乌药 橘红二钱 麻黄(去节) 川芎 白芷 桔梗 枳壳(炒)一钱 僵蚕(去丝嘴,
炒) 炮姜 甘草(炙)五分
加姜葱煎。
中风之症,皆由气血亏虚,外风乘隙而入,盒饭着意调营,使风从卫出;又或痰火内蕴,
外风乘之,盒饭清营、化痰、息风、理气。此方多用升散于养血化痰,二义阙然,与注中治
中风等症未为合法也。
苏子 半夏 前胡 浓朴(姜炒) 橘红 当归一钱 甘草(炙) 肉桂五分
加姜煎。
此等方施之于湿痰壅塞、中脘不舒者,尚嫌其太燥。乃注中主治虚阳上攻、喘嗽呕血等
症,是益火加薪。吾见其立败也。
木香 草蔻仁 益智 苍术二分 浓朴四分 青皮 陈皮 半夏 吴茱萸(汤泡) 干
姜二分茯苓 泽泻二分 升麻 柴胡一分 当归五分
东垣此方,升清降浊,使中脘开通,极有意义。但辛燥太过,宜酌用之。
槟榔 沉香 乌药 人参
等分,浓磨,煎三、四沸,温服。
四磨汤,原为气逆喘急而设。若用人参,不如勿服之为佳矣。除人参,加木香、枳实者
为宜,且于气厥者尤合。
香附(醋炒) 苍术(泔浸炒) 抚芎 神曲(炒) 栀子(炒黑)
等分曲糊为丸。
凡郁病必先气病。气得流通,郁于何有?此方注云∶统治六郁。岂有一时而六郁并集者
乎?须知古人立方不过昭示大法。气郁者,香附为君;湿郁者,苍术为君;血郁者,川芎为
君;食郁者,神曲为君;火郁者,栀子为君。相其病在何处,酌量加减,方能得古人之意,
而不泥古人之方。读一切方书,皆当作如是观。
乌药、橘红各二钱,麻黄(去节)、川芎、白芷、桔梗、枳壳(炒)各一钱,僵蚕(去丝嘴,炒)、炮姜、甘草(炙)各五分。
加入生姜、葱白煎煮服用。
中风这一病证,都是由气血亏虚,外风趁机侵入所致,应当着重调理营血,使风邪从卫分透出;或者痰火内蕴,外风乘虚而入,应当清营、化痰、息风、理气。此方多用升散之品而缺乏养血化痰之法,这两方面都缺失了,与注释中治疗中风等病症的方法并不符合规范。
苏子、半夏、前胡、浓朴(姜炒)、橘红、当归各一钱,甘草(炙)、肉桂各五分。
加入生姜煎煮服用。
这类方剂施用于湿痰壅塞、中脘部不适的患者,尚且嫌其过于燥热。然而注释中主治虚阳上攻、喘嗽呕血等症状,这无异于火上浇油。我见到使用此法会导致立即败坏病情。
木香、草蔻仁、益智、苍术二分,浓朴四分,青皮、陈皮、半夏、吴茱萸(汤泡)、干姜二分、茯苓、泽泻二分,升麻、柴胡一分,当归五分。
东垣的这张方剂,能够升清降浊,使中脘通畅,极有意义。但是辛燥太过,应当酌情使用。
槟榔、沉香、乌药、人参。
等分,浓磨成浆,煎煮三到四沸,温服。
四磨汤,原本是为气逆喘急而设立的。如果使用人参,不如不服用更好。除去人参,加入木香、枳实较为适宜,而且对于气厥患者尤其合适。
香附(醋炒)、苍术(泔浸炒)、抚芎、神曲(炒)、栀子(炒黑)。
等分,用曲糊制作成丸剂。
凡是郁病必定先有气病。气机得以流通,郁滞又从何而来?此方注释说:统管六郁。难道有一时之间六种郁证同时聚集的情况吗?必须知道古人创立方剂不过是昭示大法。气郁者,以香附为君药;湿郁者,以苍术为君药;血郁者,以川芎为君药;食郁者,以神曲为君药;火郁者,以栀子为君药。观察疾病发生在何处,酌情加减,才能领会古人的意图,而不拘泥于古人的方剂。阅读一切方书,都应当这样看待。
Wuyao (Linderae Radix), Juhong (Citri Reticulatae Pericarpium Rubrum) 2 qian; Mahuang (Ephedrae Herba, removed nodes), Chuanxiong (Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus Immaturus, stir-fried) 1 qian; Jiangcan (Bombyx Batryticatus, removed silk and mouthparts, stir-fried), Paojiang (Zingiberis Rhizoma Preparatum), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) 5 fen.
