〔成〕动气者,为筑筑然动跳于腹者是也。动气在右,不可发汗,发汗则衄而渴,心苦烦,饮即吐水。(《活人》
云∶先服五苓散三服,次服竹叶汤。)动气在左,不可发汗,发汗则头眩,汗不止,筋惕肉 。(《活人》云∶
先服防风、白术、牡蛎,汗止,次服建中汤,方见自汗。)动气在上,不可发汗,发汗则气上冲,正在心端。(《活
人》云∶宜服李根汤,方见气上冲。)动气在下,不可发汗,发汗则无汗,心中大烦,骨节苦疼,目晕,恶寒,
食则反吐,谷不能进。(《活人》云∶先服大橘皮汤,吐止后,服小建中汤。)动气在右不可下,下之则津
液内竭,咽燥鼻干,头眩心悸也。动气在左,不可下,下之则腹内拘急,食不下,动气更剧,虽身有热,卧则欲蜷。
动气在上,不可下,下之则掌握热烦,身上浮冷,热汗自泄,欲得水自灌。动气在下不可下,下之则腹胀满,
卒起头眩,食则下清谷,心下痞也。
〔云〕伤寒汗下后,脐在有动气者,宜防葵散。
防葵(一两) 木香(不见火) 柴胡 黄芩(各半两)
上锉为细末,每服五钱,水煎服。
伤寒汗下后,脐上有动气者,宜枳壳散。
枳壳(麸炒,五钱) 赤茯苓 当归 三棱(炮。各一两) 木香 诃黎勒(各五钱)
上为末,每服五钱,沸汤点服。
伤寒汗下后,脐右有动气者,宜前胡散。
前胡 赤茯苓 大腹皮 人参(各五钱) 木香 槟榔 大黄(各三钱)
上为细末,每服五钱,沸汤点服。
伤寒汗下后,脐下有动气者,宜茯苓散。
赤茯苓(一两) 槟榔(三钱) 桂心 大腹皮 川茴香(炮,炒) 良姜(各五钱)
上为细末,每服五钱,沸汤点服。
如久不治,传为积热,治之难痊,不可汗下也。
如果动气位于右侧,不可使用发汗法治疗;若误用发汗法,会导致鼻出血且口渴,心中苦闷烦躁,饮水后即呕吐出水。(《伤寒百问》说:应先服用五苓散三次,再服用竹叶汤。)
如果动气位于左侧,不可使用发汗法治疗;若误用发汗法,会导致头晕目眩,汗出不止,筋肉跳动抽搐。(《伤寒百问》说:先服用防风、白术、牡蛎,待汗止后,再服用小建中汤,方剂见自汗篇。)
如果动气位于上方,不可使用发汗法治疗;若误用发汗法,会导致气机上冲,直抵心窝部位。(《伤寒百问》说:适宜服用李根汤,方剂见气上冲篇。)
如果动气位于下方,不可使用发汗法治疗;若误用发汗法,会导致无汗,心中极度烦乱,骨节疼痛难忍,眼前发黑昏花,恶寒,进食后反而呕吐,食物无法进咽。(《伤寒百问》说:先服用大橘皮汤,呕吐停止后,再服用小建中汤。)
如果动气位于右侧,不可使用攻下法治疗;若误用攻下法,会导致体内津液枯竭,咽喉干燥,鼻孔干涩,头晕目眩,心悸。(《伤寒百问》未直接引用此条,但属原文逻辑延续)
如果动气位于左侧,不可使用攻下法治疗;若误用攻下法,会导致腹内拘挛急迫,饮食不下,动气症状更加剧烈,即使身体发热,也只想蜷缩着躺卧。
如果动气位于上方,不可使用攻下法治疗;若误用攻下法,会导致手掌心发热烦闷,身上感觉浮肿寒冷,热汗自行渗出,想要喝水浇淋全身。
如果动气位于下方,不可使用攻下法治疗;若误用攻下法,会导致腹部胀满,突然起身时头晕目眩,进食后排泄未消化的食物(完谷不化),胃脘部痞塞不通。
[王好古云] 伤寒经过发汗或攻下治疗后,脐部仍有动气的,适宜使用防葵散。
以上药材切碎成细末,每次服用五钱,用水煎煮后服用。
枳壳(麸皮炒,五钱) 赤茯苓 当归 三棱(炮制。各一两) 木香 诃黎勒(各五钱)
以上药材研为细末,每次服用五钱,用沸水冲服。
前胡 赤茯苓 大腹皮 人参(各五钱) 木香 槟榔 大黄(各三钱)
以上药材研为细末,每次服用五钱,用沸水冲服。
赤茯苓(一两) 槟榔(三钱) 桂心 大腹皮 川茴香(炮制,炒) 良姜(各五钱)
以上药材研为细末,每次服用五钱,用沸水冲服。
[Cheng Wuji's Commentary] "Dongqi" (Moving Qi) refers to the sensation of throbbing or jumping within the abdomen.
