经曰∶肝之积,名曰肥气。在左胁下,如复杯,有头足,久不愈。令人发咳、 疟,连
已。咳,肺病也。积气上攻至肺则咳,侮所不胜也。 疟,三日疟也,肝所生病为往来寒热
,连岁不已者,积不去则疟亦不已也。
温白丸(《局方》) 通治五积及十种水气、八种痞气、五种淋疾、九种心痛、七
十二种风、三十六种遁尸疰忤、癫痫、翻胃噎塞、胀满不通。
紫菀(去苗) 菖蒲(九节者,去毛) 吴茱萸(汤洗七次,焙干) 柴胡 浓朴(姜制,各
一两) 桔
梗(去芦) 茯苓(去皮) 皂荚(去皮子弦,炙) 桂枝 干姜(炒) 黄连 川椒(去目及闭口
者,微炒出汗) 巴豆(去皮膜油) 人参(各半两) 川乌(炮去皮脐,八钱)
为细末,入巴豆研匀,蜜丸桐子大,每服三丸,渐加至五丸、七丸,生姜汤送下,临卧
服。有孕忌服。易老云∶本方治肥气,加柴胡、川芎。
鳖甲丸 治肥气体瘦,饮食少思。
鳖甲(一枚重四两者,洗净,以醋和黄泥固济背上可浓三分令干) 京三棱(炮,制) 枳
壳(麸
炒黄,各三两) 川大黄(锉,炒,二两) 木香(忌火) 桃仁(去皮尖双仁,用麸炒微黄,细
研如膏,一两半)
上除鳖甲外,俱捣为细末,后泥一风炉子,上开口,可安鳖甲,取前药末,并桃仁膏,
内鳖
甲中,有好米醋二升,时时旋取入鳖甲内,慢火熬令稠,取出药,却将鳖甲去泥净,焙干,
捣为细末,与前药同和捣为丸,梧子大,每服二十丸,温酒送下,空心临卧各一服。
《黄帝内经》记载:肝脏的积块,称为“肥气”。它位于左侧胁下,形状像倒扣的杯子,有头有足,若久治不愈,会导致患者出现咳嗽、疟疾,且症状连绵不断。咳嗽属于肺部的病变。积聚之气向上攻冲至肺部就会引发咳嗽,这是肝木反侮肺金(即“侮所不胜”)的表现。这里的疟疾指的是三日疟,是肝脏所引发的疾病,表现为寒热往来;如果连年不愈,是因为体内的积块未除,那么疟疾也就无法痊愈。
温白丸(出自《太平惠民和剂局方》):通用治疗五种积证以及十种水气病、八种痞气病、五种淋证、九种心痛、七十二种风邪病、三十六种遁尸注忤病、癫痫、翻胃噎塞、胀满不通等症。
配方组成:紫菀(去除苗茎)、石菖蒲(选取九节者,去除毛须)、吴茱萸(用汤水洗七次,焙干)、柴胡、厚朴(姜汁制,各一两)、桔梗(去除芦头)、茯苓(去皮)、皂荚(去除皮及子弦,炙烤)、桂枝、干姜(炒制)、黄连、川椒(去除目及闭口者,微炒至出汗)、巴豆(去皮膜及油)、人参(以上药材各半两)、川乌(炮制后去皮脐,八钱)。
制作与服用方法:将上述药材研成细末,加入巴豆研磨均匀,用蜂蜜制成如梧桐子大小的丸药。每次服用三丸,逐渐增加至五丸、七丸,用生姜汤送服,临睡前服用。孕妇忌服。易老(指张元素)说:本方用于治疗肥气时,需加用柴胡、川芎。
配方组成:鳖甲(一枚重四两者,洗净,用醋和黄泥封固背部,厚度约三分,待其干燥)、京三棱(炮制,修治)、枳壳(麸皮炒至微黄,各三两)、川大黄(锉碎,炒制,二两)、木香(忌用火烤)、桃仁(去皮尖及双仁者,用麸皮炒至微黄,细研成膏状,一两半)。
制作与服用方法:除鳖甲外,其余药材均捣为细末。随后取一个泥制的风炉,上方开口,可安放鳖甲。将前面的药末和桃仁膏放入鳖甲内,加入好米醋二升,不时地旋转向鳖甲内添加醋液,用慢火熬煮至稠厚。取出药物,再将鳖甲去掉泥土清理干净,焙干,捣为细末,与前药混合捣匀制成丸药,大小如梧桐子。每次服用二十丸,用温酒送服,空腹及临睡前各服一次。
The *Classic of Internal Medicine* states: The accumulation in the Liver is named "Feiqi" (Fatty Qi). It is located under the left hypochondrium, resembling an inverted cup, with a head and feet. If not cured for a long time, it causes coughing and malaria, which persist continuously. Coughing is a disease of the Lung. When the accumulated Qi attacks upward to the Lung, it induces coughing; this is due to the Liver insulting its invincible counterpart (Metal/Lung), known as "insulting the invincible." The malaria referred to here is the tertian malaria (malaria occurring every third day), a disease generated by the Liver, characterized by alternating chills and fever. If it persists for years without ceasing, it is because the accumulation remains; thus, the malaria will not cease either.
