论曰∶血痹之状,形体肌肤,如被微风所吹者是也。盖血为阴,邪入于血而痹,故谓之
血痹。宜先针引阳气,后以药治之。
治血痹。去邪益心,悦颜色,壮筋力。干地黄丸方。
生干地黄(焙二两半) 五味子 桂(去粗皮) 秦艽(去苗土) 独活(去芦头) 附
子(炮
裂,去皮脐) 石斛(去根各一两半) 远志(去心一两) 肉苁蓉(酒浸,切,焙) 萆
(炒)
仁(去皮尖、双
仁,炒各一两半) 诃梨勒皮 槟榔(各三两半锉)
上一十七味,捣罗为末,炼蜜和丸,如梧桐子大。每日空心食前温酒下二十丸。
治风血痹,皮肤不仁。防风汤方。
防风(去叉二两) 甘草(炙,锉半两) 独活(去芦头三分) 当归(切,焙) 赤
茯苓(去
黑皮) 秦艽(去苗土各一两) 茵芋(去粗茎半两) 桂(去粗皮三分) 杏仁(汤浸去
皮尖、双
仁,麸炒半两)
上九味,粗捣筛。每服四钱匕,水酒各七分,入生姜五片,煎至八分,去滓温服,不计
时候。
治血痹手足 麻不仁,游走无定。萆 丸方。
萆 (炒) 山芋 牛膝(酒浸,切,焙各一两) 白术(半两) 泽泻(一两) 地
肤子
(炒半两) 干漆(炒令烟出) 蛴螬(生研) 天雄(炮裂,去皮脐各三分) 熟干地黄
(焙一两)
狗脊(
上一十四味,除蛴螬研入外,捣罗为末,和令匀,炼蜜和丸,如梧桐子大。空心食前温
酒下十丸至十五丸,日二夜一。
治风血痹,身体不仁肉冷。芍药汤方。
赤芍药 侧子(炮裂,去皮脐) 桂(去粗皮) 麻黄(去根节) 萆 (炒) 当归
(切,焙)
上九味,锉如麻豆。每服三钱匕,水一盏,入生姜五片,同煎至六分,去滓温服,不计
时候。
治风血痹,阴阳俱微,寸口关上微,或尺中小紧。其状身体不仁,如贼风所中。黄 汤
方。
黄 (锉) 芍药(各一两) 桂(去粗皮三分)
上三味,粗捣筛。每服五钱匕,以水一盏半,枣二枚(劈破),生姜一枣大(拍碎),同
煎
至八分。去滓温服,早晨、午间、近晚各一服。
治血痹及诸痹甚者,四肢不随。黄 酒方。
黄 独活(去芦头) 防风(去叉) 甘草(炙) 蜀椒(去目并闭口者,炒出汗) 附
子(
炮裂,去皮脐) 白术 牛膝 芎 细辛(去苗叶各三两) 干姜(炮三两半) 当归(切,
焙
)桂(去粗皮各二两半) 葛根 秦艽(去苗土) 乌头(炮裂,去皮脐) 山茱萸(各
二两) 大
黄(一两生,锉)
上一十八味,锉如麻豆,用夹绢囊盛贮,以清酒一斗浸之,春夏五日,秋冬七日。初服
一合,日再夜一,渐增之,以知为度。虚弱者,加苁蓉二两;下利者,加女萎三两;心下有
水,加茯苓二两。一方加石斛、菖蒲各二两。
治血痹及五脏、六腑、皮肤、骨髓、肌肉、筋脉等疾,不问新久。萆 酒方。
萆 防风(去叉) 菟丝子 杜仲(去粗皮,锉,炒) 黄 菊花 天雄(炮裂,
去皮
脐) 石斛(去根) 生干地黄(焙) 地骨皮 续断 金牙( ,醋淬) 石南 肉苁蓉
(酒浸,
切,焙) 蜀椒(去目及闭口者,炒出汗各一两)
上一十五味, 咀如麻豆,夹绢囊盛贮,以无灰酒五升浸二七日。每日任性服。候减一
升,即旋添酒一升,药力薄即别制,年老者亦可服。
治风血痹,肌体手足痿弱,四肢拘挛。茵芋酒方。
