張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)教(jiao)授(shou)(shou)，山(shan)東德州人(ren)，山(shan)東省名老(lao)(lao)中(zhong)(zhong)(zhong)(zhong)醫(yi)。他(ta)從醫(yi)70余年(nian)，在(zai)(zai)(zai)(zai)應(ying)(ying)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)小(xiao)青(qing)(qing)(qing)龍(long)(long)(long)(long)湯(tang)方(fang)(fang)(fang)的(de)(de)(de)(de)(de)過(guo)(guo)(guo)程(cheng)中(zhong)(zhong)(zhong)(zhong)積(ji)累了寶貴(gui)經(jing)(jing)驗(yan)。小(xiao)青(qing)(qing)(qing)龍(long)(long)(long)(long)湯(tang)是(shi)(shi)(shi)(shi)治療外感(gan)(gan)(gan)風(feng)寒、寒飲內(nei)停(ting)喘(chuan)(chuan)(chuan)(chuan)咳的(de)(de)(de)(de)(de)常用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)方(fang)(fang)(fang)，但(dan)(dan)在(zai)(zai)(zai)(zai)其(qi)(qi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)量(liang)(liang)及(ji)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)法(fa)上(shang)(shang)有(you)(you)(you)(you)(you)(you)巧招(zhao)。同(tong)一(yi)(yi)(yi)(yi)張(zhang)(zhang)方(fang)(fang)(fang)有(you)(you)(you)(you)(you)(you)的(de)(de)(de)(de)(de)人(ren)使用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)效(xiao)(xiao)果較(jiao)好(hao)，有(you)(you)(you)(you)(you)(you)的(de)(de)(de)(de)(de)人(ren)使用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)則療效(xiao)(xiao)差(cha)強人(ren)意，其(qi)(qi)原(yuan)因(yin)(yin)(yin)(yin)僅為(wei)(wei)(wei)個別藥(yao)(yao)(yao)(yao)(yao)物用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)量(liang)(liang)及(ji)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)法(fa)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)同(tong)。古人(ren)為(wei)(wei)(wei)保持自身(shen)醫(yi)術(shu)(shu)的(de)(de)(de)(de)(de)獨特性(xing)，或是(shi)(shi)(shi)(shi)防止(zhi)徒(tu)弟砸(za)場子(zi)(zi)，在(zai)(zai)(zai)(zai)傳(chuan)(chuan)授(shou)(shou)醫(yi)術(shu)(shu)時(shi)(shi)(shi)往(wang)往(wang)留一(yi)(yi)(yi)(yi)招(zhao)，故(gu)有(you)(you)(you)(you)(you)(you)“傳(chuan)(chuan)道不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)傳(chuan)(chuan)術(shu)(shu)、傳(chuan)(chuan)術(shu)(shu)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)傳(chuan)(chuan)方(fang)(fang)(fang)、傳(chuan)(chuan)方(fang)(fang)(fang)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)傳(chuan)(chuan)藥(yao)(yao)(yao)(yao)(yao)、傳(chuan)(chuan)藥(yao)(yao)(yao)(yao)(yao)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)傳(chuan)(chuan)量(liang)(liang)”之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)說，張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)教(jiao)授(shou)(shou)無私地傳(chuan)(chuan)授(shou)(shou)小(xiao)青(qing)(qing)(qing)龍(long)(long)(long)(long)湯(tang)中(zhong)(zhong)(zhong)(zhong)細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)、五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)等藥(yao)(yao)(yao)(yao)(yao)物的(de)(de)(de)(de)(de)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)量(liang)(liang)及(ji)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)法(fa)，現分(fen)述(shu)如下。1、入煎(jian)劑(ji)五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)需(xu)打碎(sui)(sui)(sui)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)《傷寒論(lun)》中(zhong)(zhong)(zhong)(zhong)干(gan)(gan)姜(jiang)、細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)、五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)是(shi)(shi)(shi)(shi)治咳常用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)藥(yao)(yao)(yao)(yao)(yao)。張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)認(ren)(ren)(ren)為(wei)(wei)(wei)五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)酸(suan)(suan)甜苦(ku)辛(xin)(xin)(xin)(xin)(xin)(xin)咸五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)俱全，但(dan)(dan)辛(xin)(xin)(xin)(xin)(xin)(xin)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)尤為(wei)(wei)(wei)重要(yao)。他(ta)曾長(chang)期擔任《傷寒論(lun)》的(de)(de)(de)(de)(de)講授(shou)(shou)工作(zuo)，也(ye)給(gei)(gei)“西(xi)學中(zhong)(zhong)(zhong)(zhong)”的(de)(de)(de)(de)(de)同(tong)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)們講授(shou)(shou)此(ci)(ci)(ci)課。“西(xi)學中(zhong)(zhong)(zhong)(zhong)”的(de)(de)(de)(de)(de)同(tong)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)們學習(xi)熱情很(hen)高(gao)，經(jing)(jing)常品嘗(chang)(chang)(chang)、研究中(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)性(xing)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)。有(you)(you)(you)(you)(you)(you)學生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)曾問(wen)及(ji)五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)酸(suan)(suan)甜苦(ku)咸都能(neng)嘗(chang)(chang)(chang)出(chu)來，但(dan)(dan)嘗(chang)(chang)(chang)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)出(chu)辣(la)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)是(shi)(shi)(shi)(shi)何原(yuan)因(yin)(yin)(yin)(yin)？張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)認(ren)(ren)(ren)為(wei)(wei)(wei)是(shi)(shi)(shi)(shi)五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)沒有(you)(you)(you)(you)(you)(you)打碎(sui)(sui)(sui)，故(gu)嘗(chang)(chang)(chang)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)出(chu)辣(la)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)。五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)的(de)(de)(de)(de)(de)辣(la)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)在(zai)(zai)(zai)(zai)仁(ren)中(zhong)(zhong)(zhong)(zhong)，不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)打碎(sui)(sui)(sui)則無辣(la)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)且(qie)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)起(qi)辛(xin)(xin)(xin)(xin)(xin)(xin)散作(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)。用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)小(xiao)青(qing)(qing)(qing)龍(long)(long)(long)(long)湯(tang)治哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)必(bi)(bi)須把五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)打碎(sui)(sui)(sui)，有(you)(you)(you)(you)(you)(you)了辛(xin)(xin)(xin)(xin)(xin)(xin)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)服(fu)(fu)(fu)20g、30g均(jun)可(ke)(ke)，且(qie)服(fu)(fu)(fu)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)后(hou)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)會(hui)出(chu)現憋氣(qi)甚至(zhi)喘(chuan)(chuan)(chuan)(chuan)得更厲害的(de)(de)(de)(de)(de)狀(zhuang)況。