治素患劳嗽,因外感袭肺,而劳嗽益甚,或兼喘逆,痰涎壅滞者。
麻黄(二钱) 石膏(三钱, 捣) 生山药(五钱) 寸麦冬(四钱,带心) 清半夏(三钱) 牛蒡子(三钱,
炒捣)
玄参(三钱) 甘草(一钱五分) 大枣(三枚,擘开) 生姜(三片)
《伤寒论》有桂枝二越婢一汤,治太阳病发热恶寒,热多寒少。《金匮》有越婢汤,治受风水肿。有越
婢加半夏汤,治外感袭肺,致肺中痰火壅滞,胀而作喘。今因其人素患劳嗽,外感之邪与肺中蕴蓄之痰,互相
胶漆,壅滞肺窍而劳嗽益甚。故用越婢加半夏汤,以祛外袭之邪,而复加山药、玄参、麦冬,牛蒡子,以治其
劳嗽。此内伤外感兼治之方也。
一叟,年近七旬。素有劳嗽,初冬宿病发动,又兼受外感,痰涎壅滞胸间,几不能息。剧时昏不知人,身
躯后挺。诊其脉,浮数无力。为制此汤,一剂气息通顺,将麻黄、石膏减半,又服数剂而愈。
或问∶子尝谓石膏宜生用,不宜 用。以石膏寒凉之中,原兼辛散, 之则辛散之力,变为收敛,服之转
可增病。乃他方中,石膏皆用生者,而此独用 者何也?答曰∶此方所主之病,外感甚轻,原无大热。方中用
麻黄以祛肺邪,嫌其性热,故少加石膏佐之。且更取 者,收敛之力,能将肺中痰涎凝结成块,易于吐出。此
理从用 石膏点豆腐者悟出,试之果甚效验。后遇此等证,无论痰涎如何壅盛、如何杜塞,投以此汤,须臾,
药力行后,莫不将痰涎结成小块,连连吐出,此皆 石膏与麻黄并用之
效也。若以治寒温大热,则断不可 。若更多用,则更不可 也( 石膏用于此方,且止三钱,自无妨碍。然愚后
来志愿,欲全国药局,皆不备 石膏,后有用此方者,若改用生石膏四钱更佳)。
治疗平素患有劳嗽(慢性咳嗽,多因阴虚肺燥或久咳伤肺所致),又因外感邪气侵袭肺部,导致劳嗽加重,或者兼有气喘逆乱、痰涎壅盛阻滞的情况。
麻黄(二钱) 石膏(三钱,捣碎) 生山药(五钱) 寸麦冬(四钱,保留心部) 清半夏(三钱) 牛蒡子(三钱,炒后捣碎)
玄参(三钱) 甘草(一钱五分) 大枣(三枚,掰开) 生姜(三片)
《伤寒论》中有桂枝二越婢一汤,用于治疗太阳病(太阳经受邪所致的病证)发热恶寒,热重寒轻的症状。《金匮要略》中有越婢汤,用于治疗风水水肿。还有越婢加半夏汤,用于治疗外感邪气侵袭肺部,导致肺中痰火壅滞,胸部胀满而作喘。现在因为患者平素患有劳嗽,外感的邪气与肺中蕴积的痰浊互相胶结,阻塞肺窍,从而使劳嗽更加严重。所以使用越婢加半夏汤,以祛除外袭的邪气,同时加入山药、玄参、麦冬、牛蒡子,来治疗其劳嗽。这是一个内伤与外感兼治的方剂。
有一位老翁,年龄接近七十岁。平素有劳嗽,初冬时宿疾发作,又兼受外感,痰涎壅塞在胸间,几乎无法呼吸。病情剧烈时昏迷不省人事,身体向后挺伸。诊察其脉象,浮数而无力。为此配制此汤,服用一剂后气息通畅,将麻黄、石膏减半,又服用几剂后痊愈。
有人问道:您曾经说石膏宜生用,不宜煅用。因为石膏在寒凉之中,原本兼有辛散之性,煅烧之后辛散之力变为收敛,服用后反而可能增加病情。既然其他方剂中,石膏都用生品,而唯独这个方剂用煅石膏,为什么呢?回答说:此方所主治的病证,外感很轻微,原本没有大热。方中使用麻黄以祛除肺中邪气,担心其药性温热,所以少加石膏作为佐制。并且更取用煅石膏,利用其收敛之力,能将肺中的痰涎凝结成块,易于吐出。这个道理是从用煅石膏点豆腐的经验中领悟出来的,试用果然非常有效。后来遇到这类证候,无论痰涎如何壅盛、如何堵塞,投以此汤,片刻之后,药力运行过后,无不将痰涎结成小块,连续吐出,这都是煅石膏与麻黄并用的功效。如果用来治疗寒温病(外感热病)的大热证,则绝对不可以用煅石膏。如果使用更多,则更不可以用(煅石膏用于此方,且仅用三钱,自然没有妨碍。然而我后来的志愿是,希望全国药局都不备煅石膏,后来有用此方者,若改用生石膏四钱更佳)。
Translation of the original text into modern vernacular Chinese, then into academic English based on WHO standards.
