治肾脏真阳不足。火不归原。
熟地黄(八两) 山茱萸肉 干山药(微焙。各四两) 牡丹皮 白茯苓(去皮) 白泽泻(去毛。各三两) 附
子(童便浸煮。去皮脐。切) 肉桂(去粗皮。勿见火。各一两)
上八味。为末。炼白蜜丸。梧子大。每服五七十丸。空心淡盐汤。临卧时温酒下。以美膳压之。
金匮肾气丸
八味丸肉桂易桂枝。
钱氏六味丸(一名六味地黄丸 作汤。名生料六味丸) 治肾水真阴不足。
八味丸去桂、附。方中熟地黄用缩砂蜜八钱制。 按金匮八味肾气地黄本无缩砂之制。以中有附子之雄。肉桂之窜
也。钱氏裁去二味。治小儿解颅等证。虽曰素禀肾虚。而纯阳未动。地黄不制可也。后世借治真阴不足。乃用缩砂制地
黄。不特无减食作泻之虞。服后连嗳数声。气转食运。脾肾安和。其阳生阴长之妙。世都莫知。兹特表而出之。
加减六味丸 治阴虚咳嗽。吐血骨蒸。及童劳晡热消瘦等证。
六味丸去山茱萸。加葳蕤四两。亦可作膏。
河车六味丸 治禀质素虚。将欲成劳。
六味丸本方用紫河车熬膏丸服。
都气丸 治肾水不固。咳嗽精滑。
八味丸去桂、附。加五味子一两。
七味丸 治肾虚火不归根。游散在上在外。
八味丸去附子。(一方。桂用二两)
加减八味丸 治肾虚火不归源。哄热咳嗽。
八味丸去附子。加五味子一两。
济生肾气丸 治肾气不化。小便涩数。
八味丸本方用茯苓三两。熟地四两。山药、山萸、丹皮、泽泻、肉桂各一两。附子五钱。加牛膝、车前各一两。 此
本金匮肾气方中诸药。各减过半。惟桂、苓二味。仍照原方。为宣布五阳。开发阴邪之专药。更加牛膝、车前。为太阳
厥阴之向导。以肝为风木之脏。凡走是经之药。性皆上升。独牛膝通津利窍。下走至阴。车前虽行津液之府。而不伤犯
正气。故济生方用之。详金匮肾气用桂枝而不用肉桂者。阴气固结于内。势必分解于外。则肾气得以流布周身。而此既
用牛膝引入至阴。又需桂、附蒸动三焦。不特决渎有权。膀胱亦得以化。所以倍用肉桂。暗藏桂苓丸之妙用。愈于五苓
十倍矣。但方中牛膝滑精。精气不固者勿用。
清金壮水丸 治肾脏水亏火旺。蒸热咳嗽。
八味丸去桂、附。加麦门冬三两。(去心)五味子一两。
纳气丸 治脾肾皆虚。蒸热咳嗽。倦怠少食。
八味丸去桂、附。加沉香一两。砂仁二两。如泄泻少食者。用干山药末。调糊代蜜为丸。
香茸八味丸 治肾与督脉皆虚。头旋眼黑。
八味丸去桂、附。加沉香一两。鹿茸一具。
十补丸 治禀赋阳虚。下体无力。小儿解颅。胫软膝盖不生。
八味丸加鹿茸一具。五味子一两。
治疗肾脏真阳不足,虚火不能归元。
熟地黄(八两) 山茱萸肉 干山药(微焙,各四两) 牡丹皮 白茯苓(去皮) 白泽泻(去毛,各三两) 附子(用童便浸泡后煮制,去皮和脐部,切片) 肉桂(去掉粗皮,不要见火,各一两)
以上八味药,研成细末,用炼过的白蜜制成丸药,大小如梧桐子。每次服用五七十丸,空腹时用淡盐汤送服,临睡前用温酒送服,服药后用美味饮食压住药力。
金匮肾气丸
八味丸中的肉桂换成桂枝。
钱氏六味丸(又名六味地黄丸,作汤剂时名为生料六味丸) 治疗肾水真阴不足。
八味丸去掉肉桂、附子。方中熟地黄用缩砂蜜八钱炮制。按《金匮要略》中八味肾气丸的原方,地黄本没有用缩砂炮制的规定,因为方中有附子的雄烈和肉桂的走窜之性。钱乙裁去这两味药,用于治疗小儿解颅等证候,虽然说是先天禀赋肾虚,但小儿纯阳之气未动,地黄不经过炮制也可以。后世借用此方治疗真阴不足,才使用缩砂炮制地黄,这不仅没有减少食欲导致腹泻的担忧,服药后连打几次嗝,气机通畅,食欲增进,脾肾安和,这体现了“阳生阴长”的奇妙作用,世人都不知晓。这里特意表彰并指出这一点。
加减六味丸 治疗阴虚咳嗽、吐血、骨蒸潮热,以及儿童劳损午后发热消瘦等证候。
六味丸去掉山茱萸,加入葳蕤四两,也可以制成膏剂。
河车六味丸 治疗禀赋体质素来虚弱,即将形成虚劳。
六味丸原方中使用紫河车熬膏制成丸药服用。
都气丸 治疗肾水不固,咳嗽,遗精滑泄。
八味丸去掉肉桂、附子,加入五味子一两。
七味丸 治疗肾虚,虚火不能归根,游散于上部和体表。
八味丸去掉附子。(一方中,肉桂用二两)
加减八味丸 治疗肾虚,虚火不归源,烘热咳嗽。
八味丸去掉附子,加入五味子一两。
济生肾气丸 治疗肾气不化,小便涩滞频数。
八味丸原方中茯苓用三两,熟地黄四两,山药、山茱萸、牡丹皮、泽泻、肉桂各一两,附子五钱,再加入牛膝、车前子各一两。这本是《金匮要略》肾气方中的药物,各药剂量减半,只有肉桂、茯苓两味,仍照原方剂量,作为宣通五阳、开发阴邪的专用药物。再加上牛膝、车前子,作为太阳经和厥阴经的向导。因为肝是风木之脏,凡是走这条经络的药物,性质大多上升,唯独牛膝通利津液和窍道,下行至阴部;车前子虽然运行津液的府库,但不伤犯正气。所以济生方中使用它们。详细考察《金匮要略》肾气丸用桂枝而不用肉桂的原因,是因为阴气在内固结,势必在外分解,这样肾气才能流布周身。而此方既然用牛膝引入至阴,又需要肉桂、附子蒸腾调动三焦,不仅决渎之官有权能,膀胱也能气化,所以加倍使用肉桂,暗藏桂苓丸的妙用,疗效比五苓散好十倍。但是方中牛膝有滑精的作用,精气不固的人不要使用。
清金壮水丸 治疗肾脏水亏火旺,蒸热咳嗽。
八味丸去掉肉桂、附子,加入麦门冬三两(去心),五味子一两。
纳气丸 治疗脾肾皆虚,蒸热咳嗽,倦怠少食。
八味丸去掉肉桂、附子,加入沉香一两,砂仁二两。如果有泄泻少食的情况,用干山药末,调糊代替蜂蜜制成丸药。
香茸八味丸 治疗肾与督脉皆虚,头晕眼花。
八味丸去掉肉桂、附子,加入沉香一两,鹿茸一具。
