以各经之药。皆是辛温解表之剂。与伤寒传变相似。此六方以尽其变也。
辛平解表之剂 消风百解散 川芎茶调散 消风散
辛凉解表之剂 柴胡升麻汤
辛温解表之剂 小续命汤
辛凉解表攻里之剂 钱氏大青膏 防风通圣散
泄痢治之勿参差。升汗实肠分注利。
〔泄泻〕
治湿之剂 胃苓汤 茯苓汤 五苓散 机要白术芍药汤
治风之剂 神术散 胃风汤 苍术防风汤 机要防风芍药汤
治热之剂 局方戊己丸
治暑之剂 来复丹 香薷饮 桂苓甘露饮
治寒之剂 白术汤 理中汤 机要浆水散
治风寒之剂 本事曲芎丸
止涩之剂 仲景桃花汤 实肠散 真人养脏汤
去积之剂 本事温脾汤
升发之剂 东垣升阳除湿汤 益胃升阳汤 升阳除湿防风汤
调补脾胃之剂 钱氏白术散 易简白术汤
〔滞下诸痢〕
治热之剂 黄连阿胶丸 芍药柏皮丸 导滞汤 仲景白头翁汤
治寒之剂 局方桃花丸 严氏当归丸 诃黎勒散
冷热之剂 古方驻车丸 局方香连丸 戊己丸
治风湿之剂与泄泻方选而用之
治暑之剂 黄连香薷饮 桂苓甘露饮
攻下之剂 大承气汤 宣明玄青丸 导滞汤
消积之剂 脾胃论圣饼子 元戎圣功丸
止涩之剂 仲景桃花汤 真人养脏汤 水煮木香丸 宣明香连丸 严氏禹余粮丸
收敛之剂 严氏乌梅丸 元戎乌梅散
补剂 十全大补汤
噤口痢 仓 汤
百一选方澹寮方
六经头痛无牙疼。各以引经为佐使。
〔诸经头痛〕
阳明头痛自汗发热 白芷
少阳头痛脉弦往来寒热 柴胡
太阳头痛恶风恶寒 川芎
太阴头痛痰物理重腹痛 半夏 苍术
少阴头痛手三阴三阳经不流行而足寒逆为寒厥 细辛
厥阴头痛 吴茱萸
虚头痛 黄 当归
巅顶痛 本
眉棱痛 白芷 羌活
有一身尽痛。疏风秦艽羌活汤之类。除湿守真除湿丹之类。
〔伤寒头痛〕
太阳经无汗麻黄汤 有汗桂枝汤
阳明经 白虎汤
少阳经 小柴胡汤
太阴脉浮 桂枝汤 脉沉理中汤
少阴脉沉发热 麻黄附子细辛汤
厥阴经 桂枝麻黄各半汤
〔诸牙齿痛治例〕
治风热牙疼。喜冷恶热。 生地黄。牡丹皮。当归。升麻。黄连。
治寒多热少牙疼。 草豆蔻。细辛。升麻。骨灰。当归。黄连。防风。
治大寒犯脑。牙齿疼痛。 白芷。桂枝。升麻。吴茱萸。草豆蔻。 本。
治寒邪风邪犯脑疼牙痛。 细辛。白芷。桂枝。麻黄。骨灰。羌活。升麻。防风。
治人口臭不可近。牙齿疳蚀。牙龈肉脱落血不止。东垣神功丸。
治虫牙疼蚀动甚者。取虫或熏之。盖手足阳明湿热甚而生虫也。
热痛凉膈散。疳蚀出血者。桃仁大黄下之。
阳明经标有风湿客痛。大戟。芫花。细辛。苍耳叶。花椒。小麦。
标有血滞。经郁而痛。用葱白。艾叶。黑豆。花椒。
或风毒肿痛。细辛。草乌白芷。
化虫治积本其因。甚者随例当默识。
〔诸积药例〕
肉积。 砂。巴豆。甚者信石。
酒积。干葛。神曲。麦 。甚者甘遂。牵牛。
血积。当归梢。桃仁。甚者水蛭。虻虫。
气积。木香。槟榔。甚者枳壳。牵牛。
水积。牵牛。泽泻。郁李仁。甚者芫花。甘遂。大戟。
涎积。雄黄。腻粉。甚者瓜蒂。甘遂。
食积。砂仁。香附。牵牛。甚者礞石。巴豆。
痰积。半夏。南星。甚者瓜蒂。黎芦。
癖积。三棱。蓬术。甚者甘遂。蝎梢。
虫积。宝鉴化虫丸。补金散。
膈噎方随治十般。寒热明分散与丸。
〔十般膈气〕
冷膈 热膈 风膈 气膈 痰膈 忧膈 悲膈 喜膈 水膈 食膈 皆病源也
宝鉴十膈气散 五膈嘉禾散 木香流气散
治喘满痰嗽闷冒壅滞成热膈 宝鉴人参利膈丸
治五噎寒膈 宝鉴汉防己散 豆蔻散
破经调血微行卫。补气犹滋血乃安。
调诸经闭而不行方。兼行其气者。温经汤。通经丸。
经血虚实
经因气结不通。实痛者玉烛散。血虚四物汤。
血虚寒小腹痛。增损四物汤。姜黄汤。
血虚寒热劳倦者。逍遥散。
经过作痛良方。当归散。小柴胡汤。合四物之类。
经行而痛良方。桃仁散。
去恶血活血。当归梢。苏木。红花。
经水暴下崩漏不止。蒲黄散。宝鉴 凉血地黄汤。备金散。
干血气经不行。大全良方。琥珀散。桃仁散之类。
血积 瘕良方。通经丸之类。
诸虚不足
髓竭不足。生地黄。当归。
肺气不足。天门冬。麦门冬。五味子。
心气不足。上党参。茯神。菖蒲。
肝气不足。天麻。川芎。
脾气不足。白术。白芍药。益智。
肾气不足。熟地黄。远智。牡丹皮。
胆气不足。细辛。酸枣仁。地榆。
神昏不足。朱砂。预知子。茯神。
非天雄。不能治上焦之阳虚。
非附子。不能治下焦之阳虚。
天真丸。三建丹。皆补阳虚之剂也。
地黄丸。滋肾丸。皆补阴虚之剂也。
补阴虚阳竭。仲景八味地黄丸。
调阴阳升降脾胃之气饮食劳役者。补中益气汤。随证加减用之。此补气滋血之大法也。
补元气须用人参。黄 。
补胃虚。进饮食。陈皮。人参。甘草。
补三焦元气。调和诸药共力成功者。炙甘草。
治诸虚痛宜调理。实痛唯施下乃痊。
胁下痛。往来热。用柴胡。丹溪龙荟丸。
气刺痛。用枳壳。以引经药导之。
血刺痛。用当归。
茎中痛。用甘草梢。
胃脘痛。用草果。
内伤物食诸痛。备急丹之类。
心痛药。临时随证为用。当分寒热虚实。
寒痛。铁刷汤。 热痛。泻心汤。 气痛。木香乳香之类。 血痛。四物汤。
臂痛。用苍术。半夏。南星。陈皮。香附。茯苓之类。
腰痛。 肾虚者。杜仲。补骨脂。 瘀血作痛。桃仁红花。 湿热而痛。用苍术。杜仲
。黄柏。川芎之类。或子和煨肾散。 痰者南星。
闪肭打击。诸实痛者。宜当归承气等汤下之。
眼暴赤肿泻诸热。喉痹淋癃治亦然。
赤肿及痛
气实而热肿。用凉膈散。
气虚而热肿。用清心莲子饮。
血实而热肿。犀角地黄汤。柴胡之类。
血虚而热肿。四物汤。黄连之类。
风热目赤。或自泪。用防风通圣散。川芎石膏汤之类。
内障青盲雀目。羊肝丸。瞀昏翳膜。明目地黄丸之类。
喉痹
轻者甘桔汤 凉膈散
肿痛者僵蚕大黄
闭者胆矾 巴豆入明矾枯过者 雄黄 尘煤 芒硝等吹之皆可选用
淋赤白浊 痛
白属气热而淋 八正散 宝鉴海金砂散
赤属血热而淋 导赤散 石韦散
内伤痞郁及气滞。胀满当分热与寒。
东垣内伤法
