论曰久病消渴之人,营卫不足,筋骨羸劣,肌肤瘦瘁,故病虽瘥而气血未复,乃为虚乏,
又有缘少服乳石而消渴者,病后津液虚竭,经络痞涩。亦令虚乏,须防痈疽之变。救治之法。
所不可忽。
治消渴后,四肢羸弱。气虚乏。地黄生姜煎丸方
生姜汁(一升) 生地黄汁(五升) 蜜(二斤绵滤过) 生麦门冬汁(三升) 牛胫
骨内髓(
一升) 茯神(去木) 甘草(炙) 石斛(去根) 黄连(去须各四两) 栝蒌根(五两)
五味子
(微炒) 知母(焙) 人参 当归(切焙) 丹参(各二两) 肉苁蓉(酒浸切焙三两除
前五味外
茯神等一十一味捣罗为末) 地骨皮(锉二升) 胡麻仁(二升) 葳蕤(锉五两) 生竹
根(锉三
升)
上二十味,先以水一斗五升,煮地骨皮等四味,至水四升,绞去滓,下麦门冬地黄汁,
再煎五六沸,却下蜜髓姜汁,再煎至七升为膏,稀稠得所,入前件药末,和为丸,如梧桐子
大,不拘时候,竹叶汤下三十丸。
治虚热小便利而多,服石散人虚热,当风取冷,患香港脚发动,兼消渴后虚乏,肾脉细弱。
阿胶汤方
阿胶(二挺) 干姜(二两) 麻子(一升) 远志(四两) 附子(一枚)
上五味,除阿胶捣筛粗散。以水七升,煮取二升半,去滓内胶令烊。分三服,一说云小
便利多白,日夜数拾行,频服良。
治虚热四肢羸乏,渴热不止,止渴补虚。茯神煮散方
茯神 肉苁蓉(去鳞切细酒浸三日取出焙干秤) 葳蕤(各四两) 生石斛(去苗) 黄
连(
去须) 栝蒌根 丹参(各一两) 甘草(炙) 五味子 知母 人参 当归(切焙各三分)
大麦
(炒七合半)
上一十三味,粗捣筛,每服五钱匕,水一盏半,煎至一盏,去滓食前温服。
治消渴后气乏体羸,腿胫细瘦。苁蓉丸方
肉苁蓉(酒浸切焙) 黄 (锉) 牛膝(去苗酒浸切焙) 车前子 萆 白茯苓(去
黑皮)
子(炒去角)
人参 白芍药(各一两一分) 泽泻 桑螵蛸(炒各一两) 枳壳(去瓤麸炒三分) 生干
地黄(
焙二两)
上一十八味,捣罗为末,炼蜜丸如梧桐子大,每服空心粟米饮下三十丸。
治消渴后虚乏。钟乳丸方
炼成钟乳粉 续断 熟干地黄(焙) 石苇(去毛各一两) 杜仲(去粗皮锉炒三两三
分)
天雄(炮裂去皮脐半两) 山茱萸 蛇床子(各一两) 远志(去心) 肉苁蓉(酒浸切焙
一两三
分) 防风(去叉) 山芋 石斛(去根) 赤石脂(各一两三分) 甘草(炙锉) 牛膝
(酒浸切焙
各一两)
上一十六味,捣罗为末,炼蜜丸如梧桐子大,每服三十丸,温酒下。
治消渴后虚乏。填骨煎方
白茯苓(去黑皮) 菟丝子(酒浸焙别捣) 山茱萸 当归(切焙各二两半) 肉苁蓉
(三两
酒浸切焙) 大豆(炒去皮三合) 石苇(去毛一两三分) 牛膝(酒浸切焙) 巴戟天(去
心)
麦门冬(去心各二两半) 天门冬(去心三两三分) 五味子 人参 远志(去心各二两半)
桂
(去粗皮一两三分) 附子(炮裂去皮脐) 石斛(去根各二两半)
上一十七味,捣罗为末,用生地黄生栝蒌根各三斤。捣绞取汁,以银石器,慢水煎减半,
然后内药,并下白蜜十两,牛髓五两,再煎令如糜食,如鸡子黄大,米饮下,日三。药末不
必尽入,惟看稀稠得所佳。
治消渴羸瘦,小便不禁。铅丹散方
铅丹(研一两) 栝蒌根(三两) 黄连(去须) 白石脂(各一两半)
上四味,捣罗为散,每服二钱匕,食后以浆水调下。
治消渴,肌肤羸瘦,或转筋,小便利甚。栝蒌根散方
栝蒌根 黄连(去须) 防己 铅丹(研各一两半)
上四味,捣罗前三味,入研铅丹和匀,每食后良久,煎醋一合水二合,调三钱匕。日二
服。
论述说:长期患有消渴病的人,营气和卫气不足,筋骨瘦弱无力,肌肤消瘦憔悴。因此,虽然疾病表面好转,但气血尚未恢复,从而出现虚乏的症状。又有因为少量服用石药(矿物类丹药)而引发消渴病的,病后津液枯竭,经络阻滞不通。这也导致身体虚乏,必须预防痈疽(皮肤及皮下组织的化脓性感染)的发生。救治的方法,不可轻视。
治疗消渴病后,四肢瘦弱无力,气虚乏力的地黄生姜煎丸方:
生姜汁(一升)、生地黄汁(五升)、蜂蜜(二斤,用绵布过滤)、生麦门冬汁(三升)、牛胫骨内的骨髓(一升)、茯神(去除木质部分)、甘草(炙烤)、石斛(去除根部)、黄连(去除须根,各四两)、栝蒌根(五两)、五味子(微炒)、知母(焙干)、人参、当归(切片焙干)、丹参(各二两)、肉苁蓉(酒浸后切片焙干,三两)。除前五味药外,将茯神等十一味药捣碎过筛成粉末。地骨皮(锉碎,二升)、胡麻仁(二升)、葳蕤(锉碎,五两)、生竹根(锉碎,三升)。
