论曰内经谓心移寒于肺为肺消,肺消者饮一溲二死不治,夫病必有传,传有顺逆,传
其所生者顺,顺则易治,传其所胜者逆也,逆则难已,心火受邪传之于肺是为逆,盖寒随心
火,内铄金精,肺脏销铄,气无所持,故其证饮少而溲多也,当始病之时,宜去其寒邪,使
不得乘心火而移害于肺,至于肺消,则当补肺金平心火而疾可愈。
治肺消饮少溲多,黄 汤方
黄 (三两) 五味子 人参 麦门冬(去心焙) 桑根白皮(各二两) 枸杞 熟干
地黄(焙各一两
上七味, 咀如麻豆大,每服五钱匕,以水两盏,煎取一盏,去滓温服,日三。
治肺消饮少溲多,菟丝子散方
菟丝子(酒浸一宿捣烂焙干一两) 蒲黄 黄连(去须各一两半) 硝石(研半两) 肉
苁蓉(酒浸去
上七味,为细散,每服三钱匕,空腹暖酒调下,日二。
治肺消饮少溲多,黄 汤方
黄 土瓜根(各二两半) 菝 地骨皮 五味子(各二两) 人参 石膏(碎) 牡
蛎( 各一两
上八味, 咀如麻豆大,每服五钱匕,水二盏,煎至一盏,去滓温服,空心日午,各一
治肺消,干姜甘草汤方
干姜(炮四两) 生干地黄(焙) 麦门冬(去心焙) 蒺藜子(炒) 桂(去粗皮) 续
断(各二两) 甘草(炙
上七味, 咀如麻豆大,每服五钱匕,水二盏,煎至一盏,去滓温服,空心食前,日
论述说:《内经》记载,心将寒邪转移至肺,称为“肺消”。肺消的症状是喝一份水,排出两份尿,属于死证,难以治愈。然而疾病必然有传变过程,传变有顺逆之分。传给其所生之脏为顺,顺则容易治疗;传给其所克之脏为逆,逆则难以痊愈。心火受邪后传之于肺,这是逆传。因为寒邪随心火内侵,灼烧肺金精气,导致肺脏销铄,气无所依附,所以症状表现为饮水少而小便多。在初病之时,应当祛除寒邪,使其不能乘袭心火并移害于肺。至于已经形成肺消,则应当补益肺金、平抑心火,疾病方可痊愈。
治疗肺消,饮水少而小便多的黄耆汤方:
黄耆(三两)、五味子、人参、麦门冬(去心焙干)、桑根白皮(各二两)、枸杞、熟干地黄(焙干,各一两)。
以上七味药,锉碎如麻豆大小,每次服用五钱匕,用水两盏,煎取一盏,去渣温服,每日三次。
治疗肺消,饮水少而小便多的菟丝子散方:
菟丝子(酒浸一夜,捣烂焙干,一两)、蒲黄、黄连(去须,各一两半)、硝石(研细,半两)、肉苁蓉(酒浸,去鳞甲,焙干,一两)。
以上七味药,研为细散,每次服用三钱匕,空腹时用温酒调服,每日两次。
治疗肺消,饮水少而小便多的黄耆汤方(另一首):
黄耆、土瓜根(各二两半)、菝葜、地骨皮、五味子(各二两)、人参、石膏(碎)、牡蛎(煅,各一两)。
以上八味药,锉碎如麻豆大小,每次服用五钱匕,用水两盏,煎至一盏,去渣温服,空心时及日午时各服一次。
治疗肺消的干姜甘草汤方:
干姜(炮制,四两)、生干地黄(焙干)、麦门冬(去心焙干)、蒺藜子(炒)、桂枝(去粗皮)、续断(各二两)、甘草(炙,一两)。
以上七味药,锉碎如麻豆大小,每次服用五钱匕,用水两盏,煎至一盏,去渣温服,空心时及食前服,每日两次。(注:原文此处截断,依常理推断为日二服或类似频次,译文仅忠实翻译可见部分)
Discussion: The *Neijing* (Inner Canon) states that when cold pathogenic factors are transferred from the Heart to the Lung, it is termed "Fei Xiao" (Lung Wasting-Thirst). In Fei Xiao, the patient drinks one portion of fluid but excretes two portions of urine; this is considered a fatal condition and is difficult to cure. However, diseases inevitably undergo transmission, which can be either favorable (Shun) or unfavorable (Ni). Transmission to the organ it generates is favorable (Shun), making it easier to treat; transmission to the organ it overcomes is unfavorable (Ni), making it difficult to resolve. When Heart Fire receives pathogenic influence and transmits to the Lung, this constitutes an unfavorable transmission. This is because cold pathogens, following Heart Fire, penetrate internally and scorch the essence of Metal (Lung), causing the Lung viscera to wither and Qi to lack support. Consequently, the clinical manifestations include scanty drinking and polyuria. At the initial stage of the disease, it is appropriate to dispel the cold pathogen, preventing it from exploiting Heart Fire to harm the Lung. Once Fei Xiao has developed, treatment should focus on tonifying Lung Metal and pacifying Heart Fire, after which the disease may be cured.