消食强胃 枳术丸 丁香烂饭丸 宽中进食丸
伤冷物胃脘痛 感应丸 木香见呗丸 草豆蔻丸 备急丹
虚痞者气也 实痞者物也 非白术不能行湿 非枳实不能消痞
五志所过。非药可治者。五胜为宜。
忧胜怒。肝属木。在志为怒。过节则反自伤。故曰怒伤肝。故以所胜者制之。
恐胜喜。心属火。在志为喜。过节则反自伤。故曰喜伤心。故以所胜者制之。
怒胜思。脾属土。在志为思。过节则反自伤。故曰思伤脾。故以所胜者制之。
喜胜忧。肺属金。在志为忧。过节则反自伤。故曰忧伤肺。故以所胜者制之。
思胜恐。肾属水。在志为恐。过节则反自伤。故曰恐伤肾。故以所胜者制之。
六郁随丹溪越鞠丸加减用之。
〔气〕香附 苍术 抚芎
〔湿〕苍术 抚芎 白术
〔痰〕海石 香附 栝蒌 半夏
〔热〕香附 抚芎 青黛 苍术 山栀
〔血〕桃仁 香附 红花 抚芎 青黛
〔食〕苍术 神曲 香附 山楂 针砂
气郁。乃因忧愁思虑甚多所成。
局方分心气饮 木香分气饮 七气汤 盐煎散 蟠葱散之类
气虚气弱者 陈皮 黄 人参
气实气结者 青皮 浓朴 木香 沉香
热胀。及中满鼓胀。气胀。水气胀。大热胀。宝鉴中满分消丸。
寒胀。及中满寒疝。大小便不通。阴躁。足不收。四肢厥逆。食入反出。下虚中满。腹
中寒。心下痞。脉沉虚弱者。宜中满分消丸。
大实腹满。大小承气汤选用之。
虚胀。则升降其气。陈皮。浓朴。升麻。柴胡之类。
水气实满宣明神金散。十枣汤之类。
十二经中但有疮。皆血结气聚。必用连翘于诸托里散内。出疮毒。消疮肿。黍粘子。
疮出膈以上。须用防风上节。羌活。桔梗。
疮出身中以下。须用洒水各半煎药。
疮坚而溃者。昆布。广术。三棱。
疮痛者。黄芩。知母。黄连。
疮出而呕吐者。半夏。生姜。
疮出而渴闷者。黄连。
大便燥结而常难者。桃仁。麻子仁。郁李仁。
上焦有疮。须用黄芩。
中焦有疮。用黄连。
下焦有疮。用黄柏。知母。防风。疮药中用皂角针者。以其能引药直达入疮也。
疔疮恶肿。初起甚者。有用毒药攻。如穿山甲。蟾酥。枯矾。全蝎。乳香。信石。轻粉
。蜗牛。蜈蚣之类也。
必先岁气分时令。三法随宜大意完。
必先岁气。无伐天和。随四时用之。为去病之药。不可犯时禁。 〔春〕防风。升麻。
〔夏〕黄芩。知母。白芍药。 〔秋〕泽泻。茯苓。 〔冬〕桂姜。
三法药
吐剂如瓜蒂。铜绿。齑汁。沧盐。可以吐痰。栀子。豆豉。吐伤寒懊 。黄连。黄芩。
吐风热。苦参。藜芦。吐中风。常山吐疟。木香。浓朴。吐气郁。当随证用用之。
汗剂如桂枝。麻黄。五积败毒。皆发汗辛热之药也。升麻。葛根。解肌逼毒。皆辛温之
汗药
也。大小柴胡饮子。若寒之汗药也。通圣当归饮子。皆辛凉之汗药也。通圣当归饮子。皆辛
凉之汗药也。故外寒内热。宜辛凉。外热内寒。宜辛温之
类。下剂如枳实。槟榔。杏仁。下气之痞滞也。巴豆腻粉下诸积。大黄。朴硝下诸热。芫花
。大戟。甘遂。牵牛。下诸水。石蜜。郁李仁。猪羊血。下燥。当择气味。随证选而用之。
欲求活要知方制。试举元戎掌上看。
王海藏医垒元戎。备见加减用药例。今以六气分方制法陈于下。临证当审内外虚实。加
减如元戎用之可也。
风制法 风淫于内。治以辛凉。佐以甘辛。以甘缓之。以辛散之。
防风通圣散 防风天麻散 消风散 排风散 小续命汤 防风汤
暑治法 热淫于内。治以咸寒。佐以甘苦。以酸收之。以苦发之。
桂苓甘露饮 白虎汤 玉壶丸 益元散 玉露散 石膏汤 湿制法 湿淫于内。治以苦
热。佐以咸淡。以苦燥之。以淡泄之。
白术木香散 葶苈木香散 橘皮白术散 桂苓白术散 大橘皮汤 益元散
火制法 火淫于内。治以咸寒。佐以甘辛。以酸收之。以苦发之。
黄连解毒汤 凉膈散 诸承气汤 八正散 调胃散 神芎丸 泻心汤
燥制法 燥淫于内。治以苦温。佐以甘辛。以辛润之。以苦下之。
神功丸 麻仁丸 脾约丸
寒制法 寒淫于内。治以甘热。佐以苦辛。以辛散之。以苦坚之。
姜附汤 四逆汤 二姜汤 附子理中汤 大己寒丸 术附汤
东垣立方本旨
夫脾胃虚者。因饮食劳倦。心火亢甚而乘其土位。其次肺气受邪。须用黄 最多。人参
甘草
次之。脾胃若虚。肺气先绝。故用黄 以益皮毛而闭腠理。不令自汗上喘气短损其元气。人
参以补之。心火乘脾。炙甘草之甘温。以泻火热而补脾胃中元气。若脾胃急痛。腹中急缩者
宜多用之。经云。急者
缓之。白术苦甘温。除胃中热。利腰脐间血。胃中清气在下。升麻柴胡以引之。引黄 甘草
甘温之气味上升。能补卫气之散解而实其表也。又缓带脉之缩急。二味苦平之薄者。阴中之
阳。引清气上升也。气乱于胸中。为清浊相干。用陈皮以理之。又能助阳气之升以散滞气。
助诸甘辛为用也。脾胃气虚。不能升浮。为阴火伤其生发之气。荣血大亏。阴火炽盛。是血
中伏火日渐煎熬。血气日减。心主血。血减则心无所养。致使心乱而烦。病名曰 。 者。
心惑而烦闷不安也。故加辛甘微温之剂生阳气。阳旺则能生阴血。更以当归和之。是名补中
益气汤。或少加黄柏以救肾水。能消阴中之伏火。如烦不止。少加生地黄补肾水。肾水旺而
心火自降。如心气浮乱。更以朱砂安神丸镇固之。补中益气汤加减例略。
如心下痞或痛中寒者加附子
痞而腹胀加枳实浓朴木香砂仁
痞而有痰脉缓加半夏黄连
心下痞不能食加生姜陈皮
心下痞劣闷者加芍药黄连
顶痛脑痛加 本细辛
嗌痛颔肿脉洪面赤加黄芩桔梗鼠粘子
腹中痛加白芍药在寒时加益智豆蔻
头痛加蔓荆子川芎
胁下痛倍加柴胡
以治疗各经疾病的药物来看,大多属于辛温解表(使用辛温性质的药物来发散体表邪气)的方剂,这与伤寒病传变的过程相似。这六个方面的方剂已经穷尽了其中的变化规律。
【辛平解表之剂】消风百解散、川芎茶调散、消风散。
【辛凉解表之剂】柴胡升麻汤。
【辛温解表之剂】小续命汤。
【辛凉解表攻里之剂】钱氏大青膏、防风通圣散。
治疗泄泻和痢疾不要混淆差错,发汗法会导致肠道津液枯竭而加重腹泻,分利小便法则能止泻。
【泄泻】
治疗湿邪的方剂:胃苓汤、茯苓汤、五苓散、机要白术芍药汤。
