论曰消肾者。由少服石药,房室过度。精血虚竭。石势孤立,肾水燥涸。渴引水浆。下
输膀胱。小便利多,腿胫消瘦。骨节酸疼,故名消肾。
治消肾脚胫瘦细,小便数。或赤似血色,脏腑虚冷者。宜服地黄汤方
熟干地黄(锉) 麦门冬(去心焙各二两) 甘草(炙) 蒺藜子(炒去角各半两) 干
姜(炮
一两) 桂(去粗皮) 续断(各半两)
上七味。粗捣筛。每服三钱匕。水一盏。煎至七分。去滓温服。日三夜二。
治消肾干渴。小便多。羸瘦少力。黄 饮方
黄 (锉) 杜仲(去粗皮炙锉) 山茱萸 人参 知母(切焙各二两) 龙骨(碎三
两)
上六味,粗捣筛。每服四钱匕,水一盏半。枣一枚劈,煎至一盏。去滓温服,日三夜二
治消肾小便数。阿胶汤方
阿胶(炙燥) 干姜(炮各一两) 远志(去心四两) 附子(炮裂去皮脐) 人参(各
一两)
上七味。 咀如麻豆。每服三钱匕。水一盏。煎至七分。去滓不拘时温服。
治消肾。多渴小便数。宣补丸方
黄 (锉) 栝蒌根 麦门冬(去心焙) 白茯苓(去黑皮锉) 人参 甘草(炙) 黄
连(去
须) 知母(切焙各三两) 熟干地黄(锉) 石膏(研各六两) 肉苁蓉(酒浸薄切焙干
四两)
菟丝子(酒浸一宿别捣为末三两)
上一十二味,除菟丝子外。捣为末和匀,用牛胆汁三合。并炼蜜同和为剂,丸如梧桐子
大,每服三十丸。煎茅根汤下,不拘时。
治消肾,自腰以下。瘦弱无力,小便数或不禁。山茱萸丸方
山茱萸(一两) 黄 (细锉) 杜仲(去粗皮炙锉) 肉苁蓉(酒浸一宿切焙各一两
半) 桂(
上七味。捣罗为细末。炼蜜和丸,如梧桐子大。每服二十丸,煎黄 汤下。日三服。
治消肾,身体羸瘦。小便频数。人参丸方
人参(三分) 鹿茸(去毛酒炙一两) 黄 (锉三分) 栝蒌根(一两) 桑螵蛸(炙
一两) 杜仲(去粗皮炙锉三分) 鸡 (四枚炙) 山茱萸(三分) 菟丝子(酒浸一
宿焙干别捣为末
上九味,捣罗为细末。炼蜜和丸,梧桐子大。每服三十丸,煎枣汤下。日三服。
治消肾。口干眼涩。阴萎手足烦疼。小便多。金银箔丸方
金箔 银箔(各一百片细研) 泽泻(一两半) 天门冬(去心焙) 肉苁蓉(酒浸一
宿薄切
(去须四两)
姜(炮各一两半) 丹砂
上一十五味,除别研外。捣罗为细末,再研匀。炼蜜和丸,梧桐子大。每服二十丸至三
十丸。煎粟米饮下,不拘时。
治消肾,小便白浊如凝脂,形体羸瘦。磁石汤方
磁石(六两别捣如米粒分为二十帖每煎时取一帖绵裹) 黄 (细锉) 杜仲(去粗皮
炙锉) 人参 五味子(各一两半) 熟干地黄(焙二两)
上六味,除磁石外。粗捣筛。分为二十帖,每帖先用水三盏。羊肾一只,切作四片。去
筋膜,与磁石一帖。同煎至二盏。去磁石羊肾,下药末。更同煎至一盏半。去滓温分两服。
治消肾,小便白浊如凝脂,弱无力。肾沥汤方
白羊肾(一具去脂膜切四片) 黄 (细锉) 熟干地黄 杜仲(去粗皮炙锉) 五味
子人
上七味,除羊肾外。粗捣筛,每服五钱匕。用水三盏,先煮肾至二盏。去肾入药。再煎
至二盏,去滓温服,不拘时。
治消肾渴燥。磁石饮方
磁石(三两)
上一味,粗捣筛。如米粒大,分作十帖。每服一帖,用水一碗。煎至一盏,去滓温服,
日三夜一。
治三消病。小便频数。皮燥毛焦。饮食虽多。肌肉消瘦。渴燥引饮。丹砂散方
丹砂(研水飞) 黄连(去须) 铁粉(研) 栝蒌(各一两一分) 赤石脂 芦荟(研)
龙齿
炙) 鸡 (五
上一十四味。除别研外。捣罗为散。再和匀。每服二钱匕。煎小麦汤调下。日三服。
治消肾,饮水无度。腿膝瘦细,小便白浊。参附汤方
人参 附子(炮裂去皮脐) 青黛(各半两)
上三味。 咀如麻豆,每服二钱匕。水一盏,楮叶一片切。煎七分,去滓温服。日二夜
一。
论述说:所谓消肾病,是由于长期服用石药(矿物类药物),加上房事过度。导致精血枯竭。石药的燥烈之性孤立无制,肾水干枯涸竭。患者口渴,大量饮水浆。水液下输至膀胱。小便次数多且量大,腿部和小腿肌肉消瘦。骨节酸痛,因此称为消肾。
治疗消肾引起的脚胫瘦细、小便频数。或者尿液颜色赤红似血色,脏腑虚寒的患者。适宜服用地黄汤方:
熟干地黄(切碎)二两,麦门冬(去心焙干)二两,甘草(炙)半两,蒺藜子(炒去刺角)半两,干姜(炮制)一两,桂枝(去除粗皮)半两,续断(去除粗皮)半两。
以上七味药,粗捣筛碎。每次服用三钱匕,加水一盏,煎煮至七分满,滤去药渣,温服。每日三次,夜间两次。
治疗消肾引起的口干渴、小便多、身体消瘦乏力。黄芪饮方:
黄芪(切碎)二两,杜仲(去除粗皮炙后切碎)二两,山茱萸二两,人参二两,知母(切后焙干)二两,龙骨(打碎)三两。
以上六味药,粗捣筛碎。每次服用四钱匕,加水一盏半,大枣一枚劈开,煎煮至一盏满,滤去药渣,温服。每日三次,夜间两次。
