能归,转觉口腻涎粘,胃中生浊,独何故欤。盖一饮一食,皆赖脾胃为之磨化,然后化津化气,足以养生。
而脾胃之磨化,尤赖肾中之一点真阳蒸变,炉薪不熄,釜爨方成也。今虚阳尽从上越,则命火之蒸变,
反属无权,脾胃之旋转失职,胃本无浊,而浊自生矣。此时虚阳挟得些微之浊,流露于外,则结糜尤易。
若投化浊,则燥药更易伤阴。若叠壮水源,则胃中之浊,必拒而不受,即复能受,虚浊必愈堆愈满。若大
队引导,则阴不下吸,导之必不能下。兹拟以极轻之品,益水之上源,金为水母,所谓虚则补其母也,芳
以泄浊,以避燥也,复以纯阴之品,以制阳光。然否正之。
炒黄北沙参 盐水炒竹茹 炒焦豆豉 炒黄枇杷叶 金钗石斛 盐水炒橘白
炒黄白粳米 炒麦冬 茯苓神 上濂珠 川贝母(二味研极细先调服用白荷花露冲)
右 面发泡疮,目胞赤肿,身热脉大而数。此风湿热壅于阳络。先为清泄。
荆芥 薄荷 连翘 黑元参 大力子 丝瓜络
马勃 银花 青黛 夏枯草 荷叶梗 绿豆衣 鲜菊叶
郁(左) 左目红赤,目胞肿胀,泪下多眵,脉形浮滑。风热内郁。先为清解。
粉丹皮 荆芥 白蒺藜 连翘壳 甘菊花 淡黄芩
防风 晚蚕砂 石决明 黑山栀 夏枯草
陈(左) 小溲灼热,右目骤然失明。经云、五脏六腑之精气不能上注于目,与阴虚而木旺者有间也。
制半夏 广皮 赤白苓 白蒺藜 龙胆草 炒菊花 泽泻 车前子 晚蚕砂
某(左) 两目并不红赤,多眵模糊,视物少神,睛脉不清。素体湿痰,此非风火为恙。
左秦艽 煨天麻 白蒺藜 晚蚕砂 木防己 炒菊花
建泽泻 生薏仁 净钩钩 独活 香附 桂枝 陈皮
徐(右) 目为肝窍,为脏腑精气之所聚。目疾之后, 痒多泪,脉数微弦。此风热未清,风为阳邪,其气通
肝,所以风即为热。拟养血清肝熄风,俾不致伤精气为上。
制首乌(四钱) 蜜炙桑叶(一钱) 滁菊花(一钱五分) 炒地骨皮(二钱) 决明子(四钱) 晚蚕砂(三钱)
炒荆芥(一钱) 桔梗(八分) 黑豆衣(四钱) 赤芍(一钱五分)
二诊 脉症相安,但右目不赤不痛,不因见风亦时常流泪。是肝胆气弱,肾水不足,虽有风邪,不能自
越。以丸药缓图之。
大熟地(三两川椒二钱煎汤蒸制) 上徭桂(一钱去皮另研和入) 建泽泻(一两五钱) 蜜水炒川芎(一两)
粉丹皮(一两五钱) 熟附片(一钱) 萸肉炭(一两) 炒山药(二两) 茯苓(二两)
周(左) 五脏六腑之精气,皆上注于目,而为之睛。阴虚于下,痰湿上盛,精气不能贯注而上,浊火转从
上蒸,气轮翳膜遮睛。拟化浊熄肝。
制半夏(一钱五分) 白蒺藜(三钱去刺) 赤白芍(各二钱) 决明子(三钱) 木贼草(三分) 生薏仁(
三钱) 广橘红(一钱) 晚蚕砂(三钱) 青葙子(三钱) 木猪苓(二钱)
二诊 化浊熄肝,脉症相安。前法出入,再望应手。
熟地炭(三钱) 盐水炒菟丝子(三钱) 白茯苓(三钱) 制半夏(一钱五分) 决明子(三钱)
磁石(四钱) 甘杞子(三钱) 潼沙苑(三钱) 黑豆衣(三钱) 酒蒸青葙子(三钱)
三诊 一阳来复,肝阳走入胃。络暂为清养,参以熄肝。
川石斛(三钱) 白蒺藜(三钱) 粉丹皮(一钱五分) 酒炒女贞子(三钱) 甘菊花(一钱五分)
石决明(四钱) 黑豆衣(三钱) 大麦冬(三钱) 钩钩(三钱) 鲜活水芦根(六钱)
四诊 羞明稍减,而偏左牙痛。头痛。肝经之火,袭入少阳阳明之络。再为清养。
细生地(四钱) 大麦冬(二钱) 西洋参(二钱) 桑叶(一钱五分) 晚蚕砂(三钱) 大天冬(二钱)
川石斛(四钱) 粉丹皮(二钱) 黑山栀(二钱) 荷叶边(三钱)
程(左) 湿痹经久才愈,至今阴茎尚时碎痒,其湿热之盛,即此可知。乃于去冬旋觉眼目昏花,如蒙云
雾。夫目者五脏六腑之精也。土郁则木郁,精气不能上承,风湿热转从目系上注,将成内障之症。拟拨
云退翳法。
蔓荆子(五钱) 滁菊花(四钱) 白蒺藜(五钱) 荆芥穗(四钱) 薄荷(一钱五分) 木贼草(五钱去节)
川雅连(三钱酒炒) 楮实子(一钱五分) 生甘草(一钱五分) 川芎(三钱) 蜀椒(一钱三分) 蛇蜕(
