治天行时气, 初起头痛, 壮热等疫.
大黄四两 白芍二两 黄芩 甘草 ( 炙 ) 桂心 麻黄各三两, 右
为粗末, 每撮一两 , 水煎服. 汗下不再服.
川大黄 ( 生 ) 一斤 皂角 ( 猪牙者, 去皮弦, 微炒 ) 四两, 右为
末,和匀, 水泛为丸, 每服三钱, 无根水下. 弱者减服.
【注】天行时气, 即四时不正之气, 感而为病者, 初不名疫也. 因病
气互相传染, 老幼相似, 沿门阖境而共病之, 故曰: 天行时气也. 然
此疫气从鼻而入, 一受其邪, 脏腑皆病, 若不急逐病出, 则多速死.
急逐之法, 非汗即下, 故古人治疫之方, 以下为主, 以汗次之, 是为
病寻出路也. 此二方, 一以治冬疫, 一以治春疫. 冬疫多寒, 春疫多
热.多寒者宜水解散, 方中用麻, 桂, 芍, 草发营卫之汗, 大黄, 黄
芩泻疫毒之邪. 多热者宜救苦丹, 方中用皂角开窍而发表, 大黄泻火
而攻里, 使毒亦从汗下而出也. 二方审而用之, 治疫之大法可类推矣
.
一名益元散 一名六一散 治夏时中暑, 热伤元气, 内
外俱热, 无气以动, 烦渴欲饮, 肠胃枯涸者. 又能催生下乳, 积聚水
蓄,里急后重, 暴注下迫者宜之.
桂府滑石 ( 水飞 ) 六两 甘草一两 辰砂三钱, 右为细末, 新汲水
一碗, 调服三钱.
【集注】柯琴曰: 元气虚而不支者死, 邪气盛而无制者亦死. 今热伤
元气, 无气以动, 斯时用参, 耆以补气, 则邪愈甚; 用芩, 连以清热
,则气更伤. 惟善攻热者, 不使败人元气; 善补虚者, 不使助人邪气
,必得气味纯粹之品以主之. 滑石禀土中冲和之气, 行西方清肃之令
,秉秋金坚重之形, 寒能胜热, 甘不伤脾, 含天乙之精而具流走之性
,异于石膏之凝滞, 能上清水源, 下通水道, 荡涤六腑之邪热从小便
而泄. 炙甘草禀草中冲和之性, 调和内外, 止渴生津, 用以为佐, 保
元气而泻虚火, 则五脏自和矣. 然心为五脏主, 暑热扰中, 神明不安
,必得朱砂以镇之, 则神气可以遽复; 凉水以滋之, 则邪热可以急除
,此清心之阳热可通行也. 至于热痢初起, 里急后重者宜之, 以滑可
去着也. 催生下孔, 积聚蓄水等证, 同乎此义, 故兼治之. 是方也,
益气而不助邪, 逐邪而不伤气, 不负益元之名, 宜与白虎, 生脉三方
鼎足也.