張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)認(ren)(ren)(ren)為(wei)(wei)(wei)此(ci)(ci)(ci)說張(zhang)(zhang)錫純先(xian)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)早已(yi)(yi)(yi)有(you)(you)(you)(you)(you)(you)言，并非(fei)出(chu)于家(jia)傳(chuan)(chuan)。《醫(yi)學衷中(zhong)(zhong)(zhong)(zhong)參(can)西(xi)錄》曰：“五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)，性(xing)溫，五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)俱備，酸(suan)(suan)、咸居多(duo)(duo)。其(qi)(qi)酸(suan)(suan)也(ye)能(neng)斂(lian)肺(fei)……凡入煎(jian)劑(ji)宜(yi)搗碎(sui)(sui)(sui)，以(yi)(yi)(yi)(yi)(yi)其(qi)(qi)仁(ren)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)辛(xin)(xin)(xin)(xin)(xin)(xin)與(yu)皮之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)酸(suan)(suan)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)相(xiang)濟，自不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)至(zhi)酸(suan)(suan)斂(lian)過(guo)(guo)(guo)甚，服(fu)(fu)(fu)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)脹滿也(ye)。”張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)所(suo)以(yi)(yi)(yi)(yi)(yi)重申此(ci)(ci)(ci)問(wen)題原(yuan)因(yin)(yin)(yin)(yin)有(you)(you)(you)(you)(you)(you)三(san)，一(yi)(yi)(yi)(yi)是(shi)(shi)(shi)(shi)科(ke)班(ban)出(chu)身(shen)的(de)(de)(de)(de)(de)學生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)很(hen)少(shao)(shao)聽老(lao)(lao)師講課之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)時(shi)(shi)(shi)提(ti)及(ji)此(ci)(ci)(ci)事；二是(shi)(shi)(shi)(shi)現今著名的(de)(de)(de)(de)(de)傷寒家(jia)亦(yi)少(shao)(shao)提(ti)及(ji)；三(san)是(shi)(shi)(shi)(shi)藥(yao)(yao)(yao)(yao)(yao)房(fang)(fang)配(pei)藥(yao)(yao)(yao)(yao)(yao)時(shi)(shi)(shi)醫(yi)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)若(ruo)(ruo)(ruo)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)注明(ming)打碎(sui)(sui)(sui)，藥(yao)(yao)(yao)(yao)(yao)房(fang)(fang)司藥(yao)(yao)(yao)(yao)(yao)人(ren)員(yuan)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)會(hui)主動(dong)給(gei)(gei)打碎(sui)(sui)(sui)。所(suo)以(yi)(yi)(yi)(yi)(yi)有(you)(you)(you)(you)(you)(you)必(bi)(bi)要(yao)提(ti)醒年(nian)輕(qing)(qing)大(da)(da)夫(fu)入煎(jian)劑(ji)時(shi)(shi)(shi)五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)需(xu)注明(ming)打碎(sui)(sui)(sui)，如果不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)打碎(sui)(sui)(sui)藥(yao)(yao)(yao)(yao)(yao)效(xiao)(xiao)就得不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)到發(fa)揮。張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)曾以(yi)(yi)(yi)(yi)(yi)五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)40g治咳嗽和(he)哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)。1996年(nian)，一(yi)(yi)(yi)(yi)位70歲(sui)退休軍官(guan)患(huan)(huan)(huan)哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)兼咳嗽曾于醫(yi)院就診(zhen)(zhen)，效(xiao)(xiao)果不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)好(hao)，轉(zhuan)求(qiu)于他(ta)診(zhen)(zhen)治。癥見咯(ge)痰(tan)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)多(duo)(duo)，張(zhang)(zhang)目大(da)(da)口呼(hu)吸，已(yi)(yi)(yi)有(you)(you)(you)(you)(you)(you)數日未(wei)能(neng)臥床(chuang)睡(shui)眠，脈象弦滑，雖感(gan)(gan)(gan)痛苦(ku)但(dan)(dan)精神狀(zhuang)態尚(shang)可(ke)(ke)。乃(nai)以(yi)(yi)(yi)(yi)(yi)小(xiao)青(qing)(qing)(qing)龍(long)(long)(long)(long)湯(tang)損益，突出(chu)五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)量(liang)(liang)：半(ban)(ban)夏(xia)10g，麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)6g，橘紅10g，川貝母(mu)10g，款(kuan)冬花15g，細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)10g，射干(gan)(gan)10g，干(gan)(gan)姜(jiang)6g，露蜂(feng)房(fang)(fang)6g，五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)40g(打碎(sui)(sui)(sui))，水煎(jian)分(fen)4次服(fu)(fu)(fu)，5 h1次，連飲6劑(ji)癥狀(zhuang)銳減(jian)。遂(sui)壓縮一(yi)(yi)(yi)(yi)半(ban)(ban)藥(yao)(yao)(yao)(yao)(yao)量(liang)(liang)，改(gai)為(wei)(wei)(wei)每日1劑(ji)，又(you)服(fu)(fu)(fu)4d而(er)(er)愈(yu)。按：方(fang)(fang)(fang)以(yi)(yi)(yi)(yi)(yi)小(xiao)青(qing)(qing)(qing)龍(long)(long)(long)(long)湯(tang)去(qu)桂枝、芍藥(yao)(yao)(yao)(yao)(yao)、甘草加(jia)(jia)橘紅、款(kuan)冬、川貝、露蜂(feng)房(fang)(fang)。橘紅、款(kuan)冬二藥(yao)(yao)(yao)(yao)(yao)性(xing)溫，潤肺(fei)下氣(qi)、化痰(tan)止(zhi)嗽；貝母(mu)性(xing)微(wei)寒而(er)(er)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)甘苦(ku)；射干(gan)(gan)性(xing)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)苦(ku)辛(xin)(xin)(xin)(xin)(xin)(xin)，均(jun)主咳逆(ni)上(shang)(shang)氣(qi)；蜂(feng)房(fang)(fang)除攻毒、殺蟲、止(zhi)癢(yang)外，還有(you)(you)(you)(you)(you)(you)止(zhi)咳平喘(chuan)(chuan)(chuan)(chuan)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)效(xiao)(xiao)。該(gai)(gai)方(fang)(fang)(fang)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)特色是(shi)(shi)(shi)(shi)以(yi)(yi)(yi)(yi)(yi)大(da)(da)量(liang)(liang)五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)斂(lian)肺(fei)止(zhi)咳。2、小(xiao)青(qing)(qing)(qing)龍(long)(long)(long)(long)湯(tang)中(zhong)(zhong)(zhong)(zhong)細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)可(ke)(ke)過(guo)(guo)(guo)錢(qian)(qian)古語云：“細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)過(guo)(guo)(guo)錢(qian)(qian)，過(guo)(guo)(guo)錢(qian)(qian)人(ren)命懸。”但(dan)(dan)張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)在(zai)(zai)(zai)(zai)實踐過(guo)(guo)(guo)程(cheng)中(zhong)(zhong)(zhong)(zhong)發(fa)現，用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)小(xiao)青(qing)(qing)(qing)龍(long)(long)(long)(long)湯(tang)時(shi)(shi)(shi)3g細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)量(liang)(liang)太小(xiao)，杯(bei)水車薪，救不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)了“火”。在(zai)(zai)(zai)(zai)復方(fang)(fang)(fang)中(zhong)(zhong)(zhong)(zhong)，他(ta)常用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)10g，少(shao)(shao)時(shi)(shi)(shi)也(ye)要(yao)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)6g。為(wei)(wei)(wei)穩妥起(qi)見可(ke)(ke)以(yi)(yi)(yi)(yi)(yi)陸續加(jia)(jia)量(liang)(liang)，從4g開(kai)始到10g。1957年(nian)他(ta)在(zai)(zai)(zai)(zai)山(shan)東省中(zhong)(zhong)(zhong)(zhong)醫(yi)院治一(yi)(yi)(yi)(yi)例老(lao)(lao)年(nian)慢性(xing)支(zhi)(zhi)(zhi)氣(qi)管炎，癥見咳嗽兼有(you)(you)(you)(you)(you)(you)哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)、呼(hu)吸困難，雖然痰(tan)多(duo)(duo)但(dan)(dan)喉內(nei)無水雞(ji)聲(sheng)。