汗出筋惕肉 ,若眩悸,振振欲擗地者,及服大青龙汤后厥逆者,俱宜真武汤。(方见战掉及发热。)
若动气在左,头汗不止者,《活人》用防风白术牡蛎,次服建中汤。(论见重寒。)
汗下吐温针后,若肤 动,胸烦,面色青黄者,难治。(论见痞。)若经脉动惕,脉微,心下痞,气冲咽
喉者,久而成痿。(论见痞。)
发汗过多,叉手自冒心,心下悸欲得按者,桂枝甘草汤。(方论见悸。)
少阳耳聋目赤,胸满而烦者,不可吐下,吐下则悸而惊。(论见口苦。)
伤寒八九日,下之胸满烦惊,小便不利,谵语,一身尽重,不可转侧者,宜柴胡加龙骨牡蛎汤。
半夏(二合) 大枣(六枚) 柴胡(四两) 生姜 人参 龙骨 铅丹 桂枝 茯苓(各一两半) 大
黄(二两半) 牡蛎(一两半)
上 咀,每服五钱,水一盏半,煎至八分,去渣温服。
伤寒脉浮,医以火迫劫之,亡阳必惊狂,起卧不安者,桂枝去芍药加蜀漆牡蛎龙骨救逆汤主
之。(《活人》云∶医以火于卧床下或周身用火迫劫汗出,或熨而成火邪者是也。)
桂枝蜀漆牡蛎龙骨救逆汤
桂枝(去皮,三两) 甘草(炙,二两) 生姜(切,三两) 牡蛎(炒,五两) 龙骨(四两) 大枣(十二枚)
蜀漆(洗,去腥三两)
上 咀,每服五钱,水一盏半,煎至八分,去渣温服。
太阳伤寒者,加温针必惊也。风温脉浮自汗,身重多眠,若被火者,微则发黄,剧则如惊痫,时螈 。
(论见风温。)阳明病,脉浮紧,口苦咽干,腹满,若加烧针,必怵惕烦躁不眠。(论见自汗。)
汗出导致筋脉跳动、肌肉瞤动,若伴有眩晕、心悸,身体震颤欲倒仆于地者,以及服用大青龙汤后出现四肢厥逆者,都适宜使用真武汤。(方剂详情见“战栗”及“发热”章节。)
若脐旁左侧有动气感,且头部出汗不止者,《活人书》主张先用防风白术牡蛎散,随后服用小建中汤。(相关论述见“重寒”章节。)
经过发汗、攻下、催吐、温灸或针刺治疗后,若皮肤肌肉跳动,胸中烦闷,面色青黄者,难以治疗。(相关论述见“痞证”章节。)若经脉跳动惕然不安,脉象微弱,心下部痞塞,气上冲至咽喉者,日久将发展为痿证。(相关论述见“痞证”章节。)
发汗过多,患者双手交叉按压心胸部,自觉心下部悸动且喜欢被按压者,适用桂枝甘草汤。(方剂与论述见“心悸”章节。)
少阳病表现为耳聋、目赤、胸中满闷而心烦者,不可使用催吐或攻下法,若误用吐下法,则会导致心悸和惊狂。(相关论述见“口苦”章节。)
伤寒病程已过八九日,经误用攻下法后,出现胸中满闷、烦躁惊惧、小便不利、胡言乱语、全身沉重、无法随意转侧者,适宜使用柴胡加龙骨牡蛎汤。
药材:半夏(二合)、大枣(六枚)、柴胡(四两)、生姜、人参、龙骨、铅丹、桂枝、茯苓(各一两半)、大黄(二两半)、牡蛎(一两半)。
制法:将药物捣碎成粗末,每次服用五钱,加水一盏半,煎煮至八分,滤去药渣,温服。
伤寒脉象浮,医生用火法强迫发汗劫夺津液,导致亡阳,必然出现惊狂、坐卧不安的症状,应用桂枝去芍药加蜀漆牡蛎龙骨救逆汤主治。(《活人书》记载:医生在床下烧火或周身用火迫劫令其出汗,或因熨烫而成火邪的情况即是如此。)
方名:桂枝蜀漆牡蛎龙骨救逆汤
药材:桂枝(去皮,三两)、甘草(炙,二两)、生姜(切,三两)、牡蛎(炒,五两)、龙骨(四两)、大枣(十二枚)、蜀漆(洗去腥味,三两)。
制法:将药物捣碎成粗末,每次服用五钱,加水一盏半,煎煮至八分,滤去药渣,温服。
太阳伤寒证,若加用温针,必然引起惊恐。风温病脉象浮、自汗、身体沉重、嗜睡,若误用火法治疗,轻则发黄,重则如惊痫发作,时而抽搐。(相关论述见“风温”章节。)阳明病,脉象浮紧,口苦咽干,腹部胀满,若加用烧针,必然出现恐惧、惕惕不安、烦躁不眠的症状。(相关论述见“自汗”章节。)
Sweating leading to twitching of sinews and quivering of muscles, if accompanied by dizziness and palpitations, with the body trembling as if about to fall to the ground, as well as cases of cold limbs (Jue Ni) appearing after taking Da Qing Long Tang (Great Blue Dragon Decoction), all are suitable for treatment with Zhen Wu Tang (True Warrior Decoction). (For the formula details, see chapters on "Trembling" and "Fever".)
