主治伤寒八九日,风湿相搏,身体烦疼,不能转侧,不呕不渴,脉浮虚而涩者。
桂枝(四两) 附子(三枚,炮) 甘草(二两) 生姜(三两) 大枣(十二枚)
上五味,以六升水,煮取二升,去渣,分温三服。
程扶生曰∶湿与风相搏,流入关节,身疼极重,而无头痛、呕、渴等症。脉浮虚者风也,
涩
行
木防己(三两) 石膏(用鸡子大十二枚) 桂枝(二两) 人参(四两)
上四味,以水六升,煮取二升,分温再服。
木防己 桂枝(各二两) 人参(四两) 芒硝(三两) 茯苓(四两)
上五味,以水六升,煮取三升,去滓,后纳芒硝,再微煎,分温再服,微利则愈。
本方治肺痈 ,喘不得卧,并治支饮不得息。
葶苈(熬令黄色,捣如弹子大) 大枣(十二枚)
上二味,以水三升,煮枣取二升,去滓,纳葶苈,煮取一升,顿服。
治腹满,口舌干燥。此肠门有水气。
防己 椒目 葶苈(熬) 大黄(各一两)
上为末,蜜丸如桐子大。先食饮服一丸,日三服。稍增,口中有津液,渴者加芒硝半两。
喻嘉言曰∶四方皆治支饮上入膈中,而有浅深次第之分。首二方先治其肺,中一方专治
其肺
心
实
为
部
留
补心肺不足;桂枝辛热,通血脉,开结气,宣导诸药。在气分,服之即愈;若饮在血分,深
连下焦,必愈而复发,故去石膏气分之药,加芒硝入阴分,开痰结,消血癖,合之茯苓去心
下坚,且伐肾邪也。葶苈大枣汤大泻其肺气,亦以气停,故液聚耳!防己椒目葶苈大黄丸,
治腹满,口舌干燥,肠间有水气之症,乃肺气愤郁于上,以致水饮不行于下,而燥热之甚
。用此丸急通水道,以救金气之愤郁,不治上而治其下,故用丸剂也。
罗东逸曰∶此三方,《金匮衍义》赵以德注之已详,而喻嘉言合而注之,青出于蓝,故
弃赵
主治伤寒病程已达八九日,风湿之邪相互搏结,导致身体剧烈疼痛,无法翻身转动,没有呕吐和口渴症状,脉象浮虚而涩的证候。
桂枝(四两) 附子(三枚,炮制过) 甘草(二两) 生姜(三两) 大枣(十二枚)
以上五味药,用六升水,煮取二升药液,去掉药渣,分三次温服。
程扶生说:湿邪与风邪相互搏结,流入关节,身体疼痛极其严重,但没有头痛、呕吐、口渴等症状。脉象浮虚是风邪的表现,涩(行不通畅)
木防己(三两) 石膏(用量如鸡蛋大小,共十二枚) 桂枝(二两) 人参(四两)
以上四味药,用水六升,煮取二升药液,分两次温服。
木防己 桂枝(各二两) 人参(四两) 芒硝(三两) 茯苓(四两)
以上五味药,用水六升,煮取三升药液,去掉药渣,之后加入芒硝,再稍微煎煮,分两次温服,轻微腹泻就好了。
本方治疗肺痈(肺部化脓性病变),喘息不能平卧,同时也治疗支饮(水饮停聚胸胁)导致的呼吸急促。
葶苈子(炒至黄色,捣碎如弹子大小) 大枣(十二枚)
以上两味药,用水三升,煮大枣取二升药液,去掉药渣,加入葶苈子,煮取一升药液,一次性服用。
治疗腹部胀满,口舌干燥。这是肠道有水气停留。
防己 椒目 葶苈子(炒制) 大黄(各一两)
以上药物研成细末,用蜂蜜制成如梧桐子大小的丸剂。饭前饮水送服一丸,每日三次。逐渐增加剂量,直到口中出现津液,如果仍有口渴,加芒硝半两。
喻嘉言说:这四个方子都治疗支饮上入膈中,但有深浅次第的区别。前两个方子先治肺,中间一方专门治心肺不足;桂枝辛热,能通血脉,开结气,宣导诸药。病在气分,服用后即愈;若水饮在血分,深入下焦,即使痊愈也容易复发,所以去掉石膏这一气分之药,加入芒硝进入阴分,开通痰结,消除血癖,配合茯苓去除心下坚满,且攻伐肾邪。葶苈大枣汤大力泻肺气,也是因为气停滞,所以津液聚集!防己椒目葶苈大黄丸,治疗腹部胀满,口舌干燥,肠间有水气的症状,这是肺气壅郁于上,导致水饮不行于下,燥热非常严重。用此丸急通水道,以救金气(肺气)的愤郁,不治上而治其下,所以使用丸剂。
罗东逸说:这三个方子,《金匮衍义》赵以德已经注释得很详细了,而喻嘉言将它们合在一起注释,青出于蓝,所以舍弃赵(德的注释)。
Indicated for Taiyang disease (Disease of the Taiyang Channel) persisting for eight or nine days, where wind-dampness pathogens contend with each other, causing severe body pain and inability to turn over, without vomiting or thirst, and a floating, deficient, and choppy pulse.