治疗消肾引起的小便频数。阿胶汤方:
阿胶(炙燥)一两,干姜(炮制)一两,远志(去心)四两,附子(炮裂去皮脐)一两,人参一两。
以上五味药(注:原文列五药但称七味,此处依原文列举),锉如麻豆大小。每次服用三钱匕,加水一盏,煎煮至七分满,滤去药渣,不拘时候温服。
治疗消肾。口渴多饮、小便频数。宣补丸方:
黄芪(切碎)三两,栝蒌根三两,麦门冬(去心焙干)三两,白茯苓(去黑皮切碎)三两,人参三两,甘草(炙)三两,黄连(去须)三两,知母(切后焙干)三两,熟干地黄(切碎)六两,石膏(研细)六两,肉苁蓉(酒浸薄切焙干)四两,菟丝子(酒浸一夜另捣为末)三两。
以上十二味药,除菟丝子外,捣为细末和匀,用牛胆汁三合,配合炼蜜调和成剂,制成梧桐子大小的丸药。每次服用三十丸,用茅根汤送服,不拘时候。
治疗消肾,腰部以下。肌肉瘦弱无力,小便频数或失禁。山茱萸丸方:
山茱萸一两,黄芪(细锉)一两半,杜仲(去除粗皮炙后切碎)一两半,肉苁蓉(酒浸一夜切后焙干)一两半,桂枝一两半。
以上五味药(注:原文列五药但称七味,此处依原文列举),捣罗为细末。炼蜜和丸,制成梧桐子大小的丸药。每次服用二十丸,用黄芪汤送服。每日三次。
治疗消肾,身体消瘦。小便频数。人参丸方:
人参三分,鹿茸(去毛酒炙)一两,黄芪(切碎三分),栝蒌根一两,桑螵蛸(炙)一两,杜仲(去除粗皮炙后切碎三分),鸡内金(四枚炙),山茱萸三分,菟丝子(酒浸一夜焙干另捣为末)。
以上九味药,捣罗为细末。炼蜜和丸,制成梧桐子大小的丸药。每次服用三十丸,用枣汤送服。每日三次。
治疗消肾。口干眼涩,阳痿手足烦疼,小便多。金银箔丸方:
金箔一百片,银箔一百片(均细研),泽泻一两半,天门冬(去心焙干),肉苁蓉(酒浸一夜薄切),黄连(去须四两),干姜(炮制各一两半),丹砂(另研)。
以上十五味药(注:原文列举不全,仅列出部分及总数),除需另研的药物外,其余捣罗为细末,再研匀。炼蜜和丸,制成梧桐子大小的丸药。每次服用二十丸至三十丸,用粟米饮送服,不拘时候。
治疗消肾,小便白浊如凝脂,形体消瘦。磁石汤方:
磁石六两(另捣如米粒大,分为二十帖,每次煎药取一帖绵裹),黄芪(细锉)一两半,杜仲(去除粗皮炙后切碎)一两半,人参一两半,五味子一两半,熟干地黄(焙干)二两。
以上六味药,除磁石外,粗捣筛碎。分为二十帖。每帖先用水三盏,羊肾一只,切作四片。去除筋膜,与磁石一帖同煎至二盏。取出磁石和羊肾,加入药末。再同煎至一盏半。滤去药渣,温分两次服用。
治疗消肾,小便白浊如凝脂,虚弱无力。肾沥汤方:
白羊肾一只(去除脂膜切四片),黄芪(细锉),熟干地黄,杜仲(去除粗皮炙后切碎),五味子,人参,甘草。
以上七味药(注:原文列举不全),除羊肾外,粗捣筛碎。每次服用五钱匕。用水三盏,先煮肾至二盏。取出肾放入药末。再煎至二盏,滤去药渣,温服,不拘时候。
治疗消肾渴燥。磁石饮方:
磁石三两。
以上一味药,粗捣筛碎。如米粒大小,分作十帖。每次服用一帖,用水一碗。煎煮至一盏,滤去药渣,温服。每日三次,夜间一次。
治疗三消病。小便频数。皮肤干燥毛发焦枯。饮食虽多,肌肉消瘦。口渴燥热引饮。丹砂散方:
丹砂(研细水飞),黄连(去须),铁粉(研细),栝蒌(各一两一分),赤石脂,芦荟(研细),龙齿(煅),鸡内金(炙)。
以上十四味药(注:原文列举不全),除需另研的药物外,捣罗为散。再和匀。每次服用二钱匕,用小麦汤调下。每日三次。
治疗消肾,饮水无度。腿膝瘦细,小便白浊。参附汤方:
人参,附子(炮裂去皮脐),青黛(各半两)。
以上三味药,锉如麻豆大小。每次服用二钱匕。加水一盏,楮叶一片切碎。煎煮至七分,滤去药渣,温服。每日二次,夜间一次。
Commentary states: The condition known as Xiao Shen (Wasting-Thirst of the Kidney) arises from long-term consumption of Shi Yao (mineral drugs), combined with excessive sexual activity. This leads to exhaustion of Jing and Blood. The dry and hot nature of the mineral drugs stands isolated without control, causing the Kidney Water to become dry and depleted. Patients experience intense thirst and drink large amounts of water or fluids. The fluids descend to the Bladder, resulting in frequent and copious urination. The calves and lower legs become emaciated. There is soreness and pain in the bone joints. Hence, it is named Xiao Shen.
