内治之法,不外审脉用药。如风痰,脉必兼浮;热痰,脉必洪数;气痰,脉濡;瘰 ,
脉虚
弱。筋 之或弦或涩,痰 之或弱或滑,尤在临症时,细察病原,别其膏粱藜藿,观其寒热
虚实,老幼荣枯,细询起居嗜好,而知为何症,当用何方,病机自无循情矣。兹将平昔试验
之方,缕列于下∶
防风 荆芥 连翘 牛蒡子 归尾 赤芍 生甘 银花(各一钱) 土茯苓(二钱) 灯蕊
(十七茎)
连翘(二钱) 当归 山栀 桔梗 条芩 花粉 僵蚕(各一钱) 生石膏(二钱) 竹茹
甘草(各五分)
夏枯草(一钱引) 藿香(二钱) 香附 白芷 陈皮 桔梗 茯苓 柴胡 法夏 白术
浓朴 腹皮 甘草(各一钱)
白芍(三钱) 当归(三钱) 昆布 穿甲 牡蛎 花粉 云苓 天葵子(各二钱) 桔梗(
一钱) 山栀 柴胡(各钱五分)
龟胶 云苓(各三钱) 川贝 白芍 当归 白术 柴胡 丹皮 牡蛎(各二钱) 山栀(
一钱) 生甘(一钱) 竹叶(二十片)
川贝 陈皮 茯苓 花粉 牡蛎 海藻(各二钱) 牛蒡子(钱半) 黄芩 连翘 木香
木瓜(各一钱)
以上各方,凡痰 在上身者,俱可加入桔梗,在下体者,可加入怀牛膝,以为引经报使
,则药性易达,而收功亦速也。
内治的方法,不外乎审察脉象来选用药物。例如风痰,脉象必定兼有浮象;热痰,脉象必定洪大且数;气痰,脉象濡软;瘰疬(颈部淋巴结结核),脉象虚弱。筋病(如筋痹)的脉象或弦或涩,痰病的脉象或弱或滑,尤其需要在临诊时,仔细考察病因,辨别患者平素饮食是膏粱厚味还是藜藿淡食,观察其寒热虚实的体质状况,以及患者的年龄老少、气血盛衰,详细询问其起居习惯和嗜好,从而知道是何种病症,应当使用哪个方剂,疾病的机理自然就不会违背情理了。现将平日试验有效的方剂,逐一列举如下:
防风、荆芥、连翘、牛蒡子、当归尾、赤芍、生甘草、金银花(各一钱),土茯苓(二钱),灯心草(十七茎)。
连翘(二钱)、当归、山栀、桔梗、黄芩条、天花粉、僵蚕(各一钱),生石膏(二钱),竹茹、甘草(各五分)。
夏枯草(一钱为引)、藿香(二钱)、香附、白芷、陈皮、桔梗、茯苓、柴胡、法半夏、白术、厚朴、腹皮、甘草(各一钱)。
白芍(三钱)、当归(三钱)、昆布、穿山甲、牡蛎、天花粉、云茯苓、天葵子(各二钱),桔梗(一钱),山栀、柴胡(各五分)。
龟板胶、云茯苓(各三钱),川贝母、白芍、当归、白术、柴胡、丹皮、牡蛎(各二钱),山栀(一钱),生甘草(一钱),竹叶(二十片)。
川贝母、陈皮、茯苓、天花粉、牡蛎、海藻(各二钱),牛蒡子(一钱半),黄芩、连翘、木香、木瓜(各一钱)。
以上各方,凡是痰证在上半身者,均可加入桔梗,在下半身者,可加入怀牛膝,作为引经报使药,这样药性容易到达病所,而收效也迅速。
The method of internal treatment essentially involves examining the pulse to select medications. For instance, in wind-phlegm (Wind-Phlegm), the pulse must be accompanied by a floating quality; in heat-phlegm (Heat-Phlegm), the pulse must be surging and rapid; in qi-phlegm (Qi-Phlegm), the pulse is soggy; in scrofula (Luo Li, cervical lymphadenitis), the pulse is deficient and weak. In cases of tendon disorders (Jin Bing), the pulse may be wiry or choppy; in phlegm disorders, the pulse may be deficient or slippery. It is especially crucial during clinical practice to carefully investigate the etiology, distinguish whether the patient’s diet consists of rich/fatty foods or coarse/plain foods, observe their patterns of cold/heat and deficiency/excess, as well as their age (young/old) and vitality (robust/withered). By inquiring in detail about their daily habits and preferences, one can determine the specific syndrome and the appropriate formula, ensuring that the pathogenesis aligns with reality. The following are formulas tested and effective in my practice, listed in detail:
Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Herba), Lianqiao (Forsythiae Fructus), Niubangzi (Arctii Fructus), Guiwei (Angelicae Sinensis Radix caulis), Chishao (Paeoniae Radix Rubra), Sheng Gancao (Glycyrrhizae Radix et Rhizoma Preparatum), Yinhua (Lonicerae Japonicae Flos) (each 1 qian), Tufuling (Smilacis Glabrae Rhizoma) (2 qian), Dengxin (Junci Medullia) (17 stems).
