则咳。用紫菀百部以清热。金性刚燥。恶冷者也。遇寒则咳。用白前陈皮以治寒。且肺为娇脏。外主皮毛。
最易受邪。不行表散。则邪气流连而不解。故用荆芥以散表。肺有二窍。一在鼻。一在喉。鼻窍贵开而不
贵闭。喉窍贵闭。不贵开。今鼻窍不通。则喉窍启而为咳。故用桔梗以开鼻窍。此方温润和平。不寒不热。
肺气安宁。
千金麦门冬汤
麦冬(三钱) 桔梗(二钱) 桑皮(三钱) 半夏(二钱) 生地(三钱) 紫菀(三钱) 竹茹(三钱) 麻
黄(一钱) 五味(一钱) 生姜(三片) 甘草(一钱)
风寒客于肺中。引痰生火。故用桔梗桑皮半夏生姜。以利除痰饮。用生地紫菀竹茹麦冬五味。以清敛
火气。然陈寒不除。则痰火旋去而旋生。故以麻黄一味。搜剔陈寒。惟甘草则取调诸药而已。凡寒中包
火。火中伏寒。皆能治之。
柴胡梅连散
柴胡(三钱) 人参(三钱) 黄芩(三钱) 甘草(一钱) 黄连(一钱) 白芍(三钱) 当归(三钱)
柴胡汤。逍遥散。各半成方。而重在黄连一味。较二方尤擅清火之功。心者肝之子。黄连泻心。实则泻其子。
甘桔汤
甘草(三钱) 桔梗(三钱)
葶苈大枣泻肺汤
葶苈(炒香捣三钱) 大枣(擘破五枚)
先圣用药。泻必兼补。故无弊。即如此两方。桔梗以开达肺气。凡咽痛肺痈排脓。皆生用之。而必君以甘
草。以土生金。助其开达之势。葶苈苦寒。力能降泄肺中之气。火热壅肺。水饮冲肺。皆能随其实而泻之。
而必君以大枣。使邪去而正不伤。得此意者。可知配合之义。
保和丸
知母(三钱) 贝母(三钱) 天门冬(三钱) 款冬花(三钱) 天花粉(三钱) 薏苡仁(三钱) 五味子
(一钱) 甘草(一钱) 马兜铃(三钱) 生地黄(三钱) 紫菀(三钱) 百合(三钱) 阿胶(三钱)
当归(三钱) 紫苏(二钱) 薄荷(一钱) 百部(三钱) 饴糖(二两) 生姜(三钱)
此方药味虽多。而实以润肺清火为主。凡是虚劳咳血。皆肺中阴津不足。火热乘之使然。火壅于内。则
皮毛固闭。洒淅而恶寒。易招外感。火盛则水津凝滞。胶结为痰。而气愈不得息。痿咳所以不愈也。方用
饴胶地归百合百部甘草紫菀花粉款冬。大生津液以润肺。五味天冬知母。以清肺火。犹恐外寒闭之。
则火郁而不清。故佐以姜苏薄荷。以疏解其郁。痰饮滞之。则火阻而不降。故用贝母苡仁。以导利其滞。
郁解滞行。火清肺润。咳嗽愈而痿燥除。无论寒久变火。火郁似寒。诸症皆能治之。十药神书。载此方加
减甚详。余谓此方药味已多。如再加减。便杂而无功。对证之方甚伙。何须执此一方。苦苦加减。便欲医
尽诸病耶。为末。饴糖丸服。
泻肺丸
栝蒌霜(三钱) 贝母(三钱) 半夏(三钱) 郁金(二钱) 葶苈(三钱炒) 杏仁(三钱)
黄连(二钱) 黄芩(三钱) 大黄(钱半) 甘草(一钱)
肺部痰火血气壅滞不降。用此方解泄破下。力量最大。是从人参泻肺汤。葶苈大枣半夏泻心小结胸
等汤。割取而成。又加郁金大破血分。药虽猛峻。然果遇实证。非此不克。
消化丸
礞石(三钱 ) 明矾(二钱) 牙皂(一钱) 云苓(三钱) 陈皮(一钱) 枳壳(一钱)
枳实(一钱) 南星(一钱生) 沉香(一钱) 半夏(一钱生) 薄荷(一钱) 黄芩(二钱)
神曲(二钱) 姜汁(一钱) 饴糖(三钱)
为末。神曲姜汁为丸。卧时饴糖拌吞。仰卧则药流入肺。去痰除根。痰即水也。寒郁之。气阻之。火凝之。是
以胶粘潮溢。而不能去也。此方以燥降坠利去水为主。而用薄荷以散寒。用黄芩以清火。尤妙。明矾入
浊水而能清。牙皂入污垢而能去。二物合用。为涤除痰涎之妙品。诸药猛峻。故用饴糖以缓之。葛可久
法。服后即服太平丸以补之。可知泻实。亦宜补虚。然遇实证。慎毋畏而不用也。
太平丸
天门冬(二钱) 麦门冬(二钱) 款冬花(二钱) 知母(二钱) 杏仁(二钱) 熟地黄(三钱)
生地黄(三钱) 川黄连(一钱) 当归(三钱) 阿胶(二钱蛤粉炒) 蒲黄(二钱) 京墨(五分)
桔梗(二钱) 薄荷(一钱) 麝香(少许)
炼蜜为丸弹子大。食后。薄荷汤化下一丸。义取润肺清金。豁痰止血。诸药显而易见。惟黄连一味。是泻
心之药。心者肺之贼。泻心即是清肺。乃隔治之法。麝香一味。是透窍之药。肺者气之窍。通窍即所以安
肺。是从治法。仲景金匮。亦有上焦得通。津液得下之语。盖上焦通。则津液不凝为痰。下降而火亦随降。
葛可久制方。原未证诸仲景。而其义有可通。故引证之。第此方治肺。取滋利宣通。上焦虚枯滞涩者皆
宜。若下焦阴虚。则大不宜。盖下焦之病宜敛藏。用宣通法。又其所忌。
二陈汤
半夏(三钱) 陈皮(三钱) 茯苓(三钱) 甘草(二钱)
此方为去除痰饮之通剂。痰之本。水也。茯苓治水。以治其本。痰之动。湿也。茯苓渗湿以镇其动。其余半
夏降逆。陈皮顺气。甘草调中。皆取之以为茯苓之佐使耳。故仲景书。凡痰多者。俱加茯苓。呕者俱加半
夏。今人不穷古训。以半夏为去痰专品。不知半夏非不去痰。而辛降之气最甚。究属降气之主。故凡用
药。不可失其真面也。
紫菀散
紫菀(三钱) 人参(二钱) 知母(二钱) 贝母(二钱) 桔梗(二钱) 茯苓(三钱) 阿胶(二钱) 五
味(一钱) 甘草(一钱)
肺痿咳痰。取参草胶苑。以滋补肺阴。又用知母以清其火。五味以敛其气。桔梗贝母茯苓。以利其痰。火
气痰三者俱顺。则肺愈受其益。此较保和汤。救肺汤。又在不清不浊之间。用方者随宜择取。
礞石滚痰丸
礞石(三钱) 黄芩(三钱) 大黄(三钱) 沉香(三钱)
痰者。水之所结也。肺胃火盛。煎灼其水。则凝而为瘀。与饮同主于水。而饮则动于寒。故清而不稠。痰则
熬以火。故粘而难下。王隐君制此方。用黄芩清肺中无形之火。用大黄泻胃中实积之火。此治痰先清
火。所以治其原也。然痰本水湿所成。故佐以礞石之悍燥以除水。痰之所留。气即阻而不利。故用沉香
以速降之。二黄得礞石沉香。则能迅扫直攻老痰巢穴。浊垢之处。而不少留。此滚痰之所由名也。为末。
水丸。姜汤下。仰卧。忌饮食半日。若喉间粘壅。乃病药相拒。少顷药力到自愈。方虽猛峻。然顽痰变见诸
怪证。非此不治。
旋复代赭石汤
人参(三钱) 甘草(二钱) 半夏(三钱) 生姜(三钱) 大枣(五枚) 赭石(三钱 ) 旋复花(三钱炙)
此方治哕呃。人皆知之。而不知呃有数端。胃绝而呃不与焉。一火呃。宜用承气汤。一寒呃。宜理中汤。加
丁香柿蒂。一瘀血滞呃。宜大柴胡。加桃仁丹皮。此方乃治痰饮作呃之剂。与诸呃有异。不得见呃即用
此汤也。方取参草大枣以补中。而用生姜旋复以去痰饮。用半夏赭石以镇逆气。中气旺。则痰饮自消。
痰饮清。则气顺。气顺则呃止。治病者。贵求其本。斯方有效。不为古人所瞒。兼火者。可加麦冬枯芩。兼寒
者。可加丁香柿蒂。痰多者。加茯苓。盖既得其真面。然后可议加减。
温胆汤
半夏(三钱) 云苓(三钱) 陈皮(二钱) 甘草(钱半) 竹茹(三钱) 枳壳(钱半)
二陈汤为安胃祛痰之剂。竹茹以清膈上之火。加枳壳以利膈上之气。总求痰气顺利。而胆自宁。温之
实清之也。用治痰气呕逆为宜。
真武汤
白术(三钱) 茯苓(三钱) 白芍(三钱) 生姜(三钱) 附子(炮三钱)
水饮者。肾之所主也。肾阳化水。则水下行而不泛上。故用附子入肾补阳。以为镇管水气之主。制水者
土也。用苓术以防之。白芍苦降。从其类以泻之。生姜辛散。循其末而宣之。合之宣泻防制。水有所宰。而
自不动矣。故取此方真武水神以名汤。
苓桂术甘汤
茯苓(五钱) 桂枝(三钱) 白术(五钱) 甘草(三钱炙)
甘草白术。填中宫以塞水。茯苓以利之。桂枝以化之。水不停而饮自除。治水气陵心大效。盖桂枝补心
火。使下交于肾。茯苓利肾水。使不上陵心。其实茯苓是脾药。土能治水。则水不克火也。桂枝是肝药。化
水者肝。为肾之子。实则泻其子。而肝又主疏泄。故有化水气之功。补心火者。虚则补其母。肝为心火之
母。而桂又色赤入心也。发汗亦用桂枝。借木气之温。以散布外达也。其降冲逆。亦用桂枝者。以冲脉下