以上二十味药,先用水一斗五升,煮地骨皮等四味药,煮至水剩四升时,绞去药渣,加入麦门冬汁和生地黄汁,再煮沸五六次,然后加入蜂蜜、骨髓和生姜汁,再煎至七升,制成膏状,稀稠适度,加入前面准备好的药末,混合制成梧桐子大小的丸剂。不拘时候,用竹叶汤送服三十丸。
治疗虚热,小便频多,服用石散者出现的虚热,因当风取冷,导致脚气发作,兼有消渴病后的虚乏,肾脉细弱的阿胶汤方:
阿胶(二挺)、干姜(二两)、麻子(一升)、远志(四两)、附子(一枚)。
以上五味药,除去阿胶,将其他药物捣碎筛选成粗散。用水七升,煮取二升半,去药渣,放入阿胶使其溶化。分三次服用。另一种说法认为,如果小便频多且色白,日夜数十次,频繁服用效果良好。
治疗虚热,四肢瘦弱乏力,口渴发热不止,具有止渴补虚作用的茯神煮散方:
茯神、肉苁蓉(去除鳞叶,切碎,酒浸三日取出焙干称重)、葳蕤(各四两)、生石斛(去除苗头)、黄连(去除须根)、栝蒌根、丹参(各一两)、甘草(炙烤)、五味子、知母、人参、当归(切片焙干,各三分)、大麦(炒制,七合半)。
以上十三味药,粗捣筛选。每次服用五钱匕,加水一盏半,煎至一盏,去药渣,饭前温服。
治疗消渴病后气虚乏力,身体消瘦,小腿细瘦的苁蓉丸方:
肉苁蓉(酒浸后切片焙干)、黄芪(锉碎)、牛膝(去除苗头,酒浸后切片焙干)、车前子、萆薢、白茯苓(去除黑皮)、菟丝子(炒制去角)、人参、白芍药(各一两一分)、泽泻、桑螵蛸(炒制,各一两)、枳壳(去除瓤,麸炒,三分)、生干地黄(焙干,二两)。
以上十八味药,捣碎过筛成粉末,炼蜜制成梧桐子大小的丸剂。每次空腹用粟米饮送服三十丸。
治疗消渴病后虚乏的钟乳丸方:
炼成的钟乳粉、续断、熟干地黄(焙干)、石苇(去除毛刺,各一两)、杜仲(去除粗皮,锉碎炒制,三两三分)、天雄(炮裂,去皮脐,半两)、山茱萸、蛇床子(各一两)、远志(去除心)、肉苁蓉(酒浸后切片焙干,一两三分)、防风(去除叉枝)、山芋、石斛(去除根部)、赤石脂(各一两三分)、甘草(炙烤锉碎)、牛膝(酒浸后切片焙干,各一两)。
以上十六味药,捣碎过筛成粉末,炼蜜制成梧桐子大小的丸剂。每次服用三十丸,用温酒送服。
治疗消渴病后虚乏的填骨煎方:
白茯苓(去除黑皮)、菟丝子(酒浸焙干后单独捣碎)、山茱萸、当归(切片焙干,各二两半)、肉苁蓉(三两,酒浸后切片焙干)、大豆(炒制去皮,三合)、石苇(去除毛刺,一两三分)、牛膝(酒浸后切片焙干)、巴戟天(去除心)、麦门冬(去除心,各二两半)、天门冬(去除心,三两三分)、五味子、人参、远志(去除心,各二两半)、桂(去除粗皮,一两三分)、附子(炮裂,去皮脐)、石斛(去除根部,各二两半)。
以上十七味药,捣碎过筛成粉末,用生地黄和生栝蒌根各三斤,捣碎绞取汁液,用银器或石器,慢火煎至减半,然后加入药末,并加入白蜜十两、牛髓五两,再煎至如粥食般粘稠,制成如鸡蛋黄大小的块状,用米饮送服,每日三次。药末不必全部用完,只要稀稠适度即可。
治疗消渴病,身体消瘦,小便失禁的铅丹散方:
铅丹(研细,一两)、栝蒌根(三两)、黄连(去除须根)、白石脂(各一两半)。
以上四味药,捣碎过筛成散剂。每次服用二钱匕,饭后用浆水调服。
治疗消渴病,肌肤消瘦,或发生转筋(肌肉痉挛),小便极多的栝蒌根散方:
栝蒌根、黄连(去除须根)、防己、铅丹(研细,各一两半)。
以上四味药,将前三味药捣碎过筛,加入研细的铅丹混合均匀。每次在进食后良久,用醋一合、水二合,调服三钱匕。每日两次。
Commentary states: Individuals who have suffered from Xiao Ke (Wasting and Thirsting Syndrome) for a long time lack Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi), resulting in emaciated and weak sinews and bones, and wasted, emaciated skin and flesh. Therefore, although the disease may appear to have subsided, the Qi and Blood have not