茵芋(去粗茎) 附子(炮裂,去皮脐) 天雄(炮裂,去皮脐) 乌头(炮裂,去皮
脐) 秦
艽(去苗土) 女萎 防风(去叉) 羊踯躅 防己 石南 细辛(去苗叶) 桂(去粗皮
各一
两
上一十二味, 咀如麻豆,夹绢囊盛贮,以清酒五升浸之,冬七日,夏三日,春秋五日
。初服一合,日三,渐增之。
治风邪游走无定处,名曰血痹。萆 丸方。
萆 (锉,炒令黄) 山芋 牛膝(切,焙) 泽泻(各一两) 白术(三分) 地肤
子(半
两) 山茱萸(炒一两一分) 狗脊(细锉,去毛三分) 茵芋(用叶,炙过一分) 熟干
地黄(焙
二两半)
上一十味,捣罗为末,炼蜜和丸,如梧桐子大。每服十丸,温酒下,不拘时,稍加至十
五丸。
论述说:血痹的症状,是形体肌肤感觉像被微风吹拂一样。因为血属阴,邪气侵入血脉导致痹阻,所以称为血痹。治疗应当先通过针刺引导阳气,然后再用药物进行治疗。
治疗血痹。祛除邪气,补益心脏,使面色悦泽,增强筋力。干地黄丸方。
生干地黄(焙干二两半) 五味子 桂枝(去除粗皮) 秦艽(去除苗和泥土) 独活(去除芦头) 附子(炮制裂开,去除皮和脐) 石斛(去除根,各一两半) 远志(去除心,一两) 肉苁蓉(酒浸,切片,焙干) 萆薢(炒) 杏仁(去皮尖、双仁,炒,各一两半) 诃梨勒皮 槟榔(各三两半,锉碎)
以上十七味药,捣碎过筛成粉末,用炼蜜调和制成丸药,大小如梧桐子。每天空腹、饭前用温酒送服二十丸。
治疗风血痹,皮肤麻木不仁。防风汤方。
防风(去除叉枝,二两) 甘草(炙,锉碎,半两) 独活(去除芦头,三分) 当归(切片,焙干) 赤茯苓(去除黑皮) 秦艽(去除苗土,各一两) 茵芋(去除粗茎,半两) 桂枝(去除粗皮,三分) 杏仁(热水浸,去皮尖、双仁,麸炒,半两)
以上九味药,粗捣筛过。每次服用四钱匕,用水七分、酒三分,加入生姜五片,煎至八分满,去渣温服,不限时候。
治疗血痹手足麻木不仁,游走不定。萆薢丸方。
萆薢(炒) 山芋 牛膝(酒浸,切片,焙干,各一两) 白术(半两) 泽泻(一两) 地肤子(炒,半两) 干漆(炒至烟出) 蛴螬(生研) 天雄(炮制裂开,去除皮和脐,各三分) 熟干地黄(焙干,一两) 狗脊(未列明剂量,依上下文推测为常规用量或漏字,此处仅译原文结构)
以上十四味药,除蛴螬单独研入外,其余捣碎过筛成粉末,混合均匀,用炼蜜调和制成丸药,大小如梧桐子。空腹、饭前用温酒送服十丸至十五丸,每日两次,夜间一次。
治疗风血痹,身体麻木不仁,肌肉发冷。芍药汤方。
赤芍药 侧子(炮制裂开,去除皮和脐) 桂枝(去除粗皮) 麻黄(去除根节) 萆薢(炒) 当归(切片,焙干)
以上九味药,锉碎如麻豆大小。每次服用三钱匕,用水一盏,加入生姜五片,同煎至六分满,去渣温服,不限时候。
治疗风血痹,阴阳脉象俱微弱,寸口脉和关脉微弱,或者尺中脉稍紧。症状表现为身体麻木不仁,像被贼风击中一样。黄芪汤方。
黄芪(锉碎) 芍药(各一两) 桂枝(去除粗皮,三分)
以上三味药,粗捣筛过。每次服用五钱匕,用水一盏半,大枣二枚(劈破),生姜一块枣大(拍碎),同煎至八分满。去渣温服,早晨、午间、傍晚各服一次。