属于肝。内通于肾。桂枝温肝气以引之。化肾水以泄之。凡下焦寒水攻发。冲阳上浮者。往往佐苓夏以
收功。须知桂枝其色赤。其气温。纯得水火之气。助火化木。是其所长。如无寒水。而用之发热动血。阳盛
则毙。仲景已有明戒。不可不凛。失血之家。尤宜慎用。或曰。仲景炙甘草汤。是补血药。而亦未尝忌用桂
枝。何也。曰。此正仲景慎于用桂枝处。方义以中焦取汁。变赤为血。不得不用桂枝。助心火以化赤。然即
恐桂枝伤血。故用桂极少。而用麦冬地黄极多。以柔济刚。用桂而能制桂。仲景如此之慎。可知失血家。
不可轻用桂也。
二加龙骨汤
龙骨(三钱 ) 牡蛎(三钱 ) 白薇(三钱) 附子(钱半炮) 白芍(三钱) 甘草(一钱) 大枣(三钱)
生姜(三片)
此方乃清散上焦。温补下焦之药。方用甘枣。从中宫以运上下。姜薇清散。使上焦之火不郁。附芍龙牡
温敛。使下焦之火归根。合观其方。以温为正治。以清为反佐。真寒假热。虚阳上浮。为对证。陈修园极赞
其妙。今人不察。往往误用。惜哉。
团鱼丸
川贝母 知母 前胡 柴胡(各五钱) 团鱼(重十二两)
同煮。先取肉汁食之。次将药渣焙干为末。鱼骨煮汁。丸梧子大。麦冬汤下。团鱼乃甲虫之长。能破肝之
结。肉亦带酸。入肝养阴。合清利痰火。疏理凝滞之品。凡肝经血郁气郁。火郁痰郁。以致骨蒸咳嗽者。
此丸力能治之。盖此丸以调肝者利肺。金木交和。则血气清宁。痨瘵不作。
月华丸
天门冬(三钱) 麦门冬(三钱) 生地黄(三钱) 山药(二钱) 百部(三钱) 川贝母(三钱)
云茯苓(五钱) 白菊花(三钱) 沙参(三钱) 阿胶(三钱) 三七(二钱) 桑叶(三钱) 獭肝(一具)
獭肝随月变形。每月生一叶。正月则合为一叶。以其变化不测。而性又能杀虫。凡痨虫隐伏幻怪者。亦
以此幻怪之物治之。乃自古相传之灵药。方名月华。实以此药命名。而虫所由生。则由于瘀血所变。故
用三七以化瘀。血之所以化虫者。又由于痰热所蒸。故用余药润利。以清痰火。但取杀虫。则獭肝一味
已足。但取消瘀。则三七一味已足。而必多其品物者。攻补兼行。标本兼治。乃为全胜之师也。
生化汤
当归(三钱) 川芎(二钱) 黑姜(一钱) 桃仁(三钱) 甘草(一钱) 益母草(三钱)
血瘀能化之。则所以生之也。产后多用。
止衄散
生地(五钱) 白芍(三钱) 黄 (三钱炙) 赤苓(三钱) 当归(三钱) 阿胶(二钱)
生地凉血。当归和血。白芍降血。阿胶秉阿水潜行地中之性。能潜伏血脉。此最易见者也。妙在黄 运
气摄血。则血不外泄。赤苓渗水利气。则引血下行。但黄 一味。气虚者得之。则鼓动充满。而血得所统
矣。设气实者得之。以水济水。以涂附涂。益气横决。愈逼血妄行矣。此用方者。所以贵有加减。
生地黄散
生地(五钱) 川芎(钱半) 黄芩(三钱) 侧柏叶(三钱) 桔梗(二钱) 栀子(二钱) 蒲黄(三钱) 阿
胶(二钱) 白茅根(三钱) 丹皮(三钱) 白芍(三钱) 甘草(钱半) 童便(一杯) 莱菔汁(一杯)
此方以治肝为主。以肝主血故也。而亦兼用心肺之药者。以心主火。治火必先治心。肺主气。降气必先
清肺。为凉血止血之通剂。方义虽浅而易效。
地骨皮散
生地黄(三钱) 当归(三钱) 川芎(一钱) 白芍(三钱) 牡丹皮(三钱) 地骨皮(三钱)
柯韵伯曰。阴虚者阳凑之。故热。仲景言阴弱则发热。阳气陷入阴中。必发热。然当分三阴而治之。阳邪
陷入太阴脾部。当补中益气汤。以升举之。清阳复位。而火自熄也。若陷入少阴肾部。当六味地黄丸。以
对待之。壮水之主。而火自平也。陷入厥阴肝部。当地骨皮饮以凉补之。血有所藏。而火自安也。四物汤。
为肝家滋阴调血之剂。加地骨皮清志中之火以安肾。补其母也。加牡丹皮。清神中之火以凉心。泻其
子也。二皮凉而不润。但清肝火。不伤脾胃。与四物加知柏之苦寒者不同。故逍遥散。治肝火之郁于本
脏者也。木郁达之。顺其性也。地骨皮饮。治阳邪之陷于肝脏者也。客者除之。勿纵寇以遗患也。二者皆
肝家得力之剂。
归脾汤
(接上文)则出现咳嗽。使用紫菀、百部来清除肺热。肺在五行中属金,其性刚燥,厌恶寒冷。遇到寒气就会引发咳嗽,因此使用白前、陈皮来治疗寒邪。况且肺是娇嫩的脏器,外部主管皮毛,最容易受到外邪侵袭。如果不通过发汗等方法疏散表邪,邪气就会留恋体内无法解除,所以使用荆芥来疏散表邪。肺有两个窍道,一个在鼻,一个在喉。鼻窍贵在通畅而不贵闭塞,喉窍贵在闭合而不贵开放。现在鼻窍不通畅,喉窍就会开启从而引发咳嗽,所以使用桔梗来开通鼻窍。这个方子温润平和,不寒不热,能使肺气安宁。
千金麦门冬汤
麦冬(三钱) 桔梗(二钱) 桑白皮(三钱) 半夏(二钱) 生地黄(三钱) 紫菀(三钱) 竹茹(三钱) 麻黄(一钱) 五味子(一钱) 生姜(三片) 甘草(一钱)
风寒之邪客居于肺中,引动痰饮并化火,所以用桔梗、桑白皮、半夏、生姜来利气以消除痰饮;用地黄、紫菀、竹茹、麦冬、五味子来清泄并收敛火气。然而陈旧的寒邪若不除去,痰火就会刚刚去除又重新产生,所以只用麻黄一味药,来搜剔深层的旧寒。只有甘草是用来调和诸药的。凡是寒邪中包裹着火热,或火热中潜伏着寒邪的情况,都能治疗。
柴胡梅连散
柴胡(三钱) 人参(三钱) 黄芩(三钱) 甘草(一钱) 黄连(一钱) 白芍(三钱) 当归(三钱)
此方由小柴胡汤和逍遥散各取一半组成,但重在黄连这一味药,比这两个方子更擅长清泻火气。心是肝的子脏,黄连泻心火,这是“实则泻其子”的治疗方法。
葶苈大枣泻肺汤
葶苈子(炒香捣碎三钱) 大枣(掰开五枚)
古代圣人在用药时,泻法必定兼用补法,所以没有弊端。就像这两个方子:桔梗用来宣通肺气,凡是咽痛、肺痈排脓,都生用桔梗,并且必须以甘草为君药,因为土能生金,以此助长桔梗宣通的气势。葶苈子苦寒,力量能够降泄肺中的气机,无论是火热壅塞于肺,还是水饮冲逆于肺,都能随着其实证而泻除,并且必须以大枣为君药,使邪气去除了而正气不受伤。懂得这个道理,就可以明白药物配合的意义。
保和丸
知母(三钱) 贝母(三钱) 天门冬(三钱) 款冬花(三钱) 天花粉(三钱) 薏苡仁(三钱) 五味子(一钱) 甘草(一钱) 马兜铃(三钱) 生地黄(三钱) 紫菀(三钱) 百合(三钱) 阿胶(三钱) 当归(三钱) 紫苏(二钱) 薄荷(一钱) 百部(三钱) 饴糖(二两) 生姜(三钱)
这个方子药味虽然多,但实际上以润肺清火为主。凡是虚劳引起的咳血,都是由于肺中阴津不足,火热乘虚而入所致。火热壅塞在内,导致皮毛固闭,身体洒淅恶寒,容易招致外感。火盛则水津凝滞,胶结成为痰,导致气更加不能顺畅呼吸,这就是痿弱咳嗽久治不愈的原因。方中使用饴糖、阿胶、地黄、当归、百合、百部、甘草、紫菀、花粉、款冬花,大量生津液以滋润肺部;使用五味子、天门冬、知母,来清泄肺火。还担心外寒闭郁,导致火气郁结而不能清解,所以佐以生姜、紫苏、薄荷,来疏解其中的郁结。痰饮停滞,会导致火气受阻而不能下降,所以使用贝母、薏苡仁,来导利其中的滞涩。郁结解开,滞涩通行,火气清解,肺部滋润,咳嗽痊愈,痿弱干燥消除。无论寒邪日久变为火热,还是火热郁结看似寒象,各种症状都能治疗。《十药神书》记载了这个方子的加减方法非常详细。我认为这个方子药味已经很多了,如果再随意加减,就会杂乱而无功效。对症的方剂很多,何必执着于这一个方子,苦苦地加减,就想医治尽所有的疾病呢?将药物研成粉末,用饴糖制成丸剂服用。
泻肺丸
瓜蒌霜(三钱) 贝母(三钱) 半夏(三钱) 郁金(二钱) 葶苈子(三钱,炒) 杏仁(三钱) 黄连(二钱) 黄芩(三钱) 大黄(钱半) 甘草(一钱)
肺部痰火气血壅滞不降,使用这个方子来解泄破下,力量最大。这是从人参泻肺汤、葶苈大枣半夏泻心汤、小结胸汤等方剂中选取精华组合而成。又加入了郁金大力破除血分瘀滞。药性虽然猛烈峻急,但如果确实遇到实证,不用这个方子就不能攻克。
