(《本事方》)
治子淋,心烦 乱(子淋,膀胱、小肠虚热也。虚则不能制水,热则不能通利,故淋。
心
人参 细辛(一两) 当归 甘草 灯草(五钱) 木通 滑石 麦冬(三钱)。为末。
每二
此手太阴、足太阳、少阴药也。陈来章曰∶虚热宜补,故用人参、甘草之甘;淋 宜通
,故用木通、灯草之渗,滑石之滑;肺燥则天气不降,而麦冬能清之;肾燥则地气不升,而
细辛能润之(经曰∶地气上为云,天气下为雨,上下交,阴阳和,而后便得通也);血燥则
沟渎
(丹溪)
治妊娠转胞(转胞者,胎逼及胞,压在一边,胞系转戾,脐下急痛,溲数或闭也,因气
血
当归 熟地黄芎 芍药 人参 白术 陈皮(留白) 半夏 甘草(炙)。加姜煎。
空心
此足太阴、厥阴药也。气虚补以四君,血虚补以四物,痰饮消以二陈,使气得升举而胞
自通也(朱丹溪曰∶转胞之病,妇人禀受弱者,忧闷多者,性躁急者,食味浓者,多有之。
古方用滑利药解效,因思胞不自转,为胎所压,胎若举起,胞系自疏,水道自通矣。近吴宅
庞人患此,脉似涩重则弦。余曰∶此得之忧患,涩为血少气多,弦为有饮,血少则胎弱不能
举,气多有饮,中焦不清而隘,则胎知所避而就下,乃以上药与服,随以指探喉中,吐出药
汁,候气定,又与之,八贴而安。此恐偶中,后治数人,皆效。仲景云∶妇人本肥盛,今反
羸瘦,胞系了戾,但利小便则愈,宜服肾气丸,以中有茯苓故也;地黄为君,功在补胞。昂
按∶治下部不通,每用吐法)。又法∶将孕妇倒竖,胎转而小便自通矣。
附∶丹溪参木膏∶人参(二钱五分) 白术(二钱) 黄 (钱半) 茯苓 陈皮 桃
仁(各一钱) 炙甘草(五分)。用猪羊胞煮汤,入药煎服,治产后胞损或淋沥证(丹溪曰∶
收生不谨,以致损胞而得淋沥,有徐氏妇,壮年患此,因思肌肉破伤在外者,且可补完,胞
虽在内,恐亦有治,诊其脉虚甚,因悟曰∶难产之人,多是气虚,难产之后,血气尤虚,因
用峻补,以参术膏煎以猪羊胞,极饥时与之,每剂一两,一月而安。盖令血气骤长,其胞可
完,若稍迟缓,恐难成功)。
(出自《本事方》)
治疗子淋,心烦意乱。子淋,是膀胱和小肠虚热所致。虚则不能制约水液,热则不能通利水道,所以发生淋证。
人参、细辛(各一两)、当归、甘草、灯心草(五钱)、木通、滑石、麦冬(各三钱)。研为末。
每次服用二钱……
这是手太阴肺经、足太阳膀胱经、足少阴肾经的药物。陈来章说:虚热适宜用补法,所以用人参、甘草的甘味;淋证适宜通利,所以用木通、灯心草的渗湿作用,滑石的滑利作用;肺燥则天气不降,而麦冬能清润肺燥;肾燥则地气不升,而细辛能润补肾燥(医经说:地气上升化为云,天气下降化为雨,上下交感,阴阳调和,然后小便才能通利);血燥则沟渠……
(朱丹溪方)
治疗妊娠转胞。转胞,是指胎儿压迫膀胱,使其偏向一侧,膀胱系膜扭转屈曲,脐下急痛,小便频数或闭塞不通。这是由于气血……
当归、熟地黄、川芎、白芍药、人参、白术、陈皮(保留白色部分)、半夏、甘草(炙)。加生姜煎服。
空腹服用。
这是足太阴脾经、足厥阴肝经的药物。气虚用四君子汤补益,血虚用四物汤补益,痰饮用二陈汤消除,使气得以升举,膀胱自然通畅。(朱丹溪说:转胞这种病,禀赋虚弱的妇女,忧愁闷郁多的妇女,性情急躁的妇女,饮食口味浓重的妇女,多有此病。古方使用滑利药物治疗无效,我思考膀胱自身不会扭转,是因为被胎儿压迫,如果将胎儿举起,膀胱系膜自然舒展,水道自然通畅了。近来吴家仆人患此病,脉象似涩,重按则弦。我说:这是因忧患所致,涩脉主血少气多,弦脉主有饮邪,血少则胎弱不能举起,气多且有饮邪,中焦不清而狭窄,则胎儿知道躲避而下坠,于是给予上述药物服用,随即用手指探喉催吐,吐出药汁,待气息平稳后,再喂服,八剂后痊愈。这恐怕是偶然中的,后来治疗了几个人,都有效。张仲景说:妇人本来肥胖,现在反而消瘦,膀胱系膜扭转屈曲,只要通利小便就能痊愈,适宜服用肾气丸,因为其中含有茯苓的缘故;地黄作为君药,功效在于补益膀胱。汪昂按:治疗下部不通,常常使用吐法。)另一种方法:让孕妇倒立,胎儿转动,小便自然通畅了。
附注:丹溪参木膏:人参(二钱五分)、白术(二钱)、黄芪(一钱半)、茯苓、陈皮、桃仁(各一钱)、炙甘草(五分)。用猪羊膀胱煮汤,加入药物煎服,治疗产后膀胱损伤或淋漓不尽之证(朱丹溪说:接生不慎,导致损伤膀胱而得淋漓之症,有徐氏妇人,壮年患此,我思考肌肉破损在外者,尚且可以修补完整,膀胱虽在内,恐怕也有治疗方法,诊察其脉象非常虚弱,于是领悟到:难产之人,多是气虚,难产之后,气血尤其虚弱,因此使用峻补之法,以参术膏配合猪羊膀胱煎服,在极度饥饿时给予服用,每剂一两,一个月后痊愈。大概是为了让气血迅速生长,其膀胱即可修复,如果稍显迟缓,恐怕难以成功)。
