中恶腹胀,紧细者生。脉若浮大,邪气已深。
不善之谓恶。暗袭潜侵,忽然倒仆,昏不知人,或手足厥寒,或肌肤粟起,或
语言错妄,或唇齿噤关,或肢体不仁,或面目青黑,即客忤卒厥,鬼击飞尸之类。
涉水登山,穿冢入庙,夜行露卧,吊死问丧者,多得之。然非正气之大虚,邪亦不
能一时中伤如此也。初宜灌以苏合丸。候窍开气转,再以调气平胃散与服。若服后
吐下者,如六君子汤、香砂四君子汤,皆中的之药,视与证相宜者,投之自无不效
也。人之正气,自内达表,自胸腹而达四肢者,其常也。卒中外邪,则正气不能达
外,而反退缩于中。退缩于中,则气机敛实,而紧细之脉象见矣。腹安得不胀?药
力一助,正气必张,邪气必散,紧者仍舒,细者仍充,而本来之面目可还也。故知
其生。若脉浮大,则正先散越。散越于外,则里更虚。里更虚,则邪必深入,而欲为之治,不亦难乎?
苏合香丸(见第十八)
调气平胃散
木香 乌药 白豆蔻 檀香 砂仁(各一钱) 藿香(一钱二分) 苍术(一钱半) 浓朴(姜汁炒) 陈
皮(各一钱) 甘草(五分)
水二钟,姜三片,煎八分,食前服。
六君子汤(见第十六)
香砂四君子汤(即四君子加砂仁、木香,见第十六)
千金返魂汤(见第三十五)
玉枢丹(即紫金锭。见第六十三)
华佗救中恶方 治一应忤恶鬼气。
犀角末(五钱) 辰砂(水飞过) 麝香(研,各二钱五分)
每服二钱,井水调下。如一时不能得此药,用雄黄末一钱,煎桃枝叶汤调灌之。
又无雄黄,可用着身上多时遭汗衣,或贴肉衬衣。男用女,女用男。烧存性,服二钱,百沸汤调下。
又方 韭菜捣汁滴鼻中。冬月用韭根。
又方 百会穴,人中穴,足大拇指离甲一韭叶许,名鬼眼穴,及丹田、气海诸穴,
灸七壮,愈多愈妙。一二处醒,即止,不必俱灸也。以炭火烹米醋熏鼻亦妙。诸
急证,宜先以牙皂末搐鼻取嚏。牙关紧者,以乌梅肉擦之自开。皆通关之法,后可进药。
砒毒 早禾杆烧灰,新汲水淋汁,绢滤过。冷服一碗,得下利即安。新汲水调白扁
豆末亦好。华佗用黑铅磨浓水灌之。
附子、天雄、川乌、斑蝥毒 煮大小黑豆汁饮。
河豚毒 仓卒无药,用清油多灌之,得吐愈。
巴豆毒 煮黄连汁饮。
诸药毒 甘草、黑豆、淡竹叶等分,水一碗煎服。
刺毛虫毒 疼痛不已,蚯蚓泥干搽。又治胡蜂叮。
郁肉漏脯毒(郁肉,密器盖隔宿者。漏脯,茅屋漏下沾着者) 烧犬屎,酒服方寸匕。生韭汁亦好。
马肉毒 香豉二两,杏仁三两,蒸一饭时,杵之。酒煎服。芦根煮汁饮,亦良。
牛肉毒 甘草煮汁饮之,即解。
犬肉毒 心下坚,腹胀口干,发热妄语,或洞下。杏仁一升,不去皮,熟研,以沸汤三升和取汁。
分三服。利下肉片良。
中箭死鸟兽肉毒 大豆煮汁及盐汁,服之解。
诸鱼毒 橘皮煎浓汁饮之解。芦根煮汁亦食。
蟹毒 紫苏煮汁饮之。苏子亦好。
诸果毒 猪骨烧过为末,水服方寸匕,解。
诸菌毒 闷乱欲死,人粪汁饮一升。饮土浆一、二升亦良。大豆浓煮汁饮之,或服
吐利药,俱可解。亦治枫树菌毒,令人哭不止。(哭,一作笑。)
野芋毒 即前方。
闭口椒毒 戟入咽喉,气欲绝,或吐白沫,身冷,用肉桂煎汁饮之。或多饮冷水,
或食蒜,或饮地浆,俱良。
水莨菪叶毒 人每误认作菜食,令人狂乱吐血。甘草煮汁饮之,即解。
芹菜毒 手背腹满痛,名蛟龙病。以芹上带蛟蜃精耳,用硬糖二、三升煮服之,当吐如蜥蜴者。