治疗风邪的方剂:神术散、胃风汤、苍术防风汤、机要防风芍药汤。
治疗热邪的方剂:局方戊己丸。
治疗暑邪的方剂:来复丹、香薷饮、桂苓甘露饮。
治疗寒邪的方剂:白术汤、理中汤、机要浆水散。
治疗风寒邪气的方剂:本事曲芎丸。
具有收敛固涩作用的方剂:仲景桃花汤、实肠散、真人养脏汤。
去除积滞的方剂:本事温脾汤。
升发清阳的方剂:东垣升阳除湿汤、益胃升阳汤、升阳除湿防风汤。
调理补益脾胃的方剂:钱氏白术散、易简白术汤。
【滞下诸痢(各种痢疾)】
治疗热邪的方剂:黄连阿胶丸、芍药柏皮丸、导滞汤、仲景白头翁汤。
治疗寒邪的方剂:局方桃花丸、严氏当归丸、诃黎勒散。
治疗冷热错杂的方剂:古方驻车丸、局方香连丸、戊己丸。
治疗风湿邪气的方剂,从治疗泄泻的方剂中选择使用。
治疗暑邪的方剂:黄连香薷饮、桂苓甘露饮。
攻下通便的方剂:大承气汤、宣明玄青丸、导滞汤。
消除积滞的方剂:脾胃论圣饼子、元戎圣功丸。
收敛固涩的方剂:仲景桃花汤、真人养脏汤、水煮木香丸、宣明香连丸、严氏禹余粮丸。
收敛固脱的方剂:严氏乌梅丸、元戎乌梅散。
补益方剂:十全大补汤。
治疗噤口痢(痢疾患者无法进食):仓廪汤、百一选方澹寮方。
【诸经头痛】
阳明头痛,伴有自汗、发热,用白芷。
少阳头痛,脉弦,忽冷忽热,用柴胡。
太阳头痛,恶风、恶寒,用川芎。
太阴头痛,痰多、身体沉重、腹痛,用半夏、苍术。
少阴头痛,手三阴经和三阳经气血运行不畅,足部寒冷逆冷为寒厥,用细辛。
厥阴头痛,用吴茱萸。
虚证头痛,用黄芪、当归。
巅顶痛,用藁本。
眉棱骨痛,用白芷、羌活。
如果全身疼痛,可用疏风的秦艽羌活汤之类,或除湿的守真除湿丹之类。
【伤寒头痛】
太阳经无汗用麻黄汤,有汗用桂枝汤。
阳明经用白虎汤。
少阳经用小柴胡汤。
太阴经脉浮用桂枝汤,脉沉用理中汤。
少阴经脉沉、发热用麻黄附子细辛汤。
厥阴经用桂枝麻黄各半汤。
【诸牙齿痛治例】
治疗风热引起的牙疼,喜欢冷饮、厌恶热食,用药:生地黄、牡丹皮、当归、升麻、黄连。
治疗寒多热少的牙疼,用药:草豆蔻、细辛、升麻、骨灰、当归、黄连、防风。
治疗大寒侵犯脑部引起的牙齿疼痛,用药:白芷、桂枝、升麻、吴茱萸、草豆蔻、藁本。
治疗寒邪和风邪侵犯脑部引起的头疼和牙痛,用药:细辛、白芷、桂枝、麻黄、骨灰、羌活、升麻、防风。
治疗人口臭不可靠近,牙齿被虫蚀,牙龈肉脱落出血不止,用东垣神功丸。
治疗虫牙疼痛腐蚀严重的,取虫或熏蒸治疗,因为手足阳明经湿热严重而生虫。
热痛用凉膈散;虫蚀出血的用桃仁、大黄攻下。
阳明经标部有风湿客邪疼痛,用大戟、芫花、细辛、苍耳叶、花椒、小麦。
标部有血瘀阻滞,经络郁结而痛,用葱白、艾叶、黑豆、花椒。
或者是风毒肿痛,用细辛、草乌、白芷。
化除虫积是治本的原因,病情严重的应当默默记住这些案例。
【诸积药例】
肉积(肉食积滞),用砂仁、巴豆,严重的用信石。
酒积(饮酒积滞),用干葛、神曲、麦芽,严重的用甘遂、牵牛子。
血积(血瘀积滞),用当归梢、桃仁,严重的用水蛭、虻虫。
气积(气滞积滞),用木香、槟榔,严重的用枳壳、牵牛子。
水积(水饮积滞),用牵牛子、泽泻、郁李仁,严重的用芫花、甘遂、大戟。
涎积(痰涎积滞),用雄黄、腻粉,严重的用瓜蒂、藜芦。
食积(食物积滞),用砂仁、香附、牵牛子,严重的用礞石、巴豆。
痰积(痰浊积滞),用半夏、南星,严重的用瓜蒂、藜芦。
癖积(胁下痞块),用三棱、蓬术,严重的用甘遂、蝎梢。
虫积,用宝鉴化虫丸、补金散。
治疗膈噎(吞咽困难)的方子随治十般膈气,寒热明分散与丸剂。
【十般膈气】
冷膈、热膈、风膈、气膈、痰膈、忧膈、悲膈、喜膈、水膈、食膈,这些都是病源。
方剂:宝鉴十膈气散、五膈嘉禾散、木香流气散。
治疗喘满、痰嗽、闷冒、壅滞成热膈,用宝鉴人参利膈丸。
治疗五噎、寒膈,用宝鉴汉防己散、豆蔻散。
破经调血微微行卫气,补气还要滋血才能安宁。
调理诸经闭经不行的方子,兼行其气的,用温经汤、通经丸。
【经血虚实】
经血因气结不通,实证疼痛的用玉烛散;血虚的用四物汤。
血虚且寒凝小腹痛,用增损四物汤、姜黄汤。
血虚且有寒热、劳倦者,用逍遥散。
经期作痛的良方,用当归散、小柴胡汤、合四物汤之类。
经行期间疼痛的良方,用桃仁散。
去除恶血、活血,用当归梢、苏木、红花。
经血暴下、崩漏不止,用蒲黄散、宝鉴凉血地黄汤、备金散。
干血气导致经血不行,用大全良方、琥珀散、桃仁散之类。
血积、瘕聚的良方,用通经丸之类。
【诸虚不足】
髓竭不足,用生地黄、当归。
肺气不足,用天门冬、麦门冬、五味子。
心气不足,用上党参、茯神、菖蒲。
肝气不足,用天麻、川芎。
脾气不足,用白术、白芍药、益智仁。
肾气不足,用熟地黄、远志、牡丹皮。
胆气不足,用细辛、酸枣仁、地榆。
神昏不足,用朱砂、预知子、茯神。
非天雄,不能治疗上焦的阳虚。
非附子,不能治疗下焦的阳虚。
天真丸、三建丹,都是补阳虚的方剂。
地黄丸、滋肾丸,都是补阴虚的方剂。
补阴虚兼阳竭,用仲景八味地黄丸。
调理阴阳升降、脾胃之气、饮食劳役损伤的,用补中益气汤,随证加减使用。这是补气滋血的大法。
补元气必须用人参、黄芪。
补胃虚,增进饮食,用陈皮、人参、甘草。
补三焦元气,调和诸药共同发挥功效的,用炙甘草。
治疗各种虚痛适宜调理,实证疼痛只有施以下法才能痊愈。
胁下痛,忽冷忽热,用柴胡、丹溪龙荟丸。
气刺痛,用枳壳,用引经药引导。
血刺痛,用当归。
茎中痛,用甘草梢。
胃脘痛,用草果。
内伤饮食等各种疼痛,用备急丹之类。
心痛药,临时随证使用,应当分辨寒热虚实。
寒痛,用铁刷汤。热痛,用泻心汤。气痛,用木香、乳香之类。血痛,用四物汤。
臂痛,用苍术、半夏、南星、陈皮、香附、茯苓之类。
腰痛,肾虚的用杜仲、补骨脂;瘀血作痛的用桃仁、红花;湿热而痛的,用苍术、杜仲、黄柏、川芎之类,或者子和煨肾散;痰湿的用南星。
