论曰∶风寒湿三气杂至,合而为痹,以秋遇此者为皮痹。盖肺主皮毛,于五行为金,于
四时为秋。当秋之时,感于三气则为皮痹,盖正言其时之所感者尔。固有非秋时而得之者,
皮肤不营而为不仁,则其证然也。
治肺中风寒湿,项强头昏,胸满短气,嘘吸颤掉,言语声嘶,四肢缓弱,皮肤 痹。防
风汤方。
防风(去叉) 芎 麻黄(去根节各一两) 独活(去芦头) 桂(去粗皮) 前胡
(去芦头)
神(去木,炙
三分) 细辛(去苗叶) 甘菊花 黄 山茱萸 甘草(炙,锉各半两)
上一十六味,锉如麻豆。每服四钱匕,水一盏半,生姜五片,煎至八分,去滓,稍热服
,不拘时。
治肺感外邪,皮肤 痹,项强背痛,四肢缓弱,冒昧昏塞,心胸短气。赤箭丸方。
赤箭 羌活(去芦头) 细辛(去苗叶) 桂(去粗皮) 当归(锉,炒) 甘菊花 防
风(去
叉) 天雄(炮裂,去皮脐) 麻黄(去根节) 蔓荆实 白术 杏仁(汤浸去皮尖、双仁,
炒,
研) 萆 (锉) 茯神(去木) 山茱萸 羚羊角(镑) 芎 犀角(镑) 五加皮(锉)
五味
子阿胶(炙令燥) 人参 枫香脂(研) 天南星(炮) 白附子(炮各半两) 龙脑(研)
麝香
(研) 牛黄(研各一钱)
上二十八味,捣罗二十三味极细,与研者五味拌匀,炼蜜和捣三二百杵,丸如梧桐子大
。每服十五丸,荆芥汤下,不拘时。
治皮痹皮中如虫行,腹胁胀满,大肠不利,语声不出。羌活汤方。
羌活(去芦头) 蒺藜子(炒去角) 沙参 丹参 麻黄(去根节) 白术 羚羊角(镑)
细
辛(去苗叶) 萆 五加皮 五味子 生干地黄(焙) 赤茯苓(去黑皮) 杏仁(汤浸
去皮尖
、双仁,炒) 菖蒲(去毛) 枳壳(去瓤,麸炒) 郁李仁(汤浸,去皮尖,炒) 附子
(炮裂,
去皮脐) 桂(去粗皮各三分) 木通 槟榔(各半两)
上二十一味,锉如麻豆。每服四钱匕,水一盏半,生姜五片,煎至七分。去滓温服,不
拘时。
治皮痹肌肉不仁,心胸气促,项背硬强。天麻散方。
天麻 附子(炮裂,去皮脐) 麻黄(去根节) 白花蛇肉(酥拌,炒) 防风(去叉)
细辛
(去苗叶) 芎 菖蒲 荆芥穗 黄 (锉) 桑根白皮(锉) 蒺藜子(炒去角) 杏
仁(汤浸
去皮尖、双仁,炒,研各三分) 牛黄(研) 麝香(研各一分)
上一十五味,捣罗十二味为散,与研者三味,拌匀再罗。每服一钱匕,薄荷酒调下,不
拘时。
治皮痹。蒴 蒸汤方。
蒴 根(并叶) 桃皮(并叶) 菖蒲叶(各锉三升) 细糠(一斗) 秫米(五升)
上五味,以水一石五斗,煮取米熟为度,以大盆盛,作小竹床子罩盆,人坐床上,四面
将席荐障风,别以被衣盖覆身上,觉气急,即旋开孔取气,如两食久,通身汗出,凡经三蒸
。非惟治风寒湿痹,但是皮肤中一切冷气,皆能治之。
治风寒湿之气,感于肺经,皮肤 痹不仁。麻黄汤方。
麻黄(去根节) 桂(去粗皮) 人参 芎 附子(炮裂,去皮脐) 防风(去叉) 芍
药
黄芩(去黑心) 白术 甘草(炙,锉各一两) 赤茯苓(去黑皮三分)
上一十一味,锉如麻豆。每服五钱匕,水一盏半,入生姜五片,煎至一盏,去滓稍热服
。盖覆出汗,愈。
治皮痹不仁。蔓荆实丸方。
蔓荆实(去浮皮三分) 防风(去叉) 羌活(去芦头) 桔梗(炒) 白附子(炮) 枳
壳(去
瓤,麸炒) 蒺藜子(炒去角各半两) 皂荚(半斤不 者,新水浸一宿,揉熟,绢滤去滓,
入面少许,同煎成膏)
上八味,捣罗七味为末,入膏中和捣,丸如梧桐子大。每服二十丸,食后熟水下。
治皮肤 痹。天麻丸方。
天麻(酒浸,切,焙三两) 玄参 没药(研) 地榆 乌头(炮裂,去皮脐各一两) 麝
香
(研一分)
上六味,捣罗四味为末,与二味研者和匀,炼蜜丸如梧桐子大。每服二十丸,空心食前
温酒下。
论述说:风、寒、湿三种邪气混杂侵袭人体,结合而成为痹证,在秋季感受这三种邪气所形成的称为皮痹。因为肺主司皮毛,在五行中属金,在四季中对应秋季。在秋季之时,若感受这三种邪气就会形成皮痹,这确实是说明了在该时节所感受的病因。固然也有并非在秋季却患上此病的,表现为皮肤缺乏气血濡养而导致麻木不仁,这就是其症状表现。
防风汤方:用于治疗肺经受风寒湿邪侵袭,出现项部僵硬、头晕目眩、胸部胀满、呼吸短促、呼吸时身体颤抖动摇、言语声音嘶哑、四肢松弛无力、皮肤痹痛等症状。
药材:防风(去除叉枝)、川芎、麻黄(去除根和节,各一两)、独活(去除芦头)、桂枝(去除粗皮)、前胡(去除芦头)、神曲(去除木屑,炙烤,三分)、细辛(去除苗叶)、甘菊花、黄芪、山茱萸、甘草(炙烤,锉碎,各半两)。
