初得病一二日,便成阳毒;或服药吐下后,变成阳毒。其病腰背痛,烦闷不安,
狂言欲走,或见鬼,或下利,其脉浮大而数,面赤斑斑如锦纹,咽喉痛,吐下脓血。五日可治,七
日不可治,升麻汤主之。(不可作煮散。)
升麻 当归 甘草(各二分) 雄黄(研,一分) 桂枝(一分) 鳖甲(半两) 蜀椒(半分)
咀,水二升,煎一升,去滓,温服一盏,食顷再服。温覆手足出汗,汗出则解,未解重作之,
得吐尤佳。
阳毒宜葛根龙胆汤。(方在可发汗证中。)
初得病一二日,便成阴毒;或服药六七日以上至十日,变成阴毒。其病身重背强,腹中绞痛,
咽喉不利,毒瓦斯攻心,心坚强,气不得息,呕逆,唇青面黑,四肢厥冷,其脉沉细而紧。仲景云∶
阴毒之候,身痛如被杖,喉咽痛。五六日可
治,七日不可治,甘草汤主之。(不可作煮散。)
甘草 鳖甲 升麻 当归 桂枝(各二分) 蜀椒(一分) 雄黄(一分)
咀,水三升,煎取一升,去滓。温温每饮一盏,食顷再服,温覆。中毒当汗吐之,汗吐则愈,
不吐再服之。
治阴毒反阴丹。
硫黄(五两,研末) 太阴玄精石(味咸者,研末) 硝石(研末,各二两)
用铁铫子先铺玄精石一半,次铺硝石一半,中间下硫黄,又以硝石盖硫黄,都以玄精石盖之,
用盏子合定,令三斤炭火烧令得所,勿以烟出多,急取出,以瓦盆合定地下,四面灰拥,勿令烟出。
直候冷,取细研,蒸饼心,丸豌豆大,艾汤下十五丸,病重加至二三十丸,此法甚验。喘促吐逆者,
入口便安;服此药三五服,觉不退,便于脐下一寸半灸之,须是大炷百壮,未愈可至二百壮;若手
足极冷,小便涩,小腹硬, 痛囊缩,即须更于脐下四寸,如前灸之,乃与当归四逆并反阴丹
频频与服,内外通逐方可解,若稍缓即死矣。当归四逆乃加吴茱萸生姜者是,慎勿与寻常利小便药。
此是阴毒,气结在小腹所致也。有见小便不通,便用炒盐及裹热药熨脐下,欲望小便通利,其冷气
在小腹之间,被热物所熨,无处通出,即奔上冲心,其死速矣。
又治阴毒硫黄丸。
硫黄(二两) 水银(一两)
同研入铫,洒少醋,慢火炒,欲似烟出,再出火,洒醋,如此三四遍,地上放冷研之,蒸饼丸
梧桐子大。每服二十、三十丸,艾汤吞下,日三服,食前。
阴毒,脉沉微欲绝,四肢逆冷,大躁而渴不止,附子饮子。
附子(一枚,半两以上者,炮,去皮尖,四破。)
以水九升,煎至三升,去附子,入瓶,油单紧封沉井底,候极冷,取饮之。仍下硫黄丸甚妙。
阴毒之为病,因汗下药性冷所变,多在四五日也;或素来阳气虚冷,始得病便成阴毒;或始因
伤风伤冷物,便成阴毒。其病六日内可治,过六日不可治。
刚患病一两天,就形成阳毒;或者服药经过催吐、泻下之后,转变为阳毒。这种病症表现为腰背疼痛,心中烦闷不安,胡言乱语想要奔跑,或者出现幻觉看见鬼怪,或者腹泻,脉象浮大而数,面部红赤且有斑纹如同锦缎花纹,咽喉疼痛,呕吐或排泄物中有脓血。发病五天内可以治疗,七天后则难以治愈,用升麻汤主治。(不可制成煮散剂。)
升麻、当归、甘草(各二分)、雄黄(研细,一分)、桂枝(一分)、鳖甲(半两)、蜀椒(半分)。将药材切碎,加水二升,煎煮至一升,滤去药渣,温服一盏,过一顿饭的时间再服一次。服用后覆盖身体使手足出汗,汗出则病愈,若未痊愈可重新煎服,能引起呕吐效果更佳。
阳毒适宜使用葛根龙胆汤。(该方剂记载在“可发汗证”章节中。)
刚患病一两天,就形成阴毒;或者服药六七天以上直至十天,转变为阴毒。这种病症表现为身体沉重、背部僵硬,腹部剧烈绞痛,咽喉不畅,毒气攻心,心脏部位感觉坚硬,气息不能顺畅呼吸,呕吐逆气,嘴唇青紫、面色发黑,四肢冰冷,脉象沉细而紧。张仲景说:阴毒的症状,身体疼痛如同被棍棒打过,咽喉疼痛。发病五到六天可以治疗,七天后则难以治愈,用甘草汤主治。(不可制成煮散剂。)
甘草、鳖甲、升麻、当归、桂枝(各二分)、蜀椒(一分)、雄黄(一分)。将药材切碎,加水三升,煎取一升,滤去药渣。温热地每次饮用一盏,过一顿饭的时间再服一次,服用后覆盖身体。中毒应当通过发汗或催吐来治疗,汗出或吐出则痊愈,若不呕吐可再次服用。
硫黄(五两,研成粉末)、太阴玄精石(味咸的,研成粉末)、硝石(研成粉末,各二两)。先用铁锅铺一半玄精石,再铺一半硝石,中间放入硫黄,再用硝石覆盖硫黄,最后全部用玄精石覆盖。用碗盖住固定,用三斤炭火煅烧至火候适当,不要让烟冒出太多,迅速取出,用瓦盆扣住放在地下,四周用灰围住,不让烟逸出。一直等到冷却,取出细研,用蒸饼的心部作为粘合剂,制成如豌豆大小的丸药。用艾叶汤送服十五丸,病情重的加至二三十丸,此法非常有效。对于气喘急促、呕吐逆气的患者,入口即感舒适;服用此药三五次后,若感觉病情不退,就在脐下一寸半处施灸,必须用大艾炷灸一百壮,若未痊愈可增至二百壮;如果手脚极度寒冷,小便涩滞,小腹胀硬,睾丸收缩,就必须再在脐下四寸处,像前面那样施灸,同时配合当归四逆汤和反阴丹频繁服用,内外通逐才能解除,如果稍微迟缓就会死亡。当归四逆汤是指加入了吴茱萸和生姜的版本,千万不要与普通的利尿药混淆。这是阴毒,是由于气结在小腹所致。有人见到小便不通,就用炒盐及热敷药熨烫脐下,希望小便通利,但冷气在小腹之间,被热物熨烫后,无处排出,反而奔冲上达心脏,死亡速度极快。
