(见血门)
(见气门)
(东垣)
治脾胃虚弱,怠惰嗜卧,时值秋燥令行,湿热方退,体重节痛,口苦舌干,心不思食,
食不
于胸中
重节痛
调,湿
黄 (二两) 人参 甘草(炙) 半夏(一两。脉涩者用) 白芍(炒) 羌活 独
活防风
(小便利、不渴
枣煎。又补中益气汤加炒曲、黄芩,亦名益胃升阳汤(东垣)∶治妇人经候凝结,血块暴下,
脾虚水泻。
此足太阴、阳明药也。六君子助阳益胃,补脾胃之上药也(参、术、苓、草、陈皮、半
夏),加黄 以补肺而固卫,芍药以敛阴而调荣,羌活、独活、防风、柴胡以除湿痛(羌活
除百节之痛)而升清阳,茯苓、泽泻以泻湿热而降浊阴,少佐黄连以退阴火,补中有散,发
中有收,使气足阳升,自正旺而邪服矣(东垣曰∶此治肺之脾胃虚也。何故秋旺用参术芍药
之类反补脾,为脾胃虚则肺俱受病,故因时而补易为力也。又曰∶余病脾胃久衰,一日体重,
肢节疼痛,大便泄下,小便闭塞,默思《内经》云∶在下者,因而竭之,是先利小便也,又
治诸泻小便不利者,先分利之,治湿不利小便,非其治也,当用淡渗以利之,病虽即已,是
降之又降,复益其阴,而重竭其阳也,治以升阳风药,是为宜耳;羌活、独活、升麻、柴胡
各一钱,防风、炙甘草各五分,一剂而愈。大法寒湿之胜,风以平之,又曰∶下者举之,圣
人之法,举一可知百矣。东垣又曰∶药中但犯泽泻、猪苓、茯苓、木通、灯草淡味渗泄之类,
皆从时令之旺气,以泄脾胃之外邪,而补金水之不足也。或小便已数,肝肾不受邪者而误用
之,必大泻真阴,竭绝肾水,先损其两目也。又曰∶《灵枢》云∶头有疾,取之足,谓阳病
取阴也;足有疾、取之上,是阴病取阳也;中有疾、旁取之,中者,脾胃也,旁者少阳甲胆
克之,又是升阳助清气上行之法也)。
(参见“见血门”章节)
(参见“见气门”章节)
(李东垣)
治疗脾胃虚弱,身体倦怠嗜睡,正值秋季燥气当令,湿热之气刚刚消退,身体沉重且关节疼痛,口苦舌干,心中不想进食,食物停滞在胸中导致沉重和关节疼痛。
[此处原文存在排版错乱,结合上下文及《医方集解》原意,以下为对“升阳益胃汤”组成及功效的连贯翻译]
药物组成:黄连(二两)、人参、炙甘草、半夏(一两,脉象涩者使用)、炒白芍、羌活、独活、防风等。(若小便通利、不口渴者,用大枣煎服)。
另外,“补中益气汤”加入炒神曲、黄芩,也称为“益胃升阳汤”(李东垣):治疗妇人月经凝结,血块突然大量下泄,以及脾虚引起的水样腹泻。
这是足太阴脾经和足阳明胃经的药物。六君子汤(人参、白术、茯苓、甘草、陈皮、半夏)能助阳益胃,是补益脾胃的上等方剂;加入黄连以补肺气而固护卫气,白芍药以收敛阴气而调和营气,羌活、独活、防风、柴胡以祛除除湿邪引起的疼痛(羌活专门祛除全身各关节的疼痛)并提升清阳之气,茯苓、泽泻以泻除湿热并下降浊阴之气,稍加黄连以退去阴火。此方补中有散,发散中有收敛,使正气充足、阳气上升,自然正气旺盛而邪气屈服。
(李东垣说:这是治疗因肺病导致的脾胃虚弱。为什么在秋季金旺之时反而用人参、白术、白芍之类来补脾呢?因为脾胃虚弱则肺也会受累患病,所以顺应时令进行补益更容易见效。)
(又说:我患脾胃久衰之病,有一天身体沉重,四肢关节疼痛,大便泄泻,小便闭塞。静思《内经》所说:“病在下部,应当因势利导使其排出”,即先通利小便。又治各种腹泻伴小便不利者,应先分利水道。治疗湿邪不通利小便,不是正确的治法,应当用淡渗利湿的方法。病虽然好了,但这是降之又降,反而益其阴,从而再次耗竭其阳。治疗应当用升阳的风药,这才是适宜的。)
(羌活、独活、升麻、柴胡各一钱,防风、炙甘草各五分,服用一剂痊愈。大原则是:寒湿偏胜,用风药来平抑它。)
(又说:“下部有病,应当提升举之”,这是圣人的法则,举一反三可知其余。)
(李东垣又说:药方中如果使用了泽泻、猪苓、茯苓、木通、灯心草等淡味渗泄的药物,都是顺应时令旺气,以泄除脾胃之外的邪气,并补益肺金和水水的不足。但如果小便已经频数,肝肾不受邪气侵扰时误用这些药,必定会严重泻夺真阴,枯竭肾水,首先损害双眼视力。)
(又说:《灵枢》说:“头部有病,取足部的穴位”,这是阳病取阴经;“足部有病,取上部的穴位”,这是阴病取阳经;“中部有病,从旁侧取穴”,中部指脾胃,旁侧指少阳胆经克制它,这也是升阳帮助清气上行的方法。)
(See the section on "Bleeding")
(See the section on "Qi Disorders")
(Li Dongyuan)
Treats Spleen and Stomach deficiency (Pi Wei Xu), lethargy, and drowsiness. It is applied when the dryness of autumn prevails, damp-heat is receding, the body feels heavy with joint pain, there is a bitter taste in the mouth and dry tongue, anorexia, food stagnation in the chest causing heaviness and joint pain.
