痰症百病多起于痰无痰则不能成病然痰之生必非无因非阳气之衰即阴气之乏也阳气既
衰而
风邪外中则痰必生矣其痰之生也或如黄块或如败絮种种之不同或咳嗽之不已或呕吐之不足而
继之膨闷治之法以二陈汤加减以治阳症之痰实有奇效然此方人多不善用之往往取败者为何亦
因
其欠补阳气之味也吾今加减其方名为加减二陈汤以此治阳症之痰无不神效汝见有火少加枯芩
一钱可也阴症之痰吐如清水或如蟹涎口必不渴或腹内作声或胸中作闷或夜重而昼轻或面红而
时白皆阴虚之痰也阴虚者非脾气之不足则肾气之匮乏也治之法健脾以化其痰补肾以归其水此
大法也更有一种下寒之甚火气无多水波泛上必须补其肾中之火以生脾土则土旺始能摄水自然
不化痰而化精又在人善于治之也肾火虚寒以致水泛者用八味丸最妙余不再定其方惟是脾肾之
虚不至命门之火太微者可兼治脾土而不必纯去补肾余定一方一剂轻二剂痰静三剂痰消乌有矣
此方之妙妙在纯去健脾而又去泻湿湿去则痰无党可聚又有白芥子消其膜膈之痰而神曲砂仁又
最是醒脾之品同群共济有不奏功如神者乎
加减二陈汤
白术(三钱) 陈皮(一钱) 甘草(一钱) 茯苓(五钱) 半夏(一钱) 人参(五分) 麦冬(三钱)
苏子(八分)水煎服
后方
白术(五钱) 山药(五钱) 芡实(五钱) 薏仁(五钱) 神曲(五分) 砂仁(二粒) 白芥子(三
钱)水煎服
痰证引发的百病大多源于痰,没有痰就不能形成疾病。然而,痰的产生必然有其原因,不是阳气衰弱就是阴气匮乏。阳气既然衰弱,风邪从外部侵袭,那么痰就一定会产生。痰的形态各异,有的像黄色的块状物,有的像破旧的棉絮,种类繁多不一;症状表现上,有的咳嗽不止,有的呕吐不尽,随后出现腹部胀满和胸闷。治疗的方法是用二陈汤进行加减化裁来治疗阳症之痰,确实有奇效。然而,许多人并不善于使用此方,往往取得不佳的效果,这也是因为该方缺少补益阳气的药物成分。我现在对方剂进行加减,命名为“加减二陈汤”,用此方治疗阳症之痰,无不神效。如果你见到患者火气稍大,可以加入一钱枯芩(黄芩的一种)。
阴症之痰,吐出的痰液像清水或者像螃蟹的涎液,口必定不渴,或者腹内有声响,或者胸中感到闷堵,或者夜间症状重而白天轻,或者面色发红但时而发白,这些都是阴虚之痰。阴虚的原因,要么是脾气不足,要么是肾气匮乏。治疗方法是健脾以化解痰湿,补肾以引导水液归元,这是根本大法。另外还有一种情况是下焦寒邪极盛,火气很少,导致水波泛滥上行,必须补益肾中的命门之火以生助脾土,只有脾土旺盛才能摄纳水液,自然痰化为精,这又在于医生善于治疗。如果是肾火虚寒导致水液泛滥,使用八味丸最为巧妙。我不再另行制定方剂,只是对于脾肾之虚不至命门之火太微弱的情况,可以兼顾治疗脾土而不必纯粹去补肾。我定下一个方子:服用一剂后病情减轻,两剂后痰静息,三剂后痰消,绝无遗留。这个方子的妙处在于纯用健脾药而又兼用泻湿药,湿气去除则痰没有同党可以聚集,又有白芥子消除膈膜之间的痰,以及神曲、砂仁是最能醒脾的药物,它们协同作用,难道不能奏效如神吗?
