心火炽盛,五中烦燥,面红目赤,口燥唇裂,甚则衄血吐血,加味泻心汤主之。
加味泻心汤(自制)
黄连(五分) 犀角(五分) 蒲黄(一钱) 天冬(二钱) 丹参(二钱)
元参(一钱五分) 连翘(二钱) 茯苓(二钱) 甘草(五分) 淡竹叶(二十张) 灯芯(三尺)
此方以黄连清气分之火,以犀角解血分之热,丹参、元参、天冬、甘草以清养心脏,连翘、蒲黄、竹叶、灯芯
以佐连、犀。再以茯苓佐甘草之甘淡,所以顾脾胃也。泻心家实火,而不忘脾胃,所谓毋使过之,伤其正
也。《内经》之真理,吾于先生得之矣。祖怡注。
心血大亏,心阳鼓动,舌绛无津,烦燥不寐,加味养心汤主之。
加味养心汤(自制)
天冬(一钱五分) 麦冬(一钱五分) 生地(五钱) 人参(一钱) 丹参(二钱)
龟版(五钱) 当归(一钱五分) 茯神(二钱) 柏仁(二钱) 枣仁(一钱五分)
远志(五分) 甘草(四分) 淡竹叶(二十张)
同一心火,同一烦燥,前证为实火,此由阴血虚。用天王补心丹方,去桔梗、元参、茯苓、五味,而加龟版、茯
神、甘草、竹叶,不独心肝脾可资挹注,主血三脏俱已顾到,即与血同类之肺肾阴分,亦未放过。此方与
心受燥热养心润燥汤,大半相同,所不同者彼用犀角,此用龟版;彼只用天冬,此兼用麦冬;彼兼用松
仁,此只用柏仁;彼用藕汁,此用竹叶;更加枣仁、远志,异中有同,同中有异。初学制方选药,必须于异同
中求之。治心方如此,其他诸方,亦何莫不然。祖怡注。
心火炽盛,五脏中心烦燥热,面部发红、眼睛充血,口干燥、嘴唇干裂,严重时会发生鼻出血或吐血,使用加味泻心汤主治。
加味泻心汤(自制)
黄连(五分) 犀角(五分) 蒲黄(一钱) 天冬(二钱) 丹参(二钱)
玄参(一钱五分) 连翘(二钱) 茯苓(二钱) 甘草(五分) 淡竹叶(二十张) 灯芯(三尺)
此方用黄连清除气分的火热,用犀角解除血分的温热,丹参、玄参、天冬、甘草用来清润滋养心脏,连翘、蒲黄、竹叶、灯芯辅助黄连和犀角的作用。再用茯苓辅助甘草的甘淡之性,以此来顾护脾胃。在泻除心脏的实火时,不忘顾护脾胃,这就是所说的“不要过度治疗,以免损伤正气”。《黄帝内经》中的真理,我从先生那里领悟到了。祖怡注。
心血严重亏损,心阳鼓动,舌质深红且无津液,心烦燥热、失眠,使用加味养心汤主治。
加味养心汤(自制)
天冬(一钱五分) 麦冬(一钱五分) 生地(五钱) 人参(一钱) 丹参(二钱)
龟版(五钱) 当归(一钱五分) 茯神(二钱) 柏仁(二钱) 枣仁(一钱五分)
远志(五分) 甘草(四分) 淡竹叶(二十张)
同样是心火,同样是心烦燥热,前一种证候属于实火,这一种是由于阴血虚损所致。采用天王补心丹的方子,去掉桔梗、玄参、茯苓、五味子,而加入龟版、茯神、甘草、竹叶,不仅心、肝、脾三脏可以得到补充滋养,主司血液的这三个脏器都已顾及到,就连与血液同类的肺、肾阴分,也没有遗漏。这个方子与用于心受燥热、养心润燥的养心润燥汤大体相同,不同的地方在于:前者用犀角,这里用龟版;前者只用天冬,这里兼用麦冬;前者兼用松仁,这里只用柏仁;前者用藕汁,这里用竹叶;再加上枣仁、远志,异中有同,同中有异。初学者学习组方选药,必须在辨析异同中寻求规律。治疗心脏的方剂如此,其他各类方剂,又何尝不是这样呢?祖怡注。
Heart Fire Blazing, with vexation and irritability in the five viscera (Wuzhong), red face, red eyes, dry mouth, cracked lips, and even epistaxis or hematemesis; Jiawei Xiexin Tang (Modified Heart-Draining Decoction) is the primary prescription.
