咳嗽属肺,风热郁于肺则生痰,故嗽有喉间作小鸡声者,先用小红丸下之。不惟下痰,
且肺与大肠相为表里,腑不实脏不能实也。大率顺气化痰清肺为主,宜清金贝母汤。
清金贝母汤
贝母 杏仁 桑皮 花粉 桔梗 枳壳 甘草 黄芩 木通 苏子 陈皮 茯苓
痰甚加胆星;食积痰去贝母,加制半夏、山楂;痰而嗽甚加山栀;喘加马兜铃或紫菀;
嗽而血加山栀、石膏;嗽而气逆,倍苏子;嗽不转加麻黄、石膏;嗽久加款冬花、马兜铃,或瓜
蒌仁、紫菀、五味、乌梅。
食枳痰须用制半夏、枳实、青皮、枳壳,嗽甚,眼白上有 肉生者,此嗽伤血分也,宜服
生地、当归入血分,槟榔下其气。
疟者有暑、有痰、有风、有湿、有食。儿病多食风痰,无汗要有汗,散风邪为主。大人兼
补,小儿不必,宜清脾退热饮。
清脾退热饮
柴胡 黄芩 枳壳 半夏 花粉 青皮 槟榔 山楂 常山 草果 茯苓 陈皮 甘草
暑加香薷,渴甚加石膏,湿加苍术。
有汗要无汗,扶正气为主。大人小儿俱带发散,用加减补中益气汤。
补中益气汤
人参 白术 黄 柴胡 归身 升麻 黄芩 陈皮 茯苓
加减法如前。
久疟一补一泻,柴胡、黄芩、枳实、半夏、槟榔、山楂、白术、茯芩、陈皮、甘草。
疟后寒热虽停,尚有余热,宜清脾退热饮去常山、草果,加地骨皮、知母,腹胀加桔梗、卜子。
疟母者,寒热时血气与邪相争,饮冷所致。结块在胁下,宜鳖甲丸、阿魏丸等。
鳖甲丸
生地 当归 川芎 红花 牡丹皮 槟榔 蓬术 香附 浓朴 鳖甲(醋炙) 穿山甲
尤妙。
阿魏丸
阿魏(沸汤泡) 雄黄(研末,各二钱半) 辰砂(研末,一钱半)
面糊丸,绿豆大。
胎疟六七发过,即宜截,久则元气虚。久疟成劳,用四兽饮、截疟饮。
四兽饮
常山(三钱) 枳壳(三钱) 槟榔(一个) 生姜(五片)
水煎,五更服。
截疟饮
全归(三钱) 川芎(三钱) 甘草(三钱) 何首乌(二两,新而大者佳)
阴阳水各一大碗,煎一碗,临日面朝东,五更温服。
咳嗽的病位归属于肺,若风热之邪郁结于肺则会产生痰液,因此咳嗽时喉咙间发出类似小鸡叫声的,应先用小红丸进行攻下治疗。这不仅能泻下痰浊,而且因为肺与大肠互为表里关系,腑气不通实,脏气也无法充实。大抵治疗以顺气、化痰、清肺为主,适宜使用清金贝母汤。
清金贝母汤
组成:贝母、杏仁、桑白皮、天花粉、桔梗、枳壳、甘草、黄芩、木通、苏子、陈皮、茯苓。
加减法:痰多者加胆南星;因食积导致痰多者去掉贝母,加入制半夏、山楂;痰多且咳嗽剧烈者加山栀;气喘者加马兜铃或紫菀;咳嗽带血者加山栀、石膏;咳嗽伴气逆者,加倍使用苏子;咳嗽不止者加麻黄、石膏;久咳不愈者加款冬花、马兜铃,或者瓜蒌仁、紫菀、五味子、乌梅。
若是食积停滞导致的痰嗽,必须使用制半夏、枳实、青皮、枳壳。若咳嗽剧烈,眼白上长出息肉(胬肉),这是咳嗽损伤了血分,适宜服用生地、当归以入血分调理,并配合槟榔以行气降逆。
疟疾的病因有暑邪、痰饮、风邪、湿邪、食积几种。小儿患病多兼夹风痰,若无汗而需要发汗,应以疏散风邪为主。成人治疗需兼顾补益,小儿则不必,适宜使用清脾退热饮。
清脾退热饮
组成:柴胡、黄芩、枳壳、半夏、天花粉、青皮、槟榔、山楂、常山、草果、茯苓、陈皮、甘草。
加减法:暑邪重者加香薷,口渴严重加石膏,湿邪重者加苍术。
若有汗而需要止汗,则以扶助正气为主。成人和儿童都带有发散性质,使用加减补中益气汤。
补中益气汤
组成:人参、白术、黄芪、柴胡、当归身、升麻、黄芩、陈皮、茯苓。
加减法同前文所述。
对于久疟,采用一补一泻的方法,药物包括柴胡、黄芩、枳实、半夏、槟榔、山楂、白术、茯苓、陈皮、甘草。
疟疾发作停止后,虽然寒热症状已停,但体内尚有余热,适宜使用清脾退热饮,去掉常山、草果,加入地骨皮、知母;若出现腹胀,加桔梗、莱菔子。
所谓“疟母”,是在寒热交替时,气血与病邪相互争斗,加之饮用冷物所致。表现为胁下结块,适宜使用鳖甲丸、阿魏丸等治疗。
鳖甲丸
组成:生地、当归、川芎、红花、牡丹皮、槟榔、莪术、香附、厚朴、鳖甲(醋炙)、穿山甲。
此方尤为奇妙。
阿魏丸
组成:阿魏(用沸水浸泡)、雄黄(研成粉末,各二钱半)、辰砂(研成粉末,一钱半)。
用面糊制成丸药,大小如绿豆。
胎疟发作六七次之后,就应当采取截断疗法,否则日久会导致元气虚弱。久疟发展成劳损,使用四兽饮、截疟饮。
四兽饮
组成:常山(三钱)、枳壳(三钱)、槟榔(一个)、生姜(五片)。
用水煎煮,在五更天服用。
