脑漏者,鼻如渊泉,涓涓流涕。致病有三∶曰风也,火也,寒也。鼻为肺窍,司呼吸以通阳,贼风
侵入,随吸入之气上彻于脑,以致鼻窍不通,时流清涕,此风伤之脑漏也。阳邪外铄,肝火内燔
,鼻窍半通,时流黄水,此火伤之脑漏也。冬月祁寒,感冒重阴,寒气侵脑,鼻窍不通,时流浊涕
,此寒伤之脑漏也。致病不同,施治各异。宜随证辨之。
风伤脑,桑菊愈风汤主之。
桑菊愈风汤(自制)
桑叶(三钱) 杭菊(三钱) 蔓荆子(一钱五分) 当归(一钱五分) 桔梗(一钱)
枳壳(一钱) 川贝(二钱) 杏仁(三钱) 川芎(八分) 黑芝麻(一撮)
火伤脑,清肝透顶汤主之。
清肝透顶汤(自制)
羚羊角(一钱五分) 夏枯草(二钱) 石决(八钱) 丹皮(一钱五分) 元参(一钱)
桔梗(一钱) 蝉衣(一钱五分) 桑叶(二钱) 薄荷(一钱) 陈橄榄(二枚) 寒伤脑,通
阳圣化汤主之。
通阳圣化汤(自制)
当归(二钱) 川芎(一钱) 香附(二钱) 白术(一钱五分) 羌活(一钱)
白芷(五分酒蒸) 辛夷(一钱切) 天麻(六分) 红枣(五枚) 姜(三片)
鼻衄一证,与吐血不同。吐血者,阴分久亏,龙雷之火犯肺,日受熏灼,金气大伤,其来也由渐
,其病也最深,故血从口出,而不从鼻出。鼻衄之证,其平日肺气未伤,只因一时肝火蕴结,骤犯
肺穴,火性炎上,逼血上行,故血从鼻出,而不从口出。每见近来医家,因方书犀角地黄汤条下,
有统治吐血、衄血之语,一遇鼻衄,即以犀角地黄汤治之,究竟百无一效,此其弊在拘执古方,不
明经络。盖犀角地黄,多心肾之药,用以治肝肺,宜其格不相入矣。予自制豢龙汤一方,专治鼻衄
,无不应手而效,数十年历历有验,可知医道当自出手眼,辨证察经,不可徒执古方也。
豢龙汤(自制)
羚羊角(一钱五分) 牡蛎(四钱) 石斛(三钱) 南沙参(四钱) 麦冬(一钱五分青黛
少许拌) 川贝母(二钱去心研) 夏枯草(一钱五分) 丹皮(一钱五分) 黑荆芥(一钱)
薄荷炭(一钱) 茜草根(二钱) 牛膝(二钱) 茅根(五钱) 藕(五大片)
脑漏,是指鼻腔像深渊泉水一样,不断流出清涕。导致此病的病因有三类:风、火、寒。鼻是肺的窍道,主管呼吸以通达阳气。贼风侵入人体,随着吸入的空气上行直达脑部,导致鼻窍不通畅,时常流出清涕,这是风邪损伤所致的脑漏。阳热邪气在外部灼烧,肝火在内部燃烧,鼻窍半通半塞,时常流出黄水,这是火邪损伤所致的脑漏。冬季严寒,感受重阴寒气,寒气侵袭脑部,鼻窍不通畅,时常流出浊涕,这是寒邪损伤所致的脑漏。致病原因不同,治疗方法也各异。应当根据具体证候进行辨别。
风邪损伤脑部,用桑菊愈风汤主治。
桑菊愈风汤(自制方)
桑叶(三钱) 杭菊(三钱) 蔓荆子(一钱五分) 当归(一钱五分) 桔梗(一钱)
枳壳(一钱) 川贝母(二钱) 杏仁(三钱) 川芎(八分) 黑芝麻(一撮)
火邪损伤脑部,用清肝透顶汤主治。
清肝透顶汤(自制方)
羚羊角(一钱五分) 夏枯草(二钱) 石决明(八钱) 牡丹皮(一钱五分) 玄参(一钱)
桔梗(一钱) 蝉蜕(一钱五分) 桑叶(二钱) 薄荷(一钱) 陈橄榄(两枚)
寒邪损伤脑部,用通阳圣化汤主治。
通阳圣化汤(自制方)
当归(二钱) 川芎(一钱) 香附(二钱) 白术(一钱五分) 羌活(一钱)
白芷(五分,酒蒸制) 辛夷(一钱,切碎) 天麻(六分) 红枣(五枚) 生姜(三片)
鼻衄这一病证,与吐血不同。吐血者,是因为阴分长期亏损,龙雷之火侵犯肺部,每日受到熏烤灼伤,肺金之气大受损伤,其发病过程是逐渐形成的,病情最为深重,所以血液从口而出,而不从鼻出。鼻衄的病证,患者平日肺气并未受损,只因一时之间肝火蕴结郁滞,突然侵犯肺脏,火性炎上,逼迫血液向上逆行,所以血液从鼻而出,而不从口出。常常见到近来的医家,因为方书中犀角地黄汤条目下有统管治疗吐血和衄血的说法,一旦遇到鼻衄,就用犀角地黄汤来治疗,结果百无一效,这弊病在于拘泥固执于古方,不明白经络脏腑的关系。因为犀角地黄汤多为入心、肾经的药物,用来治疗肝、肺的疾病,自然是不相适宜的。我自创豢龙汤一方,专门治疗鼻衄,没有不随手见效的,几十年来历历有验,可知医学之道应当有自己的独到见解,辨证察经,不可仅仅执着于古方。
豢龙汤(自制方)
羚羊角(一钱五分) 牡蛎(四钱) 石斛(三钱) 南沙参(四钱) 麦冬(一钱五分,拌少许青黛) 川贝母(二钱,去心研碎) 夏枯草(一钱五分) 牡丹皮(一钱五分) 黑荆芥(一钱)
