人之一身,自顶至踵,俱有痛病。其始也,或因于风,或因于寒,或因于火,或因于气,病各
不同,而其为气凝血滞则一也。气能捍卫,则外感何由而入;营能流灌,则内病何自而生。不通则
痛,理固宜然。兹将痛病略举其凡。其咽痛、疝痛、肢节痛,见于肺病、疝病、痹病中者,不复赘。
头痛有因于风者,肌表不固,太阳受风,巅顶作痛,鼻窍微塞,时流清涕,香芷汤主之。
香芷汤(自制)
香附(二钱) 白芷(六分) 当归(一钱五分) 川芎(八分) 防风(一钱)
桑叶(一钱) 菊花(二钱) 蝉衣(一钱) 蔓荆子(一钱五分) 桔梗(一钱)
黑芝麻(三钱)
本方以白芷、防风、桔梗升清阳而去风邪,因桔梗力小而加香附。以蝉衣、蔓荆、桑、菊清利
头目,而以芎、归、黑芝麻养血。芎本血分中风药,治风寒头痛,是其特长。而桑、麻合作,本是
养脑之古方,乃用风药而不忘养血之原则。祖怡注。
有因于火者,肝阳上升,头痛如劈,筋脉掣起,痛连目珠。当壮水柔肝,以熄风火,不可过用
风药。盖风能助火,风药多则火势更烈也。羚羊角汤主之。
羚养角汤(自制)
羚羊角(二两) 龟版(八钱) 生地(六钱) 白芍(一钱) 丹皮(一钱五分)
柴胡(一钱) 薄荷(一钱) 菊花(二钱) 夏枯草(一钱五分) 蝉衣(一钱)
红枣(十枚) 生石决(八钱打碎)
本方以羚羊、龟版、石决清肝火而潜风阳;以地、芍、丹皮、夏枯草养血凉血;加柴胡、薄荷
蝉衣、菊花,发抑
遏之火;红枣则恐其血寒而凝,以反佐地、芍、丹皮也。大队清凉之中,加一味红枣温药,制方巧
不可言。祖怡注。
有血虚头痛者,自觉头脑俱空,目 而眩,养血胜风汤主之。
养血胜风汤(自制)
生地(六钱) 当归(二钱) 白芍(一钱五分) 川芎(一钱) 枸杞(三钱)
五味(五分) 枣仁(一钱五分) 柏仁(二钱) 杭菊(二钱) 桑叶(一钱)
红枣(十枚) 黑芝麻(三钱)
本方以芎、归、地、芍四物为君,辅以枸、菊、桑、麻、枣仁、柏仁大队养血。再用五味、红枣
者,所以佐芎、归而收耗散之气血也。理法双清,是名大家之特色。 以上三方,第一方风药多
,第二方清药多,第三方养血药多,而桑、菊二味,兼有去风熄风之长。三方鼎立,确不可移。祖
怡注。
人的全身,从头顶到脚后跟,都可能出现疼痛病症。其起因,有的因风邪所致,有的因寒邪所致,有的因火邪所致,有的因气机失调所致,病因各不相同,但导致气血凝滞、运行不畅这一病理结果是相同的。气具有卫外防御的功能,则外邪如何侵入;营气能够流畅灌注,则内生病变从何产生。经络不通就会疼痛,道理本来就是这样。这里将疼痛病症略举其大要。其中咽痛、疝痛、肢节痛,在肺病、疝病、痹病(以肢体关节疼痛为主症的疾病)中已有论述的,不再重复赘述。
头痛有因风邪引起的,肌表不固密,太阳经受风邪侵袭,导致巅顶部位疼痛,鼻窍轻微堵塞,时常流出清稀鼻涕,用香芷汤主治。
香芷汤(自制方)
香附(二钱) 白芷(六分) 当归(一钱五分) 川芎(八分) 防风(一钱)
桑叶(一钱) 菊花(二钱) 蝉衣(一钱) 蔓荆子(一钱五分) 桔梗(一钱)
黑芝麻(三钱)
本方以白芷、防风、桔梗升发清阳之气并祛除风邪,因为桔梗药力较小,所以加入香附。以蝉衣、蔓荆子、桑叶、菊花清利头目,而以川芎、当归、黑芝麻滋养血液。川芎是血分中的祛风药,治疗风寒头痛是其特长。而桑叶与黑芝麻合用,本是滋养脑髓的古方,此处使用祛风药却不忘记养血的原则。(祖怡注)
头痛有因火邪引起的,肝阳上亢上升,头痛剧烈如刀劈,筋脉抽搐隆起,疼痛牵连眼球。应当壮水滋阴以柔养肝脏,以熄灭风火,不可过度使用祛风药。因为风能助长火势,祛风药过多则火势更加猛烈。用羚羊角汤主治。
羚羊角汤(自制方)
羚羊角(二两) 龟版(八钱) 生地(六钱) 白芍(一钱) 丹皮(一钱五分)
柴胡(一钱) 薄荷(一钱) 菊花(二钱) 夏枯草(一钱五分) 蝉衣(一钱)
红枣(十枚) 生石决明(八钱,打碎)
本方以羚羊角、龟版、石决明清泻肝火并潜降风阳;以生地、白芍、丹皮、夏枯草滋养血液并凉血;加入柴胡、薄荷、蝉衣、菊花,发散被遏制郁结之火;红枣则是担心血液受寒而凝滞,作为反佐药配合生地、白芍、丹皮使用。在大队清凉药物中,加入一味红枣这味温性药物,制方的巧妙难以言表。(祖怡注)
有血虚引起的头痛,自觉头脑空虚,眼睛干涩且眩晕,用养血胜风汤主治。
养血胜风汤(自制方)
生地(六钱) 当归(二钱) 白芍(一钱五分) 川芎(一钱) 枸杞(三钱)
五味子(五分) 枣仁(一钱五分) 柏仁(二钱) 杭菊(二钱) 桑叶(一钱)
红枣(十枚) 黑芝麻(三钱)
本方以川芎、当归、生地、白芍四物汤为君药,辅以枸杞、菊花、桑叶、黑芝麻、枣仁、柏仁大队滋养血液的药物。再用五味子、红枣,是为了辅助川芎、当归收敛耗散的气血。理法清晰明了,这是名家的特色。以上三方,第一方祛风药多,第二方清热药多,第三方养血药多,而桑叶、菊花两味药,兼有祛风和熄风的长处。三方鼎立,确实不可更改。(祖怡注)
The human body, from the crown of the head to the heels, is susceptible to pain syndromes. The initial causes may be wind pathogen (Feng), cold pathogen (Han), fire pathogen (Huo), or Qi dysfunction (Qi). Although the specific etiologies differ, the resulting pathological state of Qi stagnation and blood stasis (Qi Ning Xue Zhi) remains consistent. Qi functions as a defensive barrier; if robust, how can external pathogens invade? Ying Qi (Nutritive Qi) circulates and irrigates; if smooth, how can internal