赤石脂 禹余粮(各一斤)
伤寒下之利不止,病在下焦者,此方主之。
下之利不止者,下之虚其里,邪热乘其虚,故利;虚而不能禁固,故不止;更无中焦之
证,故曰病在下焦。涩可以固脱,故用赤石脂;重可以镇固,故用禹余粮。然惟病在下焦者
可以用之。若病在中焦而误与焉!虚者则二物之寒,益坏中气;实者固而涩之,则邪无自而
泄,必增腹胀且痛矣。慎之!
旋复花 甘草(各三两) 代赭石(一两) 人参(二两) 半夏(半升) 生姜(五
两) 大枣
(十二枚)
伤寒发汗,若吐,若下,解后,心下痞硬,噫气不除者,此方主之。
汗、吐、下而解,则中气必虚,虚则浊气不降而上逆,故作痞硬;逆气上干于心,心不
受邪,故噫气不除,《内经·宣明五气篇》曰∶五气所病,心为噫是也。旋复之咸,能软痞
硬而下气;代赭之重,能镇心君而止噫;姜、夏之辛,所以散逆;参、草、大枣之甘,所以
补虚。或曰∶汗、吐中虚,肺金失令,肝气乘脾而作上逆,逆气于心,心病为噫。此方用代
赭石,固所以镇心,而亦所以平肝也。亦是究理之论。
葛根(半斤) 黄芩(炒) 甘草(各二两) 黄连(三两)
太阳表证,医反下之,利遂不止,表证尚在,喘而汗出者,此方主之。
病在表而下之,则虚其里,阳邪乘虚而入,故协热而利不止;表有头疼,发热恶寒,故
曰表证尚在;里有热邪,故喘而汗出。表证尚在,故用葛根、甘草之辛甘以解表;里有邪热,
故
伤寒病经过攻下治疗后,腹泻仍然不止,病位在下焦的,此方主治。
攻下后导致腹泻不止,是因为攻下损伤了里气,邪热乘虚而入,所以发生腹泻;正气虚弱而不能固摄,所以腹泻不止;如果没有中焦的症状,所以说病位在下焦。涩味药物可以固脱止泻,所以使用赤石脂;重镇药物可以镇固收敛,所以使用禹余粮。然而只有病位在下焦的患者才可以使用此方。如果病位在中焦却误用此方!体质虚弱的患者,二药的寒性会进一步破坏中气;体质实热的患者,若用涩法固涩,则邪气没有出路而排出,必然会增加腹胀且疼痛的症状。务必谨慎!
旋复花、甘草(各三两)、代赭石(一两)、人参(二两)、半夏(半升)、生姜(五两)、大枣(十二枚)
伤寒病经过发汗、催吐或攻下治疗后,表证已解,但出现胃脘部痞塞坚硬,嗳气持续不除的症状,此方主治。
经过汗、吐、下法治疗而病解,说明中气必然虚弱,气虚则浊气不能下降反而上逆,所以造成痞塞坚硬;逆气上冲干扰心脏,心脏不受邪气侵犯,所以嗳气不止,《内经·宣明五气篇》说:“五脏之气所主的病症中,心对应的症状是嗳气”,正是这个意思。旋复花的咸味,能够软化痞硬并降气;代赭石的沉重之性,能够镇安心神并停止嗳气;生姜、半夏的辛味,用来散除逆气;人参、甘草、大枣的甘味,用来补益虚弱。有人说:汗、吐法导致中虚,肺金功能失常,肝气乘袭脾土导致上逆,逆气影响心脏,心脏病变表现为嗳气。此方使用代赭石,固然可以镇心安神,同时也能够平抑肝气。这也是探究医理的正确论述。
太阳经表证存在时,医生反而使用攻下法,导致腹泻不止,此时表证依然存在,伴有气喘和出汗的症状,此方主治。
病在表证阶段却使用攻下法,会导致里气虚弱,阳热邪气乘虚而入,所以形成协热下利且腹泻不止;体表有头痛、发热、恶寒的症状,所以说表证依然存在;体内有热邪,所以出现气喘和出汗。因为表证依然存在,所以使用葛根、甘草的辛甘之性来解表;因为里有邪热,所以……
Chishizhi (Halloysitum Rubrum), Yuyuliang (Haematitum) (each 1 jin)
In Shaoyang disease, if purgation is administered and diarrhea persists, indicating the pathology is in the Lower Jiao (Lower Burner), this formula is indicated.
