연합뉴스 [1보] 문대통령 "개혁은 검경입장 떠나 국민위한 것…입법도 그러해야" [1보] 노정희 선관위원장 사의…"국민에 심려 끼쳐 사과" --------------------------------------------------------------------------------------- (충격) 문재인의 일자리예산 51조원 출처터졌다! 정성산 TV 문재인 일자리;예산 51조 중 50조원 전남 호남 광주 신안 편중 지원 https://www.youtube.com/watch?v=0tBvZzDXQ10 ------------------------------------------------------------------------------------ 문재인이 마지막으로 해야 할 일 이봉규TV https://youtu.be/N807w7w-rWg ------------------------------------------------------------------------------------ KH그룹 회장의 정체 ㄷㄷ 임청하 http://www.ilbe.com/view/11409306374 w1.JPG KH그룹 회장의 정체 ㄷㄷ....JPG 얼마전 알펜시아 리조트를 인수한 KH그룹 e1.JPG KH그룹 회장의 정체 ㄷㄷ....JPG 리조트계의 알짜로 평가 받는 알펜시아가 다소 듣보잡 회사에 인수당해 이런 소리가 있기도 했는데.... 그럼 KH그룹이 어떤 회사냐 01.27866530.1.jpg KH그룹 회장의 정체 ㄷㄷ....JPG 이런 회사임 w2.JPG KH그룹 회장의 정체 ㄷㄷ....JPG 얼마전에는 쌍용차 인수한다고 쌍방울과 손 잡기도 함 무엇보다도 KH그룹의 배회장이란 사람의 과거 행적이 진짜 엽기적임 납치 고문을 서슴없이 자행한 리얼 진짜 조폭 ㄷㄷ 요즘 조폭은 비리비리한 상장사 인수해서 회장 직함 다는게 일반적 대부3에 보면 마이클 꼴리오네가 바티칸 소유 회사 인수하려 하듯이 영화서는 실패했지만 한국에선 성공함 홍어인간아웃/ 일베 댓글 쌍방울 인수해서 그걸 토대로 여러 회사 인수하고 주가조작한 김성태도 목포새마을파 출신 조폭임. 이런 놈한테 변호사비 지원받은게 이재명... 이러니 이재명이 조폭과 호형호제한다는 말이 나오지.. 쌍방울 이번에는 쌍용차 인수한답시고 자기 회사 및 계열사 주식 폭등시키고 팔아치웠는데 금감원이라는 새끼들이 이런 거 조사도 안함. 금융계는 홍어들에 의해 완전히 썩어 문드러지고 있음. 윤석열 정권 되고 나면 금융계부터 싹다 도려내야 함 윤석열이 사실 금융범죄 수사 전문임 ---------------------------------------------------------------------------------- 조던 피터슨 : 자유시장 경제는 심오하게 평등하다 시장은 아주 계산적인 메커니즘으로 개인들의 가치를 모두 뭉뚱그려서 분권화 된 전체에 통합한다. 기업가들은 자본주의적 기업 윤리를 부끄러워하지 말아야 한다. Jordan Peterson on Austrian Economics: Free Markets Are "Profoundly Equitable" Peterson Joakim Book Jordan Peterson is a Canadian psychologist, lecturer, and intellectual with a comparative advantage in enraging the left-establishment elites. That’s a valuable trait on its own, but Peterson’s more profound contributions to cultural and intellectual life in the 2010s and 2020s lay in his YouTube lectures, books (primarily 12 Rules for Life and the recent Beyond Order), and public lectures that have drawn millions of people for deep conversations about biblical stories. It’s safe to say that his words have influenced and inspired countless people, improving