十首、附方七
《局方》中和义,参术茯苓甘草比。(人参、白术、茯苓各二钱,甘草一钱。气味中和,
故名君子。)益以夏陈半夏、陈皮名六君子汤,祛痰补气阳虚饵。(二陈除痰,四君补气,
脾弱阳虚宜之。)除却半夏名异功(散,钱氏。)或加香砂胃寒使。(加木香、砂仁,行气温
中
(汤,东垣)参术 ,黄连半夏草陈皮。苓泻防风羌独活,柴胡白芍枣姜随。〔黄 二
两,人参、半夏、炙甘草各一钱,羌活、独活、防风、白芍(炒)各五钱,陈皮四钱,白术、
茯苓、泽泻、柴胡各三钱,黄连二钱。每服三钱,加姜枣煎。六君子助阳,补脾除痰;重用
黄,补气固胃;柴胡、羌、独,除湿升阳;泽泻、茯苓,泻热降浊。加芍药和血敛阴,少
佐黄连以退阴火。按∶东垣治疗首重脾胃,而益胃又以升阳为先,故每用补中、上升下渗之
药。此方补中有散,发中有收,脾胃诸方多从此仿也。〕
(散,罗谦甫)地骨皮,艽菀参苓柴半知。地黄芍药天冬桂,甘桔桑皮劳热宜。(治虚
劳骨蒸,晡热咳嗽,食少盗汗∶黄 、鳖甲、天冬各五钱,地骨、秦艽、茯苓、柴胡各三钱,
紫菀、半夏、知母、生地、白芍、桑皮、炙草各二钱半,人参、肉桂、桔梗各钱半。每服一
两,加姜煎。鳖甲、天冬、知、芍,补水养阴;参、 、桂、苓、甘草,固卫助阳;桑、桔
泻肺热,菀、夏理痰嗽;艽、柴、地骨退热升阳。为表里气血交补之剂。)
第十首及附方七首
《太平惠民和剂局方》中的“中和义”(即四君子汤),由人参、白术、茯苓、甘草按比例组成。(人参、白术、茯苓各二钱,甘草一钱。药性气味平和中正,所以称为君子之剂。)在此基础上加入半夏和陈皮,命名为六君子汤,用于祛除痰湿并补气,适用于阳气虚弱的患者服用。(二陈汤去除痰湿,四君子汤补益元气,脾弱阳虚者适宜使用。)如果去掉半夏,则名为异功散(出自钱乙)。或者加入木香和砂仁,用于治疗胃寒,起到行气温中的作用(出自李东垣的益胃汤)。
(此处为补中益气汤类方的歌诀与解析)黄耆二两,人参、半夏、炙甘草各一钱,羌活、独活、防风、白芍(炒制)各五钱,陈皮四钱,白术、茯苓、泽泻、柴胡各三钱,黄连二钱。每次服用三钱,加入生姜和大枣煎煮。六君子汤辅助阳气,补益脾胃并祛除痰湿;重用黄耆,以补气固护胃气;柴胡、羌活、独活,用以祛除湿邪并升发阳气;泽泻、茯苓,用以泻热降浊。加入芍药以调和血液、收敛阴液,少量佐以黄连以消退阴火。按语:李东垣在治疗时首先重视脾胃,而益胃又以升发阳气为先务,因此经常使用补中益气、升清降浊的药物。此方补益之中兼有发散,发散之中兼有收敛,治疗脾胃的各种方剂大多从此方仿效而来。
(此处为补劳热骨蒸方歌诀与解析)地骨皮,秦艽、紫菀、人参、茯苓、柴胡、半夏、知母。地黄、芍药、天冬、肉桂,甘草、桔梗、桑白皮,适用于治疗虚劳发热。(主治虚劳引起的骨蒸潮热,傍晚发热咳嗽,食欲不振,盗汗:黄耆、鳖甲、天冬各五钱,地骨皮、秦艽、茯苓、柴胡各三钱,紫菀、半夏、知母、生地黄、白芍、桑白皮、炙甘草各二钱半,人参、肉桂、桔梗各钱半。每次服用一两,加入生姜煎煮。鳖甲、天冬、知母、白芍,滋养肾水、补养阴液;人参、黄耆、肉桂、茯苓、甘草,固护卫气、辅助阳气;桑白皮、桔梗,清泻肺热;紫菀、半夏,调理痰嗽;秦艽、柴胡、地骨皮,退热并升发阳气。此为表里气血兼顾补益的方剂。)
Song 10 and Seven Attached Formulas
The "Zhonghe Yi" (Harmonizing Righteousness, referring to Si Jun Zi Tang / Four Gentlemen Decoction) from the *Tai Ping Hui Min He Ji Ju Fang* is composed of Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma), Fu Ling (Poria), and Gan Cao (Licorice Root) in specific proportions. (Ren Shen, Bai Zhu, and Fu Ling are each two qian, and Gan Cao is one qian. The medicinal properties and flavors are mild and balanced, hence named after the "gentleman".) Adding Ban Xia (Pinelliae Rhizoma) and Chen Pi (Citri Reticulatae Pericarpium) creates Liu Jun Zi Tang (Six Gentlemen Decoction), which dispels phlegm and tonifies Qi, suitable for patients with Yang deficiency. (Er Chen Tang dispels phlegm, and Si Jun Zi Tang tonifies Qi; it is appropriate for those with Spleen weakness and Yang deficiency.) If Ban Xia is removed, it is named Yi Gong San (Extraordinary Merit Powder, from Qian Yi). Alternatively, adding Mu Xiang (Aucklandiae Radix) and Sha Ren (Amomi Fructus) treats Stomach cold by promoting Qi circulation and warming the middle. (Yi Wei Tang, from Li Dongyuan).
