(万病虚劳同用)
取七岁以下。五岁以上。黄牛新生者。乳一升。以水四升。煎取一升。如人体温。稍稍饮之。不得过多。十日服。
不绝为佳。
琥按黄牛属土。其乳色白。又属金。味甘气温。大能补气。养营。润燥除虚热。解劳乏。病后肺脾气虚。大肠枯
燥者。大宜服之。
栀子仁(三七枚) 石膏(五两) 香豉(一升) 鼠屎(尖头大者二十枚)
上四味。 咀。以水七升。煮取三升。分三服。
琥按上主治云。劳复。或食饮。或动作。夫两者之复。不无少异。盖饮食之复。宜消导。动作之复。宜调补。在
仲景既以枳实栀子豉汤两用之。上方之用。即祖仲景之意也。大抵此方专治劳复热渴证。故以石膏鼠粪。二者之甘寒。
以凉解之。愚以石膏一味太寒重。莫若以知母。或栝蒌根代之。千金又一方。治食大饱不消。劳复脉实者。即上方中去
石膏加大黄。此又仲景法云。有宿食者。加大黄如博棋子大五六枚是也。愚谓以上等方。治食复。固效。治劳复。尚宜
斟酌。
烧鳖甲末饮服方寸匕
琥按上方。乃治少阴厥阴劳复。寒热间作之证。
治劳复气欲绝。起死人方。
麦门冬(去心一两) 甘草(二两) 京枣(二十枚) 竹叶(切一升)
上四味。 咀。以水七升。煮粳米一升。令熟。去米。内诸药。煎取三升。分三服。不能服者。绵滴汤。内口中。
用之有效。(据原方中。麦冬止一两。太少。可增至三两。)
琥按上方。乃治肺脾劳乏之剂。即仲景竹叶石膏汤之变也。王海藏治劳复。亦用此方。去京枣复云。加人参大妙。
(适用于各种虚劳病症通用)
取七岁以下、五岁以上的小黄牛所产的新鲜乳汁一升,加入水四升,煎煮至剩下一升。待药液温度与人体体温相当时,少量多次饮用。不可过量服用。连续服用十天,以不间断为佳。
琥按:黄牛属土,其乳汁色白,又属金。味甘性温,大能补气,滋养营血,润燥清除虚热,解除疲劳乏力。对于病后肺脾之气虚弱、大肠干枯燥结的患者,非常适宜服用。
栀子仁(三十七枚) 石膏(五两) 香豉(一升) 鼠屎(尖头大的二十枚)
以上四味药,切碎,用水七升,煎煮取汁三升,分三次服用。
琥按:上述主治条文提到“劳复”,无论是因饮食不当还是过度活动引起的复发,两者虽略有不同。一般来说,饮食引起的复发,宜用消食导滞的方法;活动引起的复发,宜用调理补益的方法。在张仲景的著作中,枳实栀子豉汤被用于这两种情况。上方(指栀子豉汤类方)的运用,正是秉承了张仲景的本意。大抵此方专门治疗因劳累导致的发热口渴证候,因此使用石膏和鼠粪这两味甘寒之品,来清热凉解。我认为单用石膏过于寒凉沉重,不如用知母或栝蒌根代替。《千金方》还有另一方,治疗因暴饮暴食导致消化不良、劳累复发且脉象实有力的患者,即在上方中去掉石膏,加入大黄。这也是遵循张仲景的说法:“如果有宿食,加大黄如博棋子大小五六枚。”我认为以上等方剂治疗饮食引起的复发固然有效,但治疗劳累引起的复发,仍需谨慎斟酌。
将鳖甲烧成末,每次饮服一方寸匕。
琥按:上方是治疗少阴经和厥阴经劳累复发的方剂,症状表现为寒热交替发作。
治疗因劳累导致气机欲绝、起死回生的方子。
麦门冬(去心一两) 甘草(二两) 京枣(二十枚) 竹叶(切细一升)
以上四味药,切碎,用水七升,先煮粳米一升,煮至熟烂,去掉米粒,再加入其他药物,煎煮取汁三升,分三次服用。如果无法吞咽,可用绵花蘸药汤滴入口中。使用此法有效。(根据原方,麦冬仅用一两,量太少,可增加到三两。)
琥按:上方是治疗肺脾劳累乏力的方剂,即张仲景竹叶石膏汤的变方。王海藏治疗劳累复发,也使用此方,并说去掉京枣后,加入人参效果更佳。
(Applicable to various deficiency-fatigue conditions)
Take fresh milk from a young yellow cow aged between five and seven years, one sheng. Add four sheng of water, and decoct until only one sheng remains. When the temperature of the liquid is equivalent to human body temperature, drink it slowly in small amounts. Do not consume too much. Take it for ten days; it is best to take it continuously without interruption.