治疗血痹及严重的各种痹证,四肢不能随意运动。黄芪酒方。
黄芪 独活(去除芦头) 防风(去除叉枝) 甘草(炙) 蜀椒(去除目并闭口者,炒出汗) 附子(炮制裂开,去除皮和脐) 白术 牛膝 川芎 细辛(去除苗叶,各三两) 干姜(炮制,三两半) 当归(切片,焙干) 桂枝(去除粗皮,各二两半) 葛根 秦艽(去除苗土) 乌头(炮制裂开,去除皮和脐) 山茱萸(各二两) 大黄(一两,生用,锉碎)
以上十八味药,锉碎如麻豆大小,用夹绢袋盛装,用清酒一斗浸泡,春夏五天,秋冬七天。初次服用一合,白天两次,夜间一次,逐渐增加剂量,以见效为度。体虚者,加肉苁蓉二两;腹泻者,加女萎三两;心下有停水者,加茯苓二两。另一方案加石斛、石菖蒲各二两。
治疗血痹及五脏、六腑、皮肤、骨髓、肌肉、筋脉等疾患,不论新久。萆薢酒方。
萆薢 防风(去除叉枝) 菟丝子 杜仲(去除粗皮,锉碎,炒) 黄芪 菊花 天雄(炮制裂开,去除皮和脐) 石斛(去除根) 生干地黄(焙干) 地骨皮 续断 金牙(煅,醋淬) 石南 肉苁蓉(酒浸,切片,焙干) 蜀椒(去除目及闭口者,炒出汗,各一两)
以上十五味药,锉碎如麻豆大小,用夹绢袋盛装,用无灰酒五升浸泡两个七日。每天随意服用。等到药液减少一升,就随即添加酒一升,药力变薄时就重新制作,年老的人也可以服用。
治疗风血痹,肌体和手足痿软无力,四肢拘挛。茵芋酒方。
茵芋(去除粗茎) 附子(炮制裂开,去除皮和脐) 天雄(炮制裂开,去除皮和脐) 乌头(炮制裂开,去除皮和脐) 秦艽(去除苗土) 女萎 防风(去除叉枝) 羊踯躅 防己 石南 细辛(去除苗叶) 桂枝(去除粗皮,各一两)
以上十二味药,锉碎如麻豆大小,用夹绢袋盛装,用清酒五升浸泡,冬季七天,夏季三天,春秋五天。初次服用一合,每日三次,逐渐增加剂量。
治疗风邪游走无定处,名为血痹。萆薢丸方。
萆薢(锉碎,炒至黄色) 山芋 牛膝(切片,焙干) 泽泻(各一两) 白术(三分) 地肤子(半两) 山茱萸(炒,一两一分) 狗脊(细锉,去毛,三分) 茵芋(用叶,炙过,一分) 熟干地黄(焙干,二两半)
以上十味药,捣碎过筛成粉末,用炼蜜调和制成丸药,大小如梧桐子。每次服用十丸,用温酒送服,不限时候,可稍加至十五丸。
Discussion: The manifestation of Blood Bi (Blood Obstruction) is characterized by the body and skin feeling as if blown by a gentle breeze. Since Blood belongs to Yin, when pathogenic factors enter the Blood causing obstruction, it is termed Blood Bi. Treatment should first involve acupuncture to guide Yang Qi, followed by herbal medication.