life for one of the most overlooked and derided demographics in the West today: young, white, working-class men. The connection to Austrian economics and monetary regimes is not obvious, but it’s there. A few years ago, Jonathan Newman reflected that Peterson’s lecture series Maps of Meaning “presents a framework for human action with many similarities to that of Mises and Rothbard.” With extracts from Jordan Peterson, Ludwig von Mises, and Murray N. Rothbard’s work side by side, we see the striking resemblance in how these intellectuals see things like subjective valuation, the uncertainty of the future, and the role of action as demonstrating preference. Last year, Peterson interviewed both Bob Murphy and Saifedean Ammous explicitly to try to learn about the Austrian school and about bitcoin. Before that, he had had a ninety-minute conversation with four major bitcoin personalities to learn more about sound money and the current monetary system. After the conversation with Ammous, Peterson announced that he had acquired bitcoin for himself. In early April, at the premier bitcoin conference organized by the parent company of Bitcoin Magazine, BTC Media, Peterson was interviewed by Tuur Demeester for almost an hour and delivered a ringing defense of capitalism. Clearly, Peterson has absorbed much of the Austrian thinking he has been exposed to over the last year. Markets, Calculation, and Existential Necessities Peterson described himself “as somebody who regards the free market as an existential necessity.” Markets are the very calculative mechanism that aggregates individuals’ values into a decentralized whole. Nobody is in charge of London’s bread production, yet anyone in that city in the mood for a sandwich can easily acquire one. It’s the entrepreneurial function of an economy’s businessmen that makes this possible. Guided by the prices of inputs, an estimation of what consumers would pay for the product, and the allure of the profit that could follow, entrepreneurs put their wealth on the line. With skin in the game, businessmen supply value to others. If those others don’t