Purgation damaging the interior leads to deficiency, allowing pathogenic heat to exploit this weakness, resulting in diarrhea; the deficiency fails to secure and contain, causing persistent diarrhea; the absence of Middle Jiao symptoms confirms the pathology resides in the Lower Jiao. Astringent properties can consolidate leakage, hence Chishizhi is used; heavy substances can stabilize and secure, hence Haematitum is used. However, this formula is only suitable for pathologies in the Lower Jiao. If mistakenly used for Middle Jiao pathologies: for deficient patients, the cold nature of these two herbs will further damage Middle Qi; for excess patients, astringing and consolidating will trap pathogens without an exit, inevitably increasing abdominal distension and pain. Exercise caution!
Xuanfuhua (Inulae Flos), Gancao (Glycyrrhizae Radix et Rhizoma) (each 3 liang), Daizheshi (Haematitum) (1 liang), Renshen (Panacis Ginseng Radix), Banxia (Pinelliae Rhizoma Preparatum) (0.5 sheng), Shengjiang (Zingiberis Rhizoma Recens) (5 liang), Dazao (Jujubae Fructus) (12 pieces)
After Shaoyang disease has been treated with sweating, vomiting, or purging, and the exterior syndrome has resolved, if epigastric fullness and hardness persist along with incessant belching, this formula is indicated.
Resolution via sweating, vomiting, or purging implies that Middle Qi must be deficient. Deficiency causes turbid Qi to fail to descend and instead rebel upward, creating fullness and hardness; rebellious Qi harasses the Heart, which does not accept pathogens directly, thus belching persists. As stated in *Su Jing · Xuan Ming Wu Qi Pian* of the *Nei Jing*: "Among diseases caused by the five Qi, the Heart manifests as belching." The salty flavor of Inulae Flos softens fullness and directs Qi downward; the heaviness of Haematitum calms the Heart Spirit and stops belching; the pungency of Zingiberis Rhizoma Recens and Pinelliae Rhizoma Preparatum disperses rebellion; the sweetness of Panacis Ginseng Radix, Glycyrrhizae Radix et Rhizoma, and Jujubae Fructus tonifies deficiency. Some argue: Sweating and vomiting cause Middle deficiency, leading to Lung Metal losing its command, allowing Liver Qi to invade Spleen Earth, causing upward rebellion affecting the Heart, manifesting as belching. Using Haematitum in this formula not only calms the Heart but also pacifies the Liver. This is also a valid theoretical explanation.
Gegen (Puerariae Lobatae Radix) (0.5 jin), Huangqin (Scutellariae Radix) (stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma) (each 2 liang), Huanglian (Coptidis Rhizoma) (3 liang)
When Taiyang exterior syndrome exists, if the physician erroneously applies purgation, resulting in persistent diarrhea while the exterior syndrome remains, accompanied by wheezing and sweating, this formula is indicated.
Treating an exterior syndrome with purgation damages the interior, allowing Yang pathogens to enter due to deficiency, resulting in diarrhea with accompanying heat; exterior symptoms such as headache, fever, and aversion to cold indicate the exterior syndrome persists; internal heat pathogens cause wheezing and sweating. Since the exterior syndrome persists, Gegen and Gancao's pungent-sweet properties are used to release the exterior; since there is internal pathogenic heat, therefore...