For treating Blood Bi. To eliminate pathogens, benefit the Heart, enhance complexion, and strengthen tendons and muscles. Gan Di Huang Wan (Rehmannia Pill) Formula:
Sheng Gan Di Huang (Raw Dried Rehmanniae Radix, roasted, 2 liang 5 qian), Wu Wei Zi (Schisandrae Fructus), Gui Zhi (Cinnamomi Ramulus, remove coarse bark), Qin Jiao (Gentianae Macrophyllae Radix, remove seedlings and soil), Du Huo (Angelicae Pubescentis Radix, remove rhizome head), Fu Zi (Aconiti Lateralis Radix Praeparata, roasted until cracked, remove skin and navel), Shi Hu (Dendrobii Caulis, remove roots, each 1 liang 5 qian), Yuan Zhi (Polygalae Radix, remove heart, 1 liang), Rou Cong Rong (Cistanches Herba, soaked in wine, sliced, roasted), Bi Xie (Dioscoreae Hypoglaucae Rhizoma, stir-fried), Xing Ren (Armeniacae Semen, remove skin and tips, twin kernels removed, stir-fried, each 1 liang 5 qian), He Li Le Pi (Terminaliae Chebulae Pericarpium), Bing Lang (Arecae Semen, each 3 liang 5 qian, crushed).
The above seventeen ingredients are pounded and sifted into powder. Mix with refined honey to form pills the size of Sophora japonica seeds. Take twenty pills orally with warm wine before meals on an empty stomach daily.
For treating Wind-Blood Bi with skin numbness and insensitivity. Fang Feng Tang (Saposhnikoviae Decoction) Formula:
Fang Feng (Saposhnikoviae Radix, remove forked branches, 2 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, crushed, half liang), Du Huo (Angelicae Pubescentis Radix, remove rhizome head, 3 fen), Dang Gui (Angelicae Sinensis Radix, sliced, roasted), Chi Fu Ling (Poria cum Risus, remove black skin), Qin Jiao (Gentianae Macrophyllae Radix, remove seedlings and soil, each 1 liang), Yin Yu (Skimmiae Japonicae Cortex, remove coarse stems, half liang), Gui Zhi (Cinnamomi Ramulus, remove coarse bark, 3 fen), Xing Ren (Armeniacae Semen, soaked in hot water, remove skin and tips, twin kernels removed, bran-fried, half liang).
The above nine ingredients are coarsely pounded and sieved. Each dose consists of four qian bi (spoonfuls), decocted with seven parts water and three parts wine, adding five slices of Sheng Jiang (Zingiberis Rhizoma Recens). Simmer until eight parts remain, strain, and take warm at any time.
For treating Blood Bi with numbness and insensitivity in hands and feet, wandering without fixed location. Bi Xie Wan (Dioscoreae Hypoglaucae Rhizoma Pill) Formula:
Bi Xie (Dioscoreae Hypoglaucae Rhizoma, stir-fried), Shan Yu (Dioscoreae Rhizoma), Niu Xi (Achyranthis Bidentatae Radix, soaked in wine, sliced, roasted, each 1 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma, half liang), Ze Xie (Alismatis Rhizoma, 1 liang), Di Fu Zi (Kochiae Fructus, stir-fried, half liang), Gan Qi (Drymarchon corneum, stir-fried until smoke emerges), Qi Cao (Silphae Larva, ground raw), Tian Xiong (Aconiti Kusnezoffii Radix Praeparata, roasted until cracked, remove skin and navel, each 3 fen), Shu Gan Di Huang (Prepared Dried Rehmanniae Radix, roasted, 1 liang), Gou Ji (Rhizoma et Radix Cibotii).
The above fourteen ingredients, except for Qi Cao which is ground separately, are pounded and sifted into powder, mixed evenly, and formed into pills with refined honey the size of Sophora japonica seeds. Take ten to fifteen pills orally with warm wine before meals on an empty stomach, twice daily and once at night.
