四证,方二首
太阳中风,脉浮紧,发热恶寒,身体疼痛,不汗出而烦,大青龙汤主之。若脉微弱,汗
出
麻黄(去节,六两) 桂枝(二两) 甘草(二两,炙) 杏仁(四十枚,去皮尖两仁
者) 生
姜(三两,切) 大枣(十枚,擘) 石膏(如鸡子大,碎,绵裹)
上七味,以水九升,先煮麻黄减二升,去上沫,纳诸药,煮取三升,去滓,温服一升。
取微似汗。汗出多者,温粉粉之,一服汗者,勿再服;若复服,汗出多,亡阳逆虚,恶风,
躁不得眠。
伤寒,脉浮缓,其身不疼,但重,乍有轻时,无少阴证者,可与大青龙汤发之(用上方)
伤寒表不解,心下有水气,咳而发热,或渴,或利,或噎,或小便不利,少腹满,或喘
者,小青龙汤主之,方∶
麻黄(去节,三两) 芍药 细辛 干姜 甘草(炙) 桂枝(各三两) 五味子 半
夏(各
半升,洗)
上八味,以水一斗,先煮麻黄,减二升,去上沫,纳诸药,煮取三升,去滓,温服一升
。渴则去半夏,加栝蒌根三两;微利者,去麻黄,加荛花一鸡子大,熬令赤色;噎者去麻黄,
加附子一枚,炮;小便不利,少腹满,去麻黄,加茯苓四两;喘者,去麻黄,加杏仁半升,
去皮。
伤寒,心下有水气,咳而微喘,发热不渴,服汤已而渴者,此为寒去为欲解,小青龙汤
主之(用上方)。
四种证候,对应两个方剂。
太阳中风证,表现为脉象浮紧,发热且恶寒,身体疼痛,无汗并伴有烦躁,以大青龙汤为主治方剂。如果脉象微弱,且有汗出,则不可使用此方。
麻黄(去除节部,六两) 桂枝(二两) 甘草(二两,蜜炙) 杏仁(四十枚,去皮尖且为双仁者) 生姜(三两,切片) 大枣(十枚,掰开) 石膏(如鸡蛋大小,打碎,用丝绵包裹)
以上七味药,用水九升,先煮麻黄,水量减少二升时,撇去水面上的浮沫,然后加入其余药物,煎煮至剩余三升,滤去药渣,每次温服一升。服药后应使全身微微似有汗出。若汗出过多,可用温粉扑身以止汗;若服用一次后即出汗,则停止后续服用;若再次服用,会导致汗出过多,出现亡阳、逆虚、怕风、烦躁不得睡眠等危重症状。
伤寒证,脉象浮缓,身体不疼痛,只是沉重,偶尔有减轻的时候,且没有少阴病证候的,可以给予大青龙汤发汗解表(使用上述大青龙汤方)。
伤寒表证未解,心下有停饮(水气),咳嗽且发热,或口渴,或腹泻,或咽喉噎塞感,或小便不利、小腹胀满,或气喘的,以小青龙汤为主治方剂,方剂组成如下:
麻黄(去除节部,三两) 芍药 细辛 干姜 甘草(蜜炙) 桂枝(各三两) 五味子 半夏(各半升,洗净)
以上八味药,用水一斗,先煮麻黄,水量减少二升时,撇去水面上的浮沫,然后加入其余药物,煎煮至剩余三升,滤去药渣,每次温服一升。若口渴,则去掉半夏,加入栝蒌根三两;若有轻微腹泻,则去掉麻黄,加入荛花如鸡蛋大小,炒至赤色;若有咽喉噎塞感,则去掉麻黄,加入一枚炮附子;若小便不利、小腹胀满,则去掉麻黄,加入茯苓四两;若气喘,则去掉麻黄,加入半升杏仁,去皮。
伤寒,心下有停饮,咳嗽且轻微气喘,发热但不口渴,服用汤药后感到口渴的,这是寒邪已去、病情即将解除的表现,仍以小青龙汤为主治方剂(使用上述小青龙汤方)。
Four syndromes, two prescriptions.
