夫胆腑者。主肝也。肝合气于胆。胆者中清之腑也。号将军决曹吏。重三两三铢。长三
寸三
脑
恒之
此受
不能实。六腑者。传化物而不藏。故实而不能满也。所以然者。水谷入口
食下则肠实而胃虚。故曰实而不满。满而不实也。
左手关上阳绝者。无胆脉也。苦膝疼。口中苦。眯目善畏。如见鬼。多惊少力。刺足厥
阴治阴。在足大指间或刺三毛中。
左手关上阳实者。胆实也。苦腹中不安。身躯习习也。刺足少阳治阳。在足上第二指本
节后
胆病者善太息。口苦。呕宿汁。心澹澹恐。如人将捕之。咽仲介介然。数唾。候在足少
阳之
恐。
胃
胆胀者胁下痛胀。口苦太息。
肝前受病移于胆。肝咳不已。则呕胆汁。
厥气客于胆。则梦斗讼。
肝应筋。爪浓色黄者胆浓。爪薄色红者胆薄。爪坚色青者胆急。爪软色赤者胆缓。爪直
色白
扁鹊云。足厥阴与少阳为表里。表清里浊。其病若实极则伤热。热则惊动。精神而不守。
卧
足
夫左手关上脉阳实者足少阳经也。为胆实热。盖实则为有余。有余则生热。故其证苦腹
中气
痛
龙胆泻肝汤(出卫生宝鉴)治热盛口苦胆瘅。乃肝主谋虑。胆主决断汁计二
合。是中清之府
而使然也。
柴胡(一钱) 黄芩(七分) 生甘草 人参 天门冬(去心) 黄连(去苗) 龙胆
草知母
山
菊花散(出圣惠方)治胆伏热。精神惊悸不安。
甘菊花(一两) 牛黄(研半两) 犀角(镑屑三分) 铁粉(半两) 黄连(去须三
分) 麦门
冬(
食后淡竹
沥
半夏汤 治胆腑实热。精神不宁。
半夏 宿姜(各三两) 黄芩(一两) 生地(五两) 远志 茯苓(各三两) 秫米
(一斗)
酸枣
取
人参
酸枣仁丸(出永类钤方)治胆气实热不得睡。神思不安。
茯苓 酸枣仁(去核) 远志(去心) 柏子仁(炒) 防风(各一两) 生地黄 枳
壳(各半
两)
升麻汤(出圣惠方)治足少阳经热积久。腹中气满。睡不安。头昏口苦。小便
不利。胆实热
升麻 麦门冬(去心) 黄芩 茯神(去木) 大黄(炒) 地骨皮(去土) 羚羊角
(镑下)
甘草
临
卧。
楝实丸 治胆经实热。心神惊悸。小便不利。
楝实(三两童子小便浸一宿又火煮烂去皮焙干) 大黄 栀子仁(炒各一两) 人参 赤
茯
苓
匀。
炼蜜
泻热汤 治实热。精神不安之病。
龙胆草 酸枣仁(微炒) 黄芩(去黑心) 茯神(去木) 升麻 伏龙肝 竹茹 甘
草(炙
各等
泻胆汤(出永类钤方)治胆实热及洒洒寒热。腹中气满。胁下硬。口苦咽干。
头疼不欲饮食
半夏(三两汤泡去滑) 生地黄(五两) 酸枣仁(二两半) 黄芩(一两) 远志(去
心) 茯
苓(
澄
清
流水汤 治胆实生热。腹中气浊。饮食不下。咽干头重。洒洒恶寒。两胁胀痛。
半夏(汤洗炒一两) 酸枣仁(二两) 黄芩(去黑心五钱) 赤茯苓(一钱) 山栀
子(去皮)
生
升。
姜五片。煎一盏去滓。温二服。空心食后各一服。一方无地黄。
枳壳汤(出圣惠方)治胆经有热。腹中气满不安。咽干头重。心神惊悸。小便
不利。一名人
枳壳(去瓤麸炒一两) 人参 葵子 甘草(炙各五钱) 赤茯苓 黄芩(各三两) 上
捣
筛。每
山栀子饮 治肝胆邪热。神思不宁。喜怒狂躁。口苦舌干。
山栀子(一两五钱) 竹茹(一两) 豆豉(一升) 大青(八钱) 陈皮(汤浸去白
一两) 上
捣筛
胡黄连丸(出圣惠方)治胆热精神不宁。卧起不安。口中常苦。
胡黄连(一两) 羚羊角(屑一两) 蛇黄(火 五钱) 熊胆(一分) 青黛(别研
一分) 上
为末
胆腑,主要与肝相配合。肝气通于胆。胆属于“中清之腑”(指胆内藏清净胆汁,不直接受纳水谷的脏腑)。胆被称为“将军之官”,负责决断。其重量为三两三铢,长度约为三寸。
胆的功能特点是“实而不能满”。六腑的共同特点是传导和消化食物,而不像五脏那样贮藏精气。因此,六腑的状态是“实而不满”(指食物通过时暂时充实,但不能像五脏那样充满精气)。“满而不实”则是五脏的特点。之所以如此,是因为当水谷入口、食物咽下后,肠道变得充实而胃相对空虚;反之,当胃中有食物时,肠道相对空虚。所以说,六腑是“实而不满”,五脏是“满而不实”。
如果左手关部脉象表现为“阳绝”,说明没有胆脉。患者会感到膝盖疼痛,口中发苦,眯着眼睛,容易恐惧,好像看见鬼怪一样,经常受到惊吓且体力不足。治疗应针刺足厥阴肝经以调理阴分,取穴在大脚趾缝间或大脚趾爪甲旁的“三毛处”(即大敦穴)。
如果左手关部脉象表现为“阳实”,这是胆实证的表现。患者会感到腹部不安宁,身体感觉异样(如蚁行感或不适)。治疗应针刺足少阳胆经以调理阳分,取穴在足背第二趾根部后方。
患有胆病的人喜欢叹气,口苦,呕吐宿存的胆汁样液体,心中悸动不安,恐惧害怕,好像有人要抓捕自己一样,咽喉部感觉异物梗塞,频繁吐唾沫。这些征候反映在足少阳胆经上。
