厥证者,四肢逆冷是也。其证不一,各有致病之由。如手足厥寒,脉微欲绝,为寒厥属表者,
以当归四逆汤主之。如四肢厥冷,脉细欲绝,为寒厥属里者,以通脉四逆汤主之。如阴阳不相顺接,四
肢厥冷,为热厥属表者,以四逆散主之,如内火炽盛,或大便结闭,热在脏腑,逼阴于外,而四肢逆冷
,为热厥属里者,以白虎承气汤主之。如猝然暴死,名为大厥者,以半夏末方主之。如身脉皆动,
而形无知,名为尸厥者,以还魂汤主之。如气血俱乱,相薄成厥,名为薄厥者,以蒲黄酒方主之,如因
暴怒而得者,名为气厥,以七气汤主之。如因痰动而得者,名为痰厥,以二术二陈汤主之。如因过饱而得者
,名为食厥,以平胃散主之。如因醉后而得者,名为酒厥,以五苓散主之。如妇人气厥、血厥如死人者
,以白薇汤主之。
当归四逆汤
(方见痢疾)
通脉四逆汤
(方见泄泻)
四逆散
柴胡 白芍 枳实 甘草各等分共为末,每服三钱,米汤调下,日三服。
白虎汤
石膏(八钱生研) 知母(三钱) 甘草(一钱) 粳米(四钱) 水煎大半杯,温服。
大承气汤
(方见温证)
半夏末方
用半夏研细末,搐鼻中,取嚏,厥回后,再议药。
还魂汤
麻黄(三钱) 杏仁(二十五粒去皮尖) 肉桂(一钱) 甘草(一钱炙) 水煎大半杯,
温服。
蒲黄酒方
生蒲黄(一两) 黑豆(二两) 先将黑豆炒香,合蒲黄,以湿酒淋下,取酒饮一杯。
七气汤
茯苓(三钱) 半夏(三钱) 浓朴(二钱) 苏叶(二钱) 加生姜三片,水
煎服。枳壳、杏仁、砂仁、陈皮均可加。
二术二陈汤
茯苓(四钱) 半夏(三钱) 陈皮(三钱) 甘草(一钱) 苍术(二钱) 白术(二钱)
加南星、竹沥、姜汁水煎服。
平胃散
(方见吞酸) 加萝菔子三钱,煎服探吐。
五苓散
(方见痰饮) 去桂枝加黄连、黄芩、干葛水煎服。
白薇汤
白薇(三钱) 人参(三钱) 当归(三钱) 甘草(二钱炙) 水煎大半杯温服。
厥证,是指四肢逆冷(手脚冰凉)的病证。其表现不一,各有致病原因。例如手足寒冷,脉象微弱几乎摸不到,属于寒邪在表的寒厥,用当归四逆汤主治。例如四肢冰冷,脉象细弱几乎摸不到,属于寒邪在里的寒厥,用通脉四逆汤主治。例如阴阳之气不能顺接,导致四肢冰冷,属于热邪在表的热厥,用四逆散主治;如果体内火气炽盛,或者大便干结闭塞,热邪在脏腑内,逼迫阴气外越,从而出现四肢逆冷,属于热邪在里热厥,用白虎承气汤主治。例如突然昏倒似死,名为大厥,用半夏末方主治。例如脉搏跳动正常,但形体无知觉,名为尸厥,用还魂汤主治。例如气血混乱,相互搏结形成厥证,名为薄厥,用蒲黄酒方主治;如果是因暴怒引起的,名为气厥,用七气汤主治。如果是因痰饮扰动引起的,名为痰厥,用二术二陈汤主治。如果是因过饱引起的,名为食厥,用平胃散主治。如果是因醉酒后引起的,名为酒厥,用五苓散主治。如果是妇女因气或血导致的厥证,严重如死人一般,用白薇汤主治。
四逆散
柴胡、白芍、枳实、甘草各等分,共研为末,每次服用三钱,用米汤调服,每日三次。
白虎汤
石膏(八钱,生研)、知母(三钱)、甘草(一钱)、粳米(四钱),加水煎至大半杯,温服。
大承气汤
(方剂见温病章节)
半夏末方
用半夏研成细末,吹入鼻中,引起打喷嚏,待厥回醒后,再商议用药。
还魂汤
麻黄(三钱)、杏仁(二十五粒,去皮尖)、肉桂(一钱)、甘草(一钱,炙),加水煎至大半杯,温服。
蒲黄酒方
生蒲黄(一两)、黑豆(二两),先将黑豆炒香,与蒲黄混合,用湿酒淋下,取药酒饮用一杯。
七气汤
茯苓(三钱)、半夏(三钱)、浓朴(二钱)、苏叶(二钱),加生姜三片,加水煎服。也可加入枳壳、杏仁、砂仁、陈皮。
二术二陈汤
茯苓(四钱)、半夏(三钱)、陈皮(三钱)、甘草(一钱)、苍术(二钱)、白术(二钱),加南星、竹沥、姜汁,加水煎服。
Jue syndrome refers to the condition of cold limbs (cold hands and feet). Its manifestations vary, each having its own etiology. For instance, cold hands and feet with a faint pulse almost imperceptible indicate Cold Jue at the exterior, treated primarily with Danggui Sini Decoction. For example, cold limbs with a fine pulse almost imperceptible indicate Cold Jue at the interior, treated primarily with Tongmai Sini Decoction. When Yin and Yang Qi fail to connect smoothly, resulting in cold limbs, it is Heat Jue at the exterior, treated with Sixi San. If internal fire is blazing, or if stool is dry and obstructed, with heat residing in the Zang-Fu organs forcing Yin outward, thereby causing cold limbs, it is Heat Jue at the interior, treated primarily with Baihu Chengqi Tang. For sudden collapse resembling death, named Da Jue, Banxia Mo Fang is used. For cases where the pulse moves normally but the body lacks consciousness, named Shi Jue, Huanhun Tang is used. When Qi and Blood are chaotic and clash to form Jue, named Bo Jue, Puhuang Jiu Fang is used; if caused by sudden rage, named Qi Jue, Qi Qi Tang is used. If caused by phlegm disturbance, named Tan Jue, Ershu Erchen Tang is used. If caused by overeating, named Shi Jue, Pingwei San is used. If caused by drunkenness, named Jiu Jue, Wuling San is used. For women suffering from Qi Jue or Xue Jue so severe as to resemble death, Baiwei Tang is used.