In Taiyang Wind-Strike (Taiyang Fengzhong), characterized by a floating and tight pulse, fever with aversion to cold, body pain, absence of sweating accompanied by irritability, Da Qing Long Tang (Major Blue Dragon Decoction) is the primary treatment. If the pulse is faint and weak with sweating present, this prescription should not be used.
Ephedrae Herba (Mahuang, 麻黄) [6 liang], removed nodes; Cinnamomi Ramulus (Guizhi, 桂枝) [2 liang]; Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [2 liang], honey-fried; Armeniacae Semen Amarum (Xingren, 杏仁) [40 seeds], skin and pointed ends removed, retaining those with two kernels; Zingiberis Rhizoma Recens (Shengjiang, 生姜) [3 liang], sliced; Ziziphi Jujubae Fructus (Dazao, 大枣) [10 fruits], split open; Gypsum Fibrosum (Shigao, 石膏) [size of a chicken egg], crushed, wrapped in silk gauze.
The above seven ingredients are decocted in nine sheng of water. First, boil Ephedrae Herba until the volume reduces by two sheng, skim off the foam on the surface, then add the remaining herbs. Continue boiling until three sheng remain. Strain the dregs. Take one sheng warm. The goal is to induce a slight, uniform perspiration. If sweating is excessive, apply warm powder to the body to stop it. If sweating occurs after the first dose, do not take further doses. Re-administration may lead to excessive sweating, resulting in Yang collapse (Wang Yang), counterflow deficiency, aversion to wind, restlessness, and insomnia.
In Shanghan (Cold Damage), if the pulse is floating and slow, the body is not painful but feels heavy, occasionally feeling lighter, and there are no Shaoyin syndrome signs, Da Qing Long Tang (Major Blue Dragon Decoction) may be administered to induce sweating (using the aforementioned prescription).
If Shanghan exterior syndrome is unresolved, with fluid retention (Water Qi) in the heart region, presenting with cough and fever, or thirst, or diarrhea, or a sensation of choking in the throat, or dysuria with lower abdominal fullness, or wheezing, Xiao Qing Long Tang (Minor Blue Dragon Decoction) is the primary treatment. Prescription:
Ephedrae Herba (Mahuang, 麻黄) [3 liang], removed nodes; Paeoniae Radix (Shaoyao, 芍药); Asari Radix (Xixin, 细辛); Zingiberis Rhizoma (Ganjiang, 干姜); Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), honey-fried; Cinnamomi Ramulus (Guizhi, 桂枝) [each 3 liang]; Schisandrae Fructus (Wuweizi, 五味子); Pinelliae Rhizoma (Banxia, 半夏) [each half sheng], washed.
The above eight ingredients are decocted in ten sheng of water. First, boil Ephedrae Herba until the volume reduces by two sheng, skim off the foam, then add the remaining herbs. Continue boiling until three sheng remain. Strain the dregs. Take one sheng warm. If thirsty, remove Pinelliae Rhizoma and add Trichosanthis Radix (Gualougen, 栝蒌根) [3 liang]. If there is mild diarrhea, remove Ephedrae Herba and add Aconiti Lateralis Radix Preparata (Fuzi, 附子) [one piece, processed] (Note: Text says "Ranghua" but contextually often implies modification for specific symptoms, however strictly translating text: Add Euphorbiae Pekinensis Radix (Ranghua, 荛花) [size of a chicken egg], fried until red). If there is a sensation of choking, remove Ephedrae Herba and add one processed Aconitum carmichaelii lateral root (Pao Fuzi, 炮附子). If dysuria with lower abdominal fullness, remove Ephedrae Herba and add Poria (Fuling, 茯苓) [4 liang]. If wheezing, remove Ephedrae Herba and add Armeniacae Semen Amarum (Xingren, 杏仁) [half sheng], skin removed.
In Shanghan, with fluid retention in the heart region, presenting with cough and mild wheezing, fever without thirst, if the patient becomes thirsty after taking the decoction, this indicates that the cold pathogen has departed and the condition is about to resolve. Xiao Qing Long Tang (Minor Blue Dragon Decoction) remains the primary treatment (using the aforementioned prescription).