治阳明伤寒,脉长身热,不恶寒,目疼鼻干,不得卧,腹满,咽干渴,大便
硬,谵语;或汗后脉沉实;或下利,心下坚;或已经下,其脉按之浮沉尚有力者。
大黄(酒洗,半两) 芒硝(一分,别研入) 浓朴(姜制,一两) 枳实(一分,锉炒去瓤)
上为粗末。每服五钱,水二盏,煎八分,去滓,入硝再煎服。若脉迟而滑,汗出身重
,时发潮热;并得病二三日无太阳证,烦躁,心下硬,下利后谵语者,去芒硝,名小承
气。或发汗不解,蒸蒸发热,温温欲吐,胸中痛,大便反溏;及吐利后,腹胀,厥烦,谵语
,去浓朴、枳实,入甘草半两、芒硝一分煎,名调胃承气。或结热膀胱,如狂状,下血,小
腹急结者,去浓朴、枳实,加桃仁十二个、桂、甘草各半两、硝一分,名桃核承气。
治证状大略与大承气汤同。轻则柴胡,重则承气。
柴胡(四两) 黄芩 赤芍药(各一两半) 半夏(汤去滑,一两一分) 枳实(麸炒,一分)
上为粗末。每服三大钱,水一盏半,姜五片,枣一枚,煎八分,去滓,食后温服。若内
热里实,身体疼痛,是表证未解,不可服。
足少阳胆经伤寒,胸胁痛,耳聋,口苦咽干,往来寒热,目眩干呕。其脉流注与伤风
同,以少阳主胆,属半表半里,故三传之。
治疗阳明伤寒,症见脉象长、身体发热、不恶寒、眼睛疼痛、鼻干、无法安卧、腹部胀满、咽喉干燥且口渴、大便坚硬、胡言乱语;或者发汗后脉象沉实;或者下利(腹泻),心下部坚硬;或者已经使用过泻下法,但脉搏按之浮取和沉取仍有力量者。
大黄(用酒清洗,半两) 芒硝(一分,单独研磨后加入) 浓朴(姜汁制,一两) 枳实(一分,锉碎炒制并去除瓤)
以上药材捣成粗末。每次服用五钱,加水二盏,煎煮至八分,滤去药渣,加入芒硝再煎煮后服用。如果脉象迟而滑,出汗后身体沉重,时常发作潮热;以及患病二三日没有太阳病证候,烦躁,心下部硬,下利之后出现胡言乱语的,去掉芒硝,名为小承气汤。或者发汗后病邪未解,蒸蒸发热,恶心欲吐,胸中痛,大便反而稀溏;以及呕吐、下利之后,腹胀,四肢厥冷且烦躁,胡言乱语的,去掉浓朴、枳实,加入甘草半两、芒硝一分煎煮,名为调胃承气汤。或者热结于膀胱,表现为像发狂的样子,下血,小腹急迫结聚的,去掉浓朴、枳实,加入桃仁十二个、桂枝半两、甘草半两、芒硝一分,名为桃核承气汤。
治疗的证状大体与大承气汤相同。病情轻的用小柴胡汤,病情重的用大承气汤。
柴胡(四两) 黄芩 赤芍药(各一两半) 半夏(开水烫去滑腻,一两一分) 枳实(麸皮炒,一分)
以上药材捣成粗末。每次服用三大钱,加水一盏半,生姜五片,大枣一枚,煎煮至八分,滤去药渣,饭后温服。如果内热里实,身体疼痛,这是表证未解,不可服用。
足少阳胆经受伤寒,症见胸胁疼痛,耳聋,口苦咽干,忽冷忽热,头晕眼花,干呕。其脉象流注与伤风相同,因为少阳主胆,属于半表半里,所以经过三传(指病邪由表入里的传变过程)。
Treatment for Yangming Cold Damage (Yangming Shanghan), presenting with a long pulse, body heat, aversion to cold absent, eye pain, nasal dryness, inability to sleep, abdominal fullness, throat dryness and thirst, hard stool, and delirium; or a deep and solid pulse after sweating; or diarrhea with hardness in the epigastrium; or after purgation has already been administered, yet the pulse remains forceful upon both superficial and deep palpation.
Dahuang (Rhubarb Radix et Rhizoma, washed with wine, ban liang) Mangxiao (Natrii Sulfas, fen, separately ground and added) Nongpo (Magnoliae Officinalis Cortex, ginger-processed, yi liang) Zhishi (Aurantii Fructus Immaturus, fen, sliced, stir-fried, pith removed)
The above ingredients are coarsely powdered. Each dose consists of five qian, boiled with two zhan of water until reduced to eight fen, filtered to remove dregs, then Mangxiao is added and boiled again before administration. If the pulse is slow and slippery, accompanied by sweating, heavy body, and periodic tidal fever; or if, within two to three days of illness, there are no Taiyang syndrome signs, but rather irritability, epigastric hardness, and delirium following diarrhea, remove Mangxiao; this formula is named Xiao Chengqi Tang (Minor Order the Qi Decoction). If, after sweating, the pathogen remains unresolved, with steaming-hot fever, nausea, chest pain, and loose stools; or after vomiting and diarrhea, with abdominal distension, cold extremities with irritability, and delirium, remove Nongpo and Zhishi, add Gancao (Licorice Root) ban liang and Mangxiao fen, boil and administer; this is named Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction). If heat binds in the Bladder, presenting as maniacal behavior, bloody stool, and urgency/clumping in the lower abdomen, remove Nongpo and Zhishi, add Taoren (Persicae Semen) twelve kernels, Guizhi (Cinnamon Twig) ban liang, Gancao ban liang, and Mangxiao fen; this is named Taohe Chengqi Tang (Peach Kernel Order the Qi Decoction).
The treated symptoms are generally similar to those of Dachengqi Tang. For mild cases, Chaihu Tang is used; for severe cases, Dachengqi Tang is used.
Chaihu (Bupleuri Radix, si liang) Huangqin (Scutellariae Radix) Chishao Yao (Paeoniae Radix Rubra, each yi liang ban) Banxia (Pinelliae Tuber, blanched to remove slipperiness, yi liang yi fen) Zhishi (Aurantii Fructus Immaturus, bran-fried, fen)
The above ingredients are coarsely powdered. Each dose consists of three da qian, boiled with one and a half zhan of water, five slices of Shengjiang (Fresh Ginger), and one Zao (Jujube Fruit), until reduced to eight fen, filtered to remove dregs, and taken warm after meals. If there is internal heat and interior excess, with body pain indicating that the exterior syndrome is not yet resolved, it must not be taken.
Cold damage affecting the Foot-Shaoyang Gallbladder Meridian presents with chest and hypochondriac pain, deafness, bitter taste in the mouth, throat dryness, alternating chills and fever, vertigo, and dry retching. Its pulse flow is similar to Wind Injury; since Shaoyang governs the Gallbladder and belongs to the Half-Exterior Half-Interior level, it undergoes San Chuan (three-stage transmission).