十补丸 治疗禀赋阳虚,下肢无力,小儿解颅,小腿软弱膝盖不生。
八味丸加入鹿茸一具,五味子一两。
Treats insufficiency of the true Yang of the Kidney, where fire fails to return to its origin.
Shu Di Huang (Rehmanniae Radix Praeparata, 8 liang) Shan Zhu Yu (Corni Fructus) Gan Shan Yao (Dioscoreae Rhizoma, lightly roasted, 4 liang each) Mu Dan Pi (Moutan Cortex) Bai Fu Ling (Poria, peeled) Bai Ze Xie (Alismatis Rhizoma, de-haired, 3 liang each) Fu Zi (Aconiti Lateralis Radix Praeparata, soaked in child's urine and boiled, peel and navel removed, sliced) Rou Gui (Cinnamomi Cortex, coarse bark removed, avoid heat/fire, 1 liang each)
The above eight herbs are ground into powder. Form pills with refined white honey, sized like wu-tzu (Chinese parasol tree seeds). Take 50-70 pills per dose. On an empty stomach, take with light salt water; before sleep, take with warm wine, followed by a nutritious meal to settle the medicine.
Jinkui Shenqi Wan (Kidney Qi Pill from the Golden Cabinet)
In the Bawei Wan (Eight-Ingredient Pill), replace Rou Gui with Guizhi (Cinnamon Twig).
Qianshi Liuwang Wan (Dr. Qian's Six-Ingredient Pill, also known as Liuwei Dihuang Wan; when made as a decoction, it is called Shengliao Liuwang Wan) Treats insufficiency of the true Yin of Kidney Water.
Remove Rou Gui and Fu Zi from the Bawei Wan. In this formula, Shu Di Huang is processed with Su Sha Mi (Amomi Fructus, 8 qian). According to the original formula of Bawei Shenqi in *Jinkui Yaolue*, Rehmannia was not originally processed with Su Sha because the formula contains the potent nature of Fu Zi and the dispersing nature of Rou Gui. Qian Yi removed these two herbs to treat conditions such as "jie lu" (delayed closure of fontanelles) in children. Although this is attributed to congenital Kidney deficiency, the child's pure Yang has not yet moved, so unprocessed Rehmannia is acceptable. Later generations borrowed this formula to treat true Yin insufficiency and began processing Rehmannia with Su Sha. This not only avoids the risk of reduced appetite and diarrhea but also causes belching after ingestion, promoting qi circulation and appetite, harmonizing the Spleen and Kidney. This embodies the subtle efficacy of "Yang generating Yin," which the world generally does not understand. Here, it is specifically highlighted and explained.
