(附 )
HT 者逆也。阴阳气不相接则厥。手足逆冷是也。其症不一。散之方书者甚多。今姑撮大
概。
色白也。然阳厥伏热深而振栗。及见身冷脉微。欲绝而死者。阳极似阴。服热药即死。阴厥
虚寒。甚而发燥。欲坐于泥水之中。此阴极似阳。服寒药即死。不可不辨。外此又有暑厥。
中暑耗气发厥。脉虚自汗。有气厥。因暴怒而得。即气中也。与中风相似。风中身热。气中
身冷。有痰厥。其脉洪滑。或咽中如拽锯声。有蛔厥。胃中冷。吐出长虫者是。有气虚厥。
脉细者是。有血虚厥。脉大如葱管者是。有惊厥。因劳后后。饮水被惊而发者是。有尸厥。
凡吊死问疾。或入庙登冢。卒中外邪。与脏气相忤。气遏不行。忽手足冷。头面青黑。牙关
紧急。昏晕卒倒。或错言妄语。决不可作风治。
HT 逆之脉。多于沉伏者。但沉迟散为之寒。沉伏而数为之热。浮而无力者是气虚。洪滑
有力属顽痰。沉滑身冷者难治。
苏合丸 凡厥症。先以姜汁。调服灌醒然后议脉辨症用药。
白术(土炒) 青木香 朱砂(研水飞) 犀角 沉香 麝香 诃梨勒(煨取皮) 安息香(
酒熬
膏) 丁香 白檀香 荜茇 香附(以上各二两) 龙脑(五钱) 薰陆香 酥合油(各一两)
上为细末研匀。和安息香膏。加炼蜜丸如龙眼核大。每服一丸。
大承气汤 治阳厥。与阳极似阴。(方见伤寒门)
四君子汤 治气虚厥。
白术(土炒) 白茯苓(去皮各一钱) 人参(二钱) 甘草(五分)
水二钟。加黑枣二枚。热服。
四物汤 治血虚厥。
当归 白芍 川芎 怀生地(各二钱)
水二钟。加龙眼肉七枚。不拘时服。
加味理中汤 治蛔厥。
大附子(童便制一钱) 干姜(炒黑) 甘草 槟榔 白术(生炒) 人参(各八分) 肉桂
川椒(各六分)
水一钟。乌梅三个煎服。
逐痰汤 治寒痰发厥。
广橘红(二钱) 半夏 甘草(各一钱二分) 大附子 川贝母(各一钱)
水二钟。加竹沥姜汁煎服。
四逆汤 治阴厥。与阴极似阳。(方见伤寒门)
祛暑汤 治暑厥。气升不省人事。
香薷 浓朴(姜汁炒) 白扁豆(各一钱炒) 沉香(二钱) 川黄连(酒炒) 陈皮 桔梗(
各一钱二分)
水二钟。加灯心三十茎。煎七分服。
乌药顺气散治气逆厥。(方见中风门)
镇邪饮 治尸厥如神。先以酥合丸灌醒。再服此方。
紫朴 胆星 苍术 广木香 橘红(各一钱) 甘草 辰砂(各三分)
水二钟。加姜汁半盏。酒一盏同煎服。
(附注)
厥证(指阴阳之气不相顺接,导致手足逆冷的病证)是气机逆乱的表现。当阴气与阳气不能相互衔接时,就会发生厥证,其典型症状是手脚逆冷。厥证的临床表现多种多样,散见于各类医书中的记载非常多。这里暂且概括其主要情况。
面色苍白。然而,阳厥(热深厥亦深)表现为体内伏热极深而出现寒战栗动,甚至见到身体冰冷、脉搏微弱似有若无、濒临死亡的状态,这是阳极似阴(真热假寒),如果服用热性药物就会导致死亡。阴厥(虚寒厥)表现为虚寒严重,甚至出现烦躁不安,想要坐在泥水中降温,这是阴极似阳(真寒假热),如果服用寒性药物就会导致死亡。这一点不可不仔细辨别。除此之外,还有暑厥,因中暑耗伤正气而引发厥证,脉象虚弱且自汗;有气厥,因突然暴怒而得病,即所谓“气中”,症状与中风相似,但中风患者身体发热,气中患者身体发冷;有痰厥,脉象洪大滑利,或者咽喉中有如拉锯般的痰鸣声;有蛔厥,因胃中寒冷,吐出长虫所致;有气虚厥,脉象细弱;有血虚厥,脉象大而中空如葱管;有惊厥,因劳累之后饮水受到惊吓而发作;有尸厥,凡是遇到吊死之人探视病人,或进入庙宇登上坟墓,突然感受外邪,与脏腑之气相冲撞,导致气机阻滞不行,忽然手足冰冷,头面部青黑,牙关紧闭,昏晕突然倒地,或者胡言乱语,绝对不可以当作风证来治疗。
厥证的脉象,大多沉伏。但脉象沉迟散漫属于寒证,脉象沉伏而数属于热证,脉象浮而无力属于气虚,脉象洪大滑利有力属于顽痰,脉象沉滑且身体冰冷的难以治疗。
苏合丸:凡遇厥证,先用姜汁调服灌醒,然后再根据脉象和症状辨证用药。
白术(土炒)、青木香、朱砂(研细后水飞)、犀角、沉香、麝香、诃梨勒(煨后取皮)、安息香(酒熬成膏)、丁香、白檀香、荜茇、香附(以上各二两)、龙脑(五钱)、薰陆香、酥合油(各一两)。
将上述药材研成细末并混合均匀,加入安息香膏,再加炼蜜制成如龙眼核大小的药丸。每次服用一丸。
四君子汤:治疗气虚厥。
白术(土炒)、白茯苓(去皮,各一钱)、人参(二钱)、甘草(五分)。
用水二钟,加黑枣二枚,热服。
四物汤:治疗血虚厥。
当归、白芍、川芎、怀生地(各二钱)。
用水二钟,加龙眼肉七枚,不拘时候服用。
加味理中汤:治疗蛔厥。
大附子(童便制,一钱)、干姜(炒黑)、甘草、槟榔、白术(生炒)、人参(各八分)、肉桂、川椒(各六分)。
用水一钟,加乌梅三个煎服。
逐痰汤:治疗寒痰引发的厥证。
广橘红(二钱)、半夏、甘草(各一钱二分)、大附子、川贝母(各一钱)。
用水二钟,加竹沥、姜汁煎服。
祛暑汤:治疗暑厥,症见气机上逆、神志不清。
香薷、浓朴(姜汁炒)、白扁豆(各一钱,炒)、沉香(二钱)、川黄连(酒炒)、陈皮、桔梗(各一钱二分)。
用水二钟,加灯心草三十茎,煎至七分服。
镇邪饮:治疗尸厥效果神奇。先以酥合丸灌醒,再服用此方。
紫朴、胆星、苍术、广木香、橘红(各一钱)、甘草、辰砂(各三分)。
用水二钟,加姜汁半盏、酒一盏同煎服。
(Attachment)
