疸证不可过用寒凉,当审其虚实寒热,各从其机,用法治之。诸证莫离脾胃,而疸更为
脾胃之病,不可轻忽也。
身黄、目黄、小便赤黄。黄柏、人参、干葛、神曲、甘草,水煎服。
疸证,渴欲饮茶,热在上焦,清心莲子饮;嘈杂,热在中焦,宜温中;不渴,热在下焦
肾疸目黄,浑身黄,小便黄,羌活、防风、 本、独活、柴胡各五分,升麻二分;小便
不通,儿茶末一钱, 蓄汤调服。
暑气身目黄,茯苓、泽泻、猪苓、白术各五分,苍术一钱,神曲二钱,水煎服。
口渴者,系胃火。口干不渴,见于夜者,命门相火与心包络火熏于肺,肺少津液而干也
。用黄 三钱,归身三钱润之,连服必愈。见白虎汤则死。若口干身热,肺燥已甚,生黄 八钱
,归身四钱润之。内伤身热口干渴,益气加炮姜二钱。
口渴多饮,消渴也。黄 九钱,甘草三钱,煎服。
上消百杯而不止渴,宜清肺。麦冬、五味、黄连煎服;条芩、杏仁、栝蒌、栀子、元参
、干姜各三钱,诃子、人参各五钱,丸服。专补脾阴之不足,用参苓白术散米糊丸服。中消数食
而不充饥,或下脓浊,赤白如豆渣,病亦难愈。盖食多不饱,饮多不止渴,脾阴不足也。用
山药、归身、茯苓、陈皮、甘草、苡仁;或清脾火,大黄、栀子、石膏、枯芩、连翘、乌梅
各二钱,诃子、人参各五钱;或用黄连五分,入猪肚内煮熟食;或川连、白术等分,丸服。
下消因色欲而玉茎不萎,宜清肾。黄柏、知母;或黄柏、知母、泽泻、栀子、生地,五味各
二钱,诃子、人参各五钱。
验案
一人思想过度,日饮茶数十杯,精神困倦,嗜卧。此心火乘脾,胃燥而肾无救也,名曰
肾消。用黄 、五味、生地各五分,人参、麦冬、归身各一钱,水煎服。
一人平素嗜茶,心思过度,其渴尤甚,更加恶心。脉举之不足,按之两关短数,两尺弱
。此因多思,致水不升、火不降也。数者,胃气有余。宜补阴中之阳。用人参、白芍、归身各一
两,山药、茯苓、熟地、枸杞子各二两,甘草、五味各五钱,枣仁一两五钱,丸服。
黄疸病证不可过度使用寒凉药物,应当审查其虚、实、寒、热的性质,根据各自的病机,采用相应的法治之。各种病证都离不开脾胃,而黄疸更是属于脾胃的疾病,不可轻视。
身体发黄、眼睛发黄、小便颜色深黄。用黄柏、人参、干葛(即葛根)、神曲、甘草,加水煎煮后服用。
黄疸病证中,如果口渴想喝茶,说明热邪在上焦,可用清心莲子饮;如果感到胃中嘈杂不适,说明热邪在中焦,适宜温中散寒;如果不口渴,且出现下焦肾疸、眼睛发黄、全身发黄、小便发黄的症状,可用羌活、防风、藁本、独活、柴胡各五分,升麻二分;如果小便不通畅,取儿茶末一钱,用萆薢分清饮(注:原文“蓄汤”疑为萆薢分清饮或类似利湿通淋方剂的简称,此处依字面译为相关汤剂)调服。
因暑气导致的身体和眼睛发黄,用茯苓、泽泻、猪苓、白术各五分,苍术一钱,神曲二钱,加水煎煮后服用。
感到口渴的,是胃火旺盛所致。如果夜间口干但不觉得渴,这是命门相火与心包络之火熏蒸于肺,导致肺中津液不足而干燥。用黄芪三钱、当归身三钱来滋润,连续服用必定痊愈。如果见到白虎汤则会导致死亡。如果是口干且身体发热,说明肺燥非常严重,用生黄芪八钱、当归身四钱来滋润。如果是内伤引起的身体发热、口干且口渴,在益气汤中加入炮姜二钱。
口渴且大量饮水,这是消渴病。用黄芪九钱、甘草三钱,煎煮后服用。
上消症,喝一百杯水仍不能止渴,适宜清肺。用麦冬、五味子、黄连煎煮服用;或者用条芩(黄芩)、杏仁、栝蒌、栀子、元参(玄参)、干姜各三钱,诃子、人参各五钱,制成丸药服用。专门补充脾阴的不足,用人参白术散,用米糊制作丸药服用。
中消症,吃很多食物却仍不饱腹,或者排泄物中有脓浊物质,呈赤白色像豆渣一样,这种病也难以治愈。这是因为吃得虽多却不饱,喝得虽多却不止渴,根源在于脾阴不足。用山药、当归身、茯苓、陈皮、甘草、薏苡仁;或者清泄脾火,用大黄、栀子、石膏、枯芩(黄芩)、连翘、乌梅各二钱,诃子、人参各五钱;或者用黄连五分,放入猪肚内煮熟后食用;或者用川黄连、白术等量,制成丸药服用。
下消症,因为房事过度导致阴茎勃起不衰(玉茎不萎),适宜清肾热。用黄柏、知母;或者用黄柏、知母、泽泻、栀子、生地、五味子各二钱,诃子、人参各五钱。
验案一则:
有一人思虑过度,每天喝几十杯茶,精神困倦,喜欢躺着睡觉。这是心火乘袭脾土,导致胃燥而肾水无法救济,名叫肾消。用黄芪、五味子、生地各五分,人参、麦冬、当归身各一钱,加水煎煮后服用。
