身动而轻。言语有声。目睛了了。鼻中呼吸出入能往来。口中鼻中俱气热。(出此事虽知)
用调胃承气汤治之。(方见前)
身静而重。语言无声。气少难以布息。目睛不了了。鼻中呼吸不能出入往来。口中鼻中气俱冷
。水浆不入。大小便不禁。面上恶寒。有如刀刮。(出此事难知)用四逆汤、及葱熨法治之。
【仲景四逆汤】
甘草(炙。二两) 干姜(炮。一两半) 附子(一枚。生用。去皮。破八片。今宜泡用)
上三味。每服斟酌多少。用水二盏。煮取八分。去渣。温服。
【活人书葱熨法】
葱一束。以绳缠如饼大。切去根叶。惟存葱白长二寸许。以火烘一面令热。勿至灼火。乃以热
处着病患脐。连脐下。其上以熨斗盛火熨之。令葱饼热气。透入腹中。更作三四饼。如壤不可熨
。即易一饼。俟病患渐醒。手足温有汗。乃瘥。更服四逆汤以温内。
手足逆冷。大便秘结。小便赤色。或大便黑硬。脉沉而滑。(出活人书。按此手足逆冷。名热厥。与阴厥不同。详见
后篇厥证条下。证轻者用白虎汤。重者小承气汤治之。二方并见前)
身微热。烦躁。面赤。脉沉而微。(出活人书)
(按身微热是里寒。烦躁是阴盛。发躁。面赤是下元虚阳泛上。犹日落而霞光上天也。与阳证
面赤不同。
仲景少阴证面赤用四逆汤加葱白治之。方见前)
身冷。脉细沉数。烦躁。不饮水。(出活人书)此名阴盛格阳。用仲景干姜附子汤加人参治
之。
干姜(一两) 附子(一枚。炮去皮。破八片) 人参(半两)
上三味。每服酌量多少。水一盏半。煎至八分。去渣。或温或凉服。
伤寒目赤而烦渴。脉七八至。东垣曰。此阴盛格阳于外。非热也。诊脉以数为热。迟为寒。今脉七
八至。是热极也。然按之至骨则无脉。是无根蒂之脉。虽七八至。其下无根蒂。故知非热也。(出试效文)治法用干姜附
子汤加人参。(方见前。
)○又用仲景白通加猪胆汁汤。
葱白(四茎) 干姜(二两) 附子(一枚。炮去皮。破八片)
人尿(五合) 猪胆汁(二合)
上锉。每服酌量多少。水一盏。煮至五分。去渣。纳尿胆汁和匀。或温或凉服。无胆亦可。
身体动作灵活且感觉轻盈。说话声音洪亮。眼神清晰明亮。鼻中呼吸出入通畅。口中及鼻中呼出的气息均觉发热。(虽然知道这是阳证,但需仔细辨别)
使用调胃承气汤进行治疗。(方剂见前文)
身体静止且感觉沉重。说话无声。气息微弱,难以顺畅呼吸。眼神模糊不清。鼻中呼吸不能正常出入往来。口中及鼻中呼出的气息均觉寒冷。无法进食进水。大小便失禁。面部畏寒,感觉如同刀刮一般。(这种情况难以辨识)使用四逆汤以及葱熨法治疗。
【仲景四逆汤】
甘草(炙,二两) 干姜(炮,一两半) 附子(一枚,生用,去皮,破成八片,现在适宜用炮制品)
以上三味药,每次服用根据情况斟酌用量,用水两盏,煮取八分量的药液,去渣滓,温服。
【活人书葱熨法】
一束葱,用绳子缠绕成饼状大小,切去根和叶,只保留长约二寸的葱白部分,在一面用火烘烤使其变热,但不要烧焦,然后将热的一面贴在患者的肚脐上,连同脐下部位一起热敷。上面用熨斗盛火熨烫,使葱饼的热气透入腹中。再制作三四张葱饼,如果葱饼变凉不可继续熨烫,就更换一张新饼。等到患者逐渐苏醒,手足温暖并有汗出,病就好了。再服用四逆汤以温补体内阳气。
手足逆冷,大便秘结,小便颜色红赤,或者大便黑而硬,脉象沉而滑。(出自《活人书》,按:此手足逆冷名为热厥,与阴厥不同,详见后篇厥证条下。证候轻者使用白虎汤,重者用小承气汤治疗,两个方剂并见前文)
身体微热,烦躁,面色发红,脉象沉而微弱。(出自《活人书》)
(按:身体微热是里寒所致,烦躁是阴气盛极引发的躁动,面色发红是由于下元虚阳浮越于上,就像日落时霞光映上天际一样。这与阳证的面赤不同。
张仲景治疗少阴证面赤使用四逆汤加葱白,方剂见前文)
身体发冷,脉象细、沉、数,烦躁,不口渴想喝水。(出自《活人书》)这名叫阴盛格阳,使用张仲景的干姜附子汤加人参治疗。
干姜(一两) 附子(一枚,炮制去皮,破成八片) 人参(半两)
以上三味药,每次服用酌情决定用量,用水一盏半,煎至八分量,去渣滓,或温服或凉服。
伤寒导致眼睛发红且烦渴,脉搏跳动七八次一息,李东垣说:这是阴盛格阳于外,并非真热。诊脉以数为热,迟为寒。现在脉搏七八次一息,似乎是热极的表现。然而按压至骨则无脉,这是无根蒂的脉象。虽然脉搏快达七八次一息,但其下无根蒂,所以知道这不是真热。(出自《试效方》)。治疗方法使用干姜附子汤加人参。(方剂见前。)○又使用张仲景的白通加猪胆汁汤。
葱白(四茎) 干姜(二两) 附子(一枚,炮制去皮,破成八片)
人尿(五合) 猪胆汁(二合)
以上药材切碎,每次服用酌情决定用量,用水一盏,煮至五分量,去渣滓,纳入人尿和猪胆汁混合均匀,或温服或凉服。没有猪胆汁也可以。
The body moves freely and feels light. Speech is audible. Eyes are clear and bright. Nasal respiration enters and exits smoothly. The breath from both the mouth and nose feels hot. (Although this indicates a Yang syndrome, careful differentiation is required.)
