时毒者。感四时不正之气。初发状似伤寒。五七日间。乃能杀人。十日外。不治自愈。诊其
脉。滑数浮洪沉紧弦涩。皆其候也。浮数者。邪气在表。宜发之。沉实者。邪气在里。当下之。
此症有阴有阳。有可汗有可下。常见粗工但云热毒。骤用寒凉。不知病有轻重。治有逆从。岂容
轻忽也。(寒凉不可轻用)头面耳项肿赤痛甚。恶寒口渴。大便闭涩。脉数实者。表里俱实也。
防风通圣散主之。无表里症。或已汗下。肿不消者。小柴胡加酒连连翘玄参薄荷桔梗鼠粘子天花
粉和解之。肿甚 痛。汗下不消。宜砭去恶血。内服解毒药。势不可散。欲脓脉
弱。不溃。宜托里。饥年传染。先因胃虚饮食不节。邪乘虚入。宜从轻治。发散解毒。必加人参
以固元气。病颐颔肿者。(即俗名虾幕瘟是也。又名曰 腮。)先用败毒散微汗之。次以酒芩连
(黄连非热甚且缓之。栀芩足矣。)玄参薄荷连翘甘草桔梗升麻鼠粘子频频缓服。大便实者。加
熟大黄。(此法。即非流行。凡遇见此症。用之自效。)大抵热不止。不可便与谷食。恐助邪热
也。脉虚。无停滞者不禁。
荆防败毒散
羌活(臣) 独活(佐) 前胡(佐) 软柴胡(臣) 川芎(佐) 枳壳(佐)
茯苓(佐) 荆芥(臣) 防风(君)
上加人参甘桔去荆防。名人参败毒散。立斋加玄参牛蒡子。
防风通圣散
白芍(臣) 防风(君) 当归(酒洗臣) 川芎(佐) 滑石(臣) 石膏(君) 芒硝
(使) 桔梗(佐) 荆芥(佐) 麻黄(佐) 薄荷(使) 甘草(臣) 栀子(
焙臣) 大黄(煨使) 白术(君) 连翘(臣) 黄芩(佐) 生姜(使)
普济消毒饮
泰和间。民病疫疠。初觉憎寒体重。次传头面肿盛。目不能开。上喘。咽喉不利。舌干口燥。俗
云大头天行。诸药罔效。明之云。身半以上天之气。邪热客心肺之间。上攻头面而肿。须用下药。
(大头天行。湿热为肿。木盛为痛。湿热从阳明。木盛从少阳。阳明为邪首大肿。少阳邪出于耳
前后。)
黄连(佐) 黄芩(佐) 人参(臣) 桔梗(佐) 生甘草(佐) 陈皮(佐)
元参(君) 连翘(臣) 板蓝根(使) 马勃(使) 鼠粘子(焙研) 僵蚕(炒二味臣)
升麻(使) 柴胡(臣)上为末。半用汤调。时时呷之。半用蜜丸。噙化。服尽良愈。或加薄荷
川芎当归。 咀。每服五钱。水煎。时时稍热服之。如大便硬。加酒煨大黄一钱。或二钱以利之
。肿势盛者。宜砭刺之。
消毒托里散
治时毒已经汗下解毒。不消。势欲成脓。未成即消。已成即溃。
黄 (盐水拌炒) 人参(二味君) 白术(臣) 茯苓(臣) 当归(臣) 芍药(佐)
川芎(佐) 甘草(臣) 金银花(佐) 白芷(佐)
水煎。分疮上下。食前后服之。
时毒,是指感受四时不正之气所致。初起症状类似伤寒,在五到七天之间可能致死,若过了十天,即使不治疗也能自愈。诊察其脉象,滑、数、浮、洪、沉、紧、弦、涩等脉象,都是该病的征候。脉浮数的,说明邪气在表,宜用发汗法;脉沉实的,说明邪气在里,宜用攻下法。此病有阴证和阳证之分,有可用发汗法的,也有可用攻下法的。常见庸医只说是热毒,就贸然使用寒凉药物,不知道疾病有轻重之分,治疗有逆治和从治的区别,怎么可以轻视疏忽呢?(寒凉药物不可轻易使用)头面、耳部、颈部红肿疼痛剧烈,伴有恶寒、口渴、大便闭结不通,脉象数而有力的,属于表里俱实证,以防风通圣散为主方。如果没有表证或里证,或者已经经过发汗或攻下治疗,但肿胀仍未消退的,用小柴胡汤加酒炒连翘、玄参、薄荷、桔梗、鼠粘子(牛蒡子)、天花粉来和解少阳。如果肿胀严重且疼痛,发汗和攻下后仍不消退,宜用砭石刺破排出恶血,内服解毒药物。如果病势无法消散,想要化脓但脉象虚弱,疮疡不能溃破的,宜用托里透脓法。饥荒年份发生传染,多因胃气虚弱、饮食不节制,邪气乘虚而入,宜从轻治疗,采用发散解毒法,必须加入人参以固护元气。患颐颔部肿胀的病证(即俗称虾蟆瘟,又名痄腮),先用败毒散使其微微出汗,随后用酒炒黄芩、黄连(若热势不盛且病情缓和,仅用栀子和黄芩即可)、玄参、薄荷、连翘、甘草、桔梗、升麻、鼠粘子频频缓服。大便干结坚实的,加入熟大黄。(此方法,即使是非流行性病例,凡遇到此类病症,使用也自有效验。)大抵热势不退,不可立即给予谷类食物,恐怕会助长邪热。脉象虚弱的,若无积滞停食,则不禁忌补益。
荆防败毒散
羌活(臣药) 独活(佐药) 前胡(佐药) 软柴胡(臣药) 川芎(佐药) 枳壳(佐药)
茯苓(佐药) 荆芥(臣药) 防风(君药)
上方加入人参、甘草、桔梗,去掉荆芥、防风,称为人参败毒散。薛立斋在此基础上加入玄参、牛蒡子。
防风通圣散
白芍(臣药) 防风(君药) 当归(酒洗,臣药) 川芎(佐药) 滑石(臣药) 石膏(君药) 芒硝(使药) 桔梗(佐药) 荆芥(佐药) 麻黄(佐药) 薄荷(使药) 甘草(臣药) 栀子(焙干,臣药) 大黄(煨制,使药) 白术(君药) 连翘(臣药) 黄芩(佐药) 生姜(使药)
普济消毒饮
泰和年间,百姓患瘟疫。初起感觉憎恶寒冷、身体沉重,随后传变至头面部肿胀严重,眼睛无法睁开,向上气喘,咽喉不利,舌干口燥。俗称为大头天行,各种药物都无效。李东垣认为,身半以上属天之阳气,邪热客居在心肺之间,上攻头面导致肿胀,必须使用下药。(大头天行,湿热导致肿胀,肝木旺盛导致疼痛。湿热之邪源于阳明经,肝木之邪源于少阳经。阳明经受邪则头部肿大,少阳经受邪则耳前后发病。)
黄连(佐药) 黄芩(佐药) 人参(臣药) 桔梗(佐药) 生甘草(佐药) 陈皮(佐药)
元参(君药) 连翘(臣药) 板蓝根(使药) 马勃(使药) 鼠粘子(焙干研碎) 僵蚕(炒,以上两味为臣药)
