治舌喑不能言。足废不能行。此谓少阴气厥不至。急当温之。名曰痱症。
地黄饮子少阴方。桂附蓉苓并地黄。麦味远蒲萸戟斛。薄荷加入煮须详。(肉桂附子肉
苁蓉茯苓熟地黄麦冬五味子远志菖蒲山茱萸巴戟天石斛各五分。薄荷叶七片。水一杯二分。
煎八分温服。)
陈修园曰。命火为水中之火。昔人名为龙火。其火一升。故舌强不语。以肾脉荣于舌本
也。火一升而不返。故猝倒不省人事。以丹田之气。欲化作冷风而去也。方用桂附苁蓉巴戟
以导之。龙升则水从之。故痰涎如涌。以痰之本则为水也。方用熟地茯苓山药石斛以安之。
火迸于心。则神识昏迷。方用远志菖蒲以开之。风动则火发。方用麦冬五味子以清敛之。肾
主通身之骨。肾病则骨不胜任。故足废不能行。方用十二味以补之。然诸药皆质重性沉。以
镇逆上之火。而火由风发。风则无形而行疾。故用轻清之薄荷为引导。又微煎数沸不令诸药
尽出重浊之味。俾轻清走于阳分。以散风。重浊走于阴分。以镇逆。刘河间制方之妙。汪
庵辈从未悟及。无怪时医之愦愦也。
治中风脾缓。舌强不语。半身不遂。与地黄饮子同意。但彼重在肾。此重在脾。
资寿特名解语汤。专需竹沥佐些姜。羌防桂附羚羊角。酸枣麻甘十味详。(羌活五分。
防风附子羚羊角酸枣仁天麻各一钱。肉桂八分。甘草炙五分。水二杯煎八分。入竹沥五钱。
生姜汁二钱。调服。○喻嘉言治肾气不萦于舌本。加枸杞首乌天冬菊花石蒲元参。)
陈修园曰。此与前方相仿。但表药较多。外证重者相宜。方中羚羊角一味。甚妙。
治疗舌体僵硬不能言语,足部痿废不能行走。这称为少阴经气机逆乱,阳气不能到达四肢末端。应当紧急使用温补法治疗。这种病症叫做痱症(中风后遗症之一,以舌强不语、足废不用为特征)。
地黄饮子是治疗少阴病的方剂。方中包含肉桂、附子、肉苁蓉、茯苓和熟地黄。还有麦冬、五味子、远志、石菖蒲、山茱萸、巴戟天、石斛。加入薄荷叶一起煎煮,需要仔细斟酌火候与配伍。(肉桂、附子、肉苁蓉、茯苓、熟地黄、麦冬、五味子、远志、石菖蒲、山茱萸、巴戟天、石斛各五分;薄荷叶七片。用水一杯二分,煎至八分,温服。)
陈修园说:命门之火是水中的火,古人称之为龙火。当这股火升腾时,就会导致舌体僵硬不能说话,因为肾脉荣养于舌根。如果火升而不降,就会导致突然昏倒不省人事,这是因为丹田之气欲化作冷风离去。方中使用肉桂、附子、肉苁蓉、巴戟天来引导火势下行。龙火上升则水随之而动,所以痰涎涌出,因为痰的根本来源是水。方中使用熟地黄、茯苓、山药、石斛来安定水源。火气迸发到心脏,就会导致神识昏迷,方中使用远志、石菖蒲来开窍醒神。风动则火发,方中使用麦冬、五味子来清热收敛。肾主管全身的骨骼,肾病则骨骼无法支撑身体,所以足部痿废不能行走。方中用十二味药来补肾。然而这些药物大多质地沉重、性质沉降,用来镇压逆上的虚火。而火是由风引发的,风无形且运行迅速,所以使用轻清之性的薄荷作为引导。又通过轻微煎煮数沸,不让药物的重浊味道完全析出,使得轻清之气走上阳分以散风,重浊之气走下阴分以镇逆。这是刘河间制方的精妙之处,汪昂等人从未领悟到,难怪当时的医生们糊涂无知。
治疗中风引起的脾脏功能缓弱,舌体僵硬不能言语,半身不遂。这与地黄饮子的治意相同,但地黄饮子重在补肾,此方重在健脾。资寿解语汤专门需要竹沥配合生姜汁使用。方中含有羌活、防风、肉桂、附子、羚羊角、酸枣仁、天麻、甘草等十味药。(羌活五分,防风、附子、羚羊角、酸枣仁、天麻各一钱,肉桂八分,炙甘草五分。用水二杯煎至八分,加入竹沥五钱、生姜汁二钱,调匀服用。○喻嘉言治疗因肾气不能上萦于舌本导致的症状,加枸杞、首乌、天冬、菊花、石菖蒲、玄参。)
Treats tongue aphasia (inability to speak due to tongue stiffness) and leg flaccidity (inability to walk). This is referred to as the failure of Shaoyin (Lesser Yin) Qi to reach the extremities. Urgent warming treatment is required. This condition is called Fei syndrome (a type of stroke sequelae characterized by aphasia and lower limb paralysis).