另一人平时嗜爱喝茶,思虑过度,他的口渴症状尤为严重,还伴有恶心。脉象轻取无力,重按两关部短促数急,两尺部虚弱。这是因为多思虑,导致肾水不能上升、心火不能下降。数脉表示胃气有余(亢盛)。适宜补益阴中之阳。用人参、白芍、当归身各一两,山药、茯苓、熟地、枸杞子各二两,甘草、五味子各五钱,酸枣仁一两五钱,制成丸药服用。
Jaundice should not be treated with excessive use of cold and bitter drugs. One must examine the deficiency, excess, cold, and heat patterns, and treat according to the specific pathogenesis. All diseases are related to the Spleen and Stomach, and jaundice is particularly a disease of the Spleen and Stomach; it must not be neglected.
Symptoms include yellowing of the body, yellowing of the eyes, and dark yellow urine. Use Huangbai (Phellodendri Cortex), Renshen (Ginseng Radix et Rhizoma), Gange (Puerariae Radix), Shenqu (Massa Medicata Fermentata), and Gancao (Licorice Root) decocted in water for oral administration.
In cases of jaundice accompanied by thirst and a desire to drink tea, the heat is located in the Upper Jiao (Upper Burner); Qingxin Lianzi Yin (Clear the Heart Lotus Seed Decoction) is indicated. If there is epigastric discomfort (gastric clank), the heat is in the Middle Jiao (Middle Burner), and warming the middle is appropriate. If there is no thirst, but symptoms of Lower Jiao Kidney Jaundice occur—such as yellowing of the eyes, whole-body yellowing, and yellow urine—use Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Ben Cao (Ligustici Chuanxiong Rhizoma), Duhuo (Angelicae Pubescentis Radix), and Chaihu (Bupleuri Radix), each 5 fen, and Shengma (Cimicifugae Rhizoma) 2 fen. If urination is obstructed, take 1 qian of Ercha (Karela Gum/Arabic Gum) mixed with a diuretic decoction.
For jaundice caused by summerheat affecting the body and eyes, use Fuling (Poria), Zexie (Alisma Rhizoma), Zhuling (Polyporus), Baizhu (Atractylodis Macrocephalae Rhizoma), each 5 fen; Cangzhu (Atractylodis Rhizoma) 1 qian; and Shenqu (Massa Medicata Fermentata) 2 qian, decocted in water.