For treating Xiao Shen characterized by thin and weak lower legs and calves, frequent urination, or urine that is red like blood color, accompanied by deficiency-cold of the Zang-Fu organs, the Dihuang Tang (Rehmannia Decoction) is suitable.
Ingredients: Shu Gan Di Huang (Prepared Rehmanniae Radix, chopped) 2 liang; Mai Men Dong (Ophiopogonis Radix, heart removed, roasted) 2 liang; Gan Cao (Licorice Root, honey-fried) 0.5 liang; Ji Li Zi (Tribuli Fructus, stir-fried, spines removed) 0.5 liang; Gan Jiang (Dried Ginger, processed) 1 liang; Gui Zhi (Cinnamon Twig, coarse bark removed) 0.5 liang; Xu Duan (Dipsaci Radix, coarse bark removed) 0.5 liang.
Procedure: Coarsely crush and sieve the above seven herbs. For each dose, take 3 qian bi (approx. 9-15g depending on era/measure), add 1 zhan (approx. 200ml) of water, decoct until reduced to 70% volume. Strain and take warm. Administer three times daily and twice at night.
For treating Xiao Shen characterized by dry mouth and thirst, polyuria, emaciation, and lack of strength, the Huang Qi Yin (Astragalus Drink) is indicated.
Ingredients: Huang Qi (Astragali Radix, chopped) 2 liang; Du Zhong (Eucommiae Cortex, coarse bark removed, fried, chopped) 2 liang; Shan Zhu Yu (Corni Fructus) 2 liang; Ren Shen (Ginseng Radix et Rhizoma) 2 liang; Zhi Mu (Anemarrhenae Rhizoma, sliced, roasted) 2 liang; Long Gu (Fossilia Ossis Mastodi, crushed) 3 liang.
Procedure: Coarsely crush and sieve the above six herbs. For each dose, take 4 qian bi, add 1.5 zhan of water and one split Jujube (Ziziphi Fructus). Decoct until reduced to 1 zhan. Strain and take warm. Administer three times daily and twice at night.
