治少阴伤寒,自利不渴,呕哕不止;或吐利俱发,小便不利;或汗出过多,脉
微欲绝,腹痛胀满,手足冷;及一切虚寒厥冷。凡病伤寒,有此证候,皆由阳气虚有寒,虽
更觉头痛体疼,发热恶寒,四肢拘急,表里悉具者,未可攻表,宜先服此药以助阳救里。
甘草(炙,一分) 干姜(二钱,炮) 附子(炮去皮脐,半两)
上锉散。每服五钱匕,水一盏半,煎七分,去滓,食前服。强人,加干姜一钱;或恶寒
脉微而利,利止仍亡血者,加人参半两;或发汗,若下之,病仍不能解,烦躁者,仍加茯苓
半两;面赤者,加连须葱九茎;腹中痛者,去葱,加芍药一两;呕者,加生姜一两;咽痛者
,去芍药,加桔梗半两。
桂枝、麻黄,皆攻太阳经表药,方各见太阳经,其如阳明、太阴、少阳、厥阴,并可于
风寒二方论中,随证施治。
阴毒为病,手足冷,腰背强,头疼腹痛,或烦渴,精神恍惚,额与手背,时出冷汗,音
声郑重,爪甲面色青黑,多因脾肾虚寒伏阴,重感于寒所致。
治阴毒伤寒,唇青面黑,身重强,四肢冷;或因服冷药过度,心腹胀满,昏沉不识人。
附子(炮去皮脐,三分) 桂心(半两) 当归 白术(各半两) 半夏(汤洗去滑) 干姜(各一分,炮)
上为末。每服三钱,水二盏,生姜三片,煎六分,不以时热服,衣覆取汗。
治疗少阴伤寒,出现自发性腹泻且不口渴,呕吐呃逆不止;或者呕吐与腹泻同时发作,小便不通畅;或者出汗过多,脉搏微弱几乎摸不到,腹部疼痛且胀满,手脚冰冷;以及一切虚寒导致的四肢厥冷。凡是患伤寒病,有这些证候的,都是由于阳气虚弱且有寒邪所致,即使同时感觉头痛身体疼痛,发热恶寒,四肢拘挛紧急,表证和里证都具备,也不可以急于解表攻邪,应当先服用此药来扶助阳气、救治里证。
甘草(炙用,一分) 干姜(二钱,炮制) 附子(炮制后去皮去脐,半两)
以上药材切碎成散剂。每次服用五钱匕,用水一盏半,煎煮至七分水量,滤去药渣,饭前温服。体质强壮的人,增加干姜一钱;如果怕冷、脉微细且腹泻,腹泻停止但仍有亡血症状的,增加人参半两;如果经过发汗或泻下治疗后,病情仍未解除且出现烦躁的,仍增加茯苓半两;面色发红的,增加带须葱九根;腹部疼痛的,去掉葱,增加芍药一两;呕吐的,增加生姜一两;咽喉疼痛的,去掉芍药,增加桔梗半两。
桂枝、麻黄,都是攻击太阳经表证的药物,方剂分别记载在太阳经相关章节中。至于阳明经、太阴经、少阳经、厥阴经的病证,都可以参考风寒两方面的论述,根据具体证候进行治疗。
阴毒这种病,表现为手脚冰冷,腰背僵硬强直,头痛腹痛,或者心烦口渴,精神恍惚不定,额头和手背时常渗出冷汗,声音沉重浑浊,指甲和面色青黑,多因脾肾虚寒,伏匿之阴寒之气,再次感受寒邪所致。
治疗阴毒伤寒,出现嘴唇青紫、面色发黑,身体沉重僵硬,四肢冰冷;或者因为过度服用寒凉药物,导致心腹胀满,神志昏沉不认识人。
附子(炮制后去皮去脐,三分) 桂心(半两) 当归 白术(各半两) 半夏(汤洗去除滑腻感) 干姜(各一分,炮制)
以上药材研为粉末。每次服用三钱,用水二盏,加入生姜三片,煎煮至六分水量,不拘时间热服,服药后覆盖衣被以取汗。
Treat Shaoyin (Lesser Yin) cold damage, presenting with spontaneous diarrhea without thirst, and continuous vomiting or hiccups; or simultaneous vomiting and diarrhea with inadequate urination; or excessive sweating, a pulse that is faint and nearly imperceptible, abdominal pain and distension, and cold extremities; as well as all cases of deficiency-cold leading to cold reversal. In any case of cold damage, if these syndromes are present, they are caused by deficiency of Yang Qi and the presence of Cold. Even if there are concurrent headache, body ache, fever, aversion to cold, and stiffness/contraction of the four limbs, indicating both exterior and interior involvement, one should not attack the exterior prematurely. Instead, it is appropriate to first administer this formula to assist Yang Qi and rescue the interior.
Gancao (Zizhi, 1 fen) Ganjiang (2 qian, processed) Fuzi (processed, skin and umbilicus removed, 0.5 liang)
Crush into a powder. Take 5 qian bi per dose, with 1.5 zhan of water, decoct to 0.7 zhan, remove dregs, and take before meals. For robust individuals, add 1 qian of Ganjiang; if there is aversion to cold, a faint pulse, and diarrhea, and the diarrhea stops but blood loss persists, add 0.5 liang of Renshen; if after sweating or purging therapies the disease remains unresolved accompanied by irritability, still add 0.5 liang of Fuling; if the face is red, add 9 stalks of Congbai (with roots); if there is abdominal pain, remove Congbai and add 1 liang of Shaoyao; if there is vomiting, add 1 liang of Shengjiang; if there is sore throat, remove Shaoyao and add 0.5 liang of Jiegeng.
Guizhi and Mahuang are both herbs that attack the exterior of the Taiyang (Greater Yang) channel. Their formulas are detailed in the Taiyang channel sections. As for syndromes involving the Yangming (Yang Brightness), Taiyin (Lesser Yin), Shaoyang (Lesser Yang), and Jueyin (Terminal Yin) channels, treatment can be administered according to specific manifestations within the discussions on Wind-Cold formulas.
Yindu (Yin Toxin) disease presents with cold extremities, rigidity of the waist and back, headache and abdominal pain, or irritability and thirst, mental confusion, occasional cold sweat on the forehead and dorsum of hands, heavy/dull voice, cyanosis of nails and complexion. It is mostly caused by deficiency-cold of the Spleen and Kidney with latent Yin pathogenic factors, compounded by re-exposure to Cold.
Treat Yindu cold damage, presenting with cyanotic lips and blackish complexion, heavy/rigid body, and cold extremities; or due to excessive intake of cold-natured medicines causing epigastric and abdominal fullness, lethargy, and inability to recognize people.
Fuzi (processed, skin and umbilicus removed, 3 fen) Guixin (0.5 liang) Danggui Baizhu (each 0.5 liang) Banxia (washed in hot water to remove slipperiness) Ganjiang (each 1 fen, processed)
Grind into powder. Take 3 qian per dose, with 2 zhan of water and 3 slices of Shengjiang, decoct to 0.6 zhan. Take warm at any time, cover with clothing to induce sweating.