制法与用法:以上十六味药,锉碎如麻豆大小。每次服用四钱匕,加水一盏半,生姜五片,煎煮至八分量,滤去药渣,趁稍热时服用,不限定具体时间。
赤箭丸方:用于治疗肺感受外邪,皮肤痹痛麻木,项部僵硬背痛,四肢松弛无力,头昏沉闷塞,心胸呼吸短促等症状。
药材:赤箭(天麻)、羌活(去除芦头)、细辛(去除苗叶)、桂枝(去除粗皮)、当归(锉碎,炒制)、甘菊花、防风(去除叉枝)、天雄(炮裂,去皮脐)、麻黄(去除根节)、蔓荆子、白术、杏仁(热水浸泡去皮尖及双仁,炒制,研碎)、萆薢(锉碎)、茯神(去除木心)、山茱萸、羚羊角(镑碎)、川芎、犀角(镑碎)、五加皮(锉碎)、五味子、阿胶(炙烤至干燥)、人参、枫香脂(研碎)、天南星(炮制)、白附子(炮制,各半两)、龙脑(冰片,研碎)、麝香(研碎)、牛黄(研碎,各一钱)。
制法与用法:以上二十八味药,将其中二十三味捣碎过罗成极细粉末,与另外五味已研碎的药材拌匀,用炼蜜调和并捣击三二百下,制成梧桐子大小的丸剂。每次服用十五丸,用荆芥汤送服,不限定具体时间。
羌活汤方:用于治疗皮痹,感觉皮肤中有如虫爬行感,腹部胁肋胀满,大肠传导不利,声音发不出等症状。
药材:羌活(去除芦头)、蒺藜子(炒制去刺)、沙参、丹参、麻黄(去除根节)、白术、羚羊角(镑碎)、细辛(去除苗叶)、萆薢、五加皮、五味子、生干地黄(焙干)、赤茯苓(去除黑皮)、杏仁(热水浸泡去皮尖及双仁,炒制)、菖蒲(去除毛)、枳壳(去除瓤,麸炒)、郁李仁(热水浸泡去皮尖,炒制)、附子(炮裂,去皮脐)、桂枝(去除粗皮,各三分)、木通、槟榔(各半两)。
制法与用法:以上二十一味药,锉碎如麻豆大小。每次服用四钱匕,加水一盏半,生姜五片,煎煮至七分量。滤去药渣温服,不限定具体时间。
天麻散方:用于治疗皮痹,肌肉麻木不仁,心胸气息急促,项背部僵硬强直等症状。
药材:天麻、附子(炮裂,去皮脐)、麻黄(去除根节)、白花蛇肉(用酥油拌炒)、防风(去除叉枝)、细辛(去除苗叶)、川芎、菖蒲、荆芥穗、黄芪(锉碎)、桑根白皮(锉碎)、蒺藜子(炒制去刺)、杏仁(热水浸泡去皮尖及双仁,炒制,研碎,各三分)、牛黄(研碎)、麝香(研碎,各一分)。
制法与用法:以上十五味药,将其中十二味捣碎过罗成散剂,与另外三味已研碎的药材拌匀后再过罗。每次服用一钱匕,用薄荷酒调服,不限定具体时间。
蒴藋蒸汤方:用于治疗皮痹。
药材:蒴藋根(连同叶子)、桃树皮(连同叶子)、菖蒲叶(各锉碎三升)、细糠(一斗)、秫米(五升)。
制法与用法:以上五味药,用水一石五斗,煮至米熟为止。用大盆盛装,上面放置小竹床罩住盆口,人坐在竹床上,四周用席子遮挡风,另用被子覆盖身体。如果感到气急,就随时打开孔洞透气。大约经过两顿饭的时间,全身出汗,总共进行三次熏蒸。这不仅治疗风寒湿痹,凡是皮肤中的一切冷气,都能治疗。
麻黄汤方:用于治疗风寒湿邪气侵袭肺经,导致皮肤痹痛麻木不仁。
药材:麻黄(去除根节)、桂枝(去除粗皮)、人参、川芎、附子(炮裂,去皮脐)、防风(去除叉枝)、芍药、黄芩(去除黑心)、白术、甘草(炙烤,锉碎,各一两)、赤茯苓(去除黑皮,三分)。
制法与用法:以上十一味药,锉碎如麻豆大小。每次服用五钱匕,加水一盏半,加入生姜五片,煎煮至一盏量,滤去药渣趁稍热服用。服药后覆盖衣被使出汗,即可痊愈。
蔓荆实丸方:用于治疗皮痹麻木不仁。
药材:蔓荆子(去除浮皮,三分)、防风(去除叉枝)、羌活(去除芦头)、桔梗(炒制)、白附子(炮制)、枳壳(去除瓤,麸炒)、蒺藜子(炒制去刺,各半两)、皂荚(半斤不蛀坏的,新水浸泡一夜,揉熟,绢布过滤去渣,加入少许面粉,同煎成膏)。
制法与用法:以上八味药,将其中七味捣碎过罗成末,加入膏剂中调和捣匀,制成梧桐子大小的丸剂。每次服用二十丸,饭后用温水送服。
天麻丸方:用于治疗皮肤痹痛。
药材:天麻(酒浸,切片,焙干,三两)、玄参、没药(研碎)、地榆、乌头(炮裂,去皮脐,各一两)、麝香(研碎,一分)。
制法与用法:以上六味药,将其中四味捣碎过罗成末,与另外两味研碎的药材混合均匀,用炼蜜制成梧桐子大小的丸剂。每次服用二十丸,空腹饭前用温酒送服。