薄荷炭(一钱) 茜草根(二钱) 牛膝(二钱) 白茅根(五钱) 藕(五大片)
Nasal mucus discharge (Brain Leakage) refers to the condition where the nasal cavity flows like a spring from an abyss, with clear mucus dripping continuously. There are three causes for this disease: wind, fire, and cold. The nose is the orifice of the Lung (Zang-Fu organ responsible for respiration and qi), governing respiration to connect with Yang Qi. When pathogenic wind invades, it follows the inhaled air upward to penetrate the brain, causing obstruction of the nasal orifice and frequent discharge of clear mucus; this is Brain Leakage caused by Wind injury. When Yang-pathogenic heat scorches externally and Liver Fire burns internally, the nasal orifice is partially obstructed, leading to the occasional discharge of yellow fluid; this is Brain Leakage caused by Fire injury. In winter, severe cold and heavy Yin pathogens invade, with Cold Qi attacking the brain, causing nasal obstruction and frequent discharge of turbid mucus; this is Brain Leakage caused by Cold injury. Since the causes differ, the treatments must vary accordingly. One should differentiate based on the specific syndrome.
For Brain Leakage caused by Wind, Sangju Yufeng Decoction is the primary formula.
Sangju Yufeng Decoction (Self-made Formula)
Morus Folium (Sangye, 3 qian)
Chrysanthemi Flos (Hangju, 3 qian)
Vittatis Fructus (Manjingzi, 1.5 qian)
Angelicae Sinensis Radix (Danggui, 1.5 qian)
Platycodonis Radix (Jiegeng, 1 qian)
Aurantii Fructus Pericarpium (Zhike, 1 qian)
Fritillariae Cirrhosae Bulbus (Chuanbei, 2 qian)
Prunus Armeniaca Semen (Xingren, 3 qian)
Ligustici Chuanxiong Rhizoma (Chuanxiong, 0.8 fen)
Sesami Nigris Semen (Heimaizi, a pinch)
For Brain Leakage caused by Fire, Qinggan Tou Ding Decoction is the primary formula.