厥逆之气客居于胆,会导致梦见争斗或诉讼。
肝主筋,指甲的颜色和质地可以反映胆的状态:指甲浓密、颜色黄的是胆浓;指甲薄、颜色红的是胆薄;指甲坚硬、颜色青的是胆急(紧张拘急);指甲柔软、颜色赤的是胆缓(松弛);指甲挺直、颜色白的是……(原文此处中断)。
扁鹊说:足厥阴肝经与足少阳胆经互为表里。表(肝)清里(胆)浊。如果病邪发展到极实的程度,就会损伤热邪;热盛则导致惊动,精神不能守舍,睡眠不安……(原文此处中断)。
夫左手关上脉象阳实者,属于足少阳胆经,为胆实热证。因为实证则为有余,有余则生热。所以其症状表现为腹部……(原文此处中断)。
龙胆泻肝汤(出自《卫生宝鉴》),治疗热盛导致的口苦、胆瘅(胆热病)。这是因为肝主谋虑,胆主决断,这是由其中清之腑的特性所决定的。
组成:柴胡(一钱)、黄芩(七分)、生甘草、人参、天门冬(去心)、黄连(去苗)、龙胆草、知母、山……(原文此处中断)。
菊花散(出自《圣惠方》),治疗胆伏热导致的惊恐心悸、心神不安。
组成:甘菊花(一两)、牛黄(研细半两)、犀角(镑成屑三分)、铁粉(半两)、黄连(去须三分)、麦门冬……(原文此处中断)。食后服用淡竹沥……
半夏汤,治疗胆腑实热导致的精神不宁。
组成:半夏、宿姜(各三两)、黄芩(一两)、生地(五两)、远志、茯苓(各三两)、秫米(一斗)……酸枣……取……人参……
酸枣仁丸(出自《永类钤方》),治疗胆气实热导致的失眠、神思不安。
组成:茯苓、酸枣仁(去核)、远志(去心)、柏子仁(炒)、防风(各一两)、生地黄、枳壳(各半两)……
升麻汤(出自《圣惠方》),治疗足少阳经热邪积久,导致腹中气满、睡眠不安、头晕、口苦、小便不利等胆实热证。
组成:升麻、麦门冬(去心)、黄芩、茯神(去木)、大黄(炒)、地骨皮(去土)、羚羊角(镑成屑)……甘草……临卧服用。
楝实丸,治疗胆经实热导致的心神惊悸、小便不利。
组成:楝实(三两,用童子小便浸泡一夜,再火煮烂,去皮焙干)、大黄、栀子仁(炒,各一两)、人参、赤茯苓……匀……炼蜜……
泻热汤,治疗实热导致的精神不安之病。
组成:龙胆草、酸枣仁(微炒)、黄芩(去黑心)、茯神(去木)、升麻、伏龙肝、竹茹、甘草(炙,各等份)……
泻胆汤(出自《永类钤方》),治疗胆实热及忽冷忽热的症状,腹中气满,胁下硬结,口苦咽干,头痛不欲饮食。
组成:半夏(三两,汤泡去滑)、生地黄(五两)、酸枣仁(二两半)、黄芩(一两)、远志(去心)、茯苓……澄……清……
流水汤,治疗胆实生热,腹中气浊,饮食不下,咽干头重,忽冷忽热,两胁胀痛。
组成:半夏(汤洗炒一两)、酸枣仁(二两)、黄芩(去黑心五钱)、赤茯苓(一钱)、山栀子(去皮)……生……升……姜五片。煎至一盏,去滓,温服两次。空腹和饭后各服一次。另一版本无地黄。
枳壳汤(出自《圣惠方》),治疗胆经有热,腹中气满不安,咽干头重,心神惊悸,小便不利。又名人……
组成:枳壳(去瓤麸炒一两)、人参、葵子、甘草(炙,各五钱)、赤茯苓、黄芩(各三两)。上药捣……筛。每……
山栀子饮,治疗肝胆邪热,神思不宁,喜怒狂躁,口苦舌干。
组成:山栀子(一两五钱)、竹茹(一两)、豆豉(一升)、大青(八钱)、陈皮(汤浸去白一两)。上……捣筛……
胡黄连丸(出自《圣惠方》),治疗胆热导致的精神不宁,卧起不安,口中常苦。
组成:胡黄连(一两)、羚羊角(屑一两)、蛇黄(火……五钱)、熊胆(一分)、青黛(别研一分)。上……为末……
The Gallbladder Fu-organ primarily cooperates with the Liver. The Qi of the Liver connects to the Gallbladder. The Gallbladder is a "Middle-Clear Fu-organ" (a hollow organ containing clear bile, not directly receiving food and drink). It is referred to as the "General Officer," responsible for decision-making. Its weight is three taels and three zhu, and its length is approximately three cun.
