太阳渴。脉浮无汗者。五苓、滑石之类。
阳明渴。脉长有汗者。白虎、凉膈之类。
少阳渴。脉弦而呕者。小柴胡加栝蒌根也。
太阴渴。脉细不欲饮水。纵饮唯思汤不思水。四君子、理中汤之类。
少阴渴。脉沉自利者。猪苓汤、三黄汤之类。
厥阴渴。脉微引饮者。当少少与之滑石。
滑石治渴。本为窍不利而用之。以其燥而能亡津液也。天令湿气太过当用之。若无湿而用之。
是为犯禁。
假令小便不利。或渴或不渴。知内有湿热也。小便自利而渴。知内有燥也。湿宜渗泄之。燥宜
润之。则可矣。
杂证有汗而渴者。以辛润之。无汗而渴者。以苦坚之。
伤寒食少而渴者。当以和胃药止之。不可用凉药。恐损胃气。愈不能食。白术、茯苓是也。
太阳无汗而渴者。不宜白虎。汗后脉洪大而渴者。方可与之矣。
阳明有汗而渴者。不宜五苓。若小便不利。汗少脉浮而渴者。宜与之。
若人病心肺热而不渴者。知不在太阴少阴之本。只在标也。在标则不渴矣。若渴者。是在本也
。
内经云。有病口苦。名曰胆瘅。乃肝主谋虑。胆主决断。盛汁三合。为清净之府。肝取决于胆
。或不决为之患怒。怒则气逆。胆汁上溢。故口苦。或热盛使然也。主之以龙胆泻肝汤。
【龙胆泻肝汤】
黄芩(七分) 柴胡(一钱) 甘草(生) 人参
天门冬 黄连 知母 龙胆草
山栀子 麦门冬(各五分) 五味子(十个)
上十一味。 咀。作一服。水二盏。煎至一盏。去渣。温服。食远。忌辛热物。此方因焦秀才
病口苦。予制此方。用之得效。
太阳病引起的口渴。脉象浮且无汗的,适用五苓散、滑石等药物。
阳明病引起的口渴。脉象长且有汗出的,适用白虎汤、凉膈散等药物。
少阳病引起的口渴。脉象弦且伴有呕吐的,适用小柴胡汤加栝蒌根。
太阴病引起的口渴。脉象细弱且不想喝水,即使想喝也只想要热汤而不想要冷水,适用四君子汤、理中汤等药物。
少阴病引起的口渴。脉象沉且伴有自发性腹泻的,适用猪苓汤、三黄汤等药物。
厥阴病引起的口渴。脉象微弱且引水自救的,应当少量给予滑石。
滑石治疗口渴,原本是因为水道不通利而使用它。因为滑石性燥,能消耗津液。当天气湿气过重时应当使用它。如果没有湿邪而使用它,就是违反禁忌。
假如小便不利,或者口渴或者不口渴,可知体内有湿热。如果小便通畅却口渴,可知体内有燥邪。湿邪适宜用渗湿泄浊的方法治疗,燥邪适宜用润燥的方法治疗,这样就可以了。
杂病中有汗出且口渴的,用辛味药来滋润;无汗出且口渴的,用苦味药来坚阴。
伤寒病中饮食减少且口渴的,应当用调和胃气的药物来止渴,不可用寒凉药物,恐怕损伤胃气,导致更加不能进食,比如白术、茯苓就是这类药。
太阳病无汗且口渴的,不宜用白虎汤。只有在发汗后脉象洪大且口渴的,才可以给予白虎汤。
阳明病有汗且口渴的,不宜用五苓散。如果小便不利,汗少脉浮且口渴的,适宜用五苓散。
如果一个人患有心肺热证却不口渴,可知病不在太阴、少阴的根本,只在标部。在标部就不会口渴了。如果口渴,那就是病在根本。
《内经》说:有一种病表现为口苦,名叫胆瘅。这是肝主谋虑,胆主决断,储存胆汁三合,是清净之府。肝的决定权在于胆。如果胆不能决断而产生忧患愤怒,愤怒则气机上逆,胆汁上溢,所以口苦。也可能是热盛导致的。主治用龙胆泻肝汤。
【龙胆泻肝汤】
黄芩(七分) 柴胡(一钱) 甘草(生) 人参
天门冬 黄连 知母 龙胆草
山栀子 麦门冬(各五分) 五味子(十个)
以上十一味药。切碎,作为一剂服用。用水两盏,煎煮至一盏,去渣滓,温服,饭后服用。忌食辛辣热性食物。此方是因为焦秀才患有口苦病,我配制此方,使用后见效。
Thirst due to Taiyang disease. For those with a floating pulse and no sweating, Wuling San (Five-Ingredient Poria Decoction) or Shihuang (Talcum) are applicable.
