(澹寮)用五般皮,陈茯姜桑大腹奇。(陈皮、茯苓皮、姜皮、桑白皮、大腹皮)。或用
五加(皮)易桑白,脾虚肤胀此方司。(脾不能为胃行其津液,故水肿。半身以上,宜汗;
半身以下,宜利小便。此为于泻水之中,仍寓调补之意。皆用皮者,水溢皮肤,以皮行皮也。)
(汤,《局方》)羌独芎,甘蔓 木与防风。湿气在表头腰重(痛),发汗升阳有异功。
风能胜湿升能降,(气升则水自降。)不与行水渗湿同。〔湿气在表宜汗。又风能胜湿,故用
风药上升,使湿从汗散。羌活、独活各一钱,川芎、甘草(炙)、 本、防风各五分,蔓荆
子三分。如有寒湿,加附子、防己。〕若除独活芎蔓草,除湿(汤)升麻苍术充。(除独活、
川芎、蔓荆子、甘草,加升麻、苍术,名羌活除湿汤,治风湿身痛。)
治湿热,五苓六一二方缀。陈皮木香槟榔增,能消水肿及泄泻。(用五苓散,赤茯苓一
钱,猪苓、泽泻、白术、桂各五分;用六一散,滑石六钱,甘草一钱,加陈皮钱半,木香、
槟榔各三分,每服五钱,加姜煎。小水并入大肠,致小肠不利而大便泄泻。二散皆行水泄热
之药,加槟榔峻下,陈皮、木香理气,以利小便而实大便也。水肿亦湿热为病,故皆治之。)
(仲景)治疸黄,阴阳寒热细推详。阳黄大黄栀子入,〔瘀热在里,口渴便闭,
色,脉沉实者,为阳黄。茵陈六两,大黄二两(酒浸),栀子十四枚。茵陈发汗利水,能泄
太
栀子十五枚,甘草一两。按∶阳黄胃有瘀热者,宜下之。如发热者,则势外出而不内入,不
必汗下,惟用栀子、黄柏,清热利湿以和解之。若小便利,色白无热者,仲景作虚劳治,用
小建中汤。)
(澹寮方)使用五种皮类药材:陈皮、茯苓皮、生姜皮、桑白皮、大腹皮,配伍奇特。(若用五加皮代替桑白皮,此方主治脾虚引起的皮肤肿胀。)这是因为脾脏不能为胃输送津液,从而导致水肿。半身以上的肿胀,适宜采用发汗法;半身以下的肿胀,适宜采用利小便法。本方在泻水之中,仍蕴含调补之意。之所以都使用皮类药物,是因为水湿溢于皮肤,遵循“以皮行皮”的原则。
(汤剂,《太平惠民和剂局方》)由羌活、独活、川芎、甘草、蔓荆子、木香、防风组成。湿气停留在体表,导致头部和腰部沉重或疼痛,此方具有发汗升阳的独特功效。风能胜湿,升提药气能使水湿下降,(气机上升则水液自然下行。)这与直接利水渗湿的方法不同。〔湿气在表适宜发汗。又因风能胜湿,故使用风药上升,使湿气随汗液发散。用量为:羌活、独活各一钱,川芎、炙甘草、藁本、防风各五分,蔓荆子三分。若有寒湿,可加入附子、防己。〕如果去掉独活、川芎、蔓荆子、甘草,改用升麻、苍术,即名为羌活除湿汤,用于治疗风湿引起的身体疼痛。
治疗湿热证,将五苓散与六一散两方组合使用。再加入陈皮、木香、槟榔,能够消除水肿及泄泻。〔用法:取五苓散,赤茯苓一钱,猪苓、泽泻、白术、桂枝各五分;取六一散,滑石六钱,甘草一钱;再加陈皮一钱半,木香、槟榔各三分。每次服用五钱,加生姜煎服。当小便并入大肠时,导致小肠功能不利而引发大便泄泻。五苓散和六一散都是利水泄热的药物,加入槟榔峻下,陈皮、木香调理气机,通过利小便来达到实大便的目的。水肿也是湿热所致,因此这两方都能治疗。〕
(张仲景)治疗黄疸病,需仔细辨析阴阳、寒热。阳黄证使用大黄、栀子入药。〔体内有瘀热,口渴且便秘,面色发黄,脉象沉实的,称为阳黄。茵陈六两,大黄二两(酒浸),栀子十四枚。茵陈能发汗利水,栀子清泄三焦之火。〕另有栀子十五枚,甘草一两。按语:阳黄证若胃中有瘀热,适宜采用攻下法。如出现发热症状,说明病势向外发散而不向内深入,不必使用发汗或攻下法,仅用栀子、黄柏清热利湿以和解即可。若小便通畅,颜色清白且无发热者,张仲景将其作为虚劳病治疗,使用小建中汤。
(Danliao Formula) Uses five types of bark: Chenpi (Exocarpium Citri Reticulatae), Fulingpi (Poria with Hostwood), Jiangpi (Pericarpium Zingiberis Recens), Sangbaipi (Cortex Mori Radicis), and Dafupi (Fructus Arecae). The combination is unique. [If Wujia pi (Cortex Acanthopanacis Senticosi) is used instead of Sangbai pi, this formula governs skin edema caused by Spleen deficiency.] This occurs because the Spleen fails to transport fluids for the Stomach, leading to edema. Edema above the waist is suitable for diaphoresis (sweating); edema below the waist is suitable for promoting urination. This formula contains the intent of tonification within its purgative action. All ingredients are barks because water overflows into the skin, following the principle of "using bark to treat skin."
