论曰三焦有水气者。气滞不通,决渎之官内壅也。盖水聚于胃,气能传化。今气不升降,
水聚不行,则脾经受湿。故为腹满浮肿之证,治宜导气而行之,气通则水自决矣。
治三焦积气,渐成水病。腹胀四肢浮肿。宽胸膈,利小肠。槟榔汤方
槟榔(生锉) 大腹皮(锉) 白术 五味子(炒) 枳壳(去瓤麸炒) 黄 (锉) 防
己木
通(锉) 桑根白皮 陈橘皮(汤浸去白焙) 浓朴(去粗皮生姜汁炙) 桂(去粗皮各一
两) 木
上一十五味,粗捣筛,每服三钱匕,水一盏,生姜三片,枣二枚劈破,同煎至七分,去
滓温服。早晨临卧服。
治三焦不调。上乘于肺,时发喘咳,身体浮肿,坐卧不安。泽漆汤方
泽漆 防己 甜葶苈(纸上炒) 郁李仁(汤浸去皮炒各半两) 百合 陈橘皮(汤浸
去白
上九味,粗捣筛,每服三钱匕,水一盏,枣二枚劈破,同煎至七分,去滓温服,不拘时
治三焦有水气,满闷不能食,消痰气令能食。茯苓饮方
赤茯苓(去黑皮) 人参 白术 生姜(切各三两) 枳实(去瓤麸炒二两) 陈橘皮
(汤浸
上六味,锉如麻豆,每服五钱匕,水一盏半,煎至一盏。去滓温服,不拘时。
治三焦有水气,胸胁支满、目眩。茯苓汤方
赤茯苓(去黑皮四两) 桂(去粗皮) 白术 甘草(炙各三两)
上四味。粗捣筛,每服五钱匕,水一盏半,煎至一盏,去滓温服,不拘时。
治三焦不顺,心下痞满,膈间有水,目眩悸动。小半夏加茯苓汤方
半夏(汤洗去滑焙五两) 生姜(半斤) 赤茯苓(去黑皮三两)
上三味,锉如麻豆,每服五钱匕,水二盏,煎至一盏,去滓温服,不拘时。
治三焦气不通。心腹胀、喘促。大小便不利,甘遂散方
甘遂(生半两) 牵牛子(半生半炒) 续随子(去壳研) 大戟(各一两) 葶苈(纸
上炒一
分)
上五味。捣罗为散,每服半钱匕,空心浓煎灯心汤调下,利下水为效。未减更一服。
治三焦水气,甚者四肢虚肿。甘遂散方
甘遂(半两) 槟榔(生锉) 木香 牵牛子(半生半炒) 莱菔子(研各一两)
上五味,捣罗为散,每服半钱匕,煎紫苏木瓜汤调下,空心服,利下水为度,量人虚实
加减。
论述:三焦有水气,是因为气机阻滞不通,导致作为“决渎之官”的三焦内部壅塞。水液聚集于胃,正常情况下气能推动其转化输布。如今气机升降失常,水液停滞不行,致使脾经受湿邪侵袭。因此出现腹部胀满、身体浮肿的症状,治疗应当疏导气机并推动运行,气机通畅则水液自然排泄。
治疗三焦积滞之气,逐渐演变为水病。症状为腹部胀满、四肢浮肿。功效为宽畅胸膈、通利小肠。槟榔汤方:
槟榔(生锉碎)、大腹皮(锉碎)、白术、五味子(炒)、枳壳(去瓤后麸炒)、黄芪(锉碎)、防己、木通(锉碎)、桑根白皮、陈橘皮(热水浸泡去白瓤焙干)、浓朴(去粗皮后用生姜汁炙)。以上十五味药,粗捣筛过,每次服用三钱匕,加水一盏,生姜三片,大枣二枚劈破,一同煎煮至七分,滤去药渣,温服。早晨和睡前服用。
治疗三焦功能不调。邪气上乘于肺,时常发作喘咳,身体浮肿,坐卧不安。泽漆汤方:
泽漆、防己、甜葶苈(在纸上炒)、郁李仁(热水浸泡去皮后炒,各半两)、百合、陈橘皮(热水浸泡去白瓤)。以上九味药,粗捣筛过,每次服用三钱匕,加水一盏,大枣二枚劈破,一同煎煮至七分,滤去药渣,温服,不拘泥于固定时间。
治疗三焦有水气,胸闷腹胀不能进食。功效为消痰气以恢复食欲。茯苓饮方:
赤茯苓(去黑皮)、人参、白术、生姜(切片,各三两)、枳实(去瓤后麸炒,二两)、陈橘皮(热水浸泡...[原文此处截断,依常规补全逻辑])。以上六味药,锉如麻豆大小,每次服用五钱匕,加水一盏半,煎煮至一盏,滤去药渣,温服,不拘泥于固定时间。
治疗三焦有水气,胸胁支撑胀满、头晕目眩。茯苓汤方:
赤茯苓(去黑皮,四两)、桂枝(去粗皮)、白术、甘草(炙,各三两)。以上四味药,粗捣筛过,每次服用五钱匕,加水一盏半,煎煮至一盏,滤去药渣,温服,不拘泥于固定时间。
治疗三焦气机不顺,心下痞塞胀满,膈间有水饮,头晕心悸。小半夏加茯苓汤方:
半夏(热水洗去滑腻后焙干,五两)、生姜(半斤)、赤茯苓(去黑皮,三两)。以上三味药,锉如麻豆大小,每次服用五钱匕,加水二盏,煎煮至一盏,滤去药渣,温服,不拘泥于固定时间。
治疗三焦气机不通。症状为心腹胀满、气喘急促。大小便不利。甘遂散方:
甘遂(生用,半两)、牵牛子(一半生用一半炒)、续随子(去壳研碎)、大戟(各一两)、葶苈子(在纸上炒,一分)。以上五味药,捣碎过筛为散剂,每次服用半钱匕,空腹时用浓煎的灯心草汤调服,以利下水液为见效标准。若未减轻,再服一次。
治疗三焦水气严重,导致四肢虚浮肿胀。甘遂散方:
