(《金匮》)
治风水恶风,一身悉肿,脉浮不渴,续自汗出,无大热者(经曰∶肝肾并沉为石水,并
浮为风水。水在皮肤,故脉浮;里无热,故不渴;病本于风,故汗出恶风;无大热者,热未
尽退也)
麻黄(六两) 石膏(八两) 生姜(三两) 甘草(二两) 大枣(十二枚。)恶风
者,加附子
此足太阳药也。风水在肌肤之间,用麻黄之辛热以泻肺,石膏之甘寒以清胃(肺主通调
水道,胃主分别水谷),甘草佐之,使风水从毛孔中出。又以姜枣为使,调和营卫,不使其
太发散耗津液也(胃为十二经之主,脾治水谷为卑脏,若婢;经曰∶脾主为胃行其津液。是
方名越婢者
(《金匮》)
治风水脉浮身重,汗出恶风解见前;及诸风诸湿,麻木身痛(按东垣曰∶麻木为风,三
尺童子皆知之,细核则有区别∶如久坐亦麻木,绳缚之人亦麻木,非有风邪,乃气不行也,
当补肺
防己 黄 (一两) 白术(七钱半) 甘草(五钱,炙。)每服五钱。加姜、枣煎。
腹痛加
盛加茯苓、苍术,
此足太阳、太阴药也。防己大辛苦寒,通行十二经,开窍泻湿,为治风肿水肿之主药;
黄生用达表,治风注肤痛,温分肉,实腠理;白术健脾燥湿,与黄 并能止汗,为臣;防
己性
也。
本方去白术、姜、枣,加茯苓为君、桂枝,名防己茯苓汤(《金匮》);治水在皮肤,四
肢聂聂而动,名皮水(防己行经络,茯苓善渗泄,黄 达皮肤,桂枝走肢节。按∶五水脉浮
恶风,骨节疼痛,名风水;脉浮 肿,按之没指,其腹如鼓,不恶风,不渴,名皮水,当发
其汗。又云∶恶寒不渴,名风水;不恶寒而渴,名皮水;假令皮水不渴,亦当发汗。脉沉迟,
自喘,名正水;脉沉,腹满不喘,水积胞中,坚满如石,名石水;脉沉迟,发热,胸满,身
肿,汗如柏汁,名黄汁)。本方加人参(一两)、生姜(二两),防己、白术各增三倍,名防
己汤(《活人》)∶治风温,脉浮,多汗身重(中风之脉,阳浮而滑,阴濡而溺,风来乘热,
变为风温,忌发汗;误汗者,以此汤救之)。
(出自《金匮要略》)
治疗风水病,症见恶风,全身浮肿,脉象浮而口不渴,持续自汗出,体表无明显大热的情况。(经典论述说:肝肾脉象并见沉象为石水,并见浮象为风水。水邪停留在皮肤之间,所以脉象浮;体内没有热邪,所以口不渴;病因本于风邪,所以出汗且恶风;所谓“无大热”,是指热邪尚未完全消退。)
麻黄(六两) 石膏(八两) 生姜(三两) 甘草(二两) 大枣(十二枚)。若恶风明显者,加附子。
此方属于足太阳膀胱经的药物。风水之邪在肌肤之间,用麻黄的辛热之性来泻肺气,用石膏的甘寒之性来清胃热(肺主通调水道,胃主分别水谷),甘草作为佐使药,使风水之邪从毛孔中排出。又用生姜和大枣作为使药,调和营卫,防止发散太过而耗伤津液(胃是十二经脉的主宰,脾处理水谷如同卑下的婢女;经典论述说:脾主为胃传输津液。这个方剂名为“越婢”……)
(出自《金匮要略》)
治疗风水病,脉象浮,身体沉重,出汗且恶风(症状解释见前文);以及各类风邪湿邪引起的麻木、身体疼痛。(按:李东垣说:麻木是由风邪引起,三尺高的孩童都知道,但仔细推敲则有区别:比如久坐也会麻木,被绳子捆绑的人也会麻木,这并非有风邪,而是气机运行不畅所致,应当补肺气……)
防己 黄芪(各一两) 白术(七钱半) 甘草(五钱,炙用)。每次服用五钱。加入生姜、大枣煎服。
腹痛者加……
脉盛者加茯苓、苍术……
此方属于足太阳膀胱经和足太阴脾经的药物。防己味大辛苦性寒,通行十二经脉,开窍泻湿,是治疗风肿和水肿的主要药物;黄芪生用可达表,治疗风邪注滞于皮肤的疼痛,温养分肉,充实腠理;白术健脾燥湿,与黄芪配合能止汗,作为臣药;防己性……
本方去掉白术、生姜、大枣,加入茯苓为君药,再加桂枝,名为防己茯苓汤(出自《金匮要略》);治疗水邪在皮肤,四肢微微颤动,称为皮水(防己通行经络,茯苓善于渗泄,黄芪达于皮肤,桂枝走窜肢节。按:五种水气病中,脉浮恶风,骨节疼痛,称为风水;脉浮肿,按压凹陷不起,腹部如鼓,不恶风,不口渴,称为皮水,应当发汗。又说:恶寒不口渴,称为风水;不恶寒而口渴,称为皮水;假如皮水不口渴,也应当发汗。脉象沉迟,自觉气喘,称为正水;脉象沉,腹部胀满但不气喘,水积在胞中,坚硬胀满如石头,称为石水;脉象沉迟,发热,胸满,全身浮肿,汗色如柏汁,称为黄汗)。本方加入人参(一两)、生姜(二两),防己、白术各增加三倍,名为防己汤(出自《活人书》):治疗风温病,脉象浮,多汗身体沉重(中风病的脉象,阳部浮滑,阴部濡弱,风邪乘热而来,变为风温,忌用发汗法;误用发汗者,用此汤救治)。
(From *Jingui Yaolue*)
Treats Wind-Water disease, characterized by aversion to wind, generalized edema, a floating pulse without thirst, continuous spontaneous sweating, and absence of significant heat on the body surface. (The classics state: When the Kidney and Liver pulses are both deep, it is Stone Water; when both are floating, it is Wind-Water. Water residing in the skin causes the floating pulse; absence of internal heat causes lack of thirst; the root cause being Wind leads to sweating and aversion to wind; "absence of significant heat" means the pathogenic heat has not fully subsided.)
