论曰∶风寒湿三气杂至,合而为痹。以秋遇此者为皮痹,皮痹不已,复感于邪,内舍于
肺,是为肺痹。其候胸背痛甚,上气、烦满、喘而呕是也。
治肺痹上下痞塞,不能息。橘皮丸方。
陈橘皮(汤浸,去白,焙) 桔梗(锉,炒) 干姜(炮裂) 浓朴(去粗皮,生姜汁
炙) 枳
实(去瓤,麸炒) 细辛(去苗叶各三分) 胡椒 蜀椒(去闭口及目,炒出汗) 乌头(炮
裂,
去皮尖各二两) 荜茇(二两半) 人参 桂(去粗皮) 附子(炮裂,去皮脐) 白茯苓
(去
黑皮) 前胡(去芦头) 防葵 芎 (各一两) 甘草(炙) 当归(切,焙各二两) 白
术吴
茱萸(汤洗,焙干,炒各一两半) 大黄(湿纸裹,煨香熟半两) 槟榔(锉一两) 葶苈
(隔纸
炒一分) 紫苏子(炒二两)
上二十五味,捣罗为末,炼蜜丸梧桐子大。每服十丸,温酒下,日三。觉有热者,空腹
服之。
治肺痹复感风冷,胸胁满急。杏仁丸方。
杏仁(汤浸,去皮尖、双仁,微炒) 赤茯苓(去黑皮) 防葵(各二两) 吴茱萸(汤
洗,
焙干,炒) 陈橘皮(汤浸,去白,焙) 桂(去粗皮) 防风(去叉) 泽泻(各一两) 白
术射
干
上一十四味,捣罗为末,炼蜜丸如梧桐子大。每服十丸,食前温酒下,渐加至三十丸,
日再。
治肺痹上气闭塞,胸中胁下支满,乍作乍止。不得饮食,唇干口燥,手足冷痛。当归汤
方。
当归(切,焙) 防风(去叉) 黄 (细锉各二两) 柴胡(去苗八两) 细辛(去
苗叶) 麻
黄(去根节,煮一二沸,掠去沫,控干) 人参(各一两) 杏仁(去皮尖、双仁,炒黄五
十
枚)
上一十一味,粗捣筛。每服四钱匕,水一盏,入生姜七片,枣二枚劈破,同煎至六分
,去滓温服,不计时候,日三夜二。
治肺痹上气发咳。五味子汤方。
五味子(三两) 紫苏子(炒八两) 麻黄(去根节) 细辛(去苗叶) 紫菀(去苗
土) 黄
芩(去黑心) 甘草(炙各二两) 人参 桂(去粗皮) 当归(焙各一两) 半夏(汤洗
去滑七遍
三
上一十一味,粗捣筛。每服四钱匕,水一盏,入生姜五片,同煎至六分,去滓温服,不
计时候。上气病亦单煮紫苏子及生紫苏叶,冬月煮干枝茎叶服。
治肺痹胸心满塞,上气不下。紫苏子汤方。
紫苏子(炒八两) 半夏(汤洗去滑七遍五两) 陈橘皮(汤浸,去白,焙) 桂(去
粗皮各
三两) 甘草(炙) 人参 白术(各二两)
上七味,粗捣筛。每服四钱匕,水一盏,入生姜五片,枣(二枚劈),同煎至六分,去
滓
论述说:风、寒、湿三种邪气混杂侵袭人体,合而致成痹证。在秋季遭遇这些邪气而成的称为皮痹,皮痹如果不愈,再次感受邪气,病邪内传并停留于肺,这就称为肺痹。其症状表现为胸部和背部剧烈疼痛,气息上逆、胸中烦闷胀满、气喘且伴有呕吐。
治疗肺痹导致的气机上下痞塞不通,呼吸困难的橘皮丸方。
陈橘皮(用汤浸泡,去掉白色内瓤,焙干) 桔梗(切碎,炒制) 干姜(炮制至裂开) 浓朴(去掉粗糙外皮,用生姜汁炙烤) 枳实(去掉瓤,用麦麸炒) 细辛(去掉根茎和叶片,各三分) 胡椒 蜀椒(去掉闭合的口及籽目,炒至出汗) 乌头(炮制至裂开,去掉外皮和尖端,各二两) 荜茇(二两半) 人参 桂枝(去掉粗皮) 附子(炮制至裂开,去掉外皮和脐部) 白茯苓(去掉黑色外皮) 前胡(去掉芦头) 防葵 川芎(各一两) 甘草(炙制) 当归(切片,焙干,各二两) 白术 吴茱萸(用汤清洗,焙干,炒制,各一两半) 大黄(用湿纸包裹,煨至香熟,半两) 槟榔(切碎,一两) 葶苈子(隔纸炒,一分) 紫苏子(炒制,二两)
以上二十五味药,捣碎过筛成为粉末,用炼蜜制成如梧桐子大小的丸剂。每次服用十丸,用温酒送服,每日三次。如果感觉体内有热,则空腹服用。
治疗肺痹再次感受风寒,胸胁部胀满急迫的杏仁丸方。
杏仁(用汤浸泡,去掉外皮和尖端、双仁部分,微炒) 赤茯苓(去掉黑色外皮) 防葵(各二两) 吴茱萸(用汤清洗,焙干,炒制) 陈橘皮(用汤浸泡,去掉白色内瓤,焙干) 桂枝(去掉粗皮) 防风(去掉叉状分枝) 泽泻(各一两) 白术 射干
以上十四味药,捣碎过筛成为粉末,用炼蜜制成如梧桐子大小的丸剂。每次服用十丸,饭前用温酒送服,逐渐增加剂量至三十丸,每日两次。
治疗肺痹导致的气息上逆闭塞,胸中及胁下支撑胀满,时作时止。不能进食,嘴唇干燥,口舌燥渴,手足寒冷疼痛的当归汤方。
当归(切片,焙干) 防风(去掉叉状分枝) 黄芪(切碎,各二两) 柴胡(去掉根苗,八两) 细辛(去掉根苗和叶片) 麻黄(去掉根节,煮一二沸,撇去浮沫,控干水分) 人参(各一两) 杏仁(去掉外皮、尖端和双仁,炒至黄色,五十枚)
以上十一味药,粗捣后筛选。每次服用四钱匕,用水一盏,加入生姜七片,大枣二枚劈破,一同煎煮至六分,滤去药渣,温服,不限时候,每日三次,夜间两次。
治疗肺痹气息上逆引发咳嗽的五味子汤方。
五味子(三两) 紫苏子(炒制,八两) 麻黄(去掉根节) 细辛(去掉根苗和叶片) 紫菀(去掉根苗和泥土) 黄芩(去掉黑色中心) 甘草(炙制,各二两) 人参 桂枝(去掉粗皮) 当归(焙干,各一两) 半夏(用汤清洗,去除滑腻感七遍)
以上十一味药,粗捣后筛选。每次服用四钱匕,用水一盏,加入生姜五片,一同煎煮至六分,滤去药渣,温服,不限时候。治疗气息上逆的病证也可以单煮紫苏子以及新鲜紫苏叶,冬季则煮干枝、茎、叶服用。
治疗肺痹胸心部胀满堵塞,气息上逆不能下降的紫苏子汤方。
紫苏子(炒制,八两) 半夏(用汤清洗,去除滑腻感七遍,五两) 陈橘皮(用汤浸泡,去掉白色内瓤,焙干) 桂枝(去掉粗皮,各三两) 甘草(炙制) 人参 白术(各二两)
以上七味药,粗捣后筛选。每次服用四钱匕,用水一盏,加入生姜五片,大枣二枚劈破,一同煎煮至六分,滤去药渣
Commentary states: The three pathogenic factors of wind, cold, and dampness mix and invade together, combining to form Bi syndrome (obstruction syndrome). When encountered in autumn, it is called Pi Bi (Skin Bi); if Pi Bi persists and is re-exposed to pathogens, the evil qi moves inward and resides in the Lung, which is termed Fei Bi (Lung Bi). Its manifestations include severe pain in the chest and back, upward reversal of Qi, vexation and fullness, wheezing, and vomiting.