The functional characteristic of the Gallbladder is "solid but not full." The common feature of the six Fu-organs is the transmission and transformation of substances without storing essence. Therefore, the state of the Fu-organs is "solid but not full" (referring to temporary fullness during the passage of food, unlike the Zang-organs which are filled with essence). "Full but not solid" is the characteristic of the five Zang-organs. This is because when food and drink enter the mouth and are swallowed, the intestines become solid while the stomach becomes relatively empty; conversely, when the stomach contains food, the intestines are relatively empty. Thus, it is said that the Fu-organs are "solid but not full," and the Zang-organs are "full but not solid."
If the pulse at the Guan position on the left hand manifests as "Yang Absence," it indicates the absence of the Gallbladder pulse. The patient suffers from knee pain, bitter taste in the mouth, squinting eyes, excessive fear, hallucinations of seeing ghosts, frequent fright, and lack of strength. Treatment should involve needling the Foot-Jueyin Liver Meridian to regulate Yin, selecting points between the big toe or at the "Sanmao" area (Dadun, LR1) on the big toe.
If the pulse at the Guan position on the left hand manifests as "Yang Excess," this is a manifestation of Gallbladder Excess Syndrome. The patient feels abdominal discomfort and bodily sensations such as formlessness or uneasiness. Treatment should involve needling the Foot-Shaoyang Gallbladder Meridian to regulate Yang, selecting points behind the root of the second toe.
Patients with Gallbladder disease often sigh, experience a bitter taste in the mouth, vomit old bile-like fluid, feel palpitations and fear as if being pursued, have a sensation of obstruction in the throat, and frequently spit saliva. These signs reflect upon the Foot-Shaoyang Gallbladder Meridian.
Symptoms of Gallbladder Distension include pain and distension under the hypochondrium, bitter taste in the mouth, and frequent sighing.