方(fang)(fang)(fang)藥(yao)(yao)(yao)(yao)(yao)給(gei)(gei)予小(xiao)青(qing)(qing)(qing)龍(long)(long)(long)(long)湯(tang)加(jia)(jia)減(jian)：麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)10g，干(gan)(gan)姜(jiang)10g，五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)15g(打碎(sui)(sui)(sui))，細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)3g，紫(zi)苑10g，茯苓(ling)15g，半(ban)(ban)夏(xia)10g，杏仁(ren)10g，水煎(jian)分(fen)3次服(fu)(fu)(fu)，連用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)6d，患(huan)(huan)(huan)者(zhe)身(shen)上(shang)(shang)有(you)(you)(you)(you)(you)(you)汗病情不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)減(jian)。遂(sui)將(jiang)茯苓(ling)加(jia)(jia)至(zhi)30g、五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)20g稍見好(hao)轉(zhuan)，痰(tan)量(liang)(liang)已(yi)(yi)(yi)少(shao)(shao)，其(qi)(qi)他(ta)如故(gu)。張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)認(ren)(ren)(ren)為(wei)(wei)(wei)此(ci)(ci)(ci)方(fang)(fang)(fang)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)藥(yao)(yao)(yao)(yao)(yao)與(yu)病機相(xiang)契，但(dan)(dan)療效(xiao)(xiao)欠佳，問(wen)題當(dang)是(shi)(shi)(shi)(shi)出(chu)在(zai)(zai)(zai)(zai)藥(yao)(yao)(yao)(yao)(yao)量(liang)(liang)上(shang)(shang)。經(jing)(jing)過(guo)(guo)(guo)思考認(ren)(ren)(ren)為(wei)(wei)(wei)該(gai)(gai)病病機為(wei)(wei)(wei)水飲阻塞(sai)，溫肺(fei)化飲的(de)(de)(de)(de)(de)方(fang)(fang)(fang)向是(shi)(shi)(shi)(shi)正確(que)的(de)(de)(de)(de)(de)，但(dan)(dan)溫通(tong)的(de)(de)(de)(de)(de)力度不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)夠，應(ying)(ying)加(jia)(jia)大(da)(da)溫通(tong)的(de)(de)(de)(de)(de)力度。遂(sui)將(jiang)療效(xiao)(xiao)寄(ji)托于細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)，將(jiang)其(qi)(qi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)量(liang)(liang)上(shang)(shang)升至(zhi)12g，又(you)飲5劑(ji)諸(zhu)癥漸消(xiao)。1964年(nian)張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)參(can)加(jia)(jia)全國(guo)中(zhong)(zhong)(zhong)(zhong)醫(yi)教(jiao)材修審會(hui)議，住在(zai)(zai)(zai)(zai)河北江淮(huai)旅社。當(dang)時(shi)(shi)(shi)有(you)(you)(you)(you)(you)(you)一(yi)(yi)(yi)(yi)服(fu)(fu)(fu)務員(yuan)患(huan)(huan)(huan)老(lao)(lao)慢支(zhi)(zhi)(zhi)哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)請(qing)賜一(yi)(yi)(yi)(yi)方(fang)(fang)(fang)，他(ta)欣然應(ying)(ying)允診(zhen)(zhen)治后(hou)處以(yi)(yi)(yi)(yi)(yi)小(xiao)青(qing)(qing)(qing)龍(long)(long)(long)(long)湯(tang)加(jia)(jia)減(jian)。時(shi)(shi)(shi)同(tong)住一(yi)(yi)(yi)(yi)室參(can)加(jia)(jia)教(jiao)材修訂(ding)的(de)(de)(de)(de)(de)山(shan)西(xi)老(lao)(lao)同(tong)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)亦(yi)為(wei)(wei)(wei)傷寒專家(jia)，年(nian)齡較(jiao)他(ta)大(da)(da)，開(kai)方(fang)(fang)(fang)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)時(shi)(shi)(shi)在(zai)(zai)(zai)(zai)旁細(xi)(xi)(xi)(xi)心觀(guan)看，待服(fu)(fu)(fu)務員(yuan)走后(hou)，他(ta)對張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)說剛才(cai)(cai)方(fang)(fang)(fang)中(zhong)(zhong)(zhong)(zhong)細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)開(kai)8g量(liang)(liang)稍少(shao)(shao)些，服(fu)(fu)(fu)后(hou)效(xiao)(xiao)果可(ke)(ke)能(neng)稍差(cha)。張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)隨即虛(xu)心求(qiu)教(jiao)，老(lao)(lao)同(tong)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)說此(ci)(ci)(ci)服(fu)(fu)(fu)務員(yuan)為(wei)(wei)(wei)一(yi)(yi)(yi)(yi)老(lao)(lao)慢支(zhi)(zhi)(zhi)患(huan)(huan)(huan)者(zhe)，據我之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)經(jing)(jing)驗(yan)，細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)最少(shao)(shao)得用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)至(zhi)15g，方(fang)(fang)(fang)能(neng)收較(jiao)好(hao)效(xiao)(xiao)果。張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)聽后(hou)十分(fen)感(gan)(gan)(gan)激，知道老(lao)(lao)同(tong)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)與(yu)其(qi)(qi)如此(ci)(ci)(ci)交流有(you)(you)(you)(you)(you)(you)提(ti)攜之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)意。張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)回憶(yi)他(ta)的(de)(de)(de)(de)(de)老(lao)(lao)師、祖師爺應(ying)(ying)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)小(xiao)青(qing)(qing)(qing)龍(long)(long)(long)(long)湯(tang)時(shi)(shi)(shi)，也(ye)常將(jiang)細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)開(kai)至(zhi)18~20g，但(dan)(dan)指(zhi)(zhi)出(chu)一(yi)(yi)(yi)(yi)定要(yao)根據病情來用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)，謹(jin)慎為(wei)(wei)(wei)好(hao)，但(dan)(dan)也(ye)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)能(neng)因(yin)(yin)(yin)(yin)“細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)過(guo)(guo)(guo)錢(qian)(qian)，過(guo)(guo)(guo)錢(qian)(qian)命必(bi)(bi)懸”就畏(wei)手畏(wei)腳(jiao)，此(ci)(ci)(ci)法(fa)在(zai)(zai)(zai)(zai)應(ying)(ying)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)上(shang)(shang)是(shi)(shi)(shi)(shi)有(you)(you)(you)(you)(you)(you)條件的(de)(de)(de)(de)(de)。按：“細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)過(guo)(guo)(guo)錢(qian)(qian)”之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)說源(yuan)于宋(song)·陳(chen)承《證(zheng)類(lei)本草》引(yin)《本草別說》載‘細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)，若(ruo)(ruo)(ruo)單(dan)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)末，不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)可(ke)(ke)過(guo)(guo)(guo)半(ban)(ban)錢(qian)(qian)匕，多(duo)(duo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)即氣(qi)悶塞(sai)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)通(tong)者(zhe)死。’，明(ming)確(que)指(zhi)(zhi)出(chu)“若(ruo)(ruo)(ruo)單(dan)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)末，不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)可(ke)(ke)過(guo)(guo)(guo)半(ban)(ban)錢(qian)(qian)匕”是(shi)(shi)(shi)(shi)其(qi)(qi)應(ying)(ying)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)準(zhun)則。現代研究表明(ming)，細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)揮發(fa)油有(you)(you)(you)(you)(you)(you)毒性(xing)，但(dan)(dan)也(ye)是(shi)(shi)(shi)(shi)其(qi)(qi)有(you)(you)(you)(you)(you)(you)效(xiao)(xiao)成分(fen)，入煎(jian)劑(ji)煎(jian)煮后(hou)揮發(fa)油大(da)(da)量(liang)(liang)揮發(fa)，毒性(xing)減(jian)低。