拔萃六味地黄丸治肾气虚久新憔悴寝汗发热五脏齐损瘦弱虚烦骨蒸下血
丹溪大补丸降阴火补肾水
补阴丸降阴火治烦渴骨热补肾水真阴不足
并见补虚门
按此三方足少阴药下二方入阴中至阴之剂经云壮水之主以制阳光所谓求其属也
局方玄参汤治肾脏实热心胸烦满耳听无声腰背俯仰强痛口干溺赤
生地黄 玄参 五加皮 黄芩 赤茯苓 通草 石菖蒲 甘草(炙) 羚羊角屑 麦门冬
(各等分)
上 咀水煎
按此滋肾通心气血之药也
丹溪左金丸泻肝火行湿为热甚反佐开痞结治肝邪
黄连(六两) 吴茱萸(一两)
上为末粥糊丸
局方温胆汤治胆虚痰热惊悸不眠
半夏 竹茹 枳实(各二两) 陈皮 生姜(四两) 甘草(二两)
上 咀水煎每服一两
治要茯苓散治心实热口干烦渴眠卧不安
茯神 麦门冬(各一两半) 通草(一两二钱半) 知母(一两) 紫菀 桂心(各七钱半)
升麻(一两二钱半) 淡竹茹(半两) 大枣(十二枚) 赤石脂(一两七钱半)
上 咀每服一两井花水煎
茱萸散治小肠虚热或酒后频吃冷水等物其病脐下结块连外肾俱肿者
吴茱萸(二钱半) 川芎(半两) 木通(四钱) 半夏(一钱)
上 咀每三四钱入葱煎服
泻热汤治脾脏热面黄目赤季胁痛满
半夏 母姜(各八两) 枳实 栀子 茯苓 芒硝(各三两) 细辛(五两) 白术 杏仁(
各四两) 生地黄 淡竹叶(各一升)
上 咀每服一两或两半水煎后下硝温服
桂苓甘露饮治胃受湿热头疼身热烦渴吐泻口干
方见热门
橘皮汤治肺热气咳息喘奔
橘皮 麻黄(各三两) 紫苏 柴胡(各二两) 宿姜 杏仁(各四两) 石膏(八两)
上 咀每服一两水煎
生姜泄肠汤治大肠实热腹胀不通口舌生疮
生姜 橘皮 竹茹 黄芩 栀子仁 白术(各三两) 桂心(一两) 茯苓 芒硝(各二两)
生地黄(十两)
上 咀入大枣煎每服一两
金匮肾气丸治肾经虚热
方见补虚门
五苓散治发热而渴小便不利烦躁头痛
方见泄泻门
按内经注曰若调寒热之逆冷热必行则热物冷服下咽之后冷体既消热性便发由是病气随愈
矣以上诸方皆从其气以去拒格之热可临证选用求其意例也
拔萃六味地黄丸治疗肾气虚损日久,形体憔悴,夜间盗汗,发热,五脏功能全面受损,身体消瘦虚弱,心中虚烦,骨蒸潮热,下部出血。
补阴丸用于降伏阴火,治疗烦躁口渴、骨骼发热,并补肾水真阴不足。
(以上三方详见“补虚门”章节)
按语:这三方均为足少阴肾经的药物。其中后两方属于深入至阴之分的药剂。《内经》云:“壮水之主,以制阳光”,这就是所说的“求其属”(即寻找疾病的根本属性进行治疗)。
局方玄参汤治疗肾脏实热,症见心胸烦闷胀满,听力丧失,腰背僵硬疼痛,俯仰困难,口干,小便色赤。
药材:生地黄、玄参、五加皮、黄芩、赤茯苓、通草、石菖蒲、甘草(炙)、羚羊角屑、麦门冬(各等分)。
制法与用法:将药材切碎,加水煎煮。
丹溪左金丸用于泻除肝火,行气化湿,因湿热极盛而采用反佐法,开通痞结,治疗肝邪为患。
药材:黄连(六两)、吴茱萸(一两)。
制法与用法:研为细末,用米粥糊制作成丸剂。
局方温胆汤治疗胆虚伴有痰热,症见惊悸、失眠。
药材:半夏、竹茹、枳实(各二两)、陈皮、生姜(四两)、甘草(二两)。
制法与用法:将药材切碎,加水煎煮,每次服用一两。
《治要》茯苓散治疗心经实热,症见口干、烦躁口渴、睡眠不安。
药材:茯神、麦门冬(各一两半)、通草(一两二钱半)、知母(一两)、紫菀、桂心(各七钱半)、升麻(一两二钱半)、淡竹茹(半两)、大枣(十二枚)、赤石脂(一两七钱半)。
制法与用法:将药材切碎,每次服用一两,用井花水煎服。
茱萸散治疗小肠虚热,或因酒后频繁饮用冷水等物,导致脐下结成块状,牵连外肾(睾丸)一起肿胀的疾病。
药材:吴茱萸(二钱半)、川芎(半两)、木通(四钱)、半夏(一钱)。
制法与用法:将药材切碎,每次取三四钱,加入葱白煎服。
泻热汤治疗脾脏实热,症见面色发黄、眼睛发红、季胁部疼痛胀满。
药材:半夏、母姜(各八两)、枳实、栀子、茯苓、芒硝(各三两)、细辛(五两)、白术、杏仁(各四两)、生地黄、淡竹叶(各一升)。
制法与用法:将药材切碎,每次服用一两或一两半,加水煎煮,药液煎好后放入芒硝,温热服用。
桂苓甘露饮治疗胃受湿热侵袭,症见头痛、身体发热、烦躁口渴、呕吐腹泻、口干。
(此方详见“热门”章节)
橘皮汤治疗肺热气逆引起的咳嗽、喘息、奔豚气。
药材:橘皮、麻黄(各三两)、紫苏、柴胡(各二两)、宿姜、杏仁(各四两)、石膏(八两)。
制法与用法:将药材切碎,每次服用一两,加水煎煮。
生姜泄肠汤治疗大肠实热,症见腹部胀满不通、口舌生疮。
药材:生姜、橘皮、竹茹、黄芩、栀子仁、白术(各三两)、桂心(一两)、茯苓、芒硝(各二两)、生地黄(十两)。
制法与用法:将药材切碎,加入大枣煎煮,每次服用一两。
五苓散治疗发热且口渴、小便不利、烦躁、头痛。
(此方详见“泄泻门”章节)
按《内经》注解说:如果调理寒热逆乱之气,冷热之气必然运行,那么热药冷服,咽下之后,冷性消散,热性便发作,于是病气随之痊愈。以上各方都是顺应病气以去除格拒之热的方剂,可根据临床情况选用,探求其意旨和体例。
Bacui Liuwei Dihuang Wan treats chronic deficiency of Kidney Qi, resulting in emaciation and exhaustion, night sweats, fever, dysfunction of all five Zang organs, thinness and weakness, empty vexation, bone-steaming fever, and lower body bleeding.