硫黄(二两)、水银(一两)。一同研磨放入锅中,喷洒少量醋,用慢火炒制,似有烟冒出时,再离火,喷洒醋,如此重复三四遍,放在地上冷却后研磨,用蒸饼心制成如梧桐子大小的丸药。每次服用二十或三十丸,用艾叶汤吞服,每日三次,饭前服用。
阴毒病症,脉象沉微欲绝,四肢逆冷,极度烦躁且口渴不止,用附子饮子。
附子(一枚,半两以上的,炮制,去皮尖,分成四块)。用水九升,煎煮至三升,去掉附子,装入瓶中,用油布紧紧密封后沉入井底,等待极冷后取出饮用。此时再服用硫黄丸也非常妙。
阴毒这种病,是因为误用发汗或泻下药性寒凉所导致的变化,多在四五日出现;或者素来阳气虚弱寒冷,刚得病就形成阴毒;或者起初因伤风或食用生冷食物,便形成阴毒。这种病症六天内可以治疗,超过六天则难以治愈。
Upon the onset of illness for one or two days, Yang Poison (Yang Du) forms immediately; or it transforms into Yang Poison after medication-induced vomiting or purgation. The symptoms include pain in the waist and back, mental restlessness and oppression, delirious speech with a desire to run, hallucinations of seeing ghosts, or diarrhea. The pulse is floating, large, and rapid. The face is red with mottled patterns resembling brocade. There is sore throat, and vomiting or defecation of pus and blood. It is treatable within five days, but untreatable after seven days. Shengma Tang (Cimicifugae Decoction) is the primary prescription. (Do not prepare as a decoction powder.)
Shengma (Rhizoma Cimicifugae), Danggui (Radix Angelicae Sinensis), Gancao (Radix Glycyrrhizae Preparata) [each 2 fen], Xionghuang (Realgar, prepared by grinding) [1 fen], Guizhi (Ramulus Cinnamomi) [1 fen], Biejia (Carapax et Plastrum Testudinis) [0.5 liang], Shujiao (Fructus Zanthoxyli) [0.5 fen]. Cut the herbs, add two sheng of water, boil to one sheng, strain, and take one zhan warm. After a meal interval, take again. Cover warmly to induce sweating from hands and feet; resolution occurs with sweat. If unresolved, repeat the preparation. Induction of vomiting is particularly beneficial.
For Yang Poison, Gegen Longdan Tang (Puerariae Radix and Gentianae Decoctum) is suitable. (The formula is located in the section on "Syndromes Suitable for Diaphoresis".)
