稀涎皂半草矾班。(皂角一个。大半夏十四粒。炙甘草一钱。白矾二钱为末。每服一钱。
用生姜少许。冲温水灌之。得吐痰涎即醒。此夺门之兵也风国中时宜用之。)直中痰潮此斩
关。更有通关辛皂末。(细辛皂角为未。吹鼻中。名通关散。)吹来得嚏保还生。(卒中者。
用此吹鼻。有
陈修园曰。顽痰上塞咽喉。危在顷刻当以此攻之然痰为有形也痰厥宜涌吐以出其痰。气。
无形也气厥。宜取嚏以宣其气。二者皆所以开其闭也。若脱症昏倒。不省人事。亦用此法以
开之。是速其死也。慎之。
治脏腑一切痰食气血诸郁。为痛为呕为胀为利者。
六郁宜施越鞠丸。芎苍曲附并栀餐。食停气血湿痰火。得此调和顷刻安。(吴鹤皋曰。
香附开气郁。抚芎调血郁。苍术燥湿郁。栀子清火郁。神曲消食郁各等分。麦芽煎汤泛丸。
又湿郁加茯苓白芷。火郁加青黛。痰郁加星夏栝蒌海石。血郁加桃仁红花。气郁加木香槟
榔。食郁加麦芽山楂。挟寒加吴茱萸。)
季楚重曰。经云。太阴不收。肺气焦满。又云。诸气 郁。皆属于肺。然肺气之布。必
由胃气之输。胃气之运。必本三焦之化。甚至为痛为呕为胀为利。莫非胃气不宣。三焦失职
所致。方中君以香附快气。调肺之拂郁。臣以苍术开发。强胃而资生。神曲佐化水谷。栀子
清郁导火。于以达肺腾胃。而清三焦。尤妙抚芎之辛。直入肝胆。以助妙用。则少阳之生
气上朝。而营卫和。太阴之收气下肃。而精气化。此丹溪因五郁之法而变通者也。然五郁之
中。金木为尤甚。前人用逍遥散。调肝之郁。兼清火滋阴。泻白散。清肺之郁。兼润燥降
逆。要以木郁上冲即为火。金郁敛涩即为燥也。如阴虚不知滋水。气虚不知化液。是又不善
用越鞠矣。
陈修园曰。诸病起于郁者难医。时医每以郁金统治之。是徇名之误也。此药本经不载。
唐本有之。唐本云。气味苦寒无毒主血积。下气生肌。止血破恶血血淋尿血金疮。原文只此
二
治疗风痰阻塞喉中,声音如同拉锯。或者因中湿邪导致身体肿胀满闷。
稀涎皂角半、甘草、白矾、半夏。(取皂角一个,半夏十四粒,炙甘草一钱,白矾二钱,研为细末。每次服用一钱,用少许生姜汁冲入温水中灌服。若能吐出痰涎,病人即可苏醒。这是如夺门之兵般的急救之法,在风痰闭阻的紧急情况下应当使用。)直接中受痰浊上涌,此法可斩断关隘。更有通关散辛香皂角末。(将细辛和皂角研为细末,吹入鼻中,名为通关散。)吹药后若能打喷嚏,便可保全生命。(对于卒中昏倒者,用此药吹鼻,若能有喷嚏反应,说明生机尚存。)
陈修园说:顽固的痰浊上塞咽喉,情况危急,就在顷刻之间,应当用此法攻逐。然而,痰是有形的病理产物,痰厥应当采用涌吐的方法以排出痰浊;气是无形的,气厥应当采用取嚏的方法来宣通气机。这两种方法都是为了开通闭塞。如果是脱证导致的昏倒,不省人事,也使用这种方法来开窍,那就是加速死亡了。务必谨慎。
治疗脏腑一切由痰、食、气、血等郁结引起的病症,表现为疼痛、呕吐、胀满、泄泻的。
六郁症适宜施用越鞠丸。川芎、苍术、神曲、附子(注:原文此处可能有误,通常越鞠丸含香附、川芎、苍术、神曲、栀子,无附子,但依原文翻译)并配伍栀子食用。饮食停滞、气滞、血瘀、湿阻、痰凝、火郁,得到此方调和,顷刻间即可安宁。(吴鹤皋说:香附开解气郁,川芎调理血郁,苍术燥化湿郁,栀子清泻火郁,神曲消导食郁,各等分,用麦芽煎汤泛丸。另外,湿郁加茯苓、白芷;火郁加青黛;痰郁加胆南星、半夏、瓜蒌、海浮石;血郁加桃仁、红花;气郁加木香、槟榔;食郁加麦芽、山楂;兼寒加吴茱萸。)
季楚重说:《内经》云:“太阴不收,肺气焦满。”又说:“诸气膹郁,皆属于肺。”然而肺气的布散,必须通过胃气的输转;胃气的运化,必须以三焦的气化为根本。甚至出现疼痛、呕吐、胀满、泄泻等症状,无非是胃气不宣通,三焦失职所致。方中以香附为君药,快利气机,调畅肺气的拂郁;以苍术为臣药,开发脾胃,强健胃气以资生化之源;神曲为佐药,助消化水谷;栀子清解郁火,引导火热下行。借此通达肺气,腾越胃气,从而清利三焦。尤其妙在用川芎的辛味,直入肝胆,以助其妙用。这样少阳的生气得以向上朝会,营卫和谐;太阴的收气得以向下肃降,精气化生。这是丹溪先生根据五郁之法而变通运用的方剂。然而在五种郁结之中,金(肺)木(肝)两郁尤为严重。前人使用逍遥散,调理肝郁,兼清火滋阴;使用泻白散,清泻肺郁,兼润燥降逆。关键在于木郁上冲即为火,金郁敛涩即为燥。如果阴虚不知道滋补肾水,气虚不知道化生津液,那又是不善于运用越鞠丸了。
陈修园说:各种疾病起于郁结的,难以医治。当时的医生往往用郁金一味药统管治疗,这是被名称所误导的错误。郁金这本经(《神农本草经》)没有记载,唐本(《新修本草》)才有。唐本记载:气味苦、寒、无毒,主治血积,下气,生肌,止血,破恶血,治血淋、尿血、金疮。原文只有这些内容……
Treats wind-phlegm obstructing the throat, with a sound like sawing. Or swelling and fullness caused by dampness invading the interior.
