六味地黃丸 Liùwèi dìhuáng wán [Part 1]

六味地黃丸 Liùwèi dìhuáng wán [Part 1] from with commentary from the Yīfāng jíjiě 《医方集解》 1689 CE.

補真陰，除百病。(1)

Tonify true yīn, eliminates the hundred diseases. (1)

  1. 錢氏仲陽因仲景八味丸減去桂附，以治小兒，以小兒純陽，故減桂附，今用通治大小證。
  1. Doctor Qián Zhòngyáng (1032-1113) in accordance with Sage Zhòngjǐng’s Bāwèi Wan, modified it to remove guìzhi fùzi, in order to treat children, this is because children are pure yáng, therefore remove guìzhi and fùzi, now it is used to treat symptoms in both young and old.

【Indications】

治肝腎不足，真陰虧損，精血枯竭，憔悴羸弱，腰痛足酸，自汗盜汗，水泛為痰(2)。發熱欬嗽(3)。頭暈目眩(4)。耳鳴耳聾，遺精便血，消渴淋瀝，失血失音，舌燥喉痛，虛火牙痛，足跟作痛，下部瘡瘍等證(5)。
Treats liver and kidney insufficiency, true yīn depletion, jīng and blood desiccated, sallow, emaciated and weak, back pain with aching feet, spontaneous sweating night sweating, flooding water-fluids becoming phlegm (2). Fever with cough (3). Dizzy head and vision (4). Tinnitus and deafness, seminal emission and bloody stool, dispersion-thirst and dribbling [urination], blood loss and aphonia, dry tongue and throat pain, deficiency fire and tooth ache, pain in the heel, different types of sores of the lower body (5).

【註 Annotations】

  1. 仲景曰：氣虛有痰，宜腎氣丸補而逐之，丹溪曰：久病陰火上升，津液生痰不生血，宜補血以制相火，其痰自除。
  2. 腎虛則移熱於肺而欬嗽，按之至骨，其熱烙手，骨困不任，為腎熱。
  3. 直指方云：淫慾過度，腎氣不能歸元，此氣虛頭暈也。吐衄崩漏，脾不攝血，致血妄行，此血頭暈。
  4. 諸證皆由腎水不足，虛火上炎所致，詳註分見各門。
  1. Zhòngjǐng says: if there is qì deficient there is phlegm, it is appropriate to use Shènqì Wán to tonify and expel [phlegm], Dānxī says: if there is chronic illness then yīn fire will ascend, jīnyè-fluids generate phlegm and cannot generate blood, it is appropriate to tonify blood in order to control ministerial fire, then the phlegm will naturally be eliminated.
    3. If the kidneys are deficient then the heat will shift to the lungs causing cough. Pressing to feel the bone, it is burning to touch, the bones are extremely cumbersome, this is due to the kidney heat.
    4. 《Zhízhǐ Fāng》 (1264 CE Song Dynasty) states: if there is excessive desires, kidney qì cannot return to the source (yuan), this is qì deficiency dizziness. Vomiting of blood and spotting, this is spleen unable to contain the blood, causing frenetic blood movement, this is blood dizziness.
    5. All these various patterns originated in kidney water insufficiency, and as a result of deficiency fire flaming upwards, meticulously study each of these clauses.

【組成 Composition】

地黃  山茱肉 山藥  茯苓 拌乳  丹皮 澤瀉

dìhuáng, shānzhūròu, shānyào, fúlíng, dān pí, zé xiè

I would also like to thank Ivan for helping out last week with proofreading.