(From *Ben Shi Fang*)
Treats *Zilin* (suburetic syndrome during pregnancy), with vexation and restlessness. *Zilin* is caused by deficiency-heat in the Bladder and Small Intestine channels. Deficiency fails to control water, while heat fails to ensure free flow, thus leading to strangury.
Ren Shen (Ginseng Radix et Rhizoma), Xi Xin (Asari Radix et Rhizoma) [1 liang each], Dang Gui (Angelicae Sinensis Radix), Gan Cao (Licorice Root), Deng Cao (Junci Medulla) [5 qian], Mu Tong (Akebiae Caulis), Hua Shi (Talcum), Mai Dong (Ophiopogonis Radix) [3 qian each]. Pulverized.
Take 2 qian per dose...
This prescription acts on the Hand-Taiyin Lung channel, Foot-Taiyang Bladder channel, and Foot-Shaoyin Kidney channel. Chen Laizhang stated: For deficiency-heat, tonification is appropriate; hence, the sweet nature of Ren Shen and Gan Cao is used. For strangury, unblocking is required; hence, the diuretic properties of Mu Tong and Deng Cao, and the lubricating property of Hua Shi are employed. When the Lungs are dry, celestial Qi fails to descend, but Mai Dong can clear it. When the Kidneys are dry, terrestrial Qi fails to ascend, but Xi Xin can moisten them (The Classics state: Terrestrial Qi rises to form clouds, celestial Qi descends to form rain; when upper and lower interact, and Yin and Yang harmonize, urination becomes free). When Blood is dry, the ditches...
(Zhu Danxi's Formula)
Treats *Zhuanbao* (displacement of the bladder during pregnancy). *Zhuanbao* refers to the fetus pressing against the bladder, pushing it to one side, causing the bladder ligaments to twist and invert, resulting in acute pain below the umbilicus, frequent urination, or urinary retention. This is due to Qi and Blood...