Xixian San (Phlegm-Expelling Powder) composed of Zaojiao (Gleditsiae Sinensis Fructus), Banxia (Pinelliae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), and Fan (Alumen). (Take one pod of Gleditsiae sinensis fructus, fourteen grains of Pinelliae rhizoma, one qian of roasted Glycyrrhizae radix et rhizoma, and two qian of Alumen, grind into fine powder. Take one qian per dose. Mix with a small amount of fresh ginger juice in warm water and administer orally. If phlegm and saliva are vomited out, the patient will regain consciousness. This is like a surprise attack force; it should be used when wind-phlegm obstruction occurs urgently.) For sudden onset of phlegm tide directly affecting the interior, this method acts as a gate-cleaver. There is also Tongguan San (Opening the Pass Powder) made of Xixin (Asari Radix et Rhizoma) and Zaojiao (Gleditsiae Sinensis Fructus) ground into powder. (Grind Asari radix et rhizoma and Gleditsiae sinensis fructus into powder and insufflate into the nose, named Tongguan San.) If sneezing is induced after insufflation, life can be preserved. (For patients suffering from apoplexy and fainting, use this powder insufflated into the nose; if sneezing occurs, it indicates that vital qi remains and life can be saved.)
Chen Xiuyuan stated: Stubborn phlegm blocking the throat creates an emergency situation where death may occur within moments; thus, this method should be used to attack and expel it. However, phlegm is a tangible pathogenic product, so for Phlegm Jue (Phlegm Syncope), emesis should be induced to expel the phlegm. Qi is intangible, so for Qi Jue (Qi Syncope), sneezing should be induced to diffuse the qi. Both methods serve to open blockages. If fainting and loss of consciousness are due to Collapse Syndrome (Tuo Zheng), using these opening methods would only accelerate death. One must be cautious.
To treat all types of stagnation in the zang-fu organs caused by phlegm, food retention, qi stagnation, and blood stasis, manifesting as pain, vomiting, distension, or diarrhea.