消化丸
礞石(三钱) 明矾(二钱) 牙皂(一钱) 茯苓(三钱) 陈皮(一钱) 枳壳(一钱) 枳实(一钱) 南星(一钱,生用) 沉香(一钱) 半夏(一钱,生用) 薄荷(一钱) 黄芩(二钱) 神曲(二钱) 姜汁(一钱) 饴糖(三钱)
研成粉末,用神曲和姜汁制作丸剂。睡前用饴糖拌服。仰卧时药液流入肺部,可以彻底去除痰根。痰就是水,被寒邪郁结,气机阻滞,火热凝结,所以变得胶粘且如潮水般溢出,难以去除。这个方子以燥湿、降气、坠痰、利水为主,同时使用薄荷来散寒,使用黄芩来清火,尤其巧妙。明矾进入浑浊的水中能使其清澈,牙皂进入污垢中能将其去除,这两味药合用,是涤除痰涎的妙品。诸药性质猛烈峻急,所以使用饴糖来缓和药性。这是葛可久的方法,服药后立即服用太平丸来补益。可知泻实的同时,也应当补虚。然而遇到实证,千万不要因为畏惧而不敢使用。
太平丸
天门冬(二钱) 麦门冬(二钱) 款冬花(二钱) 知母(二钱) 杏仁(二钱) 熟地黄(三钱) 生地黄(三钱) 川黄连(一钱) 当归(三钱) 阿胶(二钱,蛤粉炒) 蒲黄(二钱) 京墨(五分) 桔梗(二钱) 薄荷(一钱) 麝香(少许)
用炼蜜制成如弹子大小的丸剂。饭后,用薄荷汤送服一丸。其意义在于润肺清金,豁痰止血,其他药物的作用显而易见。只有黄连一味,是泻心火的药。心是肺的贼邪(此处指心火克肺金,或心为肺之子,实则泻其子之意,原文语境偏向于心火亢盛影响肺),泻心即是清肺,这是隔脏治疗的方法。麝香一味,是透达窍道的药。肺是气的窍道,通窍也就是为了安肺,这是从治法。张仲景《金匮要略》中也有“上焦得通,津液得下”的说法。大概上焦通畅,津液就不会凝结成痰,向下流动而火气也随之下降。葛可久制定这个方子,原本没有验证于张仲景的理论,但其义理是可以相通的,所以引用加以证明。只是这个方子治疗肺病,取的是滋润滑利、宣通的作用,上焦虚枯滞涩的都适宜。如果下焦阴虚,就非常不适宜了。因为下焦的疾病宜于敛藏,使用宣通法是其所忌讳的。
二陈汤
半夏(三钱) 陈皮(三钱) 茯苓(三钱) 甘草(二钱)
这个方子是去除痰饮的通治方剂。痰的根本是水,茯苓治水,以治其本。痰的变动源于湿,茯苓渗湿以镇摄其变动。其余半夏降逆气,陈皮顺气机,甘草调和中焦,都是取它们作为茯苓的佐使药。所以在张仲景的书中,凡是痰多的,都加茯苓;呕吐的,都加半夏。现在的人不探究古人的训诫,认为半夏是去痰的专用药,不知道半夏并非不去痰,而是其辛降的气机最甚,究其根本属于降气的主药。所以凡是用药,不可失去其真面目。
紫菀散
紫菀(三钱) 人参(二钱) 知母(二钱) 贝母(二钱) 桔梗(二钱) 茯苓(三钱) 阿胶(二钱) 五味子(一钱) 甘草(一钱)
肺痿咳嗽有痰,取用人参、甘草、阿胶、紫菀,来滋补肺阴。又使用知母来清泄其中的火气,五味子来收敛肺气,桔梗、贝母、茯苓来利导痰浊。火、气、痰三者都顺遂,那么肺就能受到益处。这比起保和汤、救肺汤,又在不清不浊之间,使用方剂的人可以根据情况随意选择。
礞石滚痰丸
礞石(三钱) 黄芩(三钱) 大黄(三钱) 沉香(三钱)
痰,是水气凝结而成的。肺胃火盛,煎灼水液,就会凝结成为瘀滞。痰与饮同属于水类,但饮是因为寒而动,所以清稀而不稠厚;痰是因为火熬煮,所以粘稠而难以下咽。王隐君制定这个方子,用黄芩清泄肺中无形的火气,用大黄泻除胃中实积的火气。这是治疗痰先清火,所以是治其本源。然而痰本来是由水湿形成的,所以佐以礞石的悍烈燥性来去除水湿。痰停留的地方,气机就会阻滞而不通畅,所以使用沉香来迅速降气。大黄、黄芩得到礞石和沉香的配合,就能迅猛地扫荡直攻老痰的巢穴、浊垢之处,不留丝毫余地。这就是“滚痰”名称的由来。研成粉末,用水泛丸,姜汤送服。服药后仰卧,半小时内忌饮食。如果喉间粘滞壅塞,那是病邪与药力相互抗拒,过了一会儿药力到达自然痊愈。方子虽然猛烈峻急,但对于顽痰变生的各种怪异病症,不用这个方子是不能治疗的。
旋复代赭石汤
人参(三钱) 甘草(二钱) 半夏(三钱) 生姜(三钱) 大枣(五枚) 代赭石(三钱) 旋覆花(三钱,炙)
这个方子治疗呃逆(哕呃),人们都知道,但不知道呃逆有好几种类型。如果是胃气绝导致的呃逆,不在此列。一种是火呃,适宜用承气汤;一种是寒呃,适宜用理中汤加丁香、柿蒂;一种是瘀血阻滞导致的呃逆,适宜用大柴胡汤加桃仁、丹皮。这个方子是治疗痰饮引起呃逆的剂型,与其他类型的呃逆不同,不能见到呃逆就用这个汤剂。方中取人参、甘草、大枣来补益中气,使用生姜、旋覆花来去除痰饮,使用半夏、代赭石来镇降逆气。中气旺盛,痰饮自然消除;痰饮清除,气机就顺遂;气机顺遂,呃逆就停止。治病的人,贵在探求疾病的根本,这样这个方子才有效,不被古人所欺骗。兼有火邪的,可以加麦冬、枯芩;兼有寒邪的,可以加丁香、柿蒂;痰多的,加茯苓。只有掌握了药物的真面目,然后才可以讨论加减。
温胆汤
半夏(三钱) 茯苓(三钱) 陈皮(二钱) 甘草(钱半) 竹茹(三钱) 枳壳(钱半)
二陈汤是安胃祛痰的剂型。竹茹用来清泄膈上的火气,加入枳壳来利导膈上的气机。总体追求痰气顺利,胆自然安宁。“温”的意思实际上是“清”。用它来治疗痰气引起的呕吐逆乱是很适宜的。
真武汤
白术(三钱) 茯苓(三钱) 白芍(三钱) 生姜(三钱) 附子(炮制三钱)
水饮,是由肾所主司的。肾阳蒸化水液,水液就下行而不泛滥上行。所以使用附子入肾补阳,作为镇管水气的主药。制约水气的是土,使用茯苓、白术来防止水泛。白芍苦降,顺从其水性以泻之。生姜辛散,顺着水的末梢而宣散它。结合宣散、泻下、防范、制约,水有所主宰,自然就不妄动了。所以取这个方子名为真武汤,以真武水神命名。
苓桂术甘汤
茯苓(五钱) 桂枝(三钱) 白术(五钱) 甘草(三钱,炙)
甘草、白术,填补中宫以堵塞水势;茯苓来利导它;桂枝来化气行水。水不停留,饮邪自然消除。治疗水气凌心效果显著。大概桂枝补心火,使之下交于肾;茯苓利肾水,使之不上凌心。其实茯苓是脾药,土能治水,那么水就不能克制火。桂枝是肝药,化水的是肝,肝是肾的子脏,实则泻其子,而且肝又主疏泄,所以有化水气之功。补心火,是因为虚则补其母,肝是心火之母,而且桂枝色赤入心。发汗也用桂枝,是借木气的温和,以散布向外通达。其降冲逆之气,也用桂枝,是因为冲脉下属于肝,内通于肾,桂枝温肝气以引导它,化肾水以泄除它。凡是下焦寒水攻发,冲阳上浮的情况,往往辅助茯苓、半夏来收功。必须知道桂枝色赤,气温,纯得水火之气,助火化木,是它的长处。如果没有寒水,而用它导致发热动血,阳盛就会致死,张仲景已有明确的告诫,不可不警惕。失血的患者,尤其应该慎用。有人说,张仲景的炙甘草汤是补血药,但也未曾忌讳使用桂枝,为什么呢?回答说:这正是张仲景谨慎使用桂枝的地方。方义是从中焦取水谷精微,变赤为血,不得不使用桂枝,助心火以化赤。然而即使担心桂枝伤血,所以用量极少,而大量使用麦冬、地黄,以柔济刚,用桂枝又能制约桂枝。张仲景如此谨慎,可知失血之人,不可轻易使用桂枝。
二加龙骨汤
龙骨(三钱) 牡蛎(三钱) 白薇(三钱) 附子(钱半,炮制) 白芍(三钱) 甘草(一钱) 大枣(三钱) 生姜(三片)
这个方子是清散上焦、温补下焦的药物。方中使用甘草、大枣,从中宫运化上下。生姜、白薇清散,使上焦的火气不郁结。附子、白芍、龙骨、牡蛎温敛,使下焦的火气归根。综合观察这个方子,以温补为正治,以清散为反佐。适用于真寒假热、虚阳上浮的症状。陈修园极力称赞其妙处。现在的人不加考察,往往误用,可惜啊。
团鱼丸
川贝母 知母 前胡 柴胡(各五钱) 团鱼(重十二两)