張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)從實踐角度證(zheng)明(ming)，入湯(tang)劑(ji)時(shi)(shi)(shi)細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)的(de)(de)(de)(de)(de)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)量(liang)(liang)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)可(ke)(ke)困于“不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)過(guo)(guo)(guo)錢(qian)(qian)”之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)說。3、用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)、炙麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)分(fen)別《傷寒論(lun)》小(xiao)青(qing)(qing)(qing)龍(long)(long)(long)(long)湯(tang)所(suo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)只注明(ming)“去(qu)節”，未(wei)明(ming)言用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)抑(yi)或是(shi)(shi)(shi)(shi)炙麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)。張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)認(ren)(ren)(ren)為(wei)(wei)(wei)凡是(shi)(shi)(shi)(shi)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)惡(e)寒且(qie)無汗用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)，若(ruo)(ruo)(ruo)病人(ren)有(you)(you)(you)(you)(you)(you)汗則用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)炙麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)。若(ruo)(ruo)(ruo)患(huan)(huan)(huan)者(zhe)哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)時(shi)(shi)(shi)間較(jiao)長(chang)且(qie)屢治不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)愈(yu)可(ke)(ke)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)。張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)談及(ji)年(nian)輕(qing)(qing)時(shi)(shi)(shi)隨父(fu)出(chu)診(zhen)(zhen)，患(huan)(huan)(huan)者(zhe)為(wei)(wei)(wei)一(yi)(yi)(yi)(yi)年(nian)輕(qing)(qing)人(ren)，因(yin)(yin)(yin)(yin)患(huan)(huan)(huan)感(gan)(gan)(gan)冒引(yin)起(qi)支(zhi)(zhi)(zhi)氣(qi)管哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)，曾請(qing)多(duo)(duo)位醫(yi)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)診(zhen)(zhen)治均(jun)未(wei)治愈(yu)，請(qing)張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)父(fu)親及(ji)另一(yi)(yi)(yi)(yi)孫(sun)(sun)(sun)老(lao)(lao)先(xian)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)會(hui)診(zhen)(zhen)。孫(sun)(sun)(sun)先(xian)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)系清末秀才(cai)(cai)，為(wei)(wei)(wei)傷寒專家(jia)，但(dan)(dan)時(shi)(shi)(shi)年(nian)已(yi)(yi)(yi)75歲(sui)。兩人(ren)各開(kai)一(yi)(yi)(yi)(yi)方(fang)(fang)(fang)，互(hu)相(xiang)審看后(hou)相(xiang)互(hu)謙讓，因(yin)(yin)(yin)(yin)孫(sun)(sun)(sun)先(xian)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)年(nian)長(chang)，方(fang)(fang)(fang)子(zi)(zi)亦(yi)有(you)(you)(you)(you)(you)(you)特色，其(qi)(qi)父(fu)提(ti)出(chu)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)孫(sun)(sun)(sun)先(xian)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)方(fang)(fang)(fang)治療。孫(sun)(sun)(sun)先(xian)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)方(fang)(fang)(fang)有(you)(you)(you)(you)(you)(you)三(san)大(da)(da)特色，一(yi)(yi)(yi)(yi)是(shi)(shi)(shi)(shi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)細(xi)(xi)(xi)(xi)辛(xin)(xin)(xin)(xin)(xin)(xin)15g，二是(shi)(shi)(shi)(shi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)30g五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)(打碎(sui)(sui)(sui))，三(san)是(shi)(shi)(shi)(shi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)。張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)父(fu)親稱贊(zan)孫(sun)(sun)(sun)老(lao)(lao)先(xian)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)開(kai)的(de)(de)(de)(de)(de)方(fang)(fang)(fang)子(zi)(zi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)量(liang)(liang)老(lao)(lao)到，實屬佳方(fang)(fang)(fang)。但(dan)(dan)也(ye)提(ti)出(chu)建議，因(yin)(yin)(yin)(yin)患(huan)(huan)(huan)者(zhe)無表證(zheng)是(shi)(shi)(shi)(shi)否可(ke)(ke)以(yi)(yi)(yi)(yi)(yi)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)，改(gai)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)炙麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)治喘(chuan)(chuan)(chuan)(chuan)。孫(sun)(sun)(sun)老(lao)(lao)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)云：此(ci)(ci)(ci)方(fang)(fang)(fang)開(kai)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)經(jing)(jing)驗(yan)來自師傳(chuan)(chuan)，也(ye)是(shi)(shi)(shi)(shi)其(qi)(qi)拿手好(hao)戲和(he)得意之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)處，不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)可(ke)(ke)更改(gai)。他(ta)解釋此(ci)(ci)(ci)患(huan)(huan)(huan)者(zhe)哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)時(shi)(shi)(shi)間較(jiao)長(chang)，已(yi)(yi)(yi)請(qing)多(duo)(duo)位大(da)(da)夫(fu)診(zhen)(zhen)治屢治不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)愈(yu)，因(yin)(yin)(yin)(yin)此(ci)(ci)(ci)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)炙麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)雖能(neng)定喘(chuan)(chuan)(chuan)(chuan)但(dan)(dan)力量(liang)(liang)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)夠，此(ci)(ci)(ci)亦(yi)為(wei)(wei)(wei)患(huan)(huan)(huan)者(zhe)每次服(fu)(fu)(fu)藥(yao)(yao)(yao)(yao)(yao)均(jun)見效(xiao)(xiao)但(dan)(dan)疾病不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)除根之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)原(yuan)因(yin)(yin)(yin)(yin)，哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)仍舊發(fa)作(zuo)，故(gu)該(gai)(gai)方(fang)(fang)(fang)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)炙麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)而(er)(er)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)。之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)所(suo)以(yi)(yi)(yi)(yi)(yi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)，不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)是(shi)(shi)(shi)(shi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)其(qi)(qi)解表而(er)(er)是(shi)(shi)(shi)(shi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)其(qi)(qi)定喘(chuan)(chuan)(chuan)(chuan)，故(gu)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)必(bi)(bi)顧(gu)慮麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)發(fa)大(da)(da)汗且(qie)有(you)(you)(you)(you)(you)(you)亡(wang)陽之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)虞，因(yin)(yin)(yin)(yin)方(fang)(fang)(fang)中(zhong)(zhong)(zhong)(zhong)有(you)(you)(you)(you)(you)(you)30g五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)制約此(ci)(ci)(ci)藥(yao)(yao)(yao)(yao)(yao)。