Jue syndrome (a condition characterized by cold extremities due to the failure of Yin and Yang Qi to connect smoothly) is a manifestation of rebellious Qi. When Yin Qi and Yang Qi fail to interconnect, Jue occurs, manifesting as coldness in the hands and feet. The clinical manifestations of Jue are diverse, with numerous records scattered across various medical texts. Here, we briefly summarize the general overview.
The complexion is pale. However, Yang Jue (deeply concealed heat leading to cold extremities) presents with severe internal latent heat causing shivering and tremors, even showing cold body temperature and a faint, almost imperceptible pulse, approaching death. This is "Yang extreme resembling Yin" (true heat presenting as false cold); administering hot-natured medicines will cause death. Yin Jue (deficiency-cold Jue) presents with severe deficiency-cold, even causing restlessness and a desire to sit in mud or water for cooling. This is "Yin extreme resembling Yang" (true cold presenting as false heat); administering cold-natured medicines will cause death. This distinction must not be overlooked. Besides these, there is also Summerheat Jue, caused by summerheat consuming Qi and triggering Jue, with a deficient pulse and spontaneous sweating; there is Qi Jue, resulting from sudden rage, also known as "Qi strike," which resembles wind-stroke but differs in that wind-stroke involves fever while Qi strike involves cold body temperature; there is Phlegm Jue, with a surging and slippery pulse, or rattling sounds in the throat like sawing wood; there is Ascaris Jue, caused by cold in the stomach and expulsion of long worms; there is Qi-deficiency Jue, with a fine pulse; there is Blood-deficiency Jue, with a large and hollow pulse like a scallion stalk; there is Shock Jue, triggered by drinking water after exertion followed by fright; there is Corpse Jue, occurring when visiting hanging victims or sick people, or entering temples and tombs, suddenly contracting external pathogens that clash with Zang-Fu Qi, blocking Qi flow, leading to sudden cold extremities, cyanosis and blackening of the head and face, locked jaw, sudden fainting and collapse, or delirious speech. It must absolutely not be treated as Wind disease.