Qinggan Tou Ding Decoction (Self-made Formula)
Antilopis Cornu (Lingyangjiao, 1.5 qian)
Prunellae Spica (Xiakucao, 2 qian)
Haliotidis Concha (Shijue, 8 qian)
Moutan Cortex (Danpi, 1.5 qian)
Scrophulariae Radix (Yuanshen, 1 qian)
Platycodonis Radix (Jiegeng, 1 qian)
Cicadae Periostracum (Chanyi, 1.5 qian)
Mori Folium (Sangye, 2 qian)
Menthae Haplocalycis Herba (Bohe, 1 qian)
Canarium Oliva (Chen Ganlan, 2 pieces)
For Brain Leakage caused by Cold, Tongyang Shenghua Decoction is the primary formula.
Tongyang Shenghua Decoction (Self-made Formula)
Angelicae Sinensis Radix (Danggui, 2 qian)
Ligustici Chuanxiong Rhizoma (Chuanxiong, 1 qian)
Cyperi Rhizoma (Xiangfu, 2 qian)
Atractylodis Macrocephalae Rhizoma (Baizhu, 1.5 qian)
Notopterygii Rhizoma et Radix (Qianghuo, 1 qian)
Angelicae Dahuricae Radix (Baizhi, 0.5 fen, steamed with wine)
Magnoliae Flos (Xinyi, 1 qian, sliced)
Gastrodiae Rhizoma (Tianma, 0.6 fen)
Jujubae Fructus (Hongzao, 5 pieces)
Zingiberis Rhizoma Recens (Jiang, 3 slices)
The syndrome of Epistaxis (Nosebleed) differs from Hematemesis (Vomiting blood). In Hematemesis, the Yin aspect has been deficient for a long time, allowing Dragon-Lion Fire to invade the Lung, causing daily scorching and severe damage to Metal Qi (Lung function). Its onset is gradual, and the pathology is deep; thus, blood exits from the mouth, not the nose. In Epistaxis, the patient's Lung Qi is generally unharmed in daily life; it is only due to a sudden accumulation and constraint of Liver Fire that abruptly attacks the Lung, forcing blood upward due to the flaming nature of Fire; thus, blood exits from the nose, not the mouth. It is often observed that contemporary physicians, seeing statements in ancient formularies under Jiaojiao Dihuang Tang indicating it treats both hematemesis and epistaxis indiscriminately, use Jiaojiao Dihuang Tang for every case of epistaxis. However, it rarely proves effective. This failure stems from rigid adherence to ancient formulas without understanding the meridians. Jiaojiao Dihuang Tang primarily targets the Heart and Kidney; using it to treat Liver and Lung disorders is naturally incompatible. I have self-created Huanyong Tang specifically for treating epistaxis, which yields immediate results in all cases. Over decades, its efficacy has been consistently verified. This demonstrates that medical practice requires independent insight, precise differentiation of syndromes and meridians, and should not rely solely on ancient formulas.
Huanyong Tang (Self-made Formula)
Antilopis Cornu (Lingyangjiao, 1.5 qian)
Ostreae Concha (Muli, 4 qian)
Dendrobii Caulis (Shihu, 3 qian)
Adenophorae Radix (Nanshashen, 4 qian)
Ophiopogonis Tuber (Maidong, 1.5 qian, mixed with a small amount of Qingdai)
Fritillariae Cirrhosae Bulbus (Chuanbeimu, 2 qian, heart removed and ground)
Prunellae Spica (Xiakucao, 1.5 qian)
Moutan Cortex (Danpi, 1.5 qian)
Schizonepetae Herba Carbonisata (Heijingjie, 1 qian)
Menthae Haplocalycis Herba Carbonisata (Bohetan, 1 qian)
Rubia Cordifolia Radix et Rhizoma (Qiancaogen, 2 qian)
Achyranthis Bidentatae Radix (Niuxi, 2 qian)
Imperatae Rhizoma (Maogen, 5 qian)
Nelumbinis Nuciferae Rhizoma (Ou, 5 large slices)