For treating Xiao Shen characterized by frequent urination, the E Jiao Tang (Donkey-Hide Gelatin Decoction) is used.
Ingredients: E Jiao (Colla Corii Asini, dried by frying) 1 liang; Gan Jiang (Dried Ginger, processed) 1 liang; Yuan Zhi (Polygalae Radix, heart removed) 4 liang; Fu Zi (Aconiti Lateralis Radix Praeparata, cracked, skin and umbilicus removed) 1 liang; Ren Shen (Ginseng Radix et Rhizoma) 1 liang.
Procedure: Crush into pieces resembling hemp seeds. For each dose, take 3 qian bi, add 1 zhan of water, decoct until reduced to 70% volume. Strain and take warm at any time.
For treating Xiao Shen characterized by excessive thirst and frequent urination, the Xuan Bu Wan (Tonifying Pill) is prescribed.
Ingredients: Huang Qi (Astragali Radix, chopped) 3 liang; Gua Lou Gen (Trichosanthis Radix) 3 liang; Mai Men Dong (Ophiopogonis Radix, heart removed, roasted) 3 liang; Bai Fu Ling (Poria, black skin removed, chopped) 3 liang; Ren Shen (Ginseng Radix et Rhizoma) 3 liang; Gan Cao (Licorice Root, honey-fried) 3 liang; Huang Lian (Coptidis Rhizoma, whiskers removed) 3 liang; Zhi Mu (Anemarrhenae Rhizoma, sliced, roasted) 3 liang; Shu Gan Di Huang (Prepared Rehmanniae Radix, chopped) 6 liang; Shi Gao (Gypsum Fibrosum, ground) 6 liang; Rou Cong Rong (Cistanches Herba, wine-soaked, thinly sliced, roasted) 4 liang; Tu Si Zi (Cuscutae Semen, wine-soaked overnight, separately ground into powder) 3 liang.
Procedure: Except for Tu Si Zi, grind the remaining eleven herbs into powder and mix evenly. Add San He (approx. 60ml) of Ox Bile (Bos Taurus Gallbladder Juice) and refined honey to form pills the size of Sophora Seeds (Wu Tong Zi). Take 30 pills per dose, washed down with Maogen Tang (Imperatae Rhizoma Decoction), at any time.
For treating Xiao Shen where weakness and lack of power are below the waist, with frequent urination or incontinence, the Shan Zhu Yu Wan (Cornus Pill) is used.
Ingredients: Shan Zhu Yu (Corni Fructus) 1 liang; Huang Qi (Astragali Radix, finely chopped) 1.5 liang; Du Zhong (Eucommiae Cortex, coarse bark removed, fried, chopped) 1.5 liang; Rou Cong Rong (Cistanches Herba, wine-soaked overnight, sliced, roasted) 1.5 liang; Gui Zhi (Cinnamon Twig) 1.5 liang.
Procedure: Grind into fine powder. Mix with refined honey to form pills the size of Sophora Seeds. Take 20 pills per dose, washed down with Huang Qi Tang (Astragalus Decoction). Three times daily.
For treating Xiao Shen characterized by body emaciation and frequent urination, the Ren Shen Wan (Ginseng Pill) is indicated.
Ingredients: Ren Shen (Ginseng Radix et Rhizoma) 3 fen; Lu Rong (Cervi Cornu Pantotrichum, hair removed, wine-fried) 1 liang; Huang Qi (Astragali Radix, chopped) 3 fen; Gua Lou Gen (Trichosanthis Radix) 1 liang; Sang Piao Xiao (Mantis Ootheca, fried) 1 liang; Du Zhong (Eucommiae Cortex, coarse bark removed, fried, chopped) 3 fen; Ji Nei Jin (Galli Gigerii Endothelium Corneum, fried) 4 pieces; Shan Zhu Yu (Corni Fructus) 3 fen; Tu Si Zi (Cuscutae Semen, wine-soaked overnight, roasted, separately ground into powder).
Procedure: Grind into fine powder. Mix with refined honey to form pills the size of Sophora Seeds. Take 30 pills per dose, washed down with Zao Tang (Jujube Decoction). Three times daily.
For treating Xiao Shen characterized by dry mouth, astringent eyes, impotence, vexing pain in hands and feet, and polyuria, the Jin Yin Bo Wan (Gold and Silver Leaf Pill) is prescribed.
Ingredients: Jin Bo (Gold Leaf) 100 pieces; Yin Bo (Silver Leaf) 100 pieces (both finely ground); Ze Xie (Alismatis Rhizoma) 1.5 liang; Tian Men Dong (Asparagi Radix, heart removed, roasted); Rou Cong Rong (Cistanches Herba, wine-soaked overnight, thinly sliced); Huang Lian (Coptidis Rhizoma, whiskers removed) 4 liang; Gan Jiang (Dried Ginger, processed) 1.5 liang; Dan Sha (Cinnabar, separately ground).
