少阴病,下利,咽痛、胸满、心烦者,猪肤汤主之。
少阴下利,下焦虚矣。少阴脉循喉咙,其支者,出络心注胸中。咽痛、胸满、心烦者,肾火不藏,循经而
上走于阳分也。阳并于上,阴并于下,火不下交于肾,水不上承于心,此未济之象。猪为水畜,而津液在肤。
君其肤以除上浮之虚火,佐白蜜白粉之甘,泻心润肺而和脾。滋化源,培母气,水升火降,上热自除而下利止
矣。
猪肤汤∶
猪肤(一两)
上一味,以水一斗,煮取五升,去滓,加白蜜一升,白粉五合,熬香,和合相得,温分六服。
少阴病,二三日,咽痛者,可与甘草汤;不瘥者,与桔梗汤。
但咽痛,而无下利胸满心烦等症,但甘以缓之足矣。不瘥者,配以桔梗,辛以散之也。其热微,故用此轻
剂耳。
甘草汤∶
甘草(二两)
上一味,以水三升,煮取一升半,去滓,分温再服。
桔梗汤∶
甘草、桔梗(各二两)。余同前法。
少阴病,咽中痛,半夏散及汤主之。
半夏散∶
半夏 桂枝 甘草
上三味,各等分,各捣筛已,合治之,白饮和服方寸匕,日二服。若不能散服,以水一升,煎七沸,内散方
寸匕,更煮三沸,下火令少冷,少少咽之。
此必有恶寒欲呕证,故加桂枝以散寒,半夏以除呕。若夹相火,则辛温非所宜矣。
少阴病,呕而咽中伤,生疮不能语,声不出者,苦酒汤主之。
苦酒汤∶
半夏(十四枚,洗破如枣核大) 鸡子(一枚去黄存白留壳中)
上二味,内半夏、苦酒着鸡子内,以鸡子置刀 中,安火上,令三沸,去滓,少少含咽之。不瘥,更作三剂。
取苦酒以敛疮,鸡子以发声。而兼半夏者,必因呕而咽伤,胸中之痰饮尚在,故用之。且以散鸡子苦酒之酸寒,
但令滋润其咽,不令泥痰于胸膈也。置刀 中放火上,只三沸即去滓,此略见火气,不欲尽出其味,意可知矣。
鸡子黄走血分,故心烦不卧者宜之;其白走气分,故声不出者宜之。
少阴病,出现下利、咽喉疼痛、胸部胀满、心中烦躁的症状,应当用猪肤汤主治。
少阴病伴有下利,说明下焦已经虚损。少阴经脉循行经过喉咙,其分支从喉咙出来,联络心脏并注入胸中。出现咽喉疼痛、胸部胀满、心中烦躁,是因为肾中相火不能潜藏,顺着经脉向上走窜到阳分。阳气合并于上,阴气合并于下,火气不能下行交于肾,水气不能上行承济于心,这是水火不济(未济)的征象。猪属于水畜,其津液存在于皮肤之中。以猪皮为君药,用以清除上浮的虚火;辅以白蜜和白粉(米粉)的甘味,能够泻心火、润肺燥并调和脾气。从而滋养化源,培补母气(脾土),使水升火降,上部的热邪自然消除,下利也就停止了。
猪肤汤方:
猪肤(一两)
以上一味药,用水一斗,煮取五升药液,去掉药渣,加入白蜜一升、白粉五合,熬至香气溢出,混合均匀,分六次温服。
少阴病,发病两三天后,出现咽喉疼痛的,可以给予甘草汤治疗;如果症状没有痊愈的,再给予桔梗汤治疗。
如果只是咽喉疼痛,而没有下利、胸满、心烦等症状,只用甘味药物来缓急止痛就足够了。如果服药后症状不缓解,则配合桔梗,利用其辛散之性来疏散邪气。因为热邪轻微,所以使用这种轻剂。
甘草汤方:
甘草(二两)
以上一味药,用水三升,煮取一升半药液,去掉药渣,分两次温服。
半夏散方:
半夏、桂枝、甘草
以上三味药,各取等份,分别捣碎过筛后,混合在一起,用白开水送服一方寸匕的药末,每日服用两次。如果不能服用散剂,则用水一升,煮沸七次后,放入一方寸匕的药散,再煮沸三次,离火稍冷却后,少量多次咽下。
这种情况必定伴有恶寒、想呕吐的症状,所以加入桂枝以发散寒邪,加入半夏以消除呕吐。如果夹杂相火,那么辛温的药物就不适宜了。
少阴病,呕吐且咽喉受损,生疮导致不能说话,声音发不出来的,用苦酒汤主治。
苦酒汤方:
半夏(十四枚,洗净破开如枣核大小)、鸡蛋(一枚,去掉蛋黄保留蛋白,留蛋壳盛装)
将半夏和苦酒(醋)放入鸡蛋壳内,把蛋壳放在刀环中,置于火上,煮沸三次,去掉药渣,少量多次含咽。如果症状未愈,再制作三剂服用。
取苦酒是为了收敛疮口,鸡蛋清是为了恢复发声。之所以兼用半夏,一定是因为呕吐导致咽喉受伤,胸中的痰饮仍然存在,所以使用它。并且用半夏可以消散鸡蛋清和苦酒的酸寒之性,只让药液滋润咽喉,而不致使痰饮停滞在胸膈。将蛋壳放在刀环中置于火上,仅煮沸三次就去掉药渣,这略微见到火气,不希望完全煮出药物的味道,其中的用意可以推知。
Shaoyin disease presenting with diarrhea, sore throat, chest fullness, and irritability should be treated primarily with Zhufu Tang (Pig Skin Decoction).