炙一钱三分) 密蒙花(五钱) 蝉蜕(一钱五分) 当归(一两)
研末为丸,每服三钱。
能够归经,反而觉得口中黏腻、唾液浑浊,胃中产生浊气,这是为什么呢?因为每一次饮食,都依赖脾胃进行磨碎和消化,然后转化为津液和气,足以滋养身体。而脾胃的磨化功能,尤其依赖肾中的一点真阳来蒸腾变化,就像炉火不熄,锅里的饭才能煮熟一样。现在虚阳全部向上浮越,那么命门之火的蒸腾变化功能反而失去权力,脾胃的升降运化失职,胃本身没有浊气,但浊气却自然产生了。此时虚阳挟带着些许浊气,流露于外,则结聚成糜粥状物更容易发生。如果投用化浊的药物,燥药更容易损伤阴液。如果层层壮水之源,那么胃中的浊气必定排斥而不接受,即使能接受,虚浊也必定越堆越多。如果用大队引导药物,则阴液不能向下吸纳,引导必然无法下行。这里拟定用极轻清的药物,补益水之上源(肺),金为水之母,所谓“虚则补其母”,用芳香药物以泄浊,以避免燥性,再用纯阴的药物,以制约阳光(虚火)。不知是否正确,请指正。
炒黄北沙参 盐水炒竹茹 炒焦豆豉 炒黄枇杷叶 金钗石斛 盐水炒橘白
炒黄白粳米 炒麦冬 茯苓神 上濂珠 川贝母(这两味研成极细粉末先调服,用白荷花露冲服)
右侧面部发泡疮,眼睑赤肿,身体发热,脉象大而数。这是风湿热邪壅滞于阳络。先采用清泄法治疗。
荆芥 薄荷 连翘 黑元参 大力子 丝瓜络
马勃 银花 青黛 夏枯草 荷叶梗 绿豆衣 鲜菊叶
郁姓患者(左侧)左目红赤,眼睑肿胀,流泪多且眼屎多,脉象浮滑。风热内郁。先采用清解法治疗。
粉丹皮 荆芥 白蒺藜 连翘壳 甘菊花 淡黄芩
防风 晚蚕砂 石决明 黑山栀 夏枯草
陈姓患者(左侧)小便灼热,右目突然失明。《内经》说,五脏六腑的精气不能上注于目,这与阴虚而肝木旺盛的情况有所不同。
制半夏 广皮 赤白苓 白蒺藜 龙胆草 炒菊花 泽泻 车前子 晚蚕砂
某患者(左侧)两眼并不红赤,眼屎多且视物模糊,看东西缺乏神采,眼球脉络不清。素体有湿痰,这不是风火引起的疾病。
左秦艽 煨天麻 白蒺藜 晚蚕砂 木防己 炒菊花
建泽泻 生薏仁 净钩钩 独活 香附 桂枝 陈皮
徐姓患者(右侧)眼睛是肝之窍,也是脏腑精气汇聚之处。患眼疾之后,瘙痒多泪,脉数微弦。这是风热未清,风为阳邪,其气通于肝,所以风即为热。拟定养血、清肝、熄风之法,以使不致损伤精气为上策。
制首乌(四钱) 蜜炙桑叶(一钱) 滁菊花(一钱五分) 炒地骨皮(二钱) 决明子(四钱) 晚蚕砂(三钱)
炒荆芥(一钱) 桔梗(八分) 黑豆衣(四钱) 赤芍(一钱五分)
二诊:脉症平稳,但右目不红不痛,不因见风也时常流泪。这是肝胆气弱,肾水不足,虽有风邪,但不能自行驱散。用丸药缓慢调理。
大熟地(三两,用川椒二钱煎汤蒸制) 上徭桂(一钱,去皮另研后加入) 建泽泻(一两五钱) 蜜水炒川芎(一两)
粉丹皮(一两五钱) 熟附片(一钱) 萸肉炭(一两) 炒山药(二两) 茯苓(二两)
周姓患者(左侧)五脏六腑的精气,都上注于目,形成瞳神。下部阴虚,上部痰湿盛,精气不能贯注而上,浊火反而从上蒸腾,气轮出现翳膜遮蔽瞳孔。拟定化浊、熄肝之法。
制半夏(一钱五分) 白蒺藜(三钱,去刺) 赤白芍(各二钱) 决明子(三钱) 木贼草(三分) 生薏仁(三钱) 广橘红(一钱) 晚蚕砂(三钱) 青葙子(三钱) 木猪苓(二钱)
二诊:化浊熄肝后,脉症平稳。前方稍作加减,再望见效。
熟地炭(三钱) 盐水炒菟丝子(三钱) 白茯苓(三钱) 制半夏(一钱五分) 决明子(三钱)
磁石(四钱) 甘杞子(三钱) 潼沙苑(三钱) 黑豆衣(三钱) 酒蒸青葙子(三钱)
三诊:一阳来复,肝阳走入胃。络脉暂时清养,参入熄肝之法。
川石斛(三钱) 白蒺藜(三钱) 粉丹皮(一钱五分) 酒炒女贞子(三钱) 甘菊花(一钱五分)
石决明(四钱) 黑豆衣(三钱) 大麦冬(三钱) 钩钩(三钱) 鲜活水芦根(六钱)
四诊:畏光症状稍减,但偏左牙痛、头痛。肝经之火,袭入少阳、阳明之络。再次采用清养之法。