Commentary states: The Qi of wind, cold, and dampness mix together to invade the body, combining to form Bi syndrome (obstruction syndrome). When these three pathogens are encountered in autumn, it is called Pi Bi (Skin Bi). This is because the Lung governs the skin and hair, corresponds to Metal in the Five Elements, and to Autumn in the Four Seasons. During autumn, contracting these three pathogens results in Pi Bi, which accurately describes the pathogenic factors contracted during that specific season. However, there are cases where this condition arises not in autumn; the manifestation involves the skin lacking nourishment, leading to numbness and insensitivity, which constitutes its clinical presentation.
Fangfeng Tang (Saposhnikovia Decoction): Indicated for Lung involvement by wind-cold-dampness, presenting with stiffness of the neck, dizziness, chest fullness, shortness of breath, tremulous breathing, hoarseness, flaccidity and weakness of the four limbs, and skin Bi.
Ingredients: Fangfeng (Saposhnikoviae Radix, remove forked branches), Xiong (Ligustici Chuanxiong Rhizoma), Mahuang (Ephedrae Herba, remove roots and nodes, each 1 liang), Duhuo (Angelicae Pubescentis Radix, remove rhizome head), Gui (Cinnamomi Ramulus, remove coarse bark), Qianhu (Peucedani Radix, remove rhizome head), Shenqu (Massa Medicata Fermentata, remove wood, roasted, 3 fen), Xixin (Asari Radix et Rhizoma, remove seedlings and leaves), Gan Juhua (Chrysanthemi Flos), Huangqi (Astragali Membranacei Radix), Shanzhuyu (Corni Fructus), Gancao (Glycyrrhizae Radix et Rhizoma, roasted, cut into small pieces, each 0.5 liang).
Preparation and Administration: The above sixteen herbs are cut into pieces resembling hemp seeds. Each dose consists of 4 qianbi (approx. 4-6 grams), boiled with 1.5 sheng (approx. 300 ml) of water and 5 slices of fresh ginger until reduced to 0.8 sheng. Strain the decoction and take it while slightly warm, at any time.
