(谦甫)
治男女虚劳客热,五心烦热,四肢怠惰,咳嗽咽干,自汗食少,或日晡发热(五心∶心
窝、手心、足心也。脾主四肢,五心烦热,是心火陷于脾土之中,宜升发火郁。四肢倦怠,
脾虚也;咳嗽,肺火也;咽干,肾水不足、相火上炎也;自汗,阳虚也;食少,脾胃弱也;
日西潮
黄 (蜜炙) 鳖甲(炙) 天冬(五钱) 秦艽 柴胡 地骨皮 茯苓(三钱) 桑
白皮 紫菀 半夏 芍药 生地黄 知母 甘草(炙。三钱半) 人参 桔梗 肉桂(一钱
半。)每一两加姜煎(此即前方减当归,加黄 、茯苓、生地、芍药、天冬、知母、桑皮、
桔梗、肉桂)。《
此手足太阴、足少阳药也,鳖甲、天冬、芍、地、知母滋肾水而泻肺肝之火,以养阴也
(地黄、知母滋肾水,天冬泻肺火,鳖甲、芍药泻肝火);黄 、人参、桂、苓、甘草固卫
气而补脾肺之虚,以助阳也;桑皮、桔梗以泻肺热,半夏、紫菀以理痰嗽(紫菀润肺止嗽,
半夏化痰利咽,故《金匮》治喉痹咽痛,皆用半夏,盖辛能散亦能润也);秦艽、地骨以散
内热而除蒸,柴胡以解肌热而升阳,此表里气血交治之剂也。
(谦甫)
治风劳骨蒸,午后壮热,咳嗽,肌瘦,颊赤,盗汗,脉来细数(风,阳邪也,在表则表
热
虚火
鳖甲(一两。灸) 秦艽 知母 当归(五钱) 柴胡 地骨皮(一两) 乌梅(一个)
青蒿
此足少阳、厥阴药也。风生热而热生风,非柴胡、秦艽不能驱风邪使外出;鳖,阴类,
用甲者,骨以及骨之义;乌梅酸涩,能引诸药入骨而敛热;青蒿苦寒,能从诸药入肌而解蒸
(柴胡、青蒿,皆感少阳生发之气,凡苦寒之药,多伤脾胃,惟青蒿清芬入脾,独宜于血虚
有热之人);知母滋阴,当归和血,地骨散表邪兼清里热,又止汗除蒸之上品也地骨皮退有
汗之
(李谦甫)
治疗男女虚劳病中的客热证,表现为五心烦热、四肢倦怠无力、咳嗽咽干、自汗且食欲不振。或者在傍晚时分出现发热(所谓“五心”,指心窝、手心、足心。脾主四肢,五心烦热,是心火郁陷于脾土之中,适宜升发被郁之火。四肢倦怠,是脾虚的表现;咳嗽,是肺火所致;咽干,是肾水不足、相火上炎所致;自汗,是阳气虚弱所致;食欲减退,是脾胃虚弱所致)。
黄耆(蜜炙)、鳖甲(炙)、天冬(各五钱)、秦艽、柴胡、地骨皮、茯苓(各三钱)、桑白皮、紫菀、半夏、芍药、生地黄、知母、甘草(炙,三钱半)、人参、桔梗、肉桂(一钱半)。每服药一两,加生姜煎服。(此方即前方减去当归,加入黄耆、茯苓、生地黄、芍药、天冬、知母、桑白皮、桔梗、肉桂而成)。《医方集解》按语:此方是调理手足太阴经及足少阳经的药物。鳖甲、天冬、芍药、生地黄、知母滋养肾水并清泻肺肝之火,以养阴(其中地黄、知母滋补肾水,天冬清泻肺火,鳖甲、芍药清泻肝火);黄耆、人参、肉桂、茯苓、甘草固护卫气并补益脾肺之虚,以助阳;桑白皮、桔梗清泻肺热,半夏、紫菀调理痰嗽(紫菀润肺止咳,半夏化痰利咽,所以《金匮要略》治疗喉痹咽痛,都使用半夏,因为辛味既能发散也能润燥);秦艽、地骨皮疏散内热并除骨蒸,柴胡解除肌表之热并升发阳气,这是表里气血同治的方剂。
(李谦甫)
治疗风劳病引起的骨蒸潮热,午后高热、咳嗽、肌肉消瘦、两颊发红、盗汗、脉象细数(风,属于阳邪,在体表则引起表热,在内则为虚火)。
鳖甲(一两,炙)、秦艽、知母、当归(五钱)、柴胡、地骨皮(一两)、乌梅(一个)、青蒿。
《医方集解》按语:此方是调理足少阳经及足厥阴经的药物。风生热而热生风,非柴胡、秦艽不能驱散风邪使其外出;鳖属阴类,使用其甲壳,有深入骨骼之意;乌梅味酸涩,能引导诸药进入骨骼并收敛虚热;青蒿味苦寒,能随诸药进入肌肉层并解除骨蒸(柴胡、青蒿,皆感应少阳生发之气,凡是苦寒的药物,大多损伤脾胃,只有青蒿气味清香入脾,唯独适宜血虚有热之人);知母滋阴,当归调和血液,地骨皮疏散表邪兼清里热,又是止汗除骨蒸的上品药物。地骨皮退除有汗之……
(Li Qianfu)
Treats guest-heat (external pathogenic heat superimposed on deficiency) in consumptive diseases of men and women, characterized by five-palm heat (heat sensation in the palms, soles, and precordium), lassitude of the four limbs, cough with dry throat, spontaneous sweating, and poor appetite. Or there may be tidal fever in the late afternoon (The "five hearts" refer to the precordium, palms, and soles. The Spleen governs the four limbs; five-palm heat indicates Heart fire trapped within Spleen earth, requiring the uplifting of stagnant fire. Lassitude of the limbs indicates Spleen deficiency; cough indicates Lung fire; dry throat indicates insufficient Kidney water with ministerial fire flaming upward; spontaneous sweating indicates Yang deficiency; poor appetite indicates weak Spleen and Stomach).