细生地(四钱) 大麦冬(二钱) 西洋参(二钱) 桑叶(一钱五分) 晚蚕砂(三钱) 大天冬(二钱)
川石斛(四钱) 粉丹皮(二钱) 黑山栀(二钱) 荷叶边(三钱)
程姓患者(左侧)湿痹经久才愈,至今阴茎仍时常刺痛发痒,由此可知其湿热之盛。去年冬天忽然觉得眼目昏花,如蒙云雾。眼睛是五脏六腑之精所在。土气郁结则木气郁结,精气不能上承,风湿热邪转从目系上注,将形成内障之症。拟定拨云退翳法。
蔓荆子(五钱) 滁菊花(四钱) 白蒺藜(五钱) 荆芥穗(四钱) 薄荷(一钱五分) 木贼草(五钱,去节)
川雅连(三钱,酒炒) 楮实子(一钱五分) 生甘草(一钱五分) 川芎(三钱) 蜀椒(一钱三分) 蛇蜕(炙一钱三分) 密蒙花(五钱) 蝉蜕(一钱五分) 当归(一两)
研末制成丸药,每次服用三钱。
Neng Gui (Cibotii Rhizoma) enters the channels, yet one feels a sticky mouth and turbid saliva, with turbidity generating in the stomach. Why is this so? Every intake of drink and food relies on the Spleen and Stomach to grind and transform it, subsequently converting it into Jin-Ye (Body Fluids) and Qi, which are sufficient to nourish life. The grinding and transforming function of the Spleen and Stomach particularly depends on a spark of True Yang within the Kidney for steaming and changing, just as the pot cannot cook unless the firewood in the furnace does not extinguish. Now, since Deficient Yang floats upward entirely, the steaming and changing function of Mingmen Fire loses its authority, and the rotation and dysfunction of the Spleen and Stomach fail. The Stomach originally has no turbidity, yet turbidity generates spontaneously. At this time, Deficient Yang carries a trace of turbidity and manifests externally, making it easier to form a congealed mass like porridge. If turbidity-resolving herbs are administered, drying herbs will more easily damage Yin. If layers of water-nourishing herbs are used, the turbidity in the Stomach will surely reject and refuse acceptance; even if accepted, the deficienct turbidity will only accumulate more and more. If a large group of guiding herbs is