yet recovered, leading to deficiency and fatigue. There are also cases where Xiao Ke is induced by the occasional ingestion of Shi Yao (Mineral Drugs/Stone Powders); after the illness, body fluids are exhausted, and the meridians become obstructed and stagnant. This also results in deficiency and fatigue, and one must guard against the transformation into Yong Ju (Carbuncles and Sores). The methods of rescue and treatment cannot be neglected.
Formula for Di Huang Sheng Jiang Jian Wan (Rehmannia and Fresh Ginger Decoction Pills) to treat weakness and emaciation of the four limbs, and Qi deficiency and fatigue following Xiao Ke:
Sheng Jiang Zhi (Fresh Ginger Juice, 1 sheng), Sheng Di Huang Zhi (Fresh Rehmanniae Radix Juice, 5 sheng), Mi (Honey, 2 jin, filtered through silk cloth), Sheng Mai Men Dong Zhi (Fresh Ophiopogonis Japonici Radix Juice, 3 sheng), Niu Jing Gu Nei Sui (Marrow of Bovine Tibia Bone, 1 sheng), Fu Shen (Poria with Hostwood, woody part removed), Zhi Gan Cao (Prepared Licorice Root), Shi Hu (Dendrobii Caulis, roots removed), Huang Lian (Coptidis Rhizoma, fibrous roots removed, each 4 liang), Gua Lou Gen (Trichosanthis Radix, 5 liang), Wu Wei Zi (Schisandrae Fructus, lightly stir-fried), Zhi Mu (Anemarrhenae Rhizoma, baked), Ren Shen (Ginseng Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix, sliced and baked), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma, each 2 liang), Rou Cong Rong (Cistanches Herba, soaked in wine, sliced and baked, 3 liang). Excluding the first five ingredients, the remaining eleven ingredients (including Fu Shen) are pounded and sieved into powder. Gu Gu Pi (Lycii Cortex, chopped, 2 sheng), Hu Ma Ren (Sesami Semen, 2 sheng), Wei Yu (Polygonati Odorati Rhizoma, chopped, 5 liang), Sheng Zhu Gen (Fresh Bambusae Caulis, chopped, 3 sheng).