For treating Wind-Blood Bi with body numbness, insensitivity, and cold flesh. Shao Yao Tang (Paeoniae Radix Alba Decoction) Formula:
Chi Shao Yao (Paeoniae Radix Rubra), Ce Zi (Aconiti Radix lateralis preparata, roasted until cracked, remove skin and navel), Gui Zhi (Cinnamomi Ramulus, remove coarse bark), Ma Huang (Ephedrae Herba, remove root nodes), Bi Xie (Dioscoreae Hypoglaucae Rhizoma, stir-fried), Dang Gui (Angelicae Sinensis Radix, sliced, roasted).
The above nine ingredients are crushed like hemp seeds. Each dose is three qian bi, decocted with one cup of water and five slices of Sheng Jiang (Zingiberis Rhizoma Recens). Simmer until six parts remain, strain, and take warm at any time.
For treating Wind-Blood Bi where both Yin and Yang pulses are faint, Cun Kou (radial artery at wrist) and Guan positions are faint, or Chi position is slightly tight. Symptoms include body numbness and insensitivity, as if struck by thief-wind. Huang Qi Tang (Astragali Decoction) Formula:
Huang Qi (Astragali Radix, crushed), Shao Yao (Paeoniae Radix, each 1 liang), Gui Zhi (Cinnamomi Ramulus, remove coarse bark, 3 fen).
The above three ingredients are coarsely pounded and sieved. Each dose is five qian bi, decocted with one and a half cups of water, two Zao (Jujubae Fructus, split), and one piece of Sheng Jiang (Zingiberis Rhizoma Recens, size of a jujube, smashed). Simmer until eight parts remain. Strain and take warm, once in the morning, noon, and evening.
For treating Blood Bi and severe cases of various Bi syndromes with inability to move limbs freely. Huang Qi Jiu (Astragali Infusion) Formula:
Huang Qi (Astragali Radix), Du Huo (Angelicae Pubescentis Radix, remove rhizome head), Fang Feng (Saposhnikoviae Radix, remove forked branches), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Shu Jiao (Zanthoxyli Pericarpium, remove eyes and closed ones, stir-fried to release moisture), Fu Zi (Aconiti Lateralis Radix Praeparata, roasted until cracked, remove skin and navel), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Niu Xi (Achyranthis Bidentatae Radix), Xiong Qiong (Ligustici Chuanxiong Rhizoma), Xi Xin (Asari Radix et Rhizoma, remove seedlings and leaves, each 3 liang), Gan Jiang (Zingiberis Rhizoma, roasted, 3 liang 5 qian), Dang Gui (Angelicae Sinensis Radix, sliced, roasted), Gui Zhi (Cinnamomi Ramulus, remove coarse bark, each 2 liang 5 qian), Ge Gen (Puerariae Lobatae Radix), Qin Jiao (Gentianae Macrophyllae Radix, remove seedlings and soil), Wu Tou (Aconiti Radix, roasted until cracked, remove skin and navel), Shan Zhu Yu (Corni Fructus, each 2 liang), Da Huang (Rhei Radix et Rhizoma, 1 liang, raw, crushed).
The above eighteen ingredients are crushed like hemp seeds, placed in a silk bag, and soaked in one dou of clear wine. Soak for five days in spring/summer and seven days in autumn/winter. Initial dose is one he (unit of volume), taken twice during the day and once at night, gradually increasing until effective. For those with deficiency, add Rou Cong Rong (Cistanches Herba) 2 liang; for diarrhea, add Nu Wei (Anemones Radix) 3 liang; for fluid retention in the epigastrium, add Fu Ling (Poria) 2 liang. Another prescription adds Shi Hu (Dendrobii Caulis) and Chang Pu (Acori Tatarinowii Rhizoma) each 2 liang.
