(汤)即十全(汤,见前四物下。)除却川芎五味联。陈皮远志加姜枣,脾肺气血补方
先。(即十全大补汤除川芎,加五味、陈皮、远志。薛立斋曰∶气血两虚,变生诸症,不问
脉病,但服此汤,诸症悉退。)
(《济生》)用术参 ,归草茯神远志随。酸枣木香龙眼肉,煎加姜枣益心脾。怔忡健忘
俱可却,肠风崩漏总能医。〔人参、白术(土炒)、茯神、枣仁、龙眼肉各二钱,黄 (蜜炙)
钱半,当归(酒洗)、远志各一钱,木香、甘草(炙)各八分。血不归脾则妄行,参、 、
草、术之甘温以补脾,志、茯、枣仁、龙眼之甘温、酸苦以补心,当归养血,木香调气,气
壮则自能摄血矣。〕
用草 参,二茯芎归柏子等。夏曲远志兼桂味,再加酸枣总宁心。〔黄 (蜜炙)、茯苓
、茯神、川芎、当归(酒洗)、半夏曲各一两,甘草(炙)一钱,人参、柏子仁(去油)、五
味子、远志、枣仁(炒)各二钱半,每服五钱。参、 补心气,芎、归养心血,二茯、柏仁、
远志泄心热而宁心神,五味、枣仁收心气散越,半夏去扰心之痰涎,甘草补土以培心子,赤
桂引药以达心经。〕
(汤,仲景)桂枝芍,细辛甘草木通着。再加大枣治阴厥,脉细阳虚由血弱。〔当归、
桂枝、芍药、细辛各二两,甘草(炙)、木通各二两,枣二十五枚。成氏曰∶通脉者,必先
入心补血,当归之苦以助心血。心苦缓,急食酸以收之,芍药之酸,以收心气。肝苦急,急
食甘以缓之,甘草、大枣、木通以缓阴血。〕内有久寒加姜茱,(素有久寒者,加吴茱萸二升、
生姜半斤酒煎,名四逆加吴茱萸生姜汤,仲景。)发表温中通脉络。(桂枝散表风,吴茱萸、
生姜、细辛温经,当归、木通通经复脉。)不用附子及干姜,助阳过剂阴反灼。(姜附四逆在
于回阳,当归四逆在于益血复脉,故虽内有久寒,止加生姜、吴茱,不用干姜、附子,恐反
灼其阴也。)
(汤头)即十全大补汤,去掉川芎,加入五味子、陈皮、远志,再加生姜和大枣,这是补益脾肺气血的方剂。
(薛立斋说:气血两虚,变化产生各种病症,不论脉象和具体病名,只要服用这个汤剂,各种病症都会消退。)
《济生方》的人参养荣汤,使用白术、人参、当归、甘草、茯神、远志相随。加上酸枣仁、木香、龙眼肉,煎煮时加入生姜和大枣,以补益心脾。怔忡(心跳不安)、健忘都可以消除,肠风(便血)、崩漏(子宫出血)都能治疗。
〔人参、白术(土炒制)、茯神、酸枣仁、龙眼肉各二钱,黄芪(蜜炙)一钱半,当归(酒洗)、远志各一钱,木香、甘草(炙)各八分。血液不能归经于脾则妄行,用人参、黄芪、甘草、白术的甘温之性来补脾,用远志、茯神、酸枣仁、龙眼肉的甘温、酸苦之性来补心,当归养血,木香调气,气壮盛则自然能统摄血液。〕
另一首方剂用黄芪、人参,配合茯苓、茯神、川芎、当归、柏子仁等。加上半夏曲、远志、桂枝和五味子,再增加酸枣仁,总体起到宁心安神的作用。
〔黄芪(蜜炙)、茯苓、茯神、川芎、当归(酒洗)、半夏曲各一两,甘草(炙)一钱,人参、柏子仁(去油)、五味子、远志、酸枣仁(炒)各二钱半,每次服用五钱。人参、黄芪补心气,川芎、当归养心血,茯苓、茯神、柏子仁、远志清泄心热而宁安神志,五味子、酸枣仁收敛散越的心气,半夏去除扰乱心神的痰涎,甘草补益脾胃(土)以培补心之子(火生土,此处指培土以助心),赤桂引导药力到达心经。〕
张仲景的当归四逆汤,由桂枝、芍药、细辛、甘草、木通组成。再加入大枣治疗阴厥(手足逆冷),脉象细微是因为阳气虚弱且血虚。
〔成无己说:通脉者,必须先入心补血,当归的苦味以助心血。心气易缓散,急需食酸味以收敛它,芍药的酸味,用来收敛心气。肝气易急迫,急需食甘味以缓和它,甘草、大枣、木通用来缓和阴血。〕体内有久寒的,加入生姜和吴茱萸。(素来有久寒的人,加吴茱萸二升、生姜半斤,用酒煎煮,名为四逆加吴茱萸生姜汤,出自张仲景。)此方能发表散风、温通经络脉络。(桂枝疏散表风,吴茱萸、生姜、细辛温通经脉,当归、木通通经恢复脉搏。)不使用附子和干姜,因为助阳过猛反而灼伤阴液。(四逆汤用姜附在于回阳救逆,当归四逆汤在于益血复脉,所以虽然体内有久寒,只加生姜、吴茱萸,不用干姜、附子,恐怕反而灼伤其阴液。)
(Decoction) This refers to Shiquan Dabu Tang (Ten Complete Tonifying Decoction), excluding Chuanxiong Rhizome (Chuanxiong), and adding Schisandra Fruit (Wuweizi), Tangerine Peel (Chenpi), and Polygala Root (Yuanzhi), along with Ginger (Jiang) and Jujube (Zao). It is a formula for tonifying Qi and Blood of the Spleen and Lung.