贪食成病方 食多不消,心腹坚满痛。用盐一升,水三升,煮盐消化。分三服,当吐出食。
诸食物毒 煮甘草荠 汁饮之,通能解。
中恶病出现腹胀,若脉象紧细,预后良好;若脉象浮大,则说明邪气已经深入。
“恶”是指不善之气。这种邪气暗中侵袭,使人突然昏倒仆地,神志昏迷不知人事。症状可能表现为手足厥冷,或肌肤起粟粒状鸡皮疙瘩,或言语错乱妄言,或牙关紧闭无法张开,或肢体麻木不仁,或面目呈现青黑色。这属于客忤、卒厥、鬼击、飞尸等病症范畴。涉水登山、进入坟墓庙宇、夜间露宿野外、参加吊丧问疾等活动的人,容易患上此病。然而,如果不是人体正气极度虚弱,邪气也不能在短时间内如此猛烈地伤人。
初期适宜灌服苏合丸。待患者窍道开通、气息回转后,再服用调气平胃散进行调理。如果服药后出现呕吐或腹泻的情况,可以使用六君子汤或香砂四君子汤,这些都是对症的良药,根据病情选择适宜者投用,没有不见效的。人的正气,通常由内达表,由胸腹通达四肢,这是正常的生理状态。一旦猝然遭受外邪侵袭,正气就不能通达体表,反而退缩于体内。正气退缩于内,导致气机收敛充实,因此出现紧细的脉象。腹部怎能不胀满呢?药物力量一旦辅助正气,正气必然振奋,邪气必然消散,紧脉会变得舒缓,细脉会变得充盛,原本的面色神态即可恢复。所以知道预后良好(生)。如果脉象浮大,说明正气先已耗散。正气耗散于外,则里气更加虚弱。里气更虚,邪气必然深入,此时想要进行治疗,岂不是很难吗?
苏合香丸(见第十八章)
调气平胃散
木香、乌药、白豆蔻、檀香、砂仁(各一钱),藿香(一钱二分),苍术(一钱半),浓朴(姜汁炒),陈皮(各一钱),甘草(五分)。
用水二钟,生姜三片,煎至八分,饭前服用。
六君子汤(见第十六章)
香砂四君子汤(即四君子汤加砂仁、木香,见第十六章)
千金返魂汤(见第三十五章)
玉枢丹(即紫金锭,见第六十三章)
华佗救中恶方:治疗一切忤逆恶鬼之气。
犀角末(五钱),辰砂(水飞处理),麝香(研细,各二钱五分)。
每次服用二钱,井水调服。如果一时得不到这些药,可用雄黄末一钱,煎桃枝叶汤调服灌下。
如果没有雄黄,可用穿在身上很久出过汗的衣服,或者贴身衬衣。男用女衣,女用男衣。烧成炭存性,服用二钱,百沸开水调服。
又一方:韭菜捣汁滴入鼻中。冬季用韭根。
又一方:灸百会穴、人中穴、足大拇指离指甲约一片韭菜叶宽处(名为鬼眼穴),以及丹田、气海等穴位,每穴灸七壮,灸得越多越好。只要有一两处苏醒,就停止,不必全部灸完。用炭火烹煮米醋熏鼻也很好。各种急症,宜先用牙皂末吹鼻取嚏。牙关紧闭者,用乌梅肉擦拭,自然会张开。这些都是通关的方法,之后方可进药。
砒霜毒:早禾杆烧成灰,用新汲取的冷水淋滤出汁液,绢布过滤后,冷服一碗,若能引起腹泻排泄,病情即安。用新汲水调服白扁豆末也很好。华佗曾用黑铅磨成的浓水灌服解毒。
附子、天雄、川乌、斑蝥毒:煮大小黑豆汁饮用。
河豚毒:仓促间无药时,用大量清油灌服,能引起呕吐即可痊愈。
巴豆毒:煮黄连汁饮用。
诸般药物中毒:甘草、黑豆、淡竹叶等量,用水一碗煎服。
刺毛虫毒:疼痛不止,用蚯蚓泥干敷患处。也可治疗胡蜂叮咬。
郁肉漏脯毒(郁肉,指密闭容器盖住隔夜的肉;漏脯,指茅屋漏水沾湿的肉):烧狗屎,用酒送服方寸匕。生韭菜汁也好。
马肉毒:香豉二两,杏仁三两,蒸一顿饭的时间,捣碎。用酒煎服。芦根煮汁饮用,也很好。
牛肉毒:甘草煮汁饮用,即可解毒。