升麻(使药) 柴胡(臣药)将上述药物研为细末,一半用汤剂调服,时时小口饮用;一半制成蜜丸,含化服用。服完即可痊愈。或者加入薄荷、川芎、当归,切碎,每服五钱,水煎,时时稍热服用。如果大便干硬,加入酒煨大黄一钱或二钱以通利大便。肿胀严重的,宜用砭石刺破排脓。
消毒托里散
治疗时毒已经经过发汗、攻下及解毒治疗,但肿胀未消,病势即将成脓。若未成脓则能消散,已成脓则能溃破。
黄芪(盐水拌炒) 人参(以上两味为君药) 白术(臣药) 茯苓(臣药) 当归(臣药) 芍药(佐药)
川芎(佐药) 甘草(臣药) 金银花(佐药) 白芷(佐药)
水煎,根据疮疡部位上下、进食前后分次服用。
Shidu (Seasonal Toxicity) refers to a condition caused by contracting the abnormal Qi of the four seasons. Its initial presentation resembles Taiyang disease (a syndrome caused by pathogenic factors affecting the Taiyang meridian). It can be fatal between the fifth and seventh days, but if it persists beyond ten days, it may resolve spontaneously even without treatment. Upon pulse diagnosis, slippery (Hua), rapid (Shu), floating (Fu), surging (Hong), deep (Chen), tight (Jin), wiry (Xian), or choppy (Se) pulses are all indicative signs. A floating and rapid pulse indicates that the pathogenic factor is in the exterior; sweating methods should be used. A deep and solid pulse indicates that the pathogenic factor is in the interior; purgative methods should be used. This condition presents as either Yin or Yang syndromes, and may require either diaphoresis or purgation. Commonly, incompetent physicians merely attribute the condition to "heat toxicity" and hastily administer cold-natured drugs, failing to recognize that diseases vary in severity and treatments must follow either counteracting or following principles. How can such matters be neglected? (Cold-natured drugs should not be used lightly.) When there is severe redness, swelling, and pain in the head, face, ears, and neck, accompanied by aversion to cold, thirst, constipation, and a rapid and forceful pulse, this constitutes an excess syndrome in both the exterior and interior. Fangfeng Tongsheng San (Windproof Unblocking Powder) is the primary formula. If there are no exterior or interior symptoms, or if swelling persists despite prior sweating or purgation, Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Jiuhuang Lianqiao (Wine-processed Forsythia Fruit), Xuanshen (Scrophulariae Radix), Bohe (Menthae Haplocalycis Herba), Jiegeng (Platycodonis Radix), Niuzibang (Aubrietiae Semen/Arabis Semen - here referring to Arctii Fructus/Bullactae Fructus contextually often Arctii Fructus/Niupangzi), and Tianhuafen (Trichosanthis Radix) should be used to harmonize. If swelling is severe and