(Tang Formula, *Tai Ping Hui Min He Ji Ju Fang*) Composed of Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Chuanxiong (Ligustii Chuanxiong Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Manjingzi (Viticis Fructus), Muxiang (Aucklandiae Radix), and Fangfeng (Saposhnikoviae Radix). When dampness resides in the exterior, causing heaviness or pain in the head and waist, this formula has the unique merit of inducing sweating and raising Yang. Wind can overcome dampness; raising agents lower water (when Qi rises, water descends naturally). This differs from methods that directly promote urination and leach out dampness. [Dampness in the exterior is suitable for sweating. Since wind can overcome dampness, wind herbs are used to ascend, allowing dampness to scatter via sweat. Dosage: Qianghuo and Duhuo each 1 qian; Chuanxiong, roasted Gancao, Gaoben (Ligustici Gigantei Rhizoma), and Fangfeng each 0.5 qian; Manjingzi 0.3 qian. If cold-dampness is present, add Fuzi (Aconiti Lateralis Radix Praeparata) and Fangji (Stephaniae Tetrandrae Radix).] If Duhuo, Chuanxiong, Manjingzi, and Gancao are removed, and Shengma (Cimicifugae Rhizoma) and Cangzhu (Atractylodis Rhizoma) are added, it is named Qianghuo Chushi Tang (Qianghuo Damp-Removing Decoction), treating body pain due to wind-dampness.
To treat damp-heat, combine the Wuling San (Five-Ling Powder) and Liuyi San (Six-to-One Powder). Add Chenpi, Muxiang, and Binglang (Arecae Semen) to eliminate edema and diarrhea. [Usage: Take Wuling San: Chi Fuling (Poria cum Rubro) 1 qian, Zhuling (Poria), Zexie (Alismatis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Guizhi (Cinnamomi Ramulus) each 0.5 qian; Take Liuyi San: Huashi (Talcum) 6 qian, Gancao 1 qian; add Chenpi 1.5 qian, Muxiang 0.3 qian, Binglang 0.3 qian. Take 5 qian per dose, decoct with ginger. When urine merges into the large intestine, causing small intestine dysfunction and resulting in diarrhea, these two powders act as diuretic and heat-clearing agents. Adding Binglang provides strong downward purging, while Chenpi and Muxiang regulate Qi, benefiting urination to solidify stool. Edema is also a disease of damp-heat, hence both are treated.]
(Zhang Zhongjing) Treats jaundice, requiring careful analysis of Yin/Yang and Cold/Heat. For Yang Jaundice, use Dahuang (Rhei Radix et Rhizoma) and Zhizi (Gardeniae Fructus). [Stagnant heat in the interior, thirst, constipation, yellow complexion, and deep-solid pulse indicate Yang Jaundice. Yinchen (Artemisiae Scopariae Herba) 6 liang, Dahuang 2 liang (soaked in wine), Zhizi 14 seeds. Yinchen induces sweating and promotes urination, clearing heat from the Triple Burner.] Another prescription includes Zhizi 15 seeds, Gancao 1 liang. Note: For Yang Jaundice with stagnant heat in the Stomach, purgation is appropriate. If fever is present, the pathogenic factor is moving outward rather than inward, so neither sweating nor purgation is necessary; simply use Zhizi and Huangbai (Phellodendri Cortex) to clear heat and promote urination to harmonize. If urination is free, color is white/clear, and there is no fever, Zhang Zhongjing treats it as Xu Lao (Deficiency Consumption) using Xiaojianzhong Tang (Minor Construct the Middle Decoction).