The pulse of Jue rebellion is mostly deep and hidden. A deep, slow, and scattered pulse indicates Cold; a deep, hidden, and rapid pulse indicates Heat; a floating and forceless pulse indicates Qi deficiency; a surging, slippery, and forceful pulse indicates stubborn Phlegm; a deep, slippery pulse with cold body temperature is difficult to treat.
Suhe Wan: For all cases of Jue, first wake the patient by administering ginger juice mixed with the pill, then discuss treatment based on pulse and symptoms.
Baizhu (soil-fried), Qingmuxiang, Zhusha (ground and floated in water), Xijiao, Chenxiang, Shexiang, Helile (roasted, peel taken), Anshixiang (boiled into paste with wine), Dingxiang, Baitanxiang, Bibo, Xiangfu (each 2 liang), Longnao (5 qian), Xunluxiang, Suheyóu (each 1 liang).
Grind the above herbs into a fine powder and mix evenly. Combine with Anshixiang paste and refined honey to form pills the size of longan seeds. Take one pill per dose.
Da Chengqi Tang: Treats Yang Jue, i.e., Yang extreme resembling Yin. (Formula see Shanghan Men)
Sijunzi Tang: Treats Qi-deficiency Jue.
Baizhu (soil-fried), Baifuling (peeled, each 1 qian), Renshen (2 qian), Gancao (0.5 qian).
Decoct with 2 zhong of water, add 2 black dates, and take hot.
Siwu Tang: Treats Blood-deficiency Jue.
Danggui, Baishao, Chuanxiong, Huaishengdi (each 2 qian).
Decoct with 2 zhong of water, add 7 longan arils, and take at any time.
Jiawei Lizhong Tang: Treats Ascaris Jue.
Da Fuzi (processed with child's urine, 1 qian), Ganjiang (charred), Gancao, Binglang, Baizhu (raw and fried), Renshen (each 0.8 qian), Rougui, Chuanjiao (each 0.6 qian).
Decoct with 1 zhong of water and 3 wumei, and take.
Zhutan Tang: Treats Jue caused by Cold-Phlegm.
Guangjuhong (2 qian), Banxia, Gancao (each 1.2 qian), Da Fuzi, Chuanbeimu (each 1 qian).
Decoct with 2 zhong of water, adding Zhuli (bamboo sap) and Jiangzhi (ginger juice), and take.
Sini Tang: Treats Yin Jue, i.e., Yin extreme resembling Yang. (Formula see Shanghan Men)
Qushu Tang: Treats Summerheat Jue, characterized by rising Qi and loss of consciousness.
Xiangru, Nongpo (fried with ginger juice), Baibiandou (each 1 qian, fried), Chenxiang (2 qian), Chuanhuanglian (fried with wine), Chenpi, Jiegeng (each 1.2 qian).
Decoct with 2 zhong of water, add 30 stems of Dengxin, decoct until 0.7 portion remains, and take.
Wuyao Shunqi San: Treats Rebellious Qi Jue. (Formula see Fengzhong Men)
Zhenxie Yin: Extremely effective for treating Corpse Jue. First wake the patient with Suhe Wan, then administer this formula.
Zipu, Danning, Cangzhu, Guangmuxiang, Juhong (each 1 qian), Gancao, Chensha (each 0.3 qian).
Decoct with 2 zhong of water, adding half a zhan of ginger juice and one zhan of wine, and take.