For treating Blood Bi and diseases of the Five Zang Organs, Six Fu Organs, skin, bone marrow, muscles, and tendons, regardless of new or old onset. Bi Xie Jiu (Dioscoreae Hypoglaucae Rhizoma Infusion) Formula:
Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Fang Feng (Saposhnikoviae Radix, remove forked branches), Tu Si Zi (Cuscutae Semen), Du Zhong (Eucommiae Cortex, remove coarse bark, crush, stir-fry), Huang Qi (Astragali Radix), Ju Hua (Chrysanthemi Flos), Tian Xiong (Aconiti Kusnezoffii Radix Praeparata, roasted until cracked, remove skin and navel), Shi Hu (Dendrobii Caulis, remove roots), Sheng Gan Di Huang (Raw Dried Rehmanniae Radix, roasted), Di Gu Pi (Lycii Cortex), Xu Duan (Dipsaci Radix), Jin Ya (Oris Lithostoma, calcined, quenched in vinegar), Shi Nan (Rhododendri Mollis Folium), Rou Cong Rong (Cistanches Herba, soaked in wine, sliced, roasted), Shu Jiao (Zanthoxyli Pericarpium, remove eyes and closed ones, stir-fried to release moisture, each 1 liang).
The above fifteen ingredients are crushed like hemp seeds, placed in a silk bag, and soaked in five sheng of non-fermented wine for two periods of seven days. Drink freely daily. When the liquid reduces by one sheng, replenish with one sheng of wine. Prepare anew when potency diminishes; suitable for the elderly.
For treating Wind-Blood Bi with flaccid weakness of muscles and limbs, and contracture of extremities. Yin Yu Jiu (Skimmiae Japonicae Cortex Infusion) Formula:
Yin Yu (Skimmiae Japonicae Cortex, remove coarse stems), Fu Zi (Aconiti Lateralis Radix Praeparata, roasted until cracked, remove skin and navel), Tian Xiong (Aconiti Kusnezoffii Radix Praeparata, roasted until cracked, remove skin and navel), Wu Tou (Aconiti Radix, roasted until cracked, remove skin and navel), Qin Jiao (Gentianae Macrophyllae Radix, remove seedlings and soil), Nu Wei (Anemones Radix), Fang Feng (Saposhnikoviae Radix, remove forked branches), Yang Zhi Zhu (Rhododendri Mollis Flos), Fang Ji (Stephaniae Tetrandrae Radix), Shi Nan (Rhododendri Mollis Folium), Xi Xin (Asari Radix et Rhizoma, remove seedlings and leaves), Gui Zhi (Cinnamomi Ramulus, remove coarse bark, each 1 liang).
The above twelve ingredients are crushed like hemp seeds, placed in a silk bag, and soaked in five sheng of clear wine. Soak for seven days in winter, three days in summer, and five days in spring/autumn. Initial dose is one he, taken three times daily, gradually increasing.
For treating wind-pathogen wandering without fixed location, named Blood Bi. Bi Xie Wan (Dioscoreae Hypoglaucae Rhizoma Pill) Formula:
Bi Xie (Dioscoreae Hypoglaucae Rhizoma, crushed, stir-fried until yellow), Shan Yu (Dioscoreae Rhizoma), Niu Xi (Achyranthis Bidentatae Radix, sliced, roasted), Ze Xie (Alismatis Rhizoma, each 1 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 fen), Di Fu Zi (Kochiae Fructus, half liang), Shan Zhu Yu (Corni Fructus, stir-fried, 1 liang 1 fen), Gou Ji (Rhizoma et Radix Cibotii, finely crushed, remove hairs, 3 fen), Yin Yu (Skimmiae Japonicae Cortex, use leaves, roast, 1 fen), Shu Gan Di Huang (Prepared Dried Rehmanniae Radix, roasted, 2 liang 5 qian).
The above ten ingredients are pounded and sifted into powder. Mix with refined honey to form pills the size of Sophora japonica seeds. Take ten pills orally with warm wine at any time, can be increased to fifteen pills.