喻嘉言曰∶元丰朝立和剂局,萃集医家经验之方,于中暑一门独详。以夏月暑证,五方
历试
名
黄
浸
则
为
则
间,
生津液以益胃之虚。子和之桂苓甘露饮,用人参、甘草、葛根
去浊;或用十味香薷饮,于《局方》五味中,增人参、黄 、
湿热。乃至东垣之清暑益气汤、人参黄 汤,又补中实卫以去
中暑与否,所宜频服者也。中暑必显躁烦热闷,东垣仿仲景竹
仍以去湿为首务。夫燥与湿,相反者也,而清燥亦务除湿,非
又如益元散之去湿,而加辰砂则并去其热;五苓散之去湿,而
去热;
风一症
愚见从
入血分
解深入
火散,
治消渴,气血虚,胃火盛而作渴。
淡竹叶 生地黄(各二钱) 黄 麦冬 当归 川芎 黄芩 甘草 芍药 人参 半
夏石膏(各
一钱)
上水煎服。
柯韵伯曰∶气血皆虚,胃火独盛,善治者补泻兼施,寒之而不致亡阳,温之而不至于助
火,
只用
泻心
胃火
路也
阳之
(喻氏制。论一条)
主治诸气愤郁,诸痿喘呕。
桑叶(经霜者,三钱) 石膏(二钱五分, ) 甘草(一钱) 人参(七分) 胡麻
仁(一
钱,炒研)
(去
毛蜜炙,用一片)上九味,以水一碗,煎六分,频频二三次滚热服。痰多加贝母、栝蒌。血
枯加生地。热甚加
喻嘉言曰∶按诸气愤郁之属于肺者,属于肺之燥也。而古今治气郁之方,用辛香行气,
绝无
以
肺
大约以胃为主,胃土为肺金之母也。其天冬、知母能清金滋水,以苦寒而不用,至如苦寒降
火
其人尚有生理乎?诚仿此增损以救肺燥变生诸症,庶克有济耳。
柯韵伯曰∶古方用香燥之品以治气郁,不获奏效者,以火就燥也。惟缪仲淳知之,故用
甘凉
无
子病则母虚,用甘草调补中宫生气之源,而金有所恃;金燥则水无以食气而相生,母令子虚
矣,取阿胶、胡麻黑色通肾者,滋其阴以上通生水之源,而金始不孤;西方虚,则东实矣,
木实金平之,二叶禀东方之色,入通于肝,枇杷叶外应毫毛,固肝家之肺药,而经霜之桑叶,
非肺家之肝药乎?损其肺者益其气,人参之甘以补气;气有余便是火,故佐杏仁之苦以降气
,气降火亦降,而治节有权,气行则不郁,诸痿喘呕自除矣。要知诸气愤郁,则肺气必大虚
。若泥于肺热伤肺之说,而不用人参,必郁不开而火愈炽,皮聚毛落,喘而不休。此名之救
肺,凉而能补之谓也。若谓实火可泻,而久服芩、连,反从火化,亡可立待耳!愚所以服膺
此方而深赞之。
喻嘉言说:元丰年间设立和剂局,汇集医家经验之方,对于中暑这一门类论述特别详细。因为夏季暑证,各方历试有效,其法在于生津液以补益胃气的虚弱。张子和的桂苓甘露饮,用人参、甘草、葛根来去浊;或者用十味香薷饮,在《局方》五味的基础上,增加人参、黄芪,以去除湿热。乃至李东垣的清暑益气汤、人参黄芪汤,又是通过补中气、实卫气来去除中暑与否(指根据病情适宜频繁服用的方剂)。中暑必定显现烦躁、热闷的症状,李东垣仿照张仲景治疗风邪入血分的思路……
(此处原文有缺漏或排版错乱,根据上下文及方名“竹叶黄汤”推测为对竹叶石膏汤类方的论述,但严格依据提供的文本翻译如下)
……治消渴症,气血虚弱,胃火旺盛而致口渴。
药材:淡竹叶、生地黄(各二钱)、黄芪、麦冬、当归、川芎、黄芩、甘草、芍药、人参、半夏、石膏(各一钱)。
用法:以上药材用水煎服。
柯韵伯说:气血都虚弱,唯独胃火旺盛,善于治疗的人会补泻兼施,寒凉药使用得当不会导致亡阳,温补药使用得当不至于助长火势。
(喻氏制方。论一条)
主治各种气机愤郁、痿证、喘逆、呕吐。
药材:桑叶(经霜的,三钱)、石膏(二钱五分,打碎)、甘草(一钱)、人参(七分)、胡麻仁(一钱,炒后研碎)、阿胶(去毛,蜜炙,用一片)。
用法:以上九味药,用水一碗,煎至六分,频频分两三次滚热服用。痰多者加贝母、瓜蒌。血枯者加生地黄。热盛者加……
喻嘉言说:按诸气愤郁属于肺脏的,是由于肺燥所致。而古今治疗气郁的方子,多用辛香行气之品,绝无……(原文此处语意未尽,接下文)大约以胃为主,因为胃土是肺金之母。像天冬、知母能清金滋水,但因苦寒而不采用。至于如苦寒降火……其人还有生机吗?如果确实仿照此方增减来救治肺燥变生的各种病症,大概才能有所济助。
