猪苓 泽泻 茯苓 滑石 阿胶各一两
五苓散治湿浊不化,故用术桂,以通阳而化浊;猪苓汤治阳邪入里,故用滑石、阿胶,
以降热而存津。至于统治少阴下利,六七日,咳而呕渴,心烦不得眠,乃借泻膀胱以清肾脏,
是活用之法,而非正治也。
茯苓 桂枝二两 甘草一两 生姜二两
茯苓宜于独重,以其能渗湿安神也。姜桂性温,开解腠理,能逐水气从毛窍而出,用甘
草以补土和中,方法特妙。
半夏一升 茯苓三两 生姜半斤
古人立方,有药味少而分两重者,专走一门,为功甚巨,如半夏等汤是也。痰去,则眩
悸自
熟地四两 茯苓三两(乳拌) 山药(炒) 丹皮(酒炒) 山萸肉(酒润) 泽泻(酒
浸) 川牛膝(酒浸) 车前子(炒) 肉桂一两 附子(制)五钱
蜜丸。
此方之妙,全在导龙归海。命肾之火衰微,浊阴日渐凝结,始则小便不利,继则水气泛
溢,腹胀肢肿。但用分利之剂,徒然耗正劫阴,小便仍不能利,惟用附桂以直达命肾,使命
门之火得以熏蒸脾胃,肾中之真阳发越,则肾气通畅,而寒水亦行,小便通,则泛滥之水如
众流赴壑矣。人但知水能克火,而不知火亦能制水,发阳光以消阴翳,此类是也。
麻黄六两 石膏八两 生姜三两 甘草二两 大枣十二枚
风与水在皮肤之间,故但肿而胀,变小青龙之制,使风、水俱从毛窍而出,故名越婢。
越婢者,悦脾也。
五苓散(Wuling San, Five-Ingredient Powder with Poria)治疗湿浊之气不能运化,所以使用白术和桂枝,以通阳气温化湿浊;猪苓汤(Zhuling Tang, Polyporus Decoction)治疗阳热之邪深入体内,所以使用滑石和阿胶,以降泄热邪并保存津液。至于治疗少阴病(Shaoyin Disease,涉及心肾两脏的虚寒或虚热证)下利,病程六七天,出现咳嗽、呕吐、口渴、心烦且无法入睡的症状,这是借助泻除膀胱水气来清肃肾脏,属于灵活变通的治疗方法,而非针对病机的直接正治法。
茯苓应当重用,因为它能够渗利湿气、安定心神。生姜和桂枝药性温煦,能开通腠理(皮肤毛孔及纹理),促使水气从汗孔排出,配合甘草以补益脾胃、调和中焦,此方配伍方法尤为精妙。
古人制定方剂时,有药物种类少但单味药剂量重的情况,专攻某一病所,疗效显著,如半夏等方的用法就是如此。痰饮去除后,眩晕和心悸自然消失。
熟地黄四两、茯苓三两(用乳汁拌炒)、山药(炒制)、牡丹皮(酒炒)、山茱萸肉(酒润)、泽泻(酒浸)、川牛膝(酒浸)、车前子(炒制)、肉桂一两、附子(炮制)五钱。
制成蜜丸。
此方的妙处,全在于引导龙雷之火回归本源(命门)。当命门与肾的火气衰微时,阴寒浊气日渐凝结,起初表现为小便不利,随后水气泛滥溢出,导致腹部胀满、四肢浮肿。如果只使用分利水湿的药物,只会徒然耗伤正气、劫夺阴液,小便依然不能通畅。唯有使用附子和肉桂直达命门与肾脏,使命门之火得以熏蒸脾胃,使肾中的真阳发散,则肾气通畅,寒水随之运行,小便一通,泛滥的水气就像众流汇入沟壑一样消散了。人们只知道水能克火,却不知道火也能制约水,通过发扬阳光(阳气)来消除阴翳(阴寒),此类方剂便是例证。
风邪与水气停留在皮肤之间,所以只出现肿胀而没有疼痛,变化了小青龙汤(Xiao Qing Long Tang, Minor Green Dragon Decoction)的制方原则,使风邪和水气都从汗孔排出,因此命名为越婢汤(Yuebi Tang)。
“越婢”的意思是悦脾(使脾气愉悦舒畅)。
Zhu Ling (Polyporus), Ze Xie (Alisma Rhizome), Fu Ling (Poria), Hua Shi (Talcum), and E Jiao (Donkey-Hide Gelatin) each one liang.
