干血,血瘀而干也。瘀则生热,内伤肝肺,发热咳嗽,日以益甚,不已则成劳。《金匮
》所谓经络营卫气伤,内有干血,肌肤甲错,两目黯黑者是也。
大黄 虫丸
大黄(二两五钱) 黄芩(二两) 甘草(三两) 桃仁(一升) 杏仁(一升) 虻虫(
升) 虫(半升) 蛴螬(百枚) 芍药(四两) 干地黄(十两) 干漆(一两)
上为末,蜜丸小豆大,酒服五丸,日三服。
王念西云∶虚劳发热,未有不由瘀血者,而瘀血未有不由内伤者。人之起居饮食,一有
,便能成伤。瘀积之血,牢不可拔,新生之血,不得周灌,与日俱积,其人尚有生理乎。仲
景施活人手眼,以润剂濡干血,以蠕动啖血之物行死血,死血既去,病根以铲,而后可以从
事于滋补矣。陈大夫百劳丸可与此互用。
喻嘉言曰∶此世俗所称干血劳之良治,血结在内,手足脉必相失,宜服此方。然必兼大
补剂琼玉膏之类服之。按∶相失者,不相得也。血结脉不通使然。
陈大夫百劳丸 治一切劳瘵积滞,疾不经药坏者宜服。
锦纹大黄(去皮及黑心,四钱) 乳香 没药 当归(各一钱) 人参(二钱) 桃仁
(去皮尖,另研如泥) 虻虫 水蛭(各十四枚,炒)
上为极细末,炼蜜丸桐子大,都作一服,可百丸,五更用百劳水下,取恶物为度,服白
按∶都作一服,服当作剂。剂,量也。量病之轻重而制其大小也。云取恶物为度,则非一服令尽可知。
干血,是指血液瘀滞而干枯。瘀血会产生内热,损伤肝肺,导致发热、咳嗽,且症状日益加重,若不及时治疗则会发展为劳损(虚劳)。《金匮要略》中所说的“经络营卫之气受损,体内有干血,皮肤粗糙如鳞甲交错,两眼周围颜色暗黑”指的就是这种情况。
大黄䗪虫丸
组成:大黄(二两五钱)、黄芩(二两)、甘草(三两)、桃仁(一升)、杏仁(一升)、虻虫(半升)、䗪虫(半升)、蛴螬(一百枚)、芍药(四两)、干地黄(十两)、干漆(一两)。
制法与用法:将上述药材研为细末,用蜂蜜制成如小豆大小的丸剂,每次服用五丸,以酒送服,每日三次。
王念西说:虚劳引起的发热,没有不是由瘀血导致的;而瘀血的形成,没有不是由内部损伤引起的。人的起居饮食,只要有一点失调,就能造成损伤。瘀积的血液牢固难以去除,新生成的血液无法周身灌注,随着时间推移瘀血不断积聚,这样的人还能有生机吗?张仲景施展起死回生的手段,用滋润的药物濡养干血,用具有蠕动特性的吸血昆虫类药材推动死血,死血既已去除,病根得以铲除,之后才能进行滋补治疗。陈大夫的百劳丸可以与此方配合使用。
喻嘉言说:这是世俗所称的干血劳的良好治疗方法,血液结聚在体内,手足脉象必然不相协调,适宜服用此方。然而必须同时服用大补剂的琼玉膏之类的药物。按语:所谓“相失”,是指不相协调。这是因为血结导致脉道不通的缘故。
陈大夫百劳丸 主治各种劳瘵(慢性消耗性疾病)积滞,以及疾病经过错误药物治疗后损坏的情况适宜服用。
组成:锦纹大黄(去皮及黑心,四钱)、乳香、没药、当归(各一钱)、人参(二钱)、桃仁(去皮尖,单独研成泥状)、虻虫、水蛭(各十四枚,炒制)。
制法与用法:将上述药材研为极细粉末,用炼蜜制成如梧桐子大小的丸剂,总共做成一次服用的量,大约一百丸,在五更天用百劳水送服,以排出恶浊之物为度,随后服用白粥调养。
按语:文中说“都作一服”,这里的“服”应当理解为“剂”。剂,即剂量。根据病情的轻重来制定丸剂的大小和数量。文中说“以排出恶浊之物为度”,这就说明不是一次性全部服完可知。
Dry blood refers to blood that is stagnant and dried. Stagnation generates heat, which internally damages the Liver and Lung, causing fever and coughing that worsen day by day; if untreated, it develops into consumptive disease (Xulao). This corresponds to what is stated in *Jinkui Yaolue*: "The meridians, collaterals, Ying, and Wei Qi are damaged; there is dry blood within, the skin is rough like fish scales or armor plates, and the area around both eyes is dark."