If Dongqi is located on the right, sweating therapy should not be used. If sweating therapy is mistakenly applied, it will lead to epistaxis (nosebleed) and thirst, with the heart suffering from vexation and restlessness, and drinking water will immediately cause vomiting of fluids. (*Baiwen Lun* states: First administer Wuling San five times, then administer Zhuye Tang.)
If Dongqi is located on the left, sweating therapy should not be used. If sweating therapy is mistakenly applied, it will lead to dizziness, incessant sweating, and twitching of muscles and flesh. (*Baiwen Lun* states: First administer Fangfeng, Baizhu, and Muli; once sweating stops, administer Jianzhong Tang. See the section on spontaneous sweating for the formula.)
If Dongqi is located above, sweating therapy should not be used. If sweating therapy is mistakenly applied, it will cause Qi to rush upward, striking directly at the cardiac region. (*Baiwen Lun* states: Lifgen Tang is suitable. See the section on Qi rushing upward for the formula.)
If Dongqi is located below, sweating therapy should not be used. If sweating therapy is mistakenly applied, it will result in an inability to sweat, extreme mental vexation, severe pain in the bone joints, blurred vision, aversion to cold, regurgitation after eating, and the inability to ingest food. (*Baiwen Lun* states: First administer Dajupi Tang; after vomiting stops, administer Xiao Jianzhong Tang.)
If Dongqi is located on the right, purgative therapy should not be used. If purgative therapy is mistakenly applied, it will deplete the internal body fluids, leading to dryness of the throat and nose, dizziness, and palpitations.
If Dongqi is located on the left, purgative therapy should not be used. If purgative therapy is mistakenly applied, it will cause abdominal constriction and urgency, inability to eat, exacerbation of Dongqi, and even if there is fever, the patient will desire to lie curled up.
If Dongqi is located above, purgative therapy should not be used. If purgative therapy is mistakenly applied, it will cause heat and vexation in the palms, a sensation of floating coldness on the body, spontaneous leakage of hot sweat, and a desire to pour water over oneself.
If Dongqi is located below, purgative therapy should not be used. If purgative therapy is mistakenly applied, it will cause abdominal distension and fullness, dizziness upon sudden rising, passage of undigested food after eating, and epigastric stuffiness (Pi syndrome).
[Wang Haogu's Commentary] After sweating or purgative therapy for Shanghan (Cold Damage), if there is still Dongqi at the umbilicus, Fangkui San is suitable.
Fangkui (1 liang) Muxiang (not roasted) Chaihu Huangqin (each 0.5 liang)
Grind the above into fine powder. Take 5 qian per dose, decoct in water, and drink.
After sweating or purgative therapy for Shanghan, if there is Dongqi above the umbilicus, Zhike San is suitable.
Zhike (bran-fried, 5 qian) Chi Fuling Danggui Sanleng (roasted. each 1 liang) Muxiang Helile (each 5 qian)
Grind the above into powder. Take 5 qian per dose, mix with boiling water, and take.
After sweating or purgative therapy for Shanghan, if there is Dongqi to the right of the umbilicus, Qianhu San is suitable.
Qianhu Chi Fuling Dafupi Renshen (each 5 qian) Muxiang Binglang Dahuang (each 3 qian)
Grind the above into fine powder. Take 5 qian per dose, mix with boiling water, and take.
After sweating or purgative therapy for Shanghan, if there is Dongqi below the umbilicus, Fuling San is suitable.
Chi Fuling (1 liang) Binglang (3 qian) Guixin Dafupi Chuan Huixiang (roasted, fried) Liangjiang (each 5 qian)
Grind the above into fine powder. Take 5 qian per dose, mix with boiling water, and take.
If left untreated for a long time, it will transmit into Ji Re (accumulated heat), making treatment difficult to cure. Sweating and purgative therapies are contraindicated.