Thirst indicates Stomach Fire. Dry mouth without thirst, especially at night, results from Mingmen Ministerial Fire and Pericardium Fire steaming the Lung, depleting Lung fluids. Use Huangqi (Astragali Radix) 3 qian and Danggui Shen (Angelicae Sinensis Radix) 3 qian to moisten; continuous use will lead to recovery. The use of Baihu Tang (White Tiger Decoction) would be fatal. If dry mouth is accompanied by fever, indicating severe Lung dryness, use raw Huangqi 8 qian and Danggui Shen 4 qian to moisten. For internal injury causing fever, dry mouth, and thirst, add Paojiang (Prepared Ginger) 2 qian to Yiqi Tang (Qi-Boosting Decoction).
Excessive thirst with copious drinking characterizes Xiao Ke (Wasting-Thirst Disease). Use Huangqi 9 qian and Gancao 3 qian, decocted and taken orally.
In Shang Xiao (Upper Wasting-Thirst), drinking hundreds of cups does not quench thirst; clearing the Lung is indicated. Use Maidong (Ophiopogonis Tuber), Wuweizi (Schisandrae Fructus), and Huanglian (Coptidis Rhizoma) decocted. Alternatively, make pills using Tiaohuang Qin (Scutellariae Radix), Xingren (Armeniacae Semen Amarum), Gualou (Trichosanthis Fructus), Zhizi (Gardeniae Fructus), Yuanshen (Scrophulariae Radix), and Ganjiang (Zingiberis Rhizoma), each 3 qian; Hezi (Terminalia Chebulae Fructus) and Renshen 5 qian. To specifically tonify insufficient Spleen Yin, use Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) made into pills with rice paste.
In Zhong Xiao (Middle Wasting-Thirst), frequent eating does not satisfy hunger, or excretion contains purulent turbid matter resembling bean dregs (red and white); this condition is difficult to cure. This occurs because although food intake is high, satiety is not reached, and despite high fluid intake, thirst persists, due to insufficient Spleen Yin. Use Shanyao (Dioscoreae Rhizoma), Danggui Shen, Fuling, Chenpi (Citri Reticulatae Pericarpium), Gancao, and Yiren (Coicis Semen). Alternatively, clear Spleen Fire using Dahuang (Rhei Radix et Rhizoma), Zhizi, Shigao (Gypsum Fibrosum), Kuqin (Scutellariae Radix), Lianqiao (Forsythiae Fructus), and Wumei (Mume Fructus), each 2 qian; Hezi and Renshen 5 qian. Or, cook 5 fen of Huanglian inside a pig’s stomach and eat it. Or, make pills with equal parts of Chuanlian (Coptidis Rhizoma) and Baizhu.
In Xia Xiao (Lower Wasting-Thirst), caused by sexual excess leading to persistent erection (Yu Jing Bu Wei), clearing the Kidney is indicated. Use Huangbai and Zhimu (Anemarrhenae Rhizoma); or Huangbai, Zhimu, Zexie, Zhizi, Shengdi (Rehmanniae Radix), and Wuweizi, each 2 qian; Hezi and Renshen 5 qian.
Case Record:
One patient suffered from excessive mental exertion, drank dozens of cups of tea daily, felt spiritually exhausted, and preferred lying down. This was Heart Fire invading the Spleen, causing Stomach dryness and failure of Kidney Water to rescue; it was named Shen Xiao (Kidney Wasting-Thirst). Use Huangqi, Wuweizi, and Shengdi, each 5 fen; Renshen, Maidong, and Danggui Shen, each 1 qian, decocted in water.
Another patient, who usually loved tea and suffered from excessive mental exertion, had even more severe thirst accompanied by nausea. The pulse was deficient on superficial palpation, short and rapid at the Guan positions on deep palpation, and weak at the Chi positions on deep palpation. This resulted from excessive thinking, causing Water to fail to ascend and Fire to fail to descend. The rapid pulse indicated excess Stomach Qi. Tonifying Yang within Yin was appropriate. Use Renshen, Baishao (Paeoniae Radix Alba), and Danggui Shen, each 1 liang; Shanyao, Fuling, Shudi (Rehmanniae Radix Preparata), and Gouqizi (Lycii Fructus), each 2 liang; Gancao and Wuweizi, each 5 qian; and Suanzaoren (Ziziphi Spinosae Semen) 1.5 liang, made into pills.