If the Liver is first affected by pathogenic factors and subsequently involves the Gallbladder, persistent Liver Cough will result in vomiting of bile.
If rebellious Qi lodges in the Gallbladder, it leads to dreams of fighting or litigation.
The Liver governs the sinews, and the condition of the nails reflects the state of the Gallbladder: thick nails with yellow color indicate a robust Gallbladder; thin nails with red color indicate a deficient Gallbladder; hard nails with blue-green color indicate Gallbladder Tension; soft nails with red color indicate Gallbladder Laxity; straight nails with white color indicate... (text interrupted here).
Bian Que stated: The Foot-Jueyin Liver Meridian and the Foot-Shaoyang Gallbladder Meridian are exterior-interior pairs. The exterior (Liver) is clear, and the interior (Gallbladder) is turbid. If pathology reaches extreme excess, it damages with Heat. Excessive Heat causes agitation, leading to mental instability and restless sleep... (text interrupted here).
Regarding the pulse at the Guan position on the left hand manifesting as Yang Excess, this belongs to the Foot-Shaoyang Gallbladder Meridian and represents Gallbladder Excess-Heat Syndrome. Since Excess implies surplus, surplus generates Heat. Therefore, symptoms include abdominal... (text interrupted here).
Longdan Xiegan Tang (from *Weisheng Baojian*) treats severe Heat causing bitter taste and Dan-Disease (Gallbladder Heat Disease). This is because the Liver governs planning and the Gallbladder governs decision-making, determined by its nature as a Middle-Clear organ.
Ingredients: Chai Hu (Cimicifugae Rhizoma, 1 qian), Huang Qin (Scutellariae Radix, 7 fen), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma), Ren Shen (Ginseng Radix), Tian Men Dong (Asparagi Radix, heart removed), Huang Lian (Coptidis Rhizoma, roots removed), Long Dan Cao (Gentianae Radix), Zhi Mu (Anemarrhenae Rhizoma), Shan... (text interrupted here).
Juhua San (from *Shenghui Fang*) treats latent Heat in the Gallbladder causing fright, palpitations, and mental unrest.
Ingredients: Gan Ju Hua (Chrysanthemi Flos, 1 liang), Niu Huang (Calculus Bovis, ground, half liang), Xi Jiao (Rhinocerotis Cornu, shaved, 3 fen), Tie Fen (Ferrum, half liang), Huang Lian (Coptidis Rhizoma, roots removed, 3 fen), Mai Men Dong (Ophiopogonis Radix)... (text interrupted here). Take with light bamboo juice after meals...
Banxia Tang treats Gallbladder Fu-organ Excess-Heat causing mental unrest.
Ingredients: Ban Xia (Pinelliae Rhizoma), Su Jiang (Old Ginger, each 3 liang), Huang Qin (Scutellariae Radix, 1 liang), Sheng Di Huang (Rehmanniae Radix, 5 liang), Yuan Zhi (Polygalae Radix), Fu Ling (Poria, each 3 liang), Shu Mi (Sorghum, 1 dou)... Suan Zao... extract... Ren Shen...
Suanzaoren Wan (from *Yonglei Qianfang*) treats Gallbladder Qi Excess-Heat causing insomnia and mental unrest.
Ingredients: Fu Ling (Poria), Suan Zao Ren (Ziziphi Spinosae Semen, pitted), Yuan Zhi (Polygalae Radix, heart removed), Bai Zi Ren (Platycladi Semen, stir-fried), Fang Feng (Saposhnikoviae Radix, each 1 liang), Sheng Di Huang (Rehmanniae Radix), Zhi Ke (Aurantii Fructus, each half liang)...
Shengma Tang (from *Shenghui Fang*) treats long-standing Heat accumulation in the Foot-Shaoyang Meridian causing abdominal fullness, restless sleep, dizziness, bitter taste, and difficult urination, representing Gallbladder Excess-Heat.
Ingredients: Sheng Ma (Cimicifugae Rhizoma), Mai Men Dong (Ophiopogonis Radix, heart removed), Huang Qin (Scutellariae Radix), Fu Shen (Poria with Hostwood, wood removed), Da Huang (Rhei Radix et Rhizoma, stir-fried), Di Gu Pi (Lycii Cortex), Ling Yang Jiao (Saigae Tataricae Cornu, shaved)... Gan Cao... Take before bed.
