(里热而水涸 方见阳明实证三承气同) 阳明病见少阴中,口燥咽干要速攻,肾水将枯津液竭,大承急下有奇功。
热极风生烁肾经,利多清水色纯青,痛居心下口干燥,急要攻邪莫少停。
少阴病自太阴传,六七日中大便坚,腹内居然生胀满,急攻方得保安全。
(里寒而吐蛔) 静复心烦总不安,病为蛔厥脏中寒,虫闻食臭入于膈,呕吐旋生治觉难。
乌梅丸
细辛姜桂合乌梅,杀尽蛔虫几百枚,连柏性寒椒附热,参归气血可兼培。
当归四逆汤
(证附 表寒而里虚) 手足厥寒脉细时,惟将甘枣补脾宜,桂辛通草温经络,芍药当归营血滋。
当归四逆加吴茱萸生姜汤
(里有积寒) 脉细旋惊手足凉,腹中或有久寒藏,吴萸须共生姜用,加入当归四逆汤。
(里寒而宜吐 方见太阳坏病) 阳气不能达四肢,厥寒脉紧病危时,心生烦满饥难食,邪在胸中涌吐宜。
(里有积水 方见太阳本病) 厥逆旋惊在四肢,悸生心下病难支,胸停积水宜先治,入胃须防作利时。
(表寒而里虚) 泄利旋惊脉大时,因虚强下不相宜,设如浮革肠鸣候,汤用当归四逆医。
(里寒而厥逆 方见太阳坏病) 大汗出时热尚留,肢疼拘急利难休,恶寒厥冷宜温里,四逆良方正可投。
(里寒而阳郁 方见少阴脏病) 一经下利谷仍完,外热因知里有寒,汗出四肢如见厥,汤投通脉是仙丹。
干姜黄连黄芩人参汤
(证附 里寒而上有浮热) 病本内寒便滑溏,复经吐下胃偏伤,宜清上热温中脘,汤用芩连参合姜。
(里热导致津液枯竭,方剂可见阳明实证中的三承气汤)阳明病邪传入少阴经,出现口燥咽干的症状,必须迅速采用攻下法;此时肾水即将枯竭,津液耗尽,大承气汤急下存阴具有奇效。
热邪极盛而生风,灼伤肾经,腹泻排出青色清水,疼痛位于心下部且口舌干燥,急需攻逐邪气,不可稍有停留。
少阴病由太阴病传变而来,经过六七天大便变得坚硬,腹部竟然产生胀满感,必须紧急攻下才能保全生命。
(里寒导致呕吐蛔虫)患者安静时却心烦意乱、总不安宁,这是因为蛔厥证,脏腑内部寒冷,蛔虫闻到食物气味进入膈部,引起呕吐,治疗起来觉得困难。
乌梅丸
细辛、干姜、桂枝与乌梅配合,能杀死数百条蛔虫,黄连、黄柏性寒,花椒、附子性热,人参、当归可兼补气血。
当归四逆汤
(证候附注:表寒而里虚)手足寒冷,脉象细微时而出现,应当使用甘草、大枣来补益脾胃,桂枝、细辛、通草温通经络,芍药、当归滋养营血。
当归四逆加吴茱萸生姜汤
(里有积寒)脉象细微,突然惊悸,手足发凉,腹中或许藏有久寒,吴茱萸必须与生姜同用,加入当归四逆汤中。
(里寒适宜用吐法,方剂可见太阳病误治后的坏病)阳气不能通达四肢,手足厥冷,脉象紧束,病情危急时,心中烦闷胀满,饥饿却难以进食,邪气停留在胸中,适宜采用涌吐法。
(里有积水,方剂可见太阳本病)四肢突然厥冷惊悸,心下部悸动,病情难以支撑,胸中停聚积水应当先进行治疗,否则水气入胃必须防止发生泄利。
(表寒而里虚)腹泻泄利并伴有惊悸,脉象洪大时,因正气虚弱而强行攻下是不适宜的,如果见到浮革脉及肠鸣音亢进的症状,汤剂应用当归四逆汤治疗。
(里寒导致厥逆,方剂可见太阳病误治后的坏病)大汗出后热邪尚留,肢体疼痛拘急,泄利不止,恶寒且手足厥冷,适宜温补里阳,四逆汤是良好的选择。
(里寒导致阳气郁遏,方剂可见少阴脏病)一次下利后谷食仍完谷不化,体表发热可知体内有寒,汗出且四肢像出现厥逆一样,投用通脉四逆汤如仙丹般有效。
干姜黄连黄芩人参汤
(证候附注:里寒而上有浮热)病本为内寒导致大便滑溏,又经过吐下损伤了胃气,适宜清上焦之热、温中脘之寒,汤剂使用黄芩、黄连、人参合干姜。
(When interior heat leads to fluid exhaustion, the formulas can be seen in the Three Chengqi Decoctions for Yangming excess syndromes.) When Yangming disease transmits to the Shaoyin channel, presenting with dry mouth and throat, rapid purgation is required. At this time, kidney water is about to dry up and body fluids are exhausted; Da Cheng Qi Tang (Great Order the Qi Decoction) used urgently to preserve yin has miraculous efficacy.