For these twenty ingredients, first boil Gu Gu Pi and the other three ingredients in 15 dou of water until reduced to 4 sheng. Strain out the dregs, then add Mai Men Dong Zhi and Di Huang Zhi, boil for five or six times, then add Mi, Sui, and Sheng Jiang Zhi, and continue boiling until reduced to 7 sheng to form a paste of appropriate consistency. Add the previously prepared powders, mix well, and form pills the size of paulownia seeds. Take thirty pills at any time, washed down with Zhu Ye Tang (Bamboo Leaf Decoction).
Formula for E Jiao Tang (Donkey-Hide Gelatin Decoction) to treat deficiency-heat, frequent urination, deficiency-heat in those who took Stone Powders, onset of Hong Xiang Jiao (Tropical Swelling/Foot Distemper triggered by wind and cold), and deficiency-fatigue following Xiao Ke with a thin and weak Kidney pulse:
E Jiao (Donkey-Hide Gelatin, 2 ting), Gan Jiang (Dried Zingiberis Rhizoma, 2 liang), Ma Zi (Cannabis Semen, 1 sheng), Yuan Zhi (Polygalae Radix, 4 liang), Fu Zi (Aconiti Lateralis Radix Praeparata, 1 piece).
For these five ingredients, except for E Jiao, pound and sieve the others into coarse powder. Boil in 7 sheng of water to obtain 2.5 sheng, strain out the dregs, and dissolve the E Jiao in the liquid. Divide into three doses. Another opinion suggests that if urination is frequent and white, occurring dozens of times day and night, frequent administration is beneficial.
Formula for Fu Shen Zhu San (Poria Powder) to treat deficiency-heat, emaciation and fatigue of the four limbs, persistent thirst and heat, with effects of stopping thirst and tonifying deficiency:
Fu Shen (Poria with Hostwood), Rou Cong Rong (Cistanches Herba, scales removed, finely sliced, soaked in wine for three days, taken out and baked dry, weighed), Wei Yu (Polygonati Odorati Rhizoma, each 4 liang), Sheng Shi Hu (Fresh Dendrobii Caulis, tips removed), Huang Lian (Coptidis Rhizoma, fibrous roots removed), Gua Lou Gen (Trichosanthis Radix), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma, each 1 liang), Zhi Gan Cao (Prepared Licorice Root), Wu Wei Zi (Schisandrae Fructus), Zhi Mu (Anemarrhenae Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix, sliced and baked, each 3 fen), Da Mai (Hordei Fructus, stir-fried, 7 he and half).
For these thirteen ingredients, coarsely pound and sieve. Each dose consists of 5 qian bi, boiled in 1.5 zhan of water until reduced to 1 zhan. Strain and take warm before meals.
Formula for Rou Cong Rong Wan (Cistanche Pills) to treat Qi deficiency and fatigue, emaciated body, and thin calves following Xiao Ke:
Rou Cong Rong (Cistanches Herba, soaked in wine, sliced and baked), Huang Qi (Astragali Radix, chopped), Niu Xi (Achyranthis Bidentatae Radix, tips removed, soaked in wine, sliced and baked), Che Qian Zi (Plantaginis Semen), Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Bai Fu Ling (White Poria, black skin removed), Tu Si Zi (Cuscutae Semen, stir-fried, de-husked), Ren Shen (Ginseng Radix et Rhizoma), Bai Shao Yao (Paeoniae Radix Alba, each 1 liang and 1 fen), Ze Xie (Alismatis Rhizoma), Sang Piao Xiao (Ovi Mantidae, stir-fried, each 1 liang), Zhi Ke (Aurantii Fructus, pith removed, bran-stir-fried, 3 fen), Sheng Gan Di Huang (Dried Fresh Rehmanniae Radix, baked, 2 liang).
For these eighteen ingredients, pound and sieve into powder, refine honey to form pills the size of paulownia seeds. Take thirty pills on an empty stomach with Su Mi Yin (Millet Drink).