截疟饮
组成:全当归(三钱)、川芎(三钱)、甘草(三钱)、何首乌(二两,以新鲜肥大者为佳)。
用阴阳水各一大碗,煎取一碗,临近日出面向东方,在五更天时温服。
Cough is located in the Lung. If wind-heat pathogens stagnate in the Lung, phlegm is generated. Therefore, if a cough presents with a chirping sound in the throat resembling that of a chick, Xiaohong Wan (Little Red Pill) should be used first to purge it. This not only purges phlegm but also addresses the fact that the Lung and Large Intestine are exterior-interiorly related; if the fu-organ (Large Intestine) is not empty, the zang-organ (Lung) cannot be full. Generally, treatment focuses on regulating qi, resolving phlegm, and clearing the Lung. Qingjin Beimu Tang (Clear Metal Fritillary Decoction) is indicated.
Qingjin Beimu Tang (Clear Metal Fritillary Decoction)
Ingredients: Fritillariae Bulbus (Beimu), Armeniacae Semen Amarum (Xingren), Mori Cortex (Sangpi), Trichosanthis Radix (Huafen), Platycodonis Radix (Jiegeng), Aurantii Fructus Immaturus (Zhike), Glycyrrhizae Radix et Rhizoma (Gancao), Scutellariae Radix (Huangqin), Akebiae Caulis (Mutong), Perillae Fructus (Suzi), Citri Reticulatae Pericarpium (Chenpi), Poria (Fuling).
Modifications: For excessive phlegm, add Arisaematis Cum Bile (Danningxing); for phlegm due to food stagnation, remove Beimu and add Pinelliae Rhizoma Preparatum (Zhibanxia) and Crataegi Fructus (Shanzha); for phlegm with severe cough, add Gardeniae Fructus (Shanzhi); for wheezing, add Aristolochiae Herba (Madouling) or Asteris Radix (Ziwan); for cough with blood, add Shanzhi and Gypsum Fibrosum (Shigao); for cough with rebellious qi, double the dosage of Suzi; for persistent cough, add Ephedrae Herba (Mahuang) and Shigao; for chronic cough, add Farflos Flos (Kuandonghua) and Madouling, or Trichosanthis Semen (Gualouren), Ziwan, Schisandrae Fructus (Wuweizi), and Mume Fructus (Wumei).