see the value of what a business has produced or they don’t back words with monetary action, said business will be selected against in the free market. “The most appropriate way to understand something is to try it,” Peterson said, and that’s what entrepreneurship is. He discussed, at length, the troubles of an entrepreneur bringing a product to market, how to think about pricing, and profit as a guide for validating value brought to consumers. The fundamental ethics of capitalism follow: In a free market system, you have to offer people who could choose otherwise—freely—something they value—freely—then you have to deliver it, and it has to work reliably. All of that is ethical…. If I don’t do that, I’ll develop a very bad reputation very, very rapidly. His advice to those giving their entrepreneurial ventures a try is to not “be defensive on the ethics of your capitalistic enterprise”: You should be on the offensive, claiming, forthrightly, that what you’re doing is profoundly ethical—that you’re providing free people, free customers, the option to make free choices about what they value. It’s like: what’s wrong with that? The audience applauded loudly in approval. Running a business is ethical; capitalism is directed toward providing value for your fellow man. What, indeed, is wrong with that? The Tilt toward Totalitarianism Third parties can’t make value judgments on behalf of others. Austrian economics holds the subjective individual evaluation of means and ends in such high regard that it’s considered a foundational axiom of the praxeological edifice. Peterson seems to have embraced that Austrian insight, rallying against the interventionist and nudge kind of political proposals to have consumers act (more) according to the interest of some ruling entity. Peterson admits that it would be fine for government agencies or large corporations to guide our behavior like that if they could be right in their assessments—which he quickly objects that they could never be. You can’t make value judgments for other people: One of the fundamental axioms, in some sense, of a free market system