Formula for Zhong Ru Wan (Galena Pills) to treat deficiency-fatigue following Xiao Ke:
Lian Cheng Zhong Ru Fen (Refined Galena Powder), Xu Duan (Dipsaci Radix), Shu Gan Di Huang (Prepared Dried Rehmanniae Radix, baked), Shi Wei (Pyri Folium, hairs removed, each 1 liang), Du Zhong (Eucommiae Cortex, coarse bark removed, chopped and stir-fried, 3 liang and 3 fen), Tian Xiong (Aconiti Radix, cracked by frying, skin and umbilicus removed, 0.5 liang), Shan Zhu Yu (Corni Fructus), She Chuang Zi (Cnidii Fructus, each 1 liang), Yuan Zhi (Polygalae Radix, heart removed), Rou Cong Rong (Cistanches Herba, soaked in wine, sliced and baked, 1 liang and 3 fen), Fang Feng (Saposhnikoviae Radix, forked parts removed), Shan Yu (Dioscoreae Rhizoma), Shi Hu (Dendrobii Caulis, roots removed), Chi Shi Zhi (Halloysit Rubra, each 1 liang and 3 fen), Zhi Gan Cao (Prepared Licorice Root, chopped), Niu Xi (Achyranthis Bidentatae Radix, soaked in wine, sliced and baked, each 1 liang).
For these sixteen ingredients, pound and sieve into powder, refine honey to form pills the size of paulownia seeds. Take thirty pills, washed down with warm wine.
Formula for Tian Gu Jian (Bone-Filling Paste) to treat deficiency-fatigue following Xiao Ke:
Bai Fu Ling (White Poria, black skin removed), Tu Si Zi (Cuscutae Semen, soaked in wine, baked, pounded separately), Shan Zhu Yu (Corni Fructus), Dang Gui (Angelicae Sinensis Radix, sliced and baked, each 2.5 liang), Rou Cong Rong (Cistanches Herba, 3 liang, soaked in wine, sliced and baked), Da Dou (Sojae Semen, stir-fried, peeled, 3 he), Shi Wei (Pyri Folium, hairs removed, 1.3 liang), Niu Xi (Achyranthis Bidentatae Radix, soaked in wine, sliced and baked), Ba Ji Tian (Morindae Officinalis Radix, heart removed), Mai Men Dong (Ophiopogonis Japonici Radix, heart removed, each 2.5 liang), Tian Men Dong (Asparagi Radix, heart removed, 3.3 liang), Wu Wei Zi (Schisandrae Fructus), Ren Shen (Ginseng Radix et Rhizoma), Yuan Zhi (Polygalae Radix, heart removed, each 2.5 liang), Gui (Cinnamomi Cortex, coarse bark removed, 1.3 liang), Fu Zi (Aconiti Lateralis Radix Praeparata, cracked by frying, skin and umbilicus removed), Shi Hu (Dendrobii Caulis, roots removed, each 2.5 liang).
For these seventeen ingredients, pound and sieve into powder. Use 3 jin each of Sheng Di Huang (Fresh Rehmanniae Radix) and Sheng Gua Lou Gen (Fresh Trichosanthis Radix), pound and squeeze to extract juice. Using a silver or earthenware vessel, slowly boil the juice until reduced by half. Then add the medicinal powder, along with 10 liang of Bai Mi (White Honey) and 5 liang of Niu Sui (Bovine Marrow). Continue boiling until it resembles a thick porridge or the color of chicken egg yolk. Take with Mi Yin (Rice Drink), three times daily. It is not necessary to use all the powder; adjust the consistency as desired.
Formula for Qian Dan San (Lead Tetroxide Powder) to treat Xiao Ke, emaciation, and urinary incontinence:
Qian Dan (Lithargyrum/Lead Tetroxide, ground, 1 liang), Gua Lou Gen (Trichosanthis Radix, 3 liang), Huang Lian (Coptidis Rhizoma, fibrous roots removed), Bai Shi Zhi (Kaolinite, each 1.5 liang).
For these four ingredients, pound and sieve into powder. Take 2 qian bi per dose, mixed with Jiang Shui (Fermented Rice Water) after meals.
Formula for Gua Lou Gen San (Trichosanthes Root Powder) to treat Xiao Ke, emaciated skin, muscle spasms (Zhuan Jin), and excessive urination:
Gua Lou Gen (Trichosanthis Radix), Huang Lian (Coptidis Rhizoma, fibrous roots removed), Fang Ji (Stephaniae Tetrandrae Radix), Qian Dan (Lithargyrum/Lead Tetroxide, ground, each 1.5 liang).
For these four ingredients, pound and sieve the first three, mix evenly with the ground Qian Dan. After some time following meals, mix 3 qian bi with 1 he of Cu (Vinegar) and 2 he of Shui (Water). Take twice daily.