证
夫健忘者,陡然而忘其事也,尽心力而思量不来,为事有始无终,言谈不知首尾,皆主于心脾二经。盖
心之官则思,脾之官亦主思。此由思虑过多,伤于心则血耗散,神不守舍;伤于脾则胃气衰惫,而虑愈深。
二者皆令人事卒然而忘也。盖心生血,因血少不能养其真脏,或停饮而气郁以生痰,气既郁,脾
不得舒,是病皆由此作。
治
然治之法,必先养其心血,理其脾土,凝神定智之剂以调理。
亦当以幽闲之处,安乐之中,使其绝于忧虑,远其六淫七情,如此日渐安矣。
方
归脾散 治忧思过度,劳伤心脾,令人转盼遗忘,心下怔忡。
黄 (炙) 人参 白术 茯神(去木) 当归 远志 酸枣仁 龙眼
肉(各二钱二分) 木香(一钱) 甘草(炙,五分)
上锉作一剂,姜、枣煎服。
加减补心汤 治诸虚健忘等证。
人参(三钱) 白术(三钱) 陈皮(五钱) 白茯苓(五钱) 当归身(五钱) 白芍
(五钱,炒) 生地黄(五钱) 远志(泡,去心,五钱) 石菖蒲(三钱) 麦门冬(去心,
五钱) 酸枣仁(五钱,炒) 甘草(三钱) 黄柏(酒炒,五钱) 知母(酒炒,五钱)
上锉一剂,水煎服。
加味定志丸(陈白野方) 治健忘。
当归身(酒洗) 川芎 白芍药 生地黄(酒洗,切,各二两) 人参(六钱
)石菖蒲(二两) 远志(甘草水泡,去骨,姜汁炒,三两)
上为细末,炼蜜为丸,如梧桐子大。每服二钱,临卧白汤送下。
紫河车 治癫狂健忘,怔忡失志,及恍惚惊怖入心,神不守舍,多言不定,此药大能安心、养血、定神。
聪明汤 治不善记而多忘者。
白茯神 远志肉(甘草水泡) 石菖蒲(去毛,一寸九节者佳)
上各三两,制后共为极细末。每日用三五钱,煎汤,空心食后服,一日不拘数次。久久服之,能日诵千言。
状元丸 治健忘,开心通窍,定智宁神多记。
石菖蒲(去毛,一寸九节者佳) 地骨皮(去木) 白茯神(去皮、木) 远志肉(甘
草水泡,去心,各一两) 人参(去芦,三钱) 巴戟天(去骨,五钱)
上为末,用白茯苓去皮二两,粘米二两,共打粉,外用石菖蒲
三钱,打碎,煎浓汤,去渣,煮糊为丸。每日食后、午时、卧时服三十五丸。
证候
所谓健忘,是指突然忘记自己做过的事情,虽然尽心竭力去思索却想不起来,做事有头无尾,说话不知前因后果。这些症状主要归属于心和脾两经。因为心的功能主司思维,脾的功能也主司思维。这是由于思虑过多,损伤了心则导致血液耗散,神志不能安守于内;损伤了脾则导致胃气衰弱疲惫,而思虑反而更深。这两种情况都会使人突然遗忘事情。大概心生血,如果血少不能滋养真脏(指五脏之精气),或者体内停聚水饮导致气机郁滞而生痰,气既已郁滞,脾不得舒展,这些病症都是由此产生的。
治疗
然而治疗的方法,必须先滋养心血,调理脾土,使用凝神定智的药物进行调理。同时也应当在幽静闲适的地方,安乐的环境中生活,使其断绝忧虑,远离六淫(风、寒、暑、湿、燥、火六种外感病邪)和七情(喜、怒、忧、思、悲、恐、惊七种情志变化),这样日子久了身体就会逐渐安康。
方剂
归脾散:治疗忧思过度,劳伤心脾,使人转眼即忘,心中悸动不安。
黄芪(炙) 人参 白术 茯神(去除木质部分) 当归 远志 酸枣仁 龙眼肉(各二钱二分) 木香(一钱) 甘草(炙,五分)
以上药材切碎为一剂,加生姜、大枣煎服。
加减补心汤:治疗各种虚损引起的健忘等证候。
人参(三钱) 白术(三钱) 陈皮(五钱) 白茯苓(五钱) 当归身(五钱) 白芍(五钱,炒制) 生地黄(五钱) 远志(浸泡,去心,五钱) 石菖蒲(三钱) 麦门冬(去心,五钱) 酸枣仁(五钱,炒制) 甘草(三钱) 黄柏(酒炒,五钱) 知母(酒炒,五钱)
以上药材切碎为一剂,加水煎服。
加味定志丸(陈白野方):治疗健忘。
当归身(酒洗) 川芎 白芍药 生地黄(酒洗,切片,各二两) 人参(六钱) 石菖蒲(二两) 远志(甘草水泡,去骨,姜汁炒,三两)
以上研为细末,用炼蜜制成丸药,大小如梧桐子。每次服用二钱,临睡前用白开水送服。
紫河车:治疗癫狂健忘,心悸失志,以及恍惚惊恐入心,神志不守舍,多言不定,此药大能安心、养血、定神。
聪明汤:治疗记性不好且容易遗忘的人。
白茯神 远志肉(甘草水泡) 石菖蒲(去毛,一寸九节者佳)
以上各三两,处理后共研为极细末。每天用三五钱,煎汤,空腹及饭后服用,一天不限次数。长期服用,能够每天背诵千言文字。
状元丸:治疗健忘,开心通窍,定智宁神,增加记忆。
石菖蒲(去毛,一寸九节者佳) 地骨皮(去除木质部分) 白茯神(去皮、木质部分) 远志肉(甘草水泡,去心,各一两) 人参(去芦头,三钱) 巴戟天(去骨,五钱)