Treats patients who have a chronic history of *Lao Sou* (consumptive cough, often due to yin deficiency and lung dryness or prolonged coughing damaging the lung), whose condition is exacerbated by external pathogenic factors invading the lungs, resulting in worsened consumptive cough, possibly accompanied by wheezing and dyspnea, with copious phlegm and saliva obstructing the airways.
Ephedrae Herba (Mahuang, 麻黄) - 2 qian; Gypsum Fibrosum (Shigao, 石膏) - 3 qian, crushed; Raw Dioscoreae Rhizoma (Sheng Shanyao, 生山药) - 5 qian; Ophiopogonis Radix (Cun Maidong, 寸麦冬) - 4 qian, retaining the heart; Pinelliae Rhizoma Preparatum (Qing Banxia, 清半夏) - 3 qian; Arctii Fructus (Niuzi, 牛蒡子) - 3 qian, stir-fried and crushed; Scrophulariae Radix (Xuanshen, 玄参) - 3 qian; Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) - 1.5 qian; Jujubae Fructus (Dazao, 大枣) - 3 pieces, split open; Zingiberis Rhizoma Recens (Shengjiang, 生姜) - 3 slices.
The *Shanghan Lun* (Treatise on Cold Damage Diseases) contains the Guizhi Er Yuespi Yi Tang (Cinnamon Twig Twice-Yuespi One Decoction), which treats Taiyang disease (a syndrome caused by pathogenic invasion of the Taiyang channel) characterized by fever and aversion to cold, where heat predominates over cold. The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) contains Yuespi Tang (Yuespi Decoction) for treating Fengshui edema (edema due to wind-water). It also includes Yuespi Jia Banxia Tang (Yuespi Decoction plus Pinellia) for treating external pathogenic invasion of the lungs, leading to stagnation of phlegm-fire in the lungs, chest distension, and wheezing. In this case, since the patient has a chronic history of consumptive cough, the external pathogenic factors interact with the phlegm accumulated in the lungs, becoming mutually adhesive and obstructing the lung orifices, thereby exacerbating the consumptive cough. Therefore, Yuespi Jia Banxia Tang is used to dispel the externally invading pathogens, while adding Dioscoreae Rhizoma (Shanyao, 山药), Scrophulariae Radix (Xuanshen, 玄参), Ophiopogonis Radix (Maidong, 麦冬), and Arctii Fructus (Niuzi, 牛蒡子) to treat the consumptive cough. This is a formula that simultaneously treats internal injury and external contraction.
An elderly man, nearly seventy years old, had a chronic history of consumptive cough. In early winter, his chronic illness flared up, compounded by an external contraction. Copious phlegm and saliva obstructed the chest, making breathing nearly impossible. During severe episodes, he fell into a coma, unaware of his surroundings, with his body arching backward. His pulse was floating, rapid, and deficient in strength. This decoction was prescribed. After one dose, his breathing became smooth. The dosages of Ephedrae Herba (Mahuang, 麻黄) and Gypsum Fibrosum (Shigao, 石膏) were halved, and after several more doses, he recovered.
Someone asked: "You have previously stated that Gypsum Fibrosum (Shigao, 石膏) should be used raw and not calcined. Since Gypsum Fibrosum (Shigao, 石膏) is cold and cool but inherently possesses acrid-dispersing properties, calcination transforms these acrid-dispersing properties into astringent ones, which may aggravate the disease upon ingestion. Since other formulas use raw Gypsum Fibrosum (Shigao, 石膏), why is calcined Gypsum Fibrosum (Duan Shigao, 煅石膏) used exclusively in this formula?" The answer was: "The disease treated by this formula involves very mild external contraction and originally lacks significant heat. Ephedrae Herba (Mahuang, 麻黄) is used in the formula to expel pathogens from the lungs, but its hot nature is a concern; therefore, a small amount of Gypsum Fibrosum (Shigao, 石膏) is added as an adjunct. Furthermore, calcined Gypsum Fibrosum (Duan Shigao, 煅石膏) is chosen for its astringent power, which can condense the phlegm and saliva in the lungs into clumps, making them easier to expectorate. This principle was deduced from the experience of using calcined Gypsum Fibrosum (Duan Shigao, 煅石膏) to coagulate tofu. Clinical trials proved it highly effective. In subsequent cases of such syndromes, regardless of how severe the phlegm obstruction or blockage was, administering this decoction would, within moments after the medicinal action took effect, cause the phlegm and saliva to congeal into small clumps and be continuously expectorated. This is the efficacy of combining calcined Gypsum Fibrosum (Duan Shigao, 煅石膏) with Ephedrae Herba (Mahuang, 麻黄). However, if used to treat high fever in Hanwen diseases (exogenous febrile diseases), the use of calcined Gypsum Fibrosum (Duan Shigao, 煅石膏) is absolutely contraindicated. Using larger amounts is even more inadvisable. (Using three qian of calcined Gypsum Fibrosum (Duan Shigao, 煅石膏) in this formula poses no harm. However, my later aspiration is that all national pharmacies should not stock calcined Gypsum Fibrosum (Duan Shigao, 煅石膏). For future users of this formula, substituting four qian of raw Gypsum Fibrosum (Shigao, 石膏) is preferable)."