is that the only way to properly compute the value of the emerging horizon of the future is by sampling—and perhaps summing—the free choice of a multitude of free agents. There is no central planning way that even in principle can substitute for that. Instead, what the entire economic market system does is use the array of choices that everyone makes as the mechanism that values new things as they emerge. Central planning types, they think they can just jump over that and save the planet, let’s say…. They think they can subordinate that computational mechanism to some sort of ethical or procedural algorithm. … there is no central planning way, even in principle, that can substitute for … the free market system. More nefariously, whenever we have tried, as we did extensively during the twentieth century of big government, the result has been horrific. The evidence from the twentieth century, claims Peterson, is that as soon as you subordinate free market mechanisms to central planning ethical dogmas, you catastrophically affect the economic system in a detrimental manner, but you destabilize the entire society and tilt it towards totalitarianism. We haven’t learned that yet, because there’s always a new generation of people that think that they’re smart enough to plan the world. To all aspiring central planners out there: despite your credentials, you are not smart enough to plan the world. So, please, stop trying. What separates Austrian economists from non-Austrians, in Peterson’s view, is the humility to accept that controlling a chaotic and complex system is not an option. Any complex process is going to have corrections—unintended consequences. Explicitly referencing areas as diverse as bank bailouts, the business cycle, and forest fires, he points to a greater truth: non-Austrians “think that they can smooth out those corrections and Austrians think that you should just let the corrections happen as locally as they possibly can.” More importantly—just leave them alone. Not because those who suffer because of bankruptcies or financial crises are not worthy of help, but because “your attempts to smooth out the corrections are actually going to amplify them and make them worse.” Jordan Peterson has come a long way on his Austrian journey. ---------------------------------------------------------------------------------------------- 오적산 운용 경험 오적산은 평위산, 이진탕, 계마각반탕, 사물탕, 감초건강탕, 영계출감탕 등 여러가지의 방제를 혼합해서 만든 방제로, 담, 한, 식, 기, 혈痰、寒、食、氣、血 의 오적을 해소한다고 해서 오적산이라 명명했다. 허리의 냉통, 심복의 비민, 한증, 요통, 좌골신경통, 위염, 대하, 월경 불순腰部冷痛、心腹痞悶、寒證、腰痛、坐骨神經痛、胃炎、帶下、月經不調 등에 광범하게 응용된다. *** 중국 의사 중에는 오적산으로 코로나를 치료한 사례도 있다. 來春茂：淺談五積散之體會 五積散首見《太平惠民和劑局方》，該書云：「調中順氣、除風冷、化痰飲。治脾胃宿冷，腹脅脹痛，胸膈停痰，嘔逆噁心，或外感風寒，內傷生冷，心腹痞悶，頭目昏痛，肩背拘急，肢體怠惰，寒熱往來，飲食不進，及婦人血氣不調，心腹撮痛，經候不調，或閉不通，並宜服之」。 處方： 蒼白朮各15g，桔梗18g 麻黃、枳殼、陳皮各15g 厚朴、乾薑各12g 姜半夏、茯苓、甘草、白芷 當歸、白芍、川芎、肉桂各9g 按：配方劑量與院方有所出入，例如原書蒼朮為72g改為蒼白朮各15g，系根據我的經驗配製，白朮健脾較蒼朮強，苦甘性緩；蒼朮辛苦性烈，故前者補多於散，後者散多於補，若脾虛濕困，補運兼施，宜二術同用。 制用法 （1）上藥共粉碎如黃豆般大粗末，文火炒黃髮香即可收貯，勿泄氣。成人每日用30g煎水去渣分2—3次服完。 （2）碾細過篩為細末，收貯勿泄氣，成人每次服3—5g，開水送下，或用生薑、紅棗、蔥頭等煎湯為引，依症情選用。 驗案舉例 1、慢性胃腸炎兼帶下證 1952年土改時，我們配合下鄉防病，在昭通大寨公社，該地是高寒山區，氣候嚴寒，治一李姓婦，年34歲，結婚十年未生育。大便溏泄已有四年，每日3——5次，無膿血，腹部鼓脹疼痛如妊娠狀，按之則覺舒適。並下白帶甚多，似米泔水般清稀。患者消瘦，怯冷，乏力，舌淡白，苔膩，脈沉細而緩。證屬脾腎虛汗作瀉，予五積散細末，每次服一包，日二次，早晚用姜棗湯送服，每包重6克，一周後症情明顯減輕，腹脹消退，大便白帶均減少，再給藥一月繼續服用。於53年夏季複診時病痊癒，面色紅潤，身體健康。 2、寒熱似瘧 魏××，男，52歲，教師。 於1963年前來我院門診。 初診：患者每日下午黃昏時先惡寒、後發熱，體溫測量在38.5℃左右。燒至一小時即出汗退涼，如瘧狀，同時感到兩臂及腰酸痛，並咳嗽、胸悶、痰帶風泡，胃納呆滯，飲食少思，舌苔白厚，脈虛數。如此已一月有餘，經注射複方奎寧，中藥服過人參敗毒散，小柴胡湯未效。證屬寒濕陰邪客於經絡，表里俱寒。予五積散粗末60克，每天煎服30克，蔥姜為引，兩劑服完，病竟豁然。 體會： 五積散是一張綜合性的大複方，用平胃散（蒼朮、厚朴、陳皮、甘草）健胃，祛濕，除脹滿，消食積；參以二陳湯（法夏、陳皮、茯苓、甘草）祛濕化痰，專主內傷生冷；又合桂枝麻黃各半湯去杏仁，姜、棗加白芷，兼治外感寒邪，解除頭身疼痛；加以四物去地黃，而合甘草乾薑為治血中受寒之聖藥；並配桔梗，枳殼一升一降，利胸膈，調氣除滿，以祛痰積氣積；內藏桂苓甘術湯以滌飲散邪；小半夏茯苓湯令未盡之飲取之從小便出，此雖內集十餘方，而不嫌冗雜者，得辛溫散邪之大旨也。綜觀全方，結構嚴密，運用曲當，頗為廣泛。本方雖為痰、寒、食、氣、血五積而設，但對表里內外，臟腑經絡之寒濕陰邪，悉皆治之。日人龍野一雄用治腰部冷痛、心腹痞悶、寒證、腰痛、坐骨神經痛、胃炎、帶下、月經不調（《中醫臨證處方入門》）。據所見，在農村行醫者大都備有五積散，該方運用範圍廣泛，醫生樂用，群眾歡迎，為常用有效驗方。 五積散氣味辛溫，既發汗又溫中，開郁順氣，厥功甚偉，為去寒濕之效方。陳修園云：「中脘作痛，手不可近，乃內外不和，外則寒氣凝於皮毛，內則垢濁停於中脘，當審其體之虛實而施治……實者宜五積散（《時方妙用》），又雲」表里俱寒，外而頭項強痛，內而肚腹亦痛，較桂枝證更甚者服此湯」（《時方歌括》）。 摘自《來春茂醫話》 原文網址：https://kknews.cc/health/x2gqlyr.html ----------------------------------------------------------------------------------------- 葉橘泉의 오적산 경험 我對五積散的經驗和體會 Posted on 2020 年 10 月 11 日 五積散初見於宋《太平惠民和劑局方·傷寒門》。