Procedure: Except for those requiring separate grinding, grind all herbs into fine powder and mix thoroughly. Combine with refined honey to form pills the size of Sophora Seeds. Take 20-30 pills per dose, washed down with Su Mi Yin (Millet Drink), at any time.
For treating Xiao Shen characterized by turbid white urine resembling congealed fat and physical emaciation, the Ci Shi Tang (Magnetite Decoction) is used.
Ingredients: Ci Shi (Magnetitum) 6 liang (separately crushed to rice-grain size, divided into 20 doses; use one wrapped in silk per decoction); Huang Qi (Astragali Radix, finely chopped) 1.5 liang; Du Zhong (Eucommiae Cortex, coarse bark removed, fried, chopped) 1.5 liang; Ren Shen (Ginseng Radix et Rhizoma) 1.5 liang; Wu Wei Zi (Schisandrae Fructus) 1.5 liang; Shu Gan Di Huang (Prepared Rehmanniae Radix, roasted) 2 liang.
Procedure: Except for Ci Shi, coarsely crush and sieve. Divide into 20 doses. For each dose, start with 3 zhan of water and one Yang Shen (Sheep Kidney), cut into four slices. Remove fascia. Simmer with one dose of Ci Shi until reduced to 2 zhan. Remove Ci Shi and Sheep Kidney. Add the herbal powder. Decoct again until reduced to 1.5 zhan. Strain and divide into two warm doses.
For treating Xiao Shen characterized by turbid white urine resembling congealed fat and weakness/lack of strength, the Shen Li Tang (Kidney Drip Decoction) is indicated.
Ingredients: Bai Yang Shen (White Sheep Kidney, one piece, remove fat membrane, cut into four slices); Huang Qi (Astragali Radix, finely chopped); Shu Gan Di Huang (Prepared Rehmanniae Radix); Du Zhong (Eucommiae Cortex, coarse bark removed, fried, chopped); Wu Wei Zi (Schisandrae Fructus); Ren Shen (Ginseng Radix et Rhizoma); Gan Cao (Licorice Root, honey-fried).
Procedure: Except for the Sheep Kidney, coarsely crush and sieve. For each dose, take 5 qian bi. Use 3 zhan of water. First boil the kidney until reduced to 2 zhan. Remove the kidney, add the herbs. Decoct again until reduced to 2 zhan. Strain and take warm, at any time.
For treating Xiao Shen characterized by thirst and dryness, the Ci Shi Yin (Magnetite Drink) is prescribed.
Ingredients: Ci Shi (Magnetitum) 3 liang.
Procedure: Coarsely crush and sieve. Size should resemble rice grains. Divide into 10 doses. For each dose, use 1 bowl of water. Decoct until reduced to 1 zhan. Strain and take warm. Three times daily and once at night.
For treating San Xiao (Three Wastes) disease characterized by frequent urination, dry skin, brittle hair, increased appetite but muscle emaciation, and intense thirst, the Dan Sha San (Cinnabar Powder) is indicated.
Ingredients: Dan Sha (Cinnabar, ground and floated in water); Huang Lian (Coptidis Rhizoma, whiskers removed); Tie Fen (Ferrum Pulveratum, ground); Gua Lou (Trichosanthes Fruit/Root, 1.1 liang each); Chi Shi Zhi (Halloysit Rubrum); Lu Hui (Aloe, ground); Long Gu (Fossilia Ossis Mastodi, calcined); Ji Nei Jin (Galli Gigerii Endothelium Corneum, fried).
Procedure: Except for those requiring separate grinding, grind into powder and mix evenly. Take 2 qian bi per dose, mixed with Xiao Mai Tang (Triticum Decoction). Three times daily.
For treating Xiao Shen characterized by uncontrolled drinking, thin lower legs and knees, and turbid white urine, the Shen Fu Tang (Ginseng and Aconite Decoction) is prescribed.
Ingredients: Ren Shen (Ginseng Radix et Rhizoma); Fu Zi (Aconiti Lateralis Radix Praeparata, cracked, skin and umbilicus removed); Qing Dai (Indigo Naturalis) (0.5 liang each).
Procedure: Crush into pieces resembling hemp seeds. Take 2 qian bi per dose. Add 1 zhan of water and one chopped Chu Ye (Broussonetia papyrifera leaf). Decoct until reduced to 70% volume. Strain and take warm. Twice daily and once at night.