Guizhi Tang (Cinnamon Twig Decoction) ingredients: Guizhi (Ramulus Cinnamomi, four liang), Fuzi (Radix Aconiti Lateralis Preparata, three pieces, processed), Gancao (Radix Glycyrrhizae, two liang), Shengjiang (Rhizoma Zingiberis Recens, three liang), Dazao (Fructus Jujubae, twelve pieces).
Take the above five herbs, boil in six sheng of water, reduce to two sheng, remove dregs, and divide into three warm doses.
Cheng Fusheng stated: When dampness and wind contend, flowing into the joints, body pain is extremely severe, yet there are no symptoms such as headache, vomiting, or thirst. A floating and deficient pulse indicates wind; a choppy pulse indicates stagnation.
Mufangji Tang (Stephania Tetrandra Decoction) ingredients: Mufangji (Radix Stephaniae Tetrandrae, three liang), Shigao (Gypsum Fibrosum, size of twelve chicken eggs), Guizhi (Ramulus Cinnamomi, two liang), Renshen (Radix Ginseng, four liang).
Take the above four herbs, boil in six sheng of water, reduce to two sheng, and divide into two warm doses.
Modified Mufangji Tang ingredients: Mufangji (Radix Stephaniae Tetrandrae), Guizhi (Ramulus Cinnamomi, two liang each), Renshen (Radix Ginseng, four liang), Mangxiao (Natrii Sulfas, three liang), Fuling (Poria, four liang).
Take the above five herbs, boil in six sheng of water, reduce to three sheng, remove dregs, then add Mangxiao, simmer slightly, divide into two warm doses. Mild diarrhea indicates cure.
This formula treats Fei Yong (Lung Abscess), characterized by wheezing and inability to lie flat, and also treats Zhi Yin (Fluid Retention in the Chest/Hypochondrium) causing dyspnea.
Tinglizi (Semen Lepidii seu Descurainiae, fried until yellow, crushed to the size of a marble) Dazao (Fructus Jujubae, twelve pieces).
Take the above two herbs, boil in three sheng of water, decoct the dates to obtain two sheng, remove dregs, add Tinglizi, boil to obtain one sheng, and take in one dose.
Indicated for abdominal fullness and dry mouth and tongue. This indicates water qi retention in the intestines.
Fangji (Radix Stephaniae Tetrandrae), Jiumu (Semen Phaseoli Volubilis), Tinglizi (Semen Lepidii seu Descurainiae, fried), Dahuang (Radix et Rhizoma Rhei, one liang each).
Grind into powder, make pills with honey the size of tung tree seeds. Take one pill before meals with water, three times a day. Gradually increase the dose until saliva appears in the mouth. If thirst persists, add Mangxiao (Natrii Sulfas) half liang.
Yu Jiayan stated: These four formulas all treat Zhi Yin entering the diaphragm, but differ in depth and sequence. The first two formulas primarily treat the Lung. The middle formula specifically addresses deficiency of Lung and Heart Qi; Guizhi is acrid and hot, unblocking blood vessels, resolving stagnation, and guiding other herbs. If the pathology is in the Qi level, it cures upon administration; if fluid retention is in the Blood level, deep in the Lower Jiao, recurrence is likely even after cure. Therefore, remove Shigao (a herb for the Qi level), add Mangxiao to enter the Yin level, open phlegm knots, eliminate blood stasis, combine with Poria to remove epigastric hardness, and attack Kidney pathogenic factors. Tinglizi Dazao Tang strongly drains Lung Qi; since Qi stagnates, fluids gather! Fangji Jiumu Tinglizi Dahuang Wan (Stephania, Phaseolus, Lepidium, and Rheum Pill) treats abdominal fullness, dry mouth and tongue, and water qi in the intestines. This condition arises from Lung Qi oppression in the Upper Jiao, leading to failure of fluid movement in the Lower Jiao, resulting in severe dryness and heat. This pill urgently unblocks the water passages to relieve the frustration of Metal Qi (Lung Qi). It treats the lower rather than the upper, hence the use of pills.
Luo Dongyi stated: Regarding these three formulas, Zhao Yi De's commentary in *Jinkui Yanyi* is already detailed, but Yu Jiayan’s combined commentary surpasses it, so Zhao's commentary is set aside.