(仲景)
治伤寒十三日不解,胸胁满而呕,日晡潮热,已而微利。此本柴胡证,知医以丸药下之
,非其治也。潮热者,实也,先以小柴胡汤以解外,后以加芒硝汤主之(伤寒十三日,为再
传
小柴胡汤(见和解门)加芒硝六两
此少阳、阳明药也。表证误下,邪热乘虚入胃,以致下利而满呕,潮热之证犹在伤寒潮
热,为胃实,故宜下,故仍与柴胡汤以解少阳,加芒硝以荡胃热,亦与大柴胡两解同意。
(仲景)
治太阳误下,转属太阴,腹满大实痛者(腹胀虽属太阴,若里证尚浅,腹满时痛,犹宜
和
桂枝汤见发表门,加大黄一两,芍药三两。
此足太阳、太阴药也。误下而作结胸,则邪在上,仍属太阳,今腹满而大实痛,则邪已
入太
又曰
景之
加大
第传
药汤
不贻结
(《肘后》)
治天行一二日,头痛壮热。
麻黄(四两) 桂心 甘草(炙) 白芍(二两) 大黄 黄芩(三两)
此足太阳、阳明药也。麻黄能开腠发汗,桂心能引血化汗,黄芩以清上中之热,大黄以
泻中下之热,甘草、白芍能调胃而和中。盖天行温疫,郁热自内达外,与伤寒由表传里者不
同,
(河间)
治一切风寒暑湿,饥饱劳役,内外诸邪所伤,气血怫郁,表里三焦俱实,憎寒壮热,头
目昏
便赤涩,疮疡(音羊)肿毒,折跌损伤,瘀血便血,肠风痔漏,手足螈 ,惊狂谵妄,丹斑
瘾疹(憎寒壮热,邪在表也;头眩目赤,风热上攻也;耳鸣口苦,邪在少阳也;便秘痔漏,
热结大腑也;小便赤涩,热蓄膀胱也;疮疡痈肿,气血怫郁也;丹斑瘾疹,风热在胃也;手
足螈 、惊
防风 荆芥 连翘 麻黄 薄荷 川芎 当归 白芍(炒) 白术 山栀(炒黑) 大
黄(
加生姜、葱白煎
此足太阳、阳明表里血气药也。防风、荆芥、薄荷、麻黄轻浮升散,解表散寒,使风热
从汗
风
黄芩清中上之火;连翘散气聚血凝,甘草缓峻而和中重(用甘草、滑石,亦犹六一利水泻火
之意),白术健脾而燥湿,上下分消,表里交治,而能散泻之中,犹寓温养之意,所以汗不
伤表,
本方再加人参补气,熟地益血,黄柏、黄连除热,羌活、独活、天麻、细辛、全蝎祛风
;蜜丸,弹子大;每服一丸,茶酒任下;名祛风至宝丹(喻嘉言曰∶此中风门中不易之专方
也)。本方除大黄、芒硝,名双解散(麻黄、防风、荆芥、薄荷、川芎以解表,黄芩、栀子、
连翘、石
(张仲景)
治疗伤寒病程超过十三天仍未痊愈,出现胸胁部胀满且呕吐,每天下午定时发热,随后出现轻微腹泻。这原本属于小柴胡汤证,但医生误用丸药进行攻下治疗,这不是正确的治法。定时发热说明体内有实邪,应当先用小柴胡汤来解除表邪,然后再用加芒硝的方剂主治。(伤寒病程十三天,是病邪再次传变。)
小柴胡汤(见和解门章节),加入芒硝六两。
这是针对少阳经和阳明经的药物组合。表证被错误地攻下后,邪热乘虚进入胃中,导致腹泻、腹部胀满和呕吐,而潮热的症状仍然存在。因为伤寒中的潮热代表胃中有实邪,所以适宜使用泻下法,因此仍然给予柴胡汤以解除少阳经的病邪,加入芒硝以清除胃中的热邪,这也与大柴胡汤表里双解的思路一致。
(张仲景)
治疗太阳病被错误攻下后,病邪转入太阴经,出现腹部胀满、严重疼痛且大便硬结的情况。(虽然腹胀属于太阴病的范畴,但如果里证尚浅,只是腹部胀满且时有疼痛,仍适宜调和。)
桂枝汤(见发表门章节),加大黄一两,芍药三两。
这是针对足太阳经和足太阴经的药物组合。如果因错误攻下导致结胸,则邪气位于上部,仍属于太阳病;如今出现腹部胀满且剧烈疼痛,说明邪气已经深入太阴经。
又说:
张仲景的……
加大……
第次传变……
药物汤剂……
不遗留结胸……
(《肘后备急方》)
治疗时行温病发病一两天,出现头痛和高热。
麻黄(四两)、桂心、甘草(炙)、白芍(二两)、大黄、黄芩(三两)。
这是针对足太阳经和足阳明经的药物组合。麻黄能开启毛孔发汗,桂心能引导血液化为汗液,黄芩用来清泄上部和中部的热邪,大黄用来泻除中下部的热邪,甘草和白芍能调理胃气并调和其中焦。大概是因为时行温疫的热邪郁结,从内部达于外部,这与伤寒由体表传入体内的情况不同。
(刘河间)
治疗一切风寒暑湿,以及饥饱劳役所伤,内外各种邪气致病,导致气血郁滞,表里三焦都呈现实证,表现为怕冷高热,头目昏沉,小便赤涩,疮疡肿毒,跌打损伤,瘀血便血,肠风痔漏,手足抽搐,惊狂谵语,丹斑瘾疹。(怕冷高热,说明邪气在表;头晕目赤,是风热上攻所致;耳鸣口苦,邪气在少阳经;便秘痔漏,是热邪结聚在大肠;小便赤涩,是热邪蓄积在膀胱;疮疡痈肿,是气血郁滞所致;丹斑瘾疹,是风热在胃经;手足抽搐、惊狂……)
防风、荆芥、连翘、麻黄、薄荷、川芎、当归、白芍(炒)、白术、山栀(炒黑)、大黄(……)
加生姜、葱白煎服。
这是针对足太阳、足阳明经,表里气血的药物组合。防风、荆芥、薄荷、麻黄质地轻浮升散,能解表散寒,使风热随汗而解;黄芩清泄中上部的火邪;连翘消散气聚血凝,甘草缓和药性峻烈并调和脾胃(重用甘草、滑石,也含有六一散利水泻火的意图),白术健脾燥湿,上下分消,表里同治,能在发散泻下的同时,蕴含温养之意,所以发汗不伤表……
本方再加人参补气,熟地黄益血,黄柏、黄连清热,羌活、独活、天麻、细辛、全蝎祛风;制成蜜丸,如弹子大小;每次服用一丸,茶或酒送下;名为祛风至宝丹(喻嘉言说:这是中风门中不易得的专方)。(本方去掉大黄、芒硝,名为双解散(麻黄、防风、荆芥、薄荷、川芎以解表,黄芩、栀子、连翘、石……)
(Zhang Zhongjing)