本方主治氣、血、痰、食、飲五種病邪的鬱積，醫以五積散命名，為宋元以後歷代醫家常用的名方之一。筆者也喜用此方，薄有體會，通過進一步學習，更覺過去對該方認識的狹隘。本文擬在溫習有關文獻的基礎上，結合筆者臨床實踐的點滴經驗和體會，做一簡單介紹，以就正於同道。 一、局方五積散的處方和主治 1、處方 蒼朮（米泔水浸，去皮）二十四兩，桔梗（去蘆）十二兩，麻黃（去根節）、枳殼（去瓤炒）、陳皮（去白）各六兩，乾薑（爁）、厚朴（去粗皮）各四兩，白芷、川芎、芍藥、當歸（去蘆）、肉桂（去粗皮）、茯苓（去皮）、甘草（炙）、半夏（湯洗七次）各三兩。 以上除肉桂、枳殼、陳皮別為粗末外，一十二味同為粗末，慢火炒令色轉黃，攤冷，次入桂、枳、陳皮，令勻，每服三錢，水一盞半，入生薑三片，煎至一中盞，去滓稍熱服，日二三服。 如冷氣奔衝、心脅臍腹脹滿刺痛、反胃嘔吐、泄利清谷及痃癖癥瘕、膀胱小腸氣痛，加煨生薑三片，鹽少許同煎；如傷寒時疫，頭疼體痛、惡風發熱、項背強痛，加蔥白三寸、豆豉七粒同煎；若但覺惡寒、或身不甚熱、肢體拘急、或手足厥冷，加吳茱萸七粒，鹽少許同煎；如寒熱不調、咳嗽喘滿，加紅棗煎服，婦人難產，入醋一合同煎服之，並不拘時候。 ［橘泉按］局方五積散的炮制方法，後人稱之為熟料五積散，與生料五積散之不加炒至黃色者，應用上略有區別。以溫散寒邪為主者用熟料五積散，以發散風濕為主者用生料五積散。 本方處方之藥用量，諸書略有不同，但同為十五味，其引藥有薑、棗，或薑、蔥等，依症情而異。蒼朮一藥，《局方》一本作二十兩，一本作二十七兩，顯是傳寫之誤。 《局方》乾薑（爁），爁音覽，火焚也，等於“炮”，此《太平惠民和劑局方》常用之炮制也。半夏湯洗是古制，現在用薑制。《三因極一病證方論》先將十二味微炒令香，後入枳殼、肉桂、厚朴三味，同為細末，每服三錢，水一盞，煎七分，溫服。其余藥量，大同小異。 五積散之成人服用量，一般為每服三錢，加水適量，一次煎，煎取七分，去滓溫服，這是一次量。日二三服，總劑量為六至九錢，分次煎服，藥引臨時加入。 2、主治 ①調中順氣，除風冷，化痰飲；②治脾胃宿冷，脅腹脹痛，胸膈停痰，嘔逆惡心；③外感風寒，內傷生冷，心腹痞悶，頭目昏痛，肩背拘急，肢體怠惰，寒熱往來，飲食不進；④婦人氣血不調，心腹撮痛，經候不勻，或經閉不通，難產及胎死腹中，並宜服之。 二、五積散的應用經驗 1、歷代醫家的經驗和論述 （1）宋代陳言《三因極一病證方論》云：“五積散治太陰傷寒，脾胃不和及有積聚腹痛”者。 （2）宋代嚴用和《濟生方》：“本方主治感冒寒邪，頭疼身痛，項強拘急，惡寒或腹痛；又治傷寒發熱，頭疼惡風，內傷生冷，胸膈脹滿，風寒濕氣客於經絡，腰腳酸痛及婦人難產，血滯不通，月候不調。” （3）明代龔信父子合編《古今醫鑒》云：“五積散治寒邪卒中，直入陰經等症”，用治傷寒之陰證。本方氣味辛溫，既發表又溫中，開鬱順氣，厥功甚偉，為祛寒濕之聖劑也。 龔氏推崇五積散及防風通聖散為一陰一陽、一正一反之要方。謂寒濕陰邪也，用五積散以散其陰；燥熱陽邪也,用防風通聖散以泄其陽。並謂人之有病不外陰陽二者，善用藥者，對陽邪則用防風通聖散以治燥熱，對陰邪則用五積散以散寒濕，故春夏多宜防風通聖散，秋冬多宜五積散云。 （4）清代陳修圓《時方妙用》云：“中脘作痛，手不可近，乃內外不和，外則寒氣凝於毛皮，內則垢濁停於中脘，當審其體之虛實而施治……實者宜五積散。”又《時方歌括》云：“表裡俱寒，外而頭項強痛，內而肚腹亦痛，較桂枝證更甚者，服此湯。”如本方去麻黃，酒煎服，治痢後鶴膝風甚效云。 2、筆者臨床的點滴經驗 中醫運用復方進行整體性的治療，具有同病異治、異病同治的特點。本方的應用範圍，根據中醫八綱分析，適用於陰證、寒證、實證、表裡證及寒實證，包括痰、飲、濕、食、氣、血等諸邪積。筆者通過對《太平惠民和劑局方》和諸家經驗的溫習，結合臨床實踐，認為其適應證可以歸納為如下幾點： （1）胃內停滯寒飲宿食，胃痛或嘔吐，脘腹脹滿，或胃有振水音，腰膝有冷感者。 （2）脘腹攣急痛，疝氣上衝，或冷氣攻衝，嘔吐，飲食不能下，上熱下冷，或四肢厥冷者。 （3）婦人血氣不調，月經不勻，或痛經，白帶下，腰以下冷痛，脈沉遲者。 （4）婦人難產，或胎死腹中，或胞衣不下，腹痛，惡露不絕，伴有寒證、實證色脈者。 （5）咳嗽氣喘，動悸迫促，胸內苦悶痞塞，喉間痰涎壅塞，伴有肩背臂痛，腰股攣急痛，脈沉實有力者。 （6）風寒濕痹，筋骨疼痛，跌打損傷，腰膂冷痛，腳氣，腳膝拘攣疼痛，疝氣腹中冷痛，或遇冷則發病，腰腳冷感者。 （7）感冒風寒，惡寒頭痛，不發熱，全身疼痛，胸悶，咳嗽氣逆，或腹痛，脈實無汗者。 現將筆者驗案數則舉例如下： 1、哮喘病 江蘇吳江一農民，男性，三十歲，素來體格強壯。自某年秋在田間遭受暴風雨之淋襲以後，即常發哮喘咳嗽，遇冷即發，時發時愈，已有二三年。因當時正處於抗戰期間，筆者避亂於該鄉，適彼又發病，症見咳嗽喘促，痰多泡沫，喉間如水雞聲，胸悶不能平臥，頭痛，肩痛，腰背痛，兩目似突，苦悶欲絕，並見頭上有汗，而兩足冰冷，診其脈沉弦而緊，舌苔白膩。發病當日，不食，不解大便，時為發病第二天。