一起煮熟,先取肉汁食用。然后将药渣焙干研成粉末,用鱼骨煮汁,制成梧桐子大小的丸剂,用麦冬汤送服。团鱼是甲虫之长,能破除肝脏的结滞。其肉也带酸味,入肝养阴。配合清利痰火、疏理凝滞的药物,凡是肝经血郁、气郁、火郁、痰郁,以致引起骨蒸咳嗽的,这个丸剂都有能力治疗。大概这个丸剂通过调理肝脏来利于肺部,金木交和,血气清宁,痨瘵就不会发生。
月华丸
天门冬(三钱) 麦门冬(三钱) 生地黄(三钱) 山药(二钱) 百部(三钱) 川贝母(三钱) 云茯苓(五钱) 白菊花(三钱) 沙参(三钱) 阿胶(三钱) 三七(二钱) 桑叶(三钱) 獭肝(一具)
獭肝随月亮变化而变形,每月生长一片叶子,正月时合为一叶。因其变化莫测,且性质又能杀虫,凡是痨虫隐伏幻怪的情况,也用这种幻怪之物来治疗,这是自古相传的灵药。方名“月华”,实际上是以这种药物命名的。而虫子产生的原因,是由于瘀血变化而来,所以使用三七来化瘀。血液之所以化为虫,又是由于痰热熏蒸所致,所以使用其余药物润利,以清化痰火。如果只取杀虫,獭肝一味已足够;如果只取消瘀,三七一味已足够。但必须多用药物种类,是为了攻补兼施,标本兼治,这才是全胜的军队。
生化汤
当归(三钱) 川芎(二钱) 黑姜(一钱) 桃仁(三钱) 甘草(一钱) 益母草(三钱)
瘀血能够化解,就是所谓的“生”。产后多用此方。
止衄散
生地黄(五钱) 白芍(三钱) 黄芪(三钱,炙) 赤茯苓(三钱) 当归(三钱) 阿胶(二钱)
生地黄凉血,当归和血,白芍降血,阿胶秉承阿水潜行地下的特性,能潜伏血脉,这是最容易看到的。妙在黄芪运化气机、统摄血液,那么血就不会外泄;赤茯苓渗水利气,那么就能引血下行。但是黄芪一味药,气虚的人得到它,就能鼓动充满,血得以统摄。假设气实的人得到它,就是以水济水,以涂附涂,益气横决,反而逼迫血妄行。这就是使用方剂的人,贵在加减变化的原因。
生地黄散
生地黄(五钱) 川芎(钱半) 黄芩(三钱) 侧柏叶(三钱) 桔梗(二钱) 栀子(二钱) 蒲黄(三钱) 阿胶(二钱) 白茅根(三钱) 丹皮(三钱) 白芍(三钱) 甘草(钱半) 童便(一杯) 莱菔汁(一杯)
这个方子以治疗肝脏为主,因为肝主血。但也兼用心肺的药物,因为心主火,治火必须先治心;肺主气,降气必须先清肺。这是凉血止血的通治方剂。方义虽然浅显但疗效显著。
地骨皮散
生地黄(三钱) 当归(三钱) 川芎(一钱) 白芍(三钱) 牡丹皮(三钱) 地骨皮(三钱)
柯韵伯说:阴虚者阳气凑集,所以发热。张仲景说阴弱则发热,阳气陷入阴中,必然发热。然而应当分三阴来治疗。阳邪陷入太阴脾部,当用补中益气汤来升举它,清阳复位,火自熄灭。若陷入少阴肾部,当用六味地黄丸来对待它,壮水之主,火自平复。陷入厥阴肝部,当地骨皮饮来凉补它,血有所藏,火自安宁。四物汤,是肝家滋阴调血的剂型。加入地骨皮清志中之火以安肾,这是补其母。加入牡丹皮,清神中之火以凉心,这是泻其子。地骨皮和牡丹皮凉而不润,只清肝火,不伤脾胃,与四物汤加知母、黄柏的苦寒者不同。所以逍遥散,治疗肝火郁结在本脏的情况,木郁达之,顺其本性。地骨皮饮,治疗阳邪陷入肝脏的情况,客者除之,不要放纵寇贼留下祸患。这两者都是肝家得力的剂型。
(Continuing from the previous text) then coughing occurs. Use *Zi Wan* (Asteris Radix) and *Bai Bu* (Stemonae Radix) to clear lung heat. The Lung belongs to Metal in the Five Elements, its nature is rigid and dry, and it dislikes cold. When encountering cold, it triggers coughing; therefore, use *Bai Qian* (Cynanchi Stauntonii Rhizoma et Radix) and *Chen Pi* (Citri Reticulatae Pericarpium) to treat the cold. Moreover, the Lung is a delicate organ, externally governing the skin and hair, making it most susceptible to pathogenic factors. If the exterior pathogens are not dispersed through sweating or similar methods, the pathogens will linger and remain unresolved. Thus, *Jing Jie* (Schizonepetae Herba) is used to disperse the exterior. The Lung has two orifices: one in the nose and one in the throat. The nasal orifice should be open rather than closed, while the throat orifice should be closed rather than open. Now, because the nasal orifice is blocked, the throat orifice opens, leading to coughing. Therefore, *Jie Geng* (Platycodonis Radix) is used to open the nasal orifice. This formula is warm and moistening yet peaceful, neither cold nor hot, allowing the Lung Qi to remain tranquil.
Qianjin Maidong Decoction (Thousand-Gold Ophiopogon Decoction)
*Mai Dong* (Ophiopogonis Radix, 3 qian), *Jie Geng* (Platycodonis Radix, 2 qian), *Sang Bai Pi* (Mori Cortex, 3 qian), *Ban Xia* (Pinelliae Rhizoma Praeparatum cum Ginger et Alumine, 2 qian), *Sheng Di Huang* (Rehmanniae Radix Recens, 3 qian), *Zi Wan* (Asteris Radix, 3 qian), *Zhu Ru* (Bambusae Caulis in Taenia, 3 qian), *Ma Huang* (Ephedrae Herba, 1 qian), *Wu Wei Zi* (Schisandrae Fructus, 1 qian), *Sheng Jiang* (Zingiberis Rhizoma Recens, 3 slices), *Gan Cao* (Glycyrrhizae Radix et Rhizoma, 1 qian).
