医学衷中参西录:治消渴方

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第二十章.治消渴方

Chapter 20. Herbs for extreme thirsty

 

1.玉液汤

1. Yuye Tang (Yu here means jade in Chinese; Ye means liquid)

 治消渴。消渴,即西医所谓糖尿病,忌食甜物。

This formula is used to treat Xiaoke condition. The patient feels very thirsty. Such condition can be seen in Diabetes as diagnosed in the western medicine (Comment from the translator: the Xiaoke condition can be seen in many other diseases, not only in the type I diabetes). The patient should not eat sweet food.


山药(一两) 生黄芪(五钱) 知母(六钱) 鸡内金(二钱,捣细) 葛根(钱半) 五味子(三钱)天花粉(三钱)
Shanyao 30 gram, Huangqi 15 gram, Zhimu 18 gram, Jineijin 6 gram (grind), Gegen 4.5 gram, Wuweizi 9 gram, and Tianhuafen 9 gram.

消渴之证,多由于元气不升,此方乃升元气以止渴者也。方中以黄芪为主,得葛根能升元气。而又佐以山药知母、花粉以大滋真阴。使之阳升而阴应,自有云行雨施之妙也。用鸡内金者,因此证尿中皆含有糖质,用之以助脾胃强健,化饮食中糖质,为津液也。用五味者,取其酸收之性,大能封固肾关,不使水饮急于下趋也。
The thirsty condition is usually due to Yuan Qi not rising. This formula works to raise the Yuan Qi so to solve the thirsty. The herb Huangqi is the main ingredient in the formula. The herb Gegen helps the Huangqi to raise the Yuan Qi. The Shanyao, Zhimu and Tianhuafen work to nourish Yin. When the Yang Qi rises, the Yin will follow to develop the rain. The Jineijin works to help the Spleen-Stomach, to digest the sugar in the food, transform the sugar into liquid, so to reduce the leak of sugar into the urine. The herb Wuweizi is sour-restraining in herbal property, can fix and hold the kidney, to prevent the hurry flow of urine.

方书消证,分上消、中消、下消。谓上消口干舌燥,饮水不能解渴,系心移热于肺,或肺金本体自热不能生水,当用人参白虎汤;中消多食犹饥,系脾胃蕴有实热,当用调胃承气汤下之;下消谓饮一斗溲亦一斗,系相火虚衰,肾关不固,宜用八味肾气丸。
In medical books, the Xiao condition is separated into three group: the Upper Xiao, the Middle Xiao and the Lower Xiao condition. In the Upper Xiao condition, the person feels dry mouth and very thirsty. Drinking does not solve the thirsty at all. This is a condition due to the Heart Fire moves to the Lung, or to the self-Hot of the Lung, so that it cannot produce water for its self. In this condition, herbal formula of Baihu Jia Renshen Tang is needed. For Middle Xiao condition, the person feels very hungry and eats lots. It is due to the sthenic Fire in the Spleen-Stomach. The herbal formula of Tiaowei Chenqi Tang should be used. For Lower Xiao condition, the person drinks one cup of water, and he will pass one cup of water in urine. It is due to weakness in the Xiang Fire, so the Kidney loses its switch function. In this condition, the herbal formula needed is Bawei Shenqi Wan.

