如人下部冰冷,上部大热,渴欲饮水,下喉即吐,乃真寒反现假热之象以欺人也。法当用八味汤大剂,探凉
与服。再令一强有力者,以手擦其足心,如火之热,不热不已,以大热为度。后用吴茱萸一两、附子一钱,共为
末,麝香三分,以少许白面入之,打糊作膏,贴在足心之中。少顷,必熟睡,醒来,下部身热,而上部之火息矣。
此症上焦火盛,吐痰如涌泉,面赤喉痛,上身不欲盖衣,而下体冰凉,此上假热而下真寒也。方用∶
熟地(半斤) 山萸(四两) 丹皮(三两) 茯苓(三两) 泽泻(三两) 附子(一个) 肉桂(一两) 麦
冬(一两)
五味子(一两)
水十碗,煎至三碗,探冷与服。二渣再用水三碗,煎一碗,一气服之,立刻安静,此上病下治法也。
病有洒淅恶寒,而后发热者,盖阴脉不足,阳往从之;阳脉不足,阴往乘之。何谓阳不足?寸脉微,名曰阳不
足。阴气上入于阳中,则恶寒也。何谓阴不足?尺脉弱,名曰阴不足。阳气下陷阴中,则发热也。
凡治寒热,用柴胡升阳气,使不陷于阴中,则不热也。用黄芩降阴气,使不升入阳中,则不寒也。
火症初起,必大渴引渴,身有斑点,或身热如焚,或发狂乱语,方用:
生石膏(三钱) 元参(一两) 麦冬(一两) 甘草(三钱) 升麻(三钱) 知母(三钱) 半夏(三钱) 竹
叶(百片)
水煎服,一、二剂可止可安,三剂愈,不必四剂也。(以下据《石室秘录》初治法“发明”补)∶〔若初起之
时,火势少衰,减半与之。乘其火势初起,胃气未衰,急用此方以止遏之,则火自然骤减而不为害矣。方即竹叶石
膏汤,妙在加入元参、麦冬数两,使石膏不为主帅,而反为稗将,听麦冬、元参之差遣,则止去火而不损胃中之
阴。又妙加入升麻引其外出而不能入,止祛火而不损肾水,所以奏功如神也。倘疑升麻太多而少减之,转不能奏
功之捷,予所以又戒世人之不知用升麻者〕。(按∶《石室秘录》中麦冬为三两,元参为一两。此方论在《男科》
及《方论》中均无,疑系傅氏晚年所改)。
如果人的下部冰冷,上部却大热,口渴想喝水,但水一下喉就吐出来,这是真寒反过来呈现假热的现象来欺骗人。治疗方法应当使用八味汤的大剂量,放凉后服用。再让一个强壮有力的人,用手擦拭他的足心,直到像火一样热,不热不停止,以非常热为限度。之后用吴茱萸一两、附子一钱,共同研成粉末,加入麝香三分,用少许白面调成糊状做成膏药,贴在足心中间。过了一会儿,病人必定熟睡,醒来后,下部身体变热,而上部的火气也就平息了。
这种病症上焦火气旺盛,吐痰像泉水涌出一样,面色发红,喉咙痛,上身不想盖衣服,而下体冰凉,这是上假热而下真寒。方剂用:熟地黄(半斤)、山茱萸(四两)、牡丹皮(三两)、茯苓(三两)、泽泻(三两)、附子(一个)、肉桂(一两)、麦冬(一两)、五味子(一两)。用水十碗,煎至三碗,放凉后服用。剩下的药渣再加水三碗,煎成一碗,一口气服下,立刻安静下来,这是上病下治的方法。
疾病有先洒淅恶寒,然后发热的,这是因为阴脉不足,阳气往从之;阳脉不足,阴气往乘之。什么叫阳不足?寸脉微细,叫做阳不足。阴气进入阳分中,就会恶寒。什么叫阴不足?尺脉虚弱,叫做阴不足。阳气下陷于阴分中,就会发热。
凡是治疗寒热往来,用柴胡提升阳气,使阳气不陷入阴中,就不会发热。用黄芩沉降阴气,使阴气不升入阳中,就不会恶寒。
火症初起时,必定大渴引饮,身上出现斑点,或者身体热得像火烧一样,或者发狂说胡话,方剂用:生石膏(三钱)、玄参(一两)、麦冬(一两)、甘草(三钱)、升麻(三钱)、知母(三钱)、半夏(三钱)、竹叶(一百片)。用水煎服,一到两剂可以停止症状并安定病情,三剂痊愈,不需要用到第四剂。(以下根据《石室秘录》初治法“发明”部分补充):如果在初起之时,火势稍微衰减,将药量减半给予。趁着火势刚起,胃气尚未衰弱,急忙用此方来遏制它,那么火气自然会骤然减少而不造成危害。这个方子就是竹叶石膏汤,妙处在于加入了玄参、麦冬数两,使得石膏不再作为主帅,反而成为副将,听从麦冬、玄参的差遣,这样既能清除火邪又不损伤胃中的阴液。又妙在加入升麻引导火气向外发散而不能入内,只祛除火邪而不损伤肾水,所以功效如神。倘若怀疑升麻太多而减少用量,反而不能取得迅速的功效,所以我再次告诫世人不要不知道使用升麻。)(按:《石室秘录》中麦冬为三两,玄参为一两。此方论在《男科》及《方论》中均无,怀疑是傅青主晚年所修改)。
If the lower part of the body is cold while the upper part is extremely hot, and there is thirst with a desire to drink water, but the water is vomited immediately upon swallowing, this is a phenomenon where true cold presents as false heat to deceive. The treatment method should employ Ba Wei Tang (Eight-Ingredient Pill Decoction) in a large dose, administered after cooling. Additionally, have a strong person rub the sole of the foot until it becomes hot like fire; continue until it reaches a degree of intense heat. Subsequently, mix Wu Zhu Yu (Evodiae Fructus, 1 liang), Fu Zi (Aconiti Lateralis Radix Praeparata, 1 qian), and She Xiang (Moscus, 3 fen) into a powder. Add a small amount of white flour to form a paste/poultice, and apply it to the center of the sole of the foot. After a short while, the patient will likely fall into a deep sleep. Upon waking, the lower body will become warm, and the fire in the upper body will subside.
