皆属于痰热。
淋者,小便淋漓,欲去不去,不去又来,皆属于热也。解热利小便,山栀子之类,用苦甘草煎服。诸
药中皆加牛膝。
老人亦有气虚者,人参、白术中带木通、山栀。
亦有死血作淋者,以牛膝作膏。此证亦能损胃不食。
气虚、血虚、痰、风闭、实热。
吐之以提其气,气升则水自下之,盖气承载其水也。
气虚,用人参、黄 、升麻等,先服后吐。或参 药中探吐。
血虚,四物汤先服后吐,芎归汤吐亦可。痰多,二陈汤先服后吐。皆用探吐。
痰气闭塞,二陈汤加木香、香附探吐,实热利之。
一妇人脾痛,后患大小便不通;此是痰隔中焦,气滞于下焦。二陈汤加木通,初吃后,渣再煎服吐之。
戴云∶关格者,谓膈中觉有所碍,欲升不升,欲降不降,欲食不食,此为气之横格也。
必用吐,提其气之横格,不必在出痰也。
有痰,以二陈汤吐之,吐中便有降。有中气虚不运者,补气药中升降。
属热、属虚。
戴云∶小便不禁,出而不觉,赤者有热,白者为气虚也。热者,五苓散加解毒散。虚者,五苓散加四物汤。
(惊、痰、宜吐。)
戴云∶痰者,俗曰猪癫风者是也。
大率行痰为主,黄连、南星、栝蒌、半夏。
寻痰寻火分多少,治无不愈。
分痰分热∶有热者,以凉药清其心;有痰者,必用吐药,吐用东垣安神丸。
此证必用吐,吐后用平肝之药,青黛、柴胡、川芎之类。
淋证,表现为小便淋漓不尽,想排却排不出,排不出又反复欲排,其病机多归属于热邪。治疗应清热利小便,可使用山栀子等药物,用苦甘草煎煮后服用。在所有方药中均应加入牛膝。
老年人中也有因气虚导致淋证的,用人参、白术,并配伍木通、山栀。
也有因瘀血阻滞导致淋证的,使用牛膝熬制成膏剂服用。此证也会损伤胃气导致食欲不振。
采用催吐法以提举气机,气机上升则水液自然下行,因为气承载着水液。
对于气虚者,用人参、黄芪、升麻等药物,先服用后再进行催吐;或者在人参类药物中加入探吐药进行催吐。
对于血虚者,先服用四物汤,然后再催吐;芎归汤催吐也可以。痰多者,先服用二陈汤,然后再催吐。均采用探吐法。
若为痰气闭塞,用二陈汤加木香、香附进行探吐;若是实热证,则采用通利法治疗。
有一位妇人患有脾痛,随后出现大小便不通的症状;这是痰浊阻隔中焦,气机滞塞于下焦所致。用二陈汤加木通,初次服用后,将药渣再次煎煮服用并引发呕吐。
戴元礼说:关格证,是指胸膈间感觉有阻碍,想升不能升,想降不能降,想吃吃不下,这是由于气机横逆格拒所致。
若有痰,用二陈汤催吐,在吐的过程中便包含了降气的作用。若为中气虚弱不运化者,在补气药中加入升降气机的药物。
戴元礼说:小便不禁,指排尿时没有知觉而自行流出,尿色赤红的属于热证,尿色白的属于气虚证。热证,用五苓散加解毒散;虚证,用五苓散加四物汤。
辨别痰与火的多少,治疗没有不痊愈的。
The pathogenesis of epilepsy is generally attributed to phlegm-heat.
Lin syndrome (strangury) is characterized by dribbling urination, where the urge to void is present but ineffective, and the sensation recurs repeatedly. Its pathogenesis is primarily attributed to heat. The treatment principle is to clear heat and promote diuresis. Medications such as Gardeniae Fructus (Shanzhizi) may be used, decocted with Licorice Root (Gancao). Achyranthis Bidentatae Radix (Niuxi) should be added to all prescriptions.