白虎加人参汤,乃《伤寒论》治外感之热,传入阳明胃腑,以致作渴之方。方书谓上消者宜用之,此借用也。愚曾试验多次,然必胃腑兼有实热者,用之方的。中消用调胃承气汤,此须细为斟酌,若其右部之脉滑而且实,用之犹可,若其人饮食甚勤,一时不食,即心中怔忡,且脉象微弱者,系胸中大气下陷,中气亦随之下陷,宜用升补气分之药,而佐以收涩之品与健补脾胃之品,拙拟升陷汤后有治验之案可参观。若误用承气下之,则危不旋踵。至下消用八味肾气丸,其方《金匮》治男子消渴,饮一斗溲亦一斗。而愚尝试验其方,不惟治男子甚效,即治女子亦甚效。曾治一室女得此证,用八味丸变作汤剂,按后世法,地黄用熟地、桂用肉桂,丸中用几两者改用几钱,惟茯苓泽泻各用一钱,两剂而愈。后又治一少妇得此证,投以原方不效,改遵古法,地黄用干地黄(即今生地),桂用桂枝,分量一如前方,四剂而愈。此中有宜古宜今之不同者,因其证之凉热,与其资禀之虚实不同耳。
The herbal formula of Baihu Jia Renshen Tang, is the one used in the book
Shan Han Lunto treat the condition, in which the common cold penetrates deep into the Yangming Stomach area to cause very thirsty. In the medical books, it is said that this formula is used for the Upper Xiao condition. Here is to expand its use. I have tried several times, it works, but the person must have sthenic Fire in the Stomach meridian portion of the body. For Middle Xiao condition, use the Taowei Chenqi Tang. However, the pulse of the patient needs to be checked carefully. If the pulse on the right side is slippery and sthenic, it can be used. If the person eats very frequent. He may feel palpitation and the pulse is very weak, the movement he does not eat, it suggesting that his condition is the Big Qi sink condition. In this case, Qi-nourishing and Qi-raising herbs should be used, together with herbs to nourish the Spleen and Stomach. There are success case reports after the chapter of my Shenxian Tang, which can be a reference. If the Chenqi Tang is used, the dangerous thing could happen right away. For the Lower Xiao condition, use Bawei Shenqi Wan.  In the bookJin Kui, it is used for a condition in man, in which the person drinks one liter and he will pass urine one liter. I have tried this formula too and found that it also works for woman. I have treated a girl with this Lower Xiao condition. I changed the original pill form into the soup form and followed the later way of the preparation of the formula; the herb Dihuang used was Shoudi; and the herb Gui is the Rougui. The original weight “Liang” was changed to the “Qian”, with the amount of herb Fuling and Zexie were kept at 9 gram. After two doses, the condition was completely cured. Later I also treated a young lady with the same condition. The modified formula did not work. So, I followed the original formula, the herb Dihuang used was Shengdi, and the herb Gui was the Guizhi (not the Rougui), and remained the same amount as it was asked. Four doses solved the problem. The difference between the success with different way of formula preparation is due to the body condition, which is Hot or Cold and to the body condition, which is sthenic or asthenic.

消渴证,若其肺体有热,当治以清热润肺之品。若因心火热而铄肺者,更当用清心之药。若肺体非热,因腹中气化不升,轻气即不能上达于肺,与吸进之养气相合而生水者,当用升补之药,补其气化,而导之上升,此拙拟玉液汤之义也。然消渴之证,恒有因脾胃湿寒、真火衰微者,此肾气丸所以用桂、附。而后世治消渴,亦有用干姜白术者。尝治一少年,咽喉常常发干,饮水连连,不能解渴。诊其脉微弱迟濡。投以四君子汤,加干姜桂枝尖,一剂而渴止矣。又有湿热郁于中焦作渴者,苍柏二妙散、丹溪越鞠丸,皆可酌用。

Xiaoke Condition, if it is due to Hot in the Lung, should be treated with Hot-cleansing and Lung-wetting herbs. If it is due to Heart Fire that burns the Lung, the Heart-cleansing herbs should be used. If it is not due to the Hot in the Lung, but to the failure of the Stomach Qi to raise, e.g. the light Qi can not raise up to the Lung, to combine with the inhaled Qi to develop water, Qi-nourishing and Qi-raising herbs are needed, to supply the amount of the Qi, and to help the Qi raise up to the Lung. This is the aim of this Yuye Tang. However, the Xiaoke condition is usually caused by Spleen-Stomach Wet-Cold condition and the weak in the True Fire in Kidney. This is the reason in the Shenqi Wan to use Guizhi/Rougui, and Fuzi. Later doctors also used Ganjian and Baizhu to solve the similar condition. I treated a boy. He often felt dryness in the throat. He drank water very often but the thirsty remained. His pulse was weak, late and ru. He was given Sijunzi Tang, with addition of Ganjiang and Guizhi tip. His condition was solved with only one dose. If the thirsty is due to Wetness and Hot in the Middle Jiao, use Changbo Ermiao San, Danxi Yuju Wan.


邑人某,年二十余,贸易津门,得消渴证。求津门医者,调治三阅月,更医十余人不效,归家就医于愚。诊其脉甚微细,旋饮水旋即小便,须臾数次。投以玉液汤,加野台参四钱,数剂渴见止,而小便仍数,又加萸肉五钱,连服十剂而愈。

A man was 20 years of old. He did business and got the Xiaoke condition. He asked help form doctors in the Tianjin city for three months, changed for more than ten doctors, without any effect. He returned home to me for help. His pulse was weak and thin. He drank water and past water, several times within a short time. I used this Yuye Tang to him, with addition of wild Taishen 12 gram. After several doses, the thirsty stopped, but the urine was still frequent. With addition of Shanyurou 15 gram in the formula, continuous ten doses solved the remaining problem.

