论曰内经谓阳气者烦劳则张精绝,辟积于夏,使人煎厥,目盲不可以视,耳闭不可以听
,溃溃乎若坏都, 乎不可止。夫阳气者卫外而为固也,起居有常,喜怒调节,则志气治
而阳不扰,若动作烦劳,气乃张大,阳气张大则真气耗而精绝。积至于夏,阳气益盛,则卫
外者躁而不静,此其证所以煎迫而厥逆,视听昏塞,溃溃 ,莫知所以然也。内经又曰,
少气善怒者,阳气不治,则阳气不得出,肝气当治而未得,故善怒,名曰煎厥,亦以谓阳气
抑郁于内,不得其平,故气煎迫而厥逆也。
治煎厥气逆,头目昏愦,视听不明,少气善怒。人参汤方
人参 远志(去心) 赤茯苓(去黑皮) 防风(去叉各二两) 芍药 麦门冬(去心)
陈橘皮(汤浸去
上八味。锉如麻豆,每服五钱匕,水一盏半,煎取八分,去滓温服日再。
治动作烦劳,阳气张大,肝精不守,善怒少气,头目昏愦,病名煎厥。山芋汤方
山芋 生干地黄(焙) 防风(去叉锉) 茯神(去木) 山茱萸(炒) 桂(去粗皮)
天雄(炮裂去皮脐) 远志(去心) 细辛(去苗叶) 枳实(麸炒去瓤) 甘菊花(各一
两) 甘草(炙锉三分)
上一十二味。细锉如麻豆,每服三钱匕,水一盏,入生姜三片,煎至七分,去滓温服,
空心食前。
治煎厥少气善怒,精神不守。茯神汤方
茯神(去木) 羚羊角(屑) 五味子 葳蕤 远志(去心) 沙参 酸枣仁(微炒各
三分) 龙骨(半两
上八味。粗捣筛,每服三钱匕,水一盏,煎取七分,去滓温服,不拘时候。
治阳气内郁,肝气不治,少气善怒,视听昏塞,煎迫厥逆。龙骨丸方
龙骨 白茯苓(去黑皮) 远志(去心) 防风(去叉) 人参 柏子仁(别捣) 犀
角(镑) 生干地黄(焙
上九味。除柏子仁外,捣罗为末,同拌匀,入煮枣肉二两,炼蜜和杵数百下,丸如梧桐
子大,每服三十丸,粥饮下,空心食前。
治煎厥气逆多怒,肝气不治。柏子仁汤方
柏子仁 虎头骨(涂酥炙各一两) 人参 茯神(去木) 犀角屑 桃仁(汤浸去皮尖
双仁麸炒黄) 远志 小草(各三分)
上八味。粗捣筛,每服三钱匕,水一盏,煎取七分,去滓温服,不拘时候。
《黄帝内经》中说:阳气如果因烦劳而亢盛,就会导致精气枯竭;这种状况积累到夏季,就会使人发生煎厥,表现为双目失明无法视物,双耳闭塞无法听声,病情危急如同堤坝崩溃,势不可挡。阳气的作用是护卫体表并固守体内。如果起居有规律,情绪喜怒调节得当,那么志气调和,阳气就不会受到扰动;如果动作过度或烦劳,气机就会张大,阳气张大则导致真气耗损、精气枯竭。积热至夏季,阳气更加旺盛,卫外之气躁动而不宁静,这就是为什么会出现煎迫感、四肢厥逆、视听功能昏塞混乱,让人不知所以然的原因。
《黄帝内经》又说:气短且容易发怒的人,是阳气运行失调,导致阳气不能正常升发,肝气应当疏泄却未能疏泄,所以容易发怒,这种情况被称为“煎厥”,也可以理解为阳气在内郁结,失去平衡,因此气机煎迫而导致四肢厥逆。
治疗煎厥引起的气机上逆、头目昏沉困倦、视听不清、气短易怒的方剂:人参汤方。
药材:人参、远志(去除心)、赤茯苓(去除黑皮)、防风(去除叉枝,各二两)、芍药、麦门冬(去除心)、陈橘皮(用汤浸泡后去除白色内瓤)。
以上八味药。切碎如麻豆大小,每次服用五钱匕,加水一盏半,煎煮至剩余八分,去渣温服,每日两次。
治疗因动作烦劳导致阳气张大、肝精不守、易怒气短、头目昏沉困倦,病名为煎厥的方剂:山芋汤方。
药材:山芋、生干地黄(焙干)、防风(去除叉枝并切碎)、茯神(去除木心)、山茱萸(炒制)、桂(去除粗皮)、天雄(炮裂后去皮脐)、远志(去除心)、细辛(去除苗叶)、枳实(麸炒后去除瓤)、甘菊花(各一两)、甘草(炙烤后切碎,三分)。
以上十二味药。细细切碎如麻豆大小,每次服用三钱匕,加水一盏,放入生姜三片,煎煮至剩余七分,去渣温服,空腹及进食前服用。
治疗煎厥引起的气短易怒、精神不守的方剂:茯神汤方。
药材:茯神(去除木心)、羚羊角(锉成屑)、五味子、葳蕤、远志(去除心)、沙参、酸枣仁(微炒,各三分)、龙骨(半两)。
以上八味药。粗捣筛过,每次服用三钱匕,加水一盏,煎煮至剩余七分,去渣温服,不限时候。
治疗阳气内郁、肝气失调、气短易怒、视听昏塞、煎迫厥逆的方剂:龙骨丸方。
药材:龙骨、白茯苓(去除黑皮)、远志(去除心)、防风(去除叉枝)、人参、柏子仁(单独捣碎)、犀角(镑成薄片)、生干地黄(焙干)。
以上九味药。除柏子仁外,其余药物捣碎过筛成粉末,混合均匀,加入煮熟的枣肉二两,用炼蜜调和并杵击数百下,制成梧桐子大小的丸药,每次服用三十丸,用粥饮送下,空腹及进食前服用。
治疗煎厥引起的气逆多怒、肝气失调的方剂:柏子仁汤方。
药材:柏子仁、虎头骨(涂酥油炙烤,各一两)、人参、茯神(去除木心)、犀角屑、桃仁(汤浸后去皮尖及双仁,麸炒至黄)、远志、小草(各三分)。
以上八味药。粗捣筛过,每次服用三钱匕,加水一盏,煎煮至剩余七分,去渣温服,不限时候。
