治厥阴热利,下重,脉沉弦,渴欲饮水者。
白头翁(三两) 黄连 黄柏 秦皮(各二两)
上四味,水煎服。
柯韵伯曰∶三阴俱有下利证。自利不渴者属太阴,是脏有寒也;自利渴者属少阴,以下
焦虚
撞心
脉沉为在里,弦为肝脉,是木郁之征也;渴欲饮水,厥阴病则消渴也。白头翁临风偏静,长
于驱风,用为君者,以厥阴风木,风动则木摇而火旺,欲平走窍之火,必宁摇动之风;秦皮
木小岑高,得清阳上升之象为臣,是木郁达之,所以遂其发陈之性也;黄连泻君火,可除上
焦之渴,是苦以发之,黄柏泻相火,可止下焦之利,是苦以坚之也。治厥阴热利有二∶初利
用此方,以升阳散火,是谓下者举之,寒因热用法;久利则用乌梅丸之酸以收火,佐以苦寒
,杂以温补,是谓逆之从之,随所利而行之,调其气使之平也。
治脉沉、厥逆等证。
甘草(二两,炙) 干姜(一两) 附子(一枚,生)
上三味,以水三升,煮取一升二合,温服。
治少阴下利清谷,里寒外热,手足厥逆,脉微欲绝,身反不恶寒,其人面赤色,或腹痛,
或
干姜(三两,强人可四两) 甘草(三两,炙) 附子(一枚,生)
上三味,以水三升,煮取一升二合,温服。
加减法∶面赤色者,加葱九茎;腹中痛者,去葱,加芍药二两;呕者,加生姜二两;咽
痛者
王又原曰∶仲景真武汤一方,于水中补火;四逆与通脉四逆二方,是于水中温土。二方
用药
阳未
内阳微
姜,树
气已离
等分者
四逆;
内,面
出,而
外热,
治疗厥阴经的热性痢疾,表现为肛门坠胀感(下重),脉象沉而弦,口渴想喝水的症状。
白头翁(三两) 黄连 黄柏 秦皮(各二两)
以上四味药,用水煎煮后服用。
柯韵伯说:三阴经(太阴、少阴、厥阴)都有下利的证候。自发性腹泻且不口渴的属于太阴病,这是因为脏腑内有寒邪;自发性腹泻且口渴的属于少阴病,因为下焦虚损导致心火偏亢。脉沉表示病位在里,脉弦是肝脉的特征,这是肝气郁结的表现;口渴想喝水,是厥阴病中的消渴症状。白头翁在风中倾向于静止,擅长驱散风邪,作为君药,是因为厥阴属风木,风动则树木摇动而火势旺盛,想要平息走窜窍道的火热,必须使摇动的风安宁;秦皮树木小而高耸,具有清阳上升的意象,作为臣药,体现了“木郁达之”的原则,顺应其生发陈新的本性;黄连泻除心君之火,可以消除上焦的口渴,这是用苦味药发散郁火;黄柏泻除相火,可以止住下焦的泄利,这是用苦味药坚固阴液。治疗厥阴热利有两种情况:初期使用此方,是为了升发阳气、疏散郁火,这叫做“下者举之”,即针对热利用寒药治法中的反佐法;久痢则使用乌梅丸,用酸味收敛浮火,辅以苦寒药物,混杂温补药物,这叫作“逆之从之”,根据病情有利的一面顺势而行,调理气机使其平衡。
治疗脉象沉、四肢厥冷等证候。
甘草(二两,蜜炙) 干姜(一两) 附子(一枚,生用)
以上三味药,用水三升,煮取一升二合,温服。
治疗少阴病下利完谷不化,内寒外热,手足冰冷,脉搏微弱几乎摸不到,身体反而不恶寒,病人面色发红,或者腹痛,或者……
干姜(三两,体质强壮者可四两) 甘草(三两,蜜炙) 附子(一枚,生用)
以上三味药,用水三升,煮取一升二合,温服。
加减法:面色发红的,加葱白九茎;腹中疼痛的,去掉葱白,加芍药二两;呕吐的,加生姜二两;咽喉痛的……
王又原说:张仲景的真武汤一方,是在水中补火;四逆汤与通脉四逆汤两方,是在水中温土。这两方的用药……阳气未……内阳微弱……姜,树……气已离……等分者……四逆;内,面……出,而……外热,
Treats heat-type dysentery of the Jueyin (Terminal Yin) channel, characterized by a sensation of heaviness in the anus (tenesmus), a deep and wiry pulse, and thirst with an urge to drink water.