Treat with Tiaowei Chengqi Tang (Regulate the Stomach and Purge the Bowels Decoction). (Formula see previous section)
The body remains still and feels heavy. Speech is inaudible. Qi is scanty and difficult to distribute for breathing. Eyes appear unclear and dim. Nasal respiration cannot enter or exit normally. The breath from both the mouth and nose feels cold. Inability to ingest water or food. Incontinence of urine and feces. Facial aversion to cold, feeling as if scraped by a knife. (This condition is difficult to identify.) Treat with Sini Tang (Frigid Extremities Decoction) and Cong Yin Fa (Scallion Moxibustion Method).
[Zhongjing's Sini Tang]
Gancao (Prepared Licorice Root, 2 liang) Ganjiang (Prepared Dried Ginger, 1.5 liang) Fuzi (Aconite Lateral Root, 1 piece, raw, peeled, broken into eight pieces; currently prepared form is preferred)
Take the above three herbs. For each dose, adjust the quantity appropriately. Add two cups of water, decoct until reduced to 0.8 cup. Remove dregs. Take warm.
[Huoren Shu Scallion Moxibustion Method]
Take a bundle of scallions, tie them with rope into a cake-like shape. Cut off roots and leaves, retaining only the white part, approximately 2 cun long. Heat one side over fire until hot, but do not burn. Place the heated side against the patient's navel, covering the area below it. Use a moxibustion iron filled with fire to heat the top, allowing the heat from the scallion cake to penetrate into the abdomen. Prepare three or four more scallion cakes. Replace the cake when it cools down. Wait until the patient gradually regains consciousness, hands and feet become warm, and sweat appears, indicating recovery. Subsequently, administer Sini Tang to warm the interior.
Cold extremities extending upwards, constipation, red urine, or black hard stools, pulse deep and slippery. (From Huoren Shu. Note: This cold extremities is named Re Jue (Heat Jue), which differs from Yin Jue. See detailed discussion in the following chapter on Jue Syndrome. For mild cases, use Baihu Tang (White Tiger Decoction); for severe cases, use Xiao Chengqi Tang (Minor Order the Qi Decoction). Both formulas see previous section)
Slight fever, irritability, flushed face, pulse deep, fine, and rapid. (From Huoren Shu)
(Note: Slight fever indicates interior cold. Irritability results from extreme Yin excess causing restlessness. Flushed face is due to deficient Yang floating upward from the lower origin, similar to sunset clouds reflecting in the sky. This differs from the flushed face in Yang syndromes. Zhongjing treats flushed face in Shaoyin syndrome with Sini Tang plus Congbai (Scallion White). Formula see previous section)
Cold body, pulse fine, deep, and rapid, irritability, no desire to drink water. (From Huoren Shu) This is named Yin Sheng Ge Yang (Yin Excess Repelling Yang). Treat with Zhongjing's Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction) plus Renshen (Ginseng).
Ganjiang (Dried Ginger, 1 liang) Fuzi (Aconite Lateral Root, 1 piece, prepared, peeled, broken into eight pieces) Renshen (Ginseng Root, 0.5 liang)
Take the above three herbs. Adjust dosage per administration. Add 1.5 cups of water, decoct until reduced to 0.8 cup. Remove dregs. Take either warm or cool.
Typhoid disease causing red eyes and烦渴 (irritability with thirst), pulse rate 7-8 beats per breath. Dongyuan stated: This is Yin Excess Repelling Yang to the exterior, not true heat. Pulse diagnosis considers rapidity as heat and slowness as cold. A pulse of 7-8 beats per breath suggests extreme heat. However, pressing to the bone reveals no pulse, indicating a rootless pulse. Although rapid at 7-8 beats, the lack of root indicates it is not true heat. (From Shi Xiao Fang). Treatment method uses Ganjiang Fuzi Tang plus Renshen. (Formula see previous section.) ○ Also use Zhongjing's Baitong Tang plus Zhu Danzhi (Scallion Decoction plus Pig Bile).
Congbai (Scallion White, 4 stems) Ganjiang (Dried Ginger, 2 liang) Fuzi (Aconite Lateral Root, 1 piece, prepared, peeled, broken into eight pieces)
Ren Niao (Human Urine, 5 he) Zhu Danzhi (Pig Gallbladder Bile, 2 he)
Chop the herbs. Adjust dosage per administration. Add 1 cup of water, decoct until reduced to 0.5 cup. Remove dregs. Mix in human urine and pig bile evenly. Take either warm or cool. Pig bile can be omitted if unavailable.