甘遂(半两)、槟榔(生锉碎)、木香、牵牛子(一半生用一半炒)、莱菔子(研碎,各一两)。以上五味药,捣碎过筛为散剂,每次服用半钱匕,用紫苏木瓜汤煎好后调服,空腹服用,以利下水液为度,根据患者虚实情况加减用量。
Discussion: When there is water qi in the Sanjiao (Triple Burner), it is due to the stagnation and obstruction of Qi, causing internal congestion in the Sanjiao, which serves as the official responsible for the drainage of water passages. Normally, water gathers in the Stomach, and Qi facilitates its transformation and distribution. However, when the ascending and descending movements of Qi are dysfunctional, water accumulates and fails to move, leading to dampness invading the Spleen Meridian. Consequently, symptoms such as abdominal fullness and edema appear. The treatment should focus on guiding and moving the Qi; once Qi flows freely, water will naturally drain.
For treating accumulated Qi in the Sanjiao that gradually evolves into a water disease, characterized by abdominal distension and edema of the four limbs, with the effect of widening the chest and diaphragm and promoting urination through the Small Intestine: Binglang Tang (Areca Nut Decoction).
Ingredients: Areca Seed (Binglang, raw and crushed), Betel Nut Peel (Dafupi, crushed), Atractylodes Macrocephala Rhizome (Baizhu), Schisandra Berry (Wuweizi, stir-fried), Bitter Orange (Zhiqiao, pith removed and stir-fried with bran), Astragalus Root (Huangqi, crushed), Stephania Tetrandra Root (Fangji), Akebia Stem (Mutong, crushed), Mulberry Root Bark (Sangbaipipi), Tangerine Peel (Chenjuapi, soaked in hot water, white pith removed, and dried), Magnolia Bark (Noupi, outer bark removed and stir-fried with ginger juice).
Preparation: The above fifteen ingredients are coarsely pounded and sieved. Each dose consists of 3 qianbi (approx. 9g), boiled with one sheng (approx. 200ml) of water, three slices of fresh Ginger (Shengjiang), and two Jujubes (Zao) split open. Simmer until reduced to 70%, strain, and take warm. Take in the morning and before bedtime.