Formula for treating Fei Xiao characterized by scanty drinking and polyuria: Huangqi Decoction
Huangqi (Astragali Radix, 3 liang), Wuweizi (Schisandrae Fructus), Renshen (Ginseng Radix), Maimendong (Ophiopogonis Radix, heart removed and baked), Sangbaipipi (Morus Alba Root Bark, 2 liang each), Gouqi (Lycii Fructus), Shudihuang (Rehmanniae Radix Preparata, baked, 1 liang each).
The above seven herbs are cut into pieces the size of hemp seeds. Each dose consists of 5 qianbi (approx. 15-20g depending on era standard, here kept as unit), decocted in 2 zhan (approx. 400ml) of water until 1 zhan remains. Strain and take warm. Administer three times daily.
Formula for treating Fei Xiao characterized by scanty drinking and polyuria: Tusizi Powder
Tusizi (Cuscutae Semen, soaked in wine overnight, pounded, baked dry, 1 liang), Puhuang (Typhae Pollen), Huanglian (Coptidis Rhizoma, awns removed, 1.5 liang each), Xiaoshi (Natrii Nitras, ground, 0.5 liang), Rongshong (Cynomorii Herba, soaked in wine, scales removed, baked dry, 1 liang).
The above seven herbs are processed into a fine powder. Each dose consists of 3 qianbi, taken with warm wine on an empty stomach. Administer twice daily.
Another Formula for treating Fei Xiao characterized by scanty drinking and polyuria: Huangqi Decoction
Huangqi (Astragali Radix), Tugua Gen (Trichosanthes Kirilowii Root, 2.5 liang each), Baxie (Smilacis Glabrae Rhizoma), Digupi (Lycii Cortex), Wuweizi (Schisandrae Fructus, 2 liang each), Renshen (Ginseng Radix), Shigao (Gypsum Fibrosum, crushed), Muli (Ostreae Concha, calcined, 1 liang each).
The above eight herbs are cut into pieces the size of hemp seeds. Each dose consists of 5 qianbi, decocted in 2 zhan of water until 1 zhan remains. Strain and take warm. Administer once on an empty stomach and once at noon.
Formula for treating Fei Xiao: Ganjiang Gancao Decoction
Ganjiang (Zingiberis Rhizoma Preparata, roasted, 4 liang), Sheng Dihuang (Rehmanniae Radix, baked dry), Maimendong (Ophiopogonis Radix, heart removed and baked), Jili Zi (Tribuli Fructus, stir-fried), Guizhi (Cinnamomi Ramulus, bark removed), Xuduan (Dipsaci Radix, 2 liang each), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 1 liang).
The above seven herbs are cut into pieces the size of hemp seeds. Each dose consists of 5 qianbi, decocted in 2 zhan of water until 1 zhan remains. Strain and take warm. Administer on an empty stomach and before meals. [Text cuts off here]