患(huan)(huan)(huan)者(zhe)服(fu)(fu)(fu)1劑(ji)藥(yao)(yao)(yao)(yao)(yao)喘(chuan)(chuan)(chuan)(chuan)即止(zhi)，3劑(ji)藥(yao)(yao)(yao)(yao)(yao)癥消(xiao)人(ren)安(an)。張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)認(ren)(ren)(ren)為(wei)(wei)(wei)此(ci)(ci)(ci)方(fang)(fang)(fang)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)五(wu)(wu)味(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)(wei)子(zi)(zi)雖然打碎(sui)(sui)(sui)，但(dan)(dan)30g的(de)(de)(de)(de)(de)量(liang)(liang)依然能(neng)制約麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)，所(suo)以(yi)(yi)(yi)(yi)(yi)孫(sun)(sun)(sun)先(xian)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)不(bu)(bu)(bu)(bu)(bu)(bu)(bu)(bu)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)炙麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)而(er)(er)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)生(sheng)(sheng)(sheng)(sheng)(sheng)(sheng)麻(ma)(ma)(ma)(ma)(ma)黃(huang)(huang)(huang)(huang)(huang)(huang)其(qi)(qi)妙在(zai)(zai)(zai)(zai)此(ci)(ci)(ci)。而(er)(er)張(zhang)(zhang)志(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遠(yuan)(yuan)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)臨床(chuang)經(jing)(jing)驗(yan)值得年(nian)輕(qing)(qing)大(da)(da)夫(fu)借鑒。提(ti)示(shi)：文中(zhong)(zhong)(zhong)(zhong)處方(fang)(fang)(fang)，請(qing)在(zai)(zai)(zai)(zai)專業中(zhong)(zhong)(zhong)(zhong)醫(yi)指(zhi)(zhi)導(dao)下使用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)。
牛(niu)膝(xi)(xi)(xi)味苦(ku)、酸，性平(ping)，歸肝(gan)(gan)、腎(shen)經，有活血祛瘀，補(bu)益(yi)肝(gan)(gan)腎(shen)，強(qiang)筋壯骨，利(li)尿通(tong)淋，引血下(xia)行之功(gong)效。牛(niu)膝(xi)(xi)(xi)分懷(huai)牛(niu)膝(xi)(xi)(xi)與川牛(niu)膝(xi)(xi)(xi)兩種，懷(huai)牛(niu)膝(xi)(xi)(xi)為莧科(ke)多年生(sheng)草本植物牛(niu)膝(xi)(xi)(xi)的根(gen)；川牛(niu)膝(xi)(xi)(xi)為莧科(ke)多年生(sheng)草本植物頭序(xu)杯莧及川牛(niu)膝(xi)(xi)(xi)的根(gen)。牛(niu)膝(xi)(xi)(xi)為臨床(chuang)上的常用藥，功(gong)效很多，歸納(na)起(qi)來(lai)主要有以下(xia)六個方(fang)面。
補益肝腎
《名(ming)醫別錄》言本(ben)品“益(yi)精(jing)(jing)，利(li)陰氣，止發白”，治(zhi)(zhi)“老人失(shi)溺，填(tian)骨髓(sui)”，《藥(yao)(yao)性論》言其“治(zhi)(zhi)陰痿，補腎(shen)填(tian)精(jing)(jing)”，顯系其有補益(yi)肝腎(shen)的功效。臨床上(shang)對于肝腎(shen)不(bu)足所致(zhi)的腰(yao)膝(xi)酸痛，下(xia)肢無力，頭暈耳鳴，精(jing)(jing)力不(bu)充(chong)，甚(shen)至陽痿腳弱(ruo)，均可予以(yi)本(ben)品治(zhi)(zhi)療，常與熟(shu)地(di)、鎖陽、龜板(ban)等同(tong)用，即虎(hu)潛(qian)丸(wan)。《經(jing)驗后方》治(zhi)(zhi)腎(shen)虛(xu)下(xia)元不(bu)足之(zhi)消渴不(bu)止，用牛膝(xi)五兩(liang)為末，生地(di)黃汁五升浸(jin)之(zhi)，日(ri)曝夜浸(jin)，汁盡為度，密丸(wan)如梧子(zi)大(da)，每空心酒下(xia)三十丸(wan)，可以(yi)達到“久服壯(zhuang)筋骨，駐(zhu)顏色，黑發，津液自生”的效果。如此者甚(shen)多，不(bu)須枚舉。筆者用治(zhi)(zhi)肝腎(shen)不(bu)足時，多用懷牛膝(xi)配伍寄生、川(chuan)斷、山萸肉(rou)、山藥(yao)(yao)、枸杞子(zi)、莬絲子(zi)、仙(xian)靈(ling)脾等藥(yao)(yao)，配成丸(wan)劑緩服，效果確(que)實。
通下瘀血
本品活血(xue)祛(qu)(qu)瘀力較強，《本草正義(yi)》謂(wei)其“所主皆氣血(xue)壅滯之病”。牛膝性(xing)善下行，長于(yu)逐(zhu)瘀通經，又能祛(qu)(qu)瘀止痛(tong)，還(huan)有疏利通泄(xie)的特(te)點(dian)，故常(chang)用于(yu)婦科月經胎產諸證、傷科跌打損傷以及內科癥(zheng)瘕腹(fu)痛(tong)等。
婦科經產諸癥 婦科(ke)諸癥中(zhong)，因(yin)于血(xue)(xue)瘀者恒(heng)多，《本(ben)草經疏》謂(wei)“血(xue)(xue)行(xing)則月(yue)水自(zi)通，血(xue)(xue)結自(zi)散”，本(ben)品能逐(zhu)瘀通經，治療(liao)月(yue)經不(bu)調、經閉(bi)、經行(xing)腹(fu)痛、淋瀝不(bu)斷等(deng)由于血(xue)(xue)瘀不(bu)暢者，頗為適宜。臨床常與當歸、桃仁、紅花、赤芍等(deng)配伍(wu)(wu)，如著名的血(xue)(xue)府逐(zhu)瘀湯；治難產可以(yi)之與川(chuan)芎、紅花等(deng)配伍(wu)(wu)；治胎衣不(bu)下，可與冬(dong)葵(kui)子相(xiang)伍(wu)(wu)。若(ruo)與麝香相(xiang)伍(wu)(wu)，用(yong)作(zuo)坐藥，還可以(yi)墮胎，此法載(zai)入《梅師集驗方中(zhong)》，現在雖極少應用(yong)，但可以(yi)知其活血(xue)(xue)下血(xue)(xue)之功。當今臨床上常用(yong)于治療(liao)產后腹(fu)痛或血(xue)(xue)瘀經閉(bi)，用(yong)川(chuan)牛(niu)膝與木香、桃仁、肉桂等(deng)配伍(wu)(wu)，如《婦人大(da)全(quan)良方》所(suo)載(zai)牛(niu)膝散。
跌打損傷 牛膝為(wei)(wei)祛瘀之品(pin)，有(you)消腫止痛之功(gong)，常用于治(zhi)療跌打損傷，尤其以(yi)腰腿部的傷損更為(wei)(wei)適宜，本品(pin)常與川(chuan)斷(duan)、杜仲(zhong)、乳香、沒(mei)藥、血(xue)竭、三七等同用。除內服(fu)外，也可(ke)以(yi)本品(pin)一味(wei)打粉(fen)外敷(fu)，以(yi)促進恢復。
癥瘕積聚 《藥(yao)性論》中(zhong)記載牛膝可(ke)“逐惡(e)血流結”，《日華子本草(cao)》云(yun)其能“破癥(zheng)結”，故(gu)常(chang)用(yong)于治(zhi)療癥(zheng)瘕(jia)積聚。《外臺秘要》中(zhong)以本品一味濃煎，治(zhi)勞(lao)瘧積久不止，此(ci)即瘧疾后(hou)引起的肝(gan)脾腫大。又《三因極一病證(zheng)方論》載有萬病丸，用(yong)于治(zhi)療室女月經不通，臍下堅結，大如(ru)杯升，發熱往(wang)來，下痢(li)羸瘦，此(ci)為(wei)血瘕(jia)，以牛膝、干(gan)漆、生地配伍為(wei)丸。
療痿通痹
牛膝入肝腎經，善補益肝腎，有活血通絡之效，兼能祛風除濕，故對于肝腎虧虛于內，風寒濕邪乘之于外的痿痹諸證也頗適合。《神農本(ben)草(cao)經》言其(qi)(qi)(qi)主(zhu)(zhu)治(zhi)(zhi)病(bing)癥(zheng)，第(di)一(yi)個即(ji)是“主(zhu)(zhu)寒(han)(han)濕痿痹(bi)(bi)，四肢拘攣(luan)，膝痛(tong)(tong)不可(ke)(ke)(ke)屈”，《本(ben)草(cao)備(bei)要(yao)》云(yun)其(qi)(qi)(qi)“酒蒸則益肝(gan)腎，強筋(jin)(jin)(jin)(jin)骨，治(zhi)(zhi)腰(yao)膝骨痛(tong)(tong)，足痿筋(jin)(jin)(jin)(jin)攣(luan)，陰痿失溺”。對(dui)于(yu)牛膝既能(neng)治(zhi)(zhi)痿，又能(neng)治(zhi)(zhi)痹(bi)(bi)的(de)病(bing)機(ji)，《本(ben)草(cao)經續疏》解釋說：“痿與(yu)痹(bi)(bi)皆(jie)筋(jin)(jin)(jin)(jin)節間病(bing)，而寒(han)(han)濕有(you)已化未化，未化則浸淫筋(jin)(jin)(jin)(jin)節為(wei)(wei)病(bing)，已化則熏灼(zhuo)(zhuo)筋(jin)(jin)(jin)(jin)節為(wei)(wei)病(bing)。《素問(wen)》論痹(bi)(bi)多病(bing)于(yu)浸淫，論痿多病(bing)于(yu)熏灼(zhuo)(zhuo)。牛膝之治(zhi)(zhi)此(ci)，妙(miao)在不必問(wen)其(qi)(qi)(qi)已化未化，但執定其(qi)(qi)(qi)筋(jin)(jin)(jin)(jin)節間痛(tong)(tong)而不可(ke)(ke)(ke)屈伸(shen)者(zhe)皆(jie)能(neng)已之。”并謂(wei)其(qi)(qi)(qi)能(neng)“強者(zhe)使柔(rou)，槁(gao)者(zhe)使潤(run)，上(shang)者(zhe)使下，斷者(zhe)使連，阻者(zhe)使通，盡抑火令就水，助水令充行之治(zhi)(zhi)。”對(dui)于(yu)痿痹(bi)(bi)腰(yao)膝痛(tong)(tong)屬于(yu)肝(gan)腎不足者(zhe)，本(ben)品常配(pei)伍杜(du)(du)仲、寄生、當(dang)歸(gui)、人參等(deng)，如著名的(de)獨活寄生湯。如果(guo)痹(bi)(bi)痛(tong)(tong)邪氣盛者(zhe)，可(ke)(ke)(ke)以配(pei)伍驅邪藥物，如獨活、威靈仙等(deng)。國醫大師張(zhang)志遠先生認為(wei)(wei)，本(ben)品與(yu)木瓜配(pei)伍最為(wei)(wei)的(de)當(dang)，與(yu)芍藥甘草(cao)湯配(pei)伍，可(ke)(ke)(ke)治(zhi)(zhi)腓腸肌痙攣(luan)、不寧腿綜合癥(zheng)。如果(guo)與(yu)狗脊、杜(du)(du)仲、續斷、乳(ru)香、沒藥、鬼箭羽、三(san)七等(deng)配(pei)伍，治(zhi)(zhi)療腰(yao)椎間盤突出癥(zheng)、強直性脊柱炎、坐骨神經痛(tong)(tong)等(deng)效(xiao)佳。筆者(zhe)臨床常用此(ci)加減治(zhi)(zhi)療痹(bi)(bi)證效(xiao)佳，對(dui)于(yu)腰(yao)膝之痹(bi)(bi)痛(tong)(tong)更(geng)是治(zhi)(zhi)有(you)專功。
通利五淋
