橘皮 杏仁(泡去皮,炒) 枳实(面粉拌炒) 黄芩 栝蒌仁(酒炒) 茯苓(各一两) 胆南星 法半夏(各
一两五钱) 酒、姜汁为丸。
吴鹤皋曰∶气之不清,痰之故也。能治其痰,则气清矣。故用星、夏燥痰湿,杏、橘利痰滞,枳实攻痰积,
黄芩清痰热。茯苓渗湿以清痰,栝萎下气以除痰。愚谓痰即有形之火,火即无形之痰。火借气于五脏,痰借液于
五味。液有余则痰因而充溢,气有余则痰得以横行。善治痰者,不治痰而治火。善治火者,不治火而治气。是故
清气乃所以化痰。而曰痰治则气清,解说虽好,觉与本方义稍背。
诗曰∶清气化痰星夏橘,茯苓杏枳栝蒌实,生姜扭汁酒为丸,不遇沉 脏清密。
黄连 黄芩 黄柏 黄栀子 当归(各一两) 大黄 龙胆草 青黛 芦荟(各五钱) 木香(二钱) 麝(一钱)
风热蓄积,时发惊悸,筋惕抽搦,嗌塞不利,肠胃燥湿狂越,目上视,此方主之。
肝火为风,心火为热。心热则惊悸,肝热则搐搦上视。嗌塞不利者,肺亦火也。肠胃燥湿者,脾亦火也。狂
越者,狂妄而越礼也。经曰∶狂言为失志。又曰∶肾藏志。如斯言之,则肾亦火矣。故用黄连、山栀以泻心,黄
芩以泻肺,青黛、龙胆草以泻肝,大黄以泻脾,黄柏以泻肾。夫一水曷胜五火,不亟亟以泻之,几于无水耳。用
当归者,养脏阴于亢火之际。用木香、麝香者,和脏气于克伐之余也。
诗曰∶当归龙荟本五黄,青黛木香及麝囊,冬蜜为丸绿豆大,审其量进亦奇方。
橘皮、杏仁(浸泡后去皮,炒制)、枳实(用面粉拌炒)、黄芩、栝蒌仁(酒炒)、茯苓(以上各一两)、胆南星、法半夏(以上各一两五钱)。用酒和姜汁制作成丸剂。
吴鹤皋说:气机不清畅,是因为痰的缘故。能够治好痰,气机就清畅了。所以使用南星、半夏来燥化湿痰,杏仁、橘皮来利导痰滞,枳实来攻逐痰积,黄芩来清解痰热。茯苓渗利湿气以清除生痰之源,栝蒌下气以消除痰浊。我认为痰就是有形之火,火就是无形之痰。火借助五脏之气而存在,痰借助五味之液而生成的。体液有余则痰因此充溢,气机有余则痰得以横行。善于治疗痰的人,不直接治痰而是治火。善于治火的人,不直接治火而是治气。因此,清气才是用来化痰的方法。而说“治痰则气清”,虽然解说看似美好,但觉得与本方的本义稍有背离。
诗曰:清气化痰丸由南星、半夏、橘皮组成,加上茯苓、杏仁、枳实、栝蒌实,生姜榨汁与酒制成丸剂,若不遇到沉寒痼冷之脏,即可清密(注:此处原文可能有误或为特定语境,直译为清密,意指清理致密之痰结)。(注:最后一句“不遇沉 脏清密”原文似有脱漏或异文,通常作“不遇沉寒痼冷之证”或类似含义,此处依字面翻译并保留原意结构,结合上下文理解为非沉寒之证可用此方清理痰结)。
黄连、黄芩、黄柏、黄栀子、当归(以上各一两)、大黄、龙胆草、青黛、芦荟(以上各五钱)、木香(二钱)、麝香(一钱)。主治风热蓄积体内,时常发作惊悸,筋脉跳动抽搐,咽喉堵塞不利,肠胃燥湿不调导致狂妄越礼,眼睛向上翻视,此方主治这些症状。
肝火表现为风,心火表现为热。心热则导致惊悸,肝热则导致抽搐和眼球上视。咽喉堵塞不利,是因为肺也有火。肠胃燥湿不调,是因为脾也有火。狂妄越礼,是指行为狂妄而超越礼法。医经说:胡言乱语是神志丧失的表现。又说:肾藏志。照这样说来,那么肾也有火了。所以使用黄连、山栀来泻心火,黄芩来泻肺火,青黛、龙胆草来泻肝火,大黄来泻脾火,黄柏来泻肾火。单一的水怎能胜过五种火?如果不急切地泻火,身体几乎就要没有阴液了。使用当归,是为了在亢盛的火势中滋养脏腑的阴液。使用木香、麝香,是为了在峻猛攻伐之后调和脏腑之气。
诗曰:当归龙荟丸本于五种黄色药材(指黄连、黄芩、黄柏、黄栀子、龙胆草),加上青黛、木香及麝香,用冬蜜制成如绿豆大小的丸剂,仔细斟酌剂量服用,也是奇效之方。
Chenpi (Tangerine Peel), Xingren (Apricot Seed, soaked, peeled, stir-fried), Zhishi (Immature Bitter Orange, stir-fried with wheat flour), Huangqin (Scutellaria Root), Gualouren (Trichosanthes Seed, wine-fried), Fuling (Poria, each 1 liang), Dantanxing (Arisaema cum Bile), Fabanxia (Prepared Pinellia Rhizome, each 1.5 liang). Form pills using wine and ginger juice.