For treating dysfunction of the Sanjiao, where pathogenic factors ascend to the Lung, causing intermittent wheezing and coughing, bodily edema, and restlessness in sitting or lying down: Zeqi Tang (Euphorbia Lathyris Decoction).
Ingredients: Euphorbia Lathyris Stem (Zeqi), Stephania Tetrandra Root (Fangji), Lepidium Seed (Tinglizi, stir-fried on paper), Apricot Kernel (Yuliren, soaked in hot water, skin removed, and stir-fried, each half liang), Lily Bulb (Baihe), Tangerine Peel (Chenjuapi, soaked in hot water, white pith removed).
Preparation: The above nine ingredients are coarsely pounded and sieved. Each dose consists of 3 qianbi, boiled with one sheng of water and two split Jujubes. Simmer until reduced to 70%, strain, and take warm. Take at any time.
For treating water qi in the Sanjiao, causing chest and epigastric fullness and anorexia, with the effect of resolving phlegm and restoring appetite: Fuling Yin (Poria Decoction).
Ingredients: Red Poria (Chifuling, black skin removed), Ginseng Root (Renshen), Atractylodes Macrocephala Rhizome (Baizhu), Fresh Ginger (Shengjiang, sliced, each 3 liang), Immature Bitter Orange (Zhishi, pith removed and stir-fried with bran, 2 liang), Tangerine Peel (Chenjuapi, soaked in hot water...).
Preparation: The above six ingredients are cut like hemp seeds. Each dose consists of 5 qianbi, boiled with one and a half sheng of water until reduced to one sheng. Strain and take warm. Take at any time.
For treating water qi in the Sanjiao, causing distending fullness in the chest and hypochondrium, and dizziness: Fuling Tang (Poria Decoction).
Ingredients: Red Poria (Chifuling, black skin removed, 4 liang), Cinnamon Twig (Guizhi, outer bark removed), Atractylodes Macrocephala Rhizome (Baizhu), Licorice Root (Gancao, honey-stir-fried, each 3 liang).
Preparation: The above four ingredients are coarsely pounded and sieved. Each dose consists of 5 qianbi, boiled with one and a half sheng of water until reduced to one sheng. Strain and take warm. Take at any time.
For treating irregular flow of Qi in the Sanjiao, causing epigastric stuffiness and fullness, fluid retention between the diaphragm, dizziness, and palpitations: Xiao Banxia Jia Fuling Tang (Minor Pinellia Decoction plus Poria).
Ingredients: Pinellia Tuber (Banxia, washed in hot water to remove slipperiness and dried, 5 liang), Fresh Ginger (Shengjiang, half jin), Red Poria (Chifuling, black skin removed, 3 liang).
Preparation: The above three ingredients are cut like hemp seeds. Each dose consists of 5 qianbi, boiled with two sheng of water until reduced to one sheng. Strain and take warm. Take at any time.
For treating obstruction of Qi in the Sanjiao, characterized by epigastric and abdominal distension, panting, and difficulty in defecation and urination: Gansui San (Kansui Powder).
Ingredients: Kansui Root (Gansui, raw, half liang), Morning Glory Seed (Qianniuzi, half raw and half stir-fried), Spurge Seed (Xuisuizi, shell removed and ground), Great Euphorbia Root (Daji, each 1 liang), Lepidium Seed (Tinglizi, stir-fried on paper, 1 fen).
Preparation: The above five ingredients are pounded and sifted into a powder. Each dose consists of half a qianbi, taken on an empty stomach mixed with thickly decocted Juncus Decoction (Dengxin Tang). The goal is to promote the discharge of water. If symptoms do not subside, administer another dose.
For treating severe water qi in the Sanjiao, resulting in flaccid edema of the four limbs: Gansui San (Kansui Powder).
Ingredients: Kansui Root (Gansui, half liang), Areca Seed (Binglang, raw and crushed), Costus Root (Muxiang), Morning Glory Seed (Qianniuzi, half raw and half stir-fried), Radish Seed (Laifuzi, ground, each 1 liang).
Preparation: The above five ingredients are pounded and sifted into a powder. Each dose consists of half a qianbi, taken on an empty stomach mixed with Perilla and Papaya Decoction. The goal is to promote the discharge of water. Dosage should be adjusted according to the patient's deficiency or excess condition.