Ju Pi Wan Formula for treating Fei Bi characterized by upper and lower obstruction of Qi, inability to breathe.
Chen Ju Pi (Tangerine Peel, Citri Reticulatae Pericarpium, soaked in decoction, white pith removed, dried) Jie Geng (Platycodon Root, Platycodi Radix, chopped, stir-fried) Gan Jiang (Dried Ginger, Zingiberis Rhizoma, processed until cracked) Hou Po (Magnolia Bark, Magnoliae Officinalis Cortex, rough skin removed, stir-baked with fresh ginger juice) Zhi Shi (Immature Bitter Orange, Aurantii Fructus Immaturus, pulp removed, bran-fried) Xi Xin (Asarum Root, Asari Radix et Rhizoma, roots and leaves removed, 3 fen each) Hu Jiao (Pepper, Piperis Nigris Fructus) Shu Jiao (Sichuan Pepper, Zanthoxyli Pericarpium, closed mouths and eyes removed, stir-fried until sweat appears) Wu Tou (Aconite Root, Aconiti Radix, processed until cracked, skin and tip removed, 2 liang each) Bi Bo (Long Pepper Fruit, Piperis Longi Fructus, 2.5 liang) Ren Shen (Ginseng Root, Ginseng Radix et Rhizoma) Gui Zhi (Cinnamon Twig, Cinnamomi Ramulus, coarse bark removed) Fu Zi (Prepared Aconite Root, Aconiti Lateralis Radix Praeparata, processed until cracked, skin and navel removed) Bai Fu Ling (Poria, Poria, black skin removed) Qian Hu (Peucedani Radix, Peucedani Radix, rhizome removed) Fang Kui (Angelicae Dahuricae Radix? Note: Historical text ambiguity, usually refers to a specific root) Chuan Xiong (Szechwan Lovage Rhizome, Chuanxiong Rhizoma, 1 liang each) Gan Cao (Licorice Root, Glycyrrhizae Radix et Rhizoma, honey-fried) Dang Gui (Chinese Angelica Root, Angelicae Sinensis Radix, sliced, dried, 2 liang each) Bai Zhu (Atractylodes Rhizome, Atractylodis Macrocephalae Rhizoma) Wu Zhu Yu (Evodia Fruit, Evodiae Fructus, washed with decoction, dried, stir-fried, 1.5 liang each) Da Huang (Rhubarb Root, Rhe palmati Radix et Rhizoma, wrapped in wet paper, baked until fragrant and ripe, 0.5 liang) Bing Lang (Areca Seed, Arecae Semen, chopped, 1 liang) Ting Li Zi (Periploca Seed, Perillae Semen, stir-fried between papers, 1 fen) Zi Su Zi (Perilla Fruit, Perillae Fructus, stir-fried, 2 liang)
The above twenty-five ingredients are crushed, sieved into powder, and made into pills with refined honey, sized like paulownia seeds. Take ten pills per dose, swallowed with warm wine, three times daily. If heat sensation is felt, take on an empty stomach.
