(里虚而烦满谵语) 八九日过病已
成,下之胸满更烦惊,不能转侧因身重,小便维艰谵语生。
柴胡加龙骨牡蛎汤
半夏柴芩合大黄,桂苓参枣并生姜,再加龙牡安神妙,更入铅丹镇逆良。
(少阳病未罢 方见少阳本病) 柴胡证下气先伤,不罢仍宜用本汤,必俟
蒸蒸身振却,热生汗出乃安康。
(表未解而里实 方见少阳本病) 过经十日病非轻,攻后旋惊呕逆生,郁郁微烦
心下急,法宜表里要兼清。
柴胡加芒硝汤
(证附 表未解而里实小柴胡汤见少阳本病) 伤寒已到十三朝,胁满呕生
热发潮,解表尤宜攻里实,小柴胡内入芒硝。
【入太阴去路】
(表里未解) 发表未痊复下之,往来寒热力难支,渴生胸胁满微结,头汗心烦溺涩时。
柴胡桂枝干姜汤
发表柴胡合桂枝,干姜助里可温脾,蒌根润燥芩清火,草牡兼收补固宜。
(表解而里结胸 方见太阳坏病) 已得伤寒十日余,胸中水结郁难舒,身无大热
头微汗,汤用陷胸病可除。
(表解而里有痞) 伤寒发热呕相连,他药下之病未痊,满反不疼因作痞,汤宜半夏泻心煎。
半夏泻心汤
半夏降冲参补中,枣甘培土有奇功,芩连清火姜温里,寒热兼施痞可攻。
(里虚而烦满谵语)病程经过八九天,病邪已经入里化热成实。若误用攻下法,会导致胸中胀满、烦躁加剧、惊恐不安,身体沉重难以翻身转动,小便困难,并出现说胡话的症状。
柴胡加龙骨牡蛎汤
方由半夏、柴胡、黄芩与大黄组成,配合桂枝、茯苓、人参、大枣和生姜,再加入龙骨、牡蛎以安神定志,更加入铅丹以镇逆平冲,疗效奇妙。
(少阳病未罢 方见少阳本病)柴胡证使用攻下法后,正气先受损伤,但少阳病邪并未解除,仍应使用原方治疗。必须等到患者出现全身战栗、蒸蒸汗出之后,热退身凉,才能恢复健康。
(表未解而里实 方见少阳本病)病程已过十日,病情并不轻微。攻下之后,随即出现惊恐、呕吐逆气,心中郁郁不乐且微有烦躁,心下部拘急不适。治法应当表里双解,兼顾清泄。
柴胡加芒硝汤
(证附 表未解而里实小柴胡汤见少阳本病)伤寒病程已到十三天,胁肋胀满,呕吐,发热如潮汐般定时发作。此时解表的同时适宜攻逐里实,在小柴胡汤中加入芒硝即可。
【入太阴去路】
(表里未解)发汗治疗后病未痊愈,又误用攻下法,导致往来寒热,体力难以支撑,口渴,胸胁胀满且微有结聚,头部出汗,心烦,小便涩滞不畅。
柴胡桂枝干姜汤
方用柴胡、桂枝以解表散邪,干姜温补脾里,瓜蒌根润燥生津,黄芩清泄火热,甘草与牡蛎兼收并蓄,起到补益固护的作用。
(表解而里结胸 方见太阳坏病)伤寒病程已十余日,胸中水饮结聚,气机郁滞难以舒展,身体没有大热,仅头部微有汗出。使用陷胸汤剂,病可消除。
(表解而里有痞)伤寒发热伴有呕吐,经其他药物攻下后病未痊愈,腹部胀满但不疼痛,因而形成痞证。宜用半夏泻心汤煎服。
半夏泻心汤
方中半夏降逆止呕,人参补益中气,大枣、甘草培补脾胃,功效奇特;黄芩、黄连清泄火热,干姜温里散寒,寒热并用,痞证可除。
(表寒未解 方见太阳本病)脉象仍然浮起,适宜发汗解表。虽然出现了太阴病的某些表现,但并无脏腑内部的病变,仅是经络受邪,解表仍当使用桂枝汤。
(Interior deficiency with irritability, fullness, and delirious speech) After eight or nine days, the disease has progressed and transformed into interior excess. If purgation is mistakenly applied, it leads to chest fullness, increased irritability, fright, inability to turn over due to body heaviness, difficult urination, and the onset of delirium.
