十三首、附方八
(仲景)治太阳府,(太阳经热传入膀胱府者用之。)白术泽泻猪茯苓。膀胱化气添官桂,
利便消暑烦渴清。〔猪苓、茯苓、白术(炒)各十八铢,泽泻一两六铢,桂枝半两,每服三
钱。二苓甘淡利水,泽泻甘咸泻水,能入肺肾而通膀胱,导水以泄火邪。加白术者,补土所
以制水;加官桂者,气化乃能出也。经曰∶膀胱者,州都之官,津液藏焉,气化则能出矣。〕
除桂名为四苓散,无寒但渴服之灵。(湿胜则气不得施化,故渴,利其湿则渴自止。)猪苓汤
(仲景)除桂与术,加入阿胶滑石停。(猪苓、茯苓、泽泻、阿胶、滑石各一两。滑石泻火
解肌,最能行水。吴鹤皋曰∶以诸药过燥,故加阿胶以存津液。)此为利湿兼泻热,黄胆(小)
便闭渴呕宁。(五苓治湿胜,猪苓兼热胜。)
(仲景)。行水散痞有生姜。(半夏一升,茯苓三钱,生姜半斤。除茯苓,名小半夏汤。)
加桂除夏治悸厥,茯苓甘草汤名彰。(加桂枝、甘草,除半夏,名茯苓甘草汤,仲景治伤寒
水气乘心,厥而心下悸者,先治其水,却治其厥。火因水而下行,则眩悸止而痞满治矣。)
(《金匮》)内用干姜,茯苓甘草白术襄。伤湿身痛与腰冷,亦名甘姜苓术汤。〔
、茯苓各四两,炙甘草、白术(炒)各二两。数药行水补土,此湿邪在经而未入腑脏者。〕
黄防己(汤,《金匮》)除姜茯,术甘姜枣共煎尝。此治风水与诸湿,身重汗出服之良。〔黄
、防己各一两,白术七钱半,甘草(炙)五钱,加姜、枣煎。防己大辛苦寒,通行十二经,
开窍行水;黄 生用达表,白术燥湿强脾,并能止汗。加甘草者,益土所以制水,又以缓防
己之峻急也。〕
十三首、附方八
(张仲景)治疗太阳腑证,(这是指太阳经的热邪传入膀胱腑时使用的方剂。)使用白术、泽泻、猪苓和茯苓。在促进膀胱气化功能方面添加官桂(肉桂),能够通利小便,消除暑热引起的烦渴症状。〔猪苓、茯苓、炒白术各十八铢,泽泻一两六铢,桂枝半两,每次服用三钱。猪苓和茯苓味甘淡,具有利水作用;泽泻味甘咸,能泻水,且能入肺肾二经而通达膀胱,引导水液以泄除火邪。加入白术,是为了通过补益脾土来制约水湿;加入官桂,是因为只有气化正常,水液才能排出。《内经》说:膀胱是州都之官,津液藏于其中,经过气化作用才能排出体外。〕去掉桂枝的名字叫四苓散,如果没有寒象只是口渴,服用此方很灵验。(湿气过重导致气机不能正常施化,所以出现口渴,利去湿气则口渴自然停止。)猪苓汤(张仲景的方子)去掉桂枝和白术,加入阿胶和滑石。〔猪苓、茯苓、泽泻、阿胶、滑石各一两。滑石能泻火解肌,最善于行水。吴鹤皋说:因为其他药物过于燥烈,所以加入阿胶来保存津液。〕这是利湿兼泻热的方子,对于黄疸、小便闭塞、口渴呕吐等症状有宁定疗效。(五苓散治疗湿气胜,猪苓汤兼治热邪胜。)
(张仲景)。行水散痞需要加入生姜。〔半夏一升,茯苓三钱,生姜半斤。去掉茯苓,名叫小半夏汤。〕加入桂枝、去掉半夏治疗心悸厥逆,茯苓甘草汤的名声显著。〔加入桂枝、甘草,去掉半夏,名叫茯苓甘草汤,张仲景用于治疗伤寒水气侵犯心脏,出现四肢厥冷且心下悸动的情况,先治疗水气,再治疗厥逆。火因水下行,则眩晕心悸停止,痞满也就治愈了。〕
(出自《金匮要略》)内部使用干姜,配合茯苓、甘草、白术辅助。治疗受湿邪侵袭导致的身体疼痛和腰部寒冷,也叫甘姜苓术汤。〔干姜、茯苓各四两,炙甘草、炒白术各二两。这几味药能行水补土,这是湿邪在经络而未进入脏腑的情况。〕防己黄芪汤(出自《金匮要略》)去掉干姜和茯苓,用白术、甘草、干姜、大枣共同煎煮服用。此方治疗风水及各类湿邪,身体沉重、出汗者服用效果良好。〔黄芪、防己各一两,白术七钱半,炙甘草五钱,加生姜、大枣煎服。防己味大辛苦性寒,通行十二经脉,开窍行水;黄芪生用可达体表,白术燥湿强脾,并能止汗。加入甘草,是为了补益脾土以制约水湿,同时缓和防己的峻急之性。〕
Thirteen Formulas, Eight Supplementary Formulas
(Zhang Zhongjing) Treats Taiyang Fu syndrome (a condition where heat from the Taiyang meridian transmits to the Bladder Fu organ), using Baizhu (Atractylodis Rhizoma), Zexie (Alismatis Rhizoma), Zhuling (Polyporus), and Fuling (Poria). Add Guizhi (Cinnamon Twig) to promote Bladder Qi transformation (the functional activity of the Bladder responsible for urine excretion), thereby promoting urination and clearing summerheat-induced irritability and thirst. [Zhuling, Fuling, and Chao Baizhu (Stir-fried Atractylodis Rhizoma) each 18 zhu, Zexie 1 liang 6 zhu, Guizhi half a liang; take 3 qian per dose. Both Ling herbs (Zhuling and Fuling) are sweet and bland, facilitating water drainage; Zexie is sweet and salty, draining water, entering the Lung and Kidney meridians to connect with the Bladder, guiding water to drain fire pathogens. Adding Baizhu supplements Earth to control Water; adding Guizhi ensures that Qi transformation allows water to exit. The Classic states: The Bladder is the official of the capital, storing fluids; only through Qi transformation can they be excreted.] Removing