夫水之与饮。同出而异名也。人惟脾土有亏。故平日所饮水浆不能传化。或停于心下。
或聚
水饮
为
冷痛。冷痹。水气滞于经络。血脉不行。四肢浮肿。则曰血分。凡此等类。皆水气之所由作
也。据病验证。可不究其所受之原乎。然则疗治之将何先。曰。能以表里虚实诊之斯得矣。
表有水者。其身热嗽喘。怔忡呕而微利。青龙汤汗之而愈。里有水者。其身凉。呕嗽。痞满
引胁痛硬。十枣汤下之而安。虚者脉虚。心腹满而濡。当以安肾丸为主。加青木香丸(方见
水
(
多
吐之。水不在于上焦。则常山亦能破其癖而下其水也。其水肿证候。亦此种类也。
方
桂芩汤(出直指方)治血分。
辣桂 赤茯苓 当归 川芎 赤芍药 蓬莪术 京三棱 槟榔 苍术 桑白皮(炒) 大
腹皮
上
锉散
调荣饮(出直指方)治瘀血留滞。血化为水。四肢浮肿。腹肿。名曰血分。
华阴细辛 莪术 辣桂 赤芍药 延胡索 当归 川芎 白芷 槟榔 大腹皮 桑白皮
瞿
每服三
钱
续断饮(出直指方)治血分。
延胡索 当归 川芎 牛膝 川续断 赤芍药 辣桂 白芷 五灵脂(炒) 羌活(各
一
分)
姜四片。
食前
加味枳术汤(出直指方)治气为痰饮所隔。心下坚胀。名曰气分。歌云。气分
中满并胞痹。
两处推求病端的。
湿。阴阳相得气乃行。
似旋盘。桂附术汤为最妙。
枳壳(制) 白术 紫苏茎叶 辣桂 陈皮(去白) 槟榔 桔梗 木香 五灵脂(炒
各一
分)
芎夏汤(出直指方)逐水利饮通用。
川芎 半夏(制) 茯苓(各一两) 青皮 陈皮 枳壳(各半两制) 白术 甘草(各
一分
炒)
白皮。
南星。
以类推
桂术汤(出直指方)治气分。
辣桂(三两) 白术 麻黄(去根) 细辛(去苗土) 甘草(炒各二两) 枳壳(制)
干姜(炮各
平肺汤(出直指方)肺与肾皆以至阴积水。喘促咳嗽。盖水乘之。
小青龙汤(出直指方)治表不解心下有水气。发热干呕。怔忡咳嗽。喘。微利
。
十枣汤(出直指方)治表不解。里有水。身凉汗出。干呕短气。微嗽微利。心
下痞满引胁硬
枳术丸(出保命集方)治胸膈痞闷。有停饮。
枳壳 白术(各二两) 上为末。面糊为丸。如梧桐子大。每日服三十丸至五十丸。温
汤
下。
治冷热久 实痞。不能饮食。心下虚满如水状方。\x(出千金方)
前胡 生姜 茯苓 半夏(各四两) 甘草 枳实 白术(各四两) 桂心(二两) 上
咀。
水与饮,同源而异名。人若脾土虚弱,则平日所饮水液无法运化传输。这些水液有的停滞在心下,有的积聚成饮,导致冷痛、冷痹。水气阻滞于经络,血脉运行不畅,四肢出现浮肿,这称为“血分”。凡此类情况,都是水气产生的原因。根据病症验证,难道可以不探究其发病的根源吗?那么治疗时应该先做什么呢?回答说:能够通过辨别表里虚实来进行诊断,就能找到治疗方法了。
体表有水邪的,表现为身体发热、咳嗽气喘、心悸怔忡、呕吐并伴有轻微腹泻,用青龙汤发汗即可痊愈。体内有水邪的,表现为身体发凉、呕吐咳嗽、心下痞满牵引胁肋疼痛且坚硬,用十枣汤攻下即可安宁。体质虚弱的,脉象虚软,心腹部胀满但按之濡软,应当以安肾丸为主方,加入青木香丸(方剂见前文)。如果水饮在上焦,应当采用催吐法;如果水不在上焦,常山也能破除积癖并引导水饮下行。水肿的证候,也属于这一类。
桂芩汤(出自《直指方》),治疗血分病。
辣桂、赤茯苓、当归、川芎、赤芍药、蓬莪术、京三棱、槟榔、苍术、桑白皮(炒)、大腹皮。
以上药物锉散。
调荣饮(出自《直指方》),治疗瘀血留滞,血液转化为水,四肢浮肿,腹部肿胀,名为“血分”。
华阴细辛、莪术、辣桂、赤芍药、延胡索、当归、川芎、白芷、槟榔、大腹皮、桑白皮、瞿麦。
每次服用三钱。
续断饮(出自《直指方》),治疗血分病。
延胡索、当归、川芎、牛膝、川续断、赤芍药、辣桂、白芷、五灵脂(炒)、羌活(各一分)。
生姜四片。
饭前服用。
加味枳术汤(出自《直指方》),治疗气机被痰饮阻隔,心下坚硬胀满,名为“气分”。歌诀云:“气分中满并胞痹,两处推求病端的。湿阻阴阳相得气乃行,气行如似旋盘转,桂附术汤为最妙。”
枳壳(制)、白术、紫苏茎叶、辣桂、陈皮(去白)、槟榔、桔梗、木香、五灵脂(炒)(各一分)。
芎夏汤(出自《直指方》),逐水利饮通用方。
川芎、半夏(制)、茯苓(各一两)、青皮、陈皮、枳壳(各半两,制)、白术、甘草(各一分,炒)、白皮、南星。
以此类推。
桂术汤(出自《直指方》),治疗气分病。
辣桂(三两)、白术、麻黄(去根)、细辛(去苗土)、甘草(炒,各二两)、枳壳(制)、干姜(炮,各...[原文此处似有缺漏,依文意补全逻辑])。
平肺汤(出自《直指方》),肺与肾皆因至阴之气积水,导致喘促咳嗽,这是因为水气乘袭所致。
小青龙汤(出自《直指方》),治疗表证未解,心下有停饮,表现为发热、干呕、心悸怔忡、咳嗽、气喘、轻微腹泻。
十枣汤(出自《直指方》),治疗表证未解,体内有水邪,表现为身体发凉、出汗、干呕、短气、轻微咳嗽、轻微腹泻、心下痞满牵引胁肋部坚硬。
枳术丸(出自《保命集方》),治疗胸膈痞闷,有停饮。
枳壳、白术(各二两)。
以上研为末,面糊为丸,如梧桐子大小。每日服用三十丸至五十丸,温开水送服。
治冷热久...实痞,不能饮食,心下虚满如水状方(出自《千金方》)。
前胡、生姜、茯苓、半夏(各四两)、甘草、枳实、白术(各四两)、桂心(二两)。
以上切碎。