Lianshi Wan treats Gallbladder Meridian Excess-Heat causing mental fright and palpitations, and difficult urination.
Ingredients: Lianshi (Meliae Fructus, 3 liang, soaked in urine of young boys overnight, boiled until soft, peeled, dried), Da Huang (Rhei Radix et Rhizoma), Zhizi Ren (Gardeniae Semen, stir-fried, each 1 liang), Ren Shen (Ginseng Radix), Chi Fu Ling (Red Poria)... Mix evenly... Refine honey...
Xiere Tang treats Excess-Heat causing mental unrest.
Ingredients: Long Dan Cao (Gentianae Radix), Suan Zao Ren (Ziziphi Spinosae Semen, slightly stir-fried), Huang Qin (Scutellariae Radix, black heart removed), Fu Shen (Poria with Hostwood, wood removed), Sheng Ma (Cimicifugae Rhizoma), Fu Long Gan (Dragon's House Liver/Fired Clay), Zhu Ru (Bambusae Caulis in Taeniam, Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma, equal parts)...
Xiedan Tang (from *Yonglei Qianfang*) treats Gallbladder Excess-Heat accompanied by chills and fever, abdominal fullness, hardness under the hypochondrium, bitter taste, dry throat, headache, and loss of appetite.
Ingredients: Ban Xia (Pinelliae Rhizoma, 3 liang, soaked in water to remove slipperiness), Sheng Di Huang (Rehmanniae Radix, 5 liang), Suan Zao Ren (Ziziphi Spinosae Semen, 2.5 liang), Huang Qin (Scutellariae Radix, 1 liang), Yuan Zhi (Polygalae Radix, heart removed), Fu Ling (Poria)... Clarify... Clear...
Liushui Tang treats Gallbladder Excess generating Heat, turbid Qi in the abdomen, inability to eat, dry throat, heavy head, chills, and distending pain in both hypochondria.
Ingredients: Ban Xia (Pinelliae Rhizoma, washed in water and stir-fried, 1 liang), Suan Zao Ren (Ziziphi Spinosae Semen, 2 liang), Huang Qin (Scutellariae Radix, black heart removed, 5 qian), Chi Fu Ling (Red Poria, 1 qian), Shan Zhi Zi (Gardeniae Fructus, peel removed)... Sheng... Rise... 5 slices of Ginger. Decoct to one cup, strain, take warm in two doses. One dose on an empty stomach and one after meals. Another version excludes Di Huang.
Zhike Tang (from *Shenghui Fang*) treats Heat in the Gallbladder Meridian causing abdominal fullness and unrest, dry throat, heavy head, mental fright and palpitations, and difficult urination. Also known as Ren...
Ingredients: Zhi Ke (Aurantii Fructus, pulp removed, bran-stir-fried, 1 liang), Ren Shen (Ginseng Radix), Kui Zi (Malvae Semen), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma, each 5 qian), Chi Fu Ling (Red Poria), Huang Qin (Scutellariae Radix, each 3 liang). Pound the above... Sieve. Each...
Shanzhizi Yin treats Evil Heat in the Liver and Gallbladder causing mental unrest, irritability, mania, bitter taste, and dry tongue.
Ingredients: Shan Zhi Zi (Gardeniae Fructus, 1.5 liang), Zhu Ru (Bambusae Caulis in Taeniam, 1 liang), Dou Chi (Sojae Semen Praeparatum, 1 sheng), Da Qing (Isatidis Folium, 8 qian), Chen Pi (Citri Reticulatae Pericarpium, soaked in water, white pith removed, 1 liang). The above... Pound and sieve...
Huhuanglian Wan (from *Shenghui Fang*) treats Gallbladder Heat causing mental unrest, restlessness in lying down and rising, and constant bitter taste in the mouth.
Ingredients: Hu Huang Lian (Coptidis Chinensis Rhizoma, 1 liang), Ling Yang Jiao (Saigae Tataricae Cornu, shaved, 1 liang), She Huang (Snake Gallstone/Calculus Serpentis, fired, 5 qian), Xiong Dan (Ursi Fel, 1 fen), Qing Dai (Indicum, separately ground, 1 fen). The above... Make into powder...