Baitouweng (Radix Pulsatillae, 3 liang) Huanglian (Rhizoma Coptidis) Huangbai (Cortex Phellodendri) Qinpi (Cortex Fraxini) (each 2 liang)
The above four herbs are decocted in water and taken orally.
Ke Yunbo stated: The Three Yin channels (Taiyin, Shaoyin, Jueyin) all present with diarrhea syndromes. Spontaneous diarrhea without thirst belongs to Taiyin disease, indicating cold in the zang organs; spontaneous diarrhea with thirst belongs to Shaoyin disease, due to deficiency in the lower jiao causing heart fire to harass the mind. A deep pulse indicates the pathology is interior; a wiry pulse corresponds to the Liver channel, signifying stagnation of Wood qi; thirst with an urge to drink water is the "xiaoke" (wasting-thirst) symptom associated with Jueyin disease. Baitouweng tends to remain still in the wind and is effective at dispelling wind; used as the sovereign herb, it addresses the Jueyin Wind-Wood nature: when wind moves, Wood shakes and Fire flares up. To calm the fire roaming through orifices, one must first settle the shaking wind. Qinpi, being small but tall, embodies the image of clear Yang ascending; used as the minister herb, it illustrates the principle of "dispersing stagnant Wood," thereby facilitating its generative and renovating nature. Huanglian clears the Minister Fire (Heart Fire), relieving upper jiao thirst, employing bitter flavor to disperse stagnation; Huangbai clears the Minister Fire (Ministerial Fire), stopping lower jiao diarrhea, employing bitter flavor to consolidate Yin. There are two approaches to treating Jueyin heat dysentery: In the initial stage, this formula is used to raise Yang and scatter fire, termed "lifting what has sunk," utilizing a cold treatment for heat conditions (treating heat with cold, potentially involving counter-agency); for chronic dysentery, Wumei Wan (Mume Pill) is used, employing sour flavors to astringe floating fire, assisted by bitter-cold herbs, mixed with warm-tonic herbs. This follows the principle of "opposing and following" the pathology, acting according to what is beneficial, regulating Qi to restore balance.
Treats symptoms such as a deep pulse and cold extremities (jue ni).
Gancao (Radix Glycyrrhizae, 2 liang, honey-fried) Ganjiang (Rhizoma Zingiberis, 1 liang) Fuzi (Radix Aconiti Lateralis Preparata, 1 piece, raw)
The above three herbs are boiled in three sheng of water until reduced to one sheng and two he, then taken warm.
Treats Shaoyin disease presenting with diarrhea of undigested food (qing gu), internal cold with external heat, cold extremities, a faint pulse nearly imperceptible, absence of aversion to cold despite the condition, flushed facial complexion, abdominal pain, or...
Ganjiang (Rhizoma Zingiberis, 3 liang, 4 liang for robust individuals) Gancao (Radix Glycyrrhizae, 3 liang, honey-fried) Fuzi (Radix Aconiti Lateralis Preparata, 1 piece, raw)
The above three herbs are boiled in three sheng of water until reduced to one sheng and two he, then taken warm.
Modifications: For flushed facial complexion, add nine stalks of Congbai (Scallion Stem); for abdominal pain, remove Congbai and add Shaoyao (Radix Paeoniae Alba, 2 liang); for vomiting, add Shengjiang (Rhizoma Zingiberis Recens, 2 liang); for sore throat...
Wang Youyuan stated: Zhang Zhongjing's Zhenwu Tang (True Warrior Decoction) tonifies Fire within Water; the Sini Tang (Frigid Extremities Decoction) and Tongmai Sini Tang (Pulse-Restoring Frigid Extremities Decoction) warm Earth within Water. The medication in these two formulas... Yang qi is not... Internal Yang is weak... Ginger, tree... Qi has departed... Equal parts... Sini; Internal, face... Emerges, while... External heat,