Ephedrae Herba (Mahuang, 麻黄) [6 liang], Gypsum Fibrosum (Shigao, 石膏) [8 liang], Zingiberis Rhizoma Recens (Shengjiang, 生姜) [3 liang], Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [2 liang], Jujubae Fructus (Dazao, 大枣) [12 pieces]. If aversion to wind is prominent, add Aconiti Lateralis Radix Praeparata (Fuzi, 附子).
This formula acts on the Foot-Taiyang Bladder Meridian. Wind-Water pathogens reside between the skin and muscles; Ephedrae Herba's pungent and hot nature drains Lung Qi, while Gypsum Fibrosum's sweet and cold nature clears Stomach Heat (the Lung governs the unimpeded flow of water passages, and the Stomach distinguishes food and fluids). Glycyrrhizae Radix et Rhizoma serves as an assistant, enabling the Wind-Water pathogens to exit through the pores. Ginger and Jujube act as envoys to harmonize Ying and Wei (Nutritive and Defensive Qi), preventing excessive dispersion that would consume body fluids (The Stomach is the master of the twelve meridians; the Spleen processes food and fluids like a humble servant; the classics state: The Spleen transmits fluids for the Stomach. This formula is named Yuebi...)
(From *Jingui Yaolue*)
Treats Wind-Water disease with a floating pulse, heaviness of the body, sweating, and aversion to wind (symptoms explained previously); as well as numbness and body pain caused by various Wind and Dampness pathogens. (Note: Li Dongyuan stated that numbness is caused by Wind, a fact known even to children. However, upon close examination, distinctions exist: prolonged sitting causes numbness, and those bound by ropes also experience numbness; this is not due to Wind pathogens but rather stagnation of Qi, requiring supplementation of Lung Qi...)
Stephaniae Tetrandrae Radix (Fangji, 防己) and Astragali Radix (Huangqi, 黄芪) [each 1 liang], Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) [7.5 qian], Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [5 qian, honey-fried]. Take 5 qian per dose. Decoct with Ginger and Jujube.
If abdominal pain occurs, add...
If the pulse is vigorous, add Poria (Fuling, 茯苓) and Atractylodis Rhizoma (Cangzhu, 苍术)...
This formula acts on the Foot-Taiyang Bladder Meridian and Foot-Taiyin Spleen Meridian. Stephaniae Tetrandrae Radix is greatly bitter and acrid in flavor and cold in nature, circulating through the twelve meridians, opening orifices and draining Dampness; it is the primary herb for treating Wind-Edema and Water-Edema. Astragali Radix, used raw, reaches the exterior, treats pain from Wind stagnation in the skin, warms the muscle layer, and consolidates the interstices. Atractylodis Macrocephalae Rhizoma strengthens the Spleen and dries Dampness; combined with Astragali Radix, it can stop sweating, serving as the Deputy herb. Stephaniae Tetrandrae Radix's nature...
Removing Atractylodis Macrocephalae Rhizoma, Ginger, and Jujube from this formula, adding Poria as the Sovereign herb, and adding Cinnamomi Ramulus (Guizhi, 桂枝), it is named Fangji Fuling Tang (from *Jingui Yaolue*); it treats Water in the skin, where the four limbs tremble slightly, termed Pi-Shui (Skin Water). (Stephaniae Tetrandrae Radix circulates the collaterals, Poria facilitates seepage and excretion, Astragali Radix reaches the skin, and Cinnamomi Ramulus travels to the joints. Note: Among the five types of Water diseases, if the pulse is floating with aversion to wind and joint pain, it is Feng-Shui (Wind-Water); if the pulse shows swelling, depression upon pressure remains, the abdomen is drum-like, there is no aversion to wind or thirst, it is Pi-Shui (Skin Water), which requires inducing sweating. It is also said: Aversion to cold without thirst indicates Feng-Shui; no aversion to cold but with thirst indicates Pi-Shui; even if Pi-Shui presents without thirst, sweating should still be induced. A deep and slow pulse with spontaneous asthma indicates Zheng-Shui (Correct Water); a deep pulse with abdominal fullness but no asthma, with water accumulating in the bladder/uterus, hard and full like stone, indicates Shi-Shui (Stone Water); a deep and slow pulse with fever, chest fullness, generalized edema, and sweat resembling paulownia juice indicates Huang-Zhi (Yellow Sweat).) Adding Ginseng Radix (Renshen, 人参) [1 liang] and Zingiberis Rhizoma Recens (Shengjiang, 生姜) [2 liang], and tripling the dosage of Stephaniae Tetrandrae Radix and Atractylodis Macrocephalae Rhizoma, it is named Fangji Tang (from *Ren Shu*); it treats Wind-Warmth disease with a floating pulse, profuse sweating, and body heaviness (The pulse of Wind-Stroke is floating and slippery at the Yang position, and soft and weak at the Yin position; when Wind attacks with Heat, it transforms into Wind-Warmth, for which sweating methods are contraindicated; if sweating was mistakenly induced, this formula is used to rescue the patient).