闪挫打击,各种实证疼痛,宜用当归承气等汤攻下。
眼睛突发红肿泻去各种热邪,喉痹、淋证、癃闭的治疗也是如此。
【赤肿及痛】
气实而热肿,用凉膈散。
气虚而热肿,用清心莲子饮。
血实而热肿,用犀角地黄汤、柴胡之类。
血虚而热肿,用四物汤、黄连之类。
风热目赤,或者自流泪,用防风通圣散、川芎石膏汤之类。
内障、青盲、雀目,用羊肝丸;视物模糊、翳膜,用明目地黄丸之类。
【喉痹】
轻者用甘桔汤、凉膈散。
肿痛者用僵蚕、大黄。
闭塞者用胆矾、巴豆入明矾枯过者、雄黄、尘煤、芒硝等吹鼻或患处,皆可选用。
【淋赤白浊 痛】
白色属气热而淋,用八正散、宝鉴海金砂散。
红色属血热而淋,用导赤散、石韦散。
内伤痞闷郁结以及气滞,胀满应当分辨热与寒。
【东垣内伤法】
消食强胃:枳术丸、丁香烂饭丸、宽中进食丸。
伤冷物胃脘痛:感应丸、木香见呗丸、草豆蔻丸、备急丹。
虚痞是气的问题,实痞是物的问题。非白术不能行湿,非枳实不能消痞。
五志所过,非药可治者,以五行相胜为宜。
忧胜怒,肝属木,在志为怒,过节则反自伤,故曰怒伤肝,故以所胜者制之。
恐胜喜,心属火,在志为喜,过节则反自伤,故曰喜伤心,故以所胜者制之。
怒胜思,脾属土,在志为思,过节则反自伤,故曰思伤脾,故以所胜者制之。
喜胜忧,肺属金,在志为忧,过节则反自伤,故曰忧伤肺,故以所胜者制之。
思胜恐,肾属水,在志为恐,过节则反自伤,故曰恐伤肾,故以所胜者制之。
六郁随丹溪越鞠丸加减使用。
【气郁】香附、苍术、抚芎。
【湿郁】苍术、抚芎、白术。
【痰郁】海石、香附、栝蒌、半夏。
【热郁】香附、抚芎、青黛、苍术、山栀。
【血郁】桃仁、香附、红花、抚芎、青黛。
【食郁】苍术、神曲、香附、山楂、针砂。
气郁,乃因忧愁思虑甚多所成。
方剂:局方分心气饮、木香分气饮、七气汤、盐煎散、蟠葱散之类。
气虚气弱者,用陈皮、黄芪、人参。
气实气结者,用青皮、浓朴、木香、沉香。
热胀,及中满鼓胀、气胀、水气胀、大热胀,用宝鉴中满分消丸。
寒胀,及中满寒疝、大小便不通、阴躁、足不收、四肢厥逆、食入反出、下虚中满、腹中寒、心下痞、脉沉虚弱者,宜用中满分消丸。
大实腹满,大小承气汤选用之。
虚胀,则升降其气,用陈皮、浓朴、升麻、柴胡之类。
水气实满,用宣明神金散、十枣汤之类。
十二经中只要有疮,都是血结气聚,必须在各种托里散内加入连翘,排出疮毒,消除疮肿,以及黍粘子。
疮出膈以上,须用防风上节、羌活、桔梗。
疮出身中以下,须用洒水各半煎药。
疮坚而溃破的,用昆布、广术、三棱。
疮痛的,用黄芩、知母、黄连。
疮出而呕吐的,用半夏、生姜。
疮出而渴闷的,用黄连。
大便燥结而常难者,用桃仁、麻子仁、郁李仁。
上焦有疮,须用黄芩。
中焦有疮,用黄连。
下焦有疮,用黄柏、知母、防风。疮药中用皂角针的,是因为它能引药直达入疮。
疔疮恶肿,初起严重的,有用毒药攻伐的,如穿山甲、蟾酥、枯矾、全蝎、乳香、信石、轻粉、蜗牛、蜈蚣之类也。
必须先了解岁气与时令,三种方法随宜大意完备。
必须先顺岁气,不要破坏天和,随四时季节使用,作为去病的药,不可犯时禁。
【春】防风、升麻。
【夏】黄芩、知母、白芍药。
【秋】泽泻、茯苓。
【冬】桂枝、干姜。
【三法药】
吐剂如瓜蒂、铜绿、齑汁、沧盐,可以吐痰;栀子、豆豉,吐伤寒懊憹;黄连、黄芩,吐风热;苦参、藜芦,吐中风;常山,吐疟;木香、浓朴,吐气郁。当随证使用。
汗剂如桂枝、麻黄、五积败毒,都是发汗辛热的药。升麻、葛根,解肌逼毒,都是辛温的汗药。大小柴胡饮子,若是寒之汗药。通圣当归饮子,都是辛凉的汗药。通圣当归饮子,都是辛凉的汗药。所以外寒内热,宜用辛凉;外热内寒,宜用辛温之类。
下剂如枳实、槟榔、杏仁,下气之痞滞。巴豆、腻粉,下诸积。大黄、朴硝,下诸热。芫花、大戟、甘遂、牵牛,下诸水。石蜜、郁李仁、猪羊血,下燥。当择气味,随证选而用之。
想要寻求活法要害,要知道方制,试举元戎掌上看。
王海藏《医垒元戎》,备见加减用药例。现在以六气分方制法陈述如下,临证应当审察内外虚实,加减如同元戎使用即可。
【风制法】风淫于内,治以辛凉,佐以甘辛,以甘缓之,以辛散之。
方剂:防风通圣散、防风天麻散、消风散、排风散、小续命汤、防风汤。
【暑治法】热淫于内,治以咸寒,佐以甘苦,以酸收之,以苦发之。
方剂:桂苓甘露饮、白虎汤、玉壶丸、益元散、玉露散、石膏汤。
【湿制法】湿淫于内,治以苦热,佐以咸淡,以苦燥之,以淡泄之。
方剂:白术木香散、葶苈木香散、橘皮白术散、桂苓白术散、大橘皮汤、益元散。
【火制法】火淫于内,治以咸寒,佐以甘辛,以酸收之,以苦发之。
方剂:黄连解毒汤、凉膈散、诸承气汤、八正散、调胃散、神芎丸、泻心汤。
【燥制法】燥淫于内,治以苦温,佐以甘辛,以辛润之,以苦下之。
方剂:神功丸、麻仁丸、脾约丸。
【寒制法】寒淫于内,治以甘热,佐以苦辛,以辛散之,以苦坚之。
方剂:姜附汤、四逆汤、二姜汤、附子理中汤、大己寒丸、术附汤。
【东垣立方本旨】
脾胃虚弱的人,因为饮食劳倦,心火亢盛而乘袭脾土之位,其次肺气受邪,必须用黄芪最多,人参、甘草次之。脾胃若虚,肺气先绝,所以用黄芪来益皮毛而闭腠理,不让自汗、上喘、气短损耗元气。人参用来补益。心火乘脾,用炙甘草的甘温,来泻火热而补脾胃中元气。如果脾胃急痛,腹中急缩的,宜多用之。经云:急者缓之。白术苦甘温,除胃中热,利腰脐间血。胃中清气在下,用升麻、柴胡来引导,引导黄芪、甘草甘温的气味上升,能补卫气之散解而充实表虚。又缓解带脉的缩急,这两味药苦平气薄,是阴中之阳,引导清气上升。气乱于胸中,为清浊相干,用陈皮来调理,又能助阳气之升以散滞气,助诸甘辛为用。脾胃气虚,不能升浮,为阴火伤其生发之气,荣血大亏,阴火炽盛,这是血中伏火日渐煎熬,血气日减。心主血,血减则心无所养,致使心乱而烦,病名曰“心惑”。心惑者,心惑而烦闷不安也。所以加辛甘微温的药剂生阳气,阳旺则能生阴血,更以当归调和,这就是补中益气汤。或少加黄柏来救肾水,能消阴中之伏火。如果烦闷不止,少加生地黄补肾水,肾水旺而心火自降。如果心气浮乱,更以朱砂安神丸镇固它。补中益气汤加减例略。
