〔罗〕伤寒食少而渴者,当以和胃之药止之,不可用凉药止之,恐复损胃气,愈不能食也,白术、茯苓是也。
〔海〕秦二母病太阴病,三日不解,后呕逆恶心,而脉不浮。与之半硫丸,二三服不止,复与黄 建中汤,
脉中极紧,无表里病,胸中大热,发渴引饮,皆曰阳症。欲饮之水,予反与姜、附等药,紧脉反沉细,阳犹未
生,以桂、附、姜、乌之类,酒丸,与百丸接之,二日中十余服,病患身热,烦躁不宁,欲作汗也。又以前丸
接之,覆以浓衣,阳脉方出而作大汗。翌日大小便始通,下瘀血一盆,如猪肝然。用胃风汤加桂、附三服,
血止,其寒甚如此,亦世之未见也。
少阴症,口燥舌干而渴,尺寸脉俱沉,沉迟则四逆汤,沉疾则大承气汤。少阴口燥舌干而渴,身表凉,脉
沉细而虚者,泻心汤主之,此有形无形药也。
人参汤 治伤寒七八日,汗后心烦燥渴。
人参 黄芩 柴胡 葛根(各一两) 川栀 甘草(炙。各半两)
上为粗末,每服五钱,姜、枣煎,温服。
〔《活》〕阳毒倍常,燥盛大渴者,黑奴丸主之。(方见阳毒。)风温加渴甚者,宜栝蒌汤。(方见风温。)
中暑伏热,累治不瘥,其人发渴不已,酒蒸黄连丸主之。(方见中暑。)
〔《脉》〕热病在肾,令人渴,口干舌焦黄赤,昼夜欲饮水不止,腹大而胀,尚不厌饮,目无精光者,
死不治。
【罗天益】伤寒病患者若饮食减少且伴有口渴,应当使用调和胃气的药物来治疗,不可使用寒凉药物强行止渴,因为担心这会进一步损伤胃气,导致更加无法进食,例如白术、茯苓等药即是此类。
【海藏】秦二的母亲患有太阴病,三天后病情未解,随后出现呕吐、逆气和恶心,但脉象不浮。给予半硫丸服用,服了两三剂后症状未止,又给予黄芪建中汤。此时脉象极紧,没有表证或里证的典型表现,但胸中感觉大热,引发口渴想喝水,大家都认为是阳证。病人想要喝水,我却反而给予干姜、附子等温热药物,紧脉反而变得沉细,说明阳气尚未生发。于是用桂枝、附子、干姜、乌头之类的药物制成酒丸,每次让病人连续服用一百丸,两天内服用了十多次。病患身体发热,烦躁不安,这是将要出汗的征兆。再用之前的药丸接续服用,盖上厚衣服,阳气脉象才显现出来并大汗出。第二天大小便才开始通畅,排出一盆瘀血,像猪肝一样。后用胃风汤加入桂枝、附子,服用三剂,出血停止。其寒邪之重,如此这般,也是世间罕见的病例。
少阴病,表现为口燥、舌干而渴,寸部和尺部脉象都沉。若脉沉迟,用四逆汤;若脉沉疾(快),用大承气汤。少阴病出现口燥、舌干而渴,身体表面发凉,脉象沉细而虚弱的,用泻心汤主治,这是区分有形实邪与无形虚热的用药区别。
人参汤:治疗伤寒七八日,发汗后出现心烦、躁动、口渴。
配方:人参、黄芩、柴胡、葛根(各一两)、川栀子、甘草(炙,各半两)。
制法:将上述药材捣成粗末,每次服用五钱,加生姜、大枣煎煮,温服。
【《活人书》】阳毒病症比平常严重,燥热盛大且极度口渴的,用黑奴丸主治。(方剂见“阳毒”条下。)风温病若口渴严重的,宜用栝蒌汤。(方剂见“风温”条下。)中暑伏热,经过多次治疗仍未痊愈,病人持续口渴不止的,用酒蒸黄连丸主治。(方剂见“中暑”条下。)
【《脉经》】热病在肾,使人产生口渴感,口干、舌焦黄赤,昼夜不停地想喝水,腹部胀大,仍然不满足饮水欲望,眼睛失去神采精光的,属于死症,无法医治。
[Luo Tianyi] In patients with Shanghan (Cold Damage) who have reduced appetite and are thirsty, one should use medicines that harmonize the Stomach Qi to alleviate the thirst. One must not use cold-natured medicines to forcibly stop the thirst, for fear of further damaging Stomach Qi, which would lead to an inability to eat at all. Baizhu (Atractylodis Rhizoma) and Fuling (Poria) are examples of such medicines.