Lianqiao (Forsythiae Fructus) (2 qian), Danggui (Angelicae Sinensis Radix), Shanzhi (Gardeniae Fructus), Jiegeng (Platycodonis Radix), Tiao Qin (Scutellariae Radix cut into strips), Huafen (Trichosanthis Radix), Jiangcan (Bombyx Batryticatus) (each 1 qian), Sheng Shigao (Gypsum Fibrosum) (2 qian), Zhuru (Bambusae Caulis in Taenia), Gancao (Glycyrrhizae Radix et Rhizoma) (each 5 fen).
Xiakucao (Prunellae Spica) (1 qian as guide), Huoxiang (Agastaches Herba) (2 qian), Xiangfu (Cyperi Rhizoma), Baizhi (Angelicae Dahuricae Radix), Chenpi (Citri Reticulatae Pericarpium), Jiegeng (Platycodonis Radix), Fuling (Poria), Chaihu (Bupleuri Radix), Fa Xia (Pinelliae Rhizoma Preparatum), Baizhu (Atractylodis Macrocephalae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Fupi (Tangerinae Fructus Pericarpium Viride), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 qian).
Baishao (Paeoniae Radix Alba) (3 qian), Danggui (Angelicae Sinensis Radix) (3 qian), Kunbu (Eckloniae Thallus), Chuanjia (Manis Squama), Muli (Ostreae Concha), Huafen (Trichosanthis Radix), Yunling (Poria), Tiankuizi (Adenophorae Radix) (each 2 qian), Jiegeng (Platycodonis Radix) (1 qian), Shanzhi (Gardeniae Fructus), Chaihu (Bupleuri Radix) (each 0.5 qian).
Guijiao (Colla Testudinis), Yunling (Poria) (each 3 qian), Chuanbei (Fritillariae Cirrhosae Bulbus), Baishao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Chaihu (Bupleuri Radix), Danpi (Moutan Cortex), Muli (Ostreae Concha) (each 2 qian), Shanzhi (Gardeniae Fructus) (1 qian), Sheng Gancao (Glycyrrhizae Radix et Rhizoma Preparatum) (1 qian), Zhuye (Phyllostachidis Folium) (20 leaves).
Chuanbei (Fritillariae Cirrhosae Bulbus), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria), Huafen (Trichosanthis Radix), Muli (Ostreae Concha), Haizao (Sargassum Thallus) (each 2 qian), Niubangzi (Arctii Fructus) (1.5 qian), Huangqin (Scutellariae Radix), Lianqiao (Forsythiae Fructus), Muxiang (Aucklandiae Radix), Mugua (Chaenomelis Fructus) (each 1 qian).
For all the above formulas, if the phlegm disorder is located in the upper body, Jiegeng (Platycodonis Radix) may be added; if located in the lower body, Huainiuqi (Achyranthis Bidentatae Radix from Huaiqing) may be added, serving as guiding herbs to direct the medicinal properties to the affected area, thereby facilitating faster therapeutic effects.