Danxi Dabu Wan descends ministerial fire and tonifies Kidney Water.
Buyin Wan descends ministerial fire, treats vexation and thirst, bone heat, and tonifies the true Yin deficiency of Kidney Water.
(See the "Tonifying Deficiency" section for these three formulas.)
Note: These three formulas consist of herbs from the Foot-Shaoyin (Kidney) meridian. The latter two formulas are agents that penetrate into the deepest Yin. As stated in the *Neijing* (Classic of Internal Medicine): "Strengthen the master of Water to control the solar flare," which is referred to as "seeking its affiliation" (treating the root cause).
Ju Fang Xuanshen Tang treats excess-heat in the Kidneys, manifesting as vexation and fullness in the chest and heart, deafness, stiffness and pain in the waist and back with difficulty in bending and stretching, dry mouth, and dark urine.
Ingredients: Shengdihuang (Rehmanniae Radix), Xuanshen (Scrophulariae Radix), Wujia Pi (Acanthopanacis Cortex), Huangqin (Scutellariae Radix), Chifuling (Poria cum Ramis et Ligno Rubra), Tongcao (Tetrapaninis Medulla), Shichangpu (Acori Tatarinowii Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle), Lingyangjiao Xie (Saigae Tataricae Cornu), Mai Dong (Ophiopogonis Radix) (all in equal parts).
Preparation and Administration: Decoct the chopped herbs in water.
Note: This formula nourishes Kidney Yin and unblocks Heart Qi and Blood.
Danxi Zuojin Wan purges Liver Fire, moves dampness, and uses a counter-agent method due to extreme heat-dampness to open痞结 (obstructions), treating Liver pathogenic factors.
Ingredients: Huanglian (Coptidis Rhizoma) (6 liang), Wu Zhuyu (Evodiae Fructus) (1 liang).
Preparation and Administration: Grind into powder and make pills using rice porridge paste.
Ju Fang Wendan Tang treats Gallbladder deficiency with phlegm-heat, manifesting as palpitations and insomnia.
Ingredients: Banxia (Pinelliae Rhizoma), Zhuru (Bambusae Folium), Zhishi (Aurantii Fructus Immaturus) (2 liang each), Chenpi (Citri Reticulatae Pericarpium), Shengjiang (Zingiberis Rhizoma Recens) (4 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (2 liang).