used, Yin cannot be drawn downward, and guidance will inevitably fail to descend. Here, extremely light herbs are prescribed to benefit the upper source of Water (Lung). Metal is the mother of Water, as stated in "deficiency should tonify its mother." Aromatic herbs are used to vent turbidity, avoiding dryness, and pure Yin herbs are used to restrain Solar Heat (Deficient Fire). Whether this is correct or not, please rectify.
Fried Northern Glehnia Root (Shashen), Salt-fried Bamboo Shavings (Zhuru), Fried Fermented Soybean (Douchi), Fried Loquat Leaf (Pipaye), Dendrobium Nobile Stem (Shihu), Salt-fried Tangerine Peel (Jubai), Fried White Rice Grain (Bingmi), Fried Ophiopogon Tuber (Maidong), Poria with Hostwood (Fuling Shen), Top Pearl Powder (Lianzhu), Fritillaria Bulb (Beimu) [The latter two are ground into fine powder, mixed first, and taken with White Lotus Flower Dew].
Right side of the face presents with blistering sores, eyelids are red and swollen, body heat is present, and the pulse is large and rapid. This is Wind-Damp-Heat obstructing the Yang Collaterals. First, clear and drain.
Schizonepeta Spike (Jingjie), Mint (Bohe), Forsythia Fruit (Lianqiao), Black Rehmannia Root (Xuanshen), Burdock Fruit (Niubangzi), Luffa Rind (Sigualuo)
Toad Venom (Mabo), Honeysuckle Flower (Yinhua), Indigo Naturalis (Qingdai), Prunella Spike (Xiakucao), Lotus Leaf Stem (Heyegeng), Mung Bean Coat (Lvdouyi), Fresh Chrysanthemum Leaf (Xianjuye)
Yu (Left): Left eye is red and bloodshot, eyelids are swollen, excessive tearing with much discharge, pulse is floating and slippery. Wind-Heat is internally constrained. First, clear and resolve.