Dihuang Yinzi (Rehmannia Decoction) is a formula for treating Shaoyin disease. It contains Rougui (Cinnamon Twig), Fuzi (Aconite Lateral Root Preparatio), Rongrongcao (Cistanche Herba), Fuling (Poria), and Shudihuang (Prepared Rehmannia Root). It also includes Maidong (Ophiopogon Tuber), Wuweizi (Schisandra Fruit), Yuanzhi (Polygala Root), Changpu (Acorus Rhizome), Shanyuzhu (Cornus Fruit), Bajitian (Morinda Officinalis Root), and Shihu (Dendrobium Stem). Boiling with Houbo (Mint Leaf) requires careful attention to dosage and preparation. (Rougui, Fuzi, Rongrongcao, Fuling, Shudihuang, Maidong, Wuweizi, Yuanzhi, Changpu, Shanyuzhu, Bajitian, Shihu, each 0.5 qian; Houbo 7 leaves. Decoct in 1.2 cups of water until 0.8 cup remains, take warm.)
Chen Xiuyuan stated: The Fire of Mingmen (Gate of Life) is fire within water, formerly named Longhuo (Dragon Fire). When this fire ascends, it causes tongue stiffness and aphasia, because the Kidney meridian nourishes the root of the tongue. If the fire ascends but does not descend, it causes sudden collapse and loss of consciousness, because the Qi of the Dantian desires to transform into cold wind and depart. The formula uses Rougui, Fuzi, Rongrongcao, and Bajitian to guide the fire downward. When Dragon Fire ascends, Water follows; thus, phlegm and saliva surge, because the root of phlegm is water. The formula uses Shudihuang, Fuling, Shanyao (Chinese Yam), and Shihu to stabilize the water source. When fire bursts into the Heart, it causes mental confusion and coma; the formula uses Yuanzhi and Changpu to open the orifices and revive consciousness. Wind movement triggers fire emission; the formula uses Maidong and Wuweizi to clear heat and astringe. The Kidney governs the bones of the entire body; when the Kidney is diseased, the bones cannot support the body, causing leg flaccidity and inability to walk. The twelve ingredients in the formula are used to tonify the Kidney. However, most of these herbs have heavy textures and sinking properties, used to suppress rebellious fire. Since fire is triggered by wind, which is formless and moves rapidly, light and clearing Houbo is used as a guiding agent. Furthermore, slight boiling prevents the heavy and turbid flavors from fully extracting, allowing the light and clearing aspects to ascend to the Yang aspect to disperse wind, while the heavy and turbid aspects descend to the Yin aspect to suppress rebellion. This is the subtlety of Liu Hejian's formula creation; Wang Ang and others never comprehended it, no wonder contemporary physicians are confused.
Treats Spleen flaccidity caused by Zhongfeng (Wind Stroke), tongue stiffness with aphasia, and hemiplegia. This shares the same therapeutic principle as Dihuang Yinzi, but whereas the latter focuses on the Kidney, this formula focuses on the Spleen. Zishou Jieyu Tang (Zishou Speech-Resolving Decoction) specifically requires Zhuli (Bamboo Sap) assisted by Jiangzhi (Ginger Juice). The formula contains Qianghuo (Notopterygium Rhizome), Fangfeng (Saposhnikovia Root), Rougui, Fuzi, Lingyangjiao (Saiga Antelope Horn), Suanzaoren (Ziziphus Seed), Tianma (Gastrodia Rhizome), and Gancao (Licorice Root), totaling ten ingredients. (Qianghuo 0.5 qian; Fangfeng, Fuzi, Lingyangjiao, Suanzaoren, Tianma, each 1 qian; Rougui 0.8 qian; Zhi Gancao (Honey-fried Licorice) 0.5 qian. Decoct in 2 cups of water until 0.8 cup remains, add Zhuli 5 qian and Jiangzhi 2 qian, mix and take. ○ Yu Jiayan treated symptoms where Kidney Qi failed to circulate to the tongue root by adding Gouqi (Goji Berry), Shouwu (Polygonum Multiflorum Root), Tiandong (Asparagus Tuber), Juhua (Chrysanthemum Flower), Shipu (likely Changpu/Acorus), and Xuanshen (Scrophularia Root).)
Chen Xiuyuan stated: This formula is similar to the previous one, but contains more exterior-releasing herbs, making it suitable for cases with severe external manifestations. The inclusion of Lingyangjiao in the formula is particularly exquisite.