Wind-cold pathogens lodging in the Lung draw out phlegm and generate fire. Therefore, *Jie Geng*, *Sang Bai Pi*, *Ban Xia*, and *Sheng Jiang* are used to promote Qi movement and eliminate phlegm-fluids. *Sheng Di Huang*, *Zi Wan*, *Zhu Ru*, *Mai Dong*, and *Wu Wei Zi* are used to clear and astringe the fire. However, if old cold is not eliminated, phlegm-fire will reappear immediately after being cleared. Thus, only *Ma Huang* is used to search out and eliminate deep-seated old cold. Only *Gan Cao* is employed to harmonize the other herbs. This formula can treat conditions where cold envelops fire, or fire harbors cold.
Chaihu Meilian Powder (Bupleurum and Coptis Powder)
*Chai Hu* (Bupleuri Radix, 3 qian), *Ren Shen* (Ginseng Radix, 3 qian), *Huang Qin* (Scutellariae Radix, 3 qian), *Gan Cao* (Glycyrrhizae Radix et Rhizoma, 1 qian), *Huang Lian* (Coptidis Rhizoma, 1 qian), *Bai Shao* (Paeoniae Radix Alba, 3 qian), *Dang Gui* (Angelicae Sinensis Radix, 3 qian).
This formula is composed of half of Xiao Chai Hu Tang (Minor Bupleurum Decoction) and half of Xiao Yao San (Free and Easy Wanderer Powder), but emphasizes *Huang Lian*. It is more effective at clearing fire than either of those two formulas alone. The Heart is the "son" of the Liver. *Huang Lian* drains Heart Fire, which follows the principle of "draining the son when the mother is excess."
Gan-Jie Decoction (Licorice and Platycodon Decoction)
*Gan Cao* (Glycyrrhizae Radix et Rhizoma, 3 qian), *Jie Geng* (Platycodonis Radix, 3 qian).
Tingli Dazao Fei Xie Decoction (Descurainia Seed and Jujube Decoction to Drain the Lung)
*Ting Li Zi* (Descurainiae Semen seu Fructus, 3 qian, fried until fragrant and crushed), *Da Zao* (Zizyphi Fructus, 5 pieces, split open).
Ancient sages combined draining methods with tonifying methods in their prescriptions, thus avoiding adverse effects. Consider these two formulas: *Jie Geng* promotes the diffusion of Lung Qi. For sore throat and lung abscesses requiring pus drainage, raw *Jie Geng* is always used, with *Gan Cao* as the sovereign herb. Since Earth generates Metal, this aids the diffusing action of *Jie Geng*. *Ting Li Zi* is bitter and cold, with strong descending and draining power for Qi in the Lung. Whether due to fire-heat congestion or fluid-retention rushing upward, it drains according to the excess pattern. *Da Zao* is used as the sovereign herb to ensure that while pathogens are expelled, healthy Qi remains unharmed. Understanding this reveals the logic of herbal combinations.
Baohe Pill (Preserve Harmony Pill)
*Zhi Mu* (Anemarrhenae Rhizoma, 3 qian), *Bei Mu* (Fritillariae Cirrhosae Bulbus, 3 qian), *Tian Men Dong* (Asparagi Radix, 3 qian), *Kuan Dong Hua* (Farfarae Flos, 3 qian), *Tian Hua Fen* (Trichosanthis Radix, 3 qian), *Yi Yi Ren* (Coicis Semen, 3 qian), *Wu Wei Zi* (Schisandrae Fructus, 1 qian), *Gan Cao* (Glycyrrhizae Radix et Rhizoma, 1 qian), *Ma Dou Ling* (Aristolochiae Fructus, 3 qian), *Sheng Di Huang* (Rehmanniae Radix Recens, 3 qian), *Zi Wan* (Asteris Radix, 3 qian), *Bai He* (Lilii Bulbus, 3 qian), *E Jiao* (Colla Corii Asini, 3 qian), *Dang Gui* (Angelicae Sinensis Radix, 3 qian), *Zi Su* (Perillae Folium, 2 qian), *Bo He* (Menthae Haplocalycis Herba, 1 qian), *Bai Bu* (Stemonae Radix, 3 qian), *Yi Tang* (Saccharum, 2 liang), *Sheng Jiang* (Zingiberis Rhizoma Recens, 3 qian).