Treats Taiyang disease (Disease of the Bladder and Small Intestine channels) that has not resolved after thirteen days, presenting with fullness and distension in the chest and hypochondrium accompanied by vomiting, tidal fever (fever rising at a specific time each day) in the late afternoon, followed by slight diarrhea. This originally belongs to the Xiao Chai Hu Tang (Minor Bupleurum Decoction) pattern, but the physician mistakenly used pill medicines for purgation, which is incorrect treatment. Tidal fever indicates excess; first use Xiao Chai Hu Tang to resolve the exterior, then treat with the formula adding Mang Xiao (Natrii Sulfas). (Thirteen days of Taiyang disease indicates the pathogen has transmitted again.)
Xiao Chai Hu Tang (see Harmonizing Section), add Natrii Sulfas (Mang Xiao) six liang.
This is a prescription for Shaoyang (Gallbladder and Triple Burner) and Yangming (Stomach and Large Intestine) patterns. When the exterior syndrome is mistakenly purged, pathogenic heat enters the stomach due to deficiency, causing diarrhea, abdominal fullness, and vomiting, while the tidal fever persists. Since tidal fever in Taiyang disease indicates gastric excess, purgation is appropriate. Therefore, Chai Hu Tang is still given to resolve the Shaoyang pathogen, and Natrii Sulfas is added to sweep away gastric heat. This aligns with the principle of simultaneous resolution of both interior and exterior as seen in Da Chai Hu Tang (Major Bupleurum Decoction).
(Zhang Zhongjing)
Treats Taiyang disease where mistaken purgation causes the pathogen to transfer to Taiyin (Spleen and Stomach), resulting in abdominal fullness, severe constipation, and pain. (Although abdominal fullness belongs to Taiyin, if the interior syndrome is shallow, with only intermittent fullness and pain, harmonization is still suitable.)
Guizhi Tang (Cinnamon Twig Decoction) (see Exterior-Resolving Section), add Rhubarb (Da Huang) one liang, and White Peony Root (Bai Shao) three liang.
This is a prescription for the Foot-Taiyang and Foot-Taiyin channels. If mistaken purgation leads to Jie Xiong (Chest Binding), the pathogen is in the upper jiao and still belongs to Taiyang; now, with abdominal fullness and severe pain, the pathogen has entered Taiyin.
It is also said:
Zhang Zhongjing's...
Add large...
Transmission order...
Medicinal decoction...
Do not leave behind Jie Xiong...