犬肉毒:心下坚硬,腹胀口干,发热妄语,或腹泻。杏仁一升,不去皮,熟研,用沸水三升和取汁。分三次服用。若能排出肉片样物质,效果良好。
中箭死鸟兽肉毒:大豆煮汁及盐汁,服用可解。
诸鱼毒:橘皮煎浓汁饮用可解。芦根煮汁食用亦可。
蟹毒:紫苏煮汁饮用。苏子也好。
诸果毒:猪骨烧过后研为末,用水送服方寸匕,可解。
诸菌毒:胸闷烦乱欲死,饮人粪汁一升。饮土浆一至二升也很好。大豆浓煮汁饮用,或服用催吐泻下药,均可解毒。也能治枫树菌毒,令人哭泣不止。(哭,一作笑。)
野芋毒:即前方。
闭口椒毒:戟刺咽喉,气将绝,或吐白沫,身冷,用肉桂煎汁饮用。或多饮冷水,或吃蒜,或饮地浆,都很好。
水莨菪叶毒:人们常误认为蔬菜食用,令人狂乱吐血。甘草煮汁饮用,即可解毒。
芹菜毒:手背腹部满痛,名为蛟龙病。因为芹菜上带有蛟蜃的精气所致,用硬糖二、三升煮服,应当吐出如蜥蜴状的物体。
贪食成病方:吃多不消化,心腹坚硬满痛。用盐一升,水三升,煮盐使其融化。分三次服用,应当吐出食物。
诸般食物中毒:煮甘草荠菜汁饮用,通能解毒。
Zhong'e (Sudden Onset of Malignant Pathogenic Factors) with abdominal distension: if the pulse is tight and fine, prognosis is good; if the pulse is floating and large, it indicates that the pathogenic factor has penetrated deeply.
"E" refers to malevolent qi. This pathogen secretly invades, causing sudden collapse and unconsciousness. Symptoms may include cold extremities, cutaneous gooseflesh, delirious speech, trismus (lockjaw), numbness of limbs, or cyanosis of the face and eyes. These belong to categories such as Ke Wu (Guest Malevolence), Cu Jue (Sudden Syncope), Gui Ji (Ghost Strike), and Fei Shi (Flying Corpse). Individuals who wade through water, climb mountains, enter tombs or temples, sleep outdoors at night, or attend mourning ceremonies are prone to this condition. However, unless the body's righteous qi (Zheng Qi) is severely deficient, pathogens cannot injure the person so violently in a short time.