以上研为粉末,用去皮白茯苓二两,粘米二两,共同打成粉,外用石菖蒲三钱,打碎,煎煮浓汤,去渣,煮糊作为粘合剂制成丸药。每天饭后、午时、卧时服用三十五丸。
Syndrome
What is referred to as forgetfulness (Jianwang) is the sudden forgetting of one's own actions. Despite exerting utmost effort to think, one cannot recall; tasks are started but not finished, and conversations lack coherence regarding cause and effect. These symptoms are primarily attributed to the Heart (Xin) and Spleen (Pi) meridians. The function of the Heart governs thought (Si), and the function of the Spleen also governs thought. This condition arises from excessive mental worry. If it injures the Heart, blood is consumed and scattered, and the Shen (Spirit) fails to reside within its abode; if it injures the Spleen, Stomach Qi becomes weak and exhausted, leading to deeper worry. Both conditions cause people to suddenly forget things. Generally, the Heart generates blood. If there is insufficient blood to nourish the True Zang (the essence of the five Zang organs), or if fluid retention causes Qi stagnation leading to phlegm formation, and since Qi is stagnant, the Spleen cannot relax, all these diseases arise from this mechanism.
Treatment
However, the method of treatment must first nourish Heart Blood and regulate Spleen Earth, using agents that calm the Shen and stabilize intelligence for regulation. One should also live in quiet and leisurely places, amidst peace and joy, cutting off worries and staying away from the Six Evils (Liu Yin: Wind, Cold, Summer-heat, Dampness, Dryness, Fire) and Seven Emotions (Qi Qing: Joy, Anger, Worry, Pensiveness, Sadness, Fear, Fright). In this way, health will gradually improve over time.
Formulas
Guipi San (Restore the Spleen Powder): Treats excessive worry and thought, damaging the Heart and Spleen through overwork, causing immediate forgetfulness upon turning one's head, and palpitations (Xin Xia Zheng Chong) in the chest.
