治脾虚食少无味,身倦肌瘦。肺虚色枯气短,毛发脱落,小便赤涩。营血不足,惊悸健
忘,寝汗发热,(经曰∶脾气散精,上输于肺,此地气上升也。肺主治节,通调水道,下输
膀胱,此天气下降也。脾肺虚,则上下不交而为否,营血无所籍以生。)诸种虚证。亦治发
汗过多,身振脉摇,筋惕肉 。(汗为心液,汗即血也。发汗过多,则血液枯涸,筋肉无以
荣养而然也。)
人参 白术 白芍(钱半) 黄 (蜜炙) 当归(二钱) 茯苓(一钱) 熟地(三
钱) 甘草(炙)
熟地归芍,养血之品。参 苓术,甘草陈皮,补气之品。血不足而补其气,此阳生则阴
长之义也。且参 五味,所以补肺,(肺主气,气能生血。)甘陈苓术,所以健脾。(脾统血。)
熟地所以滋肾,(肾藏精,精血相生。)远志能通肾气,上达于心,桂心能导诸药,入营生血,
五脏交养互益,故能统治诸病,而其要则归于养营也。(薛立斋曰∶气血两虚而变现诸证,
莫能名状,勿论其病,勿论其脉,但用此汤,诸证悉退,此十全大补对子也。十全大补但分
气血,此则五脏皆补,无乎不到。虚寒甚者,高氏常加附子以治之,三阴疟更妙。)
治心虚血少,神气不宁,怔忡惊悸。(心主血而藏神,经曰∶静则神藏,躁则消忘,心
血虚则易动,故怔忡惊悸,不得安宁也。)
黄 (蜜炙) 茯苓 茯神 当归 川芎 半夏曲(一两) 甘草(炙一钱) 柏子仁
(去油) 枣
参 以补心肺之气,(肺为心之华盖。)芎归以养心肝之血,(肝木能生心火。)二茯远志,
以泄心热。柏仁酸枣,以宁心神,五味收神气之散越,半夏去扰心之痰涎。甘草补土以培心
子,赤桂引药以入心经。润以滋之,温以补之,酸以收之,香以舒之,则心得其养矣。
治疗脾虚导致的食欲不振、口中无味,身体疲倦、肌肉消瘦。肺虚导致面色枯槁、气短,毛发脱落,小便颜色深黄且排尿不畅涩痛。营血不足引起的惊悸、健忘,夜间盗汗、发热,以及各类虚损证候。(《内经》记载:脾气将水谷精微散布,向上输送给肺,这是地气上升的表现。肺主治节,疏通调节水道,向下输送到膀胱,这是天气下降的表现。脾和肺虚弱,则上下气机不交而形成痞塞,营血失去赖以生成的基础。)也治疗发汗过多,导致身体震颤、脉搏跳动异常,筋肉跳动抽搐。(汗为心之液,汗即血液。发汗过多,会导致血液枯竭,筋肉失去荣养而出现上述症状。)
人参、白术、白芍(一钱半)、黄芪(蜜炙)、当归(二钱)、茯苓(一钱)、熟地黄(三钱)、甘草(炙)、陈皮。
熟地黄、当归、白芍,是养血的药物。人参、茯苓、白术、甘草、陈皮,是补气的药物。血不足而通过补气来治疗,这是“阳生则阴长”的道理。而且人参、五味子,用来补肺,(肺主气,气能生血。)甘草、陈皮、茯苓、白术,用来健脾。(脾统摄血液。)熟地黄用来滋补肾,(肾藏精,精与血相互化生。)远志能够通导肾气,上行到达心脏,桂心能够引导诸药进入营分以生血,五脏互相滋养、彼此受益,所以能统管各种疾病,而其要点在于调养营血。(薛立斋说:气血两虚而表现出各种难以名状的证候,不论是什么病,不论脉象如何,只要使用此汤,各种证候都会消退,这是十全大补汤的对应方剂。十全大补汤只区分气和血,此方则五脏皆补,无所不到。虚寒严重的,高氏常加入附子来治疗,治疗三阴疟疾更为巧妙。)
治疗心虚血少,神气不安宁,怔忡、惊悸。(心主血并藏神,《内经》记载:静则神气内守,躁动则神气消亡遗忘,心血虚则容易动摇,所以出现怔忡惊悸,不得安宁。)
黄芪(蜜炙)、茯苓、茯神、当归、川芎、半夏曲(一两)、甘草(炙一钱)、柏子仁(去油)、酸枣仁、人参。
人参用来补心肺之气,(肺为心的华盖。)川芎、当归用来养心肝之血,(肝木能生心火。)茯苓、茯神、远志,用来清泄心热。柏子仁、酸枣仁,用来宁心安神,五味子收敛散越的神气,半夏去除扰乱心神的痰涎。甘草补益脾胃(土)以培补心之子(金),赤桂引导药物进入心经。用滋润的药来滋养它,用温热的药来补益它,用酸味的药来收敛它,用芳香的药来舒展它,那么心就能得到调养了。
Treats spleen deficiency manifesting as poor appetite, lack of taste in the mouth, physical fatigue, and emaciation. Lung deficiency presenting with sallow complexion, shortness of breath, hair loss, and dark, scanty, or difficult urination. Insufficiency of Ying-blood (nutritive blood) causing palpitations, amnesia, night sweats, fever, and various other deficiency syndromes. (*Neijing* states: The Spleen scatters essence, transporting it upward to the Lung; this is the rising of Earth Qi. The Lung governs regulation, unblocking and regulating water passages, transporting downward to the Bladder; this is the descending of Heaven Qi. When the Spleen and Lung are deficient, the upper and lower do not interact, leading to obstruction [Pi], and Ying-blood has no basis for generation.) It also treats excessive sweating resulting in tremors of the body, pulsatile vessels, and twitching of muscles and sinews. (Sweat is the fluid of the Heart; sweat is essentially blood. Excessive sweating leads to the depletion of blood and fluids, causing muscles and sinews to lose nourishment, resulting in these symptoms.)