Although this formula contains many ingredients, its primary function is to moisten the Lung and clear fire. All cases of consumptive coughing with blood result from insufficient Yin fluids in the Lung, allowing fire-heat to invade. Fire congested internally causes the skin and hair pores to close tightly, leading to chills and aversion to cold, making external contraction easy. Excessive fire causes body fluids to stagnate and congeal into phlegm, further obstructing respiration, which explains why consumptive cough persists. The formula uses *Yi Tang*, *E Jiao*, *Di Huang*, *Dang Gui*, *Bai He*, *Bai Bu*, *Gan Cao*, *Zi Wan*, *Tian Hua Fen*, and *Kuan Dong Hua* to generate abundant fluids and moisten the Lung. *Wu Wei Zi*, *Tian Men Dong*, and *Zhi Mu* clear Lung fire. To prevent external cold from closing the pores and causing fire stagnation, *Sheng Jiang*, *Zi Su*, and *Bo He* are added to resolve stagnation. To address phlegm-fluid retention blocking fire descent, *Bei Mu* and *Yi Yi Ren* are used to guide and relieve obstruction. Once stagnation is resolved and obstruction cleared, fire is cleared and the Lung is moistened; cough ceases, and dryness/withering is removed. This treats various symptoms whether cold transforms into fire over time, or fire stagnation mimics cold. *Shi Yao Shen Shu* (Divine Book of Ten Medicines) details modifications extensively. I believe adding more modifications to this already complex formula would make it chaotic and ineffective. There are many appropriate formulas; why insist on modifying one single formula to cure all diseases? Grind into powder and form pills with *Yi Tang*.
Xie Fei Pill (Drain Lung Pill)
*Gua Lou Shuang* (Benzoic Acid extracted from Trichosanthis Fructus, 3 qian), *Bei Mu* (Fritillariae Cirrhosae Bulbus, 3 qian), *Ban Xia* (Pinelliae Rhizoma Praeparatum cum Ginger et Alumine, 3 qian), *Yu Jin* (Curcumae Longae Radix, 2 qian), *Ting Li Zi* (Descurainiae Semen seu Fructus, 3 qian, fried), *Xing Ren* (Armeniacae Semen Amarum, 3 qian), *Huang Lian* (Coptidis Rhizoma, 2 qian), *Huang Qin* (Scutellariae Radix, 3 qian), *Da Huang* (Rhei Radix et Rhizoma, 1.5 qian), *Gan Cao* (Glycyrrhizae Radix et Rhizoma, 1 qian).
For pulmonary phlegm-fire and Qi-blood stagnation failing to descend, this formula provides the strongest resolving, draining, and purgative power. It is derived from *Renshen Xiefei Tang* (Ginseng Decoction to Drain the Lung), *Tingli Dazao Banxia Xiexin Tang* (Descurainia Seed, Jujube, and Pinellia Decoction to Drain the Epigastrium), and *Xiao Jie Xiong Tang* (Minor Knotting-in-the-Chest Decoction). *Yu Jin* is added to strongly break blood stasis. Although potent and harsh, it is indispensable for true excess patterns.
Xiao Hua Pill (Digestion Pill)
*Meng Shi* (Calcareous Schist, 3 qian), *Ming Fan* (Alumen, 2 qian), *Ya Zao* (Gleditsiae Spina, 1 qian), *Fu Ling* (Poria, 3 qian), *Chen Pi* (Citri Reticulatae Pericarpium, 1 qian), *Zhi Ke* (Aurantii Fructus Immaturus, 1 qian), *Zhi Shi* (Aurantii Fructus Immaturus Fermentatus, 1 qian), *Nan Xing* (Arisaematis Cum Bile Rhizoma, 1 qian, raw), *Chen Xiang* (Aquilariae Lignum Resinatum, 1 qian), *Ban Xia* (Pinelliae Rhizoma Praeparatum cum Ginger et Alumine, 1 qian, raw), *Bo He* (Menthae Haplocalycis Herba, 1 qian), *Huang Qin* (Scutellariae Radix, 2 qian), *Shen Qu* (Massa Medicata Fermentata, 2 qian), *Jiang Zhi* (Zingiberis Rhizoma Recens Juice, 1 qian), *Yi Tang* (Saccharum, 3 qian).
Grind into powder, form pills with *Shen Qu* and *Jiang Zhi*. Swallow with *Yi Tang* before sleep. Lying supine allows the medicine to flow into the lungs, removing phlegm at the root. Phlegm is water; when constrained by cold, obstructed by Qi stagnation, and condensed by fire, it becomes sticky and overflows like tide, difficult to remove. This formula focuses on drying, descending, heavy-settling, and promoting urination to remove water. *Bo He* disperses cold, and *Huang Qin* clears fire, which is particularly ingenious. *Ming Fan* clarifies turbid water, and *Ya Zao* removes filth; together they are excellent for washing away phlegm-saliva. The other herbs are harsh, so *Yi Tang* is used to moderate them. This is Ge Kejiu's method; take *Taiping Wan* (Peaceful Pill) immediately after to tonify. Draining excess requires tonifying deficiency. However, do not fear using it in excess patterns.
Taiping Pill (Peaceful Pill)
*Tian Men Dong* (Asparagi Radix, 2 qian), *Mai Men Dong* (Ophiopogonis Radix, 2 qian), *Kuan Dong Hua* (Farfarae Flos, 2 qian), *Zhi Mu* (Anemarrhenae Rhizoma, 2 qian), *Xing Ren* (Armeniacae Semen Amarum, 2 qian), *Shu Di Huang* (Rehmanniae Radix Praeparata, 3 qian), *Sheng Di Huang* (Rehmanniae Radix Recens, 3 qian), *Chuan Huang Lian* (Coptidis Rhizoma, 1 qian), *Dang Gui* (Angelicae Sinensis Radix, 3 qian), *E Jiao* (Colla Corii Asini, 2 qian, stir-fried with clam powder), *Pu Huang* (Typhae Pollen, 2 qian), *Jing Mo* (China Ink, 0.5 fen), *Jie Geng* (Platycodonis Radix, 2 qian), *Bo He* (Menthae Haplocalycis Herba, 1 qian), *She Xiang* (Moschus, a little).
Form pills the size of bullet seeds with refined honey. Take one pill after meals, dissolved in *Bo He* decoction. The intent is to moisten the Lung, clear Metal, resolve phlegm, and stop bleeding. The functions of most herbs are obvious. *Huang Lian* drains Heart Fire. Since the Heart is the "thief" of the Lung (Fire controls Metal), draining the Heart clears the Lung; this is an indirect treatment method. *She Xiang* penetrates orifices. The Lung is the orifice of Qi; opening orifices calms the Lung; this is a supportive treatment method. Zhang Zhongjing's *Jin Gui Yao Lue* states, "When the Upper Jiao is unblocked, fluids descend." Generally, if the Upper Jiao is unblocked, fluids do not congeal into phlegm, and fire descends with them. Ge Keju formulated this without explicitly referencing Zhang Zhongjing, but the principles align, hence the citation. This formula nourishes, moistens, diffuses, and unblocks, suitable for Upper Jiao deficiency, dryness, and stagnation. It is contraindicated for Lower Jiao Yin deficiency, as Lower Jiao disorders require consolidation and storage; unblocking methods are taboo here.
Er Chen Tang (Two-Aged Decoction)
*Ban Xia* (Pinelliae Rhizoma Praeparatum cum Ginger et Alumine, 3 qian), *Chen Pi* (Citri Reticulatae Pericarpium, 3 qian), *Fu Ling* (Poria, 3 qian), *Gan Cao* (Glycyrrhizae Radix et Rhizoma, 2 qian).
This is a general formula for eliminating phlegm-fluids. The root of phlegm is water; *Fu Ling* treats water to address the root. The movement of phlegm is due to dampness; *Fu Ling* leaches dampness to stabilize movement. *Ban Xia* descends rebellious Qi, *Chen Pi* regulates Qi, and *Gan Cao* harmonizes the Middle Jiao; all serve as assistants to *Fu Ling*. In Zhang Zhongjing's texts, *Fu Ling* is added for excessive phlegm, and *Ban Xia* for vomiting. Modern practitioners mistakenly view *Ban Xia* as the exclusive herb for phlegm removal. *Ban Xia* does remove phlegm, but its pungent-descending Qi is most prominent; fundamentally, it is a Qi-descending herb. One must understand the true nature of herbs.