如果心下痞或痛中寒者加附子。
痞而腹胀加枳实、浓朴、木香、砂仁。
痞而有痰脉缓加半夏、黄连。
心下痞不能食加生姜、陈皮。
心下痞劣闷者加芍药、黄连。
顶痛脑痛加藁本、细辛。
咽痛颔肿脉洪面赤加黄芩、桔梗、鼠粘子。
腹中痛加白芍药,在寒时加益智、豆蔻。
头痛加蔓荆子、川芎。
胁下痛倍加柴胡。
Based on the medications for each meridian, they are mostly agents of acrid-warm exterior-resolving (using acrid and warm properties to disperse pathogenic factors from the exterior), which is similar to the transmission and transformation of Cold Damage (Shanghan). These six categories of formulas exhaust the variations within this framework.
[Acrid-Ping Exterior-Resolving Agents] Xiaofeng Baijie San, Chuanxiong Chatiao San, Xiaofeng San.
[Acrid-Cool Exterior-Resolving Agents] Chaihu Shengma Tang.
[Acrid-Warm Exterior-Resolving Agents] Xiao Xuming Tang.
[Acrid-Cool Exterior-Resolving and Interior-Purging Agents] Qian Shi Daqing Gao, Fangfeng Tongsheng San.
In treating diarrhea and dysentery, do not confuse the methods. Diaphoresis (sweating) depletes intestinal fluids and worsens diarrhea, whereas separating clear from turbid (promoting urination) stops diarrhea.
[Diarrhea]
Agents for treating Dampness: Weiling Tang, Fuling Tang, Wuling San, Jiyao Baizhu Shaoyao Tang.
Agents for treating Wind: Shenzhu San, Weifeng Tang, Cangzhu Fangfeng Tang, Jiyao Fangfeng Shaoyao Tang.
Agents for treating Heat: Ju Fang Wuji Wan.
Agents for treating Summerheat: Laifu Dan, Xiangru Yin, Guiling Ganlu Yin.
Agents for treating Cold: Baizhu Tang, Lizhong Tang, Jiyao Jiangshui San.
Agents for treating Wind-Cold: Benshi Quxiong Wan.
Astringent agents: Zhongjing Taohua Tang, Shichang San, Zhenren Yangzang Tang.
Agents for removing accumulation: Benshi Wenspi Tang.
Agents for raising Yang: Dongyuan Shengyang Chushi Tang, Yiwei Shengyang Tang, Shengyang Chushi Fangfeng Tang.
Agents for regulating and tonifying Spleen and Stomach: Qian Shi Baizhu San, Yijian Baizhu Tang.
[Dysentery (Various Types)]
Agents for treating Heat: Huanglian Ejiao Wan, Shaoyao Bapi Wan, Daozhi Tang, Zhongjing Baitouweng Tang.
Agents for treating Cold: Ju Fang Taohua Wan, Yan Shi Danggui Wan, Helile San.
Agents for treating Cold-Heat Complex: Ancient Formula Zhuche Wan, Ju Fang Xianglian Wan, Wuji Wan.
Agents for treating Wind-Dampness: Select from agents for treating diarrhea.
Agents for treating Summerheat: Huanglian Xiangru Yin, Guiling Ganlu Yin.
