本除热瘫痫
大黄 干姜 龙骨（各四两） 桂枝（三两） 甘草 牡蛎（各二两） 寒水石 滑石 赤石脂 白石英 紫石英 石
膏（各六两）
上十二味。杵粗筛。以韦囊盛之。取三指。撮。井萃水三升。煮三沸。温服一升。
琥按上方。内有六石。想即是庞氏所用汤也。愚以六石中。止寒水滑石石膏可用。余石皆温。涩不可用。得毋以
本草十剂云。湿可以去枯紫白石英之属是邪。盖火逆虽系枯燥之证。恐多用石药。更加干姜桂枝等。反增其燥。上汤之
用。不可执也。
治时行热病。六七日未得汗。脉洪大或数。面赤。目瞪。身体大热。烦躁。狂言欲走。大渴甚。又五六日以上不解。
热在胸中。口噤不能言。为坏病。伤寒医所不治。弃为死人。或人精魂已竭。心下才暖。拨开其口。灌药下咽即活。兼
治阳毒及发斑。
黄芩（一两） 釜底煤（即百草霜研入一两） 大黄（一两一分或作二两） 芒硝（一两） 灶突墨（一两研入） 梁
上尘（一两） 小麦奴（小麦未成熟时丛中不成麦捻之成黑勃是也无此亦得。庞安时云。如无即以小麦炒黑。摊地上出
火毒用之一两） 麻黄（去节泡一二沸焙干秤三两）
上件。捣罗为极细末。烁蜜为丸。如弹子大。以新汲水三合。研下一丸。渴者。但与冷水。尽足饮之。须臾。当寒
寒竟。汗出便瘥。若日移五尺。不汗。根据前法。再服一丸。瘥即止。须微利也。此药。须是病患大渴倍常。躁盛者。乃
可与之。若小渴者。强与之。翻为祸耳。
琥按上方。即千金麦奴丸也。本止治伤寒五六日以上不解云云。为坏病。活人兼治时行热病及阳毒发斑耳。愚以此
方。用以治火逆证。烦躁惊狂。渴欲饮水。谵语。大便秘而内外实热者最神。盖火逆是受火之余毒。故以釜底煤灶突墨
等药。以从治之也。
准绳载是斋方云。伤寒阴阳二证不明。或投药错误。致患人困重。垂死。七日以后。皆可服。传者云。千不失一用。
好人参（一两去芦薄切） 水（一大升）
于银石器内。煎至一盏。以新水沉之。令冷。一服而尽。汗不自他出。只在鼻梁尖上。涓涓如水。是其应也。妙甚。
苏韬光云。侍郎方丈。尝以救数十人。王使君宰清流。日 车。申屠行父之子妇。产后病。时疫。一十余日。已成坏病。
偶见问因。劝其服人参一味。遂安。是时未知有此方。偶然暗合耳。
琥按上是斋方。是治坏病中之误汗吐下。真气脱而致虚者。服之自神。
（琥）又按伤寒汗吐下针灸等法。关系非轻。今医止知汗下。而吐法与针灸之道。久已不讲。然因汗下而致逆者。
亦不少。诸逆之中。惟火为甚。以伤寒本系热病。复加以火。其逆可知。所以仲景当日。特设救逆汤以治之。其他诸逆。
虽有治法。不云救逆也。至于后贤立论。亦以火逆。谆谆垂训良有以夫。
本方主治热邪引起的瘫痪和癫痫。
大黄、干姜、龙骨（各四两）、桂枝（三两）、甘草、牡蛎（各二两）、寒水石、滑石、赤石脂、白石英、紫石英、石膏（各六两）。
以上十二味药，捣碎并粗筛。用皮囊盛装。每次取三指撮的药量，用井水三升，煮三沸。温服一升。
琥按：上方中，含有六种矿石类药物，想来就是庞安时所用的汤剂。我认为在这六种矿石中，只有寒水石、滑石、石膏可以使用，其余矿石皆属温性且涩滞，不可使用。难道是因为《本草十剂》中说：“湿可以去枯，紫石英、白石英之类是也”吗？大概火逆证虽然属于枯燥之证，但恐怕多用石药，再加上干姜、桂枝等温热药物，反而会增加其燥性。因此，对于上述汤剂的应用，不可固执拘泥。
治疗时行热病（流行性热病），经过六七天仍未得汗，脉象洪大或数，面色红赤，眼睛直视，身体高热，烦躁不安，胡言乱语想要奔跑，极度口渴。又有五六日以上大便不解，热邪在胸中，牙关紧闭不能说话，这属于坏病（病情恶化变证），是伤寒医生无法治疗的，被放弃视为死人。或者患者精气魂魄已竭，但心下部位尚有余温，拨开其口，灌下药液咽下即可复活。兼治阳毒及发斑疹。
黄芩（一两）、釜底煤（即百草霜研入一两）、大黄（一两一分，或作二两）、芒硝（一两）、灶突墨（一两研入）、梁上尘（一两）、小麦奴（小麦未成熟时丛中不成麦穗的黑褐色部分，若无此物也可，庞安时说：如无即用小麦炒黑，摊在地上除去火毒，用一两）、麻黄（去节，泡一二沸后焙干秤三两）。
以上药材，捣罗成极细末，炼蜜为丸，如弹子大小。用新汲水三合，研磨化开一丸服用。口渴者，只给冷水，尽量多喝。片刻之后，应当感到寒冷，冷感过后，出汗则病愈。如果过了五尺的距离时间（指一段时间）仍不出汗，按照前面的方法，再服一丸。病愈即止，需要轻微腹泻。此药，必须是患者极度口渴比平时加倍，躁动严重的人，才可以给予。如果是轻微口渴，强行给予，反而会成为祸害。
琥按：上方，就是《千金方》中的麦奴丸。原本只治疗伤寒五六日以上不解，成为坏病的情况，《活人书》兼治时行热病及阳毒发斑。我认为此方，用于治疗火逆证，出现烦躁惊狂，想喝水，谵语，大便秘结且内外实热者最为神奇。因为火逆是受火邪的余毒，所以用釜底煤、灶突墨等药物，以从治法来治疗它。