Hu notes: The yellow cow belongs to Earth, and its milk is white, which corresponds to Metal. Its taste is sweet and nature is warm. It greatly benefits Qi, nourishes Ying (Nutritive Qi), moistens dryness, clears deficiency heat, and relieves fatigue. For patients with Lung and Spleen Qi deficiency and dryness of the Large Intestine after illness, this is highly suitable.
Zhi Zi Ren (Gardeniae Fructus, 37 seeds) Shi Gao (Gypsum Fibrosum, 5 liang) Xiang Chi (Fermented Soybean, 1 sheng) Shu Shi (Mus Musculus Feces, 20 pointed ones)
The above four ingredients are cut into pieces. Decoct with seven sheng of water to obtain three sheng of liquid. Divide into three doses.
Hu notes: The aforementioned indications mention "relapse due to overexertion" (Lao Fu). Whether caused by diet or physical activity, there is a slight difference between the two. Generally, relapse due to dietary indiscretion should be treated with digestion-promoting methods, while relapse due to physical exertion should be treated with regulating and tonifying methods. Zhang Zhongjing used Zhi Shi Zhi Zi Chi Tang (Bitter Orange, Gardenia, and Fermented Soybean Decoction) for both. The use of the above formula follows Zhang Zhongjing's intent. Broadly speaking, this formula specifically treats heat and thirst syndromes caused by overexertion. Therefore, it uses the sweet-cold properties of Shi Gao (Gypsum Fibrosum) and Shu Shi (Mus Musculus Feces) to cool and resolve the heat. I believe using Shi Gao alone is too cold and heavy; it would be better to substitute it with Zhi Mu (Anemarrhenae Rhizoma) or Gua Lou Gen (Trichosanthis Radix). Another prescription in Qian Jin Fang treats indigestion from overeating and relapse due to overexertion with a solid pulse, by removing Shi Gao and adding Da Huang (Rhei Radix et Rhizoma) from the above formula. This also follows Zhang Zhongjing's principle: "If there is retained food, add Da Huang, size of a chess piece, five or six pieces." I consider that while these formulas are effective for dietary relapse, caution is needed when treating relapse due to overexertion.
Burn Bi Jia (Testudinis Carapax et Plastrum) to powder, take one fang cun bi with water.
Hu notes: The above formula treats relapse due to overexertion involving the Shaoyin (Lesser Yin) and Jueyin (Terminal Yin) meridians, characterized by alternating chills and fever.
Formula to treat qi exhaustion due to overexertion and revive the dead.
Mai Men Dong (Ophiopogonis Tuber, heart removed, 1 liang) Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 liang) Jing Zao (Jujubae Fructus, 20 pieces) Zhu Ye (Bambusae Folium, cut, 1 sheng)
The above four ingredients are cut into pieces. Decoct with seven sheng of water, first cooking Yi Mi (Oryzae Semen, rice) one sheng until soft. Remove the rice, then add the other herbs. Decoct to obtain three sheng of liquid. Divide into three doses. If unable to swallow, dip cotton wool in the decoction and drip into the mouth. This method is effective. (Note: In the original formula, Mai Dong is only one liang, which is too little; it can be increased to three liang.)
Hu notes: The above formula is for treating Lung and Spleen fatigue due to overexertion. It is a modification of Zhang Zhongjing's Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction). Wang Haicang also used this formula for relapse due to overexertion, stating that removing Jing Zao and adding Ren Shen (Ginseng Radix) yields excellent results.