The *Neijing* (Yellow Emperor's Inner Classic) states: When Yang qi (vital energy associated with heat and activity) becomes hyperactive due to excessive fatigue and labor, it leads to the exhaustion of Jing essence (essence stored in the kidneys). If this condition accumulates into summer, it causes Jian Jue (Frying Syncope), characterized by blindness preventing vision, deafness preventing hearing. The condition is critical, resembling a breached dam, unstoppable. Yang qi functions to protect the exterior and consolidate the interior. If daily routines are regular and emotions like joy and anger are regulated, Zhi qi (willpower/spiritual energy) remains harmonious, and Yang qi is not disturbed. However, if physical movements are excessive or there is mental fatigue, Qi expands excessively. When Yang qi expands excessively, True Qi (Zhen Qi) is consumed, leading to Jing exhaustion. Accumulating heat into summer makes Yang qi even more prosperous, causing the defensive Qi at the exterior to become restless and unstable. This explains why symptoms such as a sensation of frying pressure, cold extremities (Jue Ni), and blurred vision and hearing occur, leaving patients bewildered.
The *Neijing* also says: Those who suffer from shortness of breath and irritability have disordered Yang qi movement, preventing Yang qi from ascending properly. Liver Qi (energy of the liver responsible for free flow) should be diffused but fails to do so, resulting in irritability; this is named Jian Jue. It can also be understood as Yang qi being depressed internally, losing its balance, thus causing Qi to fry and press inward, leading to syncope and cold extremities.
Formula for treating Jian Jue with rebellious Qi, dizziness and confusion of the head and eyes, unclear vision and hearing, shortness of breath, and irritability: Renshen Tang (Ginseng Decoction).
Ingredients: Renshen (Radix Ginseng), Yuanzhi (Radix Polygalae, heart removed), Chi Fuling (Poria with Red Hosta Root, black skin removed), Fangfeng (Radix Saposhnikoviae, twigs removed, 2 liang each), Shaoyao (Radix Paeoniae Lactiflorae), Maimendong (Radix Ophiopogonis, heart removed), Chenjupi (Pericarpium Citri Reticulatae, soaked in water, white pith removed).
