悬饮者,水流胁下,咳唾引痛。胁乃肝胆之位,水气在胁,则肝气拂逆,而肺金清肃之令不能下行
,故咳而引痛也。椒目栝蒌汤主之。
椒目栝蒌汤(自制)
椒目(五十粒) 栝蒌头(五钱切) 桑皮(二钱) 葶苈子(二钱) 橘红(一钱)
半夏(一钱五分) 茯苓(二钱) 苏子(一钱五分) 蒺藜(三钱) 姜(三片)
此方仍是二陈去甘草,以椒目通水道,栝蒌通谷道,葶苈、苏子、桑皮以泻肺,疾藜以疏肝。
水饮下行,而肺肝和矣。祖怡注。
溢饮者,水气旁流于四肢也。脾受水邪,溢入四末,故肢节作肿,身重无力,桂苓神术汤主之。
桂苓神术汤(自制)
桂枝(八分) 茯苓(三钱) 白术(一钱) 茅术(一钱) 苡仁(八钱)
广皮(一钱) 半夏(一钱五分) 浓朴(一钱) 砂仁(一钱) 姜(三片)
此方合苓桂术甘、二陈、平胃,去甘草加苡仁、砂仁,纯用温运胃脾,而水饮自化。祖怡注。
支饮者,水停心下,入于胸膈,咳逆倚息短气,其形如肿,桑苏桂苓汤主之。
桑苏桂苓汤(自制)
桑皮(三钱) 苏子(二钱) 桂枝(八分) 茯苓(三钱) 泽泻(一钱五分)
大腹皮(一钱五分) 橘红(一钱) 半夏(一钱五分) 杏仁(三钱) 猪苓(一钱) 姜(三片)
此方以苓、桂、橘、半生姜治饮之本,以桑皮、苏子、杏仁泻肺,以腹皮、泻泽、猪苓行水,是
肺脾同治也。祖怡注。
悬饮,是指水液停留在胁下,咳嗽吐痰时牵引作痛。胁部是肝和胆所在的部位,水气停留在胁部,就会导致肝气郁结逆乱,而肺金清肃下降的功能无法下行,因此出现咳嗽并伴有牵引性疼痛。治疗以椒目栝蒌汤为主方。
椒目栝蒌汤(自制方)
椒目(五十粒) 瓜蒌头(五钱,切片) 桑白皮(二钱) 葶苈子(二钱) 橘红(一钱)
半夏(一钱五分) 茯苓(二钱) 苏子(一钱五分) 蒺藜(三钱) 生姜(三片)
这个方剂是在二陈汤的基础上去掉甘草,用椒目来通利水道,瓜蒌来通利谷道,葶苈子、苏子、桑白皮用来泻肺气,蒺藜用来疏肝。使水饮向下运行,从而使肺气和肝气调和。(祖怡注)
溢饮,是指水气旁流到四肢。脾受到水湿邪气的侵害,水湿溢出进入四肢末端,所以肢体关节肿胀,身体沉重无力。治疗以桂苓神术汤为主方。
桂苓神术汤(自制方)
桂枝(八分) 茯苓(三钱) 白术(一钱) 苍术(一钱) 薏苡仁(八钱)
陈皮(一钱) 半夏(一钱五分) 厚朴(一钱) 砂仁(一钱) 生姜(三片)
这个方剂融合了苓桂术甘汤、二陈汤和平胃散,去掉甘草,加入薏苡仁和砂仁,纯粹使用温运脾胃的方法,水饮自然化解。(祖怡注)
支饮,是指水液停聚在心下,进入胸膈部位,导致咳嗽气逆,需要倚靠物体呼吸,气息短促,外形看起来像浮肿。治疗以桑苏桂苓汤为主方。
桑苏桂苓汤(自制方)
桑白皮(三钱) 苏子(二钱) 桂枝(八分) 茯苓(三钱) 泽泻(一钱五分)
大腹皮(一钱五分) 橘红(一钱) 半夏(一钱五分) 杏仁(三钱) 猪苓(一钱) 生姜(三片)
这个方剂用茯苓、桂枝、橘红、半夏和生姜来治疗水饮的根本原因,用桑白皮、苏子和杏仁来泻肺气,用大腹皮、泽泻和猪苓来行水利尿,这是肺脾同治的方法。(祖怡注)
Xuan Yin (Hanging Fluid Retention) refers to water fluid accumulating under the hypochondrium, causing pulling pain during coughing and expectoration. The hypochondrium is the location of the Liver and Gallbladder meridians. When water qi stagnates in the hypochondrium, it causes Liver Qi to become stagnant and rebellious, preventing the descending function of Lung Metal's clearing and purifying action. Consequently, coughing with pulling pain occurs. Jiaomu Gualou Tang (Pepper Seed and Trichosanthes Fruit Decoction) is the primary formula for treatment.