Xing Ren Wan Formula for treating Fei Bi re-infected with wind-cold, characterized by fullness and urgency in the chest and hypochondrium.
Xing Ren (Apricot Seed, Armeniacae Semen, soaked in decoction, skin and tip/double kernels removed, lightly stir-fried) Chi Fu Ling (Red Poria, Poria with Red Skin, black skin removed) Fang Kui (1 liang each) Wu Zhu Yu (washed with decoction, dried, stir-fried) Chen Ju Pi (soaked in decoction, white pith removed, dried) Gui Zhi (coarse bark removed) Fang Feng (Saposhnikovia Root, Saposhnikoviae Radix, forked branches removed) Ze Xie (Alisma Rhizome, Alismatis Rhizoma, 1 liang each) Bai Zhu She Gan (Belamcanda Rhizome, Belamcandae Rhizoma)
The above fourteen ingredients are crushed, sieved into powder, and made into pills with refined honey, sized like paulownia seeds. Take ten pills per dose before meals, swallowed with warm wine; gradually increase dosage to thirty pills, twice daily.
Dang Gui Tang Formula for treating Fei Bi with upward reversal of Qi causing obstruction, support-like fullness in the chest and below the hypochondrium, intermittent onset and cessation. Inability to eat, dry lips, dry mouth, cold and painful hands and feet.
Dang Gui (sliced, dried) Fang Feng (forked branches removed) Huang Qi (Astragalus Root, Astragali Radix, finely chopped, 2 liang each) Chai Hu (Bupleuri Radix, Bupleuri Radix, seedlings removed, 8 liang) Xi Xin (roots and leaves removed) Ma Huang (Ephedra Herb, Ephedrae Herba, roots and joints removed, boiled for one or two boils, foam skimmed off, drained) Ren Shen (1 liang each) Xing Ren (skin, tips, and double kernels removed, stir-fried until yellow, 50 seeds)
The above eleven ingredients are coarsely crushed and sifted. Take four qian bi (measurements) per dose, add one zhan of water, seven slices of fresh ginger, and two split jujubes. Decoct until reduced to six parts, remove dregs, and take warm at any time, three times daily and twice at night.
Wu Wei Zi Tang Formula for treating Fei Bi with upward reversal of Qi inducing cough.
Wu Wei Zi (Schisandra Fruit, Schisandrae Chinensis Fructus, 3 liang) Zi Su Zi (stir-fried, 8 liang) Ma Huang (roots and joints removed) Xi Xin (roots and leaves removed) Zi Wan (Aster Root, Asteris Radix, roots and soil removed) Huang Qin (Scutellaria Root, Scutellariae Radix, black heart removed) Gan Cao (honey-fried, 2 liang each) Ren Shen Gui Zhi (coarse bark removed) Dang Gui (dried, 1 liang each) Ban Xia (Pinellia Tuber, Pinelliae Rhizoma, washed with decoction to remove slipperiness seven times)
The above eleven ingredients are coarsely crushed and sifted. Take four qian bi per dose, add one zhan of water and five slices of fresh ginger. Decoct until reduced to six parts, remove dregs, and take warm at any time. For diseases of upward reversal of Qi, Zi Su Zi and fresh Zi Su Ye (Perilla Leaf, Perillae Folium) can be boiled alone; in winter, dried stems, branches, and leaves are boiled for consumption.
Zi Su Zi Tang Formula for treating Fei Bi with fullness and blockage in the chest and heart, upward reversal of Qi that cannot descend.
Zi Su Zi (stir-fried, 8 liang) Ban Xia (washed with decoction to remove slipperiness seven times, 5 liang) Chen Ju Pi (soaked in decoction, white pith removed, dried) Gui Zhi (coarse bark removed, 3 liang each) Gan Cao (honey-fried) Ren Shen Bai Zhu (2 liang each)
The above seven ingredients are coarsely crushed and sifted. Take four qian bi per dose, add one zhan of water, five slices of fresh ginger, and two split jujubes. Decoct until reduced to six parts, remove dregs