Chaihu Jia Longgu Muli Tang (Bupleurum Decoction plus Dragon Bone and Oyster Shell)
The formula combines Banxia (Pinelliae Rhizoma), Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), and Dahuang (Rhei Radix et Rhizoma), along with Guizhi (Cinnamomi Ramulus), Fuling (Poria), Renshen (Ginseng Radix), Dazao (Ziziphi Jujubae Fructus), and Shengjiang (Zingiberis Rhizoma Recens). It adds Longgu (Fossilia Ossis Mastodi) and Muli (Concha Ostreae) for their excellent calming spirit effects, and Qian Dan (Lithargyrum) to settle rebellious qi effectively.
(Shaoyang syndrome not yet resolved; see Shaoyang primary disease) The use of purgation in Chaihu syndrome injures the qi first. If the syndrome persists, the original decoction should still be used. One must wait until the patient experiences a shivering sensation followed by steaming perspiration; only then will the heat dissipate and health be restored.
(Exterior unresolved with interior excess; see Shaoyang primary disease) Ten days have passed since the onset, and the condition is not mild. Following purgation, fright and vomiting arise. There is a sense of depression with slight irritability and urgency in the epigastrium. The treatment method requires clearing both exterior and interior simultaneously.
Chaihu Jia Mangxiao Tang (Bupleurum Decoction plus Mirabilite)
(Case attachment: Exterior unresolved with interior excess; Xiao Chaihu Tang see Shaoyang primary disease) By the thirteenth day of cold damage, there is hypochondriac fullness, vomiting, and tidal fever. While resolving the exterior, it is appropriate to attack the interior excess by adding Mangxiao (Natrii Sulfas) to Xiao Chaihu Tang (Minor Bupleurum Decoction).
[Pathway to Taiyin]
(Exterior and interior unresolved) After releasing the exterior without cure, purgation was reapplied. This results in alternating chills and fever, extreme fatigue, thirst, chest and hypochondriac fullness with slight knotting, sweating on the head, irritability, and intermittent dysuria.
Chaihu Guizhi Ganjiang Tang (Bupleurum, Cinnamon Twig, and Dried Ginger Decoction)
Chaihu (Bupleuri Radix) and Guizhi (Cinnamomi Ramulus) are combined to release the exterior. Ganjiang (Zingiberis Rhizoma) assists in warming the interior and strengthening the spleen. Gualougen (Trichosanthis Radix) moistens dryness, while Huangqin (Scutellariae Radix) clears fire. Gancao (Glycyrrhizae Radix) and Muli (Concha Ostreae) act together to gather and consolidate, providing beneficial supplementation.
(Exterior resolved but interior chest binding; see Sunyang damaged disease) More than ten days have passed since the onset of cold damage. Water accumulation binds in the chest, causing stagnation and discomfort. There is no significant body heat, only slight sweating on the head. Using Xiantong Tang (Chest-Expelling Decoction) can eliminate the disease.
(Exterior resolved but interior pi-syndrome [glomus]) Cold damage presents with continuous fever and vomiting. After being treated with other purgatives, the illness remains uncurled. Fullness occurs without pain, resulting in a pi-syndrome. Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium) is indicated.
Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium)
Banxia (Pinelliae Rhizoma) descends rebellious qi, while Renshen (Ginseng Radix) tonifies the middle. Dazao (Ziziphi Jujubae Fructus) and Gancao (Glycyrrhizae Radix) cultivate earth with remarkable efficacy. Huangqin (Scutellariae Radix) and Huanglian (Coptidis Rhizoma) clear fire, while Ganjiang (Zingiberis Rhizoma) warms the interior. Applying both cold and hot properties allows the pi-syndrome to be attacked and resolved.
(Exterior cold unresolved; see Sunyang primary disease) The pulse remains floating, indicating that sweating therapy is appropriate. Although Sunyang symptoms appear alongside Taiyin manifestations, there is no internal organ pathology, only meridian involvement. To resolve the exterior, Guizhi Tang (Cinnamon Twig Decoction) should still be used.