Jiawei Xiexin Tang (Self-made)
Coptidis Rhizoma (Huanglian, 黄连) - 5 fen
Rhinocerotis Cornu (Xijiao, 犀角) - 5 fen
Pollen Typhae (Puhuang, 蒲黄) - 1 qian
Asparagi Radix (Tandong, 天冬) - 2 qian
Salviae Miltiorrhizae Radix et Rhizoma (Danshen, 丹参) - 2 qian
Scrophulariae Radix (Yuan Shen, 元参) - 1.5 qian
Forsythiae Fructus (Lianqiao, 连翘) - 2 qian
Poria (Fuling, 茯苓) - 2 qian
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) - 5 fen
Lophatheri Herba (Dan Zhuye, 淡竹叶) - 20 leaves
Sparganii Rhizoma / Equiseti Herba (Dengxin, 灯芯) - 3 chi
This formula uses Huanglian to clear fire from the Qi level, and Xijiao to resolve heat from the Blood level. Danshen, Yuan Shen, Tandong, and Gancao are used to clear and nourish the Heart. Lianqiao, Puhuang, Zhuye, and Dengxin assist the actions of Huanglian and Xijiao. Fuling is added to assist the sweet and bland nature of Gancao, thereby protecting the Spleen and Stomach. While draining the excess fire of the Heart, one does not forget to protect the Spleen and Stomach; this is what is meant by "do not over-treat, lest you injure the healthy Qi." The profound truth of the *Neijing* was understood by me through the Master's teachings. Annotated by Zuyi.
Severe Deficiency of Heart Blood, with stirring of Heart Yang, crimson tongue without fluids, vexation, irritability, and insomnia; Jiawei Yangxin Tang (Modified Nourishing-Heart Decoction) is the primary prescription.
Jiawei Yangxin Tang (Self-made)
Asparagi Radix (Tandong, 天冬) - 1.5 qian
Ophiopogonis Radix (Maidong, 麦冬) - 1.5 qian
Rehmanniae Radix Preparata (Shengdi, 生地) - 5 qian
Ginseng Radix (Renshen, 人参) - 1 qian
Salviae Miltiorrhizae Radix et Rhizoma (Danshen, 丹参) - 2 qian
Testudinis Carapax et Plastrum (Guiban, 龟版) - 5 qian
Angelicae Sinensis Radix (Danggui, 当归) - 1.5 qian
Poria cum Pinodia (Fushen, 茯神) - 2 qian
Platycladi Semen (Baren, 柏仁) - 2 qian
Ziziphi Spinosae Semen (Zaoren, 枣仁) - 1.5 qian
Polygalae Radix (Yuanzhi, 远志) - 5 fen
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) - 4 fen
Lophatheri Herba (Dan Zhuye, 淡竹叶) - 20 leaves
Although both cases involve Heart Fire and vexation/irritability, the former is Excess Fire, while this case arises from Yin and Blood deficiency. One adopts the formula of Tianwang Buxin Dan, removing Jiegeng, Yuan Shen, Fuling, and Wuweizi, and adding Guiban, Fushen, Gancao, and Zhuye. This not only supplements and nourishes the Heart, Liver, and Spleen, but also attends to the three viscera governing Blood. Even the Yin levels of the Lung and Kidney, which are similar in nature to Blood, are not neglected. This formula is largely identical to Yangxin Runzao Tang (Nourishing-Heart and Moistening-Dryness Decoction) used for Heart affected by Dryness-Heat. The differences are: the latter uses Xijiao, whereas this uses Guiban; the latter uses only Tandong, whereas this uses both Tandong and Maidong; the latter uses Songren, whereas this uses only Baren; the latter uses Oujiang (Lotus Root Juice), whereas this uses Zhuye; additionally, Zaoren and Yuanzhi are included. There is similarity within difference, and difference within similarity. Beginners learning to formulate prescriptions and select herbs must seek principles within these similarities and differences. Such is the case with formulas treating the Heart, and how much more so with other formulas? Annotated by Zuyi.