Jiaomu Gualou Tang (Self-made Formula)
Zanthoxyli Semen (Pepper Seed) (50 grains)
Trichosanthis Fructus Caput (Trichosanthes Fruit Head) (5 qian, sliced)
Mori Cortex (Mulberry Root Bark) (2 qian)
Descurainiae Semen Lepidii Semen et Mori Cortex (Tinglizi) (2 qian)
Exocarpium Citri Reticulatae Pericarpium Rubrum (Ju Hong) (1 qian)
Pinelliae Rhizoma Preparatum (Banxia) (1.5 qian)
Poria (Fuling) (2 qian)
Perillae Fructus (Suzi) (1.5 qian)
Tribuli Fructus (Jili) (3 qian)
Zingiberis Rhizoma Recens (Shengjiang) (3 slices)
This formula is essentially Er Chen Tang (Two-Cured Decoction) with Glycyrrhizae Radix et Rhizoma (Gancao) removed. Zanthoxyli Semen (Pepper Seed) is used to unblock the water passages, while Trichosanthis Fructus (Trichosanthes Fruit) unblocks the grain passages. Descurainiae Semen (Tinglizi), Perillae Fructus (Suzi), and Mori Cortex (Mulberry Root Bark) are used to drain Lung Qi, and Tribuli Fructus (Jili) is used to soothe the Liver. This allows water fluid to descend, harmonizing the Lung and Liver. (Note by Zuyi)
Yi Yin (Overflowing Fluid Retention) refers to water qi flowing laterally into the four limbs. When the Spleen is affected by water-dampness pathogenic factors, the overflow enters the extremities, resulting in swelling of the joints and limbs, heaviness of the body, and weakness. Guiling Shenzhu Tang (Cinnamon Twig, Poria, and Atractylodes Macrocephala Decoction) is the primary formula for treatment.
Guiling Shenzhu Tang (Self-made Formula)
Cinnamomi Ramulus (Guizhi) (8 fen)
Poria (Fuling) (3 qian)
Atractylodis Macrocephalae Rhizoma (Baizhu) (1 qian)
Atractylodis Rhizoma (Cangzhu/Maozhu) (1 qian)
Coicis Semen (Yiren) (8 qian)
Citri Reticulatae Pericarpium (Guangpi/Chenpi) (1 qian)
Pinelliae Rhizoma Preparatum (Banxia) (1.5 qian)
Magnoliae Officinalis Cortex (Noupu/Houpo) (1 qian)
Amomi Fructus Rotundus (Sharen) (1 qian)
Zingiberis Rhizoma Recens (Shengjiang) (3 slices)
This formula combines Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction), Er Chen Tang (Two-Cured Decoction), and Ping Wei San (Peaceful Stomach Powder). It removes Glycyrrhizae Radix et Rhizoma (Gancao) and adds Coicis Semen (Yiren) and Amomi Fructus Rotundus (Sharen). It purely employs warming and transporting methods for the Stomach and Spleen, allowing water fluid to transform naturally. (Note by Zuyi)
Zhi Yin (Branching Fluid Retention) refers to water fluid stagnating below the heart and entering the chest and diaphragm. It causes coughing, wheezing requiring leaning support for breathing, shortness of breath, and a swollen appearance. Sangsu Guiling Tang (Mulberry Leaf, Perilla, Cinnamon Twig, and Poria Decoction) is the primary formula for treatment.
Sangsu Guiling Tang (Self-made Formula)
Mori Cortex (Mulberry Root Bark) (3 qian)
Perillae Fructus (Suzi) (2 qian)
Cinnamomi Ramulus (Guizhi) (8 fen)
Poria (Fuling) (3 qian)
Alismatis Rhizoma (Zexie) (1.5 qian)
Arecae Pericarpium (Dafupi) (1.5 qian)
Exocarpium Citri Reticulatae Pericarpium Rubrum (Ju Hong) (1 qian)
Pinelliae Rhizoma Preparatum (Banxia) (1.5 qian)
Pruni Armeniacae Semium (Xingren) (3 qian)
Polyporus (Zhuling) (1 qian)
Zingiberis Rhizoma Recens (Shengjiang) (3 slices)
This formula uses Poria (Fuling), Cinnamon Twig (Guizhi), Exocarpium Citri Reticulatae Pericarpium Rubrum (Ju Hong), Pinelliae Rhizoma Preparatum (Banxia), and Zingiberis Rhizoma Recens (Shengjiang) to treat the root cause of fluid retention. Mori Cortex (Mulberry Root Bark), Perillae Fructus (Suzi), and Pruni Armeniacae Semium (Xingren) are used to drain Lung Qi. Arecae Pericarpium (Dafupi), Alismatis Rhizoma (Zexie), and Polyporus (Zhuling) are used to promote urination and move water. This represents simultaneous treatment of the Lung and Spleen. (Note by Zuyi)