加减二陈汤
白术(三钱) 陈皮(一钱) 甘草(一钱) 茯苓(五钱) 半夏(一钱) 人参(五分) 麦冬(三钱) 苏子(八分),水煎服。
后方(即上述提到的健脾泻湿方)
白术(五钱) 山药(五钱) 芡实(五钱) 薏仁(五钱) 神曲(五分) 砂仁(二粒) 白芥子(三钱),水煎服。
The hundred diseases caused by Phlegm (Tan, 痰) mostly originate from Phlegm; without Phlegm, disease cannot form. However, the generation of Phlegm is never without cause; it is either due to the decline of Yang Qi (vital energy associated with warmth and activity) or the deficiency of Yin Qi (substance and fluids). Once Yang Qi declines and Wind Pathogen (external pathogenic factor) invades from outside, Phlegm will inevitably be generated. The forms of Phlegm vary: some resemble yellow clumps, others like broken cotton wadding, differing in many ways. Symptoms include incessant coughing, incomplete vomiting, followed by abdominal distension and chest oppression. The treatment method involves modifying Er Chen Tang (Two-Aged Decoction) to treat Phlegm in Yang-patterns, which indeed yields miraculous effects. However, many people do not use this formula well, often achieving poor results, precisely because it lacks ingredients that tonify Yang Qi. I have now modified this formula and named it Modified Er Chen Tang (Jia Jian Er Chen Tang); using this to treat Phlegm in Yang-patterns yields miraculous efficacy without exception. If you observe slight Fire (heat pathogen), add one qian of Ku Qin (Scutellariae Radix Praeparata with Honey, a type of Huangqin).
Phlegm in Yin-patterns presents as expectoration resembling clear water or crab saliva, with no thirst in the mouth, or sounds within the abdomen, or oppression in the chest, or symptoms worsening at night and improving during the day, or a red face that occasionally turns pale. These are all Phlegm resulting from Yin Deficiency. Yin Deficiency stems either from Spleen Qi insufficiency or Kidney Qi depletion. The treatment principle is to strengthen the Spleen to transform Phlegm and tonify the Kidney to guide Water back to its source; this is the fundamental law. Additionally, there is a condition where Cold in the Lower Jiao is severe, with little Fire, causing Water waves to surge upward. One must tonify the Fire of the Mingmen (Gate of Life) in the Kidney to generate Spleen Earth; only when Spleen Earth is robust can it control Water, naturally transforming Phlegm into Essence (Jing), which again depends on the physician's skillful treatment. For cases where Kidney Fire deficiency and Cold lead to Water flooding, Ba Wei Wan (Eight-Ingredient Pill) is most excellent. I will not prescribe another formula here, but for cases of Spleen and Kidney deficiency where Mingmen Fire is not extremely weak, one can concurrently treat Spleen Earth without purely focusing on tonifying the Kidney. I have established a prescription: after one dose, the condition lightens; after two doses, Phlegm settles; after three doses, Phlegm dissipates, leaving no residue. The brilliance of this formula lies in its pure use of Spleen-strengthening herbs combined with dampness-draining herbs; once Dampness is removed, Phlegm has no allies to gather. Furthermore, Bai Jie Zi (Sinapis Semen) eliminates Phlegm in the diaphragm, while Shen Qu (Massa Medicata Fermentata) and Sha Ren (Amomi Fructus) are the best items to awaken the Spleen. Working together, can they fail to produce miraculous results?
Modified Er Chen Tang (Jia Jian Er Chen Tang)
Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 qian), Chen Pi (Citri Reticulatae Pericarpium, 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Fu Ling (Poria, 5 qian), Ban Xia (Pinelliae Rhizoma, 1 qian), Ren Shen (Ginseng Radix, 0.5 qian), Mai Dong (Ophiopogonis Radix, 3 qian), Su Zi (Perillae Fructus, 0.8 fen), decocted in water and taken orally.
Later Formula (The aforementioned Spleen-strengthening and dampness-draining formula)
Bai Zhu (Atractylodis Macrocephalae Rhizoma, 5 qian), Shan Yao (Dioscoreae Rhizoma, 5 qian), Qian Shi (Euryales Semen, 5 qian), Yi Yi Ren (Coicis Semen, 5 qian), Shen Qu (Massa Medicata Fermentata, 0.5 fen), Sha Ren (Amomi Fructus, 2 grains), Bai Jie Zi (Sinapis Semen, 3 qian), decocted in water and taken orally.