开郁正元散
积聚通用正元散,苓术青陈曲麦延,香砂海粉楂甘桔,痰饮食积血气抟。
【注】五积六聚,乃痰饮食积,气血抟结而成。通用开郁正元散,其方即茯苓、白术、
青皮、陈皮、神曲、麦芽、延胡索、香附、砂仁、海粉、山楂、甘草、桔梗也。用以健脾
消食、化痰渗饮、理气和血,则积聚未有不愈者矣。
桃奴散
腹中瘀血未成形,面黄发热腹胀疼,产后经来风冷客,血室之内有瘀停。产后恶露失笑散,经闭瘀
凝玉烛攻,血蛊桃奴 鼠粪,延桂砂桃附五灵。
【注】妇人产后经行之时,伤于风冷,则血室之内必有瘀血停留,未成坚块,故不名
瘕也,其人必面色萎黄,脐腹胀痛,内热
晡热。若产后恶露不行者,宜失笑散;若经闭不通,瘀血凝聚者,宜玉烛散。瘀血不行,
蓄之既久,必成血蛊,宜用桃奴散,即桃奴、 鼠粪、延胡索、桂心、砂仁、桃仁、香附、
五灵脂也( 鼠粪,一名两头尖,即雄鼠屎。桃奴,即桃树上未成不落之干桃子也)。
失笑散(方见首卷崩漏) 玉烛散(方见首卷汇方内)
脐旁左右一筋疼,突起如弦 症名;僻在两肋名曰癖;高起如山疝病称,必引少腹腰
胁痛。三证皆由风冷成,或作或止因寒发,痛时方见不痛平。
【注】妇人脐之两旁,有筋突起疼痛,大者如臂,小者如指,状类弓弦者,名曰 。僻
在两肋之间者,名曰癖。若小腹牵连腰胁,疼痛高起者,谓之疝。名虽有三,其实皆因风
冷客于胞中而然,故其发作皆因再受风冷。发则痛,痛则见,不痛则平复如初也。
开郁正元散
治疗积聚通用的方剂是正元散,由茯苓、白术、青皮、陈皮、神曲、麦芽、延胡索、香附、砂仁、海粉、山楂、甘草、桔梗组成,用于治疗痰饮、饮食积滞和气血搏结。
【注】五积六聚,是由于痰饮、饮食积滞以及气血搏结而形成的。通用的开郁正元散,其药物组成即茯苓、白术、青皮、陈皮、神曲、麦芽、延胡索、香附、砂仁、海粉、山楂、甘草、桔梗。使用此方可以健脾消食、化痰渗湿利水、理气和血,那么积聚之证没有不痊愈的。
桃奴散
腹中瘀血尚未成形,面色萎黄、发热、腹胀疼痛,产后或经期感受风冷,导致血室(子宫)内有瘀血停留。产后恶露不尽用失笑散,经闭因瘀血凝聚用玉烛散攻逐,血蛊(腹部积块如鼓胀)用桃奴散,药物包括桃奴、鼠粪、延胡索、桂心、砂仁、桃仁、香附、五灵脂。
【注】妇女在产后或行经期间,若受到风冷侵袭,则血室之内必然有瘀血停留,但尚未形成坚硬的肿块,所以不称为瘕(jiǎ,腹内结块)。患者必定面色萎黄,脐部及腹部胀痛,伴有内热及傍晚发热(晡热)。如果产后恶露排出不畅,适宜用失笑散;如果月经闭止不通,因瘀血凝聚所致,适宜用玉烛散。瘀血运行不畅,蓄积日久,必然形成血蛊,适宜用桃奴散,该方由桃奴、鼠粪、延胡索、桂心、砂仁、桃仁、香附、五灵脂组成(鼠粪,又名两头尖,即雄鼠屎。桃奴,即桃树上未成熟而未脱落的干枯桃子)。
失笑散(方剂见首卷崩漏章节) 玉烛散(方剂见首卷汇方章节)
脐旁左右有一根筋脉疼痛,突起如琴弦,这是症(zhēng,腹内结块坚硬不移的病证)的名称;结块偏居在两肋之间称为癖(pǐ,腹内两侧结块的病证);高起如山丘的是疝病名称,必定牵引少腹及腰胁疼痛。这三种证候都是由风冷引起的,时作时止,因受寒而发作,疼痛时症状显现,不痛时则平复如初。
【注】妇女脐部两旁,有筋脉突起并疼痛,大的如手臂粗,小的如手指粗,形状像弓弦一样的,称为症。结块偏居在两肋之间的,称为癖。如果小腹牵连腰胁,疼痛且高起的,称为疝。名称虽然有三种,但实际上都是因为风冷邪气客居于胞宫所致,所以它们的发作都是由于再次感受风冷。发作时就会疼痛,疼痛时就能摸到包块,不痛时则恢复平静如初。
Kaoyu Zhengyuan San (Depression-Opening Original Decoction)
The general formula for treating accumulations and masses is Zhengyuan San, composed of Poria (Fuling), Atractylodis Macrocephalae Rhizoma (Baizhu), Tangerine Peel (Qingpi), Citri Reticulatae Pericarpium (Chenpi), Medicated Leaven (Shenqu), Hordeum Germinatum (Maiya), Corydalis Rhizoma (Yanhusuo), Cyperi Rhizoma (Xiangfu), Amomi Fructus (Sharen), Tintinnitum (Haifen), Crataegi Fructus (Shanzha), Glycyrrhizae Radix et Rhizoma (Gancao), and Platycodonis Radix (Jiegeng). It is used to treat phlegm-fluid retention, food stagnation, and qi-blood conglomeration.
