茯苓(四两) 桂枝(三两,去皮) 白术 甘草(各二两,炙) 上四味、以水六升,煮取三升,去渣,分温三
服。
伤寒若吐、若下后,心下逆满,气上冲胸,起则头眩,脉沉紧,发汗则动经,身为振振摇者,茯苓
桂枝白术甘草汤主之。此亦阳虚而动肾水之症。即真武症之轻者,故其法亦仿真武之意。
芍药 甘草(各三两,炙) 附子(一枚,炮去皮破八片) 上三味,以水五升,煮取一升五合,去渣,分温三服。
发汗病不解,反恶寒者,虚故也,芍药甘草附子汤主之。甘草附子加芍药,即有和阴之意,亦邪之
甚轻者。
桂枝(四两,别切) 甘草(四两,炙) 白术 人参 干姜(各三两) 上五味。以水九升,先煮四味,取五升
,纳桂,更煮取三升,桂独后煮,欲其于治里症药中,越出于表,以散其邪也。去渣,温服一升,日再夜一服。
太阳病,外证未除;而数下之,下之太早又多。遂协热而利,利下不止,邪陷入里。心下痞硬,邪在上
焦,犹属半表。表宜桂枝。里宜余四味。不解者,桂枝人参汤主之。此必数下之后,而现虚症,故虽协
热而仍用温补。
《论》中有汗家重发汗,必恍惚心乱,小便已,阴疼,与禹余粮丸。疑即此为丸。
赤石脂(碎) 禹余粮(碎,各一斤) 上二味,以水六升,煮取二升,去渣,分温三服。二石同煎,方中
绝少。
伤寒服汤药,下利不止,心下痞硬,服泻心汤已,复以他药下之,利不止,一误再误。医以理中与
之,利益甚,理中者,理中焦也,此利在下焦,下药太过,则大肠受伤。赤石脂禹余粮汤主之。以涩治
脱。复利不止者,当利其小便。分其清浊,则便自坚。
茯苓(四两) 桂枝(三两,去皮) 白术 甘草(各二两,经蜜炙) 以上四味药,用六升水,煎煮至三升,滤去药渣,分三次温服。
伤寒病经过催吐或泻下治疗后,出现胃脘部胀满逆气,气向上冲至胸部,起身时头晕目眩,脉象沉而紧;若此时再误用发汗法,会扰动经脉,导致身体震颤摇晃者,以茯苓桂枝白术甘草汤主治。这也是阳气虚弱而引发肾水上泛的症状。即真武汤证(真武汤证:少阴阳虚水泛证)的轻症,所以其治法也仿照真武汤的意旨。
芍药 甘草(各三两,经蜜炙) 附子(一枚,炮制后去皮并破成八片) 以上三味药,用五升水,煎煮至一升五合,滤去药渣,分三次温服。
发汗后病邪未解,反而出现恶寒症状,这是正气虚弱的缘故,以芍药甘草附子汤主治。甘草附子汤中加入芍药,便有了调和阴液的意思,这也属于邪气较轻微的情况。
桂枝(四两,另切) 甘草(四两,经蜜炙) 白术 人参 干姜(各三两) 以上五味药。用九升水,先煎煮前四味药,取五升药液,再加入桂枝,继续煎煮至三升。桂枝单独后下,是希望它在治疗里证的药物中,能够透达于表,以疏散邪气。滤去药渣,温服一升,白天服两次,晚上服一次。
太阳病,表证尚未解除;却多次使用泻下法,且泻下过早且次数过多。于是导致协热利(协热利:表证未解兼见下利的病症),下利不止,邪气陷入体内。胃脘部痞塞硬满,邪气在上焦,仍属于半表半里范畴。表证宜用桂枝汤解表,里证宜用其余四味药温中。若上述情况仍未缓解,以桂枝人参汤主治。这必定是多次泻下之后,出现了虚证,所以虽然伴有热象,仍然使用温补之法。
《伤寒论》中提到,平素多汗之人若再次重发汗,必然出现心神恍惚、心中烦乱,小便结束后尿道疼痛,给予禹余粮丸。怀疑此方即为禹余粮丸。
赤石脂(捣碎) 禹余粮(捣碎,各一斤) 以上两味药,用六升水,煎煮至二升,滤去药渣,分三次温服。两种矿物药同煎,在方剂中极为少见。
伤寒病患者服用汤药后,下利不止,胃脘部痞塞硬满,服用泻心汤后,医生又用其他药物进行泻下,导致下利不止,这是一误再误。医生用理中汤(理中汤:温中祛寒、补气健脾之剂)治疗,但下利更加严重。理中汤是调理中焦脾胃的,此处的下利位于下焦,因泻下药太过,损伤了大肠。应以赤石脂禹余粮汤主治。用收敛固涩的方法治疗滑脱不禁。如果服用后下利仍不止,应当通利小便。通过分清别浊,大便自然就会成形坚硬。
Fuling (Poria, four liang) Guizhi (Cinnamon Twig, three liang, peeled) Baizhu (Atractylodis Macrocephalae Rhizoma) Gancao (Licorice Root, two liang each, honey-fried). The above four ingredients are boiled in six sheng of water until reduced to three sheng. The dregs are removed, and the decoction is divided into three warm doses.
