(见黄疸中)
雄黄 葶苈
右二味,末之,取腊月猪脂镕,以槐枝绵裹头,四五枚,点药烙之。
(冬三月加)柴胡八分 白术八分 陈皮五分 大腹槟榔(并皮、子者)四枚 生姜
五分桔梗七分;(春三月)加枳实 减白术(共六味);(夏三月加)生姜三分 枳
实五分甘草三分(共八味);(秋三月加)陈皮三分(共六味)
以上各□咀,分为三贴,一贴以水三升,煮取二升,分温三服,如人行四、五里,进
一服;如四体壅,添甘草少许,每贴分作三小贴,每小贴以水一升,煮取七合,温服
,再合滓为一服,重煮,都成四服。(疑非仲景方)
【按】
此方证不属,不释。
诃梨勒 陈皮 厚朴各三两
右三味,末之,炼蜜丸,如桐子大,酒饮服二十丸,加至三十丸。
【按】
此方当在前篇「谷气之实也」之下。
大黄一两 干姜一两 巴豆(去皮、心,熬,外研如脂)一两
右药各须精新,先捣大黄、干姜为末,研巴豆内中,合治一千杵,用为散,蜜和丸,
亦加蜜器中贮之,莫令泄气。主心腹诸卒暴百病,若中恶客忤,心腹胀满,卒痛如锥
刺,气急口噤,停尸卒死者,以暖水苦酒服大豆许三、四丸,或不下,捧头起,灌令
下咽,须臾当差;如未差,更与三丸,当腹中鸣,即吐下,便差;若口噤,亦须折齿
灌之。
【方解】
方名备急者,以备暴然诸腹满、腹急痛及中恶客忤、噤闭卒死者也。若口噤亦须折齿
灌之,是恐人不急救则死之义,然不如后人管吹入鼻中之法为良。
【集解】
李□曰:人卒得病欲死者,皆感毒历邪阴不正之气而然,三物相须,能荡邪安正,或
吐或下,使秽气上下分消,诚足备一时急需也。
(此方见黄疸篇中)
雄黄、葶苈子。
以上两味药,研成细末,取腊月里融化的猪脂油,用槐树枝条裹住棉头,取四到五根,蘸取药粉在患处进行烙烫治疗。
(冬季三个月加入)柴胡八分、白术八分、陈皮五分、大腹槟榔(连皮和子一起算)四枚、生姜五分、桔梗七分;(春季三个月加入枳实,减去白术,共六味药);(夏季三个月加入)生姜三分、枳实五分、甘草三分(共八味药);(秋季三个月加入)陈皮三分(共六味药)。
以上各药切碎,分为三贴(剂),一贴用水三升,煮取二升药液,分三次温服。如果人行走四五里的时间,服用一次;如果出现四肢肿胀壅滞,添加少许甘草,每贴再分为三小贴,每小贴用水一升,煮取七合药液,温服,将药渣合并再次煎煮,总共成为四次服用。(怀疑不是张仲景的原方)
【按语】
此方的证候不符,不予解释。
诃梨勒、陈皮、厚朴各三两。
以上三味药,研成细末,炼蜜为丸,如梧桐子大小,酒送服二十丸,可加至三十丸。
【按语】
此方应当放在前一篇“谷气之实也”的条文之下。
大黄一两、干姜一两、巴豆(去皮、心,炒熟,另外研磨如脂状)一两。
以上药物都必须选用精制新鲜的,先捣碎大黄、干姜为粉末,将巴豆研入其中,混合捣治一千杵,制成散剂,用蜂蜜调和做成丸剂,也可以放入有蜜的容器中储存,不要让药气泄漏。主治心腹部各种突然爆发的疾病,如果是中恶邪或客忤之气,导致心腹胀满,突然疼痛如锥刺,气急口噤(牙关紧闭),甚至假死状态,用温水或苦酒送服大豆大小的三到四丸;如果药吞不下去,托起患者头部,灌药使其咽下,片刻之后应当痊愈;如果未愈,再给三丸,此时腹部会鸣响,随即呕吐或腹泻,病即痊愈;如果是牙关紧闭,也必须撬开牙齿灌药。
【方解】
方名“备急”,是为了防备突然发生的各种腹满、腹急痛以及中恶客忤、牙关紧闭假死等危急情况。如果是牙关紧闭也必须撬开牙齿灌药,这是担心人不及时急救就会死亡的用意,然而不如后人采用吹药入鼻的方法为好。
【集解】
李□说:人突然患病快要死亡的情况,都是感受了毒厉邪阴不正之气所致,这三味药相互配合,能够荡涤邪气、安定正气,或通过呕吐或通过泻下,使秽浊之气上下分消,确实足以备一时之急需。
(See in the Jaundice section)
Xionghuang (Realgar), Tinglizi (Descurainiae Semen Lepidii Seminis).