Initially, Su He Wan (Styrax Pill) should be administered. Once the orifices open and qi circulation resumes, Tiao Qi Ping Wei San (Regulate Qi and Harmonize Stomach Powder) can be taken for regulation. If vomiting or diarrhea occurs after administration, Liu Jun Zi Tang (Six Gentlemen Decoction) or Xiang Sha Si Jun Zi Tang (Aucklandia and Amomum Six Gentlemen Decoction) may be used, as these are appropriate remedies. Selecting the suitable formula according to the syndrome ensures efficacy. Normally, Zheng Qi extends from the interior to the exterior, from the chest and abdomen to the four limbs. When suddenly attacked by external pathogens, Zheng Qi fails to reach the exterior and retreats inward. This inward retreat causes qi mechanism to contract and become solid, manifesting as a tight and fine pulse. Consequently, abdominal distension occurs. With the assistance of medicinal power, Zheng Qi will flourish, pathogens will dissipate, the tight pulse will relax, the fine pulse will fill out, and the original complexion will return. Thus, recovery is anticipated. If the pulse is floating and large, it indicates that Zheng Qi has already scattered outward. Scattering outward leads to further deficiency in the interior. With deeper interior deficiency, pathogens inevitably penetrate further, making treatment difficult.
Su He Wan (See Chapter 18)
Tiao Qi Ping Wei San
Mu Xiang (Aucklandiae Radix), Wu Yao (Linderae Radix), Bai Dou Kou (Amomi Fructus Rotundus), Tan Xiang (Santalum Album Lignum), Sha Ren (Amomi Fructus) (each 1 qian); Huo Xiang (Agastaches Herba) (1.2 qian); Cang Zhu (Atractylodis Rhizoma) (1.5 qian); Nong Po (Magnoliae Officinalis Cortex, stir-fried with ginger juice); Chen Pi (Citri Reticulatae Pericarpium) (each 1 qian); Gan Cao (Glycyrrhizae Radix et Rhizoma) (0.5 qian).
Add two zhong of water and three slices of fresh ginger, decoct until eight fen remains. Take before meals.
Liu Jun Zi Tang (See Chapter 16)
Xiang Sha Si Jun Zi Tang (Si Jun Zi Tang added with Sha Ren and Mu Xiang, See Chapter 16)
Qian Jin Fan Hun Tang (See Chapter 35)
Yu Shu Dan (Also known as Zi Jin Ding, See Chapter 63)
Hua Tuo's Formula for Saving from Zhong'e: Treats all forms of adverse evil ghost qi.
Xi Jiao (Rhinocerotis Cornu, powdered) (5 qian); Chen Sha (Cinnabaris, processed with water); She Xiang (Moschus, ground) (each 2.5 qian).
Take 2 qian each time, mixed well with well water. If these medicines are unavailable, use 1 qian of Xiong Huang (Realgar, powdered), decocted with peach branch and leaf soup, and administer orally.
If Realgar is unavailable, use clothes worn for a long time that have absorbed sweat, or inner garments. Men should use women's clothes, and women should use men's clothes. Burn them to charcoal but preserve their nature, take 2 qian, mixed with boiling water.
Another prescription: Crush fresh leeks to extract juice and drip into the nose. In winter, use leek roots.
Another prescription: Moxibustion on Bai Hui (GV20), Ren Zhong (CV26), the point named Gui Yan located on the big toe about one leek-leaf width away from the nail, as well as Dan Tian and Qi Hai points. Apply seven moxa cones per acupoint; more is better. Stop once consciousness returns in one or two points; not all need to be treated. Fuming the nose with rice vinegar heated over charcoal fire is also effective. For various acute conditions, first blow Ya Zao (Gleditsiae Sinensis Spina) powder into the nose to induce sneezing. For trismus, rub with Wumei (Mume Fructus) flesh to open the jaw. These are methods to open the orifices; medication can follow.
Pishuang (Arsenic Trioxide) Poisoning: Burn early rice stalks to ash, leach with freshly drawn cold water, filter through silk cloth. Drink one bowl cold. Induction of diarrhea brings relief. Mixing Baibian Dou (Dolichos Lablab Seed) powder with fresh cold water is also effective. Hua Tuo used concentrated water made from grinding Hei Qian (Plumbum Metallicum) for oral administration.
Fuzi (Aconiti Lateralis Radix Praeparata), Tianxiong (Aconiti Radix), Chuanwu (Aconiti Kusnezoffii Radix), Banmao (Mylabris) Poisoning: Decoct Da Xiaoheidou (Sojae Semen Nigrum) juice and drink.