After a Shanghan (Cold Damage) disease has been treated with emesis or purgation, if there is fullness and rebellious qi in the epigastrium, qi rushing up to the chest, dizziness upon rising, and a deep, tight pulse; if sweating is then mistakenly induced, it will disturb the channels, causing the body to tremble and shake. In such cases, Fuling Guizhi Baizhu Gancao Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction) is the primary treatment. This is also a syndrome of yang deficiency leading to the movement of kidney water. It is a mild form of Zhenwu Syndrome (Zhenwu Syndrome: Syndrome of Shaoyin Yang Deficiency with Water Flooding), so its therapeutic principle imitates that of Zhenwu Tang.
Shaoyao (Peony Root) Gancao (Licorice Root, three liang each, honey-fried) Fuzi (Prepared Aconite Root, one piece, processed, peeled, broken into eight pieces). The above three ingredients are boiled in five sheng of water until reduced to one sheng and five he. The dregs are removed, and the decoction is divided into three warm doses.
If after sweating the disease does not resolve, but instead chills appear, this indicates deficiency. Shaoyao Gancao Fuzi Tang (Peony, Licorice, and Prepared Aconite Decoction) is the primary treatment. Adding Shaoyao to Gancao Fuzi Tang introduces the intention of harmonizing yin, indicating that the pathogenic factor is relatively mild.
Guizhi (Cinnamon Twig, four liang, cut separately) Gancao (Licorice Root, four liang, honey-fried) Baizhu (Atractylodis Macrocephalae Rhizoma) Renshen (Ginseng Root) Jiangzao (Dried Ginger, three liang each). The above five ingredients are boiled in nine sheng of water. First, boil the first four ingredients to obtain five sheng of liquid, then add Guizhi, and continue boiling until three sheng remain. Guizhi is added last to allow it to transcend from the interior-treating herbs to the exterior, thereby dispersing the pathogen. The dregs are removed, and one sheng is taken warm, twice during the day and once at night.
In Taiyang Disease (Taiyang Disease: Exterior syndrome caused by cold pathogen invasion), if the exterior symptoms persist, but multiple purgations have been used prematurely and excessively, it leads to Xiere Li (Xiere Li: Diarrhea accompanying exterior heat), with unceasing diarrhea as the pathogen sinks inward. There is hardness and stuffiness in the epigastrium; the pathogen is in the upper jiao, still belonging to the half-exterior category. For the exterior, Guizhi Tang should be used; for the interior, the remaining four ingredients should be used. If these do not resolve the condition, Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction) is the primary treatment. This must be a deficiency syndrome appearing after multiple purgations; therefore, although there is heat, warming and tonifying methods are still employed.
The *Shanghan Lun* states: "For those who sweat frequently, heavy sweating will inevitably cause mental confusion and restlessness; after urination, there will be pain in the genitalia. Give Yuyuliang Wan." It is suspected that this refers to Yuyuliang Wan.
Chishizhi (Red Halloysite, crushed) Yuyuliang (Limonitum, crushed, one jin each). The above two ingredients are boiled in six sheng of water until reduced to two sheng. The dregs are removed, and the decoction is divided into three warm doses. Boiling two mineral substances together is rare in formulas.
In a Shanghan patient who takes herbal medicine and suffers from unceasing diarrhea and epigastric stuffiness and hardness, if after taking Xiexin Tang (Heart-Draining Decoction), the physician again uses other purgatives, leading to unceasing diarrhea, this is a double error. If the physician treats with Lizhong Tang (Middle-Jiao Regulating Decoction), the diarrhea worsens. Lizhong Tang regulates the middle jiao, but this diarrhea is located in the lower jiao. Excessive use of purgatives injures the large intestine. Chishizhi Yuyuliang Tang (Red Halloysite and Limonitum Decoction) is the primary treatment. Use astringent methods to treat prolapse/looseness. If the diarrhea continues despite this, one should promote urination. By separating the clear from the turbid, the stool will naturally become firm.