In elderly patients, Lin syndrome may also result from Qi deficiency. In such cases, Ginseng Radix (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu) are used, combined with Akebiae Caulis (Mutong) and Gardeniae Fructus (Shanzhizi).
There are also cases of Lin syndrome caused by static blood (blood stasis), treated with a paste made from Achyranthis Bidentatae Radix (Niuxi). This condition can also damage the Stomach Qi, leading to loss of appetite.
(Etiologies of epilepsy include:) Qi deficiency, Blood deficiency, Phlegm, Wind obstruction, and Excess Heat.
Vomiting therapy is employed to raise Qi. When Qi rises, water naturally descends, as Qi carries water.
For Qi deficiency, Ginseng Radix (Renshen), Astragali Radix (Huangqi), and Cimicifugae Rhizoma (Shengma) are administered first, followed by induced vomiting. Alternatively, emetics may be added to Ginseng-based formulas to induce vomiting.
For Blood deficiency, Siwu Decoction (Four Substances Decoction) is taken first, followed by induced vomiting; Xiongui Decoction (Peony and Angelica Decoction) for inducing vomiting is also acceptable. For excessive phlegm, Erchen Decoction (Two-Cured Decoction) is taken first, followed by induced vomiting. All these methods utilize gentle induction of vomiting (Tan Tu).
If there is obstruction due to phlegm-Qi stagnation, Erchen Decoction (Two-Cured Decoction) is supplemented with Aucklandiae Radix (Muxiang) and Cyperi Rhizoma (Xiangfu) for gentle induction of vomiting. If it is an Excess Heat pattern, purgative or draining methods are used.
A female patient suffered from Spleen pain, which was subsequently followed by obstruction of both urination and defecation. This resulted from phlegm obstructing the Middle Jiao and Qi stagnating in the Lower Jiao. Erchen Decoction (Two-Cured Decoction) with Akebiae Caulis (Mutong) was prescribed. After the initial dose, the dregs were decocted again, consumed, and used to induce vomiting.
Dai Yuanli stated: Guan Ge syndrome (obstruction and reversal) refers to a sensation of obstruction in the chest and diaphragm, where rising is impeded, descending is blocked, and appetite is lost. This is caused by the horizontal obstruction of Qi.
Vomiting therapy must be employed to lift the horizontally obstructed Qi; it is not necessary to expel phlegm specifically.
If phlegm is present, Erchen Decoction (Two-Cured Decoction) is used for vomiting; within the act of vomiting lies the mechanism of descending Qi. If there is deficiency of Middle Qi failing to transform and transport, tonifying Qi herbs are combined with herbs that regulate ascending and descending Qi.
(Urinary incontinence) is attributed to Heat or Deficiency.
Dai Yuanli stated: Urinary incontinence refers to involuntary urination without sensation. Red urine indicates Heat, while pale urine indicates Qi deficiency. For Heat patterns, Wuling San (Five-Ingredient Powder with Poria) is combined with Jiedu San (Detoxification Powder). For Deficiency patterns, Wuling San (Five-Ingredient Powder with Poria) is combined with Siwu Tang (Four Substances Decoction).
(Startle, Phlegm: Vomiting is indicated.)
Dai Yuanli stated: The term "Phlegm" here colloquially refers to what is commonly called "pig epilepsy."
Treatment primarily focuses on resolving phlegm, using Coptidis Rhizoma (Huanglian), Arisaematis Rhizoma (Nanxing), Trichosanthis Fructus (Gualou), and Pinelliae Tuber (Banxia).
One must distinguish the relative amounts of phlegm and fire; treatment will invariably succeed if this distinction is made.
Differentiating Phlegm and Heat: For Heat, cooling herbs are used to clear Heart Fire. For Phlegm, emetic drugs are mandatory; Dongyuan Anshen Wan (Dongyuan's Calming Spirit Pill) may be used for vomiting.
This condition requires vomiting therapy. After vomiting, liver-calming herbs such as Indigo Naturalis (Qingdai), Bupleuri Radix (Chaihu), and Ligustici Chuanxiong Rhizoma (Chuanxiong) are administered.