虚劳营卫不足者,脉极虚芤迟,短气里急,四肢酸疼,腹中痛,或悸或衄,或手足烦
热,咽干口燥,宜甘酸辛药调之。甘以缓急,酸以养阴,辛以养阳也。
小建中汤方
白芍(六两) 甘草 桂枝 生姜(各三两) 大枣(十二枚) 胶饴(一升) 虚甚
者加黄 (一两半)
上六味,以水七升,煮取三升,去滓,内胶饴,更上微火消解,温服一升,日三服。深
师治虚劳腹满、食少泄泻者,无胶饴,有人参二两,半夏一升。
《必效方》治虚劳失精,加龙骨、白蔹各一两。
《古今录验》治虚劳里急,小腹急痛,气引胸胁,或心痛短气,以干姜代生姜,加当归
经云∶肝生于左,肺藏于右,心位在上,肾处在下,脾居四脏之中,生育营卫,通行津
液。
食甘以缓之,故以饴糖为君,甘草为臣。桂枝辛热,散也润也。营卫不足,润而散之;芍药
酸寒,收也泄也,津液不足,收而行之,故以芍桂为佐。生姜辛热,大枣甘温,胃者卫之源
,脾者营之本,卫不足,益之必以辛,营不足,补之必以甘,甘辛相合,脾胃健而营卫通,
大建中汤方 治内虚,里结少气,手足厥冷,小腹挛急,或腹满弦急,不能食,
起即微汗阴缩,或腹中寒痛,或唇口干,精自出,或手足乍寒乍热而烦冤,酸疼不能久立,多梦
黄 当归 桂心 芍药(各二钱) 人参 甘草(各一钱) 半夏 黑附子(
每服五钱,水二盏,姜三片,枣二枚,煎一盏,去滓,食前温服。
本方加白术、苁蓉、麦冬、川芎、熟地、茯苓,名十四味建中汤,皆补益营卫之剂也。
炙甘草汤 治虚劳不足,汗出而闷,脉结悸,行动如常,不出百日,危急者十一
炙甘草(四两) 桂枝 生姜(各三两) 麦冬(去心) 麻仁(各半升) 人参 阿
胶(各二两) 大枣(三十枚) 生地黄(一斤)
上九味,以酒七升,水八升,先煮八味取三升,去滓,内胶消尽,温服一升,日三服。
朱雀汤 治劳伤心气,变生诸疾。
雄雀(一只,取肉炙) 赤小豆(一合) 人参 赤苓 紫石英 小麦 大枣肉(
各一两) 紫菀 远志 丹参(各半两) 炙甘草(二钱半)
上细锉拌匀,每服三钱,用水一盏,煎六分,去滓,食远温服。(《奇效方》)。
虚劳病中营卫之气不足的,脉象极虚、芤且迟,呼吸短促,腹部拘急疼痛,四肢酸痛,腹中疼痛,或者出现心悸或鼻出血,或者手足烦热,咽喉干燥,口舌燥渴,适宜用甘味、酸味、辛味的药物来调理。甘味药可以缓解急迫,酸味药可以滋养阴液,辛味药可以滋养阳气。
小建中汤方
白芍(六两) 甘草 桂枝 生姜(各三两) 大枣(十二枚) 饴糖(一升) 虚损严重的加黄芪(一两半)
以上六味药,用水七升,煮取三升,滤去药渣,加入饴糖,再用微火加热使其溶解,每次温服一升,每日服用三次。《深师方》治疗虚劳导致腹部胀满、饮食减少、泄泻的,不用饴糖,改用人参二两,半夏一升。
《必效方》治疗虚劳遗精的,加龙骨、白蔹各一两。
《古今录验》治疗虚劳腹部拘急,小腹急痛,气逆牵引胸胁,或者心痛、呼吸短促的,用干姜代替生姜,加当归。
经文说:肝气生于左,肺气藏于右,心位于上,肾位于下,脾居于四脏之中,化生营卫,通行津液。
吃甘味食物可以缓解急迫,所以用饴糖作为君药,甘草作为臣药。桂枝辛热,具有发散和滋润的作用。营卫不足,通过滋润和发散来调理;芍药酸寒,具有收敛和泄降的作用,津液不足,通过收敛和运行来调理,所以用芍药、桂枝作为佐药。生姜辛热,大枣甘温,胃是卫气的源头,脾是营气的根本,卫气不足,补益必须用辛味药,营气不足,补益必须用甘味药,甘味和辛味相结合,脾胃强健而营卫通畅。
大建中汤方 治疗体内虚弱,腹部结滞、气短,手脚冰凉,小腹拘挛急痛,或者腹部胀满、弦紧急痛,不能进食,起身即微微出汗、阴茎内缩,或者腹中寒痛,或者嘴唇口干,精气自出,或者手脚忽冷忽热而烦躁郁闷,酸痛不能久立,多梦。
黄芪 当归 桂心 芍药(各二钱) 人参 甘草(各一钱) 半夏 黑附子(各二钱)
每服五钱,水两盏,生姜三片,大枣二枚,煎至一盏,滤去药渣,饭前温服。
本方加白术、肉苁蓉、麦冬、川芎、熟地黄、茯苓,名为十四味建中汤,都是补益营卫的方剂。
炙甘草汤 治疗虚劳不足,出汗而胸闷,脉搏有间歇、心悸,行动如常,不出百日,病情危急的会在十一日内死亡。
炙甘草(四两) 桂枝 生姜(各三两) 麦冬(去心) 麻仁(各半升) 人参 阿胶(各二两) 大枣(三十枚) 生地黄(一斤)
以上九味药,用酒七升,水八升,先煮前八味药,取三升,滤去药渣,加入阿胶使其完全溶解,每次温服一升,每日服用三次。
朱雀汤 治疗劳损伤伤心气,变生各种疾病。
雄雀(一只,取肉烤炙) 赤小豆(一合) 人参 赤茯苓 紫石英 小麦 大枣肉(各一两) 紫菀 远志 丹参(各半两) 炙甘草(二钱半)
以上药物细切拌匀,每服三钱,用水一盏,煎至六分,滤去药渣,饭后稍久温服。(出自《奇效方》)。