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma), Bai Shao (Paeoniae Radix Alba) (1.5 qian), Huang Qi (Astragali Radix, honey-fried), Dang Gui (Angelicae Sinensis Radix) (2 qian), Fu Ling (Poria), Shu Di Huang (Rehmanniae Radix Preparata) (3 qian), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma), Chen Pi (Citri Reticulatae Pericarpium).
Shu Di Huang, Dang Gui, and Bai Shao are herbs that nourish blood. Ren Shen, Fu Ling, Bai Zhu, Zhi Gan Cao, and Chen Pi are herbs that tonify Qi. Tonifying Qi when Blood is insufficient follows the principle that "Yang generation promotes Yin growth." Furthermore, Ren Shen and Wu Wei Zi (Schisandrae Fructus) tonify the Lung, (as the Lung governs Qi, and Qi generates Blood.) Zhi Gan Cao, Chen Pi, Fu Ling, and Bai Zhu strengthen the Spleen, (which controls Blood.) Shu Di Huang nourishes the Kidney, (as the Kidney stores Essence, and Essence and Blood mutually generate.) Yuan Zhi (Polygalae Radix) can conduct Kidney Qi upward to reach the Heart, and Gui Xin (Cinnamomi Cortex) guides the various herbs into the Ying level to generate Blood. The five Zang organs mutually nourish and benefit each other, thus governing various diseases, with the key point lying in nourishing Ying-blood. (Xue Lizhai stated: In cases of dual deficiency of Qi and Blood manifesting in indescribable syndromes, regardless of the disease name or pulse presentation, using this decoction will cause all syndromes to recede. This is the counterpart to Shi Quan Da Bu Tang. While Shi Quan Da Bu Tang only distinguishes between Qi and Blood, this formula tonifies all five Zang organs without omission. For severe deficiency-cold, Gao often adds Fu Zi (Aconiti Lateralis Radix Preparata) to treat it, which is particularly effective for San Yin Malaria.)
Treats Heart deficiency with scanty blood, restlessness of Spirit and Qi, Zheng Chong (palpitations with a sense of internal agitation), and Jing Ji (startle palpitations). (The Heart governs Blood and houses the Shen. *Neijing* states: Stillness allows the Shen to reside within; agitation causes the Shen to dissipate and be forgotten. Heart Blood deficiency leads to易动 (ease of movement/agitation), hence Zheng Chong and Jing Ji occur, preventing tranquility.)
Huang Qi (Astragali Radix, honey-fried), Fu Ling (Poria), Fu Shen (Poria with Hostwood), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Ban Xia Qu (Pinelliae Fermentatum), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma) (1 qian), Bai Zi Ren (Biota Semen), Suan Zao Ren (Ziziphi Spinosae Semen), Ren Shen (Ginseng Radix).
Ren Shen tonifies the Qi of the Heart and Lung, (the Lung is the canopy over the Heart.) Chuan Xiong and Dang Gui nourish the Blood of the Heart and Liver, (Liver Wood generates Heart Fire.) Fu Ling, Fu Shen, and Yuan Zhi drain Heat from the Heart. Bai Zi Ren and Suan Zao Ren calm the Shen and tranquilize the Heart. Wu Wei Zi gathers and consolidates the dissipating Shen Qi. Ban Xia eliminates phlegm-fluids that disturb the Heart. Zhi Gan Cao tonifies Earth (Spleen) to nurture the Child of the Heart (Metal). Chi Gui (Cinnamomi Cortex) guides the herbs into the Heart Meridian. Using moistening herbs to nourish, warming herbs to tonify, sour herbs to astringe, and aromatic herbs to diffuse, the Heart thereby receives its nourishment.