太阳伤寒者加温针必惊也
温针发汗亡阳土败胃逆神魂无归必生惊悸也
火逆下之因烧针烦躁者桂枝甘草龙骨牡蛎汤主之
火劫发汗是为火逆火逆之证下之亡其里阳又复烧针发汗亡其表阳神气离根因而烦躁不安桂枝甘草龙骨牡蛎汤桂枝甘
草疏乙木而培中脘龙骨牡蛎敛神气而除烦躁也
桂枝(一两) 甘草(二两) 龙骨(二两) 牡蛎(三两)
上为末以水五升煮二升半去滓温服八合日三服
发汗若下之病仍不解烦躁者茯苓四逆汤主之
汗下亡阳土败水侮阳气拔根扰乱无归故生烦躁茯苓四逆汤茯苓参甘泄水而补土干姜附子温脾而暖肾也
茯苓(六两) 人参(一两) 甘草(二两炙) 干姜(一两五钱) 附子(一枚去皮)
上五味以水五升煮取二升去滓温服七合日三服
下之后复发汗昼日烦躁不得眠夜而安静不呕不渴无表证脉微沉身无大热者干姜附子汤主之
汗下亡阳土败水侮微阳拔根不得下秘故昼日烦躁不得眠夜而阳气归根是以安静温气脱泄乙木郁陷故脉象沉微而身无
大热干姜附子汤干姜温中以回脾胃之阳附子温下以复肝肾之阳也
干姜(一两) 附子(一枚生用去皮破八片)
上二味以水三升煮取一升去滓顿服
汗家重发汗必恍惚心乱小便已阴疼与禹余粮丸(方缺)
平素汗家液亡神虚重发其汗阳亡神败必恍惚心乱湿动木郁小便后阴痛以木郁于水疏泄不畅便后滞气凝涩故尿孔作痛
禹余粮敛阳神于阴精蛰君火而达风木也
温针强行发汗,会导致阳气亡失;土气败坏,胃气上逆,神魂失去依附之所,必然产生惊悸症状。
因火法劫汗(火逆)后又误用下法,且因烧针导致烦躁不安的,主治方剂为桂枝甘草龙骨牡蛎汤。
所谓“火逆”,是指用火法强行发汗。火逆之证若误用下法,会损伤体内的阳气;此时若再施以烧针发汗,又会耗损体表的阳气。神气因此离根,导致烦躁不安。桂枝甘草龙骨牡蛎汤中,桂枝、甘草能疏泄乙木(肝气)并培补中脘(脾胃);龙骨、牡蛎能收敛神气并消除烦躁。
以上四味药研为细末,用水五升,煮取二升半,去滓,每次温服八合,每日服用三次。
经过发汗或攻下治疗后,病邪仍未解除,出现烦躁不安的,主治方剂为茯苓四逆汤。
汗法和下法并用导致阳气亡失,土气败坏,水气反侮脾土,阳气拔根扰乱、无所归依,因而产生烦躁。茯苓四逆汤中,茯苓、人参、甘草能渗泄水湿并补益脾土;干姜、附子能温补脾阳并暖肾阳。
茯苓(六两) 人参(一两) 甘草(二两,炙) 干姜(一两五钱) 附子(一枚,去皮)
以上五味药,用水五升,煮取二升,去滓,每次温服七合,每日服用三次。
在攻下之后又再次发汗,白天烦躁不安无法入睡,夜间却安静下来,没有呕吐,没有口渴,也没有表证,脉象微细沉伏,身体没有明显高热的,主治方剂为干姜附子汤。
汗下法并用导致阳气亡失,土气败坏,水气反侮,微弱的阳气拔根不能潜藏,所以白天烦躁不得眠,夜间阳气归根所以安静。温气脱泄,乙木(肝气)郁陷,所以脉象呈现沉微,身体没有大热。干姜附子汤中,干姜温中焦以恢复脾胃之阳,附子温下焦以恢复肝肾之阳。
以上两味药,用水三升,煮取一升,去滓,一次性顿服。
平素多汗之人,若再次重发其汗,必然导致神情恍惚、心中烦乱;小便结束后阴部疼痛,应给予禹余粮丸治疗(原书方剂缺失)。
平素多汗的人,津液已亡,神气虚弱,若再重发其汗,会导致阳气亡失、神气败坏,必然出现神情恍惚、心中烦乱。湿气妄动,肝木郁结,导致小便后阴部疼痛。这是因为肝木郁结于水中,疏泄功能不畅,便后滞气凝涩,所以尿道口作痛。禹余粮能收敛阳神于阴精之中,潜镇君火而通达风木(肝气)。
Taiyang (Greater Yang) cold damage syndrome, if treated with warm needle therapy, will inevitably cause fright.