Zi Wan San (Aster Powder)
*Zi Wan* (Asteris Radix, 3 qian), *Ren Shen* (Ginseng Radix, 2 qian), *Zhi Mu* (Anemarrhenae Rhizoma, 2 qian), *Bei Mu* (Fritillariae Cirrhosae Bulbus, 2 qian), *Jie Geng* (Platycodonis Radix, 2 qian), *Fu Ling* (Poria, 3 qian), *E Jiao* (Colla Corii Asini, 2 qian), *Wu Wei Zi* (Schisandrae Fructus, 1 qian), *Gan Cao* (Glycyrrhizae Radix et Rhizoma, 1 qian).
For Lung萎 (withering) with cough and phlegm, *Ren Shen*, *Gan Cao*, *E Jiao*, and *Zi Wan* tonify Lung Yin. *Zhi Mu* clears fire, and *Wu Wei Zi* astrings Qi. *Jie Geng*, *Bei Mu*, and *Fu Ling* facilitate phlegm discharge. When Fire, Qi, and Phlegm are all regulated, the Lung benefits. Compared to Baohe Tang and Jiufei Tang, this formula lies between clearing and turbidity; practitioners may choose based on circumstances.
Mengshi Gun Tan Wan (Schist Rolling Phlegm Pill)
*Meng Shi* (Calcareous Schist, 3 qian), *Huang Qin* (Scutellariae Radix, 3 qian), *Da Huang* (Rhei Radix et Rhizoma, 3 qian), *Chen Xiang* (Aquilariae Lignum Resinatum, 3 qian).
Phlegm is congealed water. Excessive fire in the Lung and Stomach boils water, causing it to congeal into stasis. Like fluid-retention, it originates from water, but fluid moves with cold (clear and thin), whereas phlegm is cooked by fire (sticky and hard to expectorate). Wang Yinjun created this formula: *Huang Qin* clears无形 (formless) fire in the Lung, and *Da Huang* drains solid accumulation fire in the Stomach. Clearing fire first addresses the root of phlegm. Since phlegm forms from water-dampness, *Meng Shi*'s harsh dryness removes water. Where phlegm lodges, Qi stagnates; *Chen Xiang* rapidly descends Qi. With *Meng Shi* and *Chen Xiang*, *Da Huang* and *Huang Qin* swiftly sweep old phlegm nests and turbid filth without leaving residue. Hence the name "Rolling Phlegm." Form into water pills with powder, take with ginger decoction. Lie supine, avoid food/drink for half a day. Throat stickiness indicates disease-medicine resistance; it resolves as drug power takes effect. Though harsh, it cures strange symptoms caused by stubborn phlegm.
Xuanfu Daizhe Shi Tang (Inula and Hematite Decoction)
*Ren Shen* (Ginseng Radix, 3 qian), *Gan Cao* (Glycyrrhizae Radix et Rhizoma, 2 qian), *Ban Xia* (Pinelliae Rhizoma Praeparatum cum Ginger et Alumine, 3 qian), *Sheng Jiang* (Zingiberis Rhizoma Recens, 3 qian), *Da Zao* (Zizyphi Fructus, 5 pieces), *Dai Shi* (Haematitum, 3 qian), *Xuan Fu Hua* (Inulae Flos, 3 qian, stir-fried).
Everyone knows this treats hiccup/eructation, but hiccups have different types. Hiccups from stomach Qi exhaustion are excluded. Fire-type hiccups suit Chengqi Tang. Cold-type hiccups suit Lizhong Tang plus Dingxiang and Shidi. Blood-stasis type hiccups suit Dachaihu Tang plus Taoren and Danpi. This formula treats hiccups caused by phlegm-fluids, distinct from others. Do not use it for every hiccup. *Ren Shen*, *Gan Cao*, and *Da Zao* tonify the Middle; *Sheng Jiang* and *Xuan Fu Hua* remove phlegm-fluids; *Ban Xia* and *Dai Shi* settle rebellious Qi. Strong Middle Qi eliminates phlegm-fluids; clear phlegm-fluids allow smooth Qi; smooth Qi stops hiccups. Seek the root for efficacy. Add *Mai Dong* and *Ku Qin* for fire, *Dingxiang* and *Shidi* for cold, *Fu Ling* for excessive phlegm. Understand the true nature before modifying.
Wendan Tang (Warm Gallbladder Decoction)
*Ban Xia* (Pinelliae Rhizoma Praeparatum cum Ginger et Alumine, 3 qian), *Fu Ling* (Poria, 3 qian), *Chen Pi* (Citri Reticulatae Pericarpium, 2 qian), *Gan Cao* (Glycyrrhizae Radix et Rhizoma, 1.5 qian), *Zhu Ru* (Bambusae Caulis in Taenia, 3 qian), *Zhi Ke* (Aurantii Fructus Immaturus, 1.5 qian).
Er Chen Tang stabilizes the Stomach and removes phlegm. *Zhu Ru* clears upper diaphragm fire; *Zhi Ke* promotes upper diaphragm Qi. The goal is smooth phlegm-Qi flow, calming the Gallbladder. "Warming" here implies "clearing." Suitable for phlegm-Qi vomiting and reversal.
Zhenwu Tang (True Warrior Decoction)
*Bai Zhu* (Atractylodis Macrocephalae Rhizoma, 3 qian), *Fu Ling* (Poria, 3 qian), *Bai Shao* (Paeoniae Radix Alba, 3 qian), *Sheng Jiang* (Zingiberis Rhizoma Recens, 3 qian), *Fu Zi* (Aconiti Lateralis Radix Praeparata, 3 qian, processed).
Water-fluids are governed by the Kidney. Kidney Yang vaporizes water, allowing it to descend without flooding upward. *Fu Zi* tonifies Kidney Yang to control water. Earth controls water; *Fu Ling* and *Bai Zhu* prevent flooding. *Bai Shao* is bitter and descending, following water's nature to drain it. *Sheng Jiang* is pungent and dispersing, spreading along water's extremities. Combined with dispersing, draining, preventing, and controlling, water is mastered and still. Named after Zhenwu, the Water God.
Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction)
*Fu Ling* (Poria, 5 qian), *Gui Zhi* (Cinnamomi Ramulus, 3 qian), *Bai Zhu* (Atractylodis Macrocephalae Rhizoma, 5 qian), *Gan Cao* (Glycyrrhizae Radix et Rhizoma, 3 qian, stir-fried).
*Gan Cao* and *Bai Zhu* fill the Middle Palace to block water; *Fu Ling* drains it; *Gui Zhi* transforms it. Water does not stagnate, and fluid-resorption resolves. Highly effective for water Qi harassing the Heart. *Gui Zhi* tonifies Heart Fire, connecting downward to the Kidney; *Fu Ling* drains Kidney Water, preventing upward harassment. Actually, *Fu Ling* is a Spleen herb; Earth controls water, preventing Water from overcoming Fire. *Gui Zhi* is a Liver herb; the Liver transforms water (Liver is Kidney's son, draining the son). The Liver governs free flow, aiding water transformation. Tonifying Heart Fire (mother of Liver) also applies since *Gui Zhi* enters the Heart. Sweating also uses *Gui Zhi* to spread warmth via Wood Qi. Descending Chong Mai rebellion uses *Gui Zhi* because Chong Mai connects to Liver and Kidney; *Gui Zhi* warms Liver Qi to guide it and transforms Kidney Water to drain it. For Lower Jiao cold-water attacking Chong Yang, *Fu Ling* and *Ban Xia* are often added. *Gui Zhi* is red and warm, possessing Water-Fire Qi, assisting Fire to transform Wood. Without cold-water, using it causes fever and bleeding death; Zhang Zhongjing warned against this. Bleeding patients must use cautiously. Some ask: Zhang Zhongjing's *Zhigancao Tang* tonifies blood but uses *Gui Zhi*. Why? Because it transforms Middle Jiao essence into blood, requiring *Gui Zhi* to assist Heart Fire. Fearful of damaging blood, the dose is small, balanced by large doses of *Mai Dong* and *Di Huang* (softening hardness). Zhang Zhongjing's caution shows *Gui Zhi* is unsafe for bleeding patients.