[Hai Zang] The mother of Qin Er suffered from Taiyin Disease (Disease of the Taiyin Meridian). After three days, the condition had not resolved, followed by vomiting, regurgitation, nausea, but the pulse was not floating. Banliu Wan (Half-Sulfur Pill) was administered; after two or three doses, the symptoms did not cease. Huangqi Jianzhong Tang (Astragalus Decoction for Building the Middle) was then given. The pulse became extremely tight. There were no exterior or interior pathogenic signs, but there was intense heat in the chest causing thirst and a desire to drink water. All considered this a Yang Syndrome (Yang Pattern). Although the patient desired water, I instead administered warm medicines such as Jiang (Zingiberis Rhizoma) and Fu Zi (Aconiti Lateralis Radix Praeparata). The tight pulse subsequently became deep and fine, indicating that Yang Qi had not yet generated. Therefore, pills made from Gui (Cinnamomi Ramulus), Fu Zi, Jiang, and Wu Tou (Aconiti Radix) were prepared with wine. The patient was instructed to take them continuously, about one hundred pills per dose, receiving more than ten doses over two days. The patient developed body heat and restlessness, indicating that sweat was about to emerge. The previous pills were continued, and thick clothing was used to cover the patient. Only then did the Yang pulse appear, accompanied by profuse sweating. On the following day, urination and defecation began to flow freely, and a basin full of stasis blood, resembling pig liver, was discharged. Weifeng Tang (Stomach Wind Decoction) with added Gui and Fu Zi was administered for three doses, stopping the bleeding. Such severe cold pathology is rarely seen in the world.
Shaoyin Disease (Disease of the Shaoyin Meridian) presents with dry mouth, dry tongue, and thirst. If both the Cun (Inch) and Chi (Cubit) pulses are deep: if the pulse is deep and slow, Sini Tang (Frigid Extremities Decoction) is indicated; if the pulse is deep and rapid, Dachengqi Tang (Major Order the Qi Decoction) is indicated. For Shaoyin disease presenting with dry mouth, dry tongue, and thirst, where the body surface is cool and the pulse is deep, fine, and deficient, Xiexin Tang (Drain the Epigastrium Decoction) is the primary treatment. This distinguishes the use of medicines for tangible pathogens versus intangible heat.
Renshen Tang (Ginseng Decoction): Treats Shanghan after seven or eight days, characterized by mental irritability, restlessness, and thirst following sweating.
Ingredients: Renshen (Ginseng Radix et Rhizoma), Huangqin (Scutellariae Radix), Chaihu (Bupleuri Radix), Gegen (Puerariae Lobatae Radix) (each 1 liang); Chuanzhi (Gardeniae Fructus), Gancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle) (roasted, each 0.5 liang).
Preparation: Grind into coarse powder. Take 5 qian per dose, decoct with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus), and take warm.
[Huoren Shu] In Yang Du (Yang Toxin) cases where the condition is twice as severe as usual, with intense dryness and extreme thirst, Heinu Wan (Black Slave Pill) is indicated. (Formula see under "Yang Du".) In Fengwen (Wind-Warmth) cases with severe thirst, Gualou Tang (Trichosanthis Fruit Decoction) is appropriate. (Formula see under "Fengwen".) For Zhongshu (Heat Stroke) with latent heat, refractory to multiple treatments, resulting in unceasing thirst, Jiu Zheng Huanglian Wan (Wine-Steamed Coptis Pill) is indicated. (Formula see under "Zhongshu".)
[Mai Jing] When Heat Disease affects the Kidney, it causes thirst, dry mouth, scorched yellow-red tongue, incessant desire to drink water day and night, abdominal distension and swelling, yet still not satiated by drinking, and eyes lacking luster and spirit. This is a fatal condition, untreatable.