diseases arise? Obstruction leads to pain; this principle is indeed logical. Here, the general categories of pain syndromes are briefly outlined. Pharyngeal pain, hernia pain, and limb/joint pain, which are discussed in the sections on Lung disease, Hernia disease, and Bi syndrome (Bi Syndrome: a condition characterized by obstruction of meridians causing pain, numbness, or heaviness in limbs/joints), will not be repeated.
Headache caused by wind pathogen occurs when the muscular exterior is insecure, leading to Wind invasion of the Taiyang meridian (Taiyang Meridian: the bladder meridian of foot-taiyang, governing the exterior and back). This results in pain at the vertex, slight nasal congestion, and intermittent flow of clear rhinorrhea. It is treated with Xiangzhi Tang (Cyperus and Angelica Dahurica Decoction).
Xiangzhi Tang (Self-made Formula)
Cyperi Rhizoma (2 qian) / Cyperus Rotundus (Xiangfu)
Angelicae Dahuricae Radix (6 fen) / Bai Zhi
Angelicae Sinensis Radix (1.5 qian) / Dang Gui
Ligustici Chuanxiong Rhizoma (8 fen) / Chuan Xiong
Saposhnikoviae Radix (1 qian) / Fang Feng
Mori Folium (1 qian) / Sang Ye
Chrysanthemi Flos (2 qian) / Ju Hua
Cicadae Periostracum (1 qian) / Chan Yi
Viticis Fructus (1.5 qian) / Man Jing Zi
Platycodonis Radix (1 qian) / Jie Geng
Sesami Nigrum Semen (3 qian) / Hei Zhi Ma
This formula uses Angelicae Dahuricae Radix, Saposhnikoviae Radix, and Platycodonis Radix to ascend Clear Yang and dispel Wind pathogen. Since Platycodonis Radix has weak efficacy, Cyperi Rhizoma is added. Cicadae Periostracum, Viticis Fructus, Mori Folium, and Chrysanthemi Flos clear and benefit the head and eyes, while Ligustici Chuanxiong Rhizoma, Angelicae Sinensis Radix, and Sesami Nigrum Semen nourish the Blood. Ligustici Chuanxiong Rhizoma is a Wind-dispelling herb acting in the Blood level, specializing in treating headache due to Wind-Cold. The combination of Mori Folium and Sesami Nigrum Semen is an ancient prescription for nourishing the brain. Here, Wind-dispelling herbs are used without neglecting the principle of nourishing Blood. (Zu Yi's Note)
Headache caused by Fire pathogen manifests as Liver Yang rising, with severe headache feeling like splitting, tendon vessels contracting and bulging, and pain radiating to the eyeballs. One should strengthen Water to soften the Liver and extinguish Wind-Fire. Overuse of Wind-dispelling herbs must be avoided because Wind can assist Fire, and excessive Wind-dispelling herbs will intensify the Fire. It is treated with Lingyangjiao Tang (Antelope Horn Decoction).