Preparation and Administration: Decoct the chopped herbs in water; take 1 liang per dose.
Zhiyao Fuling San treats excess-heat in the Heart, manifesting as dry mouth, vexation and thirst, and restless sleep.
Ingredients: Fushen (Poria cum Radix Pini), Mai Dong (Ophiopogonis Radix) (1.5 liang each), Tongcao (Tetrapaninis Medulla) (1.25 liang), Zhi Mu (Anemarrhenae Rhizoma) (1 liang), Ziwan (Adenophorae Radix), Guixin (Cinnamomi Ramulus) (0.75 liang each), Shengma ( Cimicifugae Rhizoma) (1.25 liang), Dan Zhuru (Bambusae Folium) (0.5 liang), Dazao (Jujubae Fructus) (12 pieces), Chishizhi (Halloysit Rubrum) (1.75 liang).
Preparation and Administration: Decoct the chopped herbs in well-water; take 1 liang per dose.
Zhuyu San treats deficiency-heat in the Small Intestine, or conditions caused by frequently drinking cold water after alcohol consumption, leading to masses below the umbilicus swelling together with the external kidneys (testes).
Ingredients: Wu Zhuyu (Evodiae Fructus) (0.25 qian), Chuanxiong (Ligusticum Chuanxiong Rhizoma) (0.5 liang), Mutong (Akebiae Caulis), Banxia (Pinelliae Rhizoma) (0.1 qian).
Preparation and Administration: Decoct the chopped herbs with scallions; take 3–4 qian per dose.
Xiere Tang treats excess-heat in the Spleen, manifesting as sallow complexion, red eyes, and pain and fullness in the hypochondrium.
Ingredients: Banxia (Pinelliae Rhizoma), Mujiang (Zingiberis Rhizoma) (8 liang each), Zhishi (Aurantii Fructus Immaturus), Zhizi (Gardeniae Fructus), Fuling (Poria), Mangxiao (Natrii Sulfas) (3 liang each), Xixin (Asari Radix et Rhizoma) (5 liang), Baizhu (Atractylodis Macrocephalae Rhizoma), Xingren (Armeniacae Semen Amarum) (4 liang each), Shengdihuang (Rehmanniae Radix), Dan Zhuye (Phyllostachdis Viridis Folium) (1 sheng each).
Preparation and Administration: Decoct the chopped herbs in water; take 1 liang or 1.5 liang per dose. Add Mangxiao (Natrii Sulfas) after decoction and take warm.
Guiling Ganyin Tang treats Stomach affected by damp-heat, manifesting as headache, fever, vexation and thirst, vomiting, diarrhea, and dry mouth.
(See the "Heat Syndromes" section for this formula.)
Jupi Tang treats Lung heat causing cough, wheezing, and Ben Tun (rushing qi syndrome).
Ingredients: Jupi (Citri Reticulatae Pericarpium), Mahuang (Ephedrae Herba) (3 liang each), Zisu (Perillae Folium), Chaihu (Bupleuri Radix) (2 liang each), Su Jiang (Zingiberis Rhizoma Recens), Xingren (Armeniacae Semen Amarum) (4 liang each), Shigao (Gypsi Fibrosus) (8 liang).
Preparation and Administration: Decoct the chopped herbs in water; take 1 liang per dose.
Shengjiang Xiechang Tang treats excess-heat in the Large Intestine, manifesting as abdominal distension and obstruction, and sores on the mouth and tongue.
Ingredients: Shengjiang (Zingiberis Rhizoma Recens), Jupi (Citri Reticulatae Pericarpium), Zhuru (Bambusae Folium), Huangqin (Scutellariae Radix), Zhiren (Gardeniae Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma) (3 liang each), Guixin (Cinnamomi Ramulus) (1 liang), Fuling (Poria), Mangxiao (Natrii Sulfas) (2 liang each), Shengdihuang (Rehmanniae Radix) (10 liang).
Preparation and Administration: Decoct the chopped herbs with Dazao (Jujubae Fructus); take 1 liang per dose.
Jinkui Shenqi Wan treats deficiency-heat in the Kidney meridian.
(See the "Tonifying Deficiency" section for this formula.)
Wuling San treats fever with thirst, difficult urination, irritability, and headache.
(See the "Diarrhea" section for this formula.)
Note: According to the commentary on the *Neijing*: If one regulates the reversal of cold and heat, the cold and qi will move accordingly. Therefore, taking hot medicine cold, after swallowing, the cold nature dissipates and the hot nature activates, thus curing the disease. All the above formulas follow the qi to remove rebellious heat; they can be selected according to clinical presentation to understand their principles.