painful, and does not subside after sweating or purgation, Bianci (Bian stone therapy) should be used to drain bad blood, and internal detoxifying herbs should be administered. If the pathological process cannot dissipate and suppuration is desired but the pulse is weak and the abscess fails to ulcerate, Tuoli (Supporting the Interior) methods should be employed. In years of famine, infectious outbreaks often occur due to Spleen/Stomach deficiency and irregular diet, allowing pathogens to enter via the deficiency. Treatment should be mild, employing dispersing and detoxifying methods, and Renshen (Ginseng Radix et Rhizoma) must be added to consolidate the Yuan Qi (Original Qi). For cases involving swelling of the jaw and chin (commonly known as Hamawen/Mumps, also called Zhasai), first use Baidu San (Toxin-Detoxifying Powder) to induce slight sweating, followed by frequent, slow administration of Jiuhuang Qinlian (Wine-processed Scutellariae Radix and Coptidis Rhizoma—note: if heat is not extreme and the condition is mild, Zhizi and Huangqin suffice), Xuanshen, Bohe, Lianqiao (Forsythiae Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng, Shengma ( Cimicifugae Rhizoma), and Niuzibang. If the stool is hard and solid, Shudahuang (Prepared Rheum Palmatum Root and Rhizome) should be added. (This method is effective for such conditions regardless of whether they are epidemic.) Generally, if heat does not subside, grain foods should not be given immediately, lest they aid the pathogenic heat. If the pulse is deficient and there is no stagnation, tonification is not prohibited.
Jingfang Baidu San (Atractylodes and Saposhnikovia Toxin-Detoxifying Powder)
Qianghuo (Notopterygii Rhizoma et Radix) [Minister]
Duhuo (Angelicae Pubescentis Radix) [Assistant]
Qianhu (Peucedani Radix) [Assistant]
Ruan Chaihu (Bupleuri Radix) [Minister]
Chuanxiong (Ligustici Chuanxiong Rhizoma) [Assistant]
Zhiqiao (Aurantii Fructus Immaturus) [Assistant]
Fuling (Poria) [Assistant]
Jingjie (Schizonepetae Spica) [Minister]
Fangfeng (Saposhnikoviae Radix) [Monarch]
Adding Renshen, Gancao, and Jiegeng to the above formula, while removing Jingjie and Fangfeng, yields Renshen Baidu San (Ginseng Toxin-Detoxifying Powder). Xue Lizhai (Li Dongyuan/Xue Yi) added Xuanshen and Niubangzi (Arctii Fructus) to this base.