Wu Ling San (Five-Ingredient Powder with Poria) treats the failure of damp-turbidity to transform; therefore, Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Gui Zhi (Cinnamomi Ramulus) are used to unblock Yang Qi and transform turbidity. Zhuling Tang (Polyporus Decoction) treats Yang pathogenic factors entering the interior; therefore, Hua Shi (Talcum) and E Jiao (Donkey-Hide Gelatin) are used to descend heat and preserve body fluids. Regarding the treatment of Shaoyin disease (diseases involving the Heart and Kidney systems) characterized by diarrhea persisting for six or seven days, accompanied by cough, vomiting, thirst, irritability, and insomnia, this approach utilizes the draining of the Bladder to clear the Kidney. This is a flexible application method rather than a direct standard treatment targeting the primary pathology.
Fu Ling (Poria) two liang, Gui Zhi (Cinnamomi Ramulus) two liang, Gan Cao (Glycyrrhizae Radix et Rhizoma) one liang, Sheng Jiang (Zingiberis Rhizoma Recens) two liang.
Fu Ling (Poria) should be used in heavy doses because it can leach out dampness and calm the mind. Sheng Jiang (Zingiberis Rhizoma Recens) and Gui Zhi (Cinnamomi Ramulus) have warm properties; they open the Cou Li (skin pores and interstices) and expel water qi through the hair follicles. Gan Cao (Glycyrrhizae Radix et Rhizoma) is used to tonify Earth (Spleen/Stomach) and harmonize the Middle Jiao. The formulation method is particularly ingenious.
Ban Xia (Pinelliae Rhizoma) one sheng, Fu Ling (Poria) three liang, Sheng Jiang (Zingiberis Rhizoma Recens) half a jin.
In ancient formula creation, there were instances where few herbs were used but with heavy dosages, focusing specifically on one pathway to achieve significant effects, such as in formulas containing Ban Xia (Pinelliae Rhizoma). Once phlegm is eliminated, dizziness and palpitations naturally cease.
Shu Di Huang (Rehmanniae Radix Preparata) four liang, Fu Ling (Poria) three liang (mixed with milk and stir-fried), Shan Yao (Dioscoreae Rhizoma) (stir-fried), Mu Dan Pi (Moutan Cortex) (wine-fried), Shan Yu Rou (Corni Fructus) (moistened with wine), Ze Xie (Alismatis Rhizoma) (soaked in wine), Chuan Niu Xi (Achyranthis Bidentatae Radix) (soaked in wine), Che Qian Zi (Plantaginis Semen) (stir-fried), Rou Gui (Cinnamomi Cortex) one liang, Fu Zi (Aconiti Lateralis Radix Preparata) five qian.
Made into honey pills.
The brilliance of this formula lies entirely in guiding the "Dragon Fire" (hyperactive ministerial fire) back to its source (the Ming Men/Gate of Life). When the fire of the Ming Men and Kidney is deficient, turbid Yin gradually condenses. Initially, this manifests as difficulty in urination; subsequently, water qi overflows, causing abdominal distension and edema of the limbs. If only diuretic agents that separate and drain are used, it merely depletes healthy Qi and injures Yin, without resolving the urinary obstruction. Only by using Fu Zi (Aconiti Lateralis Radix Preparata) and Rou Gui (Cinnamomi Cortex) to reach the Ming Men and Kidney directly can the fire of the Ming Men be allowed to steam and warm the Spleen and Stomach. When the True Yang within the Kidney is aroused, Kidney Qi becomes smooth, cold water moves, and once urination flows freely, the overflowing water dissipates like streams rushing into gullies. People only know that Water can overcome Fire, but do not realize that Fire can also control Water. By promoting the sunlight (Yang Qi) to dispel the shadows (Yin Cold), such formulas serve as examples.
Ma Huang (Ephedrae Herba) six liang, Shi Gao (Gypsum Fibrosum) eight liang, Sheng Jiang (Zingiberis Rhizoma Recens) three liang, Gan Cao (Glycyrrhizae Radix et Rhizoma) two liang, Da Zao (Jujubae Fructus) twelve pieces.
Wind and water reside between the skin and muscles; thus, swelling and distension occur without pain. By modifying the principle of Xiao Qing Long Tang (Minor Green Dragon Decoction), both wind and water are expelled through the hair follicles. Hence, it is named Yue Bi Tang (Yuebi Decoction).
"Yue Bi" means to please the Spleen.