Wenbai Wan (Warm White Pill) (from *Tai Ping Hui Min He Ji Ju Fang*): Universally treats five types of accumulations, ten kinds of water qi disorders, eight types of pi qi (glomus) disorders, five kinds of lin diseases (dysuria), nine types of heart pain, seventy-two types of wind diseases, thirty-six types of dun shi zhu wu (hidden corpse and infectious diseases), epilepsy, fan wei ye sai (regurgitation and dysphagia), and distension with obstruction.
Ingredients: Ziwan (Asteris Radix, remove seedlings), Changpu (Acori Tatarinowii Rhizoma, select those with nine nodes, remove hairs), Wuzhuyu (Evodiae Fructus, wash seven times with decoction, dry by baking), Chaihu (Bupleuri Radix), Houpo (Magnoliae Officinalis Cortex, processed with ginger juice, each 1 liang), Jiegeng (Platycodonis Radix, remove rhizome), Fuling (Poria, remove skin), Zaojiao (Gleditsiae Fructus, remove skin and woody strands, stir-bake), Guizhi (Cinnamomi Ramulus), Ganjiang (Zingiberis Rhizoma, stir-fry), Huanglian (Coptidis Rhizoma), Chuanjiao (Sichuan Pepper, remove eyes and closed-mouth ones, lightly stir-fry until sweat appears), Badou (Crotonis Fructus, remove skin, membrane, and oil), Renshen (Ginseng Radix et Rhizoma, each half liang), Chuanwu (Aconiti Radix, processed, remove skin and navel, 8 qian).
Preparation and Administration: Grind into fine powder, mix evenly with Badou, form pills the size of tung tree seeds. Take 3 pills per dose, gradually increasing to 5 or 7 pills, taken down with ginger soup before bedtime. Contraindicated for pregnant women. Yi Lao (Zhang Yuansu) stated: This formula treats Feiqi when modified with added Chaihu and Chuanxiong.
Biejia Wan (Turtle Shell Pill): Treats Feiqi accompanied by emaciation, poor appetite, and lack of desire for food.
Ingredients: Biejia (One piece weighing 4 liang, cleaned, sealed on the back with vinegar and yellow mud to a thickness of 3 fen, dried), Sanleng (Sparganii Rhizoma, processed, prepared), Zhike (Aurantii Fructus, bran-stir-fried until yellow, each 3 liang), Dahuang (Rhei Radix et Rhizoma, cut into small pieces, stir-fried, 2 liang), Muxiang (Aucklandiae Radix, avoid fire), Taoren (Persicae Semen, remove skin, tips, and twin kernels, bran-stir-fried until slightly yellow, ground finely into paste, 1.5 liang).
Preparation and Administration: Except for Biejia, all other ingredients are crushed into fine powder. Then, prepare a clay stove with an opening on top to hold the Biejia. Place the aforementioned powders and peach kernel paste inside the Biejia. Add 2 sheng of good rice vinegar, replenishing the vinegar occasionally. Simmer over low heat until thick. Remove the medicine, clean the Biejia thoroughly to remove the mud, bake dry, grind into fine powder, and mix with the previous powder. Form pills the size of walnut seeds. Take 20 pills per dose, administered with warm wine, once on an empty stomach and once before bedtime.