牛(niu)膝(xi)苦甘而(er)性(xing)平，善走下(xia)焦，利尿(niao)通(tong)(tong)淋(lin)，也可自下(xia)祛濕(shi)，又兼活血(xue)(xue)(xue)祛瘀，《本(ben)草(cao)綱目(mu)》云其主(zhu)“五(wu)淋(lin)尿(niao)血(xue)(xue)(xue)，莖中(zhong)痛”，在歷(li)代方(fang)書(shu)中(zhong)，牛(niu)膝(xi)也是治療濕(shi)熱(re)蘊結(jie)膀(bang)胱所致(zhi)(zhi)淋(lin)痛的要藥。早(zao)在《千(qian)金要方(fang)》中(zhong)就載有(you)牛(niu)膝(xi)湯，以(yi)本(ben)品(pin)配(pei)(pei)伍瞿麥(mai)、滑(hua)石(shi)、扁蓄(xu)等，治療尿(niao)道澀(se)痛、尿(niao)血(xue)(xue)(xue)等熱(re)淋(lin)、血(xue)(xue)(xue)淋(lin)；又如焦樹德(de)先生治療石(shi)淋(lin)，淋(lin)瀝不通(tong)(tong)，少腹或(huo)腰部絞痛，尿(niao)中(zhong)帶(dai)血(xue)(xue)(xue)，即泌尿(niao)系結(jie)石(shi)、腎(shen)絞痛，用本(ben)品(pin)配(pei)(pei)伍冬葵子(zi)、海金砂(sha)、金錢草(cao)等。還要特別介紹的是，《本(ben)草(cao)通(tong)(tong)玄(xuan)》治療五(wu)淋(lin)諸證極難見效者，用牛(niu)膝(xi)配(pei)(pei)乳香(xiang)煎服(fu)，連進數劑有(you)效。此(ci)方(fang)配(pei)(pei)伍有(you)獨到之(zhi)處，立(li)法從補(bu)腎(shen)活血(xue)(xue)(xue)論治，構思巧妙。而(er)清代醫家陳士鐸治療淋(lin)病(bing)，也必以(yi)活血(xue)(xue)(xue)之(zhi)品(pin)為(wei)治，與此(ci)暗合(he)。此(ci)方(fang)筆(bi)者試用之(zhi)有(you)效，尤其對(dui)于前列腺(xian)炎所致(zhi)(zhi)的淋(lin)痛，效果更佳(jia)。
引火下行
牛膝性平，雖(sui)不屬寒涼之(zhi)藥，但具導熱(re)下(xia)行，以降(jiang)(jiang)上炎之(zhi)火(huo)(huo)的功效。其原因(yin)在于，本品味苦(ku)而(er)性善(shan)泄(xie)降(jiang)(jiang)，能導熱(re)下(xia)泄(xie)，引火(huo)(huo)下(xia)行，故而(er)可用于治(zhi)療陰(yin)虛火(huo)(huo)旺、肝陽上亢、血熱(re)上溢等證(zheng)。
頭面之火 對(dui)于牙齦腫(zhong)痛、口(kou)(kou)舌(she)(she)生(sheng)瘡、喉痹乳蛾，可(ke)以單(dan)用(yong)牛(niu)膝(xi)，也可(ke)以配伍應用(yong)。如《肘后(hou)方》治療口(kou)(kou)中及舌(she)(she)上生(sheng)瘡，用(yong)牛(niu)膝(xi)一(yi)味(wei)酒漬或空含咽即效。《本草綱目》治喉痹、乳蛾，用(yong)新鮮牛(niu)膝(xi)根一(yi)握，艾(ai)葉(xie)七(qi)片(pian)，搗和(he)人乳，取汁灌入鼻內，須臾痰涎從口(kou)(kou)鼻出，且“無艾(ai)亦可(ke)”。如果配伍黃連、丹(dan)皮、當歸、生(sheng)地，對(dui)于導頭面之(zhi)火熱下(xia)行，效果更(geng)佳，如加味(wei)清胃(wei)散。另有(you)報(bao)道用(yong)牛(niu)膝(xi)、甘草水煎(jian)劑治療麻(ma)疹合并喉炎(yan)，采取少量頻服的方式，治療117例，有(you)效率達98.3%。對(dui)于牙齦腫(zhong)痛由(you)于虛火上炎(yan)者，可(ke)以用(yong)本品配伍熟地、龜板(ban)、黃柏，少佐(zuo)砂仁、肉桂，效佳。
上溢之血 本品苦泄下(xia)降(jiang)，能引血(xue)下(xia)行，以降(jiang)上炎之(zhi)火，故可治血(xue)熱妄行之(zhi)吐血(xue)、衄(nv)血(xue)，常(chang)與白茅根、小(xiao)薊、側柏葉(xie)、梔子等(deng)同用；如(ru)果是陰虛火旺所致的齒衄(nv)，可以配(pei)伍石膏(gao)、生地(di)、麥冬、知(zhi)母等(deng)同用，即玉(yu)女(nv)煎。現代有報道稱用牛(niu)膝(xi)、仙鶴草、赭石三味(wei)等(deng)分，治療鼻(bi)衄(nv)110例，均(jun)獲(huo)痊(quan)愈。此(ci)皆借牛(niu)膝(xi)引血(xue)下(xia)行之(zhi)力而(er)獲(huo)效。
肝陽之風 牛膝(xi)能(neng)引血(xue)下行，使(shi)浮越之(zhi)亢(kang)陽下潛，常與赭石、生(sheng)牡蠣(li)、生(sheng)龜甲等配伍(wu)，即張錫(xi)純先生(sheng)的(de)(de)鎮肝熄風湯(tang)。筆(bi)者在(zai)臨床上經(jing)常運用此方，對(dui)于肝陽上亢(kang)所致(zhi)的(de)(de)頭暈耳鳴(ming)，如(ru)坐舟(zhou)車，血(xue)壓升(sheng)高，甚(shen)則肢體(ti)麻木，臂如(ru)蟲行者均可取效。
引藥下行
引(yin)藥(yao)(yao)下(xia)行(xing)是(shi)牛(niu)(niu)膝(xi)(xi)的另一重(zhong)要功(gong)效(xiao)，最早提出(chu)這(zhe)一觀點的是(shi)朱丹溪，他(ta)在《本(ben)草衍(yan)義補遺》中說：“牛(niu)(niu)膝(xi)(xi)能(neng)引(yin)諸(zhu)藥(yao)(yao)下(xia)行(xing)，筋(jin)骨痛風在下(xia)者(zhe)，宜(yi)加用(yong)之(zhi)。其(qi)(qi)(qi)性雖下(xia)行(xing)走筋(jin)，然滑(hua)利之(zhi)品，精氣不(bu)固者(zhe)，終(zhong)非所(suo)宜(yi)。得酒(jiu)蒸(zheng)則(ze)能(neng)養(yang)(yang)筋(jin)，生(sheng)用(yong)則(ze)去惡血(xue)(xue)。其(qi)(qi)(qi)治(zhi)腰(yao)(yao)(yao)膝(xi)(xi)痛不(bu)可屈伸(shen)(shen)足痿之(zhi)病，非取(qu)其(qi)(qi)(qi)養(yang)(yang)血(xue)(xue)營筋(jin)之(zhi)力(li)。”自(zi)此(ci)(ci)之(zhi)后，臨床醫家對(dui)(dui)于(yu)腰(yao)(yao)(yao)膝(xi)(xi)以(yi)(yi)下(xia)疾(ji)病多以(yi)(yi)之(zhi)作(zuo)為(wei)引(yin)經之(zhi)藥(yao)(yao)。至(zhi)民(min)國張錫(xi)純對(dui)(dui)此(ci)(ci)理(li)解更深，他(ta)說：“牛(niu)(niu)膝(xi)(xi)原為(wei)補益之(zhi)品，而(er)善引(yin)血(xue)(xue)下(xia)注(zhu)，是(shi)以(yi)(yi)用(yong)藥(yao)(yao)欲其(qi)(qi)(qi)下(xia)行(xing)者(zhe)，恒(heng)以(yi)(yi)之(zhi)為(wei)引(yin)經。故善治(zhi)腎虛腰(yao)(yao)(yao)疼(teng)(teng)腿(tui)疼(teng)(teng)，或(huo)膝(xi)(xi)疼(teng)(teng)不(bu)能(neng)屈伸(shen)(shen)，或(huo)腿(tui)痿不(bu)能(neng)任地。兼(jian)治(zhi)女(nv)子月閉(bi)血(xue)(xue)枯，催生(sheng)下(xia)胎，又善治(zhi)淋痛，通利小(xiao)便，此(ci)(ci)皆其(qi)(qi)(qi)力(li)善下(xia)行(xing)之(zhi)效(xiao)也。……愚因悟得此(ci)(ci)理(li)，用(yong)以(yi)(yi)治(zhi)腦充血(xue)(xue)證，伍以(yi)(yi)赭(zhe)石、龍(long)骨、牡(mu)蠣(li)諸(zhu)重(zhong)墜(zhui)收斂之(zhi)品，莫不(bu)隨手奏效(xiao)，治(zhi)愈者(zhe)不(bu)勝記矣(yi)。”根(gen)據牛(niu)(niu)膝(xi)(xi)的下(xia)行(xing)作(zuo)用(yong)，凡腰(yao)(yao)(yao)膝(xi)(xi)以(yi)(yi)下(xia)病變皆可用(yong)牛(niu)(niu)膝(xi)(xi)作(zuo)為(wei)首選之(zhi)藥(yao)(yao)，在某些地區甚(shen)至(zhi)有(you)“無牛(niu)(niu)膝(xi)(xi)不(bu)過膝(xi)(xi)”之(zhi)說，意即(ji)如果(guo)不(bu)配(pei)伍牛(niu)(niu)膝(xi)(xi)，則(ze)方(fang)劑的藥(yao)(yao)效(xiao)作(zuo)用(yong)達不(bu)到膝(xi)(xi)關節以(yi)(yi)下(xia)，此(ci)(ci)語雖說過于(yu)武斷牽強(qiang)，但也體現(xian)出(chu)醫者(zhe)對(dui)(dui)其(qi)(qi)(qi)引(yin)藥(yao)(yao)下(xia)行(xing)功(gong)效(xiao)的重(zhong)視(shi)。筆者(zhe)在臨床上治(zhi)療腰(yao)(yao)(yao)部以(yi)(yi)下(xia)，尤其(qi)(qi)(qi)是(shi)膝(xi)(xi)關節以(yi)(yi)下(xia)病變，常常有(you)意識地配(pei)伍本(ben)品以(yi)(yi)引(yin)藥(yao)(yao)下(xia)行(xing)。如對(dui)(dui)于(yu)風濕痹痛、跌打(da)損(sun)傷(shang)、瘀血(xue)(xue)阻(zu)滯引(yin)起的下(xia)肢疼(teng)(teng)痛、麻木、冷(leng)感等，常在辨證方(fang)藥(yao)(yao)中加入牛(niu)(niu)膝(xi)(xi)而(er)取(qu)效(xiao)。
牛膝常(chang)用(yong)量(liang)為10~15克(ke)，據臨床需要(yao)可以增加劑(ji)量(liang)。中(zhong)氣下陷，脾虛泄瀉，下元不(bu)固，夢遺失精(jing)，月經過多者不(bu)宜，由于其有動胎之力，故(gu)孕婦忌用(yong)。
牛(niu)(niu)膝(xi)(xi)(xi)雖有懷(huai)(huai)牛(niu)(niu)膝(xi)(xi)(xi)與川(chuan)(chuan)牛(niu)(niu)膝(xi)(xi)(xi)兩種，而且兩種也都是莧科(ke)植物，但(dan)是二者還(huan)是有一定區分的。嚴(yan)格來(lai)說(shuo)，懷(huai)(huai)牛(niu)(niu)膝(xi)(xi)(xi)是正(zheng)品，而川(chuan)(chuan)牛(niu)(niu)膝(xi)(xi)(xi)為(wei)副品。牛(niu)(niu)膝(xi)(xi)(xi)很早就被載(zai)入到(dao)本(ben)(ben)草書中，但(dan)是唐代(dai)以(yi)前記載(zai)的牛(niu)(niu)膝(xi)(xi)(xi)，只是懷(huai)(huai)牛(niu)(niu)膝(xi)(xi)(xi)。川(chuan)(chuan)牛(niu)(niu)膝(xi)(xi)(xi)之(zhi)名首(shou)見于(yu)唐代(dai)，宋代(dai)以(yi)后，川(chuan)(chuan)牛(niu)(niu)膝(xi)(xi)(xi)的用途才逐漸(jian)擴大。從功效來(lai)看，雖然二者基本(ben)(ben)相似(si)，但(dan)是懷(huai)(huai)牛(niu)(niu)膝(xi)(xi)(xi)補益肝(gan)腎(shen)較強，而川(chuan)(chuan)牛(niu)(niu)膝(xi)(xi)(xi)活血(xue)通利的作(zuo)用更佳。因此，治療肝(gan)腎(shen)不足所致痿痹病證(zheng)用懷(huai)(huai)牛(niu)(niu)膝(xi)(xi)(xi)為(wei)宜(yi)，而用于(yu)跌(die)撲損(sun)傷、女子經閉、尿血(xue)血(xue)淋(lin)等證(zheng)，則宜(yi)選用川(chuan)(chuan)牛(niu)(niu)膝(xi)(xi)(xi)。
牛(niu)(niu)(niu)膝(xi)生(sheng)用(yong)、熟(shu)用(yong)，功效(xiao)也(ye)不盡(jin)同。《藥品化義》說：“牛(niu)(niu)(niu)膝(xi)……生(sheng)用(yong)則宣，主治癃閉管澀，白(bai)濁(zhuo)莖痛，瘀血(xue)阻(zu)滯，癥瘕凝結，婦人經閉，產后惡(e)阻(zu)，取其活(huo)(huo)血(xue)下(xia)行之功也(ye)；酒制熟(shu)則補，主治四(si)肢(zhi)拘攣，腰膝(xi)腿痛，骨筋(jin)流痛，瘧(nve)疾燥渴(ke)，老年失溺，取其補血(xue)滋陰之功也(ye)。”由于(yu)生(sheng)用(yong)與(yu)熟(shu)用(yong)、懷牛(niu)(niu)(niu)膝(xi)與(yu)川牛(niu)(niu)(niu)膝(xi)有(you)別，故(gu)用(yong)于(yu)補益時以(yi)酒制懷牛(niu)(niu)(niu)膝(xi)為(wei)佳(jia)，而(er)通利活(huo)(huo)血(xue)時則以(yi)生(sheng)用(yong)川牛(niu)(niu)(niu)膝(xi)為(wei)佳(jia)。醫者(zhe)當須注意。