 

2.滋脺饮

2. Zicui Yin (Zi means to nourish, to water, or to wet; Cui means spleen).

 

治消渴。
This formula is used to treat Xiaoke condition (the thirsty condition, as seen in type I diabetes)

生箭芪(五钱) 大生地(一两) 生怀山药(一两) 净萸肉(五钱) 生猪胰子(三钱,切碎)
Huangqi 15 gram, Shengdi 30 gram, Shanyao 30 gram, Shanyurou 15 gram, pig pancreas 9 gram (chop).

上五味,将前四味煎汤,送服猪胰子一半,至煎渣时,再送服余一半。若遇中、上二焦积有实热,脉象洪实者,可先服白虎加人参汤数剂,将实热消去强半,再服此汤,亦能奏效。
Cook the first four ingredients into herbal tea, and drink half of the pig pancreas with the help of the herbal tea. Cook the residue of the herbal tea. Drink the remaining pig pancreas with the second herbal tea. If the person has sthenic Fire in the Upper and Middle Jiao, and the pulse is waving-sthenic, first drink Baihu Jia Renshen Tang to move the sthenic Fire half, then followed by this herbal formula.

消渴一证,古有上中下之分,谓其证皆起于中焦而极于上下。究之无论上消、中消、下消,约皆渴而多饮多尿,其尿有甜味。是以《圣济总录》论消渴谓:渴而饮水多,小便中有脂,似麸而甘。至谓其证起于中焦,是诚有理,因中焦 病,而累及于脾也。盖 为脾之副脏,在中医书中,名为散膏,即扁鹊《难经》所谓脾有散膏半斤也( 尾衔接于脾门,其全体之动脉又自脾脉分支而来,故与脾有密切之关系)。有时 脏发酵,多酿甜味,由水道下陷,其人小便遂含有糖质。迨至 病累及于脾,致脾气不能散精达肺(《内经》谓脾气散精上达于肺)则津液少,不能通调水道(《内经》谓通调水道下归膀胱)则小便无节,是以渴而多饮多溲也。

(not translated at this movement).

尝阅报,有患消渴,延中医治疗,服药竟愈者。所用方中,以黄芪为主药,为其能助脾气上升,还其散精达肺之旧也。《金匮》有肾气丸,善治消渴。其方以干地黄(即生地黄)为主,取其能助肾中之真阴,上潮以润肺,又能协同山萸肉以封固肾关也。又向因治消渴,曾拟有玉液汤,方中以生怀山药为主,屡试有效。近阅医报且有单服山药以治消渴而愈者。以其能补脾固肾,以止小便频数,而所含之蛋白质,又能滋补胰脏,使其散膏充足,且又色白入肺,能润肺生水,即以止渴也。又俗传治消渴方,单服生猪胰子可愈。盖猪胰子即猪之 ,是人之 病,而可补以物之也。此亦犹鸡内金,诸家本草皆谓其能治消渴之理也。鸡内金与猪胰子,同为化食之物也。愚因集诸药,合为一方,以治消渴,屡次见效。

In the newspaper, there was report that people with the Xiaoke condition was cured with the Chinese medicine. The formula used used the herb Huangqi as the main ingredient, for its ability to raise the Spleen Qi and to distribute its nutration into the Lung. In the bookJin Kui, there is formula called Shenqi Wan, which is good at solving the Xiaoke condition. Its main ingredient is the Shengdi, for its ability to nourish the Kidney True Yin, to make it raise up to the Lung to wet the Lung, and to help the Shanyurou to fix the switch function of the Kidney for the urine. I usually treated the Xiaoke, used the Yuye Tang, in which the herb Shanyao is the main ingredient. It worked in many cases. Recently I saw a report in the newspaper that, the Shanyao alone can solve the Xioake, for its ability to nourish the Spleen and to fix the Kidney, so to stop the frequent urine. The protein content of the herb Shanyao can nourish the pancreas, to make its rich in material to produce more nutrition; its white color goes into the Lung, to wet the Lung to produce more water, so as to stop the thirsty. In folk prescription, it is used the pig pancreas alone to solve the Xiaoke condition. The pig pancreas can be used to solve the human pancreas disease, e.g. the same thing works for the same thing theory. Another example is the use of chicken stomach inside membrane (Jineijin). Medical books always said it can treat the Xiaoke. The Jineijin and the pig pancreas both are the organ for digestion). I collect them into one formula for the treatment of Xiaoka, it works often.