治热伤元气,倦怠,口干出汗。
人参(五钱) 麦冬(三钱) 五味子(三钱) 水二钟,煎八分,随时服。
生脉(散)麦味与人参,保肺清心治暑淫。(李东垣曰∶“夏月火旺克金,当以保肺为主。
清
以之治暑病,误甚。观方下治证,并无一字治暑邪者。近人不论何病,每用此方收住邪气,
杀人无算。”)气少汗多兼口渴,病危脉绝急煎斟。(汪 庵《医方集解》曰∶“人有将死脉
绝者,服此能复生之,其功甚大。”柯韵伯曰∶“仲景治伤寒,有通脉、复脉二法∶少阴病里
寒外热,下利清谷,脉微欲绝者,制通脉四逆汤,温补以扶阳;厥阴病外寒内热,心动悸
结代者,制复脉汤,凉补以滋阴。同是伤寒,同是脉病,而寒热异治者,一挽坎阳之外亡
一清相火之内炽也。生脉散本复脉立法,外无寒,故不用姜、桂之辛散;热伤无形之气,
伤有形之血,故不用地黄、阿胶、麻仁、大枣,且不令其泥膈而滞脉道也;心主脉而苦缓
急食酸以收之,故去甘草而加五味矣。脉资始于肾,资生于胃,而会于肺,仲景二方重任
草者,全赖中焦谷气以通之复之,非有待于生也。此欲得下焦天癸之元气以生之,故不借
草之缓,必取资于五味之酸矣。”王晋三《古方选注》曰∶“凡曰‘散’者,留药于胃,徐行
其性也。脉者,主于心而发源于肺。然脉中之气所赖以生者,尤必资借于肾阴。故以麦冬清
肺经治节之司,五味收先天癸水之源,人参引领麦冬、五味都气于三焦,归于肺而朝百
治疗热邪损伤元气,出现倦怠、口干、出汗的症状。
人参(五钱) 麦冬(三钱) 五味子(三钱) 用水两碗,煎至八分满,随时服用。
生脉散由麦冬、五味子和人参组成,能保养肺脏、清心安神,用于治疗暑热之邪。(李东垣说:“夏季火气旺盛克制肺金,应当以保养肺脏为主。用此方治疗暑病是错误的。看方剂下方的主治证候,没有一字提到治疗暑邪的。近代人不论什么疾病,经常使用此方来收敛滞留邪气,导致无数人死亡。”)气短、汗多兼有口渴,病情危重、脉搏微弱欲绝时急需煎服。(汪昂《医方集解》说:“有人濒临死亡、脉搏断绝时,服用此方能使其复活,功效很大。”柯韵伯说:“张仲景治疗伤寒,有两种方法:通脉法和复脉法。少阴病里寒外热,下利清谷,脉搏微弱欲绝的,制定通脉四逆汤,通过温补来扶助阳气;厥阴病外寒内热,心动悸且脉搏结代的,制定复脉汤,通过凉补来滋养阴血。同样是伤寒,同样是脉象病变,但寒热治法不同,是因为一个是为了挽回坎阳的外亡,一个是清除相火的内炽。生脉散本于复脉汤的立法原则,因为外部没有寒邪,所以不用生姜、桂枝的辛散;热邪损伤无形之气,也损伤有形之血,所以不用地黄、阿胶、麻仁、大枣,以免它们滋腻碍胃而阻滞脉道;心主血脉而苦缓,急食酸味以收敛它,所以去掉甘草而加入五味子。脉气起源于肾,滋生源于胃,而汇聚于肺,张仲景的两个方剂重用甘草,是全靠中焦的水谷之气来通达和恢复脉气,并非依赖‘生’的作用。此方想要获取下焦天癸的元气来生养脉气,所以不借助甘草的缓和,必须取用五味子的酸味。”王晋三《古方选注》说:“凡是称为‘散’的,是让药物留在胃中,缓慢发挥其药性。脉由心主宰并发源于肺。然而脉中的气所赖以生成的,尤其必须借助于肾阴。所以用麦冬清肃肺经治理节制的职能,五味子收敛先天癸水的源头,人参引领麦冬、五味子将气输送到三焦,归于肺而朝会百脉……”
Indicated for heat damaging the primordial Qi, presenting with fatigue, dry mouth, and sweating.
Ren Shen (5 qian) Mai Dong (3 qian) Wu Wei Zi (3 qian). Decoct in two zhong of water until reduced to eight fen, take at any time.
Sheng Mai San consists of Mai Dong, Wu Wei Zi, and Ren Shen; it nourishes the Lung, clears the Heart, and treats pathogenic influence of Summerheat. (Li Dongyuan stated: "In summer, Fire is prosperous and overacts on Metal [Lung]; one should prioritize protecting the Lung. Using this formula to treat Summerheat diseases is a grave error. Observing the indications listed under the formula, there is not a single word addressing Summerheat pathogens. Modern practitioners use this formula indiscriminately for various diseases to trap pathogens, resulting in countless deaths.") It is indicated for shortness of breath, profuse sweating, and thirst; when the condition is critical and the pulse is faint or imperceptible, decoct and administer urgently. (Wang Ang in *Yi Fang Ji Jie* stated: "When a person is near death with an absent pulse, taking this can restore life; its efficacy is significant." Ke Yunbo stated: "Zhang Zhongjing treated Cold Damage with two methods: Tong Mai [Unblocking the Pulse] and Fu Mai [Restoring the Pulse]. In Shaoyin disease with interior cold and exterior heat, diarrhea with undigested food, and a faint pulse nearly absent, he formulated Tong Mai Si Ni Tang to warm and tonify to support Yang; in Jueyin disease with exterior cold and interior heat, palpitations with knotted or intermittent pulses, he formulated Fu Mai Tang to cool and tonify to nourish Yin. Both are Cold Damage, both involve pulse pathology, yet the treatments differ by cold and heat because one rescues the external loss of Kan Yang, while the other clears the internal blazing of Ministerial Fire. Sheng Mai San is based on the legislation of Fu Mai Tang. Since there is no exterior cold, Ginger and Cinnamon Twig are not used for their acrid dispersal; since Heat damages formless Qi and also harms formed Blood, Rehmannia Root, Donkey-hide Gelatin, Hemp Seed, and Jujube Fruit are not used, lest they be cloying and obstruct the pulse channels; the Heart governs the vessels and dislikes laxity, so sour foods are taken urgently to astringe it; thus, Licorice Root is removed and Schisandra Berry is added. The pulse originates from the Kidney, is generated by the Stomach, and converges in the Lung. Zhang Zhongjing's two formulas heavily rely on Licorice Root, depending entirely on Middle Jiao Grain Qi to unblock and restore, not relying on 'generation'. This formula seeks to obtain the Yuan Qi of Tian Gui from the Lower Jiao to generate it, thus not borrowing the moderating nature of Licorice Root, but necessarily utilizing the sourness of Schisandra Berry." Wang Jin San in *Gu Fang Xuan Zhu* stated: "Any formula named 'San' [Powder/Scatter] retains medicine in the Stomach to slowly exert its properties. The pulse is governed by the Heart and originates from the Lung. However, the Qi within the pulse relies even more on borrowing from Kidney Yin. Thus, Ophiopogon Tuber is used to clear the Lung Meridian's governance function, Schisandra Berry gathers the source of congenital Tian Gui Water, and Ginseng leads Ophiopogon Tuber and Schisandra Berry to transport Qi through the Triple Burner, returning to the Lung to converge with all vessels...")