Jiajian Liuwang Wan (Modified Six-Ingredient Pill) Treats Yin-deficiency cough, hemoptysis, bone-steaming fever, and conditions in children such as labor-related afternoon fever and emaciation.
Remove Shan Zhu Yu from Liuwang Wan, add Wei Rui (Polygonati Odorati Rhizoma, 4 liang). It can also be made into an electuary.
Heche Liuwang Wan (Placenta Six-Ingredient Pill) Treats constitutions that are inherently deficient, approaching the state of consumptive disease.
Use the original Liuwang Wan formula, adding Zhe He Che (Human Placenta) processed into an electuary for pill formation.
Duqi Wan (Duqi Pill) Treats insecurity of Kidney Water, cough, and seminal emission/spermatorrhea.
Remove Rou Gui and Fu Zi from Bawei Wan, add Wu Wei Zi (Schisandrae Fructus, 1 liang).
Qiwei Wan (Seven-Ingredient Pill) Treats Kidney deficiency where fire fails to root, wandering upward and outward.
Remove Fu Zi from Bawei Wan. (In one variation, use 2 liang of Gui/Zhi).
Jiajian Bawei Wan (Modified Eight-Ingredient Pill) Treats Kidney deficiency where fire fails to return to its source, causing flushing heat and cough.
Remove Fu Zi from Bawei Wan, add Wu Wei Zi (1 liang).
Jisheng Shenqi Wan (Jisheng Kidney Qi Pill) Treats failure of Kidney Qi transformation, resulting in astringent and frequent urination.
In the original Bawei Wan formula, use Fu Ling (3 liang), Shu Di Huang (4 liang), Shan Yao, Shan Yu, Dan Pi, Ze Xie, and Rou Gui (1 liang each), Fu Zi (5 qian), plus Niu Xi (Achyranthis Bidentatae Radix) and Che Qian Zi (Plantaginis Semen, 1 liang each). These are the herbs from the *Jinkui* Shenqi formula, with dosages halved, except for Rou Gui and Fu Ling, which retain their original dosages as specific agents to disseminate the Five Yangs and resolve Yin pathogens. Added Niu Xi and Che Qian Zi serve as guides for the Taiyang and Jueyin meridians. Since the Liver is the organ of Wind-Wood, herbs entering this meridian generally have ascending properties. Only Niu Xi promotes fluid flow and opens orifices, descending to the lowest Yin areas. Che Qian Zi, although regulating fluid reservoirs, does not damage healthy Qi. Thus, they are used in the Jisheng formula. Regarding why *Jinkui* Shenqi uses Guizhi instead of Rou Gui: when Yin Qi is firmly consolidated internally, it must decompose externally, allowing Kidney Qi to circulate throughout the body. However, since this formula uses Niu Xi to guide herbs to the deepest Yin, and requires Rou Gui and Fu Zi to steam and activate the Sanjiao, not only does the Du Shu (water passage) function effectively, but the Bladder also undergoes Qi transformation. Therefore, Rou Gui is doubled, secretly incorporating the subtle utility of the Guiling Wan, yielding ten times the effect of Wuling San. However, Niu Xi has a slippery effect on essence; those with insecure essence should not use it.
Qingjin Zhuangshui Wan (Clear Metal and Strengthen Water Pill) Treats Kidney Water insufficiency with Fire hyperactivity, causing steaming heat and cough.
Remove Rou Gui and Fu Zi from Bawei Wan, add Mai Men Dong (Ophiopogonis Radix, 3 liang, heart removed) and Wu Wei Zi (1 liang).
Naqi Wan (Qi-Collecting Pill) Treats combined deficiency of Spleen and Kidney, steaming heat, cough, fatigue, and poor appetite.
Remove Rou Gui and Fu Zi from Bawei Wan, add Chen Xiang (Aquilariae Lignum Resinatum, 1 liang) and Sha Ren (Amomi Fructus Rotundus, 2 liang). If there is diarrhea and poor appetite, use Gan Shan Yao powder mixed with paste instead of honey for pill formation.
Xiangrong Bawei Wan (Fragrant and Velvet Antler Eight-Ingredient Pill) Treats combined deficiency of the Kidney and Du Mai (Governing Vessel), causing vertigo and blurred vision.
Remove Rou Gui and Fu Zi from Bawei Wan, add Chen Xiang (1 liang) and Lu Rong (Cervi Cornu Pantotrichum, one piece).
Shibu Wan (Ten-Nourishing Pill) Treats congenital Yang deficiency, weakness in the lower body, pediatric jie lu (delayed fontanelle closure), soft shins, and failure of knee development.
Add Lu Rong (one piece) and Wu Wei Zi (1 liang) to Bawei Wan.