[Note: The original text contains formatting errors. Based on the context of *Yi Fang Ji Jie* and Li Dongyuan's formulas, the following is a coherent translation of the composition and efficacy of "Sheng Yang Yi Wei Tang".]
Ingredients: Huanglian (Coptidis Rhizoma, 2 liang), Renshen (Ginseng Radix), Zhi Gancao (Prepared Licorice Root), Banxia (Pinelliae Tuber, 1 liang; use if the pulse is choppy), Chao Baishao (Stir-fried White Peony Root), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix), etc. (If urination is free and thirst is absent, decoct with Dazao (Jujubae Fructus)).
Additionally, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Chao Qu (Maltum stir-fried) and Huangqin (Scutellariae Radix) is also called "Yi Wei Sheng Yang Tang" (Benefit the Stomach and Raise the Yang Decoction) (Li Dongyuan): Treats women with menstrual stasis, sudden profuse discharge of blood clots, and watery diarrhea due to Spleen deficiency.
This formula acts on the Foot-Taiyin Spleen meridian and Foot-Yangming Stomach meridian. Liu Junzi Tang (Six Gentlemen Decoction: Renshen, Baizhu, Fuling, Gancao, Chenpi, Banxia) assists Yang and benefits the Stomach; it is a superior formula for tonifying the Spleen and Stomach. Adding Huanglian (Coptidis Rhizoma) supplements Lung Qi and secures the Defensive Qi (Wei Qi); Baishao (White Peony Root) astringes Yin and harmonizes the Nutritive Qi (Ying Qi); Qianghuo, Duhuo, Fangfeng, and Chaihu dispel dampness and relieve pain (Qianghuo specifically relieves pain in all joints) and raise Clear Yang; Fuling (Poria) and Zexie (Alisma Rhizoma) drain damp-heat and descend Turbid Yin; a small amount of Huanglian retreats Deficient Fire (Yin Huo). This formula combines tonification with dispersion, and release with retention, ensuring that Qi becomes sufficient and Yang rises, so that Healthy Qi flourishes and Pathogenic factors submit.
(Li Dongyuan said: This treats Spleen and Stomach deficiency caused by Lung disease. Why use Renshen, Baizhu, and Baishao to tonify the Spleen when Metal (Lung) is prosperous in Autumn? Because Spleen and Stomach deficiency leads to Lung pathology; therefore, tonifying according to the season makes treatment more effective.)
(He also said: I suffered from chronic Spleen and Stomach decline. One day, my body felt heavy, limbs and joints were painful, stool was loose, and urination was obstructed. Reflecting on the *Neijing*: "For diseases below, promote their expulsion," meaning first promote diuresis. Also, for various diarrheas with difficult urination, one must first separate and drain. Treating dampness without promoting diuresis is incorrect; one should use bland-draining methods. Although the illness may resolve, this approach lowers repeatedly, benefiting Yin while further depleting Yang. Treatment should employ acrid-warm herbs to raise Yang, which is appropriate.)
(Qianghuo, Duhuo, Shengma, and Chaihu each 1 qian; Fangfeng and Zhi Gancao each 0.5 qian. Cured after one dose. The general principle is: For excess Cold-Damp, use Wind herbs to pacify it.)
(He also said: "For conditions sinking below, lift them up." This is the method of the Sages; knowing one case reveals a hundred.)
(Li Dongyuan also said: If a formula contains bland-draining herbs such as Zexie, Zhuling, Fuling, Mutong, and Dengcao, they follow the prosperous Qi of the season to drain external pathogens from the Spleen and Stomach and supplement the insufficiency of Metal (Lung) and Water (Kidney). However, if urination is already frequent and the Liver and Kidney are not affected by pathogens, using these drugs erroneously will severely drain True Yin, exhaust Kidney Water, and damage vision first.)
(He also said: The *Lingshu* states: "Diseases of the head are treated by points on the feet"; this is treating Yang diseases by taking from Yin. "Diseases of the feet are treated by points above"; this is treating Yin diseases by taking from Yang. "Diseases of the middle are treated by points on the sides"; the middle refers to the Spleen and Stomach, and the sides refer to the Shaoyang Gallbladder channel overcoming it. This is also a method of raising Yang and assisting the ascent of Clear Qi.)