龍膽草為龍膽科植物龍膽或三花龍膽的根與根莖。性寒，味苦，歸肝、膽經，有瀉肝膽實火、除三焦濕熱之效。
清肝膽濕熱
本品苦能燥濕，寒能清熱，主入肝、膽經，故對于肝膽濕熱郁火所致諸病為第一要藥。凡肝膽濕熱之黃疸、陰腫陰癢、帶下濕瘡，用之均有良效。
濕熱黃疸 治肝膽濕熱熏蒸，膽汁外溢所致的陽黃，常與茵陳、梔子、大黃、鳳尾草等藥同用，亦可配伍他藥治療陰黃。然龍膽草苦重寒勝，故應注意不宜過用以免涼遏冰伏。筆者在臨床上治療肝炎、藥物性肝損傷等所致的各類陽黃，喜用劉渡舟先生所創制的柴胡解毒湯，如果熱重于濕，多加入此藥，常用量10~15克即可。如嫌其藥性過涼，在方中少佐3~5克桂枝即可。現代藥理研究證明，龍膽草水提物、醇提物均有很好的利膽作用，而本品所含的龍膽苷有直接的保肝作用，這可能是其治療濕熱黃疸的現代藥效機制，臨床可以參考。
陰腫陰癢 本品性沉重，易走下焦，清利濕熱之功較強，故對于濕熱下注所致的陰囊紅腫，甚則腫大如瓜，亮如水晶，墜脹疼痛，小便赤熱者，乃為必用之品，臨床常與梔子、木通、生地等藥同用，如龍膽瀉肝丸。《本草匯言》記載，治療陰囊發癢，搔之濕潤而不干，可以本品加五味子、劉寄奴同煎取汁，加入樟腦末，浸洗外用。筆者曾治療陰囊濕疹患者，內服中藥治療效果不佳者，開本方配合外用后治愈。對于婦科檢查無滴蟲、無感染的陰中瘙癢，以本品為主藥的龍膽瀉肝湯加減治療，也有良效，有資料報道，治療39例，總有效率達93.75%。
帶下淋證 濕熱下注可致婦人帶下之疾，而男女均可致淋證，本品由于善清下焦濕熱，故亦為常用之藥。如對于婦女帶下病，可與苦參、蛇床子、黃柏、蒼術等配伍，加入仙鶴草、雞冠花效果更為理想；對于濕熱淋證出現尿頻尿痛，甚則尿血，尿道澀滯，單用本品煎服即可，也可配伍瞿麥、梔子、滑石、扁蓄等，以提高療效。
濕疹濕瘡 濕熱內蘊導致濕疹、濕瘡，癥見皮膚瘙癢難耐，甚則破潰出黃水，由于本品為清利濕熱之佳品，故亦每為要藥。筆者常將其與黃柏、蒼術、牛膝、薏米、地膚子、徐長卿、赤芍、苦參、生地等配伍而取效。曾有一老干部，由于工作緊張勞累，精神壓力大，患下肢濕疹甚重，經京城很多皮膚科醫生治療，效果不甚理想，后聽他人介紹，求治于余。即以此方，重用龍膽草、黃柏、生石膏、水牛角，配合涼血藥，治療1周取效，月余皮疹消失，2月痊愈，至今數年未發。
瀉肝膽實火
龍膽草苦寒而入肝、膽經，為清瀉肝膽實火第一藥，如瀉青丸、龍膽瀉肝丸均以本品為主藥。故肝膽火盛者，恒用本品主之。《名醫別錄》有本品“益肝膽氣”之說，《本草綱目》釋義云：“相火寄于肝膽，有瀉無補，故龍膽之益肝膽之氣，正以其能瀉肝膽之邪熱也。”此言誠不虛也。
肝火脅痛 張景岳《本草正》云：“龍膽草，乃足厥陰、少陽之藥，大能瀉火。”肝膽實火逆于肝膽經脈，導致脅肋疼痛，攻沖脹悶，伴口苦、耳聾耳鳴等，常與梔子、黃芩、柴胡同用，如《醫方集解》之龍膽瀉肝湯。
肝火頭痛 肝火循經上沖于頭，出現頭痛、頭暈、目眩等癥，中老年人常伴血壓上升，大便秘結，此時用本品瀉肝火，可與梔子、大黃等同用，如《丹溪心法》當歸龍薈丸。劉渡舟先生對于肝火上沖之高血壓，頭暈頭痛如坐舟車者，曾創制一方治之，名曰三草芍甘湯，方由龍膽草、夏枯草、益母草、白芍、甘草組成，臨床每收桴鼓之效。經筆者所帶領的研究團隊證實，對于自發性高血壓大鼠，其降壓效應與尼莫地平相當，且降壓時長在尼莫地平之上，遠優于其他中藥降壓藥。現代研究證明，本品有鎮靜作用，大劑量有降壓作用，這兩個效應也有利于其治療肝火上炎所致的頭痛、頭暈以及血壓升高。
肝火目赤 肝開竅于目，肝火上炎，循經上沖則易發目赤腫痛。本品通過瀉肝經實火，能治肝膽實火上沖所致的目赤目腫甚則目中生翳，故張元素稱其為“治眼中疾必用之藥”。臨床上可單用煎水洗眼，或與清肝藥菊花、梔子、夏枯草、青葙子、決明子等同用內服。
肝火耳聾 肝火上沖所致的耳聾耳鳴也為臨床上的常見病、多發病，本病對人體聽力損害甚大，而中西醫均缺乏有效的治療藥物。尤其是突發性耳聾，發病突然，若治療不及時往往致人失聰，如能及時用大劑量龍膽草治療，大多數可取得遠勝于西藥及常規中藥治療的佳效。一圍絕經期耳聾的患者，發病后半月內完全失聰，經他醫用平肝潛陽法不效，求治于國醫大師張志遠先生，用龍膽草30克，丹皮10克，菖蒲10克，苦參10克，山梔子15克，大黃3克，連用10天，即有聽覺恢復，后龍膽草增至40克，再服2周，基本恢復正常。筆者學習張老經驗，治療此病近10人，均獲佳效。其中一患者，原右耳失聰，3月前因生氣著急而突發左側耳聾，對面說話須大聲喊才能聽到少許，平時音聲完全無反應，經三甲醫院五官科診斷為突發神經性耳聾，經高壓氧、輸液、服用營養神經藥等治療3月無效，求余診治。辨證為肝火上擾之耳聾，與龍膽草40克，菖蒲15克，全蟲5克，蟬蛻10克，大黃5克，梔子12克，白芍20克，夏枯草30克，14劑。藥后聽力明顯好轉，繼服14劑后，聽力檢查明顯改善，能聽到正常說話聲，加減后繼服3月，左耳聽力恢復正常，失聰多年的右耳也可以聽到少許聲音。
纏腰火丹 帶狀皰疹，中醫稱為纏腰火丹，多由于肝火上炎或挾濕熱所致。對此病龍膽草也有佳效。據筆者經驗，此病初起之時，皰疹焮紅，疼痛難耐，多伴有大便秘結，小便黃赤，口苦等，此時最重要的治法就是重劑清泄肝膽火熱之邪，用大劑龍膽草、大黃、梔子、連翹，加用當歸、赤芍、元胡等，令人痛快泄利數次，則疼減而皰疹變淡變淺，再配合外治，可很快痊愈，且不留后遺疼痛。如治療不及時，往往病情遷延，數月疼痛不解，余臨床上遇此者多矣，甚者有數年而仍時發疼痛者。筆者萱堂老母，86歲時患此病，皰疹明亮焮紅，疼痛難忍，即用此法治愈，龍膽草用至20克，大黃用至10克，泄利3次即疼減疹平，配合外用涂藥，月余后即安，未留任何后遺癥。
除肝熱生風
肝經蘊熱，易化火生風。本品為肝膽兩經瀉火之品，對于肝膽實熱導致的熱盛驚風有效。如肝熱極而生風，癥見高熱驚厥，手足抽搐，常與黃連、牛黃、鉤藤、青黛、麝香等配伍，如《小兒藥證直訣》之涼驚丸。若見小兒急驚，熱盛抽搐，或肝經郁火，煩躁易怒，不能安臥，尿赤便秘者，常與梔子、大黃、防風、當歸、川芎、龍腦同用，以瀉火清熱，通腑定驚，如同書中的瀉青丸。
龍膽(dan)草內服(fu)入湯(tang)劑(ji)，根據(ju)治療(liao)目的不(bu)同而決定劑(ji)量(liang)(liang)，小劑(ji)量(liang)(liang)3克左右可以刺激胃液分泌有健胃之功；對于肝火(huo)亢(kang)盛者(zhe)(zhe)，可以用至30~40克，尤其(qi)是(shi)肝火(huo)耳聾與纏腰火(huo)丹時，有是(shi)證即用是(shi)藥(yao)，不(bu)必(bi)為苦寒傷(shang)胃所囿。由于本品苦寒傷(shang)胃，故不(bu)可長期(qi)大(da)量(liang)(liang)服(fu)用；脾虛(xu)，平素大(da)便(bian)偏溏者(zhe)(zhe)慎用；陰虛(xu)津(jin)傷(shang)者(zhe)(zhe)用本品時也(ye)要注意(yi)，以免苦寒燥津(jin)。
大熊敦敏 中(zhong)醫(yi)思維(wei)十
脫發(fa)(fa)，頭(tou)發(fa)(fa)早白是現(xian)代一部分中青年人的心頭(tou)噩夢(meng)，嚴重(zhong)的甚至造成巨大的心理障(zhang)礙。
當然這種煩惱古人也有，他們是怎么做的呢？ 晉·葛洪《肘后方》記載，“ 生發方，取側柏葉，陰干作末，和油涂之 。”《本(ben)草綱目》謂其主(zhu)治“頭發不生”，“浸油，生發。燒汁，黑(hei)(hei)發。和(he)豬脂，沐發長(chang)黑(hei)(hei)。”
在民間，還廣泛流傳著(zhu)側柏(bo)葉治白發、脫發的小偏方：
鮮側柏葉二兩，用60度白酒一斤，浸一個月后，每次用少許擦頭，半小時后洗頭。 每日一次，擦(ca)完所浸之(zhi)藥為(wei)止(zhi)。頭發(fa)會慢慢生長回(hui)正常，此方乃有生發(fa)和烏(wu)須黑(hei)發(fa)之(zhi)作用。
這(zhe)個民(min)間流(liu)傳的小偏(pian)方是(shi)否有效呢？我們還是(shi)需要從中醫對脫(tuo)發的認識開始(shi)說起(qi)。
中醫對脫發的認識
中醫對脫(tuo)發(fa)的認識(shi)，主要(yao)有四大(da)理論：
第一. 腎虛的問題。
第二. 血熱的問題。
第三. 血虛的問題。
第四. 淤血的問題。
先說腎虛(xu)。中醫(yi)認(ren)為(wei)，腎，其華在發(fa)，就是(shi)說腎好(hao)不(bu)好(hao)直(zhi)接決定頭發(fa)茂盛不(bu)茂盛。為(wei)什么這樣說呢？在中醫(yi)看來，腎五行屬水(shui)，而毛發(fa)就好(hao)比土地上的草(cao)木(mu)，如(ru)果腎虛(xu)缺了水(shui)，那么草(cao)木(mu)肯定會枯(ku)死、脫(tuo)落，如(ru)同沙漠不(bu)生草(cao)。腎有腎陰(yin)、腎陽，在這里最主要的是(shi)腎陰(yin)，因為(wei)腎陰(yin)更接近(jin)水(shui)的滋潤性。
其次，是血虛(xu)的問題。中(zhong)醫理論(lun)認(ren)為，發為血之余，血液(ye)(ye)充足了，頭發才能得(de)到營(ying)養才能茂盛。如(ru)果說腎陰(yin)是水，那么血液(ye)(ye)就好比營(ying)養肥料(liao)，兩者缺一不可。
第三，血熱也會導致頭發脫落。頭皮中有豐富的毛細血管，這些毛細血管給毛囊提供營養，如果血管內的血熱了，毛囊就會被燙死。就好比你拿著熱水澆花一樣，后果可想而知。 血熱不但會導致脫發，常見的還會導致少白頭。
最(zui)后(hou)，是淤(yu)血(xue)(xue)(xue)(xue)的問題。清代(dai)著(zhu)名的醫(yi)家王(wang)清任曾在(zai)《醫(yi)林改(gai)錯》中說(shuo)，如果淤(yu)血(xue)(xue)(xue)(xue)阻塞了(le)頭皮(pi)中的血(xue)(xue)(xue)(xue)絡（毛細血(xue)(xue)(xue)(xue)管），那么也(ye)會(hui)導致脫發。這個道(dao)理也(ye)很簡單(dan)，如果給頭皮(pi)供血(xue)(xue)(xue)(xue)的血(xue)(xue)(xue)(xue)管都堵了(le)，那么毛囊得不到營養(yang)，肯定死路(lu)一(yi)條。
明白了中醫(yi)的道理，我們就能讀懂第三屆國醫(yi)大師張志遠先生的得意之方“美頭(tou)煎”了。
女貞子20 旱蓮草20 生地黃15 熟地黃15 當歸10 丹參10 紅花6 川芎6 側柏葉10
這個方子，可以針對 斑禿、雄禿 起到(dao)作用，應用一個月，或許就能給你一個驚喜。
此(ci)方又叫(jiao)“脫發有效(xiao)湯(tang)”，其中，女貞子、旱(han)蓮草(cao)、熟(shu)地黃3味(wei)是滋補腎(shen)水、滋腎(shen)陰(yin)，給(gei)毛發提供(gong)水源的。
大(da)家可(ke)以觀(guan)察一下，女(nv)貞子(zi)的(de)(de)形(xing)狀(zhuang)和腎的(de)(de)形(xing)狀(zhuang)差不多，表面是黑色，中(zhong)醫(yi)基礎理論中(zhong)說(shuo)，黑色入腎，所以女(nv)貞子(zi)肯定是補腎的(de)(de)。
另(ling)外，女(nv)(nv)貞女(nv)(nv)貞，因為它經冬不落，仍(reng)然保(bao)持翠綠之色，從春至(zhi)冬有從一而終的貞潔之操，所以才取名叫女(nv)(nv)貞。
冬天性寒，寒主水，女貞子稟受冬天水寒之氣，水寒屬陰，所以 女貞子是滋補腎陰的良藥。
旱(han)蓮草，又叫墨(mo)旱(han)蓮，生長于旱(han)地，花(hua)實如(ru)蓮房，所(suo)(suo)以(yi)叫旱(han)蓮，如(ru)果采它一個枝葉(xie)輕(qing)輕(qing)揉搓，即有墨(mo)汁樣(yang)液(ye)體(ti)流出(chu)，能把手(shou)染黑，所(suo)(suo)以(yi)名(ming)叫墨(mo)旱(han)蓮。
墨旱蓮 又叫鱧腸，鱧，在古代是指黑魚，因為黑魚的腸子細長而黑，和墨旱蓮相似，所以墨旱蓮又叫鱧腸。正因為它顏色漆黑，根據中醫理論，黑色可以入腎，質地又黏滑有汁液，所以可以 補腎陰。
女(nv)貞子和旱蓮草組成一個(ge)小(xiao)方子叫做“二至(zhi)丸”，因為女(nv)貞子冬至(zhi)時采(cai)收(shou)，旱蓮草夏至(zhi)時采(cai)收(shou)，所以叫二至(zhi)丸。
《醫方集解》中說： “二至丸，此足少陰（腎）藥也，能益下而榮上，強陰而黑發也” 。就(jiu)是說，二(er)至丸能(neng)夠通過補(bu)腎取到黑發的效果。
熟地黃，大家看上去黑乎乎，發黑發亮，前文已說，根據中醫理論，黑色入腎，黏膩的油汁能滋陰，所以古人說， 熟地大補腎水 。是滋(zi)腎陰最(zui)常用(yong)的一味藥。
說完了(le)補(bu)腎水的，我們來說說補(bu)血的一組。
補(bu)血藥中，最(zui)主要的(de)就是一味當歸，被譽為補(bu)血之圣藥。當歸補(bu)血，大家都(dou)很熟(shu)悉，比如電視廣告的(de)當歸補(bu)血顆粒，當歸阿膠(jiao)口服液，都(dou)有(you)當歸的(de)身影，婦科應用(yong)極多。