Dahuang Zhechong Wan (Cinnamon Twig and Ground Beetle Pill)
Ingredients: Dahuang (Rhei Radix et Rhizoma, 2 liang 5 qian), Huangqin (Scutellariae Radix, 2 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 3 liang), Taoren (Persicae Semen, 1 sheng), Xingren (Armeniacae Semen Amarum, 1 sheng), Mengchong (Asii Mantis Ootheca, half sheng), Zhechong (Eupolyphaga seu Steleophaga, half sheng), Qicao (Larva of Meloe, 100 pieces), Shaoyao (Paeoniae Radix Alba, 4 liang), Dihuang (Rehmanniae Radix Preparata, 10 liang), Ganqi (Lac Cinnamomi, 1 liang).
Preparation and Administration: Grind the above ingredients into fine powder, mix with honey to form pills the size of small beans. Take five pills per dose, administered with wine, three times daily.
Wang Nianxi stated: Fever arising from deficiency-consumption is invariably caused by blood stasis, and blood stasis invariably arises from internal injury. Any slight disharmony in one's daily routine or diet can cause injury. The accumulated stagnant blood is firmly fixed and difficult to dislodge; new blood cannot circulate throughout the body. As the accumulation increases day by day, how can the person retain vitality? Zhang Zhongjing employed extraordinary methods: using moistening agents to soften the dry blood, and using creeping creatures that feed on blood to move the dead blood. Once the dead blood is removed, the root of the disease is eradicated, allowing for subsequent tonification and nourishment. Chen Dafu's Bailao Wan can be used in conjunction with this formula.
Yu Jiayan stated: This is an excellent treatment for the dry-blood consumption commonly known in secular practice. When blood is knotted internally, the pulses in the hands and feet will necessarily be discordant; this formula is appropriate. However, it must be taken concurrently with a major tonic such as Qiongyu Gao (Jade Dew Paste). Note: "Discordant" means not harmonious. This is due to the obstruction of the vessels caused by blood knotting.
Chen Dafu Bailao Wan (Master Chen's Hundred Consumptions Pill)
Indications: Suitable for all types of consumptive diseases with stagnation, and for conditions deteriorated due to improper medication.
Ingredients: Jinwen Dahuang (Rhei Radix et Rhizoma, peeled and core removed, 4 qian), Ruxiang (Boswelliae Resina), Moyao (Commiphorae Resina), Danggui (Angelicae Sinensis Radix, each 1 qian), Renshen (Ginseng Radix, 2 qian), Taoren (Persicae Semen, peeled and germ removed, ground separately into a paste), Mengchong (Asii Mantis Ootheca), Shuizhi (Hirudo, each 14 pieces, stir-fried).
Preparation and Administration: Grind the above ingredients into an extremely fine powder. Mix with refined honey to form pills the size of tung tree seeds. Prepare enough for a single dose, approximately 100 pills. Administer at the fifth watch (early morning) with Bailao Water, until foul matter is expelled. Follow with white porridge.
Note: The text states "prepare as one dose"; here, "dose" should be interpreted as "quantity/formulation." Quantity refers to dosage. The size and number of pills are determined according to the severity of the illness. The phrase "until foul matter is expelled" indicates that the entire amount is not necessarily consumed in one sitting.