Water and Yin (fluid retention) share the same origin but have different names. If a person's Spleen Earth is deficient, the fluids consumed daily cannot be transported and transformed. These fluids may stagnate in the epigastrium or accumulate as Yin, causing cold pain and cold Bi syndrome. When Qi of water obstructs the meridians and collaterals, preventing the smooth flow of blood vessels, and edema occurs in the four limbs, it is termed Blood Division (Xue Fen). All such cases are caused by the generation of Water Qi. Based on symptom verification, can one fail to investigate the root cause? Then what should be done first in treatment? The answer is: if one can diagnose through differentiation of exterior/interior and deficiency/excess, the treatment method will be found.
For those with water pathogen at the exterior, symptoms include fever, cough, wheezing, palpitations, vomiting, and slight diarrhea. They can be cured by inducing sweating with Qinglong Tang (Azure Dragon Decoction). For those with water pathogen at the interior, symptoms include cool body temperature, vomiting, cough, epigastric fullness and stuffiness radiating to the hypochondrium with hardness and pain. They can be stabilized by purging with Shizao Tang (Ten Jujube Decoction). For deficiency patterns, the pulse is weak, and there is abdominal distension that feels soft upon pressure; An Shen Wan (Kidney Calming Pill) should be used as the main formula, supplemented with Qing Mu Xiang Wan (Green Ambergris Pill) (formula see above). If water-fluid is in the Upper Jiao, emesis should be induced. If water is not in the Upper Jiao, Changshan (Rhizoma Dichroae) can also break up accumulations and guide water downward. Edema syndromes also belong to this category.
Guixin Tang (Cinnamon Twig and Scutellaria Decoction) (from *Zhizhi Fang*), treats Blood Division.
Lagui (Cortex Cinnamomi), Chifuling (Poria with Hostwood), Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Chuanxiong), Chishaoyao (Radix Paeoniae Rubra), Peng'ezhu (Rhizoma Curcumae Phaeocaulis), Jing Sanleng (Rhizoma Sparganii), Binglang (Areca Seed), Cangzhu (Rhizoma Atractylodis Lanceae), Sangbaipi (Cortex Mori Radicis, stir-fried), Dafupi (Pericarpium Arecae).
The above are cut into small pieces for decoction.
Tiaorong Yin (Regulating Blood Infusion) (from *Zhizhi Fang*), treats stasis of blood remaining stagnant, where blood transforms into water, causing edema of the four limbs and abdominal swelling, named Blood Division.
Huayin Xixin (Asarum from Huayin), Ezhu (Rhizoma Curcumae), Lagui (Cortex Cinnamomi), Chishaoyao (Radix Paeoniae Rubra), Yanshusuo (Rhizoma Corydalis Yanhusuo), Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Chuanxiong), Baizhi (Radix Angelicae Dahuricae), Binglang (Areca Seed), Dafupi (Pericarpium Arecae), Sangbaipi (Cortex Mori Radicis), Qumai (Herba Siegesbeckiae).