《准绳》记载是斋方的说法：伤寒阴阳二证不明确，或者投药错误，导致患者困重，濒临死亡，七日以后，都可以服用。传言说，千次使用不失一次。
好人参（一两，去芦头，薄切）、水（一大升）。
在银石器内，煎至一盏的量，用新水浸泡使其冷却。一次服完。汗不是从其他部位流出，只在鼻梁尖端，涓涓如水渗出，这是药效的反应。非常奇妙。
苏韬光说：侍郎方丈，曾用此方救活数十人。王使君治理清流县时，每日乘车，申屠行父的儿媳妇，产后患病，时疫，十多天，已成坏病。偶然询问病因，劝她服用人参一味，于是安定。当时不知道有此方，只是偶然暗合罢了。
琥按：以上是斋方，是治疗坏病中误用汗、吐、下法，导致真气脱失而致虚的情况，服用自有效验。
（琥）又按：伤寒的汗、吐、下、针灸等方法，关系非轻。现在的医生只知道汗法和下法，而吐法和针灸之道，久已不讲。然而因汗下而致逆证的，也不少。诸种逆证之中，以火逆为最甚。因为伤寒本来属于热病，再加上火疗，其逆证可知。所以张仲景当日，特别设立救逆汤来治疗它。其他诸逆，虽有治法，但不称为救逆。至于后世贤者立论，也以火逆谆谆告诫，确实是有原因的。
This formula treats paralysis and epilepsy caused by heat pathogen.
Rhubarb (Da Huang), Dried Ginger (Gan Jiang), Dragon Bone (Long Gu) (each 4 liang), Cinnamon Twig (Gui Zhi) (3 liang), Licorice Root (Gan Cao), Oyster Shell (Mu Li) (each 2 liang), Cold Water Stone (Han Shui Shi), Talcum (Hua Shi), Red Halloysite (Chi Shi Zhi), White Quartz (Bai Shi Ying), Purple Quartz (Zi Shi Ying), Gypsum (Shi Gao) (each 6 liang).
The above twelve ingredients are crushed and coarsely sieved. Stored in a leather bag. Take a pinch held by three fingers, with well water 3 sheng, boil for three boils. Warm dose 1 sheng.
Hu notes: The above formula contains six mineral substances, which I presume is the decoction used by Pang Anshi. In my opinion, among these six minerals, only Cold Water Stone (Han Shui Shi), Talcum (Hua Shi), and Gypsum (Shi Gao) can be used; the rest of the minerals are warm and astringent, and should not be used. Is it because "Bencao Shiji" states: "Moistening agents can remove dryness, such as Purple Quartz (Zi Shi Ying) and White Quartz (Bai Shi Ying)"? It seems that although Fire Reversal (Huo Ni) syndrome is characterized by dryness, excessive use of mineral drugs, combined with warm herbs like Dried Ginger (Gan Jiang) and Cinnamon Twig (Gui Zhi), may exacerbate the dryness. Therefore, the application of the aforementioned decoction should not be rigidly adhered to.