Upon the onset of illness for one or two days, Yin Poison (Yin Du) forms immediately; or it transforms into Yin Poison after medication over six or seven days up to ten days. The symptoms include heavy body and stiff back, severe colicky abdominal pain, dysphagia or throat obstruction, toxic qi attacking the heart, hardness in the cardiac region, dyspnea, vomiting and regurgitation, cyanotic lips and blackened complexion, cold limbs, and a pulse that is deep, fine, and tight. Zhang Zhongjing stated: In Yin Poison syndrome, the body aches as if beaten by a club, accompanied by sore throat. It is treatable within five to six days, but untreatable after seven days. Gancao Tang (Glycyrrhizae Decoctum) is the primary prescription. (Do not prepare as a decoction powder.)
Gancao (Radix Glycyrrhizae Preparata), Biejia (Carapax et Plastrum Testudinis), Shengma (Rhizoma Cimicifugae), Danggui (Radix Angelicae Sinensis), Guizhi (Ramulus Cinnamomi) [each 2 fen], Shujiao (Fructus Zanthoxyli) [1 fen], Xionghuang (Realgar) [1 fen]. Cut the herbs, add three sheng of water, boil to obtain one sheng, strain. Drink one zhan warm at a time, repeat after a meal interval, and cover warmly. For poisoning, treatment should induce sweating or vomiting; recovery follows emission. If vomiting does not occur, administer again.
To treat Yin Poison, use Fanyin Dan (Reverse-Yin Pill).
Huangqi (Sulfur) [5 liang, ground to powder], Taiyin Xuanjingshi (Mineral Selenite, saline taste, ground to powder), Xiaoshi (Natrii Nitras, ground to powder) [each 2 liang]. First, line an iron pan with half of the Xuanjingshi, then half of the Xiaoshi. Place the Huangqi in the middle, cover with the remaining Xiaoshi, and finally cover entirely with the remaining Xuanjingshi. Seal tightly with a bowl. Burn with charcoal weighing three jin until properly calcined, avoiding excessive smoke. Remove promptly. Cover with a clay pot placed on the ground, surround with ash to prevent smoke escape. Wait until completely cool. Grind finely. Use the center of steamed dough as a binder to form pills the size of pea seeds. Administer fifteen pills with Mugwort Decoction (Aiyetang). For severe cases, increase to twenty to thirty pills. This method is highly effective. For patients with panting and vomiting/regurgitation, relief is immediate upon ingestion. After three to five doses, if no improvement is felt, moxibustion should be applied one and a half cun below the umbilicus. Large moxa cones are required, one hundred burns (zhuang); if unresolved, up to two hundred burns may be used. If extremities are extremely cold, urination is obstructed, the lower abdomen is hard and painful, and the scrotum is retracted, moxibustion must also be applied four cun below the umbilicus as described above. Concurrently, Danggui Sini Tang (Angelica Decoction for Cold Extremities) and Fanyin Dan should be administered frequently to promote internal and external clearance. Delay results in death. Note that Danggui Sini Tang refers to the version modified with Wuzhuyu (Fructus Evodiae) and Shengjiang (Rhizoma Zingiberis Recens). Do not confuse this with ordinary diuretics. This condition is Yin Poison caused by Qi stagnation in the lower abdomen. Some observe urinary retention and apply roasted salt or hot compresses to the lower abdomen to promote urination. However, the cold pathogen in the lower abdomen, when heated, has no outlet and rushes upward to attack the heart, leading to rapid death.
Another formula for treating Yin Poison is Huangqi Wan (Sulfur Pill).
Huangqi (Sulfur) [2 liang], Shuiyin (Hydrargyrum) [1 liang]. Grind together in a pan, sprinkle with a little vinegar, and stir-fry over low heat until faint smoke appears. Remove from fire, sprinkle vinegar again. Repeat this process three to four times. Cool on the ground and grind. Form pills the size of Chinese honeylocust seeds using steamed dough center. Take twenty to thirty pills per dose, swallowed with Mugwort Decoction. Three times daily, before meals.
In Yin Poison syndrome, characterized by a deep, minute pulse nearly imperceptible, cold extremities, extreme restlessness, and unquenchable thirst, use Fuzi Yinzi (Aconite Infusion).
Fuzi (Radix Aconiti Lateralis Preparata) [one piece, weighing more than 0.5 liang, processed, skin and bud removed, divided into four pieces]. Boil in nine sheng of water until reduced to three sheng. Remove the Fuzi. Store in a bottle, seal tightly with oil cloth, and submerge in a well until extremely cold. Take the liquid. Administration of Huangqi Wan concurrently is excellent.
Yin Poison arises from the alteration caused by the cold nature of inappropriate diaphoretic or purgative drugs, typically appearing around the fourth or fifth day; or it forms immediately upon onset due to inherent deficiency and coldness of Yang Qi; or it results from initial exposure to wind-cold or consumption of cold/raw foods. This syndrome is treatable within six days, but untreatable thereafter.