基于黄元御中气观浅谈乌梅丸

A Brief Discussion About Mume Pill Based on Huang Yuanyu's View of Middle Energizer Qi

黄元御认为,人与天地相参而化生元气,元气内蕴阴阳,阴阳之间便是中气,中气作为阴阳升降之枢纽,当枢纽运转。“中气左旋,则为己土;中气右转,则为戊土”,脾胃之气由此产生。脾以升为枢机,以阳气为用,以温运脾气,温升肾水,温畅肝阳,化生和风,温养君火为用;胃以降为枢机,以阴气为用,以清降水气,潜敛相火,生化肾水为用。中焦运化精微生血濡养周身;肝为血海,受纳余血,并运化血中之至精纯者化生胆汁;胆汁为水质,内裹相火,潜藏于下焦,蒸化肾水化生肝木温升而形成循环。中虚湿盛,致肝阳虚郁与肝血胆汁内生乏源,相火浮散,湿火际会,阴阳摩荡生风,可调治以乌梅丸。乌梅丸酸甘辛苦合用,调和中焦气机升降,温化湿邪,温畅肝阳,恢复肝血胆汁化生,用大剂酸性药物泻相火,敛阳熄风,具有温中燥化、养血暖肝、通畅郁结、潜相熄风之功。其酸苦辛甘并用的组方思路,基于中虚湿化病机之下肝阳、肝血、相火、肝风胶着为病的特殊病理机转,涵盖了后世关于厥阴风木为病的基本治疗思路。同时,风为百病之长,致病极多而常隐匿难觉,在清散外风之外,乌梅丸开拓了以酸甘柔养、崇土安相、酸苦泄相、酸敛肝风为代表的内风治疗思路。

Huang Yuanyu believed that humans are in conjunction with heaven and earth to transform ancestral qi,which contains yin and yang,with middle energizer qi serving as the pivot of the ascent and descent of yin and yang.When this pivot operates,the spleen ascends with yang qi,warms and circulates spleen qi,warms kidney water,soothes liver yang,transforms and harmonizes wind,and nourishes sovereign fire.The stomach descends with yin qi,clears and descends water qi,restrains ministerial fire,and generates kidney water.The middle energizer transports and transforms essence to generate blood and nourish the whole body.The liver,as the sea of blood,receives and transforms the most refined blood into bile;bile,containing water,wraps ministerial fire and hides in the lower energizer,steaming and transforming kidney water into liver wood that ascends and circulates.When the middle energizer is deficient and dampness is abundant,liver yang deficiency and stagnation lead to a lack of liver blood and bile generation,dispersal of ministerial fire,and the combination of dampness and fire,creating wind from the friction of yin and yang.Mume Pill can be used to regulate this.Mume Pill combines sour,sweet,bitter,and pungent flavors to harmonize qi movement ascending and descending of the middle energizer,warm and remove dampness,soothe liver yang,restore liver blood and bile formation,purge ministerial fire,restrain yang and eliminate wind with a large dose of sour medicinals.The formula has the function of warming the middle energizer and drying dampness,nourishing blood and warming the liver,smoothing stagnation,suppressing ministerial fire and eliminating.The combination of sour,bitter,pungent,and sweet ingredients in the formula is based on the special pathological mechanism of liver yang,liver blood,ministerial fire,and liver wind adhesion under the mechanism of deficiency and dampness,covering the basic treatment ideas of reverting yin wind wood as a disease in later generations.Moreover,wind is the root of all diseases,causing numerous illnesses that are often hidden and dificult to detect.In addition to clearing and dispersing external wind,Mume Pill opens a new path for treating internal wind with sour-sweet nourishing,earthempowering,sour-bitter dispersing ministerial fire,and sour-restraining liver wind methods.