Red Peony Root (Danpi), Schizonepeta Spike (Jingjie), Tribulus Fruit (Jili), Forsythia Husk (Lianqiaoqiao), Sweet Chrysanthemum Flower (Juhua), Light Scutellaria Root (Huangqin)
Saposhnikovia Root (Fangfeng), Late Silkworm Sand (Wancansha), Abalone Shell (Shijueming), Black Gardenia Fruit (Shanzhi), Prunella Spike (Xiakucao)
Chen (Left): Urination is burning hot, right eye suddenly lost vision. The Classic states that the essence and Qi of the Five Zang and Six Fu organs cannot ascend to the eyes, which differs from cases of Yin deficiency with hyperactive Liver Wood.
Prepared Pinellia Tuber (Banxia), Broad-leaved Citrus Peel (Guapi), Red and White Poria (Chibaoling), Tribulus Fruit (Jili), Gentian Root (Longdancao), Fried Chrysanthemum Flower (Juhua), Alisma Rhizome (Zexie), Plantago Seed (Cheqianzi), Late Silkworm Sand (Wancansha)
Certain Patient (Left): Both eyes are not red or bloodshot, but have much discharge and blurred vision, looking at things lacks spirit, and the eye collaterals are unclear. The constitution is prone to Damp-Phlegm; this is not caused by Wind-Fire.
Northern Gentian Root (Qinjiao), Calcuated Gastrodia Tuber (Tianma), Tribulus Fruit (Jili), Late Silkworm Sand (Wancansha), European Stallwort Stem (Mufangji), Fried Chrysanthemum Flower (Juhua)
Alisma Rhizome (Zexie), Raw Coix Seed (Yiren), Uncaria Ramulus cum Uncis (Gou gou), Angelica Pubescens Root (Duhuo), Cyperus Rhizome (Xiangfu), Cinnamon Twig (Guizhi), Tangerine Peel (Chenpi)
Xu (Right): The eyes are the opening of the Liver and the gathering place of essence and Qi of the Zang-Fu organs. After the eye disease, there is itching and excessive tearing, with a rapid and slightly wiry pulse. This is Wind-Heat not yet cleared. Wind is a Yang pathogen, its Qi connects to the Liver, so Wind becomes Heat. It is proposed to nourish Blood, clear the Liver, and extinguish Wind, so as not to damage essence and Qi.
Prepared Polygonum Multiflorum Root (He Shou Wu), Honey-fried Mulberry Leaf (Sangye), Chuzhou Chrysanthemum Flower (Ju Hua), Fried Bark of Tree Peony Root (Digupi), Cassia Seed (Jue Ming Zi), Late Silkworm Sand (Wan Can Sha)
Fried Schizonepeta Spike (Jingjie), Platycodon Root (Jiegeng), Black Soybean Coat (Heidou Yi), Red Peony Root (Chi Shao)
Second Visit: Pulse and symptoms are stable, but the right eye is neither red nor painful, and tears flow frequently even without exposure to wind. This indicates weak Qi of the Liver and Gallbladder, and insufficient Kidney Water. Although Wind pathogen exists, it cannot self-disperse. Use pill medicine for slow improvement.
Large Rehmannia Root (Shu Di Huang) [Three taels, steamed in decoction of Sichuan Pepper (Chuan Jiao) two qian], Upper Yao Cinnamon Bark (Yao Gui) [One qian, peeled, ground separately and added], Jian Alisma Rhizome (Zexie) [One tael five qian], Honey-water fried Ligusticum Rhizome (Chuanxiong) [One tael]
Red Peony Root (Danpi) [One tael five qian], Prepared Aconite Child Root (Fu Pian) [One qian], Cornus Fruit Char (Rou Tian Yu Tan), Fried Dioscorea Rhizome (Shanyao) [Two taels], Poria (Fuling) [Two taels]
Zhou (Left): The essence and Qi of the Five Zang and Six Fu organs all ascend to the eyes to form the pupil. Yin is deficient below, while Phlegm-Dampness is abundant above. Essence and Qi cannot penetrate and ascend, so Turbid Fire steams upward instead, causing membranes to obscure the pupil in the Qi wheel (sclera/conjunctiva). It is proposed to resolve turbidity and extinguish the Liver.