For Six Stagnations (Liu Yu), Yueju Wan (Yueju Pill) is appropriate. It contains Xiong (Chuanxiong Rhizoma), Cangzhu (Atractylodis Rhizoma), Qu (Shenqu), Fuzi (Aconiti Lateralis Radix Praeparata - *Note: Standard Yueju Wan does not contain Fuzi, but translated as per source text*), and Zhizi (Gardeniae Fructus). Food retention, qi stagnation, blood stasis, dampness, phlegm, and fire stagnation can be harmonized quickly with this formula. (Wu Hegao stated: Xiangfu (Cyperi Rhizoma) opens Qi stagnation; Chuanxiong (Chuanxiong Rhizoma) regulates Blood stagnation; Cangzhu (Atractylodis Rhizoma) dries Dampness stagnation; Zhizi (Gardeniae Fructus) clears Fire stagnation; Shenqu (Massa Medicata Fermentata) digests Food stagnation. Use equal parts, pill-form with malt decoction. Additionally: add Fuling (Poria) and Baizhi (Angelicae Dahuricae Radix) for Dampness stagnation; add Qingdai (Indigo Naturalis) for Fire stagnation; add Nanxing (Arisaematis Cum Bile) and Banxia (Pinelliae Rhizoma) and Gualou (Trichosanthis Fructus) and Haishi (Aragonitum) for Phlegm stagnation; add Taoren (Persicae Semen) and Honghua (Carthami Flos) for Blood stagnation; add Muxiang (Aucklandiae Radix) and Binglang (Arecae Semen) for Qi stagnation; add Maiya (Hordei Fructus Germinatus) and Shanzha (Crataegi Fructus) for Food stagnation; add Wuzhuyu (Evodiae Fructus) if accompanied by Cold.)
Ji Chuchong stated: The Classic says, "When Taiyin fails to receive, Lung Qi becomes scorched and full." It also says, "All Qi disorders involving fullness and stagnation belong to the Lung." However, the distribution of Lung Qi must rely on the transmission of Stomach Qi; the movement of Stomach Qi is fundamentally based on the transformation of the Sanjiao (Triple Burner). Even symptoms such as pain, vomiting, distension, and diarrhea are essentially caused by the failure of Stomach Qi to diffuse and the dysfunction of the Sanjiao. In this formula, Xiangfu (Cyperi Rhizoma) serves as the Sovereign herb to promote Qi movement and relieve Lung Qi stagnation; Cangzhu (Atractylodis Rhizoma) serves as the Minister herb to open the Spleen-Stomach, strengthen Stomach Qi, and support transformation; Shenqu (Massa Medicata Fermentata) assists in digesting food and fluids; Zhizi (Gardeniae Fructus) clears stagnant heat and guides fire downward. Through this, Lung Qi is reached, Stomach Qi is lifted, and the Sanjiao is cleared. Particularly ingenious is the use of Chuanxiong (Chuanxiong Rhizoma)'s acrid nature to enter the Liver and Gallbladder directly, assisting its subtle functions. Thus, the generating Qi of Shaoyang (Lesser Yang) ascends to meet the Upper Jiao, harmonizing Ying and Wei; the receiving Qi of Taiyin (Greater Yin) descends to purify, transforming Jing Essence. This is Danxi's variation of the Five Stagnations method. However, among the five stagnations, Metal (Lung) and Wood (Liver) are the most severe. Predecessors used Xiaoyao San (Free and Easy Wanderer Powder) to regulate Liver stagnation, clearing heat and nourishing yin; and Xiebai San (Drain White Powder) to clear Lung stagnation, moistening dryness and descending rebellious Qi. The key is that Wood stagnation rushing upward transforms into Fire, and Metal stagnation contracting and astringing transforms into Dryness. If yin deficiency is not treated by nourishing Water (Kidney), and qi deficiency is not treated by transforming fluids, then one is not skilled in using Yueju Wan.
Chen Xiuyuan stated: Diseases originating from stagnation are difficult to treat. Contemporary physicians often indiscriminately use Yujin (Curcumae Longae Rhizoma) to treat all cases of stagnation, which is an error of being misled by the name. Yujin is not recorded in the Ben Cao Jing (Divine Farmer's Materia Medica); it appears in the Tang Ben Cao (New Tang Materia Medica). The Tang Ben Cao states: Its flavor is bitter, cold, and non-toxic. It treats blood accumulations, promotes Qi descent, generates flesh, stops bleeding, breaks bad blood, and treats hematuria, bloody urine, and traumatic injuries. The original text contains only these contents...