柯韵伯说:古方用香燥之品治疗气郁,不能奏效的原因,是因为火就燥(火上浇油)。只有缪仲淳知道这一点,所以用甘凉……无……子病则母虚,用甘草调补中宫(脾胃)生气之源,这样肺金有所依恃;肺金燥则肾水无法受气而相生,导致母令子虚。取阿胶、胡麻黑色通肾者,滋养肾阴以上通生水之源,这样肺金才不孤立;西方(肺/金)虚,则东方(肝/木)实,木实则金平之。枇杷叶禀东方之色,入通于肝,外应毫毛,固然是肝家的肺药,而经霜的桑叶,难道不是肺家的肝药吗?损其肺者益其气,用人参的甘味以补气;气有余便是火,所以佐以杏仁的苦味以降气,气降火亦降,从而治节有权,气行则不郁,各种痿证、喘逆、呕吐自然消除。要知道诸气愤郁,肺气必然大虚。如果拘泥于肺热伤肺的说法,而不用人参,必然郁结不开而火势更炽,导致皮聚毛落,喘逆不止。这个方子名为救肺,是指凉润之中兼具补益的作用。如果说实火可以泻下,而久服黄芩、黄连,反而从火化,死亡立刻就会到来!我因此信服此方并深深称赞它。
Yu Jiayan said: During the Yuanfeng era, the Heji Bureau was established to compile prescriptions from physicians' experiences. The section on heatstroke (Zhongshu) is particularly detailed. This is because summer heat syndromes have been tested effectively across various regions, and the method lies in generating body fluids to benefit the deficiency of stomach qi. Zhang Zihe's Guiling Ganlu Yin (Cassia Twig and Poria Decoction) uses Ren Shen (Ginseng), Gan Cao (Licorice), and Ge Gen (Kudzu Root) to eliminate turbidity; or one may use Shiwei Xiangru Yin (Ten-Ingredient Mosla and Elsholtzia Decoction), adding Ren Shen (Ginseng) and Huang Qi (Astragalus) to the five ingredients of the *Jufang* (Formulas of the Bureau) to eliminate damp-heat. Similarly, Li Dongyuan's Qingshu Yiqi Tang (Clear Summerheat and Benefit Qi Decoction) and Renshen Huangqi Tang (Ginseng and Astragalus Decoction) supplement the middle jiao and strengthen the defensive qi to address heatstroke. Heatstroke must manifest with restlessness, irritability, heat, and stifling sensation. Li Dongyuan imitated Zhang Zhongjing’s approach... [Text fragment] ...to treat Xiao Ke (Wasting-Thirst syndrome), where qi and blood are deficient, and stomach fire is excessive causing thirst.
Ingredients: Dan Zhuye (Lophatherum Leaf), Sheng Dihuang (Rehmannia Root), Huang Qi (Astragalus), Maidong (Ophiopogon Tuber), Dang Gui (Angelica Sinensis), Chuanxiong (Ligusticum Rhizome), Huang Qin (Scutellaria Root), Gan Cao (Licorice), Shaoyao (Peony Root), Renshen (Ginseng), Banxia (Pinellia Tuber), Shigao (Gypsum Fibrosum). Dosage: Each 2 qian for the first two, 1 qian for the rest.