Fangfeng Tongsheng San (Windproof Unblocking Powder)
Baishao (Paeoniae Radix Alba) [Minister]
Fangfeng (Saposhnikoviae Radix) [Monarch]
Danggui (Angelicae Sinensis Radix, wine-washed) [Minister]
Chuanxiong (Ligustici Chuanxiong Rhizoma) [Assistant]
Huashi (Talcum) [Minister]
Shigao (Gypsum Fibrosum) [Monarch]
Mangxiao (Natrii Sulfas) [Envoy]
Jiegeng (Platycodonis Radix) [Assistant]
Jingjie (Schizonepetae Spica) [Assistant]
Mahuang (Ephedrae Herba) [Assistant]
Bohe (Menthae Haplocalycis Herba) [Envoy]
Gancao (Glycyrrhizae Radix et Rhizoma) [Minister]
Zhizi (Gardeniae Fructus, roasted) [Minister]
Dahuang (Rhei Radix et Rhizoma, baked) [Envoy]
Baizhu (Atractylodis Macrocephalae Rhizoma) [Monarch]
Lianqiao (Forsythiae Fructus) [Minister]
Huangqin (Scutellariae Radix) [Assistant]
Shengjiang (Zingiberis Rhizoma Recens) [Envoy]
Puji Xiaodu Yin (Universal Benefit Detoxification Decoction)
During the Taihe era, the populace suffered from epidemics. Initially, patients felt aversion to cold and heaviness of the body, which then progressed to severe swelling of the head and face, inability to open the eyes, upward panting, throat obstruction, dry tongue, and dry mouth. This was commonly called Datou Tianxing (Big Head Epidemic), and various medicines proved ineffective. Li Dongyuan stated that the upper half of the body corresponds to Heavenly Qi; when pathogenic heat lodges between the Heart and Lung, it attacks the head and face causing swelling. Purgatives are required. (Datou Tianxing involves swelling due to Damp-Heat and pain due to Wood/Liver excess. Damp-Heat follows the Yangming channel; Wood excess follows the Shaoyang channel. Pathogens in Yangming cause major head swelling; pathogens in Shaoyang affect the areas before and behind the ears.)
Huanglian (Coptidis Rhizoma) [Assistant]
Huangqin (Scutellariae Radix) [Assistant]
Renshen (Ginseng Radix et Rhizoma) [Minister]
Jiegeng (Platycodonis Radix) [Assistant]
Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma) [Assistant]
Chenpi (Citri Reticulatae Pericarpium) [Assistant]
Yuanshen/Xuanshen (Scrophulariae Radix) [Monarch]
Lianqiao (Forsythiae Fructus) [Minister]
Banlangen (Isatidis Radix) [Envoy]
Mabo (Polyporus/Cytinus contextually Polyporus Umbellatus or similar fungal agent, here likely referring to specific herbal usage for throat) [Envoy]
Niuzibang (Arctii Fructus, roasted and ground)
Jiangcan (Bombyx Batryticatus, stir-fried, these two are Ministers)
Shengma (Cimicifugae Rhizoma) [Envoy]
Chaihu (Bupleuri Radix) [Minister]
Grind the above into powder. Use half mixed with water, sipping frequently. Use the other half made into honey pills, to be held in the mouth until dissolved. Completion of the course leads to recovery. Alternatively, add Bohe, Chuanxiong, and Danggui, cut into pieces, take five qian per dose, decoct in water, and drink warm frequently. If the stool is hard, add one or two qian of Jiuwei Dahuang (Wine-baked Rheum) to promote bowel movement. For severe swelling, Bianci (stone puncture) is appropriate.
Xiaodu Tuoli San (Detoxification and Interior-Supporting Powder)
Used for Shidu (Seasonal Toxicity) where sweating, purgation, and detoxification have failed to reduce swelling, and the condition is progressing toward suppuration. If pus has not formed, it will dissipate; if formed, it will ulcerate.
Huangqi (Astragali Membranacei Radix, stir-fried with salt water)
Renshen (Ginseng Radix et Rhizoma) [These two are Monarchs]
Baizhu (Atractylodis Macrocephalae Rhizoma) [Minister]
Fuling (Poria) [Minister]
Danggui (Angelicae Sinensis Radix) [Minister]
Shaoyao (Paeoniae Radix) [Assistant]
Chuanxiong (Ligustici Chuanxiong Rhizoma) [Assistant]
Gancao (Glycyrrhizae Radix et Rhizoma) [Minister]
Jinyinhua (Lonicerae Japonicae Flos) [Assistant]
Baizhi (Angelicae Dahuricae Radix) [Assistant]
Decoct in water. Administer according to the location of the sores (upper/lower) and timing relative to meals.