In Shaoyin disease accompanied by diarrhea, the Lower Jiao (Lower Burner) is deficient. The Shaoyin meridian circulates along the throat; its branch emerges from the throat, connects with the Heart, and enters the Chest. Sore throat, chest fullness, and irritability indicate that Kidney Fire (Ministerial Fire) fails to remain concealed and travels upward along the meridian to the Yang aspect. Yang Qi merges above while Yin Qi merges below; Fire fails to descend to interact with the Kidneys, and Water fails to ascend to nourish the Heart. This presents as a state of "Wei Ji" (Failure to Complete / Unfinished Hexagram), representing disharmony between Water and Fire. Pigs are aquatic animals, and their fluids reside in the skin. Using pig skin as the Sovereign herb removes floating deficiency fire; assisted by the sweetness of White Honey (Baimi) and White Powder (Baifen, rice flour), it drains Heart heat, moistens the Lungs, and harmonizes the Spleen. This nourishes the source of transformation and cultivates the Mother Qi (Spleen Earth), causing Water to ascend and Fire to descend, thereby eliminating upper heat and stopping diarrhea.
Zhufu Tang (Pig Skin Decoction):
Zhu Fu (Pig Skin, 1 liang)
Take this single ingredient, boil in 10 dou of water until reduced to 5 sheng, remove the dregs, add 1 sheng of White Honey and 5 he of White Powder, cook until fragrant, mix thoroughly, and take warm in six divided doses.
In Shaoyin disease, if sore throat appears after two or three days, Gancao Tang (Licorice Decoction) may be administered; if there is no improvement, Jiegeng Tang (Platycodon Decoction) should be given.
If there is only sore throat without symptoms such as diarrhea, chest fullness, or irritability, using sweet herbs to moderate the condition is sufficient. If there is no improvement, Platycodon is added for its acrid property to disperse the pathogen. Since the heat is mild, a light formula is used.
Gancao Tang (Licorice Decoction):
Gancao (Licoriza Radix et Rhizoma, 2 liang)
Take this single ingredient, boil in 3 sheng of water until reduced to 1.5 sheng, remove the dregs, and take warm in two divided doses.
Jiegeng Tang (Platycodon Decoction):
Gancao (Licoriza Radix et Rhizoma) and Jiegeng (Platycodonis Radix, 2 liang each). The preparation method is the same as above.
For Shaoyin disease with severe sore throat, Banxia San (Pinellia Powder) or Banxia Tang (Pinellia Decoction) should be used.
Banxia San (Pinellia Powder):
Banxia (Pinelliae Rhizoma), Guizhi (Cinnamomi Ramulus), Gancao (Licoriza Radix et Rhizoma)
Take these three ingredients in equal proportions, crush and sieve each separately, then mix. Take one cun bi (square-inch measure) mixed with white rice water, twice daily. If powder cannot be taken, boil 1 sheng of water seven times, add one cun bi of the powder, boil three more times, remove from heat, let cool slightly, and swallow slowly in small amounts.
This condition must be accompanied by aversion to cold and desire to vomit; therefore, Guizhi (Cinnamon Twig) is added to dispel cold, and Banxia (Pinellia Tuber) to stop vomiting. If Ministerial Fire is involved, acrid-warm herbs are not suitable.
For Shaoyin disease with vomiting, injury to the throat, formation of sores, inability to speak, and loss of voice, Kujiu Tang (Vinegar Decoction) should be used.
Kujiu Tang (Vinegar Decoction):
Banxia (Pinelliae Rhizoma, 14 pieces, washed and broken like a jujube pit); Ji Zi (Gallus Gallus Domesticum Ovum, one egg, yolk removed, white retained in the shell)
Place the Banxia and Kujiu (Vinegar) into the eggshell. Place the shell in a knife ring over fire, boil three times, remove dregs, and hold/swallow slowly in small amounts. If not cured, prepare three more doses.
Kujiu (Vinegar) is used to astringe sores; Egg White is used to restore voice. Banxia is included because vomiting likely caused throat injury and phlegm-fluid retention remains in the Chest; thus, it is used to scatter the sour-cold nature of the egg white and vinegar, ensuring moisture reaches the throat without allowing phlegm to stagnate in the epigastrium. Placing the shell in the knife ring over fire and boiling only three times before removing dregs reveals a slight application of heat, avoiding the complete extraction of flavors, which indicates the intent.
Egg Yolk enters the Blood aspect and is suitable for irritability and insomnia; Egg White enters the Qi aspect and is suitable for loss of voice.