奔豚有二皆坏病也一由误汗所致一由误加烧针所致
太阳 发汗后其人脐下悸者欲作奔豚茯苓桂枝甘草大枣汤主之(方见悸)烧针令其汗针处被寒核起而赤者必发奔豚
气从少腹上冲心者灸其核上各一壮与桂枝加桂汤更加桂二两
吴 夫奔豚者如豕突之状气从少腹上冲心而痛也凡欲作奔
豚者其气在脐下筑然而动也宜茯苓大枣汤主之或理中汤去白术加肉桂主之痛甚者更加吴茱萸亦佳凡烧针令其汗出者针
处被寒核起而赤必发奔豚也宜灸其核上各一壮与桂枝加桂汤主之若痛甚手足厥逆者宜当归四逆汤加肉桂吴茱萸主之惟
桂大能泄奔豚凡药中不可缺也
茯苓桂枝甘草大枣汤方
茯苓(半斤) 甘草(炙二两) 大枣(十五枚擘) 桂枝(四两)上四味以甘烂水一斗先煮茯苓减二升纳诸药煮
取三升去滓温服一升日三服
肿有三证太阳风湿相搏身微肿者宜治湿阳明中风耳前后肿者宜刺大病瘥后腰以下肿者宜利小便
风湿相搏骨节烦疼掣痛不得屈伸近之则痛剧汗出短气小便不利恶风不欲去衣或身微肿者甘草附子汤主之
阳明中风脉弦浮大而短气腹都满胁下及心痛久按之气不通鼻干不得汗嗜卧一身及面目悉黄小便难有潮热时时哕耳
前后肿刺之小瘥
大病瘥后从腰以下有水气者牡蛎泽泻散主之
牡蛎泽泻散方
牡蛎( ) 泽泻 蜀膝 商陆 葶苈(隔纸炒) 海藻 栝蒌根(各等分)上为末每服一钱或二钱米饮调下小便
利为度身虚胃弱食少者以五苓加苍术陈皮木香砂仁之类主之若人不甚弱者以商陆一味煮粥食之亦佳凡病瘥后足肿者不
妨但节饮食胃气强自消也一方用金毛狗脊煎汤洗之亦效
奔豚病有两种,都属于误治后的变证。一种是由错误发汗所致,另一种是由错误使用烧针所致。
太阳病发汗后,如果患者感到脐下悸动,这是欲作奔豚的征兆,应当用茯苓桂枝甘草大枣汤主治。(该方剂见“悸”条)若因烧针强迫发汗,针刺部位受寒邪侵袭,出现红肿硬结(核起而赤),则必然引发奔豚。
症状表现为气从少腹向上冲撞至心胸部位,应在红肿硬结上各灸一壮,并服用桂枝加桂汤,额外增加桂枝二两。
吴氏认为:奔豚病的表现如同野猪冲撞一般,气从少腹上冲心胸并伴有疼痛。凡是欲作奔豚者,其气在脐下筑然跳动。适宜用茯苓大枣汤主治,或者用理中汤去掉白术,加入肉桂主治。疼痛剧烈者,再加入吴茱萸也很好。凡是使用烧针强迫发汗导致出汗的,针刺部位受寒出现红肿硬结,必然引发奔豚。适宜在硬结上各灸一壮,并用桂枝加桂汤主治。如果疼痛严重且手足厥冷,适宜用当归四逆汤加入肉桂、吴茱萸主治。只有桂枝具有强大的泄降奔豚之气的作用,凡药方中不可缺少。
茯苓桂枝甘草大枣汤方:
茯苓(半斤)、甘草(炙,二两)、大枣(十五枚,掰开)、桂枝(四两)。以上四味药,用甘烂水一斗,先煮茯苓,减少二升水量,然后放入其他药物,煮取三升药液,去渣,温服一升,每日三次。
水肿有三种证型:太阳病风湿相搏,身体轻微浮肿者,适宜治疗湿邪;阳明中风,耳前耳后肿胀者,适宜针刺;大病痊愈后腰以下浮肿者,适宜利小便。
风湿相搏,骨节烦痛,牵掣疼痛,不能屈伸,靠近则疼痛加剧,出汗,短气,小便不利,怕风,不想脱衣,或者身体轻微浮肿者,用甘草附子汤主治。
阳明中风,脉象弦浮大,短气,腹部胀满,胁下及心口疼痛,久按之气不通,鼻干无汗,嗜睡,全身及面目全部发黄,小便困难,有潮热,时时呃逆,耳前后肿胀,针刺后可稍愈。
牡蛎泽泻散方:
牡蛎(煅)、泽泻、蜀漆(洗去腥)、商陆根(熬)、葶苈子(隔纸炒)、海藻(洗去咸味)、栝楼根(以上各等分)。以上药物研为细末,每次服用一钱或二钱,用米饮调服,以小便通利为度。身体虚弱、胃气弱、食少者,用五苓散加入苍术、陈皮、木香、砂仁之类主治。如果病人不是特别虚弱,单用商陆一味煮粥食用也很好。凡是病愈后足部浮肿者,不妨碍,只要节制饮食,胃气强健自然消退。另一方法是用金毛狗脊煎汤清洗,也有效。
Bentun (Rushing Pig) disease has two types, both of which are complications resulting from improper treatment. One is caused by erroneous sweating therapy, and the other by the erroneous use of burning needle therapy.