For cough-phlegm caused by food stagnation, Zhibanxia, Zhiishi, Qingpi, and Zhike must be used. If the cough is severe and pterygium (fleshy growths) appear on the sclera, this indicates damage to the blood level due to cough. It is appropriate to use Rehmanniae Radix (Shengdi) and Angelicae Sinensis Radix (Danggui) to enter the blood level, combined with Arecae Semen (Binglang) to direct qi downward.
Malaria has etiologies involving summerheat, phlegm, wind, dampness, and food stagnation. Children often suffer from wind-phlegm; if there is no sweat but sweating is required, the primary approach is to disperse wind pathogens. Adults require supplementation, whereas children do not. Qingpi Tuire Yin (Clear Spleen and Reduce Fever Drink) is indicated.
Qingpi Tuire Yin (Clear Spleen and Reduce Fever Drink)
Ingredients: Bupleuri Radix (Chaihu), Scutellariae Radix (Huangqin), Zhike, Pinelliae Rhizoma (Banxia), Huafen, Qingpi, Binglang, Shanzha, Polygalae Radix (Changshan), Tsaoko Fructus (Caoguo), Fuling, Chenpi, Gancao.
Modifications: Add Moslae Herba (Xiangru) for heavy summerheat; add Shigao for severe thirst; add Atractylodis Rhizoma (Cangzhu) for dampness.
If there is sweat but cessation of sweat is desired, the focus is on supporting healthy qi. Both adults and children require formulas with dispersing properties, such as Jiabian Buzhong Yiqi Tang (Modified Tonify the Middle and Augment the Qi Decoction).
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction)
Ingredients: Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Astragali Radix (Huangqi), Chaihu, Danggui Shen (Root body of Danggui), Cimicifugae Rhizoma (Shengma), Huangqin, Chenpi, Fuling.
Modifications are as described previously.
For chronic malaria, a method of tonifying once and purging once is used, comprising Chaihu, Huangqin, Zhiishi, Banxia, Binglang, Shanzha, Baizhu, Fuling, Chenpi, and Gancao.
After malaria subsides, although chills and fever have stopped, residual heat may remain. Qingpi Tuire Yin should be used, removing Changshan and Caoguo, and adding Daphne Cortex (Digupi) and Anemarrhenae Rhizoma (Zhimu). If abdominal distension occurs, add Jiegeng and Raphani Semen (Luobozi).
"Malaria Mother" (splenic enlargement due to chronic malaria) results from the struggle between qi-blood and pathogens during chills and fever, exacerbated by drinking cold liquids. It manifests as a mass under the hypochondrium. Biejia Wan (Softshell Turtle Pill) and Awei Wan (Asafoetida Pill) are indicated.
Biejia Wan (Softshell Turtle Pill)
Ingredients: Shengdi, Danggui, Chuanxiong Hong Hua (Carthami Flos), Moutan Cortex (Mudanpi), Binglang, Curcumae Zedoariae Rhizoma (Ezhu), Cyperi Rhizoma (Xiangfu), Magnoliae Officinalis Cortex (Houpo), Testudo Carapax et Plastrum (Biejia, vinegar-fried), Manis Squama (Chuanshanjia).
This formula is particularly effective.
Awei Wan (Asafoetida Pill)
Ingredients: Asafetida (Awei, soaked in boiling water), Realgar (Xionghuang, ground into powder, 2.5 qian each), Cinnabar (Chensha, ground into powder, 1.5 qian).
Form pills with wheat paste, size of mung beans.
For congenital malaria after six or seven attacks, immediate interception therapy is necessary, otherwise healthy qi will become deficient over time. Chronic malaria developing into consumption/labor uses Six Beasts Drink (Sishou Yin) and Malaria Interception Drink (Jiemai Yin).
Sishou Yin (Six Beasts Drink)
Ingredients: Changshan (3 qian), Zhike (3 qian), Binglang (one piece), Ginger (Shengjiang, five slices).
Decoct in water and take at wugeng (between 3 am and 5 am).
Jiemai Yin (Malaria Interception Drink)
Ingredients: Quan Danggui (Whole Danggui, 3 qian), Chuanxiong (3 qian), Gancao (3 qian), Polygoni Multiflori Radix (Heshouwu, 2 liang, fresh and large specimens are best).
Decoct one large bowl of Yin-Yang Water (mixed hot and cold water) down to one bowl. Face east towards the rising sun, and take warm at wugeng.