Erjia Longgu Tang (Double-Added Dragon Bone Decoction)
*Long Gu* (Fossilia Ossis Mastodi, 3 qian), *Mu Li* (Concha Ostreae, 3 qian), *Bai Wei* (Cynanchi Atrati Radix, 3 qian), *Fu Zi* (Aconiti Lateralis Radix Praeparata, 1.5 qian, processed), *Bai Shao* (Paeoniae Radix Alba, 3 qian), *Gan Cao* (Glycyrrhizae Radix et Rhizoma, 1 qian), *Da Zao* (Zizyphi Fructus, 3 pieces), *Sheng Jiang* (Zingiberis Rhizoma Recens, 3 slices).
This formula clears/disperses the Upper Jiao and warms/tonifies the Lower Jiao. *Gan Cao* and *Da Zao* move Upper/Lower via the Middle. *Sheng Jiang* and *Bai Wei* clear/disperse, preventing Upper Jiao fire stagnation. *Fu Zi*, *Bai Shao*, *Long Gu*, and *Mu Li* warm/astringe, rooting Lower Jiao fire. Warmth is the main treatment; clearing is the counter-agent. Suitable for true cold/false heat and floating deficient Yang. Chen Xiuyuan praised it highly. Modern misuse is regrettable.
Tuan Yu Wan (Softshell Turtle Pill)
*Chuan Bei Mu* (Fritillariae Cirrhosae Bulbus), *Zhi Mu* (Anemarrhenae Rhizoma), *Qian Hu* (Peucedani Radix), *Chai Hu* (Bupleuri Radix) (each 5 qian), *Tuan Yu* (Testudinis Carapax et Plastrum / Softshell Turtle Meat, 12 liang weight).
Cook together. First consume the meat broth. Then dry and powder the dregs. Boil turtle bones for juice to form pills the size of wutong seeds. Take with *Mai Dong* decoction. Tuan Yu breaks Liver knots; its sour meat nourishes Liver Yin. Combined with phlegm-fire clearing and stagnation resolving herbs, it treats bone-steaming cough from Liver blood/Qi/fire/phlegm stagnation. By regulating the Liver to benefit the Lung, Metal and Wood harmonize, blood/Qi calm, and consumption ceases.
Yuehua Wan (Moonlight Pill)
*Tian Men Dong* (Asparagi Radix, 3 qian), *Mai Men Dong* (Ophiopogonis Radix, 3 qian), *Sheng Di Huang* (Rehmanniae Radix Recens, 3 qian), *Shan Yao* (Dioscoreae Rhizoma, 2 qian), *Bai Bu* (Stemonae Radix, 3 qian), *Chuan Bei Mu* (Fritillariae Cirrhosae Bulbus, 3 qian), *Fu Ling* (Poria, 5 qian), *Bai Ju Hua* (Chrysanthemi Flos, 3 qian), *Sha Shen* (Glehniae Radix or Adenophorae Radix, 3 qian), *E Jiao* (Colla Corii Asini, 3 qian), *San Qi* (Notoginseng Radix, 2 qian), *Sang Ye* (Mori Folium, 3 qian), *La Gan* (Leporis Hepatis, one piece).
Leporis Hepatis changes shape with the moon, growing leaves monthly. Its unpredictable nature and insect-killing property treat hidden/strange tuberculosis worms ("treating strange with strange"). The formula is named Yuehua (Moonlight) after this herb. Worms arise from blood stasis; *San Qi* resolves stasis. Blood transforming into worms is steamed by phlegm-heat; other herbs moisten/clear phlegm-fire. While *La Gan* kills worms and *San Qi* resolves stasis alone, multiple herbs are used for simultaneous attack and tonification, addressing both root and branch for complete victory.
Shenghua Tang (Generate Transformation Decoction)
*Dang Gui* (Angelicae Sinensis Radix, 3 qian), *Chuan Xiong* (Chuanxiong Rhizoma, 2 qian), *Hei Jiang* (Zingiberis Rhizoma Carbonisatum, 1 qian), *Tao Ren* (Persicae Semen, 3 qian), *Gan Cao* (Glycyrrhizae Radix et Rhizoma, 1 qian), *Yi Mu Cao* (Leonuri Herba, 3 qian).
Resolving blood stasis generates new blood. Frequently used postpartum.
Zhi Nu San (Stop Epistaxis Powder)
*Sheng Di Huang* (Rehmanniae Radix Recens, 5 qian), *Bai Shao* (Paeoniae Radix Alba, 3 qian), *Huang Qi* (Astragali Radix, 3 qian, stir-fried), *Chi Fu Ling* (Poria with Red Skin, 3 qian), *Dang Gui* (Angelicae Sinensis Radix, 3 qian), *E Jiao* (Colla Corii Asini, 2 qian).
*Sheng Di Huang* cools blood, *Dang Gui* harmonizes blood, *Bai Shao* descends blood, *E Jiao* anchors blood vessels. Ingeniously, *Huang Qi* moves Qi to control blood, preventing leakage; *Chi Fu Ling* leaches water/moves Qi, guiding blood downward. *Huang Qi* tonifies Qi in deficiency, allowing blood to be controlled. In excess Qi, it forces blood recklessly. Modification is crucial.
Sheng Di Huang San (Rehmannia Powder)
*Sheng Di Huang* (Rehmanniae Radix Recens, 5 qian), *Chuan Xiong* (Chuanxiong Rhizoma, 1.5 qian), *Huang Qin* (Scutellariae Radix, 3 qian), *Ce Bai Ye* (Biota Top Leaf, 3 qian), *Jie Geng* (Platycodonis Radix, 2 qian), *Zhi Zi* (Gardeniae Fructus, 2 qian), *Pu Huang* (Typhae Pollen, 3 qian), *E Jiao* (Colla Corii Asini, 2 qian), *Bai Mao Gen* (Imperatae Rhizoma, 3 qian), *Dan Pi* (Moutan Cortex, 3 qian), *Bai Shao* (Paeoniae Radix Alba, 3 qian), *Gan Cao* (Glycyrrhizae Radix et Rhizoma, 1.5 qian), *Tong Bian* (Child's Urine, 1 cup), *Lai Fu Zhi* (Radish Juice, 1 cup).
Primarily treats the Liver (governs blood), also Heart (fire) and Lung (Qi). Cooling blood and stopping bleeding. Simple yet effective.
Di Gu Pi San (Lycium Bark Powder)
*Sheng Di Huang* (Rehmanniae Radix Recens, 3 qian), *Dang Gui* (Angelicae Sinensis Radix, 3 qian), *Chuan Xiong* (Chuanxiong Rhizoma, 1 qian), *Bai Shao* (Paeoniae Radix Alba, 3 qian), *Mu Dan Pi* (Moutan Cortex, 3 qian), *Di Gu Pi* (Lycii Cortex, 3 qian).
Ke Yunbo stated: Yin deficiency attracts Yang, causing heat. Zhang Zhongjing said weak Yin causes fever as Yang sinks into Yin. Treat by Three Yin: Taiyin Spleen needs Buyang Heshui Tang to raise clear Yang; Shaoyin Kidney needs Liuwei Dihuang Wan to strengthen Water; Jueyin Liver needs Di Gu Pi Yin to cool/tonify, hiding blood to calm fire. Siwu Tang nourishes Liver Yin/Blood. *Di Gu Pi* clears Will-fire to calm Kidney (tonifies Mother). *Mu Dan Pi* clears Spirit-fire to cool Heart (drains Son). These barks are cooling but not moist, clearing Liver fire without harming Spleen/Stomach, unlike bitter-cold Zhimu/Huangbai. Xiaoyao San treats Liver fire stagnation in the organ itself (smooth Wood stagnation). Di Gu Pi Yin treats external Yang pathogens sinking into the Liver (expel invaders). Both are effective Liver formulas.
Guipi Tang (Restore the Spleen Decoction)