治疗天行时气(流行性传染病),初起出现头痛、高热等疫病症状。
大黄四两,白芍二两,黄芩,甘草(炙),桂心,麻黄各三两,以上药物捣碎成粗末,每次取一两,加水煎煮后服用。出汗或排便后不再服用。
川大黄(生用)一斤,皂角(猪牙形状者,去皮和筋络,微炒)四两,以上药物研成细末,混合均匀,用水泛制成丸剂,每次服用三钱,用无根水(如雨水、露水)送服。体质虚弱者减少剂量服用。
【注】天行时气,即四季中不正之气,人体感受而致病,起初不称为疫病。因为病气互相传染,老人和儿童症状相似,沿着门户遍及整个地区共同患病,所以称为:天行时气。然而这种疫气从鼻腔进入,一旦受到邪气侵袭,脏腑都会生病,如果不急于将病邪排出体外,就会迅速死亡。急于驱逐病邪的方法,不是发汗就是泻下,所以古人治疗疫病的方剂,以下法为主,发汗法次之,这是为病邪寻找出路。这两个方子,一个用于治疗冬季疫病,一个用于治疗春季疫病。冬季疫病多寒,春季疫病多热。多寒的适宜用水解散,方中使用麻黄、桂枝、白芍、甘草来发营卫之汗,使用大黄、黄芩来泻除疫毒之邪。多热的适宜使用救苦丹,方中使用皂角开窍并发表,大黄泻火并攻里,使毒邪也能通过汗法和下法排出。仔细审察后使用这两个方子,治疗疫病的大法可以类推了。
又名益元散,又名六一散。治疗夏季中暑,热邪损伤元气,内外俱热,没有力气活动,烦躁口渴想喝水,肠胃干枯枯竭的情况。又能催产下胎、促进乳汁分泌,对于积聚、水液蓄积、腹痛急迫且肛门重坠感、突然剧烈腹泻且有紧迫感的症状也适宜使用。
桂府滑石(水飞法处理)六两,甘草一两,辰砂三钱,以上药物研成细末,用一碗新汲取的凉水,调服三钱。
【集注】柯琴说:元气虚弱无法支撑的人会死,邪气强盛而没有制约的人也会死。现在热邪损伤元气,导致没有力气活动,此时如果使用人参、黄芪来补气,则邪气会更加严重;如果使用黄芩、黄连来清热,则元气会更受损伤。只有善于攻逐热邪的人,不会败坏人的元气;善于补虚的人,不会助长邪气,必须得到气味纯粹的药物来作为主药。滑石禀受土中冲和之气,行使西方清肃的命令,具备秋季金气坚重的形态,寒性能胜热,甘味不伤脾,含有天乙之精且具有流动走的特性,不同于石膏的凝滞,能上清水源,下通水道,荡涤六腑的邪热从小便排出。炙甘草禀受草中冲和的性质,调和内外,止渴生津,用作佐药,保护元气并泻除虚火,那么五脏自然调和了。然而心是五脏的主宰,暑热扰乱中焦,神明不安定,必须得到朱砂来镇摄它,那么神气就可以迅速恢复;用凉水来滋润它,那么邪热就可以紧急消除,这是清心阳热邪气可以通行的道理。至于热痢初起,出现腹痛急迫且肛门重坠感的情况适宜使用,因为“滑可去着”(滑利药可以去除粘滞)。催产下胎、积聚蓄水等症状,也是同样的道理,所以兼治这些病症。这个方子,益气而不助长邪气,驱逐邪气而不损伤元气,不负“益元”之名,应该与白虎汤、生脉散三方并列鼎足而立。
Treats Tianxing Shiqi (epidemic diseases caused by abnormal seasonal qi), initially presenting with headache, high fever, and other epidemic symptoms.
Dahuang (Rhei Radix et Rhizoma) 4 liang, Baishao (Paeoniae Radix Alba) 2 liang, Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Guixin (Cinnamomi Cortex), Mahuang (Ephedrae Herba) each 3 liang. The above herbs are crushed into coarse powder. Each dose is 1 liang, decocted in water and taken orally. Do not take again after sweating or bowel movement.
Chuan Dahuang (Rhei Radix et Rhizoma, raw) 1 jin, Zaojiao (Gleditsiae Sinensis Fructus, pig-tooth shape, peel removed, fibers removed, slightly stir-fried) 4 liang. The above herbs are ground into fine powder, mixed evenly, and formed into pills using water as a binder. Each dose is 3 qian, taken with Wugen Water (rainwater or dew). Reduce the dose for weak patients.