Purgative agents: Dachengqi Tang, Xuanming Xuanqing Wan, Daozhi Tang.
Agents for eliminating accumulation: Shenpi Lun Shengbingzi, Yuanrong Shenggong Wan.
Astringent agents: Zhongjing Taohua Tang, Zhenren Yangzang Tang, Shuizhu Muxiang Wan, Xuanming Xianglian Wan, Yan Shi Yuyuliang Wan.
Consolidating agents: Yan Shi Wumei Wan, Yuanrong Wumei San.
Tonifying agents: Shiquan Dabu Tang.
For Jin Kou Li (Dysentery with inability to eat): Cang Tang, Baiyi Xuanfang Danliao Fang.
Headaches of the Six Meridians exclude toothache; each should use guiding herbs as assistants.
[Headaches of Various Meridians]
Yangming headache with spontaneous sweating and fever: Bai Zhi.
Shaoyang headache with wiry pulse and alternating chills and fever: Chai Hu.
Taiyang headache with aversion to wind and cold: Chuan Xiong.
Taiyin headache with phlegm, heaviness, and abdominal pain: Ban Xia, Cang Zhu.
Shaoyin headache with poor circulation in the three Yin and three Yang meridians of the hand, cold feet, and reversal cold: Xi Xin.
Jueyin headache: Wu Zhu Yu.
Deficiency headache: Huang Qi, Dang Gui.
Vertex headache: Gao Ben.
Supraorbital pain: Bai Zhi, Qiang Huo.
If there is generalized body pain, use wind-dispersing formulas like Qinjiao Qianghuo Tang or damp-draining formulas like Shouzhen Chushi Dan.
[Headache due to Cold Damage]
Taiyang meridian without sweat: Mahuang Tang; with sweat: Guizhi Tang.
Yangming meridian: Baihu Tang.
Shaoyang meridian: Xiao Chaihu Tang.
Taiyin meridian with floating pulse: Guizhi Tang; with sinking pulse: Lizhong Tang.
Shaoyin meridian with sinking pulse and fever: Mahuang Fuzi Xixin Tang.
Jueyin meridian: Guizhi Mahuang Gehan Tang.
[Examples for Treating Toothaches]
For wind-heat toothache, preferring cold and disliking heat: Sheng Dihuang, Mudan Pi, Dang Gui, Sheng Ma, Huang Lian.
For toothache with more cold than heat: Caodoukou, Xi Xin, Sheng Ma, Gu Hui, Dang Gui, Huang Lian, Fang Feng.
For severe cold invading the brain causing toothache: Bai Zhi, Guizhi, Sheng Ma, Wu Zhu Yu, Caodoukou, Gao Ben.
For cold and wind pathogens invading the brain causing headache and toothache: Xi Xin, Bai Zhi, Guizhi, Mahuang, Gu Hui, Qiang Huo, Sheng Ma, Fang Feng.
For bad breath, dental caries, receding gums, and continuous bleeding: Dongyuan Shengong Wan.
For severe toothache caused by worms, remove worms or fumigate; this occurs because damp-heat is severe in the Hand and Foot Yangming meridians.
For heat pain, use Liangge San; for caries with bleeding, use Tao Ren and Da Huang to purge.
For Yangming meridian branch pain due to wind-damp invasion: Da Ji, Yuan Hua, Xi Xin, Cang Er Ye, Hua Jiao, Xiao Mai.
For blood stasis and meridian stagnation pain: Cong Bai, Ai Ye, Hei Dou, Hua Jiao.
For wind-toxin swelling and pain: Xi Xin, Cao Wu, Bai Zhi.
Eliminating worms and accumulation addresses the root cause; severe cases require memorization of these examples.
[Examples for Accumulations]
Meat accumulation: Sha Ren, Ba Dou; severe: Xin Shi.
Alcohol accumulation: Gan Ge, Shen Qu, Mai Ya; severe: Gan Sui, Qian Niu.
Blood accumulation: Dang Gui Shao, Tao Ren; severe: Shui Zhi, Meng Chong.
Qi accumulation: Mu Xiang, Bing Lang; severe: Zhi Ke, Qian Niu.
Water accumulation: Qian Niu, Ze Xie, Yuli Ren; severe: Yuan Hua, Gan Sui, Da Ji.
Saliva/Phlegm accumulation: Xiong Huang, Ni Fen; severe: Gua Di, Li Lu.
Food accumulation: Sha Ren, Xiang Fu, Qian Niu; severe: Meng Shi, Ba Dou.
Phlegm accumulation: Ban Xia, Nan Xing; severe: Gua Di, Li Lu.
Mass accumulation: San Leng, Peng Ze; severe: Gan Sui, Xie Shao.
Worm accumulation: Baojian Huachong Wan, Bujin San.
Formulas for Ge Ye (dysphagia/chest obstruction) follow the treatment of Ten Types of Ge Qi, such as Hanre Mingfen San in powder or pill form.
[Ten Types of Ge Qi]
Cold Ge, Heat Ge, Wind Ge, Qi Ge, Phlegm Ge, Worry Ge, Sorrow Ge, Joy Ge, Water Ge, Food Ge. These are all pathological sources.
Formulas: Baojian Shige Qisan, Wuge Jiahe San, Muxiang Liuqi San.
For panting, fullness, cough with phlegm, dizziness, obstruction turning into Heat Ge: Baojian Renshen Lige Wan.
For Five Sie (choking sensations) and Cold Ge: Baojian Hanfangji San, Doukou San.
Breaking menstruation and regulating blood slightly moves Wei Qi; tonifying Qi still requires nourishing Blood for peace.
To regulate closed and non-flowing menstruation in various meridians, while promoting Qi flow, use Wenjing Tang and Tongjing Wan.
[Menstrual Blood Deficiency and Excess]
When menstruation is blocked due to Qi knotting, excess pain uses Yuzhu San; blood deficiency uses Siwu Tang.
Blood deficiency with cold and lower abdominal pain: Zengsun Siwu Tang, Jianghuang Tang.
Blood deficiency with cold-heat and fatigue: Xiaoyao San.
Good formulas for pain during menstruation: Danggui San, Xiao Chaihu Tang, combined with Siwu Tang.
Good formulas for pain during menstrual flow: Tao Ren San.
To remove evil blood and invigorate blood: Dang Gui Shao, Sumu, Honghua.
For sudden heavy bleeding and metrorrhagia: Puhuang San, Baojian Liangxue Dihuang Tang, Beijin San.
For dry blood and Qi preventing menstruation: Daquan Liangfang, Hupo San, Tao Ren San.
For blood accumulation and masses: Tongjing Wan.
[Various Deficiencies]
Marrow exhaustion: Sheng Dihuang, Dang Gui.
Lung Qi deficiency: Tianmendong, Maidong, Wuweizi.
Heart Qi deficiency: Shangdang Renshen, Fushen, Changpu.
Liver Qi deficiency: Tianma, Chuan Xiong.
Spleen Qi deficiency: Baizhu, Baishao Yao, Yizhi.
Kidney Qi deficiency: Shudihuang, Yuanzhi, Mudan Pi.