Administration: Decoct in water and take orally.
Ke Yunbo said: When both qi and blood are deficient, yet stomach fire is excessively strong, a skilled physician employs both tonification and purgation. Cold-natured herbs are used without causing Yang collapse, and warm-tonic herbs are used without aggravating fire.
(Prepared by Yu. One commentary.)
Indications: Various types of qi stagnation and depression, flaccidity syndromes (Wei), wheezing, and vomiting.
Ingredients: Sang Ye (Mulberry Leaf, preferably frosted), Shigao (Gypsum Fibrosum, 2.5 qian, crushed), Gan Cao (Licorice, 1 qian), Renshen (Ginseng, 0.7 qian), Huma Ren (Sesame Seed, 1 qian, stir-fried and ground), Ejiao (Donkey-Hide Gelatin, de-haired, honey-fried, one piece).
Administration: Nine ingredients, decocted in one bowl of water until reduced to six-tenths. Take frequently while hot, divided into two or three doses. Add Bei Mu (Fritillaria Bulb) and Gualou (Trichosanthes Fruit) if phlegm is abundant; add Sheng Dihuang (Rehmannia Root) if blood is depleted; add [missing ingredient] if heat is severe.
Yu Jiayan said: Regarding qi stagnation belonging to the Lung, it is due to Lung dryness. Ancient and modern prescriptions for qi stagnation mostly use acrid-aromatic qi-moving herbs, which... [Text fragment] Generally, treatment focuses on the Stomach, as Stomach Earth is the mother of Lung Metal. Herbs like Tiandong (Asparagus Tuber) and Zhimu (Anemarrhena Rhizome) can clear Metal and nourish Water, but they are not used due to their bitter-cold nature. As for using bitter-cold herbs to descend fire... would the patient still have vitality? If one indeed imitates this prescription to adjust and save the Lung from dryness-induced complications, there might be hope.
Ke Yunbo said: Ancient prescriptions using aromatic-dry herbs to treat qi stagnation often fail because "fire follows dryness" (aggravating heat with dryness). Only Miao Zhongchun understood this, hence he used sweet-cool herbs... [Text fragment] When the child organ is diseased, the mother becomes deficient. Gan Cao (Licorice) is used to regulate and tonify the Middle Palace (Spleen/Stomach), the source of qi generation, so that Lung Metal has support. When Lung Metal is dry, Kidney Water cannot receive qi to generate mutually, leading to the mother failing the child. Ejiao (Donkey-Hide Gelatin) and Huma Ren (Sesame Seed), being black and connecting to the Kidney, nourish Yin to ascend and open the source of Water generation, so Lung Metal is not isolated. When the West (Lung/Metal) is deficient, the East (Liver/Wood) becomes excessive. Wood excess levels Metal. Pipa Ye (Loquat Leaf) inherits the color of the East, connects to the Liver, and responds externally to hair follicles; it is indeed a Lung herb within the Liver system. Is not frosted Sang Ye (Mulberry Leaf) a Liver herb within the Lung system? To damage the Lung is to benefit its Qi; Renshen (Ginseng) is sweet to tonify Qi. Excess Qi transforms into Fire, so Xing Ren (Apricot Seed) is added for its bitterness to descend Qi. When Qi descends, Fire also descends, restoring regulatory power. When Qi moves, stagnation resolves, and Wei, Chuan, and Ou (flaccidity, wheezing, vomiting) are eliminated. It must be known that in cases of qi stagnation, Lung Qi is severely deficient. If one sticks to the theory of "Lung heat injuring the Lung" and omits Renshen (Ginseng), stagnation will not resolve, fire will blaze, skin will gather, hair will fall, and wheezing will ceaselessly continue. This prescription is named "Saving the Lung," meaning it cools while tonifying. If one believes excess fire can merely be purged, and Xinqin (Scutellaria and Coptis) are taken long-term, they may transform into fire, and death will follow immediately! I therefore deeply adhere to and praise this prescription.