Danggui Sini Decoction
(See formula in Dysentery chapter)
Tongmai Sini Decoction
(See formula in Diarrhea chapter)
Sixi San
Chai Hu (Bupleuri Radix), Baishao (Paeoniae Radix Alba), Zhishi (Aurantii Fructus Immaturus), Gancao (Glycyrrhizae Radix et Rhizoma) in equal parts, ground into powder. Take three qian per dose, mixed with rice water, three times daily.
Baihu Tang
Shigao (Gypsum Fibrosum, eight qian, raw and ground), Zhimu (Anemarrhenae Rhizoma, three qian), Gancao (Glycyrrhizae Radix et Rhizoma, one qian), Jingmi (Oryza Sativa, four qian). Decoct in water until half a cup remains, take warm.
Da Chengqi Tang
(See formula in Warm Disease chapter)
Banxia Mo Fang
Grind Banxia (Pinelliae Rhizoma) into fine powder, insufflate into the nose to induce sneezing. After Jue resolves, discuss further medication.
Huanhun Tang
Mahuang (Ephedrae Herba, three qian), Xingren (Armeniacae Semen Amarum, twenty-five kernels, skin and tip removed), Rougui (Cinnamomi Cortex, one qian), Gancao (Glycyrrhizae Radix et Rhizoma, one qian, honey-fried). Decoct in water until half a cup remains, take warm.
Puhuang Jiu Fang
Sheng Puhuang (Typhae Pollen, one liang), Heidou (Sojae Semen Nigrum, two liang). First stir-fry Heidou until fragrant, mix with Puhuang, pour wet wine over them, and drink one cup of the medicinal wine.
Qi Qi Tang
Fuling (Poria, three qian), Banxia (Pinelliae Rhizoma, three qian), Houpo (Magnoliae Officinalis Cortex, two qian), Ziye (Perillae Folium, two qian). Add three slices of Shengjiang (Zingiberis Rhizoma Recens), decoct in water and take. Zhike, Xingren, Sharen, and Chenpi may also be added.
Ershu Erchen Tang
Fuling (Poria, four qian), Banxia (Pinelliae Rhizoma, three qian), Chenpi (Citri Reticulatae Pericarpium, three qian), Gancao (Glycyrrhizae Radix et Rhizoma, one qian), Cangzhu (Atractylodis Rhizoma, two qian), Baizhu (Atractylodis Macrocephalae Rhizoma, two qian). Add Nanxing (Arisaematis Rhizoma Prep aratum), Zhuli (Bambusae Caulis in Taenia), and Jiangzhi (Zingiberis Rhizoma Recens Juice), decoct in water and take.
Pingwei San
(See formula in Acid Regurgitation chapter) Add Luobuzi (Raphani Semen, three qian), decoct and take to induce vomiting.
Wuling San
(See formula in Phlegm-Fluid Retention chapter) Remove Guizhi (Cinnamomi Ramulus), add Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), and Gange (Puerariae Radix), decoct in water and take.
Baiwei Tang
Baiwei (Cynanchi Atrati Radix, three qian), Renshen (Ginseng Radix et Rhizoma, three qian), Danggui (Angelicae Sinensis Radix, three qian), Gancao (Glycyrrhizae Radix et Rhizoma, two qian, honey-fried). Decoct in water until half a cup remains, take warm.