Gallbladder Qi deficiency: Xi Xin, Suanzaoren, Diyü.
Spirit confusion deficiency: Zhusha, Yuzhizi, Fushen.
Only Tianxiong can treat Upper Jiao Yang deficiency.
Only Fuzi can treat Lower Jiao Yang deficiency.
Tianzhen Wan and Sanjian Dan are both agents for tonifying Yang deficiency.
Dihuang Wan and Zishen Wan are both agents for tonifying Yin deficiency.
For tonifying Yin deficiency with Yang exhaustion, use Zhongjing Bawei Dihuang Wan.
To regulate Yin-Yang ascending/descending and Spleen-Stomach Qi affected by diet and labor, use Buzhong Yiqi Tang, modified according to symptoms. This is the major method for tonifying Qi and nourishing Blood.
To tonify Yuan Qi, one must use Renshen and Huang Qi.
To tonify Stomach deficiency and promote appetite: Chenpi, Renshen, Gancao.
To tonify San Jiao Yuan Qi and harmonize herbs to achieve success together: Zhigancao.
Treating various deficiency pains requires regulation; excess pain is only cured by purging.
Hypochondriac pain with alternating fever: Chai Hu, Danxi Longhui Wan.
Qi stabbing pain: Zhi Ke, guided by meridian-guiding herbs.
Blood stabbing pain: Dang Gui.
Penile pain: Gancao Shao.
Epigastric pain: Caoguo.
Internal injury pain from food: Beijidan.
Heart pain medicines are used temporarily according to symptoms, distinguishing cold, heat, excess, and deficiency.
Cold pain: Tieshua Tang. Heat pain: Xiexin Tang. Qi pain: Muxiang, Ruxiang. Blood pain: Siwu Tang.
Arm pain: Cangzhu, Banxia, Nanxing, Chenpi, Xiangfu, Fuling.
Lower back pain: Kidney deficiency uses Duzhong, Buguzhi; Blood stasis pain uses Taoren, Honghua; Damp-heat pain uses Cangzhu, Duzhong, Huangbai, Chuanxiong, or Hezi Weishen San; Phlegm uses Nanxing.
Sprains and blows, various excess pains, should be treated with Danggui Chengqi Tang and others to purge.
Sudden red and swollen eyes drain various heats; Hou Bi (sore throat), Lin (dysuria), and Long (difficulty urinating) are treated similarly.
[Red Swelling and Pain]
Excess Qi with heat swelling: Liangge San.
Deficient Qi with heat swelling: Qingxin Lianzi Yin.
Excess Blood with heat swelling: Xijiao Dihuang Tang, Chai Hu.
Deficient Blood with heat swelling: Siwu Tang, Huang Lian.
Wind-heat red eyes or tearing: Fangfeng Tongsheng San, Chuanxiong Shigao Tang.
Internal cataracts, blindness, night blindness: Yanggan Wan. Blurred vision and membranes: Mingmu Dihuang Wan.
[Hou Bi (Sore Throat)]
Mild cases: Ganjie Tang, Liangge San.
Swollen and painful: Jiangcan, Dahuang.
Obstructed: Danfan, Badou mixed with calcined Mingfan, Xionghuang, Chenmei, Xiaosha, etc., insufflated.
[Lin Syndrome with Red/White Turbidity and Pain]
White indicates Qi heat and Lin syndrome: Bazheng San, Baojian Haijinsha San.
Red indicates Blood heat and Lin syndrome: Daochi San, Shiwei San.
Internal injury with epigastric fullness and Qi stagnation causes distension, which must be distinguished as heat or cold.
[Dongyuan's Internal Injury Method]
Digest food and strengthen Stomach: Zhizhu Wan, Dingxiang Lanfan Wan, Kuanzhong Jinsshi Wan.
Stomach pain from cold food: Yinggan Wan, Muxiang Jianbei Wan, Caodoukou Wan, Beijidan.
Deficient fullness is a Qi issue; excess fullness is a material issue. Only Baizhu can move Dampness; only Zhishi can eliminate fullness.
The five emotions, when excessive, cannot always be treated with medicine; using the Five Elements' overcoming cycle is appropriate.
Worry overcomes Anger: Liver belongs to Wood, emotion is Anger; excess harms itself, hence "Anger injures Liver." Use what overcomes it to control it.
Fear overcomes Joy: Heart belongs to Fire, emotion is Joy; excess harms itself, hence "Joy injures Heart." Use what overcomes it to control it.
Anger overcomes Thought: Spleen belongs to Earth, emotion is Thought; excess harms itself, hence "Thought injures Spleen." Use what overcomes it to control it.
Joy overcomes Sorrow: Lung belongs to Metal, emotion is Sorrow; excess harms itself, hence "Sorrow injures Lung." Use what overcomes it to control it.
Thought overcomes Fear: Kidney belongs to Water, emotion is Fear; excess harms itself, hence "Fear injures Kidney." Use what overcomes it to control it.
Six Stagnations are treated with Danxi Yueju Wan, modified.
[Qi Stagnation]: Xiangfu, Cangzhu, Fuxiong.
[Damp Stagnation]: Cangzhu, Fuxiong, Baizhu.
[Phlegm Stagnation]: Haishi, Xiangfu, Gualou, Banxia.
[Heat Stagnation]: Xiangfu, Fuxiong, Qingdai, Cangzhu, Shanzhi.
[Blood Stagnation]: Taoren, Xiangfu, Honghua, Fuxiong, Qingdai.
[Food Stagnation]: Cangzhu, Shenqu, Xiangfu, Shanzha, Zhen Sha.
Qi stagnation is formed by excessive worry and thought.
Formulas: Ju Fang Fenxin Qi Yin, Muxiang Fenqi Yin, Qi Qi Tang, Yanjian San, Pancong San.
Qi deficiency and weakness: Chenpi, Huang Qi, Renshen.
Qi excess and knotting: Qingpi, Nongpo, Muxiang, Chenxiang.
Heat distension, middle-fullness, drum-like distension, Qi distension, water distension, great heat distension: Baojian Zhongman Fenxiao Wan.
Cold distension, middle-fullness cold hernia, constipation and urinary retention, yin restlessness, foot weakness, limb reversal cold, vomiting after eating, lower deficiency with middle fullness, abdominal cold, epigastric fullness, sinking weak pulse: Zhongman Fenxiao Wan.
Great excess abdominal fullness: Dachengqi Tang or Xiaochengqi Tang.
Deficiency distension: Regulate Qi ascending and descending with Chenpi, Nongpo, Shengma, Chai Hu.
Water Qi excess fullness: Xuanming Shenjin San, Shizao Tang.
Sores in any of the twelve meridians result from Blood knotting and Qi gathering; Lianqiao must be added to various interior-supporting formulas to expel toxin and reduce swelling, along with Shunian Zi.
Sores above the diaphragm require upper-section Fangfeng, Qianghuo, Jiegeng.
Sores below the middle body require decoction with equal parts of sprinkling water.
Hard sores that ulcerate: Kunbu, Guangzhu, San Leng.
Painful sores: Huangqin, Zhimu, Huanglian.
Sores with vomiting: Banxia, Shengjiang.