Huangqi (Astragali Radix, honey-fried) 3.85g, Renshen (Ginseng Radix et Rhizoma) 3.85g, Baizhu (Atractylodis Macrocephalae Rhizoma) 3.85g, Fushen (Poria with Hostwood) 3.85g, Danggui (Angelicae Sinensis Radix) 3.85g, Yuanzhi (Polygalae Radix) 3.85g, Suanzaoren (Ziziphi Spinosae Semen) 3.85g, Longyanrou (Longan Aril) 3.85g, Muxiang (Aucklandiae Radix) 1.29g, Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) 0.64g.
Chop the above into one dose, decoct with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus), and take orally.
Jiajian Buxin Tang (Modified Decoction for Supplementing the Heart): Treats various deficiency syndromes presenting with forgetfulness.
Renshen (Ginseng Radix et Rhizoma) 9g, Baizhu (Atractylodis Macrocephalae Rhizoma) 9g, Chenpi (Citri Reticulatae Pericarpium) 15g, Bai Fuling (Poria) 15g, Danggui Shen (Angelicae Sinensis Radix, root body) 15g, Baishao (Paeoniae Radix Alba, stir-baked) 15g, Shengdihuang (Rehmanniae Radix Recens) 15g, Yuanzhi (Polygalae Radix, soaked, heart removed) 15g, Shichangpu (Acori Tatarinowii Rhizoma) 9g, Maidong (Ophiopogonis Radix, heart removed) 15g, Suanzaoren (Ziziphi Spinosae Semen, stir-baked) 15g, Gancao (Glycyrrhizae Radix et Rhizoma) 9g, Huangbai (Phellodendri Cortex, wine-fried) 15g, Zhimu (Anemarrhenae Rhizoma, wine-fried) 15g.
Chop the above into one dose, decoct with water, and take orally.
Jiawei Dingzhi Wan (Modified Pill for Calming the Spirit, Formula of Chen Baiye): Treats forgetfulness.
Danggui Shen (Angelicae Sinensis Radix, root body, wine-rinsed), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishaoyao (Paeoniae Radix Rubra), Shengdihuang (Rehmanniae Radix Recens, wine-rinsed, sliced) each 60g, Renshen (Ginseng Radix et Rhizoma) 18g, Shichangpu (Acori Tatarinowii Rhizoma) 60g, Yuanzhi (Polygalae Radix, soaked in Licorice water, bone removed, stir-fried with Ginger juice) 90g.
Grind the above into fine powder, make pills with refined honey, sized like Sophora seeds. Take 6g per dose, swallow with warm water before bed.
Ziheche (Human Placenta): Treats mania, forgetfulness, palpitations, loss of will, as well as trance-like states, fright entering the Heart, Shen failing to reside within, excessive talking, and instability. This herb greatly calms the Heart, nourishes Blood, and stabilizes the Shen.
Congming Tang (Intelligence Decoction): Treats those with poor memory and frequent forgetfulness.
Bai Fushen (White Poria with Hostwood), Yuanzhi Rou (Polygalae Radix flesh, soaked in Licorice water), Shichangpu (Acori Tatarinowii Rhizoma, hair removed, those with nine nodes per inch are best).
Take 90g of each, process and grind together into an extremely fine powder. Use 9-15g daily, decoct in water, take on an empty stomach and after meals, any number of times a day. Long-term use enables reciting a thousand words daily.
Zhuangyuan Wan (Number One Scholar Pill): Treats forgetfulness, opens the mind and unblocks orifices, stabilizes intelligence and calms the Shen, enhancing memory.
Shichangpu (Acori Tatarinowii Rhizoma, hair removed, those with nine nodes per inch are best), Digupi (Lycii Cortex), Bai Fushen (White Poria with Hostwood, skin and wood removed), Yuanzhi Rou (Polygalae Radix flesh, soaked in Licorice water, heart removed) each 30g, Renshen (Ginseng Radix et Rhizoma, rhizome removed) 9g, Bajitian (Morindae Officinalis Radix, bone removed) 15g.
Grind the above into powder. Take 60g of peeled White Poria and 60g of glutinous rice, grind together into powder. Use 9g of Shichangpu, crushed, decoct in strong water, remove dregs, boil into a paste to form pills. Take 35 pills after meals, at noon, and before bed.