Thirst due to Yangming disease. For those with a long pulse and sweating, Baihu Tang (White Tiger Decoction) or Liangge San (Cooling Chest Powder) are applicable.
Thirst due to Shaoyang disease. For those with a wiry pulse and vomiting, Xiaochaihu Tang (Minor Bupleurum Decoction) added with Gualougen (Trichosanthes Root) is used.
Thirst due to Taiyin disease. For those with a fine pulse and no desire to drink water; even if they wish to drink, they only desire hot soup and not cold water, Sijunzi Tang (Four Gentlemen Decoction) or Lizhong Tang (Regulate the Middle Decoction) are applicable.
Thirst due to Shaoyin disease. For those with a deep pulse and spontaneous diarrhea, Zhuling Tang (Polyporus Decoction) or Sanhuang Tang (Three-Yellow Decoction) are applicable.
Thirst due to Jueyin disease. For those with a faint pulse who seek water, Shihuang (Talcum) should be given in small amounts.
Shihuang (Talcum) treats thirst originally because it is used when the orifices are obstructed. Because it is dry and can deplete body fluids, it should be used when the heavenly climate causes excessive dampness. If used without dampness, it violates contraindications.
Suppose there is difficulty in urination, whether thirsty or not; this indicates internal damp-heat. If urination is free yet there is thirst, this indicates internal dryness. Dampness should be treated by promoting diuresis and draining turbidity, while dryness should be treated by moistening; then it will be appropriate.
In miscellaneous diseases, for those with sweating and thirst, use acrid herbs to moisten; for those without sweating and thirst, use bitter herbs to consolidate yin.
For patients with Shanghan (Cold Damage) who have reduced appetite and thirst, harmonizing stomach medicines should be used to stop the thirst. Cold-natured medicines should not be used, as they may damage stomach qi, leading to further inability to eat; Baizhu (Atractylodis Rhizoma) and Fuling (Poria) are examples of such medicines.
For Taiyang disease with no sweating and thirst, Baihu Tang (White Tiger Decoction) is not suitable. It can only be administered after sweating has occurred, when the pulse is surging and large accompanied by thirst.
For Yangming disease with sweating and thirst, Wuling San (Five-Ingredient Poria Decoction) is not suitable. However, if there is difficulty in urination, slight sweating, a floating pulse, and thirst, Wuling San (Five-Ingredient Poria Decoction) is appropriate.
If a person suffers from heat in the Heart and Lung but does not feel thirsty, it is known that the pathology is not rooted in Taiyin or Shaoyin, but exists only at the superficial level. At the superficial level, there would be no thirst. If there is thirst, the pathology is rooted in the interior.
The Neijing states: "There is a disease characterized by a bitter taste in the mouth, named Dan Dan (Biliary Distension)." This occurs because the Liver governs planning and deliberation, while the Gallbladder governs decision-making. The Gallbladder stores three he of bile and is considered a pure and clear organ. The Liver's decisions depend on the Gallbladder. If indecision leads to worry and anger, anger causes qi to rebel upwards, causing bile to overflow upward, resulting in a bitter taste in the mouth. This may also be caused by excessive heat. The primary treatment is Longdan Xiegan Tang (Gentian Liver-Draining Decoction).
[Longdan Xiegan Tang]
Huangqin (Scutellariae Radix, 7 fen) Chaihu (Bupleuri Radix, 1 qian) Gancao (Glycyrrhizae Radix et Rhizoma, raw) Renshen (Ginseng Radix)
Tianmendong (Asparagi Radix) Huanglian (Coptidis Rhizoma) Zhimu (Anemarrhenae Rhizoma) Longdancao (Gentianae Radix)
Shanzhizi (Gardeniae Fructus) Maimendong (Ophiopogonis Radix, each 5 fen) Wuweizi (Schisandrae Fructus, 10 berries)
These eleven medicinal materials are coarsely powdered. Prepare as one dose. Add two cups of water, decoct until one cup remains, remove the dregs, and take warm after meals. Avoid spicy and hot foods. This formula was prepared by me because Scholar Jiao suffered from a bitter taste in the mouth; its application proved effective.