Extreme heat generates wind and scorches the Kidney meridian; diarrhea discharges pure green watery stool; pain is located in the epigastrium with a dry mouth and tongue. It is urgent to purge the pathogen without any delay.
Shaoyin disease transmits from Taiyin disease. After six or seven days, the stool becomes hard, and abdominal distension and fullness actually occur. Urgent purgation is necessary to ensure safety and preservation of life.
(Interior cold causing vomiting of roundworms.) The patient is quiet yet irritable and restless. This is due to Huì Jué (Roundworm Revulsion Syndrome), where internal organ cold causes roundworms to enter the diaphragm upon smelling food odor, leading to vomiting, making treatment difficult.
Wu Mei Wan (Mume Pill)
Xi Xin (Asari Radix et Rhizoma), Gan Jiang (Zingiberis Rhizoma), Gui Zhi (Cinnamomi Ramulus) combined with Wu Mei (Mume Fructus) kill hundreds of roundworms. Lian Pu (Coptidis Rhizoma) and Huang Bo (Phellodendri Cortex) are cold in nature, while Hua Jiao (Zanthoxyli Pericarpium) and Fu Zi (Aconiti Lateralis Radix Praeparata) are hot; Ren Shen (Ginseng Radix) and Dang Gui (Angelicae Sinensis Radix) can simultaneously tonify qi and blood.
Dang Gui Si Ni Tang (Decoction for Nourishing Blood and Restoring Pulse)
(Syndrome annotation: Exterior cold with interior deficiency.) Hands and feet are cold, pulse is fine and intermittent. One should use Gan Cao (Licorice Root) and Da Zao (Jujube Fruit) to tonify the Spleen. Gui Zhi (Cinnamomi Ramulus), Xi Xin (Asari Radix et Rhizoma), and Tong Cao (Tetrapanacis Medulla) warm and unblock the collaterals; Shao Yao (Paeoniae Radix Alba) and Dang Gui (Angelicae Sinensis Radix) nourish Ying and Blood.
Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang (Decoction for Nourishing Blood and Restoring Pulse plus Evodia and Fresh Ginger)
(Interior accumulation of cold.) Pulse is fine, sudden palpitations occur, hands and feet are cold. There may be long-standing cold stored in the abdomen. Wu Zhu Yu (Evodiae Fructus) must be used together with Sheng Jiang (Zingiberis Rhizoma Recens) and added to Dang Gui Si Ni Tang.
(Interior cold suitable for emesis, formula seen in Taiyang damaged diseases.) Yang qi cannot reach the four limbs. When there is cold extremities, tight pulse, and critical illness, if one feels irritability and fullness in the heart/chest, hunger but inability to eat, and the pathogen resides in the chest, emesis is appropriate.
(Interior water retention, formula seen in Taiyang primary diseases.) Cold extremities and sudden palpitations in the four limbs; palpitations arise in the epigastrium, making the condition hard to sustain. Water retention in the chest should be treated first; otherwise, once it enters the stomach, diarrhea must be prevented.
(Exterior cold with interior deficiency.) Diarrhea accompanied by palpitations when the pulse is large. Forced purgation due to deficiency is inappropriate. If floating and wiry pulse characteristics and borborygmus are present, the decoction should be Dang Gui Si Ni Tang.
(Interior cold causing cold extremities, formula seen in Taiyang damaged diseases.) After profuse sweating, heat remains; limb pain and spasms persist, diarrhea does not cease. Aversion to cold and cold extremities indicate the need to warm the interior; Si Ni Tang (Frigid Extremities Decoction) is an excellent choice.
(Interior cold causing yang depression, formula seen in Shaoyin zang diseases.) After one episode of diarrhea, undigested food remains in the stool. External heat indicates interior cold. Sweating and cold extremities resembling jue syndrome require the administration of Tong Mai Si Ni Tang (Pulse-Resuscitating Frigid Extremities Decoction), which is like a divine elixir.
Gan Jiang Huang Lian Huang Qin Ren Shen Tang (Decoction of Dried Ginger, Coptis, Scutellaria, and Ginseng)
(Syndrome annotation: Interior cold with floating heat above.) The disease originates from interior cold causing loose stools, further damaging the Stomach through vomiting and purging. It is appropriate to clear upper heat and warm the middle jiao; the decoction uses Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Ren Shen (Ginseng Radix), and Gan Jiang (Zingiberis Rhizoma).