[Note] Tianxing Shiqi refers to abnormal qi of the four seasons; when contracted, it causes disease. Initially, it is not named an epidemic. Because the pathogenic qi transmits mutually, affecting both old and young with similar symptoms, spreading from house to house and throughout the region, causing widespread illness, it is called: Tianxing Shiqi. However, this epidemic qi enters through the nose. Once infected, all zang-fu organs are affected. If the pathogen is not urgently expelled, death will occur rapidly. The method to urgently expel the pathogen is either diaphoresis (sweating) or purgation (bowel evacuation). Therefore, ancient formulas for treating epidemics prioritize purgation, with diaphoresis as secondary, providing an exit route for the pathogen. These two formulas treat winter epidemics and spring epidemics respectively. Winter epidemics are mostly cold; spring epidemics are mostly heat. For those with more cold, Shuijie San (Water-Resolving Powder) is suitable. It uses Mahuang (Ephedrae Herba), Guixin (Cinnamomi Cortex), Baishao (Paeoniae Radix Alba), and Gancao (Glycyrrhizae Radix et Rhizoma) to induce sweating from Ying and Wei levels, and Dahuang (Rhei Radix et Rhizoma) and Huangqin (Scutellariae Radix) to purge epidemic toxin pathogens. For those with more heat, Jiuku Dan (Two Sages' Rescue Pain Pill) is suitable. It uses Zaojiao (Gleditsiae Sinensis Fructus) to open orifices and release the exterior, and Dahuang (Rhei Radix et Rhizoma) to purge fire and attack the interior, allowing toxins to be expelled via sweating and purgation. Carefully assess and use these two formulas; the general principles for treating epidemics can be inferred therefrom.
Also known as Yiyuan San, also known as Liuyi San. Treats summerheat stroke during summer, where heat injures Yuan Qi (Original Qi), resulting in internal and external heat, lack of energy to move, irritability, thirst with desire to drink, and dryness/depletion of the intestines and stomach. It can also induce labor, promote lactation, and is suitable for conditions such as accumulation, water retention, tenesmus (urgent abdominal pain with heavy sensation in the rectum), and sudden violent diarrhea with urgency.
Guifu Huashi (Talcum, processed by water levigation) 6 liang, Gancao (Glycyrrhizae Radix et Rhizoma) 1 liang, Chensha (Cinnabar) 3 qian. The above herbs are ground into fine powder. Mix 3 qian with one bowl of fresh cool water and take orally.
[Collected Notes] Ke Qin stated: Those whose Yuan Qi (Original Qi) is deficient and cannot support themselves die; those whose pathogenic qi is excessive and uncontrolled also die. Now, heat injures Yuan Qi (Original Qi), leading to lack of energy to move. At this time, if Renshen (Ginseng Radix) and Huangqi (Astragali Radix) are used to tonify qi, the pathogen becomes worse; if Huangqin (Scutellariae Radix) and Lianhua (Lotus Seed Plumule) are used to clear heat, the qi is further injured. Only those skilled in attacking heat do so without damaging the patient's Yuan Qi (Original Qi); only those skilled in tonifying deficiency do so without aiding the pathogen. One must obtain pure-flavored substances to serve as the principal herb. Huashi (Talcum) inherits the harmonious qi of earth, executes the clearing and descending command of the west, possesses the firm and heavy form of autumn metal, its cold nature overcomes heat, its sweet flavor does not harm the spleen, contains the essence of Tianyi (Heavenly Yin), and has a flowing nature, unlike the stagnating nature of Shigao (Gypsum Fibrosum). It can clear the source of water upwards and unblock the water passages downwards, sweeping away pathogenic heat from the six fu organs, which is excreted via urination. Honey-fried Gancao (Glycyrrhizae Radix et Rhizoma) inherits the harmonious nature of grass, harmonizes the interior and exterior, stops thirst, generates fluids, and serves as an assistant herb to protect Yuan Qi (Original Qi) and purge deficient fire, thereby harmonizing the five zang organs. However, the Heart is the master of the five zang organs. Summerheat disturbs the middle jiao, causing the Shen (Spirit) to be unsettled. Zhusha (Cinnabar) is required to calm it, so that Shen Qi (Spiritual Qi) can recover rapidly; cool water is used to nourish it, so that pathogenic heat can be urgently eliminated. This is how clearing Heart Yang heat can be conducted. As for early-stage heat dysentery with tenesmus, it is suitable because "slippery substances remove adherence." Inducing labor, accumulation, and water retention follow the same principle, hence they are treated concurrently. This formula tonifies qi without aiding the pathogen and expels the pathogen without injuring qi, living up to the name "Yiyuan" (Benefiting Original Qi). It deserves to stand tripartite with Baihu Tang (White Tiger Decoction) and Shengmai San (Generate the Pulse Powder).