Guizhi yields the name Siling San (Four-Ingredient Powder); if there is no cold but only thirst, taking this formula is effective. (Excessive dampness prevents normal Qi distribution, causing thirst; draining dampness stops thirst naturally.) Zhu Ling Tang (Zhang Zhongjing's formula) removes Guizhi and Baizhu, adding Ejiao (Donkey-hide Gelatin) and Huashi (Talcum). [Zhuling, Fuling, Zexie, Ejiao, and Huashi each 1 liang. Huashi drains fire and releases the muscle layer, most effectively moving water. Wu Hegao stated: Since other drugs are overly drying, Ejiao is added to preserve body fluids.] This is a formula that promotes dampness drainage while purging heat, calming jaundice, urinary retention, thirst, and vomiting. (Wu Ling San treats excessive dampness; Zhu Ling Tang addresses both dampness and excessive heat.)
(Zhang Zhongjing). To move water and dissipate fullness, add Shengjiang (Fresh Ginger). [Banxia 1 sheng, Fuling 3 qian, Shengjiang half a jin. Removing Fuling yields Xiao Banxia Tang (Minor Pinellia Decoction).] Adding Guizhi and removing Banxia treats palpitations and cold extremities; Fuling Gancao Tang (Poria and Licorice Decoction) gains prominence. [Adding Guizhi and Gancao, removing Banxia, yields Fuling Gancao Tang. Zhang Zhongjing used it to treat Cold Damage where water qi invades the Heart, causing cold extremities and epigastric palpitations; first treat the water, then the cold extremities. Fire descends with water, stopping dizziness and palpitations, resolving fullness.]
(From *Jin Gui Yao Lue*) Internally use Ganjiang (Dried Ginger), assisted by Fuling, Gancao, and Baizhu. Treats body pain and cold waist due to dampness injury; also named Gan Jiang Ling Zhu Tang (Ginger, Poria, and Atractylodes Decoction). [Ganjiang and Fuling each 4 liang, Zhi Gancao (Honey-fried Licorice) and Chao Baizhu each 2 liang. These herbs move water and supplement Earth; this indicates dampness pathogen in the meridians without entering the Fu-Zang organs.] Fang Ji Huang Qi Tang (from *Jin Gui Yao Lue*) removes Ganjiang and Fuling, decocting Baizhu, Gancao, Ganjiang, and Dazao together. This treats Fengshui (Wind-Water edema) and various dampness conditions; beneficial for heavy body and sweating. [Huangqi (Astragali Radix) and Fangji (Stephaniae Tetrandrae Radix) each 1 liang, Baizhu 7.5 qian, Zhi Gancao 5 qian, plus Shengjiang and Dazao. Fangji is large, bitter, pungent, and cold, circulating through the twelve meridians, opening orifices and moving water; raw Huangqi reaches the exterior, Baizhu dries dampness and strengthens Spleen, and both can stop sweating. Adding Gancao benefits Earth to control Water, and moderates the harshness of Fangji.]