(The Emergency Handbook / Zhou Hou Bei Ji Fang)
Treats epidemic febrile diseases occurring within one or two days, presenting with headache and high fever.
Ephedrae Herba (Ma Huang) (four liang), Cinnamomi Ramulus (Gui Xin), Glycyrrhizae Radix et Rhizoma (Gan Cao) (roasted), Paeoniae Radix Alba (Bai Shao) (two liang), Rheii Radix et Rhizoma (Da Huang), Scutellariae Radix (Huang Qin) (three liang).
This is a prescription for the Foot-Taiyang and Foot-Yangming channels. Ephedrae Herba can open the pores and induce sweating; Cinnamomi Ramulus guides blood to transform into sweat; Scutellariae Radix clears heat from the upper and middle jiao; Rheii Radix et Rhizoma drains heat from the middle and lower jiao; Glycyrrhizae Radix et Rhizoma and Paeoniae Radix Alba regulate the stomach and harmonize the middle. Generally, epidemic warm pathogens are constrained internally and reach the exterior, which differs from Taiyang disease where pathogens transmit from the exterior to the interior.
(Liu Hejian)
Treats all injuries caused by wind, cold, summerheat, dampness, hunger, satiety, and overwork; internal and external pathogenic factors causing qi and blood stagnation; excess conditions in the interior, exterior, and Sanjiao (Triple Burner); aversion to cold with high fever; dizziness and heavy head; dark and scanty urine; sores, ulcers, swelling, and toxicity; traumatic injuries; blood stasis and hematochezia; intestinal wind and hemorrhoids; convulsions of the limbs; mania and delirium; erysipelas, macules, and hives. (Aversion to cold and high fever indicate pathogen in the exterior; dizziness and red eyes indicate wind-heat attacking upward; tinnitus and bitter taste indicate pathogen in Shaoyang; constipation and hemorrhoids indicate heat binding in the Large Intestine; dark and scanty urine indicates heat accumulation in the Bladder; sores and abscesses indicate qi and blood stagnation; erysipelas and hives indicate wind-heat in the Stomach; limb convulsions, mania...)
Saposhnikoviae Radix (Fang Feng), Schizonepetae Spica (Jing Jie), Forsythiae Fructus (Lian Qiao), Ephedrae Herba (Ma Huang), Menthae Haplocalycis Herba (Bo He), Ligustici Chuanxiong Rhizoma (Chuan Xiong), Angelicae Sinensis Radix (Dang Gui), Paeoniae Radix Alba (Bai Shao) (stir-fried), Atractylodis Macrocephalae Rhizoma (Bai Zhu), Gardeniae Fructus (Shan Zhi) (charred black), Rheii Radix et Rhizoma (Da Huang)...
Decoct with fresh ginger and scallion white.
This is a prescription for the Foot-Taiyang and Foot-Yangming channels, addressing the interior and exterior, qi, and blood. Saposhnikoviae Radix, Schizonepetae Spica, Menthae Haplocalycis Herba, and Ephedrae Herba are light and ascending, dispersing outward and scattering cold, allowing wind-heat to exit via sweat; Scutellariae Radix clears fire in the middle and upper jiao; Forsythiae Fructus dissipates qi accumulation and blood coagulation; Glycyrrhizae Radix et Rhizoma moderates harshness and harmonizes the middle (the heavy use of Glycyrrhizae Radix et Rhizoma and Talcum, similar to Liu Yi San, implies draining water and fire); Atractylodis Macrocephalae Rhizoma strengthens the spleen and dries dampness. It eliminates heat from above and below, treats both interior and exterior, and within its dispersing and purging actions, contains nourishing intent, thus sweating does not damage the exterior...
Adding Ginseng Radix et Rhizoma (Ren Shen) to tonify qi, Rehmanniae Radix Preparata (Shu Di Huang) to nourish blood, Phellodendri Cortex (Huang Bo) and Coptidis Rhizoma (Huang Lian) to clear heat, Notopterygii Rhizoma et Radix (Qiang Huo), Angelicae Dahuricae Radix (Du Huo), Gastrodiae Rhizoma (Tian Ma), Asari Radix et Rhizoma (Xi Xin), and Scorpio (Quan Xie) to dispel wind; made into honey pills, size of a bullet; take one pill per dose, with tea or wine; named Qu Feng Zhi Bao Dan (Yu Jiayan said: This is an indispensable specialized formula in the Wind-Stroke section). Removing Rheii Radix et Rhizoma and Natrii Sulfas from this formula yields Shuang Jie San (Double Resolution Powder) (Ephedrae Herba, Saposhnikoviae Radix, Schizonepetae Spica, Menthae Haplocalycis Herba, Ligustici Chuanxiong Rhizoma to resolve the exterior; Scutellariae Radix, Gardeniae Fructus, Forsythiae Fructus, Alumen [implied context]...)