[Note] The five accumulations and six masses are formed by the conglomeration of phlegm-fluid retention, food stagnation, and qi-blood. The general Kaoyu Zhengyuan San consists of Poria (Fuling), Atractylodis Macrocephalae Rhizoma (Baizhu), Tangerine Peel (Qingpi), Citri Reticulatae Pericarpium (Chenpi), Medicated Leaven (Shenqu), Hordeum Germinatum (Maiya), Corydalis Rhizoma (Yanhusuo), Cyperi Rhizoma (Xiangfu), Amomi Fructus (Sharen), Tintinnitum (Haifen), Crataegi Fructus (Shanzha), Glycyrrhizae Radix et Rhizoma (Gancao), and Platycodonis Radix (Jiegeng). Using this prescription to invigorate the spleen, resolve food stagnation, transform phlegm, leach out dampness, regulate qi, and harmonize blood will ensure the cure of accumulations and masses.
Taonu San (Peach Servant Decoction)
When blood stasis in the abdomen has not yet formed a solid mass, presenting with sallow complexion, fever, abdominal distension, and pain; or when wind-cold invades during postpartum menstruation, causing blood stasis to remain within the Blood Chamber (uterus). For postpartum lochia retention, Shixiao San is used; for amenorrhea due to blood stasis condensation, Yuzhu San is used to purge it. For Xuegu (blood gu, an abdominal mass resembling drum distension), Taonu San is used, comprising Taonu, Mus domesticus faeces (Shufen), Corydalis Rhizoma (Yanhusuo), Cinnamomi Cortex (Guixin), Amomi Fructus (Sharen), Persicae Semen (Taoren), Cyperi Rhizoma (Xiangfu), and Trogopteri Dung (Wulingzhi).
[Note] During the postpartum period or menstruation, if women are injured by wind-cold, there must be blood stasis remaining within the Blood Chamber. However, since it has not yet formed a hard lump, it is not named Jia (a movable mass). The patient will necessarily present with a sallow complexion, umbilical and abdominal distension and pain, internal heat, and afternoon fever (Bure). If postpartum lochia does not flow smoothly, Shixiao San is appropriate; if menstruation is closed and blocked due to blood stasis condensation, Yuzhu San is appropriate. If blood stasis fails to circulate and remains accumulated for a long time, it will inevitably form Xuegu (blood gu), and Taonu San is appropriate. This formula consists of Taonu, Mus domesticus faeces (Shufen), Corydalis Rhizoma (Yanhusuo), Cinnamomi Cortex (Guixin), Amomi Fructus (Sharen), Persicae Semen (Taoren), Cyperi Rhizoma (Xiangfu), and Trogopteri Dung (Wulingzhi) (Mus domesticus faeces, also known as Liangtoujian, refers to male mouse excrement. Taonu refers to dried, unripe peaches that have not fallen from the peach tree).
Shixiao San (Formula see Volume 1, Metrorrhagia section) Yuzhu San (Formula see Volume 1, General Formulas section)
Pain in a tendon on either side of the navel, protruding like a string, is named Zheng (a hard, fixed abdominal mass); a mass located obliquely between the two hypochondria is named Pi (a lateral abdominal mass); a mass rising high like a mountain is named Shan (hernia-related mass), which necessarily radiates pain to the lower abdomen and lumbar hypochondrium. All three conditions are caused by wind-cold, appearing intermittently and triggered by cold exposure; symptoms manifest during pain and subside when pain ceases.
[Note] On both sides of the woman's navel, tendons may protrude and cause pain, large ones as thick as an arm, small ones as thin as a finger, shaped like a bowstring, which is called Zheng. Masses located obliquely between the two hypochondria are called Pi. If the lower abdomen radiates pain to the lumbar hypochondrium and presents with a high, raised mass, it is called Shan. Although the names differ, they are essentially all caused by wind-cold pathogenic factors invading the Bao Palace (uterus). Therefore, their attacks are always triggered by re-exposure to wind-cold. When attacking, pain occurs and the mass becomes palpable; when pain subsides, it returns to normal.