Huangqi Decoction (Astragali Radix, honey-fried), Biejia (Testudinis Carapax et Plastrum, fried), Tiandong (Asparagi Radix, 5 qian each), Qinjiao (Gentianae Macrophyllae Radix), Chaihu (Bupleuri Radix), Digupi (Lycii Cortex), Fuling (Poria, 3 qian each), Sangbaipi (Mori Cortex), Ziwan (Asternis Radix), Banxia (Pinelliae Rhizoma), Shaoyao (Paeoniae Radix Alba), Shengdihuang (Rehmanniae Radix), Zhimu (Anemarrhenae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 3.5 qian), Renshen (Ginseng Radix), Jiegeng (Platycodonis Radix), Rougui (Cinnamomi Cortex, 1.5 qian). For every liang of herbs, add fresh ginger and decoct. (This formula is derived from the previous one by removing Danggui and adding Huangqi, Fuling, Shengdihuang, Shaoyao, Tiandong, Zhimu, Sangbaipi, Jiegeng, and Rougui). Commentary: This formula acts on the Hand-Taiyin, Foot-Taiyin, and Foot-Shaoyang meridians. Biejia, Tiandong, Shaoyao, Shengdihuang, and Zhimu nourish Kidney water and drain Fire of the Lung and Liver to nourish Yin (Shengdihuang and Zhimu nourish Kidney water; Tiandong drains Lung fire; Biejia and Shaoyao drain Liver fire); Huangqi, Renshen, Rougui, Fuling, and Gancao secure Wei Qi (Defensive Qi) and tonify the deficiency of the Spleen and Lung to assist Yang; Sangbaipi and Jiegeng drain Lung heat; Banxia and Ziwan regulate phlegm and cough (Ziwan moistens the Lung and stops cough; Banxia transforms phlegm and benefits the throat; thus, in *Jingui Yaolue*, Banxia is used for treating throat obstruction and pain, as acrid flavors can both disperse and moisten); Qinjiao and Digupi dissipate internal heat and eliminate bone-steaming; Chaihu resolves muscle-layer heat and uplifts Yang. This is a formula that treats both exterior and interior, Qi and Blood simultaneously.
(Li Qianfu)
Treats wind-consumption causing bone-steaming tidal fever, high fever in the afternoon, cough, emaciation, flushed cheeks, night sweats, and a fine-rapid pulse (Wind is a Yang pathogen; when in the exterior, it causes exterior heat; internally, it manifests as deficient fire).
Biejia (Testudinis Carapax et Plastrum, 1 liang, fried), Qinjiao (Gentianae Macrophyllae Radix), Zhimu (Anemarrhenae Rhizoma), Danggui (Angelicae Sinensis Radix, 5 qian), Chaihu (Bupleuri Radix), Digupi (Lycii Cortex, 1 liang), Wumei (Mume Fructus, one piece), Qinghao (Artemisiae Annuae Herba).
Commentary: This formula acts on the Foot-Shaoyang and Foot-Jueyin meridians. Wind generates heat, and heat generates wind; only Chaihu and Qinjiao can drive out wind pathogens and expel them outward; Turtle belongs to the Yin category; using its carapace implies penetrating into the bones; Wumei is sour and astringent, capable of guiding other herbs into the bones to consolidate and clear heat; Qinghao is bitter and cold, capable of entering the muscles along with other herbs to resolve bone-steaming (Chaihu and Qinghao both resonate with the generating Qi of the Shaoyang; generally, bitter-cold herbs damage the Spleen and Stomach, but Qinghao has a fragrant aroma entering the Spleen, making it uniquely suitable for those with blood deficiency and heat); Zhimu nourishes Yin, Danggui harmonizes Blood, Digupi disperses exterior pathogens while clearing interior heat, and it is also a premier herb for stopping sweating and eliminating bone-steaming. Digupi removes heat associated with sweating...