Lingyangjiao Tang (Self-made Formula)
Saiga Tataricae Cornu (2 liang) / Ling Yang Jiao
Testudinis Carapax et Plastrum (8 qian) / Gui Ban
Rehmanniae Radix Recens (6 qian) / Sheng Di
Paeoniae Radix Alba (1 qian) / Bai Shao
Moutan Cortex (1.5 qian) / Dan Pi
Bupleuri Radix (1 qian) / Chai Hu
Menthae Haplocalycis Herba (1 qian) / Bo He
Chrysanthemi Flos (2 qian) / Ju Hua
Prunellae Spica (1.5 qian) / Xia Ku Cao
Cicadae Periostracum (1 qian) / Chan Yi
Jujubae Fructus (10 pieces) / Hong Zao
Concha Arcae (8 qian, crushed) / Shi Jue Ming
This formula uses Saiga Tataricae Cornu, Testudinis Carapax et Plastrum, and Concha Arcae to clear Liver Fire and subdue Wind-Yang; Rehmanniae Radix Recens, Paeoniae Radix Alba, Moutan Cortex, and Prunellae Spica nourish Blood and cool Blood; Bupleuri Radix, Menthae Haplocalycis Herba, Cicadae Periostracum, and Chrysanthemi Flos are added to disperse suppressed/stagnant Fire; Jujubae Fructus is included to prevent Blood coagulation due to cold nature, acting as a counter-agent to Rehmanniae Radix Recens, Paeoniae Radix Alba, and Moutan Cortex. Among a large group of cooling herbs, adding one warm herb, Jujubae Fructus, demonstrates unparalleled ingenuity in formula construction. (Zu Yi's Note)
Headache due to Blood deficiency presents with a sensation of emptiness in the head, dry eyes, and vertigo. It is treated with Yangxue Shengfeng Tang (Blood-Nourishing Wind-Overcoming Decoction).
Yangxue Shengfeng Tang (Self-made Formula)
Rehmanniae Radix Recens (6 qian) / Sheng Di
Angelicae Sinensis Radix (2 qian) / Dang Gui
Paeoniae Radix Alba (1.5 qian) / Bai Shao
Ligustici Chuanxiong Rhizoma (1 qian) / Chuan Xiong
Lycii Fructus (3 qian) / Gou Qi
Schisandrae Fructus (0.5 qian) / Wu Wei Zi
Ziziphi Spinosae Semen (1.5 qian) / Zao Ren
Platycodis Semen (2 qian) / Bai Zi Ren
Chrysanthemi Indici Flos (Hang Ju) (2 qian) / Hang Ju
Mori Folium (1 qian) / Sang Ye
Jujubae Fructus (10 pieces) / Hong Zao
Sesami Nigrum Semen (3 qian) / Hei Zhi Ma
This formula uses Ligustici Chuanxiong Rhizoma, Angelicae Sinensis Radix, Rehmanniae Radix Recens, and Paeoniae Radix Alba (Si Wu Tang components) as the Sovereign (Jun) herbs, assisted by Lycii Fructus, Chrysanthemi Indici Flos, Mori Folium, Sesami Nigrum Semen, Ziziphi Spinosae Semen, and Platycodis Semen—a large group of Blood-nourishing herbs. Schisandrae Fructus and Jujubae Fructus are used to assist Ligustici Chuanxiong Rhizoma and Angelicae Sinensis Radix in consolidating and arresting the dispersion of Qi and Blood. The clarity of principle and method characterizes the style of a master physician. Regarding the above three formulas: the first contains more Wind-dispelling herbs, the second contains more Cooling/Clearing herbs, and the third contains more Blood-nourishing herbs. However, Mori Folium and Chrysanthemi Flos possess both Wind-dispelling and Wind-extinguishing properties. These three formulas stand firmly together and should not be altered. (Zu Yi's Note)