In Taiyang disease, after sweating therapy, if the patient experiences palpitations below the umbilicus, this indicates an impending Bentun. It should be treated with Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction). (See the section on "Palpitations" for the formula.) If burning needles were used to induce sweating, and the puncture site was exposed to cold, resulting in a red nodule, Bentun will inevitably occur.
The symptom manifests as Qi rushing from the lower abdomen up to the heart and chest. Moxibustion should be applied to each nodule (one moxa cone), followed by administration of Guizhi Jia Gui Tang (Cinnamon Twig Decoction with Additional Cinnamon Twig), adding two liang of Guizhi (Cinnamon Twig).
Wu stated: Bentun presents like a wild boar charging; Qi rushes from the lower abdomen to the heart and chest causing pain. In cases of impending Bentun, the Qi throbs and moves below the umbilicus. It is suitable to treat with Fuling Dazao Tang (Poria and Jujube Decoction), or Lizhong Tang (Regulate the Middle Decoction) with Baizhu (Atractylodes Macrocephala Rhizome) removed and Rougui (Cinnamon Bark) added. For severe pain, adding Wuzhuyu (Evodia Fruit) is also good. Whenever burning needles are used to induce sweating, and the puncture site becomes cold with a red nodule, Bentun will definitely occur. Moxibustion should be applied to the nodule (one cone), and Guizhi Jia Gui Tang should be administered. If pain is severe accompanied by cold limbs, Danggui Sini Tang (Angelica Sinensis Decoction for Frigid Extremities) with Rougui and Wuzhuyu is indicated. Only Guizhi (Cinnamon Twig) has the strong ability to drain Bentun Qi; it must not be omitted in prescriptions.
Formula for Fuling Guizhi Gancao Dazao Tang:
Fuling (Poria) (half jin), Gancao (Licorice Root, honey-fried) (two liang), Dazao (Jujube) (fifteen pieces, split), Guizhi (Cinnamon Twig) (four liang). The above four ingredients are boiled in one dou of Ganlan Shui (Ganlan Water - water stirred vigorously to create bubbles) first. Boil the Fuling until the volume reduces by two sheng, then add the remaining herbs. Boil until three sheng remain, strain, and take one sheng warm, three times daily.
There are three types of edema: In Taiyang disease where Wind-Dampness combats, causing slight body swelling, dampness should be treated; in Yangming Wind-Strike, swelling before and behind the ears should be treated with acupuncture; after recovery from a major illness, swelling below the waist should be treated by promoting urination.
When Wind-Dampness combats, causing severe joint pain, pulling pain, inability to flex or extend, exacerbated by touch, sweating, shortness of breath, difficulty urinating, aversion to wind, reluctance to remove clothes, or slight body swelling, Gancao Fuzi Tang (Licorice and Aconite Decoction) is indicated.
In Yangming Wind-Strike, the pulse is wiry, floating, and large; there is shortness of breath, abdominal fullness, pain in the hypochondrium and heart region that does not resolve with prolonged pressure, dry nose without sweat, drowsiness, complete yellowing of the whole body and face, difficult urination, tidal fever, frequent hiccups, and swelling before and behind the ears. Acupuncture can provide slight relief.
After recovery from a major illness, if there is fluid retention below the waist, Musizi Zexie San (Oyster Shell and Alisma Powder) is indicated.
Formula for Musizi Zexie San:
Musizi (Oyster Shell, calcined), Zexie (Alisma Rhizome), Shuxi (Acropodium Root - *Note: Text says Shuxi, likely referring to Ku Xue or similar diuretic herb, but standard text often lists Ku Xue or similar; here strictly translating text*), Shanglu (Phytolacca Root), Tingli (Perilla Seed/Descurainia Seed, stir-fried between paper), Haizao (Sargassum), Gualougen (Trichosanthes Root) (all in equal parts). Grind into powder. Take one or two qian per dose, mixed with rice water. Stop when urination increases. For those with weak constitution, weak stomach Qi, and poor appetite, Wuling San (Five-Ingredient Powder with Poria) with Cangzhu (Atractylodes Lancea Rhizome), Chenpi (Tangerine Peel), Muxiang (Aucklandia Root), and Sharen (Amomum Fruit) is indicated. If the patient is not very weak, boiling Shanglu (Phytolacca Root) alone to make porridge is also effective. For foot swelling after illness recovery, no harm is done; simply regulating diet and strengthening Stomach Qi will cause it to subside naturally. Another method is washing with decoction of Jinmao Gouji (Cibotium Barometz), which is also effective.