In deficiency-consumption (Xu Lao) characterized by insufficiency of Ying and Wei Qi, the pulse is extremely deficient, knotted (Kou), and slow; there is shortness of breath, abdominal urgency and pain, soreness and pain in the four limbs, abdominal pain, palpitations or epistaxis, vexing heat in the hands and feet, dry throat, and dry mouth. It is appropriate to regulate with sweet, sour, and acrid medicines. Sweet medicines relieve urgency; sour medicines nourish Yin; acrid medicines nourish Yang.
Xiao Jian Zhong Tang (Minor Construct the Middle Decoction)
Bai Shao (Radix Paeoniae Alba) (6 liang) Gan Cao (Radix Glycyrrhizae) Gui Zhi (Ramulus Cinnamomi) Sheng Jiang (Rhizoma Zingiberis Recens) (each 3 liang) Da Zao (Fructus Jujubae) (12 pieces) Yi Tang (Malt Sugar) (1 sheng). For severe deficiency, add Huang Qi (Radix Astragali) (1.5 liang).
Take the above six herbs, decoct with 7 sheng of water until 3 sheng remains, remove the dregs, add Yi Tang, and gently heat over a low fire until dissolved. Take 1 sheng warm, three times daily.
*Shen Shi Fang* treats deficiency-consumption with abdominal fullness, poor appetite, and diarrhea; it omits Yi Tang and uses Ren Shen (Radix Ginseng) 2 liang and Ban Xia (Rhizoma Pinelliae) 1 sheng.
*Bi Xiao Fang* treats deficiency-consumption with seminal emission; it adds Long Gu (Os Draconis) and Bai Lian (Radix Akebiae) each 1 liang.
*Gu Jin Lu Yan* treats deficiency-consumption with abdominal urgency, acute pain in the lower abdomen, qi rushing to the chest and hypochondrium, or heart pain and shortness of breath; it replaces Sheng Jiang with Gan Jiang (Rhizoma Zingiberis Secatus) and adds Dang Gui (Radix Angelicae Sinensis).
The Classic states: The Liver generates on the left, the Lung stores on the right, the Heart is located above, the Kidney is located below, and the Spleen resides among the four zang organs, generating Ying and Wei, and circulating body fluids.