為何當(dang)歸能(neng)補(bu)血？因(yin)為當(dang)歸里含有(you)很(hen)多(duo)油分，古人(ren)把(ba)含油多(duo)的當(dang)歸稱之為“油當(dang)歸”，民國年(nian)間名醫張錫純說過，當(dang)歸“液濃(nong)而甘”，可以內潤(run)臟腑，這(zhe)說明(ming)當(dang)歸之所(suo)以能(neng)夠補(bu)血，是(shi)因(yin)為它質(zhi)地滋潤(run)，細細觀察當(dang)歸切片(pian)，的確質(zhi)地滋潤(run)。
質地滋潤的東西和血液滋潤之性比較接近，可以發揮濡潤的功效，而且，當歸顏色棕紅色，紅色是血的顏色，紅可入血，所以 當歸能夠補血。
說完滋陰和補血，我們再(zai)來說說清血熱(re)的側(ce)柏葉和生地黃。
側柏葉 ，長得跟松樹有點相似，但它的葉子是扁的，它的作用是 清熱涼血。
為什么側(ce)柏(bo)(bo)能(neng)清熱涼血(xue)(xue)呢？因為側(ce)柏(bo)(bo)葉(xie)經冬(dong)不凋，稟受秋冬(dong)寒氣(qi)，所以(yi)它能(neng)清熱。能(neng)清熱涼血(xue)(xue)的(de)藥有(you)很(hen)多，但是能(neng)對生發(fa)有(you)特殊作(zuo)用的(de)，只(zhi)有(you)側(ce)柏(bo)(bo)葉(xie)一個，所以(yi)有(you)人脫(tuo)發(fa)，就(jiu)買一把(ba)側(ce)柏(bo)(bo)葉(xie)泡(pao)酒，浸泡(pao)一周后，每天(tian)用棉簽涂幾次，也(ye)有(you)生發(fa)作(zuo)用。側(ce)柏(bo)(bo)冬(dong)天(tian)不落葉(xie)，不正像人們希望的(de)那樣(yang)，頭(tou)發(fa)也(ye)能(neng)堅持(chi)不落嗎？
生地黃，大家可以看看圖片，它是剛采出來的鮮生地經過日曬后變黑形成的，它還保留著新鮮地黃的涼性（一般來說，鮮草藥性涼），涼能清熱，所以 生地能涼血。
如果把生地(di)黃九蒸(zheng)九曬，就成了熟地(di)，熟地(di)的滋膩之性(xing)很大，就變(bian)成滋補腎陰的藥了。
以上是補腎、補血、涼血組，最后，我們看看丹參、紅花、川芎這三味藥，這都是活血的藥物， 通過活血，改善頭皮微循環，就能改善毛囊生存環境。
丹(dan)參，大(da)家也不陌生，現(xian)在很多老年人有冠(guan)心(xin)病，都會用(yong)丹(dan)參泡茶喝，為什(shen)么(me)用(yong)丹(dan)參泡茶治(zhi)療冠(guan)心(xin)病呢？
因為 丹參能活血化瘀 ，把冠(guan)狀動脈(mo)的瘀血化掉，血脈(mo)通(tong)了，通(tong)則(ze)不(bu)痛，就能減少心絞痛。
丹參皮部呈現紅棕色，紅色入心、入血脈，所以 丹參可以作用于心臟以及各級血絡。
又(you)因為(wei)它的味道是略苦的，略苦則微寒，所(suo)以丹參可以入(ru)血(xue)(xue)涼血(xue)(xue)。又(you)因為(wei)它是參類(lei)，參可以補(bu)益(yi)，能(neng)補(bu)血(xue)(xue)，所(suo)以丹參可以祛(qu)瘀生(sheng)新而不傷正氣。全身上下凡有(you)淤血(xue)(xue)皆可運用。
紅(hong)花也是紅(hong)色(se)的，在古代，紅(hong)花是一種紅(hong)色(se)染料，還能做胭(yan)脂。因(yin)為它顏色(se)是紅(hong)色(se)的，所以可以入心、入血脈。
另外，紅花是辛味的，辛味能走氣，加速氣的行走，所以 紅花能入血、行氣，氣行則血活 。全身(shen)上下(xia)凡有淤血(xue)皆可運用，能令淤血(xue)行走(zou)散開。
比(bi)如跌(die)打損傷(shang)了，因為瘀(yu)血阻滯，所(suo)以不(bu)通則痛，抹(mo)上一點紅花跌(die)打油，就(jiu)能促(cu)進瘀(yu)血散開，起到止痛作用。
川芎，更不用說，是活血第一藥，著名的速效救心丸中就有川芎，川芎具有一股濃烈的辛香氣，凡是香氣濃厚的藥物，古人認為都具有行散之力，因為若不能行散，它的味道是無法發散到遠處去的，所以 川芎可以行氣，可以活血，氣一行散，就能推動淤血散開。
現代(dai)研究證實，川芎能夠預防血栓形成，所以活血作用是肯定的。
到這里整個(ge)方(fang)子的(de)(de)(de)藥物(wu)就全(quan)部介紹完了，該方(fang)集補陰、補血、涼血、活血于(yu)一(yi)體，全(quan)方(fang)位改善頭皮毛囊的(de)(de)(de)環境，供給足夠(gou)的(de)(de)(de)水分和營養，祛除阻礙毛囊生長(chang)的(de)(de)(de)病(bing)理產物(wu)，堅持服用(yong)一(yi)個(ge)月，會(hui)收到比較好的(de)(de)(de)療效(xiao)。
以上內容選自：中國中醫藥報，2017.08.11，作者盧燦輝、王穎川、鄭婷。
側柏葉生發烏發的偏方與現代研究
我們再回(hui)到(dao)文(wen)章開篇(pian)提出的那個問題：側柏葉泡白酒真的可以(yi)生發(fa)烏發(fa)嗎？
側(ce)(ce)柏葉在(zai)治療脫發方面的功效(xiao)，在(zai)王燾《外臺秘要》載：“生側(ce)(ce)柏葉一升，附子（炮）四枚，豬膏三(san)斤。上(shang)二味末，以膏三(san)斤，和(he)為三(san)十丸。用(yong)布裹(guo)一丸，內煎(jian)沐(mu)頭汁中，令發長(chang)不復落也(ye)。”
側(ce)(ce)柏葉泡白酒治療脫發(fa)的偏方(fang)在(zai)《中(zhong)華本草》可以(yi)查看到(dao)：側(ce)(ce)柏葉30g，切碎，浸于60% 75%乙醇100mL中(zhong)，7天后濾去渣，涂擦毛發(fa)脫落部位，每日3次，治療160例(li)(li)，顯效33例(li)(li)，有效91例(li)(li)，總有效率77.5%。
側柏葉不僅能(neng)(neng)生(sheng)發(fa)還(huan)能(neng)(neng)烏發(fa)，《日華子本草》謂本品(pin)能(neng)(neng)“黑潤鬢發(fa)”，血熱引(yin)起的頭(tou)發(fa)早白經常用(yong)側柏葉30 50g煎(jian)湯洗(xi)頭(tou)能(neng)(neng)起到(dao)疏風清(qing)熱、涼血止癢、烏發(fa)的作用(yong)。但(dan)如果是遺傳(chuan)等(deng)原因導致(zhi)的白發(fa)，就沒有效果哦。
現代(dai)藥理研究(jiu)表明，側柏(bo)葉主要成(cheng)分為揮發(fa)油、黃(huang)酮(tong)類和鞣質等，具抑菌抗炎(yan)、擴脹(zhang)血管和祛屑(xie)防脫(tuo)及能生(sheng)須發(fa)等功效。可改善毛(mao)囊發(fa)育生(sheng)長，同時對金黃(huang)色葡萄球菌、白(bai)色葡萄球菌等具有抑制作用，能去頭(tou)皮(pi)屑(xie)，促(cu)進頭(tou)發(fa)再生(sheng)，增強(qiang)毛(mao)囊代(dai)謝功能。
浙江大學醫學院也曾經有過(guo)一項動物實驗，用(yong)紅花、當(dang)歸、生側(ce)柏(bo)葉混合煎(jian)煮(zhu)，研究結(jie)果表明，煎(jian)煮(zhu)液對小鼠觸須毛囊(nang)起到了明顯(xian)刺激生發的作用(yong)。
所以，側(ce)柏葉(xie)泡白酒助生發烏發的(de)偏方還是有科學依據(ju)的(de)。
國醫大師方和謙（1923年-2009年），生前系首都醫科大學附屬北京朝陽醫院主任醫師、教授。從醫60余載，幼承家訓，勤于治學，擅長治療疑難雜癥，尤對呼吸系統、心腦血管及肝膽系統疾病有獨到之處。專著有《北京市流行性乙腦炎治療紀實》、《中國現代百名中醫臨床家·方和謙》等。筆者通過學習有關著作，現將其用藥配伍經驗總結如下：
潛心傷寒重扶正
方和謙對《傷寒論》、《金匱要略》進行考據求源、引經據典的研究，每篇都有撰寫的講稿。他認為中醫只有在深刻領會仲景學術的基礎上，才能融會貫通，靈活運用。而「陰陽自和，必自愈」是對所有疾病治療原則的高度概括；陽明病是里熱燥火為患的疾病；少陰分寒化、熱化兩類，寒化有四逆湯、白通湯、通脈四逆湯、真武湯、附子湯、桃花湯、吳茱萸湯、麻黃附子細辛湯8方；熱化有黃連阿膠湯、豬苓湯2方。治喘有桂枝加厚樸杏子湯、麻黃湯、小青龍湯、葛根芩連湯、麻杏石甘湯、白虎湯、大承氣湯、大陷胸丸、苓桂術甘湯、真武湯、十棗湯、瓜蒂散、三物白散、小柴胡湯，分別適用于不同病證。
方和謙對古方學以致用，所謂師其法而不泥其方。如小柴胡湯為和解劑，是少陽病的代表方劑，既用于外感病，又用于內傷病，還用于尿路系統病、月經病，應用范圍很廣，但脾虛、濕溫者慎用。痰飲分痰飲、懸飲、溢飲、支飲4種，可選用苓桂術甘湯、己椒藶黃湯、大小青龍湯、五苓散及二陳湯等。他同時有所創新，如酸棗仁湯治虛煩不得眠，取竹皮大丸中的竹茹、白薇加入，對陰虛臟燥失眠效果顯著。他雖精通傷寒，但主張經方和時方合用，以滿足疾病譜的發展需要。如根據三焦辨證，上焦用桑葉、菊花、連翹；中焦用藿香正氣之類；下焦用大定風珠、三甲復脈湯等。
方和謙強調扶正固本，臨證治療時注重滋補法，自擬滋補湯（黨參、茯苓、白術、炙甘草、當歸、熟地、白芍、官桂、陳皮、木香、大棗），集益肺、養心、健脾、和肝、補腎于一方，用于治療五臟虛損疾病，可達到補益氣血、調和陰陽之目的。
專病論治有良效
方和謙擅治多種疑難雜癥，尤對呼吸、消化及心腦疾病有獨到之處。如治療咳嗽發熱者用桑葉、桑白皮、菊花、薄荷、杏仁、桔梗、連翹、蘆根、荊芥、白前、牛蒡子；肺氣失宣者用蘇葉、蘇梗、杏仁、炙杷葉、前胡、桔梗、陳皮、茯苓、法半夏、炙甘草、炙桑皮、荊芥、白前、炙紫菀、炙百部、麥冬、薄荷。哮喘屬虛者用淡干姜、茯苓、桂枝、炒白術、北細辛、五味子、炙甘草、法半夏、炒蘇子、黨參、麥冬、炙紫菀、白前；表虛者用炒蘇子、陳皮、法半夏、炙甘草、北細辛、前胡、桔梗、桂枝、厚樸、干姜、太子參、百合、麥冬、五味子。咳血肺熱傷絡者用太子參、麥冬、生熟地、百合、川貝母、桔梗、炙甘草、白芍、北沙參、玉竹、炙紫菀、知母、南藕節、炙杷葉；肺燥陰傷者用百合、生地黃、玄參、川貝母、甘草、桔梗、麥冬、白芍、當歸、仙鶴草、藕節、杏仁、炙紫菀、蘆根。黃疸者用茵陳、郁金、黃柏、土茯苓、澤瀉、車前子、連翹、枳殼、赤小豆、焦三仙；脅痛者用柴胡、黃芩、郁金、半夏、枳實、大黃、白芍、茵陳、川楝子、大豆卷、連翹、生姜；眩暈者用天麻、鉤籐、石決明、懷牛膝、生杜仲、夜交籐、石斛、茯苓、澤瀉、丹皮、玉竹、白菊花、薄荷；或鉤籐、薄荷、竹茹、麥冬、羚羊角粉、茯苓、枸杞子、生稻芽、百合等。
另外，胃痛虛實夾雜者用香砂六君子湯，肝胃不和者用和肝湯化裁；痞滿者用溫膽湯化裁；泄瀉脾虛者用參苓白術散，肝脾不和者用痛瀉要方，厥陰下痢者用白頭翁湯等；腹痛少腹久痛者用和肝湯加臺烏藥、熟地，右下腹痛者用逍遙散雞血籐、臺烏藥等。心悸者用生脈散、桂枝甘草湯合麥味地黃湯；心痛者用和肝湯加瓜蔞、半夏、郁金、陳皮等。中風者舒通經絡用大秦艽湯、小續命湯、獨活寄生湯，活血行痹用桃紅四物湯、補陽還五湯，息風化痰用鎮肝熄風湯、建瓴湯、天麻鉤籐湯，滋補扶正用地黃飲子、六味地黃湯、天王補心丹等。以上均據證選方用藥，靈活加減化裁，故而療效顯著。
和調升降保胃氣
方和謙善用和解法，以調和臟腑氣血，平衡陰陽水火，以及寒熱虛實、氣機升降出入，達到扶正祛邪目的。代表方劑有為小柴胡湯，還有調和腸胃的五瀉心湯，和調肝脾的四逆散、逍遙散。常用于調其疏泄失常所致的肝膽或肝脾不和之證，如慢性肝炎、膽囊炎、更年期綜合征等。他自創的和肝湯就是從逍遙散化裁而來，藥用當歸、白芍、黨參、茯苓、白術、柴胡、香附、薄荷、蘇梗、大棗，此方和中有補，補中有疏，體用結合，補瀉得當，用于治療肝脾氣血失和所致的各種疾病，如肝膽病、脾胃病、婦人臟躁等。可視證加減，肝炎加茵陳、黃芩、梔子、虎杖、五味子；膽石癥、膽囊炎加郁金、雞內金、枳殼、川楝子；慢性胃炎加陳皮、半夏曲、砂仁、蔻仁、炒谷麥芽；更年期綜合征加郁金、百合、麥冬、浮小麥；乳腺增生加大瓜蔞、青橘葉、蒲公英等，驗之臨床，療效頗佳。
方和謙在臨證時，首先判斷胃氣之有無，治療時注意顧護胃氣，對體壯者祛邪即是保護胃氣，虛弱者不忘胃氣為本。選藥屬中氣虛弱用黨參、黃芪、白術、甘草、大棗以補之，佐神曲、陳皮之補而不滯；中焦虛寒用干姜溫中，佐山藥、玉竹、石斛以防剛躁之性；濕盛者用薏苡仁、茯苓、蒼術以燥之；中脘氣滯用佛手、香櫞、陳皮理氣不傷陰；胃陰虛有熱用沙參、石斛、知母清之，胃燥者用玄參、麥冬、玉竹潤之。方和謙還注意用藥劑量少、藥味少、少用苦寒，常加入陳皮、木香防其礙胃，加入炒谷芽、生稻芽、焦神曲等以助運化。
運用方藥具匠心
方和謙在運用方藥中，堅持辨證合理，用藥少而力專，主張一病一方。方和謙很少用貴重藥品，力求簡、便、廉地解決問題。選擇方劑方面，如補中益氣湯為治氣虛清陽下陷之方，其中黃芪可用至15～20克，而升麻、柴胡最多不超過3克；四君子湯為治氣虛的基本方，可加味組成很多方劑應用，擴大了治療范圍；止嗽散治外感后久咳，常加蘇梗、薄荷、炙桑皮，肺熱加蘆根、炙杷葉、連翹，痰濕加茯苓、半夏、蘇子、杏仁、白芥子，陰虛加北沙參、麥冬、百合；六味地黃湯加荊芥穗、南藕節、車前子配伍治尿路感染所致血尿，效果良好。
運用藥物方面，如治咳常用麻黃、清半夏、紫菀、白前、百部、訶子、杏仁、蘇葉、陳皮、前胡、貝母、苦桔梗、蘆根、桑白皮、白果等；按性能分，宣肺有麻黃、荊芥、蘇葉、桑葉、牛蒡子、桔梗，肅肺有桑白皮、蘇子、萊菔子、葶藶子、枇杷葉、杏仁、厚樸等。止血藥喜用炭類，溫經用炮姜炭、側柏炭、艾葉炭、伏龍肝，清熱用地榆炭、川軍炭、黃柏炭、藕節炭，化瘀用血余炭、蒲黃炭，升陽走表用白及炭、鍛龍牡等。此外對于生炙甘草、生炙麻黃、荊芥、丹參、紫草、姜類等，也運用巧妙，獨具匠心。
總之，方和謙學驗俱豐，桃李眾多，對中醫藥事業貢獻很大。本文僅從用藥配伍方面予以簡述，希望后學進行深入研究，使之更好地為人民服務。
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