Process these eight herbs. Cut them into pieces the size of hemp seeds. Take 5 Qianbi per dose, add 1.5 Zhan of water, decoct until 0.8 Zhan remains, strain, and take warm. Administer twice daily.
Formula for treating Jian Jue caused by excessive labor leading to hyperactive Yang qi, failure of Liver Jing to remain secure, irritability, shortness of breath, and dizziness/confusion of the head and eyes: Shanyu Tang (Dioscorea Decoction).
Ingredients: Shanyu (Rhizoma Dioscoreae Hypoglaucae), Sheng Gan Dihuang (Radix Rehmanniae Preparata, dried and baked), Fangfeng (Radix Saposhnikoviae, twigs removed and cut), Fushen (Poria with Pine Root, wood removed), Shanzhuyu (Fructus Corni, stir-fried), Gui (Cortex Cinnamomi, rough bark removed), Tianxiong (Radix Aconiti Lateralis Preparata, cracked by firing, skin and navel removed), Yuanzhi (Radix Polygalae, heart removed), Xixin (Herba Asari, seedlings and leaves removed), Zhishi (Fructus Aurantii Immaturus, bran-fried, pulp removed), Gan Juhua (Flos Chrysanthemi Indici, 1 liang each), Gancao (Radix Glycyrrhizae Preparata, honey-fried and cut, 3 fen).
Process these twelve herbs. Finely cut them into pieces the size of hemp seeds. Take 3 Qianbi per dose, add 1 Zhan of water, put in 3 slices of fresh ginger, decoct until 0.7 Zhan remains, strain, and take warm. Take on an empty stomach before meals.
Formula for treating Jian Jue with shortness of breath, irritability, and insecure spirit: Fushen Tang (Poria Decoction).
Ingredients: Fushen (Poria with Pine Root, wood removed), Lingyangjiao (Cornu Saigae Tataricae, crushed), Wuweizi (Fructus Schisandrae), Weirui (Rhizoma Polygonati Odorati), Yuanzhi (Radix Polygalae, heart removed), Shashen (Radix Adenophorae seu Platycodi), Suanzaoren (Semen Ziziphi Spinosae, lightly stir-fried, 3 fen each), Longgu (Os Draconis, 0.5 liang).
Process these eight herbs. Coarsely crush and sieve. Take 3 Qianbi per dose, add 1 Zhan of water, decoct until 0.7 Zhan remains, strain, and take warm. Take at any time.
Formula for treating internal depression of Yang qi, disorder of Liver Qi, shortness of breath, irritability, blurred vision and hearing, frying pressure, and syncope: Longgu Wan (Dragon Bone Pill).
Ingredients: Longgu (Os Draconis), Bai Fuling (Poria, black skin removed), Yuanzhi (Radix Polygalae, heart removed), Fangfeng (Radix Saposhnikoviae, twigs removed), Renshen (Radix Ginseng), Baiziren (Semen Biotae, pounded separately), Xijiao (Cornu Rhinocerotis, shaved), Sheng Gan Dihuang (Radix Rehmanniae Preparata, dried and baked).
Process these nine herbs. Except for Baiziren, pound and sieve all ingredients into powder, mix evenly. Add 2 liang of boiled jujube flesh, blend with refined honey, and pound for hundreds of strokes to form pills the size of tung tree seeds. Take 30 pills per dose, swallow with gruel drink, on an empty stomach before meals.
Formula for treating Jian Jue with rebellious Qi, excessive anger, and disorder of Liver Qi: Baiziren Tang (Biota Seed Decoction).
Ingredients: Baiziren (Semen Biotae), Hutou Gu (Os Cranium Tigridis, coated with butter and roasted, 1 liang each), Renshen (Radix Ginseng), Fushen (Poria with Pine Root, wood removed), Xijiao Xie (Cornu Rhinocerotis, crushed), Taoren (Semen Persicae, soaked in water, skin and tips removed, non-double kernels, bran-fried until yellow), Yuanzhi (Radix Polygalae), Xiaocao (Herba Centellae, 3 fen each).
Process these eight herbs. Coarsely crush and sieve. Take 3 Qianbi per dose, add 1 Zhan of water, decoct until 0.7 Zhan remains, strain, and take warm. Take at any time.