Eating sweet foods relieves urgency; therefore, Yi Tang is used as the Sovereign herb, and Gan Cao as the Minister. Gui Zhi is acrid and hot, possessing dispersing and moistening properties. For insufficiency of Ying and Wei, moistening and dispersing are applied; Shao Yao is sour and cold, possessing astringent and purging properties. For insufficiency of body fluids, astringing and promoting circulation are applied; thus, Shao Yao and Gui Zhi are used as Assistant herbs. Sheng Jiang is acrid and hot; Da Zao is sweet and warm. The Stomach is the source of Wei Qi, and the Spleen is the root of Ying Qi. For insufficiency of Wei Qi, tonification must use acrid substances; for insufficiency of Ying Qi, tonification must use sweet substances. When sweet and acrid combine, the Spleen and Stomach become robust, and Ying and Wei flow freely.
Da Jian Zhong Tang (Major Construct the Middle Decoction)
Treats internal deficiency, abdominal knotting, shortness of breath, cold extremities, cramping and acute pain in the lower abdomen, or abdominal fullness with wiry and acute tension, inability to eat, slight sweating upon rising, retraction of the penis, cold pain in the abdomen, dry lips and mouth, spontaneous seminal emission, alternating cold and heat in the hands and feet with vexation and oppression, soreness and pain preventing prolonged standing, and frequent dreaming.
Huang Qi (Radix Astragali) Dang Gui (Radix Angelicae Sinensis) Gui Xin (Cortex Cinnamomi) Shao Yao (Radix Paeoniae Alba) (each 2 qian) Ren Shen (Radix Ginseng) Gan Cao (Radix Glycyrrhizae) (each 1 qian) Ban Xia (Rhizoma Pinelliae) Hei Fu Zi (Radix Aconiti Lateralis Preparata) (each 2 qian).
Take 5 qian per dose, with 2 zhan of water, 3 slices of ginger, and 2 dates. Decoct to 1 zhan, remove dregs, and take warm before meals.
Adding Bai Zhu (Rhizoma Atractylodis Macrocephalae), Rong Rui (Cortex Cynomorii), Mai Dong (Radix Ophiopogonis), Chuan Xiong (Rhizoma Chuanxiong), Shu Di Huang (Radix Rehmanniae Preparata), and Fu Ling (Sclerotium Poriae) to this formula creates Shi Si Wei Jian Zhong Tang (Fourteen-Ingredient Major Construct the Middle Decoction), all of which are formulas for tonifying Ying and Wei.
Zhi Gan Cao Tang (Honey-Fried Licorice Decoction)
Treats deficiency-consumption insufficiency, sweating with chest stuffiness, knotted pulse with palpitations. If the patient moves normally, death will not occur within one hundred days; if critical, death occurs within eleven days.
Zhi Gan Cao (Radix Glycyrrhizae Preparata) (4 liang) Gui Zhi (Ramulus Cinnamomi) Sheng Jiang (Rhizoma Zingiberis Recens) (each 3 liang) Mai Dong (Radix Ophiopogonis) (deveined) Ma Ren (Semen Cannabis) (each 0.5 sheng) Ren Shen (Radix Ginseng) E Jiao (Colla Corii Asini) (each 2 liang) Da Zao (Fructus Jujubae) (30 pieces) Sheng Di Huang (Radix Rehmanniae) (1 jin).
Take the above nine herbs, decoct with 7 sheng of wine and 8 sheng of water. First decoct the first eight herbs until 3 sheng remains, remove dregs, add E Jiao and dissolve completely. Take 1 sheng warm, three times daily.
Zhu Que Tang (Vermilion Bird Decoction)
Treats labor injury damaging Heart Qi, leading to various diseases.
Xiong Que (Male Sparrow) (one bird, meat roasted) Chi Xiao Dou (Semen Phaseoli Angularis) (1 he) Ren Shen (Radix Ginseng) Chi Ling (Poria cum Radix Pini) Zi Shi Ying (Fluorspar) Xiao Mai (Fructus Tritici Vulgaris) Rou of Da Zao (Fructus Jujubae) (each 1 liang) Zi Wan (Herba Asteris Tatarici) Yuan Zhi (Radix Polygalae) Dan Shen (Radix Salviae Miltiorrhizae) (each 0.5 liang) Zhi Gan Cao (Radix Glycyrrhizae Preparata) (2.5 qian).
Finely chop and mix evenly. Take 3 qian per dose, with 1 zhan of water, decoct to 0.6 zhan, remove dregs, and take warm well after meals. (From *Qi Xiao Fang*).