(钱仲阳)
治阳明伤寒中风,头疼身痛,发热恶寒,无汗口渴,目痛鼻干,不得卧;及阳明发斑,
欲出不出,寒暄不时,人多疾疫(三阳皆有头痛,故头痛属表;六经皆有身痛,在阳经则烦
痛拘急;风寒在表,故发热恶寒;寒外束,故无汗;热入里,故口渴;阳明脉络鼻、侠目,
故目痛
重若
升麻(三钱) 葛根 芍药(二钱) 甘草(一钱。炙。)加姜煎。如头痛,加川芎、
白芷(川芎为通阴阳血气之使,白芷专治阳明头痛);身痛背强,加羌活、防风(此兼太阳,
故加二药);热不退,春加柴胡、黄芩、防风(少阳司令,柴芩少阳经药),夏加黄芩、石膏
(清降火热),头面肿,加防风、荆芥、连翘、白芷、川芎、牛蒡、石膏(升散解毒);咽痛,
加桔梗(清肺利膈咽);斑出不透加紫草茸(音戎。紫草凉血润肠,用茸者,取其初得阳气,
触类升发);脉弱,加人参;胃虚食少,
此足阳明药也。阳明多气多血,寒邪伤人,则血气为之壅滞,辛能达表,轻可去实,故
以升
气也(云岐子曰∶葛根为君,升麻为佐,甘草、芍药以安其中)。升麻、甘草升阳解毒,故
又治时疫(时疫感之,必先入胃,故用阳明胃药)。斑疹已出者勿服,恐重虚其表也(麻痘
已见红点,则不可服。阳明为表之里,升麻阳明正药,凡斑疹欲出未出之际,宜服此汤以透
其毒,不可妄服寒剂以攻其热,又不可发汗、攻下,虚其表里之气。如内热甚,加黄连、犀
角、青黛、大青、知母、石膏、黄芩、黄柏、玄参之类。若斑热稍退,潮热谵语,不大便,
可用大柴胡加芒
(钱仲阳)
治疗阳明经伤寒或中风,症见头痛、身体疼痛、发热恶寒、无汗、口渴、眼睛疼痛、鼻干、无法安卧;以及阳明经发斑,斑疹欲出而未出,寒热交替不定,人群中流行疫病。(三阳经都有头痛的症状,所以头痛属于表证;六经都有身体疼痛的症状,在阳经则表现为烦躁疼痛、拘挛急迫;风寒邪气在体表,所以出现发热恶寒;寒邪束缚于外,所以无汗;热邪入里,所以口渴;阳明经脉联络鼻子、夹持目眶,所以出现眼睛疼痛沉重。)
升麻(三钱) 葛根 芍药(二钱) 甘草(一钱。蜜炙。)加生姜煎服。如果头痛,加川芎、白芷(川芎是通行阴阳血气的引经药,白芷专门治疗阳明头痛);如果身体疼痛、背部僵硬,加羌活、防风(这是兼有太阳经病,所以加这两种药);如果热不退,春季加柴胡、黄芩、防风(少阳当令,柴胡和黄芩是少阳经的药物),夏季加黄芩、石膏(清降火热);头面部肿胀,加防风、荆芥、连翘、白芷、川芎、牛蒡子、石膏(升散解毒);咽喉疼痛,加桔梗(清肺利膈通咽);斑疹出不透,加紫草茸(音戎。紫草凉血润肠,用茸是因为取其初得阳气,能触类旁通以升发);脉象虚弱,加人参;胃虚食少,
这是足阳明胃经的药方。阳明经多气多血,寒邪伤人,会导致血气壅滞,辛味药能通达体表,轻扬之品可去除实邪,所以用升麻……来升发阳气(云岐子说:葛根为君药,升麻为佐药,甘草、芍药来安定中焦)。升麻、甘草能升阳解毒,所以又用于治疗时行疫病(时疫邪气侵入人体,必先入胃,所以使用阳明胃经的药物)。斑疹已经发出的不要服用,恐怕会进一步虚损其表气(麻疹痘疮已经见到红点,则不可服用。阳明经位于表的内部,升麻是阳明经的正药,凡是斑疹欲出未出的时候,适宜服用此汤以透发毒邪,不可妄用寒凉药物攻伐其热,也不可发汗、攻下,以免虚损表里之气。如果内热严重,加黄连、犀角、青黛、大青叶、知母、石膏、黄芩、黄柏、玄参之类。如果斑热稍退,出现潮热谵语、大便不通,可用大柴胡汤加芒硝……
(Qian Zhongyang)
Treats Yangming Taiyang (Yang Brightness) Shanghan (Cold Damage) or Fengzhong (Wind Strike), presenting with headache, body pain, fever and aversion to cold, anhidrosis (absence of sweating), thirst, eye pain, nasal dryness, and inability to sleep; as well as Yangming macules (skin eruptions), where the rash desires to emerge but fails to do so, alternating chills and fever, and prevalent epidemic diseases among the population. (Headache occurs in all three Yang meridians, thus headache belongs to the exterior syndrome; body pain occurs in all six meridians, and in the Yang meridians it manifests as irritability, pain, and spasmodic tightness; Wind-Cold at the exterior causes fever and aversion to cold; Cold binding the exterior causes anhidrosis; Heat entering the interior causes thirst; the Yangming meridian connects to the nose and flanks the eyes, hence eye pain and heaviness.)