Treats epidemic febrile diseases (Shi Xing Re Bing). After six or seven days without sweating, the pulse is surging (Hong Da) or rapid (Shu), face is red, eyes are fixed, body is highly feverish, restless, delirious speech with desire to run, extreme thirst. Also, if unresolved after five or six days, with heat in the chest, trismus preventing speech, this constitutes a complicated disease (Huai Bing), which is untreatable by physicians, abandoned as dead. Or if the patient's essence and soul are exhausted, but warmth remains under the heart, opening the mouth and administering medicine orally can revive them. Also treats Yang Toxicity (Yang Du) and maculopapular rash (Fa Ban).
Scutellaria Root (Huang Qin) (1 liang), Furnace Bottom Coal (Fu Di Mei) (i.e., Ba Cao Shuang, 1 liang mixed in), Rhubarb (Da Huang) (1 liang 1 fen, or 2 liang), Mirabilite (Mang Xiao) (1 liang), Chimney Soot (Zao Tu Mo) (1 liang mixed in), Dust from Beams (Liang Shang Chen) (1 liang), Wheat Sprouts (Xiao Mai Nu) (black-brown undeveloped parts of immature wheat clusters; if unavailable, Pang Anshi suggests frying wheat until black, spreading on ground to remove fire toxicity, 1 liang), Ephedra Stem (Ma Huang) (remove nodes, soak for one or two boils, bake dry, weigh 3 liang).
The above ingredients are pounded and sifted into an extremely fine powder. Honey pills are made, size of a bullet. Grind one pill in 3 he of fresh cold water and administer. For those thirsty, provide only cold water, drink as much as possible. Shortly thereafter, chills will occur; after the chills subside, sweating indicates recovery. If no sweat occurs after a short time, repeat the method and administer another pill. Stop when recovered; slight diarrhea is expected. This medicine should only be given to patients with extreme thirst, double their usual amount, and severe restlessness. If given forcibly to those with mild thirst, it may cause harm.
Hu notes: The above formula is the Wheat Sprout Pill (Mai Nu Wan) from Qianjin Fang. Originally used only for Taiyang disease unresolved after five or six days, becoming a complicated disease (Huai Bing). Huo Ren book adds treatment for epidemic febrile diseases and Yang Toxicity with rash. I believe this formula is most effective for treating Fire Reversal (Huo Ni) syndrome presenting with restlessness,惊狂 (frightened mania), desire to drink water, delirium, constipation, and excess heat inside and outside. Since Fire Reversal is residual toxin from fire therapy, agents like Furnace Bottom Coal (Fu Di Mei) and Chimney Soot (Zao Tu Mo) are used for contrarian treatment (Cong Zhi).
Zhun Sheng records the Fang Zi formula: When Yin and Yang syndromes of Taiyang disease are unclear, or medication errors lead to severe weakness and near-death state after seven days, it can be taken. It is said that its success rate is nearly one hundred percent.
Good Quality Ginseng Root (Ren Shen) (1 liang, remove rhizome, slice thinly), Water (1 da sheng).
Decoct in silver or earthenware vessel to 1 zhen. Cool by immersing in fresh water. Take all at once. Sweat will not come from other parts, but only drip from the tip of the nose bridge, which is the therapeutic response. Very miraculous.
Su Taoguang says: Vice Minister Fang Zhang used this to save dozens of people. Wang Shijun governed Qingliu County, daily riding carriage. Shentu Xingfu's daughter-in-law suffered postpartum epidemic disease for over ten days, becoming a complicated disease (Huai Bing). Upon inquiry, advised taking single ingredient Ginseng Root (Ren Shen), thus stabilized. At that time, this formula was unknown, merely coincidental agreement.
Hu notes: The above Fang Zi formula treats complicated diseases (Huai Bing) caused by erroneous sweating, vomiting, or purging methods, leading to true qi depletion and deficiency. It is self-evidently effective.
(Hu) Furthermore, sweating, vomiting, purging, and acupuncture methods for Taiyang disease are of great significance. Current physicians only know sweating and purging, while vomiting and acupuncture have long been neglected. However, reversals (Ni) caused by sweating and purging are not few. Among various reversals, Fire Reversal (Huo Ni) is the most severe. Since Taiyang disease is essentially a heat disease, adding fire therapy leads to obvious reversal. Thus, Zhang Zhongjing specifically established Jiu Ni Tang (Rescue Reversal Decoction) to treat it. Other reversals have treatments but are not called "Rescue Reversal". Later scholars also emphasize Fire Reversal (Huo Ni) warnings, which is indeed justified.