Wu Hegao stated: The turbidity of Qi is due to Phlegm. If Phlegm can be treated, Qi will become clear. Therefore, Nanxing (Arisaema) and Banxia (Pinellia) are used to dry damp-Phlegm; Xingren (Apricot Seed) and Chenpi (Tangerine Peel) are used to promote the movement of Phlegm stagnation; Zhishi (Immature Bitter Orange) is used to attack Phlegm accumulation; Huangqin (Scutellaria Root) is used to clear Phlegm-heat. Fuling (Poria) seeps out dampness to clear the source of Phlegm; Gualou (Trichosanthes Fruit/Seed) descends Qi to eliminate Phlegm. I believe that Phlegm is visible Fire, and Fire is invisible Phlegm. Fire borrows Qi from the Five Zang organs; Phlegm borrows fluids from the Five Flavors. When fluids are in excess, Phlegm becomes overflowing; when Qi is in excess, Phlegm moves horizontally. Those skilled at treating Phlegm do not treat Phlegm directly but treat Fire. Those skilled at treating Fire do not treat Fire directly but treat Qi. Thus, clearing Qi is the method to resolve Phlegm. To say "treating Phlegm clears Qi," although the explanation sounds good, seems slightly contrary to the original intent of this formula.
Poem says: Qingqi Huatan Wan consists of Nanxing, Banxia, Chenpi, along with Fuling, Xingren, Zhishi, and Gualou. Ginger juice and wine are used to make pills; it clears dense phlegm unless encountering deep-cold conditions.
Huanglian (Coptis Rhizome), Huangqin (Scutellaria Root), Huangbai (Phellodendron Bark), Huangzhizi (Gardenia Fruit), Danggui (Angelica Sinensis Root, each 1 liang), Dahuang (Rhubarb Root), Longdancao (Gentian Root), Qingdai (Indigo Naturalis), Lvhui (Aloe), each 5 qian; Muxiang (Aucklandia Root) 2 qian; Shexiang (Musk) 1 qian. It treats wind-heat accumulating internally, causing frequent palpitations, muscle twitching and convulsions, throat obstruction and difficulty in swallowing, dryness and dampness imbalance in the intestines and stomach leading to mania and transgression of propriety, and eyes staring upward. This formula is indicated for these symptoms.
Liver Fire manifests as Wind; Heart Fire manifests as Heat. Heart heat causes palpitations; Liver heat causes convulsions and upward deviation of the eyes. Throat obstruction and difficulty indicate that the Lung also has Fire. Dryness and dampness imbalance in the intestines and stomach indicates that the Spleen also has Fire. Mania and transgression refer to arrogant behavior violating propriety. The Classics state: "Manic speech is a loss of Will." It also states: "The Kidney stores the Will." By this reasoning, the Kidney also has Fire. Therefore, Huanglian (Coptis Rhizome) and Zhizi (Gardenia Fruit) are used to drain Heart Fire; Huangqin (Scutellaria Root) to drain Lung Fire; Qingdai (Indigo Naturalis) and Longdancao (Gentian Root) to drain Liver Fire; Dahuang (Rhubarb Root) to drain Spleen Fire; Huangbai (Phellodendron Bark) to drain Kidney Fire. How can one element of Water overcome five elements of Fire? If we do not urgently drain the Fire, the body will nearly run out of Yin fluids. Danggui (Angelica Sinensis Root) is used to nourish the Yin of the Zang organs amidst hyperactive Fire. Muxiang (Aucklandia Root) and Shexiang (Musk) are used to harmonize the Qi of the Zang organs after harsh purgation.
Poem says: Danggui Longhui Wan originates from the five yellow herbs (Huanglian, Huangqin, Huangbai, Huangzhizi, Longdancao), plus Qingdai (Indigo Naturalis), Muxiang (Aucklandia Root), and Shexiang (Musk). Made into pills the size of mung beans with winter honey; administered carefully according to dosage, it is indeed a miraculous formula.