In this syndrome, the Upper Jiao (Upper Burner) has excessive fire, causing sputum to be expectorated like a gushing spring, facial redness, sore throat, and a reluctance to cover the upper body with clothing, while the lower body remains ice-cold. This is false heat above and true cold below. The prescription is: Shu Di Huang (Rehmanniae Radix Praeparata, 8 liang), Shan Zhu Yu (Corni Fructus, 4 liang), Dan Pi (Moutan Cortex, 3 liang), Fu Ling (Poria, 3 liang), Ze Xie (Alismatis Rhizoma, 3 liang), Fu Zi (Aconiti Lateralis Radix Praeparata, 1 piece), Rou Gui (Cinnamomi Cortex, 1 liang), Mai Dong (Ophiopogonis Radix, 1 liang), Wu Wei Zi (Schisandrae Fructus, 1 liang). Decoct these in ten bowls of water until three bowls remain. Administer cool. Take the remaining two dregs, add three bowls of water, decoct to one bowl, and consume in one go. Peace will be restored immediately. This is the method of treating upper diseases by addressing the lower body.
Diseases may present with initial aversion to cold accompanied by shivering, followed by fever. This occurs because when Yin pulses are deficient, Yang Qi follows them; when Yang pulses are deficient, Yin Qi invades them. What is meant by Yang deficiency? A faint Cun (inch) pulse indicates Yang deficiency. When Yin Qi enters the Yang region, aversion to cold occurs. What is meant by Yin deficiency? A weak Chi (cubit) pulse indicates Yin deficiency. When Yang Qi sinks into the Yin region, fever occurs.
Generally, to treat alternating chills and fever, use Chai Hu (Bupleuri Radix) to raise Yang Qi so it does not sink into Yin, thereby preventing fever. Use Huang Qin (Scutellariae Radix) to descend Yin Qi so it does not ascend into Yang, thereby preventing chills.
When Fire syndromes first arise, there is typically extreme thirst with a desire to drink, macules on the body, or a body temperature as high as burning, or even mania and delirious speech. The prescription is: Sheng Shi Gao (Gypsum Fibrosum, 3 qian), Yuan Shen (Scrophulariae Radix, 1 liang), Mai Dong (Ophiopogonis Radix, 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 qian), Sheng Ma ( Cimicifugae Rhizoma, 3 qian), Zhi Mu (Anemarrhenae Rhizoma, 3 qian), Ban Xia (Pinelliae Rhizoma Praeparatum, 3 qian), Zhu Ye (Bambusae Folium, 100 leaves). Decoct in water and administer orally. One or two doses can stop symptoms and stabilize the condition; three doses result in cure; a fourth dose is unnecessary. (The following is supplemented from the "Explanation" section of the Initial Treatment Method in *Shi Shi Mi Lu*): If at the onset the fire pathogen is slightly weaker, reduce the dosage by half. Seize the opportunity when the fire pathogen is just rising and Stomach Qi is not yet depleted, and urgently use this formula to suppress it, so that the fire will naturally decrease rapidly without causing harm. This formula is essentially Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction). Its brilliance lies in adding several liang of Yuan Shen and Mai Dong, making Shi Gao no longer the commander but rather a subordinate officer, subject to the direction of Mai Dong and Yuan Shen. Thus, it clears fire without damaging Stomach Yin. Another brilliance is the addition of Sheng Ma to guide the pathogen outward, preventing inward penetration, clearing fire without damaging Kidney Water, hence achieving miraculous efficacy. If one doubts that Sheng Ma is too abundant and reduces its dose, the rapid efficacy cannot be achieved. Therefore, I again warn people against failing to utilize Sheng Ma.) (Note: In *Shi Shi Mi Lu*, Mai Dong is 3 liang and Yuan Shen is 1 liang. This formula discussion is absent in both *Nan Ke* and *Fang Lun*, suggesting it may be a modification made by Fu Qingzhu in his later years).