以散寒祛濕平喘著手，因予處方五積散，以麻黃、桔梗、陳皮、半夏等為君藥，服藥一劑，喘咳大減，續服二劑。病去大半，嗣後，配制丸劑繼續服用，即不聞再發。 2、寒實痹痛 患者男性，四十四歲，泥水工人。左腰股痛，時發時止，已有數年。據稱因跌傷臀部而起，初痛尚輕微，後因修理碼頭，入水受涼，腰痛轉重，曾在某醫院被診斷為坐骨神經痛，治以針灸、電療，均能當時見效，但仍有發作。近來腰腹疼痛，臥床不起。診見患者身體壯實，面色蒼白，蜷臥床上，頭痛，胸悶，不思飲食，有輕微咳嗽，肢體疼痛，惡寒怕冷，下肢冷感，腰腹攣痛，喜熱熨，轉側困難。按其腹結實拘攣，大便三日不下。診脈滑實而緊，舌苔白膩且厚。歸納其症狀，既有表證，又有裡證。病情屬於寒證、實證，予五積散加生薑、蔥白為引藥，一劑見效，兩劑大便自下，腰腹痛著減，後略事加減數劑治愈。 3、月經不調 一農村婦女，二十八歲。自訴結婚年餘，未曾生育，婚前月經正常，近五個月來，月經期間腰痛，腹痛，月經量少色黑，有瘀塊。診其脈沉遲小滑。舌苔微白，大小便正常，腰以下冷感，即在睡臥中亦兩腳不溫，時發轉筋，每於月經來潮前五六天即開始下腹脹痛，腰痛，下肢痛，甚則上衝嘔吐，頭昏目黑。先予桂枝茯苓丸方加味治之，效果不著，後以五積散加桃仁、紅花，效驗立顯。嗣以原方，囑於每次經期前服數劑（用銼散劑，每劑約一兩，一日二次煎服），歷三月而治愈。 4、白帶下 某婦人，三十九歲，體軀肥胖，訴月經不調，不育，經期後移，量及色無異常，無痛經現像，但常以腰痛為苦，白帶下特多，頗如文獻所稱“白淫”“白沃”，腰及下肢有冷感，脈像遲滑，手足不溫。乃處以五積散方。初服四劑，白帶及腰痛略減，復診時仍予原方，續服十劑，唯腰、腳仍有冷感，因囑堅持原方繼續服用。但患者嫌此藥價廉而非補劑，乃停服，後始終未聞獲得生育。 三、討論 五積散的處方共含有十五味藥，再加藥引，粗看藥味似較龐雜，但是我們觀察中藥復方方劑的療效，不能孤立地從各個藥物個別的藥效去看，而應看反復實踐有效的方劑因其合理配伍而產生的一種綜合作用。 如本方內含蒼朮、厚朴、陳皮、甘草，為運脾化濕之平胃散；陳皮、半夏、茯苓、甘草為主治一切痰飲之二陳湯；有治太陽表證之桂枝湯；有治痰飲之苓桂朮甘湯；有治腎著病的苓薑朮甘湯；有四物去地黃，具行血通經脈之功，有麻黃合桂枝辛溫發表以疏散表寒；乾薑、肉桂、枳殼、厚朴溫裡以行氣滯；陳皮、半夏合麻黃、桔梗開肺以豁痰；麻黃、肉桂、乾薑、川芎、當歸、甘草具續命湯之方意。綜觀全方，結構嚴密，實為以上諸方綜合的復方。 依諸方之作用，可以理解本方之療效不僅主治氣、血、痰、飲、食五邪之鬱積，而對表裡內外、臟腑經絡之寒濕陰邪，悉皆能治，其治療範圍頗為廣泛。 五積散之藥量，《和劑局方》以蒼朮最多為君藥，桔梗為臣，麻黃、枳殼、陳皮等為佐藥，其余為使藥。後人有根據實際需要而變更其分量、配伍者，如《三因極一病證方論》麻黃春夏二兩，秋冬三兩；乾薑春夏一兩半，秋冬二兩；肉桂春夏三兩，秋冬四兩等。筆者用治哮喘，不以蒼朮為君，而以麻黃、桔梗、陳皮、半夏等為主藥（見驗案一）。 本方在各地中藥房均有成藥制劑、散劑、丸劑等供應。筆者喜用粗散，按照《太平惠民和劑局方》的制法，加藥引薑、棗或薑、蔥作煎劑。 筆者認為局方熟料五積散頗有意義。因本方藥味大都為芳香藥銼成粗粒（古稱如麻豆大），微炒令香，則更易發揮其有效成分之作用。成人每次總量四至五錢，一次煎，加水一盞，煎取七分，去滓溫服，一日兩次。唯此銼散劑最好臨時炒香，或炒香後密閉貯藏，如果香氣散失，療效勢必大為減損。中藥房成藥丸劑吞服，不如煎湯熱服奏效快。個別藥房習慣用蜜丸，用以嚼食之法，不大合理，應予改進。 有人主張本方宜加白朮，並減蒼朮之量，筆者同意此項意見。因本方除含平胃散以外，他如苓桂朮甘湯、苓薑朮甘湯等方均用白朮，故按《太平惠民和劑局方》蒼朮減半加白朮等量為佳。 成人每日量依照《太平惠民和劑局方》之記載，每服三錢，如日服三次，共為九錢。目前，我們處方都習慣將各個藥物寫在方箋上，一般每味藥用量二至三錢，本方共計十五味藥，則每日總劑量當在三四兩以上。筆者用治哮喘（見驗案一），就是用這樣的劑量，似屬浪費。 另筆者也曾用過散劑或丸劑，每日不足一兩，同樣收到相應的療效，尤其感到遵古（《和劑局方》）配制的銼散劑，一日兩次，每次四五錢煎服，效果最佳。上案月經不調之一例，就是這樣用法。看來中藥的劑量還可以大大節省，希望能通過實踐，共同研究提高。 在我國醫學文獻中蘊藏著許多歷經反復實踐卓有成效的名方，這是先輩醫家辛勤勞動的研究成果，也是我們今天重點研究的對像之一。通過臨床實踐，總結它們的療效，肯定它們的適應範圍，並運用中醫理論加以說明，這不僅可以闡明中醫辨證施治的規律，且為今後應用現代科學方法闡明其療效機制打下良好基礎。 以上是筆者個人的經驗和體會，希同道批評指正。 版權說明 本文摘自《葉橘泉方證藥證醫話》。 ---------------------------------------------------------------------------------------------