellariae Radix is bitter and drying, thus clearing heat in the Upper Jiao; Coptidis Rhizoma is bitter and solid, thus purging fire in the Middle Jiao; Phellodendri Cortex is bitter and moistening, thus purging fire in the Lower Jiao. Although fire has deficiency and excess types, this formula treats only excess fire. If used for deficiency fire, the fire will反而 (instead) flourish because excessive descending leads to the loss of Yin. Danxi said: Deficiency fire can be treated with tonification, such as Renshen (Ginseng) and Huangqi (Astragalus). Thus, the distinction between deficiency and excess is like heaven and earth; the wise should carefully examine the syndrome.