[Formula Analysis] Huang Qi (Astragali Radix) two liang, Ren Shen, Zhi Gan Cao (Honey-fried Licorice Root) each one qian, Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Fang Feng (Saposhnikoviae Radix), Bai Shao (Paeoniae Radix Alba, stir-fried) each five qian, Chen Pi four qian, Bai Zhu, Fu Ling, Ze Xie (Alismatis Rhizoma), Chai Hu (Bupleuri Radix) each three qian, Huang Lian (Coptidis Rhizoma) two qian. Take three qian per dose, decocted with fresh ginger and jujube. Liu Jun Zi Tang assists Yang, tonifies the Spleen, and dispels phlegm; heavy use of Huang Qi tonifies Qi and secures the Stomach; Chai Hu, Qiang Huo, and Du Huo dispel dampness and raise Yang; Ze Xie and Fu Ling drain heat and descend turbidity. Adding Bai Shao harmonizes blood and astringes Yin; a small amount of Huang Lian retreats Yin fire. Note: Li Dongyuan prioritized the Spleen and Stomach in treatment, emphasizing raising Yang to benefit the Stomach; thus, he frequently used herbs that tonify the center and ascend clear yang while descending turbid yin. This formula combines tonification with dispersion, and dispersion with retention. Most formulas for treating Spleen and Stomach disorders were modeled after this prescription.
[Attached Formula] Di Gu Pi (Lycii Cortex), Qin Jiao (Gentianae Macrophyllae Radix), Zi Wan (Asteris Radix), Ren Shen, Fu Ling, Chai Hu, Ban Xia, Zhi Mu (Anemarrhenae Rhizoma). Di Huang (Rehmanniae Radix), Bai Shao, Tian Dong (Asparagi Radix), Rou Gui (Cinnamomi Cortex), Gan Cao, Jie Geng (Platycodonis Radix), Sang Bai Pi (Mori Cortex), suitable for treating deficiency-heat. (Indicated for deficiency labor with bone-steaming fever, evening fever with cough, poor appetite, and night sweats: Huang Qi, Bie Jia (Testudinis Carapax et Plastrum), Tian Dong each five qian; Di Gu Pi, Qin Jiao, Fu Ling, Chai Hu each three qian; Zi Wan, Ban Xia, Zhi Mu, Sheng Di Huang (Rehmanniae Radix Preparata), Bai Shao, Sang Bai Pi, Zhi Gan Cao each two and a half qian; Ren Shen, Rou Gui, Jie Geng each one and a half qian. Take one liang per dose, decocted with fresh ginger. Bie Jia, Tian Dong, Zhi Mu, and Bai Shao nourish Kidney water and nourish Yin; Ren Shen, Huang Qi, Rou Gui, Fu Ling, and Gan Cao secure the Defensive Qi and assist Yang; Sang Bai Pi and Jie Geng drain Lung heat; Zi Wan and Ban Xia regulate phlegm and cough; Qin Jiao, Chai Hu, and Di Gu Pi reduce fever and raise Yang. This is a formula that tonifies both interior/exterior and Qi/Blood.)