Hetun (Pufferfish) Poisoning: In emergencies without medicine, administer copious amounts of clear oil to induce vomiting, which cures.
Badou (Crotonis Fructus) Poisoning: Decoct Huanglian (Coptidis Rhizoma) juice and drink.
General Drug Poisoning: Equal parts of Gancao (Glycyrrhizae Radix et Rhizoma), Heidou (Sojae Semen Nigrum), and Danzhuye (Lophatheri Herba). Decoct with one bowl of water and take.
Spiny Caterpillar Poisoning: For unceasing pain, apply dry Earthworm Mud externally. Also treats Vespa Orientalis stings.
Yu Rou (Sealed Meat) and Lou Fu (Leaking Cloth-covered Food) Poisoning (Yu Rou refers to meat sealed in containers overnight; Lou Fu refers to food covered by leaking roof rain): Burn dog feces, take with wine using a Fang Cun Bi measure. Fresh leek juice is also good.
Ma Rou (Horse Meat) Poisoning: Xiang Chi (Fermented Soybean) 2 liang, Xingren (Armeniacae Semen Amarum) 3 liang. Steam for the duration of cooking rice, then pound. Decoct with wine and take. Lu Gen (Phragmitis Rhizoma) juice is also beneficial.
Niu Rou (Beef) Poisoning: Decoct Gancao (Glycyrrhizae Radix et Rhizoma) juice and drink to resolve toxicity.
Quan Rou (Dog Meat) Poisoning: Hardness below the heart, abdominal distension, dry mouth, fever, delirium, or profuse diarrhea. Use 1 sheng of Xingren (Armeniacae Semen Amarum), skin on, thoroughly ground. Mix with 3 sheng of boiling water to extract juice. Divide into three doses. Passing fleshy pieces in stool is a sign of efficacy.
Poison from Birds/Beasts Killed by Arrows: Decoct Sojae Semen Nigrum (Black Soybean) juice and salt water; ingestion resolves toxicity.
General Fish Poisoning: Decoct Chen Pi (Citri Reticulatae Pericarpium) into thick juice and drink to resolve. Lu Gen (Phragmitis Rhizoma) juice is also edible and effective.
Xie (Crab) Poisoning: Decoct Zisu (Perillae Folium) juice and drink. Su Zi (Perillae Fructus) is also good.
General Fruit Poisoning: Burn pig bones to ash, take powder with water using a Fang Cun Bi measure to resolve.
General Mushroom Poisoning: Severe mental confusion and distress. Drink one sheng of human urine juice. Drinking Tu Jiang (soil slurry) one to two sheng is also good. Decoct Sojae Semen Nigrum (Black Soybean) juice strongly and drink, or administer emetic/purgative drugs; all can resolve toxicity. Also treats Feng Shu Jun (Maple Tree Mushroom) poisoning, which causes incessant crying (or laughing).
Ye Yu (Wild Taro) Poisoning: Same as previous formula.
Bi Kou Jiao (Closed-mouth Pepper) Poisoning: Sensation of stabbing in throat, impending death, white foam vomit, cold body. Decoct Rougui (Cinnamomi Cortex) juice and drink. Drinking cold water, eating garlic, or drinking Tu Jiang (soil slurry) are also good.
Shui Langdang Ye (Water Henbane Leaf) Poisoning: Often mistaken for vegetables, causing mania and hematemesis. Decoct Gancao (Glycyrrhizae Radix et Rhizoma) juice and drink to resolve.
Qin Cai (Celery) Poisoning: Fullness and pain on the back of hands and abdomen, named "Jiaolong Disease." Believed to contain essence of dragons/marvels. Boil 2-3 sheng of hard sugar and take; expect vomiting of lizard-like substances.
Prescription for Illness Caused by Gluttony: Indigestion due to overeating, hardness and fullness/pain in heart and abdomen. Use 1 sheng of salt and 3 sheng of water, boil until salt dissolves. Divide into three doses; expect vomiting of food.
General Food Poisoning: Decoct Gancao (Glycyrrhizae Radix et Rhizoma) and Jiqi (Shepherdae Fructus) juice and drink; generally resolves toxicity.