(论一首,方四十四首,灸法六首)
论曰∶病有积有聚,何以别之?答曰∶积者,阴气也;聚者,阳气也。故阴沉而伏,阳
浮而动,气之所积,名曰积;气之所聚名曰聚。故积者,五脏之所生;聚者,六腑之所成。
故积者阴气也,其始发有常处,其痛(一作病)不离其部,上下有所终始,左右有所穷已。
聚
者阳气也,其始发无根本,上下无所留止,其痛无常处,谓之聚也。故以是别知积聚也。
经络受病,入于肠胃,五脏积聚,发伏梁、息贲、肥气、痞气、奔豚。积聚之始生至其
已成,奈何?曰∶积之始生,得寒乃生,厥止乃成积。人之善病肠中积者,何以候之?曰∶
皮薄而不泽,肉不坚而淖泽,如此则肠胃伤恶,恶则邪气留止积聚,乃作肠胃之积。寒温不
次,邪气稍止,至其蓄积留止,大聚乃起病。有身体腰、髀、股、 皆肿,环脐而痛,是为
何病?曰∶病名伏梁,此风根也。不可动,动之为水溺涩之病。少腹盛,左右上下皆有根者,
伏梁也,裹脓血居肠胃之外,不可治,治之每切按之致死。此下则因阴,必下脓血,上则迫
胃脘生(王冰云当作出)膈,挟胃脘内痈,此久病也,难疗。居脐上为逆,慎勿动,亟夺其
气
溢于大肠
治五脏寒热积聚,胪胀肠鸣而噫,食不生肌肤,甚者呕逆,若伤寒寒疟已愈,令不复发,
食后服五丸,饮多者吞十丸,常服令人大小便调和,长肌肉方。
大黄(熬) 前胡(各二两) 硝石 葶苈 杏仁(各一升) 浓朴 附子 细辛 半
夏(各
一两) 茯苓(半两)
上十味,末之,蜜和,捣五千杵,服如梧子五丸,稍加至十丸,以知为度。
(本篇包含一篇论述、四十四首方剂、六首灸法)
论述说:疾病有“积”和“聚”两种,如何区分它们?回答说:“积”属于阴气;“聚”属于阳气。所以阴气沉潜而潜伏,阳气轻浮而变动。气机凝聚不散的,称为“积”;气机聚散无常的,称为“聚”。因此,“积”是由五脏产生的;“聚”是由六腑形成的。
所谓“积”,属于阴气,它发作时有固定的部位,疼痛不离开其所在的区域,上下有一定的起止范围,左右有一定的终结之处。所谓“聚”,属于阳气,它发作时没有根本固定的源头,上下没有停留止息的地方,疼痛没有固定的位置,这就叫做“聚”。因此根据这些特点来辨别“积”和“聚”。
经络受病,邪气传入肠胃,导致五脏产生积聚,表现为伏梁、息贲、肥气、痞气、奔豚这五种积聚。积聚从开始生成到完全形成,是怎么回事呢?回答说:积聚的开始生成,是由于感受寒邪才产生的,气机逆乱停滞才形成积聚。那些容易患肠中积聚的人,如何诊断呢?回答说:如果皮肤薄且缺乏光泽,肌肉不坚实而松软湿润,像这样则肠胃受损虚弱,虚弱则邪气留滞停止,从而形成积聚,进而成为肠胃之积。寒温失调,邪气暂时休止,等到邪气蓄积留滞,大的积聚就会发病。
如果有身体腰部、髀部、大腿等部位都肿胀,环绕肚脐疼痛,这是什么病?回答说:病名叫做“伏梁”,这是风邪留下的病根。不可触动,一旦触动会导致小便涩痛的病症。少腹部胀满坚硬,左右上下都有根底的,是“伏梁”,脓血包裹其中,位于肠胃之外,难以治疗,如果治疗时用力按压,往往会导致死亡。这种病向下发展则会便下脓血,向上发展则压迫胃脘产生膈塞感,挟持胃脘内部形成痈肿,这是久病,难以治愈。病灶在脐上为逆证,切勿触动,应迅速削弱其正气,使其溢于大肠。
此方用于治疗五脏寒热积聚,以及腹胀、肠鸣、嗳气,饮食不能转化为肌肉营养,严重呕吐逆气等症状。如果是伤寒或寒疟已经痊愈,为了防止复发,可在饭后服用五丸,酒量好的人吞服十丸。常服可使人大小便调和,促进肌肉生长。
药材及用量:大黄(熬制)、前胡(各二两),硝石,葶苈子,杏仁(各一升),浓朴,附子,细辛,半夏(各一两),茯苓(半两)。
以上十味药,研成粉末,用蜂蜜调和,捣击五千杵,制成丸药。每次服用如梧桐子大小的五丸,逐渐增加到十丸,以见效为度。
(One treatise, forty-four prescriptions, six moxibustion methods)
The treatise states: Diseases include "Ji" (accumulation) and "Ju" (aggregation). How can they be distinguished? The answer is: "Ji" belongs to Yin Qi; "Ju" belongs to Yang Qi. Therefore, Yin Qi is deep and latent, while Yang Qi is floating and active. When Qi accumulates and does not disperse, it is called "Ji"; when Qi gathers and scatters irregularly, it is called "Ju". Thus, "Ji" originates from the Zang organs (solid organs); "Ju" is formed by the Fu organs (hollow organs).