Decoct with fresh ginger and scallion white parts.
The syndrome of stroke is caused by deficiency of qi and blood, allowing external wind to enter through the gap. One should focus on regulating the Ying (nutritive level) so that wind exits from the Wei (defensive level); or if phlegm-fire is internally accumulated and external wind takes advantage, one should clear the Ying, resolve phlegm, extinguish wind, and regulate qi. This formula uses many ascending and dispersing herbs but lacks methods for nourishing blood and resolving phlegm. Both aspects are missing, making it inconsistent with the legal treatment methods for stroke and similar syndromes as described in the annotations.
Suzi (Perillae Fructus), Banxia (Pinelliae Rhizoma Qianzhi), Qianhu (Peucedani Radix), Nongpo (Magnoliae Officinalis Cortex, stir-fried with ginger juice), Juhong (Citri Reticulatae Pericarpium Rubrum), Danggui (Angelicae Sinensis Radix) 1 qian; Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Rougui (Cinnamomi Cortex) 5 fen.
Decoct with fresh ginger.
Such formulas, when applied to patients with obstructive damp-phlegm and discomfort in the middle jiao, are already considered too drying. However, the annotations indicate their main indications are attacking deficiency fire, wheezing, coughing, and hematemesis. This is akin to adding fuel to a fire. I have seen such applications lead to immediate deterioration of the condition.
Muxiang (Aucklandiae Radix), Cao Kou Ren (Amomi Fructus Rotundus), Yizhi (Alpiniae Oxyphyllae Fructus), Cangzhu (Atractylodis Rhizoma) 2 fen; Nongpo (Magnoliae Officinalis Cortex, 4 fen); Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma Qianzhi), Wuzhuyu (Evodiae Fructus, soaked in water), Ganjiang (Zingiberis Rhizoma) 2 fen; Fuling (Poria), Zexie (Alismatis Rhizoma) 2 fen; Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix) 1 fen; Danggui (Angelicae Sinensis Radix) 5 fen.
This formula by Dongyuan [Li Dongyuan] ascends the clear and descends the turbid, opening the middle jiao, which is highly meaningful. However, it is excessively acrid and drying, and should be used with discretion.
Binglang (Arecae Semen), Chenxiang (Aquilariae Lignum Resinatum), Wuyao (Linderae Radix), Renshen (Ginseng Radix et Rhizoma).
Equal parts, ground thickly, decocted for three to four boils, taken warm.
Simoge Tang (Four-Steaming Decoction) was originally designed for rebellious qi causing wheezing and urgency. If Ginseng is used, it is better not to take it at all. It is more appropriate to remove Ginseng and add Muxiang (Aucklandiae Radix) and Zhishi (Aurantii Fructus Immaturus), especially suitable for patients with qi syncope.
Xiangfu (Cyperi Rhizoma, stir-fried with vinegar), Cangzhu (Atractylodis Rhizoma, soaked in rice water and stir-fried), Fuxiong (Chuanxiong Rhizoma), Shenqu (Massa Medicata Fermentata, stir-fried), Zhizi (Gardeniae Fructus, stir-fried until black).
Equal parts, made into pills using fermented grain paste.
All stagnation diseases must first involve qi disorders. If qi flows freely, where can stagnation exist? The annotation for this formula states: "It governs all six types of stagnation." Can it be that all six types of stagnation gather simultaneously at one time? One must understand that ancient physicians established formulas merely to demonstrate general principles. For qi stagnation, Xiangfu (Cyperi Rhizoma) is the sovereign herb; for damp stagnation, Cangzhu (Atractylodis Rhizoma) is the sovereign herb; for blood stagnation, Chuanxiong (Chuanxiong Rhizoma) is the sovereign herb; for food stagnation, Shenqu (Massa Medicata Fermentata) is the sovereign herb; for fire stagnation, Zhizi (Gardeniae Fructus) is the sovereign herb. Observe where the disease lies, adjust and add/subtract ingredients accordingly, to truly grasp the intent of the ancients without being bound by their specific formulas. When reading any materia medica or formulary, one should adopt this perspective.