Chijian Wan (Atractylodis Lanceae Pill / Gastrodia Pill): Indicated for Lung affected by external pathogens, presenting with skin Bi and numbness, stiff neck and back pain, flaccidity and weakness of the four limbs, mental cloudiness and obstruction, and shortness of breath from the heart and chest.
Ingredients: Chijian (Gastrodiae Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix, remove rhizome head), Xixin (Asari Radix et Rhizoma, remove seedlings and leaves), Gui (Cinnamomi Ramulus, remove coarse bark), Danggui (Angelicae Sinensis Radix, cut, roasted), Gan Juhua (Chrysanthemi Flos), Fangfeng (Saposhnikoviae Radix, remove forked branches), Tianxiong (Aconiti Kusnezoffii Radix Praeparata, cracked, remove peel and navel), Mahuang (Ephedrae Herba, remove roots and nodes), Manjingzi (Viticis Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma), Xingren (Armeniacae Semen Amarum, soaked in hot water, remove peel and tip, remove twin kernels, roasted, ground), Bibo (Dioscoreae Hypoglaucae Rhizoma, cut), Fushen (Poria with Hostwood, remove wood), Shanzhuyu (Corni Fructus), Lingyangjiao (Saigae Tataricae Cornu, shaved), Xiong (Ligustici Chuanxiong Rhizoma), Xijiao (Rhinocerotis Cornu, shaved), Wujiaopi (Acanthopanacis Cortex, cut), Wuweizi (Schisandrae Chinensis Fructus), Ejiao (Asini Corii Colla, roasted until dry), Renshen (Ginseng Radix et Rhizoma), Fengxiangzhi (Liquidambaris Resina, ground), Tiannanxing (Arisomatis Tuber, prepared), Baifuzi (Typhonii Rhizoma, prepared, each 0.5 liang), Longnao (Borneolum Syntheticum, ground), Shexiang (Moschus, ground), Niuhuang (Calculus Bovis, ground, each 1 qian).
Preparation and Administration: The above twenty-eight herbs: grind twenty-three herbs into an extremely fine powder. Mix evenly with the five herbs already ground. Combine with refined honey, pound 200-300 times, and shape into pills the size of paulownia seeds. Take 15 pills per dose, washed down with Jingjie (Perillae Folium) decoction, at any time.
Qianghuo Tang (Notopterygii Decoction): Indicated for Pi Bi, sensation of insects crawling in the skin, abdominal and hypochondriac distension, dysfunction of the Large Intestine, and inability to speak.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix, remove rhizome head), Jilizi (Tribuli Fructus, roasted, remove spines), Shashen (Adenophorae Radix or Glehniae Radix), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Mahuang (Ephedrae Herba, remove roots and nodes), Baizhu (Atractylodis Macrocephalae Rhizoma), Lingyangjiao (Saigae Tataricae Cornu, shaved), Xixin (Asari Radix et Rhizoma, remove seedlings and leaves), Bibo (Dioscoreae Hypoglaucae Rhizoma), Wujiaopi (Acanthopanacis Cortex, cut), Wuweizi (Schisandrae Chinensis Fructus), Sheng Ganshengdi (Rehmanniae Radix, dried and baked), Chi Fuling (Poria, remove black skin), Xingren (Armeniacae Semen Amarum, soaked in hot water, remove peel and tip, remove twin kernels, roasted), Changpu (Acori Tatarinowii Rhizoma, remove hairs), Zhiqiao (Aurantii Fructus, remove pulp, bran-roasted), Yuliren (Pruni Semen, soaked in hot water, remove peel and tip, roasted), Fuzi (Aconiti Lateralis Radix Praeparata, cracked, remove peel and navel), Gui (Cinnamomi Ramulus, remove coarse bark, each 3 fen), Mutong (Akebiae Caulis), Binglang (Arecae Semen, each 0.5 liang).
Preparation and Administration: The above twenty-one herbs are cut into pieces resembling hemp seeds. Each dose consists of 4 qianbi, boiled with 1.5 sheng of water and 5 slices of fresh ginger until reduced to 0.7 sheng. Strain and take warm, at any time.
Tianma San (Gastrodia Powder): Indicated for Pi Bi, muscle numbness and insensitivity, shortness of breath from the heart and chest, and stiffness and rigidity of the neck and back.