Take three qian per dose.
Xuduan Yin (Teasel Root Infusion) (from *Zhizhi Fang*), treats Blood Division.
Yanshusuo (Rhizoma Corydalis Yanhusuo), Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Chuanxiong), Niuxi (Radix Achyranthis Bidentata), Chuanduan (Radix Dipsaci), Chishaoyao (Radix Paeoniae Rubra), Lagui (Cortex Cinnamomi), Baizhi (Radix Angelicae Dahuricae), Wulingzhi (Feces Trogopterori, stir-fried), Qianghuo (Rhizoma et Radix Notopterygii) (each 1 fen).
Four slices of fresh ginger.
Take before meals.
Jiawei Zhizhu Tang (Modified Aurantium and Atractylodes Macrocephala Decoction) (from *Zhizhi Fang*), treats Qi being blocked by phlegm-fluid, causing hardness and distension in the epigastrium, named Air Division (Qi Fen). The song says: "Air division involves middle-fullness and bladder Bi; seek the root of the disease in both places. When dampness allows Yin and Yang to interact, Qi flows smoothly like a spinning wheel; Guifu Zhu Tang is the best."
Zhike (Fructus Aurantii, processed), Baizhu (Rhizoma Atractylodis Macrocephalae), Zisu Jingye (Stem and Leaf of Perilla), Lagui (Cortex Cinnamomi), Chenpi (Pericarpium Citri Reticulatae, white part removed), Binglang (Areca Seed), Jiegeng (Radix Platycodonis), Muxiang (Radix Aucklandiae), Wulingzhi (Feces Trogopterori, stir-fried) (each 1 fen).
Xiongxia Tang (Ligusticum and Pinellia Decoction) (from *Zhizhi Fang*), general formula for draining water and eliminating fluid retention.
Chuanxiong (Rhizoma Chuanxiong), Banxia (Rhizoma Pinelliae, processed), Fuling (Poria) (each 1 liang), Qingpi (Pericarpium Citri Reticulatae Viride), Chenpi (Pericarpium Citri Reticulatae), Zhike (Fructus Aurantii, processed) (each half liang, processed), Baizhu (Rhizoma Atractylodis Macrocephalae), Gancao (Radix Glycyrrhizae) (each 1 fen, stir-fried), Baipi (Cortex), Nanxing (Rhizoma Arisaematis).
Apply by analogy.
Guishu Tang (Cinnamon Twig and Atractylodes Decoction) (from *Zhizhi Fang*), treats Air Division.
Lagui (Cortex Cinnamomi, 3 liang), Baizhu (Rhizoma Atractylodis Macrocephalae), Mahuang (Herba Ephedrae, roots removed), Xixin (Herba Asari, seedlings and soil removed), Gancao (Radix Glycyrrhizae, stir-fried) (each 2 liang), Zhike (Fructus Aurantii, processed), Ganjiang (Rhizoma Zingiberis, roasted) (each...).
Pingfei Tang (Lung-Calming Decoction) (from *Zhizhi Fang*). Both Lung and Kidney accumulate water due to Supreme Yin, leading to panting, coughing, and wheezing because water attacks them.
Xiaoqinglong Tang (Minor Azure Dragon Decoction) (from *Zhizhi Fang*), treats unresolved exterior condition with water qi in the epigastrium, manifesting as fever, dry retching, palpitations, cough, wheezing, and slight diarrhea.
Shizao Tang (Ten Jujube Decoction) (from *Zhizhi Fang*), treats unresolved exterior condition with water inside, manifesting as cool body, sweating, dry retching, shortness of breath, slight cough, slight diarrhea, and epigastric stuffiness radiating to hard hypochondrium.
Zhizhu Wan (Aurantium and Atractylodes Macrocephala Pill) (from *Baoming Ji Fang*), treats chest and diaphragm stuffiness with retained fluid.
Zhike (Fructus Aurantii), Baizhu (Rhizoma Atractylodis Macrocephalae) (each 2 liang).
Grind into powder, make pills with wheat paste, size of Sophora japonica seeds. Take 30 to 50 pills daily, washed down with warm water.
Formula for treating long-standing cold-heat excess stuffiness, inability to eat, and epigastric emptiness/fullness resembling water state (from *Qianjin Fang*).
Qianhu (Radix Peucedani), Shengjiang (Rhizoma Zingiberis Recens), Fuling (Poria), Banxia (Rhizoma Pinelliae) (each 4 liang), Gancao (Radix Glycyrrhizae), Zhishi (Fructus Aurantii Immaturus), Baizhu (Rhizoma Atractylodis Macrocephalae) (each 4 liang), Guixin (Cortex Cinnamomi) (2 liang).
Cut into small pieces.