Sores with thirst and stifling: Huanglian.
Dry stool and difficulty defecating: Taoren, Maziren, Yuli Ren.
Sores in Upper Jiao: Huangqin.
Sores in Middle Jiao: Huanglian.
Sores in Lower Jiao: Huangbai, Zhimu, Fangfeng. Zaocai Zhen (Gleditsia sinensis spine) is used in sore medicines because it guides herbs directly to the sore.
Ding Chuang (carbuncle) and malignant swelling, if severe at onset, may use toxic drugs to attack, such as Chanshanyjia, Chansu, Kufan, Quanxie, Ruxiang, Xinshi, Qingfen, Woniu, Wugong.
One must first understand the annual Qi and seasonal timing; the three methods are completed according to appropriateness.
First respect the annual Qi, do not violate Heavenly Harmony; use according to four seasons as disease-removing medicines, avoiding seasonal prohibitions.
[Spring]: Fangfeng, Shengma.
[Summer]: Huangqin, Zhimu, Baishao Yao.
[Autumn]: Zexie, Fuling.
[Winter]: Guizhi, Jiang.
[Three Methods Medicines]
Emetics like Goudi, Tonglv, Jizhi, Cangyan can vomit phlegm; Zhizi, Douchi vomit Cold Damage Ao Nao; Huanglian, Huangqin vomit wind-heat; Kushen, Lilv vomit stroke; Changshan vomits malaria; Muxiang, Nongpo vomit Qi stagnation. Use according to symptoms.
Diaphoretics like Guizhi, Mahuang, Wuji Baidu are acrid-warm sweating agents. Shengma, Gegen release muscle layer and force out toxins, also acrid-warm sweating agents. Daxiao Chaihu Yinzi, if for cold, are sweating agents. Tongsheng Danggui Yinzi are acrid-cool sweating agents. Thus, exterior cold with interior heat suits acrid-cool; exterior heat with interior cold suits acrid-warm.
Purgatives like Zhishi, Binglang, Xingren purge Qi stagnation. Badou, Nifen purge accumulations. Dahuang, Poxiao purge heat. Yuanhua, Daji, Gansui, Qianniu purge water. Shimie, Yuli Ren, pig/sheep blood purge dryness. Choose flavors and odors, use according to symptoms.
To seek vital living methods, know the formula system; refer to Yuanrong's palm view.
Wang Haizang's *Yilei Yuanrong* details modification examples. Here, Six Qi formula systems are presented; clinically assess interior/exterior and deficiency/excess, modifying as in Yuanrong.
[Wind System] Wind rampant internally, treat with acrid-cool, assist with sweet-acrid, soothe with sweet, disperse with acrid.
Formulas: Fangfeng Tongsheng San, Fangfeng Tianma San, Xiaofeng San, Paifeng San, Xiao Xuming Tang, Fangfeng Tang.
[Summerheat System] Heat rampant internally, treat with salty-cold, assist with sweet-bitter, astringe with sour, vent with bitter.
Formulas: Guiling Ganlu Yin, Baihu Tang, Yuhu Wan, Yiyuan San, Yulu San, Shigao Tang.
[Dampness System] Dampness rampant internally, treat with bitter-hot, assist with salty-light, dry with bitter, drain with light.
Formulas: Baizhu Muxiang San, Tingli Muxiang San, Jupi Baizhu San, Guiling Baizhu San, Dajupi Tang, Yiyuan San.
[Fire System] Fire rampant internally, treat with salty-cold, assist with sweet-acrid, astringe with sour, vent with bitter.
Formulas: Huanglian Jiedu Tang, Liangge San, Zhu Chengqi Tang, Bazheng San, Tiaowei San, Shenxiong Wan, Xiexin Tang.
[Dryness System] Dryness rampant internally, treat with bitter-warm, assist with sweet-acrid, moisten with acrid, purge with bitter.
Formulas: Shengong Wan, Maren Wan, Pi Yue Wan.
[Cold System] Cold rampant internally, treat with sweet-hot, assist with bitter-acrid, disperse with acrid, firm with bitter.
Formulas: Jiangfu Tang, Sini Tang, Erjiang Tang, Fuzi Lizhong Tang, Dajihan Wan, Shufu Tang.
[Dongyuan's Original Intent for Formulation]
Those with Spleen-Stomach deficiency, due to diet and fatigue, have hyperactive Heart Fire attacking the Earth position, followed by Lung Qi receiving pathogenic influence. Huang Qi is used most, followed by Renshen and Gancao. If Spleen-Stomach is deficient, Lung Qi is first cut off; thus Huang Qi benefits skin/hair and closes pores to prevent spontaneous sweating, panting, shortness of breath, and Qi damage. Renshen tonifies. Heart Fire attacking Spleen: Roasted Gancao's sweet-warm nature clears heat and tonifies Spleen-Stomach Yuan Qi. For urgent Spleen-Stomach pain and abdominal contraction, use more. The Classic says: "Urgency requires soothing." Baizhu is bitter-sweet-warm, clears stomach heat, promotes blood in waist/navel. Clear Qi of Stomach sinks; Shengma and Chai Hu guide it, leading the sweet-warm aroma of Huang Qi and Gancao upward, supplementing dispersed Wei Qi and solidifying the exterior. They also relax contracted Dai Mai. These two bitter-ping thin herbs are Yang within Yin, guiding clear Qi upward. Qi chaos in chest due to clear-turbid interference: Chenpi regulates, assists Yang Qi ascent to disperse stagnant Qi, aiding sweet-acrid herbs. Spleen-Stomach Qi deficiency fails to ascend, Yin Fire damages generating Qi, Ying Blood severely depleted, Yin Fire blazing, latent fire in Blood slowly simmering, Blood-Qi daily decreasing. Heart governs Blood; less Blood means Heart lacks nourishment, causing Heart chaos and vexation, named "Xin Huo" (Heart Confusion). Xin Huo means Heart confused and vexed. Add acrid-sweet-micro-warm agents to generate Yang Qi; strong Yang generates Yin Blood, harmonized with Dang Gui. This is Buzhong Yiqi Tang. Add minor Huangbai to save Kidney Water, clearing latent Yin Fire. If vexation persists, add minor Sheng Dihuang to tonify Kidney Water; strong Water lowers Heart Fire. If Heart Qi floats and chaotic, use Zhusha Anshen Wan to stabilize. Modifications of Buzhong Yiqi Tang briefly:
If epigastric fullness/pain with cold: Add Fuzi.
Fullness with abdominal distension: Add Zhishi, Nongpo, Muxiang, Sharen.
Fullness with phlegm and slow pulse: Add Banxia, Huanglian.
Epigastric fullness with inability to eat: Add Shengjiang, Chenpi.
Epigastric fullness with stifling: Add Shaoyao, Huanglian.
Vertex/head pain: Add Gao Ben, Xi Xin.
Throat pain, jaw swelling, surging pulse, red face: Add Huangqin, Jiegeng, Shunian Zi.
Abdominal pain: Add Baishao Yao; in cold, add Yizhi, Doukou.
Headache: Add Manjingzi, Chuanxiong.
Hypochondriac pain: Double Chai Hu.