Ingredients: Tianma (Gastrodiae Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata, cracked, remove peel and navel), Mahuang (Ephedrae Herba, remove roots and nodes), Baihua She Rou (Bungarus multicinctus meat, mixed with butter and roasted), Fangfeng (Saposhnikoviae Radix, remove forked branches), Xixin (Asari Radix et Rhizoma, remove seedlings and leaves), Xiong (Ligustici Chuanxiong Rhizoma), Changpu (Acori Tatarinowii Rhizoma), Jingjie Sui (Perillae Folium flower spike), Huangqi (Astragali Membranacei Radix, cut), Sanggen Baipi (Mori Cortex, cut), Jilizi (Tribuli Fructus, roasted, remove spines), Xingren (Armeniacae Semen Amarum, soaked in hot water, remove peel and tip, remove twin kernels, roasted, ground, each 3 fen), Niuhuang (Calculus Bovis, ground), Shexiang (Moschus, ground, each 1 fen).
Preparation and Administration: The above fifteen herbs: crush twelve herbs into a powder using a mortar and sieve. Mix evenly with the three herbs already ground, then sieve again. Take 1 qianbi per dose, mixed with Bohe (Menthae Haplocalycis Herba) wine, at any time.
Shuodi Zheng Tang (Dioscorea Hypoglauca Steam Bath Decoction): Indicated for Pi Bi.
Ingredients: Shuodi Gen (Dioscoreae Hypoglaucae Radix, including leaves), Tao Pi (Pruni Persicae Cortex, including leaves, each cut into pieces, 3 sheng), Xi Kang (Fine Bran, 1 dou), Shumi (Sorghum Vulgare, 5 sheng).
Preparation and Administration: The above five ingredients are boiled in 15 dan (approx. 150 liters) of water until the grain is cooked. Place in a large basin. Position a small bamboo bed over the basin. Sit on the bamboo bed, shield the surroundings with mats to block wind, and cover the body with quilts. If feeling short of breath, open the hole to breathe freely. After approximately two meal durations, profuse sweating occurs throughout the body. Perform this steaming treatment three times. This not only treats wind-cold-damp Bi but also addresses all types of cold Qi within the skin.
Mahuang Tang (Ephedra Decoction): Indicated for wind-cold-damp Qi invading the Lung Meridian, causing skin Bi and numbness.
Ingredients: Mahuang (Ephedrae Herba, remove roots and nodes), Gui (Cinnamomi Ramulus, remove coarse bark), Renshen (Ginseng Radix et Rhizoma), Xiong (Ligustici Chuanxiong Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata, cracked, remove peel and navel), Fangfeng (Saposhnikoviae Radix, remove forked branches), Shaoyao (Paeoniae Radix Alba), Huangqin (Scutellariae Radix, remove black heart), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, roasted, cut into small pieces, each 1 liang), Chi Fuling (Poria, remove black skin, 3 fen).
Preparation and Administration: The above eleven herbs are cut into pieces resembling hemp seeds. Each dose consists of 5 qianbi, boiled with 1.5 sheng of water and 5 slices of fresh ginger until reduced to 1 sheng. Strain and take while slightly warm. Cover with blankets to induce sweating for cure.
Manjingzi Wan (Vitex Fruit Pill): Indicated for Pi Bi with numbness and insensitivity.
Ingredients: Manjingzi (Viticis Fructus, remove floating skin, 3 fen), Fangfeng (Saposhnikoviae Radix, remove forked branches), Qianghuo (Notopterygii Rhizoma et Radix, remove rhizome head), Jiegeng (Platycodonis Radix, roasted), Baifuzi (Typhonii Rhizoma, prepared), Zhiqiao (Aurantii Fructus, remove pulp, bran-roasted), Jilizi (Tribuli Fructus, roasted, remove spines, each 0.5 liang), Zaojiao (Gleditsiae Fructus, half jin of non-borer quality, soak in fresh water overnight, knead until soft, filter through silk cloth to remove dregs, add a little flour, boil into a paste).
Preparation and Administration: The above eight herbs: grind seven herbs into powder. Mix with the paste and pound evenly. Shape into pills the size of paulownia seeds. Take 20 pills per dose after meals with warm water.
Tianma Wan (Gastrodia Pill): Indicated for skin Bi.
Ingredients: Tianma (Gastrodiae Rhizoma, soaked in wine, sliced, dried, 3 liang), Xuanshen (Scrophulariae Radix), Moyao (Myrrha, ground), Diyü (Sanguisorbae Radix), Wutou (Aconiti Radix, cracked, remove peel and navel, each 1 liang), Shexiang (Moschus, ground, 1 fen).
Preparation and Administration: The above six herbs: grind four herbs into powder. Mix evenly with the two ground herbs. Combine with refined honey and shape into pills the size of paulownia seeds. Take 20 pills per dose before meals on an empty stomach with warm wine.