Dang Gui (Angelicae Sinensis Radix), Shu Di Huang (Rehmanniae Radix Preparata), Xiong Diao (Ligustici Chuanxiong Rhizoma), Bai Shao Yao (Paeoniae Radix Alba), Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chen Pi (Citri Reticulatae Pericarpium - keep the white pith), Ban Xia (Pinelliae Rhizoma Preparatum), Gan Cao (Licorice Root, honey-fried). Decoct with fresh ginger slices.
Take on an empty stomach.
This prescription acts on the Foot-Taiyin Spleen channel and Foot-Jueyin Liver channel. For Qi deficiency, tonify with Si Jun Zi Tang (Four Gentlemen Decoction); for Blood deficiency, tonify with Si Wu Tang (Four Substance Decoction); for phlegm-fluid retention, eliminate with Er Chen Tang (Two Aged Decoction), so that Qi ascends and lifts, allowing the bladder to open naturally. (Zhu Danxi said: The disease of *Zhuanbao* is common in women with weak constitutions, those prone to worry and depression, those with irritable temperaments, and those who consume rich flavors. Ancient formulas using slippery/diuretic herbs were ineffective. I reasoned that the bladder does not twist itself; it is pressed by the fetus. If the fetus is lifted, the bladder ligaments will naturally relax, and the water passage will open. Recently, a servant in the Wu household suffered from this. His pulse was seemingly choppy, becoming wiry upon heavy pressure. I said: This resulted from worry and distress. A choppy pulse indicates little Blood and excess Qi; a wiry pulse indicates fluid retention. Little Blood makes the fetus weak and unable to lift; excess Qi with fluid retention causes turbidity in the Middle Jiao and narrowing, so the fetus avoids the top and sinks downward. Therefore, I administered the aforementioned medicine. Immediately after, I induced vomiting by probing the throat with a finger, expelled the medicinal juice, waited for his Qi to settle, and then administered it again. After eight doses, he recovered. This may have been a lucky hit, but subsequent treatments of several patients were also effective. Zhang Zhongjing said: Women who were originally obese but now appear emaciated, with twisted bladder ligaments, can be cured by promoting urination; they should take Shen Qi Wan (Kidney Qi Pill) because it contains Fu Ling (Poria). Di Huang (Rehmanniae Radix) serves as the sovereign herb, its function being to tonify the bladder. Wang Ang notes: In treating obstructions in the lower part of the body, the method of inducing vomiting is often used.) Another method: Hang the pregnant woman upside down; once the fetus shifts position, urination will naturally resume.
Appendix: Danxi Shenmu Gao (Danxi Ginseng and Atractylodes Paste): Ren Shen (Ginseng Radix et Rhizoma) [2.5 qian], Bai Zhu (Atractylodis Macrocephalae Rhizoma) [2 qian], Huang Qi (Astragali Radix) [1.5 qian], Fu Ling (Poria), Chen Pi (Citri Reticulatae Pericarpium), Tao Ren (Persicae Semen) [1 qian each], Zhi Gan Cao (Honey-fried Licorice Root) [0.5 qian]. Decoct with broth made from boiling pig or sheep bladders, add the herbs, and administer. Treats postpartum bladder damage or dribbling urine syndrome. (Zhu Danxi said: Careless midwifery leads to bladder injury and dribbling. There was a Mrs. Xu, in her prime, suffering from this. I reasoned that if external muscle tears can be repaired, internal bladder injuries might also be treatable. Her pulse was extremely deficient. I realized that difficult labor often involves Qi deficiency, and postpartum Qi and Blood are especially deficient. Thus, I used strong tonification, preparing a paste of Ren Shen and Bai Zhu decocted with pig/sheep bladder, administering it when she was extremely hungry, one liang per dose. She recovered within a month. This works by rapidly boosting Qi and Blood to repair the bladder. If the treatment is delayed, success may be difficult.)