Shengma (Rhizoma Cimicifugae, 3 qian) Gegen (Puerariae Lobatae Radix), Shaoyao (Paeoniae Radix Alba, 2 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian, honey-fried). Decoct with fresh ginger. If headache is present, add Chuanxiong (Ligustici Chuanxiong Rhizoma) and Baizhi (Angelicae Dahuricae Radix) (Chuanxiong serves as a guide for circulating Yin-Yang and Qi-Blood; Baizhi specifically treats Yangming headaches); if body pain and back stiffness are present, add Qianghuo (Notopterygii Rhizoma et Radix) and Fangfeng (Saposhnikoviae Radix) (this involves the Taiyang meridian, hence these two herbs are added); if heat does not subside, in Spring add Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), and Fangfeng (Shaoyang is in command during Spring; Chaihu and Huangqin are herbs for the Shaoyang meridian); in Summer add Huangqin and Shigao (Gypsum Fibrosum) (to clear and descend fire-heat); if there is swelling of the head and face, add Fangfeng, Jingjie (Schizonepetae Herba), Lianqiao (Forsythiae Fructus), Baizhi, Chuanxiong, Niubangzi (Arctii Fructus), and Shigao (to ascend, disperse, and resolve toxicity); if there is sore throat, add Jiegeng (Platycodonis Radix) (to clear the Lung, benefit the diaphragm, and soothe the throat); if the macules fail to emerge thoroughly, add Zicao Rong (Radix Arnebiae seu Lithospermi, the root tuft) (Zicao cools Blood and moistens the intestines; using the root tuft is intended to utilize its initial acquisition of Yang Qi to facilitate ascending and emerging through association); if the pulse is weak, add Renshen (Ginseng Radix et Rhizoma); if there is Stomach deficiency and poor appetite,
This is a formula for the Foot-Yangming Stomach meridian. The Yangming meridian is abundant in Qi and Blood. When Cold Evil injures the body, it causes stagnation of Qi and Blood. Pungent substances can reach the exterior, and light substances can remove excess; therefore, Shengma... is used to ascend Yang Qi (Yunqi Zi stated: Gegen is the Sovereign herb, Shengma is the Assistant herb, Gancao and Shaoyao stabilize the Middle Jiao). Shengma and Gancao ascend Yang and resolve toxicity, thus they are also used to treat seasonal epidemics (Seasonal epidemic pathogens first enter the Stomach, hence Yangming Stomach herbs are used). Do not administer if macules and rashes have already emerged, lest it further deplete the exterior Qi (If measles or smallpox spots have already appeared red, this must not be taken. Yangming is the interior of the exterior; Shengma is the primary herb for Yangming. Whenever macules and rashes desire to emerge but have not yet done so, it is appropriate to take this decoction to penetrate and release the toxin. One should not recklessly use cold-natured agents to attack the heat, nor induce sweating or purge downward, which would deplete the Qi of both the interior and exterior. If internal heat is severe, add Huanglian (Coptidis Rhizoma), Xijiao (Rhinocerotis Cornu - note: protected species, often substituted), Qingdai (Indigo Naturalis), Daqingye (Isatidis Folium), Zhimu (Anemarrhenae Rhizoma), Shigao, Huangqin, Huangbai (Phellodendri Cortex), and Xuanshen (Scrophulariae Radix). If the macule-heat slightly subsides, but tidal fever, delirious speech, and constipation occur, Dahuang Tang (Major Bupleurum Decoction) plus Mangxiao (Natrii Sulfas) may be used...