Regarding "Ji", which belongs to Yin Qi, its onset has a fixed location, pain does not leave its specific area, and there are definite upper and lower boundaries as well as left and right limits. Regarding "Ju", which belongs to Yang Qi, its onset has no fixed root, it does not stay or stop at any specific upper or lower point, and the pain has no fixed location; this is called "Ju". Therefore, one distinguishes between "Ji" and "Ju" based on these characteristics.
When meridians are affected by disease, pathogens enter the stomach and intestines, leading to accumulations in the five Zang organs, manifesting as Fuliang (Hidden Beam), Xiben (Panting Accumulation), Feiqi (Fat Qi), Piqi (Stagnant Qi), and Ben Tun (Running Piglet). How do accumulations develop from initial formation to completion? It is said: Accumulations begin with the contraction of cold, forming when rebellious Qi stagnates. How can one identify those prone to intestinal accumulations? It is said: If the skin is thin and lacks luster, and the muscles are not firm but soft and moist, the stomach and intestines are damaged. Weakness allows pathogenic factors to linger and accumulate, resulting in intestinal accumulation. Disordered cold and warmth cause pathogenic factors to temporarily subside; when they accumulate and stagnate, major aggregations arise.
If there is swelling in the waist, thighs, and legs, along with pain around the umbilicus, what disease is this? It is said: This disease is named Fuliang (Hidden Beam), which is the root of wind pathogens. It must not be manipulated; manipulation leads to difficulty in urination. Fullness and hardness in the lower abdomen with roots extending left, right, up, and down indicate Fuliang. Pus and blood are enclosed outside the stomach and intestines. It is difficult to treat; forceful pressing during treatment may cause death. Downward progression results in passing pus and blood; upward progression presses against the epigastrium causing dysphagia (diaphragm obstruction) and forms internal abscesses near the stomach. This is a chronic condition and difficult to cure. Lesions above the umbilicus are considered adverse; do not manipulate them. Quickly deplete their Qi so that it overflows into the large intestine.
This prescription treats accumulations of cold and heat in the five Zang organs, abdominal distension, borborygmus (intestinal rumbling), belching, inability of food to nourish muscles, and severe vomiting or regurgitation. For patients who have recovered from Taiyang Cold Damage (Shanghan) or cold malaria, to prevent recurrence, take five pills after meals. Those who consume alcohol may swallow ten pills. Regular use harmonizes bowel movements and urination and promotes muscle growth.
Ingredients: Dahuang (Rhubarb Radix et Rhizoma, processed), Qianhu (Peucedani Radix, each 2 liang), Xiaoshi (Natrii Sulfas), Tingli (Descurainiae Semen seu Lepidii Semen), Xingren (Prunus Armeniacae Semen Amarum, each 1 sheng), Nongpu (Magnoliae Officinalis Cortex), Fuzi (Aconiti Lateralis Radix Praeparata), Xixin (Asari Radix et Rhizoma, Banxia (Pinelliae Rhizoma, each 1 liang), Fuling (Poria, 0.5 liang).
The above ten ingredients are powdered, mixed with honey, and pounded for five thousand strokes. Take pills the size of wutong seeds, starting with five pills and gradually increasing to ten pills, adjusting until the desired effect is achieved.