Prepared Pinellia Tuber (Banxia), Tribulus Fruit (Jili) [Three qian, remove spines], Red and White Peony Roots (Chi Bai Shao) [Two qian each], Cassia Seed (Jue Ming Zi) [Three qian], Equisetum Herb (Mu Zei Cao), Raw Coix Seed (Yi Yi Ren) [Three qian], Broad-leaved Citrus Peel (Guo Hong) [One qian], Late Silkworm Sand (Wan Can Sha) [Three qian], Celosia Seed (Qing Xiang Zi) [Three qian], Polyporus (Zhu Ling) [Two qian]
Second Visit: After resolving turbidity and extinguishing the Liver, pulse and symptoms are stable. Modify the previous method slightly, hoping for a response.
Rehmannia Root Char (Shu Di Tan), Salt-fried Dodder Seed (Tu Si Zi), White Poria (Bai Fu Ling), Prepered Pinellia Tuber (Ban Xia), Cassia Seed (Jue Ming Zi)
Magnetite (Ci Shi), Goji Berry (Gou Qi Zi), Astragalus Complanatus Seed (Tong Sha Yuan), Black Soybean Coat (Hei Dou Yi), Wine-steamed Celosia Seed (Qing Xiang Zi)
Third Visit: One Yang returns, Liver Yang enters the Stomach. Collaterals are temporarily cleared and nourished, combined with extinguishing Liver methods.
Chuan Dendrobium Stem (Shi Hu), Tribulus Fruit (Ji Li), Red Peony Root (Dan Pi), Wine-fried Privet Fruit (Nu Zhen Zi), Sweet Chrysanthemum Flower (Ju Hua)
Abalone Shell (Shi Jue Ming), Black Soybean Coat (Hei Dou Yi), Large Ophiopogon Tuber (Mai Dong), Hook (Gou Gou), Fresh Water Reed Rhizome (Shui Lu Gen)
Fourth Visit: Photophobia is slightly reduced, but there is toothache on the left side and headache. Fire of the Liver Channel invades the collaterals of Shaoyang and Yangming. Again, clear and nourish.
Fine Rehmannia Root (Sheng Di Huang), Large Ophiopogon Tuber (Mai Dong), American Ginseng (Xi Yang Shen), Mulberry Leaf (Sang Ye), Late Silkworm Sand (Wan Can Sha), Large Asparagus Tuber (Tian Dong)
Chuan Dendrobium Stem (Shi Hu), Red Peony Root (Dan Pi), Black Gardenia Fruit (Shan Zhi), Lotus Leaf Edge (He Ye Bian)
Cheng (Left): Damp Bi syndrome healed only after a long time, yet the penis still occasionally stings and itches, indicating the severity of Damp-Heat. Last winter, vision suddenly became dim and blurry, as if covered by clouds and mist. The eyes are the essence of the Five Zang and Six Fu organs. Earth stagnation causes Wood stagnation; essence and Qi cannot ascend. Wind-Damp-Heat turns to ascend via the optic nerve system, likely forming an internal cataract. It is proposed to use the method of dispelling clouds and removing nebulae.
Vitex Fruit (Man Jing Zi), Chuzhou Chrysanthemum Flower (Ju Hua), Tribulus Fruit (Ji Li), Schizonepeta Spike Head (Jing Jie Sui), Mint (Bo He), Equisetum Herb (Mu Zei Cao) [Remove joints]
Chuan Coptis Rhizome (Ya Lian) [Wine-fried], Chinese Wolfberry Fruit (Chu Shi Zi), Raw Licorice Root (Sheng Gan Cao), Ligusticum Rhizome (Chuan Xiong), Sichuan Pepper (Shu Jiao), Snake Slough (She Tui) [Roasted], Flos Eyebright (Mi Meng Hua), Cicada Slough (Chan Tui), Angelica Sinensis Root (Dang Gui)
Grind into powder and make pills, take three qian per dose.