Warm needle therapy forcibly induces sweating, leading to the loss of Yang Qi; Earth Qi fails, Stomach Qi rebels, and the Spirit loses its abode, inevitably resulting in palpitations and fright.
For cases where fire-induced sweating (Fire Adverse Reaction) is followed by erroneous purgation, and restlessness is caused by burning needles, Guizhi Gancao Longgu Muli Tang (Cinnamon Twig, Licorice, Dragon Bone, and Oyster Shell Decoction) is the primary treatment.
"Fire Adverse Reaction" refers to forcibly inducing sweating using fire methods. If a Fire Adverse Reaction case is erroneously treated with purgation, it damages internal Yang Qi; if burning needles are then used to induce sweating, it further depletes external Yang Qi. The Spirit becomes detached from its root, causing restlessness. In Guizhi Gancao Longgu Muli Tang, Guizhi (Cinnamon Twig) and Gancao (Licorice) soothe Yi Wood (Liver Qi) and nourish the Middle Jiao (Spleen and Stomach); Longgu (Dragon Bone) and Muli (Oyster Shell) astringe the Spirit and alleviate restlessness.
Guizhi (1 liang), Gancao (2 liang), Longgu (2 liang), Muli (3 liang).
Grind the above four herbs into powder. Boil in 5 sheng of water until reduced to 2.5 sheng, strain, and take 8 ge warm per dose, three times daily.
If after sweating or purging therapies the disease persists and restlessness occurs, Fuling Sini Tang (Poria, Four-Ingredient Decoction) is the primary treatment.
The combination of sweating and purging leads to Yang Qi loss, Earth Qi failure, Water Qi counteracting Earth, Yang Qi becoming uprooted and chaotic without return, thus generating restlessness. In Fuling Sini Tang, Fuling (Poria), Renshen (Ginseng), and Gancao (Licorice) drain dampness and tonify Earth; Ganjiang (Dried Ginger) and Fuzi (Prepared Aconite) warm the Spleen and warm the Kidney.
Fuling (6 liang), Renshen (1 liang), Gancao (2 liang, honey-fried), Ganjiang (1.5 liang), Fuzi (1 piece, peeled).
Boil the above five herbs in 5 sheng of water until reduced to 2 sheng, strain, and take 7 ge warm per dose, three times daily.
After purgation followed by re-sweating, if there is daytime restlessness preventing sleep but nighttime quietness, no vomiting, no thirst, no exterior syndrome signs, a faint and deep pulse, and no significant body heat, Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction) is the primary treatment.
The combination of sweating and purging leads to Yang Qi loss, Earth Qi failure, Water Qi counteracting, and weak Yang Qi becoming uprooted and unable to descend. Thus, there is daytime restlessness and insomnia, while nighttime quietness occurs as Yang Qi returns to its root. The escape of warming Qi causes Yi Wood (Liver Qi) to stagnate and sink, resulting in a faint and deep pulse and absence of high fever. Ganjiang warms the Middle Jiao to restore Spleen and Stomach Yang; Fuzi warms the Lower Jiao to restore Liver and Kidney Yang.
Ganjiang (1 liang), Fuzi (1 piece, raw, peeled, broken into eight pieces).
Boil the above two herbs in 3 sheng of water until reduced to 1 sheng, strain, and take all at once in one dose.
For individuals prone to sweating, if heavy sweating is induced again, it will inevitably lead to mental confusion and inner turmoil; pain in the genitalia after urination should be treated with Yuyuliang Wan (Hematitum Pill) [Formula missing].
Individuals prone to sweating have depleted fluids and deficient Spirit. Heavy sweating further depletes Yang Qi and damages the Spirit, inevitably causing mental confusion and inner turmoil. Dampness moves chaotically, Liver Wood stagnates, causing post-urinary genital pain. This is because Liver Wood stagnates within Water, impairing free flow; after urination, stagnant Qi condenses, causing pain in the urethral meatus. Yuyuliang (Hematitum) astringes Yang Spirit into Yin Essence, anchors Ministerial Fire, and unblocks Wind-Wood (Liver Qi).