(Xue Lizhai stated: When both Qi and Blood are deficient, various symptoms may arise regardless of pulse or specific disease diagnosis; simply administering this decoction will cause all symptoms to recede.)
The Renshen Yangrong Tang (Ginseng Nourishing Harmony Decoction) from *Jisheng Fang* uses Atractylodes Macrocephala Rhizome (Baizhu), Ginseng Radix (Renshen), Angelica Sinensis Radix (Danggui), Licorice Root (Gancao), Poria Cocos (Fushen), and Polygala Root (Yuanzhi). It adds Sour Jujube Seed (Suanzaoren), Aucklandia Root (Muxiang), and Longan Aril (Longyanrou); when decocted with Ginger and Jujube, it benefits the Heart and Spleen. Palpitations (Zhongchong) and forgetfulness can be eliminated, while intestinal wind (bleeding) and metrorrhagia (Benglou) can be treated.
[Each dose contains Ren Shen (Ginseng Radix), Bai Zhu (Atractylodes Macrocephala Rhizome, stir-fried in soil), Fu Shen (Poria Cocos with Hostwood), Zao Ren (Sour Jujube Seed), and Long Yan Rou (Longan Aril) at 2 qian each; Huang Qi (Astragalus Membranaceus Radix, honey-fried) at 1.5 qian; Dang Gui (Angelica Sinensis Radix, wine-washed) and Yuan Zhi (Polygala Root) at 1 qian each; Mu Xiang (Aucklandiae Radix) and Gan Cao (Licorice Root, fried) at 0.8 fen each. When blood fails to return to and be controlled by the Spleen, it flows recklessly. The sweet-warm properties of Renshen, Huangqi, Gancao, and Baizhu tonify the Spleen; the sweet-warm and sour-bitter properties of Yuanzhi, Fushen, Zaoren, and Longyanrou tonify the Heart; Danggui nourishes Blood, and Muxiang regulates Qi. When Qi is robust, it naturally controls the Blood.]
Another formula uses Huang Qi (Astragalus Membranaceus Radix) and Ren Shen (Ginseng Radix), combined with Fu Ling (Poria Cocos), Fu Shen (Poria Cocos with Hostwood), Chuan Xiong (Chuanxiong Rhizome), Dang Gui (Angelica Sinensis Radix), and Bai Zi Ren (Biota Seed). It also includes Ban Xia Qu (Pinellia Fermented Paste), Yuan Zhi (Polygala Root), Gui Zhi (Cinnamon Twig), Wu Wei Zi (Schisandra Fruit), and adds more Zao Ren (Sour Jujube Seed) to generally calm the Mind.
[Each dose contains Huang Qi (honey-fried), Fu Ling, Fu Shen, Chuan Xiong, Dang Gui (wine-washed), and Ban Xia Qu at 1 liang each; Gan Cao (fried) at 1 qian; Ren Shen, Bai Zi Ren (de-oiled), Wu Wei Zi, Yuan Zhi, and Zao Ren (stir-fried) at 2.5 qian each. Take 5 qian per serving. Renshen and Huangqi tonify Heart Qi; Chuanxiong and Danggui nourish Heart Blood; Fu Ling, Fu Shen, Bai Zi Ren, and Yuanzhi drain Heart Heat and calm the Spirit; Wuweizi and Zaoren gather scattered Heart Qi; Banxia removes phlegm-fluids that disturb the Heart; Gancao tonifies Earth (Spleen) to support the Heart's child element; Chi Gui (Red Cinnamon Twig) guides the herbs to reach the Heart Meridian.]
Zhang Zhongjing's Danggui Sini Tang (Angelica Decoction for Reversing Cold Hands) consists of Guizhi (Cinnamon Twig), Shaoyao (Peony Root), Xixin (Asarum Root), Gancao (Licorice Root), and Mutong (Akebia Stem). Adding large dates treats Yin Jue (cold extremities due to Yin excess/cold); a fine pulse indicates Yang deficiency stemming from Blood weakness.
[Cheng Wuji stated: To unblock the vessels, one must first enter the Heart to nourish Blood; the bitter nature of Danggui assists Heart Blood. The Heart dislikes laxity, so urgently consume sour flavors to astringe it; the sour nature of Shaoyao astringes Heart Qi. The Liver dislikes tension, so urgently consume sweet flavors to relax it; Gancao, Dazao, and Mutong relax Yin Blood.] If there is long-standing cold within, add Jiang (Ginger) and Zhuyu (Evodia Fruit). [For those with chronic cold, add 2 sheng of Wuzhuyu (Evodia Fruit) and half a jin of Shengjiang (Fresh Ginger), decocted in wine; this is named Sini Jia Wuzhuyu Shengjiang Tang (Sini Decoction plus Evodia and Fresh Ginger), from Zhang Zhongjing.] This formula releases the exterior to disperse wind and warms the meridians to unblock collaterals. [Guizhi disperses exterior wind; Wuzhuyu, Shengjiang, and Xixin warm the meridians; Danggui and Mutong unblock meridians and restore the pulse.] Do not use Fuzi (Aconite Lateral Root) or Ganjiang (Dried Ginger), as excessive warming yang agents may scorch Yin. [Sini Tang using Jiang and Fuzai aims to restore Yang; Danggui Sini Tang aims to benefit Blood and restore the pulse. Therefore, even if there is long-standing cold, only Shengjiang and Wuzhuyu are added, avoiding Ganjiang and Fuzi, lest they scorch the Yin.]