The above two ingredients are powdered. Take lard melted from the twelfth lunar month, wrap four to five willow branches with cotton on their ends, dip them in the medicine powder, and apply by cauterization.
(In the winter months, add:) Chaihu (Bupleuri Radix), 8 fen; Baizhu (Atractylodis Macrocephalae Rhizoma), 8 fen; Chenpi (Citri Reticulatae Pericarpium), 5 fen; Dafubinglang (Arecae Seed, including peel and kernel), 4 pieces; Shengjiang (Zingiberis Rhizoma Recens), 5 fen; Jiegeng (Platycodonis Radix), 7 fen; (In the spring months, add Zhishi (Aurantii Fructus Immaturus), reduce Baizhu (total six ingredients); (In the summer months, add:) Shengjiang (Zingiberis Rhizoma Recens), 3 fen; Zhishi (Aurantii Fructus Immaturus), 5 fen; Gancao (Glycyrrhizae Radix et Rhizoma), 3 fen (total eight ingredients); (In the autumn months, add:) Chenpi (Citri Reticulatae Pericarpium), 3 fen (total six ingredients).
Crush the above ingredients into coarse powder, divide into three doses (tie). For one dose, use three sheng of water, decoct to obtain two sheng of liquid, divide into three warm doses. If a person walks for the time it takes to cover four or five li, administer one dose; if there is edema and stagnation in the four limbs, add a small amount of Gancao (Glycyrrhizae Radix et Rhizoma), divide each dose into three smaller portions. For each small portion, use one sheng of water, decoct to obtain seven ge of liquid, take warm. Combine the dregs and decoct again, resulting in a total of four doses. (Suspected not to be an original formula of Zhang Zhongjing)
[Note]
This formula does not match the syndrome; no explanation is provided.
Helile (Terminalia Chebulae Fructus), Chenpi (Citri Reticulatae Pericarpium), Houpo (Magnoliae Officinalis Cortex) each 3 liang.
The above three ingredients are powdered, mixed with refined honey to form pills the size of paulownia seeds. Take 20 pills with wine, increasing up to 30 pills.
[Note]
This formula should appear under the clause "Excess of grain qi" in the previous chapter.
Dahuang (Rhei Radix et Rhizoma), 1 liang; Ganjiang (Zingiberis Rhizoma), 1 liang; Badou (Crotonis Fructus, peeled, core removed, roasted, and separately ground into a paste), 1 liang.
The above medicines must be selected for being refined and fresh. First, pound Dahuang (Rhei Radix et Rhizoma) and Ganjiang (Zingiberis Rhizoma) into powder, then grind Badou (Crotonis Fructus) into it, mix and pound for one thousand strokes. Use as a powder, or mix with honey to form pills. Store in a vessel containing honey to prevent loss of medicinal energy. It treats various sudden acute diseases of the heart and abdomen, such as Zhong'e (sudden attack by evil qi) or Kewu (hostile spirit invasion), causing abdominal distension and fullness, sudden pain like needle pricking, shortness of breath, Jinbi (lockjaw), or sudden death resembling corpse retention. Administer three or four pills the size of soybeans with warm water or bitter wine. If unable to swallow, support the head upright and force the medicine down the throat; recovery should occur shortly. If not recovered, administer three more pills; bowel sounds will arise, followed by vomiting or purging, leading to recovery. If lockjaw occurs, teeth must also be pried open for administration.
[Fangjie (Formula Analysis)]
The name "Beiji" (Ready for Emergency) refers to its preparation for sudden abdominal fullness, acute abdominal pain, Zhong'e (sudden attack by evil qi), Kewu (hostile spirit invasion), lockjaw, and sudden death-like states. The instruction to pry open teeth for administration implies that failure to rescue urgently leads to death. However, the later method of blowing medicine into the nose is considered superior.
[Jijie (Collected Commentary)]
Li [Qian] stated: Sudden severe illness approaching death is caused by exposure to toxic, harsh, yin, and irregular evil qi. These three ingredients work together to purge evil and stabilize righteous qi, eliminating turbid qi through vomiting or purging, making it truly sufficient for emergency needs.