If there is a sensation of Qi movement on the left side of the umbilicus, accompanied by continuous sweating only on the head, *Huo Ren Shu* (Book of Life People) recommends using Fang Feng Bai Zhu Mu Li San (Saposhnikovia, Atractylodes Macrocephala, and Oyster Shell Powder) first, followed by Jian Zhong Tang (Establish the Middle Decoction). (The discussion can be found in the chapter on "Severe Cold".)
After undergoing sweating, purging, vomiting, warming moxibustion, or acupuncture treatments, if the skin and muscles twitch, there is chest irritability, and the complexion is greenish-yellow, the condition is difficult to treat. (The discussion can be found in the chapter on "Pi Syndrome" [Epigastric Fullness]). If the meridians show twitching and restlessness, the pulse is faint, there is epigastric fullness (Pi), and Qi rushes up to the throat, it will eventually develop into Wei Syndrome (Flaccidity Syndrome). (The discussion can be found in the chapter on "Pi Syndrome".)
Excessive sweating causing the patient to cross their hands over the heart region, feeling palpitations in the epigastrium that are relieved by pressure, should be treated with Gui Zhi Gan Cao Tang (Cinnamon Twig and Licorice Decoction). (Formula and discussion see "Palpitations".)
In Shaoyang disease presenting with deafness, red eyes, chest fullness, and irritability, emetics and purgatives must not be used. If vomiting or purging is mistakenly applied, it will result in palpitations and fright. (Discussion see "Bitter Taste in Mouth".)
In Shang Han (Cold Damage) lasting eight or nine days, if purgatives were mistakenly used, resulting in chest fullness, irritability, fright, difficulty in urination, delirium, heaviness of the entire body, and inability to turn the body, Chai Hu Jia Long Gu Mu Li Tang (Bupleurum plus Dragon Bone and Oyster Shell Decoction) is appropriate.
Ingredients: Ban Xia (Pinelliae Rhizoma, 2 he), Da Zao (Ziziphi Jujubae Fructus, 6 pieces), Chai Hu (Bupleuri Radix, 4 liang), Sheng Jiang (Zingiberis Rhizoma Recens), Ren Shen (Ginseng Radix), Long Gu (Fossilia Ossis Mastodi), Qian Dan (Lodanum), Gui Zhi (Cinnamomi Ramulus), Fu Ling (Poria, each 1.5 liang), Da Huang (Rhei Radix et Rhizoma, 2.5 liang), Mu Li (Ostreae Concha, 1.5 liang).
Preparation: Coarsely crush the herbs. Take 5 qian per dose, add 1.5 zhan of water, decoct until 0.8 zhan remains, remove the dregs, and take warm.
In Shang Han, if the pulse is floating and the physician uses fire methods to force sweating and deplete fluids, leading to Yang collapse (Wang Yang), it will inevitably cause fright, mania, restlessness, and inability to lie still. This should be primarily treated with Gui Zhi Qu Shao Yao Jia Shu Qi Mu Li Long Gu Jiu Ni Tang (Cinnamon Twig Decoction without Paeonia plus Chinese Perilla Leaf, Oyster Shell, and Dragon Bone for Saving from Emergency). (*Huo Ren Shu* states: This refers to situations where physicians place fires under the bed or use fire around the body to force sweating, or cause fire pathogenic factors through hot compresses.)
Formula Name: Gui Zhi Shu Qi Mu Li Long Gu Jiu Ni Tang
Ingredients: Gui Zhi (Cinnamomi Ramulus, peeled, 3 liang), Gan Cao (Licorizae Radix et Rhizoma, honey-fried, 2 liang), Sheng Jiang (Zingiberis Rhizoma Recens, sliced, 3 liang), Mu Li (Ostreae Concha, stir-fried, 5 liang), Long Gu (Fossilia Ossis Mastodi, 4 liang), Da Zao (Ziziphi Jujubae Fructus, 12 pieces), Shu Qi (Perillae Folium, washed to remove fishy smell, 3 liang).
Preparation: Coarsely crush the herbs. Take 5 qian per dose, add 1.5 zhan of water, decoct until 0.8 zhan remains, remove the dregs, and take warm.
In Taiyang Shang Han, adding warm needle therapy will inevitably cause fright. In Feng Wen (Wind-Warmth) disease, characterized by floating pulse, spontaneous sweating, heavy body, and excessive sleepiness, if fire methods are mistakenly used, mild cases will result in jaundice, while severe cases will resemble convulsive epilepsy with intermittent spasms. (Discussion see "Feng Wen".) In Yangming disease, with a floating-tight pulse, bitter taste in mouth, dry throat, and abdominal fullness, if burning needles are added, it will inevitably cause fear, apprehension, irritability, and insomnia. (Discussion see "Spontaneous Sweating".)